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The Effect of Aged-Care Rural Clinical Placements on Health Student Self-Efficacy: A Mixed-Methods Evaluation
Get PDFObjective
The objective of this study was to determine the effect of rural clinical placements on allied health students' perceived self-efficacy in service delivery, as part of a larger evaluation of facilitated student placements in Northern New South Wales residential aged-care homes.
Methods
A mixed-methods design was employed. Allied health students from a variety of universities undertook at least five-week clinical placements in two rural residential aged-care homes via a programme designed and coordinated by the University Centre for Rural Health in partnership with the Aged Care Residential facility. Quantitative data were collected using a modified Self-Efficacy in Clinical Performance Scale, pre and post-placement. Semi-structured interviews were conducted post-placement. Self-efficacy scores were compared using the Wilcoxon Signed-Rank test, and the effect size was calculated. Reflexive thematic analysis was conducted to identify themes from interview transcripts.
Results
Twenty-five students completed the surveys, and 12 interviews were included in this study. There was a statistically significant increase, post-placement compared to pre-placement, in total self-efficacy in clinical performance scores, as well as in subscale scores. The subscales related to assessment, diagnosis, and planning and implementation. Two themes were identified from the qualitative interviews: (1) heightened confidence, independence, and work readiness; and (2) confidence and enthusiasm for interprofessional work.
Conclusions
Our findings provide beginning evidence that a well-resourced and focused programme of clinical placements can improve allied health student self-efficacy and may stimulate greater enthusiasm for working in the rural aged-care sector.Full Tex
Autism in eye care: A mixed-methods study of professional knowledge, confidence and clinical experience
No full textPURPOSE: Autistic people face significant barriers when accessing healthcare, which contribute to health disparities and unmet needs. While emerging research has described the experiences of autistic individuals accessing eye care, little is known about the perspectives of eye care professionals. This study aimed to examine autism-related knowledge, self-efficacy and attitudes among a sample of eye care professionals, and to explore their clinical experiences, perceived challenges and support needs when providing care to autistic patients. METHODS: A mixed-methods design was used, combining quantitative survey data and qualitative content analysis. A total of 198 eye care professionals (optometrists, n = 107; ophthalmologists, n = 52) predominantly from Australia (n = 84), the USA (n = 79) and the United Kingdom (n = 20) completed an online survey. Regression analyses examined whether professional role, country, age, experience, personal connection to autism and frequency of contact predicted autism knowledge, self-efficacy and disability attitudes. Correlations explored relationships among these three variables. Open-ended responses were analysed using conventional content analysis. RESULTS: Participants reported moderately high levels of self-efficacy, autism knowledge and positive disability attitudes, yet only 14% perceived they had received formal autism-specific training. Frequent clinical contact with autistic individuals was the strongest predictor of higher self-efficacy (p < 0.001). Qualitative analysis identified common challenges (e.g., sensory sensitivities, time constraints and communication barriers) and practical strategies (e.g., flexible testing, sensory accommodations and clear communication). Participants expressed a strong desire for further training and system-level supports to provide more accessible, person-centred care. CONCLUSIONS: Eye care professionals in this sample appeared motivated to support autistic patients, but often perceived a lack of structured training and identified systemic constraints that limited their capacity to provide accessible services. Practical, autism-informed resources, developed in collaboration with autistic people, alongside changes in clinical policy and workflow, may help address these challenges.Full Tex
Where is the nutrition? Content analysis of learning objectives within tertiary medicine and health degree programs at an Australian university
Get PDFBackground: Poor diet is a leading cause of mortality and morbidity globally. Given their frequent engagement with the community, medical and healthcare professionals can support improved dietary behaviours, as key brokers of nutritional knowledge. Yet, medical and healthcare professionals report receiving suboptimal nutrition education to support practice. Objective: This project aimed to identify the nutrition education content provided across tertiary medicine and health degree programmes at an Australian university. Methods: A list of programmes and core courses was compiled using publicly available information in 2023. Learning objectives of core courses were compared against a Nutrition Competency Framework for Australian Medical Training to identify the nutrition education provided. Results: A total of 13 programmes and 176 core courses were included. No programme made reference to all competencies from the Nutrition Competency Framework for Medicine. The Master of Dietetics Studies programme made the greatest number of references to nutrition (n=39), followed by the Bachelor of Physiotherapy (Hons) (n=36) and the Bachelor of Nursing and Midwifery (n=31). The Master of Organisational Psychology programme made the least number of references to nutrition (n=2), followed by the Master of Psychology (n=5) and Master of Clinical Psychology (n=8). Programmes most frequently included foundational (knowledge-based) nutrition competencies (n=103, 51%), with limited application to clinical practice. Conclusions: There is a need for increased skills-based nutrition education in medicine and health degree programmes to support the translation of knowledge to future practice. Interprofessional competencies provide an opportunity for synergy across programmes.Full Tex
Building an Air Force for a Long, Big War
Get PDFAustralia’s 2024 National Defence Strategy warns of protracted major regional conflicts. Fighting such long, big wars requires modern air forces to have three important attributes that they do not currently possess. There are some alternatives to addressing the identified shortfalls but the preferred approach is adopting the heterogeneous air power model. This uses crewed aircraft, rockets, missiles and drones in coordinated, synchronised and collaborative ways to efficiently achieve operational objectives. To build such a new model air force will require changes in the Fundamental Inputs to Capability.Full Tex
Unveiling a Hidden Driver of Online Rating Bias: The Role of Consumer Variety-Seeking Behavior
Get PDFVariety-seeking is a fundamental motivation in consumer decision making, yet its subsequent effect on consumer behavior is not fully understood. Thus, this study aims to investigate how consumers’ variety-seeking behaviors influence their subsequent ratings on online reputation platforms. We proposed a framework and constructed econometric models to validate it based on large-scale restaurant-review data from an online reputation platform. Several robustness-check methods were employed to ensure the reliability of our results. The empirical results demonstrate that consumers exhibit a positive rating bias in their reviews for variety-seeking options, compared to regular ones. Further analysis reveals that the influence of variety-seeking dynamically changes with the time-varying characteristics of consumers and restaurants. Specifically, as consumers accumulate a larger number of similar experiences and as restaurants age, the observed rating bias gradually diminishes. This study found a previously undocumented but widely prevalent factor causing rating bias on online reputation platforms, and its significant impact warrants attention. The findings also extend the theoretical application scope of variety-seeking in the field of consumer behavior and offer practical implications for managers and platform designers.Full Tex
Making 'safer injecting' matter for people who inject image and performance enhancing drugs
Get PDFImage and performance-enhancing drugs (IPEDs) are primarily injected intramuscularly or subcutaneously, yet traditional harm reduction strategies, focused on blood-borne virus prevention, often overlook the specific health enhancement goals of people who use IPEDs. This study advocates for a collaborative approach to safer injecting practices, informed by the lived-living experiences of people injecting IPEDs, to develop targeted messaging that aligns with their unique motivations. Thirty participants who inject IPEDs were recruited through community networks and partnerships. The study used qualitative focus groups and semi-structured interviews to explore injection practices and safety strategies. Data analysis followed an inductive, line-by-line approach, identifying themes related to injection methods and safer techniques, drawing on matters-of-concern. Stigma and misinformation about IPED injection practices were prevalent, contributing to a heightened risk of infection. Participants expressed anxiety about injection site reactions and reported limited knowledge of safe techniques, with poor injecting literacy leading to risky behaviours like needle reuse and inadequate hygiene. Importantly, participants highlighted that IPED injecting knowledge is often shared through peer support networks. This research calls for reframing harm reduction to focus on health enhancement, optimising injecting techniques, and integrating evidence-based resources, empowering peer-led harm reduction to better support the health aspirations of this population.Full Tex
Integrated berth allocation and quay crane assignment under cooperation among multiple container terminals
Get PDFAs international trade thrives, terminal operators attempt to increase productivity to satisfy the growing demand and offer better services for customers. Cooperation among multiple terminal operators in a port is an option to better utilise the existing resources and achieve a high level of service without additional capital investment. To achieve an effective and efficient operation under cooperation, this study investigates a joint problem of berth allocation and quay crane assignment considering coordinated operation among multiple terminals in a port. Mixed-integer linear programming model considering operational constraints is developed to minimise the total operation cost, including the delay cost of vessels, transshipment cost of export containers and crane assignment cost. An adaptive large neighbourhood search algorithm is proposed to solve the integer linear programming model and tested in a series of numerical experiments. Numerical results show that cooperation not only helps to reduce the total operation cost significantly but also increases the level of service by reducing the number of delayed vessels and their total delay time. Moreover, the proposed algorithm outperforms the commercial solver, Gurobi, with better convergence results and less computational time, which enables the proposed algorithm to be applied to large-scale real-world problems.Full Tex
Advances in Functionalized Metal–Organic Frameworks for PFAS Detection: Design, Mechanisms, Performance, and Future Perspectives
No full textPer- and polyfluoroalkyl substances (PFAS) characterized by environmental persistence, bioaccumulation potential, and ecotoxicological risks, have emerged as contaminants of significant global concern in aquatic environments. Accurate and timely detection of PFAS in aqueous systems is essential for effective pollution monitoring, risk assessment, and remediation efforts. Metal-organic frameworks (MOFs), attributing to their ultrahigh surface area, tunable pore architectures, and selective molecular recognition properties, demonstrate exceptional capacity for trace-level contaminant adsorption and detection, rendering them promising materials for developing high-performance sensors. This review aims to provide an overview of recent MOFs-based analytical strategies for PFAS detection, including mass spectrometry, fluorescence detection, surface-enhanced Raman spectrometry monitoring, and electrochemical sensing. Key aspects addressed include functionalized MOFs for PFAS detection mechanisms, factors affecting PFAS detection, and performance evaluation. Despite substantial progress, challenges remain in translating laboratory-scale MOFs-based detection techniques into field-deployable sensors. These include the need for integrated sampling, preconcentration, and matrix-tolerant sensing platforms to achieve reliable performance in complex environmental conditions.No Full Tex
Integrated time-series analysis and high-content CRISPR screening delineate the dynamics of macrophage immune regulation
Get PDFMacrophages are innate immune cells involved in host defense. Dissecting the regulatory landscape that enables their swift and specific response to pathogens, we performed time-series analysis of gene expression and chromatin accessibility in murine macrophages exposed to various immune stimuli, and we functionally evaluated gene knockouts at scale using a combined CROP-seq and CITE-seq assay. We identified new roles of transcription regulators such as Spi1/PU.1 and JAK-STAT pathway members in immune cell homeostasis and response to pathogens. Macrophage activity was modulated by splicing proteins SFPQ and SF3B1, histone acetyltransferase EP300, cohesin subunit SMC1A, and mediator complex proteins MED8 and MED14. We further observed crosstalk among immune signaling pathways and identified molecular drivers of pathogen-induced dynamics. In summary, this study establishes a time-resolved regulatory map of pathogen response in macrophages, and it describes a broadly applicable method for dissecting immune-regulatory programs through integrative time-series analysis and high-content CRISPR screening. A record of this paper's transparent peer review process is included in the supplemental information.Full Tex
Passive Micro Elastofluidic Controller for Constant Flow Rate
No full textPrecise flow rate control is critical for microfluidic systems in biomedical, chemical, and analytical applications. Conventional flow-regulating microvalves often depend on complex, active components for sensor-based feedback. Active flow rate control increases system complexity and cost. For applications that require a constant flow rate, independent of the inlet pressure, a passive controller is a more favorable option. This paper presents a passive micro elastofluidic device that achieves autonomous flow control through elastic membrane deformation, eliminating the need for external actuation and power supply. The device incorporates a single elastic polydimethylsiloxane (PDMS) membrane integrated into a compact, multi-layer polymethyl methacrylate (PMMA) device. Utilizing both fluid-structure interaction (FSI) simulation in COMSOL and experimental validation, the influence of membrane shape (rectangular, circular, elliptical) and thickness (300–350 µm) on flow regulation is investigated. The results demonstrate that circular membranes offer the most stable flow control with minimum variation (2.63%), while thicker membranes improve regulation precision but raise threshold pressures. Experimental results closely matched simulation predictions, confirming the robust self-regulating behavior of the device. This work offers a simple, cost-effective solution for consistent passive flow control in microfluidic platforms, with applications in precise drug delivery, chemical synthesis, and lab on a chip.Full Tex