The prevalence and perception of pain amongst hospital in-patients

The aim of this paper is to describe the prevalence and perceptions of pain and pain management amongst hospital in-patients. A cross-sectional descriptive survey of 205 patients was conducted. Presence and severity of pain was assessed using verbal descriptor and visual analogue scales, and perceptions of pain were assessed using multi-item scales. Although the severity of pain reported was consistent across age groups and clinical areas, women in the study sample were significantly more likely to report high levels of pain than men. Differences in how men and women communicate their pain were observed, with women indicating that they were less willing to ask for help with their pain. Results suggest that pain continues to be an important problem for a large number of men and women in hospital, and that the experience of pain impacts negatively upon their well-being. Gender differences in the experience of and response to pain remain important considerations for clinical nurses who have major responsibilities for the management of pain in hospitalized patients.

Creating 'saviour siblings' : the notion of harming by conceiving in the context of healthy children

Over the past decade there have been a number of families who have utilised assisted reproductive technologies (ARTs) to create a tissue-matched child, with the purpose of using the child’s tissue to cure an existing sick child. This inevitably brings such families a sense of hope as the ultimate aim is to overcome a family health crisis. However, this specific use of reproductive technologies has been the subject of significant criticism, most of which is levelled against the potential harm to the ‘saviour’ child. In Australia, families seeking to access reproductive technologies in this context are therefore required to justify their motives to an ethics committee in order to establish, amongst other things, whether the child will suffer harm once born. This paper explores the concept of harm in the context of conception, focusing on whether it is possible to ‘harm’ a healthy child who has been conceived to save another. To achieve this, the paper will evaluate the impact of the ‘non-identity’ principle in the ‘saviour sibling’ context, and assess the existing body of literature which addresses ‘harm’ in the context of conception. As will be established, the majority of such literature has focused on ‘wrongful life’ cases which seek to address whether an existing child who has been born with a disability, has been harmed. Finally, this paper will distinguish the harm arguments in the ‘saviour sibling’ context based on the fact that the harm evaluation concerns the ‘future-life’ assessment of a healthy child.

Assessing the overuse of antibiotics in children with URTIs in Saudi Arabia : development of the parental perception on antibiotics scale (PAPA scale)

Background: Antibiotic overuse is influenced by several factors that can only be measured using a valid and reliable psychosocial measurement instrument. This study aims to establish translation and early stage validation of an instrument recently developed by this research team to measure factors influencing the overuse of antibiotics in children with upper respiratory tract infections in Saudi Arabia. Method: The content evaluation panel was composed of area experts approached using the Delphi Technique. Experts were provided with the questionnaires iteratively, on a three-round basis until consensus on the relevance of items was reached independently. Translation was achieved by adapting Brislin’s model of translation. Results: After going through the iterative process with the experts, consensus was reached to 58 items (including demographics). Experts also pointed out some issues related to ambiguity and redundancy in some items. A final Arabic version was produced from the translation process. Conclusion: This study produced preliminary validation of the developed instrument from the experts’ contributions. Then, the instrument was translated from English to Arabic. The instrument will undergo further validation steps in the future, such as construct validity.

Assessing the overuse of antibiotics in children in Saudi Arabia : validation of the parental perception on antibiotics scale (PAPA scale)

Background Antibiotics overuse is a global public health issue influenced by several factors, of which some are parent-related psychosocial factors that can only be measured using valid and reliable psychosocial measurement instruments. The PAPA scale was developed to measure these factors and the content validity of this instrument was assessed. Aim This study further validated the recently developed instrument in terms of (1) face validity and (2) construct validity including: deciding the number and nature of factors, and item selection. Methods Questionnaires were self-administered to parents of children between the ages of 0 and 12 years old. Parents were conveniently recruited from schools’ parental meetings in the Eastern Province, Saudi Arabia. Face validity was assessed with regards to questionnaire clarity and unambiguity. Construct validity and item selection processes were conducted using Exploratory factor analysis. Results Parallel analysis and Exploratory factor analysis using principal axis factoring produced six factors in the developed instrument: knowledge and beliefs, behaviours, sources of information, adherence, awareness about antibiotics resistance, and parents’ perception regarding doctors’ prescribing behaviours. Reliability was assessed (Cronbach’s alpha = 0.78) which demonstrates the instrument as being reliable. Conclusion The ‘factors’ produced in this study coincide with the constructs contextually identified in the development phase of other instruments used to study antibiotic use. However, no other study considering perceptions of antibiotic use had gone beyond content validation of such instruments. This study is the first to constructively validate the factors underlying perceptions regarding antibiotic use in any population and in parents in particular.

Exploring the validity and predictive power of an extended volunteer functions inventory within the context of episodic skilled volunteering by retirees

The current study examined the structure of the volunteer functions inventory within a sample of older individuals (N = 187). The career items were replaced with items examining the concept of continuity of work, a potentially more useful and relevant concept for this population. Factor analysis supported a four factor solution, with values, social and continuity emerging as single factors and enhancement and protective items loading together on a single factor. Understanding items did not load highly on any factor. The values and continuity functions were the only dimensions to emerge as predictors of intention to volunteer. This research has important implications for understanding the motivation of older adults to engage in contemporary volunteering settings.

Video-based road commentary training improves hazard perception of young drivers in a dual task

This study used a video-based hazard perception dual task to compare the hazard perception skills of young drivers with middle aged, more experienced drivers and to determine if these skills can be improved with video-based road commentary training. The primary task required the participants to detect and verbally identify immediate hazard on video-based traffic scenarios while concurrently performing a secondary tracking task, simulating the steering of real driving. The results showed that the young drivers perceived fewer immediate hazards (mean = 75.2%, n = 24, 19 females) than the more experienced drivers (mean = 87.5%, n = 8, all females), and had longer hazard perception times, but performed better in the secondary tracking task. After the road commentary training, the mean percentage of hazards detected and identified by the young drivers improved to the level of the experienced drivers and was significantly higher than that of an age and driving experience matched control group. The results will be discussed in the context of psychological theories of hazard perception and in relation to road commentary as an evidence-based training intervention that seems to improve many aspects of unsafe driving behaviour in young drivers.

A description of the Mei2-like protein family; structure, phylogenetic distribution and biological context

The Schizosaccharomyces pombe Mei2 gene encodes an RNA recognition motif (RRM) protein that stimulates meiosis upon binding a specific non-coding RNA and subsequent accumulation in a “mei2-dot” in the nucleus. We present here the first systematic characterization of the family of proteins with characteristic Mei2-like amino acid sequences. Mei2-like proteins are an ancient eukaryotic protein family with three identifiable RRMs. The C-terminal RRM (RRM3) is unique to Mei2-like proteins and is the most highly conserved of the three RRMs. RRM3 also contains conserved sequence elements at its C-terminus not found in other RRM domains. Single copy Mei2-like genes are present in some fungi, in alveolates such as Paramecium and in the early branching eukaryote Entamoeba histolytica, while plants contain small families of Mei2-like genes. While the C-terminal RRM is highly conserved between plants and fungi, indicating conservation of molecular mechanisms, plant Mei2-like genes have changed biological context to regulate various aspects of developmental pattern formation.

A critical assessment of the Australian OHS accreditation system's "Body of Knowledge (BoK)"

In response to an increasing perception of poor OHS consultancy quality amongst the Australian public, regulator and OHS professionals, the Safety Institute Australia (SIA) was tasked by the Victorian government to establish an accreditation process for OHS professionals. The OHS accreditation board decided to base its accreditation on a core "body of knowledge" (BoK), against which applicants are assesssed. While the foundation and structure of the BoK is unclear, the BoK consists of a collection of essays from a variety of invited authors. The BoK comprises about 811 pages in 34 chapters, with significant redundancy and considerable subjective components. The SIA BoK is benchmarked against two international best-practices, the German "Core Definition, Object Catalog and Research Domains of Labour Science (Ergonomics)" (Luzcak, Volpert, Raeithel & Schwier, 1989)(100 pages) and the American "Core Competency Model" for the "Master's Degree in Public Health" (Association of Schools of Public Health, 2006) (21 pages). Both "core definition" and "core competency model" are on a comparative level to the BoK. While the German expert panel consisted of 14 eminent professors, the American panel consisted of 135 members, organized in 6 groups chaired by discipline leading academics. The Australian approach employed a broad approach, where 137 professionals, consultants, emerging academics and academics contributed to 8 workshops. Both the German and the American panels maintained an open communication amongst members and with the discipline community throughout the process, whereas SIA applied an open and directed peer-review process. Moreover, the German process involved an analysis of all congress content and journal publications in the scientific domain in a set timeframe, which were then systematically clustered. These results were further expanded by structured interviews with 38 professors in the discpline, grasping their research and teaching practice. The American workgroup however assumed core scientific areas, underlying the domain. Based upon the a-priori assumption, they then established well defined competencies across all areas using a modified Delphi process. Although the BoK attempts to explore the knowledge in the OHS domain without an imposed structure in a bottom-up approach, it does not result in a structured systematic of the science. We conclude that the outcome of the German, rigorous academic approach, and the US American democratic approach under unambiguous academic leadership both outperform the Australian advocacy group approach. This product was determined for both structure and content of the taxonomy delivered through the processes.

Revisiting the concept of the ‘problem young driver’ within the context of the ‘young driver problem’ : Who are they?

For decades there have been two young driver concepts: the ‘young driver problem’ where the driver cohort represents a key problem for road safety; and the ‘problem young driver’ where a sub-sample of drivers represents the greatest road safety problem. Given difficulties associated with identifying and then modifying the behaviour of the latter group, broad countermeasures such as graduated driver licensing (GDL) have generally been relied upon to address the young driver problem. GDL evaluations reveal general road safety benefits for young drivers, yet they continue to be overrepresented in fatality and injury statistics. Therefore it is timely for researchers to revisit the ‘problem young driver’ concept to assess its potential countermeasure implications. This is particularly relevant within the context of broader countermeasures that have been designed to address the ‘young driver problem’. Personal characteristics, behaviours and attitudes of 378 Queensland novice drivers aged 17-25 years were explored during their pre-, Learner and Provisional 1 (intermediate) licence as part of a larger longitudinal project. Self-reported risky driving was measured by the Behaviour of Young Novice Drivers Scale (BYNDS), and five subscale scores were used to cluster the drivers into three groups (high risk n=49, medium risk n=163, low risk n=166). High risk ‘problem young drivers’ were characterised by greater self-reported pre-Licence driving, unsupervised Learner driving, and speeding, driving errors, risky driving exposure, crash involvement, and offence detection during the Provisional period. Medium risk drivers were also characterised by more risky road use than the low risk group. Interestingly problem young drivers appear to have some insight into their high-risk driving, since they report significantly greater intentions to bend road rules in future driving. The results suggest that tailored intervention efforts may need to target problem young drivers within the context of broad countermeasures such as GDL which address the young driver problem in general. Experiences such as crash-involvement could be used to identify these drivers as a pre-intervention screening measure.

Regeneration reuse in the context of the waste management cycle of the built environment

This original study creates a philosophy of regeneration reuse, which is a conceptual framework that utilises construction and demolition waste products by building component, relocation and adaptive reuse. Case studies from the greater Brisbane, wider southeast Queensland region and greater London area are used to demonstrate the principles of regeneration reuse through research activities, analysis and evaluation. The regeneration reuse conceptual process draws upon assessing embodied carbon and sustainable benefits to deconstruct rather than destruct, and consider alternative options to waste treatment technologies in the built environment. The importance of waste management is examined, specifically the impacts of governance to the principles of regeneration reuse through analysis of legislation in the Australian and UK jurisdictions. Design process considerations when incorporating the principles of regeneration reuse are defined, and phasing and staging assessment explored to determine the most effective point of intervention in the design process to include waste management strategies.

In the blink of an eye : the circadian effects on ocular and subjective indices of driver sleepiness

Driver sleepiness contributes substantially to fatal and severe crashes and the contribution it makes to less serious crashes is likely to as great or greater. Currently, drivers’ awareness of sleepiness (subjective sleepiness) remains a critical component for the mitigation of sleep-related crashes. Nonetheless, numerous calls have been made for technological monitors of drivers’ physiological sleepiness levels so drivers can be ‘alerted’ when approaching high levels of sleepiness. Several physiological indices of sleepiness show potential as a reliable metric to monitor drivers’ sleepiness levels, with eye blink indices being a promising candidate. However, extensive evaluations of eye blink measures are lacking including the effects that the endogenous circadian rhythm can have on eye blinks. To examine the utility of ocular measures, 26 participants completed a simulated driving task while physiological measures of blink rate and duration were recorded after partial sleep restriction. To examine the circadian effects participants were randomly assigned to complete either a morning or an afternoon session of the driving task. The results show subjective sleepiness levels increased over the duration of the task. The blink duration index was sensitive to increases in sleepiness during morning testing, but was not sensitive during afternoon testing. This finding suggests that the utility of blink indices as a reliable metric for sleepiness are still far from specific. The subjective measures had the largest effect size when compared to the blink measures. Therefore, awareness of sleepiness still remains a critical factor for driver sleepiness and the mitigation of sleep-related crashes.

The state of the art defence : defining the Australian experience in the context of pharmaceuticals

One of the defences within Part 3-5 of the Australian Consumer Law is the state of the art, or development risk defence. This defence, although significant, has often been neglected in Australian jurisprudential analysis and has triggered at most generic academic analysis. However, with the rise of pharmaceutical and medical device litigation in Australia, it could become a vital weapon for Australian manufacturers against product liability claims. This paper will firstly review the two ways this defence could operate. It will also discuss the three types of defects which the defence could apply to. This paper aims to determine exactly when and how this defence should apply in Australia, in the context of pharmaceutical product liability claims.

Assessing the construct validity and reliability of the parental perception on antibiotics (PAPA) scales

Background: The overuse of antibiotics is becoming an increasing concern. Antibiotic resistance, which increases both the burden of disease, and the cost of health services, is perhaps the most profound impact of antibiotics overuse. Attempts have been made to develop instruments to measure the psychosocial constructs underlying antibiotics use, however, none of these instruments have undergone thorough psychometric validation. This study evaluates the psychometric properties of the Parental Perceptions on Antibiotics (PAPA) scales. The PAPA scales attempt to measure the factors influencing parental use of antibiotics in children. Methods: 1111 parents of children younger than 12 years old were recruited from primary schools’ parental meetings in the Eastern Province of Saudi Arabia from September 2012 to January 2013. The structure of the PAPA instrument was validated using Confirmatory Factor Analysis (CFA) with measurement model fit evaluated using the raw and scaled χ2, Goodness of Fit Index, and Root Mean Square Error of Approximation. Results: A five-factor model was confirmed with the model showing good fit. Constructs in the model include: Knowledge and Beliefs, Behaviors, Sources of information, Adherence, and Awareness about antibiotics resistance. The instrument was shown to have good internal consistency, and good discriminant and convergent validity. Conclusion: The availability of an instrument able to measure the psychosocial factors underlying antibiotics usage allows the risk factors underlying antibiotic use and overuse to now be investigated.

Tablets (iPad) for M-Learning in the context of social constructivism to institute an effective learning environment

With the proliferation of mobile devices, educational institutions have experimented with various mobile devices to implement mobile learning (M-Learning). Mobile devices have been used to facilitate, support, and enhance and extend the reach of teaching and learning. Although there are very few empirically evaluated studies on M-Learning projects, these studies reported that mobile devices brought a transformation to the educational process. To be able to view M-Learning as a rich, collaborative and conversational experience, whether in the classroom or outside we need good mobile applications. Studies have revealed that effective learning happens when teachers and learners are actively participating in the knowledge building process. Therefore, there is a need for applications that create effective learning environments which are learner-centred, knowledge-centred, assessment-centred and community-centred.