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Background: To support collaborative drawing, it is essential to investigate how students make collaborative drawings and how these contribute to elaborating their ideas. This study examines how 5th and 6th grade students' group drawings contributed to increased levels of explanations of their drawings about sound transmission. Methods: We analyzed two cases of group drawing processes, that showed a large difference in the explanatory levels in their drawings, to find discourse patterns and visualized these patterns through discourse maps in relation to the progressions of drawing. Findings: In the first case, the students successfully co-constructed sound transmission drawings following Demand-Give-Acknowledge patterns. The students continuously questioned how to visualize particles' vibration, used multimodal resources to generate alternative drawings, and determined most scientific drawings. In the second case, the students did not reach consensus on how to visualize particles' vibrations, following repetitive patterns of Give-Refute. While the teacher intervened and mediated student's conflicting ideas, the students did not generate any alternative ideas. Contribution: This study illustrates in close detail how the process of multimodal transactive discussion contributed to conceptual understanding during collaborative drawings. The discourse map may be instrumental to analyze students' collaboration systematically and devise pedagogical approaches.

In this paper, we build on southern and decolonial theories of multilingualism and invite a south-north conversation through a concept we propose as "reciprocal multilingual awareness." Reciprocity is a core value of southern societies that balance pluralities of episteme, language, and communality. Central features of southern multilingualisms, including transknowledging (reciprocal exchanges and translation of knowledge), and linguistic citizenship (the exercise of linguistic agency and choice), are usual moves that people make every day. Here, we lift forward southern reciprocities and linguistic citizenship together in conversation with northern conceptualisations of "multilingual awareness." We draw attention to the "longue durée" of expertise and knowledge of multilingualism in post-colonial societies to invite conversation with critical multilingual language awareness (CMLA) as a contribution to this special issue. In this frame, we recognise the potential in 'multilingual awareness' for a dynamic and reciprocal process situated within specific place, time and ideology. We offer eirical experiences of multilingual reciprocities from Australia and Brazil in which community, student and teacher agency are foregrounded to illustrate and amplify southern theorisation of multilingualisms and linguistic citizenship. In conceptualising "reciprocal multilingual awareness as a practice of linguistic citizenship" our primary concern is to offer a contribution to teacher education that can more fully engage with organic, community and student-generated language ideologies.

This study investigates the potential of "VoiceThread" (VT) as a learning tool in order to enhance learners' performance and confidence, and to provide the basis for continuing independent practice. The participants were students from culturally and linguistically diverse backgrounds on a 10-week English for Academic Purposes (EAP) programme in academic speaking and listening skills in an Australian university. Students carried out a weekly extended speaking task in the form of an academic presentation, on a theme/topic related to their own interests. To prepare for this they used VT to record and rehearse their presentation, uploading their recordings to the Learning Management System for other students to listen to, and for the teacher to provide individual feedback. The recordings were analysed in relation to a number of features to measure utterance fluency, including speed, repairs and pauses. Questionnaires were used to investigate students' perceptions of the value of the task, of their performance on the task, and of changes in their performance and confidence over time. Interviews were used to investigate the potential of recording and rehearsal for long term independent practice. The study involved a total of 34 students in 10 week courses, 22 students using the "VoiceThread" software, and 12 students in a comparison class following the same curriculum, but without the "VoiceThread" software. The results suggest that, over time, regular VT tasks help students develop their performance and confidence in spoken English. Such voice-recording activities have the potential to improve oral performance by encouraging independent practice of oral activities, and so tackling the limitations on time, practice and feedback inherent in classroom-based courses.

The number of Saudi female international students (SFISs) pursuing higher degrees in Western countries has increased dramatically. Many are faced with unusual challenges, especially acting without a male's permission, interacting with males, and using an open, free Internet. This article proposes that SFISs experience a "digital shift" whereby their cultural, educational, and digital backgrounds impact their information-seeking behavior in Australia. The study used a qualitative interpretivist methodology, interviewing a diverse group of SFISs studying in Australia, to better understand this impact on their everyday information needs and use of information sources. Findings indicate that SFISs' imperfect online search skills, exacerbated by English language deficiency, increase their challenges. Recommendations for supporting SFISs are offered for institutions and service providers.

Key findings, analysis and recommendations that have emerged from a research project, 'Using Human Language Technology to enhance academic integrity, inclusivity, knowledge exchange, student diversity and retention' at the University of South Australia conducted in 2019 are discussed in this article. The primary purpose of the project was to address some of the challenges and opportunities afforded by increasing student and teacher diversity at a predominantly English-medium Australian university through newly enhanced human language translation technology (HLT) also known as machine translation (MT). This technology is frequently used for the translation of human language, and it falls under the umbrella of Artificial Intelligence (AI) technologies. From the institution's perspective, key aims of the project were to contribute to the university's Digital Learning Strategy priorities and core values embedded in a structural transformation of the university. These include integrity, accountability, diversity, social justice, engagement and collaboration. The researchers' objectives focussed on multilingual pedagogies using HLT to support knowledge exchange (transknowledging), and translanguaging for all students. These disrupt inequitable hierarchies, and position bi-/multilingual students as valuable resources for monolingual staff and students.

This paper argues that meaning-making with multimodal representations in science learning is always contextualized within a genre and, conversely, what constitutes an ongoing genre also depends on a multimodal coordination of speech, gesture, diagrams, symbols, and material objects. In social semiotics, a genre is a culturally evolved way of doing things with language (including non-verbal representations). Genre provides a useful lens to understand how a community's cultural norms and practices shape the use of language in various human activities. Despite this understanding, researchers have seldom considered the role of scientific genres (e.g., experimental account, information report, explanation) to understand how students in science classrooms make meanings as they use and construct multimodal representations. This study is based on an enactment of a drawing-to-learn approach in a primary school classroom in Australia, with data generated from classroom videos and students' artifacts. Using multimodal discourse analysis informed by social semiotics, we analyze how the semantic variations in students' representations correspond to the recurring genres they were enacting. We found a general pattern in the use and creation of representations across different scientific genres that support the theory of a mutual contextualization between genre and representation construction.

This study attempts to determine the choice of the feedback model related to discipline categorised as hard-applied, soft-applied, hard-pure and soft-pure. It also attempts to explore the extent in which the lecturers practise socio-constructivist feedback. It was a non-experimental study conducted in an offshore campus in Malaysia of an established Australian university. The data were collected by six research assistants through semi-structured interviews involving 31 lecturers from all the seven Schools in the university. The data were transcribed and analysed using the framework method as a form of thematic analysis. Since it was a deductive study, academic disciplines were used as pre-selected themes and in each feedback category, there were pre-defined codes. The results reveal that there is no serious evidence to link discipline to the choice of feedback model. In addition, lecturers do practise socio-constructivist feedback as well as other variants of feedback.

International students' capacity to undertake a digital journey to embrace new digital resources has real life implications in terms of their ability to adjust to their new environment. This article explores links between international students' use of online social networking sites and their social networks, including drawing on digital resources beyond only those from their home country. Given the increased focus on online learning and engagement with students in higher education, there is an even greater need to examine students' digital journeys, in terms of their capacity to navigate both their academic worlds and everyday lives abroad. This article demonstrates that students continue to use a range of online sources from their home countries, even as they transition to their new lives in Australia. This has implications for the way institutions communicate with international students more broadly.

This study explores the use of a Moodle-based electronic textbook (e-textbook) created for an on-campus intensive academic writing course. The role of the e-textbook in facilitating collaborative writing practice and developing academic digital literacy skills as part of a blended learning approach is investigated. The study involved 83 students used the e-textbook over a period of 10 weeks. Data from activities posted on the e-textbook web-site, e-learning journals, course evaluations, and the researchers' field notes and reflections based on classroom observations were analysed to explore 1) student reactions to the materials and the blended learning approach and 2) the effect on student writing practice and the development of academic literacy skills. The results identify practical, pedagogical, and affective aspects of student adaption to the e-textbook materials and to the blended learning approach. The intervention appears to have achieved its major aims, but further investigation is suggested, including of the role played by guidelines for creating e-textbooks.

Australian Aboriginal and Torres Strait Islander communities face complex challenges that require Indigenous-led research. Increasing the Indigenous research workforce depends on structural change within higher education institutions, including better pathways to research training and careers for Aboriginal and Torres Strait Islander students. Undergraduate research experiences can improve student success and encourage more students to progress to research programs and careers. The Kungullanji Summer Research Program offers research experiences for Australian Aboriginal and Torres Strait Islander undergraduates while recognizing their contributions to research. The Kungullanji program approach is a strengths-based research training framework that recognizes existing ability outside of institutional definitions of success and adapts to student needs with multi-layered support. The initial results suggest that this approach increases students' self-confidence and interest in conducting research.

Problem-based learning (PBL) has a history of producing strong educational results in engineering; however, global society is challenged by highly complex environmental, socio-political and technical problems summarised in the UN Sustainable Development Goals (SDGs). This obliges us to explore educational approaches that address complexity. Yet, confronting complexity is sometimes constrained within PBL structures. This conceptual paper posits practice-based education (PBE) as a whole-of-education approach embracing complexity. We present a PBE framework with three elements: (1) the context of an authentic engineering practice, (2) supporting learners' agency in the process of becoming professionals, and (3) opportunities to work and learn simultaneously. We make the case for innovative engineering education through the implementation of PBE using the case of the Engineering Practice Academy at Swinburne University of Technology. We detail innovations in student experience as a process of becoming, curriculum and assessment, and provide advice on the application of PBE elsewhere.

Skin and soft tissue reconstruction has long been based on the reconstructive ladder. However, a skin substitute has become popular due to its predictable outcomes, without donor-site morbidity. The biodegradable temporizing matrix (BTM; NovoSorb, PolyNovo Ltd., Port Melbourne, Australia) is a synthetic skin substitute that has recently gained its clinical application. Compared with those of other dermal templates, the clinical efficacy and performance of the BTM are not well established, especially among the Asian population. This study aims to share our experience and strategy of using BTM in various wound conditions. The data of patients who underwent skin and soft tissue reconstruction with BTM at a single institution between January 2022 and December 2023 were reviewed. The patient demographics, wound characteristics, surgical details, secondary procedures, and complications were recorded and analyzed. Postoperative 6-month photographs were collected and independently evaluated by two plastic surgeons and two wound care center nurses using the Manchester Scar Scale (MSS). This study included 37 patients, consisting of 22 males and 15 females with a mean age of 51.8 years (range, 18–86 years old). The wound etiologies included trauma (67.6%), necrotizing soft tissue infection (16.2%), burns (10.8%), toe gangrene (2.7%), and scar excision (2.7%). The average wound area covered by BTM was 50.6 ± 47.6 cm2. Among the patients, eight received concomitant flap surgery and BTM implantation, 20 (54.1%) underwent subsequent split-thickness skin grafts (STSG), and 17 had small wounds (mean: 21.6 cm2) healed by secondary intention. Infection was the most common complication, affecting six patients (n = 6 [16.2%]), five of whom were treated conservatively, and only one required debridement. Thirty-three patients (89.2%) had good BTM take, and only four had BTM failure, requiring further reconstruction. At the last follow-up, 35 out of the 37 patients (94.6%) achieved successful wound closure, and the total MSS score was 10.44 ± 2.94, indicating a satisfactory scar condition. The patients who underwent BTM grafting without STSG had better scar scores than those who received STSG (8.71 ± 2.60 vs. 11.18 ± 2.84, p = 0.039). In conclusion, the BTM is effective and feasible in treating various wounds, with relatively low complication rates, and it can thus be considered as an alternative for skin and soft tissue reconstruction. When combined with adipofasical flap reconstruction, it achieves a more comprehensive anatomical restoration. [ABSTRACT FROM AUTHOR]

Purpose: Emergency and disaster management planning is an emerging role with limited practical guidance on how it should be implemented by community, disability, health and rehabilitation service providers. This study examined the emergency preparedness of service providers and how they viewed their role and contributions to disaster risk reduction, including their capacity and willingness to facilitate preparedness planning with their clients. Materials and Methods: A questionnaire was developed and administered nationally. Descriptive statistics, multivariate regression analyses, and thematic analysis of open-ended questions provide insight on the knowledge, tools and training needs of service providers to contribute to preparedness of themselves and the people they support. Results: Facilitating emergency preparedness with people with disability was strongly associated with a high level of mental preparedness, household preparedness scores, and completion of Person-Centred Emergency Preparedness (P-CEP) training. Perceived lack of funding, insufficient tools, and exclusion of emergency planning from job descriptions were negatively associated with facilitating emergency preparedness with clients. Conclusions: Study findings lay the groundwork for development of the role and capabilities of individual service providers including the need to equip disability, health and rehabilitation service providers with training and tools to prepare themselves and the people they support for emergencies. IMPLICATIONS FOR REHABILITATION: Participation in emergency training such as psychological first aid, evacuation drills, and Person-Centred Emergency Preparedness (P-CEP) can increase the personal preparedness of service providers. Rehabilitation professionals are advised to develop their capabilities in emergency preparedness before facilitating emergency planning with their clients. Rehabilitation professionals should connect with their local emergency services to learn about disaster risks and preparedness actions they can take to increase personal emergency preparedness for themselves and their clients. [ABSTRACT FROM AUTHOR]

The role of species interactions in setting species range limits is rarely empirically explored. Here, we quantify host and parasite densities in subtropical eastern Australia (26.65°–30.20°S) to examine whether parasitism might contribute to range limitation of Acropora corals at their cold-range boundary. 79% of Acropora corals had endolithic barnacles (family Pyrgomatidae), with higher parasite load in larger corals and up to 141 barnacles per coral. Parasite load increased poleward and closer to the mainland and was greater in cooler and high nutrient environments. Parasite burden was higher at sites with fewer Acropora corals, broadly consistent with the hypothesis that parasites can fragment host populations where host densities are low, and the parasite is a better disperser than the host. Whilst the mechanism is unclear, our findings suggest that at the high densities recorded here, coral-barnacles could influence range dynamics of Acropora corals at their poleward range limit. [ABSTRACT FROM AUTHOR]

The purpose of this Delphi-study was to establish the face and content validity of 10 movement skills, each with four evaluation criteria, to create the Children Focused Injury Risk Screening Tool (ChildFIRST) for 8-12-year-old children. We asked an international expert panel (n = 22) to validate a series of movement skills and evaluation criteria. This Delphi-process consisted of three rounds. In the first two rounds, the experts scored the movement skills and evaluation criteria using 5-point Likert scales. Consensus on validating an item was achieved when 75% or more of the experts scored "Agree" or "Strongly Agree." In the third-round, the experts ranked and established the final list with the validated movement skills and evaluation criteria. This study provided preliminary validity evidence for 10 movement skills, each with four evaluation criteria, to create the ChildFIRST. The ChildFIRST is designed to be used to evaluate movement competence and risk of musculoskeletal injury.

The purpose of this study is to investigate the process of students' construction of scientific explanations through drawing explanatory diagrams. For this, we observed fifth and sixth graders' drawing processes in a gifted science class involving learning physics concepts in mechanics. The analysis was carried out on three pictorial representational levels: sensory (e.g. observed materials), unseen substance (e.g. molecules) and unseen non-substance (e.g. forces). We found that there were five patterns of interplay depending on the sequential path through the pictorial representational levels. All students began drawing explanatory diagrams from the sensory level as the first step and then constructed explanations using the unseen levels based on the interplay among different levels. In the process of forming meaningful relationships among the three levels of representation, students focused on a specific phenomenon through drawing at a sensory level and extended their making sense of the phenomenon from what happened to why it happened. Based on these findings, we suggest how teachers can use the interplay among the different pictorial representational levels to guide students in generating scientific explanations through drawing.

This paper explores the role of identity in helping international students form social networks at an Australian institution and how these networks contribute to creating a sense of home away. The findings suggest that international students form distinct social networks that are not necessarily solely made up of fellow students from their home countries. Rather, international students form a mixture of social networks that are based on the complex individual identities of each student centred on a variety of common factors, such as: course of study, place of work, neighbourhood, culture, religion and personal interests (hobbies). Hence many students are part of social groups that consist of international students from their specific region and beyond, as well as local (Anglo and non-Anglo) students. These locally based social networks complement existing home-based networks which are maintained virtually through social media to create a home away from home.

From a social semiotic perspective, image designs in science textbooks are inevitably influenced by the sociocultural context in which the books are produced. The learning environments of Australia and Taiwan vary greatly. Drawing on social semiotics and cognitive science, this study compares classificational images in Australian and Taiwanese junior high school science textbooks. Classificational images are important kinds of images, which can represent taxonomic relations among objects as reported by Kress and van Leeuwen ("Reading images: the grammar of visual design," 2006). An analysis of the images from sample chapters in Australian and Taiwanese high school science textbooks showed that the majority of the Taiwanese images are covert taxonomies, which represent hierarchical relations implicitly. In contrast, Australian classificational images included diversified designs, but particularly types with a tree structure which depicted overt taxonomies, explicitly representing hierarchical super-ordinate and subordinate relations. Many of the Taiwanese images are reminiscent of the specimen images in eighteenth century science texts representing "what truly is", while more Australian images emphasize structural objectivity. Moreover, Australian images support cognitive functions which facilitate reading comprehension. The relationships between image designs and learning environments are discussed and implications for textbook research and design are addressed.

Exposure to pollutants is a potentially crucial but overlooked driver of population declines in shorebirds along the East Asian-Australasian Flyway. We combined knowledge of moult strategy and life history with a standardised sampling protocol to assess mercury (Hg) contamination in 984 individuals across 33 migratory shorebird species on an intercontinental scale. Over one-third of the samples exceeded toxicity benchmarks. Feather Hg was best explained by moulting region, while habitat preference (coastal obligate vs. non-coastal obligate), the proportion of invertebrates in the diet and foraging stratum (foraging mostly on the surface vs. at depth) also contributed, but were less pronounced. Feather Hg was substantially higher in South China (Mai Po and Leizhou), Australia and the Yellow Sea than in temperate and Arctic breeding ranges. Non-coastal obligate species (Tringa genus) frequently encountered in freshwater habitats were at the highest risk. It is important to continue and expand biomonitoring research to assess how other pollutants might impact shorebirds. Over one-third of the sampled shorebirds along the East Asian-Australasian Flyway are facing Hg risk. Tringa genus in South China was at the highest risk. Feather Hg was best explained by feathers' moulting region, while habitat preference, diet, and foraging stratum were less important. [ABSTRACT FROM AUTHOR]

This paper reports on an investigation of student engagement with e-learning, using practitioner reflection as a lens. Five e-learning practitioners each provided a case study from their teaching, which was the focus of practitioners' reflective accounts. Each of the practitioners had used e-learning as a way of promoting both learning and engagement in their classrooms, and while the contexts in which they worked were varied, there were some emergent similarities in their experiences. The practitioners' reflections show that e-learning is used as a tool to promote various types of engagement from engineering students; indeed, students' engagement in some cases evolved beyond that which the practitioners had intended or anticipated. While the intended outcomes were certainly achieved, other emergent changes in student engagement were reported by the practitioners.

This paper outlines the context and focus of the late 2008 survey of 45 early career nursing graduates working in public hospitals in an outer-urban area of Sydney who were identified by their supervisors as performing successfully. It gives an overview of the key quantitative and qualitative results for 2008 compared with the results of earlier studies of successfully performing nurses and other professionals in the first 3-5 years of their career. Based on this analysis it makes a range of recommendations on how to optimise the quality and relevance of the learning design, support and assessment systems experienced by undergraduate nursing students. The study confirms that, in addition to possessing a high level of technical competence, it is a particular combination of personal, interpersonal and cognitive capabilities which characterises the most effective performers. The most productive approaches to developing these capabilities focus on: consistent two-way links between theory and practice; the availability of responsive, committed academic staff with current clinical experience; provision of clear direction and integration between different units of study; the systematic use of case-based learning, simulations, clinical placements and associated assessment tasks which are "real-world" focused, integrated and problem-based, and which concentrate on the key capabilities identified as counting most for successful early career practice in this and parallel studies.

Background: Communication partners (CPs) find it challenging to communicate with people with communication disorders post-stroke. Stroke communication partner training (CPT) can enhance CPs' ability to support the communication and participation of people post-stroke. While evidence for the efficacy of aphasia-based CPT is strong, implementation in healthcare settings is unclear. Aims: To investigate Australian speech pathologists' current stroke CPT practices, factors influencing the implementation of CPT and how reported practice compares with the research evidence. Methods & Procedures: Speech pathologists in Australia who had worked with people post-stroke were invited to complete a 99-item online survey. The survey was informed by a comprehensive review of the literature review, the Template for Intervention Description and Replication (TIDieR) intervention taxonomy, and the theoretical domains framework. data were analyzed using descriptive statistics and content analysis. Outcomes & Results: A total of 122 clinicians were surveyed. Most participants reported providing CPT to treat a range of post-stroke communication disorders. While 98.3% reported training familiar CPs, only 66.1% reported training unfamiliar CPs. Current stroke CPT practice is characterized by one to two < 1 h sessions of informal face-to-face education and skills training. Only 13.3% and 10.0% of participants used evidence-based published programmes with unfamiliar and familiar CPs respectively. The main barriers included the perceived lack of behavioural regulation, skills, reinforcement, beliefs about consequences, positive social influences and resources. The main facilitators included clinicians' intentions to provide CPT, perception of CPT as part of their role and perceived compatibility of CPT with clinical practice. Conclusion & Implications: A significant evidence-practice gap exists. Research exploring the implementation of stroke CPT in healthcare settings, expanding evidence to support CPT for the range of post-stroke communication disorders, developing freely accessible step-by-step CPT programmes that consider restrictions in current practice and providing explicit instructions of CPT best practice are warranted. A supportive workplace culture and freely accessible formal training opportunities are also needed.

This paper reports on evaluation of a scheme to improve University teaching through action research over a five-year period in the science, engineering, and technology division of a large Australian dual sector University. Between 2002 to 2006 this scheme directly committed approximately A$210,000 in grants and involved over 130 teaching and other staff in sponsoring projects of up to eight months' duration, with a total of 34 projects completed. Evaluation was informed by the desire of the academic developers concerned with the scheme to engage more widely with staff in predominantly empirical disciplinary cultures, to be more accountable within a University business management paradigm, and to contribute to the scholarship of academic development. The paper provides evidence--in terms of quality, effectiveness, practicality, participation, and satisfaction--to show how this scheme enhanced the scholarship of teaching and learning in the University. The paper outlines issues encountered and further work to be done in undertaking evaluation of such a scheme. (Contains 3 tables.)

Dust storms and wildfires occur frequently in south-eastern Australia. Their effects on the ecology, environment and population exposure have been the focus of many studies recently. Dust storms do not emit ground-sequestered carbon, but wildfires emit significant quantities of carbon into the atmosphere. However, both natural events promote phytoplankton growth in water bodies because carbon, and other trace elements such as iron, deposit on the surface water of oceans. Carbon dioxide is reabsorbed by phytoplankton via photosynthesis. The carbon balance cycle due to dust storms and wildfires is not well known. Recent studies on the carbon emission of the 2019–2020 summer wildfires in eastern Australia indicated that this megafire event emitted approximately 715 million tonnes of CO2 (195 Tg C) into the atmosphere from burned forest areas. This study focusses on the association of dust storms and wildfires in southeastern Australia with phytoplankton growth in the Tasman Sea due to the February 2019 dust storm event and the 2019–2020 Black Summer wildfires. Central Australia and western New South Wales were the sources of the dust storm emission (11 to 16 February 2019), and the Black Summer wildfires occurred along the coast of New South Wales and Victoria (from early November 2019 to early January 2020). The WRF-Chem model is used for dust storm simulation with the AFWA (Air Force Weather Agency of the US) dust emission version of the GOCART model, and the WRF-Chem model is used for wildfire simulation with FINN (Fire Emission Inventory from NCAR) emission data. The results show the similarities and differences in the deposition of particulate matter, phytoplankton growth and carbon reabsorption patterns in the Tasman Sea from these events. A higher rate of deposition of PM2.5 on the ocean surface corresponds to a higher rate of phytoplankton growth. Using the WRF-Chem model, during the 5-day dust storm event in February 2019, approximately ~1230 tons of total dust was predicted to have been deposited in the Tasman Sea, while ~132,000 tons of PM10 was deposited in the early stage of the wildfires from 1 to 8 November 2019. [ABSTRACT FROM AUTHOR]

Background: This study aimed to evaluate the cost-effectiveness of a telehealth coaching intervention to prevent gestational diabetes mellitus (GDM) and to calculate the breakeven point of preventing GDM. Methods: Data to inform the economic evaluation model was sourced directly from the large quaternary hospital in Brisbane, where the Living Well during Pregnancy (LWdP) program was implemented, and further supplemented with literature-based estimates where data had not been directly collected in the trial. A cost-effectiveness model was developed using a decision tree framework to estimate the potential for cost savings and quality of life improvement. A total of 1,315 pregnant women (49% with a BMI 25-29.9, and 51% with a BMI ≥ 30) were included in the analyses. Results: The costs of providing routine care and routine care plus LWdP coaching intervention to pregnant women were calculated to be AUD 20,933 and AUD 20,828, respectively. The effectiveness of the LWdP coaching program (0.894 utility) was slightly higher compared to routine care (0.893). Therefore, the value of the incremental cost-effectiveness ratio (ICER) was negative, and it indicates that the LWdP coaching program is a dominant strategy to prevent GDM in pregnant women. We also performed a probabilistic sensitivity analysis using Monte Carlo simulation through 1,000 simulations. The ICE scatter plot showed that the LWdP coaching intervention was dominant over routine care in 93.60% of the trials using a willingness to pay threshold of AUD 50,000. Conclusion: Findings support consideration by healthcare policy and decision makers of telehealth and broad-reach delivery of structured lifestyle interventions during pregnancy to lower short-term costs associated with GDM to the health system. [ABSTRACT FROM AUTHOR]

Despite their relatively small numbers, large old trees play disproportionately important roles in global biodiversity and ecosystem functions. There is a lack of systematic reviews and quantitative analyses of the accumulated literature. Understanding the research context and evolution could pump prime research and conservation endeavors. Using the comprehensive Web of Science, we applied VOSviewer (1.6.19) and CiteSpace (6.1R2) bibliometric software to examine the large old tree research field in 2000–2022. The queries of the bibliographic database generated quantitative–visual depictions in the form of knowledge maps. The nodes denote research intensity, and inter-node linkages denote the pathways and frequencies of collaborative activities. The research outputs differed significantly in terms of regions, countries, institutions, high-citation articles, productive researchers, hot topics, and research frontiers. Conspicuous spatial disparities were displayed, with the U.S.A., China, and Australia leading in publication counts and a cluster of European countries making considerable collective contributions. The research collaboration demonstrated a dichotomy: European countries networked more by geographical propinquity, and the top three countries connected by long-distance leap-frog jumps. The entrenched discrepancies between the endowed developed domains vis-à-vis the deprived developing domains were clearly expressed. The research productivity progressed through three stages: initial, growth, and flourishing. The leading institutions, researchers, and highly cited papers were recognized. The keyword analysis pinpointed diverse research hotspots: growth dynamics, conservation and management, ecological functions, and environmental response. This study informs recommendations for future research directions and cooperation on longevity mechanisms, evolutionary adaptation, dynamic monitoring, and temporal–spatial patterns. The integrated application of GIS, machine learning, and big data technologies could strengthen research capability. [ABSTRACT FROM AUTHOR]

Background and Aims: Pulmonary rehabilitation (PR) improves dyspnoea, fatigue and healthcare‐related quality of life (QoL) in patients with chronic lung disease (CLD). Non‐English‐speaking background (NESB) patients face language and cultural barriers that hinder their access to PR programmes, contributing to health disparities. Our trial aimed to demonstrate the effectiveness and feasibility of a Chinese language‐specific PR programme on lung function, functional exercise capacity and QoL measures. Methods: A prospective cohort study was conducted over a 2‐year period. Participants were enrolled in an 8‐week PR programme with biweekly sessions conducted by Chinese‐speaking physiotherapists. Baseline and post‐rehabilitation testing included pulmonary function testing, 6‐min walk test (6MWT), St. George Respiratory Questionnaire (SGQR) and Short Form Health Survey (SF‐36). Results: We enrolled 76 patients (58% male) with a median age of 77 years (interquartile range (IQR) 68–81) and achieved a completion rate of 86.8% (n = 66). CLD included chronic obstructive pulmonary disease (42%), asthma (15%) and interstitial lung disease (3%). Baseline median forced expiratory volume in 1 s (FEV1) was 1.63 L (IQR 1.17–2.05), and the median 6MWT was 282 m (IQR 232–332). Post‐intervention median 6MWT increased to 332 m (IQR 290–390), and the median FEV1 was 1.99 L (IQR 1.3–2.1). Both QoL measures (SGQR and SF‐36) showed significant improvement after intervention (P < 0.05). Conclusion: Our study demonstrates that a language‐specific PR programme is feasible, improving outcomes in NESB patients with CLD. The improvement in 6MWT and QoL measures was comparable to English‐based programmes. Ensuring equal access to healthcare programmes, regardless of cultural background or language barriers, is crucial in promoting health equity. [ABSTRACT FROM AUTHOR]

Background: Provision of critical care in rural areas is challenging due to geographic distance, smaller facilities, generalist skill mix and population characteristics. Internationally, the amalgamation telemedicine and retrieval medicine services are developing to overcome these challenges. Virtual emergency clinical advisory and transfer service (vCare) is one of these novel services based in New South Wales, Australia. We aim to describe patient encounters with vCare from call initiation at the referring site to definitive care at the accepting site. Methods: This retrospective observational study reviewed all patients using vCare in rural and remote Australia for clinical advice and/or inter-hospital transfer for higher level of care between February and March 2021. Data were extracted from electronic medical records and included remoteness of sites, presenting complaint, triage category, camera use, patient characteristics, transfer information, escalation of therapeutic intervention and outcomes. Data were summarised using cross tabulation. Results: 1,678 critical care patients were supported by vCare, with children (12.5%), adults (50.6%) and older people (36.9%) evenly split between sexes. Clinicians mainly referred to vCare for trauma (15.1%), cardiac (16.1%) and gastroenterological (14.8%) presentations. A referral to vCare led to an escalation of invasive intervention, skill, and resources for patient care. vCare cameras were used in 19.8% of cases. Overall, 70.5% (n = 1,139) of patients required transfer. Of those, 95.1% were transferred to major regional hospitals and 11.7% required secondary transfer to higher acuity hospitals. Of high-urgency referrals, 42.6% did not receive high priority transport. Imaging most requested included CT and MRI scans (37.2%). Admissions were for physician (33.1%) and surgical care (23.3%). The survival rate was 98.6%. Conclusion: vCare was used by staff in rural and remote facilities to support decision making and care of patients in a critical condition. Issues were identified including low utilisation of equipment, heavy reliance on regional sites and high rates of secondary transfer. However, these models are addressing a key gap in the health workforce and supporting rural and remote communities to receive care. [ABSTRACT FROM AUTHOR]

Background: Women with substance-use issues are overrepresented in prison. Research on women's recidivism often focuses on offending behaviour rather than the health and social circumstances women are experiencing when reimprisonment occurs. This study examines the relationship between social determinants of health (SDOH), mental health, substance-use and recidivism among women exiting prison with histories of substance-use. Methods: A retrospective cohort study of women exiting prison who completed the transitional support programme "Connections" between 2008 and 2018. Recidivism was measured up to two years post-release. Women's support needs were measured at baseline (4 weeks pre-release) and follow-up (four weeks post-release). Ongoing needs in relation to well-established SDOH were calculated if: (1) at baseline women were identified as having a re-entry need with housing, employment, finances, education, domestic violence, child-custody and social support and (2) at follow-up women reported still needing help in that area. Women's self-reported substance-use and mental health since release were captured at follow-up. Descriptive statistics were calculated for all measures. Associations between SDOH, mental health, substance-use and recidivism were estimated by multiple logistic regression, adjusting for potential confounders. We also evaluated the mediating effects of mental health on the relationship between SDOH and substance-use. Results: Substance-use was associated with increased odds of recidivism (adjusted odds ratio (AOR) 1.8, 95% confidence interval (CI) 1.1–2.9; p = 0.02). Poor mental health (AOR 2.9, 95% CI 1.9–4.6; p = < 0.01), ongoing social support (AOR 3.0, 95% CI 1.9–5.0; p = < 0.01), child-custody (AOR 1.9, 95% CI 1.0–3.3 p = 0.04), financial (AOR 2.0, 95% CI 1.3–3.2; p = < 0.01) and housing (AOR 1.8, 95% CI 1.1–2.9; p = 0.02) needs were individually associated with increased odds of substance-use. Mediation analysis found mental health fully mediated the effects of ongoing housing (beta efficiency (b) = − 033, standard error (SE) 0.01; p = 0.05), financial (b = 0.15, SE 0.07; p = 0.05), child-custody (b = 0.18, SE 0.01; p = 0.05) and social support (b = 0.36, SE 0.1; p = 0.05) needs onto substance-use, and partially mediated the effects of domestic violence (b = 0.57, SE 0.23; p = 0.05) onto substance-use. Conclusion: This study underscores the critical importance of addressing the interplay between SDOH, mental health, substance-use and recidivism. An approach that targets SDOH holds the potential for reducing mental distress and substance-use, and related recidivism. [ABSTRACT FROM AUTHOR]

Introduction: Cough is the most common symptom leading to medical consultation. Chronic cough results in significant health care costs, impairs quality of life, and may indicate the presence of a serious underlying condition. Here, we present a summary of an updated position statement on cough management in the clinical consultation. Main recommendations: Assessment of children and adults requires a focused history of chronic cough to identify any red flag cough pointers that may indicate an underlying disease. Further assessment with examination should include a chest x‐ray and spirometry (when age > 6 years). Separate paediatric and adult diagnostic management algorithms should be followed. Management of the underlying condition(s) should follow specific disease guidelines, as well as address adverse environmental exposures and patient/carer concerns. First Nations adults and children should be considered a high risk group. The full statement from the Thoracic Society of Australia and New Zealand and Lung Foundation Australia for managing chronic cough is available at https://lungfoundation.com.au/resources/cicada‐full‐position‐statement. Changes in management as a result of this statement: Algorithms for assessment and diagnosis of adult and paediatric chronic cough are recommended.High quality evidence supports the use of child‐specific chronic cough management algorithms to improve clinical outcomes, but none exist in adults.Red flags that indicate serious underlying conditions requiring investigation or referral should be identified.Early and effective treatment of chronic wet/productive cough in children is critical.Culturally specific strategies for facilitating the management of chronic cough in First Nations populations should be adopted.If the chronic cough does not resolve or is unexplained, the patient should be referred to a respiratory specialist or cough clinic. [ABSTRACT FROM AUTHOR]

Background and Aims: Connections is a voluntary health program that facilitates access to opioid agonist treatment (OAT) and social services for people with opioid use exiting prison. This study aimed to measure the effectiveness of Connections in reducing recidivism and improving health outcomes for people with a history of opioid use on leaving prison. Design: Retrospective cohort study with quasi‐random allocation to the program. Setting: Public adult prisons in New South Wales, Australia, 2008–2015. Participants: Adults released from custody with a history of opioid use. Of 5549 eligible releasees, 3973 were allocated to Connections and 1576 to treatment‐as‐usual. Measurements Outcomes were return‐to‐custody, all‐cause mortality, and OAT participation. Findings Regression analyses on an intention‐to‐treat basis, and adjusting for baseline propensity scores, comparing patients allocated to Connections versus treatment‐as‐usual showed no difference in rates of return‐to‐custody within 2 years (hazard ratio [HR]: 1.01; 95% confidence interval [CI]: 0.92 –1.12). Patients allocated to the Connections program were more likely to access OAT (odds ratio [OR]: 1.21; 95% CI: 1.06–1.39) and had lower mortality within 28 days of release (0.25% vs. 0.66%; HR: 0.38; 95% CI: 0.14–1.03). Differences in mortality did not persist beyond 28 days. Subgroup analyses showed that allocation to Connections was associated with higher risk of return‐to‐custody within 28 days for Aboriginal and/or Torres Strait Islander (Indigenous) and female releasees. Conclusions: The Connections program for people with opioid use exiting prison did not reduce the likelihood of return‐to‐custody but did facilitate opioid agonist treatment participation on release from prison. [ABSTRACT FROM AUTHOR]

The aim of this study is to investigate the reasons that English for Academic Purposes (EAP) students in the Open Access College at the University of Southern Queensland give to explain their success in a course of study. It will examine how students' internal and external attributions change while studying EAP. The data has been gathered through a survey administered four times to EAP students. The students come from English as an Additional Language (EAL) backgrounds and intend to undertake tertiary study in English at USQ. The data foregrounds the potential role of adaptive and maladaptive attribution processes in the EAP learning experience, showing that the majority of students possess a mixture of internal and external attributions that evolve over a course of EAP study. The implications of this study are the potential to contribute to the development of more holistic approaches in EAP programs.

Bronchiectasis is a chronic respiratory disorder that is most prevalent in Indigenous populations in remote northern communities in Australia. Indigenous Australians with bronchiectasis have a shorter life expectancy compared to non-Indigenous adults with the condition. The Thoracic Society of Australia and New Zealand (TSANZ) has released a position statement to increase awareness and provide evidence-based recommendations for diagnosis, treatment, and prevention. The statement emphasizes early diagnosis and treatment in children and the need for health service equity to ensure appropriate care for Indigenous populations and underserviced communities. The updated statement covers various aspects of bronchiectasis, including clinical features, investigations, management objectives, and other related topics. The statement aims to improve patient care and will be supported by webinars, checklists, and quality standards documents. However, there are still knowledge gaps and more efforts are needed to address the heterogeneity of the condition and allocate resources to diverse populations. [Extracted from the article]

Extreme heat has been linked to increased mortality and morbidity across the globe. Increasing temperatures due to climatic change will place immense stress on healthcare systems. This review synthesises Australian literature that has examined the effect of hot weather and heatwaves on various health outcomes. Databases including Web of Science, PubMed and CINAHL were systematically searched for articles that quantitatively examined heat health effects for the Australian population. Relevant, peer-reviewed articles published between 2010 and 2023 were included. Two authors screened the abstracts. One researcher conducted the full article review and data extraction, while another researcher randomly reviewed 10% of the articles to validate decisions. Our rapid review found abundant literature indicating increased mortality and morbidity risks due to extreme temperature exposures. The effect of heat on mortality was found to be mostly immediate, with peaks in the risk of death observed on the day of exposure or the next day. Most studies in this review were concentrated on cities and mainly included health outcome data from temperate and subtropical climate zones. There was a dearth of studies that focused on tropical or arid climates and at-risk populations, including children, pregnant women, Indigenous people and rural and remote residents. The review highlights the need for more context-specific studies targeting vulnerable population groups, particularly residents of rural and remote Australia, as these regions substantially vary climatically and socio-demographically from urban Australia, and the heat health impacts are likely to be even more substantial. [ABSTRACT FROM AUTHOR]

People with disability face heightened vulnerability during disasters due to functional limitations and inadequate support. This study explores disaster preparedness, capabilities, and support needs among Australians with disability. A cross-sectional survey was conducted, aligned with the Person-Centred Emergency Preparedness (P-CEP) framework: a co-designed and tested framework that helps people with disability assess their capabilities, identify their needs, communicate with others, and plan for different emergency scenarios. Data collection involved self-administered online surveys and interviewer-administered telephone surveys through convenience sampling. Descriptive statistics and regression modelling were employed for data analysis. Of the 138 respondents, most were female (68.1%) and aged 60–69 (23.9%). While 60.3% had emergency plans, motivators included enhancing survival chances (36.7%) and past disaster experiences (22.7%). Barriers included uncertainty about preparation (22.0%) and difficulty obtaining information (11.3%). Those perceiving bushfire risk were more likely to have a plan (p = 0.004), while individuals living alone were less likely (p = 0.019). Common preparedness actions included safely storing important documents (57.5%), but fewer had backup plans for support workers (9.2%) or home generators (9.7%). Respondents with disaster experience highlighted diverse support needs, encompassing health, emotional well-being, and practical assistance. Inclusive disaster risk reduction should involve individuals with disability in assessing their capabilities and support requirements. This study underscores the necessity of tailored emergency preparedness measures to safeguard the well-being of this demographic. [ABSTRACT FROM AUTHOR]

Background: Australia persistently has one of the highest rates of colorectal cancer (CRC) in the world. Australia's National Bowel Cancer Screening Program (NBCSP) sends a biennial Faecal Immunochemical Test (FIT)—the 'NBCSP kit'—to everyone eligible for the programme between 50 and 74 years old; however, participation in the programme is low, especially in the 50- to 60-year-old age group. Our previous efficacy trial ('SMARTscreen') demonstrated an absolute increase in uptake of 16.5% (95% confidence interval = 2.02–30.9%) for people sent an SMS with motivational and instructional videos, from their general practice prior to receiving their NBCSP kit, compared to those receiving usual care. Building on the strengths of the SMARTscreen trial and addressing limitations, the 'SMARTERscreen' trial will test the effect on participation in the NBCSP of sending either an SMS only or an SMS with online video material to general practice patients due to receive their NBCSP compared to 'usual care'. Methods: SMARTERscreen is a three-arm stratified cluster randomised controlled trial involving 63 general practices in two states in Australia. Eligible patients are patients who are aged 49–60 years and due to receive their NBCSP kit within the next 2 weeks during the intervention period. General practices will be equally randomised to three trial arms (21:21:21, estimated average 260 patients/practice). The two interventions include (i) an SMS with an encouraging message from their general practice or (ii) the same SMS with weblinks to additional motivational and instructional videos. The control arm will receive 'usual care'. Using the intention-to-treat approach, primary analysis will estimate the three pair-wise between-arm differences in the proportion of eligible patients who participate in the NBCSP within 6 months of when their kit is sent, utilising screening data from the Australian National Cancer Screening Register (NCSR). Patient intervention adherence to the interventions will also be evaluated. Findings will be incorporated into the Policy1-Bowel microsimulation model to estimate the long-term health benefits and cost-effectiveness of the interventions. Discussion: SMARTERscreen will provide high-level evidence determining whether an SMS or an SMS with web-based material sent to general practice patients prior to receiving their NBCSP kit increases participation in bowel cancer screening. Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12623000036617. Registered on 13 January 2023. Trial URL: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=385119&isClinicalTrial=False [ABSTRACT FROM AUTHOR]

BACKGROUND: Malnutrition is a serious health risk facing older people living in residential aged care facilities. Aged care staff record observations and concerns about older people in electronic health records (EHR), including free-text progress notes. These insights are yet to be unleashed. OBJECTIVE: This study explored the risk factors for malnutrition in structured and unstructured electronic health data. METHODS: Data of weight loss and malnutrition were extracted from the de-identified EHR records of a large aged care organization in Australia. A literature review was conducted to identify causative factors for malnutrition. Natural language processing (NLP) techniques were applied to progress notes to extract these causative factors. The NLP performance was evaluated by the parameters of sensitivity, specificity and F1-Score. RESULTS: The NLP methods were highly accurate in extracting the key data, values for 46 causative variables, from the free-text client progress notes. Thirty three percent (1,469 out of 4,405) of the clients were malnourished. The structured, tabulated data only recorded 48% of these malnourished clients, far less than that (82%) identified from the progress notes, suggesting the importance of using NLP technology to uncover the information from nursing notes to fully understand the health status of the vulnerable older people in residential aged care. CONCLUSION: This study identified 33% of older people suffered from malnutrition, lower than those reported in the similar setting in previous studies. Our study demonstrates that NLP technology is important for uncovering the key information about health risks for older people in residential aged care. Future research can apply NLP to predict other health risks for older people in this setting. [ABSTRACT FROM AUTHOR]