Patients’ and health professionals’ views and experiences of atrial fibrillation and oral-anticoagulant therapy:a qualitative meta-synthesis

Objective - Atrial fibrillation (AF) patients are prescribed oral-anticoagulant (OAC) therapy, often warfarin, to reduce stroke risk. We explored existing qualitative evidence about patients’ and health professionals’ experiences of OAC therapy. Methods - Systematic searches of eight bibliographic databases were conducted. Quality was appraised using the Critical Appraisal Skills Programme tool and data from ten studies were synthesised qualitatively. Results - Four third-order constructs, emerged from the final step in the analysis process: (1) diagnosing AF and the communication of information, (2) deciding on OAC therapy, (3) challenges revolving around patient issues, and (4) healthcare challenges. Synthesis uncovered perspectives that could not be achieved through individual studies. Conclusion - Physicians’ and patients’ experiences present a dichotomy of opinion on decision-making, which requires further exploration and changes in practice. Outcomes of workload pressure on both health professionals and patients should be investigated. The need for on-going support and education to patients and physicians is critical to achieve best practice and treatment adherence. Practice implications - Such research could encourage health professionals to understand and attend better to the needs and concerns of the patient. Additionally these findings can be used to inform researchers and healthcare providers in developing educational interventions with both patients and health professionals.

Contrasting views and experiences of health professionals on the management of comorbid substance misuse and mental disorders

Objectives: To determine opinions and experiences of health professionals concerning the management of people with comorbid substance misuse and mental health disorders. Method: We conducted a survey of staff from mental health services and alcohol and drug services across Queensland. Survey items on problems and potential solutions had been generated by focus groups. Results: We analysed responses from 112 staff of alcohol and drug services and 380 mental health staff, representing a return of 79% and 42% respectively of the distributed surveys. One or more issues presented a substantial clinical management problem for 98% of respondents. Needs for increased facilities or services for dual disorder clients figured prominently. These included accommodation or respite care, work and rehabilitation programs, and support groups and resource materials for families. Needs for adolescent dual diagnosis services and after-hours alcohol and drug consultations were also reported. Each of these issues raised substantial problems for over 70% of staff. Another set of problems involved coordination of client care across mental health and alcohol and drug services, including disputes over duty of care. Difficulties with intersectoral liaison were more pronounced for alcohol and drug staff than for mental health. A majority of survey respondents identified 13 solutions as practical. These included routine screening for dual diagnosis at intake, and a range of proposals for closer intersectoral communication such as exchanging client information, developing shared treatment plans, conducting joint case conferences and offering consultation facilities. Conclusions: A wide range of problems for the management of comorbid disorders were identified. While solution of some problems will require resource allocation, many may be addressed by closer liaison between existing services.

Issues and concerns of microscopic calibration process at different network levels : case study of Pacific Motorway

Calibration process in micro-simulation is an extremely complicated phenomenon. The difficulties are more prevalent if the process encompasses fitting aggregate and disaggregate parameters e.g. travel time and headway. The current practice in calibration is more at aggregate level, for example travel time comparison. Such practices are popular to assess network performance. Though these applications are significant there is another stream of micro-simulated calibration, at disaggregate level. This study will focus on such microcalibration exercise-key to better comprehend motorway traffic risk level, management of variable speed limit (VSL) and ramp metering (RM) techniques. Selected section of Pacific Motorway in Brisbane will be used as a case study. The discussion will primarily incorporate the critical issues encountered during parameter adjustment exercise (e.g. vehicular, driving behaviour) with reference to key traffic performance indicators like speed, lane distribution and headway; at specific motorway points. The endeavour is to highlight the utility and implications of such disaggregate level simulation for improved traffic prediction studies. The aspects of calibrating for points in comparison to that for whole of the network will also be briefly addressed to examine the critical issues such as the suitability of local calibration at global scale. The paper will be of interest to transport professionals in Australia/New Zealand where micro-simulation in particular at point level, is still comparatively a less explored territory in motorway management.

Issues and concerns of microscopic calibration process at different network levels : case study of pacific motorway

Calibration process in micro-simulation is an extremely complicated phenomenon. The difficulties are more prevalent if the process encompasses fitting aggregate and disaggregate parameters e.g. travel time and headway. The current practice in calibration is more at aggregate level, for example travel time comparison. Such practices are popular to assess network performance. Though these applications are significant there is another stream of micro-simulated calibration, at disaggregate level. This study will focus on such micro-calibration exercise-key to better comprehend motorway traffic risk level, management of variable speed limit (VSL) and ramp metering (RM) techniques. Selected section of Pacific Motorway in Brisbane will be used as a case study. The discussion will primarily incorporate the critical issues encountered during parameter adjustment exercise (e.g. vehicular, driving behaviour) with reference to key traffic performance indicators like speed, land distribution and headway; at specific motorway points. The endeavour is to highlight the utility and implications of such disaggregate level simulation for improved traffic prediction studies. The aspects of calibrating for points in comparison to that for whole of the network will also be briefly addressed to examine the critical issues such as the suitability of local calibration at global scale. The paper will be of interest to transport professionals in Australia/New Zealand where micro-simulation in particular at point level, is still comparatively a less explored territory in motorway management.

Screening to identify large truck potential blackspots : methodological issues and concerns

1. Overview of hotspot identification (HSID)methods 2. Challenges with HSID 3. Bringing crash severity into the ‘mix’ 4. Case Study: Truck Involved Crashes in Arizona 5. Conclusions • Heavy duty trucks have different performance envelopes than passenger cars and have more difficulty weaving, accelerating, and braking • Passenger vehicles have extremely limited sight distance around trucks • Lane and shoulder widths affect truck crash risk more than passenger cars • Using PDOEs to model truck crashes results in a different set of locations to examine for possible engineering and behavioral problems • PDOE models point to higher societal cost locations, whereas frequency models point to higher crash frequency locations • PDOE models are less sensitive to unreported crashes • PDOE models are a great complement to existing practice

Pre-service Physical Education teachers and concerns regarding their ability to successfully facilitate school-based physical activity promotion strategies

Regular physical activity (PA) in youth has numerous immediate and long-term health benefits. With several studies indicating low levels of youth PA globally, schools settings have become increasingly critical settings for youth health promotion strategies. The role of physical education (PE) teachers has long been considered central to the facilitation of such strategies. However, PE teachers have a selfreported lack of knowledge, skills, understanding, and competence to successfully implement these strategies. Tertiary education programs are fundamental to adequately preparing, and shaping the attitudes and philosophies of future PE teachers towards their involvement within these programs. The aim of this investigation was to explore the beliefs and perceptions of future secondary school PE teachers, regarding their potential roles in future school-based programs designed to promote student PA. Fifty-seven (21 males and 36 females) pre-service PE teachers completed a series of open-ended survey questions concerning their perceptions towards participating in school-based PA promotion programs both as preservice during practicum, and prospectively as practising teachers. Responses were analysed thematically. Participants responded both positively and enthusiastically to both questions. Concerns regarding time, and the intention or expectation to participate in such programs were also key themes for pre-service and practicing teacher participation respectively. Critically in this study, participants did not identify any limitations which may impact upon their ability to successfully promote youth PA in school settings. This may indicate that participants have misconceptions regarding their ability to fulfil this role, or conversely, the deficiency of current PE teachers regarding school-based PA promotion has been recognised by the tertiary institution, and addressed to adequately prepare its students. School-based PA promotion is an integral element of pre-service PE teacher education, and ongoing professional development of practicing PE teachers. This trend is expected to continue in the future, in order to address ongoing public health concerns.

A profile of Australian travel journalists' professional views and ethical standards

Despite significant changes in mainstream journalism in recent decades, journalistic fields beyond the news have been little explored. In an attempt to contribute to a deeper understanding of such fields, this article examines the role perceptions of 85 Australian travel journalists. By viewing travel journalism as a distinct field of practice that is affected by a unique mix of influences, this study identifies five dimensions of practitioners’ role perceptions. These relate to travel journalists’ views of themselves as Cultural Mediators, Critics, Entertainers, Information Providers and Travellers. In addition, the study examines in some depth the ethical standards of travel journalists. Determinants of these views and standards are explored. The study argues that, in light of travel journalists’ increasingly important role in reporting about foreign places, more remains to be done to promote travel stories that show a deeper understanding of other cultures and which contain a more critical appraisal of destinations.

Psycho-educational assessment of specific learning disabilities: Views and practices of Australian psychologists and guidance counsellors

This paper reports an investigation of the views and practices of 203 Australian psychologists and guidance counsellors with respect to psycho-educational assessment of students with Specific Learning Disabilities (SLDs). Results from an online survey indicated that practitioners draw upon a wide-range of theoretical perspectives when conceptualising and identifying SLDs, including both response to intervention and IQ – achievement discrepancy models. Intelligence tests (particularly the Wechsler scales) are commonly employed, with the main stated reasons for their use being ‘traditional’ perspectives (including IQ-achievement discrepancy-based definitions of SLDs), to exclude a diagnosis of intellectual disability, and to guide further assessment and intervention. In contrast participants reported using measures of academic achievement and tests of specific cognitive deficits known to predict SLDs (e.g., phonological awareness) relatively infrequently.

INSA: new initiatives and concerns

The Indian National Science Academy (INSA), New Delhi which is currently in its Platinum Jubilee year, has maintained its eminence and dignity all these years. The Fellowship of INSA is highly cherished. The Academy enjoys considerable prestige. This prestige needs to be converted into influence. INSA is in the process of setting up a Science Policy Study Cell. The Academy needs to strengthen its role as a think-tank in the service of the nation on science-related issues. INSA is also in the process of establishing an archive. We can understand the present and plan for the future only in the context of the past. Thirdly, we would like to establish an electronic hub of science information at INSA. We do not wish to solely hold large quantities of information. But we need to have links with all major depositories of science- related information in the country. This is in consonance with the general philosophy of an Academy. The Academy is not a major implementer or executor of policies and programmes. It is a catalyst and a beacon that guides.

Australian journalism students’ professional views and news consumption: Results from a representative study

Journalism education’s role in shaping students’ professional views has been a topic of interest among scholars for the past decade in particular. Increasing numbers of studies are concerned with examining students’ backgrounds and views in order to identify what role exposure to the tertiary environment may play in socializing them into the industry. This study reports on the results of the largest survey of Australian journalism students undertaken to date, with a sample size of 1884 students. The study finds that time spent studying journalism appears to be related to changes in role perceptions and news consumption. Final-year students are significantly more likely to support journalism’s watchdog role and to reject consumer-oriented and ‘loyal’ roles. They also consume more news than first-year students. On the other hand, journalism education appears to have little impact on views of controversial practices, with only marginal differences between final- and first-year students.

Localized data gathering paradigms for small and marginal farm lands in Semi-Arid region – Issues and Concerns

In this work we explore the application of wireless sensor technologies for the benefit of small and marginal farmers in semi-arid regions. The focus in this paper is to discuss the merits and demerits of data gathering & relay paradigms that collect localized data over a wide area. The data gathered includes soil moisture, temperature, pressure, rain data and humidity. The challenge to technology intervention comes mainly due to two reasons: (a) Farmers in general are interested in crop yield specific to their piece of land. This is because soil texture can vary rapidly over small regions. (b) Due to a high run-off, the soil moisture retention can vary from region to region depending on the topology of the farm. Both these reasons alter the needs drastically. Additionally, small and marginal farms can be sandwiched between rich farm lands. The village has very little access to grid power. Power cuts can extend up to 12 hours in a day and upto 3 or 4 days during some months in the year. In this paper, we discuss 3 technology paradigms for data relaying. These include Wi-Fi (Wireless Fidelity), GPRS (General Packet Radio Service) and DTN (Delay and Disruption Tolerant Network) technologies. We detail the merits and demerits of each of these solutions and provide our final recommendations. The project site is a village called Chennakesavapura in the state of Karnataka, India.

Rescue, rehabilitation, and release of marine mammals: An analysis of current views and practices.

Stranded marine mammals have long attracted public attention. Those that wash up dead are, for all their value to science, seldom seen by the public as more than curiosities. Animals that are sick, injured, orphaned or abandoned ignite a different response. Generally, public sentiment supports any effort to rescue, treat and return them to sea. Institutions displaying marine mammals showed an early interest in live-stranded animals as a source of specimens -- in 1948, Marine Studios in St. Augustine, Florida, rescued a young short-finned pilot whale (Globicephala macrorhynchus), the first ever in captivity (Kritzler 1952). Eventually, the public as well as government agencies looked to these institutions for their recognized expertise in marine mammal care and medicine. More recently, facilities have been established for the sole purpose of rehabilitating marine mammals and preparing them for return to the wild. Four such institutions are the Marine Mammal Center (Sausalito, CA), the Research Institute for Nature Management (Pieterburen, The Netherlands), the RSPCA, Norfolk Wildlife Hospital (Norfolk, United Kingdom) and the Institute for Wildlife Biology of Christian-Albrects University (Kiel, Germany).(PDF contains 68 pages.)