Simulation based learning in Australian midwifery curricula: results of a national electronic survey.

OBJECTIVE: The primary aim of this paper is to describe the extent, nature and types of simulation used as a learning method in contemporary Australian midwifery curricula. METHOD: An electronic survey was developed using Graduate e-Cohort Pro and administered to key midwifery academics who had responsibility for 38 curricula leading to initial midwifery registration in Australia. FINDINGS: Engagement of midwifery academics in the survey was high with a response rate of 82%. There is a range of midwifery programs by type and level of award across Australia that vary in duration, enrolments, and by component theoretical and clinical hours. The proportion of simulation hours in curricula varied across programs accounting for up to 17% of clinical program hours. However simulation was used extensively to teach all identified generic technical skills (n=16) midwifery technical skills (n=51) and generic non-technical skills (n=6). Most commonly used simulation types were scenarios, peer-to-peer learning, partial task trainers and standardised patients. Simulation types were suited to the learning tasks. CONCLUSION: Simulation is used extensively in midwifery education in Australia. Further research is required to understand the curriculum development imperatives of simulation and there is a need to adequately resource and support staff in the use of simulation to provide high quality simulation learning experiences for students.

The Effect of Immigration on Religious Belief and Practice: A Theologizing or Alienating Experience?

Using data from the New Immigrant Survey, we examine the religious beliefs and practices of new legal immigrants to the United States. We find that Christian immigrants are more Catholic, more Orthodox, and less Protestant than American Christians, and that those immigrants who are Protestant are more likely to be evangelical. In addition to being more Catholic and more Orthodox than American Christians, the new immigrants are also paradoxically less Christian, with a fifth reporting some other faith. Detailed analysis of reported church attendance at places of origin and in the United States suggest that immigration is a disruptive event that alienates immigrants from religious practice rather than "theologizing" them. In addition, our models clearly show that people who join congregations in the United States are highly selected and unrepresentative of the broader population of immigrants in any faith. In general, congregational members were more observant both before and after emigration, were more educated, had more cumulative experience in the United States, and were more likely to have children present in the household and be homeowners and therefore yield biased representations of all adherents to any faith. The degree of selectivity and hence bias also varies markedly both by religion and nationality.

Life-cycle case study comparison of permeable reactive barrier versus pump-and-treat remediation.

A permeable reactive barrier (PRB) is a passive remediation technology, which over decades of use, may reduce lifetime environmental impacts when compared with a conventional pump-and-treat system (PTS). Greater material production requirements to install PRBs may offset the expected reductions in operational phase impacts and the trade-offs can be investigated in a life-cycle assessment (LCA). The life-cycle environmental impacts of a zerovalent iron (ZVI) containing PRB with a funnel and gate configuration and a PTS were compared in a case study. Potential impacts of the model PRB are driven by the ZVI reactive medium and the energy usage during construction, while for the PTS they are driven by the operational energy demand. Medium longevity governed the magnitude of the potential PRB impacts and the extent to which it was optimal relative to the PTS. Even at conservatively low estimates of longevity, the PRB offers significant environmental advantages in impact categories of human health and ozone depletion. The minimum ZVI longevity for PRB benefit over the PTS system in all impact categories was 10 years. Suggested PRB design innovations to reduce environmental impacts include the development of alternative reactive media and construction methods.

Health Care Use Among Elderly Mexicans in the United States and Mexico: The Role of Health Insurance.

The authors sought to contribute to public policy on U.S. immigrants by comparing patterns of health care use among the Mexican-origin population aged 70 and older in the United States and Mexico. They studied the role of health insurance in the propensity to have doctor visits and hospitalizations, controlling for aspects of health and the economic and sociodemographic characteristics of individuals. The authors found that the elderly of Mexican origin in the United States were more likely to be hospitalized than those in Mexico, regardless of health insurance. However, in the absence of health insurance, visits to doctors were more likely in Mexico than in the United States. The results indicate that although in both countries, the availability of health insurance is associated with a higher propensity to use any health care services, a lack of health insurance may have more negative consequences for primary health care in the United States than in Mexico.