Measuring multidisciplinary team effectiveness in a ward-based healthcare setting : development of the Team Functioning Assessment Tool

Nontechnical skills relating to team functioning are vital to the effective delivery of patient care and safety. In this study, we develop a reliable behavioral marker tool for assessing nontechnical skills that are critical to the success of ward-based multidisciplinary healthcare teams. The Team Functioning Assessment Tool (TFAT) was developed and refined using a literature review, focus groups, card-sorting exercise, field observations, and final questionnaire evaluation and refinement process. Results demonstrated that Clinical Planning, Executive Tasks, and Team Relations are important facets of effective multidisciplinary healthcare team functioning. The TFAT was also shown to yield acceptable inter-rater agreement.

Effects of physical activity intervention in youth : a review

Effects of physical activity interventions in youth: A review. International SportMed Journal. Vol.2 No.5 2001. The purpose of this paper is to review the peer-reviewed literature pertinent to physical activity interventions for children and adolescents. In order to provide a more quantitative conclusion regarding the effectiveness of these interventions, a meta-analytic approach was utilized in which effect sizes (the efficacy of each intervention or magnitude of the intervention effect was expressed as a standardized effect size, which represents the influence of the treatment or intervention on the dependent variable) from each study are pooled to provide a global estimate of effectiveness. A search of the relevant peer-reviewed literature was conducted using several computer-based databases, including MEDLINE, PYSCHLIT, SOCIAL SCIENCE INDEX, and SPORTS DISCUS. Manual searches were also made using the reference lists from recovered articles. Applying strict criteria for quality of design and assessment of physical activity, 10 studies were located, yielding a total of 44 effect sizes. The mean effect size was 0.47 (95% C.I. 0.28 – 0.66) suggesting that interventions have produced moderate increases in physical activity behavior. Effect sizes ranged from –0.61 to 2.5. Interventions focusing on increasing the amount of physical activity performed during regular physical education were more effective than those targeting overall levels of physical activity. Interventions were almost entirely school-based. Accordingly, the development and evaluation of community-based approaches for promoting physical activity among young people, especially older adolescents, remains an urgent priority for future research.

Integrating understandability in the evaluation of consumer health search engines

In this paper we propose a method that integrates the no- tion of understandability, as a factor of document relevance, into the evaluation of information retrieval systems for con- sumer health search. We consider the gain-discount evaluation framework (RBP, nDCG, ERR) and propose two understandability-based variants (uRBP) of rank biased precision, characterised by an estimation of understandability based on document readability and by different models of how readability influences user understanding of document content. The proposed uRBP measures are empirically contrasted to RBP by comparing system rankings obtained with each measure. The findings suggest that considering understandability along with topicality in the evaluation of in- formation retrieval systems lead to different claims about systems effectiveness than considering topicality alone.

Evaluation of public hospital performance in Khanh Hoa Province : Vietnam in connection with patient and staff satisfaction surveys

This research aimed to develop a framework for performance evaluation of public hospitals in Vietnam that is culturally, socially, and politically appropriate. The research included both qualitative and quantitative methods and identified and validated novel instruments to measure patient satisfaction and job satisfaction of hospital staff and to determine a set of hospital indicators that reflect the quality of hospital performance. New models for understanding the determinants of patient and staff satisfaction were developed along with a new performance indicator framework for hospital performance. These instruments will now be applied to the evaluation of hospital services in Khanh Hoa Province, permitting longer term evaluation of their effectiveness in changing system wide performance and satisfaction.

Evaluation of emerging intelligent transport systems to improve safety on level crossings : an overview

Safety at railway level crossings (RLX) is one part of a wider picture of safety within the whole transport system. Governments, the rail industry and road organisations have used a variety of countermeasures for many years to improve RLX safety. New types of interventions are required in order to reduce the number of crashes and associated social costs at railway crossings. This paper presents the results of a large research program which aimed to assess the effectiveness of emerging Intelligent Transport Systems (ITS) interventions, both on-road and in-vehicle based, to improve the safety of car drivers at RLXs in Australia. The three most promising technologies selected from the literature review and focus groups were tested in an advanced driving simulator to provide a detailed assessment of their effects on driver behaviour. The three interventions were: (i) in-vehicle visual warning using a GPS/smartphone navigation-like system, (ii) in-vehicle audio warning and; (iii) on-road intervention known as valet system (warning lights on the road surface activated as a train approaches). The effects of these technologies on 57 participants were assessed in a systematic approach focusing on the safety of the intervention, effects on the road traffic around the crossings and driver’s acceptance of the technology. Given that the ITS interventions were likely to provide a benefit by improving the driver’s awareness of the crossing status in low visibility conditions, such conditions were investigated through curves in the track before arriving at the crossing. ITS interventions were also expected to improve driver behaviour at crossings with high traffic (blocking back issue), which were also investigated at active crossings. The key findings are: (i) interventions at passive crossings are likely to provide safety benefits; (ii) the benefits of ITS interventions on driver behaviour at active crossings are limited; (iii) the trialled ITS interventions did not show any issues in terms of driver distraction, driver acceptance or traffic delays; (iv) these interventions are easy to use, do not increase driver workload substantially; (v) participants’ intention to use the technology is high and; (vi) participants saw most value in succinct messages about approaching trains as opposed to knowing the RLX locations or the imminence of a collision with a train.

The automation of radiotherapy treatment planning assessment

Aim The assessment of treatment plans is an important component in the education of radiation therapists. The establishment of a grade for a plan is currently based on subjective assessment of a range of criteria. The automation of assessment could provide a number of advantages including faster feedback, reduced chance of human error, and simpler aggregation of past results. Method A collection of treatments planned by a cohort of 27 second year radiation therapy students were selected for quantitative evaluation. Treatment sites included the bladder, cervix, larynx, parotid and prostate, although only the larynx plans had been assessed in detail. The plans were designed with the Pinnacle system and exported using the DICOM framework. Assessment criteria included beam arrangement optimisation, volume contouring, target dose coverage and homogeneity, and organ-at-risk sparing. The in-house Treatment and Dose Assessor (TADA) software1 was evaluated for suitability in assisting with the quantitative assessment of these plans. Dose volume data were exported in per-student and per-structure data tables, along with beam complexity metrics, dose volume histograms, and reports on naming conventions. Results The treatment plans were exported and processed using TADA, with the processing of all 27 plans for each treatment site taking less than two minutes. Naming conventions were successfully checked against a reference protocol. Significant variations between student plans were found. Correlation with assessment feedback was established for the larynx plans. Conclusion The data generated could be used to inform the selection of future assessment criteria, monitor student development, and provide useful feedback to the students. The provision of objective, quantitative evaluations of plan quality would be a valuable addition to not only radiotherapy education programmes but also for staff development and potentially credentialing methods. New functionality within TADA developed for this work could be applied clinically to, for example, evaluate protocol compliance.

Management of atopic dermatitis in children : evaluation of parents' self-efficacy, outcome expectations, and self-reported task performance using the Child Eczema Management Questionnaire

Child behaviour management is crucial to successful treatment of atopic dermatitis. This study tested relationships between parents’ self-efficacy, outcome expectations, and self-reported task performance when caring for a child with atopic dermatitis. Using a cross-sectional study design, a community-based convenience sample of 120 parents participated in pilot-testing of the Child Eczema Management Questionnaire - a self-administered questionnaire which appraises parents’ self-efficacy, outcome expectations, and self-reported task performance when managing atopic dermatitis. Overall, parents’ self-reported confidence and success with performing routine management tasks was greater than that for managing their child’s symptoms and behaviour. Therewas a positive relationship between time since diagnosis and self-reported performance of routine management tasks; however, success with managing the child’s symptoms and behaviour did not improve with illness duration. Longer time since diagnosis was also associated with more positive outcome expectations of performing tasks that involved others in the child’s care (i.e. healthcare professionals, or the child themselves). This study provides the foundation for further research examining relationships between child, parent, and family psychosocial variables, parent management of atopic dermatitis, and child health outcomes. Improved understanding of these relationships will assist healthcare providers to better support parents and families caring for children with atopic dermatitis. KEYWORDS

Improving treatment for obese women with early stage cancer of the uterus : rationale and design of the levonorgestrel intrauterine device ±Metformin ±weight loss in endometrial cancer (feMME) trial

Purpose Endometrial adenocarcinoma (EC) is the most common gynaecologic cancer. Up to 90% of EC patients are obese which poses a health threat to patients post-treatment. Standard treatment for EC includes hysterectomy, although this has significant side effects for obese women at high risk of surgical complications and for women of childbearing age. This trial investigates the effectiveness of non-surgical or conservative treatment options for obese women with early stage EC. The primary aim is to determine the efficacy of: levonorgestrel intrauterine device (LNG-IUD); with or without metformin (an antidiabetic drug); and with or without a weight loss intervention to achieve a pathological complete response (pCR) in EC at six months from study treatment initiation. The secondary aim is to enhance understanding of the molecular processes and to predict a treatment response by investigating EC biomarkers. Methods An open label, three-armed, randomised, phase-II, multi-centre trial of LNG-IUD ± metformin ± weight loss intervention. 165 participants from 28 centres are randomly assigned in a 3:3:5 ratio to the treatment arms. Clinical, quality of life and health behavioural data will be collected at baseline, six weeks, three and six months. EC biomarkers will be assessed at baseline, three and six months. Conclusions There is limited prospective evidence for conservative treatment for EC. Trial results could benefit patients and reduce health system costs through a reduction in hospitalisations and through lower incidence of adverse events currently observed with standard treatment.

Evaluation of features for leaf classification in challenging conditions

Fine-grained leaf classification has concentrated on the use of traditional shape and statistical features to classify ideal images. In this paper we evaluate the effectiveness of traditional hand-crafted features and propose the use of deep convolutional neural network (ConvNet) features. We introduce a range of condition variations to explore the robustness of these features, including: translation, scaling, rotation, shading and occlusion. Evaluations on the Flavia dataset demonstrate that in ideal imaging conditions, combining traditional and ConvNet features yields state-of-theart performance with an average accuracy of 97:3%�0:6% compared to traditional features which obtain an average accuracy of 91:2%�1:6%. Further experiments show that this combined classification approach consistently outperforms the best set of traditional features by an average of 5:7% for all of the evaluated condition variations.

Evaluation of the efficacy of radiation-modifying compounds using γH2AX as a molecular marker of DNA double-strand breaks

Radiation therapy is a widely used therapeutic approach for cancer. To improve the efficacy of radiotherapy there is an intense interest in combining this modality with two broad classes of compounds, radiosensitizers and radioprotectors. These either enhance tumour-killing efficacy or mitigate damage to surrounding non-malignant tissue, respectively. Radiation exposure often results in the formation of DNA double-strand breaks, which are marked by the induction of H2AX phosphorylation to generate γH2AX. In addition to its essential role in DDR signalling and coordination of double-strand break repair, the ability to visualize and quantitate γH2AX foci using immunofluorescence microscopy techniques enables it to be exploited as an indicator of therapeutic efficacy in a range of cell types and tissues. This review will explore the emerging applicability of γH2AX as a marker for monitoring the effectiveness of radiation-modifying compounds.

Evaluation of Indigenous justice programs.: final report / Project D, Safe Aboriginal Youth Patrol Programs in New South Wales and Northbridge Policy and Juvenile Aid Group in Western Australia

The Australian Government has provided funding to evaluate the effectiveness of Indigenous law and justice programs across five subject areas to identify the best approaches to tackling crime and justice issues and better inform government funding decisions in the future. This report presents the findings of subject area "D", which examined two different approaches to delivering community and night patrol services for young people: the Safe Aboriginal Youth Patrol programs in New South Wales, and the Northbridge Policy project (the Young People in Northbridge project), in Western Australia. Night patrols can address crime either directly or indirectly, by prevention work or by addressing the social causes of crime through community development.

The effectiveness of dietary counselling versus oral nutrition supplements in improving nutritional intake in malnourished patients with Chronic Obstructive Pulmonary Disease (COPD)

The evidence for nutritional support in COPD is almost entirely based on oral nutritional supplements (ONS) yet despite this dietary counseling and food fortification (DA) are often used as the first line treatment for malnutrition. This study aimed to investigate the effectiveness of ONS vs. DA in improving nutritional intake in malnourished outpatients with COPD. 70 outpatients (BMI 18.4 SD 1.6 kg/m2, age 73 SD 9 years, severe COPD) were randomised to receive a 12-week intervention of either ONS or DA (n 33 ONS vs. n 37 DA). Paired t-test analysis revealed total energy intakes significantly increased with ONS at week 6 (+302 SD 537 kcal/d; p = 0.002), with a slight reduction at week 12 (+243 SD 718 kcal/d; p = 0.061) returning to baseline levels on stopping supplementation. DA resulted in small increases in energy that only reached significance 3 months post-intervention (week 6: +48 SD 623 kcal/d, p = 0.640; week 12: +157 SD 637 kcal/d, p = 0.139; week 26: +247 SD 592 kcal/d, p = 0.032). Protein intake was significantly higher in the ONS group at both week 6 and 12 (ONS: +19.0 SD 25.0 g/d vs. DA: +1.0 SD 13.0 g/d; p = 0.033 ANOVA) but no differences were found at week 26. Vitamin C, Iron and Zinc intakes significantly increased only in the ONS group. ONS significantly increased energy, protein and several micronutrient intakes in malnourished COPD patients but only during the period of supplementation. Trials investigating the effects of combined nutritional interventions are required.

Economic evaluation of adolescent reproductive health education interventions in Chilinh, Vietnam

This research was an economic analysis of two novel health education interventions compared to existing practice for reproductive health among young people in northern Vietnam. The research showed that implementing an educational intervention including school-based and health facility-based components was cost effective for males and females. The findings will assist decision makers in efficient allocation of scarce resources for adolescent health promotion in Vietnam and similar socio-economic contexts in Asia.

Standardising and assessing digital images for use in clinical trials : a practical, reproducible method that blinds the assessor to treatment allocation

With the increasing availability of high quality digital cameras that are easily operated by the non-professional photographer, the utility of using digital images to assess endpoints in clinical research of skin lesions has growing acceptance. However, rigorous protocols and description of experiences for digital image collection and assessment are not readily available, particularly for research conducted in remote settings. We describe the development and evaluation of a protocol for digital image collection by the non-professional photographer in a remote setting research trial, together with a novel methodology for assessment of clinical outcomes by an expert panel blinded to treatment allocation.

Evaluation of ANPR trials for traffic policing in Queensland. Report to the Queensland Police Service, State Traffic Support Branch

In response to the Travelsafe Committee Report No. 51 – report on the inquiry into Automatic Plate Recognition Technology – it was recommended that the Queensland Police Service continue to trial the deployment of ANPR technology for traffic enforcement work and to evaluate the road safety impacts and operational effectiveness of the technology. As such, the purpose of this report is to provide an independent evaluation of a trial of ANPR that was conducted by a project team within the State Traffic Support Branch of the Queensland Police Service (QPS) and provide recommendations as to the applicability and usability of the technology for use throughout Queensland...