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Inspiration and pro-environmental behaviour in virtual nature-based tourism
No full textThe natural environment is facing deterioration, yet little is known about how immersive nature-based VR tourism experiences cultivate pro-environmental behaviours. Grounded in the transmission model of inspiration, this research seeks to assess whether and how virtual nature-based tourism experiences can inspire tourists to engage in pro-environmental behaviours over time. Using a sequential mixed-methods approach, Study 1 developed a VR nature-based tourism environment and examined its epistemic activation central to the inspiration process through both self-report and biosensor measures. Study 2 surveyed 253 participants, finding that the virtual nature-based tourism experience sparked inspiration (the inspired-by process), which subsequently led to increased pro-environmental behavioural intentions (the inspired-to process). Furthermore, the moderation analysis indicated that the impact of virtual nature exposure is more pronounced for tourists with a strong internal locus of control or with minimal prior experience with VR technology. Beyond behavioural intentions, actual pro-environmental behaviours were assessed at baseline (T1) and one month later (T2), showing a higher frequency of such behaviours at T2 compared to T1. This research advances theoretical understanding of inspiration within virtual tourism experiences and articulates the potential of immersive technology to foster pro-environmental behaviours, providing nuanced insights for tourism professionals seeking innovative approaches to promote conservation.No Full Tex
Implementing enhanced paediatric asthma care in rural Australia: Qualitative insights from healthcare professionals
Get PDFBACKGROUND: Healthcare professionals (HCPs) face barriers delivering effective paediatric asthma care, particularly in rural areas due to fragmented care, resource constraints, geographic, workforce and educational challenges. As part of the Asthma Care from Home project, we implemented a multicomponent asthma model of care for children in regional Australia, comprising educational resources, post-discharge communication and nurse-led virtual follow-up visits to standardise care, improve access and reduce hospitalisations. This study explored HCP perspectives on implementation to assess real-world feasibility in rural settings. METHODS: This qualitative study explored contextual factors influencing HCP implementation. Purposive and convenience sampled HCPs from thirteen participating hospitals across four rural New South Wales Local Health Districts participated in virtual focus groups and semi-structured interviews. Interview guides were informed by the Consolidated Framework for Implementation Research, and data were analysed using hybrid inductive-deductive thematic analysis. RESULTS: Twenty-five HCPs participated in eight interviews and five focus groups. Three themes emerged: (1) Acceptability: HCPs valued standardised resources improving care consistency and virtual home visits overcoming geographic barriers, but identified challenges including variable parental engagement, General Practitioner accessibility, and workforce instability; (2) Standardisation: the model achieved consistent, equitable care with improved guideline adherence and enhanced hospital-community collaboration, strengthening HCP confidence and parent knowledge; (3) Transitioning to standard practice: participants advocated for continuation, suggesting digitised resources and greater integration into nurse-led pathways for sustainability. CONCLUSION: HCPs found the asthma care model feasible and acceptable despite rural healthcare challenges. Findings highlight the potential to embed the model within routine clinical practice in rural settings.Full Tex
Employer association evolution in China: reassessing countervailing power
Get PDFThis paper provides a historical review of Employer Associations (EAs) in China across three distinct political regimes, characterised first by weak and then by dominant state influence. This study extends the current knowledge of EA behaviour through an examination of a case of a non-liberal democratic state, hitherto largely neglected in the EA literature. It also contributes to the recent literature that examines the countervailing power thesis in relation to EAs by uncovering state hegemony as a boundary condition of EAs’ countervailing power.Full Tex
Myeloperoxidase Enzyme Activity in Feces Reflects Endoscopic Severity in Inflammatory Bowel Disease
Get PDFBackground Concentrations of the neutrophil protein myeloperoxidase are elevated in the feces of individuals with endoscopically active inflammatory bowel disease (IBD). Its enzyme activity could give an immediate readout of endoscopic inflammation. We investigated whether fecal myeloperoxidase activity (fMPOa) is associated with IBD endoscopic inflammation. We also investigated whether myeloperoxidase promotes oxidative stress in IBD. Methods Myeloperoxidase enzyme activity was measured using an enzyme-linked immunosorbent assay (ELISA fMPOa), a novel CM-sepharose extraction assay (CM-S fMPOa), or by quantifying urinary glutathione sulfonamide (GSA) by tandem mass spectrometry. GSA is a specific biomarker of myeloperoxidase activity. IBD activity was assessed using the ulcerative colitis endoscopic index of severity or the simple endoscopic score for Crohn's disease (SES-CD). Spearman's correlation and receiver operating characteristic curves evaluated biomarker utility. Results IBD patients (n = 172) were recruited prospectively (ulcerative colitis, n = 72; Crohn's disease, n = 100). fMPO was mostly active. Its enzyme activity, measured either as ELISA fMPOa or CM-S fMPOa, correlated with endoscopic inflammation in both ulcerative colitis and Crohn's disease. Urinary GSA is also correlated with endoscopic disease inflammation. Correlations of urinary GSA with disease measures and other biomarkers were stronger in ulcerative colitis than in Crohn's disease. Conclusions Myeloperoxidase is active in IBD and its enzyme activity is a reliable marker of IBD endoscopic inflammation. Our results with the CM-S fMPOa assay demonstrate the potential for an immediate and accurate measure of fMPO enzyme activity as a robust, low-cost test for IBD activity. Myeloperoxidase may contribute to tissue damage in IBD.Full Tex
Enhancing employee engagement and knowledge collecting: impact of anthropomorphic features in company generative AI systems
Get PDFThis study investigates the impact of anthropomorphic design features in enterprise generative artificial intelligence (GenAI) systems on employee engagement and knowledge collection. Leveraging a two-study approach, we examine how high versus low levels of anthropomorphism in GenAI avatars affect employees’ interactions with these systems. Two experimental studies were conducted. Results indicate that high anthropomorphism enhances both knowledge collection and employee engagement. Mediation analysis further reveals that knowledge collecting mediates the relationship between anthropomorphic design and employee engagement. Results also show that data protection disclosure significantly influences employee engagement and knowledge collecting, with moderated mediation analysis highlighting that high anthropomorphic features positively impact knowledge collection, which in turn enhances employee engagement. The findings highlight the importance of anthropomorphic design in fostering effective employee interactions with GenAI and provide practical insights for optimising AI implementations in organisational settings. This paper contributes to the literature on human-computer interaction by elucidating how anthropomorphism and contextual factors like data protection disclosure influence employee engagement and knowledge management.Full Tex
Insights into patellofemoral kinematics and cartilage stresses following paediatric anterior cruciate ligament reconstruction: An exploratory in silico study
Get PDFAnterior cruciate ligament (ACL) injuries are prevalent among physically active paediatric and adolescent populations, often necessitating ACL-reconstruction (ACLR) to restore passive knee stability. Complications in the patellofemoral joint (PFJ), such as pain and early osteoarthritis, are common following ACLR. Despite these concerns, post-ACLR PFJ biomechanics remain insufficiently studied. This study aimed to explore the influence of ACLR surgical parameters and subject-specific factors (i.e., knee phenotype, neuromusculoskeletal function) on PFJ biomechanics using an in-silico neuromusculoskeletal (NMSK)-finite element (FE) modeling approach. Three subject-specific NMSK-FE models were used to simulate the effects of four surgical parameters (graft type, size, location, and pre-tension) on PFJ biomechanics (kinematics and cartilage stresses) during walking. Additionally, ACL-deficient (ACLD) models were included to compare PFJ biomechanics in the absence of ACLR. Each surgical combination and ACLD were compared to a corresponding intact knee. Normalized root-mean-square error (nRMSE) quantified deviations in PFJ biomechanics among ACLR, ACLD, and intact knees. PFJ biomechanics in ACLD knees consistently deviated more from intact knees than those in ACLR models, underscoring the restorative effect of reconstruction. Most ACLR surgical combinations restored PFJ kinematics and stress to near intact levels (nRMSE 10 %) for one participant, potentially increasing the risk of cartilage degeneration. Subject-specific factors influenced PFJ outcomes but showed no consistent trends. These findings emphasize the importance of incorporating individualized geometry and loading in simulations to optimize ACLR for biomechanical outcomes. This study provides the first comprehensive evaluation of surgical parameter effects on paediatric PFJ biomechanics following ACLR.Full Tex
Consumer and community involvement in paediatric intensive care research across Australia and New Zealand: a protocol for a mixed-methods environmental scan
Get PDFBackground
Paediatric intensive care provides specialist expertise and support for critically ill children, often with complex conditions or in life-threatening circumstances. Hospitalisation of a child in a Paediatric Intensive Care Unit (PICU) can be extremely stressful for both the child and family which makes research in this area challenging. The involvement of patients and families (consumers) in the design and conduct of research in PICU is essential to ensure research is aligned with their priorities and meets their needs. However, the current level of consumer and community involvement (CCI) in Australia and New Zealand (ANZ) PICU research is unknown.
Methods
This protocol reports a mixed-methods environmental scan employing two phases. Phase 1, a scoping review, will include published, unpublished, and ongoing PICU research, reporting information about study methodology and conduct, and CCI. Quantitative data will be primarily reported using descriptive statistics, and inductive content analysis will be used for qualitative data. Phase 2, semi-structured interviews, will be conducted with purposive sampling of research teams and consumers to gather insights about their experiences of CCI in PICU research, using content analysis to identify key concepts.
Discussion
Environmental scanning is an effective approach to information gathering and has been used in healthcare as an optimal method for studying real-world interventions. Our study will advance understanding of the current state of CCI in PICU research, identifying strengths, challenges, and areas for improvement. With the assessment of the needs of both consumers and the research community, our study will enable the development of strategies for improving CCI and subsequently the quality of PICU research. A multifaceted approach to dissemination of the findings of this environmental scan, informed by consumer advisors, will be used to reach diverse audiences. This may include email distribution, social media, academic journals, conferences or relevant institutional symposiums.Full Tex
Priority outpatient paracentesis prevents unplanned presentations
No full textBackground and Aim: Large-volume paracentesis (LVP) for diuretic refractory ascites (RA) often requires regular hospital visits. Typically, this is facilitated through day units shared with other specialties. The unpredictable nature of ascites accumulation and lack of availability of day unit beds can result in unplanned hospital presentations for LVP. This increases clinical demands in the emergency department, and skill mix availability may lead to unnecessary hospitalization and increased patient length of stay (LOS). We implemented a Priority Outpatient Paracentesis (POP) Clinic using dedicated beds on the liver and gastroenterology ward to streamline care for patients requiring regular LVP. The primary outcome was a reduction in unplanned LVP, with secondary outcomes including an increase in planned LVP and a decrease in LOS.
Methods: This single-centre retrospective cohort study analyzed data from the 12 months before implementation of the POP Clinic, where LVP was performed in the non-specialized Day Unit Investigation and Therapy (DUIT), and compared this to the 12 months after implementation of POP Clinic. Across the 24-month study period, LVP was classified as planned or unplanned, and LOS was recorded.
Results: The cohort comprised 114 patients undergoing 373 LVPs; nine patients overlapped both phases. In DUIT, 62 patients (44 male) underwent 168 paracenteses (52% unplanned, 48% planned). In the POP Clinic, 61 patients (44 male) underwent 205 paracenteses (37% unplanned, 63% planned). POP Clinic implementation significantly increased planned LVPs (p = 0.004; Figure 1). Total number of LVPs increased by 22% in the POP Clinic phase. Despite an increase in the number of LVPs, the total LOS was significantly reduced (p = 0.04).
Conclusion: Implementation of the POP Clinic significantly reduced the number of unplanned admissions for LVP. LOS was significantly reduced, reflecting improved access to timely LVP through a dedicated facility.No Full Tex
Authentic Consumer–Clinician Co-Design of a Labour and Childbirth Intervention to Optimise Maternal Hydration in Labour: Reaching Consensus to Enhance Rigour
Get PDFIntroduction
Medical interventions during labour and childbirth have rarely been designed with end-users, including frontline clinicians and consumers of maternity care. This has resulted in difficulties in evidence uptake, translation and acceptability by those who it is designed to help. Diverse views of ‘what is best’ in research interventions and approaches exist, yet arguably, if consensus can be reached, more rigorous and acceptable interventions will ensue. One such area of uncertainty is hydration management in induced labour, with an increasing reliance on intravenous therapy, without high-quality evidence pervasive across maternity settings. Therefore, we aimed to co-design a labour and childbirth intervention to optimise maternal physiology during labour, through evidence synthesis, consumer survey and a consensus-generating activity.
Methods
A multi-modal, intervention co-design study was undertaken. This involved three key stages: evidence-synthesis, consumer-survey and then a modified nominal group technique workshop to reach consensus on the intervention design. The whole process took place between April and November, 2023 in South-East Queensland, Australia.
Results
In total, 96 completed responses were returned in the consumer survey, detailing women's preferences for hydration management during induced labour. This informed a Nominal Group Technique Workshop, inclusive of consumers, midwives, obstetricians, lactation consultants, dietitians, clinical trialists, neonatologists and nurses. Following robust discussion and various viewpoints presented, the expert reference group decided to support an approach whereby women would self-determine their own intake during induced labour and that the routine administration of intravenous fluids as a ‘side-line’ (current ‘standard practice’) to the synthetic oxytocin (labour hormone) infusion for induction of labour would not be routinely administered. In order to provide information/education to women on how best to optimise their hydration, a co-designed information brochure was developed.
Conclusion
What clinicians and researchers may assume is important as interventions and outcomes in a clinical trial may not always align with the opinions and lived experience of consumers. Incorporating co-design into trial protocol development has the potential to improve the relevance of research to the target population. This in turn may improve trial feasibility through enhanced recruitment, intervention and treatment adherence, and fidelity.
Patient or Public Contribution
People with lived experience (inclusive of both first-time mothers who had recently experienced a labour induction; and two maternity consumers involved in advocacy and research work to optimise labour and birth care) were involved in several parts of this study. This included study conceptualisation, data collection and analysis, interpretation and authorship of manuscript.Full Tex
Tell el-Amarna, Autumn 2024 to Spring 2025
Get PDFFieldwork at Amarna from autumn 2024 to spring 2025 involved excavation and survey in Amarna’s housing areas, including the house of the vizier Nakht, and the continuation of several post-excavation projects. The post-excavation work reported on here is the study of human skeletal materials, pottery, and matting from the non-elite cemeteries; relief fragments from the Maru-Aten; zooarchaeological samples from the house of Panehesy; and lithics and osseous technological pieces from various locations at Amarna. Ongoing community engagement work is also summarised.Full Tex