Is foot ulcer simulation training (FUST) really effective? Participants’ supervisors speak out

Background Foot ulcers are a common reason for diabetes-related hospitalisation. Foot ulcer simulation training (FUST) programs have increased podiatry participants self-confidence to manage foot ulcers. However, supervisors’ perspectives on their participants attending these simulation programs have not been investigated. This mixed method (quantitative and qualitative) study aimed to investigate home clinical supervisors’ perspectives on any changes to their participants’ competence and practice following FUST. Methods Clinical supervisors of fifteen podiatrists, who participated in a two-day Foot Ulcer Simulation Training (FUST) course, were recruited. Supervisors completed quantitative surveys evaluating their participants’ foot ulcer competence pre-FUST and 6-months post-FUST, via a purposed designed 21-item survey using a five-point Likert scale (1=Very limited, 5=Highly competent). Supervisors also attended a semi-structured qualitative group interview to investigate supervisors’ perspectives on FUST. Results Supervisors surveys returned were pre-FUST (n=10) and post-FUST (n=12). Significant competence improvements were observed at the 6-month survey (mean scores 2.84 cf. 3.72, p < 0.05). Five supervisors attended the group interview. Five sub-themes emerged: i) FUST provided a good foundation for future learning, ii) FUST modelled good clinical behaviour, iii) clinical practice improvement was evident in most participants, iv) clinical improvements were dependent on participant’s willingness to change and existing workplace culture, v) FUST needs to be reinforced back in the home clinic. Conclusion Overall, supervisors of FUST participants indicated that the course improved their participants’ competence and clinical practice. However, the degree of improvement appears dependant on the participants’ home workplace culture and willingness to embrace change.

Foot ulcer simulation training (FUST) : are podiatrists FUST with long-term clinical confidence?

Background Foot ulcers are a leading cause of diabetes-related hospitalisations. Clinical training has been shown to be beneficial in foot ulcer management. Recently, improved self-confidence in podiatrists was reported immediately after foot ulcer simulation training (FUST) pilot programs. This study aimed to investigate the longer-term impacts of the FUST program on podiatrists’ self-confidence over 12 months in a larger sample. Methods Participants were podiatrists attending a two-day FUST course comprising web-based interactive learning, low-fidelity part-tasks and high-fidelity full clinical scenarios. Primary outcome measures included participants’ self-confidence measured pre-, (immediately) post-, 6-month post- and 12-month post-course via a purpose designed 21-item survey using a five-point Likert scale (1=Very limited, 5=Highly confident). Participants’ perceptions of knowledge gained, satisfaction, relevance and fidelity were also investigated. ANOVA and post hoc tests were used to test any differences between groups. Results Thirty-four participants completed FUST. Survey response rates were 100% (pre), 82% (post), 74% (6-month post), and 47% (12-month post). Overall mean scores were 3.13 (pre), 4.49 (post), 4.35 (6-month post) and 4.30 (12-month post) (p < 0.05); post hoc tests indicated no differences between the immediately, 6-month and 12-month post group scores (p > 0.05). Satisfaction, knowledge, relevance and fidelity were all rated highly. Conclusion This study suggests that significant short-term improvements in self-confidence to manage foot ulcers via simulation training are retained over the longer term. It is likely that improved self-confidence leads to improved foot ulcer clinical practice and outcomes; although this requires further research.

Psychological maladjustment among homeless adolescents

The prevalence of psychological maladjustment in homeless adolescents (n = 54) was compared to control group (n 58) in Brisbane, Australia using the Youth Self-Report Scale [1]. Overall, 74% of the homeless group and 22.4% of the control group scored within the clinical range on one or more of the clinical subscales. There was considerable diversity of symptomatology in the homeless group. Less than half of the homeless group were within the clinical range on both the delinquent subscale and the thought disorder subscale. Depressive, Aggressive and Somatic Complaints were also prevalent. The study challenges preconceived notions of simple relationship between adolescent homelessness and delinquency, and draws attention to the psychological needs of this group of adolescents.

High-frequency global navigation satellite system’s receivers for airborne gravimetry

The development of global navigation satellite systems (GNSS) provides a solution of many applied problems with increasingly higher quality and accuracy nowadays. Researches that are carried out by the Bavarian Academy of Sciences and Humanities in Munich (BAW) in the field of airborne gravimetry are based on sophisticated data processing from high frequency GNSS receiver for kinematic aircraft positioning. Applied algorithms for inertial acceleration determination are based on the high sampling rate (50Hz) and on reducing of such factors as ionosphere scintillation and multipath at aircraft /antenna near field effects. The quality of the GNSS derived kinematic height are studied also by intercomparison with lift height variations collected by a precise high sampling rate vertical scale [1]. This work is aimed at the ways of more accurate determination of mini-aircraft altitude by means of high frequency GNSS receivers, in particular by considering their dynamic behaviour.

Development of an online role-play assessment initiative for nursing students in their bioscience studies

Devising assessment tasks for large units that embrace academic goals of authenticity and assessment variety can be a challenge. We developed an online Role-Play Assessment Initiative for first year nursing students in bioscience. Students responded to a case study by preparing two role-play dialogues: as a nurse with the patient, and between two nurses. The aims were to assess whether the students could: 1) understand the underlying disease process (pathophysiology) and relate it to clinical practice; 2) use language appropriate for lay and medical conversation; and 3) apply information using active learning. We conducted a student survey using quantitative questions (Likert scale: 1=strongly disagree to 5=strongly agree), and qualitative questions. 65 completed surveys were received. 80% of respondents agreed (includes agree or strongly agree) that it was a useful way to learn and understand pathophysiology of the case study. 86% agreed that it was useful to apply pathophysiology from lectures to a clinical setting. Overall, students found it enjoyable, which is beneficial for enhanced student engagement, and agreed that it allowed them to work well in a group (74% and 85%, respectively). Most qualitative suggestions for improvement related to group work, despite the encouraging response to group work in quantitative questions. Most positive comments surrounded different communication with a nurse compared with a patient. These results demonstrate that students developed deeper understanding of pathophysiology through active learning and were able to expand their nursing career skills during the role-play. Learning using role-play to simulate the workforce has fostered active learning.

Australia’s first Allied Health Prescribing Program – exploring participants' understanding and confidence in clinical therapy choices for patient management

BACKGROUND Globally there are emerging trends for non-medical health professionals to expand their scope of practice into prescribing. The NPS Prescribing Competencies Framework and the Health Professionals Prescribing Pathway Program are recent initiatives to assist with implementation of prescribing for allied health professionals (AHPs). For AHPs to become prescribers, training programmes must be designed to extend their knowledge of medicines information and medicine management principles with the aim of optimising medicines related outcomes for patients. AIM To explore the understanding and confidence in clinical therapeutic choices for patient management of those AHPs enrolled in the Allied Health Prescribing Training Program Module One: Introduction to clinical therapeutics for prescribers, delivered by Queensland University of Technology, Brisbane. METHOD A pre-post survey was developed to explore key themes around understanding and confidence in selecting therapeutic choices for patients with varying complexities of conditions. Data were collected from participants in week one and 13 of the module via an online survey using a five-point Likert scale (1 = Strongly Agree (SA) to 5 = Strongly Disagree (SD)). RESULTS In the pre-Module survey the AHPs had a limited degree (D/SD) of understanding and confidence regarding the safe and effective use of medicines and appropriate therapeutic choices for managing patients, particularly with complex patients. This improved significantly in the post Module survey (A/SA).

Quantitative characterization of kaolinite dispersibility in styrene–butadiene rubber composites by fractal dimension

A fractal method was introduced to quantitatively characterize the dispersibility of modified kaolinite (MK) and precipitated silica (PS) in styrene–butadiene rubber (SBR) matrix based on the lower magnification transmission electron microscopic images. The fractal dimension (FD) is greater, and the dispersion is worse. The fractal results showed that the dispersibility of MK in the latex blending sample is better than that in the mill blending samples. With the increase of kaolinite content, the FD increases from 1.713 to 1.800, and the dispersibility of kaolinite gradually decreases. There is a negative correlation between the dispersibility and loading content. With the decrease of MK and increase of PS, the FD significantly decreases from 1.735 to 1.496 and the dipersibility of kaolinite remarkably increases. The hybridization can improve the dispersibility of fillers in polymer matrix. The FD can be used to quantitatively characterize the aggregation and dispersion of kaolinite sheets in rubber matrix.

Digital elevation model error in terrain analysis

Digital elevation models (DEMs) have been an important topic in geography and surveying sciences for decades due to their geomorphological importance as the reference surface for gravita-tion-driven material flow, as well as the wide range of uses and applications. When DEM is used in terrain analysis, for example in automatic drainage basin delineation, errors of the model collect in the analysis results. Investigation of this phenomenon is known as error propagation analysis, which has a direct influence on the decision-making process based on interpretations and applications of terrain analysis. Additionally, it may have an indirect influence on data acquisition and the DEM generation. The focus of the thesis was on the fine toposcale DEMs, which are typically represented in a 5-50m grid and used in the application scale 1:10 000-1:50 000. The thesis presents a three-step framework for investigating error propagation in DEM-based terrain analysis. The framework includes methods for visualising the morphological gross errors of DEMs, exploring the statistical and spatial characteristics of the DEM error, making analytical and simulation-based error propagation analysis and interpreting the error propagation analysis results. The DEM error model was built using geostatistical methods. The results show that appropriate and exhaustive reporting of various aspects of fine toposcale DEM error is a complex task. This is due to the high number of outliers in the error distribution and morphological gross errors, which are detectable with presented visualisation methods. In ad-dition, the use of global characterisation of DEM error is a gross generalisation of reality due to the small extent of the areas in which the decision of stationarity is not violated. This was shown using exhaustive high-quality reference DEM based on airborne laser scanning and local semivariogram analysis. The error propagation analysis revealed that, as expected, an increase in the DEM vertical error will increase the error in surface derivatives. However, contrary to expectations, the spatial au-tocorrelation of the model appears to have varying effects on the error propagation analysis depend-ing on the application. The use of a spatially uncorrelated DEM error model has been considered as a 'worst-case scenario', but this opinion is now challenged because none of the DEM derivatives investigated in the study had maximum variation with spatially uncorrelated random error. Sig-nificant performance improvement was achieved in simulation-based error propagation analysis by applying process convolution in generating realisations of the DEM error model. In addition, typology of uncertainty in drainage basin delineations is presented.

The research capacity and culture of Australian podiatrists

Background Best practice clinical health care is widely recognised to be founded on evidence based practice. Enhancing evidence based practice via the rapid translation of new evidence into every day clinical practice is fundamental to the success of health care and in turn health care professions. There is little known about the collective research capacity and culture of the podiatry profession across Australia. Thus, the aim of this study was to investigate the research capacity and culture of the podiatry profession within Australia and determine if there were any differences between podiatrists working in different health sectors and workplaces. Method All registered podiatrists were eligible to participate in a cross-sectional online survey. The Australian Podiatry Associations disseminated the survey and all podiatrists were encouraged to distribute it to colleagues. The Research Capacity and Culture (RCC) tool was used to collect all research capacity and culture item variables using a 10-point scale (1 = lowest; 10 = highest). Additional demographic, workplace and health sector data variables were also collected. Mann–Whitney-U, Kruskal–Wallis and logistic regression analyses were used to determine any difference between health sectors and workplaces. Word cloud analysis was used for qualitative responses of individual motivators and barriers to research culture. Results There were 232 fully completed surveys (6% of Australian registered podiatrists). Overall respondents reported low success or skills (Median rating < 4) on the majority of individual success or skill items. Podiatrists working in multi-practitioner workplaces reported higher individual success or skills in the majority of items compared with sole practitioners (p < 0.05). Non-clinical and public health sector podiatrists reported significantly higher post-graduate study enrolment or completion, research activity participation, provisions to undertake research and individual success or skill than those working privately. Conclusions This study suggests that podiatrists in Australia report similar low levels of research success or skill to those reported in other allied health professions. The workplace setting and health sector seem to play key roles in self reported research success and skills. This is important knowledge for podiatrists and researchers aiming to translate research evidence into clinical practice.

Koulun kestävän kehityksen työn merkitys kiinteistön jätehuollossa Case: Helsingin peruskoulujen jätekustannukset ja -määrät

Koulujen kestävän kehityksen työllä tarkoitetaan ekologiseen, taloudelliseen, sosiaaliseen ja kulttuuriseen kestävyyteen pohjautuvaa ympäristökasvatusta. Helsingissä peruskoulujen kestävän kehityksen työvälineet (ympäristökartoitukset ja – ohjelmat) ovat perustuneet koulujen ympäristöasioiden suunnitteluun, opetussuunnitelmien toteutumiseen ja ylläpitotoimintoihin, kuten jätehuoltoon. Opetusvirasto käytti vuosina 2005 ja 2009 ympäristötoiminnan arvioinnissa ympäristötasokuvauksia 1-3, joista arvosana 3 kuvaa ympäristöasioissa edistyneintä koulua. Tutkielman tavoitteena on tutkia ympäristötoiminnan tasojen perusteella ryhmiteltyjen peruskoulujen välisiä eroja jätekustannuksissa ja – määrissä (euroa/henkilö ja kg/henkilö) ja löytää mahdollisesti eroihin vaikuttavia tekijöitä. Tutkielman toimeksiantajana on 4V-Välitä, vaikuta, viihdy, voi hyvin – hanke, jonka yhtenä toiminnan osa-alueena on koulujen kestävän kehityksen työ. Tuloksista tullaan johtamaan tietoa Opetusviraston sekä muiden tahojen, kuten HSY:n ja Palmian ympäristötyöhön sekä Kiinteistöviraston Tilakeskuksen hallinnassa olevien koulukiinteistöjen jätehuollon kehittämiseen. Tutkimusaineistoina käytettiin Helsingin peruskoulujen vuoden 2009 jätekustannuksia ja tutkielman yhteydessä kerätyn jäteseurannan tuloksia vuodelta 2010. Jätekustannus- ja jätemääräaineistot yhdistettiin vuoden 2009 ympäristötoiminnan tasoluokitusten perusteella otokseksi (n=64). Lopullinen jätekustannus- ja jätemääräanalyysi tehtiin 29 koulun otoksella, josta oli rajattu pois kiinteistöt, joilla on koulun toiminnan lisäksi muita käyttötarkoituksia. Analyysiin sisällytettiin myös tarkempi tarkastelu koulujen seka- ja biojätejakeiden kustannuksista ja määristä. Tutkimuksen johtopäätöksenä todettiin, että eri ympäristötasoisten peruskoulujen välillä on huomattavia euro- ja kilomääräisiä eroja henkilöä kohden lasketuissa jätekustannuksissa ja –määrissä. Kokonaisjätemäärässä ei ole tapahtunut merkittävää muutosta tarkasteluvuosien välillä, mutta lajittelu näyttäisi kuitenkin tehostuneen. Tulosten perusteella ympäristöasioissa edistyneiden tason 3 koulujen keskimääräiset sekajätemäärät ja -kustannukset olivat pienimmät tasojen 1 ja 2 kouluihin verrattuna. Biojätemäärät ja –kustannukset olivat suurimmat tason 2 kouluissa. Jätekustannuksiin ja – määriin näyttäisivät vaikuttavan jäteastioiden määrien, kokojen ja tyhjennysrytmien optimointi sekä jäteastioiden täyttöasteet. Peruskoulujen tulisi keskittyä kestävän kehityksen työn avulla jätteiden synnyn ehkäisyyn ja vähentämiseen, jotta jätekustannuksetkin vähentyisivät jätehuollon kehittämistoimenpiteiden seurauksena.

Quantum Dots and Nanoroads of Graphene Embedded in Hexagonal Boron Nitride

The quest for novel two-dimensional materials has led to the discovery of hybrids where graphene and hexagonal boron nitride (h-BN) occur as phase-separated domains. Using first-principles calculations, we study the energetics and electronic and magnetic properties of such hybrids in detail. The formation energy of quantum dot inclusions (consisting of n carbon atoms) varies as 1/root n, owing to the interface. The electronic gap between the occupied and unoccupied energy levels of quantum dots is also inversely proportional to the length scale, 1/root n-a feature of confined Dirac fermions. For zigzag nanoroads, a combination of the intrinsic electric field caused by the polarity of the h-BN matrix and spin polarization at the edges results in half-metallicity; a band gap opens up under the externally applied ``compensating'' electric field. For armchair nanoroads, the electron confinement opens the gap, different among three subfamilies due to different bond length relaxations at the interfaces, and decreasing with the width.

Image fusion in GRDSS for Land use Mapping

Image fusion techniques are useful to integrate the geometric detail of a high-resolution panchromatic (PAN) image and the spectral information of a low-resolution multispectral (MSS) image, particularly important for understanding land use dynamics at larger scale (1:25000 or lower), which is required by the decision makers to adopt holistic approaches for regional planning. Fused images can extract features from source images and provide more information than one scene of MSS image. High spectral resolution aids in identification of objects more distinctly while high spatial resolution allows locating the objects more clearly. The geoinformatics technologies with an ability to provide high-spatial-spectral-resolution data helps in inventorying, mapping, monitoring and sustainable management of natural resources. Fusion module in GRDSS, taking into consideration the limitations in spatial resolution of MSS data and spectral resolution of PAN data, provide high-spatial-spectral-resolution remote sensing images required for land use mapping on regional scale. GRDSS is a freeware GIS Graphic User Interface (GUI) developed in Tcl/Tk is based on command line arguments of GRASS (Geographic Resources Analysis Support System) with the functionalities for raster analysis, vector analysis, site analysis, image processing, modeling and graphics visualization. It has the capabilities to capture, store, process, analyse, prioritize and display spatial and temporal data.

Control de malezas en el cultivo de la soya (Glycine max L. Merril) variedad (Biloxi y hardee) 69-341

En el Centro Experimental Agropecuario La Calera, Managua, Nicaragua, se estableció en siembra de agosto a noviembre de 1976, un ensayo para determinar el tratamiento mas efectivo y rentable en el control de las malezas del cultivo de la soya (Glycine max L. Merril). Se escogió la variedad (Biloxi x Hardee) 69-341 de crecimiento determinado y ciclo vegetativo intermedio de 90-100 días. Los tratamientos que se evaluaron fueron los siguientes: Alachlor, Metribuzin, Linuron, Trifluralina, Alachlor + Metribuzin, Alachlor + Linuron, Alachlor + Trifluralina, Metribuzin + Lanuron, Metribuzin + Trifluralina, Linuron + Trifluralina en dosis de 2049,5 ml, 497,70 g, 966,00 g, 533,75 ml, 1024,75 ml + 248,85 g, 1024,75 ml + 483,00 g, 1024,75 ml + 266,87 ml, 248,85 g + 483,00 g, 248,85 g + 266,87 ml y 483,00 g, + 266,87 ml, por hectárea respectivamente, usando como comparadores un tratamiento mecánico y un testigo absoluto. Los tratamientos fueron distribuidos en un diseño de bloques completos al azar, con cuatro repeticiones. La parcela experimental consto de ocho surcos de cinco metros de largo, espaciados a cincuenta centímetros entre si y a 2,50 centímetros entre planta, correspondiendo a la parcela útil los cuatro surcos centrales a los cuales se les elimino 50,0 centímetros en cada extremo. El análisis de varianza practicado en los rendimientos de granos y en los porcentajes de control de malezas determino diferencia altamente significativa entre tratamientos al nivel de 0,01 de probabilidad de error. La mezcla de Alachlor + Metribuzin fue el tratamiento herbicida que ejerció el mayor control sobre gramíneas y hojas ancha, con 97,00 por ciento de control hasta los 60 días de emergida la soya. Los tratamientos Metribuzin, Metribuzin + Trifluralina y Alachlor fueron estadisticamente igual al nivel del 0,05 de probabilidad de error con: 74,00; 72,00 y 71;00 por ciento. Los tratamientos que menor porcentaje de control de malezas ejercieron hasta los 60 dias fueron Linuron y Linuron + Trifluralina con 34.00 por ciento. Los mayores rendimientos significativos de grano de soya, se lograron con: testigo mecanico, Alachlor + Metribuzin, Alachlor, y Alachlor + Linuron obteniendo 2,539.00, 2.294.00, 2.279.00 y 2.194.00 kilogramos por hectárea respectivamente. Los menores rendimientos correspondieron a: Trifluralina con 1,103.00 hectarea y testigo absoluto con 844.00 por hectarea. El analisis economico de los rendimientos por tratamiento, revelo que los mayores ingresos netos se obtuvieron con: testigo mecánico, Alachlor + Metribuzin, y Alachlor y Alachlor + Linuron de: 1,945.22, 1,800.12, 1,771.87 y 1,668.31 córdobas por hectárea respectivamente, pero la mayor relación beneficio-costo se logro con los tratamientos Alachlor, Alachlor + Metribuzin, testigo mecánico y Alachlor + Linuron, con 2.31, 2.30, 2.23 y 2.21 respectivamente.

A journey in Brazil

Jean Louis Rodolphe Agassiz foi professor e naturalista suíço naturalizado americano. Nasceu em Motiers, em 28 de maio de 1807, e morreu em Cambridge, em 1873. Estudou em Universidades suíças e alemãs, doutorando-se em Medicina, em Munique, em 1830. Em 1846, fixou-se nos Estados Unidos, onde lecionou em Harvard, e, em 1861, tornou-se cidadão americano. O estudo e a classificação de espécies de peixes brasileiros despertou-lhe o interesse pelo Brasil e , em 1865, chegou ao País à frente de uma expedição científica, que ficou conhecida como Thayer Expedition, custeada pelo milionário americano Nathanael Thayer e patrocinada pelo Imperador D. Pedro II. Permaneceu no País por quinze meses, explorando o Rio Amazonas e o interior cearense, período em que classificou 1.800 espécies da fauna ictiológica. Dessa viagem, resultou o livro A journey in Brasil. Seus estudos de Zoologia e Paleontologia, assim como os dos glaciares da Europa e da América, tornaram-se célebre. A obra científica de Agassiz é constituída por mais de quatrocentos volumes.

Voyage au Brésil / M. et Mme. Agassiz ; abrégé sur la traduction de F. Vogeli par J. Belin-de Launay et contenant une Carte e 16 gravures sur bois

Jean Louis Rodolphe Agassiz foi professor e naturalista suíço naturalizado americano. Nasceu em Motiers, em 28 de maio de 1807, e morreu em Cambridge, em 1873. Estudou em Universidades suíças e alemãs, doutorando-se em Medicina, em Munique, em 1830. Em 1846, fixou-se nos Estados Unidos, onde lecionou em Harvard, e, em 1861, tornou-se cidadão americano. O estudo e a classificação de espécies de peixes brasileiros despertou-lhe o interesse pelo Brasil e , em 1865, chegou ao País à frente de uma expedição científica, que ficou conhecida como Thayer Expedition, custeada pelo milionário americano Nathanael Thayer e patrocinada pelo Imperador D. Pedro II. Permaneceu no País por quinze meses, explorando o Rio Amazonas e o interior cearense, período em que classificou 1.800 espécies da fauna ictiológica. Dessa viagem, resultou o livro A journey in Brasil. Seus estudos de Zoologia e Paleontologia, assim como os dos glaciares da Europa e da América, tornaram-se célebre. A obra científica de Agassiz é constituída por mais de quatrocentos volumes.