Development and testing of an iPad application for teaching self-management to heart failure patients. (Nursing/Allied Health Professional Investigator Award)- Abstract

Purpose: Heart failure (HF) is the leading cause of hospitalization and significant burden to the health care system in Australia. To reduce hospitalizations, multidisciplinary approaches and enhance self-management programs have been strongly advocated for HF patients globally. HF patients who can effectively manage their symptoms and adhere to complex medicine regimes will experience fewer hospitalizations. Research indicates that information technologies (IT) have a significant role in providing support to promote patients' self-management skills. The iPad utilizes user-friendly interfaces and to date an application for HF patient education has not been developed. This project aimed to develop the HF iPad teaching application in the way that would be engaging, interactive and simple to follow and usable for patients' carers and health care workers within both the hospital and community setting. Methods: The design for the development and evaluation of the application consisted of two action research cycles. Each cycle included 3 phases of testing and feedback from three groups comprising IT team, HF experts and patients. All patient education materials of the application were derived from national and international evidence based practice guidelines and patient self-care recommendations. Results: The iPad application has animated anatomy and physiology that simply and clearly teaches the concepts of the normal heart and the heart in failure. Patient Avatars throughout the application can be changed to reflect the sex and culture of the patient. There is voice-over presenting a script developed by the heart failure expert panel. Additional engagement processes included points of interaction throughout the application with touch screen responses and the ability of the patient to enter their weight and this data is secured and transferred to the clinic nurse and/or research data set. The application has been used independently, for instance, at home or using headphones in a clinic waiting room or most commonly to aid a nurse-led HF consultation. Conclusion: This project utilized iPad as an educational tool to standardize HF education from nurses who are not always heart failure specialists. Furthermore, study is currently ongoing to evaluate of the effectiveness of this tool on patient outcomes and to develop several specifically designed cultural adaptations [Hispanic (USA), Aboriginal (Australia), and Maori (New Zealand)].

Access to Cardiac Rehabilitation does not Equate to Attendance. (On Behalf of the Cardiac ARIA Project. Winner Nursing/Allied Health Professional Investigator Award)

Background/Aims Timely access to appropriate cardiac care is critical for optimizing positive outcomes after a cardiac event. Attendance at cardiac rehabilitation (CR) remains less than optimal (10%–30%). Our aim was to derive an objective, comparable, geographic measure reflecting access to cardiac services after a cardiac event in Australia. Methods An expert panel defined a single patient care pathway and a hierarchy of the minimum health services for CR and secondary prevention. Using geographic information systems a numeric/alpha index was modelled to describe access before and after a cardiac event. The aftercare phase was modelled into five alphabetical categories: from category A (access to medical service, pharmacy, CR, pathology within 1 h) to category E (no services available within 1 h). Results Approximately 96% or 19 million people lived within 1 h of the four basic services to support CR and secondary prevention, including 96% of older Australians and 75% of the indigenous population. Conversely, 14% (64,000) indigenous people resided in population locations that had poor access to health services that support CR after a cardiac event. Conclusion Results demonstrated that the majority of Australians had excellent ‘geographic’ access to services to support CR and secondary prevention. Therefore, it appears that it is not the distance to services that affects attendance. Our ‘geographic’ lens has identified that more research on socioeconomic, sociological or psychological aspects to attendance is needed.

Rail incident investigator training: Is there support for a standardised Australasian training framework?

Background: Historically rail organisations have been operating in silos and devising their own training agendas. However with the harmonisation of the Australian workplace health and safety legislation and the appointment of a national rail safety regulator in 2013, rail incident investigator experts are exploring the possibility of developing a unified approach to investigator training. Objectives: The Australian CRC for Rail Innovation commissioned a training needs analysis to identify if common training needs existed between organisations and to assess support for the development of a national competency framework for rail incident investigations. Method: Fifty-two industry experts were consulted to explore the possibility of the development of a standardised training framework. These experts were sourced from within 19 Australasian organisations, comprising Rail Operators and Regulators in Queensland, New South Wales, Victoria, Western Australia, South Australia and New Zealand. Results: Although some competency requirements appear to be organisation specific, the vast majority of reported training requirements were generic across the Australasian rail operators and regulators. Industry experts consistently reported strong support for the development of a national training framework. Significance: The identification of both generic training requirements across organisations and strong support for standardised training indicates that the rail industry is receptive to the development of a structured training framework. The development of an Australasian learning framework could: increase efficiency in course development and reduce costs; establish recognised career pathways; and facilitate consistency with regards to investigator training.

Training needs research applied to the development of a standardised incident investigator training framework

In response to the rail industry lacking a consistently accepted standard of minimal training to perform incident investigations, the Australasian rail industry requested the development of a unified approach to investigator training. This paper details how the findings from a training needs analysis were applied to inform the development of a standardised training package for rail incident investigators. Data from job descriptions, training documents and subject matter experts sourced from 17 Australasian organisations were analysed and refined to yield a draft set of 10 critical competencies. Finally the draft of critical competencies was reviewed by industry experts to verify the accuracy and completeness of the competency list and to consider the most appropriate level of qualification for training development. The competencies identified and the processes described to translate research into an applied training framework in this paper, can be generalised to assist practitioners and researchers in developing industry approved standardised training packages.

Award Winner in the Young Investigator Category, 2014 Society for Biomaterials Annual Meeting and Exposition, Denver, Colorado, April 16-19, 2014: Periodically perforated core-shell collagen biomaterials balance cell infiltration, bioactivity, and mechanical properties.

Orthopedic tissue engineering requires biomaterials with robust mechanics as well as adequate porosity and permeability to support cell motility, proliferation, and new extracellular matrix (ECM) synthesis. While collagen-glycosaminoglycan (CG) scaffolds have been developed for a range of tissue engineering applications, they exhibit poor mechanical properties. Building on previous work in our lab that described composite CG biomaterials containing a porous scaffold core and nonporous CG membrane shell inspired by mechanically efficient core-shell composites in nature, this study explores an approach to improve cellular infiltration and metabolic health within these core-shell composites. We use indentation analyses to demonstrate that CG membranes, while less permeable than porous CG scaffolds, show similar permeability to dense materials such as small intestine submucosa (SIS). We also describe a simple method to fabricate CG membranes with organized arrays of microscale perforations. We demonstrate that perforated membranes support improved tenocyte migration into CG scaffolds, and that migration is enhanced by platelet-derived growth factor BB-mediated chemotaxis. CG core-shell composites fabricated with perforated membranes display scaffold-membrane integration with significantly improved tensile properties compared to scaffolds without membrane shells. Finally, we show that perforated membrane-scaffold composites support sustained tenocyte metabolic activity as well as improved cell infiltration and reduced expression of hypoxia-inducible factor 1α compared to composites with nonperforated membranes. These results will guide the design of improved biomaterials for tendon repair that are mechanically competent while also supporting infiltration of exogenous cells and other extrinsic mediators of wound healing.

An exploratory study of Principal Investigator roles in UK University Proof-of-Concept processes: an Absorptive capacity perspective

The increasing emphasis on academic entrepreneurship, technology transfer and research commercialisation within UK universities is predicated on basic research being developed by academics into commercial entities such as university spin-off companies or licensing arrangements. However, this process is fraught with challenges and risks, given the degree of uncertainty regarding future returns. In an attempt to minimise such risks, the Proof-of-Concept (PoC) process has been developed within University Science Park Incubators (USIs) to test the technological, business and market potential of embryonic technology. The key or the pivotal stakeholder within the PoC is the Principal Investigator (PI), who is usually the lead academic responsible for the embryonic technology. Within the current literature, there appears to be a lack of research pertaining to the role of the PI in the PoC process. Moreover, Absorptive Capacity (ACAP) has emerged within the literature as a theoretical framework or lens for exploring the development and application of new knowledge and technology, where the USI is the organisation considered in the current study. Therefore, the aim of this paper is to explore the role and influence of the PI in the PoC process within a USI setting using an ACAP perspective. The research involved a multiple case analysis of PoC applications within a UK university USI. The results demonstrate the role of the PI in developing practices and routines within the PoC process. These practices and processes were initially tacit and informal in nature but became more explicit and formal over time so that knowledge was retained within the USI after the PIs had completed the PoC process. © 2010 The Authors. R&D Management © 2010 Blackwell Publishing Ltd.

SWAT 1:what effects do site visits by the principal investigator have on recruitment in a multicentre randomized trial?

The SWAT (Study Within A Trial) programme has been established to develop a series of studies that would embed research within research, so as to resolve uncertainties about the effects of different ways of designing, conducting, analyzing and interpreting evaluations of health and social care. It was described in an Education piece in the Journal of Evidence-Based Medicine in 2012. We have now prepared the first example of the design summary for a SWAT, using the template that will be used for other SWAT. This is presented in this article.

The influence of investigator disturbance on aggressive behaviour and breeding success of ring-billed gulls (Larus delawarensis) /

Increased losses of eggs and chicks resulting from human intrusion (investigator or other) into seabird colonies has been well documented. In 1990/91, I studied the effects of investigator disturbance on aggressive behaviour and breeding success of individual pairs of ring-billed gulls nesting at two colonies near Port Colborne, Ontario. The insular colony was on an artificial breakwall, associated with the Welland Ship Canal, approximately 1 km off the north shore of Lake Erie. The mainland colony was adjacent to the canal approximately 1 km east of the breakwall. The frequencies of adult threat and assault behaviours, chick movement and adult attacks on chicks were recorded by continuous scan sampling 30 min prior to, 30 min during and 60 (2 X 30) min after investigator disturbance. The frequency of threat and assault behaviours increased during the period of investigator activity in the colony while the duration of wingpulls and beakpulls decreased. Significantly more chicks ran ("runners") from their natal territories during disturbances and "runners" were more frequently attacked than "territorial" chicks. No chicks were fatally attacked during disturbance and "runners" returned to their natal territories quickly after disturbance. Breeding success was determined for pairs nesting in study plots subjected to two levels of disturbance (normal and moderate). The disturbance level of each plot differed in visitation frequency and activities performed on each visit. Investigator disturbance had no effect on the hatching success or fledging success (taken as 21 days of age) of ring-billed gull study pairs at either colony.

New alternative for human identification. Investigator IDplex Kit - QIAGEN® reproducibility: Latin American interlaboratory study

In 2010 QIAGEN® launched to eight kits of different combinations of STRs, including the Investigator IDplex Kit. This kit allows amplification in one PCR 16 markers. The aim of this study was to evaluate the reproducibility of Investigator IDplex Kit among Latin America laboratories. In the framework of the 'III International Theoretical-Practice Course in Populations Genetic and Biologicals Filiations' in Medellín-Colombia, all participants were invited to evaluate the reproducibility of this kit, they were provided of the necessary materials for the study. The results reported by participating were tabulated for the study the reproducibility. Results and comments were received on the agreed date of 12 of the 22 laboratories registered, one participant submits comments only. Some laboratories reported greater sensitivity Investigator IDplex Kit compared with other kits containing similar markers, also highlight the easy adaptability to existing conditions in laboratories, without involving major changes to its implementation. This paper shows the high reproducibility of Investigator IDplex Kit, a new tool offered by QIAGEN® for all laboratories that perform human identification testing and biological relationship testing using DNA markers. © 2011 Elsevier B.V.