A series of on-farm quality assurance schemes for red meat producers across Australia were developed in the late 1990s in response to increasing global demands for greater accountability within the whole food. The Cattlecare and Flockcare schemes were introduced in 1996 and 1998, respectively, to provide mechanisms for producers to demonstrate that their livestock were free of potential chemical residues, and that they had taken measures to prevent injury or stress to livestock. These schemes were independently audited codes of practice. After several years there was some dissatisfaction with the levels of adoption of these schemes, especially Flockcare. By 2001 just over 5% of all cattle producers and just over 1% of all sheep producers had implemented on-farm quality assurance. This covered nearly 16% of all cattle and 2% of all sheep in Australia, indicating that the larger than average producers were implementing quality assurance. Based on previous studies and anecdotal evidence that there were few current benefits for producers, the aims of this study were to identify the reasons for slow uptake and to quantify factors affecting implementation of on-farm quality assurance in the red meat industry. Surveys of "adopters" and "nou-adopters" of these schemes were developed and implemented in 2000 and 2001. Producers were approached initially by phone and given the options of completing the survey over the phone, by mail or by fax. / Three hundred and forty-seven Cattlecare producers (9% of all certified Cattlecare producers) and 142 Flockcare producers (22% of certified Flockcare producers) across Australia were initially approached. A total of 382 adopter surveys were completed. The level of interest from adopters was remarkable, with a 75% completion rate from telephone approaches and only 9 direct refusals. These producers had over 1.3 million cattle and 0.9 million sheep covered by quality assurance schemes. This represented 5% of the total cattle population (27% of certified cattle) and less than 1% of all sheep (26% of certified sheep) in Australia at that time. There was an extremely large variation in the size of properties surveyed, which reflected the structure of the industry. The producers were asked about what motivated them to implement quality assurance, what were the problems, where could it be improved, how much time and money had they invested specifically into implementing quality assurance, what benefits had they gained (financial and other), how it had changed their management or product offered for sale, and their opinion on various issues associated with quality assurance and food safety. In addition 133 non-adopter surveys were also completed to provide a control data set. These producers had over 0.12 million cattle and 0.48 million sheep on their properties. In general, it was much harder to persuade these producers to participate. It was estimated that about 60% of producers approached refused to participate. These producers were asked similar questions; except that they were asked to estimate (if they could) how much time and money it would take to implement quality assurance. Unfortunately, most of these producers were uninterested or knew little about quality assurance and were reluctant to estimate these values, so the data for these producers was very limited. / Analysis of the adopter data indicated the adoption rates between regions and schemes were significantly different. A benefit cost analysis was completed for the adopters based on estimated time and money invested into quality assurance and the tangible benefits gained from selling certified animals. The resulting net benefits were calculated as annual equivalent annuities. Only about 30% of adopters had gained any tangible benefit, and only half of these (15% of the total analysed producers) had a positive net benefit, and these were all cattle producers. Description of time, effort and money spend by adopting producers was most representative using median values due to the extreme data from some producers. Overall, implementation took a median of 13 days in the initial year and 6 days in subsequent years per property, and the median cost was $1,200 in the initial year and $500 in subsequent years. This investment of time and money equated to a median cost of $875 per year. The median net financial loss per year from adopting quality assurance was $660 per property or $2 per 100 DSE of livestock managed. Producers indicated that they were implementing quality assurance to gain financial and market benefits; but, with only 15% of producers gaining a positive net benefit, some producers were disappointed with the schemes. However they did report improvements in product (15% of producers) or management practices (90% had at least one). / Improvements in product included livestock were free from chemical residues, cattle were dehorned and yards had been improved so bruising was reduced. Improvements in management practices included improved record keeping, chemical control and livestock handling. While producers mostly believed it was the right thing to do for the industry, they indicated that they would need to be rewarded for their efforts at some stage. Adopters and non-adopters had different motives for implementing quality assurance. Peer pressure, market advantage and increased returns (27%, 26% and 18% of producers, respectively) were cited as the three major prompts for adopters. All the other categories of reasons for adoption were not business-based, but more emotional. Non-adopters, however, cited increased returns, market advantage and supply chain pressure (44%, 7% and 6%, respectively) as possible prompts to implement quality assurance. Difficulties in adoption actually experienced by adopters were also different to the difficulties anticipated by non-adopters. Paperwork, actually getting to implementing it and the extra time demands (19%, 13% and 12%, respectively) were the major difficulties for adopters, while time, in costs and paperwork (19%, 16% and 12%, respectively) were the anticipated difficulties for non-adopters. / Twenty-four percent of adopters had not had any difficulties, while 16% of non- adopters anticipated no difficulties. Simplification of initial paperwork, increased demand for quality assured livestock and a need to promote the schemes and the associated benefits to producers were the three highest ranking categories of suggested improvements by adopters. Non-adopters indicated similar issues but in a different order - a need to promote the schemes and the associated benefits to producers, simplification of initial paperwork and the process of implementation. Grouping producers based on inputs, attitudes, investment or any combination of these indicators failed to provide a statistically significant prediction of the net benefit or loss for a new adopter. The only way to identify or predict which producers would gain a positive net benefit was to focus on the methods of selling livestock. Selling direct to processors either over the hook, with forward contracts or privately appeared to be the only way to gain financial benefits from implementing quality assurance on-farm.

This qualitative, descriptive study explored physiotherapists' experience of participating in peer review in public and private health services in New Zealand. Peer review is a professional activity where one health practitioner evaluates the practice of another. Accordingly, much professional effort has been expended on developing peer review systems and implementing review processes, yet the benefits of peer review are uncertain. A changing legislative environment where producing evidence of ongoing professional development is required, has provided impetus for this study given the limited research to support the use of peer review in this context. While the literature identifies competing focuses on professional development and accountability, there is lack of clarity about which model of peer review is being implemented in this country and which might serve the profession better. This study is a first step in clarifying the issues by identifying the personal, professional and organisational factors that influence health professionals' participation in peer review. The methodology consisted of a qualitative descriptive approach situated within a post positivist paradigm. Seven physiotherapists working in the New Zealand health system who had participated in a peer review process within the last 3 years participated in this study. Semi structured interviews were conducted, guided by broad questions relating to central themes identified during an extensive literature review. Interviews were then audio taped and transcribed verbatim to form the data. Transcripts were analysed by assigning content labels to units of text that seemed to encapsulate one complete thought or idea. The labelled groups were analysed into sub themes. Finally, the general themes that arose were described. Findings indicate that while peer review systems have been developed and are carried out as prescribed, therapists lack clarity about the intended outcomes. While recognising the benefits of receiving feedback on practice, many manage the review process to maintain positive working relationships and ensure their practice is favourably reviewed. The strategies they employ and the consequences of managing peer review in these ways are described. Current peer review processes in New Zealand do not provide reliable information about competence to practice. Neither do they fully achieve their potential as a professional development tool. Therefore, the professional emphasis and effort on peer review needs to be revisited. The findings highlight the need for consultation amongst individual physiotherapists, physiotherapy managers, physiotherapy professional organisations, and the registration board, to negotiate whether regulatory or professional development needs will drive peer review processes in New Zealand in the future.

Statement of the Problem: Source data verification (SDV) is the process of comparing data collected at the source to data recorded on a Case Report Form, either paper or electronic (1) to ensure that the data are complete, accurate and verifiable. Good Clinical Practice (GCP) Guidelines are vague and lack evidence as to the degree of SDV and whether or not SDV affects study outcomes. Methods of Investigation: We performed systematic reviews to establish the published evidence-base for methods of SDV and to examine the effect of SDV on study outcomes. We then conducted a national survey of Canadian Critical Care investigators and research coordinators regarding their attitudes and beliefs regarding SDV. We followed by an audit of the completed and in-progress Randomized Controlled Trials (RCTs) of the Canadian Critical Care Trials Group (CCCTG). Results: Systematic Review of Methods of SDV: The most common reported or recommended frequency of source data verification (10/14 - 71%) was either based on level or risk, or that it be conducted early (i.e. after 1st patient enrolled). The amount of SDV recommended or reported, varied from 5-100%. Systematic Review of Impact of SDV on Study Outcomes: There was no difference in study outcomes for 1 trial and unable to assess in the other. National Survey of Critical Care Investigators and Research Coordinators: Data from the survey found that 95.8% (115/120) of respondents believed that SDV was an important part of Quality Assurance; 73.3% (88/120) felt that academic studies should do more SDV; and 62.5% (75/120) felt that there is insufficient funding available for SDV. Audit of Source Data Verification Practices in CCCTG RCTs: In the national audit of in-progress and completed CCCTG RCTs, 9/15 (60%) included a plan for SDV and 8/15 (53%) actually conducted SDV. Of the 9 completed published trials, 44% (4/9) conducted SDV. Conclusion: There is little evidence base for methods and effect of SDV on study outcomes. Based on the results of the systematic review, survey, and audit, more research is needed to support the evidence base for the methods and effect of SDV on study outcomes.

The ultimate success of bypass surgery depends on the construction of a technically perfect bypass graft to an appropriate coronary vessel using a conduit which will remain durable for the lifetime of the patient. This thesis explores methods to improve coronary surgery by enhancing intraoperative imaging and conduit selection in the operating room. It is known that technical errors in graft construction cause failure of up to 12% of coronary bypass grafts in the operating room. We performed investigations of a new technique of intraoperative fluorescence angiography using indocyanine green dye to determine graft patency. We developed optimal methods of obtaining images and preliminary investigations revealed the technique was highly reproducible. In a follow-up trial, we demonstrated that over 80% of technical errors which would otherwise have been missed were identifiable with indocyanine green angiography, while only 25% of these errors were identified by transit-time ultrasonic flow measurement, the current clinical standard. We also determine that coronary surgery with indocyanine green angiographic graft patency verification was associated with less perioperative myocardial injury than bypass surgery without graft patency assessment. The long term graft patency of saphenous vein grafts is sub-optimal, with over 40% of such grafts totally occluded and a further 30% significantly diseased at ten years. We attempted to improve these outcomes by increasing the use of arterial grafts, which are less prone to intimal hyperplasia. In a multicentre clinical trial, we demonstrated a 40% relative risk reduction in graft occlusion at one year when radial arteries were used as bypass conduits versus saphenous veins. We identified that women and patients with small coronary vessels maximally benefited from radial artery bypass grafts. Conversely, in settings of less severe target vessel stenosis or concomitant peripheral vascular disease, saphenous veins performed as well as radial arteries. We have demonstrated that high quality imaging to identify technical errors during the operation, increased use of radial artery grafts and careful consideration of individual patient and target vessel characteristics can all improve graft patency. Future studies will be aimed at identifying the role of intraoperative imaging and arterial grafting in improving long-term clinical outcomes.

There is increasing pressure from animal rights organizations (AROs) on restaurant chains, food retailers, and meat processors to implement more stringent farm animal welfare (FAW) requirements for their suppliers. In the United States, AROs have recently initiated successful ballots to phase out confinement practices in several states. In Canada AROs have been pressuring both public and private sector stakeholders to improve FAW. Are FAW issues, however, paramount in the minds of Canadian consumers? Is the demand for more stringent FAW protocols primarily determined by a subset of consumers with very strong preferences or does it signal a more fundamental underlying change in consumer and societal preferences? Given the credence nature of FAW, who do consumers trust (i.e., government vs. private industry vs. independent third parties) in the market place for the provision of FAW quality assurances? What are the determinants of trust in these organizations for providing accurate information about animal welfare?<p> In order to answer these questions, a stated preference consumer survey encompassing FAW issues specific to the Canadian pork sector was tested on two samples of consumers in summer 2008, namely: a general population sample (GPS) across Canada and a sample of AROs members. Consumers participated in a purchase experiment where they had to chose between pork chops characterized by combinations of different levels of FAW attributes (i.e., housing system, gestation stalls, and use of antibiotics), quality verifying organization, and price. Multinomial Logit and Latent Class Logit Models were used to analyse the survey data.<p> Surprisingly, outdoor system does not seem to resonate well with Canadians, as both the GPS and the members of the AROs discounted this attribute. As expected, the AROs members have much stronger preferences for the other FAW attributes than have consumers in the GPS. Nevertheless, significant heterogeneity exists within consumer preferences. Five classes of consumers were identified in the GPS with respect to their preferences for FAW. At one end of the spectrum are the FAW sensitive consumers (12.3%) that have higher willingness-to-pay (WTP) for FAW, while at the other end of the spectrum Price Conscious consumers (18.3%) do not exhibit any WTP for FAW. The other three classes (69.4%) comprise respondents with mixed perceptions regarding FAW. Government and Third Party verification of FAW quality assurances had the strongest influence on consumers preferences in both samples. As well, scientific experts in FAW along with the above two organizations are the most credible in providing information about the welfare of pigs. The extent to which these organizations are knowledgeable about the welfare of pigs is the most important factor enhancing consumers trust. Results from this study suggest that there are potential marketing opportunities for pork chops sourced from pigs raised on farms where sows are kept in groups, and where credible quality assurances can be established, that private industry could consider. As well, the results suggest that consumers would derive benefits from the government taking a more active role with respect to validating FAW quality assurances.

The ultimate success of bypass surgery depends on the construction of a technically perfect bypass graft to an appropriate coronary vessel using a conduit which will remain durable for the lifetime of the patient. This thesis explores methods to improve coronary surgery by enhancing intraoperative imaging and conduit selection in the operating room. It is known that technical errors in graft construction cause failure of up to 12% of coronary bypass grafts in the operating room. We performed investigations of a new technique of intraoperative fluorescence angiography using indocyanine green dye to determine graft patency. We developed optimal methods of obtaining images and preliminary investigations revealed the technique was highly reproducible. In a follow-up trial, we demonstrated that over 80% of technical errors which would otherwise have been missed were identifiable with indocyanine green angiography, while only 25% of these errors were identified by transit-time ultrasonic flow measurement, the current clinical standard. We also determine that coronary surgery with indocyanine green angiographic graft patency verification was associated with less perioperative myocardial injury than bypass surgery without graft patency assessment. The long term graft patency of saphenous vein grafts is sub-optimal, with over 40% of such grafts totally occluded and a further 30% significantly diseased at ten years. We attempted to improve these outcomes by increasing the use of arterial grafts, which are less prone to intimal hyperplasia. In a multicentre clinical trial, we demonstrated a 40% relative risk reduction in graft occlusion at one year when radial arteries were used as bypass conduits versus saphenous veins. We identified that women and patients with small coronary vessels maximally benefited from radial artery bypass grafts. Conversely, in settings of less severe target vessel stenosis or concomitant peripheral vascular disease, saphenous veins performed as well as radial arteries. We have demonstrated that high quality imaging to identify technical errors during the operation, increased use of radial artery grafts and careful consideration of individual patient and target vessel characteristics can all improve graft patency. Future studies will be aimed at identifying the role of intraoperative imaging and arterial grafting in improving long-term clinical outcomes.

Syftet med denna studie är att skapa ett underlag och sammanställning till vad som kan utgöra en utbildningsbok som kan följa elever som går transportteknisk inriktning av fordonsprogrammet i GY11. En elev som genomgår en gymnasial utbildning för att bli yrkeschaufför får, under förutsättning att eleven klarat av utbildningen och bedöms lämplig, med sig ett antal körkortsbehörigheter samt särskilda förarbevis eller yrkesbevis. Dessa olika körkort och bevis är nödvändiga för att eleven ska med laglig rätt få utöva sitt arbete efter genomgången utbildning. Det är också nödvändigt för att eleverna ska kunna möta branschens krav och för att de ska bli anställningsbara. I skolans vardag är dokumentation ett naturligt inslag och hur mycket den tar av lärarens tid är olika beroende på typ av utbildning. Det som står helt klart är att läraren måste dokumentera elevens olika framsteg. Undersökningens slutresultat strävar efter att få fram förslag till ett dokumentationssystem som kan hjälpa läraren i arbetet med dokumentation. Undersökningen genomfördes med hjälp av dokumentanalys som metod. Dokumentanalys är ett verktyg för att ta del av offentlig information på ett alternativt sätt till att läsa det från pärm till pärm. . Denna metod hjälper till att plocka ut de viktigaste komponenterna i det önskade ämnet och underlättar sammanställning av information. Denna rapport innehåller ett förslag till ett dokumentationssystem som klarar kraven på dokumentation från Skolverket, Transportstyrelsen och TYA(Transportfackens Yrkes- och Arbetsmiljönämnd) inför nya GY11. Materialet i denna rapport är ej ännu testat i praktiken. Efter praktiska test bör en utvärdering ske av dokumentationsförslagen som presenteras i rapporten för att se om förändringar behöver göras. / The purpose of this study is to create a foundation and a summary to what could be an education book which can follow those students attending the vehicle program with direction of transport engineering in GY11. A student who is attending a high school education to become a professional driver gets, under the condition that the student completes the education, a number of different driving licenses and professional certificates. These different licenses and certificates are necessary for the student to possess for a legal reason in their future line of work. These certificates are also necessary for the students to be able to meet the business demands and to make the students attractive to the business market. In the school world, documentation is a natural element and the amount of time that is possible for the teacher to dedicate to documentation is depending on the kind of education. What is perfectly clear though, is that teachers must document their students’ progresses. The essence of this study is to create suggestions for a tool to help the teacher in his or her daily work with documentation. The study was made with the help of document analysis. Document analysis is a tool for getting hold of public information as an alternative to be reading it page by page. This method defines the major facts in the actual topic and simplifies the compilation of information.  The result of this study contains suggestions of documentation opportunities which could live up to the demands from Skolverket, Transportstyrelsen and TYA (the board of transport and professional environment unions) in the new GY11. The material in this study has not yet been tried in real life. After practical tests an evaluation of the documentation suggestions in the report should be done to discover if any changes are necessary.

Automatic Vehicle Location (AVL) and Automatic Passenger Counting (APC) systems can be powerful tools for transit agencies to archive large, detailed quantities of transit operations data. Managing data quality is an important first step for exploiting these rich datasets. This thesis presents an automated quality assurance (QA) methodology that identifies unreliable archived AVL/APC data. The approach is based on expected travel and passenger activity patterns derived from the data. It is assumed that standard passenger balancing and schedule matching algorithms are applied to the raw AVL/APC data along with any existing automatic validation programs. The proposed QA methodology is intended to provide transit agencies with a supplementary tool to manage data quality that complements, but does not replace, conventional processing routines (that can be vendor-specific and less transparent). The proposed QA methodology endeavours to flag invalid data as “suspect” and valid data as “non-suspect”. There are three stages: i) the first stage screens data that demonstrate a violation of physical constraints; ii) the second stage looks for data that represent outliers; and iii) the third stage evaluates whether the outlier data can be accounted for with valid or invalid pattern. Stop-level tests are mathematically defined for each stage; however data is filtered at the trip-level. Data that do not violate any physical constraints and do not represent any outliers are considered valid trip data. Outlier trips that may be accounted for with a valid outlier pattern are also considered valid. The remaining trip data is considered suspect. The methodology is applied to a sample set of AVL/APC data from Grand River Transit in the Region of Waterloo, Ontario, Canada. The sample data consist of 4-month’s data from September to December of 2008; it is comprised of 612,000 stop-level records representing 25,012 trips. The results show 14% of the trip-level data is flagged as suspect for the sample dataset. The output is further dissected by: reviewing which tests most contribute to the set of suspect trips; confirming the pattern assumptions for the valid outlier cases; and comparing the sample data by various traits before and after the QA methodology is applied. The latter task is meant to recognize characteristics that may contribute to higher or lower quality data. Analysis shows that the largest portion of suspect trips, for this sample set, suggests the need for improved passenger balancing algorithms or greater accuracy of the APC equipment. The assumptions for valid outlier case patterns were confirmed to be reasonable. It was found that poor schedule data contributes to poorer quality in AVL-APC data. An examination of data distribution by vehicle showed that usage and the portion of suspect data varied substantially between vehicles. This information can be useful in the development of maintenance plans and sampling plans (when combined with information of data distribution by route). A sensitivity analysis was conducted along with an impact analysis on downstream data uses. The model was found to be sensitive to three of the ten user-defined parameters. The impact of the QA procedure on network-level measures of performance (MOPs) was not found to be significant, however the impact was shown to be more substantial for route-specific MOPs.

There is increasing pressure from animal rights organizations (AROs) on restaurant chains, food retailers, and meat processors to implement more stringent farm animal welfare (FAW) requirements for their suppliers. In the United States, AROs have recently initiated successful ballots to phase out confinement practices in several states. In Canada AROs have been pressuring both public and private sector stakeholders to improve FAW. Are FAW issues, however, paramount in the minds of Canadian consumers? Is the demand for more stringent FAW protocols primarily determined by a subset of consumers with very strong preferences or does it signal a more fundamental underlying change in consumer and societal preferences? Given the credence nature of FAW, who do consumers trust (i.e., government vs. private industry vs. independent third parties) in the market place for the provision of FAW quality assurances? What are the determinants of trust in these organizations for providing accurate information about animal welfare?<p> In order to answer these questions, a stated preference consumer survey encompassing FAW issues specific to the Canadian pork sector was tested on two samples of consumers in summer 2008, namely: a general population sample (GPS) across Canada and a sample of AROs members. Consumers participated in a purchase experiment where they had to chose between pork chops characterized by combinations of different levels of FAW attributes (i.e., housing system, gestation stalls, and use of antibiotics), quality verifying organization, and price. Multinomial Logit and Latent Class Logit Models were used to analyse the survey data.<p> Surprisingly, outdoor system does not seem to resonate well with Canadians, as both the GPS and the members of the AROs discounted this attribute. As expected, the AROs members have much stronger preferences for the other FAW attributes than have consumers in the GPS. Nevertheless, significant heterogeneity exists within consumer preferences. Five classes of consumers were identified in the GPS with respect to their preferences for FAW. At one end of the spectrum are the FAW sensitive consumers (12.3%) that have higher willingness-to-pay (WTP) for FAW, while at the other end of the spectrum Price Conscious consumers (18.3%) do not exhibit any WTP for FAW. The other three classes (69.4%) comprise respondents with mixed perceptions regarding FAW. Government and Third Party verification of FAW quality assurances had the strongest influence on consumers preferences in both samples. As well, scientific experts in FAW along with the above two organizations are the most credible in providing information about the welfare of pigs. The extent to which these organizations are knowledgeable about the welfare of pigs is the most important factor enhancing consumers trust. Results from this study suggest that there are potential marketing opportunities for pork chops sourced from pigs raised on farms where sows are kept in groups, and where credible quality assurances can be established, that private industry could consider. As well, the results suggest that consumers would derive benefits from the government taking a more active role with respect to validating FAW quality assurances.

No description available.