Development and pilot study of the Primary Care Practice Improvement Tool (PC-PIT) : an innovative approach

Objective To assess the usability and validity of the Primary Care Practice Improvement Tool (PC-PIT), a practice performance improvement tool based on 13 key elements identified by a systematic review. It was co-created with a range of partners and designed specifically for primary health care. Design This pilot study examined the PC-PIT using a formative assessment framework and mixed-methods research design. Setting and participants Six high-functioning general practices in Queensland, Australia, between February and July 2013. A total of 28 staff participated — 10 general practitioners, six practice or community nurses, 12 administrators (four practice managers; one business manager and eight reception or general administrative staff). Main outcome measures Readability, content validity and staff perceptions of the PC-PIT. Results The PC-PIT offers an appropriate and acceptable approach to internal quality improvement in general practice. Quantitative assessment scores and qualitative data from all staff identified two areas in which the PC-PIT required modification: a reduction in the indicative reading age, and simplification of governance-related terms and concepts. Conclusion The PC-PIT provides an innovative approach to address the complexity of organisational improvement in general practice and primary health care. This initial validation will be used to develop a suite of supporting, high-quality and free-to-access resources to enhance the use of the PC-PIT in general practice. Based on these findings, a national trial is now underway.

Improvement of the mode II interface fracture toughness of glass fiber reinforced plastics/aluminum laminates through vapor grown carbon fiber interleaves

The effects of acid treatment, vapor grown carbon fiber (VGCF) interlayer and the angle, i.e., 0° and 90°, between the rolling stripes of an aluminum (Al) plate and the fiber direction of glass fiber reinforced plastics (GFRP) on the mode II interlaminar mechanical properties of GFRP/Al laminates were investigated. The experimental results of an end notched flexure test demonstrate that the acid treatment and the proper addition of VGCF can effectively improve the critical load and mode II fracture toughness of GFRP/Al laminates. The specimens with acid treatment and 10 g m−2 VGCF addition possess the highest mode II fracture toughness, i.e., 269% and 385% increases in the 0° and 90° specimens, respectively compared to those corresponding pristine ones. Due to the induced anisotropy by the rolling stripes on the aluminum plate, the 90° specimens possess 15.3%–73.6% higher mode II fracture toughness compared to the 0° specimens. The improvement mechanisms were explored by the observation of crack propagation path and fracture surface with optical, laser scanning and scanning electron microscopies. Moreover, finite element analyses were carried out based on the cohesive zone model to verify the experimental fracture toughness and to predict the interface shear strength between the aluminum plates and GFRP laminates.

The civic virtue of developmentalism : on the mining industry’s social licence to develop Western Australia

This paper examines the social licence to operate (SLO) of Western Australia's (WA's) mining industry in the context of the state's ‘developmentalist’ agenda. We draw on the findings of a multi-disciplinary body of new research on the risks and challenges posed byWA's mining industry for environmental, social and economic sustainability. We synthesise the findings of this work against the backdrop of the broader debates on corporate social responsibility (CSR) and resource governance. In light of the data presented, this paper takes issue with the mining sector's SLO and its assessment of social and environmental impacts in WA for three inter-related reasons. A state government ideologically wedded to resource-led growth is seen to offer the resource sector a political licence to operate and to give insufficient attention to its potential social and environmental impacts. As a result, the resource sector can adopt a self-serving CSR agenda built on a limited win–win logic and operate with a ‘quasi social licence’ that is restricted to mere economic legitimacy. Overall, this paper problematises the political-cum-commercial construction and neoliberalisation of the SLO and raises questions about the impact of mining in WA.

Corneal confocal microscopy shown an improvement in small-fibre neuropathy in subjects with type 1 diabetes on continuous subcutaneous insulin infusion compared to multiple daily injection

Improved glycemic control is the only treatment that has been shown to be effective for diabetic peripheral neuropathy in patients with type 1 diabetes (1). Continuous subcutaneous insulin infusion (CSII) is superior to multiple daily insulin injection (MDI) for reducing HbA1c and hypoglycemic events (2). Here, we have compared the benefits of CSII compared withMDI for neuropathy over 24months....

Patients Undergoing Subacute Physical Rehabilitation following an Acute Hospital Admission Demonstrated Improvement in Cognitive Functional Task Independence

Objective. This study investigated cognitive functioning among older adults with physical debility not attributable to an acute injury or neurological condition who were receiving subacute inpatient physical rehabilitation. Design. A cohort investigation with assessments at admission and discharge. Setting. Three geriatric rehabilitation hospital wards. Participants. Consecutive rehabilitation admissions () following acute hospitalization (study criteria excluded orthopaedic, neurological, or amputation admissions). Intervention. Usual rehabilitation care. Measurements. The Functional Independence Measure (FIM) Cognitive and Motor items. Results. A total of 704 (86.5%) participants (mean age = 76.5 years) completed both assessments. Significant improvement in FIM Cognitive items (-score range 3.93–8.74, all ) and FIM Cognitive total score (-score = 9.12, ) occurred, in addition to improvement in FIM Motor performance. A moderate positive correlation existed between change in Motor and Cognitive scores (Spearman’s rho = 0.41). Generalized linear modelling indicated that better cognition at admission (coefficient = 0.398, ) and younger age (coefficient = −0.280, ) were predictive of improvement in Motor performance. Younger age (coefficient = −0.049, ) was predictive of improvement in FIM Cognitive score. Conclusions. Improvement in cognitive functioning was observed in addition to motor function improvement among this population. Causal links cannot be drawn without further research.

Professional learning from the inside - teachers as agents of school improvement: a principal's case study

This study considered the relationship between professional learning, teacher agency and school improvement. Specifically, it explored the principal's role in supporting teacher agency in their professional learning. It found that, with appropriate pressure and support from principals, school improvement for the betterment of student learning is attainable through teacher professional learning that is based 'within' a school. Particularly, it ascertained that schools need to give greater attention to the allocation of time for teacher professional learning, specifically: time before, during and after professional learning activities. Privileging time efficiently and effectively, heightens teacher agency in their learning.

Leadership to support quality improvement in Vietnamese higher education

The impetus for the study reported in this paper is the Higher Education (HE) reform agenda outlined by the Vietnamese Ministry of Education and Training (MOET). The paper reports on phase one of a mixed method research; a quantitative approach using the Multifactor Leadership Questionnaire (MLQ) to investigate the Vietnamese HE leaders’ leadership styles. The MLQ survey was administered to approximately 190 senior managers in State HE institutions in Mekong Delta region in Vietnam (nine of colleges). The psychometrics of the MLQ for the Vietnamese sample confirmed the reliability and validity of the instrument with a Cronbach’s alpha of 0.779. A CFA was conducted and all factor structures were stable and consistent. The demographic variables were used to analyse patterns of leadership behaviours by the different sub-groups. The findings suggest that leaders who have different educational background and different gender in Mekong Delta region, Vietnam do not differ significantly in their perceptions about leadership factors.

Participatory action research for civic engagement

The future of civic engagement is characterised by both technological innovation as well as new technological user practices that are fuelled by trends towards mobile, personal devices; broadband connectivity; open data; urban interfaces; and, cloud computing. These technology trends are progressing at a rapid pace, and have led global technology vendors to package and sell the ‘Smart City’ as a centralized service delivery platform predicted to optimize and enhance cities’ key performance indicators – and generate a profitable market. The top-down deployment of these large and proprietary technology platforms have helped sectors such as energy, transport, and healthcare to increase efficiencies. However, an increasing number of scholars and commentators warn of another ‘IT bubble’ emerging. Along with some city leaders, they argue that the top-down approach does not fit the governance dynamics and values of a liberal democracy when applied across sectors. A thorough understanding is required, of the socio-cultural nuances of how people work, live, play across different environments, and how they employ social media and mobile devices to interact with, engage in, and constitute public realms. Although the term ‘slacktivism’ is sometimes used to denote a watered down version of civic engagement and activism that is reduced to clicking a ‘Like’ button and signing online petitions, we believe that we are far from witnessing another Biedermeier period that saw people focus on the domestic and the non-political. There is plenty of evidence to the contrary, such as post-election violence in Kenya in 2008, the Occupy movements in New York, Hong Kong and elsewhere, the Arab Spring, Stuttgart 21, Fukushima, the Taksim Gezi Park in Istanbul, and the Vinegar Movement in Brazil in 2013. These examples of civic action shape the dynamics of governments, and in turn, call for new processes to be incorporated into governance structures. Participatory research into these new processes across the triad of people, place and technology is a significant and timely investment to foster productive, sustainable, and livable human habitats. With this chapter, we want to reframe the current debates in academia and priorities in industry and government to allow citizens and civic actors to take their rightful centerpiece place in civic movements. This calls for new participatory approaches for co-inquiry and co-design. It is an evolving process with an explicit agenda to facilitate change, and we propose participatory action research (PAR) as an indispensable component in the journey to develop new governance infrastructures and practices for civic engagement. This chapter proposes participatory action research as a useful and fitting research paradigm to guide methodological considerations surrounding the study, design, development, and evaluation of civic technologies. We do not limit our definition of civic technologies to tools specifically designed to simply enhance government and governance, such as renewing your car registration online or casting your vote electronically on election day. Rather, we are interested in civic media and technologies that foster citizen engagement in the widest sense, and particularly the participatory design of such civic technologies that strive to involve citizens in political debate and action as well as question conventional approaches to political issues (DiSalvo, 2012; Dourish, 2010; Foth et al., 2013). Following an outline of some underlying principles and assumptions behind participatory action research, especially as it applies to cities, we will critically review case studies to illustrate the application of this approach with a view to engender robust, inclusive, and dynamic societies built on the principles of engaged liberal democracy. The rationale for this approach is an alternative to smart cities in a ‘perpetual tomorrow,’ (cf. e.g. Dourish & Bell, 2011), based on many weak and strong signals of civic actions revolving around technology seen today. It seeks to emphasize and direct attention to active citizenry over passive consumerism, human actors over human factors, culture over infrastructure, and prosperity over efficiency. First, we will have a look at some fundamental issues arising from applying simplistic smart city visions to the kind of a problem a city is (cf. Jacobs, 1961). We focus on the touch points between “the city” and its civic body, the citizens. In order to provide for meaningful civic engagement, the city must provide appropriate interfaces.

Proactive behavior-based safety management for construction safety improvement

Construction is one of the most hazardous industries due to its dynamic, temporary, and decentralized nature. The Hong Kong Commissioner for Labor identifies worker behavior as the root cause of construction accidents. Behavior-based safety (BBS) is one effective approach in managing employee safety issues. However, there is little research on the application of BBS in the construction industry. This research proposes an extension of the BBS approach, proactive behavior-based safety (PBBS), to improve construction safety. PBBS integrates the theory of BBS with the technology of Proactive Construction Management System (PCMS). The innovations of PBBS are: (1) automatically monitoring location-based behaviors; (2)quantitatively measuring safety performance; (3) investigating potential causes of unsafe behaviors; and (4) improving the efficiency of safety management. A pilot study of a Hong Kong construction site practicing PBBS was conducted. The experiment results showed that PBBS performed well on construction accident prevention and the Safety Index (SI) of the two project teams, with increased improvements by 36.07% and 44.70% respectively. It is concluded that PBBS is effective and adaptable to construction industry.

Voltage balance improvement in urban low voltage distribution networks

This project is a step forward in developing effective methods to mitigate voltage unbalance in urban residential networks. The method is proposed to reduce energy losses and improve quality of service in strongly unbalanced low-voltage networks. The method is based on phase swapping as well as optimal placement and sizing of Distribution Static Synchronous Compensator (D-STATCOM) using a Particle Swarm Optimisation method.

Analysis and improvement of a construction permit approval process: A teaching case for developing business process development capabilities, targeting developing nations

With the increasing competitiveness in global markets, many developing nations are striving to constantly improve their services in search for the next competitive edge. As a result, the demand and need for Business Process Management (BPM) in these regions is seeing a rapid rise. Yet there exists a lack of professional expertise and knowledge to cater to that need. Therefore, the development of well-structured BPM training/ education programs has become an urgent requirement for these industries. Furthermore, the lack of textbooks or other self-educating material, that go beyond the basics of BPM, further ratifies the need for case based teaching and related cases that enable the next generation of professionals in these countries. Teaching cases create an authentic learning environment where complexities and challenges of the ‘real world’ can be presented in a narrative, enabling students to evolve crucial skills such as problem analysis, problem solving, creativity within constraints as well as the application of appropriate tools (BPMN) and techniques (including best practices and benchmarking) within richer and real scenarios. The aim of this paper is to provide a comprehensive teaching case demonstrating the means to tackle any developing nation’s legacy government process undermined by inefficiency and ineffectiveness. The paper also includes thorough teaching notes The article is presented in three main parts: (i) Introduction - that provides a brief background setting the context of this paper, (ii) The Teaching Case, and (iii) Teaching notes.

Mechanisms underlying the effect of acupuncture on cognitive improvement: A systematic review of animal studies

Acupuncture has been reported to be beneficial in treating cognitive impairment in various pathological conditions. This review describes the effort to understand the signaling pathways that underlie the acupunctural therapeutic effect on cognitive function. We searched the literature in 12 electronic databases from their inception to November 2013, with full text available and language limited to English. Twenty-three studies were identified under the selection criteria. All recruited animal studies demonstrate a significant positive effect of acupuncture on cognitive impairment. Findings suggest acupuncture may improve cognitive function through modulation of signaling pathways involved in neuronal survival and function, specifically, through promoting cholinergic neural transmission, facilitating dopaminergic synaptic transmission, enhancing neurotrophin signaling, suppressing oxidative stress, attenuating apoptosis, regulating glycometabolic enzymes and reducing microglial activation. However, the quality of reviewed studies has room for improvement. Further high-quality animal studies with randomization, blinding and estimation of sample size are needed to strengthen the recognition of group differences.

DoGood : A gamified mobile app to promote civic engagement

The rise of the mobile Internet enables the creation of applications that provide new and easier ways for people to organise themselves, raise issues, take action and interact with their city. However, a lack of motivation or knowledge often prevents many citizens from regularly contributing to the common good. Therefore, this thesis presents DoGood, a smartphone app, that aims at motivating citizens to carry out civic activities. The thesis asks what kinds of activities citizens consider to be civic and to what extent gamification can motivate users in this context. The DoGood app uses gamified elements to encourage citizens to submit and promote their civic activities as well as to join the activities of others. Gamification is sometimes criticized for simply adding a limited number of game elements, such as leaderboards, on top of an existing experience. However, in the case of the DoGood app, the process of game design was an integral part of the development, and the gamified elements target the user’s intrinsic motivations instead of providing them with an external reward. DoGood was implemented as hybrid mobile app and deployed to citizens of Brisbane in a five weeks long user study. The app successfully motivated most of its users to do more civic activities and its gamified elements were well received. Based on the results of the user study, civic activities can be defined as activities that give citizens the opportunity to become involved and improve life in their local community.