Is peer assessment of asynchronous group discussions fostering skills relevant to our future graduates?

The increasing use of peer assessment in higher education institutions, as well as its benefits in term of students' learning is well documented. Distance education can be fraught with challenges, but creating a community of practice has been proven to increase student engagement and learning. This paper reports on the implementation of peer assessment of online asynchronous group discussions to foster a community of practice and equip future graduates with lifelong skills relevant to their chosen professional path. Through a careful preparation of students, the implementation of the peer assessment process proved beneficial. This paper describes the analysis performed to establish the validity and reliability of the peer assessment process in the context of a 3rd year unit of study of the bachelor of nursing at Charles Darwin University. © 2010 Stéphane Bouchoucha & Helen Wozniak.

Does maternal concern about children's weight affect children's body size perception at the age of 6.5? A community-based study

OBJECTIVE: Though overweight is often established by school entry, not all mothers of such children report weight concerns. Enhancing concern might assist lifestyle change, but could lead to child body dissatisfaction. We investigated (i) perceived/desired body size and body dissatisfaction in mothers and their 6.5-year-old children, and (ii) the impact of earlier maternal concern about overweight on children's body mass index (BMI) status and body dissatisfaction. DESIGN: Prospective community study. SETTING: Melbourne, Australia. SUBJECTS: 317 mother-child dyads. MAIN EXPOSURES: Child and maternal BMI (kg m(-2)) at 4.0 and 6.5 years; maternal concern about child overweight at 4.0 years. OUTCOME MEASURES: Paired perceived and desired body size on 7-point figural rating scales self-reported by mothers and children, and reported by mothers regarding children; dissatisfaction ('desired' minus 'perceived') score. RESULTS: For all three actual BMI perceived size pairings (mother self-report, mother's report on child and child self-report), BMI correlated with perceived body size (r=0.82 (mother self-report); r=0.65 (mother reporting on child); r=0.22 (child self-report); all P<0.001). Similarly, all three dissatisfaction scores were greater with increasing BMI status. Children's own dissatisfaction scores correlated with their actual BMI, but were not related to mothers' own body dissatisfaction scores or with mothers' dissatisfaction with children's body size. Maternal concern about overweight at the age of 4 years was not associated with BMI change, or child body dissatisfaction by the age of 6.5. Most mothers of overweight and obese children (88 and 90%, respectively) regarded their child as the middle figure (that is, 4) or thinner. CONCLUSIONS: Despite low rates of recognition of child overweight, maternal perceptions of the child's body correlated strongly with the child's actual BMI. Maternal concerns about child BMI did not appear to impact on child BMI change or child body dissatisfaction.

Beyond community-based diabetes management and the COAG coordinated care trial

OBJECTIVE: This article describes the patient management processes developed during the Council of Australian Governments (COAG) coordinated care trial and use of health outcome measures to monitor changes in utilisation patterns and patient well-being over time for a subgroup of 398 patients with type 2 diabetes. DESIGN: The Eyre component of the South Australian (SA) HealthPlus coordinated care trial was a matched geographically controlled study in which the outcomes for the intervention group of 1350 patients were compared with those of a similar control group of 500 patients in another rural health region in SA. SETTING: The trial was carried out on Eyre Peninsula in SA across populations in rural communities and in the main centres of Whyalla, Port Lincoln and Ceduna. Care planning was organised through general practitioner practices and services negotiated with allied health services and hospitals to meet patient needs. SUBJECTS: The SA HealthPlus trial included 1350 patients with chronic and complex illness. A subset of this group comprising 398 patients with type 2 diabetes is described in this report. Patients recruited into the three-year trial were care planned using a patient centred care planning model through which patient goals were generated along with medical management goals developed by clinicians and primary health care professionals. Relevant health services were scheduled in line with best practice and care plans were reviewed each year. Patient service utilisation, progress towards achieving health related goals and patient health outcomes were recorded and assessed to determine improvements in health and well-being along with the cost and profile of the services provided. RESULTS: Significant numbers of patients experienced improved health outcomes as a consequence of their involvement in the trial, and utilisation data showed reductions in hospital and medical expenditure for some patients. These results suggest that methods applied in the SA HealthPlus coordinated care trial have led to improvements in health outcomes for patients with diabetes and other chronic illnesses. In addition, the processes associated with the COAG trial motivated significant organisational change in the Regional Health Service as well as providing an opportunity to study the health and well-being outcomes resulting from a major community health intervention. CONCLUSIONS: The importance of the SA HealthPlus trial has been the demonstrated link between a formal research trial and significant developments in the larger health system with the trial not only leading to improvements in clinical outcomes for patients, but also acting as a catalyst for organisational reform. We now need to look beyond the illness focus of health outcome research to develop population based health approaches to improving overall community well-being.

Optimising the impact of education for community pharmacy in Australia

Aims & rationale/Objectives : This paper examines the extent to which different models of community pharmacist continuing education (CE) are evidence-based. It also describes the impact of varying education models on attendance and attitudes within the profession.

Methods : A literature review was conducted to establish principles that should be applied to health professional education, and pharmacy in particular. Interviews were conducted with representatives from four organisations involved in the education of pharmacists to understand their current models. Four focus groups were held with community pharmacists to understand their educational experiences and attitudes.

Principal findings : The purpose of CE is to improve the clinical performance of health practitioners. Literature examining outcomes from CE underlines the importance of adult learning principles. Focus groups supported the view that consideration of these principles is beneficial. These principles, including problem-based learning, clinical applicability, relevance, and active involvement in the learning process, are currently incorporated into educational models to varying extents. Access problems such as cost, distance, insufficient flexibility in delivery, and poor promotion of educational opportunities prevent many pharmacists from taking responsibility for their own learning. A lack of appropriate assessment by some registering authorities is counterproductive to achieving CE outcomes in clinical practice. Participants already engaged in continuing professional development (CPD) agreed with the principles of its introduction.

Discussion : Optimising outcomes from CE requires considerable input from numerous stakeholders. The recent introduction of mandatory pharmacist CPD across Australia should encourage an individual focus on learning outcomes. Focus group participants are likely to be education enthusiasts and may not represent the views of the entire profession.

Implications : This study identifies the need for a system-wide approach for achieving outcomes from CE. It is therefore advisable that a coordinated strategy be developed by all stakeholders for education delivery so as to optimise the impact of CE.

Protocol for ACCESS : a qualitative study exploring barriers and facilitators to accessing the emergency contraceptive pill from community pharmacies in Australia

INTRODUCTION: The rate of unplanned pregnancy in Australia remains high, which has contributed to Australia having one of the highest abortion rates of developed countries with an estimated 1 in 5 women having an abortion. The emergency contraceptive pill (ECP) offers a safe way of preventing unintended pregnancy after unprotected sex has occurred. While the ECP has been available over-the-counter in Australian pharmacies for over a decade, its use has not significantly increased. This paper presents a protocol for a qualitative study that aims to identify the barriers and facilitators to accessing the ECP from community pharmacies in Australia.

METHODS AND ANALYSIS: Data will be collected through one-on-one interviews that are semistructured and in-depth. Partnerships have been established with 2 pharmacy groups and 2 women's health organisations to aid with the recruitment of women and pharmacists for data collection purposes. Interview questions explore domains from the Theoretical Domains Framework in order to assess the factors aiding and/or hindering access to ECP from community pharmacies. Data collected will be analysed using deductive content analysis. The expected benefits of this study are that it will help develop evidence-based workforce interventions to strengthen the capacity and performance of community pharmacists as key ECP providers.

ETHICS AND DISSEMINATION: The findings will be disseminated to the research team and study partners, who will brainstorm ideas for interventions that would address barriers and facilitators to access identified from the interviews. Dissemination will also occur through presentations and peer-reviewed publications and the study participants will receive an executive summary of the findings. The study has been evaluated and approved by the Monash Human Research Ethics Committee.

A community-based complex systems approach to high school completion

High school completion, like many educational phenomena, is the result of processes that, when taken together, constitute a complex system. In this paper, we describe the innovative use of group model building (GMB) as an entry point for complex systems analysis of educational processes that collectively determine high school completion. GMB exercises were conducted in a community in the state of Victoria in Australia. GMB brought together stakeholders from around the community and encouraged them to view high school completion from a complex systems perspective. Not only were participants able to use their experience to create an action plan to increase high school graduation rates but they also provided researchers with valuable information that can be used as input into rigorous, quantitative models of high school completion.

Benzodiazepine use of community-based violent offenders : a preliminary investigation

Objective: To explore the relationship between benzodiazepine use and violent crime in a sample of community-based offenders. Methods: Participants were recruited via drug diversion and treatment programs in Melbourne, Australia. Data regarding benzodiazepine and other substance use, mental health, personality characteristics, and crime involvement were collected through semistructured interviews conducted in 2011. Participants (n = 82, 79.3% male) were 21–56 years old, predominantly Australian-born (89%), with 14.6% identifying as Aboriginal or Torres Strait Islanders. Eligibility criteria were having been charged with a criminal offence in the previous six months and at least monthly benzodiazepine use. Group differences between violent (n = 11) and nonviolent offenders were assessed via independent samples t-tests (two-tailed) and nonparametric tests. Results: Individuals charged with violent index offences were significantly more likely to use higher average doses of alprazolam (p = 0.040) and exhibit benzodiazepine dependence (p = 0.037) as well as report high levels of sensation seeking, prior violence, and the diagnoses of depression and personality disorder than individuals charged with nonviolent index offences. Conclusions: The findings suggest the existence of a complex dynamic between mental health and violent offending that may be influenced by benzodiazepine use, in particular alprazolam. A core implication of these preliminary findings includes attending to the interpersonal skills and adaptive coping resources of violent offenders.

A simultaneous extraction of context and community from pervasive signals using nested dirichlet process

Understanding user contexts and group structures plays a central role in pervasive computing. These contexts and community structures are complex to mine from data collected in the wild due to the unprecedented growth of data, noise, uncertainties and complexities. Typical existing approaches would first extract the latent patterns to explain human dynamics or behaviors and then use them as a way to consistently formulate numerical representations for community detection, often via a clustering method. While being able to capture high-order and complex representations, these two steps are performed separately. More importantly, they face a fundamental difficulty in determining the correct number of latent patterns and communities. This paper presents an approach that seamlessly addresses these challenges to simultaneously discover latent patterns and communities in a unified Bayesian nonparametric framework. Our Simultaneous Extraction of Context and Community (SECC) model roots in the nested Dirichlet process theory which allows a nested structure to be built to summarize data at multiple levels. We demonstrate our framework on five datasets where the advantages of the proposed approach are validated.

Giving Muslim girls ‘a voice’: the possibilities and limits to challenging patriarchal interpretations of Islam in one English community

This paper presents the philosophies and practices of ‘Laura’, a young English community liaison worker and former religious studies teacher who has recently converted to Islam. Drawing on data generated from a qualitative and predominantly interview‐based research project that investigated issues of pedagogy and social justice in English schools, the focus is on Laura’s efforts to support Muslim girls through an Islamic discussion group. The paper highlights how Laura draws on Islamic beliefs to support the girls’ questioning of patriarchal interpretations of Islam within their Pakistani immigrant community. The paper also provides insight, however, into some of the tensions and limitations of Laura’s liberatory approach in terms of her positioning as white, western, and middle‐class. Against this backdrop, a self‐reflexive approach that is sensitive to how ‘ethnic‐specific sociability’ shapes understandings and enactments of gender is advocated. Such an approach is presented as central in considering how spaces of gender justice might be mobilised within community environments where unprecedented levels of multi‐cultural fragmentation and diversity have amplified tensions and conflict between and amongst racial and religious groups.