Western Australia and the evolving regional order: challenges and opportunities

Executive Summary: 21st century Asia is a powerhouse in the contemporary global economy. In a short period of time it has closed the development gap between the Region and the rest of the world. All indications suggest that this growth performance will continue into the foreseeable future.Australia’s high levels of economic growth over the last decade are directly related to Asia’s ‘economic miracle,’ with Western Australia playing a lead role in Australia’s regional economic engagement. Indeed, the State has accounted for nearly 50 per cent of Australia’s commodity export trade in recent years, concentrated overwhelmingly in Asia. In this sense Australia, and Western Australia in particular, are becoming increasingly ‘hard wired’ into the Region. This presents many opportunities but also challenges.The First Murdoch Commission was established to identify how these opportunities may be pursued and how the challenges may be addressed. The initial impetus was that future prosperity required well-informed strategies and policy settings to optimise potential benefits and sustainable gains.The broad context of the inquiry was the contemporary rise of Asia. This rise is a story of success, yet it is success accompanied by significant challenges. Deepening regional integration is an essential part of the story, with the effect of distributing risks as well as benefits. The ongoing performance of the Region is thus also a question about addressing major problems including rapid urbanisation, resources security, demographic burdens and environmental pressures.This insight underpinned the deliberations of the Commission and its investigation of how economic engagement and the growing interdependency of Western Australia, Australia and the Region can be pursued to enhance mutual benefit and long-term resilience.A distinct feature of the Commission’s investigations was its regional approach. This included the composition of the Commission’s membership, and a series of meetings and consultations with various stakeholder groups and individuals in major regional centres. This approach was taken precisely because Australia’s core interests are now closely intertwined with Asia’s continuing prosperity and stability.The Commission found that there is a strategic choice to be taken by Australia: whether to remain a mere exporter to the Region or to become a more active participant engaging in the Region. The former choice leaves Australia susceptible to the volatilities of a game that it has little capacity to influence. By contrast, the latter offers Australia far greater potential influence, opportunity and long-term benefit for its economic prosperity and wider future. Efforts in this space should not underestimate the major challenges confronting both the Region and the Australian economy, and how regional cooperation can provide ways to address these challenges.Western Australia provided a fertile case for the Commission to examine regional opportunities and challenges from the standpoint of a sub-national unit. There is potential for Western Australia to develop a more prominent role in the Region, and the Commission identified various possibilities at hand.The Commission concluded that greater regional engagement offered many benefits. This includes opportunities for Australia to contribute to addressing some of the major challenges in the Region, especially in areas such as food security and capacity building. Western Australia in particular has a lot to offer and a lot to gain in this respect

Career Matters: Leveraging Positive Psychology to Guide Us to Good and Right Work

In order to live well, we should love what we do and feel that what we do is important. Some of us struggle with the difficulty of finding our way onto the right life path, while others navigate with energy and enthusiasm to fulfilling, successful lives. What is it that makes the difference? I believe that the principles of positive psychology can be applied to the career navigation process to elevate and enhance our capacity to find good and right work. In this paper, I will look through a positive psychology lens at career development theory and propose a series of interventions for the career navigation process which apply strengths-based interventions that have proven effective in non-career focused settings. Focusing on signature strengths both in the career development process and as an element of the career goal can provide numerous self-reinforcing, engaging and energizing pathways. The intended outcomes include leveraging of strengths to increase well-being along the way; creative exploration and career discovery; crafting powerful visions of future possibilities; cultivation of hope and perseverance to build resilience; and linking purpose and meaning to career goals to pave the path toward good and right work

Leveraging Positive Psychology to Support First Year College Students: The ROCK Goes to College

Each spring, students in the Master of Applied Positive Psychology (MAPP) program at the University of Pennsylvania complete service learning projects in partnership with nonprofits from around the world. For this specific project, MAPP students collaborated with the ROCK Center for Youth Development, a nonprofit currently providing positive education and programming to middle and high school students in Midland, Michigan. The ROCK is about to begin offering its services to local universities as well and requested assistance adapting an existing workshop to better address the social and cognitive impediments to student success in college. Our literature review indicated that college students commonly struggle with stress, time management issues, and belonging uncertainty, and all three are correlated with poor outcomes across a variety of academic and well-being metrics. In contrast, social connectedness and sense of purpose are overwhelming linked to positive outcomes at college. Based on this research, our application plan for the ROCK recommends that they retain the sections of their existing workshop covering stress management and building positive relationships while adding three evidence-based activities detailed herein. The first activity mitigates belonging uncertainty, the second assesses and develops time management skills, and the third cultivates students’ sense of academic purpose

Venous Thromboembolism Following Colorectal Surgery for Suspected or Confirmed Malignancy

Surgery for colorectal cancer conveys a high risk of venous thromboembolism (VTE). The effect of thromboprophylactic regimens of varying duration on the incidence of VTE was assessed in 417 patients undergoing surgery between 2005 and 2009 for colorectal cancer. Low-dose unfractionated heparin (LDUH) was used in 52.7% of patients, low-molecular-weight heparin (LMWH) in 35.3%, and 10.7% received LDUH followed by LMWH. Pharmacological prophylaxis was continued after hospitalisation in 31.6%. Major bleeding occurred in 4% of patients. The 30-day mortality rate was 1.9%. The incidence of symptomatic VTE from hospital admission for surgery to 12 months after was 2.4%. There were no in-hospital VTE events. The majority of events occurred in the three-month period after discharge, but there were VTE events up to 12 months, especially in patients with more advanced cancer and multiple comorbidities

Retrofitting Tractors with Rollover Protective Structures: Perspective of Equipment Dealers

This study was one of a cluster of studies that originated via requests for proposals from the NIOSH National Agricultural Tractor Safety Initiative. The present study design consisted of several steps: (1) formation of an advisory group, (2) development and testing of a standard paper self-responding survey instrument, (3) sample selection of farm equipment dealers, (4) administration of the survey, (5) assessment and analysis of the survey, and (6) in-person response panel of dealers (n = 80) to review results of the questionnaire for further definition and sharpening of the recommendations from the survey. A key finding is that most dealers do not currently sell or install ROPS retrofit kits. Barriers cited by dealers included (1) actual or perceived lack of farmer demand, (2) injury liability, (3) expensive freight for ordering ROPS, (4) lack of dealer awareness of the magnitude of deaths from tractor overturns and the high life-protective factor of ROPS, and (5) difficulty and incursion of non-recoverable expenses in locating and obtaining specific ROPS. Despite not currently selling or installing ROPS, dealers responded favorably about their future potential role in ROPS promotion and sales. Dealers were willing to further promote, sell, and install ROPS if there was demand from farmers. Recommendations include establishing a ROPS “clearing house” that dealers could contact to facilitate locating and obtaining ROPS orders from customers. Additional recommendations include education and social marketing targeting farm machinery dealers as well farmers, manufacturers, and policy makers

Foundations for the Future: Lessons from a Science Foundation Year Programme

Higher Education Institutions (HEIs) have long been aware that some groups of adults are less likely to meet the entry requirements needed to access Higher Education (HE). In 2018 the Office for Students (OfS) set out ambitious targets for HEIs to eliminate the gaps in access, success and progression for students from groups which are underrepresented in HE. In relation to access, an increasingly popular approach for HEIs has been the development of Foundation Year (FY) programmes which constitute a fully integrated Year 0 of degree programmes (not to be confused with a Foundation Degree). FY programmes circumvent the standard admissions requirements whilst offering additional study skills support for non-traditional students with a view to preparing them for progression into Year 1. A recent report from The Sutton Trust, for example, recommended the expansion of Foundation Year or ‘Year 0’ programmes (Bolliver et al. 2017) at some of the UK’s most selective universities to widen access to HE. Our presentation considers a FY programme at a university in the East Midlands which began delivery in 2017/18. Set within a regional context of low levels of HE participation, geographically dispersed communities and with areas of severe deprivation, the Science Foundation Year (SFY) programme is an example of cross-institutional collaboration to support widening participation. Offering places to adults who do not meet standard entry requirements in terms of the required combination of subjects or lower than expected grades, it provides not only access to but support for continued success in HE for a diverse cohort including mature students, students with caring responsibilities, Black and Minority Ethnic (BAME) students and entrants with BTEC qualifications. This presentation draws on data from two teams at one institution – one from the evaluators of the university’s Access and Participation Plan alongside data compiled and analysed by the SFY team themselves. They have been brought together to provide practical and accessible insights into the SFY programme and the views and experiences of its students for those interested in finding out more about the ways in which they can best be supported to succeed. By bringing together the insights of the programme team, the voice of the students and the perspective of the external evaluation team, the presentation will provide a view of a SFY ‘in the round’

A drop-in centre for treating mental health problems in children with chronic illness: outcomes for parents and their relationship with child outcomes

BACKGROUND: Children with chronic health conditions and their parents are at greater risk of developing emotional and behavioural problems compared to their physically healthy peers. The psychological impact on parents is crucial to understand given the relationship between parental mental health and child emotional and behavioural difficulties. This study was part of a broader research project examining the acceptability, feasibility and impact of a ‘Mental Health and Psychological Wellbeing Drop-in Centre’ in a paediatric hospital providing access to support and intervention for children and their families. This paper aimed to investigate the impact of the centre on parents (n = 148). METHODS: Parental anxiety and depression were assessed using the GAD-7 and PHQ-9 at baseline and 6-month post-baseline. Child mental health was assessed using the parent-report Strengths and Difficulties Questionnaire (SDQ). If parents had significant mental health needs, a brief intervention/signposting to relevant services was provided. RESULTS: At baseline, 48% of parents scored above clinical threshold for anxiety and 41% for depression, and parent reported child SDQ scores were correlated with parental anxiety and parental low mood. Self-reported parental anxiety and low mood decreased at 6-months post-baseline (parental anxiety: mean decrease = 2.29 [1.22–3.36], d = 0.38; parental low mood: mean decrease = 1.81 [0.64–3.00], d = 0.28). There were no significant correlations between change in parent reported child wellbeing and changes in parental low mood and anxiety between baseline and 6-month post-baseline. CONCLUSIONS: Assessing and providing a brief treatment to address the mental health needs of parents of children with comorbidity may bring important benefits. It is recommended that children's mental health services consider assessment of parental mental health as part of routine care

Variability in the performance of preventive services and in the degree of control of identified health problems: A primary care study protocol

Background: Preventive activities carried out in primary care have important variability that makes necessary to know which factors have an impact in order to establish future strategies for improvement. The present study has three objectives: 1) To describe the variability in the implementation of 7 preventive services (screening for smoking status, alcohol abuse, hypertension, hypercholesterolemia, obesity, influenza and tetanus immunization) and to determine their related factors; 2) To describe the degree of control of 5 identified health problems (smoking, alcohol abuse, hypertension, hypercholesterolemia and obesity); 3) To calculate intraclass correlation coefficients. Design: Multi-centered cross-sectional study of a randomised sample of primary health care teams from 3 regions of Spain designed to analyse variability and related factors of 7 selected preventive services in years 2006 and 2007. At the end of 2008, we will perform a cross-sectional study of a cohort of patients attended in 2006 or 2007 to asses the degree of control of 5 identified health problems. All subjects older than16 years assigned to a randomised sample of 22 computerized primary health care teams and attended during the study period are included in each region providing a sample with more than 850.000 subjects. The main outcome measures will be implementation of 7 preventive services and control of 5 identified health problems. Furthermore, there will be 3 levels of data collection: 1) Patient level (age, gender, morbidity, preventive services, attendance); 2) Health-care professional level (professional characteristics, years working at the team, workload); 3) Team level (characteristics, electronic clinical record system). Data will be transferred from electronic clinical records to a central database with prior encryption and dissociation of subject, professional and team identity. Global and regional analysis will be performed including standard analysis for primary health care teams and health-care professional level. Linear and logistic regression multilevel analysis adjusted for individual and cluster variables will also be performed. Variability in the number of preventive services implemented will be calculated with Poisson multilevel models. Team and health-care professional will be considered random effects. Intraclass correlation coefficients, standard error and variance components for the different outcome measures will be calculated

Scoping potential routes to UK civil unrest via the food system: Results of a structured expert elicitation

We report the results of a structured expert elicitation to identify the most likely typesof potential food system disruption scenarios for the UK, focusing on routes to civil unrest. Wetake a backcasting approach by defining as an end-point a societal event in which 1 in 2000 peoplehave been injured in the UK, which 40% of experts rated as “Possible (20–50%)”, “More likely thannot (50–80%)” or “Very likely (>80%)” over the coming decade. Over a timeframe of 50 years, thisincreased to 80% of experts. The experts considered two food system scenarios and ranked theirplausibility of contributing to the given societal scenario. For a timescale of 10 years, the majorityidentified a food distribution problem as the most likely. Over a timescale of 50 years, the expertswere more evenly split between the two scenarios, but over half thought the most likely route tocivil unrest would be a lack of total food in the UK. However, the experts stressed that the variouscauses of food system disruption are interconnected and can create cascading risks, highlighting theimportance of a systems approach. We encourage food system stakeholders to use these results intheir risk planning and recommend future work to support prevention, preparedness, response andrecovery planning

Multiorgan MRI findings after hospitalisation with COVID-19 in the UK (C-MORE): a prospective, multicentre, observational cohort study

Introduction: The multiorgan impact of moderate to severe coronavirus infections in the post-acute phase is still poorly understood. We aimed to evaluate the excess burden of multiorgan abnormalities after hospitalisation with COVID-19, evaluate their determinants, and explore associations with patient-related outcome measures. Methods: In a prospective, UK-wide, multicentre MRI follow-up study (C-MORE), adults (aged ≥18 years) discharged from hospital following COVID-19 who were included in Tier 2 of the Post-hospitalisation COVID-19 study (PHOSP-COVID) and contemporary controls with no evidence of previous COVID-19 (SARS-CoV-2 nucleocapsid antibody negative) underwent multiorgan MRI (lungs, heart, brain, liver, and kidneys) with quantitative and qualitative assessment of images and clinical adjudication when relevant. Individuals with end-stage renal failure or contraindications to MRI were excluded. Participants also underwent detailed recording of symptoms, and physiological and biochemical tests. The primary outcome was the excess burden of multiorgan abnormalities (two or more organs) relative to controls, with further adjustments for potential confounders. The C-MORE study is ongoing and is registered with ClinicalTrials.gov, NCT04510025. Findings: Of 2710 participants in Tier 2 of PHOSP-COVID, 531 were recruited across 13 UK-wide C-MORE sites. After exclusions, 259 C-MORE patients (mean age 57 years [SD 12]; 158 [61%] male and 101 [39%] female) who were discharged from hospital with PCR-confirmed or clinically diagnosed COVID-19 between March 1, 2020, and Nov 1, 2021, and 52 non-COVID-19 controls from the community (mean age 49 years [SD 14]; 30 [58%] male and 22 [42%] female) were included in the analysis. Patients were assessed at a median of 5·0 months (IQR 4·2–6·3) after hospital discharge. Compared with non-COVID-19 controls, patients were older, living with more obesity, and had more comorbidities. Multiorgan abnormalities on MRI were more frequent in patients than in controls (157 [61%] of 259 vs 14 [27%] of 52; p<0·0001) and independently associated with COVID-19 status (odds ratio [OR] 2·9 [95% CI 1·5–5·8]; padjusted=0·0023) after adjusting for relevant confounders. Compared with controls, patients were more likely to have MRI evidence of lung abnormalities (p=0·0001; parenchymal abnormalities), brain abnormalities (p<0·0001; more white matter hyperintensities and regional brain volume reduction), and kidney abnormalities (p=0·014; lower medullary T1 and loss of corticomedullary differentiation), whereas cardiac and liver MRI abnormalities were similar between patients and controls. Patients with multiorgan abnormalities were older (difference in mean age 7 years [95% CI 4–10]; mean age of 59·8 years [SD 11·7] with multiorgan abnormalities vs mean age of 52·8 years [11·9] without multiorgan abnormalities; p<0·0001), more likely to have three or more comorbidities (OR 2·47 [1·32–4·82]; padjusted=0·0059), and more likely to have a more severe acute infection (acute CRP >5mg/L, OR 3·55 [1·23–11·88]; padjusted=0·025) than those without multiorgan abnormalities. Presence of lung MRI abnormalities was associated with a two-fold higher risk of chest tightness, and multiorgan MRI abnormalities were associated with severe and very severe persistent physical and mental health impairment (PHOSP-COVID symptom clusters) after hospitalisation. Interpretation: After hospitalisation for COVID-19, people are at risk of multiorgan abnormalities in the medium term. Our findings emphasise the need for proactive multidisciplinary care pathways, with the potential for imaging to guide surveillance frequency and therapeutic stratification