Evaluation of a pilot second-opinion child telepsychiatry service

A second-opinion child psychiatry service was piloted for six months in the northern-most two-thirds of Queensland. It provided specialist expertise by telehealth to local multidisciplinary teams of mental health staff. During the study period, 28 videoconferences were performed by the service: nine for administrative purposes, two for educational purposes, and 17 for direct and indirect clinical applications. The mean time between a referral being made and a consultation being performed was 4.7 days (range 1-13), A survey administered to referring and non-referring mental health workers showed that the major barriers to service implementation included the limited allied health applications that were offered, a perceived lack of communication during the implementation phase of the service, and the creation of a new referral network that did not conform to traditional referral patterns in the north of Queensland.

Evaluation of the Western Australian Department of Health telehealth project

In 1999, the Department of Health in Western Australia began a telehealth project, which finished in 2004. The 75 videoconferencing sites funded by the project were part of a total state-wide videoconference network of 104 sites. During the period from January 2002 to December 2003, a total of 3266 consultations, case reviews and patient education sessions took place. Clinical use grew to 30% of all telehealth activity. Educational use was approximately 40% (1416 sessions) and management use was about 30% (1031 sessions). The average overhead cost per telehealth session across all regions and usage types was $A192. Meaningful comparisons of the results of the present study with other public health providers were difficult, because many of the available Websites on telehealth were out of date. Despite the successful use of telehealth to deliver clinical services in Western Australia, sustaining the effort in the post-project phase will present significant challenges.

A pragmatic 2 × 2 × 2 factorial cluster randomized controlled trial of educational outreach visiting and case conferencing in palliative care—methodology of the Palliative Care Trial [ISRCTN 81117481]

The demand for palliative care is increasing, yet there are few data on the best models of care nor well-validated interventions that translate current evidence into clinical practice. Supporting multidisciplinary patient-centered palliative care while successfully conducting a large clinical trial is a challenge. The Palliative Care Trial (PCT) is a pragmatic 2 x 2 x 2 factorial cluster randomized controlled trial that tests the ability of educational outreach visiting and case conferencing to improve patient-based outcomes such as performance status and pain intensity. Four hundred sixty-one consenting patients and their general practitioners (GPs) were randomized to the following: (1) GP educational outreach visiting versus usual care, (2) Structured patient and caregiver educational outreach visiting versus usual care and (3) A coordinated palliative care model of case conferencing versus the standard model of palliative care in Adelaide, South Australia (3:1 randomization). Main outcome measures included patient functional status over time, pain intensity, and resource utilization. Participants were followed longitudinally until death or November 30, 2004. The interventions are aimed at translating current evidence into clinical practice and there was particular attention in the trial's design to addressing common pitfalls for clinical studies in palliative care. Given the need for evidence about optimal interventions and service delivery models that improve the care of people with life-limiting illness, the results of this rigorous, high quality clinical trial will inform practice. Initial results are expected in mid 2005. (c) 2005 Elsevier Inc. All rights reserved.

Quel role pour la langue de reference dans les representations des apprenants? Le cas de l'evaluation en langue etrangere

This research project explores learner’s representations of strategic L1 use in the foreign language classroom and highlights both the positive or negative roles attributed to the L1 in the language learning process - particularly with respect to language assessment - continuing to explore the relatively understudied domain of student representations within a scholarly context. Surveying a population of Australian (N=18) and French students (N=25), this study uses both questionnaire and interview responses in order to analyse the roles allocated to the L1 with respect to learning outcomes. The results indicate that students have a very balanced view of the L1 with respect to the learning of grammar, vocabulary and social aspects, yet its use in assessment aspects appears much more advantageous. The importance of this study and its findings is in recognizing the complex nature of learner representations in order to facilitate a discussion that is based more on the reality of language teaching, with the hope of renewing classroom practices.

Representing part-whole relationships in conceptual modeling: An empirical evaluation

The part-of or part-whole construct is a fundamental element of many conceptual modeling grammars that is used to associate one thing (a component) with another thing (a composite). Substantive theoretical issues surrounding the part-whole construct remain to be resolved, however. For instance, contrary to widespread claims, the relationship between components and composites is not always transitive. Moreover, how the partwhole construct should be represented in a conceptual schema diagram remains a contentious issue. Some analysts argue composites should be represented as a relationship or association. Others argue they should be represented as an entity. In this paper we use an ontological theory to support our arguments that composites should be represented as entities and not relationships or associations. We also describe an experiment that we undertook to test whether representing composites as relationships or entities enables users to understand a domain better. Our results support our arguments that using entities to represent composites enables users to better understand a domain.