19683 research outputs found
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Lived experience consultants to a child sexual abuse inquiry: Survivor epistemology as a counterweight to legal and administrative proceduralism
No full textAbstract:Background: The Independent Inquiry into Child Sexual Abuse (IICSA) in England and Wales was the first major child abuse inquiry internationally to appoint survivors to a formal role. The appointment of the Victims and Survivors Consultative Panel (VSCP) reflects growing recognition of the value of lived experience expertise and a broader shift in the policy domain towards public involvement and co-design. Objective: This article draws on research that sought to understand both the experiences of a group of victims and survivors with related professional expertise consulting to a public inquiry, and the impact they had on the operation of the inquiry. Participants and setting: Seven members of the VSCP joined the study as co-researchers, alongside academic researchers. Six IICSA staff also participated in the project. Methods: A participatory research methodology was developed. First, a two-day workshop comprising four focus group sessions was held with VSCP members and researchers. Individual interviews were then conducted with the VSCP members and IICSA employees. Finally, there were two participatory data analysis workshops, which included both VSCP members and researchers, and where the themes were refined and consensus reached. Results: The study found striking epistemological differences between survivor approaches, and the dominant civil services and legal paradigms that characterize public inquiries. This clash negatively impacted the VSCP, with each member reporting adverse effects on their work and personal lives. When a survivor epistemology was integrated into inquiry processes, there were clear benefits for external survivors, inquiry staff and the VSCP. Conclusions: Engaging victims and survivors as consultants to non-recent child abuse inquiries has the potential to transform and improve inquiry processes and outcomes. However, consultation and co-design alone are not sufficient to guarantee success. Careful consideration is required in relation to how lived experience expertise can be meaningfully integrated into an inquiry's culture to safeguard survivors and enhance inquiry outcomes.</p
Order Subcontracting Versus Platform Employment in Blockchain-Enabled Agricultural Supply Chains
No full textNo description supplied.</p
Survey questionnaire - evaluating an open educational resource (OER)
No full textThis survey questionnaire is developed for a research study on student perception and engagement with the La Trobe eBureau open textbook Foundations of Biomedical Science by Julian Pakay.Our survey focuses on evaluating how students interact with and perceive this OER, offering insights into aspects such as accessibility, clarity, utility, and overall satisfaction. This data will inform future changes and improvements to the resource. The survey was approved as part of a successful ethics application submitted to the La Trobe University Human Research Ethics Committee.We encourage OER authors and open practitioners to modify, adapt, or localise this into a survey that is applicable for their own OER projects and learning & teaching goals.</p
Introduction to the Special Issue on Activation and the Digital Welfare State
No full textNo description supplied</p
Adverse commercial determinants of health in low- and middle-income countries: a public health challenge
No full textResearch on the Commercial Determinants of Health (CDoH) has primarily focused on high-income countries and large commercial entities, with limited scholarly literature addressing the practices of smaller commercial entities in low- and middle-income countries (LMICs). However, LMICs face the greatest public health challenges resulting from harmful commercial activities, and most commercial entities in these countries are small and medium-sized enterprises (SMEs). This perspective article examines harmful practices commonly adopted by SMEs in LMICs, drawing on a published framework of commercial sector practices and portfolio. By sharing examples of these practices, the paper highlights harmful actions of SMEs in LMICs, illustrates the significant public health burden they create, and calls for more research and policy focus on these issues. There is an urgent need for CDoH research in LMIC contexts, which should include documenting and monitoring the activities of commercial actors, including SMEs. It is essential for researchers from LMICs to be involved in this research, and efforts should focus on building capacity in this area. To minimize the harms associated with these commercial practices, local regulatory action is required, alongside support from intergovernmental organizations such as the World Health Organization.</p
Diagnostic and Clinical Utility of the 2‐Item Patient Health Questionnaire (PHQ‐2) for Screening Depressive Symptoms in Individuals With Persistent Musculoskeletal Pain Attending Physiotherapy
No full textIntroduction: This cross-sectional study evaluates the diagnostic and clinical utility of the two-item Patient Health Questionnaire (PHQ-2) for screening depressive symptoms in individuals with persistent musculoskeletal pain attending physiotherapy. Methods: A total of 450 patients (mean age = 53.3 ± 12.2 years; 109 male) with persistent musculoskeletal pain were recruited from 84 private physiotherapy practices. Participants completed both the PHQ-9 and PHQ-2. Internal consistency was assessed using Cronbach's alpha. Receiver operating characteristic curve analysis and Youden's J identified the optimal PHQ-2 cutoff score. Chi-square tests examined physiotherapists' intentions to provide advice or refer patients based on PHQ-2 scores. Results: Internal consistency was good for the PHQ-9 (α = 0.85) and acceptable for the PHQ-2 (α = 0.71). A strong correlation was found between PHQ-2 and PHQ-9 scores (r = 0.51, p 2(1) = 11.1, p 2(1) = 30.6, p Discussion: PHQ-2 is a brief, clinically useful tool with acceptable psychometric properties for screening depressive symptoms in patients with persistent pain in physiotherapy settings. Conclusions: PHQ-2 shows promise as a quick screening tool to identify patients with musculoskeletal pain who may need mental health support.</p
Toward improved understanding and treatment of self-injurious behaviors in autistic individuals with profound intellectual disability
No full textSelf-injurious behaviors (SIB) commonly occur in autism spectrum disorder (ASD) and span diverse topographies of self-inflicted behaviors ranging from head banging to hitting oneself against hard objects. Despite the high rates of SIB in autistic individuals, relatively little research has focused on psychological factors associated with the development and maintenance of SIB in individuals with autism and moderate-profound intellectual disability (ID). This commentary synthesizes existing literature on SIB and highlights the need for more research focused on psychological correlates and mechanisms in autistic individuals with moderate-profound ID. We highlight the key role of difficulties in emotion regulation (ER) and co-occurring internalizing symptoms in the manifestation of self-harm behaviors in clinical samples and autism. Furthermore, this commentary proposes a framework for understanding the interplay between poor ER and internalizing symptoms in the development and maintenance of SIB in autistic individuals with moderate-profound ID. Specifically, we explore the emergence of SIB in the context of precipitating cues that trigger strong emotions, ER processes and strategy deployment, and co-occurring internalizing symptoms. Future directions and implications for longitudinal research, measurement development, and clinical treatments are discussed.</p
Diagnostic and Clinical Utility of the Generalised Anxiety Disorder-2 (GAD-2) for Screening Anxiety Symptoms in Individuals With Persistent Musculoskeletal Pain Attending Physiotherapy
No full textIntroduction: This cross-sectional study assesses the diagnostic and clinical utility of the 2-item Generalised Anxiety Disorder Scale (GAD-2) for screening anxiety symptoms in individuals with persistent musculoskeletal pain attending physiotherapy. Methods: In total, 450 patients (mean age = 53.3 ± 12.2 years; 109 male; mean illness duration = 0.5 ± 8.8 years) with persistent musculoskeletal pain were recruited in 84 private physiotherapy practices. Patients completed the Generalised Anxiety Disorder-7 (GAD-7) and GAD-2. Internal consistency was calculated for both measures. Area under the receiver operating characteristics curve (AUC) and Youden's J were calculated to determine the optimal GAD-2 cutoff score for identifying clinically significant anxiety symptoms, as defined by the previously validated GAD-7 cutoff score of ≥ 11 for persistent pain patients. Results: Internal consistency was good for the GAD-7 (Cronbach α = 0.89) and acceptable for the GAD-2 (α = 0.71). Both measures were moderately correlated (r = 0.39, p Discussion: The GAD-2 is a clinically useful and psychometrically acceptable tool for screening anxiety symptoms in patients with persistent pain attending physiotherapy. Conclusion: The GAD-2 has the potential to identify patients with persistent pain who are at risk of anxiety disorders and who may benefit from additional mental health support.</p
The Effect of Early Post‐Operative Outpatient Physiotherapy on Outcomes Following Lower Limb Arthroplasty: A Systematic Review and Meta‐Analysis
No full textBackground: Although joint arthroplasties are generally successful, many patients experience persistent impairments. It is unknown whether early outpatient physiotherapy can address these persistent impairments. Objective: To determine whether early outpatient physiotherapy, compared with delayed physiotherapy, improves pain, physical function and quality of life (QOL) in patients following lower limb arthroplasty. Method: A systematic review and meta-analysis was conducted following the PRISMA guidelines. Searches were conducted across MEDLINE, Embase, CINAHL, Cochrane and PsycINFO. Eligible studies included randomised control trials (RCTs) comparing early and delayed physiotherapy in patients after lower limb arthroplasty. Data were pooled using a random-effects model. Risk of bias assessment was completed using the Physiotherapy Evidence Database scale. The Grading of Recommendations Assessment, Development and Evaluation approach was used to assess the certainty of evidence. Results: Three RCTs involving 224 participants undergoing joint arthroplasty (lateral uni-compartment knee replacement, total knee replacement and total hip replacement) were included. Meta-analyses demonstrated no significant differences in pain, physical function or QOL between early and delayed physiotherapy in short, medium or long term follow-ups. The certainty of evidence ranged from very low to low, with negligible to minimal effect sizes indicating minimal clinical relevance. Conclusion: The systematic review and meta-analysis found low to very low quality evidence that early outpatient physiotherapy following knee or hip joint arthroplasty does not improve pain, physical function or QOL compared with delayed physiotherapy. Future research should aim to confirm modifiable risk factors contributing to poor outcomes post-operatively and evaluate the effectiveness of early targeted physiotherapy in these high-risk subgroups.</p
Valine Restriction Extends Survival in a Drosophila Model of Short-Chain Enoyl-CoA Hydratase 1 (ECHS1) Deficiency
No full textShort-chain enoyl-CoA hydratase 1 deficiency (ECHS1D) is a rare genetic disorder caused by biallelic pathogenic variants in the ECHS1 gene. ECHS1D is characterised by severe neurological and physical impairment that often leads to childhood mortality. Therapies such as protein and single nutrient-restricted diets show poor efficacy, whereas the development of new treatments is hindered by the low prevalence of the disorder and a lack of model systems for treatment testing. Here, we report on the establishment of a Drosophila model of ECHS1D. Flies carrying mutations in Echs1 (CG6543) were characterised for their physical and metabolic phenotypes, and dietary intervention to improve fly model health was explored. The Echs1 null larvae recapitulated human ECHS1D phenotypes including poor motor behaviour and early mortality and could be rescued by the expression of a human ECHS1 transgene. We observed that both restriction of valine in isolation, or all branched-chain amino acids (BCAAs—leucine, isoleucine and valine) together, extended larval survival, supporting the idea that reducing BCAA pathway catabolic flux is beneficial in this disorder. Further, metabolic profiling revealed substantial changes to carbohydrate metabolism, suggesting that Echs1 loss causes widespread metabolic dysregulation beyond valine metabolism. The similarities between Drosophila and human ECHS1D suggest that the fly model is a valuable animal system in which to explore mechanisms of pathogenesis and novel treatment options for this disorder.</p