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Chasing Ghosts: Young People, History and Public Space in Footscray
No full text© 2025 Anna-Marieke Lechner-ScottWhat happens to public spaces when councils invest millions of dollars to create amenable, enjoyable public spaces, only to find them unused or even undesirable by large portions of the population? This paper proposes a novel methodology titled “Haunted Photovoice” to engage young adults understanding of why the feel the way they do in certain spaces. Previous studies into young adults’ perceptions of public space have focused on understanding physical aspects or individual memory associations. Very little research has examined how young adults preconfigure their understanding of space, and how that sits within broader power structures. Through co-designed analyses, I posit that young adults are haunted by a ghost of social harmony, which guides both their fears, and hopes for a changing society. The findings in this paper yield key policy recommendations based on a co-designed, co-analysed call for a society that actively cares for the other
A conformational change of C-reactive protein drives neutrophil extracellular trap formation in inflammation
No full textBACKGROUND: C-reactive protein (CRP) represents a routine diagnostic marker of inflammation. Dissociation of native pentameric CRP (pCRP) into the monomeric structure (mCRP) liberates proinflammatory features, presumably contributing to excessive immune cell activation via unknown molecular mechanisms. RESULTS: In a multi-translational study of systemic inflammation, we found a time- and inflammation-dependent pCRP dissociation into mCRP. We were able to confirm that mCRP co-localizes with leukocytes at the site of injury after polytrauma and therefore assessed whether the CRP conformation potentiates neutrophil activation. We found mCRP-induced neutrophil-extracellular trap formation in vitro and ex vivo involving nicotinamide adenine dinucleotide phosphate oxidase activation, p38/mitogen-activated protein kinase signaling, and histone H3 citrullination. Mimicking the trauma milieu in a human ex vivo whole blood model, we found significant mCRP generation as well as NET formation, prevented by blocking pCRP conformational changes. CONCLUSIONS: Our data provide novel molecular insights how CRP dissociation contributes to neutrophil activation as driver of various inflammatory disorders
Intensive Outreach for Mental Health: Young People’s Experiences of an Intensive Outreach Model on Recovery and Engagement
No full textEngagement with traditional mental health services can be particularly challenging for young people experiencing severe and complex mental health problems. Assertive community treatment-based services providing mobile outreach, such as Intensive Mobile Youth Outreach Services (IMYOS), operate across Australia to support these young people's mental health needs in the transition to adulthood. Past research on IMYOS has focused on quantitative outcome measures, and young people's experiences of this type of model are poorly understood. This study explored youth service users' experiences of an IMYOS program, focusing on the model and intervention aspects perceived as barriers and facilitators to their overall recovery and service engagement. Semi-structured, in-depth interviewing was undertaken with nine young people aged 16-19 years (M = 17.61 years) who were current or recent service users of an IMYOS program in Melbourne, Australia. Data were analysed using thematic analysis. Having a therapeutic space, clinicians' specialised expertise, use of an outreach and community-oriented approach, and care continuity and availability across settings were program aspects identified by young people as facilitating their recovery and service engagement. Program aspects perceived as barriers to recovery and engagement were clinical unsuitability and ineffectiveness of the program and interventions, and conflicts between personal autonomy and assertive care. Young people's perceptions of clinical suitability and therapeutic relevance influenced their evaluations of the overall effectiveness of the IMYOS service, which subsequently impacted their engagement. The findings provide opportunities for IMYOS clinicians to enhance young people's recovery and engagement outcomes and have implications for the improvement of this innovative service for at-risk young people
Underlying disease risk among patients with fatigue: a population-based cohort study in primary care
No full textBACKGROUND: Presenting to primary care with fatigue is associated with a wide range of conditions, including cancer, although their relative likelihood is unknown. AIM: To quantify associations between new-onset fatigue presentation and subsequent diagnosis of various diseases, including cancer. DESIGN AND SETTING: A cohort study of patients presenting in English primary care with new-onset fatigue during 2007-2017 (the fatigue group) compared with patients who presented without fatigue (the non-fatigue group), using Clinical Practice Research Datalink data linked to hospital episodes and national cancer registration data. METHOD: The excess short-term incidence of 237 diseases in patients who presented with fatigue compared with those who did not present with fatigue is described. Disease-specific 12-month risk by sex was modelled and the age-adjusted risk calculated. RESULTS: The study included 304 914 people in the fatigue group and 423 671 in the non-fatigue group. In total, 127 of 237 diseases studied were more common in men who presented with fatigue than in men who did not, and 151 were more common in women who presented with fatigue. Diseases that were most strongly associated with fatigue included: depression; respiratory tract infections; insomnia and sleep disturbances; and hypo/hyperthyroidism (women only). By age 80 years, cancer was the third most common disease and had the fourth highest absolute excess risk in men who presented with fatigue (fatigue group: 7.01%, 95% confidence interval [CI] = 6.54 to 7.51; non-fatigue group: 3.36%, 95% CI = 3.08 to 3.67; absolute excess risk 3.65%). In women, cancer remained relatively infrequent; by age 80 years it had the thirteenth highest excess risk in patients who presented with fatigue. CONCLUSION: This study ranked the likelihood of possible diagnoses in patients who presented with fatigue, to inform diagnostic guidelines and doctors' decisions. Age-specific findings support recommendations to prioritise cancer investigation in older men (aged ≥70 years) with fatigue, but not in women at any age, based solely on the presence of fatigue
Mucosamin Spray for the Prevention of Oral Mucositis in Cancer Patients Receiving Chemotherapy: A Retrospective Cohort Study
No full textINTRODUCTION: It has been suggested that hyaluronic acid can prevent oral mucositis in patients receiving cancer treatment. We aimed to compare the efficacy of a commercial preparation of sodium hyaluronate spray supplemented with a pool of amino acids (Mucosamin) to standard oral care (SOC) in the prevention of chemotherapy-induced oral mucositis. METHODS: In this retrospective cohort study, consecutive cancer patients who had received chemotherapy without prior or concomitant radiotherapy at a tertiary care University Hospital in Naples, Italy, were eligible for inclusion. The exposure of interest was the use of Mucosamin spray prior to commencing the prescribed cycle of chemotherapy. The primary endpoint of the study was the onset of oral mucositis in both groups during and after their chemotherapy regimens. The secondary endpoint was to determine the severity of pain for patients who developed oral mucositis in either group. RESULTS: A reduction was observed in the incidence of mucositis in patients who had used Mucosamin prophylactically (4%, 2/57) compared to SOC (33%, 16/49), with an effect size ϕ of 0.39. Patients in the Mucosamin group experienced a significant risk reduction (RR = 0.11; 95% CI 0.03-0.44). The use of Mucosamin resulted in an absolute risk reduction of 29.14%, and the number needed to treat to prevent one additional case of mucositis was 3.43. DISCUSSION: Our results show that cancer patients receiving Mucosamin spray prior to the commencement of chemotherapy are at a reduced risk of developing oral mucositis compared to those receiving care as usual
Bondi Junction stabbings: Did guidelines for responsible reporting on mental illness and crime work?
No full textThis article examines if Australian media guidelines for reporting on mental illness in the context of crime were successfully implemented by the media in 2024 after the tragic events at Bondi Junction Shopping Centre. The incident was the first major news event featuring a person with complex mental illness after the publication of new Mindframe guidelines in 2020. We conducted an analysis of the television and text-based news coverage in Australia and asked, ‘Did mainstream media coverage of the Bondi stabbing adhere to newly established guidelines on ethical reporting of complex mental illness?’ We found some news organizations had implemented the best practice reporting that worked to de-stigmatize mental illness, but a significant amount of content was clearly stigmatizing towards people with complex mental illness. We concluded that more needs to be done to help experts and journalists understand the importance of the guidelines, which seek to provide a balanced and accurate view of people who live with complex mental illness and to encourage help-seeking behaviour
‘Remix!': Continuity through innovation in the manyardi song tradition of western Arnhem Land
No full textThis chapter considers intergenerational transmission of manyardi, an Indigenous dance-song genre from western Arnhem Land. Focussing on the Inyjalarrku ‘mermaid’ song-set, we suggest that innovation and maintenance of manyardi can be understood through multiple localised senses of the concept ‘remix’. Firstly, as a call from younger dancers to elders in the manyardi singing ensemble, requesting that they perform specific song items that change from fast to slow tempo. Secondly, as a way of understanding long-standing compositional and creative processes in which manyardi is renewed through the songman receiving songs and associated dances in dreams from ancestors. The chapter draws on insights and expressions in Mawng by Inyjalarrku manyardi songmen Rupert Manmurulu, Renfred Manmurulu and lead female dancer Jenny Manmurulu, and analysis by long-term collaborators and ethnomusicologists Reuben Brown and Isabel O'Keeffe. We analyse how distinct musical elements of manyardi are retained over time, while expressions of rhythmic mode in the didjeridu are innovated. This highlights intergenerational custodianship of manyardi underpinned by ideologies of ‘same but different’ and ‘different together’. These Arrarrkpi practices of remix and remixing, and the continual adaptation of manyardi to different performance contexts, demonstrate how continuity of performance practice in western Arnhem Land is maintained through change and adaptation, rather than in spite of change
Polyphenol-Mediated Engineering of Lipid Nanoparticles With Crystalline Mesophases.
No full textLipids self-assemble into lipid nanoparticles (LNPs) with different crystalline mesophases, including lamellar and nonlamellar (e.g., cubic and hexagonal) mesophases. Although various additives can modulate lipid curvature, the formation of nonlamellar crystalline mesophases in LNPs typically depends on specific phase-forming lipids, which limits the overall design space and structural versatility for cargo loading. Herein, a new class of nonlamellar LNPs is engineered through the one-step assembly of two components-a polyphenol and a lipid-where the lipid mesophases are modulated by the polyphenols in a concentration-dependent manner. The polyphenol-based LNPs exhibit ordered Im3m micellar cubic or hexagonal nanostructures and can load metal ions, small-molecule drugs, polypeptides, proteins, polysaccharides, and mRNA. The present study establishes an approach to generate nonlamellar LNPs with ordered nanostructures and functional cargos for diverse applications
Help-seeking behaviours and service use following suicidal thoughts and behaviours in people of culturally and linguistically diverse backgrounds: An exploratory mixed methods approach
No full text© 2025 Gowri RajaramBackground: Suicide prevention in culturally and linguistically diverse (CALD) populations remains an underexplored public health issue in Australia. While CALD populations generally experience lower rates of suicide compared to non-CALD populations, evidence suggests that those who experience suicidal thoughts and behaviours (STB) face substantial barriers in accessing appropriate clinical care. However, the nature of these barriers and their impact on help-seeking behaviours remains poorly understood. Furthermore, there is a lack of epidemiological data on STB in the Australian CALD population which would be required to inform tailored interventions. This thesis aims to: 1) quantify the prevalence of STB among CALD populations in Australia; and 2) understand help-seeking behaviours and service use following STB in these populations.
Methods: This thesis employed a mixed-methods approach guided by a critical realist paradigm and a theoretical model of help-seeking. Three complementary studies were conducted: Study 1 analysed population-level survey data from the National Study of Mental Health and Wellbeing (2020-2022) to examine STB prevalence and patterns of clinical service use across different CALD groups. Study 2 examined emergency department (ED) presentations for self-harm and suicide ideation at a major metropolitan hospital between 2012-2019, comparing presentations by CALD people and non-CALD people. Study 3 used semi-structured interviews to explore help-seeking experiences of young people from CALD backgrounds who had accessed clinical care following STB.
Results: Study 1 revealed variations in STB prevalence across CALD groups. Australian-born individuals reported the highest prevalence of lifetime suicide ideation (18.3%) and attempts (5.3%), while those born in South Asia reported the lowest (5.9% and 1.6%, respectively). People born in East Asia and the Pacific or Sub-Saharan Africa, and those with moderate English proficiency, were significantly less likely to use clinical services following STB. Study 2 found that ED presentations by CALD people were more likely to result in ward admission despite being initially triaged as less urgent, had longer ED stays (median 6.0 hours vs 4.8 hours), and were 24% less likely to return to the ED following suicide ideation or self-harm compared to presentations by non-CALD people. Study 3 identified four key themes in help-seeking experiences: 1) cultural taboos and generational differences create challenges; 2) isolation is a barrier to reaching out; 3) it’s hard to disclose and discuss STB with clinicians; and 4) not being taken seriously in clinical settings.
Conclusions: This thesis provides the first comprehensive examination of STB and help-seeking in CALD populations in Australia. The findings highlight disparities in service use, particularly among specific CALD subgroups, while also identifying barriers operating at individual, interpersonal, and organisational levels. The strong social connectedness reported by many CALD people, though sometimes a barrier to help-seeking, represents potential for developing culturally appropriate intervention strategies that leverage these social supports. These findings have implications for improving suicide prevention efforts through both clinical and community-based approaches, including enhanced cultural competency and language support in clinical settings, optimising emergency services, and developing culturally-adapted gatekeeper programs that leverage existing community networks and social support. Future research should examine the effectiveness of culturally adapted interventions in emergency departments and evaluate different types of informal support offered within CALD communities and their effectiveness in facilitating formal help-seeking
Impact of a 3-year transformational change project in family violence clinical response: Qualitative evaluation of the depth and breadth of knowledge in hospital clinicians by training level
No full textClinician family violence knowledge has traditionally been evaluated using quantitative measures via self-rating of skills. Qualitative methods have been used less frequently, in ways that require clinicians to provide specific information to demonstrate their skill base. Objectives: This study aimed to investigate the impact of different levels of training in family violence (no training, some training, clinical champions), on the clinician knowledge of key family violence response skills, using qualitative, survey obtained text-box responses. Design: A cross-sectional, online, survey of hospital clinicians in a major trauma hospital was conducted. Methods: The Assisting Patient/Clients Experiencing Family Violence: Royal Melbourne Hospital Clinician Survey tool was utilised and open for clinicians to complete, anonymously over a 6-week period. Free-text survey responses were analysed using an inductive thematic analysis approach. Results: Five hundred twenty-six clinical staff participated, 30% with no training, 52% with some training and 18% who were trained as clinical champions. A clear pattern was observed across training levels. Those with no training opted to demonstrate their family violence knowledge base less frequently. When they did, answers lacked specific information and details, showed limited knowledge of covert family violence indicators and provided a higher proportion of responses that did not align with best practice guidelines. Staff with some training showed a more sophisticated understanding in these areas. However, the quality of their responses did not match those of the clinical champions, who also provided an ongoing community of practice to further their skills. Conclusions: Providing some training in family violence yields a higher degree of family violence knowledge in clinicians, relative to no training. However, the extra resourcing required to train and maintain a clinical champions model in family violence provides demonstratable benefits, via a more sophisticated and nuanced understanding of indicators, enquiry and disclosure response skills, that align with best practice guidelines