The experiences of women with polycystic ovary syndrome on a very low-calorie diet

The research was funded by an educational grant from LighterLife. Broom was the Medical Director for LighterLife at the time of the research. Johnson is the Head of Nutrition and Research at LighterLife. The authors report no other conflicts of interest in this work.Peer reviewedPublisher PD

Australian critical care nursing professionals' attitudes towards the use of traditional “chest physiotherapy” techniques

Background: Chest physiotherapy techniques, such as percussion, postural drainage, and expiratory vibrations, may be employed in a critical care setting. Physiotherapists are primarily responsible for their provision; however, nurses have also traditionally implemented these treatments. It is unclear whether nurses consider chest physiotherapy to be a part of their role, or how they perceive their knowledge and confidence pertaining to these techniques. Objective: To investigate the attitudes of nurses towards traditional chest physiotherapy techniques. Method: A total of 1222 members of the Australian College of Critical Care Nurses were invited to participate in an anonymous online survey. Results: There were 142 respondents (12%) with the majority (n = 132, 93%) having performed chest physiotherapy techniques in clinical practice. Most of them considered that the provision of chest physiotherapy was a part of nurse's role. Commonly cited factors influencing nurses' use of chest physiotherapy techniques were the availability of physiotherapy services, adequacy of nursing staff training and skill, and perceptions of professional roles. Conclusions: Nurses working in critical care commonly utilised traditional chest physiotherapy techniques. Further research is required to investigate the reasons why nursing professionals might assume responsibility for the provision of chest physiotherapy techniques, and if their application of these techniques is consistent with evidence-based recommendations

Peer Learning in Virtual Schools

This is the published version. Copyright 2014 Canadian Network for Innovation in EducationThis article is about peer-to-peer learning amongst students within K–12 virtual schools. This issue is examined through a case study of experiences of three students with disabilities enrolled in one virtual school and that of their parents, teachers, and school administrators. The article is framed around variability in learners’ aptitudes for peer-to-peer learning, in the design of the learning environment and what it affords for interpersonal interactions, and in the context where that learning design is implemented (and whether or not it promotes peer-to-peer learning). Each of these areas of variability impacted whether or not peer-to-peer learning occurred

Development of a Survey Instrument to Explore the Characteristics of Australian Private Physiotherapy Practitioners’ Interprofessional Interactions

Background: Interprofessional collaboration is a complex process defined by the relationships and interactions between health practitioners from diverse professional backgrounds. Although the benefits of a collaborative health workforce are widely acknowledged, it is currently poorly understood to what extent private physiotherapy practitioners engage in interprofessional collaboration as a part of their clinical practice, and whether they consider to be adequately trained in this area. Information regarding the frequency, modes of communication, and perceived level of satisfaction associated with private physiotherapy practitioners’ interprofessional interactions is also limited. Purpose: The aim of this paper is to describe the development of a survey instrument that can be used to explore the characteristics of Australian private physiotherapy practitioners’ interprofessional interactions. Methods: A multiphase process was used to develop the survey instrument. The research team conducted a literature search which resulted in the generation of 34 individual survey items. After the initial pool of survey items was developed, three experienced physiotherapists were invited to review the items. The draft survey instrument was then subject to online testing with private physiotherapy practitioners to evaluate the utility of the instrument. Results: All three physiotherapists invited to review the initial pool of survey items provided written feedback to the research team. Following revision, five private physiotherapy practitioners participated in pilot testing the survey instrument. Pilot testing revealed that approximately 10 minutes was required to complete the online survey. Conclusions: The final survey instrument has 29 questions in six sections with categorical, Likert and free text response options and can be used to explore the characteristics of Australian private physiotherapy practitioners’ interprofessional interactions. Information obtained from future research projects utilising this survey may guide the development of effective interventions aimed at enhancing the nature and quality of clinical interactions between private physiotherapy practitioners and other health practitioners working in Australia

Development of a survey instrument to explore the characteristics of Australian private physiotherapy practitioners’ interprofessional interactions

Background: Interprofessional collaboration is a complex process defined by the relationships and interactions between health practitioners from diverse professional backgrounds. Although the benefits of a collaborative health workforce are widely acknowledged, it is currently poorly understood to what extent private physiotherapy practitioners engage in interprofessional collaboration as a part of their clinical practice, and whether they consider to be adequately trained in this area. Information regarding the frequency, modes of communication, and perceived level of satisfaction associated with private physiotherapy practitioners’ interprofessional interactions is also limited. Purpose: The aim of this paper is to describe the development of a survey instrument that can be used to explore the characteristics of Australian private physiotherapy practitioners’ interprofessional interactions. Methods: A multiphase process was used to develop the survey instrument. The research team conducted a literature search which resulted in the generation of 34 individual survey items. After the initial pool of survey items was developed, three experienced physiotherapists were invited to review the items. The draft survey instrument was then subject to online testing with private physiotherapy practitioners to evaluate the utility of the instrument. Results: All three physiotherapists invited to review the initial pool of survey items provided written feedback to the research team. Following revision, five private physiotherapy practitioners participated in pilot testing the survey instrument. Pilot testing revealed that approximately 10 minutes was required to complete the online survey. Conclusions: The final survey instrument has 29 questions in six sections with categorical, Likert and free text response options and can be used to explore the characteristics of Australian private physiotherapy practitioners’ interprofessional interactions. Information obtained from future research projects utilising this survey may guide the development of effective interventions aimed at enhancing the nature and quality of clinical interactions between private physiotherapy practitioners and other health practitioners working in Australia

Perioperative Laboratory Abnormalities in Gynecologic Oncology Surgical Patients

Background: Laboratory blood testing incurs financial costs and the blood draws can increase discomfort, yet minimal data exists regarding routine testing in gynecologic oncology surgical patients. Additionally, an increasing number of gynecologic oncology surgeries are performed via a laparoscopic approach. Thus, further investigation into perioperative laboratory testing for gynecologic oncology patients is warranted. An increasing number of gynecologic oncology surgeries are performed via a laparoscopic approach. Thus, further investigation into perioperative laboratory testing for gynecologic oncology patients is warranted. Objective: The aims of this study were (1) to evaluate the frequency and etiology of perioperative laboratory test abnormalities in patients undergoing laparoscopic and laparotomy surgery in a gynecologic oncology service, and (2) to establish an evidence-based algorithm to reduce unnecessary laboratory testing. Materials and Methods: A single-institution retrospective study was completed, investigating laparoscopic and laparotomic surgeries over 4 years. Information on preoperative and postoperative laboratory data, surgical parameters, perioperative interventions, and patient demographics was collected. Quality-assurance data were reviewed. Data were tabulated and analyzed using Statistical Product and Service Solutions (SPSS) version 22. A Student's t-test was used to test for group differences for continuous variables with equal variance, the Mann-Whitney?U test for continuous variables when unequal variance was detected, and Pearson's ?2 was used to investigate categorical variables of interest. p-Values 98% of patients underwent at least one preoperative and postoperative laboratory test, totaling 8060 preoperative and 5784 postoperative results. The laparoscopy group was significantly less likely to have postoperative metabolic abnormalities or to undergo perioperative blood transfusion. Patients taking an angiotensin-converting-enzyme inhibitor, angiotensin-II?receptor blocker, or diuretic were significantly more likely to have elevated creatinine preoperatively (odds ratio [OR]: 5.0; p?Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140101/1/gyn.2015.0106.pd

Clinical Educator and Student Perceptions of iPad™ Technology to Enhance Clinical Supervision: The Electronically-Facilitated Feedback Initiative (EFFI)

Purpose: Growing demands placed upon healthcare systems require more health professionals to be trained. Clinical placement education is an integral component of health professional training, however accommodating increasing numbers of student placements is a challenge for health services. Personal digital assistants such as iPads™ may assist in delivery of clinical education, by facilitating transfer of knowledge and skills from clinical educators to health professional students, however such an initiative has not been formally investigated. The present study sought to explore perceptions of clinical educators and allied health students regarding the impact of an iPad™-based feedback delivery system on student reflection and learning. Methods: A pilot study was performed using iPads™ with specialised software to deliver electronic formative feedback to physiotherapy, occupational therapy and speech pathology students during clinical placements. Students and clinical educators completed a questionnaire exploring advantages and disadvantages of the technology. Results: Nine clinical educators and 14 students participated and completed the survey. Clinical educators largely (n=7, 78%) reported the electronic feedback system was easy to use and 67% (n=6) reported it improved the quality of feedback provided to students. Five (56%) clinical educators thought electronic feedback improved student performance. Most students (n=10, 71%) reported electronic feedback facilitated reflection upon performance, and 64% (n=9) reported improved performance as a result. Disadvantages included poor wireless internet access and software inefficiencies (n=7 [78%] clinical educators, n=7 [50%] students), and difficulties using iPads™ in settings requiring infection control (n=2 [22%] clinical educators). Conclusions: Clinical educators and students perceived electronic feedback as a positive adjunct to student learning on clinical placement, however technological and software interface factors need to be considered for implementation in some settings

Weight loss for women with and without polycystic ovary syndrome following a very low-calorie diet in a community-based setting with trained facilitators for 12 weeks.

Background: Polycystic ovary syndrome (PCOS) affects between 2% and 26% of reproductive-age women in the UK, and accounts for up to 75% of anovulatory infertility. The major symptoms include ovarian disruption, hyperandrogenism, insulin resistance, and polycystic ovaries. Interestingly, at least half of the women with PCOS are obese, with the excess weight playing a pathogenic role in the development and progress of the syndrome. The first-line treatment option for overweight/obese women with PCOS is diet and lifestyle interventions; however, optimal dietary guidelines are missing. Although many different dietary approaches have been investigated, data on the effectiveness of very low-calorie diets on PCOS are very limited. Materials and methods: The aim of this paper was to investigate how overweight/obese women with PCOS responded to LighterLife Total, a commercial very low-calorie diet, in conjunction with group behavioral change sessions when compared to women without PCOS (non-PCOS). Results: PCOS (n=508) and non-PCOS (n=508) participants were matched for age (age ±1 unit) and body mass index (body mass index ±1 unit). A 12-week completers analysis showed that the total weight loss did not differ significantly between PCOS (n=137) and non-PCOS participants (n=137) (-18.5±6.6 kg vs -19.4±5.7 kg, P=0.190). Similarly, the percentage of weight loss achieved by both groups was not significantly different (PCOS 17.1%±5.6% vs non-PCOS 18.2%±4.4%, P=0.08). Conclusion: Overall, LighterLife Total could be an effective weight-loss strategy in overweight/obese women with PCOS. However, further investigations are needed to achieve a thorough way of understanding the physiology of weight loss in PCOS

An open-format enteroid culture system for interrogation of interactions between Toxoplasma gondii and the intestinal epithelium.

When transmitted through the oral route, Toxoplasma gondii first interacts with its host at the small intestinal epithelium. This interaction is crucial to controlling initial invasion and replication, as well as shaping the quality of the systemic immune response. It is therefore an attractive target for the design of novel vaccines and adjuvants. However, due to a lack of tractable infection models, we understand surprisingly little about the molecular pathways that govern this interaction. The in vitro culture of small intestinal epithelium as 3D enteroids shows great promise for modeling the epithelial response to infection. However, the enclosed luminal space makes the application of infectious agents to the apical epithelial surface challenging. Here, we have developed three novel enteroid-based techniques for modeling T. gondii infection. In particular, we have adapted enteroid culture protocols to generate collagen-supported epithelial sheets with an exposed apical surface. These cultures retain epithelial polarization, and the presence of fully differentiated epithelial cell populations. They are susceptible to infection with, and support replication of, T. gondii. Using quantitative label-free mass spectrometry, we show that T. gondii infection of the enteroid epithelium is associated with up-regulation of proteins associated with cholesterol metabolism, extracellular exosomes, intermicrovillar adhesion, and cell junctions. Inhibition of host cholesterol and isoprenoid biosynthesis with Atorvastatin resulted in a reduction in parasite load only at higher doses, indicating that de novo synthesis may support, but is not required for, parasite replication. These novel models therefore offer tractable tools for investigating how interactions between T. gondii and the host intestinal epithelium influence the course of infection

Gridded and direct Epoch of Reionisation bispectrum estimates using the Murchison Widefield Array

We apply two methods to estimate the 21~cm bispectrum from data taken within the Epoch of Reionisation (EoR) project of the Murchison Widefield Array (MWA). Using data acquired with the Phase II compact array allows a direct bispectrum estimate to be undertaken on the multiple redundantly-spaced triangles of antenna tiles, as well as an estimate based on data gridded to the $uv$-plane. The direct and gridded bispectrum estimators are applied to 21 hours of high-band (167--197~MHz; $z$=6.2--7.5) data from the 2016 and 2017 observing seasons. Analytic predictions for the bispectrum bias and variance for point source foregrounds are derived. We compare the output of these approaches, the foreground contribution to the signal, and future prospects for measuring the bispectra with redundant and non-redundant arrays. We find that some triangle configurations yield bispectrum estimates that are consistent with the expected noise level after 10 hours, while equilateral configurations are strongly foreground-dominated. Careful choice of triangle configurations may be made to reduce foreground bias that hinders power spectrum estimators, and the 21~cm bispectrum may be accessible in less time than the 21~cm power spectrum for some wave modes, with detections in hundreds of hours.Comment: 19 pages, 10 figures, accepted for publication in PAS