University of the Sunshine Coast
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Nonmedical Switching From Originators to Biosimilars: Does the Nocebo Effect Explain Treatment Failures and Adverse Events in Rheumatology and Gastroenterology?
No full textThe act of nonmedical switching, defined as switching stable patients who are generally doing well with their current therapy from an originator biologic to its biosimilar, has been endorsed as a reasonable treatment strategy. The safety and efficacy of nonmedical switching have been evaluated in randomized controlled and real-world evidence studies, which have demonstrated that although many patients maintain treatment response after the switch, some patients experience therapy failure, resulting in therapy discontinuation. It has been postulated that the vast majority, if not all, of these treatment failures result from a “nocebo effect”, defined as patients’ negative expectations toward the therapy change. Reports suggest that the risk of a nocebo effect is higher following a mandated nonmedical switch. Although the nocebo effect is a well-recognized phenomenon in pain studies, evidence is limited in immune-mediated diseases primarily because it is difficult to quantify, especially retrospectively. In spite of this, numerous biosimilar studies in patients with immune-mediated diseases have concluded that nonmedical switching failures are due to a nocebo effect. The objective of this narrative review was to explore the reasons for nonmedical switch failure or discontinuation and the role of the nocebo effect among patients with inflammatory rheumatic and gastrointestinal diseases who switched from an originator biologic to its biosimilar
The Use of Coercive Diplomacy against Violent Non-State Actors
No full textThe rise of violent non-state actors (VNSAs) has become a feature of international security in the past few decades. Despite enormous efforts from the academic, policy and intelligence community, VNSAs have proven remarkably difficult actors to engage with or defeat. This thesis applies the strategy of coercive diplomacy to the VNSA problem and argues it provides policymakers a useful option for countering VNSAs. The thesis incorporates findings from fields as diverse as international relations, history, psychology and behavioural economics to provide an understanding of coercer and VNSA behaviour under coercive diplomacy situations. The primary aim of this thesis is to construct a framework of factors that heighten coercive diplomacy’s probability for success against VNSAs. These factors are (1) an asymmetry of motivation in favour of the coercer; (2) credible threats and objectives; (3) the support of others and (4) incentives. Implementation of the framework does not guarantee a successful outcome as coercive diplomacy is a highly contextual strategy that can deliver vastly different results in varying circumstances. To demonstrate the importance of context this study tests the framework against two case studies. The first considers the British government’s coercive diplomacy strategy against the Provisional Irish Republican Army and argues that coercive diplomacy was successful owing to a strategy that conformed to the framework. The second is a test-case that examines the feasibility of a US led coercive diplomacy strategy against the Islamic State, arguing that it is an example of the limitation of coercive diplomacy against VNSAs. These case studies demonstrate that coercive diplomacy has important implications for countering VNSAs in the future. While coercive diplomacy will not be a suitable strategy in some circumstances, to date it has been vastly underutilised.Submitted in the fulfilment of the requirements of the degree of Doctor of Philosophy, University of the Sunshine Coast, 2020
Hydraulic improvements in culverts for climate change adaptation
No full textLong lasting hydraulic engineering is challenged by changes and trends in weather patterns, causing different discharge rates that were not anticipated in the original design of the structures. Flow rates, higher than anticipated in the original design, potentially damage the infrastructure itself as well as upstream property. Culverts are a common solution for crossings between man-made transport routes and natural streams. The aim of this research was to find efficient ways to substantially increase the discharge capacity of existing culverts to cope with new hydrological parameters without rebuilding them. To investigate possible improvements, factors that influence performance in culverts were reviewed (Chapter 1). This review determined the following research areas that comprised the study; a performance comparison of flow regimes in submerged flow conditions (Chapter 2), different inlet modifications and their potential to increase discharge capacities (Chapter 3), possible improvements for misaligned culverts (Chapter 4) and the risk of culvert blockage due to debris mobilization and transportation (Chapter 5). This research found that (i) discharge improvements in culverts allow for a flexible adaption to changing precipitation patterns at low economic costs and (ii) that flow improvements for misaligned culverts reduced sedimentation and erosion issues. These findings can be used to improve and expand existing guidelines and adapt existing structures at a savings compared to complete replacements.Submitted in the fulfilment of the requirements of the degree of Doctor of Philosophy, University of the Sunshine Coast, 2020
Rapid host expansion of an introduced parasite, the spiny rat louse Polyplax spinulosa (Psocodea: Phthiraptera: Polyplacidae), among endemic rodents in Australia
No full textBackground: Historical European exploration and colonization resulted in the introduction of four species of rodents to the Australian continent from Eurasia: the brown rat, Rattus norvegicus, the black rat, R. rattus, the Pacific rat, R. exulans, and the house mouse, Mus musculus. The spread of these rodents created opportunities for their co-introduced sucking lice to parasitize and adapt to endemic rodents in Australia. Methods: We collected sucking lice from rodent specimens in seven museums across Australia. We identified the spiny rat louse, Polyplax spinulosa, based on morphology. We sequenced the mitochondrial cox1 and rrnL genes of P. spinulosa specimens and constructed a phylogenetic tree with rrnL sequences. Results: We examined 989 rodent specimens of 54 species and collected 2111 adult sucking lice and 1064 nymphal sucking lice. We found that P. spinulosa had nearly doubled its host range by parasitizing at least six endemic rodent species in Australia. The other two introduced lice, P. serrata and Hoplopleura pacifica, however, have apparently failed to expand to any endemic rodents in Australia. Our analysis of mitochondrial rrnL gene sequences divided P. spinulosa into two genotypes (European vs Southeast Asian), which differ by 7.5%; both genotypes were introduced into Australia and then expanded their host ranges to include endemic rodents. Conclusions: The earliest record of a European ship landing in Australia was in 1606, followed by British settlement in 1788. The expansion of P. spinulosa to at least six endemic rodent species in Australia has therefore occurred in the time frame of 200 to 400 years, which is extremely rapid relative to its host expansion to eight native rat species in Eurasia in ~ 16 million years since it diverged from P. serrata. The host expansion of P. spinulosa is remarkable for a blood-sucking louse and is in stark contrast to the absence of host expansion by P. serrata and H. pacifica. Comparison among these three introduced sucking lice indicated that both louse-specific factors and host-specific factors can contribute to the success or failure of host expansion
Relationships between Nut Size, Kernel Quality, Nutritional Composition and Levels of Outcrossing in Three Macadamia Cultivars
No full textTree nuts play an important role in healthy diets, but their economic value and nutritional quality may be affected by their size and paternity. We assessed relationships between nut size and kernel recovery, the incidence of whole kernels, fatty acid composition and mineral nutrient concentrations in three macadamia cultivars, “Daddow”, “816” and “A4”. We determined to what extent differences in nut size and quality were the result of different levels of cross- or self-paternity. Small nuts of all cultivars had lower kernel recovery than large nuts, and small nuts provided lower incidence of whole kernels in “Daddow” and “A4”. Small kernels had a lower relative abundance of the saturated fatty acid, palmitic acid, in all cultivars and higher relative abundance of the unsaturated fatty acid, oleic acid, in “Daddow” and “A4”. Small kernels had higher concentrations of many essential nutrients such as nitrogen and calcium, although potassium concentrations were lower in small kernels. Most nuts arose from cross-pollination. Therefore, nut size and kernel quality were not related to different levels of cross- and self-paternity. Identified cross-paternity was 88%, 78% and 90%, and identified self-paternity was 3%, 2% and 0%, for “Daddow”, “816” and “A4”, respectively. Small macadamia kernels are at least as nutritious as large macadamia kernels. High levels of cross-paternity confirmed that many macadamia cultivars are predominantly outcrossing. Macadamia growers may need to closely inter-plant cultivars and manage beehives to maximise cross-pollination
Skeletal Muscle Microvascular Blood Flow as a Potential Treatment Target for Exercise Intolerance in Patients with Peripheral Arterial Disease
No full textPeripheral arterial disease (PAD) is an atherosclerotic disease characterised by stenosis or occlusion of the arteries supplying the lower limbs. PAD is associated with severe exercise intolerance, which cannot be fully explained by the limitation in conduit artery blood flow. PAD also leads to chronic changes in the skeletal muscle phenotype, including alterations in skeletal muscle capillary density and ultrastructure, which are positively related to exercise intolerance. However, the extent to which calf muscle microvascular blood flow (i.e. perfusion) is affected by PAD is largely unknown. Using contrast-enhanced ultrasound (CEU), studies have shown a reduction in peak muscle perfusion capacity in response to ischemic provocation tests, such as thigh cuff occlusion and pain-limiting leg exercise in PAD compared with control participants. However, these studies were generally limited by the fact that they did not match PAD and control participants for age, and have not considered whole-leg or conduit artery blood flow responses when interpreting muscle microvascular responses to ischaemic provocation tests, such as cuff occlusion or exercise. Because age differences between groups may potentially bias the disease-related differences in muscle perfusion, this thesis first investigated the effect of age (Study One) and then, the effect of PAD (Study Two) on skeletal muscle microvascular perfusion responses to cuff occlusion and steady-state submaximal leg exercise using CEU. To further explore the influence of macrovascular (whole-limb) blood on muscle microvascular perfusion, this thesis investigated the effect of restored conduit artery flow, through lower-limb revascularisation, on microvascular perfusion in patients with PAD (Study Three). Last, a systematic review (Study Four) of the adjunct benefits of exercise therapy following revascularisation in patients with PAD was conducted. This review aimed to clarify whether the effect of this combined therapy approach, which has the potential to induce microvascular adaptations, is superior to revascularisation or exercise training alone.Submitted in the fulfilment of the requirements of the degree of Doctor of Philosophy, University of the Sunshine Coast, 2020
The effect of Instagram #fitspiration images on young women’s mood, body image, and exercise behaviour
No full textThe present study experimentally examined the effects of viewing Instagram images of fitspiration on body dissatisfaction, mood, and exercise behaviour among young women. Further, the study investigated if exercise engagement following exposure to fitspiration images could mitigate any negative effects from image exposure. Participants were 108 women, aged 17–25 years, who were randomly assigned to a 2 (image type: fitspiration, travel inspiration) × 2 (activity type: exercise, quiet rest) between groups design. State body dissatisfaction and mood were assessed at baseline, following image exposure, and following participation in 10 min of walking or quiet rest. Results demonstrated that exposure to fitspiration images led to significantly higher negative mood and body dissatisfaction relative to exposure to travel images. There was no difference in actual exercise behaviour according to image type. However, participants who exercised following exposure to fitspiration images were significantly more likely to report higher subjective exertion ratings. Overall, negative mood and body dissatisfaction decreased after both exercise and quiet rest, with no additional benefit of exercise for the fitspiration condition. These findings provide further evidence highlighting fitspiration as a potentially harmful online trend
Does Ecotourism Influence Environmental Awareness? A Methodological Approach Based on Virtual Reality and Physiological Responses
No full textMore than 16,000 Scholars assert that engagement in nature-based activities is a critical approach to help modern society transform its contemporary culture into a sustainable one. This connection, however, has not been scientifically proven, because so far the methods applied relied on questioning and observing tourists involved in ecotourism activities, hence research samples were small and biased. This work presents an alternative methodological approach for exploring this influence with larger and less biased samples, while understanding how and why memorable experiences are evaluated and appreciated. It uses immersive virtual reality, mobile electroencephalograph, electro-dermal activity sensors, mobile eye tracker devices, a camera / software of facial expressions recognition, questionnaires and Bayesian Belief Networks. This methodological approach was built based on a multidisciplinary approach. It learnt from the tourism literature that the level of influence of nature-based activities on the way tourists relate with nature depends: on the experience (stimuli) and on tourists’ profile (gender, age and socio-cultural background), previous level of environmental awareness, previously lived similar experiences (level of novelty) and motivations to enrol on the experience. Based on these learnings, this study proposes a methodology that uses non-voluntary reactions to assess the level of influence of nature-based activities on the way tourists relate with nature. To do so, this method compares tourists’ non-voluntary reactions (brain waves, skin conductance, facial expressions and focus) to different simulated tourism experiences and how these affect the recall of the experiences
“I See Nothing but a Fence of Tears”: The Impact of Australia’s Immigration Detention and Border Protection Policies on the Asylum Seeker Child’s Geographies of Hope and Hopelessness
No full textAs a signatory to both the United Nation Refugee Convention and the United Nations Convention on the Rights of the Child, Australia’s border protection policy to detain offshore asylum seekers who reach Australian borders by boat, including accompanied and unaccompanied minors, is under intense international scrutiny. In the context of Australia’s “Operation Sovereign Borders,” however, the asylum seeker child’s perspectives and their geographies of hope and hopelessness have not yet been fully explored. Drawing on recent literature within children’s geographies, which emphasizes the “emotional” matters within policy development and professional practice, and how they affect children, this paper seeks to contribute to emerging debates exploring borders, asylum seeker children, and children’s emotional geographies. Utilizing drawings, letters, and poems produced by children for an Australian Human Rights Commission’s National Inquiry into Children in Immigration Detention on Nauru, a child-centred approach was applied to privilege children’s own perspective of their indefinite internment. The primary focus of the paper is to emphasize the ways in which “the asylum seeker child” constructs their own emotional geographies within the inherently complex and restrictive context of Australia’s border protection policy
Temperature Variation through Deep Multigrade Asphalt Pavements and Proposed Method for Accounting for Fluctuations
No full textMultigrade bitumen asphalt is a quality asphalt product that is not used in many places globally. Multigrade bitumen is believed to be less sensitive to temperature, which gives it an advantage over conventional binders. Previous testing has shown that asphalt temperature changes greatly with depth, but currently the industry standard is to nominate a single temperature for design. For detailed design of asphalt roads, perhaps asphalt layers should be divided into nominal layer depths and different modulus and fatigue equations/values should be used to reflect the temperatures of each respective layer. Previous laboratory testing conducted on multigrade bitumen asphalt beams under a range of temperatures and loading conditions was analyzed. The samples tested included 0% or 15% recycled asphalt pavement (RAP) to determine the impact of the recycled material on the fatigue life and stiffness of the pavement. This study investigated the temperature susceptibility of multigrade bitumen asphalt pavements compared with that of conventional binders by combining previous testing that included conducting a range of fatigue tests, developing complex modulus master curves for each mix, and a study of how pavement temperature changes through pavement depth. The materials properties were analyzed using the pavement design software. This investigation found that the final design of the pavement is greatly affected by the nominated pavement temperature and respective material properties. This paper outlines a potential revision to the current design approach for asphalt pavements and proposes that further investigation is needed into pavement temperature and its incorporation into design