Interprofessional Scenario-Based Learning for New Graduates in a Regional Setting: A Pilot Study

Introduction: Globally there is an increased emphasis on the provision of high quality healthcare and improved productivity under mounting financial constraints. Interprofessional collaboration and practice are considered crucial in promoting teamwork and optimising patient outcomes. However, there is a lack of structured, evaluated interprofessional learning opportunities for graduates in regional and rural health services in Australia. This pilot study reports on a novel interprofessional new graduate learning program that was developed and implemented to address the lack of structured post-qualification interprofessional learning opportunities in the Central Queensland Hospital and Health Service. Methods: Twenty-one participants enrolled in the six-month program, which consisted of six ninety-minute sessions. A mixed method exploratory design was used to collect data using the Interprofessional Socialization and Valuing Scale before and after the program, and a reflective summary at program completion. Results: Results indicated that participation in the program had a positive effect on participants’ attitudes, beliefs and behaviours regarding interprofessional practice as measured on the Interprofessional Socialization and Valuing Scale. Various themes about the usefulness of the program to participants were elicited from the reflective summary data. These included enhanced understanding of interprofessional practice, increased confidence in own professional role, improved understanding of the roles of other professions, increased collaboration with others, improved patient outcomes and improved networking with colleagues. Conclusions: It was concluded that the new graduate interprofessional learning program was a feasible and effective way to facilitate interprofessional learning among health graduates in a regional health service

A Spatial Characterization of the Sagittarius Dwarf Galaxy Tidal Tails

We measure the spatial density of F turnoff stars in the Sagittarius dwarf tidal stream, from Sloan Digital Sky Survey (SDSS) data, using statistical photometric parallax. We find a set of continuous, consistent parameters that describe the leading Sgr stream's position, direction, and width for 15 stripes in the North Galactic Cap, and 3 stripes in the South Galactic Cap. We produce a catalog of stars that has the density characteristics of the dominant leading Sgr tidal stream that can be compared with simulations. We find that the width of the leading (North) tidal tail is consistent with recent triaxial and axisymmetric halo model simulations. The density along the stream is roughly consistent common disruption models in the North, but possibly not in the South. We explore the possibility that one or more of the dominant Sgr streams has been mis-identified, and that one or more of the `bifurcated' pieces is the real Sgr tidal tail, but we do not reach definite conclusions. If two dwarf progenitors are assumed, fits to the planes of the dominant and `bifurcated' tidal tails favor an association of the Sgr dwarf spheroidal galaxy with the dominant Southern stream and the `bifurcated' stream in the North. In the North Galactic Cap, the best fit Hernquist density profile for the smooth component of the stellar halo is oblate, with a flattening parameter q = 0.53, and a scale length of r_0 = 6.73. The Southern data for both the tidal debris and the smooth component of the stellar halo do not match the model fits to the North, although the stellar halo is still overwhelmingly oblate. Finally, we verify that we can reproduce the parameter fits on the asynchronous Milkyway@home volunteer computing platform.Comment: 35 pages, 8 figures, 9 tables. Accepted for publication in The Astrophysical Journa

The Stellar Metallicity Distribution Function of the Galactic Halo from SDSS Photometry

We explore the stellar metallicity distribution function of the Galactic halo based on SDSS ugriz photometry. A set of stellar isochrones is calibrated using observations of several star clusters and validated by comparisons with medium-resolution spectroscopic values over a wide range of metal abundance. We estimate distances and metallicities for individual main-sequence stars in the multiply scanned SDSS Stripe 82, at heliocentric distances in the range 5 - 8 kpc and |b| > 35 deg, and find that the in situ photometric metallicity distribution has a shape that matches that of the kinematically-selected local halo stars from Ryan & Norris. We also examine independent kinematic information from proper-motion measurements for high Galactic latitude stars in our sample. We find that stars with retrograde rotation in the rest frame of the Galaxy are generally more metal poor than those exhibiting prograde rotation, which is consistent with earlier arguments by Carollo et al. that the halo system comprises at least two spatially overlapping components with differing metallicity, kinematics, and spatial distributions. The observed photometric metallicity distribution and that of Ryan & Norris can be described by a simple chemical evolution model by Hartwick (or by a single Gaussian distribution); however, the suggestive metallicity-kinematic correlation contradicts the basic assumption in this model that the Milky Way halo consists primarily of a single stellar population. When the observed metallicity distribution is deconvolved using two Gaussian components with peaks at [Fe/H] ~ -1.7 and -2.3, the metal-poor component accounts for ~20% - 35% of the entire halo population in this distance range.Comment: Accepted for publication in Ap

A Wisp3 Cre-knockin Allele Produces Efficient Recombination in Spermatocytes during Early Prophase of Meiosis I

Individuals with the autosomal recessive skeletal disorder Progressive Pseudorheumatoid Dysplasia have loss-of-function mutations in WISP3, and aberrant WISP3 expression has been detected in tumors from patients with colon and breast cancer. In mice however, neither absence nor over-expression of WISP3 was found to cause a phenotype, and endogenous Wisp3 expression has been difficult to detect. To confirm that Wisp3 knockout mice have no phenotype and to identify potential sites of endogenous Wisp3 expression, we generated mice with a knockin allele (Wisp3GFP-Cre) designed to express Green Fluorescent Protein (GFP) and Cre-recombinase instead of WISP3. Heterozygous and homozygous knockin mice were fertile and indistinguishable from their wild-type littermates, confirming that mice lacking Wisp3 have no phenotype. We could not detect GFP-expression from the knockin allele, but we could detect Cre-expression after crossing mice with the knockin allele to Cre-reporter mice; the double heterozygous offspring had evidence of Cre-mediated recombination in several tissues. The only tissue that had high levels of Cre-mediated recombination was the testis, where recombination in spermatocytes occurred by early prophase of meiosis I. As a consequence, males that were double heterozygous for a Wisp3GFP-Cre and a floxed allele only contributed a recombined allele to their offspring. We detected no evidence of Cre-mediated recombination in the female ovary, although when double heterozygous females contributed the reporter allele to their offspring it had recombined ~7% of the time. Wisp3GFP-Cre expression therefore occurs less frequently and most likely at a later stage of oocyte development in female mice compared to male mice. We conclude that although WISP3 is dispensable in mice, male mice with a Wisp3GFP-Cre allele (Jackson Laboratory stock # 017685) will be useful for studying early prophase of meiosis I and for efficiently recombining floxed alleles that are passed to offspring

Presphenoidal synchondrosis fusion in DBA/2J mice

Cranial base growth plates are important centers of longitudinal growth in the skull and are responsible for the proper anterior placement of the face and the stimulation of normal cranial vault development. We report that the presphenoidal synchondrosis (PSS), a midline growth plate of the cranial base, closes in the DBA/2J mouse strain but not in other common inbred strains. We investigated the genetics of PSS closure in DBA/2J mice by evaluating F1, F1 backcross, and/or F1 intercross offspring from matings with C57BL/6J and DBA/1J mice, whose PSS remain open. We observed that PSS closure is genetically determined, but not inherited as a simple Mendelian trait. Employing a genome-wide SNP array, we identified a region on chromosome 11 in the C57BL/6J strain that affected the frequency of PSS closure in F1 backcross and F1 intercross offspring. The equivalent region in the DBA/1J strain did not affect PSS closure in F1 intercross offspring. We conclude that PSS closure in the DBA/2J strain is complex and modified by different loci when outcrossed with C57BL/6J and DBA/1J mice. Electronic supplementary material The online version of this article (doi:10.1007/s00335-012-9437-8) contains supplementary material, which is available to authorized users

A Spatial Characterization of the Saggitarius Dwarf Galaxy Tidal Tails

We measure the spatial density of F turnoff stars in the Sagittarius dwarf tidal stream, from Sloan Digital Sky Survey data, using statistical photometric parallax. We find a set of continuous, consistent parameters that describe the leading Sgr stream\u27s position, direction, and width for 15 stripes in the north Galactic cap, and three stripes in the south Galactic cap. We produce a catalog of stars that has the density characteristics of the dominant leading Sgr tidal stream that can be compared with simulations. We find that the width of the leading (north) tidal tail is consistent with recent triaxial and axisymmetric halo model simulations. The density along the stream is roughly consistent with common disruption models in the north, but possibly not in the south. We explore the possibility that one or more of the dominant Sgr streams has been misidentified, and that one or more of the bifurcated pieces is the real Sgr tidal tail, but we do not reach definite conclusions. If two dwarf progenitors are assumed, fits to the planes of the dominant and bifurcated tidal tails favor an association of the Sgr dwarf spheroidal galaxy with the dominant southern stream and the bifurcated stream in the north. In the north Galactic cap, the best fit Hernquist density profile for the smooth component of the stellar halo is oblate, with a flattening parameter q = 0.53, and a scale length of r 0 = 6.73. The southern data for both the tidal debris and the smooth component of the stellar halo do not match the model fits to the north, although the stellar halo is still overwhelmingly oblate. Finally, we verify that we can reproduce the parameter fits on the asynchronous MilkyWay@home volunteer computing platform

Plasma Desmosine and Abdominal Aortic Aneurysm Disease

Background It is recognized that factors beyond aortic size are important in predicting outcome in abdominal aortic aneurysm (AAA) disease. AAA is characterized by the breakdown of elastin within the aortic tunica media, leading to aortic dilatation and rupture. The aim of this study was to investigate the association of plasma desmosine (pDES), an elastin-specific degradation product, with disease severity and clinical outcome in patients with AAA. Methods and Results We measured pDES and serum biomarker concentrations in 507 patients with AAAs (94% men; mean age, 72.4±6.1 years; mean AAA diameter, 48±8 mm) and 162 control subjects (100% men; mean age, 71.5±4.4 years) from 2 observational cohort studies. In the longitudinal cohort study (n=239), we explored the incremental prognostic value of pDES on AAA events. pDES was higher in patients with AAA compared with control subjects (mean±SD: 0.46±0.22 versus 0.33±0.16 ng/mL; P<0.001) and had the strongest correlation with AAA diameter (r=0.39; P<0.0001) of any serum biomarker. After adjustment for baseline AAA diameter, pDES was associated with an AAA event (hazard ratio, 2.03 per SD increase [95% CI, 1.02-4.02]; P=0.044). In addition to AAA diameter, pDES provided incremental improvement in risk stratification (continuous net reclassification improvement, 34.4% [95% CI, -10.8% to 57.5%; P=0.09]; integrated discrimination improvement, 0.04 [95% CI, 0.00-0.15; P=0.050]). Conclusions pDES concentrations predict disease severity and clinical outcomes in patients with AAA. Clinical Trial Registration http://www.isrctn.com. Unique identifier: ISRCTN76413758