Investigation of Non-Academic Characteristics used for Selection Entry of Pre-Service Teachers into Higher Education Courses

: Education reform is prioritised in most countries. In 2014, the Australian federal government established the Teacher Education Ministerial Advisory Group with a mandate to improve initial teacher education (ITE) to better prepare new teachers for the classroom. One recommendation involved higher education providers selecting ITE candidates who possessed the required academic skills and non-academic characteristics to become successful teachers. This study investigates the prevalence and impact of non-academic characteristics among first-year graduates, using insights from principals in Western Australian public schools. According to the available literature, the link between non-academic characteristics in the ITE selection process and student outcomes and teacher employment is not clearly established. Principals confirmed first year graduates possessing the required non-academic characteristics impacted on student learning and were more employable

Academic performance of third-year medical students learning in rural settings

Investigate the academic performance of medical students in rural and remote discipline rotations by rurality of placement.A retrospective cohort study.Rural and remote clinical placement locations in Queensland, Australia.University of Queensland third-year medical students.In this study, student results for a range of assessments are the main outcome measures with rural area of student placement locations as categorised by the Australian Standard Geographical Classification - Remoteness Areas system the independent variable of interest.There was a significant effect of Australian Standard Geographical Classification - Remoteness Areas of placement on the health project, clinical case presentation, clinical participation assessment and overall grade, after controlling for the potential confounding impact of sex, age, students who attended the rural clinical school, cohort year, rotation during the year and type of health service where students were placed. No significant effect of rural placement level was identified for the written examination, poster or journal of achievement assessments.Medical students' academic achievement is associated with many factors, but this study shows that being placed in remote areas is one factor that either does not impede or can positively influence the learning and academic performance of medical students

Minimal information for studies of extracellular vesicles (MISEV2023): From basic to advanced approaches

Extracellular vesicles (EVs), through their complex cargo, can reflect the state of their cell of origin and change the functions and phenotypes of other cells. These features indicate strong biomarker and therapeutic potential and have generated broad interest, as evidenced by the steady year-on-year increase in the numbers of scientific publications about EVs. Important advances have been made in EV metrology and in understanding and applying EV biology. However, hurdles remain to realising the potential of EVs in domains ranging from basic biology to clinical applications due to challenges in EV nomenclature, separation from non-vesicular extracellular particles, characterisation and functional studies. To address the challenges and opportunities in this rapidly evolving field, the International Society for Extracellular Vesicles (ISEV) updates its 'Minimal Information for Studies of Extracellular Vesicles', which was first published in 2014 and then in 2018 as MISEV2014 and MISEV2018, respectively. The goal of the current document, MISEV2023, is to provide researchers with an updated snapshot of available approaches and their advantages and limitations for production, separation and characterisation of EVs from multiple sources, including cell culture, body fluids and solid tissues. In addition to presenting the latest state of the art in basic principles of EV research, this document also covers advanced techniques and approaches that are currently expanding the boundaries of the field. MISEV2023 also includes new sections on EV release and uptake and a brief discussion of in vivo approaches to study EVs. Compiling feedback from ISEV expert task forces and more than 1000 researchers, this document conveys the current state of EV research to facilitate robust scientific discoveries and move the field forward even more rapidly

Adding 6 months of androgen deprivation therapy to postoperative radiotherapy for prostate cancer: a comparison of short-course versus no androgen deprivation therapy in the RADICALS-HD randomised controlled trial

Background Previous evidence indicates that adjuvant, short-course androgen deprivation therapy (ADT) improves metastasis-free survival when given with primary radiotherapy for intermediate-risk and high-risk localised prostate cancer. However, the value of ADT with postoperative radiotherapy after radical prostatectomy is unclear. Methods RADICALS-HD was an international randomised controlled trial to test the efficacy of ADT used in combination with postoperative radiotherapy for prostate cancer. Key eligibility criteria were indication for radiotherapy after radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to radiotherapy alone (no ADT) or radiotherapy with 6 months of ADT (short-course ADT), using monthly subcutaneous gonadotropin-releasing hormone analogue injections, daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as distant metastasis arising from prostate cancer or death from any cause. Standard survival analysis methods were used, accounting for randomisation stratification factors. The trial had 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 80% to 86% (hazard ratio [HR] 0·67). Analyses followed the intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov, NCT00541047. Findings Between Nov 22, 2007, and June 29, 2015, 1480 patients (median age 66 years [IQR 61–69]) were randomly assigned to receive no ADT (n=737) or short-course ADT (n=743) in addition to postoperative radiotherapy at 121 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 9·0 years (IQR 7·1–10·1), metastasis-free survival events were reported for 268 participants (142 in the no ADT group and 126 in the short-course ADT group; HR 0·886 [95% CI 0·688–1·140], p=0·35). 10-year metastasis-free survival was 79·2% (95% CI 75·4–82·5) in the no ADT group and 80·4% (76·6–83·6) in the short-course ADT group. Toxicity of grade 3 or higher was reported for 121 (17%) of 737 participants in the no ADT group and 100 (14%) of 743 in the short-course ADT group (p=0·15), with no treatment-related deaths. Interpretation Metastatic disease is uncommon following postoperative bed radiotherapy after radical prostatectomy. Adding 6 months of ADT to this radiotherapy did not improve metastasis-free survival compared with no ADT. These findings do not support the use of short-course ADT with postoperative radiotherapy in this patient population

Duration of androgen deprivation therapy with postoperative radiotherapy for prostate cancer: a comparison of long-course versus short-course androgen deprivation therapy in the RADICALS-HD randomised trial

Background Previous evidence supports androgen deprivation therapy (ADT) with primary radiotherapy as initial treatment for intermediate-risk and high-risk localised prostate cancer. However, the use and optimal duration of ADT with postoperative radiotherapy after radical prostatectomy remains uncertain. Methods RADICALS-HD was a randomised controlled trial of ADT duration within the RADICALS protocol. Here, we report on the comparison of short-course versus long-course ADT. Key eligibility criteria were indication for radiotherapy after previous radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to add 6 months of ADT (short-course ADT) or 24 months of ADT (long-course ADT) to radiotherapy, using subcutaneous gonadotrophin-releasing hormone analogue (monthly in the short-course ADT group and 3-monthly in the long-course ADT group), daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as metastasis arising from prostate cancer or death from any cause. The comparison had more than 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 75% to 81% (hazard ratio [HR] 0·72). Standard time-to-event analyses were used. Analyses followed intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov , NCT00541047 . Findings Between Jan 30, 2008, and July 7, 2015, 1523 patients (median age 65 years, IQR 60–69) were randomly assigned to receive short-course ADT (n=761) or long-course ADT (n=762) in addition to postoperative radiotherapy at 138 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 8·9 years (7·0–10·0), 313 metastasis-free survival events were reported overall (174 in the short-course ADT group and 139 in the long-course ADT group; HR 0·773 [95% CI 0·612–0·975]; p=0·029). 10-year metastasis-free survival was 71·9% (95% CI 67·6–75·7) in the short-course ADT group and 78·1% (74·2–81·5) in the long-course ADT group. Toxicity of grade 3 or higher was reported for 105 (14%) of 753 participants in the short-course ADT group and 142 (19%) of 757 participants in the long-course ADT group (p=0·025), with no treatment-related deaths. Interpretation Compared with adding 6 months of ADT, adding 24 months of ADT improved metastasis-free survival in people receiving postoperative radiotherapy. For individuals who can accept the additional duration of adverse effects, long-course ADT should be offered with postoperative radiotherapy. Funding Cancer Research UK, UK Research and Innovation (formerly Medical Research Council), and Canadian Cancer Society

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

Investigation of early career teacher attrition and the impact of induction programs in Western Australia

This paper contributes to the limited knowledge about Australian early career teacher (ECT) attrition. The population studied included ECTs employed by the Department of Education Western Australia from 2004–2018. This quantitative study focused on ECT attrition rate and profiling ECTs who were likely to leave teaching, and used mixed-methods to investigate ECTs university preparation, intent to stay, resignation reasons and the combined supports received while employed. Study findings reinforced the need for a standardised definition and method of measuring attrition to enable comparisons, and provided information to optimise conditions in retaining ECTs. Ultimately, this will inform planning for teacher workforce supply and provide justification to continue the scale and scope of support for ECTs to address ECT attrition

Investigation of non-academic characteristics used for selection entry of pre-service teachers into higher education courses

Education reform is prioritised in most countries. In 2014, the Australian federal government established the Teacher Education Ministerial Advisory Group with a mandate to improve initial teacher education (ITE) to better prepare new teachers for the classroom. One recommendation involved higher education providers selecting ITE candidates who possessed the required academic skills and non-academic characteristics to become successful teachers. This study investigates the prevalence and impact of non-academic characteristics among first-year graduates, using insights from principals in Western Australian public schools. According to the available literature, the link between non-academic characteristics in the ITE selection process and student outcomes and teacher employment is not clearly established. Principals confirmed first year graduates possessing the required non-academic characteristics impacted on student learning and were more employable

Using evaluation to improve medical student rural experience

Objective The aim of this evaluation was to see whether interventions implemented to improve the Rural Medicine Rotation made this a more effective rural medical education experience. Multiple interventions targeting the student experience, lecturers and preceptors were implemented. Methods A quasi-experimental design using pre- and post-measures was used. The participants were all University of Queensland, School of Medicine, Rural Medicine Rotation students who completed the 2009 and 2010 rural medicine rotation evaluations. There were 769 students, with an 84% response rate in 2009 and an 80% response rate in 2010. In addition, all the 25 program preceptors who were visited in 2009 and the 34 who were visited in 2010 participated in the study. Results The implementation of interventions resulted in significant improvement in three outcome measures, namely teaching effectiveness, provision of an environment supportive of learning in a rural/remote setting and opportunities for professional growth. Two of the three other outcome measures - ensuring a safe clinical placement and opportunities for procedural skills experience and development - were very positively evaluated in both 2009 and 2010. Conclusions The interventions contributed to a more effective rural medical education experience, providing students with the opportunity to develop skills and knowledge relevant for rural medicine and to gain an understanding of the context in which rural medicine is practiced. What is known about the topic? Many Australian medical schools offer students rural-based educational opportunities based on the premise that placing medical students in a rural setting may ultimately lead to them choosing careers in rural medicine. However, there is a paucity of evidence on the factors that are considered necessary for medical students to gain a positive rural experience of short conscripted rural placements. What does the paper add? This paper identifies successful interventions to the rotation and placements that provide a positive experience of the rural clinical placement for students. These interventions occurred within an ongoing evaluation program embedded in the rotation. What are the implications for practitioners? Through ongoing evaluation, interventions can be selected and implemented that succeed in contributing to students having a positive rural clinical placement experience. This paper demonstrates how an embedded continuous improvement program serves to provide direction for ongoing modifications