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An integrated pancreatic disease unit needs to deliver high-quality care both to patients with malignant and non-malignant pancreatic disease. The regionalisation of pancreatic cancer services which followed the publication of policy frameworks by the Department of Health and NHS executive led to the development of disease-site-specialised high-volume multidisciplinary teams. As the majority of patients with pancreatic cancer are not suitable for surgery, partner hospitals within a region need to provide access to a wide range of non-surgical treatment. The implementation of such working may require pooling of local resources to create networks of equivalence to tertiary centres. The provision of care to non-malignant pancreatic disease can benefit from this type of working and services can be modelled on, and integrate with, cancer services. One way of achieving this is to establish working groups based upon diseases rather than traditional departments, which can deliver standardised and optimal care with a patient-centred approach. However, this poses a number of potential problems. This review examines how an integrated pancreatic unit may be developed in district general and larger hospitals, and also describes our experience in developing such a unit.

This article shows that, compared with some recent elections, ethnic and immigration issues attracted little interest in 2007, in spite of record high levels of immigration under the Government of John Howard. Ironically the Chinese vote may have played a role in Howard's loss in the seat of Bennelong.

Leukotrienes derived from the 5-lipoxygenase pathway are proinflammatory lipid mediators that possibly play a role in inflammatory bowel diseases. The expression of 5-lipoxygenase pathway proteins has not previously been examined in colonic mucosa in inflammatory bowel disease.Quantitative immunohistochemical analyses showed that, compared to those of the control subjects (n = 9), colonic biopsies from patients with active inflammatory bowel disease (n = 17) had 3- to 7-fold higher mean counts of cells expressing 5-lipoxygenase (P = 0.03), 5-lipoxygenase-activating protein (P = 0.005), and the leukotriene A(4) hydrolase (P = 0.004), which make up the biosynthetic pathway of the potent neutrophil chemotaxin leukotriene B(4). Immunoexpression of the leukotriene C(4) synthase was unaltered (P0.2). The increased representation of leukotriene B(4)-pathway enzymes was associated with higher counts of neutrophils (P = 0.0001), macrophages (P = 0.03), eosinophils (P = 0.0004), CD8(+) T cells (P0.001), activated T cells (P0.05), and B cells (P0.05) but not of mast cells (P0.9). These eicosanoid and cellular changes were most marked in the subgroup of patients with ulcerative colitis (n = 9), and were absent in patients with quiescent disease (n = 6). The anomalies in the 5-lipoxygenase pathway were accompanied as expected by more cells immunostaining for cytokine-inducible COX-2 (P = 0.004, n = 17), but this study also revealed a greater number of cells expressing COX-1 in the samples from the patients in the ulcerative colitis subgroup (P = 0.03, n = 9).The 5-lipoxygenase data provide a cellular basis for increased tissue synthesis of the leukotriene B(4), as reflected in the colonic mucosa and rectal dialysates of patients with active inflammatory bowel disease, which contributes to neutrophil influx and colonic injury. The COX-1/COX-2 data highlight the ambiguous functional role of prostanoid pathways in inflammatory bowel diseases.

(1997). Tacking into the wind: Immigration and multicultural policy in the 1990s. Journal of Australian Studies: Vol. 21, Fatal shores, pp. 29-39.

The interaction between government and community-based advocacy organisations is becoming complex and highly structured. While some analysts seek to explain such interplay within neo-Marxist or public choice frameworks, we argue the relationship is best understood as a two-way street, full of tensions but neither a conspiracy against the public interest nor part of a larger design to deradicalise social movements. Drawing on a wide range of Australian examples, but focusing in particular on peak women's and ethnic communities' organisations, we explore how social movements have been able to exert independent influence on the policy agenda.

Epidemiological studies have been published worldwide in recent decades describing the incidence, mortality, aetiology and trends of chronic pancreatitis. Accumulated evidence suggests that chronic pancreatitis is increasing in incidence and hospital admission rates are rising accordingly. Alcoholic chronic pancreatitis was previously more common in the developed world than elsewhere, but is now increasing worldwide due to growing per capita alcohol consumption in each nation. Supporting alcohol and smoking cessation in individual patients is essential to slow disease progression and improve overall health, as most patients will die of cirrhosis, cardiovascular disease or smoking related cancers rather than chronic pancreatitis. The socioeconomic impact of chronic pancreatitis is difficult to quantify as little data exists, however given the rising incidence the costs to health care and society are likely to increase. This chapter will describe the epidemiology and aetiology of chronic pancreatitis worldwide and discusses the factors that influence its socioeconomic impact.

Three defining events have shaped public policy in Australia towards the "war on terrorism." The September 2001 attack on New York was obviously the first. This prompted legislation in the following year that expanded the powers of the main intelligence body, the Australian Security and Intelligence Organisation (ASIO), and expedited its move from intelligence collection to security operations. The second was the bombing attacks in London in July 2005, which shifted the emphasis from immigration control to domestic vigilance. The third was the major race riot at Cronulla, Sydney in December 2005. This alerted authorities to the deterioration in ethnic relations created by these previous events and led to increased penalties against violence. No terrorist attacks have happened in Australia. Only a handful of arrests have been made, most awaiting trial. Loss of life has been confined to the Bali bombing of October 2002, which was not directed specifically against Australians. This resulted in greatly improved cooperation between Indonesian and Australian security and police, something that had started to develop in response to the prevention of unauthorised asylum seeker arrivals, most of whom came through Indonesia. Thus the major policy shifts were from border protection to internal security. But the public debate was more concerned with immigration, multiculturalism, and the integration of the Muslim population. Both the 2001 and 2004 elections were fought essentially on security, to the advantage of the ruling Liberal-National coalition led by John Howard.PLANNED, SELECTIVE, AND CONTROLLED IMMIGRATIONThere is nothing random about Australian immigration. Everyone entering for whatever purpose must have a visa, with the exception of New Zealand citizens. New Zealanders receive a nominal visa on arrival. Others arriving without a valid visa may be returned to their place of origin or given a "bridging visa," which allows them to remain while their status is determined. Those seeking asylum under the UN convention and protocol on refugees (1951/1967) will also be given a bridging visa if they arrive on another visa. If they have no visa, they are mandatorily detained until their status is determined. This has been the case since 1993.1Those asylum seekers arrested at sea were often deported to two Pacific Islands (Nauru and Manus) under the now suspended "Pacific solution" of 2001-02 Refugees and humanitarian settlers are processed overseas mainly through the UN high commissioner for refugees or by Australian migration posts. Ideally, then, nobody enters Australia other than in transit without the permission of the Australian government. If they do, they are interned. This was clearly stated by Prime Minister John Howard during his victorious 2001 election campaign: "We will decide who comes to this country and under what circumstances." While this implicitly breached the UN convention of which Australia is a signatory, the principle of national sovereignty has been rigorously asserted ever since. This was easily sustained. Regular passenger access to Australia is now exclusively by air and there are fewer than 20 regulated points of entry.3This tightening of admission criteria follows a long history of planned and financially assisted immigration (1831-1982) that allowed Australian authorities to select those immigrants they favoured. Steadily over the years, the visa system was extended until it became one of the tightest in the world. But state intervention also involved actively encouraging immigration, usually with financial inducements such as paid or subsidized passages. Just as few other developed societies so rigidly imposed visas, so no other so generously encouraged those it wanted to settle. This degree of state control is not fully understood in Australia even now. In public debates that break out from time to time, many seem to think that anyone can come to Australia. This is far from being the case. …

This article examines migration policy in Australia with reference to the "White Australia" policy prior to 1975 and the multicultural policy thereafter. Mass immigration has not caused major social tensions. Mass tourism has been welcomed. Australian attitudes have changed from fear of massive numbers of Asians and mass poverty and ignorance to multiculturalism. Suspicious attitudes toward Asians, however, are still present among a minority of Australians. The most influential arguments against Asians are the concerns about employment of new arrivals and the environmental impact of an increasing population. Although there are many cultural differences, Australia is linked to Singapore, Malaysia, and the Philippines in that all have a history of British or American influence. Educated Indians and Sri Lankans are linked to Australians by their common language and Christian religion. The integration of Asians in the business and financial community holds the potential for economic gain over the years. The author finds that the Australian relationship to Asia is more acceptable in public arenas than the comparable changing relationship between Britain and Europe. The roots of a Whites-only policy extend back to 1901, when the Commonwealth Immigration Restriction Act was ratified. The exclusion of non-European immigrants was not specified in the law. The mechanism for exclusion was included in the law. Undesirable immigrants could be excluded. Under mass migration programs after 1947 the population of non-English speaking Europeans increased. By 1973 government shifted from an assimilationist approach to a multicultural approach due to pressure from the Department of Foreign Affairs. Numerous historical events occurring during 1942-80 drew Australia out of its isolationist position in the world. At present about 25% of the total population are of non-British origin. Over 900,000 would have been excluded under the old migration policy. In 1991, 665,315 persons were born in Asia, of which the largest numbers came from Mainland China, Malaysia, and the Philippines. Asian immigrants are either refugees from Viet Nam, Cambodia, and Laos or voluntary Asian immigrants.

(1979). New Hebrides 1978–79: Self‐government by whom and for whom? The Journal of Pacific History: Vol. 14, No. 4, pp. 208-220.

(1979). The new Hebrides: From condominium to independence. Australian Outlook: Vol. 33, No. 1, pp. 15-26.