Creating a therapeutic environment : a non-randomised controlled trial of a quiet time intervention for patients in acute care

Background: Noise is a significant barrier to sleep for acute care hospital patients, and sleep has been shown to be therapeutic for health, healing and recovery. Scheduled quiet time interventions to promote inpatient rest and sleep have been successfully trialled in critical care but not in acute care settings. Objectives: The study aim was to evaluate as cheduled quiet time intervention in an acute care setting. The study measured the effect of a scheduled quiet time on noise levels, inpatients’ rest and sleep behaviour, and wellbeing. The study also examined the impact of the intervention on patients’, visitors’ and health professionals’ satisfaction, and organisational functioning. Design: The study was a multi-centred non-randomised parallel group trial. Settings: The research was conducted in the acute orthopaedic wards of two major urban public hospitals in Brisbane, Australia. Participants: All patientsadmitted to the two wards in the5-month period of the study were invited to participate, withafinalsample of 299 participants recruited. This sample produced an effect size of 0.89 for an increase in the number of patients asleep during the quiet time. Methods: Demographic data were collected to enable comparison between groups. Data for noise level, sleep status, sleepiness and well being were collected using previously validated instruments: a Castle Model 824 digital sound level indicator; a three point sleep status scale; the Epworth Sleepiness Scale; and the SF12 V2 questionnaire. The staff, patient and visitor surveys on the experimental ward were adapted from published instruments. Results: Significant differences were found between the two groups in mean decibel level and numbers of patients awake and asleep. The difference in mean measured noise levels between the two environments corresponded to a ‘perceived’ difference of 2 to 1. There were significant correlations between average decibel level and number of patients awake and asleep in the experimental group, and between average decibel level and number of patients awake in the control group. Overall, patients, visitors and health professionals were satisfied with the quiet time intervention. Conclusions: The findings show that a quiet time intervention on an acute care hospital ward can affect noise level and patient sleep/wake patterns during the intervention period. The overall strongly positive response from surveys suggests that scheduled quiet time would be a positively perceived intervention with therapeutic benefit.

Moderation as judgement practice: Reconciling system level accountability and local level practice

Internationally, recognition of the role of assessment to inform the learning process has received much attention in recent years. Assessment for learning, not just of learning is being supported by an increasing body of literature providing strategies that teachers and their students can incorporate to support the learning process (Assessment Reform Group, 2002; Broadfoot & Black, 2004; James, 2006). Concurrently there has been an increase internationally in systemic accountability requirements of schools in terms of student results. The convergence of these two movements has resulted in some education systems promoting standards-driven reform involving authentic assessment and a re-examination of the relationship between the teacher and the student in the learning process. In this context standards are intended to be used as the basis for judgements of student achievement; while the results from assessment tasks are meant to both inform the teaching/learning process, and to report and track student progress. In such system, the role and reliability of teacher judgement takes centre stage.

The use of online counselling within an Australian secondary school setting: a practitioner’s viewpoint

This paper proposes that the provision of online counselling services for young people accessed through their local school website has the potential to assist students with mental health issues as well as increasing their help seeking behaviours. It stems from the work of the authors who trialled an online counselling service within one Australian secondary school. In Australia, online counselling with the adult population is now an accepted part of the provision of mental health services. Online provision of mental health information for young people is also well accepted. However, online counselling for young people is provided by only a few community organisations such as Kids Help Line within Australia. School based counselling services which are integral to most secondary schools in Australia, seem slow to provide this service in spite of initial interest and enthusiasm by individual school counsellors. This discussion is the product of reflection on the potential benefits of this trial with a consideration of relevant research of the issues raised. It highlights the need for further research into the use of computer mediated communication in the provision of counselling within a school setting.

Adolescence: A useful concept for this millennium

‘Adolescence’ has become increasingly recognised as a nebulous concept. Previous conceptualisations of adolescence have adopted a ‘deficit’ view, regarding teenagers as ‘unfinished’ adults. The deficit view of adolescence is highly problematic in an era where adulthood itself is difficult to define. The terms ‘kidult’ or ‘adultescent’ have emerged to describe adult-age people whose interests and priorities match those of their teenage counterparts. Rather than relying on ‘lock-step’ models of physical, cognitive and social growth put forward by developmental psychology, adolescence can be more usefully defined by looking at the common experiences of people in their teenage years. Common experiences arise at an institutional level; for example, all adolescents are treated as the same by legal and education systems. The transition from primary to secondary schooling is a milestone for all children, exposing them to a new type of educational environment. Shared experiences also arise from generational factors. Today’s adolescents belong to the millennial generation, characterised by technological competence, global perspectives, high susceptibility to media influence, individualisation and rapid interactions. This generation focuses on teamwork, achievement, modesty and good conduct, and has great potential for significant collective accomplishments. These generational factors challenge educators to provide relevant learning experiences for today’s students. Many classrooms still utilise textbook-based pedagogy more suited to previous generations, resulting in disengagement among millennial students. Curriculum content must also be tailored to generational needs. The rapid pace of change, as well as the fluidity of identity created by dissolving geographical and vocational boundaries, mean that the millennial generation will need more than a fixed set of skills and knowledge to enter adulthood. Teachers must enable their students to think like ‘expert novices’, adept at assimilating new concepts in depth and prepared to engage in lifelong learning.

Education futures : transforming teacher education in the middle years

The young people who populate our classrooms live in a changed and rapidly changing society: a society where information is the most valued commodity and where traditional ‘truth’s such as nation and family are increasingly destabilized and fragmented. Educators at primary, secondary and tertiary level must, with some urgency, address issues relating the emergence of new citizenships and identities, the impact of new technologies and new economies. Our pedagogy and curriculums must be relevant to the need of students now and in the future. The School of Education, The University of Queensland is addressing issues of change, new technologies, new work places, critical citizenry and the need for pedagogical and curriculum innovation through the development of a new Middle Years of Schooling Dual Degree program. This program is designed to equip pre-service teachers to approach pedagogy and curriculum in innovative ways and to challenge them to embrace diversity and change. This paper outlines the key features of the Middle Years of Schooling Dual Degree, identifying a number of innovative approaches to pre-service teacher education.

Secondary teachers’ conceptions of teaching and learning

This paper presents a phenomenographic analysis of the conceptions of teaching and learning held by a sample of 16 secondary school teachers in two Australian schools. It provides descriptions of four categories, derived from pooled data, of the ways in which these teachers thought about teaching and about learning, their teaching strategies, and their focus on student or content. The categories for teaching and learning are described with each teacher allocated to the category most typical of their conceptions of teaching and of learning. The lack of congruence, in some cases, between the conceptions of teaching and of learning held by these teachers is discussed.

Transitional employment aspirations for bridging retirement : implications for training and development

Purpose: The aim of this study was to identify the transitional employment aspirations and training and development needs of older and younger workers at risk of early retirement due to limited education and/or employment in blue collar occupations. Design/ Methodology/ Approach: A computer based methodology was used to evaluate the demographic effects of gender, education level and occupation group on aspirations pertaining to transitional employment and training and development in a sample of over 1000 Local Government employees. Findings: Older blue collar, secondary school educated and younger workers were less interested in transitional employment than older workers with higher levels of education or from white collar backgrounds. The early retirement risk factors of blue collar work and secondary school education had a more limited effect on perceived training and development needs for older workers. However for younger workers, these risk factors provided the impetus to undertake training to move into less physically demanding or more challenging roles as their careers progressed. Practical Implications: Via the identification of education level and occupation types groups’ transitional employment aspirations and perceptions of preparatory training and development within younger and older cohorts, long term strategies to develop and retain staff may be formulated. Originality/ Value: Past studies of transitional employment have rarely included younger workers or older workers at risk of early retirement. Preparatory training and development for transitional employment roles has not been considered in the literature.

High-level concept annotation using ontology and probabilistic inference

Image annotation is a significant step towards semantic based image retrieval. Ontology is a popular approach for semantic representation and has been intensively studied for multimedia analysis. However, relations among concepts are seldom used to extract higher-level semantics. Moreover, the ontology inference is often crisp. This paper aims to enable sophisticated semantic querying of images, and thus contributes to 1) an ontology framework to contain both visual and contextual knowledge, and 2) a probabilistic inference approach to reason the high-level concepts based on different sources of information. The experiment on a natural scene database from LabelMe database shows encouraging results.