Problem-Based Learning in Action: The Development of the Virtual Health and Wellness Centre

Nursing education in Australia has undergone significant change over the past 30 years. Most notably, the transfer from a traditional apprenticeship model to that of a professional degree based course in the tertiary sector. Contemporary healthcare institutions demand graduates who are ‘work ready’ and able to ‘hit the ward running’. The demographics of the Australian population indicate that groups of culturally diverse individuals are seeking healthcare along with an ageing population of Australians who have unique needs. The growing demand for more highly trained, work ready nurses has landed squarely on the shoulders of universities providing comprehensive nursing education. The problem now for nurse educators is to facilitate teaching and learning strategies that will engage the student nurse in processes that promote critical thinking and problem solving in the work place. While various models and curricula are in use across Australia in pre-registration nursing education, there is growing evidence to suggest that Problem-Based Learning (PBL) is perhaps the most suited to producing professionals who are able to problem solve and address the multiple demands of an ever changing environment. The introduction of a PBL curriculum will meet this demand. Here at Edith Cowan University, the School of Nursing Midwifery and Postgraduate Medicine has undertaken a pilot project introducing a web based resource to align with the introduction of a hybrid PBL curricula. Undergraduate nursing students undertaking the Bachelor of Science (Nursing) were given the opportunity to meet a paediatric patient in the Virtual Health and Wellness Centre. This virtual site enables nursing students to explore case study in various nursing areas such as paediatrics, critical care, medical/surgical and aged care. Students progress through a scenario which incorporates theory relating to anatomy and physiology, pathophysiology, pharmacology, psychosocial issues, research, professional issues and relevant nursing skills. Each scenario is formulated around a set of learning outcomes, which are evaluated by the student at the completion of the case study. During practical laboratory sessions students are able to contextualise their learning and seek informal peer feedback. The development of these case scenarios are context rich and built around the central aim of engaging students in self-directed learning. This discovery learning leads to higher comprehension and transferability of knowledge. Students will be able to practice the skills and theory in practical laboratory sessions which adds a functional dimension to the online material making the meanings derived from the combination of theory and practice more profound and ‘real world’. Gibbon (2005) states that “in PBL we take a collection of information, pertinent to the problem. We learn a little about each and synthesise it to solve the problem, like a jigsaw” (p. 6

Modelling the spatial variation in Alopecurus myosuroides for precision weed management

Alopecurus myosuroides Huds. (black-grass) grows in patches within fields. This presents an opportunity for site-specific management by patch spraying. Despite the economic and environmental benefits of this type of management, it is not being readily taken up by farmers, largely due to the risk of missing weeds that fall outside of established patches. I focus on the environmental determinants of patch location in A. myosuroides and the scale-dependence of relationships between A. myosuroides and environmental properties. Understanding these relationships allowed me to determine which abiotic factors can be used to identify A. myosuroides vulnerable zones within fields and if these relationships occur at scales appropriate for management. This presents a more conservative approach than patch spraying according to observations of previous years’ infestations, as a greater area of the field is sprayed, yet the overall use of pesticide is still reduced. By combining field work, pot experiments, and modelling, I discovered that soil organic matter, water, and pH, amongst other environmental properties, show strong scale-dependent relationships with the within-field distribution of A. myosuroides. These relationships between A. myosuroides and soil properties were often strongest at coarse scales making them particularly useful for the implementation of management practices, which are often limited to coarse-scale implementation by the available machinery. The effects of these soil properties on A. myosuroides are both direct (affecting the plant’s life-cycle) and indirect (altering herbicide efficacy). The incremental changes I observed to different aspects of the life-cycle due to soil properties may seem too small to be of consequence when studied independently, yet when combined in a modelling approach their additive nature revealed them as important determinants of the withinfield distribution of this species and the coarse-scale relationships observed in the field are an emergent property of the model

Mapping to underpin management of tropical littoral rainforest

[Extract] The aim of the project was to produce fine-resolution mapping of the location of the critically endangered Littoral Rainforest & Coastal Vine Thickets of Eastern Australia ecological community (LRF) between Townsville and Cooktown and the threats to its persistence and condition from the impacts of sea-level rise, storm surge and extreme weather events. A pilot study conducted in the Mission Beach area (Metcalfe et al. 2014) developed a mapping approach which accounts for the identification and distribution of Littoral rainforest consistent with the Listing Advice. This project extended that approach across the distribution of the ecological community from Townville to Cooktown. This project used coastal LiDAR data (1 m grid, 0.15 m accuracy) to compile fine-scale terrain layers to derive inundation levels for an 80 cm sea-level rise and for eight storm surge Annual Recurrence Intervals (ARIs) between 20 and 10,000 years. Spatial layers of the location of LRF and inundation were overlaid to determine the probability and magnitude of risk to the ecological community from these effects and to prioritise management interventions. The following spatial layers were derived and are available at the CSIRO data portal: • LRF vegetation that ‘wholly-equates’ to the EPBC Listing Advice • ‘Potential’ LRF delineating areas consistent with broad characteristics of the community described in the EPBC Listing Advice • Inundation statistics for each patch of wholly-equate LRF and potential LRF (patches defined by RE mapping) indicating: o the proportion of each patch inundated with 80 cm sea-level rise o the proportion of each patch inundated at each of 8 ARIs with and without sea-level rise o the ARI at which a patch first becomes inundated o the ARI at which a patch is >20% inundated o the ARI at which a patch is >50% inundated We describe the distribution and extent of LRF in the study region, the current pressures on LRF in the region and the distribution of LRF in the region with respect to the conservation estate and other tenures. Our mapping and inundation analysis can be used to define a number of different roles of LRF in the landscape on which a portfolio of management approaches can be derived which allow for the short-, medium- and long-term effects of sea-level rise and storm surge. We define ‘refugial’, ‘buffer’ and ‘leading-edge’ LRF patches by the relative frequency at which they become inundated and suggest management actions to improve resilience of the community as a whole

Policing and Health Collaboration in England and Wales. Landscape review.

The links between health, offending and policing are complex but inextricable. Collaborative working between the police and health has a long history but is still not commonplace. This landscape review aims to consider the breadth of the subject, and also to look at emerging themes and to influence future approaches

The implications of spatially variable pre-emergence herbicide efficacy for weed management

BACKGROUND The efficacy of pre-emergence herbicides within fields is spatially variable due to soil heterogeneity. We quantified the effect of soil organic matter on the efficacy of two pre-emergence herbicides; flufenacet and pendimethalin, against A. myosuroides and investigated the implications of variation in organic matter for weed management using a crop-weed competition model. RESULTS Soil organic matter played a critical role in determining the level of control achieved. The high organic matter soil had more surviving weeds with higher biomass than the low organic matter soil. In the absence of competition, surviving plants recovered to produce the same amount of seed as if no herbicide were applied. The competition model predicted that weeds surviving pre-emergence herbicides could compensate for sub-lethal effects even when competing with the crop. The ED50 was higher for weed seed production than seedling mortality or biomass. This difference was greatest on high organic matter soil. CONCLUSION These results show that the application rate of herbicides should be adjusted to account for within-field variation in soil organic matter. The results from the modelling emphasised the importance of crop competition in limiting the capacity of weeds surviving pre-emergence herbicides to compensate and replenish the seedbank

An adaptive two-arm clinical trial using early endpoints to inform decision making : design for a study of sub-acromial spacers for repair of rotator cuff tendon tears

Background There is widespread concern across the clinical and research communities that clinical trials, powered for patient-reported outcomes, testing new surgical procedures are often expensive and time-consuming, particularly when the new intervention is shown to be no better than the standard. Conventional (non-adaptive) randomised controlled trials (RCTs) are perceived as being particularly inefficient in this setting. Therefore, we have developed an adaptive group sequential design that allows early endpoints to inform decision making and show, through simulations and a worked example, that these designs are feasible and often preferable to conventional non-adaptive designs. The methodology is motivated by an ongoing clinical trial investigating a saline-filled balloon, inserted above the main joint of the shoulder at the end of arthroscopic debridement, for treatment of tears of rotor cuff tendons. This research question and setting is typical of many studies undertaken to assess new surgical procedures. Methods Test statistics are presented based on the setting of two early outcomes, and methods for estimation of sequential stopping boundaries are described. A framework for the implementation of simulations to evaluate design characteristics is also described. Results Simulations show that designs with one, two and three early looks are feasible and, with appropriately chosen futility stopping boundaries, have appealing design characteristics. A number of possible design options are described that have good power and a high probability of stopping for futility if there is no evidence of a treatment effect at early looks. A worked example, with code in R, provides a practical demonstration of how the design might work in a real study. Conclusions In summary, we show that adaptive designs are feasible and could work in practice. We describe the operating characteristics of the designs and provide guidelines for appropriate values for the stopping boundaries for the START:REACTS (Sub-acromial spacer for Tears Affecting Rotator cuff Tendons: a Randomised, Efficient, Adaptive Clinical Trial in Surgery) study

Species matter when considering landscape effects on carabid distributions

Increasing the abundance and diversity of carabid beetles is a common objective of farm habitat management to deliver sustainable pest control. Carabid spatial distributions in relation to crop areas are important to the delivery of this ecosystem service. We used pitfall count data at distances from edge habitats into crop centres, from farm sites across the UK, to determine the effects of in-field and adjacent environmental features on carabid abundance and diversity. Overall carabid abundance increased towards the crop centre, whilst species richness and diversity decreased. The analyses of carabid abundance based on all the species pooled together strongly reflected the behaviour of the most abundant species. Species preferences varied by crop, soil type, and environmental features. For instance, some species were positively associated with habitats such as margins, while others responded negatively. This contrast in individual species models highlights the limitations on pooled models in elucidating responses. Studies informing farm-habitat design should consider individual species’ preferences for effective enhancement of pest control services. Diverse cropping and landscape heterogeneity at the farm scale can benefit the varied preferences of individual species, help build diverse communities and, potentially increase service resilience and stability over time

The utility of the ‘Arable Weeds and Management in Europe’ database: Challenges and opportunities of combining weed survey data at a European scale

Over the last 30 years, many studies have surveyed weed vegetation on arable land. The ‘Arable Weeds and Management in Europe’ (AWME) database is a collection of 36 of these surveys and the associated management data. Here, we review the challenges associated with combining disparate datasets and explore some of the opportunities for future research that present themselves thanks to the AWME database. We present three case studies repeating previously published national scale analyses with data from a larger spatial extent. The case studies, originally done in France, Germany and the UK, explore various aspects of weed ecology (community composition, management and environmental effects and within-field distributions) and use a range of statistical techniques (canonical correspondence analysis, redundancy analysis and generalised linear mixed models) to demonstrate the utility and versatility of the AWME database. We demonstrate that (i) the standardisation of abundance data to a common measure, before the analysis of the combined dataset, has little impact on the outcome of the analyses, (ii) the increased extent of environmental or management gradients allows for greater confidence in conclusions and (iii) the main conclusions of analyses done at different spatial scales remain consistent. These case studies demonstrate the utility of a Europe-wide weed survey database, for clarifying or extending results obtained from studies at smaller scales. This Europe-wide data collection offers many more opportunities for analysis that could not be addressed in smaller datasets; including questions about the effects of climate change, macro-ecological and biogeographical issues related to weed diversity as well as the dominance or rarity of specific weeds in Europe.Publishe