Current measure of food insecurity used in the National Health Survey may be underestimating its prevalence

Objective: Food insecurity may be associated with a number of adverse health and social outcomes however our knowledge of its public health significance in Australia has been limited by use of a single-item measure in the Australian National Health Surveys (NHS) and, more recently, the exclusion of food security items from these surveys. The current study compares prevalence estimates of food insecurity in disadvantaged urban areas of Brisbane using the one-item NHS measure with three adaptations of the United States Department of Agriculture Food Security Survey Module (USDA-FSSM). Design: Data were collected by postal survey (n= 505, 53% response). Food security status was ascertained by the measure used in the NHS, and the 6-, 10- and 18-item versions of the USDA-FSSM. Demographic characteristics of the sample, prevalence estimates of food insecurity and different levels of food insecurity estimated by each tool were determined. Setting: Disadvantaged suburbs of Brisbane city, Australia, 2009. Subjects: Individuals aged ≥ 18 years. Results: Food insecurity was prevalent in socioeconomically-disadvantaged urban areas, estimated as 19.5% using the single-item NHS measure. This was significantly less than the 24.6% (P <0.01), 22.0% (P = 0.01) and 21.3% (P = 0.03) identified using the 18-item, 10-item and 6-item versions of the USDA-FSSM, respectively. The proportion of the sample reporting more severe levels of food insecurity were 10.7%, 10% and 8.6% for the 18-, 10- and 6-item USDA measures respectively, however this degree of food insecurity could not be ascertained using the NHS measure. Conclusions: The measure of food insecurity employed in the NHS may underestimate its prevalence and public health significance. Future monitoring and surveillance efforts should seek to employ a more accurate measure.

Referral patterns and proximity to palliative care inpatient services by level of socio-economic disadvantage : a national study using spatial analysis

Background: A range of health outcomes at a population level are related to differences in levels of social disadvantage. Understanding the impact of any such differences in palliative care is important. The aim of this study was to assess, by level of socio-economic disadvantage, referral patterns to specialist palliative care and proximity to inpatient services. Methods: All inpatient and community palliative care services nationally were geocoded (using postcode) to one nationally standardised measure of socio-economic deprivation – Socio-Economic Index for Areas (SEIFA; 2006 census data). Referral to palliative care services and characteristics of referrals were described through data collected routinely at clinical encounters. Inpatient location was measured from each person’s home postcode, and stratified by socio-economic disadvantage. Results: This study covered July – December 2009 with data from 10,064 patients. People from the highest SEIFA group (least disadvantaged) were significantly less likely to be referred to a specialist palliative care service, likely to be referred closer to death and to have more episodes of inpatient care for longer time. Physical proximity of a person’s home to inpatient care showed a gradient with increasing distance by decreasing levels of socio-economic advantage. Conclusion: These data suggest that a simple relationship of low socioeconomic status and poor access to a referral-based specialty such as palliative care does not exist. Different patterns of referral and hence different patterns of care emerge.

Development of a survey instrument to measure TEFL academics' perceptions about, individual and workplace characteristics for conducting research

The Chinese Ministry of Education (MOE) initiatives to improve the English competence of college students, as well as increased proficiency level of entering college students (Cheng, 2002) have contributed to greater demands on Teaching English as a Foreign Language (TEFL) academics (MOE, 2004), as “the upgrading of national English proficiency, then, is predicated largely on the professional competence of the teaching force” (Hu, 2005, p. 655). For TEFL academics, one component of this competence is the capacity to conduct research (Shu, 2002), which also reflects other changes in Chinese higher education. The aspirations of higher education institutions at all levels have led to more rigorous recruitment policies and promotion requirements (Che, 2004; Wang, 2007), stressing research as an important indicator of academics’ performance (Shi, 2002; Pan, 2006). These changes highlight the role of research in higher education institutions’ efforts to raise their national status and world ranking (Zhang, Wang, & He, 2006), and have exerted influences on faculty’s academic role. Academics are obliged to engage in research activities, and this has posed challenges to teaching-oriented institutions and disciplines.

Recent emergence of dengue virus serotype 4 in French Polynesia results from multiple introductions from other south pacific islands

BACKGROUND: Infection by dengue virus (DENV) is a major public health concern in hundreds of tropical and subtropical countries. French Polynesia (FP) regularly experiences epidemics that initiate, or are consecutive to, DENV circulation in other South Pacific Island Countries (SPICs). In January 2009, after a decade of serotype 1 (DENV-1) circulation, the first cases of DENV-4 infection were reported in FP. Two months later a new epidemic emerged, occurring about 20 years after the previous circulation of DENV-4 in FP. In this study, we investigated the epidemiological and molecular characteristics of the introduction, spread and genetic microevolution of DENV-4 in FP. METHODOLOGY/PRINCIPAL FINDINGS: Epidemiological data suggested that recent transmission of DENV-4 in FP started in the Leeward Islands and this serotype quickly displaced DENV-1 throughout FP. Phylogenetic analyses of the nucleotide sequences of the envelope (E) gene of 64 DENV-4 strains collected in FP in the 1980s and in 2009-2010, and some additional strains from other SPICs showed that DENV-4 strains from the SPICs were distributed into genotypes IIa and IIb. Recent FP strains were distributed into two clusters, each comprising viruses from other but distinct SPICs, suggesting that emergence of DENV-4 in FP in 2009 resulted from multiple introductions. Otherwise, we observed that almost all strains collected in the SPICs in the 1980s exhibit an amino acid (aa) substitution V287I within domain I of the E protein, and all recent South Pacific strains exhibit a T365I substitution within domain III. CONCLUSIONS/SIGNIFICANCE: This study confirmed the cyclic re-emergence and displacement of DENV serotypes in FP. Otherwise, our results showed that specific aa substitutions on the E protein were present on all DENV-4 strains circulating in SPICs. These substitutions probably acquired and subsequently conserved could reflect a founder effect to be associated with epidemiological, geographical, eco-biological and social specificities in SPICs.

Environments For Healthy Living (EFHL) Griffith birth cohort study : characteristics of sample and profile of antenatal exposures

Background The Environments for Healthy Living (EFHL) study is a repeated sample, longitudinal birth cohort in South East Queensland, Australia. We describe the sample characteristics and profile of maternal, household, and antenatal exposures. Variation and data stability over recruitment years were examined. Methods Four months each year from 2006, pregnant women were recruited to EFHL at routine antenatal visits on or after 24 weeks gestation, from three public maternity hospitals. Participating mothers completed a baseline questionnaire on individual, familial, social and community exposure factors. Perinatal data were extracted from hospital birth records. Descriptive statistics and measures of association were calculated comparing the EFHL birth sample with regional and national reference populations. Data stability of antenatal exposure factors was assessed across five recruitment years (2006–2010 inclusive) using the Gamma statistic for ordinal data and chi-squared for nominal data. Results Across five recruitment years 2,879 pregnant women were recruited which resulted in 2904 live births with 29 sets of twins. EFHL has a lower representation of early gestational babies, fewer still births and a lower percentage of low birth weight babies, when compared to regional data. The majority of women (65%) took a multivitamin supplement during pregnancy, 47% consumed alcohol, and 26% reported having smoked cigarettes. There were no differences in rates of a range of antenatal exposures across five years of recruitment, with the exception of increasing maternal pre-pregnancy weight (p=0.0349), decreasing rates of high maternal distress (p=0.0191) and decreasing alcohol consumption (p<0.0001). Conclusions The study sample is broadly representative of births in the region and almost all factors showed data stability over time. This study, with repeated sampling of birth cohorts over multiple years, has the potential to make important contributions to population health through evaluating longitudinal follow-up and within cohort temporal effects.

Epidemiologic characteristics of cases for influenza A(H7N9) virus infections in China

China's National Health and Family Planning Commission announced 3 deaths caused by avian-origin influenza A(H7N9) virus in March, which was the first time that the H7N9 strain has been found in humans [1]. This is of major public health significance and raises urgent questions and global concerns [2, 3]. To explore epidemic characteristics of human infections with H7N9 virus, data on individual cases from 19 February 2013 (onset date of first case) to 14 April 2013 were collected from the China Information System for Disease Control and Prevention, which included information about sex; age; occupation; residential address; and day of symptom onset, diagnosis, and outcome for each case. The definition of an unconfirmed probable H7N9 case is a patient with epidemiologic evidence of contact …

Equal access to the opportunities available? Equity and diversity laws and policies in Australia

Australia has been populated for more than 40,000 years with Indigenous Australians joined by European settlers only 230 years ago. The first settlers consisted of convicts from more than 28 countries and members of the British army who arrived in 1788 to establish a British penal colony. Mass migration in the nineteenth century with one and a half million immigrants from Europe, principally from the United Kingdom and Ireland (Haines and Shlomowitz, 1992), established the continent as an Anglo society in the Pacific. In the twentieth century immigrants came from many European countries and in the latter decades from many parts of Asia and the Middle East (Collins, 1991, pp.10-13). In the 21st century Australia has an ethnically and culturally diverse population. The original Indigenous population of Australia accounts for approximately 460,000 or 2.5 per cent of the total population (ABS, 2006a). Estimates are that around 4.5m. persons in the population (close to 20 per cent), were born outside Australia with the majority of these arriving from Europe, principally the United Kingdom, and New Zealand (ABS, 2006b). Like many other countries, Australia has a legacy of discrimination and inequality in employment. Propelled by racist ideologies and the male breadwinner ideology, Indigenous Australians, and non-European immigrants, and women were barred from certain jobs and paid less for their work than any white male counterpart. These conditions were legally sanctioned through the industrial relations system and other laws in the nineteenth and first half of the twentieth century. Since the 1960s a dramatic change has occurred in social policy and national legislation and Australia today has an extensive array of laws which forbid employment discrimination on race, ethnicity, gender and many other characteristics, and other approaches which promote proactive organizational plans and actions to achieve equity in employment. This chapter outlines these developments.

The penetrance and characteristics of contact lens wear in Australia

Background A population-based, cross-sectional telephone survey was conducted to estimate the penetrance and characteristics of contact lens wear in Australia. Methods Based on postcode distribution, 42,749 households around Australia were randomly selected from the national electronic telephone directory. During calls, the number of individuals and contact lens wearers in each household aged between 15 and 64 years was ascertained. Contact lens wearers were interviewed using a structured questionnaire, to determine details of demographics, lens type, mode of lens wear and hygienic habits. Contact lens wear characteristics and habits were compared by lens type and mode of use. Results Of the 32,405 households contacted, 19,171 (59.2 per cent) agreed to participate. The penetrance of contact lens wear during the study period was 5.01 per cent (95% CI: 4.78-5.24). The mean age of lens wearers was 36.5 ± 18.3 years and 63.4 per cent were female. There were significant differences in the habits and characteristics of lens wearers depending on their lens type and mode of use. Conclusions The penetrance of contact lens wear concurs with market estimates and equates to approximately 680,000 contact lens wearers aged between 15 and 64 years in Australia. This is the most detailed and extensive population-based survey of contact lens wearers ever conducted. The discrepancies found between the characteristics of lens wearers surveyed in this study compared to those in previous studies of contact lens practitioners highlights the importance of study design. These results may be applied to other regions with similar health-care and regulatory systems.

Prescribing for nausea in palliative care : A cross-sectional national survey of Australian palliative medicine doctors

Background: Nausea can be a debilitating symptom for patients with a life-limiting illness. While addressing reversible components, nonpharmacological strategies and antiemetics are the main therapeutic option. The choice of medication, dose, and route of administration remain highly variable. Objective: The aim of this study was to codify the current clinical approaches and quantify any variation found nationally. Methods: A cross-sectional study utilizing a survey of palliative medicine clinicians examined prescribing preferences for nausea using a clinical vignette. Respondent characteristics, the use of nonpharmacological interventions, first- and second-line antiemetic choices, commencing and maximal dose, and time to review were collected. Results: Responding clinicians were predominantly working in palliative medicine across a range of settings with a 49% response rate (105/213). The main nonpharmacological recommendation was “small, frequent snacks.” Metoclopramide was the predominant first-line agent (69%), followed by haloperidol (26%), while second-line haloperidol was the predominant agent (47%), with wide variation in other nominated agents. Respondents favoring metoclopramide as first-line tended to use haloperidol second-line (65%), but not vice versa. Maximal doses for an individual antiemetic varied up to tenfold. Conclusion: For nausea, a commonly encountered symptom in palliative care, clinicians' favored metoclopramide and haloperidol; however, after these choices, there was large variation in antiemetic selection. While most clinicians recommended modifying meal size and frequency, use of other nonpharmacological therapies was limited.

Effects of transit quality of service characteristics on daily bus ridership

This study explores how explicit transit quality of services (TQoS) measures including service frequency, service span, and travel time ratio, along with implicit environmental predictors such as topographic grade factor influence bus ridership using a case study city of Brisbane, Australia. The primary hypothesis tested was that bus ridership is higher within suburbs with high transit quality of service than suburbs that have limited service quality. Using Multiple Linear Regression (MLR) this study identifies a strong positive relationship between route intensity (bus-km/h-km2) and bus ridership, indicating that increasing both service frequency and spatial route density correspond to higher bus ridership. Additionally, travel time ratio (in-vehicle transit travel time to in-vehicle auto travel time) is also found to have significant negative association with ridership within a suburb, reflecting a decline in transit use with increased travel time ratio. Conversely, topographic grade and service span are not found to exert any significant impact on bus ridership in a suburb. Our study findings enhance the fundamental understanding of traveller behaviour which is informative to urban transportation policy, planning and provision.

Affordances of ICTs: an environmental study of a French language unit offered at university level

This project investigates the integration of Information Communication Technologies (ICTs) into educational settings by closely looking at the uptake of the perceived affordances offered by ICTs by students enrolled in a French language course at Queensland University of Technology. This cross-disciplinary research uses the theoretical concepts of: Ecological Psychology (Gibson, 1979; Good, 2007; Reed, 1996); Ecological Linguistics (Greeno, 1994; Leather & van Dam, 2003; van Lier 2000, 2003, 2004a, 2004b); Design (Norman, 1988, 1999); Software Design/ Human-Computer Interaction (Hartson, 2003; McGrenere & Ho, 2000); Learning Design (Conole & Dyke, 2004a, 2004b; Laurillard et al. 2000;); Education (Kirschner, 2002; Salomon, 1993; Wijekumar et al., 2006) and Educational Psychology (Greeno, 1994). In order to investigate this subject, the following research questions, rooted in the theoretical foundations of the thesis, were formulated: (1) What are the learners’ attitudes towards the ICT tools used in the project?; (2) What are the affordances offered by ICTs used in a specific French language course at university level from the perspective of the teacher and from the perspective of language learners?; (3) What affordances offered by ICT tools used by the teacher within the specific teaching and learning environment have been taken up by learners?; and (4) What factors influence the uptake by learners of the affordances created by ICT tools used by the teacher within the specific teaching and learning environment? The teaching phase of this project, conducted between 2006 and 2008, used Action Research procedures (Hopkins, 2002; McNiff & Whitehead, 2002; van Lier 1994) as a research framework. The data were collected using the following combination of qualitative and quantitative methods: (1) questionnaires administered to students (Hopkins, 2002; McNiff & Whitehead, 2002) using Likert-scale questions, open questions, yes/no questions; (2) partnership classroom observations of research participants conducted by Research Participant Advocates (Hopkins, 2002; McNiff & Whitehead, 2002); and (3) a focus group with volunteering students who participated in the unit (semi-structured interview) (Hopkins, 2002; McNiff & Whitehead, 2002). The data analysis confirms the importance of a careful examination of the teaching and learning environment and reveals differences in the ways in which the opportunities for an action offered by the ICTs were perceived by teacher and students, which impacted on the uptake of affordances. The author applied the model of affordance, as described by Good (2007), to explain these differences and to investigate their consequences. In conclusion, the teacher-researcher considers that the discrepancies in perceiving the affordances result from the disparities between the frames of reference and the functional contexts of the teacher-researcher and students. Based on the results of the data analysis, a series of recommendations is formulated supporting calls for careful analysis of frames of reference and the functional contexts of all participants in the learning and teaching process. The author also suggests a modified model of affordance, outlining the important characteristics of its constituents.

Cultural policy and Australia's national cultural heritage: Issues and challenges in the GLAM landscape

In 2012 the Australian Commonwealth government was scheduled to release the first dedicated policy for culture and the arts since the Keating government's Creative Nation (1994). Investing in a Creative Australia was to appear after a lengthy period of consultation between the Commonwealth government and all interested cultural sectors and organisations. When it eventuates, the policy will be of particular interest to those information professionals working in the GLAM (galleries, libraries, archives and museums) environment. GLAM is a cross-institutional field which seeks to find points of commonality among various cultural-heritage institutions, while still recognising their points of difference. Digitisation, collaboration and convergence are key themes and characteristics of the GLAM sector and its associated theoretical discipline. The GLAM movement has seen many institutions seeking to work together to create networks of practice that are beneficial to the cultural-heritage industry and sector. With a new Australian cultural policy imminent, it is timely to reflect on the issues and challenges that GLAM principles present to national cultural-heritage institutions by discussing their current practices. In doing so, it is possible to suggest productive ways forward for these institutions which could then be supported at a policy level by the Commonwealth government. Specifically, this paper examines four institutions: the National Gallery of Australia, the National Library of Australia, the National Archives of Australia and the National Museum of Australia. The paper reflects on their responses to the Commonwealth's 2011 Cultural Policy Discussion Paper. It argues that by encouraging and supporting collecting institutions to participate more fully in GLAM practices the Commonwealth government's cultural policy would enable far greater public access to, and participation in, Australia's cultural heritage. Furthermore, by considering these four institutions, the paper presents a discussion of the challenges and the opportunities that GLAM theoretical and disciplinary principles present to the cultural-heritage sector. Implications for Best Practice * GLAM is a developing field of theory and practice that encompasses many issues and challenges for practitioners in this area. * GLAM principles and practices are increasingly influencing the cultural-heritage sector. * Cultural policy is a key element in shaping the future of Australia's cultural-heritage sector and needs to incorporate GLAM principles.

Differences in identifying healthcare associated infections using clinical vignettes and the influence of respondent characteristics: A cross-sectional survey of Australian infection prevention staff

Background Australia has commenced public reporting and benchmarking of healthcare associated infections (HAIs), despite not having a standardised national HAI surveillance program. Annual hospital Staphylococcus aureus bloodstream (SAB) infection rates are released online, with other HAIs likely to be reported in the future. Although there are known differences between hospitals in Australian HAI surveillance programs, the effect of these differences on reported HAI rates is not known. Objective To measure the agreement in HAI identification, classification, and calculation of HAI rates, and investigate the influence of differences amongst those undertaking surveillance on these outcomes. Methods A cross-sectional online survey exploring HAI surveillance practices was administered to infection prevention nurses who undertake HAI surveillance. Seven clinical vignettes describing HAI scenarios were included to measure agreement in HAI identification, classification, and calculation of HAI rates. Data on characteristics of respondents was also collected. Three of the vignettes were related to surgical site infection and four to bloodstream infection. Agreement levels for each of the vignettes were calculated. Using the Australian SAB definition, and the National Health and Safety Network definitions for other HAIs, we looked for an association between the proportion of correct answers and the respondents’ characteristics. Results Ninety-two infection prevention nurses responded to the vignettes. One vignette demonstrated 100 % agreement from responders, whilst agreement for the other vignettes varied from 53 to 75 %. Working in a hospital with more than 400 beds, working in a team, and State or Territory was associated with a correct response for two of the vignettes. Those trained in surveillance were more commonly associated with a correct response, whilst those working part-time were less likely to respond correctly. Conclusion These findings reveal the need for further HAI surveillance support for those working part-time and in smaller facilities. It also confirms the need to improve uniformity of HAI surveillance across Australian hospitals, and raises questions on the validity of the current comparing of national HAI SAB rates.

ACE research briefing paper 009: Global Entrepreneurship Monitor: GEM Australia - 2014 National Report

Most policymakers and academics agree that entrepreneurship is critical to the development and wellbeing of society. Entrepreneurs create jobs. They drive and shape innovation, thereby speeding up structural changes in the economy. By introducing new competition they contribute indirectly to increased productivity and overall economic activity. Entrepreneurship is thus a catalyst for economic growth and national competitiveness. In 2014, the Global Entrepreneurship Monitor (GEM)conducted its 15th annual survey of the rate and profile of entrepreneurial activity around the globe. GEM interviewed over 206,000 adults aged 18–64 in 70 economies, spanning diverse geographies and a range of development levels. The Australian Centre for Entrepreneurship Research (ACE) participated as the Australian GEM partner, surveying 2,177 Australian adults. This report provides a summary of entrepreneurship in Australia as measured by GEM, and benchmarks this against other countries. We compare the level of entrepreneurship in the population across different phases of the entrepreneurial process, and provide a profile of some key characteristics of entrepreneurs and the businesses they are starting. We also report on some of the institutional and framework conditions that support entrepreneurship.

Effects of transit quality of service characteristics on daily bus ridership

A case study of Brisbane, the capital city of Queensland, Australia, explored how explicit measures of transit quality of service (e.g., service frequency, service span, and travel time ratio) and implicit environmental predictors (e.g., topographic grade factor) influenced bus ridership. The primary hypothesis tested was that bus ridership was higher in suburbs with high transit quality of service than in suburbs with limited service quality. Multiple linear regression, used to identify a strong positive relationship between route intensity (bus-km/h-km2) and bus ridership, indicated that both increased service frequency and spatial route density corresponded to higher bus ridership. Additionally, the travel time ratio (i.e., the ratio of in-vehicle transit travel time to in-vehicle automobile travel time) had a significant negative association with suburban ridership: transit use declined as travel time ratio increased. In contrast, topographic grade and service span did not significantly affect suburban bus ridership. The study findings enhance the fundamental understanding of traveler behavior, which is informative to urban transportation policy, planning, and provision.