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The new religion of Spiritualism emerged in the mid-19th century. Through mediumship, Spiritualists contacted the dead, believing them to have "passed over" to another plane of existence. It spread from America to Great Britain before arriving in Australia in the 1850s. This article charts the history of the world's oldest continuously running Spiritualist organisation, the Victorian Spiritualists' Union (VSU, est. 1870), exploring the unexpected survival of the movement in Australia. It challenges the common idea that Spiritualism enjoyed only a brief revival in the interwar period and has maintained a tenuous status ever since. Rather, I argue that Spiritualism has experienced several peaks and troughs since its emergence in Australia, including a widespread revival in the 1970s, spearheaded by the VSU. Spiritualism in Australia survives due to the development of a church movement, the advocacy of groups such as the VSU, the generous volunteer efforts of individual Spiritualists, the acquisition of church buildings, and its geographic mobility, all of which have allowed Spiritualist churches to be responsive to changing social and cultural conditions for more than a century. It is one of Australia's largest and most resilient alternative religious movements, not simply a Victorian-era curio. [ABSTRACT FROM AUTHOR]

Using expert reviews and item response theory (IRT), this study evaluated the language- and culture-related construct-irrelevant variance and reliability of the 2019 TIMSS sense of school belonging scale (SSBS) for grades 4 and 8. The five items of the SSBS, which were identical for both grades, were reviewed for the language- and culture-related construct-irrelevant variance evidence by 10 assessment experts who have expertise in Chinese and English languages and cultures. Further, the existing TIMSS 2019 SSBS data associated with the countries of China (Hong Kong), Singapore, Australia, and America were analyzed within the framework of IRT for estimating the item and scale information function values (i.e., reliability) of the SSBS. The experts did find language- and culture-related evidence in each of the five items that might lead to the construct variance of the SSBS across these four countries. The IRT results further indicated that the SSBS item and scale information function values varied considerably across these four countries. Suggestions for revising the SSBS are proposed for TIMSS program developers. [ABSTRACT FROM AUTHOR]

Background: Tuberculosis (TB) is a communicable disease that is a major cause of death and one of the leading causes of death worldwide. Currently, there is no analyzed data to examine the financial profile of TB by country, continent, and year; this article analyzed TB prevention, diagnosis, and treatment financial profile during the last two decades. Methods: Original research, reviews, and governmental databases are analyzed to present the financial profile of TB. Results: Analyzed data showed Europe (23137.133), Asia (20137.073), and Africa (15237.973) had the most allocated funds (US $ million), and Oceania (236.702), and America (4745.043) had the lowest allocated fund (US $ million) during 2006–2021. Additionally, the allocation of funds (domestic funds, global funds, and grants [excluding global funds]) in different countries and proper planning for TB eradication has caused that in the last two decades, the slope of the confirmed cases and deaths graph line is negative. Conclusion: The number of confirmed cases and deaths reported globally is decreasing. The trend lines showed that the assigned funds are increasing, indicating that the TB eradication plan can be apprehended soon. [ABSTRACT FROM AUTHOR]

One of the most successful defence pacts in history, Australia's alliance with America is becoming ever more central to our strategic policy. This is a bipartisan trend that has been supported by previous governments, including in the Morrison government's 2020 Defence Strategic Update, and is being implemented by the Albanese government, as confirmed in its 2023 Defence Strategic Review. At the same time, successive U.S. administrations have refocussed on the Indo-Pacific despite competing strategic priorities in other regions, including the Ukraine war. This has led to Australia and America pursuing a policy of deeper integration of their armed forces at the operational and strategic levels. This is most visible in northern Australia, whose value to Australian and allied defence planning is increasing for geopolitical reasons. Building on the Marine rotational force in Darwin announced in President Obama's pivot to Asia, U.S. force posture initiatives are upgrading northern Australian defence infrastructure and deploying additional forces for exercises and contingency planning at a time when Australia is also investing in its northern bases. While cutting-edge capabilities such as SSN-AUKUS submarines will boost Australia's strategic contribution to the alliance, its strength lies in the solid public support it enjoys. [ABSTRACT FROM AUTHOR]

Background: Autism spectrum disorder (ASD) is one of the serious developmental disorders that is usually diagnosed below the age of three years. Although the severity of the disease's symptoms varies from patient to patient, the ability to communicate with others is affected in all forms of ASD. This study aimed to determine the prevalence of ASD in high-risk groups by continent. Methods: The present study was conducted by systematic review and meta-analysis from 2008 to July 2021. Databases such as Science Direct, PubMed, Scopus, SID, Magiran, Web of Science (WoS), and Google Scholar from 2008 to July 2021 were searched to find related studies. Data were analysed using Comprehensive Meta-Analysis software (Version 2). Results: A total of 74 studies with 30,212,757 participants were included in this study. The prevalence of ASD in the world was 0.6% (95% confidence interval: 0.4–1%). Subgroup analyses indicated that the prevalence of ASD in Asia, America, Europe, Africa and Australia was 0.4% (95% CI: 0.1–1), 1% (95% CI: 0.8–1.1), 0.5% (95% CI: 0.2–1), 1% (95% CI: 0.3–3.1), 1.7% (95% CI: 0.5–6.1) respectively. Conclusion: ASD imposes a heavy health burden on communities around the world. Early detection of ASD can reduce the incidence of developmental disorders and improve patients' communication skills. Therefore, health policymakers need to be aware of the prevalence and increasing trend of ASD to implement appropriate planning and interventions to reduce its consequences. [ABSTRACT FROM AUTHOR]

Alcoholics Anonymous (AA) is an NGO designed to support anyone who identifies as alcoholic to stop drinking alcohol. Existing qualitative research in this field has primarily reflected the experiences of those who have conformed to AA ideology and had positive experiences in AA. To address this, the current study aimed to explore the perspectives and experiences of individuals who have left AA with some degree of disappointment. The study involved semi-structured interviews with 11 ex-members of AA from America, Australia, and England, who were recruited from several private social media platforms. The study used an interactionist conception of social career involving conversion and deconversion, and data were analyzed thematically. Findings included that while participants experienced some genuinely positive aspects of AA, they retrospectively believed that they remained in AA because they had been indoctrinated into a particular way of understanding themselves. Moreover, findings highlighted participants' concerns with the people, ideology and practices within AA that ultimately led to their dissociation from the community. Our findings demonstrate a disparity between the idealistic principles in AA and the actual experiences of participants, and this is discussed in relation to the breadth of possible experiences across varying groups and AA's unregulated peer-to-peer framework. [ABSTRACT FROM AUTHOR]

Background: Practice-integrated education and professional development programs (also known as residencies), have been available to pharmacists in America and the United Kingdom for many years. In 2016, the Society of Hospital Pharmacists of Australia launched Australia's novel Foundation Residency Program to support the development of early-career pharmacists, and has been implemented across many hospitals nationally. This model was adopted by the South Australian (SA) public hospital pharmacy statewide service and was granted full accreditation. The study aimed to explore key stakeholders' expectations and early perceptions of the structure, role and impact of the SA program and in that process, to identify key influencing factors and strategies informing future program planning and design. Methods: Purposeful sampling was adopted to recruit participants who oversee preceptors and residents, across all employment levels and pharmacy service sites. Stakeholders participated in individual semi-structured interviews. Each interview was audio-recorded and transcribed verbatim. The transcribed dataset was managed using NVivo softwareTM (version 10) and analysed using reflexive thematic analysis through the lens of the PRECEDE-PROCEED logic model framework. Results: Thirty-three staff consented to participate. Participants were de-identified with a randomly assigned code number. Three key themes were identified using reflexive thematic analysis; alignment of program goals and visions, culture shift to prioritising workforce development as core business, program structure supports focused workforce development. Conclusions: Participants view the residency as beneficial for development of the residents, preceptors, and the hospital pharmacy workforce. The multisite structure was a strength of the program. Whilst it was acknowledged that the rotations, cross-site rotations, and research project presented challenges, they were deemed worth the investment. Overall, it was felt that incremental increases in program capacity will occur over time, as culture changes, and as investing in workforce development becomes core business. The findings have led to several key recommendations to guide program expansion. [ABSTRACT FROM AUTHOR]

Cotton in Australia has always been entwined with America and England. From the initial stimulus of the American War of Independence to the boost created by the boll weevil outbreak in the 1920s, the fortunes of Australian cotton producers have been shaped by American history as much as their own nation’s political and economic imperatives. Scientists and farmers relied on American experience, importing seed, knowledge, personnel, and technology. The global market reflected fluctuations in the US cotton industry and the demands of English cotton mills. Australia relied on the imports of the English cotton mills and an injection of funds by the British Cotton Growing Association (BCGA) in the 1920s to boost industry. While Australian politicians promoted cotton as a domestic economic and demographic stimulant, fulfilment of these nation-state objectives was deeply entangled with, and dependent on, those of America and England. [ABSTRACT FROM AUTHOR]

In the 1980s, at the onset of the AIDS crisis, as public debate around youth sex education intensified, teenage girls in Australia and the United States looked to teen girl magazines for up-to-the-minute information on sex. Through a close textual analysis of Seventeen and Dolly magazines and original oral history interviews, this article explores the role of Australian and American teen girl magazines in the sex education of teenage girls during this time. While these magazines existed in very different national contexts, both drew on their long-standing role as trusted advisors to provide frank advice on sex and AIDS to teenage girls. My approach highlights how girls used their magazines as sources of accurate practical information and platforms to speak out about the need to take girls' sex education seriously, thus broadening our understanding of sex education and providing a new perspective on the agency of teenage girls within this. [ABSTRACT FROM AUTHOR]

Statistical trend analyses of observed precipitation (P) time series are key to validate theoretical arguments and climate projections suggesting that extreme P will increase in a warmer climate. Recent work warned about possible misinterpretation of trend tests if the presence of serial correlation and field significance are not considered. Here, we investigate these two aspects focusing on extreme P frequencies derived from 100‐year daily records of 1,087 worldwide gauges of the Global Historical Climatology Network. For this aim, we perform Monte Carlo experiments based on count time series generated with the Poisson integer autoregressive model and characterized by different sample size, level of autocorrelation, and trend magnitude. The main results are as follows. (a) Empirical autocorrelations are consistent with those of uncorrelated and stationary or nonstationary count time series, while empirical trends cannot be explained as the exclusive effect of autocorrelation; incorporating the impact of serial correlation in trend tests on extreme P frequency has then limited impacts on tests' performance. (b) Accounting for field significance improves interpretation of test results by limiting type‐I errors, but it also decreases test power; results of local tests could complement field significance outcomes and help identify weak trend signals where several trends of coherent sign are detected. (c) Based on these findings, evident patterns of statistically significant increasing (decreasing) trends emerge in central and eastern North America, northern Eurasia, and central Australia (southwestern America, southern Europe, and southern Australia). The methodological insights of this work support trend analyses of any hydroclimatic variable. Key Points: Monte Carlo simulations based on the integer autoregressive model allow assessing trends on observed extreme precipitation frequencyAccounting for serial correlation in observed extreme precipitation frequency has limited impact on statistical trend analysesAccounting for field significance limits type‐I error of statistical trend tests, but reduces power when the trend signal is low [ABSTRACT FROM AUTHOR]

This article analyses policing, ill-discipline, and crime in the Australian–American alliance during the Second World War. Though these topics have received considerable scholarly attention, previous studies have been narrowly focused both geographically and thematically. Providing a broad analysis of these subjects, this article places these issues within their wider political and legal context, and examines the nature of cooperation between Australian police (both military and civil) and their US allies. It also traces general patterns of ill-discipline and crime in Australia and its territory of Papua and mandate of New Guinea, highlighting policies that successfully limited inter-Allied violence. [ABSTRACT FROM AUTHOR]

The aim of the study is to assess the strength of the world stock exchanges reaction to the SARS-CoV-2 coronavirus pandemic at the turn of 2019–2020. We analyze the risk and intensity of the decline in the values of the basic stock indices by means of selected methods of survival analysis. The spreading pandemic within a few months covered all continents and had a significant impact on the socio-economic situation of all countries. We studied the time of the 20% drop in stock market indices. This is a value that is taken as a sign of a crisis. In order to assess the probability of indices' value decrease, we use the Kaplan–Meier's estimator. We determine the risk of decline by means of a logit model and the intensity of the decline by means of an empirical hazard estimator and the Cox proportional hazard model. The intensity and risk of the decline of stock indices varied from continent to continent. The obtained results show that the intensity is highest in the fourth and eighth week after the peak and is the highest on European exchanges and then American and Asian exchanges (including Australia). The risk of falling the stock indices' prices is the highest in America, followed by Europe, Asia and Australia, and lowest in Africa. Half of the analyzed indices record a 20% drop in value after 52 days (median duration). The study is a prelude to further analyses related to the crisis and the normalization of the situation on world stock exchanges. It allows to learn about the impact of the pandemic on the economic situation and to detect the differences between the continents. [ABSTRACT FROM AUTHOR]

Indigenous peoples are more likely than non-Indigenous peoples to experience family violence (FV), with wide-reaching impacts on individuals, families, and communities. Despite this, service providers indicate that Indigenous peoples are less likely to seek support than non-Indigenous peoples. Little is known about the reasons for this, particularly from the perspective of Indigenous people themselves. In this scoping review, we explore the views Indigenous peoples have on help seeking for FV. Online databases, Google Scholar, and reference lists were searched for relevant studies. Inclusion and exclusion criteria were applied so that only original studies where the Indigenous voice was specifically sought were chosen. Fifteen studies met our inclusion criteria including qualitative and mixed-methods research. Studies were conducted in the Americas, New Zealand, Australia, and India. Overall, findings suggest that Indigenous peoples are reluctant to engage in help-seeking behaviors for FV. Data were inductively organized into three main themes reflecting this reluctance: tendency to avoid help seeking (acknowledging the barriers of shame, tight-knit communities, and inappropriate service responses causing mistrust and fear), turning to informal support networks, and help is sought when crisis point is reached. We conclude that to overcome barriers for Indigenous peoples seeking help for FV, improving service providers response to FV through training and more research about what works is required; these activities need to be informed by both male and female Indigenous voices. [ABSTRACT FROM AUTHOR]

The number of people waiting for a transplant far outweighs the number of organ donors in Australia. The Northern Territory (NT) of Australia has the highest incidence of end-stage kidney disease (ESKD) in Australia. A large proportion of those with ESKD are First Nations Australians that require renal dialysis and who are more likely to require and benefit from a renal transplant. In 2018, 53% (21/40) of potential organ donors referred to DonateLife NT identified as First Nations Australian; one of these went on to become an organ donor. DonateLife NT coordinates all organ donation activities across the NT and is responsible for increasing community awareness, promoting the importance of organ donation, and discussing willingness to be an organ donor with families. During these activities with First Nations Australians, a variety of views that influence thoughts and decision making about organ donation have become very apparent. To explore this further, a literature review was undertaken to determine the views on organ donation among First Nations People and consider how this compared to the anecdotal experience of DonateLife NT. Findings from the literature review are consistent with the experience of DonateLife NT. To optimise dialogue about organ donation with First Nations People, it must be conducted in a respectful and culturally appropriate way. This serves to empower through enhancing knowledge and understanding and enables the ability to make informed decisions. Further qualitative research is recommended to increase understanding of the views of First Nations Australians about organ donation and ultimately ensure that donation discussions are appropriately informed, culturally secure, and form part of quality end of life care in hospital settings. [ABSTRACT FROM AUTHOR]

Background: The influence of social media and Twitter in general surgery research, mentorship, networking, and education is growing. Limited data exist regarding individuals who control the dialogue. Our goal was to characterize influencers leading the discussion in general surgery.Methods: Right Relevance Insight API was searched for "general surgery," and individual influencers were ranked by a comprehensive assessment of connections (followers/following) and engagement (likes, retweets, and comments). Profession, specialty, gender, and location were collected utilizing Twitter, Doximity, LinkedIn, ResearchGate, and institutional websites. American Board of Surgery and Royal College of Physicians and Surgeons of Canada were queried for board certification and academic h-index scores were acquired from Scopus.Results: Eighty-eight individual influencers in general surgery were identified, with 73 holding positions in general surgery. Attending level general surgeons comprised 50%, of which 91% are board certified, and 94% completed a fellowship (surgical oncology, laparoscopic surgery, critical care/trauma, and colorectal surgery). Residents comprised 31%; 11% were nonsurgeons and 3% were not physicians. The majority of residents and fellow influencers were female (72%). Many general surgery influencers were international (51%), particularly Canadian (28% overall). The academic h-indices for these influencers (n = 73) ranged from 0 to 73 (mean 14.5 ± 8.2; median 9.5).Discussion: Our data describe the positions, backgrounds, and research contributions of the top Twitter influencers in general surgery. Those engaged in social media should consider the background, expertise, and motivation of these influencers as the utilization and impact of this platform grows. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID‐19) is a zoonosis like most of the great plagues sculpting human history, from smallpox to pandemic influenza and human immunodeficiency virus. When viruses jump into a new species the outcome of infection ranges from asymptomatic to lethal, historically ascribed to "genetic resistance to viral disease." People have exploited these differences for good and bad, for developing vaccines from cowpox and horsepox virus, controlling rabbit plagues with myxoma virus and introducing smallpox during colonization of America and Australia. Differences in resistance to viral disease are at the core of the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) crisis, yet our understanding of the mechanisms in any interspecies leap falls short of the mark. Here I review how the two key parameters of viral disease are countered by fundamentally different genetic mechanisms for resistance: (1) virus transmission, countered primarily by activation of innate and adaptive immune responses; and (2) pathology, countered primarily by tolerance checkpoints to limit innate and adaptive immune responses. I discuss tolerance thresholds and the role of CD8 T cells to limit pathological immune responses, the problems posed by tolerant superspreaders and the signature coronavirus evasion strategy of eliciting only short‐lived neutralizing antibody responses. Pinpointing and targeting the mechanisms responsible for varying pathology and short‐lived antibody were beyond reach in previous zoonoses, but this time we are armed with genomic technologies and more knowledge of immune checkpoint genes. These known unknowns must now be tackled to solve the current COVID‐19 crisis and the inevitable zoonoses to follow. [ABSTRACT FROM AUTHOR]

Mycobacterial disease is an immense burden worldwide. This disease group includes tuberculosis, leprosy (Hansen's disease), Buruli Ulcer, and non-tuberculous mycobacterial (NTM) disease. The burden of NTM disease, both pulmonary and ulcerative, is drastically escalating globally, especially in developed countries such as America and Australia. Mycobacteria's ability to inhibit or evade the host immune system has contributed significantly to its continued prevalence. Pre-clinical studies have highlighted promising candidates that enhance endogenous pathways and/or limit destructive host responses. Autophagy is a cell-autonomous host defense mechanism by which intracytoplasmic cargos can be delivered and then destroyed in lysosomes. Previous studies have reported that autophagy-activating agents, small molecules, and autophagy-activating vaccines may be beneficial in restricting intracellular mycobacterial infection, even with multidrug-resistant strains. This review will examine how mycobacteria evade autophagy and discusses how autophagy could be exploited to design novel TB treatment strategies, such as host-directed therapeutics and vaccines, against Mycobacterium tuberculosis and NTMs. [ABSTRACT FROM AUTHOR]

Law Student Oaths, Honour Codes and Pledges have been variously used as a way to communicate and regulate standards of law student behaviour and to inculcate them into the ethical and professional values and attitudes seen as important for future legal professionals, such as a commitment to honesty and integrity. Variations of Oaths, Codes and Pledges are used extensively in America and in many other parts of the world. However, they have never really featured in the Australian university landscape. This article reports on the introduction of a Law Student Pledge as part of the first year law experience at the University of Wollongong (UOW) in New South Wales, Australia. Through focus groups held with students, feedback from first year teaching staff, and through a practice of collaborative review, this article reports on the impact, benefits and challenges of introducing the Pledge at UOW, as well as the research team's learnings and the future development of the Pledge. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is the most common cancer accounting for about one-fourth of total cancer cases and 15% of all cancer deaths among women worldwide. It is important to determine its trend across the regions in the world to find the high-focus regions. Hence, the current study was done to assess the global trends and deviations in the incidence of breast cancer. Materials and Methods: A descriptive trend analysis was done using the data on breast cancer incidence from the WHO Cancer Incidence Data of Five Continents plus database. Joinpoint regression was performed to determine the average annual percent change (AAPC), and age-period-cohort analysis was done to obtain age-, period-, and cohort-specific deviations and rate ratio. Results: All the regions showed an increasing trend in breast cancer incidence, with an exception of America. Maximum increase was observed in Asia (AAPC = 2.6%; 95% confidence interval [CI]: 2.4%--2.9%) followed by Europe (AAPC = 0.7%; 95% CI: 0.5%--1%). There was consistent rise in the breast cancer incidence across the age groups in all the four continents with maximum burden in elderly (P < 0.001). Except in America, all other regions showed consistent rise in the incidence of breast cancer through the periods 1998--2002 to 2007--2012 (P < 0.001). There was consistent increase across the cohorts from 1923--1927 to 1978--1982 in continents such as Asia and Oceania (P < 0.001). Conclusion: To summarize, the incidence of breast cancer shows an increasing trend globally with a maximum increase in the Asian region. This makes a strong need for newer strategies irrespective of current prevention and control interventions. [ABSTRACT FROM AUTHOR]

Considering that smoking is an important aspect of health in the immigrant population, the purpose of this study is therefore to pool studies that have examined smoking in the immigrant population to obtain a pooled prevalence. This study used the PRISMA protocol. Online available articles until March 2020 in PubMed and Scopus databases were targeted. After collecting the articles, data were extracted from them. The extracted data were analyzed in Stata software and the pooled prevalence of smoking was investigated. For a detailed analysis, several subgroups were analyzed. Heterogeneity was also studied in the studies. Of the 3585 articles that were found in the two databases, eventually, 52 articles were eligible. The prevalence of smoking is 24% with a confidence interval (CI) between 18% and 30%. For current smoking, the prevalence of smoking is 16% and for former smoking, the prevalence of smoking is 17%. In men, the prevalence of smoking is 38% and for women, the prevalence is 17%. The difference was noticeable in the prevalence of smoking on the continents. Europe has the highest prevalence of immigrant smokers (36%), followed by Asia (18%), American (18%), and Australia (12%). I2 and χ2 showed a high degree of heterogeneity. Given the known effects of smoking on different health dimensions, more attention is needed to the increasing health of the immigrant population. [ABSTRACT FROM AUTHOR]

With full belief in the need for Egyptian education - especially preuniversity education - to change in light of rigid and traditional curricula, many aspirations were attached to the Child University program as an alternative outlet in supporting an educational environment supportive of science and technology to achieve some of the goals and orientations of the state within the national strategy for science and technology And innovation 2030 AD, however, this program specifically in Fayoum University faces a set of obstacles to play its role in developing skills, scientific, technological, engineering, and sports STEM represented in the quality of the activities provided and the methods of their organization, and therefore the current research seeks to develop A set of proposed controls to activate the role of the Child University at Fayoum University in supporting STEM-based education by leveraging the experiences of the United States and Australia using the comparative approach. [ABSTRACT FROM AUTHOR]

During the period 2012-2016 field research was conducted in Australia and America which led to a different conceptualisation of educational leadership with an entirely new metaphor, that of ‘leading beautifully’ instead of either ‘effectively’ or ‘successfully’. This new image of leadership emanated from a two-pronged inquiry that side-stepped the dominant business and economic models in which leadership logic and practice were situated in both countries. In a quest to expand the vision of the nature of leadership in an area where success and attainment are not only as complex, but arguably more creative, the researchers turned to the arts and the concept of ‘performance’ as the indicator of attainment. They were especially influenced by the work of Elliot Eisner and his notion of the construct of connoisseurship, a term that included not only competence and skill development, but advanced considerably beyond those indices to include the acquisition of fine-grained distinctions rendered by a ‘discerning eye’. The empirical base for the study included interviews with 10 artists (painters, sculptors, dancers, choreographers, theatre directors and musical composers) and a similar number of educators who were school principals, a community arts educator and a school superintendent in America and an equivalent position in Australia. The results were presented in refereed papers at conferences of the Australian Association for Research in Education (AARE) and the American Educational Research Association (AERA). The study revealed how artists and leaders develop a ‘discerning eye’ and seven attributes of both groups of how this ability was developed and nurtured. The research also revealed 10 core dimensions of connoisseurship. The final outcome was a book published by Routledge, Leading Beautifully: Educational leadership as connoisseurship (English & Ehrich, 2016). [ABSTRACT FROM AUTHOR]

Objective: Evidence‐based management for patients with acute traumatic spinal cord injury (TSCI) in the ED has a critical impact on long‐term outcomes. Acute hypotension post‐injury may compromise spinal cord perfusion and extend neurological damage. Published guidelines recommend mean arterial blood pressure (BP) maintenance between 85 and 90 mmHg for 7 days post‐injury; the extent to which this is followed in Australia is unknown. Methods: Prospective observational study of patients ≥16 years with TSCI, treated at 48 hospitals across two Australian states. Mean arterial BPs were recorded in the Ambulance, and ED arrival and discharge. Patients' medical records documented treatment provided (intravenous fluids, vasopressors or both) for BP augmentation. Hypotension was defined as mean arterial BP <85 mmHg, per the American Association of Neurological Surgeons guidelines. Results: The 208 patients with TSCI in the present study were more likely to receive BP augmentation if they experienced direct transport to a Spinal Cord Service hospital (OR 5.57, 95% CI 2.32–10.11), had a cervical level injury (OR 2.32, 95% CI 1.01–5.5) or were hypotensive on ED arrival (OR 2.42, 95% CI 1.34–4.39). Of the 112 patients who were hypotensive, 71 (63.4%) received treatment for this; however, the majority (76%) remained hypotensive on discharge. Conclusion: Hypotensive patients' post‐TSCI experienced heterogeneous ED care discordant with published guidelines; varying by hospital type. Specialist care and more severe injury increased likelihood of guideline adherence. Lack of adherence may influence patient outcomes. Level 1 evidence is needed along with consistent guideline implementation and clinician training to likely improve TSCI management and outcomes. [ABSTRACT FROM AUTHOR]

Recent decades have brought growing interest in understanding and measuring psychological well-being. Although multiple measures of well-being exist, most were developed with Western populations. The current study tested the factor structure of a Chinese translation of the engagement, perseverance, optimism, connectedness and happiness (EPOCH) Measure of Adolescent Well-Being with 3,629 Chinese students (1,980 males, 1,649 females), and tested measurement invariance. The five-factor structure of the model was supported, and the model was invariant across age and gender. Combined with data from 2,041 American and 1,057 Australian adolescents, measurement invariance across cultures was supported for factor loadings but not intercepts or residuals. Results suggest that the factor structure is adequate across cultures, but the mean scores should not be directly compared. The findings support the EPOCH measure as an adequate scale, raise questions about different modeling decisions, and inform culturally sensitive approaches to comparing positive psychological variables across cultures. [ABSTRACT FROM AUTHOR]

Large trees are keystone structures in many terrestrial ecosystems. They contribute disproportionately to reproduction, recruitment and succession, and influence the structure, dynamics and diversity of forests. Recently, researchers have become concerned about evidence showing rapid declines in large, old trees in a range of ecosystems across the globe. We used ≥10 cm diameter at breast height (DBH) stem inventory data from 20, 0.5 ha forest plots spanning the wet tropical rainforest of Queensland, Australia to examine the contribution of large-diameter trees to above ground biomass (AGB), richness, dominance, mortality and recruitment. We show consistencies with tropical rainforest globally in that large-diameter trees (≥70 cm DBH) contribute much of the biomass (33%) from few trees (2.4% of stems ≥10 cm DBH) with the density of the largest trees explaining much of the variation (62%) in AGB across plots. Measurement of AGB in the largest 5% of trees allows plot biomass to be predicted with ~85% precision. In contrast to rainforest in Africa and America, we show that a high proportion of tree species are capable of reaching a large-diameter in Australian wet tropical rainforest resulting in weak biomass hyperdominance (~10% of species account for 50% of the biomass) leading to high potential resilience to regional disturbances and global environmental change. We show that the high AGB in Australian tropical forests is driven primarily by the high density of large trees coupled with contributions from high densities of medium size trees. Australian wet tropical rainforests are well positioned to maintain the current densities of large-diameter trees and high AGB into the future due to the species richness of large trees and a high density of replacement smaller trees. [ABSTRACT FROM AUTHOR]

Purpose A survey of guidelines and current practices was conducted to examine the safe handling procedures for antineoplastic and other hazardous drugs that are used in 24 countries including the Americas, Europe, the Mideast, Far East, and Australia. Methods Subject experts were asked to complete a brief survey regarding safe handling guidelines and practices for hazardous drugs in their countries. Questions addressed practices for handling monoclonal antibodies, the use of closed-system transfer devices, medical surveillance practices, and measurements of compliance with existing guidelines. Results Responses from 37 subject experts representing 24 countries revealed considerable variation in the content and scope of safe handling guidelines and pharmacy practices among the participating countries. Guidelines in the majority of countries used the term "cytotoxics," while others referred to "hazardous" or "antineoplastic" drugs. The International Society of Oncology Pharmacy Practice standard was cited by six countries, and five cited the National Institute for Occupational Safety and Health Alert. Others cited international guidelines other than International Society of Oncology Pharmacy Practice, or they have created their own guidelines. Approximately half reported that their guidelines were mandatory under federal, state, or provincial legislation. Only 11 countries reported that monoclonal antibodies were covered in their guidelines. Closed-system drug-transfer devices are widely used, but were not specifically recommended in four countries, while one country required their use. Medical surveillance programs are in place in 20 countries, but only in The Netherlands is surveillance mandatory. Nine countries reported that they have completed recent updates or revisions of guidelines, and the measures for their adoption have been initiated. Conclusions Although the overall goals in the participating countries were similar, the approaches taken to assure safe handling of hazardous drugs varied considerably in some cases. [ABSTRACT FROM AUTHOR]

The article compares the content and construct/convergent validity of five nutrient profiling models from places such as Canada, Europe, and the Americas, and it mentions evaluations of the nutritional quality and healthfulness of various food items.

Background: Tivantinib (ARQ 197), a selective, oral MET inhibitor, improved overall survival and progression-free survival compared with placebo in a randomised phase 2 study in patients with high MET expression (MET-high) hepatocellular carcinoma previously treated with sorafenib. The aim of this phase 3 study was to confirm the results of the phase 2 trial.Methods: We did a phase 3, randomised, double-blind, placebo-controlled study in 90 centres in Australia, the Americas, Europe, and New Zealand. Eligible patients were 18 years or older and had unresectable, histologically confirmed, hepatocellular carcinoma, an Eastern Cooperative Oncology Group performance status of 0-1, high MET expression (MET-high; staining intensity score ≥2 in ≥50% of tumour cells), Child-Pugh A cirrhosis, and radiographically-confirmed disease progression after receiving sorafenib-containing systemic therapy. We randomly assigned patients (2:1) in block sizes of three using a computer-generated randomisation sequence to receive oral tivantinib (120 mg twice daily) or placebo (twice daily); patients were stratified by vascular invasion, extrahepatic spread, and α-fetoprotein concentrations (≤200 ng/mL or >200 ng/mL). The primary endpoint was overall survival in the intention-to-treat population. Efficacy analyses were by intention to treat and safety analyses were done in all patients who received any amount of study drug. This study is registered with ClinicalTrials.gov, number NCT01755767.Findings: Between Dec 27, 2012, and Dec 10, 2015, 340 patients were randomly assigned to receive tivantinib (n=226) or placebo (n=114). At a median follow-up of 18·1 months (IQR 14·1-23·1), median overall survival was 8·4 months (95% CI 6·8-10·0) in the tivantinib group and 9·1 months (7·3-10·4) in the placebo group (hazard ratio 0·97; 95% CI 0·75-1·25; p=0·81). Grade 3 or worse treatment-emergent adverse events occurred in 125 (56%) of 225 patients in the tivantinib group and in 63 (55%) of 114 patients in the placebo group, with the most common being ascites (16 [7%] patients]), anaemia (11 [5%] patients), abdominal pain (nine [4%] patients), and neutropenia (nine [4%] patients) in the tivantinib group. 50 (22%) of 226 patients in the tivantinib group and 18 (16%) of 114 patients in the placebo group died within 30 days of the last dose of study medication, and general deterioration (eight [4%] patients) and hepatic failure (four [2%] patients) were the most common causes of death in the tivantinib group. Three (1%) of 225 patients in the tivantinib group died from a treatment-related adverse event (one sepsis, one anaemia and acute renal failure, and one acute coronary syndrome).Interpretation: Tivantinib did not improve overall survival compared with placebo in patients with MET-high advanced hepatocellular carcinoma previously treated with sorafenib. Although this METIV-HCC trial was negative, the study shows the feasibility of doing integral tissue biomarker studies in patients with advanced hepatocellular carcinoma. Additional randomised studies are needed to establish whether MET inhibition could be a potential therapy for some subsets of patients with advanced hepatocellular carcinoma.Funding: ArQule Inc and Daiichi Sankyo (Daiichi Sankyo Group). [ABSTRACT FROM AUTHOR]

The facility to describe scenes and events is important in everyday communication, but little is known about the description skills and strategies of young people using aided communication. This article explores how 81 children and adolescents using aided communication and 56 peers using natural speech, aged 5–15 years, described pictured scenes and events presented on video to a partner who had no prior knowledge of the content. The group who used aided communication took longer and included fewer elements in their descriptions than the reference group; however, the groups did not differ in their use of irrelevant or incorrect elements, suggesting that both groups stayed on topic. Measures related to aided message efficiency correlated significantly with measures of spoken language comprehension. There were no significant differences between groups for their descriptions of pictured scenes and video events. Analyses showed both unpredicted group similarities and predictable differences, suggesting key components for future research consideration. [ABSTRACT FROM PUBLISHER]

Narratives are a pervasive form of discourse and a rich source for exploring a range of language and cognitive skills. The limited research base to date suggests that narratives generated using aided communication may be structurally simple, and that features of cohesion and reference may be lacking. This study reports on the analysis of narratives generated in interactions involving aided communication in response to short, silent, video vignettes depicting events with unintended or unexpected consequences. Two measures were applied to the data: the Narrative Scoring Scheme and the Narrative Analysis Profile. A total of 15 participants who used aided communication interacted with three different communication partners (peers, parents, professionals) relaying narratives about three video events. Their narratives were evaluated with reference to narratives of 15 peers with typical development in response to the same short videos and to the narratives that were interpreted by their communication partners. Overall, the narratives generated using aided communication were shorter and less complete than those of the speaking peers, but they incorporated many similar elements. Topic maintenance and inclusion of scene-setting elements were consistent strengths. Communication partners offered rich interpretations of aided narratives. Relative to the aided narratives, these interpreted narratives were typically structurally more complete and cohesive and many incorporated more elaborated semantic content. The data reinforce the robust value of narratives in interaction and their potential for showcasing language and communication achievements in aided communication. [ABSTRACT FROM PUBLISHER]

A fundamental requirement of a supportive language development for young children who need aided communication is that an aided communication system is made available and its use is supported. There is limited information about the age at which children are typically provided with a communication aid or about how aided communication is used in everyday situations. Using questionnaire-based interview data, this study investigated (a) the pattern of provision of communication aids to 84 children and adolescents, (b) parents’ and professionals’ evaluation of the quality of communication across contexts, and (c) availability and use of aided communication in these contexts. The age at which the participants received their first aided system varied considerably across the group; however, most were considerably older than the age at which children with typical development usually begin to speak. Parents and professionals rated most everyday situations as good communication situations but reported that the participants did not have their main form of expressive language available in many of these situations, or did not use it much. Parents rated their child’s education in relation to aided language positively, but many professionals indicated that they had limited knowledge about the participant’s use of aided communication outside of the school environment, or about the parents’ attitudes. The study gives insights into the language learning situation of children and adolescents who develop aided communication. [ABSTRACT FROM PUBLISHER]

Children with severe motor impairments are restricted in their manipulation and exploration of objects, but little is known about how such limitations influence cognitive development. This study investigated visual-constructional abilities in 75 children and adolescents, aged 5;0–15;11 (years;months), with severe speech impairments and no intellectual disabilities (aided group) and in 56 children and adolescents with typical development (reference group). Verbal comprehension, non-verbal reasoning, and visual-spatial perception were assessed with standardized tests. The task of the participants was to verbally instruct communication partners to make physical constructions identical to models that the partner could not see. In the aided group, 55.7% of the constructions were identical to the models participants described, compared to 91.3% in the reference group. In the aided group, test results explained 51.4% of the variance in construction errors. The results indicate that the participants’ language skills were decisive for construction success. Visual-perceptual challenges were common among the aided communicators, and their instructions included little information about size and spatial relations. This may reflect less experience with object manipulation and construction than children with typical development, and using aided communication to instruct others to make three-dimensional constructions. The results imply a need for interventions that compensate for the lack of relevant experience. [ABSTRACT FROM PUBLISHER]