Designing care bundle documentation to support the recognition and treatment of acute kidney injury: a route to quality improvement

The chapter describes development of care bundle documentation, through an iterative, user-centred design process, to support the recognition and treatment of acute kidney injury (AKI). The chapter details stages of user and stakeholder consultation, employed to develop a design response that was sensitive to user experience and need, culminating in simulation testing of a near final prototype. The development of supplementary awareness-raising materials, relating to the main care bundle tool is also discussed. This information design response to a complex clinical decision-making process is contrasted to other approaches to promoting AKI care. The need for different but related approaches to the working tool itself and the tool’s communication are discussed. More general recommendations are made for the development of communication tools to support complex clinical processes.

Interactive Vector Field Feature Identification

We introduce a flexible technique for interactive exploration of vector field data through classification derived from user-specified feature templates. Our method is founded on the observation that, while similar features within the vector field may be spatially disparate, they share similar neighborhood characteristics. Users generate feature-based visualizations by interactively highlighting well-accepted and domain specific representative feature points. Feature exploration begins with the computation of attributes that describe the neighborhood of each sample within the input vector field. Compilation of these attributes forms a representation of the vector field samples in the attribute space. We project the attribute points onto the canonical 2D plane to enable interactive exploration of the vector field using a painting interface. The projection encodes the similarities between vector field points within the distances computed between their associated attribute points. The proposed method is performed at interactive rates for enhanced user experience and is completely flexible as showcased by the simultaneous identification of diverse feature types.

Structure-Based Approach for the Study of Estrogen Receptor Binding Affinity and Subtype Selectivity

Estrogens exert important physiological effects through the modulation of two human estrogen receptor (hER) subtypes, alpa (hER alpha) and beta (hER beta). Because the levels and relative proportion of hER alpha and hER beta differ significantly in different target cells, selective hER ligands could target specific tissues or pathways regulated by one receptor subtype without affecting the other. To understand the structural and chemical basis by which small molecule modulators are able to discriminate between the two subtypes, we have applied three-dimensional target-based approaches employing a series of potent hER-ligands. Comparative molecular field analysis (CoMFA) studies were applied to a data set of 81 hER modulators, for which binding affinity values were collected for both hER alpha and hER beta. Significant statistical coefficients were obtained (hER alpha, q(2) = 0.76; hER beta, q(2) = 0.70), indicating the internal consistency of the models. The generated models were validated using external test sets, and the predicted values were in good agreement with the experimental results. Five hER crystal structures were used in GRID/PCA investigations to generate molecular interaction fields (MIF) maps. hER alpha and hER beta were separated using one factor. The resulting 3D information was integrated with the aim of revealing the most relevant structural features involved in hER subtype selectivity. The final QSAR and GRID/PCA models and the information gathered from 3D contour maps should be useful for the design or novel hER modulators with improved selectivity.

Tro, hopp och kärlek : Berättelser om återhämtning från psykisk ohälsa

Syftet med föreliggande studie var att undersöka vilken betydelse hopp, egenmakt samt stigmatisering kan ha i en återhämtningsprocess från psykisk ohälsa. En kvalitativ metod tillämpades och individuella intervjuer med deltagare ur Högskolan Dalarnas erfarenhetspanel genomfördes. För att analysera empirin tillämpades en kvalitativ innehållsanalys som resulterade i följande teman: att bli accepterad, hoppets förutsättningar samt normaliserande. Resultatet visade att hopp snarare var en produkt av återhämtningen än det var en bidragande faktor. Att bli accepterad främjade egenmakt och skyddade mot stigmatisering. Normaliserande faktorer som medmänsklighet och att se till de friska sidorna främjade egenmakt och bröt vanmakt. Uppsatsens resultat kan betraktas som erfarenhetsbaserad kunskap, vilket är en grundförutsättning för en evidensbaserad socialtjänst där brukarperspektivet betonas.

New approaches to gene discovery with animal models of obesity and diabetes

DNA-based approaches to the discovery of genes contributing to the development of type 2 diabetes have not been very successful despite substantial investments of time and money. The multiple gene-gene and gene-environment interactions that influence the development of type 2 diabetes mean that DNA approaches are not the ideal tool for defining the etiology of this complex disease. Gene expression-based technologies may prove to be a more rewarding strategy to identify diabetes candidate genes. There are a number of RNA-based technologies available to identify genes that are differentially expressed in various tissues in type 2 diabetes. These include differential display polymerase chain reaction (ddPCR), suppression subtractive hybridization (SSH), and cDNA microarrays. The power of new technologies to detect differential gene expression is ideally suited to studies utilizing appropriate animal models of human disease. We have shown that the gene expression approach, in combination with an excellent animal model such as the Israeli sand rat (Psammomys obesus), can provide novel genes and pathways that may be important in the disease process and provide novel therapeutic approaches. This paper will describe a new gene discovery, beacon, a novel gene linked with energy intake. As the functional characterization of novel genes discovered in our laboratory using this approach continues, it is anticipated that we will soon be able to compile a definitive list of genes that are important in the development of obesity and type 2 diabetes.

Partnerships for capacity building: community, governments and universities working together

This paper summarises initiatives in the area of capacity building between communities, governments and universities since Rio 1992.

First the global advances through the UN and associated agencies are described with lessons learned and challenges remaining being highlighted. This is followed by a similar approach for first regionally based initiatives and finally some of the better examples of nationally based approaches.

Among the key findings from the review were: trying to keep the initial message simple, asking the “user” what they want and what they need from capacity building, the use of local experts in capacity building where ever possible, universities extending themselves to engage in genuine partnerships as well as offering new courses, subjects, etc., attempting to match the strengths and weaknesses of partners in capacity building, concentrating on improving regional partnerships across national boundaries, deriving methods to sustain capacity building programs over the long term, questioning the absence of the private sector from capacity building partnerships, questioning whether capacity building is receiving the attention, funding and centrality to ICM promotion that it warrants, a proposal to build a global ICM capacity building network, the need for greater critical analysis of capacity building programs, integrating capacity building into ICM practices and recognising that effective capacity building practice may require some time and effort to build up, i.e. there are no universal “quick-fixes”.

Obesity and diabetes gene discovery approaches

New treatments are currently required for the common metabolic diseases obesity and type 2 diabetes. The identification of physiological and  biochemical factors that underlie the metabolic disturbances observed in obesity and type 2 diabetes is a key step in developing better therapeutic outcomes. The discovery of new genes and pathways involved in the  pathogenesis of these diseases is critical to this process, however  identification of genes that contribute to the risk of developing these diseases represents a significant challenge as obesity and type 2 diabetes are complex diseases with many genetic and environmental causes. A number of diverse approaches have been used to discover and validate potential new targets for obesity and diabetes. To date, DNA-based approaches using candidate gene and genome-wide linkage analysis have had limited success in identifying genomic regions or genes involved in the development of these diseases. Recent advances in the ability to evaluate linkage analysis data from large family pedigrees using variance components based linkage analysis show great promise in robustly identifying genomic regions associated with the development of obesity and diabetes. RNA-based technologies such as cDNA microarrays have identified many genes differentially expressed in tissues of healthy and diseased subjects. Using a combined approach, we are endeavouring to focus attention on differentially expressed genes located in chromosomal regions previously linked with obesity and / or diabetes. Using this strategy, we have identified Beacon as a potential new target for obesity and diabetes.

Methodological shifts in ratio-based modelling of corporate collapse

The year 1968 saw a major shift from univariate to multivariate methodological approaches to ratio-based modelling of corporate collapse. This was facilitated by the introduction of a new statistical tool called Multiple Discriminant Analysis (MDA). However, it did not take long before other statistical tools were developed. The primary objective for developing these tools was to enable deriving models that would at least do as good a job asMDA, but rely on fewer assumptions. With the introduction of new statistical tools, researchers became pre-occupied with testing them in signalling collapse. lLTUong the ratio-based approaches were Logit analysis, Neural Network analysis, Probit analysis, ID3, Recursive Partitioning Algorithm, Rough Sets analysis, Decomposition analysis, Going Concern Advisor, Koundinya and Purl judgmental approach, Tabu Search and Mixed Logit analysis. Regardless of which methodological approach was chosen, most were compared to MDA. This paper reviews these various approaches. Emphasis is placed on how they fared against MDA in signalling corporate collapse.

Adopting web-based learning and teaching: a case study in higher education

Most universities worldwide are becoming distance education providers through adopting web-based learning and teaching via the introduction of learning management systems that enable them to open their courses to both on- and off-campus students. Whether this is an effective introduction depends on factors that enable and impede the adoption of such systems and their related pedagogical strategies. This study examines such factors related to adopting a learning management system in a large multicampus urban Australian university. The research method used case study approaches and purposively selected the sample consisting of innovative teaching academics from across the university, who used web-based approaches to teach both on- and off-campus learners. The data were analyzed using a combination of Rogers' theory of diffusion of innovations and actor-network theory and revealed a series of enabling and impeding factors faced by pioneering technology-adopter teaching academics, some of which are technology related while others are policy related and common to large multicampus institutions. The study found that safe adoption environments recognizing career priorities of academics are a result of the continuous negotiation between the evolving institution and its innovative and creative staff. The article concludes with a series of conditions that would form a safe, enabling, and encouraging environment for technology-adopter teaching academics in a large multicampus higher education setting.

The spatial pattern of natural selection when selection depends upon experience

Apostatic (frequency‐ or density‐dependent) selection, aposematic signals, and mate choice behavior generally require that the mean prey or potential mate density m value be high enough (above a threshold T) to result in sufficient encounter rates for the searcher to learn or retain the association between conspicuous signals and prey unprofitability, to forage apostatically, or to choose among mates. This assumes that all searchers experience , which implicitly assumes an even dispersion of targets among searcher territories. Uneven dispersion generates new phenomena. If , then only territories with local density x values that are greater than T favor experience‐based behavior, leading to spatially variable frequency‐ or density‐dependent selection intensity. As aggregation increases, the increase in percentage of targets in favorable territories ( ) is greater than the increase in the percentage of territories that are favorable. The relationship is reversed when . In both cases, because as few as 10% of the territories can contain 80% of the targets, only a few territory holders may account for most of the selection on most of the target population; accidents of experience in only a few searchers can have unexpectedly large effects on the target population. This also provides an explanation for high searcher behavior variation (personalities) : individuals from favorable territories will behave differently in behavioral experiments than those from unfavorable territories, at least with respect to similar kinds of targets. These effects will generate spatial heterogeneity in natural and sexual selection in what are otherwise uniform environments.

Study of the Geelong Local Learning and Employment Network

In common with many Western nations, Australian governments, both state and federal, have increasingly embraced network-based approaches in responding to the effects of globalisation. Since 2001, thirty one Local Learning and Employment Networks (LLEN) have been established across all areas of Victoria, Australia in line with recommendations of a Ministerial Review into Post Compulsory Education and Training Pathways. That review reported that, in the globalised context, youth in transition from schooling to independence faced persistent and severe difficulties unknown to previous generations; it also found problems were frequently concentrated in particular groups and regions. LLEN bring together the expertise and experience of local education providers, industry, community organisations, individuals and government organisations. As a result of their local decisions, collaboration and community building efforts it is intended that opportunities for young people will be enhanced. My research was conducted within an Australian Research Council Linkage Project awarded to Deakin University Faculty of Education in partnership with the Smart Geelong Region LLEN (SGR LLEN). The Linkage Project included two separate research components one of which forms my thesis: a case study of SGR LLEN. My data was generated through participant observation in SGR LLEN throughout 2004 and 2005 and through interviews, reflective writing and archival review. In undertaking my analysis and presenting my thesis I have chosen to weave a series of panels whose orientation is poststructural. This approach was based in my acceptance that all knowledge is partial and fragmentary and, accordingly, researchers need to find ways that highlight the intersections in and indeterminacy of their empirical data. The LLEN is -by its nature as a network -more than the contractual entity that gains funding from government, acts as the administrative core and occupies the LLEN office. As such I have woven firstly the formation and operational structure of the bounded entity that is SGR LLEN before weaving a series of six images that portray the unbounded LLEN as an instance-in-action. The thesis draws its theoretical inspiration from the work of Deleuze and Guattari (1987). Despite increased use of notions of networks, local decision-making and community building by governments there had been little empirical research that explored stakeholder understandings of networks and their role in community building as well as a lack of theorisation of how networks actually ‘work.’ My research addresses this lack and suggests an instituted network can function as a learning community capable of fostering systemic change in the post compulsory education training and employment sector and thereby contributing to better opportunities for young people. However the full potential of the policy is undermined by the reluctance of governments to follow through on the implications of their policies and, in particular, to confront the limiting effects of performativity at all levels.

The methodology of students-as-researchers : valuing and using experience and expertise to develop methods

Students in England are increasingly involved in consultation and governance of schools. Some are also involved in researching their own learning, how they are taught, the kinds of curriculum on offer, and school policies and practices. In this article, we suggest that this could be seen as a form of “standpoint research”. We suggest that one way standpoint can be exercised is via the construction of experience-based research tools. We exemplify this through a student research project in which photo-elicitation and verbal scenarios based in students' understandings of their school did not produce an “authentic” and homogenised voice, but rather multiple perspectives of the classroom and wider school.

Extending double standards and stereotyping approaches to hiring older workers

This thesis examined factors underlying discrimination against older job applicants. Drawing upon stereotyping and double standards-based approaches to discrimination the thesis found that positive and negative aspects of the older worker stereotype can have cumulative effects on hiring decisions and may interact with job requirements to affect discrimination.

MUSTe method for quantifying virtual environment training system efficacy

In the current era increased attention and interest of utilizing advanced computer technologies for training and education at all managerial levels and functional areas is apparent. One of such technologies, virtual environment (VE), is perceived to be effective in enhancing human abilities to learn abstract concept and complex procedural tasks. Despite its adaptation for training and fast-paced technological advancements, ways in which to evaluate efficacy of such technology are unclear. We have approached this problem by developed a new evaluation method focus on cognitive, affective and skillbased learning dimensions, based on traditional usability evaluation methods but tailored to specifically suit for the quantification of 3D VE system. We first describe the construct of the new method and then report a study utilizing the method in the context of quantifying a VE efficacy in an object assembly task. At last, we discuss the implications of such a method.

A human rights-based practice framework for sexual offenders

Human rights create a protective zone around people and allow them the opportunity to further their own valued personal projects without interference from others. In our view, the emphasis on community rights and protection may, paradoxically, reduce the effectiveness of sex offender rehabilitation by ignoring or failing to ensure that offenders' core human interests are met. In this paper we consider how rights-based values and ideas can be integrated into therapeutic work with sex offenders in a way that safeguards the interests of offenders and the community. To this end we develop a rights-based normative framework (the Offender Practice Framework: OPF) that is orientated around the three strands of justice and accountability, offender needs and risk, and the utilization of empirically supported interventions and strength-based approaches. We examine the utility of this framework for the different phases of sex offender practice.