Search

Many technology acceptance models used in education were originally designed for general technologies and later adopted by education researchers. This study extends Davis' technology acceptance model to specifically evaluate educational technologies in higher education, focusing on virtual classrooms. Prior research informed the construction of the model, which contains perceived usefulness, perceived ease of use, behavioural intent, access and convenience, system attributes and self‐efficacy. Education‐specific constructs include cognitive engagement, feedback, instructor practice and class interaction and communication. Additionally, a new construct called comfort and well‐being is introduced. A total of 427 valid responses on a 5‐point Likert scale were received from university students. Exploratory factor analysis, confirmatory factor analysis and structural equation modelling were used to analyse the data. The model accounted for 78% of variance of behavioural intent, with comfort and well‐being demonstrating the strongest influence. Cognitive engagement, access and convenience influenced perceived usefulness, and system attributes and self‐efficacy influenced perceived ease of use. Feedback, instructor practice and class interaction and communication were not significant as educational constructs for this cohort. Based on this analysis, a final extended educational technology acceptance model (EETAM) is proposed for further use and testing.Practitioner notesWhat is already known about this topic Most technology acceptance models used in education were made for general technologies, or do not include factors specific to learning and pedagogy. Most students prefer face‐to‐face learning experiences and active class engagement. Qualitative research shows that instructional attributes and student comfort and well‐being are known to be important for students. What this paper adds A novel extended educational technology acceptance model, informed by prior empirical research, is presented. Confirmation of the importance of including student comfort and well‐being in technology acceptance models used in education. The model revealed the heterogeneous nature of the student learning experience. Implications for practice and research Technology acceptance models used in educational settings should include factors specific for education and learning, and student comfort and well‐being. We encourage use of the presented model in educational settings to further test the model. Most technology acceptance models used in education were made for general technologies, or do not include factors specific to learning and pedagogy. Most students prefer face‐to‐face learning experiences and active class engagement. Qualitative research shows that instructional attributes and student comfort and well‐being are known to be important for students. A novel extended educational technology acceptance model, informed by prior empirical research, is presented. Confirmation of the importance of including student comfort and well‐being in technology acceptance models used in education. The model revealed the heterogeneous nature of the student learning experience. Technology acceptance models used in educational settings should include factors specific for education and learning, and student comfort and well‐being. We encourage use of the presented model in educational settings to further test the model. [ABSTRACT FROM AUTHOR]

This paper discusses a two-year study at an Australian university in which 154 undergraduate and 51 postgraduate students reflected on their experiences with flexible and personalised assessment where they could choose assessment tasks, submission dates and weightings of their assignments. Through pre- and post-course surveys and a focus group, feelings of empowerment and attitudes towards flexibility were investigated. Students were positive about all aspects of the flexible approach and felt it was beneficial for their learning. Only the postgraduate group showed significant improvement in feelings of empowerment and grades suggesting that more experienced learners may adapt more easily to this model. We argue that empowering learners is not about better grades but about students gaining more input, voice and control in their learning and assessment. Despite the disadvantages of increased workload for teachers and a decision-making burden on students, the potential benefits for students justify consideration of more personalised and flexible assessment. [ABSTRACT FROM AUTHOR]

Background: Depressive episodes are common after first-episode psychosis (FEP), affecting more than 40% of people, adding to individual burden, poor outcomes, and healthcare costs. If the risks of developing depression were lower, this could have a beneficial effect on morbidity and mortality, as well as improving outcomes. Sertraline is a selective serotonin reuptake inhibitor and a common first-line medication for the treatment of depression in adults. It has been shown to be safe when co-prescribed with antipsychotic medication, and there is evidence that it is an effective treatment for depression in established schizophrenia. We present a protocol for a multi-centre, double-blind, randomised, placebo-controlled clinical trial called ADEPP that aims to investigate the efficacy and cost-effectiveness of sertraline in preventing depression after FEP. Methods: The recruitment target is 452 participants between the ages of 18 and 65 years who are within 12 months of treatment initiation for FEP. Having provided informed consent, participants will be randomised to receive either 50 mg of sertraline daily or matched placebo for 6 months, in addition to treatment as usual. The primary outcome measure will be a comparison of the number of new cases of depression between the treatment and placebo arms over the 6-month intervention phase. Secondary outcomes include suicidal behaviour, anxiety, rates of relapse, functional outcome, quality of life, and resource use. Discussion: The ADEPP trial will test whether the addition of sertraline following FEP is a clinically useful, acceptable, and cost-effective way of improving outcomes following FEP. Trial registration: ISRCTN12682719 registration date 24/11/2020. [ABSTRACT FROM AUTHOR]

Persistent anxiety in childhood and adolescence could represent a novel treatment target for psychosis, potentially targeting activation of stress pathways and secondary nonresolving inflammatory response. Here, we examined the association between persistent anxiety through childhood and adolescence with individuals with psychotic experiences (PEs) or who met criteria for psychotic disorder (PD) at age 24 years. We also investigated whether C-reactive protein mediated any association. Data from the Avon Longitudinal Study of Parents and Children (ALSPAC) were available in 8242 children at age 8 years, 7658 at age 10 years, 6906 at age 13 years, and 3889 at age 24 years. The Development and Well-Being Assessment was administered to capture child and adolescent anxiety. We created a composite score of generalized anxiety at ages 8, 10, and 13. PEs and PD were assessed at age 24, derived from the Psychosis-like Symptoms Interview. The mean of C-reactive protein at ages 9 and 15 years was used as a mediator. Individuals with persistent high levels of anxiety were more likely to develop PEs (odds ratio 2.02, 95% CI 1.26–3.23, p =.003) and PD at age 24 (odds ratio 4.23, 95% CI 2.27–7.88, p <.001). The mean of C-reactive protein at ages 9 and 15 mediated the associations of persistent anxiety with PEs (bias-corrected estimate −0.001, p =.013) and PD (bias-corrected estimate 0.001, p =.003). Persistent high levels of anxiety through childhood and adolescence could be a risk factor for psychosis. Persistent anxiety is potentially related to subsequent psychosis via activation of stress hormones and nonresolving inflammation. These results contribute to the potential for preventive interventions in psychosis, with the novel target of early anxiety. [ABSTRACT FROM AUTHOR]

Rationale: Rumination is a repetitive, negative, self-focused thinking style associated with various forms of psychopathology. Recent studies suggest that rumination increases craving for alcohol and predicts harmful drinking and alcohol-related problems. However, the acute effects of alcohol on rumination have not been previously studied. It is proposed that alcohol may reduce ruminative thinking through decreasing negative mood. Objectives: In the present study, we aimed to test the previously unexplored effects of acute alcohol consumption on rumination in a hazardous drinking population. Methods: We conducted a randomised placebo-controlled laboratory study to examine the effect of low (0.4 g kg−1) and high doses (0.8 g kg−1) of alcohol on state rumination compared to placebo. Participants completed a rumination induction task prior to receiving drinks. We then measured state rumination and mood at repeated time points; 30 min, 60 min and 90 min post-drinks consumption. Results: We found a significant decrease in state rumination in the low-dose alcohol group compared to placebo at 30 min post-alcohol consumption, but no difference was observed between the high-dose alcohol and placebo groups. Mediation analysis provided evidence for an indirect effect of alcohol on state rumination through concurrent changes in negative mood. Conclusions: These findings suggest that acute alcohol consumption can regulate negative mood and concurrently rumination, providing preliminary evidence for the role of rumination in alcohol use disorders. Rumination may be a treatment target in alcohol use disorders. [ABSTRACT FROM AUTHOR]

Although traditional assumptions tend to conceptualize stress as inherently dysfunctional, psychological theory suggests that it is not intrinsically maladaptive. Contemporary models emphasize that the stress response can be differentiated into both negative and positive aspects, known as distress and eustress. Research examining the differential effect of positive and negative stress on adolescent well‐being is limited and has been hindered by a lack of appropriate measurement tools. The aim of the present study was to utilize the recently developed Adolescent Distress‐Eustress Scale to provide a balanced understanding of the impact of stress on positive mental health, holistically considering the effect of both distress and eustress on adolescent well‐being. One thousand eighty‐one Australian adolescents (Mage = 15.14, 54.03% female) completed an online survey composed of the Adolescent Distress‐Eustress Scale alongside measures of well‐being, self‐efficacy, psychological ill‐being, physical activity, and daytime sleepiness. Conditional process analysis suggested that distress exerted no direct influence on well‐being, with the observed negative relationship fully mediated by psychological and behavioural variables. Contrastingly, eustress was both directly related to increased well‐being and exerted an indirect effect through relationships with mediating variables. These results demonstrate that stress can have profoundly positive consequences. Theoretical contributions, implications for practice, and perspectives for future research are discussed. [ABSTRACT FROM AUTHOR]

The aim of this theoretical review was to identify the important factors shown to affect attitudes towards use of educational technologies by students or educators in higher education institutions and organise them into broad, intermediate and narrow groupings. This was done to assist the construction of more objective measurement instruments used in the evaluation of educational technologies. A qualitative review of the influential factors that affect user attitudes, intentions and motivations to use educational technologies was conducted, first by interrogating the fundamental behavioural theories underpinning technology acceptance models, and then by exploring the findings of later and contemporary empirical research conducted in the educational context. Identified factors were grouped to produce an ordered taxonomy of measurement constructs. This taxonomy provides each construct's lineage back through tertiary, secondary and primary taxonomic groups and provides a greater scope of measurement than commonly used models. Seven primary and twenty two secondary and tertiary taxonomic groups were defined, which collectively comprise sixty one measurement constructs. The taxonomy is designed to reduce measurement bias within studies and also acts as a basis for consistent and objective benchmarking within and across institutions. Practitioner NotesWhat is already known about this topic Technology acceptance models are derived from a number of foundational behavioural and motivational theories.The TAM and UTAUT are validated models that appraise attitude and/or behavioural intent to use an educational technology, which nonetheless do not cover the entire scope of what has been shown to be important in various studies.There is little consistency from study to study of measurement constructs used in technology acceptance models.What this paper adds Collection and organisation of the salient measurement constructs into a flexible taxonomy.Establishment of a consistent measurement scope that is specifically suited to educational technology research.Establishment of construct lineage that clearly shows similarities and differences between the various constructs.Implications for practice and/or policy The taxonomy supports robust instrument construction to improve both convergent and discriminant validity of measurement models.The taxonomy provides a recommended scope for higher education institutions to measure factors affecting use of various educational technologies.Consistent use of the taxonomy will provide an objective standard that can be used to compare across institutions or within institutions over time, which assist with benchmarking and management decisions.The taxonomy can be used as a framework for meta‐analyses or to collate 'prior' data to use in Bayesian‐type technology evaluation. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to compare and contrast characteristics of use and adoption of mobile learning in higher education in developed and developing countries. A comparative case study based on a survey questionnaire was conducted with 189 students (undergraduate and postgraduate) from Makerere University in Uganda and the University of Adelaide in Australia. The Unified Theory of Acceptance and Use of Technology (UTAUT) was employed as the theoretical framework. The results indicated that higher education students in developed and developing countries use a range of technologies for learning, with major differences between Uganda and Australia. The study concludes that mobile learning in higher education in developed and developing country contexts is still at an experimental stage with students using mobile devices in pedagogically limited ways. [ABSTRACT FROM AUTHOR]

Optic nerve head drusen are benign acellular calcium concretions that usually form early in life, just anterior to the lamina cribrosa. Improving imaging using optical coherence tomography suggests they are common and may be present in many clinically normal discs. These drusen may change in appearance in early life, but are generally stable in adulthood, and may be associated with visual field defects, anterior ischaemic optic neuropathy, or rarer complications. Based on long-term clinical data and optical coherence tomography, we propose a refined hypothesis as to the cause of optic disc drusen. Here we summarise recent findings and suggest future studies to better understand the forces involved. [ABSTRACT FROM AUTHOR]

Self and peer-assessment are becoming central aspects of student-centred assessment processes in higher education. Despite increasing evidence that both forms of assessment are helpful for developing key capabilities in students, such as taking more responsibility for their own learning, developing a better understanding of the subject matter, assessment criteria and their own values and judgements, and developing critical reflection skills, both forms of assessment are still not the norm at universities. This paper provides the findings of a two-year study of formative self and peerassessment at an Australian university. The study supports other research showing that students tend to regard formative self and peer-assessment as beneficial for gaining more insights about the assessment process and for improving their own work. We argue that self and peer-assessment requires careful design and implementation for it to be an effective tool for formative assessment processes; and that the development of students'capacities for giving feedback, and the continuous and timely involvement of the teacher, are central aspects for successful self and peer-assessment. The move to self and peer-assessment is not simple for teachers and students but is worthwhile and necessary for twenty-first century higher education. [ABSTRACT FROM AUTHOR]

This article assesses Reacting to the Past , a humanities role-immersion pedagogy that is popular at many colleges and universities in the United States. This pedagogy has been found to have many learning gains compared to traditional face-to-face teaching, but has not been adequately compared to online versions of the course. The findings of the article suggest that while learning gains can be achieved that are comparable to face-to-face versions of the course, student satisfaction was lower. The article concludes not by rejecting the online Reacting to the Past , however, but by suggesting possible ways to incorporate successful elements of it within a blended approach. These findings will be of interest to people interested in this particular pedagogy, but also to those who are interested in the general comparison between online and face-to-face learning and teaching. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to analyse gender differences in wellbeing, as related to work status, among working-age people with severe impairments. Methods: This study is based on register and survey data for a sample of 7298 persons, drawn from the entire Swedish population of 15,515 working-age people 16–64 years old who, at the end of 2010, received Sweden’s unique personal assistance allowance, an allowance paid from the Swedish Social Insurance Agency (SSIA) to persons with severe impairments, enabling them to pay for assistants to support them in the functions of daily life. Logistic regression models were used to estimate the strength of relations between six measures of wellbeing, work status (not working, irregular work and regular work) and gender, together with key confounders. Results: Of the persons surveyed, 21% responded that they had regular work. Gender differences were found for all confounders, except for age. They were mostly in favour of men, which could reflect the general pattern in the labour market at large. Our results indicated there are substantial differences between non-working, irregularly working and working persons for several wellbeing aspects. Conclusions: This study analyses the contributions to wellbeing of work participation among working-age people with severe impairments, with a focus on gender differences. The analysis shows that work is an important determinant of the six measures of wellbeing examined, where the relationship between work participation and wellbeing is especially strong for peoples’ perceived standard of living. This major finding holds for both genders; however, the data show gender imbalance, in that compared with women, there was a larger percentage of men with severe impairments who have regular work. Future research should focus on finer distinctions between the types of work and the value added of personal assistants in the work context. Measures of general health not available for this study are needed to filter out a clearer picture of the interaction of work and well-being. Despite drawbacks, this study is nevertheless path-breaking in its focus on the value of work participation for the well-being of persons with severe impairments. For this reason, it provides a valuable extension of our knowledge and a clear point of departure for future studies. [ABSTRACT FROM AUTHOR]

Flexible teaching and learning and the ‘flipped classroom’ are current buzzwords in higher education in Australia and elsewhere in the world. They are reflections of the progressive change in higher education over the last few decades towards more student-and learning centred pedagogies and practices, which are made possible through new technologies and more delivery of online and blended (combination of face-to-face and online components) courses. The increasing personalising and flexibility of learning in higher education requires equal attention spent to assessment practices to ensure a cohesive learning experience. This paper provides the findings and conclusions of a study about a flipped classroom, which also included flexible assessment components. The study showed that students enjoy and are more engaged in a flipped classroom, prefer a blended learning to a fully online learning approach, want and require clear structure and guidelines, and strongly value flexible assessment through more choices and control. The main concern of higher education teachers is the time commitment and lack of institutional support for flipping classrooms and providing flexible assessment. It is argued that personalising learning requires more personalising of assessment, and that it is mainly the responsibility of teachers and institutions to develop ‘flexible students’. [ABSTRACT FROM AUTHOR]

Simple Summary: Entrepreneurship and intrapreneurship (entrepreneurial behaviour of employees) foster business innovation and growth and support wealth creation and employment in both privately owned and corporate businesses such as those that deliver contemporary veterinary services. Yet we know little about the propensity for entrepreneurship or intrapreneurship of entrants to the veterinary sector. In our study population of veterinary science, entrepreneurship, and human nursing final-year students, veterinary respondents stood out overall for their high entrepreneurial intention and outcome expectations of business ownership but low financial self-efficacy and corporate work intentions. These findings raise questions about (i) the effectiveness of veterinary business curricula which focus on expense management and (ii) the goals and expectations of new entrants to the veterinary sector. However, cluster analysis of responses to these measures revealed that 28.8% of veterinary respondents were entrepreneurial, 17.8% entrepreneurial and intrapreneurial (particularly men), and 13.1% intrapreneurial only (i.e., ~31% intrapreneurial), signalling the opportunities and risks for large veterinary businesses to harness these individuals and their intrapreneurial tendencies. Post hoc analysis revealed cluster differences per veterinary school. To inform curricular change, we recommend further research to evaluate the relative impact of individual factors, admissions factors, and the formal or hidden curricula on entrepreneurial intention in veterinary final-year students. Little is known about veterinary entrepreneurial predisposition. Yet entrepreneurship and intrapreneurship (entrepreneurial behaviour of employees) foster business innovation and growth and support wealth creation and employment in both privately and corporately owned businesses which deliver contemporary veterinary services. We used responses from 515 final-year students in Australian entrepreneurship, nursing, and veterinary programs to capture entrepreneurial intention (EI), outcome expectations (OE-sb), entrepreneurial self-efficacy (ESE), and corporate/large organisation work intentions (CWIs). Veterinary respondents stood out for their high EI and high OE-sb, but low financial ESE and low CWI. Proportions of veterinary, entrepreneurship, and nursing respondents differed markedly across distinct cluster profiles representing entrepreneurial, intrapreneurial, both entrepreneurial and intrapreneurial, indifferent, and corporate employment intentions and attributes. Post hoc analysis revealed proportional cluster membership differences for respondents from different veterinary schools. Our findings raise questions regarding (1) the effectiveness of veterinary business curricula competencies which focus on expense management and (2) the implications of the mismatch of motivations and goals of new veterinary sector entrants whose low intent to work in a corporate environment is at odds with increasing corporate ownership of veterinary practices. To inform curricular change, we recommend further research to evaluate the relative impact of individual factors, admissions factors, and the formal or hidden curricula on entrepreneurial intention in veterinary final-year students. [ABSTRACT FROM AUTHOR]

The principal objective of this article is to offer an extended theoretical framework for further development of persuasive message design for media-based health campaigns. Drawing upon considerable convergent evidence that attention to and processing of persuasive messages is a function of both cognitive and biologically based processes, we consider implications for attention and processing from an extension of the activation model of information exposure through the addition of a cognitive variable associated with the elaboration likelihood model, need for cognition. The overall goal is to determine how target audiences are optimally influenced with persuasive health information that attracts and holds attention, triggers information processing, and eventually brings about behavior change. [ABSTRACT FROM AUTHOR]

Following the Second World War, the idea of the life course with distinct periods of education, work, and retirement became popular as a result of the alliance of interests of unions and management, with politicians seizing the opportunity to accommodate them. These "social partners" implemented benefit rules and created practices for using old age and disability to ease the exit of older workers. Although justifiable at the time, now those rules and practices hinder individual and employer incentives to invest in human capital and work environments that enable older workers to remain in the workforce. The article argues that the workforce environment of the coming half-century, which is relevant for persons born around 2000, is much different from that a hundred years earlier, which determined the opportunities for people born around 1900. People are healthier and live much longer and work environments are friendlier. The article argues that it is no longer justifiable to subsidize exit from the workforce around the age of 60 for healthy workers, especially in view of the coming labor shortage in Europe. It also argues that the introduction of the principles of the Swedish NDC pension reform in Europe would provide possibilities for flexible exit from the workforce and remove impediments to labor mobility in Europe, which are embedded in many of Europe's present pension arrangements. [ABSTRACT FROM AUTHOR]

Background: Computer-aided learning is accepted by students as a learning resource, but the views of the teaching community are largely unknown. Purpose: To document clinicians' experience with computers and to record their attitudes toward computer usage in clinical practice and student education. Methods: Questionnaire mailed out to all clinicians, including interns and residents, fellows, and attending physicians in 3 major teaching hospitals in South Australia, with a total of 646 clinical staff. Results: Replies were received from 246 staff. Eighty percent of clinicians had at least 2 years of experience with computers and used computers for at least 2 hr each week. Despite this, there was an obvious lack of conviction among clinicians that computer-aided learning was of use in student education and assessment. This may reflect their lack of experience with this medium as an educational tool. Conclusions: If computer-aided learning is to make any significant impact on medical student education, it must be carefully and objectively evaluated, and its benefit must be clearly demonstrated to clinical teachers. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to evaluate the place of computer-aided learning in a basic science course in the undergraduate medical curriculum at the University of Adelaide. Methods A software program was written which would allow students to study the anatomy and physiology of the liver and biliary tree in three different styles. Identical content was produced, matched for each style (problem-based, didactic and free text response) and students randomly allocated to one of four groups (three computer and one control). Students were tested before and after access to the program. Results Ninety second-year students completed the study. Those students who had access to the material in the problem-based and free text response styles did no better in the post-study test than the controls, whilst the group who had studied the didactically presented computer material performed significantly better than the other three groups. All three computer groups accessed the material on a similar number of occasions, but the group who had access to the free text entry program spent significantly less time on computer study. Conclusions If computer materials are to be provided as a learning resource for the basic medical sciences, provision must be made for the style of teaching of the course and the style of learning of the students attending that course. [ABSTRACT FROM AUTHOR]

This article examines the historic plight, current status, and future challenges of Blacks in the United States within the contexts of education, housing, employment, poverty, crime and the legal system. It is concluded that the Reagan administration legacy of a "colorblind society", social program cutbacks, and Supreme court appointments dealt a devastating blow to opportunity and progress for Blacks and that the current and future challenges will require a concerted effort, concern and involvement by all sectors of society. [ABSTRACT FROM AUTHOR]

The article examines the striking conceptual similarities between the personality-theory approach of Dr Carl Rogers and the television-programming approach of Mr Fred Rogers. Their similarities in background and early training, their basic concern for children, and their focussing on concepts of acceptance, feelings, sensitivity and growth-experience are examined and discussed. [ABSTRACT FROM AUTHOR]

Reports on the development of a computer-based learning package aimed at expanding students' knowledge base, as well as improving data-handling abilities and clinical problem-solving skills. Evaluation of the program by monitoring of its use by students and canvassing of users' opinions; Measurement of the effectiveness as a learning tool compared to tutorials on the same material.

Evaluates the place of the computer in the assessment of clinical skills of junior medical students in Adelaide, South Australia. History taking and physical examination skills of the students; Correlation between the performance of students at the non-computer history taking stations, the examination stations and the overall performance; Scores of the students on the computer-based tasks and in the observed stations.

The flipped classroom model challenges the way educators structure and implement their courses, and how students learn. Although there is burgeoning evidence for the effectiveness of flipped classrooms for improving student performance, student satisfaction is also an important consideration insofar as student evaluations can affect uptake of new education approaches. Yet we know little about the extent to which students are satisfied with the flipped model. To address this discrepancy, this article reports a world‐first meta‐analysis of student satisfaction with flipped classrooms and teachers relative to traditional teaching approaches across disciplines and education level (overall 53 studies; 8,429 students). Overall, the flipped classroom had a weak–moderate positive effect on student satisfaction with courses (k = 50; g = 0.36) and instructors (k = 26; g = 0.40). We also report moderating effects relating to discipline, education level, pre‐class testing, in‐class activities, group size, and sophistication of flipped designs. Lay Description: What is already known about this topicThe flipped classroom model is now widely employed around the worldThere is increasing evidence that it is associated with improved student performance, relative to traditional teaching approachesStudent satisfaction with teaching has implications for student motivation and performance; teacher‐related outcomes; and institution recruitment and fundingWhat this paper addsReports a world‐first meta‐analysis of effects of the flipped classroom model on student satisfaction, relative to traditional teaching approaches (overall 53 studies; 8,429 students)The flipped classroom has a weak‐moderate positive effect on student satisfaction with courses (k = 50; g = 0.36) and instructors (k = 26; g = 0.40)Even a classroom that is only 'minimally' flipped is associated with higher levels of student satisfaction, relative to traditional teaching modelsImplications for practice and/or policyFlipped classroom designs should be encouraged on both pedagogical and pragmatic grounds; in the case of the latter, students prefer a flipped classroom approachStudents are likely to respond positively to teachers and institutions who employ a flipped classroom approach [ABSTRACT FROM AUTHOR]

Background: Exit examinations in medicine are ‘high stakes’ examinations and as such must satisfy a number of criteria including psychometric robustness, fairness and reliability in the face of legal or other challenges. Aims: We have undertaken a critical review of the exit examination from the University of Adelaide focussing on the written components. This examination consisted of an objective structure clinical examination (OSCE), a multiple choice question (MCQ) paper and a modified essay question (MEQ) paper. Methods: The two written papers were assessed for item writing flaws and taxonomic level using modified Bloom's criteria. Curriculum experts independently assessed adequacy of the examination for validity and fidelity. Results: The overall examination had good fidelity and validity. The results of the MEQ and MCQ were strongly and positively correlated and there was a weak negative correlation between these papers and the OSCE. The MEQ had a higher proportion of questions focussed on recall of knowledge and the questions were more structurally flawed compared with the MCQs. The MEQ re-marking process resulted in lower scores than were awarded by the original, discipline-based expert markers. The MEQ paper failed to achieve its primary purpose of assessing higher cognitive skills. Conclusion: The University of Adelaide's MBBS programme has since dropped the MEQ paper from its exit examination and is evaluating in its place the Script Concordance test. [ABSTRACT FROM AUTHOR]

This paper presents a wide-area control approach to improve the transient stability of the power systems while also damping the post-fault inter-area oscillations. The proposed approach employs a nonlinear Kalman filter to estimate the inter-area modes using phasor measurement units (PMUs). The wide-area control system then uses the estimated inter-area dynamics through the developed control algorithms to improve the first swing and damping stability of the system. The performance of the proposed approach is evaluated on the simplified Australian test system with different load models including induction motors and the results show significant improvement in the stability of the system by simply adding the wide-area control signals to the available controllers in the system. The application of the proposed wide-area control system is shown to be feasible on realistic systems by improving the system stability and efficiency. [ABSTRACT FROM PUBLISHER]

This study proposes a new method for stabilising disturbed power systems using wide‐area measurement and controllable devices. A new control algorithm based on kinetic energy is proposed to be applied on the controllers to improve the first swing stability of power systems following large disturbances while also damping the subsequent inter‐area oscillations. The wide‐area controller is implemented by using the Kalman filter estimation of the area‐based model of the system, to stabilise the inter‐area dynamic and improve the stability margin of the system. The proposed approach is simulated on several test systems and the results show significant improvement in the first swing and damping stability of the test systems. [ABSTRACT FROM AUTHOR]

Aims: Studies show a negative association between an absence from work due to disease of injury (sickness absence (SA)) and subsequent earnings; however, little is known about the association between SA and an individuals’ subsequent overall economic welfare. Our primary objective was to evaluate individuals’ disposable income (DI) following a spell of SA. Our secondary objective was to examine if the potential association between SA and DI differs, depending on the diagnosis given to that sickness or the duration of the SA spell. Methods: We used a cohort based on a linked individual register database that includes all individuals living in Sweden from 2001 to 2005, aged 30–54. DI was measured 2–6 years after a spell of SA and compared with a propensity score-matched reference group (individuals without SA in 2005). Each year of follow-up during 2007–2011 was estimated by linear regression for three different forms of exposure: SA (yes/no), diagnosis specific (cancer, circulatory, injuries, musculoskeletal or mental illnesses), and by duration of the SA spell (15–29, 30–89, 90–179 or > 179 days). Results: Individuals with SA during 2005 had 4% lower disposable income in subsequent years than the reference group. Our results were similar across diagnoses, except for mental diagnoses, where disposable income was 7–10% lower than the reference group; and for cancer, where we found only a marginal difference among those with SA and the reference group. Furthermore, DI was negatively associated with the SA spell duration. Conclusions: SA was associated with lower subsequent DI, 2–6 years after a SA spell, especially after a mental illness diagnosis and if the SA was for longer spells. [ABSTRACT FROM PUBLISHER]

Objective: Early evidence suggests that ketamine may be an effective treatment to sustain abstinence from alcohol. The authors investigated the safety and efficacy of ketamine compared with placebo in increasing abstinence in patients with alcohol use disorder. An additional aim was to pilot ketamine combined with mindfulness-based relapse prevention therapy compared with ketamine and alcohol education as a therapy control.Methods: In a double-blind placebo-controlled phase 2 clinical trial, 96 patients with severe alcohol use disorder were randomly assigned to one of four conditions: 1) three weekly ketamine infusions (0.8 mg/kg i.v. over 40 minutes) plus psychological therapy, 2) three saline infusions plus psychological therapy, 3) three ketamine infusions plus alcohol education, or 4) three saline infusions plus alcohol education. The primary outcomes were self-reported percentage of days abstinent and confirmed alcohol relapse at 6-month follow-up.Results: Ninety-six participants (35 women; mean age, 44.07 years [SD=10.59]) were included in the intention-to-treat analysis. The treatment was well tolerated, and no serious adverse events were associated with the study drug. Although confidence intervals were wide, consistent with a proof-of-concept study, there were a significantly greater number of days abstinent from alcohol in the ketamine group compared with the placebo group at 6-month follow-up (mean difference=10.1%, 95% CI=1.1, 19.0), with the greatest reduction in the ketamine plus therapy group compared with the saline plus education group (15.9%, 95% CI=3.8, 28.1). There was no significant difference in relapse rate between the ketamine and placebo groups.Conclusions: This study demonstrated that treatment with three infusions of ketamine was well tolerated in patients with alcohol use disorder and was associated with more days of abstinence from alcohol at 6-month follow-up. The findings suggest a possible beneficial effect of adding psychological therapy alongside ketamine treatment. [ABSTRACT FROM AUTHOR]

A new approach is proposed for obtaining a non‐linear area‐based equivalent model of power systems to express the inter‐area oscillations using synchronised phasor measurements. The generators that remain coherent for inter‐area disturbances over a wide range of operating conditions define the areas, and the reduced model is obtained by representing each area by an equivalent machine. The parameters of the reduced system are identified by processing the obtained measurements, and a non‐linear Kalman estimator is then designed for the estimation of equivalent area angles and frequencies. The simulation of the approach on a two‐area system shows substantial reduction of non‐inter‐area modes in the estimated angles. The proposed methods are also applied to a ten‐machine system to illustrate the feasibility of the approach on larger and meshed networks. [ABSTRACT FROM AUTHOR]

Objectives: To describe the epidemiology of sepsis in critical care by applying the Sepsis-3 criteria to electronic health records.Design: Retrospective cohort study using electronic health records.Setting: Ten ICUs from four U.K. National Health Service hospital trusts contributing to the National Institute for Health Research Critical Care Health Informatics Collaborative.Patients: A total of 28,456 critical care admissions (14,332 emergency medical, 4,585 emergency surgical, and 9,539 elective surgical).Measurements and Main Results: Twenty-nine thousand three hundred forty-three episodes of clinical deterioration were identified with a rise in Sequential Organ Failure Assessment score of at least 2 points, of which 14,869 (50.7%) were associated with antibiotic escalation and thereby met the Sepsis-3 criteria for sepsis. A total of 4,100 episodes of sepsis (27.6%) were associated with vasopressor use and lactate greater than 2.0 mmol/L, and therefore met the Sepsis-3 criteria for septic shock. ICU mortality by source of sepsis was highest for ICU-acquired sepsis (23.7%; 95% CI, 21.9-25.6%), followed by hospital-acquired sepsis (18.6%; 95% CI, 17.5-19.9%), and community-acquired sepsis (12.9%; 95% CI, 12.1-13.6%) (p for comparison less than 0.0001).Conclusions: We successfully operationalized the Sepsis-3 criteria to an electronic health record dataset to describe the characteristics of critical care patients with sepsis. This may facilitate sepsis research using electronic health record data at scale without relying on human coding. [ABSTRACT FROM AUTHOR]

Abstract: This paper proposes a new approach for state estimation of angles and frequencies of equivalent areas in large power systems with synchronized phasor measurement units. Defining coherent generators and their correspondent areas, generators are aggregated and system reduction is performed in each area of inter-connected power systems. The structure of the reduced system is obtained based on the characteristics of the reduced linear model and measurement data to form the nonlinear model of the reduced system. Then a Kalman estimator is designed for the reduced system to provide an equivalent dynamic system state estimation using the synchronized phasor measurement data. The method is simulated on two test systems to evaluate the feasibility of the proposed method. [Copyright &y& Elsevier]

This study analyses the development of the economic wellbeing of Swedes aged 65 years and older from 1990. This period was characterised by Sweden's deepest and most prolonged recession since the Great Depression, but was then followed by buoyant growth. In a series of interventions from 1991 through to 1998, pensions were cut and their full price indexation abandoned. In spite of these dramatic measures, this study shows that pensioners fared better than the workingage population, but also that poverty among older Swedes increased in absolute terms. During the following years of rapid economic growth, in contrast, the growth in pensioners' income fell behind that of workers and their relative poverty increased. The analysis shows that the limited resources of many older Swedes put them close to a social poverty line. The study also shows that income inequality among older Swedes has grown with the increasing importance of capital income for the better off. We conclude that the increasing gap between better-off and worse-off older people raises issues about the future provision of expenditures on public services for them. The paper concludes that, overall, poverty among older people in Sweden remains low by international standards and that the Swedish welfare state has maintained its resilience. [ABSTRACT FROM AUTHOR]

Background: A number of previous studies have investigated various predictors for being granted a disability pension. The aim of this study was to test the efficacy of sick-leave track record as a predictor of being granted a disability pension in a large dataset based on subjects sampled from the general population and followed for a long time. Methods: Data from five ongoing population-based Swedish studies was used, supplemented with data on all compensated sick leave periods, disability pensions granted, and vital status, obtained from official registers. The data set included 8,218 men and women followed for 16 years, generated 109,369 person years of observation and 97,160 sickness spells. Various measures of days of sick leave during follow up were used as independent variables and disability pension grant was used as outcome. Results: There was a strong relationship between individual sickness spell duration and annual cumulative days of sick leave on the one hand and being granted a disability pension on the other, among both men and women, after adjustment for the effects of marital status, education, household size, smoking habits, geographical area and calendar time period, a proxy for position in the business cycle. The interval between sickness spells showed a corresponding inverse relationship. Of all the variables studied, the number of days of sick leave per year was the most powerful predictor of a disability pension. For both men and women 245 annual sick leave days were needed to reach a 50% probability of transition to disability. The independent variables, taken together, explained 96% of the variation in disability pension grantings. Conclusion: The sick-leave track record was the most important predictor of the probability of being granted a disability pension in this study, even when the influences of other variables affecting the outcome were taken into account. [ABSTRACT FROM AUTHOR]

Evaluates the use of computer-based material to supplement the clinical experience in a surgical clerkship using a software program MEDICI at the University of Adelaide in South Australia. Advantages of using the software; Potential applications.

A battery-less 5.8-GHz transmitter (TX), compact and lightweight enough to enable flight of $\sim 90$ mg honeybees and free roaming of bumblebees within their nest, was developed. The TX was coupled to a compact phased-array antenna receiver to achieve angle of arrival (AOA) estimation and bee localization through a received signal strength indicator approach (RSSI). The receiver was integrated into a commercial unmanned aerial vehicle (UAV) to support autonomous position updates based on the AOA estimates and a software development kit. A simple model predicting the system detection range was finally developed and is herein discussed. Our experimental results provide proof of concept toward autonomous tracking of tagged bees both in open air and in polytunnel settings. [ABSTRACT FROM AUTHOR]

Multimorbidity is the presence of more than one chronic disease condition in an individual. Health-related, socioeconomic, cultural and environmental factors, as well as patient behaviour, all influence the outcomes of multimorbidity. Addressing these complex and often interacting biopsychosocial factors therefore requires a shift in treatment from a physical damage model towards person-centred integrated care with increased patient agency. Education influences behaviour and can be used to empower patients and their carers with greater agency, thus allowing greater responsibility for and control over the management of patient care. In this paper we reflect on our own learning as a community of health practitioners from different disciplines. Recognizing the increasing importance of patient agency in driving the evolution of health care, we describe the concept of a web-based personal digital health hub for integrated patient care. Informed by collaboration between patient, health and education communities, we share our early experience in the implementation of a health hub around a cohort of patients with hip fractures. We also describe a vision for future health care based on the co-creation of digital health hubs centred on patients' and carers' needs. The health hub could allow important advances and efficiencies to be achieved in workforce practice and education; patient and carer engagement in self-care; and the collection of patient-reported health data required for ongoing research and improvements in health care. [ABSTRACT FROM AUTHOR]

Extant literature describes stress as an unavoidable occurrence that can be bifurcated into both negative and positive aspects, known as distress and eustress, respectively. Despite this theoretical conceptualization, there are no measures of adolescent stress encompassing both aspects of the construct. In pursuing the creation of such a measure, the current study explored young people's experience of stress, describing the phenomena adolescents identify as salient indicators of both distress and eustress. Semistructured qualitative interviews were conducted with 20 adolescents; thematic analysis of the transcripts focused on those indicators useful for discriminating between distress and eustress. In all, 6 key dimensions were proposed, along which eustress and distress were differentiated in adolescents: state of mind, function, perceived efficacy, affect, constitution, and connection. Although many of these identified phenomena were comparable with those proposed by the adult-focused literature, the participants demonstrated a range of distinctive perspectives. Unlike adults, the adolescents considered personal connections and self-regard as salient indicators of the stress response, whereas meaningfulness was not considered a pertinent phenomenon. These idiosyncrasies emphasize the inappropriateness of directly translating adult-focused literature to the adolescent context and robustly reiterate the need for a measure of stress that reflects and respects young people's unique experiences. [ABSTRACT FROM AUTHOR]

A suspension system for the BiVACOR biventricular assist device (BiVAD) has been developed and tested. The device features two semi-open centrifugal impellers mounted on a common rotating hub. Flow balancing is achieved through the movement of the rotor in the axial direction. The rotor is suspended in the pump casings by an active magnetic suspension system in the axial direction and a passive hydrodynamic bearing in the radial direction. This paper investigates the axial movement capacity of the magnetic bearing system and the power consumption at various operating points. The force capacity of the passive hydrodynamic bearing is investigated using a viscous glycerol solution. Axial rotor movement in the range of ±0.15 mm is confirmed and power consumption is under 15.5 W. The journal bearing is shown to stabilize the rotor in the radial direction at the required operating speed. Magnetic levitation is a viable suspension technique for the impeller of an artificial heart to improve device lifetime and reduce blood damage. [ABSTRACT FROM AUTHOR]

The diagnosis of pneumonia in ventilated patients is exceedingly difficult. Although culture of tracheal aspirates have poor diagnostic value they are frequently used to diagnose ventilator-associated pneumonia (VAP). Recently a number of studies have reported on the diagnostic value of “blind” protected specimen brush (B-PSB) sampling in the diagnosis of VAP. B-PSB sampling can readily and safely be performed by respiratory care practitioners (RCPs). The aim of this study was to determine the cost-effectiveness of B-PSB sampling performed by respiratory therapists in patients with suspected VAP. During a 3-month run-in period, patients in our medical intensive care unit (MICU) with suspected VAP were treated based on clinical criteria and tracheal aspirate culture. Following this run-in period the house staff, nurses, and RCPs were prevented from sending tracheal aspirates for culture. All patients suspected of having VAP underwent B-PSB sampling with quantitative culture. The B-PSB sampling was performed by RCPs who had been trained to perform the technique. A PSB with a potential bacterial pathogen concentration greater than 500 CFU/ml was regarded as positive. During the 3-month run-in period 172 patients received mechanical ventilation with an average of 4.9 ± 3.1 ventilator days/patient. During this period 79 patients were treated for VAP. During the 3-month study period 160 patients received mechanical ventilation, with an average of 5.1 ± 2.9 ventilator days/patient (NS). Fifty-eight B-PSB samplings were performed in 50 patients for suspected VAP. No complications related to the procedure were reported. No tracheal aspirates were cultured during this time period. Eight patients had positive PSB cultures. Antibiotics were changed in three of these patients based on the PSB results. Thirty-eight courses of antibiotics (in 36 patients) were stopped based on negative PSB results. Twelve cases of VAP were suspected in six patients receiving antibiotics for other reasons. No change in antibiotics were made in these cases based on the negative PSB results. The length of mechanical ventilation was 5.4 ± 3.2 days in the 38 culture-negative patients in whom antibiotics were stopped compared to 8.2 ± 4.7 days in the 8 patients with PSB-positive VAP (NS; p = 0.14). The direct cost savings as a result of discontinuing antibiotics was $9,500. There were additional cost savings due to the reduced number of culture specimens sent to the laboratory (approximately $3,000; taking the $23 cost of the PSB brush into account), with a projected annual cost savings of $50,000. B-PSB sampling is a simple and cost-efficient diagnostic test that can safely be performed by adequately trained RCPs. Furthermore, this study confirms that antibiotics may be safely discontinued in patients with negative quantitative culture results. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "A new model for postgraduate and continuing education in psychiatry," by D. Burke in the 2001 issue.