'The early exposure is really helpful' : students' views of participating in communication skills screening

Students commence university with many hopes and dreams for their future and for most, these are realised. Health professional students must succeed in both their academic and clinical experiences. Excellent communication with their patients and colleagues on placement is necessary and particularly so for speech pathology students. This qualitative, descriptive study investigates how first- and final-year students view the screening of their communication skills in which they participate. The focus groups took place within the speech pathology department of a major Australian metropolitan university. Data were transcribed and analysed thematically. Three main themes arose: professional development, students’ cognitive and emotional responses, and the organisation of the screener. Both groups of students felt the screener was both an important part of their professional development and a way of identifying and supporting speech pathology students with communication difficulties. They valued the student-led nature of the process. Implications for the value of using a student-led communication screener to identify students with weaker communication skills early in their program and for the support of such students are discussed

The Keck Planet Search: Detectability and the Minimum Mass and Orbital Period Distribution of Extrasolar Planets

We analyze 8 years of precise radial velocity measurements from the Keck Planet Search, characterizing the detection threshold, selection effects, and completeness of the survey. We carry out a systematic search for planets by assessing the false alarm probability associated with Keplerian orbit fits to the data. This allows us to understand the detection threshold for each star in terms of the number and time baseline of the observations, and size of measurement errors and stellar jitter. We show that all planets with orbital periods 20 m/s, and eccentricities <0.6 have been announced, and summarize the candidates at lower amplitudes and longer orbital periods. For the remaining stars, we calculate upper limits on the velocity amplitude of a companion, typically 10 m/s, and use the non-detections to derive completeness corrections at low amplitudes and long orbital periods. We give the fraction of stars with a planet as a function of planet mass and orbital period, and extrapolate to long period orbits and low planet masses. A power law fit for planet masses >0.3 Jupiter masses and periods <2000 days gives a mass-period distribution dN=C M^\alpha P^\beta dlnM dlnP with \alpha=-0.31 \pm 0.2, \beta=0.26\pm 0.1, and the normalization constant C such that 10.5% of solar type stars have a planet with mass in the range 0.3-10 Jupiter masses and orbital period 2-2000 days. The orbital period distribution shows an increase in the planet fraction by a factor of 5 for orbital periods beyond 300 days. Extrapolation gives 17-20% of stars having gas giant planets within 20 AU. Finally, taking into account differences in detectability, we find that M dwarfs are 3 to 10 times less likely to harbor a Jupiter mass planet than solar type stars.Comment: 20 pages, 17 figures, accepted for publication in PAS

Evaluation of the effect of patient education on rates of falls in older hospital patients: Description of a randomised controlled trial

Background. Accidental falls by older patients in hospital are one of the most commonly reported adverse events. Falls after discharge are also common. These falls have enormous physical, psychological and social consequences for older patients, including serious physical injury and reduced quality of life, and are also a source of substantial cost to health systems worldwide. There have been a limited number of randomised controlled trials, mainly using multifactorial interventions, aiming to prevent older people falling whilst inpatients. Trials to date have produced conflicting results and recent meta-analyses highlight that there is still insufficient evidence to clearly identify which interventions may reduce the rate of falls, and falls related injuries, in this population. Methods and design. A prospective randomised controlled trial (n = 1206) is being conducted at two hospitals in Australia. Patients are eligible to be included in the trial if they are over 60 years of age and they, or their family or guardian, give written consent. Participants are randomised into three groups. The control group continues to receive usual care. Both intervention groups receive a specifically designed patient education intervention on minimising falls in addition to usual care. The education is delivered by Digital Video Disc (DVD) and written workbook and aims to promote falls prevention activities by participants. One of the intervention groups also receives follow up education training visits by a health professional. Blinded assessors conduct baseline and discharge assessments and follow up participants for 6 months after discharge. The primary outcome measure is falls by participants in hospital. Secondary outcome measures include falls at home after discharge, knowledge of falls prevention strategies and motivation to engage in falls prevention activities after discharge. All analyses will be based on intention to treat principle. Discussion. This trial will examine the effect of a single intervention (specifically designed patient education) on rates of falls in older patients in hospital and after discharge. The results will provide robust recommendations for clinicians and researchers about the role of patient education in this population. The study has the potential to identify a new intervention that may reduce rates of falls in older hospital patients and could be readily duplicated and applied in a wide range of clinical settings. Trial Registration. ACTRN12608000015347

The LCES HIRES/Keck Precision Radial Velocity Exoplanet Survey

This document is the Accepted Manuscript version of the following article: R. Paul Butler, et al, The LCES HIRES/Keck Precision Radial Velocity Exoplanet Survey, The Astronomical Journal, Vol 153 (5), 19 pp., published 13 April 2017. The Version of Record is available online at doi: https://doi.org/10.3847/1538-3881/aa66ca. Paper data available at: http://home.dtm.ciw.edu/ebps/data/. © 2017. The American Astronomical Society. All rights reserved.We describe a 20-year survey carried out by the Lick-Carnegie Exoplanet Survey Team (LCES), using precision radial velocities from HIRES on the Keck-I telescope to find and characterize extrasolar planetary systems orbiting nearby F, G, K, and M dwarf stars. We provide here 60,949 precision radial velocities for 1,624 stars contained in that survey. We tabulate a list of 357 significant periodic signals that are of constant period and phase, and not coincident in period and/or phase with stellar activity indices. These signals are thus strongly suggestive of barycentric reflex motion of the star induced by one or more candidate exoplanets in Keplerian motion about the host star. Of these signals, 225 have already been published as planet claims, 60 are classified as significant unpublished planet candidates that await photometric follow-up to rule out activity-related causes, and 54 are also unpublished, but are classified as "significant" signals that require confirmation by additional data before rising to classification as planet candidates. Of particular interest is our detection of a candidate planet with a minimum mass of 3.9 Earth masses and an orbital period of 9.9 days orbiting Lalande 21185, the fourth-closest main sequence star to the Sun. For each of our exoplanetary candidate signals, we provide the period and semi-amplitude of the Keplerian orbital fit, and a likelihood ratio estimate of its statistical significance. We also tabulate 18 Keplerian-like signals that we classify as likely arising from stellar activity.Peer reviewedFinal Accepted Versio

Paths Explored, Paths Omitted, Paths Obscured: Decision Points & Selective Reporting in End-to-End Data Analysis

Drawing reliable inferences from data involves many, sometimes arbitrary, decisions across phases of data collection, wrangling, and modeling. As different choices can lead to diverging conclusions, understanding how researchers make analytic decisions is important for supporting robust and replicable analysis. In this study, we pore over nine published research studies and conduct semi-structured interviews with their authors. We observe that researchers often base their decisions on methodological or theoretical concerns, but subject to constraints arising from the data, expertise, or perceived interpretability. We confirm that researchers may experiment with choices in search of desirable results, but also identify other reasons why researchers explore alternatives yet omit findings. In concert with our interviews, we also contribute visualizations for communicating decision processes throughout an analysis. Based on our results, we identify design opportunities for strengthening end-to-end analysis, for instance via tracking and meta-analysis of multiple decision paths

Depression and anxiety in patients with rheumatoid arthritis: prevalence rates based on a comparison of the Depression, Anxiety and Stress Scale (DASS) and the hospital, Anxiety and Depression Scale (HADS)

<p>Abstract</p> <p>Background</p> <p>While it is recognised that depression is prevalent in Rheumatoid Arthritis (RA), recent studies have also highlighted significant levels of anxiety in RA patients. This study compared two commonly used scales, the Depression Anxiety and Stress Scale (DASS) and the Hospital Anxiety and Depression Scale (HADS), in relation to their measurement range and cut points to consider the relative prevalence of both constructs, and if prevalence rates may be due to scale-specific case definition.</p> <p>Methods</p> <p>Patients meeting the criteria for RA were recruited in Leeds, UK and Sydney, Australia and asked to complete a survey that included both scales. The data was analysed using the Rasch measurement model.</p> <p>Results</p> <p>A total of 169 RA patients were assessed, with a repeat subsample, resulting in 323 cases for analysis. Both scales met Rasch model expectations. Using the 'possible+probable' cut point from the HADS, 58.3% had neither anxiety nor depression; 13.5% had anxiety only; 6.4% depression only and 21.8% had both 'possible+probable' anxiety and depression. Cut points for depression were comparable across the two scales while a lower cut point for anxiety in the DASS was required to equate prevalence.</p> <p>Conclusions</p> <p>This study provides further support for high prevalence of depression and anxiety in RA. It also shows that while these two scales provide a good indication of possible depression and anxiety, the estimates of prevalence so derived could vary, particularly for anxiety. These findings are discussed in terms of comparisons across studies and selection of scales for clinical use.</p

Persistent Amyloidosis following Suppression of Aβ Production in a Transgenic Model of Alzheimer Disease

BACKGROUND: The proteases (secretases) that cleave amyloid-β (Aβ) peptide from the amyloid precursor protein (APP) have been the focus of considerable investigation in the development of treatments for Alzheimer disease. The prediction has been that reducing Aβ production in the brain, even after the onset of clinical symptoms and the development of associated pathology, will facilitate the repair of damaged tissue and removal of amyloid lesions. However, no long-term studies using animal models of amyloid pathology have yet been performed to test this hypothesis. METHODS AND FINDINGS: We have generated a transgenic mouse model that genetically mimics the arrest of Aβ production expected from treatment with secretase inhibitors. These mice overexpress mutant APP from a vector that can be regulated by doxycycline. Under normal conditions, high-level expression of APP quickly induces fulminant amyloid pathology. We show that doxycycline administration inhibits transgenic APP expression by greater than 95% and reduces Aβ production to levels found in nontransgenic mice. Suppression of transgenic Aβ synthesis in this model abruptly halts the progression of amyloid pathology. However, formation and disaggregation of amyloid deposits appear to be in disequilibrium as the plaques require far longer to disperse than to assemble. Mice in which APP synthesis was suppressed for as long as 6 mo after the formation of Aβ deposits retain a considerable amyloid load, with little sign of active clearance. CONCLUSION: This study demonstrates that amyloid lesions in transgenic mice are highly stable structures in vivo that are slow to disaggregate. Our findings suggest that arresting Aβ production in patients with Alzheimer disease should halt the progression of pathology, but that early treatment may be imperative, as it appears that amyloid deposits, once formed, will require additional intervention to clear

Global warming and recurrent mass bleaching of corals

During 2015–2016, record temperatures triggered a pan-tropical episode of coral bleaching, the third global-scale event since mass bleaching was first documented in the 1980s. Here we examine how and why the severity of recurrent major bleaching events has varied at multiple scales, using aerial and underwater surveys of Australian reefs combined with satellite-derived sea surface temperatures. The distinctive geographic footprints of recurrent bleaching on the Great Barrier Reef in 1998, 2002 and 2016 were determined by the spatial pattern of sea temperatures in each year. Water quality and fishing pressure had minimal effect on the unprecedented bleaching in 2016, suggesting that local protection of reefs affords little or no resistance to extreme heat. Similarly, past exposure to bleaching in 1998 and 2002 did not lessen the severity of bleaching in 2016. Consequently, immediate global action to curb future warming is essential to secure a future for coral reefs