Genome stability pathways in head and neck cancers

Genomic instability underlies the transformation of host cells toward malignancy, promotes development of invasion and metastasis and shapes the response of established cancer to treatment. In this review, we discuss recent advances in our understanding of genomic stability in squamous cell carcinoma of the head and neck (HNSCC), with an emphasis on DNA repair pathways. HNSCC is characterized by distinct profiles in genome stability between similarly staged cancers that are reflected in risk, treatment response and outcomes. Defective DNA repair generates chromosomal derangement that can cause subsequent alterations in gene expression, and is a hallmark of progression toward carcinoma. Variable functionality of an increasing spectrum of repair gene polymorphisms is associated with increased cancer risk, while aetiological factors such as human papillomavirus, tobacco and alcohol induce significantly different behaviour in induced malignancy, underpinned by differences in genomic stability. Targeted inhibition of signalling receptors has proven to be a clinically-validated therapy, and protein expression of other DNA repair and signalling molecules associated with cancer behaviour could potentially provide a more refined clinical model for prognosis and treatment prediction. Development and expansion of current genomic stability models is furthering our understanding of HNSCC pathophysiology and uncovering new, promising treatment strategies. © 2013 Glenn Jenkins et al.

What factors influence nurses’ assessment practices? Development of the Barriers to Nurses’ use of Physical Assessment Scale

Aim To develop and psychometrically test the Barriers to Nurses’ use of Physical Assessment Scale. Background There is growing evidence of failure to recognise hospitalised patients at risk of clinical deterioration, in part due to inadequate physical assessment by nurses. Yet, little is known about the barriers to nurses’ use of physical assessment in the acute hospital setting and no validated scales have been published. Design Instrument development study. Method Scale development was based on a comprehensive literature review, focus groups, expert review and psychometric evaluation. The scale was administered to 434 acute care registered nurses working at a large Australian teaching hospital between June and July 2013. Psychometric analysis included factor analysis, model fit statistics and reliability testing. Results The final scale was reduced to 38 items representing seven factors, together accounting for 57.7% of the variance: (1) reliance on others and technology, (2) lack of time and interruptions, (3) ward culture, (4) lack of confidence, (5) lack of nursing role models, (6) lack of influence on patient care, and; (7) specialty area. Internal reliability ranged from .70 to .86. Conclusion Findings provide initial evidence for the validity and reliability of the Barriers to Nurses’ use of Physical Assessment Scale and point to the importance of understanding the organisational determinants of nurses’ assessment practices. The new scale has potential clinical and research applications to support nursing assessment in acute care settings.

Teaching Teachers for the Future (TTF) Project TPACK Survey : summary of the key findings

This paper presents a summary of the key findings of the TTF TPACK Survey developed and administered for the Teaching the Teachers for the Future (TTF) Project implemented in 2011. The TTF Project, funded by an Australian Government ICT Innovation Fund grant, involved all 39 Australian Higher Education Institutions which provide initial teacher education. TTF data collections were undertaken at the end of Semester 1 (T1) and at the end of Semester 2 (T2) in 2011. A total of 12881 participants completed the first survey (T1) and 5809 participants completed the second survey (T2). Groups of like-named items from the T1 survey were subject to a battery of complementary data analysis techniques. The psychometric properties of the four scales: Confidence - teacher items; Usefulness - teacher items; Confidence - student items; Usefulness- student items, were confirmed both at T1 and T2. Among the key findings summarised, at the national level, the scale: Confidence to use ICT as a teacher showed measurable growth across the whole scale from T1 to T2, and the scale: Confidence to facilitate student use of ICT also showed measurable growth across the whole scale from T1 to T2. Additional key TTF TPACK Survey findings are summarised.

Thermodynamic modeling of ethanol fumigation in a diesel engine

Due to rapidly diminishing international supplies of fossil fuels, such as petroleum and diesel, the cost of fuel is constantly increasing, leading to higher costs of living, as a result of the significant reliance of many industries on motor vehicles. Many technologies have been developed to replace part or all of a fossil fuel with bio-fuels. One of the dual fuel technologies is fumigation of ethanol in diesel engines, which injects ethanol into the intake air stream of the engine. The advantage of this is that it avoids any costly modification of the engine high pressure diesel injection system, while reducing the volume of diesel required and potentially increasing the power output and efficiency. This paper investigates the performance of a diesel engine, converted to implement ethanol fumigation. The project will use both existing experimental data, along with generating computer modeled results using the program AVL Boost. The data from both experiments and the numerical simulation indicate desirable results for the peak pressure and the indicated mean effective pressure (IMEP). Increase in ethanol substitution resulted in elevated combustion pressure and an increase in the IMEP, while the variation of ethanol injection location resulted in negligible change. These increases in cylinder pressure led to a higher work output and total efficiency in the engine as the ethanol substitution was increased. In comparing the numerical and experimental results, the simulation showed a slight elevation, due to the inaccuracies in the heat release models. Future work is required to improve the combustion model and investigate the effect of the variation of the location of ethanol injection.

AUSPRAC : The Nurse Practitioner Research Toolkit

Chapter 1: Introduction Overview and background Chapter 2: Conducting clinical audit of nurse practitioner practice The nature and purpose of clinical audit-- Data collection tools for clinical audit-- References and readings Chapter 3: Researching nurse practitioner practice The nature and purpose of clinical practice research-- Data collection tools for researching practice-- References and readings Chapter 4: Researching nurse practitioner service Principles and purpose of health services research-- Data collection tools for researching health services-- References and readings Chapter 5: Researching nurse practitioner patient outcomes Principles and purpose of researching patient outcomes-- Data collection tools for researching patient outcomes-- References and readings Chapter 6: Conducting a nurse practitioner census National workforce census-- Data collection tools for National/State census of nurse practitioners--References and readings

The Nurse Practitioner Standards Project : Toolkit

"The aims of the project have been to conduct research that will inform a description of the core role of the nurse, core competency standards for the nurse and standards for education and program accreditation for nurse preparation leading to regsitration and authorisation. Includes Nurse Practitioner Standards Project: Toolkit, developed from the findings of the Nurse Practitioner standards research project. It presents standards related to Nurse Practitioner practice, education and authorisation/evaluation."--Libraries Australia

A protocol for a pragmatic randomized controlled trial evaluating outcomes of emergency nurse practitioner service

Aim To evaluate emergency nurse practitioner service effectiveness on outcomes related to quality of care and service responsiveness. Background Increasing service pressures in the emergency setting have resulted in the adoption of service innovation models; the most common and rapidly expanding of these is the emergency nurse practitioner. The delivery of high quality patient care in the emergency department is one of the most important service indicators to be measured in health services today. The rapid uptake of emergency nurse practitioner service in Australia has outpaced the capacity to evaluate this model in outcomes related to safety and quality of patient care. Design Pragmatic randomized controlled trial at one site with 260 participants. Methods This protocol describes a definitive prospective randomized controlled trial, which will examine the impact of emergency nurse practitioner service on key patient care and service indicators. The study control will be standard emergency department care. The intervention will be emergency nurse practitioner service. The primary outcome measure is pain score reduction and time to analgesia. Secondary outcome measures are waiting time, number of patients who did not wait, length of stay in the emergency department and representations within 48 hours. Discussion Scant research enquiry evaluating emergency nurse practitioner service on patient effectiveness and service responsiveness exists currently. This study is a unique trial that will test the effectiveness of the emergency nurse practitioner service on patients who present to the emergency department with pain. The research will provide an opportunity to further evaluate emergency nurse practitioner models of care and build research capacity into the workforce.

Applying Enterprise Architecture to Business Networks

Globalization, financial deregulation, economic turmoil, and technology breakthroughs are profoundly exposing organizations to business networks. Engaging these networks requires explicit planning from the strategic level down to the operational level of an organization, which significantly affects organizational artefacts such as business services, processes, and resources. Although enterprise architecture (EA) aligns business and IT aspects of organizational systems, previous applications of EA have not comprehensively addressed a methodological framework for planning. In the context of business networks, this study seeks to explore the application of EA for business network planning where it builds upon relevant and well-established prescriptive and descriptive aspects of EA. Prescriptive aspects include integrated models of services, business processes, and resources among other organizational artefacts, at both business and IT levels. Descriptive aspects include ontological classifications of business functionality, which allow EA models to be aligned semantically to organizational artefacts and, ultimately higher-level business strategy. A prominent approach for capturing descriptive aspects of EA is business capability modelling. In order to explore and develop the illustrative extensions of EA through capability modelling, a list of requirements (capability dimensions) for business network planning will be identified and validated through a revelatory case study encompassing different business network manifestations, or situations. These include virtual organization, liquid workforce, business network orchestration, and headquarters-subsidiary. The use of artefacts, conventionally, modelled through EA will be considered in these network situations. Two general considerations for EA extensions are explored for the identified requirements at the level of the network: extension of artefacts through the network and alignment of network level artefacts with individual organization artefacts. The list of requirements provides the basis for a constructivist extension of EA in the following ways. Firstly, for descriptive aspects, it offers constructivist insights to guide extensions for particular EA techniques and concepts. Secondly, for prescriptive aspects it defines a set of capability dimensions, which improve the analysis and assessment of organization capabilities for business network situations.

The development of an intervention to promote the capacity to wait in children with intellectual disability

Aim: Individuals with intellectual disability (ID) often have difficulty with waiting, an important aspect of everyday life. Successful waiting require cognitive, emotional and behavioural self-regulation, and is an essential element in the capacity to delay gratification. Method: We developed an intervention to provide parents with the knowledge and strategies to promote their child’s capacity to wait. The intervention was grounded in previous work about the skills underpinning successful waiting, such as goal-setting, understanding time, and managing frustration. Eleven parents of children with ID (mean CA 9.4 years; mean MA 47 months) participated in an intervention trial. Following pre-testing of their child’s capacity to wait and delay gratification, parents attended a 1 day workshop that was followed by monthly phone discussions with the researchers to monitor progress and provide advice. Post-testing was undertaken 1 year later. Results: Compared with a wait-listed control group, children whose parents had completed the intervention displayed significant improvements in their capacity to wait on a delay of gratification task. Parents reported that their child had become more successful in everyday waiting situations. Conclusion: The results of this pilot study are promising and pave the way for larger-scale interventions to improve self-regulatory skills in people with ID.

Modular green roof systems in mid-rise multifamily residential units

This paper presents the results of a full-scale research project undertaken to assess scour losses/gains for modular tray green roof specimens placed on a mock-up building, and identify important factors to consider for wind design criteria. Visual assessment of the experimental results showed that usage of vegetation, parapet height, wind direction, and test duration were the predominant factors affecting scour resistance of the growth media in tested specimens. Statistical analysis results indicated that the differences in soil losses measured among Phase 2’s test trials were more significant than those in Phase 1. This was attributed to the lack of parapet, cornering wind conditions, and longer test duration found in Phase 2. Findings presented in this paper constitute a benchmark for future research to improve the knowledge gap that exists in green roof wind design.

Defining and Accounting for Fundraising Income and Expenses

Charities' fundraising financial transactions should be reported in the interests of accountability, and the report should be publicly available. However, research shows that at present there is little consistency in how fundraising is defined or in how such transactions are reported, and little guidance from accounting standards. This report examines whether the current reporting of fundraising in annual financial statements by Australian charities is fit for the purposes of informing the donating public and other stakeholders, whether through the Australian Charities and Not-for-profits Commission’s registry strategy or through other means such as private ratings agencies. The authors endeavour to suggest a way forward if it is not.

Defining and Accounting for Fundraising Income and Expenses : Executive Summary : ACPNS Current issues Information Sheet 2014/2

Executive summary of Report examining definitions of fundraising and formal Australian accounting standards to ascertain their impact on reporting fundraising transactions by not-for-profit entities.

The impact of nurse practitioner services on cost, quality of care, satisfaction and wait times in the emergency department: A systematic review

Aims To provide the best available evidence to determine the impact of nurse practitioner services on cost, quality of care, satisfaction and waiting times in the emergency department for adult patients. Background The delivery of quality care in the emergency department is one of the most important service indicators in health delivery. Increasing service pressures in the emergency department have resulted in the adoption of service innovation models: the most common and rapidly expanding of these is emergency nurse practitioner services. The rapid uptake of emergency nurse practitioner service in Australia has outpaced the capacity to evaluate this service model in terms of outcomes related to safety and quality of patient care. Previous research is now outdated and not commensurate with the changing domain of delivering emergency care with nurse practitioner services. Data A comprehensive search of four electronic databases from 2006-­‐2013 was conducted to identify research evaluating nurse practitioner service impact in the emergency department. English language articles were sought using MEDLINE, CINAHL, Embase and Cochrane and included two previous systematic reviews completed five and seven years ago. Methods A three step approach was used. Following a comprehensive search, two reviewers assessed identified studies against the inclusion criteria. From the original 1013 studies, 14 papers were retained for critical appraisal on methodological quality by two independent reviewers and data extracted using standardised tools. Results Narrative synthesis was conducted to summarise and report the findings as insufficient data was available for meta-­‐analysis of results. This systematic review has shown that emergency nurse practitioner service has a positive impact on quality of care, patient satisfaction and waiting times. There was insufficient evidence to draw conclusions regarding impact on costs. Conclusion Synthesis of the available research attempts to provide an evidence base for emergency nurse practitioner service to guide healthcare leaders, policy makers and clinicians in reforming emergency department service provision. The findings suggest that further quality research is required for comparative measures of clinical and service effectiveness of emergency nurse practitioner service. In the context of increased health service demand and the need to provide timely and effective care to patients, such measures will assist in delivering quality patient care.

Time to analgesia for care delivered by nurse practitioners in the emergency department: A retrospective chart audit

Objectives To evaluate quality of care delivered to patients presenting to the emergency department (ED) with pain and managed by emergency nurse practitioners by measuring: 1) Evaluate time to analgesia from initial presentation 2) Evaluate time from being seen to next analgesia 3) Pain score documentation Background The delivery of quality care in the emergency department (ED) is emerging as one of the most important service indicators being measured by health services. Emergency nurse practitioner services are designed to improve timely, quality care for patients. One of the goals of quality emergency care is the timely and effective delivery of analgesia for patients. Timely analgesia is an important indicator of ED service performance. Methods A retrospective explicit chart review of 128 consecutive patients with pain and managed by emergency nurse practitioners was conducted. Data collected included demographics, presenting complaint, pain scores, and time to first dose of analgesia. Patients were identified from the ED Patient Information System (Cerner log) and data were extracted from electronic medical records Results Pain scores were documented in 67 (52.3%; 95% CI: 43.3-61.2) patients. The median time to analgesia from presentation was 60.5 (IQR 30-87) minutes, with 34 (26.6%; 95% CI: 19.1-35.1) patients receiving analgesia within 30 minutes of presentation to hospital. There were 22 (17.2%; 95% CI: 11.1-24.9) patients who received analgesia prior to assessment by a nurse practitioner. Among patients that received analgesia after assessment by a nurse practitioner, the median time to analgesia after assessment was 25 (IQR 12-50) minutes, with 65 (61.3%; 95% CI: 51.4-70.6) patients receiving analgesia within 30 minutes of assessment. Conclusions The majority of patients assessed by nurse practitioners received analgesia within 30 minutes after assessment. However, opportunities for substantial improvement in such times along with documentation of pain scores were identified and will be targeted in future research.

Developing an engaging IT degree

Curriculum renewal is a constant activity in Information Technology (IT), Information Systems (IS), Information and Communication Technology (ICT) and Computer Science (CS). Guiding documents from curriculum authorities such as AIS, IEEE and ACM assist in this process, as do those from professional societies, but these are often out of date when the institution seeks to refresh its approaches to learning, and position its graduates for emerging roles and technologies. This paper describes and discusses a curriculum renewal project undertaken in response to changing government requirements,student interests and the adoption of a learner-centric, active learning paradigm utilizing new physical collaborative learning facilities. This paper presents the stimulus for change, describes the use of reference resources and discusses the resulting degree structure, its majors and learning approaches.