Department for Education and Child Development

BACKGROUND: Understanding the health profile, service and medicine use of Australians in the aged care sector will help inform appropriate service provision for our ageing population. AIMS: To examine the 2006-2015 trends in (i) comorbidities and frailty of individuals accessing aged care, and (ii) health services, medicine use and mortality after entry into long-term care. METHODS: Cross-sectional and population-based trend analyses were conducted using the Registry of Senior Australians. RESULTS: From 2006 to 2015, 509 944 individuals accessed permanent residential care, 206 394 home care, 283 014 respite and 124 943 transition care. Over this time, the proportion of individuals accessing permanent residential care with high frailty scores (≥0.3) increased (19.7-49.7%), as did the proportion with 5-9 comorbidities (46.4-54.5%), with similar trends observed for those accessing other services. The median number of medicines dispensed in the year after entering permanent residential care increased from 9 (interquartile range (IQR) 6-12) to 10 (IQR 7-14), while remaining stable in home care (2006: 9, IQR 5-12, 2015: 9, IQR 6-13). Short-term (within 100 days) mortality in those accessing permanent care was higher in 2006 (15.6%, 95% CI 15.2-16.0) than 2015 (14.6%, 95% CI 14.3-14.9). Longer term (101-1095 days, 2006: 44.3%, 95% CI 43.7-45.0, 2015: 46.4%, 95% CI 45.8-46.9) mortality was higher in 2015 compared to 2006. Mortality in individuals accessing home care did not change. CONCLUSION: The health of older Australians accessing aged care programmes has declined while frailty increased, with an increasing use of medicine and worse long-term mortality in some. Funding and care models need to adapt to this changing profile.

Poor academic performance has been linked with particular lifestyle behaviors, such as unhealthy diet, short sleep duration, high screen time, and low physical activity. However, little is known about how lifestyle behavior patterns (or combinations of behaviors) contribute to children's academic performance. We aimed to compare academic performance across clusters of children with common lifestyle behavior patterns. We clustered participants (Australian children aged 9-11 years, n = 284) into four mutually exclusive groups of distinct lifestyle behavior patterns, using the following lifestyle behaviors as cluster inputs: light, moderate, and vigorous physical activity; sedentary behavior and sleep, derived from 24-hour accelerometry; self-reported screen time and diet. Differences in academic performance (measured by a nationally administered standardized test) were detected across the clusters, with scores being lowest in the Junk Food Screenies cluster (unhealthy diet/high screen time) and highest in the Sitters cluster (high nonscreen sedentary behavior/low physical activity). These findings suggest that reduction in screen time and an improved diet may contribute positively to academic performance. While children with high nonscreen sedentary time performed better academically in this study, they also accumulated low levels of physical activity. This warrants further investigation, given the known physical and mental benefits of physical activity.

Summary A randomised controlled trial of the effects of two different physical activity programmes on coronary heart disease (CHD) risk factors, academic performance, and classroom behaviour, was conducted on over 500 children (mean age 10) in eight Adelaide primary schools in 1978. During a fourteen‐week intervention period classes were involved in either: an endurance fitness programme, a skills programme, or participated as controls. The Fitness group experienced significant gains in physical work capacity and decreases in body fat compared to the Control and Skill groups. Diastolic blood pressure decreased significantly more in the Skill group than in the Control; but no significant difference was observed between the Fitness and Control groups. Changes in the other CHD risk factors measured, systolic blood pressure, plasma cholesterol, triglycerides and HDL cholesterol did not differ between groups. Both the Fitness and Skill groups demonstrated improvements in classroom behaviour compared to the control group; but no differences in academic performance were observed.

Purpose The purpose of this paper is to describe the application of empowerment and the role that it plays in fostering community participation, community integration and in enabling a healthy re-settlement of culturally and linguistically diverse migrants who have recently arrived in Australia from Sub Saharan Africa. Design/methodology/approach The paper's approach is a discussion expressing the views of authors supported by the relevant literature drawn from a wide range of sources on migration, settlement, health, social, environment, cultural and public health issues. The African community and its peak organisation, the African Communities Council of South Australia is presented and various empowerment strategies used by the council are discussed as a healthy model for empowering new settlers in the new environment. Findings The first part of the paper describes the migration of African migrants in South Australia and sets the scenario describing the current state of these migrants including opportunities and challenges they face in the new environment. The second part describes theories and contexts of community empowerment, relationship between community empowerment and a healthy settlement; and the relevance and implications of community empowerment. The third part draws the above context and the empowerment strategy is specifically related to the African Community in South Australia. The empowerment strategy in this case represents a wide range of interventions aimed to equip new African migrants to a successful and a healthy resettlement and integration in South Australia. By addressing a wide range of settlement challenges and issues, the strategy employs concepts of empowerment that have been used in public health in general, health promotion, health education, communications, community engagement and community development. Originality/value The paper highlights challenges and opportunities for new migrants in the new environment and argues that community empowerment is an important enabling tool for a healthy settlement, particularly for people with refugee backgrounds. The paper also acknowledges that the community development approach has assisted the target group and has improved their ability to overcome challenges associated with settlement through capacity building, social capital and community connectivity.

This article explores the power of student voice, in recognition of the child's right to be treated as a capable, competent social actor involved in the education process. In this study, student voice is considered in the light of improving students' engagement and personal and social development at the primary school level. It emphasizes the importance of soliciting and respecting students' voice through their involvement as individuals in collective decision-making and governance as part of a “Students' Parliament.” The aim is to understand how children view their roles and opportunities to be involved in making decisions about their own learning and about the wider school community. The study has significant implications for educators about ways of effectively and respectfully engaging students in matters that are important to them, which in turn has a positive impact on students' engagement, motivation, and individual development.

BACKGROUND: Attendance at face-to-face sessions and completion of online components of the National Prescribing Curriculum was made compulsory for final year medical students at the University of Adelaide in 2010. AIMS: To determine the impact of a compulsory prescribing curriculum for final year medical students on their prescribing competencies at the start of clinical practice. Graduates' attitudes to their medical school training in prescribing were also surveyed. METHODS: Two cohorts of medical graduates from the University of Adelaide who commenced medical practice in 2010 and 2011 were required to complete a prescribing task using the National Inpatient Medication Chart (NIMC) at orientation and after 6 months of clinical practice. The main outcome measure was a performance in a scenario-based prescribing test, as determined by test scores and overall safety of prescriptions at orientation and 6 months of clinical practice. RESULTS: There was a small difference in the average total score for the prescribing task between the 2010 and 2011 cohorts at orientation (P = 0.0007). The 2011 cohort had a higher number of safer charts at commencement of practice. We found no difference between the 2010 and 2011 cohorts in attitudes towards their undergraduate pharmacology education, and new graduates feel poorly prepared. CONCLUSION: Medical graduates who are required to complete a practically oriented prescribing curriculum in final year perform slightly better on a prescribing assessment at commencement of practice. More work on preparing graduates for this complex task before graduation is needed.

ABSTRACT BACKGROUND The purpose of this study was to determine whether there was an association between dietary patterns and children's academic performance. METHODS This cross‐sectional study involved 315 children aged 9‐11 years from 26 schools in Australia. Academic performance was measured in 4 domains (reading, writing, numeracy, and language—subdomains: spelling, grammarm and punctuation) using the National Assessment Program in Literacy and Numeracy (NAPLAN). A self‐reported child questionnaire collected dietary intake data. “Core” (healthy) and “noncore” (unhealthy) dietary patterns were derived using principal components analysis. RESULTS The noncore pattern was associated with lower NAPLAN scores across all academic domains (mean: −12.6, 95% CI: −18.7 to −6.4, r 2 = .073, p < .001) except writing, while the core foods pattern was not associated with NAPLAN scores across all domains. When the noncore model was adjusted for sociodemographic covariates (child body mass index, ethnicity, sex, parental education, household income, marital status, mother's employment hours, and number of siblings), the association was attenuated but remained statistically significant (NAPLAN summary score: −8.5, 95% CI −15.0 to −1.9, r 2 = .123, p = .011). CONCLUSIONS Academic performance was deleteriously associated with a nutrient‐poor, energy‐dense diet, yet not associated with a nutritious diet.

Since the pandemic started, organisations have been actively seeking ways to improve their organisational agility and resilience (regility) and turn to Artificial Intelligence (AI) to gain a deeper understanding and further enhance their agility and regility. Organisations are turning to AI as a critical enabler to achieve these goals. AI empowers organisations by analysing large data sets quickly and accurately, enabling faster decision-making and building agility and resilience. This strategic use of AI gives businesses a competitive advantage and allows them to adapt to rapidly changing environments. Failure to prioritise agility and responsiveness can result in increased costs, missed opportunities, competition and reputational damage, and ultimately, loss of customers, revenue, profitability, and market share. Prioritising can be achieved by utilising eXplainable Artificial Intelligence (XAI) techniques, illuminating how AI models make decisions and making them transparent, interpretable, and understandable. Based on previous research on using AI to predict organisational agility, this study focuses on integrating XAI techniques, such as Shapley Additive Explanations (SHAP), in organisational agility and resilience. By identifying the importance of different features that affect organisational agility prediction, this study aims to demystify the decision-making processes of the prediction model using XAI. This is essential for the ethical deployment of AI, fostering trust and transparency in these systems. Recognising key features in organisational agility prediction can guide companies in determining which areas to concentrate on in order to improve their agility and resilience.

To identify early life factors associated with posttraumatic stress disorder (PTSD), we investigated the association between childhood trauma and mental disorders with International Classification of Diseases (ICD)-diagnosed past-year PTSD in employed military and civilian men. Data were derived from the 2010 Australian Defence Force (ADF) Mental Health Prevalence and Wellbeing Study (N = 1,356) and the 2007 Australian Bureau of Statistics (ABS) National Survey of Mental Health and Wellbeing Study (N = 2,120) and analyzed using logistic regression and generalized structural equation modeling. After controlling for demographics, PTSD was associated with childhood anxiety, adjusted odds ratio (AOR) = 3.94, 95% CI [2.36, 6.58]; and depression, AOR = 7.01, 95% CI [2.98, 16.49], but not alcohol use disorders, in the ADF. In civilians, PTSD was associated with childhood anxiety only, AOR = 7.06, 95% CI [3.50, 14.22]. These associations remained significant after controlling for childhood and adult trauma in both populations and service factors and deployment, combat, or adult trauma in the ADF. In both populations, PTSD was associated with more than three types of childhood trauma: AOR = 2.97, 95% CI [1.53, 5.75] for ADF and AOR = 5.92, 95% CI [3.00, 11.70] for ABS; and childhood interpersonal, but not noninterpersonal, trauma: AOR = 3.08, 95% CI [1.61, 5.90] for ADF and AOR = 6.63, 95% CI [2.74, 16.06] for ABS. The association between childhood trauma and PTSD was fully mediated by childhood disorder in the ADF only. Taking a lifetime perspective, we have identified that the risk of PTSD from childhood trauma and disorder is potentially predictable and, therefore, modifiable.

the Symphony Way Pavement Dwellers, Cape Town, Pambazuka Press, 2011, 160 pp., £16.95 (paperback), ISBN 978-1-906387-84-6 In this major new book of anthology, everyone is singing a common tune and ...

Standard hybridoma production involves the fusion of spleen cells from an immunized mouse with a non-secretory murine myeloma cell line. While this technology has provided numerous reagents that are highly valuable, demand is now increasing for monoclonal antibodies which can distinguish between closely related antigens. Induction of tolerance towards common antigens enables the recovery of high-specificity reagents that have previously proved elusive. This review details a number of strategies using either complex protein mixtures or purified proteins as tolerogens and subsequent immunization with a closely related immunogen.

The drivers and rate of vegetation change across spatial gradients can give critical insights into the compositional and structural change we can expect under climate change. Spatial ecotones are of particular interest as they represent heterogeneity in the patterning of vegetation that may reflect how temporal environmental change will manifest in more abrupt step changes in plant composition and/or structure. Another dimension of interest is the degree to which survey methodology impacts the detectability of thresholds in vegetation. We surveyed a Mediterranean to arid zone gradient in South Australia with nested and non-nested transect designs and related the observed vegetation change to soil, landscape and climate to determine the strongest environmental associations. Ordination, principal components analysis (PCA) and threshold indicator taxa analysis (TITAN) were used to detect potential ecotones associated with environmental thresholds. Results from the two transects were compared with test the effects of survey method and spatial sampling on pattern detection. Ordinations and regressions for both transects indicated vegetation changed linearly along the environmental gradient. Species richness and total cover increased with rainfall. Species turnover was very high, with low nestedness, indicating high susceptibility to environmental change. Climate is the major driver of broad-scale vegetation change on our gradient and at this scale vegetation trends are detectable with a range of survey methodologies. TITAN identification of a threshold within the shorter, nested transect (but not the longer transect which extended into the arid zone) indicated that survey methodology influences ecotone detectability, and that although smaller-scale vegetation disjunctions may be present, change spanning the entire mesic to arid zone is largely monotonic.

Abstract Using metaphor in therapy, both in the process of joining with a family and as a process in itself within which interventions are delivered, can lead to extraordinary and sometimes unexpected behavioural change. Yet for the therapist beginning to consider the use of therapeutic metaphor the prospect must be daunting when, with a few notable exceptions, the literature suggests the ideal as a complex, isomorphic and often elegant story. This paper attempts to broaden yet simplify technique using clinical example to examine the use of metaphor in language and action in family therapy.

Improving quality in education: dynamic approaches to school improvement, by Bert P.M. Creemers and Leonidas Kyriakides, London and New York, Routledge, 2012, 301 pp., £28.88/US$51.95 (paperback), ...

It is shown that every compact nonconnected semigroup (semiring) which has commuting congruences, has a nontrivial continous homomorphic image which is iseomorphic to a direct product of finite congruence free semigroups (semirings). (This extends parts of earlier work by Kaplansky (1947) on compact rings.) It is also shown that there is a possibly finer representation but onto a product of congruence free semigroups (semirings) known only to be compact Hausdorff. A number of the techniques used evolve from work of Professor Wallace, who retired in mid-1973, and to whom this paper is dedicated.

In children, the majority of cases are self-limiting and thus many paediatric patients can be managed conservatively with minimal complications. This varies considerably compared to adult newly diagnosed immune thrombocytopaenia (NDITP) where, in most cases, thrombocytopaenia persists with higher risk of moderate to severe bleeding complications. In the past decade, local and international guidelines have emerged to support approaches to the investigation and management of NDITP, with a focus primarily on adult immune thrombocytopaenia (ITP). International consensus guidelines on paediatric NDITP have been developed, however gaps remain, and approaches vary between North American, Asia, Europe and the UK. There are no current Australian or New Zealand paediatric ITP guidelines readily available, rather differing guidelines for each state, territory or island. These inconsistencies cause uncertainty for patients, families and physicians managing cases. Subsequently, physicians, including paediatric haematologists and general paediatricians, have come together to provide a consensus approach guideline specific to paediatric NDITP for Australian or New Zealand. Persistent or chronic paediatric ITP remains a complex and separate entity and are not discussed here.

An Australian, visiting our classrooms for six months, gives some insightful reactions to what he observed.

In every evaluation context, the question of worth underpins the motivation or role of the evaluation, even if it is not explicitly stated. Often, this question cannot be answered fully, simply because people or parties may make varying subjective judgments about the value and likelihood of different outcomes—it is at this juncture that cost–benefit analysis (CBA) can be of use. For evaluations where most significant inputs and outcomes can be valued in monetary terms, CBA provides a systematic methodology for reaching conclusions on ‘worth’. CBA is best used in conjunction with traditional evaluation approaches rather than as a replacement approach. The use of CBA can help an evaluator to be more confident in stating the evaluation findings, particularly in social policy settings where the use and importance of CBA is growing. This article aims to help evaluators learn more about CBA by demonstrating its use to analyse an intervention designed to help young people disengaged from learning.

On a recent tour of the United States, Graham Martin spent a privileged, information‐packed, two and a half days at Butler Hospital, Providence, Rhode Island, in a programme carefully organised by Dr Duane Bishop. During that visit Dr Epstein agreed to the following interview.

Importance: The long-term impacts of the COVID-19 pandemic on after-school activity patterns among youths remain poorly understood, hindering the development of policies to promote beneficial engagement. Objective: To examine longitudinal changes in after-school activity participation before (2019), during (2020 to 2021), and after (2022) the COVID-19 pandemic and assess whether these changes differed by sex. Design, Setting, and Participants: This longitudinal cohort study used linked yearly census survey data from the Well-Being and Engagement Collection (WEC) survey in South Australia. Participants were youths starting year 6 of school on January 29, 2019, who progressed to starting year 9 by January 31, 2022. Data analyzed were collected in weeks 2 to 5 of term 2 (May 2019 to May 2022). Exposure: COVID-19 pandemic. Main Outcomes and Measures: Weekly frequency of engagement in 11 after-school activities was measured in the WEC survey. Ordinal logistic regression models examined the trajectory of after-school activity participation. The results were visualized as estimated proportions over time. Results: A total of 14 350 participants (mean [SD] age in 2019, 11.7 [0.5] years; 7232 [50.4%] male) contributing 36 572 observations were included in the analysis. Participation in music, art, reading for fun, hanging out with friends, tutoring, and sports declined during and after the pandemic. Among these participants, youths who never participated in art (2019, 25.7% [95% CI, 24.5%-27.0%]; 2022, 70.4% [95% CI, 68.8%-72.0%]) and reading for fun (2019, 10.8% [95% CI, 10.1%-11.6%]; 2022, 52.6% [95% CI, 50.5%-54.8%]) showed the largest changes. Conversely, time spent watching television, doing chores, and playing electronic games showed meaningful increases but returned to prepandemic levels in 2022. Social media was the only activity that showed consistent increases during the 4 years, demonstrating the greatest growth. Everyday use increased from 26.0% (95% CI, 24.6%-27.3%) in 2019 to 85.4% (95% CI, 84.1%-86.7%) in 2022. Females spent more time on social media than males, while males experienced a more pronounced decline in reading. Conclusions and Relevance: This cohort study found associations between the COVID-19 pandemic and after-school activity participation patterns among youths, with rapid increases in social media use compared with all other activities. These associations largely persisted 3 years after the onset of the pandemic. These findings provide a timely benchmark for evaluating forthcoming policies aimed at restricting youth access to social media platforms. Interventions to support activities such as sports, art, and music are warranted.