Recruiting and retaining plasmapheresis donors: A critical belief analysis

This paper identifies critical beliefs underpinning intentions to commence and continue plasmapheresis donation. Whole blood (n = 624) and first-time plasmapheresis (n = 460) donors completed a cross-sectional survey assessing the belief-base of the theory of planned behaviour and rated their plasmapheresis donation intentions. While the idea of red blood cells being returned was a key deterrent for all donors, critical beliefs underlying commencement and continuation in the plasmapheresis donor panel differed and varied as a function of blood donation history. Findings will assist the development of targeted persuasion messages to optimise recruitment and retention of plasmapheresis donors in a non-remunerated context.

Parkinson's disease, nutrition, and surgery in context of critical care

Parkinson’s disease is a common neurodegenerative disorder with a higher risk of hospitalization than the general population. Therefore, there is a high likelihood of encountering a person with Parkinson’s disease in acute or critical care. Most people with Parkinson’s disease are over the age of 60 years and are likely to have other concurrent medical conditions. Parkinson’s disease is more likely to be the secondary diagnosis during hospital admission. The primary diagnosis may be due to other medical conditions or as a result of complications from Parkinson’s disease symptoms. Symptoms include motor symptoms, such as slowness of movement and tremor, and non-motor symptoms, such as depression, dysphagia, and constipation. There is a large degree of variation in the presence and degree of symptoms as well as in the rate of progression. There is a range of medications that can be used to manage the motor or non-motor symptoms, and side effects can occur. Improper administration of medications can result in deterioration of the patient’s condition and potentially a life-threatening condition called neuroleptic malignant-like syndrome. Nutrients and delayed gastric emptying may also interfere with intestinal absorption of levodopa, the primary medication used for motor symptom management. Rates of protein-energy malnutrition can be up to 15 % in people with Parkinson’s disease in the community, and this is likely to be higher in the acute or critical care setting. Nutrition-related care in this setting should utilize the Nutrition Care Process and take into account each individual’s Parkinson’s disease motor and non-motor symptoms, the severity of disease, limitations due to the disease, medical management regimen, and nutritional status when planning nutrition interventions. Special considerations may need to be taken into account in relation to meal and medication times and the administration of enteral feeding. Nutrition screening, assessment, and monitoring should occur during admission to minimize the effects of Parkinson's disease symptoms and to optimise nutrition-related outcomes.

Socially critical pedagogy and the 'production of skilled performers': Further considerations of teaching and learning in physical education

The growing call for physical educators to move beyond the bounds of performance has been a powerful discourse. However, it is a discourse that has tended to be heavy on theory but light on practical application. This paper discusses recent work in the area of skill acquisition and what this might mean for pedagogical practices in physical education. The acquisition of motor skill has traditionally been a core objective for physical educators, and there has been a perception that child-centred pedagogies have failed in the achievement of this traditional yardstick. However, drawing from the work of Rovegno and Kirk (1995) and Langley (1995; 1997), and making links with current work in the motor learning area, it is possible to show that skill acquisition is not necessarily compromised by child-centred pedagogy. Indeed, working beyond Mosston's discovery threshold and using models such as Games for Understanding, can provide deeper skill-learning experiences as well as being socially just.

Notes on the future of critical discourse studies

In How to Do Things with Words, Austin (1975) described marriages, sentencings and ship launchings as prototypes of performative utterance. What’s the appropriate speech act for launching an academic journal? First editions of journals tend to take a field as formed a priori, as having “come of age”, and state good intents to capture its best or most innovative work.

Multiple stages classification of Alzheimer’s disease based on structural brain networks using generalized low rank approximations (GLRAM)

To classify each stage for a progressing disease such as Alzheimer’s disease is a key issue for the disease prevention and treatment. In this study, we derived structural brain networks from diffusion-weighted MRI using whole-brain tractography since there is growing interest in relating connectivity measures to clinical, cognitive, and genetic data. Relatively little work has usedmachine learning to make inferences about variations in brain networks in the progression of the Alzheimer’s disease. Here we developed a framework to utilize generalized low rank approximations of matrices (GLRAM) and modified linear discrimination analysis for unsupervised feature learning and classification of connectivity matrices. We apply the methods to brain networks derived from DWI scans of 41 people with Alzheimer’s disease, 73 people with EMCI, 38 people with LMCI, 47 elderly healthy controls and 221 young healthy controls. Our results show that this new framework can significantly improve classification accuracy when combining multiple datasets; this suggests the value of using data beyond the classification task at hand to model variations in brain connectivity.

‘True Blood’ the critical care story: An audit of blood sampling practice across three adult, paediatric and neonatal intensive care settings

Background Anaemia is common in critically ill patients, and has a significant negative impact on patients' recovery. Blood conservation strategies have been developed to reduce the incidence of iatrogenic anaemic caused by sampling for diagnostic testing. Objectives Describe practice and local guidelines in adult, paediatric and neonatal Australian intensive care units (ICUs) regarding blood sampling and conservation strategies. Methods Cross-sectional descriptive study, conducted July 2013 over one week in single adult, paediatric and neonatal ICUs in Brisbane. Data were collected on diagnostic blood samples obtained during the study period, including demographic and acuity data of patients. Institutional blood conservation practice and guidelines were compared against seven evidence-based recommendations. Results A total of 940 blood sampling episodes from 96 patients were examined across three sites. Arterial blood gas was the predominant reason for blood sampling in each unit, accounting for 82% of adult, 80% of paediatric and 47% of neonatal samples taken (p <. 0.001). Adult patients had significantly more median [IQR] samples per day in comparison to paediatrics and neonates (adults 5.0 [2.4]; paediatrics 2.3 [2.9]; neonatal 0.7 [2.7]), which significantly increased median [IQR] blood sampling costs per day (adults AUD$101.11 [54.71]; paediatrics AUD$41.55 [56.74]; neonatal AUD$8.13 [14.95]; p <. 0.001). The total volume of samples per day (median [IQR]) was also highest in adults (adults 22.3. mL [16.8]; paediatrics 5.0. mL [1.0]; neonates 0.16. mL [0.4]). There was little information about blood conservation strategies in the local clinical practice guidelines, with the adult and neonatal sites including none of the seven recommendations. Conclusions There was significant variation in blood sampling practice and conservation strategies between critical care settings. This has implications not only for anaemia but also infection control and healthcare costs.

Education critical to going beyond business as usual

As government and industry grapple with 21st century challenges, building the capacity to look at complex problems through fresh eyes is critical.

Defining green road infrastructure projects—A critical review

Green infrastructure is considered as a strategic approach to address the ecological and social impacts of urban sprawl. The main elements of green infrastructure have been well established and include a series of multifunctional ecological systems, such as green urban space, green road infrastructure and the links between these systems. However, it should be noted that the elements of green road infrastructure have only been briefly mentioned in isolated life cycle stages, e.g. design, procurement, construction, maintenance and operation. The definition of green road infrastructure and the elements in green road infrastructure projects remain largely unknown. To explore the elements in green road infrastructure, a critical review was adopted. As the development of green road infrastructure projects is guided by rating systems, a comparison of three major green roads rating systems, including GreenroadsTM, EnvisionTM and Infrastructure Sustainability Rating Tool—IS, was conducted. The comparison reveals that green roads can be defined as road projects that have superior performance in economic, social and environmental sustainability. The sustainability features in green roads mainly include environmental sustainability, social sustainability, economic sustainability, quality, pavement technology and innovation. The results will contribute to an increased understanding of green roads and will be useful to improve the performance of road projects on these sustainability features.

Location and labor: Critical crossroads in global film and television

I approached the editorial prompt as an opportunity to work through some of the concerns driving my current research on creative labor in emergent or ‘peripheral’ media hubs, centers of production activity outside established media capitals that are nevertheless increasingly integrated into a global production apparatus. It builds from my research on the role that film, television and digital media production have played in the economic and cultural strategies of Glasgow, Scotland, and extends the focus on media work to other locations, including Prague and Budapest. I am particularly drawn to the spatial dynamics at play in these locations and how local producers, writers, directors and crew negotiate a sense of place and creative identity against the flows and counter-flows of capital and culture. This means not only asking questions about the growing ensemble of people, places, firms and policies that make international productions possible, but also studying the more quotidian relationships between media workers and the locations (both near and far) where they now find work. I do not see these tasks as unrelated. On the one hand, such queries underscore how international production depends on a growing constellation of interchangeable parts and is facilitated by various actors whose agendas may or may not converge. On the other hand, these questions also betray an even more complicated dynamic, a process that is shifting the spatial orientation of both location and labor around uneven and contested scales. As local industries reimagine themselves as global players, media practitioners are caught up in a new geography of creative labor: not only are personnel finding it increasingly necessary to hop from place to place to follow the work, but also place itself is changing, as locations morph into nebulous amalgamations of tax rebates, subsidized facilities, production services and (when it still matters) natural beauty.

Performance pay for Australian teachers: A critical policy historiography

In May 2011, the Australian Federal Education Minister announced there would be a unique, innovative and new policy of performance pay for teachers, Rewards for Great Teachers (Garrett, 2011a). In response, this paper uses critical policy historiography to argue that the unintended consequences of performance pay for teachers makes it unlikely it will deliver improved quality or efficiency in Australian schools. What is new, in the Australian context, is that performance pay is one of a raft of education policies being driven by the federal government within a system that constitutionally and historically has placed the responsibility for schooling with the states and territories. Since 2008, a key platform of the Australian federal Labor government has been a commitment to an Education Revolution that would promote quality, equity and accountability in Australian schools. This commitment has resulted in new national initiatives impacting on Australian schools including a high-stakes testing regime 14 National Assessment Program 13 Literacy and Numeracy (NAPLAN) 14a mandated national curriculum (the Australian Curriculum), professional standards for teachers and teacher accreditation 14Australian Institute for Teaching and School Leadership (AITSL) 14and the idea of rewarding excellent teachers through performance pay (Garrett, 2011b). These reforms demonstrate the increased influence of the federal government in education policy processes and the growth of a 1Ccoercive federalism 1D that pits the state and federal governments against each other (Harris-Hart, 2010). Central to these initiatives is the measuring, or auditing, of educational practices and relationships. While this shift in education policy hegemony from state to federal governments has been occurring in Australia at least since the 1970s, it has escalated and been transformed in more recent times with a greater emphasis on national human capital agendas which link education and training to Australia 19s international economic competitiveness (Lingard & Sellar, in press). This paper uses historically informed critical analysis to critique claims about the effects of such policies. We argue that performance pay has a detailed and complex historical trajectory both internationally and within Australian states. Using Gale 19s (2001) critical policy historiography, we illuminate some of the effects that performance pay policies have had on education internationally and in particular within Australia. This critical historical lens also provides opportunities to highlight how teachers have, in the past, tactically engaged with such policies.

Practical guidelines for planning and implementing fauna translocations

A successful translocation involves many complex factors, including a genetically appropriate source population that can sustain harvest, social and governmental support, assessment of disease transmission risk and a release site with appropriately secure habitat that can support population establishment and persistance. This information is typically discussed during staturory approval processes and can take considerable time. However, following approval, for translocations of most fauna, the initial critical step involves the inherently stressful process of capture, holding, transportation and release. This process is unpredictable and novel, and is especially challenging for wild animals when they are confined in close proximity to conspecifics and humans. In contrast, captive-reared animals have to cope with the unfamiliar challenges of finding food and shelter, along with coping with competition and predation. Little has been written in the scientific literature about the translocation process. This is unsurprising because this process has usually been the realm of skilled practioners, often with animal husbandry backgrounds, rather than research scientists. Highly skilled intuition, observation and the translocation practioner's equivalent of a 'green thumb' often guides the way. However, theory and experimentation, particularly on the effects of stress, is available and this work is invaluable for a successful translocation. Here, we provide a brief description of the translocation process, and discussion of what stress is and how it can be managed. We then provide practical guidelines for the successful translocation of invertebrates, lizards, turtles, passerine birds, marsupials and bats, using examples from Australia and New Zealand.

To increase or decrease dosage of antimicrobials in septic patients during continuous renal replacement therapy: the eternal doubt

Critical illness, acute renal failure and continuous renal replacement therapy (CRRT) are associated with changes in pharmacokinetics. Initial antibiotic dose should be based on published volume of distribution and generally be at least the standard dose, as volume of distribution is usually unchanged or increased. Subsequent doses should be based on total clearance. Total clearance varies with the CRRT clearance which mainly depends on effluent flow rate, sieving coefficient/saturation coefficient. As antibiotic clearance by healthy kidneys is usually higher than clearance by CRRT, except for colistin, subsequent doses should generally be lower than given to patients without renal dysfunction. In the future therapeutic drug monitoring, together with sophisticated pharmacokinetic models taking into account the pharmacokinetic variability, may enable more appropriate individualized dosing.

End-of-life care practices of critical care nurses: A national cross-sectional survey

Background: The critical care context presents important opportunities for nurses to deliver skilled, comprehensive care to patients at the end of life and their families. Limited research has identified the actual end-of-life care practices of critical care nurses. Objective: To identify the end-of-life care practices of critical care nurses. Design: A national cross-sectional online survey. Methods: The survey was distributed to members of an Australian critical care nursing association and 392 critical care nurses (response rate 25%) completed the survey. Exploratory factor analysis using principal axis factoring with oblique rotation was undertaken on survey responses to identify the domains of end-of-life care practice. Descriptive statistics were calculated for individual survey items. Results: Exploratory factor analysis identified six domains of end-of-life care practice: information sharing, environmental modification, emotional support, patient and family centred decision-making, symptom management and spiritual support. Descriptive statistics identified a high level of engagement in information sharing and environmental modification practices and less frequent engagement in items from the emotional support and symptom management practice areas. Conclusions: The findings of this study identified domains of end-of-life care practice, and critical care nurse engagement in these practices. The findings highlight future training and practice development opportunities, including the need for experiential learning targeting the emotional support practice domain. Further research is needed to enhance knowledge of symptom management practices during the provision of end-of-life care to inform and improve practice in this area.