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This paper describes the research protocol for the Educational and Developmental Gains in Early Childhood (EDGE) Study, which will examine the implementation of two years of funded kindergarten prior to the first year of school in Victoria, Australia. EDGE will examine whether children's language, cognitive, social-emotional, and behavioural outcomes are improved after two years of kindergarten compared to one year. The experiences of (and impacts on) teachers, service leaders, and families will also be examined. The study includes a cross-sectional cohort of 95 early childhood education and care (ECEC) services, and an embedded longitudinal observational cohort of children attending these services. Case studies of 15-20 ECEC services will also be collected, in addition to interviews with policy stakeholders.

As artificial intelligence (AI) continues to evolve, its impact on academic environments, especially in postgraduate research supervision, becomes increasingly significant. This study explored the impact of ChatGPT, an advanced AI conversational model, on five dimensions of research supervision: functional, enculturation, critical thinking, emancipation and relationship development. Using a qualitative approach, we examined the practices and perspectives of 20 postgraduate research students with at least 4 months' experience of using ChatGPT in research activities in Australia. The study revealed several areas of impact, including accelerated research progress, enhanced research quality, improved scholarly development and professional skills, enhanced critical thinking, increased student confidence and autonomy, and a deeper supervisory relationship. The findings suggest a shift in the roles and responsibilities of supervisors and students: the former provides strategic direction and high-level guidance, while the latter transits from apprentices to autonomous researchers due to the independence fostered by ChatGPT. This shift suggests an evolving model of postgraduate research supervision, with educational technology acting as epistemic tools to enhance the supervisory process. The study also considers the ethical implications of AI-enabled support.

This paper investigates the visual and verbal representation of diversity in Australian early childhood picture books, focusing on those that have been shortlisted for the Children's Book Council of Australia (CBCA) Early Childhood Book of the Year award (2001-2020). Educators at all levels draw on award lists to help create their reading lists and build their library collections. For early childhood to kindergarten educators, these selections are principally picture books. Picture books are significant for the cultural messages and values they convey about society, and for helping children learn about their world. How diverse that world is impacts on a child's sense of belonging and inclusion. Using content analysis, this study demonstrates the extent to which the story worlds in the CBCA award winning early childhood picture books may be considered a source of diversity for young Australian readers.

Research writing is an important part of doctoral study. Previous studies suggest that students who speak English as an additional language (EAL) may experience difficulties in writing a thesis in English. This study investigated the nature of the writing challenges experienced by EAL doctoral students. Drawing on data collected from individual semi-structured interviews with 27 EAL doctoral students in various disciplines at an Australian university, this study found that while many participants encountered linguistic challenges and socio-cultural challenges, some participants thought that native speakers also faced challenges in academic writing. Major linguistic challenges reported were over-reliance on translation and L1-L2 rhetorical differences. Additional challenges included lacking local learning experiences, difference in learning expectations, and social isolation. This study has practical implications for curriculum design of language support services for doctoral students and training programs for supervisors. It concludes with recommendations for students, supervisors, and academic literacy professionals.

This paper reflects on a team translation project on Aboriginal culture designed to enhance university students' intercultural communication competence and understanding through engaging in an interactive team translation project funded by the Australia-China Council. A selected group of Chinese speaking translation students participated in the project and two English books on Australian Aboriginal history and culture were translated to Chinese from August 2011 to May 2012. The two bilingual books were published by Aboriginal Studies Press in May 2013. After the one-year translation project was completed, the author conducted a survey and audio-taped interviews about the participants' translation experience. Using social constructivist theory (SCT), the author coded the data, conducted critical analysis of the contents, and categorised the themes. It was found that the participants not only improved their translation skills through combining theories with practices, but also got better knowledge of Australian Aboriginal cultural tradition and history than before. Having understood cross-linguistic differences, they combined translation theory with practice and raised their intercultural awareness after going through various organized learning activities centering on the translation project. Such an interaction-based student engagement learning approach helped student translators achieve meaningful communication and learner autonomy through individual reflections, group discussions, and seminars. Finally the pedagogical implications of the team translation project were discussed.

Past research has found that many pre-university L2 learners, having completed an Intensive English Program (IEP) still have difficulty in undertaking various disciplines in English-speaking tertiary institutions and continue to exhibit numerous linguistic problems (Bialystok, 2001, Celce Murcia 2001). The purpose of this paper is to present the findings on the investigation of L2 learners' English proficiency in reading, writing, grammar, listening and speaking upon their completion of an Intensive English (IE) program using their IELTS (Academic), in-house exams and English Placement Tests (EPT) scores, and the efficacy of IE program. IELTS test is chosen for this study due to its increasing popularity in Malaysia and its internationally recognised value and quality. The study was conducted in two parts. In Part One, all 72 Level 4 IE students were given an in-house EPT (English Placement Test) pre-test on their entry and another EPT post-test on their exit, and then their pre-test and post-test results were compared. In Part Two, 22 volunteers sat the IELTS test at the end of the program. The IELTS results of the 22 volunteers were compared with those who did not. Data were analyzed using both quantitative and qualitative methods. This paper hopes to shed some light on (i) whether or not L2 learners' English language proficiency can be significantly enhanced and influenced by an intensive English program and (ii) how leaners' perception of their own learning strategies influence their learning progress.

This paper examines a good practice for service learning that has been implemented for years in TESOL Internship, a professional unit for students doing Master of Arts (MA) in Teaching English to Speakers of Other Languages (TESOL) at a major university in Australia. The author has investigated and identified three key features of a good practice in service learning, including critical reflection, community engagement and intercultural communication, which are evidenced in student service learning in various English language centres in Great Western Sydney. Data are collected from student reports, supervising teachers' reports and comments, weekly workshop discussions and emails. Using constructivist grounded theory (Glaser & Strauss, 1967), the author conducts thematic analysis to code the data, categorizes them into key themes for critical analysis. The results show that during their practicum period TESOL student teachers critically reflect on their observation experience and participate in curriculum-relevant and extra-curriculum activities, particularly their own teaching practices drawing on relevant TESOL theories and communicating with their peers and mentors. Furthermore they come to understand local communities better as they are actively engaged in interacting with members of local communities. Finally their intercultural awareness is enhanced through regular and active intercultural communication with people of diverse language and cultural backgrounds. Opportunities and challenges for good service learning practices are also discussed.

Writing for publication in English-medium refereed academic journals can be a challenging task for doctoral students who use English as an Additional Language (EAL). Limited research, however, has been conducted in the Australian context to explore this practice among EAL doctoral students. Adopting a qualitative research approach with semi-structured interviews for data collection, this study aims to investigate the experiences of seven Vietnamese international students studying doctoral programs in Australian universities when writing for publication in English. Particularly, it seeks to find out what challenges this group of students encountered and the strategies they employed for scholarly publishing. The results show that these Vietnamese students faced similar linguistic and rhetorical challenges in scholarly writing with other groups of EAL doctoral students. Yet, some of their difficulties (for example, linguistic bias in journal gatekeeping, power inequality between co-authors) as well as some of their adopted strategies, are quite different from those of students in non-Anglophone contexts. It is possible that the close connection to the English-based academic discourse community gives Vietnamese students more confidence than those in non-Anglophone contexts. This study provides practical recommendations for writing support programs for this cohort of doctoral students in Australian universities.

The first language (L1) of language learners is a rich source of language knowledge that bilingual teachers and learners can bring to classrooms to facilitate second-language (L2) acquisition. While previous research suggests that L1 can provide learners with cognitive, pedagogical, and psychological benefits, what functions that it performs and how it supports language learning has not been thoroughly explored. This study aims to investigate different functions of L1 use in a beginner English class for 17 adult migrants in Australia through analysing teacher-students and students-students classroom interactions. Data were collected from lesson recordings, classroom observations and two interviews with the English-Chinese bilingual teacher. This study provides a refined categorisation of L1 functions through speech data rather than teacher's self-reports. Results show that the L1 was frequently used by the teacher for pedagogical purposes, classroom environment control and social relationship building. In particular, the L1 was mainly used for eliciting answers, giving classroom instructions and explaining meanings, and it was employed by learners to ask questions, give responses when they lacked the necessary skills in the target language, and to offer peer assistance. This study has implications for bilingual language support and learning materials design for beginner adult learners.

Several studies have been undertaken to develop instruments to measure English teachers' TPACK, but few studies have measured English teachers' TPACK to develop meaningful relationships among technology, content, and pedagogy in the context whereby literacy should be associated with a range of semiotic modes beyond the written language. The interactions with a wider range of texts across modes, media and contexts point to the need for an instrument that can measure English teachers' TPACK in the context of teaching multimodal literacies. In this study, we investigated what factors and items were necessary for examining pre-service teachers' TPACK in multimodal literacy teaching. The proposed TPACK instrument was validated with 220 pre-service teachers across three institutions in Indonesia, China, and Australia. The study shows that the proposed eight-factor instrument generally expressed acceptable validity and reliability and was appropriate for assessing pre-service teachers' TPACK for multimodal literacies. Implications and further research are discussed with the aim of equipping pre-service teachers with the capabilities to integrate content, pedagogy, technology and understand the complex interdependence of contextually bound factors that influence their classroom readiness in teaching multimodal literacies.

From a social semiotic perspective, image designs in science textbooks are inevitably influenced by the sociocultural context in which the books are produced. The learning environments of Australia and Taiwan vary greatly. Drawing on social semiotics and cognitive science, this study compares classificational images in Australian and Taiwanese junior high school science textbooks. Classificational images are important kinds of images, which can represent taxonomic relations among objects as reported by Kress and van Leeuwen ("Reading images: the grammar of visual design," 2006). An analysis of the images from sample chapters in Australian and Taiwanese high school science textbooks showed that the majority of the Taiwanese images are covert taxonomies, which represent hierarchical relations implicitly. In contrast, Australian classificational images included diversified designs, but particularly types with a tree structure which depicted overt taxonomies, explicitly representing hierarchical super-ordinate and subordinate relations. Many of the Taiwanese images are reminiscent of the specimen images in eighteenth century science texts representing "what truly is", while more Australian images emphasize structural objectivity. Moreover, Australian images support cognitive functions which facilitate reading comprehension. The relationships between image designs and learning environments are discussed and implications for textbook research and design are addressed.

This article conceptually examines TESOL teacher intercultural identity development in the Australian multicultural context. Using intercultural communication competence theory, the author discusses how TESOL teacher intercultural identity is developed and transformed in action and across languages and cultures. The in-progress formation of TESOL teacher intercultural identity is discussed from three perspectives. First, TESOL teachers must have second language knowledge and demonstrate ability to manage intercultural verbal communicative skills and styles. Second, they need to have more than one set of body languages and demonstrate ability to manage intercultural nonverbal communicative style and sensitivity. Third, they are engaged in social co-construction of intercultural identity through teacher-stakeholder interaction, having positive impact on themselves and on their students, particularly those with a refugee background. The author also proposes three strategies for TESOL teacher intercultural identity development and points out the future research on its potential contributing and/or interfering factors.

In a 2013-2014 Australia-China Council project, middle school students in Australia and China shared digital stories about their everyday lives and local cultures, and traditional tales with a modern twist. This article reports on research that aimed to explore the successes and challenges associated with this digital story exchange between Australia and China as a pedagogical approach to support language learning and intercultural understanding. An interpretivist approach was taken, focusing on the perspectives of the teachers. According to the teachers, the exchange was successful to a degree in supporting students' learning in the areas of language, intercultural understanding and twenty-first-century skills, including digital literacies and technological skills, and helped teachers extend their pedagogical horizons. A number of challenges also arose. Analysis of interview data revealed that both the successes and challenges fell into four interrelated domains, which we have labelled structures, practices, capabilities and technologies. This article offers new insights into the exchange of multimodal digital stories as learning activities in the Australian-Chinese context and provides recommendations to guide educators in these four domains.

Purpose: This paper aims to review and identify the major patterns and trends in learning analytics practices in higher education institutions. The review covers the characteristics of the institutions, as well as the characteristics and outcomes of the learning analytics practices. Design/methodology/approach: This research collected literature published in 2011-2016 which reported learning analytics practices from Scopus and Google Scholar, covering a total of 47 institutions, and categorised the information about the relevant institutions and practices. Findings: The results show that most of the institutions were public ones in the USA and the UK of various sizes and offering different levels of study. The learning analytics practices were mainly institution-wide, apart from a small number focusing on selected courses. The purposes of the practices were mainly to enhance the effectiveness of learning support and administration, followed by facilitating students' learning progress. The most common types of data collected for the practices were students' academic behaviours and their background information. Positive outcomes were reported for a majority of the practices, and the most frequent ones being an increase in cost-effectiveness and understanding of students' learning behaviours. Other outcomes included the improvement of student retention, timely feedback and intervention, support for informed decision-making and the provision of personalised assistance to students. Originality/value: The results provide an overview of the use of learning analytics in the higher education sector. They also reveal the trends in learning analytics practices, as well as future research directions.

China opened its market to the world after it entered The World Trade Organisation (WTO) at the turn of the last century. The Chinese Ministry of Education recently reviewed a series of policies about international cooperation in higher education with foreign countries in an effort to standardise their practice through centralised control. The purpose of this paper is to analyse current features and trends in international cooperation in Chinese higher education. This paper also develops a benefit-driven model of the internationalisation of Chinese higher education, and attempts to address the reasons for the marketability of cooperative programs in China. Finally, this paper discusses the issues related to the internationalisation of Chinese higher education, and makes recommendations for Australian universities intending to enter the Chinese higher educational market successfully. (Contains 5 tables, 2 figures, and 1 footnote.)

The annual National Assessment Program--Literacy and Numeracy (NAPLAN) measures the literacy and numeracy skills of primary and secondary students in Australia. Under the three Smarter Schools National Partnership, additional funding is provided to the independent schools with the expectation of improving student performance. Using multilevel modelling to account for within-school variables and demographics, we analyse NAPLAN data from the 2008-2011 tests for a sample of independent schools to estimate the effect of the National Partnerships on student performance. The results indicated that on average male students performed higher in the numeracy test but scored lower in each of the literacy tests. Aboriginal and Torres Strait Islander students scored lower in numeracy, reading, writing, and grammar and punctuation. Students from low socioeconomic status schools performed lower in writing.

To determine the impact implementation of Emergency Department Clinical Emergency Response System (EDCERS) on inpatient deterioration events and identify contributing causal factors. EDCERS was implemented in an Australian regional hospital, integrating a single parameter track and trigger criteria for escalation of care, and emergency, specialty and critical care clinician response to patient deterioration. In this controlled pre-post study, electronic medical records of patients who experienced a deterioration event (rapid response call, cardiac arrest or unplanned intensive care admission) on the ward within 72 h of admission from the emergency department (ED) were reviewed. Causal factors contributing to the deteriorating event were assessed using a validated human factors framework. Implementation of EDCERS reduced the number of inpatient deterioration events within 72 h of emergency admission with failure or delayed response to ED patient deterioration as a causal factor. There was no change in the overall rate of inpatient deterioration events. This study supports wider implementation of rapid response systems in the ED to improve management of deteriorating patients. Tailored implementation strategies should be used to achieve successful and sustainable uptake of ED rapid response systems and improve outcomes in deteriorating patients. [ABSTRACT FROM AUTHOR]

The history and current state of Chinese teaching in Australia has largely been determined by two key factors: first, the country's policy on languages, and in particular its policy regarding foreign language education; and second, its immigrants and overseas students from Chinese-speaking countries and regions. Beginning in the 1980s, Chinese teaching gained powerful support under Australia's official language policy, and the number of people studying Chinese has continuously grown. At the same time, it is worth noting that the majority of those learning Chinese are students of Chinese descent. The questions of how to design courses, prepare teaching materials, grade examinations, and train qualified teachers in response to this situation merit careful consideration. [This article was translated by Carissa Fletcher.]

The objective of this paper is to better understand the factors that affect the chances of re-engaging early school leavers in education, with a particular focus on the importance of time out from school (duration dependence) and school-related factors. Using data from three cohorts of the Longitudinal Survey of Australian Youth and duration models that control for unobserved heterogeneity, our results suggest that programmes that encourage an early return to study and those that develop post-school career plans may be more effective than programmes that concentrate on improving numeracy and literacy scores.

The purpose of this systematic review was to examine whether online or computer-based technologies were effective in assisting the development of speech and language skills in children with hearing loss. Relevant studies of children with hearing loss were analysed with reference to (1) therapy outcomes, (2) factors affecting outcomes, and (3) publication and methodological quality. The study quality was assessed using the 11-point PEDro scale. The review identified ten studies of relevance to the question of interest. All studies had relatively low PEDro quality scores with only four studies scoring in the mid-range on the scale. For these four studies, computer-based training appeared favourable at the group level. However, the small number of studies found significantly limits the generalizations and indicates the usage of these technologies in this population as an area requiring further rigorous research.

Hong Kong is seeking to increase the use of "assessment for learning" rather than rely on "assessment of learning" through summative examinations. Nearly 300 teachers from 14 primary and secondary schools answered a Chinese translation of the Teachers' Conceptions of Assessment inventory and a new Practices of Assessment Inventory. Structural equation modelling showed that there was clear alignment between conceptions and practices. Further, there were significant differences in the conceptions of assessment held by Hong Kong teachers as compared to New Zealand and Queensland teachers. This sample of Hong Kong teachers strongly associated (r = 0.91) using assessment to improve teaching and learning with making students accountable through assessment, which, in turn, led to a strong use of examination preparation practices (beta = 0.43). Hong Kong teachers believed learning outcomes were improved by using assessments to make students accountable and by preparing them for examinations. These results suggest that broader Chinese cultural norms concerning examinations are part of school culture and may provide barriers for the assessment reform agenda in Hong Kong and other Confucian societies. (Contains 3 figures and 1 table.)

The S-Star Trial Bioinformatics on-line course (www.s-star.org) is a global experiment in bioinformatics distance education. Six universities from five continents have participated in this project. One hundred and fifty students participated in the first trial course of which 96 followed through the entire course and 70 fulfilled the overall course requirements. The course was built up of 12 lectures covering different basic and advanced topics within bioinformatics. The lectures consist of streaming video and synchronized slides with follow-up discussion forums and a final assessment. It draws on experts from diverse institutions to share their teaching expertise and resources via distance learning. A major goal of S-Star is to provide free introductory web-based education. Here we present the outline of the course, experiences from a global collaboration, and feedback from the first trial of the on-line S-Star course. (Contains 2 tables, 1 figure and 1 footnote.)

To determine the incidence, characteristics (including timeframe) and predictors of patients discharged from the Emergency Department (ED) that later return and require admission. A retrospective cross-sectional study examining all return visits to three EDs in Sydney, Australia, over a 12-month period. Patients returning within 28 days from ED discharge with the same or similar complaint were classified as a return visit to ensure capture of all return visits. Descriptive and inferential statistics were used to analyse the data and logistic regression was performed to predict factors associated with return visits with general admission, and return visits admitted to critical care. There were 1,798 (30%) return visits which resulted in admission, mostly to a non-critical care area (1,679, 93%). The current NSW 48 -h time frame used to define a return visit in NSW captured half of all admitted returns (49.5%) and just over half (59.2%) of critical care admissions. Variables associated with an admission to critical care were age (OR 1.02, 95% CI 1.01, 1.03), initial presentation (index visit) made to a lower level ED (OR 3.76 95% CI 2.06, 6.86), Triage Category 2 (OR 3.67 95% CI 2.04, 6.60) and a cardiac diagnosis (OR 5.76, 95% CI 3.01, 11.01). This model had adequate discriminant ability with AUROC = 0.825. A small number of return visits result in admission, especially to critical care. These patients are at risk of poor outcomes. As such, clinicians should have increased index of suspicion for patients who return that are older, present with cardiac problems, or have previously presented to a lower level ED. Revision of the current timeframe that defines a return visit ought to be considered by policy makers to improve the accuracy of this widely used key performance indicator. [ABSTRACT FROM AUTHOR]

Advice discourse is common in our everyday life. As such, research on advice is diverse and covers advice-related communicative practices such as advice-seeking, advice-giving and reception to advice. Past research on advice has also examined various factors affecting advicerelated practices such as the relationship between advice and politeness, gender, and characteristics of interlocutors. Although advice is a much-researched area, comparative studies that attempt to compare advice-seeking strategies in two similar contexts are scarce. The present study seeks to fulfill this gap, hence a comparative study that compares the strategies used by women in Malaysia and Australia when they seek advice on infertility treatment in a Malaysian online forum and in an Australian online forum is carried out. A total of 100 advice-seeking messages from each forum are examined using Locher's (2006) content analysis method that involves analysis of the discursive moves, relational work, and linguistic realisations of moves in the advice-seeking messages. The results show that although there is homogeneity in many aspects in both forums, there are still variations in the women's adviceseeking strategies due to cultural backgrounds, specifically on the frequency and levels of problem disclosure, as well as the use of local slangs and syntax constructions that are typical of their cultural community. The study provides insights about how cultural elements shape one's advice-seeking strategies, subsequently contributing to our understanding of crosscultural pragmatics. [ABSTRACT FROM AUTHOR]

In response to increasing emergency department presentations and wait times in Australia, multiple strategies and models of care have been implemented with varying results. One effective strategy has been the implementation of pre-hospital blood collection by paramedics when they insert an intravenous cannula. This research aims to determine the efficiency of and barriers to wider implementation of a pre-hospital blood collection trial in a regional context. In particular, to evaluate the impact of the pre-hospital blood collection on time to pathology results and error rates, and paramedic opinion. This retrospective controlled cohort study was conducted over 12 months from August 2018. Emergency and pathology data were used to determine the haemolysis and error rates, as well as the time to result availability of pre-hospital blood collection samples compared to in hospital samples arrived by ambulance. To determine the facilitators and barriers to wider implementation a survey of 48 paramedics was conducted following completion of the 12-month trial. The survey was informed by the Theoretical Domains Framework, a behavior change theory associated with improved uptake when applied. Overall 237 samples were collected. There was a 65% (51 min) reduction in time taken for samples to be received at pathology and a 38% (50 min) improvement in time taken for results to return from pathology for patients arrived by ambulance. There were no labelling errors in the pre-hospital blood collection group or change in haemolysis rates. The majority (79%) of paramedics who completed the survey were optimistic about the protocol improving patient outcomes and 89% regarded the change in practice as acceptable. Three main themes emerged: 1. Training, environmental challenges and adequate equipment; 2. increased efficiency and improved patient care and 3. Prerequisites to implementing a new practice. Integration of Quantitative and Qualitative data resulted in 10 key influencers of behavior that need to be addressed in any future implementation. The introduction of pre-hospital phlebotomy reduced the time to blood results availability by 38% and resulted in fewer labelling errors. Wider implementation is supported by paramedics, but more training is required. [ABSTRACT FROM AUTHOR]

The involvement of families, carers and significant others (i.e. social support networks) has a positive corollary for a person experiencing mental health problems. Accordingly, in Australia involvement of social support networks within mental health services is endorsed in national health policy and service guidelines. Despite the endorsement, this is yet to be fully realised in all areas that provide mental health services, including emergency departments. Social support networks are integral in the provision of mental health consumers' care. Supporting the involvement of social support networks in the emergency department can provide healthcare services with opportunities for enhanced and cost-effective care, contributing to improved outcomes for consumers. An overview of some of the barriers and facilitators of social support network involvement is provided. The intention of this paper is to encourage reflection and dialogue on this important area of mental health service provision and support the evolution of a new paradigm of research into social support network involvement in the emergency department. [ABSTRACT FROM AUTHOR]

Background: Better population data on respiratory viruses in children in tropical and southern hemisphere countries is needed.Methods: The epidemiology of respiratory viruses among healthy children (6 months to <10 years) with influenza-like illness (ILI) was determined in a population sample derived from an influenza vaccine trial (NCT01051661) in 17 centers in eight countries (Australia, South East Asia and Latin America). Active surveillance for ILI was conducted for approximately 1 year (between February 2010 and August 2011), with PCR analysis of nasal and throat swabs.Results: 6266 children were included, of whom 2421 experienced 3717 ILI episodes. Rhinovirus/enterovirus had the highest prevalence (41.5%), followed by influenza (15.8%), adenovirus (9.8%), parainfluenza and respiratory syncytial virus (RSV) (both 9.7%), coronavirus (5.6%), human metapneumovirus (5.5%) and human bocavirus (HBov) (2.0%). Corresponding incidence per 100 person-years was 29.78, 11.34, 7.03, 6.96, 6.94, 4.00, 3.98 and 1.41. Except for influenza, respiratory virus prevalence declined with age. The incidence of medically-attended ILI associated with viral infection ranged from 1.03 (HBov) to 23.69 (rhinovirus/enterovirus). The percentage of children missing school or daycare ranged from 21.4% (HBov) to 52.1% (influenza).Conclusions: Active surveillance of healthy children provided evidence of respiratory illness burden associated with several viruses, with a substantial burden in older children. [ABSTRACT FROM AUTHOR]

This chapter examines the role played by intercultural nonverbal communication competence of Australian university staff members working in a culturally diverse setting and its impact on the management of intercultural working relationships with the students. The discussion starts with a critical review of relevant nonverbal communication theories (e.g. paralinguistics, proxemics, and kinesics). Then it focuses on various body language challenges academic and professional staff members working in Australian universities face on a daily basis while facilitating and working with students who come from diverse linguistic and cultural backgrounds. The body language facing academic staff members inside classroom is challenging due to intricate intercultural differences and potential intercultural misunderstanding. It is argued that an issue common to both academic and professional staff members is that some of them may have insufficient intercultural nonverbal communication competence and few have received intercultural nonverbal communication training relevant to their work roles though their verbal communication skills are sound. It is believed that competent intercultural nonverbal communication is crucial and indispensable for both academic and professional staff members working in Australian university context because Australian higher education sector has such a linguistically and culturally diverse environment and it has an internationally high-stake profile with some universities having as many as 20% or more international students from different cultures. This has created pedagogical implications that students are likely to achieve better learning outcomes and have better learning experience when their teachers are able to demonstrate their intercultural nonverbal communication competence. It is the same case with professional staff members whose competent intercultural nonverbal communication skills can accommodate students' various needs (e.g. psychological, emotional, and social). In a word, Australian university staff members' good intercultural understanding (language and cultural knowledge about international students, so-called clients) and effective nonverbal communication skills will contribute to presenting their universities a positive public image, internationalizing Australian higher education industry and making it competitive globally. [ABSTRACT FROM AUTHOR]

Background: Malnutrition is a prevalent issue in aged care facilities (RACFs), leading to adverse health outcomes. The ability to efficiently extract key clinical information from a large volume of data in electronic health records (EHR) can improve understanding about the extent of the problem and developing effective interventions. This research aimed to test the efficacy of zero-shot prompt engineering applied to generative artificial intelligence (AI) models on their own and in combination with retrieval augmented generation (RAG), for the automating tasks of summarizing both structured and unstructured data in EHR and extracting important malnutrition information., Methodology: We utilized Llama 2 13B model with zero-shot prompting. The dataset comprises unstructured and structured EHRs related to malnutrition management in 40 Australian RACFs. We employed zero-shot learning to the model alone first, then combined it with RAG to accomplish two tasks: generate structured summaries about the nutritional status of a client and extract key information about malnutrition risk factors. We utilized 25 notes in the first task and 1,399 in the second task. We evaluated the model's output of each task manually against a gold standard dataset., Result: The evaluation outcomes indicated that zero-shot learning applied to generative AI model is highly effective in summarizing and extracting information about nutritional status of RACFs' clients. The generated summaries provided concise and accurate representation of the original data with an overall accuracy of 93.25%. The addition of RAG improved the summarization process, leading to a 6% increase and achieving an accuracy of 99.25%. The model also proved its capability in extracting risk factors with an accuracy of 90%. However, adding RAG did not further improve accuracy in this task. Overall, the model has shown a robust performance when information was explicitly stated in the notes; however, it could encounter hallucination limitations, particularly when details were not explicitly provided., Conclusion: This study demonstrates the high performance and limitations of applying zero-shot learning to generative AI models to automatic generation of structured summarization of EHRs data and extracting key clinical information. The inclusion of the RAG approach improved the model performance and mitigated the hallucination problem., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Objectives: Systematic reviews (SRs) are becoming essential evidence in the decision-making process within the field of social sciences. This study aimed to investigate how Campbell SRs were cited and explore their specific application roles., Study Design and Setting: We included Campbell SRs published between 2016 and 2020 by searching the Wiley online library, and retrieved the articles and documents citing Campbell SRs from the Web of Science and Google Scholar by December 31, 2021. We described the characteristics of the SRs and citations, and formulated a set of application roles by analyzing the sentences or paragraphs where the SRs were cited., Results: Sixty nine Campbell SRs were published between 2016 and 2020; they were cited in 641 articles or documents a total of 1,289 times. The primary types of articles that cited Campbell SRs were cross-sectional studies (n = 226, 35.3%), SRs (n = 112, 17.5%), randomized controlled trials (n = 77, 12.0%), and policy reports (n = 57, 8.8%). Articles utilizing Campbell SRs were predominantly led by authors from the United States (n = 184, 28.7%), the United Kingdom (n = 98, 15.3%), and Australia (n = 51, 8.0%). We formulated a set of 10 application roles for the Campbell SRs, of which the most frequent were: describing the current status in the field of interest (n = 691, 53.6%), corroboration of the results (n = 140, 10.9%), identifying research gaps (n = 130, 10.1%), and providing methodological references (n = 126, 9.8%); the role of supporting policy recommendations or decisions accounted for 6.0% (n = 77) of the citations. Approximately 12% of Campbell SRs were used to support policy recommendations or decisions., Conclusion: Campbell SRs are widely applied, particularly in scientific research, to describe the current status in the field of interest. Although the current application of Campbell SRs in supporting policy recommendations and decisions may not be predominant, there is a growing recognition of their value in using Campbell SRs to inform decision-making., Competing Interests: Declaration of competing interest The authors declare that they have no conflicts of interest., (Copyright © 2023. Published by Elsevier Inc.)

Osteoporotic fracture as a serious complication of osteoporosis which is usually treated surgically, and its recovery is closely related to one's own behavior and lifestyle, and is a long-term, complex management process that often requires the individual to self-manage many health-related factors., Objective: To gather and synthesize the most robust evidence regarding self-management in patients with postoperative osteoporotic fractures, in order to provide scientific, evidence-based guidance for clinical healthcare professionals to assist postoperative patients in self-management efforts, and to assist patients in optimizing their self-management practices and behavioral norms., Methods: Based on the "6 S" pyramid model of evidence resources (System, Summaries, Synopses of synthesis, Syntheses, Synopses of studies, Studies), we searched the Up To Date, BMJ Best Practice, The Cochrane Library, Australian Joanna Briggs Institute JBI Evidence-Based Medicine Center Healthcare Database, National Institute for Health and Clinical Excellence (NICE), Guidelines International Network (GIN), National Guideline Clearinghouse (NGC) and Scottish Intercollegiate Guide lines Network (SIGN), MedPulse, Embase, PubMed, CINAHL, Web of Science, SinoMed, Chinese Medical Journal Full Text Database, CNKI, Wanfang Data Knowledge Service Platform, and VIP database, etc, The search period for clinical decision-making, systematic evaluation, clinical guidelines, evidence summaries and expert consensus on self-management of postoperative osteoporotic fracture patients, and it was from the establishment of the database to 18 February 2023. To ensure the quality of the literature, three researchers strictly screened the literature according to the literature inclusion and exclusion criteria, and two or more researchers independently evaluated the quality of the included literature, and extracted and integrated the relevant evidence., Results: Thirteen documents were finally included, including 4 clinical practice guidelines, 5 expert consensus, 2 recommended practices, 1 systematic evaluation, and 1 clinical decision report. The research team summarized the evidence in 6 dimensions: multidisciplinary teamwork, management of daily living, management of treatment adherence, management of exercise, management of fall prevention and subsequent fracture, and management of emotions, and 33 pieces of evidence were extracted., Conclusion: The study summarized 33 best evidence of self-management in postoperative osteoporotic fracture patients, which provides a scientific and reasonable self-management program for postoperative patients, and also provides important reference and information for clinical healthcare professionals to provide more comprehensive and scientific self-management health education to patients., Competing Interests: Declaration of competing interest The authors of this study declared no conffict of interest., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Natural Language Processing (NLP) is a powerful technique for extracting valuable information from unstructured electronic health records (EHRs). However, a prerequisite for NLP is the availability of high-quality annotated datasets. To date, there is a lack of effective methods to guide the research effort of manually annotating unstructured datasets, which can hinder NLP performance. Therefore, this study develops a five-step workflow for manually annotating unstructured datasets, including (1) annotator training and familiarising with the text corpus, (2) vocabulary identification, (3) annotation schema development, (4) annotation execution, and (5) result validation. This framework was then applied to annotate agitation symptoms from the unstructured EHRs of 40 Australian residential aged care facilities. The annotated corpus achieved an accuracy rate of 96%. This suggests that our proposed annotation workflow can be used in manual data processing to develop annotated training corpus for developing NLP algorithms.

This study proposes an ontology model to represent the surgical pathways for appendicectomy, incorporating domain knowledge extracted from literature and electronic records in an Australian health district. The ontology comprised 108 concepts and 81 object properties. The model is useful for continuous quality improvement initiatives, i.e., process mining to understand what happens in the hospital versus what is required by the policy.

Nursing staff record observations about older people under their care in free-text nursing notes. These notes contain older people's care needs, disease symptoms, frequency of symptom occurrence, nursing actions, etc. Therefore, it is vital to develop a technique to uncover important data from these notes. This study developed and evaluated a deep learning and transfer learning-based named entity recognition (NER) model for extracting symptoms of agitation in dementia from the nursing notes. We employed a Clinical BioBERT model for word embedding. Then we applied bidirectional long-short-term memory (BiLSTM) and conditional random field (CRF) models for NER on nursing notes from Australian residential aged care facilities. The proposed NER model achieves satisfactory performance in extracting symptoms of agitation in dementia with a 75% F1 score and 78% accuracy. We will further develop machine learning models to recommend the optimal nursing actions to manage agitation.

Background: Diagnosis of skin cancer requires medical expertise, which is scarce. Mobile phone-powered artificial intelligence (AI) could aid diagnosis, but it is unclear how this technology performs in a clinical scenario. Our primary aim was to test in the clinic whether there was equivalence between AI algorithms and clinicians for the diagnosis and management of pigmented skin lesions., Methods: In this multicentre, prospective, diagnostic, clinical trial, we included specialist and novice clinicians and patients from two tertiary referral centres in Australia and Austria. Specialists had a specialist medical qualification related to diagnosing and managing pigmented skin lesions, whereas novices were dermatology junior doctors or registrars in trainee positions who had experience in examining and managing these lesions. Eligible patients were aged 18-99 years and had a modified Fitzpatrick I-III skin type; those in the diagnostic trial were undergoing routine excision or biopsy of one or more suspicious pigmented skin lesions bigger than 3 mm in the longest diameter, and those in the management trial had baseline total-body photographs taken within 1-4 years. We used two mobile phone-powered AI instruments incorporating a simple optical attachment: a new 7-class AI algorithm and the International Skin Imaging Collaboration (ISIC) AI algorithm, which was previously tested in a large online reader study. The reference standard for excised lesions in the diagnostic trial was histopathological examination; in the management trial, the reference standard was a descending hierarchy based on histopathological examination, comparison of baseline total-body photographs, digital monitoring, and telediagnosis. The main outcome of this study was to compare the accuracy of expert and novice diagnostic and management decisions with the two AI instruments. Possible decisions in the management trial were dismissal, biopsy, or 3-month monitoring. Decisions to monitor were considered equivalent to dismissal (scenario A) or biopsy of malignant lesions (scenario B). The trial was registered at the Australian New Zealand Clinical Trials Registry ACTRN12620000695909 (Universal trial number U1111-1251-8995)., Findings: The diagnostic study included 172 suspicious pigmented lesions (84 malignant) from 124 patients and the management study included 5696 pigmented lesions (18 malignant) from the whole body of 66 high-risk patients. The diagnoses of the 7-class AI algorithm were equivalent to the specialists' diagnoses (absolute accuracy difference 1·2% [95% CI -6·9 to 9·2]) and significantly superior to the novices' ones (21·5% [13·1 to 30·0]). The diagnoses of the ISIC AI algorithm were significantly inferior to the specialists' diagnoses (-11·6% [-20·3 to -3·0]) but significantly superior to the novices' ones (8·7% [-0·5 to 18·0]). The best 7-class management AI was significantly inferior to specialists' management (absolute accuracy difference in correct management decision -0·5% [95% CI -0·7 to -0·2] in scenario A and -0·4% [-0·8 to -0·05] in scenario B). Compared with the novices' management, the 7-class management AI was significantly inferior (-0·4% [-0·6 to -0·2]) in scenario A but significantly superior (0·4% [0·0 to 0·9]) in scenario B., Interpretation: The mobile phone-powered AI technology is simple, practical, and accurate for the diagnosis of suspicious pigmented skin cancer in patients presenting to a specialist setting, although its usage for management decisions requires more careful execution. An AI algorithm that was superior in experimental studies was significantly inferior to specialists in a real-world scenario, suggesting that caution is needed when extrapolating results of experimental studies to clinical practice., Funding: MetaOptima Technology., Competing Interests: Declaration of interests SWM is on the scientific advisory board of SciBase AB, and previously for Kāhu (MoleMap), both of which produce competing diagnostic devices for skin cancer. MM received payment from MetaOptima Technology for doing the trial in Sydney. She has also received payments from MetaOptima Technology (unrelated to and before the trial) as a consultant. SNL's institute has received payment for consultancy services from MetaOptima Technology, unrelated to the trial. WY, JL, and MR are employees of MetaOptima Technology. MR is a board member and equity owner of MetaOptima Technology. PT has received fees for professional services from Silverchair; an unrestricted 1-year postdoctoral grant from MetaOptima Technology (2017); speaker fees from Novartis, Lilly, and FotoFinder; and unrestricted grants from Lilly. He is also on the executive board of the International Dermoscopy Society, is President of the Austrian Dermatopathology Society, and is a coauthor of textbooks on dermatoscopy (published by Facultas) and dermatopathology (published by Springer). PG has received fees for professional services from MetaOptima Technology, unrelated to the trial. She has also received fees from La Roche-Posay and Pierre Fabre, support for attending meetings from La Roche-Posay, and is on the faculty of Melanoma Institute Australia. RAS has received fees for professional services from MetaOptima Technology, F Hoffmann-La Roche, Evaxion Biotech, Provectus Biopharmaceuticals Australia, Qbiotics, Novartis, Merck Sharp & Dohme, NeraCare, Amgen, Bristol Myers Squibb, Myriad Genetics, and GlaxoSmithKline. HHC serves as a medical advisor to Metasense. DC has served as a speaker for AbbVie, Gilead Sciences, ViiV Healthcare, and MSD; has served as an advisory board member for ViiV Healthcare; and has received travel support from AbbVie, MSD, ViiV Healthcare, and Gilead Sciences. MG has received a conference travel grant from Sun Pharmaceutical Industries. GH has been supported by an Avant Foundation Early Career Researcher grant and by National Health and Medical Research Council Centres of Research Excellence funding (1135285). PK has received fees and travel support from Sanofi. JMR has received speakers honoraria from Bristol Myers Squibb, Roche, Amgen, and Novartis, and travel support from Roche, Bristol Myers Squibb, and Sanofi. MS has received consulting fees and travel support from Gilead Sciences, ViiV Healthcare/GSK, and MSD; is on the advisory boards of Gilead Sciences, ViiV Healthcare/GSK, and MSD; and is a board member of the Austrian Sexually Transmitted Disease Society. JT has received speaker fees from Lilly and Novartis, travel support from Almirall and AbbVie, and an unrestricted grant from Lilly. PW has received travel support from Pfizer and Merz Pharma, and fees for a case report from Novartis. WW has received a grant from WWTF; consulting fees from Böhringer Ingelheim, Sanofi Genzyme, Eli Lilly, AbbVie, LEO Pharma, Janssen, and Pfizer. He is a committee member of the Austrian Society of Dermatology and Venerology and is on the advisory boards of Sanofi Genzyme, Böhringer Ingelheim, and Eli Lilly. CZ was a coinvestigator on Sydney Cancer Partners Pilot Study Scheme Grant Procel Study-Perioperative Propranolol and Celexocib in Stage III melanoma. HK has received speaker fees from La Roche-Posay, Novartis, Eli Lilly, Pelpharma, Heine, and FotoFinder; has received equipment to his institution from Heine, FotoFinder, Canfield, and DermaMedical; and has received license fees to his institution from MetaOptima Technology, Heine, and Casi. He is member of the executive board of the International Dermoscopy Society. All other authors declare no competing interests., (Copyright © 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)

Purpose: To explore the benefits of a recorded maternal voice intervention on weight, recumbent length, head circumference, and heart rate of preterm infants in the neonatal intensive care unit., Methods: A pilot randomised controlled trial was conducted in this study. Preterm infants in the neonatal intensive care unit (N = 109) were recruited and randomly assigned to an intervention or control group. Both groups received routine nursing care, while preterm infants in the intervention group received a recorded maternal voice program of 20 min, twice daily for 21 days. Preterm infants' daily weight, recumbent length, head circumference, and heart rate were collected during the 21-day intervention. Participants' heart rate in the intervention group was also recorded once a day pre-during-after the recorded maternal voice program., Results: Preterm infants in the intervention group showed a significant increase in weight (-75.94, 95% CI -108.04, -43.85, P < 0.001), recumbent length (-0.54, 95% CI -0.76, -0.32, P < 0.001), and head circumference (-0.37, 95%CI -0.56, -0.18, P < 0.001) compared with the control group. Preterm infants in the intervention group also showed significant changes in heart rate pre-during-after the recorded maternal voice program. However, no significant differences were found in the heart rate scores between the two groups., Discussion: The changes in heart rate pre-during-after the intervention may help explain participants' more significant increase in weight, recumbent length, and head circumference., Practice Implications: The recorded maternal voice intervention could be incorporated into clinical practice to promote growth and development in preterm infants in the neonatal intensive care unit., Study Registration: Australian New Zealand Clinical Trials Register, https://www.anzctr.org.au/; (registration number: ACTRN12622000019707)., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Background: Though snoring is often regarded as a harmless condition that coincides with sound sleep, it is a sleep disorder that can be a potential indicator of more severe conditions such as sleep apnea syndrome. In the present study, we investigated the association between seasonal variations and snoring., Method: Search index for snoring (SIS) data were obtained from Google Trends and Baidu Index. SIS data were collected for the USA, India, Germany, Russia, Japan, Australia, China, and Brazil from 2011 to 2020, with the periodicity of the relationship between seasonal time series data and snoring evaluated using a time series decomposition model., Result: The highest average SIS growth rates from 2011 to 2020 were observed for Brazil, Japan, and Germany, with average SIS values of 94%, 68%, and 49%, respectively. The SIS of the USA, Russia, Japan, Brazil, Australia, Germany, and India increased by 22.3%, 12.4%, 11.9%, 35.4%, 12.3%, 28.0%, and 55.8%, respectively, in comparison with their SIS values in 2019, whereas for China, it decreased by 13.7%. Relative to countries in the southern hemisphere, those in the northern hemisphere showed comparable SIS trends, increasing from September to February and decreasing from March to August., Conclusion: The SIS data showed cyclical changes over the study period. The search index for snoring increased during the cold season or the heating season, suggesting that snoring is associated with seasonal changes., (© 2022. The Author(s).)

We developed and validated a composite healthy ageing score (HAS) to address the absence of a definitive composite score comprising multiple health domains that measure healthy ageing in epidemiology. The HAS is developed from 13 health domains reported to influence healthy ageing. Data to measure these domains was extracted from the 45 and Up Study baseline. We applied best practices for scale validation and development. Physical functioning, cognitive function, mental health, sleep, quality of life, balance, social connections and overall health were retained. Functional capacity and resilience were uncovered as underlying latent structures. The HAS ranges from 0 to 16 with higher scores indicating a better health profile. This research contributes a comprehensive measuring tool, HAS, It enables examination and comparison of individual or collective health profiles and the investigation of the factors that influence their chances of living healthy for longer., (© The Author(s) 2023. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Objective: The objective was to analyse the trends in the incidence of oropharyngeal cancers (OPC) across Australia from 1982 to 2017 with implications for prevention., Methods: Data were obtained from the Australian Cancer Database (ACD) compiled at the Australian Institute of Health and Welfare (AIHW). Joinpoint analyses are presented., Results and Discussion: There was a striking increase of age-standardised incidence rate (ASIR) of OPC by over 1.5 times; the most significant rise was between 2007 and 2017 with an annual percentage change (APC) of +5.24% (p < 0.001). Slow but gradual growth of ASIR was observed amongst women with a statistically significant APC of +1.02% (p < 0.001). Statistically significant bimodal increasing trends of APC were also observed in total ASIR of OPC. These rising trends are widely attributed to increased oral sex practices. The highest number of incident cases was found in patients aged 55-69 years attributable to continued alcohol and tobacco exposure. The most common subsites affected were base of the tongue (BOT) and 'oropharynx' from 1982 to 2017., Conclusion: Oropharyngeal cancer is rising rapidly across Australia, particularly in men. Whilst the national proportion of cases driven by HPV is not known, it is evident that vaccination is yet to have an impact., (© 2022 The Authors. Oral Diseases published by Wiley Periodicals LLC.)

Comprehensive utilization of cottonseeds is limited by the presence of pigment glands and its inclusion gossypol. The ideal cotton has glandless seeds but a glanded plant, a trait found in only a few Australian wild cotton species, including Gossypium bickii. Introgression of this trait into cultivated species has proved to be difficult. Understanding the biological processes toward pigment gland morphogenesis and the associated underlying molecular mechanisms will facilitate breeding of cultivated cotton varieties with the trait of glandless seeds and glanded plant. In this study, single-cell RNA sequencing (scRNA-seq) was performed on 12 222 protoplasts isolated from cotyledons of germinating G. bickii seeds 48 h after imbibition. Clustered into 14 distinct clusters unsupervisedly, these cells could be grouped into eight cell populations with the assistance of known cell marker genes. The pigment gland cells were well separated from others and could be separated into pigment gland parenchyma cells, secretory cells, and apoptotic cells. By integrating the pigment gland cell developmental trajectory, transcription factor regulatory networks, and core transcription factor functional validation, we established a model for pigment gland formation. In this model, light and gibberellin were verified to promote the formation of pigment glands. In addition, three novel genes, GbiERF114 (ETHYLENE RESPONSE FACTOR 114), GbiZAT11 (ZINC FINGER OF ARABIDOPSIS THALIANA 11), and GbiNTL9 (NAC TRANSCRIPTION FACTOR-LIKE 9), were found to affect pigment gland formation. Collectively, these findings provide new insights into pigment gland morphogenesis and lay the cornerstone for future cotton scRNA-seq investigations., (Copyright © 2023 The Author. Published by Elsevier Inc. All rights reserved.)

The high accuracy of short-term power load forecasting has a pivotal role in helping power companies to construct reasonable production scheduling plans and avoid resource waste. In this paper, a multi-model short-term power load prediction method based on Variational mode decomposition (VMD)-improved whale optimization algorithm (IWOA)-wavelet temporal convolutional network (WTCN)-bidirectional gated recurrent unit (BiGRU)-attention and CatBoost model fusion is proposed. First, VMD was employed to decompose the load data into different intrinsic mode functions. Second, a WTCN was utilized to extract the load data features, and multi-dimensional feature factors were integrated into the BiGRU network for model training. Moreover, an attention mechanism was added to enhance the influence degree of important information. The WTCN-BiGRU-attention model is improved by the WOA algorithm to optimize the hyperparameters of the network. Finally, the model was fused with the predicted data of the CatBoost network by the mean absolute percentage error-reciprocal weight (MAPE-RW) algorithm to construct the best fusion model. Compared with other forecasting models, the proposed multi-model fusion method has higher accuracy in short-term power load forecasting using the public data set for an Australian region.

This study aims to investigate the prediction of hospital readmission of alcohol use disorder patients within 28 days of discharge and compare the performance of six machine learning methods i.e., random forest (RF), logistics regression, linear support vector machine (SVM), polynomial SVM, radial SVM, and sigmoid SVM.

Background Preeclampsia is pregnancy specific, involving significant maternal endothelial dysfunction. Predictive biomarkers are lacking. We evaluated the biomarker potential, expression, and function of PSG7 (pregnancy-specific β-1 glycoprotein 7) and PSG9 (pregnancy-specific β-1 glycoprotein 9) in preeclampsia. Methods and Results At 36 weeks gestation preceding term preeclampsia diagnosis, PSG7 and PSG9 (in Australian cohorts of n=918 and n=979, respectively) were significantly increased before the onset of term preeclampsia (PSG7, P =0.013; PSG9, P =0.0011). In samples collected at 28 to 32 weeks from those with preexisting cardiovascular disease and at high risk of preeclampsia (Manchester Antenatal Vascular Service, UK cohort, n=235), both PSG7 and PSG9 were also significantly increased preceding preeclampsia onset (PSG7, P <0.0001; PSG9, P =0.0003) relative to controls. These changes were validated in the plasma and placentas of patients with established preeclampsia who delivered at <34 weeks gestation (PSG7, P =0.0008; PSG9, P <0.0001). To examine whether PSG7 and PSG9 are associated with increasing disease severity, we measured them in a cohort from South Africa stratified for this outcome, the PROVE (Preeclampsia Obstetric Adverse Events) cohort (n=72). PSG7 ( P =0.0027) and PSG9 ( P =0.0028) were elevated among patients who were preeclamptic with severe features (PROVE cohort), but not significantly changed in those without severe features or with eclampsia. In syncytialized first trimester cytotrophoblast stem cells, exposure to TNFα (tumor necrosis factor α) or IL-6 (interleukin 6) significantly increased the expression and secretion of PSG7 and PSG9. In contrast, when we treated primary endothelial cells with recombinant PSG7 and PSG9, we only observed modest changes in Flt-1 (FMS-like tyrosine kinase-1) expression and Plgf (placental growth factor) expression, and no other effects on proangiogenic/antiangiogenic or endothelial dysfunction markers were observed. Conclusions Circulating PSG7 and PSG9 are increased before preeclampsia onset and among those with established disease with their production and release potentially driven by placental inflammation.

Using a suite of artificial intelligence technologies, the current study sought to determine the prevalence of agitated behaviors in people with dementia in residential aged care facilities (RACFs) in Australia. Computerized natural language processing allowed extraction of agitation instances from the free-text nursing progress notes, a component of electronic health records in RACFs. In total, 59 observable agitated behaviors were found. No difference was found in dementia prevalence between female and male clients (44.1%), across metropolitan and regional facilities (42.1% [ SD = 17.9%]), or for agitation prevalence in dementia (76.5% [ SD = 18.4%]). The top 10 behaviors were resisting, wandering, speaking in excessively loud voice, pacing, restlessness, pushing, shouting, complaining, frustration, and using profane language. Four to 17 agitated behaviors coexisted in 53% of people with dementia agitation, indicating high caregiver burden in these RACFs. Improving workforce training and redesigning care models are urgent for sustainability of dementia care in RACFs. [ Journal of Gerontological Nursing, 48 (4), 57-64.].

Background : This study aimed to investigate the longitudinal changes in emergency department (ED) presentations incurred by patients with alcohol use disorders. Methods : A retrospective quantitative analysis was conducted on patients' ED presentations between December 2011 and January 2019 in an Australian regional health district. The health district has five EDs serving rural, regional, and metropolitan areas. Patients with alcohol use disorders were divided into two groups for comparison: those who had interactions with the community-based Drug and Alcohol (D&A) services and those who did not. Results : A total of 2,519 individual patients with alcohol use disorders made 21,715 ED presentations. Among these patients, 75.4% did not have interactions with the community-based D&A services. Compared with those who had, these patients were older, more likely to be diagnosed with abdominal pain (26.9% vs 12.0%, p  < 0.001) and chest pain (16.2% vs 8.6%, p  < 0.001), and had longer mean length of ED stay (7 hours and 41.7 minutes vs 6 hours and 25.6 minutes, p  < 0.001). For the patients who had interactions with the community-based D&A services, their 28-day re-presentation rates decreased from 55.5% (2013-14) to 45.1% (2017-18); however, were higher than that of those who had no interactions (41.1% to 32.8%). Overall, 21.9%-24.5% of the patients were frequent ED presenters (i.e., ≥4 visits per year). Frequent ED presenters were proportionately higher among the patients who had interactions with the community-based D&A services, consistently over the relevant years. Although patients with alcohol use disorders frequently presented to EDs, their alcohol use disorders were only identified in 8.9% of their presentations. Conclusions : Patients with alcohol use disorders were often unidentified in EDs. Those who did not have interactions with the community-based D&A services were less likely to be diagnosed with alcohol use disorders when presenting to EDs.