Complete Year Research Articles

The impact of policy settings on language education in Australian schools: a comparative analysis of language enrolments and attrition in New South Wales and Victoria

ABSTRACT We explore the impact of language education policy on language enrolments and provision in primary and secondary government schools In Australia, specifically in New South Wales (NSW) and Victoria, which have strikingly different policy settings. NSW adopts a ‘weak but flexible’ policy, mandating a very limited minimum time allocation for language study but allowing multiple entry points at senior secondary level. Victoria adopts a ‘strong’ mandatory policy, requiring continuous commitment to language study. Using available data, the study first compares enrolment data trends overall before considering the most widely taught languages at primary and secondary level, with additional analysis of a single secondary student cohort. Amongst the findings, we observe a marked reversal of previously falling language enrolments over time in Victoria, with substantially higher numbers overall compared to NSW where numbers have instead fallen, thus seemingly attesting to the impact of effective mandatory policies. While neither policy setting seems impactful enough in attracting and sustaining language study through to senior secondary level, a seeming pattern of convergence at this level masks at least partly the effect of access to alternative learning mechanisms on enrolments, resulting in much more frequent completion of Year 12 language study in Victoria.

Picture This: Evaluating Healthcare Education Using Student Generated Pictorial Data

Objective: Healthcare student expectation and experience of professional training is likely to impact retention on their chosen programme. Understanding the experience of healthcare students is essential to support programme completion and ensure a future workforce with sufficient staff. The objectives of this study were to: (1) investigate the similarities and differences between undergraduate nursing and radiotherapy students’ expectations and experiences of the first year of their programme through pictorial data, and (2) develop a process of interpreting pictorial data for student evaluation. Methods: With written consent, students participating in nursing (n=31) and radiotherapy (n=22) completed a pictorial data collection tool on commencement and completion of year one. Data were analyzed using an adapted thematic content analysis. Independent data analysis, use of an audit trail and a reflective approach ensured a rigorous process. Results: Three themes were identified: professional identity, expectation of workload, and confidence. The students in both cohorts indicated an expectation that they would complete their studies, demonstrating a growing understanding of their profession over the first year of their studies, alongside a high workload. Nursing students indicated pride associated with being a nurse that was evident at the start and end of their first year of training. They experienced fatigue and lacked time to spend in activities other than studying and sleeping. Radiotherapy students indicated a better work-life balance. Conclusion: Informed by the findings, recommendations for healthcare programmes are made. Pictorial data were found to be quick, accessible, and inexpensive to collect and analyse. Impact of the visual data was powerful, giving novel insights into student expectation and experience. Pictorial data may provide a valuable complement to traditional methods of evaluation in healthcare education.

Time for preference-informed foundation allocation?

Successful completion of year 1 of the UK Foundation Programme is a General Medical Council requirement that newly qualified doctors must achieve in order to gain full registration for licence to practise in the UK. We present compelling evidence that both sections of the UK Foundation Programme allocation process, consisting of the Educational Performance Measure and Situational Judgement Test scores, are not fit for purpose. The ranking process drives competitive behaviours among medical students and undermines NHS teamworking values. Furthermore, data from 2013-2020 show that UK minority ethnic students consistently receive significantly lower SJT scores than White students. The current process in the UK allocates lower ranked students, who often need more academic and social support, to undersubscribed regions. This can lead to vacancies in less popular regions, ultimately worsening health inequality. A preference-informed allocation process will improve trainee access to support and help retain trainees in underserved regions. We aim to summarise the flaws of the current system and report a potential radical solution.

Addressing the Sophomore Slump: First-Generation College Students’ Completion of Year Two of Study in a Rural Bachelor’s Degree Granting College

There is limited research on the experiences of first-generation students who have completed their second year and enrolled for a third year in order to continue their studies even though this population of students are the most likely to drop out of college in their second year. The purpose of this qualitative study was to understand how current first-generation college students, who are enrolled or completed the second semester of their sophomore year, experience college as a first-generation student and made the decision to persist toward completing their bachelor’s degree. Through first-hand accounts of participants’ experiences of their time at the university, this study highlights what factors students contributed to their persistence toward graduation. The findings have the potential to facilitate a deeper understanding of what stakeholders working with first-generation college students can do to assist in retention efforts of this population.

Re-Imagining Indigenous Education for Health, Wellbeing and Sustainable Development in Remote Australia

In Australia both Indigenous communities and governments are concerned at the educational outcomes of Indigenous children, especially children in remote regions. However, there are divergent visions of Indigenous education. For Indigenous communities, education embraces culture and contributes to wellbeing, the focus of our research, while for governments, educational goals comprise school attendance, English literacy and completion of year 12. Our team of Indigenous and non-Indigenous researchers explored wellbeing for Indigenous people in remote Australia through focus groups and interviews. Grounded analysis showed how research participants would like more Indigenous education for their children. Their vision for education includes transmission of Indigenous knowledge and skills in art, culture, history, land and sea management, and literacy in both English and Indigenous languages. Remote Indigenous communities hold under-utilised resources and strengths for education, and Indigenous people’s knowledge is needed, particularly in conservation and land and sea management. Research participants feel thwarted by education policies which require competition for funding and segregation of services. Re-imagining education from the perspectives of Indigenous communities offers opportunities to enhance education, together with employment, health and wellbeing, and strengthen Indigenous languages, knowledge and skills. These are important for both overcoming Indigenous disadvantage and for Australia to reach its commitments to conservation and sustainable development goals.

PrEP Chicago: A randomized controlled peer change agent intervention to promote the adoption of pre-exposure prophylaxis for HIV prevention among young Black men who have sex with men.

Advances in biomedical prevention strategies such as pre-exposure prophylaxis (PrEP) represent a new opportunity for reducing HIV incidence among young Black men who have sex with men, for whom the number of new HIV infections continues to rise. However, studies have documented low rates of PrEP uptake in this community. Research suggests that the peer networks of young Black men who have sex with men play important roles in their sexual health decisions. PrEP Chicago is a randomized controlled trial network intervention designed to increase PrEP uptake among young Black men who have sex with men living in Chicago. The aims of this study are twofold. Aim 1 is to estimate the effectiveness of a peer change agent intervention for (1) increasing the number of referrals made to a PrEP information line, (2) increasing the rate of PrEP adoption among non-participant peers, and (3) increasing PrEP knowledge, attitudes, and intentions among participants. Aim 2 is to determine the individual and network variables that explain peer change agent effectiveness. PrEP Chicago is a social network intervention that utilizes the influence of peer change agents to link young Black men who have sex with men in Chicago to PrEP. Young Black men who have sex with men were recruited using respondent-driven sampling. Once screened for eligibility, participants were randomly assigned to either one of two treatment sequences: (1) intervention treatment in Year 1 followed by a minimal contact attention control in Year 2 or (2) the minimal contact attention control in Year 1 followed by treatment in Year 2. The treatment consists of a PrEP/peer change agent training workshop followed by booster calls for 12 months. The attention control consists of a sex diary activity designed to help participants assess sexual risk. Psychosocial, sexual health, and network data are collected from all participants at baseline and at 12- and 24-month follow-ups. In total, 423 participants aged 18-35 have been enrolled (more than 100% target enrollment) and have completed baseline data collection. A majority of participants in both intervention and control groups reported having heard of PrEP before enrolling in the study, yet also reported having had no current or prior experience taking PrEP. Statistical analyses await completion of Year 1 of the trial in March 2018. PrEP Chicago addresses a gap in HIV prevention research and intervention design by utilizing the existing social networks among young Black men who have sex with men as mechanisms for information diffusion, behavioral influence, social support, and empowerment. Therefore, interventions that leverage peer influence processes to facilitate PrEP uptake are promising strategies to improve sexual health engagement and overcome disparities in outcomes among this at-risk population.

A Leadership Intervention to Further the Training of Female Faculty (LIFT-OFF) in Radiology

Women are under-represented in the field of radiology, occupy a minority of leadership positions, and, at our institution, have not achieved the same level of academic success as their male counterparts. Consequently, the authors designed, implemented, and evaluated the Leadership Intervention to Further the Training of Female Faculty (LIFT-OFF) program to (1) improve access to opportunities for women's faculty development and advancement, and (2) improve clarification of expectations about the role and path of advancement. LIFT-OFF was developed based on the results of a needs assessment survey. The results generated 14 priority topics, which served as the basis for educational modules conducted by expert speakers. Module effectiveness was assessed with pre- and postsurveys to elicit participant knowledge about the targeted subject matter. A formative program evaluation was performed at the completion of year 1 of 2 to assess outcomes and impacts to date. Seventeen of 55 (31%) educational module post-survey questions demonstrated a statistically significant (P < 0.05) increase in "yes" responses, indicating an improved understanding of targeted information. At year 1, 75% of the participants indicated that the program improved access to faculty development opportunities and 62% reported improved access to career advancement opportunities. Satisfaction with pace of professional advancement increased from 25% to 46% for junior women faculty (P = 0.046). Faculty development programs such as LIFT-OFF can provide career development opportunities and executive skills necessary for women to achieve academic career success and assume leadership positions.

Evolution and Initial Experience of a Statewide Care Transitions Quality Improvement Collaborative: Preventing Avoidable Readmissions Together.

Increasing scrutiny of hospital readmission rates has spurred a wide variety of quality improvement initiatives. The Preventing Avoidable Readmissions Together (PART) initiative is a statewide quality improvement learning collaborative organized by stakeholder organizations in South Carolina. This descriptive report focused on initial interventions with hospitals. Eligible participants included all acute care hospitals plus home health organizations, nursing facilities, hospices, and other health care organizations. Measures were degree of statewide participation, curricular engagement, adoption of evidence-based improvement strategies, and readmission rate changes. Fifty-nine of 64 (92%) acute care hospitals and 9 of 10 (90%) hospital systems participated in collaborative events. Curricular engagement included: webinars and coaching calls (49/59, 83%), statewide in-person meetings (35/59, 59%), regional in-person meetings (44/59, 75%), and individualized consultations (46/59, 78%). Among 34 (58%) participating hospitals completing a survey at the completion of Year 1, respondents indicated complete implementation of multidisciplinary rounding (58%), post-discharge telephone calls (58%), and teach-back (32%), and implementation in process of high-quality transition records (52%), improved discharge summaries (45%), and timely follow-up appointments (39%). A higher proportion of hospitals had significant decreases (≥10% relative change) in all-cause readmission rates for acute myocardial infarction (55.6% vs. 30.4%, P=0.01), heart failure (54.2% vs. 31.7%, P=0.09), and chronic obstructive pulmonary disease (41.7% vs. 33.3%, P=0.83) between 2011-2013 compared to earlier (2009-2011) trends. Focus on reducing readmissions is driving numerous, sometimes competing, quality improvement initiatives. PART successfully engaged the majority of acute care facilities in one state to harmonize and accelerate adoption of evidence-based care transitions strategies.

Role modelling of clinical tutors: a focus group study among medical students.

BackgroundRole modelling by clinicians assists in development of medical students’ professional competencies, values and attitudes. Three core characteristics of a positive role model include 1) clinical attributes, 2) teaching skills, and 3) personal qualities. This study was designed to explore medical students’ perceptions of their bedside clinical tutors as role models during the first year of a medical program.MethodsThe study was conducted with one cohort (n = 301) of students who had completed Year 1 of the Sydney Medical Program in 2013. A total of nine focus groups (n = 59) were conducted with medical students following completion of Year 1. Data were transcribed verbatim. Thematic analysis was used to code and categorise data into themes.ResultsStudents identified both positive and negative characteristics and behaviour displayed by their clinical tutors. Characteristics and behaviour that students would like to emulate as medical practitioners in the future included:1) Clinical attributes: a good knowledge base; articulate history taking skills; the ability to explain and demonstrate skills at the appropriate level for students; and empathy, respect and genuine compassion for patients.2) Teaching skills: development of a rapport with students; provision of time towards the growth of students academically and professionally; provision of a positive learning environment; an understanding of the student curriculum and assessment requirements; immediate and useful feedback; and provision of patient interaction.3) Personal qualities: respectful interprofessional staff interactions; preparedness for tutorials; demonstration of a passion for teaching; and demonstration of a passion for their career choice.ConclusionExcellence in role modelling entails demonstration of excellent clinical care, teaching skills and personal characteristics. Our findings reinforce the important function of clinical bedside tutors as role models, which has implications for faculty development and recruitment.

Surgical teaching program for our senior medical students: room for improvement.

BackgroundTo ensure the quality of surgical teaching within our graduate entry medical program, a distinctive surgical teaching program has been developed at Sydney Medical School-Central. Spanning 2 years, the program includes lectures, small group surgical clinical tutorials, and formal student surgical grand rounds presentations, plus clinical placements and attendance in operating theaters. We sought to evaluate the effectiveness of the program.MethodsIn 2013, at the completion of year 4, all graduating students (n=54) were asked to complete an open and closed-ended questionnaire regarding their experience of the surgical program.ResultsA total of 44/54 (81%) students completed the questionnaire. Students reported a high level of engagement with their experience in clinical tutorials, and a moderate level of engagement in surgical lectures. Students found the clinical attachment to be the least useful method of teaching, with the surgical grand rounds presentation also eliciting a poor response from students.ConclusionWhile both large group lectures and small group learner-centered teaching methods were highly valued by students, changes are needed to enhance clinical attachments for students in surgical wards. The benefits of students being made to feel part of a team during their surgical clinical attachments, along with adequate inpatient contact and formative feedback, should not be underestimated.

The Impact of School Academic Quality on Low Socioeconomic Status Students

The issue addressed by this article is whether there is an interaction between school ‘quality’ and students' socioeconomic status. That is, is a school that is of ‘high quality’ for high socioeconomic status students as effective for students from a low socioeconomic background? The answer is that a school that is of ‘high-quality’ benefits all students in terms of completion of Year 12, but more so for the most vulnerable of students: those who have low academic achievement at age 15 years in addition to coming from a low socioeconomic status background.

Results From a Phase IV Open-Label Study Evaluating Changes In Bone Marrow Morphology In Adult Immune Thrombocytopenia (ITP) Patients Receiving Romiplostim: Analysis Of The 1- and 2-Year Romiplostim Cohorts

IntroductionReticulin is a normal and common component of the bone marrow stroma. In clinical trials of adults with chronic ITP treated with the thrombopoietin mimetic romiplostim, a small number of cases of reticulin and/or collagen in bone marrow were reported. However, bone marrow biopsies were not systematically performed in these trials. Here, we report a multicenter study of adult ITP patients that evaluated bone marrow biopsies for reticulin and collagen pre- and post-treatment with romiplostim. MethodsEligible ITP patients had platelet counts <50x109/L, received ≥1 prior ITP therapy, and no collagen in baseline bone marrow biopsies (ie, before romiplostim). Three cohorts of patients were scheduled for biopsies after 1 (Cohort 1), 2 (Cohort 2), or 3 years of romiplostim, dosed to maintain platelet counts at 50–200x109/L. Bone marrow biopsies were also performed if patients discontinued early or failed to achieve/maintain a response to romiplostim, defined as platelet counts ≤20x109/L for 4 consecutive weeks at the maximum romiplostim dose of 10 µg/kg. Reticulin and collagen formation were measured using the modified Bauermeister scale (0 no reticulin; 1 occasional fine fibers/foci fine fiber network; 2 fine fiber network; 3 diffuse fiber network, scattered coarse fibers; 4 diffuse coarse fiber network with areas of collagenization). Collagen was detected by trichrome staining and reticulin by silver staining. Cohort 1 biopsy samples were reread as the modified Bauermeister scale had not been applied as specified in the study protocol. All samples were read by 2 hematopathologists at a central bone marrow laboratory with grading discrepancies reviewed by an independent bone marrow panel. Data cutoff for this analysis was August 10, 2012. ResultsOf the 50 patients enrolled in Cohort 1 (54% female, mean age 55.5 years, range 20–86 years), 39 patients received romiplostim and had bone marrow biopsies (Table). Mean (SD) dose was 3.8 (2.9) µg/kg. No patients with evaluable results developed collagen. No patients had an increase ≥2 grades from baseline in reticulin. Of the 50 patients enrolled in Cohort 2 (76% female, mean age 48.6 years, range 19–83 years), 39 patients received romiplostim and had bone marrow biopsies (Table). Mean (SD) dose was 4.1 (3.2) µg/kg. Again, of the patients with evaluable results, none developed collagen. Two patients had a 2-grade increase in reticulin (1 patient: baseline grade 0 to 2 at year 2; 1 patient: baseline grade 1 to 3 at end of treatment). The safety profile was similar to previous trials. In Cohort 1, 3 patients died (not attributed to romiplostim); causes were fungal sepsis in a patient with longstanding corticosteroid use, cerebral hemorrhage, and pulmonary hemorrhage in a patient with pulmonary thrombosis treated with acenocumarol. In Cohort 2, 2 patients died (not attributed to romiplostim); causes were acute renal failure, in a patient with a medical history of chronic renal insufficiency, and suicide. There were no neutralizing antibodies to romiplostim or thrombopoietin in the 2 cohorts. Summary/ConclusionThere was no evidence of collagen formation after 2 years of romiplostim treatment. The incidence of increase in reticulin was low, consistent with results of previous romiplostim studies. This ongoing study will provide additional data on bone marrow changes with up to 3 years of romiplostim treatment.At completion of year 1 treatment, discontinuations included withdrew consent (n=5), non-responders (n=4), died (n=3), adverse event (n=1, severe joint pain), administration decision (n=1).At completion of year 2 treatment, discontinuations included withdrew consent (n=6), non-responders (n=2), declined biopsy (n=2), adverse events (n=2, dermatitis and suspected non-Hodgkins lymphoma), died (n=1), required alternate therapy (n=1). Disclosures:Janssens:Amgen, GSK, Mundipharma, Roche: Membership on an entity's Board of Directors or advisory committees. Rodeghiero:Amgen, GSK: Honoraria; Amgen, Eisai, GSK, LFB, Suppremol: Membership on an entity's Board of Directors or advisory committees. Chong:Amgen, GSK: Research Funding. Pabinger:CSL Behring: Research Funding; Amgen, Baxter, Bayer, Boehringer Ingelheim, CSL Behring, Pfizer: Honoraria; Amgen, Baxter, Bayer, Boehringer Ingelheim, CSL Behring, Pfizer: Membership on an entity's Board of Directors or advisory committees. Cervinek:Alexion, Amgen, GSK: Consultancy. Wang:Amgen: Employment, Equity Ownership. Lopez:Amgen: Employment, Equity Ownership.

A Simulation-Based Acute Care Curriculum for Pediatric Emergency Medicine Fellowship Training Programs

Currently, many pediatric hospitals are using simulation technology to teach trainees the skills required to effectively succeed in managing critically ill patients. Unfortunately, no curricula integrating the use of simulation have been described for pediatric emergency medicine (PEM) fellowship programs. Our objective was to outline our experience with the development, integration, and evaluation of a simulation-based, acute care curriculum into our current PEM fellowship training program. Using the American Board of Pediatrics and the Royal College of Physicians and Surgeons of Canada learning objectives for PEM as a guide, 12 modules composed of 43 scenarios were developed to address the skill sets required for PEM fellows. Six modules were identified as "core," allocated for completion in year 1 of fellowship, whereas the remaining modules were "subspecialty," designed for completion in year 2 of training. A 12-question survey (5-point Likert scale) was used to evaluate trainee satisfaction with regard to 4 domains: level of realism, utility of debriefing, quality of instruction, and overall satisfaction. A total of 66 surveys were collected between March and July 2007. Twenty-five surveys were completed by PEM fellows. Trainees responded favorably for all 4 domains, reporting that the new simulation curriculum provided realistic scenarios with high-quality debriefing, instruction, and an overall excellent learning experience. We have successfully integrated a simulation-based acute care curriculum into our PEM fellowship program. Satisfaction ratings were high for this program. Research to assess educational outcomes related to this curriculum is necessary.

Reference Solar Radiation Year and Some Climatology Aspects of East Coast of West Malaysia

Problem statement: This study examined in detail some aspects of radia tion climatology for Terengganu state in Malaysia. The geographical co-ordinates of the site are 5°10'N latitude 103°06'E longitude and 5.2 m altitude. Approach: The data used in the present study were taken from a recording data station installed at site by the M alaysian Meteorology Department (2004). In addition to this, wind speed, solar radiation and air temper ature data taken from University Malaysia Terengganu Renewable Energy Station were also analyzed. The averaged solar radiation year for Terengganu is generated from mid-term daily global solar radiation data. The averaged data of the daily global solar radiation for the locations cons idered are presented in a tabular form for a comple te year. Results: The highest daily and monthly mean global solar irr adiation values were 7560 and 6566 Wh m -2 day -1 , respectively. The highest hourly average solar ir radiance intensity was 1139 W m -2 during this study period. Yearly average daily sol ar energy was 18.92 MJ m -2 day -1 . Besides the global solar radiation, the clearness indexes, wind speed and air temperature variation are discussed. Conclusion/Recommendations: The results in this study will fill the gap that c omplete and detailed reference solar radiation and climatologically data , which are not available for Terengganu state of Malaysia and will be useful to the designers of sol ar energy conversion and utilization devices.

Study of Nevi in Children (SONIC): Baseline Findings and Predictors of Nevus Count

The authors report baseline findings and predictors of nevus count (log total nevi) at the completion of year 1 (2004) of the first known population-based, prospective study of nevi in a US cohort of children. Overall, 64% (n = 443/691) of grade 5 students and their parents in Framingham, Massachusetts, completed surveys and underwent digital photography. Total nevus count was associated with skin and hair color and tendency to burn, as measured by a sun sensitivity index. In multivariate analyses, male gender (rate ratio (RR) = 1.38, 95% confidence interval (CI): 1.22, 1.55; P < 0.0001), spending 5-6 weekly hours outdoors between 10 AM and 4 PM (RR = 1.13, 95% CI: 1.00, 1.28; P = 0.051), getting a painful sunburn once (RR = 1.24, 95% CI: 0.98, 1.57; P = 0.073) and at least twice (RR = 1.34, 95% CI: 0.99, 1.82; P = 0.061), and wearing a shirt at the beach or pool rarely (RR = 1.29, 95% CI: 1.08, 1.54; P = 0.005), sometimes (RR = 1.26, 95% CI: 1.01, 1.57; P = 0.041), and often and always (RR = 1.32, 95% CI: 1.13, 1.54; P = 0.001) were associated with increased number of nevi. Identifying factors that predict the development of nevi will improve primary prevention efforts during early life.

Train-the-trainer as an Educational Model in Public Health Preparedness

Train-the-trainer (TTT) is a widely acknowledged educational model across a number of disciplines, including public health preparedness. However, many questions arise about its proper use, its efficacy, and its optimal role in preparedness education. After careful consideration of the literature and past anecdotal experiences with this educational model, TTT was selected as the preferred and sustainable method for public health preparedness in Maine. Upon completion of Year 1 of the Maine TTT program, our evaluation results revealed that TTT was successful and well received by participants. It is evident that TTT is potentially a valuable tool in public health preparedness, but it should be noted that there is no clear prescription for implementing TTT. Institutions and communities adopting TTT as an educational model must be flexible and willing to revise the training plan as challenges are encountered. Future research is required to help clarify optimal ways of using TTT to promote public health preparedness in the 21st century.

Defining competency - the role of standard setting.

The responsibility to determine just who is competent to practice medicine, and at what standard, is great. Whilst there is still a period available for potential remediation, examinations at the completion of year three of the four-year Graduate Entry Medical Programme (GEMP) at Flinders University of South Australia (FUSA) are high stakes and contain the majority of final summative assessment for the certification of student to doctor. Therefore, the medical school has recently examined its methods for certification, the clinical practice standards sought in its programme and how to determine these standards. For all assessments a standard was documented and methods employed to set these standards using specific measures of performance. A modification of the Angoff method was applied to the written examination and the Rothman method, using two criteria, was used to determine competency in the objective structured clinical examination (OSCE). These methods were used for the first time in 1998. Both methods used trained 'experts' as standard setters and both methods used the notion of the 'borderline candidate' to determine the passing standard. This paper describes these two criterion-referenced standard-setting procedures as used in this school and related examination performance. Whilst the use of standard-setting procedures goes part way to defining and measuring competence, it is time consuming and requires significant examiner training and acceptance. Using 50% to determine who is and isn't competent is simpler but not transparent, fair nor defensible.

The Role of the Dietitian in an Outpatient Heart Failure Center

LEARNING OUTCOME: To identify a model for the role of a dietitian in an outpatient heart failure center and to identify outcome indicators appropriate for use with congestive heart failure outpatients. The establishment of outpatient heart failure centers is recognized as an essential step in decreasing the staggering cost of caring for the patient with congestive heart failure (CHF). These outpatient centers use a multi-disciplinary team approach to aggressively manage and educate patients with CHF. One heart failure center in Nebraska received outside funding for a two-year demonstration project which will: 1) define the role of the dietitian in the heart failure center through the development and testing of practice guidelines, and 2) examine nutrition and health outcomes associated with the use of a dietitian in an outpatient heart failure center. As a first step in this project, a needs assessment was completed. Ten major heart failure centers were surveyed in order to identify their use of a dietitian. The results of this survey indicate that: 1) dietitians are not active members of outpatient heart failure teams, 2) ongoing patient teaching on sodium and fluid is the responsibility of nurses, and 3) nutrition education materials were not specific to the CHF patient. Patients enrolled in the heart failure center completed surveys which indicated confusion in understanding the most basic nutrition principles (e.g. importance of sodium versus fat), and interviews with the center's team members provided background on typical patient questions and ideas for incorporating the dietitian into the team. At the completion of year one of the project, a dietitian has developed, implemented and is testing nutrition practice guidelines based on the needs of heart failure staff and patients. Ninety percent of all heart failure patients receive medical nutrition therapy and of those, approximately 79% meet their dietary sodium goal and 82% meet their fluid intake goal. The dietitian has become a valued member of the heart failure team. This team has succeeded in decreasing hospital admissions by 30%, hospital days by 42%, and average length of stay by 17%.

Eligibility and Self Selection: Discontinuities in Transition to Tertiary Education in Victoria

Most studies of transition to tertiary education focus on a single outcome variable: expectations of further study, a dichotomous indicator of participation in college and university, or simply years of further education achieved. In this paper, the authors contend that a more complete analysis of the social and personal factors which determine tertiary participation can be gained by regarding transition as a series of discontinuities in the individual's educational history. If an analysis was to commence with a cohort of Year 12 students, indicators of these discontinuities could include completion of Year 12, application to a college or university, receipt of an offer, self-selection at enrolment, and delayed entry. In a recent published study of college and university applicants in Victoria, the authors used administrative and survey data to develop causal models of the decision of successful applicants to enrol either full- or part-time rather than defer or decline. In this paper the administrative data are used to specify a model which includes two transition variables. The variables identify those who received an offer, from a defined cohort of applicants, and those who subsequently took up the offer. This model enables a distinction to be made between factors which affect the students’ eligibili!y to enrol and factors that affect subsequent self-selection into tertiary education. Group and individual inequalities can therefore be assessed in terms of their total effecton transition and their separate effects on eligibility and self-selection.

HUGE STELLAR LOOKING‐GLASS WILL TAKE TWO YEARS TO COMPLETE

School Science and MathematicsVolume 34, Issue 3 p. 239-239 HUGE STELLAR LOOKING-GLASS WILL TAKE TWO YEARS TO COMPLETE First published: March 1934 https://doi.org/10.1111/j.1949-8594.1934.tb10727.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume34, Issue3March 1934Pages 239-239 RelatedInformation