A home environment test battery for status assessment in patients with motor fluctuations

Background and aims Evaluating status in patients with motor fluctuations is complex and occasional observations/measurements do not give an adequate picture as to the time spent in different states. We developed a test battery to assess advanced Parkinson patients' status consisting of diary assessments and motor tests. This battery was constructed and implemented on a handheld computer with built-in mobile communication. In fluctuating patients, it should typically be used several times daily in the home environment, over periods of about one week. The aim of this battery is to provide status information in order to evaluate treatment effects in clinical practice and research, follow up treatments and disease progression and predict outcome to optimize treatment strategy. Methods Selection of diary questions was based on a previous study with Duodopa® (DIREQT). Tapping tests (with and without visual cueing) and a spiral drawing test were added. Rapid prototyping was used in development of the user interface. An evaluation with two pilot patients was performed before and after receiving new treatments for advanced disease (one received Duodopa® and one received DBS). Speed and proportion missed taps were calculated for the tapping tests and entropy of the radial drawing velocity was calculated for the spiral tests. Test variables were evaluated using non-parametric statistics. Results Post-treatment improvement was detected in both patients in many of the test variables. Conclusions Although validation work remains, preliminary results are promising and the test battery is currently being evaluated in a long-term health economics study with Duodopa® (DAPHNE).

Gathering for God : George Brown in Oceania

Combining 'the gathering of artefacts with the gathering of souls', George Brown was a key figure in the Christian, and especially the Wesleyan Methodist, history of nineteenth-century Oceania. Using his life as a case study, Helen Bethea Gardner examines the role of Christian missionaries in the Pacific Islands. Brown's career (1860-1908) spanned one of the most tumultuous political periods in the South Pacific, as one by one islands were colonised by imperial nations. He was one of the most politically engaged of all missionaries, encouraging colonial rule in the Pacific by America, Britain, Germany and, eventually, Australia and New Zealand. Originally from the north of England, he worked as a missionary in Samoa from 1860, moving to the Bismarck Archipelago (now Papua New Guinea) in 1875. From the 1880s until his retirement in 1907, he worked in Sydney as the general secretary of the Australasian Methodist Overseas Mission. Gathering for God examines Brown's missionary letters, journals and journalism, exploring how he attracted Pacific Islanders to Christian teachings, analysing his leadership during an armed attack on New Britain villages accused of cannibalism, and looking at his work in the new discipline of anthropology. He was a major collector of artefacts (his collection is now in the Osaka Museum) and photographer of Pacific peoples (his collection is in the Australian Museum).

Building materials selection: greenhouse strategies for built facilities

This paper aims to consider the embodied energy of building materials in the context of greenhouse gas emission mitigation strategies. Previous practice and research are highlighted where they have the potential to influence design decisions. Latest embodied energy figures are indicated, and the implications of applying these figures to whole buildings are discussed. Several practical examples are given to aid building designers in the selection of building materials for reduced overall life cycle greenhouse gas emissions.

From local to national: aspects of mapping the welfare third sector in Australia

The paper charts the authors' research experiences in various types of sociological mapping ofc ommunity or third sector organisations. Specifically this was a search for a way of understanding how third sector organisations dealing with welfare issues were operating in Australia in the mid I990s.

The paper tells the story of how the researchers worked through the implications of being faced initially with a dearth of information about their subject and of how lessons were learnt about the disjunctions between what is formally given as textbook knowledge about research practice and what actually can and does happen: that is, the relationship between the theory and the practice of research.

In discussing the creation of a database of organisations, conducting focus groups and a national sample survey, the paper comments on some of the practical problems facing third sector researchers as well as looking at concept generation and typology building as analytical tools.

The effect of intellectual disability on children's recall of an event across different question types

This research examined the performance of 80 children aged 9–12 years with either a mild and moderate intellectual disability when recalling an innocuous event that was staged in their school. The children actively participated in a 30-min magic show, which included 21 specific target items. The first interview (held 3 days after the magic show) provided false and true biasing information about these 21 items. The second interview (held the following day) was designed to elicit the children's recall of the target details using the least number of specific prompts possible. The children's performance was compared with that of 2 control groups; a group of mainstream children matched for mental age and a group of mainstream children matched for chronological age. Overall, this study showed that children with either a mild or moderate intellectual disability can provide accurate and highly specific event-related information. However, their recall is less complete and less clear in response to free-narrative prompts and less accurate in response to specific questions when compared to both the mainstream age-matched groups. The implications of the findings for legal professionals and researchers are discussed.

Managing contactability in telephone surveys

The Australian market research industry relies on telephone interviewing as one of its major data collection methods. Through Its LIST initiative, the industry has committed to best practice In research methods in order to address various concerns, especially the decline in response rates for telephone interviews. Response rates are determined by the co-operation of eligible respondents and their degree of contactabllity. The reported study is concerned with the way the industry attempts to manage contactabiIity. A study of fieldwork managers responSible for over 75% of all phone interviews in Australia revealed a limited use of contact enhancing strategies such as longer fieldwork periods and more callbacks. Commercial imperatives for timely surveys and a lack of end-user concern for response rate issues, along with cost issues, were believed to be responsible.

The role of information and communication technology in the urgent decision making process : a work in progress report

This paper reports part of a study that examines how members of a senior management team in a public sector organisation make decisions under urgency. Four regional managers, who are geographically dispersed around New Zealand were interviewed, either face-to-face or via telephone, regarding their experiences of decision making under urgency.

Preliminary results indicate that only three out of a possible seven steps of a conventional decision making process are used during the urgent decision making process. The study also shows that participants do not fully utilise the information and communication technology available during the decision making process. The implications the findings have for practice and research are discussed.

The dimensions of self-service technologies and the relation to 'self'

This paper assesses the “behavioural” notion of “self” across the various dimensions of self-service technologies (SSTs). In the context of SSTs, it is acknowledged that the customer role is extended to include that of “service employee”. Therefore, the authors propose the need to explore this new role, from the customer’s perspective, across a diverse range of SSTs. This proposition is supported in that prior research has looked generally across a broad range of SSTs, as opposed to drawing comparisons across the different types of SSTs. In bringing together two classification schemes of SSTs, which does not appear to have been done previously, the authors draw on past research and industry examples to explore the customer experience across different categories of SSTs. It is proposed that the dimensions of SSTs, including level of customer participation as influenced by the purpose of the SST, location of the SST, and type of technology employed, will uniquely influence the notion of “self”, and thus the customer’s SST experience. These propositions have implications for both future research and practice. Future research is needed to study empirically the characteristics of specific SSTs, and compare the many different types of SSTs, and how their unique characteristics influence the customer’s production/consumption experience. When marketers gain a better understanding of the dimensions of individual SSTs, and their influence on the customer, more effective management and use of SSTs will result.

Effective and strategic use of electronic reverse auctions

This paper reports the findings of an empirical study of Electronic Reverse Auctions (e-RAs). This study seeks to better understand the underlying and emerging issues in e-RAs to comprehend the implications of e-RAs on organizational procurement. The study contributes to practice and research by providing insight into emerging e-RA adoption issues, and by discussing strategies for improving e-RA processes, thus improving the effectiveness of e-RAs.

Security issues within virtual worlds such as second life

The advancement in Internet and bandwidth has resulted in a number of new applications to be developed. An area of advancement has been in the development of virtual worlds, where people can interact together via virtual characters. Virtual World systems have been so complex that virtual lives can be lived, including all aspect of life such as education, commerce, social activities etc. Not surprisingly, the problems that exist in the real world such as theft, fraud, vandalism and terrorism, also exist in the virtual worlds. The more developed these virtual worlds become the greater the breaches of security will be in the virtual as well as the real world.This paper explores and categorises several security issues within the Virtual World of Second Life. It contributes to practice and research by emphasising the importance of security awareness for businesses and the general public in Virtual Worlds.

Nurses' strategies for managing pain in the postoperative setting

Acute pain is a significant problem in the postoperative setting. Patients report a lack of information about pain-control measures and ineffective pain control. Nurses continue to rely on pharmacologic measures and tend to under-administer analgesics. The purpose of this study was to determine the strategies nurses used to manage patients’ pain in the postoperative setting. It also sought to examine the effect of context, including organization of care, nurses’ prioritization of work activities, and pressures during a working shift, on their pain-management strategies. An observational design was used in two surgical units of a metropolitan teaching hospital in Melbourne, Australia. Six fixed observation times were identified as key periods for pain activities, each comprising a 2-hour duration. An observation period was examined at least 12 times, resulting in the completion of 74 observations and the identification of 316 pain cases. Fifty-two nurses were observed during their normal day’s work with postoperative patients. Six themes were identified: managing pain effectively; prioritizing pain experiences for pain management; missing pain cues for pain management; regulators and enforcers of pain management; preventing pain; and reactive management of pain. The findings highlighted the critical nature of communication between clinicians and patients and among clinicians. It also demonstrated the influence of time on management strategies and the relative importance that nurses place on nonpharmacologic measures in actual practice. This research, which portrays what happens in actual clinical practice, has facilitated the identification of new data that were not evident from other research studies.

Evidence-based clinical policy: case report of a reproducible process to encourage understanding and evaluation of evidence

We report within a case study a reproducible process to facilitate the explicit incorporation of evidence by a multidisciplinary group into clinical policy development. To support the decision-making of a multidisciplinary Intersectoral Advisory Group (IAG) convened by the Royal Australasian College of Physicians Health Policy Unit, a systematic review of randomized controlled trials about environmental tobacco smoke and smoking cessation interventions in paediatric settings was first undertaken. As reported in detail here, IAG members were then formally engaged in a transparent and replicable process to understand and interpret the synthesized evidence and to proffer their independent reactions regarding policy, practice and research. Our intention was to ensure that all IAG members were democratically engaged and made aware of the available evidence. As clinical policy must engage stakeholder representatives from diverse backgrounds, a process to equalize understanding of the evidence and 'democratize' judgment about its implications is needed. Future research must then examine the benefits of such explicit steps when guidelines, in turn, are implemented. We hypothesize that changes to future practice will be more likely if processes undertaken to develop guidelines are transparent to clinicians and other target groups.

Security and ethical issues in the virtual world of Second Life

In recent times, Virtual Worlds such as Second Life have generated substantial publicity due to the participation of Fortune 500 companies, and other public and private organisations. As practitioners continue to discuss how organisations could derive business value from Virtual Worlds, new security and ethical issues in Virtual Worlds have emerged to challenge Virtual World users and stakeholders. This paper discusses privacy, intellectual property and a host of other security and ethical issues in Virtual Worlds. It contributes to practice and research by (i) providing insight into emerging security and ethical issues in Virtual Worlds, (ii) analysing the implication of these issues, within and beyond Virtual Worlds, and (iii) raising awareness on security and ethics among Virtual World users and stakeholders.

Nutrition therapy in the prevention and treatment of pressure ulcers

Pressure ulcers are serious problems within hospital and aged care settings and are associated with adverse health outcomes and high treatment costs. Because of a high incidence of pressure ulcers in the health system, attention is now being directed to not just preventing, but also more effectively treating them. Nutrition plays a fundamental part in wound healing, with malnutrition, dehydration and recent weight loss identified as independent risk factors for the development of pressure ulcers. While the optimal nutrient intake to promote wound healing is unknown, increased needs for energy, protein, zinc and vitamins A, C and E have been documented. There is reasonable evidence to show that nutritional support, mostly by high-protein oral nutritional supplements, is effective in significantly reducing the incidence of pressure ulcers in at-risk patients by 25%. Intervention studies using high-protein or specialised disease-specific nutritional supplements support a trend to increased healing of established pressure ulcers. Such specialised supplements are typically based on defined amounts of arginine, vitamin C and zinc. Mechanisms by which nutritional support can aid in pressure ulcer prevention and healing are likely related to addressing macro- and/or micro-nutrient deficiencies arising from either poor oral intake or increased nutrient requirements related to the wound healing process. With much more research still to be done in this area, nutrition support appears an efficacious and costeffective adjunct to current medical and nursing approaches in the prevention and treatment of pressure ulcers.

The second curriculum opera : Arias, assessment and methodological traces

Drawing on contemporary forms of qualitative research such as performance ethnography (McCall, 2000), autoethnography (Ellis & Bochner, 2000; Ellis & Flaherty, 1992) and using narrative and writing as forms of inquiry (Richardson, 1990; 1992; 1995a; 1995b; 1997; 1999; 2000), this research project constructs a 'learning through' (Gardner, 1983; 1993; 1995; 1999; 2003a; 2003b) approach to curriculum within pre-service teacher education. During 2002 we initiated the first curriculum opera (Dixon & White, 2003; Dixon, White, & Smerdon, 2003) in our Faculty of Education with thirty-seven students. In 2003 we developed this learning and teaching approach with twice as many students. We also reconsidered assessment of students involved in the opera for overall theoretical consistency. As students increasingly took control, they 'imagined curriculum' (Doll & Gough, 2002) and transformed their exploration of identity in the 'process of becoming' teachers (Britzman, 2003). In this paper, we outline the project and the learning involved. We also indicate future directions for learning and teaching in preservice teacher education as well as the potential uses and misuses of teacher assessment through portfolio.