Dropping off the edge 2015: persistent communal disadvantage in Australia

This report shows that complex and entrenched disadvantage is experienced by a small but persistent number of locations in each state and territory across Australia. Foreword In 2007, Jesuit Social Services and Catholic Social Services Australia commissioned ground-breaking research into place-based disadvantage across the nation. The resulting report, Dropping off the edge, built on previous work that Jesuit Social Services had engaged Professor Tony Vinson to undertake on its behalf and quickly became a critical resource for governments, service providers and communities attempting to address the challenge of entrenched and often complex geographical disadvantage. That report received over 284 scholarly citations and supported the establishment of the Australian Social Inclusion Board – a body charged with identifying long-term strategies to end poverty in Australia. Since the publication of Dropping off the edge, our organisations have received many requests to update the findings and produce a new report tracking the wellbeing of communities in Australia over the intervening time. Sadly, the current report drives home the enormous challenge that lies in front of our policy makers and service providers, as many communities identified as disadvantaged in 2007 once again head the list in each state and territory. As a society we cannot, and should not, turn away from the challenge of persistent and entrenched locational disadvantage, no matter how difficult it may be to solve the problem. We call on government, community and business to come together to work alongside these communities to ensure long term sustainable change. We hold hope that the young people and future generations in these communities will have a better outlook and life opportunities than is currently available to them. It is our belief that every Australian should have access to the opportunities in life that will enable them to flourish – to complete their education, to get a job, to access safe and affordable housing, to raise their children in safe communities and to see the next generation thrive. Jesuit Social Services and Catholic Social Services Australia are indebted to the dedication and perseverance of Professor Tony Vinson in leading this important research and analysis over the past 15 years. Julie Edwards Chief Executive Officer Jesuit Social Services Marcelle Mogg Chief Executive Officer Catholic Social Services Australi

Teacher Education Courses In Victoria: Perceptions Of Their Effectiveness And Factors Affecting Their Impact

Investment in teacher education is a major strategy to enhance the quality of teaching and learning in our schools. Agencies, such as the Victorian Institute of Teaching (VIT), with responsibility for the accreditation of teacher education, can use feedback about the effectiveness of different modes of teacher preparation to support providers. It is vital that data for this purpose be valid and reliable. The Future Teachers Project (FTP) was designed to collect such data. It was designed to address two major questions: What are the perceptions of stakeholders (beginning teachers and their employers) about the effectiveness of current teacher education models in Victoria? What changes do stakeholders believe should be made to teacher education programs to better prepare future teachers

Evaluation of the Middle Years Reform Program

The Middle Years Reform Program (MYRP) was conducted in all Victorian government secondary and P-12 schools over the period 2001-2003. The program was designed to provide these schools with financial support to employ additional classroom teaching capacity to develop and implement initiatives in the areas of literacy, attendance and the ‘thinking curriculum’ in Years 7-9. Data for the evaluation were taken from: a. Literature and document review; b. Three preliminary consultations with representative groups of regional office personnel, school principals, middle years co-ordinators and other teachers familiar with middle years issues; c. A questionnaire that was distributed by e-mail to all schools with students in years 7-9 that achieved a response rate of just over 80%; d. Analysis of school-level aggregate data for the period 1998-2003 on Year 9 literacy, Years 7, 8 and 9 attendance, and retention to Year 11; e. Six brief case studies of purposefully selected schools with Year 7-9 students. The questionnaire data formed a key component of the evaluation of MYRP

Evaluation of school-based arts education programmes in Australian schools

This report presents evaluations of four Australian school-based arts programmes: Arts@Direk (SA), Boys’ Business (NT), Indigenous Music Education Programme (NT), and SCRAYP – Youth Arts with an Edge (Vic). Arts@Direk and SCRAYP provided a focus on drama, while Boys’ Business and Indigenous Music Education Programme (IMEP) concentrated on music. There was a range of ages from Year 4 to Year 10 and a diverse range of backgrounds amongst the participating students. The study investigated the impact of each arts programme on students’ academic progress, engagement with learning and school attendance. It also considered which attributes of arts programmes were of particular benefit to the students

Neutrino-nucleus cross sections for oscillation experiments

Neutrino oscillations physics is entered in the precision era. In this context accelerator-based neutrino experiments need a reduction of systematic errors to the level of a few percent. Today one of the most important sources of systematic errors are neutrino-nucleus cross sections which in the hundreds-MeV to few-GeV energy region are known with a precision not exceeding 20%. In this article we review the present experimental and theoretical knowledge of the neutrino-nucleus interaction physics. After introducing neutrino oscillation physics and accelerator-based neutrino experiments, we overview general aspects of the neutrino-nucleus cross sections, both theoretical and experimental views. Then we focus on these quantities in different reaction channels. We start with the quasielastic and quasielastic-like cross section, putting a special emphasis on multinucleon emission channel which attracted a lot of attention in the last few years. We review the main aspects of the different microscopic models for this channel by discussing analogies and differences among them.The discussion is always driven by a comparison with the experimental data. We then consider the one pion production channel where data-theory agreement remains very unsatisfactory. We describe how to interpret pion data, then we analyze in particular the puzzle related to the impossibility of theoretical models and Monte Carlo to simultaneously describe MiniBooNE and MINERvA experimental results. Inclusive cross sections are also discussed, as well as the comparison between the $\nu_\mu$ and $\nu_e$ cross sections, relevant for the CP violation experiments. The impact of the nuclear effects on the reconstruction of neutrino energy and on the determination of the neutrino oscillation parameters is reviewed. A window to the future is finally opened by discussing projects and efforts in future detectors, beams, and analysis

Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH): a stepped-wedge cluster-randomised trial

Background: Emergency abdominal surgery is associated with poor patient outcomes. We studied the effectiveness of a national quality improvement (QI) programme to implement a care pathway to improve survival for these patients. Methods: We did a stepped-wedge cluster-randomised trial of patients aged 40 years or older undergoing emergency open major abdominal surgery. Eligible UK National Health Service (NHS) hospitals (those that had an emergency general surgical service, a substantial volume of emergency abdominal surgery cases, and contributed data to the National Emergency Laparotomy Audit) were organised into 15 geographical clusters and commenced the QI programme in a random order, based on a computer-generated random sequence, over an 85-week period with one geographical cluster commencing the intervention every 5 weeks from the second to the 16th time period. Patients were masked to the study group, but it was not possible to mask hospital staff or investigators. The primary outcome measure was mortality within 90 days of surgery. Analyses were done on an intention-to-treat basis. This study is registered with the ISRCTN registry, number ISRCTN80682973. Findings: Treatment took place between March 3, 2014, and Oct 19, 2015. 22 754 patients were assessed for elegibility. Of 15 873 eligible patients from 93 NHS hospitals, primary outcome data were analysed for 8482 patients in the usual care group and 7374 in the QI group. Eight patients in the usual care group and nine patients in the QI group were not included in the analysis because of missing primary outcome data. The primary outcome of 90-day mortality occurred in 1210 (16%) patients in the QI group compared with 1393 (16%) patients in the usual care group (HR 1·11, 0·96–1·28). Interpretation: No survival benefit was observed from this QI programme to implement a care pathway for patients undergoing emergency abdominal surgery. Future QI programmes should ensure that teams have both the time and resources needed to improve patient care. Funding: National Institute for Health Research Health Services and Delivery Research Programme

Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH): a stepped-wedge cluster-randomised trial

BACKGROUND: Emergency abdominal surgery is associated with poor patient outcomes. We studied the effectiveness of a national quality improvement (QI) programme to implement a care pathway to improve survival for these patients. METHODS: We did a stepped-wedge cluster-randomised trial of patients aged 40 years or older undergoing emergency open major abdominal surgery. Eligible UK National Health Service (NHS) hospitals (those that had an emergency general surgical service, a substantial volume of emergency abdominal surgery cases, and contributed data to the National Emergency Laparotomy Audit) were organised into 15 geographical clusters and commenced the QI programme in a random order, based on a computer-generated random sequence, over an 85-week period with one geographical cluster commencing the intervention every 5 weeks from the second to the 16th time period. Patients were masked to the study group, but it was not possible to mask hospital staff or investigators. The primary outcome measure was mortality within 90 days of surgery. Analyses were done on an intention-to-treat basis. This study is registered with the ISRCTN registry, number ISRCTN80682973. FINDINGS: Treatment took place between March 3, 2014, and Oct 19, 2015. 22 754 patients were assessed for elegibility. Of 15 873 eligible patients from 93 NHS hospitals, primary outcome data were analysed for 8482 patients in the usual care group and 7374 in the QI group. Eight patients in the usual care group and nine patients in the QI group were not included in the analysis because of missing primary outcome data. The primary outcome of 90-day mortality occurred in 1210 (16%) patients in the QI group compared with 1393 (16%) patients in the usual care group (HR 1·11, 0·96-1·28). INTERPRETATION: No survival benefit was observed from this QI programme to implement a care pathway for patients undergoing emergency abdominal surgery. Future QI programmes should ensure that teams have both the time and resources needed to improve patient care. FUNDING: National Institute for Health Research Health Services and Delivery Research Programme

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

SummaryBackground Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatoryactions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19.Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospitalwith COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients wererandomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once perday by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatmentgroups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment andwere twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants andlocal study staff were not masked to the allocated treatment, but all others involved in the trial were masked to theoutcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treatpopulation. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) wereeligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomlyallocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall,561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days(rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days(rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, nosignificant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilationor death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24).Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or otherprespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restrictedto patients in whom there is a clear antimicrobial indication

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Why Parents Choose Public or Private Schools

Assumptions have often been made about what parents are looking for in the school they select for their children but there has been little evidence to support these assumptions. An ACER study for The Sydney Morning Herald looked into the reasons behind the drift away from public schools in Australia and asked what do parents really think of our schools