Search

Community-based primary care, such as general practice (GP) or urgent care, serves as the primary point of access to healthcare for most Australians and New Zealanders. Coronavirus disease 2019 (COVID-19) has created significant and ongoing disruptions to primary care. Traditional research methods have contributed to gaps in understanding the experiences of primary care workers during the pandemic. This paper describes a novel research design and method that intended to capture the evolving impact of the COVID-19 pandemic on primary care workers in Australia and New Zealand. Recurrent, rapid cycle surveys were fielded from May 2020 through December 2021 in Australia, and May 2020 through February 2021 in New Zealand. Rapid survey development, fielding, triangulated analysis and dissemination of results allowed close to real-time communication of relevant issues among general practice workers, researchers and policy-makers. A conceptual model is presented to support longitudinal analysis of primary care worker experiences during the COVID-19 pandemic in Australia and New Zealand, and key learnings from applying this novel method are discussed. This paper will assist future research teams in development and execution of policy-relevant research in times of change and may inform further areas of interest for COVID-19 research in primary care. [ABSTRACT FROM AUTHOR]

Simple Summary: The dairy industry in Australia and New Zealand is pasture-based, therefore, monitoring failed transfer of passive immunity (FTPI) is challenging. This study involved a systematic literature search and meta-analysis of papers reporting FTPI data from dairy calves within eight days of birth in Australia and New Zealand, until the end of 2022. An overall prevalence of 33% of FTPI in dairy calves in Australasia and a prevalence of 38% at the farm level were calculated from the meta-analysis, comparable to rates observed elsewhere. Factors, such as the frequency of calf removal from the calving area, time of the first colostrum feed after birth, colostrum volume and quality, and other management practices, were found to play a significant role in FTPI in Australasia. Monitoring and minimizing the prevalence of failed transfer of passive immunity (FTPI) in dairy replacement calves within the first week of life is crucial for calf health and farm profitability. In this study, a systematic literature search and meta-analysis were conducted on papers reporting the prevalence of FTPI in calves from pasture-based dairy farms in Australia and New Zealand. Two search methods, a "traditional method" and a "search engine method", were conducted to identify published studies on FTPI in Australia and New Zealand. Data from a total of 13,430 calves from eight studies in Australasia were included in the analysis for FTPI within 8 days of birth. The meta-analysis revealed that the average prevalence of FTPI was 33% across the two countries, with the lowest FTPI (9%) in Western Australia and the highest FTPI (59%) in New Zealand. Using farm data from three studies, the average prevalence of FTPI at the farm level in Australasia was 38%, with the lowest prevalence found in a farm in South Australia (6%). In conclusion, the meta-analysis confirmed the need for good management of cows and newborn calves after birth in pasture-based systems to reduce FTPI in calves. Collecting newborn calves from pasture at least twice per day after birth and providing colostrum of sufficient quantity and quality as soon as possible were the best practices for preventing FTPI in Australasian dairy systems. [ABSTRACT FROM AUTHOR]

Introduction: Rural doctors typically work in low resource settings and with limited professional support. They are sometimes pushed to the limits of their usual scope of practice to provide the medical care needed by their community. In a previous phenomenological study, we described the concept of clinical courage as underpinning rural doctors' work in this context. In this paper, we draw on rural doctors' experiences during the unfolding COVID pandemic to re examine our understanding of the attributes of clinical courage. Methods: Semi structured interviews were conducted with rural doctors from 11 countries who had experience preparing for or managing patients with COVID 19. Interviews were transcribed verbatim and coded using NVivo. A deductive thematic analysis was undertaken to identify common ideas and responses related to the features of clinical courage. Results: Thirteen interviews from rural doctors during the unfolding COVID 19 pandemic affirmed and enriched our understanding of the attributes of clinical courage, particularly the leadership role rural doctors can have within their communities. Conclusion: This study extended our understanding that rural doctors' experience of clinical courage is consistent amongst participants in many parts of the world, including developing countries. [ABSTRACT FROM AUTHOR]

Background: Primary healthcare services have principal responsibility for providing child and youth wellbeing and mental health services, but have lacked appropriate measurement instruments to assess the wellbeing of Indigenous children and youth or to evaluate the effectiveness of programs and services designed to meet their needs. This review assesses the availability and characteristics of measurement instruments that have been applied in primary healthcare services in Canada, Australia, New Zealand and the United States (CANZUS countries) to assess the wellbeing of Indigenous children and youth. Methods: Fifteen databases and 12 websites were searched in December 2017 and again in October 2021. Pre-defined search terms pertained to Indigenous children and youth, CANZUS country names, and wellbeing or mental health measures. PRISMA guidelines were followed, with eligibility criteria guiding screening of titles and abstracts, and selected full-text papers. Results are presented based on the characteristics of documented measurement instruments assessed according to five desirability criteria: development for Indigenous youth populations, adherence to relational strength-based constructs, administration by child and or youth self-report, reliability and validity, and usefulness for identifying wellbeing or risk levels. Results: Twenty-one publications were found that described the development and or use by primary healthcare services of 14 measurement instruments, employed across 30 applications. Four of the 14 measurement instruments were developed specifically for Indigenous youth populations, four focused solely on strength-based wellbeing concepts but none included all Indigenous wellbeing domains. Conclusion: There is a diversity of measurement instruments available, but few fit our desirability criteria. Although it is possible that we missed relevant papers and reports, this review clearly supports the need for further research to develop, refine or adapt instruments cross-culturally to measure the wellbeing of Indigenous children and youth. [ABSTRACT FROM AUTHOR]

Simple Summary: Crofton weed toxicity, caused by Ageratina adenophora, has been recognized as a cause of fatal lung disease in horses for over a century. Despite its impact on horse health in many areas of the world, the toxic syndrome is poorly understood and understudied. This paper looks at the prior research on weed biology, the potential toxicology mechanisms, and the pathology in horses and other species, as well as the future directions to improve our understanding of this fatal toxic weed affecting horses. Crofton weed (Ageratina adenophora) is a global and highly invasive weed, with ingestion causing severe respiratory disease in horses, leading to irreversible and untreatable pulmonary fibrosis and oedema. While reports of equine pneumotoxicity remain common in Australia and New Zealand, equine pneumotoxicity may be underdiagnosed in other countries where Crofton weed is endemic but poorly differentiated. The pathogenesis of Crofton weed toxicity following ingestion has been well described in a number of different animal models, including rodents, rabbits, and goats. However, induced toxicity is organ-selective across different animal species, and these vastly differ from the pathogenesis described in horses, both clinically and after experimental exposure. Sources of variation may include species-specific susceptibility to different toxins present in the plant, different mechanistic processes of toxicity, and species differences in toxin biotransformation and bioactivation across different organs. Considering disease severity and Crofton weed's invasiveness globally, assessing published toxicological and exposure data is necessary to advance research, identify specific toxins for horses, and possible prophylactic and therapeutic strategies. This review presents an overview of the available literature on equine toxicity, parallels between toxicity in horses and other animal species, and important aspects to be included in the future research agenda. [ABSTRACT FROM AUTHOR]

Background: There is limited research into how midwives use social media within their professional role. Small pilot studies have explored the introduction of social media into maternity practice and teaching but there is little evidence around how midwives use social media professionally. This is important as 89% of pregnant women turn to social media for advice during pregnancy, and how midwives use social media could be influencing women, their perception of birth and their decision making. Methods: Aim: To analyse how popular midwives portray birth on the social media platform Instagram. This is an observational mixed methods study using content analysis. Five 'popular' midwives from each country (UK, New Zealand, USA and Australia) were identified and their posts about birth collated from a one-year period (2020–21). Images/videos were then coded. Descriptive statistics enabled comparison of the posts by country. Categorisation was used to analyse and understand the content. Results: The study identified 917 posts from the 20 midwives' accounts, containing 1216 images/videos, with most coming from USA (n = 466), and UK (n = 239), Australia (n = 205) and New Zealand (n = 7) respectively. Images/videos were categorised into 'Birth Positivity', 'Humour', 'Education', 'Birth Story' and 'Advertisement'. Midwives' portrayals of birth represented a greater proportion of vaginal births, waterbirths and homebirths than known national birth statistics. The most popular midwives identified mainly had private businesses (n = 17). Both the midwives and women portrayed in images were primarily white, demonstrating a disproportionate representation. Conclusion: There is a small midwifery presence on Instagram that is not representative of the broader profession, or the current picture of midwifery care. This paper is the first study to explore how midwives are using the popular social media platform Instagram to portray birth. It provides insight into how midwives post an un-medicalised, low risk representation of birth. Further research is recommended to explore midwives' motivation behind their posts, and how pregnant and postnatal women engage with social media. [ABSTRACT FROM AUTHOR]

Background: International and migrant students face specific challenges which may impact their mental health, well-being and academic outcomes, and these may be gendered experiences. The purpose of this scoping review was to map the literature on the challenges, coping responses and supportive interventions for international and migrant students in academic nursing programs in major host countries, with a gender lens. Methods: We searched 10 databases to identify literature reporting on the challenges, coping responses and/or supportive interventions for international and migrant nursing students in college or university programs in Canada, the United-States, Australia, New Zealand or a European country. We included peer-reviewed research (any design), discussion papers and literature reviews. English, French and Spanish publications were considered and no time restrictions were applied. Drawing from existing frameworks, we critically assessed each paper and extracted information with a gender lens. Results: One hundred fourteen publications were included. Overall the literature mostly focused on international students, and among migrants, migration history/status and length of time in country were not considered with regards to challenges, coping or interventions. Females and males, respectively, were included in 69 and 59% of studies with student participants, while those students who identify as other genders/sexual orientations were not named or identified in any of the research. Several papers suggest that foreign-born nursing students face challenges associated with different cultural roles, norms and expectations for men and women. Other challenges included perceived discrimination due to wearing a hijab and being a 'foreign-born male nurse', and in general nursing being viewed as a feminine, low-status profession. Only two strategies, accessing support from family and other student mothers, used by women to cope with challenges, were identified. Supportive interventions considering gender were limited; these included matching students with support services' personnel by sex, involving male family members in admission and orientation processes, and using patient simulation as a method to prepare students for care-provision of patients of the opposite-sex. Conclusion: Future work in nursing higher education, especially regarding supportive interventions, needs to address the intersections of gender, gender identity/sexual orientation and foreign-born status, and also consider the complexity of migrant students' contexts. [ABSTRACT FROM AUTHOR]

Background: Pacific people living in New Zealand, Australia, United States, and the Pacific region continue to experience a disproportionately high burden of long-term conditions, making culturally contextualised behaviour change interventions a priority. The primary aim of this study was to describe the characteristics of behaviour change interventions designed to improve health and effect health behaviour change among Pacific people.Methods: Electronic searches were carried out on OVID Medline, PsycINFO, PubMed, Embase and SCOPUS databases (initial search January 2019 and updated in January 2020) for studies describing an intervention designed to change health behaviour(s) among Pacific people. Titles and abstracts of 5699 papers were screened; 201 papers were then independently assessed. A review of full text was carried out by three of the authors resulting in 208 being included in the final review. Twenty-seven studies were included, published in six countries between 1996 and 2020.Results: Important characteristics in the interventions included meaningful partnerships with Pacific communities using community-based participatory research and ensuring interventions were culturally anchored and centred on collectivism using family or social support. Most interventions used social cognitive theory, followed by popular behaviour change techniques instruction on how to perform a behaviour and social support (unspecified). Negotiating the spaces between Eurocentric behaviour change constructs and Pacific worldviews was simplified using Pacific facilitators and talanoa. This relational approach provided an essential link between academia and Pacific communities.Conclusions: This systematic search and narrative synthesis provides new and important insights into potential elements and components when designing behaviour change interventions for Pacific people. The paucity of literature available outside of the United States highlights further research is required to reflect Pacific communities living in New Zealand, Australia, and the Pacific region. Future research needs to invest in building research capacity within Pacific communities, centering self-determining research agendas and findings to be led and owned by Pacific communities. [ABSTRACT FROM AUTHOR]

Background: Given the persistence of Indigenous health inequities across national contexts, many countries have adopted strategies to improve the health of Indigenous peoples. Governmental recognition of the unique health needs of Indigenous populations is necessary for the development of targeted programs and policies to achieve universal health coverage. At the same time, the participation of Indigenous peoples in decision-making and program and policy design helps to ensure that barriers to health services are appropriately addressed and promotes the rights of Indigenous peoples to self-determination. Due to similar patterns of Indigenous health and health determinants across borders, there have been calls for greater global collaboration in this field. However, most international studies on Indigenous health policy link Anglo-settler democracies (Canada, Australia, Aotearoa/New Zealand and the United States), despite these countries representing a small fraction of the world's Indigenous people. Aim: This paper examines national-level policy in Australia, Brazil, Chile and New Zealand in relation to governmental recognition of differential Indigenous health needs and engagement with Indigenous peoples in health. The paper aims to examine how Indigenous health needs and engagement are addressed in national policy frameworks within each of the countries in order to contribute to the understanding of how to develop pro-equity policies within national health care systems. Methods: For each country, a review was undertaken of national policies and legislation to support engagement with, and participation of, Indigenous peoples in the identification of their health needs, development of programs and policies to address these needs and which demonstrate governmental recognition of differential Indigenous health needs. Government websites were searched as well as the following databases: Google, OpenGrey, CAB Direct, PubMed, Web of Science and WorldCat. Findings: Each of the four countries have adopted international agreements regarding the engagement of Indigenous peoples in health. However, there is significant variation in the extent to which the principles laid out in these agreements are reflected in national policy, legislation and practice. Brazil and New Zealand both have established national policies to facilitate engagement. In contrast, national policy to enable engagement is relatively lacking in Australia and Chile. Australia, Brazil and New Zealand each have significant initiatives and policy structures in place to address Indigenous health. However, in Brazil this is not necessarily reflected in practice and although New Zealand has national policies these have been recently reported as insufficient and, in fact, may be contributing to health inequity for Māori. In comparison to the other three countries, Chile has relatively few national initiatives or policies in place to support Indigenous engagement or recognise the distinct health needs of Indigenous communities. Conclusions: The adoption of international policy frameworks forms an important step in ensuring that Indigenous peoples are able to participate in the formation and implementation of health policy and programs. However, without the relevant principles being reflected in national legislature, international agreements hold little weight. At the same time, while a national legislative framework facilitates the engagement of Indigenous peoples, such policy may not necessarily translate into practice. Developing multi-level approaches that improve cohesion between international policy, national policy and practice in Indigenous engagement in health is therefore vital. Given that each of the four countries demonstrate strengths and weaknesses across this causal chain, cross-country policy examination provides guidance on strengthening these links. [ABSTRACT FROM AUTHOR]

Background: Cultural differences between health professionals and Indigenous peoples contribute to health inequalities, and effective cross-cultural communication and person-centred healthcare are critical remedial elements. Community pharmacists can play a significant role by reducing medication-related problems through medication reviews, yet barriers to access include cultural and linguistic challenges. The Indigenous Medication Review Service (IMeRSe) aimed to address these barriers via a culturally responsive intervention. The aim of this paper is to present the cross-cultural training framework developed as a component of this intervention and the feasibility evaluation of the first stage of the training framework. Methods: A training framework was developed, emphasising pharmacists' skills and confidence in effective cross-cultural communication and relationship-building with Indigenous Australians (Please note that the use of the term 'Indigenous' in this manuscript includes all Aboriginal and Torres Strait Islander people and acknowledges their rich traditions and heterogenous cultures) across three stages: (1) online and workshop-based, covering Indigenous history and health, cross-cultural communication and a holistic, strengths-based approach to intervention delivery; (2) orientation to local Aboriginal Health Services, community and cultural protocols; and (3) ongoing mentoring. The feasibility evaluation of the first stage included the following: self-reported levels of cultural capability, cultural confidence and skills, motivators and barriers to working with Indigenous Australians, assessed pre- and post-training. Participants completed self-administered questionnaires including a 22-item validated Cultural Capability Measurement Tool. Paired t tests assessed change in mean scores of Likert scale data. Results: Stage 1 development resulted in an 8.5-h standardised cross-cultural training programme tested with 39 pharmacists working across urban and rural/remote Australia. Thirty-six pharmacists completed the feasibility evaluation (75.7% female, all non-Indigenous, 75.7% never attended prior cross-cultural training). Participants reported overall acceptability with training; the majority perceived it added value to their practice. Improved cultural capability post-training was reflected in increased scores for 21/22 items, nine reaching statistical significance. There were significant improvements for all 26 confidence and skills statements, and selected motivational and barrier statements, particularly participants role in improving Indigenous health outcomes and cross-cultural communication. Conclusions: This study provides preliminary evidence that the training programme was feasible to deliver and prepared pharmacists to deliver a culturally responsive medication review intervention. The online knowledge-based modules and face-to-face workshops provide a standardised framework for larger-scale implementation of the intervention training. Trial registration: Australia and New Zealand Clinical Trials Registry ACTRN12618000188235.Prospectively registered 22 January 2018. [ABSTRACT FROM AUTHOR]

Optimal nutrition care is important in the management of cystic fibrosis (CF). This paper summarises the '2017 Nutrition Guidelines for Cystic Fibrosis in Australia and New Zealand (NZ)'. CF dietitians formulated 68 practice questions which were used to guide a systematic literature search and review of the evidence for nutrition in CF. Identified papers underwent quality and evidence assessment using the American Dietetic Association quality criteria checklist and the National Health and Medical Research Council of Australia (NHMRC) rankings. Evidence statements, graded recommendations and practice points were developed covering core nutrition topics (assessment and nutrition interventions including oral, enteral and micronutrient supplementation); nutrition-related co-morbidities (including pancreatic insufficiency, CF-related diabetes, bone health and distal intestinal obstruction syndrome); and key new topic areas (genetic modulator therapies, overweight/obesity and complementary therapies). This paper showcases highlights from the guidelines, focussing on new topic areas and geographic and climate considerations for vitamin D, salt and hydration. • This paper summarises the 2017 Nutrition guidelines for CF for Australia and NZ • A systematic approach to evidence appraisal and guideline development was used • Nutrition assessment, nutrition support and micronutrient supplementation are covered • Nutrition-related topics including CF-related co-morbidities and PERT are covered • Novel topic areas include genetic modulators, overweight/obesity and probiotics [ABSTRACT FROM AUTHOR]

A recent report by the Foundation for Young Australians that derived from an analysis of 4.2 million job advertisements in Australia from 2012 to 2015, revealed that the demand for professionals possessing creative problem-solving skills grew by 249%. This paper reflects on the successes of engineering educators in developing creative graduates and discusses the means to instil the skills of creative problem-solving. It considers research evidence of the suitability of heuristics (methods) for problem framing and idea generation that are sourced from the Theory of Inventive Problem Solving (TRIZ) for enhancing the creative problem-solving skills of engineering students. Twelve TRIZ heuristics are considered. A repository of TRIZ educatinal materials (TRIZ Repository) is introduced. The outcomes of four studies from Australia, Hong Kong and New Zealand that embedded educational materials offered by the TRIZ Repository into existing courses are presented. This paper concludes that TRIZ heuristics are suitable for embedding into courses that require students to tackle open-ended problems. As demonstrated by the studies, even one class devoted to a TRIZ heuristic can statistically significantly enhance students' creative problem-solving self-efficacy. The TRIZ Repository of educational materials may enable many engineering educators to instil creative problem-solving into their courses. [ABSTRACT FROM AUTHOR]

Objective: Professional sport occupies a prominent cultural position in societies across the globe and commercial organisations make use of this to promote their products. The present scoping review explores existing academic literature on the relationship between professional sports clubs and food and drink marketing and considers how this relationship may impact upon the public's health.Design: The scoping review searched six databases. Experts were also consulted. Records written in languages other than English were excluded. We also excluded records relating to mega events (e.g. Olympics, Football World Cup) and alcohol marketing, because of the attention already given to these.Setting: Professional sports clubs.Results: We identified 18 166 titles, reviewed 163 abstracts and read twenty-six full texts. We included six papers in the review. Four were from Australia and New Zealand. The Australasian literature focused largely on the marketing of foods and beverages to children and the potential impact on consumption. Single papers from researchers in Turkey and the USA were identified. The Turkish paper analysed shirt sponsorship in football leagues internationally and showed food and beverage (including alcohol) companies were the most common sponsors. The US paper examined a mixed reaction to a football team named after an energy drink.Conclusions: Commercial relationships between professional sports clubs and Big Food corporations have largely eluded scrutiny in much of the world. The current review highlights the lack of public health research on these relationships. Research exploring the interdependent commercial practices of food and drink companies and professional sports clubs is urgently needed. [ABSTRACT FROM AUTHOR]

This paper presents experimental and numerical investigations into the post-fire cross-section compressive behaviour and resistances of circular recycled aggregate concrete-filled stainless steel tube (RACFSST) stub columns. Twelve stub column specimens, fabricated from concretes with three recycled coarse aggregate replacement ratios (0%, 35% and 70%), were tested after exposure to the ISO-834 standard fire for 0 min (i.e. at ambient temperature), 15 min, 30 min and 45 min. The experimental investigation included heating and cooling of specimens, cylinder tests and post-fire tensile coupon tests and stub column tests. The test results, including load–end shortening curves, failure loads and failure modes, were fully reported and the initial compressive stiffnesses and confinement effect were discussed. The numerical investigation was subsequently conducted, where thermal and mechanical finite element models were developed and validated against the test results and then used to perform parametric studies to generate further numerical data. Given the absence of design codes for stainless steel–recycled aggregate concrete composite structures after exposure to fire, the relevant design rules for circular natural aggregate concrete-filled carbon steel tube stub columns at ambient temperature, as set out in the European code, Australia/New Zealand standard and American specification, were assessed, using post-fire material properties, for their applicability to circular RACFSST stub columns after exposure to fire, based on the test and numerical data. The assessment results generally revealed that the European code and the Australian/New Zealand standard led to an acceptable level of design accuracy and consistency, while the American specification resulted in rather conservative and scattered post-fire cross-section compression resistance predictions. • The compressive behaviour of circular RACFSST stub columns after exposure to fire is investigated. • Post-fire compression tests on twelve circular RACFSST stub column specimens are conducted. • The influences of heating durations and RCA replacement ratios are analysed. • Thermal and mechanical FE models are validated against test results and then used to conduct parametric studies. • The relevant design codes are assessed against the test and FE data. [ABSTRACT FROM AUTHOR]

Background: This paper aimed to describe the airway practices of intensive care units (ICUs) in Australia and New Zealand specific to patients presenting with COVID-19 and to inform whether consistent clinical practice was achieved. Specific clinical airway guidelines were endorsed in March 2020 by the Australian and New Zealand Intensive Care Society (ANZICS) and College of Intensive Care Medicine (CICM). Methods and findings: Prospective, structured questionnaire for all ICU directors in Australia and New Zealand was completed by 69 ICU directors after email invitation from ANZICS. The online questionnaire was accessible for three weeks during September 2020 and analysed by cloud-based software. Basic ICU demographics (private or public, metropolitan or rural) and location, purchasing, airway management practices, guideline uptake, checklist and cognitive aid use and staff training relevant to airway management during the COVID-19 pandemic were the main outcome measures. The 69 ICU directors reported significant simulation-based inter-professional airway training of staff (97%), and use of video laryngoscopy (94%), intubation checklists (94%), cognitive aids (83%) and PPE "spotters" (89%) during the airway management of patients with COVID-19. Tracheal intubation was almost always performed by a Specialist (97% of ICUs), who was more likely to be an intensivist than an anaesthetist (61% vs 36%). There was a more frequent adoption of specific airway guidelines for the management of COVID-19 patients in public ICUs (94% vs 71%) and reliance on specialist intensivists to perform intubations in private ICUs (92% vs 53%). Conclusion: There was a high uptake of a standardised approach to airway management in COVID-19 patients in ICUs in Australia and New Zealand, likely due to endorsement of national guidelines. [ABSTRACT FROM AUTHOR]

Background: Active surveillance (AS) is the disease management option of choice for low-risk prostate cancer. Despite this, men with low-risk prostate cancer (LRPC) find management decisions distressing and confusing. We developed Navigate, an online decision aid to help men and their partners make management decisions consistent with their values. The aims are to evaluate the impact of Navigate on uptake of AS; decision-making preparedness; decisional conflict, regret and satisfaction; quality of illness communication; and prostate cancer-specific quality of life and anxiety. In addition, the healthcare cost impact, cost-effectiveness and patterns of use of Navigate will be assessed. This paper describes the study protocol.Methods: Three hundred four men and their partners are randomly assigned one-to-one to Navigate or to the control arm. Randomisation is electronically generated and stratified by site. Navigate is an online decision aid that presents up-to-date, unbiased information on LRPC tailored to Australian men and their partners including each management option and potential side-effects, and an interactive values clarification exercise. Participants in the control arm will be directed to the website of Australia's peak national body for prostate cancer. Eligible patients will be men within 3 months of being diagnosed with LRPC, aged 18 years or older, and who are yet to make a treatment decision, who are deemed eligible for AS by their treating clinician and who have Internet access and sufficient English to participate. The primary outcome is self-reported uptake of AS as the first-line management option. Secondary outcomes include self-reported preparedness for decision-making; decisional conflict, regret and satisfaction; quality of illness communication; and prostate cancer-specific quality of life. Uptake of AS 1 month after consent will be determined through patient self-report. Men and their partners will complete study outcome measures before randomisation and 1, 3 and 6 months after study consent.Discussion: The Navigate online decision aid has the potential to increase the choice of AS in LRPC, avoiding or delaying unnecessary radical treatments and associated side effects. In addition, Navigate is likely to reduce patients' and partners' confusion and distress in management decision-making and increase their quality of life.Trial Registration: Australian and New Zealand Clinical Trial Registry ACTRN12616001665426 . Registered on 2 December 2016. All items from the WHO Trial Registration Data set can be found in this manuscript. [ABSTRACT FROM AUTHOR]

Background: Indigenous children living in high income countries have a consistently high prevalence of mental health problems. We aimed to identify psychosocial risk and protective factors for mental health in this setting. Methods: A systematic review of studies published between 1996 and 2016 that quantitatively evaluated the association between psychosocial variables and mental health among Indigenous children living in high income countries was conducted. Psychosocial variables were grouped into commonly occurring domains. Individual studies were judged to provide evidence for an association between a domain and either good mental health, poor mental health, or a negligible or inconsistent association. The overall quality of evidence across all studies for each domain was assessed using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) guidelines. Results: Forty-seven papers were eligible (mainland US 30 [64%], Canada 8 [17%], Australia 7 [15%], Hawaii 4 [9%]), including 58,218 participants aged 4-20 years. Most papers were cross-sectional (39, 83%) and measured negative mental health outcomes (41, 87%). Children's negative cohesion with their families and the presence of adverse events appeared the most reliable predictors of increased negative mental health outcomes. Children's substance use, experiences of discrimination, comorbid internalising symptoms, and negative parental behaviour also provided evidence of associations with negative mental health outcomes. Positive family and peer relationships, high self-esteem and optimism were associated with increased positive mental health outcomes. Conclusions: Quantitative research investigating Indigenous children's mental health is largely cross-sectional and focused upon negative outcomes. Indigenous children living in high income countries share many of the same risk and protective factors associated with mental health. The evidence linking children's familial environment, psychological traits, substance use and experiences of discrimination with mental health outcomes highlights key targets for more concerted efforts to develop initiatives to improve the mental health of Indigenous children. [ABSTRACT FROM AUTHOR]

Background: People living in rural and remote communities commonly experience significant health disadvantages. Geographical barriers and reduced specialist and generalist services impact access to care when compared with metropolitan context. Innovative models of care have been developed for people living with chronic diseases in rural areas with the goal of overcoming these inequities. The aim of this paper was to describe the characteristics and outcomes of studies investigating innovative models of care for people living with chronic disease in rural areas of developed countries where a metropolitan comparator was included.Methods: An integrative systematic review was undertaken. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method was used to understand the empirical and theoretical data on clinical outcomes for people living with chronic disease in rural compared with metropolitan contexts and their models of care in Australia, New Zealand, United States, Canada and the United Kingdom.Results: Literature searching revealed 620 articles published in English between 1st January 2000 and 31st March 2019. One hundred sixty were included in the review including 68 from the United States, 59 from Australia and New Zealand (5), 21 from Canada and 11 from the United Kingdom and Ireland. 53% (84) focused on cardiovascular disease; 27% (43) diabetes mellitus; 8% (12) chronic obstructive pulmonary disease; and 13% (27) chronic kidney disease. Mortality was only reported in 10% (16) of studies and only 18% (29) reported data on Indigenous populations.Conclusions: This integrated review reveals that the published literature on common chronic health issues pertaining to rural and remote populations is largely descriptive. Only a small number of publications focus on mortality and comparative health outcomes from health care models in both urban and non-urban populations. Innovative service models and telehealth are together well represented in the published literature but data on health outcomes is relatively sparse. There is significant scope for further directly comparative studies detailing the effect of service delivery models on the health outcomes of urban and rural populations. We believe that such data would further knowledge in this field and help to break the deadly synergy between increased rurality and poorer outcomes for people with chronic disease. [ABSTRACT FROM AUTHOR]

Background: Since the early 90s, patient navigation programs were introduced in the United States to address inequitable access to cancer care. Programs have since expanded internationally and in scope. The goals of patient navigation programs are to: a) link patients and families to primary care services, specialist care, and community-based health and social services (CBHSS); b) provide more holistic patient-centred care; and, c) identify and resolve patient barriers to care. This paper fills a gap in knowledge to reveal what is known about motivators and factors influencing implementation and maintenance of patient navigation programs in primary care that link patients to CBHSS. It also reports on outcomes from these studies to help identify gaps in research that can inform future studies.Methods: This scoping literature review involved: i) electronic database searches; ii) a web site search; iii) a search of reference lists from literature reviews; and, iv) author follow up. It included papers from Canada, the United States, the United Kingdom, Australia, New Zealand, and/or Western Europe published between January 1990 and June 2013 if they discussed navigators or navigation programs in primary care settings that linked patients to CBHSS.Results: Of 34 papers, most originated in the United States (n = 29) while the remainder were from the United Kingdom, Canada and Australia. Motivators for initiating navigation programs were to: a) improve delivery of health and social care services; b) support and manage specific health needs or specific population needs, and; c) improve quality of life and wellbeing of patients. Eleven factors were found to influence implementation and maintenance of these patient navigation programs. These factors closely aligned with the Diffusion of Innovation in Service Organizations model, thus providing a theoretical foundation to support them. Various positive outcomes were reported for patients, providers and navigators, as well as the health and social care system, although they need to be considered with caution since the majority of studies were descriptive.Conclusions: This study contributes new knowledge that can inform the initiation and maintenance of primary care patient navigation programs that link patients with CBHSS. It also provides directions for future research. [ABSTRACT FROM AUTHOR]

Long-term air temperature prediction is of major importance in a large number of applications, including climate-related studies, energy, agricultural, or medical. This paper examines the performance of two Machine Learning algorithms (Support Vector Regression (SVR) and Multi-layer Perceptron (MLP)) in a problem of monthly mean air temperature prediction, from the previous measured values in observational stations of Australia and New Zealand, and climate indices of importance in the region. The performance of the two considered algorithms is discussed in the paper and compared to alternative approaches. The results indicate that the SVR algorithm is able to obtain the best prediction performance among all the algorithms compared in the paper. Moreover, the results obtained have shown that the mean absolute error made by the two algorithms considered is significantly larger for the last 20 years than in the previous decades, in what can be interpreted as a change in the relationship among the prediction variables involved in the training of the algorithms. [ABSTRACT FROM AUTHOR]

The Bureau of Meteorology Atmospheric high-resolution Regional Reanalysis for Australia (BARRA) is the first atmospheric regional reanalysis over a large region covering Australia, New Zealand, and Southeast Asia. The production of the reanalysis with approximately 12 km horizontal resolution – BARRA-R – is well underway with completion expected in 2019. This paper describes the numerical weather forecast model, the data assimilation methods, the forcing and observational data used to produce BARRA-R, and analyses results from the 2003–2016 reanalysis. BARRA-R provides a realistic depiction of the meteorology at and near the surface over land as diagnosed by temperature, wind speed, surface pressure, and precipitation. Comparing against the global reanalyses ERA-Interim and MERRA-2, BARRA-R scores lower root mean square errors when evaluated against (point-scale) 2 m temperature, 10 m wind speed, and surface pressure observations. It also shows reduced biases in daily 2 m temperature maximum and minimum at 5 km resolution and a higher frequency of very heavy precipitation days at 5 and 25 km resolution when compared to gridded satellite and gauge analyses. Some issues with BARRA-R are also identified: biases in 10 m wind, lower precipitation than observed over the tropical oceans, and higher precipitation over regions with higher elevations in south Asia and New Zealand. Some of these issues could be improved through dynamical downscaling of BARRA-R fields using convective-scale (<2 km) models. [ABSTRACT FROM AUTHOR]

Objective: We carried out a bibliometric study on the scientific papers related to secondgeneration antipsychotic drugs (SGAs) in Malaysia. Methods: With the SCOPUS database, we selected those documents made in Malaysia whose title included descriptors related to SGAs. We applied bibliometric indicators of production and dispersion, as Price's law and Bradford's law, respectively. We also calculated the participation index of the different countries. The bibliometric data were also been correlated with some social and health data from Malaysia (total per capita expenditure on health and gross domestic expenditure on R&D). Results: We found 105 original documents published between 2004 and 2016. Our results fulfilled Price's law, with scientific production on SGAs showing exponential growth (r = 0.401, vs. r = 0.260 after linear adjustment). The drugs most studied are olanzapine (9 documents), clozapine (7), and risperidone (7). Division into Bradford zones yields a nucleus occupied by the Medical Journal of Malaysia, Singapore Medical Journal, Australian and New Zealand Journal of Psychiatry, and Pharmacogenomics. Totally, 63 different journals were used, but only one in the top four journals had an impact factor being greater than 3. Conclusion: The publications on SGAs in Malaysia have undergone exponential growth, without evidence a saturation point. [ABSTRACT FROM AUTHOR]

Background The Australian and New Zealand Intensive Care Society (ANZICS) Adult Patient Database (APD) collects voluntary data on patient admissions to Australian and New Zealand intensive care units (ICUs). This paper presents an in-depth statistical analysis of risk-adjusted mortality of ICU admissions from 2000 to 2010 for the purpose of identifying ICUs with unusual performance. Methods A cohort of 523, 462 patients from 144 ICUs was analysed. For each ICU, the natural logarithm of the standardised mortality ratio (log-SMR) was estimated from a risk-adjusted, three-level hierarchical model. This is the first time a three-level model has been fitted to such a large ICU database anywhere. The analysis was conducted in three stages which included the estimation of a null distribution to describe usual ICU performance. Log-SMRs with appropriate estimates of standard errors are presented in a funnel plot using 5% false discovery rate thresholds. False coverage-statement rate confidence intervals are also presented. The observed numbers of deaths for ICUs identified as unusual are compared to the predicted true worst numbers of deaths under the model for usual ICU performance. Results Seven ICUs were identified as performing unusually over the period 2000 to 2010, in particular, demonstrating high risk-adjusted mortality compared to the majority of ICUs. Four of the seven were ICUs in private hospitals. Our three-stage approach to the analysis detected outlying ICUs which were not identified in a conventional (single) risk-adjusted model for mortality using SMRs to compare ICUs. We also observed a significant linear decline in mortality over the decade. Distinct yearly and weekly respiratory seasonal effects were observed across regions of Australia and New Zealand for the first time. Conclusions The statistical approach proposed in this paper is intended to be used for the review of observed ICU and hospital mortality. Two important messages from our study are firstly, that comprehensive risk-adjustment is essential in modelling patient mortality for comparing performance, and secondly, that the appropriate statistical analysis is complicated. [ABSTRACT FROM AUTHOR]

Objective The main aim of this study was to explore any association between colorectal cancer (CRC) and rotating shift work in nurses and midwives. The secondary aim of this study was to identify risk factors for CRC in nurses and midwives who are rotating shift workers. Design Cross-sectional study. Setting Electronic survey of participants from Australia, New Zealand and the United Kingdom. Subjects A sample of 8,199 male and female nurses and midwives from Australia, New Zealand and the United Kingdom invited through their registration papers or newsletter advertisement. Main outcome measure Prevalence of CRC in participants who have worked rotating shifts for 1-14 years or ≥15 years compared to participants who have never worked rotating shifts. In addition, risk factors for CRC in the rotating shift work population were analysed in a multivariate logistic regression model in order to obtain odds ratio of CRC. Results No statistically significant difference was found in the prevalence of CRC between those who have never worked rotating shift work, worked 1-14 years and worked 15 or more years. Among rotating shift workers, diabetes was associated with a 123-fold (95% CI 39-392; p<0.001) increased odds of CRC, while Inflammatory Bowel Disease (IBD) was associated with a 190-fold (95%CI 68-526; p<0.001) increased odds of CRC. Screening colonoscopy or sigmoidoscopy for CRC was associated with a 10-fold (95% CI 3-35; p<0.001) increased odds of being diagnosed with CRC. Conclusion No significant association was found between rotating shift work and colorectal cancer in nurses and midwives. In nurses and midwives who are rotating shift workers, diabetes, IBD and CRC screening significantly increased the odds of CRC. [ABSTRACT FROM AUTHOR]

Introduction: Healthcare organisations serve clients from diverse Indigenous and other ethnic and racial groups on a daily basis, and require appropriate client-centred systems and services for provision of optimal healthcare. Despite advocacy for systems-level approaches to cultural competence, the primary focus in the literature remains on competency strategies aimed at health promotion initiatives, workforce development and student education. This paper aims to bridge the gap in available evidence about systems approaches to cultural competence by systematically mapping key concepts, types of evidence, and gaps in research. Methods: A literature search was completed as part of a larger systematic search of evaluations and measures of cultural competence interventions in health care in Canada, the United States, Australia and New Zealand. Seventeen peer-reviewed databases, 13 websites and clearinghouses, and 11 literature reviews were searched from 2002 to 2015. Overall, 109 studies were found, with 15 evaluating systems-level interventions or describing measurements. Thematic analysis was used to identify key implementation principles, intervention strategies and outcomes reported. Results: Twelve intervention and three measurement studies met our inclusion criteria. Key principles for implementing systems approaches were: user engagement, organisational readiness, and delivery across multiple sites. Two key types of intervention strategies to embed cultural competence within health systems were: audit and quality improvement approaches and service-level policies or strategies. Outcomes were found for organisational systems, the client/practitioner encounter, health, and at national policy level. Discussion and implications: We could not determine the overall effectiveness of systems-level interventions to reform health systems because interventions were context-specific, there were too few comparative studies and studies did not use the same outcome measures. However, examined together, the intervention and measurement principles, strategies and outcomes provide a preliminary framework for implementation and evaluation of systems-level interventions to improve cultural competence. Identified gaps in the literature included a need for cost and effectiveness studies of systems approaches and explication of the effects of cultural competence on client experience. Further research is needed to explore the extent to which cultural competence improves health outcomes and reduces ethnic and racially-based healthcare disparities. [ABSTRACT FROM AUTHOR]

This paper discusses the rationale behind the redefinition of the design gust speed in the Australian/New Zealand Standard for Wind Actions, AS/NZS 1170.2, as one with a duration of 0.2 seconds, based on a moving average of that time. The origin of the basic gust in the Australian Standards since 1971, from the Dines anemometer, is discussed, and the relative response of that anemometer to gusts is compared with the current recording system based on cup anemometers, with digital processing including a moving average filter. The cup anemometers in the automatic weather stations (AWS), with the associated 3-second digital averaging, that have replaced the Dines in Australia, since the early 1990s, are shown to significantly attenuate the high frequency wind fluctuations, and hence record lower gust wind speeds. The correction factors provided in the paper for the post-1990 gusts should be applied by writers of future editions of the standard wishing to use AWS data. It should be noted that users of the standard will not be affected by the redefinition as there will be no changes to either the wind speeds or the shape factors. [ABSTRACT FROM AUTHOR]

Background: Waiting lists for treatment are common in outpatient and community services, Existing methods for managing access and triage to these services can lead to inequities in service delivery, inefficiencies and divert resources from frontline care. Evidence from two controlled studies indicates that an alternative to the traditional "waitlist and triage" model known as STAT (Specific Timely Appointments for Triage) may be successful in reducing waiting times without adversely affecting other aspects of patient care. This trial aims to test whether the model is cost effective in reducing waiting time across multiple services, and to measure the impact on service provision, health-related quality of life and patient satisfaction.Methods/design: A stepped wedge cluster randomised controlled trial has been designed to evaluate the impact of the STAT model in 8 community health and outpatient services. The primary outcome will be waiting time from referral to first appointment. Secondary outcomes will be nature and quantity of service received (collected from all patients attending the service during the study period and health-related quality of life (AQOL-8D), patient satisfaction, health care utilisation and cost data (collected from a subgroup of patients at initial assessment and after 12 weeks). Data will be analysed with a multiple multi-level random-effects regression model that allows for cluster effects. An economic evaluation will be undertaken alongside the clinical trial.Discussion: This paper outlines the study protocol for a fully powered prospective stepped wedge cluster randomised controlled trial (SWCRCT) to establish whether the STAT model of access and triage can reduce waiting times applied across multiple settings, without increasing health service costs or adversely impacting on other aspects of patient care. If successful, it will provide evidence for the effectiveness of a practical model of access that can substantially reduce waiting time for outpatient and community services with subsequent benefits for both efficiency of health systems and patient care.Trial Registration: Australian and New Zealand Clinical Trials Registry ACTRN12615001016527 . Approved 15/9/2015. [ABSTRACT FROM AUTHOR]

This paper focuses on a statutory provision common to Australian, New Zealand and Canadian personal property securities legislation which requires a grantor of a security interest generally to have 'rights in the collateral' before a security interest can attach to that collateral. It analyses the extent to which a particular construction of that provision, initially developed by Canadian courts and commentators in the context of certain lease transactions and now applied in New Zealand, may and should colour construction of the equivalent Australian legislation. The paper argues that 'new learning', which holds the interest of a lessee sufficient to enable a security interest to attach to leased goods, is capable of achievement through different reasoning to that currently adopted by New Zealand courts. Such reasoning has significant implications for understanding when a security interest may attach to personal property more broadly. [ABSTRACT FROM AUTHOR]

As a theoretical paradigm, the use of economics has domi-nated legal analysis both in academia and the courts in the United States for the last three decades. This popularity, though, does not extend to most other jurisdictions. Judge Richard Posner, one of the pioneers of the law and economics movement, developed a model comparing the structures of the legal profession in the United States, the United Kingdom, and continental Europe to ex-plain the lack of the use of law and economics in the latter two regions compared with the United States. This paper compares the use of economic analysis in judicial decisions in the United States with the extent of such use in two other common law jurisdictions: Australia and New Zealand. Judge Posner s model is used to examine the structure of the legal professions in Australia and New Zealand to predict the extent to which law and economics is used by each jurisdiction's respective judiciary. It is observed that Australian courts do not use eco-nomic analysis to any great extent, with senior members of the ju-diciary adopting an explicitly negative view of the value of economic reasoning in resolving legal disputes. Even those judges who attempt to apply economic tools to justify their decisions tend to do so in a simplistic fashion that does not draw on the full ad-vantages such an approach offers and does nothing to counteract the claims of the paradigm's critics. New Zealand's judiciary has demonstrated a more receptive attitude, with little if any hostility expressed openly (unlike Australia), with notable senior members of the judiciary openly advocating for the courts to make greater use of economic reasoning in resolving legal disputes. These find-ings are in line with the expectations formed under Judge Posner's model. Further observations are made regarding the legal education systems in the United States, Australia and New Zealand, finding that law and economics is taught to a greater extent in line with the use of economic reasoning in the respective court system. While it is difficult to draw conclusions as to any causal relationship, an explanation is suggested that judicial attitudes, especially in Aus-tralia and New Zealand, have a strong influence on the extent to which law and economics is taught in law schools. Australia's and New Zealand's systems of legal education are much more focused, by necessity, on fundamental legal knowledge useful for a career in law, a restriction that does not exist to the same extent in the United States. The popularity of law and economics courses in Australia and New Zealand reflects the judicial attitudes observed in this paper's main analysis. [ABSTRACT FROM AUTHOR]

Background: Primary care services have not generally been effective in meeting mental health care needs. There is evidence that collaboration between primary care and specialist mental health services can improve clinical and organisational outcomes. It is not clear however what factors enable or hinder effective collaboration. The objective of this study was to examine the factors that enable effective collaboration between specialist mental health services and primary mental health care. Methods: A narrative and thematic review of English language papers published between 1998 and 2009. An expert reference group helped formulate strategies for policy makers. Studies of descriptive and qualitative design from Australia, New Zealand, UK, Europe, USA and Canada were included. Data were extracted on factors reported as enablers or barriers to development of service linkages. These were tabulated by theme at clinical and organisational levels and the inter-relationship between themes was explored. Results: A thematic analysis of 30 papers found the most frequently cited group of factors was "partnership formation", specifically role clarity between health care workers. Other factor groups supporting clinical partnership formation were staff support, clinician attributes, clinic physical features and evaluation and feedback. At the organisational level a supportive institutional environment of leadership and change management was important. The expert reference group then proposed strategies for collaboration that would be seen as important, acceptable and feasible. Because of the variability of study types we did not exclude on quality and findings are weighted by the number of studies. Variability in local service contexts limits the generalisation of findings. Conclusion: The findings provide a framework for health planners to develop effective service linkages in primary mental health care. Our expert reference group proposed five areas of strategy for policy makers that address organisational level support, joint clinical problem solving, local joint care guidelines, staff training and supervision and feedback. [ABSTRACT FROM AUTHOR]

In roof systems, a high strength steel profiled sheeting fastened to high strength steel cold-formed purlins of a lipped C- or Z-section is commonly used throughout the world. The design of such systems is performed according to the provisions of the limit states Australia/New Zealand Standard for Cold-Formed Steel Structures in Australia and the North American Specification for the Design of Cold-Formed Steel Structural Members in the United States. In both standards, which include the newly developed direct strength method of design (DSM), the method presented is limited to pure compression and pure bending. The situations of pure shear and combined bending and shear as occurs in a continuous purlin system are not considered. In order to extend the DSM to purlin systems, three different test series on high strength cold-formed C-section purlins have been performed at the University of Sydney. The test series include predominantly shear, combined bending and shear, and bending only test series. Two different section depths and three different thicknesses of the lipped channel section were tested in this study. Further, tests with and without torsion/distortion restraint straps screwed on the top flanges adjacent to the loading points were also considered. This paper summarizes the test results and formulas developed from the effective width method and the DSM. Proposals for design are included in this paper. Comparisons with the Australian Steel Structures Standard are also included to take account of the tension field action. [ABSTRACT FROM AUTHOR]

Background: Acute respiratory illness (ARI) is the most common cause of acute presentations and hospitalisations of young Indigenous children in Australia and New Zealand (NZ). Environmental tobacco smoke (ETS) from household smoking is a significant and preventable contributor to childhood ARI. This paper describes the protocol for a study which aims to test the efficacy of a family-centred tobacco control program about ETS to improve the respiratory health of Indigenous infants in Australia and New Zealand. For the purpose of this paper 'Indigenous' refers to Australia's Aboriginal and Torres Strait Islander peoples when referring to Australian Indigenous populations. In New Zealand, the term 'Indigenous' refers to Maori. Methods/Design: This study will be a parallel, randomized, controlled trial. Participants will be Indigenous women and their infants, half of whom will be randomly allocated to an 'intervention' group, who will receive the tobacco control program over three home visits in the first three months of the infant's life and half to a control group receiving 'usual care' (i.e. they will not receive the tobacco control program). Indigenous health workers will deliver the intervention, the goal of which is to reduce or eliminate infant exposure to ETS. Data collection will occur at baseline (shortly after birth) and when the infant is four months and one year of age. The primary outcome is a doctor-diagnosed, documented case of respiratory illness in participating infants. Discussion: Interventions aimed at reducing exposure of Indigenous children to ETS have the potential for significant benefits for Indigenous communities. There is currently a dearth of evidence for the effect of tobacco control interventions to reduce children's exposure to ETS among Indigenous populations. This study will provide high-quality evidence of the efficacy of a family-centred tobacco control program on ETS to reduce respiratory illness. Outcomes of our study will be important and significant for Indigenous tobacco control in Australia and New Zealand and prevention of respiratory illness in children. Trial registration: Australian New Zealand Clinical Trials Registry (ACTRN12609000937213) [ABSTRACT FROM AUTHOR]

The article focuses on the proposal about consumer guarantees in Australia. The proposal aims to improve consumer well-being through consumer empowerment and protection which encourages effective competition between consumers and suppliers in the market. Member of Parliament Dr. Craig Emerson released an Issues Paper on behalf of the Commonwealth Consumer Affairs Advisory Council (CCAAC), which is in in-charge on the review of the consumer law. The paper examined the adequacy of the existing laws on implied terms and the need for amendments if any. The adoption of Consumer Guarantees Act (CGA) of New Zealand (NZ) will provide greater certainty and clarity of the proposal.

A series of tests on cold-formed high-strength stainless steel square and rectangular hollow sections subjected to web crippling is presented in this paper. The types of stainless steel investigated in this study were high strength austenitic and duplex material. The measured web slenderness value of the hollow sections ranged from 16.5 to 49.7. The tests were carried out under four loading conditions considered in the American Specification and Australian/New Zealand Standard for cold-formed stainless steel structures, namely end-one-flange, interior-one-flange, end-two-flange, and interior-two-flange loading conditions. The web crippling test strengths were compared with the design strengths obtained using the American, Australian/New Zealand, and European Specifications for stainless steel structures. In addition, the North American Specification for cold-formed carbon steel structural members was also used to predict the web crippling strengths and compared with the test results. It is shown that the design strengths predicted by the specifications are either unconservative or very conservative. Hence, a unified web crippling equation with new coefficients for cold-formed high strength stainless steel square and rectangular hollow sections is proposed in this paper. It is shown that the proposed web crippling equation is safe and reliable. [ABSTRACT FROM AUTHOR]

Abstract: This paper reviews the development of ecological economics in Australia and New Zealand since its beginnings in the late 1970s. A historical account is presented that focuses particularly on the activities of the Australia New Zealand Society for Ecological Economics and key ecological economics research activities. Achievements of ecological economics in Australia and New Zealand are assessed, using a range of quantitative and qualitative data. The main areas of expertise developed by Australian and New Zealand ecological economists were found to be: theoretical foundations and visions for ecological economics; biodiversity and resilience; input–output analysis; heterodox valuation approaches; analysis of economy–environment interactions; sustainability indicators; sustainable agriculture, fisheries and oceans; and energy/thermodynamics. Both countries are ranked at the top (or near the top) of the world rankings in terms of per capita ISEE membership and publication rates in Ecological Economics. A defining feature of ecological economics in Australia and New Zealand has also been its practical and problem-solving focus and the level of end-user engagement. The paper concludes by discussing the challenges that face the future development of ecological economics in Australia and New Zealand. [Copyright &y& Elsevier]

An experimental investigation of cold-formed stainless steel hollow sections subjected to web crippling is presented in this paper. Tests were conducted on square and rectangular hollow sections of austenitic stainless steel type 304. Tensile and compression coupon tests were performed to obtain the longitudinal tension and transverse compression material properties. The web crippling tests were conducted under two loading conditions for end-two-flange and interior-two-flange specified in the current American Specification and Australian/New Zealand Standard for cold-formed stainless steel structures. The test strengths obtained from this study and the test strengths of stainless steel lipped channel sections under end-one-flange and interior-one-flange loading conditions conducted by other researchers are compared with the design strengths obtained using the current American Specification, Australian/New Zealand Standard and European Code for cold-formed stainless steel structures. In addition, the test strengths are also compared with the design strengths obtained using the unified web crippling equation as specified in the North American Specification for cold-formed carbon steel structural members. A unified web crippling equation for cold-formed stainless steel sections with single web is proposed in this paper. [ABSTRACT FROM AUTHOR]

This paper presents guidelines for establishing a QuestionPoint collaborative virtual reference partnership between academic libraries in Australia/New Zealand and the US. These guidelines reflect the practices of the state-of-the-art collaborative QuestionPoint partnership, 'AskASERI' as well as the unofficial standards and guidelines for virtual reference services established by IFLA and NISO. Throughout the paper, the projected benefits of international virtual reference collaboration are weighed against the costs. In conclusion, international collaborative virtual reference partnerships are presented to be net beneficial and worthy of further study and consideration. [ABSTRACT FROM AUTHOR]

Background: Lone parents and their children experience higher than average levels of adverse health and social outcomes, much of which are explained by high rates of poverty. Many high income countries have attempted to address high poverty rates by introducing employment requirements for lone parents in receipt of welfare benefits. However, there is evidence that employment may not reduce poverty or improve the health of lone parents and their children.Methods: We conducted a systematic review of qualitative studies reporting lone parents' accounts of participation in welfare to work (WtW), to identify explanations and possible mechanisms for the impacts of WtW on health and wellbeing. Twenty one bibliographic databases were searched. Two reviewers independently screened references and assessed study quality. Studies from any high income country that met the criteria of focussing on lone parents, mandatory WtW interventions, and health or wellbeing were included. Thematic synthesis was used to investigate analytic themes between studies.Results: Screening of the 4703 identified papers and quality assessment resulted in the inclusion of 16 qualitative studies of WtW in five high income countries, USA, Canada, UK, Australia, and New Zealand, covering a variety of welfare regimes. Our synthesis found that WtW requirements often conflicted with child care responsibilities. Available employment was often poorly paid and precarious. Adverse health impacts, such as increased stress, fatigue, and depression were commonly reported, though employment and appropriate training was linked to increased self-worth for some. WtW appeared to influence health through the pathways of conflict and control, analytical themes which emerged during synthesis. WtW reduced control over the nature of employment and care of children. Access to social support allowed some lone parents to manage the conflict associated with employment, and to increase control over their circumstances, with potentially beneficial health impacts.Conclusion: WtW can result in increased conflict and reduced control, which may lead to negative impacts on mental health. Availability of social support may mediate the negative health impacts of WtW. [ABSTRACT FROM AUTHOR]

Sedentary behaviour (SB) has emerged as a potential risk factor for metabolic health in youth. Knowledge on the determinants of SB in youth is necessary to inform future intervention development to reduce SB. A systematic review was conducted to identify predictors and determinants of SB in youth. Pubmed, Embase, CINAHL, PsycINFO and Web of Science were searched, limiting to articles in English, published between January 2000 and May 2014. The search strategy was based on four key elements and their synonyms: (a) sedentary behaviour, (b) determinants, (c) types of sedentary behaviours, (d) types of determinants. The full protocol is available from PROSPERO (PROSPERO 2014:CRD42014009823). Cross-sectional studies were excluded. The analysis was guided by the socio-ecological model. 37 studies were selected out of 2654 identified papers from the systematic literature search. Most studies were conducted in Europe (n = 13), USA (n = 11), and Australia (n = 10). The study quality, using the Qualsyst tool, was high with a median of 82 % (IQR: 74-91 %). Multiple potential determinants were studied in only one or two studies. Determinants were found at the individual, interpersonal, environmental and policy level but few studies examined a comprehensive set of factors at different levels of influences. Evidence was found for age being positively associated with total SB, and weight status and baseline assessment of screen time being positively associated with screen time (at follow-up). A higher playground density and a higher availability of play and sports equipment at school were consistently related to an increased total SB, although these consistent findings come from single studies. Evidence was also reported for the presence of safe places to cross roads and lengthening morning and lunch breaks being associated with less total SB. Future interventions to decrease SB levels should especially target children with overweight or obesity and should start at a young age. However, since the relationship of many determinants with SB remains inconsistent, there is still a need for more longitudinal research on determinants of SB in youth. [ABSTRACT FROM AUTHOR]

The article discusses the volunteers in theological libraries with focus on Australian and New Zealand Theological Library Association (ANZTLA). Topics include introductory paper presented by library science expert Philip Harvey at the Adelaide Conference of ANZTLA in July 2013 and the edited summary of an online conversation between members of the Association in June 2013 held on the ANZTLA-Forum presented by Philip Harvey.

Cold-formed steel (CFS) Tab connections are popular due to their rapid fastening and ease of installation, and their applications have increased recently in Pacific countries, including Australia and New Zealand. This type of connection consists of a Tab plate formed from the web of the supporting beam and is screwed to the joist web, providing a dependable load path from the joist to the galvanized C-section supporting beam. However, no studies have been reported in the literature for the shear capacity of such connections. This paper presents a shear test program designed to determine the shear capacity of CFS Tab connections and to identify their failure mechanism. The experimental program included three different beam sizes, C-150, C-190 and C-240. Each test was repeated three times, resulting in nine tests in total. All the specimens failed in plate yielding and plate tearing, which occurred on the tension side of the plate (top region). Nonlinear finite element (FE) models were then developed and verified against the test results. The FE results showed good agreement with the test results in terms of connection stiffness, connection strength and failure modes. Finally, it was shown that the design equations given in the Australia/New Zealand standard (AS/NZS 4600) and American Iron and Steel Institute (AISI S100) for predicting the combined bending and shear capacity could predict the ultimate shear capacity of CFS Tab connections investigated in this study. • The results of monotonic shear tests of a novel CFS Tab connection are reported. • CFS Tab connections failed in plate yeailding and tearing. • A nonlinear FE model is developed. Results showed good agreement with the test results. • A design procedure is proposed for predicting the shear capacity of CFS Tab connections. [ABSTRACT FROM AUTHOR]

Restoration of postmining substrates to native forest is a standard requirement of resource consents for mine sites located within areas of native forest in New Zealand. Unweathered waste rock presents significant challenges for plant growth, and past research highlights the importance of replacing soil as part of restoration. However, replacing soil with its horizon structure intact or even obtaining sufficient soil for restoration can be a challenge in some situations. In this paper, we describe the results of two trials undertaken at the OceanaGold Ltd. open‐cast gold mine in Reefton to explore the influence of substrate conditions on the growth of native forest seedlings. We show that beech (Nothofagus) seedlings grown on A‐horizon soil grew significantly better than those grown on soil mixed with waste rock, and both grew significantly better than plants grown just on waste rock. In the second trial, we show that bark chips are not a good substitute for soil. These results confirm the importance of having the correct substrate for successful native forest restoration. [ABSTRACT FROM AUTHOR]

Background Health Impact Assessment (HIA) involves assessing how proposals may alter the determinants of health prior to implementation and recommends changes to enhance positive and mitigate negative impacts. HIAs growing use needs to be supported by a strong evidence base, both to validate the value of its application and to make its application more robust. We have carried out the first systematic empirical study of the influence of HIA on decision-making and implementation of proposals in Australia and New Zealand. This paper focuses on identifying whether and how HIAs changed decision-making and implementation and impacts that participants report following involvement in HIAs. Methods We used a two-step process first surveying 55 HIAs followed by 11 in-depth case studies. Data gathering methods included questionnaires with follow-up interview, semi-structured interviews and document collation. We carried out deductive and inductive qualitative content analyses of interview transcripts and documents as well as simple descriptive statistics. Results We found that most HIAs are effective in some way. HIAs are often directly effective in changing, influencing, broadening areas considered and in some cases having immediate impact on decisions. Even when HIAs are reported to have no direct effect on a decision they are often still effective in influencing decision-making processes and the stakeholders involved in them. HIA participants identify changes in relationships, improved understanding of the determinants of health and positive working relationships as major and sustainable impacts of their involvement. Conclusions This study clearly demonstrates direct and indirect effectiveness of HIA influencing decision making in Australia and New Zealand. We recommend that public health leaders and policy makers should be confident in promoting the use of HIA and investing in building capacity to undertake high quality HIAs. New findings about the value HIA stakeholders put on indirect impacts such as learning and relationship building suggest HIA has a role both as a technical tool that makes predictions of potential impacts of a policy, program or project and as a mechanism for developing relationships with and influencing other sectors. Accordingly when evaluating the effectiveness of HIAs we need to look beyond the direct impacts on decisions. [ABSTRACT FROM AUTHOR]

We examine whether a single (dynamic) housing market exists across 16 cities within Australia and New Zealand. The two countries are closely integrated but cities are up to 5,000 kilometres apart. A single housing market exhibits a common set of forces determining the long run real house price path in all cities. A strong (weak) form occurs when an innovation affects house prices across all cities to an equal (unequal) degree. The 16 cities comprise a weak form single housing market with significant spatial and dynamic complexities. Three city groups emerge with a natural interpretation in terms of economic and spatial characteristics. [ABSTRACT FROM AUTHOR]

Cold-formed C-channel sections have been used in portal frame sheds for a wide range of domestic, agricultural and light industrial applications for many years in Australia and New Zealand. However, in many cases the knee joint designs have been copied from hot-rolled portal frame designs, regardless of the clearly different nature of the sections being connected. Testing has demonstrated that many of the joint designs widely used in practice do not achieve the moment capacity of the sections and fail prematurely. Various alternative joint designs have been proposed and constructed, but many of these also fail to meet required capacities under test. This paper reviews the issues relevant to design and construction of such knee joints and considers the positives and negatives of the principal categories of joints currently used in the cold-formed shed industry. It summarises the findings from a large number of tests conducted over a number of years on many of these joints. It concludes with some cautionary notes regarding what is required for design and construction if these commonly used structures are to function as intended from a structural viewpoint. [ABSTRACT FROM AUTHOR]

Both Australia and New Zealand have been marked by powerful claims for reparation for wrongs committed against indigenous peoples, with the responses to these claims including apologies. The trajectories of these responses have differed, however, particularly with respect to the relative role of formal institutional recognition and social movements. This paper argues that the institutionalisation of Crown apologies to New Zealand Māori has led to a certain alienation of these apologies from broader Pākehā society, whereas the failure to institutionalise recognition of Aboriginal and Torres Strait Islander rights in Australia has more deeply engaged questions of national identity for Australia as a whole. This comparative finding is consistent with a complex understanding of the relationship between political opportunity structures and social movements, whereby "a mix of open and closed structures" (Eisinger 1983: 15) is most conducive to social movements. [ABSTRACT FROM AUTHOR]

Objective This paper examines how negative experiences with the health-care system create a lack of confidence in receiving medical care in seven countries: Australia, Canada, Germany, the Netherlands, New Zealand, the United Kingdom, and the United States. Methods The empirical analysis is based on data from the Commonwealth Fund International Health Policy Survey 2007, with nationally representative samples of adults aged 18 and over. For the analysis of the experience of cost barriers and confidence in receiving medical care, we conducted pairwise comparisons of group percentages as well as country-wise multivariate logistic regression models. Results Individuals who have experienced cost barriers show a significantly lower level of confidence in receiving safe and quality medical care than those who have not. This effect is most pronounced in the United States, where people who have foregone necessary treatment because of costs are four times as likely to lack confidence as individuals without the experience of cost barriers (adjusted odds ratio 4.00). In New Zealand, Germany, and Canada, individuals with the experience of cost barriers are twice as likely to report low confidence compared with those without this experience (adjusted odds ratios of 1.95, 2.19 and 2.24, respectively). In the Netherlands and UK, cost barriers are only a marginal phenomenon. Conclusions The fact that the experience of financial barriers considerably lowers confidence indicates that financial incentives, such as private co-payments, have a negative effect on overall public support and therefore on the legitimacy of health-care systems. [ABSTRACT FROM AUTHOR]

This paper proposes the sampling factor for the mean test value as an alternative to that of the minimum test value of resistance for acceptance in prototype testing. The sampling factor was introduced in Australian/New Zealand loading standards AS/NZS 1170.0 to account for the uncertainties involved in prototype testing of a small number of samples to derive the characteristic properties of a much larger population. It requires the use of the minimum test value divided by a sampling factor to obtain an estimate of the 5-percentile value of the population. It is shown that while both procedures are mathematically equivalent, the use of mean value leads to more consistent estimate of the characteristic value of resistance. The sampling factors for the minimum and the mean test values are provided for Weibull and lognormal distributions by Monte Carlo simulation. This process was not feasible at the time when the original minimum value method was proposed about three decades ago. [ABSTRACT FROM AUTHOR]

The legality of ritual slaughter rests upon both law and merits. On the one hand, the international freedom of religion requires that communities can obtain meat of a suitable standard, and on the other, current scientific literature indicates that any distinct risks to animal welfare are manageable. Despite this, ritual slaughter remains controversial, particularly Jewish kosher slaughter (Shechita), for which electrical pre-stunning before throat-cutting - arguably the sine qua non of welfare risk management - is incompatible. Through a mixture of theological, legal, and scientific argument, this paper examines the level of protection Shechita receives as a manifestation of belief, with particular reference to developments in Australia and New Zealand. [ABSTRACT FROM AUTHOR]

Abstract: The construction of high resolution chronologies of sediment profiles corresponding to the last 50–100 years usually entails the measurement of fallout radionuclides 210Pb and 137Cs. The anthropogenic radionuclide, 137Cs, originating from atmospheric nuclear weapons testing can provide an important “first appearance” horizon of known age (1954–1955), providing much-needed validation for the sometimes uncertain interpretations associated with 210Pb geochronology. However, while 137Cs usually provides a strong signal in sediment in the northern hemisphere, total fallout of 137Cs in the southern hemisphere was only 25% that of the north and the low activities of 137Cs seen in Australian and New Zealand sediments can make its horizon of first appearance somewhat arguable. Low 137Cs fallout also limited the size of the 1963–1964 fallout peak, a peak that is usually seen in northern hemisphere sediment profiles but is often difficult to discern south of the equator. This paper shows examples of the use of nuclear weapons fallout Pu as a chronomarker in sediment cores from Australia (3 sites) and New Zealand (1 site). The Pu profiles of five cores are examined and compared with the corresponding 137Cs profiles and 210Pb geochronologies. We find that Pu has significant advantages over 137Cs, including greater measurement sensitivity using alpha spectrometry and mass spectrometric techniques compared to 137Cs measurements by gamma spectrometry. Moreover, Pu provides additional chronomarkers associated with changes in the Pu isotopic composition of fallout during the 1950s and 1960s. In particular, the 238Pu/239+240Pu activity ratio shows distinct shifts in the early 1950s and the mid to late 1960s, providing important known-age horizons in southern hemisphere sediments. For estuarine and near-shore sediments Pu sometimes has another significant advantage over 137Cs due to its enrichment in bottom sediment relative to 137Cs resulting from the more efficient scavenging of dissolved Pu in seawater by sediment particles. [Copyright &y& Elsevier]