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National Apology Day
No full textWhat is apology day? National Apology Day refers to February 13, 2008, when then-Prime Minister Kevin Rudd delivered the National Apology to the Stolen Generations in the Australian Parliament. This significant event aimed to acknowledge the pain, suffering, and trauma endured by the Stolen Generations due to forced removal policies
Supporting cancer-related fatigue self-management: A conversation analytic study of nurse counsellor and cancer survivor consultations
No full textPurpose: Cancer-related fatigue (CRF) is a prevalent and distressing symptom experienced by people affected by cancer. A breakdown of the clinician-patient partnership and suboptimal clinician communication has been identified as a significant barrier to implementing into clinical practice effective self-management strategies for CRF. This study examined the use and impact of communication practices employed by trained cancer nurse counsellors when providing CRF self management support to cancer survivors.
Methods: Interactions from 41 telehealth consultations between three nurse counsellors and 23 cancer survivors in a CRF self-management support clinic in Queensland, Australia were recorded and analysed using conversation analysis methods.
Results: Analysis found that in instances where nurses established the agenda of a consultation from the outset of a session (e.g., focusing on fatigue self-management support), cancer survivors displayed clearer understandings of their self-management role, the tasks, and goals of a session; and displayed less difficulty engaging in supportive care discussions. Furthermore, clinicians used formulation practices, such as summarising dialogue, to sustain focus on fatigue during consultations, and to close discussion matters not ostensibly pertinent to fatigue self-management planning supporting the goals of the CRF SMS clinic consultations.
Conclusion: For supportive care sessions targeting fatigue management, clinicians should ideally focus discussion on CRF support early, by clearly introducing the agenda at the outset of the consultation while also asking for client agreement. Periodically summarising patient’s talk allows clinicians to maintain a focus on matters relevant for self-management fatigue planning and provide support within the typically constrained timeframes allocated for addressing CRF
Improved risk prediction in human papillomavirus-associated endocervical adenocarcinoma through assessment of binary silva pattern-based classification: An international multicenter retrospective observational study led by the International Society of Gynecological Pathologists (ISGYP)
Get PDFEndocervical adenocarcinomas (EACs) are a group of malignant neoplasms associated with diverse pathogenesis, morphology, and clinical behavior. As a component of the International Society of Gynecological Pathologists International Endocervical Adenocarcinoma Project, a large international retrospective cohort of EACs was generated in an effort to study potential clinicopathological features with prognostic significance that may guide treatment in these patients. In this study, we endeavored to develop a robust human papillomavirus (HPV)-associated EAC prognostic model for surgically treated International Federation of Gynecology and Obstetrics (FIGO) stage IA2 to IB3 adenocarcinomas incorporating patient age, lymphovascular space invasion (LVSI) status, FIGO stage, and pattern of invasion according to the Silva system (traditionally a 3-tier system). Recently, a 2-tier/binary Silva pattern of invasion system has been proposed whereby adenocarcinomas are classified into low-risk (pattern A/pattern B without LVSI) and high-risk (pattern B with LVSI/pattern C) categories. Our cohort comprised 792 patients with HPV-associated EAC. Multivariate analysis showed that a binary Silva pattern of invasion classification was associated with recurrence-free and disease-specific survival (P \u3c 0.05) whereas FIGO 2018 stage I substages were not. Evaluation of the current 3-tiered system showed that disease-specific survival for those patients with pattern B tumors did not significantly differ from that for those patients with pattern C tumors, in contrast to that for those patients with pattern A tumors. These findings underscore the need for prospective studies to further investigate the prognostic significance of stage I HPV-associated EAC substaging and the inclusion of the binary Silva pattern of invasion classification (which includes LVSI status) as a component of treatment recommendations
What outcomes matter most to paediatric burn patients and their caregivers: A comparison of short-term and long-term priorities
No full textIdentifying outcomes that matter most is key in driving specialized paediatric burn care. The aim of this study was to discover the most important outcomes for paediatric burns. Parents of children (0–3 year and 4–11 years old) and adolescents (12–17 yearss old) completed surveys to identify outcomes that matter most in the short-term (\u3c6 months postburn) and long-term (6–24 months postburn). The percentage of patients scoring an outcome as ‘very important’ was used to rank the outcomes. Fifty-four parents/adolescents participated (response rate: 27%). Children had a median TBSA burned of 5.0% (IQR: 2.0–7.0%). In the short-term, ‘good wound healing’ and ‘no wound infection’ (both at 71.4–100%) were very important for all children. ‘Not having pain’ (90.3–93.8%) was ranked highest for children ≤11 years old, whereas ‘walking or moving around’ (85.7%) was most important for older children. In the long-term, more variation was seen in outcome priorities; however, both ‘not having pain’ (53.6–85.7%) and ‘flexibility of scar(s)’ (60.7–71.4%) were considered very important by all three groups. Patient- and parent-derived priorities are important for developing consumer-centric, highest-value care pathways. The priority of the outcomes identified is a starting point to discuss treatment options and recovery priorities in a family-centric approach to guide high-value, individualized care
Relational Apophaticism and a Contemporary, Ecumenical Practice of Christian Spiriutal Direction in the Western Church
Get PDFDefining and nurturing Christian spiritual growth and maturity is challenging. This is especially so in a contemporary environment that might be considered individualistic and self-preoccupied and where the meaning of the term ‘spiritual’ has become increasingly vague. This thesis explores the concept of ‘relational apophaticism’ proposing it as a pathway of spiritual growth and the essence of spiritual maturity. A contemporary, ecumenical ministry of Christian spiritual direction in the Western Church, and perspectives on spiritual growth and maturity evident in St. Gregory of Nyssa’s mystical writings The Life of Moses and Homilies on the Song of Songs are drawn on to create a synthesis of understanding of spiritual growth and maturity, allowing the development of relational apophaticism. Practical implications of relational apophaticism to the ministry of spiritual direction for a contemporary, ecumenical spiritual director are then explored
Living Charity: Beata Caterina, the Pizzicaiuoli Altarpiece and Lived Religion in Fifteenth-Century Siena
Get PDFThis thesis examines charity as a key element of early modern experience in the context of the Pizzicaiuoli altarpiece (1447). Painted by well-known artist Giovanni di Paolo, the altarpiece was commissioned by the Sienese guild of grocers, the Pizzicaiuoli, and was situated in the church of the Santissima Annunziata, located in the hospital of Santa Maria della Scala in Siena. The central focus of the altarpiece is the main panel depicting the Presentation of Christ in the Temple (Presentation), which is surrounded by iconic images of saints. Below the Presentation scene, in a predella (the lowermost horizontal component of the altarpiece), is a hagiographic narrative relating to the native beata (blessed) Catherine of Siena. Although small in size, Catherine’s images were an important focus of devotion and continue to offer key information about the nature of her reception in the early modern period. Following a close visual analysis of the altarpiece, this thesis argues that the Catherine narrative had a direct thematic relationship to the main panel, with both the former and latter framed predominantly within the context of charity. Given the prominence of Catherine and the concept of charity in this artwork, it seems evident that both held substantial importance in the lives and mission of the Pizzicaiuoli. Consequently, this thesis employs the lens of lived religion to understand how charity was perceived within the structures of devotion and everyday life in this specific context. By shifting the focus of interrogation from the altarpiece itself to its patrons and viewers, this study will shed light on this elusive group of people – the Pizzicaiuoli guild – their interaction with the altarpiece and the altarpiece’s impact on their religious behaviour and actions. Finally, this thesis will demonstrate the effectiveness of art as a tool for unveiling crucial insights into the lived religious experience of past societies
Closing the Culture Gaps: Policies and Codesign in Remote Western Australia. A Long-Time Story of a Community-Based Kimberley Aboriginal Organisation
No full textThis research is the result of a collaboration with the Kimberley Aboriginal Law and Cultural Centre (KALACC), a remote community-based Aboriginal Community Controlled Organisation (ACCO) located in Fitzroy Crossing, Western Australia. The research investigates the organisation’s strategies to overcome systemic barriers to support remote Aboriginal communities to achieve Closing the Gap (CTG) socioeconomic targets in improving education, employment, and health. KALACC believes that without culture at the centre of CTG strategies, the targets will not be achieved. The key question is how will diverse understandings of culture be achieved through codesign and engagement with Aboriginal people and their community-based organisations to achieve CTG’s socioeconomic targets? To address this question, the research adopted collaborative ethnography, Community Based Participatory Research (CBPR), reflexivity and participating observations as its methods, guided by KALACC’s interpretative frameworks.
The research identified ‘culture gaps’ between KALACC, remote Aboriginal communities and the government. To close these gaps, codesign engagement led by KALACC affords a pathway for culture’s social values to inform CTG targets. The research identified challenges for the CTG National Agreement’s (2020) Priority Reforms in shared decision making and empowering and building partnerships with ACCOs, although there are synergies between government and ACCOs that can bridge these gaps. The significance of the research is that it expands on conceptual understandings of culture for CTG policies, and on ways that government engagement strategies can better support ACCOs. Lastly, it contributes to recognising the valuable role ACCOs can play in closing the gap, one that supports and advocates for the cultural strengths of marginalised remote Aboriginal communities in Australia
Exploring general practitioners\u27 knowledge, attitudes, and practices towards e-cigarette use/vaping in children and adolescents: A pilot cross-sectional study in Sydney
No full textBackground: The increasing use of e-cigarettes/vaping in children and adolescents has been recognised as a global health concern. We aim to explore the Knowledge, Attitude, and Practice of General Practitioners (GPs) in Sydney regarding the use of e-cigarettes in children and adolescents and identify the barriers to addressing this issue. (2) Methods: This pilot study was a cross-sectional study conducted using an electronic questionnaire with a Likert scale and free-text responses. (3) Results: Fifty-three GPs participated in the study (male = 24 and female = 29) with a mean age of 50 ± 5.5 years. There was strong agreement (mean 4.5) about respiratory adverse effects and addictive potential. However, there was less awareness of cardiac side effects and the occurrence of burns. There is a lack of conversation about e-cigarettes in GP practice and a deficit of confidence in GPs regarding managing e-cigarette use in children and adolescents. (4) Conclusions: Our pilot study has shown that GPs are somewhat knowledgeable about the potential adverse effects of the use of e-cigarettes in children and adolescents, though there is a lack of knowledge of the complete spectrum of adverse effects and more importantly, there is a paucity of a structured approach to discuss the use of e-cigarettes with children and adolescents, and there is a low level of confidence in addressing these issues. There is a need for educational interventions for GPs to increase awareness of the potential adverse effects of using e-cigarettes and build confidence in providing management to children and adolescents regarding the use of e-cigarettes