Aggressive surgical interventions for severe stroke: Impact on quality of life, caregiver burden and family outcomes

Introduction: Decompressive hemicraniectomy, clot evacuation, and aneurysmal interventions are considered aggressive surgical therapeutic options for treatment of massive cerebral artery infarction (MCA), intracerebral hemorrhage (ICH), and severe subarachnoid hemorrhage (SAH) respectively. Although these procedures are saving lives, little is actually known about the impact on outcomes other than short-term survival and functional status. The purpose of this study was to gain a better understanding of personal and social consequences of surviving these aggressive surgical interventions in order to aid acute care clinicians in helping family members make difficult decisions about undertaking such interventions. Methods: An exploratory mixed method study using a convergent parallel design was conducted to examine functional recovery (NIHSS, mRS & BI), cognitive status (Montreal Cognitive Assessment Scale, MoCA), quality of life (Euroqol 5-D), and caregiver outcomes (Bakas Caregiver Outcome Scale, BCOS) in a cohort of patients and families who had undergone aggressive surgical intervention for severe stroke between the years 2000–2007. Data were analyzed using descriptive statistics, univariate and multivariate analysis of variance, and multivariate logistic regression. Content analysis was used to analyze the qualitative interviews conducted with stroke survivors and family members. Results: Twenty-seven patients and 13 spouses participated in this study. Based on patient MOCA scores, overall cognitive status was 25.18 (range 23.4-26.9); current functional outcomes scores: NIHSS 2.22, mRS 1.74, and BI 88.5. EQ-5D scores revealed no significant differences between patients and caregivers (p=0.585) and caregiver outcomes revealed no significant differences between male/female caregivers or patient diagnostic group (MCA, SAH, ICH; p=""0.103).<"/span><"/span> Discussion: Overall, patients and families were satisfied with quality of life and decisions made at the time of the initial stroke. There was consensus among study participants that formal community-based support (e.g., handibus, caregiving relief, rehabilitation assessments) should be continued for extended periods (e.g., years) post-stroke. Ongoing contact with health care professionals is valuable to help them navigate in the community as needs change over time.

Embedding sustainability in a real-world context: Developing a world class early learning centre

This symposium describes what is possible when early childhood professionals work with designers to develop a vision for an exemplary early childhood centre with a focus on Education for Sustainability (EfS). The symposium provides insights into cross-disciplinary initiatives between QUT Early childhood and Design staff and students, who have worked together with the iconic Lone Pine Koala Sanctuary in Brisbane, to explore imperatives around EfS, including leadership and professionalism. This practical, real world project has seen all stakeholders engage in a focus on sustainability which has opened new ways of thinking about early childhood centre design. Cross-disciplinarity has created space to re-think the potential of the disciplines to interweave, and in so doing opened different ways for thinking about early childhood centres – their operation and their function. For the first time in Queensland, this project creates strategic alliances between EfS, childcare, business and sustainable design. EfS is essential for addressing local and global environmental issues and early childhood EfS research has been gaining international momentum, with governments nominating this area as having significant capacity to empower communities and promote change. While models for collaboration exist in the early childhood programs in Reggio Emilia, we offer sustainability as a unique and contemporary focus with immense potential to generate international and national interest. To date Early Childhood degree students enrolled in a leadership and management unit/subject have worked collaboratively with Design students to explore the sustainable design of the proposed Lone Pine early childhood centre. Providing students with a ‘real world’ project sees them re-positioned from ‘novice’ to ‘professional’, where their knowledge, expertise and perspectives are simultaneously validated and challenged. These learning experiences are enabling students to practice a new model of early childhood leadership, one that is vital for leading in an increasingly complex world. The symposium will be comprised of three discrete, though interconnected presentations, that work together to tell the story of this project. Three key facets of the project will be explored during the 90 minute session, as the perspectives of key stakeholders are shared. The first presentation (A/Prof Julie Davis, Dr Lyndal O’Gorman& Dr Megan Gibson) will outline the role of QUT School of Early Childhood staff and students, with attention to the ways in which the project was embedded in students’ work in the final year of their degree program of study. The second presentation (Ms Lindy Osborne) will provide insights into the Design students’ collaborative work in the project. Finally, the key role of the Lone Pine Koala Sanctuary and their commitment for EfS (Ms Peta Wilson & Dr Sue Elliott) will map out the philosophy that underpins the project. Together, the authors will conclude key project outcomes that have been achieved through this real-world, cross-disciplinary work.

An exploratory investigation of the practice of assessment for learning in Vietnamese higher education: Three case studies of lecturers' practice

In response to limited research conducted on the practice of assessment for learning (AfL) in higher education and in Asian educational settings, this qualitative study, using sociocultural theories of learning and a multiple case study approach, investigates how AfL was implemented by three lecturers in one Vietnamese university. Findings revealed that the lecturers engaged with AfL principles and practices to some extent. However, despite the lecturers' significant efforts, Vietnamese sociocultural factors such as respect for harmony, hierarchy, and examination-oriented learning, impacted on their practice of AfL. This study therefore argues that AfL requires adaptation for it to be effective in the Vietnamese tertiary context.

Cost and outcomes of assessing patients with chest pain in an Australian emergency department

Objectives: We sought to characterise the demographics, length of admission, final diagnoses, long-term outcome and costs associated with the population who presented to an Australian emergency department (ED) with symptoms of possible acute coronary syndrome (ACS). Design, setting and participants: Prospectively collected data on ED patients presenting with suspected ACS between November 2008 and February 2011 was used, including data on presentation and at 30 days after presentation. Information on patient disposition, length of stay and costs incurred was extracted from hospital administration records. Main outcome measures: Primary outcomes were mean and median cost and length of hospital stay. Secondary outcomes were diagnosis of ACS, other cardiovascular conditions or non-cardiovascular conditions within 30 days of presentation. Results: An ACS was diagnosed in 103 (11.1%) of the 926 patients recruited. 193 patients (20.8%) were diagnosed with other cardiovascular-related conditions and 622 patients (67.2%) had non-cardiac-related chest pain. ACS events occurred in 0 and 11 (1.9%) of the low-risk and intermediate-risk groups, respectively. Ninety-two (28.0%) of the 329 high-risk patients had an ACS event. Patients with a proven ACS, high-grade atrioventricular block, pulmonary embolism and other respiratory conditions had the longest length of stay. The mean cost was highest in the ACS group ($13 509; 95% CI, $11 794–$15 223) followed by other cardiovascular conditions ($7283; 95% CI, $6152–$8415) and non-cardiovascular conditions ($3331; 95% CI, $2976–$3685). Conclusions: Most ED patients with symptoms of possible ACS do not have a cardiac cause for their presentation. The current guideline-based process of assessment is lengthy, costly and consumes significant resources. Investigation of strategies to shorten this process or reduce the need for objective cardiac testing in patients at intermediate risk according to the National Heart Foundation and Cardiac Society of Australia and New Zealand guideline is required.

The identification of teaching interactions used in one-to-one teaching of number in the early years of schooling

This research paper reports on phase one of an investigation of video recorded intensive one-to-one teaching interactions with 6–7-year-old students who were in their second year of schooling in Australia and identified by the their teacher as low attaining in early number. The two-phased study from which this paper emerges was originally conducted in 1998 as part of my Bachelor of Teaching Honours (Research) program at Southern Cross University Lismore, New South Wales. That study identified teaching interactions particularly suited to one-to-one teaching in the Maths Recovery Program, a program designed for these students who were at risk of failure in early number. Since that time a great deal has not changed with limited literature available that comprehensively reports on teaching interactions in intensive one-to-one settings. Revisiting the original study is considered timely given the increasing number of withdrawal and intensive programs now funded and adopted by schools and yet, rarely reported on in terms of the effectiveness of the teaching interactions that occur in such settings. This paper then presents a discussion of a preliminary series of teaching interactions that either positively and or negatively influence an intensive one-to-one teaching and learning setting

“Come in and look around.” Professional development of student teachers through public pedagogy in a library exhibition

This paper describes a public pedagogy project embedded into "The Global Teacher", a subject within the Bachelor of Education program for student teachers at an Australian university. The subject provides a global perspective on socio-political issues that shape education. In 2013, The Global Teacher introduced an approach that asked student teachers to create a museum-style exhibition depicting six global education themes. This exhibition was displayed in the State Library and the public were invited to engage with the installations and the student teachers who created them. Our paper describes how the project was implemented by means of close collaboration between the QUT teacher educators, curators at the State Library of Queensland (SLQ), and student groups working on visually translating their understandings of global educational issues into a public exhibition. We discuss what was learned by our students and ourselves, as teacher educators, by engaging in this public pedagogy.

Designing experiences with wearables : A case study exploring the blurring boundaries of art, design, technology, culture and distance

This paper details a workshop aimed at exploring opportunities for experience design through wearable art and design concepts. Specifically it explores the structure of the workshop with respect to facilitating learning through technology in the development of experiential wearable art and design. A case study titled Cloud Workshop: Wearables and Wellbeing; Enriching connections between citizens in the Asia-Pacific region was initiated through a cooperative partnership between Hong Kong Baptist University (HKBU), Queensland University of Technology (QUT) and Griffith University (GU). Digital technologies facilitated collaboration through an inter-disciplinary, inter-national and inter- cultural approach (Facer & Sandford, 2010) between Australia and Hong Kong. Students cooperated throughout a two-week period to develop innovative wearable concepts blending art, design and technology. An unpacking of the approach, pedagogical underpinning and final outcomes revealed distinct educational benefits as well as certain learning and technological challenges of the program. Qualitative feedback uncovered additional successes with respect to student engagement and enthusiasm, while uncovering shortcomings in the delivery and management of information and difficulties with cultural interactions. Potential future versions of the program aim to take advantage of the positives and overcome the limitations of the current pedagogical approach. It is hoped the case study will become a catalyst for future workshops that blur the boundaries of art, design and technology to uncover further benefits and potentials for new outcomes in experience design.

Understanding the heterogeneity of entrepreneurship education: going beyond Gartner

This paper seeks to draw attention to the importance of appreciating and using ever-present diversity to achieve increased legitimacy for entrepreneurship education. As such, it aims to draw the reader into a reflective process of discovery as to why entrepreneurship education is important and how such importance can be prolonged. Design/methodology/approach - The paper revisits Gartner's 1985 conceptual framework for understanding the complexity of entrepreneurship. The paper proposes an alternative framework based on the logic of Gartner's framework to advance the understanding of entrepreneurship education. The authors discuss the dimensions of the proposed framework and explain the nature of the dialogic relations contained within. Findings - It is argued that the proposed conceptual framework provides a new way to understand ever-present heterogeneity related to the development and delivery of entrepreneurship education. Practical implications - The paper extends an invitation to the reader to audit their own involvement and proximity to entrepreneurship education. It argues that increased awareness of the value that heterogeneity plays in student learning outcomes and programme branding is directly related to the presence of heterogeneity across the dimensions of the conceptual framework. Originality/value - The paper introduces a simple yet powerlu1 means of understanding what factors contribute to the success or otherwise of developing and delivering entrepreneurship education. The simplicity of the approach suggested provides all entrepreneurship educators with the means to audit all facets of their programme.

Enterprise education: Learning through personal experience

This paper outlines the development of a reflective process through which student feelings are brought to the surface to advance their learning outcomes. A key notion in relation to the capacity of student development is the ability of students to alter their collective habits of thought and in turn the nature of the learning environment. The paper examines student reflection in the context of students' heightened awareness of self and their potential influence on their environment. The notion of 'surfacing feelings' is used to describe the outcome of individual and group reflection through which several parties become aware of the active reflections of individual students, thereby increasing the potential depth of overall reflection. Finally, the author considers the transferability of the ideas discussed to other educational contexts.

Best practice full-stop: Anticipating the spillover effects of enterprise education

This paper considers the potential flow-on benefits that may arise from the increasing provision of enterprise education. The issue of vulnerability is proposed to be a factor associated with superior learning outcomes. Therefore, this paper aims to highlight the use of student and facilitator vulnerability to increase the capacity for learning in Higher Education. It is argued that students benefit from having to struggle to find their identity within a learning environment. That group work can assist the development of confidence through which improved learning behaviours are adopted. Also, the development of good learning practices in the domain of enterprise education have the potential to aid student learning outcomes in other areas of study. This paper provides another means of valuing the potential gains to be received from enterprise education.

Tutoring with higher mathematics and the use of technology

We discuss three approaches to the use of technology as a teaching and learning tool that we are currently implementing for a target group of about one hundred second level engineering mathematics students. Central to these approaches is the underlying theme of motivating relatively poorly motivated students to learn, with the aim of improving learning outcomes. The approaches to be discussed have been used to replace, in part, more traditional mathematics tutorial sessions and lecture presentations. In brief, the first approach involves the application of constructivist thinking in the tertiary education arena, using technology as a computational and visual tool to create motivational knowledge conflicts or crises. The central idea is to model a realistic process of how scientific theory is actually developed, as proposed by Kuhn (1962), in contrast to more standard lecture and tutorial presentations. The second approach involves replacing procedural or algorithmic pencil-and-paper skills-consolidation exercises by software based tasks. Finally, the third approach aims at creating opportunities for higher order thinking via "on-line" exploratory or discovery mode tasks. The latter incorporates the incubation period method, as originally discussed by Rubinstein (1975) and others.

R U there yet? using virtual classrooms to transform teaching practice

Access to quality higher education is challenging for many Western Australians that live outside the metropolitan area. In 2010, the School of Education moved to flexible delivery of a fully online Bachelor of Education degree for their non -metropolitan students. The new model of delivery allows access for students from any location provided they have a computer and an internet connection. A number of academic staff had previously used an asynchronous environment to deliver learning modules housed within a learning management system (LMS) but had not used synchronous software with their students. To enhance the learning environment and to provide high quality learning experiences to students learning at a distance, the adoption of synchronous software (Elluminate Live) was introduced. This software is a real-time virtual classroom environment that allows for communication through Voice over Internet Protocol (VoIP) and videoconferencing, along with a large number of collaboration tools to engage learners. This research paper reports on the integration of a live e-learning solution into the current LMS environment. Qualitative data were collected from academic staff through informal interviews and participant observation. The findings discuss (i) perceived level of support; (ii) identification of strategies used to create an effective online teacher presence; (iii) the perceived impact on the students' learning outcomes; and (iv) guidelines for professional development to enhance pedagogy within the live e-learning environment.

Rethinking connectedness : an investigation into the access of teacher professional learning in regional and remote Western Australia

Many teachers working in remote and regional areas have limited access to collegial support networks. This research aimed to examine the existing strategies that were being undertaken by the Department of Education in Western Australia, to provide professional learning to teachers in regional and remote areas. It was important to establish the perceptions of teachers’ access to professional learning from those working at the coalface in geographically dispersed areas. Consequently, the possible opportunity for improving the amount and variety of professional learning, through the application of both synchronous and asynchronous technologies was proposed. The study was guided by the primary research question: “In what ways might technology be used to support professional development of regional and remote teachers in Western Australia?” Generating descriptions of current practice of professional learning along with the teacher perceptions were central to this research endeavour. The study relied on a mixed method research approach in order to attend to the research question. The data were collected in phases, referred to as an explanatory mixed methods design. Quantitative data were collected from 104 participants to provide a general picture of the research problem. To further refine this general picture, qualitative data were collected through interviews and e-interviews of 10 teachers. Participants in the study included graduate teachers, teachers who had taught more than two years, senior teachers and Level Three teachers from seven teaching districts within Western Australia. An investigation into current practice was included in this phase and technologies available to support a professional learning community over distance were documented. The final phase incorporated the formulation of a conceptual framework where a model was developed to facilitate the successful implementation of a professional learning community through the application of synchronous and asynchronous technologies. The study has identified that travel time in order to access professional development is significant and impacts on teachers’ personal time. There are limited relief teachers available in these isolated areas which impacts on the opportunities to access professional development. Teachers face inequities, in terms of promotion, because professional development is explicitly linked to promotional opportunities. Importantly, it was found that professional learning communities are valued, but are often limited by small staff numbers at the geographic locality of the school. Teachers preferred to undertake professional learning in the local context of their district, school or classroom and this professional learning must be established at the need of the individual teacher in line with the school priorities. Teachers reported they were confident in using technology and accessing professional development online if required, however, much uncertainty surrounded the use of web 2.0 technologies for this purpose. The recommendations made from the study are intended to identify how a professional learning community might be enhanced through synchronous and asynchronous technologies.

The logic of data-sense: Thinking through Learning Personalisation

Big Data and Learning Analytics’ promise to revolutionise educational institutions, endeavours, and actions through more and better data is now compelling. Multiple, and continually updating, data sets produce a new sense of ‘personalised learning’. A crucial attribute of the datafication, and subsequent profiling, of learner behaviour and engagement is the continual modification of the learning environment to induce greater levels of investment on the parts of each learner. The assumption is that more and better data, gathered faster and fed into ever-updating algorithms, provide more complete tools to understand, and therefore improve, learning experiences through adaptive personalisation. The argument in this paper is that Learning Personalisation names a new logistics of investment as the common ‘sense’ of the school, in which disciplinary education is ‘both disappearing and giving way to frightful continual training, to continual monitoring'.

With the best of intentions: A critical discourse analysis of HPE curriculum materials

Much of physical education curriculum in the developed world and specifically in Australia tends to be guided in principle by syllabus documents that represent, in varying degrees, some form of government education priorities. Through the use of critical discourse analysis we analyze one such syllabus example (an official syllabus document of one of the Australian States) to explore the relationships between the emancipatory/social justice expectations presented in the rubric of and introduction to the official syllabus document, and the language details of learning outcomes that indicate how the expectations might be satisfied. Given the complexity and multilevel pathways of message systems/ideologies we question the efficacy of such documents oriented around social justice principles to genuinely deliver more radical agendas which promote social change and encourage a preparedness to engage in social action leading to a betterment of society.