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 status and relevance of Vietnamese journalism education: An empirical analysis

Based primarily on data from indepth interviews with senior journalists and journalism educators as well as a content analysis of journalism curricula, this paper sets out to provide an overview of the demand, overall provision structure, teaching materials and methods of Vietnamese journalism education. It first shows that with a fast expansion in both size and substance, the Vietnamese media system is beginning to feel the urgent need for formal journalism education. However, the country's major journalism programs have been criticised for producing hundreds of unqualified journalism graduates a year. In general, the most deplorable aspects of Vietnamese journalism education include its body of outdated and awkward teaching material, its undue focus on theories and politics at the expense of practical training, its lack of qualified teaching staff and its inadequate teaching resources.

I-Spi: innovative shared practical ideas: a support guide for literacy and numeracy in the early years of schooling, for home tutor/supervisors in distance education

Innovative Shared Practical Ideas (I-Spi) is a guide to help you and your children learn together. It is designed to affirm, support and strengthen your role as home tutor/supervisors in your daily learning sessions with your children. In this guide particular emphasis is given to the value of talk, formal and informal early literacy and numeracy practices (including ideas from distance school lessons, from home tutor/supervisors, research, and beyond), assessment of these practices together with informal assessment ideas for gauging your children’s literacy and numeracy progress, and stepping in and building on strategies

Formalising progress properties of non-blocking programs

A non-blocking program is one that uses non-blocking primitives, such as load-linked/store-conditional and compare-and-swap, for synchronisation instead of locks so that no process is ever blocked. According to their progress properties, non-blocking programs may be classified as wait-free, lock-free or obstruction-free. However, a precise description of these properties does not exist and it is not unusual to find a definition that is ambiguous or even incorrect. We present a formal definition of the progress properties so that any confusion is removed. The formalisation also allows one to prove the widely believed presumption that wait-freedom is a special case of lock-freedom, which in turn is a special case of obstruction-freedom.

English language education in policy studies

Content-based instruction (CBI) is increasingly important in curriculum development for second-language acquisition (SLA), as language and non-language departments in universities are finding the integration of core-content as part of the second language curriculum to be beneficial. With this in mind, this paper describes the English program at Nanzan University’s Faculty of Policy Studies and examines the synergy presently being developed between core-content and English language instruction there. Specifically, this paper seeks to shed light on how instructors can reflect on the meaning of language instruction at higher education through an illustration of our activities.

Formal verification of ASM designs using the MDG tool

In this paper, we present a formal hardware verification framework linking ASM with MDG. ASM (Abstract State Machine) is a state based language for describing transition systems. MDG (Multiway Decision Graphs) provides symbolic representation of transition systems with support of abstract sorts and functions. We implemented a transformation tool that automatically generates MDG models from ASM specifications, then formal verification techniques provided by the MDG tool, such as model checking or equivalence checking, can be applied on the generated models. We support this work with a case study of an Island Tunnel Controller, which behavior and structure were specified in ASM then using our ASM-MDG tool successfully verified within the MDG tool.

Fostering professional development through integrating work and formal learning

The Undergraduate Site Learning Program (USLP) is an innovative work-based learning program that addresses the call to develop a broader set ofattributes in engineering graduates. Unlike cooperative education programs, site learning can give students full academic credit for their placement without extending the duration of the degree through the use of an innovative learning alignment model. A cenrralpart ofthis program is a unique course entitled Professional Development in which students articulate and reflect upon the lessons they leom while on placement in industry. Students spend the bulk ofa semester on-site often in remote locations, which requires a flexible approach to course operation and fosters independent learning. Thus the USLP challenges both staff and students and produces outcomes that bofh the alumni and industry value.