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Background: Fragile X syndrome (FXS) is an early diagnosed monogenic disorder, associated with a striking pattern of cognitive/attentional difficulties and a high risk of poor behavioural outcomes. FXS therefore represents an ideal model disorder to study prospectively the impact of early attention deficits on behaviour. Methods: Thirty-seven boys with FXS aged 4-10 years and 74 typically developing (TD) boys took part. Study 1 was designed to assess visual and auditory attention at two time-points, 1 year apart. Study 2 investigated attention to multimodal information. Both tested attention markers as longitudinal predictors of risk for poor behaviour in FXS. Results: Children with FXS attended less well than mental-age matched TD boys and experienced greater difficulties with auditory compared to visual stimuli. In addition, unlike TD children, they did not benefit from multimodal information. Attention markers were significant predictors of later behavioural difficulties in boys with FXS. Conclusions: Findings demonstrate, for the first time, greater difficulties with auditory attention and atypical processing of multimodal information, in addition to pervasive global attentional difficulties in boys with FXS. Attention predicted outcomes longitudinally, underscoring the need to dissect what drives differing developmental trajectories for individual children within a seemingly homogeneous group. [ABSTRACT FROM AUTHOR]

Signaling dissatisfaction with particular events, policies, or situations, modes of protest encompass individual expressions through to the development and mobilization of social movements. Indeed, protests can range from bodies blocking space and time to the aggregation of clicked signatures in an online petition and the sharing of campaign content through social media. All of these modes are currently employed within the Australian public sphere to bring about change or closure of the live export industry. This article analyzes the current dimensions and flows of public protest against Australia's live export industry, examining how they are shaped not only by a myriad of organizations but also by differing modes of protest, as well as by the different modes of appeal in use by activists to mobilize the Australian public sphere in protest. Through this discussion, insight is gained into some of the capacities and efficacies of multimodal protest and its significance for both public engagement and political and industry uptake. [ABSTRACT FROM AUTHOR]

Multinational corporations use nationalism as a marketing tool to promote products. Vice versa, marketing facilitates positive images of the nation. The advertising of multinational corporations therefore covertly contributes to people's understanding of identity. It is against this background that this research investigates how the relationship between nation-states and multinational corporations is established in advertising discourse. Drawing on multimodal critical discourse analysis as a theoretical framework, this study examines a marketing campaign of the multinational supermarket chain Woolworths in Australia. The main research question is "How does advertising discourse establish a link between nation-states and multinational corporations?" To address this central question, this study investigates how (1) the world is represented in advertising discourse, (2) various imagined communities are represented in advertising discourse, and (3) Australia is represented as different from all other nations in the campaign. Findings suggest that banal forms of cosmopolitanism go hand in hand with banal forms of nationalism in the campaign. Under the guise of educating customers, these ideologies serve to promote consumption and brand the company as Australian. [ABSTRACT FROM AUTHOR]

Observational studies have found that placement of peripheral intravenous cannulas (PIVCs) in the antecubital fossa (ACF) is associated with increased risks of infection, including healthcare-associated Staphylococcus aureus bacteraemia (HA-SAB). Avoiding placement of the PIVC in the ACF area along with other preventive measures such as aseptic technique, staff education on documentation, standardised insertion packs and alerts for timely removal, may reduce the overall risk of acquiring an HA-SAB. Aim: To implement a multimodal awareness programme on ACF cannulas and the risk of infection, and to reduce PIVC-associated HA-SAB in one hospital in Australia. Method: The authors performed a baseline digital survey to identify root causes for clinical decision making related to PIVCs and to raise awareness of the project. The authors performed weekly audits and provided feedback on four key wards over 12 weeks. Simple linear regression was used to look at the trend of ACF cannulation rates over time. HA-SAB rates were calculated per 10 000 occupied bed days. Findings: Improved insertion documentation was observed during the intervention period. The ACF cannulation rates decreased by 0.03% per day during the study, although this did not quite reach statistical significance (P=0.06). There were no PIVC-associated SAB events during the intervention period. The SAB rates decreased by 0.02% per day over the period of the study. [ABSTRACT FROM AUTHOR]

It is well-established in both scholarship and policy documents that students' home language practices can be leveraged as a key resource for their learning. However, it can be challenging for teachers to embed students' language resources in class activities in ways that link to wider learning objectives. We report how the inclusion of home language literacy practices can both enhance English language learning and promote multiliteracies. Data are drawn from a design-based study on the incorporation of home languages in the teaching of English. In the article, we focus on the teaching and learning that occurred in the classroom of two English as an Additional Language (EAL) teachers. Data collected comprised lesson sequences, teacher reflection, student work samples and student reflection. It was found that teacher-initiated support for home language literacy practices led to positive student engagement. The support included giving an active role to bi/multilingual teaching assistants and Google Translate. [ABSTRACT FROM AUTHOR]

This paper reports on an instrumental case study exploring what migrant and refugee-background youth in Australia make of the critical media literacy they learn in school, and what critical media practices they use out of school. It addresses the perennial question of the relationship between school literacy learning and everyday literate lives, paying deliberate attention to the experiences of youth whose diversity is underrepresented in research. Interviews with two English teachers and focus groups with culturally and linguistically diverse Year 10 students were analysed using content analysis and the concept of recontextualization. Findings are that these youth see significant value in their critical literacy learning at school, and they report utilising the types of critical reading/viewing skills they experience at school but for different purposes. They frequently use five main strategies for critical reading/viewing out of school: 1. using awareness of myriad multimodal semiotic features to examine representations of products and information; 2. evaluating trustworthiness; 3. fact checking; 4. doing further research; 5. identifying attempts at positioning. This research brings in-school and out-of-school domains together to understand the connections between critical literacy practices undertaken in school, and those reshaped by immigrant youth, who are still learning English, out of school. [ABSTRACT FROM AUTHOR]

This study seeks to understand the role of representation in news media, trust in news, and participation in multicultural audiences' sense of belonging to society. A multimodal survey combining online, CATI, and CAPI methods was conducted in Australia at the end of 2021 and early 2022 (N =1,084). The top five non-English language communities in Australia (Arabic, Cantonese, Italian, Mandarin, and Vietnamese) were included in the survey, of which n =851 were born overseas. The findings reveal a significant link between the perception of sufficient representation in Australian news media, trust in news, confidence to participate in society, and sense of belonging. When multicultural audiences see themselves fairly and adequately represented in the news, they are more likely to trust the news and participate in the community by discussing the news and current affairs. This, in turn, leads to a stronger sense of belonging to society. We also found confidence in English and time spent in Australia were important factors contributing to perceptions of representation. While the length of stay has a positive impact on the perception of representation among those with high confidence in English, this perception is significantly lower among those who have lower confidence. This result confirms the significant role language proficiency plays in migrants' experiences in the host country. [ABSTRACT FROM AUTHOR]

Introduction: Neurosyphilis is an infection caused by the spirochete Treponema pallidum, which causes infiltration and thickening of brain meninges. Despite being an Old World disease, the rates of infection continue to rise. This clinical challenge involves early and accurate diagnosis, as neurosyphilis masquerades with various clinical symptoms and is often missed during initial presentation to the hospital. A comprehensive history and clinical examination are essential to detect suspicious cases early for further cerebrospinal fluid examination and neuroimaging. Patients treated with benzylpenicillin for a specific duration often show promising clinical and cognitive improvement, thus emphasizing the need for constant vigilance in our day-to-day practice.Case Presentation: A 77-year-old Caucasian gentleman presented to our hospital repeatedly with multiple episodes of presyncope and cognitive impairment. He also demonstrated bilateral deafness, tabes dorsalis, and left sixth cranial nerve palsy. His cerebrospinal fluid examination showed a nonreactive venereal disease research laboratory test, and magnetic resonance imaging of the brain revealed a gumma.Conclusion: The diagnosis of neurosyphilis in the elderly requires a combination of clinical vigilance and a high index of suspicion, along with multimodal investigations, including cerebrospinal fluid examination and brain imaging. [ABSTRACT FROM AUTHOR]

It is important that educators understand learning styles as an evolving individual characteristic. We investigate the changes in learning styles and preferences of first-year undergraduate nursing/midwifery students after six months of preliminary testing. Curry’s ‘onion ring model’ proposes a stable inner ‘Information processing’ style (assessed by instruments such as Kolb Learning Style Inventory) compared to the outer ‘Instructional preference’ style (assessed by the VARK (Visual/Aural/Read–Write/Kinaesthetic) questionnaire), which is more easily influenced by external factors. Therefore, re-examining students after one semester of teaching should result in an increase in multimodal VARK learning with lesser changes to the LSI results. A cross-sectional survey with pre-post design (n = 96) showed 45% of students remaining in the same VARK mode, 30% becoming more multimodal and 25% showing changes. Surprisingly, the LSI questionnaire showed similar results with 45% of students remaining in the same learning modality and 55% of students changing. This research highlights the dynamic changes within students’ information processing and instructional preferences. [ABSTRACT FROM AUTHOR]

In a 2013-2014 Australia-China Council project, middle school students in Australia and China shared digital stories about their everyday lives and local cultures, and traditional tales with a modern twist. This article reports on research that aimed to explore the successes and challenges associated with this digital story exchange between Australia and China as a pedagogical approach to support language learning and intercultural understanding. An interpretivist approach was taken, focusing on the perspectives of the teachers. According to the teachers, the exchange was successful to a degree in supporting students' learning in the areas of language, intercultural understanding and twenty-first-century skills, including digital literacies and technological skills, and helped teachers extend their pedagogical horizons. A number of challenges also arose. Analysis of interview data revealed that both the successes and challenges fell into four interrelated domains, which we have labelled structures, practices, capabilities and technologies. This article offers new insights into the exchange of multimodal digital stories as learning activities in the Australian-Chinese context and provides recommendations to guide educators in these four domains. [ABSTRACT FROM AUTHOR]

The 'family crisis' narrative is frequently used in dementia studies to explain ethnic minority families' pathways to health and aged care and why there is delayed dementia diagnoses in ethnic minority communities. Such narratives may obscure the family carers' agency in negotiating services and managing personal, social and structural burdens in the lead up to diagnosis. To illuminate agency, this article describes ethnic minority families' pathways to a dementia diagnosis using the concept of sense-making. Three case studies were drawn from 56 video interviews with family carers of older adults with dementia from Chinese, Arab and Indian backgrounds. Interviews were conducted across Australia from February to August 2018, then translated, transcribed and thematically analysed. Findings suggest families did not enter into formal care because of a crisis, instead navigating fragmented systems and conflicting advice to obtain a dementia diagnosis and access to relevant care. This experience was driven by sense-making (a search for plausible explanations) that involved family carers interpreting discrepant cues in changes to the behaviour of the person with dementia over time, managing conflicting (medical) advice about these discrepancies and reinterpreting their relationships with hindsight. The sense-making concept offers a more constructive hermeneutic than the 'family crisis' narrative as it illuminates the agency of carers' in understanding changed behaviours, negotiating services and managing personal, social and structural barriers pre-diagnosis. The concept also demonstrates the need for a multimodal approach to promoting timely diagnosis of dementia in ethnic minority communities through dementia awareness and literacy campaigns as well as initiatives that address structural inequities. [ABSTRACT FROM AUTHOR]

Seasonal variation in resource availability can have strong effects on life histories and population densities. Emergent rocks (ERs) are an essential oviposition resource for multiple species of stream insects. The availability of ERs depends upon water depth and clast size, which vary with discharge and river geomorphology, respectively. Recruitment success for populations may depend on whether peak egg‐laying periods occur at times when ERs are also abundant. For multiple species that oviposit on ERs, we tested whether seasonal fluctuations in ER abundance were concurrent with oviposition phenology. We also tested whether high discharge drowned ERs for sufficiently long periods to preclude egg laying, and whether this problem varied between rivers differing in channel morphology and particle size distribution.We obtained a continuous timeseries of water level (WL) measured every 30 min for 2 years at sites on three rivers in south‐eastern Australia with similar hydrology but different geomorphology. A relationship between WL and ER numbers was determined empirically at each site and these relationships were used to predict ER availability over the 2 years. Egg masses of 10 species of caddisflies were enumerated each month for a year in one river to establish oviposition phenology.Abundance of ERs was inversely related to discharge in all three rivers. ERs were most abundant during autumn and scarce during spring. Site‐specific geomorphology resulted in skewed or multimodal distributions of ER abundance each year. Between years, catchment‐scale hydrometeorology mediated patterns of ER availability, despite the close proximity of sites. Temporal variance in ER availability was not consistently correlated with mean WL or WL variance. ER variance increased with WL variance, when WL was below a threshold equivalent to mean annual WL. Above this threshold, most ERs were likely to be submerged.Oviposition phenology varied strongly among the 10 species of caddisflies, with egg‐laying ranging from 1–2 months to year‐round. Temporal variations in ER and egg mass abundance were not correlated for most species. Below a threshold minimum number of ERs, egg masses were highly crowded onto the few available ERs, which is evidence that ERs were in short supply. For five species, high egg mass abundance was positively associated with periods of the year when the time above the threshold number of ERs was high. Unusually, two species laid most egg masses during winter and when the time above this threshold was short. Three species showed no association between egg mass abundance and time above this threshold; two of these species laid eggs year‐round.Regional hydrometeorology controlled the availability of ERs, but between‐river differences were sufficient to deliver different outcomes in the availability of oviposition sites between years and seasons. Caddisflies were rarely prevented from laying eggs but periods when ERs were in short supply created crowding, which may be associated with negative fitness effects on hatching larvae. Geomorphological controls on availability of oviposition resources may have strong implications for the coexistence of species that overlap in egg‐laying phenology. ​ [ABSTRACT FROM AUTHOR]

Aims and objectives. To describe the development and evaluation of a pre-emptive and multimodal pain management protocol that aims to improve patient experiences following vitreo-retinal day surgery. Background. Vitreo-retinal surgery has been increasingly performed as day surgery that requires patients to undertake postoperative self-care, including the management of pain. While vitreo-retinal surgery is known to be painful in the convalescent period, pain management following day surgery has been described as problematic across many surgical specialties. Design. One hundred patient audit and in-depth qualitative interviews with nine participants. Methods. A pain management protocol was developed from research evidence, established knowledge and expert opinion, then implemented and evaluated. Results. The pre-emptive and multimodal protocol used intravenous Parecoxib in conjunction with regional ocular anaesthesia and oral paracetamol. Parecoxib 40 mg was administered prior to discharge, and participants were instructed to take the paracetamol six hours post-regional anaesthesia. Rescue analgesia was also provided. Following implementation of the protocol in a single clinical site, low levels of pain were reported in the audited patient cohort and confirmed in the qualitatively explored experiences of nine participants. Conclusions. The results of this study were encouraging, in that post vitreo-retinal day surgery pain appeared to have been successfully self-managed with a multi-modal and pre-emptive protocol. The protocol was flexible and sensitive to patient comorbidities, surgical complexity, previous experiences and medical preferences. Further research is required to consolidate the success of this protocol to effectively support patients' self-care pain management and provide capacity to generalise the findings. Relevance to clinical practice. Knowledge developed through this clinically based research has the potential for informing future patient care across many sites where day surgery is an integral component of treatment for people with vitreo-retinal disease. [ABSTRACT FROM AUTHOR]

In this paper, we propose a social semiotic approach to studying PowerPoint in university classrooms. Our approach is centred on two premises: (1) PowerPoint is a semiotic technology that can be integrated into the pedagogical discourse of classrooms, and (2) PowerPoint technology encompasses three interrelated dimensions of social semiotic practices: the design of the software, the composition of the slides and the slideshow-supported presentations, i.e. lectures. Using this approach, we explore how PowerPoint has been used in seven cultural studies lectures in an Australian university. Our analysis demonstrates how multimodal resources in PowerPoint have been used for pedagogic recontextualisation. More specifically, it shows how different semiotic resources have been deployed and combined to recontextualise two key types of knowledge – signifying practice and subjectivity – in the classroom discursive space, and how different strengths of pedagogic framing are achieved multimodally. [ABSTRACT FROM AUTHOR]

An otherwise healthy 72-year-old Chinese patient diagnosed with exudative age-related macular degeneration and decreased vision in left eye was fully investigated. The retrospective analysis of past multimodal imaging revealed bilateral severe choroidal neovascularization and choroiditis associated with a positive tuberculin skin testing and interferon-gamma release assay (QuantiFERON-TB Gold – Cellestis®, Chadstone, VIC, Australia) suggestive of latent ocular tuberculosis. The variable presentation and tests' results interpretation represent the greatest limitations in understanding and treating intraocular TB (IOTB). This may present without any other systemic symptoms, the intraocular tissues are of limited access to biopsies and other tests, including imaging and immunological tests, are of relative value. This case highlights how variable may be the presentation of IOTB, which can be easily misdiagnosed leading to a delayed treatment and worse prognosis. [ABSTRACT FROM AUTHOR]

Current studies in design education suggest that students and educators base their designs on what they already know about themselves and their peers, or on stereotypical notions of others. This article presents a critical examination of a pedagogical approach employed in several architecture and interior design studios to determine how best to develop student understanding of how to design for real users and users with abilities different from themselves. This authentic learning approach with spatial design students and teachers from the School of Design, Queensland University of Technology, Australia and with people with differing abilities, used qualitative and quantitative questionnaires, student journals and design studio projects to create a multimodal data set. While there are no simple conclusions, or easy answers to unravel the complexity in creating inclusive designs, our findings point towards enabling new engagements and knowledge processes and scaffolding these activities around authentic learning, so that design students and educators can begin to understand the differing ways of designing for/with people with disabilities. The significance of this research is that it opens up new approaches for teaching design students about inclusive design beyond fake personas, building codes and anthropometric data, and provides evidence of the need for a more holistic, authentic and scaffolded approach. [ABSTRACT FROM AUTHOR]

Background/Objective: People living with dementia (PLWD) in residential aged care homes (RACHs) are frequently prescribed psychotropic medications due to the high prevalence of neuropsychiatric symptoms, also known as behaviours and psychological symptoms of dementia (BPSD). However, the gold standard to support BPSD is using psychosocial/non-pharmacological therapies. This study aims to describe and evaluate services and neuropsychiatric outcomes associated with the provision of psychosocial person-centred care interventions delivered by national multidisciplinary dementia-specific behaviour support programs. Methods: A 2-year retrospective pre-post study with a single-arm analysis was conducted on BPSD referrals received from Australian RACHs to the two Dementia Support Australia (DSA) programs, the Dementia Behaviour Management Advisory Service (DBMAS) and the Severe Behaviour Response Teams (SBRT). Neuropsychiatric outcomes were measured using the Neuropsychiatric Inventory (NPI) total scores and total distress scores. The questionnaire version "NPI-Q" was administered for DBMAS referrals whereas the nursing home version "NPI-NH" was administered for SBRT referrals. Linear mixed effects models were used for analysis, with time, baseline score, age, sex, and case length as predictors. Clinical significance was measured using Cohen's effect size (d ; ≥0.3), the mean change score (MCS; 3 points for the NPI-Q and 4 points for the NPI-NH) and the mean percent change (MPC; ≥30%) in NPI parameters. Results: A total of 5,914 referrals (55.9% female, age 82.3 ± 8.6 y) from 1,996 RACHs were eligible for analysis. The most common types of dementia were Alzheimer's disease (37.4%) and vascular dementia (11.7%). The average case length in DSA programs was 57.2 ± 26.3 days. The NPI scores were significantly reduced as a result of DSA programs, independent of covariates. There were significant reductions in total NPI scores as a result of the DBMAS (61.4%) and SBRT (74.3%) programs. For NPI distress scores, there were 66.5% and 69.1% reductions from baseline for the DBMAS and SBRT programs, respectively. All metrics (d , MCS, MPC) were above the threshold set for determining a clinically significant effect. Conclusions: Multimodal psychosocial interventions delivered by DSA programs are clinically effective as demonstrated by positive referral outcomes, such as improved BPSD and related caregiver distress. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine educators' and specialists' provision of communication adjustments for students on the autism spectrum in mainstream and supported education settings. Secondary analysis of data collected from educators and specialists in the Australian Autism Educational Needs Analysis was undertaken. Thematic analysis of adjustment descriptions identified 11 categories. The use of the 11 specific adjustment categories with reference to (a) participant group (educator versus specialists), and (b) setting (mainstream versus supported) were described and associations investigated using Chi-square analyses. Only 32% of the 381 educators and specialists reported using adjustments. Of the adjustments reported, those categorised as "Multimodal Communication", "Structured Teaching", and "Assistive Technology" were frequently included by both groups. Significant associations were apparent between groups and the use of specific adjustments including naturalistic communication strategies. Significant differences were evident in the proportion of specific adjustments used by participants in supported as opposed to mainstream settings. Possible reasons for the differences in the adjustments reported by educators and specialists and the role that setting may play in these are discussed. These include resourcing, the choice of adjustment being driven by school setting rather than student need, and possible differences between professionals in describing the adjustments made. [ABSTRACT FROM AUTHOR]

Background Calciphylaxis is a rare disease, predominantly affecting patients with chronic kidney disease (CKD) and associated with significant morbidity and mortality due to progressive cutaneous calcification, necrotic ulceration and infection. Clinical registries have been established to better understand the risk factors, optimal treatments and disease outcomes of calciphylaxis. Methods We established a prospective, Internet-based clinical registry for the online notification of calciphylaxis cases in Australia. Seven institutions participated, with data recorded on patient characteristics, biochemical parameters, treatments and disease outcomes. Results Between 2014 and 2019, 47 cases of calciphylaxis were registered. The mean patient age was 66 ± 11 years and body mass index was 35 ± 9 kg/m2, with a higher proportion of females (51%). Eighty-seven percent of patients had end-stage kidney disease (ESKD), with 61% on hemodialysis or hemodiafiltration, with a median dialysis vintage of 4.8 [interquartile range (IQR) 1.7–7.4)] years. Five patients had CKD not requiring dialysis and two were kidney transplant recipients. Diabetes was present in 76% of patients and the cause of ESKD in 60%; 34% received vitamin K antagonists (VKAs) before diagnosis. The median parathyroid hormone level at diagnosis was 32 (IQR 14–50) pmol/L. The most common site of calciphylaxis was the lower limbs (63%), with 19% of patients having more than one area involved. Ten patients (22%) had a resolution of calciphylaxis and 25 died, with 50% mortality at a median of 1.6 (IQR 0.2–2.5) years from diagnosis. Conclusions The Australian Calciphylaxis Registry highlights risk factors for calciphylaxis, including diabetes, obesity and VKA use. Resolution of calciphylaxis is uncommon despite multimodal therapy and mortality from calciphylaxis in the first year following diagnosis remains high. [ABSTRACT FROM AUTHOR]

Background Chronic prescription opioid use is a major international public health issue associated with significant harms, including increased risk of hospitalisation, morbidity and death. Guidance for healthcare professionals on when and how to deprescribe or reduce opioids is required. A key step for guideline development for deprescribing pharmacotherapy is to understand the perspectives of stakeholders. The aim of this study was to explore the perspectives of healthcare professional stakeholders on the challenges associated with opioid deprescribing and factors to be considered in the development of opioid deprescribing guidelines. Methods A qualitative study was undertaken with a purposive sample of healthcare professionals including prescribers, pharmacists and nurses. An initial cohort of participants was identified at the 2018 Australian Deprescribing Network annual meeting and two focus groups were conducted (n=20). Individual interviews were conducted with a further 11 healthcare professionals. Focus groups and interviews were audio-recorded and transcribed verbatim. Data underwent inductive thematic analysis using a phenomenological perspective. Results Healthcare professionals viewed opioid deprescribing as a challenge and identified several key barriers to deprescribing in clinical practice. Medication, patient, prescriber and health system level challenges were identified. Participants requested evidence-based guidance on the withdrawal of opioid therapies and suggested that prospective opioid deprescribing guidelines require a multitarget, multimodal intervention strategy that addresses patient psychosocial factors and incorporates behavioural change techniques. Conclusion Opioid deprescribing was perceived as a complex and challenging practice with continued prescribing the default behaviour. Evidence-based opioid deprescribing guidelines may be a valuable resource for clinicians to support clinical decision-making and reduce suboptimal opioid use. [ABSTRACT FROM AUTHOR]

The notions of 'Country' and 'Land' lie deep at the heart of Indigenous epistemologies and ontologies, and this is true for both Indigenous peoples who live in remote communities and those who reside in Australia's urban centres. Country and Land are more than a geographical location; they are highly complex notions that shape understandings of identity and wellbeing for Australian First Nations. Yet, the age of the 'Anthropos' suddenly introduced into the continent by settler colonialism brought about drastic changes and new configurations within the relationship between 'life' and 'nonlife', ownership and stewardship. Such relations are constantly negotiated and debated as Indigenous communities strive to protect their homes, claim their land back and reconnect to Country using the means at their disposal. Digital technology, in particular, has become a very important tool in the hands of Indigenous communities over the past decade. Many are the projects that use digital technologies and platforms, from applications like #Thismymob (Digital Land Rights Project) to Kurdiji 1.0, the 3D animations of the Wunungu Awara project, and the work of the Karrabing Collective, just to mention a few. Looking at the narratives portrayed in the filmography of the Karrabing Collective from a multimodal perspective, and with a primary focus on the film Wutharr, this article explores approaches to Country and Land as mediated via the digital. Through these examples and case study, I thus argue that the digital provides a productive terrain to challenge current configurations of Land management, while proposing new forms of sovereignty, from the digital to the real. In order to better support these claims, I have embraced a theoretical framework that draws from Indigenous knowledges and methods, posthuman critical theory and geontologies. [ABSTRACT FROM AUTHOR]

Contemporary curriculum guidelines, such as those provided in the incoming Australian curriculum, call for English to attend to multimodal forms of text and literacy as well as more traditional forms. Students are expected to become capable and critical readers, users and creators of texts and forms of literacy that span everything from newspapers to classic texts to visual art to computer games. How to do so, and what this means for English, is often less clear. In this paper, we describe an English curriculum that was at once literary and multimodal, analytic and creative, and embraced a range of opportunities for students to study and create literary and aesthetic texts in many forms. We discuss the opportunities this presented to connect with the excitement of the contemporary world, and the ways in which longstanding principles and philosophies of good teaching and learning, and the central concerns of English curriculum across time, might be understood and reconstituted in the digital age. [ABSTRACT FROM AUTHOR]

Background: The major influences on musculoskeletal medicine practitioners in Australia in the last 20 years have been from an eclectic mix of local and international experts and evidence from many disciplines. This has resulted in practitioners with a multimodal approach that combines evidence with pragmatism. The effectiveness of this combined approach on Australian patients with low back pain needs testing to see if it has broader application. Objectives: This study aimed to measure the effectiveness of a multimodal approach practiced by musculoskeletal medicine practitioners in a private clinic setting supported by a referral network of allied health professionals. Patients and Methods: This non-randomised, non-consecutive audit comprised 75 patients with low back pain with or without leg pain from three musculoskeletal medicine practices in Queensland, Australia. Pain, disability, general health and global response were followed in participants for 6 months. Results: For this cohort, the mean ± SD age was 45 ± years and the median duration of low back pain was 4 years (IQR, 0.5-8 years). The follow-up rate at 6 months was 75%. Clinically and statistically significant reductions in mean scores from baseline to 6 months were noted for pain from 5.5 (95% confidence interval [CI], 5.0-6.0) to 2.9 (95% CI, 2.3-3.5) at 6 months and for Roland-Morris disability questionnaire from 12.2 (95% CI, 11.0-13.3) to 7.7 (95% CI, 6.2-9.2). At 6 months, 51% were much improved or very much improved. Better reductions in pain and disability were noted in subgroups that were not working, that had pain duration up to 3 months and a past history of one to two episodes of low back pain. Conclusions: The improvements in pain and disability at 6 months observed in this study were similar to those observed for other conservative treatment methods for chronic low back pain. [ABSTRACT FROM AUTHOR]

This paper describes a practical automated procedure to calibrate and validate a transit assignment model. An optimization method based on particle swarm algorithm is adopted to minimize a defined error term. This error term which is based on the percentage of root mean square error and the mean absolute percent error encompasses deviation of model outputs from observations considering both segment level as well as the mode level and can be applied to a large scale network. This study is based on the frequency-based assignment model using the concept of optimal strategy while any transit assignment model can be used in the proposed methodological framework. Lastly, the model is validated using another weekday data. The proposed methodology uses automatic fare collection (AFC) data to estimate the origin–destination matrix. This study combines data from three sources: the general transit feed specification, AFC, and a strategic transport model from a large-scale multimodal public transport network. The South-East Queensland (SEQ) network in Australia is used as a case study. The AFC system in SEQ has voluminous and high quality data on passenger boardings and alightings across bus, rail and ferry modes. The results indicate that the proposed procedure can successfully develop a multi-modal transit assignment model at a large scale. Higher dispersions are seen for the bus mode, in contrast to rail and ferry modes. Furthermore, a comparison is made between the strategies used by passengers and the generated strategies by the model between each origin and destination to get more insights about the detailed behaviour of the model. Overall, the analysis indicates that the AFC data is a valuable and rich source in calibrating and validating a transit assignment model. [ABSTRACT FROM AUTHOR]

Background: Vancomycin is the primary treatment for methicillin‐resistant Staphylococcus aureus infections. Hospital audits have showed that dosing and therapeutic drug monitoring practices for vancomycin are suboptimal. Limited studies have examined the current educational resources used to support vancomycin use. Aims: To explore and compare the perceptions of health educators and recipients of education on the methods currently used to educate health professionals about vancomycin and to identify ideal methods of education. Methods: Semi‐structured interviews were conducted with health educators around Australia and with recipients of education (doctors and nurses). Interview questions explored previous experiences of education and perceptions of ideal methods of education. Interviews were audio‐taped, transcribed and thematically analysed. Results: Health educators explained that current vancomycin education comprises large‐scale presentations, but they perceived these to be ineffective. The recipients of vancomycin education reported a lack of formal education on vancomycin. Despite this, both educators and recipients agreed on the ideal methods of education: nurses are reported to be protocol driven, and education for nurses should be through in‐services or e‐learning modules, while doctors require an evidenced‐based approach. Senior doctors initially require convincing that education is needed. Once convinced, they respond well to brief emails and case‐based and one‐on‐one education strategies. Technology‐based strategies and problem‐based learning were observed to be effective methods for junior doctors. Conclusions: Vancomycin dosing and therapeutic drug monitoring involves multiple health professionals, but current education strategies do not take this into account. Ideal education strategies need to be multimodal and targeted to specific health profession groups. [ABSTRACT FROM AUTHOR]

Aspiration for higher education has been a focus of significant policy intervention in Australia for some time, with numerous large-scale research studies investigating the formation of aspiration amongst high school students. However, case studies in particular schools which might provide insights into the complexities and contradictions of aspirations for individual young people are scarce. This paper explores aspirations for particular futures from the perspectives of young women in a single-sex NSW government school in an area of historically lower HE participation. Rather than conventional interview-based methods where researchers ask young people to articulate their plans for the future, the study adopted creative arts-based methods which enabled students to engage with each other and a range of materials to produce multimodal 'aspiration artefacts' of their imagined futures. The method assemblage privileged imagination and embodied feelings, beyond the rational information-driven pedagogies that are promoted in widening participation policies. Our close readings of artefacts created by three Year 9 girls demonstrate that aspiration is a process that is relational, embodied, affectively and discursively constituted; and further, that this is inflected by gender, class and other positionalities in elusive and unanticipated ways. Arts-based methods allow us to tentatively trace the work of thinking–feeling–imagining that is entailed in developing and articulating aspirations for particular futures. [ABSTRACT FROM AUTHOR]

Background: Severe leptospirosis can have a case-fatality rate of over 50%, even with intensive care unit (ICU) support. Multiple strategies–including protective ventilation and early renal replacement therapy (RRT)–have been recommended to improve outcomes. However, management guidelines vary widely around the world and there is no consensus on the optimal approach. Methodology/Principal findings: All cases of leptospirosis admitted to the ICU of Cairns Hospital in tropical Australia between 1998 and 2018 were retrospectively reviewed. The patients' demographics, presentation, management and clinical course were examined. The 55 patients' median (interquartile range (IQR)) age was 47 (32–62) years and their median (IQR) APACHE III score was 67 (48–105). All 55 received appropriate antibiotic therapy, 45 (82%) within the first 6 hours. Acute kidney injury was present in 48/55 (87%), 18/55 (33%) required RRT, although this was usually not administered until traditional criteria for initiation were met. Moderate to severe acute respiratory distress syndrome developed in 37/55 (67%), 32/55 (58%) had pulmonary haemorrhage, and mechanical ventilation was required in 27/55 (49%). Vasopressor support was necessary in 34/55 (62%). Corticosteroids were prescribed in 20/55 (36%). The median (IQR) fluid balance in the initial three days of ICU care was +1493 (175–3567) ml. Only 2/55 (4%) died, both were elderly men with multiple comorbidities. Conclusion: In patients with severe leptospirosis in tropical Australia, prompt ICU support that includes early antibiotics, protective ventilation strategies, conservative fluid resuscitation, traditional thresholds for RRT initiation and corticosteroid therapy is associated with a very low case-fatality rate. Prospective studies are required to establish the relative contributions of each of these interventions to optimal patient outcomes. Author summary: Severe leptospirosis continues to carry a high mortality. To improve outcomes, several countries have developed national guidelines for the management of severe disease. However, there is substantial variation in these guidelines despite the fact that severe leptospirosis has a very similar presentation around the world. In tropical Australia, the case-fatality rate of severe leptospirosis is only 4%. This retrospective study reviewed 55 patients with leptospirosis requiring support in an Australian Intensive Care Unit (ICU) in an effort to identify the management strategies that might explain these excellent outcomes. The low case-fatality rate was associated with prompt multimodal ICU support that included early antibiotics, protective ventilation strategies, conservative fluid resuscitation, traditional thresholds for renal replacement therapy initiation and corticosteroid therapy. However prospective, multinational studies–which include the resource-poor settings that bear the greatest burden of disease–are necessary to define which of these interventions have the greatest therapeutic value. [ABSTRACT FROM AUTHOR]

Context: This study investigated individual sociocognitive factors from the theory of planned behavior and their relationship to exercise for postconcussion recovery. Design and Methods: Four hundred and fifty-nine Australian adults, two-thirds of whom had no concussion history (66%), completed an online survey of their beliefs and attitudes toward exercise for postconcussion recovery. Secondary questions evaluated program design features that could affect engagement (eg, session frequency). Results: Structured equation modeling found that subjective norms were the strongest significant predictor of intention to participate in exercise for postconcussion recovery. Perceived behavioral control was also a significant predictor of intention to participate but to a lesser extent. Attitude did not predict participation intention. The design features identified as key were personalization and being supervised during the program. Conclusions: This study found that people's intention to participate in a program of exercise postconcussion recovery is shaped by individual psychological factors and identified program design features that could be adjusted for increased engagement. Program success could be maximized through strategies such as supporting individuals to have a stronger sense of control over their participation through the choice of session timing or frequency and harnessing the influence of significant others via supportive messaging from key professionals. [ABSTRACT FROM AUTHOR]

Background/Objectives: Evidence-based guidelines and care standards recommend offering oral nutrition supplements to all older adults with hip fracture, not just those already malnourished. This study aimed to identify the proportion of inpatients in a sample of hospitals in two countries that were provided with oral nutritional supplementation (ONS) following a hip fracture and to identify factors associated with ONS provision. Methods: An analysis of prospectively collected data from a bi-national Hip Fracture Registry nutrition sprint and registry audit data limited to older adults (≥65 years) undergoing surgical intervention for a fractured hip from 1 to 31 August 2021. Multivariable logistic regression was used to identify factors associated with providing ONS. Results: Patient-level data was available for 385 older adults (median 85 years; 60.5% female) admitted to twenty-nine hospitals. Less than half (n = 47.3%) of the audited inpatients were provided ONS. After adjusting for covariates, ONS was more likely to be provided to older adults who were identified as malnourished on formal testing (OR 11.92; 95%CI 6.57, 21.69). Other factors associated with prescription of ONS included those who did not have a preoperative medical assessment (OR 2.26; 95%CI 1.19, 4.27) or were cognitively impaired (OR 1.83; 95%CI 1.01, 3.32), severely frail, or terminally ill (OR 3.17; 95%CI 1.10, 9.17). Conclusions: ONS was provided in line with evidence-based recommendations for less than half of the older adults with a hip fracture in 29 hospitals in two countries. A structured approach to implementation may be required to reduce complications and improve outcomes for all older adults after a hip fracture, not just those assessed as cognitively impaired, frail, and/or malnourished. [ABSTRACT FROM AUTHOR]

Background: Digital weight loss services (DWLSs) that use Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have demonstrated potential in contributing to a shift in global obesity rates. However, reasonable concerns have been raised about the prescribing safety of these services. Prior to this study, electronic prescribing safety had only been investigated in hospital settings and community clinics. Methods: This study retrospectively analyzed prescribing errors committed over a 6-month period in 2023 at Australia's largest GLP-1 RA-supported DWLS. Results: The analysis found that 1654 (4.4%) of the 37323 audited GLP-1 RA prescriptions contained an error. Most errors pertained to insufficient safety counselling (49.15%) and inadequate investigations of potential contraindications (30.29%). Although a large portion of prescribing errors were detected via the automated query method (64.9%), the other three auditing methods all detected a significant number of true errors (>100). Patients from the highest body mass index category (40+ kg/m2) were overrepresented in the service's prescribing error data. Conclusions: These findings lay a vital foundation in the emerging literature on GLP-1 RA-supported DWLSs. [ABSTRACT FROM AUTHOR]

Background: Multiple sclerosis (MS) is a complex immune‐mediated disease with no currently known cure. There is growing evidence to support the role of diet in reducing some of the symptoms and disease progression in MS, and we previously developed and tested the feasibility of a digital nutrition education program for people with MS. Objective: The aim of this study was to explore factors that influenced engagement in the digital nutrition education program, including features influencing capability, opportunity and motivation to change their dietary behaviours. Methods: Semi‐structured interviews were conducted with people who had MS, and who completed some or all of the program until data saturation was reached. Interviews were analysed inductively using thematic analysis. Themes were deductively mapped against the COM‐B (Capability, Opportunity, Motivation, Behaviour) behaviour change model. Results: Sixteen interviews were conducted with participants who completed all (n = 10) or some of the program (n = 6). Four themes emerged: (1) acquiring and validating nutrition knowledge; (2) influence of time and social support; (3) getting in early to improve health and (4) accounting for food literacy experiences. Discussion: This is the first online nutrition program with suitable behavioural supports for people with MS. It highlights the importance of disease‐specific and evidence‐based nutrition education to support people with MS to make dietary changes. Acquiring nutrition knowledge, coupled with practical support mechanisms, such as recipe booklets and goal setting, emerged as crucial for facilitating engagement with the program. Conclusions: When designing education programs for people with MS and other neurological conditions, healthcare professionals and program designers should consider flexible delivery and building peer support to address the needs and challenges faced by participants. Patient or Public Contribution: Members of the MS Nutrition Research Program Stakeholder Reference Group, which includes people with MS and MS health professionals, provided input during the development of the nutrition education program and study design stages. [ABSTRACT FROM AUTHOR]

Background: Patient Assessment of Care in Chronic Conditions (PACIC+), included in some Australian guidelines, has been shown reliable for measuring patient engagement and perception of their care in primary care settings. Various studies have focussed on PACIC+ use in specific conditions. This study aims to expand PACIC+ to measure patient empowerment to self-manage their chronic condition and validate it in the broader Australian primary care population. This study aims to evaluate internal consistency and reliability of PACIC+ and six new supplementary items proposed to assess patient wellbeing and empowerment to self-manage their chronic condition. Methods: A repeated-measures correlation design study assessed the expanded PACIC+ over three time-points. Particpants were patients with at least one chronic disease, referred by consultant physician, or recruited by advertisement posters in hospital clinic areas. Results: PACIC+ (26-item) had acceptable internal consitency (Cronbach's alpha 0.96). Test–retest reliability (Time-1 and 2, P < 0.01) was acceptable: Total score r (48) = 0.43; and New supplementary items: Confidence r (48) = 0.54; Understanding r (48) = 0.62; Support r (48) = 0.43; Overall Health r (48) = 0.42; Overall Health Change r (48) = −0.31, P = 0.03; and Acute Episodes of Care in 1-month r (48) = 0.42, P < 0.01. Four factors from the original PACIC+ accounted for 66.5% of the variance. Conclusions: The expanded PACIC+ is an improved psychometric tool providing for the patient's voice in a shared health journey. It is a valid, reliable tool to monitor and measure self-management of chronic conditions in Australian population clinic and primary healthcare settings. Six new supplementary patient empowerment and health status measures proved reliable and, in combination with the PACIC+ psychometric tool, could offer a method to monitor and measure the self-management of chronic conditions in the Australian clinic setting and for future research. [ABSTRACT FROM AUTHOR]

Background: Group allied health interventions for people with chronic conditions may be a solution to increasing access to allied health in primary care. This umbrella review aimed to determine the effectiveness of allied health group interventions to improve health-related outcomes for adults with chronic conditions and the applicability of the findings to the Australian primary health care context. Methods: An umbrella review of systematic reviews conducted April-July 2022, searching eight databases. Systematic reviews were eligible if they included randomised controlled trials (RCT) or quasi-RCTs, community dwelling adults aged ≥ 18, at least one chronic condition, group intervention in scope for allied health professionals, and published in English after 2000. Studies were excluded if interventions were conducted in hospital or aged care facilities, out of scope for allied health, or unsupervised. Results: Two thousand three hundred eighty-five systematic reviews were identified: after screening and full text review 154 were included and data extracted from 90. The chronic conditions included: cancer (n = 15), cardiovascular disease (n = 6), mixed chronic conditions (n = 3), kidney disease (n = 1), low back pain (n = 12), respiratory disease (n = 8), diabetes (n = 14), heart failure (n = 9), risk of falls (n = 5), hypertension (n = 4, osteoarthritis (n = 6) and stroke (n = 8). Most group interventions included prescribed exercise and were in scope for physiotherapists and exercise physiologists. Overall, allied health group exercise programs for community dwelling adults improved health outcomes for most chronic conditions. Aggregated data from the systematic reviews suggests programs of 45–60 min per session, 2–3 times per week for 12 weeks. Lifestyle education and support for people with type-2 diabetes improved glycaemic control. Conclusions: Prescribed group exercise delivered by allied health professionals, predominantly by exercise physiologists and physiotherapists, significantly improved health outcomes for community dwelling adults with a broad range of chronic conditions. [ABSTRACT FROM AUTHOR]

Enhanced recovery after surgery (ERAS) protocols have been shown to improve recovery and reduce patients' risk of morbidity and mortality1 . Some researchers have noted 30 to 50 per cent reductions in post-operative hospital length of stay2--4, reductions in surgical site infections5 and decreases in admission costs6--9 . Over the past two decades, ERAS protocols have been developed to cater to the specific needs and nuances across surgical specialties and subspecialties including general surgery (e.g. breast, hepatobiliary, colorectal and upper gastric surgeries), neurosurgery and gynaecological, orthopaedic and vascular surgeries2,6 . ERAS protocols cover the entire surgical journey, including pre-admission, pre-operative, intra- operative and post-operative phases in the pathway2 . [ABSTRACT FROM AUTHOR]

Inquiry-based representation-focused approaches in science education have shown promising outcomes when students engage in knowledge building via an active process of constructing, coordinating, and evaluating representations. To date, much of the existing research around these approaches has taken place in pre-digital classrooms, but the increasing importance of digital technologies in contemporary science classrooms that has heightened during the on-going COVID pandemic could have ramifications for such approaches. To explore the potential for productive integration of a digital technology with active learning processes, this study investigated the role an interactive online learning platform played in supporting the construction and refinement of representations by students. This paper draws on research generated in the context of an Australian Grade 9 science class studying a physics unit focused on energy transfer considerations for sustainable housing. The research design featured an exploratory case study approach using multiple methods for data collection including video capture, interviews, and student artefacts. Data analysis involved the application of socio-semiotic perspectives to understand the nature of students' meaning-making processes through their generation and coordination of both digital and non-digital multimodal representations. This study found that the online platform allowed for extended access and the flexible use of multimodal resources facilitated students' representation construction activities. However, activities involving teacher-guided discussions and ongoing feedback were limited. The socio-semiotic analysis provided insights into the effective design of online learning sequences to guide conceptual development. This paper concludes by suggesting how specific affordances of interactive online platforms can effectively facilitate the design and delivery of active learning approaches involving representation construction.

Foreign accent syndrome (FAS) is characterized by new onset speech that is perceived as foreign. Available data from acquired cases suggests focal brain damage in language and sensorimotor brain networks, but little remains known about abnormal functional connectivity in idiopathic cases of FAS without structural damage. Here, connectomic analyses were completed on three patients with idiopathic FAS to investigate unique functional connectivity abnormalities underlying accent change for the first time. Machine learning (ML)-based algorithms generated personalized brain connectomes based on a validated parcellation scheme from the Human Connectome Project (HCP). Diffusion tractography was performed on each patient to rule out structural fiber damage to the language system. Resting-state-fMRI was assessed with ML-based software to examine functional connectivity between individual parcellations within language and sensorimotor networks and subcortical structures. Functional connectivity matrices were created and compared against a dataset of 200 healthy subjects to identify abnormally connected parcellations. Three female patients (28-42 years) who presented with accent changes from Australian English to Irish (n = 2) or American English to British English (n = 1) demonstrated fully intact language system structural connectivity. All patients demonstrated functional connectivity anomalies within language and sensorimotor networks in numerous left frontal regions and between subcortical structures in one patient. Few commonalities in functional connectivity anomalies were identified between all three patients, specifically 3 internal-network parcellation pairs. No common inter-network functional connectivity anomalies were identified between all patients. The current study demonstrates specific language, and sensorimotor functional connectivity abnormalities can exist and be quantitatively shown in the absence of structural damage for future study., (© 2023. Fondazione Società Italiana di Neurologia.)

Candida auris is an emerging drug‐resistant yeast responsible for hospital outbreaks. This statement reviews the evidence regarding diagnosis, treatment and prevention of this organism and provides consensus recommendations for clinicians and microbiologists in Australia and New Zealand. C. auris has been isolated in over 30 countries (including Australia). Bloodstream infections are the most frequently reported infections. Infections have crude mortality of 30–60%. Acquisition is generally healthcare‐associated and risks include underlying chronic disease, immunocompromise and presence of indwelling medical devices. C. auris may be misidentified by conventional phenotypic methods. Matrix‐assisted laser desorption ionisation time‐of‐flight mass spectrometry or sequencing of the internal transcribed spacer regions and/or the D1/D2 regions of the 28S ribosomal DNA are therefore required for definitive laboratory identification. Antifungal drug resistance, particularly to fluconazole, is common, with variable resistance to amphotericin B and echinocandins. Echinocandins are currently recommended as first‐line therapy for infection in adults and children ≥2 months of age. For neonates and infants <2 months of age, amphotericin B deoxycholate is recommended. Healthcare facilities with C. auris should implement a multimodal control response. Colonised or infected patients should be isolated in single rooms with Standard and Contact Precautions. Close contacts, patients transferred from facilities with endemic C. auris or admitted following stay in overseas healthcare institutions should be pre‐emptively isolated and screened for colonisation. Composite swabs of the axilla and groin should be collected. Routine screening of healthcare workers and the environment is not recommended. Detergents and sporicidal disinfectants should be used for environmental decontamination. [ABSTRACT FROM AUTHOR]

Instagram is an image-centric social media application, launched in October 2010 with the explicit aim of allowing members to share their smart phone photos with the world. Posts typically combine photographs with a short verbal text, and as such provide fertile ground for multisemiotic analysis. Further, at times of political significance or upheaval, Instagram, like other social media platforms, provides a space for the public to express opinions or emotions. The fact that citizens do this through a combination of words and images on Instagram is the subject of analysis in this article. Using a dataset of 92 Instagram posts that made use of the discourse tagging hashtag #dogsatpollingstations at the time of the 2016 Australian federal election, this study demonstrates the multisemiotic strategies used by members of the public to show their dissatisfaction with the incumbent government, and their endorsement of other political parties. The study also demonstrates the triangulation of multiple methods, and as such is an example of corpus-assisted multimodal discourse analysis. [ABSTRACT FROM AUTHOR]

Purpose This study investigated the implementation of a risk profiling process for physiotherapy clients with a compensable musculoskeletal problem. Implementation targeted personal (clinician) and external (organisational) factors to facilitate behavioural change with regard to the use of formal, questionnaire-based risk profiling. Methods A theoretical construct was developed for formal questionnaire-based screening to be implemented across 12 private, metropolitan physiotherapy clinics. To target personal (clinician) factors, a multimodal educational procedure was developed focused on use of the ten-item Orebro Musculoskeletal Pain Screening Questionnaire (OMPSQ-10). To target external (organisational) factors, an administrative process was enacted to ensure routine completion of the OMPSQ-10 by compensable clients. Global practice behaviour with regard to the use of formal risk profiling was complete pre- and post-implementation. Results Pre-implementation physiotherapists understood the potential usefulness of formal risk profiling, but the large majority did not routinely have clients complete these types of questionnaires. Post-implementation there was a significant positive shift in behaviour to more frequent use the OMPSQ-10 for new compensable clients. Conclusions The results provide initial support for the use of a framework to develop an implementation strategy to increase physiotherapist adherence to the use of guideline recommended risk profiling questionnaires in clinical practice. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to explore the treatment interventions complementary and integrative medicine (CIM) practitioners use in the management of an emerging health condition, increased intestinal permeability (IP), and the association these methods have on the observed time to resolve this condition. Design and setting: A cross-sectional survey of Australian naturopaths, nutritionists, and Western herbal medicine practitioners was undertaken (n = 227) through the Practitioner Research and Collaboration Initiative (PRACI) network. Outcome measures: Frequencies and percentages of the treatment methods, including chi-square analysis to examine the associations between treatment methods and observed time to resolve IP. Results: Thirty-six CIM practitioners responded to the survey (response rate 15.9%). CIM practitioners were found to use a multimodal approach in the management of IP with 92.6% of respondents using three or more categories of treatment interventions (nutritional, herbal, dietary, and lifestyle) with a mean total of 43.0 ± 24.89 single treatment interventions frequently prescribed. The main treatments prescribed in the management of IP were zinc (85.2%), probiotics: multistrain (77.8%), vitamin D (75.0%), glutamine (73.1%), Curcuma longa (73.1%), and Saccharomyces boulardii (70.4%). CIM practitioners also advocate patients with IP to reduce alcohol (96.3%), gluten (85.2%), and dairy (75.0%) consumption. Evaluation of antibiotics (75.0%) and nonsteroidal anti-inflammatory drugs (73.1%) prescriptions were frequently advised by CIM practitioners. A longer observed time to resolve IP was seen in CIM practitioners who did not reduce intense exercise in the management of IP (p = 0.02). Conclusions: This study represents the first survey of the treatments prescribed by CIM practitioners for IP and suggests that CIM practitioners use numerous integrative treatment methods for the management of IP. The treatment interventions frequently prescribed by CIM practitioners align with preclinical research, suggesting that CIM practitioners prescribe in accordance with the published literature. The findings of this study contribute to the implementation of clinical research in the management of IP, which considers multiple concurrent treatments. [ABSTRACT FROM AUTHOR]

Current Australian policies and curricular frameworks demand that teachers and students use technology creatively and meaningfully in classrooms to develop students into 21C technological citizens. English teachers and students also have to learn new metalanguage around visual grammar since multimodal tasks often combine creative with critical General Capabilities (GC) with that of the of ICTs and literacy in the Australian Curriculum: English (AC: E). Both teachers and learners come to these tasks with varying degrees of techno-literacy, skills and access to technologies. This paper reports on case-study research following a technology based collaborative professional development (PD) program between a university Lecturer facilitator and English teachers in a secondary Catholic school. The study found that the possibilities for creative and critical engagement are rich, but there are real grounded constraints such as lack of time, impeding teachers' ability to master and teach new technologies in classrooms. Furthermore, pedagogical approaches are affected by technical skill levels and school infrastructure concerns which can militate against effective use of ICTs in school settings. The research project was funded by the Brisbane Catholic Education Office and focused on how teachers can be supported in these endeavours in educational contexts as they prepare students of English to be creative global citizens who use technology creatively. [ABSTRACT FROM AUTHOR]

Background: Annual influenza vaccination of healthcare workers (HCWs) is recommended in Australia, but uptake in healthcare facilities has historically been low (approximately 50%). The objective of this study was to develop and implement a dedicated campaign to improve uptake of staff influenza annual vaccination at a large Australian health service. Methods: A quality improvement program was developed at Alfred Health, a tertiary metropolitan health service spanning 3 campuses. Pre-campaign evaluation was performed by questionnaire in 2013 to plan a multimodal vaccination strategy. Reasons for and against vaccination were captured. A campaign targeting clinical and non-clinical healthcare workers was then implemented between March 31 and July 31 2014. Proportional uptake of influenza vaccination was determined by campus and staff category. Results: Pre-campaign questionnaire responses were received from 1328/6879 HCWs (response rate 20.4%), of which 76% were vaccinated. Common beliefs held by unvaccinated staff included vaccine ineffectiveness (37.1%), that vaccination makes staff unwell (21.0%), or that vaccination is not required because staff are at low risk for acquiring influenza (20.2%). In 2014, 6009/7480 (80.3%) staff were vaccinated, with significant improvement in uptake across all campuses and amongst nursing, medical and allied health staff categories from 2013 to 2014 (p < 0.0001). Conclusions: A non-mandatory multimodal strategy utilising social marketing and a customised staff database was successful in increasing influenza vaccination uptake by all staff categories. The sustainability of dedicated campaigns must be evaluated. [ABSTRACT FROM AUTHOR]

Regular exercise is reported to improve depressive symptoms and quality of life for people experiencing mental illness. For older adults, including strength and balance can also decrease falls. Mental health services seldom include funding for Accredited Exercise Physiologist programs. A 9-week Accredited Exercise Physiologist-led program for older adults receiving mental health treatment with a community Older People's Mental Health Service was trialed in regional Australia. This clinician-conceived small-scale feasibility study utilized a two-phase concurrent triangulation mixed-method design to evaluate physical and psychological program outcomes and identify factors related to engaging in physical activity. This tailored exercise program led to improvements in measures of psychological distress and physical and psychological function. These changes corresponded with participants identifying benefits of exercising as a group of adults living with mental illness. Such findings suggest a supervised, individualized program for older mental health consumers confers physical and psychological benefits; however, further research evaluating exercise interventions with this population is required. [ABSTRACT FROM AUTHOR]

Drawing on a multimodal approach to Critical Discourse Analysis (CDA), this research critically examines the 2017 "burqa stunt" of Australian far-right populist politician, Pauline Hanson. Adapting Scalmer's (2002) conceptualisation of the "political gimmick", this paper makes the following arguments: Firstly, that Hanson's "burqa stunt" must be understood as an articulation of Islamophobia and political performance. It was the interplay of Hanson's radical right and populist ideologies that informed the stunt. As such, this paper bridges the ideational and performative approaches to populism. Secondly, the stunt was the product of the mediatisation of politics and the logics that govern contemporary media in Australia. The aim of Hanson's stunt was clear: to generate controversy and media attention. In this, the "burqa stunt" was incredibly successful and was extensively covered both nationally and internationally. The stunt was the most overt expression of the anti-Muslim racism that has defined Hanson's contemporary political resurgence. This paper furthers our growing understanding of how far-right populist actors strategically employ performance strategies designed to generate controversy and media attention. It also highlights how racist far-right actors are able to articulate Islamophobia in novel ways that exploit the logics of the contemporary media environment. [ABSTRACT FROM AUTHOR]

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Abstract: Although multimodal management of chronic noncancer pain (CNCP) is recommended, long-term treatment utilization patterns among people using opioids are not well known. The Pain and Opioids IN Treatment study recruited Australian adults receiving opioids for CNCP for more than 6 weeks from community pharmacies. Pharmacological (opioid and nonopioid analgesics and psychotropic medicines) and nonpharmacological (physical, mental health, and specialized) treatments used in the previous 12 months and 30 days were collected annually over 4 years (2015-2018). Associations were explored between 30-day treatment use and sociodemographic characteristics and pain measures. Overall, 1334 participants completed at least one annual follow-up. The median pain severity (5.0, interquartile range [IQR] 3.8 to 6.3) and pain interference scores (5.7, IQR 3.9-7.3) indicated moderate pain throughout the study period, despite most participants reporting the use of nonopioid pharmacological (12 month: 97.6% and 30 day: 96.8%) and nonpharmacological treatments (12 month: 91.8% and 30 day: 66.1%). Some treatment use was inconsistent with guidelines: ongoing nonsteroidal anti-inflammatory drugs and sedative-hypnotic use were common, whereas fewer people engaged with pain management programs (12 month: 22.3%). Private health insurance was associated with using physical (adjusted odds ratio 1.61, 99.5% confidence intervals 1.15-2.24) and specialized nonpharmacological treatments (adjusted odds ratio 1.47, 99.5% confidence intervals 1.14-1.91). This study demonstrates that many Australians taking opioids long-term for CNCP also use nonopioid pharmacological and nonpharmacological treatments. The use of pharmacological treatments including nonsteroidal anti-inflammatory drugs, psychotropic medicines, and gabapentinoids, outside guidelines, warrants review. Furthermore, despite Australia's universal healthcare scheme subsidising some nonpharmacological treatments, overall use of these treatments was associated with having private health insurance, highlighting a need for more equitable service provision. [ABSTRACT FROM AUTHOR]