Potential uses of Bayesian networks as tools for synthesis of systematic reviews of complex interventions

Bayesian networks (BNs) are tools for representing expert knowledge or evidence. They are especially useful for synthesising evidence or belief concerning a complex intervention, assessing the sensitivity of outcomes to different situations or contextual frameworks and framing decision problems that involve alternative types of intervention. Bayesian networks are useful extensions to logic maps when initiating a review or to facilitate synthesis and bridge the gap between evidence acquisition and decision-making. Formal elicitation techniques allow development of BNs on the basis of expert opinion. Such applications are useful alternatives to ‘empty’ reviews, which identify knowledge gaps but fail to support decision-making. Where review evidence exists, it can inform the development of a BN. We illustrate the construction of a BN using a motivating example that demonstrates how BNs can ensure coherence, transparently structure the problem addressed by a complex intervention and assess sensitivity to context, all of which are critical components of robust reviews of complex interventions. We suggest that BNs should be utilised to routinely synthesise reviews of complex interventions or empty reviews where decisions must be made despite poor evidence.

Impacts of tillage and application methods on atrazine and alachlor losses from upland fields: Research paper

The effects of tillage practises and the methods of chemical application on atrazine and alachlor losses through run-off were evaluated for five treatments: conservation (untilled) and surface (US), disk and surface, plow and surface, disk and preplant-incorporated, and plow and preplant-incorporated treatments. A rainfall simulator was used to create 63.5 mm h^-1 of rainfall for 60 min and 127 mm h^-1 for 15 min. Rainfall simulation occurred 24-36 h after chemical application. There was no significant difference in the run-off volume among the treatments but the untilled treatment significantly reduced erosion loss. The untilled treatments had the highest herbicide concentration and the disk treatments were higher than the plow treatments. The surface treatments showed a higher concentration than the incorporated treatments. The concentration of herbicides in the water decreased with time. Among the experimental sites, the one with sandy loam soil produced the greatest losses, both in terms of the run-off volume and herbicide loss. The US treatments had the highest loss and the herbicide incorporation treatments had smaller losses through run-off as the residue cover was effective in preventing herbicide losses. Incorporation might be a favorable method of herbicide application to reduce the herbicide losses by run-off.

“I understand. I am a participant”: Navigating the ‘fuzzy’ boundaries of visual methods in qualitative longitudinal research

In this chapter we discuss how utilising the participatory visual methodology, photovoice, in an aged care context with its unique communal setting raised several ‘fuzzy boundary’ ethical dilemmas. To illustrate these challenges, we draw on immersive field notes from an ongoing qualitative longitudinal research (QLR) exploring the lived experience of aged care from the perspective of older residents, and focus on interactions with one participant, 81 year old Cassie. We explore how the camera, which is integral to the photovoice method, altered the researcher/participant ethical dynamics by becoming a continual ‘connector’ to the researcher. The camera took on a distinct agency, acting as a non-threatening ‘portal’ that lengthened contact, provided informal opportunities to alter the relationship dynamics and enabled unplanned participant revelation.

Amplified stories: Digital technology and representations of lived experiences

New media technologies and the narrative turn in qualitative research has expanded the methods through which we gather data about and share findings of groups who have traditionally been written about by others rather than telling their own stories to reveal the complexities of their experiences. This chapter explores two projects that use storytelling and technology in an effort to change public perceptions about disadvantaged a community or cohort that have specific circumstances but are a result of policies beyond their control.

Colonoscopy preparation in children: Safety, efficacy, and tolerance of high- versus low-volume cleansing methods

Background: The use of large-volume electrolyte balanced solutions as preparation for colonoscopy often results in poor patient compliance and acceptance. The tolerance, safety, and efficacy of high-versus low volume colon-cleansing methods as preparation for colonoscopy in children were compared by randomized operator-blinded trial. Methods: Twenty-nine children ages 3.6-14.6 years had either high-volume nasogastric balanced polyethylene glycol electrolyte lavage (20 ml/kg/h) until the effluent was clear (n = 15), or two oral doses of sodium phosphate solution (22.5-45 ml) separated by oral fluid intake (n = 14). Results: Both preparations were equally effective. The low-volume preparation was better tolerated and caused less discomfort that the high-volume preparation, judging by serial nurse observations. The incidence of abdominal symptoms, diarrhea, sleep disturbance, and vomiting was not significantly different between the two groups. Both groups had a small reduction in mean hematocrit and serum calcium levels. The sodium phosphate preparation caused increases in mean serum sodium concentrations from 140 to 145 mmol/L and serum phosphate concentrations from 1.41 to 2.53 mmol/L. Ten hours after the commencement of the preanesthetic fast, these concentrations had returned to normal. Conclusions: There are advantages in terms of tolerance, discomfort, and case of administration with acceptable colonic cleansing with the use of the less-invasive oral sodium phosphate low-volume colon-cleansing preparation in children. Safe use requires ensuring an adequate oral fluid intake during the preparation time and avoidance of use in patients with renal insufficiency.

Spatio-temporal modelling of cancer data in Queensland using Bayesian methods

Cancer is the leading contributor to the disease burden in Australia. This thesis develops and applies Bayesian hierarchical models to facilitate an investigation of the spatial and temporal associations for cancer diagnosis and survival among Queenslanders. The key objectives are to document and quantify the importance of spatial inequalities, explore factors influencing these inequalities, and investigate how spatial inequalities change over time. Existing Bayesian hierarchical models are refined, new models and methods developed, and tangible benefits obtained for cancer patients in Queensland. The versatility of using Bayesian models in cancer control are clearly demonstrated through these detailed and comprehensive analyses.

The reader-assembled narrative: Representing the random in print fiction

The growing interest in co-created reading experiences in both digital and print formats raises interesting questions for creative writers who work in the space of interactive fiction. This essay argues that writers have not abandoned experiments with co-creation in print narratives in favour of the attractions of the digital environment, as might be assumed by the discourse on digital development. Rather, interactive print narratives, in particular ‘reader-assembled narratives’ demonstrate a rich history of experimentation and continue to engage writers who wish to craft individual reading experiences for readers and to experiment with their own creative process as writers. The reader-assembled narrative has been used for many different reasons and for some writers, such as BS Johnson it is a method of problem solving, for others, like Robert Coover, it is a way to engage the reader in a more playful sense. Authors such as Marc Saporta, BS Johnson, and Robert Coover have engaged with this type of narrative play. This examination considers the narrative experimentation of these authors as a way of offering insights into creative practice for contemporary creative writers.

Terra Incognita: A symbolic mythical journey

This practice-led project is implemented in the context of rites of passage based on significant events in formative transitions of Self. It employs an intuitive methodology to examine and explore the 'Child archetype', mythos, symbolic imagination and self-narrative, through the manifestation of a visual symbolic language. The contexts, methods and processes enable empowerment, heightened awareness of personal and collective relationships, meaningful discovery and development of innovative ideas and forms. The implications for this project highlight the importance of intuition in creativity and innovation. Creative practice is a vehicle for personal and collective interconnectedness. I have discovered self-empowerment, meaningful learning and innovative forms of personal and collective communication as a way of enabling transition of a significant life event.

A methodological survey of future mobility literature: Opportunities for design research

This research establishes that the study of mobility and transportation is multi-disciplinary and highly complex, involving the diverse interplay between infrastructural and psychological factors. Coincidently, a new paradigm in personal mobility is developing. A new generation of mobility solutions is becoming widely available in the form of car and ride sharing services. These services build on the assumption that customers no longer need ownership of a product in order to benefit from it. With the emergence of this new paradigm, this paper presents a methodological review of current practises used by the wider research community. Therefore, this research piece aims to explore methodological approaches involved in the study the effect of community on an individual’s attitudes, perceptions and behaviours of future mobility solutions. The results of this review indicate that the majority of published literature uses quantitative methods as opposed to qualitative and even fewer studies have sought to understand the human factors in these new mobility solutions. This gap in knowledge is a valuable opportunity for design. Inherently qualitative and human focused, design research can fill this gap in knowledge by applying distinctly user-centred methods such as persona design, narrative storytelling, and in-depth observations to discover deeper human insights.

Telling tales and painting pictures: A narrative inquiry into the professional learning of Northern Territory primary teachers

This thesis narrates the professional learning experiences of seven Northern Territory teachers. It outlines the evolution from traditional professional development in schools to an active, responsive professional learning agenda. With increasing demands on teachers, standardisation and the quest for improved student outcomes, key themes in the re-storied narrative emerge about the definition and role of professional learning in complex conditions, effective teaching, quality programmes, and teacher agency. This thesis contributes to knowledge about the characteristics that teachers value in their professional learning experiences. An Ongoing Professional Enhancement Model (OPE) is proposed, highlighting directions in this field for key stakeholders.

Examining the profile and experiences of older sub-acute patients who present to public hospital emergency departments in South East Queensland: A mixed methods approach

There is a scarcity of research that informs Interface Health Service (IHS) development. This research applied a mixed methods approach to profile older emergency department patients and patterns of health service use and to explore their ED experiences in public hospital EDs in South-East Queensland. IHS was under-utilised by older people with complex co-morbidities. Lack of communication and need identification were factors that undermined the effectiveness of IHS in reaching this cohort which highlighted a need for change.

Haemodialysis work environment contributors to job satisfaction and stress: A sequential mixed methods study

Background: Haemodialysis nurses form long term relationships with patients in a technologically complex work environment. Previous studies have highlighted that haemodialysis nurses face stressors related to the nature of their work and also their work environments leading to reported high levels of burnout. Using Kanters (1997) Structural Empowerment Theory as a guiding framework, the aim of this study was to explore the factors contributing to satisfaction with the work environment, job satisfaction, job stress and burnout in haemodialysis nurses. Methods: Using a sequential mixed-methods design, the first phase involved an on-line survey comprising demographic and work characteristics, Brisbane Practice Environment Measure (B-PEM), Index of Work Satisfaction(IWS), Nursing Stress Scale (NSS) and the Maslach Burnout Inventory (MBI). The second phase involved conducting eight semi-structured interviews with data thematically analyzed. Results: From the 417 nurses surveyed the majority were female (90.9 %), aged over 41 years of age (74.3 %), and 47.4 % had worked in haemodialysis for more than 10 years. Overall the work environment was perceived positively and there was a moderate level of job satisfaction. However levels of stress and emotional exhaustion (burnout) were high. Two themes, ability to care and feeling successful as a nurse, provided clarity to the level of job satisfaction found in phase 1. While two further themes, patients as quasi-family and intense working teams, explained why working as a haemodialysis nurse was both satisfying and stressful. Conclusions: Nurse managers can use these results to identify issues being experienced by haemodialysis nurses working in the unit they are supervising.

Chemotherapy-induced nausea and vomiting: A narrative review to inform dietetics practice

Chemotherapy-induced nausea and vomiting (CINV) are common nutrition-impact symptoms experienced by cancer patients. They exert a detrimental effect on dietary intake, risk of malnutrition and quality of life. While CINV are primarily managed with medication, dietitians play an important role in the management of CINV-related complications such as reduced dietary intake. This review discusses the burden of nausea and vomiting which cancer patients can experience, including its effect on quality of life, nutrition status, and treatment outcomes. Implications for dietetic practice include the need to explore the nature of reported symptoms, identify predisposing risk factors, and to consider the use of a variety of interventions that are individualised to the patient’s symptoms. There are little clinical data regarding effective dietetic interventions for nausea and vomiting. In summary, this review discusses dietetic-related issues surrounding CINV including the pathophysiology, risk factors, prevalence, and both pharmacological and dietetic treatment options.

A comparative Raman study of the interaction of electron donor and acceptor molecules with graphene prepared by different methods

Interaction of tetrathiafulvalene (TTF) and tetracyanoethylene (TCNE) with few-layer graphene samples prepared by the exfoliation of graphite oxide (EG), conversion of nanodiamond (DG) and arc-evaporation of graphite in hydrogen (HG) has been investigated by Raman spectroscopy to understand the role of the graphene surface. The position and full-width at half maximum of the Raman G-band are affected on interaction with TTF and TCNE and the effect is highest with EG and least with HG. The effect of TTF and TCNE on the 2D-band is also maximum with EG. The magnitude of interaction between the donor/acceptor molecules varies in the same order as the surface areas of the graphenes. (C) 2009 Published by Elsevier B. V.