Teaching in north Queensland general practices

AIMS & RATIONALE: Primary health care (PHC) is integral to the Australian health care system. More PHC practitioners are required to practice in underserved populations and to serve an ageing population with increasing and complex comorbidities. More domestic medical students and graduates provide an opportunity to: (i) redress workforce maldistribution and shortage ; and (ii) grow the future PHC workforce that Australia will require. However, sufficient learning posts are required to capitalise on this opportunity. This study previously explored current teaching volume throughout north Queensland general practice settings and possibilities for growth in teaching capacity. Case studies of five teaching practices will now be conducted to better understand successful teaching strategies that are appropriate for a variety of practice settings. Particular interest is paid to models that might include vertically integrated and interprofessional teaching. METHODS: Case study methods (e.g. interviews, observation) to explore five exemplar teaching practices in depth. FINDINGS: An overview of case study findings will be presented, detailing successful teaching models employed in practices with a wide variety of characteristics (e.g. small/large staff numbers; rurality; number and types of learners at the practice). POTENTIAL USES FOR THIS RESEARCH: Building an appropriate PHC workforce for the future requires sufficient learners to have exposure to good quality learning opportunities in general practice settings, ideally with inspiring preceptors. Showcasing successful teaching strategies in a variety of such settings is important and may prove enlightening for GPs considering teaching or increasing their teaching load

The Ethics of Torture

A review of: Torture: Does It Make Us Safer? Is It Ever OK? A Human Rights Perspective. Edited by Kenneth Roth and Mindy Worden. New York: The New Press, 2005. 201 pp

Remembering the Past and Struggling for Justice: The Contested Legacy of Authoritarian Rule in Chile

A review of: Battling for Hearts and Minds: Memory Struggles in Pinochet’s Chile, 1973-1988. Vol. 2 of The Memory Box of Pinochet’s Chile. By Steven J. Stern. Durham, NC: Duke University Press, 2006. 247pp. and Remembering Pinochet’s Chile: On the Eve of London 1998. Vol. 1 of The Memory Box of Pinochet’s Chile. By Steven J. Stern. Durham, NC: Duke University Press, 2004. 538pp. and The Pinochet Effect: Transnational Justice in the Age of Human Rights. By Naomi Roht-Arriaza. Philadelphia: University of Pennsylvania Press, 2005. 256pp

Effective engagement of conservation scientists with decision-makers

This chapter offers advice on how the conservation science community can effectively engage with decision-makers. The rationales for why we, as scientists, need to do this have been widely discussed in the literature. Often, the reasons offered are normative, pragmatic, or instrumental (de Vente, 2016); in other words, there is a belief that engaging with decision-makers leads to better informed, more acceptable decisions. Indeed, better engagement may lead to the greater uptake of evidence for conservation decisions, something which some scholars argue is a priority for effective management (e.g. Gardner et al., 2018; Sutherland and Wordley, 2017)

The mythological perspective of modern media: Cross-cultural consciousness and modern myths

This piece assesses the cultural implications of modern narratives that incorporate classical mythology, specifically focusing on the hero’s journey. When the similarities of different myths across different cultures are analyzed, it becomes clear that there are modern analogs that incorporate mythic qualities and cultural values. These mythic foundations are analyzed here in popular works like Harry Potter, Star Trek, and Legend of Zelda, where the hero’s journey becomes an almost universal experience that inspires cross-cultural consciousness. The hero’s journey has evolved from a simple literary tool into a cross-cultural touchstone that shapes narratives into familiar works of cultural significance across new media, incorporating new values and cultural ideals that allow the audience to learn about cultures outside of their own in a positive experience. Because modern media incorporates aspects of myth, that media is both familiar and transformative and has brought new and widened perspectives of cultures across the globe. This in turn creates a cross-cultural consciousness that arises from shared media, whether that is in the form of movies, books, games, or otherwise, and shows how classical mythology is still an important artifact and foundation that influences modern culture and media

T Cell Immunosurveillance in Pancreatic Ductal Adenocarcinoma

ABSTRACT T CELL IMMUNOSURVEILLANCE IN PANCREATIC DUCTAL ADENOCARCINOMA Rebecca A. Evans Robert H. Vonderheide The prevailing theory of cancer immune surveillance, as understood from carcinogen-driven mouse models of highly mutated tumors, states that T cell-mediated immune pressure drives a continuum of tumor elimination, equilibrium, and escape. This “Triple E Hypothesis” reflects host-tumor interactions in a subset of human cancers that have responded well to cancer immunotherapy, including melanoma, small cell lung carcinoma, and bladder carcinoma; yet, many tumors remain refractory to such interventions. These clinical failures suggest that immunosurveillance in other cancers manifests with a fundamentally different biology than previously described. Here, using a genetic mouse model of spontaneous pancreatic carcinoma that features an immunosuppressive microenvironment and few non-synonymous mutations, we report that the natural history of such cancers is T cell-independent. Furthermore, tumor escape from T cell surveillance is not required for cancer progression, as tumor cells arising in T cell-depleted genetic mice grow unchecked in immune-competent hosts upon implantation. Checkpoint blockade with CTLA-4 and PD-1 antibodies does not expose mutant epitopes strong enough to elicit therapeutic responses; combined with whole exome sequencing of PDA-derived murine cell lines, these findings confirm that that PDA does not harbor a mutational burden commensurate with the current hypothesis of immunosurveillance. However, ectopic expression of a neo-antigen in PDA tumor cells is sufficient to restore immunosurveillance, override its immunosuppressive microenvironment, and establish T cell memory against “quiescent” endogenous antigens. Thus, cardinal features of tumor immunosurveillance are elicited by an antigen of sufficient strength irrespective of microenvironmental immunosuppression. The finding that antigen strength itself is a critical determinant of cancer immunosurveillance informs future clinical approaches for the majority of human tumors that are “immunologically cold” and refractory to current immunotherapies

Social support, coping strategies and the impact on relationships for adolescents who have experienced cancer

Adolescence is a period characterised by a number of biological, social and psychological changes. Those facing a cancer diagnosis in adolescence find that they have further challenges and changes to deal with, in addition to the normal challenges associated with adolescence. The purpose of this research was to understand the experiences of adolescents who have had cancer. The aim was to examine the impact their illness had on their social relationships, to explore how they coped and found support, and to investigate the impact having cancer had on the developmental tasks associated with adolescence. While there has been extensive literature on these topics internationally, there has been limited research conducted within a New Zealand context. Semi-structured interviews were completed with eight young people who had been diagnosed with cancer between the ages of 13 and 20. These interviews were transcribed and analysed using thematic analysis. Two topics that seemed to encapsulate the overall experiences of the participants were identified. These topics were coping with cancer and life will never be the same. In addition, seven themes were identified, which included: coping strategies, the importance of social support, obtaining illness related information, cancer as loss, cancer as a time of growth and development, relationships change and after the cancer is gone. The findings of this study highlighted the importance of providing information for adolescents at the right time in their cancer journey. Another major finding in this study was that many young people with cancer felt that their peers were not equipped to deal with their illness or offer support, and as a result many relationships were lost. Despite this, many participants reported that they were able to utilise social support by meeting others with cancer and receiving support from parents, siblings and some peers. Another key finding from this study was that following the completion of treatment, adolescents continue to face a number of challenges. Some of these challenges include dealing with the long term effects of their illness such as infertility or learning to adjust to a new identity as a cancer survivor. While findings in this study suggested that cancer was conceptualised as a time of loss including a loss of identity and a loss of opportunities, all participants were able to identify positive changes as a result of their illness. These changes included a newfound appreciation for life and making the most of opportunities they were provided. This thesis provides recommendations for professionals, agencies and services working with this population to ensure that appropriate emotional and psychological support is continued to be offered to young people and their families, particularly following completion of treatment. There was also a need identified for peers of young people with cancer to be given some sort of education in order to help support their peers through their cancer journey

A Qualitative Exploration of First-Generation Student Experiences at a Rural Community College

First-generation students comprise 36% of U.S. community college enrollments but struggle to remain in school to earn a college credential. First-generation students are less likely to enroll in college and have a higher probability for attrition than continuing-generation students. The purpose of this qualitative study was to understand how first-generation students attending a rural community college located in the Southeastern United States perceived that their experiences impacted their academic and nonacademic success. This study replicated and extended the Stansberry and Burnett (2014) study that explored the experiences of first-generation students attending a large, diverse research university. This phenomenological study utilized focus groups to explore the experiences of 21 first-generation rural community college students. Focus group interviews were guided by four research questions designed to explore what experiences students perceived to have impacted their academic and nonacademic success. This study further explored what challenges first-generation students perceived they faced compared to non-first-generation students, and what personal factors impacted their college success. Developing an understanding of how first-generation students perceive their lived experiences impact their academic and nonacademic success can help college leaders design support services that will aid efforts to increase retention. The findings from this study confirmed past research revealing that a lack of social capital, academic preparation, financial resources, and family support challenged this population of students in their transition to college. However study results contradict past research which offers part-time enrollment as increasing the risk of first-generation student attrition. Additionally, although this current study’s findings support the findings of the Stansberry and Burnett (2014) study, academic integration in terms of institutional fit and experiences related to access to resources and support services differed between the two samples of first-generation students