non-English Speaking Background Research Articles

A Review of Maternity Care for Migrant Women

Migrant women’s experiences of maternity services have been well documented in literature. However, many studies do not account for the impact of migrant women’s language proficiency on their experience with maternity care services. This paper explores the factors contributing to women’s experiences including language barriers, access to care, physical outcomes and emotional outcomes. It provides a comparison of English-speaking native-born women with migrant women of non-English speaking backgrounds (NESB). Through evaluation of the data, the reader will gain an understanding of the needs of migrant women where English was their second language (ESL), to reduce health inequalities and implement system reform.

The burden of alcohol-related caring for others in Australia in the 2021 pandemic period.

The magnitude of caring for others due to excessive alcohol use is unclear in Australia and internationally. This study explores the prevalence, sociodemographic predictors, and consequences of informal care for others due to alcohol use. A survey on harm from others' drinking was conducted among 2,574 Australian adults in November 2021 from national random digit dial and "Life in Australia" panel samples to elicit representative data. Respondents who indicated they had "heavy drinker/s" in their lives (n= 1,585), were asked about their experience of caring for these drinkers and their dependents in the last 12 months. Weighted logistic and linear regressions examined a) sociodemographic factors associated with informal care due to others' drinking, and b) the impact of the caregiving burden on caregiver's financial status, overall health, and quality of life. Overall, 20% of participants reported caregiving responsibilities arising from others' drinking. Older age, unemployment, residing in capital cities and reporting birth in a non-English speaking background country were associated with a reduced likelihood of caregiving, whereas higher education and more frequent risky drinking were associated with an increased likelihood. Caregivers reported significantly higher financial disadvantage, a lower quality of life and poorer overall health. One in five adults reported caring for drinkers in the previous 12 months, with this associated with negative consequences for those providing care. Service providers, health promotion practitioners and policy makers should focus upon younger age groups, those who live in regional areas, and those born in Australia who are at greater risk of being burdened by caregiving due to others' alcohol use.

Enhanced recovery after elective spinal surgery: an Australian pilot study.

The principles of enhanced recovery after surgery (ERAS) aim to reduce the physiological stress of surgery which in turn improve clinical and health economic outcomes. There is ample evidence in literature supporting ERAS methodologies in other surgical specialties, but its adoption in spinal surgery, especially in Australia remains in infancy. The aim of this project is to describe the early experience with an evidence-based ERAS pathway for simple spine surgery, a first of its kind in Australia. An ERAS protocol was designed using an evidenced-based review of the literature. The authors then conducted a prospective cohort analysis looking at outcome of patients undergoing elective spinal (lumbar and cervical) decompression surgery under ERAS principles by a single surgeon on the Westmead Hospital Campus between March 2021 to May 2023. Primary outcomes were patient length of stay (LOS), patient reported pain and disability scores and complications (including readmissions within 30 days and re-operation within 6 months). Secondary outcomes included predictors of failure for same-day discharge. A total of 52 patients underwent spinal decompression surgeries under the ERAS protocol. Overall 43 out of 52 patients (83.7%) were successfully discharged on the same day as their surgery. Patient reported outcomes were improved at 6 weeks and 6 months confirming durability of intervention. The rates of complications were similar to literature reported rates for simple lumbar or cervical decompression procedures and there were no readmissions within 30 days or re-operations within 6 months of surgery. Being of non-English speaking background [odds ratio (OR) =6.08, P=0.04] and from home alone (OR =10.25, P=0.03) were predictors of failure of same day discharge in this small cohort. Implementation of ERAS protocols for simple spinal decompression surgeries is feasible and produces durable improved patient outcomes while reducing LOS in hospitals. Patient social factors can be predictive of lack of compliance.

Front-desk workforce cultural diversity and its implications for service quality in the accommodation sector: a case from Australia

ObjetivoEl idioma y el dialecto, las costumbres y las actitudes de servicio son sólo algunas de las características que hacen que cada cultura sea única. En consecuencia, la presencia de personas de diferentes culturas durante un encuentro de servicio puede repercutir en la calidad del servicio, ya que lo que constituye una buena calidad de servicio se percibe de forma diferente en las distintas culturas. Como país con una sociedad multicultural, los inmigrantes culturalmente diversos de origen no angloparlante (NESB) desempeñan un papel cada vez más importante en el sector de la hostelería y el alojamiento en Australia. Dentro de este contexto regional, este estudio contribuye a una comprensión más sólida de la influencia de la diversidad cultural de la mano de obra en diferentes aspectos de la calidad del servicio de recepción en el sector del alojamiento.Diseño/metodología/enfoqueEn este estudio cualitativo se realizaron 31 entrevistas en profundidad semiestructuradas a huéspedes, personal de recepción y gerentes de apartamentos en Australia Occidental, seguidas de entrevistas de validación con cinco expertos en gestión de recursos humanos del sector de la hostelería.ConclusionesLos resultados de las entrevistas sugieren que la diversidad cultural del personal de los NESB afecta a varios aspectos de los servicios de recepción de los alojamientos australianos, como la calidad de la comunicación, la interacción entre el personal y los huéspedes y la satisfacción de éstos. Los hallazgos señalan que el personal de recepción de los NESB culturalmente diverso puede (1) enfrentarse a barreras de comunicación intercultural debido a los diferentes acentos extranjeros y a la presencia de jerga local, (2) mejorar la interacción huésped-personal y la experiencia general del huésped en caso de tener antecedentes culturales similares con los huéspedes, y (3) proporcionar representaciones auténticas del multiculturalismo en Australia.Originalidad/valorEl estudio arroja nueva luz sobre las cambiantes percepciones y expectativas de autenticidad de los turistas, especialmente en Australia, donde la diversidad cultural ha cobrado mayor protagonismo. Además, en el servicio de alojamiento australiano, muchos empleados de NESB que han aprendido inglés americano/británico tienen dificultades para conversar con personas con acento australiano, sobre todo cuando también está presente la jerga australiana.

'Low-value' clinical care ingeneral practice: a cross-sectional analysis oflow-value care inearly-career GPs' practice.

Nonevidence-based and 'low-value' clinical care and medical services are 'questionable' clinical activities that are more likely to cause harm than good or whose benefit is disproportionately low compared with their cost. This study sought to establish general practitioner (GP), patient, practice, and in-consultation associations of an index of key nonevidence-based or low-value 'questionable' clinical practices. The study was nested in the Registrar Clinical Encounters in Training study-an ongoing (from 2010) cohort study in which Australian GP registrars (specialist GP trainees) record details of their in-consultation clinical and educational practice 6-monthly. The outcome factor in analyses, performed on Registrar Clinical Encounters in Training data from 2010 to 2020, was the score on the QUestionable In-Training Clinical Activities Index (QUIT-CAI), which incorporates recommendations of the Australian Choosing Wisely campaign. A cross-sectional analysis used negative binomial regression (with the model including an offset for the number of times the registrar was at risk of performing a questionable activity) to establish associations of QUIT-CAI scores. A total of 3206 individual registrars (response rate 89.9%) recorded 406 812 problems/diagnoses where they were at risk of performing a questionable activity. Of these problems/diagnoses, 15 560 (3.8%) involved questionable activities being performed. In multivariable analyses, higher QUIT-CAI scores (more questionable activities) were significantly associated with earlier registrar training terms: incidence rate ratios (IRRs) of 0.91 [95% confidence interval (CI) 0.87, 0.95] and 0.85 (95% CI 0.80, 0.90) for Term 2 and Term 3, respectively, compared to Term 1. Other significant associations of higher scores included the patient being new to the registrar (IRR 1.27; 95% CI 1.12, 1.45), the patient being of non-English-speaking background (IRR 1.24; 95% CI 1.04, 1.47), the practice being in a higher socioeconomic area decile (IRR 1.01; 95% CI 1.00, 1.02), small practice size (IRR 1.05; 95% CI 1.00, 1.10), shorter consultation duration (IRR 0.99 per minute; 95% CI 0.99, 1.00), and fewer problems addressed in the consultation (IRR 0.84; 95% CI 0.79, 0.89) for each additional problem]. Senior registrars' clinical practice entailed less 'questionable' clinical actions than junior registrars' practice. The association of lower QUIT-CAI scores with a measure of greater continuity of care (the patient not being new to the registrar) suggests that continuity should be supported and facilitated during GP training (and in established GPs' practice).

635 Giant Paratesticular Liposarcoma Imitating a Recurrent Right Inguinoscrotal Hernia

Abstract Case 48-year-old male presented for elective open recurrent right inguinal hernia (RIH) repair due to ongoing right inguinoscrotal swelling; and an ultrasound suggestive of a large indirect inguinal hernia containing peritoneal fat and extending into the scrotum with displacement of the right testis. Previous open RIH repair with mesh completed 12mths prior found a moderate direct inguinal hernia; and during a post-op phone review (given the COVID pandemic) noted he was healing well. No urinary/obstructive or systemic symptoms identified. Other history included alpha thalassemia trait, ex-smoker and non-English speaking background (NESB). Intraoperatively there was no evidence of recurrent hernia, and the mesh was intact; however a large right scrotal mass was identified as the cause. An 18x8cm soft lipomatous mass surrounded the right testicle and extended up towards the cord structures at the superficial inguinal ring. Given the concern for malignancy, a right orchidectomy and excision of scrotal mass was performed. Histology confirmed a well differentiated grade 1 liposarcoma. He recovered well and is undergoing close MRI surveillance - with no sign of recurrence. Discussion Liposarcoma is an important differential for scrotal masses and can imitate an inguinoscrotal hernia on ultrasound, MRI is the gold standard investigation. The above case highlights the importance of physical post-operative examination and barriers to care during the COVID pandemic, particularly in those with NESB. Informed consent was imperative, we could safely proceed with the appropriate surgery as the patient had been explicitly consented for testicular loss due to recurrent nature of the operation.

Assurance of learning in business education – what exactly are we assuring, and whose business should it be?

PurposeThis paper aims to critically evaluate the evolution of Assurance of Learning (AoL) in business education and identify gaps and responsibilities in higher institution landscapes moving into the future. This comes amidst increasing structural reforms, an increasingly digitalised world, accelerated by the COVID-19 pandemic and wider scrutiny of graduate competencies for job readiness.Design/methodology/approachA systematic literature review comprising 27 journal articles published between 2018 and 2022 is the methodology used in this research. This approach is justified as it provides a recent synopsis of current trends on AoL and encompasses the changes over the course of the COVID-19-induced higher education landscapes.FindingsThe systematic literature review revealed a strong flavour for AoL measurement through the students' perspectives, with little emerging from faculty insights. Only six out of the 27 articles were framed in a non-English speaking background, revealing that most studies were still concentrated in a US or English environment. Also, while papers on AoL have increased in numbers from 2018 to 2022, there remains scant literature on AoL measurements related to the COVID-19 pandemic and recent digital technologies, and how these would have changed given the rapid shift to online or hybrid environments.Originality/valueA comprehensive review of AoL literature from 2018 to 2022 is undertaken through Leximancer, which reveals conceptual and relational ties between core themes and concepts of interest. The findings inform business school leaders of the current state of AoL processes, by combining the views of students, faculty and managers.

Current Cut Points of Three Falls Risk Assessment Tools Are Inferior to Calculated Cut Points in Geriatric Evaluation and Management Units

Background: Falls risk assessment tools are used in hospital inpatient settings to identify patients at increased risk of falls to guide and target interventions for fall prevention. In 2022, Western Health, Melbourne, Australia, introduced a new falls risk assessment tool, the Western Health St. Thomas’ Risk Assessment Tool (WH-STRATIFY), which adapted The Northern Hospital’s risk tool (TNH-STRATIFY) by adding non-English speaking background and falls-risk medication domains to reflect patient demographics. WH-STRATIFY replaced Peninsula Health Risk Screening Tool (PH-FRAT) previously in use at Western Health. This study compared the predictive accuracy of the three falls risk assessment tools in an older inpatient high-risk population. Aims: To determine the predictive accuracy of three falls risk assessment tools (PH-FRAT, TNH-STRATIFY, and WH-STRATIFY) on admission to Geriatric Evaluation Management (GEM) units (subacute inpatient wards where the most frail and older patients rehabilitate under a multi-disciplinary team). Method: A retrospective observational study was conducted on four GEM units. Data was collected on 54 consecutive patients who fell during admission and 62 randomly sampled patients who did not fall between December 2020 and June 2021. Participants were scored against three falls risk assessment tools. The event rate Youden (Youden IndexER) indices were calculated and compared using default and optimal cut points to determine which tool was most accurate for predicting falls. Results: Overall, all tools had low predictive accuracy for falls. Using default cut points to compare falls assessment tools, TNH-STRATIFY had the highest predictive accuracy (Youden IndexER = 0.20, 95% confidence interval CI = 0.07, 0.34). The PH-FRAT (Youden IndexER = 0.01 and 95% CI = −0.04, 0.05) and WH-STRATIFY (Youden IndexER = 0.00 and 95% CI = −0.04, 0.03) were statistically equivalent and not predictive of falls compared to TNH-STRATIFY. When calculated optimal cut points were applied, predictive accuracy improved for PH-FRAT (Cut point 17, Youden IndexER = 0.14 and 95% CI = 0.01, 0.29) and WH-STRATIFY (Cut point 7, Youden IndexER = 0.18 and 95% CI = 0.00, 0.35). Conclusions: TNH-STRATIFY had the highest predictive accuracy for falls. The predictive accuracy of WH-STRATIFY improved and was significant when the calculated optimal cut point was applied. The optimal cut points of falls risk assessment tools should be determined and validated in different clinical settings to optimise local predictive accuracy, enabling targeted fall risk mitigation strategies and resource allocation.

Bifactor analysis of the Hospital Anxiety and Depression Scale (HADS) in individuals with traumatic brain injury

Anxiety and depression symptoms are commonly experienced after traumatic brain injury (TBI). However, studies validating measures of anxiety and depression for this population are scarce. Using novel indices derived from symmetrical bifactor modeling, we evaluated whether the Hospital Anxiety and Depression Scale (HADS) reliably differentiated anxiety and depression in 874 adults with moderate-severe TBI. The results showed that there was a dominant general distress factor accounting for 84% of the systematic variance in HADS total scores. The specific anxiety and depression factors accounted for little residual variance in the respective subscale scores (12% and 20%, respectively), and overall, minimal bias was found in using the HADS as a unidimensional measure. Further, in a subsample of 184 participants, the HADS subscales did not clearly discriminate between formal anxiety and depressive disorders diagnosed via clinical interview. Results were consistent when accounting for degree of disability, non-English speaking background, and time post-injury. In conclusion, variance in HADS scores after TBI predominately reflects a single underlying latent variable. Clinicians and researchers should exercise caution in interpreting the individual HADS subscales and instead consider using the total score as a more valid, transdiagnostic measure of general distress in individuals with TBI.

Employment Disadvantages among Asian NESB Skilled Migrants in Australia: The Case of Japanese Independent Professionals

ABSTRACT Since the late 20th century, skilled labour migration has become a primary channel for resolving the increased global competition, ageing workforces, and skill shortages facing industrialised countries. Despite this ongoing policy trend, skilled migrants – who are increasingly from non-English speaking backgrounds (NESBs), including Asia – confront barriers to securing employment that is commensurate with their skill levels, which exposes them to an array of social and economic vulnerabilities. This article uses qualitative data to examine post-migration employment disadvantages among an under-researched group of Asian NESB skilled migrants in Australia: Japanese independent professionals. The findings show that their employment disadvantages in the host labour market can be attributed to what is termed here multilateral contextual gaps in skills transfer, rather than simply a lack of competence, knowledge, or work experience. The article concludes by identifying the implications of the study, including policy changes that would help improve the skills utilisation and retention of skilled migrants in Australia, which appear to be hampered by the host country’s human capital-based, market-driven skills regimes. These changes are urgent given the imperative for societies such as Australia to revive their economies in the post-pandemic era through higher intakes of skilled migrants.

Hospital Anxiety and Depression Scale Cannot Reliably Differentiate Anxiety and Depression Following Traumatic Brain Injury

<h3>Research Objectives</h3> To evaluate whether scores on the Hospital Anxiety and Depression Scale (HADS) following traumatic brain injury (TBI) reliably reflect specific factors of anxiety and depression or instead a single factor of general distress. <h3>Design</h3> Survey. Participants completed the HADS at one year post-TBI. A subsample (21%) also completed the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) at the same time. <h3>Setting</h3> Community. <h3>Participants</h3> 874 adults (mean age at injury = 40 years, 74% male, 10% non-English speaking background) recruited from consecutive admissions to a rehabilitation hospital following a moderate-to-severe TBI. Individuals with other neurological conditions or insufficient cognitive/English ability were excluded. <h3>Interventions</h3> Not applicable. <h3>Main Outcome Measures</h3> HADS. <h3>Results</h3> Bifactor analysis revealed a dominant general distress factor accounting for 84% of the systematic variance in HADS total scores. When holding this general factor constant, the specific anxiety and depression factors accounted for little residual variance in their corresponding subscale scores (12% and 19%, respectively). Item loadings on the general factor changed by only 8% on average when removing the specific factors, suggesting minimal bias in treating the HADS as a unidimensional instrument. Moreover, in a subsample who completed the SCID (n=184), the HADS subscales did not discriminate formal diagnoses of anxiety and depressive disorders (i.e., differences in subscale scores between diagnostic groups non-significant at p > .05). <h3>Conclusions</h3> In this large TBI cohort, HADS total scores predominately reflected variance due to a single underlying latent variable. The subscale scores had low reliability with most of their variance reflecting a general distress factor. We also did not find a relationship between the HADS subscale scores and their corresponding formal diagnostic categories on the SCID. We therefore recommend TBI clinicians and researchers exercise caution in interpreting the individual HADS subscales and consider instead using the total score as a more reliable measure of general distress. Whilst screening tools have advantages, transdiagnostic measures of psychopathology that can yield dissociable, homogenous symptom dimensions should also be validated for TBI. <h3>Author(s) Disclosures</h3> None.

Same degree but different outcomes: an analysis of labour market outcomes for native and international PhD students in Australia

This paper used data on career destinations over the period 1999–2015 to study the labour market outcomes of native and foreign PhD graduates staying on in Australia as skilled migrants. Natives with an English-speaking background emerge as benefiting from positive employer ‘discrimination’ (a wage premium unrelated to observed characteristics such as gender, age, and previous work experience). The premium is field-specific and applies to graduates in Science, Technology, Engineering and Mathematics (STEM). In contrast, foreign PhD graduates with a non-English speaking background experience inferior labour market outcomes, especially if they work in the university sector. Against expectations to the contrary, completing the highest degree of education in the host country and staying on in the same sector where one acquired human capital does not appear to eliminate lesser labour market outcomes for the foreign-born.

Examining the effectiveness of an online EAP course in developing researchers' virtual conference presentation skills

Virtual conferences and webinars are increasingly transforming the nature of academic communications. In their transition from conventional to digital academic venues, researchers require guided mentorship, hands-on experience, and consistent feedback. In this study, the aim was to explore the effectiveness of an online EAP course in developing researchers' virtual presentation skills. The participants included the researchers (N = 20) from different departments of sciences in a state university in Iran. Through narrative interviews, the needs analysis phase was completed. The findings demonstrated that the researchers' virtual presentation needs are characterized by academic language competence, pragmatic communication skill, and remote audience engagement. To meet these needs, an online short-term EAP course was designed and held. Through participatory observations and peer feedback, the effectiveness of the course was investigated. The results showed the positive contributions of the course. The participants' attitudes towards their immediate learning experiences were further probed through focus-group interviews. The findings highlighted the researchers' revived self-confidence, live demo experience, digital academic competence, multimedia-enhanced presentation skill-building, collaborative community-based learning, awareness of audiences' affective engagement, and increasing attention to communicative language choices in this course. The findings have potential relevance and application to those involved in the design, delivery, and teaching of online EAP courses – and not only for academics from non-English speaking background, but also English-speaking background.

Intercultural creative expression in two Australian performance works – Counting and Cracking and Mother Tongue

ABSTRACT Art can assist in exposure to difference, which may in turn open up spaces for dialogue between differences. This capacity to encourage and intervene necessarily operates at various levels and spheres and, in the arts, requires creative leadership. Creative leaders are those artists, recognised by their peers and public as artists who generate new developments in creative content to explore diversity. It is predominantly artists of non-English speaking background (‘NESB’) who bear the burden to generate the opportunities as the main producers of content that interacts with multicultural Australia. I am cautious to place sole responsibility onto the minorised and underpaid multicultural artist to transform Australian society. However, their creative leadership roles show that their work and processes can produce new narratives towards intercultural dialogues. Many ‘NESB’ artists adopt this mantle by undertaking new creative production with the potential to transform the symbols within society. This paper explores the ways in which social and creative symbols are re-negotiated through the work of two Australian performance artists. Writer and director Shakthi Shakthidharan; and dancer and choreographer, Annalouise Paul exemplify how artists from diverse backgrounds increase the level of culturally diverse creative production. They make meaning through the contestations and negotiations of multicultural Australia.

Encounters and management of oral conditions at general medical practices in Australia

BackgroundPoor oral health has been widely recognised as an ongoing public health issue. Patients with oral conditions may visit either a general practitioner (GP) or a dental practitioner for management. The aims of this study are to report (i) the GP management rate of oral health conditions by patient and GP demographics, (ii) what specific oral conditions were managed, and (iii) how GPs managed oral conditions.MethodsData from the Bettering the Evaluation and Care of Health study (2006 to 2016 inclusive) were analysed. Descriptive statistics with 95% confidence intervals around point estimates were used to summarise data. Multivariate logistic regression was performed to determine the independent effect of patient and GP characteristics.ResultsA total of 972,100 GP encounters were included in the dataset, with oral condition-related encounters managed at a rate of 1.19 oral conditions per 100 GP encounters. Patients who were aged 54 years or younger, resided in a socioeconomically disadvantaged area, came from a non-English speaking background or Indigenous background were more likely to have oral conditions managed by GPs. The most commonly reported oral conditions were dental and oral mucosa-related. Over 60% of oral conditions were managed by GPs through prescribed medications.ConclusionsThis study provided an overview of management of oral conditions by GPs in Australia. Patients from certain vulnerable demographic groups were more likely to attend a GP for management of oral conditions. Common oral conditions and management approaches were identified. The findings of this study contribute to public health and health policy discussions around optimising primary care provision in oral health.

Management of oesophageal impaction of button batteries in Queensland

Oesophageal button battery impaction (OBBI) is a medical emergency requiring timely removal due to rapid oesophageal tissue injury. The aim of this study was to characterize circumstances of OBBI and identify potential barriers to timely removal of button batteries (BB) in the paediatric population. This is a retrospective review of OBBI cases between January 2018 to June 2019. Medical records were used to obtain patient demographics, battery size and type, battery source, location of initial presentation and outcomes. Time to obtaining x-ray, transfer to tertiary centre and to removal of button battery were recorded. Eight cases of OBBI were recorded during the 18 months study timeframe. Six patients were male and two were female, aged 0.97 to 2.8 years. Six were from an English-speaking background and two were from families of non-English speaking background. Battery removal occurred at Queensland Children's Hospital (QCH) in seven of eight cases. Time from ingestion to initial presentation to hospital ranged from 39 min to 123 h with a mean time of 2h and 13 min. Overall, the total time from ingestion of BB to removal ranged from 2h 54 min to 126 h 51 min. Despite being recognized as a time critical emergency, diagnostic, geographic and logistic challenges in Queensland make optimal care a challenge. Primary prevention strategies coupled with an expanded network for safe battery removal, and novel management strategies such as honey and acetic acid could improve care and reduce morbidity.

Proposed Model for cognizance of NLP and NLU towards Enhancement in Sports

The sportsman is an amalgamation of a sound mind in cognizance with a healthy body. In the Indian context,most of the sports people are from rural areas with non-english speaking backgrounds. Thus, they face troublein executing the strategic moves and commands given by the coaches in various sports facilities. In thisresearch paper, the relationship of NLP (Neuro-Linguistic Programming) to sports and NLU (Natural LanguageUnderstanding) is explored towards improvisation of player’s performance in the game. The cognizance of NLPNLUhelps the sportsperson in executing strategic commands from the coach. The intricacies of the webcast andinformation retrieval using the NLU can reduce the stress of not understanding the jargon and enhance the thrustto involve in the gaming strategies.

Risk factors for Australian school-age children in socio-economically disadvantaged populations not passing ear and hearing screening.

Retrospective study. This study describes the outcomes of an ear and hearing screening program for children from lower socio-economic backgrounds (n = 2489; mean age 11.0 years, standard deviation 1.74 years) in New South Wales (NSW), Australia, between 2013 and 2016. Screening was conducted in a quiet room, and the test protocol included otoscopy, 226 Hertz (Hz) tympanometry, and pure tone screening at octave frequencies from 500 Hz to 4000 Hz with a referral criterion of 20 decibels hearing level (dB HL) at any one frequency. Outcomes were categorised into 1) pass; 2) middle ear dysfunction only; and 3) did not pass hearing screen (with or without middle ear dysfunction). Multinomial logistic regression was used to investigate risk factors for hearing loss and middle ear dysfunction. The factors examined were age, gender, socio-educational advantage, quarter of year assessed, non-English speaking background (NESB), Aboriginal status and region. Higher risks of middle ear dysfunction were associated with younger age and seasonal variation, with higher risk in winter and spring months (July-September and October-December, compared with January-March). There were no differences between those from NESB and those with English as a first language, between the Aboriginal population and non-Aboriginal population, or between those who resided within or outside a major city. More than one in 10 school-age children from lower socio-economic backgrounds experience hearing loss (11.5%). Targeted ear and hearing screening programs offer an opportunity to identify hearing loss during critical learning years and seasons, mitigating longer-term effects on education, and social and mental health.

“That simply cannot be allowed to happen”. The Western Sydney Wanderers and the paradox of Australian soccer

ABSTRACT The game of soccer in Australia is a paradox for many reasons. While soccer enjoys an enormous following as one of Australia’s largest amateur participation sports at the junior levels, the professional version of the game struggles for media attention in an otherwise very sports-oriented nation. In addition, while it could be described as pan-ethnic in that it has a popular participation rate across most communities, and while it has strong links to Australia’s British heritage and the origins of the game itself, soccer today is largely viewed as un-Australian, ‘existing on the margins of the Australian Anglophone sporting mainstream’ because of its ‘post-war history of association with ethnic communities of non-English speaking background’.

Abstract 9926: A Controlled Study of Frailty and Clinical Outcomes in Acute Care Patients with Atrial Fibrillation

Background: Frailty has multidimensional aetiology. AF may predict frailty and is associated with hospital mortality in epidemiological studies. In geriatric patients receiving acute hospital care, interrelationship between AF, frailty, a predisposition to subacute care and overall mortality is unclear. Aim: To investigate an association between frailty and in-hospital mortality in acute care patients with AF Methods: A retrospective study was conducted to investigate acute geriatric inpatients (&gt;65 years, n=1518) with AF admitted under General Medicine units at three Monash Health affiliated hospitals between July and November 2020. Exclusion criteria were: non-English speaking background, MMSE&lt;25, high-level care requiring residents. Frailty was measured by Rockwood clinical frailty scale. Primary endpoint was all-cause mortality. Results: Prevalence of AF was 19%. Of 294 with AF, 6% were new-onset. Mean age was 82±7 years and 43% were female. Mean left ventricular ejection fraction was 56±13 % and 30% had regional hypokinesis on transthoracic echocardiogram. Median Rockwood score was 5(IQR 3,6), acute hospital length of stay was 11±15days and 9% died during hospital stay. In comparison, Rockwood score was lower 4 (IQR 3,5) and only 2% died in a control group without AF (P=0.017). On univariate logistic regression, higher Rockwood score was associated with subacute admissions (OR=1.4,P=0.001) whereas, regional hypokinesis (OR=2.5,P=0.048), chronic kidney disease (OR=2.7,P=0.015) and higher Rockwood score (OR=2.9,P&lt;0.0001) were associated with all-cause in-hospital mortality. After adjusting for age, premorbid status, and comorbidities, higher Rockwood score remained predictive of all-cause in-hospital mortality (OR=3.0,P&lt;0.0001) in AF group. Conclusion: Frailty measured by Rockwood scale in acute care patients with AF is associated with in-hospital mortality. All-cause in-hospital mortality is significantly lower in a control group without AF. Prospective controlled studies are warranted to further strengthen the evidence.