136986 research outputs found
Sort by
Implantable Cardioverter-Defibrillator Therapy in Patients With Transposition of the Great Arteries: A Systematic Review of the Literature
No full textBackground Patients with a systemic right ventricle (sRV) due to transposition of the great arteries are known to have a particularly high risk of sudden cardiac death. Current guidelines issue a weak recommendation to consider primary prevention implantable cardioverter-defibrillator (ICD) implantation in patients with severe sRV dysfunction. This systematic review aims to ascertain factors that are associated with appropriate ICD therapy in patients with an sRV and primary prevention ICD, so that we can further refine selection criteria for implantation in this population. Methods A systematic search of MEDLINE and Embase was performed to identify all studies that explored ICD therapies and associated clinical characteristics in patients with an sRV and primary prevention ICD from the inception of the databases until February 14, 2023. Results A total of 11 articles were included in the final analysis. Among those with a primary prevention ICD, 23 (9.1%) had appropriate ICD therapies and 48 (19%) received inappropriate ICD therapies. Among those with appropriate ICD therapies, the most common reason for implantation was sRV dysfunction, followed by nonsustained ventricular tachycardia and ventricular tachycardia on a Holter monitor. Among those with a secondary prevention ICD, 15 (34.9%) received appropriate ICD therapies and 5 (11%) had inappropriate ICD therapies. Most inappropriate therapies were due to atrial tachyarrhythmias. Conclusions sRV dysfunction was the most consistently reported risk factor for appropriate ICD therapy in our review. Effective treatment of atrial tachyarrhythmias remains a priority. Larger scale studies are required to develop and validate risk calculation in this population
Does Tooth Loss Lead to School Bullying? Evidence from the Longitudinal Study of Australian Children
No full textINTRODUCTION: The impact of tooth loss during adolescence, often a consequence of dental caries or traumatic injuries, extends beyond physical discomfort to significantly affect social interactions and self-esteem. Despite the established associations between poor oral health and various forms of social disadvantage, the potential for tooth loss to be associated with bullying victimization remains inadequately investigated. OBJECTIVES: This study aims to investigate the causal association between tooth loss and bullying victimization among adolescents, using longitudinal data from Australian children. METHODS: We analyzed data from 4,476 children from wave 3 (aged 8 to 9 y) to wave 6 (aged 14 to 15 y) of the Longitudinal Study of Australian Children. Tooth loss was assessed through parent-reported dental extractions due to decay or trauma. Bullying victimization was measured through parent-reported incidents of school bullying. A fixed effects regression model was employed to control for time-invariant confounding and estimate the impact of tooth loss on bullying. Sensitivity analyses, including age restriction, lagged effects, and a negative control, were conducted to validate the findings. RESULTS: The fixed effects model revealed that adolescents experiencing tooth loss had 42% higher odds of being bullied at school (odds ratio, 1.42; 95% CI, 1.15 to 1.77), after adjusting for household income, disability, and maternal education. Sensitivity analyses supported the robustness of these findings, demonstrating a consistent effect of tooth loss on bullying victimization. CONCLUSION: By leveraging longitudinal data, this study quantifies the within-individual association between tooth loss and bullying victimization during adolescence, underscoring the importance of preventing dental caries and trauma impacts. These findings suggest that tooth loss may be a modifiable determinant of bullying risk during adolescence, with potential implications for long-term mental health outcomes.Knowledge Transfer Statement:This study demonstrates a 42% higher risk of school bullying among adolescents who experience tooth loss due to decay or trauma. These findings emphasize the critical need for clinicians to prioritize preventive dental care and early intervention to reduce the social impacts of poor oral health. Policy makers should incorporate oral health interventions alongside antibullying initiatives in schools to mitigate the cascading effects of bullying on mental health and social well-being in adolescents
A Systematic Review on the Research and Development of Adaptive Buildings
No full textRapid urbanization and industrialization have led to great changes to the climate, such as global warming, urban heat islands, and frequent fluctuations in ambient temperature, and also a large amount of building energy consumption. Adaptive building provides an appropriate solution to maintain low energy consumption under various indoor and outdoor conditions and therefore has increasingly gained attention recently. Yet there is no clear definition on adaptive buildings and the current literature often focuses on the building envelope and overlooks buildings’ mechanical system, which is also an important part of the building system for responding to the indoor requirements and outdoor conditions. This article presents a systematic review on the research and development of adaptive buildings to address the identified research gaps. Firstly, it introduces and discusses the definition and evolution of the concept of adaptive building. Secondly, it reviews the adaptive building envelope technologies of roof, wall and window. Thirdly, it investigates the research progress on the adaptive mechanical system, especially lighting and air-conditioning systems. Lastly, it demonstrates practical applications of adaptive buildings and provides recommendations on future research directions on adaptive buildings
Clinical characteristics and treatment of varicella zoster virus central nervous system infection in an Australian tertiary hospital
No full textBACKGROUND AND AIM: Varicella zoster virus (VZV) is a neurotropic herpesvirus. With improved access to molecular diagnostics, there is increasing recognition of VZV with central nervous system involvement. This study aimed to describe the demographic, clinical and treatment characteristics of patients admitted to an Australian tertiary hospital with VZV central nervous system infection. METHODS: Retrospective study of all adult patients (aged ≥18 years) presenting to an Australian tertiary hospital between November 2010 and May 2023 with a clinical syndrome of or imaging consistent with meningitis or encephalitis and detectable VZV DNA in cerebrospinal fluid using polymerase chain reaction. RESULTS: There were 48 cases of VZV meningitis and 13 cases of VZV encephalitis identified during the study period. The median age of patients with VZV meningitis and encephalitis was 34 years (range 21-86 years) and 73 years (range 22-94 years) respectively. All patients with VZV encephalitis and 37 of 48 (77.1%) with meningitis received intravenous (IV) acyclovir. Eight patients with VZV meningitis were treated with oral antivirals alone and seven were managed without antivirals or with ≤48 h of empiric antiviral therapy only; none of these patients experienced an adverse clinical outcome. Two patients with VZV encephalitis died. Seven patients experienced neurological complications, three with VZV meningitis and four with VZV encephalitis. Age and length of stay were associated with adverse clinical outcomes. CONCLUSION: VZV encephalitis predominates in older patients while VZV meningitis predominates in younger patients. IV acyclovir remains the standard of care for treatment of VZV encephalitis; however, its role in VZV meningitis is less clear. Controlled trials should be conducted to inform its use, particularly in low-risk patients with VZV meningitis
The potential of maternal and child health service data in Australia: how lessons from the COVID-19 pandemic can accelerate data-informed decision making
No full textGlyceraldehyde-3-phosphate dehydrogenase facilitates Mycoplasma synoviae colonisation in the lower respiratory system
No full textMycoplasma synoviae is a significant pathogen in commercial poultry, causing respiratory disease, synovitis, and reduced egg production. The live attenuated vaccine MS-H, derived from the virulent strain 86079/7NS (7NS) via random mutagenesis, is widely used for disease control. Comparative genomics of MS-H and 7NS revealed mutations in the genes encoding glyceraldehyde-3-phosphate dehydrogenase (GAPDH), a key glycolysis pathway enzyme, as well as the essential GTPase ObgE and the peptide transporter OppF. To examine the role of GAPDH in pathogenicity and immunogenicity, a MS-H transformant complemented with a plasmid expressing the wild-type GAPDH (MS-H + gapdh) was compared in vivo to 7NS containing the empty plasmid (7NS + EP), MS-H with or without the empty plasmid (MS-H + EP), and MS-H complemented with obgE (MS-H + obgE) or oppF (MS-H + oppF). Six groups of 20 specific-pathogen-free chickens were inoculated with each transformant and MS-H, via aerosol and eye drop routes. Postmortem examinations at 2- and 3-week post-challenge (WPI) evaluated colonisation, serological responses, and respiratory lesions in the birds. While all strains colonised the upper respiratory tract, only 7NS + EP and MS-H + gapdh colonised the lower respiratory tract. The 7NS + EP group induced significantly higher airsac lesions and tracheal mucosal thickness when compared to the remaining groups. Early systemic antibody responses were also higher in birds inoculated with MS-H + gapdh and 7NS + EP at 2-WPI compared to other groups. Thus, GAPDH enhances the colonisation and immunogenicity of MS-H in the absence of pathological lesions
Gradient or categorical? Towards a phonological typology of illusory vowels in Mandarin
No full textThis paper argues that illusory vowel perception, i.e., the perception of non-existent vowels between two consonants by nonnative listeners, is gradient rather than categorical in Mandarin Chinese, and that the strength of illusion is predictable from the mismatches between the nonnative speech input and the listeners’ native phonological grammar. We examined five phonological scenarios where illusory vowels with different qualities can be perceived, and different illusion levels can be predicted by factors including syllable phonotactic constraints, vowel minimality, and the place of articulation consistency between the illusory vowel and its preceding consonant. The predictions were examined in an AXB discrimination task (Experiment 1) and an identification task (Experiment 2), which confirmed the predictions overall, while some paradigmatic differences were also observed. By comparing the current results and previous reports, we argue that a gradient rather than categorical account of illusory vowel is more suitable for explaining and predicting nonnative cluster perception. Specifically, the place of articulation feature of the preceding consonant is important for predicting contextual illusory vowels, which reflects nonnative listeners’ interpretation of perceived gestural score across multiple segments, supporting a direct realist view of speech perception
Primary school student use of the learning environment as a tool for self-regulated learning: Does the space make a difference?
No full text© 2025 Kelly Melissa DayInnovative learning environments (ILEs) are characterised by their design, for example flexible space configurations, adaptable furniture, and effective student-focused affordances. However, through the policy directions of the Plowden Report in the mid 1960s, through to the last decade’s work of the OECD, innovative spaces are equally characterised by how they are used. ILEs allow teachers choice in how to enact a wide range of pedagogies. They also provide opportunity for students to develop skills as autonomous learners that befit their role in a future workforce, one that requires creative and collaborative individuals who operate with critical thinking skills. These two elements of ILEs are inseparable – design and use. One aim in the design of innovative learning environments (ILEs) is the development of autonomous, agentic learners with the skills for lifelong learning. However, with a paucity of literature that explored student learning processes within ILEs, evidence to support this notion was lacking.
The qualities of student learning envisaged in ILE designs suggested relationships to the extensive field of self-regulated learning (SRL). The field of SRL conceded to the importance of context when a student is self-regulating their learning; however, this had yet to be extended beyond instructional practices to the different physical environment types in which students learn. Interestingly, whilst overlapping characteristics between ILEs and SRL were identified within the literature, they were yet to be investigated together in any real depth. Due to this, the connection of these distinct fields became a focus. In narrowing the parameters of the study, the constructs of motivation and self-efficacy, based on theories of self-determination were adopted. These constructs were chosen due to the foundational nature they played for engaged students.
Based on this research problem, the study set out to explore the influence of the built environment in helping students to thrive as learners. Its aim was to understand how students perceived learning and themselves as learners in different classroom spaces, and if or how they utilised the learning environment as they self-regulated their learning. There was an aim to understand if motivation and self-efficacy may be enhanced or constrained within different types of learning environments. Further, based on this motivation and self-efficacy was there a correlation to student behaviours and their control of the environment through the utilisation of affordances when learning.
A mixed methods approach that incorporated student self-report questionnaires, interviews, observations, and teacher reported data was implemented to develop a holistic understanding of the problem. The quantitative methods gathered large scale, statistical data; however, the inclusion of qualitative findings were imperative in allowing the nuances of those findings to be drawn out. Data were collected from students in upper primary school, across four sites and from 14 classrooms in Australia (n=194). A range of learning environment designs also featured as part of the recruitment. The data were then analysed using a range of statistical analyses including descriptive statistics and inferential analysis. The qualitative analysis adopted a hybrid approach.
The study found that students in ILEs self-reported statistically significant higher self-efficacy to self-regulate their learning than their peers in the traditional or open settings. Also, within ILEs students of varied levels of motivation and self-efficacy voiced and/or were proactive regarding their use of space as a tool for learning; however, in the traditional setting this was more reserved to those more highly motivated and self-efficacious students.
This study found that a relationship existed between the learning environment and student autonomy, being that which the learning environment afforded had implications in how autonomous the student could be. In ILEs, students perceived more opportunity to be autonomous learners and used the learning environment as a tool as they self-regulated their learning. Both quantitative and qualitative data showed that in these spaces students were provided with opportunities to be agentic and autonomous and to practice the skills required to self-regulate their learning through the use of a range of affordances. This allowed for greater personalisation in learning. These findings add knowledge to the field of self-determination theory that ILEs can be considered a context where the basic psychological needs of autonomy and positive self-perception of competence in the management of learning can thrive.
Students in ILEs were more proactive in using the learning environment to increase or improve their social interaction, and they valued what the space afforded to enable more collaborative learning. This included the management of noise and distraction to make their social interactions more effective. With greater access to a range of spaces for social learning to occur, a culture of feedback to support or extend learning was observed. An increase in off-task behaviour was not related to any learning environment type.
The study concluded that ILEs are designed to and do provide a greater range of affordances and opportunities for autonomous and agentic learning. Along with the associations to increased self-efficacy for SRL, there are positive implications for the use of ILEs as a tool for the self-regulation of learning
Comparison of the psychometric performance of experimental EuroQol Toddler and Infant Populations Instrument (EQ-TIPS) and Pediatric Quality of Life Inventory™ (PedsQL) in young children
No full textObjectiveThis study aimed to test and compare the validity, reliability and responsiveness of the Experimental EuroQol Toddler and Infant Populations version 2.0 (EQ-TIPS) and the Paediatric Quality of Life Inventory™ version 4.0 (PedsQL) in young Australian children.MethodsData for children aged 2–3 years were available from the Australian Paediatric Multi-Instrument Comparison (P-MIC) study. EQ-TIPS and PedsQL were administered in randomised order to caregivers of children aged 2–3 years. We assessed acceptability, feasibility, response distribution, ceiling effects, known-group validity, convergent validity, test-retest reliability and responsiveness in the total sample and by child age. EQ-TIPS level sum scores and PedsQL total scores were used as outcomes.ResultsA total of 510 caregivers of children completed the initial survey and 286 completed a follow-up survey at four weeks. The EQ-TIPS had ceiling effects in children with special health care needs (25.8%). EQ-TIPS showed stronger effect sizes in differentiating children with health conditions whereas PedsQL showed statistical significance and a minimal clinically important difference in detecting proxy-reported improvements in health. We found moderate to strong correlations in all anticipated EQ-TIPS and PedsQL item pairs. The two instruments showed comparable performance in children age 2 and age 3.ConclusionBoth EQ-TIPS and PedsQL are valid instruments, with small differences in psychometric performance depending on user needs and context. EQ-TIPS was easier to complete and had better known-group validity and test-retest reliability, whereas PedsQL was more sensitive in detecting health improvements. Further research on the responsiveness of EQ-TIPS is needed
When is a knowledge gap filled in environmental monitoring?
No full textMonitoring is essential for environmental management, including filling knowledge gaps and improving predictive capabilities. Existing thinking around the required duration of monitoring is dominated by the perceived importance of long-term datasets. However, how long do we need to monitor to fill a knowledge gap? We use existing data on spawning of a native fish in the Goulburn River, south-east Australia, an existing flow-ecology model, and three techniques: (i) historical data evaluation (ii) bootstrapping analysis and (iii) synthetic data simulation, to examine the contribution of additional data to reducing model uncertainty. Results from the observed monitoring data appear to suggest that 4 years of data (2014–2017) is adequate, and that additional data provides limited additional understanding of the relationship between discharge and spawning. However, this result was contingent upon the particular sequence of 4 years of data that was observed. Bootstrapping the same dataset and simulating data both suggest 8 years might be necessary. With the case-study program having now collected 10 years of monitoring data, we contend that monitoring could be scaled back, with resources freed up shifting to addressing other knowledge gaps. This case study demonstrates that, when it comes to filling specific knowledge gaps, long-term data sets from monitoring are not always required, potentially allowing managers to reallocate monitoring effort to other areas of higher uncertainty. While different managers may draw this line at different points, using resampled or synthetic monitoring data to demonstrate the value of monitoring is a method that can be applied to other endpoints and other monitoring programs. This approach can serve as a useful tool to support evidence-based decision-making, ultimately contributing to more efficient environmental management