Everyone's problem but nobody's job : staff perceptions and explanations for poor nutritional intake in older medical patients

Aim: Up to 60% of older medical patients are malnourished with further decline during hospital stay. There is limited evidence for effective nutrition intervention. Staff focus groups were conducted to improve understanding of potential contextual and cultural barriers to feeding older adults in hospital. Methods: Three focus groups involved 22 staff working on the acute medical wards of a large tertiary teaching hospital. Staff disciplines were nursing, dietetics, speech pathology, occupational therapy, physiotherapy, pharmacy. A semistructured topic guide was used by the same facilitator to prompt discussions on hospital nutrition care including barriers. Focus groups were tape-recorded, transcribed and analysed thematically. Results: All staff recognised malnutrition to be an important problem in older patients during hospital stay and identified patient-level barriers to nutrition care such as non-compliance to feeding plans and hospital-level barriers including nursing staff shortages. Differences between disciplines revealed a lack of a coordinated approach, including poor knowledge of nutrition care processes, poor interdisciplinary communication, and a lack of a sense of shared responsibility/coordinated approach to nutrition care. All staff talked about competing activities at meal times and felt disempowered to prioritise nutrition in the acute medical setting. Staff agreed education and ‘extra hands’ would address most barriers but did not consider organisational change. Conclusions: Redesigning the model of care to reprioritise meal-time activities and redefine multidisciplinary roles and responsibilities would support coordinated nutrition care. However, effectiveness may also depend on hospitalwide leadership and support to empower staff and increase accountability within a team-led approach.

Sustainable Road Management in Texas : network-level flexible pavement structural condition analysis using data mining techniques

The research team recognized the value of network-level Falling Weight Deflectometer (FWD) testing to evaluate the structural condition trends of flexible pavements. However, practical limitations due to the cost of testing, traffic control and safety concerns and the ability to test a large network may discourage some agencies from conducting the network-level FWD testing. For this reason, the surrogate measure of the Structural Condition Index (SCI) is suggested for use. The main purpose of the research presented in this paper is to investigate data mining strategies and to develop a prediction method of the structural condition trends for network-level applications which does not require FWD testing. The research team first evaluated the existing and historical pavement condition, distress, ride, traffic and other data attributes in the Texas Department of Transportation (TxDOT) Pavement Maintenance Information System (PMIS), applied data mining strategies to the data, discovered useful patterns and knowledge for SCI value prediction, and finally provided a reasonable measure of pavement structural condition which is correlated to the SCI. To evaluate the performance of the developed prediction approach, a case study was conducted using the SCI data calculated from the FWD data collected on flexible pavements over a 5-year period (2005 – 09) from 354 PMIS sections representing 37 pavement sections on the Texas highway system. The preliminary study results showed that the proposed approach can be used as a supportive pavement structural index in the event when FWD deflection data is not available and help pavement managers identify the timing and appropriate treatment level of preventive maintenance activities.

Joining the dots : piloting the work diary as a data collection tool for educational research

This paper demonstrates the affordances of the work diary as a data collection tool for both pilot studies and qualitative research of social interactions. Observation is the cornerstone of many qualitative, ethnographic research projects (Creswell, 2008). However, determining through observation, the activities of busy school teams could be likened to joining dots of a child’s drawing activity to reveal a complex picture of interactions. Teachers, leaders and support personnel are in different locations within a school, performing diverse tasks for a variety of outcomes, which hopefully achieve a common goal. As a researcher, the quest to observe these busy teams and their interactions with each other was daunting and perhaps unrealistic. The decision to use a diary as part of a wider research project was to overcome the physical impossibility of simultaneously observing multiple team members. One reported advantage of the use of the diary in research was its suitability as a substitute for lengthy researcher observation, because multiple data sets could be collected at once (Lewis et al, 2005; Marelli, 2007).

Early years activities for NLNW 2012 - Pearl Barley & Charlie Parsley

This Early Years unit is designed to engage students in a sequence of activities that use a range of literacies which explore feelings, friendships and personality traits. The text, Pearl Barley and Charlie Parsley, is the focus of this unit. Suggested activities promote participation through simple and effective strategies, using technology, process drama, graphic ogranisers and critical literacy. This unit allows for flexibility so teachers can select activities that best suit time, resources and students' needs and interests. Students are asked to make connections between the text and their own friendships, understanding that the best of friends can be different in almost every way.

Team teaching : working together to promote student learning

This book chapter examines the concept of team teaching from the perspective of the various stakeholders, in order to discuss the advantages and disadvantages of team teaching for students, to consider the positive and negative dimensions of collaborative teaching for teachers, and to review the implications for educational administration. In addition, attention will be paid to the issues associated with team teaching in the context of e-learning. The chapter concludes with a case study which discusses how the implementation of collaborative teaching within the library and information science discipline at an Australian university helped develop the authors’ understanding of socially constructed knowledge.

FINALE of the U.N. International Year of Forests : culmination with a concert

Our Counselling and ISS team organised, in early December, 2011 a celebration of two years of art workshops and activities provided for our University post-graduate research students. The workshops had a number of benefits. They were to raise awareness of biodiversity and forests as well as providing a forum for engaging with others and an opportunity to belong to a semi-regular group. The 2010 theme had been the United Nations International Year of Biodiversity and the 2011 theme had been the United Nations International Year of Forests.

Combination of MEK-ERK inhibitor and hyaluronic acid has a synergistic effect on anti-hypertrophic and pro-chondrogenic activities in osteoarthritis treatment

We hypothesised that a potentially disease-modifying osteoarthritis (OA) drug such as hyaluronic acid (HA) given in combination with anti-inflammatory signalling agents such as mitogen-activated protein kinase kinase–extracellular signal-regulated kinase (MEK-ERK) signalling inhibitor (U0126) could result in additive or synergistic effects on preventing the degeneration of articular cartilage. Chondrocyte differentiation and hypertrophy were evaluated using human OA primary cells treated with either HA or U0126, or the combination of HA + U0126. Cartilage degeneration in menisectomy (MSX) induced rat OA model was investigated by intra-articular delivery of either HA or U0126, or the combination of HA + U0126. Histology, immunostaining, RT-qPCR, Western blotting and zymography were performed to assess the expression of cartilage matrix proteins and hypertrophic markers. Phosphorylated ERK (pERK)1/2-positive chondrocytes were significantly higher in OA samples compared with those in healthy control suggesting the pathological role of that pathway in OA. It was noted that HA + U0126 significantly reduced the levels of pERK, chondrocyte hypertrophic markers (COL10 and RUNX2) and degenerative markers (ADAMTs5 and MMP-13), however, increased the levels of chondrogenic markers (COL2) compared to untreated or the application of HA or U0126 alone. In agreement with the results in vitro, intra-articular delivery of HA + U0126 showed significant therapeutic improvement of cartilage in rat MSX OA model compared with untreated or the application of HA or U0126 alone. Our study suggests that the combination of HA and MEK-ERK inhibition has a synergistic effect on preventing cartilage degeneration.

Serious playground : using Second Life to engage high school students in urban planning

Virtual world platforms such as Second Life have been successfully used in educational contexts to motivate and engage learners. This article reports on an exploratory workshop involving a group of high school students using Second Life for an urban planning project. Young people are traditionally an under-represented demographic when it comes to participating in urban planning and decision making processes. The research team developed activities that combined technology with a constructivist approach to learning. Real world experiences and purposes ensured that the workshop enabled students to see the relevance of their learning. Our design also ensured that play remained an important part of the learning. By conceiving of the workshop as a ‘serious playground’ we investigated the ludic potential of learning in a virtual world.

FINALE of the U.N. International Year of Forests : culmination with a concert

Our Counselling and ISS team organised, in early December, 2011 a celebration of two years of art workshops and activities provided for our University post-graduate research students. The workshops had a number of benefits. They were to raise awareness of biodiversity and forests as well as providing a forum for engaging with others and an opportunity to belong to a semi-regular group. The 2010 theme had been the United Nations International Year of Biodiversity and the 2011 theme had been the United Nations International Year of Forests.

The red mist? red shirts, success and team sports

Baron von Richthofen (the Red Baron) arguably the most famous fighter pilot of all time painted his plane the vividest of red hues, making it visible and identifiable at great distance, showing an aggressive pronouncement of dominance to other pilots. Can colour affect aggression and performance and if so is it observable within team sports? This study explores the effect of red on sporting performances within a team sports arena, through empirical analysis of match results from the Australian Rugby League spanning a period of 30 years. Both the descriptive analysis and the multivariate analysis report a positive relationship. Nevertheless, more evidence is required to better understand whether teams in red do enjoy greater success controlling explicitly in a multivariate analysis for many factors that simultaneously affect performance.

Gaps in organizational leadership : linking strategic and operational activities through design-led propositions

The relationship between design process and business systems has been of interest to both practitioners and researchers exploring the numerous opportunities and challenges of this unlikely relationship. Often the relationship is presented as building design thinking capability within an organization, which can be broadly described as the union of design and strategy. Brown (2008) notes that design thinking is ‘‘a discipline that uses the designer’s sensibility and methods to match people’s needs with what is technically feasible and what business strategy can convert into customer value and market opportunities’’ (p. 1). The value that design thinking brings to an organization is a different way of framing situations and possibilities, doing things, and tackling problems: essentially a cultural transformation of the way it undertakes its business. The work of Martin (2009) has clearly shown the generalized differences between design thinking and business thinking, highlighting many instances in which these differences have been overcome, but also noting the many obstacles of trying to unify both approaches within an organization. Liedtka (2010) encourages firms to try and persist in overcoming these barriers, as she has noted that ‘‘business strategy desperately needs design ... because design is all about action and business strategy too often turns out to be only about talk ... fewer than 10 percent of new strategies are ever fully executed’’ (p. 9).

Observational research and verbal protocol methods

This paper describes observational research and verbal protocols methods, how these methods are applied and integrated within different contexts, and how they complement each other. The first case study focuses on nurses’ interaction during bandaging of patients’ lower legs. To maintain research rigor a triangulation approach was applied that links observations of current procedures, ‘talk-aloud’ protocol during interaction and retrospective protocol. Maps of interactions demonstrated that some nurses bandage more intuitively than others. Nurses who bandage intuitively assemble long sequences of bandaging actions while nurses who bandage less intuitively ‘focus-shift’ in between bandaging actions. Thus different levels of expertise have been identified. The second case study consists of two laboratory experiments. It focuses on analysing and comparing software and product design teams and how they approached a design problem. It is based on the observational and verbal data analysis. The coding scheme applied evolved during the analysis of the activity of each team and is identical for all teams. The structure of knowledge captured from the analysis of the design team maps of interaction is identified. The significance of this work is within its methodological approach. The maps of interaction are instrumental for understanding the activities and interactions of the people observed. By examining the maps of interaction, it is possible to draw conclusions about interactions, structure of knowledge captured and level of expertise. This research approach is transferable to other design domains. Designers will be able to transfer the interaction maps outcomes to systems and services they design.

Standardising practices improves clinical diabetic foot management: the Queensland Diabetic Foot Innovation Project, 2006-09

Objective. The aim of this paper is to report the clinical practice changes resulting from strategies to standardise diabetic foot clinical management in three diverse ambulatory service sites in Queensland, Australia. Methods. Multifaceted strategies were implemented in 2008, including: multidisciplinary teams, clinical pathways, clinical training, clinical indicators, and telehealth support. Prior to the intervention, none of the aforementioned strategies were used, except one site had a basic multidisciplinary team. A retrospective audit of consecutive patient records from July 2006 to June 2007 determined baseline clinical activity (n = 101).Aclinical pathway teleform was implemented as a clinical activity analyser in 2008 (n = 327) and followed up in 2009 (n = 406). Pre- and post-implementation data were analysed using Chi-square tests with a significance level set at P < 0.05. Results. There was an improvement in surveillance of the high risk population of 34% in 2008 and 19% in 2009, and treating according to risk of 15% in 2009 (P < 0.05). The documentation of all best-practice clinical activities performed improved 13–66% (P < 0.03). Conclusion. These findings support the use of multifaceted strategies to standardise practice and improve diabetic foot complications management in diverse ambulatory services.