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Introduction: Allied health assistants are support staff who assist medical imaging professionals in their clinical and non‐clinical role. Assistants can improve efficiency of medical imaging services; however, little is known about the specific tasks they perform. Method: A two‐phase explanatory, sequential mixed‐methods study design comprising a time motion survey and qualitative interviews was conducted across three health services in Victoria, Australia. Participants were medical imaging assistants supporting medical imaging professionals. Participants recorded tasks completed on a time motion proforma across two working days. Time spent on tasks was categorised into patient related and non‐patient related tasks. Semi‐structured interviews were conducted to explore assistants' perspectives about tasks, their roles and any responsibilities. Time motion data was descriptively analysed. Qualitative data were audiotaped, transcribed verbatim and analysed using the framework analysis method. Quantitative and qualitative findings were integrated using data triangulation. Results: Four medical imaging assistants participated, providing 4170 min of time motion data and 138 min of interview data. Integration of time motion and interview data revealed the medical imaging assistant role is predominantly non‐patient facing; autonomous and critical to workflow; diverse and requires flexibility; has the potential to expand into a more patient‐facing role. Conclusions: Medical imaging assistants make significant contributions to workflow management. Their role is predominantly non‐patient facing but there appear opportunities for the clinical role to expand. Realizing these opportunities will require careful consideration of the challenges and benefits of extending their scope of practice. [ABSTRACT FROM AUTHOR]

Background: Allied health assistants (AHAs) are support staff who complete patient and non-patient related tasks under the delegation of an allied health professional. Delegating patient related tasks to AHAs can benefit patients and allied health professionals. However, it is unclear whether the AHA workforce is utilised optimally in the provision of patient care. The purpose of this study was to determine the proportion of time AHAs spend on patient related tasks during their working day and any differences across level of AHA experience, clinical setting, and profession delegating the task.Methods: A time motion study was conducted using a self-report, task predominance work sampling method. AHAs were recruited from four publicly-funded health organisations in Victoria, Australia. AHAs worked with dietitians, occupational therapists, physiotherapists, podiatrists, social workers, speech pathologists, psychologists, and exercise physiologists. The primary outcome was quantity of time spent by AHAs on individual task-categories. Tasks were grouped into two main categories: patient or non-patient related activities. Data were collected from July 2020 to May 2021 using an activity capture proforma specifically designed for this study. Logistic mixed-models were used to investigate the extent to which level of experience, setting, and delegating profession were associated with time spent on patient related tasks.Results: Data from 51 AHAs showed that AHAs spent more time on patient related tasks (293 min/day, 64%) than non-patient related tasks (167 min/day, 36%). Time spent in community settings had lower odds of being delegated to patient related tasks than time in the acute hospital setting (OR 0.44, 95%CI 0.28 to 0.69, P < 0.001). Time delegated by exercise physiologists and dietitians was more likely to involve patient related tasks than time delegated by physiotherapists (exercise physiology: OR 3.77, 95% 1.90 to 7.70, P < 0.001; dietetics: OR 2.60, 95%CI 1.40 to 1.90, P = 0.003). Time delegated by other professions (e.g. podiatry, psychology) had lower odds of involving patient related tasks than physiotherapy (OR 0.37, 95%CI 0.16 to 0.85, P = 0.02).Conclusion: AHAs may be underutilised in community settings, and by podiatrists and psychologists. These areas may be targeted to understand appropriateness of task delegation to optimise AHAs' role in providing patient care. [ABSTRACT FROM AUTHOR]

Coastal ecosystems are exposed to multiple anthropogenic stressors. Effective management actions would be better informed from generalized predictions of the individual, combined and interactive effects of multiple stressors; however, few generalities are shared across different meta-analyses. Using an experimental study, we present an approach for analysing regression-based designs with generalized additive models that allowed us to capture nonlinear effects of exposure duration and stressor intensity and access interactions among stressors. We tested the approach on a globally distributed marine diatom, using 72 h photosynthesis and growth assays to quantify the individual and combined effects of three common water quality stressors; photosystem II-inhibiting herbicide exposure, dissolved inorganic nitrogen (DIN) enrichment and reduced light (due to excess suspended sediment). Exposure to DIN and reduced light generally resulted in additivity, while exposure to diuron and reduced light resulted in additive, antagonistic or synergistic interactions, depending on the stressor intensity, exposure period and biological response. We thus find the context of experimental studies to be a primary driver of interactions. The experimental and modelling approaches used here bridge the gap between two-way designs and regression-based studies, which provides a way forward to identify generalities in multiple stressor interactions. [ABSTRACT FROM AUTHOR]

Simple Summary: Genetic rearrangements of the KMT2A gene are associated with diagnostic and prognostic outcomes in the context of myeloid neoplasms. While cytogenetically visible KMT2A rearrangements (e.g., translocations) are relatively straightforward to detect by conventional cytogenetics, KMT2A partial tandem duplications (KMT2A-PTD) are too small to be detected by karyotype or FISH. Our study compares the detection of the KMT2A-PTD using three technologies: next-generation sequencing, multiplex-ligation probe amplification, and optical genome mapping. Background: Gene rearrangements affecting KMT2A are frequent in acute myeloid leukemia (AML) and are often associated with a poor prognosis. KMT2A gene fusions are often detected by chromosome banding analysis and confirmed by fluorescence in situ hybridization. However, small intragenic insertions, termed KMT2A partial tandem duplication (KMT2A-PTD), are particularly challenging to detect using standard molecular and cytogenetic approaches. Methods: We have validated the use of a custom hybrid-capture-based next-generation sequencing (NGS) panel for comprehensive profiling of AML patients seen at our institution. This NGS panel targets the entire consensus coding DNA sequence of KMT2A. To deduce the presence of a KMT2A-PTD, we used the relative ratio of KMT2A exons coverage. We sought to corroborate the KMT2A-PTD NGS results using (1) multiplex-ligation probe amplification (MLPA) and (2) optical genome mapping (OGM). Results: We analyzed 932 AML cases and identified 41 individuals harboring a KMT2A-PTD. MLPA, NGS, and OGM confirmed the presence of a KMT2A-PTD in 22 of the cases analyzed where orthogonal testing was possible. The two false-positive KMT2A-PTD calls by NGS could be explained by the presence of cryptic structural variants impacting KMT2A and interfering with KMT2A-PTD analysis. OGM revealed the nature of these previously undetected gene rearrangements in KMT2A, while MLPA yielded inconclusive results. MLPA analysis for KMT2A-PTD is limited to exon 4, whereas NGS and OGM resolved KMT2A-PTD sizes and copy number levels. Conclusions: KMT2A-PTDs are complex gene rearrangements that cannot be fully ascertained using a single genomic platform. MLPA, NGS panels, and OGM are complementary technologies applied in standard-of-care testing for AML patients. MLPA and NGS panels are designed for targeted copy number analysis; however, our results showed that integration of concurrent genomic alterations is needed for accurate KMT2A-PTD identification. Unbalanced chromosomal rearrangements overlapping with KMT2A can interfere with the diagnostic sensitivity and specificity of copy-number-based KMT2A-PTD detection methodologies. [ABSTRACT FROM AUTHOR]

The Maritimes Basin of Atlantic Canada contains a rich record of Pennsylvanian cyclothems. Previous studies have focused on rapidly subsiding depocenters in the central part of the basin where Carboniferous successions feature cyclic alternations between terrestrial and marginal marine strata. In contrast, the Pennsylvanian Clifton Formation was deposited on the relatively stable New Brunswick platform and contains almost entirely terrestrial strata. Although early studies of the Clifton Formation noted a cyclic architecture, particularly within Member B, this unit has remained understudied. We provide a sedimentological and sequence stratigraphic framework for the lower 85 m of Member B and interpret our results relative to a broader regional framework. Near the base of the study interval, the highstand systems tract is composed of red floodplain mudrocks; overlying sequence boundaries are composed of calcretes and (or) channels. The transgressive systems tract and maximum flooding surface are represented by coals and aquatic bivalve-bearing mudrocks. Moving upward through the section, the architecture of the highstand systems tract remains largely unchanged while sequence-bounding paleosols become less well developed, the transgressive systems tract becomes thinner and eventually not preserved, and the maximum flooding surface is only occasionally preserved, possibly represented by carbonaceous shales. These changes in cyclic architecture may be attributed to changes in the magnitude of glacioeustatic fluctuations, climate, and (or) the accommodation/sediment supply ratio. The results of this study show that the Clifton Formation represents the terrestrial/proximal endmember for cyclicity in the Maritimes Basin and provide new insight into paleotopography as a possible control on cyclothem architecture. [ABSTRACT FROM AUTHOR]

Background: Diabetes educators provide self-management education for people living with diabetes to promote optimal health and wellbeing. Their national association is the Australian Diabetes Educators Association (ADEA), established in 1981. In Australia the diabetes educator workforce is a diverse, interdisciplinary entity, with nurses, podiatrists, dietitians and several other health professional groups recognised by ADEA as providers of diabetes education. Historically nurses have filled the diabetes educator role and anecdotally, nurses are perceived to have wider scope of practice when undertaking the diabetes educator role than the other professions eligible to practise diabetes education. The nature of the interprofessional role boundaries and differing scopes of practice of diabetes educators of various primary disciplines are poorly understood. Informed by a documentary analysis, this historical review explores the interprofessional evolution of the diabetes educator workforce in Australia and describes the major drivers shaping the role boundaries of diabetes educators from 1981 until 2017. Methods: This documentary analysis was undertaken in the form of a literature review. STARLITE framework guided the searches for grey and peer reviewed literature. A timeline featuring the key events and changes in the diabetes educator workforce was developed. The timeline was analysed and emerging themes were identified as the major drivers of change within this faction of the health workforce. Results: This historical review illustrates that there have been drivers at the macro, meso and micro levels which reflect and are reflected by the interprofessional role boundaries in the diabetes educator workforce. The most influential drivers of the interprofessional evolution of the diabetes educator workforce occurred at the macro level and can be broadly categorised according to three major influences: the advent of non-medical prescribing; the expansion of the Medicare Benefits Schedule to include rebates for allied health services; and the competency movement. Conclusion: This analysis illustrates the gradual movement of the diabetes educator workforce from a nursing dominant entity, with an emphasis on interprofessional role boundaries, to an interdisciplinary body, in which role flexibility is encouraged. There is however, recent evidence of role boundary delineation at the meso and micro levels. [ABSTRACT FROM AUTHOR]

The Campbellton Formation has long been known to yield a fossil assemblage of Devonian (Emsian) fish and eurypterids at its westernmost exposure near Campbellton and Atholville, and a well described flora and early land animal fauna toward its easternmost exposure near Dalhousie Junction. Although the body fossil assemblage (paleobotany, vertebrate and invertebrate paleontology), paleoecology and paleoenvironmental context of the formation have been extensively studied, ichnofossils are rare and have not been described previously. Fossils from the vertebrate and eurypterid bearing 'Atholville Beds' contain a low diversity ichnofossil assemblage represented by three ichnotaxa: Monomorphichnus, ?Taenidium and Helminthoidichnites. Monomorphichnus is proposed here as being produced by the produced by the activity of the eurypterid Pterygotus anglicus. [ABSTRACT FROM AUTHOR]

Background: Across the Western world, demographic changes have led to healthcare policy trends in the direction of role flexibility, challenging established role boundaries and professional hierarchies. Population ageing is known to be associated with a rise in prevalence of chronic illnesses which, coupled with a reducing workforce, now places much greater demands on healthcare provision. Role flexibility within the health professions has been identified as one of the key innovative practice developments which may mitigate the effects of these demographic changes and help to ensure a sustainable health provision into the future. However, it is clear that policy drives to encourage and enable greater role flexibility among the health professions may also lead to professional resistance and inter-professional role boundary disputes. In the foot and ankle arena, this has been evident in areas such as podiatric surgery, podiatrist prescribing and extended practice in diabetes care, but it is far from unique to podiatry. Methods: A systematic review of the literature identifying examples of disputed role boundaries in health professions was undertaken, utilising the STARLITE framework and adopting a focus on the specific characteristics and outcomes of boundary disputes. Synthesis of the data was undertaken via template analysis, employing a thematic organisation and structure. Results: The review highlights the range of role boundary disputes across the health professions, and a commonality of events preceding each dispute. It was notable that relatively few disputes were resolved through recourse to legal or regulatory mandates. Conclusions: Whilst there are a number of different strategies underpinning boundary disputes, some common characteristics can be identified and related to existing theory. Importantly, horizontal substitution invokes more overt role boundary disputes than other forms, with less resolution, and with clear implications for professions working within the foot and ankle arena. [ABSTRACT FROM AUTHOR]

Background: The health professions have progressed and evolved considerably over the last few decades in response to demographic, technological, societal and political changes. They continue to do so as the volume and complexity of population health needs steadily increase. Role boundary expansion is among the key changes to the health professions, including podiatry to meet demand. Nonetheless podiatry's role boundary expansion has not been achieved swiftly or without resistance from neighbouring and dominant professions. This paper seeks to explain the nature of this resistance with respect to the sociology of the professions literature and to shed light on some of the factors and processes at play when role boundary changes arise in health care. Discussion: Six of the most contemporaneously relevant sociology of the professions theories are summarised: Taxonomic, Marxian, Bourdieusian, Foucauldian, Boundary Work and Neo-Weberian paradigms. Conclusion: This review highlights that some paradigms are more relevant than others in the current socio-political landscape. It also illustrates that there is a common theme underlying each approach to defining the professions and their boundaries: competition. This may help health professionals, including podiatrists, to understand and manage the challenges and resistance experienced when professions attempt to expand role boundaries to meet increasing and changing population health needs. [ABSTRACT FROM AUTHOR]

A stem relative of dragon- and damselflies, Brunellopteron norradi Béthoux, Deregnaucourt and Norrad gen. et sp. nov., is documented based on a specimen found at Robertson Point (Grand Lake, New Brunswick, Canada; Sunbury Creek Formation; early Moscovian, Pennsylvanian) and preserving the basal half of a hindwing. A comparative analysis of the evolution of wing venation in early odonates demonstrates that it belongs to a still poorly documented subset of species. Specifically, it displays a MP + CuA fusion, a CuA + CuP fusion, and a CuP + AA fusion, but it lacks the "extended" MP + Cu / CuA fusion and the "extended" (CuP / CuA + CuP) + AA fusion, the occurrence of which is typical of most Odonata, including Meganeura-like species. The occurrence of intercalary veins suggests that its closest relative might be Gallotypus oudardi Nel, Garrouste and Roques, 2008, from the Moscovian of northern France. [ABSTRACT FROM AUTHOR]