This article examines the emerging challenges and opportunities presented by self-management options in Australia's National Disability Insurance Scheme (NDIS). We examine the three different ways in which NDIS participants can opt to self-manage their funding and services, including direct employment and emerging Uber-style online platforms, and explore the potential implications of these options for NDIS participants, service providers and the disability support workforce. In particular, we focus on these options in relation to the transition to a marketised services landscape being developed alongside the NDIS, and examine both the risks and opportunities for each stakeholder group. Through this analysis, we identify implications for policy and practice, in particular around regulatory mechanisms and the role of government within this emerging market economy and transforming service landscape. K E Y W O R D Sdisability support workforce, individualised funding, marketisation, NDIS, self-management, Uber

Despite the best available agents to prevent mucositis, most patients receiving high-dose chemoradiotherapy regimens experience severe mucositis, and new therapies are needed. In this study, we evaluated the safety and tolerability of a milk-derived growth factor extract (PV701 mouthwash) intended to prevent oral mucositis (OM) after carmustine, etoposide, cytosine arabinoside, and melphalan (BEAM) chemotherapy. PV701 mouthwash (15 mL x 13.5 mg/mL) was administered 6 times a day for 12 days, from day--6 to day +5, to patients with lymphoma, who were given BEAM on day--6 to day--2, with autologous stem cells infused on day 0. Dose de-escalation of PV701 was planned if dose-limiting toxicities occurred. The severity and duration of OM, the duration of enteral/parenteral feeding, the requirement for intravenous opiates, and admission to intensive care were recorded. Outcomes were also compared with those of historical control patients. Nine patients received PV701 13.5 mg/mL. PV701 was well tolerated, and no dose-limiting toxicities were observed. Compared with 89 historical controls, the 9 PV701-treated patients had significantly less frequent grade 2 or 3 OM ( P=.0006) and had grade>or=3 OM for an estimated 5 fewer days ( P=.0003). There was a reduction in the need for enteral/parenteral feeding ( P=.012), its duration ( P=.010), and its frequency ( P=.022) and in the duration of intravenous opiates ( P=.0006). We conclude that PV701 mouthwash is readily administered with minimal side effects at a dose of 1215 mg/d, and further investigation of this agent is warranted.

The emergence of online disability hate speech on social media platforms is the latest form of ableist expression. This was highlighted when an alarming amount of negative attitudinal responses emerged towards people with Down syndrome and their parents on the 60 Minutes Facebook platform to their segment ‘Does Australia really want to see the end of Down syndrome?’ This article analyses the varying contours of ableism within these responses. The responses could be categorised into three broad themes: the construction of Down syndrome as an economic burden on society and a drain on public resources; social attitudes to Down syndrome; and bias related to information provided by the medical profession to pregnant women with a high probability of a Down syndrome birth. These findings allowed us to interrogate what this means in terms of how Australians view difference associated with Down syndrome, and to consider the operationalisation of ableism within the Australian social landscape.

The role of financial counsellors as providers of information, support and advocacy for those in financial difficulty is a well established mechanism in the mainstream welfare landscape in Australia. In general, the role of financial counsellors is in helping people alleviate or resolve their financial difficulties through improvement of their financial literacy. It is recognised as an important component of policy responses to assist low-income households and individuals in financial stress. The use of financial counsellors for older persons (i.e., those aged 65+ years) however appears to be underutilised. Financial hardship and abuse of older persons within our community are becoming key issues as the population of Australia "ages". Existing evidence also suggests that service providers alone do not have adequate skills to address these issues. This paper firstly examines the development of financial counselling in Australia. It then examines the newly emerging role of financial counselling in supporting older persons in addressing barriers to financial literacy and then in navigating the complex landscape of aged care service provision. The current finacialisation, marketisation and complexities of consumerdirected care are identified as key contextual factors. The paper will then discuss an evaluation study of the provision of financial counselling to the older person population designed to support financial hardship and navigation of

Co‐production is an intrinsic component of disability individualised funding schemes such as Australia's National Disability Insurance Scheme (NDIS). In this paper, we argue that an under‐explored facet of co‐production is the role that users of these services play in co‐regulation. We draw on data collected in a qualitative study exploring participants' use of providers who are not registered with the NDIS regulator, the Quality and Safeguards Commission. Employing Steiner et al.'s (2023) 5Ws framework, we focus particularly on the dimensions of what, why and where to understand the conditions underpinning client co‐regulation of quality and safety in the NDIS. We also explore the various types of activities participants engage in to co‐produce their NDIS services, highlighting activities designed to improve the quality and safety of services delivered by unregistered providers.