Facilitating needs based cancer care for people with a chronic disease : evaluation of an intervention using a multi-centre interrupted time series design

Background: Palliative care should be provided according to the individual needs of the patient, caregiver and family, so that the type and level of care provided, as well as the setting in which it is delivered, are dependent on the complexity and severity of individual needs, rather than prognosis or diagnosis. This paper presents a study designed to assess the feasibility and efficacy of an intervention to assist in the allocation of palliative care resources according to need, within the context of a population of people with advanced cancer. ---------- Methods/design: People with advanced cancer and their caregivers completed bi-monthly telephone interviews over a period of up to 18 months to assess unmet needs, anxiety and depression, quality of life, satisfaction with care and service utilisation. The intervention, introduced after at least two baseline phone interviews, involved a) training medical, nursing and allied health professionals at each recruitment site on the use of the Palliative Care Needs Assessment Guidelines and the Needs Assessment Tool: Progressive Disease - Cancer (NAT: PD-C); b) health professionals completing the NAT: PD-C with participating patients approximately monthly for the rest of the study period. Changes in outcomes will be compared pre-and post-intervention.---------- Discussion: The study will determine whether the routine, systematic and regular use of the Guidelines and NAT: PD-C in a range of clinical settings is a feasible and effective strategy for facilitating the timely provision of needs based care.

Resorbable composite scaffolds for craniofacial bone tissue engineering

Aim: Bone loss associated with trauma, osteo-degenerative diseases and tumors has tremendous socioeconomic impact related to personal and occupation disability and health care costs. In the present climate of increasing life expectancy with an ensuing increase in bone-related injuries, orthopaedic surgery is undergoing a paradigm shift from bone-grafting to bone engineering, where a scaffold is implanted to provide adequate load bearing and enhance tissue regeneration. We aim to develop composite scaffolds for bone tissue engineering applications to replace the current gold standard of autografting. ---------- Methods: Medical grade polycaprolactone-tricalcium phosphate (mPCL/TCP) scaffolds (80/20 wt%) were custom made using fused deposition modelling to produce 1x1.5x2 cm sized implants for critical-sized pig cranial implantations, empty defects were used as a control. Autologous bone marrow stromal cells (BMSCs) were extracted and precultured for 2 weeks, dispersed within fibrin glue and injected during scaffold implantation. After 2 years, microcomputed tomography and histology were used to assess bone regenerative capabilities of cell versus cell-free scaffolds. ---------- Results: Extensive bone regeneration was evident throughout the entire scaffold. Clear osteocytes embedded within mineralised matrix and active osteoblasts present around scaffold struts were observed. Cell groups performed better than cell-free scaffolds. ---------- Conclusions: Bone regeneration within defects which cannot heal unassisted can be achieved using mPCL/TCP scaffolds. This is improved by the inclusion of autogenous BMSCs. Further work will include the inclusion of growth factors including BMP-2, VEGF and PDGF to provide multifunctional scaffolds, where the three-dimensional (3D) template itself acts as a biomimetic, programmable and multi-drug delivery device.

Grade A Taipei junior high school principals’ self-reported leadership practices

The principal’s leadership and curriculum development are considered the core elements for creating a high performing junior high school. In Taiwan, mathematics curriculum reform has been an ongoing topic since 1994. The pedagogy, classroom interactions, and the underlying philosophy of mathematics education have varied with different versions of guidelines. These changes inevitably increase the requirement for principals’ leadership in order to effectively implement the curriculum reform. Principals’ leadership is essential to the success of the implementation in their school. This study aimed to explore and identify the leadership of junior high school principals whose schools had been judged by the Taipei City Government as Grade A junior high schools. Principals’ implementations of the reformed mathematics curriculum were used as examples to generate insights of their leadership. This study drew upon a multiple-case study approach. Data were collected from interviews, observations, and documentations. Bass and Avolio’s (1997) full range leadership theory provided a structure for gaining insight into these principals’ leadership practices. Five Grade A Taipei junior high school principals participated and shared their leadership concepts and experiences. Findings revealed that the leadership preferences of the five principles varied considerably. Management by exception-active, contingent reward, individualised consideration, and idealised influence were Grade A Taipei junior high school principals’ preferred leadership practices. In addition, principals’ leadership strategies associated with these practices were identified. These principals had adopted a range of leadership strategies according to the staff and school needs. Results of this study have implications for both Taiwanese principals and education departments. Principals can enhance their leadership by gaining more understanding about the Grade A principals’ leadership practices and strategies. Taiwanese education departments can improve school leadership training programs by focusing on these practices and strategies, which may also lead to more effective strategies for implementing national curriculum reform.

Proactive communication management beats hostile media exposure : training for multi-cultural community leaders in living with mass media

Proactive communication management instead of mortification in the glare of hostile media attention became the theme of a four-day training program for multi-cultural community leaders, the object of this research. The program in Brisbane from December 2009 through to February this year was conducted under auspices of a Community Media Link grant program shared by Griffith University and the Queensland Ethnic Communities Council, together with Journalism academics from the Queensland University of Technology. Twenty-eight participants from 23 organisations took part, with a team of nine facilitators from the host organisations, and guest presenters from the news media. This paper reviews the process, taking into account: its objectives, to empower participants by showing how Australian media operate and introducing participants to journalists; pedagogical thrust, where overview talks, with role play seminars with guest presenters from the media, were combined with practice in interviews and writing for media; and outcomes, assessed on the basis of participants’ responses. The research methodology is qualitative, in that the study is based on discussions to review the planning and experience of sessions, and anonymous, informal feed-back questionnaires distributed to the participants. Background literature on multiculturalism and community media was referred to in the study. The findings indicate positive outcomes for participants from this approach to protection of persons unversed in living in the Australian “mediatised” environment. Most affirmed that the “production side” perspective of the exercise had informed and motivated them effectively, such that henceforth they would venture far more into media management, in their community leadership roles.

Information transfer for multi-trauma patients on discharge from the emergency department : mixed-method narrative review

Aim. This paper is a report of a review conducted to identify (a) best practice in information transfer from the emergency department for multi-trauma patients; (b) conduits and barriers to information transfer in trauma care and related settings; and (c) interventions that have an impact on information communication at handover and beyond. Background. Information transfer is integral to effective trauma care, and communication breakdown results in important challenges to this. However, evidence of adequacy of structures and processes to ensure transfer of patient information through the acute phase of trauma care is limited. Data sources. Papers were sourced from a search of 12 online databases and scanning references from relevant papers for 1990–2009. Review methods. The review was conducted according to the University of York’s Centre for Reviews and Dissemination guidelines. Studies were included if they concerned issues that influenced information transfer for patients in healthcare settings. Results. Forty-five research papers, four literature reviews and one policy statement were found to be relevant to parts of the topic, but not all of it. The main issues emerging concerned the impact of communication breakdown in some form, and included communication issues within trauma team processes, lack of structure and clarity during handovers including missing, irrelevant and inaccurate information, distractions and poorly documented care. Conclusion. Many factors influence information transfer but are poorly identified in relation to trauma care. The measurement of information transfer, which is integral to patient handover, has not been the focus of research to date. Nonetheless, documented patient information is considered evidence of care and a resource that affects continuing care.

Curriculum alignment: Exploring student perception of learning achievement measures

The importance of constructively aligned curriculum is well understood in higher education. Based on the principles of constructive alignment, this research considers whether student perception of learning achievement measures can be used to gain insights into how course activities and pedagogy are assisting or hindering students in accomplishing course learning goals. Students in a Marketing Principles course were asked to complete a voluntary survey rating their own progress on the intended learning goals for the course. Student perceptions of learning achievement were correlated with actual student learning, as measured by grade, suggesting that student perceptions of learning achievement measures are suitable for higher educators. Student perception of learning achievement measures provide an alternate means to understand whether students are learning what was intended, which is particularly useful for educators faced with large classes and associated restrictions on assessment. Further, these measures enable educators to simultaneously gather evidence to document the impact of teaching innovations on student learning. Further implications for faculty and future research are offered.

Reduction of environmental effects of civil aircraft through multi-objective flight plan optimisation

With rising environmental alarm, the reduction of critical aircraft emissions including carbon dioxides (CO2) and nitrogen oxides (NOx) is one of most important aeronautical problems. There can be many possible attempts to solve such problem by designing new wing/aircraft shape, new efficient engine, etc. The paper rather provides a set of acceptable flight plans as a first step besides replacing current aircrafts. The paper investigates a green aircraft design optimisation in terms of aircraft range, mission fuel weight (CO2) and NOx using advanced Evolutionary Algorithms coupled to flight optimisation system software. Two multi-objective design optimisations are conducted to find the best set of flight plans for current aircrafts considering discretised altitude and Mach numbers without designing aircraft shape and engine types. The objectives of first optimisation are to maximise range of aircraft while minimising NOx with constant mission fuel weight. The second optimisation considers minimisation of mission fuel weight and NOx with fixed aircraft range. Numerical results show that the method is able to capture a set of useful trade-offs that reduce NOx and CO2 (minimum mission fuel weight).

Prospective, non-randomized phase 2 clinical trial of carboplatin plus paclitaxel with sequential radical pelvic radiotherapy for uterine papillary serous carcinoma

Objective Uterine Papillary Serous Carcinoma (UPSC) is uncommon and accounts for less than 5% of all uterine cancers. Therefore the majority of evidence about the benefits of adjuvant treatment comes from retrospective case series. We conducted a prospective multi-centre non-randomized phase 2 clinical trial using four cycles of adjuvant paclitaxel plus carboplatin chemotherapy followed by pelvic radiotherapy, in order to evaluate the tolerability and safety of this approach. Methods This trial enrolled patients with newly diagnosed, previously untreated patients with stage 1b-4 (FIGO-1988) UPSC with a papillary serous component of at least 30%. Paclitaxel (175 mg/m2) and carboplatin (AUC 6) were administered on day 1 of each 3-week cycle for 4 cycles. Chemotherapy was followed by external beam radiotherapy to the whole pelvis (50.4 Gy over 5.5 weeks). Completion and toxicity of treatment (Common Toxicity Criteria, CTC) and quality of life measures were the primary outcome indicators. Results Twenty-nine of 31 patients completed treatment as planned. Dose reduction was needed in 9 patients (29%), treatment delay in 7 (23%), and treatment cessation in 2 patients (6.5%). Hematologic toxicity, grade 3 or 4 occurred in 19% (6/31) of patients. Patients' self-reported quality of life remained stable throughout treatment. Thirteen of the 29 patients with stages 1–3 disease (44.8%) recurred (average follow up 28.1 months, range 8–60 months). Conclusion This multimodal treatment is feasible, safe and tolerated reasonably well and would be suitable for use in multi-institutional prospective randomized clinical trials incorporating novel therapies in patients with UPSC.

Strategies to facilitate grading consistency in large classes

First year undergraduate university classes can be very large, and big student numbers often creates a challenge for instructors to ensure assignments are graded consistently across the cohort. This session describes and demonstrates the use of interactive audience response technology (ART) with assessors (rather than students) to moderate assignment grading. Results from preliminary research indicate this method of moderating the grading of assignments is effective, and achieves more consistent outcomes for students.

Multi-version documents : A digitisation solution for textual cultural artefacts

Textual cultural heritage artefacts present two serious problems for the encoder: how to record different or revised versions of the same work, and how to encode conflicting perspectives of the text using markup. Both are forms of textual variation, and can be accurately recorded using a multi-version document, based on a minimally redundant directed graph that cleanly separates variation from content.

Knowledge-based development for cities and societies : integrated multi-level approaches

Over the past twenty years, the conventional knowledge management approach has evolved into a strategic management approach that has found applications and opportunities outside of business, in society at large, through education, urban development, governance, and healthcare, amongst others. Knowledge-Based Development for Cities and Socieities: Integrated Multi-Level Approaches enlightens the concepts and challenges of knowledge management for both urban environments and entire regions, enhancing the expertise and knowledge of scholars, resdearchers, practitioners, managers and urban developers in the development of successful knowledge-based development policies, creation of knowledte cities and prosperous knowledge societies. This reference creates large knowledge base for scholars, managers and urban developers and increases the awareness of the role of knowledge cities and knowledge socieiteis in the knowledge era, as well as of the challenges and opportunities for future research.

Engaging operations management students by designing the unit with industry focus

Operations management is an area concerned with the production of goods and services ensuring that business operations are efficient in utilizing resource and effective to meet customer requirements. It deals with the design and management of products, processes, services and supply chains and considers the acquisition, development, and effective and efficient utilization of resources. Unlike other engineering subjects, content of these units could be very wide and vast. It is therefore necessary to cover the content that is most related to the contemporary industries. It is also necessary to understand what engineering management skills are critical for engineers working in the contemporary organisations. Most of the operations management books contain traditional Operations Management techniques. For example ‘inventory management’ is an important topic in operations management. All OM books deal with effective method of inventory management. However, new trend in OM is Just in time (JIT) delivery or minimization of inventory. It is therefore important to decide whether to emphasise on keeping inventory (as suggested by most books) or minimization of inventory. Similarly, for OM decisions like forecasting, optimization and linear programming most organisations now a day’s use software. Now it is important for us to determine whether some of these software need to be introduced in tutorial/ lab classes. If so, what software? It is established in the Teaching and Learning literature that there must be a strong alignment between unit objectives, assessment and learning activities to engage students in learning. Literature also established that engaging students is vital for learning. However, engineering units (more specifically Operations management) is quite different from other majors. Only alignment between objectives, assessment and learning activities cannot guarantee student engagement. Unit content must be practical oriented and skills to be developed should be those demanded by the industry. Present active learning research, using a multi-method research approach, redesigned the operations management content based on latest developments in Engineering Management area and the necessity of Australian industries. The redesigned unit has significantly helped better student engagement and better learning. It was found that students are engaged in the learning if they find the contents are helpful in developing skills that are necessary in their practical life.

Cooperative multi-AUV tracking of phytoplankton blooms based on ocean model predictions

In recent years, ocean scientists have started to employ many new forms of technology as integral pieces in oceanographic data collection for the study and prediction of complex and dynamic ocean phenomena. One area of technological advancement in ocean sampling if the use of Autonomous Underwater Vehicles (AUVs) as mobile sensor plat- forms. Currently, most AUV deployments execute a lawnmower- type pattern or repeated transects for surveys and sampling missions. An advantage of these missions is that the regularity of the trajectory design generally makes it easier to extract the exact path of the vehicle via post-processing. However, if the deployment region for the pattern is poorly selected, the AUV can entirely miss collecting data during an event of specific interest. Here, we consider an innovative technology toolchain to assist in determining the deployment location and executed paths for AUVs to maximize scientific information gain about dynamically evolving ocean phenomena. In particular, we provide an assessment of computed paths based on ocean model predictions designed to put AUVs in the right place at the right time to gather data related to the understanding of algal and phytoplankton blooms.

Multi-objective four-dimensional vehicle motion planning in large dynamic environments

This paper presents Multi-Step A* (MSA*), a search algorithm based on A* for multi-objective 4D vehicle motion planning (three spatial and one time dimension). The research is principally motivated by the need for offline and online motion planning for autonomous Unmanned Aerial Vehicles (UAVs). For UAVs operating in large, dynamic and uncertain 4D environments, the motion plan consists of a sequence of connected linear tracks (or trajectory segments). The track angle and velocity are important parameters that are often restricted by assumptions and grid geometry in conventional motion planners. Many existing planners also fail to incorporate multiple decision criteria and constraints such as wind, fuel, dynamic obstacles and the rules of the air. It is shown that MSA* finds a cost optimal solution using variable length, angle and velocity trajectory segments. These segments are approximated with a grid based cell sequence that provides an inherent tolerance to uncertainty. Computational efficiency is achieved by using variable successor operators to create a multi-resolution, memory efficient lattice sampling structure. Simulation studies on the UAV flight planning problem show that MSA* meets the time constraints of online replanning and finds paths of equivalent cost but in a quarter of the time (on average) of vector neighbourhood based A*.