Overview Of Current Practice Research Articles

Project-based learning in Australian & New Zealand universities: current practice and challenges

ABSTRACT Project-based learning is a key approach to better preparing students for professional engineering practice. An overview of current practice within Australia & New Zealand is needed to better support academics and their Learning and Teaching leadership in improving their practice. This paper benchmarks current project-based learning practice in Australian & New Zealand universities to identify how project-based learning is currently being delivered as well as challenges associated with project-based learning. Key considerations noted in our research include a variety in the reasons and subsequent designs for project-based learning, workload concerns for unit coordinators, a need to better support authentic project-based learning experiences, as well as a need to manage expectations around student satisfaction. These findings highlight key concerns associated with current practice and provide data for academics and their Learning and Teaching leadership to understand and take steps to ameliorate the challenges of project-based learning.

Extracorporeal cardiopulmonary resuscitation for refractory cardiac arrest: an overview of current practice and evidence.

Cardiac arrest (CA) is acommon and potentially avoidable cause of death, while constituting asubstantial public health burden. Although survival rates for out-of-hospital cardiac arrest (OHCA) have improved in recent decades, the prognosis for refractory OHCA remains poor. The use of veno-arterial extracorporeal membrane oxygenation during cardiopulmonary resuscitation (ECPR) is increasingly being considered to support rescue measures when conventional cardiopulmonary resuscitation (CPR) fails. ECPR enables immediate haemodynamic and respiratory stabilisation of patients with CA who are refractory to conventional CPR and thereby reduces the low-flow time, promoting favourable neurological outcomes. In the case of refractory OHCA, multiple studies have shown beneficial effects in specific patient categories. However, ECPR might be more effective if it is implemented in the pre-hospital setting to reduce the low-flow time, thereby limiting permanent brain damage. The ongoing ON-SCENE trial might provide adefinitive answer regarding the effectiveness of ECPR. The aim of this narrative review is to present the most recent literature available on ECPR and its current developments.

Keratoconus Management in the Community: A Survey of Optometrists.

Defining the patterns of practice and referral criteria of optometrists within New Zealand to investigate the diagnosis and management of keratoconus. Optometrists recruited through the New Zealand Association of Optometrists, Cornea and Contact Lens Society of New Zealand, and private practices were invited to complete an anonymous survey. Responses were received from 168 optometrists (representing 20.0% of the optometrist population). Half (48%) of optometrists had ≥15 years of experience, and 22% prescribed soft contact lenses daily, whereas only 6.4% prescribed rigid gas-permeable (RGP) lenses daily. The main barriers to prescribing RGPs were experience with fitting, low market demand, and patient discomfort. When referring to an ophthalmologist, 41% reported referring on progression of corneal parameters, 27% on initial diagnosis, 21% at no set time, and 10% with a reduction in visual acuity. Most optometrists (64%) would refer for possible surgery when visual acuity dropped between 6/9 and 6/12. Optometrists with greater experience were more likely to prescribe RGP lenses and co-manage patients with ophthalmologists. Ownership of a corneal imaging unit suggested an increased likelihood of prescribing RGP lenses but did not alter referral patterns. This survey provides an overview of current practice and highlights the importance of optometrists in the diagnosis and management of keratoconus. There was a significant discrepancy in keratoconus management, regarding optical correction modality and referral criteria for ophthalmology review. Further interdisciplinary work is required between optometry and ophthalmology to standardize referral guidelines and enhance visual outcomes.

Hurdles, Hurdles, and More Hurdles: Strategic Litigation in National Security Cases

ABSTRACT Civil society organizations are adept and reactive advocates, using a range of strategies to promote their messages and respond to negative outcomes. For instance, even when unsuccessful in bringing legal arguments before the courts, such organizations can still use litigation as a platform for positive legal outcomes. In the national security context, however, things are not as straightforward. This piece analyses three unique ‘hurdles’ civil society organizations face in this context – judicial deference, lack of access to information, and secrecy – meaning their response to unsuccessful litigation becomes even harder. This piece provides an overview of current practice, while remaining optimistic for civil society’s response to the ‘hurdles’; concluding that, while a hard race to win, civil society can still prevail.

Mechanical insufflation-exsufflation for invasively ventilated critically ill patients-A focus group study.

Mechanical Insufflation-Exsufflation (MI-E) is used as an airway clearance intervention in primary care (home ventilation), long-term care (prolonged rehabilitation after intensive care, neuromuscular diseases, and spinal cord injury), and increasingly in acute care in intensive care units (ICU). We sought to develop in-depth understanding of factors influencing decision-making processes of health care professionals regarding initiation, escalation, de-escalation, and discontinuation of MI-E for invasively ventilated patients including perceived barriers and facilitators to use. We conducted focus groups (3 in the Netherlands; 1 with participants from four European countries) with clinicians representing the ICU interprofessional team and with variable experience of MI-E. The semi-structured interview guide was informed by the Theoretical Domains Framework (TDF). Two researchers independently coded data for directed content analysis using codes developed from the TDF. A purposive sample of 35 health care professionals participated. Experience varied from infrequent to several years of frequent MI-E use in different patient populations. We identified four main themes: (1) knowledge; (2) beliefs; (3) clinical decision-making; and (4) future adoption. Interprofessional knowledge and expertise of MI-E in invasively ventilated patients is limited due to minimal available evidence and adoption. Participants believed MI-E a potentially useful intervention for airway clearance and inclusion in weaning protocols when more evidence is available. This focus group study provides an overview of current practice, knowledge and expertise, and barriers and facilitators to using MI-E in mechanically ventilated patients. From these data, it is evident there is a need to develop further clinical expertise and evidence of efficacy to further understand the role of MI-E as an airway clearance technique for ventilated patients.

Patient involvement in clinical pathway development, implementation and evaluation – A scoping review of international literature

ObjectiveAlthough various pathway design methods recognize patients as stakeholders, an overview of current practice is lacking. This article describes the results of a literature review assessing patient involvement in clinical cancer pathway development, implementation and evaluation. MethodsA scoping review was conducted following PRISMA-ScR. Two databases were searched to identify studies published in English between 2014 and 2021. ResultsOf 12841articles identified 22 articles met the inclusion criteria and reported on one or more of the three phases: development phase (N = 2), implementation (N = 4), evaluation (N = 11), development/evaluation (N = 3), and implementation/evaluation (N = 2) of clinical pathways. The numbers of involved patients ranged from 10 to 793, and the reported methods varied considerably. ConclusionThis review presents a synthesis of methods for involving patients in the clinical pathway lifecycle. No relationship was found between methods and the number of involved patients or between pathway complexity and methods. Although patients are seen as valuable stakeholders in the pathway design, to involve them in practice using the best practice can be improved. Practice ImplicationsThe lack of a clear justification for the choice of methods and number of involved patients calls for further research and framework development to inform pathway developers.

Paediatric Liver Transplantation During COVID-19 Pandemic: Lessons Learned and Unanswered Questions.

COVID-19 pandemic has imposed many challenges on paediatric liver transplantation (PLT) services and has necessitated several adaptations in different stages of the process to ensure transplant centres can still deliver the proposed services in addition to protecting patients and staff against infection. This review article digs through the current literature to clarify the challenges imposed by SARS-CoV2 on PLT centres globally. It provides an overview of current practice as well as suggestions from experts in the field to overcome multiple obstacles. In paediatrics, the reaction to SARS-CoV2 may be less severe than that seen in the adult population, but this can change in view of newly discovered virus strains. Response of transplant centres to the current pandemic was variable depending on the anticipated risk and available resources. Telemedicine has helped PLT programmes to continue their activities while protecting patients, as well as staff against the risk of SARS-CoV2 virus. Further studies are needed to guide immunosuppression management in post-transplant infected candidates; answering this critical question will help PLT centres solve this dilemma.

Organizational Workplace Mental Health: An Emerging Role for Occupational Therapy

The purpose of this paper is threefold: firstly, to provide a brief overview of current practice in workplace mental health and introduce an emerging role for occupational therapy in this field (i.e., practicing at the organizational level where “clients” are workplaces or organizations, and not individual workers); secondly, to present the findings from a small qualitative study which describes this emerging role from the perspectives of occupational therapists who have worked in this area; and thirdly, to provide suggestions for future work which could advance this emerging role for occupational therapy world-wide. KEY MESSAGES Previous research suggests that there is an increasing interest among employers to address workplace mental health through organizational initiatives and that occupational therapists are beginning to consult on the topic. Occupational therapists in our small qualitative study described their role in organizational workplace mental health as one which involves adopting a business lens, practicing in an organization-centred manner, and focusing on population health promotion. Suggestions for future work to advance this emerging role include identifying the fundamental elements of the business lens, investigating models and frameworks to guide organization-centred practice, evaluating the short-, medium-, and long-term outcomes of interventions, exploring the fit between an occupational perspective and workplace mental health, and examining the impact of COVID-19 on current practice.

Current techniques and procedures in paediatric and congenital cardiac catheter intervention

<h2>Abstract</h2> There has been marked innovation and progress in the techniques, technologies and outcomes in the field of paediatric and congenital cardiac catheter intervention over the past 4 decades. In the modern era, it is now possible to treat many forms of congenital heart disease through minimally invasive percutaneous therapies, with associated reduction in morbidity for this group of patients. This article provides an overview of current practice and developments in this field, with particular focus on the interventional procedures commonly performed in the paediatric population.

Response Rates In Hospitality Research: An Overview of Current Practice and Suggestions For Future Research

In this paper, we examine published research in six top-tier hospitality journals to explore response rates for different survey distribution methods across specific characteristics like research context, respondents, and geographical regions. Data were analyzed from 1,389 papers published from January 2001 to December 2019. By looking at a large set of published response rates, distribution and enhancing methods and type of respondents, findings from this study will aid researchers in designing more effective surveys and successfully collecting necessary data. The implications for response rate in hospitality research are also presented.

Assessing the Involvement of Users During Development of Lower Limb Wearable Robotic Exoskeletons: A Survey Study.

ObjectiveTo explore user-centered design methods currently implemented during development of lower limb wearable robots and how they are utilized during different stages of product development.BackgroundCurrently, there appears to be a lack of standardized frameworks for evaluation methods and design requirements to implement effective user-centered design for safe and effective clinical or ergonomic system application.MethodResponses from a total of 191 experts working in the field of lower limb exoskeletons were analyzed in this exploratory survey. Descriptive statistics were used to present responses and measures of frequency, and chi-square tests were used to contrast the answers of respondents who identified as clinicians versus engineers.ResultsA vast majority of respondents involve users in their development, in particular at the initial and iterative stages, although some differences were found between disciplines. A variety of methods and metrics are used to capture feedback from users and test devices, and although valuable, some methods used may not be based on validated measures. Guidelines regarding tests on safety of exoskeletons also lack standardization.ConclusionThere seems to be a consensus among experts regarding the importance of a user-centered approach in exoskeleton development; however, standardized frameworks with regard to appropriate testing methods and design approaches are lacking. Such frameworks should consider an interdisciplinary focus on the needs and safety of the intended user during each iteration of the process.ApplicationThis exploratory study provides an overview of current practice among engineers and clinicians regarding the user-centered design of exoskeletons. Limitations and recommendations for future directions are identified.

4117Cardiac surveillance during breast cancer treatment; a snapshot of current practice

Abstract Background Breast cancer (BC) is the most common type of cancer in women. Over the past decades survival rates increased up to 90% at 5 years and 83% at 10 years. The various BC treatments, such as radiotherapy, chemotherapy and immunotherapy increase cardiotoxicity risk, leading to premature ischemic heart disease and heart failure amongst survivors. Both affect women's daily routine and quality of life. Reducing this adverse risk, by early recognition and (preventive) treatment, is therefore important. Despite, screening for cardiotoxicity is currently insufficiently standardized in daily practice. A fundamental step in identifying areas of improvement is providing an overview of current practice. Purpose This study aims to describe current cardiac surveillance for women with BC during and after cancer treatment, using routinely collected hospital data in the Netherlands. Methods An observational study has been performed on Dutch hospital data from 2012 up to 2015, provided by Statistics Netherlands. Information about cardiology and oncology diagnoses, diagnostic procedures, treatments and preventive measures were available. Newly diagnosed female patients with codes malignant neoplasm of the breast (ICD-10, C50.0-C50.9) in 2013 and without any comorbidities since 1–1-2012 were included in the analyses. In follow-up data up to 31–12 2015, we mapped all types of care the patients received for BC and cardiology related indications. Results We included 16040 newly diagnosed BC patients in 2013, with a mean age of 65.9 (sd 12.9). A total of 5084 (31.7%) received chemotherapy, 1385 (8.6%) immunotherapy and 7870 (49.1%) radiotherapy. Amongst all included patients, 4376 (27.3%) received any type of cardiac care. Cardiology specific laboratory tests (e.g. Troponin) were performed in 96 (0.6%). Imaging procedures, such as echocardiography and MUGA occurred in 1853 (11.5%) and 1544 (9.6%) patients, respectively. Of the 5084 patients receiving chemotherapy 1862 (36.6%) received any type of imaging or cardiac care, of the 1385 patients receiving immunotherapy 689 (49.7%), and of the 7870 patients receiving radiotherapy 2401 (31.7%). Conclusions This study shows that only a quarter of Dutch women treated for BC receive cardiac surveillance. Diagnostic procedures or laboratory tests to detect cardiotoxicity are not structurally performed in women receiving cardiotoxic cancer treatments (e.g. chemo- and radiotherapy). A more structural approach and individual risk assessment is needed to provide more tailored cardiac care during BC treatment.

Student–staff partnerships in learning and teaching: an overview of current practice and discourse

ABSTRACTStudent–staff partnerships in learning and teaching are not a new idea but have seen a growing interest and momentum in recent years. In this article, I provide an overview of the background and context of increased student–staff partnerships, a definition of partnership and some of the benefits. I highlight several examples of practice from different countries, universities and disciplines, and involving different numbers of students, which help to illustrate some of the variety of what is possible in student–staff partnerships in learning and teaching but also some of the challenges. I will focus on key ideas currently being debated in student–staff partnership work in the form of theoretical framing; contested definitions; mixed motivations and concerns about partnership being co-opted by neoliberalism; the imperative of inclusion; and the role of student–staff relationships. I conclude by considering what ways geographers might contribute to future research and practice, by offering some practical strategies for establishing and maintaining good quality partnerships in learning and teaching and with suggestions for enhancing the community and culture within which we operate.

Social management in captive great apes: An overview of current practice and related studies

Social management in captive great apes: An overview of current practice and related studies

Non-invasive ventilation for the management of children with bronchiolitis (NOVEMBR): a feasibility study and core outcome set development protocol

BackgroundBronchiolitis is an acute lower respiratory infection which predominantly affects young children. Treatment for bronchiolitis is limited to supportive therapy. Nasal oxygen therapy is part of routine care, and delivery now incorporates varying levels of non-invasive continuous positive airway pressure and/or high-flow nasal cannula oxygen therapy. Despite wide clinical use, there remains a lack of evidence on the comparative effectiveness and safety of these interventions. Furthermore, research in this field is hampered by the use of multiple outcome measures in current clinical trials.Methods/designThis mixed methods study includes a systematic review of outcome measures, telephone interviews with parents, focus group workshops and a Delphi survey with healthcare professionals and parents. These methods will be used to identify and prioritise outcomes for inclusion in a core outcome set and to explore issues pertinent to the design of a future randomised controlled trial comparing different modes of oxygen therapy for bronchiolitis. UK hospitals will also be contacted and asked to complete a survey to provide an overview of current practice to enable assessment of capability and capacity to run a future clinical trial.DiscussionThis study will facilitate the design of a future clinical trial of non-invasive ventilation in children with bronchiolitis which is acceptable to important stakeholders. Furthermore, core outcome set development will improve standardisation, measurement and reporting of clinically important outcomes in bronchiolitis.Trial registrationISRCTN Registry, ISRCTN75766048. Registered on 18 December 2017. This study was retrospectively registered in the ISRCTN Registry and on the Core Outcome Measures in Effectiveness Trials (COMET) Initiative database (15 September 2017).

Blunt thoracic aortic injury

Blunt thoracic aortic injury (BTAI) is a significant problem in cardiothoracic trauma. It is a leading cause of prehospital death from high energy motor vehicle crashes. Injuries can be classified into one of four grades: grade I – intimal tear; grade II – intra-mural hematoma; grade III – pseudoaneurysm and grade IV – uncontained rupture. Clinical symptoms and signs are often limited, especially in minor injury grades. Left sided hemothorax and a widened mediastinum on chest radiography are concerning features suggestive of BTAI. Computed scanning is now an indispensable tool used to evaluate patients and has largely replaced aortography. The aim of management is to control hemorrhage (if present) and to reduce the risk of delayed aortic rupture. Patients with pseudoaneurysm can undergo semi-elective repair, provided blood pressure can be controlled which is critical to preventing lesion progression and rupture. Patients presenting with an uncontained rupture require emergent repair. The preferred method of intervention is no longer operative repair (with bypass for distal perfusion), but thoracic endovascular aneurysm repair (TEVAR). An endovascular approach is associated with a lower morality and lower rates of spinal cord ischemia. The aim of this review is present the history of management and the supporting evidence along with an overview of current practice from a busy US trauma center.

Anti-EGFR monoclonal antibody panitumumab for the treatment of patients with metastatic colorectal cancer: an overview of current practice and future perspectives

ABSTRACTIntroduction: Targeted agents alone or in combination with chemotherapy are current standard of treatment for metastatic colorectal cancer (mCRC). Panitumumab is a fully human monoclonal antibody which inhibits the epidermal growth factor receptor (EGFR). It is currently approved in combination with chemotherapy in first- and second-line and as a monotherapy in chemorefractory patients. RAS gene mutations confer resistance to anti-EGFR agents; thus, panitumumab is restricted to the treatment of RAS wild-type (WT) tumors.Areas covered: This review explores the available data on panitumumab and presents new perspectives on predictive markers of anti-EGFR efficacy including primary tumor sidedness and BRAF mutations. Other details covered include panitumumab’s mechanism of action, pharmacokinetics, pharmacodynamics and safety aspects of the therapy as well as mechanisms of secondary resistance and future prospects of treatment in different settings.Expert opinion: Panitumumab has significantly added to the treatment armamentarium for RAS WT mCRC. The effort spent in identifying predictive biomarkers of panitumumab efficacy has been of pivotal importance to development of the molecular selection of patients with mCRC. Primary and secondary resistance, however, still represent important issues. Novel strategies to overcome those issues are currently underway with promising results which highlight the potential use of panitumumab in combination with other targeted agents in the future.

Case formulation in forensic practice: challenges and opportunities

Purpose– The purpose of this paper is to provide an overview of current practice in forensic case formulation, describing different approaches and discussing some of the practical and ethical issues that routinely arise. The paper further identifies areas where future practice and research might be strengthened.Design/methodology/approach– There is only a very small literature to draw upon in reviewing this topic. Therefore a narrative literature review was undertaken, synthesising findings from published, peer-reviewed studies, and papers that addressed case formulation in psychological practice.Findings– Despite case formation being considered by many to be a core competency of evidence-based forensic practice, it is not currently possible to describe a typical forensic case formulation or advocate for a particular approach to practice.Practical implications– A number of practical and ethical issues routinely arise in the process of conducting a forensic case formulation. Ultimately, the absence of a consistent approach can lead to lead to poor clinical decision-making and the delivery of inadequate or inappropriate intervention.Originality/value– This is one of the few discussions of case formulation that have been prepared for forensic practitioners. It is likely to be of interest to readers of the journal given the importance of the formulation process in contemporary forensic practice.

SP-0619: PotD external beam: overview of current practice

SP-0619: PotD external beam: overview of current practice

Sentinel lymph node biopsy for head and neck mucosal cancers - an update on the current evidence.

Regional metastases are a prominent feature of mucosal-associated head and neck squamous cell carcinomas and are an important prognostic factor. Sentinel lymph node biopsy (SLNB) is one modality that has potential to add to the accuracy of neck staging, although it is currently not used as widely in the head and neck as it is in other areas such as breast cancer. We review the efficacy of SLNB in head and neck mucosal squamous cell carcinomas and provide an overview of current practice and include details of technical advances.