Diagnostic accuracy of and patient satisfaction with telemedicine for the follow-up of paediatric burns patients

Videoconferencing has become a routine technique for the post-acute burns care of children in Queensland. We compared the agreement between clinical assessments conducted via videoconference and assessments conducted in the conventional, face-to-face manner (FTF). A total of 35 children with a previous burn injury were studied. Twenty-five children received three consecutive assessments: first FTF by a consultant in the outpatient department, then by a second consultant who reviewed the patient via videoconference, and then by the second consultant in person. The second consultant also reviewed another 10 children twice. At each review, the following variables were measured: scar colour, scar thickening, contractures, range of motion, the patient's level of general activity, any breakdown of the graft site, and adequacy of the consultation. Agreement between the two consultants when seeing patients FTF was moderately high, with an overall concordance of 85%. When videoconferencing was used, the level of agreement was almost the same, at 84%. If one consultant reviewed patients FTF first and then via videoconference, the overall concordance was 98%; if the process was reversed, the overall concordance was 97%. This study confirms that the quality of information collected during a videoconference appointment is comparable to that collected during a traditional, FTF appointment for a follow-up burns consultation.

Staff and patient perceptions of seclusion: Has anything changed?

Background Seclusion continues to be widely used in the management of disturbed behaviour in hospitalized patients. While early research on the topic highlighted significant differences in staff and patient perceptions, there are few recent data to indicate if these differences still exist. Aim This paper reports a study exploring the perceptions of both nursing staff and patients towards the reasons for seclusion; its effects; patients' feelings during seclusion; and possible changes to the practice. Methods Sixty nursing staff and 29 patients who had experienced seclusion at three inpatient units in Queensland, Australia completed Heyman's Attitudes to Seclusion Survey. Results The findings indicate that the two groups differed significantly on a number of the dimensions assessed. Nurses believed seclusion to be very necessary, not very punitive and a highly therapeutic practice that assisted patients to calm down and feel better. Patients, on the other hand, believed that seclusion was used frequently for minor disturbances and as a means of staff exerting power and control. Patients also believed that seclusion resulted in them feeling punished, and had little therapeutic value. Conclusion The disagreement between staff and patients highlights the need for greater dialogue between these groups. While nursing staff require greater understanding of how patients feel about seclusion, patients require information on why and how seclusion is implemented.

Male teachers, homophobia, misogyny and teacher education

Placing issues of homophobia and anti-lesbianism on the agenda of teacher education programmes often meets with resistance from some students, and others. Such resistance is indicative of broader attempts to maintain the straight face of schooling. However, one way in which it is possible to place such issues on the agenda in schooling and teacher education is to demonstrate how these discourses impact upon all students and teachers. A current opening for raising such matters within teacher education programmes is the problematisation of the calls for more male teachers, calls that are becoming pervasive in many Western education systems. Within the drives to attract more male teachers to the profession there is usually a silence relating to the ways in which homophobia and its counterpart, misogyny, work to construct normalised notions of teachers. This paper examines the ways in which these silences perpetuate existing gender regimes in schools to the detriment of female teachers, girls, and marginalised male teachers and boys. It then suggests that teacher education programmes use this topic to demonstrate the impact of homophobia and misogyny on all involved in education.

Validation and patient acceptance of a computer touch screen version of the WOMAC 3.1 osteoarthritis index

Objectives: To validate the WOMAC 3.1 in a touch screen computer format, which applies each question as a cartoon in writing and in speech (QUALITOUCH method), and to assess patient acceptance of the computer touch screen version. Methods: The paper and computer formats of WOMAC 3.1 were applied in random order to 53 subjects with hip or knee osteoarthritis. The mean age of the subjects was 64 years ( range 45 to 83), 60% were male, 53% were 65 years or older, and 53% used computers at home or at work. Agreement between formats was assessed by intraclass correlation coefficients (ICCs). Preferences were assessed with a supplementary questionnaire. Results: ICCs between formats were 0.92 (95% confidence interval, 0.87 to 0.96) for pain; 0.94 (0.90 to 0.97) for stiffness, and 0.96 ( 0.94 to 0.98) for function. ICCs were similar in men and women, in subjects with or without previous computer experience, and in subjects below or above age 65. The computer format was found easier to use by 26% of the subjects, the paper format by 8%, and 66% were undecided. Overall, 53% of subjects preferred the computer format, while 9% preferred the paper format, and 38% were undecided. Conclusion: The computer format of the WOMAC 3.1 is a reliable assessment tool. Agreement between computer and paper formats was independent of computer experience, age, or sex. Thus the computer format may help improve patient follow up by meeting patients' preferences and providing immediate results.

Promoting Learning for Sustainability: Principals' Perceptions of the Role of Outdoor and Environmental Education Centres

Outdoor and Environmental Education Centres provide programs that are designed to address a range of environmental education aims, and contribute broadly to student learning for sustainability. This paper examines the roles such Centres can play, and how they might contribute to the Australian Government’s initiative in relation to sustainable schools. Interviews with the principals of 23 such Centres in Queensland revealed three roles or models under which they operate: the destination model; the expert/advisor model; and the partnership model. Principals’ understandings of these roles are discussed and the factors that support or hinder their implementation are identified. It is concluded that while the provision of programs in the environment is still a vital role of outdoor and environmental education centres, these can also be seen as a point of entry to long-term partnerships with whole school communities.

Bridging the divide between theory and practice. Experiential learning approaches for tourism and hospitality education

Experiential learning approaches such as role-play have been found to be valuable methods of bridging the divide between academic knowledge and practical skills, a problem often cited in tourism and hospitality management education. Such approaches have been found to contribute towards deeper learning by enhancing students' interest, motivation, participation, knowledge and skill development. This paper reports on the implementation of an experiential learning approach designed to encourage and facilitate deeper learning approaches, with the contributing aims of providing students with a more interesting learning experience and a broader set of skills for future employment.