Key facilitators and barriers to quality of life in residential aged care : the role of design

Australia is undergoing a critical demographic transition: the population is ageing. By 2050, one in four Australians will be older than 65 years and by 2031, the number of older Australians requiring residential aged care will increase 63%, to 1.4 million (ABS, 2005). In anticipation of this global demographic transition, the World Health Organisation has advocated ‘active ageing’, identifying health, participation and security as the three key factors that enhance quality of life for people as they age (WHO, 2002). While there is considerable discussion and acceptance of active ageing principles, little is known about the experience of ‘active ageing’ for older Australians who live in Residential Aged Care Facilities (RACF). This research addresses this knowledge gap by exploring the key facilitators and barriers to quality of life and active ageing in aged care from the perspective of aged care residents (n=12). To do this, the project documented the initial expectations and daily life experience of new residents living in a RACF over a one-year period. Combined with in-depth interviews and surveys, the project utilised Photovoice methodology - where participants used photography to record their lived experiences. The initial findings suggest satisfaction with living in aged care centers around five key themes; resident’s mental attitude to living in aged care, forming positive peer and staff relationships, self-determination and maintaining independence, opportunities to participate in interesting activities, and living in a safe and comfortable physical environment. This paper reports on the last of these five key themes, focusing on the role of design in facilitating quality of life, specifically: “living within these walls” – safety, comfort and the physical environment.

Cohabitation, marriage, and divorce in a model of match quality

The objective of this research is to further our understanding of how and why individuals enter and leave coresidential relationships. We develop and estimate an economic model of nonmarital cohabitation, marriage, and divorce that is consistent with current data on the formation and dissolution of relationships. Jovanovic's (Journal of Political Economy 87 (1979), 972-90) theoretical matching model is extended to help explain household formation and dissolution behavior. Implications of the model reveal what factors influence the decision to start a relationship, what form this relationship will take, and the relative stability of the various types of unions. The structural parameters of the model are estimated using longitudinal data from a sample of female high school seniors from the United States. New numerical methods are developed to reduce computational costs associated with estimation. The empirical results have interesting interpretations given the structural model. They show that a significant cause of cohabitation is the need to learn about potential partners and to hedge against future bad shocks. The estimated parameters are used to conduct several comparative dynamic experiments. For example, we show that policy experiments changing the cost of divorce have little effect on relationship choices.

ERP stakeholders’ perceptions of data quality and utility

While data quality has been identified as a critical factor associated with enterprise resource planning (ERP) failure, the relationship between ERP stakeholders, the information they require and its relationship to ERP outcomes continues to be poorly understood. Applying stakeholder theory to the problem of ERP performance, we put forward a framework articulating the fundamental differences in the way users differentiate between ERP data quality and utility. We argue that the failure of ERPs to produce significant organisational outcomes can be attributed to conflict between stakeholder groups over whether the data contained within an ERP is of adequate ‘quality’. The framework provides guidance as how to manage data flows between stakeholders, offering insight into each of their specific data requirements. The framework provides support for the idea that stakeholder affiliation dictates the assumptions and core values held by individuals, driving their data needs and their perceptions of data quality and utility.

Deterministic plasma-aided synthesis of high-quality nanoislanded nc-SiC films

Despite major advances in the fabrication and characterization of SiC and related materials, there has been no convincing evidence of the synthesis of nanodevice-quality nanoislanded SiC films at low, ultralarge scale integration technology-compatible process temperatures. The authors report on a low-temperature (400 °C) plasma-assisted rf magnetron sputtering deposition of high-quality nanocrystalline SiC films made of uniform-size nanoislands that almost completely cover the Si(100) surface. These nanoislands are chemically pure, highly stoichiometric, have a typical size of 20-35 nm, and contain small (∼5 nm) nanocrystalline inclusions. The properties of nanocrystalline SiC films can be effectively controlled by the plasma parameters.

Structural evolution of nanocrystalline silicon thin films synthesized in high-density, low-temperature reactive plasmas

Silicon thin films with a variable content of nanocrystalline phase were deposited on single-crystal silicon and glass substrates by inductively coupled plasma-assisted chemical vapor deposition using a silane precursor without any hydrogen dilution in the low substrate temperature range from 100 to 300 °C. The structural and optical properties of the deposited films are systematically investigated by Raman spectroscopy, x-ray diffraction, Fourier transform infrared absorption spectroscopy, UV/vis spectroscopy, scanning electron microscopy and high-resolution transmission electron microscopy. It is shown that the structure of the silicon thin films evolves from the purely amorphous phase to the nanocrystalline phase when the substrate temperature is increased from 100 to 150 °C. It is found that the variations of the crystalline fraction fc, bonded hydrogen content CH, optical bandgap ETauc, film microstructure and growth rate Rd are closely related to the substrate temperature. In particular, at a substrate temperature of 300 °C, the nanocrystalline Si thin films of our interest feature a high growth rate of 1.63nms-1, a low hydrogen content of 4.0at.%, a high crystalline fraction of 69.1%, a low optical bandgap of 1.55eV and an almost vertically aligned columnar structure with a mean grain size of approximately 10nm. It is also shown that the low-temperature synthesis of nanocrystalline Si thin films without any hydrogen dilution is attributed to the outstanding dissociation ability of the high-density inductively coupled plasmas and effective plasma-surface interactions during the growth process. Our results offer a highly effective yet simple and environmentally friendly technique to synthesize high-quality nanocrystalline Si films, vitally needed for the development of new-generation solar cells and other emerging nanotechnologies.

Emotional climate and high quality learning experiences in science teacher education

The role of emotion during learning encounters in science teacher education is under-researched and under-theorized. In this case study we explore the emotional climates, that is, the collective states of emotional arousal, of a preservice secondary science education class to illuminate practice for producing and reproducing high quality learning experiences for preservice science teachers. Theories related to the sociology of emotions informed our analyses from data sources such as preservice teachers’ perceptions of the emotional climate of their class, emotional facial expressions, classroom conversations, and cogenerative dialogue. The major outcome from our analyses was that even though preservice teachers reported high positive emotional climate during the professor’s science demonstrations, they also valued the professor’s in the moment reflections on her teaching that were associated with low emotional climate ratings. We co-relate emotional climate data and preservice teachers’ comments during cogenerative dialogue to expand our understanding of high quality experiences and emotional climate in science teacher education. Our study also contributes refinements to research perspectives on emotional climate.

The impact of nurse practitioner services on cost, quality of care, satisfaction and wait times in the emergency department: A systematic review

Aims To provide the best available evidence to determine the impact of nurse practitioner services on cost, quality of care, satisfaction and waiting times in the emergency department for adult patients. Background The delivery of quality care in the emergency department is one of the most important service indicators in health delivery. Increasing service pressures in the emergency department have resulted in the adoption of service innovation models: the most common and rapidly expanding of these is emergency nurse practitioner services. The rapid uptake of emergency nurse practitioner service in Australia has outpaced the capacity to evaluate this service model in terms of outcomes related to safety and quality of patient care. Previous research is now outdated and not commensurate with the changing domain of delivering emergency care with nurse practitioner services. Data A comprehensive search of four electronic databases from 2006-­‐2013 was conducted to identify research evaluating nurse practitioner service impact in the emergency department. English language articles were sought using MEDLINE, CINAHL, Embase and Cochrane and included two previous systematic reviews completed five and seven years ago. Methods A three step approach was used. Following a comprehensive search, two reviewers assessed identified studies against the inclusion criteria. From the original 1013 studies, 14 papers were retained for critical appraisal on methodological quality by two independent reviewers and data extracted using standardised tools. Results Narrative synthesis was conducted to summarise and report the findings as insufficient data was available for meta-­‐analysis of results. This systematic review has shown that emergency nurse practitioner service has a positive impact on quality of care, patient satisfaction and waiting times. There was insufficient evidence to draw conclusions regarding impact on costs. Conclusion Synthesis of the available research attempts to provide an evidence base for emergency nurse practitioner service to guide healthcare leaders, policy makers and clinicians in reforming emergency department service provision. The findings suggest that further quality research is required for comparative measures of clinical and service effectiveness of emergency nurse practitioner service. In the context of increased health service demand and the need to provide timely and effective care to patients, such measures will assist in delivering quality patient care.

Benchmarking potential factors leading to education quality : a study of Cambodian higher education

Purpose To study the quality in higher education in Cambodia and explore the potential factors leading to quality in Cambodian higher education. Design/methodology/approach Five main factors that were deemed relevant in providing quality in Cambodian higher education were proposed: academic curriculum and extra-curricular activities, teachers' qualification and methods, funding and tuition, school facilities, and interactive network. These five propositions were used to compare Shu-Te University, Taiwan with the top five universities in Cambodia. The data came in the forms of questionnaire and desk research. Descriptive analytical approach is then carried out to describe these five factors. Findings Only 6 per cent of lecturers hold PhD degree and about 85 per cent never published any papers; some private universities charge as low as USD200 per academic year, there is almost no donation from international organizations, and annual government funding on higher education sector nationwide in 2005 was only about USD3.67 million; even though there is a library at each university, books, study materials etc. are not up-to-date and inadequate; 90 per cent of the lecturers never have technical discussion or meeting and about 60 per cent of students felt that their teachers did not have time for them to consult with. Originality/value A useful insight was gained into the perceived importance of quality in higher education that can stimulate debate and discussion on the role of government in building the standard quality in higher education. Also, the findings from this research can assist in the development of a framework of developing human resource.

Reconceptualizing digital service quality : a call-to-action and research approach

The nature of services and service delivery has been changing rapidly since the 1980’s when many seminal papers in services research were published. Services are increasingly digital, or have a digital component. Further, a large and heterogeneous literature, with competing and overlapping definitions, many of which are dated and inappropriate to contemporary digital services offerings is impeding progress in digital services research. In this conceptual paper, we offer a critical review of some existing conceptualizations of services and digital services. We argue that an inductive approach to understanding cognition about digital services is required to develop a taxonomy of digital services and a new vocabulary. We argue that this is a pre-requisite to theorizing about digital services, including understanding quality drivers, value propositions, and quality determinants for different digital service types. We propose a research approach for reconceptualising digital services and service quality, and outline methodological approaches and outcomes.

Course quality assurance at a glance

From 2014, QUT will be adopting a life-cycle approach to Course Quality Assurance informed by a wider and richer range of historic, ‘live’ and ‘predictive’ course data. Key data elements continue to be grouped according to the three broad categories – Viability, Quality of Learning Environment and Outcomes – and are further supported with analytic data presented within tables and charts. Course Quality Assurance and this Consolidated Courses Performance Report illuminate aspects of courses from a data evidence base highlighting the strengths and weaknesses of our courses. It provides the framework and tools to achieve QUT's commitment to excellent graduate outcomes by drawing attention and focus to the quality of our courses and providing a structured approach for bringing about change. Our portfolio of courses forms a vital part of QUT, generating almost $600 million in 2013 alone. Real world courses are fundamental to the strength of the Institution; they are what our many thousands of current and future students are drawn to and invest their time and aspirations in. As we move through a period of some regulatory and deregulatory uncertainty, there is a greater need for QUT to monitor and respond to the needs and expectations of our students. The life-cycle approach, with its rich and predicative data, provides the best source of evidence we have had, to date, to assure the quality of our courses and their relevance in a rapidly changing higher education context.

Supporting quality timely doctoral completions : online tools that deliver research outcomes

This case study applied Weick's (1979) notion of sensemaking to support timely quality doctoral completion. Taking a socio-cultural perspective the paper explored how drivers can be applied to inform better fit (Durham, 1991). Global research themes, including growth in student numbers, timely completion and generation and distribution of research outcomes, are considered. It is argued that accessible and interactive web interfaces should be informed by quality assurance measures and key performance indicators. The contribution made is a better understanding of how phenomena and contexts can be applied to generate quality management of research training environments and research outcomes in universities.

A statistical approach to quantify the impact on voltage quality caused by PV generators

A probabilistic method is proposed to evaluate voltage quality of grid-connected photovoltaic (PV) power systems. The random behavior of solar irradiation is described in statistical terms and the resulting voltage fluctuation probability distribution is then derived. Reactive power capabilities of the PV generators are then analyzed and their operation under constant power factor mode is examined. By utilizing the reactive power capability of the PV-generators to the full, it is shown that network voltage quality can be greatly enhanced.

Optimal Irrigation and N-fertilizer Management for Sustainable Winter Wheat Production in Khorezm, Uzbekistan

The efficiency of the nitrogen (N) application rates 0, 120, 180 and 240 kg N ha−1 in combination with low or medium water levels in the cultivation of winter wheat (Triticum aestivum L.) cv. Kupava was studied for the 2005–2006 and 2006–2007 growing seasons in the Khorezm region of Uzbekistan. The results show an impact of the initial soil Nmin (NO3-N + NH4-N) levels measured at wheat seeding on the N fertilizer rates applied. When the Nmin content in the 0–50 cm soil layer was lower than 10 mg kg−1 during wheat seeding in 2005, the N rate of 180 kg ha−1 was found to be the most effective for achieving high grain yields of high quality. With a higher Nmin content of about 30 mg kg−1 as was the case in the 2006 season, 120 kg N ha−1 was determined as being the technical and economical optimum. The temporal course of N2O emissions of winter wheat cultivation for the two water-level studies shows that emissions were strongly influenced by irrigation and N-fertilization. Extremely high emissions were measured immediately after fertilizer application events that were combined with irrigation events. Given the high impact of N-fertilizer and irrigation-water management on N2O emissions, it can be concluded that present N-management practices should be modified to mitigate emissions of N2O and to achieve higher fertilizer use efficiency.

Nano and ultrafine particle number concentrations in different environments : application towards air quality regulations

Particle number concentrations vary significantly with environment and, in this study, we attempt to assess the significance of these differences. Towards this aim, we reviewed 85 papers that have reported particle number concentrations levels at 126 sites covering different environments. We grouped the results into eight categories according to measurement location including: road tunnel, on-road, road-side, street canyon, urban, urban background, rural, and clean background. From these reports, the overall median number concentration for each of the eight site categories was calculated. The eight location categories may be classified into four distinct groups. The mean median particle number locations for these four types were found to be statistically different from each other. Rural and clean background sites had the lowest concentrations of about 3x103 cm-3. Urban and urban background sites showed concentrations that were three times higher (9x103 cm-3). The mean concentration for the street canyon, roadside and on-road measurement sites was 4.6x104 cm-3, while the highest concentrations were observed in the road tunnels (8.6x104 cm-3). This variation is important when assessing human exposure-response for which there is very little data available, making it difficult to develop health guidelines, a basis for national regulations. Our analyses shows that the current levels in environments affected by vehicle emissions are 3 to 28 times higher than in the natural environments. At present, there is no threshold level in response to exposure to ultrafine particles. Therefore, future control and management strategies should target a decrease of these particles in urban environments by more than one order of magnitude to bring them down to the natural background. At present there is a long way to go to achieve this.

Radiation therapist peer review: Raising the bar on quality and safety in radiation oncology

Purpose An emerging developmental tool to help radiation therapists achieve better outcomes is 'peer review'. This review of the current literature summarises the challenges and benefits of peer review in both individual and departmental practice. Discussion There is compelling evidence supporting peer review implementation at both individual and department level in many professions. Implementing peer review requires that radiation therapists and other radiation oncology professionals embrace a culture that supports safety. Peer review can identify trends and barriers associated with quality radiotherapy and share best practice or recommend changes accordingly. Support for peer review must come from pre-registration educational systems as well as clinical managers. Continuing professional development in the workplace is nurtured by peer review of radiotherapy practice and an aptitude for this should be viewed as important to the profession as technical and clinical skills. Conclusion It is clear that peer review has the potential to facilitate reflective practice, improve staff motivation and help foster a culture of quality and safety in radiation oncology. To drive the issues of quality and safety a step further radiation therapists need to accept the challenge of adopting peer review methods in day-to-day practice.