Multidisciplinary review of teaching and assessing competency attainment by non-medical prescribers

Background Prescribing is a complex task, requiring specific knowledge and skills, and the execution of effective, context-specific clinical reasoning. Systematic reviews indicate medical prescribing errors have a median rate of 7% [IQR 2%-14%] of medication orders [1-3]. For podiatrists pursuing prescribing rights, a clear need exists to ensure practitioners develop a well-defined set of prescribing skills, which will contribute to competent, safe and appropriate practice. Aim To investigate the methods employed to teach and assess the principles of effective prescribing in the undergraduate podiatry program and compare and contrast these findings with four other non-medical professions who undertake prescribing after training at Queensland University of Technology. Method The NPS National Prescribing Competency Standards were employed as the prescribing standard. A curriculum mapping exercise was undertaken to determine whether the prescribing principles articulated in the competency standards were addressed by each profession. Results A range of methods are currently utilised to teach prescribing across disciplines. Application of prescribing competencies to the context of each profession appears to influence the teaching methods used. Most competencies were taught using a multimodal format, including interactive lectures, self-directed learning, tutorial sessions and clinical placement. In particular clinical training was identified as the most consistent form of educating safe prescribers across all five disciplines. Assessment of prescribing competency utilised multiple techniques including written and oral examinations and research tasks, case studies, objective structured clinical examination exercises and the assessment of clinical practice. Effective and reliable assessment of prescribing undertaken by students in diverse settings remains challenging e.g. that occurring in the clinical practice environment. Conclusion Recommendations were made to refine curricula and to promote efficient cross-discipline teaching by staff from the disciplines of podiatry, pharmacy, nurse practitioner, optometry and paramedic science. Students now experience a sophisticated level of multidisciplinary learning in the clinical setting which integrates the expertise and skills of experience prescribers combined with innovative information technology platforms (CCTV and live patient assessments). Further work is required to establish a practical, effective approach to the assessment of prescribing competence especially between the university and clinical settings.

Yhden äänen muotokuvia : Queer-luentoja Marguerite Yourcenarin teoksista

The present dissertation belongs to the tradition of queer theoretical and feminist literary scholarship. The study deals with the literary works of Marguerite Yourcenar (1903-1987), who was the first woman ever to be elected to the French Academy. The study seeks to lead an acclaimed classical French author into a dialogue with the characteristically Anglo-American queer theory and American tradition of queering Lacanian psychoanalysis. Queering the psychoanalytic notions of homosexuality and the categories of perversion and pervert will be elaborated in the present study. The main corpus of the scrutiny consists of five pieces of fiction written in French by Yourcenar. The first person narration and especially récit genre maintain a narrative strategy that the study explores with reference to the representations of non-normative genders and sexualities. Analyzing various radically queer aspects of Yourcenar's texts, the study focuses on the topical questions of masculinity in men, women, and texts. The study also discusses the representations of sexual desire between men, and the various constructions of male homosexuality in Yourcenar's fiction. The present study addresses Yourcenar's fiction from the points of view of female masculinity and textual female masculinity. The investigation finds its study questions and methodology in the area of queer studies, especially queer theoretical literary scholarship and the queer history and historiography of sexuality. That is why the study approaches Yourcenar's fiction in the context of historical and literary representations of male homosexual love and desire. The articulation of the closet, or textual and discursive strategies of sexual secrecy especially concerning male homosexuality, is simultaneously constructed and deconstructed in Yourcenar's fiction, as the analysis indicates. The study analyzes the Yourcenarian queer textual strategies with reference to concepts such as the epistemology and rhetoric of the closet, and the structure of the open secret as a part of the rhetoric of queer or non-straight sexuality. The present investigation puts the queer, non-normative representations of gender and sexuality in the centre of the Yourcenarian oeuvre and studies, ascertaining the strong bond between Yourcenar's work and the history, tradition, and the modern strategies of representing male homosexuality and queerness.

Minästä toiseen : Lacanilaisen subjektin syntymä Anaïs Ninin House of Incestissä ja Hélène Cixous'n Dedans'issa

The study approaches two modern novels using the conceptual frame of Lacanian psychoanalysis, especially the Lacanian notion of subject. The novels can be described as subversive “Bildungsromans” (development novels) highly influenced by psychoanalytic thought. Anaïs Nin’s (1903—1977) “poetic novel” House of Incest (1936) is a story of sexual and artistic awakening while Hélène Cixous’s (b. 1937) first novel Dedans (1969) depicts the growth of a little girl whose father dies. Both are first novels and first person narratives. Concentrating in the narrator’s internal life the novels writings break with the realistic conventions of narrative, bringing forth the themes of anguish, alienation from the world and escape into the prison like realm of the self. The study follows roughly the Lacanian process of becoming a subject. Each chapter opens up with a quick introduction to the Lacanian concepts used in the following part that analyses the novels. The study can thus also be used as a brief introduction to Lacanian theory in finnish. The psychoanalytic narrative/story of the birth of the subject and the novels stories can be seen as mirroring each other. The method of the study is thus based on a dialogue between the theoretical concepts and the analyses. Novels are being approached as texts that break with the Cartesian notion of an autonomous subject making room for a dialectics of self and other, for a movement in which the “I” builds an identity mirroring itself with others. While both of the novels recount the birth of a character called I, they also have a first person narrator apart from the character “I”. Having constituted the self’s identity, the narrator finds from inside of the self also an other or “you” – this discovery is the final clue to the coffin of the autonomous self. From the Lacanian perspective man’s great Other is the order of language, Symbolic, which constitutes the individual, the speaking subject. Using this perspective the novels are interpreted as describing the process of becoming a subject of the Symbolic; subjected to Symbolic order. This “birth process” happens in particular in the Imaginary register, where the self’s identity is built. In the Imaginary or Mirror phase the “I” mirrors himself with different others (e.g. with his mirror image and the family members, the surrounding others) learning to see his body and his selfhood both as familiar and strange, other. In the Imaginary phase the novels’ characters are also trying to deal with the opposite realm of the Symcolic, the Real. The Lacanian Real is not the reality “before words” but a reality left over from the Symbolic, aside of it but constituted by the Symbolic, to be deducted only from within it. In the novels the Real is experienced as a womblike state where the self is immersed in the other’s body. The process of coming a subject of the Symbolic is depicted also as a process of renouncing the “dream of the womb”, which, if realized, could only mean the non-existence of the subject, i.e. death. The study concentrates on analysing the novels’ writing, where meanings are constantly changing: “I” becomes you, the father becomes a mother, inside becomes outside. This technique enables also the deconstruction of certain opposing notions in the novels. The Lacanian point of view exposes language as a constantly moving universe where the subject has no more stability than the momentary meanings language creates. The self’s identity depicted in the novels is a Lacanian fixed identity, whose growth is necessary but opposes the flux imminent to the Symbolic. The anguish experienced in the novels, in the “house of incest” or “inside”, is due to clinging on the unchanging “I”. However, the writing of the novels shows how the meaning of the “I” changes constantly and the fixity thus becomes movement. This way House of Incest and Dedans, despite their pessimistic stories, manage to create an image of a new, moving subject.

Identification of viral and non-viral reverse transcribing elements in pineapple ( Ananas comosus ), including members of two new badnavirus species

A previously published partial sequence of pineapple bacilliform virus was shown to be from a retrotransposon (family Metaviridae) and not from a badnavirus as previously thought. Two newly discovered sequence groups isolated from pineapple were associated with bacilliform virions and were transmitted by mealybugs. Phylogenetic analyses indicated that they were members of new badnavirus species. A third caulimovirid sequence was also amplified from pineapple, but available evidence suggests that this DNA is not encapsidated, but more likely derived from an endogenous virus.

Non-target impacts of poison baiting for predator control in Australia

1. Mammalian predators are controlled by poison baiting in many parts of the world, often to alleviate their impacts on agriculture or the environment. Although predator control can have substantial benefits, the poisons used may also be potentially harmful to other wildlife. 2. Impacts on non-target species must be minimized, but can be difficult to predict or quantify. Species and individuals vary in their sensitivity to toxins and their propensity to consume poison baits, while populations vary in their resilience. Wildlife populations can accrue benefits from predator control, which outweigh the occasional deaths of non-target animals. We review recent advances in Australia, providing a framework for assessing non-target effects of poisoning operations and for developing techniques to minimize such effects. We also emphasize that weak or circumstantial evidence of non-target effects can be misleading. 3. Weak evidence that poison baiting presents a potential risk to non-target species comes from measuring the sensitivity of species to the toxin in the laboratory. More convincing evidence may be obtained by quantifying susceptibility in the field. This requires detailed information on the propensity of animals to locate and consume poison baits, as well as the likelihood of mortality if baits are consumed. Still stronger evidence may be obtained if predator baiting causes non-target mortality in the field (with toxin detected by post-mortem examination). Conclusive proof of a negative impact on populations of non-target species can be obtained only if any observed non-target mortality is followed by sustained reductions in population density. 4. Such proof is difficult to obtain and the possibility of a population-level impact cannot be reliably confirmed or dismissed without rigorous trials. In the absence of conclusive evidence, wildlife managers should adopt a precautionary approach which seeks to minimize potential risk to non-target individuals, while clarifying population-level effects through continued research.

Strategically Pleading Intentional Torts in medical cases

The opportunities and challenges faced by litigants who strategically plead intentional torts are borne out by two recent medical cases. Both arose out of dental treatment. Dean v Phung established some key principles which were clarified in White v Johnston. Before considering those two cases it is worth examining the environment in which such intentional torts claims now exist. Following the Ipp Review of the Law of Negligence, non-uniform legislative changes to the law of negligence were introduced across Australia which have imposed limitations on liability and quantum of damages in cases where a person has been injured through the fault of another. While it seems that, given the limitation of the scope of the review and recommendations to negligently caused damage, the Ipp Review reforms were meant to be limited to injury resulting from negligent acts rather than intentional torts, the extent to which the civil liability legislation applies to intentional torts differs across Australia.

Fusion transcript loci share many genomic features with non-fusion loci

Background Fusion transcripts are found in many tissues and have the potential to create novel functional products. Here, we investigate the genomic sequences around fusion junctions to better understand the transcriptional mechanisms mediating fusion transcription/splicing. We analyzed data from prostate (cancer) cells as previous studies have shown extensively that these cells readily undergo fusion transcription. Results We used the FusionMap program to identify high-confidence fusion transcripts from RNAseq data. The RNAseq datasets were from our (N = 8) and other (N = 14) clinical prostate tumors with adjacent non-cancer cells, and from the LNCaP prostate cancer cell line that were mock-, androgen- (DHT), and anti-androgen- (bicalutamide, enzalutamide) treated. In total, 185 fusion transcripts were identified from all RNAseq datasets. The majority (76 %) of these fusion transcripts were ‘read-through chimeras’ derived from adjacent genes in the genome. Characterization of sequences at fusion loci were carried out using a combination of the FusionMap program, custom Perl scripts, and the RNAfold program. Our computational analysis indicated that most fusion junctions (76 %) use the consensus GT-AG intron donor-acceptor splice site, and most fusion transcripts (85 %) maintained the open reading frame. We assessed whether parental genes of fusion transcripts have the potential to form complementary base pairing between parental genes which might bring them into physical proximity. Our computational analysis of sequences flanking fusion junctions at parental loci indicate that these loci have a similar propensity as non-fusion loci to hybridize. The abundance of repetitive sequences at fusion and non-fusion loci was also investigated given that SINE repeats are involved in aberrant gene transcription. We found few instances of repetitive sequences at both fusion and non-fusion junctions. Finally, RT-qPCR was performed on RNA from both clinical prostate tumors and adjacent non-cancer cells (N = 7), and LNCaP cells treated as above to validate the expression of seven fusion transcripts and their respective parental genes. We reveal that fusion transcript expression is similar to the expression of parental genes. Conclusions Fusion transcripts maintain the open reading frame, and likely use the same transcriptional machinery as non-fusion transcripts as they share many genomic features at splice/fusion junctions.

Infinitiivi ja sen infiniittisyys : Tutkimus suomen kielen itsenäisistä A-infinitiivikonstruktioista

"Infinitive and its infinity" advocates an approach to infinitives that differs from most previous descriptions in several ways. Infinitives are generally considered to be an illustrative example of an inherently subordinated verb category. This is due to the fact that they are morphologically reduced and are allegedly not able to function as the only predicate of an independent clause. While former descriptions have thus treated infinitives as a linguistic category heavily dependent on the finite verb, my claim is that Finnish A-infinitives (e.g. juosta to run , olla to be ) can be used as independent grammatical units: they need not be either dependent or subordinated, but can have an equal status with finite constructions. In other words, they can be conceptually and interactionally non-dependent. Theoretically, the main objective of the thesis is to discover the nature of non-finite conceptualization and the ways in which it is utilized in everyday interactions. This is accomplished by contrasting finite and non-finite conceptualization with respect to the morphosyntactic marking of person, tense and modality. I argue that the morphologically reduced nature of infinitives can be used as an interactional resource. Independent A-infinitive constructions designate verbal processes that profile no participants, lack any connection with time, and present states of affairs as intensional, structural spaces. Consequently, they provide the interactants with a conceptual alternative in contrast to finite predications that are in Finnish always grammatically anchored to time, modality and person. The deictically unanchored character of A-infinitive constructions makes them highly affective and reflexive in nature. I discuss my findings primarily in the light of Cognitive Grammar. I have drawn insight from various other fields, too: among the theories that are touched upon are interactional linguistics, functional-typological linguistics, and studies on the poetic and metapragmatic use of language. The study is based on empirical data interpreted in qualitative terms. Analyses are based on 980 examples coming mainly from written language. Some 20 examples of spoken data are analyzed as well. In sum, the thesis presents a critical statement towards the finite-verb centred outlook on language and shows that analyzing non-finite elements as such reveals new aspects of grammar and interaction. This is to acknowledge the fact that infinitives, albeit prototypically participating in the coding of dependent events, can also be used outside of the context of the finite verb. Such a view poses several new research questions, as a linguistic category generally seen to code dependent, less prominent states of affairs , now is viewed on as possessing a full cognitive and pragmatic potential.

Drag på parnassen. Två sextiotalsstudier. : Del I: Medelklass med mänskligt ansikte. Medelklassradikalism i fyra romaner av Christer Kihlman, Jarl Sjöblom, Marianne Alopaeus och Ulla-Lena Lundberg. Del II: Modernistdebatten. Sak, person och fält i en finlandssvensk litteraturdebatt år 1965.

The objective of my dissertation Pull (or Draught, or Moves) at the Parnassus , is to provide a deeper understanding of Nordic Middle Class radicalism of the 1960 s as featured in Finland-Swedish literature. My approach is cultural materialist in a broad sense; social class is regarded a crucial aspect of the contents and contexts of the novels and literary discussions explored. In the first volume, Middle Class With A Human Face , novels by Christer Kihlman, Jarl Sjöblom, Marianne Alopaeus, and Ulla-Lena Lundberg, respectively, are read from the points of view of place, emotion, and power. The term "cryptotope" is used to designate the hidden places found to play an important role in all of these four narratives. Also, the "chronotope of the provincial small town", described by Mikhail Bakhtin in 1938, is exemplified in Kihlman s satirical novel, as is the chronotope of of war (Algeria, Vietnam) in those of Alopaeus and Lundberg s. All the four novels signal changes in the way general "scripts of emotions", e.g. jealousy, are handled and described. The power relations in the novels are also read, with reference to Michel Foucault. As the protagonists in two of them work as journalists, a critical discussion about media and Bourgeois hegemony is found; the term "repressive legitimation" is created to grasp these patterns of manipulation. The Modernist Debate , part II of the study, concerns a literary discussion between mainly Finland-Swedish authors and critics. Essayist Johannes Salminen (40) provided much of the fuel for the debate in 1963, questioning the relevance to contemporary life of the Finland-Swedish modernist tradition of the 1910 s and 1920 s. In 1965, a group of younger authors and critics, including poet Claes Andersson (28), followed up this critique in a debate taking place mainly in the newspaper Vasabladet. Poets Rabbe Enckell (62), Bo Carpelan (39) and others defended a timeless poetry. This debate is contextualized and the changing literary field is analyzed using concepts provided by sociologist Pierre Bourdieu. In the thesis, the historical moment of Middle Class radicalism with a human face is regarded a temporary luxury that new social groups could afford themselves, as long as they were knocking over the statues and symbols of the Old Bourgeoisie. This is not to say that all components of the Sixties strategy have lost their power. Some of them have survived and even grown, others remain latent in the gene bank of utopias, waiting for new moments of change.

Non-destructive assessment of Arundo donax (Poaceae) leaf quality

Leaf carbon (C) content, leaf nitrogen (N) content, and C:N ratio are especially useful for understanding plant-herbivore interactions and may be important in developing control methods for the invasive riparian plant Arundo donax L. We measured C content, N content, C:N ratio, and chlorophyll index (SPAD 502 reading) for 768 leaves from A. donax collected over a five year period at several locations in California, Nevada, and Texas. Leaf N was more variable than leaf C, and thus we developed a linear regression equation for estimating A. donax leaf N from the leaf chlorophyll index (SPAD reading). When applied to two independent data sets, the equation (leaf N content % = -0.63 + 0.08 x SPAD) produced realistic estimates that matched seasonal and spatial trends reported from a natural A. donax population. Used in conjunction with the handheld SPAD 502 meter, the equation provides a rapid, non-destructive method for estimating A. donax leaf quality.

J.W.Lindt’s Colonial man and Aborigine image from the GRAFTON ALBUM : “On chemistry and optics all does not depend, art must with these in triple union blend”

J.W.Lindt’s Colonial man and Aborigine image from the GRAFTON ALBUM: “On chemistry and optics all does not depend, art must with these in triple union blend” (text from J.W. Lindt’s photographic backing card) In this paper, I follow an argument that Lindt held a position in his particular colonial environment where he was simultaneously both an insider and an outsider and that such a position may be considered prerequisite in stimulating exchange. A study of the transition of J.W. Lindt in Grafton, N.S.W. in the 1860s from a traveller to a migrant and subsequently to a professional photographer, as well as Lindt’s photographic career, which evolved through strategic action and technical approaches to photography, bears witness to his cultural relativity. One untitled photograph from this period of work constructs a unique commentary of Australian colonial life that illustrates a non-hegemonic position, particularly as it was included in one of the first albums of photographs of Aborigines that Lindt gifted to an illustrious person (in this case the Mayor of Grafton). As in his other studio constructions, props and backdrops were arranged and sitters were positioned with care, but this photograph is the only one in the album that includes a non-Aborigine in a relationship to an Aborigine. An analysis of the props, technical details of the album and the image suggests a reconciliatory aspect that thwarts the predominant attitudes towards Aborigines in the area at that time.

Analysis of an internally mountable accelerometer balance system for use with non-isotropic models in shock tunnels

Knowledge of drag force is an important design parameter in aerodynamics. Measurement of aerodynamic forces at hypersonic speed is a challenge and usually ground test facilities like shock tunnels are used to carry out such tests. Accelerometer based force balances are commonly employed for measuring aerodynamic drag around bodies in hypersonic shock tunnels. In this study, we present an analysis of the effect of model material on the performance of an accelerometer balance used for measurement of drag in impulse facilities. From the experimental studies performed on models constructed out of Bakelite HYLEM and Aluminum, it is clear that the rigid body assumption does not hold good during the short testing duration available in shock tunnels. This is notwithstanding the fact that the rubber bush used for supporting the model allows unconstrained motion of the model during the short testing time available in the shock tunnel. The vibrations induced in the model on impact loading in the shock tunnel are damped out in metallic model, resulting in a smooth acceleration signal, while the signal become noisy and non-linear when we use non-isotropic materials like Bakelite HYLEM. This also implies that careful analysis and proper data reduction methodologies are necessary for measuring aerodynamic drag for non-metallic models in shock tunnels. The results from the drag measurements carried out using a 60 degrees half angle blunt cone is given in the present analysis.

A dosimetric retrospective planning study comparing volumetric arc therapy (VMAT) and stereotactic body radiotherapy (SBRT) treatment plans for non-small cell lung cancer (NSCLC)

Purpose A retrospective planning study comparing volumetric arc therapy (VMAT) and stereotactic body radiotherapy (SBRT) treatment plans for non-small cell lung cancer (NSCLC). Methods and materials Five randomly selected early stage lung cancer patients were included in the study. For each patient, four plans were created: the SBRT plan and three VMAT plans using different optimisation methodologies. A total of 20 different plans were evaluated. The dose parameters of dose conformity results and the target dose constraints results were compared for these plans. Results The mean planning target volume (PTV) for all the plans (SBRT and VMAT) was 18·3 cm3, with a range from 15·6 to 20·1 cm3. The maximum dose tolerance to 1 cc of all the plans was within 140% (84 Gy) of the prescribed dose, and 95% of the PTV of all the plans received 100% of the prescribed dose (60 Gy). In all the plans, 99% of the PTV received a dose >90% of the prescribed dose, and the mean dose in all the plans ranged from 67 to 72 Gy. The planning target dose conformity for the SBRT and the VMAT (0°, 15° collimator single arc plans and dual arc) plans showed the tightness of the prescription isodose conformity to the target. Conclusions SBRT and VMAT are radiotherapy approaches that increase doses to small tumour targets without increasing doses to the organs at risk. Although VMAT offers an alternative to SBRT for NSCLC and the potential advantage of VMAT is the reduced treatment times over SBRT, the statistical results show that there was no significant difference between the SBRT and VMAT optimised plans in terms of dose conformity and organ-at-risk sparing.

The essential and non-essential genes of Bovine herpesvirus 1

Bovine herpesvirus 1 (BoHV-1) is an economically important pathogen of cattle associated with respiratory and reproductive disease. To further develop BoHV-1 as a vaccine vector, a study was conducted to identify the essential and non-essential genes required for in vitro viability. Randominsertion mutagenesis utilizing a Tn5 transposition system and targeted gene deletion were employed to construct gene disruption and gene deletion libraries, respectively, of an infectious clone of BoHV-1. Transposon insertion position and confirmation of gene deletion were determined by direct sequencing. The essential or non-essential requirement of either transposed or deleted open reading frames (ORFs) was assessed by transfection of respective BoHV-1 DNA into host cells. Of the 73 recognized ORFs encoded by the BoHV-1 genome, 33 were determined to be essential and 36 to be non-essential for virus viability in cell culture; determining the requirement of the two dual copy ORFs was inconclusive. The majority of ORFs were shown to conform to the in vitro requirements of BoHV-1 homologues encoded by human herpesvirus 1 (HHV-1). However, ORFs encoding glycoprotein K (UL53), regulatory, membrane, tegument and capsid proteins (UL54, UL49.5, UL49, UL35, UL20, UL16 and UL7) were shown to differ in requirement when compared to HHV-1-encoded homologues.

Constitutive modeling of shape memory alloy wire with non-local rate kinetics

A constitutive modeling approach for shape memory alloy (SMA) wire by taking into account the microstructural phase inhomogeneity and the associated solid-solid phase transformation kinetics is reported in this paper. The approach is applicable to general thermomechanical loading. Characterization of various scales in the non-local rate sensitive kinetics is the main focus of this paper. Design of SMA materials and actuators not only involve an optimal exploitation of the hysteresis loops during loading-unloading, but also accounts for fatigue and training cycle identifications. For a successful design of SMA integrated actuator systems, it is essential to include the microstructural inhomogeneity effects and the loading rate dependence of the martensitic evolution, since these factors play predominant role in fatigue. In the proposed formulation, the evolution of new phase is assumed according to Weibull distribution. Fourier transformation and finite difference methods are applied to arrive at the analytical form of two important scaling parameters. The ratio of these scaling parameters is of the order of 10(6) for stress-free temperature-induced transformation and 10(4) for stress-induced transformation. These scaling parameters are used in order to study the effect of microstructural variation on the thermo-mechanical force and interface driving force. It is observed that the interface driving force is significant during the evolution. Increase in the slopes of the transformation start and end regions in the stress-strain hysteresis loop is observed for mechanical loading with higher rates.