Clinical placement and rurality of career commencement : a pilot study

This article reports on a project that aimed to discover whether rural placement can influence new graduates to take up rural positions, and what factors play a role in the decision-making. This pilot study reports the findings from a pre-survey of students (n = 110) who completed a questionnaire at the end of their rural placement in the Greater Green Triangle region, Australia. Findings are compared with matched questionnaire responses for students who subsequently completed a post-survey after graduation and who commenced work (n = 28). Rural placement appears to be associated with commencing rural practice after graduation. More graduates with an urban home address commenced rural practice than graduates with a rural home address who started their careers in the city. Longer placements may sway those with a city background to start work in a rural area.

Quantum bioenergetics, mental boundaries and affective response : a randomized placebo-controlled pilot study

Previous research has demonstrated the effects of ostensible subtle energy on physical systems and subjective experience. However, one subtle energy technique that has been neglected by previous studies, despite anecdotal support for its efficacy, is Quantum BioEnergetics (QBE). Furthermore, personality traits that influence subtle energy effects remain unclear, and previous experimental studies have not investigated the constructs of Love and Joy, despite qualitative and anecdotal reports indicating that these variants of positive affect are essential elements of the subtle energy experience. The aim of the present study was to investigate experimentally the effects of QBE, and the personality trait Mental Boundaries, on positive and negative affect. Participants (N = 69) were administered the Boundary Questionnaire Short Form to quantify Boundaries, and then randomly assigned to one of three conditions: QBE, Placebo ("sham"), or Control. Affect was retrospectively assessed using the Positive and Negative Affect subdimensions of the Phenomenology of Consciousness Inventory (PCI). As predicted, a significant multivariate effect for condition was found with regards to the PCI subdimensions: Joy, Sexual Excitement, Love, Anger, Sadness, and Fear. In contrast to our expectations, a significant multivariate effect was not found for Boundaries with regards to the combined PCI-Affect variables. As hypothesized, significant interactions were found between condition and Boundaries with regards to Positive Affect, Love and Joy, with the QBE/Thin Boundaries factorial combination associated with the highest mean scores for these dependent variables. It will be prudent to ascertain whether these results are replicated in a larger sample and a placebo condition that improves on the standard randomized placebocontrolled protocols of previous subtle energy research.

Pilot study of an innovative model for clinical education in dietetics

Aim: To pilot and evaluate a new model of clinical dietetics education to address the sustainability of dietetic placements in the clinical setting.

Methods: Final-year dietetics students (n = 14) completed all nine weeks of clinical placement in the pilot program at two large tertiary referral and teaching health services in metropolitan Melbourne. Staff and students completed surveys about their experience within a week of completing placement. Data collected included paid and unpaid staff working hours, hours in clinical and teaching activity, hours of student attendance and student clinical work hours. Data for the last month of the placement programs in the preceding three years were used for comparison with the pilot program.

Results: Combined data for the two providers showed that the model reduced the amount of supervision hours per student hour on placement by 16% while maintaining quality indicators during the pilot compared with previous years. Students in the pilot program were more positive about their experience compared with students in the existing program. The overall trend of responses in the staff surveys was positive for the pilot program, but the trend was not as marked as that of student responses.

Conclusion: The new model of clinical dietetics education was successfully piloted and demonstrated the potential to increase student training capacity without a negative impact on student achievement or major resource demands. Refinements to the model and opportunities to enhance integration into the dietetics degree program were identified during the project. The learning needs of non-English-speaking background students require further scrutiny.

Relating practice to theory in indigenous entrepreneurship : a pilot investigation of the Kitsaki partnership portfolio

In Canada and elsewhere around the world, Indigenous Peoples are struggling to rebuild their "nations" and improve the socioeconomic circumstances of their people. Many see economic development as the key to success. This is certainly true for Indigenous people in Canada (the First Nations, Metis, and Inuit, collectively called Aboriginal or Indigenous people). Among them, participation in the global economy through entrepreneurship and business development is widely accepted as the key to economy building and nation "re-building." As elaborated in the next section, the demand is that this participation must be on their own terms for their own purposes, and traditional lands, history, culture, and values play a critical role. There is an intriguing symmetry between the modernity of the desire for global business competence and competitiveness and the insistence upon the distinctive importance of cultural heritage in developing new enterprise. The way that the two superficially contrasting concepts of innovation and heritage are combined in the field of Indigenous entrepreneurship has been expounded by Hindle and Lansdowne.1

Recognizing the challenges they face in attempting to compete in the global economy on their own terms, Indigenous people are increasingly developing enterprises in the form of partnerships of all types among themselves and with non-Indigenous enterprises. As both a form and a context of business organization, the partnership or alliance model is particularly fraught with the need to blend the old with the new, heritage with innovation. This study is a preliminary investigation of the Kitsaki initiative of the Lac La Ronge Indian band. In it we:

* explore several ventures involved in the partnership, asking key operatives for their opinions about the factors that explain success and failure;

* distill the explanations into as few, all-embracing factors as possible;

* relate the findings to the emerging theory of Indigenous entrepreneurship, with particular reference to the suggested paradigm of Indigenous entrepreneurship developed by Hindle and Lansdowne (2002);

* project the results of the investigation into suggestions for a more structured program of future research.

CLTS: Lessons learnt from a pilot project in Timor Leste

Timor Leste, emerging from conflict ridden independence is one of the poorest countries in Asia, with major challenges in rebuilding infrastructure, particularly water and sanitation in rural areas. Community Led Total Sanitation is a relatively new approach to eliminate open defecation through community mobilisation and behaviour change, rather than subsidy and latrine construction. This paper discusses CLTS in the Timorese context, and highlights some key challenges in assessing the potential of CLTS to address sanitation issues. Some problems identified include a lack of coherence between the integration of water supply and sanitation, and the promotion of CLTS in isolation of any project activities that utilise any form of incentive or subsidy. The knock- on effect of the long term sustainability of latrine usage and maintenance CLTS is questioned unless further research clarifies the demand responsiveness of CLTS in conjunction with subsidy driven water supply.

Acceptability, impact and sustainability of the national pilot quality assurance system for self management programs

Chronic condition self-management education and training interventions such as the Stanford Self Management Programs (SMP) have the capacity to improve health and quality of life of people with chronic conditions whilst reducing the use of health services. This is in line with the outcomes from the recent Council of Australian Governments’ meeting where it was indicated that self-management will be a centrepiece in forthcoming chronic disease initiatives.
Aim: report on a large national pilot quality assurance program involving the implementation and of an evaluation and quality monitoring system for SMPs including the provision of structured feedback to courses course leaders and service providers. During 2005/06 the quality assurance program was implemented at 11 diverse organisations across Australia. The program involved assisting organisations apply the 42-item Health Education Impact Questionnaire (HEIQ), a chronic disease health education outcome measure, and then observe and evaluate the value and impact of the quality program. Interviews with course leaders (n=60) and course participants (n=35) have elicited views about course quality and feedback processes.
Results: The evaluation revealed enablers and barriers to effective implementation and sustainability. Important enablers were:
- Course Leaders and organisations valued an Australia-wide system that provided feedback on course
quality and the impact on participants.
- Course Leaders were strongly personally motivated to respond appropriately to HEI-Q course
report feedback.
- Completing the questionnaire provided participants with the opportunity to reflect on issues that
emerge in the course content and reflect on their progression at the end of the SSMP.
Sustainability issues included:
- Organisations and course leaders require support, training and flexibility on how to administer and
manage the use of the HEI-Q.
- Availability of administrative resources in organisations to support the quality assurance activities.
- The requirement that course leaders are trained in interpreting HEI-Q course report data.
A quality improvement framework was developed which identified the actions required of key stakeholders to
support effective implementation.
Discussion: With the increasing endorsement of SMP across sectors it is important that course quality is known, is acceptable, and is communicated to stakeholders to inform and engender confidence in the SSMP. To effectively implement and sustain a quality improvement program for SMP, the processes and tools for measuring outcomes need to be responsive, flexible and easily integrated into the organisation and delivery of programs.

Nurses’ utilisation of complementary therapies : a pilot study exploring scope of practice

The increasing use of complementary therapies (CTs) by the public requires nurses to be fully informed about the use and safety of these modalities. In addition, nurses need to be aware of what constitutes complementary therapy practice, its overlap with nursing practice and how to respond appropriately to patients' requests for access to and information about CTs. A pilot study that aimed to describe nurses' knowledge about, and the use of CTs was conducted in four hospitals in southeast Queensland, Australia. One hundred and twenty-nine nurses (65% response rate) of varying levels of qualification and expertise completed a questionnaire. Over 80% of the participants indicated that they engaged in some form of complementary therapy (CT) activity. The entire sample worked in acute care hospitals but 5% engaged in CTs while employed in a second job. These nurses worked in either individual private practice or a multidisciplinary clinic setting. Only 2% of the sample had formal qualifications in a specific CT. Many nurses seemed unsure about what should be defined as a CT. The most common CTs engaged in by nurses were massage, music therapy and relaxation techniques but some nurses also participated in acupuncture, acupressure, hypnotherapy and osteopathy. Some nurses were confused about the difference between CT and usual nursing care. In addition, there were knowledge deficits relating to institutional policies and professional standards. Our findings suggest that nurses require more education about the scope of CT and how it differs from nursing practice. Nurses also require access to clear policies about the safe use of CTs in specific practice settings and about appropriate referral of clients to complementary therapists with accredited qualifications.

A pilot randomized controlled crossover study comparing regional heparinization to regional citrate anticoagulation for continuous venovenous hemofiltration

OBJECTIVE: To evaluate the efficacy and safety of a regional heparinization and a regional citrate method of anticoagulation in CVVH.
DESIGN: Randomized controlled cross-over study.
SUBJECTS: Ten critically ill patients with acute renal failure.
SETTING: ICU of tertiary hospital.
INTERVENTION: CVVH was performed with pre-filter fluid replacement at 2000 ml/h and a blood flow rate of 150 ml/min. Regional heparinization was by the administration of heparin pre-filter at 1500 IU/h and protamine post-filter at 15 mg/h. Regional citrate anticoagulation was by means of a citrate-based replacement fluid (14 mmol/L) administered pre-dilution.
RESULTS: We studied nine males and one female. The mean age and APACHE II score were 70.5 and 17 respectively. Median circuit life was 13 hours (IQR 9.28) for the regional heparinization method compared to 17 hours (IQR 12,19.5) for the regional citrate method (p=0.77). There were no episodes of bleeding in either group.
CONCLUSION: Regional heparinization and regional citrate anticoagulation achieve similar circuit life in critically ill patients receiving CVVH.