ResearchOnline@ND (University of Notre Dame)
Not a member yet
7734 research outputs found
Sort by
interventions to improve the quality of low back pain care in emergency departments: A systematic review and meta‑analysis
No full textLow back pain (LBP) is a common reason people visit Emergency Departments (ED). However, the care provided is often not aligned with guideline recommendations. Despite increasing research aiming to promote guideline-based care in EDs, interventions to best implement recommendations are unknown. This study aimed to identify ED LBP implementation interventions that have been trialed and evaluate their effects on ED-relevant outcomes. A systematic review and meta-analysis, including studies that evaluated interventions to improve the quality of care provided to adults presenting to ED with LBP. Databases searched until May 2023 were Cochrane Library, CINAHL, EMBASE (via OVID), and PEDro. Interventions were categorized according to whether they had a patient, clinician, health service, or multiple-level focus. Where possible, meta-analysis was undertaken. Certainty around the results was assessed using the GRADE criteria. Twenty-eight studies were included. Interventions were categorized as patient (n = 2), clinician (n = 8), health service (n = 12), or multiple-level (n = 6) targeted. Overall, interventions successfully reduced the likelihood of receiving an opioid in ED (OR 0.65; 95% CI 0.55-0.75). However, no significant effect on lumbar imaging was demonstrated (OR 0.85; 95% CI 0.64-1.12). Subgroup analyses showed that studies reporting high baseline imaging rates ≥ 36% and those that included systems-based changes significantly reduced imaging (OR 0.60; 95% CI 0.39-0.93; and OR 0.65; 95% CI 0.45-0.94, respectively). A small reduction in ED length of stay was observed in the group exposed to the LBP interventions (mean difference - 0.38 h; 95% CI - 0.58 to - 0.17). Overall, certainty of evidence was deemed low to very low. Interventions were mostly single-system focused with a preference for education-based implementation strategies targeting patients or clinicians. The interventions reduced the use of opioid medication for LBP in ED, but the effects on lumbar imaging rates were uncertain. Further high-quality research is needed to improve LBP care in this setting
His Name is History: The Spectral Afterlife of the Joh Bjelke-Petersen Era in Queensland Fiction
No full textThis thesis by creative practice comprises a novel titled ‘His Name is History’ and a dissertation that examines how the Joh Bjelke-Petersen era in Queensland (1968–1987) manifests itself as a spectral influence in Brisbane fiction. This era, and its legacy, is remembered with some hostility as a period of social and cultural repression (Evans, Ferrier, and Rickertt 2004; Finnane 2008; Wear 2002) and political corruption (Fitzgerald 1989). Through creative and critical research, I argue that the traumatic inheritance of Queensland’s violent colonial past (Bottoms 2013, Richards 2008) passes through the Bjelke-Petersen era to the cultural psyche as an absence and nostalgic hankering for an imaginary past, and that more alternative voices need to be heard. This spectral analysis is informed by my lived experience as a Queenslander in the Bjelke-Petersen era, and by psychoanalytical and cultural literary theory, from Abraham and Torok’s concept of intergenerational ‘crypts’ that contain traumatic experience in stories (1994), to Derridean hauntology (2012), and Mark Fisher’s ghosts that mourn and warn of lost futures (2014). An interdisciplinary review of writing about historical and political corruption in Brisbane during the Bjelke-Petersen period is followed by a close, hauntological reading of two texts, Jessica Anderson’s The Commandant (2009) and Trent Dalton’s Boy Swallows Universe (2018). Finally, the process of writing and revising through haunting, of working through mourning, is considered in the context of the creative project, drawing the critical and creative processes together.
‘His Name is History’ centres on the long and potholed friendship between Liz and Alessio (Al), who were part of a generation shaped by Joh Bjelke-Petersen’s tainted National Party reign over Queensland. Liz’s narrative shifts between the 1980s, 2001, and 2019, structurally embodying the hauntological concept of the novel and echoing the words of Queensland historian Raymond Evans (2007): “The present is merely a hinge upon which the past and future swing.” Al’s life and untimely death are entangled with subcultural Brisbane’s resistance to the Bjelke-Petersen era. Liz feels compelled to exhume this encrypted past, to make sense of it for her teenage daughter. The novel excavates Liz’s haunting by Al as both absence and a refusal to mourn loss, weaving the personal and political. Collectively, the critical and creative work asks these research questions: What are the ongoing personal, political, and cultural impacts of the Bjelke-Petersen era that haunt novels written in the shadow of this era? How might hauntology be used to creatively research and write such novels, drawing on lived experience of this era
Teachers’ Perspectives and Practices for Ameliorating Dysregulation in School-Aged Children through Trauma-Informed Education Practice
Get PDFThe research investigates Western Australian (WA) teachers’ understanding of the impact of trauma-informed education practice. The main research question, which forms the basis of the study, is How do the trauma-informed education practices, currently being used in Western Australian public schools, impact the capacity of children to self-regulate their behaviour? The literature examines the impact of unresolved trauma on the developing child and reviews the trauma-informed education practices that are designed to ameliorate the negative effects of trauma. The research also investigates the trauma-informed practices that are currently being used in WA public school classrooms, as described by teachers, and the extent to which Trauma-Informed Educational Practices (TIEP) provide positive classroom experiences and assist students to self-regulate (Brunzell & Norrish, 2021).
The study was conducted using a qualitative approach which enabled the researcher to interpret responses to semi-structured interviews and journal records to identify meaningful patterns and themes (Patton, 2014) and undertake deep analysis of the understandings of the 15 purposively selected participants. Each of the participants was a WA public school teacher who was deemed by their principal to employ effective trauma-informed education practices while teaching students contending with dysregulation.
The key elements of trauma-informed education practice were identified: establishing safety, building relationships with others, increasing self-regulation, building cognitive capacity, making choices, improving communication skills, applying a trauma lens, and developing whole-school trauma-awareness. The participants identified the professional learning opportunities that they had accessed as well as the challenges they experienced around implementing TIEP in their WA schools. The frequency of dysregulated episodes exhibited by students who were trauma-affected was reduced after TIEP according to all participants. The enablers of TIEP employed in some WA schools were identified and their impact on the delivery of TIEP in the classroom was explained. Finally, barriers that impact the implementation of TIEP in WA classrooms were identified as well as their impact on students, teachers, and school systems. The research concluded that when WA public-school teachers employed a range of trauma-informed education practices, the dysregulated behaviour of students decreased.
The overall findings of the study included a recommendation for the development of an assessment tool and four recommendations to support the implementation of TIEP in WA schools. No specific TIEP was identified as the primary driver of student success. Teachers require an assessment tool that measures physiological changes that students experience as a result of specific TIEP. The study identified the need for the development of an assessment tool that could be used by teachers to determine the impact of specific TIEP and in relation to changes to behavioural changes in students who are trauma-affected. Five recommendations were formulated from the current research that could enhance the delivery of TIEP by all WA teachers. Recommendations included the implementation of whole-school trauma awareness in every school ; all staff demonstrate respect for all nationalities and cultures, support is provided for teachers, education assistants and school leaders, and student information is shared between all relevant agencies
Cancer Induced Bone Pain: Pain Classification and Management
Get PDFPain is a multidimensional personal experience influenced by biological, psychological, social and cultural factors. In the context of cancer pain, particularly cancer-induced bone pain (CIBP), it is essential that clinicians assess the multidimensional nature of pain to fully understand the patient’s pain experience, which often involves an evoked sense of both vulnerability and mortality.
Bone metastases are highly prevalent in advanced cancer, resulting in CIBP being one of the most common cancer pain syndromes. CIBP affects a patient’s physical and social functioning, reduces quality of life, increases psychological distress and often results in hospice or hospital admission. Yet, there is limited evidence to guide analgesic management. The complex pathophysiology and varied clinical presentation of CIBP warrant personalised management guided through standardised assessment.
In this thesis, the candidate used the Edmonton Classification System for Cancer Pain (ECS-CP) to assess the multidimensional experience of pain in patients with bone metastases. The five assessed domains were correlated with pain intensities and opioid requirements. Additionally, the candidate identified refractory CIBP and recruited these patients to examine the possible efficacy of methadone rotation (MR) compared to other opioid rotations (OOR) in a pilot randomised controlled study.
The studies reveal the challenge in managing CIBP lies in the high prevalence of breakthrough pain, which was associated with neuropathic pain, higher average and worst pain intensities and higher opioid requirements. Opioid rotation, including rotation to methadone, is safe and acceptable to patients while reducing pain intensities and pain interference in daily life. It also suggests that MR may have the additional benefits of providing earlier and more sustained pain reduction, particularly for worst pain intensity, with the utilisation of lower opioid equivalent doses
Ernst Jünger’s Epistemology and Metaphysics
No full textJünger is typically interpreted in the philosophical literature according to a Heideggerian reading to be a metaphysical Nietzschean who took the will to power to be the essence of reality. This is especially so for Jünger\u27s “Gestalt of the worker.” Yet Jünger likened his Gestalt to Goethe’s “Urpflanze,” a phenomenological, not metaphysical, conception. And Jünger\u27s uses of will to power and eternal return are inconsistent with cosmological readings of Nietzsche.
This thesis will argue that the core of Jünger’s epistemology is an account of “intuitive perceptions.” Through these intuitive perceptions Jünger thought he grasped metaphysical reality. Through this grasping Jünger came to maintain metaphysical commitments which are incompatible with Heidegger’s reading.
This thesis will argue that Heidegger’s reading of Jünger is mistaken and that Heidegger projects his account of Nietzsche’s metaphysics onto Jünger. And that Jünger himself advanced an epistemological method of intuitive perception and posited metaphysical commitments about the “undifferentiated,” which was his conception of ultimate reality
A public orgy of misogyny : gender, power, media, and legal spectacle in Depp v Heard
No full textPossibly no other media event has given rise to the widespread ridiculing of domestic violence as the livestreaming of Johnny Depp’s defamation action against his former wife Amber Heard. This article analyses the social media commentary surrounding a Tik Tok released by the Milani cosmetic company, which used the attacks on Heard as an advertising opportunity. The paper contextualises Milani’s intervention in the case within the wider social media commentary targeting Heard’s makeup and appearance and maps its aftermath in the emergence of a cross-platform hashtag #BruiseKit that generated a series of viral posts and videos featuring young women painting fake bruises on their faces. It concludes that the largescale diffusion of reactionary gender ideologies evidenced in the media data was partly shaped by commercial interests and platform incentives, but not—for the most part—driven by formal political actors. Rather, misogyny was commodified. It was produced and consumed as a form of entertainment
From data to diagnosis: how machine learning is revolutionizing biomarker discovery in idiopathic inflammatory myopathies
No full textIdiopathic inflammatory myopathies (IIMs) are a heterogeneous group of muscle disorders including adult and juvenile dermatomyositis, polymyositis, immune-mediated necrotising myopathy and sporadic inclusion body myositis, all of which present with variable symptoms and disease progression. The identification of effective biomarkers for IIMs has been challenging due to the heterogeneity between IIMs and within IIM subgroups, but recent advances in machine learning (ML) techniques have shown promises in identifying novel biomarkers. This paper reviews recent studies on potential biomarkers for IIM and evaluates their clinical utility. We also explore how data analytic tools and ML algorithms have been used to identify biomarkers, highlighting their potential to advance our understanding and diagnosis of IIM and improve patient outcomes. Overall, ML techniques have great potential to revolutionize biomarker discovery in IIMs and lead to more effective diagnosis and treatment
Stability and change in self-reported risk and resilience factors associated with mental health of siblings of individuals with and without neurodevelopmental conditions over 15 months
No full textBACKGROUND Siblings of individuals with neurodevelopmental conditions (NDCs) are a minority population at higher genetic and environmental risk of poorer neurocognitive and psychosocial outcomes compared to siblings of individuals without NDCs. METHOD Measured over a 15-month interval between 2021 and 2022, the present prospective follow-up study is the first Bayesian examination of the unique relationships between self-reported modifiable individual-level risk, resilience, and neuropsychiatric variables amongst siblings of persons with (n = 134) and without (n = 143) NDCs (mean age 22.42, range 9–38 years, 75.81% female, 79.78% White Caucasian). RESULTS The NDC group maintained elevated rates of self-reported mental health diagnoses at follow-up (effect size δ −0.57), with greater risk and fewer resilience variables than controls (δ ranging 0.50–1.07). The NDC group demonstrated group-level worsening of depression (δ −0.32). At the participant level, NDC siblings had statistically reliable declines in executive functioning and self-regulation (anxiety, empathy, attention, cognitive reappraisal) compared to the controls. Baseline self-reported sleep difficulties strongly predicted both depression and anxiety at follow-up for NDC siblings. Life events had minimal impact on mental health outcomes. IMPLICATIONS Findings suggest the clinical utility of interventions for NDC siblings could be improved with a multi-modal approach, and monitoring and targeting changes in transdiagnostic risk factors contributing to poorer mental health
In Altum - Put out into the deep : A formation program for missionary discipleship for students at the University of Notre Dame Australia
No full textWhile there is a significant body of research concerning Catholic faith formation in a variety of educational contexts around the world, relatively little attention has been devoted to the notion of missionary discipleship as a foundation for Catholic formation. Recently, the National Catholic Education Commission, in its document Leading Formation for Mission, also elaborates a solid definition of formation and stated: ‘Formation is imaginative, creative and honours adult learning principles […] It engages the ‘intellect’ and is nurtured by appropriate theological content and it engages the ‘Spirit’ and is characterised by contemplation and action for mission’ (2022). This paper seeks to contribute to a deeper understanding of formation for missionary discipleship by presenting an evaluation of the efficacy of In Altum, a student-focussed ministry and leadership program developed at the University of Notre Dame Australia in response to the developing magisterial teaching concerning the notion of ‘missionary discipleship’. In particular, we examine participants’ personal faith development, understanding of missionary discipleship on campus, preparation for future ministry, and understanding of contemporary challenges to discipleship. The study progresses in three parts: First, it provides a brief background to In Altum, including the philosophical and sociological context, as well as the key theological principles underpinning the formation offered within the program. Second, following an overview of the mixed-methodology approach taken in the study, which details both the use of qualitative and quantitative data derived from focus groups and an online survey, the paper presents the results of the study, which sought to investigate the efficacy of the program as it pertained to the following: (a) the building of (personal subjective assessment of) faith in participants; (b) the building of participants’ understanding of, and confidence in, the task of evangelisation as missionary discipleship in a secularised context; (c) building a strengthened sense of community amongst the participants. In the third and final section, the reported strengths and weaknesses of the program are examined. The paper also comments on implications for the program on the culture of the university more broadly, including precepts of the program’s findings that may be applied in light of the Australian Catholic Plenary Council’s findings to enhance the future directions of formation programs in the Catholic University Chaplaincy, with possible application to Catholic secondary schools and parish youth groups
The promoting physical activity in regional and remote cancer survivors (PPARCS) trial: Physical activity maintenance
No full textIntroduction
The study examined whether increased physical activity (PA) in nonmetropolitan cancer survivors was maintained 12 weeks following the PPARCS intervention. Methods
PA outcomes were assessed using an accelerometer at baseline, end of the intervention, and at 24 weeks. Linear mixed models were used to examine between-group changes in PA outcomes. Results
The increased moderate-to-vigorous PA (MVPA) following intervention was maintained with significantly higher MVPA in the intervention group at 24 weeks (vs. controls) compared to baseline nett change of 52.5 min/week (95% CI 11.0–94.0.4). Conclusions
Distance-based interventions using wearables and health coaching may produce MVPA maintenance amongst nonmetropolitan cancer survivors