A study on the effects of routing symbol design on process model comprehension

Process modeling grammars are used to create models of business processes. In this paper, we discuss how different routing symbol designs affect an individual's ability to comprehend process models. We conduct an experiment with 154 students to ascertain which visual design principles influence process model comprehension. Our findings suggest that design principles related to perceptual discriminability and pop out improve comprehension accuracy. Furthermore, semantic transparency and aesthetic design of symbols lower the perceived difficulty of comprehension. Our results inform important principles about notational design of process modeling grammars and the effective use of process modeling in practice.

Handover : the collective narrative of nursing practice

This paper examines the practice of handover in a large metropolitan hospital. It shows that the handover is a significant site at which to examine how tensions and imperatives derived from the traditional institutional position and role of the nurse are played out in contradiction with emergent professionalism. It identifies handover dimensions and focuses discussion on how the collective narrative of the handover serves to construct patient identities as well as ensure solidarity and cohesion among nurses.

Recovery model of care within the PICU

Nurses are the primary care providers of consumers admitted to the High Dependency Ward (HDU) or Psychiatric Intensive Care Unit (PICU). They are the largest professional group providing care to the acutely unwell, managing crisis and complex clinical psychiatric scenarios. It is timely to review the skills and expertise of this nursing specialty for further definition and acknowledgement.

Spatial modelling of population health screening : the role of accessibility in predicting expected patient flows

This paper describes a generalised linear mixed model (GLMM) approach for understanding spatial patterns of participation in population health screening, in the presence of multiple screening facilities. The models presented have dual focus, namely the prediction of expected patient flows from regions to services and relative rates of participation by region- service combination, with both outputs having meaningful implications for the monitoring of current service uptake and provision. The novelty of this paper lies with the former focus, and an approach for distributing expected participation by region based on proximity to services is proposed. The modelling of relative rates of participation is achieved through the combination of different random effects, as a means of assigning excess participation to different sources. The methodology is applied to participation data collected from a government-funded mammography program in Brisbane, Australia.

Exo1 plays a major role in DNA end resection in humans and influences double-strand break repair and damage signaling decisions

The resection of DNA double-strand breaks (DSBs) to generate ssDNA tails is a pivotal event in the cellular response to these breaks. In the two-step model of resection, primarily elucidated in yeast, initial resection by Mre11-CtIP is followed by extensive resection by two distinct pathways involving Exo1 or BLM/WRN-Dna2. However, resection pathways and their exact contributions in humans in vivo are not as clearly worked out as in yeast. Here, we examined the contribution of Exo1 to DNA end resection in humans in vivo in response to ionizing radiation (IR) and its relationship with other resection pathways (Mre11-CtIP or BLM/WRN). We find that Exo1 plays a predominant role in resection in human cells along with an alternate pathway dependent on WRN. While Mre11 and CtIP stimulate resection in human cells, they are not absolutely required for this process and Exo1 can function in resection even in the absence of Mre11-CtIP. Interestingly, the recruitment of Exo1 to DNA breaks appears to be inhibited by the NHEJ protein Ku80, and the higher level of resection that occurs upon siRNA-mediated depletion of Ku80 is dependent on Exo1. In addition, Exo1 may be regulated by 53BP1 and Brca1, and the restoration of resection in BRCA1-deficient cells upon depletion of 53BP1 is dependent on Exo1. Finally, we find that Exo1-mediated resection facilitates a transition from ATM- to ATR-mediated cell cycle checkpoint signaling. Our results identify Exo1 as a key mediator of DNA end resection and DSB repair and damage signaling decisions in human cells.

Creative writing in recovery from severe mental illness

There is evidence that creative writing forms an important part of the recovery experience of people affected by severe mental illness. In this paper, we consider theoretical models that explain how creative writing might contribute to recovery, and we discuss the potential for creative writing in psychosocial rehabilitation. We argue that the rehabilitation benefits of creative writing might be optimized through focus on process and technique in writing, rather than content, and that consequently, the involvement of professional writers might be important. We describe a pilot workshop that deployed these principles and was well-received by participants. Finally, we make recommendations regarding the role of creative writing in psychosocial rehabilitation for people recovering from severe mental illness and suggest that the development of an evidence base regarding the effectiveness of creative writing is a priority.

An intervention study to improve pain management by nurses : normative beliefs and perceived control

Based on a predictive model of nurses' intentions regarding pain management, an intervention was developed to improve nurses' pain management. The intervention involved a series of workshops with cohorts of nurses working in acute care wards to address the important antecedents to their intentions: normative beliefs and perceived control. Pre- and post-intervention measures demonstrate the effectiveness of the intervention. The effectiveness of this intervention in improving the management of patients' pain is compared with a patient education program group and a control group. The findings provide support for further developing interventions based on the theory of planned behavior.

Investigation of sensitivity based load ranking with composite load model in power system

Load modeling plays an important role in power system dynamic stability assessment. One of the widely used methods in assessing load model impact on system dynamic response is through parametric sensitivity analysis. Load ranking provides an effective measure of such impact. Traditionally, load ranking is based on either static or dynamic load model alone. In this paper, composite load model based load ranking framework is proposed. It enables comprehensive investigation into load modeling impacts on system stability considering the dynamic interactions between load and system dynamics. The impact of load composition on the overall sensitivity and therefore on ranking of the load is also investigated. Dynamic simulations are performed to further elucidate the results obtained through sensitivity based load ranking approach.

Paramedics' perceptions of their role in palliative care : analysis of focus group transcripts

Paramedics play an important role in out-of-hospital health care. They provide unscheduled care, assisting both patients with minor injuries and those experiencing life-threatening emergencies. Increasingly, paramedics are called on to manage chronic and complex health needs, including symptom relief for patients at the end of life. However, paramedics may not be well prepared to offer palliative care, as practice guidelines and education tend to focus on the management of acute medical emergencies and major trauma. Emergency medical services that employ paramedics rarely have practice guidelines or protocols that deal specifically with palliative care.

Community interventions for physical activity : the role of a new Cochrane systematic review

Introduction: Systematic reviews are essential in summarising the results of a range of research studies on a specific topic into a single report. They serve as a key source of evidence-based information to support and develop policy and practice for healthy communities. This presentation will examine a new review of community-wide strategies to increase population levels of physical activity and compare it to an earlier Community Guide Review (CGR) of Community-wide campaigns to increase physical activity which recommended community wide interventions. Methods: We registered a Cochrane Systematic Review (CSR) title, published a protocol and recently completed the review of Community-wide interventions to increase physical activity. We compared the definitions, design and findings of the CSR to the CGR. Results: The two reviews differed remarkably in their conclusions with the CGR recommending “strong evidence exists that community-wide campaigns are effective in increasing levels of physical activity”, and the new CSR stating “The body of evidence in this review does not support the hypothesis that multi-component community wide interventions effectively increase population levels of physical activity”. We observed that both reviews examined multi-component interventions as a “combined package”. Possible explanations for the different conclusions may be due to the definition of community (CSR defined community as “comprising those persons residing in a geographically defined community, such as a village, town, or city”, excluding interventions which were whole of state or country, and CGR as “a group of individuals who share one or more characteristics. The CSR utilised a logic model at various stages of the review process and explicitly defined a combination of strategies encompassed within the intervention. The CSR included 25 and CGR 10 studies, respectively. Six of the 10 studies that were included in CGR were excluded from the CSR due to issues relating to study design, intervention definition or duration. The two reviews also differ in function as the CSR seeks to summarise global evidence and included 7 studies in low-income countries, where as the CGR contained only studies deemed relevant to the USA context. Discussion: Differences in the findings between older and newer reviews can be due to a variety of factors. For example, in updating a review the definition of an intervention can be changed. Further, differences may also be due to improvements in the standards and methodologies for systematic reviews as well as the inclusion of newer studies. These factors need to be understood whenever differences between newer and older reviews are considered.

Fans teaching fans how to consume : the role of ritual in the consumption of entertainment

The status of entertainment as both a dimension of human culture, and a booming global industry is increasing. Given more recent consumer-centric definitions of entertainment, the entertainment consumer has grown in prominence and is now coming under closer scrutiny. However viewing entertainment consumers as always behaving in a similar fashion towards entertainment as to other products may be selling them short. For a start, entertainment consumers can exhibit a strong loyalty towards their favourite entertainment products that is the envy of the marketing world. Academic researchers and marketers who are keen to investigate entertainment consumers would benefit from a theoretical base from which to commence. This essay therefore, takes a consumer-oriented focus in defining entertainment and conceptualises a model of entertainment consumption. In approaching the study of entertainment one axiomatic question remains: how should we define it? Richard Dyer notes that, considering that the category of entertainment can include – by its own definition in the song ‘That’s entertainment!’ – everything from Hamlet and Oedipus Rex to ‘the clown with his pants falling down’ and ‘the lights on the lady in tights’, it doesn’t make much sense to try to define entertainment as being marked by particular textual features (as is done, for example, by Avrich, 2002). Dyer’s position is rather that ‘entertainment is not so much a category of things as an attitude towards things’ (Dyer, 1973: 9). He traces the modern conception of entertainment back to the writings of Molière. This writer defended the purpose of his plays against attacks from the church that they were not sufficiently edifying by insisting that, as entertainments he had no interest in edifying audiences – his ‘real purpose …was to provide people pleasure – and the definition of that was to be decided by “the people”’(Dyer, 1973: 9). In my own discipline of Marketing this approach has been embraced – Kaser and Oelkers, for example, define entertainment as ‘whatever people are willing to spend their money and spare time viewing’ (2008, 18). That is the approach taken in this paper, where I see entertainment as ‘consumer-driven culture’ (McKee and Collis, 2009) – a definition that is closely aligned with the marketing concept. Within a marketing framework I explore what the consumption of entertainment can tell us about the relationships between consumers and culture more generally. For entertainment offers an intriguing case study, and is often consumed in ways that challenge many of our assumptions about marketing and consumer behaviour.

Using ‘think aloud’ as a strategy for improving clinical reasoning in high fidelity case-based simulation for undergraduate nursing students.

Theme Paper for Curriculum innovation and enhancement theme AIM: This paper reports on a research project that trialled an educational strategy implemented in an undergraduate nursing curriculum. The project aimed to explore the effectiveness of ‘think aloud’ as a strategy for improving clinical reasoning for students in simulated clinical settings. BACKGROUND: Nurses are required to apply and utilise critical thinking skills to enable clinical reasoning and problem solving in the clinical setting (Lasater, 2007). Nursing students are expected to develop and display clinical reasoning skills in practice, but may struggle articulating reasons behind decisions about patient care. The ‘think aloud’ approach is an innovative learning/teaching method which can create an environment suitable for developing clinical reasoning skills in students (Banning, 2008, Lee and Ryan-Wenger, 1997). This project used the ‘think aloud’ strategy within a simulation context to provide a safe learning environment in which third year students were assisted to uncover cognitive approaches to assist in making effective patient care decisions, and improve their confidence, clinical reasoning and active critical reflection about their practice. MEHODS: In semester 2 2011 at QUT, third year nursing students undertook high fidelity simulation (some for the first time), commencing in September of 2011. There were two cohorts for strategy implementation (group 1= used think aloud as a strategy within the simulation, group 2= no specific strategy outside of nursing assessment frameworks used by all students) in relation to problem solving patient needs. The think aloud strategy was described to students in their pre-simulation briefing and allowed time for clarification of this strategy. All other aspects of the simulations remained the same, (resources, suggested nursing assessment frameworks, simulation session duration, size of simulation teams, preparatory materials). Ethics approval has been obtained for this project. RESULTS: Results of a qualitative analysis (in progress- will be completed by March 2012) of student and facilitator reports on students’ ability to meet the learning objectives of solving patient problems using clinical reasoning and experience with the ‘think aloud’ method will be presented. A comparison of clinical reasoning learning outcomes between the two groups will determine the effect on clinical reasoning for students responding to patient problems. CONCLUSIONS: In an environment of increasingly constrained clinical placement opportunities, exploration of alternate strategies to improve critical thinking skills and develop clinical reasoning and problem solving for nursing students is imperative in preparing nurses to respond to changing patient needs.

Interpersonal coupling in rowing : the mediating role of the environment

Evidence currently supports the view that intentional interpersonal coordination (IIC) is a self-organizing phenomenon facilitated by visual perception of co-actors in a coordinative coupling (Schmidt, Richardson, Arsenault, & Galantucci, 2007). The present study examines how apparent IIC is achieved in situations where visual information is limited for co-actors in a rowing boat. In paired rowing boats only one of the actors, [bow seat] gets to see the actions of the other [stroke seat]. Thus IIC appears to be facilitated despite the lack of important visual information for the control of the dyad. Adopting a mimetic approach to expert coordination, the present study qualitatively examined the experiences of expert performers (N=9) and coaches (N=4) with respect to how IIC was achieved in paired rowing boats. Themes were explored using inductive content analysis, which led to layered model of control. Rowers and coaches reported the use of multiple perceptual sources in order to achieve IIC. As expected(Kelso, 1995; Schmidt & O’Brien, 1997; Turvey, 1990), rowers in the bow of a pair boat make use of visual information provided by the partner in front of them [stroke]. However, this perceptual information is subordinate to perception Motor Learning and Control S111 of the relationship between the boat hull and water passing beside it. Stroke seat, in the absence of visual information about his/her partner, achieves coordination by picking up information about the lifting or looming of the boat’s stern along with water passage past the hull. In this case it appears that apparent or desired IIC is supported by the perception of extra-personal variables, in this case boat behavior; as this perceptual information source is used by both actors. To conclude, co-actors in two person rowing boats use multiple sources of perceptual information for apparent IIC that changes according to task constraints. Where visual information is restricted IIC is facilitated via extra-personal perceptual information and apparent IIC switches to intentional extra-personal coordination.