Evaluating objective structured clinical assessment (OSCA) in undergraduate nursing

The aims of this mixed methods study were to gain insight into how individual assessors determine an Objective Structured Clinical Assessment (OSCA) result for undergraduate nursing students and identify whether individual assessor perceptions and professional characteristics have an impact on students' results. Results from 25 participants showed that although less than half (44%) of the participants were teaching in the course that they were assessing, the participants were highly experienced clinicians and nearly three-quarters (72%) had completed formal teaching qualifications. There were wide variations in pass rates (16.7–90%) between assessors. The widest disparity was observed between assessors with and those without critical care experience (66% versus 39%), as well as assessors who were teaching the course and those who were not (68% versus 49%). Qualitative analysis revealed three dominant themes within participants' transcripts. The themes focused on determining student safety, and the use of personal perceptions and clinical experience to determine competency. Findings indicate that assessors' individual perceptions and clinical experience have the potential to influence and determine undergraduate nursing students OSCA results. Development of criteria standards and objective assessment may be enhanced by greater involvement of assessors and thorough education and training within the context of student assessments.

Substantial reductions in the number of diabetic ketoacidosis and severe hypoglycaemia episodes requiring emergency treatment lead to reduced costs after structured education in adults with Type 1 diabetes

To determine the impact of structured education promoting flexible intensive insulin therapy on rates of diabetic ketoacidosis, and the costs associated with emergency treatment for severe hypoglycaemia and ketoacidosis in adults with Type 1 diabetes.

Assessing the clinical competence of psychology students through Objective Structured Clinical Examinations (OSCEs): student and staff views

Objective Structured Clinical Examinations (OSCEs) are a well-known, reliable, and valid assessment method used across the healthcare sector. In the present study, we applied OSCEs in three units within professional postgraduate psychology courses, with the broad aims of identifying staff and student perceptions of the assessment. At the conclusion of each OSCE, staff and students completed a feedback questionnaire that contained both scaled and open-ended questions. Results suggest that clinical psychology OSCEs can be stressful for students, but are also well regarded. Both staff and students felt that the OSCEs were realistic, valid, and aligned well with professional practice. Students reported differences in the way in which they prepared for the OSCEs compared with a written exam or other form of assessment, while staff noted that models of OSCE development must be flexible, to adequately assess the objectives of individual units. Further, because they can be a costly exercise, OSCEs need to be applied judiciously within the tertiary sector.

Robust nonlinear controller design for three-phase grid-connected photovoltaic systems under structured uncertainties

This paper presents a robust nonlinear controller design for a three-phase grid-connected photovoltaic (PV) system to control the current injected into the grid and the dc-link voltage for extracting maximum power from PV units. The controller is designed based on the partial feedback linearization approach, and the robustness of the proposed control scheme is ensured by considering structured uncertainties within the PV system model. An approach for modeling the uncertainties through the satisfaction of matching conditions is provided. The superiority of the proposed robust controller is demonstrated on a test system through simulation results under different system contingencies along with changes in atmospheric conditions. From the simulation results, it is evident that the robust controller provides excellent performance under various operating conditions. © 2014 IEEE.

Influences on the formation of academics: the role of the doctorate and structured development opportunities

The paper examines influences of doctoral study and structured early career interventions on academic work. It uses evidence from a survey in six Australian universities (n=1158) to explore academics' engagement with research and teaching development. It regards universities as social situations that are ambiguous, presenting conflicting opportunities for growth and development and the pursuit of personal objectives. Academics' emphases on different aspects of academic work involve complex responses that are subject to many influences. It shows that doctoral work may avoid developing key skills that academics need and that the extent to which doctoral study prepares academics for different aspects of their role is different in different disciplines and institutions. It also shows that the conduct of academics in their major roles is little influenced by the training and development they engage in. The paper discusses the survey findings in terms of what constrains and what enables academics to take up particular development opportunities. It argues that to understand academic practice, analysis of how organisational influences are interpreted is needed.

Lipase-catalysed incorporation of EPA into emu oil: formation and characterisation of new structured lipids

Partial hydrolysis of emu oil was performed using Thermomyces lanuginosus lipase to remove some shorter chain fatty acids. Then eicosapentaenoic acid (EPA) was incorporated into the modified emu oil using either Lipozyme RMIM or Lipozyme TLIM to produce new EPA enriched structured lipids. Using Isooctane as a reaction solvent increased the level of EPA incorporation, which was higher with RMIM than with TLIM. TLIM incorporated EPA almost exclusively into the sn-1,3 positions, whereas RMIM incorporated EPA at sn-1,3 and sn-2 positions in an almost statistical ratio. Both structured lipids were less oxidatively stable than emu oil.

Self-monitoring of blood glucose versus self-monitoring of urine glucose in adults with newly diagnosed Type 2 diabetes receiving structured education: a cluster randomized controlled trial.

AIMS: To compare the effectiveness and acceptability of self-monitoring of blood glucose with self-monitoring of urine glucose in adults with newly diagnosed Type 2 diabetes. METHODS: We conducted a multi-site cluster randomized controlled trial with practice-level randomization. Participants attended a structured group education programme, which included a module on self-monitoring using blood glucose or urine glucose monitoring. HbA1c and other biomedical measures as well as psychosocial data were collected at 6, 12 and 18 months. A total of 292 participants with Type 2 diabetes were recruited from 75 practices. RESULTS: HbA1c levels were significantly lower at 18 months than at baseline in both the blood monitoring group [mean (se) -12 (2) mmol/mol; -1.1 (0.2) %] and the urine monitoring group [mean (se) -13 (2) mmol/mol; -1.2 (0.2)%], with no difference between groups [mean difference adjusted for cluster effect and baseline value = -1 mmol/mol (95% CI -3, 2); -0.1% (95% CI -0.3, 0.2)]. Similar improvements were observed for the other biomedical outcomes, with no differences between groups. Both groups showed improvements in total treatment satisfaction, generic well-being, and diabetes-specific well-being, and had a less threatening view of diabetes, with no differences between groups at 18 months. Approximately one in five participants in the urine monitoring arm switched to blood monitoring, while those in the blood monitoring arm rarely switched (18 vs 1% at 18 months; P < 0.001). CONCLUSIONS: Participants with newly diagnosed Type 2 diabetes who attended structured education showed similar improvements in HbA1c levels at 18 months, regardless of whether they were assigned to blood or urine self-monitoring.

Time - Dependency of chloride diffusion in concrete: a brief review and preliminary results

Abstract
Chloride ingress into concrete has long been known to decrease the service life of built infrastructure. Inadequate knowledge of the physical reasons associated with chloride diffusion into concrete could generate chloride penetration profiles that become meaningless for prediction of service life. In this study, the effects of pore closure (physical effect) and changes in chloride binding (chemical effect) on chloride diffusion through Australian General Purpose (GP) cement pastes were investigated. Through - diffusion tests and “in - and - out” diffusion tests were conducted to monitor the time - dependent chloride diffusion through cement pastes cured from 1 to 28 days. The through - diffusion test quantified the overall chloride diffusion behaviour at different stages of cement hydration, which was a combined result of physical and chemical processes controlling diffusion. The “in - and - out” test differentiated the contributions of the physical and chemical processes on the chloride diffusion at different stages of cement hydration. As expected, the reduction of chloride diffusivity was significant during the first two weeks of curing, most likely attributed to the significant reduction of porosity as well as establishment of capillary discontinuities within the pore structure. It was also observed that the amount of bound chloride was not constant but increased significantly from 1 to 28 days of curing age.

Development and Implementation of a structured intervention for alcohol use disorders for telephone helpline services

A six-session intervention for harmful alcohol use was piloted via a 24-hour alcohol and other drug (AOD) helpline, assessing feasibility of telephone-delivered treatment. The intervention, involving practice elements from Motivational Interviewing, Cognitive-Behavioral Therapy, and node-link mapping, was evaluated using a case file audit (n = 30) and a structured telephone interview one month after the last session (n = 22). Average scores on the Alcohol Use Disorder Identification Test (AUDIT) dropped by more than 50%, and there were significant reductions in psychological distress. Results suggest that, even among dependent drinkers, a telephone intervention offers effective and efficient treatment for those unable or unwilling to access face-to-face treatment.

Structured representation learning from complex data

This thesis advances several theoretical and practical aspects of the recently introduced restricted Boltzmann machine - a powerful probabilistic and generative framework for modelling data and learning representations. The contributions of this study represent a systematic and common theme in learning structured representations from complex data.

A comparative assessment of the hardness of nano-structured bainitic steel affected by using various quenchants

Quenching, in heat treatment, plays a vital role in controlling material properties. It is the most important step in manipulating the strength of steel. It involves cooling the material from the austenitizing temperature at different cooling rates using variations in quenchants to obtain corresponding material properties. The commonly used quenchants are water, oil, and brine. The cooling rate is the rate at which heat is ejected from the material by the quenchant. The effectiveness of the quenchant is judged by its ability to absorb heat from the material and thermally conduct. Because of stringent regulations regarding use and disposal, there is a need to develop new, environmentally friendly quenchants. The experimental design in this study consisted of quenching austenitized nano-structured bainitic steel in four different quenchants, namely, water, oil, brine, and 1 M sodium carbonate solution. This research gives the insight of substituting conventional quenchants with 1 M sodium carbonate solution. The final four samples were characterized using metallography. A comparative study of the hardness of nano-structured bainitic steel quenched in the newly developed quenchant (i.e., 1 M sodium carbonate solution) and of steel quenched with the conventional one is done. All the results are tabulated, and the applicability of the quenchants is discussed.

Structured type 1 diabetes education delivered in routine care in Australia reduces diabetes-related emergencies and severe diabetes-related distress: the OzDAFNE program

AIMS: To evaluate structured type 1 diabetes education delivered in routine practice throughout Australia.

METHODS: Participants attended a five-day training program in insulin dose adjustment and carbohydrate counting between April 2007 and February 2012. Using an uncontrolled before-and-after study design, we investigated: HbA1c (% and mmol/mol); severe hypoglycaemia; diabetes ketoacidosis (DKA) requiring hospitalisation, and diabetes-related distress (Problem Areas in Diabetes scale; PAID), weight (kg); body mass index. Data were collected pre-training and 6-18 months post-training. Change in outcome scores were examined overall as well as between groups stratified by baseline HbA1c quartiles. Data are mean±SD or % (n).

RESULTS: 506 participants had data eligible for analysis. From baseline to follow-up, significant reductions were observed in the proportion of participants reporting at least one severe hypoglycaemic event (24.7% (n=123) vs 12.1% (n=59), p<0.001); and severe diabetes-related distress (29.3% (n=145) vs 12.6% (n=60), p<0.001). DKA requiring hospitalisation in the past year reduced from 4.1% (n=20) to 1.2% (n=6). For those with above target baseline HbA1c there was a small, statistically significant improvement (n=418, 8.4±1.1% (69±12mmol/mol) to 8.2±1.1% (66±12mmol/mol). HbA1c improvement was clinically significant among those in the highest baseline quartile (n=122, 9.7±1.1% (82±11mmol/mol) to 9.0±1.2% (75±13mmol/mol), p<0.001).

CONCLUSIONS: The proportion of participants reporting severe hypoglycaemia, DKA and severe diabetes-related distress was at least halved, and HbA1c reduced by 0.7% (7mmol/mol) among those with highest baseline levels. Structured type 1 diabetes education delivered in routine practice offers clinically important benefits for those with greatest clinical need.