136986 research outputs found
Sort by
Strategic Bureaucracy: The Convergence of Bureaucratic and Strategic Management Logics in the Organizational Restructuring of Universities
No full textAbstract
Over recent decades, one can identify two key narratives associated with changes in university organization and governance. The first narrative focuses on the administrative consequences of an off-loading state relinquishing direct control over some of universities’ internal operations while at the same time driving bureaucratization at the institutional level. The second narrative focuses on the emergence of an increasingly competitive and uncertain environment driving universities to transform into strategically managed organizations. In this paper, we argue that while the organizational logics associated with these two narratives imply differently accentuated forms of legitimation, they converge and combine with respect to key dimensions of universities’ internal organizing, ultimately giving rise to a hybrid form of organizational governance we label ‘strategic bureaucracy’. Such strategic bureaucracy, we illustrate, is characterized by a strong focus on strategic leadership and the associated management techniques while also intensifying organizational features traditionally associated with bureaucratic governance such as formalization and hierarchical authority
Exploring Muslim Communities’ Experiences and Barriers While Accessing Assisted Reproductive Technologies: A Scoping Review of International Literature
No full textThis study adopted a scoping review methodology to analyze international literature on the barriers impacting Muslim couples' access to equitable assisted reproductive technologies (ART). A total of 27 studies were included for review. Results show that Muslim communities face several barriers when accessing ART. These include cultural and religious barriers that impacted which aspects of ART couples were open to adopting, diminished quality of care due to low cultural/religious capacity of practitioners, as well as gendered norms which intersect with experiences of ART treatments. Further research, based in western countries, should be conducted to better understand how these contexts can support Muslim patients accessing ART
C-reactive protein orchestrates acute allograft rejection in vascularized composite allotransplantation via selective activation of monocyte subsets
No full textINTRODUCTION: Despite advancements in transplant immunology and vascularized composite allotransplantation (VCA), the longevity of allografts remains hindered by the challenge of allograft rejection. The acute-phase response, an immune-inflammatory reaction to ischemia/reperfusion that occurs directly after allogeneic transplantation, serves as a catalyst for graft rejection. This immune response is orchestrated by acute-phase reactants through intricate crosstalk with the mononuclear phagocyte system. OBJECTIVE: C-reactive protein (CRP), a well-known marker of inflammation, possesses pro-inflammatory properties and exacerbates ischemia/reperfusion injury. Thus, we investigated how CRP impacts acute allograft rejection. METHODS: Prompted by clinical observations in facial VCAs, we employed a complex hindlimb transplantation model in rats to investigate the direct impact of CRP on transplant rejection. RESULTS: Our findings demonstrate that CRP expedites allograft rejection and diminishes allograft survival by selectively activating non-classical monocytes. Therapeutic stabilization of CRP abrogates this activating effect on monocytes, thereby attenuating acute allograft rejection. Intravital imagining of graft-infiltrating, recipient-derived monocytes during the early phase of acute rejection corroborated their differential regulation by CRP and their pivotal role in driving the initial stages of graft rejection. CONCLUSION: The differential activation of recipient-derived monocytes by CRP exacerbates the innate immune response and accelerates clinical allograft rejection. Thus, therapeutic targeting of CRP represents a novel and promising strategy for preventing acute allograft rejection and potentially mitigating chronic allograft rejection
Magnetically Coupled Percutaneous Connector for Chronic Electrical Peripheral Nerve Stimulation and Recording in Awake Rats
No full textUNLABELLED: A fast-growing field of neuroscience and medicine is the treatment of disease via electrical stimulation of the peripheral nervous system. Peripheral nerve stimulation delivers stimulation to nerves of the periphery where the target nerve can and is often located deep within the abdomen. Long-term preclinical animal models that demonstrate the safety and/or efficacy of electrical stimulation have predominantly used a skull mount to connect to neural interfaces. When targeting nerves of the extremities and abdomen, this mount location is less favourable due to its distance to the implant causing complications in surgery and to the longevity of the device in vivo. OBJECTIVE: Here we aimed to develop and validate a chronic magnetic percutaneous connector designed for placement on the dorsal-lumbar aspect of the spine of awake, freely moving rats. METHODS: A pedestal and external connector was developed, bench tested to assess for continuity, durability and disconnection forces, and validated in awake rats chronically implanted with an abdominal vagus nerve electrode array. The implanted pedestal and external connector were designed with custom PCBs, spring-loaded pins, magnets and biocompatible 3D printed housing. RESULTS: The magnetic coupling mechanism allowed disconnection with minimal force, was highly reliable in maintaining electrical connection in awake rats and allowed recording of electrically evoked compound action potentials after chronic implantation. CONCLUSION: In conclusion, this percutaneous connector is a useful research tool for peripheral nerve stimulation studies. SIGNIFICANCE: The connector described will allow investigation into the safety and efficacy of emerging neuromodulation therapies for the treatment of disease
Suicidal ideation, suicide plans and suicide attempts among Australian adults: Findings from the 2020–2022 National Study of Mental Health and Wellbeing
No full textOBJECTIVE: This study aimed to describe the epidemiology of suicidal ideation, suicide plans and suicide attempts, examine services received for suicide attempts, and explore the relationship between suicide attempts and self-harm without suicidal intent. METHODS: We used survey data from the 2020-2022 National Study of Mental Health and Wellbeing, which involved a nationally representative sample of Australian adults aged 16-85 (n = 15,893). Comparisons were made with the 2007 National Study of Mental Health and Wellbeing (n = 8841). RESULTS: In 2020-2022, the proportions of adults who had experienced suicidal ideation, suicide plans and suicide attempts during their lifetime were 16.6%, 7.5% and 4.9%, respectively. The proportions who had experienced these in the past 12 months were 3.3%, 1.1% and 0.3%. The odds of experiencing suicidal ideation and making a suicide plan were significantly higher in 2020-2022 than in 2007. Groups at heightened risk of suicidal ideation, suicide plans and/or suicide attempts in the previous 12 months were males, young people, people who were gay, lesbian, or bisexual or used some other term to describe their sexual identity, people outside the labour force, people from disadvantaged areas and people with mental disorders. Two-fifths of those who attempted suicide during the previous 12 months did not use health services following their attempt, and two-thirds also self-harmed without suicidal intent. CONCLUSION: The implications of these findings for the forthcoming National Suicide Prevention Strategy are discussed. Suicidal thoughts and behaviours confer risk for suicide and are significant problems in their own right. Their prevention requires a strong whole-of-government response
Mental Health, Suicidality, Health, and Social Indicators Among College Students Across Nine States in India
No full textBACKGROUND: The prevalence of mental health issues among youth is significantly high globally. This article presents findings from a survey that examined psychological distress, suicidal thoughts and behaviors, and health and social indicators among college students in India. METHODS: The study recruited 8,542 students from 30 universities spanning nine Indian states, utilizing a questionnaire that included the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) to measure depression and anxiety symptoms. It also examined the prevalence of suicidal thoughts, attempts, non-suicidal self-injury, and other health and social factors. RESULTS: Findings indicate that 18.8% and 12.4% of students had considered suicide over their lifetime and in the past year, respectively, with 6.7% having attempted it at some point in their lives. Among those with lifetime suicidal thoughts, more than one-third (38.1%) reported having previously disclosed these thoughts to someone, with friends being the most common confidants. Furthermore, one-third (33.6%) of participants reported moderate to severe symptoms of depression, and one-quarter (23.2%) reported moderate to severe symptoms of anxiety. CONCLUSIONS: The study revealed a significant prevalence of depressive and anxiety symptoms, as well as suicidal thoughts and attempts among college students in India. The study underscores the critical need for interventions aimed at improving mental health and supporting this demographic
Long-term persistence of seroprotection against measles following measles-mumps-rubella vaccination administered before and after pediatric liver transplantation
No full textLiver transplantation (LT) recipients are susceptible to infections, including measles. Concerns about the safety and efficacy of live-attenuated vaccines, such as the measles-mumps-rubella (MMR) vaccine, have led to hesitancy among providers in administering them to immunocompromised patients. This 9-year interventional study assessed seroprotection against measles following MMR vaccination in pediatric LT recipients. Of 119 participants enrolled, 60 (50%) were seroprotected against measles after transplantation. Among the 59 nonseroprotected participants, 56 fulfilled safety criteria and received MMR vaccination with a seroprotection rate of 90% (95% confidence interval [CI], 73%-98%) after a first dose, 95% (95% CI, 85%-99%) after primary vaccination with 1 to 3 doses, comparable to nonimmunocompromized populations. However, measles antibodies declined over time, suggesting the need for regular monitoring, and booster doses. Half of the vaccinees (26/53, 49%) subsequently lost seroprotection. Among them, 23 received additional doses of MMR, with a high seroconversion rate. At their last follow-up (median, 6.1 years; interquartile range, 3.0-8.1 after inclusion), 63% (95% CI, 49%-75%) of all vaccinees were seroprotected against measles. In conclusion, MMR vaccination in pediatric LT recipients offers seroprotection against measles, but long-term immunity should be monitored closely
Learning professionalism using creativity and diversity concepts
No full textClinical relevance: Professionalism is a multidimensional sociocultural construct that is abstract, evolving and context-dependent in nature. This has made the teaching and assessment of professionalism in healthcare complex and challenging. A lack of professionalism can increase patient risk and litigation. Background: This article examines group creativity and diversity across healthcare and non-healthcare disciplines and how they can assist students in constructing their own understandings and knowledge of professionalism. It is proposed that linking professionalism to creativity will improve understanding on how to help students studying healthcare learn about professionalism better. Methods: A total of 30 students from different tertiary levels and across disciplines participated in the study. They explored either a gallery or museum and examined an artefact relating to professionalism. Learning experiences were evaluated via survey results and thematic analyses of their reflective essays and semi-structured interviews. Results: Participants reported increased understanding of professionalism and appreciation of perspectives and skills of others. The creative aspect of the task was fun and engaging, and group diversity enabled different opinions and perspectives to be heard and shared. This is analogous to a professional working environment. Themes generated from the essays were: (a) intrinsic motivation, (b) diversity, (c) learnings of professionalism, and (d) challenge encountered. Conclusion: The results of this research make a meaningful contribution to existing literature by empirically demonstrating that students from different disciplines could better construct their own understandings of professionalism when their learning activities were performed in an authentically creative and diverse setting. This educational concept is underpinned by diverse types of creativities that are not mutually exclusive. It is hoped that this first piece of evidence will stimulate more studies on utilising group creativity and diversity in healthcare education
Adults’ recollections of discussions with their audiologist: a qualitative study of what was and was not successfully communicated about listening difficulties
No full textOBJECTIVES: Some adults experience challenges in successfully communicating their listening difficulties to their audiologist, and report feeling that they are not always listened to or understood. This project examined adults' recollections of discussions with their audiologist to explore (1) how adults report describing their listening difficulties and (2) information that adults report they do not communicate, or do not communicate successfully, to their audiologist. DESIGN: Individual semi-structured interviews were conducted. Interview transcripts were analysed using a template analysis approach. STUDY SAMPLE: Fifteen adults who self-report listening difficulties, and who had previously consulted an audiologist. RESULTS: Four themes were identified from adults' recollections of how they describe their listening difficulties: (1) situation or context of listening difficulties, (2) behavioural responses, (3) impacts of listening difficulties and (4) contributing factors. Adults report not always successfully communicating (1) emotional concerns and impacts, (2) descriptions of sound quality and (3) descriptions of changed listening experiences. CONCLUSION: Results provide insights about the times when adults feel that communication with their audiologist is successful, or unsuccessful. The results are useful for informing interventions to help adults and audiologists communicate more effectively together. To further inform interventions, factors affecting adults' communication should be explored
Healthy Me, Healthy Planet: Evaluation of a pilot planetary health library program
No full textISSUE ADDRESSED: The Healthy Me, Healthy Planet program was an evidence-informed pilot program conducted by a local libraries to promote the health co-benefits of action on climate change. BACKGROUND: An impact evaluation of the Healthy Me, Healthy Planet program was conducted using a mixed methods research design including pre-, during, and post-program surveys and online focus groups. METHODS: The evaluation included 136 participants aged 18+ years who were able to understand and communicate in English or simplified Chinese language. Descriptive analyses of the survey data were integrated with thematic analyses of focus group (N = 2) data to generate key themes. RESULTS: Key impacts included individual and organisational capacity building, personal and social well-being, and pro-environmental knowledge, attitudes, and behaviour. Impacts on program participants included increased confidence, motivation, positive feelings, and personal well-being after taking part in the Healthy Me, Healthy Planet program. Participants reported enhanced social connections, mental well-being, and environmental benefits such as engaging within the community on environmental issues and feeling inspired to make sustainable lifestyle changes. CONCLUSION: Libraries play a key role in promoting the health of people and planet in the community because they are a trusted, safe, and supportive community setting, a curator of credible and reliable evidence-based information on health and planetary topics and a local and free provider for skills and literacy development. SO WHAT: The evaluation of the pilot suggests that participants improved their capacity to practice sustainable living and it is recommended that this program be expanded to other library settings to enhance community connection and support local planetary health initiatives