South Australia Research Articles

Chromosome-level genome assembly of Pontederia cordata L. provides insights into its rapid adaptation and variation of flower colors.

Pontederia cordata L. is an aquatic ornamental plant native to the Americas, but has been widely distributed in South Asia, Australia, and Europe. The genetic mechanisms behind its rapid adaptation and spread have not yet been well understood. To understand the mechanisms for its rapid adaptation, this study assembled the first chromosome-level genome of P. cordata. The genome assembly, which spans 527.5Mb, is anchored on eight pseudochromosomes with a scaffold N50 of 48Mb and encompasses 29,389 protein-coding genes. Further analyses revealed that P. cordata had experienced three whole-genome duplications (WGDs) events. These WGDs are associated with gene family expansion and increased numbers of resistance gene analogs (RGAs) and transcription factors (TFs). Positive selection analysis indicated that genes derived from tandem duplication and proximal duplication were more likely to undergo positive selection, and were enriched in plant defense and disease resistance. These results implied that WGDs, tandem duplication, and positive selection enhanced the environmental adaptability of P. cordata. Additionally, we found that down-regulation of F3'5'H, DFR, ANS, and UFGT likely caused the flower color variation for P. cordata from violet to white. The first chromosome-level genome of P. cordata here provides a valuable genomic resource for investigating the rapid adaptation and flower color variation of the species.

Mechanical and Microstructural Behavior of Cemented Paste Backfill Under Cyclic Loading

Understanding the mechanical and physical behavior of aged CPB under cyclic loading is a significant area of research. Many parameters such as cementation (hydration) and the microstructure, which dictate the arrangement of particles and permeability, affect the mechanical features of cemented paste backfill (CPB). The impact of a wide range of external energy sources within the mining environment, such as cyclic loading resulting from long-term blasting, can significantly alter the applied stresses on the backfill mass. This paper aims to delve into this crucial area of research. A series of uniaxial cyclic tests were conducted on CPB, utilizing samples made from tailing materials sourced from a copper mine in South Australia. Different loading levels were applied at various curing times. All samples exhibited cyclic loading hardening behavior for cyclic loading levels between 80% and 93% of monotonic unconfined compressive strength (UCS), and a cyclic loading damage behavior was observed for 96% of UCS loading level for both 14- and 28-day curing periods. To further investigate these findings, scanning electron microscope analysis as well as sonic velocity tests were conducted for capturing microstructural changes in the samples before and after tests. These findings can be used to indicate a safe firing distance to a filled mass.

Macrophytes and Phytoplankton, Two Primary Antithetical Producers in Degraded Water Systems

One year of monthly sampling in some lagoons of the Po Delta and a pond in the Comacchio Valleys helped fill a gap in the knowledge of the primary producers of these degraded environments, focusing on the competition between macrophytes and phytoplankton. Key water column and surface sediment parameters showed a strong association with the different primary producers, explaining the main factors influencing the dominance of one group over the other. Phytoplankton, recorded as Chlorophyll-a and Phaeophytin-a, and Chlorophyceae among the macrophytes, dominated in conditions of high water turbidity and elevated nutrient concentrations. In contrast, macrophytes, particularly Rhodophyceae, their abundance, total biomass, and number of taxa. prevailed in clear, oxygenated waters. Under optimal conditions, sensitive macroalgae and aquatic angiosperms were also present. Additionally, the current list of macroalgal taxa has been updated, highlighting the dominance of some nonindigenous species (NIS) that had not been recorded before the 2000s. Specifically, Gracilaria vermiculophylla and Ulva australis, native to the North West Pacific (Japan, Korea, China, and Vietnam) and to South Australia, as well as the Indo-West Pacific (India, South Africa, Japan, and Korea), respectively, are now the most frequent and abundant taxa in these lagoons.

Origins and Distribution of Panicum Mosaic Virus and Sugarcane Mosaic Virus on Stenotaphrum secundatum in Australia.

Stenotaphrum secundatum is a premium turf grass in warm temperate and subtropical regions of the world and is the most important turf species in Australia based on the value of its production. A new disease called buffalo grass yellows (BGY) has become a problem on turf farms in Australia. We surveyed turf farms in New South Wales (NSW), Queensland (Qld) and Western Australia to determine whether panicum mosaic virus (PMV) and sugarcane mosaic virus (SCMV) were associated with BGY. PMV was only found on three farms, two located in the Hawkesbury Valley near Sydney, and a third at Echuca, about 800 km to the southwest of the former location. SCMV was more prevalent, present in all major cultivars and states surveyed. We analyzed phylogenetic relationships for SCMV and found that isolates infecting S. secundatum in Australia belonged to three clades. The first included Australian isolates typical of the population of viruses circulating in Digitaria didactyla. The second included a single NSW isolate from S. secundatum 'SS100' that grouped with otherwise American isolates of SCMV recorded in S. secundatum and Saccharum officinale from Florida, and Zea mays from Ohio. Finally, an isolate of SCMV from S. secundatum originating from a turf farm in southeast Qld grouped with viruses mostly infecting maize; this record is potentially the first maize-adapted strain of SCMV in Australia. Our study sheds light on the aetiology of the BGY disease syndrome and invasion history of PMV and SCMV in Australia.

Eradicating Waste in the Making of the Lower River Murray, Australia, 1880–1940

The concept of waste pervades contemporary water policy and the polarised debates about river management in Australia’s Murray-Darling Basin. However, the preoccupation with waste, and its associated notions of efficiency and productivity, is not merely a reaction to the relatively recent environmental critique prompted by excessive extraction from rivers and streams. We argue that the fixation with eradicating waste is embedded in the Australian colonial political imagination, where it has served as a powerful catalyst for projects of river transformation and as justification for territorial control of water. Initially control was exerted by Australian colonies and then later by state governments. A close examination of South Australia’s portion of the River Murray between 1880 and 1940 identifies four sites that were perceived as wasteful: the ocean to which the River Murray runs, wetlands, lakes and the atmosphere. To eliminate waste from and above the land surface, hydro-engineers and settler authorities transformed the lower River Murray with weirs, locks and barrages, at the same time as they altered society–water relations. Waste was articulated and acted on from within colonial processes with such force that the effects continue to set the parameters for today’s water policies and wider settler societal relations with rivers.

Australian Trachoma Surveillance Report update: 2014-2022.

Australia is the only high-income country where trachoma has been endemic, defined as an overall trachoma prevalence in Aboriginal and Torres Strait Islander children aged 5-9 years of 5% or more. The Australian Government funds the National Trachoma Surveillance and Reporting Unit to collate and analyse trachoma prevalence data and control strategies annually. This report presents data submitted from 2014 to 2022. In 2022, there were 87 remote communities considered at-risk of endemic trachoma, a decline of 51% since 2014 when 177 communities were considered at-risk. World Health Organization grading criteria are used to diagnose trachoma in at-risk populations. Overall prevalence, which includes estimates from all communities ever considered at-risk, fell below 5% endemicity thresholds for the first time in 2022 in Western Australia (2.9%), the Northern Territory (2.1%), New South Wales (0.5%), and in Queensland and South Australia (0.0% each). New cases of trachomatous trichiasis-a severe consequence of trachoma that causes blindness-were detected in eight out of 10,806 persons, aged 15 years and over, screened in 2022. Jurisdictional trichiasis prevalence was 0.2% in Western and South Australia and 0.0% in the Northern Territory. Australia must maintain overall trachoma and trichiasis prevalence below endemicity levels for a further two years before applying for World Health Organization validation of elimination of trachoma as a public health problem.

P0823 Access to an integrated Inflammatory Bowel Disease diet clinic improves patient-reported outcomes and dietary self-confidence in a tertiary service previously without dietetic services

Abstract Background Disability and impaired food-related quality of life (FRQoL) is prevalent in people with inflammatory bowel disease (IBD). The aim of this study was to examine whether access to specialised IBD diet care influenced patient-reported outcomes. Methods This was a prospective study of an IBD Diet Clinic (IBDDC) piloted at The Queen Elizabeth Hospital, South Australia between February 2021- September 2022. During routine IBD care, adults with diet-related issues were referred to a specialised IBD dietitian and invited to complete questionnaires evaluating before- and after dietary intervention. The primary outcome was change in FRQoL (defined as 0 (poor) and 149 (exceptionally high). Secondary outcomes included change in IBD-disability index (IBD-DI), domains of diet self-management including knowledge and self-confidence and satisfaction with IBD diet care. Appropriate statistical tests were applied to descriptive, categorical, and paired data. Results Of 91 who attended first consult in IBDDC, 55 completed before- and after-dietetic intervention questionnaires. FRQoL scores were 64.6 (SD 16.8) at baseline and improved by 13.9 points (95% CI 8.27, 19.6; p<0.001) following dietetic intervention. Similarly, IBD-DI scores improved by 3 points (95% CI 1.78, 4.22; p<0.001), knowledge of what to eat improved by 37% (p<0.001) and confidence in self-managing diet improved by 21% (p=0.003). Satisfaction with dietary advice was high; 46/55 (83%) were satisfied or extremely satisfied and 49/55 (89%) placed high or extremely high value on continuation of an integrated IBDDC within The Queen Elizabeth Hospital IBD service. Conclusion In an IBD service previously without a dedicated diet clinic, access to integrated, specialised and personalised IBD dietary care led to a significant improvement in all patient-reported outcomes and a high level of patient satisfaction. Poor baseline FRQoL was identified in IBD patients without access to specialised dietetic care and through attendance to an IBDDC, FRQoL, disability indices and dietary self-confidence improved.

P1247 An argument for screening? Disordered eating patterns are highly prevalent in Inflammatory Bowel Disease (IBD)

Abstract Background The complex relationship between body image perception, disordered eating behaviours, and quality of life (QoL) has been poorly examined in patients with IBD. Although individuals with chronic gastrointestinal conditions are at an increased risk for disordered eating behaviours, the prevalence and risk factors associated with these attitudes remain underexplored in IBD. Therefore, this study aimed to investigate the relationship between IBD activity, body image perception, and disordered eating behaviours to determine clinical features that impact patient QoL. Methods An online questionnaire was administered through a tertiary centre IBD clinic in South Australia. Disordered eating behaviours were assessed via the validated Eating Disorder Examination-Questionnaire (EDE-Q7). Clinically significant eating disorder attitude is defined as EDE-Q7 score >3.5. Univariate and multivariate logistic regression analyses were performed to correlate clinically significant disordered eating behaviours with patient sex, disease activity, and the presence of clinical depression or anxiety. Results In a cohort of 210 respondents, clinically significant disordered eating behaviours were observed in 33.2% of respondents. Higher global EDE-Q7 scores were significantly associated with female sex (P<0.0001), active IBD (P=0.0169), and clinical depression (P<0.0001) and anxiety (P<0.0001). High global dietary restraint, shape/weight overevaluation, and body dissatisfaction subscores were significantly associated with female sex (P=0.0063; P=0.0001; P<0.0001), patients with clinical depression (P=0.0142; P<0.0001; P<0.0001), and patients with clinical anxiety (P=0.0003; P<0.0001; P<0.0001). IBD activity and Crohn’s disease were significantly associated with high global shape/weight overevaluation subscores (P=0.0216; P=0.0175) and body dissatisfaction subscores (P=0.0063;P=0.0117). Furthermore, clinically significant disordered eating behaviours were significantly associated with IBD activity (OR, 2.2; 95% CI, 1.3-4.0; P=0.007), clinical anxiety (OR, 7.7; 95% CI, 4.0-14.7; P<0.0001) and clinical depression (OR, 4.6; 95% CI, 2.4-8.7; P<0.0001). Multivariate regression analysis showed that the odds of high global EDE-Q7 scores are significantly increased by clinical anxiety (OR, 8.9; 95% CI, 4.3-18.4; P<0.0001). Conclusion This study demonstrates that disordered eating behaviours are highly prevalent in patients with IBD. Collectively, these findings provide important insight into the eating and body image behaviours that impact the QoL of patients with IBD.

P0735 Early dietetic assessment predicts clinical efficacy of Exclusive Enteral Nutrition in adults with Crohn’s disease

Abstract Background Exclusive Enteral Nutrition (EEN) is an effective but underutilised therapy in adults with Crohn’s disease (CD). Key factors influencing patient adherence and clinical outcomes for EEN in adults remain poorly understood. This study aims to identify the determinants of adherence, therapy completion, and clinical outcomes in adults with CD. Methods This retrospective, multicentre study evaluated consecutive adult patients (≥18 years) prescribed EEN from February 1, 2019, to February 28, 2022, at two tertiary hospitals in Adelaide, South Australia, prior to EEN protocol implementation. Adherence was defined as complete exclusion of table food and fluids and meeting the minimum prescribed daily volume of EEN. Therapy completion was defined as completing the prescribed duration. The primary outcome was clinical remission (Harvey Bradshaw Index (HBI)≤4) or response (HBI change ≥3). The dietetic review frequency and adverse effects were recorded. Early review was defined as dietetic assessment during weeks 1–3 for courses ≥6 weeks. Statistical tests included Chi-squared, Fisher’s exact, and Mann-Whitney U tests, with significance at p<0.05. Multivariable logistic regression included significant covariates with age and sex as controls. Results Among 108 patients (50.0% female, mean age 41.8±16.1 years), most had ileocolonic (51/108, 47.2%) disease and stricturing phenotype (44/108, 40.7%). Baseline HBI was 8 (IQR 6-11) with 60.2% (65/108) on advanced therapies (Table 1). Full adherence to EEN was achieved by 68.2% (73/107). Of 94 patients (87.0%) prescribed EEN with a defined duration (median 6 weeks, range 2-8), completion rate was 71.8% (67/94). Among 67 patients treated for remission induction, remission and response rate was 59.7% (40/67) and 58.2% (39/67), respectively. Patients attended a median of 4 (IQR 3–6) dietetic visits. Constipation (19.2%, 20/104) was a common adverse effect. On multivariable analysis, active smoking reduced odds of remission (OR 0.028, 95% CI 0.001-0.709, p=0.030); while therapy completion (OR 23.0, 95% CI 1.8-683.5, p=0.019), early response (OR 35.2, 95% CI 1.8-683.5,p=0.019) and early remission (OR 20.4, 95% CI 1.5-273.3,p=0.019) improved odds. Number of dietetic visits predicted therapy completion (OR 2.43, 95% CI 1.53-3.85,p<0.001) and use of broth was linked to poorer adherence (OR 0.369, 95% CI 0.152-0.898,p=0.028). Conclusion EEN induced clinical response and remission in adults with CD. Clinical efficacy is enhanced by adherence and completion of therapy, which can be facilitated by increased dietetic support and avoiding non-nutritive items. Optimised EEN protocols to standardise and guide application of this effective nutrition therapy are required to determine if efficacy can be further improved.

Emergence of locally acquired Japanese encephalitis virus in Australia, January 2021-June 2022: a national case series.

In March 2022, an outbreak of Japanese encephalitis virus (JEV) infection was identified in temperate south-eastern Australia, with detections in humans and animals. The unexpected emergence of JEV prompted a national public health response and a Communicable Disease Incident of National Significance was declared. JEV has previously only been identified in tropical north-eastern Australia in localised outbreaks. This article provides a descriptive analysis of the human case epidemiology of the national outbreak from 1 January 2021 to 30 June 2022. There were 42 confirmed and probable human cases of JEV identified as acquired in Australia between 1 January 2021 and 30 June 2022. Seven deaths occurred (case fatality rate: 17%). Cases were identified in five Australian jurisdictions (New South Wales, Victoria, Queensland, South Australia and the Northern Territory). The majority of cases were aged 60 years and over (55%; 23/42), with a median age of 61.5 years (range: 0-79 years; interquartile range: 45-70 years); cases were predominantly of non-Indigenous status (90%; 38/42). Sixty-seven percent (28/42) were male. Of the cases with geographical data available (n = 41), all were likely exposed to the virus in 31 unique local government areas across regional and remote Australia. Cases were detected across Australia in five jurisdictions, requiring a national public health response, to detect and prevent further cases. There was widespread geographical distribution over 18 months. Given the risk of further cases and possible endemicity of JEV being established in Australia, expanded environmental and human surveillance programs are required.

P0690 Purposeful design and integration of a pilot Inflammatory Bowel Disease (IBD) diet clinic into a multi-disciplinary IBD service demonstrates exemplar service utility and is of high value to patients

Abstract Background International guidelines recommend people with inflammatory bowel disease (IBD) have access to a dietitian who can undertake a comprehensive nutrition assessment and provide personalised dietary counselling. Few Australian tertiary IBD services offer dedicated and co-located IBD diet clinics (IBDDCs) to enable point of care, integrated dietary management. The value of IBDDCs to patients and IBD services is unknown. This study aimed to examine the utility and patient-reported value of an integrated IBDDC. Methods A 24-month prospective clinical service audit of a pilot IBDDC at The Queen Elizabeth Hospital, Adelaide, South Australia was conducted. Adults with IBD and nutrition-related issues identified during gastroenterology consultation were referred for specialist IBD dietetic consultation. IBD-diet referral criteria and clinic templates that included direct access appointments for patients requiring point of care dietary management were established. IBDDC service activity audit captured referral rates, wait times, mode of consult delivery, attendance and appointment outcomes. A subgroup of patients completed service evaluation questionnaires. Descriptive data is presented. Results Between February 2021–February 2023, 182 new referrals to IBDDC resulted in 133 new appointments accounting for closures during COVID lockdowns. Of these, 108/133 (81%) attended first consultation and 86/108 (64%) were point of care appointments. The ratio of new to review appointment utilisation was 1:2. Of 382 scheduled reviews, 329/382 (86%) attended and 34/329 (9%) utilised point of care consults. Overall, 19/515 (3.7%) failed to attend (FTA) IBDDC appointments over 24-months. In a subgroup of 55 patients, 89.1% reported future access to integrated IBDDCs as highly valuable. Conclusion A dedicated IBDDC demonstrates high service utility and exceptionally low FTA rates over 24-months. Direct access appointments are novel and were well utilised for patients requiring point of care dietary assessment and care planning. This is exemplar of how to purposely integrate dietetic services into high acuity multi-disciplinary IBD models of care and maximise patient attendance. The next steps are to complete a health economic cost consequence analysis of IBDDC to inform integration of dietetic services into Australian IBD models of care.

Paediatric breast disease and developmental breast cysts - reflection on 20 years of experience.

Presentation with breast symptoms in the paediatric population is common but there is little existing literature on the workup and management of breast disease in this population. Retrospective series of 140 cases of breast disease in the paediatric population managed by a single surgeon in Adelaide, South Australia between 2004 and 2024. Review of patient demographics, presentation, investigation, management and outcomes of various breast symptoms and pathologies using descriptive analysis. We reviewed 140 cases including 135 females and 5 males, aged 8-18 years (median = 15). The most common reason for presentation was breast lump (n = 86, 61%), followed by large breasts (n = 13, 9%), asymmetry (n = 11, 8%), abnormal development (n = 8, 6%). Most patients were investigated with ultrasound (n = 101, 71%) and FNA biopsy was performed in cases of non-diagnostic ultrasound or to distinguish fibroadenoma from phyllodes tumour (n = 17, 12%). There was a single case of malignancy and the most common diagnoses were developmental breast cyst (n = 36, 26%) and fibroadenoma (n = 33, 24%). Gynaecomastia was the only diagnosis in males (n = 5, 4%). Majority of patients were managed non-operatively (n = 101, 72%), indications for surgery included fibroadenoma (n = 18, 13%), breast hypertrophy (n = 8, 6%) or abnormal breast development (n = 4, 3%). We reviewed 140 cases of breast disease in the paediatric population over a 20-year period. Malignancy in this population is rare but requires exclusion with history, examination and ultrasound where appropriate. Developmental breast cysts are the most common pathology, require early identification to avoid unnecessary invasive investigation and should be managed expectantly where possible.

Description of a New Species of Robertsmyia Bee Fly (Bombyliidae: Bombyliinae) from the South Australian mallee

A new species, Robertsmyia aureola sp. nov., of Bombyliinae is added to the previously monotypic genus Robertsmyia Li & Yeates, 2018. Specimens of both sexes were collected in mallee habitat from the Riverland near Cadell and Waikerie, South Australia. The generic diagnosis of Robertsmyia is revised and a key to species of the genus is provided.

Locking in hydro-engineered pathways: the lower river Murray, Australia, 1880–1940

Abstract Located downstream from substantial irrigation extraction at the “end” of the Murray–Darling River system, South Australia (SA) struggles to maintain flows and the health of the rivers within its borders. Analysis of early twentieth century engineering reports reveals that this problem is not new, beginning in the 1880s with the growth of irrigation in Australia and the riparian demands of the eastern, upstream states. I use the theory of path dependency to analyse the history of the Murray–Darling Basin from a South Australian perspective to argue that the state’s current water issues stem from cultural, institutional, and technological lock-ins shaped by its geo-political position that made it vulnerable to upstream demands for water. As SA’s negotiations for a larger water allocation failed, it turned to construction of an enviro-technical network of weirs, locks and barrages designed to assist navigation, regulate the river’s flow, keep water fresh for landholders and towns, prevent the ingress of salty sea water, and mitigate the consequences of upstream irrigation. With construction of each component the state’s hydro-engineering scheme engineers warned that with increasing extraction these strategies would only buy time and bigger-scale structures would be essential in the future to alleviate accelerating problems. Within decades SA experienced the foretold problems of diminishing flows, increasing salinity, environmental degradation and declining water quality, problems that continue and with climate change are likely to grow worse. Only a fundamental shift in cultural, institutional, and technological lock-ins can change a future trajectory that could improve the health of the river.

Co-Designing a Consumer-Focused Digital Reporting Health Platform to Improve Adverse Medicine Event Reporting: Protocol for a Multimethod Research Project (the ReMedi Project).

Adverse medicine events (AMEs) are unintended effects that occur following administration of medicines. Up to 70% of AMEs are not reported to, and hence remain undetected by, health care professionals and only 6% of AMEs are reported to regulators. Increased reporting by consumers, health care professionals, and pharmaceutical companies to medicine regulatory authorities is needed to increase the safety of medicines. We describe a project that aims to co-design a digital reporting platform to improve detection and management of AMEs by consumers and health care professionals and improve reporting to regulators. The project will be conducted in 3 phases and uses a co-design methodology that prioritizes equity in designing with stakeholders. Our project is guided by the Consolidated Framework for Implementation Research. In phase 1, we will engage with 3 stakeholder groups-consumers, health care professionals, and regulators-to define digital platform development standards. We will conduct a series of individual interviews, focus group discussions, and co-design workshops with the stakeholder groups. In phase 2, we will work with a software developer and user interaction design experts to prototype, test, and develop the digital reporting platform based on findings from phase 1. In phase 3, we will implement and trial the digital reporting platform in South Australia through general practices and pharmacies. Consumers who have recently started using medicines new to them will be recruited to use the digital reporting platform to report any apparent, suspected, or possible AMEs since starting the new medicine. Process and outcome evaluations will be conducted to assess the implementation process and to determine whether the new platform has increased AME detection and reporting. This project, initiated in 2023, will run until 2026. Phase 1 will result in persona profiles and user journey maps that define the standards for the user-friendly platform and interactive data visualization tool or dashboard that will be developed and further improved in phase 2. Finally, phase 3 will provide insights of the implemented platform regarding its impact on AME detection, management, and reporting. Findings will be published progressively as we complete the different phases of the project. This project adopts a co-design methodology to develop a new digital reporting platform for AME detection and reporting, considering the perspectives and lived experience of stakeholders and addressing their requirements throughout the entire process. The overarching goal of the project is to leverage the potential of both consumers and technology to address the existing challenges of underdetection and underreporting of AMEs to health care professionals and regulators. The project potentially will improve individual patient safety and generate new data for regulatory purposes related to medicine safety and effectiveness. DERR1-10.2196/60084.

An Autoethnography of an Islamic Teacher Education Programme

This article explores Islamic Teacher Education through an autoethnographic account of the author’s experience with the Graduate Certificate of Education (Islamic Pedagogy) at the University of South Australia. It addresses the lack of research on how Islamic Pedagogy is taught, contributing to the growing scholarship on faith-based teacher education. Autoethnography is a qualitative research method that combines autobiography and ethnography, emphasising personal experiences to explore cultural communities. It is especially useful in studying emerging concepts like Islamic Pedagogy and Faithful Praxis. This approach challenges Western positivism, promoting epistemic reflexivity, and offering critical insights into marginalised perspectives and educational practices. This paper employs autoethnography to present the author’s Faithful Praxis journey as a transformative pedagogical shift, shaped by their experiences with Western and Islamic epistemologies, aiming to empower Muslim voices in education and challenge marginalization, with the Graduate Certificate fostering epistemic reflexivity and providing a platform to reconcile Islamic and Western knowledge in the classroom. This paper also clarifies the distinction between Islamic Pedagogy and Islamic Integration through autoethnography by highlighting their complementary nature as opposed to the author’s initial assumptions around their interchangeability. Whilst this article contributes to the growing Islamic Teacher Education scholarship through an autoethnographic perspective, further research to assess broader program efficacy is still needed.

The value-for-money assessment and funding arrangements for high-priced drugs in an era of uncertainty: a comparative analysis of national health technology assessment agencies in South Korea, England, Australia, and Canada

BackgroundInnovative health technologies have increasingly emerged as a promising solution for patients with untreatable or challenging conditions. However, these technologies often come with expensive costs and limited evidence at the time of launch. This study assessed how these high-priced drugs with limited evidence were appraised and introduced in South Korea, England, Australia, and Canada, where cost-effectiveness analysis (CEA) generally plays a central role in pricing and reimbursement decisions.MethodsThe study analysed 22 high-priced drugs (24 indications) introduced in South Korea, which were granted CEA waivers due to difficulties in evidence generation and high unmet needs. Data, including funding arrangements and evidence assessed, were derived from national health technology assessment (HTA) documents and other public domains in the four countries.ResultsNearly all drugs received positive recommendations, largely through managed entry agreements (MEAs), particularly in England. Single-arm trials were more common in South Korea and England. Indirect comparison was the primary source of comparative effectiveness in England (70.0%), emphasising alignment with current practices. Australia and Canada utilised both indirect comparison and head-to-head trial data in similar proportions. Except for South Korea, all countries still required CEA data for these drugs. Data collection for coverage with evidence development was necessary in 55.0% of cases in England, and less in other countries.ConclusionHTA agencies increasingly accept the uncertainty of high-priced drugs with high unmet needs through MEAs. To ensure timely access and value for money, implementing full value assessment and uncertainty management, while strengthening national and international collaboration for effective data collection, is imperative.

The Uptake of the Influenza Vaccine in Patients With Cystic Fibrosis: A Retrospective Study.

Children with cystic fibrosis are more likely to become severely unwell with influenza-associated illness compared to children without chronic lung disease. The provision of accessible influenza vaccinations is essential in the prevention of infection. To describe the prevalence of the influenza vaccine uptake in children with cystic fibrosis from 2016 to 2020 at a single tertiary paediatric hospital site and determine if the COVID pandemic of 2020 and the introduction of telehealth encounters affected the vaccine uptake. A retrospective study of children with cystic fibrosis aged 6 months to 18 years who reside in South Australia was performed using the Women's and Children's Hospital (WCH) Respiratory Department cystic fibrosis database from 2016 to 2020. The Australian Immunisation Register (AIR) was used to determine vaccination status during this period. One hundred and eighty two children with cystic fibrosis were identified, one hundred and seventy two of whom vaccination records were available on the Australian Immunisation Register. Proportion of eligible patients who were vaccinated ranged from 66% to 88% in the years 2016-2019. There was no significant decrease in uptake during the COVID-19 pandemic in 2020 (75%). Despite the introduction of Telehealth reviews in 2020 majority (66%) of patients continued to have exclusive face-to-face appointments, of which 73% received the vaccination. Vaccination coverage of those who received combination of Telehealth and face-to-face was 81%. The high influenza vaccination rate of South Australian children with cystic fibrosis is consistent with rates seen in other tertiary centres globally. This study demonstrated that the pandemic and introduction of Telehealth appointments did not have any impact in the uptake of the influenza vaccination in our South Australian population.

Cultural Adaptation of an Aboriginal and Torres Strait Islanders Maternal and Child mHealth Intervention: Protocol for a Co-Design and Adaptation Research Study.

There is limited evidence of high-quality, accessible, culturally safe, and effective digital health interventions for Indigenous mothers and babies. Like any other intervention, the feasibility and efficacy of digital health interventions depend on how well they are co-designed with Indigenous communities and their adaptability to intracultural diversity. This study aims to adapt an existing co-designed mobile health (mHealth) intervention app with health professionals and Aboriginal and/or Torres Strait Islander mothers living in South Australia. Potential participants include Aboriginal and/or Torres Strait Islander pregnant women and mothers of children aged 0-5 years, non-Aboriginal and/or Torres Strait Islander women who are mothers of Aboriginal and/or Torres Strait Islander babies, and health professionals who predominantly care for Aboriginal and/or Torres Strait Islander mothers and babies. Participants will be recruited from multiple Aboriginal and/or Torres Strait Islander-specific health services under the local health networks around metropolitan South Australia. In this study, data collection will be carried out via culturally safe, and family-friendly yarning circles, facilitated by Aboriginal research staff to collect feedback on the existing mHealth app from approximately 20 women and 10 health professionals, with the aim to achieve data saturation. This will inform the changes required to the mHealth app. All focus groups and interviews will be audio recorded and transcribed verbatim. Data will be inductively analyzed using realist epistemology via NVivo software (Lumivero). Themes about the mHealth app's cultural acceptability, usability, and appropriateness will be used to inform the changes applied to the app. With the feedback received from participating women and health professionals, changes in the smartphone app will be made to ensure the intervention is supportive and meets the needs of Aboriginal and/or Torres Strait Islander mothers and families in South Australia. Participation of community members will promote ownership, community engagement, and implementation. A co-designed, culturally sensitive, and effective digital health intervention is likely to support Indigenous mothers and their children facing health disparities due to the disruption of Indigenous culture by colaying a foundation for a potential clinical trial and wider implementation. PRR1-10.2196/53748.

Trace element distributions among Cu-(Fe)-sulfides from the Olympic Dam Cu-U-Au-Ag deposit, South Australia

Trace element distributions among Cu-(Fe)-sulfides from the Olympic Dam Cu-U-Au-Ag deposit, South Australia