An investigation into the use of a blended model of learning

The weaknesses of ‗traditional‘ modes of instruction in accounting education have been widely discussed. Many contend that the traditional approach limits the ability to provide opportunities for students to raise their competency level and allow them to apply knowledge and skills in professional problem solving situations. However, the recent body of literature suggests that accounting educators are indeed actively experimenting with ‗non-traditional‘ and ‗innovative‘ instructional approaches, where some authors clearly favour one approach over another. But can one instructional approach alone meet the necessary conditions for different learning objectives? Taking into account the ever changing landscape of not only business environments, but also the higher education sector, the premise guiding the collaborators in this research is that it is perhaps counter productive to promote competing dichotomous views of ‗traditional‘ and ‗non-traditional‘ instructional approaches to accounting education, and that the notion of ‗blended learning‘ might provide a useful framework to enhance the learning and teaching of accounting. This paper reports on the first cycle of a longitudinal study, which explores the possibility of using blended learning in first year accounting at one campus of a large regional university. The critical elements of blended learning which emerged in the study are discussed and, consistent with the design-based research framework, the paper also identifies key design modifications for successive cycles of the research

Ten-year mortality, disease progression, and treatment-related side effects in men with localised prostate cancer from the ProtecT randomised controlled trial according to treatment received

Background The ProtecT trial reported intention-to-treat analysis of men with localised prostate cancer randomly allocated to active monitoring (AM), radical prostatectomy, and external beam radiotherapy. Objective To report outcomes according to treatment received in men in randomised and treatment choice cohorts. Design, setting, and participants This study focuses on secondary care. Men with clinically localised prostate cancer at one of nine UK centres were invited to participate in the treatment trial comparing AM, radical prostatectomy, and radiotherapy. Intervention Two cohorts included 1643 men who agreed to be randomised and 997 who declined randomisation and chose treatment. Outcome measurements and statistical analysis Analysis was carried out to assess mortality, metastasis and progression and health-related quality of life impacts on urinary, bowel, and sexual function using patient-reported outcome measures. Analysis was based on comparisons between groups defined by treatment received for both randomised and treatment choice cohorts in turn, with pooled estimates of intervention effect obtained using meta-analysis. Differences were estimated with adjustment for known prognostic factors using propensity scores. Results and limitations According to treatment received, more men receiving AM died of PCa (AM 1.85%, surgery 0.67%, radiotherapy 0.73%), whilst this difference remained consistent with chance in the randomised cohort (p = 0.08); stronger evidence was found in the exploratory analyses (randomised plus choice cohort) when AM was compared with the combined radical treatment group (p = 0.003). There was also strong evidence that metastasis (AM 5.6%, surgery 2.4%, radiotherapy 2.7%) and disease progression (AM 20.35%, surgery 5.87%, radiotherapy 6.62%) were more common in the AM group. Compared with AM, there were higher risks of sexual dysfunction (95% at 6 mo) and urinary incontinence (55% at 6 mo) after surgery, and of sexual dysfunction (88% at 6 mo) and bowel dysfunction (5% at 6 mo) after radiotherapy. The key limitations are the potential for bias when comparing groups defined by treatment received and changes in the protocol for AM during the lengthy follow-up required in trials of screen-detected PCa. Conclusions Analyses according to treatment received showed increased rates of disease-related events and lower rates of patient-reported harms in men managed by AM compared with men managed by radical treatment, and stronger evidence of greater PCa mortality in the AM group. Patient summary More than 95 out of every 100 men with low or intermediate risk localised prostate cancer do not die of prostate cancer within 10 yr, irrespective of whether treatment is by means of monitoring, surgery, or radiotherapy. Side effects on sexual and bladder function are better after active monitoring, but the risks of spreading of prostate cancer are more common

Functional and quality of life outcomes of localised prostate cancer treatments (prostate testing for cancer and treatment [ProtecT] study)

Objective To investigate the functional and quality of life (QoL) outcomes of treatments for localised prostate cancer and inform treatment decision-making. Patients and Methods Men aged 50–69 years diagnosed with localised prostate cancer by prostate-specific antigen testing and biopsies at nine UK centres in the Prostate Testing for Cancer and Treatment (ProtecT) trial were randomised to, or chose one of, three treatments. Of 2565 participants, 1135 men received active monitoring (AM), 750 a radical prostatectomy (RP), 603 external-beam radiotherapy (EBRT) with concurrent androgen-deprivation therapy (ADT) and 77 low-dose-rate brachytherapy (BT, not a randomised treatment). Patient-reported outcome measures (PROMs) completed annually for 6 years were analysed by initial treatment and censored for subsequent treatments. Mixed effects models were adjusted for baseline characteristics using propensity scores. Results Treatment-received analyses revealed different impacts of treatments over 6 years. Men remaining on AM experienced gradual declines in sexual and urinary function with age (e.g., increases in erectile dysfunction from 35% of men at baseline to 53% at 6 years and nocturia similarly from 20% to 38%). Radical treatment impacts were immediate and continued over 6 years. After RP, 95% of men reported erectile dysfunction persisting for 85% at 6 years, and after EBRT this was reported by 69% and 74%, respectively (P < 0.001 compared with AM). After RP, 36% of men reported urinary leakage requiring at least 1 pad/day, persisting for 20% at 6 years, compared with no change in men receiving EBRT or AM (P < 0.001). Worse bowel function and bother (e.g., bloody stools 6% at 6 years and faecal incontinence 10%) was experienced by men after EBRT than after RP or AM (P < 0.001) with lesser effects after BT. No treatment affected mental or physical QoL. Conclusion Treatment decision-making for localised prostate cancer can be informed by these 6-year functional and QoL outcomes

Ultraäänimonitoreiden laadunvalvontatestit

Insinöörityö tehtiin HUS-Kuvantamisen toimeksiannosta, tarkoituksena kehittää lääketieteellisessä käytössä olevien ultraäänilaitteiden kuvamonitoreiden laadunvalvontamenetelmiä sekä tutkia monitorien yleistä suorituskykyä. Ultraäänilaitteiden monitorien laadunvalvontaa ei virallisesti sido samat ohjeistukset kuin muita radiologisia kuvankatselumonitoreja, joten niiden teknistä suorituskykyä ei ole tutkittu yhtä laajasti. Ultraäänimonitorien diagnostisen käytön takia on kuitenkin syytä selvittää, että vastaako näyttöjen kuvanlaatu diagnostisille monitoreille asetettuja kliinisiä vaatimuksia. Työssä suunniteltiin ja toteutettiin laadunvalvontatestit yhteensä 26 eri ultraäänilaitteen monitorille HUSin eri kuvantamisyksiköissä. Testit perustuivat näytöiltä tarkasteltaviin testikuviin, joille suoritettiin luminanssimittarilla tehtäviä sähköisiä mittauksia sekä visuaalisia arviointeja. Vaikka kaikki testikuvat eivät välttämättä vastanneet radiologisten näyttöjen laadunvalvontaohjeistuksia, pyrittiin niille suorittamaan ohjeistuksia mukailevia sovellettuja testejä. Laadunvalvontatestien tuloksia verrattiin radiologisten näyttöjen laadunvalvontaa koskevien ohjeistuksien hyväksyntäkriteereihin. Tuloksista nähdään, että näytöt eivät yleisesti ottaen täytä radiologisten monitorien vähimmäisvaatimuksia. Kerran vuodessa suoritettavilla luminanssimittauksilla ja kerran puolessa vuodessa suoritettavalla, testikuvaan perustuvalla visuaalisella arvioinnilla voitaisiin seurata näyttöjen suorituskykyä tehokkaammin. Suositeltavaa myös olisi, että kuvantamisyksiköt selvittäisivät mahdollisuuksia näyttöjen vaihtamiseen sekä päivittämiseen.The thesis work was commissioned by HUS Medical Imaging Center. The main purpose of this work was to develop quality control methods for medical ultrasound displays and to investigate their overall technical performance. The quality control of medical ultrasound displays is not officially bound by the same guidelines and recommendations as other medical displays, and therefore the performance of displays is less studied. However, due to their diagnostic use, it is necessary to determine whether the image quality of ultrasound displays meet clinical requirements set for medical displays. In this work, quality control tests were planned and implemented on 26 different ultrasound devices in various imaging units of HUS. The tests were based on test images and patterns displayed on the screen, which were subjected to quantitative electronic measurements with a luminance meter and visual evaluations. Although not all test images may necessarily be in accordance with the quality control guidelines for medical displays, efforts were made to perform the tests in an applied manner. The test results were then compared with the acceptance criteria used for medical displays. The results show that the monitors generally do not meet the minimum requirements for medical displays. Annual luminance measurements and biannual test pattern-based visual evaluation would provide more efficient means for monitoring display performance. It would also be recommendable for the imaging departments to investigate the possibilities for screen replacements and upgrades

Benchmarking service quality in the urban water industry

Ananda, J ORCiD: 0000-0002-4072-6725Providing secure and affordable drinking water and sewerage services is the primary mandate of the urban water industry. Water businesses must balance their service obligations and the quality of service delivered in order to maximize customer value. Being a monopoly industry, the urban water sector’s service levels and associated prices are not driven by competitive market pressures but through the regulatory processes. However, improving service quality often comes at a cost and yardstick regulation requires the evaluation and benchmarking of service quality within an economic efficiency framework. This paper uses a bootstrap Data Envelopment Analysis model to evaluate the service quality performance of the Australian urban water sector from 2009–2010 to 2015–2016. Specifically, the paper models the lack of service quality as undesirable outputs of water production. It estimates the Malmquist-Luenberger productivity index and its efficiency change and technical change components for 50 integrated water and sewerage utilities in Australia. Findings indicate that, overall, the sector’s quality-adjusted productivity has improved after a marked decline in 2010/2011. A comparison of the service quality productivity results with the conventional productivity measure revealed that the conventional analysis tends to underestimate the productivity growth. The paper concludes that benchmarking service quality helps the urban water sector to move from compliance-based regulation to best-practice regulation. © 2019, Springer Science+Business Media, LLC, part of Springer Nature

Customer‐centric regulation: The case of Victorian urban water sector

Ananda, J ORCiD: 0000-0002-4072-6725The growing interest in customer engagement (CE) has triggered a new wave of reforms, particularly in utility regulation. Within the water sector, there has been a shift from a focus on cost-re!ective pricing toward customer-centric pricing pro- cesses designed to identify customer preferences and expectations. The Victorian water sector in Australia offers a unique opportunity to explore the outcomes of these CE trends given the recent "rst-time application of a novel Performance, Risk, Engagement, Management, and Outcomes (PREMO) framework. Based on in-depth interviews with senior industry represen- tatives from a diverse sample of Victorian water utilities, this paper critically analyses the scope, design, and incentive mecha- nisms that underpin the new regulatory process. Findings indicate that CE has potentially bene"cial aspects to both the regulator and the regulated utility, including more transparency in capital projects and a better understanding of customer preferences in service delivery

An investigation into the use of a blended model of learning in a first year accounting subject

The weaknesses of ‗traditional‘ modes of instruction in accounting education have been widely discussed. Many contend that the traditional approach limits the ability to provide opportunities for students to raise their competency level and allow them to apply knowledge and skills in professional problem solving situations. However, the recent body of literature suggests that accounting educators are indeed actively experimenting with ‗non-traditional‘ and ‗innovative‘ instructional approaches, where some authors clearly favour one approach over another. But can one instructional approach alone meet the necessary conditions for different learning objectives? Taking into account the ever changing landscape of not only business environments, but also the higher education sector, the premise guiding the collaborators in this research is that it is perhaps counter productive to promote competing dichotomous views of ‗traditional‘ and ‗non-traditional‘ instructional approaches to accounting education, and that the notion of ‗blended learning‘ might provide a useful framework to enhance the learning and teaching of accounting. This paper reports on the first cycle of a longitudinal study, which explores the possibility of using blended learning in first year accounting at one campus of a large regional university. The critical elements of blended learning which emerged in the study are discussed and, consistent with the design-based research framework, the paper also identifies key design modifications for successive cycles of the research

Infrared neural stimulation: influence of stimulation site spacing and repetition rates on heating

A model to simulate heating as a result of pulse repetitions during infrared neural stimulation (INS), with both single and multiple emitters is presented. This model allows the temperature increases from pulse trains rather than single pulses to be considered. The model predicts that using a stimulation rate of 250 Hz, with typical laser parameters at a single stimulation site results in a temperature increase of 2:3 C. When multiple stimulation sites are used in analogy to cochlear implants, the temperature increases further depending upon the spacing between emitters. However, when the light is more localised at multiple stimulation sites the temperature increase is reduced