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When making moral judgments of past actions, adults often think counterfactually about what could have been done differently. Considerable evidence suggests that counterfactual thinking emerges around age 6, but it remains unknown how this development influences children's moral judgments. Across two studies, Australian children aged 4-9 (N = 236, 142 Females) were told stories about two characters who had a choice that led to a good or bad outcome, and two characters who had no choice over a good or bad outcome. Results showed that 4- and 5-year-olds' moral judgments were influenced only by the actual outcome. From age 6, children's moral judgments were also influenced by the counterfactual choices that had been available to the characters.

Background: Socioeconomic inequalities in health and their determinants have been studied extensively over the past few decades. However, the role of parenting style and parents' couple relationships in explaining mental health inequalities is limited. Therefore, this study aims to investigate the distributional impact of parenting style (angry parenting, consistent parenting, and inductive parenting) and parents' couple relationships (e.g., argumentative, happy relationships) on socioeconomic inequalities and by extension on mental health status of Australian children and adolescents. Methods: This study utilized data from the Longitudinal Study of Australian Children (Waves 1–7), specifically focusing on intact biological parent families, while excluding single-parent and blended-family households. We applied the decomposition index and the Blinder Oaxaca method to investigate the extent of the contribution and temporal impact of parenting style and parents' couple relationships on the mental health status of Australian children and adolescents. Results: This study revealed that poor parenting style is the single most important factor that leads to developing mental health difficulties in children and adolescents, especially from low socioeconomic status, and it contributes almost 52% to socioeconomic inequalities in mental health status. Conversely, household income, maternal education, employment status, and parents' couple relationships contributed 28.04%, 10.67%, 9.28%, and 3.34%, respectively, to mental health inequalities in children and adolescents. Conclusion: Overall, this study underscores the importance of parenting style and parents' couple relationships as significant predictors of mental health outcomes in children and adolescents. These results highlight the need for targeted interventions to support families from low socioeconomic backgrounds to address the significant mental health inequalities observed in the study population. [ABSTRACT FROM AUTHOR]

Environmental context: Metal concentrations can build up to potentially harmful levels in marine mammals as they are at the top of the food chain. This review summarises the information available on metal concentrations in marine mammals, birds and turtles from around Australia. Despite large data gaps, the available data suggest that metal concentrations are similar to those encountered in other regions of the world. A comprehensive compilation of the published data for trace element concentrations (metals and metalloids) in Australian marine mammals, birds and turtles is presented. The majority of studies have relied on the utilisation of opportunistically collected samples, animal strandings and bycatch. This has resulted in large gaps in geographical, temporal and species coverage data. For instance, little or no data are available for cetaceans in New South Wales or the Northern Territory, and out of 14 endemic species of dolphins, data only exist for seven species. The aforementioned data gaps make it hard to identify statistically significant trends, a problem compounded by data being reported in the form of ranges without raw data. Trace element concentrations measured in various marine species and their tissue types are extremely variable, with ranges typically spanning several orders of magnitude, but are generally comparable with international data. Trends in contaminant concentrations with tissue type follow generally accepted patterns of behaviour for higher organisms, with the highest mercury concentrations in liver and cadmium in kidney tissues. Herbivores have lower contaminant loadings than carnivores, reflecting the importance of diet, and there are identifiable age-related trends for elements such as mercury. The lack of supporting pathology on dead and stranded animals and data on specimens from uncontaminated locations restrict conclusions on organism health impacts. There have been some attempts to use non-invasive sampling of indicator tissues such as fur, bristle and feathers. However, it is currently difficult to extrapolate these data to estimate contaminant concentrations in major organs. Recommendations for future investigations are made. Environmental context. Metal concentrations can build up to potentially harmful levels in marine mammals as they are at the top of the food chain. This review summarises the information available on metal concentrations in marine mammals, birds and turtles from around Australia. Despite large data gaps, the available data suggest that metal concentrations are similar to those encountered in other regions of the world. [ABSTRACT FROM AUTHOR]

Background Heart failure (HF) is a major cause of morbidity and mortality in Australia. While the therapeutic options available for HF remain limited, recent studies have expanded treatment options to include angiotensin-neprilysin inhibitors (ARNIs) and sodium-glucose co-transporter-2 (SGLT2) inhibitors. Objective The aim of this article is to provide an update on the management of HF for general practitioners (GPs), who play a pivotal part in the management of patients with complex presentations. By reviewing the stepwise diagnosis, treatment and monitoring of patients with HF, it is hoped that this article encourages GPs to take an active role in the management of patients with HF. Specifically, the aim is to increase familiarity with ARNIs and SGLT2 inhibitors, maximising their uptake and benefit for patients with HF. Discussion ARNIs and SGLT2 inhibitors reduce morbidity and confer a survival benefit in the treatment of HF with reduced ejection fraction, yet they remain underused. Further familiarisation with these new classes of medication will enable increased uptake, which will benefit patients with HF. [ABSTRACT FROM AUTHOR]

Aims: Medicines regulators issue post‐market safety warnings to advise of newly uncovered risks, but with mixed impacts. We aimed to identify factors influencing the use of regulatory warnings by primary care and specialist physicians in the US and Australia. Methods: Semi‐structured qualitative interviews were carried out with 40 primary care physicians, endocrinologists and other generalist specialists in Boston (USA) and Australia. Coding and analysis were performed inductively and iteratively to identify and examine key factors. Analysis centred around four areas: physicians' awareness of drug safety information, preferred information sources, opinion‐forming and sharing of information with patients. Results: Uncertainty, trust and clinical authority emerged as factors influencing use of advisories. Although regulators were trusted as authoritative institutions, they appeared to lack clinical authority, and physicians validated regulatory information against other trusted sources including evidence, expert opinion and experience. Specialists became aware of drug safety issues through specialised literature, using evidence and clinical consensus to form opinions. Primary care physicians, fielding high volumes of information, relied on convenient, accessible information sources including the media and the "clinical grapevine" for awareness, and on clinical colleagues, specialists and experience for interpretation. Communicating risk to patients was complicated by uncertainty; physicians tailored information to patients' health literacy and information needs. US physicians were more aware of their national regulator's post‐market safety role than Australian physicians of theirs. Conclusion: Drug safety warnings may not be optimally received or used. Regulators should consider strategies that increase trust, clinical relevance and accessibility, and address physicians' needs in communicating risk to patients. [ABSTRACT FROM AUTHOR]

Monsters, argue Jane and Lewis Gordon, have plagued humanity for millennia. Their continued presence in the modern age therefore, is nothing new. What is new, rather, are what such 'disastrous people' are made to symbolise, and the roles they are made to play, in order to ensure continued existence of the anti-black, colonial nation. In this paper I examine the specific colonial/racist conditions that have led to the recent resignification of Australia's indigenous people as monstrous beings whose very presence within the national space poses a threat to the nation's white identity. Having done so, I attempt to articulate, via the work of Lewis Gordon, the conditions to which humanity must aspire if we are to avoid such tragic occurrences. [ABSTRACT FROM AUTHOR]

This paper presents the characterization of a commercial nationwide Wi-Fi hotspot network. We examine a 5 month long log of user activity and traffic volume collected by a wireless network service provider operating hotspots in restaurants, serviced apartments, hotels and airports all over Australia. We categorize users based on their account time limits to analyze the impact of account stratification on the overall user behavior. A similarity index is developed to compare two datasets of unknown distributions which we then use to quantitatively compare how similar or different various types of accounts are. The user population of the network is found to be highly fluctuating, hence user specific, population independent metrics are proposed to account for this transience. We also introduce metrics to measure account time and data utilization. Key user and traffic statistics are presented for reference. [ABSTRACT FROM AUTHOR]

Adult survivors of child sexual abuse are high users of health and mental health services. Health professionals are well placed to improve health outcomes for them by delivering positive interventions post-abuse. The current study explored female child sexual abuse survivors' opinions on how health professionals could work better with child sexual abuse survivors. Sixty-one women, from 22-65 years old, who had been sexually abused before the age of 16 years, completed postal questionnaires in late 2004. A model was developed to guide the development of knowledge, skills, and practices for working more sensitively with child sexual abuse survivors. The model consisted of six chronological training steps: (1) knowledge on effects of child sexual abuse; (2) establishing the relationship with child sexual abuse survivors; (3) asking about child sexual abuse; (4) responding to disclosure; (5) sensitive provision of medical examinations; and (6) follow-up post examination. A systematic approach to training is proposed to assist with improving delivery of services sensitive to child sexual abuse survivor needs. [ABSTRACT FROM AUTHOR]

Optimal Right Ventricular Pacing Introduction: Long-term right ventricular apical (RVA) pacing has been associated with adverse effects on left ventricular systolic function; however, the comparative effects of right ventricular outflow tract (RVOT) pacing are unknown. Our aim was therefore to examine the long-term effects of septal RVOT versus RVA pacing on left ventricular and atrial structure and function. Methods: Fifty-eight patients who were prospectively randomized to long-term pacing either from the right ventricular apex or RVOT septum were studied echocardiographically. Left ventricular (LV) and atrial (LA) volumes were measured. LV 2D strain and tissue velocity images were analyzed to measure 18-segment time-to-peak longitudinal systolic strain and 12-segment time-to-peak systolic tissue velocity. Intra-LV synchrony was assessed by their respective standard deviations. Interventricular mechanical delay was measured as the difference in time-to-onset of systolic flow in the RVOT and LV outflow tract. Septal A' was measured using tissue velocity images. Results: Following 29 ± 10 months pacing, there was a significant difference in LV ejection fraction (P < 0.001), LV end-systolic volume (P = 0.007), and LA volume (P = 0.02) favoring the RVOT-paced group over the RVA-paced patients. RVA-pacing was associated with greater interventricular mechanical dyssynchrony and intra-LV dyssynchrony than RVOT-pacing. Septal A' was adversely affected by intra-LV dyssynchrony (P < 0.05). Conclusions: Long-term RVOT-pacing was associated with superior indices of LV structure and function compared with RVA-pacing, and was associated with less adverse LA remodeling. If pacing cannot be avoided, the RVOT septum may be the preferred site for right ventricular pacing. (J Cardiovasc Electrophysiol, Vol. 21, pp. 1120-1126) [ABSTRACT FROM AUTHOR]

The article focuses on the resistance to isoniazid and rifampicin in the estimated case of multidrug-resistant (MDR) tuberculosis in Vietnamese patients.

Background: Prader-Willi Syndrome (PWS) is a complex multisystem genetic disorder associated with several challenges for people with PWS themselves, and for their families and care givers. Support around access to food is a particular issue due to impaired satiety and, because of this, people with PWS eat excessive amounts of food (hyperphagia). Together with other aspects of the PWS phenotype including, in many cases, a reduced sensitivity to pain, hyperphagia results in life-threatening obesity and life-shortening complications for some people with PWS. Restrictions to liberty and/or access to food raise important legal and ethical considerations in the clinical management of children and adults with PWS. Particularly where disagreements arise and, in the absence of comprehensive guidance for care providers, the courts may be called upon to resolve these difficult issues.Aims: 1) To review case-law from English-speaking common law jurisdictions concerning support arrangements for people with PWS with a view to identifying issues that have required the intervention of the courts. 2) To identify principles on which to base clinical guidelines relating to the issues identified, ensuring that such guidelines are consistent with ethical and human rights imperatives.Methods: Westlaw, Westlaw AU, and Lexis Nexis were searched for case law concerning the treatment or support of a person with PWS.Results: Fifteen cases from jurisdictions in Australia, New Zealand, Canada, the United Kingdom and the United States of America met inclusion criteria. Areas requiring judicial decision making included a) detention in psychiatric hospital; b) support in least restrictive environments c) eligibility for support services; d) guardianship; e) access to special education. Judicial decisions are discussed in the context of the United Nations' Convention on the Rights of Persons with Disabilities. [ABSTRACT FROM AUTHOR]

Environmental pollution is a growing threat to wildlife health and biodiversity. The relationship between marine mammals and pollutants is, however, complex and as new chemicals are introduced to ecosystems alongside concomitant, interacting threats such as climate change and habitat degradation, the cumulative impact of these stressors to wildlife continues to expand. Understanding the health of wildlife populations requires a holistic approach to identify potential threatening processes. In the context of environmental pollution in little studied wildlife species, it is important to catalogue the current exposome to develop effective biomonitoring programs that can support diagnosis of health impacts and management and mitigation of pollution. In New South Wales, Australia, the New Zealand fur seal (Arctocephalus forsteri) is a resident species experiencing population growth following devastating historic hunting practices. This study presents a retrospective investigation into the exposure of New Zealand fur seals to a range of synthetic organic compounds and essential and non-essential trace elements. Liver tissue from 28 seals were broadly analyzed to assess concentrations of organochlorine and organophosphate pesticides, polychlorinated biphenyls, per- and polyfluoroalkyl substances, and essential and non-essential trace elements. In addition to contributing extensive pollution baseline data for the species, the work explores the influence of sex, age, and body condition on accumulation patterns. Further, based on these findings, it is recommended that a minimum of 11 juvenile male New Zealand fur seals are sampled and analyzed annually in order to maintain a holistic biomonitoring approach for this population., Competing Interests: Declaration of competing interest The authors 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 © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

Aim: The North Queensland region of Australia has a high incidence of pediatric thoracic empyema (pTE). We describe the management of empyema at the Townsville University Hospital which is the regional referral center for these children. The impact of a newly developed institutional guideline is also discussed., Methods: This retrospective audit included children under the age of 16 years treated for empyema between 1 Jan 2007 and 31 December 2018. Demographic and management-related variables were correlated to outcomes. A local guideline was introduced at the beginning of 2017 and patient outcomes characteristics pre, and post introduction of this guideline are compared., Results: There were 153 children with pTE (123 before and 30 after the introduction of a local guideline). Nonsurgical management was associated with a higher treatment failure rate. Median length of stay (LOS) was 11.8 (IQR 9.3-16) days. Longer hospital LOS was associated with younger age (r2 -0.16, P = 0.04), Aboriginal and/or Torres Strait (ATSI) ancestry (13.8 vs. 10.5 days, P = 0.002) and concomitant respiratory viral infections (14.4 vs. 10.9 days, P = 0.003). The introduction of local guideline was associated with significant decrease in the use of empirical chest CT scans (54.4% before vs. 6.7% after, P < 0.001) and duration of intravenous antibiotics (14 days before vs. 10 days after, P = 0.02). There was no significant change in the hospital LOS (12.1 days pre and 11.7 post, P = 0.8)., Conclusions: Younger age, concomitant viral respiratory infections and ATSI ancestry were identified as potential risk factors for increase LOS. Hospital LOS following the adoption of an institutional guideline was unchanged. However, such a guideline may identify populations at risk for an unfavorable course and avoid unnecessary antibiotic treatment and radiation exposure., Competing Interests: The authors have no funding or conflicts of interest to disclose., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)