(Mis)Using Pulse Oximetry : A Review of Pulse Oximetry use in Acute Care Medical Wards

Background: Nurses routinely use pulse oximetry (SpO2) monitoring equipment in acute care. Interpretation of the reading involves physical assessment and awareness of parameters including temperature, haemoglobin, and peripheral perfusion. However, there is little information on whether these clinical signs are routinely measured or used in pulse oximetry interpretation by nurses. Aim: The aim of this study was to review current practice of SpO2 measurement and the associated documentation of the physiological data that is required for accurate interpretation of the readings. The study reviewed the documentation practices relevant to SpO2 in five medical wards of a tertiary level metropolitan hospital. Method: A prospective casenote audit was conducted on random days over a three-month period. The audit tool had been validated in a previous study. Results: One hundred and seventy seven episodes of oxygen saturation monitoring were reviewed. Our study revealed a lack of parameters to validate the SpO2 readings. Only 10% of the casenotes reviewed had sufficient physiological data to meaningfully interpret the SpO2 reading and only 38% had an arterial blood gas as a comparator. Nursing notes rarely documented clinical interpretation of the results. Conclusion: The audits suggest that medical and nursing staff are not interpreting the pulse oximetry results in context and that the majority of the results were normal with no clinical indication for performing this observation. This reduces the usefulness of such readings and questions the appropriateness of performing “routine” SpO2 in this context.

Students’ beliefs about willingness to access complementary and alternative therapies (CAT) training for future integration into psychology practice.

It is suggested that all psychologists gain basic training in the types of complementary and alternative therapies (CAT) their clients may be using. As psychology students are the next cohort of health professionals who will inform future initiatives in the field, it is important to first understand the factors which influence their decisions about CAT integration. Drawing on the Theory of Planned Behavior, we investigated the beliefs that differentiate between psychology students who are high or low on willingness to access training in CAT for future practice use. Psychology students (N = 106) completed a questionnaire assessing the likelihood of both positive and negative consequences of accessing training and utilizing CAT within a psychological practice, important others approval, and barriers preventing them from this integration behavior. Those students high compared to low on willingness more likely to endorse positive outcomes (e.g., offering a more holistic approach to therapy) of accessing CAT training for future practice use and to believe that important others (e.g., clients) would support this behavior. We identified important beliefs of student psychologists related to decisions about undertaking CAT training for future professional use and can inform educators and policy-makers about CAT training and integration in psychology practice.

Telehealth for nursing homes: the utilization of specialist services for residential care

Specialist care consultations were identified by two research nurses using documentation in patient records, appointment diaries, electronic billing services and on-site observations at a 441-bed long term care facility. Over a six-month period there were 3333 consultations (a rate of 1511 consultations per year per 100 beds). Most consultations were for general practice (n = 2589, 78%); these consultations were mainly on site (99%), with only 27 taking place off site. There were 744 consultations for specialities other than general practice. A total of 146 events related to an emergency or unplanned hospital admission. The remaining medical consultations (n = 598, 18%) related to 23 medical specialities. The largest number of consultations were for surgery (n = 106), podiatry (n = 100), nursing services including wound care (n = 74), imaging (n = 41) and ophthalmology (n = 40). Many services which are currently being provided on site to metropolitan long-term care facilities could be provided by telehealth in both urban and rural facilities.

Engineering across cultures : new learning resources for intercultural competency in engineering

BACKGROUND The work described in this paper has emerged from an ALTC/OLT funded project, Exploring Intercultural Competency in Engineering. The project indentified many facets of culture and intercultural competence that go beyond a culture-as-nationality paradigm. It was clear from this work that resources were needed to help engineering educators introduce students to the complex issues of culture as they relate to engineering practice. A set of learning modules focussing on intercultural competence in engineering practice were developed early on in the project. Through the OLT project, these modules have been expanded into a range of resources covering various aspects of culture in engineering. Supporting the resources, an eBook detailing the ins and outs of intercultural competency has also been developed to assist engineering educators to embed opportunities for students to develop skills in unpacking and managing cross-cultural challenges in engineering practice. PURPOSE This paper describes the key principles behind the development of the learning modules, the areas they cover and the eBook developed to support the modules. The paper is intended as an introduction to the approaches and resources and extends an invitation to the community to draw from, and contribute to this initial work. DESIGN/METHOD A key aim of this project was to go beyond the culture-as-nationality approach adopted in much of the work around intercultural competency (Deardorff, 2011). The eBook explores different dimensions of culture such as workplace culture, culture’s influence on engineering design, and culture in the classroom. The authors describe how these connect to industry practice and explore what they mean for engineering education. The packaged learning modules described here have been developed as a matrix of approaches moving from familiar known methods through complicated activities relying to some extent on expert knowledge. Some modules draw on the concept of ‘complex un-order’ as described in the ‘Cynefin domains’ proposed by Kurtz and Snowden (2003). RESULTS Several of the modules included in the eBook have already been trialled at a variety of institutions. Feedback from staff has been reassuringly positive so far. Further trials are planned for second semester 2012, and version 1 of the eBook and learning modules, Engineering Across Cultures, is due to be released in late October 2012. CONCLUSIONS The Engineering Across Cultures eBook and learning modules provide a useful and ready to employ resource to help educators tackle the complex issue of intercultural competency in engineering education. The book is by no means exhaustive, and nor are the modules, they instead provide an accessible, engineering specific guide to bringing cultural issues into the engineering classroom.

Cytokine synthesis by intestinal intraepithelial lymphocytes. Both gamma/delta T cell receptor-positive and alpha/beta T cell receptor-positive T cells in the G1 phase of cell cycle produce IFN-gamma and IL-5

Murine intestinal intraepithelial lymphocytes (IEL) have been shown to contain subsets of alpha/beta TCR+ and gamma/delta TCR+ T cells that spontaneously produce cytokines such as IFN-gamma and IL-5. We have now determined the nature and cell cycle stage of these cytokine-producing T lymphocytes in EIL by using IFN-gamma- and IL-5-specific ELISPOT assay, cytokine-specific mRNA-cDNA dot-blot hybridization and polymerase chain reaction, and flow cytometry (FACS) for DNA analysis. When CD3+ T cells from IEL of normal C3H/HeN mice were separated into low and high density fractions by discontinuous Percoll gradients, IFN-gamma and IL-5 spot-forming cells were only found in the former population. Analysis of mRNA for these cytokines by both IFN-gamma- and IL-5-specific dot-blot hybridization and polymerase chain reaction revealed that higher levels of message for IFN-gamma and IL-5 were also seen in the low density fraction. However, cell cycle analysis of these two fractions by FACS using propidium iodide showed a similar pattern of cell cycle stages in both low and high density populations (G0 + G1 approximately 96 to 98% and S/G2 + M approximately 2 to 4%). Finally, mRNA from gamma/delta TCR+ and alpha/beta TCR+ T cells in both low and high density fractions of IEL were analyzed for IFN-gamma and IL-5 message by polymerase chain reaction. After 35 cycles of amplification, both gamma/delta TCR+ and alpha/beta TCR+ T cells in the low density fraction expressed higher levels of message for these two cytokines when compared with the high density population. These results have now shown that both gamma/delta and alpha/beta TCR+ IEL can be separated into low and high density subsets and both fractions possess a similar stage of cell cycle. However, only the low density cells (in G1 phase) of both gamma/delta and alpha/beta TCR types possess increased cytokine-specific mRNA and produce the cytokines IFN-gamma and IL-5. Our results suggest that alpha/beta TCR+ and gamma/delta TCR+ IEL can produce cytokines without cell proliferation.

Monitoring smartphones for anomaly detection

In this paper we demonstrate how to monitor a smartphone running Symbian operating system and Windows Mobile in order to extract features for anomaly detection. These features are sent to a remote server because running a complex intrusion detection system on this kind of mobile device still is not feasible due to capability and hardware limitations. We give examples on how to compute relevant features and introduce the top ten applications used by mobile phone users based on a study in 2005. The usage of these applications is recorded by a monitoring client and visualized. Additionally, monitoring results of public and self-written malwares are shown. For improving monitoring client performance, Principal Component Analysis was applied which lead to a decrease of about 80 of the amount of monitored features.

Are we keeping the bastards honest? Perceptions of corruption, integrity and influence on politics

The words of the late Don Chipp, the founder of the Australian Democrats, have a perennial relevance to politics. When Chipp talked about ‘keeping the bastards honest’, it related to a minor political party playing a role of keeping the major political parties true to their word (Warhurst 1997). Yet it is also a democratic role that citizens play on an ongoing basis, particularly through the mechanism of elections. At the ballot box, governments that are widely perceived to have acted with a lack of integrity are roundly punished. This chapter explores public opinion on issues of integrity, corruption, influence and trust in politics and politicians in Australia. The evidence paints a differentiated picture of a public which sees little sign of overtly corrupt political practices but on the other hand does not feel terribly influential and is not always confident of fair treatment from public officials...

Drugs, labels and (p)ill-fitting boxes : ADHD and children who are hard to teach

In offering a critical review of the problem we call “ADHD” this paper progresses in three stages. The first two parts juxtapose the dominant voices emanating from the literature in medicine and psychology, highlighting some interdependency between these otherwise competing interest groups. In part three, the nature of the relationship between these groups and the institution of the school is considered, as is the role that the school may play in the psycho-pathologisation of fidgety, distractible, active children who prove hard to teach. In so doing, the author provides an insight as to why the problem we call “ADHD” has achieved celebrity status in Australia and what the effects of that may be for children who come to be described in these ways.

Psychology students’ beliefs about integrating Complementary and Alternative Therapy (CAT) into their future psychology practice

We investigated whether belief-based differences exist between students who have strong and weak intentions to integrate complementary and alternative therapy (CAT) into future psychology practice by recommending CAT or specific CAT practitioners to clients. A cross-sectional methodology was used. Psychology undergraduate students (N = 106) participated in a paper-based questionnaire design to explore their underlying beliefs related to CAT integration. The study was undertaken at a major university in Queensland, Australia. The theory of planned behaviour belief-based framework guided the study. Multivariate analyses of variance examined the influence of behavioural, normative, and control beliefs on the strong and weak intention groups. A multiple regression analysis investigated the relative importance of these belief sets for predicting intentions. We found that clear differences emerged between strong and weak intenders on behavioural and normative beliefs, but not control beliefs. Strong intenders perceived the positive outcomes of integrating CAT, such as being able to offer clients a more holistic practice and having confidence in the practitioners/practices, as more likely to occur than weak intenders, and perceived the negative outcome of compromising my professional practice as less likely. Strong in-tenders were more likely than weak intenders to perceive that a range of important referents (e.g., clients) would think they should integrate CAT. Results of the regression analysis revealed the same pattern of results in that behavioural and normative beliefs, but not control beliefs, significantly predicted intentions. The findings from this study can be used to inform policy and educational initiatives that aim to encourage CAT use in psychology practice.

Leadership for creating a thinking school at Buranda State School

This article explores the role of principal leadership in creating a thinking school. It contributes to the school leadership literature by exploring the intersection of two important areas of study in education - school leadership and education for thinking - which is a particularly apt area of study, because effective school leadership is crucial if students are to learn to be critical and creative thinkers, yet this connection has not be widely investigated. We describe how one principal, Hinton, turned around an underperforming school by using critical and creative philosophical thinking as the focus for students, staff and parents. Then, drawing on the school leadership literature, the article describes seven attributes of school leadership beginning with four articulated by Leithwood and colleagues (2006) (building vision and setting direction; redesigning the organisation; understanding and developing people; managing the teaching and learning program), and adding three others (influence; self-development; and responding to context). This framework is then used in a case study format in a collaboration between practitioner and researchers to first explore evidence from empirical studies and personal reflection about Hinton's leadership of Buranda State School, and second to illuminate how these general features of school leadership apply to creating a thinking school. Based on the case study and using the general characteristics of school leadership, a framework for leading a thinking school is described. Because the framework is based on a turnaround school, this framework has wide applicability: to schools that are doing well as an indication of how to implement a contemporary approach to curriculum and pedagogy; and to schools that are underperforming and want a rigorous, high expectation and contemporary way to improve student learning.

Wetlands, climate zones and Barmah Forest virus disease in Queensland, Australia

Barmah Forest virus (BFV) disease is the second most common mosquito-borne disease in Australia, but the linkages of the wetlands and climate zones with BFV transmission remain unclear. We aimed to examine the relationship between the wetlands, climate zones and BFV risk in Queensland, Australia. Data on the wetlands, climate zones, population and BFV cases for the period 1992 to 2008 were obtained from relevant government agencies. BFV risk was grouped as low-, medium- and high-level based on BFV incidence percentiles. The buffer zones around each BFV case were made using 1, 5, 10, 15, 20, 25 and 50 km distances. We performed a discriminant analysis to determine the differences between wetland classes and BFV risk within each climate zone. The discriminant analyses show that saline 1, riverine and saline tidal influence were the most significant contributors to BFV risk in all climate and buffer zones, while lacustrine, palustrine, estuarine and saline 2 and saline 3 wetlands were less important. These models had classification accuracies of 76%, 98% and 100% for BFV risk in subtropical, tropical and temperate climate zones, respectively. This study demonstrates that BFV risk varies with wetland class and climate zone. The discriminant analysis is a useful tool to quantify the links between wetlands, climate zones and BFV risk.

Use of brain computer interface to drive : preliminary results

This paper reports on the implementation of a non-invasive electroencephalography-based brain-computer interface to control functions of a car in a driving simulator. The system is comprised of a Cleveland Medical Devices BioRadio 150 physiological signal recorder, a MATLAB-based BCI and an OKTAL SCANeR advanced driving experience simulator. The system utilizes steady-state visual-evoked potentials for the BCI paradigm, elicited by frequency-modulated high-power LEDs and recorded with the electrode placement of Oz-Fz with Fz as ground. A three-class online brain-computer interface was developed and interfaced with an advanced driving simulator to control functions of the car, including acceleration and steering. The findings are mainly exploratory but provide an indication of the feasibility and challenges of brain-controlled on-road cars for the future, in addition to a safe, simulated BCI driving environment to use as a foundation for research into overcoming these challenges.

What vs how : comparing students' testing and coding skills

The well-known difficulties students exhibit when learning to program are often characterised as either difficulties in understanding the problem to be solved or difficulties in devising and coding a computational solution. It would therefore be helpful to understand which of these gives students the greatest trouble. Unit testing is a mainstay of large-scale software development and maintenance. A unit test suite serves not only for acceptance testing, but is also a form of requirements specification, as exemplified by agile programming methodologies in which the tests are developed before the corresponding program code. In order to better understand students’ conceptual difficulties with programming, we conducted a series of experiments in which students were required to write both unit tests and program code for non-trivial problems. Their code and tests were then assessed separately for correctness and ‘coverage’, respectively. The results allowed us to directly compare students’ abilities to characterise a computational problem, as a unit test suite, and develop a corresponding solution, as executable code. Since understanding a problem is a pre-requisite to solving it, we expected students’ unit testing skills to be a strong predictor of their ability to successfully implement the corresponding program. Instead, however, we found that students’testing abilities lag well behind their coding skills.

Infrared and Raman spectroscopic characterization of the carbonate mineral weloganite – Sr3Na2Zr(CO3)6·3H2O and in comparison with selected carbonates

The mineral weloganite Na2Sr3Zr(CO3)6·3H2O has been studied by using vibrational spectroscopy and a comparison is made with the spectra of weloganite with other carbonate minerals. Weloganite is member of the mckelveyite group that includes donnayite-(Y) and mckelveyite-(Y). The Raman spectrum of weloganite is characterized by an intense band at 1082 cm−1 with shoulder bands at 1061 and 1073 cm−1, attributed to the View the MathML source symmetric stretching vibration. The observation of three symmetric stretching vibrations is very unusual. The position of View the MathML source symmetric stretching vibration varies with mineral composition. The Raman bands at 1350, 1371, 1385, 1417, 1526, 1546, and 1563 cm−1 are assigned to the ν3 (CO3)2− antisymmetric stretching mode. The observation of additional Raman bands for the ν3 modes for weloganite is significant in that it shows distortion of the carbonate anion in the mineral structure. The Raman band observed at 870 cm−1 is assigned to the (CO3)2− ν2 bending mode. Raman bands observed for weloganite at 679, 682, 696, 728, 736, 749, and 762 cm−1 are assigned to the (CO3)2− ν4 bending modes. A comparison of the vibrational spectra is made with that of the rare earth carbonates decrespignyite, bastnasite, hydroxybastnasite, parisite, and northupite.