Book review: Stanley Melbourne Bruce: Australian Internationalist

Stanley Melbourne Bruce was at the centre of Imperial politics for more than two decades from the early 1920s until the end of the Second World War. This new biography presents Bruce as a consistent internationalist. Educated in Melbourne and Cambridge, Bruce, as a businessman, was alive to the importance of international commerce, and particularly Anglo-Australian trade. This lay at the core of his internationalism, which took the form in the 1920s of encouraging the political and economic integration of the British Empire. Bruce's punitive treatment of militant Australian trade unionists and his upholding of constitutionalism and law and order in the 1920s was part of an effort to defend one form of internationalism, commitment to the British Empire, against the competing international ideology of communism. While continuing to support a unified British Empire acting as a progressive force in world affairs, Bruce championed stronger international collaboration through the League of Nations and the United Nations and through cooperation between the Empire and the United States.

On an ordinary suburban street: a brief history of Melbourne's Jewish Holocaust Centre

The Jewish Holocaust Centre (JHC) in Melbourne Australia, set well away from the sites of European atrocity, became one of the first permanent museums dedicated to the Holocaust in the Jewish Diaspora when it opened in March 1984. It was the response to the imminent passing of the survivor generation. You can enter this past from the present through an ordinary, nondescript door, opening from a suburban street. You walk up a short flight of carpeted stairs, as you might in your own house, but there waiting for you is something other than the faces of your children or parents. (Harry Redner).Upstairs in Leo Fink House, the original location for Melbourne's first permanent Holocaust exhibition, where thousands of school students now listen each year to the testimonies of Melbourne's dwindling number of Holocaust survivors, an unremarkable white door shows the original entrance. Before the changes to the location of the exhibition, and the building of the Hadasa and Szymon Rosenbaum Research Centre, the first visitors to the museum would have entered Leo Fink House from the street through Redner's 'nondescript door', past a brass plaque with words in English, Yiddish and Hebrew, and would have climbed the stairs to enter through a white door to view the intimate exhibition.These traces of the former configuration of the JHC reveal changes to the institution as it responded to different priorities, opportunities and a growth in visitor numbers during its 30-year history. The concept of biography helps us think through these changes, but also points to a longer historical focus.

The Indian diaspora : Hindus and Sikhs in Australia

Since the late 1990s, the Indian community in Australia has grown faster than any other immigrant community. The Indian Diaspora has made substantial contributions to the multi-ethnic and multi-religious diversity within Australia. The growth of Hinduism and Sikhism through gurus, temples, yoga and rituals of many kind has brought new colours, images, customs and practices to the profile of Australian religion, and the Australian landscape more widely. At the same time, Hinduism and Sikhism have themselves been transformed as Hindus and Sikhs from different parts of India as well as Fiji, Malaysia and other parts of the world have come together to establish a pan-Indian ethos. Hindus and Sikhs here have also interacted with other sectors of the Australian population and with religions from the Western world. This is the theme of this book.The Indian Diaspora covers the theory of diaspora, the historical development of the Indian communities in Australia since the late 19th century to the present times, current practices and statistical profiles of Hindus and Sikhs in Australia, and interactions between Hindus and Sikhs with the wider Australian community. There are case-studies of the Indian students and women in the Australian community, of Indian communities in Melbourne and South Australia, and of temple building and the Sikh gurdwara. The book has been edited by and contains contributions from Purushottama Bilimoria, an internationally-known scholar of philosophy and religion, Jayant Bhalchandra Bapat, one of Australia’s most senior Hindu priests and a scholar of Hinduism, and Philip Hughes, a leading analyst of the religious profiles of the Australian people. It also contains contributions from several other prominent scholars. Included are special essays on the importance of diaspora by the late Ninian Smart and on the 19th century Afghan cameleers and Indian hawkers.

The complexity of preschool children’s dramatic play behaviour and play styles in Australia: a mixed methods study

Dramatic play is recognised as an important source of learning and development for preschool children, yet there are increasing reports that the quality of dramatic play is declining. This paper aims to report on the findings of a mixed method study that examined the constructs of Australian preschool children’s dramatic play behaviour. Video observations and the Smilansky Scale for the Evaluation of Dramatic and Socio-Dramatic Play (Smilanksy & Shefatya, 1990) were used with 101 preschool children aged 4 to 6 years in selected early childhood educational settings in Melbourne, Australia. Findings reveal that the overall level of children’s dramatic play behaviour was low. A typology of four play styles will be presented. Implications on educators’ pedagogy are discussed.

Barriers, enablers and challenges to initiating end-of-life care in an Australian intensive care unit context.

BACKGROUND: Patients admitted to Australian intensive care units are often critically unwell, and present the challenge of increasing mortality due to an ageing population. Several of these patients have terminal conditions, requiring withdrawal of active treatment and commencement of end-of-life (EOL) care. OBJECTIVES: The aim of the study was to explore the perspectives and experiences of physicians and nurses providing EOL care in the ICU. In particular, perceived barriers, enablers and challenges to providing EOL care were examined. METHODS: An interpretative, qualitative inquiry was selected as the methodological approach, with focus groups as the method for data collection. The study was conducted in Melbourne, Australia in a 24-bed ICU. Following ethics approval intensive care physicians and nurses were recruited to participate. Focus group discussions were discipline specific. All focus groups were audio-recorded then transcribed for thematic data analysis. RESULTS: Five focus groups were conducted with 11 physicians and 17 nurses participating. The themes identified are presented as barriers, enablers and challenges. Barriers include conflict between the ICU physicians and external medical teams, the availability of education and training, and environmental limitations. Enablers include collaboration and leadership during transitions of care. Challenges include communication and decision making, and expectations of the family. CONCLUSIONS: This study emphasised that positive communication, collaboration and culture are vital to achieving safe, high quality care at EOL. Greater use of collaborative discussions between ICU clinicians is important to facilitate improved decisions about EOL care. Such collaborative discussions can assist in preparing patients and their families when transitioning from active treatment to initiation of EOL care. Another major recommendation is to implement EOL care leaders of nursing and medical backgrounds, and patient support coordinators, to encourage clinicians to communicate with other clinicians, and with family members about plans for EOL care.

Lazarus rises: storying the self in the migrant fandom of David Bowie

In this article we focus upon the ways that “migrants” in Melbourne have used David Bowie to story and make sense of their arrival to Australia, often as refugees or as people looking for a better life. In relation to identity and belonging, some recent work on music fandom (Groene and Hettinger 2015; Lowe 2003), has imposed a meta-frame on the empirical method, substituting voices for a top-down analysis and interpretation. Our approach is to instead draw both upon auto-ethnography and to allow our fellow fans to “story” their own responses, in an attempt to get beneath the modes of feeling that music fandom ignites – situated within the narratives that people construct as they talk these stories. We argue that Bowie’s alternative and outsider status resonates keenly with people who find themselves “strangers” in a new land.

Impact of a modified nursing handover model for improving nursing care and documentation in the emergency department: A pre- and post-implementation study

The aim of this study was to evaluate whether implementation of a new nursing handover model led to improved completion of nursing care activities and documentation. A pre- and post-implementation study, using a survey and document audit, was conducted in a hospital ED in Melbourne. A convenience sample of nurses completed the survey at baseline (n = 67) and post-intervention (n = 59), and the audit was completed at both time points. Results showed significant improvements in several processes: handover in front of the patient (P < 0.001), patients contributed and/or listened to handover discussions (P < 0.001), and provision of adequate information about all patients in the department (P < 0.001). Nurses also reported a reduction in omission of vital signs (P = 0.022) during handover. Three hundred sixty-eight medical records were audited in the two study periods: 173 (pre-intervention) and 195 (post-intervention). Statistically significant improvements in the completion of two nursing care tasks and three documentation items were identified. The findings suggest that implementation of a new handover model improved completion of nursing care activities and documentation, and transfer of important information to nurses on oncoming shifts.

When continuity of care breaks down: a systems failure in identification of osteoporosis risk in older patients treated for minimal trauma fractures

OBJECTIVE: Minimal trauma fractures may be the first indication of osteoporosis. Our aim was to determine the proportion of patients who underwent bone density testing for osteoporosis of those with a minimal trauma wrist fracture treated in the emergency department (ED).

DESIGN: This observational retrospective cohort study used explicit medical record review and scripted telephone interviews.

SETTING: EDs of three metropolitan hospitals in Melbourne in 2006.

PARTICIPANTS: Patients aged 50 years and over who were treated for wrist fracture due to minimal trauma. Data collected included demographic details, fracture details, causes of injury, any bone density testing and any osteoporosis-related medication change.

MAIN OUTCOME MEASURE: The proportion of patients who underwent bone density testing in the follow-up period.

RESULTS: 131 patients were studied; 83% were female, and the median age was 71 years. No patient was referred by an ED or fracture clinic for bone density testing (95% CI, 0-3.5%). Telephone follow-up data were obtained from 91 patients. Of these, 28 reported having bone density testing after their fracture, of whom 14 (50%; 95% CI, 32%-67%) were found to have osteoporosis. Seven were treated with a bisphosphonate and one with a selective oestrogen-receptor modulator.

CONCLUSION: Follow-up of patients suffering minimal trauma wrist fractures treated in the ED is poor. Systems to improve the identification and treatment of osteoporosis in this group are needed if future osteoporotic fractures and their consequences are to be avoided.

Information system development for demolition material management

Proceedings of 12th International Conference on Information Systems and Development, held in Melbourne, Australia, August 29-31, 2003

Coronary angiography observations: evidence-based or ritualistic practice?

Objective: The purposes of this study were to describe the incidence and occurrence of femoral artery bleeding during the first 6 hours after coronary angiography and to determine whether there is a relationship between  current postangiogram observation protocols and the detection of  complications.

Design: This was a prospective descriptive study.

Setting: The study was conducted in 3 university hospitals in Melbourne, Australia.

Patients: Subjects included 55 patients representing the complication rate of 1075 patients, mean age 61 years (SD, 12), 69% male.

Results: About 5.1% of patients had 1 or more incidents of bleeding  requiring manual compression. In 4.2% of patients, bleeding occurred within 6 hours of angiography. Bleeding occurred a median of 2.02 hours (Q1 = 45 minutes, Q3 = 4.31 hours) after angiography. Patients without pressure bandaging bled a median of 1.32 hours (Q1 = 36.50 minutes, Q3 = 2.59 hours) after angiography. Patients with pressure bandaging bled a median of 4.75 hours (Q1 = 2.25 hours, Q3 = 7.28 hours) after angiography. In 40.6% of cases, bleeding was detected through the patient’s call for assistance, and in 59.4% of cases nurses noted bleeding while checking the puncture site. Postcatheter observations were recorded 23.70 (SD, 14.60) minutes before the bleeding incident. There were no significant changes in vital signs, systolic blood pressure (P > .05), diastolic blood pressure (P > .05), or pulse (P > .05) before or during a bleeding episode. All were within normal parameters. No neurovascular assessment anomalies were detected.

Conclusion: The use of pressure bandaging has a significant effect on the incidence and pattern of bleeding. Routine vital sign measurement has no relevance in detecting local complications after angiography. The most significant complication is bleeding that requires manual compression. Detection is through frequent puncture site observation and patient recognition and communication.

McCoy and Clarke : their dispute over the age of Australia's black coal

From 1847 until his death in 1899, Professor Frederick McCoy, palaeontologist in Melbourne, maintained a war of words in the scientific literature with Rev. William Clarke, geologist in Sydney, concerning the age of Australia’s black coal deposits. McCoy was convinced that the coals were all of Mesozoic age and Clarke, during the period from 1847 to his death in 1878, maintained equally vehemently that they were Palaeozoic. In fact, Clarke was correct in placing the New South Wales coals in the Palaeozoic, and McCoy’s placing of the Victorian coals in the Mesozoic was also correct. The two men were both particularly stubborn and neither would admit that they might have been arguing about coals of differing ages. Both stood unbendingly by their Northern Hemisphere, European backgrounds, and neither would change their views in the face of new evidence from the Colonies.

Bystander resuscitation attempts at heroin overdose: does it improve outcomes?

Study objective: To document the characteristics and effectiveness of cardiopulmonary resuscitation (CPR) at non-fatal heroin overdose events in Melbourne, Australia. Methods: A retrospective analysis of a computerised database of ambulance attendance records at non-fatal heroin overdose cases for the period 1/12/1998 to 31/7/2000 was undertaken.

Main outcome measures: The main outcome measure was the rate of patient hospitalisation. The rate of CPR administration at heroin overdose cases was also examined, along with characteristics of the attendance, such as the age and sex of the overdose case, the relationship of person providing CPR to the overdose case as well as the location, time and date of the event.

Results: CPR was administered prior to ambulance arrival in 579 heroin overdose cases (9.4% of total heroin overdose cases attended) between 1/12/98 and 31/7/2000. A greater proportion of female overdose cases were administered CPR than males and CPR administrations were evenly distributed across attendances occurring in private and public locations. Bystander administration of CPR prior to ambulance attendance resulted in a significantly lower rate of heroin user hospitalisation (14.5%) compared to cases where bystander CPR was not administered (18.8%).

Conclusions: While CPR administration prior to ambulance attendance at heroin overdose events is relatively uncommon (especially compared to out-of-hospital cardiac arrest), such administration was associated with a statistically significant improvement in clinical outcomes in cases of non-fatal heroin overdose. These findings suggest that the provision of CPR training to people likely to come into contact with heroin overdose events may be an effective strategy at minimising consequent overdose-related harm.

Body image and physical disability - personal perspectives

The current study used qualitative methodology to investigate the body image concerns of people with physical disabilities. Three males and four females aged between 22 and 50 years, in Melbourne, Australia, participated in the study. Three participants were heterosexual, two were homosexual and two described their sexual identity as predominantly heterosexual but ‘bicurious’. The data were gathered through individual interviews of approximately 2 h duration, where participants responded to a set of predetermined open-ended questions. The study found that bodily impairment had a negative influence on the participants’ psychological experiences, feelings and attitudes toward their own bodies. The impact of feedback from the social environment was highlighted, and there was evidence suggesting that individuals gradually adjust to their different bodies and increasingly accept their disabilities over time.

Consumers` sensory and nutritional perceptions of three types of milk

Objective: To identify consumer perceptions of whole milk, reduced-fat milk and soy milk, and to investigate demographic influences on perceptions and types of milk consumption.

Design and setting: Questionnaires covering nutritional and sensory perceptions of three types of milk.

Subjects: Three hundred and sixty-one randomly selected shoppers in Melbourne, Australia.

Results: Generally, respondents held positive perceptions about milk. Milk was considered as having good sensory properties, providing a good source of nutrients, and being a convenient and safe product. However, despite these findings, misperceptions and unawareness about the nutrient content of milk were prevalent. Negative perceptions were most common for whole milk and were mostly related to its perceived high fat, cholesterol and energy contents. Soy milk received lower ratings on sensory quality and convenience than dairy milk. There were few sociodemographic differences in consumers' perceptions. Although reduced-fat milk consumption was more frequent among elderly people and type of milk consumption was related to parenthood, no other significant effects of demographic variables were found on the consumption of specific milk types.

Conclusion: Although positive perceptions were common, negative perceptions and misperceptions appear to be prevalent, presenting a challenge for nutrition education. Sociodemographic factors were not shown to be important predictors of perceptions and type of milk consumption.

Public perceptions of the causes and prevention of obesity among primary school children

OBJECTIVE: To investigate lay perceptions of the causes and prevention of obesity among primary school children.

DESIGN: A cross-sectional survey of randomly selected sample of adults in a shopping centre.

SUBJECTS: 315 adults in Melbourne, Australia.

MEASUREMENTS: Subjects completed a self-completion questionnaire, in which they rated the importance of 25 possible causes of obesity and the importance of 13 preventive measures on four-point scales: not important; quite important; very important; extremely important. Demographic information about the respondents' age, sex, marital status, education level and parental status was also collected.

RESULTS: The most important reported causes of childhood obesity were related to overconsumption of unhealthy food, parental responsibility, modern technology and the mass media. The most popular prevention activities were associated with specific actions aimed at children. Principal components analysis of the causes data revealed eight factors, provisionally named: parental responsibility, modern technology and media, overconsumption of unhealthy food, children's lack of knowledge and motivation, physical activity environment, lack of healthy food, lack of physical activity and genes. Two prevention factors were also derived, named government action and children's health promotion. Parents saw modern technology and media, and government activities as more important causes, and government policy as a more important means of prevention than nonparents and men. Women's responses tended to be similar to those of parents. There were few educational differences, although nontertiary educated respondents reported that modern technology and media were more important causes of obesity than did the tertiary educated.

CONCLUSION: The findings suggest that the public appears to hold quite sophisticated views of the causes and prevention of children's obesity. They suggest that a number of prevention strategies would be widely supported by the public, especially by parents.