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Flipped learning has become a popular blended learning approach in higher education and is now being adopted in medical schools across Australia and internationally. There are a number of principal educational justifications for the introduction of this approach, primarily, that it fosters deeper student learning through active engagement in the classroom. As a pedagogical intervention however, what do the various stakeholders think about its introduction? This paper explores reactions to implementation of a flipped learning approach to pre-clinical medical education in a regional Victorian medical course, via a mixed method approach. A range of quantitative and qualitative data was collected concerning the implementation, including a student survey, student focus groups, a staff survey for both academic and professional staff members involved in the implementation of the approach, and an independent student-driven social media questionnaire conducted in the second year post implementation survey. These data provide critical feedback for refinement of the flipped learning approach, including more robust student and faculty development and support during implementation of this pedagogy. Taken together, our results provide a unique perspective of the introduction of the flipped approach through different stakeholder lenses, and over time.

McArdle AM, Roberts CT, Maduwegedera D, Flower RL, Denton KM. Chronic maternal hypertension characterized by renal dysfunction is associated with reduced placental blood flow during late gestation in rabbits. Am J Physiol Regul lntegr Comp Physiol 298: R1043-R1049, 2010. First published January 20, 2010; doi: 10.1152/ajpregu.00202.2009.--Maternal hypertension associated with renal disease is a common pregnancy complication. Previously, we have shown in a rabbit model of mild hypertension that offspring from hypertensive mothers have increased blood pressure as adults, In human pregnancy, hypertension has been associated with decreased utero-placental blood flow. The aim of this study was to determine placental blood flow (PBF) in mild (2-kidney-l-wrapped; 2K-IW) and moderate (2-kidney-2-wrapped; 2K-2W) rabbit models of maternal hypertension. We hypothesized that PBF would be inversely related to the severity of the hypertension. PBF and renal blood flow (RBF) were measured using microspheres on day 28 of a 32-day gestation, in normotensive (sham), 2K-1W, and 2K-2W hypertensive groups. Mean arterial pressure (MAP, ~7 mmHg, P < 0.05) was increased, and RBF (~35%, P < 0.05) was reduced in the 2K-1W and 2K-2W (MAP ~20 mmHg, P < 0.01; RBF ~53%, P < 0.05) groups compared with the sham group. In the 2K-1W group, PBF fell by ~12% (P = 0.08) and fetal-toplacental weight ratio increased by ~12% (P < 0.01) compared with the sham group, reflecting an increase in the functional capacity of the placenta to deliver nutrients to the fetus. In the 2K-2W group, PBF decreased ~51% (P < 0.05) compared with the sham group, without changes in placental efficiency. Thus, in late gestation, placental blood flow was significantly reduced in the moderate hypertension group, without accompanying changes in fetal or placental weight or placental efficiency. In contrast, mild hypertension resulted in an increase in placental efficiency, without significant changes in placental blood flow. These findings suggest that mild and moderate hypertension may alter placental delivery of nutrients via differing mechanisms dependent upon the severity of the hypertension. placental blood flow; rabbit; hypertension; renal blood flow doi: 10.1152/ajpregu.00202.2009.

Sodium (Na) and potassium (K) concentrations in breastmilk are often used as biomarkers to define mastitis in lactating women and can be measured with small portable point-of-care ion-selective electrodes (ISEs). The aim of this study was to test the ISEs at the point of care for accuracy and acceptability in women with mastitis. Up to 5 mL of expressed breastmilk from the affected breast of 43 women with mastitis was collected at three timepoints (day 1, 3, and 10). Immediate Na and K ISE testing was later compared to the laboratory measure of inductively coupled plasma–op-tical emission spectrometry (ICP-OES). The results revealed a statistically significant difference in Na and K concentrations between the point-of-care and laboratory testing (both p = 0.001, Wilcoxon signed-rank test); however, the difference was not statistically significant when compared for Na:K ratio (p = 0.49, Wilcoxon signed-rank test). The Bland–Altman limits of agreement were acceptable, with the majority of measurements lying within two standard deviations of the mean (Na: 94%; K: 95%; and Na:K: 96%). The testing techniques were significantly correlated for Na (R2 = 0.79, p = 0.001) and Na:K (R2 = 0.99, p = 0.001). Overall, participants rated the ISE point-of-care testing as very acceptable. In conclusion, immediate ISE point-of-care testing for breastmilk Na:K ratio in women with mastitis is clinically accurate and acceptable. [ABSTRACT FROM AUTHOR]

Aim: To investigate the content and face validity of a patient-reported outcome measure used by Australian physiotherapists in the assessment of inflammatory conditions of the lactating breast. Methods: Sixty one experts representing 'women who previously had inflammatory conditions of the lactating breast' (48%), 'clinicians' (38%) and 'academics' (8%) interested in women's health and 7% unidentified participants were invited to complete a three round Delphi study. Results: Ninety five percent of participants agreed that overall, the patient-reported outcome measure was appropriate for use in assessing and treating inflammatory conditions of the lactating breast. The item'impact' was added to ensure the appropriate assessment of functional aspects of daily life. The item terminology used in the patient-reported outcome measure was simplified to 'pain', 'redness', 'hardness/tightness', 'temperature of affected area', 'sickness/wellness' and 'affected area. A clinician script was developed to ensure the patient-reported outcome measure has utility and consistency regardless of the experience of thewomen presentingwith inflammatory conditions of the lactating breast or the clinician. Conclusion: The resultant Breast InflammatorySymptomSeverity Index (BISSI) is a patient-reported outcomemeasure for use in the diagnosis and monitoring of clinical changes of symptoms associated with inflammatory conditions of the lactating breast including engorgement, blocked ducts and mastitis. It utilizes person-centred language and assesses symptoms considered important to both patient and clinician. The development of the clinician script facilitates utility regardless of the experience of either the woman with the inflammatory condition or the treating clinician. [ABSTRACT FROM AUTHOR]

Background: Little information has been documented regarding interventions for mastitis by Australian physiotherapists. It is currently not known if physiotherapy interventions vary across Australian regions and types of healthcare facilities. Research aims: (1) To identify the interventions used by Australian physiotherapists treating mothers with mastitis and (2) to determine the variability in interventions used across regions and facilities. Methods: A retrospective observational design was used. A sample of case records of mothers with mastitis was identified (N = 192). These case records documented physiotherapy interventions for mastitis in hospitals and private physiotherapy practices in Western Australia (n = 77; 40.1%), Victoria (n = 76; 39.6%), and New South Wales (n = 39; 20.3%). An electronic data collection tool was designed to examine intervention variables. Results: The physiotherapy interventions received by mothers included therapeutic ultrasound (n=175; 91.1%), education and advice (n = 160; 83.3%), and massage (n = 103; 53.6%). Therapeutic ultrasound parameters varied across regions and types of healthcare facilities. Mean documented therapeutic ultrasound intensity was approximately twice as high in New South Wales and Victoria than in Western Australia. Conclusions: Regional and facility differences exist in physiotherapy interventions for mastitis in Australia. Healthcare professionals who refer to physiotherapists for mastitis should be aware that interventions received may differ across regions and facility types. [ABSTRACT FROM AUTHOR]