New estimates for CRNA vacancies

A national survey to estimate vacancy rates of Certified Registered Nurse Anesthetists (CRNAs) in hospitals and ambulatory surgical centers was conducted in 2007. Poisson regression methods were used to improve the precision of the estimates. A significant increase in the estimated vacancy rate was reported for hospitals relative to an earlier study from 2002, although it is important to note that there were some methodological differences between the 2 surveys explaining part of the increase. Results from this study found the vacancy rate was higher in rural hospitals than in nonrural hospitals, and it was lower in ambulatory surgical centers. A number of simulations were run to predict the effects of relevant changes in the market for surgeries and number of CRNAs, which were compared to the predictions from the previous survey. The remarkable factor since the last survey was the unusually large rate of new CRNAs entering the market, yet the vacancy rates remain relatively high.

Salaries, recruitment, and retention for CRNA faculty - Part 1

The nature of differences in salaries between academic faculty and Certified Registered Nurse Anesthetists (CRNAs) working in clinical positions using recently collected data are explored. The differences in median salaries among program directors, assistant program directors, academic faculty, and clinical faculty are large. Furthermore, survey results imply that the most important barrier to recruiting teaching faculty is salary differentials. Part 1 of this 2-part column discusses salaries, recruitment, and retention of CRNA faculty; Part 2, to be published in the June 2008 issue, will focus on clinical faculty contributions to the education of CRNAs.

Clinical faculty : major contributors to the education of new CRNAs - Part 2

This study examines the important contributions of clinical faculty toward the education of the future workforce of Certified Registered Nurse Anesthetists (CRNAs). Differences in workload, work activities and income among clinical faculty, academic faculty and nonfaculty are examined. This is Part 2 of a 2-part column. Part 1, published in the April 2008 AANA Journal discussed salaries, recruitment, and retention of CRNA faculty.

Supply, demand, and equilibrium in the market for CRNAs

This study determined the current trends in supply, demand, and equilibrium (ie, the level of employment where supply equals demand) in the market for Certified Registered Nurse Anesthetists (CRNAs). It also forecasts future needs for CRNAs given different possible scenarios. The impact of the current availability of CRNAs, projected retirements, and changes in the demand for surgeries are considered in relation to CRNAs needed for the future. The study used data from many sources to estimate models associated with the supply and demand for CRNAs and the relationship to relevant community and policy characteristics such as per capita income of the community and managed care. These models were used to forecast changes in surgeries and in the supply of CRNAs in the future. The supply of CRNAs has increased in recent years, stimulated by shortages of CRNAs and subsequent increases in the number of CRNAs trained. However, the increases have not offset the number of retiring CRNAs to maintain a constant age in the CRNA population. The average age will continue to increase for CRNAs in the near future despite increases in CRNAs trained. The supply of CRNAs in relation to surgeries will increase in the near future.

Indonesian LIS professionals’ understanding of Library 2.0 : a pilot study

The literature around Library 2.0 remains largely theoretical with few empirically studies and is particularly limited in developing countries such as Indonesia. This study addresses this gap and aims to provide information about the current state of knowledge on Indonesian LIS professionals’ understanding of Library 2.0. The researchers used qualitative and quantitative approaches for this study, asking thirteen closed- and open-ended questions in an online survey. The researchers used descriptive and in vivo coding to analyze the responses. Through their analysis, they identified three themes: technology, interactivity, and awareness of Library 2.0. Respondents demonstrated awareness of Library 2.0 and a basic understanding of the roles of interactivity and technology in libraries. However, overreliance on technology used in libraries to conceptualize Library 2.0 without an emphasis on its core characteristics and principles could lead to the misalignment of limited resources. The study results will potentially strengthen the research base for Library 2.0 practice, as well as inform LIS curriculum in Indonesia so as to develop practitioners who are able to adapt to users’ changing needs and expectations. It is expected that the preliminary data of this study could be used to design a much larger and more complex future research project in this area.

Functional impairments characterising mild, moderate and severe hallux valgus

Objective Hallux valgus has been linked to functional disability and increased falls risk, but mechanisms underpinning functional disability are unclear. This study investigated functional performance, muscle strength and plantar pressures in adults with mild, moderate, and severe HV compared to controls, while considering the influence of foot pain. Methods Sixty adults with hallux valgus (classified as mild, moderate and severe on dorsalplantar radiographs) and 30 controls participated. Measures included: hallux plantarflexion and abduction strength, walking performance, postural sway and forefoot plantar pressures. Multiple analysis of covariance and pairwise comparisons (p<0.05, Bonferroni adjustment) were used to investigate differences between groups, adjusting for age, sex, body mass index and foot pain. Results Hallux plantarflexion and abduction strength was significantly reduced in those with moderate (mean differences: plantarflexion -45.8N, abduction -12.3N, p<0.001) and severe hallux valgus (plantarflexion -50.1N, p<0.001; abduction -11.2N, p=0.01) compared to controls. A significant reduction in hallux peak pressure and pressure-time integral was evident in moderate (peak pressure -90.8kPa, p<0.001) and severe hallux valgus (peak pressure -106.2kPa, p<0.001) compared to controls. Those with severe hallux valgus also demonstrated increased mediolateral postural sway in single leg stance compared to controls (3.5cm, p=0.01). Conclusion Moderate to severe hallux valgus is associated with reduced hallux plantar pressures and strength measures, while relatively normal function compared to controls was found in those with mild deformity. Greater understanding of specific functional deficits associated with different stages of hallux valgus will help inform clinical management and future research.

Correlates of foot pain severity in adults with hallux valgus : a cross-sectional study

Background Hallux valgus (HV) is highly prevalent and associated with progressive first metatarsophalangeal joint subluxation and osteoarthritis. The link between structural HV deformity and foot pain is unclear. This study investigated possible explanatory factors surrounding foot pain in HV, including radiographic HV angle and signs of joint degeneration. Methods Participants were 60 adults (53 female) with HV aged 20 to 75 years. Participant demographics and a range of radiographic, clinical and functional measures were considered potential correlates of foot pain. Self-reported foot pain (visual analogue scales and a dichotomous definition) was considered the dependent variable. Multivariate modelling was used to determine which characteristics and measures explained pain, with univariate analyses first used to screen potential variables. Results Approximately 20 to 30% of the variance in foot pain associated with HV could be explained by patient characteristics such as poorer general health status, lower educational attainment and increased occupational physical activity levels, in combination with some dynamic physical characteristics such as hallux plantarflexion weakness and reduced force-time integral under the second metatarsal during gait. Neither increasing lateral deviation of the hallux (HV angle) nor presence of first metatarsophalangeal joint osteoarthritis was associated with foot pain. Conclusions This study shows that passive structural factors, including HV angle, do not appear to be significant correlates of foot pain intensity in HV. Our data demonstrate the importance of considering patient characteristics such as general health and physical activity levels when assessing foot pain associated with HV.

Nonlinear electromagnetic fields in 0.5 MHz inductively coupled plasmas

Radial profiles of magnetic fields in the electrostatic (E) and electromagnetic (H) modes of low-frequency (∼500) inductively coupled plasmas (ICP) were measured using miniature magnetic probes. A simplified plasma fluid model explaining the generation of the second harmonics of the azimuthal magnetic field in the plasma source was proposed. Because of apparent similarity in the procedure of derivation of the pondermotive force-caused nonlinear terms, pronounced generation of the nonlinear static azimuthal magnetic field could be expected.

Organizational support and enterprise web 2.0 adoption : a qualitative study

The emerging growth of Web 2.0 has been observed by users in the workplace, and has therefore encouraged organisations to introduce Web 2.0 technologies in their businesses. Although its adoption is beneficial, it could meets with employees resistance due to some organisational factors. The successful implementation of Enterprise Web 2.0 is based on employee adoption of such social technology. Using a qualitative study, this research explores how organizational support can influence employees’ adoption of Enterprise Web 2.0. The findings show that organisational support encourages and facilitates a smooth adoption. Such support can be provided by management and colleagues in several forms: developing a Web 2.0 strategy, providing required resources for such training, recognising and encouraging adopters, and involving managers in the adoption.

Too cool for homeschool? Accessing underground unschoolers with Web 2.0

There is a new type of home education parent challenging long-held assumptions about homeschooling (cf. Morton 2012). These parents are well educated (cf. Beck 2010) but have chosen to eschew the social and cultural capital (Bourdieu & Wacquant 1992) of school in favour of some- thing completely different. They are unschoolers, which involves ‘allow- ing children as much freedom to learn in the world as their parents can possibly bear’ (cf. Holt & Farenga 2003: 238). This chapter presents the approach taken by one researcher to explore the reasons families choose unschooling. These families can be difficult to access, because they often fail to register with home education units and thus remain outside the education system (cf. Townsend 2012). Their lack of registration makes them largely invisible, affecting their ability to make an important contribution to debates around education. In spite of this invisibility, many unschoolers are keen to talk to researchers to increase wider understanding of unschooling.

The Spartan-3E Tutorial 1 : Introduction to FPGA Programming, Version 2.0

This tutorial is designed to help new users become familiar with using the Spartan-3E board. The tutorial steps through: writing a small program in VHDL which carries out simple combinational logic; connecting the program inputs and outputs to the switches, buttons and LEDs on the Spartan-3E board; downloading the program to the Spartan-3E board using version 14.7 of the Xilinx ISE; and simulating the program using the iSim Simulator.

Plagiarism 2.0 : the new economy of academic dishonesty

As a writer, teacher and scholar of ‘the knowledge economy’ in the broadest sense, plagiarism fascinates me. I first encountered plagiarism in my Year 12 English class. We had been working for weeks writing poems and had submitted them to our teacher Mr How for assessment. Mr How was generally a pleasant individual who I remember as one of my favourite school teachers; however, he did not suffer fools easily. The time arrived for each of us to read our work to the class. Year 12 poetry being what it usually is, most of our efforts tended to blur into an angsty, slightly pretentious, self-important mess (similar to staff meetings in many university departments). However, one student’s poem stood out. It was emotive, insightful and economical in its use of language … and best of all, it did not suck! The poem’s author was one of the class’ biggest jocks, and not usually one to display such sensitivity, so we were all a little taken aback by what we were hearing. Stunned silence! At the poem’s conclusion, Mr How congratulated the student on such an excellent effort and produced a copy of the collected works of Emily Dickenson (if I remember correctly) from under his desk. He asked the student to turn to a page he had marked and recite the poem printed there. It was, of course, the same one the student had passed off as his. This time, there was no stunned silence: just the sound of remorseful sobs from our jock-poet-plagiarist who had been exposed in front of his classmates.

STAR : Predicting recombination sites from amino acid sequence

Background Designing novel proteins with site-directed recombination has enormous prospects. By locating effective recombination sites for swapping sequence parts, the probability that hybrid sequences have the desired properties is increased dramatically. The prohibitive requirements for applying current tools led us to investigate machine learning to assist in finding useful recombination sites from amino acid sequence alone. Results We present STAR, Site Targeted Amino acid Recombination predictor, which produces a score indicating the structural disruption caused by recombination, for each position in an amino acid sequence. Example predictions contrasted with those of alternative tools, illustrate STAR'S utility to assist in determining useful recombination sites. Overall, the correlation coefficient between the output of the experimentally validated protein design algorithm SCHEMA and the prediction of STAR is very high (0.89). Conclusion STAR allows the user to explore useful recombination sites in amino acid sequences with unknown structure and unknown evolutionary origin. The predictor service is available from http://pprowler.itee.uq.edu.au/star.

Palliative care phase : inter-rater reliability and acceptability in a national study

Background: The concept of palliative care consisting of five distinct, clinically meaningful, phases (stable, unstable, deteriorating, terminal and bereavement) was developed in Australia about 20 years ago and is used routinely for communicating clinical status, care planning, quality improvement and funding. Aim: To test the reliability and acceptability of revised definitions of Palliative Care Phase. Design: Multi-centre cross-sectional study involving pairs of clinicians independently rating patients according to revised definitions of Palliative Care Phase. Setting/participants: Clinicians from 10 Australian palliative care services, including 9 inpatient units and 1 mixed inpatient/community-based service. Results: A total of 102 nursing and medical clinicians participated, undertaking 595 paired assessments of 410 patients, of which 90.7% occurred within 2 h. Clinicians rated 54.8% of patients in the stable phase, 15.8% in the unstable phase, 20.8% in the deteriorating phase and 8.7% in the terminal phase. Overall agreement between clinicians’ rating of Palliative Care Phase was substantial (kappa = 0.67; 95% confidence interval = 0.61–0.70). A moderate level of inter-rater reliability was apparent across all participating sites. The results indicated that Palliative Care Phase was an acceptable measure, with no significant difficulties assigning patients to a Palliative Care Phase and a good fit between assessment of phase and the definition of that phase. The most difficult phase to distinguish from other phases was the deteriorating phase. Conclusion: Policy makers, funders and clinicians can be confident that Palliative Care Phase is a reliable and acceptable measure that can be used for care planning, quality improvement and funding purposes.