Physiotherapy students\u27 perceptions and experiences of clinical prediction rules

Objectives: Clinical reasoning can be difficult to teach to pre-professional physiotherapy students due to their lack of clinical experience. It may be that tools such as clinical prediction rules (CPRs) could aid the process, but there has been little investigation into their use in physiotherapy clinical education. This study aimed to determine the perceptions and experiences of physiotherapy students regarding CPRs, and whether they are learning about CPRs on clinical placement. Design: Cross-sectional survey using a paper-based questionnaire. Participants: Final year pre-professional physiotherapy students (n=371, response rate 77%) from five universities across five states of Australia. Results: Sixty percent of respondents had not heard of CPRs, and a further 19% had not clinically used CPRs. Only 21% reported using CPRs, and of these nearly three-quarters were rarely, if ever, learning about CPRs in the clinical setting. However most of those who used CPRs (78%) believed CPRs assisted in the development of clinical reasoning skills and none (0%) was opposed to the teaching of CPRs to students. The CPRs most commonly recognised and used by students were those for determining the need for an X-ray following injuries to the ankle and foot (67%), and for identifying deep venous thrombosis (63%). Conclusions: The large majority of students in this sample knew little, if anything, about CPRs and few had learned about, experienced or practiced them on clinical placement. However, students who were aware of CPRs found them helpful for their clinical reasoning and were in favour of learning more about them

Distributed situation awareness in dynamic systems: Theoretical development and application of an ergonomics methodology

The purpose of this paper is to propose foundations for a theory of situation awareness based on the analysis of interactions between agents (i.e., both human and non-human) in subsystems. This approach may help promote a better understanding of technology-mediated interaction in systems, as well as helping in the formulation of hypotheses and predictions concerning distributed situation awareness. It is proposed that agents within a system each hold their own situation awareness which may be very different from (although compatible with) other agents. It is argued that we should not always hope for, or indeed want, sharing of this awareness, as different system agents have different purposes. This view marks situation awareness as a 1 dynamic and collaborative process that binds agents together on tasks on a moment-by-moment basis. Implications of this viewpoint for development of a new theory of, and accompanying methodology for, distributed situation awareness are offered

The radical character of the acenes: A density matrix renormalization group study

We present a detailed investigation of the acene series using high-level wavefunction theory. Our ab-initio Density Matrix Renormalization Group algorithm has enabled us to carry out Complete Active Space calculations on the acenes from napthalene to dodecacene correlating the full pi-valence space. While we find that the ground-state is a singlet for all chain-lengths, examination of several measures of radical character, including the natural orbitals, effective number of unpaired electrons, and various correlation functions, suggests that the longer acene ground-states are polyradical in nature.Comment: 10 pages, 8 figures, supplementary material, to be published in J. Chem. Phys. 127, 200

On the acoustic diffraction by the edges of benthic shells

Author Posting. © Acoustical Society of America, 2004. This article is posted here by permission of Acoustical Society of America for personal use, not for redistribution. The definitive version was published in Journal of the Acoustical Society of America 116 (2004): 239-244, doi:10.1121/1.1675813.Recent laboratory measurements of acoustic backscattering by individual benthic shells have isolated the edge-diffracted echo from echoes due to the surface of the main body of the shell. The data indicate that the echo near broadside incidence is generally the strongest for all orientations and is due principally to the surface of the main body. At angles well away from broadside, the echo levels are lower and are due primarily to the diffraction from the edge of the shell. The decrease in echo levels from broadside incidence to well off broadside is shown to be reasonably consistent with the decrease in acoustic backscattering from normal incidence to well off normal incidence by a shell-covered seafloor. The results suggest the importance of the edge of the shell in off-normal-incidence backscattering by a shell-covered seafloor. Furthermore, when considering bistatic diffraction by edges, there are implications that the edge of the shell (lying on the seafloor) can cause significant scattering in many directions, including at subcritical angles.This research was supported by the U.S. Office of Naval Research (Grant No. N00014-02-1-0095) and the Woods Hole Oceanographic Institution (WHOI), Woods Hole, MA

Local anaesthetic sympathetic blockade for complex regional pain syndrome

Local anaesthetic sympathetic blockade (LASB) is a common treatment for complex regional pain syndrome (CRPS). It involves blocking the activity of sympathetic nerves in the spine through the injection of a local anaesthetic drug. This updated review sought to identify the available evidence regarding whether LASB is effective at reducing pain in CRPS, how long any pain relief might last, and whether LASB is safe. We found a small number of small trials, all of which may be at risk of bias. We did not find evidence that LASB was better than placebo in reducing pain, or that it provided additional pain relief when added to rehabilitation. While a number of small studies compared LASB to other treatments, most did not find that LASB was better than any other intervention. Only five studies reported on adverse events. These studies reported only minor side effects but since most studies did not report this information we can draw no firm conclusions about the safety of LASB. Overall, while the evidence is very limited and precludes the drawing of strong conclusions, the existing evidence does not provide support for the efficacy of LASB in managing people with CRPS

Performance of anti-Salmonella lactic acid bacteria in the porcine intestine

Of five anti-Salmonella porcine cultures administered to pigs at 1010 cfu/day, two Lactobacillus murinus strains demonstrated superior survival during gastrointestinal transit. Both were detected at ~107 -108 cfu/g faeces which was higher (P\u3c0.05) than Pediococcus pentosaceus DPC6006 (~105 cfu/g). One Lb. murinus strain was also excreted at higher numbers (P\u3c0.05) than either Lb. salivarius DPC6005 or Lb. pentosus DPC6004 (both ~106 cfu/g). The Lb. murinus strains persisted in both the faeces and the caecum for at least 9 days post-administration. Animals fed a combination of all five strains at 1010 cfu/day excreted ~107 cfu/g of the administered strains, which was higher (P\u3c0.05) than only P. pentosaceus DPC6006. Randomly amplified polymorphic DNA (RAPD) PCR analysis revealed that both Lb. murinus strains predominated in the faeces of these animals during administration, while post-administration, both Lb. murinus strains and Lb. pentosus DPC6004 were recovered from the faeces and the caecum while P. pentosaceus DPC6006 was only detected in the caecum. After 21 days of culture administration, faecal Enterobacteriaceae counts were reduced in pigs fed Lb. salivarius DPC6005, P. pentosaceus DPC6006, Lb. pentosus DPC6004 and the culture mix, though not significantly. Overall, the porcine intestinal isolates offer potential as probiotics for enteropathogen reduction in pigs; possibly as a combination due to strain variation

A field study of team working in a new human supervisory control system

This paper presents a case study of an investigation into team behaviour in an energy distribution company. The main aim was to investigate the impact of major changes in the company on system performance, comprising human and technical elements. A socio-technical systems approach was adopted. There were main differences between the teams investigated in the study: the time of year each control room was studied (i.e. summer or winter),the stage of development each team was in (i.e. 10 months), and the team structure (i.e. hierarchical or heterarchical). In all other respects the control rooms were the same: employing the same technology and within the same organization. The main findings were: the teams studied in the winter months were engaged in more `planning’ and `awareness’ type of activities than those studies in the summer months. Newer teams seem to be engaged in more sharing of information than older teams, which maybe indicative of the development process. One of the hierarchical teams was engaged in more `system-driven’ activities than the heterarchical team studied at the same time of year. Finally, in general, the heterarchical team perceived a greater degree of team working culture than its hierarchical counterparts. This applied research project confirms findings from laboratory research and emphasizes the importance of involving ergonomics in the design of team working in human supervisory control

Development and psychometric properties of knee-specific body-perception questionnaire in people with knee osteoarthritis: The Fremantle Knee Awareness Questionnaire

Background: Recent systematic reviews have demonstrated that pain associated with knee osteoarthritis (OA) is a complex phenomenon that involves various contributors. People with knee OA exhibit symptoms of impaired body-perception, including reduced tactile acuity, impairments in limb laterality recognition, and degraded proprioceptive acuity. The Fremantle Back Awareness Questionnaire (FreBAQ) was developed to assess body-perception specific to the back in people with chronic low back pain. The aim of this study was to develop and assess the psychometric properties of a knee-specific version of the FreBAQ-J (FreKAQ-J), determine whether people with knee pain experience perceptual impairments and investigate the relationship between disturbed self-perception and clinical status. Methods: Sixty-five people with knee OA completed the FreKAQ-J. A subset of the participants completed the FreKAQ-J again two-weeks later. Rasch analysis was used to assess item order, targeting, category ordering, unidimensionality, person fit, internal consistency, and differential item functioning. Validity was investigated by examining the relationship between the FreKAQ-J and clinical valuables. Results: The FreKAQ-J had acceptable internal consistency, unidimensionality, good test-retest reliability, and was functional on the category rating scale. The FreKAQ-J was significantly correlated with pain in motion, disability, pain-related catastrophizing, fear of movement, and anxiety symptomatology. Conclusions: We developed FreKAQ-J by modifying the FreBAQ-J. The FreKAQ-J fits the Rasch measurement model well and is suitable for use in people with knee OA. Altered body perception may be worth evaluating when managing people with knee OA