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Reflective practice has been adopted by many teachers, including dissertation advisors who provide 1:1 teaching of research students. This paper discusses issues arising from our use of qualitative data analysis software (QDAS) for reflective practice and provides an analysis of the thematic coding and word/pattern searches of feedback given to postgraduate research students. We subjected written feedback provided by one dissertation advisor to three different analyses: thematic, text-string and text-pattern search. We found that use of QDAS in a thematic analysis of feedback provides new insights by indicating areas of strength and areas for improvement. Text and pattern searches are more useful in flagging students with specific learning issues.

Studies of doctors' life satisfaction (subjective well-being) have largely overlooked the specific experiences of international or overseas trained doctors. This study explores any difference in life satisfaction and its determinants between international and domestic medical graduates (i.e. IMGs vs. DMGs), in Australia (a major destination country). We pooled eight waves of data from the Medicine in Australia: Balancing Employment and Life (MABEL) longitudinal survey of Australian doctors (2009–2016). Life satisfaction was measured on a standard 10-point scale. We applied Oaxaca and Ransom's linear decomposition method to evaluate factors associated with any observed difference in satisfaction between the two groups of doctors. IMGs were more likely to report lower life satisfaction than DMGs (mean 7.37 vs 7.48, p-value < 0.001). The well-being gap (of 0.11) was largely attributable to the groups' differences in observable characteristics such as psychosocial and demographic factors. Most notably, the IMG group was worse off with respect to self-reported financial security, exposure to work-related psychosocial risk factors, and community integration. Our study highlights the importance of the workplace and community context in understanding the life satisfaction difference between IMGs and DMGs. The study results may have important implications for policies and programs that seek to promote the integration and retention of IMGs. [ABSTRACT FROM AUTHOR]

Objective: To address the increasing diversity in the linguistic and ethnic backgrounds of medical students at the University of Melbourne, a program was developed to prepare students for the particular challenges in cultural literacy and idiomatic English language proficiency, especially when exploring sensitive areas of patients' personal history. The authors outline the University of Melbourne program and present two case studies. Results: Post hoc confidential survey of students' appraisals of the program is presented. Conclusion: The survey found a high level of acceptance and approval among most students.

Background: Emergency laparotomy (EL) is performed on about 15 500 patients in Australia each year. Aside from mortality there is significant concern about the possibility that previously independent patients discharged after EL will become reliant on long‐term dependent care. This study aimed to establish the proportion of patients not returning to their pre‐admission residence, a proxy for dependent care, following EL. Methods: Data were collected on all adult patients who underwent EL across four Australian hospitals over 2 years. A total of 113 data points were collected including pre‐hospital residence, discharge destination, mortality and place of residence at 90 and 365 days. Results: A total of 782 patients underwent EL, the mean age was 64 years. Pre‐admission, 95.5% of patients were living in their own home. Inpatient mortality was 7.0% and at discharge 72.4% of patients returned directly back to their pre‐hospital residence. At 90 days, mortality was 10.5%, and 87% of patients had returned to their pre‐hospital residence, including all patients under 70 years of age. By 365 days, overall mortality was 16.8%, and only 1.5% of patients (all aged >70 years) had not returned to their pre‐hospital residence. Conclusion: Patients who survive 90 and 365 days following EL nearly all return to their pre‐hospital residence, with only a very small proportion of previously independent patients entering dependent care. This should help inform shared decision‐making regarding emergency laparotomy in the acute setting. [ABSTRACT FROM AUTHOR]

PBL is described as small-group collaborative learning; however, literature on how collaboration is enacted in PBL contexts is limited. A two-year ethnographic study examined the experiences and responses of Asian students to the obligations of PBL in a Western context. Participant-observation, videotape data, and video-stimulated recall interviews provided insights into collaborative behaviors in PBL classrooms. Even though students recognized that listening and speaking were important to collaboration, speaking was clearly privileged over listening in this PBL setting. A framework was developed that incorporated both collaborative and noncollaborative listening and speaking behaviors. This Collaborative Listening/Speaking (CLS) framework provides a structure for tutors to scaffold the novice learners' collaborative skills, and therefore more effectively facilitate the group's learning through collaboration.

There is an increasing acceptance in the education literature and in classroom settings for "best practice" to be linked with verbal clarification of knowledge and reasoning, ideally in collaborative contexts where students construct both group and individual knowledge. Problem-based learning (PBL) is one such classroom context in which participation is viewed as leading to learning and where the nature of "good" participation is verbal contribution. Students who choose to participate without speaking, or "silent" students, are often seen as failing to learn, and significant tutor time is devoted to encouraging verbal input. This article examines the experience of four "silent participants" (two overseas-educated and two local Australian) in a PBL context. The analysis reported in this article suggests that students' choice to be silent is a consequence of multiple constraints--personal, contextual and cultural--and that silence should not be taken to signify lack of learning. (Contains 2 tables.)

Background. Mitigation of wildfires at the wildland-urban interface (WUI) will be enhanced by understanding the flammability of plants growing in this zone. Aims. We aimed to: (1) compare shoot flammability among wildland native, and both urban native and urban exotic ornamental plants; (2) quantify relationships between shoot traits and flammability; and (3) establish flammability scores to distinguish low-from high-flammability species. Methods. Flammability and traits of field-collected shoots were measured and relationships quantified in 44 species from the Blue Mountains World Heritage Area, Australia. Key results. In our study area, urban exotic plants were less flammable than wildland and urban native plants. Slow-igniting shoots had high fuel moisture and bulk density; short-burning shoots had low bulk density and volume; shoots recording low maximum temperatures had high fuel moisture, low bulk density and volume; and shoots with low biomass consumed in flames had high fuel moisture and low volume. Our novel flammability scores distinguished low-flammability (e.g. Lophostemon confertus) from high-flammability native species (e.g. Callistemon citrinus). Conclusions and implications. Low-flammability plantings at the WUI should preferably use native species given potential ecological impacts of exotics. We suggest that future work should seek to identify broader suites of low-flammability native species. [ABSTRACT FROM AUTHOR]

Notes the increasing use of English language testing in Australia for nonlinguistic purposes in contexts governed by political pressures. Explores recent test examples and the pragmatic considerations giving rise to such test development. (28 references) (Author/CK)

Australia and Canada are global exemplars of skilled migration policy, designed to have important effects on economic growth. This article assesses the development and outcomes of their permanent migration programmes for a range of regulated professions. We compare the matched census data from both countries in 2016 and then examine the key drivers of the major differences found through qualitative interviews. Although the trends in numbers and source countries and characteristics of skilled migrants are similar, their earnings relative to equivalent native‐born earnings are far lower in Canada than in Australia. This reflects the Australian government's greater power to initiate and drive policy reform agendas, early strategies designed to enhance foreign credential recognition and a heightened role for employers including through two‐step migration. Canada has recently announced significantly expanded migration intakes. These seem unlikely to lead to strong economic growth, unless entry requirements are tightened and more targeted support provided. [ABSTRACT FROM AUTHOR]

Summary: Background: Benefits of breastfeeding on infant growth in children born to mothers with gestational diabetes mellitus (GDM) are uncertain. Objectives: To describe growth trajectories between birth and 14 months according to breastfeeding and maternal hyperglycaemia in pregnancy, and assess associations between breastfeeding and 14 month growth outcomes among children born to mothers with GDM. Subjects/methods: Data on 258 Aboriginal and Torres Strait Islander infants from the PANDORA study born to mothers with normoglycaemia (n = 73), GDM (n = 122), or with pre‐existing type 2 diabetes (n = 63) in pregnancy were assessed. Infant weight and BMI growth trajectories according to predominant breastfeeding at 6 months and hyperglycaemia in pregnancy were developed using mixed‐effect models and cubic splines. Associations between breastfeeding and 14‐month growth outcomes (z‐scores: weight‐for‐age, weight‐for‐length and BMI) were evaluated using linear regression in a subgroup of infants born to mothers with GDM. Results: Predominantly breastfed infants had lower BMI trajectories compared to those not predominantly breastfed, irrespective of maternal hyperglycaemia in pregnancy status (p < 0.01 for all groups), and lower weight trajectories among those born to mothers with GDM (p = 0.006). Among offspring of women with GDM, predominant breastfeeding was only associated with lower weight‐for‐age at 14 months, however adjusting for maternal obesity, smoking, and parity attenuated observed associations. Maternal obesity remained significantly associated with greater infant growth. Conclusions: Predominant breastfeeding was associated with reduced growth among children born to women with and without hyperglycaemia in pregnancy. However, among children exposed to GDM in utero, maternal obesity largely explained this association. [ABSTRACT FROM AUTHOR]

Marine species are declining at an unprecedented rate, catalyzing many nations to adopt conservation and management targets within their jurisdictions. However, marine species and the biophysical processes that sustain them are naive to international borders. An understanding of the prevalence of cross‐border species distributions is important for informing high‐level conservation strategies, such as bilateral or regional agreements. Here, we examined 28,252 distribution maps to determine the number and locations of transboundary marine plants and animals. More than 90% of species have ranges spanning at least two jurisdictions, with 58% covering more than 10 jurisdictions. All jurisdictions have at least one transboundary species, with the highest concentrations of transboundary species in the USA, Australia, Indonesia, and the Areas Beyond National Jurisdiction. Distributions of mapped biodiversity indicate that overcoming the challenges of multinational governance is critical for a much wider suite of species than migratory megavertebrates and commercially exploited fish stocks—the groups that have received the vast majority of multinational management attention. To effectively protect marine biodiversity, international governance mechanisms (particularly those related to the Convention on Biological Diversity, the Convention on Migratory Species, and Regional Seas Organizations) must be expanded to promote multinational conservation planning, and complimented by a holistic governance framework for biodiversity beyond national jurisdiction. [ABSTRACT FROM AUTHOR]

A challenge for natural area managers is to ensure that public expenditure on land restoration is cost effective, efficient and transparent but this is difficult to achieve in practice, especially when there are many possible projects across multiple years. Here we develop a "roadmap" for investment in land restoration. It explicitly considers space, time and their interaction, in relation to ecological outcomes and restoration costs (and their variation in time and space). Using integer linear programming optimization in a benefit‐cost accounting framework, the roadmap incorporates: transitions between different stages of ecological recovery in a spatial mosaic of multiple ecosystem types; cost schedules associated with managing those transitions over time; time lags between beginning management and achieving outcomes; variations to constraints and goals associated with various factors including site accessibility, specific conservation priorities (such as threatened species or ecosystems); and background environmental trends. This approach enables land managers to: (1) forecast landscape‐scale outcomes of management strategies over long timeframes; (2) address the question of how long it will take and how much it will cost to achieve specific outcomes; and (3) explore potential trade‐offs in outcomes among alternative management strategies. We illustrate its application using a case study of forest restoration in Australia by a local government authority across a public conservation estate comprising 765 land units of varying size, totaling ˜13,000 ha, across five different floristic vegetation types, with an annual budget of ˜AU$5M, projected over a 50‐yr timeframe. These simulations revealed a trade‐off between management strategies that seek to increase either the total cover of native forest or the amount of high quality forest: quality‐based strategies were favored in scenarios in which shorter term (20–30 yr) timeframes were chosen at the outset, but cover‐based strategies were favored if longer time horizons were initially targeted. Projected outcomes were also strongly influenced by assumed background rates of vegetation decline or recovery. Many of the issues in this restoration roadmap are generalizable (even though specific outcomes and trade‐offs are likely to vary among case studies), and the approach is both scalable and transferable to other regions and ecosystems. [ABSTRACT FROM AUTHOR]

This research looked at the attitudes of Community Health Service (CHS) staff regarding the integration of a lawyer into their CHS both before and after the integration occurred. It assessed their confidence in identifying and addressing elder abuse at each point. A written survey was distributed to staff before the lawyer commenced (n = 126), and approximately 12 months afterwards (n = 54). The preliminary survey demonstrated widespread agreement that legal issues can affect older people and supported having a lawyer in a CHS. Respondents were not confident about their capacity to identify abuse and provide referrals to a lawyer, but this improved in the follow‐up survey. These CHS staff were aware of the potential impacts of elder abuse and supported embedding a lawyer in the health service. Information and training as part of this service model should focus on the skills needed for CHS staff to play their role in such a partnership. [ABSTRACT FROM AUTHOR]

In this commentary, we present a brief history of the development of a national regulatory framework for xenotransplantation clinical research in Australia, including the reasons behind the imposition of a 5‐year moratorium in 2005 and its subsequent lifting. We conclude with a summary of current relevant guidelines and standards. [ABSTRACT FROM AUTHOR]

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• Most factors influencing interest and preparedness are modifiable to some extent. • Clarity is needed on the role and employment model to piqué pharmacist interest. • Clinical and interpersonal skills are among key factors influencing preparedness. High rates of suboptimal medication use exist in residential aged care facilities (RACFs). Pharmacist interventions can improve medication appropriateness. In 2023 there will be a phased implementation of pharmacists working on-site in Australian RACFs. To explore factors influencing Australian pharmacists' interest and perceived preparedness to work as on-site pharmacists in RACFs. A national cross-sectional anonymous online survey of Australian pharmacists was conducted. Pharmacists were recruited using a broad advertising strategy. The 36-question survey included three free-text questions that are the focus of this study. The questions asked participants (1) what influenced their interest in the role, (2) what influenced how prepared they felt for the role, and (3) if they had any other comments about the role. Responses were thematically analysed by two investigators using an inductive approach. Most survey respondents (n=546, 84.9%) answered at least one free-text questions. Four factors influenced interest: on-site pharmacist role, aged care setting, individual pharmacist circumstances and employment model. Four factors influenced preparedness: familiarity with aged care setting, resident-level clinical skills; ability to communicate and work with a multidisciplinary team, and experience with system-level quality use of medicines activities. Four factors important for successful roll-out emerged from the 'other comments': pharmacist attributes, pharmacist workforce planning, resources and support, and RACF stakeholder engagement. Key factors influencing pharmacist interest and preparedness to work on-site in RACFs and factors important for success were identified. These findings will support the national roll-out of the role, particularly as most identified factors are currently modifiable. [Display omitted] [ABSTRACT FROM AUTHOR]

Many people experience legal issues that affect their health, but do not seek legal help, particularly if they are disadvantaged in some way. This may be because they do not recognise they have a legal problem, they are unwilling or unable to address it, or they do not know how to go about dealing with it. Most people seek health care at some point, so linking health and legal services may help promote access to justice. There have been ongoing efforts in Australia to link health and law services, such as through co-locating health and legal services or through running legal 'clinics' in health services, but these have not always reached the intended clients. Fully integrated health justice partnerships are a model where the law/health partnership is collaborative at all levels of the organisation. This perspective piece argues that the model is particularly suitable for health services that have clients with needs in a specific area of law, and should be carefully targeted to where it is most needed. Factors that contribute to successful implementation of the model are described. [ABSTRACT FROM AUTHOR]

This special issue shares how early career researchers (ECRs) are using their scholarship to think through how the research-practice nexus might be differently negotiated and understood to build potential for change. As urban scholars, we are drawn to the plight of cities, not just with a curiosity that besets most researchers to describe, analyse and offer comment, but also with a vision to shape new perspectives and ways of thinking. To this end, urban scholarship across Australia and New Zealand becomes political, motivated by a desire for new ways of doing planning to support inclusiveness, diversity, and ecological stewardship. Sometimes colliding with prevailing orthodoxy, dominant discourses, and entrenched frameworks that determine how planners, politicians, and residents think about urban issues, urban researchers are required to consider innovative ways to engage with policy and practice that move ‘beyond’ these norms and discourses. This editorial positions the contributions in this issue against the question of how are ERCs (re)constituting urban research in a neoliberal climate. [ABSTRACT FROM PUBLISHER]

This paper has four aims. First, it defines the extent to which skilled migration to Australia has changed in recent decades in terms of scale, source country, and entry mode. Second, it describes Australia's federally driven foreign qualification recognition (FQR) reform strategy, including the pressure imposed by successive parliamentary reviews to improve outcomes. Third, it reports the growing engagement of select health regulators in reform, at a time when temporary workers constitute three-quarters of skilled migrants, and the question increasingly asked is whether regulatory bodies have the agility to facilitate twenty-first century labour migration flows. Finally, it assesses the contribution of qualification recognition reform to skilled migrants' recognition and early employment outcomes. Key learnings from Australia's FQR experience are then highlighted, of potential policy relevance to Canada. [ABSTRACT FROM AUTHOR]

Services have been increasingly directed at supporting carers of people living with mental illness but it is difficult to evaluate the impact of service change where benchmarks for carer functioning are sparse. Sixty Australian carers were assessed regarding their quality of life, psychological distress, social isolation and caregiving experience. Their scores were compared with two matched community samples and previous studies. Carers were ten times more likely to be socially isolated and quality of life was significantly less than matched community samples. Over 40 % of the carer sample met criteria for probable psychiatric disorder. Comparison of caregiving experiences with a study 15 years ago showed no improvement in negative caregiving experiences. Carers still face considerable challenges to their wellbeing as they support people living with mental illness, in spite of progress in the development of policy and services. [ABSTRACT FROM AUTHOR]

In recent years OECD countries have prioritized international students as a human capital resource. To assess their labour migration outcomes, this article defines Australian employment rates the year after graduation by two measures. Our first in-depth case study (drawing on the Graduate Destination Survey) compares international students' work status to that of domestic students in 11 professions, from 2007 to 2011. Our second case study (based on the Immigration Department's Continuous Survey of Australia's Migrants) reports the employment rates achieved from 2009 to 2011 by international students who have secured skilled migrant status in Australia, compared with those of skilled category applicants selected off-shore. Empirical analyses such as these are rare in the existing study-migration literature, which is dominated by policy and qualitative perspectives. The findings are relevant to international students as well as policymakers, in a context where governments frame migration policy but employers maintain the power to offer/withhold work. [ABSTRACT FROM AUTHOR]

Objectives: Reviews of patient satisfaction suggest seven dimensions, each of which should be assessed. This study reports development of a short generic patient satisfaction measure for use in routine clinical practice. Study Design and Settings: Participants were randomly recruited from two Australian incontinence clinics. Participants completed a follow-up questionnaire including patient satisfaction items. Iterative Mokken and Rasch analyses derived the Short Assessment of Patient Satisfaction (SAPS) scale from the item bank. Results: The SAPS psychometric properties illustrated the following features, namely its descriptive system covers all seven patient satisfaction dimensions, there were no misfitting items, and the scale exceeded the Loevinger H criteria for a strong unidimensional scale. The reliability of the SAPS was Cronbach α = 50.86. When discriminatory function was examined, the SAPS scale was more sensitive than two other generic patient satisfaction instruments. Conclusion: The SAPS scale is based on a firm theoretical model of patient satisfaction and its descriptive system covers the known dimensions contributing to patient satisfaction. Its internal psychometric properties exceeded standard psychometric standards, and it discriminated at least as well as other longer patient satisfaction measures. Although it needs further validation, the study results suggest that it may be useful for assessing patient satisfaction with health care. Copyright. [ABSTRACT FROM AUTHOR]

In the past two years Australia's reputation as a safe high quality education destination has suffered devastating damage in India - a process exacerbated by 2010-12 changes to the study-migration pathway. Within this context Indian enrolments dropped 27 per cent from 2010 to 2011 and 25 per cent from 2011 to 2012. This article examines the complex interplay of migration and education policies in relation to Indian students in the past decade. It assesses the quantitative evidence available concerning former Indian students' study choices, engagement in two-step migration, and employment outcomes relative to other international students and offshore Indian migrants to date. The likely impacts of the latest skilled migration policy trends are then explored, in a context where India remains Australia's second ranked export education market. [ABSTRACT FROM AUTHOR]

Long lead rainfall forecasts are highly valuable for planning and management of water resources and agriculture. In this study, we establish multiple statistical calibration and bridging models that use general circulation model (GCM) outputs as predictors to produce monthly rainfall forecasts for Australia with lead times up to 8 months. The statistical calibration models make use of raw forecasts of rainfall from a coupled GCM, and the statistical bridging models make use of sea surface temperature (SST) forecasts of the GCM. The forecasts from the multiple models are merged through Bayesian model averaging to take advantage of the strengths of individual models. The skill of monthly rainfall forecasts is generally low. Compared to forecasting seasonal rainfall totals, it is more challenging to forecast monthly rainfall. However, there are regions and months for which forecasts are skillful. In particular, there are months of the year for which forecasts can be skillfully made at long lead times. This is most evident for the period of November and December. Using GCM forecasts of SST through bridging clearly improves monthly rainfall forecasts. For lead time 0, the improvement is particularly evident for February to March, July and October to December. For longer lead times, the benefit of bridging is more apparent. As lead time increases, bridging is able to maintain forecast skill much better than when only calibration is applied. [ABSTRACT FROM AUTHOR]

Background: Australia's ageing population means that there is increasing emphasis on developing innovative models of health care delivery for older adults. The assessment of the most appropriate mix of services and measurement of their impact on patient outcomes is challenging. The aim of this evaluation was to describe the health related quality of life (HRQoL) of older adults with complex needs and to explore the relationship between HRQoL, readmission to acute care and survival. Methods: The study was conducted in metropolitan Melbourne, Australia; participants were recruited from a cohort of older adults enrolled in a multidisciplinary case management service. HRQoL was measured at enrolment into the case-management service using The Assessment of Quality of Life (AQoL) instrument. In 2007-2009, participating service clinicians approached their patients and asked for consent to study participation. Administrative databases were used to obtain data on comorbidities (Charlson Comorbidity Index) at enrolment, and follow-up data on acute care readmissions over 12 months and five year mortality. HRQoL was compared to aged-matched norms using Welch's approximate t-tests. Univariate and multivariate logistic regression models were used to explore which patient factors were predictive of readmissions and mortality. Results: There were 210 study participants, mean age 78 years, 67% were female. Participants reported significantly worse HRQoL than age-matched population norms with a mean AQOL of 0.30 (SD 0.27). Seventy-eight (38%) participants were readmitted over 12-months and 5-year mortality was 65 (31%). Multivariate regression found that an AQOL utility score <0.37 (OR 1.95, 95%CI, 1.03 - 3.70), and a Charlson Comorbidity Index ≥6 (OR 4.89, 95%CI 2.37 - 10.09) were predictive of readmission. Multivariate analysis demonstrated that age ≥80 years (OR 7.15, 95%CI, 1.83 - 28.02), and Charlson Comorbidity Index ≥6 (OR 6.00, 95%CI, 2.82 - 12.79) were predictive of death. Conclusion: This study confirms that the AQoL instrument is a robust measure of HRQoL in older community-dwelling adults with chronic illness. Lower self-reported HRQoL was associated with an increased risk of readmission independently of comorbidity and kind of service provided, but was not an independent predictor of five-year mortality. [ABSTRACT FROM AUTHOR]

Introduction Atypical antipsychotics are increasingly recommended as first-line treatments in international clinical guidelines. However, recent meta-analyses and effectiveness studies have found few differences between typicals and atypicals. We aimed to assess the use of atypical and typical antipsychotic medicines, their perceived effectiveness and tolerability, and associated health-related quality of life among Australian community patients with an established diagnosis of schizophrenia or related disorders. Methods A random sample of people with schizophrenia spectrum disorders ( n = 83) attending four public mental health clinics, and their treating clinicians and family carers, completed questionnaires on the effectiveness, acceptability and side-effects of current, previous and early antipsychotic medicine. Medicine use was determined from clinical notes. The Assessment of Quality of Life, Drug Attitude Inventory and Friendship Scale were also used. Results A significant shift over time towards atypical medicine use was reported: 66% of current antipsychotic use. Perceived effectiveness, satisfaction and side-effects did not differ when comparing medicine type (typical/depot/atypical) for early, previous and current medicines used. Health-related quality of life was associated with reported side-effects, but not with current medicine type. Agreement was poor between patients, case managers and carers about medicine use. Discussion Consistent with recent effectiveness trials, the findings suggest that any differences in the experience of typical and atypical antipsychotics of patients with established illnesses are obscured in the complex setting of real-world practice. Further, poor agreement between patients, case managers and carers about medicine use may indicate that they each have different understandings of the medicines that are being used. [ABSTRACT FROM AUTHOR]

The worldwide burden of diabetes is projected to be 5.4% of the adult population by the year 2025. Diabetes is associated with multiple medical complications that both decrease health-related quality of life (HR-QOL) and contribute to earlier mortality. There is growing evidence for the effectiveness of multidisciplinary disease management programs that incorporate self-management principles in improving patients' long-term outcomes. The aim of this project was to evaluate the effectiveness of this approach in improving: (1) glycemic control measured by HbA1c, and (2) HR-QOL measured by the Assessment of Quality of Life (AQOL), at enrollment and at 12-months follow-up. Between 2004 and 2008, a total of 967 patients were enrolled in the program; 545 (56%) of these patients had HbA1c data available at baseline and at 12 months. Mean HbA1c at enrollment was 8.6% (SD 1.9) versus 7.3% (SD 1.2) at 12 months ( P < 0.001). Overall, 68% of patients experienced improvements in HbA1c. At enrollment, patients reported 'fair' HR-QOL, which was significantly lower than age-adjusted population norms who reported 'good' HR-QOL. At 12 months, 251 (64%) patients had improved HR-QOL, 27 (7%) had no change, and 114 (29%) deteriorated. Mean utility scores improved by 0.11 ( P < 0.001), which is almost twice the minimum clinically important difference for the AQOL. This study confirms that a multidisciplinary disease management program for patients with poorly controlled type 2 diabetes can improve both glycemic control and HR-QOL. ( Population Health Management 2012;15:12-19) [ABSTRACT FROM AUTHOR]

The developed world continues to face a critical shortage of nurses that is yet to become more acute with an ageing population, and as a consequence the chain effect of the brain drain or brain circulation will continue. Brain drain is a thoroughly researched and documented phenomenon where source countries such as the Philippines supply nurses to the world, thereby losing their best qualified nurses to developed countries. This creates losses to the source country that trained them, given many leave soon after gaining qualifications and preliminary experience for more lucrative salaries and better lifestyles in the developed world. The situation is particularly complicated in relation to the Philippines, which has positioned itself as a global supplier of nurses, making human resource export a national government strategy. This paper explores fundamental issues surrounding health professional migration in order to assess ways of creating a win-win situation for both source and receiving countries and individual workers, taking the Philippines as a case study. The purpose of this paper is to provide background information on Filipino nurses in Australia within the context of the Philippines as a global supplier of nurses. This paper formed the foundation of an Australian Research Council Linkage Grant with Partner Organisations; Queensland Health and the University of Sydney, Griffith University, Queensland University of Technology and The University of Melbourne. Key collaborators also include York University and Queen Margaret University. [ABSTRACT FROM AUTHOR]

Abstract: The Quality of Life after Brain Injury (QOLIBRI) is a new international instrument for assessing quality of life after traumatic brain injury (TBI). We report first use and validation. Patients previously admitted with TBI to the Royal Melbourne Hospital, Melbourne, Australia, were randomly sampled (n =66, 61% response rate) and administered the QOLIBRI. Fifty-five re-completed it at 2-week follow-up. QOLIBRI scales (with two exceptions) met standard criteria for internal consistency, homogeneity and test–re-test reliability. Correlations with the Assessment of Quality of Life, Short Form-36 version 2 and the Satisfaction with Life Scale were moderate. The QOLIBRI was sensitive to the Glasgow Outcome Scale – Extended scores, Hospital Anxiety and Depression scale, and measures of social isolation (Friendship Scale). There was evidence that further refinement may improve the QOLIBRI. The QOLIBRI should be considered as an outcome measure by clinicians and researchers conducting treatment trials, rehabilitation studies or epidemiological surveys into the treatment or sequelae of trauma. [ABSTRACT FROM AUTHOR]

Objective: To report the clinical use of the QOLIBRI, a disease-specific measure of health-related quality-of-life (HRQoL) after traumatic brain injury (TBI). Methods: The QOLIBRI, with 37 items in six scales (cognition, self, daily life and autonomy, social relationships, emotions and physical problems) was completed by 795 patients in six languages (Finnish, German, Italian, French, English and Dutch). QOLIBRI scores were examined by variables likely to be influenced by rehabilitation interventions and included socio-demographic, functional outcome, health status and mental health variables. Results: The QOLIBRI was self-completed by 73% of participants and 27% completed it in interview. It was sensitive to areas of life amenable to intervention, such as accommodation, work participation, health status (including mental health) and functional outcome. Conclusion: The QOLIBRI provides information about patient's subjective perception of his/her HRQoL which supplements clinical measures and measures of functional outcome. It can be applied across different populations and cultures. It allows the identification of personal needs, the prioritization of therapeutic goals and the evaluation of individual progress. It may also be useful in clinical trials and in longitudinal studies of TBI recovery. [ABSTRACT FROM AUTHOR]

The article presents a study that investigates the potential contribution of international medical students at Australian universities to the medical workforce. Included in the study are a survey of 619 international medical students in their final two years of undergraduate- and graduate-entry medical courses in 2006-2007, and a 2009 survey of 88 international medical graduates of the University of Melbourne. Based on the results, the authors cited the eligibility of international medical students as medical workforce resource.

Quantified estimates of southern rock lobster ( Jasus edwardii) puerulus settlement have been undertaken in the Southern Zone fishery of South Australia since the early 1990s. An analysis of mean monthly puerulus settlement indices from 1995 to 2007 in three monitoring sites revealed a strong seasonal correlation ( r > 0.94 between sites) in settlement patterns. Settlement was highest during the winter months of June, July and August with peak settlement in all sites occurring in July. A reduced secondary settlement occurred during February and March. Seasonal trends were correlated with monthly wind stress and direction data in order to investigate possible environmental drivers of settlement. Using monthly averages of wind stress, it was hypothesized that strong along-shore wind-stress anomalies (ASWSA) prior to peak settlement would influence puerulus indices. Maximum ASWSA over the December–May period prior to maximum settlement was therefore examined. The results showed significant correlations ( P < 0.1, r = 0.51–0.90) between wind stress and puerulus settlement in all but one site. We suggest that storm events, in combination with onshore surface drift during the period of settlement, are the principal physical oceanographic mechanisms influencing settlement patterns within the Southern Zone rock lobster fishery of South Australia. [ABSTRACT FROM AUTHOR]

In the past decade, Australia has developed unprecedented reliance on skilled migrants, a process intensified by a period of sustained economic boom. By 2007, two-thirds were former international students recruited in Australia rather than offshore applicants, exemplifying a transition to what is termed "two-step migration." How acceptable, however, are such onshore applicants to employers, in a context where Australia's 2006 skilled migration review found less favorable outcomes for former international students than migrants recruited offshore? To address this question, key education enrollment, migration and employment databases were analyzed in-depth. Overall, former international students were found to achieve comparable labor market participation rates to migrants recruited offshore. However, former students qualified in two-year courses and/or in oversubscribed fields performed worse than offshore migrants. Between 2007 and 2010, Australia introduced major policy reforms to improve the outcomes for international students applying under the skilled migration program. In February 2010, the government corrected education sector abuses while significantly changing selection processes. This decade of Australian policy experimentation may be instructive to other countries which have introduced study-migration pathways designed to attract and retain former students as skilled migrants. [ABSTRACT FROM AUTHOR]

Background: Kidney transplants using organs from paediatric cadaver donors are uncommon and technically difficult. It has become accepted practice to transplant both kidneys en bloc from donors of 5 years into a single recipient. We aim to compare outcomes of en bloc kidney (EBK) transplants versus single kidney (SK) transplants from cadaver donors of age 5 years and lesser. Methods: Data reported to Australia and New Zealand Dialysis and Transplant Registry from 1989 to 2004 were analysed. Results: From donors 5 years of age and younger, there were 33 EBK and 38 SK transplants carried out. Overall graft survival rates at 1 and 5 years were 78 and 61%, respectively, in the EBK group and 63 and 55%, respectively, in the SK group ( P = 0.94). Vascular thrombosis was the most common cause of early graft loss with an incidence of 11 and 18%, respectively, in the EBK and SK groups ( P = 0.5). Conclusion: There is a trend towards a lower vascular thrombosis rate and a better long-term graft survival in EBK transplants. These transplants will remain a technical challenge for the surgeon and EBK transplants should remain the technique of choice for donors of 5 years and lesser. [ABSTRACT FROM AUTHOR]

A sample of 260 Australian men were surveyed about their experience as nonresident fathers and their contact with their children. Most reported having little input into decisions concerning children's postseparation living arrangements, the amount of child support they paid, and the spending of their child support payments. Many claimed to have very limited say in any parenting decisions, and little or no involvement in children's schools. Fathers' limited parental role was found to be negatively correlated with their ongoing contact and involvement with children, and positively with their reported level of interparental hostility. Many respondents viewed their marginalization as parents as an impediment to their capacity to develop meaningful relationships with their children. [ABSTRACT FROM AUTHOR]

Objective: There is conflicting evidence as to whether depression prevalence is increasing or is stable. Although birth cohort analysis studies show increasing prevalence, longitudinal studies do not. To date there are no published Australian studies providing long-term estimates of depression prevalence. The aim of the present study was to examine the increasing depression prevalence hypothesis in an Australian context. Method: Data from the 1998 and 2004 South Australian Health Omnibus Surveys were re-analysed. In each survey there were >3000 participants who were interviewed. The data were weighted to achieve representativeness prior to analysis. Depression status was classified by the Primary Care Evaluation of Mental Disorders scale (the PRIME - MD) into major, other and no depressions. Both univariate and multivariable analyses were used to examine depression trends over time and to adjust the data for significant background variables. Results: There was no significant increase in the cases of patients classified with major depression between 1998 and 2004; there was, however, a significant decrease in other depression. The overall unadjusted prevalence of major depression was 7.4% (6.8% in 1998 and 8.0% in 2004) and for other depression it was 9.5% (10.6% in 1998 and 8.4% in 2004). The highest levels of depression, both major and other, were observed among females aged 15-29 years, and the lowest levels among those aged ≥50 years. The strongest predictor of depression was poor overall health status. Conclusion: It is time for the conventional wisdom that depression is increasing to be reconsidered, and for a more realistic perspective, developed from evidence-based analyses, to be accepted. [ABSTRACT FROM AUTHOR]

Although there are many studies reporting perceived social isolation or loneliness and their correlates in specific groups, there are few modern prevalence studies. This study reports on the prevalence of perceived social isolation in an Australian community sample. Randomly sampled Australian adults ( n = 3,015) were interviewed using a standard questionnaire. In addition to perceived social isolation assessed by the Friendship Scale, data were collected on socio-demographic variables and chronic health conditions. The findings suggest that while most participants were socially connected, 9% reported some social isolation and 7% were isolated or very isolated. Perceived social isolation varied by gender and age group, region of birth, relationship, labourforce, and income status. A key finding was that younger adults had higher probabilities of being classified as being socially isolated than did older participants. Depression was very strongly associated with perceived social isolation. Other health conditions or life experiences associated with it were hearing, incontinence and lifetime trauma exposure. The demographic characteristics and chronic health conditions associated with perceived social isolation are structural circumstances of peoples’ lives. Given there are poor long-term health outcomes, including early death and suicide, there are clear public health implications for those trapped by these life circumstances. [ABSTRACT FROM AUTHOR]