Doing the right thing at the right time: Assessing responses to patient deterioration in electronic simulation scenarios using course-of-action analysis

International studies indicate that the recognition and management of deteriorating patients in hospitals are poor and that patient assessment is often inadequate. Face-to-face simulation programs have been shown to have an impact on educational and clinical outcomes; however, little is known about performance in contemporary healthcare e-simulation approaches. Using data from an open-access Web-based patient deterioration program (FIRSTACTWeb), the performance of 367 Australian nursing students in identification of treatment priorities and clinical actions was analyzed using a military model of Course of Action Simulation Analysis. Participants' performance in the whole program demonstrated a significant improvement in knowledge and skills (P ≤ .001) with high levels of participant satisfaction. Course of Action Simulation Analysis modeling identified three key participant groupings within which only 18% took the "best course of action" (the right actions and timing), with most (70%) completing the right actions but in the wrong order. The remaining 12% produced incomplete assessments and actions in an incorrect sequence. Contemporary approaches such as e-simulation do enhance educational outcomes. Measurement of performance when combined with Course of Action Simulation Analysis becomes a useful tool in the description of outcomes, an understanding of decision making, and the prediction of future events.

Diet and bipolar disorder: a review of its relationship and potential therapeutic mechanisms of action

OBJECTIVES: It is well accepted that diet quality has an important role in the prevention and treatment of several physical diseases. However, its influence on mental health has received far less attention, although there is increasing evidence to support a relationship with depression. In this narrative review, investigations into the relationship between diet and bipolar disorder are examined and the potential implications in the management and treatment of bipolar disorder are reviewed. METHODS: The authors provide a narrative review of the relevant information. RESULTS: Research is limited, although there are preliminary findings to suggest a relationship between diet and bipolar disorder. Findings from cross-sectional research suggest that people with bipolar disorder consume an unhealthier dietary pattern. This has significant treatment implications as bipolar disorder has a high comorbidity with several physical diseases. In addition, diet also influences several biological processes that are dysregulated in bipolar disorder, namely monoaminergic activity, immune/inflammatory processes, oxidative stress, mitochondrial activity, and neuroprogression. CONCLUSIONS: The role of diet in bipolar disorder requires further attention in research as it presents as a factor that may contribute to the worsening course of this condition and may potentially enhance current treatment outcomes.

Finding line of action of the force exerted on erect spine based on lateral bending test in personalization of scoliotic spine models

In multi-body models of scoliotic spine, personalization of mechanical properties of joints significantly improves reconstruction of the spine shape. In personalization methods based on lateral bending test, simulation of bending positions is an essential step. To simulate, a force is exerted on the spine model in the erect position. The line of action of the force affects the moment of the force about the joints and thus, if not correctly identified, causes over/underestimation of mechanical properties. Therefore, we aimed to identify the line of action, which has got little attention in previous studies. An in-depth analysis was performed on the scoliotic spine movement from the erect to four spine positions in the frontal plane by using pre-operative X-rays of 18 adolescent idiopathic scoliosis (AIS) patients. To study the movement, the spine curvature was considered as a 2D chain of micro-scale motion segments (MMSs) comprising rigid links and 1-degree-of-freedom (DOF) rotary joints. It was found that two MMSs representing the inflection points of the erect spine had almost no rotation (0.0028° ± 0.0021°) in the movement. The small rotation can be justified by weak moment of the force about these MMSs due to very small moment arm. Therefore, in the frontal plane, the line of action of the force to simulate the left/right bending position was defined as the line that passes through these MMSs in the left/right bending position. Through personalization of a 3D spine model for our patients, we demonstrated that our line of action could result in good estimates of the spine shape in the bending positions and other positions not included in the personalization, supporting our proposed line of action.

Bacterial modes of action for enhancing of plant growth

The greatest issue affecting the sustainability of broad acre cropping both environmentally and economically is the requirement of fertilizers. These are based on mined phosphorous or other mineral ores, ammonia produced through the Harbour-Bosch process and industrially manufactured potash. As global demand for fertilizers increases, the costs associated with the production for each of these major nutrients increases. Biofertilizers such as plant growth promoting bacteria (PGPB) are a possible biotechnology that could alleviate the need for addition of increasing amounts of fertilizers. These bacteria naturally occur in soils and aggressively colonize around plant roots and have been shown to have plant growth promoting effects. PGPB are known to influence plant growth by various direct and indirect mechanisms; while some can affect plant physiology directly by mimicking synthesis of plant hormones,others increase mineral availability and nitrogen content in soil. Here we review the previously characterized modes of action for enhancement of plant growth by PGPB such as nitrogen fixation, nutrient solubilization and production of auxins and enzymes, as well as discussing more recent proposed modes of action such as secondary metabolites.

New dibutyltin(IV) ladders: syntheses, structures and, optimization and evaluation of cytotoxic potential employing A375 (melanoma) and HCT116 (colon carcinoma) cell lines in vitro

Synthesis and spectroscopic properties of seven new dibutyltin(IV) compounds of 2-{(E)-4-hydroxy-3-[(E)-4-(aryl)iminomethyl]phenyldiazenyl}benzoic acids (L(n)HH'; n=2-8) with general formula {[Bu2Sn(L(n)H)]2O}2 (1-7) are reported. The compounds were characterized by elemental analysis and by UV-Visible, fluorescence, IR, (1)H, (13)C and (119)Sn NMR spectroscopies. Solid state structures of dibutyltin(IV) compounds 1-3, 6 and 7 were accomplished from single crystal X-ray crystallography which reveal the common ladder-type structure with two endo- and two exo-Sn atoms. The redox properties of L(n)HH' (n=2-4, 7 and 8) and their diorganotin(IV) compounds 1-3, 6 and 7 were also investigated by cyclic voltammetry. In general, the dibutyltin(IV) derivatives exhibited significant in vitro cytotoxic potency towards A375 (melanoma) and HCT116 (colon carcinoma) cell lines as determined by several experiments, like Live and Dead assay, MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) cell viability assay, LDH (lactate dehydrogenase), cleavage of caspases and PARP (poly(ADP-ribose)polymerase), and DNA fragmentation. Dibutyltin(IV) compounds increase cell death without cytolysis and decreases membrane fluidity, without interfering with p53. Among the dibutyltin(IV) compounds, compound 6 was found to be the most potent, with an IC50 value of 78nM. A mechanism of action for tumor cell death is proposed.

Wallace lines in eastern Gondwana : palaeobiogeography of Australasian permian brachipoda

The present Australian continent was a major component of the north eastern peninsula of Gondwana, itself the southern region of Pangaea, during the Permian period. Surrounding what is now Australia, were additional elements of north eastern Gondwana that are now incorporated into the tectonically complex regions of New Zealand, New Caledonia, the island of New Guinea, Timor, south east Asia, the Himalaya and southern Tibet. India was to the west and south west and Antarctica to the south. Marine water temperatures ranged from cold to temperate and tropical as Permian global climates ameliorated, global surface ocean circulation systems warmed, and due to rifting and northward drifting of some terranes.

Provincialism of global marine faunas was pronounced during the Permian and hence refined biostratigraphical correlations are often fraught with difficulty. The 'middle' Permian stratotypes approved by the International Subcommission on the Permian System have little direct relevance to correlations within the Gondwanan Region at the level of operational biostratigraphical zonal schemes. Brachiopoda are a dominant marine benthonic faunal element of Permian Gondwanan faunas and they provide refined correlations between marine basins within a specific faunal province. Modem faunal provinces are recognised by the distribution patterns of species and genera belonging to a single family or superfamily such as the Papilionoidea within the Insecta. This review provides an example from Permian Brachiopoda, using the distribution data of genera and subgenera of the superfamily Ingelarelloidea, in order to demonstrate the ability to define provinces and their 'Wallace lines' of demarcation between provinces in the geological past.

Investigation into the diffusion of innovation in technical and further education : implementing e-mail through action research

This research project examined the diffusion of change within one Victorian TAFE Institute by engaging action research to facilitate implementation of e-mail technology. The theoretical framework involving the concepts of technology innovation and action research was enhanced with the aid of Rogers's (1983) model of the diffusion of the innovation process. Political and cultural factors made up the initiation phase of innovation, enabling the research to concentrate on the implementation phase of e-mail Roger's (1983) model also provided adopter categories that related to the findings of a Computer Attitude Survey that was conducted at The School of Mines and Industries Ballarat (SMB), now the University of Ballarat—TAFE Division since amalgamation on 1st January 1998. Despite management rhetoric about the need to utilise e-mail, Institute teaching staff lacked individual computers in their work areas and most were waiting to become connected to the Internet as late as 1997. According to the action research reports, many staff were resistant to the new e-mail facilities despite having access to personal computers whose numbers doubled annually. The action research project became focussed when action researchers realised that e-mail workshop training was ineffective and that staff required improved access. Improvement to processes within education through collaborative action research had earlier been achieved (McTaggart 1994), and this project actively engaged practitioners to facilitate decentralised e-mail training in the workplace through the action research spiral of planning, acting, observing and reflecting, before replanning. The action researchers * task was to find ways to improve the diffusion of e-mail throughout the Institute and to develop theoretical constructs. My research task was to determine whether action research could successfully facilitate e-mail throughout the Institute. A rich literature existed about technology use in education, technology teaching, gender issues, less about computerphobia, and none about 'e-mailphobia \ It seemed appropriate to pursue the issue of e-mailphobia since it was marginalised, or ignored in the literature. The major political and cultural influences on the technologising of SMB and e-mail introduction were complex, making it impossible to ascertain the relative degrees of influence held by Federal and State Governments, SMB's leadership or the local community, Nonetheless, with the implementation of e-mail, traditional ways were challenged as SMB's culture changed. E-mail training was identified as a staff professional development activity that had been largely unsuccessful. Action research is critical collaborative inquiry by reflective practitioners who are accountable for making the results of their inquiry public and who are self-evaluating of their practice while engaging participative problem-solving and continuing professional development (Zuber-Skerritt 1992, 1993). Action research was the methodology employed in researching e-mail implementation into SMB because it involved collaborative inquiry with colleagues as reflective practitioners. Thoughtful questions could best be explored using deconstructivist philosophy, in asking about the noise of silence, which issues were not addressed, what were the contradictions and who was being marginalised with e-mail usage within SMB. Reviewing literature on action research was complicated by its broad definition and by the variability of research (King & Lonnquist 1992), and yet action research as a research methodology was well represented in educational research literature, and provided a systematic and recognisable way for practitioners to conduct their research. On the basis of this study, it could be stated that action research facilitated the diffusion of e-mail technology into one TAFE Institute, despite the process being disappointingly slow. While the process in establishing the action research group was problematic, action researchers showed that a window of opportunity existed for decentralised diffusion of e-mail training,in preference to bureaucratically motivated 'workshops. Eight major findings, grouped under two broad headings were identified: the process of diffusion (planning, nature of the process, culture, politics) and outcomes of diffusion (categorising, e-mailphobia, the survey device and technology in education). The findings indicated that staff had little experience with e-mail and appeared not to recognise its benefits. While 54.1% did not agree that electronic means could be the preferred way to receive Institute memost some 13.7% admitted to problems with using the voice answering service on telephones. Some 43.3% thought e-mail would not improve their connectedness (how they related) to the Institute. A small percentage of staff had trouble with telephone voice-mail and a number of these were anxious computer users. Individualised tuition and peer support proved helpful to individual staff whom action researchers believed to be 'at risk', as determined from the results of a Computer Attitude Survey. An instructional strategy that fostered the development of self-regulation and peer support was valuable, but there was no measure of the effects of this action research program, other than in qualitative terms. Nevertheless, action research gave space to reflect on the nature of the underlying processes in adopting e-mail. Challenges faced by TAFE action researchers are integrally affected by the values within TAFE, which change constantly and have recently been extensive enough to be considered as a 'new paradigm'. The influence of competition policy, the training reform agenda and technologisation of training have challenged traditional TAFE values. Action research reported that many staff had little immediate professional reason to use e-mail Theoretical answers were submerged beneath practical professional concerns, which related back to how much time teachers had and whether they could benefit from e-mail. A need for the development of principles for the sound educational uses of e-mail increases with the internationalisation of education and an increasing awareness of cultural differences. The implications for conducting action research in TAFE are addressed under the two broad issues of power and pedagogy. Issues of power included gaining access, management's inability to overcome staff resistance to technology, changing TAFE values and using technology for conducting action research. Pedagogical issues included the recognition of educational above technological issues and training staff in action research. Finally, seventeen steps are suggested to overcome power and pedagogical impediments to the conduct of action research within TAFE. This action research project has provided greater insight into the difficulties of successfully introducing one culture-specific technology into one TAFE Institute. TAFE Institutes need to encourage more action research into their operations, and it is only then that -we can expect to answer the unanswered questions raised in this research project.

Action research in higher education : the advancement of university learning and teaching

This thesis aims to contribute to the improvement and advancement of university learning, teaching, and staff development; to integrate educational theory and the practice of university teaching; and to contribute to the establishment of a new, emerging paradigm in higher education. The strategy towards achieving these aims comprises (1) an alternative research methodology in the interpretive, non-positivist paradigm; (2) an integrated framework drawing on a variety of previously unrelated theories to form an alternative model of university education; and (3) reference to the dialectical relationship between educational theory and teaching practice and their integration through action research in higher education. The thesis is not so much a critique of the traditional paradigm and of existing functionalist-structuralist approaches to higher education, but more a development and clarification of an alternative, dialectical, human action approach to higher education. The original contribution of this thesis to the theory and practice of higher education lies in the development (1) of an alternative model of university education based on an integration of previously unrelated domains of theory; (2) of a theoretical model of professional development as action research (the CRASP Model: Critical attitude, Research into teaching, Accountability, Self-evaluation, Professionalism); and (3) of action research projects in higher education. Action research is research by the university teachers themselves into their teaching practice, i.e. into problems of the curriculum and student learning. The case studies included in and appended to this thesis show that in one educational setting at least it was possible to improve and advance university learning and teaching through action research. The evidence for this advancement is provided in a number of previously published case studies compiled in the Appendix.

Action research of cyclonic transactions in online management education

The aim of the research was to generate a cyclonic model for understanding the influences and processes of continuously improving management education in an environment rich in online learning technologies. The research questions were:
1. What is the nature of the cyclonic interactions observed in the transactions of a team of online management educators?
2. How might an understanding of cyclonic interactions
a. help refine action research, and
b. generate rich insight for online management education?
The methodology was an action research project. The research team worked in an online Master of Business Administration (MBA) to continuously develop teaching practice in one unit of the MBA. The methodology matched the objectives of the project, and the appropriate rigour associated with qualitative, interpretive research. The results showed that theories of systems and relational dynamics, adapted to hermeneutics and aligned with other learning theories, can be framed by the metaphor of a cyclone to conduct research into teaching practice and build upon the theory base in the field of online education.
Online management education is subject to reinterpretations. The cyclonic framework explains some of the changes. The project showed that a chaotic but organised cyclonic program development process in one particular MBA course was informative for and informed by the chaotic and cyclonic globalized business world. For the education of managers the cyclonic view was relevant. The approach was metaphorical and, therefore, opened new ways of seeing and speaking. Findings pertained to the nature of the cyclonic interactions, how an understanding of cyclonic interactions helped to refine action research, and how an understanding of cyclonic interactions helped generate rich insight for online management education.
It was found that it was the asymmetrical impetus of imperfection that created the examples of cyclonic learning spirals formed as double feedback loops for improved understanding. Online education in the action research required cyclical enhancement of connectedness by teachers, stronger emphasis on relational considerations in learning, and heightened expectations of collaboration by educators. It became possible to correlate earlier conceptions of action research with cyclonic categories and analyse the parallels with events in this action research project. Models were developed and presented to explain 3 cyclonic connections with hermeneutics, collaborative teaching, online resource
development, and the environment of online management.

Using action research to improve the quality of teaching in basic education in remote schools in PNG.

This paper discusses the use of action research with teachers in remote primary schools in PNG to provide sustainable professional learning to help improve the quality of schooling. It arises from an ADRA research project being undertaken by the authors. The paper describes the project’s research design and its implementation to investigate the introduction, implementation and feasibility of teachers using action research to solve their own problems related to providing basic education in remote communities. If successful, action research may prove to be an effective approach to sustaining professional learning communities in locations where traditional approaches and means of professional development are difficult or impossible to sustain.

The paper describes the research team’s approach to identifying and engaging schools in remote districts of Western and East Sepik provinces, surveying teachers in those districts about their professional learning needs and circumstances, identifying schools to trial action research, and to undertake the fieldwork to implement action research and to study its implementation. The teachers’ experiences with using action research are presented in the context of their particular research topics chosen for their school. To date, the findings suggest that teachers can use action research to help them improve the quality of the education they provide for children. However, the initiation and sustainability of such an action research approach is influenced by the capacities and commitment of head teachers and standards officers, in particular, valuing and understanding reflective practice and action research for professional learning in school communities.

Association of differential gene expression with imatinib mesylate and omacetaxine mepesuccinate toxicity in lymphoblastoid cell lines

Background

Imatinib mesylate is currently the drug of choice to treat chronic myeloid leukemia. However, patient resistance and cytotoxicity make secondary lines of treatment, such as omacetaxine mepesuccinate, a necessity. Given that drug cytotoxicity represents a major problem during treatment, it is essential to understand the biological pathways affected to better predict poor drug response and prioritize a treatment regime.
Methods

We conducted cell viability and gene expression assays to determine heritability and gene expression changes associated with imatinib and omacetaxine treatment of 55 non-cancerous lymphoblastoid cell lines, derived from 17 pedigrees. In total, 48,803 transcripts derived from Illumina Human WG-6 BeadChips were analyzed for each sample using SOLAR, whilst correcting for kinship structure.
Results

Cytotoxicity within cell lines was highly heritable following imatinib treatment (h2 = 0.60-0.73), but not omacetaxine treatment. Cell lines treated with an IC20 dose of imatinib or omacetaxine showed differential gene expression for 956 (1.96%) and 3,892 transcripts (7.97%), respectively; 395 of these (0.8%) were significantly influenced by both imatinib and omacetaxine treatment. k-means clustering and DAVID functional annotation showed expression changes in genes related to kinase binding and vacuole-related functions following imatinib treatment, whilst expression changes in genes related to cell division and apoptosis were evident following treatment with omacetaxine. The enrichment scores for these ontologies were very high (mostly >10).
Conclusions

Induction of gene expression changes related to different pathways following imatinib and omacetaxine treatment suggests that the cytotoxicity of such drugs may be differentially tolerated by individuals based on their genetic background.

Incorrigible and undisciplined lines in visual social research : ways of ‘writing’ and ‘drawing’ at the interstices

In this paper the author traces the possibilities afforded by engaging with the aesthetic, historic and socio-political nature of shodo (Japanese calligraphy) as an intersectional space. Shodo literally translated as 'the way of writing' is an artistic practice bringing together ink, brush and paper. It is simultaneously a juncture between studied discipline and an ongoing mediation of subjectivities. The calligrapher/writer/drawer communicates to the reader through the bold or subtle brush strokes, the pressure and movement at the completion of each stroke. The calligrapher/writer/drawer draws across the boundaries of text and image to meet the reader blurring the lines between subject and object. This discussion re-examines the hierarchical binaries of writing/drawing, text/image, self/Other as they play out from vanishing lines of distinction between truth and conjecture. Crossing these binaries opens up opportunity for decentring and questioning representational practice by enabling other possible meanings and practices to emerge (Lather, 2007). I work from a stance of theoretical promiscuity in order to disrupt constitutive discourses and restore the liminal in social research. Drawing across the fragments of research projects I illustrate the generative and speculative space of visualising pedascapes in educational research.

Growth of rotaviruses in continuous human and monkey cell lines that vary in their expression of integrins

Rotavirus replication occurs in vivo in intestinal epithelial cells. Cell lines fully permissive to rotavirus include kidney epithelial (MA104), colonic (Caco-2) and hepatic (HepG2) types. Previously, it has been shown that cellular integrins α2β1, α4β1 and αXβ2 are involved in rotavirus cell entry. As receptor usage is a major determinant of virus tropism, the levels of cell surface expression of these integrins have now been investigated by flow cytometry on cell lines of human (Caco-2, HepG2, RD, K562) and monkey (MA104, COS-7) origin in relation to cellular susceptibility to infection with monkey and human rotaviruses. Cells supporting any replication of human rotaviruses (RD, HepG2, Caco-2, COS-7 and MA104) expressed α2β1 and (when tested) αXβ2, whereas the non-permissive K562 cells did not express α2β1, α4β1 or αXβ2. Only RD cells expressed α4β1. Although SA11 grew to higher titres in RD, HepG2, Caco-2, COS-7 and MA104 cells, this virus still replicated at a low level in K562 cells. In all cell lines tested, SA11 replicated to higher titres than did human strains, consistent with the ability of SA11 to use sialic acids as alternative receptors. Levels of cell surface α2 integrin correlated with levels of rotavirus growth. The α2 integrin relative linear median fluorescence intensity on K562, RD, COS-7, MA104 and Caco-2 cells correlated linearly with the titre of SA11 produced in these cells at 20 h after infection at a multiplicity of 0·1, and the data best fitted a sigmoidal dose–response curve (r2=1·00, P=0·005). Thus, growth of rotaviruses in these cell lines correlates with their surface expression of α2β1 integrin and is consistent with their expression of αXβ2 and α4β1 integrins.