Effectiveness of electrocardiographic guidance in CVAD tip placement

Background International standard practice for the correct confirmation of the central venous access device is the chest X-ray. The intracavitary electrocardiogram-based insertion method is radiation-free, and allows real-time placement verification, providing immediate treatment and reduced requirement for post-procedural repositioning. Methods Relevant databases were searched for prospective randomised controlled trials (RCTs) or quasi RCTs that compared the effectiveness of electrocardiogram-guided catheter tip positioning with placement using surface-anatomy-guided insertion plus chest X-ray confirmation. The primary outcome was accurate catheter tip placement. Secondary outcomes included complications, patient satisfaction and costs. Results Five studies involving 729 participants were included. Electrocardiogram-guided insertion was more accurate than surface anatomy guided insertion (odds ratio: 8.3; 95% confidence interval (CI) 1.38; 50.07; p=0.02). There was a lack of reporting on complications, patient satisfaction and costs. Conclusion The evidence suggests that intracavitary electrocardiogram-based positioning is superior to surface-anatomy-guided positioning of central venous access devices, leading to significantly more successful placements. This technique could potentially remove the requirement for post-procedural chest X-ray, especially during peripherally inserted central catheter (PICC) line insertion.

Are dietetics educators' attitudes to assessment a barrier to expanding placement opportunities? Results of a Delphi study

Aim Assessment of entry-level health professionals is complex, especially in the work-based setting, placing additional pressures on these learning environments. The present study aims to gain understanding and ideally consensus regarding the setting for assessment of all elements of competence for entry-level dietitians across Australia. Methods Seventy-five experienced academic and practitioner assessors were invited to participate in an online Delphi survey. The 166 entry-level performance criteria of the competency standards for dietitians formed the basis of the questions in the survey, with rating on which ones could be assessed in the practice setting, those which could be assessed in a classroom/university setting and which could be assessed in either setting. Forty-three of 75 invited assessors responded to the first round of the Delphi. A second modified survey was sent to the 43 participants with 34 responding. Results Consensus was achieved for the assessment setting for 86 (52%) of the performance criteria after two rounds of surveying. The majority of these performance criteria achieved consensus at round one (n = 44) and were deemed to be best assessed in the practice setting (n = 55). This study highlighted the perspectives of assessors and their preference for the work-based setting for assessment. Conclusions To reduce the focus on work-based settings as the only place for competence-based assessment of health professionals, there is a need to support individual and organisational change through challenging existing norms around assessment.

A penalty-based genetic algorithm for the migration cost-aware virtual machine placement problem in cloud data centers

In the past few years, the virtual machine (VM) placement problem has been studied intensively and many algorithms for the VM placement problem have been proposed. However, those proposed VM placement algorithms have not been widely used in today's cloud data centers as they do not consider the migration cost from current VM placement to the new optimal VM placement. As a result, the gain from optimizing VM placement may be less than the loss of the migration cost from current VM placement to the new VM placement. To address this issue, this paper presents a penalty-based genetic algorithm (GA) for the VM placement problem that considers the migration cost in addition to the energy-consumption of the new VM placement and the total inter-VM traffic flow in the new VM placement. The GA has been implemented and evaluated by experiments, and the experimental results show that the GA outperforms two well known algorithms for the VM placement problem.

Factors influencing radiation therapy student clinical placement satisfaction

Introduction Radiation therapy students at Queensland University of Technology (QUT) attend clinical placements at five different clinical departments with varying resources and support strategies. This study aimed to determine the relative availability and perceived importance of different factors affecting student support while on clinical placement. The purpose of the research was to inform development of future support mechanisms to enhance radiation therapy students’ experience on clinical placement. Methods This study used anonymous Likert-style surveys to gather data from years 1 and 2 radiation therapy students from QUT and clinical educators from Queensland relating to availability and importance of support mechanisms during clinical placements in a semester. Results The study findings demonstrated student satisfaction with clinical support and suggested that level of support on placement influenced student employment choices. Staff support was perceived as more important than physical resources; particularly access to a named mentor, a clinical educator and weekly formative feedback. Both students and educators highlighted the impact of time pressures. Conclusions The support offered to radiation therapy students by clinical staff is more highly valued than physical resources or models of placement support. Protected time and acknowledgement of the importance of clinical education roles are both invaluable. Joint investment in mentor support by both universities and clinical departments is crucial for facilitation of effective clinical learning.

Benefits of blended learning for the first year medical imaging students in preparation for clinical placement

Although there is a plethora of definitions of blended learning, the underlying distinguishing feature is the combination of traditional content delivery and the utilisation of technology. Within Medical Imaging undergraduate education there is evidence of advantages and increased student engagement when utilising a blended learning approach. Although the embedding of technology has been proven to be a useful teaching tool, “Educators should tailor their teaching media to learner’s needs rather than assume that web based learning is intrinsically superior”. This study aims to determine which clinical learning tools are perceived to be the most useful to the student in preparing them for placements.

Evaluation of a Multispectral Camera on a UAV for Agricultural Applications

Australian farmers have used precision agriculture technology for many years with the use of ground – based and satellite systems. However, these systems require the use of vehicles in order to analyse a wide area which can be time consuming and cost ineffective. Also, satellite imagery may not be accurate for analysis. Low cost of Unmanned Aerial Vehicles (UAV) present an effective method of analysing large plots of agricultural fields. As the UAV can travel over long distances and fly over multiple plots, it allows for more data to be captured by a sampling device such as a multispectral camera and analysed thereafter. This would allow farmers to analyse the health of their crops and thus focus their efforts on certain areas which may need attention. This project evaluates a multispectral camera for use on a UAV for agricultural applications.

“What are they really doing?” An exploration of student learning activities in field placement

Social work students consistently identify their field placement as having the most impact on their learning. Despite this, research on learning activities used during placement and the impact on practice competency and social work identity is limited. This is the second paper from a research study exploring student experiences of learning on placement. Data were gathered from 263 social work students about 14 key learning activities they experienced during placement. The more regularly students engaged in learning activities with their social work supervisor, the more likely they were to report a sense of social work identity and feelings of practice competence. However, the regular use of learning activities varied widely between placements. Surprisingly, approximately half the students did not regularly have the opportunity to observe social work practice, have their practice observed, or to link social work theory and the Code of Ethics to their practice with their social work supervisor.

Evaluation of the Red Light Camera Program and the Owner Onus Legislation

Red light cameras were introduced in Victoria in August 1983, with the intention of reducing the number of accidents that result from motorists disobeying red traffic signals at signalised intersections. Accident data from 46 treated and 46 control sites from 1981 to 1986 were analysed. The analysis indicated that red light camera use resulted in a reduction in the incidence of right angle accidents, and in the number of accident casualties. Legislation was introduced in March 1986 to place the onus for red light camera offences onto the vehicle owner. This legislation was intended to improve Police efficiency and therefore increase the number of red light cameras in operation. Data supplied by the Police indicated that these aims have beneficial road safety effects.

Report on Red Light Camera Program: Operation from July 1988 to December 1989

EXECUTIVE SUMMARY (excerpts) The red light camera (RLC) program commenced in July 1988, with five cameras operating at 15 sites in metropolitan Adelaide. This report deals with the first eighteen months of operation, to December 1989. A number of recommendations have been made… PROGRAM EVALUATION … In 1989 dollars, the program was estimated to have achieved an accident reduction benefit of $1.4m in the first 12 months of operation, which is almost twice the benefit expected using the assumptions made when selecting the sites. (There are 8 recommendations, mostly specific to the particular program characteristics)

The Red Light Camera Evaluation - Interim Report - July 1985

Red light cameras were introduced in August 1983 to deter run-the-red offences and therefore to reduce the incidence of right-angle accidents at signalised intersections in Melbourne. This report was prepared after two years of operation of the program. It provides a detailed account of the technical aspects of the program, but does not provide any detailed, evaluative analyses of accident data.

Dislocation after total hip replacement: there is no such thing as a safe zone for socket placement with the posterior approach

Introduction Malorientation of the socket contributes to instability after hip arthroplasty but the optimal orientation of the cup in relation to the pelvis has not been unequivocally described. Large radiological studies are few and problems occur with film standardisation, measurement methodology used and alternative definitions of describing acetabular orientation. Methods A cohort of 1,578 patients from a single institution is studied where all patient data was collected prospectively. Risk factors for patients undergoing surgery are analysed. Radiological data was compared between a series of non-dislocating hips and dislocating cases matched 2:1 by operation type, age and diagnosis. Results The overall dislocation rate for all 1,578 cases was 3.23% but the rate varied according to the type of surgery performed. The rate in uncomplicated primary cases was 2.4% which increased to 9.3% for second stage implantation for a two stage procedure for infection. There was no significant difference in the variability of the dislocating and non-dislocating groups for either inclination (p = 0.393) or anteversion (p = 0.661). Conclusions A “safe zone” for socket orientation to avoid dislocation could not be defined. The cause of dislocation is multifactorial, re-establishing the anatomic centre of rotation, balancing soft tissues and avoidance of impingement around the hip are important considerations.

The influence of the elements of procedural justice and speed camera enforcement on young novice driver self-reported speeding

Road policing is an important tool used to modify road user behaviour. While other theories, such as deterrence theory, are significant in road policing, there may be a role for using procedural justice as a framework to improve outcomes in common police citizen interactions such as traffic law enforcement. This study, using a sample of 237 young novice drivers, considered how the four elements of procedural justice (voice, neutrality, respect and trustworthiness) were perceived in relation to two forms of speed enforcement: point-to-point (or average) speed and mobile speed cameras. Only neutrality was related to both speed camera types suggesting that it may be possible to influence behaviour by emphasising one or more elements, rather than using all components of procedural justice. This study is important as it indicates that including at least some elements of procedural justice in more automated policing encounters can encourage citizen compliance.

Carer perspectives of factors affecting placement trajectories of children in out-of-home care

Carers are at the frontline working with children in the care of the child protection system. This paper reports carer's views about key factors influencing the placement trajectories of children and young people living in out-of-home care in Queensland, Australia. The study sample included 21 foster and kinship carers with a minimum two-year experience in the carer role. Study data were from semi-structured telephone interviews in which carers shared their experiences of the factors impacting upon placement stability and placement movement. Carers' responses were analysed thematically. Data analysis yielded an overarching theme regarding placement trajectory: Carer engagement, and its three sub-themes; with the child; with the child protection system; and, with the caring role. Findings suggested that carer engagement and ‘fit’ are complex constructs that play critical influential roles in placement outcomes (stability or movement) for individual children in out-of-home care. It is argued that practice needs to be better grounded in these relational dynamics, and better aligned concerning the power differentials that exist.

Asking the critical questions: An evaluation of social work students' experiences in an international placement

Preparing social work students for the demands of changing social environments and to promote student mobility and interest in overseas employment opportunities have resulted in an increasing demand for international social work placements. The literature describes numerous examples of social work programmes that offer a wide variety of international placements. However, research about the actual benefit of undertaking an overseas placement is scant with limited empirical evidence on the profile of students participating, their experience of the tasks offered, the supervisory practice and the outcomes for students' professional learning and career. This study contributes to the existing body of literature by exploring the relevance of international field placements for students and is unique in that it draws its sample from students who have graduated so provides a distinctive perspective in which to compare their international placement with their other placement/s as well as evaluating what were the benefits and drawbacks for them in terms of their careers, employment opportunities and current professional practice.

The inside story: A survey of social work students' supervision and learning opportunities on placement

Practice learning accounts for half of the content of the bachelor of social work degree course requirements in Northern Ireland in their field education programmes and share a professional and ethical responsibility with practice teachers to provide appropriate learning environments to prepare students as competent and professional practitioners. The accreditation standards for practice learning require the placement to provide students with regular supervision and exposure to a range of learning strategies, but there is little research that actually identifies the types of placements offering this learning and the key activities provided. This paper builds on an Australian study and surveys social work students in two programmes in Northern Ireland about their exposure to a range of learning activities, how frequently they were provided and how it compares to what is required by the Northern Ireland practice standards. The results indicated that, although most students were satisfied with the supervision and support they received during their placement, the frequency of supervision and type of learning activities varied according to different settings, year levels and who provided the learning opportunities.