Assessment of Health Research Capacity in Western Sydney Local Health District (WSLHD): A Study on Medical, Nursing and Allied Health Professionals.

BACKGROUND: Research should inform clinical decision-making and evidence-based practice for all health professionals. To build research capacity among all health professionals, there is a need to measure the levels of research capacity and identify the gaps and needs of health-care professionals. The aim of the study was to better understand the research culture and capacity of health professionals (medical, nursing and allied health) in Western Sydney Local Health District, Sydney, Australia. METHODS: A research capacity and culture tool (RCCT) survey was electronically distributed to all health staff in WSLHD. Data were collected between November 2016 and January 2017. Participants were surveyed through a 10-point Likert scale that measured research capacity at the individual, team and organisational levels. RESULTS: A total of 393 health staff responded to the study: allied health practitioners (46.3%), nursing staff (35.4%) and medical practitioners (18.3%). Females made 76% of the sample, and 54% were aged between 35 and 54 years. Individual responses were different across professions, with an average median score for medical 6.3 (95% CI 5.8-6.9), allied health 5.3 (95% CI 4.9-5.7) and nursing 4.5 (95% CI 4.1-5.0) after adjustment for age and gender. Team responses for medical staff (average median score 5.9 95% CI 5.3-6.4) were higher than allied health (4.1 95% CI 3.7-4.6) and nursing (4.3 95% CI 3.8-4.8), after adjusting for age and gender. However, there were no differences between the three professions for the organisational responses. Allied health and nursing staff were less confident in obtaining research funding, submitting ethics applications, writing for publication and mentoring colleagues about research. CONCLUSION: This study demonstrates the individual research capacity for medical, allied health and nursing professionals are different. Research capacity building needs to be individually tailored to the specific needs of each profession. This research will inform future capacity building activities and training for health professionals in a large public health organisation of Sydney, Australia.

Correction to: Objective and Subjective Effects of a Prototype Nasal Dilator Strip on Sleep in Subjects with Chronic Nocturnal Nasal Congestion.

The article "Objective and Subjective Effects of a Prototype Nasal Dilator Strip on Sleep in Subjects with Chronic Nocturnal Nasal Congestion", written by John R. Wheatley, Terence C. Amis, Sharon A. Lee, Renee Ciesla, Gilbert Shanga was originally published electronically on the publisher's internet portal (currently SpringerLink) on May, 22, 2019 without Open Access. The article has now been made Open Access.

Objective and Subjective Effects of a Prototype Nasal Dilator Strip on Sleep in Subjects with Chronic Nocturnal Nasal Congestion.

INTRODUCTION: This exploratory study characterized the performance of a nasal dilator strip with improved spring forces in lowering nasal resistance during sleep and reducing sleep-disordered breathing in subjects with difficulty sleeping due to chronic nocturnal nasal congestion. METHODS: Subjects applied the strip at bedtime for 28 days (active phase; n = 70). Objective assessments included snoring variables, breathing route during sleep, and polysomnography measures compared with baseline. Nasal breathing, congestion, and sleep were measured subjectively using rating scales and questionnaires. During a crossover nasal resistance phase (n = 55), nasal resistance was measured using posterior rhinomanometry with the strip applied on one of two nights. RESULTS: In the active phase, breathing and sleep were perceived to improve, with less daytime sleepiness (P < 0.04) and increased ease of breathing, sleep quality, staying asleep, and feeling refreshed in the morning (all P < 0.0001). However, while objective polysomnography metrics were generally similar with and without the strip, median wake after sleep onset time was numerically reduced by ~ 11 min, and the spontaneous arousal rate fell by ~ 37%. In the nasal resistance phase (n = 55), median resistance (at 0.2-0.25 l/s) while asleep was 39.1% lower with (n = 37) versus without (n = 36) the strip (1.34 vs. 2.20 cmH2O/l/s; P = 0.048). CONCLUSIONS: This exploratory study supports a role for the improved spring force nasal dilator strip in alleviating sleep-related symptoms in subjects with chronic nasal congestion, potentially via lowering nasal resistance and reducing nocturnal awakenings. A larger study is indicated to confirm these preliminary data. CLINICALTRIALS. GOV IDENTIFIER: NCT03105297. FUNDING: GlaxoSmithKline Consumer Healthcare. Plain language summary available for this article.

Incidental learning of allocentric and egocentric strategies by both men and women in a dual-strategy virtual Morris Water Maze.

In studies of human navigation, an underlying assumption is that, by nature, navigators are proficient with and strongly biased toward using only one strategy, either allocentric (cognitive mapping) or egocentric (stimulus-response based). Further, research often suggests that males are allocentric navigators whereas females are egocentric navigators. We tested these binary assumptions using two versions of a virtual Morris water maze (MWM). The Dual-strategy maze could be solved using either an allocentric or an egocentric strategy. Preferred strategy was tested by alternating test and probe trials. Two "Forced-strategy" probe trials tested navigators' ability to use their non-preferred strategy. Participants then completed the Place maze that was best solved using an allocentric strategy. In the Dual-strategy maze, there was no particular order of acquisition of a preferred strategy and a quarter of participants switched strategies; this switching was bilateral (from egocentric to allocentric and vice-versa). Navigators were most competent in the use of their preferred strategy. Importantly, navigators did learn (incidentally) information related to their non-preferred strategy and were capable of using that strategy. This pattern of results was shown for both males and females, although females did show a stronger preference for egocentric navigation than did males. We concluded that navigators can use all environmental information available to them and that the tendency to view people as innately allocentric or egocentric navigators does not allow for more nuanced investigations of navigational ability. Such investigations would better inform research into deficits in spatial ability in clinical populations.

Transit apps for people with brain injury and other cognitive disabilities: the state of the art.

Individuals with cognitive disability have difficulty using public transit, but little research is directed toward this issue. Recent studies suggest that smartphones may be useful assistive devices in this context. Current objectives were to (1) survey research into difficulties people with cognitive disabilities experience when using public transit, (2) survey the current state of the art of transit and personal navigation applications (apps) and features, (3) recommend best existing transit apps for people with cognitive disability, and (4) recommend the best designs and features of these apps to developers of future transit apps. Potentially useful features were found in four categories: Transit apps for (1) individuals with cognitive disabilities and (2) healthy individuals, and personal navigation apps for (3) individuals with cognitive disabilities and (4) healthy individuals. A total of 159 apps were examined, but only seven were found specific to public transit for cognitive disability. By comparing research recommendations and currently available features, we identified several unmet needs. We note that there appears to be a shortage of apps for this population-function but that there is good research in the area and it is well suited to inform app development.

Simple gaze analysis and special design of a virtual Morris water maze provides a new method for differentiating egocentric and allocentric navigational strategy choice.

We present a novel method of combining eye tracking with specially designed virtual environments to provide objective evidence of navigational strategy selection. A simple, inexpensive video camera with an easily built infrared LED array is used to capture eye movements at 60Hz. Simple algorithms analyze gaze position at the start of each virtual maze trial to identify stimuli used for navigational orientation. To validate the methodology, human participants were tested in two virtual environments which differed with respect to features usable for navigation and which forced participants to use one or another of two well-known navigational strategies. Because the environmental features for the two kinds of navigation were clustered in different regions of the environment (and the video display), a simple analysis of gaze-position during the first (i.e., orienting) second of each trial revealed which features were being attended to, and therefore, which navigational strategy was about to be employed on the upcoming trial.

Heavy snoring as a cause of carotid artery atherosclerosis.

STUDY OBJECTIVES: Previous studies have suggested that snoring and obstructive sleep apnea hypopnea syndrome may be important risk factors for the development of carotid atherosclerosis and stroke. However, it is not clear if snoring per se is independently related to the risk of developing carotid atherosclerotic plaque. DESIGN: Observational cohort study. SETTING: Volunteer sample examined in a sleep laboratory. PARTICIPANTS: One hundred ten volunteers (snorers and nonsnorers with only mild, nonhypoxic obstructive sleep apnea hypopnea syndrome) underwent polysomnography with quantification of snoring, bilateral carotid and femoral artery ultrasound with quantification of atherosclerosis, and cardiovascular risk factor assessment. Subjects were categorized into 3 snoring groups: mild (0%-25% night snoring), moderate (> 25%-50% night snoring), and heavy (> 50% night snoring). INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: The prevalence of carotid atherosclerosis was 20% with mild snoring, 32% with moderate snoring, and 64% with heavy snoring (P < 0.04, X2). Logistic regression analysis was used to determine the independent effect of snoring on the prevalence of carotid and femoral atherosclerosis. After adjustment for age, sex, smoking history, and hypertension, heavy snoring was significantly associated with carotid atherosclerosis (odds ratio 10.5; 95% confidence interval 2.1-51.8; P = 0.004) but not with femoral atherosclerosis. CONCLUSIONS: Heavy snoring significantly increases the risk of carotid atherosclerosis, and the increase is independent of other risk factors, including measures of nocturnal hypoxia and obstructive sleep apnea severity. Considering the high prevalence of snoring in the community, these findings have substantial public health implications for the management of carotid atherosclerosis and the prevention of stroke.