Change Point Estimation in Monitoring Survival Time

Precise identification of the time when a change in a hospital outcome has occurred enables clinical experts to search for a potential special cause more effectively. In this paper, we develop change point estimation methods for survival time of a clinical procedure in the presence of patient mix in a Bayesian framework. We apply Bayesian hierarchical models to formulate the change point where there exists a step change in the mean survival time of patients who underwent cardiac surgery. The data are right censored since the monitoring is conducted over a limited follow-up period. We capture the effect of risk factors prior to the surgery using a Weibull accelerated failure time regression model. Markov Chain Monte Carlo is used to obtain posterior distributions of the change point parameters including location and magnitude of changes and also corresponding probabilistic intervals and inferences. The performance of the Bayesian estimator is investigated through simulations and the result shows that precise estimates can be obtained when they are used in conjunction with the risk-adjusted survival time CUSUM control charts for different magnitude scenarios. The proposed estimator shows a better performance where a longer follow-up period, censoring time, is applied. In comparison with the alternative built-in CUSUM estimator, more accurate and precise estimates are obtained by the Bayesian estimator. These superiorities are enhanced when probability quantification, flexibility and generalizability of the Bayesian change point detection model are also considered.

Challenges of Measuring Learning Outcomes for Property Students Engaged in Work Integrated Learning

Work integrated learning (WIL) or professional practice units are recognised as providing learning experiences that help students make successful transitions to professional practice. These units require students to engage in learning in the workplace; to reflect on this learning; and to integrate it with learning at university. However, an analysis of a recent cohort of property economics students at a large urban university provides evidence that there is great variation in work based learning experiences undertaken and that this impacts on students’capacity to respond to assessment tasks which involve critiquing these experiences in the form of reflective reports. This paper highlights the need to recognise the diversity of work based experiences; the impact this has on learning outcomes; and to find more effective and equitable ways of measuring these outcomes. The paper briefly discusses assessing learning outcomes in WIL and then describes the model of WIL in the Faculty of Built Environment and Engineering at the Queensland University of Technology (QUT). The paper elaborates on the diversity of students’ experiences and backgrounds including variations in the length of work experience, placement opportunities and conditions of employment.For example, the analysis shows that students with limited work experience often have difficulty critiquing this work experience and producing high level reflective reports. On the other hand students with extensive, discipline relevant work experience can be frustrated by assessment requirements that do not take their experience into account. Added to this the Global Financial Crisis (GFC) has restricted both part time and full time placement opportunities for some students. These factors affect students’ capacity to a) secure a relevant work experience, b) reflect critically on the work experiences and c) appreciate the impact the overall experience can have on their learning outcomes and future professional opportunities. Our investigation highlights some of the challenges faced in implementing effective and equitable approaches across diverse student cohorts. We suggest that increased flexibility in assessment requirements and increased feedback from industry may help address these challenges.

Meaningful musical engagement : the potential impact of generative music systems on learning experiences

In order to create music, the student must establish a relationship with the musical materials. In this thesis, I examine the capacity of a generative music system called jam2jam to offer individuals a virtual musical play-space to explore. I outline the development of an iteration of software development named jam2jam blue and the evolution of a games-like user interface in the research design that jointly revealed the nature of this musical exploration. The findings suggest that the jam2jam blue interface provided an expressive gestural instrument to jam and experience musicmaking. By using the computer as an instrument, participants in this study were given access to meaningful musical experiences in both solo and ensemble situations and the researcher is allowed a view of their development of a relationship with the musical materials from the perspective of the individual participants. Through an iterative software development methodology, pedagogy and experience design were created simultaneously. The research reveals the potential for the jam2jam software to be used as a reflective tool for feedback and assessment purposes. The power of access to ensemble music making is realised though the participants’ virtual experiences which are brought into their physical space by sharing their experience with others. It is suggested that this interaction creates an environment conducive to self-initiated learning in which music is the language of interaction. The research concludes that the development of a relationship between the explorer and the musical materials is subject to the collaborative nature of the interaction through which the music is experienced.

Patient-practitioner relationships desired by overweight/obese adults

Objective: This study investigated the characteristics of the patient-practitioner relationship desired by overweight/obese individuals in weight management. The aim was to identify characteristics of the relationship which empower patients to make lifestyle changes. Methods: Grounded theory was used inductively to build a model of the patient-practitioner relationship based on the perspectives of 21 overweight/obese ¬adults. Results: Emerging from the match between patient and practitioner characteristics, collaboration was the key process explicitly occurring in the patient-practitioner relationship, and was characterised by two subcategories; perceived power dimensions and openness. Trust emerged implicitly from the collaborative process, being fostered by relational, informational, and credible aspects of the interaction. Patient trust in their practitioner consequently led to empowering outcomes including goal ownership and perceiving the utility of changes. Conclusion: An appropriate match between patient and practitioner characteristics facilitates collaboration which leads to trust, both of which appear to precede empowering outcomes for patients such as goal ownership and perceiving the utility of changes. Collaboration is an explicit process and precedes the patient trusting their practitioner. Practice implications: Practitioners should be sensitive to patient preferences for collaboration and the opportunity to develop trust with patients relationally, through information provision, and modelling a healthy lifestyle.

A potential HIV epidemic among male street laborers in urban Vietnam

Background: Mass migration to Asian cities is a defining phenomenon of the present age, as hundreds of millions of people move from rural areas or between cities in search of economic prosperity. Although many do prosper, large numbers of people experience significant social disadvantage. This is especially the case among poorly educated, migrant unskilled unregistered male laborers who do much of the manual work throughout the cities. These men are at significant risk for many health problems, including HIV infection. However, to date there has been little research in developing countries to explain the determinants of this risk, and thereby to suggest feasible preventive strategies. Objectives and Methodology: Using combined qualitative and quantitative methods, the aim of this study was to explore the social contexts that affect health vulnerabilities and to develop conceptual models to predict risk behaviors for HIV [illicit drug use, unsafe sex, and non-testing for HIV] among male street laborers in Hanoi, Vietnam. Qualitative Research: Sixteen qualitative interviews revealed a complex variety of life experiences, beliefs and knowledge deficits that render these mostly poor and minimally educated men vulnerable to health problems including HIV infection. This study formed a conceptual model of numerous stressors related to migrants’ life experiences in urban space, including physical, financial and social factors. A wide range of coping strategies were adopted to deal with stressors – including problem-focused coping (PFC) and emotion-focused coping (EFC), pro-social and anti-social, active and passive. These men reported difficulty in coping with stressors because they had weak social networks and lacked support from formal systems. A second conceptual model emerged that highlighted equivalent influences of individual psychological factors, social integration, social barriers, and accessibility regarding drug use and sexual risk behavior. Psychological dimensions such as tedium, distress, fatalism and revenge, were important. There were strong effects of collective decision-making and fear of social isolation on shaping risk behaviors. These exploratory qualitative interviews helped to develop a culturally appropriate instrument for the quantitative survey and informed theoretical models of the factors that affect risk behaviors for HIV infection. Quantitative Research: The Information-Motivation-Behavioral Skills (IMB) model was adopted as the theoretical framework for a large-scale survey. It was modified to suit the contexts of these Vietnamese men. By doing a social mapping technique, 450 male street laborers were interviewed in Hanoi, Vietnam. The survey revealed that the risk of acquiring and transmitting HIV was high among these men. One in every 12 men reported homosexual or bisexual behavior. These men on average had 3 partners within the preceding year, and condom use was inconsistent. One third had had sex with commercial sex workers (CSW) and only 30% of them reported condom use; 17% used illicit drugs sometimes, with 66.7% of them frequently sharing injecting equipment with peers. Despite the risks, only 19.8% of men had been tested for HIV during the previous 12 months. These men have limited HIV knowledge and only moderate motivation and perceived behavioral skills for protective behavior. Although rural-to-urban migration was not associated with sexual risk behavior, three elements of the IMB model and depression associated with the process of mobility were significant determinants of sexual behavior. A modified model that incorporated IMB elements and psychosocial stress was found to be a better fit than the original IMB model alone in predicting protected sex behavior among the men. Men who were less psychologically and socially stressed, better informed and motivated for HIV prevention were more likely to demonstrate behavioral skills, and in turn were more likely to engage in safer sexual behavior. With regard to drug use, although the conventional model accounted for slightly less variance than the modified IMB model, data were of better fit for the conventional model. Multivariate analyses revealed that men who originated from urban areas, those who were homo- or bi-sexually identified and had better knowledge and skills for HIV prevention were more likely to access HIV testing, while men who had more sexual partners and those who did not use a condom for sex with CSW were least likely to take a test. The modified IMB model provided a better fit than the conventional model, as it explained a greater variance in HIV testing. Conclusions and Implications: This research helps to highlight a potential hidden HIV epidemic among street male, unskilled, unregistered laborers. This group has multiple vulnerabilities to HIV infection through both their partners and peers. However, most do not know their HIV status and have limited knowledge about preventing infection. This is the first application of a modified IMB model of risk behaviors for HIV such as drug use, condom use, and uptake of HIV testing to research with male street laborers in urban settings. The study demonstrated that while the extended IMB model had better fit than the conventional version in explaining the behaviors of safe sex and HIV testing, it was not so for drug use. The results provide interesting directions for future research and suggest ways to effectively design intervention strategies. The findings should shed light on culturally appropriate HIV preventive education and support programs for these men. As Vietnam has much in common with other developing countries in Southeast Asia, this research provides evidence for policy and practice that may be useful for public health systems in similar countries.

From slum to suburbia : examining a spectrum of planned and unplanned urban morphology in humid sub-tropical regions of the world

The current rapid urban growth throughout the world manifests in various ways and historically cities have grown, similarly, alternately or simultaneously between planned extensions and organic informal settlements (Mumford, 1989). Within cities different urban morphological regions can reveal different contexts of economic growth and/or periods of dramatic social/technological change (Whitehand, 2001, 105). Morpho-typological study of alternate contexts can present alternative models and contribute to the present discourse which questions traditional paradigms of urban planning and design (Todes et al, 2010). In this study a series of cities are examined as a preliminary exploration into the urban morphology of cities in ‘humid subtropical’ climates. From an initial set of twenty, six cities were selected: Sao Paulo, Brazil; Jacksonville, USA; Maputo, Mozambique; Kanpur, India; Hong Kong, China; and Brisbane, Australia. The urban form was analysed from satellite imagery at a constant scale. Urban morphological regions (types) were identified as those demonstrating particular consistant characteristics of form (density, typology and pattern) different to their surroundings when examined at a constant scale. This analysis was correlated against existing data and literature discussing the proliferation of two types of urban development, ‘informal settlement’ (defined here as self-organised communities identifiable but not always synonymous with ‘slums’) and ‘suburbia’ (defined here as master planned communities of generally detached houses prevalent in western society) - the extreme ends of a hypothetical spectrum from ‘planned’ to ‘spontaneous’ urban development. Preliminary results show some cities contain a wide variety of urban form ranging from the highly organic ‘self-organised’ type to the highly planned ‘master planned community’ (in the case of Sao Paulo) while others tend to fall at one end of the planning spectrum or the other (more planned in the cases of Brisbane and Jacksonville; and both highly planned and highly organic in the case of Maputo). Further research will examine the social, economical and political drivers and controls which lead to this diversity or homogeneity of urban form and speculates on the role of self-organisation as a process for the adaptation of urban form.

Teaching planning beyond the national context : pedagogic analyses of international fieldtrip experiences

Urban and regional planners, in the era of globalization, require being equipped with skill sets to better deal with complex and rapidly changing economic, socio-cultural, political and environmental fabrics of cities and their regions. In order to provide such skill sets, urban and regional planning curriculum of Queensland University of Technology (Brisbane, Australia) offers regional planning practice in the international context. This paper reports the findings of the pedagogic analyses from the regional planning practice fieldtrips to Malaysia, Korea, Turkey, Taiwan, and discusses the opportunities and constraints of exposure of students to regional planning practice beyond the national context.

Emergency department in hospitals, a window of the world : a preliminary comparison between Australia and China

BACKGROUND: This study aimed to make a preliminary comparison of emergency department (ED) presentations between Australia and China. The comparison could provide insights into the health systems and burden of diseases and potentially stimulate discussion about the development of acute health system in China. METHODS: An observational study was performed to compare Australian ED presentations using data obtained from a single adult tertiary-referral teaching hospital in metropolitan Brisbane against Chinese ED presentations using public domain information published in existing Chinese and international medical journals. RESULTS: There are major differences in ED presentations between Australia and China. In 2008, 1) 35.4% of patients arrived at a tertiary teaching hospital ED in Brisbane, Australia by ambulance; 2) 1.7% were treated for poisoning; 3) 1.4% for cerebral vascular disease; 4) 1.7% for cardiac disease; and 5) 42.6% for trauma. The top events diagnosed were mental health problems including general psychiatric examination, psychiatric review, alcohol abuse, and counselling for alcohol abuse, which accounted for 5.5% of all ED presentations. Among ED patients in China, 6.7% arrived at a tertiary teaching hospital by ambulance in Shenyang in 1997; 3.7% were treated for poisoning in Shanxi Zhouzhi County People's Hospital ED in 2006; 14.9% for cerebral vascular diseases at Qinghai People's Hospital ED in 1993-1995; 1.7% for cardiac diseases at the Second People's Hospital ED, Shenzhen Longgang in 1993; and 44.3% for trauma at Shanxi Zhouzhi County People's Hospital ED in 2006. The top events were trauma and poisoning among the young and cerebral infarction in the older population. CONCLUSIONS: Compared with Australian, Chinese ED patients had 1) lower ambulance usage; 2) higher proportion of poisoning; 3) higher proportion of cerebral vascular diseases; 4) similar proportion of cardiac disease; 5) similar proportion of trauma; and 6) little reported mental health problems. Possible explanations for these differences in China include a pay for service pre-hospital care system, lack of public awareness about poisons, inadequate hypertension management, and lack of recognition of mental health problems.

Positive emotional experiences with portable interactive products

Positive emotions are central to human life and have implications to the overall quality of people's life (Fredrickson, 1998). This paper reports on positive experiences with two types of portable interactive devices (PIDs), specifically media/entertainment and medical/health devices. The study is based on a six-month longitudinal study exploring people's emotional experience and how PIDs mediate these experiences in everyday contexts. Previous findings by the authors (Gomez, Popovic & Blackler, 2011) presented four categories of activities including Feature, Functional, Mediation and Auxiliary activities and their relationship to emotional experience. The paper presents emotional experiences with specific activities reported with a focus on positive emotions. It concludes with a discussion of the findings on positive experiences and the implications for the future design of PIDs.

Experiences with implementing common mathematical operations using field programmable gate arrays

Many computationally intensive scientific applications involve repetitive floating point operations other than addition and multiplication which may present a significant performance bottleneck due to the relatively large latency or low throughput involved in executing such arithmetic primitives on commod- ity processors. A promising alternative is to execute such primitives on Field Programmable Gate Array (FPGA) hardware acting as an application-specific custom co-processor in a high performance reconfig- urable computing platform. The use of FPGAs can provide advantages such as fine-grain parallelism but issues relating to code development in a hardware description language and efficient data transfer to and from the FPGA chip can present significant application development challenges. In this paper, we discuss our practical experiences in developing a selection of floating point hardware designs to be implemented using FPGAs. Our designs include some basic mathemati cal library functions which can be implemented for user defined precisions suitable for novel applications requiring non-standard floating point represen- tation. We discuss the details of our designs along with results from performance and accuracy analysis tests.

Sustainable urban infrastructure development in South East Asia : evidence from Hong Kong, Kuala Lumpur and Singapore

Many South East Asian cities have experienced substantial physical, economic and social transformations during the past several decades. The rapid pace of globalization and economic restructuring has resulted in these cities receiving the full impact of urbanization pressures. In an attempt to ease these pressures, cities such as Singapore, Hong Kong and Kuala Lumpur have advocated growth management approaches focusing especially on urban infrastructure sustainability. These approaches aim to achieve triple bottom line sustainability by balancing economic and social development, and environmental protection. This chapter evaluates three Asia-Pacific city cases, Singapore, Hong Kong and Kuala Lumpur, and assesses their experiences in managing their urban forms and infrastructure whilst promoting sustainable patterns of urban development.

Success factors for ICT shared services in the higher education sector

Shared services is a prominent organizational arrangement for organizations, in particular for support functions. The success (or failure) of shared services is a critical concern as the move to shared services can entail large scale investment and involve fundamental organizational change. The Higher Education (HE) sector is particularly well poised to benefit from shared services as there is a need to improve organizational performance and strong potential from sharing. Through a multiple case study of shared services experiences in HE, this study identifies ten important antecedents of shared services success: (1) Understanding of shared services; (2) Organizational environment; (3) Top management support; (4) IT environment; (5) Governance; (6) Process centric view; (7) Implementation strategy; (8) Project management; (9) Change management; and (10) Communication. The study then develops a preliminary model of shared services success that addresses the interdependencies between the success factors. As the first empirical success model for shared services, it provides valuable guidance to practice and future research.

Fish out of water : refugee and international students in mainstream Australian schools

In this paper, the authors combine Pierre Bourdieu’s concept of hysteresis (the ‘fish out of water’ experience) with the discourse historical approach to critical discourse analysis (CDA) as a theoretical and analytical framework through which they examine specific moments in the schooling experiences of one refugee student and one international student, both enrolled in post-compulsory education in Australian mainstream secondary schools. We examine specific moments – as narrated by these students during interviews – in which these students can be described as ‘fish out of water’. As such, this paper takes up the concerns of researchers who call for an examination of the lived geographies and the everyday lives of individual students in mainstream schools. We find that our students’ habitus, conditioned by their previous schooling experiences in their home countries, did not match their new Australian schools, resulting in frustration with, and alienation from, their mainstream schools. However, we also note that schools, too, need to adapt and adjust their habitus to the new multicultural world, in which there are international and refugee students among their usual cohort of mainstream students.