Search

We used a retrospective cohort study to measure the impact of caring for children on female Australian researchers. Our aim was to see whether caring for children was associated with reduced outputs and collaboration. Women were randomly selected for inclusion if they published a first author paper in one of three Australian journals during 2007 to 2015, women who did not publish during this time were not included. One-hundred and sixty women were approached and 95 (59%) completed a survey on their history of caring for children. Two key outcomes were the women's publication and citation counts, which were accessed from Scopus. We also examined the number of authors, affiliations and countries on their published papers, as a reduction in these numbers could indicate an impaired ability to collaborate. We examined the probability of being first or last author as a measure of esteem. There was a small increase in publication counts after the first child that was reversed after the second child. Average citations counts declined after children, particularly after the second child. There was some evidence of a reduced collaboration with overseas collaborators after the first child. The probability of being the last author increased after the second child. Three women were identified as statistically influential and all three had children and were in the top 10% of overall publications and citations. After removing these women the estimated changes in outcomes were noticeably different for most of the outcomes. The repeated presence of statistically influential women shows that it may be impossible to find an "average impact" of caring for children when considering research output. Adjustments may need to be made individually, with women explaining how caring for children has altered their career. [ABSTRACT FROM AUTHOR]

The quandong or native peach (Santalum acuminatum R.Br.) has been recognised as an important and tasty food resource among Aboriginal Australians in arid and semi-arid areas of southern Australia. It is valued for its fruit that is consumed raw or dried, and for its kernel, which is eaten raw or ground into paste for medicinal and skin care purposes. This paper reports on a study of ground stone implements within the Murray Darling Basin that has identified quandong stones as a distinct type of implement made specifically for the efficient cracking of quandong nuts. Data are presented on 1,327 ground stone implements from collections in 12 different locations in the Murray-Darling Basin (MDB), an area almost completely devoid of stone sources. Given the paucity of stone, multi-purpose use of implements is widely documented. Although it was common to find pits present in mortars and other ground stone tools demonstrating multiple functions, including use as anvils, a class of single purpose stones with multiple pits and distinctive form was identified. Most of these were found in areas known for groves of quandong and four were analysed for use-wear and residues along with two other ground stone items from the MDB. The results support their identification as specialised anvil stones for cracking quandong nuts. [ABSTRACT FROM AUTHOR]

Background: Rural Australian populations experience an increased burden of ischaemic heart disease (IHD) compared to their metropolitan counterparts, similar to other developed countries, globally. Policy and other efforts need to address and acknowledge these differences in order to reduce inequalities in health burden. This paper examines rural health policy makers’ perceptions and use of evidence in efforts to reduce the burden of IHD in rural areas. Methods: Policy makers and government advisors (n = 21) who worked with, or advised on, rural health policy at local, state and federal government levels, with specific focus on the state of Victoria (n = 9) were identified from publicly available documents and subsequent snowball sample. Semi-structured qualitative interviews were conducted in regards to the use of evidence in policy to prevent IHD and thematic analysis undertaken applying two theoretical perspectives: context-based evidence-based policy making and the conceptual framework for understanding rural and remote health. Results: The rural context, particularly low resourcing, was seen as limiting potential for evidence based policy at local government (LG) level. Lower levels of political pressure and education were seen as constraints to evidence-based policy in rural communities. Participants described the potential for policy to have a greater impact on reducing heart disease in rural areas though they felt under-resourced and out of touch with the scientific evidence. Scientific studies were less valued than local anecdote to prioritise specific policy. At all levels (local, state and federal) low self-efficacy in interpreting evidence and perceived lack of relevance inhibited development of evidence informed policy. Conclusion: The rural context constrains the use of scientific evidence in policy making for the prevention of heart disease in rural areas in Australia with multiple factors influencing the capacity for evidenced based health policy. This is similar to findings at the international scale and is for consideration across other developed countries that experience inequalities in IHD disease burden between rural and urban populations. [ABSTRACT FROM AUTHOR]

Between the second half of the nineteenth and the first half of the twentieth century, Australia and the islands of the southwestern Pacific were the setting of a wide context of encounters between Europeans and Indigenous peoples, in regions that could be perceived as disconnected at a first glance. However, it was part of a wider project of colonization that overlapped on a not less wide set of Indigenous networks of interconnection. Such a colonial project had landscape modification as a main common goal, added to projects of ethnic and cultural separation and segregation. This article suggests an approach to cultural seascapes as an approach to power relations between European colonizers and Indigenous people in this region. I suggest that this level of analysis allows to connect realities that could be perceived as disparate, but which were coherent with global projects of imposition of colonial identities according to a dominant global matrix of power. I aim to highlight the value of local spaces of interconnection as expressions of wider realities, approachable throughout the analysis of cultural seascapes as mobile spaces of power relations. [ABSTRACT FROM AUTHOR]

This paper analyses two critiques of the jurisprudential basis of settler colonialism in Australia published in the early Victorian periodical press. Review articles in the North British Review and Fraser's Magazine in the 1840s deployed claims of legal sophistry to dispute the fiction that Australian colonies were settled, rather than conquered, and that the country was a terra nullius. By examining the politics and rhetoric of each article, the significance of legal ideology for both literature promoting colonization and humanitarian critiques of colonial policy is assessed. Through a combination of discourse analysis and intellectual history, the North British Review article is read as fusing Scottish Enlightenment concepts of social evolution with the rhetoric of sensibility to defend the existence of Indigenous rights to land and to argue for the degenerative implications of colonial social practices. Similarly, the Fraser's Magazine article offers an epitome of the place of law in colonial policy-making by invoking utilitarian and pragmatic approaches to law to rationalize doctrines of sovereignty and jurisdiction, minimizing legal protections for Aborigines while maximizing the legal powers of colonists. By tracing the use of jurisprudential rhetoric in reviews published in two leading metropolitan journals, the paper offers evidence that the literary sphere contributed to the emergent culture of colonial legality. [ABSTRACT FROM AUTHOR]

The rural is widely associated with traditions that modernity is presumed to disrupt or displace. But rurality is an idea produced by modernity, and endlessly engaged in and by dialogues about modernization. This paper considers the figure of the country girl as an image of distance from modernity. Insofar as she is always coming from the outside of a presumed modern identity and experience that is fixed by its urbanity, the country girl in Australian popular culture clearly has parallels in other places and other cultures. My focus here is on the difference the country girl articulates in a broad Asian-Pacific context discussed as coming ‘late’ to modernity. The country girl is always arriving at an encounter with modernity that identifies what modernity costs and what it offers. Her difference is not only a dramatic foil that throws the subject of modernity into sharp relief but offers up stories about modernity as something that must be learned. [ABSTRACT FROM PUBLISHER]

The formal study of kinship was introduced to the South Pacific Islands and the Australian colonies by Methodist missionary Lorimer Fison who distributed schedules and collected kinship data from around the region in collaboration with the founder of Anthropology in America, Lewis Henry Morgan. This article is a sequel to H. Gardner, 2008 'The origins of kinship in Oceania', Oceania, 78:2, 137-150. It traces Lorimer Fison's return to the Australian colonies from his mission post in Fiji and the subsequent spread of kinship schedules to settlers, missionaries and administrators around Australia. Based on unpublished correspondence, the article investigates Fison's gradual disillusionment with Morgan's evolutionist hypothesis of the development of the human family and his disdain for the speculation of much metropolitan anthropology in the 1870s. [ABSTRACT FROM AUTHOR]

This scoping review provides a summary of research findings on social support dynamics in the wake of disasters that occurred on the continent of Australia and Oceania between 1983 and 2013. Forty‐one studies, quantitative and qualitative, were summarised, investigating different facets of post‐disaster supportive interactions. All inquiries assessed disasters resulting from natural hazards, with the majority of them conducted following events in Australia and New Zealand. The review revealed similar patterns of post‐disaster social support dynamics that routinely unfold after disastrous incidents all over the world. Consistent with the disaster mental health literature, the documentation of social support mobilisation and social support deterioration processes was common. Salutary direct effects of supportive behaviours on post‐disaster psychological distress were also highly evident. Most studies, however, posed research questions or hypotheses that lacked empirical or theoretical grounding. In conclusion, the review offers several recommendations on how to advance research on post‐disaster social support. [ABSTRACT FROM AUTHOR]

Background: Non-AIDS-related mortality rates among HIV-infected patients still exceed those of their uninfected peers. A major driver of this excess mortality is a higher risk of non-infectious comorbidities, including cardiovascular disease, chronic kidney disease, type 2 diabetes mellitus, osteoporosis and cancer. The prevalence of mental illness and other chronic non-infectious comorbidities is identified as a primary concern of antiretroviral prescribers in Australia. Methods: We conducted a cross-sectional, observational study using data from MedicineInsight, a large-scale Australian primary care database comprising longitudinal data from electronic clinical information systems. The HIV-infected cohort included all men with a recorded diagnosis of HIV. The non-HIV-infected cohort comprised all other men from the same practices. The prevalence and risk of cardiovascular disease, chronic kidney disease, type 2 diabetes mellitus, osteoporosis, cancer, anxiety and depression were compared between the groups. Results: We included 2,406 HIV-infected males and 648,205 males with no record of HIV diagnosis attending primary care in this study. HIV-infected men were less socioeconomically disadvantaged and more urban-dwelling than men in the primary care cohort. We found that HIV-infected men attending primary care in Australia are at increased risk of chronic kidney disease, cancer, osteoporosis, anxiety and depression. There appears to be a risk of premature onset of cardiovascular disease, osteoporosis and cancer among younger HIV-infected patients. There is a high prevalence of anxiety and depression among HIV-infected men. Conclusions: Increased prevalence of non-infectious comorbidities among HIV-infected men has broad implications for the effective management of those with these chronic conditions. Education to raise awareness among both HIV-infected men and their care providers, together with a greater focus on risk reduction, monitoring and preventive care, may be effective strategies in primary healthcare settings to further narrow the gap in health outcomes between people living with HIV and their uninfected counterparts. [ABSTRACT FROM AUTHOR]

Introduction: Metabolic risk factors for cardiovascular disease (CVD) warrant significant public health concern globally. This study aims to utilise the regional database of a major laboratory network to describe the geographic distribution pattern of eight different cardiometabolic risk factors (CMRFs), which in turn can potentially generate hypotheses for future research into locality specific preventive approaches. Method: A cross-sectional design utilising de-identified laboratory data on eight CMRFs including fasting blood sugar level (FBSL); glycated haemoglobin (HbA1c); total cholesterol (TC); high density lipoprotein (HDL); albumin creatinine ratio (ACR); estimated glomerular filtration rate (eGFR); body mass index (BMI); and diabetes mellitus (DM) status was used to undertake descriptive and spatial analyses. CMRF test results were dichotomised into ‘higher risk’ and ‘lower risk’ values based on existing risk definitions. Australian Census Statistical Area Level 1 (SA1) were used as the geographic units of analysis, and an Empirical Bayes (EB) approach was used to smooth rates at SA1 level. Choropleth maps demonstrating the distribution of CMRFs rates at SA1 level were produced. Spatial clustering of CMRFs was assessed using Global Moran’s I test and Local Indicators of Spatial Autocorrelation (LISA). Results: A total of 1,132,016 test data derived from 256,525 individuals revealed significant geographic variation in the distribution of ‘higher risk' CMRF findings. The populated eastern seaboard of the study region demonstrated the highest rates of CMRFs. Global Moran’s I values were significant and positive at SA1 level for all CMRFs. The highest spatial autocorrelation strength was found among obesity rates (0.328), and the lowest for albuminuria (0.028). LISA tests identified significant High-High (HH) and Low-Low (LL) spatial clusters of CMRFs, with LL predominantly in the less populated northern, central and southern regions of the study area. Conclusion: The study describes a range of CMRFs with different distributions in the study region. The results allow generation of hypotheses to test in future research concerning location specific population health approaches. [ABSTRACT FROM AUTHOR]

Background: Bowel and bladder problems affect more than 50% of people with Multiple Sclerosis (MS). These problems have a large impact on quality of life and place a significant burden on health systems. Objectives: This study aimed to ascertain the frequency of bladder and bowel problems in a select Australian MS cohort and to investigate the relationships between level of disability, bladder and bowel problems, and fatigue. Methods: Questionnaires on the nature and severity of MS symptoms were distributed to clients attending an Australian MS centre. Log-binomial regression and multiple linear regression models were used to investigate relationships between disability, fatigue, and bladder and bowel problems. Results and conclusions: Of 167 questionnaires distributed, 136 were completed. Bladder problems were reported by 87 (74.4%) respondents, whilst 66 (48.9%) experienced functional constipation and 43 (31.9%) faecal incontinence. This frequency in our select Australian MS population is similar to that reported globally. There was a significant correlation between level of disability and: bladder problems (p = 0.015), faecal incontinence (p = 0.001), fatigue (p<0.001) and constipation (p = 0.016, relative risk: 1.16). Further investigation into the causal relationships between various MS symptoms may be beneficial in the development of novel therapeutic strategies for people with MS. [ABSTRACT FROM AUTHOR]

Australian fire weather shows spatiotemporal variability on interannual and multi-decadal time scales. We investigate the climate factors that drive this variability using 39 station-based historical time series of the seasonal 90th-percentile of the McArthur Forest Fire Danger Index (FFDI) extending from 1973 through 2017. Using correlation analyses, we examine the relationship of these time series to the El Niño Southern Oscillation (ENSO), the Southern Annular Mode (SAM) and the Indian Ocean Dipole (IOD), considering both concurrent and time-lagged relationships. Additionally, longer term behaviour of the time series using linear trend analysis is discussed in the context of the climate drivers, Interdecadal Pacific Oscillation (IPO) and anthropogenic climate change. The results show that ENSO is the main driver for interannual variability of fire weather, as defined by FFDI in this study, for most of Australia. In general, El Niño-like conditions lead to more extreme fire weather, with this effect stronger in eastern Australia. However, there are significant regional variations to this general rule. In NSW, particularly along the central coast, negative SAM is a primary influence for elevated fire weather in late-winter and spring. In the southeast (VIC and TAS), the El Niño-like impact is exacerbated when positive IOD conditions are simultaneously observed. The spring conditions are key, and strongly influence what is observed during the following summer. On longer time scales (45 years), linear trends are upward at most stations; this trend is strongest in the southeast and during the spring. The positive trends are not driven by the trends in the climate drivers and they are not consistent with hypothesized impacts of the IPO, either before or after its late-1990s shift to the cold phase. We propose that anthropogenic climate change is the primary driver of the trend, through both higher mean temperatures and potentially through associated shifts in large-scale rainfall patterns. Variations from interannual factors are generally larger in magnitude than the trend effects observed to date. [ABSTRACT FROM AUTHOR]

Black leaf streak disease, or black Sigatoka, is caused by the fungus Pseudocercospora fijiensis, and has been identified as a major constraint to global production of banana and plantain. We fitted a climatic niche model (CLIMEX) for P. fijiensis to gain an understanding of the patterns of climate suitability, and hence hazard from this disease. We then calibrated the climate suitability patterns against the results of an expert elicitation of disease pressure patterns. We found a moderately strong non-linear relationship between modelled climate suitability for P.°fijiensis and the expert ratings for disease pressure. The strength of the relationship provides a cross-validation between the CLIMEX model and the expert elicitation process. The bulk of global banana production experiences high potential threat from P. fijiensis, and the higher yielding areas for banana and plantain production are at greatest threat. By explicitly considering the role of irrigation we have been able to identify how strategic irrigation could be used to support banana production in areas that are at low risk from P. fijiensis. [ABSTRACT FROM AUTHOR]

“Why are neurotypicals so pig-ignorant about autism?” an autistic person wrote on the Curtin Autism Research Group’s on-line portal as a response to a call for research questions. Co-produced with an autistic researcher, knowledge about and attitudes towards autism were analysed from 1,054 completed surveys, representing the Australian neurotypical adult population. The majority, 81.5% of participants had a high level of knowledge and 81.3% of participants had a strong positive attitude towards autism. Neither age, nor education level had an impact on attitudes. However, attitudes were influenced by knowledge about ‘Societal Views and Ideas’; ‘What it Could be Like to Have Autism’; and the demographic variables ‘Knowing and having spent time around someone with autism’; and gender (women having more positive attitudes than men). Thus, targeted interventions, geared more towards men than women, to increase knowledge about autism could further improve attitudes and increase acceptance of the autistic community. [ABSTRACT FROM AUTHOR]

Objective: To identity differences between a general access index (Accessibility/ Remoteness Index of Australia; ARIA+) and a specific acute and aftercare cardiac services access index (Cardiac ARIA). Research design and methods: Exploratory descriptive design. ARIA+ (2011) and Cardiac ARIA (2010) were compared using cross-tabulations (chi-square test for independence) and map visualisations. All Australian locations with ARIA+ and Cardiac ARIA values were included in the analysis (n = 20,223). The unit of analysis was Australian locations. Results: Of the 20,223 locations, 2757 (14% of total) had the highest level of acute cardiac access coupled with the highest level of general access. There were 1029 locations with the poorest access (5% of total). Approximately two thirds of locations in Australia were classed as having the highest level of cardiac aftercare. Locations in Major Cities, Inner Regional Australia, and Outer Regional Australia accounted for approximately 98% of this category. There were significant associations between ARIA+ and Cardiac ARIA acute (χ2 = 25250.73, df = 28, p<0.001, Cramer’s V = 0.559, p<0.001) and Cardiac ARIA aftercare (χ2 = 17204.38, df = 16, Cramer’s V = 0.461, p<0.001). Conclusions: Although there were significant associations between the indices, ARIA+ and Cardiac ARIA are not interchangeable. Systematic differences were apparent which can be attributed largely to the underlying specificity of the Cardiac ARIA (a time critical index that uses distance to the service of interest) compared to general accessibility quantified by the ARIA+ model (an index that uses distance to population centre). It is where the differences are located geographically that have a tangible impact upon the communities in these locations–i.e. peri-urban areas of the major capital cities, and around the more remote regional centres. There is a strong case for specific access models to be developed and updated to assist with efficient deployment of resources and targeted service provision. The reasoning behind the differences highlighted will be generalisable to any comparison between general and service-specific access models. [ABSTRACT FROM AUTHOR]

Australia is currently canine rabies free. However, communities located on the northern coastline–such as the Northern Peninsula Area (NPA), Queensland–are at risk of an incursion due to their large populations of susceptible free-roaming dogs and proximity to rabies-infected Indonesian islands. A rabies-spread model was used to simulate potential outbreaks and evaluate various disease control strategies. A heterogeneous contact structure previously described in the population of interest–explorer dogs, roamer dogs and stay-at-home dogs–was incorporated into the model using six spatial kernels describing contacts between dog roaming categories. Twenty-seven vaccination strategies were investigated based on a complete block design of 50%, 70% and 90% coverage for each of the three roaming categories to simulate various targeted vaccination strategies. The 27 strategies were implemented in four population structures in which the proportion of dogs in each category varied–explorer dominant, roamer dominant, stay-at-home dominant and a field population (based on field estimates of population structure). The overall vaccination coverage varied depending on the subpopulation targeted for vaccination and the population structure modelled. A total of 108 scenarios were simulated 2000 times and the model outputs (outbreak size and duration) were compared to Strategy 14 (a standard recommended overall 70% vaccination coverage). In general, targeting explorer dogs–and to a lesser extent roamer dogs–produced similar outbreaks to Strategy 14 but with a lower overall vaccination coverage. Similarly, strategies that targeted stay-at-home dogs required a higher vaccination coverage to produce significantly smaller and shorter outbreaks. This study provides some theoretical evidence that targeting subpopulations of dogs for vaccination based on their roaming behaviours (and therefore risk of rabies transmission) could be more efficient than blanket 70% vaccination campaigns. Such information can be used in preparedness planning to help improve control of a potential rabies incursion in Australia. [ABSTRACT FROM AUTHOR]

Demand for training life scientists in bioinformatics skills led to the development of a train-the-trainer collaboration between the European Molecular Biology Laboratory–European Bioinformatics Institute (EMBL-EBI) and 2 Australian organisations, Bioplatforms Australia and Commonwealth Scientific and Industrial Research Organisation (CSIRO) in 2012. The goal of the collaboration was to establish a group of trained instructors who could develop and deliver short bioinformatics courses nationally. A train-the-trainer course introduces instructors to aspects of andragogy and evidence-based learning principles to help them better design, develop, and deliver high-quality training. Since then, both the number of trainers in the network and the course portfolio have grown. Best practises have been developed and shared between the Australian cohort and EMBL-EBI to address common challenges in bioinformatics training. The Australian trainer cohort undertook a train-the-trainer instructor course, again with EMBL-EBI, and subsequently successfully delivered train-the-trainer courses to interested bioinformatics trainers within Australia. We conclude that a train-the-trainer approach can help build national capacity and maintain a critical mass of trained instructors. [ABSTRACT FROM AUTHOR]

Purpose: Ageing in place is one of the greatest desires of elderly people. Assistive digital technologies could potentially delay the institutionalization of the elderly people and allow them ageing in place. This study develops a population-wide cost estimating framework for adopting digital technologies that can improve the quality of life of elderly people through examining an Australian region. Methods: We developed a five-stage cost estimation framework, which involved progressive forecasting of elderly population and direct cost estimation methods. The forecasting and cost estimation models have been set for a 10-year period because the prediction accuracy from cross-sectional data is better in the short to medium term compared to the long-term. For cost estimation, we categorised the ageing population on the basis of the number of chronic diseases that they have contracted. Costs of assistive technologies were collected from open sources. The model has been tested in the Fitzroy and Central West, a regional area of Queensland in Australia. A stakeholder panel discussion in a workshop format was used to validate the appropriateness of the proposed framework and the study findings. Results: This study identified eight common chronic diseases with different comorbidity patterns in Australia. We also identified the required assistive technologies to assist patients with chronic diseases. This study estimated that annual per capita cost for technological intervention could range from AUD 4,169 to AUD 7,551 on the basis of different price margins of the technologies. Conclusion: The approach of categorising the aged cohorts on the basis of the number of chronic diseases helps estimate population-wide costs compared to using single technology intervention costs for a particular chronic disease cohort. The cost estimation framework and the method developed in this study can assist the government to estimate costs for ageing-in-place programs. [ABSTRACT FROM AUTHOR]

Objectives: The Code of Ethics of pharmacy practitioners in Australia recognises the obligation to provide care to patients in a culturally safe and responsive manner. The aim of this exploratory study was to examine how Australian community pharmacists understand and experience the concept of ‘culture’ in their everyday practice environment. Methods: Voluntary, semi-structured interviews were conducted at community pharmacy placement sites in South-East Queensland, Australia. Pharmacists were asked to recall an incident that evoked their cultural awareness during the course of their practice. The question stated, verbatim: “We are preparing our students to be pharmacists in a highly multicultural community. Can you think of an incident where you learnt something about another person’s culture or it made you more aware of your own culture? Please briefly describe the incident.” Reportable responses were collected from 59 of the 92 visited pharmacists. These responses were audio-recorded and transcribed. The data were collated and analysed through iterative, reflexive, thematic analysis using constant comparison. Results and significance: The responses provided a rich selection of lived experiences within Australian multicultural pharmacy practice, describing professional dilemmas, fears and the strategies employed to overcome practice challenges. Six main response categories were identified: (i) Language/communication challenges, (ii) Cultural attitudes and behaviours, (iii) Exposure to culture due to pharmacy location, (iv) Religion, gender, and age, (v) Prejudiced/perceived racist attitudes and discrimination towards ‘other’ cultures, (vi) Perceived ‘sameness’ of different cultures. The study has provided valuable insights into community pharmacists’ experiences of culture in their day-to-day professional practice, also highlighting the associated strategies used to maintain a high standard of practice. There is merit in ensuring that the pharmacy curriculum and professional development programs are designed to respond to the ethical obligation of pharmacists to practise in a culturally safe, responsive manner that acknowledges and incorporates the importance of culture, cultural differences and intercultural relations, while addressing culturally unique needs in a skilled and professional manner. [ABSTRACT FROM AUTHOR]

Planning for a re-emergent epidemic of smallpox requires surge capacity of space, resources and personnel within health systems. There are many uncertainties in such a scenario, including likelihood and size of an attack, speed of response and health system capacity. We used a model for smallpox transmission to determine requirements for hospital beds, contact tracing and health workers (HCWs) in Sydney, Australia, during a modelled epidemic of smallpox. Sensitivity analysis was done on attack size, speed of response and proportion of case isolation and contact tracing. We estimated 100638 clinical HCWs and 14595 public hospital beds in Sydney. Rapid response, case isolation and contact tracing are influential on epidemic size, with case isolation more influential than contact tracing. With 95% of cases isolated, outbreak control can be achieved within 100 days even with only 50% of contacts traced. However, if case isolation and contact tracing both fall to 50%, epidemic control is lost. With a smaller initial attack and a response commencing 20 days after the attack, health system impacts are modest. The requirement for hospital beds will vary from up to 4% to 100% of all available beds in best and worst case scenarios. If the response is delayed, or if the attack infects 10000 people, all available beds will be exceeded within 40 days, with corresponding surge requirements for clinical health care workers (HCWs). We estimated there are 330 public health workers in Sydney with up to 940,350 contacts to be traced. At least 3 million respirators will be needed for the first 100 days. To ensure adequate health system capacity, rapid response, high rates of case isolation, excellent contact tracing and vaccination, and protection of HCWs should be a priority. Surge capacity must be planned. Failures in any of these could cause health system failure, with inadequate beds, quarantine spaces, personnel, PPE and inability to manage other acute health conditions. [ABSTRACT FROM AUTHOR]

The history of colonization contributed to Aboriginal and Torres Strait Islanders becoming one of the most disadvantaged groups in Australia. The multiple social inequalities, and therefore the constant insecurities for many about low income, poor living conditions, unemployment, and discrimination, generate chronic stress in this population. In the Baby Teeth Talk Study, an oral-health randomized controlled trial, the Perceived Stress Scale (PSS-14) was administered to 367 pregnant Aboriginal women at baseline. The aim of the present study was to evaluate the validity and reliability of the PSS-14 in an Aboriginal population. The study analysed: (a) model fit; (b) dimensionality; (c) local dependence; (d) differential item functioning; (e) threshold ordering and item fit; (f) targeting; (g) reliability; and (h) criterion validity. The dimensionality analysis indicated a two-factor structure, with negatively and positively worded items clustering together and 21.7% (95% Agresti-Coull C.I. [17.8%, 26.2%]) statistically significant t-tests between the persons’ estimates. After the creation of composite items, the revised Perceived Distress (χ2 (21) = 11.74, p = 0.946) and Perceived Coping (χ2 (28) = 17.63, p = 0.935) subscales fitted the Rasch model. Reliability was modest (PersonSeparationIndexdistress = 0.72; PersonSeparationIndexcoping = 0.76). The latent correlation between the Perceived Distress and Perceived Coping subscales was r = 0.14. It is hypothesized that the social inequalities experienced by the Aboriginal population are so pronounced that even Aboriginal pregnant women that perceived themselves as coping well with life challenges ended up endorsing items regarding high levels of stress. The present research showed that a revised PSS-14 is a culturally valid and modestly reliable psychological instrument to measure stress in a population of pregnant Aboriginal women in Australia. [ABSTRACT FROM AUTHOR]

Background: There are few quantitative studies on palliative care provision to Indigenous Australians, a population known to experience distinctive barriers to quality healthcare and to have poorer health outcomes than other Australians. Objectives: To investigate equity of specialist palliative care service provision through characterising and comparing Indigenous and non-Indigenous patients at entry to care. Methods: Using data (01/01/2010–30/06/2015) from all services participating in the multi-jurisdictional Palliative Care Outcomes Collaboration, Indigenous and non-Indigenous patients entering palliative care were compared on proportions vis-à-vis those expected from national statutory datasets, demographic characteristics, and entry-to-care status across fourteen ‘problem’ domains (e.g., pain, functional impairment) after matching by age, sex, and specific diagnosis. Results: Of 140,267 patients, 1,465 (1.0%, much lower than expected from statutory data) were Indigenous, 133,987 (95.5%) non-Indigenous, and 4,905 (3.5%) had a missing identifier. The proportion of patients with a missing identifier diminished markedly over the study period, without a corresponding increase in the proportion identified as Indigenous. Indigenous compared with non-Indigenous patients were younger (mean 62.8 versus 73.0 years, p<0.001), a higher proportion were female (51.5% versus 46.3%; p<0.001) or resided outside major cities (44.2% versus 21.5%, p<0.001). Across all domains, Indigenous compared with matched non-Indigenous patients had lower or equal risk of status requiring prompt intervention. Conclusions: Indigenous patients (especially those residing outside major cities) are substantially under-represented in care by services participating in the nationwide specialist palliative care Collaboration, likely reflecting widespread access barriers. However, the similarity of status indicators among Indigenous and non-Indigenous patients at entry to care suggests that Indigenous patients who are able to access these services do not disproportionately experience clinically important impediments to care initiation. [ABSTRACT FROM AUTHOR]

The study of domestic money goes at the heart of debates about independence and equality in intimate relationships. It provides an important window on the individualization of family life and how couples reconcile ideals around egalitarian marriage ideologies with enduring gender inequality in society and the labor market. This study approaches these issues from the prism of couples’ banking arrangements (separate vs. joint accounts), an aspect of financial organization that approximates the executive management of household resources and which has received comparatively little attention. As such, it is amongst the first to deploy large-scale, household panel data (Household, Income and Labour Dynamics in Australia Survey, n = 15,379 observations from 7,054 couples) and binary and multinomial random-effect logistic regression models to examine trends over time in couples’ banking arrangements and their socio-demographic predictors. Key findings indicate that a large share of couples in Australia favors ‘mixed’ bank account strategies (i.e., holding both joint and separate accounts), but ‘egalitarian’ choices (i.e., dual separate accounts) are prevalent and on the rise. Couples’ bank account choices are influenced in theoretically-meaningful ways by economic resources, transaction costs, relationship history, gender-role attitudes, and family background. [ABSTRACT FROM AUTHOR]

Background: The benefits of clinical supervision are more pronounced for health professionals in rural and remote areas. Most clinical supervision studies to date have occurred in metropolitan centres and have used the survey methodology to capture participant experiences. There is a lack of qualitative research that captures participants’ lived experiences with clinical supervision at the frontline. Methods: Participants were recruited from rural and remote sites of two Australian states using a purposive maximum variation sampling strategy. Data were collected through individual, semi-structured interviews with participants. Data were analysed using content analysis and themes were developed. Sixteen participants from six professions completed the interviews. Results: Eight themes were developed including the content of supervision, context of supervision, value of supervision, increased need for professional support and unique characteristics of rural and remote clinical supervision. Conclusions: This study has highlighted the value of clinical supervision for the rural and remote health professional workforce. Furthermore, it has shed light on the unique characteristics of clinical supervision in this population. This information can be used by organisations and health professionals to ensure clinical supervision partnerships are effective thereby enhancing rural and remote workforce recruitment and retention. [ABSTRACT FROM AUTHOR]

Bullying in schools is associated with an extensive public health burden. Bullying is intentional and goal oriented aggressive behavior in which the perpetrator exploits an imbalance of power to repeatedly dominate the victim. To differentiate bullying from aggressive behavior, assessment must include a valid measure of power imbalance as perceived by the victim. And yet, to date, there remains no agreement as to how to most accurately measure power imbalance among preadolescent children. This qualitative study explored children’s (age 9 to 11) understanding of power imbalance through thematic analysis of focus group discussions. Subthemes that emerged as influencing power imbalance include: age of victim, peer valued characteristics, and group membership and position. Subthemes of empathy and peer valued characteristics emerged as protecting against the negative impact of power imbalance. [ABSTRACT FROM AUTHOR]

From the late 1970s Australian governments (led in turn by Malcolm Fraser and Bob Hawke) expected New Caledonia to become independent. France responded with suspicion. From 1983, however, reformist governments in Australia and France took apparently converging views. But tensions rose because of unrest in New Caledonia and conflict over French nuclear testing. Australia’s limited capacity to influence developments waned further in 1986 when Jacques Chirac became French prime minister and countered the Kanak nationalist movement. Foreign Minister Bill Hayden favoured moderating Australia’s position, but the issue became moot in mid-1988 when the rival forces in New Caledonia agreed to the truce embodied in the Matignon Accords. The different approaches of the Fraser and Hawke governments reflected philosophical differences, the personal stance of key players, influences from their political movements, and the challenges of changing circumstances. Decades later, with a referendum due by November 2018, Australia’s approach is likely to be cautious. [ABSTRACT FROM PUBLISHER]

This article gives an overview of the involvement of Australia, New Zealand and Fiji in peacekeeping operations with attention to motives, experience and ‘lessons learnt’. Australia and New Zealand have been strongly influenced by regional considerations and an understanding of good international citizenship. Fiji’s contribution has been determined less by regional considerations and more by its position as a small developing country whose peacekeeping activities bring economic benefits, although it could be argued that by providing a basis for extending military forces they have contributed indirectly to political instability. Police contributions have been increasingly important to Australia and New Zealand and they have advocated a stronger role for police in other situations around the world. [ABSTRACT FROM AUTHOR]

Regionalism in Oceania emerged in a context shaped both by the decolonisation movement as well as the Cold War, the dynamics of which are still being played out today. This article considers two cases of particular interest in current regional politics which illustrate a number of important contradictions in conventional approaches to the analysis of colonialism. The first involves the two larger French territories in the region – New Caledonia and French Polynesia – which have recently been admitted to full membership of the Pacific Islands Forum despite falling short of the technical requirements for such membership, namely independent status. The second concerns Indonesia’s claim to sovereignty over West Papua. Although this claim has been recognised in international law since 1969, its basis is highly suspect and Indonesia’s record from the start is arguably tantamount to a repressive form of colonialism enabled by the United Nations itself. Placed in comparative perspective, these cases invite us to reconsider just what colonialism on the one hand and self-determination on the other really mean in the contemporary period. [ABSTRACT FROM PUBLISHER]

The term ‘arc of instability’ was first used in 1999 to describe the security challenges facing the South Pacific. It subsequently came to dominate Australian political discourse, although its veracity was critiqued. This article considers how Australia's political discourse about the region has evolved since 1999 and what impact this has had on Australia's relationships in the region. It begins by outlining why the arc of instability characterization emerged and how it contributed to the securitization of the South Pacific, which justified Australia's policy of new interventionism in the region. It concludes by considering whether it might be time to recharacterize the region as an ‘arc of opportunity’. This recharacterization may shift the political discourse to focus on the South Pacific's potential and opportunities, desecuritize Australia's relationship with the region and diffuse concerns about continued Australian intervention by articulating a more cooperative approach. [ABSTRACT FROM PUBLISHER]

From 1945, consistent with its broader South Pacific ambitions, Australia sought to strengthen its economic position in New Caledonia. The leaders of the European-descended ‘Caledonian’ community wanted economic autonomy for the territory and improved trade with Australia. Yet the opportunity proved illusory. France remained committed to imperial preference and economic dominance. Its revival was underwritten by Marshall Plan aid, including in New Caledonia. Australia failed to provide enough of the coal that appeared to offer economic influence. In the 1950s the Melanesians gained the vote, and the Caledonians lost political power. Conservative governments in Australia showed less interest than their Labor predecessors. Australia would have welcomed an economically autonomous New Caledonia with close Australian links, but this idea clashed with France's centralist and unitary traditions. In the tension between New Caledonia's geography and its history, France had ensured that history won. [ABSTRACT FROM PUBLISHER]

Oceania, with the exception of New Zealand, has received little comparative attention in studies of electoral reform. This article uses evidence from Fiji, Tonga, Papua New Guinea and Nauru, as well as New Zealand and Australia, in order to: understand the process of electoral reform at national and regional levels; examine variation in the process and consider whether theories of electoral reform from elsewhere apply to Oceania. It finds that electoral reform is a highly complex process that is influenced by the self-interest of parties, democratic values and diffusion. 除了新西兰，不大有人从比较选举改革的角度关注大洋洲。本文使用斐济、汤加、巴布亚新几内亚、瑙鲁以及新西兰和澳大利亚的资料，目的是在国家和地区的层面上理解选举改革的过程；探讨过程中的变异，并思考其他地方的选举改革理论是否适用于大洋洲。 [ABSTRACT FROM AUTHOR]