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

Based on historical lessons learned from irregular warfare case studies, and internal organizational analysis, this thesis seeks to provide Marine Special Operations Command (MARSOC) with specific implementable recommendations based on Edward Luttwak’s concept of relational maneuver. Luttwak defines relational maneuver as a style of warfare that requires a deep understanding of the threat and its operational environment to identify vulnerabilities, adapt, and exploit those weaknesses to destroy the enemy as a system. Luttwak argues that irregular warfare requires effective implementation of relational maneuver to achieve operational and strategic success. The U.S. military’s experiences in Iraq and Afghanistan from 2009 through 2016 have revealed insufficient use of relational maneuver, favoring, instead, employment of attrition warfare, which focuses on optimizing internal organizational efficiency without understanding, or adapting to, the threat or the operational environment. Through this research, the authors seek to influence MARSOC’s organizational strategy to more effectively wage irregular warfare. The final recommendations provide a possible path to MARSOC for overcoming institutional challenges inhibiting the employment of relational maneuver in irregular warfare., MARSOC, http://archive.org/details/relationalmaneuv1094561304, Outstanding Thesis, Major, United States Marine Corps, Lieutenant, United States Navy, Approved for public release; distribution is unlimited.

The Palliative Care Outcomes Collaboration (PCOC) is a national program that aims to improve the quality and outcomes of palliative care in Australia. This is achieved via a standardised clinical language that supports a national data collection. This report provides a high level profile of 5,873 patients who received palliative care in NSW and ACT during January to June 2019 and had their pain, symptom, family / carer and psychological / spiritual issues assessed as part of routine clinical care.

The Palliative Care Outcomes Collaboration (PCOC) is a national program that aims to improve the quality and outcomes of palliative care in Australia. This is achieved via a standardised clinical language that supports a national data collection. This report provides a high level profile of 5,588 patients who received palliative care in NSW and ACT during July to December 2018 and had their pain, symptom, family / carer and psychological / spiritual issues assessed as part of routine clinical care.

The purpose of these guidelines is to provide a resource to assist organisations, communities and individuals to work together to prevent unintentional injury to Aboriginal children in New South Wales in a way that reflects the values, attitudes and priorities of Aboriginal people.

The Australian palliative care sector is a world leader in using routine clinical assessment information to guide patient centred care and measure patient and family outcomes. Providers of palliative care are commended for their commitment to excellence in delivering evidence-based, patient-centred care by using the routine Palliative Care Outcomes Collaboration (PCOC) assessment framework and contributing patient data toward national outcome measurement and benchmarking. PCOC acknowledges the dedication and willingness of clinicians to improve the care of patients, their families and caregivers. The information collected is not just data - it represents the real-life outcomes of over 40,000 Australians who die an expected death every year. While the focus of this report is on the most recent information relating to January to June 2019, results over the last three years are also presented to highlight achievements and improvement in outcomes. The most recent information corresponds to 24,562 patients, having 31,826 episodes of care and 73,209 palliative care phases from 138 services who provide palliative care in hospital / hospice or in the person's home.

The Australian palliative care sector is a world leader in using routine clinical assessment information to guide patient centred care and measure patient and family outcomes. Providers of palliative care are commended for their commitment to excellence in delivering evidence-based, patient-centred care by using the routine Palliative Care Outcomes Collaboration (PCOC) assessment framework and contributing patient data toward national outcome measurement and benchmarking. PCOC acknowledges the dedication and willingness of clinicians to improve the care of patients, their families and caregivers. The information collected is not just data - it represents the real-life outcomes of over 40,000 Australians who die an expected death every year. While the focus of this report is on the most recent information relating to July to December 2018, results over the last three years are also presented to highlight achievements and improvement in outcomes. The most recent information corresponds to 23,333 patients, having 29,931 episodes of care and 70,135 palliative care phases from 127 services who provide palliative care in hospital / hospice or in the person's home.

This thesis traces the development of adult literacy provision in NSW over its 40 year history, with particular focus on the discursive tensions between policy and practice. A major and overriding theme has been the move away from a philosophy of humanist education and a socio-cultural view of literacy, towards an economically driven, human capital view of literacy. The study analyses the changing socio-economic background to the development of the field of adult literacy (later called adult basic education) and the ways in which resulting public and policy discourses have impacted the field. In the foundation years, the public discourse of liberal humanism was reflected in the professional discourse. From the early 1990s however, a tension began to emerge as the public and policy discourse moved increasingly towards an instrumentalist, human capital view. The study illuminates the increasing discursive tensions between policy and practice and between the public and professional discourses that have sought to shape the field. Discourse theory, with its focus on power relations, as developed for example by Foucault (1972), and elaborated by Gee (2015) and Fairclough (2015), informs the analysis of the ways in which these discursive struggles have defined and redefined the field over the period discussed. Building on this understanding of discourse, the main conceptual resource employed is that of Actor Network Theory (ANT) (Callon 1986; Latour 2005). It is chosen as a useful lens through which to view the multiplicity of ‘actors’ both human and non-human, that have interacted in a non-linear and fluid fashion to influence the direction of the field. The study uses a number of the concepts described by ANT theorists to illuminate the ways in which some assemblages of actors came to exert power and advance a dominant discourse of literacy, whilst the influence of others declined. A number of past and present practitioners were interviewed in order to capture the teache

In 1966, Peter Loveday and Allan Martin published their book Parliament Factions and Parties: The First Thirty Years of Responsible Government in New South Wales, 1856-1889. They aimed to show how factions operated within the New South Wales Parliament during the colonial period of responsible government between 1856 and 1889. While Loveday and Martin’s work was challenged briefly at the time, that challenge was short-lived. It has since become the foundational theory regarding how colonial politics worked, and most political histories written since that time use the term ‘faction’ as a short-hand description for proto-party organisation that carries connotations of disapproval and disappointment.

Objective: Low rates of driver licensing have been linked to increased risk of transport‐related injury, and reduced access to health services, employment and educational opportunities in the Aboriginal population. This paper reports on how barriers to obtaining a driver licence are being addressed in four Aboriginal communities in New South Wales and South Australia. Methods: Qualitative data were collected over a four‐month period in 2013. Interviews with Aboriginal and non‐Aboriginal stakeholders (n=31) and 11 focus groups with Aboriginal participants (n=46) were analysed thematically using a framework approach. Results: Factors facilitating licensing included: family support, professional lessons, alternative testing and programs that assist with literacy, fines management, financial assistance and access to a supervising driver. Stakeholders recommended raising awareness of existing services and funding community‐based service provision to promote access to licensing. Discussion: Facilitating licence participation requires systemic change and long‐term investment to ensure interagency collaboration, service use and sustainability of relevant programs, including job search agencies. Implications for public health: The disadvantage faced by Aboriginal people in driver licensing is a fundamental barrier to participation and a social determinant of health. Understanding the factors that promote licensing is crucial to improving access for under‐serviced populations; recommendations provide pragmatic solutions to address licensing disadvantage.

It used to be the case that participation in political life was considered to be a vocation, and that those who chose it were in it for the long haul, through thick and thin. The most prominent example of this in Australian history was Billy Hughes. Even after he lost the prime ministership in early 1923 he continued to be a member of the House of Representatives until his death in 1952. That has all changed. Mike Baird's resignation, both as New South Wales premier and from the state parliament, comes as somewhat of a shock. He is only 48, has been an MP for less than ten years and premier for less than three. One would have thought his best years in public life were ahead of him.

This working paper was commissioned by Barnardos Australia, through its Centre for Excellence in Open Adoption, to establish how open adoption can support the best interests of children in optimising developmental outcomes and establishing healthy identity formation. This paper focuses on children who are up to 5 years of age in out-of-home care (OOHC) for whom there is no realistic chance of restoration to their birth family or kinship care. Therefore, the options facing such children, according to recent amendments to the NSW Children and Young Persons (Care and Protection) Act 1998 (hereafter referred to as the Care Act) in late 2014, are either for adoption or parental responsibility of the Minister (i.e., foster care) until they are 18 years of age. This paper also represents a first attempt to investigate the experiences of children who are adopted or placed for adoption before the age of 5 years in NSW, as well as understanding the main factors that serve to facilitate or hinder the identity development and wellbeing of such children. While this paper is not intended to provide a definitive solution as to how the identity development of adopted children can best be realised, efforts have been taken to highlight the most relevant issues for children in the NSW adoption context, as well as to outline where more work and research is needed to better understand the conditions for optimal identity formation in adopted children.

A review into how open adoption can support developmental outcomes and establish healthy identity formation of children was commissioned by Barnardos Australia. The focus is on children who are up to 5 years of age in out-of-home care (OOHC) for whom there is no realistic chance of restoration to their birth family or kinship care. The options facing such children, according to recent amendments in late 2014 to the Children and Young Persons (Care and Protection) Act 1998, are either for adoption or parental responsibility of the Minister (i.e., foster care) until they are 18 years of age. Healthy identity formation refers to a number of related constructs, including the child's: acceptance of and positive regard for him/herself (self-esteem, self-concept); feeling of belonging to a family; sense of having a biological or genealogical identity; and sense of having an identity as an effective, independent person.

Weeds cost the NSW economy over $1.8 million each year through weed control costs, productivity losses, expenditure by public agencies and value lost due to price responses in agricultural markets (NRC, 2014). Good weed hygiene supports weed control efforts and can prevent weed spread. The importance of weed hygiene is reflected in the plethora of policies and guidelines on weed hygiene practices that exist for different sectors. Despite the presence of numerous weed hygiene guidelines, the 2013 National Landcare Survey (de Hayr, 2013) indicated that very few resources were being expended on weed hygiene; only 11% of agricultural businesses surveyed incurred weed hygiene costs. To date there has been limited research into the extent to which weed hygiene is being undertaken in NSW and the reasons it is or is not being implemented. The aim of this research was to explore the extent to which private landholders, public land managers, weed contractors and agricultural transport operators know about and implement best practice hygiene.

New South Wales Premier Mike Baird has this week announced a plan for a six-month trial of shark nets off the beaches of northern NSW. This would extend the state's shark net program from the 51 beaches currently netted between Wollongong and Newcastle. The announcement was triggered by Wednesday's shark accident, in which a surfer received minor injuries from a shark bite at Sharpes Beach, Ballina. The decision marks a turn-around in Premier Baird's position on sharks. For over a year he has acknowledged the importance of addressing the issue, and has adopted a measured, long-term, non-lethal approach to managing shark hazards. Specifically, the NSW government has, in the last year, allocated funding and resources to non-lethal strategies including surveillance, research and education. Killing sharks has been highly controversial in Australia in recent years, and in NSW shark nets have been a focus of ongoing, highly polarising debate.

There has been an attempt at place making in Narellan in the new extension of the local shopping mall, Narellan Town Centre.

There is a general recognition amongst language practitioners that learning of languages other than English is in decline and needs to improved in Australia. In his 2014 Adelaide Languages Festival speech, the former Education Minister Mr Christopher Pyne acknowledged this gap by highlighting the target set by the current government to have 40% of year 12 pupils studying a foreign or classical language within a decade.

The New South Wales government recently introduced two new laws that impose serious constraints on how we use public spaces. They represent just the latest round of expanded police powers and higher criminal penalties justified in the name of “public safety”. The government’s solution is to let police decide who has the right to protest.

Background: There is a growing consensus that disease-modifying therapies must be given at the prodromal or preclinical stages of Alzheimer's disease (AD) to be effective. A major unmet need is to develop and validate sensitive measures to track disease progression in these populations. Objective: To generate novel statistically-derived composites from standard scores, which have increased sensitivity in the assessment of change from baseline in prodromal AD. Methods: An empirically based method was employed to generate domain specific, global, and cognitive-functional novel composites. The novel composites were compared and contrasted with each other, as well as standard scores for their ability to track change from baseline. The longitudinal characteristics and power to detect decline of the measures were evaluated. Data from participants in the Australian Imaging, Biomarkers and Lifestyle (AIBL) Study characterized as mild cognitively impaired with high neocortical amyloid-β burden were utilized for the study. Results: The best performing standard scores were CDR Sum-of-Boxes and MMSE. The statistically-derived novel composites performed better than the standard scores from which they were derived. The domain-specific composites generally did not perform as well as the global composites or the cognitive-functional composites. Conclusion: A systematic method was employed to generate novel statistically-derived composite measures from standard scores. Composites comprised of measures including function and multiple cognitive domains appeared to best capture change from baseline. These composites may be useful to assess progression or lack thereof in prodromal AD. However, the results should be replicated and validated using an independent clinical sample before implementation in a clinical trial.

Although it was estimated that 20% of the population in Australia were mobile-only phone users in 2010, the inclusion of mobile numbers into computer-assisted telephone interviews (CATI) behavioural risk factor surveys did not occur until 2012. Methods: Three papers have been published describing the methods, weighting strategy and the impact in detail of including mobile numbers into the NSW Population Health Survey (NSWPHS). This paper identifies the important components of those papers and summarises them for a broader audience. Results: In the 2012 NSWPHS, 15,214 (15,149 with weights) interviews were completed (64% landline frame; 36% mobile frame). Response, cooperation and contact rates were 37%, 65% and 69% respectively. The inclusion of mobile phone numbers resulted in a sample that was closer to the NSW population profile and impacted on the time series of estimates for alcohol drinking, recommended fruit consumption, current smoking, and overweight or obesity. Conclusions: The papers found that including mobile phone numbers into NSWPHS did not impact negatively on response rates or data collection, but it did cost more and affect the time series for some behavioural risk factors, in that it corrected the estimates that had been produced from a sample frame that was progressively getting less representative of the population.

A combination of geochemical analysis and hydrodynamic measuring has been established in order to provide an explanation for the spatial distribution of both sediment particles and trace element pollution Gunnamatta Bay, NSW, Australia. Fifty nine samples of surface sediment were collected to determine the spatial concentrations of trace elements in the bay. Moreover, current track pathways and velocities have been measured in the bay. The distribution of trace elements such as chromium, nickel, copper, zinc, arsenic and lead had similar patterns in surface sediments. Trace element pollution is concentrated along the current trajectory in the inner part of the bay, which has deeper sites and higher percentages of mud particles. The highest concentrations of these metals were found to be in sample GU55 from the northeast of the bay, which is close to a surface discharge point and moored boats.