Survey of intensive care nurses' knowledge relating to the pulmonary artery catheter

In 2003 there was an increase in the use of pulmonary artery catheters in Australia from 12, 000 to 16, 000 units in intensive care and peri-operative care. This survey of intensive care nurses in five intensive care units in Queensland addressed knowledge of use, safety and complications of the pulmonary artery catheter, using a previously validated 31 question multiple choice survey. One hundred and thirty-nine questionnaires were completed, a response rate of 46%. The mean score was 13.3, standard deviation +/-4.2 out of a total of 31 (42.8% correct). The range was 4 to 25. Scores were significantly higher in those participants with more ICU experience, higher nursing grade, a higher self-assessed level of knowledge and greater frequency of PAC supervision. There was no significant correlation between total score and hospital- or university-based education, or total score and public or private hospital participants. Fifty-one per cent were unable to correctly identify the significant pressure change as the catheter is advanced from the right ventricle to the pulmonary artery.

A RELAÇÃO PEDAGÓGICA NA TUTORIA A DISTÂNCIA: UM ESTUDO A PARTIR DO CURSO DE PEDAGOGIA

O presente estudo de natureza qualitativa tem por objetivo explicitar as implicações da relação pedagógica com a construção do conhecimento na tutoria à distância com foco nas relações entre professores tutores e alunos da EAD da Universidade Metodista de São Paulo. Analisa a complexidade que envolve o trabalho educativo em ambiente virtual de aprendizagem e a relação estabelecida entre esses sujeitos na prática pedagógica. A partir dos pressupostos metodológicos e das abordagens multirreferencial, dialógica e transpessoal observadas sob a perspectiva da modalidade a distância na construção dos referenciais teóricos. Realizada na UMESP e no polo regional de apoio presencial Mauá-SP, a pesquisa foi desenvolvida por meio de observações, questionários exploratórios e entrevistas de aprofundamento, contou com a participação de quatro professoras tutoras do curso de Pedagogia a distância e dez alunas desse mesmo curso, além da leitura crítica de documentos, considerando a legislação educacional e diretrizes curriculares vigentes. Procurou responder aos seguintes questionamentos: O que é a relação pedagógica? Qual a importância da relação pedagógica quando a concepção educativa assumida trabalha na perspectiva de educar na/para a inteireza? Quais as possibilidades, as dificuldades e limites desta proposta de relação pedagógica na EAD considerando as relações entre professores tutores e alunos? Buscando identificar os conflitos e desafios vividos e experimentados nessa relação, foram problematizados alguns intervenientes no processo de ensino e aprendizagem para a construção do conhecimento na modalidade, desvelando características do discurso e das práticas repletas de sentido e significados. A pesquisa permitiu concluir que, apesar da distância, o aluno não está isolado, ele tem a possibilidade de participar ativamente junto a tutoria na construção de seu conhecimento e de sua formação, essa interação, no entanto, é influenciada pela relação pedagógica entre esses sujeitos e por demais fatores que podem afetar o desenvolvimento do trabalho na educação a distância. Para educar na inteireza, é necessário reconhecer a complexidade presente em todo ato educativo e o caráter da pluralidade, do multiculturalismo e da diversidade presente no contexto da realidade brasileira, bem como a emergência de autoconhecimento e formação continuada para professores na área.(AU)

Design Standardized Web-Components for e-Learning

In this paper a flexible approach to design LMS with QTI Ready component based on the e-Learning standards AICC and IMS QTI is described. This system and component permits a dynamic learning and assessment process. QTI Ready component can provide these facilities to other real world virtual learning management system.

On a Virtual Learning Environment

Education in the Information Society is based on asynchronism in time and space, interactivity and virtual restructuring of the educational space. One way to implement such a model of training is web-based - use of the WWW as a virtual environment to access educational materials or to organize the learning process. This work presents a virtual learning environment (VLE) developed for students and made up of modules of dynamically changing content implemented by authorized users. The aim is, through advanced technology for e-learning, testing and self-testing to stimulate students’ activity to focus their potential on the acquisition of the necessary knowledge, skills and competences. The VLE was developed under the Human Resources Development Operational Programme.

Assessment Criteria for Non-auditorial Educational Forms in Informatics

Report published in the Proceedings of the National Conference on "Education in the Information Society", Plovdiv, May, 2013

Technology Integration and School Leadership

The No Child Left Behind Act of 2001 (NCLB) brought many significant changes to American schools including accessibility to technology. Through an extensive literature review of the relationship between technology leadership and student achievement, five major themes emerged from data that support the need for more effective computer-based education in schools.

Serial evolutionary networks of within-patient HIV-1 sequences reveal patterns of evolution of X4 strains

Background The HIV virus is known for its ability to exploit numerous genetic and evolutionary mechanisms to ensure its proliferation, among them, high replication, mutation and recombination rates. Sliding MinPD, a recently introduced computational method [1], was used to investigate the patterns of evolution of serially-sampled HIV-1 sequence data from eight patients with a special focus on the emergence of X4 strains. Unlike other phylogenetic methods, Sliding MinPD combines distance-based inference with a nonparametric bootstrap procedure and automated recombination detection to reconstruct the evolutionary history of longitudinal sequence data. We present serial evolutionary networks as a longitudinal representation of the mutational pathways of a viral population in a within-host environment. The longitudinal representation of the evolutionary networks was complemented with charts of clinical markers to facilitate correlation analysis between pertinent clinical information and the evolutionary relationships. Results Analysis based on the predicted networks suggests the following:: significantly stronger recombination signals (p = 0.003) for the inferred ancestors of the X4 strains, recombination events between different lineages and recombination events between putative reservoir virus and those from a later population, an early star-like topology observed for four of the patients who died of AIDS. A significantly higher number of recombinants were predicted at sampling points that corresponded to peaks in the viral load levels (p = 0.0042). Conclusion Our results indicate that serial evolutionary networks of HIV sequences enable systematic statistical analysis of the implicit relations embedded in the topology of the structure and can greatly facilitate identification of patterns of evolution that can lead to specific hypotheses and new insights. The conclusions of applying our method to empirical HIV data support the conventional wisdom of the new generation HIV treatments, that in order to keep the virus in check, viral loads need to be suppressed to almost undetectable levels.

Metacommunity Structure Along Resource and Disturbance Gradients in Everglades Wetlands

We evaluated metacommunity hypotheses of landscape arrangement (indicative of dispersal limitation) and environmental gradients (hydroperiod and nutrients) in structuring macroinvertebrate and fish communities in the southern Everglades. We used samples collected at sites from the eastern boundary of the southern Everglades and from Shark River Slough, to evaluate the role of these factors in metacommunity structure. We used eigenfunction spatial analysis to model community structure among sites and distance-based redundancy analysis to partition the variability in communities between spatial and environmental filters. For most animal communities, hydrological parameters had a greater influence on structure than nutrient enrichment, however both had large effects. The influence of spatial effects indicative of dispersal limitation was weak and only periphyton infauna appeared to be limited by regional dispersal. At the landscape scale, communities were well-mixed, but strongly influenced by hydrology. Local-scale species dominance was influenced by water-permanence and nutrient enrichment. Nutrient enrichment is limited to water inflow points associated with canals, which may explain its impact in this data set. Hydroperiod and nutrient enrichment are controlled by water managers; our analysis indicates that the decisions they make have strong effects on the communities at the base of the Everglades food web.

A concepção de humanização no contexto da formação médica: o caso da UFRN

This thesis aims at understanding the aspects related to the concept of humanization that contribute to a humanized education in the pedagogical project of the medicine graduation course of the Federal University of Rio Grande do Norte (UFRN). It has been used a qualitative research through non - structured interviews to six professors and through the focus group technique with participant observation of 30 students of the 2 nd , 4 th and 6 th terms of the med program. The data has been analyzed through the cate gorical thematic subject analysis technique from which two categories have emerged: tendency changes and initial changes. In the former we ’ ve identified aspects related to the social reality based in the experiences of professors and students in their work field; the competencies such as stimulation to the students ’ critical and reflexive knowledge through professors ’ encouragements and learning to learn as a way of developing professors ’ education towards the process of learning and evaluation of students. In the latter, we ’ ve noticed positive and negative aspects. While in the positive aspects we ’ ve testified actions and attitudes that were crucial for the development of the curricular proposals, in the negative ones we ’ ve verified controversial arguments between the students and teachers ’ speeches regarding the process of medical education in a humanized approach. For last, we ’ ve got large different results within the period investigated. However, we understand that the data found in the study has contribu ted to reach the proposed objectives regarding what has been perceived between the professors and students ’ point of views in relation to a humanized based education. Even if it ́s an initial perception, it is moving towards a medical education more humaniz ed and centered in the human being.

A pilot study of orthopaedic resident self-assessment using a milestones' survey just prior to milestones implementation.

OBJECTIVE: To pilot test if Orthopaedic Surgery residents could self-assess their performance using newly created milestones, as defined by the Accreditation Council on Graduate Medical Education. METHODS: In June 2012, an email was sent to Program Directors and administrative coordinators of the 154 accredited Orthopaedic Surgery Programs, asking them to send their residents a link to an online survey. The survey was adapted from the Orthopaedic Surgery Milestone Project. Completed surveys were aggregated in an anonymous, confidential database. SAS 9.3 was used to perform the analyses. RESULTS: Responses from 71 residents were analyzed. First and second year residents indicated through self-assessment that they had substantially achieved Level 1 and Level 2 milestones. Third year residents reported they had substantially achieved 30/41, and fourth year residents, all Level 3 milestones. Fifth year, graduating residents, reported they had substantially achieved 17 Level 4 milestones, and were extremely close on another 15. No milestone was rated at Level 5, the maximum possible. Earlier in training, Patient Care and Medical Knowledge milestones were rated lower than the milestones reflecting the other four competencies of Practice Based Learning and Improvement, Systems Based Practice, Professionalism, and Interpersonal Communication. The gap was closed by the fourth year. CONCLUSIONS: Residents were able to successfully self-assess using the 41 Orthopaedic Surgery milestones. Respondents' rate improved proficiency over time. Graduating residents report they have substantially, or close to substantially, achieved all Level 4 milestones. Milestone self-assessment may be a useful tool as one component of a program's overall performance assessment strategy.

Learning Environments in Design Studio Culture

The paper reports on a study of design studio culture from a student perspective. Learning in design studio culture has been theorised variously as a signature pedagogy emulating professional practice models, as a community of practice and as a form of problem-based learning, all largely based on the study of teaching events in studio. The focus of this research has extended beyond formally recognized activities to encompass the student’s experience of their social and community networks, working places and study set-ups, to examine how these have contributed to studio culture and how there have been supported by studio teaching. Semi-structured interviews with final year undergraduate students of architecture formed the basis of the study using an interpretivist approach informed by Actor-network theory, with studio culture featured as the focal actor, enrolling students and engaging with other actors, together constituting an actor-network of studio culture. The other actors included social community patterns and activities; the numerous working spaces (including but not limited to the studio space itself); the equipment, tools of trade and material pre-requisites for working; the portfolio enrolling the other actors to produce work for it; and the various formal and informal events associated with the course itself. Studio culture is a highly charged social arena: The question is how, and in particular, which aspects of it support learning? Theoretical models of situated learning and communities of practice models have informed the analysis, with Bourdieu’s theory of practice, and his interrelated concepts of habitus, field and capital providing a means of relating individually acquired habits and modes of working to social contexts. Bourdieu’s model of habitus involves the externalisation through the social realm of habits and knowledge previously internalised. It is therefore a useful model for considering whole individual learning activities; shared repertoires and practices located in the social realm. The social milieu of the studio provides a scene for the exercise and display of ‘practicing’ and the accumulation of a form of ‘practicing-capital’. This capital is a property of the social milieu rather than the space, so working or practicing in the company of others (in space and through social media) becomes a more valued aspect of studio than space or facilities alone. This practicing-capital involves the acquisition of a habitus of studio culture, with the transformation of physical practices or habits into social dispositions, acquiring social capital (driving the social milieu) and cultural capital (practicing-knowledge) in the process. The research drew on students’ experiences, and their practicing ‘getting a feel for the game’ by exploring the limits or boundaries of the field of studio culture. The research demonstrated that a notional studio community was in effect a social context for supporting learning; a range of settings to explore and test out newly internalised knowledge, demonstrate or display ideas, modes of thinking and practicing. The study presents a nuanced interpretation of how students relate to a studio culture that involves a notional community, and a developing habitus within a field of practicing that extends beyond teaching scenarios.

Differential ability and attainment in language and arithmetic of Dutch primary school pupils.

Background. In pre-school and primary education pupils differ in many abilities and competences (‘giftedness’). Yet mainstream educational practice seems rather homogeneous in providing age-based or grade-class subject matter approaches. Aims. To clarify whether pupils scoring initially at high ability level do develop and attain differently at school with respect to language and arithmetic compared with pupils displaying other initial ability levels. To investigate whether specific individual, family or educational variables co-vary with the attainment of these different types of pupils in school. Samples. Data from the large-scale PRIMA cohort study including a total of 8258 grade 2 and 4 pupils from 438 primary schools in The Netherlands. Methods. Secondary analyses were carried out to construct gain scores for both language and arithmetic proficiency and a number of behavioural, attitudinal, family and educational characteristics. The pupils were grouped into different ability categories (highly able; able; above average; average and below). Further analyses used Pearson correlations and analyses of variance both between and within ability categories. Cross-validation was done by introducing a cohort of younger pupils in pre-school and grouping both cohorts into decile groups based on initial ability in language and arithmetic. Results. Highly able pupils generally decreased in attainment in both language and arithmetic, whereas pupils in average and below average groups improved their language and arithmetic scores. Only with highly able pupils were some educational characteristics correlated with the pupils’ development in achievement, behaviour and attitudes. Conclusions. Pre-school and primary education should better match pupils’ differences in abilities and competences from their start in pre-school to improve their functioning, learning processes and outcomes. Recommendations for educational improvement strategies are presented in closing.

The Development of Educational Materials for the Study of Architecture using Computer Game Technology

Computer game technology provides us with the tools to create web-based educational materials for autonomous and collaborative learning. At Worcester, we have researched the use of this technology in various educational contexts. This paper reports one such study; the use of the commercial game engine “Unreal Tournament 2004” (UT2004) to produce materials suitable for education of Architects. We map the concepts and principles of Architectural Design onto the affordances (development tools) provided by UT2004, leading to a systematic procedure for the realization of buildings and urban environments using this game engine. A theory for the production of web-based learning materials which supports both autonomous and collaborative learning is developed. A heuristic evaluation of our materials, used with second-year students is presented. Associated web-pages provide on-line materials for delegates.

Strategisk kompetensutveckling : En organisations strategiska förhållningssätt till kompetensutveckling

I denna fallstudie undersöks hur en kompetensbaserad personalstrategi ter sig inom en organisation. Då det är ett brett område har en avgränsning gjorts och det är enbart kompetensutveckling som berörs. Syftet är att skapa förståelse för det strategiska förhållningssättet till kompetensutveckling inom en organisation. Inom ramen för våra forskningsfrågor undersöks också de verktyg och metoder som en organisation använder sig av för att utveckla rätt kompetens samt de hinder och utmaningar som finns. Det har av tidigare forskning framkommit att ett strategiskt förhållningssätt är avgörande för en organisations överlevnad och framgång. Det finns en samstämmighet kring att organisationer vid valet av kompetensutvecklingsinsatser behöver utgå från verksamhetens behov, kundkrav och framtida mål för att bli gynnsamma. Syftet för insatserna blir därmed avgörande och en central del i det strategiska förhållningssättet till kompetensutveckling. Studien utgår från en fenomenologisk ansats och insamling av data har skett med hjälp av sju semi-strukturerade intervjuer med öppna frågor som utgått från tydliga teman. Studiens intervjuer har genomförts i en politiskt styrd organisation med cirka 5000 anställda och analysen av dessa intervjuer har skett enligt en femstegsmodell där vi avsett att synliggöra de mest väsentliga beståndsdelarna av fenomenet. Studien har tydliggjort hur organisationens strategiska förhållningssätt ser ut och också tydligt påvisat faktorer som gör det svårt att upprätthålla. De verktyg och metoder organisationen använder sig av är exempelvis webbaserad utbildning, ständiga förbättringar, nätverk, händelsehanteringssystem, en utbildningsplattform samt ett formulär för utbildningsförfrågningar. De hinder och utmaningar som synliggjorts är exempelvis utomstående faktorer, ekonomi, ansvarsfördelning och samverkan. Vår studie har också bidragit till en insikt i hur viktigt det är att noga överväga vilken metod som bör användas vid olika typer av kompetensutvecklingsinsatser. Det är viktigt att inte låta fokus hamna på att genomföra det minst kostsamma, utan låta valet av metod syfta till att ge det mest effektiva lärandet. Det är viktigt att i varje skede göra strategiska avvägningar som inte enbart har sin grund i ekonomiska perspektiv vad gäller besparingar och minskade kostnader. Ett intressant område till vidare forskning ser vi i chefsperspektivet. Vi finner detta intressant då det både genom tidigare forskning och genom vår egen studie tydligt har framgått att chefer har en nyckelroll och det finns därför ett intresse att närmre undersöka den roll som chefer delegeras i kompetensutvecklingsinsatser och vilka möjligheter de har i arbetet med dessa frågor.

Mental health nurses’ attitudes, behaviour, experience and knowledge regarding adults with a diagnosis of borderline personality disorder: systematic, integrative literature review

Aims and objectives To establish whether mental health nurses responses to people with borderline personality disorder are problematic and, if so, to inform solutions to support change. Background There is some evidence that people diagnosed with borderline personality disorder are unpopular among mental health nurses who respond to them in ways which could be counter-therapeutic. Interventions to improve nurses’ attitudes have had limited success. Design Systematic, integrative literature review. Methods Computerised databases were searched from inception to April 2015 for papers describing primary research focused on mental health nurses’ attitudes, behaviour, experience, and knowledge regarding adults diagnosed with borderline personality disorder. Analysis of qualitative studies employed metasynthesis; analysis of quantitative studies was informed by the theory of planned behaviour. Results Forty studies were included. Only one used direct observation of clinical practice. Nurses’ knowledge and experiences vary widely. They find the group very challenging to work with, report having many training needs, and, objectively, their attitudes are poorer than other professionals’ and poorer than towards other diagnostic groups. Nurses say they need a coherent therapeutic framework to guide their practice, and their experience of caregiving seems improved where this exists. Conclusions Mental health nurses’ responses to people with borderline personality disorder are sometimes counter-therapeutic. As interventions to change them have had limited success there is a need for fresh thinking. Observational research to better understand the link between attitudes and clinical practice is required. Evidence-based education about borderline personality disorder is necessary, but developing nurses to lead in the design, implementation and teaching of coherent therapeutic frameworks may have greater benefits. Relevance to clinical practice There should be greater focus on development and implementation of a team-wide approach, with nurses as equal partners, when working with patients with borderline personality disorder.