216 research outputs found
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 âwork readyâ and able to âhit the ward runningâ. 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 âreal worldâ. Gibbon (2005) states that âin 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 jigsawâ (p. 6
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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 yearsâ
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
plantâs 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 âwholly-equatesâ to the EPBC Listing Advice
⢠âPotentialâ 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 ârefugialâ, âbufferâ and âleading-edgeâ 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
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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
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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 speciesâ 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
Artificial intelligence for ultrasound scanning in regional anaesthesia: a scoping review of the evidence from multiple disciplines
Background
Artificial intelligence (AI) for ultrasound scanning in regional anaesthesia is a rapidly developing interdisciplinary field. There is a risk that work could be undertaken in parallel by different elements of the community but with a lack of knowledge transfer between disciplines, leading to repetition and diverging methodologies. This scoping review aimed to identify and map the available literature on the accuracy and utility of AI systems for ultrasound scanning in regional anaesthesia.
Methods
A literature search was conducted using Medline, Embase, CINAHL, IEEE Xplore, and ACM Digital Library. Clinical trial registries, a registry of doctoral theses, regulatory authority databases, and websites of learned societies in the field were searched. Online commercial sources were also reviewed.
Results
In total, 13,014 sources were identified; 116 were included for full-text review. A marked change in AI techniques was noted in 2016â17, from which point on the predominant technique used was deep learning. Methods of evaluating accuracy are variable, meaning it is impossible to compare the performance of one model with another. Evaluations of utility are more comparable, but predominantly gained from the simulation setting with limited clinical data on efficacy or safety. Study methodology and reporting lack standardisation.
Conclusions
There is a lack of structure to the evaluation of accuracy and utility of AI for ultrasound scanning in regional anaesthesia, which hinders rigorous appraisal and clinical uptake. A framework for consistent evaluation is needed to inform model evaluation, allow comparison between approaches/models, and facilitate appropriate clinical adoption
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