Australian Public Universities: A crisis of governance

[...]we will examine this failure of leadership through the lens of the statutory nature and governance structures of Australian public universities, cast against the current rhetoric that metaphorically equates universities with commercial corporations, to determine the extent to which such a metaphor is accurate, and ultimately (we contend) detrimental to an effective and efficient university sector. Bullying and wage theft consistently appear in recent news reports, while the casualisation of the workforce has reached unprecedented proportions: for example, the University of Melbourne, Australia's richest tertiary institution, for example, has been recently reported by the ABC as employing 72.9% of its staff on insecure terms (Duffy 2020). [...]structural changes within individual institutions occur at an increasingly rapid pace (often as a result of a new executive member being appointed to a particular portfolio), while academics lament an overall decline in the rigour and quality of the education, notwithstanding the proliferation of reporting forms and protocols allegedly designed to ensure the opposite. [...]university executives, over the past decade, have relied heavily on an international student 'market' when such reliance was not (and still is not) necessarily required by the legislative framework that establishes and regulates Australian public universities (Howard 2021). Universities have a long heritage as corporate entities (Russell 1993), having been structured as such for centuries (Compayre 1893). [...]unsurprisingly, the enabling legislation of all Australian public universities confers upon universities the capacities and powers of a body corporate.

Patient Perspectives on the Cancellation of Elective Primary Hip and Knee Arthroplasty During the COVID-19 Pandemic.

INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic resulted in the unprecedented widespread cancellation of scheduled elective primary total joint arthroplasty (TJA) in the United States. The impact of postponing scheduled total hip arthroplasty and total knee arthroplasty procedures on patients has not been well studied and may have physical, emotional, and financial consequences. METHODS: All patients whose elective primary TJA procedures at a tertiary academic medical center were postponed because of COVID-19 were surveyed. Seventy-four patients agreed to answer 13 questions concerning the physical, mental, and financial impact of surgery cancellation. Statistical analysis, including Pearson correlation coefficients, cross-tabulation analysis, and chi squares, was performed. RESULTS: 13.5% of patients strongly disagreed with the use of "elective" to describe their cancelled TJA surgery and 25.7% of patients reported substantial physical and/or mental deterioration due to postponement. Younger individuals experienced greater change in their symptoms (P = 0.034), anxiety about their pain (P = 0.010), and frustration/anger (P = 0.043). Poor quality of life, mood, and lower HOOS/KOOS Jr interval scores were correlated with greater financial strain, disagreement with the postponement, and disagreement with the use of "elective" to describe surgery. Disagreement with the use of "elective" to describe surgery was associated with greater financial strain (P = 0.013) and disagreement with the decision to postpone surgery (P = 0.008). In addition, greater financial strain was associated with disagreement with postponement (P = 0.014). CONCLUSION: The cancellation of elective TJA during the COVID-19 pandemic had a variety of consequences for patients. One in four patients reported experiencing substantial physical and/or emotional deterioration. Associations of poor quality of life and mood with greater financial strain and disagreement with the term "elective" were seen. These results help quantify the deleterious effects of cancelling elective surgery and identify at-risk patients should another postponement of surgery occur. LEVEL OF EVIDENCE: Level II-Prospective cohort study.

A multi-centre survey reveals variations in the standard treatments and treatment modifications for head and neck cancer patients during Covid-19 pandemic.

BACKGROUND: The onset of the COVID-19 pandemic necessitated rapid changes to the practice of head and neck oncology in UK. There was a delay between the onset of the pandemic and the release of guidelines from cancer societies and networks, leading to a variable response of individual centres. This survey was conducted to assess the pre-Covid-19 pandemic standard of practice for head and neck oncology patients and the treatment modifications introduced during the first wave of the pandemic in UK. METHODOLOGY: The UK National Cancer Research Institute (NCRI) Head and Neck Clinical Studies Group initiated a multi-centre survey using questionnaire to investigate the effect on feeding tube practice, radiotherapy (RT) fractionation and volumes, use of chemotherapy in the neo-adjuvant, concurrent and palliative setting, the use of immunotherapy in the palliative setting, access to radiology and histopathology services, and availability of surgical procedures. RESULTS: 30 centres were approached across UK; 23 (76.7%) centres responded and were included in the survey. There were differences in the standard practices in feeding tube policy, RT dose and fractionation as well as concurrent chemotherapy use. 21 (91%) participating centres had at least one treatment modification. 15 (65%) centres initiated a change in radical RT; changing to either a hypofractionation or acceleration schedule. For post-operative RT 10 centres (43.5%) changed to a hypofractionation schedule. 12 (52.2%) centres stopped neo-adjuvant chemotherapy for all patients; 13 (56.5%) centres followed selective omission of chemotherapy in concurrent chemo-radiotherapy patients, 17 (73.9%) centres changed first-line chemotherapy treatment to pembrolizumab (following NHS England's interim guidance) and 8 (34.8%) centres stopped the treatment early or offered delays for patients that have been already on systemic treatment. The majority of centres did not have significant changes associated with surgery, radiology, histopathology and dental screening. CONCLUSION: There are variations in the standard of practice and treatment modifications for head and neck cancer patients during Covid-19 pandemic. A timely initiative is required to form a consensus on head and neck cancer management in the UK and other countries.