Objectives This study aimed to evaluate the technical feasibility of routine distributional analyses of healthcare interventions in Australia, by adapting a Health Inequality Impact Calculator for Queensland. Building on methods established in a previous study in England, the calculator compares the magnitude of health inequality impact across interventions for different diseases. Methods The calculator was adapted for adults in Queensland using the Index of Relative Socio-economic Advantage and Disadvantage quintiles, Australian Bureau of Statistics population estimates, 2023 hospital admissions (International Classification of Diseases-10th edition 3-digit level) from Queensland Health, and published quality-adjusted life expectancy. It was used to conduct aggregate distributional cost-effectiveness analysis of 5 interventions for diseases with relatively high prevalence in disadvantaged groups, based on existing cost-effectiveness results identified by a targeted review. The health inequality impact was summarized using the slope index of inequality in quality-adjusted life-years (QALYs). Results The selected interventions were 2 screening interventions for diabetes and hypertension, and 3 treatment interventions for chronic kidney disease. The calculator demonstrated that all 5 interventions would reduce health inequality. Population screening for diabetes had the greatest impact on reducing health inequality of 8562 QALYs. Among the 3 treatment interventions, intensive blood pressure control had the greatest impact, with a health inequality benefit of 514 QALYs. Conclusions Routine aggregate distributional cost-effectiveness analysis of interventions in Queensland is feasible, once standard cost-effectiveness estimates are available. The calculator for Queensland enables fast, transparent, and replicable analysis of health inequality impacts using minimal data, with visual outputs to explore trade-offs between health outcomes, inequality, and cost-effectiveness.
Background The Australian National Lung Cancer Screening Program offers early detection opportunities for people at high risk of lung cancer. However, the stigma associated with smoking – central to screening eligibility – may deter screening participation.Aims To understand the current social and discursive context, a media content analysis of Australian newspaper articles was conducted to examine how people who smoke are portrayed.Methods An online search using Dow-Jones Factiva identified Australian newspaper articles published between 2nd May 2023 (announcement of the Program) and 31st December 2024, to provide a contextual anchor to interpret and apply findings. Eligible articles (n = 174) underwent qualitative content analysis to classify representations of people who smoke and to assess language for stigma based on established guidelines.Results Seventeen representations of people who smoke were categorised. Most common was people who smoke as “supported to potentially stop smoking” (42.5%), often emphasised by encouragement to seek smoking cessation support. Many representations were understanding, including portrayals of people who smoke as “vulnerable youth” (32.8%) or “addicted to nicotine” (22.4%). Negative representations were less frequent but included people who smoke as a “selfish polluter” (7.5%) or “drain on the economy” (4.0%). Person-first language appeared consistently in 47.8% of articles, 28.7% used an empathetic tone towards people who smoke, however 18.7% used judgemental or blaming sentiments.Discussion Findings highlight instances of stigmatising representation of people who smoke which could perpetuate negative public discourse. Use of standard, person-first language is encouraged, such as promotion of evidence-based language guidelines and strengths-based messaging, complemented by broader community-based interventions, to support respectful and consistent public discourse to address societal-level stigma.
Trauma-informed practice (TIP) and culturally responsive pedagogy (CRP) are frequently advanced as complementary equity approaches in schools, yet the practice-level interface between them remains under-specified—particularly in communities shaped by poverty, displacement, racism, and intergenerational trauma. This qualitative study examined how 26 primary school educators in a culturally diverse, socioeconomically disadvantaged Australian school described adapting trauma-informed practices to students' social and cultural contexts. Data were collected through semi-structured interviews and analysed using reflexive thematic analysis, with ecological systems theory providing an interpretive framework. Three themes captured educators' sense-making: (1) Prioritising safety and belonging, reflecting microsystem practices addressing basic needs shaped by socioeconomic adversity; (2) Navigating cultural complexity, illuminating mesosystem negotiations between institutional expectations and family cultural practices; and (3) Seeking deeper understanding, capturing educators' recognition of exosystem gaps between available professional learning and the intersecting realities of trauma, culture, and disadvantage. Findings highlight the interpretive labour educators undertake when adapting standardised frameworks to local contexts, while revealing tensions between individualised trauma responses and structural inequities. Implications for culturally responsive professional development, institutional policy reform, and educational practice are discussed.
Background Students new to flipped classrooms frequently encounter challenges with motivation and comprehension when engaging with pre-class materials independently, particularly outside scheduled class hours. Aims This study examined a scaffolded flipped-learning approach that helped students move step by step from a Faux Flipped Classroom (FFC) to a Regular Flipped Classroom (RFC), and then to a Gamified Flipped Classroom (GFC) over one semester. The goal was to support students in adapting to flipped learning, managing their mental workload, and improving their learning performance. Method Mixed methods were employed in the data collection. For quantitative data, learning achievement was assessed with tests and self-rating scales measured cognitive load, while qualitative interviews provided more detailed feedback. Results The results revealed that students in the experimental group who learned through the scaffolding strategy performed better than their counterparts in the control group. Meanwhile, both groups demonstrated a small drop in intrinsic cognitive load, likely because they became more familiar with the tasks rather than because the material got easier. However, the scaffolded group showed a larger drop in unnecessary cognitive load and a larger increase in germane cognitive effort, suggesting the intervention helped students focus more on learning and less on confusion or figuring out what to do. Intrinsic and germane cognitive load should be interpreted cautiously because they are closely related. Conclusion This study contributes to Cognitive Load Theory and scaffolding research by showing that flipped classroom success depends not only on design but also on how students are gradually prepared to use it.
Background Fear of cancer recurrence (FCR) is a top-rated concern and unmet need for support among gynaecological cancer patients yet seldom discussed during healthcare consultations. Clinicians report several challenges in initiating conversations about FCR with patients and limited practical guidance is available. Objective This study aimed to identify communication practices for initiating conversations about FCR during outpatient consultations after treatment for gynaecological cancer. Methods A collection of 30 audio-recorded outpatient consultations, involving 4 gynae-oncology clinicians, 30 people who had completed treatment for endometrial or ovarian cancer, and 11 accompanying family members and friends, were reviewed to identify instances where FCR was discussed. These instances were analysed using conversation analysis. Results Six of the 30 consultations, all involving the same gynae-oncology clinician, included talk about FCR. Two recurrent communication practices were used to initiate these conversations: (1) Universal claims (e.g., “I always ask…”) framed talk about FCR as a routine part of post-treatment follow-up for all gynaecological cancer patients, and (2) General claims (e.g., “Some people find that…”) normalised FCR post-treatment and provided opportunity for the patient to indicate if FCR was relevant to them and to describe their experience. Both practices provided avenues for the gynae-oncology clinician to discuss available support for FCR. Conclusions FCR was not regularly discussed in this collection of recordings, reflecting previous reports of clinical practice. Nonetheless, direct observation and detailed analysis of real-word consultations where FCR was discussed identified two simple strategies that clinicians can use to initiate these conversations. First, universal claims can shift the conversation to FCR specifically and frame this talk as routine. Second, general claims normalise FCR and invite patients to share their experiences. Future research could investigate use of these practices across multiple clinicians and patient groups and examine the impact of FCR conversations for patients and families.
