Clinical education in the osteopathy program at Victoria University

Health professionals typically undertake some form of clinical training prior to graduation from a pre-professional education program. This can take place in a variety of settings including hospitals, out-patient clinics and in private healthcare facilities. Whilst there is a substantial body of literature that describes clinical education in areas such as medicine and nursing, there is very little in osteopathy. The purpose of this paper is to present an overview of clinical education in the osteopathy program at Victoria University. It is anticipated this will provide a basis for further discussion and research into an area that has limited coverage in the literature

Predicting sleep disordered breathing in outpatients with suspected OSA

Objective To validate the utilities of Berlin, STOP and STOP-BANG Questionnaires, other patient characteristics, comorbidities, Epworth Sleepiness Scale (ESS), fractional exhaled nitric oxide (FENO) and blood markers for the prediction of sleep disordered breathing (SDB) on limited polygraphy. Setting North Glasgow Sleep Service (a tertiary referral centre). Participants 129 consecutive patients, aged ≥16 years, referred to the sleep clinic for assessment of possible obstructive sleep apnoea. Interventions We selected cut-points of apnoea hypopnoea index (AHI) of ≥5 and ≥15/h from their home polygraphy and determined associations of these with individual symptoms, questionnaire scores and other results. Receiver operating characteristic analysis and univariate and multivariate logistic regression were used to explore these. Primary and secondary outcomes measures Primary: The utility of STOP, STOP-BANG and Berlin Questionnaires for prediction of SDB. Secondary: The utility of other measures for prediction of SDB. Results AHI was ≥5 in 97 patients and ≥15 in 56 patients. STOP and STOP-BANG scores were associated with both AHI cut-points but results with ESS and Berlin Questionnaire scores were negative. STOP-BANG had a negative predictive value 1.00 (0.77–1.00) for an AHI ≥15 with a score ≥3 predicting AHI ≥5 with sensitivity 0.93 (95% CI 0.84 to 0.98) and accuracy 79%, while a score ≥6 predicted AHI ≥15 with specificity 0.78 (0.65 to 0.88) and accuracy 72%. Neck circumference ≥17 inch and presence of witnessed apnoeas were independent predictors of SDB. Conclusions STOP and STOP-BANG Questionnaires have utility for the prediction of SDB in the sleep clinic population. Modification of the STOP-BANG Questionnaire merits further study in this and other patient groups.</p

Sens et contexte

François Recanati, directeur d’étudesJohn MacFarlane, professeur à l’Université de Californie (Berkeley)Christopher Peacocke, professeur à l’Université Columbia Relativisation et niveaux de représentation De septembre à novembre, le séminaire de François Recanati a accueilli les conférences de prestige prononcées par des chercheurs de haut niveau invités dans le cadre de son projet ERC (European Research Council) : les « Context and Content Lectures », dont les textes remaniés seront publiés ..

The Growth Response of Tropical and Sub-Tropical Forage Species to Increasing Salinity

There is currently a growing coal seam gas (CSG) industry in Queensland, Australia. The industry requires beneficial-use strategies to consume the significant volumes of water released during CSG extraction. Irrigation of tropical and sub-tropical forage species for beef production is one option, however coal seam (CS) water is of varying quality due to moderate to high salinity and alkalinity. The application of chemically amended CS water over time could potentially increase soil salinity, which is known to reduce plant biomass production. While there were studies of salinity tolerance of many tropical and sub-tropical forage species 30 years ago, there is a need to examine the tolerance of more recently released species and cultivars which are suitable for planting in the Queensland CSG area

Estimating Increased Transient Water Storage With Increases in Beaver Dam Activity

Dam building by beaver (Castor spp.) slows water movement through montane valleys, increasing transient water storage and the diversity of residence times. In some cases, water storage created by beaver dam construction is correlated to changes in streamflow magnitude and timing. However, the total amount of additional surface and groundwater storage that beaver dams may create (and, thus, their maximum potential impact on streamflow) has not been contextualized in the water balance of larger river basins. We estimate the potential transient water storage increases that could be created at 5, 25, 50, and 100% of maximum modeled beaver dam capacity in the Bear River basin, USA, by adapting the height above nearest drainage (HAND) algorithm to spatially estimate surface water storage. Surface water storage estimates were combined with the MODFLOW groundwater model to estimate potential increases in groundwater storage throughout the basin. We tested four scenarios to estimate potential transient water storage increases resulting from the construction of 1179 to 34,897 beaver dams, and estimated surface water storage to range from 57.5 to 72.8 m3 per dam and groundwater storage to range from 182.2 to 313.3 m3 per dam. Overall, we estimate that beaver dam construction could increase transient water storage by up to 10.38 million m3 in the Bear River basin. We further contextualize beaver dam-related water storage increases with streamflow, reservoir, and snowpack volumes