Socioeconomic inequality profiles in physical and developmental health from 0-7 years : Australian National Study

Background: Early and persistent exposure to socioeconomic disadvantage impairs children’s health and wellbeing. However, it is unclear at what age health inequalities emerge or whether these relationships vary across ages and outcomes. We address these issues using cross-sectional Australian population data on the physical and developmental health of children at ages 0-1, 2-3, 4-5 and 6-7 years. Methods: 10 physical and developmental health outcomes were assessed in 2004 and 2006 for two cohorts each comprising around 5000 children. Socioeconomic position was measured as a composite of parental education, occupation and household income. Results: Lower socioeconomic position was associated with increased odds for poor outcomes. For physical health outcomes and socio-emotional competence, associations were similar across age groups and were consistent with either threshold effects (for poor general health, special healthcare needs and socio-emotional competence) or gradient effects (for illness with wheeze, sleep problems and injury). For socio-emotional difficulties, communication, vocabulary and emergent literacy, stronger socioeconomic associations were observed. The patterns were linear or accelerated and varied across ages. Conclusions: From very early childhood, social disadvantage was associated with poorer outcomes across most measures of physical and developmental health and showed no evidence of either strengthening or attenuating at older compared to younger ages. Findings confirm the importance of early childhood as a key focus for health promotion and prevention efforts.

Benchmarking clinical indicators of quality for Australian residential aged care facilities

To undertake exploratory benchmarking of a set of clinical indicators of quality care in residential care in Australia, data were collected from 107 residents within four medium-sized facilities (40–80 beds) in Brisbane, Australia. The proportion of residents in each sample facility with a particular clinical problem was compared with US Minimum Data Set quality indicator thresholds. Results demonstrated variability within and between clinical indicators, suggesting breadth of assessment using various clinical indicators of quality is an important factor when monitoring quality of care. More comprehensive and objective measures of quality of care would be of great assistance in determining and monitoring the effectiveness of residential aged care provision in Australia, particularly as demands for accountability by consumers and their families increase. What is known about the topic? The key to quality improvement is effective quality assessment, and one means of evaluating quality of care is through clinical outcomes. The Minimum Data Set quality indicators have been credited with improving quality in United States nursing homes. What does this paper add? The Clinical Care Indicators Tool was used to collect data on clinical outcomes, enabling comparison of data from a small Australian sample with American quality benchmarks to illustrate the utility of providing guidelines for interpretation. What are the implications for practitioners? Collecting and comparing clinical outcome data would enable practitioners to better understand the quality of care being provided and whether practices required review. The Clinical Care Indicator Tool could provide a comprehensive and systematic means of doing this, thus filling a gap in quality monitoring within Australian residential aged care.

A green drought : the challenge of mentoring for Australian accounting academics

Purpose: The purpose of this paper is to expose the impact of the shortage of senior academics,particularly professors, in Australian accounting schools, to relate the way one school addressed this shortage through a mentoring scheme, and to challenge existing institutional arrangements.----------- Design/methodology/approach: This is a contextualised qualitative case study of a mentoring scheme conducted in an Australian accounting school. Data collected from semi-structured interviews, personal reflections and from Australian university web sites are interpreted theoretically using the metaphor of a “green drought”.---------- Findings: The mentoring scheme achieved some notable successes, but raised many issues and challenges. Mentoring is a multifaceted investment in vocational endeavour and intellectual infrastructure, which will not occur unless creative means are developed over the long term to overcome current and future shortages of academic mentors.---------- Research limitations/implications: This is a qualitative case study, which, therefore, limits its generalisability. However, its contextualisation enables insights to be applied to the wider academic environment. ----------Practical implications: In the Australian and global academic environment, as accounting professors retire in greater numbers, new and creative ways of mentoring will need to be devised. The challenge will be to address longer term issues of academic sustainability, and not just to focus on short-term academic outcomes.---------- Originality/value: A mentoring scheme based on a collegial networking model of mentoring is presented as a means of enhancing academic endeavour through a creative short-term solution to a shortage of accounting professors. The paper exemplifies the theorising power of metaphor in a qualitative study.

The Australian Palliative Care Outcomes Collaboration (PCOC) : measuring the quality and outcomes of palliative care on a routine basis

Australia is leading the way in establishing a national system (the Palliative Care Outcomes Collaboration – PCOC) to measure the outcomes and quality of specialist palliative care services and to benchmark services across the country. This article reports on analysis of data collected routinely at point-of-care on 5939 patients treated by the first fifty one services that voluntarily joined PCOC. By March 2009, 111 services have agreed to join PCOC, representing more than 70% of services and more than 80% of specialist palliative care patients nationally. All states and territories are involved in this unique process that has involved extensive consultation and infrastructure and close collaboration between health services and researchers. The challenges of dealing with wide variation in outcomes and practice and the progress achieved to date are described. PCOC is aiming to improve understanding of the reasons for variations in clinical outcomes between specialist palliative care patients and differences in service outcomes as a critical step in an ongoing process to improve both service quality and patient outcomes. What is known about the topic? Governments internationally are grappling with how best to provide care for people with life limiting illnesses and how best to measure the outcomes and quality of that care. There is little international evidence on how to measure the quality and outcomes of palliative care on a routine basis. What does this paper add? The Palliative Care Outcomes Collaboration (PCOC) is the first effort internationally to measure the outcomes and quality of specialist palliative care services and to benchmark services on a national basis through an independent third party. What are the implications for practitioners? If outcomes and quality are to be measured on a consistent national basis, standard clinical assessment tools that are used as part of everyday clinical practice are necessary.

The association between MC1R genotype and BRAF mutation status in cutaneous melanoma : findings from an Australian population

There is increasing epidemiological and molecular evidence that cutaneous melanomas arise through multiple causal pathways. The purpose of this study was to explore the relationship between germline and somatic mutations in a population-based series of melanoma patients to reshape and refine the divergent pathway model for melanoma. Melanomas collected from 123 Australian patients were analyzed for melanocortin-1 receptor (MC1R) variants and mutations in the BRAF and NRAS genes. Detailed phenotypic and sun exposure data were systematically collected from all patients. We found that BRAF-mutant melanomas were significantly more likely from younger patients and those with high nevus counts, and were more likely in melanomas with adjacent neval remnants. Conversely, BRAF-mutant melanomas were significantly less likely in people with high levels of lifetime sun exposure. We observed no association between germline MC1R status and somatic BRAF mutations in melanomas from this population. BRAF-mutant melanomas have different origins from other cutaneous melanomas. These data support the divergent pathways hypothesis for melanoma, which may require a reappraisal of targeted cancer prevention activities.

Government, citizenship and cultural policy : expertise and participation in Australian media policy

The study of institutions and policy processes in the formation of culture have been a major concern of the "cultural policy debate", which has been a major debate in Australian cultural studies in the 1990s (Bennett 1992a; Cunningham 1992; O'Regan 1993; cf. McGuigan 1996). Bennett (1992) argues that culture in modern societies is defined less by a distinct series of artistic and intellectual practices, the ways of life of distinctive communities or social groups, or as a system for the structuring of meaning in a society, but rather in terms of "the specificity of the governmental tasks and programmes in which those practices come to be inscribed." (Bennett 1992a: 397) Within such a framework, policy becomes "not... an optional add-on but... central to the definition and constitution of culture" (Bennett 1992a: 397). This understanding of culture as "intrinsically governmental" has in turn been linked to an increasingly strategic role for discourses of citizenship as a basis for the engagement of cultural studies intellectuals with the political sphere...

Female genital mutilation : Australian law, policy and practical challenges for doctors

As long ago as 1994, the Family Law Council accepted it was likely that female genital mutilation (FGM) was being conducted in Australia. In 2010, doctors and hospitals reported that it is being conducted and that they are seeing female patients who have experienced FGM. It is impossible to obtain precise data about the extent to which it is performed in Australia, but data indicates that FGM is a relevant issue for Australian medical practitioners. The medical profession has an interest in this topic because its members may be asked to conduct FGM, advise those considering it, or treat female patients with effects from the practice. This article provides a background on the practice of FGM, explains the relevant Australian law, considers whether the current legal prohibition on FGM is justified, and discusses the practical challenges facing individual practitioners and the profession. To inform further discussions about methods of responding to demand for FGM, reference is made to strategies being promoted in African nations to abolish this cultural practice.

Wireless mobility usage: a preliminary study for management in two Australian university settings

Wireless Mobility Usage: A Preliminary Qualitative Study for Management in Two Australian University Settings, Neville Meyers, Heather Gray, Greg Hearn, Louis Sanzogni, and Sandra Lawrence.

Can hybridization cause local extinction : the case for demographic swamping of the Australian native, Senecio pinnatifolius, by the invasive, S. madagascariensis?

The outcome of interspecific hybridization between native and invasive species depends on the relative frequencies of parental taxa and viability of hybrid progeny. We investigated individual and population level consequences of hybridization between the Australian native, Senecio pinnatifolius, and the exotic S. madagascariensis, with AFLP markers and used this information to simulate the expected outcome of hybridization.A high frequency (range 8.3-75.6 %) of hybrids was detected in open pollinated seeds of both species, but mature hybrids were absent from sympatric populations indicating that sympatric populations represent tension zones. A hybridization advantage was observed for S. madagascariensis,where significantly more progeny than expected were sired based on proportional representation of the two species in sympatric populations. Simulations indicated S. pinnatifolius could be replaced in sympatric populations if hybridization was density dependent.For this native-exotic pair, prezygotic isolating barriers are weak, but low hybrid viability maintains a strong postzygotic barrier to introgression. Due to asymmetric hybridization, S. pinnatifolius appears under threat from demographic swamping, and local extinction is possible where it occurs in sympatry with S. madagascariensis.

Reconnecting the interrupted landscape : a cultural landscape approach to Australian open-cut coal mining landscapes

In the late 20th century, a value-shift began to influence political thinking, recognising the need for environmentally, socially and culturally sustainable resource development. This shift entailed moves away from thinking of nature and culture as separate entities - The former existing merely to serve the latter. Cultural landscape theory recognises 'nature' as at once both 'natural', and as a 'cultural' construct. As such it may offer a framework through which to progress in the quest for 'sustainable development'. This 2005 Masters thesis makes a contribution to that quest by asking whether contemporary developments in cultural landscape theory can contribute to rehabilitation strategies for Australian open-cut coal mining landscapes, an examplar resource development landscape. A thematic historial overview of landscape values and resource development in Australis post-1788, and a review of cultural landscape theory literature contribute to the formation of the theoretical framework: "reconnecting the interrupted landscape". The author then explores a possible application of this framework within the Australian open-cut coal mining landscape.

Low frequency of CHEK2 1100delC allele in Australian multiple-case breast cancer families : functional analysis in heterozygous individuals

A protein-truncating variant of CHEK2, 1100delC, is associated with a moderate increase in breast cancer risk. We have determined the prevalence of this allele in index cases from 300 Australian multiple-case breast cancer families, 95% of which had been found to be negative for mutations in BRCA1 and BRCA2. Only two (0.6%) index cases heterozygous for the CHEK2 mutation were identified. All available relatives in these two families were genotyped, but there was no evidence of co-segregation between the CHEK2 variant and breast cancer. Lymphoblastoid cell lines established from a heterozygous carrier contained approximately 20% of the CHEK2 1100delC mRNA relative to wild-type CHEK2 transcript. However, no truncated CHK2 protein was detectable. Analyses of expression and phosphorylation of wild-type CHK2 suggest that the variant is likely to act by haploinsufficiency. Analysis of CDC25A degradation, a downstream target of CHK2, suggests that some compensation occurs to allow normal degradation of CDC25A. Such compensation of the 1100delC defect in CHEK2 might explain the rather low breast cancer risk associated with the CHEK2 variant, compared to that associated with truncating mutations in BRCA1 or BRCA2.

Queers doing theory : Australian queer student activist print media’s representations of capitalism

Queer university student print media often represents capitalism in a framework which could be classified as Marxism. However, at the same time, queer student media extensively publishes ideas which could be classified as academic queer theory. This chapter features analysis of these representations from the 2003, 2004 and 2006 editions of national queer student publication, Querelle, and from a sample of queer student media from four Australian universities. The perspectives of Marxism and academic queer theory are often argued to be contradictory (See for example, Hennessy 1994; Morton 1996b; Kirsch 2007), and thus the students’ application of these theories in tandem could be considered problematic. McKee asks ‘Who gets to be an intellectual?’ (2004) and suggests that the intellectualising undertaken by mainstream and alternative cultural creators is just as valid as that undertaken by university academics. He also raises concerns that the concept of theory is seen to be kept separate from everyday culture (McKee 2002). This chapter argues that in the construction and representation of their politics in this manner the queer student activists are creating their own version of queer theory. This analysis of queer student media contributes to research on queer communities and queer theory, demonstrating how one specific cultural subset theorises queerness and queer politics, thereby contributing to the genealogy of queer.

Relational contracting and its efficacy of project performance in the Australian construction industry

The Australian construction industry is characterized as being a competitive and risky business environment due to lack of cooperation, insufficient trust, ineffective communication and adversarial relationships which are likely lead to poor project performance. Relational contracting (RC) is advocated by literature as an innovative approach to improve the procurement process in the construction industry. Various studies have collectively added to the current knowledge of known RC norms, but there seem to be little effort on investigating the determinants of RC and its efficacy on project outcomes. In such circumstances, there is lack of evidence and explanation on the manner on how these issues lead to different performance. Simultaneously, the New Engineering Contract (NEC) that embraced the concept of RC is seen as a modern way of contracting and also considered as one of the best approaches to the perennial problem of improving adversarial relationships within the industry. The reality of practice of RC in Australia is investigated through the lens of the NEC. A synthesis of literature views on the concept, processes and tools of RC is first conducted to develop the framework of RC. A case study approach is proposed for an in-depth analysis to explore the critical issues addressed by RC in relation to project performance. Understanding the realities of RC will assist stakeholders in the construction industry with their investment in RC.

Project alliancing Vs project partnering : a case study of the Australian National Museum project

Significant differences between project partnering and project alliancing occur in the selection process, management structure of the organisations undertaking the project and nature of risk and reward incentives. This paper helps clarify the nature of project alliancing and how alliance member organisations were selected for this case study. A core issue that differentiates between the two approaches is that in partnering, partners may reap rewards at the expense of other partners. In alliancing each alliance member places their profit margin and reward structure ÁÁat riskÂÂ. Thus in alliancing, the entire alliance entity either benefits together or not all. This fundamentally changes the motivation and dynamics of the relationship between alliance members.