Journal articles on the topic 'Post tertiary enrolment'

Education is one of the key factors of economic growth. Despite the huge amount of researches investigating the relationship between education and GDP as a proxy of well-being, to the best of our knowledge, none of these studies examined a group of post-socialist countries comparing with not-post-socialist countries. This paper aims to fill this gap. We examine the correlation between growth and education with panel data evidence for 18 post-socialist (PS) countries and 16 developed market economies (DME) over the 1990–2014 period. The goal of this paper is to test two hypotheses: (i) The relationship between GDP per capita and tertiary education’s enrolment rate is stronger in the post-socialist countries than in other countries. (ii) In the post-socialist countries, the relationship between GDP per capita and tertiary education’s enrolment rate is stronger than the relationship between GDP per capita and any other level of education. Correlation analyses confirmed both hypotheses. Our findings suggest that the patterns of relationship between GDP and measures of tertiary education are different for PS and DME countries and would be interesting to observe when and how the gap between the patterns disappears.

Various means to predict the success rate of students have been introduced by a number of educational institutions worldwide. The aim of this research was to identify predictors of success for tertiary education students. Participants were 353 students enrolled on Business and Computing programmes between 2009 and 2014, at a tertiary education provider in New Zealand. Enrolment data were used to determine the relationships between completion of the programme and prior academic achievement, age, ethnicity, gender, type of enrolment, and programme of study. These variables, as well as the overall GPA of the programme, were used to examine their relationship with the first year GPA. Results showed that pre- and post-enrolment data can be used for prediction of academic performance in ICT programmes. Based on the significance of some variables, tertiary education institutions can identify students who are likely to fail, these students can therefore be considered for additional support in the early stages of their study, in order to increase their chances of succeeding academically.

There is a need to re-vitalize science and technology education to suit today’s world. The specific aim for this study is to determine how school science in early years of schooling impacts on years 11 and 12 science studies in the areas of materials science, and subsequent further tertiary studies. Public education records were investigated to obtain post hoc enrolment data to establish trends and decline in enrolments in physics and chemistry in the final years of high school which revealed a trend in enrolments falling over a ten year period. The student population in science of physics and chemistry were not well prepared for future studies and are a challenge for students undertaking engineering and technology studies at a tertiary level. It is proposed that primary and high school science subjects be made more popular by integrating popular aspects of materials in everyday life, so making science an appealing part of the syllabus. Initiating these syllabus changes will enhance the way science subjects are taught to encourage studies into engineering.

Összefoglaló. Írásunk a középiskolai és a felsőoktatási felvételi adatokat felhasználva mutatja be az elmúlt évtizedek beiskolázási trendjeit, fókuszálva az elmúlt másfél-két évtizedben végbemenő folyamatokra. A középiskolai beiskolázás adatai szerint egyrészt megállapítható, hogy a rendszerváltás utáni trend 2011 után megtört, a középiskolás korosztályon belül egyre csökken azok aránya, akik részt vesznek valamilyen középfokú képzésben, másrészt a képzésben maradók preferenciái ugyan az általános képzés felé törekednek, de a felvettek számát és arányát tekintve mégis a szakképzésben tanulnak többen. A felsőoktatásba újonnan bekerülők jelentős hányadát adják a frissen érettségizettek, akiknek a létszáma az utóbbi 15 évben folyamatosan csökken, ezzel egyidejűleg azonban a részidős képzésekben tanulók létszáma is meredeken visszaesett. Summary. The study presents enrolment trends using secondary and tertiary enrolment data, focusing on trends over the last two decades. The data on secondary school enrolment shows that, on the one hand, the post-transition trend was broken after 2011, with the proportion of secondary school students enrolled in some form of upper secondary education decreasing, and on the other hand, while the preferences of those who remain in education are tending towards general education, more people are enrolled in vocational education and training in terms of both the number and the proportion of enrolments. A significant proportion of new entrants to higher education are recent graduates from secondary education, whose number have been declining steadily over the last 15 years, but at the same time the number of part-time students in higher education has also fallen sharply.

Most staff at universities in Australia could cite a number of high schools within their catchments with identified low rates of tertiary entry. In turn, teaching staff at those high schools have a reasonable idea and view of the percentage of students from their final year who will go on to higher education. What may develop from this identification is “opportunity blindness”, with many students not considering tertiary study as an option for post-school education. This paper is the report of a project initiative by Murdoch University and Hamilton Senior High School in Western Australia that hopes to have as its long-term outcome the increased enrolment of Year 12 students into tertiary education.

As enrolments keep expanding in tertiary institutions teaching spaces become a scare commodity. This is often so because expansion in teaching and laboratory spaces are not keeping pace with expansion in student enrolments. Efficicency in the managment of available teaching spaces becomes the watch word for institutions seeking to expand student intake. The University College of Education of Winneba which first grew out of three diploma awarding institutions had to accommodate a larger student number in its apparently overused teaching spaces in the first semester of 1992/93 session. The use made of teaching space hitherto was assessed ex post facto. A central timetable, in which all teaching spaces on the three campuses were pooled for shared use by all students was then launched. The existing teaching spaces were not only sufficient but had rooms to spare for new programme of distant education and for residential accommodation. The use of the remaining rooms restricted to teaching (and which could accommodate were classes) were then re-assessed in March 1993 and the utilization rate increased from 25.4% to 38.9%. The installation of the central timetable on the campuses unlocked the golden gate for enrolment expansion at Winneba

Background: Kangaroo Mother Care (KMC) is a practical low-cost intervention which is very cost effective in developing countries for babies weighing less than 2500 g. This study is aimed to evaluate the knowledge, attitude and practices about KMC in the post-natal mothers of low birth weight (LBW) and preterm babies before and after a teaching session by a trained staff in a tertiary care center in North KeralaMethods: A cross sectional descriptive study of 201 mothers whose neonates were admitted in Neonatal intensive care unit (NICU) of tertiary care centre from June 2014 to June 2015. Mothers were interviewed at enrolment to assess their knowledge of KMC and were then oriented on its practice. Data about their perceptions, attitudes and practices of KMC were recorded before they were discharged from the hospital.Results: At recruitment (95.4%) mothers didn’t know about KMC. 80% of mothers could follow the verbal instructions in first sitting. 92.8% of mothers reflected photo exhibition would have been better than verbal explanation, 91.8% of mothers thought that KMC is beneficial for their babies and 89% thought that it was beneficial for them too. At discharge 99% were willing to continue KMC at home with 93.1% willing to practice at night. 100% would recommend KMC to other mothers. All of them were practicing intermittent KMC and believed that other family members especially grandmothers could also be KMC providers as well.Conclusions: Maternal knowledge of KMC was low before enrolment, but after initiation mothers were happily practicing KMC in hospital with assurance to continue same from home and involve other family members in KMC care.

SummaryAlthough young people in South Africa are growing up in an era where their socioeconomic circumstances are seemingly better than those of their parents’ generation, they face greater risks in their trajectory to adulthood. This is mainly because the environment in which they are making sexual decisions is also rapidly evolving. Currently, South Africa has the highest prevalence of HIV and AIDS in the world among young people aged 15–24. This study examined the effect of sexual behaviours initiated in adolescence on enrolment in post-secondary education. The analysis was conducted using data from the longitudinal Cape Area Panel Study (CAPS, Waves 1–5) conducted in 2002–2009, which focused on young people’s sexual behaviours in Cape Town, South Africa. The sample was restricted to 3213 individuals who reported sexual debut during adolescence. Using logistic regression models fitted separately for males and females, the results revealed that several factors acted as either hindrances or protective factors to enrolment in post-secondary education. Early sexual debut (by age 17) was negatively associated with participation in tertiary education. Other variables that had a negative effect included not using contraception at first sex, parenthood, engaging in risky behaviours such as illegal substance use, cigarette smoking and drinking alcohol and neglect of school homework (doing less than an hour a day). Higher levels of parental education (except for paternal education in the female model), urban residence and higher aspirations and analogous behaviours (studying) acted as protective factors and were positively associated with post-secondary education initiation. The paper also points to the relationship between early sexual debut and persistent socioeconomic inequality and provides empirical evidence for re-thinking policy development and implementation around schooling and sex education.

Background: Kangaroo mother care (KMC) is a practical low-cost intervention which is very cost effective in developing countries for babies weighing less than 2500g. This study aimed to evaluate the knowledge, attitude and practice of post-natal mothers of LBW babies after giving a teaching session by trained personnel in a tertiary care center in Karnataka.Methods: A cross sectional descriptive study of 90 mothers whose neonates were weighing less than 2.5kg from May to October 2018.Mothers were interviewed at enrolment and were assessed about their knowledge and were oriented on its practice.Results: At recruitment (95.5%) mothers did not know about KMC.80% of mothers followed in first sitting and 86.6% of the mothers felt photo exhibition was better than verbal.96.6% of mothers thought KMC is beneficial and it was believed that other family members can even provide KMC.Conclusions: Maternal knowledge was low before now they are happily practicing KMC in hospital and thereafter at home.

<p>Earlier studies on economic growth asserts that economic prosperity and functioning of a nation depends on its physical and human capital stock in form of knowledge acquired and an agent of national development in all countries of the world. Therefore, the need to examine the effect of expenditures on education, human capital development on economic growth in Nigeria. This study focuses on public expenditures on the education with a view to ascertain the relative commitments of the governments to this sector.</p><p> </p><p>This study covers the period of 1970-2015, employing an ex-post facto research design using time series data. The data used for this study are obtained mainly from secondary data which is quantitative in nature. The study employs descriptive statistics to assess the contributions of government expenditure on education, government expenditure on health, tertiary school enrolment, secondary school enrollment, primary school enrolment on gross domestic product. Also, Unit Root Test is conducted on the series to ascertain if they are stationary while co-integration test follows suit, to also ascertain the long run relationship between expenditure on education and human capital development on economic growth. The Johansen Cointegration test and Error Correction Mechanism estimated model found that that there is no significant effect of expenditure on education and human capital development on economic growth in Nigeria.</p><p> </p>

Background: There has been a growing interest in ivermectin ever since it was reported to have an in-vitro activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This trial was conducted to test the efficacy of ivermectin in mild and moderate coronavirus disease 19 (COVID-19). Methods: A double blind, parallel, randomised, placebo-controlled trial conducted among adult COVID-19 patients with mild to moderate disease severity on admission in a COVID dedicated tertiary healthcare of eastern India. Enrolment was done between 1st August and 31st October 2020. On day 1 and 2 post enrolment, patients in the intervention arm received ivermectin 12 mg while the patients in the non-interventional arm received placebo tablets. Results: About one-fourth (23.6%) of the patients in the intervention arm and one-third (31.6%) in the placebo arm were tested reverse transcriptase polymerase chain reaction (RTPCR) negative for SARS-CoV-2 on 6th day. Although this difference was found to be statistically insignificant [rate ratio (RR): 0.8; 95% confidence interval (CI): 0.4-1.4; p=0.348]. All patients in the ivermectin group were successfully discharged. In comparison the same for the placebo group was observed to be 93%. This difference was found to be statistically significant (RR: 1.1; 95% CI; 1.0-1.2; p=0.045). Conclusions: Inclusion of ivermectin in treatment regimen of mild to moderate COVID-19 patients could not be said with certainty based on our study results as it had shown only marginal benefit in successful discharge from the hospital with no other observed benefits.

Aim/Purpose: This study investigates the factors that affect the post implementation success of a web-based learning management system at the University of Professional Studies, Accra (UPSA). Background: UPSA implemented an LMS to blend Web-based learning environment with the traditional methods of education to enable working students to acquire education. Methodology: An explanatory sequential mixed method was adopted, under the pragmatic paradigm, to investigate the level of acceptance of web-based learning by students. The effects of perceived usefulness, perceived ease of use, and other social factors were investigated. In all, 4500 final and third-year undergraduate students of UPSA made up the population. A sample size of 870 was used for this study. Contribution: This paper contributes to the body of knowledge by identifying the factors that hinder post-implementation of LMS at the tertiary level in Ghana and adds to the general literature available. Findings: The level of acceptance of LMS seems very low due to poor IT infrastructure, inadequate training, and the relevance of the system to quality lecture delivery. However, students’ intention to use LMS and the usefulness of LMS were perceived to be high, especially among students in higher levels. Recommendations for Practitioners: The authors recommend that IT infrastructure, especially reliable and fast internet connectivity, and adequate training should be provided. Recommendation for Researchers: Further research should be done to confirm if the provision of a more reliable internet system will boost students’ internet proficiency, which in turn will improve their utilisation of the LMS. Impact on Society: Help create awareness of schooling while pursuing a career and also improve interactions between students and lecturers. It will also improve enrolment and possibly reduce the cost of education in the long-run. Future Research: Researchers can look at the possibility of implementing total virtual learning systems at the tertiary level in Ghana.

PurposeThe overarching goal of the FOCUS (biomarkers related to folate-dependent one-carbon metabolism in colorectal cancer (CRC) recurrence and survival) Consortium is to unravel the effect of folate and folate-mediated one-carbon metabolism (FOCM) biomarkers on CRC prognosis to provide clinically relevant advice on folate intake to cancer patients and define future tertiary prevention strategies.ParticipantsThe FOCUS Consortium is an international, prospective cohort of 2401 women and men above 18 years of age who were diagnosed with a primary invasive non-metastatic (stages I–III) CRC. The consortium comprises patients from Austria, two sites from the Netherlands, Germany and two sites from the USA. Patients are recruited after CRC diagnosis and followed at 6 and 12 months after enrolment. At each time point, sociodemographic data, data on health behaviour and clinical data are collected, blood samples are drawn.Findings to dateAn increased risk of cancer recurrences was observed among patients with higher compared with lower circulating folic acid concentrations. Furthermore, specific folate species within the FOCM pathway were associated with both inflammation and angiogenesis pathways among patients with CRC. In addition, higher vitamin B6status was associated with better quality of life at 6 months post-treatment.Future plansBetter insights into the research on associations between folate and FOCM biomarkers and clinical outcomes in patients with CRC will facilitate the development of guidelines regarding folate intake in order to provide clinically relevant advice to patients with cancer, health professionals involved in patient care, and ultimately further tertiary prevention strategies in the future. The FOCUS Consortium offers an excellent infrastructure for short-term and long-term research projects and for combining additional biomarkers and data resulting from the individual cohorts within the next years, for example, microbiome data, omics and multiomics data or CT-quantified body composition data.

Introduction: Co-administration of albumin and furosemide has shown better response than furosemide alone in managing anasarca among children with nephrotic syndrome. There are different concentrations of albumin available. The aim of this study was to compare diuretic response to co-administration of either 5% or 20% albumin with furosemide in these children. Methods: It was a crossover randomised trial conducted on children with nephrotic syndrome with moderate to severe oedema at a tertiary care centre. They were randomised to two groups; Group A (n = 14) received 5% albumin along with furosemide in midway followed by 20% albumin after washout period of 48 hrs and group B (n = 10) received albumin vice versa. Baseline and post therapy vitals, fluid intake, urine output and biochemistry were noted. Primary outcomes were increase in urine output and reduction in weight following co-administration of albumin with furosemide. For analysis of primary outcomes, two interventional arms were formed; group I (5% Albumin co-administered with furosemide) and group II (20% albumin co-administered with furosemide). Results: Total children were 24 in each arm i.e. group I and II. Eighteen (75%) were males. Mean (range) age at enrolment and duration of illness were 55.3 (15 - 144) and 18.6 (1 - 120) months respectively. Mean difference (SD) in urine output were 1.52 (1.11) and 1.66 (0.95) ml/kg/hr (p = 0.12) and mean percentage weight loss were 2.25% (2.12) and 3.68% (3.84) in group I and II respectively (p = 0.64). On further comparing, urine output was significantly better when 5% albumin was co-administered with furosemide during first period than in second period. Conclusions: Co-administration of either 5% or 20% albumin with furosemide is equally safe and effective in increasing urine output in children with anasarca.

Introduction:Hospital pharmacists currently play a limited role in the management of nicotine withdrawal and smoking-cessation. They have multiple tasks and limited time; a strong evidence base is required to determine importance of including smoking-cessation interventions into their routine practice.Aims:The aims of this study were to evaluate the effectiveness of a hospital pharmacist initiated smoking-cessation intervention (SCI) in increasing the utilisation of Nicotine Replacement Therapy (NRT) in hospitalised smokers, and in increasing quit rates post-discharge.Methods:This study was conducted in a tertiary referral hospital using a pragmatic randomised control design. After screening, 100 inpatient smokers were enrolled and randomised by the research pharmacist (RP) to either the intervention or usual care arm (n= 50 for both arms). Smoking-cessation advice was available to all smokers during their hospital stay under the smoking management policy, which represented usual care. However, this approach is often unstructured and provided on an ad-hoc basis. Those in the intervention arm received brief SCI from the RP, who also facilitated NRT prescribing if required. Prescribing rates of NRT in the hospital and on discharge in both the groups were compared. Participants were contacted by phone three-months after enrolment to assess their seven-day point prevalence of abstinence (PPA) from smoking and use of NRT post-discharge.Results:A significantly higher proportion of participants in the intervention arm used NRT in the hospital (82% vs. 24%,Χ2= 33.8,p< 0.001) and at discharge (68% vs. 12%,Χ2= 32.7,p< 0.0001) and significantly more participants who received SCI from the RP continued to use NRT after discharge (OR 3.1, CI 1.2 to 8.2). A similar number of participants in both the groups claimed seven-day PPA after three-months (18% usual-care vs. 15% intervention-arm, OR 0.8, CI 0.24 to 2.67).Conclusions:Hospital pharmacist led brief SCI can enhance the utilisation of NRT in hospital and after discharge; there was no clear effect on cessation rates at three months. There is a need to explore feasible options for a coordinated, multidisciplinary approach to smoking-cessation in hospital and across the continuum, which may have a greater impact on long term smoking-cessation rates.

Objectives A short-stay endovascular aneurysm repair (SS-EVAR) pathway for infrarenal abdominal aortic aneurysms offers the potential to improve service efficiency and patient satisfaction by reducing the hospital length of stay. This study aimed to determine whether the implementation of a novel set of patient selection criteria for a theoretical SS-EVAR pathway could facilitate an expansion of the proportion of suitable patients, whilst maintaining patient safety and limiting unplanned emergency readmissions. Methods Two SS-EVAR selection criteria (low and high risk) were generated based upon patient pre-operative comorbidities. The low risk criteria essentially selected fit and healthy individuals, whereas the high risk criteria included patients with a range of comorbidities that could still theoretically enable enrolment onto a SS-EVAR pathway. A retrospective analysis, whereby both criteria were applied to all elective EVARs recorded in the National Vascular Registry between 2013 and 2016 at a single tertiary vascular unit was performed. Rates and timings of postoperative complications, reinterventions and unplanned readmissions for patients meeting each criteria were assessed. Results In total, 188 patients were included (92% male, mean age 75.4 ± 7.2 years). Twenty-nine patients (15%) met the low risk criteria. Two (7%) of these experienced an inpatient complication which were both detected within 24 h of operation (including one who required reintervention), and no patients in this group had an unplanned readmission within 30 days. One-hundred and ten patients (59%) met our high risk criteria and 19 (17%) experienced an inpatient complication, with 4 (4%) of these occurring beyond 24 h post-EVAR (three urinary problems and one acute on chronic kidney injury). Six (6%) of these patients required a reintervention; however, all of these complications were detected within 24 h. Two (2%) high risk cohort patients required unplanned readmission within 30 days for a femoral pseudoaneurysm and musculoskeletal back pain. Conclusions With high risk patient selection criteria and appropriate post-operative safeguards, up to 60% of infrarenal abdominal aortic aneurysms patients could be safely enrolled onto a next-day discharge SS-EVAR pathway with minimal readmissions, thus allowing more effective resource utilisation.

Background: Tuberculous meningitis (TBM), the most severe form of tuberculosis (TB), results in death or neurological disability in >50%, despite World Health Organisation recommended therapy. Current TBM regimen dosages are based on data from pulmonary TB alone. Evidence from recent phase II pharmacokinetic studies suggests that high dose rifampicin (R) administered intravenously or orally enhances central nervous system penetration and may reduce TBM associated mortality. We hypothesize that, among persons with TBM, high dose oral rifampicin (35 mg/kg) for 8 weeks will improve survival compared to standard of care (10 mg/kg), without excess adverse events. Protocol: We will perform a parallel group, randomised, placebo-controlled, double blind, phase III multicentre clinical trial comparing high dose oral rifampicin to standard of care. The trial will be conducted across five clinical sites in Uganda, South Africa and Indonesia. Participants are HIV-positive or negative adults with clinically suspected TBM, who will be randomised (1:1) to one of two arms: 35 mg/kg oral rifampicin daily for 8 weeks (in combination with standard dose isoniazid [H], pyrazinamide [Z] and ethambutol [E]) or standard of care (oral HRZE, containing 10 mg/kg/day rifampicin). The primary end-point is 6-month survival. Secondary end points are: i) 12-month survival ii) functional and neurocognitive outcomes and iii) safety and tolerability. Tertiary outcomes are: i) pharmacokinetic outcomes and ii) cost-effectiveness of the intervention. We will enrol 500 participants over 2.5 years, with follow-up continuing until 12 months post-enrolment. Discussion: Our best TBM treatment still results in unacceptably high mortality and morbidity. Strong evidence supports the increased cerebrospinal fluid penetration of high dose rifampicin, however conclusive evidence regarding survival benefit is lacking. This study will answer the important question of whether high dose oral rifampicin conveys a survival benefit in TBM in HIV-positive and -negative individuals from Africa and Asia. Trial registration: ISRCTN15668391 (17/06/2019)

Background: Tuberculous meningitis (TBM), the most severe form of tuberculosis (TB), results in death or neurological disability in >50%, despite World Health Organisation recommended therapy. Current TBM regimen dosages are based on data from pulmonary TB alone. Evidence from recent phase II pharmacokinetic studies suggests that high dose rifampicin (R) administered intravenously or orally enhances central nervous system penetration and may reduce TBM associated mortality. We hypothesize that, among persons with TBM, high dose oral rifampicin (35 mg/kg) for 8 weeks will improve survival compared to standard of care (10 mg/kg), without excess adverse events. Protocol: We will perform a parallel group, randomised, placebo-controlled, double blind, phase III multicentre clinical trial comparing high dose oral rifampicin to standard of care. The trial will be conducted across five clinical sites in Uganda, South Africa and Indonesia. Participants are HIV-positive or negative adults with clinically suspected TBM, who will be randomised (1:1) to one of two arms: 35 mg/kg oral rifampicin daily for 8 weeks (in combination with standard dose isoniazid [H], pyrazinamide [Z] and ethambutol [E]) or standard of care (oral HRZE, containing 10 mg/kg/day rifampicin). The primary end-point is 6-month survival. Secondary end points are: i) 12-month survival ii) functional and neurocognitive outcomes and iii) safety and tolerability. Tertiary outcomes are: i) pharmacokinetic outcomes and ii) cost-effectiveness of the intervention. We will enrol 500 participants over 2.5 years, with follow-up continuing until 12 months post-enrolment. Discussion: Our best TBM treatment still results in unacceptably high mortality and morbidity. Strong evidence supports the increased cerebrospinal fluid penetration of high dose rifampicin, however conclusive evidence regarding survival benefit is lacking. This study will answer the important question of whether high dose oral rifampicin conveys a survival benefit in TBM in HIV-positive and -negative individuals from Africa and Asia. Trial registration: ISRCTN15668391 (17/06/2019)

Introduction: Intubation is one of the highest-risk procedures performed in the ED. Few Canadian centres monitor intubation frequency, indications, methods used, success, and/or complication rates. An airway registry that tracks patient outcomes and variation in practice would be a valuable quality improvement (QI) tool. We describe the development of the BC-Airway Registry for Emergencies (BCARE) network, an emergency intubation database at two tertiary-care and one community hospital. Methods: Respiratory Therapists (RTs) are present at every intubation outside of the OR and complete a standardized post-intubation form. The airway forms were developed collaboratively with input from RTs, emergency physicians, intensivists, and anesthetists. Completed forms are collected from participating sites and data is entered into a secure online database where patient outcomes are analyzed in real-time. Results: We collected data from 737 unique intubations over 19 months with ongoing enrolment at the time of abstract submission. Mean age was 59.4 (Range 17-95, SD 17.6), Male 66.2%, intubation locations were ED (396, 53.7%), ICU (221, 30.0%), Ward (120, 16.3%). The most common indications for ED intubation were ICH/stroke (14.6%), seizure (10.9%), and sepsis (9.5%). Intubations are done by attending physicians more frequently in the ED (48.0%) compared to in the ICU (11.8%), and ward (8.6%). ED intubations were more commonly performed using video laryngoscopy (57.7%) with a smaller proportion using direct laryngoscopy (39.0%). First-pass success was 81.8% in the ED, 79.2% in the ICU, and 77.5% on the wards. Of ED intubations, 56 (14.1%) had complications and 73 (18.4%) were considered to be a difficult airway. Conclusion: The BCARE network tracks intubation performance across hospitals and is a valuable QI tool. BCARE can be used to ensure that all centres are meeting a benchmark success rate, for assessing the impact of practice changes such as pre-intubation checklists, and for implementing systematic methods to identify patients who previously had a “difficult airway.”

Background Transverse myelitis (TM) is an immune-mediated disorder of the spinal cord that affects adults and children and that causes motor, sensory and autonomic dysfunction. There is a prolonged recovery phase, which may continue for many years. Neuromyelitis optica (NMO) is an uncommon relapsing inflammatory central nervous system condition in which TM can be the first presenting symptom. As TM and NMO affect many patients in the prime of their working life, the disorder can impose a significant demand on health resources. There are currently no robust controlled trials in children or adults to inform the optimal treatment of TM. However, treatment with intravenous immunoglobulin (IVIG) is being effectively used in the management of a range of neurological conditions. Although other interventions such as plasma exchange (PLEX) in addition to intravenous (IV) methylprednisolone therapy can be beneficial in TM, PLEX is costly and technically challenging to deliver in the acute setting. IVIG is more readily accessible and less costly. Objective To evaluate whether additional and early treatment with IVIG is of extra benefit in TM compared with standard therapy with IV steroids. Design A multicentre, single-blind, parallel-group randomised controlled trial of IVIG compared with standard therapy for the treatment of TM in adults and children. Participants Patients aged ≥ 1 year diagnosed with either acute first-onset TM or first presentation of NMO. Target recruitment was 170 participants (85 participants per arm). Interventions Participants were randomised 1 : 1 to treatment with IV methylprednisolone only or treatment with IV methylprednisolone plus 2 g/kg of IVIG in divided doses within 5 days of the first commencement of steroid therapy. Main outcome measures Primary outcome measure – American Spinal Injury Association (ASIA) Impairment Scale at 6 months post randomisation, with a good outcome defined by a two-grade change. Secondary and tertiary outcome measures – ASIA motor and sensory scales, Expanded Disability Status Scale, health outcome, quality of life, Client Service Receipt Inventory and International Spinal Cord Injury Pain, Bladder and Bowel Basic Data Sets. Results In total, 26 participants were screened and two were randomised into the study. With the limited sample size, treatment effect could not be determined. However, we identified barriers to accrual that included strict inclusion criteria, the short enrolment window, challenges associated with the use of the ASIA Impairment Scale as an outcome measure and estimation of the incidence of TM. Conclusions The study did not reach the end point and the effect of IVIG in TM/NMO could not be determined. Investigators should be aware of the potential challenges associated with carrying out a rare disease trial with a short enrolment window. The study question is one that still necessitates investigation. Preliminary work to ameliorate the effect of the barriers encountered in this study is vital. Trial registration EudraCT 2014-002335-34, ClinicalTrials.gov NCT02398994 and Current Controlled Trials ISRCTN12127581. Funding This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 21, No. 31. See the NIHR Journals Library website for further project information. Funding was also received from Biotest AG, Germany (supply of IVIG) and the Transverse Myelitis Society (excess research cost to facilitate study initiation).

Abstract Background The novel corona virus (SARS-CoV-2) outbreak was declared as a pandemic in March 2020; this prompted the need for rapid vaccine development. Currently four EMA approved vaccines exist but their efficacy and safety data on patients with Inflammatory Bowel diseases are limited. Methods Greek IBD patients, from 10 tertiary referral centres, who had completed the initial vaccination protocol with the available anti-COVID-19 vaccines at least two weeks before enrolment, were prospectively studied. Demographic and safety data were collected and blood samples were drawn for serum Anti-S1 IgG measurement [Euroimmun Anti-SARS-CoV-2 QuantiVac ELISA (IgG)]. Results In total 403 IBD patients (59% Crohn’s disease, median age 45 years, 53% male) and 124 healthy controls (HC) were included (Table 1). Antibody testing was conducted after a median of 31 (IQR, 23–46) days post-vaccination. Following a full vaccination regimen, 98% of IBD patients seroconverted (anti-S1 IgG≥11 RU/ml). Administration of mRNA vaccines resulted in higher seroconversion rates and higher antibody titers than viral vector ones (98.6% vs 93.6%, P=0.02 and 111.2 RU/ml vs 76 RU/ml, P&lt;0.0001, respectively). In total, IBD patients had lower anti-S1 levels than HC (RU/ml 108 vs 133 RU/ml, P=0.00009). IBD patients without immunosuppression had higher antibody titers than immunocompromised patients (P=0.012). In univariable analysis, older age, longer time since vaccination, and treatment with corticosteroids, immunomodulators, anti-TNFα or combination therapy were associated with lower anti-S1 titers. In contrast, higher anti-S1 levels were detected in patients on vedolizumab monotherapy or non-immunosuppressive treatment. In multivariable analysis, only age, time since vaccination, and anti-TNFα therapy remained significant (P=0.011, P=0.002, and P=0.013 respectively). Treatment with vedolizumab monotherapy was associated with higher antibody levels than anti-TNFα or ustekinumab monotherapy (P=0.023 and P=0.032). Patients with prior COVID-19 infection showed numerically higher levels of Abs. All vaccines were safe in IBD patients. Conclusion Patients with IBD have high seroconversion rates to anti-SARS-CoV-2 vaccines, with mRNA vaccines being more efficacious. However, IBD patients have impaired response to vaccination comparing to HC. Lower antibody responses were observed in patients who received viral vector vaccines, in older patients, and in those on anti-TNFα treatment. It is important to consider booster vaccination in those low-response groups.

Abstract STUDY QUESTION Can the incidence of subsequent termination of pregnancy (TOP) be reduced by providing intrauterine contraception as part of the abortion service? SUMMARY ANSWER Provision of an intrauterine device (IUD) as part of TOP services reduced the need for subsequent TOP but the effect was limited to the first 3 years of the 5-year follow-up. WHAT IS KNOWN ALREADY An IUD is highly effective in preventing subsequent TOP. Prompt initiation of IUD use leads to a higher usage rate during follow-up, as compliance with post-TOP IUD insertion visits is low. STUDY DESIGN, SIZE, DURATION The objective of this randomised controlled trial was to assess the effect of early comprehensive provision of intrauterine contraception after TOP, with primary outcome being the incidence of subsequent TOP during the 5 years of follow-up after the index abortion. This study was conducted at a tertiary care centre between 18 October 2010 and 21 January 2013. Altogether, 748 women undergoing a first trimester TOP were recruited and randomised into two groups. The intervention group (n = 375) was provided with an IUD during surgical TOP or 1–4 weeks following medical TOP at the hospital providing the abortion care. Women in the control group (n = 373) were advised to contact primary health care for follow-up and IUD insertion. Subsequent TOPs during the 5-year follow-up were identified from the Finnish Register on induced abortions. PARTICIPANTS/MATERIALS, SETTING, METHODS The inclusion criteria were age ≥18 years, duration of gestation ≤12 weeks, residence in Helsinki and accepting intrauterine contraception. Women with contraindications to IUD were excluded. MAIN RESULTS AND THE ROLE OF CHANCE The overall numbers of subsequent TOPs were 50 in the intervention and 72 in the control group (26.7 versus 38.6/1000 years of follow-up, P = 0.027), and those of requested TOPs, including TOPs and early pregnancy failures, were 58 and 76, respectively (30.9 versus 40.8/1000, P = 0.080). Altogether 40 (10.7%) women in the intervention and 63 (16.9%) in the control group underwent one or several subsequent TOPs (hazard ratio 1.67 [95% CI 1.13 to 2.49], P = 0.011). The number of TOPs was reduced by the intervention during years 0–3 (22.2 versus 46.5/1000, P = 0.035), but not during years 4–5 (33.3 versus 26.8/1000, P = 0.631). LIMITATIONS, REASONS FOR CAUTION Both medical and surgical TOP were used. This may be seen as a limitation, but it also reflects the contemporary practice of abortion care. The immediate post-TOP care was provided by two different organizations, allowing us to compare two different ways of contraceptive service provision following TOP. WIDER IMPLICATIONS OF THE FINDINGS Providing TOP and IUD insertion comprehensively in the same heath care unit leads to significantly higher rates of attendance, IUD use and a significantly lower risk of subsequent TOP. STUDY FUNDING/COMPETING INTEREST(S) This study was supported by Helsinki University Central Hospital Research funds and by research grants provided by the Jenny and Antti Wihuri Foundation, the Yrjö Jahnsson Foundation and Finska Läkaresällskapet. E.P. has received a personal research grant from the Finnish Medical Society. The City of Helsinki supported the study by providing the IUDs. The funding organisations had no role in planning or execution of the study, or in analysing the study results. TRIAL REGISTRATION NUMBER The trial was registered at clinicaltrials.gov (NCT01223521). TRIAL REGISTRATION DATE 18 October 2010. DATE OF FIRST PATIENT’S ENROLMENT 18 October 2010.

Abstract Long-term indwelling central venous catheters (CVCs) are used for delivering chemotherapy, parenteral nutrition, antibiotics, and blood products, as well as for facilitating blood drawing, in many patients with malignancy. Although the important supportive role of CVCs is unquestioned, there is uncertainty regarding the prevention and treatment of catheter-related thrombosis (CRT) because there is a lack of prospective and contemporary data on the natural history of this complication. As a first step towards improving CRT management, we conducted a prospective cohort study to examine the incidence, clinical risk factors, and the long-term sequelae of symptomatic CRT in adults with cancer. Consecutive patients undergoing insertion of a CVC at a tertiary care center were enrolled and followed for the duration of their catheter-dwell time plus 4 weeks or a maximum of 52 weeks, whichever comes first. Scheduled assessments were done at weeks 1, 2, 4, 8, 12, 24, 36 and 52 weeks after insertion. Patients with symptomatic CRT were treated with anticoagulants and were followed for an additional 52 weeks from the date of CRT diagnosis. Baseline information and follow-up data regarding catheter patency, thromboprophylaxis, clinical symptoms, and thrombotic events was collected. Standardized regional guidelines for catheter care were followed and symptomatic CRT was diagnosed based on objective testing and satisfaction of prespecified criteria. Between March 2002 and July 2003, 444 patients underwent 500 catheter insertions. The mean patient age was 56 y (range 18–91 y) and 55% of patients were female. Catheters inserted included PICCs (65%), ports (18%), pheresis (11%), and Hickman catheters (6%). As of July 22, 2004, 442 patients had completed follow-up. The total catheter-dwell time was 59,959 d (median 88 d), while the total follow-up was 73,654 pt-d (median 151 d). Colorectal was the most common tumor type in 18% of patients and 41% of all patients at enrolment had metastatic solid tumor. Overall, there were 19 episodes of symptomatic CRT, representing an incidence of 4.3% (95% CI 2.6–6.6%) of patients or 0.3 CRTs per 1000 catheter-dwell days (95% CI 0.2–0.5 per 1000 d). The mean time to CRT was 53 d (range 6–162 d). Development of CRT was not associated with age, ECOG performance status, cancer treatment, catheter type, side of insertion, thromboprophylaxis, infection, or previous history of thrombosis. The only significant risk factor was ovarian cancer (P=0.02). In patients with symptomatic CRT, 89% (17/19) of CRTs were treated with anticoagulant therapy alone, 5.3% (1/19) had the catheter removed, and 5.3% (1/19) were treated with both; none had symptomatic pulmonary embolism or post-thrombotic syndrome during follow-up. In summary, the incidence of symptomatic CRT in adults with cancer is low and treatment with anticoagulant therapy alone was not associated with any serious long-term sequelae. Due to the small number of CRTs observed, larger studies are required to further evaluate risk factors and identify the optimal therapeutic approach for CRTs.

After 25 years with the Australian Journal of Chemistry, our editor, Dr Jan R. Zdysiewicz (known far and wide as John Z.), has recently retired. During his initial ten year period with the journal, John served as assistant editor under Bob Schoenfeld who, like John, was also very widely known throughout the Australian and New Zealand chemistry community. In 1985, John took up the editorship and under his editorial management the journal has continued to prosper. John has been an exceptionally talented editor who, despite increasing pressures over more recent times, has managed to maintain the journal’s very high editorial standard – a task aided by his wide understanding of chemistry and his truly exceptional knowledge of English usage. John had an eventful early life – details of which may be of interest to his many friends and acquaintances. He was born in Laukischken in East Prussia to parents from Mosty in eastern Poland. His parents had been taken to Germany during World War II for forced labour. After the war, the family was transferred, endlessly it seemed, from DP (displaced persons) camp to DP camp in Germany, until final acceptance for migration to Australia. After a long sea voyage on the Skaugum, the family arrived at Port Melbourne in December 1950. Then followed being shuffled between widely spread immigration holding centres in South-East Australia, finally ending up in Adelaide, where the family settled. After some difficulty in gaining enrolment, John attended Adelaide Boys High School. In 1962 at age 19, he lost his alien status and became an Australian citizen. Even during this early period, John Z. made a name for himself. He became somewhat of a celebrity for his virtuosity in playing the accordion. In 1961, he became Grand Australian Accordion Champion. On occasions, he still plays for friends and private audiences. John Z. obtained his tertiary education at the University of Adelaide. His Ph.D. research in the Department of Physical and Inorganic Chemistry was concerned with physical chemical studies on naturally occurring and synthetic polymers. He then held Post Doctoral appointments in England at the University of Lancaster (preparation and e.s.r. characterisation of radical anions), Australia at the Division of Protein Chemistry, CSIRO, Parkville (on the interactions of fluorescent compounds with protein components by photophysical techniques) and Canada at the University of Western Ontario (construction of a microsecond flash photolysis apparatus in connection with photochemical reactions involving radical ions). In 1975 he returned to Australia as the assistant editor of Aust. J. Chem. John Z. has served as the national representative on IUPAC’s Commission III.2 (on Physical Organic Chemistry) and is currently an associate member of this commission. In 1998, the Royal Australian Chemical Institute awarded him a citation for his contributions to the promotion of Australian chemistry nationally and internationally, principally through his role as editor of the journal. Finally, John is of a distinctly independent nature – perhaps a reflection of his Polish antecedents? While his management style might be said to be unique, it has always been characterised by an overriding commitment to quality. Clearly, John Zdysiewicz ranks as an exceptional individual. On behalf of my fellow advisory committee members and, indeed, also for the wider chemistry community, I thank John for a job exceedingly well done. We wish him well in his retirement.

Post-school systems of education and training have changed dramatically across the globe, including in South Africa, over the past two decades. It is ironic, however, that as many countries chose to renew and grow ‘polytechnic-type’ post-school education and training subsystems, South Africa (together with other countries from the Anglo-Saxon world) chose to reduce their role, largely through institutional mergers and processes of academic drift. Much of this difference in approach is path-dependent, shaped by the specific histories of capitalist evolution in each country. However, it also has to do with the faulty policy logic which has guided these changes over the past two decades. This article investigates the rise in significance of tertiary technical and vocational education and training (TVET) through brief case studies of two countries in Central and Northern Europe where the polytechnic sector has been expanded, not reduced. The discussion then shifts to South Africa, where graduation outcomes (in percentage terms) in the universities of technology have remained flat for more than two decades. The shift from secondary to tertiary TVET requires a significant expansion of enrolments and graduations in key applied technology fields, not the stasis we are seeing in South African universities of technology.

Health Management Work Integrated Learning is a 40 credit point penultimate course of experiential learning in the Master of Advanced Health Services Management M(Adv)HSM now offered by the School of Medicine Health at Griffith University. WIL was initiated in 2009 within the School of Public Health (Lilley et al (2009) based on a Teaching and Learning Grant to meet an existing experiential learning need identified for students studying in the enabling professional area of health management. After 15 semesters of delivery of these courses (completed at December 2016), it is timely to report on the quantitative attributes on the course to inform the post-graduate literature on this type of education. An objective of this review is to influence both curricula and student decision making regarding the future conduct and enhancement of tertiary preparation for health services management HSM employment. WIL has experienced a large increase in student enrolments in recent years suggesting that there is both strong demand for this nature of learning and student satisfaction with the quality of the learning modality in preparing for a career in HSM.

Most classical journals report on research on literary, historical and linguistic questions, and rarely allocate space to discussions of pedagogy at tertiary level. This article, however, falls into the latter category. It takes the form of a report on the teaching of Latin and Greek (both classical and post-classical) in universities in Australia and New Zealand; and it makes a number of suggestions regarding the future of the classical languages in this region.Any general examination by an outsider of the situation of Classics in Australian and New Zealand universities would readily conclude that most departments are managing well, or at least holding their own, compared to other disciplines. Student enrolments are high overall, since most departments, like those in Britain and North America, have expanded their teaching range to embrace ancient history, classical literature in translation and, in some cases, archaeology. This has been the situation for the best part of the last two decades. Often these subjects were introduced in order to ‘subsidise’ and protect the continuance of Greek and Latin with their smaller numbers; but they have been extremely popular with students in every university in Australasia in which they are taught. And so these teaching areas have come to have a life and a rightful presence of their own.

The year 2020 will unlikely be one that any member of the higher education community will forget. It has posed challenges and opportunities to rethink aspects of tertiary learning and teaching, and also confirmation of some of the better practices we have engaged in. For some, the novel coronavirus pandemic has forced bad practice – such as simple and rapid digitalisation of existing curriculum – often bundled into the pedagogically-ambiguous ‘emergency remote teaching’ or ERT (Toquero, 2020). The intense pressure for academics to deliver curriculum online, typically to the exception of time for comprehensive academic development and upskilling. The practice for an overnight transition to online learning, while deemed by many to have been essential at the time, has created a myriad of future decisions to be actioned across the sector. These range from deploying future academic development workshops to transform the workforce for continued online learning to employment of educational technologists, learning designers, or similar to enable purposeful decisions of pedagogy within online learning environments. Financial constraints have tempered the deployment of additional resources, with institutions suffering from financial modelling unexpected in late-2019 budget forecasting meetings. A reduction in student enrolments from international markets offers complexity for higher education exporter nations like Australia (Marshman & Larkins, 2020). Nonetheless, there has been a resilience from the sector to ensure continuity of education under all circumstances. The role of journals like the Journal of University Teaching and Learning Practice during the pandemic has been to support timely publication of evidence-based practices for responses to COVID-19. This has included a need to balance the acceptance of manuscripts with pre-COVID-19 data and implications, and those authors contributing to the exponentially expanding knowledge base for teaching and learning during COVID-19. For the former, we have encouraged authors during final acceptance to reflect on their work’s role in enabling a positive response to the pandemic. For those in the latter, we have ensured that writers have considered the broader implications of their work beyond the pandemic. These decisions support manuscripts publishing in JUTLP to contribute to the contemporary landscape, and also beyond the pandemic.

Purpose: Implementation of the International Consortium for Health Outcomes Measurements (ICHOM) standard for cataract surgery into clinical practice at an Italian tertiary referral centre. Methods: Prospective, observational, descriptive study consisting of the registry and analysis of cataract surgeries performed during a 6-month enrolment period at the University Eye Clinic of Trieste, Trieste, Italy. Outcomes were recorded and analysed according to the ICHOM Cataract Standard Set version 2.0.1. Records included clinician-reported outcome measures (CROMs) – visual outcome and complications – and patient-reported outcome measures (PROMs) – self-assessed vision with the Catquest-9SF questionnaire. Correlations between PROMs and CROMs were evaluated. A multiple linear regression was used for predicting the change in PROMs with surgery. Results: A total of 218 eyes (of 218 patients) were analysed. Postoperative corrected distance visual acuity (CDVA) was ⩾0.3 in 89.0% (194/218) of eyes. There was a statistically significant improvement of the post-operative Catquest-9SF global average score. ( p < 0.001). The change in the Catquest-9SF score significantly correlated with the change in Item 2 score (related to intermediate vision) ( r = 0.634, p < 0.001). A predictive model of the change in the Catquest-9SF score was found ( p < 0.001, R2: 0.527) based on preoperative Catquest-9SF total score, presence or not of macular degeneration, presence or not of intraoperative complications, age >75 years old, and preoperative CDVA. Conclusions: Cataract surgery improves the functional vision, with some factors limiting the outcomes such as comorbidities. Self-perceived improvement in intermediate vision significantly influenced the improvement in self-assessed vision.

Background: This study aimed to prospectively record changes to treatment for early breast cancer patients during the first wave of the COVID-19 pandemic in Australia. The purpose was to assess the impact on breast cancer outcomes and to determine the need for any mitigative actions. Methods: The study was conducted in the breast cancer unit of a tertiary referral hospital. Patients with early (non-metastatic) breast malignancy discussed in multidisciplinary team meetings between March and June 2020 were included. Patients were newly diagnosed, post-operative or post-neoadjuvant chemotherapy. Standard treatment was defined by Westmead Breast Cancer Institute protocols and any variations related to the pandemic were recorded. Results: In the study, 145 patients were included (median age 59 years). Pandemic-related changes to management were noted in 13 of 145 (9.0%) patients. Four patients experienced a delay to cancer treatments, four were not offered reconstructive/ symmetrisation surgical procedures, three had altered radiotherapy protocols and two patients were not offered enrolment to a clinical trial. These impacts affected the groups presenting with new cancers (n=7/86, 8.1%), post-operative cases (n=4/25, 16.0%) and post-neoadjuvant chemotherapy cases presenting for surgical planning (n=2/34, 5.9%). Conclusion: Most patients (91.0%) received standard treatment during the first wave of the pandemic. The minor variations from institutional protocols observed in this study are unlikely to affect local control or survival in this patient cohort, but close follow-up is required. Quality of life may have been affected for four patients who had downgraded or delayed reconstructive procedures.

Abstract Introduction 'No Jab, No Play' and 'No Jab, No Pay' mandatory immunisation policies were introduced in the state of Victoria and Australia nationally in January 2016. They restrict access to childcare/kindergarten and family assistance payments respectively, for under-vaccinated children. We aimed to describe the proportion of attendees to immunisation services of a tertiary hospital, the Royal Children's Hospital Melbourne (RCH), who were motivated by the policies to discuss or catch up vaccination. We also explored the association between policy motivation, vaccine hesitancy (VH) and intent to seek medical exemption, with vaccine-uptake. Referrals to the Specialist Immunisation Clinic (SIC) were also reviewed. Methods Parents/Guardians and clinicians completed surveys October 2016-May 2017 from the nurse-led immunisation Drop in Centre (DIC) or physician-led SIC. Vaccine-uptake was measured using the Australian Immunisation Register at baseline, 1 and 7 months post-attendance. The association between vaccine-uptake, policy motivation and VH was explored by logistic regression. Results Of 607 children included, 393 (65%) were from the DIC and 214 (35%) SIC. 74 (12%) of parents were motivated by the policies to attend immunisation services and 19% were VH. Only 50% of VH parents planned to catch-up vaccination for enrolment to childcare/kindergarten. Fewer children were fully immunised at 7 months if their parents were VH (difference 18%; OR 0.24, CI 0.1-0.54,p&lt;0.001) or seeking medical exemption (difference 33%, OR 0.08, CI 0.01-0.6, p 0.015). Conclusions The 'No Jab' policies motivated attendance to a tertiary immunisation service but children of vaccine hesitant parents and those seeking medical exemption to immunisation were less likely to be fully immunised post attendance, compared to baseline. These data will be used to inform a comprehensive evaluation of the impact of the policies, particularly the educational impact from loss of early childhood education.

Background: HIV rapid tests (RT) play an important role in tackling the HIV pandemic in South Africa. Third generation RT that detect HIV antibodies are currently used to diagnose HIV infection at the point of care. Determine Combo (DC) is the first fourth generation RT that detects both p24 antigen (p24Ag) and HIV antibodies (Ab), theoretically reducing the window period and increasing detection rates. Early detection of maternal HIV infection is important to mitigate the high risk of vertical transmission associated with acute maternal infection. Objectives: We assessed the performance of the DC RT against third generation RT in antenatal and post-partum women. Methods: Third generation RT Advance Quality and Acon were used in a serial algorithm to diagnose HIV infection in antenatal and post-partum women over six months at a tertiary hospital in Johannesburg, South Africa. This data provided the reference against which the DC RT was compared on plasma and whole blood samples. Results: The 1019 participants comprised 345 (34%) antenatal and 674 (66%) post-partum women. Ninety women (8.8%) tested HIV-positive of whom 59 (66%) were tested antenatally, and 31 (34%) post-partum yielding prevalence rates of 17.1% and 4.6% respectively. The sensitivity and specificity of the Ab component of DC on plasma antenatally was 100% (93.8% – 100%) and 100% (98.6% – 100%) respectively and post-partum was 100% (88.9% – 100%) and 99.6% (98.8% – 99.9%) respectively. One false positive and not a single true positive p24Ag was detected. Of 505 post-partum women who tested HIV-negative 6–12 months prior to enrolment, 12 (2.4%) seroconverted. Conclusion: The fourth generation DC offered no advantage over current third generation RT in the diagnosis of HIV infection.

Abstract Background Provider Initiated Testing and Counseling (PITC) among hospitalized children have shown to increase the probability of identifying HIV-infected children and hence be able to link them to HIV care. We aimed at determining the prevalence, clinical characteristics and outcome of HIV-infected children admitted at Bugando Medical Centre (BMC) after active provision of PITC services. Methods A cross-sectional study with follow up at three months post enrollment was done. Children with unknown HIV status were tested for HIV infection as per 2012 Tanzanian algorithm. Questionnaires were used to collect demographic, clinical and follow up information. Data was statistically analyzed in STATA v13. Results A total of 525 children were enrolled in the study. Median [IQR] age was 28 [15–54] months. Males consisted of 60.2% of all the participants. HIV prevalence was 9.3% (49/525). Thirty-three (67.3%) of HIV-infected children were newly diagnosed at enrolment. Thirty-nine (79.6%) of all HIV-infected patients had WHO HIV/AIDS clinical stage four disease, 10 (20.4%) had WHO clinical stage three and none qualified in stage one or two. About 84% (41/49) of HIV infected children had severe immunodeficiency at the time of the study. Factors that were independently associated with HIV infection were, cough (OR 2.40 [1.08–5.31], p = 0.031), oral thrush (OR 20.06[8.29–48.52], p < 0.001), generalized lymphadenopathy (OR 5.61 [1.06–29.56], p = 0.042), severe acute malnutrition (OR 6.78 [2.28–20.12], p = 0.001), severe stunting (OR 9.09[2.80–29.53], p = 0.034) and death of one or both parents (OR 3.62 [1.10–11.87], p = 0.034). The overall mortality (in-hospital and post-hospital) was 38.8% among HIV-infected children compared with 14.0% in HIV-uninfected children. Within three months period after discharge from the hospital, 71.4% (25/35) of discharged HIV-infected children reported to have attended HIV clinic at least once and 60.0% (21/35) were on antiretroviral medications. Conclusion PITC to all admitted children identified significant number of HIV-infected children. Mortality among HIV-infected children is high compared to HIV-uninfected. At the time of follow up about 30% of discharged HIV-infected children did not attend to any HIV care and treatment clinics. Therefore effective efforts are needed to guarantee early diagnosis and linkage to HIV care so as to reduce morbidity and mortality among these children.

Abstract Background Continuous body temperature monitoring during perioperative care is enabled by using a non-invasive “zero-heat-flux” (ZHF) device. However, rigorous evaluation of whether continuous monitoring capability improves process of care and patient outcomes is lacking. This study assessed the feasibility of a large-scale trial on the impact of continuous ZHF monitoring on perioperative temperature management practices and hypothermia prevention. Methods A feasibility study was conducted at a tertiary hospital. Participants included patients undergoing elective surgery under neuraxial or general anesthesia, and perioperative nurses and anesthetists caring for patient participants. Eighty-two patients pre and post introduction of the ZHF device were enrolled. Feasibility outcomes included recruitment and retention, protocol adherence, missing data or device failure, and staff evaluation of intervention feasibility and acceptability. Process of care outcomes included temperature monitoring practices, warming interventions and perioperative hypothermia. Results There were no adverse events related to the device and feasibility of recruitment was high (60%). Treatment adherence varied across the perioperative pathway (43 to 93%) and missing data due to electronic transfer issues were identified. Provision of ZHF monitoring had most impact on monitoring practices in the Post Anesthetic Care Unit; the impact on intraoperative monitoring practices was minimal. Conclusions Enhancements to the design of the ZHF device, particularly for improved data retention and transfer, would be beneficial prior to a large-scale evaluation of whether continuous temperature monitoring will improve patient outcomes. Implementation research designs are needed for future work to improve the complex area of temperature monitoring during surgery. Trial registration Prospective registration prior to patient enrolment was obtained from the Australian and New Zealand Clinical Trials Registry (ANZCTR) on 16th April 2021 (Registration number: ACTRN12621000438853).

Abstract Background Nigeria contributes significantly to the global burden of HIV, Hepatitis B and C infections, either singly or in combinations, despite progress in HIV care regionally and globally. Although some limited data on mono infection of HIV, Hepatitis B and C virus infections do exists, that of dual and triplex infections, including seroconversion and mother-to-child transmission (MTCT) rates necessary for planning to address the scourge of infections in pregnancy are not available. Objectives To determine the seroprevalence, rate of new infections, MTCT of dual and triple infections of HIV, Hepatitis B and C viruses and associated factors, among pregnant women in Nigeria. Method A multicenter prospective cohort study will be conducted in six tertiary health facilities randomly selected from the six geopolitical zones of Nigeria. All eligible pregnant women are to be tested at enrollment after informed consent for HIV, Hepatitis B and C virus infections. While those positive for at least two of the infections in any combination will be enrolled into the study and followed up to 6 weeks post-delivery, those negative for the three infections or positive for only one of the infections at enrolment will be retested at delivery using a rapid diagnostic test. On enrolment into the study relevant information, will be obtained, and laboratory test of CD4 count, liver function test and full blood counts, and prenatal ultrasonography will also be obtained/performed. Management of mother-newborns pairs will be according to appropriate national guidelines. All exposed newborns will be tested for HIV, HBV or HCV infection at birth and 6 weeks using PCR technique. The study data will be documented on the study case record forms. Data will be managed with SPSS for windows version 23. Ethical approval was obtained from National Health Research Ethics Committee (NHREC) (NHREC/01/01/2007–23/01/2020). Conclusion Pregnant women with multiple of HIV, HBV and HCV infections are at increased risk of hepatotoxicity, maternal and perinatal morbidity and mortality. Additionally, infected pregnant women transmit the virus to their unborn baby even when asymptomatic. Children born with any of the infection have significantly poorer quality of life and lower five-year survival rate. Unfortunately, the seroconversion and MTCT rates of dual or triplex infections among pregnant women in Nigeria have not been studied making planning for prevention and subsequent elimination of the viruses difficult. The study is expected to fill this knowledge gaps. Nigeria joining the rest of the world to eliminate the triple infection among children rest on the availability of adequate and reliable data generated from appropriately designed, and powered study using representative population sample. The establishment of the three-in-one study of prevalence, rate of new infection, rate and risk factor for MTCT of dual and triple infection of HIV, Hepatitis B and C viruses among pregnant women in Nigeria is urgently needed for policy development and planning for the improvement of the quality of life of mothers and the elimination of childhood triplex infection.

Abstract Background Congenital cytomegalovirus (CMV) is the most common congenital infection globally, however information about CMV is not routinely included in antenatal education in the United Kingdom. This feasibility study aimed to gather the essential data needed to design and power a large randomised controlled trial (RCT) to investigate the efficacy of a digital intervention in reducing the risk of CMV acquisition in pregnancy. In order to do this, we carried out a single-centre RCT, which explored the knowledge, attitudes and risk reduction behaviours in women in the intervention and treatment as usual groups, pre- and post-intervention. Methods CMV seronegative women living with a child less than four years old, receiving antenatal care at a single UK tertiary centre, were randomised to the digital intervention or ‘treatment as usual’ groups. Participants completed questionnaires before the digital intervention and after and at 34 gestational weeks, and responses within groups and between groups were compared using tailored randomisation tests. CMV serology was tested in the first trimester and at the end of pregnancy. Results Of the 878 women screened, 865 samples were analysed with 43% (n = 372) being CMV seronegative and therefore eligible to take part in the RCT; of these, 103 (27.7%) women were enrolled and 87 (84%) of these completed the study. Most participants (n = 66; 64%) were unfamiliar with CMV at enrolment, however at 34 gestational weeks, women in the intervention group (n = 51) were more knowledgeable about CMV compared to the treatment as usual group (n = 52) and reported engaging in activities that may increase the risk of CMV transmission less frequently. The digital intervention was highly acceptable to pregnant women. Overall, four participants seroconverted over the course of the study: two from each study group. Conclusions A large multi-centre RCT investigating the efficacy of a CMV digital intervention is feasible in the United Kingdom; this study has generated essential data upon which to power such a study. This single-centre feasibility RCT demonstrates that a digital educational intervention is associated with increase in knowledge about CMV and can result in behaviour change which may reduce the risk of CMV acquisition in pregnancy. Trial registration Clinicaltrials.gov, NCT03511274, Registered 27.04.18, http://www.Clinicaltrials.gov

Abstract Intracerebral haemorrhage in the elderly is a severe manifestation of common forms of cerebral small vessel disease. Nearly 60% of intracerebral haemorrhage survivors will develop clinical manifestations of small vessel disease progression including recurrent haemorrhage, ischaemic stroke, dementia, late-life depression and gait impairment within 5 years. Blood pressure measurements following intracerebral haemorrhage are strongly associated with this risk. However, aggressive blood pressure lowering in the elderly carries substantial risks. In order to determine whether there might be an opportunity to select individuals at the highest risk for small vessel disease progression for aggressive blood pressure reduction, we investigated whether APOE gene variants ɛ2/ɛ4 modify the association between blood pressure and small vessel disease clinical progression after intracerebral haemorrhage. We conducted a single-centre longitudinal study at a tertiary care referral centre (Massachusetts General Hospital in Boston, MA, USA), analysing 716 consecutive survivors of acute intracerebral haemorrhage, enrolled from January 2006 to December 2016. We conducted research interviews at the time of enrolment and obtained APOE genotypes from peripheral venous blood samples. We followed patients longitudinally by means of validated phone-based research encounters, aimed at gathering measurements of systolic and diastolic blood pressure, as well as information on small vessel disease clinical outcomes (including recurrent haemorrhage, incident ischaemic stroke, incident dementia, incident depression and incident gait impairment). APOE ε4 and systolic blood pressure were associated with the risk of recurrent haemorrhage, ischaemic stroke and post-haemorrhage dementia, depression and gait impairment (all P &lt; 0.05). APOE ε4 and systolic blood pressure interacted to increase the risk of recurrent haemorrhage, ischaemic stroke, dementia and gait impairment (all interaction P &lt; 0.05). Among patients with elevated blood pressure following intracerebral haemorrhage (average systolic blood pressure 120–129 mmHg and diastolic blood pressure &lt;80 mmHg) only those with one or more APOE ε4 copies were at increased risk for one or more small vessel disease outcomes (hazard ratio = 1.97, 95% confidence interval 1.17–3.31). Among haemorrhage survivors with hypertension (stage 1 and beyond) APOE genotype also stratified risk for all small vessel disease outcomes. In conclusion, APOE genotype modifies the already strong association of hypertension with multiple small vessel disease clinical outcomes among intracerebral haemorrhage survivors. These data raise the possibility that genetic screening could inform blood pressure treatment goals in this patient population.

Abstract Objectives The general objective of this study is to test the hypothesis that administration of convalescent plasma from donors with previous diagnosis of severe COVID-19 pneumonia is safe and associated with a decrease in all-cause in-hospital mortality among hospitalized patients with COVID-19 at 30 days in comparison with standard treatment alone. The secondary objectives are as follows: (1) to assess the efficacy of convalescent plasma to reduce the length of hospitalization, (2) to assess the efficacy of convalescent plasma to reduce the length of ICU stay, and (3) to assess the efficacy of convalescent plasma on reducing the requirement of invasive mechanical ventilation or ICU stay. Trial design PERUCONPLASMA is a IIb phase open label, randomized, superiority clinical trial with 1:1 allocation taking place in real life routine clinical practice at public hospitals in Lima, Peru. Participants will be randomized to receive convalescent plasma along with local standard treatment or local standard treatment alone. After allocation, all participants will be followed for a total of 30 days or until hospital discharge, whichever occurs first. Participants The population for the study are patients with severe disease with a confirmed laboratory test for SARS-CoV-2 infection hospitalized in 3 tertiary-care hospitals in Lima, Peru. Subjects are eligible for the trial if they meet all of the following inclusion criteria: Age 18 or older Hospitalization due to COVID-19 with laboratory confirmation (either with serologic, molecular, or antigen test along with a compatible clinical presentation) Severe or critical COVID-19 disease Severe illness was defined by 2 or more of the following: Respiratory rate of 22 or more Hypoxemia with oxygen saturation equal or less than 93% Abnormal blood gas analysis (PaO2 < 60 mmHg, PaCO2 > 50 mmHg, or Pa/FiO2 < 300) Critical disease was defined by either: Mechanical ventilation requirement less than 72 h. Shock. Capacity to provide informed consent (patient or patient’s direct relative) Availability of convalescent plasma units compatible with ABO blood type of the subject. Exclusion criteria: Subjects are not eligible for the trial if they meet any of the following criteria: Contraindication for transfusion (e.g., prior anaphylaxis, congestive heart failure) Hemodynamic instability (PA < 60 mmHg refractory to vasopressors) Uncontrolled concomitant infections\ Stupor or coma Platelets < 50,000/μL or disseminated intravascular coagulation Serum creatinine > 3.5 mg/dL or dialysis requirement Total bilirubin > 6 mg/dL or jaundice of unknown etiology Myocardial infarction or acute coronary syndrome Active or recent (< 7 days) intracranial hemorrhage Pregnancy Donors: The donors have to meet the following criteria: male between 30 and 60 years with a previous diagnosis of severe COVID-19-associated pneumonia within the last 3 months, with resolution of symptoms of at least 28 days. The rationale for including donors with severe disease is to maximize the probability of collecting convalescent plasma units with high titer of neutralizing antibodies, as the technology to measure this specific type of antibodies is not routinely available in Peru. Aliquots of plasma will be stored for future quantification of neutralizing antibodies. Intervention and comparator Convalescent plasma from donors with previous severe COVID-19 is the investigational medical product. The experimental group will receive 1 to 2 units of 200 to 250 ml of convalescent plasma along with local standard treatment. The control group will receive local standard treatment alone. The participants randomized to plasma will have evaluations at 6 h and 24 h to specifically evaluate possible post transfusion events. All the participants will be evaluated at day 3, day 7, and day 30 after enrolment. Main outcomes Safety outcome: Incidence of serious adverse reactions related to convalescent plasma transfusion within 24 h after convalescent plasma administration. Efficacy outcomes: Mortality from any cause during hospitalization at 30 days post randomization. Length of hospitalization at 30 days post randomization or until hospital discharge. Duration of mechanical ventilation at 30 days post randomization or until hospital discharge. Length of hospitalization in an intensive care unit at 30 days post randomization or until hospital discharge. Exploratory: Oxygen requirement evolution at days 3 and 7. Score Sequential Organ Failure Assessment (SOFA) evolution at days 3 and 7. Dynamics of inflammatory marker (lymphocyte, C-reactive protein (CRP), D-dimer, lactate dehydrogenase (LDH)) evolution at days 3 and 7. Proportion of patients progressing to multi-organ failure at 30 days post randomization or until hospital discharge. Proportion of transfusion related adverse reactions at 30 days post randomization or until hospital discharge. Randomization Randomization will be carried out within the electronic case report form (eCRF) in 1:1 ratio (receive plasma/control) in a randomization process established by blocks of size 2, 4, and 6. Allocation to the treatment arm of an individual patient will not be available to the investigators before completion of the whole randomization process. Randomization blocks will be performed with “ralloc”, Stata’s randomization process v.16.0. Randomization through the eCRF will be available 24 h every day. Blinding (masking) Both the participants and study staff will be aware of the allocated intervention. Blinded statistical analysis will be performed. Numbers to be randomized (sample size) The sample size was calculated using the Fleiss formula with continuity correction to detect a mortality reduction from 50 to 20% between the two treatment arms with a confidence level of 95% and a power of 80%. Based on this information, a total of 45 patients per arm would be needed. After adjustment for a drop-out rate of 10% after enrolment, a total of 50 patients per arm (100 patients in total) will be enrolled. Trial status Current protocol version: 5.0 dated January 04, 2021. Recruitment started on September 21, 2020, and is expected to finish by the end of March 2021. Trial registration Peruvian Register of Clinical Trials (REPEC) ID: PER-016-20, registered on June 27, 2020. Clinicaltrials.gov ID: NCT04497324, registered on August 4, 2020. Full protocol The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this letter serves as a summary of the key elements of the full protocol.

The article explores reconfiguring the concept of academic success in Zimbabwe, now premised on the attainment of benchmark Doctrine Education 5.0 pillars set by the Ministry of Higher and Tertiary Education, Innovation, Science and Technology Development and enforced by Zimbabwe Council for Higher Education (ZimCHE) as a quality assurance agency. It reviews academic success standards based on teaching and learning; research, community engagement; innovation; and industrialisation. Targeting, HEI quality assurance officers, managers, and students as the population, the study purposively selected three HEIs based on stated science, technology, engineering, and mathematics (STEM) mandates drawn from Zimbabwe’s 20 registered public and private universities. Questionnaire-elicited data were analysed using the Statistical Package for Social Scientists and presented in graphs derived from descriptive statistics to enhance meaning in findings. Findings show the five-fold Doctrine Education 5.0 remains news to HEI students although they passively participate as recipients, reflected in students-as- consumers rather than ‘students-as-partners’ among HEIs and later industry. Without students’ voice as HEI partners, success would be analogous to a maternity centre rating its success based on ‘state of the art equipment’ and high calibre staff without mention of babies delivered as core business therein. The article recommends the reconfiguration of the academic-success matrix to reflect the student-interests involvement, and the industrial perspective as end-line users of HEI graduates. A one-size fits-all approach to academic success is not tenable for HEIs, and their divergent mandates call for differentiated methodological approaches to achieve success. HEIs continue to rate their success in terms of student enrolment figure, infrastructural development at the expense of student-centred success criteria that assesses innovative skills capacity and industrial appraisals post-graduation. The shift to a business approach in higher education has been unmanaged, with telling implications for HEIs visions and stated missions, necessitating change. Consolidating HEI success requires Chief Executive Officers’ whose proven mandate espouses all education 5.0 deliverables, particularly innovation and industrialisation through research and community engagement, except for teaching and learning. Nothing in academia prepares Professors as Vice Chancellors for this task, reducing them to duds as their grasp of the five-fold mandate largely remains superficial. HEIs’ success criteria and students’ involvement continue to reflect education 3.0 scope when they should functionally be operating at 5.0, which is just on paper and tick-a-box-kind-of compliance to satisfy minimum quality assurance expectations. A danger of leaving important stakeholders behind until too late lingers, with potentially telling negative ramifications therefrom for all.

Most public higher education institutions in Africa, in response to historical conditions, have enrolled students in excess of their capacity, resulting in massification and negative consequences on educational quality. Increased enrolment has addressed issues of equity; but the equally important issue of ensuring equity in success for the enrolled students has received limited attention. Apparently graduation rates in higher education in Africa remain fairly low. Higher education institutions have taken several corrective measures to address the consequences of massification. Governments have also created new institutions and put quality assurance systems in place. There have also been continental responses. Sub-Saharan Africa has the lowest tertiary enrolment of any world region, a handicap in its development. It must also meet the demands of its rapidly increasing secondary school graduates. There is a compelling need to further increase tertiary enrolment, a situation that challenges both institutions and countries. The growth in private higher education, if regulated and quality-controlled, could relieve this pressure. Pour des raisons historiques, la majorité des établissements d’enseignement supérieur d’Afrique admet plus d’étudiants qu’elle ne peut en accueillir. Ceci conduit à la massification de l’enseignement supérieur et a des conséquences négatives sur sa qualité. L’augmentation de la participation a permis de répondre à des problèmes d’équité, mais la tout aussi importante question de l’équité dans la réussite des étudiants admis a reçu une attention limitée. Le taux de réussite dans l’enseignement supérieur en Afrique reste faible. Les établissements d’enseignement supérieur ont mis en place plusieurs mesures visant à corriger les conséquences néfastes de la massification. Les gouvernements ont aussi créé de nouvelles institutions et mis en place des systèmes d’assurance qualité. Des réponses ont par ailleurs été proposées à l’échelle du continent. Cependant, l’Afrique sub-saharienne a le plus faible taux d’inscription dans l’enseignement supérieur du monde, un handicap pour son développement. Elle doit aussi répondre aux demandes d’une population de diplômés du secondaire qui augmente rapidement. Il est impossible de nier la nécessité d’augmenter les admissions dans l’enseignement supérieur, une situation qui pose des problèmes aussi bien aux établissements qu’aux nations. La croissance des établissements privés pourrait permettre de relâcher la pression, s’ils sont correctement régulés et contrôlés en termes de qualité.

Is mathematics anxiety contributing to the declining numbers of females enrolling in tertiary computing courses? Initial observation of enrolments in tertiary computing courses at an Australian university suggests a direct correlation between the number of females in a course and the prerequisite level of mathematics required at entry. A study involving over 550 female students in Australia and Singapore was undertaken to determine student perceptions of the importance of mathematics to computing and information technology degrees. All of the students were either studying a computing subject at secondary school or university and some were already enrolled in a computing degree. Results indicate that students studying computing at tertiary level in both countries believe that computing courses require good mathematical ability, while secondary school students express high levels of uncertainty when asked the same question. The majority of students surveyed believe that females and males are equal in mathematical ability, while thirty percent of the cohort from Singapore believes that males are more able than females in mathematical ability. This paper uses these responses, combined with observation and statistical data, to posit that females perceive a strong link between mathematical ability and success in computing courses. Consequently mathematics anxiety in females could be a contributing factor to their under-representation in tertiary computing courses. Computing and mathematics educators need to combine their efforts to encourage females into computing courses and dispel this anxiety.

As the smoke cleared away from the battlefield during the truce of Christmas 1992, a degree of clarity began to emerge about the state of education in New Zealand. After four years of struggle it became apparent that however the outstanding issues were resolved in 1993 there would be legacy of problems, largely but not wholly, associated with those reforms that sought to turn education into a market and knowledge into a commodity. Not all reforms were tarnished by the market brush. Some, like the development of the national curriculum, appeared to be serendipitous, while others like government support for more Kura Kaupapa Schools betokened a degree of tolerance and understanding not, hitherto, associated with recent educational policymaking. Yet others, were clearly glossed by market policies but betokened the deeper trends of post-industrial society - the rise in tertiary enrolments for example. 1993 is, of course, a key year, for an election at least allows the possibility of taking stock of the current direction of educational policy. Equally importantly, it is women's suffrage year and many of the educational problems that now comfront us are ones women, in one way or another will ultimately have to cope with.

Background: Respiratory complications are frequent in acute pancreatitis, and respiratory dysfunction, presenting as Acute lung injury (ALI) or Acute Respiratory Distress Syndrome (ARDS), is a major component of multiple organ dysfunction syndrome (MODS), with a frequent need for ventilator support, which contributes to early death in severe acute pancreatitis. The current study was done with the objective of assessing the morbidity and mortality of acute pancreatitis cases with respiratory complications and to find out whether there is any association between the aetiology of acute pancreatitis and respiratory complications. Methodology: It was a prospective observational study conducted in a tertiary care centre in Kerala. All participants admitted with symptoms suggestive of acute pancreatitis were screened for potential enrolment. The inclusion criteria employed were that the patients should be aged above 18 years, and presenting with the first episode of pancreatitis, irrespective of aetiology. All the patients who were admitted were monitored daily for the worsening of any respiratory complications and provided with adequate respiratory supports. Results: Out of the 101 participants recruited, males were 84.2%. Mean (SD) age was 42.1 (11.4) years. Majority of cases (61%) had alcoholic aetiology. Fourteen patients required high flow nasal oxygen support, four patients were given face mask support, five patients required ventilator support and three patients required tracheostomy support. Respiratory complications and requirement of support were found to be associated with higher morbidity as well as mortality. Respiratory complications were higher in those with alcoholic etiology but this was not significant in univariate analysis. Conclusion: Respiratory complications pose challenges in clinical course of acute pancreatitis in terms of morbidity as well as mortality. Aetiology did not seem to play a major role in development of respiratory complications.

Refereed publications (also known as peer-reviewed) are the currency of academia, yet many PhD theses in Australia result in only one or two such papers. Typically, a doctoral thesis requires the candidate to present (and pass) a public Confirmation Seminar, around nine to twelve months into candidacy, in which a panel of the candidate’s supervisors and invited experts adjudicate upon whether the work is likely to continue and ultimately succeed in the goal of a coherent and original contribution to knowledge. A Final Seminar, also public and sometimes involving the traditional viva voce or oral defence of the thesis, is presented two or three months before approval is given to send the 80,000 to 100,000 word tome off for external examination. And that soul-destroying or elation-releasing examiner’s verdict can be many months in the delivery: a limbo-like period during which the candidate’s status as a student is ended and her or his receipt of any scholarship or funding guerdon is terminated with perfunctory speed. This is the only time most students spend seriously writing up their research for publication although, naturally, many are more involved in job hunting as they pin their hopes on passing the thesis examination.There is, however, a slightly more palatable alternative to this nail-biting process of the traditional PhD, and that is the PhD by Published Papers (also known as PhD by Publications or PhD by Published Works). The form of my own soon-to-be-submitted thesis, it permits the submission for examination of a collection of papers that have been refereed and accepted (or are in the process of being refereed) for publication in academic journals or books. Apart from the obvious benefits in getting published early in one’s (hopefully) burgeoning academic career, it also takes away a lot of the stress come final submission time. After all, I try to assure myself, the thesis examiners can’t really discredit the process of double-blind, peer-review the bulk of the thesis has already undergone: their job is to examine how well I’ve unified the papers into a cohesive thesis … right? But perhaps they should at least be wary, because, unfortunately, the requirements for this kind of PhD vary considerably from institution to institution and there have been some cases where the submitted work is of questionable quality compared to that produced by graduates from more demanding universities. Hence, this paper argues that in my subject area of interest—film and television studies—there is a huge range in the set requirements for doctorates, from universities that award the degree to film artists for prior published work that has undergone little or no academic scrutiny and has involved little or no on-campus participation to at least three Australian universities that require candidates be enrolled for a minimum period of full-time study and only submit scholarly work generated and published (or submitted for publication) during candidature. I would also suggest that uncertainty about where a graduate’s work rests on this continuum risks confusing a hard-won PhD by Published Papers with the sometimes risible honorary doctorate. Let’s begin by dredging the depths of those murky, quasi-academic waters to examine the occasionally less-than-salubrious honorary doctorate. The conferring of this degree is generally a recognition of an individual’s body of (usually published) work but is often conferred for contributions to knowledge or society in general that are not even remotely academic. The honorary doctorate does not usually carry with it the right to use the title “Dr” (although many self-aggrandising recipients in the non-academic world flout this unwritten code of conduct, and, indeed, Monash University’s Monash Magazine had no hesitation in describing its 2008 recipient, musician, screenwriter, and art-school-dropout Nick Cave, as “Dr Cave” (O’Loughlin)). Some shady universities even offer such degrees for sale or ‘donation’ and thus do great damage to that institution’s credibility as well as to the credibility of the degree itself. Such overseas “diploma mills”—including Ashwood University, Belford University, Glendale University and Suffield University—are identified by their advertising of “Life Experience Degrees,” for which a curriculum vitae outlining the prospective graduand’s oeuvre is accepted on face value as long as their credit cards are not rejected. An aspiring screen auteur simply specifies film and television as their major and before you can shout “Cut!” there’s a degree in the mail. Most of these pseudo-universities are not based in Australia but are perfectly happy to confer their ‘titles’ to any well-heeled, vanity-driven Australians capable of completing the online form. Nevertheless, many academics fear a similarly disreputable marketplace might develop here, and Norfolk Island-based Greenwich University presents a particularly illuminating example. Previously empowered by an Act of Parliament consented to by Senator Ian Macdonald, the then Minister for Territories, this “university” had the legal right to confer honorary degrees from 1998. The Act was eventually overridden by legislation passed in 2002, after a concerted effort by the Australian Universities Quality Agency Ltd. and the Australian Vice-Chancellors’ Committee to force the accreditation requirements of the Australian Qualifications Framework upon the institution in question, thus preventing it from making degrees available for purchase over the Internet. Greenwich University did not seek re-approval and soon relocated to its original home of Hawaii (Brown). But even real universities flounder in similarly muddy waters when, unsolicited, they make dubious decisions to grant degrees to individuals they hold in high esteem. Although meaning well by not courting pecuniary gain, they nevertheless invite criticism over their choice of recipient for their honoris causa, despite the decision usually only being reached after a process of debate and discussion by university committees. Often people are rewarded, it seems, as much for their fame as for their achievements or publications. One such example of a celebrity who has had his onscreen renown recognised by an honorary doctorate is film and television actor/comedian Billy Connolly who was awarded an Honorary Doctor of Letters by The University of Glasgow in 2006, prompting Stuart Jeffries to complain that “something has gone terribly wrong in British academia” (Jeffries). Eileen McNamara also bemoans the levels to which some institutions will sink to in search of media attention and exposure, when she writes of St Andrews University in Scotland conferring an honorary doctorate to film actor and producer, Michael Douglas: “What was designed to acknowledge intellectual achievement has devolved into a publicity grab with universities competing for celebrity honorees” (McNamara). Fame as an actor (and the list gets even weirder when the scope of enquiry is widened beyond the field of film and television), seems to be an achievement worth recognising with an honorary doctorate, according to some universities, and this kind of discredit is best avoided by Australian institutions of higher learning if they are to maintain credibility. Certainly, universities down under would do well to follow elsewhere than in the footprints of Long Island University’s Southampton College. Perhaps the height of academic prostitution of parchments for the attention of mass media occurred when in 1996 this US school bestowed an Honorary Doctorate of Amphibious Letters upon that mop-like puppet of film and television fame known as the “muppet,” Kermit the Frog. Indeed, this polystyrene and cloth creation with an anonymous hand operating its mouth had its acceptance speech duly published (see “Kermit’s Acceptance Speech”) and the Long Island University’s Southampton College received much valuable press. After all, any publicity is good publicity. Or perhaps this furry frog’s honorary degree was a cynical stunt meant to highlight the ridiculousness of the practice? In 1986 a similar example, much closer to my own home, occurred when in anticipation and condemnation of the conferral of an honorary doctorate upon Prince Philip by Monash University in Melbourne, the “Members of the Monash Association of Students had earlier given a 21-month-old Chihuahua an honorary science degree” (Jeffries), effectively suggesting that the honorary doctorate is, in fact, a dog of a degree. On a more serious note, there have been honorary doctorates conferred upon far more worthy recipients in the field of film and television by some Australian universities. Indigenous film-maker Tracey Moffatt was awarded an honorary doctorate by Griffith University in November of 2004. Moffatt was a graduate of the Griffith University’s film school and had an excellent body of work including the films Night Cries: A Rural Tragedy (1990) and beDevil (1993). Acclaimed playwright and screenwriter David Williamson was presented with an Honorary Doctorate of Letters by The University of Queensland in December of 2004. His work had previously picked up four Australian Film Institute awards for best screenplay. An Honorary Doctorate of Visual and Performing Arts was given to film director Fred Schepisi AO by The University of Melbourne in May of 2006. His films had also been earlier recognised with Australian Film Institute awards as well as the Golden Globe Best Miniseries or Television Movie award for Empire Falls in 2006. Director George Miller was crowned with an Honorary Doctorate in Film from the Australian Film, Television, and Radio School in April 2007, although he already had a medical doctor’s testamur on his wall. In May of this year, filmmaker George Gittoes, a fine arts dropout from The University of Sydney, received an honorary doctorate by The University of New South Wales. His documentaries, Soundtrack to War (2005) and Rampage (2006), screened at the Sydney and Berlin film festivals, and he has been employed by the Australian Government as an official war artist. Interestingly, the high quality screen work recognised by these Australian universities may have earned the recipients ‘real’ PhDs had they sought the qualification. Many of these film artists could have just as easily submitted their work for the degree of PhD by Published Papers at several universities that accept prior work in lieu of an original exegesis, and where a film is equated with a book or journal article. But such universities still invite comparisons of their PhDs by Published Papers with honorary doctorates due to rather too-easy-to-meet criteria. The privately funded Bond University, for example, recommends a minimum full-time enrolment of just three months and certainly seems more lax in its regulations than other Antipodean institution: a healthy curriculum vitae and payment of the prescribed fee (currently AUD$24,500 per annum) are the only requirements. Restricting my enquiries once again to the field of my own research, film and television, I note that Dr. Ingo Petzke achieved his 2004 PhD by Published Works based upon films produced in Germany well before enrolling at Bond, contextualized within a discussion of the history of avant-garde film-making in that country. Might not a cynic enquire as to how this PhD significantly differs from an honorary doctorate? Although Petzke undoubtedly paid his fees and met all of Bond’s requirements for his thesis entitled Slow Motion: Thirty Years in Film, one cannot criticise that cynic for wondering if Petzke’s films are indeed equivalent to a collection of refereed papers. It should be noted that Bond is not alone when it comes to awarding candidates the PhD by Published Papers for work published or screened in the distant past. Although yet to grant it in the area of film or television, Swinburne University of Technology (SUT) is an institution that distinctly specifies its PhD by Publications is to be awarded for “research which has been carried out prior to admission to candidature” (8). Similarly, the Griffith Law School states: “The PhD (by publications) is awarded to established researchers who have an international reputation based on already published works” (1). It appears that Bond is no solitary voice in the academic wilderness, for SUT and the Griffith Law School also apparently consider the usual milestones of Confirmation and Final Seminars to be unnecessary if the so-called candidate is already well published. Like Bond, Griffith University (GU) is prepared to consider a collection of films to be equivalent to a number of refereed papers. Dr Ian Lang’s 2002 PhD (by Publication) thesis entitled Conditional Truths: Remapping Paths To Documentary ‘Independence’ contains not refereed, scholarly articles but the following videos: Wheels Across the Himalaya (1981); Yallambee, People of Hope (1986); This Is What I Call Living (1988); The Art of Place: Hanoi Brisbane Art Exchange (1995); and Millennium Shift: The Search for New World Art (1997). While this is a most impressive body of work, and is well unified by appropriate discussion within the thesis, the cynic who raised eyebrows at Petzke’s thesis might also be questioning this thesis: Dr Lang’s videos all preceded enrolment at GU and none have been refereed or acknowledged with major prizes. Certainly, the act of releasing a film for distribution has much in common with book publishing, but should these videos be considered to be on a par with academic papers published in, say, the prestigious and demanding journal Screen? While recognition at awards ceremonies might arguably correlate with peer review there is still the question as to how scholarly a film actually is. Of course, documentary films such as those in Lang’s thesis can be shown to be addressing gaps in the literature, as is the expectation of any research paper, but the onus remains on the author/film-maker to demonstrate this via a detailed contextual review and a well-written, erudite argument that unifies the works into a cohesive thesis. This Lang has done, to the extent that suspicious cynic might wonder why he chose not to present his work for a standard PhD award. Another issue unaddressed by most institutions is the possibility that the publications have been self-refereed or refereed by the candidate’s editorial colleagues in a case wherein the papers appear in a book the candidate has edited or co-edited. Dr Gillian Swanson’s 2004 GU thesis Towards a Cultural History of Private Life: Sexual Character, Consuming Practices and Cultural Knowledge, which addresses amongst many other cultural artefacts the film Lawrence of Arabia (David Lean 1962), has nine publications: five of which come from two books she co-edited, Nationalising Femininity: Culture, Sexuality and Cinema in Britain in World War Two, (Gledhill and Swanson 1996) and Deciphering Culture: Ordinary Curiosities and Subjective Narratives (Crisp et al 2000). While few would dispute the quality of Swanson’s work, the persistent cynic might wonder if these five papers really qualify as refereed publications. The tacit understanding of a refereed publication is that it is blind reviewed i.e. the contributor’s name is removed from the document. Such a system is used to prevent bias and favouritism but this level of anonymity might be absent when the contributor to a book is also one of the book’s editors. Of course, Dr Swanson probably took great care to distance herself from the refereeing process undertaken by her co-editors, but without an inbuilt check, allegations of cronyism from unfriendly cynics may well result. A related factor in making comparisons of different university’s PhDs by Published Papers is the requirements different universities have about the standard of the journal the paper is published in. It used to be a simple matter in Australia: the government’s Department of Education, Science and Training (DEST) held a Register of Refereed Journals. If your benefactor in disseminating your work was on the list, your publications were of near-unquestionable quality. Not any more: DEST will no longer accept nominations for listing on the Register and will not undertake to rule on whether a particular journal article meets the HERDC [Higher Education Research Data Collection] requirements for inclusion in publication counts. HEPs [Higher Education Providers] have always had the discretion to determine if a publication produced in a journal meets the requirements for inclusion in the HERDC regardless of whether or not the journal was included on the Register of Refereed Journals. As stated in the HERDC specifications, the Register is not an exhaustive list of all journals which satisfy the peer-review requirements (DEST). The last listing for the DEST Register of Refereed Journals was the 3rd of February 2006, making way for a new tiered list of academic journals, which is currently under review in the Australian tertiary education sector (see discussion of this development in the Redden and Mitchell articles in this issue). In the interim, some university faculties created their own rankings of journals, but not the Faculty of Creative Industries at the Queensland University of Technology (QUT) where I am studying for my PhD by Published Papers. Although QUT does not have a list of ranked journals for a candidate to submit papers to, it is otherwise quite strict in its requirements. The QUT University Regulations state, “Papers submitted as a PhD thesis must be closely related in terms of subject matter and form a cohesive research narrative” (QUT PhD regulation 14.1.2). Thus there is the requirement at QUT that apart from the usual introduction, methodology and literature review, an argument must be made as to how the papers present a sustained research project via “an overarching discussion of the main features linking the publications” (14.2.12). It is also therein stated that it should be an “account of research progress linking the research papers” (4.2.6). In other words, a unifying essay must make an argument for consideration of the sometimes diversely published papers as a cohesive body of work, undertaken in a deliberate journey of research. In my own case, an aural auteur analysis of sound in the films of Rolf de Heer, I argue that my published papers (eight in total) represent a journey from genre analysis (one paper) to standard auteur analysis (three papers) to an argument that sound should be considered in auteur analysis (one paper) to the major innovation of the thesis, aural auteur analysis (three papers). It should also be noted that unlike Bond, GU or SUT, the QUT regulations for the standard PhD still apply: a Confirmation Seminar, Final Seminar and a minimum two years of full-time enrolment (with a minimum of three months residency in Brisbane) are all compulsory. Such milestones and sine qua non ensure the candidate’s academic progress and intellectual development such that she or he is able to confidently engage in meaningful quodlibets regarding the thesis’s topic. Another interesting and significant feature of the QUT guidelines for this type of degree is the edict that papers submitted must be “published, accepted or submitted during the period of candidature” (14.1.1). Similarly, the University of Canberra (UC) states “The articles or other published material must be prepared during the period of candidature” (10). Likewise, Edith Cowan University (ECU) will confer its PhD by Publications to those candidates whose thesis consists of “only papers published in refereed scholarly media during the period of enrolment” (2). In other words, one cannot simply front up to ECU, QUT, or UC with a résumé of articles or films published over a lifetime of writing or film-making and ask for a PhD by Published Papers. Publications of the candidate prepared prior to commencement of candidature are simply not acceptable at these institutions and such PhDs by Published Papers from QUT, UC and ECU are entirely different to those offered by Bond, GU and SUT. Furthermore, without a requirement for a substantial period of enrolment and residency, recipients of PhDs by Published Papers from Bond, GU, or SUT are unlikely to have participated significantly in the research environment of their relevant faculty and peers. Such newly minted doctors may be as unfamiliar with the campus and its research activities as the recipient of an honorary doctorate usually is, as he or she poses for the media’s cameras en route to the glamorous awards ceremony. Much of my argument in this paper is built upon the assumption that the process of refereeing a paper (or for that matter, a film) guarantees a high level of academic rigour, but I confess that this premise is patently naïve, if not actually flawed. Refereeing can result in the rejection of new ideas that conflict with the established opinions of the referees. Interdisciplinary collaboration can be impeded and the lack of referee’s accountability is a potential problem, too. It can also be no less nail-biting a process than the examination of a finished thesis, given that some journals take over a year to complete the refereeing process, and some journal’s editorial committees have recognised this shortcoming. Despite being a mainstay of its editorial approach since 1869, the prestigious science journal, Nature, which only publishes about 7% of its submissions, has led the way with regard to varying the procedure of refereeing, implementing in 2006 a four-month trial period of ‘Open Peer Review’. Their website states, Authors could choose to have their submissions posted on a preprint server for open comments, in parallel with the conventional peer review process. Anyone in the field could then post comments, provided they were prepared to identify themselves. Once the usual confidential peer review process is complete, the public ‘open peer review’ process was closed and the editors made their decision about publication with the help of all reports and comments (Campbell). Unfortunately, the experiment was unpopular with both authors and online peer reviewers. What the Nature experiment does demonstrate, however, is that the traditional process of blind refereeing is not yet perfected and can possibly evolve into something less problematic in the future. Until then, refereeing continues to be the best system there is for applying structured academic scrutiny to submitted papers. With the reforms of the higher education sector, including forced mergers of universities and colleges of advanced education and the re-introduction of university fees (carried out under the aegis of John Dawkins, Minister for Employment, Education and Training from 1987 to 1991), and the subsequent rationing of monies according to research dividends (calculated according to numbers of research degree conferrals and publications), there has been a veritable explosion in the number of institutions offering PhDs in Australia. But the general public may not always be capable of differentiating between legitimately accredited programs and diploma mills, given that the requirements for the first differ substantially. From relatively easily obtainable PhDs by Published Papers at Bond, GU and SUT to more rigorous requirements at ECU, QUT and UC, there is undoubtedly a huge range in the demands of degrees that recognise a candidate’s published body of work. The cynical reader may assume that with this paper I am simply trying to shore up my own forthcoming graduation with a PhD by Published papers from potential criticisms that it is on par with a ‘purchased’ doctorate. Perhaps they are right, for this is a new degree in QUT’s Creative Industries faculty and has only been awarded to one other candidate (Dr Marcus Foth for his 2006 thesis entitled Towards a Design Methodology to Support Social Networks of Residents in Inner-City Apartment Buildings). But I believe QUT is setting a benchmark, along with ECU and UC, to which other universities should aspire. In conclusion, I believe further efforts should be undertaken to heighten the differences in status between PhDs by Published Papers generated during enrolment, PhDs by Published Papers generated before enrolment and honorary doctorates awarded for non-academic published work. Failure to do so courts cynical comparison of all PhD by Published Papers with unearnt doctorates bought from Internet shysters. References Brown, George. “Protecting Australia’s Higher Education System: A Proactive Versus Reactive Approach in Review (1999–2004).” Proceedings of the Australian Universities Quality Forum 2004. Australian Universities Quality Agency, 2004. 11 June 2008 ‹http://www.auqa.edu.au/auqf/2004/program/papers/Brown.pdf>. Campbell, Philip. “Nature Peer Review Trial and Debate.” Nature: International Weekly Journal of Science. December 2006. 11 June 2008 ‹http://www.nature.com/nature/peerreview/> Crisp, Jane, Kay Ferres, and Gillian Swanson, eds. Deciphering Culture: Ordinary Curiosities and Subjective Narratives. London: Routledge, 2000. Department of Education, Science and Training (DEST). “Closed—Register of Refereed Journals.” Higher Education Research Data Collection, 2008. 11 June 2008 ‹http://www.dest.gov.au/sectors/research_sector/online_forms_services/ higher_education_research_data_ collection.htm>. Edith Cowan University. “Policy Content.” Postgraduate Research: Thesis by Publication, 2003. 11 June 2008 ‹http://www.ecu.edu.au/GPPS/policies_db/tmp/ac063.pdf>. Gledhill, Christine, and Gillian Swanson, eds. Nationalising Femininity: Culture, Sexuality and Cinema in Britain in World War Two. Manchester: Manchester UP, 1996. Griffith Law School, Griffith University. Handbook for Research Higher Degree Students. 24 March 2004. 11 June 2008 ‹http://www.griffith.edu.au/centre/slrc/pdf/rhdhandbook.pdf>. Jeffries, Stuart. “I’m a celebrity, get me an honorary degree!” The Guardian 6 July 2006. 11 June 2008 ‹http://education.guardian.co.uk/higher/comment/story/0,,1813525,00.html>. Kermit the Frog. “Kermit’s Commencement Address at Southampton Graduate Campus.” Long Island University News 19 May 1996. 11 June 2008 ‹http://www.southampton.liu.edu/news/commence/1996/kermit.htm>. McNamara, Eileen. “Honorary senselessness.” The Boston Globe 7 May 2006. ‹http://www. boston.com/news/local/articles/2006/05/07/honorary_senselessness/>. O’Loughlin, Shaunnagh. “Doctor Cave.” Monash Magazine 21 (May 2008). 13 Aug. 2008 ‹http://www.monash.edu.au/pubs/monmag/issue21-2008/alumni/cave.html>. Queensland University of Technology. “Presentation of PhD Theses by Published Papers.” Queensland University of Technology Doctor of Philosophy Regulations (IF49). 12 Oct. 2007. 11 June 2008 ‹http://www.mopp.qut.edu.au/Appendix/appendix09.jsp#14%20Presentation %20of%20PhD%20Theses>. Swinburne University of Technology. Research Higher Degrees and Policies. 14 Nov. 2007. 11 June 2008 ‹http://www.swinburne.edu.au/corporate/registrar/ppd/docs/RHDpolicy& procedure.pdf>. University of Canberra. Higher Degrees by Research: Policy and Procedures (The Gold Book). 7.3.3.27 (a). 15 Nov. 2004. 11 June 2008 ‹http://www.canberra.edu.au/research/attachments/ goldbook/Pt207_AB20approved3220arp07.pdf>.

Introduction The exhibition of an artist’s work is traditionally accepted as representing the final stage of the creative process (Staniszewski). This article asks, however, whether this traditional view can be reassessed so that the curatorial practice of mounting an exhibition becomes, itself, a creative outcome feeding into work that may still be in progress, and that simultaneously operates as a learning and teaching tool. To provide a preliminary examination of the issue, we use a single case study approach, taking an example of practice currently used at an Australian university. In this program, internal and external students work together to develop and deliver an exhibition of their own work in progress. The exhibition space has a professional website (‘CQUniversity Noosa Exhibition Space’), many community members and the local media attend exhibition openings, and the exhibition (which runs for three to four weeks) becomes an outcome students can include in their curriculum vitae. This article reflects on the experiences, challenges, and outcomes that have been gained through this process over the past twelve months. Due to this time frame, the case study is exploratory and its findings are provisional. The case study is an appropriate method to explore a small sample of events (in this case exhibitions) as, following Merriam, it allows the construction of a richer picture of an under-examined phenomenon to be constructed. Although it is clear that this approach will not offer results which can be generalised, it can, nevertheless, assist in opening up a field for investigation and constructing a holistic account of a phenomenon (in this case, the exhibition space as authentic learning experience and productive teaching tool), for, as Merriam states, “much can be learned from a particular case” (51). Jennings adds that even the smallest case study is useful as it includes an “in-depth examination of the subject with which to confirm or contest received generalizations” (14). Donmoyer extends thoughts on this, suggesting that the single case study is extremely useful as the “restricted conception of generalizability … solely in terms of sampling and statistical significance is no longer defensible or functional” (45). Using the available student course feedback, anonymous end-of-term course evaluations, and other available information, this case study account offers an example of what Merriam terms a “narrative description” (51), which seeks to offer readers the opportunity to engage and “learn vicariously from an encounter with the case” (Merriam 51) in question. This may, we propose, be particularly productive for other educators since what is “learn[ed] in a particular case can be transferred to similar situations” (Merriam 51). Breaking Ground exhibition, CQUniversity Noosa Exhibition Space, 2014. Photo by Ulrike Sturm. Background The Graduate Certificate of Creative Industries (Creative Practice) (CQU ‘CB82’) was developed in 2011 to meet the national Australian Quality Framework agency’s Level 8 (Graduate Certificate) standards in terms of what is called in their policies, the “level” of learning. This states that, following the program, graduates from this level of program “will have advanced knowledge and skills for professional or highly skilled work and/or further learning … [and] will apply knowledge and skills to demonstrate autonomy, well-developed judgment, adaptability and responsibility as a practitioner or learner” (AQF). The program was first delivered in 2012 and, since then, has been offered both two and three terms a year, attracting small numbers of students each term, with an average of 8 to 12 students a term. To meet these requirements, such programs are sometimes developed to provide professional and work-integrated learning tasks and learning outcomes for students (Patrick et al., Smith et al.). In this case, professionally relevant and related tasks and outcomes formed the basis for the program, its learning tasks, and its assessment regime. To this end, each student enrolled in this program works on an individual, self-determined (but developed in association with the teaching team and with feedback from peers) creative/professional project that is planned, developed, and delivered across one term of study for full- time students and two terms for part- timers. In order to ensure the AQF-required professional-level outcomes, many projects are designed and/or developed in partnership with professional arts institutions and community bodies. Partnerships mobilised utilised in this way have included those with local, state, and national bodies, including the local arts community, festivals, and educational support programs, as well as private business and community organisations. Student interaction with curation occurs regularly at art schools, where graduate and other student shows are scheduled as a regular events on the calendar of most tertiary art schools (Al-Amri), and the curated exhibition as an outcome has a longstanding tradition in tertiary fine arts education (Webb, Brien, and Burr). Yet in these cases, it is ultimately the creative work on show that is the focus of the learning experience and assessment process, rather than any focus on engagement with the curatorial process itself (Dally et al.). When art schools do involve students in the curatorial process, the focus usually still remains on the students' creative work (Sullivan). Another interaction with curation is when students undertaking a tertiary-level course or program in museum, and/or curatorial practice are engaged in the process of developing, mounting, and/or critiquing curated activities. These programs are, however, very small in number in Australia, where they are only offered at postgraduate level, with the exception of an undergraduate program at the University of Canberra (‘215JA.2’). By adopting “the exhibition” as a component of the learning process rather than its end product, including documentation of students’ work in progress as exhibition pieces, and incorporating it into a more general creative industries focused program, we argue that the curatorial experience can become an interactive learning platform for students ranging from diverse creative disciplines. The Student Experience Students in the program under consideration in this case study come from a wide spectrum of the creative industries, including creative writing, film, multimedia, music, and visual arts. Each term, at least half of the enrolments are distance students. The decision to establish an on-campus exhibition space was an experimental strategy that sought to bring together students from different creative disciplines and diverse locations, and actively involve them in the exhibition development and curatorial process. As well as their individual project work, the students also bring differing levels of prior professional experience to the program, and exhibit a wide range of learning styles and approaches when developing and completing their creative works and exegetical reflections. To cater for the variations listed above, but still meet the program milestones and learning outcomes that must (under the program rules) remain consistent for each student, we employed a multi-disciplinary approach to teaching that included strategies informed by Gardner’s theory of multiple intelligences (Gardner, Frames of Mind), which proposed and defined seven intelligences, and repeatedly criticised what he identified as an over-reliance on linguistic and logical indices as identifiers of intelligence. He asserted that these were traditional indicators of high scores on most IQ measures or tests of achievement but were not representative of overall levels of intelligence. Gardner later reinforced that, “unless individuals take a very active role in what it is that they’re studying, unless they learn to ask questions, to do things hands on, to essentially re-create things in their own mind and transform them as is needed, the ideas just disappear” (Edutopia). In alignment with Gardner’s views, we have noted that students enrolled in the program demonstrate strengths in several key intelligence areas, particularly interpersonal, musical, body-kinaesthetic, and spacial/visual intelligences (see Gardner, ‘Multiple Intelligences’, 8–18). To cater for, and further develop, these strengths, and also for the external students who were unable to attend university-based workshop sessions, we developed a range of resources with various approaches to hands-on creative tasks that related to the projects students were completing that term. These resources included the usual scholarly articles, books, and textbooks but were also sourced from the print and online media, guest speaker presentations, and digital sites such as You Tube and TED Talks, and through student input into group discussions. The positive reception of these individual project-relevant resources is evidenced in the class online discussion forums, where consecutive groups of students have consistently reflected on the positive impact these resources have had on their individual creative projects: This has been a difficult week with many issues presenting. As part of our Free Writing exercise in class, we explored ‘brain dumping’ and wrote anything (no matter how ridiculous) down. The great thing I discovered after completing this task was that by allowing myself to not censor my thoughts by compiling a writing masterpiece, I was indeed “free” to express everything. …. … I understand that this may not have been the original intended goal of Free Writing – but it is something I would highly recommend external students to try and see if it works for you (Student 'A', week 5, term 1 2015, Moodle reflection point). I found our discussion about crowdfunding particularly interesting. ... I intend to look at this model for future exhibitions. I think it could be a great way for me to look into developing an exhibition of paintings alongside some more commercial collateral such as prints and cards (Student 'B', week 6, term 1 2015, Moodle reflection point). In class I specifically enjoyed the black out activity and found the online videos exceptional, inspiring and innovating. I really enjoyed this activity and it was something that I can take away and use within the classroom when educating (Student 'C', week 8, term 1 2015, Moodle reflection point). The application of Gardner’s principles and strategies dovetailed with our framework for assessing learning outcomes, where we were guided by Boud’s seven propositions for assessment reform in higher education, which aim to “set directions for change, designed to enhance learning achievements for all students and improve the quality of their experience” (26). Boud asserts that assessment has most effect when: it is used to engage students in productive learning; feedback is used to improve student learning; students and teachers become partners in learning and assessment; students are inducted into the assessment practices of higher education; assessment and learning are placed at the centre of subject and program design; assessment and learning is a focus for staff and institutional development; and, assessment provides inclusive and trustworthy representation of student achievement. These propositions were integral to the design of learning outcomes for the exhibition. Teachers worked with students, individually and as a group, to build their capacity to curate the exhibition, and this included such things as the design and administration of invitations, and also the physical placement of works within the exhibition space. In this way, teachers and students became partners in the process of assessment. The final exhibition, as a learning outcome, meant that students were engaged in productive learning that placed both assessment and knowledge at the centre of subject and project design. It is a collation of creative pieces that embodies the class, as a whole; however, each piece also represents the skills and creativity of individual students and, in this way, are is a trustworthy representations of student achievement. While we aimed to employ all seven recommendations, our main focus was on ensuring that the exhibition, as an authentic learning experience, was productive and that the students were engaged as responsible and accountable co-facilitators of it. These factors are particularly relevant as almost all the students were either currently working, or planning to work, in their chosen creative field, where the work would necessarily involve both publication, performance, and/or exhibition of their artwork plus collaborative practice across disciplinary boundaries to make this happen (Brien). For this reason, we provided exhibition-related coursework tasks that we hoped were engaging and that also represented an authentic learning outcome for the students. Student Curatorship In this context, the opportunity to exhibit their own works-in-progress provided an authentic reason, with a deadline, for students to both work, and reflect, on their creative projects. The documentation of each student’s creative process was showcased as a stand-alone exhibition piece within the display. These exhibits not only served not only to highlight the different learning styles of each student, but also proved to inspire creativity and skill development. They also provided a working model whereby students (and potential enrollees) could view other students’ work and creative processes from inception to fully-realised project outcomes. The sample online reflections quoted above not only highlight the effectiveness of the online content delivery, but this engagement with the online forum also allowed remote students to comment on each other’s projects as well as to and respond to issues they were encountering in their project planning and development and creative practice. It was essential that this level of peer engagement was fostered for the curatorial project to be viable, as both internal and external students are involved in designing the invitation, catalogue, labels, and design of the space, while on-campus students hang and label work according to the group’s directions. Distance students send in items. This is a key point of this experiment: the process of curating an exhibition of work from diverse creative fields, and from students located thousands of kilometres apart, as a way of bringing cohesion to a diverse cohort of students. That cohesiveness provided an opportunity for authentic learning to occur because it was in relation to a task that each student apparently understood as personally, academically, and professionally relevant. This was supported by the anonymous course evaluation comments, which were overwhelmingly positive about the exhibition process – there were no negative comments regarding this aspect of the program, and over 60 per cent of the class supplied these evaluations. This also met a considerable point of anxiety in the current university environment whereby actively engaging students in online learning interactions is a continuing issue (Dixon, Dixon, and Axmann). A key question is: what relevance does this curatorial process have for a student whose field is not visual art, but, for instance, music, film, or writing? By displaying documentation of work in progress, this process connects students of all disciplines with an audience. For example, one student in 2014 who was a singer/songwriter, had her song available to be played on a laptop, alongside photographs of the studio when she was recording her song with her band. In conjunction with this, the cover artwork for her CD, together with the actual CD and CD cover, were framed and exhibited. Another student, who was also a musician but who was completing a music history project, sent in pages of the music transcriptions he had been working on during the course. This manuscript was bound and exhibited in a way that prompted some audience members to commented that it was like an artist’s book as well as a collection of data. Both of these students lived over 1,000 kilometres from the campus where the exhibition was held, but they were able to share with us as teaching staff, as well as with other students who were involved in the physical setting up of the exhibition, exactly how they envisaged their work being displayed. The feedback from both of these students was that this experience gave them a strong connection to the program. They described how, despite the issue of distance, they had had the opportunity to participate in a professional event that they were very keen to include on their curricula vitae. Another aspect of students actively participating in the curation of an exhibition which features work from diverse disciplines is that these students get a true sense of the collaborative interconnectedness of the disciplines of the creative industries (Brien). By way of example, the exhibit of the singer/songwriter referred to above involved not only the student and her band, but also the photographer who took the photographs, and the artist who designed the CD cover. Students collaboratively decided how this material was handled in the exhibition catalogue – all these names were included and their roles described. Breaking Ground exhibition, CQUniversity Noosa Exhibition Space, 2014. Photo by Ulrike Sturm. Outcomes and Conclusion We believe that the curation of an exhibition and the delivery of its constituent components raises student awareness that they are, as creatives, part of a network of industries, developing in them a genuine understanding of the way the creating industries works as a profession outside the academic setting. It is in this sense that this curatorial task is an authentic learning experience. In fact, what was initially perceived as a significant challenge—, that is, exhibiting work in progress from diverse creative fields—, has become a strength of the curatorial project. In reflecting on the experiences and outcomes that have occurred through the implementation of this example of curatorial practice, both as a learning tool and as a creative outcome in its own right, a key positive indicator for this approach is the high level of student satisfaction with the course, as recorded in the formal, anonymous university student evaluations (with 60–100 per cent of these completed for each term, when the university benchmark is 50 per cent completion), and the high level of professional outcomes achieved post-completion. The university evaluation scores have been in the top (4.5–5/.5) range for satisfaction over the program’s eight terms of delivery since 2012. Particularly in relation to subsequent professional outcomes, anecdotal feedback has been that the curatorial process served as an authentic and engaged learning experience because it equipped the students, now graduates, of the program with not only knowledge about how exhibitions work, but also a genuine understanding of the web of connections between the diverse creative arts and industries. Indeed, a number of students have submitted proposals to exhibit professionally in the space after graduation, again providing anecdotal feedback that the experience they gained through our model has had a sustaining impact on their creative practice. While the focus of this activity has been on creative learning for the students, it has also provided an interesting and engaging teaching experience for us as the program’s staff. We will continue to gather evidence relating to our model, and, with the next iteration of the exhibition project, a more detailed comparative analysis will be attempted. At this stage, with ethics approval, we plan to run an anonymous survey with all students involved in this activity, to develop questions for a focus group discussion with graduates. We are also in the process of contacting alumni of the program regarding professional outcomes to map these one, two, and five years after graduation. We will also keep a record of what percentage of students apply to exhibit in the space after graduation, as this will also be an additional marker of how professional and useful they perceive the experience to be. In conclusion, it can be stated that the 100 per cent pass rate and 0 per cent attrition rate from the program since its inception, coupled with a high level (over 60 per cent) of student progression to further post-graduate study in the creative industries, has not been detrimentally affected by this curatorial experiment, and has encouraged staff to continue with this approach. References Al-Amri, Mohammed. “Assessment Techniques Practiced in Teaching Art at Sultan Qaboos University in Oman.” International Journal of Education through Art 7.3 (2011): 267–282. AQF Levels. Australian Qualifications Framework website. 18 June 2015 ‹http://www.aqf.edu.au/aqf/in-detail/aqf-levels/›. Boud, D. Student Assessment for Learning in and after Courses: Final Report for Senior Fellowship. Sydney: Australian Learning and Teaching Council, 2010. 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Women in Universities Women have been fighting for the right to participate in universities since 1873, when Sophia Jex Blake went to court with her fight to enrol at Edinburgh University. In rejecting her application, one of the judges stated: It is a belief, widely entertained, that there is a great difference in the mental constitution of the two sexes, just as there is in their physical conformation. The powers and susceptibilities of women are as noble as those of men; but they are thought to be different, and, in particular, it is considered that they have not the same power of intense labour as men .... (Scutt 224) In Australia, from the 1850s to the 1880s, both the University of Sydney and The University of Melbourne refused to admit women as students. In 1879, the Chancellor of the University of Sydney suggested that: The best course to be taken by advocates of advanced education for women, would be to found some sort of affiliated college for them in the vicinity of the University ... if there really be a widespread wish on the part of young women for a higher education ..." (Scutt 228). Having finally won the right to study at university in 1881, and to enter the academic workforce, women are still finding many of the old prejudices remain. Numerous studies have demonstrated that women's experiences in academe are qualitatively different from men's and that women are systematically paid lower salaries than men of equivalent academic achievement, age and length of service (Bagilhole 431-47; Loder 713-4; McElrath 269-81;). Studies have shown that differences in the experiences of male and female faculty are largely explained by gender (Booth & Burton 312-33; Everett 159-75; Over & Lancaster 309-18; Ready 7) and sex discrimination is highlighted as an ongoing contributor to the inequity (Allport 5-8; Hall & Swadener 1; Tuohy 8). A recent UNESCO-Commonwealth (http://www.unesco.org/) report states that: ... in spite of advances which women have made in many areas of public life in the past two decades, in the area of higher education management they are still a long way from participating on the same footing as men. With hardly an exception, the global picture is one of men outnumbering women at about five to one at middle management level and at about twenty to one at senior management level (Singh 4). The introduction in Australia of Sex Discrimination legislation (http://www.hreoc.gov.au/sex_discrimination/) in 1984 and more recently, Affirmative Action policies ( http://www.austlii.edu.au/) in employment and promotion rounds in some universities has not improved women's situation to the extent expected. In 1978, women held 16% of full time academic posts while gaining 25% of all higher degrees and 30% of undergraduate degrees (Commonwealth Government statistics cited by Over and McKenzie 61-71). In 1999, 54% of students were women yet women's participation in academe had only increased to 35% (DETYA) (http://www.deet.gov.au/). Women are mainly employed at the lowest academic levels. In 1999, 72% of women were employed at Levels A and B (Associate Lecturer/Lecturer) compared to 46% of men, with only 8% of women reaching Levels D and E (Associate Professor/Professor) compared to 26% of men. Women continue to be clustered in the traditionally female areas of Health, Education and Arts while few seem to have successfully broken through the barriers in the traditionally male areas of Engineering, Architecture or Agriculture (DETYA) (http://www.deet.gov.au/). Business has traditionally been viewed as a male preserve but enrolments have increased to the point where women almost equal men. However, the staff ratio of men to women remains very low at 70/30 (DETYA) (http://www.deet.gov.au/). The slow growth rate for women in academe belies the fact that more women than men are now completing university degrees. The purpose of this study was to determine how well the experiences of academic women in the male-dominated faculties of business and commerce, reflect the literature on women in universities, in general. Previous empirical studies have found inequitable treatment of women without necessarily exploring the processes of discrimination. The Study This study involved interviews with academic women who had been employed in faculties of business and commerce for at least five years. The research used the 'snowballing' technique: participants initially comprised women known to me but as these women told female colleagues of my study I was given the names of other women who were willing to participate. Participants comprised twenty-one women from three universities in Western Australia, two universities in New South Wales and one Victorian university. One woman had recently left academe and started her own business because of discriminatory practices she had encountered and another was contemplating leaving. In each university, women comprised a minority of the faculty and felt disadvantaged in some way. A semi-structured interview was used to explore with the women the issues that had been identified from previous studies of sex discrimination in the academic profession. Open-ended questions were used and the interviews conducted face to face, or, in the case of those interstate, via telephone or email. The women spoke frankly about their experiences. Findings and Discussion Promotion Each of the women in this study said that their university had established an internal promotion policy based on merit. However, they felt the greatest problem they had encountered in gaining promotion was in determining the criteria upon which they would be judged each year, and in meeting those criteria. "I have been chasing promotion for over five years. At first I was told that I would not be promoted until I got my masters degree so I worked really hard to complete it but then a male colleague was promoted without a masters. Once I got the masters I was told I needed to publish to be promoted but in the next year someone else was promoted without any publications. You go all out to meet the criteria each year but in the next year the promotions committee changes and so do the criteria for that year"(Lecturer applying for Senior Lecturer position). The promotion procedure at one university was explained by a Senior Lecturer who had served on promotion committees on two occasions. "There are about ten criteria upon which promotion can be based. When the applications are received we all get together to determine which are the criteria to be applied. In the last promotion round only four of the ten criteria were used so only people satisfying those criteria were selected." When asked whether the criteria were the same as the previous year she replied: "Last year there was more emphasis on qualifications and publications. This year community involvement and involvement in university affairs were judged as more important ... it varies from year to year". On questioning about the promotion procedures at their universities, women stated they were largely dissatisfied with the process, that they were presumed to be satisfied with their lot while the men were actively encouraged to apply. "I was told not to bother to apply (for a senior lecturer position) as I would not get it ... that there was a queue of people to be promoted before me - (named males) - and until they were promoted, I would not be considered" (Lecturer). "The position was advertised with a specific male applicant in mind and specifically excluded me by stating that the appointee must have supervisory experience. Women in my department are not given the opportunity to supervise students so I didn't even bother applying."(Lecturer aspiring to a Senior Lecturer position). One woman, upon inquiring why she was not promoted, was told that she should be grateful to have tenure and asked why she wanted to be promoted, anyway. "They would never have said that to a male, they would have expected a male to be working towards promotion" (Associate Lecturer). All women interviewed stated that they had problems keeping up with the 'goal posts' which moved from year to year. The 'moving of the goal posts' is one means by which universities are able to maintain the position of women at lower levels. Unsurprisingly, some women said they felt that promotion at their university was based on politics rather than merit. However, defining merit in universities is problematic. According to Burton (430), definitions of what is meritorious depend upon the power of particular groups to define it and, as a result, can change. The narrow view of merit is 'the best person for the job' which Burton (113) describes as an "overwhelming tendency to select in your own image". Burton (430) and Allport (5) claim universities define merit along male cultural lines with current selection, remuneration and career progression practices strongly influenced by an underlying gender bias. Burton (430) argues that there is still a tendency for work to be ranked as 'men's' or women's work with lower status attributed to the latter and an assumption that different skills and abilities are needed for each. Over and McKenzie (61-71) claim that women are disadvantaged by the fact that invalid merit criteria are applied to them which men as a group are more likely to satisfy. They state that the academic careers of most women do not fit the stereotypic male experience and it is mainly men who decide whether women should be promoted. At one university in the study, the merit criteria for senior lecturer include the requirement that aspirants have a number of overseas conference presentations. "Some of us are single working mothers and overseas conference attendance is out of the question because who's going to mind our children while we are away? The senior males were astonished when I mentioned that this was a problem for me. It had never occurred to them" (Associate Lecturer on why women at her university do not apply for promotion). Family Responsibilities The women commented on the numerous difficulties they had encountered in combining an academic career with responsibility for children. They felt that certain male faculty members perceived married women with children as lacking in career commitment, whereas married men with families were viewed as being more stable and committed to their careers. One married woman claimed that when she needed to go home to tend a sick child, her male Head of Department told her she should "get her priorities right". In 1992, Family Responsibility provisions were added to the Sex Discrimination Act (http://scaleplus.law.gov.au/html/pasteact/0/171/top.htm). However, it would appear that individual practice doesn't always follow as a result of changes in policy. Equal Pay On the subject of equal pay for equal work, the women said that they were often paid lower wages than their male colleagues despite having higher qualifications and equivalent teaching and research experience. Some women felt that the barriers between academic levels were used to artificially maintain the wage gap between men and women, regardless of qualifications and ability. This was felt to be particularly the case between the levels of Associate Lecturer (Level A) and Lecturer (Level B). "They find excuses to keep you at Associate Lecturer so that they can pay you less to do the same work that you would be doing as a lecturer ... lecturing, coordinating units and so on"(Associate Lecturer). "There are no men below Lecturer in my Department, either lecturing or with Masters degrees. As soon as they get their Masters they are promoted to Lecturer.... I'm coordinating units as an Associate Lecturer while some male lecturers have less responsibility' (Associate Lecturer with Masters degree and publications) Two women said that they had been performing higher level duties (Level B) for up to five years while working on their Masters but their university refused to pay them at the higher level until they had completed their degree. Even when they satisfied all the requirements for the Masters degree and had a letter from their supervisor saying they had satisfied all the requirements, the university refused to pay them until they had actually graduated, which was some time later. Shortly afterwards their university took on two men to perform the same duties, paying these at the higher level even though they had not completed a masters degree. One former lecturer claimed that she was employed at a time when there was a large turnover of staff in her department. A number of new staff were appointed of whom she was the only female. Although she and the other new staff were all employed at Lecturer Level B, it wasn't until later on that she discovered that the men were appointed at the top of the Lecturer salary scale while she was appointed at the bottom, with a salary differential of about10 000pa. This was despite the fact that both she and the men had similar qualifications and work experience at commencement. Teaching Loads Another complaint by women concerned inequitable teaching loads. An analysis in one Business School showed that women had higher teaching loads while men were given more time off for research. The women complained that the supervision of post-graduate students was divided up between the men, and women were excluded. Since research publication and student supervision are usually the most highly ranked criteria in academic promotion rounds, women who are not given the opportunity to participate in these areas are disadvantaged when applying for promotion. This problem is compounded since women are overwhelmingly employed at the lower levels where responsibility for the majority of teaching takes place. This leaves them with little time left to devote to research even if given the opportunity. The women also said they were often pressured into taking on higher duties than those prescribed in the Position Classification Standards for their level. They tended to acquiesce because of their need to prove they were better than men to gain promotion. One woman said that the extra administrative duties she had been given meant that she had less time for research which actually reduced her prospects for tenure and promotion. She said she didn't dare complain as the men in her department would use it as an excuse to question her commitment to her job. Conclusion An examination of women's perceptions and experiences in the workplace can help us understand the informal processes that work against women. The experiences of the women discussed in this paper provide an insight into the subtle processes that continue to operate in some higher education institutions to prevent women from reaching their full potential. Although equal opportunity legislation (http://www.hreoc.gov.au/about_the_commission/legislation/index.html) has been enacted to prevent discrimination and disadvantage to women, the implementation of policy does not always filter through to the operational levels. It is still possible to circumvent legislation in subtle ways, perhaps without even being aware that these practices are discriminative. The women in this study spoke frankly about their experiences and the difficulties they had encountered in gaining equal recognition to men, with very few satisfied that they were receiving equitable treatment. The women felt that their work was not valued as highly as that of the men they worked with and they were given less opportunities for advancement. Overall, the interviews with the women revealed interesting insights into their experiences in pursuing academic careers and in trying to gain recognition for their achievements. The collective experiences of the women provide an insight into the subtle ways in which disadvantage can be engendered. The findings of this study have serious implications for university administrators, particularly deans and heads of schools. There are many well-qualified women academics and universities cannot afford to overlook the valuable contribution these women can make to teaching, research and university governance. References Allport, Caroline. 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Tuohy, John. "Sex Discrimination Infects Med Schools: Women Say Bias Blocks Chances for Advancement". USA Today2000. 8. Links http://www.unesco.org/ http://www.deet.gov.au/ http://www.hreoc.gov.au/sex_discrimination/ http://www.hreoc.gov.au/about_the_commission/legislation/index.html http://www.austlii.edu.au/cgibin/disp.pl/au/legis/cth/consol%5fact/aaeofwa 1986634/?query=title+%28+%22affirmative+action%22+%29 http://scaleplus.law.gov.au/html/pasteact/0/171/top.htm Citation reference for this article MLA Style Ellis-Newman, Jennifer. "Women and Work" M/C: A Journal of Media and Culture 4.5 (2001). [your date of access] < http://www.media-culture.org.au/0111/Ellis-Newman.xml >. Chicago Style Ellis-Newman, Jennifer, "Women and Work" M/C: A Journal of Media and Culture 4, no. 5 (2001), < http://www.media-culture.org.au/0111/Ellis-Newman.xml > ([your date of access]). APA Style Ellis-Newman, Jennifer. (2001) Women and Work. M/C: A Journal of Media and Culture 4(5). < http://www.media-culture.org.au/0111/Ellis-Newman.xml > ([your date of access]).