The Role of Volunteer Leaders in Deepening the Efforts of a Communitywide Youth Asset-building Initiative

This paper examines, from a community-building perspective, the importance of engaging adults in a deliberate way to deepen asset-building efforts that will benefit the lives of young people. This was done through a leadership application project focused on volunteer adult leaders who connected, equipped and inspired small groups through discussions that deepen their understanding and actions in support of young people. Areas of study include the role of community, volunteer leader attributes, and small group structures. In addition, the project included the development of a guided discussion curriculum for use by volunteer leaders. The paper includes a methodology with a timeline and concludes with a discussion about lessons learned and recommendations for the future of the pilot

FRIC: an expert system to recognize fricatives

In building a speaker independent continuous speech understanding sys tem, a method is needed to translate the speech signal to a phoneme string. Current recognition attempts based on statistical methods are not as accurate as desired and require vast numbers of templates for comparison. On the other hand, human experts can transcribe phoneme strings from spectrograms with a high degree of accuracy, without needing to match unidentified seg ments against identified templates. This paper discusses the development of Fric, an expert system for identifying fricative phonemes, intended to func tion as part of a phoneme identification knowledge source. Fric attempts to mimic the techniques used by human transcribers in identifying phonemes. RuleMaster, an expert system building tool developed by Radian Corporation, was used to create this system. Fric uses both forward and backward chaining as control strategies and includes an explanation system for both debugging and explanatory purposes

An Evaluation of Purebred Bull Pricing: Implications for Beef Herd Management

The selection of herd bulls is important in determining profitability of commercial ranchers and cow-calf operators as well as purebred producers. In this research, the key attributes of bulls – based on visual, performance, and ultrasound data – are valued using a traditional hedonic pricing model. The data are collected from the annual bull test trial and sale at Southern Illinois University Carbondale. The results suggest that buyers at the SIUC Beef Evaluation Station are willing to pay more for bull characteristics associated with calving ease and weaning weights. For instance bulls with a combination of both lower birth weight Expected Progeny Differences (EPDs) and high yearling weight EPDs than average can command premiums of over $1,150 per head or 67 percent above the average sale price. Farm managers can use this information in the selection of herd bulls while purebred operators can attempt to select for the most valuable traits.Livestock Production/Industries,

Intersectionality Based Policy Analysis of How Racism is Framed in Medical Education Policies Guiding Aboriginal Health Curriculum

Introduction: Racism has a profound impact on health inequities for Aboriginal and Torres Strait Islander people. Australian medical schools are required to include Aboriginal and Torres Strait Islander health curriculum in their medical courses and policies have been developed to support this work. Methods: The research question was: how is racism framed in medical education policies guiding Aboriginal and Torres Strait Islander health curriculum for entry-level medical courses? Applying an Indigenous Research Paradigm and Intersectionality Based Policy Analysis, three key policies were analysed: Australian Medical Council (AMC) Standards for Assessment and Accreditation of Primary Medical programs; Aboriginal and Torres Strait Islander Health Curriculum Framework (ATSIHCF); Committee of Deans of Australasian Medical Schools Indigenous Health Curriculum Framework (CDAMS). Results: The AMC standards did not refer to racism, while CDAMS and ATSICF supported the notion that teaching students about racism would lead to reduced racism or increased anti-racism in healthcare practice. However, both policies’ learning objectives lacked inclusion of critical reflection required to inform responsive action to racism. As the CDAMS and ATSIHCF were not mandated, there is little accountability for medical schools to implement either of the curriculum policies. Conclusion: Realising the goal of medical practitioners who understand racism and practice anti-racism requires a multi-layered approach. This involves evidence-based teaching about racism and anti-racism, Aboriginal and Torres Strait Islander leadership in curriculum development, inclusion of racism and anti-racism in medical school accreditation standards, and development of student critical reflection skills. Importantly, education and health institutions need to value and model anti-racism

Aboriginal Health Consumers Experiences of an Aboriginal Health Curriculum Framework

Introduction In settler colonised countries medical education is situated in colonist informed health systems. This form of colonisation is characterised by overt racism and contributes to the significant health inequities experienced by Indigenous peoples. Not surprisingly, medical accreditation bodies in these countries have mandated the curriculum include content relating to Indigenous peoples. However, what is absent is the Indigenous health consumer worldview of health care and their nuanced lived experience of the delivery of medical care. Methods Yarning methods, integral to Aboriginal peoples’ ways of understanding and learning, were utilised. A Yarning guide was constructed with Social Yarn and Research Topic Yarn questions to understand Aboriginal health consumer experiences of the five learning domains within the Aboriginal and Torres Strait Islander Health Curriculum Framework. Data were analysed using Framework Analysis. Results Seventeen Aboriginal adults from urban and rural areas participated in the Yarns during 2018 and 2019. Coding and mapping data identified medical practitioner enacting practices that either perpetuated racism and the settler colonial ideology or facilitated anti-racist health care. Unwanted care included three racism themes described as the practitioner perpetuating and being unresponsive to racism; assimilation and an inability to consider impacts of settler colonialism. Desired care included four anti-racist themes expressed as responsiveness to racism and settler colonialism; advocating within the settler colonial health system; engaging with diversity of Aboriginal ways of knowing, being and doing and lifelong learning and reflection. Conclusion Medical practitioners are promoting ill health through racist practices with Aboriginal health consumers. Aboriginal people’s experiences of racism via continued settler colonial processes and anti-racism in the Australian health system, are critical to meaningful curricula. However, there is a risk for tokenism if the academy continues its coloniality by privileging the biomedical model of illness and health over other models of health

The management and cost of surgical site infection in patients undergoing surgery for spinal metastasis

Background Surgical site infection (SSI) is a serious potential complication of spinal surgery. SSI can impact significantly on in-patient hospitalisation and the costs associated with extra care. Aim To investigate the management of patients experiencing SSI following surgery for spinal metastatic tumours, and to estimate the costs associated with SSI in this context. Methods Patients experiencing SSI following spinal tumour surgery at a large spinal surgery centre between January 2009 and December 2012 were identified. Existing case notes were reviewed and patient and procedural data, details of the infection and treatment interventions were collected. A bottom-up approach to calculating costs associated with infection was used for patients experiencing SSI and compared with a quasi-random sample of similar patients without SSI. Findings The mean cost of treating patients with SSI was significantly greater than costs associated with those without SSI (p=0.019). Mean cost of in-patient hospital stay was 60% higher in patients with SSI compared to those without SSI (p=0.004). In-patient hospital stay alone accounted for 59% of total costs. Return to theatre was the second most costly intervention overall, accounting for 38% of costs, and was the most expensive single intervention involved in the treatment of SSI. Conclusion SSI significantly increases healthcare costs for patients undergoing surgery for spinal metastasis, with prolonged in-patient hospitalisation and return to theatre for wound management being major contributors. The actual total cost to society derived from SSI in this patient group is likely to be far beyond just the direct costs to healthcare providers

Survival of patients undergoing surgery for metastatic spinal tumours and the impact of surgical site infection

Background Patients with metastatic spinal tumours have a limited prognosis. Surgical complications which may result in prolonged hospitalisation or readmission are highly undesirable. Surgical site infection (SSI) is one such complication which can, in extreme cases, lead to death. Aim To assess the impact of SSI on patient survival after surgery for spinal metastases. Methods Demographic, operative and survival data were collected on 152 patients undergoing surgery for spinal metastases at Salford Royal NHS Foundation Trust. American Society of Anesthesiologists (ASA) grade and the Revised To kuhashi Score (RTS) were obtained as measures of health status at baseline. A semi-parametric Cox proportional hazards survival analysis was used to assess the relationships between covariates and survival. Results Mean age at operation was 60.5 years (standard deviation 12.9 years). Seventeen patients (11.2%) experienced SSI. At the time of last follow up, 117 patients had died. RTS score (p<0.001; hazard ratio 0.82; 95% confidence interval: 0.76-0.87) and ASA grade (p=0.022; hazard ratio 1.40; 95% confidence interval: 1.05-1.87) were significantly associated with survival, with better survival found in patients with higher RTS and lower ASA scores. Infection status was of substantive importance, with better survival in those without SSI (p=0.075). Age was not substantively related to survival (p=0.299). Overall, median survival time from operation was 262 days (95% confidence interval: 190-334 days). Conclusions Five-year survival in patients undergoing surgery for spinal metastases is approximately 23%. Either or both of RTS or ASA scores can be used as indicators of patient survival. There is insufficient evidence to conclude that the presence of SSI retards survival

Experiences of Practice Educators Supporting Disabled Physiotherapy Students: a Critical Exploration

Disabled physiotherapists have been part of the profession for over one hundred years, nevertheless, the greatest influences physiotherapy has in relation to disability are the therapeutic alliances with clients; which have often been managed through a largely reductionist biomedical approach. This can lead to dissonance when a disabled person is in a professional rather than a client role. Practice educators aim to enable students to assume often standard patterns of physiotherapy ‘ways of being’. Findings from previous research suggest that while disabled students often tend to be viewed through a deficit lens, few studies have specifically sought to identify the concerns of practice educators when working with them. The aim of this thesis was to explore the experiences and understandings of practice educators and the influences that the presence of disability has on the educational process in the clinical setting. This qualitative study involved eight physiotherapy practice educators from London and the SouthEast and explored their experiences of supporting disabled students. Through an interpretive, ideographic approach which drew upon Bourdieu’s sociology of practice and critical hermeneutics key themes identified were Pressures and placements; educator needs and perceived lack of support; perceived student challenges; disclosure-communication and honesty; understandings of disability and; educator responsibility. Participants rarely explicitly discussed their understandings of disability; yet they had specific requirements for students to ‘disclose’ their impairments. Participants’ accounts were related to the professional doxa and habitus of physiotherapy that impacted upon understandings of disability and practice. Consequently, a ‘practice gap’ was identified in relation to the support of disabled students. Tensions were identified regarding the content and competence-based focus of education in contrast to possibilities offered by reconceptualising physiotherapy from traditionally biomedical definitions of disability to a more critical understanding of it. It is concluded that opportunities are needed within curricula, research and network groups to explore professionalism and psychosocial aspects of health, through critical thinking and professional reflection