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Since universities' commitment to internationalisation has been increasing, instruments for measuring institutional internationalisation performance are urgently needed to monitor and evaluate the progress made about internationalisation. Although efforts have been made to develop various tools, an internationally applicable instrument for universities to measure and compare their internationalisation performance remains missing. This study attempted to develop an indicator framework of such kind to fill the gap. A total of 182 administrative staff and 17 policymakers from 17 flagship universities in Australia, Singapore and China were consulted in order to establish the framework. The study resulted in a set of 15 indicators that captures six key dimensions of university internationalisation. It attempts to cover internationalisation in its widest possible sense with practical number of indicators. This study also contributes to the knowledge body of developing measurement for university internationalisation by reflecting on the fundamental challenge of measuring the phenomenon.

Internationalisation has become a central concern in today's higher education and has been developed as an explicit institutional-wide priority. However, as many researchers argue the meaning of internationalisation remains ambiguous and unclear. The majority of existing studies on the phenomenon are case based or focus on the divergence of intuitional motives and strategies. With all has been known about the differences, a shared construct has yet been established to theoretically conceptualise the phenomenon. This article explored university practitioners' perceptions of internationalisation, in order to construct the phenomenon. To construct university internationalisation, by and large, means to identify the comparable elements of the phenomenon across individual cases and contexts. Specifically, university policy-makers from 17 flagship universities in Australia, Singapore and China were involved in the investigation. The findings show considerable commonalities in the major motive that drives institutional internationalisation, the strategies that universities develop for internationalisation and the approach to implement internationalisation strategies. These similarities enable the establishment of an integrated construct of university internationalisation. This is not to say that university internationalisation is understood and implemented in the same manner in universities across different countries. The observed divergences are also discussed and linked to the influential contextual factors. The findings of this study contribute to the theorising of the widely discussed phenomenon by answering the key question that in what way university internationalisation can be constructed.

The plantation forestry estate in Australia has been in decline for a decade or more. Previous studies attribute observed investment inertia to factors including the long-term nature of forestry investments, high up front establishment cost and more recently water resource constraints. The introduction of plantation forestry methods as part of the Australian Carbon Credit Unit Scheme in 2017 has generated renewed interest in plantation forestry as a carbon abatement option. To assess this opportunity, we performed high spatial resolution bioeconomic modelling of southeastern Australia's Green Triangle forestry region to understand the joint influence of site productivity, species selection and spatially variable costs including agricultural land prices and transport distances on land use change and additional future timber flows. We found that additional plantations may be economically viable at a carbon price of AU$39/t CO 2 e. New softwood (P. radiata) plantations provide the lowest cost option across the region when compared to hardwood (E. globulus). However, at carbon prices below AU$50/t CO 2 e comparatively little technically feasible abatement is possible for both plantation species with only 632,000 t CO 2 e from hardwood and 12.9 Mt CO 2 e, from softwood under economically optimised conditions which equates to 0.13 and 2.5 percent of Australia's 2023 emissions respectively. We found however that this may translate to significant additional timber flows for the region's processing industry even at lower carbon prices. We estimated an additional 62,600 green metric tonnes of hardwood (1 percent of annual Australian plantation hardwood harvest) and 6.6 million m 3 of cumulative softwood (44 percent supply of annual Australian plantation softwood harvest) over a 50-year period at AU$40/t CO 2 e. However, the results were found to be sensitive to discount rate assumptions. The discussion focuses on the economic and policy factors that may enable/limit the use of carbon markets to expand the Australian plantation forestry estate., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Courtney M. Regan reports financial support was provided by the Green Triangle Forest Industries Hub on earlier iterations of this modelling. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Exposure to cold spells is associated with mortality. However, little is known about the global mortality burden of cold spells., Methods: A three-stage meta-analytical method was used to estimate the global mortality burden associated with cold spells by means of a time series dataset of 1960 locations across 59 countries (or regions). First, we fitted the location-specific, cold spell-related mortality associations using a quasi-Poisson regression with a distributed lag non-linear model with a lag period of up to 21 days. Second, we built a multivariate meta-regression model between location-specific associations and seven predictors. Finally, we predicted the global grid-specific cold spell-related mortality associations during 2000-19 using the fitted meta-regression model and the yearly grid-specific meta-predictors. We calculated the annual excess deaths, excess death ratio (excess deaths per 1000 deaths), and excess death rate (excess deaths per 100 000 population) due to cold spells for each grid across the world., Findings: Globally, 205 932 (95% empirical CI [eCI] 162 692-250 337) excess deaths, representing 3·81 (95% eCI 2·93-4·71) excess deaths per 1000 deaths (excess death ratio), and 3·03 (2·33-3·75) excess deaths per 100 000 population (excess death rate) were associated with cold spells per year between 2000 and 2019. The annual average global excess death ratio in 2016-19 increased by 0·12 percentage points and the excess death rate in 2016-19 increased by 0·18 percentage points, compared with those in 2000-03. The mortality burden varied geographically. The excess death ratio and rate were highest in Europe, whereas these indicators were lowest in Africa. Temperate climates had higher excess death ratio and rate associated with cold spells than other climate zones., Interpretation: Cold spells are associated with substantial mortality burden around the world with geographically varying patterns. Although the number of cold spells has on average been decreasing since year 2000, the public health threat of cold spells remains substantial. The findings indicate an urgency of taking local and regional measures to protect the public from the mortality burdens of cold spells., Funding: Australian Research Council, Australian National Health and Medical Research Council, EU's Horizon 2020 Project Exhaustion., Competing Interests: Declaration of interests We declare no competing interests., (Copyright © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.)

Background: More intense cyclones are expected in the future as a result of climate change. A comprehensive review is urgently needed to summarize and update the evidence on the health effects of cyclones., Objectives: We aimed to provide a systematic review with meta-analysis of current evidence on the risks of all reported health outcomes related to cyclones and to identify research gaps and make recommendations for further research., Methods: We systematically searched five electronic databases (MEDLINE, Embase, PubMed, Scopus, and Web of Science) for relevant studies in English published before 21 December 2022. Following the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines, we developed inclusion criteria, screened the literature, and included epidemiological studies with a quantitative risk assessment of any mortality or morbidity-related outcomes associated with cyclone exposures. We extracted key data and assessed study quality for these studies and applied meta-analyses to quantify the overall effect estimate and the heterogeneity of comparable studies., Results: In total, 71 studies from eight countries (the United States, China, India, Japan, the Philippines, South Korea, Australia, Brazil), mostly the United States, were included in the review. These studies investigated the all-cause and cause-specific mortality, as well as morbidity related to injury, cardiovascular diseases (CVDs), respiratory diseases, infectious diseases, mental disorders, adverse birth outcomes, cancer, diabetes, and other outcomes (e.g., suicide rates, gender-based violence). Studies mostly included only one high-amplitude cyclone (cyclones with a Saffir-Simpson category of 4 or 5, i.e., Hurricanes Katrina or Sandy) and focused on mental disorders morbidity and all-cause mortality and hospitalizations. Consistently elevated risks of overall mental health morbidity, post-traumatic stress disorder (PTSD), as well as all-cause mortality or hospitalizations, were found to be associated with cyclones. However, the results for other outcomes were generally mixed or limited. A statistically significant overall relative risk of 1.09 [95% confidence interval (CI): 1.04, 1.13], 1.18 (95% CI: 1.12, 1.25), 1.15 (95% CI: 1.13, 1.18), 1.26 (95% CI: 1.05, 1.50) was observed for all-cause mortality, all-cause hospitalizations, respiratory disease, and chronic obstructive pulmonary disease hospitalizations, respectively, after cyclone exposures, whereas no statistically significant risks were identified for diabetes mortality, heart disease mortality, and preterm birth. High between-study heterogeneity was observed., Conclusions: There is generally consistent evidence supporting the notion that high-amplitude cyclones could significantly increase risks of mental disorders, especially for PTSD, as well as mortality and hospitalizations, but the evidence for other health outcomes, such as chronic diseases (e.g., CVDs, cancer, diabetes), and adverse birth outcomes remains limited or inconsistent. More studies with rigorous exposure assessment, of larger spatial and temporal scales, and using advanced modeling strategy are warranted in the future, especially for those small cyclone-prone countries or regions with low and middle incomes. https://doi.org/10.1289/EHP12158.

Objective: This study aimed to assess whether there have been changes in the quality of clinical evidence submitted for government subsidy decisions on cancer medicines over the past 15 years., Methods: We reviewed public summary documents (PSDs) reporting on subsidy decisions made by the Pharmaceutical Benefits Advisory Committee (PBAC) from July 2005 to July 2020. Information was extracted on the study design, directness of comparison, sample size, and risk of bias (RoB). Changes in the quality of evidence were assessed using regression analysis., Results: Overall, 214 PSDs were included in the analysis. Thirty-seven percent lacked direct comparative evidence. Thirteen percent presented observational or single-arm studies as the basis for decisions. Among PSDs presenting indirect comparisons, 78 percent reported transitivity issues. Nearly half (41 percent) of PSDs reporting on medicines supported by head-to-head studies noted there was a moderate/high/unclear RoB. PSDs reporting concerns with RoB increased by a third over the past 7 years, even after adjusting for disease rarity and trial data maturity (OR 1.30, 95% CI: 0.99, 1.70). No time trends were observed regarding the directness of clinical evidence, study design, transitivity issues, or sample size during any of the analyzed periods., Conclusion: Our findings indicate that the clinical evidence supplied to inform funding decisions for cancer medicines is often of poor quality and has been deteriorating over time. This is concerning as it introduces greater uncertainty in decision making. This is particularly important as the evidence supplied to the PBAC is often the same as that supplied to other global decision-making bodies.

Background: Oral health during pregnancy is vital for both mother and child. Indigenous Australians face many barriers in accessing dental care. Service approachability is one of the key domains in accessing health services. There is little empirical evidence of the association between service approachability and dental care attendance or oral health outcome. The aim of this study is to examine the relationship between dental service approachability on dental care attendance and self-reported gum disease among South Australian women pregnant with an Aboriginal child., Methods: Four hundred and twenty-seven women pregnant with an Aboriginal child completed questionnaires in both metropolitan and regional health settings in South Australia in 2011. Four variables related to approachability of dental services: (1) perception of need; (2) service-related health literacy; (3) oral health beliefs and; (4) trust and expectation of dental service. The association between service approachability-related factors, dental utilisation and self-reported gum disease during pregnancy were assessed using Generalised Poisson regression models, after adjusting for age, remoteness, employment status and education. Estimates were presented as adjusted prevalence ratios (APR)., Results: Most participants (85.8%) reported a need for dental care, had positive oral health beliefs (88.3%) and had expectations towards dental care (86.2%). Dental service utilisation during pregnancy was low (35.7%). Many participants (78.0%) expressed knowing what to do if they needed dental care, while most (39.8%) doubted that dental care would be available the next day. Poor health service literacy was identified as a risk factor for non-optimal dental attendance (APR = 0.86, 95%CI 0.74-0.99). Perceived need for dental care was positively associated with self-reported gum disease (APR = 1.24, 95%CI 1.06-1.45)., Conclusion: Inability to navigate the dental care system was a risk factor for poor dental attendance among South Australian women pregnant with an Aboriginal child. Perceived need for dental care was associated with gum disease., (© 2021. The Author(s).)