The Ophelia (OPtimise HEalth LIteracy and Access) process : using health literacy alongside grounded and participatory approaches to develop interventions in partnership with marginalised populations

This paper seeks to explore the potential of a newly developed, grounded and participatory approach to development of health-literacy and health-care access interventions for equity – the Ophelia (OPtimising HEalth LIteracy and Access) process (Batterham et al., 2014). The methodology involves undertaking a needs assessment of the target population using intensive qualitative and quantitative methods, developing vignettes of key sub-groups within the population based on their health literacy profile of strengths and weaknesses, and then engaging with frontline practitioners and community membersin developing realistic solutions (Batterham et al., 2014).

Evaluation and comparison of 3D intervertebral disc localization and segmentation methods for 3D T2 MR data: A grand challenge.

The evaluation of changes in Intervertebral Discs (IVDs) with 3D Magnetic Resonance (MR) Imaging (MRI) can be of interest for many clinical applications. This paper presents the evaluation of both IVD localization and IVD segmentation methods submitted to the Automatic 3D MRI IVD Localization and Segmentation challenge, held at the 2015 International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI2015) with an on-site competition. With the construction of a manually annotated reference data set composed of 25 3D T2-weighted MR images acquired from two different studies and the establishment of a standard validation framework, quantitative evaluation was performed to compare the results of methods submitted to the challenge. Experimental results show that overall the best localization method achieves a mean localization distance of 0.8 mm and the best segmentation method achieves a mean Dice of 91.8%, a mean average absolute distance of 1.1 mm and a mean Hausdorff distance of 4.3 mm, respectively. The strengths and drawbacks of each method are discussed, which provides insights into the performance of different IVD localization and segmentation methods.

Accuracy and usefulness of select methods for assessing complete collection of 24-hour urine: a systematic review.

Twenty-four-hour urine collection is the recommended method for estimating sodium intake. To investigate the strengths and limitations of methods used to assess completion of 24-hour urine collection, the authors systematically reviewed the literature on the accuracy and usefulness of methods vs para-aminobenzoic acid (PABA) recovery (referent). The percentage of incomplete collections, based on PABA, was 6% to 47% (n=8 studies). The sensitivity and specificity for identifying incomplete collection using creatinine criteria (n=4 studies) was 6% to 63% and 57% to 99.7%, respectively. The most sensitive method for removing incomplete collections was a creatinine index <0.7. In pooled analysis (≥2 studies), mean urine creatinine excretion and volume were higher among participants with complete collection (P<.05); whereas, self-reported collection time did not differ by completion status. Compared with participants with incomplete collection, mean 24-hour sodium excretion was 19.6 mmol higher (n=1781 specimens, 5 studies) in patients with complete collection. Sodium excretion may be underestimated by inclusion of incomplete 24-hour urine collections. None of the current approaches reliably assess completion of 24-hour urine collection.

Perceptions of individuals living with spinal cord injury toward preference-based quality of life instruments : a qualitative exploration

BACKGROUND: Generic preference-based health-related quality of life instruments are widely used to measure health benefit within economic evaluation. The availability of multiple instruments raises questions about their relative merits and recent studies have highlighted the paucity of evidence regarding measurement properties in the context of spinal cord injury (SCI). This qualitative study explores the views of individuals living with SCI towards six established instruments with the objective of identifying 'preferred' outcome measures (from the perspective of the study participants). METHODS: Individuals living with SCI were invited to participate in one of three focus groups. Eligible participants were identified from Vancouver General Hospital's Spine Program database; purposive sampling was used to ensure representation of different demographics and injury characteristics. Perceptions and opinions were solicited on the following questionnaires: 15D, Assessment of Quality of Life 8-dimension (AQoL-8D), EQ-5D-5L, Health Utilities Index (HUI), Quality of Well-Being Scale Self-Administered (QWB-SA), and the SF-36v2. Framework analysis was used to analyse the qualitative information gathered during discussion. Strengths and limitations of each questionnaire were thematically identified and managed using NVivo 9 software. RESULTS: Major emergent themes were (i) general perceptions, (ii) comprehensiveness, (iii) content, (iv) wording and (v) features. Two sub-themes pertinent to content were also identified; 'questions' and 'options'. All focus group participants (n = 15) perceived the AQoL-8D to be the most relevant instrument to administer within the SCI population. This measure was considered to be comprehensive, with relevant content (i.e. wheelchair inclusive) and applicable items. Participants had mixed perceptions about the other questionnaires, albeit to varying degrees. CONCLUSIONS: Despite a strong theoretical underpinning, the AQoL-8D (and other AQoL instruments) is infrequently used outside its country of origin (Australia). Empirical comparative analyses of the favoured instruments identified in this qualitative study are necessary within the context of spinal cord injury.

Effects of modality, urgency and situation on responses to multimodal warnings for drivers

Signifying road-related events with warnings can be highly beneficial, especially when imminent attention is needed. This thesis describes how modality, urgency and situation can influence driver responses to multimodal displays used as warnings. These displays utilise all combinations of audio, visual and tactile modalities, reflecting different urgency levels. In this way, a new rich set of cues is designed, conveying information multimodally, to enhance reactions during driving, which is a highly visual task. The importance of the signified events to driving is reflected in the warnings, and safety-critical or non-critical situations are communicated through the cues. Novel warning designs are considered, using both abstract displays, with no semantic association to the signified event, and language-based ones, using speech. These two cue designs are compared, to discover their strengths and weaknesses as car alerts. The situations in which the new cues are delivered are varied, by simulating both critical and non-critical events and both manual and autonomous car scenarios. A novel set of guidelines for using multimodal driver displays is finally provided, considering the modalities utilised, the urgency signified, and the situation simulated.

A relação entre Escola e Família na perspectiva de futuros Educadores de Infância e de Professores do 1º ciclo do Ensino Básico: influências da formação inicial e supervisão pedagógica na promoção desta relação

Este estudo procura caracterizar a relação entre Escola e Família na perspectiva de alunos futuros Educadores de Infância e Professores do Ensino Básico do 1º ciclo, no contexto do seu estágio final de quarto ano. Partindo do pressuposto que as concepções dos alunos não se formulam num vazio, procura-se compreender as concepções teóricas e práticas acerca da relação entre Escola e Família destes alunos, no contexto da formação que os enquadra e igualmente no contexto das escolas onde realizam o seu estágio final. Realizámos um estudo de caso em duas Instituições de Ensino Superior, a Escola Superior de Educação de Beja e a Universidade de Évora, nomeadamente a quatro turmas de quarto ano das duas licenciaturas já referidas. Como instrumentos de recolha de dados fizemos uma análise das disciplinas do plano de estudos de cada licenciatura, assim como fizemos também uma análise dos instrumentos de planificação e avaliação que estes estabelecimentos de ensino utilizam, e ainda aplicámos aos alunos um inquérito por questionário. Os resultados que obtivemos mostram que os alunos dão importância à relação de complementaridade e de relação entre Escola e Família, não considerando assim a separação entre estes dois agentes educativos. Como tal, estes alunos consideraram que os professores e educadores devem ter em consideração o envolvimento das Famílias nas suas planificações de actividades e assumir os pais como agentes educativos activos. Estes dados só fazem sentido, uma vez que quer a Escola Superior de Educação de Beja, quer a Universidade de Évora, parecem fornecer aos seus alunos, formação para que estes estejam sensibilizados para a promoção da relação entre Escola e Família, através de vários propósitos que exigem aos seus alunos. Contudo salientamos uma formação inicial mais abrangente e exigente na Universidade de Évora. Ainda assim, é um facto que estes alunos encontraram factores que dificultaram o estabelecimento da relação entre Escola e Família ao longo dos seus estágios finais, no entanto, conseguiram estabelecer estratégias de modo a ultrapassá-las, estratégias estas, na sua maioria inseridas nos tipo 2 e 3 da tipologia de Joyce Epstein, assim como estratégias ligadas à comunicação e promoção da participação conjunta em actividades realizadas tanto dentro como fora da sala e/ou Instituição. ABSTRACT: This study characterizes the school-family relationships from the point of view of pre­school and primary student-teachers in their final year of initial training. Assuming that the student’s conceptions are not build in an empty context, we seek to understand the theoretical and practical concepts about the school-family relationships of these students, in the context of their experience at the University and at the schools where they undergo their final practicum. This is a case-study of two higher education institutions: Escola Superior de Educação de Beja and Universidade de Évora, and two courses in each institution: Pre-school Education and Primary School Teaching; the students belong to the four final years of these courses. Data included documentary analysis of the courses plans and the planning and evaluation instruments used within each course and a questionnaire to all students of each course. Results point out to an understanding of school-family relationships characterized by complementarity and reciprocity, rejecting a view of separation between school and family. These students considered important that teachers include in their plans opportunities to involve families and that they consider families as active educational agents. These results seem to be associated with the higher education institutions programs which encourage and require students to adopt such approach. The results seem to suggest that the teachers' training at the Universidade de Évora is slightly broader and more demanding. Despite these students having found some resistances and difficulties during their practicum in relation to implementing school and family links, they were also able to implement some strategies to overcome these difficulties. The strategies students used were mainly within Joyce Epstein's type tow and tree; strategies were mainly directed to promote communication and joint participation in activities inside as well as outside the classroom and the school.

Citizen journalism as social networking : reporting the 2007 Australian Federal Election

One of the perceived Achilles heels of online citizen journalism is its perceived inability to conduct investigative and first-hand reporting. A number of projects have recently addressed this problem, with varying success: the U.S.-based Assignment Zero was described as "a highly satisfying failure" (Howe 2007), while the German MyHeimat.de appears to have been thoroughly successful in attracting a strong community of contributors, even to the point of being able to generate print versions of its content, distributed free of charge to households in selected German cities. In Australia, citizen journalism played a prominent part in covering the federal elections held on 24 November 2007; news bloggers and public opinion Websites provided a strong counterpoint to the mainstream media coverage of the election campaign (Bruns et al., 2007). Youdecide2007.org, a collaboration between researchers at Queensland University of Technology and media practitioners at the public service broadcaster SBS, the public opinion site On Line Opinion, and technology company Cisco Systems, was developed as a dedicated space for a specifically hyperlocal coverage of the election campaign in each of Australia's 150 electorates from the urban sprawls of Sydney and Brisbane to the sparsely populated remote regions of outback Australia. YD07 provided training materials for would-be citizen journalists and encouraged them to contribute electorate profiles, interview candidates, and conduct vox-pops with citizens in their local area. The site developed a strong following especially in its home state of Queensland, and its interviewers influenced national public debate by uncovering the sometimes controversial personal views of mainstream and fringe candidates. At the same time, the success of YD07 was limited by external constraints determined by campaign timing and institutional frameworks. As part of a continuing action research cycle, lessons learnt from Youdecide2007.org are going to be translated into further iterations of the project, which will cover the local government elections in the Australian state of Queensland, to be held in March 2008, and developments subsequent to these elections. This paper will present research outcomes from the Youdecide2007.org project. In particular, it will examine the roles of staff contributors and citizen journalists in attracting members, providing information, promoting discussion, and fostering community on the site: early indications from a study of interaction data on the site indicate notably different contribution patterns and effects for staff and citizen participants, which may point towards the possibility of developing more explicit pro-am collaboration models in line with the Pro-Am phenomenon outlined by Leadbeater & Miller (2004). The paper will outline strengths and weaknesses of the Youdecide model and highlight requirements for the successful development of active citizen journalism communities. In doing so, it will also evaluate the feasibility of hyperlocal citizen journalism approaches, and their interrelationship with broader regional, state, and national journalism in both its citizen and industrial forms.

Assessing organizational culture? value management to the rescue

As part of a Doctor of Business Administration degree programme jointly run by Curtin University, Perth, Australia and Lingnan University, Hong Kong, a research thesis relating organizational effectiveness to the organizational culture of Hong Kong construction firms involved in public housing is being undertaken. Organizational effectiveness is measured by the Housing Department (HD) Performance Assessment Scoring System (PASS) and organizational culture traits and strengths have been measured by using the Denison Organizational Culture Survey (OCS), developed by Daniel Denison and William S. Neale and based on 16 years of research involving over 1,000 organizations. The PASS scores of building contractors are compared with the OCS scores to determine if there is any significant correlation between highly effective companies and particular organizational strengths and traits. Profiles are then drawn using the Denison Model and can be compared against ‘norms’ for the industry sector on which the survey has been carried out. The next stage of the work is to present the results of the survey to individual companies, conduct focus group interviews to test the results, discover more detail on that company’s culture and discuss possible actions based on the results. It is in this latter stage that certain value management techniques may well prove very useful.

Using resilience to reconceptualise child protection workforce capacity

Current approaches to managing and supporting staff and addressing turnover in child protection predominantly rely on deficit-based models that focus on limitations, shortcomings, and psychopathology. This article explores an alternative approach, drawing on models of resilience, which is an emerging field linked to trauma and adversity. To date, the concept of resilience has seen limited application to staff and employment issues. In child protection, staff typically face a range of adverse and traumatic experiences that have flow-on implications, creating difficulties for staff recruitment and retention and reduced service quality. This article commences with discussion of the multifactorial influences of the troubled state of contemporary child protection systems on staffing problems. Links between these and difficulties with the predominant deficit models are then considered. The article concludes with a discussion of the relevance and utility of resilience models in developing alternative approaches to child protection staffing issues.

Settings for mental health care

The quality of the environment is important to client recovery and rehabilitation. • The preferred environment for the care of the mentally ill over time has been the home. • Environmental strategies in the care of the mentally ill became more important in the eighteenth century, when it was noticed that patients were more manageable in a pleasant environment. • Confinement of the mentally ill in large public asylums was largely an innovation of the nineteenth century. • The therapeutic milieu is a consciously organised environment. • Maxwell Jones in the United States and Thomas Main in the United Kingdom pioneered the concept of the hospital and environment as treatment tools. • The goals of the therapeutic milieu are containment, structure, support, involvement, validation, symptom management, and maintaining links with family and the community. • The principles on which the therapeutic milieu is based include: open communication, democratisation, reality confrontation, permissiveness, group cohesion and the multidisciplinary team. • The principle guiding the care of clients in the community is that of the least-restrictive alternative. • The therapeutic community residence is an environment that encourages the development of the client as a person in interaction with others, rather than as someone suffering from a health problem or disability. • The preferred contemporary setting for the provision of mental health care is the community. • The predominant form of service delivery in the community is case management, which has been found to be most effective for people with severe mental illnesses. • The principles of caring in the community are self-determination, normalisation, a focus on client strengths, and the community as a resource

ePortfolio use by university students in Australia: A review of the Australian ePortfolio Project

In October 2008, the Australian Learning and Teaching Council (ALTC) released the final report for the commissioned project ePortfolio use by university students in Australia: Informing excellence in policy and practice. The Australian ePortfolio Project represented the first attempt to examine the breadth and depth of ePortfolio practice in the Australian higher education sector. The research activities included surveys of stakeholder groups in learning and teaching, academic management and human resource management, with respondents representing all Australian universities; a series of focus groups and semi-structured interviews which sought to explore key issues in greater depth; and surveys designed to capture students’ pre-course expectations and their post-course experiences of ePortfolio learning. Further qualitative data was collected through interviews with ‘mature users’ of ePortfolios. Project findings revealed that, while there was a high level of interest in the use of ePortfolios in terms of the potential to help students become reflective learners who were conscious of their personal and professional strengths and weaknesses, the state of play in Australian universities was very fragmented. The project investigation identified four individual, yet interrelated, contexts where strategies may be employed to support and foster effective ePortfolio practice in higher education: government policy, technical standards, academic policy, and learning and teaching. Four scenarios for the future were also presented with the goal of stimulating discussion about opportunities for stakeholder engagement. It is argued that the effective use of ePortfolios requires open dialogue and collaboration between the different stakeholders across this range of contexts.

The growth-profitability relationship : strategic orientations as moderator

Principal Topic: In this study we investigate how strategic orientation moderates the impact of growth on profitability for a sample of Danish high growth (Gazelle) firms. ---------- Firm growth has been an essential part of both management research and entrepreneurship research for decades (e.g. Penrose 1959, Birch 1987, Storey 1994). From a societal point of view, firm growth has been perceived as economic generator and job creator. In entrepreneurship research, growth has been an important part of the field (Davidsson, Delmar and Wiklund 2006), and many have used growth as a measure of success. In strategic management, growth has been seen as an approach to achieve competitive advantages and a way of becoming increasing profitable (e.g. Russo and Fouts 1997, Cho and Pucic 2005). However, although firm growth used to be perceived as a natural pathway to profitability recently more skepticism has emerged due to both new theoretical development and new empirical insights. Empirically, studies show inconsistent and inconclusive empirical evidence regarding the impact of growth on profitability. Our review reveals that some studies find a substantial positive relationship, some find a weak positive relationship, some find no relationship and further some find a negative relationship. Overall, two dominant yet divergent theoretical positions can be identified. The first position, mainly focusing on the environmental fit, argues that firms are likely to become more profitable if they enter a market quickly and on a larger scale due to first mover advantages and economic of scale. The second position, mainly focusing the internal fit, argues that growth may lead to a range of internal challenges and difficulties, including rapid change in structure, reward systems, decision making, communication and management style. The inconsistent empirical results together with two divergent theoretical positions call for further investigations into the circumstances by which growth generate profitability and into the circumstances by which growth do not generate profitability. In this project, we investigate how strategic orientations influence the impact of growth on profitability by asking the following research question: How is the impact of growth on profitability moderated by strategic orientation? Based on a literature review of how growth impacts profitability in areas such as entrepreneurship, strategic management and strategic entrepreneurship we develop three hypotheses regarding the growth-profitability relationship and strategic orientation as a potential moderator. ---------- Methodology/Key Propositions: The three hypotheses are tested on data collected in 2008. All firms in Denmark, including all listed and non-listed (VAT-registered) firms who experienced a 100 % growth and had a positive sales or gross profit over a four years period (2004-2007) were surveyed. In total 2,475 fulfilled the requirements. Among those 1,107 firms returned usable questionnaires satisfactory giving us a response rate on 45 %. The financial data together with data on number of employees were obtained from D&B (previously Dun & Bradstreet). The remaining data were obtained through the survey. Hierarchical regression models with ROA (return on assets) as the dependent variable were used to test the hypotheses. In the first model control variables including region, industry, firm age, CEO age, CEO gender, CEO education and number of employees were entered. In the second model, growth measured as growth in employees was entered. Then strategic orientation (differentiation, cost leadership, focus differentiation and focus cost leadership) and then interaction effects of strategic orientation and growth were entered in the model. ---------- Results and Implications: The results show a positive impact of firm growth on profitability and further that this impact is moderated by strategic orientation. Specifically, it was found that growth has a larger impact on profitability when firms do not pursue a focus strategy including both focus differentiation and focus cost leadership. Our preliminary interpretation of the results suggests that the value of growth depends on the circumstances and more specifically 'how much is left to fight for'. It seems like those firms who target towards a narrow segment are less likely to gain value of growth. The remaining market shares to fight for to these firms are not large enough to compensate for the cost of growing. Based on our findings, it therefore seems like growth has a more positive relationship with profitability for those who approach a broad market segment. Furthermore we argue that firms pursuing af Focus strategy will have more specialized assets that decreases the possibilities of further profitable expansion. For firms, CEOs, board of directors etc., the study shows that high growth is not necessarily something worth aiming for. It is a trade-off between the cost of growing and the value of growing. For many firms, there might be better ways of generating profitability in the long run. It depends on the strategic orientation of the firm. For advisors and consultants, the conditional value of growth implies that in-depth knowledge on their clients' situation is necessary before any advice can be given. And finally, for policy makers, it means they have to be careful when initiating new policies to promote firm growth. They need to take into consideration firm strategy and industry conditions.

On the cognitive effectiveness of routing symbols in process modeling languages

Process models provide visual support for analyzing and improving complex organizational processes. In this paper, we discuss differences of process modeling languages using cognitive effectiveness considerations, to make statements about the ease of use and quality of user experience. Aspects of cognitive effectiveness are of importance for learning a modeling language, creating models, and understanding models. We identify the criteria representational clarity, perceptual discriminability, perceptual immediacy, visual expressiveness, and graphic parsimony to compare and assess the cognitive effectiveness of different modeling languages. We apply these criteria in an analysis of the routing elements of UML Activity Diagrams, YAWL, BPMN, and EPCs, to uncover their relative strengths and weaknesses from a quality of user experience perspective. We draw conclusions that are relevant to the usability of these languages in business process modeling projects.

Improved image contrast of the bone-muscle interface with 3T MRI compared to 1.5T MRI [Abstract]

Virtual 3D models of long bones are increasingly being used for implant design and research applications. The current gold standard for the acquisition of such data is Computed Tomography (CT) scanning. Due to radiation exposure, CT is generally limited to the imaging of clinical cases and cadaver specimens. Magnetic Resonance Imaging (MRI) does not involve ionising radiation and therefore can be used to image selected healthy human volunteers for research purposes. The feasibility of MRI as alternative to CT for the acquisition of morphological bone data of the lower extremity has been demonstrated in recent studies [1, 2]. Some of the current limitations of MRI are long scanning times and difficulties with image segmentation in certain anatomical regions due to poor contrast between bone and surrounding muscle tissues. Higher field strength scanners promise to offer faster imaging times or better image quality. In this study image quality at 1.5T is quantitatively compared to images acquired at 3T. --------- The femora of five human volunteers were scanned using 1.5T and 3T MRI scanners from the same manufacturer (Siemens) with similar imaging protocols. A 3D flash sequence was used with TE = 4.66 ms, flip angle = 15° and voxel size = 0.5 × 0.5 × 1 mm. PA-Matrix and body matrix coils were used to cover the lower limb and pelvis respectively. Signal to noise ratio (SNR) [3] and contrast to noise ratio (CNR) [3] of the axial images from the proximal, shaft and distal regions were used to assess the quality of images from the 1.5T and 3T scanners. The SNR was calculated for the muscle and bone-marrow in the axial images. The CNR was calculated for the muscle to cortex and cortex to bone marrow interfaces, respectively. --------- Preliminary results (one volunteer) show that the SNR of muscle for the shaft and distal regions was higher in 3T images (11.65 and 17.60) than 1.5T images (8.12 and 8.11). For the proximal region the SNR of muscles was higher in 1.5T images (7.52) than 3T images (6.78). The SNR of bone marrow was slightly higher in 1.5T images for both proximal and shaft regions, while it was lower in the distal region compared to 3T images. The CNR between muscle and bone of all three regions was higher in 3T images (4.14, 6.55 and 12.99) than in 1.5T images (2.49, 3.25 and 9.89). The CNR between bone-marrow and bone was slightly higher in 1.5T images (4.87, 12.89 and 10.07) compared to 3T images (3.74, 10.83 and 10.15). These results show that the 3T images generated higher contrast between bone and the muscle tissue than the 1.5T images. It is expected that this improvement of image contrast will significantly reduce the time required for the mainly manual segmentation of the MR images. Future work will focus on optimizing the 3T imaging protocol for reducing chemical shift and susceptibility artifacts.

Performance tests for visual servo control systems, with application to partitioned approaches to visual servo control

Visual servoing has been a viable method of robot manipulator control for more than a decade. Initial developments involved positionbased visual servoing (PBVS), in which the control signal exists in Cartesian space. The younger method, image-based visual servoing (IBVS), has seen considerable development in recent years. PBVS and IBVS offer tradeoffs in performance, and neither can solve all tasks that may confront a robot. In response to these issues, several methods have been devised that partition the control scheme, allowing some motions to be performed in the manner of a PBVS system, while the remaining motions are performed using an IBVS approach. To date, there has been little research that explores the relative strengths and weaknesses of these methods. In this paper we present such an evaluation. We have chosen three recent visual servo approaches for evaluation in addition to the traditional PBVS and IBVS approaches. We posit a set of performance metrics that measure quantitatively the performance of a visual servo controller for a specific task. We then evaluate each of the candidate visual servo methods for four canonical tasks with simulations and with experiments in a robotic work cell.