Precarity Before and During the Pandemic: International Student Employment and Personal Finances in Australia.

There is mounting evidence of increased international student financial and work precarity over the last decade in Australia. Yet, there has been a little scholarly analysis of which students are most affected by precarity and its sources. Drawing on two surveys of international students in Australia's two largest cities, conducted before and during the pandemic, we investigate the financial and work vulnerabilities of international students. We demonstrate that vulnerability is related to characteristics which describe particular cohorts of students: being from low-income countries, working class families, seeking a low-level qualification, enrolled in a non-university institution, and being without a scholarship. The concepts of "noncitizenship" and "work precarity" are used to explain how the mechanisms of each characteristic heighten vulnerability, thereby contributing to a broader evidence-base about the causality of international student precarity.

Explaining Government Policy Inaction on International Student Housing in Australia: The Perspectives of Stakeholders.

Housing is a major concern for many international students. This is especially so in those countries where students are mostly dependent on the private market for their accommodation. Australia is one such country, and is one of the world's major destinations for international students. This article analyses governmental failure to address problems relating to international student housing affordability and conditions. Using theory on 'policy inaction' to frame the analysis, we draw on 20 interviews with policy stakeholders to explain the Australian government's reliance on: (1) market-based housing provision for international students, and (2) a longstanding policy preference not to provide support. Interviewees were widely critical of the lack of action to address international student housing problems and understood inaction in relation, rather than in opposition, to the dominance of market-based action in housing and higher education. However, analysis of stakeholder perspectives also illuminates how policy-making action benefiting some emerges as inaction for others left behind or overlooked by the status quo. The interview data points to the need for government to overhaul its policy framework, and in doing so, to collaborate with higher education providers in revising the market-based regulatory approach. The main implications for theory and policy are discussed.

Late presentation of acromegaly in medically controlled prolactinoma patients.

Co-secretion of growth hormone (GH) and prolactin (PRL) from a single pituitary adenoma is common. In fact, up to 25% of patients with acromegaly may have PRL co-secretion. The prevalence of acromegaly among patients with a newly diagnosed prolactinoma is unknown. Given the possibility of mixed GH and PRL co-secretion, the current recommendation is to obtain an insulin-like growth factor-1 (IGF-1) in patients with prolactinoma at the initial diagnosis. Long-term follow-up of IGF-1 is not routinely done. Here, we report two cases of well-controlled prolactinoma on dopamine agonists with the development of acromegaly 10-20 years after the initial diagnoses. In both patients, a mixed PRL/GH-cosecreting adenoma was confirmed on the pathology examination after transsphenoidal surgery (TSS). Therefore, periodic routine measurements of IGF-1 should be considered regardless of the duration and biochemical control of prolactinoma. LEARNING POINTS: Acromegaly can develop in patients with well-controlled prolactinoma on dopamine agonists.The interval between prolactinoma and acromegaly diagnoses can be several decades.Periodic screening of patients with prolactinoma for growth hormone excess should be considered and can lead to an early diagnosis of acromegaly before the development of complications.

MORNING SERUM CORTISOL LEVEL AFTER TRANSSPHENOIDAL SURGERY FOR PITUITARY ADENOMA PREDICTS HYPOTHALAMIC-PITUITARY-ADRENAL FUNCTION DESPITE INTRAOPERATIVE DEXAMETHASONE USE.

OBJECTIVE: Perioperative glucocorticoid (GC) is rarely needed in patients undergoing transsphenoidal surgery (TSS). We instituted a steroid-sparing protocol in the settings of intraoperative dexamethasone use. We evaluated the safety of using a cut off cortisol level of 14 µg/dL on postoperative day (POD)-1 and -6 after dexamethasone use during the surgery. We also analyzed the efficacy of serial morning cortisol levels for weaning GC replacement. METHODS: The charts of 48 adult patients who received dexamethasone 4 mg intraoperatively were reviewed. Morning cortisol levels were measured on POD-1. Patients with cortisol ≥14 µg/dL were discharged without CG replacement. Morning cortisol level was checked routinely on POD-6, and GC replacement was initiated when the level was <14 µg/dL. Serial cortisol levels were measured in patients requiring GC after the first postoperative week. RESULTS: Overall, 67% patients had POD-1 cortisol ≥14 µg/dL and did not require GC on discharge. After POD-6, 83% of patients were not on GC replacement. A cosyntropin stimulation testing (CST) was only performed in 3 patients. There were no hospital admissions for adrenal crisis during the postoperative period. CONCLUSION: A steroid-sparing protocol with POD-1 and -6 morning cortisol levels can be safely and effectively used in the settings of intraoperative dexamethasone administration. It leads to avoidance of GC in more than two-thirds of patients on discharge and more than 80% of patients after the first postoperative week. We found that dynamic adrenal testing could be omitted in the majority of patients by using serial morning cortisol levels to assess the hypothalamic-pituitary-adrenal (HPA) axis.

Temporal Stability and Authenticity of Self-Representations in Adulthood.

The temporal stability of role-specific self-representations was examined in a sample of 188 young, middle-aged, and older adults. Considerable stability was observed for all self-representations. Central self-descriptors showed significantly greater temporal stability than peripheral self-descriptors. Temporal stability of self-representations was positively associated with self-concept clarity, self-esteem, and positive affect (PA). Age differences were obtained for three of the five self-representations, with older adults showing significantly lower stabilities for self with family, self with friend, and self with significant other compared to young and middle-aged adults. Assessment of the authenticity of adults' role-specific self-representations showed that greater authenticity tended to be associated with greater temporal stability. Authenticity and the number of positive daily events were significant positive predictors of the stability of self-representations.