Advancing practice in critical care: A model of knowledge integration

It could be argued that advancing practice in critical care has been superseded by the advanced practice agenda. Some would suggest that advancing practice is focused on the core attributes of an individuals practice progressing onto advanced practice status. However, advancing practice is more of a process than identifiable skills and as such is often negated when viewing the development of practitioners to the advanced practice level. For example practice development initiatives can be seen as advancing practice for the masses which ensures that practitioners are following the same level of practice. The question here is; are they developing individually.

Effect of a magnetic field on the flow and blood oxygenation in channels of variable cross-section

The effect of a magnetic field on the flow and oxygenation of an incompressible Newtonian conducting fluid in channels with irregular boundaries has been investigated. The geometric parameter δ, which is a ratio of the mean half width of the channel d to the characteristic length λ along the channel over which the significant changes in the flow quantities occur, has been used for perturbing the governing equations. Closed form solutions of the various order equations are presented for the stream function. The equations for oxygen partial pressure remain nonlinear even after perturbation, therefore a numerical solution is presented. The expressions for shear stress at a wall and pressure distributions are derived. Here the separation in the flow occurs at a higher Reynolds number than the corresponding non-magnetic case. It is found that the magnetic field has an effect on local oxygen concentration but has a little effect on the saturation length.

Variable Size Population NSGA-II: VPNSGA-II

Multi-objective optimization is an active field of research with broad applicability in aeronautics. This report details a variant of the original NSGA-II software aimed to improve the performances of such a widely used Genetic Algorithm in finding the optimal Pareto-front of a Multi-Objective optimization problem for the use of UAV and aircraft design and optimsaiton. Original NSGA-II works on a population of predetermined constant size and its computational cost to evaluate one generation is O(mn^2 ), being m the number of objective functions and n the population size. The basic idea encouraging this work is that of reduce the computational cost of the NSGA-II algorithm by making it work on a population of variable size, in order to obtain better convergence towards the Pareto-front in less time. In this work some test functions will be tested with both original NSGA-II and VPNSGA-II algorithms; each test will be timed in order to get a measure of the computational cost of each trial and the results will be compared.

Podiatry scope of practice: The role of gender in identification as a specialist

Background Ensuring efficient and effective delivery of health care to an aging population has been a major driver for a review of the health workforce in Australia. As part of this review a new National Registration and Accreditation Scheme (NRAS) has evolved with one goal being to improve workforce flexibility. With increased flexibility there have been discussions about the role specialist scopes of practice plays. This study explored the role of gender and other work related characteristics in relation to contemporary scope of podiatry practice and specialisation in Australia. Methods A cross sectional survey was administered through an on-line survey tool on behalf of the Australasian Podiatry Council. Descriptive data was collected over a three-week period. Queensland University of Technology Human Research Ethics approval was sought and confirmed exemption from review, exemption number 1400000791. Results Of the podiatrists participating in this survey (n=218), they were predominately female (66%), early career (34%, 0-9 years) and work in private practices (78%) in multi-podiatrists centres (41%). Relationship between clinical activities performed and “self-perception” of performing a “specialist role” was significant for practitioners who undertook treatment of specific patient groups. The largest area of interest was biomechanics (n=65), followed closely by diabetes (n=61), a third area identified was paediatrics (n=26). Self-perception of specialist status was compared with gender, years of experience, location, primary work environment and clinical practice. When practitioners are asked to categorise themselves to be either “generalist” or “specialist/ generalist with a special interest” podiatrist, male gender was identified as being the only factor which would predict perception of status; 64% males identified as specialist, as opposed to 49% of female survey respondents (Chi square, df = 1, P = 0.044). Self-perception of specialist status was not explained by years of experience, location, working in rural versus urban environment, state worked in, or part-time/full-time work status. Conclusions In conclusion; gender, work environment plus area of interest form a complex relationship, which appear to influence both perception and reality of service provision. Incorporation of specialisation activity (surgical podiatry along with endorsement for use of scheduled medicines) will have lasting impact on the scope of the podiatry profession in Australia. To meet community expectation and maintain high standards, the addition of new subspecialties may be indicated.

Bond graph toolbox for handling complex variable

Bond graph is an apt modelling tool for any system working across multiple energy domains. Power electronics system modelling is usually the study of the interplay of energy in the domains of electrical, mechanical, magnetic and thermal. The usefulness of bond graph modelling in power electronic field has been realised by researchers. Consequently in the last couple of decades, there has been a steadily increasing effort in developing simulation tools for bond graph modelling that are specially suited for power electronic study. For modelling rotating magnetic fields in electromagnetic machine models, a support for vector variables is essential. Unfortunately, all bond graph simulation tools presently provide support only for scalar variables. We propose an approach to provide complex variable and vector support to bond graph such that it will enable modelling of polyphase electromagnetic and spatial vector systems. We also introduced a rotary gyrator element and use it along with the switched junction for developing the complex/vector variable's toolbox. This approach is implemented by developing a complex S-function tool box in Simulink inside a MATLAB environment This choice has been made so as to synthesise the speed of S-function, the user friendliness of Simulink and the popularity of MATLAB.

Is there a role for pharmacists in multidisciplinary health-care teams at community outreach events for the homeless?

Homelessness is a significant public health problem. It is well-documented that people experiencing homelessness exhibit more serious illnesses and have poorer health than the general population. The provision of services and interventions by health-care professionals, including pharmacists, may make a simple yet important contribution to improved health outcomes in those experiencing homelessness, but evidence of roles and interventions is limited and variable. In Australia, the Queensland University of Technology Health Clinic connects with the homeless community by taking part in community outreach events. This paper provides details of one such event, as well as the roles, interventions and experiences of pharmacists. Participation and inclusion of pharmacists in a multidisciplinary health-care team approach at homeless outreach events should be supported and encouraged.

Children’s perspectives of play and learning for educational practice

Play as a learning practice increasingly is under challenge as a valued component of early childhood education. Views held in parallel include confirmation of the place of play in early childhood education and, at the same time, a denigration of the role of play in favor for more teacher-structured and formal activities. As a consequence, pedagogical approaches towards play, the curriculum activities that constitute play, and the appropriateness of play in educational settings, have come under scrutiny in recent years. In this context, this study investigates children’s perspectives of play and how they understand the role of play and learning in their everyday activities. This article reports on an Australian study where teacher-researchers investigated child-led insights into what counts as play in their everyday classroom activities. Children (aged 3–4 years) described play as an activity that involved their active participation in “doing” something, being with peers, and having agency and ownership of ideas. Children did not always characterize their activities as “play”, and not all activities in the preschool program were described as play. The article highlights that play and learning are complex concepts that may be easily dismissed as separate, when rather they are deeply intertwined. The findings of this study generate opportunities for educators and academics to consider what counts as “play” for children, and to prompt further consideration of the role of play as an antidote to adult centric views of play.

Questions to Artificial Nature: A Philosophical Study of Interdisciplinary Models and their Functions in Scientific Practice

This thesis presents an interdisciplinary analysis of how models and simulations function in the production of scientific knowledge. The work is informed by three scholarly traditions: studies on models and simulations in philosophy of science, so-called micro-sociological laboratory studies within science and technology studies, and cultural-historical activity theory. Methodologically, I adopt a naturalist epistemology and combine philosophical analysis with a qualitative, empirical case study of infectious-disease modelling. This study has a dual perspective throughout the analysis: it specifies the modelling practices and examines the models as objects of research. The research questions addressed in this study are: 1) How are models constructed and what functions do they have in the production of scientific knowledge? 2) What is interdisciplinarity in model construction? 3) How do models become a general research tool and why is this process problematic? The core argument is that the mediating models as investigative instruments (cf. Morgan and Morrison 1999) take questions as a starting point, and hence their construction is intentionally guided. This argument applies the interrogative model of inquiry (e.g., Sintonen 2005; Hintikka 1981), which conceives of all knowledge acquisition as process of seeking answers to questions. The first question addresses simulation models as Artificial Nature, which is manipulated in order to answer questions that initiated the model building. This account develops further the "epistemology of simulation" (cf. Winsberg 2003) by showing the interrelatedness of researchers and their objects in the process of modelling. The second question clarifies why interdisciplinary research collaboration is demanding and difficult to maintain. The nature of the impediments to disciplinary interaction are examined by introducing the idea of object-oriented interdisciplinarity, which provides an analytical framework to study the changes in the degree of interdisciplinarity, the tools and research practices developed to support the collaboration, and the mode of collaboration in relation to the historically mutable object of research. As my interest is in the models as interdisciplinary objects, the third research problem seeks to answer my question of how we might characterise these objects, what is typical for them, and what kind of changes happen in the process of modelling. Here I examine the tension between specified, question-oriented models and more general models, and suggest that the specified models form a group of their own. I call these Tailor-made models, in opposition to the process of building a simulation platform that aims at generalisability and utility for health-policy. This tension also underlines the challenge of applying research results (or methods and tools) to discuss and solve problems in decision-making processes.

Advancing practice in critical care : A model of knowledge integration: A Singaporean context

It could be argued that advancing practice in critical care has been superseded by the advanced practice agenda. Some would suggest that advancing practice is focused on the core attributes of an individuals practice progressing onto advanced practice status. However, advancing practice is more of a process than identifiable skills and as such is often negated when viewing the development of practitioners to the advanced practice level. For example practice development initiatives can be seen as advancing practice for the masses which ensures that practitioners are following the same level of practice. The question here is; are they developing individually. To discuss the potential development of a conceptual model of knowledge integration pertinent to critical care nursing practice. In an attempt to explore the development of leading edge critical care thinking and practice, a new model for advancing practice in critical care is proposed. This paper suggests that reflection may not be the best model for advancing practice unless the individual practitioner has a sound knowledge base both theoretically and experientially. Drawing on the contemporary literature and recent doctoral research, the knowledge integration model presented here uses multiple learning strategies that are focused in practise to develop practice, for example the use of work-based learning and clinical supervision. Ongoing knowledge acquisition and its relationship with previously held theory and experience will enable individual practitioners to advance their own practice as well as being a resource for others.

Assessing performance in critical care nursing practice using the Benner Novice to expert model: A pilot study

Background It is often believed that by ensuring the ongoing completion of competency documents and life-long learning in nursing practice guarantees quality patient care. This is probably true in most cases where it provides reassurances that the nursing team is maintaining a safe “generalised” level of practice. However, competency does not always promise quality performance. There are a number of studies that have reported differences in what practitioners know and what they actually do despite being deemed competent. Aim The aim of this study was to assess whether our current competency documentation is fit for purpose and to ascertain whether performance assessment needs to be a key component in determining competence. Method 15 nurses within a General ICU who had been on the unit <4 years agreed to participate in this project. Using participant observation and assessing performance against key indicators of the Benner Novice to Expert5 model the participants were supported and assessed over the course of a ‘normal’ nursing shift. Results The results were surprising both positively and negatively. First, the nurses felt more empowered in their clinical decision making skills; second, it identified individual learning needs and milestones in educational development. There were some key challenges identified which included 5 nurses over estimating their level of competence, practice was still very much focused on task acquisition and skill and surprisingly some nurses still felt dominated by the other health professionals within the unit. Conclusion We found that the capacity and capabilities of our nursing workforce needs continual ongoing support especially if we want to move our staff from capable task-doer to competent performers. Using the key novice to expert indicators identified the way forward for us in how we assess performance and competence in practice particularly where promotion to higher grades is based on existing documentation.

Advancing practice in critical care: A model of knowledge integration

Explore and describe a conceptual model of knowledge integration pertinent to the development of individual practitioners in critical care. Discussion of how multiple learning strategies that are embedded in practice can be beneficial in developing knowledge.

Designing better on-farm research in Australia using a participatory workshop process

There are renewed calls for end-user participation and the integration of local knowledge in agricultural research. In Australia, the response has included an increased emphasis on participatory on-farm research with farmers and commercial agronomists that tests accepted principals to answer practical local farming questions. However, this pursuit of greater relevance has often led to compromises in research designs, unclear results and frustration amongst farmers, commercial agronomists and Research Development and Extension (RDE) agency researchers. This paper reports on a series of pre-season planning workshops from `Doing successful on-farm research', a workshop-based initiative that provides guidelines and a series of interactive activities to plan better participatory on-farm research. The workshop approach helps people design on-farm research that is appropriate to their own needs and local conditions. It assists them to clearly identify their issues, develop specific research questions and decide the best approach to answer those questions with the appropriate rigour for their own situations. These `Doing successful on-farm research' workshops address four potential deficiencies in on-farm research and farming systems RDE more generally in Australia: (1) variable participation of scientists and farmers in on-farm research; (2) the lack of clear guidelines for effective participatory practice and on-farm research; (3) limited support for on-farm research beyond the intensive investigations conducted by RDE agencies and (4) limited support for industry and farmers to contextualise information and research outcomes for specific individual circumstances and faster adaptation of technology. This may be a valuable contribution to balancing the demands for both relevance and rigour in on-farm research in Australia. In "Ground–breaking Stuff’- Proceedings of the 13th Australian Society of Agronomy Conference, 10-14 September 2006, Perth, Western Australia.

Variable growth rates of the tropical estuarine fish barramundi Lates calcarifer (Bloch) under different freshwater flow conditions

Relationships between freshwater flows and growth rates of the opportunistic predatory finfish barramundi Lates calcarifer in a dry tropical estuary were examined using data from a long-term tag-recapture programme. Lagged effects were not investigated. After accounting for length at release, time at liberty and seasonal variation (e.g. winter, spring, summer and autumn), growth rates were significantly and positively related to fresh water flowing to the estuary. Effects were present at relatively low levels of freshwater flow (i.e. 2.15 m3 s-1, the 5th percentile of the mean flow rate experienced by fish in the study during time at liberty). The analysis, although correlative, provides quantitative evidence to support the hypothesis that freshwater flows are important in driving the productivity of estuaries and can improve growth of species high in the trophic chain.

The Politics of Adoption: International Perspectives on Law, Policy and Practice, Third edition

Adoption is a complex social phenomenon, intimately knitted into its family law framework and shaped by the pressures affecting the family in its local social context. It is a mirror reflecting the changes in our family life and the efforts of family law to address those changes. This has caused it to be variously defined in different societies in the same society, at different times and across a range of contemporary societies.