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Economic and social barriers: Identifying and prioritising professional needs of Iranian novice teachers
No full textThis research aims to identify and prioritise the professional needs of novice teachers using the Delphi technique. This qualitative, emergent design employs semi-structured interviews to collect data and the Atride-Sterling style for thematic analysis. Twelve novice teachers with different educational qualifications were purposively selected, and the data were analysed using MAXQDA, which revealed five inclusive themes, 23 organising themes and 79 basic themes. The results indicated that the professional needs of novice teachers, based on their priority, include economic, social, administrative, emotional, and educational needs, which are interconnected. The results also indicate that the needs of novice teachers are in line with Maslow’s hierarchy of needs. By capturing holistic data on needs rather than just professional needs, our study’s approach has uncovered something obvious but missing from the extant literature on the needs of novice teachers: only when their basic needs are met can they focus on their role as teachers. In the West, where salaries may be lower than similar professions, teachers still make enough to meet their basic needs. In Iran, this is not always the case. This study suggests new priorities in novice teacher support that are essential before professional educational support can be effective
Prevalence of PD-L1 expression in matched recurrent and/or metastatic sarcoma samples and in a range of selected sarcomas subtypes
No full textWe assessed the frequency of programmed death-ligand 1 (PD-L1) expression by immunohistochemistry (IHC) in a cohort of 522 sarcomas from 457 patients, incuding a subset of 46 patients with 63 matched samples from local recurrence or metastases with primary tumours and/or metachronous metastases. We also investigated the correlation of PD-L1 with the presence and degree of tumour-infiltrating lymphocytes (TILs) in a subset of cases. IHC was performed using the PD-L1 SP263 companion kit (VENTANA) on tissue microarrays from an archival cohort. Evaluation of PD-L1 and TILs was performed on full sections for a subset of 23 cases. Fisher’s exact and Mann Whitney test were used to establish significance (P \u3c0.05). PD-L1 positive expression (\u3e1%) was identified in 31% of undifferentiated pleomorphic sarcomas, 29% of angiosarcomas, 26% of rhabdomyosarcomas, 18% of myxofibrosarcomas, 11% of leiomyosarcomas and 10% of dedifferentiated liposarcomas. Negative expression was present in all atypical lipomatous tumous/well-differentiated lipoasarcomas, myxoid liposarcomas, synovial sarcomas, pleomorphic liposarcomas, and Ewing sarcomas. PD-L1 IHC was concordant in 81% (38 of 47) of matched/paired samples. PD-L1 IHC was discordant in 19% (9 of 47 matched/paired samples), displaying differences in the proportion of cells expressing PD-L1 amongst paired samples with the percentage of PD-L1-positive cells increasing in the metastatic/recurrent site compared to the primary in 6 of 9 cases (67%). Significant correlation between PD-L1 expression and the degree of TILs was exclusively identified in the general cohort of leiomyosarcomas, but not in other sarcoma subtypes or in metastatic/recurrent samples. We conclude that the prevalence of PD-L1 expression in selected sarcomas is variable and likely to be clone dependent. Importantly, we demonstrated that PD-L1 can objectively increase in a small proportion of metastases/recurrent sarcomas, offering the potential of treatment benefit to immune checkpoint inhibitors in this metastatic setting
A spiritual theology of dialogue: Levinas, Burggraeve, and Catholic theology
No full textDialogue needs provocative interlocutors. Instilling a grave and shuddering awakening to the conscience, Emmanuel Levinas has provided a corpus of writings unveiling an immemorial horizon and divine calling of infinite responsibility before the other, the brother/sister stranger. Roger Burggraeve has animated Levinas’ writings within a Christian theological horizon as a source of formation in the service of promoting biblical wisdom and love in the life of faith. The writings of Pope Benedict XVI and Pope Francis together portray a Catholic theological gravity to bring dialogue into a spiritual, practical, and social domain. Accordingly, this article develops the notion of dialogue within a Jewish and Christian lens by introducing the sense of the non-reciprocal character of dialogue, an asymmetrical relation of responsibility to the other evidencing the preconditions of dialogue. Levinas’ notion of non-reciprocal dialogue, taken further by the writings of Burggraeve, reveals a pre-original affectivity or ‘dialogical’ character of interpersonal relations of commitment respecting the other’s mystery and unknowability. This means that the dialogical relation is a pathway of ethical transcendence, a holy ground evoking an integral human ecology of maternity and fraternity. Such covenantal alterity in spiritual theological terms signifies an affectivity of atonement and redemptive love. In this way, the movement towards dialogue reveals a synodal path and holy ground to walk together and imagine an integral ecology of difference and mystery to transform words into sacrifice and truth into redemptive love. Journeying together upon such holy ground witnesses to a spiritual theology of dialogue envisioning a place to hear the “good news” (Lk 4:16) and encounter “the hunger and thirst for righteousness” (Matt 5:6)
Nurse telephone support for caregivers of older adults at hospital discharge: A randomized clinical trial
No full textImportance: Informal caregivers who provide home-based care frequently experience stress and burden that adversely affect their health-related quality of life (HRQOL).
Objective: To evaluate the efficacy of the Further Enabling Care at Home (FECH+ ) program for the HRQOL of caregivers of older adults discharged home from the hospital.
Design, Setting, and Participants: This multicenter, parallel, 2-group randomized clinical trial, with blinded baseline and outcome measurements, was conducted at 3 hospitals in 2 states in Australia. Recruitment took place between August 2020 and July 2022, and follow-up was performed for 12 months after hospital discharge. Participants were dyads of caregivers and patients. Eligible caregivers were aged 18 years or older who provided informal home-based care at least weekly for a patient aged 70 years or older. Caregivers were enrolled when their patient was discharged from the hospital. Dyads were randomly assigned to either the intervention or control group. Data analysis followed an intention-to-treat approach.
Intervention: Caregivers in the intervention group received the FECH+ program, structured nurse support of 6 telephone calls over 6 months after the patient’s discharge plus usual discharge care. Caregivers in the control group received usual care alone.
Main Outcomes and Measures: Primary outcome was caregivers’ HRQOL 6 months after discharge, which was measured using the Assessment of Quality of Life 8-Dimension (AQOL-8D). Secondary outcomes were caregivers’ HRQOL 12 months after discharge as well as preparedness to care (measured using the Preparedness for Caregiving Scale), self-efficacy (measured using the Caregiver Inventory), and levels of strain and distress (measured using the Family Appraisal of Caregiving Questionnaire) at 6 and 12 months after discharge. Baseline and outcome measurements were administered by telephone at 3, 6, and 12 months after discharge.
Results: A total of 547 dyads (caregivers: 405 females [74.0%], mean [SD] age, 64.50 [12.82] years; patients: 296 females [54.1%], mean [SD] age, 83.16 [7.04] years for the intervention group and 83.45 [7.20] years for the control group) were included in the intention-to-treat analysis. There was no significant difference in caregivers’ HRQOL between the 2 groups at the primary time point of 6 months (difference in AQOL-8D score, 0.01; 95% CI, −0.02 to 0.03; P = .62) after hospital discharge.
Conclusions and Relevance: In this randomized clinical trial, the FECH+ program—a nurse telephone support intervention for caregivers of older adults after hospital discharge—did not significantly improve caregivers’ HRQOL at 6 months after discharge compared with usual care. Additional examination is warranted into improving caregivers’ HRQOL at the time of their patient’s hospital discharge.
Trial Registration: Australian New Zealand Clinical Trials Registry Identifier: ACTRN1262000006094
The Philosophy Behind the Vatican\u27s Approach to Relations with China
Get PDFThe Vatican has always played a significant role in global politics, and it continues to do so in the contemporary World. The Vatican’s relations with the People’s Republic of China (PRC) have drawn considerable attention in recent years, especially following the signing of the 2018 Vatican-China Agreement. Some scholars and commentators suggest that the 2018 Agreement and its terms represent a significant deviation from the norm in Vatican diplomacy. In light of that controversy, the present thesis provides an introductory examination of the philosophy that possibly guides the Vatican’s relations with the PRC and the implications this holds for an understanding of Vatican foreign policy under the Pontificate of Pope Francis. To investigate the core issue of this thesis, an examination of Vatican diplomacy is conducted, including an overview of the history of Vatican-China relations, an investigation into the Vatican’s current foreign policy strategy under Pope Francis, and the possible challenges that Vatican-China relations face going forward. The findings of the thesis build on the work of Rowland and others to argue that the guiding philosophy of the Vatican toward relations with China under the pontificate of Francis is Peronism, and the reason why this particular philosophy is being used to guide the Vatican’s foreign policy is because Pope Francis himself is heavily influenced by Peronism and he views it as being the best way to navigate the Chinese Communist Party’s approach to religion and religious organisations. That Peronism is a heavy influence on Francis’ decision-making is reflective of the Pope’s formative social and political experiences in Argentina prior to becoming Pope. The thesis reaches this conclusion by aligning the tenets of Peronism seen in the Vatican’s approach to relations with China, and the PRC’s strategy toward religion understood through the Government Involvement in Religion (GIR) framework proposed by the scholar Jonathan Fox. Implications for future research in Vatican diplomacy are considered
The Impact of Service-Learning on the Development of Servant Leadership in an Ignatian Context
Get PDFThis thesis investigates the impact of domestic and international service-learning on servant leadership development. Utilising mixed methods, the case study extends the current literature, which has relied largely on quantitative or qualitative data. The research comprises three Sydney Jesuit institutions and seven service-learning experiences of differing lengths and locations. The quantitative phase surveyed 60 participants using the Servant Leadership Behaviour Scale (Sendjaya et al., 2008) to capture statistically significant growth in servant leader attributes, including: voluntary subordination, covenantal relationships, authentic self, responsible morality, transforming influence and transcendental spirituality. The second phase involved 62 individual interviews with leaders and volunteers to capture more extensive and nuanced reflections on the experience. Analysis of the numerical data indicated statistically significant growth across the case, confirming the impact of service-learning on servant leadership development. Thematic analysis of the transcripts resulted in a series of emerging themes revealing key mediators of servant leadership growth. These included (i) exposure to immersive and engaging service (ii) duration/intensity of experience (iii) provision of servant leader role models (iv) opportunities for self-reflection (v) intentional fostering of moral growth and (vi) promotion of authentic relationships. These mediators supported the development of servant leader attributes fostered through the implementation of well-designed and intentional programmes. Lastly, this case study proposed a set of strategies that have farreaching implications for service-learning organisers and practitioners. This research provides significant support for Ignatian and other faith-based institutions seeking to become more intentional in their building of servant leadership capacity through their service-learning programmes
\u27Reading the Room\u27: A Mixed Methods Study of Midwifery Students\u27 Perceptions of Emotional Intelligence and its Relationship to Midwifery
No full textMidwifery is emotionally challenging work; midwives provide care to women and families at one of the most significant points of their lives and this work is not without impact upon the midwives themselves. Midwifery students require more than just the cognitive ability to learn the requisite midwifery knowledge and competence at performing practical midwifery skills, the knowledge and skills that midwives require intersect with and are influenced by a wide range of emotions and emotional experiences. Emotional intelligence (EI) is the ability to identify and manage one’s own emotions, as well as the emotions of others and within other healthcare disciplines EI is considered an essential attribute of an effective practitioner. There is a lack of evidence that investigates EI from a midwifery perspective, requiring further exploration given the emotionally challenging nature of midwifery. This study fills a gap in the knowledge by exploring EI and how it relates to midwifery from the perspective of Australian midwifery students.
The overall aim of this study was to develop an understanding of midwifery students’ perceptions of EI and its relationship to midwifery to inform education and support of midwifery students. This research employed a convergent mixed methods design comprising of a larger core qualitative component and a smaller quantitative element. The qualitative component used a phenomenographical methodology to gain a collective understanding of midwifery students’ perceptions and experiences of EI. Phenomenography has a distinctly different approach from other qualitative methods as it places emphasis on the ‘collective’ meaning over individual experience. In depth interviews were conducted with 16 midwifery students within Australia and phenomenographic analysis was used to identify five categories of description (the phenomenographic equivalent of themes) revealing the different ways midwifery students conceptualised EI and its relationship to midwifery: ‘Reading the room’, ‘Nature versus nurture’, ‘Sipping tea intelligently’, ‘Midwifery is different’ and the ‘Emotional rollercoaster’. The quantitative component used a survey design to measure the levels of EI in an Australian midwifery student sample. The survey utilised the Assessing Emotions Scale (AES) tool to measure the EI of 116 midwifery students and contained an optional open text qualitative question. Descriptive statistics reported a mean AES score of 134 for the midwifery student sample, putting this AES score in the highest 25% of recorded samples using this measure of EI, with most other populations recording mean AES score of less than 130. No statistically significant differences were found between the AES scores of the different midwifery student groups either by program type or age.
The findings of this research offer a unique midwifery perspective on the nature of EI and how it is viewed and experienced in different ways by midwifery students. Overall, this thesis brought to the forefront evidence that EI is an integral part of midwifery practice and is a necessary attribute that midwifery students require to support their practice in an emotionally challenging profession. These findings have implications for midwifery educational curricula and all those who support midwifery students within academic and clinical spaces, with recommendations made to support the development of EI to prepare midwifery students to deal with the emotional load of midwifery
An Investigation into the Nature of the Knee Pain Experience in People with Knee Osteoarthritis
Get PDFKnee osteoarthritis poses a substantial and escalating socioeconomic burden globally, exacerbated by demographic trends towards an aging population, sedentary lifestyles and increasing obesity rates. Defined by knee pain and functional limitations (Wood et al., 2023; Zhang, Doherty, et al., 2010), traditional approaches have viewed knee OA related pain and disability primarily through a biomedical lens, linking symptoms directly to structural damage and advocating surgical interventions such as total knee arthroplasty to address presumed causative pathology (Bunzli et al., 2019; Darlow et al., 2018). Despite the capacity of surgery to ameliorate structural pathology, patient centred outcomes vary considerably. Up to 30% of patients report experiencing suboptimal post-operative results secondary to persistent post-operative pain or dissatisfaction with outcome (Beswick et al., 2012; Bierke & Petersen, 2017; Brander et al., 2003; Ditton et al., 2020; Khatib et al., 2020; Koga et al., 2024; Wylde et al., 2018).
Recent insights help clarify why treatment that addresses only structural pathology fail up to a third of surgical recipients. It is now well recognised that knee pain reflects a complex interplay of biological, psychological, and social factors, and that structural damage is only a part of the clinical picture (Lotze, 2007; Moseley, 2017). This holistic perspective characterises knee OA as a multifaceted condition, influenced by biopsychosocial factors that modulate pain sensitivity and shape behavioural responses (Caneiro et al., 2020; Hunter, 2018; Kittelson, George, et al., 2014). Inspired by the Fit-For-Purpose Model (Wand et al., 2022) initially developed for chronic low back pain, this thesis aims to investigate cognitive, perceptual and behavioural factors aligned with the Fit-For-Purpose Model in the context of knee OA. The chapters of this thesis will each address specific aspects of knee OA and post-total knee arthroplasty outcomes. Chapter 2 provides the systematic review and meta-analysis protocol exploring functional improvements post total knee arthroplasty, comparing self-reported and performance-based measures of function. Chapter 3 presents the review and its findings, highlighting the less-than-ideal functional outcomes seen post knee replacement. Chapter 4 introduces two innovative tests – the Perceived Knee Size Task and the Fremantle Fragility Index. These tests aim to fill gaps in the current assessment of people with symptomatic knee OA by providing fine grained psychophysical assessments of perceptual and conceptual body representations. This chapter provides the first description of these two tasks as well as offering the first normative data and preliminary evidence of reliability. Chapter 5 focuses on a self-reported assessment of perceptual body representation specific to the knee. There is data on the measurement properties of translated versions of the Fremantle Knee Awareness Questionnaire, but no evaluation of the original English language version. This chapter explores the structural and construct validity of this questionnaire. Noting that there is currently no self-reported measure of conceptual body representation, Chapter 6 presents a short report on the Fremantle Knee Fitness Score (FKFS), a simple tool I developed to assess the views people hold regarding the degree of structural damage to their knee and the fragility of their knee. Finally, Chapter 7 integrates the Fremantle Knee Awareness Questionnaire and the Fremantle Knee Fitness Score with existing self-reported measures to explore the cross-sectional relationships between Fit-For-Purpose Model aligned factors and pain/disability in knee OA. This comprehensive analysis aims to elucidate how psychological, perceptual, and physical factors contribute to the chronicity of knee OA and inform tailored treatment approaches
