Maintaining student engagement in a multidisciplinary allied health communication skills course

Effective communication is an important graduate capability for allied health students but there are few opportunities for students to engage with these skills in a dedicated manner at an undergraduate level. This paper reported on the use of active learning and relevance-building strategies to maintain student engagement in a multidisciplinary allied health communication skills course at an Australian university. Students (N = 736) completed an engagement survey during the first and final lecture. While most degree programs reported no difference in engagement across semester, nursing/paramedic students reported a significant decrease in student engagement. A perceived lack of disciplinary relevance may account for student disengagement in this group, illustrating the challenge of delivering an authentic learning experience whilst engaging students from diverse degree programs.

Comparison of active-set method deconvolution and matched-filtering for derivation of an ultrasound transit time spectrum

The quality of ultrasound computed tomography imaging is primarily determined by the accuracy of ultrasound transit time measurement. A major problem in analysis is the overlap of signals making it difficult to detect the correct transit time. The current standard is to apply a matched-filtering approach to the input and output signals. This study compares the matched-filtering technique with active set deconvolution to derive a transit time spectrum from a coded excitation chirp signal and the measured output signal. The ultrasound wave travels in a direct and a reflected path to the receiver, resulting in an overlap in the recorded output signal. The matched-filtering and deconvolution techniques were applied to determine the transit times associated with the two signal paths. Both techniques were able to detect the two different transit times; while matched-filtering has a better accuracy (0.13 μs vs. 0.18 μs standard deviation), deconvolution has a 3.5 times improved side-lobe to main-lobe ratio. A higher side-lobe suppression is important to further improve image fidelity. These results suggest that a future combination of both techniques would provide improved signal detection and hence improved image fidelity.

Muscular activity and fatigue in lower-limb and trunk muscles during different sit-to-stand tests

Sit-to-stand (STS) tests measure the ability to get up from a chair, reproducing an important component of daily living activity. As this functional task is essential for human independence, STS performance has been studied in the past decades using several methods, including electromyography. The aim of this study was to measure muscular activity and fatigue during different repetitions and speeds of STS tasks using surface electromyography in lower-limb and trunk muscles. This cross-sectional study recruited 30 healthy young adults. Average muscle activation, percentage of maximum voluntary contraction, muscle involvement in motion and fatigue were measured using surface electrodes placed on the medial gastrocnemius (MG), biceps femoris (BF), vastus medialis of the quadriceps (QM), the abdominal rectus (AR), erector spinae (ES), rectus femoris (RF), soleus (SO) and the tibialis anterior (TA). Five-repetition STS, 10-repetition STS and 30-second STS variants were performed. MG, BF, QM, ES and RF muscles showed differences in muscle activation, while QM, AR and ES muscles showed significant differences in MVC percentage. Also, significant differences in fatigue were found in QM muscle between different STS tests. There was no statistically significant fatigue in the BF, MG and SO muscles of the leg although there appeared to be a trend of increasing fatigue. These results could be useful in describing the functional movements of the STS test used in rehabilitation programs, notwithstanding that they were measured in healthy young subjects.

A mixed-methods research approach to the review of competency standards for orthotist/prosthetists in Australia

Aim: The requirement for an allied health workforce is expanding as the global burden of disease increases internationally. To safely meet the demand for an expanded workforce of orthotist/prosthetists in Australia, competency based standards, which are up-to-date and evidence-based, are required. The aims of this study were to determine the minimum level for entry into the orthotic/prosthetic profession; to develop entry level competency standards for the profession; and to validate the developed entry-level competency standards within the profession nationally, using an evidence-based approach. Methods: A mixed-methods research design was applied, using a three-step sequential exploratory design, where step 1 involved collecting and analyzing qualitative data from two focus groups; step 2 involved exploratory instrument development and testing, developing the draft competency standards; and step 3 involved quantitative data collection and analysis – a Delphi survey. In stage 1 (steps 1 and 2), the two focus groups – an expert and a recent graduate group of Australian orthotist/prosthetists – were led by an experienced facilitator, to identify gaps in the current competency standards and then to outline a key purpose, and work roles and tasks for the profession. The resulting domains and activities of the first draft of the competency standards were synthesized using thematic analysis. In stage 2 (step 3), the draft-competency standards were circulated to a purposive sample of the membership of the Australian Orthotic Prosthetic Association, using three rounds of Delphi survey. A project reference group of orthotist/prosthetists reviewed the results of both stages. Results: In stage 1, the expert (n = 10) and the new graduate (n = 8) groups separately identified work roles and tasks, which formed the initial draft of the competency standards. Further drafts were refined and performance criteria added by the project reference group, resulting in the final draft-competency standards. In stage 2, the final draft-competency standards were circulated to 56 members (n = 44 final round) of the Association, who agreed on the key purpose, 6 domains, 18 activities, and 68 performance criteria of the final competency standards. Conclusion: This study outlines a rigorous and evidence-based mixed-methods approach for developing and endorsing professional competency standards, which is representative of the views of the profession of orthotist/prosthetists.

Correlación entre la personalidad y los factores de la Teoría del Comportamiento Planeado (TCP) en adolescentes escolarizados de 11-19 años del Caribe Colombiano

The increasing rate of pregnancies in teenagers and the high incident of the infections of sexual transmission (HIV/ AIDS, for example), these are health related issues (and especially the sexual and reproductive health), which have received great attention on the part of investigators and of the public opinion in general. Recently, there has been evidenced that teenagers carry out very easily risk sexual behaviors, and those who have not presented the above mentioned behaviors also show high levels of intention to carry out them. There is the hypothesis that besides cognitive variables such as attitudes, subjective norms, perceived behavioral control and intention, the personality of the young persons is an aspect that plays an important paper in their sexual and reproductive health. Significant correlations were found between the variales of the TPB and the personality traits; the results suggest that the direction of these correlations is associated with the specific type of behavior or situation that is assessed. Keywords: personality, theory of planned behavior, adolescents, reproductive sexuality.

Designing against boredom in automated driving

I draw on four years of experience in mobility and transport research. I was part of a research project with Siemens, for which we identified global trends in urban mobility and explored future business opportunities through scenario planning methods. Some of the proposed solutions for personal and public transport included driverless vehicles. In collaboration with BMW Design I explored the potential of new materials for automotive user interfaces...

Healing gardens in the Lady Cilento Children’s Hospital: Reflections on benefits, preferences and design from bench diaries

Background Interest in the use of healing gardens in healthcare settings to provide therapeutic benefits is increasing, however insight is needed to determine whether patients, patient families and friends, and staff who spend time in these gardens use these in the manner for which they were designed, and experience the benefits suggested by broader research in this field. Objective(s) Visitors to four of the LCCH gardens have left comments in ‘bench diaries’ (visitors books). Analysis of these comments yields valuable insights into the use of the gardens, enabling reflection on the design intent and outcomes and guidance regarding how the gardens might be better utilised, as well as a basis for further investigation into the use and value of the gardens. Method(s) Comments have been coded and analysed using a thematic analysis approach to identify patterns relating to the reasons for which people appear to come to the healing gardens; benefits they appear to receive from spending time there; and features and aspects of the gardens that they appear to appreciate in particular. Only comments related to the gardens have been used in this analysis, with all comments being deidentified. Outcome/Conclusion Comments left in the Adventure Garden and Secret Garden bench diaries were used for the analysis, as Staff Garden and Babies Garden bench diary comments did not relate to the garden. There were no negative comments relating to the gardens, other than one comment requesting additional benches. The vast majority of comments expressed gratitude for the space. The four most frequently observed themes from the comments left in the Secret Garden Bench Diary indicated that they were seeking ‘time out’ from their experiences of being at the hospital, a desire for a ‘dose of nature’ (greenery, beautiful garden, etc), and fresh air, and that the garden space provided a restorative experience to them in some manner. Comments in the Adventure Garden Bench Diary related predominately to the view. Analysis of the comments emphasises the importance of gardens providing multi-sensory experiences that significantly differentiate the space from the hospital ward and provide visitors with a sense of being away, of peacefulness, and of familiarity with the outside world. Positioning gardens with prospect, and solar aspect, appears important in these regards, as does the presence of visible greenery. Adequate seating in locations that provide pleasing views appears particularly important for staff and adult visitors. Whilst comments in the Bench Diaries did not indicate direct awareness of the stress and anxiety-reducing effects that research elsewhere has found from viewing plants and nature, however these effects may underpin many of these experiences that visitors did share.

Through the Colour Lens

Colour is used to adorn and decorate and many have tried to find an organisational system that could concretely states how colour is to be used correctly. In this book Marisha McAuliffe examines the concept of colour and its uses for those who design professionally or those who simply want to appreciate the complexities of colour. It examines light and contrast, and explains the pitfalls that are to be avoided in colour design. The book explores different concepts relating to, and including, colour history, systems and theories, requirements for a colour-based design project, research, and generation of colour schemes so as to create optimal experiences for colour in architecture, interior architecture and design. To fully understand colour, the book ventures into its scientific and ‘non-scientific’ elements compiling key points about its many characteristics. Taken together, this book is a compressive guide for those who seek to work with colour and to tap its enormous potentials for design effect.

Author response: "Missed opportunity related to statistical methods"

"We thank MrGilder for his considered comments and suggestions for alternative analyses of our data. We also appreciate Mr Gilder’s support of our call for larger studies to contribute to the evidence base for preoperative loading with high-carbohydrate fluids..."

Experiences in becoming a paramedic: The professional socialization of university qualified paramedics

In this article, the professional socialization of university educated paramedics from the United Kingdom and Australia is discussed using the anticipatory, formal and post-formal phases of socialization. Participants for this research were from universities and ambulance services in Australia and the United Kingdom, and the data were collected and analyzed by qualitative methods. The anticipatory, formal and post-formal phases were deemed to be relevant to the professional socialization of university paramedics. However a fourth phase, called the post-internship phase was identified which better accounted for the paramedic training and practice model. The findings from this research led to the development of a four phase model of professional socialization to describe the experiences of university educated paramedics making the transition from university students to qualified paramedics.

Assessment and application of clustering techniques to atmospheric particle number size distribution for the purpose of source apportionment

Long-term measurements of particle number size distribution (PNSD) produce a very large number of observations and their analysis requires an efficient approach in order to produce results in the least possible time and with maximum accuracy. Clustering techniques are a family of sophisticated methods which have been recently employed to analyse PNSD data, however, very little information is available comparing the performance of different clustering techniques on PNSD data. This study aims to apply several clustering techniques (i.e. K-means, PAM, CLARA and SOM) to PNSD data, in order to identify and apply the optimum technique to PNSD data measured at 25 sites across Brisbane, Australia. A new method, based on the Generalised Additive Model (GAM) with a basis of penalised B-splines, was proposed to parameterise the PNSD data and the temporal weight of each cluster was also estimated using the GAM. In addition, each cluster was associated with its possible source based on the results of this parameterisation, together with the characteristics of each cluster. The performances of four clustering techniques were compared using the Dunn index and Silhouette width validation values and the K-means technique was found to have the highest performance, with five clusters being the optimum. Therefore, five clusters were found within the data using the K-means technique. The diurnal occurrence of each cluster was used together with other air quality parameters, temporal trends and the physical properties of each cluster, in order to attribute each cluster to its source and origin. The five clusters were attributed to three major sources and origins, including regional background particles, photochemically induced nucleated particles and vehicle generated particles. Overall, clustering was found to be an effective technique for attributing each particle size spectra to its source and the GAM was suitable to parameterise the PNSD data. These two techniques can help researchers immensely in analysing PNSD data for characterisation and source apportionment purposes.

Atmospheric visibility and PM10 as indicators of new particle formation in an urban environment

It is well-known that new particle formation (NPF) in the atmosphere is inhibited by pre-existing particles in the air that act as condensation sinks to decrease the concentration and, thus, the supersaturation of precursor gases. In this study, we investigate the effects of two parameters - atmospheric visibility, expressed as the particle back-scatter coefficient (BSP), and PM10 particulate mass concentration, on the occurrences of NPF events in an urban environment where the majority of precursor gases originate from motor vehicle and industrial sources. This is the first attempt to derive direct relationships between each of these two parameters and the occurrence of NPF. NPF events were identified from data obtained with a neutral cluster and air ion spectrometer over 245 days within a calendar year. Bayesian logistic regression was used to determine the probability of observing NPF as functions of BSP and PM10. We show that the BSP at 08 h on a given day is a reliable indicator of an NPF event later that day. The posterior median probability of observing an NPF event was greater than 0.5 (95%) when the BSP at 08 h was less than 6.8 Mm-1.

Deposition of combustion aerosols in the human respiratory tract : comparison of theoretical predictions with experimental data

Total deposition of petrol, diesel and environmental tobacco smoke (ETS) aerosols in the human respiratory tract for nasal breathing conditions was computed for 14 nonsmoking volunteers, considering the specific anatomical and respiratory parameters of each volunteer and the specific size distribution for each inhalation experiment. Theoretical predictions were 34.6% for petrol, 24.0% for diesel, and 18.5% for ETS particles. Compared to the experimental results, predicted deposition values were consistently smaller than the measured data (41.4% for petrol, 29.6% for diesel, and 36.2% for ETS particles). The apparent discrepancy between experimental data on total deposition and modeling results may be reconciled by considering the non-spherical shape of the test aerosols by diameter-dependent dynamic shape factors to account for differences between mobility-equivalent and volume-equivalent or thermodynamic diameters. While the application of dynamic shape factors is able to explain the observed differences for petrol and diesel particles, additional mechanisms may be required for ETS particle deposition, such as the size reduction upon inspiration by evaporation of volatile compounds and/or condensation-induced restructuring, and, possibly, electrical charge effects.

Cough-generated aerosols of Pseudomonas aeruginosa and other Gram Negative Bacteria from cystic fibrosis patients.

Background: Pseudomonas aeruginosa is the most common bacterial pathogen in cystic fibrosis (CF) patients. Current infection control guidelines aim to prevent transmission via contact and respiratory droplet routes and do not consider the possibility of airborne transmission. We hypothesized that with coughing, CF subjects produce viable, respirable bacterial aerosols. Methods: Cross-sectional study of 15 children and 13 adults with CF, 26 chronically infected with P. aeruginosa. A cough aerosol sampling system enabled fractioning of respiratory particles of different size, and culture of viable Gram negative non-fermentative bacteria. We collected cough aerosols during 5 minutes voluntary coughing and during a sputum induction procedure when tolerated. Standardized quantitative culture and genotyping techniques were used. Results: P. aeruginosa was isolated in cough aerosols of 25 (89%) subjects of whom 22 produced sputum samples. P. aeruginosa from sputum and paired cough aerosols were indistinguishable by molecular typing. In 4 cases the same genotype was isolated from ambient room air. Approximately 70% of viable aerosols collected during voluntary coughing were of particles ≤ 3.3 microns aerodynamic diameter. P. aeruginosa, Burkholderia cenocepacia Stenotrophomonas maltophilia and Achromobacter xylosoxidans were cultivated from respiratory particles in this size range. Positive room air samples were associated with high total counts in cough aerosols (P=0.003). The magnitude of cough aerosols were associated with higher FEV1 (r=0.45, P=0.02) and higher quantitative sputum culture results (r=0.58, P=0.008). Conclusion: During coughing, CF patients produce viable aerosols of P. aeruginosa and other Gram negative bacteria of respirable size range, suggesting the potential for airborne transmission.