Reliability of isokinetic strength and aerobic power testing for patients with chronic heart failure

PURPOSE: The objective of this study was to assess the reliability of testing skeletal muscle strength and peak aerobic power in a clinical population of patients with chronic heart failure (CHF).

METHODS: Thirty-three patients with CHF (New York Heart Association (NYHA) Functional Class 2.3 ± 0.5; left ventricular ejection fraction 27% ± 7%; age 65 ± 9 years; 28:5 male-female ratio) underwent two identical series of tests (T1 and T2), 1 week apart, for strength and endurance of the muscle groups responsible for knee extension/flexion and elbow extension/flexion. The patients also underwent two graded exercise tests on a bicycle ergometer to measure peak oxygen consumption (VO_2peak). Three months later, 18 of the patients underwent a third test (T3) for each of the measures. Means were compared using MANOVA with repeated measures for strength and endurance, and ANOVA with repeated measures for VO_2peak.

RESULTS: Combining data for all four movement patterns, the expression of strength increased from T1 to T2 by 12% ± 25% (P < .001; intraclass correlation coefficient [ICC] = 0.89). Correspondingly, endurance increased by 13% ± 23% (P = .004; ICC = 0.87). Peak oxygen consumption was not significantly different (16.2 ± 0.8 and 16.1 ± 0.8 mL·kg^-1·min^-1 for T1 and T2, respectively;P = .686; ICC = 0.91). There were no significant differences between T2 and T3 for strength (2% ± 17%;P = .736; ICC = 0.92) or muscle endurance (-1% ± 15%;P = .812; ICC = 0.96), but VO_2peak decreased from 16.7 ± 1.2 to 14.9 ± 0.9 mL·kg^-1·min^-1 (-10% ± 18%;P = .021; ICC = 0.89).

CONCLUSIONS: These data suggest that in a population of patients with CHF, a familiarization trial for skeletal muscle strength testing is necessary. Although familiarization is not required for assessing oxygen consumption as a single measurement, VO_2peak declined markedly in the 3-month period for which these patients were followed. Internal consistency within patients was high for the second and third strength trials and the first and second tests of VO_2peak.

Testing the expectations hypothesis for interest rate term structure : some Australian evidence

Many test results are found inconsistent with the expectations hypothesis of the term structure. The aim of this paper is to re-examine the expectations hypothesis of the term structure using the Australian interest rate data from 1969(7) to 1995(7). We start with the cointegration test on R_t, r_t, and S_t followed by the Granger causality test from S_t to ∇ r_t. Finally we carry out the VAR model of cross-equation restrictions test. Our findings show that there is no conclusive rejection of the expectations hypothesis of the term structure.

Is point of care testing for anaemia (HB) and microalbumin feasible in people with type 2 diabetes attending diabetes outpatient clinics?

Introduction: Diabetes is the major cause of chronic kidney disease (CKD) in Australia. Anaemia of CKD occurs earlier than in non-diabetics and is often insidious and undetected.

Aim: A large, prospective, single-centre study was undertaken to determine the feasibility of point of care testing (POCT) haemoglobin (Hb) and microalbumin in people with type 2 diabetes (T2DM) attending routine outpatient clinic appointments (OPC).

Method: Clinic nurses measured Hb and microalbumin using the HemoCue Haemoglobin Capillary Analyser and the HemoCue Urine Albumin Analyser (Medipac Scientific), respectively when they tested blood glucose, weight and blood pressure. The nurses were trained to use the analysers before the study commenced. Standard demographic data, duration of diabetes, treatment mode, and presence of complications, comorbidities, and HbA1c were ascertained from patients’ medical records.

Results: Five hundred and fifty-four (80%) patients were screened. The nurses were able to perform the tests competently but testing, especially microalbumin, was time-consuming. Patients’ mean age was 62 years (11 SD): 230 females, mean blood glucose (BG) 10 (3.9 SD) mmol/L, mean haemoglobin 127.2 (16.3 SD) g/L; mean microalbumin 47.8 (58.7 SD) mg/L: 324 were males, mean BG 10.2 (3.9 SD) mmol/L, mean Hb 138.6 (18.8 SD) gm/L, and mean microalbumin 67.9 (73.9 SD) mg/L. 27% of males and 22% of females were anaemic. Of those with anaemia, 27% of females and 29% of males had microalbuminuria.

Conclusions: POCT is feasible in routine outpatient clinics but is time-consuming. One in four T2DM attending OPC were anaemic. POCT Hb testing in OPC is feasible and could identify T2DM who need full haematological assessment.

Rethinking the literacy capabilities of pre-service primary teachers in testing times

This paper demonstrates how teacher accreditation requirements can be responsibly aligned with a scholarly impetus to incorporate digital literacies to prepare pre-service teachers to meet changing educational needs and practices. The assessment initiatives introduced in the newly constructed four year undergraduate Bachelor of Education program at one Australian university are described and analysed in light of the debates surrounding pre-service primary teachers’ literacy capabilities. The findings and subsequent discussion have implications for all literacy teacher educators concerned about the impact of standardised assessment practices on the professional future of teachers.

Testing the navigational abilities of ocean migrants: displacement experiments on green sea turtles (Chelonia mydas)

Like many animals migrating through the oceans, sea turtles face difficult navigational tasks when they have to reach distant, specific sites. The paradigmatic case of Brazilian green turtles (Chelonia mydas), which nest on the tiny Ascension Island in the middle of the Atlantic Ocean, has often been the subject of hypotheses concerning their navigational mechanisms. To investigate their nature, we displaced 18 females from Ascension and tracked them by satellite after release from eight different points in the ocean, 60–450 km away from the island. Four turtles moved to Brazil soon after the release, 4 moved in various directions before heading to Brazil, and 10 reached the island. All the successful trips, bar 1, were winding but ended with a final straight segment of variable length, as if the turtles were searching for a sensory contact with the island which they obtained at various distances. The approach to Ascension mostly occurred from the direction opposite to the trade wind, suggesting a navigational role of wind-borne information originating from the island.

Examining the impact of reimbursement on referral to bone density testing for older adults: 8 years of data from the Barwon Statistical Division, Australia

Summary
In 2007, Medicare Australia revised reimbursement guidelines for dual energy X-ray absorptiometry (DXA) for Australians aged ≥70 years; we examined whether these changes increased DXA referrals in older adults. Proportions of DXA referrals doubled for men and tripled for women from 2003 to 2010; however, rates of utilization remained low.

Introduction
On April 1, 2007 Medicare Australia revised reimbursement guidelines for DXA for Australians aged ≥70 year; changes that were intended to increase the proportion of older adults being tested. We examined whether changes to reimbursement increased DXA referrals in older adults, and whether any sex differences in referrals were observed in the Barwon Statistical Division.

Methods
Proportions of DXA referrals 2003–2010 based on the population at risk ascertained from Australian Census data and annual referral rates and rate ratios stratified by sex, year of DXA, and 5-year age groups. Persons aged ≥70 years referred to the major public health service provider for DXA clinical purposes (n = 6,096; 21 % men).

Results
DXA referrals. Proportions of DXA referrals for men doubled from 0.8 % (2003) to 1.8 % (2010) and tripled from 2.0 to 6.3 % for women (all p < 0.001). For 2003–2006, referral ratios of men/women ranged between 1:1.9 and 1:3.0 and for 2007–2010 were 1:2.3 to 1:3.4. Referral ratios <2007:≥2007 were 1:1.7 for men aged 70–79 years (p < 0.001), 1:1.2 for men aged 80–84 years (p = 0.06), and 1:1.3 for men 85+ years (p = 0.16). For women, the ratios <2007:≥2007 were 1:2.1 (70–79 years), 1.1.5 (80–84 years), and 1:1.4 (85+ years) (all p < 0.001).

Conclusions
DXA referral ratios were 1:1.6 (men) and 1:1.8 (women) for 2007–2010 vs. 2003–2006; proportions of referrals doubled for men and tripled for women from 2003 to 2010. Overall, rates of DXA utilization remained low. Policy changes may have had minimal influence on referral; thus, ongoing evaluation over time is warranted.

Therapeutic approaches to disease modifying therapy for multiple sclerosis in adults: an Australian and New Zealand perspective: part 3 treatment practicalities and recommendations

In this third and final part of our review of multiple sclerosis (MS) treatment we look at the practical day-to-day management issues that are likely to influence individual treatment decisions. Whilst efficacy is clearly of considerable importance, tolerability and the potential for adverse effects often play a significant role in informing individual patient decisions. Here we review the issues surrounding switching between therapies, and the evidence to assist guiding the choice of therapy to change to and when to change. We review the current level of evidence with regards to the management of women in their child-bearing years with regards to recommendations about treatment during pregnancy and whilst breast feeding. We provide a summary of recommended pre- and post-treatment monitoring for the available therapies and review the evidence with regards to the value of testing for antibodies which are known to be neutralising for some therapies. We review the occurrence of adverse events, both the more common and troublesome effects and those that are less common but have potentially much more serious outcomes. Ways of mitigating these risks and managing the more troublesome adverse effects are also reviewed. Finally, we make specific recommendations with regards to the treatment of MS. It is an exciting time in the world of MS neurology and the prospects for further advances in coming years are high.

Digital material representation and testing of metal foams

In recent years, metal foams are becoming more and more popular due to their high energy absorption ability and low density, which are being widely used in automotive engineering and aerospace engineering. As a design guide, foams can be characterised by several main geometric parameters, such as pore size, pore shape, spatial distribution and arrangement and so on. Considering most foam materials have random distributions of cell size and cell shape, the digital material representation and modelling of such materials become more complex. Cell size and shape effects on mechanical behaviours of metal foams have been found and investigated numerically and experimentally in authors' previous studies in which the authors have developed a digital framework for the representation, modelling and evaluation of multi-phase materials including metal foams. In this study, 2-/3-D finite element models are both developed to represent metal foams with random cell distributions and then a series of digital testing are simulated to investigate the mechanical behaviours of such foams. For validation and verification purpose, the results obtained from 2-/3-D models have been compared and good agreement has been found which demonstrated the effectiveness of the digital framework developed for metal forms. © (2014) Trans Tech Publications, Switzerland.

The methodology in empirical sales ethics research: 1980-2010

The study examines the research methodology of more than 200 empirical investigations of ethics in personal selling and sales management between 1980 and 2010. The review discusses the sources and authorship of the sales ethics research. To better understand the drivers of empirical sales ethics research, the foundations used in business, marketing, and sales ethics are compared. The use of hypotheses, operationalization, measurement, population and sampling decisions, research design, and statistical analysis techniques were examined as part of theory development and testing. The review establishes a benchmark, assesses the status and direction of the sales ethics research methodology, and helps inform researchers who need to deal with increasing amounts of empirical research. The investigation identified changing sources of publication with the Journal of Business Ethics and the Journal of Personal Selling & Sales Management maintaining their position as the main conduit of high quality empirical sales ethics research. The results suggest that despite the use of theoretical models for empirical testing, a greater variety of moral frameworks and wider use of marketing exchange theory is needed. The review highlights many sound aspects about the empirical sales ethics research statistical methodology but also raises concerns about several areas. Ways in which these concerns might be addressed and recommendations for researchers are provided. © 2013 Springer Science+Business Media Dordrecht.

Some hypotheses on commonality in liquidity: new evidence from the Chinese stock market

In this article, we examine four specific hypotheses relating to commonality in liquidity on the Chinese stock markets. These hypotheses are (1) that market-wide liquidity determines liquidity of individual stocks; (2) that liquidity varies with firm size; (3) that sectoral-based liquidity affects individual stock liquidities differently; and (4) that commonality in liquidity has an asymmetric effect. Drawing on a two-year data set on the Shanghai and Shenzhen stock exchanges comprising over 34 million and 48 million transactions, respectively, we find strong support for commonality in liquidity and a greater influence of industry-wide liquidity in explaining liquidity of individual stocks. Moreover, our results suggest that of the three main sectors - financial, industrial, and resources - the industrial sectors liquidity is most important in explaining individual stock liquidities. Finally, we do not find any evidence of size effects and document an asymmetric effect of market-wide liquidity on liquidity of individual stocks.

Mobile application testing in industrial contexts: an exploratory multiple case-study

Recent empirical studies in the area of mobile application testing indicate the need for specific testing techniques and methods for mobile applications. This is due to mobile applications being significantly different than traditional web and desktop applications, particularly in terms of the physical constraints of mobile devices and the very different features of their operating systems. In this paper, we presented a multiple case-study involving four software development companies in the area of mobile and smartphones application. We aimed to identify testing techniques currently being applied by developers and challenges that they are facing. Our principle results are that many industrial teams seem to lack sufficient knowledge on how to test mobile applications, particularly in the areas of mobile application life-cycle conformance, context-awareness, and integration testing. We also found that there is no formal testing approach or methodology that can facilitate a development team to systematically test a critical mobile application.

Robot-assisted laparoscopic prostatectomy versus open radical retropubic prostatectomy: early outcomes from a randomised controlled phase 3 study

BACKGROUND: The absence of trial data comparing robot-assisted laparoscopic prostatectomy and open radical retropubic prostatectomy is a crucial knowledge gap in uro-oncology. We aimed to compare these two approaches in terms of functional and oncological outcomes and report the early postoperative outcomes at 12 weeks. METHOD: In this randomised controlled phase 3 study, men who had newly diagnosed clinically localised prostate cancer and who had chosen surgery as their treatment approach, were able to read and speak English, had no previous history of head injury, dementia, or psychiatric illness or no other concurrent cancer, had an estimated life expectancy of 10 years or more, and were aged between 35 years and 70 years were eligible and recruited from the Royal Brisbane and Women's Hospital (Brisbane, QLD). Participants were randomly assigned (1:1) to receive either robot-assisted laparoscopic prostatectomy or radical retropubic prostatectomy. Randomisation was computer generated and occurred in blocks of ten. This was an open trial; however, study investigators involved in data analysis were masked to each patient's condition. Further, a masked central pathologist reviewed the biopsy and radical prostatectomy specimens. Primary outcomes were urinary function (urinary domain of EPIC) and sexual function (sexual domain of EPIC and IIEF) at 6 weeks, 12 weeks, and 24 months and oncological outcome (positive surgical margin status and biochemical and imaging evidence of progression at 24 months). The trial was powered to assess health-related and domain-specific quality of life outcomes over 24 months. We report here the early outcomes at 6 weeks and 12 weeks. The per-protocol populations were included in the primary and safety analyses. This trial was registered with the Australian New Zealand Clinical Trials Registry (ANZCTR), number ACTRN12611000661976. FINDINGS: Between Aug 23, 2010, and Nov 25, 2014, 326 men were enrolled, of whom 163 were randomly assigned to radical retropubic prostatectomy and 163 to robot-assisted laparoscopic prostatectomy. 18 withdrew (12 assigned to radical retropubic prostatectomy and six assigned to robot-assisted laparoscopic prostatectomy); thus, 151 in the radical retropubic prostatectomy group proceeded to surgery and 157 in the robot-assisted laparoscopic prostatectomy group. 121 assigned to radical retropubic prostatectomy completed the 12 week questionnaire versus 131 assigned to robot-assisted laparoscopic prostatectomy. Urinary function scores did not differ significantly between the radical retropubic prostatectomy group and robot-assisted laparoscopic prostatectomy group at 6 weeks post-surgery (74·50 vs 71·10; p=0·09) or 12 weeks post-surgery (83·80 vs 82·50; p=0·48). Sexual function scores did not differ significantly between the radical retropubic prostatectomy group and robot-assisted laparoscopic prostatectomy group at 6 weeks post-surgery (30·70 vs 32·70; p=0·45) or 12 weeks post-surgery (35·00 vs 38·90; p=0·18). Equivalence testing on the difference between the proportion of positive surgical margins between the two groups (15 [10%] in the radical retropubic prostatectomy group vs 23 [15%] in the robot-assisted laparoscopic prostatectomy group) showed that equality between the two techniques could not be established based on a 90% CI with a Δ of 10%. However, a superiority test showed that the two proportions were not significantly different (p=0·21). 14 patients (9%) in the radical retropubic prostatectomy group versus six (4%) in the robot-assisted laparoscopic prostatectomy group had postoperative complications (p=0·052). 12 (8%) men receiving radical retropubic prostatectomy and three (2%) men receiving robot-assisted laparoscopic prostatectomy experienced intraoperative adverse events. INTERPRETATION: These two techniques yield similar functional outcomes at 12 weeks. Longer term follow-up is needed. In the interim, we encourage patients to choose an experienced surgeon they trust and with whom they have rapport, rather than a specific surgical approach. FUNDING: Cancer Council Queensland.

Genotoxicity evaluation of chlorpyrifos: a gender related approach in regular toxicity testing

The oral intubation of chlorpyrifos, an extensively used organophosphate insecticide, was tested for its capability to induce in vivo genotoxic upshot in blood lymphocytes of 24 male and female Wistar rats using biomarker of genotoxicity. Rats were orally administered with daily doses 3 and 12 mg/kg body weight (BW) of chlorpyrifos (CPF). The blood lymphocytes were harvested after 7 and 14 days of treatment and subjected to bi-nucleus (BN), multi-nucleus (MN) and single cell gel electrophoresis (comet assay) to evaluate the extent of DNA damage. Other than BN and MN assay, damage to DNA was assessed through comet length, height, area, head diameter, head DNA percentage and tail DNA percentage along with tail movement. A significant boost was noticed in the frequency of BN cells formation after 12 mg/kg BW CPF treatment. However, the propensity to produce MN cells was significantly more (P ≤ 0.05) in males than that of females. Likewise, the frequency of comet formation, mean comet length, height and area were more (P ≤ 0.05) in males than females even with 12 mg/kgBW. Comet head DNA % and tail length remained non-significant. Olive movement also revealed a significant increase (P ≤ 0.05) in males than females. The study inferred that the CPF can induce DNA damage in both male and female subjects but more pronounced in the male individuals.

Persistent and contemporaneous effects of job stressors on mental health: a study testing multiple analytic approaches across 13 waves of annually collected cohort data

OBJECTIVES: This study investigated the extent that psychosocial job stressors had lasting effects on a scaled measure of mental health. We applied econometric approaches to a longitudinal cohort to: (1) control for unmeasured individual effects; (2) assess the role of prior (lagged) exposures of job stressors on mental health and (3) the persistence of mental health.

METHODS: We used a panel study with 13 annual waves and applied fixed-effects, first-difference and fixed-effects Arellano-Bond models. The Short Form 36 (SF-36) Mental Health Component Summary score was the outcome variable and the key exposures included: job control, job demands, job insecurity and fairness of pay.

RESULTS: Results from the Arellano-Bond models suggest that greater fairness of pay (β-coefficient 0.34, 95% CI 0.23 to 0.45), job control (β-coefficient 0.15, 95% CI 0.10 to 0.20) and job security (β-coefficient 0.37, 95% CI 0.32 to 0.42) were contemporaneously associated with better mental health. Similar results were found for the fixed-effects and first-difference models. The Arellano-Bond model also showed persistent effects of individual mental health, whereby individuals' previous reports of mental health were related to their reporting in subsequent waves. The estimated long-run impact of job demands on mental health increased after accounting for time-related dynamics, while there were more minimal impacts for the other job stressor variables.

CONCLUSIONS: Our results showed that the majority of the effects of psychosocial job stressors on a scaled measure of mental health are contemporaneous except for job demands where accounting for the lagged dynamics was important.