The evidence-based development of an intervention to address the information needs of adults newly diagnosed with primary brain tumours and their carers

Adults diagnosed with primary brain tumours often experience physical, cognitive and neuropsychiatric impairments and decline in quality of life. Although disease and treatment-related information is commonly provided to cancer patients and carers, newly diagnosed brain tumour patients and their carers report unmet information needs. Few interventions have been designed or proven to address these information needs. Accordingly, a three-study research program, that incorporated both qualitative and quantitative research methods, was designed to: 1) identify and select an intervention to improve the provision of information, and meet the needs of patients with a brain tumour; 2) use an evidence-based approach to establish the content, language and format for the intervention; and 3) assess the acceptability of the intervention, and the feasibility of evaluation, with newly diagnosed brain tumour patients. Study 1: Structured concept mapping techniques were undertaken with 30 health professionals, who identified strategies or items for improving care, and rated each of 42 items for importance, feasibility, and the extent to which such care was provided. Participants also provided data to interpret the relationship between items, which were translated into ‘maps’ of relationships between information and other aspects of health care using multidimensional scaling and hierarchical cluster analysis. Results were discussed by participants in small groups and individual interviews to understand the ratings, and facilitators and barriers to implementation. A care coordinator was rated as the most important strategy by health professionals. Two items directly related to information provision were also seen as highly important: "information to enable the patient or carer to ask questions" and "for doctors to encourage patients to ask questions". Qualitative analyses revealed that information provision was individualised, depending on patients’ information needs and preferences, demographic variables and distress, the characteristics of health professionals who provide information, the relationship between the individual patient and health professional, and influenced by the fragmented nature of the health care system. Based on quantitative and qualitative findings, a brain tumour specific question prompt list (QPL) was chosen for development and feasibility testing. A QPL consists of a list of questions that patients and carers may want to ask their doctors. It is designed to encourage the asking of questions in the medical consultation, allowing patients to control the content, and amount of information provided by health professionals. Study 2: The initial structure and content of the brain tumour specific QPL developed was based upon thematic analyses of 1) patient materials for brain tumour patients, 2) QPLs designed for other patient populations, and 3) clinical practice guidelines for the psychosocial care of glioma patients. An iterative process of review and refinement of content was undertaken via telephone interviews with a convenience sample of 18 patients and/or carers. Successive drafts of QPLs were sent to patients and carers and changes made until no new topics or suggestions arose in four successive interviews (saturation). Once QPL content was established, readability analyses and redrafting were conducted to achieve a sixth-grade reading level. The draft QPL was also reviewed by eight health professionals, and shortened and modified based on their feedback. Professional design of the QPL was conducted and sent to patients and carers for further review. The final QPL contained questions in seven colour-coded sections: 1) diagnosis; 2) prognosis; 3) symptoms and problems; 4) treatment; 5) support; 6) after treatment finishes; and 7) the health professional team. Study 3: A feasibility study was conducted to determine the acceptability of the QPL and the appropriateness of methods, to inform a potential future randomised trial to evaluate its effectiveness. A pre-test post-test design was used with a nonrandomised control group. The control group was provided with ‘standard information’, the intervention group with ‘standard information’ plus the QPL. The primary outcome measure was acceptability of the QPL to participants. Twenty patients from four hospitals were recruited a median of 1 month (range 0-46 months) after diagnosis, and 17 completed baseline and follow-up interviews. Six participants would have preferred to receive the information booklet (standard information or QPL) at a different time, most commonly at diagnosis. Seven participants reported on the acceptability of the QPL: all said that the QPL was helpful, and that it contained questions that were useful to them; six said it made it easier to ask questions. Compared with control group participants’ ratings of ‘standard information’, QPL group participants’ views of the QPL were more positive; the QPL had been read more times, was less likely to be reported as ‘overwhelming’ to read, and was more likely to prompt participants to ask questions of their health professionals. The results from the three studies of this research program add to the body of literature on information provision for brain tumour patients. Together, these studies suggest that a QPL may be appropriate for the neuro-oncology setting and acceptable to patients. The QPL aims to assist patients to express their information needs, enabling health professionals to better provide the type and amount of information that patients need to prepare for treatment and the future. This may help health professionals meet the challenge of giving patients sufficient information, without providing ‘too much’ or ‘unnecessary’ information, or taking away hope. Future studies with rigorous designs are now needed to determine the effectiveness of the QPL.

Development and validation of novel methods for microbial source tracking based on Escherichia coli as an indicator of water quality

Microbial pollution in water periodically affects human health in Australia, particularly in times of drought and flood. There is an increasing need for the control of waterborn microbial pathogens. Methods, allowing the determination of the origin of faecal contamination in water, are generally referred to as Microbial Source Tracking (MST). Various approaches have been evaluated as indicatorsof microbial pathogens in water samples, including detection of different microorganisms and various host-specific markers. However, until today there have been no universal MST methods that could reliably determine the source (human or animal) of faecal contamination. Therefore, the use of multiple approaches is frequently advised. MST is currently recognised as a research tool, rather than something to be included in routine practices. The main focus of this research was to develop novel and universally applicable methods to meet the demands for MST methods in routine testing of water samples. Escherichia coli was chosen initially as the object organism for our studies as, historically and globally, it is the standard indicator of microbial contamination in water. In this thesis, three approaches are described: single nucleotide polymorphism (SNP) genotyping, clustered regularly interspaced short palindromic repeats (CRISPR) screening using high resolution melt analysis (HRMA) methods and phage detection development based on CRISPR types. The advantage of the combination SNP genotyping and CRISPR genes has been discussed in this study. For the first time, a highly discriminatory single nucleotide polymorphism interrogation of E. coli population was applied to identify the host-specific cluster. Six human and one animal-specific SNP profile were revealed. SNP genotyping was successfully applied in the field investigations of the Coomera watershed, South-East Queensland, Australia. Four human profiles [11], [29], [32] and [45] and animal specific SNP profile [7] were detected in water. Two human-specific profiles [29] and [11] were found to be prevalent in the samples over a time period of years. The rainfall (24 and 72 hours), tide height and time, general land use (rural, suburban), seasons, distance from the river mouth and salinity show a lack of relashionship with the diversity of SNP profiles present in the Coomera watershed (p values > 0.05). Nevertheless, SNP genotyping method is able to identify and distinquish between human- and non-human specific E. coli isolates in water sources within one day. In some samples, only mixed profiles were detected. To further investigate host-specificity in these mixed profiles CRISPR screening protocol was developed, to be used on the set of E. coli, previously analysed for SNP profiles. CRISPR loci, which are the pattern of previous DNA coliphages attacks, were considered to be a promising tool for detecting host-specific markers in E. coli. Spacers in CRISPR loci could also reveal the dynamics of virulence in E. coli as well in other pathogens in water. Despite the fact that host-specificity was not observed in the set of E. coli analysed, CRISPR alleles were shown to be useful in detection of the geographical site of sources. HRMA allows determination of ‘different’ and ‘same’ CRISPR alleles and can be introduced in water monitoring as a cost-effective and rapid method. Overall, we show that the identified human specific SNP profiles [11], [29], [32] and [45] can be useful as marker genotypes globally for identification of human faecal contamination in water. Developed in the current study, the SNP typing approach can be used in water monitoring laboratories as an inexpensive, high-throughput and easy adapted protocol. The unique approach based on E. coli spacers for the search for unknown phage was developed to examine the host-specifity in phage sequences. Preliminary experiments on the recombinant plasmids showed the possibility of using this method for recovering phage sequences. Future studies will determine the host-specificity of DNA phage genotyping as soon as first reliable sequences can be acquired. No doubt, only implication of multiple approaches in MST will allow identification of the character of microbial contamination with higher confidence and readability.

An improved genetic algorithm and graph theory based method for optimal sectionalizer switch placement in distribution networks with DG

In this paper a new graph-theory and improved genetic algorithm based practical method is employed to solve the optimal sectionalizer switch placement problem. The proposed method determines the best locations of sectionalizer switching devices in distribution networks considering the effects of presence of distributed generation (DG) in fitness functions and other optimization constraints, providing the maximum number of costumers to be supplied by distributed generation sources in islanded distribution systems after possible faults. The proposed method is simulated and tested on several distribution test systems in both cases of with DG and non DG situations. The results of the simulations validate the proposed method for switch placement of the distribution network in the presence of distributed generation.

Ethical review in creative industries and other practice-based research

The processes used in Australian universities for reviewing the ethics of research projects are based on the traditions of research and practice from the medical and health sciences. The national guidelines for ethical conduct in research are heavily based on presumptions that the researcher–participant relationship is similar to a doctor–patient relationship. The National Health and Medical Research Council, Australian Research Council and Australian Vice-Chancellors’ Committee have made a laudable effort to fix this problem by releasing the National Statement on Ethical Conduct in Human Research in 2007, to replace the 1999 National Statement on Ethical Conduct in Research Involving Humans. The new statement better encompasses the needs of the humanities, social sciences and creative industries. However, this paper argues that the revised National Statement and ethical review processes within universities still do not fully encompass the definitions of ‘research’ and the requirements, traditions, codes of practice and standards of the humanities, social sciences and creative industries. The paper argues that scholars within these disciplines often lack the language to articulate their modes of practice and risk management strategies to university-level ethics committees. As a consequence, scholars from these disciplines may find their research is delayed or stymied. The paper focuses on creative industries researchers, and explores the issues that they face in managing the ethical review process, particularly when engaging in practice-based research. Although the focus is on the creative industries, the issues are relevant to most fields in the humanities and social sciences.

Triangular Linguistic Fuzzy based performance measurement model for supply chain to assess leanness attributes

Increasing global competitiveness worldwide has forced manufacturing organizations to produce high-quality products more quickly and at a competitive cost. In order to reach these goals, they need good quality components from suppliers at optimum price and lead time. This actually forced all the companies to adapt different improvement practices such as lean manufacturing, Just in Time (JIT) and effective supply chain management. Applying new improvement techniques and tools cause higher establishment costs and more Information Delay (ID). On the contrary, these new techniques may reduce the risk of stock outs and affect supply chain flexibility to give a better overall performance. But industry people are unable to measure the overall affects of those improvement techniques with a standard evaluation model .So an effective overall supply chain performance evaluation model is essential for suppliers as well as manufacturers to assess their companies under different supply chain strategies. However, literature on lean supply chain performance evaluation is comparatively limited. Moreover, most of the models assumed random values for performance variables. The purpose of this paper is to propose an effective supply chain performance evaluation model using triangular linguistic fuzzy numbers and to recommend optimum ranges for performance variables for lean implementation. The model initially considers all the supply chain performance criteria (input, output and flexibility), converts the values to triangular linguistic fuzzy numbers and evaluates overall supply chain performance under different situations. Results show that with the proposed performance measurement model, improvement area for each variable can be accurately identified.

Content-based video indexing for sports applications using integrated multi-modal approach

To sustain an ongoing rapid growth of video information, there is an emerging demand for a sophisticated content-based video indexing system. However, current video indexing solutions are still immature and lack of any standard. This doctoral consists of a research work based on an integrated multi-modal approach for sports video indexing and retrieval. By combining specific features extractable from multiple audio-visual modalities, generic structure and specific events can be detected and classified. During browsing and retrieval, users will benefit from the integration of high-level semantic and some descriptive mid-level features such as whistle and close-up view of player(s).

Constructing tag ontology from folksonomy based on WordNet

With the emergence of Web 2.0, Web users can classify Web items of their interest by using tags. Tags reflect users’ understanding to the items collected in each tag. Exploring user tagging behavior provides a promising way to understand users’ information needs. However, free and relatively uncontrolled vocabulary has its drawback in terms of lack of standardization and semantic ambiguity. Moreover, the relationships among tags have not been explored even there exist rich relationships among tags which could provide valuable information for us to better understand users. In this paper, we propose a novel approach to construct tag ontology based on the widely used general ontology WordNet to capture the semantics and the structural relationships of tags. Ambiguity of tags is a challenging problem to deal with in order to construct high quality tag ontology. We propose strategies to find the semantic meanings of tags and a strategy to disambiguate the semantics of tags based on the opinion of WordNet lexicographers. In order to evaluate the usefulness of the constructed tag ontology, in this paper we apply the extracted tag ontology in a tag recommendation experiment. We believe this is the first application of tag ontology for recommendation making. The initial result shows that by using the tag ontology to re-rank the recommended tags, the accuracy of the tag recommendation can be improved.

Using ‘think aloud’ as a strategy for learning clinical reasoning in high fidelity case-based simulation for undergraduate nursing students

AIMS This paper reports on the implementation of a research project that trials an educational strategy implemented over six months of an undergraduate third year nursing curriculum. This project aims to explore the effectiveness of ‘think aloud’ as a strategy for learning clinical reasoning for students in simulated clinical settings. BACKGROUND Nurses are required to apply and utilise critical thinking skills to enable clinical reasoning and problem solving in the clinical setting [1]. Nursing students are expected to develop and display clinical reasoning skills in practice, but may struggle articulating reasons behind decisions about patient care. For students learning to manage complex clinical situations, teaching approaches are required that make these instinctive cognitive processes explicit and clear [2-5]. In line with professional expectations, nursing students in third year at Queensland University of Technology (QUT) are expected to display clinical reasoning skills in practice. This can be a complex proposition for students in practice situations, particularly as the degree of uncertainty or decision complexity increases [6-7]. The ‘think aloud’ approach is an innovative learning/teaching method which can create an environment suitable for developing clinical reasoning skills in students [4, 8]. This project aims to use the ‘think aloud’ strategy within a simulation context to provide a safe learning environment in which third year students are assisted to uncover cognitive approaches that best assist them to make effective patient care decisions, and improve their confidence, clinical reasoning and active critical reflection on their practice. MEHODS In semester 2 2011 at QUT, third year nursing students will undertake high fidelity simulation, some for the first time commencing in September of 2011. There will be two cohorts for strategy implementation (group 1= use think aloud as a strategy within the simulation, group 2= not given a specific strategy outside of nursing assessment frameworks) in relation to problem solving patient needs. Students will be briefed about the scenario, given a nursing handover, placed into a simulation group and an observer group, and the facilitator/teacher will run the simulation from a control room, and not have contact (as a ‘teacher’) with students during the simulation. Then debriefing will occur as a whole group outside of the simulation room where the session can be reviewed on screen. The think aloud strategy will be described to students in their pre-simulation briefing and allow for clarification of this strategy at this time. All other aspects of the simulations remain the same, (resources, suggested nursing assessment frameworks, simulation session duration, size of simulation teams, preparatory materials). RESULTS Methodology of the project and the challenges of implementation will be the focus of this presentation. This will include ethical considerations in designing the project, recruitment of students and implementation of a voluntary research project within a busy educational curriculum which in third year targets 669 students over two campuses. CONCLUSIONS In an environment of increasingly constrained clinical placement opportunities, exploration of alternate strategies to improve critical thinking skills and develop clinical reasoning and problem solving for nursing students is imperative in preparing nurses to respond to changing patient needs. References 1. Lasater, K., High-fidelity simulation and the development of clinical judgement: students' experiences. Journal of Nursing Education, 2007. 46(6): p. 269-276. 2. Lapkin, S., et al., Effectiveness of patient simulation manikins in teaching clinical reasoning skills to undergraduate nursing students: a systematic review. Clinical Simulation in Nursing, 2010. 6(6): p. e207-22. 3. Kaddoura, M.P.C.M.S.N.R.N., New Graduate Nurses' Perceptions of the Effects of Clinical Simulation on Their Critical Thinking, Learning, and Confidence. The Journal of Continuing Education in Nursing, 2010. 41(11): p. 506. 4. Banning, M., The think aloud approach as an educational tool to develop and assess clinical reasoning in undergraduate students. Nurse Education Today, 2008. 28: p. 8-14. 5. Porter-O'Grady, T., Profound change:21st century nursing. Nursing Outlook, 2001. 49(4): p. 182-186. 6. Andersson, A.K., M. Omberg, and M. Svedlund, Triage in the emergency department-a qualitative study of the factors which nurses consider when making decisions. Nursing in Critical Care, 2006. 11(3): p. 136-145. 7. O'Neill, E.S., N.M. Dluhy, and C. Chin, Modelling novice clinical reasoning for a computerized decision support system. Journal of Advanced Nursing, 2005. 49(1): p. 68-77. 8. Lee, J.E. and N. Ryan-Wenger, The "Think Aloud" seminar for teaching clinical reasoning: a case study of a child with pharyngitis. J Pediatr Health Care, 1997. 11(3): p. 101-10.

A node-based smoothed conforming point interpolation method (NS-CPIM) for elasticity problems

This paper formulates a node-based smoothed conforming point interpolation method (NS-CPIM) for solid mechanics. In the proposed NS-CPIM, the higher order conforming PIM shape functions (CPIM) have been constructed to produce a continuous and piecewise quadratic displacement field over the whole problem domain, whereby the smoothed strain field was obtained through smoothing operation over each smoothing domain associated with domain nodes. The smoothed Galerkin weak form was then developed to create the discretized system equations. Numerical studies have demonstrated the following good properties: NS-CPIM (1) can pass both standard and quadratic patch test; (2) provides an upper bound of strain energy; (3) avoid the volumetric locking; (4) provides the higher accuracy than those in the node-based smoothed schemes of the original PIMs.

Knowledge-based urban development processes of an emerging knowledge city : Brisbane, Australia

In the global knowledge economy, to attract and retain knowledge-intensive industries and workers, cities produce various development strategies. Such strategising is an important development mechanism for cities to complete their transformation into knowledge cities. This paper discusses the critical connections between knowledge city foundations and integrated knowledge-based urban development strategies, and scrutinises Brisbane’s strategies in attracting and retaining investment and talent. The paper introduces a knowledge-based urban development assessment framework and uses this framework to provide a clearer understanding of Brisbane’s knowledge-based development processes and knowledge city transformation experience. The assessment framework particularly focuses on examining Brisbane’s four development processes, institutional, economic, socio-cultural and urban development, in detail. The findings reveal that although Brisbane is still in early stages of its transformation into a fully-fledged knowledge city, global orientation and achievements of Brisbane in strategising knowledge-based urban development are noteworthy.

Moving towards a knowledge city? Brisbane's experience in knowledge-based urban development

: In the global knowledge economy, knowledge-intensive industries and knowledge workers are extensively seen as the primary factors to improve the welfare and competitiveness of cities. To attract and retain such industries and workers, cities produce knowledge-based urban development strategies, where such strategising is also an important development mechanism for cities and their economies. This paper investigates knowledge-based urban development strategies of Brisbane, Australia that support generation, attraction, and retention of investment and talent. The paper puts forward a clear understanding on the policy frameworks, and relevant applications of Brisbane’s knowledge-based urban development experience in becoming a prosperous knowledge city, and concludes by providing invaluable insights and directions for other cities seeking knowledge-based urban development.

Fat and thin adaptive HMM filters for vision based detection of moving targets

Computer vision is an attractive solution for uninhabited aerial vehicle (UAV) collision avoidance, due to the low weight, size and power requirements of hardware. A two-stage paradigm has emerged in the literature for detection and tracking of dim targets in images, comprising of spatial preprocessing, followed by temporal filtering. In this paper, we investigate a hidden Markov model (HMM) based temporal filtering approach. Specifically, we propose an adaptive HMM filter, in which the variance of model parameters is refined as the quality of the target estimate improves. Filters with high variance (fat filters) are used for target acquisition, and filters with low variance (thin filters) are used for target tracking. The adaptive filter is tested in simulation and with real data (video of a collision-course aircraft). Our test results demonstrate that our adaptive filtering approach has improved tracking performance, and provides an estimate of target heading not present in previous HMM filtering approaches.

Contributions of knowledge-based foundations of universities in knowledge city formation : a Malaysian case study

Purpose – In the 21st Century, as knowledge, technology and education are widely accepted to play key roles in the local economic development, the importance of making space and place for knowledge production is, therefore, on the rise resulting many city administrations and urban policy-makers worldwide restructuring their cities to become highly competitive and creative. Consequently, this has led to a new type of city form, knowledge city, and a new approach in their development, knowledge-based urban development. In this context, knowledge-based foundations of universities are regarded as one of the key elements for knowledge-based urban development and knowledge city formation due to their ability to provide a strong platform for knowledge generation, marketing and transfer. This paper aims to investigate the role and importance of universities and their knowledge-based foundations in the context of developing countries, particularly in Malaysia, in building prosperous knowledge cities of the era of the knowledge economy. Design/Methodology/Approach – The main methodological techniques employed in this research includes: a thorough review of the literature on the role of universities in spatial and socio-economic development of cities; a best practice analysis and policy review of urban and regional development policies targeting to use of university clusters in leveraging knowledge-based development, and; a case study in Malaysia with a review of various policy documents and strategic plans of the local universities and local and state authorities, interviews with key actors, and a trend analysis of local socio-economic and spatial changes. Originality/Value – This paper reports the findings of a pioneering research on examining the role and impact of universities and their knowledge-based foundations, in the context of Malaysia, in building knowledge cities of the era of the knowledge economy. By undertaking a case study investigation in Bandar Seri Iskandar, which is a newly emerging Malaysian knowledge city, located in Perak, Malaysia, the paper sheds light on an important issue of the 21st Century of how universities contribute to the knowledge-based development of cities. Practical Implications – Universities with their rich knowledge-based foundations are increasingly being recognised as knowledge hubs, exercising a strong influence in the intellectual vitality of the city where they are embedded. This paper reveals that universities, in joint action with business and society at large, are necessary prerequisites for constructing and maintaining knowledge societies and, therefore, building prosperous knowledge cities. In light of the literature and case findings, the paper sheds light on the contribution of knowledge-based foundations of universities in knowledge city formation and provides generic recommendations for cities and regions seeking knowledge city transformation.

Reactive image-based collision avoidance system for unmanned aircraft systems

Approximately 20 years have passed now since the NTSB issued its original recommendation to expedite development, certification and production of low-cost proximity warning and conflict detection systems for general aviation [1]. While some systems are in place (TCAS [2]), ¡¨see-and-avoid¡¨ remains the primary means of separation between light aircrafts sharing the national airspace. The requirement for a collision avoidance or sense-and-avoid capability onboard unmanned aircraft has been identified by leading government, industry and regulatory bodies as one of the most significant challenges facing the routine operation of unmanned aerial systems (UAS) in the national airspace system (NAS) [3, 4]. In this thesis, we propose and develop a novel image-based collision avoidance system to detect and avoid an upcoming conflict scenario (with an intruder) without first estimating or filtering range. The proposed collision avoidance system (CAS) uses relative bearing ƒÛ and angular-area subtended ƒê , estimated from an image, to form a test statistic AS C . This test statistic is used in a thresholding technique to decide if a conflict scenario is imminent. If deemed necessary, the system will command the aircraft to perform a manoeuvre based on ƒÛ and constrained by the CAS sensor field-of-view. Through the use of a simulation environment where the UAS is mathematically modelled and a flight controller developed, we show that using Monte Carlo simulations a probability of a Mid Air Collision (MAC) MAC RR or a Near Mid Air Collision (NMAC) RiskRatio can be estimated. We also show the performance gain this system has over a simplified version (bearings-only ƒÛ ). This performance gain is demonstrated in the form of a standard operating characteristic curve. Finally, it is shown that the proposed CAS performs at a level comparable to current manned aviations equivalent level of safety (ELOS) expectations for Class E airspace. In some cases, the CAS may be oversensitive in manoeuvring the owncraft when not necessary, but this constitutes a more conservative and therefore safer, flying procedures in most instances.

Knowledge-based urban development redefined : from theory to practice knowledge-based development of cities

The concept of knowledge-based urban development has first come to the urban planning and development agenda during the very last years of the 20th century as a promising paradigm to support the transformation process of cities into knowledge cities and their societies into knowledge societies. However, soon after the exponentially rapid advancements experienced, during the first decade of the 21st century, particularly, in the domains of economy, society, management and technology along with the severe impacts of climate change, have made the redefinition of the term a necessity. This paper, first, reports the findings of the review of the relatively short but dynamic history of urbanisation experiences of our cities around the globe. The paper, then, focuses on the 21st century urbanisation context and discusses the conceptual base of the knowledge-based development of cities and how this concept found application ground in many parts of the world. Following this, the paper speculates development of future cities by particularly highlighting potential challenges and opportunities that previously have not been fully considered. This paper, lastly, introduces and elaborates how relevant theories support the better conceptualisation of this relatively new, but rapidly emerging paradigm, and redefines it accordingly.