Obstruction and infiltration: a proposal of a quality indicator.

Background The quest for continuous improvement of the quality of provided care is the objective of nursing care. However, the insertion and permanence of a peripheral venous catheter has been associated to complications, thus making a systematic evaluation of the performance of professionals and the management of health services important. Objective: Analyse complications that caused removal of intravenous catheters. Methods A prospective study with 64 patients of a health service of Portugal, from July to September/2015. Included patients with age 18 years, with a peripheral venous catheter. Descriptive analysis using SPSS. Ethical requirements were met. Results Two hundred three (203) intravenous catheters, in 64 patients, most elderly (section 95.3 %), with mean age of 80 years were evaluated. The catheters remained inserted between one and 12 days (mean 2 days), 66 % of the devices were removed because of complications, such as: removal by the patient (17.7 %), obstruction (17.2 %), infiltration (14.8 %), phlebitis (9.4 %) and fluid exiting the insertion site (6.4 %). The prevalence of obstruction and infiltration per patient was respectively 36 % and 39 %. Conclusions Obstruction and infiltration were the complications of higher prevalence that led to the removal and reinsertion of a new peripheral venous catheter with the possibility of increased pain, infection and hospital costs. Faced with the risk of compromising patient safety and being able to contribute to the improvement of health care, we suggest the inclusion of obstruction and infiltration in the indicators of quality of care, in order to have systematic evaluation of results, (re)plan and implement preventive measures.

Building bridges between user and designer: co-creation, immersion and perspective taking

Designing for users rather than with users is still a common practice in technology design and innovation as opposed to taking them on board in the process. Design for inclusion aims to define and understand end-users, their needs, context of use, and, by doing so, ensure that end-users are catered for and included, while the results are geared towards universality of use. We describe the central role of end-user and designer participation, immersion and perspective to build user-driven solutions. These approaches provided a critical understanding of the counterpart role. Designer(s) could understand what the user’s needs were, experience physical impairments, and see from other’s perspective the interaction with the environment. Users could understand challenges of designing for physical impairments, build a sense of ownership with technology and explore it from a creative perspective. The understanding of the peer’s role (user and designer), needs and perspective enhanced user participation and inclusion.

ASSESSING QUALITY IN HIGH-UNCERTAINTY MARKETS: ONLINE REVIEWS OF CREDENCE SERVICES

In economics of information theory, credence products are those whose quality is difficult or impossible for consumers to assess, even after they have consumed the product (Darby & Karni, 1973). This dissertation is focused on the content, consumer perception, and power of online reviews for credence services. Economics of information theory has long assumed, without empirical confirmation, that consumers will discount the credibility of claims about credence quality attributes. The same theories predict that because credence services are by definition obscure to the consumer, reviews of credence services are incapable of signaling quality. Our research aims to question these assumptions. In the first essay we examine how the content and structure of online reviews of credence services systematically differ from the content and structure of reviews of experience services and how consumers judge these differences. We have found that online reviews of credence services have either less important or less credible content than reviews of experience services and that consumers do discount the credibility of credence claims. However, while consumers rationally discount the credibility of simple credence claims in a review, more complex argument structure and the inclusion of evidence attenuate this effect. In the second essay we ask, “Can online reviews predict the worst doctors?” We examine the power of online reviews to detect low quality, as measured by state medical board sanctions. We find that online reviews are somewhat predictive of a doctor’s suitability to practice medicine; however, not all the data are useful. Numerical or star ratings provide the strongest quality signal; user-submitted text provides some signal but is subsumed almost completely by ratings. Of the ratings variables in our dataset, we find that punctuality, rather than knowledge, is the strongest predictor of medical board sanctions. These results challenge the definition of credence products, which is a long-standing construct in economics of information theory. Our results also have implications for online review users, review platforms, and for the use of predictive modeling in the context of information systems research.

A house, not a home? Examining the use of the private rented sector to resolve homelessness in Scotland

Changes to homelessness legislation in post-devolution Scotland have resulted in an expansion of rights for homeless households seeking formal assistance from local authorities. These changes have led to Scotland’s homelessness arrangements being considered among the most progressive in Europe. In recent years, however, the Scottish Government has increasingly promoted homelessness prevention and Housing Options approaches as a means by which homelessness might be avoided or resolved without recourse to statutory rights. As part of that, they have promoted greater use of the private rented sector (PRS) as a key housing option, with the potential to meet the needs of homeless households. The arguments made to support use of the PRS have much in common with arguments for privatisation in other areas of social policy, notably greater choice for the individual promoting better welfare outcomes, and competition among providers encouraging improvements in quality of service provision. Critics have argued that such benefits may not be realised and that, on the contrary, privatisation may lead to exclusion or act to worsen households’ outcomes. This thesis considers the extent to which the PRS has been utilised in Scotland to accommodate homeless households, and the consequences of this for their welfare. The thesis uses a combination of quantitative and qualitative methods. To examine trends in the use of the PRS, it presents quantitative analysis of the data on the operation of the statutory system and Housing Options arrangements, and of data from a survey of local authority homelessness strategy officers. To examine the consequences of this for homeless households, the thesis uses qualitative research involving face-to-face interviews with 35 homeless households across three local authority areas. This research considers the extent to which households’ experiences of homelessness, housing need and the PRS reflect the arguments presented in the literature, and how settled accommodation has impacted on households’ ability to participate fully in society. The research found an increasing but still limited role for the PRS in resolving statutory homelessness in Scotland, with indications that the PRS is being increasingly used as part of the Housing Options approach and as a means of resolving homelessness outside the statutory system. The PRS is being utilised to varying degrees across different local authority areas, and a variety of methods are being used to do so. While local authorities saw clear advantages to making greater use of the sector, a number of significant barriers including affordability, available stock and landlord preferences - made this difficult in practice. Research with previously homeless households in the PRS similarly found broadly positive experiences and views of the sector, particularly with regard to enabling households to access good quality accommodation in desirable areas of their choosing, with many households highlighting improvements relating to social inclusion and participation. Nevertheless, concerns around the security of tenure offered by the sector, repairs, service standards and unequal power relations between landlord and tenant persisted. As such, homeless households frequently expressed their decision to enter the sector in terms of a trade-off between choice and security.

Effect of poultry viscera meal inclusion in broiler diets in different rearing periods on performance, carcass and parts yields

The objective of the present study was to evaluate the effect of the dietary inclusion of poultry viscera meal (VM) on broiler performance and carcass, parts, and abdominal fat yields in broilers by replacing a diet containing VM with a strictly vegetable diet and vice-versa. A number of 720 one-day-old broiler chicks were randomly distributed in 6 groups: G1-basal diet (BD) - corn and soybean based meal, with no VM from 1 to 42 days of age, G2- 8% VM diet from 1 to 42 days, G3- BD from 1 to 21 and 8% VM diet from 22 to 42 days, G4- BD from 1 to 35 and 8% VM diet from 36 to 42 days, G5- 8% VM diet from 1 to 21 days and BD from 22 to 42 days, G6- 8% VM diet from 1 to 35 and BD from 36 to 42 days. Average body weight, weight gain, feed intake, feed conversion ratio (FCR), production efficiency index, and mortality were determined from 1 to 42 days. There was no effect of treatments on performance or mortality, except for FCR, which was significantly better in the group fed VM from 1 to 35 days and withdrawn at the end of rearing (36-42 days). Also, there were no differences in carcass, parts, and abdominal fat yields, showing that VM in broiler diets does not influence yield parameters.

Meeting art with art : arts-based methods enhance researcher reflexivity in research with mental health service users

This paper presents a rationale for arts-based practices in music therapy research, and provides an example of using ABR techniques in research. Arts-based materials are increasingly demonstrated to have the capacity to extend processes of reflexivity and analysis in a range of qualitative health research studies. By comparison, music therapy research studies have rarely employed arts-based methods or techniques. There is a need for more studies in music therapy that employ arts-based research to demystify and elaborate a wider range of creative approaches within music therapy inquiry. In the study described in this paper, ABR was used to reflect on the contribution of a service user in a community mental health context who participated in a focus group about his experiences of music therapy. ABR was found to offer a creative way to engage service users, and to deepen and extend the researcher's reflexivity when responding to materials created by research participants.

"Music therapy helped me get back doing": perspectives of music therapy participants in mental health services

BACKGROUND: Mental health service development internationally is increasingly informed by the collaborative ethos of recovery. Service user evaluation of experiences within music therapy programs allows new phenomena about participation in services to be revealed that might otherwise remain unnoticed. OBJECTIVE: The aim of this study was to demonstrate how asking service users about their experience of music therapy can generate useful information, and to reflect upon the feedback elicited from such processes in order to gain a deeper understanding of how music therapy is received among service users in mental health. METHODS: Six mental health service users described their experiences of music therapy in one or two individual interviews. Transcripts of interviews were analyzed using the procedures and techniques of Interpretative Phenomenological Analysis. RESULTS: Interviews with mental health service users provided rich, in-depth accounts reflecting the complex nature of music therapy participation. Super-ordinate themes refer to the context in which music therapy was offered, the rich sound world of music in music therapy, the humanity of music therapy, and the strengths enhancing opportunities experienced by service users. CONCLUSIONS: Participants indicated that they each experienced music therapy in unique ways. Opinions about the value of music therapy were revealed through an interview process in which the researcher holds an open attitude, welcoming all narrative contributions respectfully. These findings can remind practitioners of the importance of closely tuning into the perspectives and understandings of those who have valuable expertise to share about their experience of music therapy services in mental health.

Fostering cultural diversity in Australia: a case study of teaching, learning and assessing African musical arts

Australia is forged by ongoing migration welcoming a range of cultures, languages and ethnicities thus celebrating a diverse range of musical arts. In this multicultural society, music and dance may serve as a positive medium to transmit and promote social cohesion. I argue that the inclusion of innovative and immersive practice of African music in particular where authentic teaching and learning is facilitated may help foster understandings of culture in educational settings and the wider society. As a migrant forming part of the African Diaspora in Melbourne, I am strongly connected to my ancestral homeland (South Africa) when teaching African music to Australian tertiary students. Having gained ethical clearance to undertake the two research projects at Deakin University in Melbourne (Attitudes and perceptions of Arts Education Students: preparing culturally responsive teachers and Pre-service teacher attitudes and understandings of Music Education), I discuss tertiary students experience in relation to the teaching and learning of African music within higher education courses. Drawing on interview, questionnaire, observation notes, anecdotal feedback and narrative reflection, I employ Interpretative Phenomenological Analysis to analyse and code the data into themes. By offering a discussion of assessment and evaluation, I explore and invite international dialogue in regards to how best we can prepare, assess and evaluate our students to improve the quality of musical arts education.

Using kernel density estimation to understand the influence of neighbourhood destinations on BMI

OBJECTIVES: Little is known about how the distribution of destinations in the local neighbourhood is related to body mass index (BMI). Kernel density estimation (KDE) is a spatial analysis technique that accounts for the location of features relative to each other. Using KDE, this study investigated whether individuals living near destinations (shops and service facilities) that are more intensely distributed rather than dispersed, have lower BMIs.

STUDY DESIGN AND SETTING: A cross-sectional study of 2349 residents of 50 urban areas in metropolitan Melbourne, Australia.

METHODS: Destinations were geocoded, and kernel density estimates of destination intensity were created using kernels of 400, 800 and 1200 m. Using multilevel linear regression, the association between destination intensity (classified in quintiles Q1(least)-Q5(most)) and BMI was estimated in models that adjusted for the following confounders: age, sex, country of birth, education, dominant household occupation, household type, disability/injury and area disadvantage. Separate models included a physical activity variable.

RESULTS: For kernels of 800 and 1200 m, there was an inverse relationship between BMI and more intensely distributed destinations (compared to areas with least destination intensity). Effects were significant at 1200 m: Q4, β -0.86, 95% CI -1.58 to -0.13, p=0.022; Q5, β -1.03 95% CI -1.65 to -0.41, p=0.001. Inclusion of physical activity in the models attenuated effects, although effects remained marginally significant for Q5 at 1200 m: β -0.77 95% CI -1.52, -0.02, p=0.045.

CONCLUSIONS: This study conducted within urban Melbourne, Australia, found that participants living in areas of greater destination intensity within 1200 m of home had lower BMIs. Effects were partly explained by physical activity. The results suggest that increasing the intensity of destination distribution could reduce BMI levels by encouraging higher levels of physical activity.

A Comparison of the Effects of Classroom and Multi-User Virtual Environments on the Perceived Speaking Anxiety of Adult Post-Secondary English Language Learners

The population of English Language Learners (ELLs) globally has been increasing substantially every year. In the United States alone, adult ELLs are the fastest growing portion of learners in adult education programs (Yang, 2005). There is a significant need to improve the teaching of English to ELLs in the United States and other English-speaking dominant countries. However, for many ELLs, speaking, especially to Native English Speakers (NESs), causes considerable language anxiety, which in turn plays a vital role in hindering their language development and academic progress (Pichette, 2009; Woodrow, 2006). Task-based Language Teaching (TBLT), such as simulation activities, has long been viewed as an effective approach for second-language development. The current advances in technology and rapid emergence of Multi-User Virtual Environments (MUVEs) have provided an opportunity for educators to consider conducting simulations online for ELLs to practice speaking English to NESs. Yet to date, empirical research on the effects of MUVEs on ELLs’ language development and speaking is limited (Garcia-Ruiz, Edwards, & Aquino-Santos, 2007). This study used a true experimental treatment control group repeated measures design to compare the perceived speaking anxiety levels (as measured by an anxiety scale administered per simulation activity) of 11 ELLs (5 in the control group, 6 in the experimental group) when speaking to Native English Speakers (NESs) during 10 simulation activities. Simulations in the control group were done face-to-face, while those in the experimental group were done in the MUVE of Second Life. The results of the repeated measures ANOVA revealed after the Huynh-Feldt epsilon correction, demonstrated for both groups a significant decrease in anxiety levels over time from the first simulation to the tenth and final simulation. When comparing the two groups, the results revealed a statistically significant difference, with the experimental group demonstrating a greater anxiety reduction. These results suggests that language instructors should consider including face-to-face and MUVE simulations with ELLs paired with NESs as part of their language instruction. Future investigations should investigate the use of other multi-user virtual environments and/or measure other dimensions of the ELL/NES interactions.

Public service motivation in public and nonprofit service providers: The cases of Belarus and Poland

The work motivation construct is central to the theory and practice of many social science disciplines. Yet, due to the novelty of validated measures appropriate for a deep cross-national comparison, studies that contrast different administrative regimes remain scarce. This study represents an initial empirical effort to validate the Public Service Motivation (PSM) instrument proposed by Kim and colleagues (2013) in a previously unstudied context. The two former communist countries analyzed in this dissertation—Belarus and Poland—followed diametrically opposite development strategies: a fully decentralized administrative regime in Poland and a highly centralized regime in Belarus. The employees (n = 677) of public and nonprofit organizations in the border regions of Podlaskie Wojewodstwo (Poland) and Hrodna Voblasc (Belarus) are the subjects of study. ^ Confirmatory factor analysis revealed three dimensions of public service motivation in the two regions: compassion, self-sacrifice, and attraction to public service. The statistical models tested in this dissertation suggest that nonprofit sector employees exhibit higher levels of PSM than their public sector counterparts. Nonprofit sector employees also reveal a similar set of values and work attitudes across the countries. Thus, the study concludes that in terms of PSM, employees of nonprofit organizations constitute a homogenous group that exists atop the administrative regimes. ^ However, the findings propose significant differences between public sector agencies across the two countries. Contrary to expectations, data suggest that organization centralization in Poland is equal to—or for some items even higher than—that of Belarus. We can conclude that the absence of administrative decentralization of service provision in a country does not necessarily undermine decentralized practices within organizations. Further analysis reveals strong correlations between organization centralization and PSM for the Polish sample. Meanwhile, in Belarus, correlations between organization centralization items and PSM are weak and mostly insignificant. ^ The analysis indicates other factors beyond organization centralization that significantly impact PSM in both sectors. PSM of the employees in the studied region is highly correlated with their participation in religious practices, political parties, or labor unions as well as location of their organization in a capital and type of social service provided.^

Pelvic-floor-muscle-training adherence “modifiers” : a review of primary qualitative studies : 2011 ICS State-of-the-Science Seminar research paper III of IV

Aims This review aims to locate and summarize the findings of qualitative studies exploring the experience of and adherence to pelvic floor muscle training (PFMT) to recommend future directions for practice and research. Methods Primary qualitative studies were identified through a conventional subject search of electronic databases, reference-list checking, and expert contact. A core eligibility criterion was the inclusion of verbatim quotes from participants about PFMT experiences. Details of study aims, methods, and participants were extracted and tabulated. Data were inductively grouped into categories describing “modifiers” of adherence (verified by a second author) and systematically displayed with supporting illustrative quotes. Results Thirteen studies (14 study reports) were included; eight recruited only or predominantly women with urinary incontinence, three recruited postnatal women, and two included women with pelvic organ prolapse. The quality of methodological reporting varied. Six “modifiers” of adherence were described: knowledge; physical skill; feelings about PFMT; cognitive analysis, planning, and attention; prioritization; and service provision. Conclusions Individuals' experience substantial difficulties with capability (particularly knowledge and skills), motivation (especially associated with the considerable cognitive demands of PFMT), and opportunity (as external factors generate competing priorities) when adopting and maintaining a PFMT program. Expert consensus was that judicious selection and deliberate application of appropriate behavior change strategies directed to the “modifiers” of adherence identified in the review may improve PFMT outcomes. Future research is needed to explore whether the review findings are congruent with the PFMT experiences of antenatal women, men, and adults with fecal incontinence.

A next application prediction service using the BaranC framework

Predicting user behaviour enables user assistant services provide personalized services to the users. This requires a comprehensive user model that can be created by monitoring user interactions and activities. BaranC is a framework that performs user interface (UI) monitoring (and collects all associated context data), builds a user model, and supports services that make use of the user model. A prediction service, Next-App, is built to demonstrate the use of the framework and to evaluate the usefulness of such a prediction service. Next-App analyses a user's data, learns patterns, makes a model for a user, and finally predicts, based on the user model and current context, what application(s) the user is likely to want to use. The prediction is pro-active and dynamic, reflecting the current context, and is also dynamic in that it responds to changes in the user model, as might occur over time as a user's habits change. Initial evaluation of Next-App indicates a high-level of satisfaction with the service.

Researching homelessness: Challenging exclusion?

This themed issue of Social Inclusion provides a timely opportunity to reflect on how contemporary research is addressing the multi-dimensional issue of homelessness around the world. The papers presented here provide a wide range of new evidence on homelessness including theoretical, methodological and empirical contributions. They draw on a range of national experiences in Europe and beyond, and addressing the issue of social inclusion and social exclusion of homeless or previously homeless people from a range of perspectives and approaches. It is hoped that the contributions to this themed issue will prove influential in terms of both scholarship and potential to enhance policy making and service delivery to some of our most excluded citizens.