Teaching and learning about force with a representational focus : pedagogy and teacher change

A large body of research in the conceptual change tradition has shown the difficulty of learning fundamental science concepts, yet conceptual change schemes have failed to convincingly demonstrate improvements in supporting significant student learning. Recent work in cognitive science has challenged this purely conceptual view of learning, emphasising the role of language, and the importance of personal and contextual aspects of understanding science. The research described in this paper is designed around the notion that learning involves the recognition and development of students’ representational resources. In particular, we argue that conceptual difficulties with the concept of force are fundamentally representational in nature. This paper describes a classroom sequence in force that focuses on representations and their negotiation, and reports on the effectiveness of this perspective in guiding teaching, and in providing insight into student learning. Classroom sequences involving three teachers were videotaped using a combined focus on the teacher and groups of students. Video analysis software was used to capture the variety of representations used, and sequences of representational negotiation. Stimulated recall interviews were conducted with teachers and students. The paper reports on the nature of the pedagogies developed as part of this representational focus, its effectiveness in supporting student learning, and on the pedagogical and epistemological challenges negotiated by teachers in implementing this approach.

'Build it, fill it and bill it' : how work in the public housing sector has changed (and stayed the same)

This paper is an ethnographic account of how 'wicked' (i.e. entrenched and enduring) problems with the 'building, filling and billing' of public housing have shaped and influenced the work of public housing workers in Victoria, Australia. With a few exceptions, the front line work of housing staff is represented in the literature as smaller, constituent parts of some larger policy process, organisational event or procedural reform. In order to understand how housing work has been constructed over time, this paper attempts to consolidate these fragmented narratives (contained in old documents, training manuals, news articles and reports) into an historical account of 'what it was like' to work in the public/social housing sector. In this paper, I will construct this 'historical account' with the stories I gathered over twelve months of field work in three different public housing offices. In their stories, public housing workers tell me how subtle and incremental has been the change to their work, how increasingly complex are the needs of tenants and how dfficult their work has become. Their stories illustrate the complexity of undersdanding and addressing these 'wicked' housing problems when tenants change, staff change and
the public housing sector has a history of frequent 'restructuring'. This contextualisation of 'old and new stories' will allow the reader to understand how the organisational reality of present day housing work has been socially constructed ('sedimented') by generation, of workers, managers and tenants.

Clinical teachers' conceptions of nursing

Lack of knowledge exists about clinical teachers’ understanding of nursing. A likely relationship between teachers’ conceptions of nursing and what they focus on when teaching nursing students in the clinical setting means that the identification of different conceptions of nursing is important. This study investigated clinical teachers’ experiences of nursing and clinical teaching of undergraduate nursing students. This article reports on clinical teachers’ conceptions of nursing. Semistructured interviews of 20 nurses employed as clinical teachers in Australian universities were conducted. Data were analyzed using a phenomenographic approach. The findings suggest that nursing is conceived as performing tasks; providing appropriate care; providing individualized patient care aimed at achieving patient outcomes; or collaborating with health care team members to provide appropriate, individualized patient care aimed at achieving patient outcomes. Insights will assist with future preparation and support of clinical teachers, the education of nursing students, and improved curriculum design.

Promoting "critical awareness" and critiquing "cultural competence" : towards disrupting received professional knowledges

There is a compelling argument that universities should be committed to advancing the Indigenous agenda. With respect to social work, as well as to nursing, psychology, and allied health, this commitment is often translated into a single goal: that graduates should be ‘‘culturally competent’’. While acknowledging that there can be tactical advantages in pursuing this goal the current paper develops a practical critique of the expectation that cultural competence is an unproblematic ‘‘add on’’ to professional education. Using a single case study as an example*how the subject ‘‘individual development’’ is transmitted as a monocultural and unproblematic formation*we argue that it is impossible to learn to work cross-culturally without developing a capacity for reflective self-scrutiny. Less likely to be a flag of convenience than ‘‘cultural competence’’, an allegiance to ‘‘critical awareness’’ prompts the interrogation of received knowledge, for example how human development and personhood is understood, as well stimulating an engagement in the lifelong process of reflecting on one’s own ideological and cultural location.

Access to alcohol outlets and harmful alcohol consumption : a multi-level study in Melbourne, Australia

Aims To assess the association between access to off-premises alcohol outlets and harmful alcohol consumption.
Design, setting and participants Multi-level study of 2334 adults aged 18–75 years from 49 census collector districts (the smallest spatial unit in Australia at the time of survey) in metropolitan Melbourne.
Measurements Alcohol outlet density was defined as the number of outlets within a 1-km road network of respondents’ homes and proximity was the shortest road network distance to the closest outlet from their home. Using multi-level logistic regression we estimated the association between outlet density and proximity and four measures of harmful alcohol consumption: drinking at levels associated with short-term harm at least weekly and monthly; drinking at levels associated with long-term harm and frequency of consumption.
Findings Density of alcohol outlets was associated with increased risk of drinking alcohol at levels associated with harm. The strongest association was for short-term harm at least weekly [odds ratio (OR) 1.10, 95% confidence interval (CI) 1.04–1.16]. When density was fitted as a categorical variable, the highest risk of drinking at levels associated with short-term harm was when there were eight or more outlets (short-term harm weekly: OR 2.36, 95% CI 1.22–4.54 and short-term harm monthly: OR 1.80, 95% CI 1.07–3.04). We found no evidence to support an association between proximity and harmful alcohol consumption.
Conclusions The number of off-premises alcohol outlets in a locality is associated with the level of harmful alcohol consumption in that area. Reducing the number of off-premises alcohol outlets could reduce levels of harmful alcohol consumption.

Dynamic privacy in a smart house environment

A smart house can be regarded as a surveillance environment in which the person being observed carries out activities that range from intimate to more public. What can be observed depends on the activity, the person observing (e.g. a carer) and policy. In assisted living smart house environments, a single privacy policy, applied throughout, would be either too invasive for an occupant, or too restrictive for an observer, due to the conflicting goals of surveillance and private environments. Hence, we propose a dynamic method for altering the level of privacy in the environment based on the context, the situation within the environment, encompassing factors relevant to ensuring the occupant's safety and privacy. The context is mapped to an appropriate level of privacy, which is implemented by controlling access to data sources (e.g. video) using data hiding techniques. The aim of this work is to decrease the invasiveness of the technology, while retaining the purpose of the system.

The role of representation in teaching and learning ideas about matter

The research described in this paper is designed around the notion that learning involves the recognition and development of students’ representational resources. This paper describes a classroom sequence in Ideas about Matter that focuses on representations and their negotiation, and reports on the effectiveness of this perspective in guiding teaching, and in providing further insight into student learning. Classroom sequences involving two experienced teachers (2008, Year 8 students) and an inexperienced teacher (2010, Year 7 students) were videotaped using a combined focus on the teacher and groups of students. Video analysis software was used to code the variety of representations used teachers and students, and sequences of representational negotiation. The paper reports on the effect of this approach on teacher pedagogy and on student learning of Ideas about Matter. The paper will present data from video of classroom activities, students’ work samples, student and teacher interviews and pre and post-unit testing, to explore what a representational focus might entail in teaching Ideas about Matter, and the role of representations in learning and reasoning and exploring scientific ideas.

Regional integration 2.0 : facilitating regional integration and development with collaborative technologies

The current global economic instability and the vulnerability of small nations provide the impetus for greater integration between the countries of the South Pacific region. This exercise is critical for their survival. Past efforts of regional integration in the South Pacific have mostly failed. However, today’s IT collaborative capabilities provide the opportunity to develop a shared IT infrastructure to facilitate integration in the South Pacific. In developing an IT-backed model of regional integration, this study identifies and reports on the antecedents of the current stage for integration in the Pacific. We conducted interviews with twenty five individuals from various sectors and find that while most respondents were optimistic about the potential of IT-backed regional integration, significant challenges exists. The study identifies and discusses these challenges providing policy implications to stakeholders in the regional integration process. The findings will assist in suggesting a model of regional integration 2.0 for the Pacific region.

Feedback reporting of survey data to healthcare aides

Background

This project occurred during the course of the Translating Research in Elder Care (TREC) program of research. TREC is a multilevel and longitudinal research program being conducted in the three Canadian Prairie Provinces of Alberta, Saskatchewan, and Manitoba. The main purpose of TREC is to increase understanding about the role of organizational context in influencing knowledge use in residential long-term care settings. The purpose of this study was to evaluate healthcare aides’ (HCAs) perceptions of a one-page poster designed to feed back aggregated data (including demographic information and perceptions about influences on best practice) from the TREC survey they had recently completed.

Methods
A convenience sample of 7 of the 15 nursing homes participating in the TREC research program in Alberta were invited to participate. Specific facility-level summary data were provided to each facility in the form of a one-page poster report. Two weeks following delivery of the report, a convenience sample of HCAs was surveyed using one-to-one structured interviews.

Results
One hundred twenty-three HCAs responded to the evaluation survey. Overall, HCAs’ opinions about presentation of the feedback report and the understandability, usability, and usefulness of the content were positive. For each report, analysis of data and production and inspection of the report took up to one hour. Information sessions to introduce and explain the reports averaged 18 minutes. Two feedback reports (minimum) were supplied to each facility at a cost of CAN$2.39 per report, for printing and laminating.

Conclusions
This study highlights not only the feasibility of producing understandable, usable, and useful feedback reports of survey data but also the value and importance of providing feedback to survey respondents. More broadly, the findings suggest that modest strategies may have a positive and desirable effect in participating sites.

Using images to communicate the hidden struggles of life on dialysis

Background Nurse‐patient communication in the hemodialysis context is unique given the amount of time spent together in a confined clinical room. Poor communication may lead to low-quality nursing care and undesirable patient outcomes.

Aim To explore the use of images as a visual communication technique for nurses and patients in the hemodialysis context.

Methods Descriptive qualitative design. Fifty-two cards containing specific photos, illustrations, and words were used to facilitate conversations about being on hemodialysis between patients (n = 9) and two nurse interviewers. Interview transcripts were thematically analysed.

Findings An overall theme titled ‘revealing the hidden struggles of living on dialysis’ conceptually captured three sub-themes: (1) the increased importance of relationships; (2) the struggle with money; and (3) quality over quantity of life. The cards assisted in uncovering these often covert (to nurses) aspects of dialysis patients' lives.

Conclusion Nurses may need to be aware of the dialysis patients' hidden struggles which include the importance of relationships, financial issues, and the importance of quality aspects such as travel. The use of images may assist in revealing the important issues for each patient struggling with the restrictive life that is imposed by dialysis.

Thai emergency nurses’ management of patients with severe traumatic brain injury: comparison of knowledge and clinical management with best available evidence

Background:
In Thailand, the rate of TBI-related hospitalisation is increasing, however, little is known about the evidence-based management of severe TBI in the developing world. The aim of this study was to explore Thai emergency nurses’ management of patients with severe TBI.

Methods:
An exploratory descriptive mixed method design was used to conduct this two stage study: survey methods were used to examine emergency nurses’ knowledge regarding management of patients with severe TBI (Stage 1) and observational methods were used to examine emergency nurses’ clinical management of patients with severe TBI (Stage 2). The study setting was the emergency department (ED) at a regional hospital in Southern Thailand.

Results:
34 nurses participated in Stage 1 (response rate 91.9%) and the number of correct responses ranged from 33.3% to 95.2%. In Stage 2, a total of 160 points of measurement were observed in 20 patients with severe TBI over 40 h. In this study there were five major areas identified for the improvement of care of patients with severe TBI: (i) end-tidal carbon dioxide (ETCO2) monitoring and targets; (ii) use of analgesia and sedation; (iii) patient positioning; (iv) frequency of nursing assessment; and (v) dose of Mannitol diuretic.

Conclusions:
There is variation in Thai nurses’ knowledge and care practices for patients with severe TBI. To increase consistency of evidence-based TBI care in the Thai context, a knowledge translation intervention that is ecologically valid, appropriate to the Thai healthcare context and acceptable to the multidisciplinary care team is needed.

Interobserver reliability of classification and characterization of proximal humeral fractures: a comparison of two and three-dimensional CT

Interobserver reliability for the classification of proximal humeral fractures is limited. The aim of this study was to test the null hypothesis that interobserver reliability of the AO classification of proximal humeral fractures, the preferred treatment, and fracture characteristics is the same for two-dimensional (2-D) and three-dimensional (3-D) computed tomography (CT). Members of the Science of Variation Group--fully trained practicing orthopaedic and trauma surgeons from around the world--were randomized to evaluate radiographs and either 2-D CT or 3-D CT images of fifteen proximal humeral fractures via a web-based survey and respond to the following four questions: (1) Is the greater tuberosity displaced? (2) Is the humeral head split? (3) Is the arterial supply compromised? (4) Is the glenohumeral joint dislocated? They also classified the fracture according to the AO system and indicated their preferred treatment of the fracture (operative or nonoperative). Agreement among observers was assessed with use of the multirater kappa (κ) measure. Interobserver reliability of the AO classification, fracture characteristics, and preferred treatment generally ranged from "slight" to "fair." A few small but statistically significant differences were found. Observers randomized to the 2-D CT group had slightly but significantly better agreement on displacement of the greater tuberosity (κ = 0.35 compared with 0.30, p < 0.001) and on the AO classification (κ = 0.18 compared with 0.17, p = 0.018). A subgroup analysis of the AO classification results revealed that shoulder and elbow surgeons, orthopaedic trauma surgeons, and surgeons in the United States had slightly greater reliability on 2-D CT, whereas surgeons in practice for ten years or less and surgeons from other subspecialties had slightly greater reliability on 3-D CT. Proximal humeral fracture classifications may be helpful conceptually, but they have poor interobserver reliability even when 3-D rather than 2-D CT is utilized. This may contribute to the similarly poor interobserver reliability that was observed for selection of the treatment for proximal humeral fractures. The lack of a reliable classification confounds efforts to compare the outcomes of treatment methods among different clinical trials and reports.