Exposure to bioaerosols in the school environment in Brisbane, Australia

Introduction: Exposure to bioaerosols in indoor environments has been linked to various adverse health effects, such as airway disorders and upper respiratory tract symptoms. The aim of this study was to assess exposure to bioaerosols in the school environment in Brisbane, Australia. Methods: Culturable fungi and endotoxin measurements were conducted in six schools between October 2010 and May 2011. Culturable fungi (2 indoor air and 1-2 outdoor air samples per school) were assessed using a Biotest RCS High Flow Air Sampler, with a flow rate of either 50L/min or 20L/min. A rose pengar agar was used for recovery, which was incubated prior to counting and partial identification. Endotoxins were sampled (8h, 2L/min) using SKC glass fibre filters (4 indoor air samples per school) and analysed using an endpoint chromogenic LAL assay. Results: The arithmetic mean for fungi concentration in indoor and outdoor air was 710 cfu/m3(125- 1900 cfu/m3) and 524 cfu/m3 (140-1250 cfu/m3), respectively. The most frequently isolated fungal genus from the outdoor air was Cladosporium (over 40 %), followed by isolated Penicillium (21%) and Aspergillus (12%). The percent of Penicillium, Cladosporium and Aspergillus in indoor air samples was 32%, 32% and 8%, respectively. The aritmetic mean of endotoxin concentration was 0.59 EU/m3 (0-2,2 EU/m3). Discussion: The results of the current study are in agreement with previously reported studies, in that airborne fungi and endotoxin concentrations varied extensively, and were mostly dependent on climatic conditions. In addition, the indoor air mycoflora largely reflected the fungal flora present in the outdoor air, with Cladosporium being the most common in both outdoor and indoor (with Penicillium) air. In indoor air, unusually high endotoxin levels, over 1 EU/m3, were detected at 2 schools. Although these schools were not affected by the recent Brisbane floods, persistent rain prior to and during the study perios could explain the results.

Transforming pedagogy: Building the new ‘old school’

Global shifts in design practice, design education and in higher education in general have radically changed teaching practices over the past decade. In a time of tightening budgets and other factors, various paradigm shifts and challenges are continually evolving and rapidly changing the higher education landscape. Rising to these challenges and responding to them is a complex task, requiring creative approaches applied to traditional methods and tools in interior architecture and interior design courses. The focus of this paper is a discussion of the adaptation of an ‘old school’ traditional tutorial approach within the context of online interior design education, which was applied in an endeavour to increase student engagement with current relevant literature pertinent to interior design theory and practice. The adaptation and application of this tutorial approach, the O-tutorial, creates a necessary link to critical thinking and meta-cognition connecting theoretical concepts to interior design process and practice. Initial data reveals that the O-tutorial allows students to engage and critically analyse issues surrounding theory and practice, thus equipping them with the skills as future design professionals. The paper concludes with reflections and recommendations for interior design education and future potential use and application of the O-tutorial.

Airborne culturable fungi in naturally ventilated primary school environments in a subtropical climate

There is currently a lack of reference values for indoor air fungal concentrations to allow for the interpretation of measurement results in subtropical school settings. Analysis of the results of this work established that, in the majority of properly maintained subtropical school buildings, without any major affecting events such as floods or visible mould or moisture contamination, indoor culturable fungi levels were driven by outdoor concentration. The results also allowed us to benchmark the “baseline range” concentrations for total culturable fungi, Penicillium spp., Cladosporium spp. and Aspergillus spp. in such school settings. The measured concentration of total culturable fungi and three individual fungal genera were estimated using Bayesian hierarchical modelling. Pooling of these estimates provided a predictive distribution for concentrations at an unobserved school. The results indicated that “baseline” indoor concentration levels for indoor total fungi, Penicillium spp., Cladosporium spp. and Aspergillus spp. in such school settings were generally ≤ 1450, ≤ 680, ≤ 480 and ≤ 90 cfu/m3, respectively, and elevated levels would indicate mould damage in building structures. The indoor/outdoor ratio for most classrooms had 95% credible intervals containing 1, indicating that fungi concentrations are generally the same indoors and outdoors at each school. Bayesian fixed effects regression modeling showed that increasing both temperature and humidity resulted in higher levels of fungi concentration.

Seasonal variations of outdoor air pollution and factors driving them in the school environment in rural Bhutan

A quantitative understanding of outdoor air quality in school environments is crucial given that air pollution levels inside classrooms are significantly influenced by outdoor pollution sources. To date, only a handful of studies have been conducted on this important topic in developing countries. The aim of this study was to quantify pollutant levels in the outdoor environment of a school in Bhutan and assess the factors driving them. Measurements were conducted for 16 weeks, spanning the wet and dry seasons, in a rural school in Bhutan. PM10, PM2.5, particle number (PN) and CO were measured daily using real-time instruments, while weekly samples for volatile organic compounds (VOCs), carbonyls and NO2 were collected using a passive sampling method. Overall mean PM10 and PM2.5 concentrations (µg/m3) were 27 and 13 for the wet, and 36 and 29 for the dry season, respectively. Only wet season data were available for PN concentrations, with a mean of 2.56 × 103 particles/cm3. Mean CO concentrations were below the detection limit of the instrumentation for the entire measurement period. Only low levels of eight VOCs were detected in both the wet and dry seasons, which presented different seasonal patterns in terms of the concentration of different compounds. The notable carbonyls were formaldehyde and hexaldehyde, with mean concentrations (µg/m3) of 2.37 and 2.41 for the wet, and 6.22 and 0.34 for the dry season, respectively. Mean NO2 cocentration for the dry season was 1.7 µg/m3, while it was below the detection limit of the instrumentation for the wet season. The pollutant concentrations were associated with a number of factors, such as cleaning and combustion activities in and around the school. A comparison with other school studies showed comparable results with a few of the studies, but in general, we found lower pollutant concentrations in the present study.

Lewis's medical-surgical nursing: Assessment and management of clinical problems [ANZ Edition, 4th Ed.]

"Using the nursing process as a framework for practice, the fourth edition has been extensively revised to reflect the rapid changing nature of nursing practice and the increasing focus on key nursing care priorities. Building on the strengths of the third Australian and New Zealand edition and incorporating relevant global nursing research and practice from the prominent US title Medical-Surgical Nursing, 9Th Edition, Lewis’s Medical-Surgical Nursing, 4th Edition is an essential resource for students seeking to understand the role of the professional nurse in the contemporary health environment."--Publisher website

Patients' outcomes related to person-centred nursing care in radiation oncology: A case study

Abstract Purpose The aim of this case study is to describe patients' responses to nursing care following the implementation of a person-centred model in a radiation oncology department. Method An instrumental case study design utilised surveys to collect data on a range of key patient outcomes: patient satisfaction (PSS), informational issues (RSEP), quality of life (FACT_G), comfort (RTCQ), and emotional status (HADS). This occurred at the beginning of, and twelve months following, the implementation of the new model of care. Results This study demonstrated that, although adverse effects of radiotherapy continue to affect patient well-being in the latter part of their course of radiation therapy, patients continue to be satisfied with nursing care. There were significant differences between groups in perceptions of the care environment and the use of the nurse as an acknowledged source of information are noteworthy, since these variables were key targets of the new model of care. The finding that nurses were seen by the post-implementation cohort as more likely to be a source of information is an important indicator that the nurses' presence was noted by patients, and they generally reported high levels of functioning despite undergoing a curative course of radiotherapy. Conclusion The person-centred nursing approach in the radiotherapy setting has contributed to some improvements in the provision of patient care. Aspects of this study may assist in planning further nursing interventions for patients undergoing radiotherapy for cancer, and continue to enhance the contribution of the radiation oncology nurse to improved patient outcomes.

Benefits and barriers to exercise in midlife women undertaking a web-based multi-modal lifestyle intervention for the primary prevention of chronic disease

Chronic diseases are a leading cause of death and disability, largely attributable to modifiable lifestyle risk factors. Many midlife Australian are getting insufficient physical activity for health and face a range of barriers to exercise. Results of this study provide evidence that benefits and barriers are an important predictor of exercise behaviour in midlife women and, that a 12 week nurse led health promotion program can effectively promote benefits and increase physical activity. This study provides evidence about benefits and barriers to exercise that will inform health promotion practice for chronic disease risk factor reduction in midlife women.

Investigating a disciplinary approach to literacy learning in a secondary school

This paper presents findings from a Design-Based Research (DBR) project undertaken in a large regional high school in Queensland. The study focused on an intervention involving explicit teaching using systemic functional grammar in assessed writing across two Year 8 subjects: English and History. The study’s findings demonstrate that, despite efforts at the whole school and classroom level to support a disciplinary literacy approach to subject learning, there are considerable constraints that need to be considered and overcome in order for students to develop appropriate writing capabilities for particular discipline areas.

“They are like family”: The emotional cost experienced by nurses when caring for haemodialysis patients

Background Haemodialysis (HD) nursing is characterised by frequent, intense interactions with patients over long periods of time resulting in a unique nurse-patient relationship. Due to the life-limiting nature of end-stage renal failure, nurses are likely to have repeated exposures to the death of patients with whom they have formed relationships. Repeated exposure to patient death translates into frequent grief experiences. There is scant literature on the psychological impact of patient death for nurses working in the HD setting. Aims To explore HD nurses experiences of patient death and coping mechanisms used. Methods A sequential mixed method study investigating job satisfaction, stress and burnout found that HD nurses had high levels of stress and burnout. These results were explored in more detail during 8 semi-structured interviews with HD nurses. Interviews were audio-recorded, transcribed verbatim and subjected to thematic analysis. Results Three themes were identified that highlight the stress experienced by nurses when a haemodialysis patient dies. The first theme, “quazi-family” describes the close relationship which forms between nurses and patients. The “complicated grief” theme outlines the impact of death on HD nurses, and the final theme, “remembrance” explains some of the coping mechanisms used in the grieving process. Conclusion Nurses develop individual coping mechanisms to accommodate the grief and loss experienced when a “close” patient dies. The grieving process caused by the death of patient’s needs to be recognised by nurses and nurse managers as causing psychological stress and strain.

Two-way strong: A study of vertebrates using Queensland Indigenous knowledges and Montessori Linnaean materials to engage Indigenous secondary school students

The marginalisation that Indigenous secondary students experience in zoology science lessons can be attributed to a chasm they experience between their life in community and the classroom. The study found that the integration of Indigenous and Western science knowledge can provide transformative learning experiences for students which work to strengthen their sense of belonging to community and school. Using action research, the study investigated the integration of both-ways science education into students' zoology lessons. It privileged the community's cultural expertise, practices and connections with students and their families, which worked to enhance student engagement in their learning.

The organisational context of nursing care in stroke units: A case study approach

Background Internationally the stroke unit is recognised as the evidence-based model for patient management, although clarity about the effective components of stroke units is lacking. Whilst skilled nursing care has been proposed as one component, the theoretical and empirical basis for stroke nursing is limited. We attempted to explore the organisational context of stroke unit nursing, to determine those features that staff perceived to be important in facilitating high quality care. Design A case study approach was used, that included interviews with nurses and members of the multidisciplinary teams in two Canadian acute stroke units. A total of 20 interviews were completed, transcribed and analysed thematically using the Framework Approach. Trustworthiness was established through the review of themes and their interpretation by members of the stroke units. Findings Nine themes that comprised an organisational context that supported the delivery of high quality nursing care in acute stroke units were identified, and provide a framework for organisational development. The study highlighted the importance of an overarching service model to guide the organisation of care and the development of specialist and advanced nursing roles. Whilst multidisciplinary working appears to be a key component of stroke unit nursing, various organisational challenges to its successful implementation were highlighted. In particular the consequence of differences in the therapeutic approach of nurses and therapy staff needs to be explored in greater depth. Successful teamwork appears to depend on opportunities for the development of relationships between team members as much as the use of formal communication systems and structures. A co-ordinated approach to education and training, clinical leadership, a commitment to research, and opportunities for role and practice development also appear to be key organisational features of stroke unit nursing. Recommendations for the development of stroke nursing leadership and future research into teamwork in stroke settings are made.

Smell and taste dysfunction following minor stroke: A case report

Smell (olfactory) and taste (gustatory) are key senses in the regulation of nourishment and individual safety. Olfactory and gustatory dysfunctions have been infrequently reported together in patients following stroke (Landis et al., 2006; Leopold et al., 2006). This case report details two patients who experienced smell and taste dysfunction following minor stroke events. Symptoms reported included hyposmia (diminished sense of smell) and anosmia (complete loss of smell), and dysgeusia (distorted taste). Patients' sense of smell and taste were assessed in an ambulatory care stroke prevention clinic eight months following their strokes. Patient A presented with minor stroke due to a lesion in the anterior circulation, patient B with a lesion in the posterior circulation. Both patients reported intense olfactory and gustatory dysfunction immediately following their strokes. Examination revealed a general inability to detect subtle odours and the ability to identify only 'sweet' tastes for both patients. In addition, both patients reported heavily salting or sweetening their food to mask the distorted and unpleasant taste, which also impacted comorbid conditions such as hypertension and diabetes. Patients and their spouses reported a decrease in their appreciation of family-related activities due to the patients' olfactory and gustatory dysfunction. Patients reported weight loss, lack of energy and strength, likely due to poor nutrition. Olfactory and gustatory dysfunctions are potentially deleterious outcomes following minor stroke and should be assessed by health care professionals prior to patient discharge. Assistance may be required to promote the health and well-being of patients and their carers if smell and taste are impacted by the stroke event.

Education in stroke prevention: Efficacy of an educational counselling intervention to increase knowledge in stroke survivors

BACKGROUND Motivational interviewing and stages of change are approaches to increasing knowledge and effecting behavioural change. This study examined the application of this approach on stroke knowledge acquisition and changing individual lifestyle risk factors in an outpatient clinic. METHODS RCT in which 200 participants were allocated to an education-counselling interview (ECI) or a control group. ECI group participants mapped their individual risk factors on a stage of change model and received an appointment to the next group lifestyle class. Participants completed a stroke knowledge questionnaire at baseline (T1), post-appointment, and three months (T3) post-appointment. Passive to active changes in lifestyle behaviour were self-reported at three months. RESULTS There was a statistically significant difference between groups from T1 toT3 in stroke knowledge (p < 0.001). While there was a significant shift from a passive to active stage of change for the overall study sample (p < 0.000), there was no significant difference between groups on the identified risk factors. CONCLUSIONS Although contact with patients in ambulatory clinical settings is limited due to time constraints, it is still possible to improve knowledge and initiate lifestyle changes utilizing motivational interviewing and a stage of change model. Stroke nurses may wish to consider these techniques in their practice setting.

Barriers and supports for development of a clinician scientist role in cerebrovascular nursing: A position paper

This position paper will: 1. Provide an update on relevant current developments in the education, training and positioning of clinician nurse scientists; 2. Provide and promote a rational argument for the development of the clinician nurse scientist role, and; 3. Discuss issues related to capacity building in clinical research in neuroscience nursing, with specific reference to and support for the cerebrovascular (stroke) specialty nursing area.

The transition from isolated, rural contexts to boarding school: Can school physical education play a part?

This study considers the transition of children from rurally isolated schooling environments to boarding school contexts. There is an assumption that these transitions are often carried out with little fuss. Moreover; there is some evidence to show this transition is beneficial to both child and school. However, contrary data suggest that parents of such children are deeply concerned about this transition from a sport and physical education perspective (Wright et al., 1998). This study attempts to address this under-researched area. Data were gathered using semi-structured interviews with teachers, children and parents in an isolated schooling context, and with teachers and children from a boarding school in a regional Queensland centre. Some videotape data of children in physical education and sporting contexts were also collected. The data indicate that the transition from rural contexts to highly competitive boarding school environments is relatively smooth, with physical education and sport being significant contributors to this process.