Naturopathic and Western herbal medicine practice in Australia - a workforce survey

Background: Despite substantial growth in the use of complementary medicine, no comprehensive national study has been undertaken of the naturopathic and Western herbal medicine component of the healthcare workforce in Australia. This study aimed to examine the nature of these practices and this currently unregulated workforce in Australia. Methods: A comprehensive survey questionnaire was developed in consultation with the profession and distributed nationally to all members of the naturopathic and Western herbal medicine workforce. Results: The practices of herbal medicine and naturopathy make up a sizeable component of the Australian healthcare sector, with approximately 1.9 million consultations annually and an estimated turnover of $AUD 85 million in consultations (excluding the cost of medicines). A large proportion of patients are referred to practitioners by word of mouth. Up to one third of practitioners work in multidisciplinary clinics with other registered sectors of the healthcare community. The number of adverse events associated with herbal medicines, nutritional substances and homoeopathic medicines recorded in Australia is substantial and the types of events reported are not trivial. Data suggest that practitioners will experience one adverse event every 11 months of full-time practice, with 2.3 adverse events for every 1000 consultations (excluding mild gastrointestinal effects). Conclusion: These data confirm the considerable degree of utilisation of naturopathic and Western herbal medicine practitioners by the Australian public. However, there is a need to examine whether statutory regulation of practitioners of naturopathy and Western herbal medicine is required to better protect the public. (C) 2004 Elsevier Ltd. All rights reserved.

Genetic diversity among community methicillin-resistant Staphylococcus aureus strains causing outpatient infections in Australia

Increasing reports of the appearance of novel nonmultiresistant methicillin-resistant Staphylococcus aureus MRSA (MRSA) strains in the community and of the spread of hospital MRSA strains into the community are cause for public health concern. We conducted two national surveys of unique isolates of S. aureus from clinical specimens collected from nonhospitalized patients commencing in 2000 and 2002, respectively. A total of 11.7% of 2,498 isolates from 2000 and 15.4% of 2,486 isolates from 2002 were MRSA. Approximately 54% of the MRSA isolates were nonmultiresistant (resistant to less than three of nine antibiotics) in both surveys. The majority of multiresistant MRSA isolates in both surveys belonged to two strains (strains AUS-2 and AUS-3), as determined by pulsed-field gel electrophoresis (PFGE) and resistogram typing. The 3 AUS-2 isolates and 10 of the 11 AUS-3 isolates selected for multilocus sequence typing (MLST) and staphylococcal chromosomal cassette mec (SCCmec) analysis were ST239-MRSA-III (where ST is the sequence type) and thus belonged to the same clone as the eastern Australian MRSA strain of the 1980s, which spread internationally. Four predominant clones of novel nonmultiresistant MRSA were identified by PFGE, MLST, and SCCmec analysis: ST22-MRSA-IV (strain EMRSA-15), ST1-MRSA-IV (strain WA-1), ST30-MRSA-IV (strain SWP), and ST93-MRSA-IV (strain Queensland). The last three clones are associated with community acquisition. A total of 14 STs were identified in the surveys, including six unique clones of novel nonmultiresistant MRSA, namely, STs 73, 93, 129, 75, and 80sIv and a new ST. SCCmec types IV and V were present in diverse genetic backgrounds. These findings provide support for the acquisition of SCCmec by multiple lineages of S. aureus. They also confirm that both hospital and community strains of MRSA are now common in nonhospitalized patients throughout Australia.

Diversification and extensible networks: The strategies of Chinese businesses in Australia

The paper reports on a study of 28 ethnic Chinese businesses in Brisbane, Adelaide, and Perth, carried out in 2000 and 2001. It focuses on their strategies of vertical, horizontal, and unrelated diversification often combining different activities, products, and markets at the same time. It demonstrates how these practices are socially embedded in their preference for using personal networks. Non-related diversification, in particular, promotes and is facilitated by using weak ties that serve as bridges, leading into new networks (Granovetter, 1973). This can create links to Chinese of different national and dialect origins and to those of other ethnicities. It is suggested that open networks and diversification mutually interact to support each other and may have evolved in tandem from earlier, more closed and niche bound business cultures and practices.

Neoliberalism, individualisation and community: Regional restructuring in Australia

Since the early 1980s, Australian governments have embraced neoliberal policies as a means of improving the nation’s global economic competitiveness. The impacts of such policies in regional areas have been quite profound, leading to socio-economic polarisation, population loss, and the growth of anti-globalisation sentiments. In this paper, we examine the process of regional restructuring that arises from this trajectory in Australia, and examine current policy responses to change under the neoliberal regime. We argue that while many such responses are individualistic, and based upon policies of personal responsibility, self-advancement and entrepreneurship, others are imbued with the language of community, social capital and collective action. The existence of individualism and community within the same policy agenda may appear contradictory, yet it is suggested that neoliberalism brings together these two opposing discourses through a process of what Nikolas Rose calls ‘governing through community’. We explore how neoliberalism underpins community approaches to regional development in Australia, arguing that such strategies do little to counter the negative forces of globalisation in non-metropolitan parts of the country.

Marriage breakdown in Australia - The social correlates of separation and divorce

Marriage breakdown through separation and divorce is a pervasive feature of Australian society. But little research investigates the social factors associated with marital breakdown in Australia. This study builds on and extends Australian research by using survival analysis models to examine patterns of association among temporal, life-course, attitudinal and economic factors associated with marital breakdown. Using data from the Household Income and Labour Dynamics in Australia (HILDA) survey, we find marital breakdown in Australia is socially patterned in similar ways to other Western countries. But our findings point to several directions for future research into marriage breakdown in Australia, and we identify certain unique features of Australian marriage breakdown that warrant a more detailed investigation, such as the relationship between ethnic origin and the risk of marital breakdown.

Profile of paediatric occupational therapy practice in Australia

Background: The purpose of the present study was to describe a profile of Australian paediatric occupational therapy practice in terms of theories, assessments and interventions used with the most frequently seen client groups. Methods: An ex post facto survey design was utilised. A purpose-designed survey was mailed to 600 occupational therapists identified by OT Australia as working in paediatrics. Results: The response rate was 55% (n = 330). Respondents in the sample worked chiefly with children with developmental delays, learning disabilities, neurological impairments, and infants/toddlers. Theoretical models used by paediatric clinicians that were common to the most frequently seen client groups focused on sensory integration/multisensory approaches, occupational performance, and client-centred practice. Assessment tools most frequently used were the Test of Visual Motor Integration, Sensory Profile, Bruininks-Oseretsky Test of Motor Proficiency, Handwriting Speed Test, and Motor-Free Visual Perception Test. The most often used treatment methods across the four most frequently seen client groups were parent/caregiver education, sensory integration/stimulation techniques, and managing activities of daily living. Conclusions: Paediatric occupational therapists appeared to draw on a range of theoretical models. With the exception of the Sensory Profile, the assessment and treatment methods most frequently used are not congruent with the most commonly used theoretical models. It is critical that the assessment and treatment methods used are conceptually consistent with the theoretical models that guide practice. Occupational therapists need to examine the evidence and determine whether their clinical practice is grounded in the best contemporary theoretical models, assessments and interventions.

Genetic variability of Tomato spotted wilt virus in Australia and validation of real time RT-PCR for its detection in single and bulked leaf samples

The potential for large-scale use of a sensitive real time reverse transcription polymerase chain reaction (RT-PCR) assay was evaluated for the detection of Tomato spotted wilt virus (TSWV) in single and bulked leaf samples by comparing its sensitivity with that of DAS-ELISA. Using total RNA extracted with RNeasy (R) or leaf soak methods, real time RT-PCR detected TSWV in all infected samples collected from 16 horticultural crop species (including flowers, herbs and vegetables), two arable crop species, and four weed species by both assays. In samples in which DAS-ELISA had previously detected TSWV, real time RT-PCR was effective at detecting it in leaf tissues of all 22 plant species tested at a wide range of concentrations. Bulk samples required more robust and extensive extraction methods with real time RT-PCR, but it generally detected one infected sample in 1000 uninfected ones. By contrast, ELISA was less sensitive when used to test bulked samples, once detecting up to I infected in 800 samples with pepper but never detecting more than I infected in 200 samples in tomato and lettuce. It was also less reliable than real time RT-PCR when used to test samples from parts of the leaf where the virus concentration was low. The genetic variability among Australian isolates of TSWV was small. Direct sequencing of a 587 bp region of the nucleoprotein gene (S RNA) of 29 isolates from diverse crops and geographical locations yielded a maximum of only 4.3% nucleotide sequence difference. Phylogenetic analysis revealed no obvious groupings of isolates according to geographic origin or host species. TSWV isolates, that break TSWV resistance genes in tomato or pepper did not differ significantly in the N gene region studied, indicating that a different region of the virus genome is responsible for this trait.

Seasonal variations of phenolic compounds in Australia-grown tea (Camellia sinensis)

Seasonal variations of phenolic compounds in fresh tea shoots grown in Australia were studied using an HPLC method. Three principal tea flavanols [epigallocatechin gallate (EGCG), epicatechin gallate (ECG), and epigallocatechin (EGC)] and four grouped phenolics [total catechins (Cs), total catechin gallates (CGs), total flavanols (Fla), and total polyphenols (PPs)] in fresh tea shoots were analyzed and compared during the commercial harvest seasons from April 2000 to May 2001. The levels of EGCG, ECG, and CGs in the fresh tea shoots were higher in the warm months of April 2000 (120.52, 34.50, and 163.75 mg/g, respectively) and May 2000 (128.63, 44.26, and 183.83 mg/g, respectively) and lower during the cool months of July 2000 (91.39, 35.16, and 132.30 mg/g, respectively), August 2000 (91.31, 31.56, and 128.64 mg/g, respectively), and September 2000 (96.12, 33.51, and 136.90 mg/g, respectively). Thereafter, the levels increased throughout the warmer months from October to December 2000 and remained high until May 2001. In the warmer months, the levels of EGCG, ECG, and CGs were in most cases significantly higher (P < 0.05) than those in the samples harvested in the cooler months. In contrast, the levels of EGC and Cs were high and consistent in the cooler months and low in the warmer months. The seasonal variations of the individual and grouped catechins were significant (P < 0.05) between the cooler and warmer months. This study revealed that EGCG and ECG could be used as quality descriptors for monitoring the seasonal variations of phenolics in Australia-grown tea leaves, and the ratio (EGCG + ECG)/EGC has been suggested as a quality index for measuring the differences in flavanol levels in fresh tea shoots across the growing seasons. Mechanisms that induce seasonal variations in tea shoots may include one or all three of the following environmental conditions: day length, sunlight, and/or temperature, which vary markedly across seasons. Therefore, further studies under controlled conditions such as in a greenhouse may be required to direct correlate flavonoid profiles of green tea leaves with their yields and also to with conditions such as rainfall and humidity.

Application of nox-restriction fragment length polymorphism for the differentiation of Brachyspira intestinal spirochetes isolated from pigs and poultry in Australia

Sixty-nine intestinal spirochetes isolated from pigs and poultry in eastern Australia were selected to evaluate the effectiveness of a species-specific PCR-based restriction fragment length polymorphism (RFLP) analysis of the Brachyspira nox gene. For comparative purposes, all isolates were subjected to species-specific PCRs for the pathogenic species Brachyspira hyodysenteriae and Brachyspira pilosicoli, and selected isolates were examined further by sequence analysis of the nox and 16S ribosomal RNA genes. Modifications to the original nox-RFLP method included direct inoculation of bacterial cells into the amplification mixture and purification of the PCR product, which further optimized the nox-RFLP for use in a veterinary diagnostic laboratory, producing sufficient product for both species identification and future comparisons. Although some novel profiles that prevented definitive identification were observed, the nox-RFLP method successfully classified 45 of 51 (88%) porcine and 15 of 18 (83%) avian isolates into 5 of the 6 recognized species of Brachyspira. This protocol represents a significant improvement over conventional methods currently used in veterinary diagnostic laboratories for rapid specific identification of Brachyspira spp. isolated from both pigs and poultry.