123 research outputs found
Exploring the Reported Strengths and Limitations of Aboriginal and Torres Strait Islander Health Research: A Narrative Review of Intervention Studies
High quality intervention research is needed to inform evidence-based practice and policy for Aboriginal and Torres Strait Islander communities. We searched for studies published from 2008–2020 in the PubMed database. A narrative review of intervention literature was conducted, where we identified researcher reported strengths and limitations of their research practice. A total of 240 studies met inclusion criteria which were categorised as evaluations, trials, pilot interventions or implementation studies. Reported strengths included community engagement and partnerships; sample qualities; Aboriginal and Torres Strait Islander involvement in research; culturally appropriate and safe research practice; capacity building efforts; providing resources or reducing costs for services and communities; understanding local culture and context; and appropriate timelines for completion. Reported limitations included difficulties achieving the target sample size; inadequate time; insufficient funding and resources; limited capacity of health workers and services; and inadequate community involvement and communication issues. This review highlights that community consultation and leadership coupled with appropriate time and funding, enables Aboriginal and Torres Strait Islander health intervention research to be conducted. These factors can enable effective intervention research, and consequently can help improve health and wellbeing outcomes for Aboriginal and Torres Strait Islander people.Romany McGuffog, Jamie Bryant, Kade Booth, Felicity Collis, Alex Brown, Jaquelyne T. Hughes, Catherine Chamberlain, Alexandra McGhie, Breanne Hobden, and Michelle Kenned
Analysing Change: Complex Rather than Dialectical?
The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.This article offers a discussion of dialectics from a complexity perspective. Dialectics is a term much utilized but infrequently defined. This article suggests that a spectrum of ideas exist concerning understandings of dialectics. We are particularly critical of Hegelian dialectics, which we see as anthropocentric and teleological. While Marxist approaches to dialectics, in the form of historical materialism, marked a break from the idealist elements of Hegelian dialectics, they retained traces of this approach. The article offers a partial discussion of essential elements of dialectics, which we consider to be the analysis of change, the centrality of contradiction, and the methodology of abstraction. Points of overlap with complexity thinking are highlighted, together with those points where complexity thinking and dialectical approaches diverge. We conclude with some suggestions as to how complexity thinking might contribute to a development of dialectical approaches
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Impact of dietary supplementation with resistant dextrin (NUTRIOSE®) on satiety, glycaemia, and related endpoints, in healthy adults
Purpose
Resistant dextrin (RD) supplementation has been shown to alter satiety, glycaemia, and body weight, in overweight Chinese men; however, there are limited data on its effects in other demographic groups. Here, we investigated the effects of RD on satiety in healthy adults living in the United Kingdom.
Methods
20 normal weight and 16 overweight adults completed this randomised controlled cross-over study. Either RD (14 g/day NUTRIOSE® FB06) or maltodextrin control was consumed in mid-morning and mid-afternoon preload beverages over a 28-day treatment period with crossover after a 28-day washout. During 10-h study visits (on days 1, 14, and 28 of each treatment period), satietogenic, glycaemic and anorectic hormonal responses to provided meals were assessed.
Results
Chronic supplementation with RD was associated with higher fasted satiety scores at day 14 (P = 0.006) and day 28 (P = 0.040), compared to control. RD also increased satiety after the mid-morning intervention drink, but it was associated with a reduction in post-meal satiety following both the lunch and evening meals (P < 0.01). The glycaemic response to the mid-morning intervention drink (0–30 min) was attenuated following RD supplementation (P < 0.01). Whilst not a primary endpoint we also observed lower systolic blood pressure at day 14 (P = 0.035) and 28 (P = 0.030), compared to day 1, following RD supplementation in the normal weight group. Energy intake and anthropometrics were unaffected.
Conclusions
RD supplementation modified satiety and glycaemic responses in this cohort, further studies are required to determine longer-term effects on body weight control and metabolic markers
Using role-play to improve students’ confidence and perceptions of communication in a simulated volcanic crisis
Traditional teaching of volcanic science typically emphasises scientific
principles and tends to omit the key roles, responsibilities, protocols, and
communication needs that accompany volcanic crises. This chapter
provides a foundation in instructional communication, education, and risk
and crisis communication research that identifies the need for authentic
challenges in higher education to challenge learners and provide
opportunities to practice crisis communication in real-time. We present
an authentic, immersive role-play called the Volcanic Hazards Simulation
that is an example of a teaching resource designed to match professional
competencies. The role-play engages students in volcanic crisis concepts
while simultaneously improving their confidence and perceptions of
communicating science. During the role-play, students assume authentic
roles and responsibilities of professionals and communicate through
interdisciplinary team discussions, media releases, and press conferences.
We characterised and measured the students’ confidence and perceptions
of volcanic crisis communication using a mixed methods research design
to determine if the role-play was effective at improving these qualities.
Results showed that there was a statistically significant improvement in
both communication confidence and perceptions of science communication.
The exercise was most effective in transforming low-confidence and
low-perception students, with some negative changes measured for our
higher-learners. Additionally, students reported a comprehensive and
diverse set of best practices but focussed primarily on the mechanics of
science communication delivery. This curriculum is a successful example
of how to improve students’ communication confidence and perceptions
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In Vitro Fermentation of NUTRIOSE® FB06, a wheat dextrin soluble fibre, in a continuous culture human colonic model system
Wheat dextrin soluble fibre may have metabolic and health benefits, potentially acting via mechanisms governed by the selective modulation of the human gut microbiota. Our aim was to examine the impact of wheat dextrin on the composition and metabolic activity of the gut microbiota. We used a validated in vitro three-stage continuous culture human colonic model (gut model) system comprised of vessels simulating anatomical regions of the human colon. To mimic human ingestion, 7 g of wheat dextrin (NUTRIOSE® FB06) was administered to three gut models, twice daily at 10.00 and 15.00, for a total of 18 days. Samples were collected and analysed for microbial composition and organic acid concentrations by 16S rRNA-based fluorescence in situ hybridisation and gas chromatography approaches, respectively. Wheat dextrin mediated a significant increase in total bacteria in vessels simulating the transverse and distal colon, and a significant increase in key butyrate-producing bacteria Clostridium cluster XIVa and Roseburia genus in all vessels of the gut model. The production of principal short-chain fatty acids, acetate, propionate and butyrate, which have been purported to have protective, trophic and metabolic host benefits, were increased. Specifically, wheat dextrin fermentation had a significant butyrogenic effect in all vessels of the gut model and significantly increased production of acetate (vessels 2 and 3) and propionate (vessel 3), simulating the transverse and distal regions of the human colon, respectively. In conclusion, wheat dextrin NUTRIOSE® FB06 is selectively fermented in vitro by Clostridium cluster XIVa and Roseburia genus and beneficially alters the metabolic profile of the human gut microbiota
Passive immunization with Pneumovax®23 and pneumolysin in combination with vancomycin for pneumococcal endophthalmitis
Training in crisis communication and volcanic eruption forecasting:Design and evaluation of an authentic role-play simulation
We present an interactive, immersive, authentic role-play simulation designed to teach tertiary geoscience students
in New Zealand to forecast and mitigate a volcanic crisis. Half of the participating group (i.e., the Geoscience Team)
focuses on interpreting real volcano monitoring data (e.g., seismographs, gas output etc.) while the other half of the
group (i.e., the Emergency Management Team) forecasts and manages likely impacts, and communicates emergency
response decisions and advice to local communities. These authentic learning experiences were aimed at enhancing
upper-year undergraduate students’ transferable and geologic reasoning skills. An important goal of the simulation was
specifically to improve students’ science communication through interdisciplinary team discussions, jointly prepared,
and delivered media releases, and real-time, high-pressure, press conferences.
By playing roles, students experienced the specific responsibilities of a professional within authentic organisational
structures. A qualitative, design-based educational research study was carried out to assess the overall student experience
and self-reported learning of skills. A pilot and four subsequent iterations were investigated.
Results from this study indicate that students found these role-plays to be a highly challenging and engaging learning
experience and reported improved skills. Data from classroom observations and interviews indicate that the students
valued the authenticity and challenging nature of the role-play although personal experiences and team dynamics
(within, and between the teams) varied depending on the students’ background, preparedness, and personality.
During early iterations, observation and interviews from students and instructors indicate that some of the goals of the
simulation were not fully achieved due to: A) lack of preparedness, B) insufficient time to respond appropriately, C)
appropriateness of roles and team structure, and D) poor communication skills. Small modifications to the design of
Iterations 3 and 4 showed an overall improvement in the students’ skills and goals being reached.
A communication skills instrument (SPCC) was used to measure self-reported pre- and post- communication competence
in the last two iterations. Results showed that this instrument recorded positive shifts in all categories of self-perceived
abilities, the largest shifts seen in students who participated in press conferences. Future research will be aimed
at adapting this curricula to new volcanic and earthquake scenarios
Nurse prescribing of medicines in Western European and Anglo-Saxon countries: a systematic review of the literature
<p>Abstract</p> <p>Background</p> <p>A growing number of countries are introducing some form of nurse prescribing. However, international reviews concerning nurse prescribing are scarce and lack a systematic and theoretical approach. The aim of this review was twofold: firstly, to gain insight into the scientific and professional literature describing the extent to and the ways in which nurse prescribing has been realised or is being introduced in Western European and Anglo-Saxon countries; secondly, to identify possible mechanisms underlying the introduction and organisation of nurse prescribing on the basis of Abbott's theory on the division of professional labor.</p> <p>Methods</p> <p>A comprehensive search of six literature databases and seven websites was performed without any limitation as to date of publication, language or country. Additionally, experts in the field of nurse prescribing were consulted. A three stage inclusion process, consisting of initial sifting, more detailed selection and checking full-text publications, was performed independently by pairs of reviewers. Data were synthesized using narrative and tabular methods.</p> <p>Results</p> <p>One hundred and twenty-four publications met the inclusion criteria. So far, seven Western European and Anglo-Saxon countries have implemented nurse prescribing of medicines, viz., Australia, Canada, Ireland, New Zealand, Sweden, the UK and the USA. The Netherlands and Spain are in the process of introducing nurse prescribing. A diversity of external and internal forces has led to the introduction of nurse prescribing internationally. The legal, educational and organizational conditions under which nurses prescribe medicines vary considerably between countries; from situations where nurses prescribe independently to situations in which prescribing by nurses is only allowed under strict conditions and supervision of physicians.</p> <p>Conclusions</p> <p>Differences between countries are reflected in the jurisdictional settlements between the nursing and medical professions concerning prescribing. In some countries, nurses share (full) jurisdiction with the medical profession, whereas in other countries nurses prescribe in a subordinate position. In most countries the jurisdiction over prescribing remains predominantly with the medical profession. There seems to be a mechanism linking the jurisdictional settlements between professions with the forces that led to the introduction of nurse prescribing. Forces focussing on efficiency appear to lead to more extensive prescribing rights.</p
The eruptive history of the Tequila volcanic field, western Mexico: ages, volumes, and relative proportions of lava types
Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/47808/1/445_2005_Article_434.pd
Whole-genome sequencing reveals host factors underlying critical COVID-19
Critical COVID-19 is caused by immune-mediated inflammatory lung injury. Host genetic variation influences the development of illness requiring critical care1 or hospitalization2–4 after infection with SARS-CoV-2. The GenOMICC (Genetics of Mortality in Critical Care) study enables the comparison of genomes from individuals who are critically ill with those of population controls to find underlying disease mechanisms. Here we use whole-genome sequencing in 7,491 critically ill individuals compared with 48,400 controls to discover and replicate 23 independent variants that significantly predispose to critical COVID-19. We identify 16 new independent associations, including variants within genes that are involved in interferon signalling (IL10RB and PLSCR1), leucocyte differentiation (BCL11A) and blood-type antigen secretor status (FUT2). Using transcriptome-wide association and colocalization to infer the effect of gene expression on disease severity, we find evidence that implicates multiple genes—including reduced expression of a membrane flippase (ATP11A), and increased expression of a mucin (MUC1)—in critical disease. Mendelian randomization provides evidence in support of causal roles for myeloid cell adhesion molecules (SELE, ICAM5 and CD209) and the coagulation factor F8, all of which are potentially druggable targets. Our results are broadly consistent with a multi-component model of COVID-19 pathophysiology, in which at least two distinct mechanisms can predispose to life-threatening disease: failure to control viral replication; or an enhanced tendency towards pulmonary inflammation and intravascular coagulation. We show that comparison between cases of critical illness and population controls is highly efficient for the detection of therapeutically relevant mechanisms of disease
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