Blood cultures for assessment of postoperative fever in arthroplasty patients

Postoperative fever in arthroplasty patients is common. The value of diagnostic workup of fever in this instance is of questionable utility. Studies have shown that blood cultures in this scenario add little to clinical management, but sample sizes have been small and the use of blood cultures in this setting continues. This study aimed to examine the value of blood cultures in the assessment of postoperative fever in a large arthroplasty population. The medical records of 101 patients who had 141 blood culture sets taken during a 2-year period were retrospectively analyzed. Of the 141 blood culture sets, only 2 returned positive results. These were both thought to be as a result of skin contamination at the time of venipuncture. No infectious sequelae occurred in either patient. We conclude that blood cultures have no role to play in the assessment of the febrile, otherwise asymptomatic arthroplasty patient in the early postoperative period.

Assessment of preterm infants' readiness to commence breastfeeding

Preterm infants commence breastfeeding when health-care professionals deem them to be ready. However, the optimal timing for commencement of breastfeeding is unclear. Currently, there is little guidance for neonatal care providers to decide when to initiate breastfeeding among preterm infants. A mixed-methods study was conducted to develop and test the Preterm Sucking Readiness (PTSR) scale in four phases. The first phase involved a chart audit to explore the use of age as a criterion by investigating when preterm infants meet feeding milestones as well as other factors that may affect an infant’s readiness to engage in nutritive sucking behaviour. The second phase utilised focus groups to explore and define how neonatal care providers decide when to commence breastfeeding. To gain consensus on the criteria mentioned by the focus groups, a Delphi survey was conducted in phase 3, involving neonatal providers across Australia and New Zealand. Phase 4 of the study involved an observational study that was used to test the six-item PTSR. The age at which specific feeding milestones were reached was consistent with what has been previously described in the literature. The chart audit showed that the time taken to the first feeding attempt in the preterm infant population was affected by gestational age at birth, birth weight, and specific interventions. Staff also considered age along with other criteria when deciding when to initiate feeding. Consensus on nine criteria for inclusion into the six-item PTSR was achieved using the Delphi technique. Three items of PTSR showed significant differences between the preterm and fullterm infant groups. Only two items, feeding-readiness behaviour and low pulse oximetry during handling, explained the variance in breastfeeding behaviour. The inter-rater variability ranged between moderate and very good for the PTSR items. The results of this study indicate the importance of assessing behavioural cues as an indication of breastfeeding readiness in the preterm infant population, once an infant is deemed physiologically stable. Age continues to be a factor in some clinicians' decisions to commence breastfeeding. However, age alone cannot be used to decide if an infant is ready to engage in breastfeeding. Further research is needed to confirm these findings.

Towards an understanding of teacher judgement in the context of social moderation

Social moderation involves teachers gathering together to discuss their judgements of the quality of student work and to reach agreement regarding the standard awarded. This qualitative study conducted over a three-year period investigated the social practice of moderation and the influence on teachers’ judgements of students work. An initial survey of teachers’ understandings of moderation and standards, pre-interviews of teachers who participated in the moderation meetings, observations of these meetings with a particular focus on one teacher (focus teachers) comprised the data collection methods. Data analysis involved organising, matching, coding, identifying patterns and themes using a constant comparative method. Socio-cultural theories of learning and assessment underpinned the approach to data analysis and proved helpful in explaining the diverse influences on teachers’ judgements beyond the task criteria, and the progressive development of shared understandings through engaging in professional discussions of students’ work. The study revealed that the process is not clear and linear and is influenced by factors such as the representation of the standards and the knowledge base of the teachers.

The Biodex Isokinetic Dynamometer for knee strength assessment in children : advantages and limitations

Objective: To critically appraise the Biodex System 4 isokinetic dynamometer for strength assessment of children. Methods: Appraisal was based on experiences from two independent laboratories involving testing of 213 children. Issues were recorded and the manufacturer was consulted regarding appropriate solutions. Results: The dynamometer had insufficient height adjustment for alignment of the knee for some children, requiring the construction of padding to better fit the child within the dynamometer. Potential for entrapment of the non-testing leg was evident in the passive and eccentric modes and a leg bracket restraint was constructed. Automated gravity correction did not operate when protocols were linked or data was exported to an external device. Conclusions: Limitations were noted, some of which were applicable to knee strength testing in general and others which were specific to use with children. However, most of these obstacles could be overcome, making the Biodex System 4 suitable for assessment of knee strength in children.

Affiliation, autonomy and assessment for learning

Assessment for Learning (AfL) is an international assessment area of interest, yet, during 20 years of AfL research, the desired outcome of increased learner autonomy remains elusive. This article analyses AfL practices in classrooms as students negotiated identities as autonomous learners within a classroom community of practice. A sociocultural theoretical framework in formed the analysis of three case studies conducted in Queensland middle school classrooms. Key findings include the importance of the teacher–student relationship, viewing AfL as patterns of participation that develop expertise, and learner autonomy as a negotiated learner identity within each classroom context.

Cyberbullying : a threat to student mental health and wellbeing

Cyberbullying is a threat to student mental health and wellbeing. As predicted the consequences of cyberbullying have been shown to be more detrimental to students than traditional bullying because of the wider audience and the 24/7 nature of this form of bullying. It is becoming an increasingly vexatious problem for victims, students who bully, educators and parents. Parents and the community are turning to schools to provide preventative strategies and to manage incidents of cyberbullying. Some sections of the community believe there is a technological solution to the problem, or that the law should be overhauled to address the problem more effectively. However, bullying is a deeply embedded social relationship problem, of which cyberbullying is one form. Therefore, planned prevention and intervention strategies need to be considered in the context of the social relationships in the whole school community.

Developing the Pattern and Structure Assessment (PASA) interview to inform early mathematics learning

The Pattern and Structure Mathematical Awareness Program(PASMAP) stems from a 2-year longitudinal study on students’ early mathematical development. The paper outlines the interview assessment the Pattern and Structure Assessment(PASA) designed to describe students’ awareness of mathematical pattern and structure across a range of concepts. An overview of students’ performance across items and descriptions of their structural development are described.

Capstones : transitions and professional identity

The literature identifies transition as a key objective for capstone experiences. Capstones should take account of the particular needs of final year students by assisting them to transition from their student to their professional identity. The authors are currently completing an Australian Learning and Teaching Council (ALTC) funded project, “Curriculum Renewal in Legal Education: articulating final year curriculum design principles and a final year program”, which seeks to achieve curriculum renewal for legal education in the Australian context through the articulation of a set of curriculum design principles for the final year and the design of a transferable model for an effective final year program. The project has investigated the contemporary role of capstones in assisting transition out by reviewing the relevant literature and considering feedback from a project reference group, a final year student focus group and a recent graduate’s focus group. Analysis of this extensive research- and evidence-base suggests that capstone experiences should support transition through: • Assisting students to develop a sense of professional identity; • Consolidating students’ lifelong learning skills; • Providing opportunities for consolidation of career development and planning processes; • Enabling students to enhance professional skills and competencies; and • Preparing students as ethical citizens and leaders. This paper will examine the role of capstones in assisting students to transition to their professional identity and will propose learning and teaching approaches and assessment of learning methods that support transition out.

Cracking the code : a checklist to complement CRAs for first year Justice students

It is well recognised in the literature on first year higher education that there is a need for Universities to provide further support and development in student learning skills and engagement. Assessment and feedback is an area with differing expectations and understandings among academics and students (e.g. AUSSE, CEQ). Consistency and explicitness in academic feedback is fundamental in assisting students in their transition to university education and learning. This poster captures the progress of an 18 month funded by the Faculty of Law Teaching and Learning Grant scheme (QUT). The project sought to develop and trial an assessment checklist/diagnostic tool to accompany Criteria Referenced Assessment sheets for students within the School of Justice, Law Faculty, Queensland University of Technology (QUT).The checklist was trialled across four units in the School of Justice (Law faculty) amongst an estimated cohort of over 600 students undertaking single and dual degrees.

Influences on student learning in engineering : some results from case study fieldwork

This paper closely examines factors affecting students’ progression in their engineering programs through fieldwork conducted at three Australian universities. To extract clues on how specific teaching methods can be used to maximize learning, the investigation considered factors such as understanding how students take in, process and present information. A number of focus groups were conducted with students and the data gathered was combined with survey results of students’ and academics’ learning styles. The paper reports on the process followed, and provides some analysis of the gathered data, as part of an Australian Learning and Teaching Council, ALTC, Associate Fellowship program.

Post-operative CT assessment of interbody fusion two years after thoracoscopic scoliosis surgery

The relationship between radiologic union and clinical outcome in thoracoscopic scoliosis surgery is not clear, as apparent non-union of a spinal fusion does not always correspond to a poor clinical result. The aim of this study was to evaluate CT fusion rates 2yrs after thoracoscopic surgery, and to explore the relationship between fusion scores and rod diameter, graft type, fusion level, implant failure, and lateral position in the disc space. This study suggests that moderate fusion scores secure successful clinical outcomes in thoracoscopic scoliosis surgery.