School Stakeholder Views on a National Approach to Teaching History in Three Australian States

This thesis examined the responses of school stakeholders in three Australian states (South Australia, Western Australia and Victoria) to development of the Australian Curriculum: History (ACHistory). These states were selected due to their accessibility for the researcher, past approaches to History education and size. Data were collected through individual interviews with parents, teachers and History Teachers’ Association members, and small focus groups with Year 9 and 10 students. These participant groups were selected after identifying them as key school stakeholders: teachers and History Teachers’ Association members due to their role in teaching the curriculum in classrooms, students as the recipients of the curriculum, and parents due to their concern for their children’s educational outcomes. Development of the ACHistory commenced in 2008 following the Melbourne Declaration on Educational Goals for Young Australians, agreed to by all state and Commonwealth education authorities. The release of the Shape of the Australian Curriculum: History in 2009 launched a series of criticism targeted at the proposed national curriculum. Much of the criticism focused on the role that Australian history would play. The criticisms continued as the ACHistory was implemented in schools. The implementation of the ACHistory saw the profile of History raised in the media, along with debates about what and how Australian students should be taught about the past. The involvement of Commonwealth in History education, particularly with the announcement of the 2014 review conducted by Kevin Donnelly and Kenneth Wiltshire, led to some concerns about politicisation and the way this could influence the History curriculum. The objectives of the project were to establish the various opinions held by different school stakeholder groups in the three states on the nature and extent of politicisation of the ACHistory, identify differences and commonalities among the views of various school stakeholder groups regarding the direction the History curriculum should take. Triangulation with articles published in the media and academic journals was used to help establish how ideological factors related to political and cultural groups shaped the curriculum, if at all. While History education was assigned different purposes by various participants it was generally accepted as an important compulsory subject. Australian history, in particular, was considered an important topic that Australian students should study. Generally, the amount of Australian history taught under the ACHistory was seen as sufficient, although there were some individual participants who felt it should be adjusted. Alternatively, some participants would have preferred a more local, state-based approach. The ability of the curriculum to cater for the diversity amongst Australian students of different cultural backgrounds and beliefs was unclear, with some teachers holding that this was the responsibility of classroom teachers, not the curriculum. In terms of the development and 2014 review process for the ACHistory, despite opportunities existing for school stakeholders to provide feedback, not all were either aware or chose to be involved. While there was a range of responses, overall, there seemed to be an acceptance that considering the requirement for a national History curriculum to balance the needs of multiple stakeholder groups, the curriculum and the process used to develop it were, for the most part, adequate. This was a small-scale qualitative study, therefore there is room in the future to investigate how widespread the views of the participants in this study are in a larger number of Australian schools, particularly given that schools would have had more time to adjust to the requirements of the Australian Curriculum, and that states such as Victoria and Western Australia have since chosen to adapt the curriculum to their own local contexts.Thesis (Ph.D.) -- University of Adelaide, School of Education, 201

General practitioner well-being during the COVID-19 pandemic : a qualitative interview study

OBJECTIVES: The COVID-19 pandemic presented new challenges for general practitioners' (GPs') mental health and well-being, with growing international evidence of its negative impact. While there has been a wide UK commentary on this topic, research evidence from a UK setting is lacking. This study sought to explore the lived experience of UK GPs during COVID-19, and the pandemic's impact on their psychological well-being. DESIGN AND SETTING: In-depth qualitative interviews, conducted remotely by telephone or video call, with UK National Health Service GPs. PARTICIPANTS: GPs were sampled purposively across three career stages (early career, established and late career or retired GPs) with variation in other key demographics. A comprehensive recruitment strategy used multiple channels. Data were analysed thematically using Framework Analysis. RESULTS: We interviewed 40 GPs; most described generally negative sentiment and many displayed signs of psychological distress and burnout. Causes of stress and anxiety related to personal risk, workload, practice changes, public perceptions and leadership, team working and wider collaboration and personal challenges. GPs described potential facilitators of their well-being, including sources of support and plans to reduce clinical hours or change career path, and some described the pandemic as offering a catalyst for positive change. CONCLUSIONS: A range of factors detrimentally affected the well-being of GPs during the pandemic and we highlight the potential impact of this on workforce retention and quality of care. As the pandemic progresses and general practice faces continued challenges, urgent policy measures are now needed

Investigating the challenges of teaching sex education to autistic learners : a qualitative exploration of teachers' experiences

Background Sex education is essential as it equips individuals with the knowledge to live independent and safe sex lives. However, in the United Kingdom, sex education is not particularly accessible for autistic learners which may lead to a lack of knowledge around appropriate sexual behaviours. Aims The current study focusses on the challenges of teaching sex education to autistic learners. Methods and procedures The data was produced through one-to-one interviews with thirteen educational practitioners that have experienced delivering sex education to autistic learners. Outcomes and results Reflexive thematic analysis (Braun & Clarke, 2006) was used to interpret the data, producing themes of (1) Pedagogical Restrictions, and (2) Sexual Impulses. Conclusions and implications These findings demonstrated that the main challenges of teaching sex education to autistic learners pertained to Pedagogical Restrictions in the classroom, and learners’ own sexual impulses. These findings are a positive step towards understanding how to adapt sex education lessons to make them more inclusive and accessible for learners with autism. This study contributes to developing understanding around how to support autistic learners, highlighting gaps in the current sex education curriculum for policy makers, and enabling those surrounding autistic individuals to best support them with body transformations

Assessment of ibrutinib plus rituximab in front-line CLL (FLAIR trial): study protocol for a phase III randomised controlled trial

Background Treatment of chronic lymphocytic leukaemia (CLL) has seen a substantial improvement over the last few years. Combination immunochemotherapy, such as fludarabine, cyclophosphamide and rituximab (FCR), is now standard first-line therapy. However, the majority of patients relapse and require further therapy, and so new, effective, targeted therapies that improve remission rates, reduce relapses, and have fewer side effects, are required. The FLAIR trial will assess whether ibrutinib plus rituximab (IR) is superior to FCR in terms of progression-free survival (PFS). Methods/design FLAIR is a phase III, multicentre, randomised, controlled, open, parallel-group trial in patients with previously untreated CLL. A total of 754 participants will be randomised on a 1:1 basis to receive standard therapy with FCR or IR. Participants randomised to FCR will receive a maximum of six 28-day treatment cycles. Participants randomised to IR will receive six 28-day cycles of rituximab, and ibrutinib taken daily for 6 years until minimal residual disease (MRD) negativity has been recorded for the same amount of time as it took to become MRD negative, or until disease progression. The primary endpoint is PFS according to the International Workshop on CLL (IWCLL) criteria. Secondary endpoints include: overall survival; proportion of participants with undetectable MRD; response to therapy by IWCLL criteria; safety and toxicity; health-related quality of life (QoL); and cost-effectiveness. Discussion The trial aims to provide evidence for the future first-line treatment of CLL patients by assessing whether IR is superior to FCR in terms of PFS, and whether toxicity rates are favourable. Trial registration ISRCTN01844152. Registered on 8 August 2014, EudraCT number 2013-001944-76. Registered on 26 April 2013

Effective bridging therapy can improve CD19 CAR-T outcomes while maintaining safety in patients with large B-cell lymphoma

The impact of bridging therapy (BT) on CD19-directed chimeric antigen receptor T-cell (CD19CAR-T) outcomes in large B-cell lymphoma (LBCL) is poorly characterised. Current practice is guided by physician preference rather than established evidence. Identification of effective BT modalities and factors predictive of response could improve CAR-T intention to treat and clinical outcomes. We assessed BT modality and response in 375 adult LBCL patients in relation to outcomes following axicabtagene ciloleucel (Axi-cel) or tisagenlecleucel (Tisa-cel). The majority of patients received BT with chemotherapy (57%) or radiotherapy (17%). We observed that BT was safe for patients, with minimal morbidity/mortality. We showed that complete or partial response to BT conferred a 42% reduction in disease progression and death following CD19CAR-T therapy. Multivariate analysis identified several factors associated with likelihood of response to BT, including response to last line therapy, the absence of bulky disease, and the use of Polatuzumab-containing chemotherapy regimens. Our data suggested that complete/partial response to BT may be more important for Tisa-cel than Axi-cel, as all Tisa-cel patients with less than partial response to BT experienced frank relapse within 12 months of CD19CAR-T infusion. In summary, BT in LBCL should be carefully planned towards optimal response and disease debulking, to improve CD19CAR-T patient outcomes. Polatuzumab-containing regimens should be strongly considered for all suitable patients, and failure to achieve complete/partial response to BT pre-Tisa-cel may prompt consideration of further lines of BT where possible

GP wellbeing during the COVID-19 pandemic : a systematic review

BACKGROUND: Doctors' organisations in the UK have reported worrying levels of work-related stress and burnout in the GP workforce for some time, and the COVID-19 pandemic has presented clear new challenges. AIM: To synthesise international evidence exploring the impact of COVID-19 on primary care doctors' mental health and wellbeing, and identify risk factors associated with their psychological wellbeing during this time. DESIGN AND SETTING: Mixed-methods systematic review. METHOD: Six bibliographic databases, Google Scholar, and MedRxiv were searched on 19 November 2020 and 3 June 2021 to identify studies of GP psychological wellbeing during the pandemic. Reference checking was also conducted. Two reviewers selected studies, extracted data, and assessed the quality of studies using standardised tools. Heterogeneity in outcomes, setting, and design prohibited statistical pooling; studies were combined using a convergent integrated thematic synthesis. RESULTS: Thirty-one studies were included. Multiple sources of stress were identified including changed working practices; risk, exposure, and inadequate personal protective equipment (PPE); information overload; pandemic preparedness; and cohesion across sectors. Studies demonstrated an impact on psychological wellbeing, with some GPs experiencing stress, burnout, anxiety, depression, fear of COVID-19, lower job satisfaction, and physical symptoms. Studies reported gender and age differences: women GPs had poorer psychological outcomes across all domains, and older GPs reported greater stress and burnout. Use of outcome measures and reporting practice varied greatly. CONCLUSION: This review of international evidence demonstrates that the COVID-19 pandemic has adversely affected GPs' wellbeing around the world. Further research could explore gender and age differences, identifying interventions targeted to these groups

Characterisation of a Wheat Breeders’ Array suitable for high throughput SNP genotyping of global accessions of hexaploid bread wheat (<i>Triticum aestivium</i>)

Targeted selection and inbreeding have resulted in a lack of genetic diversity in elite hexaploid bread wheat accessions. Reduced diversity can be a limiting factor in the breeding of high yielding varieties and crucially can mean reduced resilience in the face of changing climate and resource pressures. Recent technological advances have enabled the development of molecular markers for use in the assessment and utilization of genetic diversity in hexaploid wheat. Starting with a large collection of 819 571 previously characterized wheat markers, here we describe the identification of 35 143 single nucleotide polymorphism-based markers, which are highly suited to the genotyping of elite hexaploid wheat accessions. To assess their suitability, the markers have been validated using a commercial high-density Affymetrix Axiom® genotyping array (the Wheat Breeders' Array), in a high-throughput 384 microplate configuration, to characterize a diverse global collection of wheat accessions including landraces and elite lines derived from commercial breeding communities. We demonstrate that the Wheat Breeders' Array is also suitable for generating high-density genetic maps of previously uncharacterized populations and for characterizing novel genetic diversity produced by mutagenesis. To facilitate the use of the array by the wheat community, the markers, the associated sequence and the genotype information have been made available through the interactive web site 'CerealsDB'