30 research outputs found
Neoadjuvant treatment of pancreatic adenocarcinoma: a systematic review and meta-analysis of 5520 patients
Minions, mates and linchpins: A qualitative examination of the local social-ecological context of neoliberalist bullying impacting on sustainability domains and responses through community sustainability frameworks
Polistina, KJ ORCiD: 0000-0001-6893-2590The current global sustainability crisis is a cultural crisis (Bokova, 2013; NASA, 2018). This crisis is due largely to the negative effects created by the amorphous nature of neoliberalism (Gittins, 2010; Latouche, 2010a; Washington, 2015). The 2030 Agenda for Sustainable Development (United Nations Development Programme (UNDP), 2011) outlined seventeen goals sought to rectify this crisis. The practical realisation of these goals has proven elusive to those seeking social change as they navigate negative human behaviours in local social contexts. This research explored adult bullying behaviours as one way to examine the clash between neoliberal and sustainable systems and the dysfunctionalities found in this social dynamic at a local community level.
Cross-case study research methodology generated qualitative data from economically focussed developments in two communities in regional Australia. The presence in each case study of social interactions between individuals advocating for the perpetuation of neoliberalism and people seeking sustainability aims guided the selection of cases for this research. This first case context was a community (Arendelle community) living, and co-existing, near a non-towered aerodrome. Historically a holiday destination, the community had a range of socio-economic groups and encompassed a number of nature reserves. The case begins in 2006 with the introduction of a regional aviation company moving into the area for the purpose of implementing a portion of an international aviation contract. The second case (Gumnut Landcare) was a semi-rural community near forest and protected natural areas. Evident in the daily life of the community was a high level of understanding and implementation of sustainability practices including many forms of sustainable eco-centric lifestyle. The area also had a European dairy farming history. This case began in 2001 with the initial negotiations to purchase a parcel of land for a community site development and the desire for a special interest group to develop much of the land for an 18-hole golf course. The cross-case analysis allowed the examination of issues that represented not only the comparison of adult bullying by those advocating neoliberal aims in each case but current topical concerns relating the impacts on elements of sustainability domains and achieving sustainability aims.
This methodology and associated methods were suitable for a critical social constructionist form of interpretivist research. The data collection instruments included in-depth interviews (seven in the first case and six in the second); continual personal communication with key individuals in each case (a long-term RA committee member in Arendelle case and long-term permanent employee of Gumnut Landcare); documentary analysis of public, organisational and historical records; and researcher observations. This research contributed to the extension of our understanding of cross-case study research through the discovery of interconnected units of analysis. This strengthened the value of case study methodology in social-ecological research.
A key concept that emerged in this research but was absent in the literature on social change towards sustainability, was the need for an understanding of human behaviours considered detrimental to achieving sustainability aims, in particular, adult bullying, and the skills to alleviate those behaviours. The research extended, therefore, on the theoretical understanding of adult bullying in the social-ecological contexts of sustainability at a local community level. Firstly, it extended on the literature that examines bullying in corporate settings by constructing a normalised pattern of bullying behaviour for business development at the community level. Secondly, three categories of social connections between bystanders who utilised bullying behaviours to support individual neoliberalists emerged in each case—minions, mates and linchpins. A deeper understanding of the perpetuation of this social normalisation of bullying transpired through the surfacing of the linchpin as a new type of bystander pivotal in linking the bullying events in both cases and these cases to the broader neoliberal system.
The research contributed to greater theoretical clarity around the barriers to implementation of social change towards sustainability at the local community level. It filled a gap in the literature by providing a critical understanding of human behaviours detrimental to change towards sustainability, such as adult bullying behaviours, and their use to implement neoliberal aims. This included a heightened understanding of how community residents in both cases failed to identify or acknowledge the behaviours they experienced as bullying. The community residents’ lack of understanding of how bullying was normalised in the local context meant it was difficult for them to respond in ways that supported sustainable alternatives. This conundrum was exacerbated with the identification that some community members also lacked awareness that many of their everyday actions supported sustainability.
This research provided a framework for future research into the social-ecological context of adult bullying behaviours in local community settings, particularly as they are manifested in the behaviours of those implementing neoliberal aims. Future research needs to extend on two knowledge bases in local communities. The first is local community identification and responses to alleviating neoliberal bullying. The second is a greater ability to identify, understand and safeguard sustainable behaviours at the community level. One avenue of future research identified was the development of community sustainability frameworks (CSFs) that incorporate these knowledge bases. These CSFs would need to be developed to coincide with the increased recognition that social change towards sustainability requires a transdisciplinary and in some communities a supradisciplinary approach to policy, research, and practice at all social levels
Are neoliberalist behaviours reflective of bullying? New perspectives on influences on sustainability and global citizenship
The global sustainability crisis facing humanity is a cultural crisis with neoliberal culture, the primary driver. The necessity for global change away from neoliberal systems is well established with cultural systems pursued through sustainability seen as the most viable options to alleviate this global crisis. Whilst the goals of neoliberalism and sustainability are systemic and universal, those implementing them work at a specific level with individuals, groups and/or collectives. The literature fails, however, to provide specific examples of why, on a practical level, social change agents often struggle to implement sustainability goals. One of the primary reasons for these struggles can be found in an examination of human behaviour, for instance personality types, group dynamics and/or interpersonal or group communication skills (or lack thereof). This exploratory paper will investigate the existence of a nexus between neoliberalist and adult bullying behaviours to initiate discussion on the barriers this combination may have on social change for sustainability and global citizenship. This examination is warranted as the propensity in the neoliberalist system to support the use of bullying behaviours by its advocates is a complex, nuanced and underresearched topic. There are implications here for policy development, social and urban planning, education and governance for sustainability and global citizenship
Minions, mates and linchpins: A qualitative examination of the local social-ecological context of neoliberalist bullying impacting on sustainability domains and responses through community sustainability frameworks
The current global sustainability crisis is a cultural crisis (Bokova, 2013; NASA, 2018). This crisis is due largely to the negative effects created by the amorphous nature of neoliberalism (Gittins, 2010; Latouche, 2010a; Washington, 2015). The 2030 Agenda for Sustainable Development (United Nations Development Programme (UNDP), 2011) outlined seventeen goals sought to rectify this crisis. The practical realisation of these goals has proven elusive to those seeking social change as they navigate negative human behaviours in local social contexts. This research explored adult bullying behaviours as one way to examine the clash between neoliberal and sustainable systems and the dysfunctionalities found in this social dynamic at a local community level.
Cross-case study research methodology generated qualitative data from economically focussed developments in two communities in regional Australia. The presence in each case study of social interactions between individuals advocating for the perpetuation of neoliberalism and people seeking sustainability aims guided the selection of cases for this research. This first case context was a community (Arendelle community) living, and co-existing, near a non-towered aerodrome. Historically a holiday destination, the community had a range of socio-economic groups and encompassed a number of nature reserves. The case begins in 2006 with the introduction of a regional aviation company moving into the area for the purpose of implementing a portion of an international aviation contract. The second case (Gumnut Landcare) was a semi-rural community near forest and protected natural areas. Evident in the daily life of the community was a high level of understanding and implementation of sustainability practices including many forms of sustainable eco-centric lifestyle. The area also had a European dairy farming history. This case began in 2001 with the initial negotiations to purchase a parcel of land for a community site development and the desire for a special interest group to develop much of the land for an 18-hole golf course. The cross-case analysis allowed the examination of issues that represented not only the comparison of adult bullying by those advocating neoliberal aims in each case but current topical concerns relating the impacts on elements of sustainability domains and achieving sustainability aims.
This methodology and associated methods were suitable for a critical social constructionist form of interpretivist research. The data collection instruments included in-depth interviews (seven in the first case and six in the second); continual personal communication with key individuals in each case (a long-term RA committee member in Arendelle case and long-term permanent employee of Gumnut Landcare); documentary analysis of public, organisational and historical records; and researcher observations. This research contributed to the extension of our understanding of cross-case study research through the discovery of interconnected units of analysis. This strengthened the value of case study methodology in social-ecological research.
A key concept that emerged in this research but was absent in the literature on social change towards sustainability, was the need for an understanding of human behaviours considered detrimental to achieving sustainability aims, in particular, adult bullying, and the skills to alleviate those behaviours. The research extended, therefore, on the theoretical understanding of adult bullying in the social-ecological contexts of sustainability at a local community level. Firstly, it extended on the literature that examines bullying in corporate settings by constructing a normalised pattern of bullying behaviour for business development at the community level. Secondly, three categories of social connections between bystanders who utilised bullying behaviours to support individual neoliberalists emerged in each case—minions, mates and linchpins. A deeper understanding of the perpetuation of this social normalisation of bullying transpired through the surfacing of the linchpin as a new type of bystander pivotal in linking the bullying events in both cases and these cases to the broader neoliberal system.
The research contributed to greater theoretical clarity around the barriers to implementation of social change towards sustainability at the local community level. It filled a gap in the literature by providing a critical understanding of human behaviours detrimental to change towards sustainability, such as adult bullying behaviours, and their use to implement neoliberal aims. This included a heightened understanding of how community residents in both cases failed to identify or acknowledge the behaviours they experienced as bullying. The community residents’ lack of understanding of how bullying was normalised in the local context meant it was difficult for them to respond in ways that supported sustainable alternatives. This conundrum was exacerbated with the identification that some community members also lacked awareness that many of their everyday actions supported sustainability.
This research provided a framework for future research into the social-ecological context of adult bullying behaviours in local community settings, particularly as they are manifested in the behaviours of those implementing neoliberal aims. Future research needs to extend on two knowledge bases in local communities. The first is local community identification and responses to alleviating neoliberal bullying. The second is a greater ability to identify, understand and safeguard sustainable behaviours at the community level. One avenue of future research identified was the development of community sustainability frameworks (CSFs) that incorporate these knowledge bases. These CSFs would need to be developed to coincide with the increased recognition that social change towards sustainability requires a transdisciplinary and in some communities a supradisciplinary approach to policy, research, and practice at all social levels
Outcomes of stereotactic body radiotherapy for unresectable primary or recurrent cholangiocarcinoma
Stereotactic Body Radiation Therapy (SBRT) Combined With Chemotherapy for Unresected Pancreatic Adenocarcinoma
Copyright © 2014 The Author(s). Published by Wolters Kluwer Health, Inc. Objectives: The role of radiation therapy in the management of unresectable pancreatic cancer is controversial. One concern about concurrent chemoradiation relates to the timing of chemotherapy. In contrast to conventional radiation therapy, stereotactic body radiation therapy (SBRT) delivers high doses in a shorter duration resulting in minimal disruption in chemotherapy. Here, we report our results of patients treated with SBRT and chemotherapy for inoperable pancreatic cancer. Materials and Methods: Thirty-eight patients treated with SBRT and chemotherapy for locally advanced, borderline resectable, and medically inoperable pancreatic cancer at our institution from January 2008 to December 2012 were included in this retrospective analysis. Treatment was delivered in 5 fractions of 5 or 6 Gy per fraction over 5 days. Toxicities were scored using the Common Terminology Criteria for Adverse Events version 3. Survival was calculated using the Kaplan-Meier method. Results: The median age was 70 years (range, 45 to 90 y). Eastern Cooperative Oncology Group performance status ranged from 0 to 3. Thirty-four patients received concurrent chemotherapy. Four patients received sequential chemotherapy. Median overall survival was 14.3 months and median progression-free survival was 9.2 months from diagnosis. From radiation, overall survival and progression-free survival were 12.3 and 6.8 months, respectively. The overall local control rate was 79%. Acute toxicity was minimal. Severe late SBRT-related toxicities included 1 grade 3 gastric outlet obstruction, 1 grade 4 biliary stricture, and 1 grade 5 gastric hemorrhage. Conclusions: SBRT combined with chemotherapy for unresectable pancreatic cancer is convenient, feasible, and generally well tolerated. Outcomes of SBRT combined with chemotherapy compare favorably to results obtained with chemotherapy and conventional radiation therapy