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The purpose of this study was to compare strength, bulk and time of repair of human cadaveric flexor digitorum profundus tendons repaired in situ versus ex situ. Ninety-six human cadaveric flexor digitorum profundus tendons were transected 5 mm distal to the A2-pulley and randomized to 2-strand, 4-strand or 6-strand repairs. We found no significant differences in repair strength between in situ and ex situ repairs, but repair strength increased with increasing number of strands. The cross-sectional area of the repair was not significantly related to the number of strands, but 4- and 6-strand in situ repairs were bulkier than ex situ repairs. In situ repair took longer, and repair time increased with increasing number of strands. We suggest that cadaveric studies of flexor tendon repair should be performed in situ in order to better mimic the clinical reality of tissue handling and repair bulkiness.

Featuring contributions from leading lawyers, historians and social scientists, this path-breaking volume explores encounters of laws, people, and places in Australia since 1788.

An important aspect of an indefinite life household panel study is to provide a sample of children who become new generations of respondents over time. The representativity of children and young adults in the Household, Income and Labour Dynamics in Australia (HILDA) Survey is assessed after 16 waves. Estimates from the HILDA Survey are compared to official data sources of the Australian Bureau of Statistics (ABS) and include demographic, education, employment, income and residential mobility variables. Both cross-section and longitudinal estimates are assessed. Overall, the HILDA Survey estimates are relatively close to the ABS estimates with the exception of the year of arrival of recent immigrants, having foreign-born parents, having a certificate level qualification, type of relationship in household, having zero income, the main source of income, and residential mobility. Most of these exceptions can be explained by differences in questionnaire design, respondent recall error, linkage error, and differences in the amount of missing data. The estimate of particular concern is the proportion of immigrants arriving in the last five years, which is underestimated in the HILDA Survey due to undercoverage of recent immigrants. This could be addressed by regular refreshment samples of recent immigrants.

This paper provides a brief summary of the Household, Income and Labour Dynamics in Australia (HILDA) Survey, a nationally representative household panel survey. It describes the survey’s key design features, provides an overview of its content, and reports on response rates and sample sizes. It also highlights a few examples of research utilising the data, discusses two challenges currently facing the study, and provides details on how to access the data.

Adaptive survey design has been proposed as a solution to the decreasing response rates and higher costs associated with surveys. Much of the adaptive survey design research to date focuses on cross-sectional surveys, yet it seems there is greater potential for this approach within longitudinal surveys as data on the respondent and their survey experience builds each wave. We consider the short- to medium-term impacts of modifications to fieldwork processes in the context of two household panels. We use waves 11–16 of the Household, Income and Labour Dynamics in Australia (HILDA) Survey and waves 1–6 of the UK Household Longitudinal Study (also known as Understanding Society) to simulate eight alternative follow-up strategies. Cases are targeted based on their likelihood to improve sample balance (representativeness), as measured by the R-indicator, or to provide a response, or a combination of these components. Both individual- and household-level targeting are considered. We assess the extent to which these adjustments to fieldwork efforts impact the response rates, sample representativity, and cost. We find that if the follow-up fieldwork effort were reduced by 25 percent the least detrimental strategy is where the best households in terms of improving the R-indicator or the response rates are issued to field for follow-up. This approach resulted in the same sample balance as obtained with full follow-up practice, saved between 17 and 25 percent of follow-up calls but dropped the full balanced panel response rate over four years by 8–12 percentage points.

Children of problem gamblers are at risk of harm, however, there are no population level estimates as to how many children are currently exposed to parental problem- and at-risk gambling. The current study analysed data from the Household, Income and Labour Dynamics in Australia (HILDA) Survey, a nationally representative survey, to derive the first ever national estimates of the proportion of problem, moderate, and low risk gamblers (as measured by PGSI) in the Australian parent population. It also reports how many children under 15 years of age in Australia are exposed to parental gambling across the gambling risk categories. The results show that 13.7% of all Australian families with dependent children are currently exposed to some level of gambling risk due to parental gambling, and nearly 4% of families with children are exposed to parental moderate risk or problem gambling. This corresponds to almost 200,000 children each year. The results and approach of this study will guide future examination of child wellbeing in families where parents experience problems with gambling. The results are discussed in the context of public health approaches to familial gambling harm.

Indigenous characters have long featured in Australian detective novels. The most renowned was Arthur Upfield’s creation, Detective Inspector Napoleon Bonaparte or ‘Bony’. To the delight of audienc...

For the greater part of our shared history, the voices of Aboriginal and Torres Strait Islander women were absent from scholarship as understood by the Australian colony. Those who wrote about our ...

The depiction of Aboriginal people in Australian detective novels has always been problematic. In colonial crime stories, Aboriginal people were typically represented as dangerous brutes and noble savages. Today, overtly demeaning stereotypes are less common, but Aboriginal characters still tend to lack complexity and perform subservient roles. In recent decades, Aboriginal writers have chosen to reclaim the genre and transform it into a space of empowerment. Their primary tool is the trope of characters that bring Aboriginal voices to the centre of the narrative. This trope is evident in protagonists that are engaged with political issues that affect their communities, and who experience racism as pervasive. Aboriginal detectives often suffer from the legacies of the former child removal policy. The reconciliation of such individuals with their kin and ancestral homelands will often occur in tandem with the resolution of the crime.

BackgroundSaline mouth rinse/gargle samples have recently been shown to be a suitable option for swab-independent self-collection for SARS-CoV-2 diagnosis. We sought to evaluate a simplified process for direct reverse transcriptase PCR (RT-qPCR) testing of this novel sample type and to compare performance with routine RT-qPCR using automated nucleic acid extraction.MethodsClinical saline mouth rinse/gargle samples were subjected to automated nucleic acid extraction (“standard method”), followed by RT-qPCR using three assays including the FDA authorized US-CDC’s N1/N2 assay, which was the reference standard for determining sensitivity/specificity. For extraction-free workflow, an aliquot of each gargle sample underwent viral heat inactivation at 65 °C for 20 minutes followed by RT-qPCR testing, without an intermediate extraction step. An in-house validated RT-qPCR lab developed test (LDT), targeting the SARS-CoV-2’s S/ORF8 genes (SORP triplex assay) and the N1/N2 US-CDC assay was used to evaluate the extraction-free protocol. To improve the analytical sensitivity, we developed a single-tube hemi-nested (STHN) version of the SORP triplex assay.ResultsA total of 38 SARS-CoV-2 positive and 75 negative saline mouth rinse/gargle samples were included in this evaluation. A 100% concordance in detection rate was obtained between the standard method and the extraction-free approach for the SORP assay. An average increase of +2.63 to +5.74 of the cycle threshold (CT) values was observed for both the SORP and N1/N2 assay when extraction-free was compared between the standard method. The average ΔCT [ΔCT=CT(Direct PCR)-CT(Extracted RNA)], for each of the gene targets were: S (ΔCT= +4.24), ORF8 (ΔCT=+2.63), N1 (ΔCT=+2.74) and N2 (ΔCT=+5.74). The ΔCT for the STHN SORP assay was +1.51 and −2.05 for the S and ORF8 targets respectively, when extracted method was compared to the standard method.ConclusionOur Gargle-Direct SARS-CoV-2 method is operationally simple, minimizes pre-analytical sample processing and is potentially implementable by most molecular diagnostic laboratories. The empirical demonstration of single-tube hemi-nested RT-qPCR, to specifically address and alleviate the widely-acknowledged problem of reduced analytical sensitivity of detection of extraction-free templates, should help diagnostic laboratories in choosing Gargle-Direct protocol for high-throughput testing.

Background: While there is discussion of increasing rates of mental disorders, epidemiological research finds little evidence of change over time. This research generally compares cross-sectional surveys conducted at different times. Declining response rates to representative surveys may mask increases in mental disorders and psychological distress.Methods: Analysis of data from two large nationally representative surveys: repeated cross-sectional data from the Australian National Health Survey (NHS) series (2001–2017), and longitudinal data (2007–2017) from the Household, Income and Labor Dynamics in Australia (HILDA) Survey. Data from each source was used to generate weighted national estimates of the prevalence of very high psychological distress using the Kessler Psychological Distress scale (K10).Results: Estimates of the prevalence of very high psychological distress from the NHS were stable between 2001 and 2014, with a modest increase in 2017. In contrast, the HILDA Survey data demonstrated an increasing trend over time, with the prevalence of very high distress rising from 4.8% in 2007 to 7.4% in 2017. This increase was present for both men and women, and was evident for younger and middle aged adults but not those aged 65 years or older. Sensitivity analyses showed that this increase was notable in the upper end of the K10 distribution.Conclusions: Using household panel data breaks the nexus between declining survey participation rates and time, and suggests the prevalence of very high psychological distress is increasing. The study identifies potential challenges in estimating trends in population mental health using repeated cross-sectional survey data.

To increase the repertoire of PCR based laboratory developed tests (LDTs) for the detection of SARS-CoV-2, we describe a new multiplex assay (SORP), targeting the SARS-CoV-2's, Spike and ORF8 genes. The widely used human RNaseP internal control was modified to specifically co-amplify the RNaseP mRNA. The SORP triplex assay was tested on a cohort (n = 372; POS = 144/NEG = 228) of nasopharyngeal flocked swab (NPFS) specimens, previously tested for the presence of SARS-CoV-2 using a PCR assay targeting E and RdRp genes. The overall sensitivity and specificity of the SORP assay was: 99.31% (95% CI: 96.22–99.98%), 100.0% (95% CI: 98.4–100%) respectively. The SORP assay could also detect a panel of variants of concern (VOC) from the B1.1.7 (UK) and B1.351 (SA) lineage. In summary, access to a repertoire of new SARS-CoV-2 LDT's would assist diagnostic laboratories in developing strategies to overcome some of the testing issues encountered during high-throughput SARS-CoV-2 testing.

Test–retest reliability assessments rarely investigate whether reliability itself is stable or change in reliability affects findings from substantive models. Research across the social sciences often recognizes that measurement error could influence results, yet it rarely applies established error correction methods. Focusing on gender wage inequality, we address two questions. First, to what extent does reliability vary over time, across genders and across measurement protocols? Second, does correcting for measurement error influence substantive conclusions about gender wage inequality? Comparing British and Australian panel data, we find little temporal variability in reliability; however, measurement error effects are variable and sometimes substantial.

© 2017 Australian Statistical Publishing Association Inc. Published by John Wiley & Sons Australia Pty Ltd. The Australian Bureau of Statistics is creating a longitudinal sample, called the Australian Census Longitudinal Dataset (ACLD), by linking person records across its five-yearly Census of Population and Housing. This paper proposes a Multi-Panel framework for selecting and weighting records in the ACLD. This framework can be applied more generally to selecting longitudinal samples from a series of cross-sectional administrative files. The proposed framework avoids some significant limitations of the popular ‘Top-Up’ sampling approach to maintaining the cross-sectional and longitudinal representativeness of a sample over time.

A quarter of patients with medullary thyroid carcinoma (MTC) have germline mutations in the RET proto-oncogene indicating MEN2. Therefore genetic testing is recommended for all patients presenting with MTC. Approximately 40% of MTCs have somatic RET mutations. Somatic mutations in the RAS genes are the next most common driver mutations and appear to be mutually exclusive with germline RET mutation. The single most common somatic RAS mutation is HRASQ61R (c.182A>G), reported in 4.6% to 11% of all MTCs. Mutation-specific immunohistochemistry (IHC) initially developed to identify the NRASQ61R mutation in melanoma (clone SP174) has proven highly sensitive and specific. Because the amino acid sequences for the HRAS and NRAS proteins at codon 61 are identical, we postulated that SP174 IHC would also identify the somatic HRASQ61R mutation. IHC with SP174 was performed on a tissue microarray of 68 patients with MTC including 13 (22.8%) with molecularly confirmed MEN2. Seven (10.3%) MTCs demonstrated positive staining. Six of these patients had already undergone germline RET mutation testing as part of clinical care and were all confirmed to be wild type, excluding the diagnosis of MEN2. All SP174 immunohistochemically positive MTCs were proven to have HRASQ61R mutation (and lack KRASQ61R and NRASQ61R) by Sanger sequencing. All MEN2 patients showed negative staining. We conclude that IHC with SP174 is highly specific for the HRASQ61R mutation in MTC. Because current data suggest that this mutation is mutually exclusive with germline RET mutation, IHC may also have a role in triaging formal genetic testing for MEN2.

In this article, the authors, both of whom are Indigenous legal scholars, reflect on changes to Australian legal education since 2005. The year 2005 was chosen as the beginning point because this was the year that Author B published a vociferous critique of the treatment of Indigenous academics and students in Australian law schools. At the time, Indigenous perspectives of the law were mostly absent from legal texts. For the lucky few Indigenous scholars who broke through the glass ceiling, the experience was often clouded by isolation and unrealistic faculty expectations. Over the supervening years, both authors have had the privilege of seeing more Indigenous people enter law schools, and they have witnessed the gradual inclusion of Indigenous knowledge in the curriculum. Cultural change within law schools, however, remains a difficult task. Therefore, it is timely to revisit Author B’s article, and ask the question – Is it now possible for Indigenous people to see themselves reflected in legal education?

Longitudinal surveys follow people over time and some of these people will die during the life of the panel. Through fieldwork effort, some deaths will be reported or known, but others will be unobserved due to sample members no longer being issued to field or having inconclusive fieldwork outcomes (such as a noncontact that is not followed by a contact at a later wave). The coverage of deaths identified among sample members has flow-on implications to nonresponse correction. Using the Household, Income and Labour Dynamics in Australia (HILDA) Survey, four methods are used to examine the extent of missing death reports. The first method matches the sample to the national death register. The second method uses life-expectancy tables to extrapolate the expected number of deaths among the sample with unknown eligibility. The third method is similar but models deaths from data internal to the survey. The fourth method models deaths as part of the attrition process of a longitudinal survey. The last three methods are compared to the first method and the implications for the construction of balanced panel weights and subsequent population inference are explored.

Germline mutations of the BAP1 gene have been implicated in a cancer predisposition syndrome which includes mesothelioma, uveal melanoma, cutaneous melanocytic lesions, renal cell carcinoma, and possibly other malignancies. Double hit inactivation of BAP1 with subsequent loss of expression of the BAP1 protein also occurs in approximately 50% of mesotheliomas. The link between BAP1 mutation and lung cancer is yet to be fully explored. We sought to assess BAP1 expression in a large cohort of lung cancers undergoing surgery with curative intent. We searched the Anatomical Pathology database of our institution for lung cancer patients undergoing surgery with curative intent between 2000 and 2010. Immunohistochemistry for BAP1 was then performed in tissue microarray format. Our cohort included 257 lung cancer patients, of which 155 (60%) were adenocarcinomas and 72 (28%) were squamous cell carcinomas, with no other subtype comprising more than 3%. BAP1 loss of expression was found in only one lung cancer. We conclude that BAP1 mutation occurs very infrequently (0.4%) in non-small cell lung cancer. Given that the pathological differential diagnosis between lung carcinoma and mesothelioma may sometimes be difficult, this finding increases the specificity of loss of expression for BAP1 for the diagnosis of mesothelioma.

Hereditary leiomyomatosis and renal cell carcinoma (HLRCC) syndrome secondary to germline fumarate hydratase (FH) mutation presents with cutaneous and uterine leiomyomas, and a distinctive aggressive renal carcinoma. Identification of HLRCC patients presenting first with uterine leiomyomas may allow early intervention for renal carcinoma. We reviewed the morphology and immunohistochemical (IHC) findings in patients with uterine leiomyomas and confirmed or presumed HLRCC. IHC was also performed on a tissue microarray of unselected uterine leiomyomas and leiomyosarcomas. FH-deficient leiomyomas underwent Sanger and massively parallel sequencing on formalin-fixed paraffin-embedded tissue. All 5 patients with HLRCC had at least 1 FH-deficient leiomyoma: defined as completely negative FH staining with positive internal controls. One percent (12/1152) of unselected uterine leiomyomas but 0 of 88 leiomyosarcomas were FH deficient. FH-deficient leiomyoma patients were younger (42.7 vs. 48.8 y, P=0.024) and commonly demonstrated a distinctive hemangiopericytomatous vasculature. Other features reported to be associated with FH-deficient leiomyomas (hypercellularity, nuclear atypia, inclusion-like nucleoli, stromal edema) were inconstantly present. Somatic FH mutations were identified in 6 of 10 informative unselected FH-deficient leiomyomas. None of these mutations were found in the germline. We conclude that, while the great majority of patients with HLRCC will have FH-deficient leiomyomas, 1% of all uterine leiomyomas are FH deficient usually due to somatic inactivation. Although IHC screening for FH may have a role in confirming patients at high risk for hereditary disease before genetic testing, prospective identification of FH-deficient leiomyomas is of limited clinical benefit in screening unselected patients because of the relatively high incidence of somatic mutations.

The factors leading individuals to immigrate to developed contexts are widely studied, but comparatively less is known about those who emigrate from them. In this paper, we use data from a nationally representative cohort of Australian adults to develop longitudinal measures of emigration and to assess how social ties and individual economic position predict emigration. Cox proportional hazards models indicate that the propensity to emigrate is particularly pronounced for those with relatively little social connectedness in Australia. Specifically, our results show that first-generation Australians, especially those with relatively short durations in the country, have substantially higher emigration rates than later-generation Australians. Similarly, having a partner with deeper generational roots in Australia strongly reduces the likelihood to emigrate. At the same time, our analysis also shows that economic position matters, with the not employed having higher risks of emigration. Perhaps most interestingly, estimates from our models reveal that those with university degrees are much more likely to emigrate than individuals with lower levels of education, a finding that is true for both first- and later-generation Australians.

This chapter focuses on longitudinal surveys, the defining feature of which is the collection of repeated observations from the same units over time. Longitudinal surveys have the potential to provide rich data for analyzing the causes and consequences of change in peoples' lives. The chapter compares the reported retention rates from a range of different longitudinal studies. Only a few longitudinal studies have specifically set out to formally harmonize fieldwork practices across countries ex ante. The chapter reviews the experiences of a selection of some of the world's major longitudinal surveys in retaining sample members. It discusses the most common types of strategies used in these studies to maintain contact with sample members and encourage ongoing participation. Panel maintenance strategies are aimed at keeping in contact with sample members, especially those who are mobile, and gaining their cooperation at multiple points in time, often over a very long period.

Computer-assisted personal interviewing (CAPI) offers many attractive benefits over paper-and-pencil interviewing. There is, however, mixed evidence on the impact of CAPI on interview length, an important survey outcome in the context of length limits imposed by survey budgets and concerns over respondent burden. In this article, recent experimental and quasi-experimental evidence derived from a large, nationally representative household panel study is used to investigate CAPI’s impact on interview length. We find that effects very much depend on how CAPI is implemented, including the hardware and software adopted, the extent and nature of dependent data, and even interviewer workloads—a finding that helps explain the conflicting results from previous studies. Overall, our study leads us to the conclusion that, absent dependent data, CAPI is likely to increase interview lengths, but the potential reductions from dependent data are very large, such that even modest levels can lead to net reductions in interview lengths.

Pathogenic ALK translocations have been reported in papillary thyroid carcinoma (PTC). We developed and validated a screening algorithm based on immunohistochemistry (IHC), followed by fluorescence in situ hybridization (FISH) in IHC-positive cases to identify ALK-rearranged PTC. IHC and FISH were performed in a cohort of 259 thyroid carcinomas enriched for aggressive variants. IHC was positive in 8 cases, 6 confirmed translocated by FISH (specificity 75%). All 251 IHC-negative cases were FISH negative (sensitivity 100%). Having validated this approach, we performed screening IHC, followed by FISH in IHC-positive cases in an expanded cohort. ALK translocations were identified in 11 of 498 (2.2%) of all consecutive unselected PTCs and 3 of 23 (13%) patients with diffuse sclerosing variant PTCs. No ALK translocations were identified in 36 PTCs with distant metastases, 28 poorly differentiated (insular) carcinomas, and 20 anaplastic carcinomas. All 14 patients with ALK translocations were female (P=0.0425), and translocations occurred at a younger age (mean 38 vs. 48 y, P=0.0289 in unselected patients). ALK translocation was an early clonal event present in all neoplastic cells and mutually exclusive with BRAFV600E mutation. ALK translocation was not associated with aggressive clinicopathologic features (size, stage, metastasis, vascular invasion, extrathyroidal extension, multifocality, risk for recurrence, radioiodine resistance). We conclude that 2.2% of PTCs are ALK-translocated and can be identified by screening IHC followed by FISH. ALK translocations may be more common in young females and diffuse sclerosing variant PTC but do not connote more aggressive disease.

Crizotinib, a small molecule tyrosine kinase inhibitor, has shown tremendous promise in the treatment of lung adenocarcinomas harboring either ALK or ROS1 rearrangements. Recently, small studies of colorectal carcinomas (CRCs) have suggested an incidence of EML4-ALK translocations of 0.4% to 2.4% and FIG-ROS1 translocations of 0.8%. In lung cancer, screening immunohistochemical staining for ALK and ROS1 has been validated as highly sensitive for these translocations, but this has not been investigated in CRC. We therefore sought to investigate the incidence of ALK and ROS1 overexpression as detected by immunohistochemical staining in a large cohort of CRCs. Of the 1889 CRCs, only 1 case (0.05%) demonstrated diffuse strong positive staining for ALK, whereas 14 (0.7%) showed weak nonspecific staining; the remainder were negative. The 1 positive case was confirmed to harbor an ALK rearrangement by fluorescent in situ hybridization (FISH), whereas the 14 tumors with weak staining were FISH-negative. The ALK positive case demonstrated positive expression in all dysplastic and malignant cells indicating that the translocation was an early clonal event. No cases were positive for ROS1 by immunohistochemical staining, although 2 cases did show some nonspecific staining and were shown to be negative for ROS1 translocation by FISH. We conclude that although diffuse strong positive staining for ALK is likely to be highly specific for ALK rearrangement in CRC, both ALK and ROS1 immunohistochemical staining are very low-yield tests and difficult to justify in the routine clinical setting.

Mutations in EGFR guide treatment in non-small cell lung cancer (NSCLC). The most common mutations, exon 19 (delE746-A750) and exon 21 (L858R), can be identified by mutation specific immunohistochemistry (IHC). We present our prospective experience of universal reflex IHC and molecular testing in non-squamous NSCLC in the routine clinical setting.A total of 411 specimens from 332 patients were encountered over two years. Of these, 326 (98%) patients underwent EGFR IHC, 15 (5%) were positive for exon 19 deletions and 27 (8%) for exon 21 (L858R); 244 (73%) patients underwent molecular testing. Seventy-six mutations in 64 patients (19% of all patients encountered; 26% with sufficient material for testing) were identified. These comprised nine exon 18 (G719X) mutations, three also with exon 20 mutations; 24 exon 19 deletions, six also with exon 20 mutations; 23 exon 21 (L858R), three also with exon 20 mutations; and 8 exon 20 alone.All 15 exon 19 IHC positive patients were proven mutated (100% specificity, 63% sensitivity). Twenty-two of 27 exon 21 IHC positive cases were proven mutated while three patients had insufficient material for molecular testing (92% specificity, 96% sensitivity). The overall specificity and sensitivity of IHC for any EGFR mutation was 95% and 58%. Five patients initially thought to be wild type for EGFR but IHC positive underwent repeat molecular testing because of the discrepancy which confirmed the IHC result in three cases (60%).We conclude IHC is very specific but not sensitive. Whilst IHC cannot replace molecular testing, it is a useful adjunct which requires minimal tissue and identifies false negative molecular results which occurred in 5% of our patients with eventually confirmed EGFR mutations.