Clinical research 5: quantitative data collection and analysis

This six-part research series is aimed at clinicians who wish to develop research skills, or who have a particular clinical problem that they think could be addressed through research. The series aims to provide insight into the decisions that researchers make in the course of their work, and to also provide a foundation for decisions that nurses may make in applying the findings of a study to practice in their own Unit or Department. The series emphasises the practical issues encountered when undertaking research in critical care settings; readers are encouraged to source research methodology textbooks for more detailed guidance on specific aspects of the research process.

A couple of points:

1. It is artificial to describe research as qualitative or quantitative. Studies often include both dimensions. However, for the purposes of this paper/series, this distinction is drawn for clarity of writing.

2. It is common practice for quantitative studies to refer to study ‘subjects’ and qualitative studies to refer to study ‘participants’. For ease of reading, the latter term will be used throughout this series.

Non-invasive collection and examination of human corneal epithelial cells

Purpose. To report the development of a new apparatus for non-invasive collection of human corneal epithelial cells.

Methods. Previous methods of non-invasive, irrigative corneal cell collection resulted in low cell yields limiting potential analysis. A new ocular surface cell collection apparatus (OSCCA) was designed to collect more epithelial cells from direct irrigation of the corneal surface to allow for clinical comparisons. Forty-five samples were obtained (unilateral or bilateral over seven visits) from five human participants. Cell yield, size, phenotype, and corneal staining (prior and post eye wash) were examined.

Results. On average 364 ± 230 epithelial cells were collected from the cornea per eye. Epithelial cell sizes ranged from 8.21 to 51.69 μm in diameter, and 67.30 to 2098.85 μm2 area. The proportion of corneal specific cells collected per sample was 75 ± 14% as determined by positive K3 expression with AE5. On average, 77 ± 0.2% of epithelial cells harvested were nucleated, the remainder were non-nucleated ghost cells. Corneal staining was reduced in the OSCCA-washed vs. contralateral non-washed eyes (p = 0.02).

Conclusions. The OSCCA allows collection of human corneal epithelial cells with significantly higher yields, and greater specificity than previously reported. Reduced corneal staining observed post eye-wash demonstrated the safety of the technique, and its ability to remove cells directly from the corneal surface. The OSCCA could provide an objective non-invasive method of investigating pathological changes, effects of topical therapeutics, and impact of contact lenses and care-solutions of the cells of the ocular surface.

Determining research significance in archaeological collections from historic sites

This thesis presents a model for assessing the research significance of Australian historical archaeological collections. It identifies the criteria, and provides step-by-step guidelines, for conducting such an assessment. The model is an important tool for managing and justifying the long term preservation of increasing numbers of archaeological collections.

Understanding parental motivators and barriers to uptake of child poison safety strategies: a qualitative study

Objectives: To develop an understanding of factors acting as barriers and motivators to parental uptake of child poison safety strategies.

Design: A qualitative study involving semistructured interviews and focus groups. A grounded theory approach was used for the collection and analysis of data.

Participants: Sixty five parents of children under 5 years of age, some of whom had experienced an unintentional child poisoning incident.

Results: A range of knowledge based, environmental, and behavioral barriers to comprehensive parental uptake of poison safety practices were identified. As a result there tended to be only partial implementation of safety initiatives in the home. Selection of safety practices was often guided by the interests and behaviors of the child. This made the child vulnerable to changes in the home environment, inadequate supervision, and/or shifts in their own behavior and developmental ability. Personal or vicarious exposure of a parent to a child poisoning incident was a significant motivator for parental review of safety practices.

Conclusion: Environmental measures targeting child resistant containers, warning labels, and lockable poisons cupboards will support parents’ efforts to maintain poison safety. Additional education campaigns using stories of actual poisoning incidents may help to increase awareness of risk and encourage increased uptake.

Food insecurity, malnutrition and mortality in Maewo and Ambae islands, Vanuatu

Context: This paper reports on findings from the ex-post evaluation of the Maewo Capacity Building project in Maewo Island, Vanuatu, which was funded by World Vision Australia.
Objectives: To examine the extent to which the infrastructure and systems left behind by the project contributed to the improvement of household food security and health and nutritional outcomes in Maewo Island, using Ambae Island as a comparator.
Setting: Two-stage cluster survey conducted from 6 to 20 July 2004, which included anthropometric measures and 4.5-year retrospective mortality data collection.
Participants: A total of 406 households in Maewo comprising 1623 people and 411 households in Ambae comprising 1799 people.
Main outcome measures: Household food insecurity, crude mortality rate (CMR), under-five mortality rate (U5MR) and malnutrition prevalence among children.
Results: The prevalence of food insecurity without hunger was estimated at 15.3%
(95% confidence interval (CI): 12.1, 19.2%) in Maewo versus 38.2% (95% CI: 33.6, 43.0%) in Ambae, while food insecurity with hunger in children did not vary by location. After controlling for the child’s age and gender, children in Maewo had higher weight-for-age and height-for-age Z-scores than children of the same age in Ambae. The CMR was lower in Maewo (CMR ¼ 0.47/10 000 per day, 95% CI: 0.39, 0.55) than in Ambae (CMR ¼ 0.59/10 000 per day, 95% CI: 0.51, 0.67) but no difference existed in U5MR. The major causes of death were similar in both locations, with frequently reported causes being malaria, acute respiratory infection and
diarrhoeal disease.
Conclusions: Project initiatives in Maewo Island have reduced the risks of mortality and malnutrition. Using a cross-sectional ‘external control group’ design, this paper demonstrates that it is possible to draw conclusions about project effectiveness where baseline data are incomplete or absent. Shifting from donor-driven evaluations to impact evaluations has greater learning value for the organisation, and greater value when reporting back to the beneficiaries about project impact and transformational
development in their community. Public health nutritionists working in the field are well versed in the collection and interpretation of anthropometric data for evaluation of nutritional interventions such as emergency feeding programmes. These same skills can be used to conduct impact evaluations, even some time after project completion, and elucidate lessons to be learned and shared. These skills can also be applied more widely to projects which impact on the longer-term nutritional status of
communities and their food security.

Council amalgamations and restructuring in Victoria: how did we value the assets and liabilities?

This study aimed to identify and critically analyse the methodologies and accounting treatments adopted in the transfer of assets, liabilities, revenues and expenses resultingfrom municipal boundary changes associated with municipal restructuring (amalgamations) in Victoria during the early 1990s. In involved the collection and use of oral evidence obtained from officers of a sample of entities engaged in the process and focused on identifying and examining the methodologies used by municipalities. It has also been shown that local government is different from the commercial domain and the accounting profession has not adequately addressed some of these differences.

Assessing direct and indirect water requirements of construction

Australia is considered the driest populated continent in the world. Despite this, we consume the largest amount of water, per capita. While little of this water is used for the operation of buildings, buildings are now being designed to use less water. Additionally, rainwater collection and grey water recycling systems offer the potential to significantly reduce demand for fresh water. However, little is known about the water required directly and indirectly (ie., embodied in) construction materials and products. Embodied water comprises the water required directly for construction itself and the water consumed indirectly in the production and delivery of materials, products and services to construction. Water required directly for construction is likely to be insignificant compared to the indirect water required for the manufacture of construction materials and products (ie., through materials and other products required to support construction). There is currently a lack of research into embodied water requirements by the construction sector. The relationship between the embodied water and the operational water is also unknown, apart from a handful of studies based solely on national average statistics known as 'input-output' data. The aim of this paper is therefore to model the water required directly and indirectly by construction, integrating currently available public domain industry data with input-output data. The coverage of the industry data relative to the input-output data was evaluated for a typical commercial building, and was found to be very low.

Using autonomous mobile agents for efficient data collection in sensor networks

Sensor networks are emerging as the new frontier in sensing technology, however there are still issues that need to be addressed. Two such issues are data collection and energy conservation. We consider a mobile robot, or a mobile agent, traveling the network collecting information from the sensors themselves before their onboard memory storage buffers are full. A novel algorithm is presented that is an adaptation of a local search algorithm for a special case of the Asymmetric Traveling Salesman Problem with Time-windows (ATSPTW) for solving the dynamic scheduling problem of what nodes are to be visited so that the information collected is not lost. Our algorithms are given and compared to other work.

Limiting the list : human rights and intangible cultural heritage

UNESCO's Convention for the Safeguarding of Intangible Heritage came into force in April 2006, signalling a major expansion of the global system of heritage protection from the tangible to the intangible. It is an expansion that some heritage professionals see as opening up a Pandora's box of confusions and complexities. The conservation of inanimate objects tangible sites and monuments and artefacts - is difficult enough; but the protection of heritage embodied in people raises new sets of ethical and practical issues. The paper canvasses these concerns and focuses on how the notion of human rights must be used as a way of limiting and shaping the Intangible List. In particular it outlines the ways in which the protection and preservation of cultural heritage is linked to 'cultural rights' as a form of human rights. This linkage is not clearly recognised by cultural heritage practitioners in many countries, who view their work merely as technical, or even by human rights workers, despite the abundance of opportunities around the world to witness people struggling to assert their cultural rights in order to protect their heritage and identity.

The status of health-promoting schools in Hong Kong and implications for further development

An evaluation framework, called the Hong Kong Healthy Schools Award, has been developed to enable comprehensive collection and analysis of data reflecting the status of health-promoting schools (HPS) in Hong Kong. The key findings revealed a high prevalence of emotional problems, unhealthy eating habits, physical inactivity and risk-taking behaviours, leading to both intentional and unintentional injuries among students with higher prevalence among secondary school students. The results indicated a substantial lack of health policies in schools; it also indicated health services in schools not readily accessible to students and staff, and insufficient staff training in health promotion and education. However, most schools have made initiatives in environmental protection, established safety guidelines and strategies for managing students with emotional problems. The success of HPS depends largely on teachers' understanding of its building blocks. Evidence from the comprehensive mapping of the status of HPS in Hong Kong and from student surveys does show encouraging outcomes as well as identifying priority issues to be addressed in the next 5 years.

Sir George Simpson : 19th century fur trade governor and precursor of systematic management

Purpose – Sir George Simpson, the Governor of the Hudson's Bay Company (HBC) from 1821 to his death in 1860, was the subject of numerous biographical works that described various facets of the man including his managerial abilities, literary prowess, physical stamina, abundant energy, extensive art collection and ethnological specimens. Two related aspects of his outstanding management style have been overlooked: the genesis of his management style and where it can be placed in the evolution of management practices during the 19th century.

Design/methodology/approach – Primary data from the Hudson's Bay Company archives plus secondary sources.

Findings – Simpson's management abilities came from his grammar school education and his apprenticeship to a counting house. More importantly, it can be attributed to his association with his mentor Andrew Wedderburn, his dedication to the HBC, and his high level of physical and intellectual energy. His information intensive management style was also a significant precursor to systematic management, which occurred later in the 19th century.

Research limitations/implications – Future research should examine other examples of the evolution of management during the 19th century, particularly the transition from sub-unit accountability to systematic management.

Originality/value – The paper emphasizes the importance of managers in making management systems work.