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Increasing evidence of the effects of the COVID-19 pandemic on healthcare workers' mental health and wellbeing has prompted concerns about the longer-term impacts on healthcare delivery and health workforce sustainability. For rural health services and communities, the pandemic has compounded existing challenges including workforce shortages, potentially leading to further health inequalities. This qualitative interview study aimed to explore factors within and external to the health service environment that influenced health service staff mental health and wellbeing in rural and regional Victoria, Australia, during the first two years of the COVID-19 pandemic (2020-2021). Participants were recruited from nine publicly funded rural and regional health services. Semistructured interviews were conducted via videoconference, audio-recorded, and transcribed. Data were analysed using a five-stage framework approach. Eighteen health service staff from four rural areas participated in the study. A range of factors that were perceived by participants to influence their wellbeing were identified. These were coded to four main themes: (1) rural community relations, (2) the nature of the health workplace, (3) self-care and supportive networks, and (4) public health measures and the unpredictable nature of the pandemic. Factors coded to these themes were described as both positive and negative influences on health staff mental health and wellbeing. Optimising the mental health and wellbeing of rural health staff is imperative to the sustainability of this workforce during and beyond the COVID-19 pandemic. Rural health services must consider the community and health service (meso-level), individual (microlevel), and broader pandemic context (macrolevel) when developing and implementing strategies to promote staff wellbeing. Strategies must encompass the development of senior leadership capabilities, mechanisms to support effective leadership, and optimal communication processes within health services. Given the potential for community support to positively influence rural health staff wellbeing, community engagement should be a feature of health service wellbeing strategies. [ABSTRACT FROM AUTHOR]

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]

Allied health assistants (AHAs) are important members of the health workforce and key to meeting population health needs. Previous studies exploring the role and utility of AHAs from multiple stakeholder perspectives suggest AHAs remain poorly utilised in many healthcare settings. This qualitative study explores the experiences and perspectives of AHAs working in healthcare settings to determine the contextual factors influencing their role, and mechanisms to maximise their utility. We conducted semi‐structured interviews using purposive sampling with 21 AHAs, from one regional and three metropolitan health services in Australia, between February and July 2021. We used a team‐based framework approach to analyse the data. Four major themes were identified: 1) AHAs' interpersonal relationships, 2), clarity and recognition of AHA roles and role boundaries, 3) AHAs accessing education and professional development, and 4) the professional identity of the AHA workforce. Underpinning each of these themes were relationships between AHAs and other healthcare professionals, their patients, health services, and the wider AHA workforce. This study may inform initiatives to optimise the utility of AHAs and increase their role in, and impact on, patient care. Such initiatives include the development and implementation of guidelines and competencies to enhance the clarity of AHAs' scope of practice, the establishment of standardised educational pathways for AHAs, and increased engagement with the AHA workforce to make decisions about their scope of practice. These initiatives may precede strategies to advance the AHA career structure. [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]

Introduction and Objective: Building rural health workforce research capacity is critical to addressing rural health inequalities. Research training is a mainstay research capacity building strategy. This paper describes the delivery and evaluation of a research training program for rural and regional allied health professions (AHPs). Design: A mentored research training program was delivered to AHPs employed public health services in rural and regional Victoria, Australia. The program was evaluated using the Evidence‐Based Practice Knowledge Attitudes and Practice (EBP‐KAP) tool at baseline and 3 months post‐training. Semi‐structured interviews undertaken at 3 and 16 months post‐training explored participants' perspectives of the training, their development and application of EBP and research skills. Survey data were analysed descriptively, and interview data were analysed using a framework approach. Findings: Thirty‐four individuals from 14 organisations attended the first workshop and 31 attended the second. Thirty‐one participants completed the survey at baseline and nine at 3 months post‐training. Sixteen interviews were undertaken with 11 participants, five participating at both time points. Participants had positive EBP attitudes at both time points. Overall, participants' knowledge and incorporation of EBP into their practice, and retrieval of evidence was unchanged 3 months post‐training. Themes identified in the interview data were as follows: (1) individual research capacity enhanced through supported practice, (2) organisational factors influence individuals' progression of research and (3) individual contributions towards research capacity within the organisation. Conclusion: A mentored rural research training program promoted the application of EBP skills at the individual level and contributed to organisational research capacity. [ABSTRACT FROM AUTHOR]

General community occupational therapists (OTs) work with clients experiencing chronic and complex conditions, some living with one or more comorbid common mental health issues (such as anxiety, depression or distress). This study aimed to describe the perspectives of general community OTs of their engagement with clients experiencing mental health issues; their perceptions of the implementation of routine screening in their practice, and the knowledge, skills and support they need to identify and support their clients' mental health needs. Six focus groups were undertaken with general community OTs (n = 21) from three Australian health services in rural, regional and metropolitan settings, between December 2020 and January 2021. Data were analysed using a team‐based framework approach. Three key themes were identified: (1) OTs' experiences working with people with mental health issues; (2) impacts of engaging with clients experiencing mental health issues on OTs; and (3) implementing routine mental health screening in general community OT practice. The latter had two sub‐themes: (i) identified considerations and (ii) education and system‐level support needs. General community OTs frequently work with clients with mental health issues. These experiences impact their practice in multiple ways. This study highlights opportunities for integrating routine mental health screening into general community OT practice and identifies the system and educational development required to support this enhancement to practice. Supporting general community OTs to routinely screen for mental health issues will enhance collaborative client‐centred care. Our findings may also have implications for other community‐based health professionals and services, particularly those delivered in clients' homes. [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]

Informal interprofessional interactions have gained interest in recent interprofessional care, education, health services and social sciences research literature. Some of the established benefits associated with these interactions include enhanced communication, teamwork, research translation and the provision of safer care. Limited evidence about how informal interprofessional interactions are perceived by the allied health workforce, exists. The survey conducted at a large Australian health service explored allied health clinicians' perceptions of the benefits, challenges and enablers of informal interprofessional interactions and their recommendations to improve opportunities for these workplace interactions. Sixty-four responses were analysed descriptively (for close-ended questions) and using a framework analysis approach, informed by Bourdieu's social space theory (for open-ended questions). Perceived benefits were aligned with three themes: teams and organisations, individual clinicians and service-users. Challenges to, and enablers of, informal interprofessional interactions were identified according to five themes: socio-cultural practices, physical environment, timing-related factors, individual and organisational factors. Participant recommendations to increase opportunities for informal interprofessional workplace interactions for allied health reflected three of the aforementioned themes: socio-cultural practices, physical environment and organisational factors. This theoretically-informed analysis may aid in the development of strategies to support these types of workplace interactions and realise the benefits identified. [ABSTRACT FROM AUTHOR]

Work-integrated learning (WIL) is increasingly common in higher education, with benefits and risks for students and supervisors' wellbeing. Central to wellbeing is dignity, often described as the respectful treatment of others. While studies have explored dignity for employees, it is yet to be examined in the WIL context. This qualitative study explores 46 student and 30 supervisors' understandings of WIL dignity. Using purposive sampling, supervisors and students from 6 disciplines participated in 7 groups and 58 individual semi-structured interviews. Participants were asked to describe their understandings of workplace dignity and data were analysed using team-based framework analysis. Four themes were identified: (1) participants' difficulties articulating dignity; (2) concepts used to define dignity; (3) the valence of conceptualisations; and (4) the levels to which dignity were conceptualised. Both students and supervisors need to work together to better understand what dignity is as the crucial first step toward maximising dignity during WIL. [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]

Anger is typically thought to be an emotion that is associated with negative outcomes, such as aggression; however, evidence shows that anger can be related to positive outcomes as well, such as making amends and reparations. Two studies examined the role of anger, contempt, and disgust on behavioural tendencies (i.e., reparative action, avoidance versus aggression) in two contexts: romantic relationships (Study 1) and friendships (Study 2). We also tested whether various individual differences may impact these relationships. It was found that anger was associated with reparative action in both contexts and disgust was related to less reparative action in friendships. All three emotions were positively connected to aggression in romantic relationships (Study 1), but only disgust was related to aggression in friendships (Study 2). Disgust was positively related to avoidance in both studies. The results suggest that anger is an approach emotion, being consistently associated with the positive outcome of reparative action, and disgust is more consistently related to behavioural tendencies in close relationships than contempt. Future research should endeavour to examine when and how the positive behavioural effects of anger can be fostered in close relationships. • Anger predicted reparative action and aggression in close relationships. • Disgust predicted avoidance and aggression in close relationships. • Disgust is a more consistent predictor of behaviour than contempt. • Trait emotions showed different relationships with behaviour than state emotions. [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]

The ichnogenus Kouphichnium and associated ichnofossils attributed to xiphosuran activity are here re-examined from samples collected from the Pennsylvanian-age Steven C. Minkin Fossil Site at the Union Chapel Mine, in Walker County, Alabama, USA. The large sample size offers an unique opportunity to evaluate some Kouphichnium ichnospecies. Thus, the morphological variability resulting from the taphonomic, ethological, taxonomic variability and underprint fallout are evaluated using this large sample set. Three morphotypes have been segregated from the material previously assigned to K. aspodon discovered at this and adjacent sites. Ichnospecies of Kouphichnium identified at the Union Chapel Mine site include: K. lithographicum, K. aspodon and two new ichnospecies (K. atkinsoni and K. minkinensis). Additionally, Kouphichnium-like traces that are associated with "jumper" traces have been previously misinterpreted as Kouphichnium and Selenichnites, respectively, and are excluded from this study, leaving them in open nomenclature as they will be the subject of a subsequent publication. We here redescribe the holotype of K. aspodon and designate lectoparatypes to better define the ichnospecies. New trace makers for some Kouphichnium ichnospecies are hypothesized, in contrast to the traditional xiphosuran attribution. [ABSTRACT FROM AUTHOR]

Introduction: Identifying priority research topics that meet the needs of multiple stakeholders should maximize research investment. Aim: To identify priorities for health education research. Methods: A three-stage sequential mixed methods study was conducted. Priorities for health education research were identified through a qualitative survey with 104 students, patients, academics, and clinicians across five health sciences and 12 professions (stage 1). These findings were analyzed using framework analysis and transposed into a quantitative survey whereby 780 stakeholders rated and ranked the identified priorities. Descriptive statistics identified priorities, exploratory factor analysis grouped priorities and differences between stakeholders were determined using Mann–Whitney U tests (stage 2). Six individual or group interviews with 16 participants (stage 3) further explicated the results from previous stages. Results: Of 30 priorities identified, the top were: how best to ensure students develop the required skills for work; how to promote resiliency and well-being in students; and ensuring the curriculum prepares students for work. For the majority of priorities, no significant differences were found between different stakeholder groups. Conclusions: These findings will be used to inform health educational research strategy both locally and nationally. Further research should explore if setting priorities can be translated effectively into education research policy and practice. [ABSTRACT FROM AUTHOR]

Diabetes presents a challenge to healthcare services worldwide. Diabetes educators work with individuals and communities to reduce the impact of diabetes. In Australia, diabetes educators derive from one of several primary qualifications including nursing, medicine or a specified allied health background, and have an accredited postgraduate qualification in diabetes education. The peak professional body, the Australian Diabetes Educators Association (ADEA), promotes equivalence of all diabetes educators in terms of their scope of practice. However, in practice, there is evidence of inequities, particularly between those from nursing and allied health backgrounds. This paper uses a neo-Weberian lens to explore the interprofessional role dynamics of a 'postprofessional' group of practitioners, who adopt a common role and title to create a professional identity at post-qualifying level. Data were collected via individual interviews with 19 stakeholders and analysed using an abductive template approach. Differential role boundaries between nurse and allied health diabetes educators were established and reinforced in several ways. Diabetes education is considered a sub-specialty of nursing only; access to education and credentialing has been restricted for allied health; reinforcement of professional stereotypes and perceived professional values; and perceived legislative differences in access to medication management for nurse and allied health diabetes educators. [ABSTRACT FROM AUTHOR]

What was the educational challenge? Medical student abuse within work-integrated learning (WIL) is well-reported, with negative consequences for wellbeing, motivation, and learning. Conversely, workplace dignity, described as respecting the worth of others and self, has positive impacts on wellbeing, learning, and relationships for WIL students and supervisors. Stakeholders often struggle to articulate what workplace dignity means, and can downplay or do nothing in the face of WIL indignities. What was the solution and how was this implemented? We created an innovative research-informed online learning resource about WIL dignity to improve stakeholders' understandings and help them get the best from WIL placements ensuring these are dignified, safe, and educationally productive. The resource included three topics: (a) workplace dignity and why it matters; (b) upholding dignity; and (c) strengthening dignity. What lessons were learned? We conducted a pilot qualitative evaluation involving 13 semi-structured interviews with students and supervisors to elicit their views and experiences of the resource. Our key findings across three overarching categories were: (1) perceived benefits (motivations to complete the resource; content of the resource; online pedagogies); (2) potential applications of learning (reinforcing existing knowledge; developing new knowledge; promoting reflection; changing workplace practices); and (3) suggested improvements (barriers to resource use; resource content; online pedagogies; timing of resource implementation; embedding the resource in broader learning). What are the next steps? Although we identified numerous perceived benefits, and applications of learning, the findings suggested opportunities for further development, especially improving the resource's social interactivity. We recommend that further resource implementation includes student-educator and student-peer interactivity to maximise learning, and longitudinal evaluation of the resource. [ABSTRACT FROM AUTHOR]

The Early Mississippian (known as 'Romer's Gap') marks the beginning of a critical point in tetrapod history as they transitioned from dominantly aquatic to more terrestrial ecosystems. This paleoecological expansion set the stage for the radiation of all terrestrial tetrapod crown groups. The exact timing for the transition into freshwater continental environments is poorly understood. However, new discoveries in Scotland, England, and Nova Scotia, represent rare exceptions; offering a glimpse into coastal terrestrial ecologies during 'Romer's Gap'. These sites have evidence for a marine-water connection suggesting a coastal paleogeographic position. In contrast, Early Mississippian sedimentary deposits of the Moncton Subbasin in southern New Brunswick (NB) are interpreted as freshwater intra-continental conditions (lacustrine, wetland, fluvial, alluvial settings). A single stratigraphic horizon in the Albert Formation (Hiram Brook Member), exposed near Norton, NB, has yielded abundant tetrapod footprints. Preliminary assessments suggest at least four trackway ichnogenera: cf. Characichnos, cf.Matthewichnus, cf.Hylopus, and cf.Batrachichnus and a fifth trackway that may represent a new ichnogenus. Footprints range in size from 1 to 3 cm, suggesting that tetrapods were smaller than those documented from near time-equivalent sites in Nova Scotia, but are comparable in size to skeletal fossils described from younger strata in Scotland. These footprints are interpreted to be preserved in interfluvial crevasse splays associated with wetland forests dominated by Lepidodendropsis lycopods and Aneimites ferns preserved in their ecological context. The relatively large sample size of footprints suggests that a community of tetrapods were present and part of a diverse ecosystem, adapted to terrestrial and semi-aquatic continental environments in the earliest Mississippian. Additional trackways from slightly younger redbed playa lake deposits in the Sussex Group suggest tetrapods were also venturing into semi-arid continental environments. The ichnofossil assemblage from NB demonstrates considerable variation in ichnotaxa morphology and paleoenvironmental context from sites of approximately equivalent age. [ABSTRACT FROM AUTHOR]

The article discusses the things diabetes educators (DE) need to know about foot health and diabetes. Topics discussed include foot complications as the most common cause of non-traumatic lower limb amputation in Australia and morbidity; recommendation of National Health and Medical Research Council for diabetics to have an annual foot health assessment and referring to a podiatrist.

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 Fundy Basin of Nova Scotia and New Brunswick, Canada, is the most northern extent of the Triassic-Jurassic Newark Supergroup on land. Mesozoic sedimentary rocks in New Brunswick are rare by comparison to the neighbouring province of Nova Scotia. The Upper Triassic is known for the oldest dinosaurs in Canada, together with other vertebrates, invertebrates, plants, and ichnofossils from the Upper Triassic of the Wolfville and Blomidon formations. The present study has found the first evidence of vertebrate life from the Triassic of New Brunswick in the Alma area the Bay of Fundy. A single horizon from strata at Waterside Beach has yielded isolated vertebrate bones (vertebral element, limb bone, isolated tooth and bone fragments), while at a second outcrop along Dennis Beach, a single horizon of mudstone preserved vertebrate ichnofossils. UAV-based photographs have been collected to digitally preserve 3D models of the outcrops. This documents the current context, as these coastal sites experience tidal erosion, exposing new outcrop. The ichnoassemblage includes footprints of dinosauromorphs (e.g., lagosuchians; ichnotaxon: Rotodactylus), lepidosauromorphs/archosauromorphs (ichnotaxon: Rhynchosauroides), Archosauriformes and "Rauisuchia" (ichnotaxon: Synaptichnium), and an unidentified dinosaur-like track. Rotodactylus is thought to represent dinosauromorphs that are close to the beginning of the dinosaurian clade and is an index ichnogenus with a limited stratigraphic range of Early Triassic (latest Olenekian) through the Middle Triassic (Anisian to the earliest Ladinian). The elements of the fossil assemblage described here are commonly found together and comparable to other sites of similar Early-Middle Triassic age in Morocco, South America, and Poland. This restricts the age of the Triassic strata at Dennis Beach and the vertebrate footprints preserved at that locality to between the latest Lower Triassic and the Middle Triassic, making it the oldest evidence of vertebrates from the Mesozoic in Canada inferred from footprints and isolated bones. [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]

Synthetic hormones have been widely reported in treated sewage effluents, and consequently receiving aquatic environments. Ethinylestradiol (EE2) is a potent synthetic estrogen commonly used in conjunction with levonorgestrel in oral contraceptive pills. Both EE2 and levonorgestrel have been identified in the aquatic environment, but although there is a significant amount of literature on EE2, there is much less information on levonorgestrel. Using Australian prescription data as well as excretion and predicted wastewater removal rates, the concentrations of EE2 and levonorgestrel in Australian wastewater were calculated at 0.1 ng/L to 0.5 ng/L and 0.2 ng/L to 0.6 ng/L, respectively. Both compounds were analyzed in treated wastewater and surface water grab samples from 3 Southeast Queensland, Australia sites. The predicted no-effect concentration (PNEC) for EE2 of 0.1 ng/L was exceeded at most sites, with EE2 concentrations up to 2 ng/L in treated effluent, albeit quickly diluted to 0.1 ng/L to 0.2 ng/L in the receiving environment. A provisional PNEC for levonorgestrel of 0.1 ng/L derived in the present study was slightly lower than predicted effluent concentrations of 0.2 ng/L to 0.6 ng/L, indicating a potential risk of endocrine-related effects in exposed aquatic species. The detection limit for levonorgestrel in the present study was 2.5 ng/L, and all samples were below detection limit. The present study's results suggest that improvements in analytical capabilities for levonorgestrel are warranted to more accurately quantify the risk of this compound in the receiving environment. Environ Toxicol Chem 2016;35:1378-1385. © 2015 SETAC [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]

Aims: This commentary aims to describe a case of how meaningful co‐design between rural health service leaders and a health service‐embedded research unit can identify emerging research priorities and optimise translation. Context: The challenges facing rural health services are unique, and the important role of health service leaders in the research response is increasingly recognised. Poorly‐designed research can contribute to research waste through reduced applicability of results to rural communities, and an opportunity exists to increase research co‐designed with rural health services through the involvement of research users during study planning. Approach: In early 2020, leaders at a rural Victorian health service approached the embedded health service research unit to request research be conducted on an emerging issue: rural staff well‐being in the face of the COVID‐19 pandemic. This was based on their concern regarding the lack of available COVID‐19‐specific evidence to inform organisational policy. In collaboration with the rural health service executive, a translation‐focused study of staff well‐being with nine rural Victorian health services was developed. Key co‐design activities of the project included involving research end‐users as study investigators and conducting formal stakeholder engagement regarding study design and outcomes. Conclusion: Meaningful co‐design of research with health services is a multifaceted process that can assist researchers and end‐users alike in identifying and responding to emerging health issues. In the rural setting where there is a vital need for impactful health research, we recommend that researchers should consider employing co‐design processes in order to minimise research waste and optimise the translatability of research findings. [ABSTRACT FROM AUTHOR]

A new specimen of Batrachichnus salamandroides was recovered from a recently discovered fossil-bearing site situated along the southern shore of Grand Lake, New Brunswick, among a diverse ichnofaunal assemblage from the Middle Pennsylvanian (upper Bolsovian; lower Moscovian), upper Minto Formation. The identity of the tracemaker of this ichnogenus is reinterpreted as a composite of various late Paleozoic tetrapod taxa, based on similarities of the postcranial skeletons, notably that of the manus and pes, of both temnospondyls and some “microsaurs”. These results indicate that the tracemaker of the monospecific ichnogenus Batrachnichus is not limited solely to a temnospondyl tracemaker, as previously interpreted, and that some “microsaurs” should also be considered among tracemaker candidates for this ichnotaxon. [ABSTRACT FROM AUTHOR]

While research has started to contest traditional student-supervisor power asymmetries within work-integrated learning, substantial gaps remain about work-integrated learning feedback, power and resistance. This study explores how students and supervisors narrate student power and resistance within work-integrated learning feedback narratives. Ninety-four feedback narratives were collected from 26 higher education students and 25 supervisors from six disciplines participating in 45 interviews. Data were analysed using thematic and narrative analysis. Although the narratives often reproduced traditional power asymmetries, they also contested espoused power asymmetries. Participants reported students exercising power in feedback relationships, either of their own accord or through supervisor power-sharing. Students were also reported to enact resistance to supervisor power, sometimes resulting in supervisor undermining. Student enactment of power and resistance was also illustrated through participants' pronominal, metaphoric and identity talk. We encourage work-integrated learning students and supervisors to enhance their feedback literacy paying close attention to issues of power and resistance. Students should exercise power and resistance in productive rather than repressive ways during work-integrated learning feedback in order to avoid negative impacts for supervisor well-being and student learning. Further research is needed to explore researcher and participant identification of power and resistance across more diverse participants. [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]

The Lysine (K)-Specific Methyltransferase 2A (KMT2A) gene (formerly MLL) that resides on human chromosome 11q23 is frequently rearranged in de novo and therapy related leukemia. KMT2A translocations with various partner genes are often easily detected by classic molecular and cytogenetic approaches. However, the detection of small intragenic insertions, the partial tandem duplications of the KMT2A gene (KMT2A-PTD), is challenging. Additional co-occurring alterations, such as Trisomy 11 which alerts one to the PTD, may further hamper the identification of KMT2A-PTD. KMT2A-PTDs occur in 3-10% of adult AML and the presence of a KMT2A-PTD is associated with a poorer AML outcome. As such, accurate detection of KMT2A-PTDs in AML routine clinical diagnostic workup is important. Here we assessed the ability of three orthogonal technologies for KMT2A-PTD analysis:1) an hybridization-capture based Next Generation Sequencing targeting the KMT2A gene region, 2) an MLPA based assay covering exons 4 and 36 of KMT2A and 3) Optical Genome Mapping. We analyzed tumor samples of ten AML patients with KMT2A-PTD and evaluated the relative performance, strengths and weaknesses of these technologies. KMT2A-PTDs are in-frame duplications that typically encompass exons 3 through 9. However, our results revealed the presence of unsuspected variants of KMT2A. Specifically, copy number based approaches, in the absence of structural data, can lead to false positive and negative calls due to genomic alterations, such as unbalanced translocations, involving KMT2A. Therefore, our data suggest that a combined structural and copy number approach are required to accurately detect KMT2A PTDs. [ABSTRACT FROM AUTHOR]

The Carboniferous Joggins Fossil Cliffs UNESCO World Heritage Site, located in Nova Scotia, has long been known for its extensive paleobiodiversity. The ichnofossil record at Joggins is less known compared to body fossils. The late citizen scientist Donald Reid (known as "The Keeper of the Cliffs") contributed significantly to our understanding of the fossil record at Joggins. In his extensive ichnological collections is a morphologically unique "shrimp shaped" cubichnia (resting trace). The trace fossil is associated with faint invertebrate trackways that lead up to the resting trace and verifies the identification of this specimen as an invertebrate resting trace. The trace fossil was recovered from the upper Joggins Formation (876 m above the base) and was found in fine-grained rippled sandstones that are interpreted to be from an Open-Water to Poorly-Drained Lithofacies Assemblage transition. Horseshoe crab walking traces (Kouphichnium) are well known from this trace fossil horizon. The trace fossil specimen also has examples of invertebrate resting traces Selenichnites and Rusophycus preserved in convex hyporelief, that are commonly ascribed to horseshoe crabs and crustaceans, respectively, when found in freshwater paleoenvironments. This stratigraphic interval has previously yielded body fossils of Pygocephalus shrimp preserved in organic rich limestones and sideritic ironstone nodules. The Joggins Cliffs have yielded an abundance of trace fossils ascribed to horseshoe crabs, yet only two of their body fossils. Pygocephalus shrimp body fossils are common at Joggins, yet no trace fossils have yet been assigned to this invertebrate and perhaps have gone unrecognized. We interpret the trace fossil to have been produced by a Pygocephalus shrimp based on its morphological similarities to known body fossils from the Joggins Formation that are found in proximity to the trace fossil horizon. This new trace fossil morphology likely warrants a new ichnotaxon. [ABSTRACT FROM AUTHOR]

The evolution of arborescence in Devonian plants, followed by their architectural radiation in the Carboniferous, is a transition fundamental to Earth-system processes and ecological development. However, this evolutionary transition in trees is based on preserved trunks, of which only a few known specimens possess crowns. We describe Mississippian-aged (Tournaisian) trees with a unique three-dimensional crown morphology from New Brunswick, Canada. The trees were preserved by earthquake-induced, catastrophic burial of lake-margin vegetation. The tree architecture consists of an unbranched, 16-cm-diameter trunk with compound leaves arranged in spirals of ∼13 and compressed into ∼14 cm of vertical trunk length. Compound leaves in the upper ∼0.75 m of the trunk measure >1.75 m in length and preserve alternately arranged secondary laterals beginning at 0.5 m from the trunk; the area below the trunk bears only persistent leaf bases. The principal specimen lacks either apical or basal sections, although an apex is preserved in another. Apically, the leaves become less relaxed toward horizontal and are borne straight at an acute angle at the crown. The compact leaf organization and leaf length created a crown volume of >20–30 m3. This growth strategy likely maximized light interception and reduced resource competition from groundcover. From their growth morphology, canopy size, and volume, we propose that these fossils represent the earliest evidence of arborescent subcanopy-tiering. Moreover, although systematically unresolved, this specimen shows that Early Carboniferous vegetation was more complex than realized, signaling that it was a time of experimental, possibly transitional and varied, growth architectures. • Extensively preserved, ∼350 Ma trunk with protracted crown morphology • Early Carboniferous growth architecture presages modern fern lineages • Densely arrayed compound leaves provide expansive photosynthetic surface and cover • Fossils preserved as a consequence of earthquake-induced burial in ancient rift lake Newly discovered tree fossils from ∼350 Ma in New Brunswick, Canada, are architecturally unique, and Gastaldo et al. interpret them to presage modern tree-fern lineage growth forms. These fossils, preserved by earthquake-induced burial in an Early Carboniferous rift lake, may represent early evidence of a subcanopy forest niche. [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]

The role of tectonism associated with right lateral strike- slip faults, and related salt movement is well-documented along the eastern part of Fundy coast of New Brunswick and adjacent parts of Nova Scotia. They relate to the Yeadonian-Langsettian (early Pennsylvanian) evolution of the Cumberland basin. Transpressional flower structures of similar age are seen from the Saint John area west to Lepreau. More recent structural mapping and related stratigraphic research between Saint John and Alma has defined more transpressional flower structures affecting lower Pennsylvanian strata, and transtensional structures involved in lower Pennsylvanian deposition (Tynemouth Creek Formation), and Permian-Triassic sequences from Quaco Head, Martin Head, and Waterside. Some of these structures involved salt movement, with candidates for salt welds and diapirs now identified from Quaco Head, Martin Head, Waterside, and Alma. Timing remains an issue, but early-middle Pennsylvanian salt movement is most probable around Alma and Waterside (comparable and contiguous with structures seen on the Maringouin Peninsula and at Joggins), while the gypsum (and salt?) diapir at Martin Head could be as young as Triassic (depending on the age of the hanging wall rocks (currently correlated with middle-upper Triassic formations around St. Martins, viz: Echo Cove Formation). Refinement of the Permian and Triassic stratigraphy is underway and will further help to elucidate a detailed tectonic history, but the persistence of the right lateral strike-slip regime from the early Pennsylvanian through the Permian into the lower to middle Triassic seems probable. This begs the question of when the post-Alleghenian adjustments related to major orogen-parallel faults gave way to regional extension associated with opening of the mid-Atlantic ocean basin. With which regime should the half-grabens of the Fundy Basin (and its continuation to the southwest to the Hartford and Newark basins) be considered related? [ABSTRACT FROM AUTHOR]

Abstract Monitoring the water quality of rivers is increasingly conducted using automated in situ sensors, enabling timelier identification of unexpected values or trends. However, the data are confounded by anomalies caused by technical issues, for which the volume and velocity of data preclude manual detection. We present a framework for automated anomaly detection in high-frequency water-quality data from in situ sensors, using turbidity, conductivity and river level data collected from rivers flowing into the Great Barrier Reef. After identifying end-user needs and defining anomalies, we ranked anomaly importance and selected suitable detection methods. High priority anomalies included sudden isolated spikes and level shifts, most of which were classified correctly by regression-based methods such as autoregressive integrated moving average models. However, incorporation of multiple water-quality variables as covariates reduced performance due to complex relationships among variables. Classifications of drift and periods of anomalously low or high variability were more often correct when we applied mitigation, which replaces anomalous measurements with forecasts for further forecasting, but this inflated false positive rates. Feature-based methods also performed well on high priority anomalies and were similarly less proficient at detecting lower priority anomalies, resulting in high false negative rates. Unlike regression-based methods, however, all feature-based methods produced low false positive rates and have the benefit of not requiring training or optimization. Rule-based methods successfully detected a subset of lower priority anomalies, specifically impossible values and missing observations. We therefore suggest that a combination of methods will provide optimal performance in terms of correct anomaly detection, whilst minimizing false detection rates. Furthermore, our framework emphasizes the importance of communication between end-users and anomaly detection developers for optimal outcomes with respect to both detection performance and end-user application. To this end, our framework has high transferability to other types of high frequency time-series data and anomaly detection applications. Graphical abstract The ten-step Anomaly Detection (AD) framework for high frequency water-quality data, which includes ranking the importance of different anomaly types (e.g. sudden spikes A, sudden shifts D, anomalously high variation type E), based on end-user needs and data characteristics, to inform algorithm choice, implementation and performance evaluation. Framework numbers indicate the order of steps taken. Arrows indicate directions of influence between steps. Unlabelled Image Highlights • High frequency water-quality data requires automated anomaly detection (AD). • Rule-based methods detected all missing, out-of-range and impossible values. • Regression and feature-based methods detected sudden spikes and level shifts well. • High false negative rates were associated with other types of anomalies, e.g. drift. • Our transferable framework selects and compares AD methods for end-user needs. [ABSTRACT FROM AUTHOR]

The Pennsylvanian-aged (late Bashkirian-early Moscovian) Minto Formation of central New Brunswick was previously studied for its diverse paleoflora, rare invertebrate fauna (trigonotarbid) and rare disarticulated vertebrate fauna. The Minto Formation has been interpreted to represent a peat-forming wetland that experienced occasional euryhaline influence within back-barrier or delta-front depositional settings. A recently discovered fossil locality situated along the southern shoreline of Grand Lake, yields a diverse array of plant fossils, vertebrate trace fossils, and invertebrate body fossils. Two new terrestrial gastropods (NBMG 21521) are described that broadly conform to the genus Dendropupa, with a similar apex and post-apical whorls. However, they differ in morphology from Dendropupa by possessing axial (longitudinal) sculpture on the shell. Species of Dendropupa exhibit either fine axial lirae or pronounced axial lirae along their shell that are not preserved in the Minto Formation specimens. This is possibly because of the preservation as the shells as internal molds with only fragments of the original shell remaining. Both Minto Formation specimens exhibit the same morphology but differ in size, suggesting one is an adult and one a juvenile. The diminutive size of the shells suggests that they may represent the smallest known Carboniferous land snails in the fossil record. These two gastropods are associated with invertebrate ichnofossils (Gordia, Helminthoidichnites, and cf. Helminthopsis). These traces are similar in width to the body fossils, and trail behind them implying a trace and trace-maker relationship, broadening the tracemaker interpretations for those ichnogenera. [ABSTRACT FROM AUTHOR]