Illinois adverse pregnancy outcomes reporting system : assessment and recommendations.

Project director: Manorama Khare.

Does health assessment improve health outcomes in Indigenous people? An RCT with 13 years of follow-up

Objective: To examine the impact of a multi-component health assessment on mortality and morbidity in Kimberley Aboriginal residents during a 13-year follow-up. Method. A population-based randomised controlled trial using linked hospital, cancer and death records to evaluate outcomes in 620 intervention and 6,736 control subjects. Results: The intervention group had a higher rate of first-time hospitalisation for any reason (IRR = 1.37; 95 % Cl 1.25-1.50), a higher rate of injury-related hospital episodes (IRR = 1.31; 95 % Cl 1.15-1.48) and a higher notification rate of alcohol-related cancers. There was a smaller difference in the rates of multiple hospitalisations (IRR = 1.14; 95 % Cl 0.751.74) and no improvement in overall mortality compared with controls (IRR = 1.08; 95 % Cl 0.91-1.29). Conclusions: There was no overall mortality benefit despite increased health service contact associated with the intervention. Implications: Although not influencing mortality rates, multi-component health assessment may result in a period of increased health service use in Aboriginal and Torres Strait Islander populations, thus constituting an 'intervention'. However, this should not be confused with systematic and sustained interventions and investment in community development to achieve better health outcomes.

Applying quantitative methods in the assessment of outcomes of pharmacotherapy of psoriasis

Healthcare providers and policy makers are faced with an ever-increasing number of medical publications. Searching for relevant information and keeping up to date with new research findings remains a constant challenge. It has been widely acknowledged that narrative reviews of the literature are susceptible to several types of bias and a systematic approach may protect against these biases. The aim of this thesis was to apply quantitative methods in the assessment of outcomes of topical therapies for psoriasis. In particular, to systematically examine the comparative efficacy, tolerability and cost-effectiveness of topical calcipotriol in the treatment of mild-to-moderate psoriasis. Over the years, a wide range of techniques have been used to evaluate the severity of psoriasis and the outcomes from treatment. This lack of standardisation complicates the direct comparison of results and ultimately the pooling of outcomes from different clinical trials. There is a clear requirement for more comprehensive tools for measuring drug efficacy and disease severity in psoriasis. Ideally, the outcome measures need to be simple, relevant, practical, and widely applicable, and the instruments should be reliable, valid and responsive. The results of the meta-analysis reported herein show that calcipotriol is an effective antipsoriatic agent. In the short-tenn, the pooled data found calcipotriol to be more effective than calcitriol, tacalcitol, coal tar and short-contact dithranol. Only potent corticosteroids appeared to have comparable efficacy, with less short-term side-effects. Potent corticosteroids also added to the antipsoriatic effect of calcipotriol, and appeared to suppress the occurrence of calcipotriol-induced irritation. There was insufficient evidence to support any large effects in favour of improvements in efficacy when calcipotriol is used in combination with systemic therapies in patients with severe psoriasis. However, there was a total absence of long-term morbidity data on the effectiveness of any of the interventions studied. Decision analysis showed that, from the perspective of the NHS as payer, the relatively small differences in efficacy between calcipotriol and short-contact dithranol lead to large differences in the direct cost of treating patients with mildto-moderate plaque psoriasis. Further research is needed to examine the clinical and economic issues affecting patients under treatment for psoriasis in the UK. In particular, the maintenance value and cost/benefit ratio for the various treatment strategies, and the assessment of patient's preferences has not yet been adequately addressed for this chronic recurring disease.

As assessment of the Competition Commission Report and subsequent outcomes

Following the Office of Fair Trading's review of the British deregulated bus market as a whole in 2009, the issues raised were referred to the Competition Commission. Its final report was published in December 2011. Subsequently, the House of Commons Transport Committee carried out an enquiry into the Commission's report, and reactions to it by the operating industry, user groups, and other bodies, which was published in September 2012. A number of major issues have been raised, including the extent to which price competition may be effective, the appropriate rate of return on capital that would be expected within the industry (and appropriate actions where this is excessive in practice), and industry structure. The importance of competition per se, as distinct from attributes of direct concern to users (such as reliability, frequency, and fares) has also been debated. This paper reviews the issues raised, and outcomes to date, in the light of further evidence on the industry's performance. It is demonstrated similar rates of return could be attained through very different operating strategies, which in turn have very different implications for changes in consumer surplus. The alternative uses made of such profits (for example through reinvestment) may also have markedly different impacts effects on users. Rather than focussing on the dangers of excessive rates of return on capital, the outcomes for service users should be the main issue.

Role of assessment components and recent adverse outcomes in risk estimation and prediction: use of the Short Term Assessment of Risk and Treatability (START) in an adult secure inpatient mental health service

The Short Term Assessment of Risk and Treatability is a structured judgement tool used to inform risk estimation for multiple adverse outcomes. In research, risk estimates outperform the tool's strength and vulnerability scales for violence prediction. Little is known about what its’component parts contribute to the assignment of risk estimates and how those estimates fare in prediction of non-violent adverse outcomes compared with the structured components. START assessment and outcomes data from a secure mental health service (N=84) was collected. Binomial and multinomial regression analyses determined the contribution of selected elements of the START structured domain and recent adverse risk events to risk estimates and outcomes prediction for violence, self-harm/suicidality, victimisation, and self-neglect. START vulnerabilities and lifetime history of violence, predicted the violence risk estimate; self-harm and victimisation estimates were predicted only by corresponding recent adverse events. Recent adverse events uniquely predicted all corresponding outcomes, with the exception of self-neglect which was predicted by the strength scale. Only for victimisation did the risk estimate outperform prediction based on the START components and recent adverse events. In the absence of recent corresponding risk behaviour, restrictions imposed on the basis of START-informed risk estimates could be unwarranted and may be unethical.

Good practice guidelines for curriculum, supervision and assessment of final year engineering projects and AQF8 learning outcomes

Undergraduate engineering programs require final year students to complete capstone final year projects and demonstrate that they can integrate knowledge, skills and professional graduate attributes developed during the program at Australian Qualification Framework, level 8 (AQF8) outcomes. Literature shows that currently there is no guarantee of consistency for curriculum, supervision and assessment practices of FYEPs. Practices differ greatly between universities and littlework has been initiated that seeks to identify good practice, highlighting the need for the development of guidelines for curriculum, supervision and assessment of FYEPs. This workshop is designed to share and disseminate the good practice guidelines that have been developed on curriculum, supervision and assessment of Final Year Engineering Projects as a part of phase 2 of the project ‘Assessing Final Year Engineering Projects (FYEPs): Ensuring Learning and Teaching Standards and AQF8 Outcomes’ funded by the Australian Office for Learning and Teaching (OLT) with people working in the area of FYEPs. The guidelines typically apply to four year undergraduate engineering degrees with embedded Honours and support achievement of AQF8learning outcomes. The project team has 7 partner Universities – Central Queensland University (the lead), University of Technology Sydney, University of Adelaide, Curtin University, Deakin University, University of Tasmania and RMIT University.Participants will be invited to reflect on and evaluate guidelines and findings derived from FYEP coordinators, supervisors and the wider literature and to consider the ways in which these findings might lead to improvements in their practice.

Understanding the Impact of the Property Tax Appeal Process on Assessment Uniformity: Procedures, Structures, and Outcomes

Property taxes serve as a vital revenue source for local governments. The revenues derived from the property tax function as the primary funding source for a variety of critical local public service systems. Property tax appeal systems serve as quasi-administrative-judicial mechanisms intended to assure the public that property tax assessments are correct, fair, and equitable. Despite these important functions, there is a paucity of empirical research related to property tax appeal systems. This study contributes to property tax literature by identifying who participates in the property tax appeal process and examining their motivations for participation. In addition, the study sought to determine whether patterns of use and success in appeal systems affected the distribution of the tax burden. Data were collected by means of a survey distributed to single-family property owners from two Florida counties. In addition, state and county documents were analyzed to determine appeal patterns and examine the impact on assessment uniformity, over a three-year period. The survey data provided contextual evidence that single-family property owners are not as troubled by property taxes as they are by the conduct of local government officials. The analyses of the decision to appeal indicated that more expensive properties and properties excluded from initial uniformity analyses were more likely to be appealed, while properties with homestead exemptions were less likely to be appealed. The value change analyses indicated that appeals are clustered in certain geographical areas; however, these areas do not always experience a greater percentage of the value changes. Interestingly, professional representation did not increase the probability of obtaining a reduction in value. Other relationships between the variables were discovered, but often with weak predictive ability. Findings from the assessment uniformity analyses were also interesting. The results indicated that the appeals mechanisms in both counties improved assessment uniformity. On average, appealed properties exhibited greater horizontal and vertical inequities, as compared to non-appealed properties, prior to the appeals process. After, the appeal process was completed; the indicators of horizontal and vertical equity were largely improved. However, there were some indications of regressivity in the final year of the study.

Structured professional judgement approach to risk assessment: generalisability across patient groups for the prediction of adverse outcomes in secure mental health care

This is a redacted version of the the final thesis. Copyright material has been removed to comply with UK Copyright Law.

Engaging Students in the Implementation of Criterion Referenced Assessment in First Year Law

The Queensland University of Technology (QUT) University Academic Board approved a new QUT Assessment Policy in September 2003, which requires a criterion-referenced approach as opposed to a norm-referenced approach to assessment across the university(QUT,MOPP,2003). In 2004, the QUT Law School embarked upon a process of awareness raising about criterion-referenced assessment amongst staff and from 2004 – 2005 staggered the implementation of criterion-referenced assessment in all first year core undergraduate law units. This paper will briefly discuss the benefits and potential pitfalls of criterion referenced assessment and the context for implementing it in the first year law program, report on student’s feedback on the introduction of criterion referenced assessment and the strategies adopted in 2005 to engage students more fully in criterion referenced assessment processes to enhance their learning outcomes.

A Preliminary Assessment of Aqueous Ethanol Pulping of Bagasse: the Ecopulp Process

SRI has examined the organosolv (organic solvation) pulping of Australian bagasse using technology supplied by Ecopulp. In the process, bagasse is reacted with aqueous ethanol in a digester at elevated temperatures (between 150ºC and 200ºC). The products from the digester are separated using proprietary technology before further processing into a range of saleable products. Test trials were undertaken using two batch digesters; the first capable of pulping about 25 g of wet depithed bagasse and the second, larger samples of about 1.5 kg of wet depithed bagasse. From this study, the unbleached pulp produced from fresh bagasse did not have very good strength properties for the production of corrugated medium for cartons and bleached pulp. In particular, the lignin contents as indicated by the Kappa number for the unbleached pulps are high for making bleached pulp. However, in spite of the high lignin content, it is possible to bleach the pulp to acceptable levels of brightness up to 86.6% ISO. The economics were assessed for three tier pricing (namely low, medium and high price). The economic return for a plant that produces 100 air dry t/d of brownstock pulp is satisfactory for both high and medium pricing levels of pricing. The outcomes from the project justify that work should continue through to either pilot plant or upgraded laboratory facility.

Developing a participatory impact assessment approach and action research culture within a communication for social change organisation in Nepal

Developing an effective impact evaluation framework, managing and conducting rigorous impact evaluations, and developing a strong research and evaluation culture within development communication organisations presents many challenges. This is especially so when both the community and organisational context is continually changing and the outcomes of programs are complex and difficult to clearly identify.----- This paper presents a case study from a research project being conducted from 2007-2010 that aims to address these challenges and issues, entitled Assessing Communication for Social Change: A New Agenda in Impact Assessment. Building on previous development communication projects which used ethnographic action research, this project is developing, trailing and rigorously evaluating a participatory impact assessment methodology for assessing the social change impacts of community radio programs in Nepal. This project is a collaboration between Equal Access – Nepal (EAN), Equal Access – International, local stakeholders and listeners, a network of trained community researchers, and a research team from two Australian universities. A key element of the project is the establishment of an organisational culture within EAN that values and supports the impact assessment process being developed, which is based on continuous action learning and improvement. The paper describes the situation related to monitoring and evaluation (M&E) and impact assessment before the project began, in which EAN was often reliant on time-bound studies and ‘success stories’ derived from listener letters and feedback. We then outline the various strategies used in an effort to develop stronger and more effective impact assessment and M&E systems, and the gradual changes that have occurred to date. These changes include a greater understanding of the value of adopting a participatory, holistic, evidence-based approach to impact assessment. We also critically review the many challenges experienced in this process, including:----- • Tension between the pressure from donors to ‘prove’ impacts and the adoption of a bottom-up, participatory approach based on ‘improving’ programs in ways that meet community needs and aspirations.----- • Resistance from the content teams to changing their existing M&E practices and to the perceived complexity of the approach.----- • Lack of meaningful connection between the M&E and content teams.----- • Human resource problems and lack of capacity in analysing qualitative data and reporting results.----- • The contextual challenges, including extreme poverty, wide cultural and linguistic diversity, poor transport and communications infrastructure, and political instability.----- • A general lack of acceptance of the importance of evaluation within Nepal due to accepting everything as fate or ‘natural’ rather than requiring investigation into a problem.

Respecting local, cultural contexts for assessment practice in an era of globalization

Dissatisfaction, internationally, with existing educational practices and outcomes since the early 1990s has led to increased educational reform. At the same time, there has also been a worldwide shift in control of education away from teachers toward the state for the purposes of restructuring economies. More bureaucratic forms of curriculum and assessment have resulted, with a return to the use of more techno-rational discourse in assessment and evaluation for purposes of efficiency, accountability, impact, and performance management. There has also been an increase in the use of economic and productivity models to study educational outcomes. These models fail to account for the range of outcomes achieved and fail to identify the factors responsible for such diversity in performance.

Formative and summative assessment and the notion of constructive alignment

This paper discusses the different perceptions of first year accounting students about their tutorial activities and their engagements in assessment. As the literature suggests, unless participation in learning activities forms part of graded assessment, it is often difficult to engage students in these activities. Using an action research model, this paper reports the study of first year accounting students' responses to action-oriented learning tasks in tutorials. The paper focuses on the importance of aligning curriculum objectives, learning and teaching activities and assessment, i.e. the notion of constructive alignment. However, as the research findings indicate, without support at institutional level, applying constructive alignment to facilitate quality student learning outcomes is a difficult task. Thus, the impacts of policy constraints on curriculum issues are also discussed, focusing on the limitations faced by tutors and their lack of involvement in curriculum development.

Authentic and conventional assessment in Singapore schools : an empirical study of teacher assignments and student work

This is an empirical examination of the quality of teacher assignments and student work in Singapore schools. Using a theoretical framework based on principles of authentic assessment and intellectual quality, two sets of criteria and scoring rubrics were developed for the training of expert teachers to judge the quality of assignments and student work. Following rigorous training, the inter-rater reliability of expert teacher scoring was high. Samples of teacher assignments and student work were collected in English, social studies, mathematics, and science subject areas from a random stratified sample of 30 elementary schools and 29 high schools. For both grade levels, there were significant differences for the authentic intellectual quality of teachers’ assignments by subject area. Likewise, the differences of authentic intellectual quality for student work were significant and varied by subject area. Subject area effect was large. The correlations between the quality of teachers’ assignment tasks and student work were strong and significant at both grade levels. Where teachers set more intellectually demanding tasks, students were more likely to generate work or artefacts judged to be of higher quality. The findings suggest that teacher professional development in authentic intellectual assessment task design can contribute to the improvement of student learning and performance. It is argued that this will be a key requisite of educational systems like Singapore that are seeking to expand pedagogy and student outcomes beyond a focus on factual and rote knowledge.