The impact of surgical ward nurses practicing respiratory assessment on positive patient outcomes

Objective: A literature review to examine the incorporation of respiratory assessment into everyday surgical nursing practice; possible barriers to this; and the relationship to patient outcomes. Primary argument: Escalating demands on intensive care beds have led to highly dependent patients being cared for in general surgical ward areas. This change in patient demographics has meant the knowledge and skills required of registered nurses in these areas has expanded exponentially. The literature supported the notion that postoperative monitoring of vital signs should include the fundamental assessment of respiratory rate; depth and rhythm; work of breathing; use of accessory muscles and symmetrical chest movement; as well as auscultation of lung fields using a stethoscope. Early intervention in response to changes in a patient's respiratory health status impacts positively on patient health outcomes. Substantial support exists for the contention that technologically adept nurses who also possess competent respiratory assessment skills make a difference to respiratory care. Conclusions: Sub-clinical respiratory problems have been demonstrated to contribute to adverse events. There is a paucity of research knowledge as to whether respiratory education programs and associated inservice make a difference to nursing clinical practice. Similarly, the implications for associated respiratory educational needs are not well documented, nor has a research base been sufficiently developed to guide nursing practice. Further research has the potential to influence the future role and function of the registered nurse by determining the importance of respiratory education programs on post-operative patient outcomes.

Faculty mentoring, evidence-based assessment, and student learning : an Australian exploration of American initiatives

There have been many improvements in Australian engineering education since the 1990s. However, given the recent drive for assuring the achievement of identified academic standards, more progress needs to be made, particularly in the area of evidence-based assessment. This paper reports on initiatives gathered from the literature and engineering academics in the USA, through an Australian National Teaching Fellowship program. The program aims to establish a process to help academics in designing and implementing evidence-based assessments that meet the needs of not only students and the staff that teach them, but also industry as well as accreditation bodies. The paper also examines the kinds and levels of support necessary for engineering academics, especially early career ones, to help meet the expectations of the current drive for assured quality and standards of both research and teaching. Academics are experiencing competing demands on their time and energy with very high expectations in research performance and increased teaching responsibilities, although many are researchers who have not had much pedagogic training. Based on the literature and investigation of relevant initiatives in the USA, we conducted interviews with several identified experts and change agents who have wrought effective academic cultural change within their institutions and beyond. These reveal that assuring the standards and quality of student learning outcomes through evidence-based assessments cannot be appropriately addressed without also addressing the issue of pedagogic training for academic staff. To be sustainable, such training needs to be complemented by a culture of on-going mentoring support from senior academics, formalised through the university administration, so that mentors are afforded resources, time, and appropriate recognition.

Applied sub-transmission & distribution reliability assessment of SEQEB network in Queensland

In this paper a combined subtransmission and distribution reliability analysis of SEQEB’s outer suburban network is presented. The reliability analysis was carried out with a commercial software package which evaluates both energy and customer indices. Various reinforcement options were investigated to ascertain the impact they have on the reliability of supply seen by the customers. The customer and energy indices produced by the combined subtransmission and distribution reliability studies contributed to optimise capital expenditure to the most effective areas of the network.

How much do residential aged care staff members know about the nutritional needs of residents?

Background Undernutrition, weight loss and dehydration are major clinical issues for people with dementia in residential care, with excessive weight loss contributing to increased risk of frailty, immobility, illness and premature morbidity. This paper discusses a nutritional knowledge and attitudes survey conducted as part of a larger project focused on improving nutritional intake of people with dementia within a residential care facility in Brisbane, Australia. Aims The specific aims of the survey were to identify (i) knowledge of the nutritional needs of aged care facility residents; (ii) mealtime practices; and (iii) attitudes towards mealtime practices and organisation. Methods A survey based on those used in other healthcare settings was completed by 76 staff members. The survey included questions about nutritional knowledge, opinions of the food service, frequency of feeding assistance provided and feeding assessment practices. Results Nutritional knowledge scores ranged from 1 to 9 of a possible 10, with a mean score of 4.67. While 76% of respondents correctly identified risk factors associated with malnutrition in nursing home residents, only 38% of participants correctly identified the need for increased protein and energy in residents with pressure ulcers, and just 15% exhibited correct knowledge of fluid requirements. Further, while nutritional assessment was considered an important part of practice by 83% of respondents, just 53% indicated that they actually carried out such assessments. Identified barriers to promoting optimal nutrition included insufficient time to observe residents (56%); being unaware of residents' feeding issues (46%); poor knowledge of nutritional assessments (44%); and unappetising appearance of food served (57%). Conclusion An important step towards improving health and quality of life for residents of aged care facilities would be to enhance staff nutritional awareness and assessment skills. This should be carried out through increased attention to both preservice curricula and on-the-job training. Implications for practice The residential facility staff surveyed demonstrated low levels of nutrition knowledge, which reflects findings from the international literature. This has implications for the provision of responsive care to residents of these facilities and should be explored further.

A model for enhancing assessment and teaching practice at the coalface : Insights from a Fellow-In-Residence engagement program

Australian universities are currently engaging with new governmental policies and regulations that require them to demonstrate enhanced quality and accountability in teaching and research. The development of national academic standards for learning outcomes in higher education is one such instance of this drive for excellence. These discipline-specific standards articulate the minimum, or Threshold Learning Outcomes, to be addressed by higher education institutions so that graduating students can demonstrate their achievement to their institutions, accreditation agencies, and industry recruiters. This impacts not only on the design of Engineering courses (with particular emphasis on pedagogy and assessment), but also on the preparation of academics to engage with these standards and implement them in their day-to-day teaching practice on a micro level. This imperative for enhanced quality and accountability in teaching is also significant at a meso level, for according to the Australian Bureau of Statistics, about 25 per cent of teachers in Australian universities are aged 55 and above and more than 54 per cent are aged 45 and above (ABS, 2006). A number of institutions have undertaken recruitment drives to regenerate and enrich their academic workforce by appointing capacity-building research professors and increasing the numbers of early- and mid-career academics. This nationally driven agenda for quality and accountability in teaching permeates also the micro level of engineering education, since the demand for enhanced academic standards and learning outcomes requires both a strong advocacy for a shift to an authentic, collaborative, outcomes-focused education and the mechanisms to support academics in transforming their professional thinking and practice. Outcomes-focused education means giving greater attention to the ways in which the curriculum design, pedagogy, assessment approaches and teaching activities can most effectively make a positive, verifiable difference to students’ learning. Such education is authentic when it is couched firmly in the realities of learning environments, student and academic staff characteristics, and trustworthy educational research. That education will be richer and more efficient when staff works collaboratively, contributing their knowledge, experience and skills to achieve learning outcomes based on agreed objectives. We know that the school or departmental levels of universities are the most effective loci of changes in approaches to teaching and learning practices in higher education (Knight & Trowler, 2000). Heads of Schools are being increasingly entrusted with more responsibilities - in addition to setting strategic directions and managing the operational and sometimes financial aspects of their school, they are also expected to lead the development and delivery of the teaching, research and other academic activities. Guiding and mentoring individuals and groups of academics is one critical aspect of the Head of School’s role. Yet they do not always have the resources or support to help them mentor staff, especially the more junior academics. In summary, the international trend in undergraduate engineering course accreditation towards the demonstration of attainment of graduate attributes poses new challenges in addressing academic staff development needs and the assessment of learning. This paper will give some insights into the conceptual design, implementation and empirical effectiveness to date, of a Fellow-In-Residence Engagement (FIRE) program. The program is proposed as a model for achieving better engagement of academics with contemporary issues and effectively enhancing their teaching and assessment practices. It will also report on the program’s collaborative approach to working with Heads of Schools to better support academics, especially early-career ones, by utilizing formal and informal mentoring. Further, the paper will discuss possible factors that may assist the achievement of the intended outcomes of such a model, and will examine its contributions to engendering an outcomes-focussed thinking in engineering education.

Logan Basin Water Resource Plan : environmental assessment of the southern Moreton Bay islands. Technical Advisory Panel Report: Stage 1.

This report is a technical assessment of the hydrological environment of the southern Moreton Bay islands and follows the terms of reference supplied by the then Queensland Department of Natural Resources and Water. The terms of reference describe stage 1 as a condition assessment and stage 2 as an assessment of the implications of water planning scenarios on future condition. This report is the first stage of a two-stage investigation whose primary purpose is to identify and assess groundwater dependent ecosystems (GDEs) and the groundwater flow regimes necessary to support them. Within this context, the groundwaters themselves are also considered and comment made on their condition. Information provided in this report will inform an amendment to the Logan Basin Water Resource Plan to incorporate the southern Moreton Bay islands. The study area is the water resource plan amendment area, which includes North and South Stradbroke islands and the smaller islands between these and the mainland, including the inhabited smaller rocky islands—namely, Macleay, Russell, Karragarra, Lamb and Coochiemudlo islands. This assessment is largely a desktop study based on existing information, but incorporates some field observations, input from experts in specific areas and community representatives, and the professional experience and knowledge of the authors. This report reviews existing research and information on the southern Moreton Bay area with an emphasis on North Stradbroke Island, as it represents the largest and most regionally significant groundwater resource in southern Moreton Bay. The report provides an assessment of key waterrelated environmental features, their condition and their degree of dependence on groundwater. This report also assesses the condition and status of ecosystems within this region. In addition, the report identifies information gaps, uncertainties and potential impacts; reviews groundwater models that have been developed for North Stradbroke Island; and makes recommendations on monitoring and research needs.

Pressure ulcers in the adult intensive care unit : a literature review of patient risk factors and risk assessment scales

Background: Critically ill patients are at high risk for pressure ulcer (PrU) development due to their high acuity and the invasive nature of the multiple interventions and therapies they receive. With reported incidence rates of PrU development in the adult critical care population as high as 56%, the identification of patients at high risk of PrU development is essential. This paper will explore the association between PrU development and risk factors. It will also explore PrU development and the use of risk assessment scales for critically ill patients in adult intensive care units. Method: A literature search from 2000 to 2012 using the CINHAL, Cochrane Library, EBSCOHost, Medline (via EBSCOHost), PubMed, ProQuest and Google Scholar databases was conducted. Key words used were: pressure ulcer/s; pressure sore/s; decubitus ulcer/s; bed sore/s; critical care; intensive care; critical illness; prevalence; incidence; prevention; management; risk factor; risk assessment scale. Results: Nineteen articles were included in this review; eight studies addressing PrU risk factors, eight studies addressing risk assessment scales and three studies overlapping both. Results from the studies reviewed identified 28 intrinsic and extrinsic risk factors which may lead to PrU development. Development of a risk factor prediction model in this patient population, although beneficial, appears problematic due to many issues such as diverse diagnoses and subsequent patient needs. Additionally, several risk assessment instruments have been developed for early screening of patients at higher risk of developing PrU in the ICU. No existing risk assessment scales are valid for identification high risk critically ill patient,with the majority of scales potentially over-predicting patients at risk for PrU development. Conclusion: Research studies to inform the risk factors for potential pressure ulcer development are inconsistent. Additionally, there is no consistent or clear evidence which demonstrates any scale to better or more effective than another when used to identify the patients at risk for PrU development. Furthermore robust research is needed to identify the risk factors and develop valid scales for measuring the risk of PrU development in ICU.

Provision of customer knowledge to supply chains

Knowledge about customers is vital for supply chains in order to ensure customer satisfaction. In an ideal supply chain environment, supply chain partners are able to perform planning tasks collaboratively, because they share information. However, customers are not always able or willing to share information with their suppliers. End consumers, on the one hand, do not usually provide a retail company with demand information. On the other hand, industrial customers might consciously hide information. Wherever a supply chain is not provided with demand forecast information, it needs to derive these demand forecasts by other means. Customer Relationship Management provides a set of tools to overcome informational uncertainty. We show how CRM and SCM information can be integrated on the conceptual as well as technical levels in order to provide supply chain managers with relevant information.

Assessment of precision timing and real-time data networks for digital substation automation

This project researched the performance of emerging digital technology for high voltage electricity substations that significantly improves safety for staff and reduces the potential impact on the environment of equipment failure. The experimental evaluation used a scale model of a substation control system that incorporated real substation control and networking equipment with real-time simulation of the power system. The outcomes confirm that it is possible to implement Ethernet networks in high voltage substations that meet the needs of utilities; however component-level testing of devices is necessary to achieve this. The assessment results have been used to further develop international standards for substation communication and precision timing.

Developing a sustainability impact assessment framework for local urban planning

In order to meet the land use and infrastructure needs of the community with the additional challenges posed by climate change and a global recession, it is essential that Queensland local governments test their proposed integrated land use and infrastructure plans to ensure the maximum achievement of triple-bottom line sus-tainability goals. Extensive regulatory impact assessment systems are in place at the Australian and state government levels to substantiate and test policy and legislative proposals, however no such requirement has been extended to the local government level. This paper contends that with the devolution of responsibility to local government and growing impacts of local government planning and development assessment activities, impact assessment of regulatory planning instruments is appropriate and overdue. This is particularly so in the Queensland context where local governments manage metropolitan and regional scale responsibilities and their planning schemes under the Sustainable Planning Act 2009 integrate land use and infrastructure planning to direct development rights, the spatial allocation of land, and infrastructure investment. It is critical that urban planners have access to fit-for-purpose impact assessment frameworks which support this challenging task and address the important relationship between local planning and sustainable urban development. This paper uses two examples of sustainability impact assessment and a case study from the Queensland local urban planning context to build an argument and potential starting point for impact assessment in local planning processes.

A micro-level indexing model for the assessment of sustainable urban ecosystems

During the last several decades, the quality of natural resources and their services have been exposed to significant degradation from increased urban populations combined with the sprawl of settlements, development of transportation networks and industrial activities (Dorsey, 2003; Pauleit et al., 2005). As a result of this environmental degradation, a sustainable framework for urban development is required to provide the resilience of natural resources and ecosystems. Sustainable urban development refers to the management of cities with adequate infrastructure to support the needs of its population for the present and future generations as well as maintain the sustainability of its ecosystems (UNEP/IETC, 2002; Yigitcanlar, 2010). One of the important strategic approaches for planning sustainable cities is „ecological planning‟. Ecological planning is a multi-dimensional concept that aims to preserve biodiversity richness and ecosystem productivity through the sustainable management of natural resources (Barnes et al., 2005). As stated by Baldwin (1985, p.4), ecological planning is the initiation and operation of activities to direct and control the acquisition, transformation, disruption and disposal of resources in a manner capable of sustaining human activities with a minimum disruption of ecosystem processes. Therefore, ecological planning is a powerful method for creating sustainable urban ecosystems. In order to explore the city as an ecosystem and investigate the interaction between the urban ecosystem and human activities, a holistic urban ecosystem sustainability assessment approach is required. Urban ecosystem sustainability assessment serves as a tool that helps policy and decision-makers in improving their actions towards sustainable urban development. There are several methods used in urban ecosystem sustainability assessment among which sustainability indicators and composite indices are the most commonly used tools for assessing the progress towards sustainable land use and urban management. Currently, a variety of composite indices are available to measure the sustainability at the local, national and international levels. However, the main conclusion drawn from the literature review is that they are too broad to be applied to assess local and micro level sustainability and no benchmark value for most of the indicators exists due to limited data availability and non-comparable data across countries. Mayer (2008, p. 280) advocates that by stating "as different as the indices may seem, many of them incorporate the same underlying data because of the small number of available sustainability datasets". Mori and Christodoulou (2011) also argue that this relative evaluation and comparison brings along biased assessments, as data only exists for some entities, which also means excluding many nations from evaluation and comparison. Thus, there is a need for developing an accurate and comprehensive micro-level urban ecosystem sustainability assessment method. In order to develop such a model, it is practical to adopt an approach that uses a method to utilise indicators for collecting data, designate certain threshold values or ranges, perform a comparative sustainability assessment via indices at the micro-level, and aggregate these assessment findings to the local level. Hereby, through this approach and model, it is possible to produce sufficient and reliable data to enable comparison at the local level, and provide useful results to inform the local planning, conservation and development decision-making process to secure sustainable ecosystems and urban futures. To advance research in this area, this study investigated the environmental impacts of an existing urban context by using a composite index with an aim to identify the interaction between urban ecosystems and human activities in the context of environmental sustainability. In this respect, this study developed a new comprehensive urban ecosystem sustainability assessment tool entitled the „Micro-level Urban-ecosystem Sustainability IndeX‟ (MUSIX). The MUSIX model is an indicator-based indexing model that investigates the factors affecting urban sustainability in a local context. The model outputs provide local and micro-level sustainability reporting guidance to help policy-making concerning environmental issues. A multi-method research approach, which is based on both quantitative analysis and qualitative analysis, was employed in the construction of the MUSIX model. First, a qualitative research was conducted through an interpretive and critical literature review in developing a theoretical framework and indicator selection. Afterwards, a quantitative research was conducted through statistical and spatial analyses in data collection, processing and model application. The MUSIX model was tested in four pilot study sites selected from the Gold Coast City, Queensland, Australia. The model results detected the sustainability performance of current urban settings referring to six main issues of urban development: (1) hydrology, (2) ecology, (3) pollution, (4) location, (5) design, and; (6) efficiency. For each category, a set of core indicators was assigned which are intended to: (1) benchmark the current situation, strengths and weaknesses, (2) evaluate the efficiency of implemented plans, and; (3) measure the progress towards sustainable development. While the indicator set of the model provided specific information about the environmental impacts in the area at the parcel scale, the composite index score provided general information about the sustainability of the area at the neighbourhood scale. Finally, in light of the model findings, integrated ecological planning strategies were developed to guide the preparation and assessment of development and local area plans in conjunction with the Gold Coast Planning Scheme, which establishes regulatory provisions to achieve ecological sustainability through the formulation of place codes, development codes, constraint codes and other assessment criteria that provide guidance for best practice development solutions. These relevant strategies can be summarised as follows: • Establishing hydrological conservation through sustainable stormwater management in order to preserve the Earth’s water cycle and aquatic ecosystems; • Providing ecological conservation through sustainable ecosystem management in order to protect biological diversity and maintain the integrity of natural ecosystems; • Improving environmental quality through developing pollution prevention regulations and policies in order to promote high quality water resources, clean air and enhanced ecosystem health; • Creating sustainable mobility and accessibility through designing better local services and walkable neighbourhoods in order to promote safe environments and healthy communities; • Sustainable design of urban environment through climate responsive design in order to increase the efficient use of solar energy to provide thermal comfort, and; • Use of renewable resources through creating efficient communities in order to provide long-term management of natural resources for the sustainability of future generations.

Quality assessment of service bundles for governmental one-stop portals : a literature review

Service bundles, in the context of e-government, are used to group services together that relate to a certain citizen need. These bundles can then be presented on a governmental one-stop portal to structure the available service offerings according to citizen expectations. In order to ensure that citizens utilise the one-stop portal and comprised service bundles for future transactions, the quality of these service bundles needs to be managed and maximised accordingly. Consequently, models and tools that focus on assessing service bundle quality play an important role, when it comes to increasing or retaining usage behaviour of citizens. This study focuses on providing a rigorous and structured literature review of e-government outlets with regards to their coverage of service bundle quality and e-service quality themes. The study contributes to academia and practice by providing a framework that allows structuring and classifying existing studies relevant for the assessment of quality for government portals. Furthermore, this study provides insights into the status quo of quality models that can be used by governments to assess the quality of their service bundles. Directions for future research and limitations of the present study are provided as well.

Actigraphy assessment of mother's sleep at 6, 12 & 18 weeks postpartum

Introduction: Mothers’ sleep during the postpartum period is commonly characterised by bouts of sleep across the night, resulting in low sleep efficiency and daytime sleepiness. Understanding of the nature of mothers’ sleep disruption needs to incorporate indices of both sleep quantity and sleep quality, but objective assessment of sleep disturbance experienced during the first postpartum months has not been investigated in great detail. This longitudinal study aimed to objectively measure mothers’ sleep during the first 18 weeks postpartum, to ascertain the level of sleep disturbance experienced. Method: Eleven mothers (Mean age = 29.82, SD = 4.45) from Australia wore Actiwatch-2 devices for up to 7 days and nights at 6, 12 and 18 weeks postpartum. For each night of recording, a number of sleep bouts were identified. Total sleep time (TST) was calculated as the total number of minutes across the night within these bouts. Sleep efficiency was calculated as the percentage of minutes across the night classified as being part of a sleep bout, with higher scores indicating higher efficiency. Sleep quality captured the efficiency of sleep within sleep bouts, and was calculated as the percentage of epochs classified as sleep within sleep bouts, with higher scores indicating higher sleep quality. Results: At 6 weeks postpartum, mean total sleep time was 420.22 minutes (SD = 50.61). Total sleep time did not significantly differ across the assessment; however there was a trend towards an increase over time. Sleep efficiency increased across the time periods (F(2,10) = 10.30, p = .001), with a significant increase between week 12 and week 18. At 6 weeks postpartum, mean sleep quality was 93.15% (SD = 2.68) and scores did not significantly change across the assessment periods. While there was no relationship between sleep efficiency and sleep quality during weeks 6 and 12, a significant positive relationship was observed at week 18, r2 = .52, p = .013. Conclusions: Within this sample, a low level of disruption was consistently shown within the mothers’ night time sleep bouts. However, overall sleep efficiency suggested a significant proportion of time spent awake between sleep bouts. While TST remained stable over time, overall sleep efficiency improved, suggesting the mothers’ sleep was becoming more consolidated. A single sleep bout a night was not often experienced.

The essential parameters of a resource-based carrying capacity assessment model : an Australian case study

Carrying capacity assessments model a population’s potential self-sufficiency. A crucial first step in the development of such modelling is to examine the basic resource-based parameters defining the population’s production and consumption habits. These parameters include basic human needs such as food, water, shelter and energy together with climatic, environmental and behavioural characteristics. Each of these parameters imparts land-usage requirements in different ways and varied degrees so their incorporation into carrying capacity modelling also differs. Given that the availability and values of production parameters may differ between locations, no two carrying capacity models are likely to be exactly alike. However, the essential parameters themselves can remain consistent so one example, the Carrying Capacity Dashboard, is offered as a case study to highlight one way in which these parameters are utilised. While examples exist of findings made from carrying capacity assessment modelling, to date, guidelines for replication of such studies in other regions and scales have largely been overlooked. This paper addresses such shortcomings by describing a process for the inclusion and calibration of the most important resource-based parameters in a way that could be repeated elsewhere.

Assessment for Education : Standards, Judgement and Moderation

Do you need a practical guide to assessment, curriculum and policy? Are you also looking for a book that is firmly grounded in the theory of this subject? Assessment for Education combines both theory and practice, making it the perfect guide for students, researchers, academics and teachers. This book makes assessment processes transparent for practitioners, and shows how assessment should relate to education. It looks at evidence-informed decision-making and the interrelationships between standards, judgment and moderation practice for improved assessment, teacher quality, schools and systems. The book will provide you with: ' Knowledge about quality assessment and judgement practice ' Understanding of relationships across curriculum, assessment, teaching and learning ' Knowledge of the concept of front-ending assessment based on the learner's needs ' An analysis of practitioner judgement approaches ' Understanding of the conditions under which teacher assessment can be valid ' Principles derived from research of social moderation practices Whether you are studying and researching assessment or working in curriculum and assessment policy, this book will show you how practitioner use of achievement standards can improve learning, equity, social justice and accountability.