Principles to guide sustainable implementation of extended-scope-of-practice physiotherapy workforce redesign initiatives in Australia: Stakeholder perspectives, barriers, supports, and incentives

Sustainable implementation of new workforce redesign initiatives requires strategies that minimize barriers and optimize supports. Such strategies could be provided by a set of guiding principles. A broad understanding of the concerns of all the key stakeholder groups is required before effective strategies and initiatives are developed. Many new workforce redesign initiatives are not underpinned by prior planning, and this threatens their uptake and sustainability. This study reports on a cross-sectional qualitative study that sought the perspectives of representatives of key stakeholders in a new workforce redesign initiative (extended-scope-of-practice physiotherapy) in one Australian tertiary hospital. The key stakeholder groups were those that had been involved in some way in the development, management, training, funding, and/or delivery of the initiative. Data were collected using semistructured questions, answered individually by interview or in writing. Responses were themed collaboratively, using descriptive analysis. Key identified themes comprised: the importance of service marketing; proactively addressing barriers; using readily understood nomenclature; demonstrating service quality and safety, monitoring adverse events, measuring health and cost outcomes; legislative issues; registration; promoting viable career pathways; developing, accrediting, and delivering a curriculum supporting physiotherapists to work outside of the usual scope; and progression from "a good idea" to established service. Health care facilities planning to implement new workforce initiatives that extend scope of usual practice should consider these issues before instigating workforce/model of care changes. © 2014 Morris et al.

Herman Sommerfeld with unidentifed men and women on board a ship from Tallin to Helsinki (and on to the United States) Portraits Groups

Digital Image

Person with Scarlet Fever Excluded from East Transport, and Taken to Hospital Artworks

postwar vesion of F 38331

Estimating mineralisation of organic nitrogen from biosolids and other organic wastes applied to soils in subtropical Australia

One major benefit of land application of biosolids is to supply nitrogen (N) for agricultural crops, and understanding mineralisation processes is the key for better N-management strategies. Field studies were conducted to investigate the process of mineralisation of three biosolids products (aerobic, anaerobic, and thermally dried biosolids) incorporated into four different soils at rates of 7-90 wet t/ha in subtropical Queensland. Two of these studies also examined mineralisation rates of commonly used organic amendments (composts, manures, and sugarcane mill muds). Organic N in all biosolids products mineralised very rapidly under ambient conditions in subtropical Queensland, with rates much faster than from other common amendments. Biosolids mineralisation rates ranged from 30 to 80% of applied N during periods ranging from 3.5 to 18 months after biosolids application; these rates were much higher than those suggested in the biosolids land application guidelines established by the NSW EPA (15% for anaerobic and 25% for aerobic biosolids). There was no consistently significant difference in mineralisation rate between aerobic and anaerobic biosolids in our studies. When applied at similar rates of N addition, other organic amendments supplied much less N to the soil mineral N and plant N pools during the crop season. A significant proportion of the applied biosolids total N (up to 60%) was unaccounted for at the end of the observation period. High rates of N addition in calculated Nitrogen Limited Biosolids Application Rates (850-1250 kg N/ha) resulted in excessive accumulation of mineral N in the soil profile, which increases the environmental risks due to leaching, runoff, or gaseous N losses. Moreover, the rapid mineralisation of the biosolids organic N in these subtropical environments suggests that biosolids should be applied at lower rates than in temperate areas, and that care must be taken with the timing to maximise plant uptake and minimise possible leaching, runoff, or denitrification losses of mineralised N.

Barriers to and facilitators of cervical screening practice among African immigrant women from refugee and non-refugee backgrounds living in Brisbane

This thesis investigated and compared barriers and facilitators of cervical screening among African-born refugee and non-refugee women living in Brisbane. Refugee women were more likely to have limited or no knowledge about cervical cancer and the screening test and also less likely to use Pap smear services than non-refugee women. The analysis identified belief systems, lack of knowledge about cervical cancer and screening practices, and lack of culturally appropriate screening programs as major barriers. In the context of health promotion interventions, these findings will contribute to addressing major differential screening needs among African immigrant refugee and non-refugee women.

Letter to K.K.S.I. from Moses and Simon Content, August 19, 1828

Digital image

Evidence from molecules and morphology expands Podonomopsis Brundin (Diptera: Chironomidae: Podonominae) to include ‘genus Chile'

The informal taxon ‘genus Chile’ of Brundin, based solely on pupal exuviae of a podonomine Chironomidae, has remained inadequately known for half a century. New collections reveal life associations, and provide molecular data to hypothesise a precise phylogenetic placement in the austral Podonominae. A densely sampled molecular phylogeny based on two nuclear and one mitochondrial DNA markers shows ‘genus Chile’ to be the sister group to Podonomopsis Brundin, 1966. Within Podonomopsis a clade of South American species is sister to all Australian species. We discuss how to rank such a sister group taxon and treat ‘genus Chile’ as a new subgenus Araucanopsis, subg. nov. with the new species, Podonomopsis (Araucanopsis) avelasse, sp. nov. from Chile and Argentina as genotype of the monotypic subgenus. We describe P. (A.) avelasse in all stages and provide an expanded diagnosis and description of Podonomopsis to include Araucanopsis. A dated biogeographic hypothesis (chronogram) infers the most recent common ancestor (tmcra) of expanded Podonomopsis at 95 million years ago (Mya) (68–122 Mya 95% highest posterior density), ‘core’ Podonomopsis at 83 Mya (58–108) and Australian Podonomopsis at 65 Mya (44–87). All dates are before the South America–Australia geological separation through Antarctica, supporting previous conclusions that the taxon distribution is ‘Gondwanan’ in origin. Podonomopsis, even as expanded here, remains unknown from New Zealand or elsewhere on extant Zealandia.

Letters from Moise and Jacob Seixas to K. K. S. I. regarding reduction in seat costs because they are refugees

Digital image

An efficient and light-weight multi-tasking model to achieve Intra-Agent concurrency for SAGE

Multi-agent systems implicate a high degree of concurrency at both the Inter- and Intra-Agent levels. Scalable, fault tolerant, Agent Grooming Environment (SAGE), the second generation, FIPA compliant MAS requires a built in mechanism to achieve both the Inter- and Intra-Agent concurrency. This paper dilates upon an attempt to provide a reliable, efficient and light-weight solution to provide intra-agent concurrency with-in the internal agent architecture of SAGE. It addresses the issues related to using the JAVA threading model to provide this level of concurrency to the agent and provides an alternative approach that is based on an eventdriven, concurrent and user-scalable multi-tasking model for the agent's internal model. The findings of this paper show that our proposed approach is suitable for providing an efficient and lightweight concurrent task model for SA GE and considerably outweighs the performance of multithreaded tasking model based on JAVA in terms of throughput and efficiency. This has been illustrated using the practical implementation and evaluation of both models. © 2004 IEEE.

From neural stem cells to precursors : Molecular regulation of self-renewal and differentiation

Stem cells are responsible for tissue turnover throughout lifespan. Only highly controlled specific environment, the stem cell niche , can sustain undifferentiated stem cell-pool. The balance between maintenance and differentiation is crucial for individual s health: uncontrolled stem cell self-renewal or proliferation can lead to hyperplasia and mutations that further provoke malignant transformation of the cells. On the other hand, uninhibited differentiation may result in diminished stem cell population, which is unable to maintain tissue turnover. The mechanisms that control the switch from maintenance to differentiation in stem cells are not well known. The same mechanisms that direct the self-renewal and proliferation in normal stem cells are likely to be also involved in maintenance of cancer stem cell . Cancer stem cells exhibit stem cell like properties such as self-renewal- and differentiation capacity and they can also regenerate the tumor tissue. In this thesis, I have investigated the effect of classical oncogenes E6/E7 and c-Myc, tumor suppressors p53 and retinoblastoma (pRb) family, and vascular endothelial growth factor (VEGF) subfamily and glial cell line-derived neurothropic factor (GDNF) family ligands on behavior of embryonic neural stem cells (NSCs) and progenitors. The study includes also the characterization of cytoskeletal tumor suppressor neurofibromatosis 2 (NF2) protein merlin and ezrin-radixin-moesin (ERM) protein ezrin expression in neural progenitors cells and their progeny. This study reveals some potential mechanisms regarding to NSCs maintenance. In summary, the studied molecules are able to shift the balance either towards stem cell maintenance or differentiation; tumor suppressor p53 represses whereas E6/E7 oncogenes and c-Myc increase the proportion of self-renewing and proliferating NSCs or progenitors. The data suggests that active MEK-ERK signaling is critical for self-renewal of normal and oncogene expressing NSCs. In addition, the results indicate that expression of cytoskeletal tumor suppressor merlin and ERM protein ezrin in central nervous system (CNS) tissue and progenitors indicates their role in cell differentiation. Furthermore, the data suggests that VEGF-C a factor involved in lymphatic system development, angiogenesis, neovascularization and metastasis but also in maintenance of some neural populations in brain is a novel thropic factor for progenitors in early sympathetic nervous system (SNS). It seems that VEGF-C dose dependently through ERK-pathway supports the proliferation and survival of early sympathetic progenitor cells, and the effect is comparable to that of GDNF family ligands.

Oxidation of vitamin A1 and vitamin A2 aldehydes to the corresponding acids by enzymes from pig and rat livers

VITAMIN A is stored in rat liver largely as its ester with small amounts of the alcohol, but is transported in the normal circulating blood in the latter form1. Although it was generally believed that the alcohol form is the more physiological state of the vitamin, since the work of Dowling and Wald2, it is being recognized that vitamin A acid and not the alcohol may be nearer to the 'active vitamin A'. If this were to be so, it would be important to demonstrate that a mechanism exists in the rat for the production of vitamin A acid from vitamin A alcohol through the intermediate, the aldehyde. Regarding the formation of the aldehyde, it has been well established that the alcohol dehydrogenase can bring about the conversion of vitamin A alcohol to retinene3. The presence of an enzyme in rat and pig liver catalysing the oxidation of retinene1 and retinene2 to the corresponding acids has been demonstrated in the present work and the partially purified enzyme preparation shown to be completely devoid of alcohol dehydrogenase activity.

A new chiral oxazoline derived from camphor and its conversion to (R)-2-methylalkanoic acids

1S,5R,7R)-(-)-10, 10-Dimethyl-3-ethyl-4-oxa--atricyclo[5.2.1.0(1,5)]dec-2-ene 2 was prepared in 95% yield from (1S)-1-amino-2-exo-hydroxyapocamphane 1. The chiral oxazoline could be alkylated (Lhttp://eprints.iisc.ernet.in/cgi/users/home?screen=EPrint::Edit&eprintid=31175&stage=core#tDA/THF/-78 degrees C/RX, RX = ethyl, n-propyl, n-butyl iodides or benzyl bromide) to 3 in 95% yield and > 95% diastereoselectivity, and the products hydrolysed to (R)-2-methylalkanoic acids 4 (43-47% yield, 93-98% e.e.). (C) 2000 Elsevier Science Ltd. All rights reserved.

Isoselenocyanates derived from Boc/Z-amino acids: synthesis, isolation,characterization, and application to the efficient synthesis of unsymmetrical selenoureas and selenoureidopeptidomimetics

Isoselenocyanates derived from Boc/Z-amino acids are prepared by the reaction of the corresponding isonitriles with selenium powder in presence of triethylamine at reflux. The utility of these new classes of isoselenocyanates in the preparation of selenoureidodipeptidomimetics possessing both amino as well as carboxy termini has been accomplished. The H-1 NMR analysis confirmed that the protocol involving the conversion of isonitriles to isoselenocyanates and their use as coupling agents in assembling selenour-eido derivatives is free from racemization. (C) 2010 Elsevier Ltd. All rights reserved.