Gotowa bibliografia na temat „Evidence (Law) Australia”

The Voluntary Assisted Dying Act 2017 (Vic) will come into force in June 2019, becoming the first law in Australia in 20 years to permit voluntary assisted dying (VAD). This paper considers how other Australian states and territories are likely to respond to this development. It analyses three key factors that suggest that law reform is likely to occur in other parts of Australia: (1) the growing international trend to permit VAD; (2) social science evidence about how VAD regimes operate; and (3) changes to the local political environment. The paper argues that these three factors, coupled with the effect of Victoria changing its law, suggest that other VAD law reform is likely to occur in Australia. It also considers the different types of laws that may be adopted, including whether other states and territories will follow the very conservative Victorian approach or adopt more liberal models. What is known about the topic? Despite sustained law reform efforts in parliaments across the country, Victoria is the first Australian jurisdiction to pass a law permitting VAD in 20 years. What does this paper add? This paper addresses likely future trends in VAD law reform in Australia. Drawing on international developments, a growing body of social science evidence about how VAD regimes work in practice, and evidence about a changing local political environment, the paper argues that other states and territories in Australia will also enact laws about VAD. What are the implications for practitioners? The legalisation of VAD has significant implications for health professionals, health administrators and health systems. Understanding how reform may occur and what legal models may be considered supports participation in the law reform process and preparation for likely change.

NSW Law Society membership data 1988–2004 enables mapping over time of the presence and movement of private legal practice in rural NSW. The changing ratio of legal practices per 10 000 population is calculated against data from the Australian Bureau of Statistics. In short, while the rural population increases, the number of legal practices decreases at a much slower rate, resulting in an overall drop in the proportion of legal practices in the population. However, although some inferences could be drawn, the data do not go very far in illustrating the nature and degree of, and reasons for, the limits on access to law in rural Australia. One way of thinking about the further research that can be done is to consider the research implications of the many different ways the issue of rural access to law is expressed, and the different dimensions that are emphasised in those formulations.

The public policy discretion at common law in Australia was established in the High Court case of Bunning v Cross. The discretion has subsequently been interpreted and applied to permit courts to exclude evidence obtained by improper, unlawful or illegal conduct on the part of ‘the authorities’. The discretion has not been held to be enlivened for exercise in circumstances where the impugned conduct is on the part of private persons unconnected with law enforcement. This article argues that this fetter on the availability of the public policy discretion has been wrongly interpreted from the decision in Bunning and that, to the extent that the fetter now forms part of the common law discretion, it should be abandoned. The argument is made on the basis of the language, context, development and rationale of the public policy discretion as conceived in Bunning. The statutory Uniform Evidence Law, which applies in certain Australian jurisdictions, enacts a public policy discretion in s. 138 drawn from the common law public policy discretion. The Uniform Evidence Law is examined to indicate the absence of any fetter to the s. 138 discretion applying only to conduct by authorities as a basis for revising the understanding of the common law discretion. The comparable powers to exclude unlawfully obtained evidence in the United States and United Kingdom are examined to distinguish the rationale of the Australian discretion as requiring a broader scope of application. The internet is considered as a modern advent permitting previously unknown capacity for private persons to unlawfully police each other. Private criminal investigation through the internet is argued to be a further basis to mark the need for the extension of the Australian public policy discretion to all persons not only the authorities. The overarching thesis of this article is to demonstrate why the Australian common law public policy discretion should be enlivened by improper, unlawful or illegal conduct, regardless of the source of that conduct.

Psychological research has been pivotal in influencing the way police forces globally approach and undertake criminal investigations. Increasing psychological research in recent years has led to the development of best-practice guidelines for conducting police investigations, across a number of key areas of criminal investigation. For example, procedures for creating and conducting lineups as recommended by the American Psychology-Law Society, and the UK-developed PEACE model for investigative interviewing, have both been of influence in Australia. However, the extent to which these evidence-based recommendations have been incorporated into policing practice within Australia is unclear. In this article, we conducted an exploratory review of publicly available policing documents within Australian states and territories, to determine the extent to which best practice lineup identification and investigative interviewing procedures have been adopted into police practice. The review revealed that for lineup identification procedures, many of the basic recommendations for conducting lineups were not incorporated into publicly available policing manuals. For investigative interviewing, it appeared on the surface that elements of the PEACE model were implemented within most Australian jurisdictions, albeit this was often not explicitly stated within policing documents. A key issue identified was a lack of (understandable) public transparency of policing procedure, as a number of Australian jurisdictions failed to have publicly available policing manuals or handbooks against which to evaluate their procedures. Therefore, we argue that there is a need for better collaboration between researchers and law enforcement in order to achieve evidence-based, transparent policing within Australia.

Recent changes to Federal Therapeutic Goods Administration legislation have seen the limited introduction of the drug mifepristone to Australia for the purpose of early medical abortion. At the same time it has become evident that both methotrexate and misoprostol, licenced and available for other indications, are being used safely and appropriately for early abortion by Australian medical practitioners. Early medical abortion is widely practiced overseas where its safety and effectiveness are well supported by current evidence. However, abortion law in many states is still contained within the Criminal Codes and does not reflect current evidence-based abortion practice. In other states and territories restrictions on where abortions may be performed pose potential barriers to the introduction of mifepristone for medical abortion. There is an urgent need for abortion law to be clarified and made uniform across the country so that the best possible services can be provided to Australian women.

This article argues that not much has changed since Australia amended in 2010 its International Arbitration Act, incorporating most of the 2006 revisions to the UNCITRAL Model Law as well as other reforms aimed at positioning Australia as a plausible arbitral venue in the Asia-Pacific region. There is no evidence yet of a broader 'cultural reform' that would make international arbitration speedier and more cost-effective - as urged by Australia's then Attorney-General when introducing the 2010 amendments. In fact, the article first outlines one ongoing cross-border dispute that has engendered at least five sets of proceedings, including a (thankfully unsuccessful) constitutional challenge to the Model Law regime. It then compares case disposition statistics for other Federal Court cases decided three years before and after the amendments, finding only minor differences.1 The article suggests a range of further revisions needed for the Act that emerge from the dispute including the constitutional challenge, as well as other topics for reform including measures to encourage a more internationalist interpretation of instruments such as the Model Law. Continuous improvement and continuous vigilance are needed for Australia to keep developing distinctive expertise in this complex and evolving field of law and practice.

Indigenous peoples in Australia have been adversely affected by the process of colonisation by the British Crown. Despite Australia’s adoption of the United Nations Declaration on the Rights of Indigenous Peoples (‘Declaration’), there is little evidence that it is an effective means of redressing the historical wrongs suffered by Indigenous communities in Australia. This essay outlines the experience of Indigenous peoples in Australia and examines the utility of the Declaration in international law. While observing that Indigenous peoples have had limited engagement with the Declaration, there is still potential for the Declaration to affect change through its underpinning principles of the right to self-determination and the status of Indigenous peoples as distinct political groups.

The common law test of voluntariness has come to be associated with important policy rationales including the privilege against self-incrimination. However, when the test originated more than a century ago, it was a test concerned specifically with the truthfulness of confession evidence; which evidence was at that time adduced in the form of indirect oral testimony, that is, as hearsay. Given that, a century later, confession evidence is now mostly adduced in the form of an audiovisual recording that can be observed directly by the trial judge, rather than as indirect oral testimony, there may be capacity for a different emphasis regarding the question of admissibility. This article considers the law currently operating in Western Australia, Queensland and South Australia to see whether or not, in the form of an audiovisual recording, the exercise of judicial discretion as to the question of the admissibility of confession evidence might be supported if the common law test of voluntariness was not a strict test of exclusion.

Thesis (Ph.D.) -- La Trobe University, 2006.
Research. "A thesis submitted in total fulfilment of the requirements for the degree of Doctor of Philosophy, La Trobe Law, Faculty of Law and Management, La Trobe University, Bundoora, Victoria". Includes bibliographical references (leaves 318-338). Also available via the World Wide Web.

In August 2000, Justice O�Loughlin of the Federal Court of Australia handed down the decision in Cubillo v Commonwealth in which Lorna Cubillo and Peter Gunner took action against the Commonwealth Government, arguing that it was vicariously liable for their removal from their families and communities as children and subsequent detentions in the Northern Territory during the 1940s and 1950s. The case is the landmark decision in relation to legal action taken by members of the Stolen Generations. Using the decision in Cubillo as a key site of contestation, my thesis provides a critique of legal positivism as the dominant jurisprudential discourse operating within the Anglo-Australian legal system. I argue that the function of legal positivism as the principal paradigm and source of authority for the decision serves to ensure that the debate concerning reconciliation in Australia operates rhetorically to maintain whiteness at the centre of political and discursive power. Specifically concerned with the performative function of legal discourse, the thesis is an interrogation of the interface of law and language, of rhetoric, and the semiotics of legal discourse. The dominant theory of evidence law is a rationalist and empiricist epistemology in which oral testimony and documentary evidence are regarded as mediating the relationship between proof and truth. I argue that by attributing primacy to principles of rationality, objectivity and narrative coherence, and by privileging that which is visually represented, the decision serves an ideological purpose which diminishes the significance of race in the construction of knowledge. Legal positivism identifies the knowing subject and the object of knowledge as discrete entities. However, I argue that in Cubillo, Justice O�Loughlin inscribes himself into the text of the judgment and in doing so, reveals the way in which textual and corporeal specificities undermine the pretence of objective judgment and therefore the source of judicial authority.

This research used the Queensland Police Service, Australia, as a major case study. Information on principles, techniques and processes used, and the reason for the recording, storing and release of audit information for evidentiary purposes is reported. It is shown that Law Enforcement Agencies have a two-fold interest in, and legal obligation pertaining to, audit trails. The first interest relates to the situation where audit trails are actually used by criminals in the commission of crime and the second to where audit trails are generated by the information systems used by the police themselves in support of the recording and investigation of crime. Eleven court cases involving Queensland Police Service audit trails used in evidence in Queensland courts were selected for further analysis. It is shown that, of the cases studied, none of the evidence presented was rejected or seriously challenged from a technical perspective. These results were further analysed and related to normal requirements for trusted maintenance of audit trail information in sensitive environments with discussion on the ability and/or willingness of courts to fully challenge, assess or value audit evidence presented. Managerial and technical frameworks for firstly what is considered as an environment where a computer system may be considered to be operating “properly” and, secondly, what aspects of education, training, qualifications, expertise and the like may be considered as appropriate for persons responsible within that environment, are both proposed. Analysis was undertaken to determine if audit and control of information in a high security environment, such as law enforcement, could be judged as having improved, or not, in the transition from manual to electronic processes. Information collection, control of processing and audit in manual processes used by the Queensland Police Service, Australia, in the period 1940 to 1980 was assessed against current electronic systems essentially introduced to policing in the decades of the 1980s and 1990s. Results show that electronic systems do provide for faster communications with centrally controlled and updated information readily available for use by large numbers of users who are connected across significant geographical locations. However, it is clearly evident that the price paid for this is a lack of ability and/or reluctance to provide improved audit and control processes. To compare the information systems audit and control arrangements of the Queensland Police Service with other government departments or agencies, an Australia wide survey was conducted. Results of the survey were contrasted with the particular results of a survey, conducted by the Australian Commonwealth Privacy Commission four years previous, to this survey which showed that security in relation to the recording of activity against access to information held on Australian government computer systems has been poor and a cause for concern. However, within this four year period there is evidence to suggest that government organisations are increasingly more inclined to generate audit trails. An attack on the overall security of audit trails in computer operating systems was initiated to further investigate findings reported in relation to the government systems survey. The survey showed that information systems audit trails in Microsoft Corporation's “Windows” operating system environments are relied on quite heavily. An audit of the security for audit trails generated, stored and managed in the Microsoft “Windows 2000” operating system environment was undertaken and compared and contrasted with similar such audit trail schemes in the “UNIX” and “Linux” operating systems. Strength of passwords and exploitation of any security problems in access control were targeted using software tools that are freely available in the public domain. Results showed that such security for the “Windows 2000” system is seriously flawed and the integrity of audit trails stored within these environments cannot be relied upon. An attempt to produce a framework and set of guidelines for use by expert witnesses in the information technology (IT) profession is proposed. This is achieved by examining the current rules and guidelines related to the provision of expert evidence in a court environment, by analysing the rationale for the separation of distinct disciplines and corresponding bodies of knowledge used by the Medical Profession and Forensic Science and then by analysing the bodies of knowledge within the discipline of IT itself. It is demonstrated that the accepted processes and procedures relevant to expert witnessing in a court environment are transferable to the IT sector. However, unlike some discipline areas, this analysis has clearly identified two distinct aspects of the matter which appear particularly relevant to IT. These two areas are; expertise gained through the application of IT to information needs in a particular public or private enterprise; and expertise gained through accepted and verifiable education, training and experience in fundamental IT products and system.

Australian lawyers often request psychologists assess plaintiffs for brain injury tort litigation, but it is unknown why they do this and how they use the expert neuropsychological report. It is crucial to know this because international authors argue that the way lawyers use and manage the neuropsychological evidence they commission may introduce unconscious bias into psychologists’ expert opinions. Unconscious bias within such evidence jeopardises the procedural justice of Australian brain injury tort litigation. Therefore, the present study explored how Australian tort litigation lawyers use expert neuropsychological evidence and how plaintiff lawyers advise and prepare their clients for neuropsychological assessments. In Stage One, 10 Western Australian lawyers involved in neuropsychological tort litigation were interviewed and reported that expert neuropsychological evidence primarily assists them to describe a plaintiff’s injury, and to quantify the plaintiff’s level of impairment as caused by the injury. The lawyers also reported that they provide plaintiffs with information about brain injury symptoms and details about the neuropsychological assessment. Stage Two explored whether the Stage One themes were germane to lawyers from other states. Seventy-seven Australian lawyers completed an anonymous web-based survey constructed from the Stage One themes and limited international research literature. The results confirmed the themes applied to lawyers in all Australian legal jurisdictions. The findings suggest that the way Australian lawyers use expert neuropsychological evidence and prepare their clients for neuropsychological assessments may engender unconscious bias within the psychologist’s evidence in favour of the client. The implications of the study’s findings are discussed, emphasising that Australian psychologists must modify their practices to ensure their expert neuropsychological evidence is procedurally fair.

AbstractAustralia’s education system reflects its history of federalism. State and territory governments are responsible for administering education within their jurisdiction and across the sector comprising government (public), Catholic systemic and other independent schooling systems. They collaborate on education policy with the federal government. Over the past two decades the federal government has taken a greater role in funding across the education sector, and as a result of this involvement and the priorities of federal governments of the day, Australia now has one of the highest rates of non-government schooling in the OECD. Funding equity across the sectors has become a prominent issue. Concerns have been compounded by evidence of declining student performance since Australia’s initial participation in PISA in 2000, and the increasing gap between our high achievers and low achievers. This chapter explores Australia’s PISA 2018 results and what they reveal about the impact of socioeconomic level on student achievement. It also considers the role of school funding and the need to direct support to those schools that are attempting to educate the greater proportion of an increasingly diverse student population including students facing multiple layers of disadvantage.

AbstractThe period during which young people are financially and residentially dependent on their parents is lengthening and extending into adulthood. This has created an in-between period of “emerging adulthood” where young people are legal adults but without the full responsibilities and autonomy of independent adults. There is considerable debate over whether emerging adulthood represents a new developmental phase in which young people invest in schooling, work experiences, and life skills to increase their later lifetime chances of success or a reflection of poor economic opportunities and high living costs that constrain young people into dependence. In this chapter we examine the incidence of emerging adulthood and the characteristics and behaviours of emerging adults, investigating data from the Household, Income, and Labour Dynamics in Australia Survey. We find that a majority of young Australians who are 22 years old or younger are residentially and financial dependent on their parents and thus, emerging adults. We also find that a substantial minority of 23- to 25-year-olds meet this definition and that the proportion of young people who are emerging adults has grown over time. Emerging adults have autonomy in some spheres of their lives but not others. Most emerging adults are enrolled in school. Although most also work, they often do so through casual jobs and with low earnings. Young people with high-income parents receive co-residential and financial support longer than young people with low-income parents. Similarly, non-Indigenous young people and young people from two-parent families receive support for longer than Indigenous Australians or young people from single-parent backgrounds. The evidence strongly supports distinguishing emerging adulthood from other stages in the life course.

AbstractThe intergenerational transmission of socio-economic status is driven to a significant extent through parents with higher socio-economic status providing advantages to their children as they move through the education system. At the same time, attainment of higher education credentials constitutes an important pathway for upwards social mobility among individuals from low socio-economic family backgrounds. Given the critical importance of higher education for socio-economic outcomes of children, this chapter focuses on young people’s journeys into and out of university. Drawing on the life course approach and opportunity pluralism theory, we present a conceptual model of the university student life cycle that splits individuals’ higher education trajectories into three distinct stages: access, participation and post-participation. Using this model as a guiding framework, we present a body of recent Australian evidence on differences in pathways through the higher education system among individuals from low and high socio-economic status (SES) backgrounds. In doing so, we pay attention to factors such as family material circumstances, students’ school experiences and post-school plans, and parental education and expectations—all of which constitute important barriers to access, participation and successful transitions out of higher education for low SES students. Overall, our results indicate that socio-economic background plays a significant role in shaping outcomes at various points of individual’s educational trajectories. This is manifested by lower chances amongst low-SES individuals to access and participate in higher education, and to find satisfying and secure employment post-graduation. Our findings bear important implications for educational and social policy.

AbstractHaving a job is an important indicator of economic and social wellbeing, and two-earner families are becoming the norm rather than the exception. As a result, many more women, including mothers, are in the labour force now than ever before. Balancing family and work responsibilities therefore becomes ever more important, not just for women but also men who are sharing the caring load with their partners, especially when young pre-school children are present. However, employment is not equally distributed across families, and some families have noone in a job which leads to financial vulnerability. Even one-earner families that depend on a low-skilled, low-wage earner may struggle to get by and provide their children with the opportunities to succeed in life and achieve mental, physical and financial wellbeing. This may lead to the intergenerational transmission of disadvantage and poor outcomes from parents to children. Gender inequality and ongoing inequalities relating to gender divisions in work and family may lead to women being particularly vulnerable in terms of earnings capacity and retirement savings when a relationship ends. One-parent families are specifically at risk as they often have no partner with whom to share the care-taking role, making work-family balance difficult to achieve. In this chapter we review the Australian evidence on these issues and provide policy implications.

Abstract This chapter discusses the doctrines of duress, undue influence and unconscionable bargain, with a particular focus on how Hong Kong law has evolved from its English heritage. The doctrine of duress in Hong Kong law broadly follows that in England, and requires the entry into a transaction as the result of illegitimate pressure. Such pressure is typically exerted through unlawful threats, though lawful threats that go far beyond reasonable pressure also suffice. In relation to undue influence, Hong Kong differs from English law in not relying on presumptions to establish such influence, but instead considers the ‘totality of evidence’ to decide whether undue influence has been exercised. As regards unconscionable bargain, Hong Kong accepts a broader scope of relief for parties in a ‘serious disadvantage’, and does not confine itself to the English doctrine that requires the party concerned to be ‘poor and ignorant’. The common law position is also reinforced by the Unconscionable Contracts Ordinance, which is drawn upon consumer protection legislation in Australia, and has been interpreted in line with the latest Australian statute.

The in vitro effect of Australian snake venoms on human citrated plasma has been documented and the majority induce coagulation, in keeping with the common clinical presentation of D.I.C. following envenomation. The effect of these venoms upon platelets in vitro has hitherto not been studied extensively and clinical evidence is conflicting, some cases with thrombocyto-paenia have been reported. Twenty Australian venoms were tested, 19 elapids and one hydrophiid (Enhydrina schistosa). Four crotalid snake venoms from the Americas and S.E. Asia were also tested. All of the venoms (1 mg/ml) were investigated for t^eir ability to aggregate both fresh washed platelets (200 × 109/l) resuspended in modified Ardlie’s buffer pH 7.35 and formaldehyde fixed platelets (200 × 109/l) in phosphate buffered saline pH 7.35 using a dual channel Chronolog aggregometer. Samples were taken for electron microscopy (EM).All elapid venoms induced aggregation in fresh platelets, some only minimally and often after a long lag phase. EM studies revealed only clumping without degranulation of the platelets. This was in marked contrast to the crotalid venoms where rapid aggregation and gross degranulation occurred. The hydrophiid venom failed to induce aggregation of the fresh platelets, however upon addition of normal plasma gross aggregation and degranulation was demonstrated. Aggregation of fixed platelets was negligible in the presence of the majority of elapid and the hydrophiid venoms. The crotalid venoms however did induce aggregation, although to a lesser extent than with the fresh platelets.The elapid venoms, along with the others studied, required metabolically active platelets to exert their maximal effect. Crotalid and hydrophiid venoms were more active against platelets than the elapid venoms. The hydrophiid venom’s action on platelets was unique in that a plasma co-factor appeared to be required and this is the subject of further investigations.

Assessment is an integral component of effective teaching and a teacher’s professional judgement influences all routine aspects of their work. In the last 20 years, there has been considerable work internationally to support teachers in using assessment to improve student learning. However, there is a pressing issue that impedes teacher professional judgement being exploited to its full potential. The issue relates to teacher assessments in the context of extended performances such as essays and arises from the complexity of obtaining reliable or consistent teacher assessments of students’ work. Literature published in the United States, England and Australia details evidence of low reliability and bias in teacher assessments. As a result, despite policymakers’ willingness to consider making greater use of teachers’ judgements in summative assessment, and thus provide for greater parity of esteem between teachers’ assessment and standardised testing, few gains have been made. While low reliability of scoring is a pressing issue in contexts where the data are used for summative purposes, it also an issue for formative assessment. Inaccurate assessment necessarily impedes the effectiveness of any follow-up activity, and hence the effectiveness of formative assessment. In this session, Dr Sandy Heldsinger and Dr Stephen Humphry will share their research of writing assessment and explain how their research has led to the development of an innovative assessment process that provides the advantages of rubrics, comparative judgements and automated marking with few of the disadvantages.

The purpose of this presentation is to report mean velocity-profile data for fully-developed pipe flow of a wide range of shear-thinning liquids together with two Newtonian control liquids. Although most of the data reported are for the laminar-turbulent transition regime, data are also included for laminar and turbulent flow. The experimental data were obtained in unrelated research programmes in UK, France and Australia, all using laser Doppler anemometry (LDA) as the measurement technique. In the majority of cases, axisymmetric flow is observed for the laminar and turbulent flow conditions, although asymmetry due to the Earth’s rotation is evident for the laminar flow of a Newtonian fluid of low viscosity (i.e. low Ekman number). The key point, however, is that for certain fluids, both yield-stress and viscoelastic (all fluids in this study are shear thinning), asymmetry to varying degrees is apparent at all stages of transition from laminar to turbulent flow, i.e. from the first indications to almost fully-developed turbulence. The fact that symmetrical velocity profiles are obtained for both laminar and turbulent flow of all the non-Newtonian fluids in all three laboratories leads to the conclusion that the asymmetry must be a consequence of a fluid-dynamic mechanism, as yet not identified, rather than imperfections in the flow facilities.

Background Lung cancer is the number one cause of cancer death worldwide.(1) It is the fifth most commonly diagnosed cancer in Australia (12,741 cases diagnosed in 2018) and the leading cause of cancer death.(2) The number of years of potential life lost to lung cancer in Australia is estimated to be 58,450, similar to that of colorectal and breast cancer combined.(3) While tobacco control strategies are most effective for disease prevention in the general population, early detection via low dose computed tomography (LDCT) screening in high-risk populations is a viable option for detecting asymptomatic disease in current (13%) and former (24%) Australian smokers.(4) The purpose of this Evidence Check review is to identify and analyse existing and emerging evidence for LDCT lung cancer screening in high-risk individuals to guide future program and policy planning. Evidence Check questions This review aimed to address the following questions: 1. What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? 2. What is the evidence of potential harms from lung cancer screening for higher-risk individuals? 3. What are the main components of recent major lung cancer screening programs or trials? 4. What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Summary of methods The authors searched the peer-reviewed literature across three databases (MEDLINE, PsycINFO and Embase) for existing systematic reviews and original studies published between 1 January 2009 and 8 August 2019. Fifteen systematic reviews (of which 8 were contemporary) and 64 original publications met the inclusion criteria set across the four questions. Key findings Question 1: What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? There is sufficient evidence from systematic reviews and meta-analyses of combined (pooled) data from screening trials (of high-risk individuals) to indicate that LDCT examination is clinically effective in reducing lung cancer mortality. In 2011, the landmark National Lung Cancer Screening Trial (NLST, a large-scale randomised controlled trial [RCT] conducted in the US) reported a 20% (95% CI 6.8% – 26.7%; P=0.004) relative reduction in mortality among long-term heavy smokers over three rounds of annual screening. High-risk eligibility criteria was defined as people aged 55–74 years with a smoking history of ≥30 pack-years (years in which a smoker has consumed 20-plus cigarettes each day) and, for former smokers, ≥30 pack-years and have quit within the past 15 years.(5) All-cause mortality was reduced by 6.7% (95% CI, 1.2% – 13.6%; P=0.02). Initial data from the second landmark RCT, the NEderlands-Leuvens Longkanker Screenings ONderzoek (known as the NELSON trial), have found an even greater reduction of 26% (95% CI, 9% – 41%) in lung cancer mortality, with full trial results yet to be published.(6, 7) Pooled analyses, including several smaller-scale European LDCT screening trials insufficiently powered in their own right, collectively demonstrate a statistically significant reduction in lung cancer mortality (RR 0.82, 95% CI 0.73–0.91).(8) Despite the reduction in all-cause mortality found in the NLST, pooled analyses of seven trials found no statistically significant difference in all-cause mortality (RR 0.95, 95% CI 0.90–1.00).(8) However, cancer-specific mortality is currently the most relevant outcome in cancer screening trials. These seven trials demonstrated a significantly greater proportion of early stage cancers in LDCT groups compared with controls (RR 2.08, 95% CI 1.43–3.03). Thus, when considering results across mortality outcomes and early stage cancers diagnosed, LDCT screening is considered to be clinically effective. Question 2: What is the evidence of potential harms from lung cancer screening for higher-risk individuals? The harms of LDCT lung cancer screening include false positive tests and the consequences of unnecessary invasive follow-up procedures for conditions that are eventually diagnosed as benign. While LDCT screening leads to an increased frequency of invasive procedures, it does not result in greater mortality soon after an invasive procedure (in trial settings when compared with the control arm).(8) Overdiagnosis, exposure to radiation, psychological distress and an impact on quality of life are other known harms. Systematic review evidence indicates the benefits of LDCT screening are likely to outweigh the harms. The potential harms are likely to be reduced as refinements are made to LDCT screening protocols through: i) the application of risk predication models (e.g. the PLCOm2012), which enable a more accurate selection of the high-risk population through the use of specific criteria (beyond age and smoking history); ii) the use of nodule management algorithms (e.g. Lung-RADS, PanCan), which assist in the diagnostic evaluation of screen-detected nodules and cancers (e.g. more precise volumetric assessment of nodules); and, iii) more judicious selection of patients for invasive procedures. Recent evidence suggests a positive LDCT result may transiently increase psychological distress but does not have long-term adverse effects on psychological distress or health-related quality of life (HRQoL). With regards to smoking cessation, there is no evidence to suggest screening participation invokes a false sense of assurance in smokers, nor a reduction in motivation to quit. The NELSON and Danish trials found no difference in smoking cessation rates between LDCT screening and control groups. Higher net cessation rates, compared with general population, suggest those who participate in screening trials may already be motivated to quit. Question 3: What are the main components of recent major lung cancer screening programs or trials? There are no systematic reviews that capture the main components of recent major lung cancer screening trials and programs. We extracted evidence from original studies and clinical guidance documents and organised this into key groups to form a concise set of components for potential implementation of a national lung cancer screening program in Australia: 1. Identifying the high-risk population: recruitment, eligibility, selection and referral 2. Educating the public, people at high risk and healthcare providers; this includes creating awareness of lung cancer, the benefits and harms of LDCT screening, and shared decision-making 3. Components necessary for health services to deliver a screening program: a. Planning phase: e.g. human resources to coordinate the program, electronic data systems that integrate medical records information and link to an established national registry b. Implementation phase: e.g. human and technological resources required to conduct LDCT examinations, interpretation of reports and communication of results to participants c. Monitoring and evaluation phase: e.g. monitoring outcomes across patients, radiological reporting, compliance with established standards and a quality assurance program 4. Data reporting and research, e.g. audit and feedback to multidisciplinary teams, reporting outcomes to enhance international research into LDCT screening 5. Incorporation of smoking cessation interventions, e.g. specific programs designed for LDCT screening or referral to existing community or hospital-based services that deliver cessation interventions. Most original studies are single-institution evaluations that contain descriptive data about the processes required to establish and implement a high-risk population-based screening program. Across all studies there is a consistent message as to the challenges and complexities of establishing LDCT screening programs to attract people at high risk who will receive the greatest benefits from participation. With regards to smoking cessation, evidence from one systematic review indicates the optimal strategy for incorporating smoking cessation interventions into a LDCT screening program is unclear. There is widespread agreement that LDCT screening attendance presents a ‘teachable moment’ for cessation advice, especially among those people who receive a positive scan result. Smoking cessation is an area of significant research investment; for instance, eight US-based clinical trials are now underway that aim to address how best to design and deliver cessation programs within large-scale LDCT screening programs.(9) Question 4: What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Assessing the value or cost-effectiveness of LDCT screening involves a complex interplay of factors including data on effectiveness and costs, and institutional context. A key input is data about the effectiveness of potential and current screening programs with respect to case detection, and the likely outcomes of treating those cases sooner (in the presence of LDCT screening) as opposed to later (in the absence of LDCT screening). Evidence about the cost-effectiveness of LDCT screening programs has been summarised in two systematic reviews. We identified a further 13 studies—five modelling studies, one discrete choice experiment and seven articles—that used a variety of methods to assess cost-effectiveness. Three modelling studies indicated LDCT screening was cost-effective in the settings of the US and Europe. Two studies—one from Australia and one from New Zealand—reported LDCT screening would not be cost-effective using NLST-like protocols. We anticipate that, following the full publication of the NELSON trial, cost-effectiveness studies will likely be updated with new data that reduce uncertainty about factors that influence modelling outcomes, including the findings of indeterminate nodules. Gaps in the evidence There is a large and accessible body of evidence as to the effectiveness (Q1) and harms (Q2) of LDCT screening for lung cancer. Nevertheless, there are significant gaps in the evidence about the program components that are required to implement an effective LDCT screening program (Q3). Questions about LDCT screening acceptability and feasibility were not explicitly included in the scope. However, as the evidence is based primarily on US programs and UK pilot studies, the relevance to the local setting requires careful consideration. The Queensland Lung Cancer Screening Study provides feasibility data about clinical aspects of LDCT screening but little about program design. The International Lung Screening Trial is still in the recruitment phase and findings are not yet available for inclusion in this Evidence Check. The Australian Population Based Screening Framework was developed to “inform decision-makers on the key issues to be considered when assessing potential screening programs in Australia”.(10) As the Framework is specific to population-based, rather than high-risk, screening programs, there is a lack of clarity about transferability of criteria. However, the Framework criteria do stipulate that a screening program must be acceptable to “important subgroups such as target participants who are from culturally and linguistically diverse backgrounds, Aboriginal and Torres Strait Islander people, people from disadvantaged groups and people with a disability”.(10) An extensive search of the literature highlighted that there is very little information about the acceptability of LDCT screening to these population groups in Australia. Yet they are part of the high-risk population.(10) There are also considerable gaps in the evidence about the cost-effectiveness of LDCT screening in different settings, including Australia. The evidence base in this area is rapidly evolving and is likely to include new data from the NELSON trial and incorporate data about the costs of targeted- and immuno-therapies as these treatments become more widely available in Australia.

The Reserve Bank of Australia's Term Funding Facility (TFF) was announced in March 2020 as part of a package of policy measures to support the Australian economy. It achieved a key objective of providing banks with three-year low-cost funding and was available for drawdown until 30 June 2021. This paper examines the effectiveness of the TFF in increasing the supply of credit to businesses, which was another one of the objectives of the program. Using bank-level data and a difference-in-differences approach, we find no statistically significant evidence that the TFF increased credit supply to businesses. However, our confidence intervals are wide and there are significant identification challenges involved in disentangling the effects of the TFF from the effects of pandemic-related disruptions and other policy interventions on credit supply and demand. Nonetheless, the TFF provided an assured source of funding at a time of considerable stress in the financial system and lowered banks' funding costs, and any effects on business lending via these channels may not be fully reflected in our results.

Overview Skin cancer prevention is a component of the new Cancer Plan 2022–27, which guides the work of the Cancer Institute NSW. To lessen the impact of skin cancer on the community, the Cancer Institute NSW works closely with the NSW Skin Cancer Prevention Advisory Committee, comprising governmental and non-governmental organisation representatives, to develop and implement the NSW Skin Cancer Prevention Strategy. Primary Health Networks and primary care providers are seen as important stakeholders in this work. To guide improvements in skin cancer prevention and inform the development of the next NSW Skin Cancer Prevention Strategy, an up-to-date review of the evidence on the effectiveness and feasibility of skin cancer prevention activities in primary care is required. A research team led by the Daffodil Centre, a joint venture between the University of Sydney and Cancer Council NSW, was contracted to undertake an Evidence Check review to address the questions below. Evidence Check questions This Evidence Check aimed to address the following questions: Question 1: What skin cancer primary prevention activities can be effectively administered in primary care settings? As part of this, identify the key components of such messages, strategies, programs or initiatives that have been effectively implemented and their feasibility in the NSW/Australian context. Question 2: What are the main barriers and enablers for primary care providers in delivering skin cancer primary prevention activities within their setting? Summary of methods The research team conducted a detailed analysis of the published and grey literature, based on a comprehensive search. We developed the search strategy in consultation with a medical librarian at the University of Sydney and the Cancer Institute NSW team, and implemented it across the databases Embase, MEDLINE, PsycInfo, Scopus, Cochrane Central and CINAHL. Results were exported and uploaded to Covidence for screening and further selection. The search strategy was designed according to the SPIDER tool for Qualitative and Mixed-Methods Evidence Synthesis, which is a systematic strategy for searching qualitative and mixed-methods research studies. The SPIDER tool facilitates rigour in research by defining key elements of non-quantitative research questions. We included peer-reviewed and grey literature that included skin cancer primary prevention strategies/ interventions/ techniques/ programs within primary care settings, e.g. involving general practitioners and primary care nurses. The literature was limited to publications since 2014, and for studies or programs conducted in Australia, the UK, New Zealand, Canada, Ireland, Western Europe and Scandinavia. We also included relevant systematic reviews and evidence syntheses based on a range of international evidence where also relevant to the Australian context. To address Question 1, about the effectiveness of skin cancer prevention activities in primary care settings, we summarised findings from the Evidence Check according to different skin cancer prevention activities. To address Question 2, about the barriers and enablers of skin cancer prevention activities in primary care settings, we summarised findings according to the Consolidated Framework for Implementation Research (CFIR). The CFIR is a framework for identifying important implementation considerations for novel interventions in healthcare settings and provides a practical guide for systematically assessing potential barriers and facilitators in preparation for implementing a new activity or program. We assessed study quality using the National Health and Medical Research Council (NHMRC) levels of evidence. Key findings We identified 25 peer-reviewed journal articles that met the eligibility criteria and we included these in the Evidence Check. Eight of the studies were conducted in Australia, six in the UK, and the others elsewhere (mainly other European countries). In addition, the grey literature search identified four relevant guidelines, 12 education/training resources, two Cancer Care pathways, two position statements, three reports and five other resources that we included in the Evidence Check. Question 1 (related to effectiveness) We categorised the studies into different types of skin cancer prevention activities: behavioural counselling (n=3); risk assessment and delivering risk-tailored information (n=10); new technologies for early detection and accompanying prevention advice (n=4); and education and training programs for general practitioners (GPs) and primary care nurses regarding skin cancer prevention (n=3). There was good evidence that behavioural counselling interventions can result in a small improvement in sun protection behaviours among adults with fair skin types (defined as ivory or pale skin, light hair and eye colour, freckles, or those who sunburn easily), which would include the majority of Australians. It was found that clinicians play an important role in counselling patients about sun-protective behaviours, and recommended tailoring messages to the age and demographics of target groups (e.g. high-risk groups) to have maximal influence on behaviours. Several web-based melanoma risk prediction tools are now available in Australia, mainly designed for health professionals to identify patients’ risk of a new or subsequent primary melanoma and guide discussions with patients about primary prevention and early detection. Intervention studies have demonstrated that use of these melanoma risk prediction tools is feasible and acceptable to participants in primary care settings, and there is some evidence, including from Australian studies, that using these risk prediction tools to tailor primary prevention and early detection messages can improve sun-related behaviours. Some studies examined novel technologies, such as apps, to support early detection through skin examinations, including a very limited focus on the provision of preventive advice. These novel technologies are still largely in the research domain rather than recommended for routine use but provide a potential future opportunity to incorporate more primary prevention tailored advice. There are a number of online short courses available for primary healthcare professionals specifically focusing on skin cancer prevention. Most education and training programs for GPs and primary care nurses in the field of skin cancer focus on treatment and early detection, though some programs have specifically incorporated primary prevention education and training. A notable example is the Dermoscopy for Victorian General Practice Program, in which 93% of participating GPs reported that they had increased preventive information provided to high-risk patients and during skin examinations. Question 2 (related to barriers and enablers) Key enablers of performing skin cancer prevention activities in primary care settings included: • Easy access and availability of guidelines and point-of-care tools and resources • A fit with existing workflows and systems, so there is minimal disruption to flow of care • Easy-to-understand patient information • Using the waiting room for collection of risk assessment information on an electronic device such as an iPad/tablet where possible • Pairing with early detection activities • Sharing of successful programs across jurisdictions. Key barriers to performing skin cancer prevention activities in primary care settings included: • Unclear requirements and lack of confidence (self-efficacy) about prevention counselling • Limited availability of GP services especially in regional and remote areas • Competing demands, low priority, lack of time • Lack of incentives.

Review question / Objective: To explore the attrition problems, influencing factors and barriers to retention among regional and remote nursing students who enrolled in the undergraduate programs in Australia. Condition being studied: Student retention concerns an individual’s commitment to an learning goal. Low student retention has been a long-standing issue for nursing programs and it is an important threat to the future nursing workforce. Attrition is measured by the number of students enrolled in the first year who do not complete their study in the following year. With the growth of online programs, the issue of high attrition raises concern for students enrolled in these programs. Moreover, the social context of students may influence positive motivation and affect their decision to stay in their nursing programs.

This paper presents some initial lessons learned about the use of case studies as a key form of evidence regarding teaching quality and student learning in a multi-year teacher development study series. This study series, commissioned by the Australian Government’s Department of Foreign Affairs and Trade (DFAT), involves the investigation of teacher development initiatives in Lao People’s Democratic Republic (Laos), Timor-Leste and Vanuatu. The overall aim of the study series is to understand the extent to which the Australian investment has improved teaching quality and student learning. This paper discusses the processes used to design, implement, analyse and report case study data, and key lessons learned about these that could be applied to other contexts and programs. These processes include: design, implementation, and analysis and reporting.

This paper presents some initial lessons learned about the use of classroom observation data as a key form of evidence regarding improved teaching quality in a multi-year teacher development study series. This study series, commissioned by the Australian Government’s Department of Foreign Affairs and Trade (DFAT), involves the investigation of teacher development initiatives that are primarily designed to support the implementation of new primary curriculum in Lao People’s Democratic Republic (Laos), Timor-Leste and Vanuatu. The overall aim of the study series is to understand the extent to which the Australian investment has improved teaching quality and student learning. This paper discusses the processes used to design, implement, analyse and report classroom observation data in the Laos study, and key lessons learned about these that could be applied to other contexts and programs.

Student learning outcomes are an important source of evidence regarding improved teaching quality. A multi-year teacher development study series was commissioned by the Australian Government’s Department of Foreign Affairs and Trade (DFAT) to investigate teacher development initiatives in Lao People’s Democratic Republic (Laos), Timor-Leste and Vanuatu. The overall aim of the study series is to understand the extent to which the Australian investment has improved teaching quality and student learning. This paper outlines the different approaches to sourcing and using data in each country context, and then presents initial insights about the challenges associated with the limited availability of data for measuring and reporting student learning outcomes, as a measure of teacher effectiveness. It presents key lessons learned about conducting research with limited existing student learning outcomes data and offers some solutions to inform programs in other contexts.

Background An estimated 292 million people are living with chronic hepatitis B virus (HBV) infection globally, including 223,000 people in Australia. HBV diagnosis and linkage of people living with HBV to clinical care is suboptimal in Australia, with 27% of people living with HBV undiagnosed and 77% not receiving regular HBV clinical care. This systematic review aimed to characterize population-level interventions implemented to enhance all components of HBV care cascade and analyse the effectiveness of interventions. Review questions Question 1: What population-level interventions, programs or policy approaches have been shown to be effective in reducing the incidence of hepatitis B; and that may not yet be fully rolled out or evaluated in Australia demonstrate early effectiveness, or promise, in reducing the incidence of hepatitis B? Question 2: What population-level interventions and/or programs are effective at reducing disease burden for people in the community with hepatitis B? Methods Four bibliographic databases and 21 grey literature sources were searched. Studies were eligible for inclusion if the study population included people with or at risk of chronic HBV, and the study conducted a population-level interventions to decrease HBV incidence or disease burden or to enhance any components of HBV care cascade (i.e., diagnosis, linkage to care, treatment initiation, adherence to clinical care), or HBV vaccination coverage. Studies published in the past 10 years (since January 2012), with or without comparison groups were eligible for inclusion. Studies conducting an HBV screening intervention were eligible if they reported proportion of people participating in screening, proportion of newly diagnosed HBV (participant was unaware of their HBV status), proportion of people received HBV vaccination following screening, or proportion of participants diagnosed with chronic HBV infection who were linked to HBV clinical care. Studies were excluded if study population was less than 20 participants, intervention included a pharmaceutical intervention or a hospital-based intervention, or study was implemented in limited clinical services. The records were initially screened by title and abstract. The full texts of potentially eligible records were reviewed, and eligible studies were selected for inclusion. For each study included in analysis, the study outcome and corresponding 95% confidence intervals (95%CIs) were calculated. For studies including a comparison group, odds ratio (OR) and corresponding 95%CIs were calculated. Random effect meta-analysis models were used to calculate the pooled study outcome estimates. Stratified analyses were conducted by study setting, study population, and intervention-specific characteristics. Key findings A total of 61 studies were included in the analysis. A large majority of studies (study n=48, 79%) included single-arm studies with no concurrent control, with seven (12%) randomised controlled trials, and six (10%) non-randomised controlled studies. A total of 109 interventions were evaluated in 61 included studies. On-site or outreach HBV screening and linkage to HBV clinical care coordination were the most frequent interventions, conducted in 27 and 26 studies, respectively. Question 1 We found no studies reporting HBV incidence as the study outcome. One study conducted in remote area demonstrated that an intervention including education of pregnant women and training village health volunteers enhanced coverage of HBV birth dose vaccination (93% post-intervention, vs. 81% pre-intervention), but no data of HBV incidence among infants were reported. Question 2 Study outcomes most relevant to the HBV burden for people in the community with HBV included, HBV diagnosis, linkage to HBV care, and HBV vaccination coverage. Among randomised controlled trials aimed at enhancing HBV screening, a meta-analysis was conducted including three studies which implemented an intervention including community face-to-face education focused on HBV and/or liver cancer among migrants from high HBV prevalence areas. This analysis demonstrated a significantly higher HBV testing uptake in intervention groups with the likelihood of HBV testing 3.6 times higher among those participating in education programs compared to the control groups (OR: 3.62, 95% CI 2.72, 4.88). In another analysis, including 25 studies evaluating an intervention to enhance HBV screening, a pooled estimate of 66% of participants received HBV testing following the study intervention (95%CI: 58-75%), with high heterogeneity across studies (range: 17-98%; I-square: 99.9%). A stratified analysis by HBV screening strategy demonstrated that in the studies providing participants with on-site HBV testing, the proportion receiving HBV testing (80%, 95%CI: 72-87%) was significantly higher compared to the studies referring participants to an external site for HBV testing (54%, 95%CI: 37-71%). In the studies implementing an intervention to enhance linkage of people diagnosed with HBV infection to clinical care, the interventions included different components and varied across studies. The most common component was post-test counselling followed by assistance with scheduling clinical appointments, conducted in 52% and 38% of the studies, respectively. In meta-analysis, a pooled estimate of 73% of people with HBV infection were linked to HBV clinical care (95%CI: 64-81%), with high heterogeneity across studies (range: 28-100%; I-square: 99.2%). A stratified analysis by study population demonstrated that in the studies among general population in high prevalence countries, 94% of people (95%CI: 88-100%) who received the study intervention were linked to care, significantly higher than 72% (95%CI: 61-83%) in studies among migrants from high prevalence area living in a country with low prevalence. In 19 studies, HBV vaccination uptake was assessed after an intervention, among which one study assessed birth dose vaccination among infants, one study assessed vaccination in elementary school children and 17 studies assessed vaccination in adults. Among studies assessing adult vaccination, a pooled estimate of 38% (95%CI: 21-56%) of people initiated vaccination, with high heterogeneity across studies (range: 0.5-93%; I square: 99.9%). A stratified analysis by HBV vaccination strategy demonstrated that in the studies providing on-site vaccination, the uptake was 78% (95%CI: 62-94%), significantly higher compared to 27% (95%CI: 13-42%) in studies referring participants to an external site for vaccination. Conclusion This systematic review identified a wide variety of interventions, mostly multi-component interventions, to enhance HBV screening, linkage to HBV clinical care, and HBV vaccination coverage. High heterogeneity was observed in effectiveness of interventions in all three domains of screening, linkage to care, and vaccination. Strategies identified to boost the effectiveness of interventions included providing on-site HBV testing and vaccination (versus referral for testing and vaccination) and including community education focussed on HBV or liver cancer in an HBV screening program. Further studies are needed to evaluate the effectiveness of more novel interventions (e.g., point of care testing) and interventions specifically including Indigenous populations, people who inject drugs, men who have sex with men, and people incarcerated.