The reliability of two visual motor integration tests used with health adults

Occupational therapists often assess the visual motor integration (VMI) skills of children, adults, and the elderly, which are parts of the Body Functions and Structures of the International Classification of Functioning, Disability and Health. Objective. As it is imperative that therapists use tests and measures with strong psychometric properties, this study aims to examine the reliability of two VMI tests used with adults. Method. Sixty-one healthy adults, 18 males and 43 females, with an average age of 31.82 years, completed the Developmental Test of Visual Motor Integration (DTVMI) and the Full Range Test of Visual Motor Integration (FRTVMI). The Cronbach's alpha coefficient was used to examine the tests&rsquo; internal consistency, while the Spearman's rho correlation was used to evaluate the test–retest reliability, intrarater reliability, and interrater reliability of the two VMI tests. Results. The Cronbach's alpha coefficient for the DTVMI and FRTVMI was 0.66 and 0.80, respectively. The test–retest reliability coefficient was 0.77 (p < .001) for the DTVMI and 0.61 (p < .001) for the FRTVMI. The interrater reliability correlation was significant for both DTVMI at 0.79 (p < .001) and FRTVMI at 0.80 (p < .001). The DTVMI intrarater reliability correlation result was 0.95 (p < .001) and the FRTVMI at 0.87 (p < .001). Conclusion. Overall, the DTVMI and the FRTVMI exhibited moderate to high levels of reliability when used with a sample of healthy adults. Both VMI tests appear to exhibit reasonable levels of reliability and are recommended for use with adults and the elderly.

An exploratory cluster randomised controlled trial of knowledge translation strategies to support evidence-informed decision-making in local governments (The KT4LG study)

Background: Childhood overweight and obesity is the most prevalent and, arguably, politically complex child health problem internationally. Governments, communities and industry have important roles to play, and are increasingly expected to deliver an evidence-informed system-wide prevention program. However, efforts are impeded by a lack of organisational access to and use of research evidence. This study aims to identify feasible, acceptable and ideally, effective knowledge translation (KT) strategies to increase evidence-informed decision making in local governments, within the context of childhood obesity prevention as a national policy priority.
Methods/Design: This paper describes the methods for KT4LG, a cluster randomised controlled trial which is exploratory in nature, given the limited evidence base and methodological advances. KT4LG aims to examine a program of KT strategies to increase the use of research evidence in informing public health decisions in local governments. KT4LG will also assess the feasibility and acceptability of the intervention. The intervention program comprises a facilitated program of evidence awareness, access to tailored research evidence, critical appraisal skills development, networking and evidence summaries and will be compared to provision of evidence summaries alone in the control program. 28 local governments were randomised to intervention or control, using computer generated numbers, stratified by budget tertile (high, medium or low). Questionnaires will be used to measure impact, costs, and outcomes, and key informant interviews will be used to examine processes, feasibility, and experiences. Policy tracer studies will be included to examine impact of intervention on policies within relevant government policy documents.
Discussion: Knowledge translation intervention studies with a focus on public health and prevention are very few in number. Thus, this study will provide essential data on the experience of program implementation and evaluation of a system-integrated intervention program employed within the local government public health context. Standardised programs of system, organisational and individual KT strategies have not been described or rigorously evaluated. As such, the findings will make a significant contribution to understanding whether a facilitated program of KT strategies hold promise for facilitating evidence-informed public health decision making within complex multisectoral government organisations.

Reliable graph discovery

A critical question in data mining is that can we always trust what discovered by a data mining system unconditionally? The answer is obviously not. If not, when can we trust the discovery then? What are the factors that affect the reliability of the discovery? How do they affect the reliability of the discovery? These are some interesting questions to be investigated. In this chapter we will firstly provide a definition and the measurements of reliability, and analyse the factors that affect the reliability. We then examine the impact of model complexity, weak links, varying sample sizes and the ability of different learners to the reliability of graphical model discovery. The experimental results reveal that (1) the larger sample size for the discovery, the higher reliability we will get; (2) the stronger a graph link is, the easier the discovery will be and thus the higher the reliability it can achieve; (3) the complexity of a graph also plays an important role in the discovery. The higher the complexity of a graph is, the more difficult to induce the graph and the lower reliability it would be. We also examined the performance difference of different discovery algorithms. This reveals the impact of discovery process. The experimental results show the superior reliability and robustness of MML method to standard significance tests in the recovery of graph links with small samples and weak links.

The impact of a computerised consolidation accounting package (CCAP) on student performance

Purpose – The purpose of this paper is to investigate the association between the use of a computerised learning tool (specifically designed to teach consolidation accounting) and student performance in the final examination of an undergraduate accounting unit on Corporate Accounting.

Design/methodology/approach – A regression model was developed to analyse 1,103 observations of assignment and examination scores, collected over three semesters, to test the central proposition that computer assisted learning enhances student learning outcomes and performance in the exam.

Findings – The results show a positive and significant relationship between the computerised accounting assignment on consolidated accounting (linked to usage of the computerised tool) and the consolidation question in the final examination. The findings suggest that the computerised consolidation accounting package (CCAP) assists students to understand the concepts underpinning consolidation accounting.

Research limitations/implications – The data were collected from a single institution, which may not represent the population of accounting students. Due to ethical obligations, the study lacked a control group that would have allowed meaningful comparison and assessment of student performance. Furthermore, whilst the findings in this study were able to demonstrate a positive association between the CCAP and exam performance, it is unable to determine the quality and depth of the learning experience from using the CCAP.

Practical implications – The present study found that a CCAP and its usage has the potential to positively impact student performance on assessment tasks on subject matter similar to concepts contained the computer package. Such findings may encourage instructors to seek ways of incorporating learning technologies in the pedagogical design.

Originality/value – This is believed to be one the few papers that has exclusively studied the impact of a specific CCAP and a specific segment in accounting education (consolidation accounting) using direct measures, CCAP assignment score and the final examination score for a question dedicated to consolidation accounting.

The impact of climate variability and change on cryptosporidiosis and giardiasis rates in New Zealand

Aim: To investigate the spatial relationship between climate variability and cryptosporidiosis and giardiasis notifications in New Zealand between 1997 and 2006.

Methods: Negative binomial regression was used to analyse spatial relationships between cryptosporidiosis and giardiasis notifications in New Zealand between 1997 and 2006, and climatological average rainfall and temperature at the Census Area Unit (CAU) level. The quality of domestic water supplies, urban-rural status and deprivation were included as covariates.

Main results: Giardiasis: There was a positive association between rainfall and giardiasis and between temperature and giardiasis.

Cryptosporidiosis: There was a positive association between rainfall and cryptosporidiosis and a negative association between temperature and cryptosporidiosis. The effect of rainfall was modified by the quality of the domestic water supply.

Conclusions: These findings suggest that climate variability affects protozoan disease rates in New Zealand. However, predicting the effect of climate change from this study is difficult, as these results suggest that the projected increases in temperature and rainfall may have opposing effects on cryptosporidiosis rates. Nevertheless, water supply quality appeared to modify the impact of increased rainfall on cryptosporidiosis rates. This finding suggests that improving water supply quality in New Zealand could reduce vulnerability to the impact of climate change on protozoan diseases.

Collaborative care skills training workshops : helping carers cope with eating disorders from the UK to Australia

Purpose

The Collaborative Care Skills Training workshops, developed by Treasure and associates aim to improve the well-being, coping strategies and problem-solving skills of carers of someone with an eating disorder. Evidence has demonstrated the effectiveness of the workshops in the UK where it was developed. The aim of this pilot study was to examine whether conducting the workshops in different contexts by facilitators trained in its delivery could lead to similar impact.
Methods

The workshops were conducted with 15 carers in VIC, Australia and delivered by experienced health professionals trained in its content and delivery. A non-experimental research design with repeated measures was implemented. Quantitative data were collected at pre-and post-intervention and 8 weeks after completion of the workshops.
Results

Participation led to significant reductions in carers’ reported expressed emotion, dysfunctional coping, distress, burden and accommodation and enabling of the eating disorder behaviour, which were maintained at the 8-week follow-up.
Conclusion

Results suggest the workshops are effective in reducing carer distress and burden as well as modifying unhelpful emotional interactional styles when caring for family members with an eating disorder. The content of the workshops and its delivery, once experienced facilitators have received training, are transferable to other contexts.

Structured Type 1 Diabetes education delivered within routine care: impact on glycemic control and diabetes-specific quality of life

OBJECTIVE:
To determine whether improvements in glycemic control and diabetes-specific quality of life (QoL) scores reported in research studies for the type 1 diabetes structured education program Dose Adjustment For Normal Eating (DAFNE) are also found when the intervention is delivered within routine U.K. health care.

RESEARCH DESIGN AND METHODS:
Before and after evaluation of DAFNE to assess impact on glycemic control and QoL among 262 adults with type 1 diabetes.

RESULTS:
There were significant improvements in HbA_1c from baseline to 6 and 12 months (from 9.1 to 8.6 and 8.8%, respectively) in a subgroup with suboptimal control. QoL was significantly improved by 3 months and maintained at both follow-up points.

CONCLUSIONS:
Longer-term improved glycemic control and QoL is achievable among adults with type 1 diabetes through delivery of structured education in routine care, albeit with smaller effect sizes than reported in trials.

Experimental study of dynamic compressive behaviour of concrete material reinforced with spiral steel fibres

It has been well demonstrated that the impact loading resistance capacity of the concrete material can be effectively increased by adding fibres. Recent studies proved that compared to other conventional steel fibres, using steel fibres with spiral shape further increases the post-failure energy absorption and crack stopping capacities of concrete because of the better bonds in the concrete matrix and larger deformation ability. The present study conducts high rate impact tests using split Hopkinson pressure bar (SHPB) to further investigate the dynamic compressive properties of spiral fibre reinforced concrete (SFRC). SFRC specimens with different volume fractions of fibres ranging from zero to 1.5% are prepared and tested. The influences of different volume fractions of fibres on strength, stress-strain relation and energy absorption of SFRC specimens under quasi-static and dynamic loadings are studied. In SHPB compression tests, the strain rate achieved ranges from 50 1/s to 200 1/s. Highspeed camera is used to capture the failure processes and failure modes of SFRC specimens with different fibre volume fractions during the tests for comparison. Dynamic stress-strain curves under different strain rates are derived. The energy absorption capacities of the tested specimens are obtained and compared. Strain rate effects on the compressive strength are also discussed. The corresponding empirical DIF (dynamic increase factor) relations for SFRC are proposed.

A modelling framework for optimisation of commodity production by minimising the impact of climate change

The agricultural sector is vulnerable to the impact of climate change due to decreasing rainfall, increasing temperature, and the frequency of extreme weather events. A modelling framework was developed and applied to identify issues, problems and opportunities arising in regional agricultural systems as a consequence of climate change. This integrated framework blends together land suitability analysis, uncertainty analysis and an optimisation approach to establish optimal agricultural land-use patterns on a regional scale for current and possible future climate scenarios. The framework can also be used to identify (i) regions under threat of productivity decline, and (ii) alternative crops and their locations that can cope better with changing climate. The methods and contents of the framework are presented by means of a case study developed in the South West Region of Victoria, Australia. The results can be used to assess land suitability in support of optimised crop allocations across a local region, and to underpin the development of a regional adaptation policy framework designed to reduce the vulnerability of the agriculture sector to the impacts of climate change.

Renal access coordinators' impact on hemodialysis patient outcomes and associated service delivery: a systematic review

Background
Renal access coordinators contribute specifically to dialysis access care for people with chronic and end stage renal disease. Since the introduction of renal access coordinators into Australia in the early 2000s, there have been anecdotal examples of associated improvements in patient outcomes and service delivery; however scant published quantitative evidence exists. Thus, the impact of the implementation of renal access coordinators has not undergone a rigorous review to date.

Objective
The objective of this systematic review was to critically appraise and synthesize the best available evidence related to the impact of renal access coordinators on dialysis patient outcomes and associated service delivery.

INCLUSION CRITERIA

Types of participants
This review considered studies that included renal access coordinators (noting variations of the titles) and adult hemodialysis patients (aged 18 years and over).

Types of intervention(s)
This review considered studies that evaluated the effectiveness of the renal access coordinator. This role typically consists of clinical and administration duties such as providing pre dialysis access coordination, access surveillance patient education and nurse education.

Types of studies
The types of studies considered within this review included experimental and epidemiological study designs. Thus randomized controlled trials (RCT), non-randomized controlled trials, and quasi-experimental, before and after studies, prospective and retrospective cohort studies were considered as were case control studies, analytical cross sectional studies and descriptive cross sectional studies.

Types of outcomes
Patient outcomes considered included: days to first vascular access complication (such as stenosis or thrombosis) and/or primary intervention (such as angioplasty or surgical intervention); percentage of central line insertions (negative); rate of arteriovenous fistula (AVF)/arteriovenous graft (AVG)/central venous catheter (CVC) at start of dialysis (incidence); prevalent rate of AVF/AVG/CVC; time to occlusion of AVF and time from referral to surgery. Service outcomes included: knowledge/up skilling of renal nurses; cannulation skills, ultrasound skills, knowledge of anatomy and physiology and other access related knowledge.

Search strategy
The search strategy aimed to locate published and unpublished studies, utilizing a three-step searching approach. Studies published in English from 1990 to October 2013 were considered for inclusion in this review.

Methodological quality
The studies were assessed by two independent reviewers using the appropriate standardized critical appraisal instruments from the Joanna Briggs Institute.

Data collection
Data were extracted from papers included in the review using the standardised data extraction tool from the Joanna Briggs Institute, namely JBI Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI).

Data synthesis
This review aimed to conduct meta-analyses of the findings: however, because of the limitations of the data found, this was not possible and so the findings are presented in a narrative format.

Results
Five studies were identified for inclusion in the review. No RCTs were found, therefore four of the five studies were pre-post intervention cohort studies and one was a prospective quality assurance report. Data were heterogeneous and thus did not allow for meta-analysis. All studies included multidisciplinary teams with variable emphasis on the renal access coordinator role. The pre post intervention cohort studies measured incident and/or prevalent AVF, AVG and CVC rates in the hemodialysis population and the quality assurance report measured the difference in patency rates between AVF and AVG. All discussed the role of central coordination as a contributor to the success of vascular access care.

Conclusions
This review found insufficient data to make firm conclusions about the impact that renal access coordinators have on patient outcomes. The results of this review suggest an association between renal access coordinators and improved patient outcomes. These improved patient outcomes were apparent in an increase in incident and prevalent AVFs, and a decrease in the incidence and prevalence of CVCs. Both associations are correlated with a reduction in infection rates, length of hospital stay and healthcare costs.

Closing the emergency facility: Moving schools from literacy triage to better literacy outcomes

This article focuses on the tensions between national and international testing, educational policy and professionalism for middle school English teachers. I argue that state and federal government(s) are responding to the impact of Australia's falling results on the international testing in PISA (Programme for International Student Assessment) through the usage of their own testing program, the National Assessment Program for Literacy and Numeracy (NAPLAN). The publication of NAPLAN results on the MySchool website in a searchable and comparable form has been detrimental to many schools and has pushed these schools into "emergency mode", as they struggle to improve their scores. At the same time, the results from recent PISA examinations reveal extensive inequities in educational outcomes across Australia, as well as some consistent general trends in the Australian data. I use the metaphor of the hospital emergency department to explore this situation. Drawing on Sahlberg's (2011) notion of the Global Educational Reform Movement (GERM), I explore this metaphor becoming a pandemic. I draw on Gillborn and Youdell's (2000) usage of educational triage and cast different and multiple educational professionals playing the role of the triage nurse-the alternate federal and state government education ministers responding to international and state test results in triage; and principals of poor performing schools operating their school as though it is an emergency department; poor literacy results triaged Code Red receiving immediate focus and attention, but "treated" in terms of immediate survival and a focus on basic skills. I argue that the international testing provides better markers for how we are doing as a nation, and what might be done to improve our international standing with respect to our literacy scores. I argue that true gains in literacy and the development of more complex literacy skills are not made through triaging literacy through an emergency department, but through a long-term focus on school redesign.

SMEs and the potential for a collaborative path to environmental responsibility

Globally, the potential for small and medium-sized enterprises (SMEs) to collectively impact negatively on the environment is great. Therefore, the adoption, and maintenance, of environmentally responsible practices by this group of firms is especially critical. Studies of environmental practices successfully implemented by small firms have revealed that relationships with other firms, or other organizations, can contribute to greater awareness of the benefits of such activities and, therefore, enhance the possibility of environmental engagement. Collaborative relationships may provide opportunities for SMEs to overcome some of the barriers to implementing environmental initiatives associated with their size, and/or associated characteristics. This paper focuses on attitudes of SME owner-managers to a variety of environmental issues (including regulation and voluntary standards), and to collaborating with other firms (in either a formal or informal sense). The data this paper draws upon are from two waves of an ongoing longitudinal survey of New Zealand SMEs.

Nonparametric rank tests for non-stationary panels

We develop a set of nonparametric rank tests for non-stationary panels based on multivariate variance ratios which use untruncated kernels. As such, the tests do not require the choice of tuning parameters associated with bandwidth or lag length and also do not require choices with respect to numbers of common factors. The tests allow for unrestricted cross-sectional dependence and dynamic heterogeneity among the units of the panel, provided simply that a joint functional central limit theorem holds for the panel of differenced series. We provide a discussion of the relationships between our setting and the settings for which first- and second generation panel unit root tests are designed. In Monte Carlo simulations we illustrate the small-sample performance of our tests when they are used as panel unit root tests under the more restrictive DGPs for which panel unit root tests are typically designed, and for more general DGPs we also compare the small-sample performance of our nonparametric tests to parametric rank tests. Finally, we provide an empirical illustration by testing for income convergence among countries.

Pooled unit root tests in panels with a common factor

This paper proposes new pooled panel unit root tests that are appropriate when the data exhibit cross-sectional dependence that is generated by a single common factor. Using sequential limit arguments, we show that the tests have a limiting normal distribution that is free of nuisance parameters and that they are unbiased against heterogenous local alternatives. Our Monte Carlo results indicate that the tests perform well in comparison to other popular tests that also presumes a common factor structure for the cross-sectional dependence.

Experimental and stochastic approaches to assessing the strain demand of pipelines and flexibility requirements for coatings

A criterion for selecting a coating for an energy pipeline is that the coating should have a suitable flexibility to meet the high strain demand during hydrostatic testing and during field bending. This requires knowledge of the level of strain demand for the pipeline, and also the maximum strain that could be
tolerated by the coating system. Whereas average strains imposed during manufacturing and construction are reasonably well predicted, there is insufficient understanding on the factors leading to localised deformation of the pipe. Significant work has been carried out in the past to develop tests for assessing
the coatings’ ability to handle a certain amount of strain based on bend testing, tensile testing and burst testing. However, there is a concern as to whether these tests properly represent localised micro-strains associated with construction activities including field bending and pressure testing, particularly pressure testing of pipelines designed for operation at 80% of specified minimum yield strength (SMYS). Consequently coatings considered "suitable" for modern pipelines may fail. The first issue discussed in this paper is main factors affecting strain localisation. The non-deterministic distributions of heterogeneities over the pipe provide a ground to consider the mechanisms of localisation as a stochastic process. An approach is proposed to quantify the maximum localised strain demand through cold field bending and hydrostatic experiments. Another issue discussed in this paper is the experimental assessment of coating flexibility under the effects of localised strains. Preliminary mandrel tests have been carried out to assess the uniformity of the imposed strain. Although mandrel testing has been shown to be a useful method for relative comparison of coating flexibility, it has several weaknesses that could significantly affect the reliability and reproducibility of the results.