Student perception of a new integrated anatomy practical program: Does students' prior learning make a difference?

While there is evidence that science and non-science background students display small differences in performance in basic and clinical sciences, early in a 4-year, graduate entry medical program, this lessens with time. With respect to anatomy knowledge, there are no comparable data as to the impact previous anatomy experience has on the student perception of the anatomy practical learning environment. A study survey was designed to evaluate student perception of the anatomy practical program and its impact on student learning, for the initial cohort of a new medical school. The survey comprised 19 statements requiring a response using a 5-point Likert scale, in addition to a free text opportunity to provide opinion of the perceived educational value of the anatomy practical program. The response rate for a total cohort of 82 students was 89%. The anatomy practical program was highly valued by the students in aiding their learning of anatomy, as indicated by the high mean scores for all statements (range: 4.04-4.7). There was a significant difference between the students who had and had not studied a science course prior to entering medicine, with respect to statements that addressed aspects of the course related to its structure, organization, variety of resources, linkage to problem-based learning cases, and fairness of assessment. Nonscience students were more positive compared to those who had studied science before (P levels ranging from 0.004 to 0.035). Students less experienced in anatomy were more challenged in prioritizing core curricular knowledge. © 2011 Wiley-Liss, Inc.

Saving Indigenous nurses and midwives from historical oblivion

Learning about the Indigenous women who had worked between 1950-2005 was a surprise to me. This area of under researched Australian history became a passion which I've continued to explore and, in recent years. have extended. It's a challenging field. with issues familiar to many historians. There may be many documentary records about Indigenous nurses, hidden in publicly accessible archives and collections, but individuals may not easily be identified as Indigenous. Another enormous challenge is to question widely-held assumptions. Historically, Aboriginal people have been positioned within a deficit model and cast as recipients of health care. So it's assumed that Indigenous people did not deliver care in any way. were not part of formal training schemes, or were not in paid employment. More evidence is emerging that counters those assumptions. Aboriginal women have worked as nurses and midwives within Australia as far back as the 1890s and, who knows, perhaps earlier. Their contribution is a hidden but significant element in Indigenous and Australian history

Diet and physical activity behaviour in nurses: A qualitative study

Issue addressed: Previous research has shown that approximately 60% of nurses in Australia are overweight or obese, insufficiently active and have an unhealthy diet. The aim of this study was to gain an understanding of nurses’ determinants contributing to these behaviours. This will inform a needs assessment for a future workplace health promotion program (WHPP) in this group. Methods: Four focus group discussions (n = 17) were conducted with a convenience sample of nurses aged 25–59 years from three hospitals in the Brisbane metropolitan area. Questions addressed barriers and motivation towards diet and physical activity (PA), and suggestions for future WHPP. Data were analysed with Nvivo10 following a thematic analysis with a realistic approach using Self-determination theory as a framework. Results: Work environment was the main barrier for healthy diet behaviours. Long working hours and lack of breaks challenged nurses’ self-control and self-regulation when making dietary choices. Fatigue was the main barrier for PA. However, relaxation, feeling energised before work and better sleep after working night shifts motivated nurses to do PA. Social environment at work seemed to be an effective external motivation to encourage healthy diet and regular PA. Goal-setting, self-monitoring and social support at work were identified as potential WHHP strategies. Conclusion: The workplace and job demands negatively impacts nurses’ lifestyle behaviours. Future interventions should include social support from colleagues, which could motivate nurses to make healthier food choices at work and be more active outside work.

Current Care Guidelines for Cardiopulmonary Resuscitation : Implementation, skills and attitudes

Background: The national resuscitation guidelines were published in Finland in 2002 and are based on international guidelines published in 2000. The main goal of the national guidelines, available on the Internet free of charge, is early defibrillation by nurses in an institutional setting. Aim: To study possible changes in cardiopulmonary resuscitation (CPR) practices, especially concerning early defibrillation, nurses and students attitudes of guideline implementation and nurses and students ability to implement the guideline recommendations in clinical practices after publication of the Current Care (CC) guidelines for CPR 2002. Material and methods: CPR practices in Finnish health centres; especially concerning rapid defibrillation programmes, as well as the implementation of CC guidelines for CPR was studied in a mail survey to chief physicians of every health centre in Finland (Study I). The CPR skills using an automated external defibrillator (AED) were compared in a study including Objective stuctured clinical examination (OSCE) of resuscitation skills of nurses and nursing students in Finnish and Swedish hospital and institution (Studies II, III). Attitudes towards CPR-D and CPR guidelines among medical and nursing students and secondary hospital nurses were studied in surveys (Studies IV, V). The nurses receiving different CPR training were compared in a randomized trial including OSCE of CPR skills of nurses in Finnish Hospital (Study VI). Results: Two years after the publication, 40.7% of Finnish health centres used national resuscitation guidelines. The proportion of health centres having at least one AED (66%) and principle of nurse-performed defibrillation without the presence of a physician (42%) had increased. The CPR-D training was estimated to be insufficient regarding basic life support and advanced life support in the majority of health centres (Study I). CPR-D skills of nurses and nursing students in two specific Swedish and Finnish hospitals and institutions (Study II and III) were generally inadequate. The nurses performed better than the students and the Swedish nurses surpassed the Finnish ones. Geriatric nurses receiving traditional CPR-D training performed better than those receiving an Internet-based course but both groups failed to defibrillate within 60 s. Thus, the performance was not satisfactory even two weeks after traditional training (Study VI). Unlike the medical students, the nursing students did not feel competent to perform procedures recommended in the cardiopulmonary resuscitation guidelines including the defibrillation. However, the majority of nursing students felt confident about their ability to perform basic life support. The perceived ability to defibrillate correlated significantly with a positive attitude towards nurse-performed defibrillation and negatively with fear of damaging the patient s heart by defibrillation (Study IV). After the educational intervention, the nurses found their level of CPR-D capability more sufficient than before and felt more confident about their ability to perform defibrillation themselves. A negative attitude toward defibrillation correlated with perceived negative organisational attitudes toward cardiopulmonary resuscitation guidelines. After CPR-D education in the hospital, the majority (64%) of nurses hesitated to perform defibrillation because of anxiety and 27 % hesitated because of fear of injuring the patient. Also a negative personal attitude towards guidelines increased markedly after education (Study V). Conclusions: Although a significant change had occurred in resuscitation practices in primary health care after publication of national cardiopulmonary resuscitation guidelines the participants CPR-D skills were not adequate according to the CPR guidelines. The current way of teaching is unlikely to result in participants being able to perform adequate and rapid CPR-D. More information and more frequent training are needed to diminish anxiety concerning defibrillation. Negative beliefs and attitudes toward defibrillation affect the nursing students and nurses attitudes toward cardiopulmonary resuscitation guidelines. CPR-D education increased the participants self-confidence concerning CPR-D skills but it did not reduce their anxiety. AEDs have replaced the manual defibrillators in most institutions, but in spite of the modern devices the anxiety still exists. Basic education does not provide nursing students with adequate CPR-D skills. Thus, frequent training in the workplace has vital importance. This multi-professional program supported by the administration might provide better CPR-D skills. Distance learning alone cannot substitute for traditional small-group learning, tutored hands-on training is needed to learn practical CPR-D skills. Standardized testing would probably help controlling the quality of learning. Training of group-working skills might improve CPR performance.

A Study of Practical Biological Phantoms with Simple Instrumentation for Electrical Impedance Tomography (EIT)

16-electrode phantoms are developed and studied with a simple instrumentation developed for Electrical Impedance Tomography. An analog instrumentation is developed with a sinusoidal current generator and signal conditioner circuit. Current generator is developed withmodified Howland constant current source fed by a voltage controlled oscillator and the signal conditioner circuit consisting of an instrumentation amplifier and a narrow band pass filter. Electronic hardware is connected to the electrodes through a DIP switch based multiplexer module. Phantoms with different electrode size and position are developed and the EIT forward problem is studied using the forward solver. A low frequency low magnitude sinusoidal current is injected to the surface electrodes surrounding the phantom boundary and the differential potential is measured by a digital multimeter. Comparing measured potential with the simulated data it is intended to reduce the measurement error and an optimum phantom geometry is suggested. Result shows that the common mode electrode reduces the common mode error of the EIT electronics and reduces the error potential in the measured data. Differential potential is reduced up to 67 mV at the voltage electrode pair opposite to the current electrodes. Offset potential is measured and subtracted from the measured data for further correction. It is noticed that the potential data pattern depends on the electrode width and the optimum electrode width is suggested. It is also observed that measured potential becomes acceptable with a 20 mm solution column above and below the electrode array level.

The Feminist Transformation of Bioethics : An Analysis of Theoretical Perspectives and Practical Applications in Feminist Bioethics

The purpose of this study is to examine how transformation is defining feminist bioethics and to determine the nature of this transformation. Behind the quest for transformation is core feminism and its political implications, namely, that women and other marginalized groups have been given unequal consideration in society and the sciences and that this situation is unacceptable and should be remedied. The goal of the dissertation is to determine how feminist bioethicists integrate the transformation into their respective fields and how they apply the potential of feminism to bioethical theories and practice. On a theoretical level, feminist bioethicists wish to reveal how current ways of knowing are based on inequality. Feminists pay special attention especially to communal and political contexts and to the power relations endorsed by each community. In addition, feminist bioethicists endorse relational ethics, a relational account of the self in which the interconnectedness of persons is important. On the conceptual level, feminist bioethicists work with beliefs, concepts, and practices that give us our world. As an example, I examine how feminist bioethicists have criticized and redefined the concept of autonomy. Feminist bioethicists emphasize relational autonomy, which is based on the conviction that social relationships shape moral identities and values. On the practical level, I discuss stem cell research as a test case for feminist bioethics and its ability to employ its methodologies. Analyzing these perspectives allowed me first, to compare non-feminist and feminist accounts of stem cell ethics and, second, to analyze feminist perspectives on the novel biotechnology. Along with offering a critical evaluation of the stem cell debate, the study shows that sustainable stem cell policies should be grounded on empirical knowledge about how donors perceive stem cell research and the donation process. The study indicates that feminist bioethics should develop the use of empirical bioethics, which takes the nature of ethics seriously: ethical decisions are provisional and open for further consideration. In addition, the study shows that there is another area of development in feminist bioethics: the understanding of (moral) agency. I argue that agency should be understood to mean that actions create desires.

Inverted V-Notch: Practical Proportional Weir

This paper presents a practical linear proportional weir of simple geometric shape in the form of an inverted V-notch or inward trapezium. The flow through this weir, of half-width w and altitude d, for depths above 0.22d is proportional to the depth of flow measured above a reference plane situated at 0.08d for all heads in the range 0.22d<=h<=0.94d, with a maximum percentage deviation of ±1.5 from the theoretical discharge. The linear relationship between head and discharge is based on numerical optimization procedures. Nearly 75% of the depth of inverted V-notch can be used effectively as the measuring range. Experiments with four weirs, with different vertex angles, show excellent agreement with the theory by giving an average coefficient of discharge for each weir varying from 0.61–0.62.

Design of Single-Input-Single-Output Compliant Mechanisms for Practical Applications Using Selection Maps

We present an interactive map-based technique for designing single-input-single-output compliant mechanisms that meet the requirements of practical applications. Our map juxtaposes user-specifications with the attributes of real compliant mechanisms stored in a database so that not only the practical feasibility of the specifications can be discerned quickly but also modifications can be done interactively to the existing compliant mechanisms. The practical utility of the method presented here exceeds that of shape and size optimizations because it accounts for manufacturing considerations, stress limits, and material selection. The premise for the method is the spring-leverage (SL) model, which characterizes the kinematic and elastostatic behavior of compliant mechanisms with only three SL constants. The user-specifications are met interactively using the beam-based 2D models of compliant mechanisms by changing their attributes such as: (i) overall size in two planar orthogonal directions, separately and together, (ii) uniform resizing of the in-plane widths of all the beam elements, (iii) uniform resizing of the out-of-plane thick-nesses of the beam elements, and (iv) the material. We present a design software program with a graphical user interface for interactive design. A case-study that describes the design procedure in detail is also presented while additional case-studies are posted on a website. DOI:10.1115/1.4001877].

Practical Proposals for Specifying k-Nearest Neighbours Weights Matrices

In this article we introduce and evaluate testing procedures for specifying the number k of nearest neighbours in the weights matrix of spatial econometric models. The spatial J-test is used for specification search. Two testing procedures are suggested: an increasing neighbours testing procedure and a decreasing neighbours testing procedure. Simulations show that the increasing neighbours testing procedures can be used in large samples to determine k. The decreasing neighbours testing procedure is found to have low power, and is not recommended for use in practice. An empirical example involving house price data is provided to show how to use the testing procedures with real data.

Optimal Receive Antenna Selection in Time-Varying Fading Channels with Practical Training Constraints

Hardware constraints, which motivate receive antenna selection, also require that various antenna elements at the receiver be sounded sequentially to obtain estimates required for selecting the `best' antenna and for coherently demodulating data thereafter. Consequently, the channel state information at different antennas is outdated by different amounts and corrupted by noise. We show that, for this reason, simply selecting the antenna with the highest estimated channel gain is not optimum. Rather, a preferable strategy is to linearly weight the channel estimates of different antennas differently, depending on the training scheme. We derive closed-form expressions for the symbol error probability (SEP) of AS for MPSK and MQAM in time-varying Rayleigh fading channels for arbitrary selection weights, and validate them with simulations. We then characterize explicitly the optimal selection weights that minimize the SEP. We also consider packet reception, in which multiple symbols of a packet are received by the same antenna. New suboptimal, but computationally efficient weighted selection schemes are proposed for reducing the packet error rate. The benefits of weighted selection are also demonstrated using a practical channel code used in third generation cellular systems. Our results show that optimal weighted selection yields a significant performance gain over conventional unweighted selection.

Practical constant-accuracy linear weir

This paper is concerned with the modifications of the Extended Bellmouth Weir (EBM weir) earlier designed by Keshava Murthy. It is shown that by providing inclined sides (equivalent to providing an inward-trapezoidal weir) over a sector of a circle of radius R, separated by a distance 2t, and depth d, the measurable range of EBM can be considerably enhanced (over 375%). Simultaneously, the other parameters of the weir are optimized such that the reference plane of the weir coincides with its crest making it a constant-accuracy linear weir. Discharge through the aforementioned weir is proportional to the depths of flow measured above the crest of the weir for all heads in the range of 0.5R less-than-or-equal-to h less-than-or-equal-to 7.9R, within a maximum deviation of +/-1% from the theoretical discharge. Experiments with two typical weirs show excellent agreement with the theory by giving a constant-average coefficient of discharge of 0.619

A neural network based power system stabilizer suitable for on-line training-a practical case study for EGAT system

This paper presents the development of a neural network based power system stabilizer (PSS) designed to enhance the damping characteristics of a practical power system network representing a part of Electricity Generating Authority of Thailand (EGAT) system. The proposed PSS consists of a neuro-identifier and a neuro-controller which have been developed based on functional link network (FLN) model. A recursive on-line training algorithm has been utilized to train the two neural networks. Simulation results have been obtained under various operating conditions and severe disturbance cases which show that the proposed neuro-PSS can provide a better damping to the local as well as interarea modes of oscillations as compared to a conventional PSS