Australian nurses volunteering for the Sumatra-Andaman earthquake and tsunami of 2004 : a review of experience and analysis of data collected by the Tsunami Volunteer Hotline

This paper provides an outline of the work undertaken by nurses who participated in the relief effort as members of Australian medical teams during the Sumatra-Andaman earthquake and tsunami response. This profile is contrasted with the information provided by nurses who registered their interest in volunteering to help via the Australian Tsunami Hotline. The paper provides an overview of the skills and background of the nurses who provided information to the hotline and describes the range and extent of experience among this cohort of potential volunteers. This data is compared to nursing workforce data and internal rates of volunteering in Australia. The paper concludes that further research is necessary to examine the motivations of and disincentives for nurses to volunteer for overseas (disaster) work and, to develop an improved understanding within the discipline of the skills and experience required of volunteer responders. Further, it is argued that the development of standards for the collection of disaster health volunteer data would assist future responses and provide better tools for developing an improved understanding of disaster volunteering.

Is length of experience an appropriate criterion to identify level of expertise?

Clinical experience plays an important role in the development of expertise, particularly when coupled with reflection on practice. There is debate, however, regarding the amount of clinical experience that is required to become an expert. Various lengths of practice have been suggested as suitable for determining expertise, ranging from five years to 15 years. This study aimed to investigate the association between length of experience and therapists’ level of expertise in the field of cerebral palsy with upper limb hypertonicity using an empirical procedure named Cochrane–Weiss–Shanteau (CWS). The methodology involved re-analysis of quantitative data collected in two previous studies. In Study 1, 18 experienced occupational therapists made hypothetical clinical decisions related to 110 case vignettes, while in Study 2, 29 therapists considered 60 case vignettes drawn randomly from those used in Study 1. A CWS index was calculated for each participant's case decisions. Then, in each study, Spearman's rho was calculated to identify the correlations between the duration of experience and level of expertise. There was no significant association between these two variables in both studies. These analyses corroborated previous findings of no association between length of experience and judgemental performance. Therefore, length of experience may not be an appropriate criterion for determining level of expertise in relation to cerebral palsy practice.

How do level of experience, purpose for riding, and preference for facilities affect location of riding?

Characteristics of the road infrastructure affect both the popularity of bicycling and its safety, but comparisons of the safety performance of infrastructure may be confounded by differences in the profiles of cyclists who use them. Data from a survey of 2,532 adult bicycle riders in Queensland, Australia, demonstrated that many riders rode reluctantly in particular locations and that preference for riding location was influenced by degree of experience and riding purpose. Most riders rode most often and furthest per week on urban roads, but approximately one-third of all riders (and more new riders) rode there reluctantly. Almost two-thirds of riders rode on bicycle paths, most by choice, not reluctantly. New riders rode proportionally more on bicycle paths, but continuing riders rode further in absolute terms. Utilitarian riders were more likely to ride on bicycle paths than social and fitness riders and almost all of this riding was by choice. Fitness riders were more reluctant in their use of bicycle paths, but still most of their use was by choice. One-third of the respondents reported riding on the sidewalk (legal in Queensland), with approximately two-thirds doing so reluctantly. The frequency and distance ridden on the sidewalk was less than for urban roads and bicycle paths. Sidewalks and bicycle paths were important facilities for both inexperienced and experienced riders and for utilitarian riding, especially when urban roads were considered a poor choice for cycling.

Voices of experience : opportunities to influence creatively the designing of school libraries

Using a critical ethnographic approach this study investigates the potential for multiple voices of experience, of educators, designers/architects, education facility planners and students/learners, to influence creatively the designing of school libraries. School libraries are considered as social and cultural entities within the contexts of school life and of wider society. It is proposed that school library designing is a social interaction of concern to those influenced by its practices and outcomes. School library designing is therefore of significance to educators and students as well as to those with professionally accredited involvement in school library designing, such as designers/architects and education facility planners. The study contends that current approaches to educational space designing, including school libraries, amplify the voices of accredited designers and diminish or silence the voices of the user participants. The study is conceptualised as creative processes of discovery, through which attention is paid to the voices of experience of user and designer participants, and is concerned with their understandings and experiences of school libraries and their understandings and experiences of designing. Grounded theory coding (Charmaz) is used for initial categorising of interview data. Critical discourse analysis (CDA, Fairclough) is used as analytical tool for reflection on the literature and for analysis of the small stories gathered through semi-structured interviews, field observations and documents. The critical interpretive stance taken through CDA, enables discussions of aspects of power associated with the understandings and experiences of participants, and for recognition of creative possibilities and creative influence within and beyond current conditions. Through an emphasis on prospects for educators and students as makers of the spaces and places of learning, in particular in school libraries, the study has the potential to inform education facility designing practices and design participant relationships, and to contribute more broadly to knowledge in the fields of education, design, architecture, and education facility planning.

Providing 'best practice' placements begins with mentoring skills : overview of the Program of Experience in the Palliative Approach (PEPA) quality improvement initiatives for mentors

Objectives PEPA is funded by the Department of Health and Ageing and aims to further improve the skill and confidence of the generalist workforce to work with people with palliative care needs. Recent quality improvement initiatives to promote transfer of learning into practice include appointment of a clinical educator, implementation of an online module for mentors and delivery of a mentoring workshop (collaborating with NSAP and PCC4U). This paper presents an overview of outcomes from these quality improvement initiatives. Methods PEPA host sites are selected based on their specialist palliative care level. Host site managers are surveyed six-monthly and participants are surveyed pre and three months post-placement to collect open and fixed response data on their experience of the program. Participants in the mentoring workshop (n=39) were asked to respond to a survey regarding the workshop outcomes. Results The percentage of placement participants who strongly agreed they ‘have the ability to implement the interventions required for people who have a life-limiting illness’ increased from 35% in 2011 (n=34) to 51% in 2012 (n=91) post-placement. Responses from mentor workshop participants indicated that 76% of respondents (n=25) agreed that they were able to identify principles for mentoring in the context of palliative care. In 2012, 61% of host site managers (n=54) strongly agreed that PEPA supports clinician working with people with a life-limiting illness. Conclusion Strategies to build the capabilities of palliative care professionals to mentor and support the learning experience of PEPA participants are critical to ongoing improvements of the program.

The Atlantic Meridional Transect (AMT) data management experience

As the UK's national marine data centre, a key responsibility of the British Oceanographic Data Centre (BODC) is to provide data management support for the scientific activities of complex multi-disciplinary long-term research programmes. Since the initial cruise in 1995, the NERC funded Atlantic Meridional Transect (AMT) project has undertaken 18 north–south transects of the Atlantic Ocean. As the project has evolved there has been a steady growth in the number of participants, the volume of data, its complexity and the demand for data. BODC became involved in AMT in 2002 at the beginning of phase II of this programme and since then has provided continuous support to the AMT and the wider scientific community through the rescue, quality control, processing and access to the data. The data management is carried out by a team of specialists using a sophisticated infrastructure and hardware to manage, integrate and serve physical, biological and chemical data. Here, we discuss the approach adopted, techniques applied and some guiding principles for management of large multi-disciplinary programmes.

Lupus and Pregnancy. 15 Years of Experience in a Tertiary Center

This retrospective study was designed to evaluate the outcome of pregnancies in women diagnosed with systemic lupus erythematosus (SLE) followed in a tertiary fetal–maternal center. Data were collected from clinical charts between January 1993 and December 2007, with a total of 136 pregnancies (107 patients). Mean maternal age was 29 years, with the vast majority of patients being Caucasian. Most patients were in remission 6 months prior to pregnancy (93%) and the most frequently affected organs were the skin and joints. Renal lupus accounted for 14% of all cases. Twenty-nine percent of patients were positive for at least one antiphospholid antibody (aPL) and nearly 50% had positive SSa/SSb antibodies. All patients with positive aPL received low-dosage aspirin and low molecular- weight heparin (LMWH). There were no pregnancy complications in more than 50% of cases and hypertensive disease and intrauterine growth restriction were the most common adverse events. There were 125 live births, one neonatal death, eight miscarriages, and three medical terminations of pregnancy. Preterm delivery occurred in 25% of pregnancies. Our results are probably the conjoined result of a multidisciplinary approach together with a systematic management of SLE pregnancies, with most patients keeping their prior SLE medication combined with low-dosage aspirin and LMWH in the presence of aPL.

The role of motivational systems in community service involvement : initiating and sustaining factors and quality of experience /

Community service participation can have a positive impact on development, especially for youth. Although researchers have found positive outcomes, there has been a notable decline in youth participation over the past few years (Statistics Canada, 2000). Given the positive outcomes and current decline, it has been argued that youth should be encouraged to get involved in service activities. In the present study, quantitative and qualitative data were collected to determine factors that would help youth to initiate and sustain service, along with examining the quality of their experience. Eighty-two university undergraduate students (23 men), ranging in age from 17-20 years completed a 60-minute self-report questionnaire. Initiating and sustaining factors, motivational systems (similar to approach and avoidance dimensions), activity dimensions {Structure, Supportive Social Environment), quality of experience {Positive, Stress-Challenge), and future intention to participate in community service were measured. Eight participants also completed a 20-minute telephone interview to complement and expand on the quantitative data collected. Some initiating and sustaining factors were specific to individuals higher on the avoidance dimension, while others were relevant to those higher on the approach dimension. Several factors also were important to individuals regardless of their motivational system orientation. Positive quality of experience was related positively to experiencing a supportive social environment. In addition, women rated their community service as more positive than did men. A predicted interaction between the avoidance dimension and Structure in predicting positive quality of experience was not supported; however, positive quality of experience was predicted by the interaction of the approach dimension and Structure. A tested interaction between the avoidance dimension and Supportive Social Environment in predicting positive quality of experience was not supported. Similarly, a predicted interaction between the approach dimension and Supportive Social Environment in predicting positive experience quality was not supported. However, Supportive Social Environment was positively related to positive quality of experience. No support was found for a mediational role for positive quality of experience or stress-challenge quality of experience in exploring the relation between motivational orientation and fiiture intention to engage in service activities. The results of this study suggest that participating in a service environment that is supportive and provides the opportunity for social interactions with others would promote positive quality of experience and help youth sustain involvement. Thus, to help youth have positive experiences and to remain active in service, it is important for service agencies to promote these types of environments. In addition, some initiating and sustaining factors were specific to youth higher on the avoidance dimension and some were relevant to youth higher on the approach dimension. Therefore, service agencies may need to consider using different recruitment and retention strategies, depending on the type of youth they wish to recruit.

Neonatal meningitis according to the microbiological diagnosis: a decade of experience in a tertiary center

The aim of this study was to evaluate the incidence of and mortality due to meningitis and compare data according to microbiological diagnosis. This was a ten-year retrospective study conducted at a neonatal intensive care unit (NICU). Newborns with meningitis confirmed by positive CSF culture were included; those with congenital infection or malformations that made lumbar puncture impossible were excluded. The variables investigated were birth weight, gestational and postnatal age, procedures, hematological and CSF parameters, and complications. Parametric and non-parametric tests were used (statistical value p<0.05). The incidence of meningitis was 0.6% and mortality was 27%. of the 22 cases, 59% involved Gram-negative bacteria; 36% Gram-positive and 5% fungi. The groups did not differ in relation to birth weight, gestational and postnatal age, procedures or hematological and CSF parameters. Sepsis, convulsions and deaths were frequent in both groups, without statistical difference. Gram-negative cases showed abscesses and higher frequency of ventriculitis and hydrocephaly. Meningitis was infrequent, but presented high mortality and frequent complications.

Perception-action coupling in infants with down syndrome: Effects of experience and practice

This study examined the effects of experience and practice on the coupling between visual information and trunk sway in infants with Down syndrome (DS). Five experienced and five novice sitters were exposed to a moving room, which was oscillated at 0.2 and 0.5 Hz. Infants remained in a sitting position and data were collected on the first, fourth, and seventh days. On the first day, experienced sitters were more influenced by room oscillation than were novices. On the following days, however, the influence of room oscillation decreased for experienced but increased for novice sitters. These results suggest that the relationship between sensory information and motor action in infants with DS can be changed with experience and practice.

Sexual activity-related emergency department admissions: eleven years of experience at a Swiss university hospital

PRINCIPALS: Most people enjoy sexual intercourse without complications, but a significant, if small, number need to seek emergency medical help for related health problems. The true incidence of these problems is not known. We therefore assessed all admissions to our emergency department (ED) in direct relation to sexual intercourse. METHODS: All data were collected prospectively and entered into the ED's centralised electronic patient record database (Qualicare, Switzerland) and retrospectively analysed. The database was scanned for the standardised key words: 'sexual intercourse' (German 'Geschlechtsverkehr') or 'coitus' (German 'Koitus'). RESULTS: A total of 445 patients were available for further evaluation; 308 (69.0%) were male, 137 (31.0%) were female. The median age was 32 years (range 16-71) for male subjects and 30 years (range 16-70) for female subjects. Two men had cardiovascular emergencies. 46 (10.3%) of our patients suffered from trauma. Neurological emergencies occurred in 55 (12.4%) patients: the most frequent were headaches in 27 (49.0%), followed by subarachnoid haemorrhage (12, 22.0%) and transient global amnesia (11, 20.0%). 154 (97.0%) of the patients presenting with presumed infection actually had infections of the urogenital tract. The most common infection was urethritis (64, 41.0%), followed by cystitis (21, 13.0%) and epididymitis (19, 12.0%). A sexually transmitted disease (STD) was diagnosed in 43 (16.0%) of all patients presenting with a presumed infection. 118 (43.0%) of the patients with a possible infection requested testing for an STD because of unsafe sexual activity without underlying symptoms. CONCLUSIONS: Sexual activity is mechanically dangerous, potentially infectious and stressful for the cardiovascular system. Because information on ED presentation related to sexual intercourse is scarce, more efforts should be undertaken to document all such complications to improve treatment and preventative strategies.

Injuries, sequelae, and treatment of lightning-induced injuries: 10 years of experience at a swiss trauma center

Principals. Lightning is one of the most powerful and spectacular natural phenomena. Lightning strikes to humans are uncommon but can cause devastating injuries. We analyzed lightning-related admissions to our emergency department from January 2000 to December 2010 to review and highlight the main features of lightning-related injuries. Methods. All data were collected prospectively and entered in the emergency department' database (Qualicare Switzerland) and retrospectively analyzed. Results. Nine patients with lightning-related injuries presented to our emergency department. Four were female, and five were male. The most common site of injury was the nervous system (6 out of 9 patients) followed by the cardiovascular system (5 out of 9 patients). The third most common injuries occurred to the skin (3 out of 9 patients). Four of the patients had to be hospitalized for further observation. Conclusion. Reports of lightning strikes and related injuries are scarce. The establishment of an international register would therefore benefit the understanding of their injury patterns and facilitate specific treatment.

Ecological assessment data of the marine flora and fauna of Point Lookout in 2014 (PLEA)

In 2014, UniDive (The University of Queensland Underwater Club) conducted an ecological assessment of the Point Lookout Dive sites for comparison with similar surveys conducted in 2001. Involvement in the project was voluntary. Members of UniDive who were marine experts conducted training for other club members who had no, or limited, experience in identifying marine organisms and mapping habitats. Since the 2001 detailed baseline study, no similar seasonal survey has been conducted. The 2014 data is particularly important given that numerous changes have taken place in relation to the management of, and potential impacts on, these reef sites. In 2009, Moreton Bay Marine Park was re-zoned, and Flat Rock was converted to a marine national park zone (Green zone) with no fishing or anchoring. In 2012, four permanent moorings were installed at Flat Rock. Additionally, the entire area was exposed to the potential effects of the 2011 and 2013 Queensland floods, including flood plumes which carried large quantities of sediment into Moreton Bay and surrounding waters. The population of South East Queensland has increased from 2.49 million in 2001 to 3.18 million in 2011 (BITRE, 2013). This rapidly expanding coastal population has increased the frequency and intensity of both commercial and recreational activities around Point Lookout dive sites (EPA 2008). Methodology used for the PLEA project was based on the 2001 survey protocols, Reef Check Australia protocols and Coral Watch methods. This hybrid methodology was used to monitor substrate and benthos, invertebrates, fish, and reef health impacts. Additional analyses were conducted with georeferenced photo transects. The PLEA marine surveys were conducted over six weekends in 2014 totaling 535 dives and 376 hours underwater. Two training weekends (February and March) were attended by 44 divers, whilst biological surveys were conducted on seasonal weekends (February, May, July and October). Three reefs were surveyed, with two semi-permanent transects at Flat Rock, two at Shag Rock, and one at Manta Ray Bommie. Each transect was sampled once every survey weekend, with the transect tapes deployed at a depth of 10 m below chart datum. Fish populations were assessed using a visual census along 3 x 20 m transects. Each transect was 5 m wide (2.5 m either side of the transect tape), 5 m high and 20 m in length. Fish families and species were chosen that are commonly targeted by recreational or commercial fishers, or targeted by aquarium collectors, and that were easily identified by their body shape. Rare or otherwise unusual species were also recorded. Target invertebrate populations were assessed using visual census along 3 x 20 m transects. Each transect was 5 m wide (2.5 m either side of the transect tape) and 20 m in length. The diver surveying invertebrates conducted a 'U-shaped' search pattern, covering 2.5 m on either side of the transect tape. Target impacts were assessed using a visual census along the 3 x 20 m transects. Each transect was 5 m wide (2.5 m either side of the transect tape) and 20 m in length. The transect was surveyed via a 'U-shaped' search pattern, covering 2.5 m on either side of the transect tape. Substrate surveys were conducted using the point sampling method, enabling percentage cover of substrate types and benthic organisms to be calculated. The substrate or benthos under the transect line was identified at 0.5m intervals, with a 5m gap between each of the three 20m segments. Categories recorded included various growth forms of hard and soft coral, key species/growth forms of algae, other living organisms (i.e. sponges), recently killed coral, and, non-living substrate types (i.e. bare rock, sand, rubble, silt/clay).

ACGT: advancing clinico-genomic trials on cancer - four years of experience.

The challenges regarding seamless integration of distributed, heterogeneous and multilevel data arising in the context of contemporary, post-genomic clinical trials cannot be effectively addressed with current methodologies. An urgent need exists to access data in a uniform manner, to share information among different clinical and research centers, and to store data in secure repositories assuring the privacy of patients. Advancing Clinico-Genomic Trials (ACGT) was a European Commission funded Integrated Project that aimed at providing tools and methods to enhance the efficiency of clinical trials in the -omics era. The project, now completed after four years of work, involved the development of both a set of methodological approaches as well as tools and services and its testing in the context of real-world clinico-genomic scenarios. This paper describes the main experiences using the ACGT platform and its tools within one such scenario and highlights the very promising results obtained.

Influence of experience and training on dental students’ examination performance regarding panoramic images

Physician training has greatly benefitted from insights gained in understanding the manner in which experts search medical images for abnormalities. The aims of this study were to compare the search patterns of 30 fourth-year dental students and 15 certified oral and maxillofacial radiologists (OMRs) over panoramic images and to determine the most robust variables for future studies involving image visualization. Eye tracking was used to capture the eye movement patterns of both subject groups when examining 20 panoramic images classified as normal or abnormal. Abnormal images were further subclassified as having an obvious, intermediate, or subtle abnormality. The images were presented in random order to each participant, and data were collected on duration of the participants’ observations and total distance tracked, time to first eye fixation, and total duration and numbers of fixations on and off the area of interest (AOI). The results showed that the OMRs covered greater distances than the dental students (p<0.001) for normal images. For images of pathosis, the OMRs required less total time (p<0.001), made fewer eye fixations (p<0.01) with fewer saccades (p<0.001) than the students, and required less time before making the first fixation on the AOI (p<0.01). Furthermore, the OMRs covered less distance (p<0.001) than the dental students for obvious pathoses. For investigations of images of pathosis, time to first fixation is a robust parameter in predicting ability. For images with different levels of subtlety of pathoses, the number of fixations, total time spent, and numbers of revisits are important parameters to analyze when comparing observer groups with different levels of experience.