A perspective on trends in Australian government spending

This paper provides a summary of trends in government spending, revealing strong growth in government spending and the size of government, particularly over the past four years. It also discusses the distribution and sustainability of spending and notes the importance of high quality spending and flexibility in resource allocation in responding to future pressures

Crop Updates 2001 - Lupins

This session covers twenty six papers from different authors: INTRODUCTION, 1. Introduction, Dr Mark Sweetingham LUPIN RESEARCH AND INDUSTRY DEVELOPMENT, Agriculture Western Australia VARIETIES 2. Lupin variety performance: Are you making the most of it? Bevan J. Buirchell, Agriculture Western Australia 3. Adaption of restricted-branching lupins in Western Australia, Bob French and Laurie Wahlsten, Agriculture Western Australia 4. Isolated microspore culture of lupin for production of doubled haploids, Dr Janet Wroth, Dr Kirsty Bayliss and A/Prof. Wallace Cowling, Plant Sciences, Faculty of Agriculture, The University of Western Australia NUTRITION 5. Banding manganese fertiliser below the seed increases seed yields of narrow-leafed lupins, R.F. Brennan, Agriculture Western Australia 6. Residual value of manganese fertiliser for lupin grain production, R.F. Brennan, Agriculture Western Australia AGRONOMY 7. Lupin seeding density, Miles Dracup, Agriculture Western Australia, Nick Galwey, University of Western Australia and Bob Thomson, University of Western AustraliaPESTS AND DISEASES 8. Anthracnose in lupins – understanding the risk, Moin Salam, Art Diggle, Geoff Thomas, Mark Sweetinghamand Bill O’Neill, Agriculture Western Australia 9. Implications of the ‘green bridge’ for viral and fungal disease carry-over between seasons, Debbie Thackray, Agriculture Western Australia and Centre for Legumes in Mediterranean Agriculture 10. Insect pest development in WA via the ‘green bridge’, Kevin Walden, Agriculture Western Australia 11. Lupin anthracnose – seed infection thresholds, Geoff Thomas, Agriculture Western Australia 12. Identification and characterisation of resistance genes to Phomopsis blight in narrow-leafed lupin, M. Shankar1, M.W. Sweetingham1&2 and W.A. Cowling1&3 , 1Co-operative Research Centre for Legumes in Mediterranean Agriculture, 2Agriculture Western Australia, 3Plant Sciences 13. Plant disease diagnostics, Dominie Wright and Nichole Burges, Agriculture Western Australia 14. Detection of strains of Phomopsis exhibiting species preference in lupins, M. Shankar, 1Co-operative Research Centre for Legumes in Mediterranean Agriculture and M.W. Sweetingham, Agriculture Western Australia 15. Potential alternate host for the lupin anthracnose pathogen, Geoff Thomasa, Hu’aan Yangb, Mark Sweetinghamab and Ming Pei Youa, aAgriculture Western Australia, bCooperative Research Centre for Legumes in Mediterranean Agriculture WEEDS 16. Wild radish – the implications for our rotations, Dr David Bowran, Centre for Cropping Systems 17. Competitiveness of wild radish in a wheat – lupin rotation, Abul Hashem, Nerys Wilkins, and Terry Piper, Agriculture Western Australia 18. Population explosion and persistence of wild radish in a wheat-lupin rotation, Abul Hashem, Nerys Wilkins, Aik Cheam and Terry Piper, Agriculture Western Australia 19. Inter-row knockdowns for profitable lupins, Paul Blackwell, Agriculture Western Australia, Miles Obst, Mingenew 20. Is it safe to use 2,4-D Ester 80% pre-sowing when furrow sowing lupins? Andrew Sandison, Elders Ltd QUALITY AND MARKET DEVELOPMENT 21. Lupin protein – what we know, Bill O’Neill, Agriculture Western Australia 22. Foliar N application increases grain protein in lupins, Bob French and Laurie Wahlsten, Agriculture Western Australia 23. Can lupin grain protein be increased with Flexi-N? Cameron Weeks, Erin Hasson, Mingenew-Irwin Group and Luigi Moreschi, CSBP futurefarm 24. Putting a value on lupin use in the aquaculture industry: a fishy business? Brett D. Glencross, Fisheries WA, Fremantle Maritime Centre, Fremantle 25. Selection for thinner seed coats and pod walls in lupins, Jon Clements, Centre for Legumes in Mediterranean Agriculture and Miles Dracup, Agriculture Western Australia 26. Assessing the nutritional benefit of Australian sweet lupin (Lupinus angustifolius) in human foods, Ramon Hall (SPIRT PhD scholar), Stuart Johnson, Madeleine Ball, Deakin University, Melbourne, Sofia Sipsas and David Petterson, Agriculture Western Australi

Defining the genotypic and phenotypic spectrum of X-linked MSL3-related disorder

PURPOSE: We sought to delineate the genotypic and phenotypic spectrum of female and male individuals with X-linked, MSL3-related disorder (Basilicata-Akhtar syndrome). METHODS: Twenty-five individuals (15 males, 10 females) with causative variants in MSL3 were ascertained through exome or genome sequencing at ten different sequencing centers. RESULTS: We identified multiple variant types in MSL3 (ten nonsense, six frameshift, four splice site, three missense, one in-frame-deletion, one multi-exon deletion), most proven to be de novo, and clustering in the terminal eight exons suggesting that truncating variants in the first five exons might be compensated by an alternative MSL3 transcript. Three-dimensional modeling of missense and splice variants indicated that these have a deleterious effect. The main clinical findings comprised developmental delay and intellectual disability ranging from mild to severe. Autism spectrum disorder, muscle tone abnormalities, and macrocephaly were common as well as hearing impairment and gastrointestinal problems. Hypoplasia of the cerebellar vermis emerged as a consistent magnetic resonance image (MRI) finding. Females and males were equally affected. Using facial analysis technology, a recognizable facial gestalt was determined. CONCLUSION: Our aggregated data illustrate the genotypic and phenotypic spectrum of X-linked, MSL3-related disorder (Basilicata-Akhtar syndrome). Our cohort improves the understanding of disease related morbidity and allows us to propose detailed surveillance guidelines for affected individuals

Regenerative Futures: From Global to Local Development in 2032

The ‘Regenerative Futures: From Global to Local Development in 2032’ project was jointly conceived by the Innovation School at Glasgow School of Art and the School of Cancer Sciences at the University of Glasgow. The project partnership involved a community of experts working across both organisations including the University of Glasgow’s Mazumdar-Shaw Advanced Research Centre (ARC). Regenerative Design is about designing for people and the planet from a socio-ecological perspective. It seeks not merely to do less harm, but rather catalyses a positive force that restores, renews or revitalises products, services and systems to foster resilient and equitable futures for people and the planet. The Regenerative Futures project asked the final year BDes Product Design cohort to consider what happens in this landscape ten years from now, where Global Development has evolved to the extent that new forms of regenerative experiences of health, economies and citizenship transform how we interact with each other, with local and global communities, and the world around us. Working with an expert community of practice from the University of Glasgow’s Advanced Research Centre (the project’s partner) and a wider expert group of academic and professional stakeholders, the students, faculty, and experts co-researched, explored and designed speculative future worlds and experiences of regenerative global and local communities and systems leading towards equitable health, economies and citizenship in ten year’s time. In the first part of the project, the student cohort work in six groups to collectively research the brief, exploring the domains of Health, Economies and Citizenship from a Globally-Centred or Locally-Centred perspective. In-depth insights from the first stage fuel individual design work in Part Two. The second part of the project saw individual students select an aspect of their Future World research to develop as a design direction, which they then prototyped and produced as products, services, and/or systems. These are designed for specific communities, contexts or scenarios of use defined by the students to communicate a future experience. The output from this project is curated and presented as a public exhibition. The exhibition resulting from this research project includes products, services and experiences designed for the people who might live and work within these future contexts. Each ‘future world’ is situated within a discrete design domain: Health (Global + Local), Economies (Global + Local) and Citizenship (Global + Local). Exhibition dates: Tuesday 7th to Friday 10th February, 2023 Venue: Advanced Research Centre, University of Glasgow The deposited materials are arranged as follows: 1 - Regenerative Futures Project Brief. The Project Brief is developed as rationale, context and a guide to the project. 2 - Regenerative Futures Project Exhibition Guide. The Guide catalogues and describes the exhibits presented in the show. It takes you through each ‘Future World’ experience created by the students. It complements the videos and images presented in companion sections. 3 - Videos of the Regenerative Futures Exhibition. Here you will find short videos documenting the set-up of the exhibition and the exhibition itself. 4 - Images of the Regenerative Futures Exhibition. This section documents the Exhibition in images. 5 - Images of Studio Life. This section documents in images, the co-creation studio sessions with experts and the studio development of the show exhibits. 6 - Exhibition guides for each individual World View. These guides take you through each individual ‘Future World’; Health (Global + Local), Economies (Global + Local) and Citizenship (Global + Local)

Pregnancy and neonatal outcomes of COVID-19: The PAN-COVID study

Objective To assess perinatal outcomes for pregnancies affected by suspected or confirmed SARS-CoV-2 infection. Methods Prospective, web-based registry. Pregnant women were invited to participate if they had suspected or confirmed SARS-CoV-2 infection between 1st January 2020 and 31st March 2021 to assess the impact of infection on maternal and perinatal outcomes including miscarriage, stillbirth, fetal growth restriction, pre-term birth and transmission to the infant. Results Between April 2020 and March 2021, the study recruited 8239 participants who had suspected or confirmed SARs-CoV-2 infection episodes in pregnancy between January 2020 and March 2021. Maternal death affected 14/8197 (0.2%) participants, 176/8187 (2.2%) of participants required ventilatory support. Pre-eclampsia affected 389/8189 (4.8%) participants, eclampsia was reported in 40/ 8024 (0.5%) of all participants. Stillbirth affected 35/8187 (0.4 %) participants. In participants delivering within 2 weeks of delivery 21/2686 (0.8 %) were affected by stillbirth compared with 8/4596 (0.2 %) delivering ≥ 2 weeks after infection (95 % CI 0.3–1.0). SGA affected 744/7696 (9.3 %) of livebirths, FGR affected 360/8175 (4.4 %) of all pregnancies. Pre-term birth occurred in 922/8066 (11.5%), the majority of these were indicated pre-term births, 220/7987 (2.8%) participants experienced spontaneous pre-term births. Early neonatal deaths affected 11/8050 livebirths. Of all neonates, 80/7993 (1.0%) tested positive for SARS-CoV-2. Conclusions Infection was associated with indicated pre-term birth, most commonly for fetal compromise. The overall proportions of women affected by SGA and FGR were not higher than expected, however there was the proportion affected by stillbirth in participants delivering within 2 weeks of infection was significantly higher than those delivering ≥ 2 weeks after infection. We suggest that clinicians’ threshold for delivery should be low if there are concerns with fetal movements or fetal heart rate monitoring in the time around infection

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

A local study of costs for private allied health in Australian primary health care: variabillity and policy implications

Multidisciplinary approaches to primary health care improve outcomes for individuals living with chronic conditions. However, emerging evidence suggests access to allied health professionals in Australia is problematic. This paper reports findings of a telephone survey of allied health professionals' billing practices in one urban area. The survey was undertaken as a quality improvement project in response to the affordability queries raised by patients and carers in the clinical setting. The aim was to determine financial cost of access to allied health professionals in one urban primary health care setting. Participant practices included: physiotherapy (n = 21), podiatry (n = 8) and dietitians (n = 3). Fees were variable, with cost of the initial (assessment) appointment higher than subsequent (follow-up) appointments in 92% of practices. The average out of pocket expenses for assessment and three follow-up appointments ranged from $258 to$302. When available, the Medicare rebate reduced this to $58-106. Bulk billing was not offered. Variable costs, minimal concessions and absence of bulk billing in this confined geographical area creates a cost barrier to access for patients from lower socioeconomic groups and has implications for access to multidisciplinary care in Australian primary health care.No Full Tex

A local study of costs for private allied health in Australian primary health care: Variability and policy implications

Multidisciplinary approaches to primary health care improve outcomes for individuals living with chronic conditions. However, emerging evidence suggests access to allied health professionals in Australia is problematic. This paper reports findings of a telephone survey of allied health professionals' billing practices in one urban area. The survey was undertaken as a quality improvement project in response to the affordability queries raised by patients and carers in the clinical setting. The aim was to determine financial cost of access to allied health professionals in one urban primary health care setting. Participant practices included: physiotherapy (n≤21), podiatry (n≤8) and dietitians (n≤3). Fees were variable, with cost of the initial (assessment) appointment higher than subsequent (follow-up) appointments in 92% of practices. The average out of pocket expenses for assessment and three follow-up appointments ranged from $258 to$302. When available, the Medicare rebate reduced this to $58106. Bulk billing was not offered. Variable costs, minimal concessions and absence of bulk billing in this confined geographical area creates a cost barrier to access for patients from lower socioeconomic groups and has implications for access to multidisciplinary care in Australian primary health care

The risk of acute kidney injury in colorectal cancer survivors: an english population-based matched cohort study

Abstract Background Colorectal cancer survival has improved in recent decades but there are concerns that survivors may develop kidney problems due to adverse effects of cancer treatment or complications of the cancer itself. We quantified the risk of acute kidney injury (AKI) in colorectal cancer survivors compared to people with no prior cancer. Methods Retrospective matched cohort study using electronic health record primary care data from the Clinical Practice Research Datalink GOLD linked to hospital data in England (HES-APC). Individuals with colorectal cancer between 1997–2018 were individually matched on age, sex, and GP practice to people with no prior cancer. We used Cox models to estimate hazard ratios for an incident hospital diagnosis of AKI in colorectal cancer survivors compared to individuals without cancer, overall and stratified by time since diagnosis adjusted for other individual-level factors (adj-HR). Results Twenty thousand three hundred forty colorectal cancer survivors were matched to 100,058 cancer-free individuals. Colorectal cancer survivors were at increased risk of developing AKI compared to people without cancer (adj-HR = 2.16; 95%CI 2.05–2.27). The HR was highest in the year after diagnosis (adj-HR 7.47, 6.66–8.37), and attenuated over time, but there was still increased AKI risk > 5 years after diagnosis (adj-HR = 1.26, 1.17–1.37). The association between colorectal cancer and AKI was greater for younger people, men, and those with pre-existing chronic kidney disease. Conclusions Colorectal cancer survivors were at increased risk of AKI for several years after cancer diagnosis, suggesting a need to prioritise monitoring, prevention, and management of kidney problems in this group of cancer survivors