Confirming the position of a nasogastric tube what does the literature say?

Nasogastric tubes are a medical device that can be used for a number of purposes. The process of inserting them however can be complicated. Nurses must therefore use an evidence based approach to confirm the correct position of nasogastric tubes and there are three main techniques described in the literature to do so. To date, one group of authors has published the majority of the studies on these techniques. This paper reviews their work.

Double disadvantage : the influence of ethnicity over socioeconomic position on childhood overweight and obesity: findings from an inner urban population of primary school children

Objective: To examine the relationship between overweight/obesity in children, socioeconomic status and ethnicity/cultural background.

Design: Cross-sectional survey of children aged 4–13 years.

Setting: A total of 23 primary (elementary) schools in an inner urban municipality of Melbourne, Australia.

Participants: A total of 2685 children aged 4–13 years and their parents.

Main exposure measures: Ethnicity/cultural background – maternal region of birth; socioeconomic position (SEP) indicators – maternal and paternal educational attainment, family employment status, possession of a healthcare card, ability to buy food, indicator of disadvantage (Socioeconomic Index for Areas, SEIFA) score for school; parental weight status.

Main outcome measure: Prevalence of overweight/obesity.

Results: Prevalence of overweight/obesity approached 1 in 3 (31%) in this sample. Prevalence of overweight/obesity was greater for children of both North Africa and Middle Eastern background and children of Southern, South Eastern and Eastern European background compared with children of Australian background. This difference remained after adjusting for age, sex, height, clustering by school, SEP indicators and parental weight status; odds ratio, OR=1.57 (95% confidence interval, CI 1.12–2.19) and 1.88 (95%CI 1.24–2.85), respectively.

Conclusions: There is a clear independent effect of ethnicity above and beyond the effect of socioeconomic status on overweight and obesity in children. Further research is required to explore the mediators of this gradient.

Position estimation and tracking of an autonomous mobile sensor using received signal strength

In this paper, an algorithm for approximating the path of a moving autonomous mobile sensor with an unknown position location using Received Signal Strength (RSS) measurements is proposed. Using a Least Squares (LS) estimation method as an input, a Maximum-Likelihood (ML) approach is used to determine the location of the unknown mobile sensor. For the mobile sensor case, as the sensor changes position the characteristics of the RSS measurements also change; therefore the proposed method adapts the RSS measurement model by dynamically changing the pass loss value alpha to aid in position estimation. Secondly, a Recursive Least-Squares (RLS) algorithm is used to estimate the path of a moving mobile sensor using the Maximum-Likelihood position estimation as an input. The performance of the proposed algorithm is evaluated via simulation and it is shown that this method can accurately determine the position of the mobile sensor, and can efficiently track the position of the mobile sensor during motion.

Change of perspective: a measurable and desired outcome of chronic disease self-management intervention programs that violates the premise of preintervention/postintervention assessment

Objective: To determine if participants in chronic disease self-management courses have a change of perspective of their health status (a response shift), and if this is measurable with a paper-based questionnaire.

Methods: Nine items were developed to measure potential benefits of self-management courses. These were based on the constructs of a previous questionnaire, the Health Education Impact Questionnaire (HEI-Q). Cognitive interviews elicited spontaneous statements about the reasons for paper-based answers. Sensitivity, specificity, and overall accuracy of items were calculated using the interview as a relative gold standard. Response shift can be negative (i.e., after the course, participants realize that, before the course, they were worse than they thought they were), positive (i.e., participants now realize they were better than they thought they were), or absent (no change).

Results: Interviews (n = 39) reflected that true response shift occurred in approximately half the replies to questionnaire items. Of these, 31% were negative response shift, 20% were positive response shift. Response shift was absent in 32% of replies. Presence or absence of response shift could not be determined in 17% of replies across items. Significant concordance between questionnaires and cognitive interviews (average overall accuracy 0.79) indicated that the HEI-Q Perspective questionnaire detects response shift in participants of self-management courses. The questionnaire revealed that 87% of participants had response shift in at least 1 item.

Conclusion: This study suggests that preintervention/postintervention assessments of interventions such as self-management courses are confounded by a change in perspective of a large proportion of respondents. It also indicates response shift is a valuable outcome of self-management courses that can be measured with a paper-based questionnaire.

Socioeconomic position and children's physical activity and sedentary behaviors : longitudinal findings from the CLAN study

Background: This study aimed to examine cross-sectional and longitudinal associations between socioeconomic position (SEP) and physical activity and sedentary behaviors amongst children and adolescents.

Methods: Maternal education was reported by parents of 184 5-6 year-old and 358 10-12 year-old children in 2001. In 2001 and 2004, physical activity was assessed by accelerometry. Older children self-reported and parents of younger children proxy-reported physical activity and television (TV) viewing behaviors. Linear regression was used to predict physical activity and sedentary behaviors, and changes in these behaviors, from maternal education.

Results: Among all children, accelerometer-determined and self/parent-reported moderate and vigorous physical activity declined over three years. Girls of higher SEP demonstrated greater decreases in TV viewing behaviours than those of low SEP. In general, no prospective associations were evident between SEP and objectively-assessed physical activity. A small number of prospective associations were noted between SEP and self-reported physical activity, but these were generally weak and inconsistent in direction.

Conclusions: This study did not find strong evidence that maternal education was cross-sectionally or longitudinally predictive of children’s physical activity or sedentary behaviors. Given the well-documented inverse relationship of SEP with physical activity levels in adult samples, findings suggest that such disparities may emerge after adolescence.

Assume the position: reconfiguring the spatial in the pre-service education classroom

Current understandings of the practice of education locate pedagogy in the public domain through the articulation of the personal domain (Pinar, 2004). Critical literacy has provided teachers and teacher educators with a means of transforming subjectivity and relocating the personal through writing (Kamler, 2001). The emphasis in a critical literacy approach on the spoken and written word sits comfortably in the academic discourse of tertiary education, although it's engagement with the personal meets with some resistance. However, to engage the personal through arts based approaches meets far greater resistance. When used as the medium for core educational studies it provokes passionate responses of both dissent and accord. The authors argue the possibilities for an arts based pedagogy in pre-service education which provides a space for learning outside the accepted academic discourse and which supports the possibilities of imaging and knowing the positioned teacher. This research (dis)locates (Laclau, 1990; Edwards and Usher, 1997) the spatial configuration of the tertiary education classroom: reconfiguring the physical, positional, and epistemological.

Calcium and bone health : position statement for the Australian and New Zealand Bone and Mineral Society, Osteoporosis Australia and the Endocrine Society of Australia

This position statement was prepared by the Working Group of the Australian and New Zealand Bone and Mineral Society and Osteoporosis Australia. The final statement was endorsed by the Endocrine Society of Australia.

Currently, the balance of evidence remains in favour of fracture prevention from combined calcium and vitamin D supplementation in elderly men and women.

Adequate vitamin D status is essential for active calcium absorption in the gut and for bone development and remodelling.

In adults with a baseline calcium intake of 500–900 mg/day, increasing or supplementing this intake by a further 500–1000 mg/day has a beneficial effect on bone mineral density.

Calcium intake significantly above the recommended level is unlikely to achieve additional benefit for bone health.

Action research in cooperative education projects : developing lifelong capabilities for improving practice

There are natural synergies between action research as a method of inquiry and the practice of cooperative education. In the search to integrate theory and practice, action research is underpinned by a philosophy of experiential learning. Similarly, cooperative education is underpinned by the belief that in order to learn, there also needs to be action. The work of cooperative education students is also founded on data-based reflection is highly context based and usually collaborative; important characteristics of action research (Cardno, 2003). These similarities between action research and cooperative education provide a starting point in conceptualizing the adoption of action research for sport cooperative education projects. How can action research be integrated within cooperative education projects? This paper will discuss the theoretical basis of action research and illustrate through the use of case studies why and how action research has been utilized in cooperative education projects in sport and recreation. Sport students undertake a range of activities in the cooperative education setting. Some complete basic day to day tasks in recreation centers and with sports teams and others act as volunteers in major events. While these types of roles can fulfill desired outcomes for cooperative education program (for student, industry organization and institution), the adoption of action research can add a further dimension because it aims to create change within the setting under investigation. Through the use of cooperative education projects, students are in a unique position to frame a problem, integrate theory, determine action, and implement and evaluate that action. This paper explores how action research is used in cooperative education projects to help develop capabilities for improving practice.

NFC, moral position, socialisation and ethical decision-making

Absolutism (deontology and teleology), moral relativism (individual moral position), and individual and environmental factors are at the crossroads of descriptive ethics research. For several decades, researchers have espoused teleological aspects, such as the punitive influence of codes of ethics, as managerial tools that enhance ethical conduct in organisations. The current study modelled the individual factors of need-for-cognition (NFC), individual moral position, and occupational socialisation as influences on the work-norms of marketers. The findings from a survey of marketers suggest that NFC influences the ethical idealism, professional socialisation, and work-norms of marketers positively. The research identifies that encouraging cognitive activities among marketers may be a useful alternative when developing appropriate deontological work-norms and decision-making under ethical conditions in marketing.

Advances in self-engagement research method : the case of disadvantaged female migrant entrepreneurs in Auckland, New Zealand

The “self-engagement research method” is a set of research procedures, which aims to search latent (hidden) attitudes within a given group of individuals, such as disadvantaged women. This method also examines the research participants practises through an intensive involvement in the process of research. Research on self-regulation has also tended to emphasize having personal control over an event as the primary determinant of whether individuals can effectively monitor and alter their behaviour to attain a desired end state (W. Britt, 1999, 699).

The “self-engagement procedure” originated from fieldwork of social research, especially from the present author’s experiences as a researcher and practitioner on women’s empowerment under the micro-finance programme in Women’s Empowerment Foundation, Auckland and in Grameen Bank Micro-finance programme (Nobel prize winner Professor Mohammed Yunus on poverty reduction through micro-finance).

This technique is based on the oft-cited phenomenon of discrepancies between what research Participants say what they often believe (http://en.wikipedia.org/wiki/Participant_observation). This follows on Gabriel (1991:123-126) namely that participant observation is a useful technique for gaining insight into facts and is also useful for the rural poor or marginal groups, who are unable to communicate their problems. The problem is that since the 1980s, some anthropologists and the social scientists have questioned the degree to which participant observation can give truthful insight into the minds of other people (Geertz, Clifford,1984 & Rosaldo, Renato, 1986).

This paper discusses the difficulties found in using participant observation to discover discrepancies between what participants say and what they really believe. It also discusses self-engagement research procedures which the author has developed through the long-term research experiences with disadvantaged groups of women in Auckland. These procedures discover the discrepancies between what participants say and what is in their mind.

These self-engagement procedures were used from the beginning of the fieldwork to locate research areas and get access to the study settings. It was found there are gaps in this method. For example, there are no systematic processes in which researchers can gain access into the community or be welcomed by research participants. It was also difficult to discover the insight into the facts that cause disempowerment and how micro-finance impacts everyday life on research participants. McCracken (1988 cited in Mertens, 1998:321) argued that researchers collect data directly through observation, but it is not possible to imitate, repeat involvement in the experiences of research participants.

This research draws on and extends the long traditional of participant observation in social research. In field research practises, participant observation was used in different ways for gaining insight into different aspects. A good example is the use and mis-use of the “field journal” in this type of research. The journal typically explained and analysed experiences and understanding of participant observation, in-depth interviews and group discussions on the impact of micro-finance on women’s lives. However, researchers later realised that there were gaps in collected knowledge that needed to be filled. This led to “self-engagement procedures” which developed greater confidence that collected data could truly give insight into patterns of behaviour.

This paper addresses sensitive issues of women’s empowerment under the micro finance programmes and makes a contribution to the literature. The “self-engagement method” detects the “silent facts” of women’s lives. In research conducted amongst disadvantaged women in Auckland, New Zealand and Grameen Bank micro-finance programme in Bangladesh. The method of self-engagement led to better data when participants (both research and subjects) clearly perceived the purpose of the research, when participants have control over providing personal information, and when subjects can build trust with researchers. One overall lesson of this research is that research data and findings are more generalisaable and valid when the participants in the research process understand the relevancy to his/her disadvantaged position and the causes of this, and when participants perceive that it is an opportunity to voice his/her disadvantages and causes.

The “self-engagement research method” involves a variety of behavioural activities. This paper also attempts to discuss in detail, these activities. This paper attempts to discuss the process of the “self-engagement method” in a systematic way. This has been addressed in the research process, in which research participants and researchers become self-engaged to detect the reality of the impact of micro finance to empower the disadvantaged. The stages of self-engagement procedures were developed and followed throughout field research into entrepreneurial behaviour of disadvantaged women in Auckland.

Research on self-regulation has also tended to emphasize having personal control over an event as the primary determinant of whether individuals can effectively monitor and alter their behaviour to attain a desired end state (W. Britt, 1999, 699).

A suitable research method could identify the empowerment/disempowerment of a disadvantaged group of individuals. The self-engagement procedures create a process, in which research participants and researchers become ‘self-engaged’ and gain insight into facts.

understanding Fiji's declining foreign reserves position

This article examines the volatility in Fiji’s foreign reserves—in particular, whether shocks have an asymmetrical effect on volatility and whether shocks have a  persistent impact on volatility. In the pre-coup period (1975–86), shocks had a temporary effect on volatility; in the coup period (1987–2006), shocks had a more lasting impact. In the pre-coup period, negative shocks contributed more to  foreign reserves volatility than positive shocks; but in the period including the  coups, positive shocks increased the volatility of foreign reserves more than  negative shocks. The reasons for, and the policy implications of, this  asymmetrical behaviour are explored.

Ideal golf swing : an evaluation of its characteristics and the assumptions underlying its acquisition during coaching

The game of golf requires hitting a ball from a range of lies over a range of distances in environments that include many obstacles to be avoided. Each of these different golf shots arc designed to move the ball from the tee to the hole in the least number of strokes. However, the fundamental assumption that seems to underlie the coaching of golf, particularly to novice players, is that acquisition of an ideal basic golf swing is the most important outcome of coaching. Implicit in this view are three further assumptions. The first is that once this ideal basic golf swing is acquired by players, they are able to complete a game of golf in a competent manner even though this requires a range of different shots. The second is that there is a close correspondence between the quality of execution of any golf swing as judged in terms of this ideal swing, and the quality of outcome of the golf shot of which the swing is a part, as judged by where the ball comes to rest. The third assumption is that visual inspection of the golf swing by a coach can reveal inadequacies which can be remedied leading lo improved performance in the game of golf. The research reported in this thesis is an investigation of these assumptions. The rationale underlying coaching of golf was examined by reviewing the golf coaching literature (Chapter 1) and conducting a survey of professional golf coaches (Chapter 2). Results of the literature review and the survey indicated that the major emphasis of golf coaching of novices was on their acquiring what might be described as an ideal basic golf swing. This typically involved identifying components in sequence. Little emphasis was placed during this stage of coaching on what might be described as the complete action of a golf shot which involves hitting a ball to some target location. To examine the assumption that there was a close correspondence between the quality of execution of the golf swing and the quality of the outcome of a golf shot, two studies were conducted. In Chapter 3 the development of a 70-item checklist to be used to evaluate the quality of execution of a golf swing is reported. This checklist was based on a detailed behavioural analysis of the golf swing involving collaboration with relevant experts (i.e., golf coaches, biomechanist, kinesiologist), and information derived from a review of golf coaching materials. Development of the checklist was an iterative process in which earlier versions were used to evaluate sample golf swings, and problems identified during this lest process were used to improve the checklist. The final 70-item checklist comprised of a static component with three parts (left-hand grip; right-hand grip; stance) and a dynamic component with six parts (half backswing; full backswing; half downswing; ball contact; half followthrough; finish position). This version of the checklist was used in a study (reported in Chapter 4) of the relationship between the judged quality of execution of a golf swing and the outcome accuracy of a golf shot. Three groups of golfers with varying ability and experience were required to hit 50 balls with a 9-iron club to a target. Outcome accuracy for each shot was assessed in terms of the distance between the target and the resting location of the ball. Edited videotapes (showing only execution of the golf swing) of the five most, and five least accurate shots produced a sub-sample of these golfers (four professional players; four novice players) were subsequently viewed by three expert coaches. They independently rated using the checklist, the quality of execution of the 80 golf swings in random order without having information about the accuracy of any shot. As expected, the professional golfers completed more accurate golf shots than did the novices, and the golf swings completed by the professionals were rated more highly than those completed by the novices. However, for both groups of golfers the results indicated that there was no clear relationship between the rated quality of execution of golf swings and the outcome accuracy of the shots of which the swing were the initial part. Chapter 5 provides a summary and overview of the research reported in Chapter 1 to 4. It is argued that this research suggests a need for a change of emphasis in golf coaching away from consideration of the golf swing in isolation to consideration of the golf swing as part of a complete action. That is, the quality of execution of a golf swing should not be judged simply in relation to some ideal set of golf-swing components, but rather in relation to how well the completed swing (i.e., the golf shot) achieves the desired aim of propelling the ball from its present location to the target location.