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In this practice report, we posit that academic development encompasses more than improving and developing courses; it offers a space for tertiary educators to develop professionally, personally, and improve their well-being. The report is focussed on an initiative of a Teaching Innovation Unit to offer individual consultations to tertiary educators as a way of supporting well-being while building professional knowledge and capacity. Preliminary findings based on evaluation data suggest that the consultations were indeed a valued resource for educators. Moving forward, we propose that our assertion of the value of the consultations can be tested by applying well-being models and frameworks, such as Ryff and Keyes' (1995) scale and Wheatley's (2022) workplace well-being framework.

Uncertain times require prompt reflexes to survive and this study is a collaborative reflex to better understand uncertainty and navigate through it. The Coronavirus (Covid-19) pandemic hit hard and interrupted many dimensions of our lives, particularly education. As a response to interruption of education due to the Covid-19 pandemic, this study is a collaborative reaction that narrates the overall view, reflections from the K12 and higher educational landscape, lessons learned and suggestions from a total of 31 countries across the world with a representation of 62.7% of the whole world population. In addition to the value of each case by country, the synthesis of this research suggests that the current practices can be defined as emergency remote education and this practice is different from planned practices such as distance education, online learning or other derivations. Above all, this study points out how social injustice, inequity and the digital divide have been exacerbated during the pandemic and need unique and targeted measures if they are to be addressed. While there are support communities and mechanisms, parents are overburdened between regular daily/professional duties and emerging educational roles, and all parties are experiencing trauma, psychological pressure and anxiety to various degrees, which necessitates a pedagogy of care, affection and empathy. In terms of educational processes, the interruption of education signifies the importance of openness in education and highlights issues that should be taken into consideration such as using alternative assessment and evaluation methods as well as concerns about surveillance, ethics, and data privacy resulting from nearly exclusive dependency on online solutions.

Digital literacy has become increasingly significant in tertiary environments, as institutions move towards preparing students for 21st century workplaces and careers that emphasise digital literacy. As such, Academic Language and Learning (ALL) practitioners within these institutions are under pressure to possess familiarity and skills in the digital education space. Despite this need, there is a shortage of evidence that identifies the competencies or gaps in the current knowledge that ALL advisors have in Australian tertiary institutions; there is also a lack of awareness about how to address the gaps in knowledge for technology-enhanced learning and academic support. In light of this lacuna, in late 2018, the Association for Academic Learning and Language (AALL), the professional body for Academic Language and Learning practitioners, established a working group to investigate the knowledge and gaps in digital literacy in the ALL profession. The authors of this paper are all members of this working group and aim to explore the state of digital learning in their field. The long-term aim of the working party is to develop research-led resources and strategies to assist in the professionalisation and upskilling of ALL staff in technology-enhanced academic language development and support. This paper reports on the preliminary findings of a mixed-method participatory action research study of ALL practitioners' preferences, competencies and confidence in the digital learning space. It is hoped that this study will provide members within the AALL professional body, as well as tertiary educators generally, with strategies required to identify, develop and maintain effective digital literacies across the higher education sector.

Introduction: Academic integrity policy that is inaccessible, ambiguous or confusing is likely to result in inconsistent policy enactment. Additionally, policy analysis and development are often undertaken as top down processes requiring passive acceptance by users of policy that has been developed outside the context in which it is enacted. Both these factors can result in poor policy uptake, particularly where policy users are overworked, intellectually critical and capable, not prone to passive acceptance and hold valuable grass roots intelligence about policy enactment. Case description: The case study presented in this paper describes the actions of a community of practice (CoP) at a regional Australian university to deconstruct and translate ambiguous academic integrity policy into a suite of accessible academic integrity resources that were intelligible to staff and students, and which assisted academic staff to consistently enact policy. The paper narrates the formation of the CoP, the tangible and intangible value it created, the social learning practices enacted by its members, its grassroots policy work and the material resources produced from that work. Discussion and evaluation: An evaluation of the CoP was conducted using a value creation framework to explore its immediate value, potential value, applied value, realised value, and reframing value. These values were considered at each stages of the CoP's lifespan. The evaluation was a useful process that demonstrated the wide-ranging value created by the CoP. Six insights were drawn from the evaluation which promote understanding of the value created for a university by a CoP, particularly in contributing to academic integrity culture over a sustained period of time. Conclusions: This paper contributes to a research gap on specific examples of discretion within rule-based systems. It illustrates how academics and members of the CoP used their discretion to interpret and enact academic integrity policy within a higher education setting. Drawing from the evaluation of the CoP we argue for greater understanding of the grass-roots contribution of academic and professional staff to academic integrity policy translation and enactment.

Autism is associated with a range of costs. This paper reviews the literature on estimating the economic costs of autism spectrum disorder (ASD). More or less 50 papers covering multiple countries (US, UK, Australia, Canada, Sweden, the Netherlands, etc.) were analysed. Six types of costs are discussed in depth: (i) medical and healthcare service costs, (ii) therapeutic costs, (iii) (special) education costs, (iv) costs of production loss for adults with ASD, (v) costs of informal care and lost productivity for family/caregivers, and (vi) costs of accommodation, respite care, and out-of-pocket expenses. A general finding is that individuals with ASD and families with children with ASD have higher costs. Education costs appear to be a major cost component for parents with children with ASD.

Background: Over two‐thirds of people present to their primary care physician (or general practitioner; GP) as a first point of contact for mental health concerns. However, eating disorders (EDs) are often not identified in a primary care setting. A significant barrier to early detection and intervention is lack of primary care physician training in EDs; compounded by the significant time commitments required for training by already time‐poor general practitioners. The aim of the current study was to pilot and evaluate a microlearning programme that can be delivered to general practitioners with high workloads to help support patients with, or at risk of, developing an ED. Methods: Fifty‐one Australian general practitioners aged between 25‐to‐60 years old were recruited. Participants completed a baseline questionnaire to ascertain their experience working in general practice and with EDs. Participants then completed an online programme consisting of a series of 10 case studies (vignettes) delivered over a 6–10 week period related to various facets of ED care. Following conclusion of the programme, participants were asked to complete an evaluative questionnaire related to the content of the programme; perceived knowledge, confidence, willingness‐to‐treat, skill change; and their overall experience of microlearning. Results: All 51 GPs completed the programme and reached completion criteria for all vignettes, 40 of whom completed the programme evaluation. Participants indicated improved skill, confidence, willingness‐to‐treat, and knowledge following the completion of the pilot programme. Almost all (97.5%; n = 39) found microlearning to be an effective method to learn about EDs; with 87.5% (n = 35) of participants reporting they felt able to apply what was learnt in practice. Qualitative feedback highlighted the benefit of microlearning's flexibility to train general practitioners to work with complex health presentations, specifically EDs. Conclusions: Findings from the current study lend support to the use of microlearning in medical health professional training; notably around complex mental health concerns. Microlearning appears to be an acceptable and effective training method for GPs to learn about EDs. Given the significant time demands on GPs and the resulting challenges in designing appropriate training for this part of the workforce, this training method has promise. The pre‐existing interest in EDs in the current study sample was high; future studies should sample more broadly to ensure that microlearning can be applied at scale. Highlights: Due to busy schedules and job‐demands, GP's often have limited opportunity to learn about working with patients with complex mental health needs, such as eating disorders. Knowing how to support patients with eating disorders is particularly important given that most individuals present with seemingly unrelated concerns to the eating disorderThe current study reports on the development and piloting of a GP Microlearning programme. Microlearning is a flexible yet focussed approach to online learning that offers health professionals the opportunity to learn, without the requirement to commit to traditionally lengthy training programsGPs reported that the microlearning approach to learning about eating disorders may be an acceptable and effective approach for increasing GP knowledge, skill, confidence, and willingness to treat eating disorders. [ABSTRACT FROM AUTHOR]

Stroke survivors regularly report experiencing boredom during inpatient rehabilitation which may detrimentally affect mood, learning and engagement in activities important for functional recovery. This study explores how stroke survivors meaningfully occupy their non-therapy time and their experiences of boredom, to further our understanding of this complex phenomenon. Secondary analysis of transcripts from semi-structured interviews with stroke survivors exploring activity during non-therapy time. Transcripts were coded and analysed using a hybrid approach of inductive and deductive thematic analysis, guided by a published boredom framework. Analysis of 58 interviews of 36 males and 22 females, median age 70 years, revealed four main themes: (i) Resting during non-therapy time is valued, (ii) Managing "wasted" time, (iii) Meaningful environments support autonomy and restore a sense of normality, and (iv) Wired to be social. Whilst limited therapy, social opportunities and having "nothing to do" were common experiences, those individuals who felt in control and responsible for driving their own stroke recovery tended to report less boredom during their rehabilitation stay. Creating rehabilitation environments that support autonomy, socialisation and opportunities to participate in activity are clear targets to reduce boredom during non-therapy time, increase meaningful engagement and possibly improve rehabilitation outcomes post-stroke. Stroke survivors with a low sense of autonomy are at greater risk of boredom and may benefit from person-centred strategies to support participation in meaningful activities during non-therapy time whilst undertaking inpatient rehabilitation. Review and reduction of paternalistic practices within traditional models of care, to increase patient autonomy, may empower stroke survivors to drive their own activity and reduce boredom. The redesign and reorganisation of rehabilitation environments to increase opportunities for socialisation and access to nature and the outdoors may reduce boredom during inpatient rehabilitation. [ABSTRACT FROM AUTHOR]

Early childhood education and care (ECEC) provision can have long-lasting positive effects on children's learning and development. A key feature in fostering educational outcomes is the enhancement of parental involvement. This article builds on critical concerns with the emergent 'schoolification' of ECEC and corresponding orientations of parental involvement to explore how educational partnering is perceived across countries. A thematic analysis of 13 ECEC curricula from divergent pedagogical traditions revealed subtle yet meaningful differences in interpretation and operationalisation. Three distinct curricular approaches to parental involvement were identified, which demonstrate a lack of unanimity in top-down constructions of parental roles and responsibilities. The article concludes with a discussion on the implications of these findings for policy and practice.

Many Victorian secondary schools appear to be implementing Bring Your Own Device (BYOD) programs as the Australian Federal government's Digital Education Revolution funding has come to an end for 1-to-1 Learning programs. One of the key elements identified as important for the success of these programs is the clear communication of policies and protocols with the school community; something that may not be occurring on school websites. This paper explores the extent of 1-to-1 Learning and BYOD model implementation in Victorian secondary schools and identifies the type of information provided to parents and the school community via school websites. The results show that 78.7% (n = 88) of the sampled schools have 1-to-1 Learning programs; 64.4% (n = 72) BYOD. Information about 1- to-1 Learning programs on school websites was found to be limited or lacking for the majority of schools. The implications of these results are discussed in light of concerns for the successful, safe and equitable implementation of BYOD in educational settings.

Digital health technologies are a proposed solution to improve healthcare delivery and reduce pressures on the healthcare system, but these technologies are new to much of the health workforce. This perspective paper highlights lessons learned from the global experience of rapid digital transformation of health workforces, including fostering a culture of learning, ensuring accreditation and recognition, and adopting a transdisciplinary approach. Evidence-based actions are proposed to address recommendations to (i) ensure foundational workforce digital health capability and (2) build specialist digital health career pathways. Australia must take a national approach and strategically leverage strong collaborations across sectors including healthcare, education and government to ensure a consistent, regulated and sustainable digital workforce capability. [ABSTRACT FROM AUTHOR]

Background: Producing animal protein while reducing the animal's impact on the environment, e.g., through improved feed efficiency and lowered methane emissions, has gained interest in recent years. Genetic selection is one possible path to reduce the environmental impact of livestock production, but these traits are difficult and expensive to measure on many animals. The rumen microbiome may serve as a proxy for these traits due to its role in feed digestion. Restriction enzyme-reduced representation sequencing (RE-RRS) is a high-throughput and cost-effective approach to rumen metagenome profiling, but the systematic (e.g., sequencing) and biological factors influencing the resulting reference based (RB) and reference free (RF) profiles need to be explored before widespread industry adoption is possible. Results: Metagenome profiles were generated by RE-RRS of 4,479 rumen samples collected from 1,708 sheep, and assigned to eight groups based on diet, age, time off feed, and country (New Zealand or Australia) at the time of sample collection. Systematic effects were found to have minimal influence on metagenome profiles. Diet was a major driver of differences between samples, followed by time off feed, then age of the sheep. The RF approach resulted in more reads being assigned per sample and afforded greater resolution when distinguishing between groups than the RB approach. Normalizing relative abundances within the sampling Cohort abolished structures related to age, diet, and time off feed, allowing a clear signal based on methane emissions to be elucidated. Genus-level abundances of rumen microbes showed low-to-moderate heritability and repeatability and were consistent between diets. Conclusions: Variation in rumen metagenomic profiles was influenced by diet, age, time off feed and genetics. Not accounting for environmental factors may limit the ability to associate the profile with traits of interest. However, these differences can be accounted for by adjusting for Cohort effects, revealing robust biological signals. The abundances of some genera were consistently heritable and repeatable across different environments, suggesting that metagenomic profiles could be used to predict an individual's future performance, or performance of its offspring, in a range of environments. These results highlight the potential of using rumen metagenomic profiles for selection purposes in a practical, agricultural setting. [ABSTRACT FROM AUTHOR]

Objectives. To review the prevalence of loneliness (during/after COVID-19) in older people. Design. Scoping review using Medline and PsycInfo for worldwide prevalence estimates (white published literature search) and Google for prevalence data inside the Euregio Meuse-Rhine (grey literature). Setting. Worldwide prevalence estimates and a focus on the Euregio Meuse-Rhine. Participants. Papers published between 2016 and 2022 and a mean age of minimum of 65 years. Measurements. Prevalence estimates for older people. Results. The white literature search yielded 37 articles. Before the onset of the COVID-19 pandemic, loneliness estimates were the highest in Nigeria (46%) and the lowest in Australia (5%) (mean prevalence was 25.6%). Loneliness was reported to be higher in specific populations, for example, people living in specific communities such as senior housing communities or with impairments, than in the general population, with a mean prevalence estimate of 47.8%. During COVID-19, the prevalence of loneliness was higher than that before the pandemic: we observed a mean prevalence of 39.4%, in comparison to 25.6 before COVID-19. The grey literature search showed that, compared to Belgium and the Netherlands (13.5% and 36.5%, respectively), loneliness estimates were the lowest in Germany, with a mean prevalence of 7.7%. Conclusion. Large international differences in the prevalence of loneliness were observed between countries and populations studied. Several hypotheses could explain such differences, including sociocultural or historical-political characteristics. Without surprise, the pandemic and associated measures were linked to a higher level of loneliness. Furthermore, recommendations for addressing loneliness, including interventions, are discussed. [ABSTRACT FROM AUTHOR]

Sexual health promotion is of primary importance for young people in Australia, especially for vulnerable and at-risk young people. The authors first identify the important role of youth workers in engaging clients proactively around a broad range of sexual health issues, and then discuss real and perceived barriers that youth workers face in meeting the sexual health needs of young people. The article presents a discussion engagement framework--the PLISSIT model--and practical examples to assist workers to improve their skills and confidence in this area. (Contains 1 figure and 3 endnotes.)

Previous research has suggested that culture influences perception and attention. These studies have typically involved comparisons of Westerners with East Asians, motivated by assumed differences in the cultures' self-concept or position on the individualism-collectivism spectrum. However, other potentially important sources of cultural variance have been neglected, such as differences in traffic directionality shaped by the urban spatial environment (i.e., left-hand vs. right-hand traffic). Thus, existing research may potentially place too much emphasis on self-concepts or the individualism-collectivism dimension in explaining observed cultural differences in cognition. The present study investigated spatial cognition using a Simon task and tested participants from four nations (Australia, China, Germany, and Malaysia) that differ in both cultural orientation (collectivistic vs. individualistic) and traffic directionality (left-hand vs. right-hand traffic). The task used two possible reference frames underlying the Simon effect: a body-centered one based on global stimulus position relative to the screen's center versus an object-centered one based on local stimulus position relative to a context object. As expected, all groups showed a reliable Simon effect for both spatial reference frames. However, the global Simon effect was larger in participants from countries with left-hand traffic. In contrast, the local Simon effect was modulated by differences in cultural orientation, with larger effects in participants from collectivistic cultures. This pattern suggests that both sources of cultural variation, viz. cultural orientation and traffic directionality, contribute to differences in spatial cognition in distinct ways. [ABSTRACT FROM AUTHOR]

Special attention has been given to chromium (Cr) as a paleoproxy tracing redox cycling throughout Earth's history, due to differences in the solubility of its primary redox species at Earth's surface (Cr(III) and Cr(VI)) and isotope fractionation associated with their interconversion. In turn, chromium's paleoproxy potential has motivated studies of the modern ocean to better understand which processes drive its cycling and to constrain their impact on the Cr isotope composition (δ53Cr) of seawater. Here, we present total dissolved seawater Cr concentrations and δ53Cr along the GEOTRACES GP13 section. This section is a zonal transect extending from Australia in the subtropical southwest Pacific Ocean. Surface signals of local biological Cr cycling are minimal, in agreement with distributions of dissolved major nutrients as well as biologically-controlled trace metals in this low productivity, oligotrophic environment. Depth profiles have Cr concentration minima in surface waters and maxima at depth, and are largely shaped by the advection of nutrient- and Cr-rich subsurface waters rather than vertically-driven processes. Samples close to the sediment–water interface indicate important benthic Cr fluxes across the section. The GP13 transect crosses the hydrothermally-active Kermadec Arc. Hydrothermal fluids (consisting of <15% background seawater) were collected from three venting sites at the Brothers Volcano (along the Kermadec Arc). These fluids yielded near-crustal δ53Cr values (−0.17 to +0.08‰) and elevated [Cr] (7.5–23 nmol kg−1, hydrothermal endmember [Cr] ≈ 8–27 nmol kg−1), indicating that the Kermadec Arc may be an isotopically light Cr source. Dissolved [Fe] enrichments have been reported previously in deep waters (∼1600–3000 m) along the GP13 transect, east of the Kermadec Arc. These same waters show elevated [Cr] compared to Circumpolar Deep Water ([Cr] = 3.88 ± 0.11, δ53Cr = 0.89 ± 0.08, n = 32), with an average [Cr] accumulation of 0.71 ± 0.11 nmol kg−1 (1 SD), and an estimated δ53Cr of +0.46 ± 0.30‰ (2 SD, n = 9) for the accumulated Cr. Comparing high-temperature vent and neutrally buoyant plume data, hydrothermal-sourced Cr is likely negligable compared to Cr contributions from other processes (benthic fluxes, release from particles), and the advection of more Cr-rich Pacific Deep Water. It is unlikely that hydrothermal vents would be a major contributor within the regional or global biogeochemical Cr cycle, even if hydrothermal fluxes change by orders of magnitude, and therefore δ53Cr trends in the paleorecord may be attributable, at least in part, to major changes in other controls on Cr (e.g. widespread anoxia). [ABSTRACT FROM AUTHOR]

Objective: To investigate stroke survivors' perceptions of factors influencing their engagement in activity outside of dedicated therapy sessions during inpatient rehabilitation. Design: Qualitative study. Setting: Four metropolitan rehabilitation units in Australia. Participants: People undertaking inpatient rehabilitation after stroke. Methods: Semi-structured interviews conducted in person by a speech pathologist A stepped iterative process of inductive analysis was employed until data saturation was achieved with themes then applied against the three domains of the Theory of Planned Behaviour (perceived behavioural control, social norms and attitude). Results: Interviews of 33 stroke survivors (60% female, median age of 73 years) revealed five themes (i) uncertainty about how to navigate and what was available for use in the rehabilitation unit restricts activity and (ii) post-stroke mobility, fatigue and pre- and post-stroke communication impairments restrict activity (perceived behavioural control); (iii) unit set up, rules (perceived and actual) and staff expectations influence activity and (iv) visiting family and friends are strong facilitators of activity (social norms), and (v) personal preferences and mood influence level of activity (attitude). Conclusion: At the individual level, stroke survivors perceived that their ability to be active outside of dedicated therapy sessions was influenced by their impairments, including mood, and their attitude towards and preference for activity. At the ward level, stroke survivors perceived that their ability to be active was influenced by ward set-up, rules and staff expectations. Visitors were perceived to be important facilitators of activity outside of therapy sessions. [ABSTRACT FROM AUTHOR]

Organisms respond to their environment in various ways, including moving, adapting, acclimatising or a combination of responses. Within estuarine habitats, organisms are exposed to naturally variable environmental conditions. In urbanised estuaries, these natural variations can interact with human stressors such as habitat modification and pollution. Here, we investigated trait variation in the golden kelp Ecklonia radiata across an urban estuary - Sydney Harbour, Australia. We found that kelp morphology differed significantly between the more human-modified inner and the less modified outer harbour. Kelp individuals were smaller, had fewer laminae, and lacked spines in the inner harbour where it was warmer, more contaminated and less light was available. Inner harbour populations were characterised by lower tissue nitrogen and higher lead concentrations. These findings provide insights into how environmental variation could affect kelp morphology and physiology, and the high trait variation suggests adaptive capacity in E. radiata. • We assessed spatial variation in Ecklonia radiata traits across an urban estuary. • The inner estuary was warmer, more turbid, and contaminated than the outer estuary. • Outer harbour kelp had thicker stipes, longer and narrower laminae with spines. • Tissue concentrations of lead were higher and nitrogen lower in the inner estuary. • The high trait variation suggests environmental adaptability of E. radiata. [ABSTRACT FROM AUTHOR]

Objectives: Develop and implement a Communication Enhanced Environment model and explore its effect on language activities for patients early after stroke. Method and design: Before-and-after pilot study. Setting: An acute/slow stream rehabilitation and a rehabilitation ward in a private hospital in Perth, Western Australia. Participants: Fourteen patients recruited within 21 days of stroke. Seven recruited during the before-phase (control group: patients with aphasia = 3, patients without aphasia = 4) and seven recruited in the after-phase (intervention group: patients with aphasia = 4, patients without aphasia = 3). Intervention: The intervention group exposed to a Communication Enhanced Environment model had access to equipment, resources, planned social activities and trained communication partners. Both groups received usual stroke care. Data collection: Hospital site champions monitored the availability of the intervention. Behavioural mapping completed during the first minute of each 5-minute interval over 12 hours (between 7 am and 7 pm) determined patient engagement in language activities. Results: Seventy-one percent of the Communication Enhanced Environment model was available to the intervention group who engaged in higher, but not significant (95% CI), levels of language activities (600 of 816 observation time points, 73%) than the control group (551 of 835 observation time points, 66%). Unforeseen reorganisation of the acute ward occurred during the study. Conclusions: Implementation of a Communication Enhanced Environment model was feasible in this specific setting and may potentially influence patients' engagement in language activities. The unforeseen contextual challenges that occurred during the study period demonstrate the challenging nature of the hospital environment and will be useful in future research planning. [ABSTRACT FROM AUTHOR]

Background: Low physical activity levels in people with stroke may contribute to higher risk of cardiovascular disease morbidity and mortality. Differences in economic status, culture and the built environment may influence the applicability of interventions developed in high income countries (HIC) for stroke survivors in low to middle‐income countries (LMIC). Purpose: To compare physical activity levels of stroke survivors in HIC and LMIC and to explore the influence of lower limb impairment on physical activity levels. Methods and Materials: An exploratory secondary analysis of observational data on physical activity levels of stroke survivors from Australia (HIC) and India (LMIC). Physical activity variables (step count, light physical activity (LPA) and moderate‐to‐vigorous physical activity (MVPA)) were measured by accelerometery. Comparisons of physical activity levels between (a) Australian and Indian stroke survivors and (b) participants with and without lower limb impairments were performed using independent t‐tests or Mann‐Whitney U tests. Results: There were no significant differences in physical activity levels between (i) Australian and Indian stroke survivors (step count mean difference 201 steps [−1375 to 974], LPA mean difference −24 min [−22 to 69], MVPA mean difference 2 min [−8 to 3]), and (ii) stroke survivors with and without lower limb impairments in either country. Conclusion: Stroke survivors were highly inactive in both countries. Despite differences in economic status, cultural influences and the built environment, the physical activity of stroke survivors in Australia and India did not differ. People with and without lower limb impairment also had similar physical activity levels. [ABSTRACT FROM AUTHOR]

Background The 'Down to Test (DTT)' campaign is a sexually transmissible infection (STI) social marketing intervention delivered through outdoor music festival activations and supported by digital media communications in New South Wales, Australia. This paper investigates whether and how the tailored messages reached the intended audience. Methods Data was collected through three annual rounds of online surveys post campaign exposure, targeting young people (aged 15-29years) attending 14 music festivals in NSW from October 2017 to March 2020. Descriptive statistics, principal component analysis and multivariable logic regression were applied to identify the key client segment and factors associated with a strong intention for future STI screening. Results Of the 10044 participants with a valid urine specimen submitted, 261 (2.8%) tested positive for chlamydia. Altogether, 1776 participants (median age=22) self-completed the evaluation surveys online with more being female (73.4%) than male (26.2%). Participants were mostly Australian-born (89.5%), heterosexual (82.6%) and the majority being sexually active (96.7%). Rates of self-reported lifetime STI testing (70.4%) and intention for future STI screening ('definitely yes' in the next 12months, 39.0%) were also high. The most significant factor associated with future intention for STI testing is the Sexual Experience and Perception Factor (adjusted odds ratio [AOR]=2.02; 95%CI 1.76-2.32; P<0.001), followed by the Sexual Beliefs and Attitudes Factor (AOR=1.14; 95% CI 1.01-1.30; P<0.05). Conclusions The NSW state-wide DTT campaign has largely reached sexually active youth who are attentive to sexual health promotion messages and contributed to enhanced STI screening in a fun and peer-supportive environment. [ABSTRACT FROM AUTHOR]

Issue Addressed: Lowering the rates of adolescent overweight and obesity is a public health priority. The implementation of nutrition policies and practices in schools is recommended by various health organisations, but there is little information on the extent of their implementation. The aim of this study is to describe the prevalence of the implementation of recommended school-level nutrition policies and practices in secondary schools in New South Wales (NSW), Australia, and reported barriers and facilitators to the adoption of such policies and practices in school plans.Methods: A cross-sectional study was undertaken with school principals and canteen managers. All eligible secondary schools in NSW were approached to participate in a telephone survey (n = 440). Descriptive statistics were used to describe prevalence, and associations between school characteristics and implementation were examined using univariate statistics.Results: A total of 137 school principals and 80 canteen managers completed the survey. The implementation of practices on drinking water during class, healthy food and beverage marketing and learning opportunities regarding healthy eating was high (>90% of participating schools). The implementation of practices regarding the restriction of unhealthy drinks in school canteens, healthy school fundraisers and staff training related to healthy eating was reported in under 25% of participating schools. There were no significant differences in implementation by school sector, socio-economic status and geographic location. The main barrier to inclusion of nutrition policies and practices in the school plan was having other priorities and commitments (28.5%), and the main facilitator was support from stakeholders, the staff, students and their parents (37.2%).Conclusions: There is opportunity to improve the implementation of nutrition policies and practices in NSW secondary schools. SO WHAT?: Strategies are needed for targeting barriers. These include: gaining support from school staff, students and parents, provision of resources and funding and staff training. [ABSTRACT FROM AUTHOR]

Background: Hereditary angioedema (HAE) is a rare, debilitating, genetic disease characterized by unpredictable, recurrent, and potentially fatal swelling of the skin and mucous membranes. We conducted a noninterventional, cross-sectional, web-based survey of patients with a self-reported diagnosis of HAE type 1/2 in Australia, Austria, Canada, France, Germany, Spain, Switzerland, and the United Kingdom to gain a comprehensive real-world understanding of the characteristics of HAE and its burden from the perspective of the patient. The survey included questions on clinical and demographic characteristics, burden of disease, and treatment. Instruments used to measure patient-reported outcomes included the Angioedema Quality of Life questionnaire (AE-QoL), 12-Item Short-Form Health Survey (SF-12v2), Angioedema Control Test (AECT), Hospital Anxiety and Depression Scale (HADS), and Work Productivity and Impairment questionnaire (WPAI). Data were analyzed with descriptive statistics.Results: A total of 242 patients (67.4% female; mean [range] age 43.8 [18-92] years) completed the survey. The mean (SD) age at first symptoms was 11.5 (8.9) years, while diagnosis occurred at 20.8 (13.2) years. Patients reported a mean (SD) of 12.5 (14.1) attacks in the past 6 months. The most recent attack occurred within the past month in 79.7% of patients; most were of moderate severity, 6.6% affected the larynx, 21.9% lasted ≥ 3 days, and 76.4% were treated with on-demand medication. Hospitalizations and emergency/urgent care visits were highest for patients with more attacks. At the time of the survey, 62.4% of patients were using long-term prophylaxis, including 34.4% using androgens. Moderate to severe anxiety and depression were reported in 38.0% and 17.4% of patients, respectively, as measured using the HADS. The severity of anxiety and depression was associated with poorer quality of life and productivity, measured using the AECT (mean overall score 8.00 [moderate perceived disease control]), AE-QoL, WPAI, and SF-12v2. Scores for AECT, AE-QoL, and WPAI were also worse with a higher number of attacks.Conclusions: This survey study of a broad international sample of patients with HAE showed that despite the availability of on-demand treatment and long-term prophylaxis for the prevention of attacks, patients across a wide geographical area continue to have high disease activity, likely due to restrictions in the availability of medications or incorrect use. Subsequently, significant disease burden, including impaired quality of life and mental health and decreased productivity, was evident. Increased patient education and access to newer, more effective therapies are needed. [ABSTRACT FROM AUTHOR]

Countermovement jumps loaded with a weighted vest are often used for the training of lower body power to improve jump performance. However, it is currently unknown how this added load affects the lower extremity kinematics and kinetics, in particular whether this results in an increased injury risk. Therefore, the purpose of this investigation was to determine how lower extremity kinematics and kinetics during landing are affected by loaded jumps as demonstrated in a volleyball block jump landing. Ten elite male volleyball players performed block jump landings in an unloaded and loaded (9.89 kg) condition. Kinematic and kinetic landing data from the three highest jumps were collected and assessed. Paired samples t test was used to establish whether load condition had a significant effect on lower extremity kinematics and kinetics. Hip flexion was significantly greater in the unloaded condition compared with the loaded condition (p = .004). There was no significant difference in any other kinematic or kinetic variables measures between the unloaded and loaded conditions. These results suggest that landing from loaded volleyball block jumps does not increase injury risk compared with unloaded jumps in elite male volleyball players. [ABSTRACT FROM AUTHOR]

Purpose: Integrating preventive oral care into prenatal care is suggested as a strategy for reducing the burden of oral diseases among pregnant women and their offspring. This scoping review sought to synthesize available information and identify knowledge gaps on integrating oral health into prenatal care. Design/methodology/approach: The scoping review was conducted based on the Joanna Briggs Institute scoping review framework using the following databases: CINAHL, Cochrane Database of Systematic Reviews, Medline, ProQuest Dissertation and theses Global, Psychinfo and Web of Science®. No search limits were used. Content analysis of the included articles was performed to identify conceptual frameworks, types of integration used, study designs, study objectives and outcomes. Findings: Overall, 2,861 references were obtained from the databases search; and based on the inclusion and exclusion criteria 35 references were included in the final analysis. Of these 35 references, one document presented a conceptual model, six documents reviewed guidelines for integrating oral health in prenatal care, two were policy documents aimed at interprofessional collaboration for oral health during pregnancy, eight documents described programs focused on providing oral care during pregnancy, five of the references were literature reviews and the remaining 13 evaluated the impact of integration. Linkages between healthcare professionals were the most common type of integration used. Research limitations/implications: Despite advances in understanding integrated care concepts for healthcare delivery, there is little evidence available on the impact of the various types of, and strategies for, integrating oral health into prenatal care. Future research to bridge the identified gaps is recommended. Originality/value: The originality of this study is to provide evidence on integrated oral healthcare during pregnancy. [ABSTRACT FROM AUTHOR]

Background: Participation in adequate levels of physical activity during the early years is important for health and development. We report the 6-month effects of an 18-month multicomponent intervention on physical activity in early childhood education and care (ECEC) settings in low-income communities. Methods: A cluster randomised controlled trial was conducted in 43 ECEC settings in disadvantaged areas of New South Wales, Australia. Three-year-old children were recruited and assessed in the first half of 2015 with follow-up 6 months later. The intervention was guided by Social Cognitive Theory and included five components. The primary outcome was minutes per hour in total physical activity during ECEC hours measured using Actigraph accelerometers. Intention-to-treat analysis of the primary outcome was conducted using a generalized linear mixed model. Results: A total of 658 children were assessed at baseline. Of these, 558 (85%) had valid accelerometer data (mean age 3.38y, 52% boys) and 508 (77%) had valid accelerometry data at 6-month follow-up. Implementation of the intervention components ranged from 38 to 72%. There were no significant intervention effects on mins/hr. spent in physical activity (adjusted difference = − 0.17 mins/hr., 95% CI (− 1.30 to 0.97), p = 0.78). A priori sub-group analyses showed a greater effect among overweight/obese children in the control group compared with the intervention group for mins/hr. of physical activity (2.35mins/hr., [0.28 to 4.43], p = 0.036). Conclusions: After six-months the Jump Start intervention had no effect on physical activity levels during ECEC. This was largely due to low levels of implementation. Increasing fidelity may result in higher levels of physical activity when outcomes are assessed at 18-months. Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12614000597695. [ABSTRACT FROM AUTHOR]

Objective: To assess the nutritional quality of student canteen purchases at recess and lunch, including: (i) the mean energy (kilojoules), saturated fat (grams), total sugar (grams) and Na (milligrams) and percentage of energy from saturated fat and total sugar; and (ii) the proportion and types of foods purchased that are healthier (green) and less healthy (amber/red) according to a state school canteen policy.Design: A cross-sectional study of student canteen food and beverage recess and lunch purchases.Setting: Twenty-six randomly selected government primary schools that were non-compliant with a state school canteen policy from a region of New South Wales, Australia, were approached to participate.Participants: Students (aged 5-12 years) of participating schools.Results: Eighteen schools (69 %) consented to participate. On average students' recess purchases contained 571·2 kJ energy, 1·6 g saturated fat, 11·6 g total sugar and 132·4 mg Na with 10·0 % of energy from saturated fat and 37·8 % of energy from total sugar. Students' lunch purchases contained 685·4 kJ energy, 1·8 g saturated fat, 12·7 g total sugar and 151·4 mg Na with 9·5 % of energy from saturated fat and 31·8 % of energy from total sugar. Less healthy items represented 72 and 76 % of all items purchased at recess and lunch, respectively, with 'savoury snacks' and 'sugar-sweetened ice blocks and slushies' being the most common recess and lunch purchases, respectively.Conclusions: There is considerable scope to improve the nutritional quality of student purchases from primary-school canteens, with a high percentage of energy from total sugar. Future research is required to identify effective strategies to enhance compliance with canteen policies and support the purchase of healthier foods from school canteens. [ABSTRACT FROM AUTHOR]

Many stroke survivors require care from informal carers such as family members and friends who may experience adverse impacts. This study aimed to qualitatively explore the unmet needs of carers of stroke survivors, and their preferences for interventions and support services. We conducted 24 semi-structured, qualitative interviews with carers of stroke survivors from the Hunter region, Australia. Inductive thematic analysis was used in the context of a needs-led framework to identify key themes of their unmet needs. Key unmet needs identified by carers of stroke survivors in this study centred on four main themes: (1) social relationships and support; (2) adequacy of information; (3) taking care of oneself; and (4) accessing appropriate services. Carers of stroke survivors desired the development of services which provide connectivity to information, training, education and community support; and inclusion in a community with social relationships and other carers of stroke survivors. Ongoing unmet needs often result in adverse health and quality of life outcomes for carers of stroke survivors. Co-designed programs and resources for carers, particularly relating to unmet needs in social, information, self-care and service access domains are needed. [ABSTRACT FROM AUTHOR]

Cultural life scripts are shared knowledge about the timing of important life events. In the present study, we examined whether cultural life scripts are transmitted through traditions and whether there are additional ways through which they can be attained by asking Australian and Malaysian participants which information sources they had used to generate the life script of their culture. Participants hardly reported that they had used cultural and religious traditions. They more often reported that they had used their own experiences and experiences of relatives and friends. They also reported the use of comments of relatives and friends and the use of newspapers, books, movies and television programmes. Furthermore, we examined the stability of life scripts and similarities and differences across cultures. We found that life scripts are stable cognitive structures and that there are, besides cross-cultural differences in the content, small cross-cultural differences in the valence and distribution of life script events, with the Australian life script containing more positive events and more events expected to occur before the age of 16. [ABSTRACT FROM AUTHOR]

Objectives: To determine whether an enriched environment embedded in an acute stroke unit could increase activity levels in acute stroke patients and reduce adverse events. Design: Controlled before-after pilot study. Setting: An acute stroke unit in a regional Australian hospital. Participants: Acute stroke patients admitted during (a) initial usual care control period, (b) an enriched environment period and (c) a sustainability period. Intervention: Usual care participants received usual one-on-one allied health intervention and nursing care. The enriched environment participants were provided stimulating resources, communal areas for eating and socializing and daily group activities. Change management strategies were used to implement an enriched environment within existing staffing levels. Main Measures: Behavioural mapping was used to estimate patient activity levels across groups. Participants were observed every 10 minutes between 7.30 am and 7.30 pm within the first 10 days after stroke. Adverse and serious adverse events were recorded using a clinical registry. Results: The enriched environment group (n = 30, mean age 76.7 ± 12.1) spent a significantly higher proportion of their day engaged in 'any' activity (71% vs. 58%, P = 0.005) compared to the usual care group (n = 30, mean age 76.0 ± 12.8). They were more active in physical (33% vs. 22%, P < 0.001), social (40% vs. 29%, P = 0.007) and cognitive domains (59% vs. 45%, P = 0.002) and changes were sustained six months post implementation. The enriched group experienced significantly fewer adverse events (0.4 ± 0.7 vs.1.3 ± 1.6, P = 0.001), with no differences found in serious adverse events (0.5 ± 1.6 vs.1.0 ± 2.0, P = 0.309). Conclusions: Embedding an enriched environment in an acute stroke unit increased activity in stroke patients. [ABSTRACT FROM AUTHOR]

Objective. The aim of the present study was to identify key enabling factors for engaging multidisciplinary teams (MDTs) in cancer care across the spectrum of translational research and quality improvement (QI) projects. Methods. The study was conducted in two large Sydney metropolitan hospitals. Qualitative methods, including structured observations of MDT meetings and semi-structured interviews with MDT leaders and champions, were used to identify how teams interact with and generate research and implementation initiatives. Enabling factors for and barriers to the engagement of MDTs in translational research and QI were identified. Results. Four key enabling factors emerged from the analysis of data generated from observing 43 MDT meetings and 18 semi-structured interviews: (1) access to high-quality data around individual and team performance; (2) researchactive team leaders; (3) having experts, such as implementation scientists, embedded into teams; and (4) having dedicated research or QI-focused meetings. Barriers included a lack of time, administrative support, research expertise and access to real-time data. Conclusions. The identification of enabling factors for and barriers to translational research and QI provides evidence for how multidisciplinary cancer care teams may best be engaged in research and QI that aims to improve service and care outcomes. [ABSTRACT FROM AUTHOR]

Objective: A validated measure of daytime sleepiness for adolescents is needed to better explore emerging relationships between sleepiness and the mental and physical health of adolescents. The Epworth Sleepiness Scale (ESS) is a widely used scale for daytime sleepiness in adults but contains references to alcohol and driving. The Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD) has been proposed as the official modified version of the ESS for children and adolescents. This study describes the psychometric analysis of the ESS-CHAD as a measure of daytime sleepiness for adolescents.Methods: The ESS-CHAD was completed by 297 adolescents, 12-18 years old, from two independent schools in Victoria, Australia. Exploratory factor analysis and Rasch analysis was conducted to determine the validity of the scale.Results: Exploratory factor analysis and Rasch analysis indicated that ESS-CHAD has internal validity and a unidimensional structure with good model fit. Rasch analysis of four subgroups based on gender and year-level were consistent with the overall results. The results were consistent with published ESS results, which strongly indicates that the changes to the scale do not affect the scale's capacity to measure daytime sleepiness.Conclusions: It is concluded that the ESS-CHAD is a reliable and internally valid measure of daytime sleepiness in adolescents 12-18 years old. Further studies are needed to establish the internal validity of the ESS-CHAD for children under 12 years, and to establish external validity and accurate cut-off points for children and adolescents. [ABSTRACT FROM AUTHOR]

The article focuses on the patient-facing applications (apps) for accessing the medical records of pediatric patients while managing chronic health conditions like cystic fibrosis.

Background: Chlamydia trachomatis is one of the most frequently reported sexually transmitted infections (STI) in Australia, the UK and Europe. Yet, rates of screening for STIs remain low, especially in younger adults. Objective: To assess effectiveness of Chlamydia screening interventions targeting young adults in community‐based settings, describe strategies utilized and assess them according to social marketing benchmark criteria. Search strategy: A systematic review of relevant literature between 2002 and 2012 in Medline, Web of Knowledge, PubMed, Scopus and the Cumulative Index to Nursing and Allied Health was undertaken. Results: Of 18 interventions identified, quality of evidence was low. Proportional screening rates varied, ranging from: 30.9 to 62.5% in educational settings (n = 4), 4.8 to 63% in media settings (n = 6) and from 5.7 to 44.5% in other settings (n = 7). Assessment against benchmark criteria found that interventions incorporating social marketing principles were more likely to achieve positive results, yet few did this comprehensively. Most demonstrated customer orientation and addressed barriers to presenting to a clinic for screening. Only one addressed barriers to presenting for treatment after a positive result. Promotional messages typically focused on providing facts and accessing a testing kit. Risk assessment tools appeared to promote screening among higher risk groups. Few evaluated treatment rates following positive results; therefore, impact of screening on treatment rates remains unknown. Discussion: Future interventions should consider utilizing a comprehensive social marketing approach, using formative research to increase insight and segmentation and tailoring of screening interventions. Easy community access to both screening and treatment should be prioritized. [ABSTRACT FROM AUTHOR]

Patellar tendinopathy is the most common knee injury incurred in volleyball, with its prevalence in elite athletes more than three times that of their sub-elite counterparts. The purpose of this study was to determine whether patellar tendinopathy risk factors differed between elite and sub-elite male volleyball players. Nine elite and nine sub-elite male volleyball players performed a lateral stop-jump block movement. Maximum vertical jump, training history, muscle extensibility and strength, three-dimensional landing kinematics (250 Hz), along with lower limb neuromuscular activation patterns (1500 Hz), and patellar tendon loading were collected during each trial. Multivariate analyses of variance ( P < 0.05) assessed for between-group differences in risk factors or patellar tendon loading. Significant interaction effects were further evaluated using post-hoc univariate analysis of variance tests. Landing kinematics, neuromuscular activation patterns, patellar tendon loading, and most of the previously identified risk factors did not differ between the elite and sub-elite players. However, elite players participated in a higher training volume and had less quadriceps extensibility than sub-elite players. Therefore, high training volume is likely the primary contributor to the injury discrepancy between elite and sub-elite volleyball players. Interventions designed to reduce landing frequency and improve quadriceps extensibility are recommended to reduce patellar tendinopathy prevalence in volleyball players. [ABSTRACT FROM AUTHOR]

Background The implementation of healthy school canteen policies has been recommended as a strategy to help prevent unhealthy eating and excessive weight gain. Internationally, research suggests that schools often fail to implement practices consistent with healthy school canteen policies. Without a population wide implementation, the potential benefits of these policies will not be realised. The aim of this trial is to assess the effectiveness of an implementation intervention in increasing school canteen practices consistent with a healthy canteen policy of the New South Wales (NSW), Australia, government known as the 'Fresh Tastes @ School NSW Healthy School Canteen Strategy'. Methods/design The parallel randomised trial will be conducted in 70 primary schools located in the Hunter region of New South Wales, Australia. Schools will be eligible to participate if they are not currently meeting key components of the healthy canteen policy. Schools will be randomly allocated after baseline data collection in a 1:1 ratio to either an intervention or control group using a computerised random number function in Microsoft Excel. Thirty-five schools will be selected to receive a multi-component intervention including implementation support from research staff, staff training, resources, recognition and incentives, consensus and leadership strategies, follow-up support and implementation feedback. The 35 schools allocated to the control group will not receive any intervention support as part of the research trial. The primary outcome measures will be i) the proportion of schools with a canteen menu that does not contain foods or beverages restricted from regular sale ('red' and 'banned' items) and ii) the proportion of schools where healthy canteen items ('green' items) represent the majority (>50%) of products listed on the menu. Outcome data will be collected via a comprehensive menu audit, conducted by dietitians blind to group allocation. Intervention effectiveness will be assessed using logistic regression models adjusting for baseline values. Discussion The proposed trial will represent a novel contribution to the literature, being the first randomised trial internationally to examine the effectiveness of an intervention to facilitate implementation of a healthy canteen policy. [ABSTRACT FROM AUTHOR]

The Australian Height Datum (AHD) is the current national vertical datum for Australia, and AUSGeoid09 is the latest quasigeoid model used to compute (normal-orthometric)AHDheights fromGlobalNavigation Satellite System (GNSS) derived ellipsoidal heights. While previous studies have evaluated the AUSGeoid09 model across Australia, such studies have not focused on mountainous regions in particular. This paper investigates the performance of AUSGeoid09 in an absolute sense in the Mid Hunter and Snowy Mountains regions of New South Wales. Absolute (i.e. single point) comparisons were undertaken between AUSGeoid09-derived heights and published AHD heights. The performance of AUSGeoid09 was evaluated relative to its predecessor AUSGeoid98. In both study areas, an overall improvement is evident when applying AUSGeoid09 to compute AHD heights in an absolute sense. In the MidHunter, AUSGeoid09 provided a substantial improvement over its predecessor, clearly demonstrating the benefits of its new geometric component on GNSS-derived AHD height determination. In the Snowy Mountains, moderate improvement over AUSGeoid98 was evident. However, a slope was detected for AUSGeoid09 residuals, and it appears that the geometric component may have overcompensated for sea surface topography in this area. While this appraisal of AUSGeoid09 performance in mountainous regions is encouraging, it has been shown that some discrepancies still remain between AUSGeoid09-derived heights and AHD. Eventually, a new vertical datum will be necessary to ensure homogeneity across Australia. [ABSTRACT FROM AUTHOR]

The aim of this paper was to provide a descriptive epidemiology of anterior cruciate ligament (ACL) reconstructions in Australia. Data on all ACL reconstructions were collected from July 1, 2003 till June 30, 2008. Main outcome measures were the incidence of ACL reconstructions for Australia, per age group, sex and sport, including estimates of direct costs. There were 50 187 ACL reconstructions over the 5-year period studied. The population-based incidence of ACL reconstructions per 100 000 person-years was 52.0 [95% confidence intervals (CI): 51.6; 52.5], higher than previously published incidences from other western countries (Scandinavia 32-38). The population incidence rose rapidly through adolescence and early adulthood and then gradually declined. Males had a higher population incidence than females. Skiing had the highest incidence of ACL reconstructions per 100 000 person-years, followed by Australian rules football, rugby, netball and soccer. The total estimated hospital costs associated with ACL reconstruction surgery were over A$75 million (€45 million) per year. Further research is necessary to examine the causes for the higher population incidence of ACL reconstructions in Australia compared with other countries. The establishment of a national register of ACL injuries, similar to those developed in Scandinavia should be considered. [ABSTRACT FROM AUTHOR]

A community outbreak of gastroenteritis in Australia during 2007-2009 was caused by ingestion of playground sand contaminated with Salmonella enterica Paratyphi B, variant Java. The bacterium was also isolated from local wildlife. Findings support consideration of nonfood sources during salmonellosis outbreak investigations and indicate transmission through the animal-human interface. [ABSTRACT FROM AUTHOR]