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Objectives To project the prevalence of people receiving dialysis in Australia for 2021–30 to inform service planning and health policy. Methods Estimates were based on data from 2011 to 2020 from the Australia & New Zealand Dialysis & Transplant (ANZDATA) Registry and the Australian Bureau of Statistics. We projected dialysis and functioning kidney transplant recipient populations for the years 2021–30. Discrete-time, non-homogenous Markov models were built on probabilities for transition between three mutually exclusive states (Dialysis, Functioning Transplant, Death), for five age groups. Two scenarios were employed – stable transplant rate vs a continued increase – to assess the impact of these scenarios on the projected prevalences. Results Models projected a 22.5–30.4% growth in the dialysis population from 14 554 in 2020 to 17 829 (‘transplant growth’) – 18 973 (‘transplant stable’) by 2030. An additional 4983–6484 kidney transplant recipients were also projected by 2030. Dialysis incidence per population increased and dialysis prevalence growth exceeded population ageing in 40–59 and 60–69 year age groups. The greatest dialysis prevalence growth was seen among those aged ≥70 years. Conclusion Modelling of the future prevalence of dialysis use highlights the increasing demand on services expected overall and especially by people aged ≥70 years. Appropriate funding and healthcare planning must meet this demand.

Simple Summary A cancer diagnosis during adolescence or young adulthood presents unique medical and psychosocial challenges which must be addressed in the provision of quality, comprehensive cancer care. Tailoring services to the needs of this population requires careful work to identify, monitor and evaluate areas of care; however, published work in this area to guide service priorities is limited. This paper presents work done by the Australian Youth Cancer Services to operationalise and deliver quality care to adolescents and young adults with cancer, focusing on nationally coordinated service improvement initiatives and activity data collection in four areas that are of particular concern to young people diagnosed with cancer: clinical trial enrolment, oncofertility, psychosocial care and survivorship. This account may be instructive for health services seeking to improve the delivery and monitoring of cancer care provided to adolescents and young adults. Abstract Adolescents and young adults (aged 15–25 years) diagnosed with cancer have unique medical and psychosocial experiences and care needs, distinct from those of paediatric and older adult patients. Since 2011, the Australian Youth Cancer Services have provided developmentally appropriate, multidisciplinary and comprehensive care to these young patients, facilitated by national service coordination and activity data collection and monitoring. This paper reports on how the Youth Cancer Services have conceptualised and delivered quality youth cancer care in four priority areas: clinical trial participation, oncofertility, psychosocial care and survivorship. National activity data collected by the Youth Cancer Services between 2016–17 and 2019–20 are used to illustrate how service monitoring processes have facilitated improvements in coordination and accountability across multiple indicators of quality youth cancer care, including clinical trial participation, access to fertility information and preservation, psychosocial screening and care and the transition from active treatment to survivorship. Accounts of both service delivery and monitoring and evaluation processes within the Australian Youth Cancer Services provide an exemplar of how coordinated initiatives may be employed to deliver, monitor and improve quality cancer care for adolescents and young adults.

BACKGROUND As the proportion and number of older people in Australia continue to grow, innovative means to tackle primary care and prevention are necessary to combat the individual, social and economic challenges of non-communicable diseases. OBJECTIVE To assess risk factors (or predictors) for oral and general health outcomes and quality of life of older people (75+ years.) attending general practice (GP) clinics in South Australia. METHODS Data were collected from older people attending 48 GP clinics in metropolitan South Australia. Age, sex, education, living arrangement, material standards, chronic conditions and nutrition were assessed as risk factors. Global self-rated oral and general health and quality of life (OHIP Severity and EQ-5D Utility) were included as outcome measures. RESULTS A total of 459 participants completed the study; response rate was 78%. In the adjusted models, high satisfaction with material standards and good nutritional health were positively associated with all four oral and general health measures. Sex (β = -0.08), age (β = -0.09) and number of chronic conditions (β = -0.12) were negatively associated with EQ-5D, while living arrangement (β = 0.07) was positively associated. Further, having four or more chronic conditions (RR:1.47) was significantly associated with self-rated general health. CONCLUSION Satisfaction with material standards and nutritional risk were consistent predictors for oral and general health outcomes and quality of life of older people visiting GP clinics.

Background: As the proportion and number of older people in Australia continue to grow, innovative means to tackle primary care and prevention are necessary to combat the individual, social and economic challenges of non-communicable diseases.Objective: To assess risk factors (or predictors) for oral and general health outcomes and quality of life of older people (75+ yrs.) attending general practice (GP) clinics in South Australia.Methods: Data were collected from older people attending 48 GP clinics in metropolitan South Australia. Age, sex, education, living arrangement, material standards, chronic conditions and nutrition were assessed as risk factors. Global self-rated oral and general health and quality of life (OHIP Severity and EQ-5D Utility) were included as outcome measures.Results: A total of 459 participants completed the study; response rate was 78%. In the adjusted models, high satisfaction with material standards and good nutritional health were positively associated with all four oral and general health measures. Sex (β=-0.07), age (β=-0.09) and number of chronic conditions (β=-0.13) were negatively associated with EQ-5D, while living arrangement (β=0.06) was positively associated. Further, education level (PR:0.78), living arrangement (PR:0.75) and chronic conditions (PR:1.54) were significantly associated with self-rated general health.Conclusion: Satisfaction with material standards and nutritional risk were consistent predictors for oral and general health outcomes and quality of life of older people visiting GP clinics. Primary care teams involving general practitioners, nurses and allied health practitioners are well poised to assess risk factors for older people, and work alongside the dental team.

Objective Our aim was to examine the associations between general health and well-being with living conditions, oral health and degree of dependency. Methods We surveyed people from a primary care service and collected data on sociodemographic characteristics, general health, health utility, well-being, activities, living conditions and oral health impact. Results Overall, 459 participated (78% response rate). Poor general health was associated with decreased instrumental activities of daily living scores (18% of those with poor general health were independent vs 60% with good general health). Greater oral health impact was also related to poor general health. Health utility was lower for some dependency, for renting and oral health impact. Well-being was also lower for some dependency, for renting, not speaking English and oral health impact. Conclusion In addition to the well-known association of poor general health with dependency, our results also illustrate the potential importance of living conditions and oral health.

This pilot study evaluated a dental intervention for employees with disabilities by measuring changes in self-rated oral health, dental behaviours and oral health-related quality of life (OHRQol). Consenting employees with disabilities (≥18years) at two worksites in South Australia underwent dental examinations at baseline, three and six months. Referrals were arranged as needed to public dental clinics. At one and two months a dental hygienist provided group oral health education to the employees. Employees' demographics, self-rated oral health, dental behaviours and OHRQol were collected via face-to-face interviews. Of the 39 referred employees, 28 (72%) of them completed the recommended treatment. Self-rated oral health improved and there were significant reductions in the prevalence of oral health impact on quality of life (percentage of employees reporting 1+ items fairly/very often) from 27% to 11% (McNemar's test, p

BACKGROUND This study evaluated the associations between oral and general health behaviours, self-reported health and quality of life of adults aged 75 years or older living independently in South Australia. METHODS A cross sectional study based on a self-report mailed questionnaire was conducted in 590 independently living adults aged 75 years or older. Self-ratings of oral health and general health were assessed using single-item global ratings. Quality of life was measured using the Oral Health Impact Profile and the EuroQol instrument for health utility. RESULTS The overall response rate was 78%. The current analyses were restricted to 354 dentate older adults. Increasing age and being female were negatively associated with EuroQol scores. Good self-rated oral and general health were more prevalent in participants with higher social status who also had lower oral health impact and higher EuroQol scores. Good self-rated oral and general health were less prevalent while oral health impact was greater in participants who ate few fruits, vegetables or dairy products. CONCLUSIONS Self-rated health and quality of life were poor in older adults with inadequate fruit/vegetables/dairy intake and lower social status. These findings suggest that nutrition and socioeconomic factors may be important to the oral and general health of adults aged 75 years or older.

Annual health assessments by general practices for community-dwelling people aged 75 years and over are important for the early intervention and monitoring of chronic health conditions, including oral disease. Uptake of the health assessment to date has been poor, and little is known of the general and oral health profile of patients. Older patients attending health assessments at general practices in South Australia were sampled for this study. Data on demographic and socioeconomic characteristics, and patients’ general and oral health, were collected by mailed questionnaire from 459 respondents. By comparison with national estimates, patients attending health assessments fared worse in many of the measures, such as self-rated general health, quality of life and the prevalence of most chronic conditions, as well as their socioeconomic circumstances. Also identified were a high degree of nutritional risk and clear need for oral health treatment, with poor self-rated oral health being three-fold higher than the national age-eligible population. Patients attending health assessments would likely benefit from nutritional screening (by a validated tool) and specific assessment of their oral health and dentition, supported by appropriate referral or intervention.

Background Precarious employment has been associated with poor health, but the potential mechanisms are unclear. We examined the relationships between precarious employment and health, and investigated psychosocial working conditions as potential mediators. Methods A cross-sectional population-based survey was conducted in South Australia in 2009 (N = 1,016 employed). SF-12 measures of mental and physical health were modeled using logistic regression in relation to employment arrangement, controlling for socio-demographics, years in job and psychosocial working conditions. Results There was no association between casual full-time or part-time employment and poor mental health in multivariate analyses. Conversely, there was a significant association between casual full-time employment and poor physical health (compared to permanent full-time workers, OR = 3.14, 95% CI 1.26–7.85). The association with physical health was unaffected by adjustment for psychosocial working conditions. Conclusions Casual full-time employment was strongly associated with poor physical health but not with poor mental health. This association was not mediated by the psychosocial working conditions measured in this study, but may be related to other (unmeasured) working conditions. Am. J. Ind. Med. 56:838–844, 2013. © 2013 Wiley Periodicals, Inc.

Students choose subjects in secondary schools that can be major determinants for their future educational career. This paper systematically reviews the literature on the effect of secondary school course-taking on educational outcomes in secondary and tertiary institutions. The findings of the review and the meta analysis suggest that course-taking predicts a number of educational outcomes such as further course-taking in secondary school, tertiary course-taking, and secondary school grades. However, these effects could not be easily disentangled from the diversity of factors, such as ethnicity, socioeconomic status (SES) and prior achievement that are co-correlated with course-taking and its outcomes.

The aim of this pilot study was to train carers to provide oral care for adults with disabilities and to evaluate the training programme. Forty-one carers of 103 care recipients from three disability organisations in South Australia were trained in providing oral care for adults with disabilities (April 2013-April 2014). The training included an oral presentation and practical session by a special needs dentist on completing oral health assessments (OHA), developing oral healthcare plans, providing oral hygiene care and assessing the need for dental referral. Continued support was provided via home visits by dental hygienists for the first 2 months and a dentist visit at 3 months. At 6 months, agreement on OHAs between the dentist and trained carers was assessed. Pre- and post-training questionnaires (at 6 months) collected information on dental behaviours of carers and psychosocial factors: carer activation measure-knowledge (CAM-Knowledge), carer activation measure-skills (CAM-Skills), carer activation measure-confidence (CAM-Confidence) and carer dental efficacy (CDE) items (carer diligence, self-efficacy and priority). Post-training (among 16 retained carers), there were significant increases in the mean scores of CAM-Knowledge and CAM-Confidence, but not for CAM-Skills (paired-samples t-tests, α = 0.05). Per cent agreement of CDE items varied little between questionnaires. Carer-dentist agreement on OHAs was generally high with kappa values ranging from 0.63 for the assessment of gums to 1.0 for the assessment of tongue, roof of mouth, denture and dental pain. Further, carers were able to assess the need for referral of their care recipients' oral health similar to the dentist. These findings suggest that with combined theoretical and practical training and continued support, non-dental professionals like carers can improve their knowledge and confidence in providing oral care for adults with disabilities. However, the findings of this pilot study need to be confirmed by further research in a larger study.

The role of grazing in regulating the abundance and biomass of epiphytes of the seagrass Posidonia sinuosa Cambridge et Kuo was investigated at an oligotrophic site in lower Spencer Gulf, South Australia. Prosobranch gastropods >7 mm in size were excluded from 0.25 m 2 plots of seagrass for 3 months with four steel mesh cages, compared with four partial cages used to control for cage artefacts, and also four uncaged control plots. Abundances of epiphytic algae, invertebrates and epiphytic mass (DW, AFDW and calcium carbonate) were recorded regularly. The indirect effect of grazer exclusion on seagrass leaf mortality (necrosis) was also measured. Grazing effects on the epiphytic assemblage were detected despite some cage artefacts. Filamentous algal abundance and epiphytic biomass (AFDW) increased in response to grazer exclusion. Caging per se reduced crustose coralline algal cover and calcium carbonate during the experimental period but, after 3 months, no artefact or treatment effect was discernible. Abundances of invertebrate taxa were little affected by grazer exclusion although caging per se reduced the density of spirorbid polychaetes. Grazer exclusion did not affect seagrass necrosis. In comparison with similar studies and given the duration of exclusion, the sum of treatment effects on epiphytes and seagrass was small. Rather, the role of epiphyte grazing in this nutrient-poor area appears to be limited to the maintenance of an epiphytic assemblage that is free of filamentous algae and dominated by crustose corallines.

The influence of predators on populations of the sea urchin Evechlnus chlorot~cus in northeastern New Zealand was investigated by companng densltles, population size structure, and crevice occupancy in manne reserve ('protected') and exploited locality palrs There was no overall dlfference in sea urchin density between protected and exploited localities, but population slze structures were generally more bimodal in the protected localities Size-related patterns of crevice occupancy d ~ d not vary consistently between protected and exploited locahty pairs The effects of protection were most pronounced in the Cape Rodney Okakan Polnt (CROP) Manne Reserve, where relative to the adjacent fished area (1) sea urchln densities weie -3 times lower, (2) slze structures were more bimodal and (3) sea urchlns remained crevice-bound to larger slzes (-40 mm test diameter) Sea urchin transplant experments showed hlgher losses of 30 to 40 mm test dlameter E chorotjcus at a protected locality than a fished locahty Tests of adult sea urchins were heavler at sites in the reserve relative to the fished reference area We suggest that predatory flshes, which were larger and more numerous in the reserve, were the cause of the differences A strong bimodal size structure persisted and density declined over 10 yr at one site in CROP Manne Reserve We suggest that generahs~ng from reserve studles to exploited areas may lead to erroneous conclusions

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited., The psychosocial work environment can benefit and harm mental health. Poor psychosocial work environments and high level work-family conflict are both associated with poor mental health, yet little is known about how people with poor mental health manage the interactions among multiple life domains. This study explores the interfaces among paid work, family, community and support services and their combined effects on mental health. Methods We conducted 21 in-depth semi-structured interviews with people identified as having poor mental health to examine their experiences of paid employment and mental health and wellbeing in the context of their daily lives. Results The employment-related psychosocial work environment, particularly workplace relationships, employment security and degree of control over hours, strongly affected participants’ mental health. The interfaces among the life domains of family, community and access to support services suggest that effects on mental health differ according to: time spent in each domain, the social, psychological and physical spaces where domain activities take place, life stage and the power available to participants in their multiple domains. This paper is based on a framework analysis of all the interviews, and vignettes of four cases. Cases were selected to represent different types of relationships among the domains and how interactions among them either mitigated and/or exacerbated mental health effects of psychosocial work environments. Conclusions Examining domain interactions provides greater explanatory capacity for understanding how people with low mental health manage their lives than restricting the research to the separate impacts of the psychosocial work environment or work-family conflict. The extent to which people can change the conditions under which they engage in paid work and participate in family and social life is significantly affected by the extent to which their employment position affords them latitude. Policies that provide psychosocial protections to workers that enable them to make changes or complaints without detrimental repercussions (such as vilification or job loss) and increase access to welfare benefits and support services could improve mental health among people with paid work. These policies would have particularly important effects for those in lower socioeconomic status positions., Australian National Health and Medical Research Council

Precarious employment has been associated with poor health, but the potential mechanisms are unclear. We examined the relationships between precarious employment and health, and investigated psychosocial working conditions as potential mediators.A cross-sectional population-based survey was conducted in South Australia in 2009 (N = 1,016 employed). SF-12 measures of mental and physical health were modeled using logistic regression in relation to employment arrangement, controlling for socio-demographics, years in job and psychosocial working conditions.There was no association between casual full-time or part-time employment and poor mental health in multivariate analyses. Conversely, there was a significant association between casual full-time employment and poor physical health (compared to permanent full-time workers, OR = 3.14, 95% CI 1.26-7.85). The association with physical health was unaffected by adjustment for psychosocial working conditions.Casual full-time employment was strongly associated with poor physical health but not with poor mental health. This association was not mediated by the psychosocial working conditions measured in this study, but may be related to other (unmeasured) working conditions.

This item is under embargo for a period of 12 months from the date of publication, in accordance with the publisher's policy., Objective: We explored Australian workers’ experiences of nonstandard employment, how it related to health and wellbeing, and the role that Bourdieu’s forms of capital (cultural, economic and social resources) played in underpinning workers’ agency. Methods: Qualitative data from semistructured interviews with 32 causal workers were analysed based on framework analysis. Results: Most participants were ‘deliberate casuals’ who had chosen casual over permanent employment, with half of that group naming improved health and wellbeing as motivation. Those with greater access to capital felt more able to exercise choice, whereas those with fewer capital resources felt constrained to be casual. Gendered structures and labour market dynamics were also significant in shaping agency. Conclusions: Access to capital and a buoyant labour market underpinned workers’ agency in Australia, enabling some to gain health and wellbeing benefits from nonstandard employment.

Little is known about the experience of those in the baby boom cohort who are outside the labour market. Understanding their experience has the potential to inform policy strategies to support older people to remain longer in the workforce. Using in-depth interview data from 26 participants, this paper examines the reasons people aged between 50 and 64 years give for being not-employed, how they perceive it affects their health, how socioeconomic characteristics shape their experience and what would entice them back into paid work. Participants' main reasons for being not-employed included: feeling financially able and ready to exit, feeling unhappy about workplace reorganisations, disability, or their partner's retirement or ill-health. The reasons given and the degree to which they had planned to exit the workforce affected their willingness and capacity to consider returning. Key determinants of participants' health and wellbeing after stopping paid work were the extent to which they had planned their exit and the status of their health and wealth at the time of their exit. The paper concludes there is some scope for increasing the number of employed older people if policy makers attend to workforce health and wellbeing as crucial to workforce retention policy development. Refereed/Peer-reviewed