Impact of a novel nurse-led prechemotherapy education intervention (ChemoEd) on patient distress, symptom burden, and treatment-related information and support needs : results from a randomised, controlled trial

Background: High levels of distress and need for self-care information by patients commencing chemotherapy suggest that current prechemotherapy education is suboptimal. We conducted a randomised, controlled trial of a prechemotherapy education intervention (ChemoEd) to assess impact on patient distress, treatment-related concerns, and the prevalence and severity of and bother caused by six chemotherapy side-effects. Patients and methods: One hundred and ninety-two breast, gastrointestinal, and haematologic cancer patients were recruited before the trial closing prematurely (original target 352). ChemoEd patients received a DVD, question-prompt list, self-care information, an education consultation ≥24 h before first treatment (intervention 1), telephone follow-up 48 h after first treatment (intervention 2), and a face-to-face review immediately before second treatment (intervention 3). Patient outcomes were measured at baseline (T1: pre-education) and immediately preceding treatment cycles 1 (T2) and 3 (T3). Results: ChemoEd did not significantly reduce patient distress. However, a significant decrease in sensory/psychological (P = 0.027) and procedural (P = 0.03) concerns, as well as prevalence and severity of and bother due to vomiting (all P = 0.001), were observed at T3. In addition, subgroup analysis of patients with elevated distress at T1 indicated a significant decrease (P = 0.035) at T2 but not at T3 (P = 0.055) in ChemoEd patients. Conclusions: ChemoEd holds promise to improve patient treatment-related concerns and some physical/psychological outcomes; however, further research is required on more diverse patient populations to ensure generalisability.

Bilingual asynchronous online discussion groups : design and delivery of an e-Learning distance study module for nurse academics in a developing country

The advent of eLearning has seen online discussion forums widely used in both undergraduate and postgraduate nursing education. This paper reports an Australian university experience of design, delivery and redevelopment of a distance education module developed for Vietnamese nurse academics. The teaching experience of Vietnamese nurse academics is mixed and frequently limited. It was decided that the distance module should attempt to utilise the experience of senior Vietnamese nurse academics - asynchronous online discussion groups were used to facilitate this. Online discussion occurred in both Vietnamese and English and was moderated by an Australian academic working alongside a Vietnamese translator. This paper will discuss the design of an online learning environment for foreign correspondents, the resources and translation required to maximise the success of asynchronous online discussion groups, as well as the rationale of delivering complex content in a foreign language. While specifically addressing the first iteration of the first distance module designed, this paper will also address subsequent changes made for the second iteration of the module and comment on their success. While a translator is clearly a key component of success, the elements of simplicity and clarity combined with supportive online moderation must not be overlooked.

Design and delivery of a distance education programme : educating Vietnamese nurse academics from Australia

In 2008 a move away from medical staff providing nursing education in Vietnam saw the employment of many new nurse academics. To assist in the instruction of these novice academics and provide them with sound teaching and learning practice as well as curriculum design and implementation skills, Queensland University of Technology (QUT) successfully tendered an international grant. One of QUT’s initiatives in educating the Vietnamese academics was a distance learning programme. Developed specifically for Vietnamese nurse academics, the programme was designed for Australian based delivery to academics in Vietnam. This paper will present an overview of why four separate modules were utilised for the delivery of content (modules were delivered at a rate of one per semester). It will address bilingual online discussion boards which were used in each of the modules and the process of moderating these given comments were posted in both Vietnamese and English. It will describe how content was scaffolded across four modules and how the modules themselves modelled new teaching delivery strategies. Lastly, it will discuss the considerations of programme delivery given the logistics of an Australian based delivery. Feedback from the Vietnamese nurse academics across their involvement in the programme (and at the conclusion of their fourth and final module) has been overwhelmingly positive. Feedback suggests the programme has altered teaching and assessment approaches used by some Vietnamese nurse academics. Additionally, Vietnamese nurse academics are reporting that they are engaging more with the application of their content indicating a cultural shift in the approach taken in Vietnamese nurse education.

The Yonder project : literacy and social competency development in primary school students through co-creation of live performance

Since 2007 Kite Arts Education Program (KITE), based at Queensland Performing Arts Centre (QPAC), has been engaged in delivering a series of theatre-based experiences for children in low socio-economic primary schools in Queensland. The artist in residence (AIR) project titled Yonder includes performances developed by the children with the support and leadership of teacher artists from KITE for their community and parents/carers,supported by a peak community cultural institution. In 2009,Queensland Performing Arts Centre partnered with Queensland University of Technology (QUT) Creative Industries Faculty (Drama) to conduct a three-year evaluation of the Yonder project to understand the operational dynamics, artistic outputs and the educational benefits of the project. This paper outlines the research findings for children engaged in the Yonder project in the interrelated areas of literacy development and social competencies. Findings are drawn from six iterations of the project in suburban locations on the edge of Brisbane city and in regional Queensland.

Development of a survey instrument to measure TEFL academics' perceptions about, individual and workplace characteristics for conducting research

The Chinese Ministry of Education (MOE) initiatives to improve the English competence of college students, as well as increased proficiency level of entering college students (Cheng, 2002) have contributed to greater demands on Teaching English as a Foreign Language (TEFL) academics (MOE, 2004), as “the upgrading of national English proficiency, then, is predicated largely on the professional competence of the teaching force” (Hu, 2005, p. 655). For TEFL academics, one component of this competence is the capacity to conduct research (Shu, 2002), which also reflects other changes in Chinese higher education. The aspirations of higher education institutions at all levels have led to more rigorous recruitment policies and promotion requirements (Che, 2004; Wang, 2007), stressing research as an important indicator of academics’ performance (Shi, 2002; Pan, 2006). These changes highlight the role of research in higher education institutions’ efforts to raise their national status and world ranking (Zhang, Wang, & He, 2006), and have exerted influences on faculty’s academic role. Academics are obliged to engage in research activities, and this has posed challenges to teaching-oriented institutions and disciplines.

Wherefore art thou, inclusion? Analysing the development of inclusive education in New South Wales, Finland and Alberta

Over the last two decades, moves toward “inclusion” have prompted change in the formation of education policies, schooling structures and pedagogical practice. Yet, exclusion through the categorisation and segregation of students with diverse abilities has grown; particularly for students with challenging behaviour. This paper considers what has happened to inclusive education by focusing on three educational jurisdictions known to be experiencing different rates of growth in the identification of special educational needs: New South Wales (Australia), Alberta (Canada) and Finland (Europe). In our analysis, we consider the effects of competing policy forces that appear to thwart the development of inclusive schools in two of our case-study regions.

Robots move : bootstrapping the development of object representations using sensorimotor coordination

This paper is concerned with the unsupervised learning of object representations by fusing visual and motor information. The problem is posed for a mobile robot that develops its representations as it incrementally gathers data. The scenario is problematic as the robot only has limited information at each time step with which it must generate and update its representations. Object representations are refined as multiple instances of sensory data are presented; however, it is uncertain whether two data instances are synonymous with the same object. This process can easily diverge from stability. The premise of the presented work is that a robot's motor information instigates successful generation of visual representations. An understanding of self-motion enables a prediction to be made before performing an action, resulting in a stronger belief of data association. The system is implemented as a data-driven partially observable semi-Markov decision process. Object representations are formed as the process's hidden states and are coordinated with motor commands through state transitions. Experiments show the prediction process is essential in enabling the unsupervised learning method to converge to a solution - improving precision and recall over using sensory data alone.

Environmental rating tools and residential land development in Australia

Numerous environmental rating tools have developed around the world over the past decade or so, in an attempt to increase awareness of the impact buildings have on the environment. Whilst many of these tools can be applied across a variety of building types, the majority focus mainly on the commercial building sector. Only recently have some of the better known environmental rating tools become adaptable to the land development sector, where arguably the most visible environmental impacts are made. EnviroDevelopment is one such tool that enables rating of residential land development in Australia. This paper seeks to quantify the environmental benefits achieved by the environmental rating tool EnviroDevelopment, using data from its certified residential projects across Australia. This research will identify the environmental gains achieved in the residential land development sector that can be attributed to developers aspiring to gain certification under this rating tool.

On the reliability of classifying programming tasks using a Neo-Piagetian theory of cognitive development

Recent research has proposed Neo-Piagetian theory as a useful way of describing the cognitive development of novice programmers. Neo-Piagetian theory may also be a useful way to classify materials used in learning and assessment. If Neo-Piagetian coding of learning resources is to be useful then it is important that practitioners can learn it and apply it reliably. We describe the design of an interactive web-based tutorial for Neo-Piagetian categorization of assessment tasks. We also report an evaluation of the tutorial's effectiveness, in which twenty computer science educators participated. The average classification accuracy of the participants on each of the three Neo-Piagetian stages were 85%, 71% and 78%. Participants also rated their agreement with the expert classifications, and indicated high agreement (91%, 83% and 91% across the three Neo-Piagetian stages). Self-rated confidence in applying Neo-Piagetian theory to classifying programming questions before and after the tutorial were 29% and 75% respectively. Our key contribution is the demonstration of the feasibility of the Neo-Piagetian approach to classifying assessment materials, by demonstrating that it is learnable and can be applied reliably by a group of educators. Our tutorial is freely available as a community resource.

Calling for help : a responsive evaluation of Child Health Line

The project examined the responsiveness of the telenursing service provided by the Child Health Line (hereinafter referred to as CHL). It aimed to provide an account of population usage of the service, the call request types and the response of the service to the calls. In so doing, the project extends the current body of knowledge pertaining to the provision of parenting support through telenursing. Approximately 900 calls to the CHL were audio-recorded over the December 2005-2006 Christmas-New Year period. A protocol was developed to code characteristics of the call, the interactional features between the caller and nurse call-taker, and the extent to which there was (a) agreement on problem definition and the plan of action and (b) interactional alignment between nurse and caller. A quantitative analysis examined the frequencies of the main topics covered in calls to the CHL and any statistical associations between types of calls, length of calls and nurse-caller alignment. In addition, a detailed qualitative analysis was conducted on a subset of calls dealing with the nurse management of calls seeking medical advice and information. Key findings include: • Overall, 74% of the calls discussed parenting and child development issues, 48% discussed health/medical issues, and 16% were information-seeking calls. • More specifically: o 21% discussed health/medical and parenting and child development issues. o 3% discussed parenting and information-seeking issues. o 5% discussed health/medical, parenting/development and information issues. o 18% exclusively focussed on health and medical issues and therefore were outside the remit of the intended scope of the CHL. These calls caused interactional dilemmas for the nurse call-takers as they simultaneously dealt with parental expectations for help and the CHL guidelines indicating that offering medical advice was outside the remit of the service. • Most frequent reasons for calling were to discuss sleep, feeding, normative infant physical functions and parenting advice. • The average length of calls to the CHL was 7 minutes. • Longer calls were more likely to involve nurse call-takers giving advice on more than one topic, the caller displaying strong emotions, the caller not specifically providing the reason for the call, and the caller discussing parenting and developmental issues. • Shorter calls were characterised by the nurse suggesting that the child receive immediate medical attention, the nurse emphasising the importance or urgency of the plan of action, the caller referring to or requesting confirmation of a diagnosis, and caller and nurse call-taker discussion of health and medical issues. • The majority of calls, 92%, achieved parent-nurse alignment by the conclusion of the call. However, 8% did not. • The 8% of calls that were not aligned require further quantitative and qualitative investigation of the interactional features. The findings are pertinent in the current context where Child Health Line now resides within 13HEALTH. These findings indicate: 1. A high demand for parenting advice. 2. Nurse call-takers have a high level of competency in dealing with calls about parenting and normal child development, which is the remit of the CHL. 3. Nurse call-takers and callers achieve a high degree of alignment when both parties agree on a course of action. 4. There is scope for developing professional practice in calls that present difficulties in terms of call content, interactional behaviour and call closure. Recommendations of the project: 1. There are numerous opportunities for further research on interactional aspects of calls to the CHL, such as further investigations of the interactional features and the association of the features to alignment and nonalignment. The rich and detailed insights into the patterns of nurse-parent interactions were afforded by the audio-recording and analysis of calls to the CHL. 2. The regular recording of calls would serve as a way of increasing understanding of the type and nature of calls received, and provide a valuable training resource. Recording and analysing calls to CHL provides insight into the operation of the service, including evidence about the effectiveness of triaging calls. 3. Training in both recognising and dealing with problem calls may be beneficial. For example, calls where the caller showed strong emotion, appeared stressed, frustrated or troubled were less likely to be rated as aligned calls. In calls where the callers described being ‘at their wits end’, or responded to each proposed suggestion with ‘I’ve tried that’, the callers were fairly resistant to advice-giving. 4. Training could focus on strategies for managing calls relating to parenting support and advice, and parental well-being. The project found that these calls were more likely to be rated as being nonaligned. 5. With the implementation of 13HEALTH, future research could compare nurse-parent interaction following the implementation of triaging. Of the calls, 21% had both medical and parenting topics discussed and 5.3% discussed medical, parenting and information topics. Added to this, in 12% of calls, there was ambiguity between the caller and nurse call-taker as to whether the problem was medical or behavioural.

Towards configuring the Internet for social development in the Philippines

The Internet is one of the most significant information and communication technologies to emerge during the end of the last century. It created new and effective means by which individuals and groups communicate. These advances led to marked institutional changes most notably in the realm of commercial exchange: it did not only provide the high-speed communication infrastructure to business enterprises; it also opened them to the global consumer base where they could market their products and services. Commercial interests gradually dominated Internet technology over the past several years and have been a factor in the increase of its user population and enhancement of infrastructure. Such commercial interests fitted comfortably within the structures of the Philippine government. As revealed in the study, state policies and programs make use of Internet technology as an enabler of commercial institutional reforms using traditional economic measures. Yet, despite efforts to maximize the Internet as an enabler for market-driven economic growth, the accrued benefits are yet to come about; it is largely present only in major urban areas and accessible to a small number of social groups. The failure of the Internet’s developmental capability can be traced back to the government’s wholesale adoption of commercial-centered discourse. The Internet’s developmental gains (i.e. instrumental, communicative and emancipatory) and features, which were always there since its inception, have been visibly left out in favor of its commercial value. By employing synchronic and diachronic analysis, it can be shown that the Internet can be a vital technology in promoting genuine social development in the Philippines. In general, the object is to realize a social environment of towards a more inclusive and participatory application of Internet technology, equally aware of the caveats or risks the technology may pose. It is argued further that there is a need for continued social scientific research regarding the social as and developmental implications of Internet technology at local level structures, such social sectors, specific communities and organizations. On the meta-level, such approach employed in this research can be a modest attempt in increasing the calculus of hope especially among the marginalized Filipino sectors, with the use of information and communications technologies. This emerging field of study—tentatively called Progressive Informatics—must emanate from the more enlightened social sectors, namely: the non-government, academic and locally-based organizations.

Emerging from student to practitioner : a cumulative development tool for students

PURPOSE: This pilot project’s aim was to trial a tool and process for developing students’ ability to engage in self-assessment using reflection on their clinical experiences, including feedback from workplace learning, in order to aid them in linking theory to practice and develop strategies to improve performance. BACKGROUND: In nursing education, students can experience a mismatch in performance compared to theoretical learning, this is referred to as the ‘theory practice gap’ (Scully 2011, Chan Chan & Liu 2011). One specific contributing factor seems to be students’ inability to engage in meaningful reflection and self-correcting behaviours. A self-assessment strategy was implemented within a third year clinical unit to ameliorate this mismatch with encouraging results, as students developed self-direction in addressing learning needs. In this pilot project the above strategy was adapted for implementation between different clinical units, to create a whole of course approach to integrating workplace learning. METHOD: The methodology underpinning this project is a scaffolded, supported reflective practice process. Improved self-assessment skills is achieved by students reflecting on and engaging with feedback, then mapping this to learning outcomes to identify where performance can be improved. Evaluation of this project includes: collation of student feedback identifying successful strategies along with barriers encountered in implementation; feedback from students and teachers via above processes and tools; and comparison of the number of learning contracts issued in clinical nursing units with similar cohorts. RESULTS: Results will be complete by May 2012 and include analysis of the data collected via the above evaluation methods. Other outcomes will include the refined process and tool, plus resources that should improve cost effectiveness without reducing student support. CONCLUSION: Implementing these tools and processes over the entire student’s learning package, will assist them to demonstrate progressive development through the course. Students will have learnt to understand feedback and integrate these skills for life-long learning.

The development of a Monte Carlo system to verify radiotherapy treatment dose calculations

Recent advances in the planning and delivery of radiotherapy treatments have resulted in improvements in the accuracy and precision with which therapeutic radiation can be administered. As the complexity of the treatments increases it becomes more difficult to predict the dose distribution in the patient accurately. Monte Carlo methods have the potential to improve the accuracy of the dose calculations and are increasingly being recognised as the “gold standard” for predicting dose deposition in the patient. In this study, software has been developed that enables the transfer of treatment plan information from the treatment planning system to a Monte Carlo dose calculation engine. A database of commissioned linear accelerator models (Elekta Precise and Varian 2100CD at various energies) has been developed using the EGSnrc/BEAMnrc Monte Carlo suite. Planned beam descriptions and CT images can be exported from the treatment planning system using the DICOM framework. The information in these files is combined with an appropriate linear accelerator model to allow the accurate calculation of the radiation field incident on a modelled patient geometry. The Monte Carlo dose calculation results are combined according to the monitor units specified in the exported plan. The result is a 3D dose distribution that could be used to verify treatment planning system calculations. The software, MCDTK (Monte Carlo Dicom ToolKit), has been developed in the Java programming language and produces BEAMnrc and DOSXYZnrc input files, ready for submission on a high-performance computing cluster. The code has been tested with the Eclipse (Varian Medical Systems), Oncentra MasterPlan (Nucletron B.V.) and Pinnacle3 (Philips Medical Systems) planning systems. In this study the software was validated against measurements in homogenous and heterogeneous phantoms. Monte Carlo models are commissioned through comparison with quality assurance measurements made using a large square field incident on a homogenous volume of water. This study aims to provide a valuable confirmation that Monte Carlo calculations match experimental measurements for complex fields and heterogeneous media.

Implementing the Clean Development Mechanism in Fiji : opportunities and barriers in the energy sector

The Clean Development Mechanism (CDM) has been praised for its ingenuity in mobilising finance to implement sustainable development practices in non-industrialised countries (known as Non-Annex 1 parties under the Kyoto Protocol). During the first commitment period of the Kyoto Protocol (2008-2012), a large number of clean development mechanism projects have been registered with the CDM board. In addition to the large number of registered CDM projects, there are significant numbers of proposed projects stalled in implementation due to the cumbersome and lengthy CDM approval process. Despite this regulatory criticism it is recognised that the role performed by the CDM is essential for achieving a significant reduction in global green house gas emissions. This is because the CDM funds sustainable development in countries that lack capacity to do so on their own. It is anticipated that some form of CDM instrument will continue post the 2012 timeframe and that reform of the mechanism will be focused around making the mechanism’s approval and implementation processes faster and more efficient.

Effect of carbohydrate ingestion and ambient temperature on muscle fatigue development in endurance-trained male cyclists

The aim of the present study was to determine the effect of carbohydrate (CHO; sucrose) ingestion and environmental heat on the development of fatigue and the distribution of power output during a 16.1-km cycling time trial. Ten male cyclists (Vo(2max) = 61.7 +/- 5.0 ml.kg(-1).min(-1), mean +/- SD) performed four 90-min constant-pace cycling trials at 80% of second ventilatory threshold (220 +/- 12 W). Trials were conducted in temperate (18.1 +/- 0.4 degrees C) or hot (32.2 +/- 0.7 degrees C) conditions during which subjects ingested either CHO (0.96 g.kg(-1).h(-1)) or placebo (PLA) gels. All trials were followed by a 16.1-km time trial. Before and immediately after exercise, percent muscle activation was determined using superimposed electrical stimulation. Power output, integrated electromyography (iEMG) of vastus lateralis, rectal temperature, and skin temperature were recorded throughout the trial. Percent muscle activation significantly declined during the CHO and PLA trials in hot (6.0 and 6.9%, respectively) but not temperate conditions (1.9 and 2.2%, respectively). The decline in power output during the first 6 km was significantly greater during exercise in the heat. iEMG correlated significantly with power output during the CHO trials in hot and temperate conditions (r = 0.93 and 0.73; P < 0.05) but not during either PLA trial. In conclusion, cyclists tended to self-select an aggressive pacing strategy (initial high intensity) in the heat.