Evaluation of participants' experiences with a non-restrictive minimally-structured lifestyle intervention. CHERE Working Paper 2010/11

While there is increasing evidence that group-based lifestyle-focussed interventions may provide more realistic, effective and cost-effective alternatives to intensive, individualised dietary counselling and exercise training, relatively little is known about individuals? preferences for and perceptions of these programs. This paper reports the results of qualitative interviews conducted with participants of a lifestyle intervention trial (Shape up for Life? (SufL) aimed to improve body composition and metabolic health through long-term non-restrictive behaviour modification. Purposive sampling was used to identify 22 participants who participated in detailed interviews regarding their expectations of the intervention, perceptions of benefits and their experience post-intervention and capacity to maintain the lifestyle changes. The results indicate that in general participants are focussed on weight loss as a goal, even when the intervention offered and provided other benefits such as improved fitness and body shape and composition. The individuals who benefited most from the intervention typically had lower baseline knowledge about dietary and exercise guidelines. While the relatively non-restrictive nature of SufL provided flexibility for participants, many participants perceived that a more structured program may have assisted in achieving weight loss goals.Obesity, lifestyle intervention, weight loss, metabolic syndrome

Basketball NSW 2023 Member Report

Basketball NSW engaged the SPRINTER group at the University of Sydney to conduct their 2023 bi-annual membership survey. The objective of this report is to provide evidence for Basketball NSW’s strategic planning and vision; to realise the potential of everyone, strengthening the basketball community and making the sport accessible to all. • Excellent survey response from members, providing confidence in the findings and these findings are likely to represent the broader Basketball community. However, response rates are lower than 2021 (↓2%). Taking time to thank participants, feedback results and articulate how Basketball have listened to the insights will promote long term engagement with the survey. • Members recognise the health benefits of playing basketball. Two thirds of all members reported that basketball has improved their social connection, mental wellbeing, and overall health. The health benefits of basketball should be promoted to the community. • Overall, members are satisfied with their basketball experience. Over 90% of current members would recommend basketball to their friends and family. • Fun and enjoyment were the overwhelming motivator for new and loyal members. Prioritising having fun within the basketball community culture is essential to keep members engaged. • New members reported that improving skills was more important for them; whereas loyal members reported that playing competitively was more important. Providing skill development opportunities should be prioritised among new members and options for playing competitively should be maintained for loyal members. • Word of mouth is the most effective way to get new people to engage with basketball, more than half of new members hearing about basketball from friends and family. Create innovative approaches to encourage current members to invite friends and family to engage with basketball. For example, basketball could encourage existing members to post about their basketball experiences on social media. • Reducing the costs of basketball of providing discounts was the most reported recommendation to help keep members involved in basketball. The annual expenditure of basketball was lower than the state averages reported in Ausplay. Four out of five children used an Active Kids voucher to reduce the cost of basketball. Continue taking advantage of government interventions (e.g., NSW Active kids’ voucher) or alternate subsidiaries, and informing the basketball community about potential financial support is encouraged. 3 Basketball NSW 2023 Member Study • More than half of members reported that they would like to pay for their basketball membership in ways other than the current one-off annual fee. The provision of alternate and flexible pricing within the membership could provide diverse options for communities on varying financial budgets. • Females aged 15-17 years and 18-24 years were the most likely groups to drop out of basketball. Basketball NSW should develop a comprehensive approach to increasing participation and retention of women and girls, guided by evidence in this report. • The most common reasons for children leaving basketball were to try a different sport, basketball wasn’t enjoyable anymore, and other. ‘Other’ responses included providing social, less competitive opportunities. Research recommends that children aged 0-12 should be encouraged to try multiple sports and avoid specialisation in one sport. Strategies to improve retention should be focused on keeping basketball fun and enjoyable. • The most common reasons for adults leaving basketball were poor health, disability, or injury, trying a different sport, and fear of injury. Injury prevention and management information could be integrated into routine basketball communication. Members need a clear understanding of the factors that increase the risk of injury, and how to effectively manage injuries that do occur. • People taking on non-player roles were doing so to be more involved with family members interests and to give back to the community and do not feel the need for recognition. While non-players do not feel the need for recognition, they should have a clear understanding of how their work is contributing to basketball’s strategic objectives, and to broader social outcomes (such as mental health, or community cohesion). • One third of non-players have received no training. Providing volunteers with technical and emotional support will contribute to quality outcomes for the sport. • Members are generally unaware of how to engage with the upcoming FIBA Women’s Asia Cup. Basketball needs to increase awareness around ways for members to engage with the upcoming major event. • The results of this survey should be shared with the basketball community to share what was learnt. This will help member engagement with the sport and any future research conducted by Basketball NSW

Warwick Medical School : A four dimensional curriculum

Medical curricula vary hugely across the world. Notions of horizontal and vertical integration and spiral curricula are present in many modern curricula although true integration happens to a varying degree. By seeing the development of a curriculum as fundamentally about integration, rather than as a process of seeking to integrate separate elements, we have developed a program that prepares students well for the complexities and rate of change of practice. The risks inherent in bringing forward the point at which learners need to deal with such substantive and fundamental complexity produces challenges. Such challenges are ones that our students have shown they can not only deal with, they are often better equipped than faculty to provide solutions for themselves, their peers and those who follow them. We present the three dimensions of integration in the Warwick Medical School curriculum and note the fourth dimension provided by our students, being student led teaching and support far beyond what is normally found in medical courses

GP retention in the UK : a worsening crisis. Findings from a cross-sectional survey

Objective To investigate how recent national policy-led workforce interventions are affecting intentions to remain working as a general practitioner (GP). DESIGN:Online questionnaire survey with qualitative and quantitative questions. Setting and participants All GPs (1697) in Wessex region, an area in England for which previous GP career intention data from 2014 is available. Results 929 (54.7%) participated. 59.4% reported that morale had reduced over the past two years, and 48.5% said they had brought forward their plans to leave general practice. Intention to leave/retire in the next 2 years increased from 13% in the 2014 survey to 18% in October/November 2017 (p=0.02), while intention to continue working for at least the next 5 years dropped from 63.9% to 48.5% (p<0.0001). Age, length of service and lower job satisfaction were associated with intention to leave. Work intensity and amount were the most common reasons given for intention to leave sooner than previously planned; 51.0% participants reported working more hours than 2 years previously, predominantly due to increased workload. GPs suggested increased funding, more GPs, better education of the public and expanding non-clinical and support staff as interventions to improve GP retention. National initiatives that aligned with these priorities, such as funding to expand practice nursing were viewed positively, but low numbers of GPs had seen evidence of their roll-out. Conversely, national initiatives that did not align, such as video consulting, were viewed negatively. Conclusion While recent initiatives may be having an impact on targeted areas, most GPs are experiencing little effect. This may be contributing to further lowering of morale and bringing forward intentions to leave. More urgent action appears to be needed to stem the growing workforce crisis

The general practitioner workforce crisis in England : a qualitative study of how appraisal and revalidation are contributing to intentions to leave practice

Background The general practice (GP) workforce in England is in crisis, with declining morale and job satisfaction, increasing early retirement and declining interest in training to become a GP. We recently reported on factors that are influencing this, with appraisal and revalidation emerging as an unexpected finding; 28.6 % of GPs stating an intention to leave general practice within the next 5 years included this as ‘very important’ or ‘important’ to their decision. In this study we undertook a secondary analysis to identify how the experience of appraisal and revalidation might be influencing intentions to leave general practice. Methods Qualitative analysis of free text comments made by GPs in a survey of career intentions. All comments that included mention of appraisal or revalidation were extracted. Emergent themes were identified and a coding framework devised. Results Forty-two participants made comments that related to appraisal and revalidation. Compared to all 1192 participants who completed the main survey, they were older (76.2 % compared to 46.2 % aged 50 years and older), with more years’ general practice experience (80.0 % compared to 48.0 % with >20 years’ experience) and more likely to state an intention to retire within 5 years (72.2 % compared to 41.9 %). Key themes were appraisal and revalidation as: a bureaucratic, inflexible exercise that added to an already pressured workload; an activity that has little educational value, relevance to professional development or quality of care; and an issue that contributes to low morale, work-related distress and intentions to leave general practice. Revalidation was depicted as a cumbersome tick-box exercise that had little to do with quality of care or protecting patients. There were no comments that countered these negative views. Conclusions While the representativeness of these comments to the experience of GPs as a whole cannot be judged, it is likely that that they reflect the concerns of GPs whose experience of appraisal and revalidation is influencing their intention to leave general practice. Through its impact on GP morale and burnout, the current appraisal and revalidation system in England appears to be contributing to the workforce crisis. The findings indicate that the appraisal system may be in urgent need of re-design to increase its relevance to individual GPs’ experience and seniority, clinical activities being undertaken and professional development needs

Characterization of transgene expression in adenoviral vector-based HIV-1 vaccine candidates

Recombinant adenovirus vectors have been extensively used in gene therapy clinical studies. More recently, the capability of inducing potent cell-mediated and humoral immunity has made these vectors equally attractive candidates for prophylactic or therapeutic vaccine applications. Merck and Co., Inc., developed HIV-1 vaccine candidates based on adenovirus serotype 5 (Ad5) vectors in which the E1 gene, a critical component for adenovirus replication, was replaced by the cytomegalovirus immediate/early promoter, followed by mutated versions of the HIV-1 gag, pol or nef genes (constructs referred to as MRKAd5gag, MRKAd5pol and MRKAd5nef, respectively). Vaccine performance was evaluated in vitro in a novel assay that measures the level of transgene expression in non-permissive A549 cells. Various combinations of vectors were studied. The results indicate that the vaccine induces a dose-dependent expression of the HIV-1 transgenes in vitro. Furthermore, the gag, pol, and nef transgenes are expressed differentially in A549 cells in an MOI-dependent and formulation-dependent manner, yielding an unexpected enhancement of protein expression in trivalent vs. monovalent formulations. Our data suggest that the presence of additional virus in multivalent formulations increases individual transgene expression in A549 cells, even when the amount of DNA encoding the gene of interest remains constant. This enhancement appears to be controlled at the transcriptional level and related to both the total amount of virus and the combination of transgenes present in the formulation

Engineering the indigoidine-synthesising enzyme BpsA for diverse applications in biotechnology

Blue pigment synthase A (BpsA) is a single module non-ribosomal peptide synthetase (NRPS) originally isolated from the bacterium Streptomyces lavendulae. It synthesises an easily detectible blue pigment called indigoidine from two molecules of L-glutamine in an ATP powered reaction. BpsA is readily purified and amenable to in vitro assays that have a variety of useful applications. By spectrophotometrically quantifying indigoidine levels it is possible to accurately measure the amount of L-glutamine in complex biological fluids including urine, blood plasma and cell culture media. This method has several advantages over existing methods for glutamine measurement, including that it directly reports on glutamine levels. Existing commercially available enzymatic kits first convert glutamine into glutamate and then measure the level of glutamate, which requires additional sample processing and introduces complexity if glutamate may also be present in the target sample. Additionally, we have shown that BpsA can also be used to measure ATP concentrations in a similar manner. We have further developed a BpsA based assay to detect inhibitors of 4’-phosphopantetheinyl transferases (PPTases). PPTases are enzymes that attach a phosphopantetheine arm to fatty acid synthases, NRPSs and polyketide synthases, thereby switching them from an inactive apo form to an active holo form. PPTases have been validated as promising drug targets in several pathogenic bacteria including P. aeruginosa and M. tuberculosis. In order to detect PPTase inhibition, we have shown that BpsA can be purified in its inactive apo form and mixed with the target PPTase as well as a candidate inhibitor in vitro. The level of PPTase inhibition can then be calculated by measuring the rate of indigoidine production. The assay has been optimised for high throughput screening and used to identify several compounds from chemical libraries that inhibit essential PPTases of P. aeruginosa and M. tuberculosis

Space Shuttle Propulsion Materials, Manufacturing, and Operational Challenges

Presentations in this session include: (1) External Tank (ET) Materials, Manufacturing, and Operational Challenges; (2) Space Shuttle Main Engine (SSME) Materials, Manufacturing, and Operational Challenges,(3) Reusable Solid Rocket Motor (RSRM) Materials, Manufacturing, and Operational Challenges and (4) Solid Rocket Booster (SRB) Materials, Manufacturing, and Operational Challenges