Context,Diversity and Engagement: Early Intervention with Australian Aboriginal Families in Urban and Remote Contexts

This article describes challenges met implementing an early intervention programme for Aboriginal parents and their children in the NT (Northern Territory) of Australia in the context of efforts to remediate Aboriginal disadvantage. The intervention is an adaptation of an 8‐ to 10‐week, manualised parenting programme designed for four‐ to six‐year‐old children with behavioural difficulties. It was implemented for both Aboriginal and non‐Aboriginal children in urban Darwin and for Aboriginal children in three communities of the Tiwi Islands, near Darwin. Measured outcomes of the programme were positive overall with different outcomes by gender and Indigenous status. There were marked differences in retention of families from different socio‐cultural backgrounds in the programme, with a significant loss of participants from referral through commencement to six‐month follow‐up. This drop‐out was most marked for urban Aboriginal participants, despite highly flexible strategies of engagement and cultural adaptation of the approach pursued in each setting. The research provides lessons for the contextualisation of preventive interventions in diverse community settings and shows that systematic attention to cultural ‘fit’ of the intervention logic and cultural competence in engagement of disadvantaged families with multiple problems are fundamental to sustainability.     

Empirical assessment of the applicability of shrinkage predictors in regression when past and future data differ

Jones and Copas (1986) present theoretical and simulation results on the relative merits of a Stein predictor (Copas, 1983) and the ordinary least squares predictor in the usual linear multiple regression model, when certain distributional properties of the regressor variables arising in the past differ from those for which predictions are to be made. Here, extension is made to the practical situation where the true regression parameters are unknown. A hypothesis testing procedure is developed to help determine which of shrinkage and least squares is preferable in any given instance. This approach is applied to explain some empirical evidence on the comparative merits of the two procedures, recently given by Berk (1984).     

Design requirements for health care production control systems

This paper addresses the issue of determining design requirements for production control in health care organizations, with a restriction to the internal production control of hospitals. Hospital management has limited possibilities to control hospital production, as hospital production processes are driven by medical specialists who, however, do not manage that process. We consider therefore the hospital as a virtual organization, consisting of a number of relatively independent businesses in a common framework. Each business unit functions as a focused factory for a range of more or less homogeneous products. Production control principles can be applied to each of these businesses, but not to the system as a whole. A number of elements from classical production control theory can be also applied to health care, i.e. the use of decoupling points, the bottleneck-oriented approach, and the operational control between production and market. However, important factors that need to be considered in health production control are that often specifications on quality are not available at the start of the process, and that there is strong interaction between the patient and the process. Our conclusion is that a dedicated framework for approaching hospital production control is necessary. The specific characteristics of hospital care and its state of production control development are the main arguments for this dedicated framework.     

Relative Contributions of Four Exposure Pathways to Influenza Infection Risk

The relative contribution of four influenza virus exposure pathways—(1) virus-contaminated hand contact with facial membranes, (2) inhalation of respirable cough particles, (3) inhalation of inspirable cough particles, and (4) spray of cough droplets onto facial membranes—must be quantified to determine the potential efficacy of nonpharmaceutical interventions of transmission. We used a mathematical model to estimate the relative contributions of the four pathways to infection risk in the context of a person attending a bed-ridden family member ill with influenza. Considering the uncertainties in the sparse human subject influenza dose-response data, we assumed alternative ratios of 3,200:1 and 1:1 for the infectivity of inhaled respirable virus to intranasally instilled virus. For the 3,200:1 ratio, pathways (1), (2), and (4) contribute substantially to influenza risk: at a virus saliva concentration of 10⁶ mL⁻¹, pathways (1), (2), (3), and (4) contribute, respectively, 31%, 17%, 0.52%, and 52% of the infection risk. With increasing virus concentrations, pathway (2) increases in importance, while pathway (4) decreases in importance. In contrast, for the 1:1 infectivity ratio, pathway (1) is the most important overall: at a virus saliva concentration of 10⁶ mL⁻¹, pathways (1), (2), (3), and (4) contribute, respectively, 93%, 0.037%, 3.3%, and 3.7% of the infection risk. With increasing virus concentrations, pathway (3) increases in importance, while pathway (4) decreases in importance. Given the sparse knowledge concerning influenza dose and infectivity via different exposure pathways, nonpharmaceutical interventions for influenza should simultaneously address potential exposure via hand contact to the face, inhalation, and droplet spray.     

An investigation of order release and flow time allowance policies for assembly job shops

The effects of a number of essentially different work order release and flow time allowance policies on the assembly order flow times and assembly order due date performance are investigated. Work orders within an assembly order have different routing length. The assembly order flow time is the time that elapses between the release of the first work order and the completion of the last work order of the assembly order. The timing of the release of work orders, and the distribution of the flow time allowance over the work orders in an assembly order were varied, and used systematic computer simulation to investigate the effects on performance. The results show that the best performance is obtained with simultaneous work order release, an average operation flow time allowance equal to the average operation waiting time and equalized flow time allowances per work order in an assembly order.     

Engaging undergraduate social work students in research through experience-based learning

Social work programmes internationally have taken diverse approaches to research training in their curricula. This paper presents an Australian case study of engaging undergraduate social work students in research using experience-based learning. The case study explores the potential of experience-based learning to assist in overcoming the ‘anxiety’, students are observed to report in relation to research training and education. The social work programme at the University of Newcastle, Australia has embraced an experience-based learning model since 1991. Despite a research active and engaged staff and a commitment to research-informed pedagogy, educators continue to observe students as indifferent and reluctant to engage in research training. To address this, work-integrated learning was strengthened in the research course to enable students to design, develop and deliver practice-relevant research in partnership with local support services. Preliminary evaluation of the course highlights both potential and the pitfalls of experience-based learning approaches to research training. While found to enhance research engagement and demystify its role in practice, experience-based learning was associated with significant resource and time imposts. These findings suggest cautious consideration of structure and scope is essential for experience-based learning to be a feasible approach to research training at the undergraduate level.