Preventing physical activity induced heat illness in school settings

The climatic conditions of tropical and subtropical regions within Australia present, at times, extreme risk of physical activity induced heat illness. Many administrators and teachers in school settings are aware of the general risks of heat related illness. In the absence of reliable information applied at the local level, there is a risk that inappropriate decisions may be made concerning school events that incorporate opportunities to be physically active. Such events may be prematurely cancelled resulting in the loss of necessary time for physical activity. Under high or extremely high risk conditions however, the absence of appropriate modifications or continuation could place the health of students, staff and other parties at risk. School staff and other key stakeholders should understand the mechanisms of escalating risk and be supported to undertake action to reduce the level of risk through appropriate policies, procedures, resources and action plans.

Staff perspectives of a cardiology short stay unit

Objective To evaluate staff perceptions about working environment, efficiency and the clinical safety of a cardiovascular intervention short stay unit (SSU) during the first year of operation. Design Postal questionnaire. Setting Cardiac catheterisation laboratory (CCL), coronary care unit (CCU), general cardiology ward (GCW) and the short stay unit (SSU) of a tertiary referral hospital situated in the mid coastal region of NSW. Subjects Cardiologists (including visiting medical officers [VMO]), cardiology fellows, cardiology advanced trainees and nurses. Results Responses on the working environment of the SSU and the discharge process were statistically significant. A substantial proportion of both nurses and doctors had concerns about patient safety, even though no adverse events were formally recorded in the database. Conclusions Though the participants of the survey agree on the efficiency of the SSU in providing beds to the hospital, they disagree on aspects that are important in the functioning of the SSU, including the working environment, patient selection and clinical safety. The results highlight potential issues that could be improved or addressed and are relevant to the rollout of SSUs across NSW.

Growing demand for emergency health services in Queensland, Australia

Introduction: The demand for emergency health services (EHS), both in the prehospital (ambulance) and hospital (emergency departments) settings, is growing rapidly in Australia. Broader health system changes have reduced available health infrastructure, particularly hospital beds, resulting in reduced access to and congestion of the EHS as demonstrated by longer waiting times and ambulance “ramping”. Ambulance ramping occurring when patients have a prolonged wait on the emergency vehicle due to the unavailability of hospital beds. This presentation will outline the trends in EHS demand in Queensland compared with the rest of Australia and factors that appear to be contributing to the growth in demand. Methods: Secondary analysis was conducted using data from publicly available sources. Data from the Queensland Ambulance Service and Queensland Health Emergency Department Information System (EDIS) also were analyzed. Results: The demand for ambulance services and emergency departments has been increasing at 8% and 4% per year over the last decade, respectively; while accessible hospital beds have reduced by almost 10% contributing to the emergency department congestion and possibly contributing to the prehospital demand. While the increase in the proportion of the elderly population seems to explain a great deal of the demand for EHS, other factors also influence this growth including patient characteristics, institutional and societal factors, economic, EHS arrangements, and clinical factors. Conclusions: Overcrowding of facilities that provide EHS are causing considerable community concern. This overcrowding is caused by the growing demand and reduced access. The causes of this growing demand are complex, and require further detailed analysis in order to quantify and qualify these causes in order to provide a resilient foundation of evidence for future policy direction.

Using Trauma Injury Severity Score (TRISS) variables to predict length of hospital stay following trauma in New Zealand

Aim – To develop and assess the predictive capabilities of a statistical model that relates routinely collected Trauma Injury Severity Score (TRISS) variables to length of hospital stay (LOS) in survivors of traumatic injury. Method – Retrospective cohort study of adults who sustained a serious traumatic injury, and who survived until discharge from Auckland City, Middlemore, Waikato, or North Shore Hospitals between 2002 and 2006. Cubic-root transformed LOS was analysed using two-level mixed-effects regression models. Results – 1498 eligible patients were identified, 1446 (97%) injured from a blunt mechanism and 52 (3%) from a penetrating mechanism. For blunt mechanism trauma, 1096 (76%) were male, average age was 37 years (range: 15-94 years), and LOS and TRISS score information was available for 1362 patients. Spearman’s correlation and the median absolute prediction error between LOS and the original TRISS model was ρ=0.31 and 10.8 days, respectively, and between LOS and the final multivariable two-level mixed-effects regression model was ρ=0.38 and 6.0 days, respectively. Insufficient data were available for the analysis of penetrating mechanism models. Conclusions – Neither the original TRISS model nor the refined model has sufficient ability to accurately or reliably predict LOS. Additional predictor variables for LOS and other indicators for morbidity need to be considered.

Re-imagining school through young people’s drawings

Children’s drawings provide rich qualitative data (Walker, 2008) and “valuable information for the assessment of children's environmental perceptions” (Barraza, 1999, p. 49). They are the primary data source being used to re-imagine school from a student perspective (Schratz & Steiner-Löffler, 1998) in a research project being carried out with primary school students in Queensland, Australia. This paper will report on the progress of this project which addresses a mostly unmet need for students’ perspectives to be included in school design (Rudduck & Flutter, 2004). Grade 5/6 students in a number of primary schools have been invited to submit annotated drawings with up to 200 words of text illustrating their ideal educational spaces. Using purpose-designed analytical tools, the submissions will be compared across student backgrounds and school types to obtain a better understanding of the needs and educational desires of young people in relation to changing learning environments. The findings will inform consideration of the design and use of educational spaces with all work exhibited through a dedicated website. The term ‘educational spaces’ avoids restrictive notions of what the concept of ‘school’ means, referring to any real or virtual space in which teaching and learning may occur or, as Ferguson and Seddon (2007) have referred to it, “the shifting imagery of education” that includes red brick schools and dispersed learning networks. The theoretical framework for this study is grounded in the work of Greene (1995) and Wright-Mills (2001) who cited the deployment of critical and empathic imagination in addressing education reform.

Using a longitudinal model to estimate the effect of methicillin-resistant staphylococcus aureus infection on length of stay in an intensive care unit

Healthcare-associated methicillin-resistant Staphylococcus aureus(MRSA) infection may cause increased hospital stay or, sometimes, death. Quantifying this effect is complicated because it is a time-dependent exposure: infection may prolong hospital stay, while longer stays increase the risk of infection. We overcome these problems by using a multinomial longitudinal model for estimating the daily probability of death and discharge. We then extend the basic model to estimate how the effect of MRSA infection varies over time, and to quantify the number of excess ICU days due to infection. We find that infection decreases the relative risk of discharge (relative risk ratio = 0.68, 95% credible interval: 0.54, 0.82), but is only indirectly associated with increased mortality. An infection on the first day of admission resulted in a mean extra stay of 0.3 days (95% CI: 0.1, 0.5) for a patient with an APACHE II score of 10, and 1.2 days (95% CI: 0.5, 2.0) for a patient with an APACHE II score of 30. The decrease in the relative risk of discharge remained fairly constant with day of MRSA infection, but was slightly stronger closer to the start of infection. These results confirm the importance of MRSA infection in increasing ICU stay, but suggest that previous work may have systematically overestimated the effect size.

Homework for refugee middle school students with backgrounds marked by low levels of engagement with English school literacy

Homework presents many challenges for refugees from Africa who are arriving in Australian schools with histories of little, no or severely interrupted schooling. This is evident in the emergence of school- and community-based homework help, clubs and tutoring programs for the students. The aim of this article is to describe the homework support options accessed by eight students from Burundi, Rwanda, Eritrea and Sudan who participated in a study of pedagogy for middle school-aged African refugees, and the views on homework of their parents and teachers. The article shows some tensions between family and school expectations and the dilemmas that arise for teachers in a broader context of public concern about and official policy statement on excessive and repetitive homework. It is argued that application of policy guidelines needs to account for disadvantages that potentially accrue to students who cannot design their own independent study programs. Further, it is suggested that integration of skills and meaning-based pedagogy inherent in recent approaches to literacy education has potential for ensuring that students receive the forms of homework they require.

Integrating engineering education in the middle school mathematics curriculum

Many nations are experiencing a decline in the number of graduating engineers, an overall poor preparedness for engineering studies in tertiary institutions, and a lack of diversity in the field. Given the increasing importance of mathematics, science, engineering, and technology in our world, it is imperative that we foster an interest and drive to participate in engineering from an early age. This discuission paper argues for the intergration of engineering education within the elementary and middle school mathematics curricula. In doing so, we offer a definition of engineering education and address its core goals; consider some perceptions of engineering and engineering education held by teachers and students; and offer one approach to promoting engineering education within the elementary and middle school mathematics curriculum, namely through mathematical modeling.

Integrating engineering model eliciting activities in elementary school curricula

This paper argues for a future-oriented, inclusion of Engineering Model Eliciting Activities (EngMEAs) in elementary mathematics curricula. In EngMEAs students work with meaningful engineering problems that capitalise on and extend their existing mathematics and science learning, to develop, revise and document powerful models, while working in groups. The models developed by six groups of 12-year students in solving the Natural Gas activity are presented. Results showed that student models adequately solved the problem, although student models did not take into account all the data provided. Student solutions varied to the extent students employed the engineering context in their models and to their understanding of the mathematical concepts involved in the problem. Finally, recommendations for implementing EngMEAs and for further research are discussed.

Introducing Engineering Education in the Middle School

This paper first describes a new three-year, longitudinal project that is implementing engineering education in three middle schools in Australia (grade levels 7-9). This important domain is untapped in Australia. Hence, as a starting point, we conducted a context analysis to help situate engineering education in a school system. We report on this analysis with respect to findings from one of two literature-based surveys that gathered middle-school student responses in mathematics (n=172) and science (n=166) towards understanding their dispositions for engineering education. ANOVA indicated gender differences for 3 out of 23 items in both mathematics and science. In addition, the majority of students agreed or strongly agreed with 17 of the 23 survey items, however, there were some differences between mathematics and science. We conclude the paper with some recommendations for establishing engineering education in schools, including the development of partnerships among engineering and education faculties, school systems, and industry to develop contemporary engineering resources to support school-level mathematics, science, and technology.

How well are Australian children doing in the first year of school?

Background: The transition to school is a sensitive period for children in relation to school success. In the early school years, children need to develop positive attitudes to school and have experiences that promote academic, behavioural and social competence. When children begin school there are higher expectations of responsibility and independence and in the year one class, there are more explicit academic goals for literacy and numeracy and more formal instruction. Most importantly, children’s early attitudes to learning and learning styles have an impact on later educational outcomes. Method: Data were drawn from The Longitudinal Study of Australian Children (LSAC). LSAC is a cross-sequential cohort study funded by the Australian Government. In these analyses, Wave 2 (2006) data for 2499 children in the Kindergarten Cohort were used. Children, at Wave 2, were in the first year of formal school. They had a mean age of 6.9 years (SD= 0.26). Measures included a 6-item measure of Approaches to Learning (task persistence, independence) and the Academic Rating Scales for language and literacy and mathematical thinking. Teachers rated their relationships with children on the short form of the STRS. Results: Girls were rated by their teachers as doing better than boys on Language and literacy, Approaches to learning; and they had a better relationship with their teacher. Children from an Aboriginal or Torres Strait Island (ATSI) background were rated as doing less well on Language and Literacy and Mathematical thinking and on their Approaches to learning. Children from high Socio Economic Position families are doing better on teacher rated Language and Literacy, Mathematical thinking, Approaches to learning and they had a better relationship with their teacher. Conclusions: Findings highlight the importance of key demographic variables in understanding children’s early school success.

Breastfeeding experiences of Japanese women living in Perth, Australia

The aim of this study was to document the breastfeeding practices of Japanese-Australian mothers living in Perth. A cross-sectional survey of mothers who had delivered babies in Japan or Australia or both was carried out on a sample of 163 mothers recruited through Japanese social and cultural groups in Perth and by a 'snowball' technique. Factors involved in the decision to breastfeed were analysed using multivariate regression analysis. The main outcome measures were the initiation and duration of breastfeeding and cultural beliefs about breastfeeding. Breastfeeding initiation rates of the Japanese- Australian mothers in Japan and in Australia were higher than for other Australians and are consistent with breastfeeding rates in Japan. In Australia, 65% of Japanese-Australian mothers were still breastfeeding at six months. The most common reason for the decision to cease breastfeeding was 'insufficient breastmilk'. The significant factors in breastfeeding duration were 'the time the infant was introduced to infant formula', 'the time when the feeding decision was made', 'doctors support breastfeeding' and 'the mother received enough help from hospital staff'; these were positively associated with the duration of breastfeeding. Japanese mothers take a lot of notice of advice given by health professionals about infant feeding practices.

Using SITDRM for Privacy Rights Management

SITDRM 1 is a privacy protection system that protects private data through the enforcement of MPEG REL licenses provided by consumers. Direct issuing of licenses by consumers has several usability problems that will be mentioned in this paper. Further, we will describe how SITDRM incorporates P3P language to provide a consumer-centered privacy protection system.

Problem solving in a middle school robotics design classroom

Little research has been conducted on how students work when they are required to plan, build and evaluate artefacts in technology rich learning environments such as those supported by tools including flow charts, Labview programming and Lego construction. In this study, activity theory was used as an analytic tool to examine the social construction of meaning. There was a focus on the effect of teachers’ goals and the rules they enacted upon student use of the flow chart planning tool, and the tools of the programming language Labview and Lego construction. It was found that the articulation of a teacher’s goals via rules and divisions of labour helped to form distinct communities of learning and influenced the development of different problem solving strategies. The use of the planning tool flow charting was associated with continuity of approach, integration of problem solutions including appreciation of the nexus between construction and programming, and greater educational transformation. Students who flow charted defined problems in a more holistic way and demonstrated more methodical, insightful and integrated approaches to their use of tools. The findings have implications for teaching in design dominated learning environments.

Effects and feasibility of a multi-disciplinary orientation program for newly registered cancer patients : design of a randomised controlled trial

Background Diagnosis and treatment of cancer can contribute to psychological distress and anxiety amongst patients. Evidence indicates that information giving can be beneficial in reducing patient anxiety, so oncology specific information may have a major impact on this patient group. This study investigates the effects of an orientation program on levels of anxiety and self-efficacy amongst newly registered cancer patients who are about to undergo chemotherapy and/or radiation therapy in the cancer care centre of a large tertiary Australian hospital. Methods The concept of interventions for orienting new cancer patients needs revisiting due to the dynamic health care system. Historically, most orientation programs at this cancer centre were conducted by one nurse. A randomised controlled trial has been designed to test the effectiveness of an orientation program with bundled interventions; a face-to-face program which includes introduction to the hospital facilities, introduction to the multi-disciplinary team and an overview of treatment side effects and self care strategies. The aim is to orientate patients to the cancer centre and to meet the health care team. We hypothesize that patients who receive this orientation will experience lower levels of anxiety and distress, and a higher level of self-efficacy. Discussion An orientation program is a common health care service provided by cancer care centres for new cancer patients. Such programs aim to give information to patients at the beginning of their encounter at a cancer care centre. It is clear in the literature that interventions that aim to improve self-efficacy in patients may demonstrate potential improvement in health outcomes. Yet, evidence on the effects of orientation programs for cancer patients on self-efficacy remains scarce, particularly with respect to the use of multidisciplinary team members. This paper presents the design of a randomised controlled trial that will evaluate the effects and feasibility of a multidisciplinary orientation program for new cancer patients.