Health communication: A pilot study comparing perceptions of women with and without high functioning autism spectrum disorder

Research indicates significant health disparities for individuals with autism. Insight into characteristic sensory, cognitive, communication, social, emotional, and behavioural challenges that may influence health communication for patients with autism is vital to address potential disparities. Women with high functioning autism spectrum disorder (ASD) may have specific healthcare needs, and are likely to independently represent themselves and others in healthcare. A pilot study compared perceptions of healthcare experiences for women with and without ASD using on-line survey based on characteristics of ASD likely to influence healthcare. Fifty-eight adult female participants (32 with ASD diagnosis, 26 without ASD diagnosis) were recruited on-line from autism support organisations. Perceptions measured included self-reporting of pain and symptoms, healthcare seeking behaviours, the influence of emotional distress, sensory and social anxiety, maternity experiences, and the influence of autistic status disclosure. Results partially support the hypothesis that ASD women experience greater healthcare challenges. Women with ASD reported greater challenges in healthcare anxiety, communication under emotional distress, anxiety relating to waiting rooms, support during pregnancy, and communication during childbirth. Self-disclosure of diagnostic status and lack of ASD awareness by healthcare providers rated as highly problematic. Results offer detailed insight into healthcare communication and disparities for women with ASD.

Using the WWW to teach undergraduate nurses clinical communication

On-line learning is increasingly being used in nursing education. Nevertheless, there is still insufficient evidence to demonstrate: whether students respond positively when this form of learning is used to teach relatively practical or clinical subjects; whether it is effective; and whether it is fair to students with less access to, or familiarity with, computers and the internet. In 2003, an on-line Unit on clinical communication was developed for Australian undergraduate nurses in partnership between an Australian School of Nursing and the a Department of Clinical Psychology. Students were overwhelmingly positive in their evaluation of the Unit although some regretted the lack of face-to-face contact with tutors and peers. The best aspects of the Unit included the content and structure being perceived as interesting, fun and informative, the relevance of the material for them as nurses, flexibility to work independently, promotion of critical thinking and gaining an understanding of client issues. Neither their evaluation nor their final grades were related to students’ age or whether they preferred on-line or traditional learning. Students who had readily available computer access, however, had better final grades. Also, students’ grades were correlated with how often they accessed the Unit.

Portal-based support for mental health research

This paper describes experiences with the use of the Globus toolkit and related technologies for development of a secure portal that allows nationally-distributed Australian researchers to share data and application programs. The portal allows researchers to access infrastructure that will be used to enhance understanding of the causes of schizophrenia and advance its treatment, and aims to provide access to a resource that can expand into the world’s largest on-line collaborative mental health research facility. Since access to patient data is controlled by local ethics approvals, the portal must transparently both provide and deny access to patient data in accordance with the fine-grained access permissions afforded individual researchers. Interestingly, the access protocols are able to provide researchers with hints about currently inaccessible data that may be of interest to them, providing them the impetus to gain further access permissions.

Ongoing Adaptation as a Feature of Complexity : Further Thoughts and Possible Ideas for Pedagogy in Physical Activity

This chapter takes as its central premise the human capacity to adapt to changing environments. It is an idea that is central to complexity theory but receives only modest attention in relation to learning. To do this we will draw from a range of fields and then consider some recent research in motor control that may extend the discussion in ways not yet considered, but that will build on advances already made within pedagogy and motor control synergies. Recent work in motor control indicates that humans have far greater capacity to adapt to the ‘product space’ than was previously thought, mainly through fast heuristics and on-line corrections. These are changes that can be made in real (movement) time and are facilitated by what are referred to as ‘feed-forward’ mechanisms that take advantage of ultra-fast ways of recognizing the likely outcomes of our movements and using this as a source of feedback. We conclude by discussing some possible ideas for pedagogy within the sport and physical activity domains, the implications of which would require a rethink on how motor skill learning opportunities might best be facilitated.

MITIE C-Arm - Advanced innovation in education

Aim: In 2013 QUT introduced the Medical Imaging Training Immersive Environment (MITIE) as a virtual reality (VR) platform that allowed students to practice general radiography. The system software has been expanded to now include C-Arm. The aim of this project was to investigate the use of this technology in the pedagogy of undergraduate medical imaging students who have limited to no experience in the use of the C-Arm clinically. Method: The Medical Imaging Training Immersive Environment (MITIE) application provides students with realistic and fully interactive 3D models of C-Arm equipment. As with VR initiatives in other health disciplines (1–2) the software mimics clinical practice as much as possible and uses 3D technology to enhance 3D spatial awareness and realism. The application allows students to set up and expose a virtual patient in a 3D environment as well as creating the resultant “image” for comparison with a gold standard. Automated feedback highlights ways for the student to improve their patient positioning, equipment setup or exposure factors. The students' equipment knowledge was tested using an on line assessment quiz and surveys provided information on the students' pre-clinical confidence scale, with post-clinical data comparisons. Ethical approval for the project was provided by the university ethics panel. Results: This study is currently under way and this paper will present analysis of initial student feedback relating to the perceived value of the application for confidence in a high risk environment (i.e. operating theatre) and related clinical skills development. Further in-depth evaluation is ongoing with full results to be presented. Conclusion: MITIE C-Arm has a development role to play in the pre-clinical skills training for Medical Radiation Science students. It will augment their theoretical understanding prior to their clinical experience. References 1. Bridge P, Appleyard R, Ward J, Phillips R, Beavis A. The development and evaluation of a virtual radiotherapy treatment machine using an immersive visualisation environment. Computers and Education 2007; 49(2): 481–494. 2. Gunn T, Berry C, Bridge P et al. 3D Virtual Radiography: Development and Initial Feedback. Paper presented at the 10th Annual Scientific Meeting of Medical Imaging and Radiation Therapy, March 2013 Hobart, Tasmania.

Decreasing menopausal symptoms in women undertaking a web-based multi-modal lifestyle intervention: The Women's Wellness Program

Menopausal transition can be challenging for many women. This study tested the effectiveness of an intervention delivered in different modes in decreasing menopausal symptoms in midlife women. The Women's Wellness Program (WWP) intervention was delivered to 225 Australian women aged between 40 and 65 years through three modes (i.e., on-line independent, face-to-face with nurse consultations, and on-line with virtual nurse consultations). All women in the study were provided with a 12-week Program Book outlining healthy lifestyle behaviors while women in the consultation groups were supported by a registered nurse who provide tailored health education and assisted with individual goal setting for exercise, healthy eating, smoking and alcohol consumption. Pre- and post-intervention data were collected on menopausal symptoms (Greene Climacteric Scale), health related quality of life (SF12), and modifiable lifestyle factors. Linear mixed-effect models showed an average 0.87 and 1.23 point reduction in anxiety (p < 0.01) and depression scores (p < 0.01) over time in all groups. Results also demonstrated reduced vasomotor symptoms (β = −0.19, SE = 0.10, p = 0.04) and sexual dysfunction (β = −0.17, SE = 0.06, p < 0.01) in all participants though women in the face-to-face group generally reported greater reductions than women in the other groups. This lifestyle intervention embedded within a wellness framework has the potential to reduce menopausal symptoms and improve quality of life in midlife women thus potentially enhancing health and well-being in women as they age. Of course, study replication is needed to confirm the intervention effects.

Design and control of MIRA: A lightweight climbing robot for ship inspection

The inspection of marine vessels is currently performed manually. Inspectors use tools (e.g. cameras and devices for non-destructive testing) to detect damaged areas, cracks, and corrosion in large cargo holds, tanks, and other parts of a ship. Due to the size and complex geometry of most ships, ship inspection is time-consuming and expensive. The EU-funded project INCASS develops concepts for a marine inspection robotic assistant system to improve and automate ship inspections. In this paper, we introduce our magnetic wall–climbing robot: Marine Inspection Robotic Assistant (MIRA). This semiautonomous lightweight system is able to climb a vessels steel frame to deliver on-line visual inspection data. In addition, we describe the design of the robot and its building subsystems as well as its hardware and software components.

Why are haemodialysis nurses satisfied also experiencing burnout?

Background Haemodialysis nurses work in a technological environment caring for patients over a prolonged period of time leading to the development of unique nurse-patient relationships. In order to improve retention of nurses in this specialised area of nursing it is important to know the factors that affect job satisfaction, stress and burnout and understand how these experiences are conceptualised by haemodialysis nurses. Aim To explore the factors contributing to satisfaction with the work environment, job satisfaction, job stress and burnout in haemodialysis nurses in Australia and New Zealand. Method A quantitative dominant sequential explanatory mixed method design was used. Quantitative data was collected using an on-line questionnaire containing demographic questions and pre-existing instruments examining job satisfaction, stress, burnout and satisfaction with the work environment. The qualitative phase involved semi-structured interviews. Results 417 nurses completed the questionnaire. Overall, nurses were satisfied with their work environment and the job that they performed but there were stressors in the haemodialysis setting that led to high levels of burnout. Key themes emerged from the qualitative data related to the physical environment, intensity of nurse-patient relationships, workloads, and coping with death and dying. The qualitative findings also provide possible explanations for the high level of burnout identified in the quantitative findings. Conclusion Explanation of areas where specific nurse and patient outcomes were affected will support the development of appropriate interventions to sustain a work environment conducive to job satisfaction that also alleviates stress and burnout in these nurses.

A blended learning approach to the teaching of professional practice in architecture

This paper reports on a number of blended learning activities conducted in two subjects of a Master of Architecture degree at a major Australian university. The subjects were related to “professional practice” and as such represent a little researched area of architectural curriculum. The research provides some insight into the student perceptions of learning opportunity and engagement associated with on-line delivery modes. Students from these two subjects were surveyed for their perceptions about the opportunity for learning afforded by the on-line components, and also for their perceived level of engagement. Responses to these perceptions of traditional and on-line modes of delivery are compared and analysed for significant differences. While students were generally positive in response to the learning experiences, analysis of the results shows that students found the traditional modes to assist in their learning significantly more than on-line modes. Students were neutral regarding the opportunity for engagement that on-line modes provided. Analysis of the students’ gender, age and hours of paid work was also conducted to ascertain any relationship with attitudes to the flexibility of on-line delivery; no significant relationship was detected. This study has shown that students were generally resistant to on-line engagement opportunities and their ability to support learning.

Let's do it: A framework to investigate the affordances of experimental learning environments

BACKGROUND Experimental learning, traditionally conducted in on-campus laboratory venues, is the cornerstone of science and engineering education. In order to ensure that engineering graduates are exposed to ‘real-world’ situations and attain the necessary professional skill-sets, as mandated by course accreditation bodies such as Engineers Australia, face-to-face laboratory experimentation with real equipment has been an integral component of traditional engineering education. The online delivery of engineering coursework endeavours to mimic this with remote and simulated laboratory experimentation. To satisfy student and accreditation requirements, the common practice has been to offer equivalent remote and/or simulated laboratory experiments in lieu of the ones delivered, face-to face, on campus. The current implementations of both remote and simulated laboratories tend to be specified with a focus on technical characteristics, instead of pedagogical requirements. This work attempts to redress this situation by developing a framework for the investigation of the suitability of different experimental educational environments to deliver quality teaching and learning. PURPOSE For the tertiary education sector involved with technical or scientific training, a research framework capable of assessing the affordances of laboratory venues is an important aid during the planning, designing and evaluating stages of face-to-face and online (or cyber) environments that facilitate student experimentation. Providing quality experimental learning venues has been identified as one of the distance-education providers’ greatest challenges. DESIGN/METHOD The investigation draws on the expertise of staff at three Australian universities: Swinburne University of Technology (SUT), Curtin University (Curtin) and Queensland University of Technology (QUT). The aim was to analyse video recorded data, in order to identify the occurrences of kikan-shido (a Japanese term meaning ‘between desks instruction’ and over-the-shoulder learning and teaching (OTST/L) events, thereby ascertaining the pedagogical affordances in face-to-face laboratories. RESULTS These will be disseminated at a Master Class presentation at this conference. DISCUSSION Kikan-shido occurrences did reflect on the affordances of the venue. Unlike with other data collection methods, video recorded data and its analysis is repeatable. Participant bias is minimised or even eradicated and researcher bias tempered by enabling re-coding by others. CONCLUSIONS Framework facilitates the identification of experiential face-to-face learning venue affordances. Investigation will continue with on-line venues.

Structure matters: Adoption of structured classification Approach in the context of cognitive presence classification

Within online learning communities, receiving timely and meaningful insights into the quality of learning activities is an important part of an effective educational experience. Commonly adopted methods – such as the Community of Inquiry framework – rely on manual coding of online discussion transcripts, which is a costly and time consuming process. There are several efforts underway to enable the automated classification of online discussion messages using supervised machine learning, which would enable the real-time analysis of interactions occurring within online learning communities. This paper investigates the importance of incorporating features that utilise the structure of on-line discussions for the classification of "cognitive presence" – the central dimension of the Community of Inquiry framework focusing on the quality of students' critical thinking within online learning communities. We implemented a Conditional Random Field classification solution, which incorporates structural features that may be useful in increasing classification performance over other implementations. Our approach leads to an improvement in classification accuracy of 5.8% over current existing techniques when tested on the same dataset, with a precision and recall of 0.630 and 0.504 respectively.

Examining novice education: What can we learn from a compulsory program delivered to both mature-age and young pre-learner licence drivers?

This paper reports results from a qualitative evaluation of a compulsory pre-Learner driver education program within the Australian Capital Territory(ACT), Australia. Two methods were used to obtain feedback from those involved in the delivery of the program as well as those who participated in programs. The first, semi-structured interviews, was undertaken with class room teachers who run the program in their schools, group facilitators running the program with more mature-age students at private facilities (n = 15 in total), and former participants in both school-based and private-based versions of the program (n = 19). The second method used an on-line survey for students (n = 79). Results from both methods were consistent with each other, indicating that strengths of the program were perceived as being its interactive components and the high level of engagement of the target audience. There was strong support from young and mature-age students for the program to remain compulsory. However, consistent with other findings on novice driver education, mature-age participants identified that the program was less relevant to them. It may be that to have greater relevance to mature-age learners, content could address and challenge perceptions about behaviours other than intentional high-risk behaviours (e.g. low level speeding, fatigue) as well as encourage planning/strategies to avoid them. While a longer term, outcome focussed, evaluation of the pre-learner education program is needed, this study suggests that the program is well received by pre-licence drivers and that teachers and facilitators perceive it as both effective and beneficial.

Haemodialysis work environment contributors to job satisfaction and stress: A sequential mixed methods study

Background: Haemodialysis nurses form long term relationships with patients in a technologically complex work environment. Previous studies have highlighted that haemodialysis nurses face stressors related to the nature of their work and also their work environments leading to reported high levels of burnout. Using Kanters (1997) Structural Empowerment Theory as a guiding framework, the aim of this study was to explore the factors contributing to satisfaction with the work environment, job satisfaction, job stress and burnout in haemodialysis nurses. Methods: Using a sequential mixed-methods design, the first phase involved an on-line survey comprising demographic and work characteristics, Brisbane Practice Environment Measure (B-PEM), Index of Work Satisfaction(IWS), Nursing Stress Scale (NSS) and the Maslach Burnout Inventory (MBI). The second phase involved conducting eight semi-structured interviews with data thematically analyzed. Results: From the 417 nurses surveyed the majority were female (90.9 %), aged over 41 years of age (74.3 %), and 47.4 % had worked in haemodialysis for more than 10 years. Overall the work environment was perceived positively and there was a moderate level of job satisfaction. However levels of stress and emotional exhaustion (burnout) were high. Two themes, ability to care and feeling successful as a nurse, provided clarity to the level of job satisfaction found in phase 1. While two further themes, patients as quasi-family and intense working teams, explained why working as a haemodialysis nurse was both satisfying and stressful. Conclusions: Nurse managers can use these results to identify issues being experienced by haemodialysis nurses working in the unit they are supervising.

Podiatry scope of practice: The role of gender in identification as a specialist

Background Ensuring efficient and effective delivery of health care to an aging population has been a major driver for a review of the health workforce in Australia. As part of this review a new National Registration and Accreditation Scheme (NRAS) has evolved with one goal being to improve workforce flexibility. With increased flexibility there have been discussions about the role specialist scopes of practice plays. This study explored the role of gender and other work related characteristics in relation to contemporary scope of podiatry practice and specialisation in Australia. Methods A cross sectional survey was administered through an on-line survey tool on behalf of the Australasian Podiatry Council. Descriptive data was collected over a three-week period. Queensland University of Technology Human Research Ethics approval was sought and confirmed exemption from review, exemption number 1400000791. Results Of the podiatrists participating in this survey (n=218), they were predominately female (66%), early career (34%, 0-9 years) and work in private practices (78%) in multi-podiatrists centres (41%). Relationship between clinical activities performed and “self-perception” of performing a “specialist role” was significant for practitioners who undertook treatment of specific patient groups. The largest area of interest was biomechanics (n=65), followed closely by diabetes (n=61), a third area identified was paediatrics (n=26). Self-perception of specialist status was compared with gender, years of experience, location, primary work environment and clinical practice. When practitioners are asked to categorise themselves to be either “generalist” or “specialist/ generalist with a special interest” podiatrist, male gender was identified as being the only factor which would predict perception of status; 64% males identified as specialist, as opposed to 49% of female survey respondents (Chi square, df = 1, P = 0.044). Self-perception of specialist status was not explained by years of experience, location, working in rural versus urban environment, state worked in, or part-time/full-time work status. Conclusions In conclusion; gender, work environment plus area of interest form a complex relationship, which appear to influence both perception and reality of service provision. Incorporation of specialisation activity (surgical podiatry along with endorsement for use of scheduled medicines) will have lasting impact on the scope of the podiatry profession in Australia. To meet community expectation and maintain high standards, the addition of new subspecialties may be indicated.