Reliability of point-of-care testing of INR in acute stroke

Background In the emergency department, portable point-of-care testing (POCT) coagulation devices may facilitate stroke patient care by providing rapid International Normalized Ratio (INR) measurement. The objective of this study was to evaluate the reliability, validity, and impact on clinical decision-making of a POCT device for INR testing in the setting of acute ischemic stroke (AIS). Methods A total of 150 patients (50 healthy volunteers, 51 anticoagulated patients, 49 AIS patients) were assessed in a tertiary care facility. The INR's were measured using the Roche Coaguchek S and the standard laboratory technique. Results The interclass correlation coefficient and 95% confidence interval between overall POCT device and standard laboratory value INRs was high (0.932 (0.69 - 0.78). In the AIS group alone, the correlation coefficient and 95% CI was also high 0.937 (0.59 - 0.74) and diagnostic accuracy of the POCT device was 94%. Conclusions When used by a trained health professional in the emergency department to assess INR in acute ischemic stroke patients, the CoaguChek S is reliable and provides rapid results. However, as concordance with laboratory INR values decreases with higher INR values, it is recommended that with CoaguChek S INRs in the > 1.5 range, a standard laboratory measurement be used to confirm the results.

A comparison land-water environment of maximal voluntary isometric contraction during manual muscle testing through surface electromyography

Background The aim of this study was to compare through surface electromyographic (sEMG) recordings of the maximum voluntary contraction (MVC) on dry land and in water by manual muscle test (MMT). Method Sixteen healthy right-handed subjects (8 males and 8 females) participated in measurement of muscle activation of the right shoulder. The selected muscles were the cervical erector spinae, trapezius, pectoralis, anterior deltoid, middle deltoid, infraspinatus and latissimus dorsi. The MVC test conditions were random with respect to the order on the land/in water. Results For each muscle, the MVC test was performed and measured through sEMG to determine differences in muscle activation in both conditions. For all muscles except the latissimus dorsi, no significant differences were observed between land and water MVC scores (p = 0.063–0.679) and precision (%Diff = 7–10%) were observed between MVC conditions in the muscles trapezius, anterior deltoid and middle deltoid. Conclusions If the procedure for data collection is optimal, under MMT conditions it appears that comparable MVC sEMG values were achieved on land and in water and the integrity of the EMG recordings were maintained during wáter immersion.

Genetics of path lengths in brain connectivity networks: HARDI-based maps in 457 adults

Brain connectivity analyses are increasingly popular for investigating organization. Many connectivity measures including path lengths are generally defined as the number of nodes traversed to connect a node in a graph to the others. Despite its name, path length is purely topological, and does not take into account the physical length of the connections. The distance of the trajectory may also be highly relevant, but is typically overlooked in connectivity analyses. Here we combined genotyping, anatomical MRI and HARDI to understand how our genes influence the cortical connections, using whole-brain tractography. We defined a new measure, based on Dijkstra's algorithm, to compute path lengths for tracts connecting pairs of cortical regions. We compiled these measures into matrices where elements represent the physical distance traveled along tracts. We then analyzed a large cohort of healthy twins and show that our path length measure is reliable, heritable, and influenced even in young adults by the Alzheimer's risk gene, CLU.

The Step approach to Message Design and Testing (SatMDT): A conceptual framework to guide the development and evaluation of persuasive health messages

This paper provides an important and timely overview of a conceptual framework designed to assist with the development of message content, as well as the evaluation, of persuasive health messages. While an earlier version of this framework was presented in a prior publication by the authors in 2009, important refinements to the framework have seen it evolve in recent years, warranting the need for an updated review. This paper outlines the Step approach to Message Design and Testing (or SatMDT) in accordance with the theoretical evidence which underpins, as well as empirical evidence which demonstrates the relevance and feasibility, of each of the framework’s steps. The development and testing of the framework have thus far been based exclusively within the road safety advertising context; however, the view expressed herein is that the framework may have broader appeal and application to the health persuasion context.

The life of data: Evolving national testing

To this point, the collection has provided research-based, empirical accounts of the various and multiple effects of the National Assessment Program – Literacy and Numeracy (NAPLAN) in Australian schooling as a specific example of the global phenomenon of national testing. In this chapter, we want to develop a more theoretical analysis of national testing systems, globalising education policy and the promise of national testing as adaptive, online tests. These future moves claim to provide faster feedback and more useful diagnostic help for teachers. There is a utopian testing dream that one day adaptive, online tests will be responsive in real time providing an integrated personalised testing, pedagogy and intervention for each student. The moves towards these next generation assessments are well advanced, including the work of Pearson’s NextGen Learning and Assessment research group, the Organization for Economic Co-operation and Development’s (OECD) move into assessing affective skills and the Australian Curriculum, Assessment and Reporting Authority’s (ACARA) decision to phase in NAPLAN as an online, adaptive test from 2017...

National testing from an Australian perspective

Introduction This book examines a pressing educational issue: the global phenomenon of national testing in schooling and its vernacular development in Australia. The Australian National Assessment Program – Literacy and Numeracy (NAPLAN), introduced in 2008, involves annual census testing of students in Years 3, 5, 7 and 9 in nearly all Australian schools. In a variety of ways, NAPLAN affects the lives of Australia’s 3.5 million school students and their families, as well as more than 350,000 school staff and many other stakeholders in education. This book is organised in relation to a simple question: What are the effects of national testing for systems, schools and individuals? Of course, this simple question requires complex answers. The chapters in this edited collection consider issues relating to national testing policy, the construction of the test, usages of the testing data and various effects of testing in systems, schools and classrooms. Each chapter examines an aspect of national testing in Australia using evidence drawn from research. The final chapter by the editors of this collection provides a broader reflection on this phenomenon and situates developments in testing globally...

Local experiences, global similarities: Teacher perceptions of the impacts of national testing

Since 2008, Australian schoolchildren in Years 3, 5, 7 and 9 have sat a series of tests each May designed to assess their attainment of basic skills in literacy and numeracy. These tests are known as the National Assessment Program – Literacy and Numeracy (NAPLAN). In 2010, individual school NAPLAN data were first published on the MySchool website which enables comparisons to be made between individual schools and statistically like schools across Australia. NAPLAN represents the increased centrality of the federal government in education, particularly in regards to education policy. One effect of this has been a recast emphasis of education as an economic, rather than democratic, good. As Reid (2009) suggests, this recasting of education within national productivity agendas mobilises commonsense discourses of accountability and transparency. These are common articles of faith for many involved in education administration and bureaucracy; more and better data, and holding people to account for that data, must improve education...

NAPLAN, MySchool and accountability: Teacher perceptions of the effects of testing

This paper explores Rizvi and Lingard’s (2010) idea of the “local vernacular” of the global education policy trend of using high-stakes testing to increase accountability and transparency, and by extension quality, within schools and education systems in Australia. In the first part of the paper a brief context of the policy trajectory of National Assessment Program – Literacy and Numeracy (NAPLAN) is given in Australia. In the second part, empirical evidence drawn from a survey of teachers in Western Australia (WA) and South Australia (SA) is used to explore teacher perceptions of the impacts a high-stakes testing regime is having on student learning, relationships with parents and pedagogy in specific sites. After the 2007 Australian Federal election, one of Labor’s policy objectives was to deliver an “Education Revolution” designed to improve both the equity and excellence in the Australian school system1 (Rudd & Gillard, 2008). This reform agenda aims to “deliver real changes” through: “raising the quality of teaching in our schools” and “improving transparency and accountability of schools and school systems” (Rudd & Gillard, 2008, p. 5). Central to this linking of accountability, the transparency of schools and school systems and raising teaching quality was the creation of a regime of testing (NAPLAN) that would generate data about the attainment of basic literacy and numeracy skills by students in Australian schools.

The path less travelled: Vertical circulation spaces in apartment buildings in the subtropics

This paper presents data on residents’ use of common stairways and lifts (vertical circulation spaces) in multi-storey apartment buildings (MSABs) in Brisbane, Australia. Vertical movement is a defining aspect of multi-storey living and the energy consumed by lifts contributes significantly to the energy budget of the typical MSAB. The purpose is to investigate whether a reappraisal of vertical circulation design, through the lens of residents’ requirements, might contribute to energy reductions in this building type. Data was gathered on a theoretical sample of MSAB ranging from five decades old to very recent schemes. 90 residents were surveyed about their day-to-day experiences of circulation and access systems. The results showed that residents mainly chose to use the stairs for convenience and exercise. Building management regimes that limited residents’ access to collective spaces were the main impediment to discretionary stair use. Only two buildings did not have fully enclosed stairwells and these had the highest stair usage, suggesting that stair design, and building governance are two areas that might be worthy of attention. The more that circulation design is focussed on limiting access, the less opportunities there are for personal choice, incidental social interaction and casual surveillance of collective spaces. The more that design of vertical circulation spaces in MSAB meets residents’ needs the less likely they are to be reliant on continuous energy supply for normal functioning.

pH testing for detecting the position of nasogastric tubes in adults and children (Intervention Protocol)

This is the protocol for a review and there is no abstract. The objectives are as follows: Our objective is to determine if there is sufficient evidence to recommend the use of pH testing (the intervention under scrutiny) for verification of correct placement of nasogastric tubes in adults and children. To this end, we will attempt to answer the following questions: 1. In adults and children, is pH testing an effective and safe method for determining whether nasogastric tubes are correctly positioned in the stomach before feeding (or delivery of any fluid) begins? 2. What evidence is there about the risk of adverse events in the case of incorrect placement? For this review, pH testing is defined as: litmus paper, pH indicator test strips, pH meters. These will be tested against other methods used for detecting placement of nasogastric tubes, including visual examination of aspirate, auscultation with insufflation of air, detection of air bubbles in a bowl of water, X-ray, ultrasonography, endoscopy, enzyme analysis of aspirate, capnography, and other methods that do not rely on measurement of pH.

Who pays for standardised testing? A cost-benefit study of mandated testing in three Queensland secondary schools

This paper reports on an Australian study that explored the costs and benefits of the National Assessment Programme, Literacy and Numeracy (NAPLAN) testing, both tangible and intangible, of Year 9 students in three Queensland schools. The study commenced with a review of pertinent studies and other related material about standardised testing in Australia, the USA and UK. Information about NAPLAN testing and reporting, and the pedagogical impacts of standardised testing were identified, however little about administrative costs to schools was found. A social constructivist perspective and a multiple case study approach were used to explore the actions of school managers and teachers in three Brisbane secondary schools. The study found that the costs of NAPLAN testing to schools fell into two categories: preparation of students for the testing; and administration of the tests. Whilst many of the costs could not be quantified, they were substantial and varied according to the education sector in which the school operated. The benefits to schools of NAPLAN testing were found to be limited. The findings have implications for governments, curriculum authorities and schools, leading to the conclusion that, from a school perspective, the benefits of NAPLAN testing do not justify the costs.

Myriad genetics: Patent law and genetic testing

This paper considers the legal challenges to the legal validity of the patents held by Myriad Genetics in respect of genetic testing for breast cancer and ovarian cancer. It argues that broad-based patents on gene sequences and medical diagnostics will have a harmful effect upon access to patient care, genetic research, and the administration of public health care.

The path towards greening the Malaysian construction industry

Construction industry contributes significantly to environmental degradation, and governments in many countries which are endeavouring to address the situation. Malaysia is no exception. This paper examines the path towards green construction project delivery in Malaysia, focusing on current green policies and initiatives by governments. The historical waves in Malaysian approaches to tackling environmental issues are described, starting from the early 20th century, through the 1990s to the present, and the influence of these approaches on construction practices is analysed. Based on the findings of policy review, essential green construction practices aimed at mitigating the adverse effects of construction activities on the environment in Malaysia were identified. This paper paves the way for future studies in construction and sustainability in Malaysia, especially for the Southeast Asian region where sustainability practices are urgently needed.