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The goal of this study was to evaluate the measurement invariance of an adapted assessment of motivations for social withdrawal ("Social Preference Scale--Revised"; SPS-R) across cultural contexts and explore associations with loneliness. Participants were a large sample of university students (N = 4,397; M[subscript age] = 20.08 years, SD = 2.96; 66% females) from 10 countries (Argentina, Australia, Canada, China, India, Italy, South Korea, Norway, Turkey, and the United States). With this cross-cultural focus, we illustrate the "multiple-group factor analysis alignment method," an approach developed to assess measurement invariance when there are several groups. Results indicated approximate measurement invariance across the 10 country groups. Additional analyses indicated that overall, shyness, avoidance, and unsociability are three related, but distinct factors, with some notable country differences evident (e.g., in China, India, and Turkey). Shyness and avoidance were related positively to loneliness in all countries, but the strength of the association between shyness and loneliness differed in Italy and India relative to the other countries. Results also indicated that unsociability was related positively to loneliness in the United States only. Theoretical and assessment implications are discussed.

The Dying2Learn massive open online course (MOOC) was a five-week course designed for the general community covering various topics related to death and dying, developed with a sociocultural focus that encouraged personal reflection and open discussion, rather than a medical or clinical focus. Yet, the majority of the participants identified as health care workers. Their motivations to enrolling in the course as well as their learning goals were examined. Responses to questions relating to their motivations for enrolment and learning goals were assigned codes and grouped into themes. We then made comparisons between the different demographic and occupational groups. The most commonly mentioned responses related to general interest in the topic of death and dying. HCWs were more likely to mention work-related motivations and improving communication skills than non-HCWs. We found that HCWs hoped to be better at talking about death and dying, which might indicate a possible gap in their formal education in this area.

This paper explores the relationship between workforce competence, migration, and quality improvement in the Asia-Pacific through analysis of Early Childhood Education (ECE) policy texts from three East Asia Summit countries. Content (word level) analysis of salient policy texts was undertaken to address two questions: How are culture and diversity "conceptualized" in these texts? How are diverse educators "positioned" in these texts? We show that, despite differing historical trajectories of ECE, policy frameworks in all three countries fail to sufficiently acknowledge the potential contribution of migrant educators to quality improvement initiatives. We conclude by calling for greater attention to workforce mobility and diversity in ECE policies, and for further research into the untapped competence of migrant educators.

One cohort that has not been given extended attention in the period during which transition takes place is academically high-performing students. This research study uniquely synthesises some of these key factors by investigating how students in mixed-ability, seventh-grade classrooms across Australia, Peru, Scotland, South Korea, Spain and Vietnam regard a hypothetical, academically able peer. The fictitious student's intellectual ability, positive social traits and popularity varied across the six countries involved in this study, and were observed according to the gender of the perceiver. More specifically, the perceived popularity of a high-performing boy or girl was reported differently among the country groups. In Scotland, for example, the authors uncovered a potential risk to female social status arising from peer reactions to her academic achievement. Yet in Vietnam, female study participants maintained a positive perception of both hypothetical students, regardless of gender. The results of this study are discussed herein.

This cross-national scenario based study examined fourth-grade students' perceptions of high-performing classmates in terms of their expected intellectual abilities, positive social qualities and popularity among their peers across seven countries. The overall results show that high academic achievements predominantly lead to positive expectations within the peer group. However, pronounced differences were found between the countries. The results indicated that students from Spanish-speaking countries viewed their potential high-performing peers most favorably, followed by students from Australia, the United Kingdom and Germany. The least favorable expectations, but by no means negative attitude, were exhibited by students from the two East-Asian countries Korea and Vietnam. In contrast, the respondents' gender and the gender of the hypothetical successful classmates had less influence on student perceptions of high-performers. These findings have implications for the educational provision of high performing students in different cross-national contexts.

This study explores how secondary school students perceive high-performing potential classmates. A total of 1,794 seventh- and 10th-grade students from five countries completed a questionnaire measuring their expectations of hypothetical male and female high-performing classmates in three categories: intellectual ability, positive social qualities, and popularity. Across the five countries represented in this study, analyses of variance indicated that students did not report negative attitudes toward the three potential characteristics of a hypothetical gifted peer. Vietnamese students in particular reported more positive observations about the hypothetical classmate than their Australian, Peruvian, South Korean, and Spanish counterparts. Differing cross-national attitudes toward high-performing peers and the implications therein are discussed.

Aims To evaluate a self-administered digital education resource for patients after a heart attack (adapted simplified Chinese version of Cardiac College™) on secondary prevention knowledge and health behaviour change outcomes. Methods and results Chinese immigrants recovering from a heart attack were recruited from cardiac rehabilitation programmes at four metropolitan tertiary hospitals. Participants provided access to Cardiac College™ (adapted simplified Chinese version), a self-learning secondary prevention virtual education resource over 4 weeks. The web-based resources include 9 booklets and 10 pre-recorded video education sessions. Assessments included health literacy, secondary prevention knowledge, self-management behaviours, self-reported physical activity, and a heart-healthy diet. Satisfaction, acceptability, and engagement were also assessed. From 81 patients screened, 67 were recruited, and 64 (95.5%) completed the study. The participants' mean age was 67.2 ± 8.1 years old, 81.2% were males, and the majority had no English proficiency (65.6%). Following the intervention, significant improvements were observed for secondary prevention knowledge overall and in all subdomains, with the most improvement occurring in medical, exercise, and psychological domains (P < 0.001). Dietary and self-management behaviours also improved significantly (P < 0.05). According to participants, the educational materials were engaging (100%), and the content was adequate (68.8%); however, 26.6% found the information overwhelming. Overall, 46.9% were highly satisfied with the resources. Conclusion A self-learning virtual patient-education package improved secondary prevention knowledge and self-care behaviour in Chinese immigrants after a heart attack. The culturally adapted version of Cardiac College™ offers an alternative education model where bilingual staff or translated resources are limited. [ABSTRACT FROM AUTHOR]

While professional development has been emphasised in many countries, few comparative studies have examined the degree of teachers' participation in professional development and its effect on teachers. Using the TIMSS 2007 data, this study analyses to what extent teachers participated in professional development in 50 TIMSS countries and examines the relationship among high-quality teachers' professional development, teachers' beliefs, attitudes and job satisfaction. The study found that the extent to which teachers have participated in professional developmental activities was surprisingly low. In particular, teachers in 47 countries have rarely participated in active learning. The study also found that high-quality teacher professional development was significantly associated with greater job satisfaction, higher expectations for student performance and more positive attitudes in teachers concerning their implementing the school's curriculum. Policy implications for professional development are discussed.

Background: Infantile nephropathic cystinosis (INC) is a systemic lysosomal storage disease causing intracellular cystine accumulation, resulting in renal Fanconi syndrome, progressive kidney disease (CKD), rickets, malnutrition, and myopathy. An INC-specific disproportionately diminished trunk length compared to leg length poses questions regarding the functionality of the trunk. Methods: Thus, we prospectively investigated thoracic dimensions and proportions, as well as their clinical determinants in 44 pediatric patients with INC with CKD stages 1–5 and 97 age-matched patients with CKD of other etiology between the ages of 2–17 years. A total of 92 and 221 annual measurements of patients with INC and CKD, respectively, were performed, and associations between anthropometric and clinical parameters were assessed using linear mixed-effects models. Results: Patients with INC exhibited altered chest dimensions that were distinct from CKD controls, characterized by markedly increased chest depth to height and chest depth to chest width ratio z-scores (> 1.0), while those of patients with CKD were only mildly affected (z-score within ± 1.0). Ratio z-scores differed significantly between both patient groups from 2–6 years of age onward. The degree of chest disproportion in INC patients was significantly associated with both the degree of CKD and tubular dysfunction (e.g., low serum phosphate and bicarbonate) across three different age groups (2–6, 7–12, and 13–17 years). Conclusion: Our data show an INC-specific alteration in thoracic shape from early childhood onward, which is distinct from CKD of other etiologies, suggesting early childhood subclinical changes of the musculoskeletal unit of the thoracic cage, which are associated with kidney function. [ABSTRACT FROM AUTHOR]

Previous empirical studies have yielded inconclusive results about peer perceptions of academically high performing students. The purpose of this study was to investigate students' perceptions of the intellectual ability, positive social qualities, and popularity of a hypothetical new high performing classmate. Participants were 1060 Vietnamese, South Korean, British, Australian, Peruvian, and Spanish boys and girls in 10th grade. The results revealed that the perceptions of academically high performing classmates differed by country group. Positive perceptions of intellectual ability and social qualities were commonly found in all countries except the two Asian countries (Vietnam and South Korea), where the students reported more neutral views of high performers. In conclusion, it is argued that there is no evidence for possible iatrogenic effects of gifted education programs aiming at high achievements.

The fishery of the western rock lobster, Panulirus cygnus George, 1962 , is Australia's most valuable wild-caught single-species fishery. Recruitment in some regions of the fishery was observed to be significantly lower than expected after the 2010/2011 West Australian marine heatwave that caused extensive disturbance of dominant coastal habitats. This event generated interest in the study of the factors influencing survival and recruitment of post-larval benthic P. cygnus after settlement. The habitat associations of the highly cryptic post-settlement early-juveniles were previously unknown, with only anecdotal observations of individuals within limestone crevices in nearshore habitats. Our study used early-juveniles derived from ongoing monitoring of puerulus settlement to examine their habitat association mechanism in mesocosm experiments. Comparison of common nearshore habitat assemblages (bare sand, limestone crevices, and seagrasses (Posidonia and Amphibolis) at varying seagrass densities) found that most early-juveniles associated strongly with Amphibolis assemblages at high stem densities (~2,100 stems m–2). A shift in association between Amphibolis fronds and stems at high stem density to Amphibolis -shaded sand and leaf debris at low stem density indicated active habitat selection by early-juveniles. Habitat choices were tested with the scents of prey items and habitat types within Amphibolis assemblages using Y-maze bioassays. No significant olfactory choices were found, suggesting that habitat associations may be driven by multiple cues. Our study provides new laboratory-based insights into the habitat association of early-juvenile P. cygnus and suggests changes in seagrass assemblage identity and density are likely to be important. Further experimentation is needed to define the cues driving these patterns. The impact of habitat change on recruitment in this important fishery remains unknown and should be an objective of future research. [ABSTRACT FROM AUTHOR]

We used population sample data from 25 societies to answer the following questions: (a) How consistently across societies do adolescents report more problems than their parents report about them? (b) Do levels of parent-adolescent agreement vary among societies for different kinds of problems? (c) How well do parents and adolescents in different societies agree on problem item ratings? (d) How much do parent-adolescent dyads within each society vary in agreement on item ratings? (e) How well do parent-adolescent dyads within each society agree on the adolescent's deviance status? We used five methods to test cross-informant agreement for ratings obtained from 27,861 adolescents ages 11 to 18 and their parents. Youth Self-Report (YSR) mean scores were significantly higher than Child Behavior Checklist (CBCL) mean scores for all problem scales in almost all societies, but the magnitude of the YSR-CBCL discrepancy varied across societies. Cross-informant correlations for problem scale scores varied more across societies than across types of problems. Across societies, parents and adolescents tended to rate the same items as low, medium, or high, but within-dyad parent-adolescent item agreement varied widely in every society. In all societies, both parental noncorroboration of self-reported deviance and adolescent noncorroboration of parent-reported deviance were common. Results indicated many multicultural consistencies but also some important differences in parent-adolescent cross-informant agreement. Our findings provide valuable normative baselines against which to compare multicultural findings for clinical samples. (Contains 5 tables and 1 figure.)

The management of invasive species has been greatly enhanced by population genetic analyses of multilocus single-nucleotide polymorphism (SNP) datasets that provide critical information regarding pest population structure, invasion pathways, and reproductive biology. For many applications there is a need for protocols that offer rapid, robust and efficient genotyping on the order of hundreds to thousands of SNPs, that can be tailored to specific study populations and that are scalable for long-term monitoring schemes. Despite its status as a model laboratory species, there are few existing resources for studying wild populations of house mice (Mus musculus spp.) that strike this balance between data density and laboratory efficiency. Here we evaluate the utility of a custom targeted capture genotyping-by-sequencing approach to support research on plaguing house mouse populations in Australia. This approach utilizes 3,651 hybridization capture probes targeting genome-wide SNPs identified from a sample of mice collected in grain-producing regions of southeastern Australia genotyped using a commercially available microarray platform. To assess performance of the custom panel, we genotyped wild caught mice (N = 320) from two adjoining farms and demonstrate the ability to correctly assign individuals to source populations with high confidence (mean >95%), as well as robust kinship inference within sites. We discuss these results in the context of proposed applications for future genetic monitoring of house mice in Australia. [ABSTRACT FROM AUTHOR]

The current study investigated associations between the frequency of and motivations for social withdrawal during adolescence and emotional distresses in young adulthood. Perceived motivations for social withdrawal included unsociability, isolation, shyness, and low mood. Social withdrawal during adolescence was assessed using a retrospective questionnaire completed by Australian and Korean university students. They also completed measures of general self-worth, social relationships, loneliness, social anxiety, and depression at university. Partial correlations and path analyses revealed that different motivations for social withdrawal had different risk status for later adjustment across the two samples. In particular, it appeared that shy and unsociable individuals in Korea showed better social and emotional adjustment than their counterparts in Australia. In contrast, social relationships of sad/depressed and isolated respondents in Korea appeared to be more seriously impaired than their Australian counterparts. These cross-cultural differences are discussed in terms of socio-cultural values and environments unique to the two countries. (Contains 2 figures and 6 tables.)

We identify individuals who set daily intake budgets and examine if an intervention making people estimate their calorie intake up to a certain point in the day helps those setting daily budgets to regulate their calorie intake for the remainder of the day, after high prior consumption. We conducted an online experiment in five countries: Australia, China, Germany, India, and the UK (n = 3,032) using a 2 (setting calorie budget: yes vs. no, measured) x 2 (intervention: intake reminder vs. control, manipulated) between-subjects design, with the amount of prior consumption measured. Participants were contacted in the afternoon. Those in the intervention condition were asked to estimate their prior calorie intake on that day. We measured the individual characteristics of those who set daily calorie budgets and the intended calorie intake for the remainder of the day. Among people who set daily calorie budgets, the intervention reduced intended calorie intake for the remainder of the day by 176 calories if they had already consumed a high amount of calories that day. A timely intervention to estimate one's calorie intake can lower additional intended calorie intake among those who set daily calorie budget. [ABSTRACT FROM AUTHOR]

In an evolving business environment characterised by globalisation and a challenging competitive paradigm, it is imperative for strategic management processes to focus on the financial perspectives of value and risk in intellectual capital to create sustainability in long-term value. This paper presents the key issues pertaining to the strategic management of value and risk in intellectual capital and presents some hypotheses for a strategic management framework based on identified underlying value-drivers, which in turn helps to focus and address the issue of risk management more adequately. The pervasive value-drivers in three intellectual capital-intensive sectors in Australia are identified from an analysis of case studies, then specified and extrapolated to provide implications for the strategic management of value and risk in the knowledge-based firms. The strategic management implications of these value-drivers are discussed and explained.

Changing human behaviour and social systems are key to reversing the global biodiversity crisis. Pro‐environmental behaviour is guided by values and connection with nature, but because they have mostly been studied separately, the interplay between values and nature connection in influencing pro‐environmental behaviour remains unclear.In particular, it is uncertain whether people who hold anthropocentric values have a less positive connection with nature than those who hold ecocentric values, and whether nature protection behaviours differ between people with different values or strengths of connection to nature.We used a stratified survey of 2100 respondents across Australia to measure orientation towards nature. We created segments based on individual values and connection with nature and characterised each segment based on demographics, nature‐exposure, pro‐environmental behaviours, support for environmental policies and political alignment.We discovered that a quarter of respondents had anthropocentric values alongside a strong connection with nature. Moreover, of those with a strong connection with nature, people with anthropocentric values more frequently undertook certain pro‐environmental behaviours than those with ecocentric values.Our findings indicate that the strong expression of pro‐environmental behaviour is not limited to people with ecocentric values. Rather, people with different values and strengths of connection to nature engage in different types of impactful nature protection behaviours, challenging stereotypes about those with anthropocentric values.These results further suggest that behavioural intervention strategies could be tailored to reach sectors of society with various combinations of values and strengths of connection to nature, thus maximising the expression of pro‐environmental behaviour across the entire population. Read the free Plain Language Summary for this article on the Journal blog. Read the free Plain Language Summary for this article on the Journal blog. [ABSTRACT FROM AUTHOR]

Aims It is recommended that patients and clinicians discuss end-of-life deactivation of their implantable cardioverter defibrillator (ICD) prior to device implantation and throughout the illness trajectory to facilitate shared decision-making. However, such discussions rarely occur, and little is known about patients' openness to this discussion. The purpose of this study was to explore factors associated with patients' openness to discussing end-of-life ICD deactivation with clinicians. Methods and results This cross-sectional study recruited 293 patients with an ICD from outpatient clinics in the USA, Australia, and South Korea. Patients were classified into an open or resistant group based on their desire to discuss device deactivation at end of life with clinicians. Multivariable logistic regression was used to explore factors related to patients' openness to this discussion. About half of the participants (57.7%) were open to discussing such issues with their clinicians. Factors related to patients' openness to discussing device deactivation at end of life were living with someone, not having severe comorbid conditions (cancer and/or chronic kidney disease), greater ICD knowledge, and more experience discussing end-of-life issues with clinicians (odds ratio: 0.479, 0.382, 1.172, 1.332, respectively). Conclusion Approximately half of the ICD recipients were reluctant to discuss device deactivation at end of life with clinicians. Unmodifiable factors were their living arrangement and severe comorbidity. ICD knowledge and prior experience discussing end-of-life issues were potentially modifiable factors in the future. These factors should be addressed when assessing patients' readiness for a shared discussion about device deactivation at end of life. [ABSTRACT FROM AUTHOR]

The hook turn, which is rarely seen outside of Melbourne, Australia, reduces congestion in narrow road spaces shared with trams. Australia allows people from 44 nations to convert their home country driver's license to an Australian driver's license without a driving test. Visitors who have never heard of the hook-turn experience difficulty driving following the new traffic rule. From this aspect, investigating how inexperienced drivers encounter the hook-turn intersection is valuable for safety reasons. A driving simulator including virtual reality technology is developed to evaluate the level of safety of human driving behavior. The simulator in this research was developed by integrating Vissim and Unity3D embedded head-mounted display and driving devices to ensure a better driving experience. This research presented the development of a robust virtual reality driving simulator. It investigated how nonexperienced drivers respond to a completely new road condition. The results were compared with microsimulation outcomes (here, Vissim). The results showed that a human-driven car had a higher collision risk than a computer-driven car. The trajectories of the driver type were statistically different (t = 6.03, p 0.01, in the case of time-to collision ≤1.5 between experienced and computerized drivers). Participant responses to a postexperiment survey found that the simulator was realistic (4.31 out of 5.00), which could help beginner drivers (4.00 out of 5.00). Therefore, the simulator can be utilized for safety-related research as well as drivers' training. [ABSTRACT FROM AUTHOR]

Antarctic ozone has been regarded as a major driver of the Southern Hemisphere (SH) circulation change in the recent past. Here, we show that Antarctic ozone can also affect the subseasonal-to-seasonal (S2S) prediction during the SH spring. Its impact is quantified by conducting two reforecast experiments with the Global Seasonal Forecasting System 5 (GloSea5). Both reforecasts are initialized on September 1st of each year from 2004 to 2020 but with different stratospheric ozone: one with climatological ozone and the other with year-to-year varying ozone. The reforecast with climatological ozone, which is common in the operational S2S prediction, shows the skill re-emergence in October after a couple of weeks of no prediction skill in the troposphere. This skill re-emergence, mostly due to the stratosphere–troposphere dynamical coupling, becomes stronger in the reforecast with year-to-year varying ozone. The surface prediction skill also increases over Australia. This result suggests that a more realistic stratospheric ozone could lead to improved S2S prediction in the SH spring. [ABSTRACT FROM AUTHOR]

Background: Chronic limb‐threatening ischaemia (CLTI) carries significant amputation and mortality risks. Australian population‐based outcomes for CLTI are inadequately known. This study aimed to distinguish factors associated with outcomes in the first 2 years after CLTI surgery. Methods: By linking routinely collected health administrative and mortality data from New South Wales, this population‐based cohort study identified patients with ischaemic rest pain, gangrene or ulceration undergoing vascular surgery in public hospitals between 2010 and 2012. The primary outcome was 2‐year amputation‐free survival (AFS), and secondary outcomes included readmission and reoperation rates. Multivariable regression analysis identified prognostic factors adjusted for patient, hospital and geographic factors. Results: Primary CLTI surgery was performed on 4898 patients. Almost half the cohort had minor amputations without concurrent revascularization (2398, 49%), and the remaining patients had open (652, 13%) or endovascular (1848, 38%) surgery. At 2‐years, the AFS rate was 72%. Significant disparity was seen between age groups, with the 2‐year AFS 71% in patients aged 75 years or older, compared to 95% in patients aged less than 75 years (P < 0.001). Place of residence or hospital training status did not significantly influence AFS or readmission, but non‐training hospitals had higher rates of reoperation. Conclusion: This population‐based cohort study demonstrated variable outcomes for patients with CLTI, particularly with respect to older age, admission acuity and comorbidity. Results may guide service improvements however further research is needed into how population‐wide health initiatives can address age‐related disparities in CLTI. [ABSTRACT FROM AUTHOR]

Our province recently experienced an outbreak of neonatal rotavirus-associated leukoencephalopathy. This study aimed to verify whether rotavirus-associated leukoencephalopathy constituted fifth-day fits, which prevailed in Europe and Australia between the 1970s and mid-1980s. Of 118 full-term neonates who were admitted between 2008 and 2017 due to seizures, those who fulfilled the following criteria for fifth-day fits were included: healthy full-term neonates prior to seizures; absence of perinatal asphyxia; seizure onset during 4-6 days of age; and no known cause of neonatal seizures. Overall, 54 patients (45.8%) met the criteria for fifth-day fits. Of them, 44 patients (81.5%) also had rotavirus-associated leukoencephalopathy. The mean annual incidence of fifth-day fits was 5.4 cases, which peaked in 2012-2013 (13 cases) and became zero in 2017. Fifth-day fits with rotavirus-associated leukoencephalopathy accounted for 37.2% of neonatal seizures, which peaked at 70.6% in 2012, and gradually reduced to zero in 2017. Concordance of clinical features between rotavirus-associated leukoencephalopathy and fifth-day fits and their epidemic-like features suggest that rotavirus-associated leukoencephalopathy is one of the main causes of fifth-day fits. [ABSTRACT FROM AUTHOR]

Background: Obstetric anal sphincter injuries (OASIs) are a significant complication of vaginal delivery, and a leading cause of anal incontinence in women. Aims: The aims were to explore the management of OASIs in Australia and New Zealand (ANZ) by colorectal surgeons and how this compares with current recommendations and international experience, and to identify the deterrents to the provision of best‐practice care among colorectal surgeons. Materials and Methods: Three hundred colorectal surgeons of the Colorectal Surgical Society of ANZ were mailed questionnaires. Areas of interest included: surgeon demographics; exposure to OASIs; understanding of current recommendations; and opinions regarding the importance of symptoms and assessment tools in OASIs. Results: There were 94 completed questionnaires (response rate 31.3%). Fifty‐seven surgeons (60.6%) reported low exposure to OASIs during their fellowship training. Greater than 90% believed patients with grade three tears and above should have anal sphincter assessment. Sixty‐six (70.2%) reported that they routinely review women who have had OASIs. However, 56.4% were unaware if their obstetrics department followed a standard protocol for OASIs. Surgeons practising in metropolitan centres reported higher rates of their obstetrics department following a protocol (P = 0.013), and greater access to investigative tools (P < 0.001), when compared to rural‐based surgeons. Conclusions: Most ANZ colorectal surgeons have had minimal training in OASI management. Colorectal surgeons are more commonly involved with OASI patients in the non‐acute setting. Management protocols involving a multidisciplinary team of both colorectal surgeons and obstetricians should be clearly defined, and the gap between metropolitan and rural centres needs to be reviewed. [ABSTRACT FROM AUTHOR]

Background: Societal restrictions and lockdown during the coronavirus (COVID‐19) pandemic have had a significant impact on the volume and nature of trauma admissions. We assessed the impact of COVID‐19 related societal restrictions and lockdown on trauma admissions to single level 1 trauma centre in Westmead, Australia. We hypothesized that the number of trauma admissions would decrease and number of admissions due to self‐harm and assault (specifically domestic violence) would increase. Methods: Data was collected from the prospectively maintained Westmead Hospital Trauma Registry. The primary outcome compared was the average number of trauma admissions during March and April during years 2016 to 2020. Analysis of variance was used to analyse means. Pairwise differences among group means were evaluated with Tukey's honestly significant difference test. Secondary outcomes compared were in‐hospital interventions and patient outcomes. Results: There was a 23–34% decrease (P = 0.018) in the mean monthly average trauma admissions during March/April 2020 compared with previous years 2016–2019. In addition, there was a 40–52% decrease (P = 0.025) and 13–29% decrease (P = 0.020) in admissions due to road traffic collisions and falls respectively. Conclusion: There was a significant decrease in the overall number of trauma‐related admissions during the COVID‐19‐related period of societal restrictions and lockdown. This was due to a decrease in minor traumas, falls and road traffic collisions. There was no difference in the number of admissions secondary to major traumas, self‐harm or assault. [ABSTRACT FROM AUTHOR]

Background: An inguinal hernia is one of the most common surgical pathologies, and therefore the repair of an inguinal hernia is one of the most common general surgical procedures. The aim of this study was to assess the trend in inguinal hernia repair (IHR) rates in Australia between 2000/2001 and 2014/2015 using population data from public and private hospitals. Methods: ICD‐10 data cubes from the Australian Institute of Health and Welfare were analysed to determine the number of inguinal hernia repairs performed, open or laparoscopically, between 2000/2001 and 2014/2015 financial years. These data were combined with the Australian Bureau of Statistics population data estimates for the corresponding years, to give a procedure per 100 000 estimates. Results: Incidence of IHRs within Australia decreased from 217 to 194 per 100 000 population over the 15‐year study period. There was a clear shift towards increased uptake of laparoscopic surgery with a subsequent fall in rates of open IHRs. Males accounted for the majority of IHR procedures. Unilateral repair was more common; however, the incidence of unilateral repair rates decreased while bilateral IHR rates increased over the study period. Conclusion: Laparoscopic techniques are increasingly being used within public and private institutions across the country for inguinal hernia repair. There has also been a decrease in the incidence of IHR procedures performed per year over the 15‐year period studied, consistent with published literature from Europe and the USA. [ABSTRACT FROM AUTHOR]

This paper presents a view of the principalship as it is subjectively perceived by the principal. The role is constrained by a number of factors. One of these is the principal's private office that both signifies and produces the principal's unique status and position. One of the principal's primary obligations is to maintain the social structure within and outside the school. Principals' obligations involve situation-defining or defining the school structure, but the definitions are not of their own making. Recent changes in managerial styles create new demands on the principal, including a greater demand for measurable indicators of efficiency and effectiveness. The principal is also constrained by the way time is measured within the bureaucracy and by its strict use as an organizing feature of school life. As a consequence of these constraints, the principal may easily acquire a sense of being a victim of circumstance rather than the creator of occasions. It may be that the principal is the human agency through which the organization defines itself. (Author/JM)

Introduction and Aims: Take-home naloxone (THN) programs commenced in Australia in 2012 in the Australian Capital Territory and programs now operate in five Australian jurisdictions. The purpose of this paper is to record the progress of THN programs in Australia, to provide a resource for others wanting to start THN projects, and provide a tool for policy makers and others considering expansion of THN programs in this country and elsewhere.Design and Methods: Key stakeholders with principal responsibility for identified THN programs operating in Australia provided descriptions of program development, implementation and characteristics. Short summaries of known THN programs from each jurisdiction are provided along with a table detailing program characteristics and outcomes.Results: Data collected across current Australian THN programs suggest that to date over 2500 Australians at risk of overdose have been trained and provided naloxone. Evaluation data from four programs recorded 146 overdose reversals involving naloxone that was given by THN participants.Discussion and Conclusions: Peer drug user groups currently play a central role in the development, delivery and scale-up of THN in Australia. Health professionals who work with people who use illicit opioids are increasingly taking part as alcohol and other drug-related health agencies have recognised the opportunity for THN provision through interactions with their clients. Australia has made rapid progress in removing regulatory barriers to naloxone since the initiation of the first THN program in 2012. However, logistical and economic barriers remain and further work is needed to expand access to this life-saving medication. [ABSTRACT FROM AUTHOR]

Abstract: Background: Temporal artery biopsy is considered the investigation of choice to diagnose definitively giant cell arteritis (GCA) in patients with compatible symptoms. However it is invasive and not completely sensitive. Serum markers, particularly erythrocyte sedimentation rate (ESR), can be supportive, but are not definitive in individual cases. Aims: To investigate whether indices derived from the full blood count, including neutrophil‐to‐lymphocyte ratio (NLR) and platelet‐to‐lymphocyte ratio (PLR) were associated with a positive biopsy in patients with suspected GCA. Methods: The clinical and pathological details of 537 patients undergoing temporal artery biopsy at our institution from 1992 to 2015 were reviewed. Results: In univariate analysis high platelets (odds ratio (OR) 4.44, P < 0.001), NLR (OR 1.81, P = 0.02), PLR (OR 3.25, P < 0.001), C‐reactive protein (CRP) (OR 3.00, P < 0.001), ESR (OR 3.62, P < 0.001) and increased age (OR 1.03, P = 0.006) were strongly associated with a positive biopsy. In multivariate modelling only high platelets (P < 0.001) and ESR (P = 0.049) maintained significance. Conclusions: We conclude that the presence of thrombocytosis and high NLR, PLR, ESR and CRP can all be used clinically to support the diagnosis of GCA prior to biopsy. Of particular note, in multivariate modelling the presence of thrombocytosis is a stronger predictor of a positive temporal artery biopsy than ESR. Therefore, careful consideration of the findings in a full blood count can be used to predict the likelihood of a positive temporal artery biopsy in patients with suspected GCA. [ABSTRACT FROM AUTHOR]

Objectives: This study explored the models of services and experiences of coordinators and directors engaged in providing complementary and alternative medicine (CAM) or integrative medicine (IM) in oncology centers throughout Australia. Design: Fourteen leaders of IM programs from ten systematically selected Australian oncology centers were interviewed. Participants described their center's service model. Interview transcripts were thematically analyzed to identify underlying themes. Results were merged using the matrix technique for triangulation. Results: Ten oncology centers were reviewed. IM was perceived in the context of supportive care and wellness. IM program types provided included the following: body-mind programs (56%); body-energy programs (23%), and body programs (21%). All programs were outpatient focused, generally did not require a doctors' referral, were freely accessible to cancer patients and carers at no or minimal cost, were centralized by coordinators, and involved volunteers, nurses, allied health practitioners, third parties, and patients in their treatment planning. Interaction between medical and CAM/IM teams was limited and tended to be informal. The underlying structure comprised four main themes: cultural context, human components, systematic components, and resource availability. Human components and resources were considered important in influencing cultural context and systematic components in the IM structure. Conclusion: Australian integrative oncology models are based on the concept of wellness and individualized care, focused on patient empowerment and engagement. IM models are generally independent of conventional medical care. Building relationships and trust between stakeholders and open collaboration with conventional medical care will be important to integrate IM into the hospital system. Systemic changes to deliver patient centered care in the provision of IM healthcare will facilitate the incorporation of CAM and IM into cancer services in hospital settings. [ABSTRACT FROM AUTHOR]

Aim The main aim of this research was to describe the availability and integration of supportive care programs (SCPs), particularly complementary and alternative medicine (CAM) services, for adults in Australian oncology treatment centers. Methods We systematically searched 124 Australian hospitals listed as having an oncology department out of a total of 1157 hospitals listed in the Australian Hospitals and Aged Care Databases (2014), and assessed their website and relevant leaflets. Direct contact was made with a relevant staff member in each hospital. Data were collected regarding the range of SCP and CAM services available. Results Of the 124 hospitals, 89 (72%) provide nonspecific guidance to SCP or a staff member (e.g. social worker or care coordinator) who directs patients, advising them about SCP; 35 hospitals (28%) provide active referral to SCP, of which 24 of 35 (69%) include CAM in their service, with individual variation in how it is incorporated. Only 11 (46%) of these 24 CAM incorporated oncology centers in Australia provided systematically integrated CAM programs. Conclusion The majority of Australian oncology departments do not have CAM incorporated into their services. In those that do, less than half had systemically integrated CAM. The types of CAM available, how they are accessed and how they are integrated varied across hospitals. Further research is required to understand how to successfully and systematically integrate cancer-specific supportive care such as CAM into Australian cancer services. [ABSTRACT FROM AUTHOR]