The obsessive compulsive drinking scale is a valid measure of alcohol craving in young adults

Background: Alcohol craving is associated with greater alcohol-related problems and less favorable treatment prognosis. The Obsessive Compulsive Drinking Scale (OCDS) is the most widely used alcohol craving instrument. The OCDS has been validated in adults with alcohol use disorders (AUDs), which typically emerge in early adulthood. This study examines the validity of the OCDS in a nonclinical sample of young adults. Methods: Three hundred and nine college students (mean age of 21.8 years, SD = 4.6 years) completed the OCDS, Alcohol Use Disorders Identification Test (AUDIT), and measures of alcohol consumption. Subjects were randomly allocated to 2 samples. Construct validity was examined via exploratory factor analysis (n = 155) and confirmatory factor analysis (n = 154). Concurrent validity was assessed using the AUDIT and measures of alcohol consumption. A second, alcohol-dependent sample (mean age 42 years, SD 12 years) from a previously published study (n = 370) was used to assess discriminant validity. Results: A unique young adult OCDS factor structure was validated, consisting of Interference/Control, Frequency of Obsessions, Alcohol Consumption and Resisting Obsessions/Compulsions. The young adult 4-factor structure was significantly associated with the AUDIT and alcohol consumption. The 4 factor OCDS successfully classified nonclinical subjects in 96.9% of cases and the older alcohol-dependent patients in 83.7% of cases. Although the OCDS was able to classify college nonproblem drinkers (AUDIT <13, n = 224) with 83.2% accuracy, it was no better than chance (49.4%) in classifying potential college problem drinkers (AUDIT score ≥13, n = 85). Conclusions: Using the 4-factor structure, the OCDS is a valid measure of alcohol craving in young adult populations. In this nonclinical set of students, the OCDS classified nonproblem drinkers well but not problem drinkers. Studies need to further examine the utility of the OCDS in young people with alcohol misuse.

Evaluation of the year 1 literacy and numeracy checkpoints assessments trial - 2010

The draft Year 1 Literacy and Numeracy Checkpoints Assessments were in open and supported trial during Semester 2, 2010. The purpose of these trials was to evaluate the Year 1 Literacy and Numeracy Checkpoints Assessments (hereafter the Year 1 Checkpoints) that were designed in 2009 as a way to incorporate the use of the Year 1 Literacy and Numeracy Indicators as formative assessment in Year 1 in Queensland Schools. In these trials there were no mandated reporting requirements. The processes of assessment were related to future teaching decisions. As such the trials were trials of materials and the processes of using those materials to assess students, plan and teach in year 1 classrooms. In their current form the Year 1 Checkpoints provide assessment resources for teachers to use in February, June and October. They aim to support teachers in monitoring children's progress and making judgments about their achievement of the targeted P‐3 Literacy and Numeracy Indicators by the end of Year 1 (Queensland Studies Authority, 2010 p. 1). The Year 1 Checkpoints include support materials for teachers and administrators, an introductory statement on assessment, work samples, and a Data Analysis Assessment Record (DAAR) to record student performance. The Supported Trial participants were also supported with face‐to‐face and on‐line training sessions, involvement in a moderation process after the October Assessments, opportunities to participate in discussion forums as well as additional readings and materials. The assessment resources aim to use effective early years assessment practices in that the evidence is gathered from hands‐on teaching and learning experiences, rather than more formal assessment methods. They are based in a model of assessment for learning, and aim to support teachers in the “on‐going process of determining future learning directions” (Queensland Studies Authority, 2010 p. 1) for all students. Their aim is to focus teachers on interpreting and analysing evidence to make informed judgments about the achievement of all students, as a way to support subsequent planning for learning and teaching. The Evaluation of the Year 1 Literacy and Numeracy Checkpoints Assessments Supported Trial (hereafter the Evaluation) aimed to gather information about the appropriateness, effectiveness and utility of the Year 1 Checkpoints Assessments from early years’ teachers and leaders in up to one hundred Education Queensland schools who had volunteered to be part of the Supported Trial. These sample schools represent schools across a variety of Education Queensland regions and include schools with:  - A high Indigenous student population; - Urban, rural and remote school locations; - Single and multi‐age early phase classes; - A high proportion of students from low SES backgrounds. The purpose of the Evaluation was to: Evaluate the materials and report on the views of school‐based staff involved in the trial on the process, materials, and assessment practices utilised. The Evaluation has reviewed the materials, and used surveys, interviews, and observations of processes and procedures to collect relevant data to help present an informed opinion on the Year 1 Checkpoints as assessment for the early years of schooling. Student work samples and teacher planning and assessment documents were also collected. The evaluation has not evaluated the Year 1 Checkpoints in any other capacity than as a resource for Year 1 teachers and relevant support staff.

Mesenchymal stem cells

Cell based therapies as they apply to tissue engineering and regenerative medicine, require cells capable of self renewal and differentiation, and a prerequisite is to be able to prepare an effective dose of ex vivo expanded cells for autologous transplants. The in vivo identification of a source of physiologically relevant cell types suitable for cell therapies therefore figures as an integral part of tissue engineering. Stem cells serve as a reserve for biological repair, having the potential to differentiate into a number of specialised cell types within the body; they therefore represent the most useful candidates for cell based therapies. The primary goal of stem cell research is to produce cells that are both patient specific, as well as having properties suitable for the specific conditions for which they are intended to remedy. From a purely scientific perspective, stem cells allow scientists to gain a deeper understanding of developmental biology and regenerative therapies. Stem cells have acquired a number of uses for applications in regenerative medicine, immunotherapy, gene therapy, but it is in the area of tissue engineering that they generate most excitement, primarily as a result of their capacity for self-renewal and pluripotency. A unique feature of stem cells is their ability to maintain an uncommitted quiescent state in vivo and then, once triggered by conditions such as disease, injury or natural wear or tear, serve as a reservoir and natural support system to replenish lost cells. Although these cells retain the plasticity to differentiate into various tissues, being able to control this differentiation process is still one of the biggest challenges facing stem cell research. In an effort to harness the potential of these cells a number of studies have been conducted using both embryonic/foetal and adult stem cells. The use of embryonic stem cells (ESC) have been hampered by strong ethical and political concerns, this despite their perceived versatility due to their pluripotency. Ethical issues aside, other concerns raised with ESCs relates to the possibility of tumorigenesis, immune rejection and complications with immunosuppressive therapies, all of which adds layers of complications to the application ESC in research and which has led to the search for alternative sources for stem cells. The adult tissues in higher organisms harbours cells, termed adult stem cells, and these cells are reminiscent of unprogrammed stem cells. A number of sources of adult stem cells have been described. Bone marrow is by far the most accessible source of two potent populations of adult stem cells, namely haematopoietic stem cells (HSCs) and bone marrow mesenchymal stem cells (BMSCs). Autologously harvested adult stem cells can, in contrast to embryonic stem cells, readily be used in autografts, since immune rejection is not an issue; and their use in scientific research has not attracted the ethical concerns which have been the case with embryonic stem cells. The major limitation to their use, however, is the fact that adult stem cells are exceedingly rare in most tissues. This fact makes identifying and isolating these cells problematic; bone marrow being perhaps the only notable exception. Unlike the case of HSCs, there are as yet no rigorous criteria for characterizing MSCs. Changing acuity about the pluripotency of MSCs in recent studies has expanded their potential application; however, the underlying molecular pathways which impart the features distinctive to MSCs remain elusive. Furthermore, the sparse in vivo distribution of these cells imposes a clear limitation to their study in vitro. Also, when MSCs are cultured in vitro, there is a loss of the in vivo microenvironment, resulting in a progressive decline in proliferation potential and multipotentiality. This is further exacerbated with increased passage numbers in culture, characterized by the onset of senescence related changes. As a consequence, it is necessary to establish protocols for generating large numbers of MSCs but without affecting their differentiation potential. MSCs are capable of differentiating into mesenchymal tissue lineages, including bone, cartilage, fat, tendon, muscle, and marrow stroma. Recent findings indicate that adult bone marrow may also contain cells that can differentiate into the mature, nonhematopoietic cells of a number of tissues, including cells of the liver, kidney, lung, skin, gastrointestinal tract, and myocytes of heart and skeletal muscle. MSCs can readily be expanded in vitro and can be genetically modified by viral vectors and be induced to differentiate into specific cell lineages by changing the microenvironment–properties which makes these cells ideal vehicles for cellular gene therapy. MSCs can also exert profound immunosuppressive effects via modulation of both cellular and innate immune pathways, and this property allows them to overcome the issue of immune rejection. Despite the many attractive features associated with MSCs, there are still many hurdles to overcome before these cells are readily available for use in clinical applications. The main concern relates to in vivo characterization and identification of MSCs. The lack of a universal biomarker, sparse in vivo distribution, and a steady age related decline in their numbers, makes it an obvious need to decipher the reprogramming pathways and critical molecular players which govern the characteristics unique to MSCs. This book presents a comprehensive insight into the biology of adult stem cells and their utility in current regeneration therapies. The adult stem cell populations reviewed in this book include bone marrow derived MSCs, adipose derived stem cells (ASCs), umbilical cord blood stem cells, and placental stem cells. The features such as MSC circulation and trafficking, neuroprotective properties, and the nurturing roles and differentiation potential of multiple lineages have been discussed in details. In terms of therapeutic applications, the strengths of MSCs have been presented and their roles in disease treatments such as osteoarthritis, Huntington’s disease, periodontal regeneration, and pancreatic islet transplantation have been discussed. An analysis comparing osteoblast differentiation of umbilical cord blood stem cells and MSCs has been reviewed, as has a comparison of human placental stem cells and ASCs, in terms of isolation, identification and therapeutic applications of ASC in bone, cartilage regeneration, as well as myocardial regeneration. It is my sincere hope that this book will update the reader as to the research progress of MSC biology and potential use of these cells in clinical applications. It will be the best reward to all contributors of this book, if their efforts herein may in some way help the readers in any part of their study, research, and career development.

The development of the extended adolescent injury checklist (E-AIC) : a measure for injury prevention program evaluation

The Extended Adolescent Injury Checklist (E-AIC), a self-report measure of injury based on the model of the Adolescent Injury Checklist (AIC), was developed for use in the evaluation of school-based interventions. The three stages of this development involved focus groups with adolescents and consultations with medical staff, pilot testing of the revised AIC in a high school context, and use of the finalised checklist in pre- and post-questionnaires to examine its utility. Results revealed that responses to the final version of the E-AIC were meaningful and remained consistent over time. The E-AIC appears to be a promising measure of adolescent injury that is simple, time-efficient and appropriate for use in the evaluation of school-based injury prevention programs.

Managing Trust in Online Social Networks

In recent years, there is a dramatic growth in number and popularity of online social networks. There are many networks available with more than 100 million registered users such as Facebook, MySpace, QZone, Windows Live Spaces etc. People may connect, discover and share by using these online social networks. The exponential growth of online communities in the area of social networks attracts the attention of the researchers about the importance of managing trust in online environment. Users of the online social networks may share their experiences and opinions within the networks about an item which may be a product or service. The user faces the problem of evaluating trust in a service or service provider before making a choice. Recommendations may be received through a chain of friends network, so the problem for the user is to be able to evaluate various types of trust opinions and recommendations. This opinion or recommendation has a great influence to choose to use or enjoy the item by the other user of the community. Collaborative filtering system is the most popular method in recommender system. The task in collaborative filtering is to predict the utility of items to a particular user based on a database of user rates from a sample or population of other users. Because of the different taste of different people, they rate differently according to their subjective taste. If two people rate a set of items similarly, they share similar tastes. In the recommender system, this information is used to recommend items that one participant likes, to other persons in the same cluster. But the collaborative filtering system performs poor when there is insufficient previous common rating available between users; commonly known as cost start problem. To overcome the cold start problem and with the dramatic growth of online social networks, trust based approach to recommendation has emerged. This approach assumes a trust network among users and makes recommendations based on the ratings of the users that are directly or indirectly trusted by the target user.

Characterisation of public mobile data networks for aeronautical telemetry purposes

This paper describes the characterisation for airborne uses of the public mobile data communication systems known broadly as 3G. The motivation for this study was to explore how this mature public communication systems could be used for aviation purposes. An experimental system was fitted to a light aircraft to record communication latency, line speed, RF level, packet loss and cell tower identifier. Communications was established using internet protocols and connection was made to a local server. The aircraft was flown in both remote and populous areas at altitudes up to 8500ft in a region located in South East Queensland, Australia. Results show that the average airborne RF levels are better than those on the ground by 21% and in the order of -77 dbm. Latencies were in the order of 500 ms (1/2 the latency of Iridium), an average download speed of 0.48 Mb/s, average uplink speed of 0.85 Mb/s, a packet of information loss of 6.5%. The maximum communication range was also observed to be 70km from a single cell station. The paper also describes possible limitations and utility of using such a communications architecture for both manned and unmanned aircraft systems.

The molecular mechanisms utilised by mesenchymal stem cells in migration to acute myocardial infarction

Heart damage caused by acute myocardial infarction (AMI) is a leading cause of death and disability in Australia. Novel therapies are still required for the treatment of this condition due to the poor reparative ability of the heart. As such, cellular therapies that assist in the recovery of heart muscle are of great current interest. Culture expanded mesenchymal stem cells (MSC) represent a stem and progenitor cell population that has been shown to promote tissue recovery in pre-clinical studies of AMI. For MSC-based therapies in the clinic, an intravenous route of administration would ideally be used due to the low cost, ease of delivery and relative safety. The study of MSC migration is therefore clinically relevant for a minimally invasive cell therapy to promote regeneration of damaged tissue. C57BL/6, UBI-GFP-BL/6 and CD44-/-/GFP+/+ mice were utilised to investigate mMSC migration. To assist in murine models of MSC migration, a novel method was used for the isolation of murine MSC (mMSC). These mMSC were then expanded in culture and putative mMSC were positive for Sca-1, CD90.2, and CD44 and were negative for CD45 and CD11b. Furthermore, mMSC from C57BL/6 and UBI-GFP-BL/6 mice were shown to differentiate into cells of the mesodermal lineage. Cells from CD44-/-/GFP+/+ mice were positive for Sca-1 and CD90.2, and negative for CD44, CD45 and CD11b however, these cells were unable to differentiate into adipocytes and chondrocytes and express lineage specific genes, PLIN and ACAN. Analysis of mMSC chemokine receptor (CR) expression showed that although mMSC do express chemokine receptors, (including those specific for chemokines released after AMI), these were low or undetectable by mRNA. However, protein expression could be detected, which was predominantly cytoplasmic. It was further shown that in both healthy (unperturbed) and inflamed tissues, mMSC had very little specific migration and engraftment after intravenous injection. To determine if poor mMSC migration was due to the inability of mMSC to respond to chemotactic stimuli, chemokine expression in bone marrow, skin injury and hearts (healthy and after AMI) was analysed at various time points by quantitative real-time PCR (qRT PCR). Many chemokines were up-regulated after skin biopsy and AMI, but the highest acute levels were found for CXCL12 and CCL7. Due to their high expression in infarcted hearts, the chemokines CXCL12 and CCL7 were tested for their effect on mMSC migration. Despite CR expression at both protein and mRNA levels, migration in response to CXCL12 and CCL7 was low in mMSC cultured on Nunclon plastic. A novel tissue culture plastic technology (UpCellTM) was then used that allowed gentle non-enzymatic dissociation of mMSC, thus preserving surface expression of the CRs. Despite this the in vitro data indicated that CXCL12 fails to induce significant migration ability of mMSC, while CCL7 induces significant, but low-level migration. We speculated this may be because of low levels of surface expression of chemokine receptors. In a strategy to increase cell surface expression of mMSC chemokine receptors and enhance their in vitro and in vivo migration capacity, mMSC were pre-treated with pro-inflammatory cytokines. Increased levels of both mRNA and surface protein expression were found for CRs by pre-treating mMSC with pro-inflammatory cytokines including TNF-á, IFN-ã, IL-1á and IL-6. Furthermore, the chemotactic response of mMSC to CXCL12 and CCL7 was significantly higher with these pretreated cells. Finally, the effectiveness of this type of cell manipulation was demonstrated in vivo, where mMSC pre-treated with TNF-á and IFN-ã showed significantly increased migration in skin injury and AMI models. Therefore this thesis has demonstrated, using in vitro and in vivo models, the potential for prior manipulation of MSC as a possible means for increasing the utility of intravenously delivery for MSC-based cellular therapies.

Introducing action research as a vehicle to bring about change to a psychiatric nursing curriculum in Taiwan

The focus of this study is on curriculum change within a School of Nursing in Taiwan where there is a growing demand for educational reform in order to meet the new accreditation standards and demands of the Taiwan Nursing Accreditation Council (TNAC). The aim of this study was to transform the Psychiatric Nursing curriculum in ways that are empowering, generative and sustainable. This study introduced Action Research as a vehicle to bring about curriculum transformation. I conceptualised a framework to guide the transformation process based on the notions of learner-centredness, conceptual change, pedagogical knowledge, reflection, collaboration, reculturing and empowerment. The Action Plan was developed in accordance with the conceptual framework, and was developed in five steps through which team members explored and became aware of our conceptions of teaching and learning, and then planned and implemented actions to change our curriculum, and examined and reflected on the curriculum transformation. The study demonstrated the value of working collaboratively to solve educational problems. This study also suggested that experiential knowledge, when shared and integrated with theoretical knowledge, can constructively contribute to all aspects of curriculum transformation. This study further supported the value of including clinical facilitators in the development and transformation of curricula. It confirmed that academics and clinical facilitators can work together to create new learning for students. This study is significant for both practical and political reasons. Its practical significance lies in its direct utility to the learners and teachers who were involved in the study. The political significance lies in the potential of the study to lead to further changes or improvements in other, similar contexts. The study is limited in that any interpretations cannot be generalised to other contexts. However, what emerged adds to the body of knowledge in such a way that it would constitute the basis for better informed educational practice.

Influence of parameters on the heterogeneous photocatalytic degradation of pesticides and phenolic contaminants in wastewater : a short review

In recent years, the application of heterogeneous photocatalytic water purification process has gained wide attention due to its effectiveness in degrading and mineralizing the recalcitrant organic compounds as well as the possibility of utilizing the solar UV and visible light spectrum. This paper aims to review and summarize the recently published works on the titanium dioxide (TiO2) photocatalytic oxidation of pesticides and phenolic compounds, predominant in storm and waste water effluents. The effect of various operating parameters on the photocatalytic degradation of pesticides and phenols are discussed. Results reported here suggested that the photocatalytic degradation of organic compounds depends on the type of photocatalyst and composition, light intensity, initial substrate concentration, amount of catalyst, pH of the reaction medium, ionic components in water, solvent types, oxidizing agents/electron acceptors, catalyst application mode, and calcinations temperature in water environment. A substantial amount of research has focused on the enhancement of TiO2 photocatalysis by modification with metal, non-metal and ion doping. Recent developments in TiO2 photocatalysis for the degradation of various pesticides and phenols are also highlighted in this review. It is evident from the literature survey that photocatalysis has shown good potential for the removal of various organic pollutants. However, still there is a need to find out the practical utility of this technique on commercial scale.

A grouping model for distributed pipeline assets maintenance decision

Distributed pipeline assets systems are crucial to society. The deterioration of these assets and the optimal allocation of limited budget for their maintenance correspond to crucial challenges for water utility managers. Decision makers should be assisted with optimal solutions to select the best maintenance plan concerning available resources and management strategies. Much research effort has been dedicated to the development of optimal strategies for maintenance of water pipes. Most of the maintenance strategies are intended for scheduling individual water pipe. Consideration of optimal group scheduling replacement jobs for groups of pipes or other linear assets has so far not received much attention in literature. It is a common practice that replacement planners select two or three pipes manually with ambiguous criteria to group into one replacement job. This is obviously not the best solution for job grouping and may not be cost effective, especially when total cost can be up to multiple million dollars. In this paper, an optimal group scheduling scheme with three decision criteria for distributed pipeline assets maintenance decision is proposed. A Maintenance Grouping Optimization (MGO) model with multiple criteria is developed. An immediate challenge of such modeling is to deal with scalability of vast combinatorial solution space. To address this issue, a modified genetic algorithm is developed together with a Judgment Matrix. This Judgment Matrix is corresponding to various combinations of pipe replacement schedules. An industrial case study based on a section of a real water distribution network was conducted to test the new model. The results of the case study show that new schedule generated a significant cost reduction compared with the schedule without grouping pipes.

Benchmarking local E-Government

Increasingly, almost everything we do in our daily lives is being influenced by information and communications technologies (ICTs) including the Internet. The task of governance is no exception with an increasing number of national, state, and local governments utilizing ICTs to support government operations, engage citizens, and provide government services. As with other things, the process of governance is now being prefixed with an “e”. E-governance can range from simple Web sites that convey basic information to complex sites that transform the customary ways of delivering all sorts of government services. In this respect local e-government is the form of e-governance that specifically focuses on the online delivery of suitable local services by local authorities. In practice local e-government reflects four dimensions, each one dealing with the functions of government itself. The four are: (a) e-services, the electronic delivery of government information, programs, and services often over the Internet; (b) e-management, the use of information technology to improve the management of government. This might range from streamlining business processes to improving the flow of information within government departments; (c) e-democracy the use of electronic communication vehicles, such as e-mail and the Internet, to increase citizen participation in the public decision-making process; (d) e-commerce, the exchange of money for goods and services over the Internet which might include citizens paying taxes and utility bills, renewing vehicle registrations, and paying for recreation programs, or government buying office supplies and auctioning surplus equipment (Cook, LaVigne, Pagano, Dawes, & Pardo, 2002). Commensurate with the rapid increase in the process of developing e-governance tools, there has been an increased interest in benchmarking the process of local e-governance. This benchmarking, which includes the processes involved in e-governance as well as the extent of e-governance adoption or take-up is important as it allows for improved processes and enables government agencies to move towards world best practice. It is within this context that this article discusses benchmarking local e-government. It brings together a number of discussions regarding the significance of benchmarking, best practices and actions for local e-government, and key elements of a successful local e-government project.

Injuries across adolescence : an investigation using the Extended Adolescent Injury Checklist (E-AIC)

Injury is the leading cause of death among adolescents, and in many countries, accounts for more deaths than all other causes combined. Rates of death due to injury also increase dramatically across adolescence. The Australian Institute of Health and Welfare reported that, in 2005, there were 954 deaths of young Australians due to injury, which is a rate of 26 deaths per 100,000 young people. Of these deaths, 4% were adolescents aged 12-14, 17% were aged 15-17, and 80% were aged 18-24 years. Issues addressed: Injuries are the leading cause of death among adolescents. The current research examined a measure of adolescent injury in terms of whether it encompasses the diverse injury experiences of Australian adolescents, including high-risk and normative adolescents, and thus determine its utility as a tool for health promotion research. Grade 9 students from two Brisbane high schools (n=202, aged 13-14 years) and adolescents recruited from the Emergency Department waiting rooms of four Brisbane hospitals (n=98, aged 16-18 years) completed the Extended Adolescent Injury Checklist (E-AIC). The most common cause of injury among adolescents was a sports activity, followed by fights for all participants except schoolbased males, who experienced more bicycle injuries. Alcohol use was most frequently reported in association with interpersonal violence injuries. A broad variety of injuries, occurring in context of multiple risk as well as normative behaviours, were reported by adolescents in both school and ED settings, and were captured by the E-AIC. Findings suggest that the E-AIC is a useful measure that captures the injury experiences of adolescents in different contexts. The high occurrence of injuries that do not result in formal medical treatment also indicates scope for interventions to be based around lessons in first aid, while also incorporating injury prevention components.

Proton-transfer compounds of isnipecotamide with the aromatic dicarboxylic acids 4-nitrophthalic, 4,5-dichlorophthalic, 5-nitroisophthalic and terephthalic acid

The structures of the 1:1 proton-transfer compounds of isonipecotamide (4-piperidinecarboxamide) with 4-nitrophthalic acid, 4-carbamoylpiperidinium 2-carboxy-4-nitrobenzoate, C6H13N2O8+ C8H4O6- (I), 4,5-dichlorophthalic acid, 4-carbamoylpiperidinium 2-carboxy-4,5-dichlorobenzoate, C6H13N2O8+ C8H3Cl2O4- (II) and 5-nitroisophthalic acid, 4-carbamoylpiperidinium 3-carboxy-5-nitrobenzoate, C6H13N2O8+ C8H4O6- (III) as well as the 2:1 compound with terephthalic acid, bis(4-carbamoylpiperidinium)benzene-1,2-dicarboxylate dihydrate, 2(C6H13N2O8+) C8H4O42- . 2H2O (IV)have been determined at 200 K. All salts form hydrogen-bonded structures, one-dimensional in (II) and three-dimensional in (I), (III) and (IV). In (I) and (III) the centrosymmetric R2/2(8) cyclic amide-amide association is found while in (IV) several different types of water-bridged cyclic associations are present [graph sets R2/4(8), R3/4(10), R4/4(12), R3/3(18) and R4/6(22)]. The one-dimensional structure of (I), features the common 'planar' hydrogen 4,5-dichlorophthalate anion together with enlarged cyclic R3/3(13) and R3/4(17) associations. With the structures of (I) and (III) the presence of head-to-tail hydrogen phthalate chain substructures is found. In (IV) head-to-tail primary cation-anion associations are extended longitudinally into chains through the water-bridged cation associations and laterally by piperidinium N-H...O(carboxyl) and water O-H...O(carboxyl) hydrogen bonds. The structures reported here further demonstrate the utility of the isonipecotamide cation as a synthon for the generation of stable hydrogen-bonded structures. An additional example of cation--anion association with this cation is also shown in the asymmetric three-centre piperidinium N-H...O,O'(carboxyl) interaction in the first-reported structure of a 2:1 isonipecotamide-carboxylate salt.

Adaptive Bayesian compound designs for dose finding studies

We consider the problem of how to efficiently and safely design dose finding studies. Both current and novel utility functions are explored using Bayesian adaptive design methodology for the estimation of a maximum tolerated dose (MTD). In particular, we explore widely adopted approaches such as the continual reassessment method and minimizing the variance of the estimate of an MTD. New utility functions are constructed in the Bayesian framework and are evaluated against current approaches. To reduce computing time, importance sampling is implemented to re-weight posterior samples thus avoiding the need to draw samples using Markov chain Monte Carlo techniques. Further, as such studies are generally first-in-man, the safety of patients is paramount. We therefore explore methods for the incorporation of safety considerations into utility functions to ensure that only safe and well-predicted doses are administered. The amalgamation of Bayesian methodology, adaptive design and compound utility functions is termed adaptive Bayesian compound design (ABCD). The performance of this amalgamation of methodology is investigated via the simulation of dose finding studies. The paper concludes with a discussion of results and extensions that could be included into our approach.

Development and evaluation of an integrated clinical learning model to inform continuing education for acute care nurses

Background Significant ongoing learning needs for nurses have occurred as a direct result of the continuous introduction of technological innovations and research developments in the healthcare environment. Despite an increased worldwide emphasis on the importance of continuing education, there continues to be an absence of empirical evidence of program and session effectiveness. Few studies determine whether continuing education enhances or develops practice and the relative cost benefits of health professionals’ participation in professional development. The implications for future clinical practice and associated educational approaches to meet the needs of an increasingly diverse multigenerational and multicultural workforce are also not well documented. There is minimal research confirming that continuing education programs contribute to improved patient outcomes, nurses’ earlier detection of patient deterioration or that standards of continuing competence are maintained. Crucially, evidence-based practice is demonstrated and international quality and safety benchmarks are adhered to. An integrated clinical learning model was developed to inform ongoing education for acute care nurses. Educational strategies included the use of integrated learning approaches, interactive teaching concepts and learner-centred pedagogies. A Respiratory Skills Update education (ReSKU) program was used as the content for the educational intervention to inform surgical nurses’ clinical practice in the area of respiratory assessment. The aim of the research was to evaluate the effectiveness of implementing the ReSKU program using teaching and learning strategies, in the context of organisational utility, on improving surgical nurses’ practice in the area of respiratory assessment. The education program aimed to facilitate better awareness, knowledge and understanding of respiratory dysfunction in the postoperative clinical environment. This research was guided by the work of Forneris (2004), who developed a theoretical framework to operationalise a critical thinking process incorporating the complexities of the clinical context. The framework used educational strategies that are learner-centred and participatory. These strategies aimed to engage the clinician in dynamic thinking processes in clinical practice situations guided by coaches and educators. Methods A quasi experimental pre test, post test non–equivalent control group design was used to evaluate the impact of the ReSKU program on the clinical practice of surgical nurses. The research tested the hypothesis that participation in the ReSKU program improves the reported beliefs and attitudes of surgical nurses, increases their knowledge and reported use of respiratory assessment skills. The study was conducted in a 400 bed regional referral public hospital, the central hub of three smaller hospitals, in a health district servicing the coastal and hinterland areas north of Brisbane. The sample included 90 nurses working in the three surgical wards eligible for inclusion in the study. The experimental group consisted of 36 surgical nurses who had chosen to attend the ReSKU program and consented to be part of the study intervention group. The comparison group included the 39 surgical nurses who elected not to attend the ReSKU program, but agreed to participate in the study. Findings One of the most notable findings was that nurses choosing not to participate were older, more experienced and less well educated. The data demonstrated that there was a barrier for training which impacted on educational strategies as this mature aged cohort was less likely to take up educational opportunities. The study demonstrated statistically significant differences between groups regarding reported use of respiratory skills, three months after ReSKU program attendance. Between group data analysis indicated that the intervention group’s reported beliefs and attitudes pertaining to subscale descriptors showed statistically significant differences in three of the six subscales following attendance at the ReSKU program. These subscales included influence on nursing care, educational preparation and clinical development. Findings suggest that the use of an integrated educational model underpinned by a robust theoretical framework is a strong factor in some perceptions of the ReSKU program relating to attitudes and behaviour. There were minimal differences in knowledge between groups across time. Conclusions This study was consistent with contemporary educational approaches using multi-modal, interactive teaching strategies and a robust overarching theoretical framework to support study concepts. The construct of critical thinking in the clinical context, combined with clinical reasoning and purposeful and collective reflection, was a powerful educational strategy to enhance competency and capability in clinicians.