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Background: Despite electroconvulsive therapy being one of the most effective treatments in psychiatry, few studies report trends in the provision of electroconvulsive therapy over time. This study aims to investigate the use of electroconvulsive therapy between 2009 and 2020 in an Australian public tertiary mental health facility, and to describe the electroconvulsive therapy patient population and change in courses of treatment. Methods: Routinely collected data for 677 patients who received 1669 electroconvulsive therapy courses of treatment at an Australian public tertiary mental health facility between 2009 and 2020 were examined. Results: The provision of acute electroconvulsive therapy was stable across the study period; however, the number of maintenance electroconvulsive therapy courses commenced declined over the study. Schizophrenia was the most common indication for index treatment (37.4%). The majority of patients (85.7%) received acute electroconvulsive therapy only. Voluntary provision of electroconvulsive therapy declined over the study period, reducing from 44.9% in 2009 to 16.3% in 2020. Conclusion: Over the study period, there was a significant reduction in the number of maintenance electroconvulsive therapy courses commenced, and a large increase in involuntary treatment. The provision of electroconvulsive therapy was more likely to occur in males with a diagnosis of schizophrenia. Further studies are needed to generate a greater understanding of the factors influencing the provision of electroconvulsive therapy within differing geographical, social and healthcare landscapes. [ABSTRACT FROM AUTHOR]

Dingoes arrived in Australia during the mid‐Holocene and are the top‐order terrestrial predator on the continent. Although dingoes subsequently spread across the continent, the initial founding population(s) could have been small. We investigated this hypothesis by sequencing the whole genomes of three dingoes and also obtaining the genome data from nine additional dingoes and 56 canines, including wolves, village dogs and breed dogs, and examined the signatures of bottlenecks and founder effects. We found that the nucleotide diversity of dingoes was low, 36% less than highly inbred breed dogs and 3.3 times lower than wolves. The number of runs of homozygosity (RoH) segments in dingoes was 1.6–4.7 times higher than in other canines. While examining deleterious mutational load, we observed that dingoes carried elevated ratios of nonsynonymous‐to‐synonymous diversities, significantly higher numbers of homozygous deleterious Single Nucleotide Variants (SNVs), and increased numbers of loss of function SNVs, compared to breed dogs, village dogs, and wolves. Our findings can be explained by bottlenecks and founder effects during the establishment of dingoes in mainland Australia. These findings highlight the need for conservation‐based management of dingoes and the need for wildlife managers to be cognisant of these findings when considering the use of lethal control measures across the landscape. [ABSTRACT FROM AUTHOR]

The S-Star Trial Bioinformatics on-line course (www.s-star.org) is a global experiment in bioinformatics distance education. Six universities from five continents have participated in this project. One hundred and fifty students participated in the first trial course of which 96 followed through the entire course and 70 fulfilled the overall course requirements. The course was built up of 12 lectures covering different basic and advanced topics within bioinformatics. The lectures consist of streaming video and synchronized slides with follow-up discussion forums and a final assessment. It draws on experts from diverse institutions to share their teaching expertise and resources via distance learning. A major goal of S-Star is to provide free introductory web-based education. Here we present the outline of the course, experiences from a global collaboration, and feedback from the first trial of the on-line S-Star course. (Contains 2 tables, 1 figure and 1 footnote.)

Following on from the publication of the Royal Australian and New Zealand Journal of Psychiatry Mood Disorder Clinical Practice Guidelines (2020) and criticisms of how these aberrantly addressed repetitive transcranial magnetic stimulation treatment of depression, questions have continued to be raised in the journal about this treatment by a small group of authors, whose views we contend do not reflect the broad acceptance of this treatment nationally and internationally. In fact, the evidence supporting the use of repetitive transcranial magnetic stimulation treatment in depression is unambiguous and substantial, consisting of an extensive series of clinical trials supported by multiple meta-analyses, network meta-analysis and umbrella reviews. Importantly, the use of repetitive transcranial magnetic stimulation treatment in depression has also been subject to a series of health economic analyses. These indicate that repetitive transcranial magnetic stimulation is a cost-effective therapy and have been used in some jurisdictions, including Australia, in support of public funding. An argument has been made that offering repetitive transcranial magnetic stimulation treatment may delay potentially effective pharmacotherapy. In fact, there is considerably greater danger of the opposite happening. Repetitive transcranial magnetic stimulation is as, if not more effective, than antidepressant medication after two unsuccessful medication trials and should be a consideration for all patients under these circumstances where available. There is no meaningful ongoing debate about the use of repetitive transcranial magnetic stimulation treatment in depression – it is a safe, effective and cost-effective treatment. [ABSTRACT FROM AUTHOR]

Background: We studied the prevalence of neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS) in Indigenous populations of Australia and New Zealand with the aim of assessing potential differences. Methods: Cases of possible NMOSD and MS were collected from Australia and New Zealand. Clinical details, MR imaging, and serologic results were used to apply 2015 IPND diagnostic criteria for NMOSD and 2010 McDonald criteria for MS. Frequencies of self-determined ethnic ancestry were calculated for confirmed NMOSD, suspected NMOSD, and MS. Prevalence rates for NMOSD and MS according to ancestry were compared. Results: There were 75 cases with NMOSD, 89 with suspected NMSOD, and 101 with MS. NMOSD cases were more likely to have Asian, Indigenous, or Other ancestry compared to suspected NMOSD or MS. There were no differences in the clinical phenotype of NMOSD seen in Indigenous compared to European ancestry populations. Per 100,000, the prevalence estimate for NMOSD in people with Māori ancestry was 1.50 (95% CI 0.52–2.49) which was similar to those with Asian ancestry 1.57 (95% CI 1.15–1.98). NMOSD prevalence in Australian Aboriginal and Torres Strait Islander populations was 0.38 (95% CI 0.00–0.80) per 100,000. Conclusion: The prevalence of NMOSD in the Māori population is similar to South East Asian countries, reflecting their historical origins. The prevalence of MS in this group is intermediate between those with South East Asian and European ancestry living in New Zealand. Both NMOSD and particularly MS appear to be uncommon in the Indigenous populations of Australia. [ABSTRACT FROM AUTHOR]

The 'Australian Consensus Framework for Ethical Collaboration in the Healthcare Sector' (ACF) is an Australian initiative aimed at countering dysfunction and growing mistrust in the health sector through the development of a cross‐sectoral consensus framework. The development of this framework arose from Australia's involvement in the Asia Pacific Economic Cooperative (APEC) and has since become the largest of its kind internationally, with over 70 signatories representing professional bodies, industry organisations, hospital and health services associations, regulators and patient and advocacy groups. In this article, we describe and critique the framework and outline its implementation. [ABSTRACT FROM AUTHOR]

Rhyzopertha dominica and Tribolium castaneum are key pests of stored grains globally. Fumigation with phosphine gas is the primary control method for these beetles, so the development of phosphine resistant populations threatens the continued use of this fumigant. Developing effective strategies to manage the spread of phosphine resistance requires an understanding of the genetic diversity and structuring in these pests. We therefore assessed the phylogeographic structuring of these beetles in Australia and India, two significant grain producing countries. Genetic diversity was high in T. castaneum, with 40 discrete haplotypes identified from the 268 specimens sequenced. Four haplotypes, including the three most common haplotypes, were found in both India and Australia. Genetic diversity was notably lower in India, potentially driven by the higher frequency of phosphine fumigations in India. No genetic structuring was identified in Australia T. castaneum, but a small amount was detected in India. Genetic diversity was much lower in R. dominica, with only three discrete COI haplotypes identified from 215 specimens. The low level of genetic diversity in R. dominica suggests selection may be occurring on the mitochondrial genome, potentially driven by an endosymbiont such as Wolbachia. The contrasting phylogeographic patterns, across species and countries, emphasise the importance of developing insecticide resistance management practices that are both species specific (even if pests share a similar environment), as well as region specific. For instance, the limited genetic structuring identified in T. castaneum suggests phosphine resistance could potentially spread rapidly across Australia, meaning broad-scale resistance management strategies are essential. [ABSTRACT FROM AUTHOR]

The publication in 2001 by Adcock et al. [Adcock GJ, et al. (2001) Proc Natl Acad Sci USA 98(2):537-542] in PNAS reported the recovery of short mtDNA sequences from ancient Australians, including the 42,000-y-old Mungo Man [Willandra Lakes Hominid (WLH3)]. This landmark study in human ancient DNA suggested that an early modern human mitochondrial lineage emerged in Asia and that the theory of modern human origins could no longer be considered solely through the lens of the "Out of Africa" model. To evaluate these claims, we used second generation DNA sequencing and capture methods as well as PCR-based and single-primer extension (SPEX) approaches to reexamine the same four Willandra Lakes and Kow Swamp 8 (KS8) remains studied in the work by Adcock et al. Two of the remains sampled contained no identifiable human DNA (WLH15 and WLH55), whereas the Mungo Man (WLH3) sample contained no Aboriginal Australian DNA. KS8 reveals human mitochondrial sequences that differ from the previously inferred sequence. Instead, we recover a total of five modern European contaminants from Mungo Man (WLH3). We show that the remaining sample (WLH4) contains ~1.4% human DNA, fromwhich we assembled two complete mitochondrial genomes. One of these was a previously unidentified Aboriginal Australian haplotype belonging to haplogroup S2 that we sequenced to a high coverage. The other was a contaminatingmodern European mitochondrial haplotype. Although none of the sequences that we recovered matched those reported by Adcock et al., except a contaminant, these findings show the feasibility of obtaining important information from ancient Aboriginal Australian remains. [ABSTRACT FROM AUTHOR]

Psychiatric Advance Directives (PADs) have been adopted in many jurisdictions around the world and in most Australian states and territories. They are seen as a less restrictive and patient-centered approach to the provision of mental health care. Electroconvulsive therapy (ECT) is a restricted treatment in most jurisdictions in Australia and across the world. This paper explores the history, regulation and use of ECT and PADs and the intersections between them. It provides an overview of the legislative framework in each Australian state and territory and explores some of the issues which have arisen such as complexity of the regulatory framework, making PADs binding for refusing and consenting to ECT, involving treating teams in how PADs are made, using restrictive interventions to implement PADs, and the role of the Tribunal. While PADs are often framed as an important legal tool for allowing patients to refuse psychiatric treatment (especially ECT), the paper emphasizes that they can also be an innovative way for people to consent to psychiatric treatment in advance and an empowering option to access mental health care. It then makes some suggestions for future reform. [ABSTRACT FROM AUTHOR]

Much is discussed about privacy laws in developed economies such as The US, EU, Japan, Canada, and Australia. However, not many studies have focused on privacy laws that are evolving in emerging economies such as India. As the economy becomes global and companies resort to global outsourcing, much of the data of clients, customers and common citizens are slowly being dispersed around the world for processing, analyzing and simple storage. Therefore, developing countries that handle such data are no longer exempt from the privacy concerns associated with them. This paper studies and critically analyzes the evolution of privacy laws in India. India, being a democracy of 1.2 billion people, is an especially interesting 'subject' to study in this regard. The study offers an illustration of the interactions of security, privacy and politics of its citizens, interest groups, security agencies and politicians - as they all mash together, constantly reposition themselves, pressure and compromise with each other to arrive at ways to define and protect privacy while not compromising on security. [ABSTRACT FROM AUTHOR]

Abstract Objective  To examine associations between area and individual socio-economic characteristics and premature cancer mortality using multilevel analysis. Methods  We modeled cancer mortality among 25–64-year-old men and women (n = 16,340) between 1998 and 2000 in Australia. Socio-economic characteristics of Statistical Local Areas (n = 1,317) were measured using an Index of Relative Socio-economic Disadvantage (quintiles), and individual socio-economic position was measured by occupation (professionals, white and blue collar). Results  After adjustment for within-area variation in age and occupation, the probability of premature cancer mortality was highest in the most disadvantaged areas for all-cancer mortality for men (RR 1.48 95% CI 1.35–1.63) and women (RR 1.30 95% CI 1.18–1.43) and for lung cancer mortality for men (1.91 95% CI 1.63–2.25) and women (1.51 95% CI 1.04–2.18). Men in blue collar occupations had a higher rate of cancer mortality (RR 1.57 95% CI 1.50–1.65) and lung cancer mortality (RR 2.31 95 % CI 2.09–2.56), whereas men in white collar occupations had a lower all-cancer mortality rate (RR 0.78 95% CI 0.72–0.85). Compared with professionals, women in white collar occupations had an all-cancer mortality rate that was lower (RR 0.85 95% CI 0.80–0.90). When deaths from breast cancer were excluded, women in blue collar occupations had a significantly higher all-cancer mortality rate than professionals (RR 1.12 95% CI 1.02–1.22). Conclusions  Area disadvantage and individual socio-economic position were independently associated with premature cancer mortality, suggesting that interventions to reduce inequalities should focus on places and people. [ABSTRACT FROM AUTHOR]

Background: In Australia, studies finding an association between area-level socioeconomic disadvantage and mortality are often based on aggregate-ecological designs which confound area-level and individual-level sources of socioeconomic variation. Area-level socioeconomic differences in mortality therefore may be an artefact of varying population compositions and not the characteristics of areas as such. Objective: To examine the associations between area-level disadvantage and all-cause mortality before and after adjustment for within-area variation in individual-level socioeconomic position (SEP) using unlinked census and mortality-register data in a multilevel context. Setting, participants and design: The study covers the total Australian continent for the period 1998-2000 and is based on decedents aged 25-64 years (n = 43 257). The socioeconomic characteristics of statistical local areas (SLA, n = 1317) were measured using an index of relative socioeconomic disadvantage, and individual-level SEP was measured by occupation. Results: Living in a disadvantaged SLA was associated with higher all-cause mortality after adjustment for within-SLA variation in occupation. Death rates were highest for blue-collar workers and lowest among white-collar employees. Cross-level interactions showed no convincing evidence that SLA disadvantage modified the extent of inequality in mortality between the occupation groups. Conclusions: Multilevel analysis can be used to examine area variation in mortality using unlinked census and mortality data, therefore making it less necessary to use aggregate-ecological designs. In Australia, area-level and individual-level socioeconomic factors make an independent contribution to the probability of premature mortality. Policies and interventions to improve population health and reduce mortality inequalities should focus on places as well as people. [ABSTRACT FROM AUTHOR]

Objectives: To examine whether area level socioeconomic disadvantage and social capital have different relations with women's and men's self rated health. Methods: The study used data from 15 112 respondents to the 1998 Tasmanian (Australia) healthy communities study (60% response rate) nested within 41 statistical local areas. Gender stratified analyses were conducted of the associations between the index of relative socioeconomic disadvantage (IRSD) and social capital (neighbourhood integration, neighbourhood alienation, neighbourhood safety, political participation, social trust, trust in institutions) and individual level self rated health using multilevel logistic regression analysis before (age only) and after adjustment for individual level confounders (marital status, indigenous status, income, education, occupation, smoking). The study also tested for interactions between gender and area level variables. Results: IRSD was associated with poor self rated health for women (age adjusted p<0.00) and men (age adjusted p<0.00), however, the estimates attenuated when adjusted for individual level variables. Political participation and neighbourhood safety were protective for women's self rated health but not for men's. Interactions between gender and political participation (p = 0.010) and neighbourhood safety (p=0.023) were significant. Conclusions: These finding suggest that women may benefit more than men from higher levels of area social capital. [ABSTRACT FROM AUTHOR]

The author discusses the role and status of the generalist and the specialist by contrasting Australian and British practice in government services. With the disperse and not easily exploitable resources of the Australian Colonies, the development of the country became the responsibility of Colonial Governments as of private enterprise. The first public service legislation in Australia, the Victorian Service Act of 1862, divided the whole service into a Professional and an Ordinary Division, with no special recognition for the head of a department. On the other hand, the Institution of Professional Civil Servants has been making efforts to obtain better salaries and a better share in the administration of professional departments since 1918 in Great Britain.

A letter to the editor is presented in response to the article about the Australian mental health care system in the previous issue.

Blue swimmer crab species are widely distributed in Indian and west Pacific Oceans including the coastline around Australia and have been identified as potential candidates for stock enhancement. A recent taxonomic review revealed the presence of two blue swimmer crab species in Australia, namely Portunus armatus which is found around most of the Australian coastline, and Portunus pelagicus which is found in the northern coast where it is sympatric with P. armatus. It is important to understand population structure and genetic diversity of Portunus spp. to efficiently manage stocks. In the present study we investigated species classification and population structure of Portunus spp. in Australia using full and partial genomic information, namely mitochondrial COX1 gene sequences derived from whole genome sequencing and single nucleotide polymorphic (SNP) markers developed from partial genome sequencing. Blue swimmer crab samples were collected from the western (n = 52), northern (n = 17) and eastern (n = 110) coasts of Australia. Genetic diversity and population genetic structure were assessed for within and between region variation. Our genomic results indicated the presence of two blue swimmer crab species in Australia. One, namely, P. pelagicus was found only in Northern Territory (Darwin), and other, namely P. armatus was found around Australia. There was evidence of natural hybridisation between two species in Northern Territory (Darwin) where they were sympatric. P. armatus populations from the western, northern and eastern regions were genetically different although there were no significant genetic differences observed between the Queensland and New South Wales populations nor between the two neighbouring populations in Western Australia. Results found in the present study supports the view that the P. armatus populations in western, northern and eastern regions of Australia should be treated as at least three different stocks. A lack of genetic structuring along the eastern coast suggests blue swimmer crabs can be considered as a single stock along the sampled range at least in relation to fisheries enhancement, release programs and broodstock management. • Genomic analyses indicated presence of two blue swimmer crab species in Australia. • There is evidence for natural hybrids between Portunus pelagicus and P. armatus. • We determined the population structure of P. armatus using SNPs. • P. armatus in the west, north and east Australian coasts are genetically different. • There were no significant genetic differences among eastern P. armatus populations. [ABSTRACT FROM AUTHOR]

Abstract: Socio-economic gradients in cardiovascular disease (CVD) and diabetes have been found throughout the developed world and there is some evidence to suggest that these gradients may be steeper for women. Research on social gradients in biological risk factors for CVD and diabetes has received less attention and we do not know the extent to which gradients in biomarkers vary for men and women. We examined the associations between two indicators of socio-economic position (education and household income) and biomarkers of diabetes and cardiovascular disease (CVD) for men and women in a national, population-based study of 11,247 Australian adults. Multi-level linear regression was used to assess associations between education and income and glucose tolerance, dyslipidaemia, blood pressure (BP) and waist circumference before and after adjustment for behaviours (diet, smoking, physical activity, TV viewing time, and alcohol use). Measures of glucose tolerance included fasting plasma glucose and insulin and the results of a glucose tolerance test (2 h glucose) with higher levels of each indicating poorer glucose tolerance. Triglycerides and High Density Lipoprotein (HDL) Cholesterol were used as measures of dyslipidaemia with higher levels of the former and lower levels of the later being associated with CVD risk. Lower education and low income were associated with higher levels of fasting insulin, triglycerides and waist circumference in women. Women with low education had higher systolic and diastolic BP and low income women had higher 2 h glucose and lower HDL cholesterol. With only one exception (low income and systolic BP), all of these estimates were reduced by more than 20% when behavioural risk factors were included. Men with lower education had higher fasting plasma glucose, 2 h glucose, waist circumference and systolic BP and, with the exception of waist circumference, all of these estimates were reduced when health behaviours were included in the models. While low income was associated with higher levels of 2-h glucose and triglycerides it was also associated with better biomarker profiles including lower insulin, waist circumference and diastolic BP. We conclude that low socio-economic position is more consistently associated with a worse profile of biomarkers for CVD and diabetes for women. [Copyright &y& Elsevier]