19683 research outputs found
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Evaluation of a codesigned group cognitive–behavioural therapy intervention for trans young people (TAG TEAM): protocol for a feasibility trial and a subsequent pilot RCT
No full textINTRODUCTION: Trans young people are at a higher risk of mental health difficulties such as depression, anxiety and suicidality than their cisgender peers, due in part to their experiences of minority stress. This protocol describes a feasibility trial and subsequent pilot randomised controlled trial (RCT) of a codesigned group cognitive-behavioural therapy intervention for trans young people, named Trans Adolescent Group ThErapy for Alleviating Minority stress (TAG TEAM). METHODS AND ANALYSIS: To evaluate TAG TEAM, we will conduct a feasibility trial followed by a pilot RCT with trans young people aged 14-16 years who have been referred to the Royal Children's Hospital Gender Service in Melbourne, Australia. In the feasibility trial, we aim to enrol 32 participants who will be randomised at a 1:1 ratio to either in-person or online intervention arms. Participants will be assessed at baseline and post-treatment, with a nested qualitative evaluation post-treatment. Primary outcomes are the feasibility and acceptability of the intervention and the study design and associated procedures, including comparison of the in-person and online delivery modes. In the subsequent pilot RCT, we aim to enrol 64 participants who will be randomised at a 1:1 ratio to an intervention or waitlist control arm, with delivery mode determined by the feasibility trial. Participants will complete assessments at baseline, post-treatment and 3-month follow-up. Primary outcomes are the feasibility and acceptability of the RCT study design. In both the feasibility trial and pilot RCT, participants will complete assessments related to mood, anxiety, suicidality, quality of life, minority stress, family support and social transition. Quantitative data will be analysed using descriptive statistics. Qualitative data will be analysed using thematic and interpretive analysis. ETHICS AND DISSEMINATION: The Royal Children's Hospital Human Research Ethics Committee has approved this study (#91162). Informed consent will be obtained in writing from all participants and a legal guardian. Findings will inform the development of a full-scale RCT to evaluate the efficacy of TAG TEAM and will be disseminated through conferences and peer-reviewed journals. TRIAL REGISTRATION NUMBER: ACTRN12623000302651, ACTRN12623000318684
If we build it together, will they use it? A mixed-methods study evaluating the implementation of Prep-to-Play PRO: an injury prevention programme for women's elite Australian Football
No full textObjectives: We evaluated the implementation of Prep-to-Play PRO, an injury prevention programme for women’s elite Australian Football League (AFLW). Methods: The Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) of Prep-to-Play PRO were assessed based on the proportion of AFLW players and/or staff who: were aware of the programme (R), believed it may reduce anterior cruciate ligament injury (E), attempted to implement any/all programme components (A), implemented all intended components as practically as possible (I) and intended future programme implementation (M). Quantitative and qualitative data were triangulated to assess 58 RE-AIM items (evidence of yes/no/unsure/no evidence) and the 5 RE-AIM dimensions (fully achieved=evidence of yes on >50% dimension items, partially achieved=50% of items evidence of yes and 50% unsure or 50% mix of unsure and unanswered, or not met=evidence of yes on <50% dimension items). Results: Multiple sources including AFLW training observations (n=7 total), post-implementation surveys (141 players, 25 staff), semistructured interviews (19 players, 13 staff) and internal programme records (9 staff) contributed to the RE-AIM assessment. After the 2019 season, 8 of 10 (80%) AFLW clubs fully met all five RE-AIM dimensions. All 10 clubs participating in the AFLW fully achieved the reach (R) dimension. One club partially achieved the implementation (I) dimension, and one club partially achieved the effectiveness (E) and adoption (A) dimensions. Conclusion: The Prep-to-Play PRO injury prevention programme for the AFLW achieved high implementation, possibly due to the programme’s deliberately flexible approach coupled with our pragmatic definition of implementation. Engaging key stakeholders at multiple ecological levels (organisation, coaches, athletes) throughout programme development and implementation likely enhanced programme implementation.</p
Pitavastatin treatment remodels the HDL subclass lipidome and proteome in hypertriglyceridemia
No full textHDL particles vary in lipidome and proteome, which dictate their individual physicochemical properties, metabolism, and biological activities. HDL dysmetabolism in nondiabetic hypertriglyceridemia (HTG) involves subnormal HDL-cholesterol and apoAI levels. Metabolic anomalies may impact the qualitative features of both the HDL lipidome and proteome. Whether particle content of bioactive lipids and proteins may differentiate HDL subclasses (HDL2b, 2a, 3a, 3b, and 3c) in HTG is unknown. Moreover, little is known of the effect of statin treatment on the proteolipidome of hypertriglyceridemic HDL and its subclasses. Nondiabetic, obese, HTG males (n = 12) received pitavastatin calcium (4 mg/day) for 180 days in a single-phase, unblinded study. ApoB-containing lipoproteins were normalized poststatin. Individual proteolipidomes of density-defined HDL subclasses were characterized prestatin and poststatin. At baseline, dense HDL3c was distinguished by marked protein diversity and peak abundance of surface lysophospholipids, amphipathic diacylglycerol and dihydroceramide, and core cholesteryl ester and triacylglycerol, (normalized to mol phosphatidylcholine), whereas light HDL2b showed peak abundance of free cholesterol, sphingomyelin, glycosphingolipids (monohexosylceramide, dihexosylceramide, trihexosylceramide, and anionic GM3), thereby arguing for differential lipid transport and metabolism between subclasses. Poststatin, bioactive lysophospholipid (lysophosphatidylcholine, lysoalkylphosphatidylcholine, lysophosphatidylethanolamine, and lysophosphatidylinositol) cargo was preferentially depleted in HDL3c. By contrast, baseline lipidomic profiles of ceramide, dihydroceramide and related glycosphingolipids, and GM3/phosphatidylcholine were maintained across particle subclasses. All subclasses were depleted in triacylglycerol and diacylglycerol/phosphatidylcholine. The abundance of apolipoproteins CI, CII, CIV, and M diminished in the HDL proteome. Statin treatment principally impacts metabolic remodeling of the abnormal lipidome of HDL particle subclasses in nondiabetic HTG, with lesser effects on the proteome.</p
Midwifery workforce challenges in Victoria, Australia. A cross-sectional study of maternity managers
No full textBackground: In Australia, there is a lack of accurate data on midwifery workforce staffing and skill mix, which in turn hinders workforce policy and planning. Aim: To describe the current staffing levels of the midwifery workforce in Victoria, Australia, explore workforce challenges and assess the impact of COVID-19 pandemic on staffing. Design: Cross-sectional. Methods: Midwifery managers in all public and private maternity services in Victoria, Australia were invited to complete a survey exploring midwifery staffing numbers and adequacy. Topics explored included midwifery turnover, recruitment, and skill mix. Descriptive statistics were used. Findings: The survey was open March to October 2021, and 56 % (38/68) of managers responded. Of these, 76 % reported inadequate midwifery staff levels, with deficits ranging from one to 19 estimated Full-Time Equivalent (EFT) midwives, with a combined total deficit of 135 EFT. In the 12 months prior to the survey, 73 % of services had found it difficult to recruit midwives, with increased difficulty during the COVID-19 pandemic. Managers were concerned about retaining and recruiting ‘experienced’ midwives due to an ageing workforce and high turnover due to work/life imbalance and job dissatisfaction. These issues have led to a predominantly early career midwifery workforce and created concern about skill mix. Conclusion: Victorian maternity services have a midwifery workforce shortage and are experiencing significant skill mix issues. The pandemic has exacerbated these considerable gaps in the workforce. Urgent implementation of retention and recruitment schemes are needed, along with strategies to improve the working conditions for the current workforce.</p
From the Inner Circle to Rebuilding Social Networks: A Grounded Theory Longitudinal Study Exploring the Experience of Close Personal Relationships from the Perspective of People with Post Stroke Aphasia
No full textBackground: Interpersonal relationships are frequently subject to challenges and changes following the onset of aphasia and have strong ties with psychosocial and health outcomes. In order to be able to effectively support people with aphasia, a greater understanding of how challenges and changes evolve over time is needed. Aims: The current research sought to understand the lived experience of interpersonal relationships for people with aphasia through longitudinal enquiry over the first year following the onset of stroke. Methods and Procedures: Seven participants with aphasia (6 male, 1 female) with aphasia ranging from mild to severe were recruited through inpatient rehabilitation units. Four were married and three lived alone. They were interviewed on four occasions beginning around the time of their discharge home and lasting for around one year following their return home. Researchers adopted a constructivist grounded theory approach and data were transcribed, coded and analysed using a constant comparative method. Outcomes and Results: This research provides novel insights into the progression of interpersonal relationships over time following the onset of aphasia. Early on, participants retreated into a core group of close others characterised as their ‘inner circle’. During early stages, inner circle relationships were subject to challenges and changes as people learned to live with aphasia. As they felt ready, people with aphasia began to reconnect with friends. This process was often mediated by spouses and in the early phases of recovery was limited and challenging. Reconnection with friends brought with it varying degrees of connectedness, however for those without strong inner circle relationships, marked isolation occurred at all points throughout the year following discharge. Conclusions: Relationships are frequently impacted by the presence of aphasia and are subject to changes and challenges. This research highlights phases which people with aphasia may move through as they adjust to their new social worlds. These findings have clear implications for the development and timing of interventions and emphasise the need to support those most at risk
Attracting teacher candidates from regional and rural areas to initial teacher education (ITE) programs: Initiatives and evidence of impact
No full textTo address teacher shortages in regional and rural areas, a number of initiatives have been implemented to attract teacher candidates, particularly from regional and rural areas, to teach in these areas. This systematic literature review aims to identify such initiatives reported between 2000 and 2022 and the evidence of their impact. Of the 15 articles identified, this review revealed that federally and state-funded alternative pathways, as well as university–school partnerships, have initiated promising teaching pathways for teacher candidates from regional and rural areas. Despite this, however, there is limited systematic evidence of the impact of these initiatives.</p
Organisational Culture in Disability Accommodation Services
No full textCulture refers to shared beliefs, values, basic assumptions, norms, and patterns of behaviour that influence how staff think, feel, and act. It exists at multiple levels within organisations (e.g., whole of organisation, senior managers, frontline service) and it enables and constrains what staff do. Most research on culture in disability organisations has occurred at the service level. Culture can account for poor practice and abuse of people with intellectual disabilities living in supported accommodation services. Conversely, it can contribute to good quality support and quality of life outcomes. This chapter explains what is culture, how it influences staff behaviour, the characteristics of culture in good and poor quality services, and how to change culture.</p
Acceptability, feasibility and preliminary efficacy of low-moderate intensity Constraint Induced Aphasia Therapy and Multi-Modality Aphasia Therapy in chronic aphasia after stroke
No full textBackground: High-intensity Constraint-Induced Aphasia Therapy Plus (CIAT-Plus) and Multi-Modality Aphasia Therapy (M-MAT) are effective interventions for chronic post-stroke aphasia but challenging to provide in clinical practice. Providing these interventions may be more feasible at lower intensities, but comparative evidence is lacking. We therefore explored feasibility, acceptability, and preliminary efficacy of the treatments at a lower intensity. Methods: A multisite, single-blinded, randomized Phase II trial was conducted within the Phase III COMPARE trial. Groups of participants with chronic aphasia from the usual care arm of the COMPARE trial were randomized to M-MAT or CIAT-Plus, delivered at the same dose as the COMPARE trial but at lower intensity (6 hours/week × 5 weeks rather than 15 hours/week × 2 weeks). Blinded assessors measured aphasia severity (Western Aphasia Battery-Revised Aphasia Quotient), word retrieval, connected speech, multimodal communication, functional communication, and quality of life immediately post interventions and after 12 weeks. Feasibility and acceptability were explored. Results: Of 70 eligible participants, 77% consented to the trial; 78% of randomized participants completed intervention and 98% of assessment visits were conducted. Fatigue and distress ratings were low with no related withdrawals. Adverse events related to the trial (n = 4) were mild in severity. Statistically significant treatment effects were demonstrated on word retrieval and functional communication and both interventions were equally effective. Conclusions: Low–moderateintensity CIAT-Plus and M-MAT were feasible and acceptable. Both interventions show preliminary efficacy at a low–moderate intensity. These results support a powered trial investigating these interventions at a low–moderate intensity
Hypervalent Iodine(III) Chemistry: Facts, Myths and Discoveries
No full textA thesis submitted in total fulfillment of the requirements for the degree of Doctor of Philosophy to the School of Agriculture, Biomedicine and Environment, La Trobe University, Victoria, Australia.</p
Living open textbook development model
No full textA model for iteratively developing open textbooks powered by a continuous cycle of project dissemination, feedback, and adaptive publication. This leads to community-powered OER development through cross-institutional collaboration. It is particularly appropriate for tackling larger problems at scale.In this case, that problem is how to transform legal education by mainstreaming climate change considerations. It is being addressed by the Climate Conscious Lawyers OER project. This model is used to continuously develop the core text associated with this project, Becoming a Climate Conscious Lawyer: Climate and the Australian Legal System published by the La Trobe eBureau (2024).</p