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How to improve adolescents' sun protection behavior? Age and gender issues
No full textObjective: To explore adolescents' self-reported reasons for sun protection, as adolescents as a group continue to have poor sun protection practices. Methods: Seventeen age- and gender-segregated focus groups were conducted in Australian high schools. Results: Reasons for using sun protection included personal comfort, appearance, policies, fear of skin cancer, expectations of authority figures, peer actions, and habit. Reasons for not using sun protection included desire for a tan, inconvenience, low perceived risk, and fashion. Age and gender effects were found. Conclusion: Avenues for intervention with adolescents include authority figures, peer advocacy, the fashion industry, and improved sun protection products
Ecotoxicity of construction and demolition waste fine residues from material recovery facilities
No full textThis data includes experimental setups and results designed to assess the ecotoxicity potential of fine residues from construction and demolition waste (C&DW) collected at material recovery facilities. It investigates the ecotoxic effects of these C&DW residues on the early growth of Sinapis alba and Triticum aestivum, as well as the reproduction of Eisenia fetida
Advances in career development: unveiling the voices of women academics in Saudi Arabia
No full textSaudi Arabia has among the world's lowest rates of female workforce participation. For cultural reasons, women have been restricted in their work and careers. However, since 2016 the situation has changed with a major government initiative, Vision 2030, that encourages Saudi women to enter the workforce and pursue careers. The research presented here was motivated by a desire to understand how women navigate their careers and how Vision 2030 might affect this. The focus of the research, undertaken during this time of change, is Saudi academic women and their career experiences. General career development theories and literature on women’s careers are typically Western, emphasising individual and organisational factors with little regard for context, including culture, religion, and individual agency. The few studies of women’s careers in Arabic nations identify career barriers but tend to regard all Middle Eastern women as the same and fail to examine how women navigate these barriers. The aim of the research was to investigate how Saudi Arabian women academics exert their agency in traversing career barriers within the context of Islam, segregated workplaces, and a restrictive national culture. An exploratory, qualitative, multi-case study research design was employed to address the research aim. Semi-structured interviews were held with 30 academics from three public universities in different regions in Saudi Arabia. Interview transcripts were analysed using thematic analysis and organised into four composite narratives representing four hypothetical women academics at four different stages of their careers: early career; junior without a PhD; mid-career with overseas experience; and senior academic in a management position. Because of the inclusion of context, Social Cognitive Career Theory (SCCT) (Lent & Brown, 1996; Lent et al., 1994) was used as a guiding theoretical framework. Through the four composite narratives, the women make a distinction between religion and culture, using their religion to resist cultural power imbalances, patriarchy, and unfair practices within their organisational cultures. These women exercised their agency in various ways to tackle career challenges and seize opportunities where they could. However, their agency is individual rather than collective as they lack support from colleagues, policies, and the organisational culture. Although the women actively resist male-dominated structures and negative sub-cultures, at times their behaviours inadvertently reinforce these problems by undermining the authority of female colleagues and perpetuating the cultural belief in male superiority. The research moves away from the typical Western portrayal of Muslim women as helpless victims, instead recognising them as individuals who exercise their own forms of agency within the structural and religious contexts of their lives and workplaces. Overall, the findings augur well for Saudi women being able to embrace and accelerate change. Importantly, apart from the novel use of composite narratives, the thesis contributes to three literatures: management theory generally exemplified through career development theory; specific contributions to extending factors in SCCT; and contributions to gender studies and Islamic feminism. Additionally, it offers practical implications for higher education, and university policymakers, and academic women leaders
Assessing the influence of safety climate on off-site manufacturing safety performance: a Bayesian network approach
No full textOff-site manufacturing (OSM) has been promoted as a contemporary production technique applied in the construction industry. It involves 60–90% of construction tasks being carried out in a manufacturing facility off-site prior to moving the product to the construction site. Several benefits are expected from OSM because it occurs in a controlled environment. Benefits include improved quality, time savings, increased resource efficiencies, reduction in construction waste and decreased on-site activity. Among these benefits, many industry practitioners and researchers believe that OSM offers a safer environment for workers because most of the activities are performed in a controlled environment, that is, a factory. However, safety management in OSM has become of particular concern with poor safety performance measures. Somewhat surprisingly, injury data from the USA indicate higher injury rates in OSM than in traditional construction. Accordingly, research is needed to empirically examine the factors that influence OSM safety performance and test these assertions. The aim of the present research was to examine the influence of safety climate, workers perception about safety state in an organisation, on safety performance in the OSM sector. Initially, key safety performance categories (i.e., human, organisational, and work environment) pertinent to OSM and safety climate dimensions were identified through an extensive literature review along with their underlying causal factors. Following this, a quantitative methodological approach was chosen, and a questionnaire survey designed to gather empirical data from OSM practitioners in Australia. Consequently, a Bayesian network approach was adopted to explore the probabilistic relationships between the identified factors associated with safety climate. A final OSM safety climate model was then validated using sensitivity analysis (e.g., tornado diagrams, derivatives of sensitivity), injury data gathered as part of the questionnaire survey and strength of influence analysis. The main findings included that OSM safety performance was influenced by safety climate factors related to human, organisational and work environment facets. It was discovered that OSM safety performance had contrasting effect from safety climate dimensions and their underlying causal factors. Three separate models were developed to present probabilities associated with different states of safety climate factors, identify interrelationships among factors and underlying causal factors and to explain the influence of these factors regarding OSM safety performance. In the first model, it was discovered that human safety influence was affected by different factors of worker involvement and co-worker support of safety. The results indicate that human safety influence can be improved by enhancing a co-worker’s safety value and practice, management safety response, as well as improving worker involvement to safety by providing appropriate safety training and reducing production pressure over safety. The second model concerning organisational safety influence suggests that there is a greater effect from safety climate dimensions such as management commitment, supervisor commitment and safety communication while comparatively lower effect was identified from safety training and safety rules and procedures. Several strategies were identified to improve organisational safety influence include, but not limited to, improvements in areas of management safety response, balance between safety and production, credibility of training, frequency of safety meetings, programs and campaigns, supervisors’ safety actions and expectations and feedback and feed-forward systems. The third model, work environment safety influence was assessed through the two lenses of technological and physical environment and identified that the former has a greater effect on OSM safety performance. The safety improvement strategies for work environment include enhancing machinery and equipment safety condition, factory housekeeping and supportiveness of factory layout for safety. Consideration on factory designing and planning at early stage is important particularly for OSM because the OSM workers are exposed to machinery, tools and equipment exclusive for OSM practice. Finally, these three models were integrated to develop an integrated OSM safety climate model to predict safety performance in an OSM organisation. The Bayesian network approach developed and used to underpin this research offers an effective tool to predict OSM safety performance by considering antecedents of OSM safety performance including human, organisational and work environment aspects. Researchers and practitioners in this domain will benefit from using the tool developed from this research to examine the interrelationships between factors associated with safety climate. This study also extends safety climate knowledge by investigating its influence in OSM and utilising a distinctive Bayesian network approach compared with conventional statistical analysis methods. For industry practitioners, it offers a platform to identify appropriate safety management strategies in an optimal safety expenditure such as savings from safety investments and additional training time allocation. The model also provides an understanding of the causality between several factors and underlying causes related to OSM safety. Therefore, industry stakeholders and practitioners in an OSM factory such as safety managers or factory managers can make informed decisions regarding safety management
Exploring the association between adolescent-perceived parental monitoring on dietary intake
No full textParenting practices such as parental monitoring are known to positively impact dietary behaviours in offspring. However, links between adolescent-perceived parental monitoring and dietary outcomes have rarely been examined and never in an Australian context. This study investigated whether adolescent-perceived parental monitoring is associated with more fruit and vegetable, and less sugar-sweetened beverages (SSB) and junk food consumption in Australian adolescents. Cross-sectional data was collected as part of baseline measurement for a randomised controlled trial in 71 Australian schools in 2019. Self-reported fruit, vegetable, SSB and junk food intake, perceived parental monitoring and sociodemographic factors were assessed. Each dietary variable was converted to “not at risk/at risk” based on dietary guidelines, binary logistic regressions examined associations between dietary intake variables and perceived parental monitoring while controlling for gender and socio-economic status. The study was registered in ANZCTR clinical trials. The sample comprised 6053 adolescents (Mage = 12.7, SD = 0.5; 50.6% male-identifying). The mean parental monitoring score was 20.1/24 (SD = 4.76) for males and 21.9/24 (SD = 3.37) for females. Compared to adolescents who perceived lower levels of parental monitoring, adolescents reporting higher parental monitoring had higher odds of insufficient fruit (OR = 1.03; 95% CI = 1.02–1.05) and excessive SSB (OR = 1.07; 95% CI = 1.06–1.09) intake, but lower odds of excessive junk food (OR = 0.96; 95% CI = 0.95–0.98) and insufficient vegetable (OR = 0.97, 95% CI = 0.96–0.99) intake. Adolescent dietary intake is associated with higher perceived parental monitoring; however, these associations for fruit and SSB differ to junk food and vegetable intake. This study may have implications for prevention interventions for parents, identifying how this modifiable parenting factor is related to adolescent diet has highlighted how complex the psychological and environmental factors contributing to dietary intake are
Development and evaluation of an individualised, app-delivered psychological flexibility skills training intervention for medical student burnout and wellbeing
No full textBurnout is an adverse psychological response to persistent imbalances between work-related demands and coping resources. Among medical physicians, burnout is an epidemic problem that has worsened during the global COVID-19 pandemic, and which has detrimental consequences for individual health and organisational healthcare delivery. With recent evidence demonstrating that burnout frequently emerges during medical education and persists throughout a physician’s professional life, there are increasing calls for the early implementation of interventions that can prevent burnout and its associated outcomes. Interventions that train medical students in adaptive psychological resources for responding to challenges could strengthen wellbeing and buffer medical students against burnout, particularly given the likelihood of ongoing exposure to unmodifiable stressors that are inherent to this career path. Rigorous research is needed to identify psychological resources that can be targeted by an intervention to produce beneficial impacts on medical students’ burnout and wellbeing. Further, identification of methodologies that facilitate accessibility (e.g. app-delivered) and individual differences (e.g. tailored, or “individualised”) are identified research priorities. The purpose of this research thesis was to develop a theory-driven psychological resource-building intervention for medical students, and to evaluate its feasibility and effectiveness with respect to burnout and psychological wellbeing outcomes. Psychological flexibility processes were identified as adaptive resources of potential importance to medical students’ burnout risk, and this model formed the basis of a two-stage Acceptance and Commitment Training intervention that was developed for this research thesis. Stage 1 provided education regarding the full psychological flexibility model, and stage 2 delivered “on-demand” access to brief skill training activities in specific processes. To address methodological issues related to individual heterogeneity, stage 2 was either individualised (i.e. delivered training in psychological flexibility processes that aligned with students’ identified present moment needs) or non-individualised. Delivery via a smartphone app was implemented to facilitate intervention accessibility and individualisation procedures. This research thesis provides a literature review outlining the rationale for the approaches adopted; an overview of the app-delivered Acceptance and Commitment Training intervention and its development process; the results of a small feasibility trial (Study 1) of the individualised app (published manuscript); an overview of how medical student end-user feedback from the feasibility trial was incorporated into the intervention development process; and the study protocol (published manuscript) and results (published manuscript) of a randomised controlled trial (Study 2) evaluating the effectiveness of the individualised and non-individualised intervention (compared with a waitlist group) with respect to burnout, wellbeing, psychological flexibility/inflexibility, and psychological distress outcomes. Studies 1 and 2 were conducted with samples of medical students from two Australian universities. Behavioural and subjective user experience data from Study 1 demonstrated the functional feasibility and usability of the app, and supported its subsequent implementation in Study 2. Subjective feedback provided by students who actively engaged with the app was generally positive across several indicators, including usability, perceived relevance and helpfulness, accessibility, maintenance of privacy, and opportunity for self-reflection. Disengagement from the app was an identified challenge that may have been affected by time constraints, expectations regarding app interface functioning, and individual differences in confidence and self-efficacy when implementing skills. In Study 2, the mean differences in change from baseline to post-intervention (5 weeks) between the intervention groups and the waitlist group were not statistically significant for self-reported burnout outcomes (exhaustion, cynicism, and academic efficacy). However, compared with the waitlist group, the individualised group demonstrated statistically significant post-intervention improvements in psychological flexibility, inflexibility, and stress, and the non-individualised group demonstrated improvements in wellbeing and stress. Between-group differences for the individualised and non-individualised arms were not statistically significant. This thesis provides early support for the potential benefits of Acceptance and Commitment Training for medical student well-being and psychological outcomes and demonstrates that psychological flexibility and inflexibility can be trained using a smartphone app. Although postintervention burnout outcomes were not statistically significant, improvements in secondary outcomes could indicate early risk mitigation. Replication studies with larger samples and longer-term follow-up are required, and future research should focus on improving implementation frameworks to increase engagement and optimise individualisation methods
Classical approaches versus modern molecular techniques to dissect neuronal heterogeneity in the dorsal horn: opposite ends of the same spectrum?
No full textThe work contained within this thesis addresses a critical question across the field of neuroscience – how to identify unique cell types that serve specific roles, and perform specific functions, in the central nervous system (CNS). While this is relevant in all disciplines of neuroscience, the model used in this work focuses on the dorsal horn (DH) of the spinal cord, an area that processes sensory information. Traditionally, DH neurons can be divided into two broad types, those that relay information from the DH to higher cortical regions and those that form modulating networks within the DH itself. The latter, referred to as interneurons, are often the focus of pain and sensory research but no definitive atlas or taxonomy for the region exists. In the past, DH neurons (including interneurons) have been subdivided based on morphological features, neurochemical profiles, or electrophysiological properties. This has produced an extensive and, in many cases, confounding literature on DH neuron heterogeneity. To date, the multiple methodologies have not arrived at a nomenclature consensus for DH interneuron subtypes. More recently, advances
in molecular and genetic sequencing approaches have been implemented, using the transcriptional profile of individual neurons (or their nuclei) in conjunction with bioinformatic analysis, to distinguish different cell types. This has also produced multiple identification schemes for differentiating DH neuron types. The key objective of this thesis is to assess the relationship between classical (morphology,neurochemical, and electrophysiological) and transcriptional (molecular, genetic) VII classification systems of DH neurons. A previously identified DH population that expresses Calretinin (CR) was chosen as a test group, as there is an extensive literature on this population and past functional studies characterizing these cells suggested discrete CR subpopulations exist
The soluble (pro)renin receptor promotes a preeclampsia-like phenotype both in vitro and in vivo
No full textPreeclampsia is classified as new-onset hypertension coupled with gross endothelial dysfunction. Placental (pro)renin receptor ((P)RR) and plasma soluble (P)RR (s(P)RR) are elevated in patients with preeclampsia. Thus, we aimed to interrogate the role (P)RR may play in the pathogenesis of preeclampsia. Human uterine microvascular endothelial cells (HUtMECs, n = 4) were cultured with either; vehicle (PBS), 25–100 nM recombinant s(P)RR, or 10 ng/ml TNF-a (positive control) for 24 h. Conditioned media and cells were assessed for endothelial dysfunction markers via qPCR, ELISA, and immunoblot. Angiogenic capacity was assessed through tube formation and adhesion assays. Additionally, pregnant rats were injected with an adenovirus overexpressing s(P)RR from mid-pregnancy (day 8.5), until term (n = 6–7 dams/treatment). Maternal and fetal tissues were assessed. HUtMECs treated with recombinant s(P)RR displayed increased expression of endothelial dysfunction makers including vascular cell adhesion molecule-1, intracellular adhesion molecule-1, and endothelin-1 mRNA expression (P = 0.003, P = 0.001, P = 0.009, respectively), along with elevated endothelin-1 protein secretion (P < 0.001) compared with controls. Recombinant s(P)RR impaired angiogenic capacity decreasing the number of branches, total branch length, and mesh area (P < 0.001, P = 0.004, and P = 0.009, respectively), while also increasing vascular adhesion (P = 0.032). +ADV rats exhibited increased systolic (P = 0.001), diastolic (P = 0.010), and mean arterial pressures (P = 0.012), compared with -ADV pregnancies. Renal arteries from +ADV-treated rats had decreased sensitivity to acetylcholine-induced relaxation (P = 0.030), compared with -ADV pregnancies. Our data show that treatment with s(P)RR caused hypertension and growth restriction in vivo and caused marked endothelial dysfunction in vitro. These findings demonstrate the significant adverse actions of s(P)RR on vascular dysfunction that is characteristic of the preeclamptic phenotype
Tenecteplase versus standard of care for minor ischaemic stroke with proven occlusion (TEMPO-2): a randomised, open label, phase 3 superiority trial
No full textBackground: Individuals with minor ischaemic stroke and intracranial occlusion are at increased risk of poor outcomes. Intravenous thrombolysis with tenecteplase might improve outcomes in this population. We aimed to test the superiority of intravenous tenecteplase over non-thrombolytic standard of care in patients with minor ischaemic stroke and intracranial occlusion or focal perfusion abnormality. Methods: In this multicentre, prospective, parallel group, open label with blinded outcome assessment, randomised controlled trial, adult patients (aged ≥18 years) were included at 48 hospitals in Australia, Austria, Brazil, Canada, Finland, Ireland, New Zealand, Singapore, Spain, and the UK. Eligible patients with minor acute ischaemic stroke (National Institutes of Health Stroke Scale score 0–5) and intracranial occlusion or focal perfusion abnormality were enrolled within 12 h from stroke onset. Participants were randomly assigned (1:1), using a minimal sufficient balance algorithm to intravenous tenecteplase (0·25 mg/kg) or non-thrombolytic standard of care (control). Primary outcome was a return to baseline functioning on pre-morbid modified Rankin Scale score in the intention-to-treat (ITT) population (all patients randomly assigned to a treatment group and who did not withdraw consent to participate) assessed at 90 days. Safety outcomes were reported in the ITT population and included symptomatic intracranial haemorrhage and death. This trial is registered with ClinicalTrials.gov, NCT02398656, and is closed to accrual. Findings: The trial was stopped early for futility. Between April 27, 2015, and Jan 19, 2024, 886 patients were enrolled; 369 (42%) were female and 517 (58%) were male. 454 (51%) were assigned to control and 432 (49%) to intravenous tenecteplase. The primary outcome occurred in 338 (75%) of 452 patients in the control group and 309 (72%) of 432 in the tenecteplase group (risk ratio [RR] 0·96, 95% CI 0·88–1·04, p=0·29). More patients died in the tenecteplase group (20 deaths [5%]) than in the control group (five deaths [1%]; adjusted hazard ratio 3·8; 95% CI 1·4–10·2, p=0·0085). There were eight (2%) symptomatic intracranial haemorrhages in the tenecteplase group versus two (<1%) in the control group (RR 4·2; 95% CI 0·9–19·7, p=0·059). Interpretation: There was no benefit and possible harm from treatment with intravenous tenecteplase. Patients with minor stroke and intracranial occlusion should not be routinely treated with intravenous thrombolysis
Investigating new treatments for chronic obstructive pulmonary disease
No full textChronic obstructive pulmonary (COPD) disease is a highly destructive lung disease with high personal and social burden. Cigarette smoke is the predominant risk factor for the development of COPD, with 50% of lifelong smokers developing this disease during their lifetime. COPD is continuing to increase in prevalence and is now ranked as the 3rd leading cause of death worldwide. This results from a lack of an effective treatment, which in turn is largely due to the poor understanding of the mechanisms of disease pathogenesis. The pathogenesis of COPD is characterized by inflammation of bronchi, lung fibrosis and alveolar destruction. COPD is progressive in nature, and the lung destruction is not fully reversible. Oxidative stress and abnormal inflammatory responses have been implicated in the pathogenesis of COPD. Additionally, endogenous antioxidant and anti-inflammatory factors which are crucial in maintaining lung homeostasis are depleted in COPD patients. Consequently, understanding the mechanisms of disease pathogenesis is crucial for the development of potential therapeutic interventions and disease management. This thesis describes a series of studies that I performed to understand the causes and mechanisms of oxidative stress and inflammation that drive COPD pathogenesis and target them with novel antioxidant and anti-inflammatory molecules as potential treatments. I utilised a short-term cigarette smoke-induced experimental murine model that our group developed and have used extensively, which recapitulates the hallmark features of human COPD. I showed that cigarette smoke exposure had significant impact in altering the levels of endogenous hydrogen sulfide (H2S), which is an antioxidant and anti-inflammatory molecule and maintains lung homeostasis. H2S deficiency was found to be associated with mitochondrial dysfunction-induced oxidative stress and inflammation, which are key drivers of COPD pathogenesis. Over-expressing mitochondrial catalase (MCAT), an endogenous antioxidant enzyme, significantly attenuated oxidative stress and prevented the development of hallmark features of COPD in mice. Similarly, supplementing H2S specifically in mitochondria with mitochondria-targeted hydrogen sulfide donors (mtH2SDs), prevented cigarette smoke-induced inflammation, hallmark features of COPD, mitochondrial dysfunction and oxidative stress. Furthermore, I showed that supplementing H2S in mitochondria reverses pre-existing lung damage induced by cigarette smoke exposure in mice. Using our experimental model, I also demonstrated the involvement of the lung vascular endothelium, which plays a crucial role in immune cell infiltration from the circulation into the lungs. I showed that cigarette smoke exposure alters the expression dynamics of cells adhesion molecules on endothelial cells, which was partially normalised by treatment with mtH2SDs in mice. I further profiled lung immune cells, and showed altered populations of monocytes, neutrophils and alveolar and interstitial macrophages following cigarette smoke exposure, and mtH2SDs treatment had a significant impact in preventing these alterations. I further advanced my research by studying lung macrophage phenotype and polarization in experimental COPD. I found altered macrophage phenotype and polarization of alveolar and interstitial macrophages in the lungs in experimental COPD. However, the treatment with mtH2SDs did not prevent these alterations induced by cigarette smoke exposure. To translate the findings from experimental COPD to human, I tested the effects of mtH2SDs in human primary bronchial epithelial cells derived from healthy individuals and COPD patients and exposed to cigarette smoke extract (CSE). I showed that treatment with mtH2SDs prevented CSE-induced oxidative stress and partially suppressed inflammation by mitigating the release of pro-inflammatory mediator interleukin (IL)-8. These findings have advanced our understanding of the mechanisms of oxidative stress and altered immune responses in COPD pathogenesis. They have also highlighted a significant role of endogenous MCAT and H2S in maintaining lung homeostasis and preventing the development of COPD. Finally, my findings have demonstrated a new effective therapeutic strategy, and may potentially be developed into mitochondria-targeted interventions to treat COPD and related lung diseases