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Intraoperative Coronal Alignment Safe Zones Influence Patient Outcomes Following Total Knee Arthroplasty:A Systematic Review and Network Meta-Analysis
No full textBackground: Despite surgically successful total knee arthroplasties, up to 20% of patients are dissatisfied postoperatively. A factor thought to influence dissatisfaction is the alignment strategy utilized. Inconsistencies in safe zone definitions between neutral and kinematic alignment strategies have limited previous systematic reviews. The systematic review aimed to identify whether different intraoperative coronal alignment safe zones influence patient-reported and functional outcomes. Methods: A literature search in Medline, Scopus, PubMed, Web of Science, CINAHL, and Cochrane databases was conducted in November 2024. Articles reporting patient outcomes at a minimum 12-month postoperatively, and coronal alignment safe zones were included. The Methodological Index for Non-Randomized Studies was used to conduct a quality assessment for each article. The Forgotten Joint Score pain measures, the Oxford Knee Score, and knee flexion were compared between safe zones. Random-effects network meta-analyses were conducted with treatment rankings, and a back-calculation method determined consistency between direct and indirect measures. A publication bias analysis was conducted for each outcome measure. Of the 26 studies eligible, 13 (knees n = 1,653, approximately 57% women) were included in the network meta-analysis. Results: There were four coronal safe zones identified: 0° (neutral), ± 3°, 6° varus to 3° valgus (6VR-3VL), and unrestricted. The 6VR-3VL was superior for the Forgotten Joint Score (standardized mean difference [SMD] = 1.59, 95% confidence interval [95% CI] = 0.25 to 2.92), pain measures (SMD = −0.85, 95% CI = −1.64 to −0.05), and knee flexion (SMD = −1.04, 95% CI = 0.08 to 1.99). There was significant publication bias in studies reporting pain. Unrestricted alignment was associated with greater knee flexion (SMD = 0.28, 95% CI = 0.02 to 0.53). Conclusions: The outcomes suggest 6VR-3VL had consistently better patient outcomes, and unrestricted alignment had better functional outcomes, than neutral alignment. This was potentially due to better restoration of the patient's prearthritic alignment.</p
Using a music-based framework to support oral language and writing in the English classroom
No full textThis presentation outlines an Australian study conducted in three school contexts which explored oral language through music education principles for writing development. Principles from Orff Schulwerk and Kodàly music pedagogies were applied through a LIRIC (listening, interpreting, rehearsing, improvising and composing) framework to explore language as an aesthetic musical resource.This completed PhD research study conducted in Australian NSW and Canberra schools over two years, explored the potential for music and music education principles to support oral language for writing development in the primary classroom. While oral language is often emphasised as an important basis for literacy development and as a key to equity outcomes, connections with music and song are still not generally emphasised in the literacy classroom, in western-influenced Anglophone settings. Yet, spoken language and music share a prosodic connection in human development, both in evolutionary and anthropological terms and as seen in child development. A LIRIC (listening, interpreting, rehearsing, improvising and composing) model was developed in three primary school classrooms, combining pedagogical principles from music and English, but which heavily drew on Orff Schulwerk and Kodály methods. Teachers and students explored language in musical and aesthetic terms to appreciate and experiment with prosodic cadence and rhythm, and their significance for the meanings of created texts. The findings indicate that a classroom which applied a music pedagogy-based approach through the elements of LIRIC directly supported oral language and writing development. Benefits through the elements associated with creativity - rehearsal and improvisation - were reported by teachers and students. These benefits included an increased sense of agency, writing fluency, peer collaboration, and risk-taking. This study also showed that generalist teachers without music expertise could apply the LIRIC principles and found them beneficial. These highlight the further potential for oral language and music connections to be applied in research, policy and practice.<br/
A Systematic Review of Multimodal Signal Fusion for Acute Pain Assessment Systems
No full textPain assessment poses unique challenges due to its subjective and multifaceted nature, often requiring the integration of various sensor modalities. This review aims to provide a comprehensive overview of recent research focused specifically on acute pain assessment, with specific attention to: (a) identifying combinations of sensor modalities utilised for pain assessment, (b) exploring methods for fusing data from diverse sensing modalities, and (c) examining the application of artificial intelligence (AI) methods for pain assessment using multimodal sensor data. A thorough literature search was conducted in September 2024, encompassing IEEE Xplore, Scopus, and Google Scholar databases, with a focus on papers published between January 2015 and September 2024. A total of 31 studies were included in this review, covering topics related to multimodal sensing, fusion techniques, and learning approaches. Notably, significant opportunities exist in integrating physiological signals, particularly from the heart, skin, and brain, by leveraging domain knowledge and deep learning methods to enhance the accuracy of pain monitoring systems. Furthermore, both the challenges and future directions for developing more effective pain assessment systems are discussed
Designing supports for family and friends:Outcomes from an Australian lived experience of suicide workshop
No full textThis study addresses the pivotal role of family and friends in supporting individuals experiencing suicidal distress. The research draws insights from a workshop at an Australian Lived Experience of Suicide Summit (2023) to explore how information and peer support should be presented and used in support programs and resources for family and friends supporting someone experiencing suicidal distress. The study engaged 52 delegates in an interactive workshop, comprising individuals with a lived experience of suicidal distress (30%), those bereaved by suicide (27%), family members or friends supporting someone with a lived experience of suicide (20%), sector representatives (16%) and others (7%). The workshop involved discussions on language, images, multimedia resources, key messages for programs and the integration of peer support. Content analysis categorized responses, and themes were ranked by popularity. Consensus emerged on preferred language referring to family and friends and those receiving support. Participants highlighted the importance of diversity in language, multimedia and images used in programs. This work helps to provide an understanding of family and friends' preferences for language, media, imagery and messaging when considering developing programs for family and friends supporting someone in suicidal distress. Peer support was also acknowledged as valuable for family and friends, but further understanding of the format and implementation of peer support is needed. Adapting program content based on end-users' advice is crucial for safety and engagement.</p
The impact of differences in bulk-billing rates:strategies for greater equity in Medicare
No full textExperiences and perceptions of sexism in dementia research careers: A global cross-sectional survey
No full textINTRODUCTION Sexism is prevalent in academia and is a crucial factor driving women out of the academic workforce. However, sexism in dementia research remains underexplored. This study aimed to understand the perceptions and experiences of early-career dementia researchers (ECDRs) with sexism in the field. METHODS In September/October 2021, a global online survey was conducted targeting ECDRs. The survey assessed their career experiences, including sexism, and was distributed through networks, social media, and e-mail lists. Responses were analyzed using descriptive and inferential statistics. RESULTS Of the 345 respondents, more than half of the female ECDRs (52%) reported facing sexism in their careers, ranging from overt discrimination to subtle biases. Experiences varied by career stage and location, and many ECDRs reported a lack of institutional support. DISCUSSION These findings reveal the prevalent nature of sexism in dementia research and highlight the need for targeted interventions to foster a more inclusive research environment
Exploring Paradigm Shifts in Researching Long-Term Disaster Recovery
No full textThis editorial article introduces a Special Issue ‘Exploring Paradigm Shifts in Researching Long-Term Disaster Recovery’ and suggests future directions for research. For this issue, we called for multidisciplinary manuscripts addressing different aspects of long-term disaster recovery and risk reduction, encouraging the adoption of new lenses for exploring topics such as: challenging the apparent assumption of linearity between short- and long-term recovery lifecycles and promoting new frameworks to research long-term disaster recovery and disaster risk reduction. The questions we wanted to ask were: ‘what challenges do researchers face when studying long-term recovery? how does long-term recovery differ from short-term reconstruction? what types of leadership are elicited through recovery? and how could long-term disaster recovery be handled differently to bring better outcomes?’ This editorial is organised as follows. It initially presents the sheer complexity and challenges faced by researchers investigating long-term recovery, together with the different disciplinary approaches they have brought into this field of research. We then provide an overview of the research questions and findings of the seven contributing papers selected for this Special Issue of the journal. Finally, we suggest what we believe are the next steps in investigating long-term recovery to further develop this important field of research.</p
Benefits and Challenges with the Modular Model of Teacher Certification in Australia: Listening to Teachers’ Voices
No full textThis paper examines teachers’ views about the Highly Accomplished and Lead Teacher (HALT) Certification 2.0 Modular Model (CMM 2.0). The research reveals teachers’ voices and agency in relation to HALT certification. Participants in this study included HALT certified teachers, current HALT participants, and prospective participants. The semi-structured interviews conducted provide insights into the benefits and challenges associated with the CMM 2.0. Thematic coding and systematic analysis were applied to the data to arrive at the key findings. The research revealed that teachers believed that the modular approach was advantageous as it was flexible and provided professional recognition and development. Issues identified by the participants were the time, cost and workload involved, and the role of leadership and peer collaboration in certification. This study makes a contribution to knowledge about the nature and benefits of a modular approach, which can inform the design and implementation of certification in Australia and internationally
Bracket creep and soft economists
Get PDFThe Albanese government reduced the Stage 3 tax cuts that were designed to address some the burden of bracket creep. The trouble is bracket creep is built into our progressive tax system. Unless something is routinely legislated to fix it, bracket creep happens systemically. Labor sent that plan backwards.Instead, Labor has focused on the unjustifiable figure of 275 energy saving was grossly wrong, and energy prices keep going up and will continue to do so under Labor.Where are the economists? In my opinion, they must all be Labor supporters who are staying mum
The Sustainable Personalised Interventions for Cognition, Care, and Engagement (SPICE) Program: Interim analysis of a twelve week multicomponent intervention for people with dementia and care partners
No full textBackgroundThe Sustainable Personalised Interventions for Cognition, Care, and Engagement (SPICE) program was developed to address an identified gap in access to high-quality integrated post-diagnostic rehabilitation for people with dementia and their care partners in Canberra, Australia. The multicomponent intervention aims to maximise quality of life (QoL) and independence of people with dementia by increasing engagement in everyday and meaningful activities and promoting care partners' physical and mental well-being.MethodThe SPICE program is a waiting-list study design delivered by a multidisciplinary allied health team over twelve weeks. The five components are: 1) cognitive stimulation therapy; 2) carer support and capacity building; 3) physical activity; 4) Care of People with dementia in their Environments (COPE) program; and 5) dietary assessment and advice. Each group comprises up to seven people with dementia and their care partners. They engage in group activities twice weekly and receive the COPE program and dietary assessment and advice as a dyad. Outcome measures include QoL, neuropsychiatric symptoms, cognitive and physical function, and carer well-being. Early feasibility of the program contributed to expansion of the study. Here, we report on the first six completed groups.ResultThirty-eight people with dementia and 38 care partners attended group activities with 92% and 91% attendance, respectively. Participants completed 98% of COPE program appointments and 93% of dietary appointments. Pre- to post-program improvements were observed in proxy-reported QoL (p = 0.02), reduced neuropsychiatric symptoms (p<0.001) and carer distress related to these symptoms (p = 0.04), and reduced caregiving challenges (p<0.001). Both people with dementia and care partners improved in the Alternating Step Test (AST) (both; p<0.001), as did care partners in Timed Up and Go (TUG) (p = 0.04). Twenty-six people with dementia and 26 care partners have completed follow-up, improving from baseline to 24 weeks in self-reported QoL of the person with dementia (p = 0.03), and reduced neuropsychiatric symptoms (p<0.01) and carer distress related to these symptoms (p = 0.02). Care partners maintained improvements in the AST (p<0.01) and TUG (p = 0.05).ConclusionInterim analysis suggests the SPICE program benefits people with dementia and their care partners. Further results are required to support continuation and expansion of the program