From research to practice: The case of mathematical reasoning

Mathematical proficiency is a key goal of the Australian Mathematics curriculum. However, international assessments of mathematical literacy suggest that mathematical reasoning and problem solving are areas of difficulty for Australian students. Given the efficacy of teaching informed by quality assessment data, a recent study focused on the development of evidence-based Learning Progressions for Algebraic, Spatial and Statistical Reasoning that can be used to identify where students are in their learning and where they need to go to next. Importantly, they can also be used to generate targeted teaching advice and activities to help teachers progress student learning. This paper explores the processes involved in taking the research to practice

Septic shock: the changing Zeitgeist of management

Most interventions in critically unwell patients with septic shock are poorly supported by evidence, in part reflecting the difficulty of conducting trials in this heterogeneous group. Four important clinical trials in 2001-2 appeared to demonstrate mortality benefits associated with early goal-directed resuscitation, intensive glycaemic control, physiological-dose steroid replacement and activated protein C. However, recent evidence has not confirmed the beneficial effect of these interventions

Angiopoietin-2 is increased in sepsis and inversely associated with nitric oxide-dependent microvascular reactivity

IntroductionAngiopoietin-2 (ang-2), an angiogenic peptide released by endothelial cell Weibel-Palade bodies (WPBs), increases endothelial activation and vascular permeability. Ang-2 is raised in severe sepsis but the mechanisms underlying this are not known. Nitric oxide (NO) inhibits WPB exocytosis, and bioavailability of endothelial NO is decreased in sepsis. We hypothesized that endothelial NO bioavailability would be inversely correlated with ang-2 concentrations in sepsis. MethodsPlasma ang-2, vascular endothelial growth factor (VEGF) and endothelial-active cytokines were assessed in 83 patients with early sepsis and 41 hospital controls, and related to reactive hyperaemia-peripheral arterial tonometry, RH-PAT, a measure of endothelial NO bioavailability. ResultsPlasma Ang-2 was elevated in sepsis (median [interquartile range (IQR)], ng/ml: severe sepsis 12.4 [8.5-33.4], sepsis without organ failure 6.1 [5.0-10.4], controls 2.7 [2.2-3.6], P < 0.0001). It correlated inversely with RH-PAT (r = -0.38, P < 0.0001) and positively with IL-6 (r = 0.57, P < 0.0001) and degree of organ failure (sequential organ function assessment score) (r = 0.58, P < 0.0001). The correlation of ang-2 with RH-PAT persisted after controlling for sepsis severity. In a longitudinal mixed-effects model, recovery of RH-PAT over time was associated with decline in ang-2. ConclusionsAng-2 is elevated in proportion to sepsis severity, and inversely correlated with NO-dependent microvascular reactivity. Impaired endothelial NO bioavailability may contribute to increased endothelial cell release of ang-2, endothelial activation and capillary leak. Agents that increase endothelial NO bioavailability or inhibit WPB exocytosis and/or Ang-2 activity may have therapeutic potential in sepsis

Sepsis-associated microvascular dysfunction measured by peripheral arterial tonometry: an observational study

INTRODUCTION: Sepsis has a high mortality despite advances in management. Microcirculatory and endothelial dysfunction contribute to organ failure, and better tools are needed to assess microcirculatory responses to adjunctive therapies. We hypothesised that peripheral arterial tonometry (PAT), a novel user-independent measure of endothelium-dependent microvascular reactivity, would be impaired in proportion to sepsis severity and related to endothelial activation and plasma arginine concentrations. METHODS: Observational cohort study in a 350-bed teaching hospital in tropical Australia. Bedside microvascular reactivity was measured in 85 adults with sepsis and 45 controls at baseline and 2-4 days later by peripheral arterial tonometry. Microvascular reactivity was related to measures of disease severity, plasma concentrations of L-arginine (the substrate for nitric oxide synthase), and biomarkers of endothelial activation. RESULTS: Baseline reactive hyperaemia index (RH-PAT index), measuring endothelium-dependent microvascular reactivity; (mean [95% CI]) was lowest in severe sepsis (1.57 [1.43-1.70]), intermediate in sepsis without organ failure (1.85 [1.67-2.03]) and highest in controls (2.05 [1.91-2.19]); P < 0.00001. Independent predictors of baseline RH-PAT index in sepsis were APACHE II score and mean arterial pressure, but not plasma L-arginine or markers of endothelial activation. Low baseline RH-PAT index was significantly correlated with an increase in SOFA score over the first 2-4 days (r = -0.37, P = 0.02). CONCLUSIONS: Endothelium-dependent microvascular reactivity is impaired in proportion to sepsis severity and suggests decreased endothelial nitric oxide bioavailability in sepsis. Peripheral arterial tonometry may have a role as a user-independent method of monitoring responses to novel adjunctive therapies targeting endothelial dysfunction in sepsis

Adjunctive granulocyte colony-stimulating factor for treatment of septic shock due to melioidosis

1427 E 60TH ST, CHICAGO, USA, IL, 60637-295

Asymmetric Dimethylarginine, Endothelial Nitric Oxide Bioavailability and Mortality in Sepsis

Abstract Background: Plasma concentrations of asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide synthase, are raised in patients with chronic vascular disease, causing increased cardiovascular risk and endothelial dysfunction, but the role of ADMA in acute inflammatory states is less well defined

Agribusiness Sheep Updates - 2004 - Part 1

Proceedings of the Agribusiness Sheep Updates - 2004 Forward Dr Mark Dolling Manager, Sheep Industries and Pasture, Department of Agriculture Western Australia Keynotes Australian Wool Innovation Limited DR LEN STEPHENS AUSTRALIAN WOOL INNOVATION LIMITED (AWI) Commercialisation of Sheepmeat Eating Quality Outcomes, David Thomason, General Manger Marketing Meat & livestock Australia Limited PLENARY The Fitness of the Future Merino, Norm Adams and Shimin Liu, CSIRO Livestock Industries Ovine Johne’s Disease – Managing the Disease, Managing the Issues, PETER BUCKMAN, CHIEF VETERINARY OFFICER, DEPARTMENT OF AGRICULTURE WESTERN AUSTRALIA Animal Welfare – Changes in Latitudes Changes in Attitudes, Michael Paton and Dianne Evans, Department of Agriculture Western Australian. Live Sheep Exports, JOHN EDWARDS. CHAIRMAN, WESTERN AUSTRALIAN LIVE SHEEP EXPORTERS ASSOCIATION MeCustomising to the Needs of the Customer – Insights from the New Zealand Merino Experience, DR SCOTT CHAMPION, RESEARCH, DEVELOPMENT AND PRODUCT INNOVATION MANAGER, THE NEW ZEALAND MERINO COMPANY LIMITED Agribusiness Sheep Updates Conference -Economic and Financial Market Update Alan Langford, Economist, BankWest Concurrent sessions - Meeting the Market Breeding Wool to Address Consumer Requirements in Fabrics A.C. SCHLINK CSIRO Livestock Industries, J.C. GREEFF AND M. E. LADYMAN Department of Agriculture Western Australia Fibre Contribution to Retail Demand for Knitwear Melanie LadymanA and John StantonAB ADepartment of Agriculture Western Australia and BCurtin University of Technology Sustainable Merino, is this the Future for Merino? Stuart Adams, iZWool International P/L Meeting lamb Market Specs from Crossbred Ewes Dr. Neal Fogarty, NSW Agriculture and the Australian Sheep Industry CRC Use of Serial Body Weight Measurements in Prime Lamb Finishing Systems Matthew Kelly, CSIRO Livestock Industries, James Skerritt, Ian McFarland Department of Agriculture Western Australia, Australian Sheep Industry CR

Resource use, governance and case load of rapid response teams in Australia and New Zealand in 2014

Background: Rapid response teams (RRTs) are a mandatory element of Australian national health care policy. However, the uptake, resourcing, case load and funding of RRTs in Australian and New Zealand hospitals remain unknown.Aim: To assess the clinical activity, funding, staffing and governance of RRTs in Australian and New Zealand hospitals.Methods: Survey of Australian and New Zealand hospitals as part of a biannual audit of intensive care resources and capacity.Results: Of 207 hospitals surveyed, 165 (79.7%) participated, including 22 (13.3%) from New Zealand. RRTs were present in 138/143 (95.5%) Australian and 11/22 (50%) New Zealand hospitals equipped with intensive care units (P &lt; 0.001). Additional funding was provided in 43/146 hospitals (29.4%) but was more likely in tertiary ICUs (P &lt; 0.001) and in New Zealand (P = 0.012). ICU staff participated in 147/148 RRTs (99.3%), which involved medical staff only (10.2%), nursing staff only (6.8%), and both medical and nursing staff (76.2%). Isolated ICU nursing involvement was more common in smaller ICUs (P = 0.005), in rural/regional and metropolitan hospitals (P = 0.04), and in New Zealand (P = 0.006). Dedicated ICU outreach registrars and consultants were present in 19/146 hospitals (13.0%) and 14/145 hospitals (9.7%), respectively. The ICU provided oversight for 122/147 RRTs (83%). In the 2013&ndash;14 financial year, there were more than 104 000 RRT calls.Conclusion: In cases where data were known, ICU staff provided staff for most RRTs, and oversight for more than 80% of RRTs. However, additional funding for ICU RRT staff and dedicated doctors was relatively uncommon