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A comprehensive evaluation of somatosensory function in acute low back pain and pain-free individuals using quantitative sensory testing
No full textThesis by publication.Includes bibliographical references.Chapter 1. Introduction -- Chapter 2. Early changes in somatosensory function in low back pain -- Chapter 3. A comparison of somatosensory function between acute low back pain and pain-free controls -- Chapter 4. Conditioned pain modulation in acute low back pain and pain-free controls : a comparison using two test paradigms -- Chapter 5. The prognostic value of Quantitative Sensory Testing in low back pain -- Chapter 6. The long-term reliability of Quantitative Sensory Testing in healthy individuals -- Chapter 7. The temporal development of somatosensory changes in acute low back pain -- Chapter 8. Discussion -- Appendices.Low back pain is a common complaint and has the highest global disability burden when measured as years lived with a disability. After an episode of low back pain, up to two-thirds of people will experience variable levels of chronic pain after one year and around 10% will be significantly disabled in association with low back pain. Recent research has revealed that people with chronic low back pain are characterised by widespread pain hypersensitivity, suggesting that neuroplastic changes at the central nervous system underlie this condition. While this knowledge has enhanced our understanding of pathophysiological processes in chronic low back pain, it is currently unclear how early these somatosensory changes develop. Therefore, the broad aims of this thesis are: to investigate the time course of somatosensory changes from the acute stage of low back pain without serious pathology; to examine the prognostic utility of this information in low back pain; and to address methodological aspects of such assessment using quantitative sensory testing (QST).In order to meet these aims, several research approaches have been undertaken. Two systematic reviews of the literature were carried out to establish whether somatosensory changes are a feature of acute low back pain compared to healthy controls (Chapter 2) and to investigate the prognostic ability of QST in low back pain (Chapter 5). An inception cohort study, using a comprehensive QST assessment, was carried out to inform whether early somatosensory changes can be detected soon after low back pain onset compared to pain-free individuals (Chapter 3). The assessment included evaluation of endogenous pain modulation (Chapter 4) and tracked changes in somatosensory function over time, until 4 months after onset (Chapter 7). This comprehensive data set has also enabled the evaluation of important methodological issues related to the stability of QST over time in healthy individuals (Chapter 6).Overall, the work presented in this thesis has contributed to the body of evidence regarding the evaluation of somatosensory function in the early stages of low back pain, as well as providing novel methodological insights into QST testing. This scholarly work has specific implications for clinicians and researchers addressing low back pain, the condition of highest disability burden worldwide.Mode of access: World wide web1 online resource (xvi, 169 pages) diagrams, table
Coping with chronicity: exploring women's experiences living with autoimmune diseases that fluctuate and flare
No full textTheoretical thesis.Bibliography: pages 49-54.Introduction -- 1. Through sickness and wellness -- 2. Loss and learning -- 3. Control and hope -- 4. Silences and stigma -- 5. Conclusion -- References -- Appendix.This thesis examines the illness experience for Australian women with autoimmune diseases with a relapse / remitting or fluctuating disease course. Drawing on ethnographic interviews, I explore the impact of chronicity and the shifting between sickness and wellness on their lives. I address how participants responded to the disruptive force of disease onset and diagnosis, and their tactics to manage and seek control of their illness. In sum, I seek to demonstrate that the women's approaches to living with chronic illness are not static, but reflect the shifting grounds of their disease experience, changing sense of self, and support received from others.1 online resource (56 pages) illustration
Fabricating a steel city
No full textTheoretical thesis.Bibliography: pages 85-95Introduction: Fabricating a Steel City -- Chapter 1: Rise and Fall of the Steel City -- Chapter 2: Streets of Steel -- Chapter 3: Forged in Adversity -- Chapter 4: Future of the Steel City -- ConclusionThe city and its urban environment have been largely under-theorised in the field of Anthropology. This thesis considers the theorisation of urban environments in a study of the steel industry in the Illawarra region. The economic profitability of the Port Kembla, or BlueScope, Steelworks has decreased over the past ten years and threatened with closure on multiple occasions. My research aims to investigate how policies directed towards the steel industry, and relationships between local, national and global processes, are shaping the Illawarra's urban environment. To address this question, this thesis investigates four processes: the rise and fall of the steel city, and the logics both for and against the production of steel at Port Kembla. It will consider the existence of local activism, particularly the 'save our steel' (or SOS) campaign, which has been instrumental in the creation of the steel protection bill. The negative attitudes towards the steel industry stem from environmental and health concerns as well as issues of exploitation. Finally, this thesis seeks to answer questions concerning the region's development in the future with or without steel, based on policy projections, case studies, and fears or hopes of my field participants.1 online resource (98 pages) illustration
Engaging in More-than-Conservation in Multispecies Cities: A Study of One Central Park, Sydney
No full textTheoretical thesis.Bibliography: pages 66-731.Introduction -- 2. Background: conservation and dwelling in the city -- 3.Methods: a bricolage approach to more-than-human geography -- 4.Storying place I: A history of dwelling in Blackwattle Swamp Creek Valley and development in Chippendale, Sydney -- 5. Storying place II: making worlds at One Central Park -- 6. Storying place III: living walls and multispecies cities -- 7. Conclusion.This thesis engages with how 'living walls' could play a role in familiarising urban human populations with multispecies cohabitation, contributing to an ethic of conviviality in cities. A bricolage approach, comprising semi-structured interviews, observation, participatory photography and review of grey literature, historical sources and ethology literature, has been used to develop a more-than-human geography of the East and West towers at One Central Park. One Central park is a privately owned, mixed-use, green infrastructure precinct in Sydney City with two residential buildings that are characterised by living walls filled with vertical gardens and planter boxes. Bringing more-than-human geography into close dialogue with approaches in the broader environmental humanities, this project looks to engage with the unequal experiences of dwelling in multispecies cities in the Anthropocene, and advocates for the practice of 'more-than-conservation' in the policy and planning of cities. Using a storied approach, this thesis focuses on three key themes: temporality, biocultural belonging, and multispecies conflicts. It argues that living walls provide a forced close proximity between human and nonhuman dwellers that, if coupled with facilitated engagements and thoughtful urban design, could provide opportunities to foster attentiveness to nonhumans, contributing to an ethic of conviviality among residents. If this coupling does not occur this kind of intervention may instead entrench existing dualisms, like that of nature/culture and wild/domestic, within the city1 online resource (viii, 92 pages
The Dissertation examination : identifying critical factors in the success of Indigenous Australian doctoral students
No full textIndigenous Australians represent 2.2% of the working age population, yet account for only 1.4% of all university enrolments. In relation to higher degree research students, Indigenous Australians account for 1.1% of enrolments, but only 0.8% of all higher degree research completions. This paper reports on findings that emerged from an Australian Research Council-funded study which aimed to establish a model of best practice for the supervision of Indigenous doctoral students. The project identified the dissertation examination as one of the critical factors underpinning the success of doctoral candidates. Whilst research into the examination process for doctoral students is limited, the research that specifically explores the examination of dissertations submitted by Indigenous students is entirely inadequate. Our research identified key epistemological concerns that impact approaches to the examination process, to demonstrate how the dominance of Western methods of research impact the examination process for Indigenous doctoral students. This paper explores the experiences of 50 successful Indigenous Australian doctors with a specific focus on their examiner preference and disciplinary requirements. It highlights the limitations that some Indigenous students and their supervisors experience in finding an appropriate examiner.13 page(s
Epigenetics and the evolution of instincts : instincts may evolve from learning and share the same cellular and molecular mechanisms
No full textAn animal mind is not born as an empty canvas: Bottlenose dolphins know how to swim and honey bees know how to dance without ever having learned these skills. Little is known about how animals acquire the instincts that enable such innate behavior. Instincts are widely held to be ancestral to learned behavior. Some have been elegantly analyzed at the cellular and molecular levels, but general principles do not exist. Based on recent research, we argue instead that instincts evolve from learning and are therefore served by the same general principles that explain learning.2 page(s
Evaluating short sequence repeats (SSRs) markers in Sordaria fimicola by high resolution melt analysis
No full textSordaria fimicola is found worldwide but little is known about its population structure in any region. To bridge this knowledge gap, we attempted to develop molecular markers to study the genetic variations and population structure in the natural strains of S. fimicola. Based on the whole genome sequence of S. macrospora we targeted sixteen genomic regions that contain short sequence repeats (SSRs). Primers were then designed to amplify the homologous regions in S. fimicola. We used high resolution melt (HRM) analyses and amplicon sequencing to analyse the genetic diversity of the wild strains of S. fimicola collected from the opposing slopes (i.e., South facing slope and North facing slope) of the Evolution Canyon (EC), representing contrasting environments. We found twelve regions that were homologous to that of S. macrospora containing (CAT)7, (TTG)7, (T)14, (GAA)7, (CGT)6, (AAGCAC)6, (GT)5, (GGC)6 (ACA)8, (CTG)7 (CT)6 and (CAGGGG)5 were first time reported in S. fimicola. During this genotyping of SSRs we found variations in SSRs motif number and enrichment in strains isolated from stressed and harsh environment than strains from natural and benign environment in Evolution Canyon. The findings favour the hypothesis that genetic variations are present in strains of stressed environment.7 page(s
Cohort profile : a data linkage cohort to examine health service profiles of people with intellectual disability in New South Wales, Australia
No full textPurpose: People with intellectual disability are a minority group who experience poorer physical and mental health than the general population and have difficulty accessing healthcare services. There is lack of knowledge about healthcare service needs and gaps experienced by people with intellectual disability. This study aims to interrogate a large linked administrative data set containing hospital admissions, presentations to emergency departments (ED) and mortality data to provide evidence to inform the development of improved health and mental health services for this population. Participants: A retrospective cohort of people with intellectual disability (n=51 452) from New South Wales (NSW), Australia, to explore health and mental health profiles, mortality, pattern of health service use and associated costs between 2005 and 2013. The cohort is drawn from: the Disability Services Minimum Data Set; Admitted Patients Data Collection; Emergency Department Data Collection, Australian Bureau of Statistics Death Registry and Registry of Births, Deaths and Marriages. Mental health service usage among those with intellectual disability will be compared to a cohort of people who used mental health services (n=1 073 139) and service usage other than for mental health will be compared with published data from the general population. Findings to date: The median age of the cohort was 24 at the time of the last hospital admission and 21 at the last ED presentation. The cohort has a higher proportion of men than women and accounts for 0.6% of the NSW population in 2011. Over 70% had up to 5 ED presentations and hospitalisations between 2005 and 2012. A high proportion of people with intellectual disability live in the most disadvantaged neighbourhoods. Future plans: Results will be used to inform the development of more responsive healthcare, including improved interactions between health, social and disability supports. More generally, the results will assist the development of more inclusive policy frameworks for people with intellectual disability.10 page(s
Defining disease in the context of overdiagnosis
No full textRecently, concerns have been raised about the phenomenon of ‘overdiagnosis’, the diagnosis of a condition that is not causing harm, and will not come to cause harm. Along with practical, ethical, and scientific questions, overdiagnosis raises questions about our concept of disease. In this paper, we analyse overdiagnosis as an epistemic problem and show how it challenges many existing accounts of disease. In particular, it raises questions about conceptual links drawn between disease and dysfunction, harm, and risk. We argue that ‘disease’ should be considered a vague concept with a non-classical structure. On this view, overdiagnosed cases are ‘borderline’ cases of disease, falling in the zone between cases that are clearly disease, and cases that are clearly not disease. We then develop a précising definition of disease designed to provide practical help in preventing and limiting overdiagnosis. We argue that for this purpose, we can define disease as dysfunction that has a significant risk of causing severe harm to the patient.12 page(s
Intrinsic and extrinsic influences on standard metabolic rates of three species of Australian otariid
No full textThe study of marine mammal energetics can shed light on how these animals might adapt to changing environments. Their physiological potential to adapt will be influenced by extrinsic factors, such as temperature, and by intrinsic factors, such as sex and reproduction. We measured the standard metabolic rate (SMR) of males and females of three Australian otariid species (two Australian fur seals, three New Zealand fur seals and seven Australian sea lions). Mean SMR ranged from 0.47 to 1.05 l O2 min⁻¹, which when adjusted for mass was from 5.33 to 7.44 ml O2 min⁻¹ kg⁻¹. We found that Australian sea lion mass-specific SMR (sSMR; in millilitres of oxygen per minute per kilogram) varied little in response to time of year or moult, but was significantly influenced by sex and water temperature. Likewise, sSMR of Australian and New Zealand fur seals was also influenced by sex and water temperature, but also by time of year (pre-moult, moult or post-moult). During the moult, fur seals had significantly higher sSMR than at other times of the year, whereas there was no discernible effect of moult for sea lions. For both groups, females had higher sSMR than males, but sea lions and fur seals showed different responses to changes in water temperature. The sSMR of fur seals increased with increasing water temperature, whereas sSMR of sea lions decreased with increasing water temperature. There were no species differences when comparing animals of the same sex. Our study suggests that fur seals have more flexibility in their physiology than sea lions, perhaps implying that they will be more resilient in a changing environment.14 page(s