The Australian sugarcane industry has long maintained high sugar content in cane and ranks among the world's lowest-cost raw sugar producers.This paper analyzes the key factors behind this competitive performance....The Australian sugarcane industry has long maintained high sugar content in cane and ranks among the world's lowest-cost raw sugar producers.This paper analyzes the key factors behind this competitive performance.It examines industry statistics,cost of production studies,historical records,and international comparisons.The analysis shows that the industryʼs advantage stems not from any single factor,but from a combination of six elements:(a)a climate favorable for high sucrose accumulation;(b)economies of scale in both farming and milling;(c)a high level of mechanization,particularly in harvesting;(d)a cane pricing formula that incentivizes high sugar content;(e)a research and development system that is mandatory-funded,industry-led,and industry-controlled by growers and millers;and(f)prolonged exposure to international competition with minimal trade protection.For other sugar-producing countries aiming to lower costs,this suggests pathways such as facilitating farm consolidation,introducing mechanization within suitably adapted farming systems,reforming cane payment systems to reward sugar content,refocusing R&D investment to better meet industry needs,and optimizing nutrient management to reduce nitrogen fertilizer use.展开更多
Objectives This study aimed to develop a blueprint based on empirical data to guide the integration of nursing informatics(NI)into undergraduate nursing programs.Methods This study employed a qualitative,holistic mult...Objectives This study aimed to develop a blueprint based on empirical data to guide the integration of nursing informatics(NI)into undergraduate nursing programs.Methods This study employed a qualitative,holistic multiple-case study design,allowing each case to be examined as an integrated contextual system.Data were obtained from four cases—two from Australian universities and two from South African universities—all of which were public institutions offering undergraduate nursing programs.Twenty-one academic staff participated.Data collection involved semi-structured interviews,document review,and field observations.The documents reviewed included national digital health strategies,health informatics and NI standards,nursing education policies,accreditation standards,and curriculum guidelines.Materials from institutions—including subject outlines,program handbooks,and teaching policies—were also reviewed to gain a better understanding of how NI was integrated in each case.An individual case analysis employed conventional content analysis,followed by a cross-case thematic comparison.Data collection and analysis were conducted iteratively until saturation was achieved.Results This study highlighted the need for NI in undergraduate nursing programs.Foundational competencies,such as computer and information literacy,and advanced NI competencies,including digital health literacy,data security,and privacy literacy,alongside other competencies,were identified across varying levels of proficiency.Data from four cases led to the development of a blueprint to guide the integration of NI into undergraduate curricula.It comprises eight context-responsive steps,including situational and training needs analysis,NI competency identification and mapping against national and international standards,NI content development,sequencing NI content and experience,NI content review,implementation,and evaluation.The blueprint promotes responsive curricula that strengthen NI capabilities and readiness for digital healthcare.Conclusion The blueprint aligns with nursing education priorities,workforce needs,and emerging technologies,thereby supporting NI competency development that advances digitally transformed healthcare.展开更多
BACKGROUND Hepatocellular carcinoma(HCC)is a leading cause of cancer-related deaths worldwide.Liver transplantation(LT)offers the most effective treatment.HCC recurrence is the strongest risk factor that decreases pos...BACKGROUND Hepatocellular carcinoma(HCC)is a leading cause of cancer-related deaths worldwide.Liver transplantation(LT)offers the most effective treatment.HCC recurrence is the strongest risk factor that decreases post-LT survival in patients transplanted for HCC.The rate of HCC recurrence is generally reported as 8%-20%in the literature.Many predictors of HCC have already been researched,however,to our knowledge there are no published studies on this topic using Australian data.AIM To determine the rate and identify predictors of HCC recurrence in a contemporary Western Australian LT cohort.METHODS We performed a retrospective cohort study of all liver transplants in patients with HCC at Sir Charles Gairdner Hospital between 2006 and 2021.Data was collected from various health record databases and included recipient demographics,serum biochemistry,radiology,operation notes,explant histopathology and details of recurrence.Overall survival of HCC patients post-LT,stratified for recurrence,was calculated by Kaplan Meier analysis.Univariate and multivariate Cox regression was used to determine predictors of HCC recurrence post-LT.RESULTS Between 1/1/2006 and 12/31/2021,119 patients were transplanted with HCC.8.4%of subjects developed recurrent HCC after LT with median follow-up time of 5.4 years.The median time to recurrence was 2.9 years±0.75 years.When comparing baseline characteristics,a greater proportion of subjects with recurrence had common characteristics on explant histopathology,including>3 viable nodules(P=0.001),vascular invasion(P=0.003)and poorly differentiated HCC(P=0.03).Unadjusted survival curves showed lower 1-year,3-year,5-year and 10-year survival rates in subjects with HCC recurrence compared to those without HCC recurrence(90%vs 92%,70%vs 88%,42%vs 80%,14%vs 76%,respectively;log rank P<0.001).CONCLUSION HCC recurrence was low at 8.4%in this contemporary Australian cohort,however it significantly impacted post-LT survival.Further studies are required to confirm predictors of recurrence and improve recipient outcomes.展开更多
We document,for the first time,Mesoproterozoic-aged,continental arc magmatism in the Tasmanides.Granitoid samples intruding the Proterozoic Cape River Metamorphics in northeast Queensland contain abundant∼1200 Ma ign...We document,for the first time,Mesoproterozoic-aged,continental arc magmatism in the Tasmanides.Granitoid samples intruding the Proterozoic Cape River Metamorphics in northeast Queensland contain abundant∼1200 Ma igneous zircons,with early-Paleozoic metamorphic rim overgrowths.Analytical mixing between the igneous and metamorphic zircons produces cryptic discordant analyses,but the origin of said discordance is resolved with zircon Th/U ratios.Samples of the Fat Hen Creek Complex are peraluminous,calc-alkaline,S-type granitoids,that record high-grade metamorphism and trace element mobilization.The P3 and P42 intrusions are metaluminous,calc-alkaline,I-type granodiorite,which intruded the Cape River Metamorphics,and contain trace element signatures consistent with a continental-arc setting.We propose that a Mesoproterozoic continental terrane,herein referred to as the Oakvale Province,exists as basement to the Thomson Orogen.We propose several models for the formation of the Oakvale Province,with potential links to the Tarim Block,and the Yangtze Craton,during the late-Mesoproterozoic.We propose that the Oakvale Province supplied the Tasmanides with late-Mesoproterozoic detritus,and that such detritus was not solely sourced from the Musgrave Province as previously interpreted.Finally,we interpret the oroclinal bending of Paleozoic deformation and plutonic fabrics to reflect the buried extent of the Oakvale Province,and to potentially map out the Neoproterozoic rift margin associated with Rodinia break-up.展开更多
In this article,we present a comprehensive overview of the regulatory landscape governing Chinese medicinal practices in Australia,in which we describe the regulations for Chinese medicine practitioners in Australia,a...In this article,we present a comprehensive overview of the regulatory landscape governing Chinese medicinal practices in Australia,in which we describe the regulations for Chinese medicine practitioners in Australia,as of 2024,focusing in particular on the Title Protection model under the Health Practitioner Regulation National Law.Central to this discussion are the core roles of the Chinese Medicine Board of Australia(the Board)and the Australian Health Practitioner Regulation Agency(Ahpra)in ensuring public safety by guaranteeing that practitioners are appropriately qualified and suitable for registration.We also examine the structure and demographics of the Chinese medicine workforce in Australia and present details of the required registration process for practitioners.In addition,the article outlines specific requirements for registration,including the standards set by the Board for initial and ongoing registration,which are administered with the support of Ahpra under the National Registration and Accreditation Scheme.Furthermore,we present details regarding the approved qualifications,the rigorous assessment process for overseas qualifications,and the important role of regulatory examinations designed to uphold the high standards expected of practitioners,thereby ensuring they have acquired the professional competencies required by the Australian healthcare system.This overview offers valuable insights for both current and prospective practitioners of Chinese medicine in Australia.展开更多
Rationale:Australia is the only inhabited continent,which is not endemic to leishmaniasis.There are some published articles reporting cutaneous leishmaniasis in travellers,immigrants and refugees.However,mucocutaneous...Rationale:Australia is the only inhabited continent,which is not endemic to leishmaniasis.There are some published articles reporting cutaneous leishmaniasis in travellers,immigrants and refugees.However,mucocutaneous leishmaniasis has not been reported previously from the continent.Patient concerns:Lesions were present over the nasal septum and the oropharynx of a 34-year-old healthy non-indigenous male.Diagnosis was delayed as it took multiple biopsies as well as extensive discussions in a multidisciplinary team.Diagnosis:Mucocutaneous leishmaniasis.Interventions:Liposomal Amphotericin for 20 days.Outcomes:The patient was symptomatically improved after 3 weeks’treatment.Lessons:With international travel resuming after the pandemic,it becomes imperative that physicians in Australia are aware of this imported disease and its various presentations.展开更多
Objective To examine general practitioners’(GPs)referral patterns to allied health services for people with dementia compared with those without dementia across two large Australian Primary Health Networks(PHNs).Desi...Objective To examine general practitioners’(GPs)referral patterns to allied health services for people with dementia compared with those without dementia across two large Australian Primary Health Networks(PHNs).Design A retrospective cohort study using routinely collected general practice data.Logistic regression was used to compare odds of allied health referrals,adjusting for age,sex and socioeconomic status.Setting De-identified patient and episode activity data from 537 GP practices across two PHNs in Australia between 2018 and 2023.Participants Data from 1153304 patients and 28667517 GP episodes of care were analysed.After merging records,693328 unique patients were identified,including 16610 patients with dementia.Subcohorts included patients with dementia,stroke,Parkinson’s disease and combinations of these conditions.Results The dementia cohort(n=16610)had a similar overall allied health referral rate(36.1%)to the control cohort(n=48977)(35.4%).Patients with dementia only were significantly less likely to receive any allied health referral compared with those with stroke(adjusted OR(aOR)0.76,95%CI 0.72 to 0.80;p<0.001)or Parkinson’s disease(aOR 0.72,95%CI 0.66 to 0.78;p<0.001).Those with dementia and stroke were also less likely to receive referrals than those with stroke only(aOR 0.71,95%CI 0.61 to 0.82;p<0.001).No significant difference was found between dementia with Parkinson’s and Parkinson’s only groups(p=0.48).Patients with dementia were consistently less likely to be referred to key allied health services(p<0.05).Conclusion Despite strong evidence supporting allied health interventions for dementia,referral rates remain comparatively low.Enhancing GP referral resources and education,integrating dementia-specific care pathways and implementing supportive policy changes are needed to improve access and equity in dementia care.展开更多
Objective This systematic review assessed trial-based economic evaluations to provide empirical evidence on the cost-effectiveness of non-drug interventions(NDIs)that are currently recommended within the Royal Austral...Objective This systematic review assessed trial-based economic evaluations to provide empirical evidence on the cost-effectiveness of non-drug interventions(NDIs)that are currently recommended within the Royal Australian College of General Practitioners Handbook of Non-Drug Interventions(HANDI).Methods Medline,CINAHL and PsycINFO along with clinical trial registries(clinicaltrials.gov and WHO International Clinical Trials Registry Platform)were searched from inception to 1 July 2025.Randomised controlled trials(RCTs)that reported cost effectiveness for a prescribed non-drug intervention(NDI)from HANDI were included in the study.The primary outcome was the incremental cost-utility ratio(ICUR)derived from cost-utility analyses(CUAs).Results A total of 11187 citations were identified,from which 156 RCTs were included.These RCTs enrolled a total of 66926 participants(median=214,IQR 139–342),with a median follow-up duration of 12 months(IQR 6–12 months).Over half of the CUA NDIs were for mental health conditions(n=81;54.0%),one-third were for were for musculoskeletal conditions(n=44;29.3%),while only 16.0%(n=24)were for those with cardiovascular/metabolic conditions.Out of the 150 NDIs that reported CUAs,40%were deemed to be in the south-east(SE)quadrant(cheaper and more effective)and 49.3%fell in the north-east(NE)quadrant(more costly but more effective),with 70%considered cost effective against a￡25000/quality-adjusted life-year(QALY)willingness to pay threshold.The overall median ICUR was￡2400/QALY(IQR−18986 to 20027).Conclusions Most of the HANDI NDIs that were included within this systematic review are cost-effective compared with a variety of alternatives including usual care or waiting list controls.HANDI NDIs warrant use as a first line of treatment when clinically appropriate.展开更多
BACKGROUND Fear of childbirth(FoC)is a widespread issue that impacts the health and well-being of mothers and newborns.However,there is inconsistency regarding the prevalence of FoC in the and there is limited researc...BACKGROUND Fear of childbirth(FoC)is a widespread issue that impacts the health and well-being of mothers and newborns.However,there is inconsistency regarding the prevalence of FoC in the and there is limited research on the prevalence of FoC among Australian pregnant women.AIM To investigate the prevalence of FoC,its risk factors and birth outcomes in Aust-ralian multiparous women.METHODS In this prospective cohort quantitative study,212 multiparous women were re-cruited from antenatal clinics at Westmead Hospital in western Sydney from 2019 to 2022.Pregnant women who attended antenatal visits and met the inclusion criteria signed the consent forms and completed several online questionnaires at baseline.After they gave birth,their birth outcomes were collected from the hospital’s medical record database.The data were analyzed using SPSS software and descriptive statistics,χ^(2)test,independent samples t-test,and multivariable logistic regression analysis.RESULTS Out of 212 participants,24%experienced a high level of FoC and 7%experienced severe FoC.Theχ^(2)test results revealed that a family income of≤$100000,no alcohol intake during pregnancy,pre-existing health problems,previous caesarean section(emergency or planned),and previous neutral/traumatic childbirth experiences were significantly associated with higher levels of FoC(P<0.05).Other risk factors included being moderately to very worried and fearful about the upcoming birth,having severe to extremely severe anxiety throughout pregnancy,and expressing low relationship satisfaction.According to multivariable logistic regression,the odds of a high level of FoC were higher in women with anxiety,a history of traumatic childbirth experience,a history of sexual assault during childhood,pre-existing health problems,and lower relationship satisfaction(P<0.05).CONCLUSION High-severe levels of FoC are experienced by pregnant multiparous women and are affected by several demo-graphic factors.However,due to the small sample size in the present study,further studies with larger sample sizes are required to draw a firm conclusion on the prevalence of severe FoC among multiparous women and its associated risk factors and birth outcomes.展开更多
Moisture accumulation within road pavements,particularly in unbound granular materials with or without thin sprayed seals,presents significant challenges in high-rainfall regions such as Queensland.This infiltration o...Moisture accumulation within road pavements,particularly in unbound granular materials with or without thin sprayed seals,presents significant challenges in high-rainfall regions such as Queensland.This infiltration often leads to various forms of pavement distress,eventually causing irreversible damage to the pavement structure.The moisture content within pavements exhibits considerable dynamism and directly influenced by environmental factors such as precipitation,air temperature,and relative humidity.This variability underscores the importance of monitoring moisture changes using real-time climatic data to assess pavement conditions for operational management or incorporating these effects during pavement design based on historical climate data.Consequently,there is an increasing demand for advanced,technology-driven methodologies to predict moisture variations based on climatic inputs.Addressing this gap,the present study employs five traditional machine learning(ML)algorithms,K-nearest neighbors(KNN),regression trees,random forest,support vector machines(SVMs),and gaussian process regression(GPR),to forecast moisture levels within pavement layers over time,with varying algorithm complexities.Using data collected from an instrumented road in Brisbane,Australia,which includes pavement moisture and climatic factors,the study develops predictive models to forecast moisture content at future time steps.The approach incorporates current moisture content,rather than averaged values,along with seasonality(both daily and annual),and key climatic factors to predict next step moisture.Model performance is evaluated using R2,MSE,RMSE,and MAPE metrics.Results show that ML algorithms can reliably predict long-term moisture variations in pavements,provided optimal hyperparameters are selected for each algorithm.The best-performing algorithms include KNN(the number of neighbours equals to 15),medium regression tree,medium random forest,coarse SVM,and simple GPR,with medium random forest outperforming the others.The study also identifies the optimal hyperparameter combinations for each algorithm,offering significant advancements in moisture prediction tools for pavement technology。展开更多
The Ediacaran-Cambrian Petermann Orogen is a dextral transpressional orogen exposed in central Australia,which facilitated the exhumation of a high-pressure core and the deformation of the Neoproterozoic-Palaeozoic Am...The Ediacaran-Cambrian Petermann Orogen is a dextral transpressional orogen exposed in central Australia,which facilitated the exhumation of a high-pressure core and the deformation of the Neoproterozoic-Palaeozoic Amadeus Basin.Several studies have investigated the metamorphic and deformational evolution of the Petermann Orogen;however,the spatiotemporal variation of the deformation and cooling history is yet to be fully understood.In situ muscovite and biotite Rb-Sr geochronology,in combination with Ti-in-quartz thermometry is applied to map the spatiotemporal deformation and cooling patterns of the northern part of the Petermann Orogen.Interpreted muscovite Rb-Sr growth ages obtained from samples in the Petermann Nappe Complex(PNC),range between c.598 Ma and 565 Ma,which correlate with the timing of deformation during the 600-520 Ma Petermann Orogeny.Interpreted muscovite and biotite cooling ages are younger in the east of the PNC(c.556-541 Ma)and broadly correlate with the regional pattern of crustal heat production,suggesting that the geothermal gradient had a significant control on the timing and duration of cooling.Biotite Rb-Sr cooling ages between c.555 Ma and 497 Ma for the orogenic core show no correlation with high heat production areas,however,differences in exhumed crustal levels across the Petermann Orogen are observed:high-P granulite facies rocks in the orogenic core vs middle-upper crustal rocks in the PNC,indicating that at least part of the spatiotemporal variation of cooling ages can be attributed to differential exhumation during the Petermann Orogeny.Hence,crustal heat production and differential exhumation were likely the main controlling factors on the duration and variation of cooling rates in the Petermann Orogen.展开更多
Chronic pain affects 3.6 million Australians and this number is projected to reach 5.23 million by 2050,costing A$73.2 billion annually.Current care relies heavily on pharmacotherapy-particularly opioids-which leads t...Chronic pain affects 3.6 million Australians and this number is projected to reach 5.23 million by 2050,costing A$73.2 billion annually.Current care relies heavily on pharmacotherapy-particularly opioids-which leads to approximately 150 hospitalizations,14 emergency visits,and three opioid-related deaths daily.National strategies now promote multimodal and non-pharmacological options.One of these options-acupuncture-offers a safe,evidence-based alternative with opioid-sparing effects for patients with acute and chronic pain.Therefore,its current application across various settings highlights its strong potential for integration into mainstream care.Here,we conducted a structured review of peer-reviewed literature,regulatory documents,workforce reports,and government publications on acupuncture to assess registration and education standards,workforce capacity,and professional and consumer acceptance of acupuncture.Australian pain management guidelines(2015-2025)that included acupuncture were systematically identified and evaluated.Acupuncture is a nationally registered profession with the protected title of“Acupuncturist.”Over 4800 practitioners currently provide care and consumer and professional attitudes are generally positive.However,public funding is minimal,with access largely dependent on out-of-pocket payments or limited private health insurance rebates.Few Australian guidelines recommend acupuncture for pain,in contrast to its more widespread endorsement in the United States and Europe.Some state health services and hospitals have piloted programs;however,their implementation remains fragmented.Global evidence,consumer acceptance,and the person-centered nature of acupuncture allow it to complement existing pain strategies and reduce opioid reliance in Australia.However,to achieve this,the profession must strengthen education in contemporary pain science,foster inter-professional collaboration,and expand research on its role in multidisciplinary care.Advocating for public funding is also critical.Embedding acupuncture within an integrated pain framework can better meet consumer needs,improve outcomes,and contribute to the long-term sustainability of the healthcare system.展开更多
This study examines the relationships among the monsoon-like southwest Australian circulation （SWAC）, the South- ern Annular Mode （SAM）, and southwest Western Australia winter rainfall （SWR）, based on observed r...This study examines the relationships among the monsoon-like southwest Australian circulation （SWAC）, the South- ern Annular Mode （SAM）, and southwest Western Australia winter rainfall （SWR）, based on observed rainfall, reanalysis datasets, and the results of numerical modeling. By decomposing the SWAC into two components using a linear model, i.e. the component related to SAM （RSAM） and the component unrelated to SAM （SWACI＊）, we find it is the SWACI＊ that shows a significant influence on SWR. Similarly, it is the component of SAM associated with SWAC that exhibits an impact on SWR, whereas the component unrelated to SAM. A similar result is obtained in terms of the circulation associated with SWAC and the SAM. These facts suggest the SAM plays an indirect role in influencing SWR, and raise the possibility that SWAC acts as a bridge between the SAM and SWR, by which the SAM passes its influences onto SWR. This is due to the fact that the variations of SWAC are closely linked to the thermal contrast between land and sea across the southern Indian Ocean and southwest Australia. By contrast, the SAM does not significantly relate to this thermal structure, particularly for the component unrelated to SWAC. The variations of surface sea temperature over the southern Indian Ocean contribute to the favored rainfall circulation patterns. This finding is supported by the numerical modeling results. The strong coupling between SWAC and SWR may be instrumental for understanding the interactions between SWR and the southern Indian Ocean, and provides another perspective in examining the variations in SWR.展开更多
Background:Shared decision-making(SDM)implementation is a priority for Australian health systems,including general practices but it remains complex for specific groups like older rural Australians.We initiated a quali...Background:Shared decision-making(SDM)implementation is a priority for Australian health systems,including general practices but it remains complex for specific groups like older rural Australians.We initiated a qualitative study with older rural Australians to explore barriers to and facilitators of SDM in local general practices.Methods:We conducted a patient-oriented research,partnering with older rural Australians,families,and health service providers in research design.Participants who visited general practices were purposively sampled from five small rural towns in South Australia.A semi-structured interview guide was used for interviews and reflexive thematic coding was conducted.Results:Telephone interviews were held with 27 participants.Four themes were identified around older rural adults’involvement in SDM:(1)Understanding of"patient involvement";(2)Positive and negative outcomes;(3)Barriers to SDM;and(4)Facilitators to SDM.Understanding of patient involvement in SDM considerably varied among participants,with some reporting their involvement was contingent on the“opportunity to ask questions”and the“treatment choices”offered to them.Alongside the opportunity for involvement,barriers such as avoidance of cultural care and a lack of continuity of care are new findings.Challenges encountered in SDM implementation also included resource constraints and time limitations in general practices.Rural knowledge of general practitioners and technology integration in consultations were viewed as potential enablers..Conclusion:Adequate resources and well-defined guidelines about the process should accompany the implementation of SDM in rural general practices of South Australia.Innovative strategies by general practitioners promoting health literacy and culturally-tailored communication approaches could increase older rural Australians'involvement in general.展开更多
The Australian farming sector is continuing to intensify, particularly within 300 km of the east and southern coastlines. In the future there will be fewer and larger farms, which will use more fertilizer, support mor...The Australian farming sector is continuing to intensify, particularly within 300 km of the east and southern coastlines. In the future there will be fewer and larger farms, which will use more fertilizer, support more stock, grow more monoculture crops, and utilise more marginal soils. This is likely to increase the major environmental impacts of soil degradation, salt, nutrient and sediment contamination of waterways, and greenhouse gas emissions. Australian national water policy continues to focus on land, stream and groundwater salinity issues, although there is now a greater recognition of the importance of nitrogen and phosphorus losses from agriculture. The general philosophy of policy for dealing with non- point source pollution has been towards a voluntary rather than regulatory approach, with state and national governments supporting a range of programs to encourage sustainable agricultural practices. A catchment (watershed) based approach, through the use of integrated catchment management plans, is the primary way that non-point source pollution is addressed at the farm and local level. At an industry level, cotton, grains, meat, sugarcane and dairy amongst others, as well as the Australian fertilizer industry, have responded to non-point source issues by investing in research and development, and developing codes of practice aimed at abating these environmental impacts. Understanding the economic, social, political and cultural contexts of farming as well as the environmental impacts of agriculture are very important in determining the appropriateness of policy responses for Australian farming systems.展开更多
AIM:To evaluate the long-term treatment outcomes of entecavir monotherapy in treatment naive patients in an Australian tertiary care setting. METHODS:A retrospective analysis of treatment naive patients receiving ente...AIM:To evaluate the long-term treatment outcomes of entecavir monotherapy in treatment naive patients in an Australian tertiary care setting. METHODS:A retrospective analysis of treatment naive patients receiving entecavir monotherapy through Westmead Hospital was performed.Patients were excluded if they had received previous treatment with another nucleoside or nucleotide analogue,were pregnant or less than 18 years old. RESULTS:Out of 336 patients,163 patients fulfilled the selection criteria.Range of follow up was 3-46 mo (mean 26 mo).134 patients(82.2%)had pre-treatment biopsies,with 26 patients(16.0%)demonstrating F3-4 fibrosis.In total,153 patients(93.9%)achieved at least Partial Virological Suppression(PVS),with 134 patients (82.2%)achieving complete virological suppression. The cumulative CVS and PVS rates at 36 mo were 82.1%and 96.4%,respectively.3 patients(1.8%)failed to achieve PVS,while 5 patients(3.0%)developed virological rebound.128 patients(78.5%)maintained CVS throughout follow up.Predictors of CVS included lower baseline DNA level(P=0.001),hepatitis B virus e antigen negative status(P=0.001)and increasing age at treatment(log rank 0.001).No significant adverse effects were reported necessitating cessation of entecavir. CONCLUSION:Entecavir monotherapy is efficacious and safe in an Australian tertiary care setting.Resistance and rebound rates are very low.This is similar to data from controlled and uncontrolled trials around the world.展开更多
1.Introduction As nations around the world seek to reduce carbon dioxide emissions in order to mitigate climate change risks,there has been a resurgence of interest in the use of hydrogen as a zero-emissions energy ca...1.Introduction As nations around the world seek to reduce carbon dioxide emissions in order to mitigate climate change risks,there has been a resurgence of interest in the use of hydrogen as a zero-emissions energy carrier.Hydrogen can be produced from diverse feedstocks via a range of low-emissions pathways and has broad potential in the process of decarbonization across the energy,transport,and industrial sectors.With an abundance of both renewable and fossil fuel energy resources,a comparatively low national energy demand and excellent existing regional resource trading links,Australia is well positioned to pursue industrial-scale hydrogen production for both domestic and export purposes[1,2].In this paper,we present an overview of the progress at the government,industry,and research levels currently undertaken to enable a large-scale hydrogen industry for Australia.展开更多
BACKGROUND： This study aimed to make a preliminary comparison of emergency department （ED） presentations between Australia and China. The comparison could provide insights into the health systems and burden of dise...BACKGROUND： This study aimed to make a preliminary comparison of emergency department （ED） presentations between Australia and China. The comparison could provide insights into the health systems and burden of diseases and potentially stimulate discussion about the development of acute health system in China.METHODS： An observational study was performed to compare Australian ED presentations using data obtained from a single adult tertiary-referral teaching hospital in metropolitan Brisbane against Chinese ED presentations using public domain information published in existing Chinese and international medical journals.RESULTS： There are major differences in ED presentations between Australia and China. In 2008, 1） 35.4% of patients arrived at a tertiary teaching hospital ED in Brisbane, Australia by ambulance; 2） 1.7% were treated for poisoning; 3） 1.4% for cerebral vascular disease; 4） 1.7% for cardiac disease; and 5） 42.6% for trauma. The top events diagnosed were mental health problems including general psychiatric examination, psychiatric review, alcohol abuse, and counselling for alcohol abuse, which accounted for 5.5% of all ED presentations. Among ED patients in China, 6.7% arrived at a tertiary teaching hospital by ambulance in Shenyang in 1997; 3.7% were treated for poisoning in Shanxi Zhouzhi County People＇s Hospital ED in 2006; 14.9% for cerebral vascular diseases at Qinghai People＇s Hospital ED in 1993-1995; 1.7% for cardiac diseases at the Second People＇s Hospital ED, Shenzhen Longgang in 1993; and 44.3% for trauma at Shanxi Zhouzhi County People＇s Hospital ED in 2006. The top events were trauma and poisoning among the young and cerebral infarction in the older population.CONCLUSIONS： Compared with Australian, Chinese ED patients had 1） lower ambulance usage; 2） higher proportion of poisoning; 3） higher proportion of cerebral vascular diseases; 4） similar proportion of cardiac disease; 5） similar proportion of trauma; and 6） little reported mental health problems. Possible explanations for these differences in China include a pay for service pre-hospital care system, lack of public awareness about poisons, inadequate hypertension management, and lack of recognition of mental health problems.展开更多
This paper examines the current state of three of the key areas of geospatial science in Australia:positioning;earth observation(EO);and spatial infrastructures.The paper discusses the limitations and challenges that ...This paper examines the current state of three of the key areas of geospatial science in Australia:positioning;earth observation(EO);and spatial infrastructures.The paper discusses the limitations and challenges that will shape the development of these three areas of geospatial science over the next decade and then profiles what each may look like in about 2026.Australia’s national positioning infrastructure plan is guiding the development of a nation-wide,sub decimeter,real-time,outdoor positioning capability based on multi-GNSS and in particular the emerging precise point positioning−real-time kinematic(PPP-RTK)capability.Additional positioning systems including the ground-based Locata system,location-based indoor systems,and beacons,among others are also discussed.The importance of the underpinning role of a next generation dynamic datum is considered.The development of Australia’s first EO strategy is described along with the key national needs of the products of remote sensing.The development of massive on-line multi-decadal geospatial imagery data stores and processing engines for co-registered stacks of continuous base-line satellite imagery are explored.Finally,perspectives on the evolution of a future spatial knowledge infrastructure(SKI)emerging from today’s traditional spatial data infrastructures(SDIs)are provided together with discussion of the growing importance of geospatial analytics for transforming whole supply chains.展开更多
文摘The Australian sugarcane industry has long maintained high sugar content in cane and ranks among the world's lowest-cost raw sugar producers.This paper analyzes the key factors behind this competitive performance.It examines industry statistics,cost of production studies,historical records,and international comparisons.The analysis shows that the industryʼs advantage stems not from any single factor,but from a combination of six elements:(a)a climate favorable for high sucrose accumulation;(b)economies of scale in both farming and milling;(c)a high level of mechanization,particularly in harvesting;(d)a cane pricing formula that incentivizes high sugar content;(e)a research and development system that is mandatory-funded,industry-led,and industry-controlled by growers and millers;and(f)prolonged exposure to international competition with minimal trade protection.For other sugar-producing countries aiming to lower costs,this suggests pathways such as facilitating farm consolidation,introducing mechanization within suitably adapted farming systems,reforming cane payment systems to reward sugar content,refocusing R&D investment to better meet industry needs,and optimizing nutrient management to reduce nitrogen fertilizer use.
基金funded by James Cook University Postgraduate Research Scholarship(JCUPRS).
文摘Objectives This study aimed to develop a blueprint based on empirical data to guide the integration of nursing informatics(NI)into undergraduate nursing programs.Methods This study employed a qualitative,holistic multiple-case study design,allowing each case to be examined as an integrated contextual system.Data were obtained from four cases—two from Australian universities and two from South African universities—all of which were public institutions offering undergraduate nursing programs.Twenty-one academic staff participated.Data collection involved semi-structured interviews,document review,and field observations.The documents reviewed included national digital health strategies,health informatics and NI standards,nursing education policies,accreditation standards,and curriculum guidelines.Materials from institutions—including subject outlines,program handbooks,and teaching policies—were also reviewed to gain a better understanding of how NI was integrated in each case.An individual case analysis employed conventional content analysis,followed by a cross-case thematic comparison.Data collection and analysis were conducted iteratively until saturation was achieved.Results This study highlighted the need for NI in undergraduate nursing programs.Foundational competencies,such as computer and information literacy,and advanced NI competencies,including digital health literacy,data security,and privacy literacy,alongside other competencies,were identified across varying levels of proficiency.Data from four cases led to the development of a blueprint to guide the integration of NI into undergraduate curricula.It comprises eight context-responsive steps,including situational and training needs analysis,NI competency identification and mapping against national and international standards,NI content development,sequencing NI content and experience,NI content review,implementation,and evaluation.The blueprint promotes responsive curricula that strengthen NI capabilities and readiness for digital healthcare.Conclusion The blueprint aligns with nursing education priorities,workforce needs,and emerging technologies,thereby supporting NI competency development that advances digitally transformed healthcare.
文摘BACKGROUND Hepatocellular carcinoma(HCC)is a leading cause of cancer-related deaths worldwide.Liver transplantation(LT)offers the most effective treatment.HCC recurrence is the strongest risk factor that decreases post-LT survival in patients transplanted for HCC.The rate of HCC recurrence is generally reported as 8%-20%in the literature.Many predictors of HCC have already been researched,however,to our knowledge there are no published studies on this topic using Australian data.AIM To determine the rate and identify predictors of HCC recurrence in a contemporary Western Australian LT cohort.METHODS We performed a retrospective cohort study of all liver transplants in patients with HCC at Sir Charles Gairdner Hospital between 2006 and 2021.Data was collected from various health record databases and included recipient demographics,serum biochemistry,radiology,operation notes,explant histopathology and details of recurrence.Overall survival of HCC patients post-LT,stratified for recurrence,was calculated by Kaplan Meier analysis.Univariate and multivariate Cox regression was used to determine predictors of HCC recurrence post-LT.RESULTS Between 1/1/2006 and 12/31/2021,119 patients were transplanted with HCC.8.4%of subjects developed recurrent HCC after LT with median follow-up time of 5.4 years.The median time to recurrence was 2.9 years±0.75 years.When comparing baseline characteristics,a greater proportion of subjects with recurrence had common characteristics on explant histopathology,including>3 viable nodules(P=0.001),vascular invasion(P=0.003)and poorly differentiated HCC(P=0.03).Unadjusted survival curves showed lower 1-year,3-year,5-year and 10-year survival rates in subjects with HCC recurrence compared to those without HCC recurrence(90%vs 92%,70%vs 88%,42%vs 80%,14%vs 76%,respectively;log rank P<0.001).CONCLUSION HCC recurrence was low at 8.4%in this contemporary Australian cohort,however it significantly impacted post-LT survival.Further studies are required to confirm predictors of recurrence and improve recipient outcomes.
文摘We document,for the first time,Mesoproterozoic-aged,continental arc magmatism in the Tasmanides.Granitoid samples intruding the Proterozoic Cape River Metamorphics in northeast Queensland contain abundant∼1200 Ma igneous zircons,with early-Paleozoic metamorphic rim overgrowths.Analytical mixing between the igneous and metamorphic zircons produces cryptic discordant analyses,but the origin of said discordance is resolved with zircon Th/U ratios.Samples of the Fat Hen Creek Complex are peraluminous,calc-alkaline,S-type granitoids,that record high-grade metamorphism and trace element mobilization.The P3 and P42 intrusions are metaluminous,calc-alkaline,I-type granodiorite,which intruded the Cape River Metamorphics,and contain trace element signatures consistent with a continental-arc setting.We propose that a Mesoproterozoic continental terrane,herein referred to as the Oakvale Province,exists as basement to the Thomson Orogen.We propose several models for the formation of the Oakvale Province,with potential links to the Tarim Block,and the Yangtze Craton,during the late-Mesoproterozoic.We propose that the Oakvale Province supplied the Tasmanides with late-Mesoproterozoic detritus,and that such detritus was not solely sourced from the Musgrave Province as previously interpreted.Finally,we interpret the oroclinal bending of Paleozoic deformation and plutonic fabrics to reflect the buried extent of the Oakvale Province,and to potentially map out the Neoproterozoic rift margin associated with Rodinia break-up.
文摘In this article,we present a comprehensive overview of the regulatory landscape governing Chinese medicinal practices in Australia,in which we describe the regulations for Chinese medicine practitioners in Australia,as of 2024,focusing in particular on the Title Protection model under the Health Practitioner Regulation National Law.Central to this discussion are the core roles of the Chinese Medicine Board of Australia(the Board)and the Australian Health Practitioner Regulation Agency(Ahpra)in ensuring public safety by guaranteeing that practitioners are appropriately qualified and suitable for registration.We also examine the structure and demographics of the Chinese medicine workforce in Australia and present details of the required registration process for practitioners.In addition,the article outlines specific requirements for registration,including the standards set by the Board for initial and ongoing registration,which are administered with the support of Ahpra under the National Registration and Accreditation Scheme.Furthermore,we present details regarding the approved qualifications,the rigorous assessment process for overseas qualifications,and the important role of regulatory examinations designed to uphold the high standards expected of practitioners,thereby ensuring they have acquired the professional competencies required by the Australian healthcare system.This overview offers valuable insights for both current and prospective practitioners of Chinese medicine in Australia.
文摘Rationale:Australia is the only inhabited continent,which is not endemic to leishmaniasis.There are some published articles reporting cutaneous leishmaniasis in travellers,immigrants and refugees.However,mucocutaneous leishmaniasis has not been reported previously from the continent.Patient concerns:Lesions were present over the nasal septum and the oropharynx of a 34-year-old healthy non-indigenous male.Diagnosis was delayed as it took multiple biopsies as well as extensive discussions in a multidisciplinary team.Diagnosis:Mucocutaneous leishmaniasis.Interventions:Liposomal Amphotericin for 20 days.Outcomes:The patient was symptomatically improved after 3 weeks’treatment.Lessons:With international travel resuming after the pandemic,it becomes imperative that physicians in Australia are aware of this imported disease and its various presentations.
基金funded by the Australian Government Medical Research Future Fund(MRFF),Grant number 2015947.
文摘Objective To examine general practitioners’(GPs)referral patterns to allied health services for people with dementia compared with those without dementia across two large Australian Primary Health Networks(PHNs).Design A retrospective cohort study using routinely collected general practice data.Logistic regression was used to compare odds of allied health referrals,adjusting for age,sex and socioeconomic status.Setting De-identified patient and episode activity data from 537 GP practices across two PHNs in Australia between 2018 and 2023.Participants Data from 1153304 patients and 28667517 GP episodes of care were analysed.After merging records,693328 unique patients were identified,including 16610 patients with dementia.Subcohorts included patients with dementia,stroke,Parkinson’s disease and combinations of these conditions.Results The dementia cohort(n=16610)had a similar overall allied health referral rate(36.1%)to the control cohort(n=48977)(35.4%).Patients with dementia only were significantly less likely to receive any allied health referral compared with those with stroke(adjusted OR(aOR)0.76,95%CI 0.72 to 0.80;p<0.001)or Parkinson’s disease(aOR 0.72,95%CI 0.66 to 0.78;p<0.001).Those with dementia and stroke were also less likely to receive referrals than those with stroke only(aOR 0.71,95%CI 0.61 to 0.82;p<0.001).No significant difference was found between dementia with Parkinson’s and Parkinson’s only groups(p=0.48).Patients with dementia were consistently less likely to be referred to key allied health services(p<0.05).Conclusion Despite strong evidence supporting allied health interventions for dementia,referral rates remain comparatively low.Enhancing GP referral resources and education,integrating dementia-specific care pathways and implementing supportive policy changes are needed to improve access and equity in dementia care.
基金funded by the Australian National Health and Medical Research Council(NHMRC)Investigator Grant(2008379).
文摘Objective This systematic review assessed trial-based economic evaluations to provide empirical evidence on the cost-effectiveness of non-drug interventions(NDIs)that are currently recommended within the Royal Australian College of General Practitioners Handbook of Non-Drug Interventions(HANDI).Methods Medline,CINAHL and PsycINFO along with clinical trial registries(clinicaltrials.gov and WHO International Clinical Trials Registry Platform)were searched from inception to 1 July 2025.Randomised controlled trials(RCTs)that reported cost effectiveness for a prescribed non-drug intervention(NDI)from HANDI were included in the study.The primary outcome was the incremental cost-utility ratio(ICUR)derived from cost-utility analyses(CUAs).Results A total of 11187 citations were identified,from which 156 RCTs were included.These RCTs enrolled a total of 66926 participants(median=214,IQR 139–342),with a median follow-up duration of 12 months(IQR 6–12 months).Over half of the CUA NDIs were for mental health conditions(n=81;54.0%),one-third were for were for musculoskeletal conditions(n=44;29.3%),while only 16.0%(n=24)were for those with cardiovascular/metabolic conditions.Out of the 150 NDIs that reported CUAs,40%were deemed to be in the south-east(SE)quadrant(cheaper and more effective)and 49.3%fell in the north-east(NE)quadrant(more costly but more effective),with 70%considered cost effective against a￡25000/quality-adjusted life-year(QALY)willingness to pay threshold.The overall median ICUR was￡2400/QALY(IQR−18986 to 20027).Conclusions Most of the HANDI NDIs that were included within this systematic review are cost-effective compared with a variety of alternatives including usual care or waiting list controls.HANDI NDIs warrant use as a first line of treatment when clinically appropriate.
文摘BACKGROUND Fear of childbirth(FoC)is a widespread issue that impacts the health and well-being of mothers and newborns.However,there is inconsistency regarding the prevalence of FoC in the and there is limited research on the prevalence of FoC among Australian pregnant women.AIM To investigate the prevalence of FoC,its risk factors and birth outcomes in Aust-ralian multiparous women.METHODS In this prospective cohort quantitative study,212 multiparous women were re-cruited from antenatal clinics at Westmead Hospital in western Sydney from 2019 to 2022.Pregnant women who attended antenatal visits and met the inclusion criteria signed the consent forms and completed several online questionnaires at baseline.After they gave birth,their birth outcomes were collected from the hospital’s medical record database.The data were analyzed using SPSS software and descriptive statistics,χ^(2)test,independent samples t-test,and multivariable logistic regression analysis.RESULTS Out of 212 participants,24%experienced a high level of FoC and 7%experienced severe FoC.Theχ^(2)test results revealed that a family income of≤$100000,no alcohol intake during pregnancy,pre-existing health problems,previous caesarean section(emergency or planned),and previous neutral/traumatic childbirth experiences were significantly associated with higher levels of FoC(P<0.05).Other risk factors included being moderately to very worried and fearful about the upcoming birth,having severe to extremely severe anxiety throughout pregnancy,and expressing low relationship satisfaction.According to multivariable logistic regression,the odds of a high level of FoC were higher in women with anxiety,a history of traumatic childbirth experience,a history of sexual assault during childhood,pre-existing health problems,and lower relationship satisfaction(P<0.05).CONCLUSION High-severe levels of FoC are experienced by pregnant multiparous women and are affected by several demo-graphic factors.However,due to the small sample size in the present study,further studies with larger sample sizes are required to draw a firm conclusion on the prevalence of severe FoC among multiparous women and its associated risk factors and birth outcomes.
基金the financial and intellectual support provided by Queensland University of Technology(QUT),Australia,through its Higher Degree Research Program,which played a crucial role in the successful completion of this research study
文摘Moisture accumulation within road pavements,particularly in unbound granular materials with or without thin sprayed seals,presents significant challenges in high-rainfall regions such as Queensland.This infiltration often leads to various forms of pavement distress,eventually causing irreversible damage to the pavement structure.The moisture content within pavements exhibits considerable dynamism and directly influenced by environmental factors such as precipitation,air temperature,and relative humidity.This variability underscores the importance of monitoring moisture changes using real-time climatic data to assess pavement conditions for operational management or incorporating these effects during pavement design based on historical climate data.Consequently,there is an increasing demand for advanced,technology-driven methodologies to predict moisture variations based on climatic inputs.Addressing this gap,the present study employs five traditional machine learning(ML)algorithms,K-nearest neighbors(KNN),regression trees,random forest,support vector machines(SVMs),and gaussian process regression(GPR),to forecast moisture levels within pavement layers over time,with varying algorithm complexities.Using data collected from an instrumented road in Brisbane,Australia,which includes pavement moisture and climatic factors,the study develops predictive models to forecast moisture content at future time steps.The approach incorporates current moisture content,rather than averaged values,along with seasonality(both daily and annual),and key climatic factors to predict next step moisture.Model performance is evaluated using R2,MSE,RMSE,and MAPE metrics.Results show that ML algorithms can reliably predict long-term moisture variations in pavements,provided optimal hyperparameters are selected for each algorithm.The best-performing algorithms include KNN(the number of neighbours equals to 15),medium regression tree,medium random forest,coarse SVM,and simple GPR,with medium random forest outperforming the others.The study also identifies the optimal hyperparameter combinations for each algorithm,offering significant advancements in moisture prediction tools for pavement technology。
基金supported by the Mineral Exploration Cooperative Research Centre whose activities are funded by the Australian Government’s Cooperative Research Centre Program.This is MinEx CRC Document 2025/06.
文摘The Ediacaran-Cambrian Petermann Orogen is a dextral transpressional orogen exposed in central Australia,which facilitated the exhumation of a high-pressure core and the deformation of the Neoproterozoic-Palaeozoic Amadeus Basin.Several studies have investigated the metamorphic and deformational evolution of the Petermann Orogen;however,the spatiotemporal variation of the deformation and cooling history is yet to be fully understood.In situ muscovite and biotite Rb-Sr geochronology,in combination with Ti-in-quartz thermometry is applied to map the spatiotemporal deformation and cooling patterns of the northern part of the Petermann Orogen.Interpreted muscovite Rb-Sr growth ages obtained from samples in the Petermann Nappe Complex(PNC),range between c.598 Ma and 565 Ma,which correlate with the timing of deformation during the 600-520 Ma Petermann Orogeny.Interpreted muscovite and biotite cooling ages are younger in the east of the PNC(c.556-541 Ma)and broadly correlate with the regional pattern of crustal heat production,suggesting that the geothermal gradient had a significant control on the timing and duration of cooling.Biotite Rb-Sr cooling ages between c.555 Ma and 497 Ma for the orogenic core show no correlation with high heat production areas,however,differences in exhumed crustal levels across the Petermann Orogen are observed:high-P granulite facies rocks in the orogenic core vs middle-upper crustal rocks in the PNC,indicating that at least part of the spatiotemporal variation of cooling ages can be attributed to differential exhumation during the Petermann Orogeny.Hence,crustal heat production and differential exhumation were likely the main controlling factors on the duration and variation of cooling rates in the Petermann Orogen.
文摘Chronic pain affects 3.6 million Australians and this number is projected to reach 5.23 million by 2050,costing A$73.2 billion annually.Current care relies heavily on pharmacotherapy-particularly opioids-which leads to approximately 150 hospitalizations,14 emergency visits,and three opioid-related deaths daily.National strategies now promote multimodal and non-pharmacological options.One of these options-acupuncture-offers a safe,evidence-based alternative with opioid-sparing effects for patients with acute and chronic pain.Therefore,its current application across various settings highlights its strong potential for integration into mainstream care.Here,we conducted a structured review of peer-reviewed literature,regulatory documents,workforce reports,and government publications on acupuncture to assess registration and education standards,workforce capacity,and professional and consumer acceptance of acupuncture.Australian pain management guidelines(2015-2025)that included acupuncture were systematically identified and evaluated.Acupuncture is a nationally registered profession with the protected title of“Acupuncturist.”Over 4800 practitioners currently provide care and consumer and professional attitudes are generally positive.However,public funding is minimal,with access largely dependent on out-of-pocket payments or limited private health insurance rebates.Few Australian guidelines recommend acupuncture for pain,in contrast to its more widespread endorsement in the United States and Europe.Some state health services and hospitals have piloted programs;however,their implementation remains fragmented.Global evidence,consumer acceptance,and the person-centered nature of acupuncture allow it to complement existing pain strategies and reduce opioid reliance in Australia.However,to achieve this,the profession must strengthen education in contemporary pain science,foster inter-professional collaboration,and expand research on its role in multidisciplinary care.Advocating for public funding is also critical.Embedding acupuncture within an integrated pain framework can better meet consumer needs,improve outcomes,and contribute to the long-term sustainability of the healthcare system.
基金supported by the 973 Program (Grant No. 2013CB430203)the National Natural Science Foundation of China (Grant Nos. 41205046 and 41475076)the Australia–China Bilateral Climate Change Partnerships Program of Australian Department of Climate Change and Energy Efficiency
文摘This study examines the relationships among the monsoon-like southwest Australian circulation （SWAC）, the South- ern Annular Mode （SAM）, and southwest Western Australia winter rainfall （SWR）, based on observed rainfall, reanalysis datasets, and the results of numerical modeling. By decomposing the SWAC into two components using a linear model, i.e. the component related to SAM （RSAM） and the component unrelated to SAM （SWACI＊）, we find it is the SWACI＊ that shows a significant influence on SWR. Similarly, it is the component of SAM associated with SWAC that exhibits an impact on SWR, whereas the component unrelated to SAM. A similar result is obtained in terms of the circulation associated with SWAC and the SAM. These facts suggest the SAM plays an indirect role in influencing SWR, and raise the possibility that SWAC acts as a bridge between the SAM and SWR, by which the SAM passes its influences onto SWR. This is due to the fact that the variations of SWAC are closely linked to the thermal contrast between land and sea across the southern Indian Ocean and southwest Australia. By contrast, the SAM does not significantly relate to this thermal structure, particularly for the component unrelated to SWAC. The variations of surface sea temperature over the southern Indian Ocean contribute to the favored rainfall circulation patterns. This finding is supported by the numerical modeling results. The strong coupling between SWAC and SWR may be instrumental for understanding the interactions between SWR and the southern Indian Ocean, and provides another perspective in examining the variations in SWR.
基金financed by the Flinders University College of Business,Government and Law Large Project Grant(Grant number:100031.21).
文摘Background:Shared decision-making(SDM)implementation is a priority for Australian health systems,including general practices but it remains complex for specific groups like older rural Australians.We initiated a qualitative study with older rural Australians to explore barriers to and facilitators of SDM in local general practices.Methods:We conducted a patient-oriented research,partnering with older rural Australians,families,and health service providers in research design.Participants who visited general practices were purposively sampled from five small rural towns in South Australia.A semi-structured interview guide was used for interviews and reflexive thematic coding was conducted.Results:Telephone interviews were held with 27 participants.Four themes were identified around older rural adults’involvement in SDM:(1)Understanding of"patient involvement";(2)Positive and negative outcomes;(3)Barriers to SDM;and(4)Facilitators to SDM.Understanding of patient involvement in SDM considerably varied among participants,with some reporting their involvement was contingent on the“opportunity to ask questions”and the“treatment choices”offered to them.Alongside the opportunity for involvement,barriers such as avoidance of cultural care and a lack of continuity of care are new findings.Challenges encountered in SDM implementation also included resource constraints and time limitations in general practices.Rural knowledge of general practitioners and technology integration in consultations were viewed as potential enablers..Conclusion:Adequate resources and well-defined guidelines about the process should accompany the implementation of SDM in rural general practices of South Australia.Innovative strategies by general practitioners promoting health literacy and culturally-tailored communication approaches could increase older rural Australians'involvement in general.
基金supported by the China Council for International Cooperation on Environment and Development (CCICED)
文摘The Australian farming sector is continuing to intensify, particularly within 300 km of the east and southern coastlines. In the future there will be fewer and larger farms, which will use more fertilizer, support more stock, grow more monoculture crops, and utilise more marginal soils. This is likely to increase the major environmental impacts of soil degradation, salt, nutrient and sediment contamination of waterways, and greenhouse gas emissions. Australian national water policy continues to focus on land, stream and groundwater salinity issues, although there is now a greater recognition of the importance of nitrogen and phosphorus losses from agriculture. The general philosophy of policy for dealing with non- point source pollution has been towards a voluntary rather than regulatory approach, with state and national governments supporting a range of programs to encourage sustainable agricultural practices. A catchment (watershed) based approach, through the use of integrated catchment management plans, is the primary way that non-point source pollution is addressed at the farm and local level. At an industry level, cotton, grains, meat, sugarcane and dairy amongst others, as well as the Australian fertilizer industry, have responded to non-point source issues by investing in research and development, and developing codes of practice aimed at abating these environmental impacts. Understanding the economic, social, political and cultural contexts of farming as well as the environmental impacts of agriculture are very important in determining the appropriateness of policy responses for Australian farming systems.
文摘AIM:To evaluate the long-term treatment outcomes of entecavir monotherapy in treatment naive patients in an Australian tertiary care setting. METHODS:A retrospective analysis of treatment naive patients receiving entecavir monotherapy through Westmead Hospital was performed.Patients were excluded if they had received previous treatment with another nucleoside or nucleotide analogue,were pregnant or less than 18 years old. RESULTS:Out of 336 patients,163 patients fulfilled the selection criteria.Range of follow up was 3-46 mo (mean 26 mo).134 patients(82.2%)had pre-treatment biopsies,with 26 patients(16.0%)demonstrating F3-4 fibrosis.In total,153 patients(93.9%)achieved at least Partial Virological Suppression(PVS),with 134 patients (82.2%)achieving complete virological suppression. The cumulative CVS and PVS rates at 36 mo were 82.1%and 96.4%,respectively.3 patients(1.8%)failed to achieve PVS,while 5 patients(3.0%)developed virological rebound.128 patients(78.5%)maintained CVS throughout follow up.Predictors of CVS included lower baseline DNA level(P=0.001),hepatitis B virus e antigen negative status(P=0.001)and increasing age at treatment(log rank 0.001).No significant adverse effects were reported necessitating cessation of entecavir. CONCLUSION:Entecavir monotherapy is efficacious and safe in an Australian tertiary care setting.Resistance and rebound rates are very low.This is similar to data from controlled and uncontrolled trials around the world.
文摘1.Introduction As nations around the world seek to reduce carbon dioxide emissions in order to mitigate climate change risks,there has been a resurgence of interest in the use of hydrogen as a zero-emissions energy carrier.Hydrogen can be produced from diverse feedstocks via a range of low-emissions pathways and has broad potential in the process of decarbonization across the energy,transport,and industrial sectors.With an abundance of both renewable and fossil fuel energy resources,a comparatively low national energy demand and excellent existing regional resource trading links,Australia is well positioned to pursue industrial-scale hydrogen production for both domestic and export purposes[1,2].In this paper,we present an overview of the progress at the government,industry,and research levels currently undertaken to enable a large-scale hydrogen industry for Australia.
文摘BACKGROUND： This study aimed to make a preliminary comparison of emergency department （ED） presentations between Australia and China. The comparison could provide insights into the health systems and burden of diseases and potentially stimulate discussion about the development of acute health system in China.METHODS： An observational study was performed to compare Australian ED presentations using data obtained from a single adult tertiary-referral teaching hospital in metropolitan Brisbane against Chinese ED presentations using public domain information published in existing Chinese and international medical journals.RESULTS： There are major differences in ED presentations between Australia and China. In 2008, 1） 35.4% of patients arrived at a tertiary teaching hospital ED in Brisbane, Australia by ambulance; 2） 1.7% were treated for poisoning; 3） 1.4% for cerebral vascular disease; 4） 1.7% for cardiac disease; and 5） 42.6% for trauma. The top events diagnosed were mental health problems including general psychiatric examination, psychiatric review, alcohol abuse, and counselling for alcohol abuse, which accounted for 5.5% of all ED presentations. Among ED patients in China, 6.7% arrived at a tertiary teaching hospital by ambulance in Shenyang in 1997; 3.7% were treated for poisoning in Shanxi Zhouzhi County People＇s Hospital ED in 2006; 14.9% for cerebral vascular diseases at Qinghai People＇s Hospital ED in 1993-1995; 1.7% for cardiac diseases at the Second People＇s Hospital ED, Shenzhen Longgang in 1993; and 44.3% for trauma at Shanxi Zhouzhi County People＇s Hospital ED in 2006. The top events were trauma and poisoning among the young and cerebral infarction in the older population.CONCLUSIONS： Compared with Australian, Chinese ED patients had 1） lower ambulance usage; 2） higher proportion of poisoning; 3） higher proportion of cerebral vascular diseases; 4） similar proportion of cardiac disease; 5） similar proportion of trauma; and 6） little reported mental health problems. Possible explanations for these differences in China include a pay for service pre-hospital care system, lack of public awareness about poisons, inadequate hypertension management, and lack of recognition of mental health problems.
文摘This paper examines the current state of three of the key areas of geospatial science in Australia:positioning;earth observation(EO);and spatial infrastructures.The paper discusses the limitations and challenges that will shape the development of these three areas of geospatial science over the next decade and then profiles what each may look like in about 2026.Australia’s national positioning infrastructure plan is guiding the development of a nation-wide,sub decimeter,real-time,outdoor positioning capability based on multi-GNSS and in particular the emerging precise point positioning−real-time kinematic(PPP-RTK)capability.Additional positioning systems including the ground-based Locata system,location-based indoor systems,and beacons,among others are also discussed.The importance of the underpinning role of a next generation dynamic datum is considered.The development of Australia’s first EO strategy is described along with the key national needs of the products of remote sensing.The development of massive on-line multi-decadal geospatial imagery data stores and processing engines for co-registered stacks of continuous base-line satellite imagery are explored.Finally,perspectives on the evolution of a future spatial knowledge infrastructure(SKI)emerging from today’s traditional spatial data infrastructures(SDIs)are provided together with discussion of the growing importance of geospatial analytics for transforming whole supply chains.
