Supportive and palliative care for lung cancer patients

Lung cancer patients face poor survival and experience co-occurring chronic physical and psychological symptoms. These symptoms can result in significant burden, impaired physical and social function and poor quality of life. This paper provides a review of evidence based interventions that support best practice supportive and palliative care for patients with lung cancer. Specifically, interventions to manage dyspnoea, one of the most common symptoms experienced by this group, are discussed to illustrate the emerging evidence base in the field. The evidence base for the pharmacological management of dyspnoea report systemic opioids have the best available evidence to support their use. In particular, the evidence strongly supports systemic morphine preferably initiated and continued as a once daily sustained release preparation. Evidence supporting the use of a range of other adjunctive non-pharmacological interventions in managing the symptom is also emerging. Interventions to improve breathing efficiency that have been reported to be effective include pursed lip breathing, diaphragmatic breathing, positioning and pacing techniques. Psychosocial interventions seeking to reduce anxiety and distress can also improve the management of breathlessness although further studies are needed. In addition, evidence reviews have concluded that case management approaches and nurse led follow-up programs are effective in reducing breathlessness and psychological distress, providing a useful model for supporting implementation of evidence based symptom management strategies. Optimal outcomes from supportive and palliative care interventions thus require a multilevel approach, involving interventions at the patient, health professional and health service level.

Technological tools for science classrooms : choosing and using for productive and sustainable teaching and learning experiences

In this age of rapidly evolving technology, teachers are encouraged to adopt ICTs by government, syllabus, school management, and parents. Indeed, it is an expectation that teachers will incorporate technologies into their classroom teaching practices to enhance the learning experiences and outcomes of their students. In particular, regarding the science classroom, a subject that traditionally incorporates hands-on experiments and practicals, the integration of modern technologies should be a major feature. Although myriad studies report on technologies that enhance students’ learning outcomes in science, there is a dearth of literature on how teachers go about selecting technologies for use in the science classroom. Teachers can feel ill prepared to assess the range of available choices and might feel pressured and somewhat overwhelmed by the avalanche of new developments thrust before them in marketing literature and teaching journals. The consequences of making bad decisions are costly in terms of money, time and teacher confidence. Additionally, no research to date has identified what technologies science teachers use on a regular basis, and whether some purchased technologies have proven to be too problematic, preventing their sustained use and possible wider adoption. The primary aim of this study was to provide research-based guidance to teachers to aid their decision-making in choosing technologies for the science classroom. The study unfolded in several phases. The first phase of the project involved survey and interview data from teachers in relation to the technologies they currently use in their science classrooms and the frequency of their use. These data were coded and analysed using Grounded Theory of Corbin and Strauss, and resulted in the development of a PETTaL model that captured the salient factors of the data. This model incorporated usability theory from the Human Computer Interaction literature, and education theory and models such as Mishra and Koehler’s (2006) TPACK model, where the grounded data indicated these issues. The PETTaL model identifies Power (school management, syllabus etc.), Environment (classroom / learning setting), Teacher (personal characteristics, experience, epistemology), Technology (usability, versatility etc.,) and Learners (academic ability, diversity, behaviour etc.,) as fields that can impact the use of technology in science classrooms. The PETTaL model was used to create a Predictive Evaluation Tool (PET): a tool designed to assist teachers in choosing technologies, particularly for science teaching and learning. The evolution of the PET was cyclical (employing agile development methodology), involving repeated testing with in-service and pre-service teachers at each iteration, and incorporating their comments i ii in subsequent versions. Once no new suggestions were forthcoming, the PET was tested with eight in-service teachers, and the results showed that the PET outcomes obtained by (experienced) teachers concurred with their instinctive evaluations. They felt the PET would be a valuable tool when considering new technology, and it would be particularly useful as a means of communicating perceived value between colleagues and between budget holders and requestors during the acquisition process. It is hoped that the PET could make the tacit knowledge acquired by experienced teachers about technology use in classrooms explicit to novice teachers. Additionally, the PET could be used as a research tool to discover a teachers’ professional development needs. Therefore, the outcomes of this study can aid a teacher in the process of selecting educationally productive and sustainable new technology for their science classrooms. This study has produced an instrument for assisting teachers in the decision-making process associated with the use of new technologies for the science classroom. The instrument is generic in that it can be applied to all subject areas. Further, this study has produced a powerful model that extends the TPACK model, which is currently extensively employed to assess teachers’ use of technology in the classroom. The PETTaL model grounded in data from this study, responds to the calls in the literature for TPACK’s further development. As a theoretical model, PETTaL has the potential to serve as a framework for the development of a teacher’s reflective practice (either self evaluation or critical evaluation of observed teaching practices). Additionally, PETTaL has the potential for aiding the formulation of a teacher’s personal professional development plan. It will be the basis for further studies in this field.

Combining recommender and reputation systems to produce better online advice

Although recommender systems and reputation systems have quite different theoretical and technical bases, both types of systems have the purpose of providing advice for decision making in e-commerce and online service environments. The similarity in purpose makes it natural to integrate both types of systems in order to produce better online advice, but their difference in theory and implementation makes the integration challenging. In this paper, we propose to use mappings to subjective opinions from values produced by recommender systems as well as from scores produced by reputation systems, and to combine the resulting opinions within the framework of subjective logic.

Residual stresses in rail-ends from the in-service insulated rail joints using neutron diffraction

Insulated rail joints (IRJs) are an integral part of the rail track signaling system and pose significant maintenance and replacement costs due to their low and fluctuating service lives. Failure occurs mainly in rail head region, bolt- holes of fishplates and web-holes of the rails. Propagation of cracks is influenced by the evolution of internal residual stresses in rails during rail manufacturing (hot-rolling, roller-straightening, and head-hardening process), and during service, particularly in heavy rail haul freight systems where loads are high. In this investigation, rail head accumulated residual stresses were analysed using neutron diffraction at the Australian Nuclear Science and Technology Organisation (ANSTO). Two ex-service two head-hardened rail joints damaged under different loading were examined and results were compared with those obtained from an unused rail joint reference sample in order to differentiate the stresses developed during rail manufacturing and stresses accumulated during rail service. Neutron diffraction analyses were carried out on the samples in longitudinal, transverse and vertical directions, and on 5mm thick sliceed samples cut by Electric Discharge Machining (EDM). For the rail joints from the service line, irrespective of loading conditions and in-service times, results revealed similar depth profiles of stress distribution. Evolution of residual stress fields in rails due to service was also accompanied by evidence of larger material flow based on reflected light and scanning electron microscopy studies. Stress evolution in the vicinity of rail ends was characterised by a compressive layer, approximately 5 mm deep, and a tension zone located approximately 5- 15mm below the surfaces. A significant variation of d0 with depth near the top surface was detected and was attributed to decarburization in the top layer induced by cold work. Stress distributions observed in longitudinal slices of the two different deformed rail samples were found to be similar. For the undeformed rail, the stress distributions obtained could be attributed to variations associated with thermo-mechanical history of the rail.

A Matlab toolbox for parametric identification of radiation-force models of ships and offshore structures

This article describes a Matlab toolbox for parametric identification of fluid-memory models associated with the radiation forces ships and offshore structures. Radiation forces are a key component of force-to-motion models used in simulators, motion control designs, and also for initial performance evaluation of wave-energy converters. The software described provides tools for preparing non-parmatric data and for identification with automatic model-order detection. The identification problem is considered in the frequency domain.

Joint identification of infinite-frequency added mass and fluid-memory models of marine structures

This paper addresses the problem of joint identification of infinite-frequency added mass and fluid memory models of marine structures from finite frequency data. This problem is relevant for cases where the code used to compute the hydrodynamic coefficients of the marine structure does not give the infinite-frequency added mass. This case is typical of codes based on 2D-potential theory since most 3D-potential-theory codes solve the boundary value associated with the infinite frequency. The method proposed in this paper presents a simpler alternative approach to other methods previously presented in the literature. The advantage of the proposed method is that the same identification procedure can be used to identify the fluid-memory models with or without having access to the infinite-frequency added mass coefficient. Therefore, it provides an extension that puts the two identification problems into the same framework. The method also exploits the constraints related to relative degree and low-frequency asymptotic values of the hydrodynamic coefficients derived from the physics of the problem, which are used as prior information to refine the obtained models.

Community media production : access, institutions, and ethics

In policy terms, community media are known as the “third sector” of the media. The description reflects the historical expectation that community media can fulfill a need not met by the commercial and public service broadcasters. A defining element of this “need” has been the means to production for nonprofessionals, particularly groups not represented in the mainstream media. The historical construction of community media reveals production to be a guiding principle; both a means and an end in itself. This chapter examines the various rationales underpinning community media production, including empowerment, media diversity, and the independent producer movement. Using case studies from youth media, the chapter critiques producer-centric models of community media. In the contemporary media environment, production alone cannot meet the social needs that community media were established to address. Instead, I propose a rationale that combines both production and consumption ethics.

Introspective service interface synthesis in business networks

Service mismatches involve the adaptation of structural and behavioural interfaces of services, which in practice incurs long lead times through manual, coding e ort. We propose a framework, complementary to conventional service adaptation, to extract comprehensive and seman- tically normalised service interfaces, useful for interoperability in large business networks and the Internet of Services. The framework supports introspection and analysis of large and overloaded operational signa- tures to derive focal artefacts, namely the underlying business objects of services. A more simpli ed and comprehensive service interface layer is created based on these, and rendered into semantically normalised in- terfaces, given an ontology accrued through the framework from service analysis history. This opens up the prospect of supporting capability comparisons across services, and run-time request backtracking and ad- justment, as consumers discover new features of a service's operations through corresponding features of similar services. This paper provides a rst exposition of the service interface synthesis framework, describing patterns having novel requirements for unilateral service adaptation, and algorithms for interface introspection and business object alignment. A prototype implementation and analysis of web services drawn from com- mercial logistic systems are used to validate the algorithms and identify open challenges and future research directions.

Synthesis of orchestrators from service choreographies

Interaction topologies in service-oriented systems are usually classified into two styles: choreographies and orchestrations. In a choreography, services interact in a peer-to-peer manner and no service plays a privileged role. In contrast, interactions in an orchestration occur between one particular service, the orchestrator, and a number of subordinated services. Each of these topologies has its trade-offs. This paper considers the problem of migrating a service-oriented system from a choreography style to an orchestration style. Specifically, the paper presents a tool chain for synthesising orchestrators from choreographies. Choreographies are initially represented as communicating state machines. Based on this representation, an algorithm is presented that synthesises the behaviour of an orchestrator, which is also represented as a state machine. Concurrent regions are then identified in the synthesised state machine to obtain a more compact representation in the form of a Petri net. Finally, it is shown how the resulting Petri nets can be transformed into notations supported by commercial tools, such as the Business Process Modelling Notation (BPMN).

Public sector change, person-organization fit, and work attitudes : a mediation model

Organizational change is a typical phenomenon within public sector agencies in OECD countries. An increasing number of studies in the literature examine the implementation of change and its resulting impact on the work attitudes of public sector employees; however, little is known about the extent to which change management processes impact on employees’ work attitudes. This study aims to address this issue by developing a path model underpinned by change management and public service motivation literature. The path model was tested on a sample of 308 managerial and non-managerial public sector employees from the U.S. The results provide further empirical evidence on the types of change initiatives on nursing work and change management processes being implemented. Public sector agencies in the sample implemented a variety of change initiatives such as downsizing, delayering and empowerment. Employees reported two change management processes: the provision of change-related information and participation in change decision making. While the results indicate that change produces change-induced stressors, change information tends to reduce stressors and, subsequently, role stress. The results also indicate that change management processes are associated with higher levels of public service motivation, which is in turn connected to higher levels of person–organization fit. Person–organization fit was found to partially mediate the relationship between public service motivation and job satisfaction in the context of change.

The ethics, aesthetics and practical politics of ownership in co-creative media

What is ‘best practice’ when it comes to managing intellectual property rights in participatory media content? As commercial media and entertainment business models have increasingly come to rely upon the networked productivity of end-users (Banks and Humphreys 2008) this question has been framed as a problem of creative labour made all the more precarious by changing employment patterns and work cultures of knowledge-intensive societies and globalising economies (Banks, Gill and Taylor 2014). This paper considers how the problems of ownership are addressed in non-commercial, community-based arts and media contexts. Problems of labour are also manifest in these contexts (for example, reliance on volunteer labour and uncertain economic reward for creative excellence). Nonetheless, managing intellectual property rights in collaborative creative works that are created in community media and arts contexts is no less challenging or complex than in commercial contexts. This paper takes as its focus a particular participatory media practice known as ‘digital storytelling’. The digital storytelling method, formalised by the Centre for Digital Storytelling (CDS) from the mid-1990s, has been internationally adopted and adapted for use in an open-ended variety of community arts, education, health and allied services settings (Hartley and McWilliam 2009; Lambert 2013; Lundby 2008; Thumin 2012). It provides a useful point of departure for thinking about a range of collaborative media production practices that seek to address participation ‘gaps’ (Jenkins 2006). However the outputs of these activities, including digital stories, cannot be fully understood or accurately described as user-generated content. For this reason, digital storytelling is taken here to belong to a category of participatory media activity that has been described as ‘co-creative’ media (Spurgeon 2013) in order to improve understanding of the conditions of mediated and mediatized participation (Couldry 2008). This paper reports on a survey of the actual copyrighting practices of cultural institutions and community-based media arts practitioners that work with digital storytelling and similar participatory content creation methods. This survey finds that although there is a preference for Creative Commons licensing a great variety of approaches are taken to managing intellectual property rights in co-creative media. These range from the use of Creative Commons licences (for example, Lambert 2013, p.193) to retention of full copyrights by storytellers, to retention of certain rights by facilitating organisations (for example, broadcast rights by community radio stations and public service broadcasters), and a range of other shared rights arrangements between professional creative practitioners, the individual storytellers and communities with which they collaborate, media outlets, exhibitors and funders. This paper also considers how aesthetic and ethical considerations shape responses to questions of intellectual property rights in community media arts contexts. For example, embedded in the CDS digital storytelling method is ‘a critique of power and the numerous ways that rank is unconsciously expressed in engagements between classes, races and gender’ (Lambert 117). The CDS method privileges the interests of the storyteller and, through a transformative workshop process, aims to generate original individual stories that, in turn, reflect self-awareness of ‘how much the way we live is scripted by history, by social and cultural norms, by our own unique journey through a contradictory, and at times hostile, world’ (Lambert 118). Such a critical approach is characteristic of co-creative media practices. It extends to a heightened awareness of the risks of ‘story theft’ and the challenges of ownership and informs ideas of ‘best practice’ amongst creative practitioners, teaching artists and community media producers, along with commitments to achieving equitable solutions for all participants in co-creative media practice (for example, Lyons-Reid and Kuddell nd.). Yet, there is surprisingly little written about the challenges of managing intellectual property produced in co-creative media activities. A dialogic sense of ownership in stories has been identified as an indicator of successful digital storytelling practice (Hayes and Matusov 2005) and is helpful to grounding the more abstract claims of empowerment for social participation that are associated with co-creative methods. Contrary to the ‘change from below’ philosophy that underpins much thinking about co-creative media, however, discussions of intellectual property usually focus on how methods such as digital storytelling contribute to the formation of copyright law-compliant subjects, particularly when used in educational settings (for example, Ohler nd.). This also exposes the reliance of co-creative methods on the creative assets storytellers (rather than on the copyrighted materials of the media cultures of storytellers) as a pragmatic response to the constraints that intellectual property right laws impose on the entire category of participatory media. At the level of practical politics, it also becomes apparent that co-creative media practitioners and storytellers located in copyright jurisdictions governed by ‘fair use’ principles have much greater creative flexibility than those located in jurisdictions governed by ‘fair dealing’ principles.

Profiling emergency nurse practitioner service

The aim of this study was to investigate the practice profile of emergency nurse practitioners across Australia. Nurse practitioners have been providing health service in the emergency setting internationally for more than 30 years, and evidence supports the value of this role in terms of patient satisfaction, effectiveness in improving service indicators, and acceptability of the role. The introduction of this service model has been instrumental in reducing waiting times for low-acuity patients and impacting positively on emergency department service delivery. Recent rapid uptake of this role internationally has outpaced development of the service model to inform education and ongoing service development. This was a national study that used interpretive research methods to identify the practice profile of emergency nurse practitioners. Data were collected from December 2012 to February 2013 through in-depth interviews. An inductive approach was used in data analysis to identify conceptual themes and develop an analysis framework. The study participants worked in a range of service models and managed patient presentations across all levels of acuity and complexity. The findings show that although there is no single definable model of the emergency nurse practitioner role in Australia, there are practice features that are common across all service models; these have been conceptualized as "modes of practice." This study has produced new knowledge about the practice profile of emergency nurse practitioners. The findings will inform development of practice standards for education and continuing professional development for emergency nurse practitioners and facilitate standardized operational definitions for ongoing research into this growing service model.

The primacy of vital signs – Acute care nurses’ and midwives’ use of physical assessment skills: A cross sectional study

BACKGROUND: Registered nurses and midwives play an essential role in detecting patients at risk of deterioration through ongoing assessment and action in response to changing health status. Yet, evidence suggests that clinical deterioration frequently goes unnoticed in hospitalised patients. While much attention has been paid to early warning and rapid response systems, little research has examined factors related to physical assessment skills. OBJECTIVES: To determine a minimum data set of core skills used during nursing assessment of hospitalised patients and identify nurse and workplace predictors of the use of physical assessment to detect patient deterioration. DESIGN: The study used a single-centre, cross-sectional survey design. SETTING and PARTICIPANTS: The study included 434 registered nurses and midwives (Grades 5-7) involved in clinical care of patients on acute care wards, including medicine, surgery, oncology, mental health and maternity service areas, at a 929-bed tertiary referral teaching hospital in Southeast Queensland, Australia. METHODS: We conducted a hospital-wide survey of registered nurses and midwives using the 133-item Physical Assessment Skills Inventory and the 58-item Barriers to Registered Nurses’ Use of Physical Assessment scale. Median frequency for each physical assessment skill was calculated to determine core skills. To explore predictors of core skill utilisation, backward stepwise general linear modelling was conducted. Means and regression coefficients are reported with 95% confidence intervals. A p value < .05 was considered significant for all analyses. RESULTS: Core skills used by most nurses every time they worked included assessment of temperature, oxygen saturation, blood pressure, breathing effort, skin, wound and mental status. Reliance on others and technology (F = 35.77, p < .001), lack of confidence (F = 5.52, p = .02), work area (F = 3.79, p = .002), and clinical role (F = 44.24, p < .001) were significant predictors of the extent of physical assessment skill use. CONCLUSIONS: The increasing acuity of the acute care patient plausibly warrants more than vital signs assessment; however, our study confirms nurses’ physical assessment core skill set is mainly comprised of vital signs. The focus on these endpoints of deterioration as dictated by early warning and rapid response systems may divert attention from and devalue comprehensive nursing assessment that could detect subtle changes in health status earlier in the patient's hospitalisation.

How to plan and implement an environmental education program for a conservation area : lessons from Australia and Borneo

The Augo Wetland Forest Park, along with other conservation areas around the world, provides an opportunity for a personal connection with the natural world - an opportunity for creating ways to convince people to reverse the degradation of the planet. In this presentation I use the settings approach, as used by the World Health Organisation in health promotion, as a framework. The WHO’s 1986 Ottawa Charter states that "Health is created and lived by people within the settings of their everyday life; where they learn, work, play, and love." I argue that, similarly, a conservation area provides a setting for people to connect with environmental issues and can be the place where positive behaviours and actions for the environment are created and enacted. In a wired and virtual world, such settings may be the only opportunity some people, especially children, get to connect with the environment. An evidence-based, intentionally designed and implemented environmental education program enhances the opportunities for the personal connection and subsequent action. Planning and implementing an Environmental education program for a conservation area requires an understanding of the principles of three domains: • Environmental Communication • Environmental Education • Environmental Interpretation In this presentation I define these domains and demonstrate how they become interdependent within the context of a particular setting such as a conservation area. I outline the principles of each domain and demonstrate how they can be enacted with reference to environmental education program case studies from settings in Australia and Borneo. The first case study is based around a proposal for a planned residential community at Eden’s Crossing, in Brisbane’s high growth Western corridor. The setting featured a number of important natural and heritage conservation characteristics and the developer wanted to be pro-active in informing the market what this development aims to achieve in terms of innovative community and environmental objectives. By designing an education and interpretation program in line with best practice education and interpretation principles the developers would be assisted in their efforts to build community, preserve heritage, and facilitate environmentally sensitive lifestyles for the future residents of Eden’s Crossing. Above all, the strategy focused on advancing sustainability in a way that made the Eden’s Crossing greenfield development significantly greener. It did this by interacting with prospective purchasers, and building knowledge about sustainability with a view to shaping the future community of Eden’s Crossing in terms of attitudes and behaviours. The second case study is based around the development of the Rainforest Interpretation Centre (RIC), now renamed the Rainforest Discovery Centre, an environmental education facility managed by the Sabah Forestry Department (SFD) and located at the edge of the Kabili-Sepilok Forest Reserve in the East Malaysian state of Sabah (Borneo). This setting is of paramount importance for biodiversity conservation and research and a vital habitat for orang utan. As an Environmental Education Consultant I was tasked with developing an environmental education program for this setting as part of the SFD’s long- term strategy towards sustainable forest management. By employing the principles of Environmental Education and Environmental Interpretation I designed and implemented a program with three major components: • an environmental education component for visiting primary and secondary school groups. • an environmental education component for in-service and pre-service teachers and teacher educators. • a public awareness and environmental interpretation component which caters for the general public and tourists. From these modest beginnings the program has expanded and new facilities have been developed to meet the demands of visitors, teachers and students. The effectiveness of the program can be traced back to the grounding in the principles of best practice environmental education, communication and interpretation.

Empirical modelling of the relationship between bus and car speeds on signalised urban networks

Vehicle speed is an important attribute for analysing the utility of a transport mode. The speed relationship between multiple modes of transport is of interest to traffic planners and operators. This paper quantifies the relationship between bus speed and average car speed by integrating Bluetooth data and Transit Signal Priority data from the urban network in Brisbane, Australia. The method proposed in this paper is the first of its kind to relate bus speed and average car speed by integrating multi-source traffic data in a corridor-based method. Three transferable regression models relating not-in-service bus, in-service bus during peak periods, and in-service bus during off-peak periods with average car speed are proposed. The models are cross-validated and the interrelationships are significant.