Non-retinal light stimulation and the human biological clock

Since 1998, debate has occurred over whether light synchronises the human biological clock through the visual system only, or if the light penetrating our skin is also influential. This thesis provides definitive, debate ending, evidence that skin exposure to even intensely bright light has no impact on circadian timing. The portfolio presents a review of the literature regarding the efficacy of dialectical behavior therapy as a treatment for borderline personality disorder, a summary of the proposed mechanisms of action on the various treatment components, and a description of the clinical application of the four 'skills training modules' via the use of four case study examples.

Differential response to resistance training in CHF according to ACE genotype

Background : The Angiotensin Converting Enzyme (ACE) gene may influence the risk of heart disease and the response to various forms of exercise training may be at least partly dependent on the ACE genotype. We aimed to determine the effect of ACE genotype on the response to moderate intensity circuit resistance training in chronic heart failure (CHF) patients.

Methods : The relationship between ACE genotype and the response to 11 weeks of resistance exercise training was determined in 37 CHF patients (New York Heart Association Functional Class = 2.3 ± 0.5; left ventricular ejection fraction 28 ± 7%; age 64 ± 12 years; 32:5 male:female) who were randomised to either resistance exercise (n = 19) or inactive control group (n = 18). Outcome measures included VO_2peak power output and muscle strength and endurance. ACE genotype was determined using standard methods.

Results : At baseline, patients who were homozygous for the I allele had higher VO_2peak (p = 0.02) and peak power (p = 0.003) compared to patients who were homozygous for the D allele. Patients with the D allele, who were randomised to resistance training, compared to non-exercising controls, had greater peak power increases (ID p < 0.001; DD p < 0.001) when compared with patients homozygous for the I allele, who did not improve. No significant genotype-dependent changes were observed in VO_2peak, muscle strength, muscle endurance or lactate threshold.

Conclusion : ACE genotype may have a role in exercise tolerance in CHF and could also influence the effectiveness of resistance training in this condition.

Individual factors associated with investigative interviewers' use of non-leading open-ended questions

This thesis represents one of the first research papers to examine individual factors and their association with best-practice investigative interviewing. Findings indicate that adherence to open-ended questioning (arguably one of the most important skills in child abuse interviewing) is largely the by-product of good training rather than personal attributes or job experience per se. maximising interviewer performance is crucial if the quality of evidence obtained from child witnesses is to improve on a global level.

Intervention for depression among palliative care patients and their families : a study protocol for evaluation of a training program for professional care staff

Background: Clinical depression is highly prevalent yet under-detected and under-treated in palliative care settings and is associated with a number of adverse medical and psychological outcomes for patients and their family members. This article presents a study protocol to evaluate a training intervention for non-physician palliative care staff to improve the recognition of depression and provide support for depressed patients and their family members. Details of the hypotheses and expected outcomes, study design, training program development and evaluation measures are described.
Methods and Design: A randomised controlled trial will be implemented across two palliative care services to evaluate the “Training program for professional carers to recognise and manage depression in palliative care settings”. Pre-, post- and three-month follow-up data will be collected to assess: the impact of the training on the knowledge, attitudes, self-efficacy and perceived barriers of palliative care staff when working with depression; referral rates for depression; and changes to staff practices. Quantitative and qualitative methods, in the form of self-report questionnaires and interviews with staff and family members, will be used to evaluate the effectiveness of the intervention.
Discussion: This study will determine the effectiveness of an intervention that aims to respond to the urgent need for innovative programs to target depression in the palliative care setting. The expected outcome of this study is the validation of an evidence-based training program to improve staff recognition and appropriate referrals for depression, as well as improve psychosocial support for depressed patients and their family members.

From training to artisanal practice : rethinking choreographic relationships in modern dance

In the first part of the twentieth century early modern dancers created both a new art form and the forms of group social organisation that were its condition of possibility. This paper critically examines the balletic and disciplinary ‘training’ model of dancer formation and proposes that the assumption of training in dance can obscure other ways of understanding dance-making relationships and other values in early modern dance. An ‘artisanal’ mode of production and knowledge transmission based on a non-binary relationship between ‘master’ and apprentice and occurring in a quasi-domestic and personalised space of some intimacy is proposed as a more pertinent way to think the enabling conditions of modern dance creation.

The place of information and communication technology-mediated consultations in primary care : GPs' perspectives

Background: New information and communication technologies such as email and text messaging have been shown to be useful in some aspects of primary care service delivery. Little is known about Scottish GPs’ attitudes towards the adoption of these technologies as routine consultation tools.

Objectives: To explore GPs’ perceptions of the potential place of new non-face-to-face consultation technologies in the routine delivery of primary care; to explore GPs’ perceived barriers to the introduction of these technologies and to identify the processes by which GPs feel that new consultation technologies could be incorporated into routine primary care.

Methods: Qualitative interview study: 20 in-depth semi-structured interviews carried out with maximum variation sample of GPs across Scotland.

Results: Whilst the face-to-face consultation was seen as central to much of the clinical and diagnostic work of primary care, many GPs were conditionally willing to consider using new technologies in the future, particularly to carry out administrative or less complex tasks and therefore maximize practice efficiency and patient convenience. Key considerations were access to appropriate training, IT support and medico-legal guidance.

Conclusions: GPs are conditionally willing to use new consultation media if clinically appropriate and if medico-legal and technical support is available.

E-simulations for the purpose of training forensic (investigative) interviewers

One of the most critical issues facing investigative organisations is how best to administer effective practice opportunities in investigative interviewing on a global scale. Interviewer evaluation research across the world has highlighted inadequacies in the adherence to and maintenance of best-practice interview approaches, and insufficient opportunities for practice and feedback are the major reasons attributed by experts for poor interviewer competency. “Unreal Interviewing: Virtual Forensic Interviewing of a Child” (an e-simulation created at Deakin University, Australia) was developed as a way to ‘expand the reach’ of trainers in the investigative interviewing area. The simulation enables trainers to provide ongoing professional development for forensic interviewers in dispersed work environments, without the financial burden on organisations of extracting large numbers of professionals from the workplace to the classroom. This chapter provides readers with: an overview of the key stages involved in the development of Unreal Interviewing and the education and technical decisions that needed to be made; and a review of the application of “Unreal Interviewing” in the training and continuing professional development of trainees in their workplace.

Reduction in corticospinal inhibition in the trained and untrained limb following unilateral leg strength training

This study used transcranial magnetic stimulation to measure the corticospinal responses following 8 weeks of unilateral leg strength training. Eighteen healthy, non-strength trained participants (14 male, 4 female; 18–35 years of age) were matched for age, gender, and pre-training strength; and assigned to a training or control group. The trained group participated in unilateral horizontal leg press strength training, progressively overloaded and wave periodised, thrice per week for 8 weeks. Testing occurred prior to the intervention, at the end of 4 weeks and at the completion of training at 8 weeks. Participants were tested in both legs for one repetition maximum strength, muscle thickness, maximal electromyography (EMG) activity, and corticospinal excitability and inhibition. No changes were observed in muscle thickness in either leg. The trained leg showed an increase in strength of 21.2% (P = 0.001) and 29.0% (P = 0.007, compared to pre-testing) whilst the untrained contralateral leg showed 17.4% (P = 0.01) and 20.4% (P = 0.004, compared to pre-testing) increases in strength at 4 and 8 weeks, respectively. EMG and corticospinal excitability did not change; however, corticospinal inhibition was significantly reduced by 17.7 ms (P = 0.003) and 17.3 ms (P = 0.001) at 4 and 8 weeks, respectively, in the trained leg, and 25.1 ms (P = 0.001) and 20.8 ms (P = 0.001) at 4 and 8 weeks, respectively, in the contralateral untrained leg. This data support the theory of corticospinal adaptations underpinning cross-education gains in the lower limbs following unilateral strength training.

Enhancing audio-haptic enabled novel dental training platform performance

Existing haptic and non-haptic dental simulators do not eliminate the problem of hand instability while using the haptic devices for training purpose. This paper reports an audio-haptic dental training platform, which uses a Hand Stability System to reduce the effect of nervousness and hand instability for trainee dental students. Maintaining the ease of implementation, application customizability and the cost factor, the proposed platform increases the training efficiency by enhancing the immersive haptic experience with hand stability. This haptic platform includes multiple angle viewing techniques, audio feedback and session recording for after action review. Trials using this preliminary platform reduced the effect of human nervousness and hand instability due to the customized design.

Collaborative care skills training workshops : helping carers cope with eating disorders from the UK to Australia

Purpose

The Collaborative Care Skills Training workshops, developed by Treasure and associates aim to improve the well-being, coping strategies and problem-solving skills of carers of someone with an eating disorder. Evidence has demonstrated the effectiveness of the workshops in the UK where it was developed. The aim of this pilot study was to examine whether conducting the workshops in different contexts by facilitators trained in its delivery could lead to similar impact.
Methods

The workshops were conducted with 15 carers in VIC, Australia and delivered by experienced health professionals trained in its content and delivery. A non-experimental research design with repeated measures was implemented. Quantitative data were collected at pre-and post-intervention and 8 weeks after completion of the workshops.
Results

Participation led to significant reductions in carers’ reported expressed emotion, dysfunctional coping, distress, burden and accommodation and enabling of the eating disorder behaviour, which were maintained at the 8-week follow-up.
Conclusion

Results suggest the workshops are effective in reducing carer distress and burden as well as modifying unhelpful emotional interactional styles when caring for family members with an eating disorder. The content of the workshops and its delivery, once experienced facilitators have received training, are transferable to other contexts.

Differentiated mTOR but not AMPK signaling after strength vs endurance exercise in training-accustomed individuals

The influence of adenosine mono phosphate (AMP)-activated protein kinase (AMPK) vs Akt-mammalian target of rapamycin C1 (mTORC1) protein signaling mechanisms on converting differentiated exercise into training specific adaptations is not well-established. To investigate this, human subjects were divided into endurance, strength, and non-exercise control groups. Data were obtained before and during post-exercise recovery from single-bout exercise, conducted with an exercise mode to which the exercise subjects were accustomed through 10 weeks of prior training. Blood and muscle samples were analyzed for plasma substrates and hormones and for muscle markers of AMPK and Akt-mTORC1 protein signaling. Increases in plasma glucose, insulin, growth hormone (GH), and insulin-like growth factor (IGF)-1, and in phosphorylated muscle phospho-Akt substrate (PAS) of 160 kDa, mTOR, 70 kDa ribosomal protein S6 kinase, eukaryotic initiation factor 4E, and glycogen synthase kinase 3α were observed after strength exercise. Increased phosphorylation of AMPK, histone deacetylase5 (HDAC5), cAMP response element-binding protein, and acetyl-CoA carboxylase (ACC) was observed after endurance exercise, but not differently from after strength exercise. No changes in protein phosphorylation were observed in non-exercise controls. Endurance training produced an increase in maximal oxygen uptake and a decrease in submaximal exercise heart rate, while strength training produced increases in muscle cross-sectional area and strength. No changes in basal levels of signaling proteins were observed in response to training. The results support that in training-accustomed individuals, mTORC1 signaling is preferentially activated after hypertrophy-inducing exercise, while AMPK signaling is less specific for differentiated exercise.

The effects of training on performance and performance-related states in individual elite athletes : a dynamic approach

There are difficulties undertaking controlled training studies with elite athletes. Thus, data from non-elite performers are often presented in scientific journals and subsequently used to guide general training principles. This information may not be transferable or specific enough to inform training practices in an individual elite athlete. However, the nature of athletic participation at elite levels provides the opportunity to collect training data, performance-related variables, and performance data of elite athletes over long periods. In this paper, we describe how dynamic linear models provide an opportunity to use these data to inform training. Data from an elite female triathlete collected over a 111-day training period were used to model the relationship between training and self-reported fatigue. The dynamic linear model analysis showed the independent effects of the three modes of triathlon training on fatigue, how these can change across time, and the possible influence of other unmeasured variables. This paper shows the potential for the use of dynamic linear models as an aid to planning training in elite athletes.

The design and implementation of a novel method for quantifying training loads in elite rowing: the T2minute method

Introduction: A systematic approach to managing the training of elite athletes is supported by accurate training load measurement. However, quantifying the training of elite Australian rowers is complex due to unique challenges: 1) the multi-centre, multi-state structure of the national program; 2) the variety of training undertaken, incorporating rowing-specific and non-specific modalities, with continuous and interval efforts that span the full intensity spectrum; and 3) the limitations of existing quantification methods for capturing total training loads undertaken from varied training. These challenges highlighted a need to create a consistent, location-independent framework for prescribing training in elite rowing, with a capacity to account for varied training. Methods: An in-house proprietary measure (the T2minute method) was developed at the National Rowing Centre of Excellence (NRCE), as a collaborative project between sport scientists and national squad coaches. The design phase was informed by assessments of the existing training measures, and built upon standardised intensity zones established at the Australian Institute of Sport. A common measurement unit was chosen: one T2minute equates to one minute of on-water single scull rowing at T2 intensity (∼60–72% VO2max). Each intensity zone was assigned a weighting factor according to the curvilinear relationship between power output, intensity, and blood lactate response. Each training mode was assigned a weighting factor based on whether coaches perceived it to be “harder” or “easier” than onwater rowing. With coaches’ feedback, the method was refined over a period of five months. The T2minute method was implemented as the core framework for prescribing training for elite Australian rowers throughout the 2009–2012 Olympic cycle. Results: The implementation of the T2minute method successfully established consistency with training prescription and monitoring practices within the NRCE high performance program. The national roll out this method has influenced rowing training methodology at elite and sub-elite levels in Australia. Since implementation, the method has undergone scientific validation. Further research is underway, utilising the method to explore complex relationships between rowers’ training and performance outcomes. Conclusion: The T2minute method is a novel approach that allows rowing coaches and sport scientists to utilise one consistent system to quantify load from varied training. Its implementation represents a considerable achievement in establishing a common framework for managing the training process within a complex organisational structure. This collaborative approach used to develop the T2minute method provides unique insight into the important considerations and practical challenges of applying training science to enhance elite sport performance.

Formation of cortical plasticity in older adults following tDCS and motor training

Neurodegeneration accompanies the process of natural aging, reducing the ability to perform functional daily activities. Transcranial direct current stimulation (tDCS) alters neuronal excitability and motor performance; however its beneficial effect on the induction of primary motor cortex (M1) plasticity in older adults is unclear. Moreover, little is known as to whether the tDCS electrode arrangement differentially affects M1 plasticity and motor performance in this population. In a double-blinded, cross-over trial, we compared unilateral, bilateral and sham tDCS combined with visuomotor tracking, on M1 plasticity and motor performance of the non-dominant upper limb, immediately post and 30 min following stimulation. We found (a) unilateral and bilateral tDCS decreased tracking error by 12–22% at both time points; with sham decreasing tracking error by 10% at 30 min only, (b) at both time points, motor evoked potentials (MEPs) were facilitated (38–54%) and short-interval intracortical inhibition was released (21–36%) for unilateral and bilateral conditions relative to sham, (c) there were no differences between unilateral and bilateral conditions for any measure. These findings suggest that tDCS modulated elements of M1 plasticity, which improved motor performance irrespective of the electrode arrangement. The results provide preliminary evidence indicating that tDCS is a safe non-invasive tool to preserve or improve neurological function and motor control in older adults.

O where are you going? O do you imagine? Reproduction and response : a reflexive sociology of scholarship of teaching and learning in practical legal training

My doctoral research studies Australian PLT practitioners’ engagement with scholarship of teaching and learning. I argue that many PLT practitioners are motivated to engage with scholarship of teaching and learning in their work. There are, however, individual and extra-individual impediments.
PLT practitioners are lawyers that teach in institutional practical legal training (“PLT”). Satisfactory completion of mandatory PLT is an eligibility requirement for admission to the Australian legal profession. The PLT requirement is additional to academic legal qualifications. PLT is undertaken at a post-graduate level with, or after, the academic law degree.
My study investigates PLT practitioners’ motivations and capabilities to engage with scholarship of teaching and learning (“SoTL”). I study organisational symbolic support for SoTL in PLT, and organisational allocation of resources to SoTL in PLT.
The study involves individual and extra-individual domains of PLT practitioners’ work. It considers how social structures (e.g. “the juridical”) are inscribed into individuals’ practices (“teaching”) and, conversely, whether practices influence social structures.
My research adopts qualitative methodologies. These involve inter-disciplinary exchanges between law, legal education, practice research, sociology of law, cultural theory, and theory and practice of teaching and learning. My theoretical framework draws on Pierre Bourdieu’s “reflexive sociology”, and Michel de Certeau’s “heterological science”.
I sourced data from documents, and semi-structured interviews with 36 Australian PLT practitioners. Documentary sources include statutory instruments, speeches, reports, practice directions, histories, and scholarly publications.
To analyse the data I adopted Kelle’s characterisation of “theoretical sensitivity”, drawing on “explicit” and “emergent” analysis strategies derived from “grounded theory”. The explicit strategies were based on my theoretical framework. The emergent strategy involved sensitivity to non-explicit concepts and theories that emerged from the data. Computer-aided qualitative data analysis software expedited these methods.
My findings to date question dominant legal structures’ readiness for change, the implications of this for teaching and learning in PLT, and in particular for PLT practitioners’ engagement with SoTL in PLT.
The espoused rationale for mandatory PLT (in statutes) is improvement for the protection of clients, the administration of justice, and to assure quality legal services. The tacit rationale is improved quality of legal education, and experiences, for lawyers-to-be. My thesis argues dominant structures in legal education impede the espoused and tacit objectives, and impede PLT practitioners’ engagement with scholarship of teaching and learning.