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Ayahuasca is a psychoactive Amazonian plant brew. It is usually made from the Banisteriopsis caapi vine (Spruce ex Griseb. Morton, Malpighiaceae), which contains three primary harmala alkaloids, along with the leaves of Psychotria viridis (Ruiz et Pavon, Rubiaceae) in which the potent psychedelic dimethyltryptamine (DMT) is found. DMT-harmaloid concoctions have gained popularity in recent years, due to growing anecdotal and scientific reports of therapeutic benefits associated with their consumption. Ayahuasca is now ingested in a variety of different settings across the globe, from traditional ethnobotanical to so called "neo-shamanic" ceremonies. Furthermore, related preparations involving alternative sources of DMT and harmala alkaloids are becoming increasingly common as knowledge of ayahuasca continues to spread internationally. This article reviews the existing literature and draws on original qualitative data from a large cross-sectional study of ayahuasca drinkers, to propose a model of psychotherapeutic processes associated with the consumption of ayahuasca. We assert that it is these processes, facilitated by a range of neurobiological effects, that lead to beneficial mental health and wellbeing outcomes. Our proposed model identifies five key psychotherapeutic processes or effects inherent to the ayahuasca experience; somatic effects; introspection and emotional processing; increased Self-connection; increased spiritual connection, and finally the gaining of insights and new perspectives. We note some important differences in these processes compared with other classic psychedelics as well as the implications of the model for the therapeutic use of ayahuasca. Improved understanding of the psychotherapeutic processes involved with the ayahuasca experience will better equip practitioners to work with this potentially transformative concoction and enable the optimization of therapeutic treatment models for potential clinical use.

Nursing and midwifery informatics position statements are important to guide and inform our workforce. Australasian position statements have been developed to establish the place of nursing and midwifery informatics in the health system and progress the development of senior roles.

Background/Objectives: Continuous positive airway pressure (CPAP) concomitant with weight loss is a recommended treatment approach for adults with moderate-severe obstructive sleep apnoea (OSA) and obesity. This requires multiple synchronous behaviour changes. The aim of this study was to examine the effectiveness of a 6-month lifestyle intervention and to determine whether the timing of starting a weight loss attempt affects weight change and trajectory after 12 months in adults newly diagnosed with moderate-severe OSA and treated at home with overnight CPAP. Method(s): Using a stepped-wedge design, participants were randomised to commence a six-month lifestyle intervention between one and six-months post-enrolment, with a 12-month overall follow-up. Adults (n = 60, 75% males, mean age 49.4 SD 10.74 years) newly diagnosed with moderate-severe OSA and above a healthy weight (mean BMI 34.1 SD 4.8) were recruited. Result(s): After 12 months, exposure to the intervention (CPAP and lifestyle) resulted in a 3.7 (95% CI: 2.6 to 4.8, p < 0.001) kg loss of weight compared to the control condition (CPAP alone). Timing of the weight loss attempt made no difference to outcomes at 12 months. When exposed to CPAP only (control period) there was no change in body weight (Coef, [95% CI] 0.03, [-0.3 to 0.36], p = 0.86). Conclusion(s): The lifestyle intervention resulted in a modest reduction in body weight, while timing of commencement did not impact the degree of weight loss at 12 months. These findings support the recommendation of adjunctive weight-loss interventions within six-months of starting CPAP.Copyright © 2022, The Author(s).

As children’s use of screens increased during the COVID pandemic, their reading of traditional books was affected, a national survey of Australian parents shows. The study was conducted by researchers at the University of Melbourne to compare young people’s use of screens and books in the pandemic. Their online survey of 513 primary caregivers of children aged seven to thirteen around Australia showed that tablet use flourished during the pandemic and that COVID lockdowns influenced book buying and library borrowing in consequential ways for publishing and literature. Many parents believed their children’s use of screens had come at the expense of book reading.

BACKGROUND/OBJECTIVES: Continuous positive airway pressure (CPAP) concomitant with weight loss is a recommended treatment approach for adults with moderate-severe obstructive sleep apnoea (OSA) and obesity. This requires multiple synchronous behaviour changes. The aim of this study was to examine the effectiveness of a 6-month lifestyle intervention and to determine whether the timing of starting a weight loss attempt affects weight change and trajectory after 12 months in adults newly diagnosed with moderate-severe OSA and treated at home with overnight CPAP. METHODS: Using a stepped-wedge design, participants were randomised to commence a six-month lifestyle intervention between one and six-months post-enrolment, with a 12-month overall follow-up. Adults (n = 60, 75% males, mean age 49.4 SD 10.74 years) newly diagnosed with moderate-severe OSA and above a healthy weight (mean BMI 34.1 SD 4.8) were recruited. RESULTS: After 12 months, exposure to the intervention (CPAP and lifestyle) resulted in a 3.7 (95% CI: 2.6 to 4.8, p < 0.001) kg loss of weight compared to the control condition (CPAP alone). Timing of the weight loss attempt made no difference to outcomes at 12 months. When exposed to CPAP only (control period) there was no change in body weight (Coef, [95% CI] 0.03, [-0.3 to 0.36], p = 0.86). CONCLUSIONS: The lifestyle intervention resulted in a modest reduction in body weight, while timing of commencement did not impact the degree of weight loss at 12 months. These findings support the recommendation of adjunctive weight-loss interventions within six-months of starting CPAP.

Background and objectives: Peripheral blood mononuclear cells (PBMCs) have shown promise as a tissue sensitive to subtle and possibly systemic transcriptomic changes, and as such may be useful in identifying responses to weight loss interventions. The primary aim was to comprehensively evaluate the transcriptomic changes that may occur during weight loss and to determine if there is a consistent response across intervention types in human populations of all ages. Method(s): Included studies were randomised control trials or cohort studies that administered an intervention primarily designed to decrease weight in any overweight or obese human population. A systematic search of the literature was conducted to obtain studies and gene expression databases were interrogated to locate corresponding transcriptomic datasets. Datasets were normalised using the ArrayAnalysis online tool and differential gene expression was determined using the limma package in R. Over-represented pathways were explored using the PathVisio software. Heatmaps and hierarchical clustering were utilised to visualise gene expression. Result(s): Seven papers met the inclusion criteria, five of which had raw gene expression data available. Of these, three could be grouped into high responders (HR, >= 5% body weight loss) and low responders (LR). No genes were consistently differentially expressed between high and low responders across studies. Adolescents had the largest transcriptomic response to weight loss followed by adults who underwent bariatric surgery. Seven pathways were altered in two out of four studies following the intervention and the pathway 'cytoplasmic ribosomal proteins' (WikiPathways: WP477) was altered between HR and LR at baseline in the two datasets with both groups. Pathways related to 'toll-like receptor signalling' were altered in HR response to the weight loss intervention in two out of three datasets. Conclusion(s): Transcriptomic changes in PBMCs do occur in response to we

There is a complex relationship between home and work for people with a disability that is not reflected in the many policies and legislative frameworks that apply to housing in Australia. These include Commonwealth housing policy (largely financial in nature), the Building Code of Australia, and Home Modification Schemes run through the National Disability Insurance Scheme. Much current policy settings assume housing as a passive economic generator – a financial asset that appreciates and gains value over time. However, for many people with disability, the home is a place of active economic activity, both by the person with disability (working from home) and for them, as external workers come into the home to provide services that support their activities of daily life. This complicates the spaces within dwellings, particularly in terms of public and private space, which effects personal and professional places. The policy and legislative disconnect is reflected in housing design which manifests in a structural inequality – homes are not accessible, and a social inequality – homes do not support work or socializing. This paper reviews the policy and legislation used to support appropriate design recognising the role of the home as a location that blends elements of privacy, work, and socialising, while also providing the physical support so people can work and socialize in the community as full citizens. The aim of the ongoing research is to show how change and innovation to the legislative frameworks and the role that AECM consultants can play in improving the wellbeing of people who live with disability.

A meeting of architects in Melbourne at a popular comedy venue in 1978, ended in disarray. It should be no surprise, after all John Pinder’s Collingwood venue, which opened in 1976, was called, “The Last Laugh Theatre Restaurant and Zoo.” There were fisticuffs, yelling, hoodlum activity, violence, and a huge amount of drunkenness. The meeting was to establish an alternative to the conservative RAIA from outside the organisation rather than within. But mayhem developed, probably in part due to there being no set agenda, and the event came to be inscribed in the mythologies of Melbourne architecture and culture as yet another failed uprising by a troublesome underbelly. Using material gained from public and private archives, as well as interviews, this paper traces the trajectories of this event. This event is important in Australian architecture as Melbourne architects processed the ideals of the Whitlam project (1972–75). Moreover, the meeting at the Last Laugh signifies the emergence in architectural discourse of a larrikinism, as Australian architects embraced post-modernism seeking to counter a patrician and cringe-worthy recent history.

Australian readers have a thirst for non-fiction books. A growing preference for autobiographies and biographies, true stories and criticism, investigative journalism and narrative journalism (Thompson, 2017, p. 204) showcases a trend towards “real” content that piques readers’ curiosity and offers deeper insight into the lives of public persons, and sometimes a perspective that might otherwise be considered private. But writing the tell-all or exposé is not without consequences, particularly with Australia’s defamation laws notorious for casting a “chilling effect” on freedom of speech (Dent and Kenyon, 2004, p. 3; Amponsah, 2005, p. 1) by regarding reputation above publications with a public interest element. This paper explores non-fiction trade book publishing alongside a contemporary construction of reputation and argues that in Australia “reputational interests” (Partlett, 2016, p. 67) in defamation law have created a practice of implicit censorship through legalling manuscripts, avoiding publication entirely, or even intercepting book distribution. In comparing the Australian legal framework with recent UK developments, this paper also asks if law reform can correct the balance between reputation and freedom of speech, thereby allowing authors more autonomy and allowing literary culture to thrive in the contemporary Australian publishing landscape.

BACKGROUND AND OBJECTIVES: Peripheral blood mononuclear cells (PBMCs) have shown promise as a tissue sensitive to subtle and possibly systemic transcriptomic changes, and as such may be useful in identifying responses to weight loss interventions. The primary aim was to comprehensively evaluate the transcriptomic changes that may occur during weight loss and to determine if there is a consistent response across intervention types in human populations of all ages. METHODS: Included studies were randomised control trials or cohort studies that administered an intervention primarily designed to decrease weight in any overweight or obese human population. A systematic search of the literature was conducted to obtain studies and gene expression databases were interrogated to locate corresponding transcriptomic datasets. Datasets were normalised using the ArrayAnalysis online tool and differential gene expression was determined using the limma package in R. Over-represented pathways were explored using the PathVisio software. Heatmaps and hierarchical clustering were utilised to visualise gene expression. RESULTS: Seven papers met the inclusion criteria, five of which had raw gene expression data available. Of these, three could be grouped into high responders (HR, ≥ 5% body weight loss) and low responders (LR). No genes were consistently differentially expressed between high and low responders across studies. Adolescents had the largest transcriptomic response to weight loss followed by adults who underwent bariatric surgery. Seven pathways were altered in two out of four studies following the intervention and the pathway 'cytoplasmic ribosomal proteins' (WikiPathways: WP477) was altered between HR and LR at baseline in the two datasets with both groups. Pathways related to 'toll-like receptor signalling' were altered in HR response to the weight loss intervention in two out of three datasets. CONCLUSIONS: Transcriptomic changes in PBMCs do occur in response to weight ch

Architect Norman Day has been integral to shaping Melbourne’s built work since the early 1970s through built work, exhibitions, writing, and teaching. The representation of architecture through the written word of Norman Day revisits the role of the ‘Architectural Critic' through a contemporary lens to assess the implication it made on the Australian built environment. Having worked in Robin Boyd's office, Day was also the architectural commentator for The Age—Melbourne’s daily newspaper—from 1976-2011, where he contributed over 500 articles. During this time, he was Australia’s pre-eminent architectural critic also working with ABCTV and the Sydney Morning Herald. He was awarded the Bates Smart Award for Architecture in the Media in 2004. This research was conducted as archival work of the written word in a variety of publications, mainly newspaper but also in books and magazine articles. The analysis of these articles results in a grouped based content analysis referencing projects, themes, and chronology. Days main projects during this time are positioned alongside his public criticism. Several interviews were also undertaken with Norman Day. Not dissimilar to Robin Boyd, it will be argued that Day’s architectural journalism as simultaneously making the activity of the architect accessible to the public, while communicating to architects globally the philosophies and methodologies at that moment in time. However, Day’s critiques, mode of criticisms and engagement with media were quite different from Boyd's.

As cities went into lockdown in response to COVID-19, for many, the role of the home in everyday life expanded. Activities that would normally occur at another venue, including work, study, recreation, and health appointments, were reconfigured to be done in the home. Among the legacies from this experience is a clearer understanding of the spatial and phenomenological quality of the spaces in which we live. Housing design already assigns private and public areas within dwellings, such as bedrooms and living rooms, but these are often rigidly defined and largely inflexible for alternative uses. Research on designing housing suitable for people with cognitive disabilities, including autism spectrum disorder (ASD), (such as a 'sensory design' approach, where it is necessary to move beyond public vs private, and recognise other dicotisms, light/ dark, warm/cool, loud/quiet, hard/soft, work/rest, and so on, and the transition between modes), may provide lessons for more general COVID-normal housing design. This study analyses three case studies of residential accommodation for people with ASD as opportunities for developing more responsive housing that can adapt to the demand for a greater range of activities to be fulfilled in the home.