Adolescent depressive disorders and family based interventions in the family options multicenter evaluation: study protocol for a randomized controlled trial

Background
There is increasing community and government recognition of the magnitude and impact of adolescent depression. Family based interventions have significant potential to address known risk factors for adolescent depression and could be an effective way of engaging adolescents in treatment. The evidence for family based treatments of adolescent depression is not well developed. The objective of this clinical trial is to determine whether a family based intervention can reduce rates of unipolar depressive disorders in adolescents, improve family functioning and engage adolescents who are reluctant to access mental health services.

Methods/Design
The Family Options study will determine whether a manualized family based intervention designed to target both individual and family based factors in adolescent depression (BEST MOOD) will be more effective in reducing unipolar depressive disorders than an active (standard practice) control condition consisting of a parenting group using supportive techniques (PAST). The study is a multicenter effectiveness randomized controlled trial. Both interventions are delivered in group format over eight weekly sessions, of two hours per session. We will recruit 160 adolescents (12 to 18 years old) and their families, randomized equally to each treatment condition. Participants will be assessed at baseline, eight weeks and 20 weeks. Assessment of eligibility and primary outcome will be conducted using the KID-SCID structured clinical interview via adolescent and parent self-report. Assessments of family mental health, functioning and therapeutic processes will also be conducted. Data will be analyzed using Multilevel Mixed Modeling accounting for time x treatment effects and random effects for group and family characteristics. This trial is currently recruiting. Challenges in design and implementation to-date are discussed. These include diagnosis and differential diagnosis of mental disorders in the context of adolescent development, non-compliance of adolescents with requirements of assessment, questionnaire completion and treatment attendance, breaking randomization, and measuring the complexity of change in the context of a family-based intervention.

Post-anaesthetic discharge scoring criteria: key findings from a systematic review

Background
Patient safety depends on nurses' clinical judgment. In post-anaesthetic care, objective scoring systems are commonly used to help nurses assess when a patient is ready to go back to the ward or be discharged home after day surgery. Although there are several criteria used to assess patient readiness for discharge from the post-anaesthetic care unit, evaluation of the validity and reliability of these criteria is scarce.

Aims
This article presents key findings from a systematic review conducted to identify the essential components of an effective and feasible scoring system to assess patients following surgical anaesthesia for discharge from the post-anaesthetic care unit.

Methods
The protocol for the systematic review of quantitative studies investigating assessment criteria for discharge of adult patients from the post-anaesthetic care unit was approved by the Joanna Briggs Institute and conducted consistent with the methodology of the Institute. Twelve databases and grey literature, such as conference proceedings, were searched for published studies between 1970 and 2010. Two reviewers independently assessed study eligibility for inclusion. Reference lists of included studies were appraised.

Results
Eight studies met the inclusion criteria; only one was a randomised controlled trial. Variables identified as essential when assessing a patient's readiness for discharge from the post-anaesthetic care unit were conscious state, blood pressure, nausea and vomiting, and pain. Assessment of psychomotor and cognitive recovery and other vital signs were also identified as relevant variables to consider.

Conclusions
There was limited high-quality research regarding criteria to assess patient readiness for discharge from the post-anaesthetic unit. The key recommendations, with moderate to high risk of bias, include that assessment of specific variables (pain, conscious state, blood pressure, and nausea and vomiting) should be made before patient discharge. These key findings have informed a subsequent study to reach international consensus on effective assessment criteria and a project to test the clinical reliability of a tool for use by nurses in assessing patient readiness for discharge from post-anaesthetic care.

Visionnaire 2013

Visionnaire: a screening of graduate and masters short films: Wolf, Shaw, Mawrgan. Treasure, Horton, Kyle. Descent, Coughlin, Michael. Cut, Hendriks, Frouwke. A Silent Waltz, Lefoe, Kelsey; Elliott, Isaac; Nanayakkara, Ashini; Tillett, Michael; Teychenne, Danielle; Axiaq, Christopher. Siren, Brander, Dale; Heath, Katherine, Stielow, Rebecca; Bellamy, Edward; Boldeman, Emma; Dong, Jing. The Man Who Cared Too Much, Milner, Robert; Di Quinzio, Carl; Lancaster, Tabitha; Hennequin, Blake; Pinnock, Alicia; Hay, Sarah. Perspective, Hampson, Matt; Gubieski, Alex; Lam, Yen; Jokomo, Nyasha; Carew, Keanan; Burr, Harrison. A Cut Above, Giebler, Heather; Blythe, Carolyn, Carell, Eden; Lai, Cyrus; Rattenbury, Todd; Gatsios, Isaac. Pumpkins, Davies, Brooke; Scharf, Harrison; Jayawardena, Kevin; Lee, Sebastian; Haidari, Ali; Morris, Travis. The Runner, Mitchinson, Liz; Kelly, Rhin; Fomin, Nina; Luxa, Haili; Williams-Pate, Robert; Karoutsos, Antonios. Doors, Sadeghi, Sam; Ward, Ben; Thomson, Alana; Brown, Sam; Earl, Richard; Watterson, James. Daddy’s Little Girl, Dahlenburg, Zoe; Atalla, Joanna; McConnell, Adam; Perri, Tim; Turnbull, Sophie; Leszczynski, Dale. Hopscotch, Egenes, Silge Vikor; Burns, Matt; Fuller, Kelly; Wurm, Christopher; Parker, Stephen; Carson, Brooke Aung.

Converting Mrs Crouch: women, wonders and the formation of English methodism, 1738-1741

This article examines the development of English Methodism during the formative period between 1738 and 1741, focusing upon the experiences of women, who made up the majority of Methodists both at this time and through much of the movement’s history. In particular, the role that women and questions of gender played in the conflict between the Wesley brothers and the Moravian leadership in London is considered. Using accounts written by the male leaders of both groups and the women who supported them, it is argued that women’s choices determined the outcome of this early battle, shaping the nascent movement in crucial ways.

The synthesis of a dichloroalane complex and its reaction with an α-diimine

Reaction of an α-diimine, {MesN[double bond, length as m-dash]CH}2 (Mes = 2,4,6-trimethylphenyl), with the dichloroalane [AlCl2H(IMes)] (IMes = 1,3-bis(2,4,6-trimethylphenyl)imidazol-2-ylidene) affords an N-heterocyclic carbene (NHC) transfer complex [AlCl2{MesNC([double bond, length as m-dash]IMes)C(H)NMes}] rather than the expected hydroalumination product.

Renal access coordinators' impact on hemodialysis patient outcomes and associated service delivery: a systematic review

Background
Renal access coordinators contribute specifically to dialysis access care for people with chronic and end stage renal disease. Since the introduction of renal access coordinators into Australia in the early 2000s, there have been anecdotal examples of associated improvements in patient outcomes and service delivery; however scant published quantitative evidence exists. Thus, the impact of the implementation of renal access coordinators has not undergone a rigorous review to date.

Objective
The objective of this systematic review was to critically appraise and synthesize the best available evidence related to the impact of renal access coordinators on dialysis patient outcomes and associated service delivery.

INCLUSION CRITERIA

Types of participants
This review considered studies that included renal access coordinators (noting variations of the titles) and adult hemodialysis patients (aged 18 years and over).

Types of intervention(s)
This review considered studies that evaluated the effectiveness of the renal access coordinator. This role typically consists of clinical and administration duties such as providing pre dialysis access coordination, access surveillance patient education and nurse education.

Types of studies
The types of studies considered within this review included experimental and epidemiological study designs. Thus randomized controlled trials (RCT), non-randomized controlled trials, and quasi-experimental, before and after studies, prospective and retrospective cohort studies were considered as were case control studies, analytical cross sectional studies and descriptive cross sectional studies.

Types of outcomes
Patient outcomes considered included: days to first vascular access complication (such as stenosis or thrombosis) and/or primary intervention (such as angioplasty or surgical intervention); percentage of central line insertions (negative); rate of arteriovenous fistula (AVF)/arteriovenous graft (AVG)/central venous catheter (CVC) at start of dialysis (incidence); prevalent rate of AVF/AVG/CVC; time to occlusion of AVF and time from referral to surgery. Service outcomes included: knowledge/up skilling of renal nurses; cannulation skills, ultrasound skills, knowledge of anatomy and physiology and other access related knowledge.

Search strategy
The search strategy aimed to locate published and unpublished studies, utilizing a three-step searching approach. Studies published in English from 1990 to October 2013 were considered for inclusion in this review.

Methodological quality
The studies were assessed by two independent reviewers using the appropriate standardized critical appraisal instruments from the Joanna Briggs Institute.

Data collection
Data were extracted from papers included in the review using the standardised data extraction tool from the Joanna Briggs Institute, namely JBI Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI).

Data synthesis
This review aimed to conduct meta-analyses of the findings: however, because of the limitations of the data found, this was not possible and so the findings are presented in a narrative format.

Results
Five studies were identified for inclusion in the review. No RCTs were found, therefore four of the five studies were pre-post intervention cohort studies and one was a prospective quality assurance report. Data were heterogeneous and thus did not allow for meta-analysis. All studies included multidisciplinary teams with variable emphasis on the renal access coordinator role. The pre post intervention cohort studies measured incident and/or prevalent AVF, AVG and CVC rates in the hemodialysis population and the quality assurance report measured the difference in patency rates between AVF and AVG. All discussed the role of central coordination as a contributor to the success of vascular access care.

Conclusions
This review found insufficient data to make firm conclusions about the impact that renal access coordinators have on patient outcomes. The results of this review suggest an association between renal access coordinators and improved patient outcomes. These improved patient outcomes were apparent in an increase in incident and prevalent AVFs, and a decrease in the incidence and prevalence of CVCs. Both associations are correlated with a reduction in infection rates, length of hospital stay and healthcare costs.

Commercial awareness in real estate courses

 Abstract
Purpose – The purpose of this paper is to evaluate how and to what extent commercial awareness is
embedded within the curriculum of the UK Royal Institution of Chartered Surveyors (RICS)-accredited
real estate courses. It also discusses the development of commercial awareness taxonomy.
Design/methodology/approach – This paper presents the research findings of questionnaire
survey and interviews with RICS-accredited real estate course providers in the UK. The questionnaire
aimed to gather course directors’ views on the definitions and components of commercial awareness
and identify what skills and attributes are required for its development. It also evaluated how
commercial awareness has been embedded in the real estate courses. The aim of the interview was to
gain deeper insight on how components of commercial awareness are embedded in real estate courses
and nine interviews were conducted. The interviews were recorded, transcribed and coded to identify
similar themes. The frequency of the answer in the questionnaire and comments from interviewees
is presented.
Findings – The UK real estate academics agreed the most important definition of commercial
awareness as that of a “person’s ability on understanding of the economics of business”. They agreed
that “strategic” is the most important component for commercial awareness, followed with “financial”
and “process”. However, the “financial” component is embedded the most in the curriculum. The most
important skill and attribute for commercial awareness development are “ability to define and solve
problems” and “ability and willingness to update professional knowledge”, respectively. Commercial
awareness was embedded in the overall curriculum and the key element for developing it is through
having “practical experience”.
Originality/value – This project is the first to conduct an in-depth analysis of commercial awareness
in real estate education. It also develops the pioneer commercial awareness taxonomy.
Keywords UK, Curriculum development, Commercial awareness, Curriculum enhancement,
Real estate education
Paper type Research paper

Competency expectations for property professionals in Australia

Purpose – The aim of this paper is to identify the competency expectations for property
professionals in Australia. It further discusses differences in competency expectations between property professionals who have different professional backgrounds, such as valuers or non-valuers, and property professionals who work in different sectors or different-sized companies and who have differing amounts of experience. The competencies identified in this paper include knowledge areas, skills and attributes.

Design/methodology/approach – This paper presents the research findings of a questionnaire survey sent to Australian Property Institute members, which aimed to gather Australian property professionals’ views on the knowledge, skills and attributes required to perform their roles effectively.  The percentage of the respondents who provided different choices of given answers for each of the 31 knowledge areas, 20 skills and 21 attributes was identified and discussed. The professional backgrounds of the respondents were also identified to see whether these impact on competency expectations for property professionals. Content analysis was used to analyse written comments collected in the questionnaire.

Findings – The most important categories of knowledge, skill and attribute for Australian property professionals are valuation, effective written communication and practical experience, respectively.  The least important are international real estate, second language and creativity. Knowledge of rural valuation is very important in Australia, although this has not been mentioned in previous studies.  Professional backgrounds have a large influence on Australian property professionals’ views on knowledge requirements, but less so on skills and attributes.

Practical implications – The findings of this paper can be used as guidance for property professionals in their professional development plan. In addition, property course providers can use the research findings of this paper to inform their curriculum development and redesign.

Originality/value – This project is the first to identify the comprehensive competency expectations of property professionals as a whole in Australia. At the same time, it identifies differences in the competency expectations of property professionals who have different professional backgrounds.  Similar types of study have been conducted in the UK, the USA, Hong Kong and New Zealand but not yet in Australia. An understanding of the knowledge, skills and attributes required for property professionals is important for continuing professional development, curriculum development and the redesign of relevant property courses in order to maintain performance and competitiveness in the property sector.