Stressors and coping resources of Australian kidney transplant recipients related to medication taking: a qualitative study

AIM: To understand the stressors related to life post-kidney transplantation, with a focus on medication adherence, and the coping resources people use to deal with these stressors. BACKGROUND: Although kidney transplantation offers enhanced quality and years of life for patients, the management of a kidney transplant post-surgery is a complex process. DESIGN: A descriptive exploratory study. METHOD: Participants were recruited from five kidney transplant units in Victoria, Australia. From March to May 2014, patients who had either maintained their kidney transplant for ≥ 8 months or had experienced a kidney graft loss due to medication non-adherence were interviewed. All audio-recordings of interviews were transcribed verbatim and underwent Ritchie and Spencer's framework analysis. RESULTS: Participants consisted of fifteen men and ten women aged 26 - 72 years old. All identified themes were categorised into: 1) Causes of distress and 2) Coping resources. Post-kidney transplantation, causes of distress included the regimented routine necessary for graft maintenance, and the everlasting fear of potential graft rejection, contracting infections and developing cancer. Coping resources utilised to manage the stressors were firstly, a shift in perspective about how easy it was to manage a kidney transplant than to be dialysis-dependent and secondly, receiving external help from fellow patients, family members and healthcare professionals in addition to utilising electronic reminders. CONCLUSION: An individual well-equipped with coping resources is able to deal with stressors better. It is recommended that changes, such as providing regular reminders about the lifestyle benefits of kidney transplantation, creating opportunities for patients to share their experiences and promoting the utilisation of a reminder alarm to take medications, will reduce the stress of managing a kidney transplant.

SYSTEM DYNAMICS MODELING AS A QUANTITATIVE-QUALITATIVE FRAMEWORK FOR SUSTAINABLE WATER RESOURCES MANAGEMENT: INSIGHTS FOR WATER QUALITY POLICY IN THE GREAT LAKES REGION

Early water resources modeling efforts were aimed mostly at representing hydrologic processes, but the need for interdisciplinary studies has led to increasing complexity and integration of environmental, social, and economic functions. The gradual shift from merely employing engineering-based simulation models to applying more holistic frameworks is an indicator of promising changes in the traditional paradigm for the application of water resources models, supporting more sustainable management decisions. This dissertation contributes to application of a quantitative-qualitative framework for sustainable water resources management using system dynamics simulation, as well as environmental systems analysis techniques to provide insights for water quality management in the Great Lakes basin. The traditional linear thinking paradigm lacks the mental and organizational framework for sustainable development trajectories, and may lead to quick-fix solutions that fail to address key drivers of water resources problems. To facilitate holistic analysis of water resources systems, systems thinking seeks to understand interactions among the subsystems. System dynamics provides a suitable framework for operationalizing systems thinking and its application to water resources problems by offering useful qualitative tools such as causal loop diagrams (CLD), stock-and-flow diagrams (SFD), and system archetypes. The approach provides a high-level quantitative-qualitative modeling framework for "big-picture" understanding of water resources systems, stakeholder participation, policy analysis, and strategic decision making. While quantitative modeling using extensive computer simulations and optimization is still very important and needed for policy screening, qualitative system dynamics models can improve understanding of general trends and the root causes of problems, and thus promote sustainable water resources decision making. Within the system dynamics framework, a growth and underinvestment (G&U) system archetype governing Lake Allegan's eutrophication problem was hypothesized to explain the system's problematic behavior and identify policy leverage points for mitigation. A system dynamics simulation model was developed to characterize the lake's recovery from its hypereutrophic state and assess a number of proposed total maximum daily load (TMDL) reduction policies, including phosphorus load reductions from point sources (PS) and non-point sources (NPS). It was shown that, for a TMDL plan to be effective, it should be considered a component of a continuous sustainability process, which considers the functionality of dynamic feedback relationships between socio-economic growth, land use change, and environmental conditions. Furthermore, a high-level simulation-optimization framework was developed to guide watershed scale BMP implementation in the Kalamazoo watershed. Agricultural BMPs should be given priority in the watershed in order to facilitate cost-efficient attainment of the Lake Allegan's TP concentration target. However, without adequate support policies, agricultural BMP implementation may adversely affect the agricultural producers. Results from a case study of the Maumee River basin show that coordinated BMP implementation across upstream and downstream watersheds can significantly improve cost efficiency of TP load abatement.

INCORPORATING STIMULATING QUICK-WRITE PROMPTS WITHIN A SECONDARY SCIENCE CLASSROOM: A CASE STUDY IN LESOTHO

The use of intriguing open-ended quick-write prompts within the Basotho science classroom could potentially provide a way for secondary teachers in Lesotho to have a time-efficient alternative to stimulate student thinking and increase critical thinking or application of scientific principles. Writing can be used as a powerful means to improve the achievement of students across many subject areas, including the sciences (Moore, 1993; Rivard, 1994; Rillero, Zambo, Cleland, and Ryan, 1996; Greenstein, 2013). This study focuses on the use of a non-traditional nor extensively studied writing method that could potentially support learning in science. A quasi-experimental research design, with a control and experimental group, was applied. The study was conducted at two schools, with one experimental classroom in one school and a second control group classroom in the second school for a period of 4 weeks. 51 Form B (US Grade 9 equivalent) students participated as the experimental group and 43 Form B students as the control group. In an effort to assess learning achievement, a 1 hour (35 mark) pre-test evaluation was made by and given to students by Basotho teachers at the beginning of this study to have an idea of student’s previous knowledge. Topics covered were Static Electricity, Current Electricity, Electromagnetic Waves, and Chemistry of Water. After the experimental trial period, an almost completely identical post-test evaluation was given to students in the same fashion to observe and compare gains in achievement. Test data was analyzed using an inferential statistics procedure that compared means and gains in knowledge made by the experimental and control groups. Difference between the gains of mean pre-test and post-test scores were statistically significant within each group, but were not statistically significant when the control and experimental groups were compared. Therefore, there was no clear practical effect. Qualitative data from teachers’ journals and students’ written feedback provides insight on the assessments, incorporation of the teaching method, and the development of participating students. Both mid and post-study student feedback shows that students had an overall positive and beneficial experience participating in this activity. Assessments and teacher journals showed areas of strength and weaknesses in student learning and on differences in teaching styles. They also helped support some feedback claims made by students. Areas of further research and improvement of the incorporation of this teaching method in the Basotho secondary science classroom are explored.

Design of products to honor people post mortem

The cemeterial units, are places of social practices of everyday life and worship and the tomb where nostalgia can be externalized and the memory of the deceased revered. In Western societies we can find a category of artifacts meant to evoke the memory or honor the dead. In this paper we we mention three examples of products that enabled a reflection on the concepts that gave rise to their ways, and that risks to fit them into a new "material culture", in that it may have created a break with the traditional system codes and standards shared by companies, and its manifestations in relation to the physical creation of this category of products. This work offers a reflection on the Design Products.What probably makes it special is the field where it is located: the design of products in one post mortem memory. Usually made of granite rock or marble, have the form of plate or tablet, open book or rolled sheet. On one side have a photograph of the person who intend to honor and inscriptions. The thought of inherent design of this work put on one side the intricate set of emotions that this type of product can generate, and other components more affordable, and concerning the form, function and object interactions with users and with use environments. In the definition of the problem it was regarded as mandatory requirements: differentiation, added value and durability as key objectives.The first two should be manifested in the various components / product attributes. The aesthetic and material/structural durability of product necessarily imply the introduction of qualifying terms and quantitative weights, which positively influence the generation and evaluation of concepts based on the set of 10 principles for the project that originated a matrix as a tool to aid designing products. The concrete definition of a target audience was equally important. At this stage, the collaboration of other experts in the fields of psychology and sociology as disciplines with particular ability to understand individuals and social phenomena respectively was crucial. It was concluded that a product design to honor someone post mortem, should abandon the more traditional habits and customs to focus on identifying new audiences. Although at present it can be considered a niche market, it is believed that in the future may grow as well as their interest in this type of products.

An exploration of students’ perceptions and attitudes towards creativity in engineering education

Thesis (Master, Mechanical and Materials Engineering) -- Queen's University, 2016-09-29 17:45:16.051

Post: 9/11: hidden pedagogy: the positional forces of pedagogy in Victoria, Australia

This qualitative study charts the lived narratives of twelve participants, six teachers and six students from urban and rural Victoria, Australia. The study examines in detail the question ‘How do teachers teach, post 9/11?’. 9/11 has become accepted shorthand for September 11th 2001, in which terrorist attacks took place in the United States of America. The attacks heralded a ‘post- 9/11 world, [in which] threats are defined more by the fault lines within societies than by the territorial boundaries between them’ (National Commission on Terrorist Attacks, 2011, p. 361). The study is embedded in the values that have come to the fore in the wake of the 9/11 attacks and the ideological shifts that have occurred globally. These values and ideologies are reflected via issues of culture and consumption. In education this is particularly visible through pedagogy. The research employs a multimethodological (Esteban-Guitart, 2012) form of inquiry through the use of bricolage (Kincheloe & Berry, 2004) which is comprised at the intersectional points of critical pedagogy (Kincheloe, 2008b), public pedagogy (Sandlin, Schultz, & Burdick, 2010b) and cultural studies (Hall, Hobson, Lowe, & Willis, 1992). This study adopts a critical ontological perspective, and is grounded in qualitative research approaches (Lather & St. Pierre, 2013). The methods of photo elicitation, artefact analysis, video observation and semi-structured interviews are used to critically examine the ways in which teacher and student identities are shaped by the pedagogies of contemporary schooling, and how they form common sense understandings of the world and themselves, charting possibilities between accepted common sense beliefs and 21st century neoliberal capitalism. The research is presented through a prototypical form of literary journalism and intertextuality which examines the interrelationship between teaching and social worlds exposing the hidden influence of enculturation and addressing the question ‘How do teachers teach, post 9/11?’

Thinking through things

Catalgue essay to accompany Patrick Pound's exhibition entitled Patrick Pound: Thinking through things, curated with the Flinders University Art Museums collections

Theorizing agency in post-girlpower times

Post-structuralist youth studies theorists have argued for nuanced perspectives on agency that are not reliant on an assumption of subjects as rational and internally coherent individuals, and understand subjectivity and social structure as produced in concert. These are important theoretical developments that have shaped recent scholarship on girls' identities and cultures. In this paper, we seek to give them some further sociological grounding by thinking through their resonance for the specific debate about young women and what feminist agency consists of, or looks like today. What we wish to further flesh out is how more familiar, modernist ideas about girls' agency have started to reach their limits not merely because of the post-structuralist turn, but because of the socio-cultural conditions of neoliberalism, post-feminism and post-girlpower. We unpack some recent shifts and complexities around three concepts: choice, empowerment and voice. These are the terms by which the possibility of girls' and young women's agency has traditionally been understood in feminist scholarship and much work in girls' studies. However, when we interrogate these concepts within the specific neoliberal, post-feminist, post-girlpower context, their usefulness for either understanding or enabling feminist agency is thrown into question.

2014 Australian Association for Research in Education presidential address: educational research and the tree of knowledge in a post human digital age

The 2014, 41st Australian Association for Research in Education (AARE) presidential address is both inspired and guided by the discursive genres of presidential addresses and the role of the president in a member association such as AARE. In the address, typically the president speaks to the members on an issue or issues that are to shape or conclude their term of office, as it is in my case. Like many of the 40 AARE presidents who have gone before me, I will embed some things that are professional, personal and political—not in the interests of advancing my research agenda, but to add ‘‘to the weave and pattern of the association’s history’’ (Reid 2010, p. v). Threads of my research since completing my PhD in 2000 will appear to support the broad argument. Also, I will draw on the outcomes of the 2014 Australian Research Council Discovery round (see Australian Research Council: ARC archives 2016) to encapsulate my key argument that educational research and its (ex)changes are being reshaped: in a post human digital age, the tree of knowledge is mutating. To make my argument, I will review how the thinking and doing of educational research mid-way through the second decade of the twenty-first century is constructed and ask what research endeavours might be created to make the best possible worlds for our member community and the aspirations of the association.

Le stress post-traumatique chez l'agresseur – intérêt pour le clinicien

Introduction : Cet article présente un cas de psychothérapie de stress post-traumatique chez l’agresseur. Ce syndrome clinique est bien décrit dans la littérature, mais notre recherche ne nous a permis de trouver que 2 rapports de cas témoignant de son traitement en psychothérapie. Le traitement de cette population présente plusieurs défis. Un effort a dû être déployé pour réviser une littérature complexe. D’autres contraintes à notre démarche touchaient l’identification d’un sujet éligible, l’adaptation du protocole de psychothérapie à ce sujet et à au contexte de la pratique clinique, ainsi que l’administration du protocole en tenant compte de contraintes organisationnelles spécifiques. Méthode : Toutes les étapes du projet ont été dirigées par le premier auteur. Une revue de la littérature sur l’état de stress post-traumatique chez l’agresseur a été réalisée sous la supervision du deuxième auteur. Elle a été présentée au congrès annuel de l’Association des Médecins Psychiatres du Québec (AMPQ) de 2011. Cette expérience a permis une sensibilisation aux manifestations de ce syndrome clinique dans la pratique psychiatrique. Grâce à cela, un sujet hospitalisé a été identifié comme présentant des symptômes suggestifs d’état de stress post-traumatique chez l’agresseur. Une psychothérapie a été planifiée et administrée, à partir des connaissances acquises lors de la revue de la littérature, sous la supervision du troisième auteur. Le sujet a été sélectionné par échantillon de convenance. Les données colligées concernant l’évolution clinique du sujet sont de nature qualitative. La méthode d’intervention est une thérapie cognitivo-comportementale intensive, chez un patient hospitalisé. Une attention particulière a été portée au vécu subjectif de l’agresseur, tel que suggéré par la littérature. Un suivi a eu lieu en clinique externe par la suite, permettant de colliger des données supplémentaires. Résultats : L’évolution du sujet a été positive, se concluant par le désir de devenir un membre productif de la société. Conclusion : Un protocole de thérapie cognitivo-comportementale visant l’état de stress post-traumatique en général peut être adapté à la situation de l’agresseur. L’exercice d’être attentif à l’expérience subjective de l’agresseur permet de dépasser certains défis que présente son traitement. La psychothérapie peut être adaptée à la situation du patient hospitalisé en psychiatrie. L’ensemble de la démarche illustrée dans cet article représente un exemple concret d’application de principes scientifiques au traitement d’un sujet dont la présentation clinique ne correspond pas à un diagnostic pour lequel il existe un traitement bien établi. Nous invitons le lecteur clinicien à aborder les défis présentés par un cas clinique en formulant une question de recherche pertinente, qui pourra être mise à l’épreuve pendant la phase de traitement du patient. De plus, nous croyons que la rédaction d’une histoire de cas, organisée en fonction de ce principe, constitue un outil didactique précieux dans la formation en psychiatrie.

Índice acumulativo de riesgo (nice) como prueba diagnóstica con base en tomografía corneal por elevación en la prevención de ectasia corneal post-lasik

Antecedentes La ectasia corneal post-lasik (ECPL) es una complicación infrecuente, pero devastadora en la cirugía lasik (queratomileusis asistida con éxcimer láser) para el tratamiento de la miopía con o sin astigmatismo. Con base en la tomografía corneal por elevación por imágenes de Scheimpflug (Sistema Pentacam HR, Oculus Wetzlar, Alemania), se propone un novedoso índice acumulativo de riesgo para ser utilizado como prueba diagnóstica de tamizaje y así prevenir esta complicación. Metodología Se realizó un estudio observacional analítico, de corte transversal tipo pruebas diagnósticas, con el fin de evaluar las características operativas del índice NICE teniendo como estándar de referencia el módulo de Belin-Ambrosio (Pentacam HR) utilizando un modelo de regresión logística binaria, tablas de contingencia y estimando el área bajo la curva ROC. Resultados Se evaluaron 361 ojos de los cuales el 59,3% provenían de pacientes de sexo femenino, la edad media global fue de 30 años (RIC 11,0). El modelo logístico binario aplicado se construyó con base en cuatro variables independientes cuantitativas (K2, PAQUI, EP e I-S) y una cualitativa (SEXO), y se determinó su relación con la variable dependiente, NICE (puntaje final). Las variables predictoras fueron estadísticamente significativas clasificando adecuadamente el 92,9% de los ojos evaluados según presencia o ausencia de riesgo. El coeficiente de Nagelkerke fue de 74,4%. Conclusiones El índice acumulativo de riesgo NICE es una herramienta diagnóstica novedosa en la evaluación de candidatos a cirugía refractiva lasik para prevenir la ectasia secundaria.

The Coming of Post-reflexive Society: Commodification and Language in Digital Capitalism

Language is a unique aspect of human communication because it can be used to discuss itself in its own terms. For this reason, human societies potentially have superior capacities of co-ordination, reflexive self-correction, and innovation than other animal, physical or cybernetic systems. However, this analysis also reveals that language is interconnected with the economically and technologically mediated social sphere and hence is vulnerable to abstraction, objectification, reification, and therefore ideology – all of which are antithetical to its reflexive function, whilst paradoxically being a fundamental part of it. In particular, in capitalism, language is increasingly commodified within the social domains created and affected by ubiquitous communication technologies. The advent of the so-called ‘knowledge economy’ implicates exchangeable forms of thought (language) as the fundamental commodities of this emerging system. The historical point at which a ‘knowledge economy’ emerges, then, is the critical point at which thought itself becomes a commodified ‘thing’, and language becomes its “objective” means of exchange. However, the processes by which such commodification and objectification occurs obscures the unique social relations within which these language commodities are produced. The latest economic phase of capitalism – the knowledge economy – and the obfuscating trajectory which accompanies it, we argue, is destroying the reflexive capacity of language particularly through the process of commodification. This can be seen in that the language practices that have emerged in conjunction with digital technologies are increasingly non-reflexive and therefore less capable of self-critical, conscious change.