Rebuilding in Ranongga : reflecting on practice based research

Two hundred million people are displaced annually due to natural disasters with a further one billion living in inadequate conditions in urban areas. Architects have a responsibility to respond to this statistic as the effects of natural and social disasters become more visibly catastrophic when paired with population rise. The research discussed in this paper initially questions and considers how digital tools can be employed to enhance rebuilding processes, but still achieve sensitive, culturally appropriate and accepted built solutions. Secondly the paper reflects on the impact ‘real-world’ projects have on architectural education. Research aspirations encouraged an atypical ‘research by design’ methodology involving a focused case study in the recently devastated village Keigold, Ranongga, Solomon Islands. Through this qualitative approach specific place data and the accounts of those affected were documented through naturalistic and archival methods of observation and participation. Findings reveal a number of unanticipated results which would have been otherwise undetected if field research within the design and rebuilding process was not undertaken, reflecting the importance of place specific research in the design process. Ultimately, the study proves that it is critical for issues of disaster to be addressed on a local rather than global scale; decisions cannot be speculative, or solved at a distance, but require intensive collaborative work with communities to achieve optimum solutions. Architectural education and design studios would continue to benefit from focused community engagement and field research within the design process.

The effectiveness of non-pharmacological interventions in improving psychological outcomes for heart transplant recipients : a systematic review

Background Post-heart transplant psychological distress may both directly hinder physiological health as well as indirectly impact on clinical outcomes by increasing unhealthy behaviours, such as immunosuppression non-adherence. Reducing psychological distress for heart transplant recipients is therefore vitally important, in order to improve patients’ overall health and well-being but also clinical outcomes, such as morbidity and mortality. Evidence from other populations suggests that non-pharmacological interventions may be an effective strategy. Aim To appraise the efficacy of non-pharmacological interventions on psychological outcomes after heart transplant. Method A systematic review was conducted using the Joanna Briggs Institute methodology. Experimental and quasi-experimental studies that involved any non-pharmacological intervention for heart transplant recipients were included, provided that data on psychological outcomes were reported. Multiple electronic databases were searched for published and unpublished studies and reference lists of retrieved studies were scrutinized for further primary research. Data were extracted using a standardised data extraction tool. Included studies were assessed by two independent reviewers using standardised critical appraisal instruments. Results Three studies fulfilled the inclusion and exclusion criteria, which involved only 125 heart transplant recipients. Two studies reported on exercise programs. One study reported a web-based psychosocial intervention. While psychological outcomes significantly improved from baseline to follow-up for the recipients who received the interventions, between-group comparisons were not reported. The methodological quality of the studies was judged to be poor. Conclusions Further research is required, as we found there is insufficient evidence available to draw conclusions for or against the use of non-pharmacological interventions after heart transplant.

A rural health education, training and research network

The purpose of the Rural Health Education, Training and Research Network is to support the education and training of rural health practitioners and research in rural health through the optimum use of appropriate information and communication technologies to link and inform all individuals and organisation involved in the teaching, planning and delivery of health care in rural and remote Queensland. The health care of people in rural areas has the potential to be enhanced, through providing the rural and remote health professionals in Queensland with the same access to educational and training opportunities as their metropolitan colleagues. This consultative, coordinated approach should be cost-effective through both increasing awareness and utilisation of existing and developing networks, and through more efficient and rational use of both the basic and sophisticated technologies which support them. Technological hardware, expertise and infrastructure are already in place in Queensland to support a Rural Health Education, Training and Research Network, but are not being used to their potential, more often due to a lack of awareness of their existence and utility than to their perceived costs. Development of the network has commenced through seeding funds provided by Queensland Health. Future expansion will ensure access by health professionals to existing networks within Queensland. This paper explores the issues and implications of a network for rural health professionals in Queensland and potentially throughout Australia, with a specific focus on the implications for rural and isolated health professional.

A point prevalence study of cancer nursing practices for managing intravascular devices in an Australian tertiary cancer center

Purpose The use of intravascular devices is associated with a number of potential complications. Despite a number of evidence-based clinical guidelines in this area, there continues to be nursing practice discrepancies. This study aims to examine nursing practice in a cancer care setting to identify nursing practice and areas for improvement respective to best available evidence. Methods A point prevalence survey was undertaken in a tertiary cancer care centre in Queensland, Australia. On a randomly selected day, four nurses assessed intravascular device related nursing practices and collected data using a standardized survey tool. Results 58 inpatients (100%) were assessed. Forty-eight (83%) had a device in situ, comprising 14 Peripheral Intravenous Catheters (29.2%), 14 Peripherally Inserted Central Catheters (29.2%), 14 Hickman catheters (29.2%) and six Port-a-Caths (12.4%). Suboptimal outcomes such as incidences of local site complications, incorrect/inadequate documentation, lack of flushing orders, and unclean/non intact dressings were observed. Conclusions This study has highlighted a number of intravascular device related nursing practice discrepancies compared with current hospital policy. Education and other implementation strategies can be applied to improve nursing practice. Following education strategies, it will be valuable to repeat this survey on a regular basis to provide feedback to nursing staff and implement strategies to improve practice. More research is required to provide evidence to clinical practice with regards to intravascular device related consumables, flushing technique and protocols.

National survey of viruses in pastures of subterranean clover. II. Statistical methodology for large scale quantitative ELISA

Statistical methodology was applied to a survey of time-course incidence of four viruses (alfalfa mosaic virus, clover yellow vein virus, subterranean clover mottle virus and subterranean clover red leaf virus) in improved pastures in southern regions of Australia. -from Authors

A methodology for effective implementation of lean strategies and its performance evaluation in manufacturing organizations

Purpose – The purpose of this paper is to develop an effective methodology for implementing lean manufacturing strategies and a leanness evaluation metric using continuous performance measurement (CPM). Design/methodology/approach – Based on five lean principles, a systematic lean implementation methodology for manufacturing organizations has been proposed. A simplified leanness evaluation metric consisting of both efficiency and effectiveness attributes of manufacturing performance has been developed for continuous evaluation of lean implementation. A case study to validate the proposed methodology has been conducted and proposed CPM metric has been used to assess the manufacturing leanness. Findings – Proposed methodology is able to systematically identify manufacturing wastes, select appropriate lean tools, identify relevant performance indicators, achieve significant performance improvement and establish lean culture in the organization. Continuous performance measurement matrices in terms of efficiency and effectiveness are proved to be appropriate methods for continuous evaluation of lean performance. Research limitations/implications – Effectiveness of the method developed has been demonstrated by applying it in a real life assembly process. However, more tests/applications will be necessary to generalize the findings. Practical implications – Results show that applying the methods developed, managers can successfully identify and remove manufacturing wastes from their production processes. By improving process efficiency, they can optimize their resource allocations. Manufacturers now have a validated step by step methodology for successfully implementing lean strategies. Originality/value – According to the authors’ best knowledge, this is the first known study that proposed a systematic lean implementation methodology based on lean principles and continuous improvement techniques. Evaluation of performance improvement by lean strategies is a critical issue. This study develops a simplified leanness evaluation metric considering both efficiency and effectiveness attributes and integrates it with the lean implementation methodology.

A methodology for estimating exposure-controlled crash risk using traffic Police crash data

Exposure control or case-control methodologies are common techniques for estimating crash risks, however they require either observational data on control cases or exogenous exposure data, such as vehicle-kilometres travelled. This study proposes an alternative methodology for estimating crash risk of road user groups, whilst controlling for exposure under a variety of roadway, traffic and environmental factors by using readily available police-reported crash data. In particular, the proposed method employs a combination of a log-linear model and quasi-induced exposure technique to identify significant interactions among a range of roadway, environmental and traffic conditions to estimate associated crash risks. The proposed methodology is illustrated using a set of police-reported crash data from January 2004 to June 2009 on roadways in Queensland, Australia. Exposure-controlled crash risks of motorcyclists—involved in multi-vehicle crashes at intersections—were estimated under various combinations of variables like posted speed limit, intersection control type, intersection configuration, and lighting condition. Results show that the crash risk of motorcycles at three-legged intersections is high if the posted speed limits along the approaches are greater than 60 km/h. The crash risk at three-legged intersections is also high when they are unsignalized. Dark lighting conditions appear to increase the crash risk of motorcycles at signalized intersections, but the problem of night time conspicuity of motorcyclists at intersections is lessened on approaches with lower speed limits. This study demonstrates that this combined methodology is a promising tool for gaining new insights into the crash risks of road user groups, and is transferrable to other road users.

Text messaging to support off-campus clinical nursing facilitators : a descriptive survey

Background Managing large student cohorts can be a challenge for university academics, coordinating these units. Bachelor of Nursing programmes have the added challenge of managing multiple groups of students and clinical facilitators whilst completing clinical placement. Clear, time efficient and effective communication between coordinating academics and clinical facilitators is needed to ensure consistency between student and teaching groups and prompt management of emerging issues. Methods This study used a descriptive survey to explore the use of text messaging via a mobile phone, sent from coordinating academics to off-campus clinical facilitators, as an approach to providing direction and support. Results The response rate was 47.8% (n = 22). Correlations were found between the approachability of the coordinating academic and clinical facilitator perception that, a) the coordinating academic understood issues on clinical placement (r = 0.785, p < 0.001), and b) being part of the teaching team (r = 0.768, p < 0.001). Analysis of responses to qualitative questions revealed three themes: connection, approachability and collaboration. Conclusions This study demonstrates that use of regular text messages improves communication between coordinating academics and clinical facilitators. Findings suggest improved connection, approachability and collaboration between the coordinating academic and clinical facilitation staff.

Humanities and social scientific research methods in porn studies

Porn studies researchers in the humanities have tended to use different research methods from those in social sciences. There has been surprisingly little conversation between the groups about methodology. This article presents a basic introduction to textual analysis and statistical analysis, aiming to provide for all porn studies researchers a familiarity with these two quite distinct traditions of data analysis. Comparing these two approaches, the article suggests that social science approaches are often strongly reliable – but can sacrifice validity to this end. Textual analysis is much less reliable, but has the capacity to be strongly valid. Statistical methods tend to produce a picture of human beings as groups, in terms of what they have in common, whereas humanities approaches often seek out uniqueness. Social science approaches have asked a more limited range of questions than have the humanities. The article ends with a call to mix up the kinds of research methods that are applied to various objects of study.

Current dementia research in Australia : a report from the Alzheimer's Australia 15th National Conference

The Alzheimer’s Australia 15th National Conference held on 14–17 May 2013 in Hobart (Tasmania, Australia) attracted a wide range of attendees, including people living with dementia, family caregivers, health professionals and researchers. The conference theme, The Tiles of Life Coloring the Future, invoking a vision of a better future for those affected by dementia, had seven subthemes: liberation, rehabilitation, leisure,service, creativity, wellbeing and research.

What is the evidence to guide best practice for the management of older people with cognitive impairment presenting to emergency departments? A systematic review

The aim of this study was to conduct a systematic literature review of research-based studies to identify practices designed to meet the specific care needs of older cognitively impaired patients in emergency departments (ED). A systematic literature review of studies was completed using PRIMSA methodology. The search criteria included articles from both emergency and acute care settings. A total of 944 articles were screened, and a total of 43 articles were identified as eligible. The review found a number of intervention studies to improve quality of care for older persons with cognitive impairment carried out or commenced in emergency settings, including interventions to improve cognitive impairment recognition (n = 9) and clinical approaches to reduce falls (n = 1) and both delirium incidence and prevalence (n = 2). Relevant studies carried out in acute care settings regarding cognitive impairment recognition (n = 4) and primary and secondary prevention of delirium (n = 18) and intervention studies that reduced the prescription of deliriogenic drugs (n = 1), reduced behavioral symptoms and discomfort (n = 7), and improved nutritional intake (n = 1) in hospitalized older persons with dementia were also identified. There is limited research available that reports interventions that improve the quality of care of older ED patients with cognitive impairment. Although this review found evidence obtained from the acute care setting, additional research is needed to identify whether these interventions are beneficial in fast-paced emergency settings.

A short-term production scheduling methodology for open-pit mines

A multi-resource multi-stage scheduling methodology is developed to solve short-term open-pit mine production scheduling problems as a generic multi-resource multi-stage scheduling problem. It is modelled using essential characteristics of short-term mining production operations such as drilling, sampling, blasting and excavating under the capacity constraints of mining equipment at each processing stage. Based on an extended disjunctive graph model, a shifting-bottleneck-procedure algorithm is enhanced and applied to obtain feasible short-term open-pit mine production schedules and near-optimal solutions. The proposed methodology and its solution quality are verified and validated using a real mining case study.

Innovation through action research in environmental education : from project to praxis

This thesis is a work-in-progress that articulates my research journey based on the development of a curriculum innovation in environmental education. This journey had two distinct, but intertwined phases: action research based fieldwork, conducted collaboratively, to create a whole school approach to environmental education curriculum planning; and a phase of analysis and reflection based on the emerging findings, as I sought to create personal "living educational theory" about change and innovation. A key stimulus for the study was the perceived theory-practice gap in environmental education, which is often presented in the literature as a criticism of teachers for failing to achieve the values and action objectives of critical environmental education. Hence, many programs and projects are considered to be superficial and inconsequential in terms of their ability to seriously address environmental issues. The intention of this study was to work with teachers in a project that would be an exemplar of critical environmental education. This would be in the form of a whole school "learnscaping" curriculum in a primary school whereby the schoolgrounds would be utilised for interdisciplinary critical environment education. Parallel with the three cycles of action research in this project, my research objectives were to identify and comment upon the factors that influence the generation of successful educational innovation. It was anticipated that the project would be a collaboration involving me, as researcher-facilitator, and many of the teachers in the school as active participants. As the project proceeded through its action cycles, however, it became obvious that the goal of developing a critical environmental education curriculum, and the use of highly participatory processes, were unrealistic. Institutional and organisational rigidities in education generally, teachers' day-to-day work demands, and the constant juggle of work, family and other responsibilities for all participants acted as significant constraints. Consequently, it became apparent that the learnscaping curriculum would not be the hoped-for exemplar. Progress was slow and, at times, the project was in danger of stalling permanently. While the curriculum had some elements of critical environmental education, these were minor and not well spread throughout the school. Overall, the outcome seemed best described as a "small win"; perhaps just another example of the theory-practice gap that I had hoped this project would bridge. Towards the project's end, however, my continuing reflection led to an exploration of chaos/complexity theory which gave new meaning to the concept of a "small win". According to this theory, change is not the product of linear processes applied methodically in purposeful and diligent ways, but emerges from serendipitous events that cannot be planned for, or forecast in advance. When this perspective of change is applied to human organisations - in this study, a busy school - the context for change is recognised not as a stable, predictable environment, but as a highly complex system where change happens all the time, cannot be controlled, and no one can be really sure where the impacts might lead. This so-called "butterfly effect" is a central idea of this theory where small changes or modifications are created - the effects of which are difficult to know, let alone determine - and which can have large-scale impacts. Allied with this effect is the belief that long term developments in an organisation that takes complexity into account, emerge by spontaneous self-organising evolution, requiring political interaction and learning in groups, rather than systematic progress towards predetermined goals or "visions". Hence, because change itself and the contexts of change are recognised as complex, chaos/complexity theory suggests that change is more likely to be slow and evolutionary - cultural change - rather than fast and revolutionary where the old is quickly ushered out by radical reforms and replaced by new structures and processes. Slow, small-scale changes are "normal", from a complexity viewpoint, while rapid, wholesale change is both unlikely and unrealistic. Therefore, the frustratingly slow, small-scale, imperfect educational changes that teachers create - including environmental education initiatives - should be seen for what they really are. They should be recognised as successful changes, the impacts of which cannot be known, but which have the potential to magnify into large-scale changes into the future. Rather than being regarded as failures for not meeting critical education criteria, "small wins" should be cause for celebration and support. The intertwined phases of collaborative action research and individual researcher reflection are mirrored in the thesis structure. The first three chapters, respectively, provide the thesis overview, the literature underpinning the study's central concern, and the research methodology. Chapters 4, 5, and 6 report on each of the three action research cycles of the study, namely Laying the Groundwork, Down to Work!, and The Never-ending Story. Each of these chapters presents a narrative of events, a literature review specific to developments in the cycle, and analysis and critique of the events, processes and outcomes of each cycle. Chapter 7 provides a synthesis of the whole of the study, outlining my interim propositions about facilitating curriculum change in schools through action research, and the implications of these for environmental education.

Advancing Nursing Practice in Pain Management

This book showcases the development and evaluation of innovative examples of pain management initiatives by advanced practitioners. It considers each service development or community initiative both in terms of advanced practice nursing and pain management. There is a wide range of examples of innovation in pain management included - from the introduction of ketamine use in one trust, to wider issues around meeting the needs of pain management in the community. The book considers issues including use of research, education and interprofessional working in the advanced practitioner role. Each chapter looks at development of the service, challenges of implementation, evaluation of the service's success and justifying the importance of the advanced nurse in the service's achievements.

Is age a factor in the success or failure of remote monitoring in heart failure? Telemonitoring and structured telephone support in elderly heart failure patients

Background There are few data regarding the effectiveness of remote monitoring for older people with heart failure. We conducted a post-hoc sub-analysis of a previously published large Cochrane systematic review and meta-analysis of relevant randomized controlled trials to determine whether structured telephone support and telemonitoring were effective in this population. Methods A post hoc sub-analysis of a systematic review and meta-analysis that applied the Cochrane methodology was conducted. Meta-analyses of all-cause mortality, all-cause hospitalizations and heart failure-related hospitalizations were performed for studies where the mean or median age of participants was 70 or more years. Results The mean or median age of participants was 70 or more years in eight of the 16 (n=2,659/5,613; 47%) structured telephone support studies and four of the 11 (n=894/2,710; 33%) telemonitoring studies. Structured telephone support (RR 0.80; 95% CI=0.63-1.00) and telemonitoring (RR 0.56; 95% CI=0.41-0.76) interventions reduced mortality. Structured telephone support interventions reduced heart failure-related hospitalizations (RR 0.81; 95% CI=0.67-0.99). Conclusion Despite a systematic bias towards recruitment of individuals younger than the epidemiological average into the randomized controlled trials, older people with heart failure did benefit from structured telephone support and telemonitoring. These post-hoc sub-analysis results were similar to overall effects observed in the main meta-analysis. While further research is required to confirm these observational findings, the evidence at hand indicates that discrimination by age alone may be not be appropriate when inviting participation in a remote monitoring service for heart failure.