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Randomised controlled trial of a nurse coordination intervention for people living with dementia and their carers: study protocol.
Get PDFINTRODUCTION: The multifaceted impact of dementia means that people living with dementia require multidisciplinary care across different services and settings; however, these care transitions pose a risk of fragmented care. Models that improve integration and coordination of care in the community are needed. METHODS AND ANALYSIS: This randomised control trial will test the effectiveness and cost effectiveness of a dementia nurse-led intervention to: (1) increase days lived in the community at 12-month follow-up (primary outcome) among people living with dementia and (2) improve quality of life for people living with dementia and their carers, compared with usual care. Participants are recruited from several sources including private and public geriatric medicine clinics, carer support groups and self-referral. People living with dementia and their carers are randomised as a dyad to (1) usual care or (2) dementia nurse-led care-coordination. The dementia nurse will provide care coordination and direct support through a tailored, integrated and patient-centred approach. The needs of people living with dementia will be identified and addressed, with a focus on improving the management of comorbidities, risk reduction and symptoms. Carers will also receive support. The model for people living with dementia will focus on days lived in their community as the outcome variable. Differences between groups in quality of life at 12-month follow-up will be assessed using linear mixed effects regression. Analysis will follow the intention to treat principles. People living with dementia and carers' data will be analysed separately and collectively for the economic study. ETHICS AND DISSEMINATION: The trial has been approved by the Hunter New England Research Ethics Committee (2023/ETH01221) and the University of Newcastle Ethics Committee (R-2024-0021). Trial findings will be disseminated via peer-reviewed publications and conference presentations. If the intervention is effective, the research team aims to further implement the intervention as usual care within the participating services and beyond. TRIAL REGISTRATION NUMBER: The trial was prospectively registered via the Australian New Zealand Clinical Trials Registry: ACTRN12624000235505. Registration date: 11 March 2024
IDENTIFYING THE ORIGIN OF LYMPHANGIOLEIOMYOMATOSIS CELLS USING SINGLE CELL RNA-SEQUENCING AND GENERATION OF HUMAN CELL LINE LYMPHANGIOLEIOMYOMATOSIS MODELS
No full textPod-a-Bye Baby: Podcasting as a Pathway to Continued Participation for Academic Parents
No full textParticipation in academic outreach and engagement activities can be particularly challenging for academics who are parents/carers. Using as a case study the podcast Music Mothers and Others, made by Australian
academics and parents Liz Giuffre and Shelley Brunt, this chapter positions podcasting as an accessible way for academics who are parents/carers to continue to conduct research while also engaging with their peers and a general audience. Further, the content and context of Music Mothers and Others is offered as a model to demonstrate how research, industry, and audience
engagement can be achieved through podcasting
An extensive multi-variant deep neural network approach to enhance genomic prediction of endometriosis
Get PDFDeep neural networks have shown significant advancements in modelling complex non-linear relationships in high-dimensional biomedical data. Understanding the interplay between genetic variants and disease susceptibility is still a considerable challenge that prevents certain genomic diseases to be predicted accurately for clinical interventions. In this study, we introduce the Extensive Multi-Variant Deep Neural Network (EMV-DNN), an innovative deep learning methodology designed to enhance polygenic risk prediction. Unlike conventional polygenic risk score methods, EMV-DNN incorporates single nucleotide polymorphisms (SNPs) alongside structural variants including insertions and deletions (indels), short tandem repeats (STRs), and copy number variants (CNVs) using variant-specific subnetworks to extract informative embeddings which capture a richer and holistic genomic context. Evaluated on real-world cohorts from the UK Biobank and All of Us, EMV-DNN outperforms conventional PRS methods and classic machine learning algorithms across binary and multi-class prediction tasks. Beyond predictive performance, SHapley Additive exPlanations (SHAP) analysis revealed biologically plausible variant–gene–disease associations, highlighting pathways related to endometrial cell proliferation, fibrosis, and immune regulation. Our findings underscore the value of multi-variant integration and non-linear approaches to capture the intricate genetic architecture of complex genomic diseases. Despite challenges such as dataset limitations and the complexity of diseases with multiple contributing factors, the EMV-DNN methodology presents a promising avenue for enhancing the predictive accuracy of PRS, thereby facilitating personalized healthcare interventions and advancing our understanding of genetic predispositions to disease
Fresh and mechanical properties of binary and ternary blended cement binders using Australian calcined clay
No full textThe concrete industry significantly contributes to CO2 emissions, with most emissions generated during cement production. Using supplementary cementitious materials (SCMs) to partially replace Portland cement is one of the most effective strategies to reduce the carbon footprint of concrete production while also enhancing the concrete properties. Among promising SCMs, calcined clays have gained remarkable attention due to their abundant availability. In this study, calcined clay was produced using locally available clay sourced in Australia. The fresh and mechanical properties of mortars containing the Australian calcined clay, including the flow and compressive strength of binary and ternary blends have been investigated. The performance of Australian calcined clay mortars was compared to those containing conventional SCMs, including ground granulated blast furnace slag and fly ash. The total cement replacement was up to 50%, reflecting an industry representative standard of targeting low carbon concrete. Furthermore, the compatibility of calcined clay blends with commercial concrete admixtures was assessed based on both the fresh and mechanical properties to demonstrate the feasibility of using calcined clay technology and to support its practical implementation in major Australian infrastructure projects. The fineness, chemical and mineral composition of the Australian calcined clay were analysed to elucidate the performance of the calcined clay binders. The findings from this study provide fundamental insights for selecting appropriate concrete mix design compositions incorporating Australian calcined clay, in compliance with Australian standards and specifications
Crisis negotiation as communication: Perspectives from language and communication theories
No full textFlexural Performance of Rubberized Concrete Beams Reinforced with Waste Tyre Steel Fibres
No full textThis study examines the static flexural behaviour of High-Performance Reinforced Green Control Concrete (GCC) and Reinforced Rubberized Concrete (RuC) beams. The GCC, serving as the control, had a compressive strength of 100.2 MPa, while the RuC reached a compressive strength of 86.4 MPa. The addition of 1% Waste Tyre Steel Fibers (WTSF) reduced the compressive strength of rubberized concrete by 5.4% compared to unreinforced plain RuC. When the WTSF content increased to 2%, compressive strength further declined, showing a 19.8% reduction relative to the 1% WTSF RuC mix. In terms of flexural performance, a 2% WTSF content significantly enhanced flexural strength, reaching 10.3 MPa, a 9.6% increase over the GCC mix. Structurally, RuC beams reinforced with both steel rebar and WTSF exhibited enhanced crack control and significantly improved load-bearing capacity. The inclusion of 1% WTSF resulted in a nearly fourfold increase in cracking deflection, rising from 1.60 mm in base RuC beam to 6.50 mm. Remarkably, the RuC beam achieved a peak load slightly higher than the GCC beam despite the incorporation of 10% waste tyre rubber (WTR), which tends to initiate early cracking. The addition of 1% WTSF also increased the peak deflection to 35.20 mm, a substantial improvement compared to RuC without WTSF
Care, disability and digital interfaces
No full textCare work in the disability sector is perpetually in crisis, rooted in the historical undervaluation of care labour, exacerbated by neoliberal capitalism’s focus on efficiency and regulatory control. Yet the sector faces another in-built challenge: the impact of the design of digital management technologies on care workers and recipients. This chapter examines the intersection of care labour and digital management technologies, focusing on Client Management Systems (CMS) within Australian disability services. CMS are centralised databases designed to streamline tasks and ensure compliance. While these systems are integral to meeting the National Disability Insurance Scheme’s (NDIS) accountability requirements, their design prioritises standardisation and quantification over relational, person-centred care. Through a detailed analysis of a widely used CMS platform, we examine its impact on care workers and recipients, highlighting the epistemological consequences of interface design. Employing “think-aloud” protocols and content analysis, we reveal how CMS categorisation oversimplifies individual identities and fragments vital human experiences. These findings confirm that CMS, far from being neutral tools, perpetuate a “database culture” that diminishes the relational and affective dimensions of care. We argue for alternative design approaches that foreground relationality and interdependence, addressing the limitations of existing systems and fostering environments where high-quality, person-centred care can thrive. Without such reforms, CMS risks perpetuating the care crisis it aims to alleviate
Bridging Regional Corporate Sustainability Differences With Diasporic Insights: A Case Made by the Indian Diaspora in Australia
Get PDFABSTRACT Corporate Social Responsibility (CSR) programs are often developed in the Global North and applied in the Global South with minimal input from local Southern stakeholders. This may lead to a limited understanding of Southern cultural contexts, making CSR programs less effective. Despite growing calls for more culturally contextualized approaches, few studies explore CSR perceptions from the perspective of a Southern public. This paper addresses this gap by exploring the role of Southern diasporas as possible intermediaries in evaluating corporate sustainability efforts. The mixed‐method study—comprising focus groups and an online survey conducted in Australia in 2022/23—focuses on the Indian Australian diaspora's evaluation of corporate sustainability and, more specifically, Porter and Kramer's Creating Shared Value (CSV) strategies. Through triangulation of the qualitative and quantitative findings, the research reveals that trust in corporate sustainability remains fragile but that the CSV model can offer a compelling and legitimate approach. It shows that certain CSV strategies, particularly those aligned with cultural and institutional frameworks, resonate more strongly with participants. This study underlines the value of culturally attuned corporate sustainability approaches and positions the active engagement with diasporas as a potential pathway to more effective, culturally informed, and locally relevant corporate sustainability practices
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