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Patient reported outcome measures (PROMs) are widely used to capture patients' perspectives of their health status and treatment outcomes and to enable practitioners to evaluate the effectiveness of interventions. The aim of this study was to explore Australian osteopaths' perceptions of the use of respiratory PROMS in the management of chronic lung conditions. This study drew on the social ecological model (SEM), which highlights the interdependence of contextual structures and processes. Osteopaths who were initially part of a larger mixed-methods study were invited to participate in semi-structured interviews. Transcripts were thematically analysed using the SEM. Seven of the original study osteopaths were interviewed. When presented with a patient who had a co-morbid respiratory condition, they focused on the musculoskeletal aspects of that condition (intrapersonal factors). Participants described sporadic use of musculoskeletal and quality of life PROMs in practice, and scarce use of respiratory PROMs (intrapersonal and organizational factors). Participants' perceptions of their scope of practice strongly influenced their use of respiratory PROMs (environmental factors). Intrapersonal and environmental factors were dominant drivers for participants' scant use of respiratory PROMs. Further education on the scope and contribution of osteopaths to the management of chronic lung conditions and the use of respiratory PROMS is called for to promote multidisciplinary patient care. • Osteopaths described sporadic use of musculoskeletal and quality of life PROMs and scarce use of respiratory PROMs. • Osteopaths treated COPD in the context of a co-morbidity associated with musculoskeletal conditions. • Integrating a biomedical approach with holism and wellness was considered a barrier to the use of PROMs. [ABSTRACT FROM AUTHOR]

This paper investigates the perceptions, attitudes and experiences of osteopathy students who had opportunity to engage with differing curriculum interventions focused on patient communication, and compare these with those of industry professionals. Three different osteopathy student cohorts had opportunity to engage with different communication curriculum interventions. Using focus group discussions, perceptions, attitudes, and experiences about patient centred care were gathered and thematically analysed using a realist lens. Semi-structured interviews were conducted with industry professionals to capture their perceptions, attitudes and experiences about patient centred care and compared with the students. Cohorts with zero or one semester of advanced communication curriculum displayed underdeveloped concepts about the professional skill sets needed of an osteopath, patient-centred care and confidence and readiness for supervised clinical practise. In stark contrast, the one cohort who had opportunity to engage with the full communication curriculum i.e. introductory and advanced displayed views about patient centred care closely aligned with the views of industry professionals, demonstrated advanced ideas about skill sets of an osteopath, and were eager to commence supervised clinical practise. An explicit and appropriately integrated curriculum appears to expedite student confidence and maturity to align more closely with industry professional views regarding the skill priorities needed of an osteopath. [ABSTRACT FROM AUTHOR]

This paper explores the adaptation and validation of the SEGUE checklist as a tool to assess clinical communication skills in undergraduate osteopathy students in Australia. A literature review guided instrument selection of the SEGUE tool for the learning, teaching and assessment of clinical communication skills in undergraduate osteopathy students. The SEGUE framework checklist was modified and adapted to meet the practises of undergraduate osteopathy students and a subsequent study was conducted to assess its validity; intra-rater and inter-rater reliability over three time points. A modified SEGUE checklist was developed and validated. Statistical analysis revealed acceptable inter-rater reliability at two time points six weeks apart. Intra-rater reliability revealed moderate to good reliability between the two time points six weeks apart. Testing also revealed scope for further sub-element refinement. The SEGUE checklist has the potential to be suitably adapted for both teaching and assessing clinical communication skills in undergraduate osteopathy students. Further work across a number of universities is needed to add and refine sub-elements of the checklist. [ABSTRACT FROM AUTHOR]

Digital health technologies are poised to revolutionise the healthcare industry by improving accessibility to services and patient outcomes. The novel coronavirus disease-19 (COVID-19) pandemic has presented unprecedented challenges for the delivery of allied healthcare and has catalysed rapid adoption of telehealth. As such, allied healthcare consumers and providers stand to benefit from the capabilities of the digital health movement, ultimately justifying a scoping review of current and emerging technologies. To provide decision makers with up-to-date information on the allied health applications of new and emerging digital health technologies; their evidence of efficacy, scope of use, and limitations. A scoping review of the literature was conducted, guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. To synthesise original research, MEDLINE, CINAHL, and EMBASE databases were searched from 2010 to June 2020 and reference lists were examined for randomised control trials analysing the efficacy of these technologies in allied health applications. A total of 14 articles were included with a focus on common musculoskeletal conditions managed by allied health service providers. Studies were selected for data extraction after abstract and full-text screening by three independent reviewers. The results of this review indicate that telehealth technology effectively monitors and progresses patient care, while mobile health applications provide remote support and enable data collection. Emerging trends suggest that digital technologies serve as promising adjuncts to allied healthcare. Further research is warranted regarding the safety and efficacy of digital health technologies in this context. [ABSTRACT FROM AUTHOR]

Telehealth is increasingly becoming a significant strategy for the delivery of healthcare in Australia in a wide range of professions. Recent physical distancing requirements were a catalyst for professions such as osteopathy (where the dominant care model is manual therapy) to make significant changes to adapt their approach for telehealth platforms. To explore the perceptions of Australian osteopaths' use of telehealth for patient care, and the associated barriers and enablers of its implementation. The Theoretical Domains Framework informed the development of semi-structured interviews which were conducted with osteopaths. Transcriptions were analysed thematically. Nine osteopaths participated in semi-structured interviews. They described their beliefs about osteopathy and the challenge telehealth has posed to their professional identity as healthcare providers. Osteopaths described uses ranging from simply staying connected with patients, through to innovative ways to assess and teach patients how to self-treat and self-manage their conditions. Enablers for the use of telehealth by participating osteopaths were face-to-face practice restrictions imposed during the pandemic lockdown and acknowledgement of the potential for telehealth to offer convenient and beneficial care, particularly for patients with limited access. Participating osteopaths who saw their value and self-worth as healthcare providers of manual therapy, and a lack of training in telehealth platforms, were major barriers to its uptake in osteopathic practice. [ABSTRACT FROM AUTHOR]

The future health and longevity of the osteopathy profession relies heavily on its practitioners and industry stakeholders to support it. Possessing a deeper understanding of practitioner and stakeholder views of the profession may provide crucial insights into the wellbeing of the workforce and their perceived skills and expertise in the wider healthcare landscape. To provide a review of current and emerging attitudes, beliefs and behaviours of Australian osteopaths and supportive external stakeholders towards the profession. A qualitative approach using grounded theory explored the attitudes, beliefs and behaviours of Australian osteopaths and supportive external stakeholders. Purposive sampling identified 18 practitioners (Victoria 10, Western Australia 5, and New South Wales 3) and 6 external stakeholders. All participated in semi-structured focus groups. A constant comparative method followed data collection whereby repeated ideas formed the extraction of the emerging themes presented. Central themes for each group included: 1) practitioner wellbeing and 2) osteopathic skills and expertise. Subthemes included: 1) career sustainability and longevity for practitioners, and 2) osteopathy within the broader context of allied healthcare in Australia. Threats to practitioner wellbeing included lack of early career support, limited career pathways, and uncertainty surrounding the future of the profession. External stakeholders echoed similar concerns regarding the future of the profession, acknowledging whilst osteopathy may play a sustainable role in managing the health and wellbeing of Australians, their skills and expertise are not unique nor exclusive to the profession, are under-evidenced, and undervalued by other healthcare professionals. Fostering a healthy and fulfilled workforce lies in securing a sustainable role for the profession by addressing these limitations. • Sustainability of the osteopathy profession is strongly influenced by the professional satisfaction of its workforce; thus, efforts are required to mitigate significant threats to practitioner wellbeing, most notably uncertainty surrounding the future of the profession and its place in contemporary healthcare. • Osteopathy is positioned as an economical, accessible, and complementary healthcare modality; however, the current skills and expertise are not well defined nor are they unique or exclusive to the profession. • Repurposing current skillsets and developing pathways for specialized care addressing pressing healthcare needs will be significantly advantageous for the longevity of osteopathy in Australia and the wellbeing of its workforce. [ABSTRACT FROM AUTHOR]

Dry powder inhalers are increasingly popular for delivering drugs to the lungs for the treatment of respiratory diseases, but are complex products with multivariate performance determinants. Heuristic product development guided by in vitro aerosol performance testing is a costly and time-consuming process. This study investigated the feasibility of using artificial neural networks (ANNs) to predict fine particle fraction (FPF) based on formulation device variables. Thirty-one ANN architectures were evaluated for their ability to predict experimentally determined FPF for a self-consistent dataset containing salmeterol xinafoate and salbutamol sulfate dry powder inhalers (237 experimental observations). Principal component analysis was used to identify inputs that significantly affected FPF. Orthogonal arrays (OAs) were used to design ANN architectures, optimized using the Taguchi method. The primary OA ANN r² values ranged between 0.46 and 0.90 and the secondary OA increased the r² values (0.53-0.93). The optimum ANN (9-4-1 architecture, average r² 0.92 ± 0.02) included active pharmaceutical ingredient, formulation, and device inputs identified by principal component analysis, which reflected the recognized importance and interdependency of these factors for orally inhaled product performance. The Taguchi method was effective at identifying successful architecture with the potential for development as a useful generic inhaler ANN model, although this would require much larger datasets and more variable inputs. [ABSTRACT FROM AUTHOR]

Analogous to medical professionals, allied healthcare manual therapies such as osteopathy, chiropractic and physical therapy/physiotherapy rely on patient centred communication skills to optimise positive outcomes of clinical encounters. The objective of this review is to identify how communication skills are taught and learned within these specific professions. CINAHL, AMED, PubMED, ERIC and PsychINFO were searched in April 2018 (search years: inception-2018). Papers were independently selected by two researchers. A narrative synthesis of results was formulated. Six papers on how patient centred communication skills are being developed in the undergraduate manual therapy healthcare professions were identified. All excluding one paper reported interventions used in undergraduate physical therapy/physiotherapy. The additional paper provided a summary of teaching methods used in undergraduate physical therapy/physiotherapy university programmes across the United Kingdom. Training programmes employed a combination of instruction, modelling and problem-based learning. Only one paper measured the effectiveness of their training to identify if the changes in the students' patient centred communication skills were observable. There is little evidence to indicate communication skills training is being provided to chiropractic and osteopathy students. However, communication skills training is being provided to physical therapists/physiotherapists and is varied in the types of teaching techniques used, the duration of teaching and the timing of teaching around clinical placements. [ABSTRACT FROM AUTHOR]

This paper investigates the impact of a spiral curriculum intervention using a validated assessment rubric for communication skill development of undergraduate osteopathy students. Over a three-year period, students from three cohorts were exposed to zero, one or two semesters of a newly integrated and scaffolded communication curriculum. Using a checklist rubric to collect mean scores and then undertaking comparisons through Pearson chi square analysis, the impact of the curriculum intervention on communication skill development was explored. Cohorts who received zero or two full semesters of communication curriculum performed better (x = 6.34, x = 10.51 respectively) than the cohort who received one (x = 6.03). Despite using an explicit assessment rubric, insufficiently contextualised and integrated curriculum appears to disrupt student learning, whilst a spiralled, scaffolded curriculum delivered at an appropriate level in combination with explicit assessment rubrics work well together to support deeper learning and development. ∙An insufficiently contextualised and integrated curriculum combined with the frequency of content being re-visited (spiral curriculum) can disrupt the students learning experience. ∙Using a spiralled and scaffolded curriculum significantly improves the development of communication skills. ∙For deeper learning to occur students require a combination of both explicit curriculum and accompanying assessment rubrics. [ABSTRACT FROM AUTHOR]

A variety of capsule-based dry powder inhalers were used to evaluate formulation-device interaction. The in vitro deposition of salbutamol sulphate ( SS) was compared directly to published data for salmeterol xinafoate ( SX). A 32 factorial design was used to assess the effect of SS formulations with three blends of different grade coarse lactose supplemented with different levels of fine lactose. These formulations were tested for homogeneity and evaluated for their in vitro deposition using Aeroliser, Handihaler and Rotahaler devices. The performance of the SS-lactose formulations differed across the grade of lactose and amount of fine lactose used compared to the same powder compositions blended with SX. SX had a greater fine particle fraction than SS for most of the comparable formulations, probably because of the different cohesiveness of the drugs. A head-to-head comparison of 'matched' SX and SS formulations when aerosolised from the same three devices demonstrated that formulation-device interactions are as critical in determining the in vitro deposition of drug-lactose blends as the identity of the active pharmaceutical ingredient. This work has revealed the limitations of the interpretative value of published in vitro performance data generated with a single device (even at equivalent aerosolisation force), when designing formulations for a different device. © 2015 Wiley Periodicals, Inc. and the American Pharmacists Association J Pharm Sci 104:3861-3869, 2015 [ABSTRACT FROM AUTHOR]

Objectives: Our objective was to evaluate the impact of vein graft harvesting technique on structure and function of vasa vasorum. Methods: Paired segments of great saphenous veins harvested either with conventional harvesting technique or no-touch technique were obtained from 9 consecutive patients undergoing coronary artery bypass grafting. Quantitative measurements, using immunohistochemistry and morphometry, were performed. Ultrastructural analyses of vasa vasorum were performed with electron microscopy. Video footage of superficial vasa vasorum in an implanted saphenous vein graft harvested with the no-touch technique was captured during a coronary bypass operation and is presented for online viewing. Results: The total area of vasa vasorum in vein grafts harvested with the conventional technique was significantly reduced both in the media (P = .007) and in the adventitia (P = .014) compared with vein grafts harvested with the no-touch technique. Ultrastructural findings indicated that the no-touch technique preserved an intact vasa vasorum whereas the conventional technique did not. Video footage showed retrograde flow in the vasa vasorum in vein graft harvested with the no-touch technique. Conclusions: These findings show that the no-touch technique for saphenous vein graft harvesting for coronary bypass grafting preserves an intact vasa vasorum. This could represent one of the mechanisms underlying the improved patency of saphenous vein grafts harvested with this technique. [ABSTRACT FROM AUTHOR]

Purpose: The melanocortin-1 receptor (MC1R) regulates melanin biogenesis. Deoxyribonucleic acid sequence variants in the form of single nucleotide polymorphisms (SNPs) of MC1R affect melanin expression and are linked to skin phenotype. We aimed to determine whether SNPs of MC1R were associated with unexpectedly severe ionizing radiation reactions. Methods and Materials: The MC1R genotype of a cohort of Australians with unexpectedly severe acute and/or late reactions (Common Terminology Criteria Version 3 (CTCv3) Grade 3 or 4) to radiotherapy (RT) for cancer (n = 30) was analyzed. The findings were compared with control data from our previous study of MC1R representative of the general Australian population (n = 1,787). Results: The difference in frequency of alleles encoding a “red hair color” phenotype in the cohort of patients with unexpectedly severe acute radiation reactions (n = 12) was significantly increased compared with the control population (p = 0.003). Acute radiosensitivity was especially associated with the R160W variant allele (odds ratio, 3.64 [95% confidence interval, 1.3–10.27]). The corresponding comparison of MC1R controls with unexpectedly severe late radiation reactions (n = 18) was not significant. It was also found that R160W as a part of the genotype in the patients with unexpectedly severe acute RT side effects as compared with the control group was also significant (p = 0.043). Conclusions: In this small cohort of cancer patients, deoxyribonucleic acid sequence variants of the MC1R gene, especially the R160W variant, have been associated with unexpectedly severe acute reactions to RT. This result needs to be verified in a larger cohort of patients. [Copyright &y& Elsevier]

Abstract: A variation of the Orowan equation is developed for aluminium alloys strengthened by dispersed, deformation-resistant {100} α precipitate plates, and the quantitative effects of precipitate volume fraction, number density and aspect ratio on increments in Orowan strengthening are examined. The validity of the model is examined by a combination of mechanical property measurements and rigorous quantitative stereology of the size and distribution of {100} α plates of θ′ phase in an Al–4Cu–0.05Sn (wt.%) alloy aged isothermally at 200°C. For the ageing conditions selected, the predictions of the model for Orowan strengthening increments are in good quantitative agreements with those observed experimentally. The model predicts that, for a given volume fraction and number density of precipitate plates, an increase in plate aspect ratio can lead to a substantial increase in strength. In addition, it is not necessary to invoke a transition from precipitate deformation to Orowan strengthening to account for the form of the precipitation-strengthening response of the alloy. The maximum strengthening increment is associated with the minimum effective inter-particle spacing, rather than a critical thickness of the precipitate plates. [Copyright &y& Elsevier]

Abstract: The solution pH in a given bioleaching operation is determined by the balance between the acid-producing and acid-consuming reactions and also by the input of acid or alkali into the system by the mine-site operator. Despite the general understanding of the need for low pH for bioleaching of mineral sulfides, very little research has been conducted to describe the effect of pH on rates of Fe2+ and S0 oxidation by bioleaching strains. A series of experiments was performed using pH-stat batch stirred tank reactors and selected bioleaching strains to examine the effect of pH on the growth of the strains and oxidation rates of Fe2+ and S0. Activity and growth of test strains at pH ranging from 0.5 to 3.5 were monitored over time. Sulfobacillus thermosulfidooxidans had a narrow optimum pH range for oxidation of Fe2+, whereas Acidithiobacillus thiooxidans had a relatively broad optimum pH range for growth and oxidation of S0. To a lesser extent, Leptospirillum ferriphilum and Metallosphaera hakonensis also had a relatively broad optimum pH range for oxidation of Fe2+. The two archaeal strains grew or oxidised energy sources optimally over a lower pH range than most of the bacterial strains tested. This study showed that some microorganisms respond differently when grown at different pH. This variation in the effect of pH on the growth and activity of bioleaching strains has implications for selection of strains applied to bioleaching processes. [Copyright &y& Elsevier]

The paper presents results of the experimental investigation of the role of strain rate and temperature on stress corrosion cracking (SCC) of mild steel at elevated temperatures. For investigation of SCC-susceptibility, slow strain rate tests were carried out at various strain rates (in the range of 0.12×10-6–0.55×10-6 s-1) in an industrial caustic solution and an inert environment (liquid paraffin) at 90 and 150 °C. The mode of the SCC crack propagation and the fractographic details of the specimens tested in the two environments have been compared. The investigation suggests susceptibility of the mild steel to SCC in the given caustic solution at 150 °C only when the tests were carried out at a strain rate <0.25×10-6s-1, and no susceptibility at 90 °C. [Copyright &y& Elsevier]

This paper presents failure analysis of an ex-service cast iron component exposed to aggressive caustic solutions during Bayers process for alumina processing. The cracks and the neighbouring areas in the ex-service samples were examined using conventional metallography, scanning electron microscopy (SEM), the extraction replica technique in the transmission electron microscope (TEM) and Auger electron spectroscopy (AES). The features include intergranular stress corrosion cracking and grain boundary embrittlement ahead of the crack-tips. The paper also argues the possibility of hydrogen-assisted crack propagation. [Copyright &y& Elsevier]

Formation of bainite in steels requires redistribution of carbon and is thus diffusional, but not necessarily diffusion controlled. Formation of bainitic ferrite involves an invariant plane strain change of shape and is thus unquestionably displacive. A conceptual framework is provided, within which these apparently conflicting descriptions of the transformation may be reconciled. [Copyright &y& Elsevier]

The prevalence of in-service failures in the welds of chromium–molybdenum ferritic steels causes great concern in steam generating/handling systems of power plants, and components of petroleum/petrochemical industries. This paper is a review of the non-uniform scaling behaviour across microstructural gradients in weldments of pressure vessel steels in order to develop a global model for life-assessment by relating oxide scale thickness with time–temperature history of in-service components. The paper also investigates gaseous corrosion-assisted deterioration of the weldment microstructure. [Copyright &y& Elsevier]

Abstract: In this study, corrosion of Zn surfaces caused by fine size acidified droplets (diameter ∼0.1–5μm) was quantified. Fine size droplets of various chemistries were deposited using an unmodified inkjet printer and damage was quantified in terms of volume loss (ΔV) as determined through optical profilometry (OP). SEM–EDS and FIB milling were used to characterise corrosion products and perform cross-sectional analysis of surface oxides. Results show synergistic interactions between chloride concentration and the types of acids used for acidification. Corrosion under fine size droplets was found to be dependent on the initial volume of aerosols, oxygen diffusion, surface area to volume ratio and likely the microstructural features of the underlying metal. [Copyright &y& Elsevier]

Abstract: Precipitation of the γ′(AlAg2) phase was investigated in Al–Ag(–Cu) alloys using high-resolution transmission electron microscopy and scanning transmission electron microscopy. Precipitation commenced with segregation of Ag to stacking faults, followed by thickening in steps corresponding to single unit cell height ledges. In conjunction with gradual segregation of Ag and Al into ordered layers, this yielded γ′ phase platelets with a thickness of either 2 or 3×the AlAg2 c-lattice parameter. Plates with a thickness of 2c(AlAg2) could not achieve self-accommodation of the shape strain for transformation. Further thickening of the precipitates was slow, despite considerable Ag segregation around the precipitates. Growth by the addition of single unit cell height ledges is expected to lead to an additional shear strain energy barrier to ledge nucleation and this may contribute to a process of nucleation-limited growth. [Copyright &y& Elsevier]

Abstract: Atmospheric corrosion of Zn under a variety of simulated marine aerosols was studied. In-situ monitoring of droplet pH, volume loss measurements, identification and distribution of crystalline and amorphous phases from corrosion under different droplets were used to understand the role of acidification on atmospheric corrosion of Zn. Results for various droplet chemistries are discussed in terms of initiation mechanism, phase distribution and surface morphology in conjunction with chemical equilibrium calculations. Zn exposed to sulphate containing droplets had relatively small corrosion rates and greater coverage with Gordaite as compared to sulphate-free droplets where coupons have relatively more coverage with Simonkolleite. [Copyright &y& Elsevier]

A genuine non-destructive imaging of embedded nanoparticles is demonstrated using the novel technique of momentum-transfer X-ray diffraction imaging. For the first time, the method yields direct estimation of the statistical properties of the nanoparticle ensemble. Statistical analysis of the experimental data reveals quantitative information about the size distribution of the diffracting objects. Experimental results defining the statistically average form, orientation and dimensions of metastable Al2Cu (θ″, θ′ phases) precipitates embedded in binary Al–Cu solid solution are reported and analyzed. [ABSTRACT FROM AUTHOR]