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Objective: This study aimed to investigate potential missed diagnoses of acute rheumatic fever and rheumatic heart disease during hospital-based care among persons subsequently identified with these conditions. Methods: This retrospective cohort study used linked emergency department and inpatient administrative records from Queensland, Northern Territory, South Australia, and New South Wales during 2003–2018 (varying between jurisdictions by completeness of data) of all persons first identified with acute rheumatic fever or rheumatic heart disease while aged 8–24 years. Using coded discharge diagnoses from the preceding 3 years, we identified presentations (e.g. joint pains or heart murmur without specific identified cause) that potentially mimic and thereby represent a missed opportunity to detect acute rheumatic fever or rheumatic heart disease. Sociodemographic factors associated with experiencing ≥1 mimic diagnoses were investigated using multivariable logistic regression models. Results: Among 1855 persons, 65 (3.5%) (using narrow diagnostic inclusions) and 146 (7.9%) (with broad inclusions) experienced ≥1 mimic diagnosis. Joint disorders predominated. Mimics categorised as 'high-likelihood' (most specific) were more frequent among persons subsequently diagnosed as young adults (18–24 years) than as children (8–12 years) (odds ratio [OR] 2.45, 95% confidence interval [CI] 1.34–4.47), and those from low-risk ethnic groups (including Australian-born non-Indigenous persons) compared with Aboriginal and Torres Strait Islander peoples (OR 2.44, 95% CI 1.02–5.85). Conclusion: Missed opportunities to detect acute rheumatic fever and rheumatic heart disease continue to occur in Australian hospitals, and present disproportionately among persons from demographic groups considered to be at low risk, suggesting the need for enhanced clinical suspicion in these groups. What is known about the topic? Rheumatic heart disease often presents without documented antecedent acute rheumatic fever or as advanced disease, implicating missed opportunities for early diagnosis. What does this paper add? A proportion of young persons in Australia identified with acute rheumatic fever and/or rheumatic heart disease, particularly those considered at low risk, may have had these conditions previously overlooked during emergency department or inpatient care, having received one or more prior diagnoses mimicking these conditions. What are the implications for practitioners? Clinical suspicion of acute rheumatic fever and/or rheumatic heart disease in Australian hospitals requires enhancement. [ABSTRACT FROM AUTHOR]

Background: Anecdotally, patients don't seem to be more unwell than they were 10 years ago, yet they still seem more 'complex'. Aims: The aim of this study was to use an objective measure to assess the trend in complexity of general medicine patients over a 9‐year period. Methods: Complexity was pragmatically defined as a composite of comorbidity plus dependence/frailty. We selected 100 consecutive patients discharged from General Medicine at Monash Medical Centre (a tertiary hospital in Melbourne, Australia) in the month of April of each year from 2011 to 2019. For each patient, we retrospectively calculated their burden of comorbidity and their degree of dependency/frailty. Comorbidity was measured using the Charlson Comorbidity Index (CCI), and dependence/frailty was assessed using the Katz Index of Independence in Activities of Daily Living (Katz ADL) and the Braden Scale (BS). The BS is a pressure injury risk assessment tool. Additional demographic data were collected, including length of stay, admission and discharge residence, 30‐day readmission rate and inpatient mortality. Results: There was no statistically significant change in the CCI or the Katz ADL. The median BS did however significantly decrease from 19 in 2011 to 16 in 2019 (P = 0.006), reflecting an increased risk of pressure injuries. Conclusions: Despite a stable level of comorbidity, our finding of a decreasing BS score may suggest that patients are becoming more dependent. This increase in dependency rather than a change in chronic disease burden may be the cause of apparent increasing patient complexity. [ABSTRACT FROM AUTHOR]

Poison frogs are well known for their ability to sequester alkaloids from their diet of leaf-litter arthropods for use in defense against predators and pathogens. Australian frogs in the genus Pseudophryne (Myobatrachidae) represent an understudied lineage of poison frogs, with a unique ability to both sequester dietary alkaloids and synthesize pseudophrynamine alkaloids. Herein, we describe the alkaloid profiles and diet of six species of Pseudophryne (P. guentheri [Boulenger, 1882], P. occidentalis [Parker, 1940], P. semimarmorata [Lucas, 1892], P. dendyi [Lucas 1892], P. bibronii [Günther, 1859], and P. coriacea [Keferstein, 1868]) to gain a better understanding of how alkaloid defenses and diet are related within and among species. We characterized and quantified alkaloids using Gas Chromatography-Mass Spectrometry (GC-MS), and assessed diet by way of dissection and examination of stomach contents using light microscopy. We found that alkaloid profiles varied significantly among species, with pumiliotoxins (dietary-derived) and pseudophrynamines (biosynthesized) being the most abundant alkaloids. Pseudophryne bibronii and P. dendyi contained mostly dietary-derived alkaloids, whereas P. coriacea, P. guentheri, P. semimarmorata, and P. occidentalis possessed mostly biosynthesized alkaloids. The stomachs of all the studied species were largely empty, containing mostly soil and few partially digested insects. Our data suggest that frogs eat minimally during the breeding season. Therefore, a decrease in dietary alkaloids may be compensated by the biosynthesized pseudophrynamines, which could allow Australian poison frogs to remain defended from predators during this vulnerable time period. [ABSTRACT FROM AUTHOR]

The transfer of nursing education into the tertiary section in Australia aimed to address a number of issues for nursing, the most significant of which was to enhance the status of the profession. A side effect of the establishment of university-based nursing programs is the increased flexibility that makes studies in nursing an option for students who may otherwise not have had this opportunity. Such accessibility is not without problems as many students enter tertiary nursing programs after a prolonged period of absence from a scholarly environment. Those who do enrol directly from other forms of study are often overwhelmed by the specific requirements of nursing programs. In order to promote student succession and reduce attrition, universities have established a number of mechanisms to support students as they transition to the tertiary environment. This article reports on a survey of 112 nursing students enrolled in their first year of study at a regional university in Australia. Findings are presented under the major areas of questions, these being, "issues faced in adapting to the role of a university student in the first year of study, services or support mechanisms accessed to assist in transition to the role of university student, and services lacking that would have assisted in the transition to the role of university student." These findings are then discussed in the context of existing knowledge of the first-year experience of university students.

Peer mentoring programs are designed to address problems experienced by new students to assist them in making the transition to university study. The University of New South Wales offers such a program to new undergraduate students. Feedback on the program is obtained from participants through questionnaires and is used to identify problems and to elicit suggestions for program improvement. The study examines the effectiveness of improvements to the program as a result of evaluation feedback. Findings show that improvements to program content and delivery result in better outcomes for mentees but that administrative problems still need to be addressed. (Contains 3 tables and 1 figure.)

Purpose: The 5 + 1 Collaboration is an initiative where five teaching hospitals and a leading Melbourne university collaborate to promote and strengthen research, clinical practice in health social work, teaching, and collaboration. This collaboration fosters greater connection between academics, practitioners, and social work students. The 5 + 1 Collaboration provides a unique platform for the advancement of effective practice, practice-driven research, and student field education placements. Method: In a prospective study (2020 through 2021), employing the 5 + 1 model, at the time of the COVID-19 pandemic, over 100 frontline hospital social workers from five Melbourne hospitals participated in this study to determine, in detail, how the pandemic had affected their work. Results: This provided at a granular level, significant insights relating to the impact of the pandemic on the provision of social work services in the acute hospital setting. Additionally, during the study period, academic social work student placements were made at the five participating hospitals, with the students actively participating as part of the research team and providing feedback about their own experiences. Discussion: The study documented the challenges to hospital social work practice because of the pandemic, how hospital social workers rose to the challenges, and, importantly, adapted their practice and acquired new skills. This information may inform future hospital social work practice. The study also demonstrated that effective on-line student placements were possible, even in the setting of a pandemic. [ABSTRACT FROM AUTHOR]

In the public imaginary, drinking is often thought of as a behaviour separate from individuals' formal labour practices, but studies increasingly highlight the complex ways alcohol is entwined with work. Building on recent conceptual developments in the sociological fields of youth, health and work, we illustrate how drinking can be productively understood as 'affective labour', and thus itself a form of work that generates valuable embodied states and atmospheres. To do so, we draw on data from six focus groups with men coworkers from three hospitality workplaces and three corporate workplaces in Victoria. For the corporate groups, work‐related drinking was tied to an unravelling of certain professional affects and facilitated harmonious and productive workplace relationships, but also introduced risks ranging from embarrassment to sexual harassment. For hospitality workers, drinking was more deeply enmeshed in workplace relationships and, for one group, drinking on‐shift was positively framed as creating an affect and atmosphere that appealed to clientele, despite taking a toll on workers' wellbeing. In both settings not drinking risked limiting one's ability to get on colleagues' affective 'level'. Our data deepens current understandings of how drinking cultures may be woven through occupational settings, produce value for organisations and introduce unique potential for exclusion. [ABSTRACT FROM AUTHOR]

We assess the impact of three bias correction approaches on present day means and extremes, and climate change signal, for six climate variables (precipitation, minimum and maximum temperature, radiation, vapour pressure and mean sea level pressure) from dynamically downscaled climate simulations over Queensland, Australia. Results show that all bias‐correction methods are effective at removing systematic model biases, however the results are variable and season‐dependent. Importantly, our results are based on fully independent cross‐validation, an advantage over similar studies. Linear scaling preserves the climate change signals for temperature, while quantile mapping and the distribution‐based transfer function modify the climate change signal and patterns of change. The Perkins score for all the values above the 95th percentile and below the 5th percentile was used to evaluate how well the climate model matches the observational data. Bias correction improved Perkins score for extremes for some variables and seasons. We rank the bias‐correction methods based on the Kling–Gupta efficiency (KGE) score calculated during the validation period. We find that linear scaling and empirical quantile mapping are the best approaches for Queensland for mean climatology. On average, bias correction led to an improvement in the KGE score of 23% annually. However, in terms of extreme values, quantile mapping and statistical distribution‐based transfer function approaches perform best, and linear scaling tends to perform worst. Our results show that, except linear scaling, all approaches impact the climate change signal. [ABSTRACT FROM AUTHOR]

Background: Tuberculosis (TB) incidence is decreasing in the Northern Territory (NT) but still exceeds rates elsewhere in Australia. Deaths and morbidity from advanced TB continue, with delay in diagnosis a contributor to adverse outcomes. Aims: We aimed to describe the delay in diagnosis of TB, identify risk factors for delay and examine the associations between delay and clinical outcomes. Methods: We conducted a historical cohort analysis which included adult inpatients diagnosed with TB at the Royal Darwin Hospital from 2010 to 2020. Patient delay was measured as time from symptom onset to first seeking care, and health system delay was quantified as time from first relevant clinical contact to diagnosis. The sum of these two periods was the total delay. Ethics approval was granted by NT HREC (2020‐3852). Results: Eighty‐four cases were included; the median total delay was 90 days (interquartile range (IQR): 60–121), patient delay was 53 days (IQR: 30–90), and health system delay was 21 days (IQR: 12–45). Patient delay was longer among patients with extrapulmonary (median: 100 days (IQR: 90–105) compared with pulmonary TB patients (39 days (IQR: 27–54), P < 0.0001). Health system delay was longer in those aged ≥45 years (30 days (IQR: 16–51) vs younger patients (14 days (IQR: 8–30), P = 0.007) and among non‐smokers (31 days (IQR: 21–55) vs 21 days (IQR: 10–40), P = 0.048). Median delay was longer among patients with non‐drug‐related complications of disease (P < 0.0001), those admitted to critical care (P < 0.0001), and those with respiratory failure (P = 0.001). Conclusion: The patient delays we report are longer than reported elsewhere in Australia. The next steps will require concerted efforts to improve community awareness of TB and strategies to strengthen health systems through better resourcing and healthcare provider support. [ABSTRACT FROM AUTHOR]

This article tells the story of two projects initiated by the University of Tasmania's English program, which were designed to investigate and improve the pathway from pre-tertiary to tertiary English studies in the state: the First Year English Survey (2012-2014) and the Teaching of English in Tasmania Community of Practice (TETCoP). The authors draw on the findings from the survey to show that students in Tasmania who enrol in tertiary English believe that they are progressing their studies in a discipline with which they are already familiar; it seems reasonable to assume that is also the case nationally. The article, then, presents TETCoP as an example of one approach to developing and maintaining productive links between English educators in the senior secondary and tertiary sectors--as a means to encourage others to build on or learn from the work we have done in Tasmania.

The new mckelveyite group mineral, alicewilsonite-(YLa), Na 2 Sr 2 YLa(CO 3) 6 ⋅ 3H 2 O, was found together with kamphaugite-(Y), paratooite-(Y), bastnäsite-(La), and decrespignyite-(Y) coating along fractures in dolomite at the Paratoo copper mine, South Australia, Australia. It occurs as pale pink to colourless pseudohexagonal tabular crystals up to 150 µ m in size. The streak is white; the lustre is vitreous. The mineral has no cleavage. Dcalc is 3.37 g cm -3. Alicewilsonite-(YLa) is optically biaxial (-), α = 1.556(2), β= 1.582(2), γ= 1.592(2), 2V (meas.) = 60(2)°, 2V (calc.) = 63° (589 nm). The IR spectrum is reported. The composition (wt %, average of seven analyses) is Na 2 O 7.43, CaO 2.00, SrO 18.43, BaO 1.64, Y 2 O 3 9.59, La 2 O 3 11.74, Pr 2 O 3 1.29, Nd 2 O 3 5.74, Sm 2 O 3 0.44, Eu 2 O 3 0.09, Gd 2 O 3 0.95, Dy 2 O 3 1.15, Ho 2 O 3 0.25, Er 2 O 3 0.89, Yb 2 O 3 0.29, CO 2 29.78, H 2 O 6.18, total 97.88. The empirical formula calculated on the basis of six cations with 3 H 2 O molecules is as follows: Na 2.10 Ca 0.31 Sr 1.56 Ba 0.10 Y 0.74 La 0.63 Pr 0.07 Nd 0.30 Sm 0.03 Eu 0.01 Gd 0.04 Dy 0.05 Ho 0.01 Er 0.04 Yb 0.01 (CO 3) 5.92 (H 2 O) 3. The mineral is triclinic, P 1, a= 8.9839(2), b= 8.9728(3), c= 6.7441(2) Å, α= 102.812(2)°, β= 116.424(2)°, γ= 60.128(2)°, and V= 422.17(2) Å 3 and Z= 1. The strongest reflections of the powder X-ray diffraction pattern [ d ,Å(I)(hkl)] are 6.03(43)(001), 4.355(100)(1 1‾ 0, 2‾1‾ 1, 120), 4.020(30)(1‾ 11, 210, 1‾2‾ 1), 3.188(29)(2‾1‾ 2, 1 1‾ 1, 121), 2.819(96)(002, 1‾ 12, 211, 1‾2‾ 2), 2.592(40)(3‾ 01, 030, 3‾3‾ 1), 2.228(33)(2‾ 21, 4‾2‾ 1, 2‾4‾ 1). 2.011(36)(2‾ 22, 003, 420, 2‾4‾ 2), 1.9671(32)(3‾ 03, 301, 0 3‾ 2, 032, 3‾3‾ 3, 331). The crystal structure was solved and refined from single-crystal X-ray diffraction data (R1= 0.058). [ABSTRACT FROM AUTHOR]

Background: Pulmonary embolism (PE) is a life‐threatening disease where preemptive anticoagulation is recommended by guidelines for patients with intermediate to high pretest risk of PE. Aims: The primary objective of our study was to describe the use of preemptive anticoagulation from the emergency department (ED) or inpatient wards stratified by risk assessment score. Methods: We performed a retrospective observational cohort study of consecutive patients undergoing computed tomography pulmonary angiography (CTPA) for investigation of PE. Patients were classified as either ED patients or hospital ward patients based on where the CTPA was requested. The pretest risk of PE was calculated using the Revised Geneva Score (RGS) and patients were divided into low and intermediate to high risk. Results: A total of 392 consecutive patients who underwent CTPA at Monash Health were reviewed. There were 108 (27.6%) patients who were categorised as low risk (RGS 0–3) and 284 (72.4%) categorised as intermediate to high risk (RGS >3). There were 29 (7.4%) patients overall who received preemptive anticoagulation. Diagnostic yield of CTPA in the ED was low, with only four of 144 (2.8%) CTPA scans positive for PE. The yield of CTPA was higher in ward patients, with 63 of 248 (25.4%) being diagnostic of PE. Conclusions: The use of preemptive anticoagulation for suspected PE was uncommon and was not influenced by the pretest probability of PE as determined by a validated clinical prediction tool. This may reflect concerns regarding haemorrhagic complications without any clear evidence of benefit. Diagnostic yield of CTPA performed in the ED was low. [ABSTRACT FROM AUTHOR]

Background: First Nations peoples in colonised countries often feel culturally unsafe in hospitals, leading to high self-discharge rates, psychological distress and premature death. To address racism in healthcare, institutions have promised to deliver cultural safety training but there is limited evidence on how to teach cultural safety. To that end, we created Ask the Specialist Plus: a training program that focuses on improving healthcare providers intercultural communication skills to improve cultural safety. Our aim is to describe training implementation and to evaluate the training according to participants. Methods: Inspired by cultural safety, Critical Race Theory and Freirean pedagogy, Ask the Specialist Plus was piloted at Royal Darwin Hospital in Australia's Northern Territory in 2021. The format combined listening to an episode of a podcast called Ask the Specialist with weekly, one-hour face-to-face discussions with First Nations Specialists outside the clinical environment over 7 to 8 weeks. Weekly surveys evaluated teaching domains using five-point Likert scales and via free text comments. Quantitative data were collated in Excel and comments were collated in NVivo12. Results were presented following Kirkpatrick's evaluation model. Results: Fifteen sessions of Ask the Specialist Plus training were delivered. 90% of participants found the training valuable. Attendees enjoyed the unique format including use of the podcast as a catalyst for discussions. Delivery over two months allowed for flexibility to accommodate clinical demands and shift work. Students through to senior staff learnt new skills, discussed institutionally racist systems and committed to behaviour change. Considering racism is commonly denied in healthcare, the receptiveness of staff to discussing racism was noteworthy. The pilot also contributed to evidence that cultural safety should be co-taught by educators who represent racial and gender differences. Conclusion: The Ask the Specialist Plus training program provides an effective model for cultural safety training with high potential to achieve behaviour change among diverse healthcare providers. The training provided practical information on how to improve communication and fostered critical consciousness among healthcare providers. The program demonstrated that training delivered weekly over two months to clinical departments can lead to positive changes through cycles of learning, action, and reflection. [ABSTRACT FROM AUTHOR]

Unhealthy diet is associated with increased risk of cardiovascular diseases (CVD). However, there are no studies reporting the impact and trends of dietary risk factors on CVD in Australia. This study aimed to determine the burden of CVDs attributable to dietary risk factors in Australia between 1990 and 2019. We used data from the Global Burden of Diseases (GBD) study and quantified the rate (per 100,000) of deaths, disability-adjusted life years (DALYs), years lived with a disability (YLDs), and years of life lost (YLLs) for 21 CVDs attributable to 13 dietary risk factors (eight food groups and five nutrients) in Australia by sex and age groups (≥25 years and over). In 2019, the age-standardised rates of deaths, YLDs, YLLs, and DALYs attributable to dietary risk factors attributable to CVDs in the Australian population were 26.5, 60.8, 349.9, and 410.8 per 100,000 in women and 46.1, 62.6, 807.0, and 869.6 in men. Between 1990 and 2019, YLLs consistently contributed more towards the rates of DALYs than YLDs. Over the 30-year period, CVD deaths, YLLs, and DALYs attributable to dietary risk factors declined in both women and men. The leading dietary risk factors for CVD deaths and DALYs were a diet high in red meat (6.1 deaths per 100,000 [3.6, 8.7] and 115.6 DALYs per 100,000 [79.7, 151.6]) in women and a diet low in wholegrains (11.3 deaths [4.4, 15.1] and 220.3 DALYs [86.4, 291.8]) in men. Sex differences were observed in the contribution of dietary risk factors to CVD over time such that the lowest rate of decrease in deaths and DALYs occurred with diets high in sodium in women and diets high in processed meat in men. Although the burden of diet-related CVD has decreased significantly in the Australian population over the past 30 years, diets low in wholegrains and high in red meat continue to contribute significantly to the overall CVD burden. Future nutrition programs and policies should target these dietary risk factors. [ABSTRACT FROM AUTHOR]

Purpose: Drawing on the resource-based view (RBV), the purpose of this paper is to develop a framework and instrument to measure the organisational capabilities of university schools/departments. In doing so, this study provides evidence of the way competitive resources are bundled to generate organisational capabilities that give university schools/departments a sustainable competitive advantage. Design/methodology/approach: A questionnaire to measure the resources that contribute to the capabilities of university schools/departments was developed. Constructs were determined, and the questionnaire was refined based on an analysis of responses from 166 Heads of schools/departments across all 39 Australian public universities. Findings: Heads conceive of the development of capabilities within their schools/departments along the core operating functions of research, teaching, and networking. Reliability and supplementary analysis confirm these constructs have strong convergent and discriminant validity as well as internal consistency. Research limitations/implications: The findings confirm that effective management and coordination of research, teaching, and networking with important stakeholders are keys to success. The framework and instrument developed in this paper also provides the opportunity to investigate university performance through the perspective of the RBV, which will enhance the understanding of the determinants of universities' performance. Practical implications: The framework and questionnaire developed in this study can be utilised by Heads as a diagnostic tool to gain an understanding of their department's/school's organisational capabilities in the areas of research, teaching, and networking. Originality/value: This paper is the first study to develop a framework and questionnaire to measure organisational capabilities for university academic schools/departments.

Universities play a fundamental role in addressing global environmental challenges as their education, research and community involvement can produce long-lasting environmental effects and societal change. By demonstrating best practice in their operations, research and teaching, universities have both multiple and multiplier effects on society. For universities to comprehensively address sustainability, a "learning for sustainability" approach needs to be embedded across every aspect of institutional operations in a synergistic way. Using semi-structured interviews, this research explored the factors that influence the integration of sustainability into the operations, teaching and research activities of universities in Australia and England. The research found that individuals, committed to the goal of a more sustainable world, play a vital role in the success of integrating environmental sustainability into universities. The factors critical to enabling universities to undertake the transformational changes necessary to embed environmental sustainability into all university areas included: a strong policy environment, resourcing of strategies, and encouragement of leaders and environmental sustainability advocates. Educating and building the awareness of university staff of the importance of environmental sustainability to future generations was key to a successful strategy.

This paper reflects upon international arts education action and relative local in-action. The first half of the paper provides a brief narrative of the World Alliance for Arts Education's advocacy work and the development of the UNESCO Seoul Agenda: Goals for the development of arts education. The second half of the paper highlights a dance education research project in New Zealand that relates to strategies and actions noted within the Seoul Agenda. This dance education research reveals both the power and impotence of policies and events such as the Seoul Agenda and International Arts Education Week. The research reveals that when you step off the global stage and turn to your own backyard, reality strikes hard. Arts education is valued, yet relatively few teachers, fewer schools and even fewer governments are actually willing to fully realise the potential of arts education. Arts education for all the rhetoric lacks commitment and investment. Using dance education as a lens, this research examines what teachers in New Zealand are doing in their classrooms and what this means for local communities, teachers, schools, teacher education institutions, advocacy and support organisations, then provides suggestions so that dance and other arts can fulfil their potential.