Employment in a “Land of Opportunity?” Immigrants’ Experiences of Racism and Discrimination in the Australian Workplace

Immigrants are an important part of the Australian labor force and constitute a major source of net labor force growth. Immigrants arriving in Australia, however, face a number of barriers finding employment that is commensurate with their training and education (Reid, Australian and New Zealand Journal of Public Health 36:120-125, 2012) and can end up in poor-quality jobs. Through a series of interviews and focus groups with newcomers, our study examined immigrants’ experience of finding employment and their working conditions in Australia. In this manuscript, we specifically explore how discrimination shaped workers’ experiences and the strategies workers used to overcome and deal with the barriers they encountered. We end with a discussion of how racism and its consequences can impact quality of work and worker health and safety

Development of a Decision Support System for Diagnosis and Grading of Brain Tumours using in-vivo Magnetic Resonance Single Voxel Spectra

A computer-based decision support system to assist radiologists in diagnosing and grading brain tumours has been developed by the multi-centre INTERPRET project. Spectra from a database of 1H single-voxel spectra of different types of brain tumours, acquired in vivo from 334 patients at four different centres, are clustered according to their pathology, using automated pattern recognition techniques and the results are presented as a two-dimensional scatterplot using an intuitive graphical user interface (GUI). Formal quality control procedures were performed to standardize the performance of the instruments and check each spectrum, and teams of expert neuroradiologists, neurosurgeons, neurologists and neuropathologists clinically validated each case. The prototype decision support system (DSS) successfully classified 89% of the cases in an independent test set of 91 cases of the most frequent tumour types (meningiomas, low-grade gliomas and high-grade malignant tumours-glioblastomas and metastases). It also helps to resolve diagnostic difficulty in borderline cases. When the prototype was tested by radiologists and other clinicians it was favourably received. Results of the preliminary clinical analysis of the added value of using the DSS for brain tumour diagnosis with MRS showed a small but significant improvement over MRI used alone. In the comparison of individual pathologies, PNETs were significantly better diagnosed with the DSS than with MRI alone

Impact of Evidence‐Based Stroke Care on Patient Outcomes: A Multilevel Analysis of an International Study

Background The uptake of proven stroke treatments varies widely. We aimed to determine the association of evidence‐based processes of care for acute ischemic stroke ( AIS ) and clinical outcome of patients who participated in the HEADPOST (Head Positioning in Acute Stroke Trial), a multicenter cluster crossover trial of lying flat versus sitting up, head positioning in acute stroke. Methods and Results Use of 8 AIS processes of care were considered: reperfusion therapy in eligible patients; acute stroke unit care; antihypertensive, antiplatelet, statin, and anticoagulation for atrial fibrillation; dysphagia assessment; and physiotherapist review. Hierarchical, mixed, logistic regression models were performed to determine associations with good outcome (modified Rankin Scale scores 0–2) at 90 days, adjusted for patient and hospital variables. Among 9485 patients with AIS, implementation of all processes of care in eligible patients, or “defect‐free” care, was associated with improved outcome (odds ratio, 1.40; 95% CI, 1.18–1.65) and better survival (odds ratio, 2.23; 95% CI , 1.62–3.09). Defect‐free stroke care was also significantly associated with excellent outcome (modified Rankin Scale score 0–1) (odds ratio, 1.22; 95% CI , 1.04–1.43). No hospital characteristic was independently predictive of outcome. Only 1445 (15%) of eligible patients with AIS received all processes of care, with significant regional variations in overall and individual rates. Conclusions Use of evidence‐based care is associated with improved clinical outcome in AIS . Strategies are required to address regional variation in the use of proven AIS treatments. Clinical Trial Registration URL : https://www.clinicaltrials.gov . Unique Identifier: NCT 02162017. </jats:sec

Impact of Evidence-Based Stroke Care on Patient Outcomes: A Multilevel Analysis of an International Study

Background-The uptake of proven stroke treatments varies widely. We aimed to determine the association of evidence-based processes of care for acute ischemic stroke (AIS) and clinical outcome of patients who participated in the HEADPOST (Head Positioning in Acute Stroke Trial), a multicenter cluster crossover trial of lying flat versus sitting up, head positioning in acute stroke. Methods and Results-Use of 8 AIS processes of care were considered: reperfusion therapy in eligible patients; acute stroke unit care; antihypertensive, antiplatelet, statin, and anticoagulation for atrial fibrillation; dysphagia assessment; and physiotherapist review. Hierarchical, mixed, logistic regression models were performed to determine associations with good outcome (modified Rankin Scale scores 0-2) at 90 days, adjusted for patient and hospital variables. Among 9485 patients with AIS, implementation of all processes of care in eligible patients, or defect-free care, was associated with improved outcome (odds ratio, 1.40; 95% CI, 1.18-1.65) and better survival (odds ratio, 2.23; 95% CI, 1.62-3.09). Defect-free stroke care was also significantly associated with excellent outcome (modified Rankin Scale score 0-1) (odds ratio, 1.22; 95% CI, 1.04-1.43). No hospital characteristic was independently predictive of outcome. Only 1445 (15%) of eligible patients with AIS received all processes of care, with significant regional variations in overall and individual rates. Conclusions-Use of evidence-based care is associated with improved clinical outcome in AIS. Strategies are required to address regional variation in the use of proven AIS treatments.National Health and Medical Research Council of AustraliaUniv New South Wales, Fac Med, George Inst Global Hlth, Sydney, NSW, AustraliaCtr Estudios Clin, Inst Ciencias & Innovac Med, Santiago, ChileClin Alemana Univ Desarrollo, Fac Med, Serv Neurol, Dept Neurol & Psiquiatria, Santiago, ChilePeking Univ, Hlth Sci Ctr, George Inst Global Hlth, Beijing, Peoples R ChinaAustralian Catholic Univ, Nursing Res Inst, St Vincents Hlth Australia Sydney, Sydney, NSW, AustraliaUniv Cent Lancashire, Fac Hlth & Wellbeing, Preston, Lancs, EnglandUniv Chile, Fac Med, Dept Ciencias Neurol, Santiago, ChileUniv Sao Paulo, Ribeirao Preto Med Sch, Stroke Serv Neurol Div, Ribeirao Preto, BrazilFukuoka Univ, Fac Med, Dept Prevent Med & Publ Hlth, Fukuoka, Fukuoka, JapanUniv Leicester, Dept Cardiovasc Sci, Leicester Biomed Res Ctr, Leicester, Leics, EnglandUniv Leicester, Natl Inst Hlth Res, Leicester Biomed Res Ctr, Leicester, Leics, EnglandUniv Edinburgh, Ctr Clin Brain Sci, Edinburgh, Midlothian, ScotlandGeorge Inst Global Hlth, Sydney, NSW, AustraliaUniv Desarrollo, Serv Neurol, Dept Neurol & Psiquiatria Clin Alemana Santiago, Santiago, ChileSt Vincents Hlth Australia Sydney, Sydney, NSW, AustraliaAustralian Catholic Univ, Sydney, NSW, AustraliaUniv Cent Lancashire, Stroke Practice Res Unit, Sch Hlth, Lancashire Clin Trials Unit, Preston, Lancs, EnglandUniv Leicester, Dept Cardiovasc Sci, Cardiovasc Res Ctr, British Heart Fdn, Leicester, Leics, EnglandUniv Kelaniya, Dept Pharmacol, Fac Med, Colombo, Sri LankaChristian Med Coll & Hosp, Dept Neurol, Ludhiana, IndiaKaohsiung Med Univ & Hosp, Dept Neurol, Kaohsiung, TaiwanLinkou Chang Gung Mem Hosp, Dept Neurol, Taipei, TaiwanPeking Union Med Coll Hosp, Beijing, Peoples R ChinaUniv Sao Paulo, Ribeirao Preto Sch Med, Ribeirao Preto, BrazilMonash Univ, Dept Epidemiol & Prevent Med, Melbourne, Vic, AustraliaUniv Cent Lancashire, Sch Hlth Sci, Coll Hlth & Wellbeing, Preston, Lancs, EnglandUniv Desarrollo, Santiago, ChileUniv New South Wales, Neurosci Res Australia, Sydney, NSW, AustraliaNatl Univ Singapore, Dept Pharmacol, Singapore, SingaporeBradford Royal Infirm, Bradford Inst Hlth Res, Leeds, W Yorkshire, EnglandChristian Med College, Ludhiana, Punjab, IndiaRemediumOne Pvt Ltd, Kandy, Sri LankaKaohsiung Med Univ, Chung Ho Mem Hosp, Kaohsiung, TaiwanCalvary Publ Hosp Bruce, Bruce, AustraliaRoyal North Shore Hosp, St Leonards, NSW, AustraliaRoyal Prince Alfred Hosp, Camperdown, NSW, AustraliaConcord Repatriat Gen Hosp, Camperdown, NSW, AustraliaFiona Stanley Hosp, Camperdown, NSW, AustraliaMacquarie Base Hosp, Melbourne, Vic, AustraliaUniv Sao Paulo, Fac Med Ribeirao Preto, Hosp Clin, Sao Paulo, BrazilHosp Governador Celso Ramos, Florianopolis, SC, BrazilSao Paulo State Univ, Hosp Fac Med Botucatu, UNESP, Sao Paulo, BrazilYangquan Coalmine Grp Gen Hosp, Yangquan, Peoples R ChinaNanjing Med Univ, Nanjing Hosp 1, Nanjing, Jiangsu, Peoples R China85 Hosp Peoples Liberat Army, Beijing, Peoples R ChinaChifeng Univ, Affiliated Hosp, Chifeng, Peoples R ChinaBeijing Pinggu Hosp, Beijing, Peoples R ChinaWenzhou Med Univ, Affiliated Hosp 1, Wenzhou, Peoples R ChinaSoochow Univ, Affiliated Hosp 2, Suzhou, Peoples R ChinaHebei Med Univ, Hosp 3, Shijiazhuang, Hebei, Peoples R ChinaCapital Med Univ, Xuanwu Hosp, Beijing, Peoples R ChinaJining Med Univ, Affiliated Hosp, Jining, Peoples R ChinaThird Peoples Hosp Huizhou, Huizhou, Peoples R ChinaSecond Cangzhou Cent Hosp, Cangzhou, Peoples R ChinaShanghai Jiao Tong Univ, Hosp Affiliated, Sch Med, Shanghai, Peoples R ChinaBaogang Hosp, Baotou, Peoples R ChinaHarbin Med Univ, Affiliated Hosp 1, Harbin, Heilongjiang, Peoples R ChinaShanghai Jiao Tong Univ Sch, Tong Ren Hosp, Peoples Hosp Hejian City, Shanghai, Peoples R ChinaPeking Univ, Shougang Hosp, Beijing, Peoples R ChinaGuangzhou Med Univ, Affiliated Hosp 3, Guangzhou, Guangdong, Peoples R ChinaSecond Hosp Nanchang, Nanchang, Jiangxi, Peoples R ChinaBethune Int Peace Hosp, Beijing, Peoples R ChinaHua Henan Prov Peoples Hosp, Beijing, Peoples R ChinaHua Henan Prov Peoples Hosp, Zhengzhou, Henan, Peoples R ChinaShanghai Jiao Tong Univ, Sch Med, Shanghai Ninth Peoples Hosp, Shanghai, Peoples R ChinaShijiazhuang Cent Hosp, Shijiazhuang, Hebei, Peoples R ChinaHosp Base San Jos de Osorno, Osorno, ChileChristian Med Coll & Hosp, Ludhiana, Punjab, IndiaUnit Narayana Hrudayalaya Ltd, Mazumdar Shaw Med Ctr, Bangalore, Karnataka, IndiaDr Ramesh Cardiac & Multispecial Hosp Pvt Ltd, Guntur, IndiaPost Grad Inst Med Educ & Res, Chandigarh, IndiaBaby Mem Hosp Ltd, Calicut, Kerala, IndiaSree Chitra Tirunal Inst Med Sci & Technol, Thiruvananthapuram, Kerala, IndiaSri Jayawardenepura Gen Hosp, Sri Jayawardenepura Kott, Sri LankaColombo North Teaching Hosp, Colombo, Sri LankaColombo South Coching Hosp, Colombo, Sri LankaLinkou Chang Gung Mem Hosp, Taoyuan, TaiwanTaipei Med Univ, Shuang Ho Hosp, Taipei, TaiwanEn Chu Kong Hosp, New Taipei, TaiwanNatl Cheng Kung Univ Hosp, Tainan, TaiwanQueen Alexandra Hosp, Portsmouth, Hants, EnglandPortsmouth Hosp NHS Natl Hlth Serv iTrust, Portsmouth, Hants, EnglandUniv Coll London Hosp NHS Fdn Trust, London, EnglandUniv Hosp Birmingham NHS Fdn Trust, Queen Elizabeth Hosp Birmingham, Birmingham, W Midlands, EnglandSouthend Univ Hosp NHS Fdn Trust, Southend On Sea, EnglandKings Coll Hosp London, London, EnglandYork Teaching Hosp NHS Fdn Trust, York, N Yorkshire, EnglandNottingham Univ Hosp NHS Trust, Nottingham, EnglandBlackpool Teaching Hosp NHS Fdn Trust, Blackpool, EnglandGloucestershire Hosp NHS Fdn Trust, Gloucestershire Royal Hosp, Gloucester, EnglandTeaching Hospi NHS Fdn Trust, London, EnglandRoyal Cornwall Hosp NHS Trust, Truro, EnglandRoyal London Hosp, Barts Hlth NHS Trust, London, EnglandSheffield Teaching Hosp NHS Fdn Trust, Sheffield, S Yorkshire, EnglandCambridge Univ Hosp NHS Fdn Trust, Addenbrookes Hosp, Cambridge, EnglandRoyal Victoria Hosp, Belfast Hlth & Social Care Trust, London, EnglandPinderfields Gen Hosp, Mid Yorkshire Hosp NHS Trust, Wakefield, EnglandRoyal Devon & Exeter NHS Fdn Trust, London, EnglandBradford Teaching Hosp NHS Fdn Trust, Bradford, W Yorkshire, EnglandGreat Western Hosp NHS Fdn Trust, Swindon, Wilts, EnglandWatford Dist Gen Hosp, Watford, EnglandImperial Coll Healthcare NHS Trust, London, EnglandMedway NHS Fdn Trust, Gillingham, EnglandRoyal Liverpool & Broadgreen Univ NHS Trust, Liverpool, Merseyside, EnglandCalderdale & Huddersfield NHS Fdn Trust, Huddersfield, W Yorkshire, EnglandHywel Dda Univ Hlth Board, Haverfordwest, WalesChesterfield Royal Hosp NHS Fdn Trust, Calow, EnglandLuton & Dunstable Univ Hosp NHS Fdn Trust, Luton, Beds, EnglandCountess Chester Hosp NHS Fdn Trust, Chester, Cheshire, EnglandPeterborough City Hosp, Peterborough, Cambs, EnglandUniv Hosp Leicester NHS Trust, Leicester Royal Infirm, Leicester, Leics, EnglandDist Hosp NHS Fdn Trust, London, EnglandBarnsley Hosp NHS Fdn Trust, Barnsley, EnglandDorset Cty Hosp NHS Fdn Trust, Dorchester, EnglandRoyal Bournemouth & Christchurch Hosp NHS Fdn Tru, Royal Bournemouth Hosp, Bournemouth, Dorset, EnglandSouthern Hlth & Social Care Trust, Craigavon Area Hosp, Portadown, EnglandUnited Lincolnshire Hosp NHS Trust, Pilgrim Hosp, Lincoln, EnglandBedford Hosp NHS Trust, Bedford, EnglandSao Paulo State Univ, Hosp Fac Med Botucatu, UNESP, Sao Paulo, BrazilNational Health and Medical Research Council of Australia: 106696