Introduction of a novel magnetic resonance imaging-based scoring system for assessing disease activity in children with juvenile dermatomyositis

Objectives: We aimed to develop and assess the reliability of a novel MRI-based scoring system for reporting the severity of MRI findings in children with suspected JDM. Methods: Nine consultant paediatric radiologists independently assessed and scored 40 axial and 30 coronal thigh MR images of children with suspected JDM on two occasions using the juvenile dermatomyositis magnetic resonance Imaging Score (JIS). JIS was calculated for both reads for each plane and each limb, with possible scores ranging from 0 (normal) to 100 (severe). Inter- and intraobserver agreement was calculated using the intraclass correlation coefficient (ICC) and two- and one-way random effects models, respectively. Bland-Altman plots of the difference in JIS against the average JIS were also produced for each rater. Results: Overall, the interobserver reliability and agreement was good-for axial images, JIS ranged from 46.8 to 61.0 [ICC = 0.88 (95% CI: 0.82, 0.92)] for the left limb and 47.9-61.4 [ICC = 0.87 (95% CI: 0.81, 0.92)] for the right limb. For coronal images, JIS ranged from 56.7 to 65.1 [ICC = 0.90 (95% CI: 0.85, 0.95)] for the left limb and 55.7 to 66.8 [ICC = 0.90 (95% CI: 0.84, 0.94)] for the right limb. The intraobserver reliability and agreement was good, with ICC ranging from 0.90 to 0.94. Conclusion: JIS is a semi-objective scoring system with potential to serve as a reliable biomarker of disease severity and response to therapeutic interventions in children with JDM

The Lived Experience of Residential Undergraduates from Minority Ethnic Backgrounds Diagnosed with a Mental Health Condition

Research has demonstrated that mental health illnesses have increased, particularly among college students. Although there is a general understanding of the implications of this trend, there remains a lack of evidence on the impact of mental health diagnoses on residential undergraduate minority ethnic students. This qualitative phenomenological study aims to gain insight into the lived experiences of 10 residential undergraduate minority students aged 18 to 36 diagnosed with one or more mental health disorders. The goal is to understand their personal experiences, including any stigma they may have encountered. Through comprehensive interviews, the study explored their lived experiences. The findings revealed several themes, including the nature of their diagnoses, the challenges of living with a mental health disorder, their experiences in a residential college environment, the support they received, their desire for independence, concerns about others’ reactions to their diagnoses, and their approach to disclosure. Participants reported no evidence of stigma related to their diagnoses; however, this may be due to their limited disclosure strategy

Meaning and mission: Exploring a contemporary approach to spiritual formation for Catholic school educators

This thesis documents Australian research into contemporary spiritual formation for Catholic school educators within a systemic context. It contributes to international research that identifies concern for an appropriate approach to formation for Catholic educators. This concern has been intensified by the rapidly declining number of religious and clergy, the rising expectation on 'lay' educators to model authentic Catholic leadership, growing understanding of the adult developmental journey, and shifts in perception and practice around spiritual formation

Associate Professor Bruce McDonald, Senior Philanthropy Adviser in the University Advancement team and a career spanning more than 50 years at Swinburne

In the late summer of 1965 Bruce McDonald was 21 years old, a newly minted teacher embarking on his first proper job at Swinburne Technical College and just a little nervous. Assigned to teach accounting, law and economics, the normally ebullient Bruce was uncomfortably aware that he was fronting a classroom of students almost his own age - in many cases, older

Test characteristics of history, examination and investigations in the evaluation for septic arthritis in the child presenting with acute non-traumatic limp. A systematic review

Background Septic arthritis is an uncommon but potentially significant diagnosis to be considered when a child presents to the emergency department (ED) with non-traumatic limp. Our objective was to determine the diagnostic accuracy of clinical findings (history and examination) and investigation results (pathology tests and imaging) for the diagnosis of septic arthritis among children presenting with acute non-traumatic limp to the ED.Methods Systematic review of the literature published between 1966 and June 2019 on MEDLINE and EMBASE databases. Studies were included if they evaluated children presenting with lower limb complaints and evaluated diagnostic performance of items from history, physical examination, laboratory testing or radiological examination. Data were independently extracted by two authors, and quality assessment was performed using the Quality Assessment Tool for Diagnostic Accuracy Studies 2 tool.Results 18 studies were identified, and included 2672 children (560 with a final diagnosis of septic arthritis). There was substantial heterogeneity in inclusion criteria, study setting, definitions of specific variables and the gold standard used to confirm septic arthritis. Clinical and investigation findings were reported using varying definitions and cut-offs, and applied to differing study populations. Spectrum bias and poor-to-moderate study design quality limit their applicability to the ED setting.Single studies suggest that the presence of joint tenderness (n=189; positive likelihood ratio 11.4 (95% CI 5.9 to 22.0); negative likelihood ratio 0.2 (95% CI 0.0 to 1.2)) and joint effusion on ultrasound (n=127; positive likelihood ratio 8.4 (95% CI 4.1 to 17.1); negative likelihood ratio 0.2 (95% CI 0.1 to 0.3)) appear to be useful. Two promising clinical risk prediction tools were identified, however, their performance was notably lower when tested in external validation studies.Discussion Differentiating children with septic arthritis from non-emergent disorders of non-traumatic limp remains a key diagnostic challenge for emergency physicians. There is a need for prospectively derived and validated ED-based clinical risk prediction tools