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In this article the author examines the decision in Ruddock v Vadarlis (2001) in which a majority of the FCA determined that the federal government retained executive powers (traceable to the unwritten prerogative powers of the Crown) in order to justify the decision to prevent Afghan asylum seekers lodging refugee claims in Australia. The article analyses those aspects of the decision that deal with the difficult question of when a prerogative power is abrogated or abridged by statute by implication.

This article offers a critical analysis of the norms, policy, procedures and outcomes associated with contemporary decision-making under the ‘character test’ per Migration Act 1958 (Cth) s 501. Of late there has been a steep increase in the number of visa refusals and cancellations on adverse character grounds due to the convergence of a reformulated character test and single-minded, authoritarian, administration by ministerial office-holders. This article teases out the significant and, arguably, adverse consequences for the quality of administrative justice of ministerial control over visa decisions absent independent administrative review. It is argued that the integrity of ministerial decision-making and the legitimacy of outcomes are dubious. This is because the process of identifying and balancing the important countervailing community interests and individual (human) rights, in the course of reaching the preferable decision, does not appear to be carried out in a detached, proper and genuine manner, pursuant to rational and intelligible reasoning processes. In conclusion, when viewed holistically, the judicial decisions analysed in this article suggest that the unwavering pursuit of community protection has come at a significant adverse cost to administrative justice and, necessarily, to individuals/families who bear the harsh consequences.

Summary Background Radical surgery via total mesorectal excision might not be the optimal first-line treatment for early-stage rectal cancer. An organ-preserving strategy with selective total mesorectal excision could reduce the adverse effects of treatment without substantially compromising oncological outcomes. We investigated the feasibility of recruiting patients to a randomised trial comparing an organ-preserving strategy with total mesorectal excision. Methods TREC was a randomised, open-label feasibility study done at 21 tertiary referral centres in the UK. Eligible participants were aged 18 years or older with rectal adenocarcinoma, staged T2 or lower, with a maximum diameter of 30 mm or less; patients with lymph node involvement or metastases were excluded. Patients were randomly allocated (1:1) by use of a computer-based randomisation service to undergo organ preservation with short-course radiotherapy followed by transanal endoscopic microsurgery after 8–10 weeks, or total mesorectal excision. Where the transanal endoscopic microsurgery specimen showed histopathological features associated with an increased risk of local recurrence, patients were considered for planned early conversion to total mesorectal excision. A non-randomised prospective registry captured patients for whom randomisation was considered inappropriate, because of a strong clinical indication for one treatment group. The primary endpoint was cumulative randomisation at 12, 18, and 24 months. Secondary outcomes evaluated safety, efficacy, and health-related quality of life assessed with the European Organisation for Research and Treatment of Cancer (EORTC) QLQ C30 and CR29 in the intention-to-treat population. This trial is registered with the ISRCTN Registry, ISRCTN14422743. Findings Between Feb 22, 2012, and Dec 19, 2014, 55 patients were randomly assigned at 15 sites; 27 to organ preservation and 28 to radical surgery. Cumulatively, 18 patients had been randomly assigned at 12 months, 31 at 18 months, and 39 at 24 months. No patients died within 30 days of initial treatment, but one patient randomly assigned to organ preservation died within 6 months following conversion to total mesorectal excision with anastomotic leakage. Eight (30%) of 27 patients randomly assigned to organ preservation were converted to total mesorectal excision. Serious adverse events were reported in four (15%) of 27 patients randomly assigned to organ preservation versus 11 (39%) of 28 randomly assigned to total mesorectal excision (p=0·04, χ2 test). Serious adverse events associated with organ preservation were most commonly due to rectal bleeding or pain following transanal endoscopic microsurgery (reported in three cases). Radical total mesorectal excision was associated with medical and surgical complications including anastomotic leakage (two patients), kidney injury (two patients), cardiac arrest (one patient), and pneumonia (two patients). Histopathological features that would be considered to be associated with increased risk of tumour recurrence if observed after transanal endoscopic microsurgery alone were present in 16 (59%) of 27 patients randomly assigned to organ preservation, versus 24 (86%) of 28 randomly assigned to total mesorectal excision (p=0·03, χ2 test). Eight (30%) of 27 patients assigned to organ preservation achieved a complete response to radiotherapy. Patients who were randomly assigned to organ preservation showed improvements in patient-reported bowel toxicities and quality of life and function scores in multiple items compared to those who were randomly assigned to total mesorectal excision, which were sustained over 36 months’ follow-up. The non-randomised registry comprised 61 patients who underwent organ preservation and seven who underwent radical surgery. Non-randomised patients who underwent organ preservation were older than randomised patients and more likely to have life-limiting comorbidities. Serious adverse events occurred in ten (16%) of 61 non-randomised patients who underwent organ preservation versus one (14%) of seven who underwent total mesorectal excision. 24 (39%) of 61 non-randomised patients who underwent organ preservation had high-risk histopathological features, while 25 (41%) of 61 achieved a complete response. Overall, organ preservation was achieved in 19 (70%) of 27 randomised patients and 56 (92%) of 61 non-randomised patients. Interpretation Short-course radiotherapy followed by transanal endoscopic microsurgery achieves high levels of organ preservation, with relatively low morbidity and indications of improved quality of life. These data support the use of organ preservation for patients considered unsuitable for primary total mesorectal excision due to the short-term risks associated with this surgery, and support further evaluation of short-course radiotherapy to achieve organ preservation in patients considered fit for total mesorectal excision. Larger randomised studies, such as the ongoing STAR-TREC study, are needed to more precisely determine oncological outcomes following different organ preservation treatment schedules. Funding Cancer Research UK.

This article critically examines legislative reforms to the ‘character test’, related changes to policy and government administration, with a particular focus on the recent introduction and enforcement of an unprecedented regime of mandatory visa cancellation for non-citizens considered to be of bad character. Non-citizens subject to mandatory visa cancellation include those possessing a ‘substantial criminal record’. These individuals are subject to extended periods of imprisonment after the expiration of non-parole periods, or lengthy periods of immigration detention upon the expiration of their prison sentence. They are vulnerable to removal from Australia notwithstanding deep and enduring community ties. Justified by politicians as a measure of effective crime control, visa cancellations on the grounds of bad character have increased rapidly since 2014, largely as a consequence of the introduction of mandatory visa cancellation. The revision of the character test, and introduction of mandatory visa cancellation, coheres with global ‘crimmigration’ trends as a means of effecting social exclusion for those represented as undesirable and unworthy of the ‘privilege’ of community membership. This article examines mandatory visa cancellation in light of the concept of ‘crimmigration’, and critiques the reasoning behind its introduction and the regulations and procedures governing its application. This article argues that mandatory visa cancellation, detention, attendant legal processes, and the sanction of removal, are, in several and sometimes distinctive ways, effectively punitive, and often conflict with individual’s fundamental rights.

Australian politicians have been categorical about their commitment to protecting the Australian community from the risk of harm that may result from criminal activity by non-citizens, proclaiming that there “is no place in Australia for foreign criminals”. This policy has been pursued through administrative, regulatory, means. Specifically, via the administration of the ‘character test’ under section 501 Migration Act 1958 (Cth), and through general visa cancellation powers governing ‘risky’ non-citizens. This chapter critically examines recent reforms to the ‘character test’,—reforms that introduced an unprecedented regime of mandatory visa cancellation for non-citizens considered to be of bad character—and the administration of those new powers. Non-citizens subject to mandatory visa cancellation include, notably, those possessing a ‘substantial criminal record’. These individuals are subject to administrative detention upon the expiration of their prison sentence, and are vulnerable to removal from Australia as unlawful non-citizens. Justified by politicians as a measure of effective crime control, visa cancellations on the grounds of bad character have increased by over 1, 400 per cent, as a consequence of the introduction of mandatory visa cancellation powers in December 2014. This chapter analyses and critiques the introduction, justification and administration of mandatory visa cancellation in Australia. The chapter argues that visa cancellation, consequential detention (‘immcarceration’), attendant legal processes, and the sanction of removal, are akin to double punishment, largely because non-citizens experience these measures as punitive.

Exclusion and expulsion from Australia has, largely, been achieved via the application of s 501 Migration Act 1958 (Cth) (the ‘character test’) and, more recently, via application of s 116 (‘general visa cancellation’). Strengthened visa cancellation provisions and associated policies, coupled with stringent enforcement over felonious non-citizens and restricted forms of legal redress, are distinctive features of modern crimmigration law and practice in Australia. Courts cannot conduct an assessment of whether administrative decision-making outcomes are substantively just, overly harsh, or disproportionate to the risks posed by the non-citizen to community safety. Nor can the Courts assess the conformity of cancellation decisions with human rights norms and enforce those rights against the State. In light of this state of affairs we argue that there is a pressing need to revisit how human rights principles are enshrined in law and how the human rights implications of character decisions are properly accounted for and weighed in the decision-making balance. We also ventilate our concerns about the nature and scope of visa cancellation powers and their contemporary administration by the executive branch of government. We advocate for an overhaul of the character test and general visa cancellation powers, and caution against the trend towards personal ministerial administration of statutory powers.

This multidisciplinary book introduces readers to original perspectives on crimmigration that foster holistic, contextual, and critical appreciation of the concept in Australia and its individual consequences and broader effects. This collection draws together contributions from nationally and internationally respected legal scholars and social scientists united by common and overlapping interests, who identify, critique, and reimagine crimmigration law and practice in Australia, and thereby advance understanding of this important field of inquiry. Specifically, crimmigration is addressed and analysed from a variety of standpoints, including: criminal law/justice; administrative law/justice; immigration law; international law; sociology of law; legal history feminist theory, settler colonialism, and political sociology. The book aims to: explore the historical antecedents of contemporary crimmigration and continuities with the past in Australia; reveal the forces driving crimmigration and explain its relationship to border securitisation in Australia; identify and examine the different facets of crimmigration, comprising: the substantive overlaps between criminal and immigration law; crimmigration processes; investigative techniques, surveillance strategies, and law enforcement agents, institutions and practices; uncover the impacts of crimmigration law and practice upon the human rights and interests of non-citizens and their families; analyse crimmigration from assorted critical standpoints; including settler colonialism, race and feminist perspectives. By focusing upon these issues, the book provides an interconnected collection of chapters with a cohesive narrative, notwithstanding that contributors approach the themes and specific issues from different theoretical and critical standpoints, and employ a range of research methods.

Background Parastomal herniation is a common problem following formation of a stoma after both elective and emergency abdominal surgery. Symptomatic hernias give rise to a significant amount of patient morbidity, and in some cases mortality, and therefore may necessitate surgical treatment to repair the hernial defect and/or re-site the stoma. In an effort to reduce this complication, recent research has focused on the application of a synthetic or biological mesh, inserted during stoma formation to help strengthen the abdominal wall. Objectives The primary objective was to evaluate whether mesh reinforcement during stoma formation reduces the incidence of parastomal herniation. Secondary objectives included the safety or potential harms or both of mesh placement in terms of stoma-related infections, mesh-related infections, patient-reported symptoms/postoperative quality of life, and re-hospitalisation/ambulatory visits. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL; the Cochrane Library 2018, Issue 1), Ovid MEDLINE (1970 to 11 January 2018), Ovid Embase (1974 to 11 January 2018), and Science Citation Index Expanded (1970 to 11 January 2018). To identify ongoing studies, we also searched the metaRegister of Controlled Trials (mRCT) on 11 January 2018. Selection criteria We considered for inclusion all randomised controlled trials (RCTs) of prosthetic mesh (including biological/composite mesh) placement versus a control group (no mesh) for the prevention of parastomal hernia. Data collection and analysis Two review authors independently assessed the studies identified by the literature search for potential eligibility. We obtained the full articles for all studies that potentially met the inclusion criteria and included all those that met the criteria. Any differences in opinion between review authors were resolved by consensus. We pooled study data into a meta-analysis. We assessed heterogeneity by calculation of I2 and expressed results for each variable as a risk ratio (RR) with corresponding 95% confidence intervals (CI). We expressed continous outcomes as mean difference (MD) with corresponding 95% CIs. Main results We included 10 RCTs involving a total of 844 participants. The primary outcome was overall incidence of parastomal herniation. Secondary outcomes were rate of reoperation at 12 months, operative time, postoperative length of hospital stay, stoma-related infections, mesh-related infections, quality of life, and rehospitalisation rate. We judged the risk of bias across all domains to be low in six trials. We judged four trials to have an overall high risk of bias. The overall incidence of parastomal hernia was less in participants receiving a prophylactic mesh compared to those who had a standard ostomy formation (RR 0.53, 95% CI 0.43 to 0.66; 10 studies, 771 participants; I2 = 69%; low-quality evidence). In absolute numbers, the incidence of parastomal hernia was 22 per 100 participants (18 to 27) receiving prophylactic mesh compared to 41 per 100 participants having a standard ostomy formation. There were no differences in the need for reoperation (RR 0.90, 95% CI 0.50 to 1.64; 9 studies, 757 participants; I2 = 0%; low-quality evidence); operative time (MD -6.50 (min), 95% CI -18.24 to 5.24; 6 studies, 671 participants; low-quality evidence); postoperative length of hospital stay (MD -0.95 (days), 95% CI -2.03 to 0.70; 4 studies, 500 participants; moderate-quality evidence); or stoma-related infections (RR 0.89, 95% CI 0.32 to 2.50; 6 studies, 472 participants; I2 = 0%; low-quality evidence) between the two groups. We were unable to analyse mesh-related infections, quality of life, and rehospitalisation rate due to sparse data or because the outcome was not reported in the included studies. Authors' conclusions This Cochrane Review included 10 RCTs with a total of 844 participants. The review demonstrated a reduction in the incidence of parastomal hernia in people who had a prophylactic synthetic mesh placed at the time of the index operation compared to a standard ostomy formation. However, our confidence in this estimate is low due to the presence of a large degree of clinical heterogeneity, as well as high variability in follow-up duration and technique of parastomal herniation detection. We found the rate of stoma-related infection to be similar in both the intervention and control groups.

This article critically examines extensive reforms to the 'character test', contained in s 501 Migration Act 1958 - reforms that introduced an unprecedented regime of mandatory visa cancellation for non-citizens considered to be of bad character. Noncitizens subject to mandatory visa cancellation include, notably, those possessing a 'substantial criminal record'. These individuals are subject to administrative detention upon the expiration of their prison sentence, and are vulnerable to removal from Australia as unlawful non-citizens. Justified by politicians as a measure of effective crime control, visa cancellations on the grounds of bad character have increased tenfold in the last three years, as a consequence of the introduction of mandatory visa cancellation powers. The revision of the character test, and introduction of mandatory visa cancellation coheres with global 'crimmigration' trends as a means of effecting social exclusion for 'undesirable' community members. This article employs the concept of 'crimmigration' to analyse and critique the introduction, justification and administration of mandatory visa cancellation in Australia. The article argues that visa cancellation, consequential detention ('immcarceration'), attendant legal processes, and the sanction of removal, are akin to double punishment, largely because noncitizens experience these measures as punitive.

This Article examines the disconformity between international refugee law and Australian migration law and practice, identifying the convoluted and overlapping set of substantive qualifications to refugee protection and complementary (human rights-based) protection under the Migration Act 1958. The Article, identifies, explains and analyses how exclusionary principles under domestic law extend well beyond the reach of international norms governing exclusion from refugee/complementary protection raising the spectre of refoulement.

Federal government interventions designed to address irregular maritime arrivals and socio-economic conditions in particular Indigenous communities in the Northern Territory have been characterised by juridical exceptionalism - the partial suspension or withdrawal of the juridical order. Perceived emergencies - broadly, border (in)security and physical (in)security - have resulted in the creation of legal spaces in which 'Others' are constituted within and without the juridical order by the sovereign. This article critically explores these exceptional spaces - 'offshore excised places', immigration detention centres and 'prescribed' parts of the Northern Territory - and investigates the ethical, political and historical rationalities underpinning them. Crucially, this includes consideration of how social memories have influenced the regulation of irregular maritime arrivals and the creation of emergency response laws in the Northern Territory. It is argued that social, 'governmental' memories about the efficacy and legacy of law/policy responses to border insecurity and the socio-economic problems facing Indigenous communities have, to a degree, been infected by nostalgia. This yearning for the restoration of past experience is associated with a sense of loss, including a loss of state sovereignty due to irregular maritime arrivals, a loss of control over (conditions in) Aboriginal communities and a loss of national unity and identity. This longing has activated politician's 'retro' ideas and the refashioning of legal responses to current social dilemmas. Arguably, such strategies risk discounting or excusing the failings of past social policies, leaving individuals to bear the adverse effects once more.

The Federal Disability Discrimination Act 1992 (Cth) (DDA) defines assistance animals to include dogs or other animals that are trained to assist a person with a disability to alleviate the effect of the disability and to meet standards of hygiene and behaviour that are appropriate for an animal in a public place. The Federal Court of Australia Full Court has read this definition widely to include a selftrained dog that has not been accredited or trained by a recognised specialist disability animal training association. Considering an estimated four million Australians could claim to have a disability under the wide definition of disability in the DDA, and the extremely low bar to establish that an animal provides assistance to a person with a disability, the impact of these laws are significant and are generating substantial concerns to government, industry and the disability community.The current regulatory approach to defining disability assistance animals has resulted in questions that law, policy and theory are struggling to answer, such as:• How should animals, whether they are dogs, cats, miniature horses, birds, or others, have their suitability as assistance animals Determined and regulated?• Who should be qualified to train and accredit disability assistance animals?• Should there be legal limitations on what impairment categories or which individuals can use disability assistance animals?• How can policies and regulations prevent pets being “passed off” as disability assistance animals?

Autoimmune sensorineural hearing loss (ASNHL) is characterized typically by bilateral, rapidly progressive hearing loss that responds therapeutically to corticosteroid treatment. Despite its name, data implicating autoimmunity in the etiopathogenesis of ASNHL have been limited, and targeted self-antigens have not been identified. In the current study we show that the inner ear-specific proteins cochlin and beta-tectorin are capable of targeting experimental autoimmune hearing loss (EAHL) in mice. Five weeks after immunization of SWXJ mice with either Coch 131-150 or beta-tectorin 71-90, auditory brainstem responses (ABR) showed significant hearing loss at all frequencies tested. Flow cytometry analysis showed that each peptide selectively activated CD4(+) T cells with a proinflammatory Th1-like phenotype. T cell mediation of EAHL was determined by showing significantly increased ABR thresholds 6 weeks after adoptive transfer of peptide-activated CD4(+) T cells into naive SWXJ recipients. Immunocytochemical analysis showed that leukocytic infiltration of inner ear tissues coincided with onset of hearing loss. Our study provides a contemporary mouse model for clarifying our understanding of ASNHL and facilitating the development of novel effective treatments for this clinical entity. Moreover, our data provide experimental confirmation that ASNHL may be a T cell-mediated organ-specific autoimmune disorder of the inner ear.

Objective The aim of this study was to identify the lymphatic drainage of the inner ear in guinea pigs. Study Design Prospective study. Methods The prospective study was performed in guinea pigs by injection of keyhole limpet hemocyanin (KLH) into either the right-side scala tympani or the middle ear cavity. The left side was not injected and served as a control. Fifteen minutes after injection, the animals were killed by intracardiac perfusion with paraformaldehyde and tissue specimens (right and left temporal bones, cervical lymph nodes, and the spleen) were collected. The presence of KLH in each specimen was determined by immunohistochemical assay of frozen sections using polyclonal mouse anti-KLH antibodies. Results After injection into the middle ear, labeled cells were identified in the parotid, superficial ventral, mandibular, and deep cranial cervical lymph nodes. However, after inner ear injections KLH was present in only the parotid and superficial ventral cervical nodes. The spleen contained KLH-positive cells following injection into either the middle or inner ear, but not all animals contained labeled spleen cells. Conclusions The inner ear has a connection to the lymphatic drainage system. Because fewer lymph nodes contained labeled cells after inner ear injection than after middle ear injection, it is concluded that the inner ear does not simply drain to the middle ear and subsequently to the lymph nodes but seems likely to have its own connections.

The aim of this paper is to report the high prevalence of important extracolonic findings, including cancer, at computed tomography (CT) colonography.

Introduction The aim of this paper is to report the high prevalence of important extracolonic findings, including cancer, at CT colonography. Methods Using the PACS system all CT colonograms performed for symptomatic indications between December 2006 and June 2011 were retrieved as part of our ongoing audit. Extracolonic findings were identified and analysed. They were categorised into extracolonic malignancies, benign and important benign findings which were findings that required further investigation or management. Results 830 patients underwent CT Colonography during this time period (518 females, 313 males, average age 74). 85 colonic cancers were identified and 103 patients had colonic polyps with or without extracolonic findings. Extracolonic abnormalities were found in 383 patients (46%). Of those patients with extracolonic findings 9% had extracolonic malignancies, 26% had important extracolonic findings requiring further investigation, management or referral and 65% were benign incidental findings requiring no further follow-up. The most common benign incidental finding was renal cysts and the most common extracolonic malignancy was renal carcinoma. Abstract OC-152 table 1 gives a summary of the number of extracolonic findings identified with the highest prevalence. Conclusion CT Colonography has the potential to pick up cancers and other life threatening lesions such as large non ruptured AAA at a preclinical stage. While we acknowledge that extracolonic abnormalities are common with the correct planning and management we do not believe that this should necessarily increase the number of further unnecessary investigations or costs. Competing interests None declared.

We have allowed the liberal use of antiseptics for wound care to become an established practice with little consideration of any toxicity on exposed healing tissues. The care of open wounds and chronic ulcers is largely delegated to nursing staff with little help or advice from their medical colleagues. Alexander Fleming felt that antiseptics would only be of benefit in septic wounds if they stimulated or conserved natural defence mechanisms! He also regarded the assessment of tissue toxicity as being more important than any antimicrobial effect but there has been little research into this field.

Following a rise in the number of irregular maritime arrivals seeking refugee protection in Australia, and two successful legal challenges to their refugee processing policies, the Labor Government has resuscitated notorious aspects of the ‘Pacific Solution’ as part of a ‘no advantage’ policy. This strategy seeks to deter ‘irregular’ asylum seekers by treating them no more favourably than refugees seeking protection from overseas awaiting entry to Australia through regular refugee/humanitarian channels. In furtherance of this ‘no advantage’ policy, extra-territorial processing on Nauru and Papua New Guinea has been re-introduced and ‘excision’ provisions are to be extended to mainland Australia placing the continent outside of its ‘migration zone’ and, therefore, asylum seekers beyond the regular laws and processes for protection seekers. This article analyses the seismic shifts in asylum seeker policy that have occurred in Australia over the recent past and the politics underpinning them.

In this article the author examines the decision in Ruddock v Vadarlis (2001) in which a majority of the FCA determined that the federal government retained executive powers (traceable to the unwritten prerogative powers of the Crown) in order to justify the decision to prevent Afghan asylum seekers lodging refugee claims in Australia. The article analyses those aspects of the decision that deal with the difficult question of when a prerogative power is abrogated or abridged by statute by implication.

The article examines the extent to which the due process norms enshrined in international human rights law have been applied to, influenced, and informed the law and policy of refugee‐receiving states. Such an inquiry is necessary because the international protection regime for refugees is under threat from state practices which are almost universally abrogating procedural standards of fairness in refugee determination processes. Furthermore, domestic due process standards, or natural justice traditions have proved largely impotent in preventing or moderating this lowering of legal procedural safeguards. Thus, it becomes necessary to examine the protection potentially available under human rights law. The examination of the relevant provisions in the UDHR, ICCPR, ECHR AND ACHR comprise the main body of the article, with particular emphasis placed on the jurisprudence of the European Court of Human Rights and European Commission in respect of Article 6(1) and Article 5(4).