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BACKGROUND:Anticoagulation for preventing stroke in atrial fibrillation is under-utilised despite evidence supporting its use, resulting in avoidable death and disability. We aimed to evaluate an intervention to improve the uptake of anticoagulation. METHODS:We carried out a national, cluster randomised controlled trial in the Australian primary health care setting. General practitioners received an educational session, delivered via telephone by a medical peer and provided information about their patients selected either because they were not receiving anticoagulation or for whom anticoagulation was considered challenging. General practitioners were randomised to receive feedback from a medical specialist about the cases (expert decisional support) either before or after completing a post-test audit. The primary outcome was the proportion of patients reported as receiving oral anticoagulation. A secondary outcome assessed antithrombotic treatment as appropriate against guideline recommendations. RESULTS:One hundred and seventy-nine general practitioners participated in the trial, contributing information about 590 cases. At post-test, 152 general practitioners (84.9%) completed data collection on 497 cases (84.2%). A 4.6% (Adjusted Relative Risk = 1.11, 95% CI = 0.86-1.43) difference in the post-test utilization of anticoagulation between groups was not statistically significant (p = 0.42). Sixty-one percent of patients in both groups received appropriate antithrombotic management according to evidence-based guidelines at post-test (Adjusted Relative Risk = 1.0; 95% CI = 0.85 to 1.19) (p = 0.97). CONCLUSIONS:Specialist feed-back in addition to an educational session did not increase the uptake of anticoagulation in patients with AF. TRIAL REGISTRATION:ANZCTRN12611000076976 Retrospectively registered.

A novel facile and cost-effective synthesis method for anatase TiO₂ nanoparticles has been developed by using poly-acrylic acid hydrogel as template at room temperature. The newly developed synthesis method avoids the use of hazardous reagents and/or hydrothermal steps, and enables production of highly active TiO₂ nanoparticles from low cost inorganic titanium sources. The synthesized TiO₂ nanoparticles have been studied in several applications including dye-sensitized solar cells as a photoanode as well as in organics degradation of methyl orange in aqueous media. Good photocatalytic performances were obtained in both applications.

Acute decompensated heart failure is a common cause of hospitalisation. This is a period of vulnerability both in altered pathophysiology and also the potential for iatrogenesis due to therapeutic interventions. Renal dysfunction is often associated with heart failure and portends adverse outcomes. Identifying heart failure patients at risk of renal dysfunction is important in preventing progression to chronic kidney disease or worsening renal function, informing adjustment to medication management and potentially preventing adverse events. However, there is no working or consensus definition in international heart failure management guidelines for worsening renal function. In addition, there appears to be no concordance or adaptation of chronic kidney disease guidelines by heart failure guideline development groups for the monitoring of chronic kidney disease in heart failure. Our aim is to encourage the debate for an agreed definition given the prognostic impact of worsening renal function in heart failure. We present the case for the uptake of the Acute Kidney Injury Network criteria for acute kidney injury with some minor alterations. This has the potential to inform study design and meta-analysis thereby building the knowledgebase for guideline development. Definition consensus supports data element, clinical registry and electronic algorithm innovation as instruments for quality improvement and clinical research for better patient outcomes. In addition, we recommend all community managed heart failure patients have their baseline renal function classified and routinely monitored in accordance with established renal guidelines to help identify those at increased risk for worsening renal function or progression to chronic kidney disease. © 2014 Elsevier Ireland Ltd.

A large class of scattering problems of surface water waves by vertical barriers lead to mixed boundary value problems for Laplace equation. Specific attentions are paid, in the present article, to highlight an analytical method to handle this class of problems of surface water wave scattering, when the barriers in question are non-reflecting in nature. A new set of boundary conditions is proposed for such non-reflecting barriers and tile resulting boundary value problems are handled in the linearized theory of water waves. Three basic poblems of scattering by vertical barriers are solved. The present new theory of non-reflecting vertical barriers predict new transmission coefficients and tile solutions of tile mathematical problems turn out to be extremely simple and straight forward as compared to the solution for other types of barriers handled previously.

The problem of generation of surface water waves at tile interface of two immiscible liquids by a onesided porous wave maker is studied in both the cases of water of infinite as well as finite depth by suitable application of the generalisation of Havelock's expansion theorem. The solution of the the problem of reflection of water waves due to a fixed porous wall is derived as a particular case.