Doing the right thing at the right time: Assessing responses to patient deterioration in electronic simulation scenarios using course-of-action analysis

International studies indicate that the recognition and management of deteriorating patients in hospitals are poor and that patient assessment is often inadequate. Face-to-face simulation programs have been shown to have an impact on educational and clinical outcomes; however, little is known about performance in contemporary healthcare e-simulation approaches. Using data from an open-access Web-based patient deterioration program (FIRSTACTWeb), the performance of 367 Australian nursing students in identification of treatment priorities and clinical actions was analyzed using a military model of Course of Action Simulation Analysis. Participants' performance in the whole program demonstrated a significant improvement in knowledge and skills (P ≤ .001) with high levels of participant satisfaction. Course of Action Simulation Analysis modeling identified three key participant groupings within which only 18% took the "best course of action" (the right actions and timing), with most (70%) completing the right actions but in the wrong order. The remaining 12% produced incomplete assessments and actions in an incorrect sequence. Contemporary approaches such as e-simulation do enhance educational outcomes. Measurement of performance when combined with Course of Action Simulation Analysis becomes a useful tool in the description of outcomes, an understanding of decision making, and the prediction of future events.

Homeland, territory, property: contesting land, state, and nation in urban Timor-Leste

This article considers contestations over land, state and nation in Aitarak Laran, an urban settlement in post-independence Timor-Leste. Since 2010 the settlement has been resisting eviction by the East Timorese state, which wishes to use the land it occupies to build a National Library and Cultural Centre. In exploring the contestation, the purpose of this article is two-fold. Firstly, it explores the nature of social connection to land within postcolonial state- and nation-building. Here, the contestation at Aitarak Laran reveals counter-posed imaginings of land as homeland, territory and property. Secondly, the article draws out the implications of these counter-posed imaginings for thinking about the 'right to the city', a notion first theorised by Lefebvre (1996 [1968]) and subsequently developed to encompass a range of modes of urban protest. In the settlement, the promises of independence-unity, equivalence, and inclusion within the sovereign nation-state-are at odds with residents' experiences of what independence has in fact brought. Land, in its multiple imaginings, becomes a crucible upon which this painful disjuncture plays out. Reading Aitarak Laran as an instance of 'right to the city' struggle, these tensions emerge as well not only in practice but also in theory, reflected particularly in the limitations and ambiguities of rights discourse.

Migration and the right to social security: perceptions of off-farm migrants' rights to social insurance in China's Jiangsu Province

In 2001 China ratified the International Covenant on Economic, Social and Cultural Rights. By so doing the national government became legally bound, "to the maximum of its available resources", to achieve "progressively" full realization of the rights specified in the Covenant. Included amongst these entitlements is the "right of everyone to social security, including social insurance". This paper uses data from Jiangsu to examine the extent to which urbanites agree that previously disenfranchised migrants have the same right to social insurance as the urban population. Many urbanites fear that their existing entitlements to social protection will be diluted if social insurance coverage is extended to include new populations. Accordingly, state agencies and the media have sought to promote acceptance of a more positive view of migrant workers than has traditionally prevailed within towns and cities. We find that younger urban residents, urban residents who already have social insurance and urban residents working in the state-owned sector are more likely to agree that migrants have the same right to social insurance as the urban population. © 2007 Institute of World Economics and Politics, Chinese Academy of Social Sciences.

Bias and precision of measures of survival gain from right-censored data

In cost-effectiveness analyses of drugs or health technologies, estimates of life years saved or quality-adjusted life years saved are required. Randomised controlled trials can provide an estimate of the average treatment effect; for survival data, the treatment effect is the difference in mean survival. However, typically not all patients will have reached the endpoint of interest at the close-out of a trial, making it difficult to estimate the difference in mean survival. In this situation, it is common to report the more readily estimable difference in median survival. Alternative approaches to estimating the mean have also been proposed. We conducted a simulation study to investigate the bias and precision of the three most commonly used sample measures of absolute survival gain - difference in median, restricted mean and extended mean survival - when used as estimates of the true mean difference, under different censoring proportions, while assuming a range of survival patterns, represented by Weibull survival distributions with constant, increasing and decreasing hazards. Our study showed that the three commonly used methods tended to underestimate the true treatment effect; consequently, the incremental cost-effectiveness ratio (ICER) would be overestimated. Of the three methods, the least biased is the extended mean survival, which perhaps should be used as the point estimate of the treatment effect to be inputted into the ICER, while the other two approaches could be used in sensitivity analyses. More work on the trade-offs between simple extrapolation using the exponential distribution and more complicated extrapolation using other methods would be valuable.

Finding and Keeping the Right People How to Recruit Motivated Employees

This book provides managers, team leaders, personnel and human resources managers, and human resources students with a guide to knowing how to hire the right people, keep them motivated, and keep them with the company

Lifting the cloak of conceptual confusion: Exploring the meaning of the human right to higher education

The right to education, and specifically higher education, is clearly set out in international law. Higher education is, however, in a state of change as a result of pressures from the increased demand for higher education, globalisation and the impact of new technology (Barber, Donnelly and Rizvi 2013, 1–2). This article asserts that before significant changes to higher education are made, we should reflect on the content of the human rights obligations contained in the international documentation. It seeks to outline the content and scope of the right to higher education in an effort to assist this consideration.

Religious ambivalence: suppression of pro-social attitudes toward asylum seekers by right-wing authoritarianism

A survey of 168 White Australian community members examined whether ambivalence toward certain social groups by some religious individuals constituted a suppression effect in which authoritarian motivated prejudice suppressed more pro-social attitudes toward asylum seekers. Using mediation analysis, it was found that Christian religious identity was not significantly associated with prejudice at a bivariate level. However, when Right-Wing Authoritarianism (RWA) was taken into account, Christians (compared with non-Christians) were less likely to hold negative attitudes toward asylum seekers in Australia. Inclusion of acculturation ideologies (assimilation, multiculturalism, and color-blindness) in the models indicated that the suppression effect was specific to RWA rather than due to other intergroup attitudes. However, findings suggest that multiculturalism may be one proximal indicator of Christian pro-sociality.

International legal norms on the right to sexual orientation and gender identity: Australian reforms contextualised

At a time when the international momentum for sexual orientation and gender identity rights is strong it is important that scholars and activists remain vigilant to ensure that the discourses framing sexuality rights do not intentionally, or inadvertently, deepen incursions on the rights of individuals of sexual and bodily diversity. This chapter offers a critical examination of selected Australian case law and legal reform for the putative progress t offers sexual minorities. Identifying the entrenched binary determinism at the heart of the law, this chapter echoes the call of queer criminology, concluding that challenging invisibility is but part of the project. Queer scholars need also remain vigilant about the law’s constitutive power, and its role in producing sexual minorities as objects of pathology, perversion and criminality.

The right to supported decision-making for people rarely heard

 This thesis explored supported decision-making for people with severe or profound intellectual disability. The findings provide guidance to supporters and policy makers to assist people with severe or profound intellectual disability to lead maximally autonomous lives, a clear obligation of Australia under the Convention on the Rights of Persons with Disabilities.

Cathodal transcranial Direct Current Stimulation (tDCS) to the right cerebellar hemisphere affects motor adaptation during gait

The cerebellum appears to play a key role in the development of internal rules that allow fast, predictive adjustments to novel stimuli. This is crucial for adaptive motor processes, such as those involved in walking, where cerebellar dysfunction has been found to increase variability in gait parameters. Motor adaptation is a process that results in a progressive reduction in errors as movements are adjusted to meet demands, and within the cerebellum, this seems to be localised primarily within the right hemisphere. To examine the role of the right cerebellar hemisphere in adaptive gait, cathodal transcranial direct current stimulation (tDCS) was administered to the right cerebellar hemisphere of 14 healthy adults in a randomised, double-blind, crossover study. Adaptation to a series of distinct spatial and temporal templates was assessed across tDCS condition via a pressure-sensitive gait mat (ProtoKinetics Zeno walkway), on which participants walked with an induced 'limp' at a non-preferred pace. Variability was assessed across key spatial-temporal gait parameters. It was hypothesised that cathodal tDCS to the right cerebellar hemisphere would disrupt adaptation to the templates, reflected in a failure to reduce variability following stimulation. In partial support, adaptation was disrupted following tDCS on one of the four spatial-temporal templates used. However, there was no evidence for general effects on either the spatial or temporal domain. This suggests, under specific conditions, a coupling of spatial and temporal processing in the right cerebellar hemisphere and highlights the potential importance of task complexity in cerebellar function.

Inflation and debt indexation : the equivalence of two alternative schemes for the case of periodic payments

The presence of inflation has induced the financial institutions to implement procedures devised to protect the real values of theirs loans. Two of such procedurcs, the floaaing rale scheme and the monetary correction mechanism, tend to lead to very different streams of payments. However, whenever the floating rate scheme follows the rule of Strict adhercnce to lhe Fisher equation, lhe two procedures are financially equivalent.