A Delphi study of district nursing research priorities in Australia

This study, using a Delphi approach, sought the opinion of a self-selected panel of 320 district nurses regarding research priorities for district nursing in Australia. Over three rounds of questionnaires, the 419 research clinical problem areas requiring research as suggested by the panel were each rated in importance by the panel and then ranked through analysis from high to low average rating scores, thereby, whittling down the list to the top 15% (68) research questions and to a final list of the top 10 research priorities overall. Research questions focusing on discharge planning are dominant in these top 10 priorities, with documentation issues the second most common focus. Other foci in the top 10 priorities are staffing, aged care, palliative care, and assessment. The organization-specific top 10 research priorities focus on wound care, funding, education, and communication issues. Additionally, the top 68 priorities, which are either finitely practice-based or contextual-issues research questions, were categorized into 20 themes. The results will hopefully lead to scarce human and financial resources being directed to practice-relevant research programs that will facilitate improved health for district nursing (primarily home-nursing) clients in Australia and elsewhere. (c) 2005 Elsevier Inc. All rights reserved.

Initiation of biological agents in patients with ankylosing spondylitis: results of a Delphi study by the ASAS Group

Background: There is ample evidence of important symptomatic efficacy of tumour necrosis factor alpha (TNFalpha) inhibition in ankylosing spondylitis (AS). Moreover, studies suggest that anti-TNF could be considered as the first disease controlling antirheumatic treatment (DC-ART) for AS. Objective: To determine precisely which patients with AS are most likely to benefit from anti-TNFalpha treatment because of the cost and possible long term side effects of such treatment. Methods: Assessment in Ankylosing Spondylitis (ASAS) members were asked to use a Delphi technique to name the characteristics of patients with AS for whom they would start DC-ART, in three different clinical presentations (isolated axial involvement, peripheral arthritis, enthesitis). Results: Among the 62 invited ASAS members, more than 50% actively participated in the four phases of definition according to the Delphi technique. For each of the three clinical presentations, a combination of five to six domains was proposed, with an evaluation instrument and a cut off point defining a minimum level of activity for each domain. Conclusion: This study provides a profile for a patient with AS for considering initiation of biological agents that reflects the opinion of the ASAS members, using a Delphi exercise. Further studies are required to assess their relevance and their consistency with clinical practice.

Major Issues in Business Process Management: An Expert Perspective

The results presented in this report form a part of a larger global study on the major issues in BPM. Only one part of the larger study is reported here, viz. interviews with BPM experts. Interviews of BPM tool vendors together with focus groups involving user organizations, are continuing in parallel and will set the groundwork for the identification of BPM issues on a global scale via a survey (including a Delphi study). Through this multi-method approach, we identify four distinct sets of outcomes. First, as is the focus of this report, we identify the BPM issues as perceived by BPM experts. Second, the research design allows us to gain insight into the opinions of organisations deploying BPM solutions. Third, an understanding of organizations’ misconceptions of BPM technologies, as confronted by BPM tool vendors is obtained. Last, we seek to gain an understanding of BPM issues on a global scale, together with knowledge of matters of concern. This final outcome is aimed to produce an industry driven research agenda which will inform practitioners and in particular, the research community world-wide on issues and challenges that are prevalent or emerging in BPM and related areas.

Developing a framework for assessment of the environmental determinants of walking and cycling

The focus for interventions and research on physical activity has moved away from vigorous activity to moderate-intensity activities, such as walking. In addition, a social ecological approach to physical activity research and practice is recommended. This approach considers the influence of the environment and policies on physical activity. Although there is limited empirical published evidence related to the features of the physical environment that influence physical activity, urban planning and transport agencies have developed policies and strategies that have the potential to influence whether people walk or cycle in their neighbourhood. This paper presents the development of a framework of the potential environmental influences on walking and cycling based on published evidence and policy literature, interviews with experts and a Delphi study. The framework includes four features: functional, safety, aesthetic and destination; as well as the hypothesised factors that contribute to each of these features of the environment. In addition, the Delphi experts determined the perceived relative importance of these factors. Based on these factors, a data collection tool will be developed and the frameworks will be tested through the collection of environmental information on neighbourhoods, where data on the walking and cycling patterns have been collected previously. Identifying the environmental factors that influence walking and cycling will allow the inclusion of a public health perspective as well as those of urban planning and transport in the design of built environments. (C) 2002 Elsevier Science Ltd., All rights reserved.

Measurement of functional ability following traumatic brain injury using the Clinical Outcomes Variable Scale: A reliability study

This study determined the inter-tester and intra-tester reliability of physiotherapists measuring functional motor ability of traumatic brain injury clients using the Clinical Outcomes Variable Scale (COVS). To test inter-tester reliability, 14 physiotherapists scored the ability of 16 videotaped patients to execute the items that comprise the COVS. Intra-tester reliability was determined by four physiotherapists repeating their assessments after one week, and three months later. The intra-class correlation coefficients (ICC) were very high for both inter-tester reliability (ICC > 0.97 for total COVS scores, ICC > 0.93 for individual COVS items) and intra-tester reliability (ICC > 0.97). This study demonstrates that physiotherapists are reliable in the administration of the COVS.

Numerical Study of Hypersonic Leeward Flow over a Blunt Nosed Delta Wing

A kinetic theory based Navier-Stokes solver has been implemented on a parallel supercomputer (Intel iPSC Touchstone Delta) to study the leeward flowfield of a blunt nosed delta wing at 30-deg incidence at hypersonic speeds (similar to the proposed HERMES aerospace plane). Computational results are presented for a series of grids for both inviscid and laminar viscous flows at Reynolds numbers of 225,000 and 2.25 million. In addition, comparisons are made between the present and two independent calculations of the some flows (by L. LeToullec and P. Guillen, and S. Menne) which were presented at the Workshop on Hypersonic Flows for Re-entry Problems, Antibes, France, 1991.

The Genetic Speciation of Archaeological Fish Bone: A Feasibility Study from Southeast Queensland

Current genetic methods enable highly specific identification of DNA from modern fish bone. The applicability of these methods to the identification of archaeological fish bone was investigated through a study of a sample from late Holocene southeast Queensland sites. The resultant overall success rate of 2% indicates that DNA analysis is, as yet, not feasible for identifying fish bone from any given site. Taphonomic issues influencing the potential of genetic identification methods are raised and discussed in light of this result.

Exploring Change in Neanderthal Behavioural Complexity: An Innovative Approach to the Study of Neanderthal Behaviour

Diachronic approaches provide potential for a more sophisticated framework within which to examine change in Neanderthal behavioural complexity using archaeological proxies such as symbolic artefacts, faunal assemblages and technology. Analysis of the temporal appearance and distribution of such artefacts and assemblages provide the basis for identifying changes in Neanderthal behavioural complexity in terms of symbolism, faunal extraction and technology respectively. Although changes in technology and faunal extraction were examined in the wider study, only the results of the symbolic study are presented below to illustrate the potential of the approach.

One size doesn't fit all: Research methodologies in a language variation study of Sudanese teens

The research reported here draws on a study of five teenagers from a Dinka-speaking community of Sudanese settling in Australia. A range of factors including language proficiency, social network structure and language attitudes are examined as possible causes for the variability of language use. The results and discussion illustrate how the use of a triangular research approach captured the complexity of the participants' language situation and was critical to developing a full understanding of the interplay of factors influencing the teens' language maintenance and shift in a way that no single method could. Further, it shows that employment of different methodologies allowed for flexibility in data collection to ensure the fullest response from participants. Overall, this research suggests that for studies of non-standard communities, variability in research methods may prove more of a strength that the use of standardised instruments and approaches.

Experimental study of the quantum driven pendulum and its classical analog in atom optics

We present experimental results for the dynamics of cold atoms in a far detuned amplitude-modulated optical standing wave. Phase-space resonances constitute distinct peaks in the atomic momentum distribution containing up to 65% of all atoms resulting from a mixed quantum chaotic phase space. We characterize the atomic behavior in classical and quantum regimes and we present the applicable quantum and classical theory, which we have developed and refined. We show experimental proof that the size and the position of the resonances in phase space can be controlled by varying several parameters, such as the modulation frequency, the scaled well depth, the modulation amplitude, and the scaled Planck’s constant of the system. We have found a surprising stability against amplitude noise. We present methods to accurately control the momentum of an ensemble of atoms using these phase-space resonances which could be used for efficient phase-space state preparation.

Optical study of a light diaphragm rupture process in an expansion tube

Rupture of a light cellophane diaphragm in an expansion tube has been studied by an optical method. The influence of the light diaphragm on test flow generation has long been recognised, however the diaphragm rupture mechanism is less well known. It has been previously postulated that the diaphragm ruptures around its periphery due to the dynamic pressure loading of the shock wave, with the diaphragm material at some stage being removed from the flow to allow the shock to accelerate to the measured speeds downstream. The images obtained in this series of experiments are the first to show the mechanism of diaphragm rupture and mass removal in an expansion tube. A light diaphragm was impulsively loaded via a shock wave and a series of images was recorded holographically throughout the rupture process, showing gradual destruction of the diaphragm. Features such as the diaphragm material, the interface between gases, and a reflected shock were clearly visualised. Both qualitative and quantitative aspects of the rupture dynamics were derived from the images and compared with existing one-dimensional theory.

Breastfeeding and the responsibilities of GPs: a qualitative study of general practice registrars

The most recent National Health Survey reports that more than 80% of women initiate breastfeeding, while recent studies describe initiation rates of more than 90%. Yet fewer than 50% of women continue to breastfeed for 6 months or longer. This is at odds with National Health and Medical Research Council recommendations that 80% of infants be exclusively breastfed for the first 6 months of life. Women are more likely to initiate and continue to breastfeed if their doctor supports and encourages them to do so. Conversely, women perceive a neutral attitude by doctors toward breastfeeding to be similar to a negative attitude. Therefore, while doctors may not perceive their support or encouragement to be a determining factor in a woman’s breastfeeding decisions, women often place great emphasis on their GP's attitude to breastfeeding and are much more likely to think that information provided by a doctor is important. No previous research in Australia has addressed the issue of how GPs perceive their roles and responsibilities regarding breastfeeding. As part of a larger research project investigating the breastfeeding skills and knowledge of general practice registrars, this article reports the results of qualitative interviews with eight general practice registrars and their views and beliefs about GPs’ responsibilities to breastfeeding women.