Evaluation of the Chinese version of the disability of the arm, shoulder and hand (DASH-HKPWH): cross-cultural adaptation process, internal consistency and reliability study

Abstract
The Disability of the Arm, Shoulder and Hand (DASH) was translated into Chinese by a physiotherapy team of the Prince of Wales Hospital, Hong Kong (DASH-HKPWH).

Objectives
This study evaluated the cross-cultural adaptation process, face validity, internal consistency and reliability of the DASH-HKPWH.

Method
Language officers and medical professionals from different fields were invited to translate and evaluate the face validity of the DASH-HKPWH. 88 patients were recruited to complete two DASH questionnaires on two occasions 1-2 weeks apart.

Results
Some adjustments were made to the translations based on the cultural and linguistic practice in Hong Kong. The face validity was satisfactory with a mean endorsement score of 3.2. The difference between the mean of DASH scores was not significant (t = −0.35, p = 0.73). The ICC (1,1) and Cronbach's alpha for the 30-item Disability/Symptom of the DASH-HKPWH was 0.77 and 0.94, respectively.

Conclusion
The translation was valid and reliable and acceptably equivalent to the original version. The questionnaire is suitable for measuring changes experienced by patients with any upper extremity disorders.

Evaluation of the environments for health framework

Environments for Health, Five Years On…
Since its release in 2001, Victoria’s Environments for Health Municipal Public Heath Planning Framework, has represented a leading edge approach to supporting quality public health planning at the local government level.

In 2006 the Department of Human Services appointed an external evaluation team from Deakin and Melbourne Universities to assess the introduction of the Environments for Health framework to municipal public health planning and to make recommendations for its future direction.

The evaluation aimed to determine the extent to which Environments for Health and related implementation activities had:

* been incorporated by local governments in their policies and practices
* created greater opportunities for health gain, and
* been supported effectively by the Department of Human Services and other stakeholders

The evaluation project involved participation from a broad range of key stakeholders, including all local Councils within Victoria. Data collection covered four distinct stages - document analysis, key informant interviews, state-wide survey of practitioners, and council and stakeholder forums, all with opportunities for input to the evaluation.

Australian implementation and evaluation of active support

Background The implementation and evaluation of Active Support in Australia is reported, the first such formal evaluation outside the UK.

Method Residents and staff of five group homes participated. Active Support was introduced by training staff in one home at a time. Effectiveness was assessed using direct observation of resident engagement in activity and of staff help, as well as written assessments of resident outcomes.

Results Staff help and resident engagement increased in four of five group homes. There was significantly greater participation in a wider variety of domestic activities, as well as more frequent and varied community participation. Change in resident engagement was positively related to change in staff help, but not related to residents' level of adaptive behaviour.

Conclusions Most of our findings were consistent with earlier UK studies. There was evidence of the successful transfer of Active Support training skills to an Australian training team. Nonsignificant trends towards reduced depression and increased adaptive behaviour warrant further investigation.

What (a) difference a degree makes : the evaluation of the new social work degree in England

After many years of debate in the UK about the need for a degree-level qualification in social work, the arguments for a minimum degree-level qualification were accepted. The requirements for the degree in England were developed drawing on work from a number of sources, including a benchmark statement for undergraduate degrees in social work and focus groups with stakeholders. The new degree in England, launched in 2003, involves one extra year’s study; improvements in the qualifying standard for social work; and specific curriculum and entrance requirements. At the time of launching the degree, the government department responsible for funding (Department of Health) commissioned a three-year evaluation of the implementation of the new degree to establish whether the new qualifying level leads to improvements in the qualified workforce. The aim of the evaluation is to describe the experiences of those undertaking the degree, collect the views of the various stakeholders about the effectiveness of the degree and measure the impact of a degree-level qualification on those entering the workforce. This article, written by the team undertaking the evaluation of the England degree, explores the reasons for the methodological approach adopted and the issues that have arisen in setting up the research.

Longitudinal evaluation of a risk-factor model for adolescent suicidality

This research developed two best-fitting structural equation models of risk factors for adolescent depression and suicidality: a core model, which included parenting factors, gender, depression, and suicidality, and an extended model, which also encompassed personality traits (Introversion and Impulsivity) and mood factors (Anxiety and Anger). Further, this research investigated the consistency of model fit across time (Le., 1 month & 12 months) and samples, and explored the effectiveness of the ReachOut! Internet site as a psychoeducational prevention strategy for adolescent depression and suicidality. Gender, age, and location differences were also explored. Participants were 185 Year-9 students and 93 Year-10 students aged 14 - 16 years, from seven secondary schools in regional and rural Victoria. Students were given a survey which included the Parental Bonding Instrument (Parker, Tupling, & Brown, 1979), the Millon Adolescent Personality Inventory (Millon, Green, & Meagher, 1982), the Profile of Mood States Inventory (McNair & Lorr, 1964), items on suicidal behaviour including some questions from the Revised Adolescent Suicide Questionnaire (Pearce & Martin, 1994), and questions on loss and general demographics. Results supported an indirect model of risk factors, with family factors directly influencing personality factors, which in turn influenced mood factors, including depression, which then influenced suicidality. At the theoretical level, results supported Attachment Theory (Bowlby, 1969), demonstrating that perceived parenting styles that are warm and not overly controlling are more conducive to an adolescent's emotional well-being than are parenting styles that are cold and controlling. Further, results supported Millon's theory of personality (1981), demonstrating that parenting style influences a child's personality. Short-term intervention effects from the internet site were a decrease in Introversion for the full sample, and decreased Inhibition and Suicidality for a high-risk subgroup. Long-term age effects were decreased Inhibition and increased Anxiety for the fall sample. There was also a probable intervention effect for Depression for the high-risk subgroup. No location differences for the risk factors were found between regional and rural areas.

An evaluation of a community aged care nurse practitioner service

Evaluation aims: An evaluation is presented that aimed to augment current understandings of the nurse practitioner role by investigating potential outcomes of a community aged care nurse practitioner (ACNP) service on clients and the health care team.

Background: In Australia, the nurse practitioner role is being implemented in a variety of health care settings and is characterized by extended practice: prescribing of medications, requests for diagnostic investigations, referral to medical specialists and admitting clients to inpatient facilities.

Design: An exploratory qualitative evaluation method through data collection by interview and thematic analysis was undertaken.

Method: All clients referred to the ACNP service between June and August 2003, and a convenience sample of health professionals, were invited to participate in individual semi-structured interviews.

Results: Findings suggested that an ACNP could provide a high quality of holistic nursing care and positively affect clients' physical and psychological symptom management, enhance clients' quality of life, assist with supplies, provide health education and assist with advocacy. Health professionals commented on effective collaboration with the ACNP service during their partnerships in client care provision.

Conclusions: Overall, the positive effects of the ACNP service on clients and the health care team support the full implementation of the role within the community setting.

Relevance to clinical practice: Funding support for the nurse practitioner role is a vital addition to consideration in the development of international policy on advanced practice nursing. Without adequate funding, the full benefits of the nurse practitioner role in clinical practice, as suggested by the findings presented in this evaluation, will be compromised.

Innovation in accounting education

An exploration of a distinctive inter-disciplinary, problem-based, team-based and student centred learning environment: the Inter-disciplinary Industrial Project. Goal-free evaluation shows the IDIP successfully prepares students for the workplace. Case study narratives and outcome oriented conceptual models elaborate a Grounded Theory of Team-based Problem Solving.

Dynamic interactions in models with Kaleckian lags

Provides a careful assessment of previous research on lags in economic models. Several interesting lines of research are opened up. Chief among them is the analysis of bubbles and their bursting in the financial components of economic models.

Haptically enable interactive virtual assembly training system development and evaluation

Virtual training systems are attracting paramount attention from the manufacturing industries due to their potential advantages over the conventional training practices. Significant cost savings can be realized due to the shorter times for the development of different training-scenarios as well as reuse of existing designed engineering (math) models. In addition, use of computer based virtual reality (VR) training systems can shorten the time span from computer aided product design to commercial production due to non-reliance on the hardware parts for training. Within the aforementioned conceptual framework, a haptically enabled interactive and immersive virtual reality (HIVEx) system is presented. Unlike existing VR systems, the presented idea tries to imitate real physical training scenarios by providing comprehensive user interaction, constrained within the physical limitations of the real world. These physical constrains are imposed by the haptics devices in the virtual environment. As a result, in contrast to the existing VR systems that are capable of providing knowledge generally about assembly sequences only, the proposed system helps in cognitive learning and procedural skill development as well, due to its high physically interactive nature.

A qualitative evaluation of a regional early psychosis service 3 years after its commencement

Objective. To outline the major findings of a qualitative evaluation of an Early Psychosis Service 3 years after its establishment.

Design. Data to evaluate the service were collected from team meetings, focus groups, individual interviews and questionnaires administered to clinicians, school staff, patients, carers and families.

Setting. Barwon Health; Mental Health, Drug and Alcohol Services provide public mental health care to the Geelong, Victoria, region (population 270 000), which is a mixed urban and rural setting. The Early Psychosis Service model implemented involved the placement of two early psychosis workers into each offive adult geographically based Area Mental Health Teams rather than the establishment of a single Early Psychosis Team.

Results. The service was found not to adhere to its original design in several key respects. Caseloads and periods of case management were found to be lower and shorter respectively than was originally planned for, caseworkers often experienced isolation and resentment from their adult service coworkers, the service was perceived to be difficult to access and premises not to be youth friendly and communication and engagement with external agencies and service providers was perceived to be poor.

Conclusions. The choice of service model, inadequate consultation with stakeholders and inadequate promotion of the service contributed to its failure to reach early expectations. Because of these and other issues, including difficulties distinguishing between early psychosis and non-psychosis, a decision was made to restructure youth services and

Evaluation of chlorine decay kinetics expressions for drinking water distribution systems modelling

The decay of chlorine in drinking water involves a complex set of reactions that is usually simplified to first order kinetics in models of water quality in distribution systems. However, to be useful in optimising chlorine dosing regimes, the kinetics expression should accurately describe the shape of the chlorine decay curve for different chlorine doses and be able to simulate re-chlorination. After considering the nature of the reactions involved in chlorine decay, five simplified reaction schemes were evaluated for their suitability to describe chlorine concentration in bulk water. Each scheme was fitted to a sample of experimental data of chlorine decay in raw water obtained from Warragamba Dam (the major source of water supplied to Sydney, Australia). A scheme involving two parallel reactions of organic carbon compounds with chlorine is both necessary and sufficient to satisfy the requirements of modelling chlorine decay accurately.

High rate filtration using buoyant medium : experiments and mathematical models

In this study, the high rate filtration system using buoyant medium of polypropylene or polystyrene was introduced with the study on its performance evaluation via: (i) specific surface coverage, (ii) ultimate specific deposit, (iii) blocking effect and (iv) particle detachment. The filter system was arranged in the downflow mode with an in-line flocculation. Experimental results obtained were analyzed using filtration models. This study showed that: (i) the specific surface coverage increased with the increase in the velocity; (ii) the ultimate specific deposit changed slightly at different filtration velocities and different flocculants; (iii) the blocking effect was significant in the transient stage removal of flocs; and (iv) the detachment model parameter was found to decrease with the increase in the adhesive force, Fad that acts on the flocs (above-micron size).

Mixed methods evaluation research for a mental health screening and referral clinical pathway

Rationale: This study is an exemplar of mixed method evaluation research for development of a clinical pathway.

Aim: To develop and evaluate an evidence-based, feasible mental health screening and referral clinical pathway for Department of Veterans’ Affairs-funded community nursing care of war veterans and war widows in the Australian context.

Methods: Mixed methods were applied to formulate and clinically evaluate an appropriate pathway. The pathway was applied at urban and rural sites for the nursing care of 97 war veteran and war widow clients. Evaluative data were collected from clients, their informal carers, community nurses, and general practitioners. Chart auditing and pre-post measures were undertaken. Collaboration occurred with an interdisciplinary design team.

Results: The final modified six-page pathway includes use of validated screening tools (Kessler Psychological Distress Scale [K10]) and Alcohol Use Disorder Identification Test, appropriate referral information, directions for support and health-promoting education, and evidence-based guidelines. Implications for Practice: The clinical pathway is a useful, tested, evidence-based guide for generalist community nurses to identify and suitably respond to common mental healthcare needs of war veterans and war widows. The pathway provides outcomes acceptable to clients and their carers, nurses and doctors.

Conclusions: This study provides an evaluated clinical pathway for generalist community nurses to screen for mental health difficulties, make appropriate referrals as required and to support war veteran and war widow clients. However, the study also shows how research can be used to develop and evaluate
practical, evidence-based clinical pathways.

Team clinical supervision in acute hospital wards : a feasibility study

Clinical supervision provides a strategy to mitigate nurses’ workplace stress and enhance retention, but the literature provides little guidance about its implementation beyond mental health nursing. This study explored the feasibility of implementing and evaluating ward-based team clinical supervision for general nurses on two separate wards at one public and one private hospital. Nurses completed the Work Environment Questionnaire pre- (n = 36) and post intervention (n = 27), and focus groups (n = 20) explored their perceptions of supervision. Staff were unfamiliar with clinical supervision, so information sessions were required. The questionnaire may not have been suitable to evaluate this type of intervention. Focus group findings revealed that team supervision improved communication, enhanced working relationships, and empowered nurses to challenge existing practices, which had a positive impact on their perceived stress. This study provides insights to guide implementation and evaluation of clinical supervision in acute settings.

User-centered design and evaluation of an interactive visual-haptic-auditory interface : a user study on assembly

Utilizing user-centred system design and evaluation method has become an increasingly important tool to foster better usability in the field of virtual environments (VEs). In recent years, although it is still the norm that designers and developers are concerning the technological advancement and striving for designing impressive multimodal multisensory interfaces, more and more awareness are aroused among the development team that in order to produce usable and useful interfaces, it is essential to have users in mind during design and validate a new design from users' perspective. In this paper, we describe a user study carried out to validate a newly developed haptically enabled virtual training system. By taking consideration of the complexity of individual differences on human performance, adoption and acceptance of haptic and audio-visual I/O devices, we address how well users learn, perform, adapt to and perceive object assembly training. We also explore user experience and interaction with the system, and discuss how multisensory feedback affects user performance, perception and acceptance. At last, we discuss how to better design VEs that enhance users perception, their interaction and motor activity.