Children's Silences in Mareeba Aboriginal English

This thesis examines the role of silence in conversations between teacher’s aides and 5-6 year old Indigenous Australian children at school. Recent studies of conversation among adult Aboriginal Australians have observed that a positive value is ascribed to silence, and that it is not percieved as indicating a breakdown in communication. Studies of Aboriginal children in school settings have similarly remarked on the prevalence of silence, observing that Indigenous students appear reticent to speak in certain types of classroom interaction. This thesis uses a Conversation Analysis approach to analyse in depth the role of silence in one-on-one conversations between young Indigenous children and teacher’s aides. These conversations were recorded in Mareeba in Far North Queensland, with children who speak varieties of Aboriginal English at home. Factors influencing the extent to which the children were silent in these conversations are considered. The results of this study are in line with previous research, in finding that factors such as the language variety spoken by the children, the structure of the discourse, and whether or not the interlocutor is Indigenous play a role in the extent to which the children are silent

Holding Baby: a creative exploration to raise awareness about kinship care through the writing of a play, Holding Baby, and a poetry collection, Holding

Holding Baby: A creative exploration to raise awareness about Kinship Care through a play, Holding Baby, a poetry collection, Holding, and a critical commentary placing the work in a cultural, societal and practice-led context. The dramatic work Holding Baby covers a crisis where a grandparent is left taking responsibility for a young baby. In the tradition of social realist and community based drama, it reflects the real life stories of a growing number of connected persons or family members raising children who are not theirs by birth. The poetry collection Holding considers the personal response of the author, as a kinship carer, to that role's challenges and its rewards. In the critical commentary issues around kinship care are considered together with the history of the writing and its context. A detailed account is offered of the stage production process, as well as problems and possibilities around reaching potential audiences for both play and poetry. The relationship between the direct focus of the script and the comparative subjectivity of the poetry is reflected on and discussed

The social context of gender-based violence, alcohol use and HIV risk among women involved in high-risk sexual behaviour and their intimate partners in Kampala, Uganda.

This paper explores the interaction between gender-based violence and alcohol use and their links to vulnerability to HIV-infection in a population of women and their regular male partners in Kampala, Uganda. Data derive from 20 life history interviews (10 women and 10 men). Participants were drawn from a cohort of women at high risk of sexually transmitted infection (including HIV). Six of the women were current or former sex workers. Findings reveal that life histories are characterised by recurrent patterns of gender inequity related to violence, limited livelihood options and socioeconomic disadvantage. Overall, findings suggest women are able to negotiate safer sex and protect themselves better against abuse and violence from clients than from their intimate partners, although the status of men as 'client' or 'partner' is transitory and fluid. Among male respondents, alcohol led to intimate partner violence and high levels of sexual-risk taking, such as engagement with sex workers and reduced condom use. However, male partners are a heterogeneous group, with distinct and contrasting attitudes towards alcohol, condom use and violence. Actions to address gender-based violence need to be multi-pronged in order to respond to different needs and circumstances, of both women and men

Views about Euthanasia and Dementia: Exploring Perceptions Utilising Evidence from the Mass Observation Archive

This paper contributes to the ongoing discussion in the United Kingdom regarding euthanasia and assisted dying, using data specifically related to individuals with dementia. A qualitative approach was taken with data captured via a set of written questions in the form of a Mass Observation Archive Directive. The respondents, known as Observers, provided written responses; there was no limit to the length of the responses and the Observers were able to provide as much or as little detail as they chose. The data were analysed thematically utilising NVivo software. One-hundred and seven responses were received, representing a range of beliefs, and with opinions regarding euthanasia and dementia with pro, anti, and uncertain views being expressed. Five main themes emerged during our data analysis: capacity, legislation, agency and personal philosophies, disquietude, and incumbrance. Consistent with previous research capturing public views regarding euthanasia and assisted dying for people with dementia, the findings suggest policy makers may wish to consult the British public regarding legislation regarding euthanasia and dementia

Lessons learned from a multiagency community mental health centre quality improvement learning collaborative in New Hampshire

Background/Aims Community mental health centres in the US often struggle to implement the evidenced-based metrics and measurement processes required for quality reporting initiatives. Through the co-design and facilitation of a learning collaborative, all 10 community mental health centres in New Hampshire agreed on the goal of demonstrating measurement alignment and improvement across three behavioural health metrics related to depression and suicide risk, aiming for a screening rate of at least 85% in a year. Methods The learning system framework and Lean Six Sigma define, measure, analyse, improve and control methodologies were used to increase participation and improve quality reporting. Teams were asked to participate in both a group learning collaborative and individual centre facilitation sessions, working with a quality improvement specialist. Reported measures were compared with subsets of the population data and between centres. Outliers were identified for potential reporting inaccuracies and opportunities for improvement. Results All 10 community mental health centres were able to accurately report screening results on all three measures. After 12 months, 70% of the teams were able to reach the group-determined goal of at least 85% of eligible patients being screened in one measure, 40% of the teams met the benchmark in two measures and 20% of the teams were able to meet the benchmark in all three measures. Conclusions Early investment by community mental health centre leadership through the development of a shared aim and project outcomes is essential to support learning and achieve positive outcomes. Quality improvement specialists are vital for facilitation of shared learning and practice across organisations

Lost in transition: experiences following initial systemic anti-cancer treatment completion for haematological cancers in Wales, UK

The aim of this study was to explore Welsh adults’ experiences of the transition into survivorship from initial active systemic anti-cancer treatments for haematological cancers. An exploratory, qualitative descriptive study consisting of in-depth, face-to-face interviews was designed. A convenience sample of adults in Wales, UK, who had completed their initial systemic anti-cancer treatment for haematological cancer was recruited from one University Health Board. Data were generated in digitally recorded, individual, face-to-face interviews during 2017. Interviews were fully transcribed and analysed using a qualitative thematic approach. Seven people participated in interviews. Thematic analysis revealed three themes: encountering ambiguity, the pursuit of normality and navigating treatment completion. The transition from patient to survivor was characterised by trepidation and uncertainty. While participants sought to resume a sense of normality in their lives, they were beset by enduring treatment effects. They felt insufficiently prepared for these effects and were uncertain about the availability of the ongoing supportive care which met their individual needs. Participants articulated that they desired much more from haematology providers in preparing them for life beyond initial SACT

How does Europe Make Its Mind Up? Connections, cliques, and compatibility between countries in the Eurovision Song Contest

We investigate the complex relationships between countries in the Eurovision Song Contest, by recasting past voting data in terms of a dynamical network. Despite the British tendency to feel distant from Europe, our analysis shows that the U.K. is remarkably compatible, or 'in tune', with other European countries. Equally surprising is our finding that some other core countries, most notably France, are significantly 'out of tune' with the rest of Europe. In addition, our analysis enables us to confirm a widely-held belief that there are unofficial cliques of countries -- however these cliques are not always the expected ones, nor can their existence be explained solely on the grounds of geographical proximity. The complexity in this system emerges via the group 'self-assessment' process, and in the absence of any central controller. One might therefore speculate that such complexity is representative of many real-world situations in which groups of 'agents' establish their own inter-relationships and hence ultimately decide their own fate. Possible examples include groups of individuals, societies, political groups or even governments

The impact of SASA!, a community mobilisation intervention, on women's experiences of intimate partner violence: secondary findings from a cluster randomised trial in Kampala, Uganda.

BACKGROUND: Intimate partner violence (IPV) is a global public health and human rights concern, though there is limited evidence on how to prevent it. This secondary analysis of data from the SASA! Study assesses the potential of a community mobilisation IPV prevention intervention to reduce overall prevalence of IPV, new onset of abuse (primary prevention) and continuation of prior abuse (secondary prevention). METHODS: A pair-matched cluster randomised controlled trial was conducted in 8 communities (4 intervention, 4 control) in Kampala, Uganda (2007-2012). Cross-sectional surveys of community members, 18-49 years old, were undertaken at baseline (n=1583) and 4 years postintervention implementation (n=2532). Outcomes relate to women's past year experiences of physical and sexual IPV, emotional aggression, controlling behaviours and fear of partner. An adjusted cluster-level intention-to-treat analysis compared outcomes in intervention and control communities at follow-up. RESULTS: At follow-up, all types of IPV (including severe forms of each) were lower in intervention communities compared with control communities. SASA! was associated with lower onset of abuse and lower continuation of prior abuse. Statistically significant effects were observed for continued physical IPV (adjusted risk ratio 0.42, 95% CI 0.18 to 0.96); continued sexual IPV (0.68, 0.53 to 0.87); continued emotional aggression (0.68, 0.52 to 0.89); continued fear of partner (0.67, 0.51 to 0.89); and new onset of controlling behaviours (0.38, 0.23 to 0.62). CONCLUSIONS: Community mobilisation is an effective means for both primary and secondary prevention of IPV. Further support should be given to the replication and scale up of SASA! and other similar interventions. TRIAL REGISTRATION NUMBER: NCT00790959

Incorporating ecological and evolutionary processes into continental-scale conservation planning

Systematic conservation planning research has focused on designing systems of conservation areas that efficiently protect a comprehensive and representative set of species and habitats. Recently, there has been an emphasis on improving the adequacy of conservation area design to promote the persistence and future generation of biodiversity. Few studies have explored incorporating ecological and evolutionary processes into conservation planning assessments. Biodiversity in Australia is maintained and generated by numerous ecological and evolutionary processes at various spatial and temporal scales. We accommodated ecological and evolutionary processes in four ways: (1) using sub-catchments as planning units to facilitate the protection of the integrity and function of ecosystem processes occurring on a sub-catchment scale; (2) targeting one type of ecological refugia, drought refugia, which are critical for the persistence of many species during widespread drought; (3) targeting one type of evolutionary refugia which are important for maintaining and generating unique biota during long-term climatic changes; and (4) preferentially grouping priority areas along vegetated waterways to account for the importance of connected waterways and associated riparian areas in maintaining processes. We identified drought refugia, areas of relatively high and regular herbage production in arid and semiarid Australia, from estimates of gross primary productivity derived from satellite data. In this paper, we combined the novel incorporation of these processes with a more traditional framework of efficiently representing a comprehensive sample of biodiversity to identify spatial priorities across Australia. We explored the trade-offs between economic costs, representation targets, and connectivity. Priority areas that considered ecological and evolutionary processes were more connected along vegetated waterways and were identified for a small increase in economic cost. Priority areas for conservation investment are more likely to have long-term benefits to biodiversity if ecological and evolutionary processes are considered in their identification

'We've just had to hit the ground running': Health professionals' experiences of cancer immunotherapy: A qualitative study

Background This paper reports early findings from a qualitative investigation of people’s experiences of cancer immunotherapy with immune checkpoint inhibitors. Cancer immunotherapy is transforming outcomes for some people affected by cancer. Clinical trials have found that immune checkpoint inhibitors (ICIs) demonstrate clinical benefit across various cancers. Several ICIs are now approved for a range of cancers and used across UK cancer centres. However, there is little research focused on UK healthcare professionals’ experiences of delivering and supporting people receiving ICI’s together with their associated education and training needs. Method This study sought to obtain in-depth insight into healthcare professionals’ experiences of caring for people receiving cancer immunotherapy and their associated education, training and support needs. NHS ethical approval was granted for the participating NHS sites. UK healthcare professionals (11 nurses, 3 doctors and 2 pharmacists) from oncology services, primary and secondary care (acute oncology) were recruited using purposive and snowball sampling. In view of COVID-19 physical distancing requirements, digitally-recorded, semi-structured telephone interviews were conducted between May and September 2020. Transcribed, anonymised data were analysed using Braun and Clarke’s reflexive, thematic analysis. Results Data suggest healthcare professionals have variable educational and training needs relative to supportive care in cancer immunotherapy. The provision of immunotherapy care, particularly within oncology, is currently approached predominantly through the biomedical lens of toxicity management. Perspectives on holistic patient care, including psychological support, were limited. This disparity might be owing to ICI treatment as relatively novel compared with other anti-cancer treatments. Professionals considered ICIs as complex to manage, with significant efforts to establish a range of toxicities from both single-agent and combination ICI treatment ongoing, with many still considered unknown. Conclusion Further research should consider how healthcare professionals’ ongoing education and training needs for holistic supportive care can be best addressed. Impact statement This study seeks to make recommendations for ICI supportive care guidance development, cancer immunotherapy education materials for healthcare professionals, cancer policy and further research