Development of an online role-play assessment initiative for nursing students in their bioscience studies

Devising assessment tasks for large units that embrace academic goals of authenticity and assessment variety can be a challenge. We developed an online Role-Play Assessment Initiative for first year nursing students in bioscience. Students responded to a case study by preparing two role-play dialogues: as a nurse with the patient, and between two nurses. The aims were to assess whether the students could: 1) understand the underlying disease process (pathophysiology) and relate it to clinical practice; 2) use language appropriate for lay and medical conversation; and 3) apply information using active learning. We conducted a student survey using quantitative questions (Likert scale: 1=strongly disagree to 5=strongly agree), and qualitative questions. 65 completed surveys were received. 80% of respondents agreed (includes agree or strongly agree) that it was a useful way to learn and understand pathophysiology of the case study. 86% agreed that it was useful to apply pathophysiology from lectures to a clinical setting. Overall, students found it enjoyable, which is beneficial for enhanced student engagement, and agreed that it allowed them to work well in a group (74% and 85%, respectively). Most qualitative suggestions for improvement related to group work, despite the encouraging response to group work in quantitative questions. Most positive comments surrounded different communication with a nurse compared with a patient. These results demonstrate that students developed deeper understanding of pathophysiology through active learning and were able to expand their nursing career skills during the role-play. Learning using role-play to simulate the workforce has fostered active learning.

Meeting the nutrition challenge of stage 3 renal failure : considerations for nursing practice

Self-care management is needed for effective management of chronic kidney disease. The main aim for treatment or management of chronic kidney disease is to delay the worsening of kidney function, and to prevent or to manage the co-morbidities. Selfcare management is not easy, and patients will face many challenges, especially when they cannot get use to the new treatment plan. One of the challenges they face is dietary restriction, which is a very important aspect in any self-care management programme. Chronic kidney disease patients require a low-protein, low-sodium, low-potassium, and low-phosphorus diet. There are several strategies patients can undertake to ensure adherence, such as self-monitoring their dietary habits and type of food consumed using a food diary; involving social support, such as family members and spouse to help them to adhere to their diet restrictions; setting goals and providing positive reinforcement when they achieved the targeted goals; joining self-management programmes to equip themselves with the necessary skills so that they can better adhere to the treatment regimes, including diet restriction; and lastly, having the knowledge about their regime, and using this knowledge to help them understand and improve their adherence.

Teaching and assessment of prescribing medicines : how does pharmacy perform?

BACKGROUND Prescribing is a complex task, requiring specific knowledge and skills combined with effective, context-specific clinical reasoning. Prescribing errors can result in significant morbidity and mortality. For all professions with prescribing rights, a clear need exists to ensure students graduate with a well-defined set of prescribing skills, which will contribute to competent prescribing. AIM To describe the methods employed to teach and assess the principles of effective prescribing across five non-medical professions at Queensland University of Technology. METHOD The NPS National Prescribing Competencies Framework (PCF) was used as the prescribing standard. A curriculum mapping exercise was undertaken to determine how well the PCF was addressed across the disciplines of paramedic science, pharmacy, podiatry, nurse practitioner and optometry. Identified gaps in teaching and/or assessment were noted. RESULTS Prescribing skills and knowledge are taught and assessed using a range of methods across disciplines. A multi-modal approach is employed by all disciplines. The Pharmacy discipline uses more tutorial sessions to teach prescribing principles and relies less on case studies and clinical appraisal to assess prescribing when compared to other disciplines. Within the pharmacy discipline approximately 90% of the PCF competencies are taught and assessed. This compares favourably with the other disciplines. CONCLUSION Further work is required to establish a practical, effective approach to the assessment of prescribing competence especially between the university and clinical settings. Effective and reliable assessment of prescribing undertaken by students in diverse settings remains challenging.

Temporal trends and bioavailability assessment of heavy metals in the sediments of Deception Bay, Queensland, Australia

Thirteen sites in Deception Bay, Queensland, Australia were sampled three times over a period of 7 months and assessed for contamination by a range of heavy metals, primarily As, Cd, Cr, Cu, Pb and Hg. Fraction analysis, enrichment factors and Principal Components Analysis-Absolute Principal Component Scores (PCA-APCS) analysis were conducted in order to identify the potential bioavailability of these elements of concern and their sources. Hg and Te were identified as the elements of highest enrichment in Deception Bay while marine sediments, shipping and antifouling agents were identified as the sources of the Weak acid Extractable Metals (WE-M), with antifouling agents showing long residence time for mercury contamination. This has significant implications for the future of monitoring and regulation of heavy metal contamination within Deception Bay.

Assessment of the short-term success of a translocation of lesser short-tailed bats Mystacina tuberculata

Translocation is a powerful tool that has been used in the conservation of a wide range of taxa. However, few translocations of bats have been attempted and we know of no successes. The few translocations which have been attempted have either failed due to dispersal from the release site or have not been monitored sufficiently to determine the cause of failure. We assessed the short-term success of a translocation of lesser short-tailed bats Mystacina tuberculata by the New Zealand Department of Conservation, where 3 release methods were used to minimise dispersal or mortality: bats were juveniles, were maintained in captivity at the release site, and were provided with supplementary food and roosts following release. Success was assessed by determining if founders remained at the release site and maintained condition (weight). Recapture showed that at least 9 of the 20 bats remained at the release site 232 d after release. There was weak evidence that bats lost weight, although final weights were comparable to those of bats from a natural population. However, all bats caputred 8 mo after release had damaged, infected ears and some were balding. The problem was treated but recurred, and bats were returned to captivity. Our results are th first to demonstrate that translocated bats can remain at their release site and survive. However, disease may be an issue in future translocations.

The contribution of major depression to the global burden of ischemic heart disease : a comparative risk assessment

Background Cardiovascular disease and mental health both hold enormous public health importance, both ranking highly in results of the recent Global Burden of Disease Study 2010 (GBD 2010). For the first time, the GBD 2010 has systematically and quantitatively assessed major depression as an independent risk factor for the development of ischemic heart disease (IHD) using comparative risk assessment methodology. Methods A pooled relative risk (RR) was calculated from studies identified through a systematic review with strict inclusion criteria designed to provide evidence of independent risk factor status. Accepted case definitions of depression include diagnosis by a clinician or by non-clinician raters adhering to Diagnostic and Statistical Manual of Mental Disorders (DSM) or International Classification of Diseases (ICD) classifications. We therefore refer to the exposure in this paper as major depression as opposed to the DSM-IV category of major depressive disorder (MDD). The population attributable fraction (PAF) was calculated using the pooled RR estimate. Attributable burden was calculated by multiplying the PAF by the underlying burden of IHD estimated as part of GBD 2010. Results The pooled relative risk of developing IHD in those with major depression was 1.56 (95% CI 1.30 to 1.87). Globally there were almost 4 million estimated IHD disability-adjusted life years (DALYs), which can be attributed to major depression in 2010; 3.5 million years of life lost and 250,000 years of life lived with a disability. These findings highlight a previously underestimated mortality component of the burden of major depression. As a proportion of overall IHD burden, 2.95% (95% CI 1.48 to 4.46%) of IHD DALYs were estimated to be attributable to MDD in 2010. Eastern Europe and North Africa/Middle East demonstrate the highest proportion with Asia Pacific, high income representing the lowest. Conclusions The present work comprises the most robust systematic review of its kind to date. The key finding that major depression may be responsible for approximately 3% of global IHD DALYs warrants assessment for depression in patients at high risk of developing IHD or at risk of a repeat IHD event.

Jet and flash imprint defectivity - Assessment and reduction for semiconductor applications

Defectivity has been historically identified as a leading technical roadblock to the implementation of nanoimprint lithography for semiconductor high volume manufacturing. The lack of confidence in nanoimprint's ability to meet defect requirements originates in part from the industry's past experiences with 1 × lithography and the shortage in enduser generated defect data. SEMATECH has therefore initiated a defect assessment aimed at addressing these concerns. The goal is to determine whether nanoimprint, specifically Jet and Flash Imprint Lithography from Molecular Imprints, is capable of meeting semiconductor industry defect requirements. At this time, several cycles of learning have been completed in SEMATECH's defect assessment, with promising results. J-FIL process random defectivity of < 0.1 def/cm2 has been demonstrated using a 120nm half-pitch template, providing proof of concept that a low defect nanoimprint process is possible. Template defectivity has also improved significantly as shown by a pre-production grade template at 80nm pitch. Cycles of learning continue on feature sizes down to 22nm. © 2011 SPIE.

Nutritional challenges for the family caregiver and person with dementia dyad

ABSTRACT Background: The majority of people with dementia live at home until quite late in the disease trajectory, supported by family caregivers who typically take increasing responsibility for providing nutrition. Caregiving is highly stressful and thus both dyad partners are at risk of nutritional issues. Objective: This study evaluated the nutritional status of both dyad members and the associations between these. Design Descriptive, correlational Setting Community Participants 26 dyads of persons with dementia and caregivers Measurements: The nutritional status of each dyad member was evaluated at home using a comprehensive battery of measures including the Mini-Nutritional Assessment, Corrected Arm Muscle Area and a 3-day food diary. Stage of dementia and functional eating capacity was measured for the person with dementia. Caregivers completed a brief burden scale. Results: Of those with dementia (n = 26), a large proportion had nutritional issues (one was malnourished and another 16 were at risk). Six of the caregivers were at risk of malnutrition. In addition, fifteen of the people with dementia did not meet their recommended daily energy requirements. A moderate and significant positive correlation between functional eating skills and nutritional status (MNA score) among participants with dementia was found (r =.523, n = 26, p.006). Conclusion: These findings suggest that a dyadic perspective of nutritional status provides important insights into risk in this vulnerable group. Specifically, monitoring of the functional eating independence skills of the person with dementia is critical, along with assisting caregivers to be aware of their own eating patterns and intake.

The clinical utility of the Cornell Scale for Depression in Dementia as a routine assessment in nursing homes

Objective To examine the clinical utility of the Cornell Scale for Depression in Dementia (CSDD) in nursing homes. Setting 14 nursing homes in Sydney and Brisbane, Australia. Participants 92 residents with a mean age of 85 years. Measurements Consenting residents were assessed by care staff for depression using the CSDD as part of their routine assessment. Specialist clinicians conducted assessment of depression using the Semi-structured Clinical Diagnostic Interview for DSM-IV-TR Axis I Disorders for residents without dementia or the Provisional Diagnostic Criteria for Depression in Alzheimer Disease for residents with dementia to establish expert clinical diagnoses of depression. The diagnostic performance of the staff completed CSDD was analyzed against expert diagnosis using receiver operating characteristic (ROC) curves. Results The CSDD showed low diagnostic accuracy, with areas under the ROC curve being 0.69, 0.68 and 0.70 for the total sample, residents with dementia and residents without dementia, respectively. At the standard CSDD cutoff score, the sensitivity and specificity were 71% and 59% for the total sample, 69% and 57% for residents with dementia, and 75% and 61% for residents without dementia. The Youden index (for optimizing cut-points) suggested different depression cutoff scores for residents with and without dementia. Conclusion When administered by nursing home staff the clinical utility of the CSDD is highly questionable in identifying depression. The complexity of the scale, the time required for collecting relevant information, and staff skills and knowledge of assessing depression in older people must be considered when using the CSDD in nursing homes.

Assessment of the effects of CT dose in averaged x-ray CT images of a dose-sensitive polymer gel

The signal-to-noise ratio achievable in x-ray computed tomography (CT) images of polymer gels can be increased by averaging over multiple scans of each sample. However, repeated scanning delivers a small additional dose to the gel which may compromise the accuracy of the dose measurement. In this study, a NIPAM-based polymer gel was irradiated and then CT scanned 25 times, with the resulting data used to derive an averaged image and a "zero-scan" image of the gel. Comparison between these two results and the first scan of the gel showed that the averaged and zero-scan images provided better contrast, higher contrast-to- noise and higher signal-to-noise than the initial scan. The pixel values (Hounsfield units, HU) in the averaged image were not noticeably elevated, compared to the zero-scan result and the gradients used in the linear extrapolation of the zero-scan images were small and symmetrically distributed around zero. These results indicate that the averaged image was not artificially lightened by the small, additional dose delivered during CT scanning. This work demonstrates the broader usefulness of the zero-scan method as a means to verify the dosimetric accuracy of gel images derived from averaged x-ray CT data.

Method of symptom assessment influences cognitive, affective and somatic post-concussion-like symptom base rates

Primary objective: To investigate whether assessment method influences the type of post-concussion-like symptoms. Methods and procedures: Participants were 73 Australian undergraduate students (Mage = 24.14, SD = 8.84; 75.3% female) with no history of mild traumatic brain injury (mTBI). Participants reported symptoms experienced over the previous 2 weeks in response to an open-ended question (free report), mock interview and standardized checklist (British Columbia Post-concussion Symptom Inventory; BC-PSI). Main outcomes and results: In the free report and checklist conditions, cognitive symptoms were reported significantly less frequently than affective (free report: p < 0.001; checklist: p < 0.001) or somatic symptoms (free report: p < 0.001; checklist: p = 0.004). However, in the mock structured interview condition, cognitive and somatic symptoms were reported significantly less frequently than affective symptoms (both p < 0.001). No participants reported at least one symptom from all three domains when assessed by free report, whereas most participants did so when symptoms were assessed by a mock structured interview (75%) or checklist (90%). Conclusions: Previous studies have shown that the method used to assess symptoms affects the number reported. This study shows that the assessment method also affects the type of reported symptoms.

Editorial - Assessment of EAL/D learners : the validity of teachers' professional judgements

Assessment is a recurring theme in this issue of TESOL in Context. It is the focus of a themed section; addressed in some of the award-winning thesis research we feature; and one of several topics in an article on EFL teacher preparation in an Australian university. In the first section of the issue we are pleased to publish précis of the theses produced by the joint winners of the Penny McKay Memorial Award for Best Thesis in Language Education. Penny was a major figure in the development of EAL/D education in Australia (see Dooley & Moore, 2009). Her work is remembered and continued through an Award established by the Australian Council of TESOL Associations (ACTA) and the Applied Linguistics Association of Australia (ALAA). The award recognises doctoral research which makes an outstanding contribution to second/additional language education in Australian schools (http://www.tesol.org.au/About-ACTA/PENNY-MCKAY-MEMORIAL-FUND)...

Transit route occupancy load factor and passenger average travel time for quality of service assessment

This paper investigates quality of service (QoS) and resource productivity implications of transit route passenger loading and travel time. It highlights the value of occupancy load factor as a direct passenger comfort QoS measure. Automatic Fare Collection data for a premium radial bus route in Brisbane, Australia, is used to investigate time series correlation between occupancy load factor and passenger average travel time. Correlation is strong across the entire span of service in both directions. Passengers tend to be making longer, peak direction commuter trips under significantly less comfortable conditions than off-peak. The Transit Capacity and Quality of Service Manual uses segment based load factor as a measure of onboard loading comfort QoS. This paper provides additional insight into QoS by relating the two route based dimensions of occupancy load factor and passenger average travel time together in a two dimensional format, both from the passenger’s and operator’s perspectives. Future research will apply Value of Time to QoS measurement, reflecting perceived passenger comfort through crowding and average time spent onboard. This would also assist in transit service quality econometric modeling. The methodology can be readily applied in a practical setting where AFC data for fixed scheduled routes is available. The study outcomes also provide valuable research and development directions.

Transit route occupancy load factor and passenger average travel time for quality of service assessment

This presentation investigates quality of service (QoS) and resource productivity implications of transit route passenger loading and travel time. It highlights the value of occupancy load factor as a direct passenger comfort QoS measure. Automatic Fare Collection data for a premium radial bus route in Brisbane, Australia, is used to investigate time series correlation between occupancy load factor and passenger average travel time. Correlation is strong across the entire span of service in both directions. Passengers tend to be making longer, peak direction commuter trips under significantly less comfortable conditions than off-peak. The Transit Capacity and Quality of Service Manual uses segment based load factor as a measure of onboard loading comfort QoS. This paper provides additional insight into QoS by relating the two route based dimensions of occupancy load factor and passenger average travel time together in a two dimensional format, both from the passenger’s and operator’s perspectives. Future research will apply Value of Time to QoS measurement, reflecting perceived passenger comfort through crowding and average time spent onboard. This would also assist in transit service quality econometric modeling. The methodology can be readily applied in a practical setting where AFC data for fixed scheduled routes is available. The study outcomes also provide valuable research and development directions.