Are councils on chiropractic education expectations of chiropractic graduates changing for the better: A comparison of similarities and differences of the graduate competencies of the Chiropractic Council on Education-Australasia from 2009 to 2017

Background The Council on Chiropractic Education Australasia (CCE-A) is tasked with assessment and accreditation of chiropractic programs (CPs) in the Australasian community. To achieve this process the CCE-A has developed educational standards and graduate competencies which include minimum expectations of graduates prior to entry into the workforce. We sought to explore if these are changing overtime, and if so are these changes for the better. Method The CCE-A 2009 and 2017 Competency Standards were located and downloaded. The competencies were placed into tables for a comparative analyses in a systematic manner to enable the identification of similarities and differences. In addition, word counts were conducted for the most commonly occurring words and this took place in December 2019. Results The 2017 competency standards were over three times smaller than the previous standards 2009 standards. More similarities than differences between the old and the new standards were found. There were 18 additions to the 2017 graduate competencies with many that were in unison with contemporary aspects of healthcare such as patient centred-care, respect for practitioner-patient boundaries and patient sexual orientation, transitioning patients to self-management, and consideration of improving lifestyle options. Some competencies were not bought forward to the new standards and included, among others, students being competent in screening for mental health conditions, an expectation to discuss cost of care, re-evaluating and monitoring patients at each visit, and knowing when to discharge patients. The competencies continued to be silent on known issues within the chiropractic profession of a lack of a definition for chiropractic that would inform scope of practice and the presence of vitalism within CPs. Conclusion There have been positive changes which reflect contemporary mainstream health care standards between CCE-A graduate competency revisions. The absence of a clear definition of chiropractic and its attendant scope of practice as well as continued silence on vitalism reflect known issues within the chiropractic profession. Recommendations are made for future accreditation standards to inform the required competencies and aid the integration of chiropractic into the broader health care community

A stochastic model for early placental development

In the human, placental structure is closely related to placental function and consequent pregnancy outcome. Studies have noted abnormal placental shape in small-for-gestational age infants which extends to increased lifetime risk of cardiovascular disease. The origins and determinants of placental shape are incompletely under-stood and are difficult to study in vivo. In this paper we model the early development of the placenta in the human, based on the hypothesis that this is driven by dynamics dominated by a chemo-attractant effect emanating from proximal spiral arteries in the decidua. We derive and explore a two-dimensional stochastic model for these events, and investigate the effects of loss of spiral arteries in regions near to the cord insertion on the shape of the placenta. This model demonstrates that placental shape is highly variable and disruption of spiral arteries can exert profound effects on placental shape, particularly if this disruption is close to the cord insertion. Thus, placental shape reflects the underlying maternal vascular bed. Abnormal placental shape may reflect an abnormal uterine environment, which predisposes to pregnancy complications

Stability of a bi-layer free film: simultaneous or individual rupture events?

We consider the stability of a long free film of liquid composed of two immiscible layers of differing viscosities, where each layer experiences a van der Waals force between its interfaces. We analyse the different ways the system can exhibit interfacial instability when the liquid layers are sufficiently thin. For an excess of surfactant on one gas–liquid interface the coupling between the layers is relatively weak and the instability manifests as temporally separated rupture events in each layer. Conversely, in the absence of surfactant the coupling between the layers is much stronger and the instability manifests as rupture of both layers simultaneously. These features are consistent with recent experimental observations

Strategies for Innovation and Sustainability: Insights from Leaders of Open Source Repository Organizations

4th International Conference on Open RepositoriesThis presentation was part of the session : Conference PresentationsThis panel convenes leaders of organizations that provide the major open repository software platforms featured at OR09. This session provides an opportunity to learn about the strategic processes behind the software - both from a technical and business perspective. The panelists will each provide an overview of their strategic approach open source and open repositories. Specific attention will be paid to strategies for promoting innovation, governance and organization models, and revenue and business models. The area of sustainability and business models for open source software is active and evolving and there is no one-size-fits-all solution. The panelists will discuss their views on ensuring the health and vitality of their platforms, addressing challenges such as: ensuring stability while promoting innovation; generating revenue; enabling community process, governance, and organizational development

f(R)f(R) theory and geometric origin of the dark sector in Horava-Lifshitz gravity

Inclusion of $f(R)$ term in the action of Horava-Lifshitz quantum gravity with projectability but without detailed balance condition is investigated, where $R$ denotes the 3-spatial dimensional Ricci scalar. Conditions for the spin-0 graviton to be free of ghosts and instability are studied. The requirement that the theory reduce to general relativity in the IR makes the scalar mode unstable in the Minkowski background but stable in the de Sitter. It is remarkable that the dark sector, dark matter and dark energy, of the universe has a naturally geometric origin in such a setup. Bouncing universes can also be constructed. Scalar perturbations in the FRW backgrounds with non-zero curvature are presented.Comment: Mod. Phys. Lett. A26, 387-398 (2011

Antigen-Independent Maturation of CD2, CD11a/CD18, CD44, and CD58 Expression on Thymic Emigrants in Fetal and Postnatal Sheep

We have compared the expression of CD2, CD11a/CD18, CD44, and CD58 on αβ and γδ T cells emigrating from the fetal and postnatal thymus. We report that both γδ and the CD4+ CD8- and CD4-CD8+ subsets of αβ T cells express mature levels of the adhesion molecules CD11a/CD18, CD44, and CD58 upon emigration from the thymus. Whereas CD44 is up-regulated on γδ+ thymocytes prior to export, down-regulation of both CD11a/CD18 and CD58 occurs prior to emigration from the thymus, suggesting that down-regulation of these molecules may be a final maturational step taken by developing γδ T cells before their export from the thymus. In contrast, there is continued up-regulation of CD2 on αβ and γδ T cells upon emigration from the thymus and as they move into the mature peripheral T-cell pool. There was also a marked reduction in the number of CD2+ γδ T cells exported during fetal development that was associated with a marked reduction in the percentage of CD22+ γδ thymocytes exported. The postthymic maturation of CD2 and the other changes in adhesion-molecule expression appear to be independent of extrinsic antigen, as the same changes were observed in the antigen-free environment of the fetus as in the postnatal lamb, which has been exposed to extrinsic antigen. It thus appears that these changes in adhesion-molecule expression are as a result of the normal maturation pathway from a developing thymocyte to a mature peripheral T cell

Clavicle fracture nonunion in the paediatric population: a systematic review of the literature.

Aims: Clavicle fracture nonunions are extremely rare in children. The aim of this systematic review was to assess what factors may predispose children to form clavicle fracture nonunions and evaluate the treatment methods and outcomes. Methods: We performed a systematic review according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, aiming to find papers reporting clavicle fracture nonunion in children under the age of 18 years. Data was collected on patient demographics, fracture type, mechanism of injury (MOI), surgical intervention and reported outcome. Two independent reviewers evaluated all the data. Results: A total of 13 articles reporting 21 cases of clavicle fracture nonunion were identified. The mean age at time of injury was 11.4 years (4 to 17). Falls were the most common MOI. The majority of nonunions occurred after displaced fractures on the right side. Six were refractures. Mean time of presentation following injury was 13.5 months (4 to 60). In all, 16 were treated surgically. Radiographic union was eventually achieved in 12 cases, with functional outcome satisfactory in all cases. Conclusion: Clavicle nonunion is an extremely rare but possible complication in children. The majority occur after displaced right-sided fractures or refractures and present around one year after injury. Surgical fixation provides good radiographic healing and functional outcomes. Level of evidence: IV

Recent advances in diffusion neuroimaging: applications in the developing preterm brain

Measures obtained from diffusion-weighted imaging provide objective indices of white matter development and injury in the developing preterm brain. To date, diffusion tensor imaging (DTI) has been used widely, highlighting differences in fractional anisotropy (FA) and mean diffusivity (MD) between preterm infants at term and healthy term controls; altered white matter development associated with a number of perinatal risk factors; and correlations between FA values in the white matter in the neonatal period and subsequent neurodevelopmental outcome. Recent developments, including neurite orientation dispersion and density imaging (NODDI) and fixel-based analysis (FBA), enable white matter microstructure to be assessed in detail. Constrained spherical deconvolution (CSD) enables multiple fibre populations in an imaging voxel to be resolved and allows delineation of fibres that traverse regions of fibre-crossings, such as the arcuate fasciculus and cerebellar-cortical pathways. This review summarises DTI findings in the preterm brain and discusses initial findings in this population using CSD, NODDI, and FBA