Investigating fitness to drive in older drivers with cognitive impairment

This thesis investigated driving behaviour of senior drivers with cognitive impairment in order to gain an understanding of how cognition impacts on driver behaviour and fitness to drive.

Factors to drive clinical practice improvement in a Malaysian intensive care unit : assessment of organisational readiness using a mixed method approach

This study assessed organisational readiness and factors to drive clinical practice improvement for VAP, CRBSI and PU in a Malaysian intensive care unit (ICU). A mixed method study approach was undertaken in a 16-bed ICU in regional Malaysia using an environmental scan, key informant interviews, staff surveys, and patient audit to elucidate factors contributing to planning for clinical practice improvement. Measurements of sustainability of practice and regard for the practice environment were assessed using validated measures. An environmental scan demonstrated high patient occupancy and case load. Nineteen percent of ICU patients developed complications according to validated measures. Survey results indicated that the majority of nurses had a good knowledge of strategies to prevent ICU complications and a positive attitude toward change processes. Engaging executive leadership was identified as crucial in priming the clinical site for practice change. Providing nurses with tools to monitor their clinical practice and empowering them to change practices are important in improving clinical outcomes.

Perceived sports competence mediates the relationship between childhood motor skill proficiency and adolescent physical activity and fitness : a longitudinal assessment

Background: The purpose of this paper was to investigate whether perceived sports competence mediates the relationship between childhood motor skill proficiency and subsequent adolescent physical activity and fitness.

Methods: In 2000, children's motor skill proficiency was assessed as part of a school-based physical activity intervention. In 2006/07, participants were followed up as part of the Physical Activity and Skills Study and completed assessments for perceived sports competence (Physical Self-Perception Profile), physical activity (Adolescent Physical Activity Recall Questionnaire) and cardiorespiratory fitness (Multistage Fitness Test). Structural equation modelling techniques were used to determine whether perceived sports competence mediated between childhood object control skill proficiency (composite score of kick, catch and overhand throw), and subsequent adolescent self-reported time in moderate-to-vigorous physical activity and cardiorespiratory fitness.

Results: Of 928 original intervention participants, 481 were located in 28 schools and 276 (57%) were assessed with at least one follow-up measure. Slightly more than half were female (52.4%) with a mean age of 16.4 years (range 14.2 to 18.3 yrs). Relevant assessments were completed by 250 (90.6%) students for the Physical Activity Model and 227 (82.3%) for the Fitness Model. Both hypothesised mediation models had a good fit to the observed data, with the Physical Activity Model accounting for 18% (R2 = 0.18) of physical activity variance and the Fitness Model accounting for 30% (R2 = 0.30) of fitness variance. Sex did not act as a moderator in either model.

Conclusion: Developing a high perceived sports competence through object control skill development in childhood is important for both boys and girls in determining adolescent physical activity participation and fitness. Our findings highlight the need for interventions to target and improve the perceived sports competence of youth.

The relevance of import competition to merger assessment in Australia

The Australian Competition and Consumer Commission has been criticised for failing to take due account of the impact import competition has on domestic firms when assessing whether or not a proposed merger will be likely to substantially lessen competition. This article reviews the approach taken by the ACCC to import competition in its merger assessments. Consideration is given to both the policy adopted by the ACCC and the statistical relevance that has, in fact, been placed on import competition in merger assessment. A conclusion is then drawn as to the appropriateness of the ACCC's current policy and practice.

A conditional probability approach to risk assessment for child sexual offenders with different classes of victim

Specific scales were developed for discriminating child sexual offenders with different classes of victim. The project demonstrates a method of individualising scores on actuarial risk assessment measured in a way that makes them more meaningful for those involved in decision-making about individual child sexual offenders. At present, the only quantifiable approach to specific decision-making relies on a general prediction of future behaviour, based on group data. The Bayesian approach is one method that can be used to assist decision-makers to use this information in ways that lead to the more appropriate management of risk. Ultimately, the better management of known child sexual offenders will lead to fewer offences and a reduction in the number of children who lives are profoundly affected by sexual victimisation.

Kurdungurlu got to drive Toyota : differential colonizing process among the Warlpiri

This thesis is based on fieldwork I carried out between December 1987 and June 1989 while living with the residents of a small Warlpiri Outstation Community situated ca. 75 km north-west of Tennant Creek in the Northern Territory of Australia. Colonialism is a process whereby incommensurate gender regimes impact differently on women and men and this is reflected in the indigenous response which affects the socialization of Western things. The notion of the indigenous KIRDA-KURDUNGURLU reciprocity is shown to be consistent with a gender system and to articulate all exchange relations as pro-creative social relationships. This contrasts with the Western capitalist system of production and social reproduction of gendered individuals in that it does not ascribe gender to biological differences between women and men but is derived from a land based social division between Sister-Brother. Social relationships are put under great strain in an effort to socialize Western things for Warlpiri internal use, I argue that the colonization of Aboriginal societies is an ongoing process. Despite the historical shift from a physical all-male frontier to the present day cross-cultural negotiations between Aborigines and Non-Aborigines, men still privilege men. The negotiation process for ownership of a Community Toyota is the most recent phenomenon where this can be observed. Male privilege is established by linking control over the access to the Community Toyota with traditional rights to land. However, the Toyota as Western object has a Western gender identity as well. By pitting women against men it engages people in social conflict which is brought into existence through an organisation of Western concepts based on an alien gender regime. But Western things, especially the Community Toyota, resist socialization because the Warlpiri do not produce these things. Warlpiri people know this and, to satisfy their need for Western things, they engage them in a process of social differentiation. By this process they can be seen actively to maintain the Western system in an effort to maintain themselves as Warlpiri and to secure the production of Western things. This investigation of the cultural response to Western influences shows that indigenous gender relations are only maintained through a socially stressful process of socializing Western things.

Using online environments to promote assessment as a learning enhancement process

The 21st century presents new challenges relating to the need for assessment to be more innovative, more responsive to students' needs, and more relevant and authentic. The characteristics of good assessment are well known and resources abound to assist academic staff to change their practices. Yet, at a time when the imperative for reconsidering practices has never been greater, it appears to be very difficult to bring about and maintain substantive change in assessment. This paper presents case studies that illustrate the way some academic staff have responded to the challenges. In particular, how the online environment can enhance learning through formative assessment is illustrated with four case studies. The paper outlines specific challenges faced in each case and  discusses issues that arose during development and delivery. It concludes by identifying some of the factors that helped to facilitate changes in assessment practices in these specific cases.

In what ways does policy on academic integrity, copyright and privacy need to respond in order to accommodate assessment with Web 2.0 tools?

Increasingly social web technologies, such as blogging and micro-blogging, audio and video podcasting, photo/video, social bookmarking, social networking, wiki writing or virtual worlds are being used as forms of authoring or content creation to support students’ learning in higher education. As Web 2.0 teaching practice is characterised by open access to information and collaborative networks there are both familiar and novel challenges for policy-makers in higher education institutions. The Government 2.0 Taskforce heralded legislative and practice changes necessary because of Web 2.0. We reflect on the qualitative feedback received from innovative higher education practitioners using Web 2.0 to assess student work. This indicates a need for information policy review to accommodate the cultural shift towards information exchange and communication across traditional institutional boundaries. Issues involved when implementing Web 2.0 assessments are identified to highlight requisite areas for policy improvement in higher education, in particular for academic integrity, copyright and privacy policies

Ensuring a proactive, evidence-based, patient safety approach to patient assessment

Aims and objectives: To argue that if all nurses were to adopt the primary survey approach (assessment of airway, breathing, circulation and disability) as the first element of patient assessment, they would be more focused on active detection of clinical deterioration rather than passive collection of patient data. Background: Nurses are the professional group that carry the highest level of responsibility for patient assessment, accurate data collection and interpretation. The timely recognition of, and response to deteriorating patients, is dependent on the measurement and interpretation of pertinent physiological data by nurses. Design: Discursive paper. Methods: Traditionally taught and commonly used approaches to patient assessment such as 'vital signs' and 'body systems' are not evidence-based nor framed in patient safety. The primary survey approach as the first element in patient assessment has three major advantages: (1) data are collected according to clinical importance; (2) data are collected using the same framework as most organisation's rapid response system activation criteria; and (3) the primary survey acts as a patient safety checklist, thereby decreasing the risk of failure to recognise, and therefore respond to, deteriorating patients. Conclusion: The vital signs and body systems approaches to patient assessment have significant limitations in identifying clinical deterioration. The primary survey approach provides nurses with a consistent, evidence-based and sequenced approach to patient assessment in every clinical setting. Relevance to clinical practice: All nurses should use a primary survey approach as the first element of patient assessment in every patient encounter as a patient safety strategy. © 2014 John Wiley & Sons Ltd.

A novel approach to needs assessment in curriculum development: going beyond consensus methods

BACKGROUND: Needs assessment should be the starting point for curriculum development. In medical education, expert opinion and consensus methods are commonly employed. AIM: This paper showcases a more practice-grounded needs assessment approach. METHODS: A mixed-methods approach, incorporating a national survey, practice audit, and expert consensus, was developed and piloted in thrombosis medicine; Phase 1: National survey of practicing consultants, Phase 2: Practice audit of consult service at a large academic centre and Phase 3: Focus group and modified Delphi techniques vetting Phase 1 and 2 findings. RESULTS: Phase 1 provided information on active curricula, training and practice patterns of consultants, and volume and variety of thrombosis consults. Phase 2's practice audit provided empirical data on the characteristics of thrombosis consults and their associated learning issues. Phase 3 generated consensus on a final curricular topic list and explored issues regarding curriculum delivery and accreditation. CONCLUSIONS: This approach offered a means of validating expert and consensus derived curricular content by incorporating a novel practice audit. By using this approach we were able to identify gaps in training programs and barriers to curriculum development. This approach to curriculum development can be applied to other postgraduate programs.