850 resultados para outcomes assessment
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Interactional competence has emerged as a focal point for language testing researchers in recent years. In spoken communication involving two or more interlocutors, the co-construction of discourse is central to successful interaction. The acknowledgement of co-construction has led to concern over the impact of the interlocutor and the separability of performances in speaking tests involving interaction. The purpose of this article is to review recent studies of direct relevance to the construct of interactional competence and its operationalisation by raters in the context of second language speaking tests. The review begins by tracing the emergence of interaction as a criterion in speaking tests from a theoretical perspective, and then focuses on research salient to interactional effectiveness that has been carried out in the context of language testing interviews and group and paired speaking tests.
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Background: Impairments in upper-body function (UBF) are common following breast cancer. However, the relationship between arm morbidity and quality of life (QoL) remains unclear. This investigation uses longitudinal data to describe UBF in a population-based sample of women with breast cancer and examines its relationship with QoL. ---------- Methods: Australian women (n = 287) with unilateral breast cancer were assessed at three-monthly intervals, from six- to 18-months post-surgery (PS). Strength, endurance and flexibility were used to assess objective UBF, while the Disability of the Arm, Shoulder and Hand questionnaire and the Functional Assessment of Cancer Therapy- Breast questionnaire were used to assess self-reported UBF and QoL, respectively. ---------- Results: Although mean UBF improved over time, up to 41% of women revealed declines in UBF between sixand 18-months PS. Older age, lower socioeconomic position, treatment on the dominant side, mastectomy, more extensive lymph node removal and having lymphoedema each increased odds of declines in UBF by at least twofold (p < 0.05). Lower baseline and declines in perceived UBF between six- and 18-months PS were each associated with poorer QoL at 18-months PS (p < 0.05). ---------- Conclusions: Significant upper-body morbidity is experienced by many following breast cancer treatment, persisting longer term, and adversely influencing the QoL of breast cancer survivors.
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This paper provides a review of the state of the art relevant work on the use of public mobile data networks for aircraft telemetry and control proposes. Moreover, it describes the characterisation for airborne uses of the public mobile data communication systems known broadly as 3G. The motivation for this study was the explore how this mature public communication systems could be used for aviation purposes. An experimental system was fitted to a light aircraft to record communication latency, line speed, RF level, packet loss and cell tower identifier. Communications was established using internet protocols and connection was made to a local server. The aircraft was flown in both remote and populous areas at altitudes up to 8500 ft in a region located in South East Queensland, Australia. Results show that the average airborne RF levels are better than those on the ground by 21% and in the order of - 77dbm. Latencies were in the order of 500ms (1/2 the latency of Iridium), an average download speed of 0.48Mb/s, average uplink speed of 0.85Mb/s, a packet of information loss of 6.5%. The maximum communication range was also observed to be 70km from a single cell station. The paper also describes possible limitations and utility of using such communications architecture for both manned and unmanned aircraft systems.
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The costs of work-related crashes In Australia and overseas, fleet safety or work-related road safety is an issue gaining increased attention from researchers, organisations, road safety practitioners and the general community. This attention is primarily in response to the substantial physical, emotional and economic costs associated with work-related road crashes. The increased risk factors and subsequent costs of work-related driving are also now well documented in the literature. For example, it is noteworthy that research has demonstrated that work-related drivers on average report a higher level of crash involvement compared to personal car drivers (Downs et al., 1999; Kweon and Kockelman, 2003) and in particular within Australia, road crashes are the most common form of work-related fatalities (Haworth et al., 2000).
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This article deals with the non-linear oscillations assessment of a distribution static comensator ooperating in voltage control mode using the bifurcation theory. A mathematical model of the distribution static compensator in the voltage control mode to carry out the bifurcation analysis is derived. The stabiity regions in the Thevein equivalent plane are computed. In addition, the stability regions in the control gains space, as well as the contour lines for different Floquet multipliers are computed. The AC and DC capacitor impacts on the stability are analyzed through the bifurcation theory. The observations are verified through simulaation studies. The computation of the stability region allows the assessment of the stable operating zones for a power system that includes a distribution static compensator operating in the voltage mode.
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PURPOSE. To measure tear film surface quality in healthy and dry eye subjects using three noninvasive techniques of tear film quality assessment and to establish the ability of these noninvasive techniques to predict dry eye. METHODS. Thirty four subjects participated in the study, and were classified as dry eye or normal, based on standard clinical assessments. Three non-invasive techniques were applied for measurement of tear film surface quality: dynamic-area high-speed videokeratoscopy (HSV), wavefront sensing (DWS) and lateral shearing interferometry (LSI). The measurements were performed in both natural blinking conditions (NBC) and in suppressed blinking conditions (SBC). RESULTS. In order to investigate the capability of each method to discriminate dry eye subjects from normal subjects, the receiver operating curve (ROC) was calculated and then the area under the curve (AUC) was extracted. The best result was obtained for the LSI technique (AUC=0.80 in SBC and AUC=0.73 in NBC), which was followed by HSV (AUC=0.72 in SBC and AUC=0.71 in NBC). The best result for DWS was AUC=0.64 obtained for changes in vertical coma in suppressed blinking conditions, while for normal blinking conditions the results were poorer. CONCLUSIONS. Non-invasive techniques of tear film surface assessment can be used for predicting dry eye and this can be achieved in natural blinking as well as suppressed blinking conditions. In this study, LSI showed the best detection performance, closely followed by the dynamic-area HSV. The wavefront sensing technique was less powerful, particularly in natural blinking conditions.
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There are several noninvasive techniques for assessing the kinetics of tear film, but no comparative studies have been conducted to evaluate their efficacies. Our aim is to test and compare techniques based on high-speed videokeratoscopy (HSV), dynamic wavefront sensing (DWS), and lateral shearing interferometry (LSI). Algorithms are developed to estimate the tear film build-up time TBLD, and the average tear film surface quality in the stable phase of the interblink interval TFSQAv. Moderate but significant correlations are found between TBLD measured with LSI and DWS based on vertical coma (Pearson's r2=0.34, p<0.01) and higher order rms (r2=0.31, p<0.01), as well as between TFSQAv measured with LSI and HSV (r2=0.35, p<0.01), and between LSI and DWS based on the rms fit error (r2=0.40, p<0.01). No significant correlation is found between HSV and DWS. All three techniques estimate tear film build-up time to be below 2.5 sec, and they achieve a remarkably close median value of 0.7 sec. HSV appears to be the most precise method for measuring tear film surface quality. LSI appears to be the most sensitive method for analyzing tear film build-up.
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Prospective clinical case series of 100 patients receiving thoracoscopic anterior scoliosis correction surgery. The objective was to evaluate the relationship between clinical outcomes of thoracoscopic anterior scoliosis surgery and deformity correction using the Scoliosis Research Society (SRS) outcomes instrument questionnaire. The surgical treatment of scoliosis is quantitatively assessed in the clinic using radiographic measures of deformity correction, as well as the rib hump, but it is important to understand the extent to which these quantitative measures correlate with self-reported improvements in patients’ quality of life following surgery. A series of 100 consecutive adolescent idiopathic scoliosis patients received a single anterior rod via a thoracoscopic approach at the Mater Children’s Hospital, Brisbane, Australia. Patients completed SRS outcomes questionnaires pre-operatively and at 24 months post-operatively. There were 94 females and 6 males with a mean age of 16.1 years. The mean Cobb angle improved from 52º pre-operatively to 25º post-operatively (52%) and the mean rib hump improved from 16º to 8º (51%). The mean total SRS score for the cohort was 99.4/120. None of the deformity related parameters in the multiple regression were significant. However, patients with the lowest post-operative major Cobb angles reported significantly higher SRS scores than those with the highest post-operative Cobb angles, but there was no difference on the basis of rib hump correction. There were no significant differences between patients with either rod fractures or screw-related complications compared to those without complications.
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The primary clinical role of the non-invasive physical measurement of a bone, generally referred to as ‘bone densitometry,’ is to identify those subjects at risk of an osteoporotic fracture and their subsequent response to pharmaceutical intervention. The true ‘gold standard’ measurement of the mechanical integrity of a bone, and hence its fracture load, is a destructive test, generally performed by compressing either a regular shaped sample or whole bone.
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To undertake exploratory benchmarking of a set of clinical indicators of quality care in residential care in Australia, data were collected from 107 residents within four medium-sized facilities (40–80 beds) in Brisbane, Australia. The proportion of residents in each sample facility with a particular clinical problem was compared with US Minimum Data Set quality indicator thresholds. Results demonstrated variability within and between clinical indicators, suggesting breadth of assessment using various clinical indicators of quality is an important factor when monitoring quality of care. More comprehensive and objective measures of quality of care would be of great assistance in determining and monitoring the effectiveness of residential aged care provision in Australia, particularly as demands for accountability by consumers and their families increase. What is known about the topic? The key to quality improvement is effective quality assessment, and one means of evaluating quality of care is through clinical outcomes. The Minimum Data Set quality indicators have been credited with improving quality in United States nursing homes. What does this paper add? The Clinical Care Indicators Tool was used to collect data on clinical outcomes, enabling comparison of data from a small Australian sample with American quality benchmarks to illustrate the utility of providing guidelines for interpretation. What are the implications for practitioners? Collecting and comparing clinical outcome data would enable practitioners to better understand the quality of care being provided and whether practices required review. The Clinical Care Indicator Tool could provide a comprehensive and systematic means of doing this, thus filling a gap in quality monitoring within Australian residential aged care.
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Various countries have been introducing sustainable assessment tools for real estate design to produce integrated sustainability components not just for the building, but also the landscape component of the development. This paper aims to present the comparison between international and local assessment tools of landscape design for housing estate developments in Bangkok Metropolitan Region (BMR), Thailand. The methodologies used are to review, then compare and identify discrepancy indicators among the tools. This paper will examine four international tools; LEED for Neighbourhood Development (LEED – ND) of United State of America (USA), EnviroDevelopment standards of Australia, Residential Landscape Sustainability of United Kingdom (UK) and Green Mark for Infrastructure of Singapore; and three BMR’s existing tools; Land Subdivision Act B.E. 2543, Environmental Impact Assessment Monitoring Awards (EIA-MA) and Thai’s Rating for Energy and Environmental Sustainability of New construction and major renovation (TREES-NC). The findings show that there are twenty two elements of three categories which are neighbourhood design, community management, and environmental condition. Moreover, only one element in neighbourhood designs different between the international and local tools. The sustainable assessment tools have existed in BMR but they are not complete in only one assessment tool. Thus, the development of new comprehensive assessment tool will be necessary in BMR; however, it should meet the specific environment and climate condition for housing estate development at BMR.
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Background Research involving incapacitated persons with dementia entails complex scientific, legal, and ethical issues, making traditional surveys of layperson views on the ethics of such research challenging. We therefore assessed the impact of democratic deliberation (DD), involving balanced, detailed education and peer deliberation, on the views of those responsible for persons with dementia. Methods One hundred and seventy-eight community-recruited caregivers or primary decision-makers for persons with dementia were randomly assigned to either an all-day DD session group or a control group. Educational materials used for the DD session were vetted for balance and accuracy by an interdisciplinary advisory panel. We assessed the acceptability of family-surrogate consent for dementia research (“surrogate-based research”) from a societal policy perspective as well as from the more personal perspectives of deciding for a loved one or for oneself (surrogate and self-perspectives), assessed at baseline, immediately post-DD session, and 1 month after DD date, for four research scenarios of varying risk-benefit profiles. Results At baseline, a majority in both the DD and control groups supported a policy of family consent for dementia research in all research scenarios. The support for a policy of family consent for surrogate-based research increased in the DD group, but not in the control group. The change in the DD group was maintained 1 month later. In the DD group, there were transient changes in attitudes from surrogate or self-perspectives. In the control group, there were no changes from baseline in attitude toward surrogate consent from any perspective. Conclusions Intensive, balanced, and accurate education, along with peer deliberation provided by democratic deliberation, led to a sustained increase in support for a societal policy of family consent in dementia research among those responsible for dementia patients.
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Of the numerous factors that play a role in fatal pedestrian collisions, the time of day, day of the week, and time of year can be significant determinants. More than 60% of all pedestrian collisions in 2007 occurred at night, despite the presumed decrease in both pedestrian and automobile exposure during the night. Although this trend is partially explained by factors such as fatigue and alcohol consumption, prior analysis of the Fatality Analysis Reporting System database suggests that pedestrian fatalities increase as light decreases after controlling for other factors. This study applies graphical cross-tabulation, a novel visual assessment approach, to explore the relationships among collision variables. The results reveal that twilight and the first hour of darkness typically observe the greatest frequency of pedestrian fatal collisions. These hours are not necessarily the most risky on a per mile travelled basis, however, because pedestrian volumes are often still high. Additional analysis is needed to quantify the extent to which pedestrian exposure (walking/crossing activity) in these time periods plays a role in pedestrian crash involvement. Weekly patterns of pedestrian fatal collisions vary by time of year due to the seasonal changes in sunset time. In December, collisions are concentrated around twilight and the first hour of darkness throughout the week while, in June, collisions are most heavily concentrated around twilight and the first hours of darkness on Friday and Saturday. Friday and Saturday nights in June may be the most dangerous times for pedestrians. Knowing when pedestrian risk is highest is critically important for formulating effective mitigation strategies and for efficiently investing safety funds. This applied visual approach is a helpful tool for researchers intending to communicate with policy-makers and to identify relationships that can then be tested with more sophisticated statistical tools.
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Background: Factors that individually influence blood sugar control, health-related quality of life, and diabetes self-care behaviors have been widely investigated; however, most previous diabetes studies have not tested an integrated association between a series of factors and multiple health outcomes. ---------- Objectives: The purposes of this study are to identify risk factors and protective factors and to examine the impact of risk factors and protective factors on adaptive outcomes in people with type 2 diabetes.---------- Design: A descriptive correlational design was used to examine a theoretical model of risk factors, protective factors, and adaptive outcomes.---------- Settings: This study was conducted at the endocrine outpatient departments of three hospitals in Taiwan. Participants A convenience sample of 334 adults with type 2 diabetes aged 40 and over.---------- Methods: Data were collected by a self-reported questionnaire and physiological examination. Using the structural equation modeling technique, measurement and structural regression models were tested.---------- Results: Age and life events reflected the construct of risk factors. The construct of protective factors was explained by diabetes symptoms, coping strategy, and social support. The construct of adaptive outcomes comprised HbA1c, health-related quality of life, and self-care behaviors. Protective factors had a significant direct effect on adaptive outcomes (β = 0.68, p < 0.001); however, risk factors did not predict adaptive outcomes (β = − 0.48, p = 0.118).---------- Conclusions: Identifying and managing risk factors and protective factors are an integral part of diabetes care. This theoretical model provides a better understanding of how risk factors and protective factors work together to influence multiple adaptive outcomes in people living with type 2 diabetes.
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Measuring the comparative sustainability levels of cities, regions, institutions and projects is an essential procedure in creating sustainable urban futures. This paper introduces a new urban sustainability assessment model: “The Sustainable Infrastructure, Land-use, Environment and Transport Model (SILENT)”. The SILENT Model is an advanced geographic information system and indicator-based comparative urban sustainability indexing model. The model aims to assist planners and policy makers in their daily tasks in sustainable urban planning and development by providing an integrated sustainability assessment framework. The paper gives an overview of the conceptual framework and components of the model and discusses the theoretical constructs, methodological procedures, and future development of this promising urban sustainability assessment model.