Principles to guide sustainable implementation of extended-scope-of-practice physiotherapy workforce redesign initiatives in Australia: Stakeholder perspectives, barriers, supports, and incentives

Sustainable implementation of new workforce redesign initiatives requires strategies that minimize barriers and optimize supports. Such strategies could be provided by a set of guiding principles. A broad understanding of the concerns of all the key stakeholder groups is required before effective strategies and initiatives are developed. Many new workforce redesign initiatives are not underpinned by prior planning, and this threatens their uptake and sustainability. This study reports on a cross-sectional qualitative study that sought the perspectives of representatives of key stakeholders in a new workforce redesign initiative (extended-scope-of-practice physiotherapy) in one Australian tertiary hospital. The key stakeholder groups were those that had been involved in some way in the development, management, training, funding, and/or delivery of the initiative. Data were collected using semistructured questions, answered individually by interview or in writing. Responses were themed collaboratively, using descriptive analysis. Key identified themes comprised: the importance of service marketing; proactively addressing barriers; using readily understood nomenclature; demonstrating service quality and safety, monitoring adverse events, measuring health and cost outcomes; legislative issues; registration; promoting viable career pathways; developing, accrediting, and delivering a curriculum supporting physiotherapists to work outside of the usual scope; and progression from "a good idea" to established service. Health care facilities planning to implement new workforce initiatives that extend scope of usual practice should consider these issues before instigating workforce/model of care changes. © 2014 Morris et al.

Where and how to conserve: Extending the scope of spatial reserve network design

Ongoing habitat loss and fragmentation threaten much of the biodiversity that we know today. As such, conservation efforts are required if we want to protect biodiversity. Conservation budgets are typically tight, making the cost-effective selection of protected areas difficult. Therefore, reserve design methods have been developed to identify sets of sites, that together represent the species of conservation interest in a cost-effective manner. To be able to select reserve networks, data on species distributions is needed. Such data is often incomplete, but species habitat distribution models (SHDMs) can be used to link the occurrence of the species at the surveyed sites to the environmental conditions at these locations (e.g. climatic, vegetation and soil conditions). The probability of the species occurring at unvisited location is next predicted by the model, based on the environmental conditions of those sites. The spatial configuration of reserve networks is important, because habitat loss around reserves can influence the persistence of species inside the network. Since species differ in their requirements for network configuration, the spatial cohesion of networks needs to be species-specific. A way to account for species-specific requirements is to use spatial variables in SHDMs. Spatial SHDMs allow the evaluation of the effect of reserve network configuration on the probability of occurrence of the species inside the network. Even though reserves are important for conservation, they are not the only option available to conservation planners. To enhance or maintain habitat quality, restoration or maintenance measures are sometimes required. As a result, the number of conservation options per site increases. Currently available reserve selection tools do however not offer the ability to handle multiple, alternative options per site. This thesis extends the existing methodology for reserve design, by offering methods to identify cost-effective conservation planning solutions when multiple, alternative conservation options are available per site. Although restoration and maintenance measures are beneficial to certain species, they can be harmful to other species with different requirements. This introduces trade-offs between species when identifying which conservation action is best applied to which site. The thesis describes how the strength of such trade-offs can be identified, which is useful for assessing consequences of conservation decisions regarding species priorities and budget. Furthermore, the results of the thesis indicate that spatial SHDMs can be successfully used to account for species-specific requirements for spatial cohesion - in the reserve selection (single-option) context as well as in the multi-option context. Accounting for the spatial requirements of multiple species and allowing for several conservation options is however complicated, due to trade-offs in species requirements. It is also shown that spatial SHDMs can be successfully used for gaining information on factors that drive a species spatial distribution. Such information is valuable to conservation planning, as better knowledge on species requirements facilitates the design of networks for species persistence. This methods and results described in this thesis aim to improve species probabilities of persistence, by taking better account of species habitat and spatial requirements. Many real-world conservation planning problems are characterised by a variety of conservation options related to protection, restoration and maintenance of habitat. Planning tools therefore need to be able to incorporate multiple conservation options per site, in order to continue the search for cost-effective conservation planning solutions. Simultaneously, the spatial requirements of species need to be considered. The methods described in this thesis offer a starting point for combining these two relevant aspects of conservation planning.

Present status and future scope of fisheries in the Andaman group of islands

The coastal area of approximately 2000 km and the water-bodies in between the Andaman and Nicobar islands are rich in fishery potential which range from 0.012-0.47 million tonnes. The fishery is dominated by catches of sardines, perches, carangids, mackerels, Leiognathus elasmobranchs, seerfish, mullets and tunas. About 2050 fishermen, with 1150 country craft, 113 mechanised boats and 1367 different kinds of nets and lines are engaged in active fishing in the island. Numerous bays, lagoons and creeks are available among the group of islands for mariculture activities. The mangroves of these islands provide feeding and nursery grounds for juveniles of penaeid prawns, crabs and finfishes.

Determining the Scope of English Quantifiers

How can one represent the meaning of English sentences in a formal logical notation such that the translation of English into this logical form is simple and general? This report answers this question for a particular kind of meaning, namely quantifier scope, and for a particular part of the translation, namely the syntactic influence on the translation. Rules are presented which predict, for example, that the sentence: Everyone in this room speaks at least two languages. has the quantifier scope AE in standard predicate calculus, while the sentence: At lease two languages are spoken by everyone in this room. has the quantifier scope EA. Three different logical forms are presented, and their translation rules are examined. One of the logical forms is predicate calculus. The translation rules for it were developed by Robert May (May 19 77). The other two logical forms are Skolem form and a simple computer programming language. The translation rules for these two logical forms are new. All three sets of translation rules are shown to be general, in the sense that the same rules express the constraints that syntax imposes on certain other linguistic phenomena. For example, the rules that constrain the translation into Skolem form are shown to constrain definite np anaphora as well. A large body of carefully collected data is presented, and used to assess the empirical accuracy of each of the theories. None of the three theories is vastly superior to the others. However, the report concludes by suggesting that a combination of the two newer theories would have the greatest generality and the highest empirical accuracy.

Missing data in randomized clinical trials for weight loss: scope of the problem, state of the field, and performance of statistical methods.

BACKGROUND: Dropouts and missing data are nearly-ubiquitous in obesity randomized controlled trails, threatening validity and generalizability of conclusions. Herein, we meta-analytically evaluate the extent of missing data, the frequency with which various analytic methods are employed to accommodate dropouts, and the performance of multiple statistical methods. METHODOLOGY/PRINCIPAL FINDINGS: We searched PubMed and Cochrane databases (2000-2006) for articles published in English and manually searched bibliographic references. Articles of pharmaceutical randomized controlled trials with weight loss or weight gain prevention as major endpoints were included. Two authors independently reviewed each publication for inclusion. 121 articles met the inclusion criteria. Two authors independently extracted treatment, sample size, drop-out rates, study duration, and statistical method used to handle missing data from all articles and resolved disagreements by consensus. In the meta-analysis, drop-out rates were substantial with the survival (non-dropout) rates being approximated by an exponential decay curve (e(-lambdat)) where lambda was estimated to be .0088 (95% bootstrap confidence interval: .0076 to .0100) and t represents time in weeks. The estimated drop-out rate at 1 year was 37%. Most studies used last observation carried forward as the primary analytic method to handle missing data. We also obtained 12 raw obesity randomized controlled trial datasets for empirical analyses. Analyses of raw randomized controlled trial data suggested that both mixed models and multiple imputation performed well, but that multiple imputation may be more robust when missing data are extensive. CONCLUSION/SIGNIFICANCE: Our analysis offers an equation for predictions of dropout rates useful for future study planning. Our raw data analyses suggests that multiple imputation is better than other methods for handling missing data in obesity randomized controlled trials, followed closely by mixed models. We suggest these methods supplant last observation carried forward as the primary method of analysis.

Two Views of ‘Subordination’: the Personal Scope of Employment Discrimination Law in Jivraj v Hashwani

In Jivraj v Hashwani, the Supreme Court considered what requirements are necessary for a relationship to be considered as an employment relationship for the purposes of determining the scope of domestic employment discrimination law. The Court held that an element of subordination was necessary for the relationship to be considered employment under a contract personally to do work. This article discusses what the Court in Jivraj meant by this requirement, contrasting two differing views of subordination. It examines some implications of the decision for the relationship between employment law and anti-discrimination law, and for recent debates on the scope of employment law more generally.

Broad and restricted scope of the concept of civil service: a multipolarização do conceito de publica nos modelos hibricos. A capacidade transformadora dos memorados de entendimento: Portugal e Irlanda

Analise do conceito de Função Publica, identificando, á partida, uma dicotomia conceptual, entre um modelo marcadamente continental(broad concept of civil service) e um modelo restrito(restricted scope of the concept of civil service), característico dos países anglo-saxónicos, aflorando a reforma da Administração Publica, na senda da New Public Management, como o caminho para a afirmação de modelos híbridos, com características de laboralização da Função Publica e de flexisegurança, que surgem como consequência da pulverização daquela dicotomia, revelando uma miscigenação entre os modelos iniciais e elementos externos, de acordo com as idiossincrasias de cada país. Posterior estudo de caso, versando sobre Portugal e a Irlanda , dois países que, são contrario do que a tradição anglo- saxónica da Irlanda faria adivinhar, partilham um conceito amplo de Função Publica(broad concept of Civil Service), apoiado num sistema de carreira(carrear sytem). Percorrerem, quase em simultâneo, o caminho de um regate económico-financeiro desenvolvido pelo Fundo Monetário Internacional, Banco Central Europeu e Comissão Europeia. Procurara investiga-se se o acordo firmado entre os dois países e a Troika, materializado nos respectivos Memorando de Entendimento e sucessivas revisões, no período compreendido entre 16 de Dezembro de 2010 e 31 de Dezembro de 2012, introduziu modificações nos respectivos modelos de Função Publica, designadamente forçando-os a uma aproximação do restricted scope of the concept of Civil Service e, com isso, projectando-os para a adopção de modelos híbridos.

A new approach for multi-agent coalition formation and management in the scope of electricity markets

This paper presents a new methodology for the creation and management of coalitions in Electricity Markets. This approach is tested using the multi-agent market simulator MASCEM, taking advantage of its ability to provide the means to model and simulate VPP (Virtual Power Producers). VPPs are represented as coalitions of agents, with the capability of negotiating both in the market, and internally, with their members, in order to combine and manage their individual specific characteristics and goals, with the strategy and objectives of the VPP itself. The new features include the development of particular individual facilitators to manage the communications amongst the members of each coalition independently from the rest of the simulation, and also the mechanisms for the classification of the agents that are candidates to join the coalition. In addition, a global study on the results of the Iberian Electricity Market is performed, to compare and analyze different approaches for defining consistent and adequate strategies to integrate into the agents of MASCEM. This, combined with the application of learning and prediction techniques provide the agents with the ability to learn and adapt themselves, by adjusting their actions to the continued evolving states of the world they are playing in.

On the Scope of Egalitarian Justice.

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