Improving psychosocial care: a professional development programme

Despite the numerous reports of difficulties experienced by health care providers in providing psychosocial care to terminally ill patients and their families, few studies have yet been undertaken to examine the effectiveness of different educational approaches to addressing these issues. The aim of this paper is to describe a programme of professional development for palliative care nurses, which is currently being offered to 181 registered nurses in Queensland, Australia. The programme is based on an action learning model and is designed to facilitate processes of reflection and peer consultation. In Part One of this paper, a review of this literature is presented to provide the background and rationale for the programme design. Details of the research programme developed to evaluate the programme will be presented in Part Two of this paper, which is to be published in the next issue of this Journal. Surveys of health professionals suggest that the demands of working with terminally ill patients are associated with a great deal of stress (Beaton and Degner 1990, Seale 1992, Vachon 1995), and emotional burden, as they are confronted with their patients' physical and emotional suffering over extended periods of time (Ullrich and Fitzgerald 1990). Key areas of concern (Lyons 1988, Bramwell 1989, Seale 1992, Copp and Dunn 1993, Wilkinson 1995) include: * Handling questions and conversations with dying patients. * Dealing with ethical and moral issues. * Handling emotions. * Giving hope. * Providing spiritual care and bereavement support. * Confronting team communication problems.

Changing work design in disaster response : the potential for innovation

Work design operates as the system of arrangements and procedures for organizing work to achieve organizational goals. These systems are commonly established in periods of environmental and organizational stability and formulated to achieve efficiencies in resources, employee and team configuration. However, organizations charged with responding to disasters need to be prepared to respond to unexpected events on a large scale, and disaster response planning needs to accommodate a broad range of possible disasters. When the disaster state occurs, enactment of the specific organizational response is devolved to group or individual level managers. While this enactment presents a range of risks, it also provides a potential avenue for innovation. Employees ultimately are the foundation of change and innovation, as it is people who develop, respond, change and implement new ideas. This study analyzes motivational characteristics of work design at an Australian humanitarian organization encompassing normal operations and periods of disaster activation. The study will identify the paradox of dual work designs and the implications for organizational innovation.

A Framework for Adaptation of Australian Households to Heat Waves

Climate change is leading to an increased frequency and severity of heat waves. Spells of several consecutive days of unusually high temperatures have led to increased mortality rates for the more vulnerable in the community. The problem is compounded by the escalating energy costs and increasing peak electrical demand as people become more reliant on air conditioning. Domestic air conditioning is the primary determinant of peak power demand which has been a major driver of higher electricity costs. This report presents the findings of multidisciplinary research which develops a national framework to evaluate the potential impacts of heat waves. It presents a technical, social and economic approach to adapt Australian residential buildings to ameliorate the impact of heat waves in the community and reduce the risk of its adverse outcomes. Through the development of a methodology for estimating the impact of global warming on key weather parameters in 2030 and 2050, it is possible to re-evaluate the size and anticipated energy consumption of air conditioners in future years for various climate zones in Australia. Over the coming decades it is likely that mainland Australia will require more cooling than heating. While in some parts the total electricity usage for heating and cooling may remain unchanged, there is an overall significant increase in peak electricity demand, likely to further drive electricity prices. Through monitoring groups of households in South Australia, New South Wales and Queensland, the impact of heat waves on both thermal comfort sensation and energy consumption for air conditioning has been evaluated. The results show that households are likely to be able to tolerate slightly increased temperature levels indoors during periods of high outside temperatures. The research identified that household electricity costs are likely to rise above what is currently projected due to the impact of climate change. Through a number of regulatory changes to both household design and air conditioners, this impact can be minimised. A number of proposed retrofit and design measures are provided, which can readily reduce electricity usage for cooling at minimal cost to the household. Using a number of social research instruments, it is evident that households are willing to change behaviour rather than to spend money. Those on lower income and elderly individuals are the least able to afford the use of air conditioning and should be a priority for interventions and assistance. Increasing community awareness of cost effective strategies to manage comfort and health during heat waves is a high priority recommended action. Overall, the research showed that a combined approach including behaviour change, dwelling modification and improved air conditioner selection can readily adapt Australian households to the impact of heat waves, reducing the risk of heat related deaths and household energy costs.

Characterization of precursors to methanol synthesis catalysts Cu/ZnO system

The composition of a series of hydroxycarbonate precursors to copper/zinc oxide methanol synthesis catalysts prepared under conditions reported as optimum for catalytic activity has been studied. Techniques employed included thermogravimetry (TG), temperature-programmed decomposition (TPD), X-ray diffraction (XRD), high-resolution transmission electron microscopy (HRTEM), and Raman and FTIR spectroscopies. Evidence was obtained for various structural phases including hydrozincite, copper hydrozincite, aurichalcite, zincian malachite and malachite (the concentrations of which depended upon the exact Cu/Zn ratio used). Significantly, previously reported phases such as gerhardite and rosasite were not identified when catalysts were synthesized at optimum solution pH and temperature values, and after appropriate aging periods. Calcination of the hydroxycarbonate precursors resulted in the formation of catalysts containing an intimate mixture of copper and zinc oxides. Temperature-programmed reduction (TPR) revealed that a number of discrete copper oxide species were present in the catalyst, the precise concentrations of which were determined to be related to the structure of the catalyst precursor. Copper hydrozincite decomposed to give zinc oxide particles decorated by highly dispersed, small copper oxide species. Aurichalcite appeared to result ultimately in the most intimately mixed catalyst structure whereas zincian malachite decomposed to produce larger copper oxide and zinc oxide grains. The reason for the stabilization of small copper oxide and zinc oxide clusters by aurichalcite was investigated by using carefully selected calcination temperatures. It was concluded that the unique formation of an 'anion-modified' oxide resulting from the initial decomposition stage of aurichalcite was responsible for the 'binding' of copper species to zinc moieties.

Perceived environmental correlates and physical activity: What neighborhood aspects really matter for mothers and fathers of young children?

Limited research has been conducted with at-risk populations in examining perceived environmental correlates of physical activity (PA); thus, we examined this relationship among parents with young children, a group at risk for physical inactivity. Parents (252 mothers, 206 fathers) completed a questionnaire assessing measures of perceived neighborhood environment and a 1-week follow-up of PA behavior. Mothers were more likely than fathers to perceive their neighborhood as unsafe to go for walks at night and less likely to perceive transit stops within 10–15 minutes walking distance, sidewalks on most streets, and facilities to bicycle. Adjusting for demographics, shops within easy walking distance, sidewalks on most streets, and having no more than one motor vehicle were associated with being active for both sexes. Access to transit stops and free/low cost recreational facilities were also associated with mothers’ PA. These findings suggest that environmental factors may support parents being active at recommended levels.

Social influences and the physical activity intentions of parents of young-children families: An extended Theory of Planned Behavior Approach

Evidence within Australia and internationally suggests parenthood as a risk factor for inactivity; however, research into understanding parental physical activity is scarce. Given that active parents can create active families and social factors are important for parents’ decision making, the authors investigated a range of social influences on parents’ intentions to be physically active. Parents (N = 580; 288 mothers and 292 fathers) of children younger than 5 years completed an extended Theory of Planned Behavior questionnaire either online or paper based. For both genders, attitude, control factors, group norms, friend general support, and an active parent identity predicted intentions, with social pressure and family support further predicting mothers’ intentions and active others further predicting fathers’ intentions. Attention to these factors and those specific to the genders may improve parents’ intentions to be physically active, thus maximizing the benefits to their own health and the healthy lifestyle practices for other family members.

"If they say go faster or something I'll probably go faster" - peer influence upon the risky driving behaviour of young novice drivers

Purpose Young novice drivers are at considerable risk of injury on the road, and their behaviour appears vulnerable to the social influence of their friends. Research was undertaken to identify the nature and mechanisms of peer influence upon novice driver (16-25 years) behaviour to inform the design of more effective young driver countermeasures. Methods. Peer influence was explored in small group interviews (n = 21) and three surveys (n1 = 761, n2 = 1170, n3 = 390) as part of a larger Queensland-wide study. Surveys two and three were part of a six-month longitudinal study. Results Peer influence was reported from the pre-Licence to the Provisional (intermediate) periods. Young novice drivers who experienced or expected social punishments including ‘being told off’ for risky driving reported less riskiness. Conversely young novice drivers who experienced or expected social rewards such as being ‘cheered on’ by their friends – who were also more risky drivers – reported more risky driving including crashes and offences. Conclusions Peers appear influential in the risky behaviour of young novice drivers, and influence occurs through social mechanisms of reinforcement and sanction. Interventions enhancing positive influence and curtailing negative influence may improve road safety outcomes not only for young novice drivers, but for all persons who share the road with them. Among the interventions warranting further development and evaluation are programs to encourage the modelling of safe driving behaviour and attitudes by young drivers; and minimisation of social reinforcement and promotion of social sanctions for risky driving behaviour in particular.

"My mother would freak out" : understanding the influence of parents on the risky behaviour of their young novice drivers

Purpose Parents can influence the driving behaviour of their young novice drivers in a variety of ways. Research was undertaken to explore and identify the nature and mechanisms of parental influence upon novice drivers (16-25 years) to inform the design of more effective young driver countermeasures. Methods The mechanisms and nature of parental influence on young novice drivers were explored in small group interviews (n = 21) and three surveys (n1 = 761, n2 = 1170, n3 = 390) in a larger Queensland-wide study. Surveys two and three were part of a six-month longitudinal study. Results Parental influence appeared to occur across the pre-Licence, Learner, and Provisional (intermediate) periods. The most risky novice drivers (in terms of pre-Licence driving, unsupervised driving while a Learner, and risky driving behaviours such as speeding) reported that their parents were less likely to punish risky driving, and that their parents – who they were more likely to imitate – were also risky drivers (indicated by crashes and offences). Conclusions Parents appear influential in the risky behaviour of young novice drivers. Interventions enhancing their positive influence may improve road safety outcomes not only for young novice drivers, but for all persons who share the road with them. Among the interventions warranting further development and evaluation are programs to encourage the modelling of safe driving behaviour by parents; continued parental monitoring of driving during the pre-Licence, Learner and Provisional periods (e.g., Checkpoints program); and sharing the family vehicle during the first six months of independent licensure.

Pro Bono partnerships : community lawyering to promote environmental justice

Rural communities across Australia are increasingly being asked to shoulder the environmental and social impacts of intensive mining and gas projects. Escalating demand for coal seam gas (CSG) is raising significant environmental justice issues for rural communities. Chief amongst environmental concerns are risks of contamination or depletion of vital underground aquifers as well as treatment and disposal of high-saline water close to high quality agricultural soils. Associated infrastructure such as pipelines, electricity lines, gas processing and port facilities can also adversely affect communities and ecosystems great distances from where the gas is originally extracted. Whilst community submission (and appeal) rights do exist, accessing expert independent information is challenging, legal terminology is complex and submission periods are short, leading ultimately to a lack of procedural justice for landholders and their communities. Since August 2012, Queensland University of Technology (QUT) has worked in partnership with not-for-profit legal centre - Queensland’s Environmental Defenders Office (EDO) - to help better educate communities about mining and CSG assessment processes. The project, now entering its third semester, aims to empower communities to access relevant information and actively engage in legal processes on their own behalf. Students involved in the project so far have helped to research chapters of a comprehensive community guide to mining and CSG law as well as organising multidisciplinary community forums and preparing information on land access and compensation rights for landholders. While environmental justice issues still exist without significant law reform, the project has led to greater awareness amongst the community of the laws relating the CSG. At the same time, it has led to a greater understanding by students and academics of real life environmental justice issues currently faced by rural communities.

Sampling environmental acoustic recordings to determine bird species richness

Acoustic sensors can be used to estimate species richness for vocal species such as birds. They can continuously and passively record large volumes of data over extended periods. These data must subsequently be analyzed to detect the presence of vocal species. Automated analysis of acoustic data for large numbers of species is complex and can be subject to high levels of false positive and false negative results. Manual analysis by experienced surveyors can produce accurate results; however the time and effort required to process even small volumes of data can make manual analysis prohibitive. This study examined the use of sampling methods to reduce the cost of analyzing large volumes of acoustic sensor data, while retaining high levels of species detection accuracy. Utilizing five days of manually analyzed acoustic sensor data from four sites, we examined a range of sampling frequencies and methods including random, stratified, and biologically informed. We found that randomly selecting 120 one-minute samples from the three hours immediately following dawn over five days of recordings, detected the highest number of species. On average, this method detected 62% of total species from 120 one-minute samples, compared to 34% of total species detected from traditional area search methods. Our results demonstrate that targeted sampling methods can provide an effective means for analyzing large volumes of acoustic sensor data efficiently and accurately. Development of automated and semi-automated techniques is required to assist in analyzing large volumes of acoustic sensor data. Read More: http://www.esajournals.org/doi/abs/10.1890/12-2088.1

Cost-effectiveness of a telephone-delivered education programme to prevent early childhood caries in a disadvantaged area : a cohort study

Objectives Early childhood caries is a highly destructive dental disease which is compounded by the need for young children to be treated under general anaesthesia. In Australia, there are long waiting periods for treatment at public hospitals. In this paper, we examined the costs and patient outcomes of a prevention programme for early childhood caries to assess its value for government services. Design Cost-effectiveness analysis using a Markov model. Setting Public dental patients in a low socioeconomic, socially disadvantaged area in the State of Queensland, Australia. Participants Children aged 6 months to 6 years received either a telephone prevention programme or usual care. Primary and secondary outcome measures A mathematical model was used to assess caries incidence and public dental treatment costs for a cohort of children. Healthcare costs, treatment probabilities and caries incidence were modelled from 6 months to 6 years of age based on trial data from mothers and their children who received either a telephone prevention programme or usual care. Sensitivity analyses were used to assess the robustness of the findings to uncertainty in the model estimates. Results By age 6 years, the telephone intervention programme had prevented an estimated 43 carious teeth and saved £69 984 in healthcare costs per 100 children. The results were sensitive to the cost of general anaesthesia (cost-savings range £36 043–£97 298) and the incidence of caries in the prevention group (cost-savings range £59 496–£83 368) and usual care (cost-savings range £46 833–£93 328), but there were cost savings in all scenarios. Conclusions A telephone intervention that aims to prevent early childhood caries is likely to generate considerable and immediate patient benefits and cost savings to the public dental health service in disadvantaged communities.

Travel time prediction on signalised urban arterials by applying SARIMA modelling on Bluetooth data

Travel time prediction has long been the topic of transportation research. But most relevant prediction models in the literature are limited to motorways. Travel time prediction on arterial networks is challenging due to involving traffic signals and significant variability of individual vehicle travel time. The limited availability of traffic data from arterial networks makes travel time prediction even more challenging. Recently, there has been significant interest of exploiting Bluetooth data for travel time estimation. This research analysed the real travel time data collected by the Brisbane City Council using the Bluetooth technology on arterials. Databases, including experienced average daily travel time are created and classified for approximately 8 months. Thereafter, based on data characteristics, Seasonal Auto Regressive Integrated Moving Average (SARIMA) modelling is applied on the database for short-term travel time prediction. The SARMIA model not only takes the previous continuous lags into account, but also uses the values from the same time of previous days for travel time prediction. This is carried out by defining a seasonality coefficient which improves the accuracy of travel time prediction in linear models. The accuracy, robustness and transferability of the model are evaluated through comparing the real and predicted values on three sites within Brisbane network. The results contain the detailed validation for different prediction horizons (5 min to 90 minutes). The model performance is evaluated mainly on congested periods and compared to the naive technique of considering the historical average.

Recognising team activities from noisy data

Recently, vision-based systems have been deployed in professional sports to track the ball and players to enhance analysis of matches. Due to their unobtrusive nature, vision-based approaches are preferred to wearable sensors (e.g. GPS or RFID sensors) as it does not require players or balls to be instrumented prior to matches. Unfortunately, in continuous team sports where players need to be tracked continuously over long-periods of time (e.g. 35 minutes in field-hockey or 45 minutes in soccer), current vision-based tracking approaches are not reliable enough to provide fully automatic solutions. As such, human intervention is required to fix-up missed or false detections. However, in instances where a human can not intervene due to the sheer amount of data being generated - this data can not be used due to the missing/noisy data. In this paper, we investigate two representations based on raw player detections (and not tracking) which are immune to missed and false detections. Specifically, we show that both team occupancy maps and centroids can be used to detect team activities, while the occupancy maps can be used to retrieve specific team activities. An evaluation on over 8 hours of field hockey data captured at a recent international tournament demonstrates the validity of the proposed approach.

Quality of life, fatigue and activity in Australians with chronic kidney disease : a longitudinal study

Aims and objectives This study sought to determine the relationship between health related quality of life (HRQoL), fatigue and activity levels of people with anaemia secondary to chronic kidney disease (CKD) over a 12 month period following the introduction of an erythropoietin stimulating agent (ESA). Background CKD occurs in five stages and it is a complex chronic illness which severely impacts on an individual’s HRQoL, and ability to perform everyday activities. Fatigue is also a common symptom experienced by people with CKD. Design and methods Using a longitudinal repeated measures design, 28 people with CKD completed the SF-36, human activity profile and fatigue severity scale at the commencement of an ESA and then at 3, 6 and 12 months. Results Over a 12 month period, people reported a significant change in HRQoL in relation to role physical, vitality, mental health/emotional well-being and overall mental health. However activity levels did not significantly improve during that time. Both the amount of breathlessness and level of fatigue were highest at baseline and declined over time. Both fatigue and breathlessness were correlated with less reported general health over time. Conclusion Renal nurses, in dialysis units and CKD outpatient clinics, have repeated and frequent contact with people with CKD over long periods of time, and are in an ideal position to routinely assess fatigue and activity levels and to institute timely interventions. Early detection would enable timely nursing interventions to optimise HRQoL and independent activity. Relevance to Clinical Practice Drawing on rehabilitation nursing interventions could assist renal nurses to minimize the burden of fatigue and its impact on simple everyday activities and a person’s quality of life. These interventions are important for people who are living at home and could assist in lowering the burden on home support services.

The consistency of crash involvement recall across time

Introduction Road safety researchers rely heavily on self-report data to explore the aetiology of crash risk. However, researchers consistently acknowledge a range of limitations associated with this methodological approach (e.g., self-report bias), which has been hypothesised to reduce the predictive efficacy of scales. Although well researched in other areas, one important factor often neglected in road safety studies is the fallibility of human memory. Given accurate recall is a key assumption in many studies, the validity and consistency of self-report data warrants investigation. The aim of the current study was to examine the consistency of self-report data of crash history and details of the most recent reported crash on two separate occasions. Materials & Method A repeated measures design was utilised to examine the self-reported crash involvement history of 214 general motorists over a two month period. Results A number of interesting discrepancies were noted in relation to number of lifetime crashes reported by the participants and the descriptions of their most recent crash across the two occasions. Of the 214 participants who reported having been involved in a crash, 35 (22.3%) reported a lower number of lifetime crashes as Time 2, than at Time 1. Of the 88 drivers who reported no change in number of lifetime crashes, 10 (11.4%) described a different most recent crash. Additionally, of the 34 reporting an increase in the number of lifetime crashes, 29 (85.3%) of these described the same crash on both occasions. Assessed as a whole, at least 47.1% of participants made a confirmed mistake at Time 1 or Time 2. Conclusions These results raise some doubt in regard to the accuracy of memory recall across time. Given that self-reported crash involvement is the predominant dependent variable used in the majority of road safety research, this issue warrants further investigation. Replication of the study with a larger sample size that includes multiple recall periods would enhance understanding into the significance of this issue for road safety methodology.