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This article conceptualises studies in professional learning through the novel lens of 'reflexive empathy'. Reflexive empathy draws on Margaret Archer's theory of reflexivity, and positions it as an enabler of empathy to support researchers' approaches to providing contextualised, supportive professional learning for teachers who are involved in research studies. To argue this, we reflect on the results of a funded project, informed by Archerian reflexivity, which focused on improving writing in Australian primary schools. This article argues for the need to resist neoliberal approaches to professional learning by providing agentic, contextualised programs that value teachers' individual emotional, social, and cognitive responses to their participation in research informed co-designed professional learning.

Little is currently known about the autism spectrum disorder (ASD)-related difficulties of females narrowly below the ASD diagnostic threshold and whether the disorder conceptualisation should be broadened to capture their presentations. We extracted fine-grained information from the assessment reports of 222 children who were either diagnosed with ASD (n = 156) or not diagnosed despite many ASD traits (n = 78). Females were less likely than males to meet Criterion B3 (restricted interests), and this was especially the case for subclinical (non-ASD) females. Non-ASD females lacked sufficient atypicality for diagnosis in several key domains, particularly Criterion A1 (social-emotional reciprocity). Evidence of sex/gender-specific restricted interests and stereotypical behaviours was found. Many behaviours differed in the extent to which they predicted the ASD diagnostic result for males and females, perhaps suggesting that sex/gender influences how ASD-related behaviours are perceived. We discuss these findings in the context of underdiagnosis of ASD in females and propose adjustments to assessment protocols.

Teacher professional development in writing is an increasing area of interest due to the complex nature of the profession including learning needs of students and the demands of external assessment regimes in the contemporary landscape. However, professional development often denies the contextual experiences and expertise of teachers in favor of prescriptive top-down approaches. This paper contributes to the literature on effective teacher professional learning by showing how co-design between teachers and researchers can have an impact on student learning. In this study we focus on professional learning for the teaching of writing in the elementary classroom context, working with third grade students in the age range of 8-9. Through a reflexive analysis of multiple data sets including student writing samples, interviews, classroom observation footage, and teacher testimony, this study reveals the importance of teacher confidence in enabling students to view themselves as writers with a clear audience and purpose. The findings show how positioning teachers as research partners throughout a co-design process of professional learning benefits both students and teachers as it provides authentic, contextualized and creative approaches to teaching writing and improved writing outcomes for students.

In this paper, we show how children's creativity manifests in literary aesthetics and how they explore moral subjects as a result. Literary aesthetics involve a range of artistic elements or expressions within a textual work. Writers may use aesthetic properties to express individual appreciation or how people view the world, often in relation to moral values. This paper takes an interdisciplinary approach to understanding the relation between aesthetics and moral value in children's writing. First, we situate our discussion within the context of reflexivity theory, which framed the larger study from which these data are drawn. Second, we apply appraisal theory within the lens of reflexivity to analyse children's writing samples for their aesthetic representations of moral qualities. As a result of our study, we show how teachers may improve and complicate the way children practice literary aesthetics in their writing. We argue it is important for students to learn about aesthetics in writing as aesthetics are a key quality of literary expression and may educate readers on the perception and moral values of others.

Despite an increasing interest in the sociocultural aspects of teacher professional development and the recognition of context in teacher education, there is a lack of a conceptualisation of how professional learning occurs within and across various contexts. To this aim, we take up a view of professional learning that is dialogic and apply the concept of "polyphony" to conceptualise teacher practice and teacher professional learning as the teacher's orchestration of multiple voices within context. Inviting "polyphony" to the realm of teacher education refers to the composition of multiple co-existing contextual affordances and constraints affecting teacher practice. It is the multitude of various and at times disagreeing voices surrounding teacher practice. Our proposed model offers a reflexive definition of "teacher agency" that involves the recognition of the voices that the teacher draws upon so that they can be interrogated and deliberately invoked or suppressed in practice for particular contexts. We discuss two methodological implications including a polyphonic design methodology of professional learning opportunities, and a polyphonic education research method in addressing the problem of teachers' implementation and adjustment to new practices.

A problem-based immersive virtual environment (IVE) about bushfire safety was developed as a learning tool for children aged 10-12. Its effectiveness was assessed in relation to children's ability to determine how to be safer in a bushfire incident. A series of experiential activities were developed in the IVE with digital storytelling and two-stage embedded assessments providing children with an opportunity to engage with tasks and solve problems while receiving feedback on their performance. Changes from pre- to postsurvey results showed positive learning outcomes as evidenced by significant improvements in children's knowledge of bushfire safety and confidence in their ability to contribute to decisions during a bushfire incident. The significant change in children's knowledge as well as their performance at two-stage embedded assessments was independent of their gender, background knowledge and perceived ability in responding to bushfire hazards. This suggests that when appropriately designed and implemented within educational settings, immersive virtual learning tools can effectively engage children and enhance learning outcomes associated with bushfire safety. The paper also argues that such immersive problem-based learning can improve self-efficacy amongst children in relation to coping with a bushfire situation. Implications of the findings are also discussed.

Background: Chronic, non-malignant diseases (CNMD) like chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF) and dementia in advanced stages are very burdensome for patients. Timely palliative care with strong collaboration between general practitioners (GPs) and specialist palliative home care (SPHC) teams can reduce symptom burden, hospitalization rates, hospitalization costs and overall healthcare costs. The KOPAL-study on strengthening interprofessional collaboration for patients with palliative care needs tested the effect of an intervention comprising of a SPHC nurse assessment and an interprofessional case conference. This qualitative evaluative study explores patients', proxies' and their associates' motivation to participate in the KOPAL-study and views on the (benefits of the) intervention. Methods: We interviewed 13 male and 10 female patients as well as 14 proxies of patients with dementia and six associates of study participants using a semi-structured interview guide. All interviews were digitally recorded, transcribed verbatim and analysed with deductive-inductive qualitative content analysis. Results: Motivation for participation was driven by curiosity, the aim to please the GP or to support research, respectively to help other patients. Few interviewees pointed out to have expected positive effects for themselves. The nurse visit was evaluated very positively. Positive changes concerning health care or quality of life were reported sparsely. Most study participants did not prepare for the SPHC nurse assessment. They had no expectations concerning potential benefits of such an assessment, the interdisciplinary case conference and an early integration of palliative care. The majority of interviewees reported that they did not talk about the nurse visit and the interprofessional case conference with their GPs. Conclusion: Our results lead to the conclusion that SPHC nurses can serve as an advocate for the patient and thereby support the patients' autonomy. GPs should actively discuss the results of the interdisciplinary case conference with patients and collaboratively decide on further actions. Patient participation in the interdisciplinary case conference could be another way to increase the effects of the intervention by empowering patients to not just passively receive the intervention. Trial registration: DRKS00017795 German Clinical Trials Register, 17Nov2021, version 05. [ABSTRACT FROM AUTHOR]

Introduction: Divergent thinking is a crucial component of effective problem-solving. This study investigated the divergent thinking of students with visual impairments (i.e., blindness or low vision) in three countries and explored the correlates of their performance on two tasks. Methods: A sample of 52 students with visual impairments completed two divergent thinking tasks, one traditional Alternate Uses task, and one scenario-based task created for this study. Each student's teacher of students with visual impairments completed a questionnaire containing demographic, curriculum, and student characteristics. Results: Of the correlates examined, teacher-rated academic independence, working on grade level, number of expanded core curriculum (ECC) areas of instruction currently received, and ongoing receipt of assistive technology instruction were significantly related to task performance. Discussion: Findings demonstrate the strong relationship between real-life problem-solving, divergent thinking, and academic functioning in students with visual impairments. Further investigation is needed about the relationship between aspects of problem-solving instruction and student outcomes as they relate to divergent thinking. Implications for practitioners: Given the connection of divergent thinking to overall problem-solving ability, teachers should assess these skills in students. Using similar scenario-based real-life tasks, they can also incorporate practice opportunities for divergent thinking within ECC instruction.

Objective: Australia has relatively high multiple myeloma (MM) incidence and mortality rates. Advancements in MM treatment over recent decades have driven improvements in MM survival in high-income countries; however, reporting in Australia is limited. We investigated temporal trends in population-wide MM survival across 3 periods of treatment advancements in New South Wales (NSW), Australia. Methods: Individuals with an MM diagnosis in the NSW Cancer Registry between 1985 and 2015 with vital follow-up to 2020, were categorized into 3 previously defined treatment eras according to their diagnosis date (1985--1995, chemotherapy only; 1996--2007, autologous stem cell transplantation; and 2008--2015, novel agents including proteasome inhibitors and immunomodulatory drugs). Both relative survival and cause-specific survival according to Fine and Gray's competing risks cumulative incidence function were calculated by treatment era and age at diagnosis. Results: Overall, 11,591 individuals were included in the study, with a median age of 70 years at diagnosis. Five-year relative survival improved over the 36-year (1985--2020) study period (31.0% in 1985--1995; 41.9% in 1996--2007; and 56.1% in 2008--2015). For individuals diagnosed before 70 years of age, the 5-year relative survival nearly doubled, from 36.5% in 1985--1995 to 68.5% in 2008--2015. Improvements for those > 70 years of age were less pronounced between 1985--1995 and 1996--2007; however, significant improvements were observed for those diagnosed in 2008--2015. Similar overall and age-specific patterns were observed for cause- specific survival. After adjustment for gender and age at diagnosis, treatment era was strongly associated with both relative and cause-specific survival (P < 0.0001). Conclusions: Survival of individuals with MM is improving in Australia with treatment advances. However, older age groups continue to experience poor survival outcomes with only modest improvements over time. Given the increasing prevalence of MM in Australia, the effects of MM treatment on quality of life, particularly in older age, warrant further attention. [ABSTRACT FROM AUTHOR]

Objectives: To examine changes in multiple myeloma incidence and mortality rates during 1982–2018, and to estimate its incidence, mortality, and prevalence for 2019–2043. Study design: Population‐based statistical modelling study; analysis of and projections based on Australian Institute of Health and Welfare multiple myeloma incidence, mortality, and survival data. Setting: Australia, 1982–2018 (historical data) and projections to 2043. Main outcome measures: Changes in multiple myeloma incidence and mortality rates, 1982–2018, determined by joinpoint regression analysis (age‐standardised to 2021 Australian population); projection of rates to 2043 based on age–period–cohort models; estimated 5‐ and 30‐year prevalence of multiple myeloma (modified counting method). Results: The incidence of multiple myeloma increased during 1982–2018 (eg, annual percentage change [APC], 2006–2018, 1.9%; 95% confidence interval [CI], 1.7–2.2%), but the mortality rate declined during 1990–2018 (APC, –0.4%; 95% CI, –0.5% to –0.2%). The age‐standardised incidence rate was projected to increase by 14.9% during 2018–2043, from 8.7 in 2018 to 10.0 (95% CI, 9.4–10.7) new cases per 100 000 population in 2043; the mortality rate was projected to decline by 27.5%, from 4.0 to 2.9 (95% CI, 2.6–3.3) deaths per 100 000 population. The annual number of people newly diagnosed with multiple myeloma was estimated to increase by 89.2%, from 2120 in 2018 to 4012 in 2043; the number of deaths from multiple myeloma was projected to increase by 31.7%, from 979 to 1289. The number of people living with multiple myeloma up to 30 years after initial diagnosis was projected to increase by 163%, from 10 288 in 2018 to 27 093 in 2043, including 13 019 people (48.1%) diagnosed during the preceding five years. Conclusion: Although the decline in the mortality rate was projected to continue, the projected increases in the incidence and prevalence of multiple myeloma in Australia over the next 25 years indicate that investment in prevention and early detection research, and planning for prolonged treatment and care, are needed. [ABSTRACT FROM AUTHOR]

The paper examines if there has been an increase in the attention paid to social and environmental issues (SEI) in accounting curricula. Using schools participating in the Aspen Institute's Beyond Grey Pinstripes (BGP) program, we measure the increase in the number of accounting courses incorporating SEI across the biennial application years of 2005, 2007 and 2009. We also examine the percentage of SEI coverage in accounting courses between 2007 and 2009. Our findings suggest that there was not an appreciable increase in the number of accounting courses dealing with SEI between 2005 and 2007, but that the increase was significant during the period from 2007 to 2009. Further, the increase over the four-year period from 2005 to 2009 was also significant. In addition, there is a significant increase in the percentage of SEI coverage in accounting courses between 2007 and 2009. Implications of these findings are discussed.

This article explores the impact of mental health issues on paramedics in Australia, particularly Post-Traumatic Stress Disorder, caused by their exposure to high levels of stress. The prevalence of Post-Traumatic Stress Disorder is higher among paramedics than any other occupation, and this could be a cause for concern, especially for undergraduate student paramedics. The article examines the need to build resilience among student paramedics to help them handle the trauma they may experience during clinical placement. This study conducted a two-step process to review literature and university handbooks to determine the level of education provided to paramedic students on Post-Traumatic Stress Disorder and resilience during clinical placement, due to the lack of research in this area. The first step involved a search for relevant articles, while the second step involved a search of the Australian Health Practitioner Regulation Agency website to identify paramedicine programs and a manual evaluation of each undergraduate pre-registration paramedicine curriculum in Australia. This study conducted a systematic search of national and international literature and Australian undergraduate pre-registration paramedicine programs to identify any studies pertaining to the education of paramedic students in resilience and Post Traumatic Stress Disorder. The search found that only 15 (5.95 %) of the 252 reviewed subjects had reference to mental health, resilience or Post-Traumatic Stress Disorder, with only 4 (1.59 %) of them discussing these topics in preparation for clinical practice. The study highlights the lack of emphasis on student paramedic self-care as an essential underpinning for clinical placement preparation in the curriculum. This literature review concludes that appropriate training and support, teaching resilience, and promoting self-care are crucial in preparing paramedic students for the emotional and psychological demands of their work. Equipping students with these tools and resources can improve their mental health and well-being and enhance their ability to provide high-quality care to patients. Promoting self-care as a core value in the profession is essential in creating a culture that supports paramedics in maintaining their own mental health and well-being. [ABSTRACT FROM AUTHOR]

Australia has been widely condemned for its harsh and comprehensive external border controls that seek to control the inward mobility of would-be asylum seekers through visa denial, interdiction and offshore detention. Less widely discussed is the fact that internal controls have been repeatedly ramped up over the past two decades. This includes the administrative removal of lawfully-present non-citizens following visa cancellation on character grounds under s501 of the Migration Act 1958 (Cth). Automatic visa cancellation was introduced in 2014 for non-citizens sentenced to a prison term of 12  months or more, or for certain offences, bypassing individualised decision-making and raising the spectre of a visa cancellation pipeline feeding a highly automated deportation machinery. In an age of increasingly automated forms of governance, a key question that arises is the role that has been played by automated systems in achieving what has been a seismic shift in practice, and the normative implications of any developments towards automation within the visa cancellation and removal systems. This paper outlines the shift towards automation in other systems of governance in Australia—most notably the notorious Robodebt scheme—before examining automation in Australia’s visa cancellation system. Documentary analysis of recent parliamentary inquiries, independent reports and government policy is used to piece together the development of inter-agency data exchange practices and automation over three specific periods—historical practice pre-2014, post-2014 to the present, and proposed future developments. We conclude that Australia’s s501 visa cancellation system is neither automated nor automatic. Rather, the 2014 law reform gave rise to a ‘surveillance fantasy’ with immense consequences for non-citizens, particularly those who face long days in immigration detention at the conclusion of their prison sentence. We show that while concerns about increasing automation are well-founded, systems based on less sophisticated forms of information handling and reliant on human decision-making nevertheless continue to raise age-old questions concerning efficiency, accuracy and fairness. [ABSTRACT FROM AUTHOR]

Aim: Male dietitians are under‐represented in the global dietetics workforce, including in Australia. This study explores Australian males' experiences as dietitians in the Australian workforce, with the aim to identify influences that initially attracted them to dietetics, as well as barriers that may affect their decision to stay in or leave the profession. Methods: A cross‐sectional, semi‐quantitative web‐based survey was distributed to male dietitians using purposive, snowball sampling. Closed and open‐ended questions were included. Descriptive statistics were generated, and content analysis of free‐text responses identified major themes. Results: Seventy‐one respondents opened the survey link, of which 65 respondents attempted the survey. Fifty‐four (83.1%) respondents agreed that dietetics is female‐dominated. An interest in food and nutrition was the most reported reason for studying dietetics (73.8%). Of the 55 respondents who were not intending to retire in the next 5 years, 15 (27.3%) stated they were somewhat or extremely likely to leave the profession of dietetics. Respondents identified issues that impacted their experiences as a male dietitian, including gender differences, a lack of male role models, barriers to career progression/employment, and perceptions of a lack of respect and impact within healthcare. Conclusions: Australian male dietitians perceive systemic, social, and personal factors that have influenced their career experiences. Greater exposure to prominent male role models may be self‐perpetuating in improving male dietitian recruitment and eventually, retention. A multi‐pronged approach is needed to improve the rate of recruitment of male dietitians, with a role for tertiary education providers and peak dietetics bodies. [ABSTRACT FROM AUTHOR]

Background: To adequately prepare graduates for the dynamic demands of paramedic practice, adopting a contemporary educational approach is essential. This involves collaborating to identify crucial competencies through input from industry stakeholders, experienced practitioners, and discipline-specific experts. Accreditation assumes a central role within this framework, serving as a cornerstone to ensure that paramedicine curricula align with paramedics' diverse and evolving professional roles. Methods: A narrative review of the literature and a directed search of grey literature were performed to identify specific developments in paramedicine competencies and scope of practice and mapped to the professional capabilities published by the Paramedicine Board of Australia. In determining a competency map and accreditation's role in a competency framework specific to current and evolving paramedic practice, key documents were analysed using a qualitative approach based on content analysis to identify common traits among documents, countries and other professions. Results: The review process identified 278 themes that were further allocated to 22 major analytical groupings. These groupings could further be mapped to previously reported cognitive, technical, integrative, context, relationship, affective/moral competencies and habits of mind. At the same time, the highest-rated groupings were key competencies of intellectual skills, safety, accountability, clinical decision-making, professionalism, communications, team-based approach and situational awareness. Two groups were represented in the literature but not in the professional capabilities, namely Health and Social continuum and self-directed practice. Conclusions: This review highlights the importance of measuring and validating the professional capabilities of Paramedicine Practitioners. The study explores various metrics and competency frameworks used to assess competency, comparing them against national accreditation schemes' professional capability standards. The findings suggest that accreditation frameworks play a crucial role in improving the quality of paramedicine practice, encompassing intellectual skills, safety, accountability, clinical decision-making, professionalism, communication, teamwork, and situational awareness. [ABSTRACT FROM AUTHOR]

The increased uptake of variable renewable energy sources has increased electricity price volatility in many energy pool markets, providing an opportunity for storage systems to profit through energy arbitrage. Comparison between the cost or value of storage systems engaging in energy arbitrage should be performed on a levelised basis due to differences in system lifetime. Existing energy arbitrage models with bid/offer curves and imperfect forecasting are typically computationally expensive and are impractical for calculating lifetime levelised cost metrics. In this work, an open-source modular energy arbitrage model with bid and offer curve inputs was developed for a lithium-ion battery energy storage system (BESS) and pumped hydro system (PHS) to analyse lifetime levelised cost and revenue. The mixed integer linear program scheduling module included a new piece-wise linearised description of PHS charging behaviour for rapid optimisation. A one-at-a-time sensitivity analysis indicated that levelised cost and revenue were highly sensitive to discharging efficiency. In a case study based on Australia's National Electricity Market, imperfect forecasting with no risk hedging was found to increase levelised costs by up to 24% and decrease levelised revenue by up to 50% relative to perfect price forecasting, despite 95% of prices being forecast to be within $35/MWh of the actual trading price. BESS levelised costs were more significantly correlated with consistent low risk bids (Kendall Tau-b of 0.75), since the undiscounted capital costs contribute to a larger proportion of the overall costs than in the PHS systems. [ABSTRACT FROM AUTHOR]

The representation of publicists in popular culture appears to have a direct relationship with how publishing sector publicity staff are perceived by their colleagues and peers, having a distinct knock-on effect to work practices and labour conditions. In this article, we explore these perceptions and, through interviews with eight publicists working in publishing houses in Australia, explore how the work of publicity is commonly misrecognised and undervalued. In framing publicists as cultural intermediaries who contribute to the shaping of cultural tastes, we further illuminate the significant gap between the common gendered perceptions of publicists and the realities of their professional practice. [ABSTRACT FROM AUTHOR]

Background: Infantile nephropathic cystinosis (INC) is a systemic lysosomal storage disease causing intracellular cystine accumulation, resulting in renal Fanconi syndrome, progressive kidney disease (CKD), rickets, malnutrition, and myopathy. An INC-specific disproportionately diminished trunk length compared to leg length poses questions regarding the functionality of the trunk. Methods: Thus, we prospectively investigated thoracic dimensions and proportions, as well as their clinical determinants in 44 pediatric patients with INC with CKD stages 1–5 and 97 age-matched patients with CKD of other etiology between the ages of 2–17 years. A total of 92 and 221 annual measurements of patients with INC and CKD, respectively, were performed, and associations between anthropometric and clinical parameters were assessed using linear mixed-effects models. Results: Patients with INC exhibited altered chest dimensions that were distinct from CKD controls, characterized by markedly increased chest depth to height and chest depth to chest width ratio z-scores (> 1.0), while those of patients with CKD were only mildly affected (z-score within ± 1.0). Ratio z-scores differed significantly between both patient groups from 2–6 years of age onward. The degree of chest disproportion in INC patients was significantly associated with both the degree of CKD and tubular dysfunction (e.g., low serum phosphate and bicarbonate) across three different age groups (2–6, 7–12, and 13–17 years). Conclusion: Our data show an INC-specific alteration in thoracic shape from early childhood onward, which is distinct from CKD of other etiologies, suggesting early childhood subclinical changes of the musculoskeletal unit of the thoracic cage, which are associated with kidney function. [ABSTRACT FROM AUTHOR]

In the absence of intellectual impairment, girls are diagnosed with autism spectrum disorder significantly less and later than boys. This study explored potential reasons for why autism spectrum disorder may be more difficult to identify in girls, based on carer concerns during the pre-diagnosis period. Carers of 92 boys and 60 girls diagnosed with autism spectrum disorder from school age completed an online survey addressing concerns regarding the child's development during the pre-school years (pre-diagnosis). Significant sex differences were evident in key early concerns, as well as the strategies used to navigate pre-school social situations, and the types of restricted interests. Findings suggest, from carer perspective, that girls who went on to be diagnosed with autism spectrum disorder presented differently when compared to boys, providing insight into why the diagnosis of autism spectrum disorder may be more difficult to make with cognitively able girls.

Background and Objective: Since 2016, new therapies have transformed the standard of care for lung cancer, creating a need for up-to-date evidence for health economic modelling. We developed a discrete event simulation of advanced lung cancer treatment to provide estimates of survival outcomes and healthcare costs in the Australian setting that can be updated as new therapies are introduced. Methods: Treatment for advanced lung cancer was modelled under a clinician-specified treatment algorithm for Australia in 2022. Prevalence of lung cancer subpopulations was extracted from cBioPortal and the Sax Institute's 45 and Up Study, a large prospective cohort linked to cancer registrations. All costs were from the health system perspective for the year 2020. Pharmaceutical and molecular diagnostic costs were obtained from public reimbursement fees, while other healthcare costs were obtained from health system costs in the 45 and Up Study. Treatment efficacy was obtained from clinical trials and observational study data. Costs and survival were modelled over a 10-year horizon. Uncertainty intervals were generated with probabilistic sensitivity analyses. Overall survival predictions were validated against real-world studies. Results: Under the 2022 treatment algorithm, estimated mean survival and costs for advanced lung cancer 10 years post-diagnosis were 16.4 months (95% uncertainty interval [UI]: 14.7–18.1) and AU$116,069 (95% UI: $107,378–$124,933). Survival and costs were higher assuming optimal treatment utilisation rates (20.5 months, 95% UI: 19.1–22.5; $154,299, 95% UI: $146,499–$161,591). The model performed well in validation, with good agreement between predicted and observed survival in real-world studies. Conclusions: Survival improvements for advanced lung cancer have been accompanied by growing treatment costs. The estimates reported here can be used for budget planning and economic evaluations of interventions across the spectrum of cancer control. [ABSTRACT FROM AUTHOR]

Purpose: To compare the incidence profile of four major cancers in Australia by place of birth. Methods: In this retrospective population-based cohort study, the analysis included 548,851 residents diagnosed with primary colorectum, lung, female breast, or prostate cancer during 2005–2014. Incidence rate ratio (IRR) and 95% confidence intervals (CI) were calculated for migrant groups relative to Australian-born. Results: Compared with Australian-born residents, most migrant groups had significantly lower incidence rates for cancers of the colorectum, breast and prostate. The lowest rates of colorectal cancer were among males born in Central America (IRR = 0.46, 95% CI 0.29–0.74) and females born in Central Asia (IRR = 0.38, 95% CI 0.23–0.64). Males born in North-East Asia had the lowest rates of prostate cancer (IRR = 0.40, 95% CI 0.38–0.43) and females born in Central Asia had the lowest rates of breast cancer (IRR = 0.55, 95% CI 0.43–0.70). For lung cancer, several migrant groups had higher rates than Australian-born residents, with the highest rates among those from Melanesia (males IRR = 1.39, 95% CI 1.10–1.76; females IRR = 1.40, 95% CI 1.10–1.78). Conclusions: This study describes cancer patterns among Australian migrants, which are potentially helpful in understanding the etiology of these cancers and guiding the implementation of culturally sensitive and safe prevention measures. The lower incidence rates observed for most migrant groups may be maintained with continued emphasis on supporting communities to minimize modifiable risk factors such as smoking and alcohol consumption and participation in organized cancer screening programmes. Additionally, culturally sensitive tobacco control measures should be targeted to migrant communities with high lung cancer incidence rates. [ABSTRACT FROM AUTHOR]

Prior research points to a meaningful confidence-accuracy (CA) relationship for positive identification decisions. However, there are theoretical grounds for expecting that different aspects of the CA relationship (calibration, resolution, and over/underconfidence) might be undermined in some circumstances. This research investigated whether the CA relationship for eyewitness identification decisions is affected by three, forensically relevant variables: exposure duration, retention interval, and divided attention at encoding. In Study 1 (N = 986), a field experiment, we examined the effects of exposure duration (5 s vs. 90 s) and retention interval (immediate testing vs. a 1-week delay) on the CA relationship. In Study 2 (N = 502), we examined the effects of attention during encoding on the CA relationship by reanalyzing data from a laboratory experiment in which participants viewed a stimulus video under full or divided attention conditions and then attempted to identify two targets from separate lineups. Across both studies, all three manipulations affected identification accuracy. The central analyses concerned the CA relation for positive identification decisions. For the manipulations of exposure duration and retention interval, overconfidence was greater in the more difficult conditions (shorter exposure; delayed testing) than the easier conditions. Only the exposure duration manipulation influenced resolution (which was better for 5 s than 90 s), and only the retention interval manipulation affected calibration (which was better for immediate testing than delayed testing). In all experimental conditions, accuracy and diagnosticity increased with confidence, particularly at the upper end of the confidence scale. Implications for theory and forensic settings are discussed. (Contains 5 tables, 4 figures and 1 footnote.)

The burden of acute illicit drug use in Australia is largely unknown. Establishing a prospective drug surveillance system in emergency departments using analytical confirmation may facilitate the early identification of emerging drugs. We describe demographic data and acute toxicity patterns, stratified by analytical confirmation of illicit drugs and novel psychoactive substances, to emergency departments in Western Australia. Patients presenting with severe and/or unusual clinical features consistent with recreational drug toxicity were identified across five Western Australian emergency departments participating in the Emerging Drugs Network of Australia between April 2020 and December 2021. Demographic and toxicology patterns in patients with and without analytically confirmed illicit drugs/novel psychoactive substances from blood samples were collected during the emergency department presentation. The cohort included 434 severe and/or unusual toxicology presentations; median age 33 years (first and third quartiles 25–40 years), 268 (61.8%) males. Any substance (illicit, novel psychoactive substance, pharmaceutical) was detected in 405 (93.3%) presentations. Illicit drugs/novel psychoactive substances were detected in 257 (59.2%) presentations, including 73 (28.3%) with more than one confirmed illicit drug/novel psychoactive substance. Frequent illicit drugs identified were metamfetamine (n = 201, 77.9%) and gamma-hydroxybutyrate (n = 30, 11.6%). Forty-eight novel psychoactive substances were detected within 43 (16.7%) presentations. Novel benzodiazepines were most frequently detected (n = 29, 60.4%). Frequent pharmaceuticals detected included diazepam (n = 100, 26.1%) and clonazepam (n = 40, 10.4%). One hundred and fifty-five (35.7%) presentations were discharged home and 56 (12.9%) were admitted to intensive care. Presentations with detected illicit drugs/novel psychoactive substances had a lower median intensive care length of stay compared to presentations without detected illicit drugs/novel psychoactive substances (32.6 h versus 50.8 h respectively, P < 0.001). Integration of clinical and analytic data in patients with severe and/or unusual toxicology presentations via the Emerging Drugs Network of Australia provides insight into illicit drug/novel psychoactive substance use responsible for acute harm across Western Australian emergency departments. [ABSTRACT FROM AUTHOR]

Explorations of memory accuracy control normally contrast forced-report with free-report performance across a set of items and show a trade-off between memory quantity and accuracy. However, this memory control framework has not been tested with lineup identifications that may involve rejection of all alternatives. A large-scale (N = 439) lineup study explored regulation of identification decisions either with an initial forced-choice decision followed by free-report decision or with the reverse. Overall, initial free-report decisions provided stronger evidence of suspect guilt than forced-choice decisions, with little cost to memory quantity. The 2 response orders produced different patterns of response associated with control of accuracy. A model based on evaluation of the strength of the best candidate answer was able to provide only a partial fit to the data, suggesting that witnesses use more than simple memory strength of a candidate answer when controlling the accuracy of their responses in free report. (Contains 3 figures, 1 table and 3 footnotes.)

Different disciplinary groups are increasingly questioning current conceptualisations of young adults' educational, social and personal lives after compulsory schooling. New perspectives are being advanced on the life trajectories of choice and complexity now experienced by school leavers. A consistent theme is the changed nature of young adults' lives, reflecting social and economic pressures on educational, work and personal life goals. This age group has the highest incidence of mental disorders of any age cohort (Andrews, Hall, Teesson, & Henderson, 1999). The changed learning environment in the move to university entails life and environmental events that create risk conditions for young adults. In these circumstances varying degrees of loss, challenge and personal growth exist. Concurrent personal losses, such as death of a peer or family member, broken love relationships, and failure to achieve the dream of a future career, can create particular vulnerabilities. Loss may interfere with the natural progression of intellectual--emotional--psychological growing up (Kastenbaum, 2001). In this article the mental health of young adults is viewed through the lens of loss experiences within a context of change in their life trajectory. Data is drawn from a mixed method study involving questionnaire completion and in-depth interviews of students in four university campuses in New South Wales.

Multiple myeloma (MM) is a disease of older people, yet factors relating to comorbidity and frailty may threaten treatment tolerability for many of this heterogenous group. There has been increasing interest in defining specific and clinically relevant frailty assessment tools within the MM population, with the goal of using these frailty scores, not just as a prognostic instrument, but also as a predictive tool to allow for a frailty‐adapted treatment approach. This paper reviews the various frailty assessment frameworks used in the evaluation of patients with MM, including the International Myeloma Working Group Frailty Index (IMWG‐FI), the Mayo Frailty Index and the simplified frailty scale. While the IMWG‐FI remains the most widely accepted tool, the simplified frailty scale is the most user‐friendly in busy day‐to‐day clinics based on its ease of use. This paper summarises the recommendations from the Myeloma Scientific Advisory Group (MSAG) of Myeloma Australia, on the use of frailty assessment tools in clinical practice and proposes a frailty‐stratified treatment algorithm to aid clinicians in tailoring therapy for this highly heterogeneous patient population. [ABSTRACT FROM AUTHOR]

Objective: To investigate the trial-based cost-effectiveness of the addition of a tailored digitally enabled exercise intervention to usual care shown to be clinically effective in improving mobility in the Activity and MObility UsiNg Technology (AMOUNT) rehabilitation trial compared to usual care alone. Design: Economic evaluation alongside a pragmatic randomized controlled trial. Participants: 300 people receiving inpatient aged and neurological rehabilitation were randomized to the intervention (n = 149) or usual care control group (n = 151). Main measures: Incremental cost effectiveness ratios were calculated for the additional costs per additional person demonstrating a meaningful improvement in mobility (3-point in Short Physical Performance Battery) and quality-adjusted life years gained at 6 months (primary analysis). The joint probability distribution of costs and outcomes was examined using bootstrapping. Results: The mean cost saving for the intervention group at 6 months was AU$2286 (95% Bootstrapped cost CI: −$11,190 to $6410) per participant; 68% and 67% of bootstraps showed the intervention to be dominant (i.e. more effective and cost saving) for mobility and quality-adjusted life years, respectively. The probability of the intervention being cost-effective considering a willingness to pay threshold of AU$50,000 per additional person with a meaningful improvement in mobility or quality-adjusted life year gained was 93% and 77%, respectively. Conclusions: The AMOUNT intervention had a high probability of being cost-effective if decision makers are willing to pay AU$50,000 per meaningful improvement in mobility or per quality-adjusted life year gained, and a moderate probability of being cost-saving and effective considering both outcomes at 6 months post randomization. [ABSTRACT FROM AUTHOR]

Introduction: There have been significant advancements in risk identification and treatment for ovarian cancer over the last decade. However, their impact on health services costs is unclear. This study estimated the direct health system costs (government perspective) for women diagnosed with ovarian cancer in Australia during 2006–2013, as a benchmark prior to opportunities for precision-medicine approaches to treatment, and for health care planning. Methods: Using cancer registry data, we identified 176 incident ovarian cancers (including fallopian tube and primary peritoneal cancer) in the Australian 45 and Up Study cohort. Each case was matched with four cancer-free controls on sex, age, geography, and smoking history. Costs were derived from linked health records on hospitalisations, subsidised prescription medicines and medical services to 2016. Excess costs for cancer cases were estimated for different phases of care relative to cancer diagnosis. Overall costs for prevalent ovarian cancers in Australia in 2013 were estimated based on 5-year prevalence statistics. Results: At diagnosis, 10% of women had localised disease, 15% regional spread and 70% distant metastasis (5% unknown). The mean excess cost per ovarian cancer case was $40,556 in the initial treatment phase (≤12 months post-diagnosis), $9,514 per annum in the continuing care phase and $49,208 in the terminal phase (up to 12 months before death). Hospital admissions accounted for the greatest proportion of costs during all phases (66%, 52% and 68% respectively). Excess costs were higher for patients diagnosed with distant metastatic disease, particularly during the continuing care phase ($13,814 versus $4,884 for localised/regional disease). The estimated overall direct health services cost of ovarian cancer in 2013 was AUD$99million (4,700 women nationally). Conclusion: The excess health system costs of ovarian cancer are substantial. Continued investment in ovarian cancer research, particularly prevention, early detection and more effective personalised treatments is necessary to reduce the burden of disease. [ABSTRACT FROM AUTHOR]

The historical study of exemptions has focused on escape from protectionist policies designed to control and monitor Aboriginal people in Australia — restricting their freedom of movement, intruding into their family life, and reducing their ability to participate on equal terms in the labour force. In this paper, we consider a contemporary policy — income management — which primarily restricts the freedom to dispose of personal income and has targeted Aboriginal people and communities, both directly and indirectly. Provisions for individual exemptions have been incorporated inconsistently within the many iterations of income management, and Aboriginal people are significantly less likely than others to be granted an exit from this form of financial control. The study reported here is an example of mixed‐methods social research, rather than an historiography. We use techniques of historical comparison to illuminate contemporary practices and identify the ongoing influence of settler‐colonial governance in the lives of Aboriginal people. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to identify early clinical biomarkers from birth to 16 weeks corrected age to predict typical outcome and developmental delay in infants born very preterm or with very low birthweight. Method: A prospective cohort of infants on the Sunshine Coast, Australia, was assessed using the Premie‐Neuro Examination, the General Movement Assessment (GMA), the Alberta Infant Motor Scale, and the Infant Sensory Profile 2. At 24 months corrected age, delay was identified using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley‐III) and Neurosensory Motor Developmental Assessment (NSMDA). Results: One hundred and four infants were recruited; 79 completed outcome assessments (43 females, 36 males; mean gestational age 30 weeks [SD 1 week 6 days], mean birthweight 1346 g [SD 323]). The incidence of developmental delay (motor or cognitive) was 6.3%. Suboptimal quality of fidgety general movements (temporal organization) at 16 weeks corrected age demonstrated the best predictive accuracy (Bayley‐III motor: sensitivity 100% [95% confidence interval {CI} 3–100], specificity 75% [95% CI 63–84], area under the curve [AUC] 0.87); Bayley‐III cognitive: sensitivity 100% [95% CI 3–100], specificity 75% [95% CI 64–84], AUC 0.88); NSMDA motor: sensitivity 100% [95% CI 40–100], specificity 81% [95% CI 70–90], AUC 0.91 [95% CI 0.86–0.95]). GMA trajectories that combined abnormal writhing general movements at 4 to 5 weeks corrected age with suboptimal quality of fidgety movement at 16 weeks corrected age were strongly predictive of developmental delay, superior to all other clinical tools, and perinatal and demographic variables investigated (p = 0.01, Akaike information criterion method 18.79 [score corrected for small sample size], accounting for 93% of the cumulative weight). Interpretation: Only the GMA had sufficient predictive validity to act as a biomarker for both conditions: typical outcome and developmental delay (motor or cognitive). GMA trajectories that assessed both writhing general movements at 4 to 5 weeks corrected age and quality of fidgety movement at 16 weeks corrected age predicted adverse neurodevelopmental outcome, accurately differentiating between infants with typical outcomes and those at increased risk for motor or cognitive delay. [ABSTRACT FROM AUTHOR]

Ontological parochialism persists in International Relations (IR) scholarship among gestures towards relational ontological reinvention. Meanwhile, the inter-polity relations of many Indigenous peoples pre-date contemporary IR and tend to be substantively relational. This situation invites rethinking of IR's understandings of political order and inter-polity relations. We take up this task by laying out necessary methodological innovations to engage with Aboriginal Australia and then showing how conventional and much recent heterodox IR seek to create forms of 'escape' from lived political relations by asserting the powerful yet problematic social science mechanism of observer's distance. This demonstrates a need to take Aboriginal Australia as a system on its own terms to speak back to IR. We next explain how Aboriginal Australian people produce political order on the Australian continent through a 'relational-ecological' disposition that contrasts with IR's predominant 'survivalist' disposition. The accompanying capacity to manage survivalism through relationalism provides an avenue for engaging with and recasting some of mainstream IR's survivalist assumptions, including by considering an Aboriginal approach to multipolarity, without attempting 'pure escape' through alternative ontologies. We thus argue that while it is necessary to critique and recast dominant IR, doing so requires putting dominant IR and Indigenous understandings into relational exchange. [ABSTRACT FROM AUTHOR]

Objective: Burden of disease studies measure the impact of disease at the population level;however, methods and data sources for estimates of prevalence vary. Using a selection of cardiovascular diseases, we aimed to describe the implications of using different disease models and linked administrative data on prevalence estimation within three Australian burden of disease studies. Methods: Three different methods (A = 2011 Australian Burden of Disease Study; B = 2015 Australian Burden of Disease Study; C = 2015 Western Australian Burden of Disease Study), which used linked data, were used to compare prevalence estimates of stroke, aortic aneurysm, rheumatic valvular heart disease (VHD) and non-rheumatic VHD. We applied these methods to 2015 Western Australian data, and calculated crude overall and age-specific prevalence for each condition. Results: Overall, Method C produced estimates of cardiovascular prevalence that were lower than the other methods, excluding non-rheumatic VHD. Prevalence of acute and chronic stroke was up to one-third higher in Method A and B compared to Method C. Aortic aneurysms had the largest change in prevalence, with Method A producing an eight-fold higher estimate compared to Method C, but Method B was 10–20% lower. Estimates of VHD varied dramatically, with an up to six-fold change in prevalence in Method C due to substantial changes to disease models and the use of linked data. Conclusions: Prevalence estimates require the best available data sources, updated disease models and constant review to inform government policy and health reform. Availability of nation-wide linked data will markedly improve future burden estimates. What is known about the topic? Accurate prevalence and subsequent burden estimates that reflect population-level disease burden are an important resource and are necessary for informing health policy decisions and resource distribution. What does this paper add? For cardiovascular disease, the comparison between direct use of linked data and other population-wide data sources highlighted the significant differences in the methods between Australia-wide and Western Australian-based studies in calculating prevalence estimates. What are the implications for practitioners? Continued, effective collaboration for improved disease models and subsequent burden estimates are necessary for appropriately informed decisions about health and resource distribution. [ABSTRACT FROM AUTHOR]

Purpose: Lung cancer (LC) in never-smoking individuals would rank as Australia's eighth most deadly cancer, yet risk factors remain uncertain. We investigated demographic, lifestyle and health-related exposures for LC among never-smoking Australians. Methods: Using the prospective 45 and Up Study with 267,153 New South Wales (NSW) residents aged ≥ 45 years at recruitment (2006–2009), we quantified the relationship of 20 potential exposures with LC among cancer-free participants at baseline who self-reported never smoking. Adjusted hazard ratios (HR) and 95% confidence intervals (CI) for incident LC were estimated using Cox regression. The NSW Cancer, Lifestyle and Evaluation of Risk (CLEAR) Study, a case–control study including 10,781 NSW residents aged ≥ 18 years (2006–2014), was used to examine 16 potential LC exposures among cancer-free never-smoking participants. Adjusted odds ratios (OR) and 95% CI of LC were estimated using logistic regression. Results: There were 226 LC cases among 132,354 cancer-free 45 and Up Study participants who reported never smoking, with a median follow-up of 5.41 years. The CLEAR Study had 58 LC cases and 1316 cancer-free controls who had never smoked. Analyses of both datasets showed that Asian-born participants had a higher risk of LC than those born elsewhere: cohort, adjusted HR = 2.83 (95% CI 1.64–4.89) and case–control, adjusted OR = 3.78 (1.19–12.05). No significant association with LC was found for other exposures. Conclusion: Our findings support the growing evidence that never-smoking, Asian-born individuals are at higher risk of developing LC than those born elsewhere. Ethnicity could be considered when assessing potential LC risk among never-smoking individuals. [ABSTRACT FROM AUTHOR]

Aim: Systemic therapies for lung cancer are rapidly evolving. This study aimed to describe lung cancer treatment patterns in New South Wales, Australia, prior to the introduction of immunotherapy and latest‐generation targeted therapies. Methods: Systemic therapy utilization and treatment‐related factors were examined for participants in the New South Wales 45 and Up Study with incident lung cancer ascertained by record linkage to the New South Wales Cancer Registry (2006–2013). Systemic therapy receipt to June 2016 was determined using medical and pharmaceutical claims data from Services Australia, and in‐patient hospital records. Factors related to treatment were identified using competing risks regressions. Results: A total of 1,116 lung cancer cases were identified with a mean age at diagnosis of 72 years and median survival of 10.6 months. Systemic therapy was received by 45% of cases. Among 400 cases with metastatic non–small cell lung cancer, 51% and 28% received first‐ and second‐line systemic therapy, respectively. Among 112 diagnosed with small‐cell lung cancer, 79% and 29% received first‐ and second‐line systemic therapy. The incidence of systemic therapy was lower for participants with indicators of poor performance status, lower educational attainment, and those who lived in areas of socioeconomic disadvantage; and was higher for participants with small‐cell lung cancer histology or higher body mass index. Conclusion: This population‐based Australian study identified patterns of systemic therapy use for lung cancer, particularly small‐cell lung cancer. Despite a universal healthcare system, the analysis revealed socioeconomic disparities in health service utilization and relatively low utilization of systemic therapy overall. [ABSTRACT FROM AUTHOR]