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Value of renal histology in predicting cardiorenal outcomes in heart transplant-listed patients
No full textCardiorenal syndrome (CRS) contributes significantly to morbidity and mortality in patients requiring mechanical circulatory support and transplantation. There are no validated markers to predict major adverse kidney events (MAKEs), for which simultaneous heart-kidney transplant (SHKT) could offer improved survival. We evaluate renal histology in predicting MAKEs in transplant-listed patients.
Methods: We identified 18 patients with renal histology consistent with CRS from 655 consecutive heart transplant-listed patients between 2010 and 2019. Biopsies were analyzed for glomerular, tubular, interstitial, and arteriolar changes tallied to give a biopsy chronicity score. The primary outcome, MAKE, was a composite of death, need for renal replacement therapy (RRT), or estimated glomerular filtration rate decline \u3e50%. These were evaluated at 2 time points: before and following the transplant. Secondary outcomes included the individual components of the composite outcomes and the need for short-term RRT following the transplant.
Results: The mean age was 52.3 y, 22% were female. Five patients did not survive to transplant. One patient underwent successful SHKT. MAKE occurred in 8 of 18 before the transplant and in 8 of 13 following the transplant. Neither outcome was predicted by baseline biochemistry. The biopsy chronicity score was significantly higher in patients with MAKE before transplant (4.3 versus 1.7, P = 0.024) and numerically higher in patients requiring short-term RRT following transplant (3.2 versus 0.7, P = 0.075). Contrary to limited previous literature, interstitial fibrosis did not predict any outcome, whereas tubular atrophy and arteriosclerosis were associated with MAKE before transplant.
Conclusions: A higher biopsy chronicity score was associated with adverse kidney endpoints, raising its potential utility over standard biochemistry in considering SHKT referral
Keep the Fire Burning! Blak, Loud and Proud.
Get PDFThis year\u27s National NAIDOC theme celebrates the unyielding spirit of our people and communities and invites all to honour the legacies, continue to stand in solidarity and amplify the voices of First Nations people for the future
Lived Experiences of Former Secondary School Students with Attention Deficit Hyperactivity Disorder: A Phenomenological Study
Get PDFThis study was an exploration of the lived experiences of students with ADHD in the Australian secondary school classroom in identifying factors influencing their learning outcomes. Students with ADHD face short-term issues, such as strained relationships with teachers, peers, and parents, a lack of relatedness and engagement with school, late arrival and absenteeism, and high drop-out rates, leading to poor academic outcomes (Dembo et al., 2016; Fried et al., 2016). In the long-term, their poor academic achievements have led to many other negative outcomes including psychological conditions, under-employment, substance abuse, criminality, and an overall poorer quality of life, causing significant social and economic burdens to society (Australian ADHD Professionals Association, 2019; Faraone et al., 2015). It is timely, therefore, to explore the less researched student perspective in identifying the factors which contribute to improvements in the learning outcomes of students with ADHD.
The literature review underscored four themes, which facilitated the development of the conceptual design of this study. These four themes are: ADHD core symptoms and executive function; co-occurring conditions; teacher attitudes; and emotional dysregulation/impact. The dynamic interaction between these themes was determined to directly influence learning outcomes for students with ADHD.
This study adopted a qualitative research paradigm with a constructivist epistemological stance and an interpretivist theoretical perspective based on the methodological principles of transcendental phenomenological analysis. The method of data collection was in-depth, semi-structured individual interviews with ten former Australian public and private secondary school students from New South Wales, Victoria, and Tasmania. Moustakis’ (1994) structured approach to data analysis was used in analysing the data collected through participant interviews.
The core symptoms of ADHD and their direct connection with poor executive functions posed the main learning challenges for the participants. Nevertheless, it is the dynamic interaction of co-occurring conditions, such as anxiety and depression, with negative teacher attitudes, that led to the lack of self-confidence in students with ADHD’s abilities, low self-esteem, and poor learning outcomes. The importance of teachers’ positive attitude towards these students and the critical role of an ‘executive assistant’ to support their compromised executive functions on a continued basis emerged as positive factors towards emotional stability and improved learning outcomes.
The findings of this study highlight emotional stability within the classroom as an important element influencing improved learning outcomes for students with ADHD. Although, emotional stability was found to be directly connected with positive self-esteem and improved learning outcomes, participants of this study had often experienced low self-esteem resulting from a lack of self-confidence in their academic abilities, and a lack of belonging/relatedness and engagement within the classroom.
The researcher identified several key factors influencing improved learning outcomes for these students which included supporting academic challenges; positive teacher attitudes; peer acceptance; healthy friendships; engaging talents; emotional support; enhancing creativity and intrinsic motivation; and engaging support persons, support systems and support tools. Based on these factors, recommendations include considerations that promote improved learning outcomes, such as: supporting students’ academic challenges; enhancing teacher knowledge and skills; facilitating healthy peer relations within the classroom; identifying a key support person or ’executive assistant’; managing co-occurring psychological conditions; adopting a career focused approach through talents and interests; and parallel curricular
AI-enhanced personality identification of websites
No full textThis paper addresses the challenge of objectively determining a website’s personality by developing a methodology based on automated quantitative analysis, thus avoiding the biases inherent in human surveys. Utilizing a database of 3000 websites, data extraction tools gather relevant data, which are then analyzed using Artificial Intelligence (AI) techniques, including machine learning (ML) and natural language processing. Four ML algorithms—K-means, Expectation Maximization, Hierarchical Agglomerative Clustering, and DBSCAN—are implemented to assess and classify website personality traits. Each algorithm’s strengths and weaknesses are evaluated in terms of data organization, cluster flexibility, and handling of outliers. A software tool is developed to facilitate the research process, from database creation and data extraction to ML application and results analysis. Experimental validation, conducted with identical training and testing datasets, achieves a success rate of up to 94% (with an Error of ≤ 50%) in accurately identifying website personality, which is validated by subsequent surveys. The research highlights significant relationships between website attributes and personality traits, offering practical applications for website developers. For instance, developers can use these insights to design websites that align with business goals, enhance customer engagement, and foster brand loyalty. Additionally, the methodology can be applied to creating culturally resonant websites, thus supporting New Zealand’s cultural initiatives and promoting cross-cultural understanding. This research lays the groundwork for future studies and has broad applicability across various domains, demonstrating the potential for automated, unbiased website personality classification
The mental health of Australians bereaved during the first two years of the COVID-19 pandemic: A latent class analysis
No full textBackground: The COVID-19 pandemic disrupted many areas of life, including culturally accepted practices at end-of-life care, funeral rites, and access to social, community, and professional support. This survey investigated the mental health outcomes of Australians bereaved during this time to determine how these factors might have impacted bereavement outcomes.
Methods: An online survey indexing pandemic and bereavement experiences, levels of grief, depression, anxiety, and health, work, and social impairment. Latent class analysis (LCA) was used to identify groups of individuals who shared similar symptom patterns. Multinomial regressions identified pandemic-related, loss-related, and sociodemographic correlates of class membership.
Results: 1911 Australian adults completed the survey. The LCA identified four classes: low symptoms (46.8%), grief (17.3%), depression/anxiety (17.7%), and grief/depression/anxiety (18.2%). The latter group reported the highest levels of health, work, and social impairment. The death of a child or partner and an inability to care for the deceased due to COVID-19 public health measures were correlated with grief symptoms (with or without depression and anxiety). Preparedness for the person’s death and levels of pandemic-related loneliness and social isolation differentiated all four classes. Unemployment was associated with depression/anxiety (with or without grief).
Conclusions: COVID-19 had profound impacts for the way we lived and died, with effects that are likely to ricochet through society into the foreseeable future. These lessons learned must inform policymakers and healthcare professionals to improve bereavement care and ensure preparedness during and following future predicted pandemics to prevent negative impacts
BBBEE fairness perceptions and job performance: The role of leadership styles and psychological availability
No full textOrientation: Studies suggest that employees fairness perceptions of the workplace are positively linked to job performance. Employees associate perceptions of fairness in the workplace with transformational and transactional leaders. It is important to recognise that employees’ personal resources can be compromised when they perceive a lack of fairness in the workplace.
Research purpose: This study investigated the role of leadership styles and psychological availability on the relationship between fairness perceptions of Broad-Based Black Economic Empowerment (BBBEE) and job performance of employees, within the South African work setting.
Motivation for the study: Little is known about the association between the fairness perceptions of BBBEE and job performance. Also, less is known about the mediating variables that can influence this relationship.
Research approach/design and method: A quantitative cross-sectional design was employed. Convenience sampling yielded 300 participants from whom data were collected.
Main findings: The results showed that the perceived fairness of BBBEE had an indirect relationship with job performance by means of transactional leadership styles and psychological availability. Practical/managerial implications: Achieving optimal job performance from this group of employees hinges on transactional leaders satisfying the needs of employees in return for employees meeting agreed-upon obligations. Furthermore leaders need to monitor the extent to which employees are psychologically available at work.
Contribution/value-add: The Job Demands-Resources (JD-R) model was extended to demonstrate the impact that fairness perceptions of BBBEE have on organisational behaviour. The study also revealed that the fairness perceptions of BBBEE affect job performance through transactional leadership styles and psychological availability
Tracking deaths of people who have experienced homelessness: A dynamic cohort study in an Australian city
No full textObjective: Life expectancy and rates of premature death are fundamental markers of health and social equity globally, and measures on which people experiencing homelessness face enormous disparities. However, unlike for other population groups with similar disparities, concerted government action to reduce homeless mortality is rare, partly due to a lack of reliable, timely data. Contemporaneous tracking of homeless deaths is required to render such deaths less invisible and measure trends over time. Drawing on multiple data sources as recommended by the US National Health Care for the Homeless Council’s seminal Homeless Mortality Data Toolkit, we routinely and contemporaneously capture, verify and report on deaths occurring among people who have experienced homelessness in the Australian city of Perth.
Design: Dynamic cohort study.
Setting: Perth, Western Australia, Australia, between 2016 and 2022, with deaths examined between 2020 and 2022.
Participants: For this study, the cohort comprised 8753 people who experienced homelessness in Perth, with ‘recruitment’ into the cohort governed by engagement with one or more local homelessness services and programmes over the period.
Outcome measures: Number and median age-at-death statistics.
Results: There were 360 deaths over the 3-year period, which is likely an undercount. The median age at death was 50 years, \u3e3 decades below the current Australian median age at death of 82 years. Aboriginal people accounted for 30% of the deaths.
Conclusion: The ongoing poor health and premature death of people who have experienced homeless are indictments on our society. Triangulation of multiple data sources is required to identify and monitor deaths among homeless populations. Timely, verified data on homeless mortality are important for galvanising action and accountability, and targets should be set to reduce the observed three-decade life expectancy chasm