Enhancing the use of Internet and Web services for quality learning : an action research

Internet and Web services have been used in both teaching and learning and are gaining popularity in today’s world. E-Learning is becoming popular and considered the latest advance in technology based learning. Despite the potential advantages for learning in a small country like Bhutan, there is lack of eServices at the Paro College of Education. This study investigated students’ attitudes towards online communities and frequency of access to the Internet, and how students locate and use different sources of information in their project tasks. Since improvement was at the heart of this research, an action research approach was used. Based on the idea of purposeful sampling, a semi-structured interview and observations were used as data collection instruments. 10 randomly selected students (5 girls and 5 boys) participated in this research as the controlled group. The study findings indicated that there is a lack of educational information technology services, such as e-learning at the college. Internet connection being very slow was the main barrier to learning using e-learning or accessing Internet resources. There is a strong relationship between the quality of written task and the source of the information, and between Web searching and learning. The source of information used in assignments and project work is limited to books in the library which are often outdated and of poor quality. Project tasks submitted by most of the students were of poor quality.

Diffusion of business improvement processes in manufacturing companies in India

Manufacturing organisations spend more on Business Process Improvement initiatives to make them more competitive in growing global market. This paper presents a Rapid Improvement Workshop (RIW) framework which companies can used to identify the critical factors regulating the diffusion of business process improvement in their company. The framework can then be used address how process improvement can be efficiently implemented. We use the results from case studies at Caterpillar India. The paper identifies the critical factors that contribute to the successful implementation of process improvement programs in manufacturing organisations. We further identify certain technological and cultural barriers to the implementation of process improvement programs and how Indian manufacturing companies can overcome these barriers to attain competitive advantage in the global markets.

Children of substance-using mothers : child health engagement and child protection outcomes

Aim: Maternal substance use has been associated with a range of child risk factors. The study investigated the relationship between engagement with child health services and child protection outcomes for children of substance using mothers. ----- ----- Methods: A sample of 119 children of mothers who disclosed opiate, amphetamine or methadone use during a maternity admission between 2000 and 2003, as included in a previous matched co-hort study1, were included in the current study. Statutory child protection agency and child health engagement information for the first two years of life, was obtained. The relationship between type of maternal substance use, child health engagement and child protection outcomes was examined. ----- ----- Results: Seventy two percent of study group infants were engaged with child health services during the first two years of life. Chi square analysis showed no significant relationship between child health engagement and child protection reports. Child health engagement was associated with decreased substantiated child protection notifications for children of methadone using mothers, but not for children of illicit substance users. ----- ----- Conclusions: Almost a quarter of identified children of substance using mothers are not accessing standard child health services in their first two years of life. This study provides support for increased attention to the provision of child health services for children of methadone using mothers. Further research into effective intervention strategies for children of illicit substance using mothers is indicated.

Validation and automation of the DYNJAWS component module of the BEAMnrc Monte Carlo code

The purpose of this work is to validate and automate the use of DYNJAWS; a new component module (CM) in the BEAMnrc Monte Carlo (MC) user code. The DYNJAWS CM simulates dynamic wedges and can be used in three modes; dynamic, step-and-shoot and static. The step-and-shoot and dynamic modes require an additional input file defining the positions of the jaw that constitutes the dynamic wedge, at regular intervals during its motion. A method for automating the generation of the input file is presented which will allow for the more efficient use of the DYNJAWS CM. Wedged profiles have been measured and simulated for 6 and 10 MV photons at three field sizes (5 cm x 5 cm , 10 cm x10 cm and 20 cm x 20 cm), four wedge angles (15, 30, 45 and 60 degrees), at dmax and at 10 cm depth. Results of this study show agreement between the measured and the MC profiles to within 3% of absolute dose or 3 mm distance to agreement for all wedge angles at both energies and depths. The gamma analysis suggests that dynamic mode is more accurate than the step-and-shoot mode. The DYNJAWS CM is an important addition to the BEAMnrc code and will enable the MC verification of patient treatments involving dynamic wedges.

The effects of ambulance ramping on Emergency Department length of stay and mortality

Background: Ambulance ramping within the Emergency Department (ED) is a common problem both internationally and in Australia. Previous research has focused on various issues associated with ambulance ramping such as access block, ED overcrowding and ambulance bypass. However, limited research has been conducted on ambulance ramping and its effects on patient outcomes. ----- ----- Methods: A case-control design was used to describe, compare and predict patient outcomes of 619 ramped (cases) vs. 1238 non-ramped (control) patients arriving to one ED via ambulance from 1 June 2007 to 31 August 2007. Cases and controls were matched (on a 1:2 basis) on age, gender and presenting problem. Outcome measures included ED length of stay and in-hospital mortality. ----- ----- Results: The median ramp time for all 1857 patients was 11 (IQR 6—21) min. Compared to nonramped patients, ramped patients had significantly longer wait time to be triaged (10 min vs. 4 min). Ramped patients also comprised significantly higher proportions of those access blocked (43% vs. 34%). No significant difference in the proportion of in-hospital deaths was identified (2%vs. 3%). Multivariate analysis revealed that the likelihood of having an ED length of stay greater than eight hours was 34% higher among patients who were ramped (OR 1.34, 95% CI 1.06—1.70, p = 0.014). In relation to in-hospital mortality age was the only significant independent predictor of mortality (p < 0.0001). ----- ----- Conclusion: Ambulance ramping is one factor that contributes to prolonged ED length of stay and adds additional strain on ED service provision. The potential for adverse patient outcomes that may occur as a result of ramping warrants close attention by health care service providers.

Understanding speeding in school zones in Malaysia and Australia using an extended Theory of Planned Behaviour : the potential role of mindfulness

Speeding in school zones is a problem in both Malaysia and Australia. While there are differences between the countries in terms of school zone treatments and more generally, these differences do not explain why people choose to speed in school zones. Because speeding is usually an intentional behaviour, the Theory of Planned Behaviour (TPB) has been used to understand speeding and develop interventions, however it has limitations which can be addressed by extending the model to incorporate other constructs. One promising construct is mindfulness, which can improve the explanatory value of the TPB by taking into account unintentional speeding attributable to a lack of focus on important elements of the driving environment. We explain what mindfulness is (and is not), how it can assist in providing a better understanding of speeding in school zones, and how it can contribute to the development of interventions. We then outline a program of research which has been commenced, investigating the contribution of mindfulness to an understanding of speed choice in school zones in two different settings (Australia and Malaysia) using the TPB.

iRAP Malaysia training course : decade of action for road safety

The International Road Assessment Program (iRAP) is a not-for-profit organisation that works in partnership with governments and non-government organisations in all parts of the world to make roads safe. The iRAP Malaysia pilot study on 3700km of road identified the potential to prevent 31,800 deaths and serious injuries over the next 20 years from proven engineering improvements. To help ensure the iRAP data and results are available to planners and engineers, iRAP, together with staff from the Centre for Accident Research and Road Safety – Queensland (CARRS-Q) and the Malaysian Institute of Road Safety Research (MIROS), developed a five-day iRAP training course that covers the background, theory and practical application of iRAP protocols, with a special focus on Malaysian case studies. Funding was provided by a competitive grant from the Australia-Malaysia Institute.

Comparison of intraocular pressure measurement between rebound, non-contact and Goldmann applanation tonometry in treated glaucoma patients

Background: To compare the intraocular pressure readings obtained with the iCare rebound tonometer and the 7CR non-contact tonometer with those measured by Goldmann applanation tonometry in treated glaucoma patients. Design: A prospective, cross sectional study was conducted in a private tertiary glaucoma clinic. Participants: 109 (54M:55F) patients including only eyes under medical treatment for glaucoma. Methods: Measurement by Goldmann applanation tonometry, iCare rebound tonometry and 7CR non-contact tonometry. Main Outcome Measures: Intraocular pressure. Results: There were strong correlations between the intraocular pressure measurements obtained with Goldmann and both the rebound and non-contact tonometers (Spearman r values ≥ 0.79, p < 0.001). However, there were small, statistically significant differences between the average readings for each tonometer. For the rebound tonometer, the mean intraocular pressure was slightly higher compared to the Goldmann applanation tonometer in the right eyes (p = 0.02), and similar in the left eyes (p = 0.93) however these differences did not reach statistical significance. The Goldmann correlated measurements from the noncontact tonometer were lower than the average Goldmann reading for both right (p < 0.001) and left (p > 0.01) eyes. The corneal compensated measurements from the non-contact tonometer were significantly higher compared to the other tonometers (p ≤ 0.001). Conclusions: The iCare rebound tonometer and the 7CR non-contact tonometer measure IOP in fundamentally different ways to the Goldmann applanation tonometer. The resulting IOP values vary between the instruments and will need to be considered when comparing clinical versus home acquired measurements.

The challenge of working in mental health settings: perceptions of newly graduated occupational therapists

Working in mental health settings is a growing area of practice for occupational therapists. The work nowadays is mostly within the community, where occupational therapists may be found in a wide variety of teams. This study investigated the specific challenges that new graduate occupational therapists are faced with when commencing work in a mental health setting. One-to-one semi-structured interviews were carried out with 15 newly graduated occupational therapists, working in mental health settings in south-east Queensland. The interview transcripts were analysed using a consensual qualitative research approach. Three domains were identified from the transcripts. The first related to the ideas of the participants about the skills and knowledge needed by new graduates commencing mental health practice; the second related to the extent to which undergraduate studies had prepared them for practice; and the third related to the means by which they acquired capacity to practise and overcame deficits in skills and knowledge. The core ideas and themes associated with these domains are examined and the implications of the findings for education and training and for orientation to practice are discussed.

The development of an observation tool for use with parents with psychiatric disability and their preschool children

Community-based treatment and care of people with psychiatric disabilities has meant that they are now more likely to engage in the parenting role. This has led to the development of programs designed to enhance the parenting skills of people with psychiatric disabilities. Evaluation of these programs has been hampered by a paucity of evaluation tools. This study's aim was to develop and trial a tool that examined the parent-child interaction within a group setting, was functional and easy to use, required minimum training and equipment, and had acceptable levels of reliability and validity. The revised tool yielded a single scale with acceptable reliability. It had discriminative validity and concurrent validity with non-independent global ratings of parenting. Sensitivity to change was not investigated. The findings suggest that this method of evaluating parenting is likely to have both clinical and research utility and further investigation of the psychometric properties of the tool is warranted.

Integration of CENA practice standards for postgraduate emergency nursing assessment

The use of professional competency standards to assess postgraduate nursing student’s clinical performance has been in place since 2004, at the Queensland University of Technology, School of Nursing & Midwifery (SONAM) when the Graduate Certificate in Emergency Nursing degree commenced. Emergency nursing students were assessed in their workplace, using a Clinical Performance Appraisal Tool or CPAT which was based on the Australian College of Critical Care Nurses (ACCCN) Competency Standards. With the subsequent formation of a separate Emergency Nursing Course advisory group in 2007, there was a review of clinical assessment course component. The release of the 2008 CENA revised Practice Standards for the Emergency Nursing Specialist’s, led to the emergency nursing course advisory committee supporting the integration of the CENA practice standards for assessment of emergency nurses in preference to the less relevant ACCCN competency standards. The SONAM emergency nursing study area team commenced the phasing in and progression of the CENA practice standards across the two Graduate Certificate units, and Graduate Diploma and Master of Nursing (emergency) clinical major options in 2009. As some units undertaken in the degree are available to nurses in other disciplines a separate CPAT was devised for the clinical assessments according to speciality context. The team has had to carefully consider how the professional standards are integrated into the teaching and assessment of the unit and not just applied instead of the ACCCN competency standards. Professional standards for the emergency context has also helped tailor course content and learning outcomes to be relevant across a number of emergency nursing contexts in Australia. The assessment of the CPAT is undertaken at the workplace by QUT appointed clinical lecturers. Clinical lecturers need to apply and have suitable postgraduate qualification to undertake the position. The clinical lecturer support role is well established at QUT. The integration of the new CENA practice standards has necessitated a review of the postgraduate assessment of emergency nurses. A clinical lecturer workshop has been organised to review role, scope and how to utilise the new look CENA based CPAT, clinical assessment format.

Comparison of Kenz Lifecorder EX and ActiGraph accelerometers in 10-yr-old children

A new accelerometer, the Kenz Lifecorder EX (LC; Suzuken Co. Ltd, Nagoya, Japan), offers promise as a feasible monitor alternative to the commonly used Actigraph (AG: Actigraph LLC, Fort Walton Beach, FL). Purpose: This study compared the LC and AG accelerometers and the Yamax SW-200 pedometer (DW) under free-living conditions with regard to children's steps taken and time in light-intensity physical activity (PA) and moderate to vigorous PA (MVPA). Methods: Participants (N = 31, age = 10.2 ± 0.4 yr) wore LC, AG, and DW monitors from arrival at school (7:45 a.m.) until they went to bed. Time in light and MVPA intensities were calculated using two separate intensity classifications for the LC (LC_4 and LC_5) and four classifications for the AG (AG_Treuth, AG_Puyau, AG_Trost, and AG_Freedson). Both accelerometers provided steps as outputs. DW steps were self-recorded. Repeated-measures ANOVA was used to assess overlapping monitor outputs. Results: There was no difference between DW and LC steps (Δ = 200 steps), but a nonsignificant trend was observed in the pairwise comparison between DW and AG steps (Δ = 1001 steps, P = 0.058). AG detected significantly greater steps than the LC (Δ = 801 steps, P = 0.001). Estimates of light-intensity activity minutes ranged from a low of 75.6 ± 18.4 min (LC_4) to a high of 309 ± 69.2 min (AG_Treuth). Estimates of MVPA minutes ranged from a low of 25.9 ± 9.4 min (LC_5) to a high of 112.2 ± 34.5 min (AG_Freedson). No significant differences in MVPA were seen between LC_5 and AG_Treuth (Δ = 4.9 min) or AG_Puyau (Δ = 1.7 min). Conclusion: The LC detected a comparable number of steps as the DW but significantly fewer steps than the AG in children. Current results indicate that the LC_5 and either AG_Treuth or AG_Puyau intensity derivations provide similar mean estimates of time in MVPA during-free living activity in 10-yr-old children.

Improving cyclodiode - a risk factor analysis of complications

PURPOSE: The purpose of this study is to identify risk factors for developing complications following treatment of refractory glaucoma with transscleral diode laser cyclophotocoagulation (cyclodiode), to improve the safety profile of this treatment modality. METHOD: A retrospective analysis of 72 eyes from 70 patients who were treated with cyclodiode. RESULTS: The mean pre-treatment IOP was 37.0 mmHg (SD 11.0), with a mean post-treatment reduction in intraocular pressure (IOP) of 19.8 mmHg, and a mean IOP at last follow-up of 17.1 mmHg (SD 9.7). Mean total power delivered during treatment was 156.8 Joules (SD 82.7) over a mean of 1.3 treatments (SD 0.6). Sixteen eyes (22.2% of patients) developed complications from the treatment, with the most common being hypotony, occurring in 6 patients, including 4 with neovascular glaucoma. A higher pre-treatment IOP and higher mean total power delivery also were associated with higher complications. CONCLUSIONS: Cyclodiode is an effective treatment option for glaucoma that is refractory to other treatment options. By identifying risk factors for potential complications, cyclodiode can be modified accordingly for each patient to improve safety and efficacy.

Driving for work : a series of organisational audit results

Previous research has indicated that road crashes are the most common form of work related fatalities (Haworth et al., 2000). Historically, industry has often taken a “silver bullet” approach developing and implementing a single countermeasure to address all their work related road safety issues, despite legislative requirements to discharge obligations through minimising risk and enhancing safety. This paper describes the results and implications from a series of work related road safety audits that were undertaken across five organisations to determine deficiencies in each organisation‟s safe driving management and practice. Researchers conducted a series of structured interviews, reviewed documentation relating to work related driving, and analysed vehicle related crash and incident records to determine each organisation‟s current situation in the management of work related road safety and driver behaviour. A number of consistent themes and issues across each organisation were identified relating to managing driver behaviour, organisational policies, incident recording and reporting, communication and education, and formalisation of key work related road safety strategies. Although organisations are required to undertake risk reduction strategies for all work related driving, the results of the research suggest that many organisations fail to systematically manage driver behaviour and mitigate work related road safety risk. Future improvements in work related road safety will require organisations to firstly acknowledge the high risk associated with drivers driving for work and secondly adopt comprehensive risk mitigation strategies in a similar manner to managing other workplace hazards.