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The validity of Scolopsis regina Whitley 1937, described from a single specimen from Australia and long treated as a junior synonym of Scolopsis monogramma (Cuvier in Cuvier and Valenciennes 1830), is confirmed in this study. The two species share the following features: 45–48 lateral-line scales; 9–11 total gill rakers on first gill arch; no anteriorly projecting suborbital spine; scaled dorsal area of head reaching anteriorly to between anterior margin of eye and posterior nostril; bony ridge of opercle and lower limb of preopercle scaled; scaled lateral area of head extending to just behind eye; and two longitudinal blue bands connecting anterior margins of eyes when fresh. However, S. regina is distinguished from S. monogramma by having 18–20 (modally 19) scale rows below the lateral line [vs. 17–20 (18) in S. monogramma], 6 or 7 (7) preopercular scale rows below eye [5 or 6 (6)], two distinct brown bands across dorsum of snout after preservation (lower band indistinct), a distinct suborbital blue band from lower margin of eye to upper-jaw lip when fresh (blue band indistinct or absent) and the blue band becoming a distinct brown band after preservation (band disappearing), caudal-fin base dark blue when fresh (yellow), a blue longitudinal band on upper caudal-fin lobe (absent), relatively long upper and lower caudal-fin lobes (relatively short), and a relatively wide marginal blue band posteriorly on caudal fin (relatively narrow). Scolopsis regina is distributed off northern Australia, whereas S. monogramma occurs in East and Southeast Asian waters. [ABSTRACT FROM AUTHOR]

This systematic review was conducted to identify the incidence, nature and mechanisms of head, neck and facial (HNF) injuries in cricket and the reported use of helmets. Five databases were searched up to 30th November 2020. From peer-reviewed cricket injury studies published in English, studies reporting on HNF cricket injuries as per the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were selected. Twenty-nine studies were included. HNF injuries had a cumulative total of 794/5,886 injuries equating to 13% of all injuries. Non- specified HNF injuries (n=210, 26%) were the most prevalent type of injury followed by non-specified head injuries (n=130, 16%), other non-specified fractures (n=119, 15%) and concussions (n=60, 8%).The impact of the ball was reported as the most common mechanism for sustaining HNF injuries in cricket. The use of helmet was reported in only three studies (10%). From studies reporting on HNF cricket injuries, facial fractures, and concussions were the most common specified-types of injury. There is little evidence on reporting of HNF cricket injuries as per the international cricket consensus injury definitions, as well as the use of helmets at the time of injury. [ABSTRACT FROM AUTHOR]

• Males, indigenous Australians, and those residing in remote areas, are at higher risk of head trauma. • Vehicle accidents are the most common mechanism of injury, particularly severe injury and polytrauma. • Assault is a significant cause of head trauma in the indigenous population, with more than one-third reported as domestic violence. • Head trauma patients that receive prehospital TXA are almost 5-times more likely to die. Head trauma is a leading cause of death and disability worldwide. Young males, Indigenous people, and rural/remote residents have been identified as high-risk populations for head trauma, however, Australian research is limited. Our aim was to define and describe the incidence, demographics, causes, prehospital interventions, and outcomes of head trauma patients transported by aeromedical services within North Queensland, Australia. We hypothesized that young, Indigenous males living remotely would be disproportionately affected by head trauma. We conducted a retrospective study of all head trauma patients transferred by air to or between Townsville, Cairns, Mount Isa and Mackay Hospitals between January 1, 2016 and December 31, 2018. Patients were identified from the Trauma Care in the Tropics data registry and followed for a median 30-months post-injury. Primary endpoints were patient and injury characteristics. Secondary outcome measures were hospital stay and mortality. A total of 981 patients were included and 31.1 % were Indigenous. Sixty-seven percent of injuries occurred remotely and the median time from injury to hospital was 5.8-hours (range 67–3780 min). Eighty percent of severe head injuries occurred in males (p = 0.007). Indigenous and remote patients were more likely to sustain mild injuries. The most common mechanism of injury overall was vehicle accident (37.5 %), compared to assault in the Indigenous subgroup (46.6 %, p <0.001). The overall mortality rate was 4.9 %, with older age and lower initial Glasgow Coma Score significant predictors of in-hospital mortality. Prehospital intubation was associated with a 7-fold increased risk of mortality (p = 0.056), while patients that received tranexamic acid (TXA) were almost 5-times more likely to die. In North Queensland, young Indigenous males are at highest risk of traumatic head injuries. Vehicle accidents are an important preventable cause of head injury in the region. TXA administration is an important consideration for remote head trauma retrievals, in which time to emergency care is prolonged. Appropriate treatment and risk stratification strategies considering time to definitive care, severity of injury, and other prehospital patient factors require further investigation. [ABSTRACT FROM AUTHOR]

The aims of this study were to investigate the frequency, magnitude, and distribution of head impacts sustained by youth AF players over a season of games and report subjective descriptions on the mechanism-of-injury and sign and symptoms experienced. A prospective observational cohort study with participants (n = 19) (age range 13-14 yr., mean ± SD 13.9 ± 0.3 yr.) wearing a wireless impact measuring device behind their right ear over the mastoid process prior to game participation. Participants completed an individual post-game logbook providing feedback responses on recalling having a direct hit to their head with another player or the surface. Players experienced a mean (SD) of 5 (+4) impacts per-player per-game. The peak linear rotation (PLA) median, (95th percentiles) were 15.2g (45.8g). The median (95th percentile) peak rotational acceleration (PRA) were 183,117 deg/s² (594,272 deg/s²). Median (95th percentile) Head Impact Telemetry Severity profile were 15.1 (46.1) and Risk Weighted Exposure Combined Probability were 0.0012 (0.7062). Twelve participants reported sustaining a head impact. Players reporting a head impact had a faster mean impact duration (t(25) = 2.4; p = 0.0025) and had a lower median PLA(g) (F(23,2) = 845.5; p = 0.0012) than those who did not report a head impact. These results show similar measurements to the older junior- (aged 17-19) and seniorleague (20+) players. Furthermore, players who reported sustaining a direct or indirect impact during games had similar measurements to those who did not, thus highlighting the difficulty of concussion recognition, at least with youth. Future research may need to establish the relationship between concussion-like symptoms in the absence of an impact and in relation to concussion evaluation assessments such as the King-Devick and SCAT5. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: Most Australian universities have abbreviated the anatomy curriculum and modified its mode of delivery. This study examines dental student perceptions of different methods of head and neck anatomy teaching with respect to the adequacy of allocated time and the relative meaningfulness of the teaching methods. Methods: All second‐year students in the School of Dentistry and Health Sciences at Charles Sturt University (CSU) were invited to complete a matrix‐grid questionnaire. Participants were asked to score four methods of teaching (lectures, study of prosected materials, tutorials and quizzes) using a 5‐point Likert scale. The questionnaire included questions about the time adequacy for anatomy lectures, tutorials and laboratory study, and the potential value of learning anatomy through the study of prosected materials. SPSS (Version 21.0) was used to analyse the data, and statistical significance was set at 0.05. Results: Seventy‐two students (79.5%) responded to the survey. Overall, learning anatomy through the study of prosected materials was the single highest scored method, followed by lectures, tutorials and quizzes. Graduate entrants felt that not enough time was devoted to learning anatomy through the study of prosected materials, compared with school leavers (89.4% and 10.6%, respectively), having one extra session of learning in the anatomy laboratory (71.4% and 28.6%, respectively) and adding dissection (75.0% and 25.0%, respectively) would be helpful. Conclusion: This study demonstrates that dental students perceive the study of prosected materials in the wet laboratory as the most valuable method of learning anatomy, but an extended anatomy curriculum would be even more effective and appreciated. [ABSTRACT FROM AUTHOR]

Background/objective: Headaches present commonly in general practice, and doctors face uncertainties and pressures in dealing with them. This study identifies key characteristics of headaches investigated through head imaging, in the hope of strengthening existing guidelines.Method: A 7-year retrospective analysis of head imaging scans ordered for investigating headaches among patients aged ≥18 in an Australian general practice setting.Results: A total of 109 of the 517 (21.1%) patients required head imaging, although 14 (2.7%) of these had repeat scans. Three-quarters were females, and most of the headaches were recurrent (56.9%), severe (62.4%) or had associated red flags (78.0%). Computed tomography (CT) and magnetic resonance imaging (MRI) were the only scans adopted (4:1 and 1:1 for first and repeat scans, respectively). Twelve (11.0%) scans had findings likely to explain the headaches after the initial scans, with no difference in findings between diagnoses from CTs and MRIs (P = 0.41). Repeat scans offered no additional benefits, and roughly one in three patients were referred to third-party carers (mostly neurologists). Females had more recurrent headaches (OR = 2.63; CI = 1.09-6.35; P = 0.03). Patients with psycho-morbidities were less likely to have scan findings that explained their headaches (OR = 0.22; CI = 0.06-0.88; P = 0.03), and, though not quite significant, were also more likely to undergo imaging (OR = 1.47; CI 0.96-2.27; P = 0.08).Conclusion: Significant intracranial findings were uncommon following imaging for headaches, and MRIs offer no advantages over CTs. Repeating head scans within 5 years offers no clear benefits. Psycho-morbidities should be considered when deciding the imaging needs, given the lesser chance of findings. Larger studies will help validate these findings. [ABSTRACT FROM AUTHOR]

Background: Middle ear disease (otitis media) is endemic among Aboriginal and Torres Strait Islander children in Australia and represents an important cause of hearing loss. The disease is the result of a mix of biological, environmental and host risk factors that interact in complex, non-linear ways along a dynamic continuum. As such, it is generally recognised that a holistic, systems approach is required to reverse the high rates of otitis media in Aboriginal and Torres Strait Islander children. The objective of this paper is to examine the alignment between efforts designed to address otitis media in Aboriginal and Torres Strait Islander children in Queensland, Australia and core concepts of systems thinking. This paper’s overall purpose is to identify which combination of activities, and at which level, hold the potential to facilitate systems changes to better support ear health among Aboriginal and Torres Strait Islander children. Methods: We began with a review of documents identified in consultation with stakeholders and an online search. In addition, key informants were invited to participate in an online survey and a face-to-face or phone interview. Qualitative interviews using a semi-structured interview guide were used to explore survey responses in more depth. We also undertook interviews at the community level to elicit a diverse range of views. Ideas, statements or activities reported in the documents and interviews as being performed under the Intervention Level Framework were identified using qualitative thematic and content analysis. A quantitative descriptive analysis was also undertaken, whereby data was extracted into an Excel spreadsheet and coded under the relevant strategic directions and performance indicators of the Framework. Subsequently, we coded activities against the five-level intervention framework developed by Malhi and colleagues, that is: 1) paradigm; 2) goals; 3) system structure; 4) feedback and delays; and 5) structural elements. Results: Overall, twenty documents were reviewed. We examined surveys and interviews with six key informants. Twenty-four individual and 3 group interviews were conducted across central and community level informants. One hundred and four items were coded from the 20 documents and 156 items from interview data. For both data sets, the majority of activities were coded at the structural elements level. The results suggested three key areas where further work is needed to drive sustained improvements: 1) build the governance structures needed for paradigm shift to achieve a multi-sectoral approach; 2) develop shared system level goals; 3) develop system-wide feedback processes. Conclusions: Sustained progress in improving ear health within Aboriginal and Torres Strait Islander children requires a holistic, system-wide approach. To advance such work, governance structures for multi-sectoral collaboration including the development of joint goals and monitoring and feedback are required. Intervening at these higher leverage points could have a profound effect on persistent public health issues. [ABSTRACT FROM AUTHOR]

Background: Globally, trachoma is the leading cause of infectious blindness and Australia is the only developed country with endemic trachoma. It is found in remote Indigenous communities burdened with poverty, overcrowding and poor hygiene. Lack of culturally appropriate health promotion, a small trachoma workforce and lack of awareness and support for trachoma elimination in general, were early barriers. Methods: A cross-sectional pre-post study using a convenience sample, was conducted in clinics, schools and community work-settings from 63 of the 82 remote Aboriginal communities identified as being at risk of trachoma in the Northern Territory (NT). The study assessed the effect of a multi-component health promotion strategy aimed at increasing knowledge, attitude and practice amongst health, education and community support settings staff. Data were collected between 2010 and 2012. The health promotion initiatives were introduced in communities in staggered delivery over a one-year period; 272 participants were surveyed at baseline and 261 at follow-up. Results: Trachoma related knowledge, attitudes and practice increased across all settings and for all primary outcome measures. Across all settings, there was a significant increase in the proportion of participants reporting the most important thing to do if a child has a ‘dirty’ face is to ‘wash it every time its dirty’ (61.6% cf 69.7%; X2p = 0.047), a significant reduction in the proportion of respondents answering ‘no’ to the question “Is it normal for kids to have dirty faces in your community’ (40.5% cf 29.6%; X2p = 0.009) and a significant increase in reported capacity to teach others about trachoma prevention (70.8% cf 83.3%; X2p <0.001). Conclusion: Health promotion was associated with increased trachoma knowledge, attitude and practice amongst health, education and community support staff working with children and in remote NT communities. In the early stages of the trachoma health promotion program, this increased trachoma awareness and improved local workforce capacity and support for trachoma elimination in three health promotion settings in remote communities in the NT. [ABSTRACT FROM AUTHOR]

Objective: To present treatment coverage rates and risk factors associated with uncorrected refractive error in Australia. Methods: Thirty population clusters were randomly selected from all geographic remoteness strata in Australia to provide samples of 1738 Indigenous Australians aged 40 years and older and 3098 non-Indigenous Australians aged 50 years and older. Presenting visual acuity was measured and those with vision loss (worse than 6/12) underwent pinhole testing and hand-held auto-refraction. Participants whose corrected visual acuity improved to be 6/12 or better were assigned as having uncorrected refractive error as the main cause of vision loss. The treatment coverage rates of refractive error were calculated (proportion of participants with refractive error that had distance correction and presenting visual acuity better than 6/12), and risk factor analysis for refractive correction was performed. Results: The refractive error treatment coverage rate in Indigenous Australians of 82.2% (95% CI 78.6–85.3) was significantly lower than in non-Indigenous Australians (93.5%, 92.0–94.8) (Odds ratio [OR] 0.51, 0.35–0.75). In Indigenous participants, remoteness (OR 0.41, 0.19–0.89 and OR 0.55, 0.35–0.85 in Outer Regional and Very Remote areas, respectively), having never undergone an eye examination (OR 0.08, 0.02–0.43) and having consulted a health worker other than an optometrist or ophthalmologist (OR 0.30, 0.11–0.84) were risk factors for low coverage. On the other hand, speaking English was a protective factor (OR 2.72, 1.13–6.45) for treatment of refractive error. Compared to non-Indigenous Australians who had an eye examination within one year, participants who had not undergone an eye examination within the past five years (OR 0.08, 0.03–0.21) or had never been examined (OR 0.05, 0.10–0.23) had lower coverage. Conclusion: Interventions that increase integrated optometry services in regional and remote Indigenous communities may improve the treatment coverage rate of refractive error. Increasing refractive error treatment coverage rates in both Indigenous and non-Indigenous Australians through at least five-yearly eye examinations and the provision of affordable spectacles will significantly reduce the national burden of vision loss in Australia. [ABSTRACT FROM AUTHOR]

Traditional 1D anthropometric data have been the primary source of information used by ergonomists for the dimensioning of head and facial gear. Although these data are simple to use and understand, they only provide univariate measures of key dimensions. 3D anthropometric data, however, describe the complete shape characteristics of the head surface, but are complicated to interpret due to the abundance of information they contain. Consequently, current headform standards based on 1D measurements may not adequately represent the actual head shape variations of the intended user groups. The purpose of this study was to introduce a set of new digital headform models representative of the adult cyclists' community in Australia. Four models were generated based on an Australian 3D anthropometric database of head shapes and a modified hierarchical clustering algorithm. Considerable shape differences were identified between our models and the current headforms from the Australian standard. We conclude that the design of head and facial gear based on current standards might not be favorable for optimal fitting results. [ABSTRACT FROM AUTHOR]

Marine turtles are caught and slaughtered for consumption as part of traditional indigenous community harvest in Australia as well as in many countries in which marine turtles can be found. However, changes to the Animal Care and Protection Act 2001 in 2012 resulted in Australian indigenous hunters becoming potentially liable to prosecution for using traditional practices to slaughter marine turtles. To provide indigenous hunters with an alternative scientifically tested method to hunt, we developed and tested a humane method as an option to use in indigenous communities. Between 2012 and 2015, a device was developed, tested on 11 carcasses to determine effectiveness and repeatability, used on 5 anaesthetised animals independently diagnosed as candidates for euthanasia, and ultimately used on 2 healthy, conscious animals as part of normal indigenous community subsistence harvesting under observation before being left with the communities for use. Feedback was sought from the communities on the suitability and potential adoption of the device. The device effectively ablated the hind brain and severed the spinal cord when deployed in 81% (9/11) of the tested carcasses, with death in 100% (5/5) of turtles, on average, within 78 seconds of deployment on anaesthetised turtles and death in 100% (2/2) of turtles, on average, within 144 seconds when deployed on healthy turtles within community. Failure to ablate the hindbrain and sever the spinal cord in the cadaver cases was due to incorrect deployment of the device. This device showed promise as an alternative euthanasia method available to indigenous communities of the Torres Straits. Further work is required to encourage acceptance by hunters. [ABSTRACT FROM AUTHOR]

Background: Head injury is a common reason children present to EDs. Guideline development to improve care for paediatric head injuries should target the information needs of ED clinicians and factors influencing its uptake., Methods: We conducted semi-structured qualitative interviews (November 2017-November 2018) with a stratified purposive sample of ED clinicians from across Australia and New Zealand. We identified clinician information needs, used the Theoretical Domains Framework (TDF) to explore factors influencing the use of head CT and clinical decision rules/guidelines in CT decision-making, and explored ways to improve guideline uptake. Two researchers coded the interview transcripts using thematic content analysis., Results: A total of 43 clinicians (28 doctors, 15 nurses), from 19 hospitals (5 tertiary, 8 suburban, 6 regional/rural) were interviewed. Clinicians sought guidance for scenarios including ED management of infants, children with underlying medical issues, delayed or representations and potential non-accidental injuries. Improvements to the quality and content of discharge communication and parental discussion materials were suggested. Known risks of radiation from head CTs has led to a culture of observation over use of CT in Australasia (TDF domain: beliefs about consequences). Formal and informal policies have resulted in senior clinicians making most head CT decisions in children (TDF domain: behavioural regulation). Senior clinicians consider their gestalt to be more accurate and outperform existing guidance (TDF domain: beliefs about capabilities), although they perceive guidelines as useful for training and supporting junior staff. Summaries, flow charts, publication in ED-specific journals and scripted training materials were suggestions to improve uptake., Conclusion: Information needs of ED clinicians, factors influencing use of head CT in children with head injuries and the role of guidelines were identified. These findings informed the scope and implementation strategies for an Australasian guideline for mild-to-moderate head injuries in children., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.)

A new species of Troglopedetes Joseph from a Christmas Island Cave, Australia is described and illustrated here. Troglopedetes eberhardi sp. nov. resembles other species by presence of eyes and dorsal chaetotaxy of the second thoracic segment to third abdominal segment, but differs in head chaetotaxy, fourth abdominal segment and elongated unguis median tooth, which character is documented here in the genus for the first time. A comparison and identification key for all eyed species is provided. This is the first record of Troglopedetes for Australia and the genus now has 37 nominal species, of which nine have eyes.

The aim of the study was to identify the mechanisms and spectrum of injuries sustained to the head and face in surfboard riders, requiring presentation to an emergency department. A retrospective case series was undertaken from January 2008 to April 2012 at a tertiary hospital on the North Shore of Sydney. Twenty-nine patients were included, 26 with acute injuries and 3 with chronic pathologies. Fifteen patients (58%) had been struck in the head by their own board – 9 (60%) suffered facial bone fractures. Contact with the surfboard was the cause of facial bone fracture in 100% of cases. One patient struck by their own board ruptured their globe. Chronic/progressive deafness was the indication for undertaking imaging in three patients. Hundred percent had bilateral exostoses of the external auditory canal (surfers ear). Head and facial injuries are a significant and potential risk of surfboard riding. It is envisaged that greater knowledge of the spectrum and mechanisms of injuries sustained by surfers will drive surfboard and surfing accessory design and increase public awareness to minimise the risk of injury in the future. [ABSTRACT FROM AUTHOR]

Background: The American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) surgical risk calculator (SRC) is an open access calculator predicting patients' risk of postoperative complications. This study aims to assess the validity of the SRC in patients undergoing microsurgical free flap reconstruction at an Australian tertiary referral centre., Methods: This is a retrospective cohort study of 200 consecutive patients treated up to November 2020. SRC-predicted rates of postoperative complications and hospital length of stay (LOS) were compared to those observed for the ablative and reconstructive components of the procedure. The performance of the SRC was assessed using Brier scores, area under the receiver operating characteristic (ROC) curve (AUC), and the Hosmer-Lemeshow test., Results: For both ablative and reconstructive components, the SRC discriminates well for pneumonia and urinary tract infection, and it is calibrated well for readmission and sepsis, but it does not discriminate and calibrate well for any single outcome. SRC-predicted hospital LOS and actual LOS did not correlate well for the reconstructive component, but they correlated strongly for the ablative component., Conclusions: The SRC is a poor predictor of postoperative complication rates and hospital LOS in patients undergoing head and neck microsurgical reconstruction., Competing Interests: Declaration of Competing Interest No conflicts of interest have been declared., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Exceptionally well-preserved remains belonging to the Australian Early Cretaceous (Albian) ichthyosaur Platypterygius longmani Wade, 1990 are described in detail. The material is used to reconstruct some of the cranial musculature and provide a brief functional analysis of the skull and mandible. Preparation of specimens using acetic acid and application of high-resolution X-ray computed tomographic analyses has revealed many previously unrecorded anatomical details, including the absence of a coronoid and squamosal, and the presence of well-developed epipterygoid facets on the pterygoid and parietal (possibly indicating retention of an unossified epipterygoid element). Reconstruction of the jaw musculature suggests a well-developed m. adductor mandibulae internus pterygoideus (serving to close the jaws against inertia and drag of the surrounding water), and possibly an m. intramandibularis (acting to accentuate static pressure along the elongate mandible when the jaws were closed). Despite its large size (maximum total body length of around 7 m), the long, narrow snout of P. longmani (together with preserved gut contents) indicates selective feeding on relatively small prey such as fish, small tetrapods and probably cephalopods. Large orbits are indicative of a visual hunter, but extensive external passages for nerves and blood vessels might suggest the presence of a dermal sensory system. The massive stapes appears to have lost all sound conductive function, serving primarily as structural support in the basicranial region. © 2005 The Linnean Society of London, Zoological Journal of the Linnean Society, 2005, 145, 583–622. [ABSTRACT FROM AUTHOR]

Introduction: Head and neck anatomy is complex for students to learn and educators to teach. Instructing students on anatomy using radiological imaging can aid comprehension and prepare them for future clinical practice. Computer-aided anatomy instruction is accessible to diverse learners and avoids barriers identified with face-to-face teaching., Methods: We designed a self-guided PowerPoint tutorial with multiple medical imaging modalities, clinical correlations, and self-review questions incorporated throughout. The tutorial was evaluated with a group of 178 Australian preclinical medical students who had prior teaching related to head and neck anatomy. Student participants were divided into experimental and control groups. Participants completed two knowledge assessments: experimental group before and after tutorial engagement and control group before tutorial engagement. All participants were invited to provide feedback on their experiences with the tutorial via questionnaires., Results: Engagement with the tutorial improved overall head and neck anatomy knowledge ( p < .001). Knowledge outcomes were maintained across question group type (e.g., multiple-choice questions, identification, and short-answer questions; p < .05), with participants reporting 96% overall positive feedback related to the tutorial experience., Discussion: Given the improved outcomes following tutorial exposure, our results suggest that this tutorial is efficacious when used in concert with existing anatomy curricula. Participants' perceived value of the tutorial additionally suggests that it would be taken up well by medical students and is an effective addition to the existing tutorial series. Further research is needed to assess the tutorial's use as a stand-alone addition to the anatomy curriculum., (© 2022 Hussey et al.)

Objectives: Clinical guidelines state brain computed tomography (CT) for atraumatic headache or first generalized afebrile, atraumatic seizure as nonindicated in neurologically normal children. We aimed to adapt 2 rigorously validated United States-based measures that examine overuse of CT in children with these conditions, and to determine whether these measures can be used in an Australian setting to determine rates of CT scanning in current practice., Methods: Within an Australian tertiary pediatric hospital, we successfully adapted the measures from the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) coding system of the United States measures to the International Classification of Diseases, Tenth Revision, Australian Modification (ICD-10-AM) coding system used in Australia. We conducted a retrospective audit of electronic medical record data from April 1, 2017, to March 31, 2018. Eligible patients were children aged 4 to 17 years who attended one of the hospital outpatient clinics and/or emergency department and/or were admitted to an inpatient ward. The conditions of interest were (1) atraumatic headache and (2) first generalized afebrile, atraumatic seizure., Results: The measure for afebrile seizure was found to have low accuracy and low feasibility in this setting and was not tested further. The adapted measure for atraumatic headache was highly accurate in determining the encounters of interest; however, manual chart review was required to identify nonindicated brain CTs. Using this measure, 601 encounters for atraumatic headache were identified, of which 98 (16.3%) received at least 1 brain CT. We found that 14.1% of these scans were nonindicated, meaning 2% all atraumatic headache encounters received a nonindicated scan; lower than rates reported in international literature., Conclusions: Using the tool developed in this study, rigorous measurement of the overuse of CT scans in other settings may determine the reasons for the lower rates observed in this study; inform future interventions to minimize overuse; and provide safer, higher quality care to children., Competing Interests: Disclosure: The authors declare no conflict of interest., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Video surveillance and detection of players with visible signs of concussion by experienced medical staff facilitates rapid on-field screening of suspected concussion in professional sports. This method, however has not been validated in community sports where video footage is unavailable. This study aimed to explore the utility of visible signs of concussion to identify players with decrements in performance on concussion screening measures. In this observational prospective cohort study, personnel with basic training observed live matches across a season (60 matches) of community male and female Australian football for signs of concussion outlined in the community-based Head Injury Assessment form (HIAf). Players identified to have positive signs of concussion (CoSign+) following an impact were compared with players without signs (CoSign-). Outcome measures, the Sport Concussion Assessment Tool (SCAT3) and Cogstate, were administered at baseline and post-match. CoSign+ ( n  = 22) and CoSign- ( n  = 61) groups were similar with respect to age, sex, education, baseline mood, and medical history. CoSign+ players exhibited worse orientation, concentration, and recall, and slower reaction time in attention and working memory tasks. Comparing individual change from baseline to post-match assessment revealed 100% (95% confidence interval [CI]: 84-100%) of CoSign+ players demonstrated clinically significant deficits on SCAT3 or Cogstate tasks, compared with 59% (95% CI: 46-71%) of CoSign- players. All CoSign+ players observed to have a blank/vacant look demonstrated clinically significant decline on the Standardized Assessment of Concussion (SAC). Detection of visible signs of concussion represents a rapid, real-time method for screening players suspected of concussion in community sports where video technology and medical personnel are rarely present. Consistent with community guidelines, it is recommended that all CoSign+ players be immediately removed from play for further concussion screening.

Focuses on the debate over the use of heads of Australian Aboriginal men for scientific collection in Australian and European universities between 1803 and 1834. Circumstances surrounding the deaths of the men; Overview of scientific records on the heads; Correlation between colonial violence and anatomical science.

Objectives: To quantify the incidence and characteristics of purposeful headers and unintentional head impacts during male and female youth football (soccer) games in Australia., Design: Cross-sectional observational study., Methods: Ten match-videos (total n=110) per playing age (under 13-20 males; under 13-17 females) from the 2019 National Premier League season were coded for purposeful headers and unintentional head impacts. Total headers and head impacts as well as incidence rate (IR) per 1000 match-hours for different match characteristics were calculated., Results: Purposeful headers accounted for 99% (n=4615, IR:1618) of total head impacts. The IR of purposeful headers per 1000 match-hours was highest for under-15 males (IR:2117) and under-17 females (IR:2090) followed by under-20 males (IR:1761). Midfielders completed the most headers in all female age groups (mean IR:713) and under 13-14 males (mean IR:891), with defenders completing the most headers in under 15-20 males (mean IR:760). Heading duels accounted for 16% of total headers with most headers performed during free play (68%), throw-ins (15%), free kicks (12%) and corner kicks (5%). Only 57 head impacts (IR:20) were coded as unintentional head impacts resulting from being struck by the ball or opponent body part with 4 (IR:1.4) requiring medical attention., Conclusions: Heading is a complex skill. Given the propensity of youth players of all ages to purposefully head the ball, consideration should be given to coaching heading technique based on specific game scenarios for their playing position and age group. The findings of this study can be used to inform heading guidelines., (Copyright © 2021 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.)

The impact of head and neck position (HNP) on horse welfare has received much attention in the scientific literature within the last two decades. Studies have identified physiological and behavioral signs of distress in horses ridden for prolonged time in an HNP with their noseline behind the vertical (BTV), which may compromise their welfare. The objective of this study was to compare potential differences of HNPs shown in horse sales photographs advertised in an Australian horse sales magazine (Horse Deals) from the years 2005 and 2018. In addition, factors potentially impacting HNPs, such as type of tack presented in (e.g., noseband type), riding discipline, and competition experience of the horse, were investigated. The sample population (n = 570) comprised horses ridden with headgear and bit in walk, trot, or canter/gallop, advertised in an Australian horse sales magazine. Issues from April 2005 and October/November 2018 were selected. Head and neck position was categorized as BTV, on the vertical (OV), slightly in front of the vertical (IFV), or extremely in front of the vertical (EIFV; any HNP >30° IFV). Data were analyzed using the chi-squared test and post hoc testing via a multiple regression approach through SPSS and test of proportions via the Z-score calculator for two independent population proportions. Analysis of combined data from years 2005 and 2018 showed 47.0% (n = 570) of the horse sample population were advertised with HNPs BTV. Behind-the-vertical HNP was observed as the predominant HNP (57.8%; n = 268) in the warmblood/eventers/show/performance (WESP) category (P < .0005). In 2005, 53.4% (n = 303) of the sample population were ridden BTV compared with 39.7% (n = 267) in 2018 (P < .001), 12.9% (n = 303) were OV in 2005 compared with 15.0% (n = 267) in 2018 (P > .05), and 10.9% (n = 303) were IFV in 2005 compared with 27.3% (n = 267) in 2018 (P < .0004). These results suggest a positive development with fewer vendors/riders selecting images where the horse's nose was BTV. However, this may be explained by the larger proportion of horses advertised in the WESP category in 2005 (63.0%; n = 303) versus 2018 (28.5%; n = 267), and the WESP category predominantly comprised of dressage, jumper, and eventing horses. In addition, the reduction of HNPs BTV from 53.4% (n = 303) in 2005 to 39.7% (n = 267) in 2018 could be attributed to the observation that in 2018, a larger proportion of horses were listed in categories that do not require the horses to be worked with a flexed HNP referred to as "on-the-bit" (e.g., western, endurance, Australian sStock horses). The HNP BTV remains preferential by a substantial proportion of the horse-owning public when advertising horses for sale, particularly in disciplines where the horse is worked in a flexed HNP or "on-the-bit.", (Copyright © 2020 Elsevier Inc. All rights reserved.)

Objective: To explore the potential utility of head acceleration event (HAE) measurements to augment identification of players for further concussion screening in non-helmeted contact sport., Design: Prospective observational pilot study., Participants: 210 (118 female) professional Australian football players in 2017 season., Methods: Players wore the X-Patch® accelerometer for one match each with data collected across 14 matches. Players with HAEs above thresholds associated with concussion, 95 g (males) or 85.5 g (females), were compared to players identified to have suspected concussion by club personnel during the inspected matches. Video review of matches was undertaken by a physician blinded to HAEs to identify players with concussive signs., Results: Among 26 players (50% female) with HAEs above threshold, two players were screened for concussion. Of the remaining 24 players, nine were not visible on video at the HAE time, six sustained verifiable head impacts, and nine sustained verifiable body impacts with no head impacts. Among 184 players with HAEs below threshold, five players were screened., Conclusion: Players were identified to have head impacts and suspected concussion in the absence of HAEs above threshold. Use of X-Patch® was not sufficiently reliable for identifying players for further concussion screening in professional Australian football. Video review of head impacts remains essential in concussion screening., Competing Interests: Declaration of competing interest The X2 Biosystems X-Patch© devices were purchased on a commercial basis, and no author has any financial interest in the product or distribution of the product., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Background: Exposure to head acceleration events (HAEs) has been associated with player sex, player position, and player experience in North American football, ice hockey, and lacrosse. Little is known of these factors in professional Australian football. Video analysis allows HAE verification and characterization of important determinants of injury., Purpose: To characterize verified HAEs in the nonhelmeted contact sport of professional Australian football and investigate the association of sex, player position, and player experience with HAE frequency and magnitude., Study Design: Descriptive epidemiology study., Methods: Professional Australian football players wore a nonhelmeted accelerometer for 1 match, with data collected across 14 matches. HAEs with peak linear accelerations (PLAs) ≥30 g were verified with match video. Verified HAEs were summarized by frequency and median PLA and compared between the sexes, player position, and player experience. Characterization of match-related situations of verified HAEs was conducted, and the head impact rate per skill execution was calculated., Results: 92 male and 118 female players were recruited during the 2017 season. Male players sustained more HAEs (median, 1; IQR, 0-2) than female players (median, 0; IQR, 0-1; P = .007) during a match. The maximum PLAs incurred during a match were significantly higher in male players (median, 61.8 g ; IQR, 40.5-87.1) compared with female players (median, 44.5 g ; IQR, 33.6-74.8; P = .032). Neither player position nor experience was associated with HAE frequency. Of all verified HAEs, 52% (n = 110) occurred when neither team had possession of the football, and 46% (n = 98) were caused by contact from another player attempting to gain possession of the football. A subset of HAEs (n = 12; 5.7%) resulted in players seeking medical aid and/or being removed from the match (median PLA, 58.8 g ; IQR, 34.0-89.0), with 2 (male) players diagnosed with concussion after direct head impacts and associated PLAs of 62 g and 75 g , respectively. In the setting of catching (marking) the football, female players exhibited twice the head impact rate (16 per 100 marking contests) than male players (8 per 100 marking contests)., Conclusion: Playing situations in which players have limited control of the football are a common cause of impacts. Male players sustained a greater exposure to HAEs compared with female players. Female players, however, sustained higher exposure to HAEs than male players during certain skill executions, possibly reflecting differences in skill development. These findings can therefore inform match and skill development in the emerging professional women's competition of Australian football.

The second and third larval instars of the Australian endemic dytiscid Chostonectes nebulosus (Macleay, 1871) are described and illustrated for the first time including a detailed chaetotaxic analysis of head capsule and appendages, legs, last abdominal segment and urogomphi. Collected larvae were successfully associated with adults using rearing and a molecular approach. The identification key and COI barcodes for C. nebulosus, C. gigas (Boheman, 1858) and C. johnsonii (Clark, 1862) are provided.

The quality of medical care in a medical organization is largely determined by the effectiveness of its Head. The article looks at current regulatory acts, main factors of healthcare organization process in developed countries (France, Switzerland, Australia and South Korea) and methods for assessing the quality of health services. This work analyzes the world practice of appointment, functioning and activity effectiveness of the heads of healthcare system.

This pilot study aimed to evaluate the clinical efficacy and feasibility of a fluidised positioning device to reduce occipital pressure injuries (PIs). A post-test design with a historical control group was used in a 54-bed intensive care unit between September 2017 and August 2018. Patients who were receiving either extracorporeal membrane oxygenation, were mechanically ventilated, or had raised intracranial pressure (≥20) were recruited. The intervention consisted of a fluidised positioning device under the patient's head, and a skin assessment every 8 h. Outcome measures included the occurrence of occipital PIs and registered nurses (RNs)' perspectives of the intervention. Data collected from patients in the intervention group were compared with data obtained from the historical control group between May 2016 and April 2017. Sixty-four patients were recruited in the intervention phase and 63 were in the historical control group. Results showed a statistically significant reduction in occipital PIs by 87.7% (16/63; 25.4% historical control vs 2/64; 3.13% interventional group). Bedside RNs provided positive evaluation of the fluidised positioning device. The findings demonstrate that the fluidised positioning device is a feasible and effective intervention in reducing the risk of occipital PIs in intensive care patients, which merits the continuation of use and further evaluation through a larger-scale study., (© 2018 Medicalhelplines.com Inc and John Wiley & Sons Ltd.)

Objective: Child occupant behavior and head position when travelling in child restraint systems (CRS) may have an effect on injury risk in the event of a motor vehicle crash. The current study aimed to describe the common characteristics and behaviors of child occupants during everyday, real-world motor vehicle travel in a sample of Australian families to identify potential safety implications of observed behaviors and head position within the CRS. Methods: Two instrumented study vehicles were used by 42 families for approximately two weeks. Continuous video and audio data were collected across 1,651 trips (over 600 hours). An online survey provided additional parent, familial and child occupant data. The characteristics and behaviors of 72 child occupants (aged 14 months to 9 years) who travelled in a forward-facing CRS (FFCRS) or a belt-positioning booster seat (BS) were observed and recorded by manual review of a sample of the video/audio recordings. One quarter of all trips ( n = 414) was randomly selected for coding/analysis and, within each trip, one child occupant was selected who was travelling in a FFCRS or BS. Child occupant behaviors, head position within the FFCRS or BS, and other relevant information was coded for each trip during nine discrete five second intervals or 'epochs' (5%, 17%, 25%, 30%, 50%, 53%, 75%, 89% and 95% of trip duration). Results: In the majority of epochs (74%), child occupants' heads were observed to be 'optimally' positioned within the FFCRS or BS. For more than half of the epochs, child occupants were observed to be: correctly restrained (58%) and involved in an interaction with another vehicle occupant (59%). Bivariate analyses revealed that children travelling in a FFCRS were significantly more likely to be observed to have optimal head positions than those travelling in a BS (78% vs. 62%), χ 2 (1) = 86.00, p < 0.001. Child occupants who were observed to be 'correctly' restrained were significantly more likely to be observed to have optimal head positions than those who were observed to be 'incorrectly' restrained (80% vs. 20%), χ 2 (1) = 10.33, p < 0.01. Conclusions: This is the first naturalistic driving study (NDS) to specifically explore the factors associated with child occupants' head position when travelling in a CRS. Findings from the current study can be used to inform the positioning of anthropometric test dummies (ATD) in CRS testing, guide improvements to CRS/vehicle design, and develop targeted educational strategies to improve child occupant safety.

Scolopsis meridiana n. sp., described from 30 specimens collected from northern Australia, is closely related to S. taenioptera, both species having a dorsal scaled area on the head extending anteriorly to between the anterior margin of the eye and anterior nostril, the upper part of the pectoral-fin base with a reddish blotch when fresh, and lacking a small antrorse spine below the eye. However, the new species is distinguished from the latter by having two bands across the snout dorsum (vs. one band in S. taenioptera), 18-20 diagonal lines on the lateral body surface below the lateral line (diagonal lines absent), the posterior nostril horizontally elongated (vertically elongated), a deep caudal-peduncle and short pre-dorsal-fin length. Scolopsis meridiana is distributed in northern Australia, whereas S. taenioptera occurs in Southeast Asia. Two geographic populations of S. taenioptera (Philippines and remaining Southeast Asian region) are recognized following morphological and genetic analyses.

Recent findings suggest that children with Autism Spectrum Disorder (ASD) are larger in size for head circumference (HC), height, and weight compared to typically developing (TD) children; however, little is known about their rate of growth, especially in height and weight. The current study aimed to: (a) confirm and extend upon previous findings of early generalized overgrowth in ASD; and (b) determine if there were any differences in the rate of growth between infants and toddlers with ASD compared to their TD peers. Measurements of HC, height, and weight were available for 135 boys with ASD and 74 TD boys, from birth through 3 years of age. Size and growth rate in HC, height, and weight were analyzed using a linear mixed-effects model. Infants with ASD were significantly smaller in size at birth for HC, body length, and weight compared to TD infants (all P < 0.05); however, they grew at a significantly faster rate in HC and height in comparison to the TD children (P < 0.001); there was no significant difference between the groups in growth rate for weight (P > 0.05). The results confirmed that male infants and toddlers with ASD exhibit skeletal growth dysregulation early in life. Autism Res 2018, 11: 846-856. © 2018 International Society for Autism Research, Wiley Periodicals, Inc., Lay Summary: Recent findings suggest that infants with Autism Spectrum Disorder (ASD) are smaller in size at birth compared to typically developing infants but grow larger than their peers during the first year. Little is known about their rate of growth, especially for height and weight. Our findings confirmed that infants with ASD are smaller in size at birth for head circumference (HC), height, and weight, but grow at a faster rate in HC and height than their peers from birth to 3 years., (© 2018 International Society for Autism Research, Wiley Periodicals, Inc.)

This study investigated prey captures in free-ranging adult female Australian fur seals (Arctocephalus pusillus doriferus) using head-mounted 3-axis accelerometers and animal-borne video cameras. Acceleration data was used to identify individual attempted prey captures (APC), and video data were used to independently verify APC and prey types. Results demonstrated that head-mounted accelerometers could detect individual APC but were unable to distinguish among prey types (fish, cephalopod, stingray) or between successful captures and unsuccessful capture attempts. Mean detection rate (true positive rate) on individual animals in the testing subset ranged from 67-100%, and mean detection on the testing subset averaged across 4 animals ranged from 82-97%. Mean False positive (FP) rate ranged from 15-67% individually in the testing subset, and 26-59% averaged across 4 animals. Surge and sway had significantly greater detection rates, but also conversely greater FP rates compared to heave. Video data also indicated that some head movements recorded by the accelerometers were unrelated to APC and that a peak in acceleration variance did not always equate to an individual prey item. The results of the present study indicate that head-mounted accelerometers provide a complementary tool for investigating foraging behaviour in pinnipeds, but that detection and FP correction factors need to be applied for reliable field application.

Objective: To examine the long term trend in assault admissions at an inner city major trauma centre and determine the association between clinical evidence of alcohol intoxication and major trauma due to assault., Methods: Adult trauma patients admitted due to assault between 1999 and 2009 were identified through the hospital based trauma registry at an inner city major trauma centre in Sydney. Demographic data, incident details, clinical evidence of alcohol intoxication, injury severity scores and injury related outcomes were collected. Population based incidences were calculated and outcomes compared between intoxicated and non-intoxicated patients. Major trauma was defined as a composite outcome of severe injury (injury severity score>15), intensive care admission or in-hospital mortality., Results: There were 2380 patients analysed. Clinical evidence of alcohol intoxication was documented in 12% (287/2380) of cases. There was a marked peak in incidence of hospital admissions due to assault which occurred between 2000 and 2002. Overall, the rate of hospital admissions due to assault decreased during the study period (incident rate ratios 0.94, 95% CI 0.90 to 0.99, p<0.001). The odds of major trauma were three times higher in patients with clinical evidence of intoxication compared to those that did not (adjusted OR 2.9, 95% CI 2.1 to 4.0, p<0.001)., Conclusions: There was a peak in hospital admissions due to inner city assault around 2000-2002 associated with an overall decline in hospital admissions at this trauma centre over 10 years. Clinical evidence of alcohol intoxication in patients admitted for assault appears to be associated with more severe injury, including severe head injury., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)

Introduction: Performing specific neck strengthening exercises has been proposed to decrease the incidence of neck injury and pain in high performance combat pilots. However, there is little known about these exercises in comparison to the demands on the neck musculature in flight., Methods: Eight male non-pilots performed specific neck exercises using two different modalities (elastic band and resistance machine) at six different intensities in flexion, extension, and lateral bending. Six Royal Australian Air Force Hawk pilots flew a sortie that included combinations of three +Gz levels and four head positions. Surface electromyography (EMG) from selected neck and shoulder muscles was recorded in both activities., Results: Muscle activation levels recorded during the three elastic band exercises were similar to in-flight EMG collected at +1 Gz (15% MVIC). EMG levels elicited during the 50% resistance machine exercises were between the +3 Gz (9-40% MVIC) and +5 Gz (16-53% MVIC) ranges of muscle activations in most muscles. EMG recorded during 70% and 90% resistance machine exercises were generally higher than in-flight EMG at +5 Gz., Discussion: Elastic band exercises could possibly be useful to pilots who fly low +Gz missions while 50% resistance machine mimicked neck loads experienced by combat pilots flying high +Gz ACM. The 70% and 90% resistance machine intensities are known to optimize maximal strength but should be administered with care because of the unknown spinal loads and diminished muscle force generating capacity after exercise.

Background: This study aimed to obtain clinical and economic information about patterns of treatment of solar keratoses (SKs) by general practitioners in Australia. The study design was a retrospective survey relating to the treatment of patients presenting to their doctor with previously untreated SKs., Methods: Data were collected between May and June 2000, from a sample of doctors who were asked to randomly select two SK patients from their medical records and complete a self-administered postal questionnaire. Information about treatment types, number of visits, treatment complications, and specialist referrals were directly extracted from the patient records., Results: A total of 156 patients were recruited to the study (61% male) who had been treated for a total of 251 SKs (average 1.6 lesions/patient). The most common treatment employed was cryotherapy (63%). Excision was also commonly used (18%). Five per cent of patients were treated with a mixture of excision and cryotherapy. Topical agents were not commonly employed. Of those patients who consulted a doctor, 9% were referred to a specialist for diagnosis or treatment, of which 57% were referred to a dermatologist., Conclusion: The typical number of doctor visits varied from 1.9 to 4.6 with a range of cost per patient of 55.13-249.70 Australian dollars depending on complexity of the case and the need for referral.

A study was undertaken among Royal Australian Air Force fighter pilots to determine whether, as an occupational group, they had developed any particular protective head positioning strategies in order to minimize their risk of sustaining a +Gz-induced neck injury during air combat maneuvering. There were 42 F/A-18 Hornet pilots who responded to an anonymous questionnaire which asked about head positioning strategies. Of these, 29 pilots reported using a protective strategy. Several pilots reported using several different techniques. The most popular strategy reported was positioning the head prior to the application of +Gz (13 respondents). Eleven pilots reported using aircraft structures to wedge or brace their heads against. The results of this study show that fighter pilots who are regularly exposed to high +Gz forces develop an individualized approach to protecting their cervical spines from +Gz-induced injury.