Implementation and evaluation of a new model of nursing practice in radiation oncology

Patients undergoing radiation therapy for cancer face a series of challenges that require support from a multidisciplinary team which includes radiation oncology nurses. However, the specific contribution of nursing, and the models of care that best support the delivery of nursing interventions in the radiotherapy setting, is not well described. In this case study, the Interaction Model of Client Health Behaviour and the associated principles of person-centred care were incorporated into a new model of care that was implemented in one radiation oncology setting in Brisbane, Australia. The new model of care was operationalised through a Primary Nursing/Collaborative Practice framework. To evaluate the impact of the new model for patients and health professionals, multiple sources of data were collected from patients and clinical staff prior to, during, and 18 months following introduction of the practice redesign. One cohort of patients and clinical staff completed surveys incorporating measures of key outcomes immediately prior to implementation of the model, while a second cohort of patients and clinical staff completed these same surveys 18 months following introduction of the model. In-depth interviews were also conducted with nursing, medical and allied health staff throughout the implementation phase to obtain a more comprehensive account of the processes and outcomes associated with implementing such a model. From the patients’ perspectives, this study demonstrated that, although adverse effects of radiotherapy continue to affect patient well-being, patients continue to be satisfied with nursing care in this specialty, and that they generally reported high levels of functioning despite undergoing a curative course of radiotherapy. From the health professionals’ perspective, there was evidence of attitudinal change by nursing staff within the radiotherapy department which reflected a greater understanding and appreciation of a more person-centred approach to care. Importantly, this case study has also confirmed that a range of factors need to be considered when redesigning nursing practice in the radiotherapy setting, as the challenges associated with changing traditional practices, ensuring multidisciplinary approaches to care, and resourcing a new model were experienced. The findings from this study suggest that the move from a relatively functional approach to a person-centred approach in the radiotherapy setting has contributed to some improvements in the provision of individualised and coordinated patient care. However, this study has also highlighted that primary nursing may be limited in its approach as a framework for patient care unless it is supported by a whole team approach, an appropriate supportive governance model, and sufficient resourcing. Introducing such a model thus requires effective education, preparation and ongoing support for the whole team. The challenges of providing care in the context of complex interdisciplinary relationships have been highlighted by this study. Aspects of this study may assist in planning further nursing interventions for patients undergoing radiotherapy for cancer, and continue to enhance the contribution of the radiation oncology nurse to improved patient outcomes.

A distributed denial of service testbed

The Denial of Service Testing Framework (dosTF) being developed as part of the joint India-Australia research project for ‘Protecting Critical Infrastructure from Denial of Service Attacks’ allows for the construction, monitoring and management of emulated Distributed Denial of Service attacks using modest hardware resources. The purpose of the testbed is to study the effectiveness of different DDoS mitigation strategies and to allow for the testing of defense appliances. Experiments are saved and edited in XML as abstract descriptions of an attack/defense strategy that is only mapped to real resources at run-time. It also provides a web-application portal interface that can start, stop and monitor an attack remotely. Rather than monitoring a service under attack indirectly, by observing traffic and general system parameters, monitoring of the target application is performed directly in real time via a customised SNMP agent.

Service learning in teacher education

If the student wellbeing pedagogy characterised by the troika metaphor is to become more widely adopted, beginning teachers need to be inducted into service learning. In this chapter, we discuss the implementation and outcomes of a service learning program in a Bachelor of Education course in Australia. The program provides pre-service teachers with insights into service learning practice. Pre-service teachers are given supported opportunities to examine and challenge traditional beliefs and values about student diversity and the role of schools in developing a more inclusive society. They are supported in developing ethics of care and concern for inclusive and equitable practices – characteristics necessary for quality teaching. Thus, the Queensland University of Technology (QUT) service learning program is an ideal example of the troika effect in practice, in that the pedagogy fuses values education, quality teaching and service learning to develop within each student an inclusive ethical framework that will inform their classroom practice as beginning quality teachers.

Embedding 'philosophy in the classroom' in pre-service teacher education

The holistic conception of the troika, as described in the first chapter, centres on the relationship between the implicit and explicit teaching of values the nurturing of the specific dimensions of quality teaching and the opportunity to ‘walk the talk’ of the values education program through aspects such as practical citizenship (Lovat, Toomey, Clement, Crotty & Nielsen, 2009). It is proposed in this chapter that the conception can be realized through the embedding of Philosophy in the Classroom within pre-service teaching programs. The troika, a Russian sleigh with three horses, only function well when there is complete synergy and balance between all Classroom is a scaffold for ensuring that all three elements of the troika, namely, quality teaching, values education and service learning in the form of education for citizenship, exist within the classroom to achieve an optimal learning, growth and wellbeing for all students. For this to be more widely accomplished Philosophy in the Classroom and discusses how it constitutes a successful synergy and balance of the troika for effective teaching. It then proposes how it might be embedded into pre-service teacher education.

Compliance, normality and the patient on peritoneal dialysis

Monitoring and enhancing patient compliance with peritoneal dialysis (PD) is a recurring and problematic theme in the renal literature. A growing body of literature also argues that a failure to understand the patient's perspective of compliance may be contributing to these problems. The aim of this study was to understand the concept of compliance with PD from the patient's perspective. Using the case study approach recommended by Stake (1995), five patients on PD consented to in-depth interviews that explored the meaning of compliance in the context of PD treatment and lifestyle regimens recommended by health professionals. Participants also discussed factors that influenced their choices to follow, disregard, or refine these regimens. Results indicate that health professionals acting in alignment with individual patient needs and wishes, and demonstrating an awareness of the constraints under which patients operate and the strengths they bring to their treatment, may be the most significant issues to consider with respect to definitions of PD compliance and the development of related compliance interventions. Aspects of compliance that promoted relative normality were also important to the participants in this study and tended to result in greater concordance with health professionals' advice.

Service bid comparisons by fuzzy ranking in open railway market timetabling

In an open railway access market, the Infrastructure Provider (IP), upon the receipts of service bids from the Train Service Providers (TSPs), assigns track access rights according to its own business objectives and the merits of the bids; and produces the train service timetable through negotiations. In practice, IP chooses to negotiate with the TSPs one by one in such a sequence that IP optimizes its objectives. The TSP bids are usually very complicated, containing a large number of parameters in different natures. It is a difficult task even for an expert to give a priority sequence for negotiations from the contents of the bids. This study proposes the application of fuzzy ranking method to compare and prioritize the TSP bids in order to produce a negotiation sequence. The results of this study allow investigations on the behaviors of the stakeholders in bid preparation and negotiation, as well as evaluation of service quality in the open railway market.

Scheduling coordination through negotiation between train service providers in an open railway access market

A schedule coordination problem involving two train services provided by different operators is modeled as an optimization of revenue intake. The coordination is achieved through the adjustment of commencement times of the train services by negotiation. The problem is subject to constraints regarding to passenger demands and idle costs of rolling-stocks from both operators. This paper models the operators as software agents having the flexibility to incorporate one of the two (and potentially more) proposed negotiation strategies. Empirical results show that agents employing different combination of strategies have significant impact on the quality of solution and negotiation time.

Fostering cultural awareness in pre-service teacher education : an experiment in Asia literacy capacity building in an Australian university

This paper presents the findings of a small pilot study conducted with a group of final year pre-service teachers studying a secondary social science curriculum method unit in an Australian university. One of the study’s research objectives aimed at identifying how students responded to efforts to embed intercultural understanding through Studies of Asia in their final curriculum method unit. The unit was designed and taught by the researcher on the assumption that beginning social science teachers need to be empowered with pedagogical skills and new dispositions to deal with value laden emerging regional and global concerns in their Australian secondary school classrooms. This pilot study’s research methodology was located within the qualitative framework of a participatory action research model whereby the lecturer who designed, coordinated and taught the unit was also the researcher. Its scope was limited to one semester with volunteer students. The pilot study sought to investigate responses to several issues, and this paper reports on pre-service teacher reflections on the content, pedagogy and learning they experienced in their weekly sessions with specific reference to cultural understanding, Studies of Asia and the development of Asia literacy. It also reports on pre-service teacher reflections about their own evolving capacity as beginning teachers. The findings indicate that pre-service teachers valued the opportunity to engage with learning experiences which enhanced their conceptual understandings about culture whilst also extending their pedagogical and content knowledge.

Embedding values through global education in social sciences pre-service teacher education : linking the head and heart

This chapter aims to situate values education as a core component of social science pre-service teacher education. In particular, it reflects on an experiment in embedding a values laden Global Education perspective in a fourth year social science curriculum method unit. This unit was designed and taught by the researcher on the assumption that beginning social science teachers need to be empowered with pedagogical skills and new dispositions to deal with value laden emerging global and regional concerns in their secondary school classrooms. Moreover, it was assumed that when pre-service teachers engage in dynamic and interactive learning experiences in their curriculum unit, they commence the process of ‘capacity building’ those skills which prepare them for their own lifelong professional learning. This approach to values education also aimed at providing pre-service teachers with opportunities to ‘create deep understandings of teaching and learning’ (Barnes, 1989, p. 17) by reflecting on the ways in which ‘pedagogy can be transformative’ (Lovat and Toomey, 2011 add page no from Chapter One). It was assumed that this tertiary experience would foster the sine qua non of teaching – a commitment to students and their learning. Central to fostering new ‘dispositions’ through this approach, was the belief in the power of pedagogy to make the difference in enhancing student participation and learning. In this sense, this experiment in values education in secondary social science pre-service teacher education aligns with the Troika metaphor for a paradigm change, articulated by Lovat and Toomey (2009) in Chapter One.

Regulation of train service by coasting control in metro railway system

To maximise the capacity of the rail lineand provide a reliable service for pas-sengers throughout the day, regulation of train service to maintain steady service headway is es-sential. In most current metro systems, train usually starts coasting at a fixed distance from the departed station to achieve service regulation. However, this approach is only effective with re-spect to a nominal operational condition of train schedule but not necessarily the current service demand. Moreover, it is not simply to identify the necessary starting point for coasting under the run time constraints of current service conditions since train movement is attributed by a large number of factors, most of which are non-linear and inter-dependent. This paper presents an ap-plication of classical measures to search for the appropriate coasting point to meet a specified inter-station run time and they can be integrated in the on-board Automatic Train Operation (ATO) system and have the potential for on-line implementation in making a set of coasting command decisions.

Markov modelling of the IEEE 802.11 DCF for real-time applications with periodic traffic

Popular wireless network standards, such as IEEE 802.11/15/16, are increasingly adopted in real-time control systems. However, they are not designed for real-time applications. Therefore, the performance of such wireless networks needs to be carefully evaluated before the systems are implemented and deployed. While efforts have been made to model general wireless networks with completely random traffic generation, there is a lack of theoretical investigations into the modelling of wireless networks with periodic real-time traffic. Considering the widely used IEEE 802.11 standard, with the focus on its distributed coordination function (DCF), for soft-real-time control applications, this paper develops an analytical Markov model to quantitatively evaluate the network quality-of-service (QoS) performance in periodic real-time traffic environments. Performance indices to be evaluated include throughput capacity, transmission delay and packet loss ratio, which are crucial for real-time QoS guarantee in real-time control applications. They are derived under the critical real-time traffic condition, which is formally defined in this paper to characterize the marginal satisfaction of real-time performance constraints.

Weighted fairness with MCR guarantee and a general-purpose explicit rate allocation algorithm for ATM ABR service

In this paper, weighted fair rate allocation for ATM available bit rate (ABR) service is discussed with the concern of the minimum cell rate (MCR). Weighted fairness with MCR guarantee has been discussed recently in the literature. In those studies, each ABR virtual connection (VC) is first allocated its MCR, then the remaining available bandwidth is further shared among ABR VCs according to their weights. For the weighted fairness defined in this paper, the bandwidth is first allocated according to each VC's weight; if a VC's weighted share is less than its MCR, it should be allocated its MCR instead of the weighted share. This weighted fairness with MCR guarantee is referred to as extended weighted (EXW) fairness. Certain theoretical issues related to EXW, such as its global solution and bottleneck structure, are first discussed in the paper. A distributed explicit rate allocation algorithm is then proposed to achieve EXW fairness in ATM networks. The algorithm is a general-purpose explicit rate algorithm in the sense that it can realise almost all the fairness principles proposed for ABR so far whilst only minor modifications may be needed.

Psychometric analysis of the Brisbane Practice Environment Measure (B-PEM)

Purpose: To undertake rigorous psychometric testing of the newly developed contemporary work environment measure (the Brisbane Practice Environment Measure [B-PEM]) using exploratory factor analysis and confirmatory factor analysis. Methods: Content validity of the 33-item measure was established by a panel of experts. Initial testing involved 195 nursing staff using principal component factor analysis with varimax rotation (orthogonal) and Cronbach's alpha coefficients. Confirmatory factor analysis was conducted using data from a further 983 nursing staff. Results: Principal component factor analysis yielded a four-factor solution with eigenvalues greater than 1 that explained 52.53% of the variance. These factors were then verified using confirmatory factor analysis. Goodness-of-fit indices showed an acceptable fit overall with the full model, explaining 21% to 73% of the variance. Deletion of items took place throughout the evolution of the instrument, resulting in a 26-item, four-factor measure called the Brisbane Practice Environment Measure-Tested. Conclusions: The B-PEM has undergone rigorous psychometric testing, providing evidence of internal consistency and goodness-of-fit indices within acceptable ranges. The measure can be utilised as a subscale or total score reflective of a contemporary nursing work environment. Clinical Relevance: An up-to-date instrument to measure practice environment may be useful for nursing leaders to monitor the workplace and to assist in identifying areas for improvement, facilitating greater job satisfaction and retention.

Fair flow control of ABR service by per-VC virtual queuing

In this paper, a rate-based flow control scheme based upon per-VC virtual queuing is proposed for the Available Bit Rate (ABR) service in ATM. In this scheme, each VC in a shared buffer is assigned a virtual queue, which is a counter. To achieve a specific kind of fairness, an appropriate scheduler is applied to the virtual queues. Each VC's bottleneck rate (fair share) is derived from its virtual cell departure rate. This approach of deriving a VC's fair share is simple and accurate. By controlling each VC with respect to its virtual queue and queue build-up in the shared buffer, network congestion is avoided. The principle of the control scheme is first illustrated by max–min flow control, which is realised by scheduling the virtual queues in round-robin. Further application of the control scheme is demonstrated with the achievement of weighted fairness through weighted round robin scheduling. Simulation results show that with a simple computation, the proposed scheme achieves the desired fairness exactly and controls network congestion effectively.

Embracing Philosophy and Raising the Standard of Pre-service Teacher Education Programs

In this chapter, a rationale is developed for incorporating philosophy into teacher training programs as a means of both preparing quality teachers for the 21st century and meeting the expectations detailed in the professional standards established by the statutory authority that regulates the profession in Queensland, the Queensland College of Teaching is presented. Furthermore, in-service teachers from Buranda State School, a Brisbane primary school that has been successfully teaching philosophy to its students for over 10 years, shares their experiences of teaching philosophy and how it has enhanced student learning and the quality of teaching and professionalism of the teachers. Finally, the implications of embedding philosophy into teacher training programs are explored in terms of developing the personal integrity of beginning teachers.