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[In Press] Primary care practitioner and patient perspectives on care following bariatric surgery : a meta-synthesis of qualitative research
No full textPrimary care is central to ongoing health care following bariatric surgery and patients indicate a reference for receiving follow-up support by their primary care practitioner (PCP). This meta-synthesis investigates the perspectives of both PCPs and patients in post-bariatric surgery care provided by PCPs. The aim was to synthesize themes from qualitative research to recommend improvements in post-bariatric surgery clinical care in primary care settings. Systematic searches of Scopus, Medline, EMBASE, PsycINFO, the Cochrane Library, and Google Scholar resulted in the inclusion of eight papers in the meta-synthesis. Papers were critiqued using the Critical Appraisal Skills Program (CASP) and thematically coded in Quirkos Cloud. Seven themes were reached by author consensus including stigma and judgment; clinician barriers and facilitators; patient-related support needs; communication considerations; patient context or determinants; health care setting; and adapting to life after surgery. PCPs reported barriers including poor communication and guidance from bariatric surgery centers, limited knowledge and training in bariatric patient care, and patients who may have unrealistic outcomes and poor health literacy. Patients seek comprehensive care from their PCP, however, barriers hindering the provision of this care include adverse surgical outcomes, a poor relationship with their PCP, and limited and short-term follow-up care from the PCP. Insights from this meta-synthesis offer actionable recommendations for PCPs and bariatric surgery centers to enhance patient care immediately
[In Press] Mental health and wellbeing of international students in Australia : a systematic review
No full textBackground: concerns have been raised that international students are at high risk of poor mental health and wellbeing. Aims: the aim of this study was to systematically review the literature on the mental health and wellbeing of international students in Australia. Methods: A literature search was conducted using ciNAHl, MeDliNe, PsyciNFO, and Academic Search complete using eBScOhost interface for articles published from 2000. A pre-determined set of eligibility criteria was used to screen articles and eligible articles were quality appraised using the Mixed Methods Appraisal tool. Due to considerable heterogeneity, the data was narratively analysed, considering the statistical significance and the text narratives. Nineteen studies (N = 19) met the inclusion criteria. Results: Mental health issues experienced by international students included anxiety (2.4-43%, N = 5), depression (3.6-38.3%, N = 6), psychological stress/distress (31.6-54%, N = 9) and gambling problems (3.3-50.7%, N = 3). Factors affecting student wellbeing included loneliness/isolation (60-65%, N = 4), work/financial difficulties (15.4-95%, N = 4) and discrimination/safety concerns (9-50%, N = 3). Other factors affecting students included cross-cultural transition experiences, language difficulties, social interaction, university belonging, technology difficulties, self-harm, use of counselling services and mental health literacy. Conclusion: international students in Australia experience various issues affecting their mental health and wellbeing. More effort needs to be made to better support students
Cultivating gresilience : climate change & sustainable agriculture
No full textClimate change is upon us — and is affecting global food production, forcing us to devise various adaptation strategies. The Food and Agriculture Organization of the United Nations (FAO) estimates that climate change could push 122 million more people, mainly farmers, into extreme poverty by 2030 and increase cereal prices by 29% by 2050, among other adverse effects.1 Rising temperatures, changing precipitation patterns, extreme weather events, and alterations in pest and disease dynamics pose formidable challenges to global agricultural systems
Participation in physical activity and sport in adolescent girls from Middle Eastern backgrounds
No full textObjectives: This study investigated the barriers and facilitators to physical activity and sport participation among adolescent girls from Middle Eastern backgrounds. These factors were explored through the perspectives of both adolescent girls and parents of adolescent girls, living in Australia.
Design: A qualitative study design was used to understand perceived barriers and facilitators to physical activity and sport in adolescent girls. Participants were 18 adolescent girls and 9 parents of adolescent girls, all of Middle Eastern backgrounds, living in Western Sydney, Australia. Data were collected through five focus groups and four one-on-one interviews, separated for girls and parents. Data were analysed using an inductive approach and thematic analysis.
Results: Three main themes (family, social support, religion and culture) and nine subthemes were identified. The main facilitators for physical activity and sport included the values and presence of an active family role model, religion to encourage lifelong physical activity skills, and promotion of physical activity from peers, school, and social media. The predominant barriers to physical activity and sport included established cultural norms and traditional gender roles, which were often influenced by religion and culture, and extended time using technology.
Conclusion: The findings of the current study show the complex relationships between family, religion, and culture when promoting physical and sport participation. Such factors highlight the need to develop culturally tailored physical activity interventions that consider the perceived barriers and facilitators for adolescent girls' participation from Middle Eastern backgrounds
Modern approaches to enhancing rust resistance in wheat leading to global food security
No full textRust diseases pose significant threats to wheat production. The deployment of wheat cultivars endowed with rust resistance stands as the most potent strategy for effective rust management. This resistance is primarily inherited through Mendelian principles discovered in 1905, but traditional breeding methods are time-consuming. Modern strategies have emerged to develop rust-resistant wheat varieties efficiently. Marker-Assisted Selection (MAS) accelerates the breeding process through precise screening, bringing about a revolution in the creation of rust-resistant wheat varieties. Genetic engineering techniques allow the transfer of resistance genes from other species into susceptible crops, but GMO use remains controversial and regulated. Gene editing, especially with CRISPR-Cas9, is a game-changer, enabling the introduction of natural variations or inactivation of critical genes in rust pathogens, enhancing plant resistance. RNA interference (RNAi) is another promising strategy, using small RNA molecules to inhibit rust pathogen gene expression, reducing disease severity. Induced Systemic Resistance (ISR) primes plant immune systems by treating them with beneficial microorganisms or compounds, fortifying them against subsequent rust infections. Eco-friendly biofungicides with antagonistic microorganisms suppress rust infections as alternatives to chemical fungicides. The development of climate-resilient wheat varieties is essential, as they indirectly enhance rust resistance, ensuring stable production amid changing climate conditions. These efforts to improve wheat productivity and rust resistance are crucial for feeding the growing global population. Integrating modern methods with traditional breeding is key to effectively combatting rust diseases and enhancing food security
[In Press] On international law and Gaza : critical reflections
No full textAs Israel’s assault on Gaza continues into its tenth month, the language of legality has become the dominant frame of popular and political discourse. Public interest in the International Court of Justice (ICJ) and its proceedings is at a level perhaps never seen before; so too in the International Criminal Court (ICC), its Prosecutor at once urged to act and condemned for inaction, his recent request to judges for the issuing of arrest warrants both celebrated and damned. International law has emerged as the global vernacular of both condemnation and legitimation; few commentators today speak of Gaza or Palestine without invoking the language of il/legality. What are we to make of this groundswell of interest in and resort to international law? What is the significance of the current series of ICJ proceedings and popular engagements with them? How should we think about the clamorous championing of The Hague and its institutions as the harbingers of justice? The editors of the London Review of International Law invited our advisory editors and others in the academic community of critical scholars to reflect on these questions
Real-time anomaly detection using hardware-based unsupervised Spiking Neural Network (TinySNN)
No full textWe present TinySNN, a novel unsupervised spiking neural network hardware designed for real-time anomaly detection. TinySNN provides an energy-efficient edge computing solution for detecting anomalies in industrial settings. TinySNN can model and extract spatio-temporal features in sensory data, thereby enabling it to identify anomalous inputs with high accuracy. During inference, the spike rate of the TinySNN model acts as an indicator of anomalous patterns within these features. We demonstrate TinySNN’s potential using publicly available vibration datasets, achieving impressive anomaly detection results. TinySNN demonstrates exceptional sensitivity to subtle deviations from normal operation, and can dynamically adapt during online, unsupervised training. We provide a digital implementation of TinySNN on an FPGA for hardware efficiency. The TinySNN hardware can be trained online on real industrial data without requiring power hungry computing architectures like GPUs. This approach presents a promising and practical solution that allows for the dynamic learning of normal industrial operations and assists in mitigating risks through continuous monitoring. TinySNN can help ensure the safe and reliable operation of critical industrial systems through neuromorphic processing
"I wish I knew then what I know now" : pain science education concepts important for female persistent pelvic pain : a reflexive thematic analysis
No full textPain science education (PSE) provides people with an understanding of “how pain works” grounded in the biopsychosocial model of pain; it has been demonstrated to improve outcomes in musculoskeletal pain conditions. Preliminary evidence suggests PSE may be effective for female individuals with persistent pelvic pain, but how the content of PSE needs to be modified for this group remains to be determined. A reflexive thematic analysis of qualitative data was performed to identify PSE concepts that female individuals with persistent pelvic pain consider important and why. Twenty individual, semistructured interviews were conducted with adult females who had engaged with PSE and had self-identified as having “improved” pelvic pain. Most participants had been diagnosed with endometriosis (n = 16). Four themes were generated capturing PSE concepts considered important by female individuals with “improved” pelvic pain: (1) “A sensitised nervous system leads to overprotective pain” validated their pelvic pain as being real; (2) “Pain does not have to mean the body is damaged (although sometimes it does)” provided reassurance that pelvic pain does not mean their condition is worsening; (3) “How I think, feel, and ‘see’ my pain can make it worse” enabled participants to find optimal ways to manage their pain; and (4) “I can change my pain… slowly” provided hope that pelvic pain can improve and empowered them to pursue pain improvement as a viable goal. This study generated 4 PSE learning concepts that were important to female individuals with improved pelvic pain and may be incorporated into PSE curricula for female individuals with pelvic pain
Investigating the impact of exercise on T and NK cells in skin cancer : a systematic review
No full textSkin cancer has the highest incidence of all cancers, and their incidence are increasing in both melanoma and non-melanoma skin cancers. Alternative adjuvant treatment strategies appropriate for their management are needed. Modifiable lifestyle factors influence disease outcomes, either improving or worsening outcomes. Exercise is an example of a modifiable lifestyle factor, and can be prescribed as an adjuvant therapy in other cancer types to improve immune function and overall clinical outcomes. The initial aim of the review was to investigate the T-cell specific mechanisms of exercise which affect clinical/disease outcomes in skin cancer. Study quality was assessed by a modified Covidence quality assessment template with animal-model study specific criteria. A total of 10 articles were included; all articles were murine model studies investigating melanoma. Eight studies (n=8) employed a randomised controlled trial design, with two bio-informatics studies, and one study using human data which could solidify a link to human health. While the review focussed initially on T-cells, many studies reported significant changes in NK cells, and as they share the same haematopoietic lineage/ common lymphoid progenitor as T cells, the data was included in the analyses. Most studies indicated that exercise reduced melanoma tumour burden. Exercising prior to melanoma inoculation was most effective for delaying carcinogenesis and reducing tumour burden. Synergism was a topic identified in studies; PD-1/PD-L1 treatment, and exercise were not synergistic. Conversely, exercise and mental stimulation were synergistic, and the temperature at which exercise was conducted significantly reduced tumour burden. Several murine studies reported that exercise improved clinical outcomes in melanoma, and that long-term exercise was more effective in reducing tumour burden. Further studies are required to investigate this relationship in humans, and in other types of skin cancer