Automated segmentation of mouse OCT volumes (ASiMOV): Validation & clinical study of a light damage model
- Antony, Bhavna, Kim, Byung-Jin, Lang, Andrew, Carass, Aaron, Prince, Jerry, Zack, Donald
- Authors: Antony, Bhavna , Kim, Byung-Jin , Lang, Andrew , Carass, Aaron , Prince, Jerry , Zack, Donald
- Date: 2017
- Type: Text , Journal article
- Relation: PLoS One Vol. 12, no. 8 (2017), p. e0181059-e0181059
- Full Text:
- Reviewed:
- Description: The use of spectral-domain optical coherence tomography (SD-OCT) is becoming commonplace for the in vivo longitudinal study of murine models of ophthalmic disease. Longitudinal studies, however, generate large quantities of data, the manual analysis of which is very challenging due to the time-consuming nature of generating delineations. Thus, it is of importance that automated algorithms be developed to facilitate accurate and timely analysis of these large datasets. Furthermore, as the models target a variety of diseases, the associated structural changes can also be extremely disparate. For instance, in the light damage (LD) model, which is frequently used to study photoreceptor degeneration, the outer retina appears dramatically different from the normal retina. To address these concerns, we have developed a flexible graph-based algorithm for the automated segmentation of mouse OCT volumes (ASiMOV). This approach incorporates a machine-learning component that can be easily trained for different disease models. To validate ASiMOV, the automated results were compared to manual delineations obtained from three raters on healthy and BALB/cJ mice post LD. It was also used to study a longitudinal LD model, where five control and five LD mice were imaged at four timepoints post LD. The total retinal thickness and the outer retina (comprising the outer nuclear layer, and inner and outer segments of the photoreceptors) were unchanged the day after the LD, but subsequently thinned significantly (p < 0.01). The retinal nerve fiber-ganglion cell complex and the inner plexiform layers, however, remained unchanged for the duration of the study.
- Authors: Antony, Bhavna , Kim, Byung-Jin , Lang, Andrew , Carass, Aaron , Prince, Jerry , Zack, Donald
- Date: 2017
- Type: Text , Journal article
- Relation: PLoS One Vol. 12, no. 8 (2017), p. e0181059-e0181059
- Full Text:
- Reviewed:
- Description: The use of spectral-domain optical coherence tomography (SD-OCT) is becoming commonplace for the in vivo longitudinal study of murine models of ophthalmic disease. Longitudinal studies, however, generate large quantities of data, the manual analysis of which is very challenging due to the time-consuming nature of generating delineations. Thus, it is of importance that automated algorithms be developed to facilitate accurate and timely analysis of these large datasets. Furthermore, as the models target a variety of diseases, the associated structural changes can also be extremely disparate. For instance, in the light damage (LD) model, which is frequently used to study photoreceptor degeneration, the outer retina appears dramatically different from the normal retina. To address these concerns, we have developed a flexible graph-based algorithm for the automated segmentation of mouse OCT volumes (ASiMOV). This approach incorporates a machine-learning component that can be easily trained for different disease models. To validate ASiMOV, the automated results were compared to manual delineations obtained from three raters on healthy and BALB/cJ mice post LD. It was also used to study a longitudinal LD model, where five control and five LD mice were imaged at four timepoints post LD. The total retinal thickness and the outer retina (comprising the outer nuclear layer, and inner and outer segments of the photoreceptors) were unchanged the day after the LD, but subsequently thinned significantly (p < 0.01). The retinal nerve fiber-ganglion cell complex and the inner plexiform layers, however, remained unchanged for the duration of the study.
Tourism and Islandscapes: Cultural realignment, social-ecological resilience and change
- Cheer, Joseph, Cole, Stroma, Reeves, Keir, Kato, Kumi
- Authors: Cheer, Joseph , Cole, Stroma , Reeves, Keir , Kato, Kumi
- Date: 2016
- Type: Text , Journal article
- Relation: Shima (Sydney, N.S.W.) Vol. 11, no. 1 (2016), p.41-54
- Full Text:
- Reviewed:
- Description: If, as according to Robin (2015: online), “islands are idealised ecological worlds, the Edens of a fallen planet’”, the rationale underpinning tourism expansion should acknowledge MacLeod’s (2013) notion of “cultural realignment” that calls for optimal and resilient encounters. This introductory article to the subsequent theme section of the journal on sustainable tourism acts as a bridge toward the development of emergent themes that describe how island peoples adapt and respond in localised cultural islandscapes as a consequence of tourism expansion. The links between cultural alignment and social-ecological resilience are clear and the principal and overarching question posed in this introductory article is: To what extent are islandscapes resilient to rapidly changing utilities, significances and ways of life wrought by tourism expansion? The vulnerabilityresilience duality remains firmly entrenched in the discourse on islands where tourism has become prominent, and although tourism provides some resiliency, overall, islandscapes remain subject to externally driven fast and slow change that exercises an overwhelming influence. Islander agency will likely remain subject to the fluctuations in the demands of the tourism supply chain. Therefore, tourism as a standalone focus of islands is a high-risk proposition, especially in contexts where externally driven change is likely to intensify.
- Authors: Cheer, Joseph , Cole, Stroma , Reeves, Keir , Kato, Kumi
- Date: 2016
- Type: Text , Journal article
- Relation: Shima (Sydney, N.S.W.) Vol. 11, no. 1 (2016), p.41-54
- Full Text:
- Reviewed:
- Description: If, as according to Robin (2015: online), “islands are idealised ecological worlds, the Edens of a fallen planet’”, the rationale underpinning tourism expansion should acknowledge MacLeod’s (2013) notion of “cultural realignment” that calls for optimal and resilient encounters. This introductory article to the subsequent theme section of the journal on sustainable tourism acts as a bridge toward the development of emergent themes that describe how island peoples adapt and respond in localised cultural islandscapes as a consequence of tourism expansion. The links between cultural alignment and social-ecological resilience are clear and the principal and overarching question posed in this introductory article is: To what extent are islandscapes resilient to rapidly changing utilities, significances and ways of life wrought by tourism expansion? The vulnerabilityresilience duality remains firmly entrenched in the discourse on islands where tourism has become prominent, and although tourism provides some resiliency, overall, islandscapes remain subject to externally driven fast and slow change that exercises an overwhelming influence. Islander agency will likely remain subject to the fluctuations in the demands of the tourism supply chain. Therefore, tourism as a standalone focus of islands is a high-risk proposition, especially in contexts where externally driven change is likely to intensify.
Multidisciplinary simulation training for perioperative teams : an integrative review
- Hibberson, Michelle, Lawton, Jessica, Whitehead, Dean
- Authors: Hibberson, Michelle , Lawton, Jessica , Whitehead, Dean
- Date: 2021
- Type: Text , Journal article
- Relation: Journal of Perioperative Nursing Vol. 34, no. 2 (2021), p. 3-13
- Full Text:
- Reviewed:
- Description: Background The perioperative environment is a high-risk and complex area and the provision of safe, high-quality surgical care requires a multifaceted approach provided by multidisciplinary health care teams. However, it is reported that the multidisciplinary nature of perioperative teams can present barriers to patient safety through ineffective teamwork, ineffective collaboration and/ or ineffective communication. Multidisciplinary simulation training creates realistic situations in safe environments to allow perioperative teams to improve teamwork and communication alongside the technical skills needed to manage emergency situations. This integrative review critically examines and reports the effects of multidisciplinary simulation training on perioperative teams and highlights the actual and potential advantages and disadvantages of such training. Method A structured integrative literature review process was undertaken yielding 14 key articles that were critically appraised and examined for emergent ‘themes’. Results Multidisciplinary simulation training improved communication, teamwork, teamwork behaviours and teamwork attitudes between multidisciplinary perioperative team members. Overall, improvements in communication and teamwork correlated with improvements in perioperative patient safety. Despite the numerous benefits of multidisciplinary simulation training there are notable barriers to the implementation of such training programs. Multidisciplinary simulation training can be costly to set up and time consuming to facilitate. However, overall increases in patient safety offset the cost of simulation training and time-based barriers can be reduced by running simulation training in conjunction with existing education programs. Conclusion Multidisciplinary simulation training improved communication and teamwork among perioperative teams and this method of training is recommended overall within perioperative units. However, there were notable gaps within the literature, and further research involving multidisciplinary perioperative teams within Australian perioperative units should be conducted to gain a greater insight into the presence of multidisciplinary simulation training and the effects of such training. © 2021, Australian College of Perioperative Nurses. All rights reserved.
- Authors: Hibberson, Michelle , Lawton, Jessica , Whitehead, Dean
- Date: 2021
- Type: Text , Journal article
- Relation: Journal of Perioperative Nursing Vol. 34, no. 2 (2021), p. 3-13
- Full Text:
- Reviewed:
- Description: Background The perioperative environment is a high-risk and complex area and the provision of safe, high-quality surgical care requires a multifaceted approach provided by multidisciplinary health care teams. However, it is reported that the multidisciplinary nature of perioperative teams can present barriers to patient safety through ineffective teamwork, ineffective collaboration and/ or ineffective communication. Multidisciplinary simulation training creates realistic situations in safe environments to allow perioperative teams to improve teamwork and communication alongside the technical skills needed to manage emergency situations. This integrative review critically examines and reports the effects of multidisciplinary simulation training on perioperative teams and highlights the actual and potential advantages and disadvantages of such training. Method A structured integrative literature review process was undertaken yielding 14 key articles that were critically appraised and examined for emergent ‘themes’. Results Multidisciplinary simulation training improved communication, teamwork, teamwork behaviours and teamwork attitudes between multidisciplinary perioperative team members. Overall, improvements in communication and teamwork correlated with improvements in perioperative patient safety. Despite the numerous benefits of multidisciplinary simulation training there are notable barriers to the implementation of such training programs. Multidisciplinary simulation training can be costly to set up and time consuming to facilitate. However, overall increases in patient safety offset the cost of simulation training and time-based barriers can be reduced by running simulation training in conjunction with existing education programs. Conclusion Multidisciplinary simulation training improved communication and teamwork among perioperative teams and this method of training is recommended overall within perioperative units. However, there were notable gaps within the literature, and further research involving multidisciplinary perioperative teams within Australian perioperative units should be conducted to gain a greater insight into the presence of multidisciplinary simulation training and the effects of such training. © 2021, Australian College of Perioperative Nurses. All rights reserved.
The efficacy of an iterative “sequence of prevention” approach to injury prevention by a multidisciplinary team in professional rugby union
- Tee, Jason, Bekker, Sheree, Collins, Rob, Klingbiel, Jannie, van Rooyen, Ivan, van Wyk, David, Till, Kevin, Jones, Ben
- Authors: Tee, Jason , Bekker, Sheree , Collins, Rob , Klingbiel, Jannie , van Rooyen, Ivan , van Wyk, David , Till, Kevin , Jones, Ben
- Date: 2018
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 21, no. 9 (2018), p. 899-904
- Full Text:
- Reviewed:
- Description: Objectives: Due to the complex systems nature of injuries, the responsibility for injury risk management cannot lie solely within a single domain of professional practice. Interdisciplinary collaboration between technical/tactical coaches, strength and conditioning coaches, team doctors, physical therapists and sport scientists is likely to have a meaningful impact on injury risk. This study describes the application and efficacy of a multidisciplinary approach to reducing team injury risk in professional rugby union. Design: Observational longitudinal cohort study. Methods: Epidemiological injury data was collected from a professional rugby union team for 5 consecutive seasons. Following each season, these data informed multidisciplinary intervention strategies to reduce injury risk. The effectiveness of these strategies was iteratively assessed to inform future interventions. Specific examples of intervention strategies are provided. Results: Overall team injury burden displayed a likely beneficial decrease (−8%; injury rate ratio (IRR) 0.9, 95%CI 0.9–1.0) from 2012 to 2016. This was achieved through a most likely beneficial improvement in non-contact injury burden (−39%; IRR 0.6, 95%CI 0.6–0.7). Contact injury burden was increased, but to a lesser extent (+18%; IRR 1.2, 95%CI 1.1–1.3, most likely harmful) during the same period. Conclusions: The range of skills required to effectively manage complex injury phenomena in professional collision sport crosses disciplinary boundaries. The evidence presented here points to the effectiveness of a multidisciplinary approach to reducing injury risk. This model will likely be applicable across a range of team and individual sports.
- Authors: Tee, Jason , Bekker, Sheree , Collins, Rob , Klingbiel, Jannie , van Rooyen, Ivan , van Wyk, David , Till, Kevin , Jones, Ben
- Date: 2018
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 21, no. 9 (2018), p. 899-904
- Full Text:
- Reviewed:
- Description: Objectives: Due to the complex systems nature of injuries, the responsibility for injury risk management cannot lie solely within a single domain of professional practice. Interdisciplinary collaboration between technical/tactical coaches, strength and conditioning coaches, team doctors, physical therapists and sport scientists is likely to have a meaningful impact on injury risk. This study describes the application and efficacy of a multidisciplinary approach to reducing team injury risk in professional rugby union. Design: Observational longitudinal cohort study. Methods: Epidemiological injury data was collected from a professional rugby union team for 5 consecutive seasons. Following each season, these data informed multidisciplinary intervention strategies to reduce injury risk. The effectiveness of these strategies was iteratively assessed to inform future interventions. Specific examples of intervention strategies are provided. Results: Overall team injury burden displayed a likely beneficial decrease (−8%; injury rate ratio (IRR) 0.9, 95%CI 0.9–1.0) from 2012 to 2016. This was achieved through a most likely beneficial improvement in non-contact injury burden (−39%; IRR 0.6, 95%CI 0.6–0.7). Contact injury burden was increased, but to a lesser extent (+18%; IRR 1.2, 95%CI 1.1–1.3, most likely harmful) during the same period. Conclusions: The range of skills required to effectively manage complex injury phenomena in professional collision sport crosses disciplinary boundaries. The evidence presented here points to the effectiveness of a multidisciplinary approach to reducing injury risk. This model will likely be applicable across a range of team and individual sports.
An overview of long covid support services in australia and international clinical guidelines, with a proposed care model in a global context
- Luo, Shiqi, Zheng, Zhen, Bird, Stephen, Plebanski, Magdalena, Figueiredo, Bernardo, Jessup, Rebecca, Stelmach, Wanda, Robinson, Jennifer, Xenos, Sophia, Olasoji, Micheal, Wan, Dawn, Sheahan, Jacob, Itsiopoulos, Catherine
- Authors: Luo, Shiqi , Zheng, Zhen , Bird, Stephen , Plebanski, Magdalena , Figueiredo, Bernardo , Jessup, Rebecca , Stelmach, Wanda , Robinson, Jennifer , Xenos, Sophia , Olasoji, Micheal , Wan, Dawn , Sheahan, Jacob , Itsiopoulos, Catherine
- Date: 2023
- Type: Text , Journal article , Review
- Relation: Public Health Reviews Vol. 44, no. (2023), p.
- Full Text:
- Reviewed:
- Description: Objective: To identify gaps among Australian Long COVID support services and guidelines alongside recommendations for future health programs. Methods: Electronic databases and seven government health websites were searched for Long COVID-specific programs or clinics available in Australia as well as international and Australian management guidelines. Results: Five Long COVID specific guidelines and sixteen Australian services were reviewed. The majority of Australian services provided multidisciplinary rehabilitation programs with service models generally consistent with international and national guidelines. Most services included physiotherapists and psychologists. While early investigation at week 4 after contraction of COVID-19 is recommended by the Australian, UK and US guidelines, this was not consistently implemented. Conclusion: Besides Long COVID clinics, future solutions should focus on early identification that can be delivered by General Practitioners and all credentialed allied health professions. Study findings highlight an urgent need for innovative care models that address individual patient needs at an affordable cost. We propose a model that focuses on patient-led self-care with further enhancement via multi-disciplinary care tools. Copyright © 2023 Luo, Zheng, Bird, Plebanski, Figueiredo, Jessup, Stelmach, Robinson, Xenos, Olasoji, Wan, Sheahan and Itsiopoulos.
- Authors: Luo, Shiqi , Zheng, Zhen , Bird, Stephen , Plebanski, Magdalena , Figueiredo, Bernardo , Jessup, Rebecca , Stelmach, Wanda , Robinson, Jennifer , Xenos, Sophia , Olasoji, Micheal , Wan, Dawn , Sheahan, Jacob , Itsiopoulos, Catherine
- Date: 2023
- Type: Text , Journal article , Review
- Relation: Public Health Reviews Vol. 44, no. (2023), p.
- Full Text:
- Reviewed:
- Description: Objective: To identify gaps among Australian Long COVID support services and guidelines alongside recommendations for future health programs. Methods: Electronic databases and seven government health websites were searched for Long COVID-specific programs or clinics available in Australia as well as international and Australian management guidelines. Results: Five Long COVID specific guidelines and sixteen Australian services were reviewed. The majority of Australian services provided multidisciplinary rehabilitation programs with service models generally consistent with international and national guidelines. Most services included physiotherapists and psychologists. While early investigation at week 4 after contraction of COVID-19 is recommended by the Australian, UK and US guidelines, this was not consistently implemented. Conclusion: Besides Long COVID clinics, future solutions should focus on early identification that can be delivered by General Practitioners and all credentialed allied health professions. Study findings highlight an urgent need for innovative care models that address individual patient needs at an affordable cost. We propose a model that focuses on patient-led self-care with further enhancement via multi-disciplinary care tools. Copyright © 2023 Luo, Zheng, Bird, Plebanski, Figueiredo, Jessup, Stelmach, Robinson, Xenos, Olasoji, Wan, Sheahan and Itsiopoulos.
A feature agnostic approach for glaucoma detection in OCT volumes
- Maetschke, Stefan, Antony, Bhavna, Ishikawa, Hiroshi, Wollstein, Gadi, Schuman, Joel, Garnavi, Rahil
- Authors: Maetschke, Stefan , Antony, Bhavna , Ishikawa, Hiroshi , Wollstein, Gadi , Schuman, Joel , Garnavi, Rahil
- Date: 2019
- Type: Text , Journal article
- Relation: PLoS One Vol. 14, no. 7 (2019), p. e0219126
- Full Text:
- Reviewed:
- Description: Optical coherence tomography (OCT) based measurements of retinal layer thickness, such as the retinal nerve fibre layer (RNFL) and the ganglion cell with inner plexiform layer (GCIPL) are commonly employed for the diagnosis and monitoring of glaucoma. Previously, machine learning techniques have relied on segmentation-based imaging features such as the peripapillary RNFL thickness and the cup-to-disc ratio. Here, we propose a deep learning technique that classifies eyes as healthy or glaucomatous directly from raw, unsegmented OCT volumes of the optic nerve head (ONH) using a 3D Convolutional Neural Network (CNN). We compared the accuracy of this technique with various feature-based machine learning algorithms and demonstrated the superiority of the proposed deep learning based method. Logistic regression was found to be the best performing classical machine learning technique with an AUC of 0.89. In direct comparison, the deep learning approach achieved a substantially higher AUC of 0.94 with the additional advantage of providing insight into which regions of an OCT volume are important for glaucoma detection. Computing Class Activation Maps (CAM), we found that the CNN identified neuroretinal rim and optic disc cupping as well as the lamina cribrosa (LC) and its surrounding areas as the regions significantly associated with the glaucoma classification. These regions anatomically correspond to the well established and commonly used clinical markers for glaucoma diagnosis such as increased cup volume, cup diameter, and neuroretinal rim thinning at the superior and inferior segments.
- Authors: Maetschke, Stefan , Antony, Bhavna , Ishikawa, Hiroshi , Wollstein, Gadi , Schuman, Joel , Garnavi, Rahil
- Date: 2019
- Type: Text , Journal article
- Relation: PLoS One Vol. 14, no. 7 (2019), p. e0219126
- Full Text:
- Reviewed:
- Description: Optical coherence tomography (OCT) based measurements of retinal layer thickness, such as the retinal nerve fibre layer (RNFL) and the ganglion cell with inner plexiform layer (GCIPL) are commonly employed for the diagnosis and monitoring of glaucoma. Previously, machine learning techniques have relied on segmentation-based imaging features such as the peripapillary RNFL thickness and the cup-to-disc ratio. Here, we propose a deep learning technique that classifies eyes as healthy or glaucomatous directly from raw, unsegmented OCT volumes of the optic nerve head (ONH) using a 3D Convolutional Neural Network (CNN). We compared the accuracy of this technique with various feature-based machine learning algorithms and demonstrated the superiority of the proposed deep learning based method. Logistic regression was found to be the best performing classical machine learning technique with an AUC of 0.89. In direct comparison, the deep learning approach achieved a substantially higher AUC of 0.94 with the additional advantage of providing insight into which regions of an OCT volume are important for glaucoma detection. Computing Class Activation Maps (CAM), we found that the CNN identified neuroretinal rim and optic disc cupping as well as the lamina cribrosa (LC) and its surrounding areas as the regions significantly associated with the glaucoma classification. These regions anatomically correspond to the well established and commonly used clinical markers for glaucoma diagnosis such as increased cup volume, cup diameter, and neuroretinal rim thinning at the superior and inferior segments.
Multidisciplinary simulation training for Australian perioperative teams : a qualitative descriptive exploratory study
- Hibberson, Michelle, Lawton, Jessica, Whitehead, Dean
- Authors: Hibberson, Michelle , Lawton, Jessica , Whitehead, Dean
- Date: 2023
- Type: Text , Journal article
- Relation: Journal of Perioperative Nursing Vol. 36, no. 4 (2023), p. e-14-e-35
- Full Text:
- Reviewed:
- Description: Background: Perioperative units are complex and high-risk environments in which teams of multidisciplinary health care professionals work collaboratively. Multidisciplinary simulation training is a form of education that allows perioperative teams to practise the non-technical and technical skills essential for managing emergency events within the perioperative environment. Despite the benefits of multidisciplinary simulation training, there is a paucity of literature about it; therefore, this study examined the experiences of Australian multidisciplinary perioperative team members who had undertaken simulation training. Objectives: This study examined the experiences of Australian multidisciplinary perioperative team members who had undertaken multidisciplinary simulation training with the aim of: 1. identifying the enablers of and/or barriers to multidisciplinary simulation training 2. gaining insight into the frequency of training and types of scenarios used during simulation training 3. exploring the potential changes to teamwork and communication following multidisciplinary simulation training. Design: A qualitative descriptive exploratory design was adopted. Methods: Data were collected from nursing and anaesthetic participants through individual interviews using a semi-structured interview guide. Interviews were recorded and transcribed, and data were analysed using thematic analysis. Results: Four themes and nine subthemes were identified within the data. The themes were simulation is educational, safe space, frequency and teamwork. The subthemes were emergency scenarios, practise skills and knowledge, training novice and inexperienced staff, fear of simulation, facilitators, debriefing, available facilities, staff availability and multidisciplinarity. Conclusion: Australian perioperative teams widely used multidisciplinary simulation training to practise the technical skills needed to manage emergencies consistently. However, the frequency was variable and dependent on the availability of staff and facilities. A ‘safe space’ was vital, allowing perioperative team members to engage in training and discussions without judgement or embarrassment. Multidisciplinary simulation training is an effective training technique and should be routinely undertaken by Australian perioperative teams to develop consistency in managing emergency events within the perioperative setting. © 2023, Australian College of Perioperative Nurses. All rights reserved.
- Authors: Hibberson, Michelle , Lawton, Jessica , Whitehead, Dean
- Date: 2023
- Type: Text , Journal article
- Relation: Journal of Perioperative Nursing Vol. 36, no. 4 (2023), p. e-14-e-35
- Full Text:
- Reviewed:
- Description: Background: Perioperative units are complex and high-risk environments in which teams of multidisciplinary health care professionals work collaboratively. Multidisciplinary simulation training is a form of education that allows perioperative teams to practise the non-technical and technical skills essential for managing emergency events within the perioperative environment. Despite the benefits of multidisciplinary simulation training, there is a paucity of literature about it; therefore, this study examined the experiences of Australian multidisciplinary perioperative team members who had undertaken simulation training. Objectives: This study examined the experiences of Australian multidisciplinary perioperative team members who had undertaken multidisciplinary simulation training with the aim of: 1. identifying the enablers of and/or barriers to multidisciplinary simulation training 2. gaining insight into the frequency of training and types of scenarios used during simulation training 3. exploring the potential changes to teamwork and communication following multidisciplinary simulation training. Design: A qualitative descriptive exploratory design was adopted. Methods: Data were collected from nursing and anaesthetic participants through individual interviews using a semi-structured interview guide. Interviews were recorded and transcribed, and data were analysed using thematic analysis. Results: Four themes and nine subthemes were identified within the data. The themes were simulation is educational, safe space, frequency and teamwork. The subthemes were emergency scenarios, practise skills and knowledge, training novice and inexperienced staff, fear of simulation, facilitators, debriefing, available facilities, staff availability and multidisciplinarity. Conclusion: Australian perioperative teams widely used multidisciplinary simulation training to practise the technical skills needed to manage emergencies consistently. However, the frequency was variable and dependent on the availability of staff and facilities. A ‘safe space’ was vital, allowing perioperative team members to engage in training and discussions without judgement or embarrassment. Multidisciplinary simulation training is an effective training technique and should be routinely undertaken by Australian perioperative teams to develop consistency in managing emergency events within the perioperative setting. © 2023, Australian College of Perioperative Nurses. All rights reserved.
Evaluation of the prescribing practice of guideline-directed medical therapy among ambulatory chronic heart failure patients
- Parajuli, Daya, Shakib, Sepehr, Eng-Frost, Joanne, McKinnon, Ross, Caughey, Gillian, Whitehead, Dean
- Authors: Parajuli, Daya , Shakib, Sepehr , Eng-Frost, Joanne , McKinnon, Ross , Caughey, Gillian , Whitehead, Dean
- Date: 2021
- Type: Text , Journal article
- Relation: BMC Cardiovascular Disorders Vol. 21, no. 1 (2021), p.
- Full Text:
- Reviewed:
- Description: Background: Studies have demonstrated that heart failure (HF) patients who receive direct pharmacist input as part of multidisciplinary care have better clinical outcomes. This study evaluated/compared the difference in prescribing practices of guideline-directed medical therapy (GDMT) for chronic HF patients between two multidisciplinary clinics—with and without the direct involvement of a pharmacist. Methods: A retrospective audit of chronic HF patients, presenting to two multidisciplinary outpatient clinics between March 2005 and January 2017, was performed; a Multidisciplinary Ambulatory Consulting Service (MACS) with an integrated pharmacist model of care and a General Cardiology Heart Failure Service (GCHFS) clinic, without the active involvement of a pharmacist. Results: MACS clinic patients were significantly older (80 vs. 73 years, p <.001), more likely to be female (p <.001), and had significantly higher systolic (123 vs. 112 mmHg, p <.001) and diastolic (67 vs. 60 mmHg, p <.05) blood pressures compared to the GCHF clinic patients. Moreover, the MACS clinic patients showed more polypharmacy and higher prevalence of multiple comorbidities. Both clinics had similar prescribing rates of GDMT and achieved maximal tolerated doses of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) in HFrEF. However, HFpEF patients in the MACS clinic were significantly more likely to be prescribed ACEIs/ARBs (70.5% vs. 56.2%, p = 0.0314) than the GCHFS patients. Patients with both HFrEF and HFpEF (MACS clinic) were significantly less likely to be prescribed
- Authors: Parajuli, Daya , Shakib, Sepehr , Eng-Frost, Joanne , McKinnon, Ross , Caughey, Gillian , Whitehead, Dean
- Date: 2021
- Type: Text , Journal article
- Relation: BMC Cardiovascular Disorders Vol. 21, no. 1 (2021), p.
- Full Text:
- Reviewed:
- Description: Background: Studies have demonstrated that heart failure (HF) patients who receive direct pharmacist input as part of multidisciplinary care have better clinical outcomes. This study evaluated/compared the difference in prescribing practices of guideline-directed medical therapy (GDMT) for chronic HF patients between two multidisciplinary clinics—with and without the direct involvement of a pharmacist. Methods: A retrospective audit of chronic HF patients, presenting to two multidisciplinary outpatient clinics between March 2005 and January 2017, was performed; a Multidisciplinary Ambulatory Consulting Service (MACS) with an integrated pharmacist model of care and a General Cardiology Heart Failure Service (GCHFS) clinic, without the active involvement of a pharmacist. Results: MACS clinic patients were significantly older (80 vs. 73 years, p <.001), more likely to be female (p <.001), and had significantly higher systolic (123 vs. 112 mmHg, p <.001) and diastolic (67 vs. 60 mmHg, p <.05) blood pressures compared to the GCHF clinic patients. Moreover, the MACS clinic patients showed more polypharmacy and higher prevalence of multiple comorbidities. Both clinics had similar prescribing rates of GDMT and achieved maximal tolerated doses of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) in HFrEF. However, HFpEF patients in the MACS clinic were significantly more likely to be prescribed ACEIs/ARBs (70.5% vs. 56.2%, p = 0.0314) than the GCHFS patients. Patients with both HFrEF and HFpEF (MACS clinic) were significantly less likely to be prescribed
Best practices in online therapy
- Abbott, Jo-Anne, Klein, Britt, Ciechomski, Lisa
- Authors: Abbott, Jo-Anne , Klein, Britt , Ciechomski, Lisa
- Date: 2008
- Type: Text , Journal article
- Relation: Journal of Technology in Human Services Vol. 26, no. 2-4 (2008), p. 360-375
- Full Text: false
- Reviewed:
- Description: This article discusses important issues in delivery of best practice Internet-based therapy (etherapy). Etherapy is first defined as the interaction between a consumer and a therapist via the Internet (commonly via e-mail) in association with the use of a structured web-based clinical treatment program. A summary of the professional and ethical issues is provided, along with illustrated examples of best-practice principles experienced in clinical and research work by members of the Swinburne University of Technology Etherapy Unit (formerly the Etherapy Research, Education, and Training Unit in the Department of General Practice at Monash University). Etherapy has been found to be effective in treating a range of psychological disorders. Future research investigating methods of enhancing consumers' ability to engage in etherapy should further increase the effectiveness of this type of therapy. © 2008 by The Haworth Press. All rights reserved.
- Verheyen, Vincent, Cruickshank, Alicia, Wild, Karl, Heaven, M., McGee, R., Watkins, Mark, Nash, David
- Authors: Verheyen, Vincent , Cruickshank, Alicia , Wild, Karl , Heaven, M. , McGee, R. , Watkins, Mark , Nash, David
- Date: 2010
- Type: Text , Journal article
- Relation: Bioresource Technology Vol. 102, no. 2 (2010), p. 2118-2125
- Full Text: false
- Reviewed:
- Description: Wastewater from a dairy processor is being reused and recycled both within the plant and for irrigation. Flash pyrolysis GC–MS was used to examine nitrogen and phenol containing compounds (M.W. = 35 to 450 g/mol) in the particulate fraction of the milk condensate, combined clean wastewater and aerobic bioreactor effluent. For comparison, the particulates were also prepared for standard GC–MS analyses using conventional solvent extraction methods. Compounds detected by pyrolysis GC–MS were found mostly in the bioreactor with the amino acid arginine (220 mg/kg) and the amino acid derivative 1-methyl-5-oxo-L-proline methyl ester (130 mg/kg) found at the highest concentrations. In comparison, sterols detected in the effluent were found at higher concentrations when using solvent extraction indicating some degradation with pyrolysis GC–MS. However, with few exceptions, particulates were generally found not to act as passive collectors capable of concentrating less water soluble chemicals.
- Ondrasek, Gabrijel, Kranjčec, Filip, Filipović, Lana, Filipović, Vilim, Bubalo Kovačić, Marina, Badovinac, Ivana Jelovica, Peter, Robert, Petravić, Mladen, Macan, Jelena, Rengel, Zed
- Authors: Ondrasek, Gabrijel , Kranjčec, Filip , Filipović, Lana , Filipović, Vilim , Bubalo Kovačić, Marina , Badovinac, Ivana Jelovica , Peter, Robert , Petravić, Mladen , Macan, Jelena , Rengel, Zed
- Date: 2021
- Type: Text , Journal article
- Relation: The Science of the total environment Vol. 753, no. (2021), p. 141902-141902
- Full Text: false
- Reviewed:
- Description: One of negative side-effects of usage of bio-renewables might be generation of mineral (ash) material, potential source of environmental pollution. A hypothesis was that bottom ash (BA from biomass cogeneration facility) could be efficiently (re) used in soil chemical conditioning similarly to widely-used dolomite-based soil conditioner (DO from Croatian Dinaric-coastal region) which we tested by: i) physicochemical characterisation of BA and DO, and ii) bioassay with Raphanus sativus cultivated in acidic soil amended with BA or DO. Scanning electron microscopy with energy dispersive X-ray spectroscopy (SEM-EDX) confirmed complex chemical/physical structures and morphology between amendments, X-ray diffraction (XRD) showed their distinctive mineralogy with predominantly dolomite (in DO) vs. quartz and calcite (in BA), while secondary ion mass spectrometry (SIMS) revealed their diverse elemental/isotopic composition. The BA or DO amendments ameliorated soil acidity, increased available P, K and most other nutrients, but not Cd. The BA or DO amendments improved vegetative growth and edible hypocotyl yield. However, both amendments also increased Cd accumulation in all radish tissues, which was unexpected given the alkaline matrix of bio-ash and dolomite that would be likely to facilitate retention and immobilisation of toxic Cd. Thus, thorough characterisation and evaluation of BA- and/or DO-based materials and relevant soils (with an emphasis on metal sorption/immobilisation) prior to application in (agro) ecosystems is crucial for producing food clean of toxic metals. [Display omitted] •Biomass bottom ash (BA) & dolomite (DO) are very alkaline (pHKCl = 10.2–11.2) matrices.•BA & DO ameliorated soil acidity quickly (by >1.5 pH units) & nutrient availability.•BA & DO improved radish vegetative growth & nutrition accumulation.•BA & DO increased Cd uptake and accumulation in all radish tissues.
Transdisciplinary synthesis for ecosystem science, policy and management : The Australian experience
- Lynch, Jasmyn, Thackway, Richard, Specht, Alison, Beggs, Paul, Brisbane, S., Burns, E. L., Byrne, M., Capon, Samantha, Casanova, Michelle, Clarke, Philip, Davies, J. M., Dovers, Stephen, Dwyer, R. G., Ens, Emilie, Fisher, Diana, Flanigan, M., Garnier, E., Guru, Siddeswara, Kilminster, Kieryn, Locke, John, Mac Nally, Ralph, McMahon, Kathryn, Mitchell, Paul, Pierson, J. C., Rodgers, Essie, Russell-Smith, Jeremy, Udy, James, Waycott, Michelle
- Authors: Lynch, Jasmyn , Thackway, Richard , Specht, Alison , Beggs, Paul , Brisbane, S. , Burns, E. L. , Byrne, M. , Capon, Samantha , Casanova, Michelle , Clarke, Philip , Davies, J. M. , Dovers, Stephen , Dwyer, R. G. , Ens, Emilie , Fisher, Diana , Flanigan, M. , Garnier, E. , Guru, Siddeswara , Kilminster, Kieryn , Locke, John , Mac Nally, Ralph , McMahon, Kathryn , Mitchell, Paul , Pierson, J. C. , Rodgers, Essie , Russell-Smith, Jeremy , Udy, James , Waycott, Michelle
- Date: 2015
- Type: Text , Journal article
- Relation: Science of the Total Environment Vol. 534, no. (2015), p. 173-184
- Full Text: false
- Reviewed:
- Description: Mitigating the environmental effects of global population growth, climatic change and increasing socio-ecological complexity is a daunting challenge. To tackle this requires synthesis: the integration of disparate information to generate novel insights from heterogeneous, complex situations where there are diverse perspectives. Since 1995, a structured approach to inter-, multi- and trans-disciplinary. 11Transdisciplinary: A theory, methodology, point of view or perspective that transcends entrenched categories and engages both researchers and practitioners in formulating problems in new ways to address real-world problems (e.g. eco-health, ecosystem services). collaboration around big science questions has been supported through synthesis centres around the world. These centres are finding an expanding role due to ever-accumulating data and the need for more and better opportunities to develop transdisciplinary and holistic approaches to solve real-world problems. The Australian Centre for Ecological Analysis and Synthesis (ACEAS <. http://www.aceas.org.au>) has been the pioneering ecosystem science synthesis centre in the Southern Hemisphere. Such centres provide analysis and synthesis opportunities for time-pressed scientists, policy-makers and managers. They provide the scientific and organisational environs for virtual and face-to-face engagement, impetus for integration, data and methodological support, and innovative ways to deliver synthesis products.We detail the contribution, role and value of synthesis using ACEAS to exemplify the capacity for synthesis centres to facilitate trans-organisational, transdisciplinary synthesis. We compare ACEAS to other international synthesis centres, and describe how it facilitated project teams and its objective of linking natural resource science to policy to management. Scientists and managers were brought together to actively collaborate in multi-institutional, cross-sectoral and transdisciplinary research on contemporary ecological problems. The teams analysed, integrated and synthesised existing data to co-develop solution-oriented publications and management recommendations that might otherwise not have been produced. We identify key outcomes of some ACEAS working groups which used synthesis to tackle important ecosystem challenges. We also examine the barriers and enablers to synthesis, so that risks can be minimised and successful outcomes maximised. We argue that synthesis centres have a crucial role in developing, communicating and using synthetic transdisciplinary research. © 2015 Elsevier B.V.
- «
- ‹
- 1
- ›
- »