Assessment of Professional Competence in a Construction Management Problem-based Learning Setting

This paper discusses the congruence between problem-based learning (PBL) and competencybased assessment and describes how competency based assessment has been implementedin a professional construction management programme. The design andunderlying principles of assessment approaches used to determine students' professionalcompetence through use of professional standards to frame learning and assessment arediscussed. Through presentation of preliminary findings of a case study that explores staffand student experiences in the construction management programme, the authors describethe issues and challenges they have encountered in implementing competencybased assessment in a PBL programme within the context of higher education

Primary care screening for peripheral arterial disease:a cross-sectional observational study

Background Early identification of peripheral arterial disease (PAD) and subsequent instigation of risk modification strategies could minimise disease progression and reduce overall risk of cardiovascular (CV) mortality. However, the feasibility and value of primary care PAD screening is uncertain. Aim This study (the PIPETTE study — Peripheral arterial disease In Primary carE: Targeted screening and subsequenT managEment) aimed to determine the value of a proposed primary care PAD screening strategy. Outcomes assessed were: prevalence of PAD and agreement of ankle– brachial index (ABI)-defined PAD (ABI ≤0.9) with QRISK®2-defined high CV risk (≥20). Design and setting A cross-sectional observational study was undertaken in a large general practice in Merthyr Tydfil, Wales. Method In total, 1101 individuals with ≥2 pre-identified CV risk factors but no known CV disease or diabetes were invited to participate. Participants underwent ABI measurement and QRISK2 assessment, and completed Edinburgh Claudication Questionnaires. Results A total of 368 people participated in the study (participation rate: 33%). Prevalence of PAD was 3% (n = 12). The number needed to screen (NNS) to detect one new case of PAD was 31. Refining the study population to those aged ≥50 years with a smoking history reduced the NNS to 14, while still identifying 100% of PAD cases. Of participants with PAD, 33% reported severe lifestyle-limiting symptoms of intermittent claudication that warranted subsequent endovascular intervention, yet had not previously presented to their GP. The QRISK2 score predicted high CV risk in 92% of participants with PAD. Conclusion The low PAD yield and the fact that QRISK2 was largely comparable to the ABI in predicting high CV risk suggests that routine PAD screening may be unwarranted. Instead, strategies to improve public awareness of PAD are neede

Neurospora msh4 ortholog confirmed by split-marker deletion

Although most eukaryotes have both MSH4 and MSH5 orthologs, Neurospora was initially thought to lack msh-4. We have deleted the most likely msh-4 candidate and observed a delay in the sexual cycle, disruption to meiosis and a reduction in fertility. Deletion is dominant, showing msh-4 is subject to MSUD. We conclude that Neurospora has a MSH4 ortholog and that it may have remained undetected because of an unusually high number of introns

DETERMINING THE TOXICITY OF THE UV FILTER OXYBENZONE IN THE HARD CORAL, GALAXEA FASCICULARIS

Despite limited toxicological studies of UV filters in corals, legislative activity in Hawaii and other locations has led to bans on the sale and/or use of sunscreens containing the active ingredient oxybenzone (BP-3). The few published coral toxicity studies on BP-3 are difficult to compare due to varied methodology and inconstant acute and chronic toxicological responses. Therefore, I conducted repeated acute (96-hour) toxicity tests with copper and a common hard coral, Galaxea fascicularis, based on standard invertebrate toxicity testing guidelines to determine the species’ utility as a standard testing organism as well as the utility of copper as a positive control. This was followed by acute and chronic (28-day) toxicity tests with BP-3 using the same methodology to determine this compound’s toxicity. Multiple endpoints pertinent to risk assessments (mortality and growth) and additional biological endpoints were examined. Using these results, preliminary risk quotients of BP-3 and Galaxea fascicularis were calculated

An Exploration of Nurses’ health beliefs: Ways of Knowing and Implications for Learning and Teaching

Background The origin, evolution and potential impact of personal ways of knowing, underpinned by health beliefs, are shaped by experience and sociocultural factors. These need to be explored if contemporary nurse educators and clinicians are to realize the goals of promoting healthy, positive outcomes for their clientele that are founded in other ways of knowing. Problem- based learning is argued to be an approach to the design of learning that encourages critical thinking and supports learners to develop new ways of thinking about real life problems. This requires an ability to integrate multiple ways of knowing to create and modify personal beliefs and learn. Method Q-methodology was used to gain the perspectives of nurses’ health beliefs and sources of knowledge from 236 nurses, clinical and academic, from Thailand, South Korea, Australia, China and Japan. Results and conclusions The study revealed tensions between personal beliefs, often nested in cultural traditions, and contemporary evidence that counters those beliefs. Three themes relevant to nurses’ ‘ways of knowing’ emerged: sources of belief, unexamined beliefs, and knowing from experience. The sorting process acted as intervention in itself to create dissonance within the nurses about the sources and veracity of their beliefs. The study illuminated a need to recognise that critical health literacy, seen as the hallmark of contemporary practice, may be at odds with personal beliefs, values and culture

Warfarin prevalence, indications for use and haemorrhagic events

Warfarin, the standard oral anticoagulant drug used in Ireland, is a widely prescribed medication, particularly in the elderly. A HSE Mid-Western Area wide audit was undertaken over a 12-month period to examine the prevalence and indications for warfarin use and haemorrhagic complications associated with the drug. Every patient receiving warfarin therapy over a 13-week period was included (2564). The age standardised rate varied from 0.09% of 35-39 year olds to 6.1% of 80-84 year olds. Atrial fibrillation was the most common indication (54%) in patients attending the Mid-Western Regional Hospital anticoagulation clinic. The annual cumulative incidence of adverse haemorrhagic events in patients with a recorded INR > or = 5.0 episode was 16.6%. The incidence of major and minor haemorrhagic events per INR > or = 5.0 episode was 1.3% and 15.3% respectively. The most common sites of haemorrhage were genitourinary (39%) and gastrointestinal (27%). No fatal or intracranial haemorrhage relating to episodes of over-anticoagulation were reported during the audit period. The most frequent reason for over-anticoagulation was drug interaction (43%). In 74% of patients, the elevated INR was reversed by omitting or reducing warfarin dose. In 17% of cases, vitamin K was administered. Only 3% of incidents were treated with fresh frozen plasma or prothrombin complex concentrates.Warfarin, the standard oral anticoagulant drug used in Ireland, is a widely prescribed medication, particularly in the elderly. A HSE Mid-Western Area wide audit was undertaken over a 12-month period to examine the prevalence and indications for warfarin use and haemorrhagic complications associated with the drug. Every patient receiving warfarin therapy over a 13-week period was included (2564). The age standardised rate varied from 0.09% of 35-39 year olds to 6.1% of 80-84 year olds. Atrial fibrillation was the most common indication (54%) in patients attending the Mid-Western Regional Hospital anticoagulation clinic. The annual cumulative incidence of adverse haemorrhagic events in patients with a recorded INR > or = 5.0 episode was 16.6%. The incidence of major and minor haemorrhagic events per INR > or = 5.0 episode was 1.3% and 15.3% respectively. The most common sites of haemorrhage were genitourinary (39%) and gastrointestinal (27%). No fatal or intracranial haemorrhage relating to episodes of over-anticoagulation were reported during the audit period. The most frequent reason for over-anticoagulation was drug interaction (43%). In 74% of patients, the elevated INR was reversed by omitting or reducing warfarin dose. In 17% of cases, vitamin K was administered. Only 3% of incidents were treated with fresh frozen plasma or prothrombin complex concentrates