Using a clinical pathway and education to reduce inappropriate prescribing of enoxaparin in patients with acute coronary syndromes: a controlled study

Aims: To evaluate efficacy of a pathway-based quality improvement intervention on appropriate prescribing of the low molecular weight heparin, enoxaparin, in patients with varying risk categories of acute coronary syndrome (ACS). Methods: Rates of enoxaparin use retrospectively evaluated before and after pathway implementation at an intervention hospital were compared to concurrent control patients at a control hospital; both were community hospitals in south-east Queensland. The study population was a group of randomly selected patients (n = 439) admitted to study hospitals with a discharge diagnosis of chest pain, angina, or myocardial infarction, and stratified into high, intermediate, low-risk ACS or non-cardiac chest pain: 146 intervention patients (September-November 2003), 147 historical controls (August-December 2001) at the intervention hospital; 146 concurrent controls (September-November 2003) at the control hospital. Interventions were active implementation of a user-modified clinical pathway coupled with an iterative education programme to medical staff versus passive distribution of a similar pathway without user modification or targeted education. Outcome measures were rates of appropriate enoxaparin use in high-risk ACS patients and rates of inappropriate use in intermediate and low-risk patients. Results: Appropriate use of enoxaparin in high-risk ACS patients was above 90% in all patient groups. Inappropriate use of enoxaparin was significantly reduced as a result of pathway use in intermediate risk (9% intervention patients vs 75% historical controls vs 45% concurrent controls) and low-risk patients (9% vs 62% vs 41%; P < 0.001 for all comparisons). Pathway use was associated with a 3.5-fold (95% CI: 1.3-9.1; P = 0.012) increase in appropriate use of enoxaparin across all patient groups. Conclusion: Active implementation of an acute chest pain pathway combined with continuous education reduced inappropriate use of enoxaparin in patients presenting with intermediate or low-risk ACS.

The role of software tools in influencing creative problem solving in engineering design and education

Creativity is increasingly recognised as an essential component of engineering design. This paper describes an exploratory study into the nature and importance of creativity in engineering design problem solving in relation to the possible impact of software design tools. The first stage of the study involved an empirical investigation in the form of a case study of the use of standard CAD tool sets and the development of a systems engineering software support tool. It was found that there were several ways in which CAD influenced the creative process, including enhancing visualisation and communication, premature fixation, circumscribed thinking and bounded ideation. The tool development experience uncovered the difficulty in supporting creative processes from the developer's perspective. The issues were the necessity of making assumptions, achieving a balance between structure and flexibility, and the pitfalls of satisfying user wants and needs. The second part of the study involved the development of a model of the creative problem solving process in engineering design. This provided a possible explanation for why purpose designed engineering software tools might encourage an analytical problem solving approach and discourage a more creative approach.

Connection of Network Sensors to Distributed Information Measurement and Control System for Education and Research

The development of the distributed information measurement and control system for optical spectral research of particle beam and plasma objects and the execution of laboratory works on Physics and Engineering Department of Petrozavodsk State University are described. At the hardware level the system is represented by a complex of the automated workplaces joined into computer network. The key element of the system is the communication server, which supports the multi-user mode and distributes resources among clients, monitors the system and provides secure access. Other system components are formed by equipment servers (CАМАC and GPIB servers, a server for the access to microcontrollers MCS-196 and others) and the client programs that carry out data acquisition, accumulation and processing and management of the course of the experiment as well. In this work the designed by the authors network interface is discussed. The interface provides the connection of measuring and executive devices to the distributed information measurement and control system via Ethernet. This interface allows controlling of experimental parameters by use of digital devices, monitoring of experiment parameters by polling of analog and digital sensors. The device firmware is written in assembler language and includes libraries for Ethernet-, IP-, TCP- и UDP-packets forming.

"We don't need no education" - Or do we? Management education and alumni adoption of strategy tools

Despite concerns about the relevance of management education, there is relatively little evidence about whether graduates use the management tools and concepts they are taught. We address this gap with evidence from a survey of business school alumni adoption of tools typically taught in strategic management courses. Our findings show that four educational characteristics-level of formal education, frequency of management training, specificity of strategic management education, and time elapsed since formal education-drive adoption of strategy tools. Specifically, features such as postgraduate over undergraduate qualifications and frequent exposure to management training predispose greater user of strategy tools. However, other factors, such as time elapsed since formal education, are not as great a predictor of variation in use. We conclude with a predictive model of the relative weight and importance of educational and demographic characteristics on strategy tool adoption and discuss our findings in light of the relevance debate. © The Author(s) 2013.

Experiences on dynamic simulation software in chemical engineering education

Commercial process simulators are increasing interest in the chemical engineer education. In this paper, the use of commercial dynamic simulation software, D-SPICE® and K-Spice®, for three different chemical engineering courses is described and discussed. The courses cover the following topics: basic chemical engineering, operability and safety analysis and process control. User experiences from both teachers and students are presented. The benefits of dynamic simulation as an additional teaching tool are discussed and summarized. The experiences confirm that commercial dynamic simulators provide realistic training and can be successfully integrated into undergraduate and graduate teaching, laboratory courses and research. © 2012 The Institution of Chemical Engineers.

Integrating service user and practitioner expertise within a web-based system for collaborative mental-health risk and safety management

Objectives: To develop a decision support system (DSS), myGRaCE, that integrates service user (SU) and practitioner expertise about mental health and associated risks of suicide, self-harm, harm to others, self-neglect, and vulnerability. The intention is to help SUs assess and manage their own mental health collaboratively with practitioners. Methods: An iterative process involving interviews, focus groups, and agile software development with 115 SUs, to elicit and implement myGRaCE requirements. Results: Findings highlight shared understanding of mental health risk between SUs and practitioners that can be integrated within a single model. However, important differences were revealed in SUs' preferred process of assessing risks and safety, which are reflected in the distinctive interface, navigation, tool functionality and language developed for myGRaCE. A challenge was how to provide flexible access without overwhelming and confusing users. Conclusion: The methods show that practitioner expertise can be reformulated in a format that simultaneously captures SU expertise, to provide a tool highly valued by SUs. A stepped process adds necessary structure to the assessment, each step with its own feedback and guidance. Practice Implications: The GRiST web-based DSS (www.egrist.org) links and integrates myGRaCE self-assessments with GRiST practitioner assessments for supporting collaborative and self-managed healthcare.

A component model of methods for evaluation of the quality in education

Report published in the Proceedings of the National Conference on "Education in the Information Society", Plovdiv, May, 2013

VisibleZ: A Mainframe Architecture Emulator for Computing Education

This paper describes a PC-based mainframe computer emulator called VisibleZ and its use in teaching mainframe Computer Organization and Assembly Programming classes. VisibleZ models IBM’s z/Architecture and allows direct interpretation of mainframe assembly language object code in a graphical user interface environment that was developed in Java. The VisibleZ emulator acts as an interactive visualization tool to simulate enterprise computer architecture. The provided architectural components include main storage, CPU, registers, Program Status Word (PSW), and I/O Channels. Particular attention is given to providing visual clues to the user by color-coding screen components, machine instruction execution, and animation of the machine architecture components. Students interact with VisibleZ by executing machine instructions in a step-by-step mode, simultaneously observing the contents of memory, registers, and changes in the PSW during the fetch-decode-execute machine instruction cycle. The object-oriented design and implementation of VisibleZ allows students to develop their own instruction semantics by coding Java for existing specific z/Architecture machine instructions or design and implement new machine instructions. The use of VisibleZ in lectures, labs, and assignments is described in the paper and supported by a website that hosts an extensive collection of related materials. VisibleZ has been proven a useful tool in mainframe Assembly Language Programming and Computer Organization classes. Using VisibleZ, students develop a better understanding of mainframe concepts, components, and how the mainframe computer works. ACM Computing Classification System (1998): C.0, K.3.2.

A comparison of the effects of classroom and Multi-User Virtual Environments on the perceived speaking anxiety of adult post-secondary English Language Learners

The population of English Language Learners (ELLs) globally has been increasing substantially every year. In the United States alone, adult ELLs are the fastest growing portion of learners in adult education programs (Yang, 2005). There is a significant need to improve the teaching of English to ELLs in the United States and other English-speaking dominant countries. However, for many ELLs, speaking, especially to Native English Speakers (NESs), causes considerable language anxiety, which in turn plays a vital role in hindering their language development and academic progress (Pichette, 2009; Woodrow, 2006). ^ Task-based Language Teaching (TBLT), such as simulation activities, has long been viewed as an effective approach for second-language development. The current advances in technology and rapid emergence of Multi-User Virtual Environments (MUVEs) have provided an opportunity for educators to consider conducting simulations online for ELLs to practice speaking English to NESs. Yet to date, empirical research on the effects of MUVEs on ELLs' language development and speaking is limited (Garcia-Ruiz, Edwards, & Aquino-Santos, 2007). ^ This study used a true experimental treatment control group repeated measures design to compare the perceived speaking anxiety levels (as measured by an anxiety scale administered per simulation activity) of 11 ELLs (5 in the control group, 6 in the experimental group) when speaking to Native English Speakers (NESs) during 10 simulation activities. Simulations in the control group were done face-to-face, while those in the experimental group were done in the MUVE of Second Life. ^ The results of the repeated measures ANOVA revealed after the Huynh-Feldt epsilon correction, demonstrated for both groups a significant decrease in anxiety levels over time from the first simulation to the tenth and final simulation. When comparing the two groups, the results revealed a statistically significant difference, with the experimental group demonstrating a greater anxiety reduction. These results suggests that language instructors should consider including face-to-face and MUVE simulations with ELLs paired with NESs as part of their language instruction. Future investigations should investigate the use of other multi-user virtual environments and/or measure other dimensions of the ELL/NES interactions.^

Users Acceptance of Online Enrollment Processes in a Higher Education Institution

Little is known about students’ perceptions of online enrollment processes. Student satisfaction is part of the assessment required for accreditation, but evidence suggests that college administrators are oriented to retention and graduation rates rather than to consumer perception. The purpose of this descriptive quantitative study was to develop and validate a model that enables the measurement of online enrollment processes by the analysis of the students’ perceptions. The theoretical framework used to support this study was the process virtualization theory while the conceptual framework was based on Technology Acceptance Model (TAM). TAM is the most valid framework for studying user acceptance of technology and virtual processes. The model was modified, adding a new variable to fit this study. Research questions were used to determine if an institution knows how its students perceive online enrollment processes and how they can become more efficient and effective, improving usage and satisfaction. Descriptive data were collected and analyzed in phases: the pilot study phase, data collection phase, and analysis phases. Inferential statistics were used to draw information from sampled observations of the population; a Cronbach Alpha was conducted to determine the reliability and validity of the model. The study demonstrated that the modified TAM is valid, reliable, and fit to assess the perceptions of the users of online enrollment processes. This study will effect positive social change by providing enrollment managers and administrators information on how to analyze the acceptance their online enrollment processes from the perspective of their students as customers of an institution of higher learning.