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Objectives To analyse the impact of the uro-oncology multidisciplinary meeting ( MDM) at an Australian tertiary centre on patient management decisions, and to develop criteria for patient inclusion in MDMs. Methods Over a 3-month period, all cases presented at our weekly uro-oncology MDM were prospectively assessed, by asking the presenting clinician to state their provisional management plans and comparing this with the subsequent consensus decision. The impact of the MDM was graded as high if there was a major change in the management plan or if a plan was developed where there was none. Results Over the study period, 120 discussions about 107 patients were recorded. Prostate, urothelial, kidney and testis cancer represented 46 (38.3%), 36 (30%), 26 (21.6%) and 12 (10%) of the discussions, respectively. The MDM made high impact changes to the original plan in 32 (26.7%) cases. High impact changes were nearly twice as likely to occur in patients with metastatic disease as in those without metastases ( P < 0.05). Primary cross referral between disciplines occurred in 40 (33.3%) cases, including 66.7% of testicular and 42% of bladder cancers but only 26% of prostate and 19% of kidney cancers ( P < 0.02). Conclusions The uro-oncology MDM alters management plans in about one-quarter of cases. Additionally, MDMs also serve other purposes, such as cross-referral or consideration for clinical trials. Patients should be discussed in MDMs if multimodal therapy may be required, clinical trial eligibility is being considered or if metastasis or recurrence is noted. [ABSTRACT FROM AUTHOR]

Accessible Summary: What Is Known on the Subject: Smoking rates have decreased in the general population but remain high among people with severe mental illness (SMI). What the Paper Adds to Existing Knowledge: An individualized smoking cessation program was tested with 99 adults with SMI.The program showed it is possible to help people with SMI smoke fewer cigarettes and reduce nicotine addiction.Customized smoking cessation programs are essential for those with high nicotine dependence and mental health challenges. Implications for Practice: Mental health services should offer tailored tobacco cessation programs because these programs can improve the health of people with mental illness who smoke.It is important for mental health services to follow government guidelines and provide evidence‐based support. Introduction: Despite significant reductions in smoking rates in the general population over recent decades, smoking rates remain relatively unchanged among people with SMI. Aim: To evaluate the feasibility and preliminary effectiveness of the Keep Quitting in Mind pilot program, an individualized smoking cessation program for people experiencing SMI. Methods: In total, 99 adult participants with SMI and engaged with a community mental health service, participated in the intervention. The intervention included motivational interviewing and goal setting, in addition to provision of pharmaceutical aids (including nicotine replacement therapy). Results: Analysis determined that the Keep Quitting in Mind pilot program was feasible in a public adult mental health service and participation in the program was associated with reductions in the number of cigarettes smoked daily and level of nicotine addiction. Discussion: This real‐world pilot program demonstrated feasibility and potential effectiveness in reducing smoking among adults with mental illness. Aligning with government guidelines, tailored smoking cessation programs are crucial due to high nicotine dependence and mental health complexities. Implications for Practice: Given the high rates of cigarette smoking by people with mental illness and the cardiometabolic health risks associated with this, mental health services should consider adding evidence‐based and bespoke tobacco cessation programs as part of core business. [ABSTRACT FROM AUTHOR]

Sustainability leadership, exercised towards ecologically sustainable practices in business and society, has emerged as an important aim of leadership development programmes. Through the multimodal discursive analysis of a sustainability leadership centre in Australia, we demonstrate how its identity narratives reproduce individualist ideals of leadership and take for granted the hyperagency of heroic individuals to single-handedly solve environmental crises. Specifically, we illustrate how the development of sustainability leaders is co-constructed through the Buddhist narrative of Prince Siddhartha via three stages: leaders first find their calling that activates their inherent capability to effect change, reach awakening through self-discovery and self-empowerment with the help of the development programme, and finally transform the world through building both successful and meaningful careers. In the light of these findings, we question whether sustainability leadership discourses glorify the self and ironically sustain our disconnection from nature in the pursuit of business success. [ABSTRACT FROM AUTHOR]

Cave drip water response to surface meteorological conditions is complex due to the heterogeneity of water movement in the karst unsaturated zone. Previous studies have focused on the monitoring of fractured rock limestones that have little or no primary porosity. In this study, we aim to further understand infiltration water hydrology in the Tamala Limestone of SW Australia, which is Quaternary aeolianite with primary porosity. We build on our previous studies of the Golgotha Cave system and utilize the existing spatial survey of 29 automated cave drip loggers and a lidar-based flow classification scheme, conducted in the two main chambers of this cave. We find that a daily sampling frequency at our cave site optimizes the capture of drip variability with the least possible sampling artifacts. With the optimum sampling frequency, most of the drip sites show persistent autocorrelation for at least a month, typically much longer, indicating ample storage of water feeding all stalactites investigated. Drip discharge histograms are highly variable, showing sometimes multimodal distributions. Histogram skewness is shown to relate to the wetter-than-average 2013 hydrological year and modality is affected by seasonality. The hydrological classification scheme with respect to mean discharge and the flow variation can distinguish between groundwater flow types in limestones with primary porosity, and the technique could be used to characterize different karst flow paths when high-frequency automated drip logger data are available. We observe little difference in the coefficient of variation (COV) between flow classification types, probably reflecting the ample storage due to the dominance of primary porosity at this cave site. Moreover, we do not find any relationship between drip variability and discharge within similar flow type. Finally, a combination of multidimensional scaling (MDS) and clustering by k means is used to classify similar drip types based on time series analysis. This clustering reveals four unique drip regimes which agree with previous flow type classification for this site. It highlights a spatial homogeneity in drip types in one cave chamber, and spatial heterogeneity in the other, which is in agreement with our understanding of cave chamber morphology and lithology. [ABSTRACT FROM AUTHOR]

Aims and objectives To determine potential facilitators and barriers and tailor interventions to optimise future implementation of a patient-assessment framework into emergency nursing practice. Background An evidence-informed patient-assessment framework HIRAID (History, Identify Red flags, Assessment, Interventions, Diagnostics, communication and reassessment) improves the quality of patient assessments performed by emergency nurses. Facilitators and barriers must be understood and tailored interventions selected to optimise implementation. Design A mixed-method convergent study design was used. Methods Thirty eight early career emergency nurses from five Australian hospitals participated in an education workshop on the HIRAID assessment framework. Simulated clinical scenarios enabled participants to experience conducting a patient assessment with and without using the framework. All participants completed surveys, interviews and focus groups to identify potential facilitators and barriers. Twenty three participants completed follow-up telephone surveys 4-6 months later. Quantitative and qualitative data were analysed separately using descriptive statistics and inductive content analysis, prior to integration. Implementation interventions were selected using the Behaviour Change Wheel. Results Nine facilitators and nine barriers were identified to potentially effect implementation of the HIRAID assessment framework. Twelve of the 23 participants (52.2%) who completed follow-up surveys reported using the framework in the clinical setting. To optimise future implementation, the education workshop needs refinement, and environmental restructuring, modelling and social support are required. Conclusion A multimodal strategy is needed to promote future successful implementation of the HIRAID assessment framework into emergency nursing practice. Relevance for clinical practice The successful implementation of the HIRAID assessment framework has the potential to improve nursing assessments of patients in emergency and other acute care settings. This study demonstrates how to systematically identify facilitators and barriers to behaviour change and select interventions to optimise implementation of evidence-informed nursing practices. [ABSTRACT FROM AUTHOR]

In the Gurindji community of Kalkaringi in Northern Australia the shared practices of everyday communication employed by both hearing and deaf members of the community include conventionalized manual actions from the lexicon of Indigenous sign as well as some recent visual practices derived from contact with both written English and with Auslan. We consider some dimensions of these multimodal practices, including kinship signs and signs for time-reference, and discuss several notable features in these domains. The first is gender-motivated use of the left and right sides of the body in several kinship signs. The second is the use of celestial anchoring in some signs for time. The use of spatially accurate pointing also contributes to the indexical richness of these communicative practices, as do some introduced semiotic resources, such as air-writing, and Auslan fingerspelling. As the first description of Gurindji sign, we establish a basis for further understandings of how tradition and innovation are incorporated into these shared practices. [ABSTRACT FROM AUTHOR]

Abstract: Deprescribing is the systematic process of discontinuing drugs when harms outweigh the benefits. We conducted semistructured telephone interviews with 22 general practitioners (GPs) who had prescribed or deprescribed opioids in patients with chronic noncancer pain within the past 6 months to investigate the barriers and facilitators to deprescribing opioid analgesics in patients with chronic noncancer pain. We also explored GPs' perspectives on the available resources to assist them with opioid deprescribing. Interviews were audio-recorded, transcribed verbatim, and then coded using an iterative process until data saturation reached. The thematic analysis process identified themes, first as concepts, and then refined to overarching themes after the merging of similar subthemes. Themes exploring barriers to deprescribing highlighted the difficulties GPs face while considering patient factors and varying prescribing practices within the confines of the health system. Patient motivation and doctor-patient rapport were central factors to facilitate deprescribing and GPs considered the most important deprescribing resource to be a multidisciplinary network of clinicians to support themselves and their patients. Therefore, although GPs emphasised the importance of deprescribing opioid analgesics, they also expressed many barriers relating to managing complex pain conditions, patient factors, and varying prescribing practices between clinicians. Some of these barriers could be mitigated by GPs having time and resources to educate and build rapport with their patients. This suggests the need for further development of multimodal resources and improved support through the public health system to enable GPs to prioritise patient-centred care. [ABSTRACT FROM AUTHOR]

Family language policy (FLP) impacts the maintenance of heritage language(s) in the family domain, where parents play a crucial role in making language-related decisions for their children. Globalisation, immigration, the COVID-19 pandemic, and digital communication have all affected FLP. Studies are now calling for examining how dispersed transnational families incorporate digital practices as a part of their FLP, given the shift from the exclusive use of traditional face-to-face communication to the inclusion of digital communication media such as Skype and WhatsApp. This research examines the viability of utilising Spolsky's tripartite framework to study the new concept of 'networked FLP,' a term coined by Curdt-Christiansen and Huang, which acknowledges dispersed families and digital communication. We examine data from ten Bengali immigrant families in Australia with dispersed senior family members living abroad. Our findings enrich the concept of networked FLP by highlighting the digital affordances that networked FLP provides to dispersed transnational families and the importance of socio-cultural and emotional factors when applying Spolsky's framework to FLP with digital media. We show that family bonding, maintaining heritage culture, and emotional connections are the primary motivations for digital communication, while language learning is secondary. Our study finds that it is essential to incorporate sociocultural and emotional factors when investigating networked FLP. [ABSTRACT FROM AUTHOR]

Background: Back pain is a huge global problem. For some people, the pain is so severe that they feel the need to present to an emergency department (ED). Our aim was to explore patient and staff perspectives for the development of a digital care pathway (DCP) for people with back pain who have presented to ED, including acceptability, barriers and facilitators. Methods: We used a descriptive phenomenology approach using semi‐structured interviews with patient and staff participants at a tertiary hospital. Interviews were transcribed and data codes were developed using inductive thematic analysis. Themes were discussed between researchers until consensus was achieved. Results: A total of 16 interviews were carried out, half of which involved patient participants. We identified three major themes: (i) expectations and experiences of staff and patients with low back pain in ED; (ii) a digital care pathway can empower patients and support clinicians in providing care; and (iii) acceptability, barriers, facilitators and recommendations of engaging with a DCP to track the trajectory of back pain. Each theme was further categorised into subthemes. Conclusion: Introducing a DCP was perceived as acceptable and beneficial by patients and staff. Both groups were aware of the potential participant burden if surveys were too long. Introducing a DCP could be a valuable adjunct to current management care models, providing a standardised source of education with the potential for individualised tracking and monitoring. The design and development of a DCP will need to consider reported facilitators and address perceived barriers for engagement. Patient or Public Contribution: This project sought insights from patients and staff about a digital care pathway. This forms the first step of patient and consumer consultation before implementing a digital care pathway. All consumers were offered the opportunity to review their responses and our interpretation. [ABSTRACT FROM AUTHOR]

Background: Current suicide prevention approaches are not adapted to international student needs, and participatory design is a method that may facilitate the development or adaptation of appropriate programmes for this group. Methods: This qualitative study investigated the experiences of international university students studying in Australia who participated in a co‐consultation process to adapt the LivingWorks safeTALK suicide prevention programme. Eight international students from the co‐consultation workshop completed semi‐structured interviews about their workshop experience. The data were analysed using reflexive thematic analysis. Results: The findings showed that participants found the co‐consultation process empowering and engaging. They also reported that the experience promoted mutual learning and challenged simplistic views of suicide. No students reported experiencing distress. Suggestions for improving participatory design for international students focussed on enhancing participant interaction, supporting quiet voices to be heard and ensuring understanding of mental health and suicide through shared language. Conclusions: This study underscores the value of participatory design in suicide prevention, emphasising its potential to empower international students and facilitate culturally sensitive programme adaptations. Patient or Public Contribution: International students were involved in the co‐consultation process to redevelop the training content and provided a series of recommendations for improving such processes for international students in the future. The two researchers who conducted the interviews and data analysis were former international students. [ABSTRACT FROM AUTHOR]

Although visual arts pedagogies are considered central within early childhood education programs, teacher self-efficacy has a direct impact on the quality and delivery of visual arts curricula. Until recently, the visual arts self-efficacy, pedagogical knowledge, and practice of in-service early childhood teachers have remained largely unexplored. The authors of this paper present a qualitative, iterative re-analysis of their three PhD studies which broadly focussed on early childhood visual arts praxis and specifically examined the visual arts beliefs and pedagogy of early childhood teachers in Australia and New Zealand. A thematic analysis of the intersecting self-efficacy findings raised in the three studies identifies the powerful influence of self-efficacy on teaching practice in the visual arts domain and offers new understandings about visual arts self-efficacy amongst early childhood teachers. The combined findings reveal several factors that restrain or enhance teachers' visual arts self-efficacy across time, including the impact of childhood experiences, pre-service training and epistemological beliefs. The paper also identifies several enabling conditions that appear to support teachers to develop and maintain positive visual arts self-efficacy beliefs, including practical engagement with materials, sustained professional learning, relational trust and intentional leadership. These enabling conditions offer practical strategies and research recommendations in service of positive visual arts self-efficacy to enhance quality visual arts teaching in early childhood contexts. [ABSTRACT FROM AUTHOR]

Pain recognition for culturally diverse people is complex as pain experience is subjective and influenced by cultural background. We compared the prevalence, intensity, and association of pain with neuropsychiatric symptoms (NPS) between immigrants and non-immigrants living with dementia in residential aged care homes (RACHs) who were referred to two Dementia Support Australia programs. Immigrant status was defined by the documented country of birth. Pain and NPS were assessed using PainChek® and the Neuropsychiatric Inventory, respectively. Subgroup analyses were also completed for English-speaking and non-English-speaking immigrants. A total of 17,637 referrals [immigrants, n = 6340; non-immigrants, n = 11,297] from 2792 RACHs were included. There were no significant differences for the prevalence of pain across all groups. Immigrants were slightly more likely to have moderate pain or severe pain than non-immigrants. Non-English-speaking immigrants had 0.5 points higher total pain scores on average (Cohen's d = 0.10 [0.05, 0.15], p < 0.001) than non-immigrants. Total pain score had a significant effect on total NPS severity scores in all groups. While pain prevalence is similar across groups, higher pain intensities are more common among immigrants living with dementia. Increased care staff awareness, education, and training about the potential effect of culture on pain expression is needed. [ABSTRACT FROM AUTHOR]

Compared with nations around the world, Australia has one of the highest rates of refugee resettlement per capita. Approximately 40 per cent of newly arrived refugees in Australia in 2018-19 were under the age of 18 and close to 90 per cent spoke a language other than English. Given that education is compulsory until the age of 16 in most states and territories of Australia, young people labelled as refugee-background students (RBSs) are tasked with navigating the English-only education system, in which their multilingualism is often viewed as a barrier; however, there are increasing calls for research to focus on the positive, affirmative practices of RBSs through a strengths-based approach in education, to counter a 'damage-centred' and deficit discourse. Thus, this article presents a systematic literature review of studies conducted in Australia with RBSs between 2010 and 2022. Specifically, this review explores the strengthsbased multilingual practices of RBSs in compulsory education in Australia. Inspired by RefugeeCrit theory, we seek to highlight strengths-based examples of RBSs multilingual practices as examples of counter-narratives to the prevailing deficit discourse, while remaining attentive to issues of trauma, agency and multilingualism. [ABSTRACT FROM AUTHOR]

Drawing on ethnographic interview analysis of Aboriginal participants in Australia, this study seeks to expand the critical discussions in Applied Linguistics by understanding the concept of translanguaging in relation to its "mundanity" (or ordinariness). Our data shows that rather than perceiving translanguaging as extraordinary, for Aboriginal speakers it is more likely to be considered normal, unremarkable, mundane, and as a long-existing phenomenon. The concept of the mundanity of translanguaging is thereby expanded through three main discussions in this article: 1) negotiating identity and resisting racism, where the Aboriginal speakers choose to translanguage using their full linguistic repertoires, but with appropriate communicative adjustments made for their interlocutor; 2) a display of respect towards their land, heritage and language; and 3) as an inherent and mundane everyday practice where they constantly negotiate between heritage languages, English, Kriol, and Aboriginal English varieties. The significance of this study lies in the normalisation of translanguaging as a mundane disinvention strategy, as this urges us to perceive linguistic separateness as a colonial ideological construct that is used to exhibit control over diverse peoples and to maintain uniformity and stability of nation-states. [ABSTRACT FROM AUTHOR]

Increasingly large numbers of people are using digital weight loss services (DWLSs) to treat being overweight and obesity. Although it is widely agreed that digital modalities improve access to care in general, obesity stakeholders remain concerned that many DWLSs are not comprehensive or sustainable enough to deliver meaningful health outcomes. This study adopted a mixed methods approach to assess why and after how long patients tend to discontinue Australia's largest DWLS, a program that combines behavioural and pharmacological therapy under the guidance of a multidisciplinary care team. We found that in a cohort of patients who commenced the Eucalyptus DWLS between January and June 2022 (n = 5604), the mean program adherence was 171.2 (±158.2) days. Inadequate supplying of a patient's desired glucose-like peptide-1 receptor agonist medication was the most common reason for discontinuation (43.7%), followed by program cost (26.2%), result dissatisfaction (9.9%), and service dissatisfaction (7.2%). Statistical tests revealed that ethnicity and age both had a significant effect on patient adherence. These findings suggest that DWLSs have the potential to improve access to comprehensive, continuous obesity care, but care models need to improve upon the one observed in the Eucalyptus Australia DWLS to mitigate common real-world program attrition factors. [ABSTRACT FROM AUTHOR]

Purpose: The Functional External Memory Aid Tool (FEMAT) is a performancebased measure of applied cognitive-linguistic abilities and attempted use of compensatory aids and strategies (e.g., using a calendar to recall an appointment) through completion of simulated everyday living tasks. The FEMAT was originally developed in the United States (US), and a need arose from clinicians to adapt the FEMAT for use in other countries. The aim of this study is to describe the cultural adaptation process that resulted in the United Kingdom (UK) and Australian (AU) versions of the FEMAT via international clinical research partnerships. Method: The FEMAT was adapted into UK and AU cultures using established guidelines for cultural and linguistic adaptation. The adaptation was completed by researchers and clinicians from the US, UK, and AU, and we followed a sixstep process: (a) preparation, (b) forward translation, (c) back translation, (d) committee review, (e) field testing, and (f) finalization. Results: The FEMAT items and materials were successfully adapted from the source culture (i.e., English-US) to the target cultures (i.e., English-UK, English- AU). Through the adaptation process, the FEMAT items were determined to be conceptually appropriate for each culture and minimal modifications were made to the FEMAT materials (e.g., voicemail recordings recorded in target dialect). The finalized FEMAT-English-UK and the FEMAT-English-AU versions are available for free on the FEMAT website. Conclusions: Through successful international clinical research collaborations, the FEMAT was successfully adapted for use in other English-speaking cultures. This work provides guidance to streamline future FEMAT cultural adaptations. [ABSTRACT FROM AUTHOR]

Gifted education has been recognised as a fractured field that can be categorised using varying paradigmatic approaches. Over the past thirty years, Gagné's Differentiated Model of Giftedness and Talents (DMGT) has maintained a strong influence in Australia, which means that the paradigmatic assumptions that are present in this model have shaped the Australian policy landscape. With recent changes in the gifted education policy and guidance space in many Australian states and territories, it is appropriate to explore whether there is a paradigmatic shift occurring. This research adopted a document study methodology, and found that the DMGT is still a favoured model, which means that an essentialist vein continues to flow through many of the Australian state and territory gifted education approaches. At the same time, most states and territories are attempting to embrace more dynamic approaches to supporting giftedness, which leads to paradigmatic confusion at the policy and guidance level. [ABSTRACT FROM AUTHOR]

Objectives: Internationally, hip or knee arthroplasty (TJA) with a 1-day hospital length of stay (LOS) is common and demonstrates improved patient and health service outcomes. This study aimed to develop and pilot an enhanced recovery program (ERP) for patients undergoing TJA to achieve a next-day discharge in an Australian public hospital setting. Methods: A project lead and six perioperative clinical craft group leads developed an ERP protocol based on enhanced recovery after surgery (ERAS) principles. Strict patient eligibility criteria were developed. Quality improvement methodology was used to implement the ERP. A patient navigator was put in place as a single contact point for patients. Results: A total of 825 patients were screened for the ERP and 47 patients completed the protocol. The mean ± standard deviation (s.d.) of the LOS was 34.7 (± 7.2) h with 41 patients (87%) achieving next-day discharge, the remaining six (13%) discharged on Day 2. Compliance with ERAS was high (96%) with mobilisation within 12 h occurring on 87% of occasions. There were no adverse events. Patient experience was positive. Conclusion: Next-day discharge was achieved with a selected cohort of patients with no adverse events and positive patient experience, using a multidisciplinary approach and an improvement framework. Broadening inclusion criteria will make ERP available to more patients. What is known about the topic? Next-day discharge following hip or knee arthroplasty in Australian public hospital settings is uncommon and little has been published reflecting enhanced recovery principles in this local context. What does this paper add? This paper describes the development and piloting of an enhanced recovery program using a novel approach to achieve next-day discharge following hip and knee replacement. What are the implications for practitioners? Other health services may leverage this approach to design and implement an enhanced recovery program to reduce hospital length of stay and improve patient and health service outcomes. [ABSTRACT FROM AUTHOR]

Automation and artificial intelligence (AI) is already possible for many radiation therapy planning and treatment processes with the aim of improving workflows and increasing efficiency in radiation oncology departments. Currently, AI technology is advancing at an exponential rate, as are its applications in radiation oncology. This commentary highlights the way AI has begun to impact radiation therapy treatment planning and looks ahead to potential future developments in this space. Historically, radiation therapist's (RT's) role has evolved alongside the adoption of new technology. In Australia, RTs have key clinical roles in both planning and treatment delivery and have been integral in the implementation of automated solutions for both areas. They will need to continue to be informed, to adapt and to transform with AI technologies implemented into clinical practice in radiation oncology departments. RTs will play an important role in how AI‐based automation is implemented into practice in Australia, ensuring its application can truly enable personalised and higher‐quality treatment for patients. To inform and optimise utilisation of AI, research should not only focus on clinical outcomes but also AI's impact on professional roles, responsibilities and service delivery. Increased efficiencies in the radiation therapy workflow and workforce need to maintain safe improvements in practice and should not come at the cost of creativity, innovation, oversight and safety. [ABSTRACT FROM AUTHOR]

In this paper we focus on one facet of Asia literacy and examine the potential of intercultural understanding through two films about Asians in Australia, as the basis for exploring Asia and Australia's engagement with Asia 'inside' and not through the more accepted mode of 'outside' the nation. In doing so we foreground how teachers' critical and imaginative curriculum work can realise some of the promises of the framing document for the current national curriculum project, the Melbourne Declaration (MCEECDYA, 2008). In particular, we focus on opportunities for young people to develop an Asia-related cultural literacy that goes beyond instrumental notions of engagement with Asia and explore the evolving nature of contemporary Australian society; a society that continues to develop in response to regional flows and interactions with people and cultures. To this end we engage with the notion of 'diasporic hybridity' as a dynamic cultural space through selected films and literature, about Asia in Australia, in particular, Bondi Tsunami (Lucas, 2004) and Footy Legends (Do, 2006) and selected prose works. Our paper introduces the policy background of the Australian Curriculum and suggests multimodal, English classroom applications for the films and literature under study. [ABSTRACT FROM AUTHOR]

This paper offers a multimodal perspective on how identities are performed and negotiated in discourse, concentrating on the interaction of language and body language within a particular genre, Youth Justice Conferencing. These conferences operate as a diversionary form of sentencing in the juvenile justice system of New South Wales, Australia. Typically, they involve a young person who has committed an offense coming face to face with the victim of their crime, in the presence of family members, community workers, police, and a conference 'convenor.' We conduct close, multimodal discourse analysis of the interactions that occur during the Rejoinder step in a particular conference, and investigate an 'angry boy' identity enacted by two young persons at this point in the proceedings. This persona is very different to the forthcoming and remorseful persona idealized by conference designers. The role of body language in intermodally proposing and negotiating bonds within the conference is explored. [ABSTRACT FROM AUTHOR]

The article presents a study on the implementation and evaluation of a multisite drug usage evaluation program across Australian hospitals. 62 hospitals participated in the Acute Postoperative Pain Management (APOP) project. Among 23 respondents to the evaluation survey, 18 reported improvements in the documentation of pain scores at their hospital. 15 strongly agreed or agreed that participation in APOP directly resulted in increased prescribing of multimodal analgesia for pain relief.

A substantial body of research shows that various types of audiovisual (AV) input such as videos and videos with second language (L2) subtitles can facilitate language learning. However, language teachers' day-to-day practices with regard to multimodal input is less understood. To bridge the gap in language education, this study investigates teachers' perceived use of four types of AV input (video only, video with subtitles, video with captions and video with enhanced captions) and factors influencing teachers' perspectives on these types of input for in-class and out-of-class learning. Questionnaire data were collected from 193 L2 teachers across the globe about their perceived use of AV input. Teachers reported that they use video and captioned video most frequently in both classroom and out-of-class contexts. Logistic regression analyses revealed that teachers' perceived importance and comfort using specific AV input types were the two most important factors explaining teachers' reported use. Complementarily, open-ended responses were analyzed qualitatively to identify teachers' additional reasons for (non)use of such input.

Global communication is being transformed by new forms of meaning-making in a culturally diverse world. This article concerns these shifts, releasing key findings of a critical ethnography that investigated how a teacher implemented the multiliteracies pedagogy. The study documented a series of media-based lessons with a teacher's culturally and linguistically diverse Year 6 class (students ages 11-12 years). The reporting of this research is timely because teaching multiliteracies is a key feature of Australian educational policy initiatives and syllabus requirements. This article moves the field of literacy research forward by examining the intersection of pedagogy for multimodal textual practices and issues of equity. The important findings concern the differing degrees to which learners utilised the affordances of media for specific cultural purposes through a pedagogy of multiliteracies. Some students reproduced existing designs whereas others applied their knowledge of texts with substantial innovation and creativity. Comparisons are made between the learning demonstrated by students who were of the dominant Anglo-Australian, middle-class culture and by those who were not. Recommendations are given for applying the multiliteracies pedagogy to enable meaningful designing. [ABSTRACT FROM AUTHOR]

"Multiliteracies in the Early Years," a series of four videos which tries to capture the learning journeys of the four primary teachers who explored the theory of multiliteracies and make it come to life in their classrooms in Australia. The first program in the series explores the changing nature of communications environment. The second program examines the two multiliteracies: multi-lingualism, or variability of meaning making, and the impact of new communications technologies in creating multimodal representations, in which written-linguistic modes of meaning interface with visual, audio, gestural and spatial patterns of meaning. The third program looks at the muliliteracies theory around pedagogy. In the final program, the academics and teachers and students reflect on their learning, offer advice on planning and assessment and suggest future directions.

The concept of authentic leadership rose to prominence through its idealization as an inherently moral and universally desirable trait. We problematize this romantic notion by exploring how the ‘authenticity’ of the CEOs of four major Australian banks was discursively constructed before and during the global financial crisis (GFC). Using multimodal discourse analysis of media texts, we show how what it meant to be an ‘authentic leader’ was co-constructed differently by the CEOs and the media. We also highlight the dynamic nature of context, where the GFC was variously framed by and for each of the CEOs. Our study challenges the acontextual notion of authentic leadership by showing how a discursively constructed context can reinforce or undermine leaders’ narratives of authenticity. [ABSTRACT FROM AUTHOR]

Background: Despite advances in cancer diagnosis and treatment have significantly improved survival rates, patients post-treatment-related health needs are often not adequately addressed by current health services. The aim of the Women's Wellness after Cancer Program (WWACP), which is a digitised multimodal lifestyle intervention, is to enhance health-related quality of life in women previously treated for blood, breast and gynaecological cancers.Methods: A single-blinded, multi-centre randomized controlled trial recruited a total of 351 women within 24 months of completion of chemotherapy (primary or adjuvant) and/or radiotherapy. Women were randomly assigned to either usual care or intervention using computer-generated permuted-block randomisation. The intervention comprises an evidence-based interactive iBook and journal, web interface, and virtual health consultations by an experienced cancer nurse trained in the delivery of the WWACP. The 12 week intervention focuses on evidence-based health education and health promotion after a cancer diagnosis. Components are drawn from the American Cancer Research Institute and the World Cancer Research Fund Guidelines (2010), incorporating promotion of physical activity, good diet, smoking cessation, reduction of alcohol intake, plus strategies for sleep and stress management. The program is based on Bandura's social cognitive theoretical framework. The primary outcome is health-related quality of life, as measured by the Functional Assessment of Cancer Therapy-General (FACT-G). Secondary outcomes are menopausal symptoms as assessed by Greene Climacteric Scale; physical activity elicited with the Physical Activity Questionnaire Short Form (IPAQ-SF); sleep measured by the Pittsburgh Sleep Quality Index; habitual dietary intake monitored with the Food Frequency Questionnaire (FFQ); alcohol intake and tobacco use measured by the Australian Health Survey and anthropometric measures including height, weight and waist-to-hip ratio. All participants were assessed with these measures at baseline (at the start of the intervention), 12 weeks (at completion of the intervention), and 24 weeks (to determine the level of sustained behaviour change). Further, a simultaneous cost-effectiveness evaluation will consider if the WWACP provides value for money and will be reported separately.Discussion: Women treated for blood, breast and gynaecological cancers demonstrate increasingly good survival rates. However, they experience residual health problems that are potentially modifiable through behavioural lifestyle interventions such as the WWACP.Trial Registration: The protocol for this study was registered with the Australian and New Zealand Clinical Trials Registry, Trial ID: ACTRN12614000800628 , July 28, 2014. [ABSTRACT FROM AUTHOR]

Background: Obsessive-compulsive disorder (OCD) is a debilitating neuropsychiatric anxiety disorder (DSM-5) characterised by emotionally disturbing, unwanted cognitions (obsessions) and repetitive compulsions (1). OCD typically presents in adolescence, causing circadian rhythm sleep disorders and severe debilitation (2). The recommended treatments for OCD are cognitive-- behavioural therapy using exposure and response prevention and/or pharmacotherapy. Increasing treatment effectivity using a multimodal approach reduces long term pharmacological use and provides support in treatment resistant OCD. Early intervention using nutritional and environmental medicine approaches may be effective in the treatment of OCD (3). Objectives: This case report discusses the environmental impact of OCD, integrative therapies, and clinical implications for OCD. It discusses conventional treatment options such as psychotropic medication treatment and cognitive behavioural therapy and the potential for adjunct nutraceutical treatment to support key drivers including inflammation, immune modulation, digestive health, and serotonin synthesis. Identification of the therapeutic benefit of dietary guidelines for patients with OCD is included. Conclusions: Early childhood neural development is complex and influenced by environmental and nutritional factors (4). Neurodevelopmental processes including neural circuit formation are influenced by hyperactivity of systemic immune pathways. Reducing neuroinflammation with immune-modulatory dietary and lifestyle interventions and reducing environmental influences may be beneficial in the treatment of OCD. Expanding assessment to include personalised biomarker assessments including internal and external environmental factors such as environmental exposure, toxic load and microbiota will assist health and well-being outcomes (5). [ABSTRACT FROM AUTHOR]

Background: Pre-operative physical status and its association with post-operative surgical outcomes is poorly understood in patients with peritoneal malignancy who undergo cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC). The aims of this study were to determine the pre-operative physical function in patients having CRS-HIPEC and investigate the association between physical function and post-operative outcomes., Patients and Methods: Patients undergoing CRS-HIPEC between 2017 and 2021 were recruited at a single quaternary referral hospital in Sydney, Australia. The primary physical function measures were the 6-min walk test (6MWT) and the five-times sit to stand test (5STS). Data were collected pre-operatively and at post-operative day 10, and were analysed according to pre-operative patient characteristics and post-operative outcomes such as length of hospital stay (LOS) and complications., Results: The cohort of patients that participated in functional assessments consisted of 234 patients, with a median age of 56 years. Patients having CRS-HIPEC performed worse on the 6MWT pre-operatively compared with the general Australian population (p < 0.001). Post-operatively, these patients experienced a further deterioration in 6MWT and 5STS performance and the degree of the post-operative decline in function was associated with post-operative morbidity. A higher level of pre-operative physical function was associated with shorter LOS and minor post-operative complications., Conclusions: Patients who have undergone CRS-HIPEC were functionally impaired pre-operatively compared with the general population and experience a further deterioration of physical function post-operatively. A higher level of pre-operative physical function is associated with minor post-operative morbidity, which is highly relevant for pre-operative optimisation of patients with cancer., (© 2022. Crown.)

Background: Surgical patients are at risk of postoperative complications, which may lead to increased morbidity, mortality, hospital length-of-stay and healthcare costs. Enhanced Recovery After Surgery (ERAS®) protocols are evidence-based and have demonstrated effectiveness in decreasing complications and associated consequences. However, their adoption in Australia has been limited and the reason for this is unclear. This study aimed to describe clinicians' perceptions of ERAS protocols in Australia. Methods: A national online survey of anaesthetists, surgeons and nurses was undertaken. Invitations to participate were distributed via emails from professional colleges. The 30-item survey captured respondent characteristics, ERAS perceptions, beliefs, education and learning preferences and future planning considerations. The final question was open-ended for elaboration of perceptions of ERAS. Descriptive and inferential statistics were used to describe and compare group differences across disciplines relative to perceptions of ERAS. Results: The sample included 178 responses (116 nurses, 65.2%; 36 surgeons, 20.2%; 26 anaesthetists, 14.6%) across six states and two territories. More than half (n = 104; 58.8%) had used ERAS protocols in patient care, and most perceived they were 'very knowledgeable' (n = 24; 13.6%) or 'knowledgeable' (n = 71; 40.3%) of ERAS. However, fewer nurses had cared for a patient using ERAS (p <.01) and nurses reported lower levels of knowledge (p <.001) than their medical counterparts. Most respondents agreed ERAS protocols improved patient care and financial efficiency and were a reasonable time investment (overall Md 3–5), but nurses generally recorded lower levels of agreement (p.013 to < 0.001). Lack of information was the greatest barrier to ERAS knowledge (n = 97; 62.6%), while seminars/lectures from international and national leaders were the preferred learning method (n = 59; 41.3%). Most supported broad implementation of ERAS (n = 130; 87.8%). Conclusion: There is a need to promote ERAS and provide education, which may be nuanced based on the results, to improve implementation in Australia. Nurses particularly need to be engaged in ERAS protocols given their significant presence throughout the surgical journey. There is also a need to co-design implementation strategies with stakeholders that target identified facilitators and barriers, including lack of support from senior administration, managers and clinicians and resource constraints. [ABSTRACT FROM AUTHOR]

Background: Elder abuse often goes unreported and undetected. Older people may be ashamed, fearful, or otherwise reticent to disclose abuse, and many health providers are not confident in asking about it. In the No More Shame study, we will evaluate a co-designed, multi-component intervention that aims to improve health providers' recognition, response, and referral of elder abuse. Methods: This is a single-blinded, pragmatic, cluster randomised controlled trial. Ten subacute hospital sites (i.e. clusters) across Australia will be allocated 1:1, stratified by state to a multi-component intervention comprising a training programme for health providers, implementation of a screening tool and use of site champions, or no additional training or support. Outcomes will be collected at baseline, 4 and 9 months. Our co-primary outcomes are change in health providers' knowledge of responding to elder abuse and older people's sense of safety and quality of life. We will include all inpatients at participating sites, aged 65 + (or aged 50 + if Aboriginal or Torres Strait Islander), who are able to provide informed consent and all unit staff who provide direct care to older people; a sample size of at least 92 health providers and 612 older people will provide sufficient power for primary analyses. Discussion: This will be one of the first trials in the world to evaluate a multi-component elder abuse intervention. If successful, it will provide the most robust evidence base to date for health providers to draw on to create a safe environment for reporting, response, and referral. Trial registration: ANZCTR, ACTRN12623000676617p. Registered 22 June 2023. Key points: - Underreporting of elder abuse is significant due to barriers to disclosure. - Health providers may not feel confident in asking about or responding to elder abuse. - Hospital-based health providers are in a unique position to detect and respond to elder abuse. - We report our protocol for No More Shame, a pragmatic cluster randomised control trial that aims to train health providers to recognise and respond to elder abuse. - Our outcomes include health providers' knowledge and management of elder abuse, older people's quality of life and sense of safety, and rates of elder abuse detection and referrals at hospital sites. [ABSTRACT FROM AUTHOR]

Background: Mild cognitive impairment (MCI) is commonly defined as a transitional subclinical state between normal aging and dementia. A growing body of research indicates that health behaviors may play a protective role against cognitive decline and could potentially slow down the progression from MCI to dementia. The aim of this study is to conduct a bibliometric analysis of literature focusing on health behaviors and MCI to summarize the factors and evidence regarding the influence of health behaviors on MCI. Methods: The study performed a bibliometric analysis by retrieving publications from the Science Citation Index and Social Sciences Citation Index subdatabases within the Web of Science Core Collection. Utilizing VOSviewer and CiteSpace software, a total of 2,843 eligible articles underwent co-citation, cokeywords, and clustering analyses. This methodology aimed to investigate the current status, trends, major research questions, and potential future directions within the research domain. Results: The bibliometric analysis indicates that research on healthy behaviors in individuals with MCI originated in 2002 and experienced rapid growth in 2014, reflecting the increasing global interest in this area. The United States emerged as the primary contributor, accounting for more than one-third of the total scientific output with 982 articles. Journals that published the most articles on MCI-related health behaviors included "Journal of Alzheimer's Disease," "Neurobiology of Aging," "Frontiers in Aging Neuroscience," and other geriatricsrelated journals. High-impact papers identified by VOSviewer predominantly cover concepts related to MCI, such as diagnostic criteria, assessment, and multifactorial interventions. Co-occurrence keyword analysis highlights five research hotspots in health behavior associated with MCI: exercise, diet, risk factors and preventive measures for dementia, cognitive decline-related biomarkers, and clinical trials. Conclusion: This study provides a comprehensive review of literature on health behavior in individuals with MCI, emphasizing influential documents and journals. It outlines research trends and key focal points, offering valuable insights for researchers to comprehend significant contributions and steer future studies. [ABSTRACT FROM AUTHOR]

Atypical habituation to repetitive information has been commonly reported in Autism Spectrum Disorder (ASD) but it is not yet clear whether similar abnormalities are present in Neurofibromatosis Type 1 (NF1). We employed a cross-syndrome design using a novel eye tracking paradigm to measure habituation in preschoolers with NF1, children with idiopathic ASD and typically developing (TD) children. Eye movements were recorded to examine fixation duration to simultaneously presented repeating and novel stimuli. Children with NF1 showed a bias for longer look durations to repeating stimuli at the expense of novel stimuli, and slower habituation in NF1 was associated with elevated ASD traits. These findings could indicate aberrant modulation of bottom-up attentional networks that interact with the emergence of ASD phenotypes. [ABSTRACT FROM AUTHOR]

Many transgender individuals face inequities, discrimination, and sometimes even a lack of transgender-specific knowledge in health care settings. Educational curricula can address such disparities and help future health professionals to become more knowledgeable, confident, and well-prepared for addressing the needs of transgender individuals. This systematic review aims to summarize current training interventions about care of transgender individuals for health and allied health students, and to analyse the effects of the respective intervention. A total of six databases (Pubmed, MEDLINE, Scopus, Web of Science, Embase and SciSearch) were screened for original articles published between 2017 and June 2021. Search terms and eligibility criteria were pre-specified, and after a structured selection process 21 studies were included into further analysis. Extracted data contained information on general study properties, population, design, program format and outcomes of interest. A narrative synthesis was used to summarize detected results. Study quality was assessed for each individual study. A self-developed 18-item checklist combining criteria of two prior published tools was used to assess overall quality of quantitative studies. For qualitative studies a 10-item checklist by Kmet et al. [HTA Initiat, 2004] was applied. Eligible studies were designed for multiple health or allied health profession students, and varied widely regarding program format, duration, content, and assessed outcomes. Almost all (N = 19) interventions indicated improvements in knowledge, attitude, confidence and comfort levels or practical skills concerning care for transgender clients. Major limitations included the lack of long-term data, validated assessment tools, control groups and comparative studies. Training interventions contribute to prepare future health professionals to deliver competent and sensitive care and which may improve the prospective experienced health care reality of transgender individuals. However, currently there is no common consensus about best practice of education. Additionally, little is known about whether detected effects of training interventions translate into noticeable improvements for transgender clients. Further studies are warranted to assess the direct impact of specific interventions in the light of the respective target populations. [ABSTRACT FROM AUTHOR]

Objective To identify factors acting as barriers or enablers to the process of healthcare consent for people with intellectual disability and to understand how to make this process equitable and accessible. Data sources Databases: Embase, MEDLINE, PsychINFO, PubMed, SCOPUS, Web of Science and CINAHL. Additional articles were obtained from an ancestral search and hand- searching three journals. Eligibility criteria Peer- reviewed original research about the consent process for healthcare interventions, published after 1990, involving adult participants with intellectual disability. Synthesis of results Inductive thematic analysis was used to identify factors affecting informed consent. The findings were reviewed by co- researchers with intellectual disability to ensure they reflected lived experiences, and an easy read summary was created. Results Twenty- three studies were included (1999 to 2020), with a mix of qualitative (n=14), quantitative (n=6) and mixed- methods (n=3) studies. Participant numbers ranged from 9 to 604 people (median 21) and included people with intellectual disability, health professionals, carers and support people, and others working with people with intellectual disability. Six themes were identified: (1) health professionals' attitudes and lack of education, (2) inadequate accessible health information, (3) involvement of support people, (4) systemic constraints, (5) person- centred informed consent and (6) effective communication between health professionals and patients. Themes were barriers (themes 1, 2 and 4), enablers (themes 5 and 6) or both (theme 3). Conclusions Multiple reasons contribute to poor consent practices for people with intellectual disability in current health systems. Recommendations include addressing health professionals' attitudes and lack of education in informed consent with clinician training, the coproduction of accessible information resources and further inclusive research into informed consent for people with intellectual disability. PROSPERO registration CRD42021290548. [ABSTRACT FROM AUTHOR]

Background: Reducing antibiotic use in Australia, and the subsequent impact on antimicrobial resistance, requires multiple, sustained approaches with appropriate resources and support. Additional strategies to reduce antibiotic prescribing include effective vaccines, against pathogens such as Streptococcus pyogenes, the most common bacterial cause of sore throat. As part of efforts towards assessing the benefits of introducing new strategies to reduce antimicrobial prescribing, we aimed to determine the burden of antimicrobial prescribing for sore throat in general practice. Methods: General practice activity data from 2013 – 2017 derived from the first 8 practices participating in the 'Primary Care Audit, Teaching and Research Open Network' (Patron) program were analysed according to reason for visit (upper respiratory tract infection, URTI, or sore throat) and antibiotic prescription. The main outcome measures were percentage of sore throat or URTI presentations with antibiotic prescription by age. Results: A total of 722,339 visits to general practice were made by 65,449 patients; 5.7% of visits were for URTI with 0.8% meeting the more specific criteria for sore throat. 66.1% of sore throat visits and 36.2% of URTI visits resulted in antibiotic prescription. Penicillin, the recommended antibiotic for sore throat when indicated, was the antibiotic of choice in only 52.9% of sore throat cases prescribed antibiotics. Broader spectrum antibiotics were prescribed more frequently in older age groups. Conclusions: Frequency of antibiotic prescribing for sore throat is high and broad, despite Australian Therapeutic guideline recommendations. Multiple, sustained interventions to reduce prescribing, including availability of effective S. pyogenes vaccines that could reduce the incidence of streptococcal pharyngitis, could obviate the need to prescribe antibiotics and support ongoing efforts to promote antimicrobial stewardship. [ABSTRACT FROM AUTHOR]

Melanoma is the leading cause of global skin cancer-related death and currently ranks as the third most commonly diagnosed cancer in Australia. Melanoma patients with in-transit metastases (ITM), a type of locoregional metastasis located close to the primary tumor site, exhibit a high likelihood of further disease progression and poor survival outcomes. Immunotherapies, particularly immune checkpoint inhibitors (ICI), have demonstrated remarkable efficacy in ITM patients with reduced occurrence of further metastases and prolonged survival. The major challenge of immunotherapeutic efficacy lies in the limited understanding of melanoma and ITM biology, hindering our ability to identify patients who likely respond to ICIs effectively. In this review, we provided an overview of melanoma and ITM disease. We outlined the key ICI therapies and the critical immune features associated with therapy response or resistance. Lastly, we dissected the underlying biological components, including the cellular compositions and their communication networks within the tumor compartment, to enhance our understanding of the interactions between immunotherapy and melanoma, providing insights for future investigation and the development of drug targets and predictive biomarkers. [ABSTRACT FROM AUTHOR]

Background: This study compares aspirin to enoxaparin for symptomatic VTE prophylaxis within 90 days of any type of hip or knee arthroplasty performed for any diagnosis, in patients enrolled in the CRISTAL trial. Materials and methods: CRISTAL was a cluster-randomised crossover, registry-nested non-inferiority trial across 31 hospitals in Australia. The primary publication was restricted to patients undergoing primary total hip or knee arthroplasty for a diagnosis of osteoarthritis. This report includes all enrolled patients undergoing hip or knee arthroplasty procedures (partial or total, primary or revision) performed for any indication. Hospitals were randomized to administer patients aspirin (100mg daily) or enoxaparin (40mg daily), for 35 days after hip arthroplasty and 14 days after knee arthroplasty. Crossover occurred after the patient enrolment target had been met for the first group. The primary outcome was symptomatic VTE within 90 days. Analyses were performed by randomization group. Results: Between April 20, 2019 and December 18, 2020, 12384 patients were enrolled (7238 aspirin group and 5146 enoxaparin). Of these, 6901 (95.3%) given aspirin and 4827 (93.8%) given enoxaparin (total 11728, 94.7%) were included in the final analyses. Within 90 days, symptomatic VTE occurred in 226 (3.27%) aspirin patients and 85 (1.76%) enoxaparin patients, significant for the superiority of enoxaparin (estimated treatment difference 1.85%, 95% CI 0.59% to 3.10%, p = 0.004). Joint-related reoperation within 90 days was lower in the enoxaparin group (109/4827 (2.26%) vs 171/6896 (2.47%) with aspirin, estimated difference 0.77%; 95% CI 0.06% to 1.47%, p = 0.03). There were no significant differences in the other secondary outcomes. Conclusion: In patients undergoing hip or knee arthroplasty (of any type, performed for any indication) enrolled in the CRISTAL trial, aspirin compared to enoxaparin resulted in a significantly higher rate of symptomatic VTE and joint-related reoperation within 90 days. These findings extend the applicability of the CRISTAL trial results. Trial registration: Anzctr.org.au, identifier: ACTRN12618001879257. [ABSTRACT FROM AUTHOR]

With the anticipated launch of the Australian Bragg Centre for Proton Therapy and Research (ABCPTR) in Adelaide, Australia, proton therapy will become a significant addition to existing cancer treatment options for Australians. The anticipated benefits will be particularly evident in rare cancers such as clival chordomas, a challenging tumour entity due to the anatomical relationship with critical structures, and proven radio-resistance to conventional radiation therapy. The article synthesises key findings from major studies and evaluates the current evidence supporting various management strategies for clival chordomas. It also considers the influence of institutional volume and multidisciplinary team management on patient outcomes and outlines how high-quality care can be effectively delivered within the Australian healthcare system, emphasising the potential impact of proton therapy on the treatment paradigm of clival chordomas in Australia. [ABSTRACT FROM AUTHOR]

Structured health system-based programs, such as cardiac rehabilitation, may reduce the risk of recurrent stroke. This study aimed to co-design and evaluate a structured program of rehabilitation, developed based on insights from focus groups involving stroke survivors and health professionals. Conducted in Tasmania, Australia in 2019, the 7-week program comprised one hour of group exercise and one hour of education each week. Functional capacity (6 min walk test), fatigue, symptoms of depression (Patient Health Questionnaire), and lifestyle were assessed pre- and post-program, with a historical control group for comparison. Propensity score matching determined the average treatment effect (ATE) of the program. Key themes from the co-design focus groups included the need for coordinated care, improved psychosocial management, and including carers and peers in programs. Of the 23 people approached, 10 participants (70% men, mean age 67.4 ± 8.6 years) completed the program without adverse events. ATE analysis revealed improvements in functional capacity (139 m, 95% CI 44, 234) and fatigue (−5 units, 95% CI −9, −1), with a small improvement in symptoms of depression (−0.8 units, 95% CI −1.8, 0.2) compared to controls. The co-designed program demonstrated feasibility, acceptability, and positive outcomes, suggesting its potential to support stroke survivors. [ABSTRACT FROM AUTHOR]

This study investigates the current use of bedrooms to fill a knowledge gap in the existing sleep studies literature by focusing on user preferences and their needs. Despite substantial research into the optimal physical conditions for sleep, there remains a gap in understanding how individuals use their bedrooms today. As an initial step to bridge this gap, we employed a mixed-method research approach, integrating quantitative and qualitative data results. A survey including multiple-choice and open-ended questionnaire items was undertaken in Australia with 304 participants. Our research findings indicate that 'having a separate bedroom in a house' is the most common arrangement. However, other arrangements, such as living in a bedsit or sharing a bedroom, are indicators of diverse bedroom conditions. In total, 70% of respondents stated that they would like to make changes to their bedrooms for physical, functional, comfort-based, and aesthetic reasons, with comfort ranked as the highest. The majority of respondents stating they would not make any modifications in their bedrooms were found to be owner-occupiers. Mattress quality and privacy emerged as the most significant factors impacting the respondents' bedroom experience, and female participants were reported to place higher importance on cleanliness compared to male participants. Additionally, preferences for sleeping alone or with a partner were found to shift with age. Based on our findings, we suggest that survey-based sleep studies should evaluate the bedroom arrangements before the individual's sleep habits. Further studies are needed to understand how privacy needs influence sleep quality. From a built environment viewpoint, this study emphasizes the need to develop bedroom design solutions tailored to optimize bedroom conditions, particularly for rental tenants who often have limited control over the physical conditions of their sleep environment. [ABSTRACT FROM AUTHOR]

Smoke haze events have increasingly affected Australia's environmental quality, having demonstrable effects on air quality, climate, and public health. This study employs a hybrid methodology, merging satellite-based aerosol optical depth (AOD) data with Chemical Transport Model (CTM) simulations to comprehensively characterize these events. The AOD data are sourced from the Japan Aerospace Exploration Agency (JAXA), Copernicus Atmosphere Monitoring Service (CAMS), and the Commonwealth Scientific and Industrial Research Organization (CSIRO), and they are statistically evaluated using mean, standard deviation, and root mean square error (RMSE) metrics. Our analysis indicates that the combined dataset provides a more robust representation of smoke haze events than individual datasets. Additionally, the study investigates aerosol distribution patterns and data correlation across the blended dataset and discusses possible improvements such as data imputation and aerosol plume scaling. The outcomes of this investigation contribute to enhancing our understanding of the impacts of smoke haze on various environmental factors and can assist in developing targeted mitigation and management strategies. [ABSTRACT FROM AUTHOR]

Background: The Internet is a widely used source of health information, yet the accuracy of online information can be low. This is the case for low back pain (LBP), where much of the information about LBP treatment is poor. Methods: This research conducted a content analysis to explore what pain treatments for LBP are presented to the public on websites of Australian pain clinics listed in the PainAustralia National Pain Services Directory. Websites providing information relevant to the treatment of LBP were included. Details of the treatments for LBP offered by each pain service were extracted. Results: In total, 173 pain services were included, with these services linking to 100 unique websites. Services were predominantly under private ownership and located in urban areas, with limited services in non-urban locations. Websites provided detail on a median of six (IQR 3–8) treatments, with detail on a higher number of treatments provided by services in the private sector. Physical, psychological and educational treatments were offered by the majority of pain services, whereas surgical and workplace-focused treatments were offered by relatively few services. Most services provided details on multidisciplinary care; however, interdisciplinary, coordinated care characterised by case-conferencing was infrequently mentioned. Conclusions: Most websites provided details on treatments that were largely in-line with recommended care for LBP, but some were not, especially in private clinics. However, whether the information provided online is a true reflection of the services offered in clinics remains to be investigated. Information online about how low back pain should be treated is often not comprehensive and of low quality. Websites of Australian pain services endorsed by PainAustralia often offer treatments recommended for low back pain, but there is little information on the importance of interdisciplinary care and fewer pain services in non-urban areas. Patients are likely being educated about guideline-endorsed care for low back pain, but patients in non-urban areas are likely to experience difficulty in accessing this. [ABSTRACT FROM AUTHOR]

Monitoring is necessary for the management of any threatened species if its predicament and status are to improve. Monitoring establishes baseline data for tracking trends in distribution and abundance and is a key tool for informing threatened species management. Across much of the Old World, bats in the genus Pteropus (Pteropodidae, Chiroptera) face significant threats from habitat loss, conflict with humans, and hunting. Despite conflict with humans and their threatened status, few Pteropus are being monitored. Often, this is because of difficulties associated with their high mobility, large and easily disturbed aggregations, and their use of unknown or remote habitat. Here we describe 10 years of results from the National Flying-fox Monitoring Program (NFFMP) for the grey-headed flying-fox, (Pteropus poliocephalus) in Australia. Range-wide quarterly surveys were conducted over a three-day period since November 2012 using standardized methods appropriate to conditions encountered at each roost. For our analysis of the population and its trend, we used a state-space model to account for the ecology of the grey-headed flying-fox and the errors associated with the surveying process. Despite the general perception that the species is in decline, our raw data and the modelled population trend suggest the grey-headed flying-fox population has remained stable during the NFFMP period, with the range also stable. These results indicate that the species' extreme mobility and broad diet bestow it with a high level of resilience to various disturbance events. Long-term, range-wide studies such as this one, are crucial for understanding relatively long-lived and highly nomadic species such as the grey-headed flying-fox. The outcomes of this study highlight the need for such systematic population monitoring of all threatened Pteropus species. [ABSTRACT FROM AUTHOR]

The past decade has seen an increase in the prevalence of sequence type (ST) 45 methicillin-resistant Staphylococcus aureus (MRSA), yet the underlying drivers for its emergence and spread remain unclear. To better understand the worldwide dissemination of ST45 S. aureus, we performed phylogenetic analyses of Australian isolates, supplemented with a global population of ST45 S. aureus genomes. Our analyses revealed a distinct lineage of multidrug-resistant ST45 MRSA harbouring qacA, predominantly found in Australia and Singapore. Bayesian inference predicted that the acquisition of qacA occurred in the late 1990s. qacA was integrated into a structurally variable region of the chromosome containing Tn552 (carrying blaZ) and Tn4001 (carrying aac(6')-aph(2")) transposable elements. Using mutagenesis and in vitro assays, we provide phenotypic evidence that qacA confers tolerance to chlorhexidine. These findings collectively suggest both antimicrobial resistance and the carriage of qacA may play a role in the successful establishment of ST45 MRSA. A study underscores the emergence of a qacA-harbouring multidrug-resistant sequence type 45 methicillin-resistant Staphylococcus aureus lineage, highlighting the potential impact of biocide tolerance on its recent clonal spread in Australia and Asia. [ABSTRACT FROM AUTHOR]

Researchers have found that many post-secondary music students suffer from physical and mental health issues. However, researchers have mainly studied these problems at the individual level, with little investigation of how music students' work is shaped by the coordinating effects of policies, texts, and discourses at and beyond their local site. This paper describes a protocol for an international project that will explore the health of music students in the context of their daily work. Using an institutional ethnography approach, we will examine the social organization of music students' work at three universities: two in Canada and one in Australia. This will be the first set of studies that use institutional ethnography specifically for the purpose of understanding how the social organization of music students' work shapes their health. Data will be collected using several methods common to institutional ethnography: interviews, focus groups, observations, and collecting texts. Data analysis will begin during the data collection process and proceed in two fluid stages. The first stage will involve a detailed investigation of the pertinent work activities at each music school. The second will involve linking that work to specific social relations within and beyond the institution. After data analysis has been completed at all three sites, findings will be compared to one another to identify commonalities and differences in how students' work is organized. Findings of the entire project may inform policy-making and lead to positive change at the institutions studied, as well as others where similar social organization may occur. The novel approach described here will provide opportunities to expand current knowledge about music students' work and health beyond what has been learned through approaches that focus on students' individual behaviours and attributes. [ABSTRACT FROM AUTHOR]