Advanced nursing practice : a global perspective

Aim: To review the titles, roles and scope of practice of Advanced Practice Nurses internationally.----- Background: There is a worldwide shortage of nurses but there is also an increased demand for nurses with enhanced skills who can manage a more diverse, complex and acutely ill patient population than ever before. As a result, a variety of nurses in advanced practice positions has evolved around the world. The differences in nomenclature have led to confusion over the roles, scope of practice and professional boundaries of nurses in an international context.----- Method: CINAHL, Medline, and the Cochrane database of Systematic Reviews were searched from 1987 to 2008. Information was also obtained through government health and professional organisation websites. All information in the literature regarding current and past status, and nomenclature of advanced practice nursing was considered relevant.----- Findings: There are many names for Advanced Practice Nurses, and although many of these roles are similar in their function, they can often have different titles.----- Conclusion: Advanced Practice Nurses are critical for the future, provide cost-effective care and are highly regarded by patients/clients. They will be a constant and permanent feature of future health care provision. However, clarification regarding their classification and regulation is necessary in some countries.

Cholesterol-lowering management of stroke : inconsistencies of evidence and practice

Cholesterol-lowering treatment by statins is an important and costly issue; however, its role in stroke has not been well documented. The aim of the present study was to review literature and current practice regarding cholesterol-lowering treatment for stroke patients. A literature review was conducted on lipids in stroke and their management with both statins and diet, including the cost-effectiveness of medical nutrition therapy. Qualifying criteria and prescription procedures of the Pharmaceutical Benefits Scheme (PBS) were also reviewed. Data on lipid levels and statin prescriptions were analysed for 468 patients admitted to a stroke unit. The literature shows that management with both medication and diet can be effective, especially when combined; however, 60% of patients with an ischaemic event had fasting total cholesterol measures ≥4 mmol/L (n = 231), with only 52% prescribed statins on discharge (n = 120). Hypercholesterolaemia is an underdiagnosed and undertreated risk factor within the stroke population. It appears that the PBS has not kept pace with advances in the evidence in terms of statin use in the stroke population, and review is needed. The present review should address the qualifying criteria for the stroke population and recommendations on referral to dietitians for dietary advice. Cholesterol-lowering treatment for both stroke patients and the wider population is an area that needs awareness raising and review by the PBS, medical practitioners and dietitians. The role of dietary and pharmacological treatments needs to be clearly defined, including adjunct therapy, and the cost-effectiveness of medical nutrition therapy realised.

A participatory design agenda for ubiquitous computing : a case study in dental practice

This paper reflects upon our attempts to bring a participatory design approach to design research into interfaces that better support dental practice. The project brought together design researchers, general and specialist dental practitioners, the CEO of a dental software company and, to a limited extent, dental patients. We explored the potential for deployment of speech and gesture technologies in the challenging and authentic context of dental practices. The paper describes the various motivations behind the project, the negotiation of access and the development of the participant relationships as seen from the researchers' perspectives. Conducting participatory design sessions with busy professionals demands preparation, improvisation, and clarity of purpose. The paper describes how we identified what went well and when to shift tactics. The contribution of the paper is in its description of what we learned in bringing participatory design principles to a project that spanned technical research interests, commercial objectives and placing demands upon the time of skilled professionals.

MILK : the Mobile Informal Learning Kit. Collaborating to design successful mobile learning applications

This paper suggests ways for educators and designers to understand and merge priorities in order to inform the development of mobile learning (m-learning) applications that maximise user experiences and hence learning opportunities. It outlines a User Experience Design (UXD) theory and development process that requires designers to conduct a thorough initial contextual inquiry into a particular domain in order to set project priorities and development guidelines. A matrix that identifies the key contextual considerations namely the social, cultural, spatial, technical and temporal constructs of any domain is presented as a vital tool for achieving successful UXD. The frame of reference provided by this matrix ensures that decisions made throughout the design process are attributable to a desired user experience. To illustrate how the proposed UXD theory and development process supports the creation of effective m-learning applications, this paper documents the development process of MILK (Mobile Informal Learning Kit). MILK is a support tool that allows teachers and students to develop event paths that consist of a series SMS question and answer messages that lead players through a series of checkpoints between point A and point B. These event paths can be designed to suit desired learning scenarios and can be used to explore a particular place or subject. They can also be designed to facilitate formal or informal learning experiences.

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.

Respecting local, cultural contexts for assessment practice in an era of globalization

Dissatisfaction, internationally, with existing educational practices and outcomes since the early 1990s has led to increased educational reform. At the same time, there has also been a worldwide shift in control of education away from teachers toward the state for the purposes of restructuring economies. More bureaucratic forms of curriculum and assessment have resulted, with a return to the use of more techno-rational discourse in assessment and evaluation for purposes of efficiency, accountability, impact, and performance management. There has also been an increase in the use of economic and productivity models to study educational outcomes. These models fail to account for the range of outcomes achieved and fail to identify the factors responsible for such diversity in performance.

Annual Review : practice and research in career counseling and development – 2008

The career development literature published in 2008 is summarized and presented thematically: (a) professional issues, (b) career assessment, (c) career development, (d) career theory and concepts, (e) career interventions, (f) advances in technology, (g) employment, (h) international perspectives, and (i) research design and methodology. Traditional and emerging theories and practices are robust and vibrant.

Reviewing psychologists’ qualifications for career development practice in Australia

Vocational psychology and the practice of career development are important dimensions of the psychology discipline. This paper contains an overview of the Australian career development industry in light of recent trends, particularly the formalisation of professional career development practice. Given the advent of the Professional Standards for Career Development Practitioners, an audit of postgraduate degrees in organisational, developmental and educational, and counselling psychology was conducted to determine their alliance with the competencies of the Standards. The audit revealed significant areas of consistency on generic competencies, however there was a serious lack of training specific to career development. The implications of the audit results are discussed in light of the evolution of the career development industry and the threat to psychologists’ standing in this field.

Consumer protection in the banking sector : reviewing the Code of Banking Practice

This article explains the relevance of the Code and its place in the regulatory framework, discusses some of the key issues arising in the recent review (as identified by consumer advocates1), and explains the relationship between the Code and the Financial Ombudsman Service.

From literacy to multiliteracies : diverse learners and pedagogical practice

In this paper, we provide specific examples of the educational promises and problems that arise as multiliteracies pedagogical initiatives encounter conventional institutional beliefs and practices in mainstream schooling. This paper documents and characterizes the ways in which two specific digital learning initiatives were played out in two distinctive traditional schooling contexts, as experienced by two different student groups: one comprising an elite mainstream and the other an excluded minority. By learning from the instructive complications that arose out of attempts by innovative and well-meaning educators to provide students with more relevant learning experiences than currently exist in mainstream schooling, this paper contributes fresh perspectives and more nuanced understandings of how diverse learners and their teachers negotiate the opportunities and challenges of the New London Group's vision of a multiliteracies approach to literacy and learning. We conclude by arguing that, where multiliteracies are understood as “garnish” to the “pedagogical roast” of traditional code-based and print-based academic literacies, they will continue to work on the sidelines of mainstream schooling and be seen only as either useful extensions or helpful interventions for high-performing and at-risk students respectively.

Four years after graduation : occupational therapists' work destinations and perceptions of preparedness for practice

Objective: The present study sought to identify the work destinations of graduates and ascertain their perceived preparedness for practice from a regional occupational therapy program, which had been specifically developed to support the health requirements of northern Australians by having an emphasis on rural practice. ---------- Design: Self-report questionnaires and semistructured in-depth telephone interviews. ---------- Participants: Graduates (n = 15) from the first cohort of occupational therapists from James Cook University, Queensland. ---------- Main outcome measure: The study enabled comparisons to be made between rural and urban based occupational therapists, while the semistructured interviews provided a deeper understanding of participants' experiences regarding their preparation for practice. ---------- Results: Demographic differences were noted between occupational therapists working in rural and urban settings. Rural therapists were predominantly younger and had worked in slightly more positions than their urban counterparts. The study also offered some insights into the value that therapists placed on the subjects taught during their undergraduate occupational therapy training, and had highlighted the differences in perceptions between therapists with rural experience and those with urban experience regarding the subjects that best prepared them for practice. Generally, rural therapists reported that all subjects included in the curriculum had equipped them well for practice. ---------- Conclusions: Findings suggest the need to undertake further research to determine the actual nature of rural practice, the personal characteristics of rural graduates and the experiences of students while on rural clinical placements.

Report on the Development and Validation of the Best Practice Decision Matrix

The Co-operative Research Centre for Construction Innovation (CRC-CI) is funding a project known as Value Alignment Process for Project Delivery. The project consists of a study of best practice project delivery and the development of a suite of products, resources and services to guide project teams towards the best procurement approach for a specific project or group of projects. These resources will be focused on promoting the principles that underlie best practice project delivery rather than simply identifying an off-the-shelf procurement system. This project builds on earlier work by Sidwell, Kennedy and Chan (2002), on re-engineering the construction delivery process, which developed a procurement framework in the form of a Decision Matrix

Procurement Case Study and Decision-making Strategies

Objectives The procurement research of Sydney Opera House FM Exemplar Project aims to develop innovative methods and guidelines for the procurement of FM services, applicable to iconic and / or performing arts centre facilities, or facilities with similar FM functions. The initial procurement report in June 2005 analysed the strategic objectives and operational requirements that provide ‘demand statements’ as evaluation criteria in the service procurement process. The subsequent interim procurement report in September 2005 discussed the elements contributing to the criteria for decision-making in the service procurement process. This procurement report concentrates on the research on procurement strategies and innovative methods using a case study approach. The objectives of this report are: • to investigate service procurement methods and process in iconic and/or performing arts centre facilities; • to showcase FM innovation in Sydney Opera House through a case study; • to establish a preliminary decision-making framework and guidelines for selection of appropriate FM procurement routes to provide a useful model for FM community. Findings Findings from this procurement research are presented as follows. • FM innovation and experience of Sydney Opera House • Innovative procurement methods and processes, drawn from a case study of Sydney Opera House as exemplar • An integrated performance framework to link maintenance service functions to high level organisational objective and strategies • Procurement methods and contract outcomes, focusing on building maintenance and cleaning services of Sydney Opera House • Multi-dimensional assessment of Service Providers • General decision-making strategies and guidelines for selection of appropriate FM procurement routes Further Research Whilst the Sydney Opera House case study emphasises the experience of Sydney Opera House, a study of procurement strategies and methods from published research and FM good practice will supply facilities managers with alternative procurement routes. Further research on the procurement theme will develop a final decision-making model for the procurement of FM services, drawn from the evaluation of the case study outcomes, as well as FM good practice and findings from current published research.

Review of international procurement procedures

Contractor selection is a crucial element in construction procurement (Drew & Skitmore 1993, p. 363). Contractors are selected through the tender process, which varies according to country, state and contracting organisation and is subject to individual differences. This paper reviews a range of international tender processes, highlighting the ethical features that govern these guidelines. The paper is part of a project to develop ethical guidelines for procurement for major contracting authorities. By reviewing tender guidelines we are able to gain an indication of the type of ethical standards reserved for procurement. The need for good business ethics in the tender process stems from the belief that ‘good ethical practice’ is critical in meeting organisational goals (Vee & Skitmore 2003, p. 125). Hence, an ethical tender process will select ethical contractors who are viewed as beneficial to the contracting authority.