Doing the right thing at the right time: Assessing responses to patient deterioration in electronic simulation scenarios using course-of-action analysis

International studies indicate that the recognition and management of deteriorating patients in hospitals are poor and that patient assessment is often inadequate. Face-to-face simulation programs have been shown to have an impact on educational and clinical outcomes; however, little is known about performance in contemporary healthcare e-simulation approaches. Using data from an open-access Web-based patient deterioration program (FIRSTACTWeb), the performance of 367 Australian nursing students in identification of treatment priorities and clinical actions was analyzed using a military model of Course of Action Simulation Analysis. Participants' performance in the whole program demonstrated a significant improvement in knowledge and skills (P ≤ .001) with high levels of participant satisfaction. Course of Action Simulation Analysis modeling identified three key participant groupings within which only 18% took the "best course of action" (the right actions and timing), with most (70%) completing the right actions but in the wrong order. The remaining 12% produced incomplete assessments and actions in an incorrect sequence. Contemporary approaches such as e-simulation do enhance educational outcomes. Measurement of performance when combined with Course of Action Simulation Analysis becomes a useful tool in the description of outcomes, an understanding of decision making, and the prediction of future events.

The fluid nature of action research

Action research is a fluid, unfolding process of research. It involves cycles of questioning, gathering data, critical reflection and deciding on a course of action (Stringer, 2008). Through action research, educators research their own practice in their own setting. They learn from their experiences as the action research cycles progress, and apply new learning to practice.

Ethical-moral courses of action and active citizenship in health students

Abstract Introduction: The practice of active citizenship, ethical-moral courses of action and civic, moral and ethics education are essentials for ethical decision making in health. Objetive: To determine if gender influences students’ ethical- moral course of action. Methods: Descriptive study with a non-probabilistic sample of 85 students enrolled in the 1st cycle of the health degree. Results: Of the participants surveyed 61.2% were found to say that action should take into account their moral principles, with ethical/ moral subjectivism prevailing; 44.7% consider that one should “Do what will have the best consequences for the greatest number of people”, with the principle of utilitarianism being significant; 55.3% think that “An action is ethically good” if “It is in accordance with morality”, thereby highlighting subjectivism/relativism; 45.9% believe that “ethical-moral values” “are relative and vary from society to society” agreeing with relativism as an explanatory principle for action. Males showed a greater tendency to support their decision-making with the principle of objectivism, (Fischer=.010). Conclusion: The results suggest that students’ ethical-moral education is required to promote an ethical-moral course of action in their professional practice. Thus, universities with their health courses should be at the forefront of this education, making their graduates ambassadors/interveners of a way of knowing and of being as well as promoters of the dignity of the citizen of the modern world.

Conceptualisation de l’activité pédagogique en contexte d’apprentissage hybride et développement professionnel des enseignant(e)s universitaires

L’intégration des nouvelles technologies en enseignement supérieur ne devrait pas être vue comme un simple effet de mode, mais plutôt comme un cadre de réflexion sur les orientations nouvelles à donner à l’Université du 21ème siècle, en termes de culture institutionnelle, de ressources organisationnelles et d’opérationnalisation d’objectifs de recherche et d’enseignement (Duderstadt et al, 2002 ; Guri-Rosenblit, 2005). En effet, l’émergence d’une nouvelle tendance de formation post-secondaire, qu’est l’intégration des solutions virtuelles au présentiel, n’est pas sans incidences sur les pratiques enseignantes. Or, la littérature n’offre pas de modèles descriptifs satisfaisants permettant de mieux saisir la pertinence des liens entre l’enseignement en contexte d’apprentissage hybride et le développement professionnel des enseignants universitaires. Aussi avons-nous procédé par des observations participantes de deux cours en sciences de la gestion à HEC Montréal, dans les programmes de certificat de premier cycle ainsi que par des entretiens d’explicitation et d’autoconfrontation, pendant toute la session d’automne 2014, pour respectivement recueillir des données sur les pratiques réelles d’un maître d’enseignement, en sociologie du travail, et d’une chargée de cours, en gestion de projets. Notre analyse du corpus, par catégorisations conceptualisantes, a permis la production d’énoncés nomologiques rendant compte de la dynamique de relations entre ces deux phénomènes. Sur le plan scientifique, elle a apporté un éclairage nouveau sur les processus de construction identitaire professionnelle en pédagogie universitaire, en regard des mutations technologiques, socioculturelles et économiques que subissent l’Université, en général, et les pratiques enseignantes et étudiantes, en particulier. L’approche inductive utilisée a donc permis de définir la structure des interactions des deux phénomènes, selon la perspective des deux enseignants, et d’élaborer des modèles d’intervention enracinés dans leurs pratiques quotidiennes. Aussi sur le plan social, ces modèles sont-ils l’expression d’une grammaire de la pensée et de l’action, ancrée dans les valeurs des enseignants eux-mêmes. Nous avons pris en compte le paradigme de la tâche réelle, versus celui de la tâche prescrite, en termes de mise en œuvre concrète des processus pédagogiques, pour rendre les résultats de cette recherche signifiants pour la pratique. Les modèles, qui ont émergé de notre configuration de la pensée dialogique des participants, peuvent être intégrés à la formation des enseignants universitaires en contexte de bimodalisation de l’Université.

Conceptualisation de l’activité pédagogique en contexte d’apprentissage hybride et développement professionnel des enseignant(e)s universitaires

L’intégration des nouvelles technologies en enseignement supérieur ne devrait pas être vue comme un simple effet de mode, mais plutôt comme un cadre de réflexion sur les orientations nouvelles à donner à l’Université du 21ème siècle, en termes de culture institutionnelle, de ressources organisationnelles et d’opérationnalisation d’objectifs de recherche et d’enseignement (Duderstadt et al, 2002 ; Guri-Rosenblit, 2005). En effet, l’émergence d’une nouvelle tendance de formation post-secondaire, qu’est l’intégration des solutions virtuelles au présentiel, n’est pas sans incidences sur les pratiques enseignantes. Or, la littérature n’offre pas de modèles descriptifs satisfaisants permettant de mieux saisir la pertinence des liens entre l’enseignement en contexte d’apprentissage hybride et le développement professionnel des enseignants universitaires. Aussi avons-nous procédé par des observations participantes de deux cours en sciences de la gestion à HEC Montréal, dans les programmes de certificat de premier cycle ainsi que par des entretiens d’explicitation et d’autoconfrontation, pendant toute la session d’automne 2014, pour respectivement recueillir des données sur les pratiques réelles d’un maître d’enseignement, en sociologie du travail, et d’une chargée de cours, en gestion de projets. Notre analyse du corpus, par catégorisations conceptualisantes, a permis la production d’énoncés nomologiques rendant compte de la dynamique de relations entre ces deux phénomènes. Sur le plan scientifique, elle a apporté un éclairage nouveau sur les processus de construction identitaire professionnelle en pédagogie universitaire, en regard des mutations technologiques, socioculturelles et économiques que subissent l’Université, en général, et les pratiques enseignantes et étudiantes, en particulier. L’approche inductive utilisée a donc permis de définir la structure des interactions des deux phénomènes, selon la perspective des deux enseignants, et d’élaborer des modèles d’intervention enracinés dans leurs pratiques quotidiennes. Aussi sur le plan social, ces modèles sont-ils l’expression d’une grammaire de la pensée et de l’action, ancrée dans les valeurs des enseignants eux-mêmes. Nous avons pris en compte le paradigme de la tâche réelle, versus celui de la tâche prescrite, en termes de mise en œuvre concrète des processus pédagogiques, pour rendre les résultats de cette recherche signifiants pour la pratique. Les modèles, qui ont émergé de notre configuration de la pensée dialogique des participants, peuvent être intégrés à la formation des enseignants universitaires en contexte de bimodalisation de l’Université.

iRAP Malaysia training course : decade of action for road safety

The International Road Assessment Program (iRAP) is a not-for-profit organisation that works in partnership with governments and non-government organisations in all parts of the world to make roads safe. The iRAP Malaysia pilot study on 3700km of road identified the potential to prevent 31,800 deaths and serious injuries over the next 20 years from proven engineering improvements. To help ensure the iRAP data and results are available to planners and engineers, iRAP, together with staff from the Centre for Accident Research and Road Safety – Queensland (CARRS-Q) and the Malaysian Institute of Road Safety Research (MIROS), developed a five-day iRAP training course that covers the background, theory and practical application of iRAP protocols, with a special focus on Malaysian case studies. Funding was provided by a competitive grant from the Australia-Malaysia Institute.

iRAP Malaysia training course: Decade of Action for Road Safety. Report to Department of Foreign Affairs and Trade, Australia-Malaysia Institute

The International Road Assessment Program (iRAP) is a not-for-profit organisation that works in partnership with governments and non-government organisations in all parts of the world to make roads safe. The iRAP Malaysia pilot study on 3,700km of road identified the potential to save 31,800 deaths and serious injuries over the next 20 years from proven engineering improvements. To help ensure the iRAP data and results are available to planners and engineers, iRAP, together with staff from the Centre for Accident Research and Road Safety – Queensland (CARRS-Q) and the Malaysian Institute of Road Safety Research (MIROS) developed a 5-day iRAP training course that covers the background, theory and practical application of iRAP protocols, with a special focus on Malaysian case studies. Funding was provided by a competitive grant from the Australian-Malaysia Institute.

International students' perceptions of their experience of higher education in Australia: A focus on Saudi Arabian students in their first year of a business course in a major Australian university

This study examined perceptions of international students from Saudi Arabia living and studying in Australia. As a qualitative study that featured case study methodology, the thesis discusses the experiences of Saudi Arabian students in the light of two important factors: students' expectations prior to coming to Australia and the impact of intercultural competency on students' experiences. The study found that while study participants reported mostly positive experiences, there were challenges faced such as coping with English language and culture shock. The thesis culminates in a comprehensive list of implications for educators in the light of the study's findings.

Modern-day clinical course of type 1 diabetes mellitus after 30 years' duration:the diabetes control and complications trial/epidemiology of diabetes interventions and complications and Pittsburgh epidemiology of diabetes complications experience (1983-2005)

Clinical treatment goals of type 1 diabetes mellitus (T1DM) have changed since the Diabetes Control and Complications Trial (DCCT) demonstrated reduced long-term complications with intensive diabetes therapy. There have been few longitudinal studies to describe the clinical course of T1DM in the age of intensive therapy. Our objective was to describe the current-day clinical course of T1DM.

Infants' Understanding of Object Weight: Relations with Action Experience and Strength

Thesis (Ph.D.)--University of Washington, 2016-06

Information practices of teen content creators : the intersection of action and experiences a grounded theory study

What are the information practices of teen content creators? In the United States over two thirds of teens have participated in creating and sharing content in online communities that are developed for the purpose of allowing users to be producers of content. This study investigates how teens participating in digital participatory communities find and use information as well as how they experience the information. From this investigation emerged a model of their information practices while creating and sharing content such as film-making, visual art work, story telling, music, programming, and web site design in digital participatory communities. The research uses grounded theory methodology in a social constructionist framework to investigate the research problem: what are the information practices of teen content creators? Data was gathered through semi-structured interviews and observation of teen’s digital communities. Analysis occurred concurrently with data collection, and the principle of constant comparison was applied in analysis. As findings were constructed from the data, additional data was collected until a substantive theory was constructed and no new information emerged from data collection. The theory that was constructed from the data describes five information practices of teen content creators. The five information practices are learning community, negotiating aesthetic, negotiating control, negotiating capacity, and representing knowledge. In describing the five information practices there are three necessary descriptive components, the community of practice, the experiences of information and the information actions. The experiences of information include information as participation, inspiration, collaboration, process, and artifact. Information actions include activities that occur in the categories of gathering, thinking and creating. The experiences of information and information actions intersect in the information practices, which are situated within the specific community of practice, such as a digital participatory community. Finally, the information practices interact and build upon one another and this is represented in a graphic model and explanation.

Linking the fifth pillar to the first in the UN Decade of Action

The UN Decade of Action outlines five pillars of activity within a safe system framework to achieve the goal of slowing and then reversing the global growth in road traffic fatalities, especially in low-income and middle-income countries. The first four pillars - road safety management, safer roads and mobility, safer vehicles, and safer road users – have a strong focus on prevention of road traffic crashes and mitigation of energy exchange when a crash occurs. The fifth pillar – post-crash response – is far more specific, focusing only on crash victims in the event of a safe system failure. The victims appear to be relevant to the first four pillars only insofar as their numbers can be used to evaluate the success of road safety programs and identify the target groups and contributing factors. This paper argues that a better understanding of the lived experience of long term disability from traffic crashes has the potential to provide a feedback loop from the fifth pillar to the first. Research conducted in Thailand with male crash victims with spinal injury demonstrates that patterns of attribution and social and cultural factors have important implications for road safety management and for interventions aimed at influencing behaviour. In addition, the mobility constraints experienced by people with long term disability can point to systemic issues that might otherwise go unnoticed. The UN Decade of Action can benefit from a more thorough exploration of the experiences and circumstances of people with long term disability as the result of a road traffic crash. Rather than being evidence of the failure of the safe system, they can inform the development of more effective road safety management on low-income and middle-income countries.

The life course of Australian researchers : experiences of applying for research funding

The life course of Australian researchers includes regular funding applications, which incur large personal and time costs. We previously estimated that Australian researchers spent 550 years preparing 3,727 proposals for the 2012 NHMRC Project Grant funding round, at an estimated annual salary cost of AU$66 million. Despite the worldwide importance of funding rounds, there is little evidence on what researchers think of the application process. We conducted a web-based survey of Australian researchers (May–July 2013) asking about their experience with NHMRC Project Grants. Almost all researchers (n=224 at 31 May) supported changes to the application (96%) and peer-review (88%) processes; 73% supported the introduction of shorter initial Expressions of Interest; and half (50%) provided extensive comments on the NHMRC processes. Researchers agreed preparing their proposals always took top priority over other work (97%) and personal (87%) commitments. More than half (57%) provided extensive comments on the ongoing personal impact of concurrent grant-writing and holiday seasons on family, children and other relationships. Researchers with experience on Grant Review Panels (34%) or as External Reviewers (78%) reported many sections of the proposals were rarely or never read, which suggests these sections could be cut with no impact on the quality of peer review. Our findings provide evidence on the experience of Australian researchers as applicants. The process of preparing, submitting and reviewing proposals could be streamlined to minimise the burden on applicants and peer reviewers, giving Australian researchers more time to work on actual research and be with their families.

Ginger - mechanism of action in chemotherapy-induced nausea and vomiting: A review

Despite advances in anti-emetic therapy, chemotherapy-induced nausea and vomiting (CINV) still poses a significant burden to patients undergoing chemotherapy. Nausea, in particular, is still highly prevalent in this population. Ginger has been traditionally used as a folk remedy for gastrointestinal complaints and has been suggested as a viable adjuvant treatment for nausea and vomiting in the cancer context. Substantial research has revealed ginger to possess properties that could exert multiple beneficial effects on chemotherapy patients who experience nausea and vomiting. Bioactive compounds within the rhizome of ginger, particularly the gingerol and shogaol class of compounds, interact with several pathways that are directly implicated in CINV in addition to pathways that could play secondary roles by exacerbating symptoms. These properties include 5-HT3, substance P and acetylcholine receptor antagonism; anti-inflammatory properties; and modulation of cellular redox signalling, vasopressin release, gastrointestinal motility, and gastric emptying rate. This review outlines these proposed mechanisms by discussing the results of clinical, in vitro and animal studies both within the chemotherapy context and in other relevant fields. The evidence presented in this review indicates that ginger possesses multiple properties that could be beneficial in reducing chemotherapy-induced nausea and vomiting.