Assessing advanced life support (ALS) competence: Victorian practices

Advanced life support (ALS) assessments are performed to assess nurses’ abilities to recognize cardiac arrest events, and appropriately manage patients according to resuscitation guidelines. Although there is evidence for conducting assessments after initial ALS education, there is little evidence to guide educators about ongoing assessments in terms of methods, format and frequency.

The aim of this study was to determine methods used by educators to assess ALS skills and knowledge for nurses in Victorian intensive care units. This descriptive study used telephone interviews to collect data. Data were analysed using content analysis. Twenty intensive care educators participated in this study. Thirteen educators (65%) were employed in public hospitals, and 7 educators (35%) worked in private hospitals across 12 Level 3 (60%) and 8 Level 2 (40%) intensive care units.

Results showed all educators used scenarios to assess ALS skills, with 12 educators (60%) including an additional theoretical test. There was variability in ALS assessment frequency, assessment timing in relation to initial/ongoing education, person performing the assessment, and the assessor/participant ratio. Nineteen educators (95%) reported ALS skill competency assessments occurred annually; 1 educator (5%) reported assessments occurred every 2 years. Assessments were conducted during a designated month (n = 10), numerous times throughout the year (n = 8), or on nurses’ employment anniversaries (n = 2). All educators reported many nurses avoided undertaking assessments.

Variability in ongoing ALS assessment methods was evident in Victorian intensive care units with some units applying evidence-based practices. Consideration should be given to the purposes and methods of conducting annual ALS assessments to ensure resources and strategies are directed appropriately. To encourage nurses to retain ALS skills and knowledge, regular practices are recommended as an alternative to assessments. However, further research is required to support this notion.

Towards cultural competence : Australian Indigenous content in undergraduate psychology

This paper discusses the development and preliminary analysis of psychology undergraduate courses on cultural competence in relation to Indigenous Australians. The paper summarises the process that led to the formation of draft curriculum guidelines for psychology academics, including the need to critically examine the assumptions and history of Western psychology in relation to Indigenous peoples, the inclusion of non-conventional teaching and learning methods, staff and institutional support, and appropriate staff development. The paper then discusses the responses of students to one of the courses developed from these guidelines. The courses were well received by students and although they do not in themselves teach professional psychological skills in working effectively with Indigenous people, they provide a solid basis for the development of such skills. Because this is a relatively new area, it is likely that there will be much refinement of these courses in coming years.

Complexity, age and motor competence effects on fine motor kinematics

Prehension is a fundamental skill usually performed as part of a complex action sequence in everyday tasks. Using an information processing framework, these studies examined the effects of task complexity, defined by the number of component movement elements (MEs), on performance of prehension tasks. Of interest was how motor control and organisation might be influenced by age and/or motor competence. Three studies and two longitudinal case studies examined kinematic characteristics of prehension tasks involving one-, two- and three-MEs: reach and grasp (low-complexity); reach, grasp and object placement (moderate-complexity); and reach, grasp and double placement of object (high-complexity). A pilot study established the suitability of tasks and procedures for children aged 5-, 8- and 11-years and showed that responses to task complexity and object size manipulations were sensitive to developmental changes, with increasing age associated with faster movements. Study 2 explored complexity and age effects further for children aged 6- and 11-years and adults. Increasing age was associated with shorter and less variable movement times (MTs) and proportional deceleration phases (%DTs) across all MEs. Task complexity had no effect on simple reaction time (SRT), suggesting that there may be little preprogramming of movements beyond the first ME. In addition, MT was longer and more on-line corrections were evident for the high- compared to the moderate-complexity task for ME1. Task complexity had a greater influence on movements in ME2 and ME3 than ME1. Adults, but not children, showed task specific adaptations in ME2. Study 3 examined performance of children with different levels of motor competence aged between 5- and 10-years. Increasing age was associated with shorter SRTs, and MTs for ME1 only. A decrease in motor competence was associated with greater difficulty in planning and controlling movements as indicated by longer SRTs, higher %DTs and more on-line corrections, especially in ME2. Task complexity affected movements in all MEs, with a greater influence on ME1 compared to Study 2. Findings also indicated that performance in MEs following prehension may be especially sensitive to motor competence effects on movement characteristics. Case studies for two children at risk of Developmental Coordination Disorder (DCD) revealed two different patterns of performance change over a 16-17 month period, highlighting the heterogeneous nature of DCD. Overall, findings highlighted age-related differences, and the role of motor competence, in the ability to adapt movements to task specific requirements. Results are useful in guiding movement education programmes for children with both age-appropriate and lower levels of motor competence.

A model for assessing financial competence

This thesis aimed to design a valid and reliable assessment of financial competence to decide whether or not someone required help in looking after their finances. A multidimensional assessment was developed that was found useful in identifying the financial difficulties experiences by people with a cognitive impairment.

Perceptions of athletic competence and fear of negative evaluation during physical education

Background. Physical education (PE) aims to enhance self-esteem, develop sporting interests and to encourage a physically active life-style. However, little is known about how a fear of negative evaluation (FNE), the socially evaluative aspect of social anxiety, affects children's attitudes to PE.

Aim. The aim of the study was to investigate the relationships between perceived athletic competence and FNE within PE lessons, specifically looking at differences between boys and girls and primary and secondary schools.

Sample. The participants were 192 children in three primary schools (N=85, mean age=9.5±1.1 years) and two secondary schools (N=107, mean age=14.5±0.8 years) from rural areas of North Wales and the Midlands region of England.

Methods. The participants completed the Brief-FNE Scale and the Self-Perception Profile for Children immediately post-lesson on one occasion.

Results. Girls had higher FNE but lower perceptions of athletic competence than did boys. Older girls had higher FNE and lower perceived competence than the remaining three groups. Additionally, a significant and reverse but weak correlation was observed between girls' perceived athletic competence and FNE.

Conclusions. The findings suggest that girls with a high FNE report lower perceptions of their athletic competence. Individuals who are high in FNE behave in ways to avoid the prospect of being evaluated negatively. However, they may seek feedback from significant others as a signal that unfavourable evaluations have been avoided. Therefore, positive, encouraging feedback used in child-centred learning strategies may foster feelings of competence in boys and girls and could reduce the girls' social anxiety.

A.R.T., surrogacy and legal parentage : a comparative legislative review

This is one of three Occasional Papers published by the Victorian Law Reform Commission as part of the Commission's work on assisted reproduction and adoption. A central issue which arises in the context of assisted reproduction is how to recognise and protect the best interests of children who are conceived through assisted reproduction. The three Occasional Papers deal with different aspects of this question. This Paper examines how laws in the other Australian states, and in the United States, United Kingdom and Canada regulate access to assisted reproduction, control the use of surrogacy and deal with issues relating to parentage of children conceived through assisted reproduction. Generally, this legislation gives priority to protecting the best interests of children, but the way in which this is done varies considerably.

Strategies to embed intercultural competence as a soft skill in university curriculum

Intercultural competence (IC) has become significantly important as we interact and function in the global workplace and multicultural societies. To be effective in operating within a diverse multicultural society, understanding, negotiating and managing the differences is crucial. Additionally, the rich diversity should be celebrated in order to have a safe, sustainable and harmony global community. Specifically, internationalization in higher education has led to a significant increase in the importance of IC for students and staff. For international students, “learning shock” and different expectations of teaching styles require them to develop IC in order to be able to interact and facilitate their learning in different cultures. For local students, the increasing numbers of international students and new immigrant students result in the necessity to develop IC. For educators, IC enables them to be responsive to the diverse multicultural student body in order to deliver quality teaching and learning.
In this paper, based on the literature review, we attempt to suggest ways to embed intercultural competence as the soft skill in the university curriculum. Two complementary strategies will be discussed. The first approach focuses on embedding IC in the university curriculum. Considering IC is an abstract skill and difficult to measure, an outcome-based approach will be proposed to map students’ development of IC. The second is through international experience program that provides cross-cultural experience for students. This strategy describes how teaching practicum in other culture appears to be compatible with the principles to develop intercultural competence.

Operation of guardianship laws in the emergency ward

Enduring and workable legislative schemes typically include (a) a balanced approach to the rights and duties of all parties under their purview; and (b) consideration of all major consequences that may flow from the codification of underpinning doctrines. This column examines the 1999 amendments to the Guardianship and Administration Act 1986 (Vic) regulating patients’ consent to medical treatment focusing on their application in modern emergency departments. The legislation needs to reconcile the human rights principle that humane and appropriate treatment is a fundamental right of all those who suffer from ill health and disease, with the principle that all patients (including those with impaired, but not totally absent, decisional capacity) have an absolute right to refuse life-saving treatment. Consent and refusal of treatment provisions should be based on the notion of reasonableness, including recognition that the mental and emotional states experienced by physically ill people may, in the short term, adversely affect their decision-making capacity. Unless the consent legislation factors in the realities of modern emergency practice and resources, statutory thresholds for decisional competence, instead of affording protection, may result in much worse outcomes for vulnerable patients.

Intellectual property law in Southeast Asia : Recent legislative and institutional developments

Over the last few decades, countries belonging to the Association of Southeast Asian Nations (ASEAN) all had to revise their intellectual property systems. These revisions resulted at first from bilateral pressure of major trading partners such as the US and EU, then from the WTO-TRIPS Agreement and more recently from bilateral Free Trade Agreements. To observe the IP developments in ASEAN over this period is interesting, because this group of countries covers developed (Singapore), developing as well as least developed countries. All countries had to reform their outdated laws from the colonial era in very short time. However, in comparison to the early 1980s, important differences with regards to intellectual property policies have emerged in recent years.

This article will briefly sketch the developments in individual ASEAN countries and after that examine some broader trends in law making, IP administration, enforcement and the court system. It concludes that the ASEAN enlargement process has created a very diverse picture with regards to IP. With the fast pace of the legislative development, countries have been struggling to keep up with the creation of the institutional and administrative framework. Progress in the ASEAN harmonisation process has been limited. Statistics indicate that some of the new laws have been reasonably well received at the domestic level, while the patent sector remains foreign dominated.

Oral language competence in incarcerated young offenders : links with offending severity

Previous research in Australia and overseas has shown that young offenders serving community-based orders are at high-risk for undetected but clinically significant oral language difficulties. However, this phenomenon has received little attention in incarcerated samples, and links with offending severity, mental health, and other markers of early risk have not previously been systemically examined. A cross-sectional examination of 100 young offenders (mean age 19.03 years) completing custodial sentences in Victoria, Australia was conducted. A range of standardized oral language, IQ, mental health, and offending severity measures was employed. Forty-six per cent of participants were classified as language impaired (LI), and these were compared with the non-LI sub-group on background and offending variables. When the sub-group with high scores on a measure of offending severity was compared with those with (relatively) lower offending scores, significant differences on a range of language measures were identified. A range of early risk indicators (such as placement in Out of Home Care) was also examined with respect to language impairment in this high-risk group. Results are discussed with respect to policy and practice pertaining to early intervention for vulnerable children, and implications for service delivery within the justice system. In particular, emphasis is placed on the need to closely examine the oral language skills of children who struggle with the transition to literacy and then display behavioural difficulties in the classroom. Once a young person is engaged with youth justice services, a high index of suspicion should be maintained with respect to their oral language skills; for example, in relation to forensic interviewing and the ability to benefit from verbally mediated interventions.