71 research outputs found
An Exploration of Accountants' Perceptions of Their Learning in Practice
This study arose from an awareness of a need for greater understanding about learning by professional accountants in practice, as a complement to the existing body of knowledge on the provision of education for accountants in practice. The exploration consisted of three stages of enquiry, producing both quantitative and qualitative data from questions asked of six selected, professional, practising accountants. The first stage asked the accountants to describe events, associated with learning, which they considered important to them in their daily practice; the second stage of questions asked the participants to reflect upon these events in the light of their experience; the third stage, in conjunction with the researcher, considered the totality of perceptions of their learning in practice so revealed
Continuing Professional Education in Australia: A Tale of Missed Opportunities
The thesis presents the first reporting of the story of Continuing Professional Education (CPE) in Australia. CPE is a different style of educational provision and has not been recognised as a distinct stand alone sector. However it is perceived in this thesis as an accepted sector and that it is cross-professional and a legitimate part of professional education. The story is not a history of the field. The writer is not an historian but his work as an active participant, researcher, consultant and colleague in the field has allowed him to develop this generalised tale from the individual experiences of the many professions, as managed by their associations. The culmination of the story is the 2010 creation of a national registration regime for select health professions. In the research on CPE's origins and early development, the situation appeared regularly of opportunities that CPE had missed for gaining recognition and acceptance. When similar circumstances were also discovered in more recent years and the current century, the general theme of 'missed opportunities' was adopted. Having established the nature of CPE in an introduction, the origins and early development of CPE are noted. Then the educational context in which CPE developed is described and various opportunities identified
Non-Formal Education in Fiji: The Potential for Primary School-Based Programmes
Non-formal education is an accepted form of education in Fiji. Many programmes have been instituted by different providers either institutionally or community-based. Primary-school-based NFE is a recent innovation initiated mainly by headteachers in some rural schools, with the support of some government and non-government officers. The programmes that have attempted to respond to various perceived needs and problems in the community, showed a stop-start, ad hoc and uncoordinated nature. It will be established in this study whether there is lack of empirical knowledge and understanding of the concept of NFE and the potential of NFE primary-school-based programmes in Fiji. Thus, the central purpose of this study was to explore the potential of NFE primary-school-based programmes in Fiji. The examination of Fiji's socio-economic, cultural and political background provided a context for the study. An examination of western adult education literature was then used to reveal essential features and strategies that were the basis on which an ideal model of NFE was constructed. These key features were of two types. The first feature is related to the conceptualisation of NFE while the remaining seven were concerned with programme planning at various level of organisation. These key features were operationally defined and provided the assumptions that were the basis on which the actual NFE programmes were assessed
The Application of an Adult Learning Approach to Genetic Counselling: An Exploratory Study
The aim of this thesis was to explore the applicability of an adult learning approach to genetic counselling. This exploration commenced by reviewing the literature on genetic counselling and adult learning theory and examining the relationship between the two. Four selected transcripts of genetic counselling sessions were then analysed in two phases. The first phase included the categorisation of genetic counsellee dialogue according to the elements of a form of learning, contemplation, described by Jarvis' (1987) model of adult learning. The second phase included an examination of two aspects of the application of Jarvis' (1987) contemplation learning model which were considered to be important. One of these aspects involved searching the categorised genetic counsellee dialogue for evidence of cognitive versus affective domain material to determine if both could be accounted for. It was assumed that learners do not follow Jarvis' (1987) contemplation learning model in any sequential order. Therefore, the second phase also comprised a line by line analysis of the transcripts. This was intended to show the extent to which the genetic counsellees deviated from the sequence of the model. The review of the literature suggested there was a relationship between adult learning theory and genetic counselling, and analysis of the transcripts supported this. The analysis of the transcripts showed that Jarvis' (1987) contemplation learning model could be used to explore, discuss and understand the process genetic counsellees undergo, in both the cognitive and affective domains, but was not followed in the strict sequential order of Jarvis' (1987) model. The implications of the study for clinical practice, the education of genetic counsellors and future research are discussed
Just a Pretty Picture? The practising artist and the influence of art education in the lives of visual arts graduates
Every year in Australia, around 2000 students graduate from higher education in the visual and performing arts. The intent of many of these visual arts courses in particular, is to produce practising artists. However. the occupation of practising artist is not an easy one in which to survive. In 1999 there were around 16,000 visual. community arts, and craft-persons practising professionally. Therefore, Questions arise as to how the majority of graduates apply their professional knowledge gained in art school? And what happens to these graduates in their later lives? These questions are of importance to tertiary visual art education because the majority of these art school graduates will sooner or later end up working in fields that are ditTerent from the one they trained in, that is, the profession of practising artist
Potential use of oxygen as a metabolic biosensor in combination with T2*-weighted MRI to define the ischemic penumbra
We describe a novel magnetic resonance imaging technique for detecting metabolism indirectly through changes in oxyhemoglobin:deoxyhemoglobin ratios and T2* signal change during âoxygen challengeâ (OC, 5âmins 100% O2). During OC, T2* increase reflects O2 binding to deoxyhemoglobin, which is formed when metabolizing tissues take up oxygen. Here OC has been applied to identify tissue metabolism within the ischemic brain. Permanent middle cerebral artery occlusion was induced in rats. In series 1 scanning (n=5), diffusion-weighted imaging (DWI) was performed, followed by echo-planar T2* acquired during OC and perfusion-weighted imaging (PWI, arterial spin labeling). Oxygen challenge induced a T2* signal increase of 1.8%, 3.7%, and 0.24% in the contralateral cortex, ipsilateral cortex within the PWI/DWI mismatch zone, and ischemic core, respectively. T2* and apparent diffusion coefficient (ADC) map coregistration revealed that the T2* signal increase extended into the ADC lesion (3.4%). In series 2 (n=5), FLASH T2* and ADC maps coregistered with histology revealed a T2* signal increase of 4.9% in the histologically defined border zone (55% normal neuronal morphology, located within the ADC lesion boundary) compared with a 0.7% increase in the cortical ischemic core (92% neuronal ischemic cell change, core ADC lesion). Oxygen challenge has potential clinical utility and, by distinguishing metabolically active and inactive tissues within hypoperfused regions, could provide a more precise assessment of penumbra
Zika virus tropism and interactions in myelinating neural cell cultures: CNS cells and myelin are preferentially affected
The recent global outbreak of Zika virus (ZIKV) infection has been linked to severe neurological disorders affecting the peripheral and central nervous systems (PNS and CNS, respectively). The pathobiology underlying these diverse clinical phenotypes are the subject of intense research; however, even the principal neural cell types vulnerable to productive Zika infection remain poorly characterised. Here we used CNS and PNS myelinating cultures from wild type and Ifnar1 knockout mice to examine neuronal and glial tropism and short-term consequences of direct infection with a Brazilian variant of ZIKV. Cell cultures were infected pre- or post-myelination for various intervals, then stained with cell-type and ZIKV-specific antibodies. In bypassing systemic immunity using ex vivo culture, and the type I interferon response in Ifnar1 deficient cells, we were able to evaluate the intrinsic infectivity of neural cells. Through systematic quantification of ZIKV infected cells in myelinating cultures, we found that ZIKV infection is enhanced in the absence of the type I interferon responses and that CNS cells are considerably more susceptible to infection than PNS cells. In particular, we demonstrate that CNS axons and myelinating oligodendrocytes are especially vulnerable to injury. These results have implications for understanding the pathobiology of neurological symptoms associated with ZIKV infection. Furthermore, we provide a quantifiable ex vivo infection model that can be used for fundamental and therapeutic studies on viral neuroinvasion and its consequences
Assessment of the impact of the scanner-related factors on brain morphometry analysis with Brainvisa.
BACKGROUND: Brain morphometry is extensively used in cross-sectional studies. However, the difference in the estimated values of the morphometric measures between patients and healthy subjects may be small and hence overshadowed by the scanner-related variability, especially with multicentre and longitudinal studies. It is important therefore to investigate the variability and reliability of morphometric measurements between different scanners and different sessions of the same scanner. METHODS: We assessed the variability and reliability for the grey matter, white matter, cerebrospinal fluid and cerebral hemisphere volumes as well as the global sulcal index, sulcal surface and mean geodesic depth using Brainvisa. We used datasets obtained across multiple MR scanners at 1.5 T and 3 T from the same groups of 13 and 11 healthy volunteers, respectively. For each morphometric measure, we conducted ANOVA analysis and verified whether the estimated values were significantly different across different scanners or different sessions of the same scanner. The between-centre and between-visit reliabilities were estimated from their contribution to the total variance, using a random-effects ANOVA model. To estimate the main processes responsible for low reliability, the results of brain segmentation were compared to those obtained using FAST within FSL. RESULTS: In a considerable number of cases, the main effects of both centre and visit factors were found to be significant. Moreover, both between-centre and between-visit reliabilities ranged from poor to excellent for most morphometric measures. A comparison between segmentation using Brainvisa and FAST revealed that FAST improved the reliabilities for most cases, suggesting that morphometry could benefit from improving the bias correction. However, the results were still significantly different across different scanners or different visits. CONCLUSIONS: Our results confirm that for morphometry analysis with the current version of Brainvisa using data from multicentre or longitudinal studies, the scanner-related variability must be taken into account and where possible should be corrected for. We also suggest providing some flexibility to Brainvisa for a step-by-step analysis of the robustness of this package in terms of reproducibility of the results by allowing the bias corrected images to be imported from other packages and bias correction step be skipped, for example.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are
Utilisation of an operative difficulty grading scale for laparoscopic cholecystectomy
Background
A reliable system for grading operative difficulty of laparoscopic cholecystectomy would standardise description of findings and reporting of outcomes. The aim of this study was to validate a difficulty grading system (Nassar scale), testing its applicability and consistency in two large prospective datasets.
Methods
Patient and disease-related variables and 30-day outcomes were identified in two prospective cholecystectomy databases: the multi-centre prospective cohort of 8820 patients from the recent CholeS Study and the single-surgeon series containing 4089 patients. Operative data and patient outcomes were correlated with Nassar operative difficultly scale, using Kendallâs tau for dichotomous variables, or JonckheereâTerpstra tests for continuous variables. A ROC curve analysis was performed, to quantify the predictive accuracy of the scale for each outcome, with continuous outcomes dichotomised, prior to analysis.
Results
A higher operative difficulty grade was consistently associated with worse outcomes for the patients in both the reference and CholeS cohorts. The median length of stay increased from 0 to 4 days, and the 30-day complication rate from 7.6 to 24.4% as the difficulty grade increased from 1 to 4/5 (both pâ<â0.001). In the CholeS cohort, a higher difficulty grade was found to be most strongly associated with conversion to open and 30-day mortality (AUROCâ=â0.903, 0.822, respectively). On multivariable analysis, the Nassar operative difficultly scale was found to be a significant independent predictor of operative duration, conversion to open surgery, 30-day complications and 30-day reintervention (all pâ<â0.001).
Conclusion
We have shown that an operative difficulty scale can standardise the description of operative findings by multiple grades of surgeons to facilitate audit, training assessment and research. It provides a tool for reporting operative findings, disease severity and technical difficulty and can be utilised in future research to reliably compare outcomes according to case mix and intra-operative difficulty
Populationâbased cohort study of outcomes following cholecystectomy for benign gallbladder diseases
Background The aim was to describe the management of benign gallbladder disease and identify characteristics associated with allâcause 30âday readmissions and complications in a prospective populationâbased cohort. Methods Data were collected on consecutive patients undergoing cholecystectomy in acute UK and Irish hospitals between 1 March and 1 May 2014. Potential explanatory variables influencing allâcause 30âday readmissions and complications were analysed by means of multilevel, multivariable logistic regression modelling using a twoâlevel hierarchical structure with patients (level 1) nested within hospitals (level 2). Results Data were collected on 8909 patients undergoing cholecystectomy from 167 hospitals. Some 1451 cholecystectomies (16·3 per cent) were performed as an emergency, 4165 (46·8 per cent) as elective operations, and 3293 patients (37·0 per cent) had had at least one previous emergency admission, but had surgery on a delayed basis. The readmission and complication rates at 30 days were 7·1 per cent (633 of 8909) and 10·8 per cent (962 of 8909) respectively. Both readmissions and complications were independently associated with increasing ASA fitness grade, duration of surgery, and increasing numbers of emergency admissions with gallbladder disease before cholecystectomy. No identifiable hospital characteristics were linked to readmissions and complications. Conclusion Readmissions and complications following cholecystectomy are common and associated with patient and disease characteristics
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