Multiple myeloma survival in New South Wales, Australia, by treatment era to 2020

Objective: Australia has relatively high multiple myeloma(MM) incidence and mortality rates. Advancements in MM treatment over recent decades have driven improvements in MM survival in high-income countries;however, reporting in Australia is limited. We investigated temporal trends in population-wide MM survival across 3 periods of treatment advancements in New South Wales(NSW), Australia.Methods: Individuals with an MM diagnosis in the NSW Cancer Registry between 1985 and 2015 with vital follow-up to 2020, were categorized into 3 previously defined treatment eras according to their diagnosis date(1985±1995, chemotherapy only;1996±2007, autologous stem cell transplantation;and 2008±2015, novel agents including proteasome inhibitors and immunomodulatory drugs). Both relative survival and cause-specific survival according to Fine and Gray's competing risks cumulative incidence function were calculated by treatment era and age at diagnosis.Results: Overall, 11,591 individuals were included in the study, with a median age of 70 years at diagnosis. Five-year relative survival improved over the 36-year(1985±2020) study period(31.0% in 1985±1995;41.9% in 1996±2007;and 56.1% in 2008±2015). For individuals diagnosed before 70 years of age, the 5-year relative survival nearly doubled, from 36.5% in 1985±1995 to 68.5% in 2008±2015. Improvements for those > 70 years of age were less pronounced between 1985±1995 and 1996±2007;however, significant improvements were observed for those diagnosed in 2008±2015. Similar overall and age-specific patterns were observed for causespecific survival. After adjustment for gender and age at diagnosis, treatment era was strongly associated with both relative and cause-specific survival(P < 0.0001).Conclusions: Survival of individuals with MM is improving in Australia with treatment advances. However, older age groups continue to experience poor survival outcomes with only modest improvements over time. Given the increasing prevalence of MM in Australia, the effects of MM treatment on quality of life, particularly in older age, warrant further attention.

The Making of a Health Profession:How Chinese Medicine Became a Nationally Registered Allied Health Profession in Australia

In 2012, traditional Chinese medicine(TCM) practitioners in Australia became nationally-registered allied health professionals in three categories: acupuncturist, Chinese herbal medicine practitioner, and Chinese herbal medicine dispenser. Australia was the first Western country to introduce national registration for Chinese medicine, followed by Portugal and, recently, New Zealand. The practice of TCM in Australia can be traced back to the beginning of Chinese immigration to Australia during the Victorian Gold Rush which began in the 1850s. The process which led to national registration commenced in the early 1970s with the establishment of the first acupuncture courses. Decades of gradual development of courses from unaccredited part-time diplomas to accredited bachelor degrees, and the development, by the profession, of national consensus on educational standards were essential elements in the process which led to registration. Professional associations, such as the Australian Acupuncture and Chinese Medicine Association Ltd.(AACMA), also developed a framework of professional selfregulation, including Codes of Ethics, Codes of Conduct, ongoing professional development requirements and Infection Control Guidelines, and provided leadership in the development of the profession. After decades of tribalism and division within the TCM profession, the National Academic Standards Committee brought almost all stakeholders together to reach a consensus on the Australian Guidelines for Traditional Chinese Medicine Education which were published by AACMA in 2001. Professional associations also collaborated on joint submissions to the government in support of registration, which was introduced first in the state of Victoria in 2000, and subsequently became national in 2012. Despite national registration, some barriers still remain, and professional associations continue to lobby the federal government for inclusion in Medicare, chronic disease management scheme, and Veterans Affairs.

Shared decision making in rural general practices:a qualitative exploration of older rural South Australians'perceived involvement in clinical consultations with doctors

Background:Shared decision-making(SDM)implementation is a priority for Australian health systems,including general practices but it remains complex for specific groups like older rural Australians.We initiated a qualitative study with older rural Australians to explore barriers to and facilitators of SDM in local general practices.Methods:We conducted a patient-oriented research,partnering with older rural Australians,families,and health service providers in research design.Participants who visited general practices were purposively sampled from five small rural towns in South Australia.A semi-structured interview guide was used for interviews and reflexive thematic coding was conducted.Results:Telephone interviews were held with 27 participants.Four themes were identified around older rural adults’involvement in SDM:(1)Understanding of"patient involvement";(2)Positive and negative outcomes;(3)Barriers to SDM;and(4)Facilitators to SDM.Understanding of patient involvement in SDM considerably varied among participants,with some reporting their involvement was contingent on the“opportunity to ask questions”and the“treatment choices”offered to them.Alongside the opportunity for involvement,barriers such as avoidance of cultural care and a lack of continuity of care are new findings.Challenges encountered in SDM implementation also included resource constraints and time limitations in general practices.Rural knowledge of general practitioners and technology integration in consultations were viewed as potential enablers..Conclusion:Adequate resources and well-defined guidelines about the process should accompany the implementation of SDM in rural general practices of South Australia.Innovative strategies by general practitioners promoting health literacy and culturally-tailored communication approaches could increase older rural Australians'involvement in general.

A great thermal divergence in the mantle beginning 2.5 Ga:Geochemical constraints from greenstone basalts and komatiites

Greenstone basalts and komatiites provide a means to track both mantle composition and magma generation temperature with time. Four types of mantle are characterized from incompatible element distributions in basalts and komatiites： depleted, hydrated, enriched and mantle from which komatiites are derived. Our most important observation is the recognition for the first time of what we refer to as a Great Thermal Divergence within the mantle beginning near the end of the Archean, which we ascribe to thermal and convective evolution. Prior to 2.5 Ga, depleted and enriched mantle have indistinguishable thermal histories, whereas at 2.5-2.0 Ga a divergence in mantle magma generation temperature begins between these two types of mantle. Major and incompatible element distributions and calculated magma generation temperatures suggest that Archean enriched mantle did not come from mantle plumes, but was part of an undifferentiated or well-mixed mantle similar in composition to calculated primitive mantle. During this time, however, high-temperature mantle plumes from dominantly depleted sources gave rise to komatiites and associated basalts. Recycling of oceanic crust into the deep mantle after the Archean may have contributed to enrichment ofTi, A1, Ca and Na in basalts derived from enriched mantle sources. After 2.5 Ga, increases in Mg# in basalts from depleted mantle and decreases in Fe and Mn reflect some combination of growing depletion and cooling of depleted mantle with time. A delay in cooling of depleted mantle until after the Archean probably reflects a combination of greater radiogenic heat sources in the Archean mantle and the propagation of plate tectonics after 3 Ga.

Petrogenesis of 3.15 Ga old Banasandra komatiites from the Dharwar craton, India： Implications for early mantle heterogeneity

Spinifex-textured, magnesian （MgO 〉25 wt.%） komatiites from Mesoarchean Banasandra greenstone belt of the Sargur Group in the Dharwar craton, India were analysed for major and trace elements and 147,146Sm-143,142Nd systematics to constrain age, petrogenesis and to understand the evolution of Archean mantle. Major and trace element ratios such as CaOJAl203, Al2O3JTiO2, GdJYb, LaJNb and NbJY suggest aluminium undepleted to enriched compositional range for these komatiites. The depth of melting is estimated to be varying from 120 to 240 km and trace-element modelling indicates that the mantle source would have undergone multiple episodes of melting prior to the generation of magmas parental to these komatiites. Ten samples of these komatiites together with the published results of four samples from the same belt yield 147Sm-143Nd isochron age of ca. 3.14 Ga with an initial ENd（t） value of ＋3.5. High precision measurements of 142Nd/144Nd ratios were carried out for six komatiite samples along with standards AMES and La Jolla. All results are within uncertainties of the terrestrial samples. The absence of 142Nd/144Nd anomaly indicates that the source of these komatiites formed after the extinction of 146Sm, i.e. 4.3 Ga ago. In order to evolve to the high eNd（t） value of ＋3.5 by 3.14 Ga the time-integrated ratio of 147Sm/144Nd should be 0.2178 at the minimum. This is higher than the ratios estimated, so far, for mantle during that time. These results indicate at least two events of mantle differentiation starting with the chondritic composition of the mantle. The first event occurred very early at ~ 4.53 Ga to create a global early depleted reservoir with superchondritic Sm/Nd ratio, The source of Isua greenstone rocks with positive ~42Nd anomaly was depleted during a second differentiation within the life time of 146Sm, i.e. prior to 4.46 Ga. The source mantle of the Banasandra komatiite was a result of a differentiation event that occurred after the extinction of the 146Sm, i,e. at 4.3 Ga and prior to 3,14 Ga. Banasandra komatiites therefore provide evidence for preservation of heterogeneities generated during mantle differentiation at 4,3 Ga.

Formation Age of the Sujiagou Komatiites in Western Shandong: Further Constraints from SHRIMP U-Pb Zircon Dating on Granitic Dykes

Komatiites are presented as direct evidence for higher mantle temperatures during the Archean. In the North China Craton, komatiites with spinifex structure have been identified only at one locality, i.e. the Sujiagou area, western Shandong. They were considered as formed during the early Neoarchean mainly based on their association with supracrustal rocks considered to be that age. This study carried out SHRIMP U-Pb zircon dating on metamorphosed trondhjemitic and monzogranitic dykes intruding the Sujiagou komatiites, and they have magmatic zircon ages of 2592 ± 12 Ma and 2586 ± 13 Ma respectively. This provides direct evidence that the komatiites formed during the early Neoarchean.

Geochemical constraints on komatiite volcanism from Sargur Group Nagamangala greenstone belt,western Dharwar craton,southern India:Implications for Mesoarchean mantle evolution and continental growth

We present field, petrographic, major and trace element data for komatiites and komatiite basalts from Sargur Group Nagamangala greenstone belt, western Dharwar craton. Field evidences such as crude pillow structure indicate their eruption in a marine environment whilst spinifex texture reveals their komatiite nature. Petrographic data suggest that the primary mineralogy has been completely altered during post-magmatic processes associated with metamorphism corresponding to greenschist to lower amphibolite facies conditions. The studied komatiites contain serpentine, talc, tremolite, actinolite and chlorite whilst tremolite, actinolite with minor plagioclase in komatiitic basalts. Based on the published Sm-Nd whole rock isochron ages of adjoining Banasandra komatiites （northern extension of Naga- mangala belt） and further northwest in Nuggihafli belt and Kalyadi belt we speculate ca. 3.2-3.15 Ga for komatiite eruption in Nagamangala belt. Trace element characteristics particularly HFSE and REE patterns suggest that most of the primary geochemical characteristics are preserved with minor influ- ence of post-magmatic alteration and[or contamination. About 1[3 of studied komatiites show AI- depletion whilst remaining komatiites and komatiite basalts are Al-undepleted. Several samples despite high MgO, （Gd]Yb）N ratios show low CaO/AI203 ratios. Such anomalous values could be related to removal of CaO from komatiites during fluid-driven hydrothermal alteration, thus lowering CaOJAI203 ratios. The elemental characteristics of Al-depleted komatiites such as higher （Gd/Yb）N （〉 1.0）, CaO/AI203 （〉1.0）, Al203frio2 （〈18） together with lower HREE, Y, Zr and Hf indicate their derivation from deeper upper mantle with minor garnet （majorite？） involvement in residue whereas lower （GdIYb）N （〈1.0）, CaO/AI203 （〈0.9）, higher A1203]TiO2 （〉18） together with higher HREE, Y, Zr suggest their derivation from shallower upper mantle without garnet involvement in residue. The observed chemical characteristics （CaO/AI203, AI203]TiO2, MgO, Ni, Cr, Nb, Zr, Y, Hf, and REE） indicate derivation of the komatiite and komatiite basalt magmas from heterogeneous mantle （depleted to primitive mantle） at different depths in hot spot environments possibly with a rising plume. The low content of incompatible elements in studied komatiites suggest existence of depleted mantle during ca. 3.2 Ga which in turn imply an earlier episode of mantle differentiation, greenstone volcanism and continental growth probably during ca. 3.6-3.3 Ga which is substantiated by Nd and Pb isotope data of gneisses and komatiites in western Dharwar craton （WDC）.

SM-ND AGE OF TUNCHANG BASALTIC KOMATIITES AND ITS GEOLOGICAL SIGNIFICANCE ON HAINAN ISLAND

The petrogenetic age of Tunchang basaltic komatiites in Hainan Island has never been solved for a long time.Five samples of the basaltic komatiites are taken to be measured by Sm－ Nd radioactive isotope method in this study.The Sm－ Nd whole rock isochron age of 1 687± 10 Ma with INd=0.510796± 0.000006 (2σ ) and ε Nd(T)=＋ 6.64 has been obtained.Meanwhile the basaltic komatiites give Nd model age of 1637～ 1 756 Ma which correspond basically to the isochron age of 1 687 Ma.These indicate that Tunchang basaltic komatiites were formed in the Palaeoproterozoic (about 1 687 Ma) and its primary magma would be derived from a depleted mantle.

A systems perspective on national prioritisation of sustainable development goals:Insights from Australia

Achieving the Sustainable Development Goals(SDGs)requires effective national initiatives and resource allo-cation.Yet,the simultaneous attainment of all goals is hindered by constraints such as limited budgets and resources,varied national priorities,and the intricate nature of the goals.As we approach 2030 and beyond,an urgent need for an effective,data-driven prioritisation system exists to optimise what can be accomplished.A considerable knowledge gap persists in identifying the priority areas that demand concentrated attention and how their improvement would propel overall sustainability goals.To bridge this gap,our study presents a priori-tisation approach that identifies significant SDG indicators based on urgency and impact,utilising Benchmarking,Bivariate,and Network analysis.Furthermore,we introduce an innovative Impact Index(IMIN)to assess an indi-cator’s extensive effect on the SDG network.This system carries significant international relevance by establishing a robust framework to identify key,potent,and interconnected indicators.It supports decision-makers worldwide in comprehending their nation’s SDG performance and promotes efficient resource allocation.In the specific con-text of Australia,our analysis spotlights several impactful,yet underperforming SDG indicators.These include the protection of Freshwater,Terrestrial,and Mountain Key Biodiversity Areas(KBAs),the share of renewable energy and energy intensity level of primary energy,targeted research and development,gender equality in national parliaments,and carbon-efficient manufacturing,amongst others.

The quality of older adults'involvement in clinical communication with general practitioners:evidence from rural towns in Australia

Objective:A study was conducted about the putative links of older rural Australians'health knowledge and preparation with their quality of involvement in patient-general practitioner(GP)communication during health intake visits.Methods:It was a cross-sectional study between January 2021 and April 2022.The 32-item quality of involvement in communication scale was designed and incorporated into the SurveyGizmo software.This online survey was administered by sending an email request to the Renmark Rotary Club,which actively promoted this study across five rural towns in South Australia.121 participants completed the surveys.Mean-sum scores were calculated based on the questionnaire responses to evaluate outcomes,specifically initiation of information,active participation,and emotional expression.We employed different methods including t-tests,ANOVA,and leaner regressions to analyse data.Results:The demographic profile of participants characterised by a female predominance(58.7%,71/121),a majority falling within the 65-<70 age bracket(47.1%,57/121),and a high level of educational attainment(58.7%had completed high school or higher,71/121).Additionally,35%of the participants predominantly spoke a language other than English at home.Regarding the initiation of information with GPs,the mean sum-score was(20.5+3.7),indicating a marginally above-average level of engagement.Contrarily,the active participation was suboptimal,as suggested by a mean sum score of(35.9±6.3).Furthermore,the emotional expression was relatively low,with a mean score of(13.9±1.8).Substantial variations were discerned in the quality of patient-GP communication,contingent upon factors such as educational background,language spoken at home,health literacy,and preparatory measures for clinical visits.Participants who predominantly spoke a language other than English at home demonstrated significantly lower levels of information initiation with their GPs(P<0.o01).Higher educational attainment was positively correlated with increased active participation(P<0.001).Enhanced health literacy and thorough visit preparation were significantly associated with increased levels of active participation(P<0.001).Conclusion:Meaningful engagement through recognition,empowerment,and support(health literacy programs)for older rural adults is suggested for improving their quality of involvement in communication with GPs.

冀东迁西群内Komatiite的探讨

引言 冀东老变质岩的地层学研究,前人曾做了大量的工作(张树业等,1958—1962)。1975年河北区测二队提出本区地层三群十一组的方案,目前为大家所采用。最近华北所发表了对本区地层和构造研究的新成果(孙大中、白瑾等,1979),为深入研究本区的基础地质和成矿规律问题打下了良好的基础。

数字化、国际化发展背景下澳大利亚TAFE模式的改革趋向

TAFE是国际上公认的先进职业教育模式,在澳大利亚教育体系、终身学习体系中扮演着不可替代的角色,引领澳大利亚职业教育走出了一条独具特色的发展道路,为世界各国争相效仿。随着全球经济的萎靡下行和人口老龄化的加剧,澳大利亚TAFE迈向2030面临新的挑战,在数字化转型、国际化发展、服务全民终身学习等方面日益呈现出诸多新的变化和趋势。积极借鉴澳大利亚TAFE改革实践经验,可为中国特色职业教育发展提供新的思考和有益启示。

澳大利亚职业教育数字技能人才培养的制度供给与实践路径

随着数字经济不断成为全球经济增长与发展的新引擎和新动能,澳大利亚职业教育加大数字技能人才培养力度,这不仅是满足数字经济战略对数字技能人才刚需的内在要求,也是源于产业数字化转型背景下对技能人才数字技能水平提出的基本要求。澳大利亚通过颁布政策以加强顶层规划、建立数字技能的评价标准、建立微证书的资格认证制度,不断完善职业教育数字技能人才培养的制度供给。在具体培养路径上,澳大利亚从增强职业学校实训场域的智能化、开发凸显行业需求的数字技能课程、构建协同的数字技能人才培养共同体、多种方式提高职业教育教师的数字能力等方面,多措并举提高职业教育数字技能人才培养质量。

地位焦虑视角下澳大利亚对华政策的嬗变

21世纪以来,中澳关系在较长时期内保持了良好发展的态势。但自2016年下半年始,在中美战略竞争背景下,澳大利亚开始逐渐产生地位焦虑情绪。澳大利亚认为,中国的迅速崛起将会冲击印太地区既有的权势结构和秩序,而一旦中国主导印太秩序,它将无法在新秩序中维系既有的国家地位。因此,在地位焦虑情绪的驱使下,澳大利亚对中国实施了一系列强硬政策,两国关系进入剧烈动荡期。不过,自2022年5月阿尔巴尼斯领导的工党政府上台后,澳大利亚的地位焦虑情绪有所缓解,两国关系实现破冰、转圜,经贸合作企稳回升,但在安全层面澳大利亚联美制华的趋势短期恐难改变。

澳大利亚教师文化胜任力测评的特色省思

2022年,澳大利亚教学与学校领导协会启动教师队伍文化胜任力测评工作,开启国家层面对土著学生校园文化安全的战略优化工程。澳大利亚立足自我反思工具、文化能力框架和土著文化应答进阶连续统三个核心领域纵向提升教师的文化胜任力水平,为培养教师队伍高水平的文化应答性知识与技能搭建深度学习资源与提升支架,力求实现文化融合背景下的教育包容与均衡。

中澳TAFE课程线上线下混合式教学设计及模式构建研究

通过对本校中澳合作的TAFE课程教学的研究,本研究依托超星平台和MOODLE等网络教学平台,分别从课前、课中、课后3个阶段展开探讨线上线下融合的TAFE课程教学活动设计方案,并通过线上线下混合式教学改革实践,尤其是海外线上教学进行实践检验,探索构建中澳TAFE课程线上与线下融合的混合式教学模式,以提高TAFE课程教学质量,确保中澳合作国际化办学成效。

体育本科专业核心课程设置的域外经验与中国启示——以英、美、澳为例

通过文献资料调研,梳理英国、美国、澳大利亚体育本科专业核心课程设置的共性经验。发现:这3个国家通常由专业协会主导核心课程设置、多元主体广泛参与;分模块构建体育专业核心知识,并基于核心知识研设核心课程;充分发挥高校在核心课程设置中的自主权;秉持结果导向的理念研制核心课程标准;构建多样的核心课程评价形式。对我国的启示:①以知识和能力结构模型为基础,反向研制核心课程标准;②基于体育实践问题需求,倡导跨学科核心课程设置;③响应国家需求,适度增加健康类相关课程;④基于产出导向,优化核心课程评价体系。

PDCA循环理论视角下中澳高校教师绩效管理体系比较研究

新时代如何在提高教师绩效的同时减少教师压力,成为值得关注的问题。本文在PDCA循环理论视角下,比较了中国和澳大利亚两国高校在绩效计划、绩效实施、绩效评价、绩效反馈四个环节的差异。在绩效计划方面,澳大利亚高校实行人本化制定,中国高校多为校、院、系三级层层划分制定。绩效实施方面,澳大利亚高校绩效辅导贯穿绩效考核周期,注重信息反馈,中国高校绩效辅导淡化过程,看重结果。绩效评价方面,澳大利亚高校多采取差异化年度考核方式,中国高校进行标准化年度考核。澳大利亚高校在教师晋升考核方面分层级,中国高校则多为预聘制和非预聘制。绩效反馈方面,澳大利亚高校对于绩效不达标的教师所采取的整改措施较严格,中国高校同样有惩罚措施。中国高校绩效管理,可以从四个方面进行优化:一是绩效计划的制定做到标准化与个性化结合;二是重视绩效实施环节,建立沟通机制;三是针对性优化各类考核;四是对绩效结果进行诊断,助力下一循环。

澳大利亚STEM教育政策分析与启示

近年来,澳大利亚政府部门、学术组织推出促进STEM教育发展的系列政策。这些政策主要受澳大利亚政治体制、技术发展、社会性别因素的影响,政策行动者呈现出多元化特点。政策内容在制度领域、资源配置和教与学方面都有涉及,但以资源配置为主。在政策实施上以项目为主并注重继承与创新。借鉴澳大利亚的做法,我国STEM教育政策的制定应成为多部门的责任,在内容上可综合考虑制度领域、资源配置和教与学等方面,同时在实施中加强推广成熟做法。

护航战略目标落地:澳大利亚国家教育监测评估的经验与启示

开展针对国家中长期教育政策性宣言的教育监测评估是澳大利亚推进教育改革发展的有效经验,包括:以法律和政策坚实监测评估“合法性”基础,依据政策性宣言设计监测指标体系,打造支撑监测评估的多源异构数据基座,以“见林见树”的全面观呈现现状与发展趋势,强化监测评估服务行政决策和公共监督。澳大利亚的经验对我国开展国家教育监测评估有如下启示:一是政府委托专门机构对国家教育中长期战略落实进展监测评估,二是监测评估坚持纵向发展与横向国际比较相结合,三是强化监测评估服务政府决策和舆论引导效应,四是推动人工智能等新一代信息技术与教育监测评估深度融合。