variables were then correlated with the results from a pressure-flow study. RESULTSThe IPP was a statistically significant predictor ( P < 0.001) of bladder outlet obstruction (BOO) compared with other variables in the initial evaluation. In all, 125 patients had significant BOO, defined as a BOO index of >40. Of these men, 94 had grade III and 30 had grade I-II IPP. Seventy-five patients had a BOO index of <40; 69 had grade I-II and six grade III IPP. In patients with BOO confirmed on the pressure-flow study, grade III IPP was associated with a higher BOO index than was grade I-II ( P < 0.001). CONCLUSIONThe IPP assessed by transabdominal ultrasonography is a better and more reliable predictor of BOO than the other variables assessed. KEYWORDS intravesical protrusion, prostate, lower urinary tract symptoms, bladder outlet obstruction OBJECTIVESTo determine the effect of intravesical protrusion of the prostate (IPP, graded I to III) on lower urinary tract function, by correlating it with the results of a pressure-flow study. PATIENTS AND METHODSIn a prospective study men (aged >50 years) with lower urinary tract symptoms were initially evaluated as recommended by the International Consultation on Benign Prostatic Hyperplasia, together with the IPP and prostate volume, as measured by transabdominal ultrasonography. These

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Asynchronous online discussion forums are common in blended learning models and are popular with students. A previous report has suggested that participation in these forums may assist student learning in a gross anatomy subject but it was unclear as to whether more academically able students post more often or whether participation led to improved learning outcomes. This study used a path model to analyze the contribution of forum participation, previous academic ability, and student campus of enrolment to final marks in a multicampus gross anatomy course for physiotherapy students. The course has a substantial online learning management system (LMS) that incorporates asynchronous forums as a learning tool, particularly to answer learning objectives. Students were encouraged to post new threads and answer queries in threads started by others. The forums were moderated weekly by staff. Discussion forums were the most used feature of the LMS site with 31,920 hits. Forty-eight percent of the students posted at least once with 186 threads initiated by students and a total of 608 posts. The total number of posts made a significant direct contribution to final mark (P = 0.008) as did previous academic ability (P = 0.002). Although campus did not contribute to final mark, there was a trend for students at the campus where the course coordinator was situated to post more often than those at the other campus (P = 0.073). These results indicate that asynchronous online discussion forums can be an effective tool for improving student learning outcomes as evidenced by final marks in gross anatomy teaching.