E-commerce and graduate education: is educational quality taking a nose dive?

Purpose: Online education has been growing rapidly, but has not had the benefit of the extensive teaching pedagogy development of traditional face-to-face teaching. This paper aims to provide a review of the current literature and present the results of a survey, conducted to determine the effectiveness of a graduate online subject. Design/methodology/approach: The literature was reviewed to identify measures of success and quality in online education delivery. These measures were then considered in relation to their application in practice via a case study based around a survey conducted at Deakin University in Australia. Findings: A total of 16 relevant measures of teaching quality were identified in the literature. Most measures had elements of bias and some were more generally applicable to online learning. The case study suggested that the value of computer mediated learning in an online environment was limited and that a combination of print and computer mediated conferencing performed better in more of the identified quality matrices. Practice implications: Online learning does not save teaching resources if standards of quality are maintained. It can be used to provide a remote teaching facility, provided it is backed up by resources such as printed study guides. For the subject evaluated, online mediated learning did not the provide the same quality of education. Originality/value: Whilst some research has been conducted in this area, no substantive grounded theory has been applied to postgraduate or fee-paying online education regimes. As a result, case studies of such applications can be very helpful in the design of future teaching systems.

Womens satisfaction with their breast prosthesis: What determines a quality prosthesis

The aim of this study is to determine what factors constitute a quality prosthesis and ascertain which factors affect prosthesis satisfaction. Sixty-four women who received full funding for their prosthesis and 38 women who received their hospital’s usual fundingwere recruited. Women rated the information provided about breast prostheses very highly, with 85% reporting that it was "very good" or "excellent." Satisfaction was significantly associatedwith how well the prosthesis fit (1 week,p=.001; 3 months,p=.01), level of comfort (3 months,p=.005), and appearance of the prosthesis when worn (6 months,p = .001). Quality was significantly associated with how well it fit (1 week,p = .001; 3months,p = .001), how natural it felt (1 week,p = .001; 6months,p=.01), the weight of the prosthesis (3 months,p=.003), and appearance when worn (6 months,p = .03). The results will be used to improve women’s access to a quality prosthesis.

The nose and tongue as chemical detectors

Human chemical senses are the gatekeepers of our digestive system. Chemical separation combined with human sensory perception has been used to isolate and identify a natural non-steroidal anti-inflammatory compound in olive oil.

External breast prosthesis use: experiences and views of women with breast cancer, breast care nurses, and prosthesis fitters

After mastectomy, the provision of an appropriate breast prosthesis can help to improve body image and quality of life and reduce associated emotional distress. Although up to 90% of women use an external breast prosthesis after mastectomy, little is known about their experiences and satisfaction with breast prosthesis use. Focus groups were conducted with women who had been fitted with an external breast prosthesis, breast care nurses, and prosthesis fitters to explore women's experiences of prosthesis use. Qualitative thematic content analysis of focus group transcripts indicated that whereas women's initial reaction to the prosthesis generally was negative, this improved over time. Provision of adequate information and support, characteristics of the fitter and the fitting experience, and relationships with breast care nurses and prosthesis fitters were important to women's acceptance and satisfaction with their prosthesis. The study results highlighted the key role that breast care nurses play and the underestimation of the prosthesis fitter's role. Common themes concerning the impact of prosthesis use included body image, appearance, and feminine identity. These findings have important implications for professionals involved in the delivery of breast prostheses services.

Do women have equitable access to quality breast prosthesis services?

Although up to 90% of women who have had a mastectomy use breast prostheses, significant gaps exist around current breast prosthesis services for Australian women. These gaps include the timeliness and quality of information provision, the disparity in financial assistance, and the lack of knowledge regarding the determinants of what constitutes a "quality" breast prosthesis. Revised policy initiatives are central to addressing these gaps to ensure equitable access to quality breast prosthesis services.

Laboratory model studies of flushing of trapped salt water from a blocked tidal estuary

Results are presented from a series of laboratory model studies of the flushing of saline water from a partially- or fully-closed estuary. Experiments have been carried out to determine quantitatively the response of the trapped saline volume to fresh water flushing discharges Q for different values of the estuary bed slope α and the density difference (∆ρ)_o between the saline and fresh water. The trapped saline water forms a wedge within the estuary and for maintained steady discharges, flow visualisation and density profile data confirm that its response to the imposition of the freshwater purging flow occurs in two stages, namely (i) an initial phase characterised by intense shear-induced mixing at the nose of the wedge and (ii) a relatively quiescent second phase where the mixing is significantly reduced and the wedge is forced relatively slowly down and along the bed slope. Scalings based upon simple energy balance considerations are shown to be successful in (i) describing the time-dependent wedge behaviour and (ii) quantifying the proportion of input kinetic energy converted into increasing the potential energy of the wedge/river system. Measurements show that the asymptotic value of the energy conversion factor increases with increasing value of the river Froude number Fr_o at small values of Fr_o, thereafter reaching a maximum value and a gradual decrease at the highest values of Fr_o. Dimensional analysis considerations indicate that the normalised, time-dependent wedge position (x_w)³(g')o/q² can be represented empirically by a power-law relationship of the form (x_w)[(g')_o/q²]^1/3 =C [(t)[(g')_o²/q]^1/3]"where the proportionality coefficient C is a function of both Fr_o and the slope angle α and the exponent n has a value of 0.24. Successful attempts are made to relate the model data to existing field observations from a microtidal estuary.

Experiments with multiple, intermittent periodic flushing flows confirm the importance of the starting phase of each flushing event for the time dependent behaviour of the saline wedge after reaching equilibrium in the intervals between such events. For the parameter ranges investigated and for otherwise-identical external conditions, no significant differences are found in the position of the wedge between cases of sequential multiple flushing flows and steady single discharges of the same total duration.

The salt wedge position in a bar-blocked estuary subject to pulsed inflows

A series of laboratory experiments were carried out to investigate the response of a bar-blocked, saltwedge estuary to the imposition of both steady freshwater inflows and transient inflows that simulate storm events in the catchment area or the regular water releases from upstream reservoirs. The trapped salt water forms a wedge within the estuary, which migrates downstream under the influence of the freshwater inflow. The experiments show that the wedge migration occurs in two stages, namely (i) an initial phase characterized by intense shear-induced mixing at the nose of the wedge, followed by (ii) a relatively quiescent phase with significantly reduced mixing in which the wedge migrates more slowly downstream.

Provided that the transition time t_T between these two regimes satisfies t_T>g′h⁴L/q³α, as was the case for all our experiments and is likely to be the case for most estuaries, then the transition occurs at time t_T=1.2(gα³L⁶/g′³q²)^1/6, where g′=gΔρ/ρ0 is the reduced gravity, g the acceleration due to gravity, Δρ the density excess of the saline water over the density ρ₀ of the freshwater, q the river inflow rate per unit width, and L and α are the length and bottom slope of the estuary, respectively.

A simple model, based on conversion of the kinetic energy of the freshwater inflow into potential energy to mix the salt layer, was developed to predict the displacement xw over time t of the saltwedge nose from its initial position. For continuous inflows subject to t<t_T, the model predicts the saltwedge displacement as x_w/h=1.1 (t/τ)^1/3, where the normalizing length and time scales are h=(q²/g)^1/3 and τ=g′α²h4L/q³, respectively. For continuous inflows subject to t>tT, the model predicts the displacement as xw/h=0.45N1/6(t/τ)1/6/α, where N=q²/g′h²L is a non-dimensional number for the problem. This model shows very good agreement with the experiments. For repeated, pulsed discharges subject to t<t_T, the saltwedge displacement is given by (xw/h)3−(x0/h)(xw/h)2=1.3t/τ, where x₀ is the initial displacement following one discharge event but prior to the next event. For pulsed discharges subject to t>t_T, the displacement is given by (xw/h)⁶−(x0/h)(xw/h)⁵=0.008N(t/τ)/α⁶. This model shows very good agreement with the experiments for the initial discharge event but does systematically underestimate the wedge position for the subsequent pulses. However, the positional error is less than 15%.

Audit of the use of antimicrobial prophylaxis in nasal surgery at a speciali

Background: In 2002−03 a retrospective audit of the use of surgical antimicrobial prophylaxis (AMP) for elective nasal surgery was undertaken at the Royal Victorian Eye and Ear Hospital (RVEEH). The RVEEH is a publicly funded teaching hospital that provides specialist eye, nose and throat medicine in Victoria, Australia. The aim of the audit was to determine the extent to which the use of antimicrobial prophylaxis in the hospital was consistent with Australian and international evidence-based guidelines and if there was a need for the hospital to develop internal guidelines for the use of AMP.

Methods: The histories of 500 consecutive patients who had undergone nasal surgery within the study period of August 2001 and July 2002 were examined. The data collected from these histories included information such as the patients' age, gender, diagnosis, surgical procedure performed, antimicrobial agents used, and the length of follow up and a range of factors shown in previous studies to increase the risk of surgical site infection.

Results: A total of 306 (72.86%) patients were found to have received antimicrobial agents either prior to admission, during admission or on discharge. Only 24 patients (5.71%) were administered antimicrobials immediately prior to surgery and at no other time.

Conclusions: The findings of this study support the need for further research to examine the appropriateness of the use of AMP at the RVEEH and the need for internal guidelines for its use.

Access to breast prostheses via a government-funded service in Victoria, Australia

For many women, the only alternative to breast reconstruction following a mastectomy is to use external prostheses, which need replacing regularly at a cost of up to $395 per prosthesis. Commonwealth and state governments across Australia have responded to this need by providing subsidies to assist in the purchase of breast prostheses. However, current arrangements have been highly variable and sometimes difficult to access. As part of a larger review of breast pros-thesis services in Victoria, Australia, the aim of this research was to evaluate client satisfaction among Victorian women who accessed funds through the State Government's Aids and Equipment Program, compare the responses of the program service providers with the experiences of clients accessing funding, and identify opportunities to improve service provision.

Safety and efficacy of routine postoperative ibuprofen for pain and disability related to ectopic bone formation after hip replacement surgery (HIPAID): a randomised control trial

Objectives To determine the benefits and risks of a non-steroidal anti-inflammatory drug (NSAID) as prophylaxis for ectopic bone formation in patients undergoing total hip replacement (or revision) surgery.
Design Double blind randomised placebo controlled clinical trial, stratified by treatment site and surgery (primary or revision).
Setting 20 orthopaedic surgery centres in Australia and New Zealand.
Participants 902 patients undergoing elective primary or revision total hip replacement surgery.
Intervention 14 days' treatment with ibuprofen (1200 mg daily) or matching placebo started within 24 hours of surgery.
Main outcome measures Changes in self reported hip pain and physical function 6 to 12 months after surgery (Western Ontario and McMaster University Arthritis index).
Results There were no significant differences between the groups for improvements in hip pain (mean difference -0.1, 95% confidence interval -0.4 to 0.2, P = 0.6) or physical function (-0.1, -0.4 to 0.2, P = 0.5), despite a decreased risk of ectopic bone formation (relative risk 0.69, 0.56 to 0.83) associated with ibuprofen. There was a significantly increased risk of major bleeding complications in the ibuprofen group during the admission period (2.09, 1.00 to 4.39).
Conclusions These data do not support the use of routine prophylaxis with NSAIDs in patients undergoing total hip replacement surgery.
Trial registration NCT00145730.