A pilot randomised control trial of general practitioner and exercise physiologist interventions to reduce primary cardiovascular risk in overweight patients [Abstract]

Aims & Rationale/Objectives: With the knowledge that overweight is a major public health concern in Australia, that a multidisciplinary team approach to the management of lifestyle-related conditions is supported, and that the Australian Government recently recognised the role of the exercise physiologist (EP) in reducing the health burden of disease by their inclusion for reimbursement under the Medicare Plus scheme, this study sought to undertake a pilot RCT to compare GP and EP interventions to reduce primary cardiovascular risk in the overweight general practice population. Methods and Measures: Overweight patients recruited by a convenience sample of GPs were randomised into one of three arms: the control group, or the GP or EP intervention group (in which patients received either five GP or five EP consultations over 24 weeks). Patients had baseline, 12- and 24-week measures of body composition and cardio-respiratory fitness, and completed baseline and end-of-study surveys, fasting lipids and glucose. GPs and EPs completed an end-of-study survey. Results:Sixty-seven patients attended the baseline assessment. Overall retention rate was 67%. Patients were generally satisfied with the effectiveness of the interventions and their weight reduction. Favourable trends in BMI, weight, glucose and exercise levels for GP and EP intervention groups and in physical activity levels for all groups Conclusions: This study supports the feasibility of a RCT of GP and EP interventions for decreasing primary cardiovascular risk in the overweight general practice population.

Blogs, wikis and podcasts : collaborative knowledge building tools in a design and technology course

Design and Technology has become an important part of the school curriculum. In Queensland, Australia, Technology (which encompasses Design) is one of the Key Learning Areas (KLAs) for students in the first ten years of schooling. This KLA adopts a student-centred, hands-on constructivist approach to teaching and learning. The ability to conceptualise and implement appropriate learning experiences, however, has been a challenge for some early career teachers. This paper describes how Design and Technology is being taught to pre-service primary teachers at an Australian University through their involvement in a range of authentic problem-solving activities supported by social learning tools such as wikis and blogs. An interview with a sample from this group (N=5) provides an insight into how these social software tools enhanced their knowledge and learning. This paper will describe how these social learning tools impact on the agency of learning.

Interdisciplinarity vs disciplinarity : developing knowledge for problem solving in middle years of schooling

Interdisciplinary studies are fundamental to the signature practices for the middle years of schooling. Middle years researchers claim that interdisciplinarity in teaching appropriately meets the needs of early adolescents by tying concepts together, providing frameworks for the relevance of knowledge, and demonstrating the linking of disparate information for solution of novel problems. Cognitive research is not wholeheartedly supportive of this position. Learning theorists assert that application of knowledge in novel situations for the solution of problems is actually dependent on deep discipline based understandings. The present research contrasts the capabilities of early adolescent students from discipline based and interdisciplinary based curriculum schooling contexts to successfully solve multifaceted real world problems. This will inform the development of effective management of middle years of schooling curriculum.

Clinical results in primary THR

Written by the surgeons of the Exeter Hip Team and their colleagues from around the world, this book describes 40 years of innovation and development with cemented hip replacement. Topics covered include the basic science behind successful cemented hip replacement, modern surgical techniques and recent advances. There is also extensive coverage of the revision techniques developed at Exeter and elsewhere, focussing on femoral and acetabular impaction grafting. Each chapter is a self-contained article with an emphasis, where appropriate, on practical techniques and surgical tips, supported by line drawings and intra-operative photographs.

Is there a need for routine follow-up after primary total hip arthroplasty?

Background: The objective of routine outpatient assessment of well functioning patients after primary total hip arthroplasty (THA) is to detect asymptomatic failure of prostheses to guide recommendations for early intervention. We have observed that the revision of THAs in asymptomatic patients is highly uncommon. We therefore question the need for routine follow-up of patients after THA. Methods: A prospective analysis of an orthopaedic database identified 158 patients who received 177 revision THAs over a 4 year period. A retrospective chart review was conducted. Patient demographics, primary and revision surgery parameters and follow-up information was recorded and cross referenced with AOA NJRR data. Results: 110 THAs in 104 patients (average age 70.4 (SD 9.8 years). There were 70 (63.6%) total, 13 (11.8%) femoral and 27 (24.5%) acetabular revisions. The indications for revision were aseptic loosening (70%), dislocation (8.2%), peri-prosthetic fracture (7.3%), osteolysis (6.4%) and infection (4.5%). Only 4 (3.6%) were asymptomatic revisions. A mean of 5.3 (SD 5.2 and 1.9 (SD 5.3 follow-up appointments were required before revision in patients with and without symptoms, respectively. The average time from the primary to revision surgery was 11.8 (SD 7.23) years. Conclusions: We conclude that patients with prostheses with excellent long term clinical results as validated by Joint Registries, routine follow-up of asymptomatic THA should be questioned and requires further investigation. Based on the work of this study, the current practice of routine follow-up of asymptomatic THA may be excessively costly and unnecessary and a less resource-intensive review method may be more appropriate.

Developing the Primary Palliative Care Workforce in Australia

Current healthcare models promote the equitable provision of palliative care to oncology patients with advancing disease, in the setting of their usual care, often in conjunction with anti-cancer therapies. This has resulted in specialist cancer services, as well as primary care across metropolitan, rural and remote communities, being called upon to integrate palliative care principles into their practice. To meet this increased demand for skilled health care professionals several national strategies have been initiated over the last five years. In this paper two projects are discussed in detail: the Palliative Care Curriculum for Undergraduates and the Program of Experience in the Professional Approach.

Making use of pedagogic models as reflective catalysts for investigating pedagogic practice

The notion of pedagogy for anyone in the teaching profession is innocuous. The term itself, is steeped in history but the details of the practice can be elusive. What does it mean for an academic to be embracing pedagogy? The problem is not limited to academics; most teachers baulk at the introduction of a pedagogic agenda and resist attempts to have them reflect on their classroom teaching practice, where ever that classroom might be constituted. This paper explores the application of a pedagogic model (Education Queensland, 2001) which was developed in the context of primary and secondary teaching and was part of a schooling agenda to improve pedagogy. As a teacher educator I introduced the model to classroom teachers (Hill, 2002) using an Appreciative Inquiry (Cooperrider and Srivastva 1987) model and at the same time applied the model to my own pedagogy as an academic. Despite being instigated as a model for classroom teachers, I found through my own practitioner investigation that the model was useful for exploring my own pedagogy as a university academic (Hill, 2007, 2008). Cooperrider, D.L. and Srivastva, S. (1987) Appreciative inquiry in organisational life, in Passmore, W. and Woodman, R. (Eds) Research in Organisational Changes and Development (Vol 1) Greenwich, CT: JAI Press. Pp 129-69 Education Queensland (2001) School Reform Longitudinal Study (QSRLS), Brisbane, Queensland Government. Hill, G. (2002, December ) Reflecting on professional practice with a cracked mirror: Productive Pedagogy experiences. Australian Association for Research in Education Conference. Brisbane, Australia. Hill, G. (2007) Making the assessment criteria explicit through writing feedback: A pedagogical approach to developing academic writing. International Journal of Pedagogies and Learning 3(1), 59-66. Hill, G. (2008) Supervising Practice Based Research. Studies in Learning, Evaluation, Innovation and Development, 5(4), 78-87

Analysis of primary user duty cycle impact on spectrum sensing performance

Spectrum sensing is considered to be one of the most important tasks in cognitive radio. Many sensing detectors have been proposed in the literature, with the common assumption that the primary user is either fully present or completely absent within the window of observation. In reality, there are scenarios where the primary user signal only occupies a fraction of the observed window. This paper aims to analyse the effect of the primary user duty cycle on spectrum sensing performance through the analysis of a few common detectors. Simulations show that the probability of detection degrades severely with reduced duty cycle regardless of the detection method. Furthermore we show that reducing the duty cycle has a greater degradation on performance than lowering the signal strength.

Teachers’ conceptions of essential knowledge for integrated social education : a middle years of schooling perspective from Australia

Integrated social education in Australia is a divisive educational issue. The last decade has been marked by a controversial integrated social studies curriculum called Studies of Society and Environment (SOSE) where history, geography and environmental studies were integrated with civics and citizenship. The introduction of a compulsory K-10 Australian Curriculum from 2011, however, marks the return to history and geography and the abandonment of SOSE. Curriculum reform aside, what do teachers think is essential knowledge for middle years social education? The paper reports on a phenomenographical exploration of thirty-one middle school teachers’ conceptions of essential knowledge for SOSE. Framed by Shulman’s (1986, 1987) theoretical framework of the knowledge base for teaching, the research identified seven qualitatively different ways of understanding essential knowledge for integrated social education. The study indicates a practice-based theorization of integrated social education that justifies attention to disciplinary process and teacher identity in middle school social education.