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More than 30 of the 43 universities in Australia offer an exercise science and/or sport science degree programs. In the Vocational Education and Training (VET) sector, more than 160 Registered Training Organisations offer Australian Government approved fitness training courses. The paper is a self-reflective exercise based upon mentoring placement students from multiple registered course providers from the VET sector fitness strand. Combined with reflection on apparently healthy general population hours for placement students from six Sydney city and one regional New South Wales based universities this represented evaluation of more than 200 students and more than 20,000 placement supervision hours. This observation was based upon student placements conducted over the previous seven years, though a significant proportion of the students surveilled were from the previous 36 months. A number of recommendations were developed that may be relevant not just for health, fitness and exercise and sport science courses, but also may be relevant to industry mentorship across a range of fields.

Background: Australia is known for its outdoor culture, with a large percentage of its population engaging in outdoor recreational activities, aquatic, non-aquatic and outdoor occupational activities. However, these outdoor enthusiasts face increased exposure to ultraviolet radiation (UVR), leading to a higher risk of skin cancer, including malignant melanoma (MM). Over the past 40 years, there has been a significant rise in skin cancer rates in Australia, with two out of three Australians expected to develop some form of skin cancer by age 70. Currently, skin cancer examinations are not endorsed in asymptomatic or low-risk individuals in Australia, with only high-risk individuals recommended to undergo regular skin examinations. Notably, the Melanoma Institute Australia suggests that one-half of patients identify MMs themselves, although this claim appears to be based on limited Australian data which may not reflect contemporary practice. Therefore this study sought to determine the percentage of patients who were able to self-identify MMs as lesions of concern when presenting for a skin cancer examination. Methods: Multi-site, cross-sectional study design incorporating a descriptive survey and total body skin cancer screening, including artificial intelligence by a skin cancer doctor. Results: A total of 260 participants with suspect MM lesions were biopsied, with 83 (31.9%) found to be melanomas. Of the true positive MMs only a small percentage of participants (21.7% specificity) correctly had concerns about the suspect lesion being a MM. These MMs were located primarily on the back (44.4%), shoulder (11.1%) and upper leg (11.1%). There was no significant difference in the size between those participants aware of a MM versus those who were not (P = 0.824, 24.6 vs 23.4 mm2). Significantly more males identified lesions of concern that were MMs as compared to females (P = 0.008, 61.1% vs 38.9%, respectively). With regard to true negatives males and females were similar (52.1% vs 47.9%, respectively). With regard to false negatives (n = 65), a greater percentage of males than females did not recognize the MM as a lesion of concern (66.2% vs 33.8%, respectively). Participants were more likely to correctly identify an invasive MM as opposed to an in situ MM (27.3% versus 21.3%). Conclusions: Only a small percentage of participants in this study were able to self-identify either in situ or invasive MM as a lesion of concern with a tendency to identify the more advanced, thicker MMs. Given that MM is associated with a high mortality and cost of treatment, particularly when invasive, the inability of lay persons to identify these cancerous lesions will likely lead to delayed treatment and a possible adverse outcome. We believe the current melanoma screening practices in Australian general practice should be revisited to improve patient outcomes with regard to MM. Additionally, prevention campaigns should include images and primary risk factors for MM. [ABSTRACT FROM AUTHOR]

In this reflective article, we offer innovative approaches to creating opportunities for leadership learning through questioning the intentions versus impacts of leading short‐term study abroad courses. We consider the critical relevance of approaching a course like this from a learning disposition—recognizing our roles as learners, as well as facilitators of learning. We note the impacts of hegemony and identity, the effort and skills of dialoguing across difference, the complexities of constructive ambiguity, and the necessity to be adaptable as we navigate liminal spaces, concepts, and efforts for peace leadership. In the end, although this was a brief, 10‐day experience, we came to realize our entire outlook on facilitating leadership learning shifted to recognize and grapple with these complexities. [ABSTRACT FROM AUTHOR]

Simple Summary: Early detection of malignant melanoma (MM) has the potential to significantly reduce morbidity and mortality as the thickness of the lesion is closely associated with prognosis. Artificial intelligence (AI) is a non-invasive technology that has the potential to aid clinicians in the early diagnosis of skin cancers, including melanoma. Performance metrics of machine-based AI have been shown to rival or improve upon clinician diagnosis. However, many studies have limited this scope to pre-build image databases that may not replicate real-world settings experienced in general practice. This systematic review aimed to report the performance of commercial or market-approved dermatoscopic systems with AI in the form of convolutional neural networks (CNNs) when tasked with classifying melanoma. The sensitivity and specificity of CNNs are highly varied and illustrate the necessity of clinician-to-patient interaction in the diagnosis process. Clinicians working in unison with AI show the most promise for better performance when classifying MM. Background: Cutaneous melanoma remains an increasing global public health burden, particularly in fair-skinned populations. Advancing technologies, particularly artificial intelligence (AI), may provide an additional tool for clinicians to help detect malignancies with a more accurate success rate. This systematic review aimed to report the performance metrics of commercially available convolutional neural networks (CNNs) tasked with detecting MM. Methods: A systematic literature search was performed using CINAHL, Medline, Scopus, ScienceDirect and Web of Science databases. Results: A total of 16 articles reporting MM were included in this review. The combined number of melanomas detected was 1160, and non-melanoma lesions were 33,010. The performance of market-approved technology and clinician performance for classifying melanoma was highly heterogeneous, with sensitivity ranging from 16.4 to 100.0%, specificity between 40.0 and 98.3% and accuracy between 44.0 and 92.0%. Less heterogeneity was observed when clinicians worked in unison with AI, with sensitivity ranging between 83.3 and 100.0%, specificity between 83.7 and 87.3%, and accuracy between 86.4 and 86.9%. Conclusion: Instead of focusing on the performance of AI versus clinicians for classifying melanoma, more consistent performance has been obtained when clinicians' work is supported by AI, facilitating management decisions and improving health outcomes. [ABSTRACT FROM AUTHOR]

Background The Nurse-Family Partnership (NFP) is a home visiting program serving first-time, low-income mothers, with an area of focus on healthy early childhood development. Previous foundational trials of program effect on breastfeeding and immunizations have shown a mix of neutral and positive results. The present evaluation investigates these effects following program scale-up, using a large contemporary cohort of clients. Methods Nurse-Family Partnership client breastfeeding and immunization status were compared to National Survey of Children's Health data and National Immunization Survey data, respectively. Sample differences in demographic covariates were adjusted using logistic regression. Results Nurse-Family Partnership clients were significantly more likely to have ever breastfed (adjusted prevalence ratio [aPR: 1.20 (1.17, 1.23)] and maintain breastfeeding at 6 [aPR: 1.17 (1.10, 1.24)] and 12 [aPR: 1.39 (1.25, 1.53)] months, but less likely to exclusively breastfeed at 6 months [aPR: 0.84 (0.70, 0.95)] NFP clients were significantly more likely to be up-to-date on immunizations at 6 [aPR: 1.23 (1.22, 1.25)], 18 [aPR: 1.33 (1.30,1.35)], and 24 [aPR: 1.15 (1.14, 1.16)] months of age than the reference cohort, with no significant difference at 12 months. Discussion Nurse-Family Partnership clients had more beneficial breastfeeding and immunization outcomes than children of mothers with demographically similar profiles. However, exclusive breastfeeding at 6 months lags behind the reference sample and represents a potential area for further improvement., Author(s): William Thorland [sup.1] , Dustin Currie [sup.1] [sup.2] , Emily R. Wiegand [sup.3] , Joe Walsh [sup.4] , Nick Mader [sup.3] Author Affiliations: (1) Nurse-Family Partnership, National Service Office, [...]

In the United States, Paralympic sport is governed by the United States Olympic Committee (USOC), as set forth in the Ted Stevens Olympic and Amateur Sports Act of 1998. The USOC formed a dedicated Paralympic Division in 2001 to manage this responsibility in close cooperation with other USOC divisions and many of the sport-specific national governing bodies such as USA Archery and USA Hockey. Together, the USOC and the national sport-specific organizations execute a plan to secure slots for the United States in Paralympic competitions and then select the top athletes to represent the United States at each edition of the games. This article describes how athletes with disabilities gain access to sports and recreation opportunities and how the USOC and a number of other organizations support them in their respective sports. (Contains 1 table.)