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Purpose: Literature limited in scope regarding the incorporation of sustainability into engineering curriculum encouraged authors to look at the current approaches of universities to the integration of sustainability into university curricula. The purpose of this study is to evaluate the literature published and analyse the university secondary data (information published on the university websites and magazines and programme catalogues) to understand the current status of Australian universities regarding the integration of sustainability in engineering. Design/methodology/approach: Articles and reports from different trustworthy sources have been analysed in this study. A text mining methodology was used to gather information from websites, magazines and programme catalogues. Findings: Obtained information and data indicate that the universities are considering sustainability seriously with both internal and external stakeholders of universities working towards embedding sustainability in engineering curricula. Most of the Australian universities have successfully implemented sustainable engineering education and the rest are focussing on integrating sustainability into their engineering education curriculum. Originality/value: This is the first review, which focusses on incorporating sustainability into the engineering education of Australian universities. However, considering current progress and also some drawbacks of the universities regarding the integration of sustainability into engineering curriculum, 15 future research questions have been developed, which should be considered to make the integration process more efficient and equip engineers who would be able to engage and tackle the environmental, personal, social and economic challenges of the twenty-first century.

The current study examined the associations between perceived actual-ideal discrepancies in facial and bodily attributes and adolescent girls' appearance satisfaction and whether these relationships were moderated by the importance associated with the attributes and/or the country of the participants. A multilingual survey was completed by 900 girls aged 12–18 years old living in Australia, China, India, and Iran. Girls in India and Iran were most satisfied with their appearance followed by girls in China and Australia. Iranian girls had the highest perceived actual-ideal discrepancies in facial and bodily attributes. Chinese and Indian girls perceived their facial attributes to be more important to their overall sense of appearance than their bodily attributes, whereas Australian and Iranian girls valued them equally. Higher perceived actual-ideal facial discrepancies were related to lower appearance satisfaction only for Iranian girls and higher perceived bodily discrepancies were linked to lower appearance satisfaction only for Australian girls. The importance associated with physical attributes and/or the country of participants did not moderate the relationship between perceived discrepancies and appearance satisfaction for facial or bodily attributes. Findings underscore the critical role of cultural nuances in understanding body image among adolescent girls and determinants of appearance satisfaction. [ABSTRACT FROM AUTHOR]

Aim: In wide‐ranging taxa occupying broad climate gradients, alternative colour pattern variants (i.e. morphs) may emerge as an adaptive response to local climatic regimes. We explore the patterns of geographical segregation among colour morphs of the Lace monitor and determine whether morphs occupy divergent climatic niches along a mesic–arid gradient. Location: Eastern and south‐eastern Australia. Taxon: Varanus varius. Methods: We compiled a dataset of crowdsourced, georeferenced photographic records (n = 1637) of V. varius and scored each photographed lizard as one of two discrete colour pattern phenotypes—Lace morph (mostly dark with fine pale patterning) or Bell's morph (broad yellow and black bands). We then analysed the geographical segregation of colour morphs under an exploratory point‐pattern process analysis framework. Finally, we quantified similarities and differences between each colour morphs' realised climatic niche in univariate and multivariate (i.e. Centroid shift, Overlap, Unfilling, and Expansion and n‐dimensional hypervolume frameworks) environmental space. Results: While both morphs co‐occur over much of the species' range, there is a coastal–inland clinal transition in the relative densities of the morphs' occurrences—the Bell's morph becomes the more prevalent phenotype towards inland locations and is rare or absent towards coastal regions. Analysis of the realised climatic niches shows that the Bell's morph exploits areas that are relatively more arid, receive more solar irradiation and experience a broader range of thermal extremes than those occupied by the Lace morph. Main conclusions: The mesic–arid transition zone in eastern Australia is a primary axis of environmental variation over which geographical variation in colour polymorphism has emerged in V. varius. More broadly, this study demonstrates how photographs from citizen science platforms can be used to explore geographical variation in colour polymorphisms without needing to conduct expensive, time‐consuming field studies on wild organisms. [ABSTRACT FROM AUTHOR]

As a biomarker for liver disease, bilirubin has been utilized in prognostic scoring systems for cirrhosis. While laboratory-based methods are used to determine bilirubin levels in clinical settings, they do not readily lend themselves to applications outside of hospitals. Consequently, bilirubin monitoring for cirrhotic patients is often performed only intermittently; thus, episodes requiring clinical interventions could be missed. This work investigates the feasibility of measuring bilirubin concentration in whole porcine blood samples using dual-wavelength transmission measurement. A compact and low-cost dual-wavelength transmission measurement setup is developed and optimized to measure whole blood bilirubin concentrations. Using small volumes of whole porcine blood (72 µL), we measured the bilirubin concentration within a range corresponding to healthy individuals and cirrhotic patients (1.2–30 mg/dL). We demonstrate that bilirubin levels can be estimated with a positive correlation (R-square > 0.95) and an accuracy of ±1.7 mg/dL, with higher reliability in cirrhotic bilirubin concentrations (> 4 mg/dL) – critical for high-risk patients. The optical and electronic components utilized are economical and can be readily integrated into a miniature, low-cost, and user-friendly system. This could provide a pathway for point-of-care monitoring of blood bilirubin outside of medical facilities (e.g., patient's home). [ABSTRACT FROM AUTHOR]

The diffusive and nonspecific nature of nonpoint source contaminants such as sediment makes their management and mitigation challenging. Conventional source‐based tracing techniques for sediment simply apportion downstream sediment load to diffuse upstream sources classified by a limited number of source types including underlying rock type, land cover, and/or erosion process. Here, we develop a grid‐based sediment tracing technique that improves the precision of source contribution estimates and enhances the granularity of sediment source maps. We test the proposed technique using source and suspended sediment samples collected from the Emu Creek Catchment (911 km2), south‐east Queensland, Australia. Geochemical tracers were employed to distinguish sediments derived from the heterogenous and complex underlying rock types. Importantly, the proposed technique provided a greater spatial resolution of the sediment sources by assigning sediment contributions into grid sources rather than the area‐specific source types. [ABSTRACT FROM AUTHOR]

Sediment tracing using geochemical properties is an efficient way to identify the spatial sources of transported sediments delivered to waterways. Here, the contribution of soil sources to river bed sediments has been quantified in Emu Creek, a headwater catchment in south eastern Queensland, Australia. Soil samples were collected from the eight major rock types present in the catchment and were related to river bed sediments collected from eight sites along the main channel. Geochemistry, as characterized by 39 elemental concentrations, was measured using inductively coupled plasma mass spectrometry and inductively coupled plasma optical emission spectrometry. Three particle size fractions were examined, <10, 10-63 and 63-212 µm, with the three resultant mixing models showing divergent results. We conclude that the results of sediment mixing models based on the analysis of one grain size should not be assumed to apply across the entire particle size range of transported sediment, emphasizing the need to match the size fraction used in tracing studies to that size fraction of interest in downstream sinks. Furthermore, we present results highlighting the control transport distance plays in source dominance, with this particularly evident in the coarser fraction, where local sources dominate over more distant sources. Copyright © 2015 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Metropolitan planning strategies are a critical tool for achieving urban sustainability. The last significant evaluation of metropolitan strategies in Australia was undertaken in 2004. In this review it was identified that the sustainability construct is filtrating into the strategic understanding of planning. However, it was inconclusive whether these early signs of incorporating the sustainability imperative would be consolidated within the emergent wave of Australian metropolitan planning. Since the evaluation, state governments have released updated metropolitan planning strategies for the nation's five major urban regions, and in 2011, a new national urban policy was released by the federal government. It is timely to reconsider whether the concept of sustainability has been consolidated into this new wave of metropolitan planning strategies, something that Gleesonet al. observed was emerging. The aim of the paper is, therefore, to ascertain current positions on environmental sustainability in five Australian metropolitan planning strategies and the National Urban Policy. We argue that both the state and federal governments' policy documents in fact offer little in transformative change, but offers seeds of change, or at least an alternative outlook towards positive change for a more sustainable society. [ABSTRACT FROM AUTHOR]

The role of population in and significance of population to sustainability discourse is not well understood. Population is rarely discussed as a sustainability issue in its own right, nor are the complexities surrounding population explored by sustainability scholars, despite the significant role population plays in progression towards just and sustainable societies. This paper draws on tools developed within sustainability literature to provide a political economy typology that classifies different perspectives on recurrent population issues into neoliberal, liberal, social democrat and radical categories. While the focus of this review paper is to understand the way in which key population issues are understood by thinkers from each of the four ideological categories in Australia, the typology offers a way forward to capturing the diversity of the arguments over population and how they sit within sustainability discourse in a form that remains sufficiently clear to make sense of the debate. This paper concludes with implications for further engagement with the population issue amongst sustainability scholars. [ABSTRACT FROM AUTHOR]

Background: Goal-directed fluid therapy (GDFT) has been shown to reduce complications and hospital length of stay following major surgery. However, there has been no assessment regarding its use in clinical practice. Methods: An electronic survey was administered to randomly selected anaesthetists from the United Kingdom (UK, n = 2000) and the United States of America (USA, n = 2000), and 500 anaesthetists from Australia/New Zealand (AUS/NZ). Preferences, clinical use and attitudes towards GDFT were investigated. Results were collated to examine regional differences. Results: The response rates from the UK (n = 708) and AUS/NZ (n = 180) were 35%, and 36% respectively. The response rate from the USA was very low (n = 178; 9%). GDFT use was significantly more common in the UK than in AUS/NZ (p < 0.01). The Oesophageal Doppler Monitor was the most preferred instrument in the UK (n = 362; h76%) with no clear preferences in other regions. GDFT was most commonly utilised in major abdominal surgery and for patients with significant comorbidities. The commonest reasons stated for not using GDFT were either lack of availability of monitoring tools (AUS/NZ: 57 (70%); UK: 94 (64%)) or a lack of experience with instruments (AUS/NZ: 43 (53%); UK: 51 (35%)). A subset of respondents (AUS/NZ: 22(27%); UK: 45 (30%)) felt GDFT provided no perceived benefit. Enthusiasm towards the use of GDFT in the absence of existing barriers was high. Conclusion: Several hypotheses were generated regarding important differences in the use of GDFT between anaesthetists from the UK and AUS/NZ. There is significant interest in utilising GDFT in clinical practice and existing barriers should be addressed. [ABSTRACT FROM AUTHOR]

House price growth in Australia has outstripped income growth to the point where more than one million low and middle income households are now experiencing housing stress. Moreover, social housing provision has been gradually wound back in Australia since the 1980s in favour of a residual model based on tax concessions and subsidies, that has exacerbated the problem. However innovative policies introduced in 2009 by the Australian Government in response to the global economic crisis suggest a change in direction that might offer new, affordable social housing in a difficult economic climate. This paper critically reviews affordable housing policy in Australia and new initiatives such as the National Affordable Housing Agreements. We conclude that current initiatives remain constrained by hastily implemented policies, a 'rush to build' and a reluctance to provide an ongoing commitment to social housing. [ABSTRACT FROM AUTHOR]

Sustainability is one of the most contested ideologies of our time because everyone acknowledges that it must occur but no one can agree on what needs to change in response. This is unsurprising, because objecting to the goal of sustainability is like objecting to other inherently good goals like peace or freedom. Responses to sustainability exist on a long continuum, with some interpreting sustainability to mean conservation-at-all-costs and reduced economic growth, while others suggest that the market will ensure sustainable outcomes eventually result. Further, sustainability can be easily manipulated to justify predetermined outcomes. There are, indeed, a multitude of conceptual and pragmatic challenges to operating on sustainability, particularly when the scale shifts from a global goal to local action. Using the application of sustainability to affordable housing in Australia as a case study, this article argues that rather than limiting sustainable outcomes, the existence of the sustainability debate which focuses on the many challenges is a positive indicator that sustainability may be attainable. [Copyright &y& Elsevier]

The article offers information on the causes and effects of early post-operative fever (EPOF) to individuals in Australia. The author mentions the EPOF is a fever that occurred 48 hours after surgery which temperature is above 38 temperature. Moreover, it states that EPOF is caused by pulmonary embolism and deep venous thrombosis.

Purpose: Numerous oncology units have separated outpatient appointments and chemotherapy delivery to another day (TOD) to improve efficiency. This survey assessed patient preferences for scheduling medical oncology outpatient appointments and chemotherapy delivery for either treatment delivered on the same day as the outpatient appointment (TSD) or TOD. Patients and Methods: Patients (N = 198) from two major metropolitan tertiary centers in Perth—Sir Charles Gairdner Hospital (n = 110) and Royal Perth Hospital (n = 88)—completed surveys from April 15 to May 24, 2013. Eligibility criteria included any adult patient with cancer receiving an intravenous chemotherapy or targeted agent who had completed ≥ two cycles of treatment or attended ≥ two chemotherapy appointments on a concurrent chemoradiotherapy program. Results: The majority of patients preferred TSD (85%) versus TOD. Convenience (50%) and distance or difficulty in transportation to hospital (25%) were the most common reasons for TSD preference. Current treatment schedule (odds ratio [OR], 59.2; 95% CI, 18.7 to 265.2) was significantly associated with treatment schedule preference. Younger age (58.3 v 65.2 years; P = .01) and presence of household dependents (OR, 4.2; 95% CI, 1.2 to 27.1) were also associated with TSD preference. Scheduling preference was not influenced by time prepared to wait for chemotherapy (χ(2)2 = 3.86; P = .14), with 44% and 39% of patients willing to wait up to 60 and 120 minutes, respectively. Almost all patients preferred chemotherapy delivery before 2 PM (99%). Conclusion: Patients preferred to receive chemotherapy on the same day as their medical oncology outpatient appointment. Morning delivery of chemotherapy was preferred. Meeting patients' expectations will present significant challenges to efficient service provision as caseloads increase. [ABSTRACT FROM AUTHOR]

Background: Nonalcoholic fatty liver disease (NAFLD) is a global health challenge, with a rising rate in line with other metabolic diseases. We aimed to assess the global prevalence of NAFLD in adult and pediatric populations., Methods: PubMed, Scopus and Web of Science databases were systematically searched up to May 2023. Heterogeneity was assessed using Cochran's Q test and I 2 statistics, and random-effects model was used for meta-analysis. Analyses were performed using STATA version 18., Results: A total of 479 studies with 78,001,755 participants from 38 countries were finally included. The global prevalence of NAFLD was estimated to be 30.2% (95% CI: 28.7-31.7%). Regionally, the prevalence of NAFLD was as follows: Asia 30.9% (95% CI: 29.2-32.6%), Australia 16.1% (95% CI: 9.0-24.8%), Europe 30.2% (95% CI: 25.6-35.0%), North America 29% (95% CI: 25.8-32.3%), and South America 34% (95% CI: 16.9-53.5%). Countries with a higher human development index (HDI) had significantly lower prevalence of NAFLD (coefficient = -0.523, p = 0.005). Globally, the prevalence of NAFLD in men and women was 36.6% (95% CI: 34.7-38.4%) and 25.5% (95% CI: 23.9-27.1%), respectively. The prevalence of NAFLD in adults, adults with obesity, children, and children with obesity was 30.2% (95% CI: 28.8-31.7%), 57.5% (95% CI: 43.6-70.9%), 14.3% (95% CI: 10.3-18.8%), and 38.0% (95% CI: 31.5-44.7%), respectively., Conclusion: The prevalence of NAFLD is remarkably high, particularly in countries with lower HDI. This substantial prevalence in both adults and children underscores the need for disease management protocols to reduce the burden., (Copyright © 2024 Instituto Mexicano del Seguro Social (IMSS). Published by Elsevier Inc. All rights reserved.)

The aim of this study was to evaluate the tripartite influence model of body image and disordered eating among 12-18-year-old girls (N = 900) living in Australia (n = 184), China (n = 293), India (n = 223), and Iran (n = 200). Participants completed measures about appearance pressures from family, peers, and media, thin-ideal internalization, appearance comparisons, appearance satisfaction, and disordered eating. Results indicated that media- pressures were most salient in Australia, whereas Iranians perceived family pressures to be the strongest. Indians felt the most pressure to look attractive from their family and peers, whereas Chinese felt similar levels of pressure from family, peers, and media. Path analyses suggested direct associations from one or more sociocultural factors to appearance satisfaction or disordered eating, with indirect paths via thin-ideal internalization and appearance comparisons emerging in all countries. Certain sociocultural factors contributed more strongly to the internalization of ideals and appearance comparisons within some countries. Multigroup path analyses demonstrated some cross-cultural variations in the strength of the pathways. Findings extend cross-cultural support for a modified tripartite influence model emphasizing culture-based specificities that can further guide preventative efforts to improve body image and eating attitudes among young girls in these four countries., Competing Interests: Declaration of Competing Interest None., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Purpose: The risk of treatment-related toxicity is important for patients with localised prostate cancer to consider when deciding between treatment options. We developed a model to predict hospitalisation for radiation-induced genitourinary toxicity based on patient characteristics., Methods: The prospective South Australian Prostate Cancer Clinical Outcomes registry was used to identify men with localised prostate cancer who underwent curative intent external beam radiotherapy (EBRT) between 1998 and 2019. Multivariable Cox proportional regression was performed. Model discrimination, calibration, internal validation and utility were assessed using C-statistics and area under ROC, calibration plots, bootstrapping, and decision curve analysis, respectively., Results: There were 3,243 patients treated with EBRT included, of which 644 (20%) patients had a treated-related admission. In multivariable analysis, diabetes (HR 1.35, 95% CI 1.13-1.60, p < 0.001), smoking (HR 1.78, 95% CI 1.40-2.12, p < 0.001), and bladder outlet obstruction (BOO) without transurethral resection of prostate (TURP) (HR 7.49, 95% CI 6.18-9.08 p < 0.001) followed by BOO with TURP (HR 4.96, 95% CI 4.10-5.99 p < 0.001) were strong independent predictors of hospitalisation (censor-adjusted c-statistic = 0.80). The model was well-calibrated (AUC = 0.76). The global proportional hazards were met. In internal validation through bootstrapping, the model was reasonably discriminate at five (AUC 0.75) years after radiotherapy., Conclusions: This is the first study to develop a predictive model for genitourinary toxicity requiring hospitalisation amongst men with prostate cancer treated with EBRT. Patients with localised prostate cancer and concurrent BOO may benefit from TURP before EBRT., (© 2022. Crown.)

Introduction: Stroke reperfusion therapies, comprising intravenous thrombolysis (IVT) and/or endovascular thrombectomy (EVT), are best practice treatments for eligible acute ischemic stroke patients. In Australia, EVT is provided at few, mainly metropolitan, comprehensive stroke centres (CSC). There are significant challenges for Australia's rural and remote populations in accessing EVT, but improved access can be facilitated by a 'drip and ship' approach. TACTICS (Trial of Advanced CT Imaging and Combined Education Support for Drip and Ship) aims to test whether a multicomponent, multidisciplinary implementation intervention can increase the proportion of stroke patients receiving EVT., Methods and Analysis: This is a non-randomised controlled, stepped wedge trial involving six clusters across three Australian states. Each cluster comprises one CSC hub and a minimum of three primary stroke centre (PSC) spokes. Hospitals will work in a hub and spoke model of care with access to a multislice CT scanner and CT perfusion image processing software (MIStar, Apollo Medical Imaging). The intervention, underpinned by behavioural theory and technical assistance, will be allocated sequentially, and clusters will move from the preintervention (control) period to the postintervention period., Primary Outcome: Proportion of all stroke patients receiving EVT, accounting for clustering., Secondary Outcomes: Proportion of patients receiving IVT at PSCs, proportion of treated patients (IVT and/or EVT) with good (modified Rankin Scale (mRS) score 0-2) or poor (mRS score 5-6) functional outcomes and European Quality of Life Scale scores 3 months postintervention, proportion of EVT-treated patients with symptomatic haemorrhage, and proportion of reperfusion therapy-treated patients with good versus poor outcome who presented with large vessel occlusion at spokes., Ethics and Dissemination: Ethical approval has been obtained from the Hunter New England Human Research Ethics Committee (18/09/19/4.13, HREC/18/HNE/241, 2019/ETH01238). Trial results will be disseminated widely through published manuscripts, conference presentations and at national and international platforms regardless of whether the trial was positive or neutral., Trial Registration Number: ACTRN12619000750189; UTNU1111-1230-4161., Competing Interests: Competing interests: Boehringer Ingelheim is the manufacturer of the tissue plasminogen activator (tPA) drug and thus has an interest in the study. They, however, have no right to publish any results arising from this trial., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Anecdotal evidence reveals that medical equipment are easily found in hospital changing rooms. Access to potentially lethal drugs and intravenous access equipment may put vulnerable medical staff at risk. The aims are to quantify the burden of medical equipment found in this environment, calculate the associated cost burden and to raise clinician awareness about a potential health hazard., Methods: We prospectively collected data on the medical paraphernalia found in surgical changing rooms from one private and two public hospitals in South Australia over 2 months. We systematically searched open surgical lockers, benches and floors in male and female lockers rooms. Item costs were calculated from Imprest and the Pharmacy Department., Results: During the study period, we found a total of 537 items. There were 280 sharps, including 185 scalpels found in one open locker. There were 78 items of intravenous paraphernalia, 38 surgical tapes, 70 bandages and 73 miscellaneous items. In addition, there were six medications found including 3 × 5 mL vials of 1% lignocaine, one vial of lignocaine with adrenaline, one ketorolac suppository and 5 mL fentanyl. There were 529 (98.5%) items within their date of expiry. The total cost of the items was 2358 Australian dollars (AUD), with an estimated annual cost of 14 148 AUD over the three sites and 424 400 AUD over South Australia., Conclusion: The burden of available medical supplies found in the theatre changing room is high and worrisome. Strategies for appropriate disposal and safe storage of medical equipment are required., (© 2020 Royal Australasian College of Surgeons.)

Introduction: Designing and funding chemotherapy care to meet patient expectations is challenging. Issues including convenience, outcomes, cost, and continuity of care are all potentially important and the appropriate trade-off between them is not clear. Regions with significant geographic spread and concentration of care in metropolitan areas pose a particular problem as ensuring low-cost convenient care is potentially difficult. However, the relative value of different aspects of chemotherapy are as yet unknown. The objective of this work is to quantify the relative value of different aspects of chemotherapy service delivery in an older Australian general population sample., Methods: A discrete choice experiment was administered in an older Australian general population sample without cancer. The survey approach asks a series of hypothetical choice tasks and allows estimation of the relative value of different aspects of care. Analysis considered the average respondent, and then also explored the level of preference divergence across the population., Results: One thousand and sixty-two individuals provided data and were included in the analysis. There was a strong population preference for home-based chemotherapy, for follow-up by a specialist, for psycho-social support, and for low cost care., Conclusion: These strong population preferences should be considered when designing chemotherapy care. This poses a significant challenge, both logistically and financially. However, this information can help policy makers identify the components of good value care.

Background: Cancers comprise a significant proportion of urologic workload. The epidemiology of prostate and renal cancers is well described. We report the incidence, survival and predictors of survival for non-prostate, non-renal urologic cancers between 1977 and 2013., Methods: All patients in the South Australian Cancer Registry diagnosed with bladder, testis, penis, renal pelvis, ureteric and other male genital organ cancers between 1977 and 2013 were included. Demographic data included age, sex, year of diagnosis, grade, and metropolitan/rural status. Changes in incidence, survival and predictors of survival are reported for each cancer type., Results: Between 1977 and 2013, bladder cancer was the most common of the studied urologic cancers (6465/9317). Age standardized incidence rate for bladder cancer decreased from 15.6-9.0 per 100,000 in 2013 (Annual Percentage Change (APC) -0.97 %, p < 0.05 %). Between 1977 and 2013 mortality has increased in patients with bladder cancer (HR 1.01 per year, p = 0.004). Testicular cancer diagnoses increased from 1.7 to 4.7 per 100,000 through 1977-2012 (APC 2.41 %, p < 0.05 %). Survival has increased (HR 0.95 per year, p < 0.001). Incidence of penile cancers has increased from 0.23 to 0.46 per 100,000 (APC 2.8 %); Penile cancer survival has remained static (HR 1.02 p = 0.23).Five and ten year survival estimates were highest for testicular cancer - 93.4 % and 91.1 % respectively; and lowest for renal pelvis - 36.3 % and 24.6 %., Conclusion: The incidence of non-prostate, non-renal urologic cancers remains low and stable. The age-standardized incidence of testicular cancer has increased whilst there has been a decline in the age-standardized incidence of bladder cancer. Bladder cancer survival has decreased since the 1970s., Competing Interests: Declaration of Competing Interest None., (Crown Copyright © 2020. Published by Elsevier Ltd. All rights reserved.)

Introduction: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder with no known cure and with an average life expectancy of 3-5 years post diagnosis. The use of complementary medicine such as medicinal cannabis in search for a potential treatment or cure is common in ALS. Preclinical studies have demonstrated the efficacy of cannabinoids in extending the survival and slowing of disease progression in animal models with ALS. There are anecdotal reports of cannabis slowing disease progression in persons with ALS (pALS) and that cannabis alleviated the symptoms of spasticity and pain. However, a clinical trial in pALS with these objectives has not been conducted., Methods and Analysis: The Efficacy of cannabis-based Medicine Extract in slowing the disease pRogression of Amyotrophic Lateral sclerosis or motor neurone Disease trial is a randomised, double-blind, placebo-controlled cannabis trial in pALS conducted at the Gold Coast University Hospital, Australia. The investigational product will be a cannabis-based medicine extract (CBME) supplied by CannTrust Inc., Canada, with a high-cannabidiol-low-tetrahydrocannabinol concentration. A total of 30 pALS with probable or definite ALS diagnosis based on the El Escorial criteria, with a symptom duration of <2 years, age between 25 and 75years and with at least 70% forced vital capacity (FVC) will be treated for 6 months. The primary objective of the study is to evaluate the efficacy of CBME compared with placebo in slowing the disease progression measured by differences in mean ALS Functional Rating Scale-Revised and FVC score between the groups at the end of treatment. The secondary objectives are to evaluate the safety and tolerability of CBME by summarising adverse events, the effects of CBME on spasticity, pain, weight loss and quality of life assessed by the differences in mean Numeric Rating Scale for spasticity and Numeric Rating Scale for pain, percentage of total weight loss and ALS specific quality of life-Revised questionnaire., Ethics and Dissemination: The study has been approved by the local Institutional Review Board. The results of this study will be published in a peer-reviewed journal., Trial Registration Number: NCT03690791., Competing Interests: Competing interests: The investigational product has been provided by CannTrust Inc., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background and Purpose: Uncertainty exists over whether quality improvement strategies translate into better health-related quality of life (HRQoL) and survival after acute stroke. We aimed to determine the association of best practice recommended interventions and outcomes after stroke., Methods: Data are from the Australian Stroke Clinical Registry during 2010 to 2014. Multivariable regression was used to determine associations between 3 interventions: received acute stroke unit (ASU) care and in various combinations with prescribed antihypertensive medication at discharge, provision of a discharge care plan, and outcomes of survival and HRQoL (EuroQoL 5-dimensional questionnaire visual analogue scale) at 180 days, by stroke type. An assessment was also made of outcomes related to the number of processes patients received., Results: There were 17 585 stroke admissions (median age 77 years, 47% female; 81% managed in ASUs; 80% ischemic stroke) from 42 hospitals (77% metropolitan) assessed. Cumulative benefits on outcomes related to the number of care processes received by patients. ASU care was associated with a reduced likelihood of death (hazard ratio, 0.49; 95% confidence interval, 0.43-0.56) and better HRQoL (coefficient, 21.34; 95% confidence interval, 15.50-27.18) within 180 days. For those discharged from hospital, receiving ASU+antihypertensive medication provided greater 180-day survival (hazard ratio, 0.45; 95% confidence interval, 0.38-0.52) compared with ASU care alone (hazard ratio, 0.64; 95% confidence interval, 0.54-0.76). HRQoL gains were greatest for patients with intracerebral hemorrhage who received care bundles involving discharge processes (range of increase, 11%-19%)., Conclusions: Patients with stroke who receive best practice recommended hospital care have improved long-term survival and HRQoL., (© 2017 American Heart Association, Inc.)

The dingo (Canis lupus dingo) is an iconic animal in the native culture of Australia, but archaeological and molecular records indicate a relatively recent history on the continent. Studies of mitochondrial DNA (mtDNA) imply that the current dingo population was founded by a small population of already tamed dogs from Southeast Asia. However, the maternal genetic data might give a unilateral picture, and the gene pool has yet to be screened for paternal ancestry. We sequenced 14,437 bp of the Y-chromosome (Y-chr) from two dingoes and one New Guinea Singing Dog (NGSD). This positioned dingo and NGSD within the domestic dog Y-chr phylogeny, and produced one haplotype not detected before. With this data, we characterized 47 male dingoes in 30 Y-chr single-nucleotide polymorphism sites using protease-mediated allele-specific extension technology. Only two haplotypes, H3 and H60, were found among the dingoes, at frequencies of 68.1 and 31.9 %, respectively, compared to 27 haplotypes previously established in the domestic dog. While H3 is common among Southeast Asian dogs, H60 was specifically found in dingoes and the NGSD, but was related to Southeast Asian dog Y-chr haplotypes. H3 and H60 were observed exclusively in the western and eastern parts of Australia, respectively, but had a common range in Southeast. Thus, the Y-chr diversity was very low, similar to previous observations for d-loop mtDNA. Overall genetic evidence suggests a very restricted introduction of the first dingoes into Australia, possibly from New Guinea. This study further confirms the dingo as an isolated feral dog.