Trends in referral to outpatient cardiac rehabilitation in the Hunter Region of Australia, 2002-2007

BACKGROUND: Cardiac rehabilitation (CR) is an underutilized evidence-based treatment. We described trends in referral to outpatient CR (OCR) and the factors associated with referral. DESIGN: Cross-sectional survey data provided by Hunter residents aged 20 years or older discharged from public hospitals in the region between 2002 and 2007 with an OCR eligible diagnosis were extracted from the Hunter New England Heart and Stroke Register database. METHODS: Trends in referral were determined using the chi test for trend. Factors associated with referral were examined using multiple logistic regression. RESULTS: Sixty-five percent (4971 of 7678) of patients provided sufficient data for inclusion in the analysis. Approximately half of the patients reported being referred to OCR. No increase over time was observed. Factors associated with referral were age less than 70 years, male sex, being married, urban residence, at least one admission to the tertiary referral hospital for cardiology, at least one admission for acute myocardial infarction, revascularization, no admissions for congestive heart failure, a self-reported history of high cholesterol, and no history of stroke or atrial fibrillation. CONCLUSION: Access to this treatment of proven benefit remained suboptimal despite the provision of new programs and expansion of existing programs. Automatic referral, which is recommended in Australia, should be standard practice.

Well-known trade marks, foreign investment and local industry : a comparison of China and Indonesia

Strengthened protection for well-known trade marks in accordance with the TRIPS Agreement is an important issue for developing countries, which has led to trade pressures from industrialised nations in the past. ‘Trade mark squatting’, referring to the registration in bad faith of foreign well-known marks in order to sell them back to their original owners, is a much discussed phenomenon in this context. This article outlines the history and development of well-known trade marks and the applicable law in China and Indonesia. It looks not just at foreign and international brands subjected to ‘trade mark squatting’, but also at how local enterprises are using the system. Rather remarkably in view of the countries’ turbulent histories, local well-known marks have a long history and are well respected for their range of products. They are not normally affected by the ‘trade mark squatting’ phenomenon and are rarely the subject of disputes. Enhanced protection under the TRIPS Agreement is especially relevant for international brands and the article shows the approaches in the two countries. In China, government incentives assist the proliferation of nationally well-known and locally ‘famous’ marks. In Indonesia, lack of implementing legislation has left the matter of recognition to the discretion of the courts.

Life-history and spatial determinants of somatic growth dynamics in Komodo dragon populations

Somatic growth patterns represent a major component of organismal fitness and may vary among sexes and populations due to genetic and environmental processes leading to profound differences in life-history and demography. This study considered the ontogenic, sex-specific and spatial dynamics of somatic growth patterns in ten populations of the world's largest lizard the Komodo dragon (Varanus komodoensis). The growth of 400 individual Komodo dragons was measured in a capture-mark-recapture study at ten sites on four islands in eastern Indonesia, from 2002 to 2010. Generalized Additive Mixed Models (GAMMs) and information-theoretic methods were used to examine how growth rates varied with size, age and sex, and across and within islands in relation to site-specific prey availability, lizard population density and inbreeding coefficients. Growth trajectories differed significantly with size and between sexes, indicating different energy allocation tactics and overall costs associated with reproduction. This leads to disparities in maximum body sizes and longevity. Spatial variation in growth was strongly supported by a curvilinear density-dependent growth model with highest growth rates occurring at intermediate population densities. Sex-specific trade-offs in growth underpin key differences in Komodo dragon life-history including evidence for high costs of reproduction in females. Further, inverse density-dependent growth may have profound effects on individual and population level processes that influence the demography of this species.

Life history and the ecology of stress: how do glucocorticoid hormones influence life-history variation in animals?

Glucocorticoids hormones (GCs) are intuitively important for mediation of age-dependent vertebrate life-history transitions through their effects on ontogeny alongside underpinning variation in life-history traits and trade-offs in vertebrates. These concepts largely derive from the ability of GCs to alter energy allocation, physiology and behaviour that influences key life-history traits involving age-specific life-history transitions, reproduction and survival. Studies across vertebrates have shown that the neuroendocrine stress axis plays a role in the developmental processes that lead up to age-specific early life-history transitions. While environmental sensitivity of the stress axis allows for it to modulate the timing of these transitions within species, little is known as to how variation in stress axis function has been adapted to produce interspecific variation in the timing of life-history transitions. Our assessment of the literature confirms that of previous reviews that there is only equivocal evidence for correlative or direct functional relationships between GCs and variation in reproduction and survival. We conclude that the relationships between GCs and life-history traits are complex and general patterns cannot be easily discerned with current research approaches and experimental designs. We identify several future research directions including: (i) integration of proximate and ultimate measures, including longitudinal studies that measure effects of GCs on more than one life-history trait or in multiple environmental contexts, to test explicit hypotheses about how GCs and life-history variation are related and (ii) the measurement of additional factors that modulate the effects of GCs on life-history traits (e.g. GC receptors and binding protein levels) to better infer neurendocrine stress axis actions. Conceptual models of HPA/I axis actions, such as allostatic load and reactive scope, to some extent explicitly predict the role of GCs in a life-history context, but are descriptive in nature. We propose that GC effects on life-history transitions, survival probabilities and fecundity can be modelled in existing quantitative demographic frameworks to improve our understanding of how GC variation influences life-history evolution and GC-mediated effects on population dynamics Lay Summary Functional Ecology

Knowledge, attitudes, and self care practices associated with age related eye disease in Australia

AIM: To determine the level of correct knowledge about common eye disease and attitudes towards blindness prevention and treatment, and how these factors influence self care practices in a population based sample. METHODS: A cluster random sample of the Victorian population was interviewed. The study population comprised residents aged 40 years of age or older living in five randomly selected Melbourne metropolitan suburbs and four randomly selected rural areas of Victoria. Questions were asked to ascertain each person's knowledge of common age related eye disease--that is, cataract, age related macular degeneration (AMD), and glaucoma. A subsample of the population was also asked questions to determine their attitudes to blindness prevention and treatment. All respondents were asked the year of their last visit to an eye practitioner. RESULTS: A total of 3184 (89%) eligible residents were assessed. Sex (females), age (younger people), higher levels of education (secondary, trade, or tertiary education), recent visit to an eye practitioner (within the past 2 years) and English spoken at home appeared to be significant predictors of knowledge of common age related eye conditions. Younger people believed blindness prevention and blindness treatment were the highest priorities compared with other diseases; people who spoke English at home and people with knowledge of common age related eye disease also considered blindness treatment to be the highest priority compared with other diseases. People with a previous diagnosis of age related eye disease, older people, females, people with correct knowledge of common eye diseases, and those who spoke English at home were significantly more likely to be under eye care. No interaction was found between knowledge and positive attitudes to self care practices. CONCLUSION: These data show that there is a large gap in the public's knowledge and understanding of eye disease that will need to be understood for eye health promotion activities.

Patterns of connectivity and population structure of the southern calamary Sepioteuthis australis in southern Australia

The southern calamary, Sepioteuthis australis, is a commercially and recreationally important inshore cephalopod endemic to southern Australia and New Zealand. Typical of other cephalopods, S. australis has a short life span, form nearshore spawning aggregations and undergo direct development. Such life history traits may restrict connectivity between spawning grounds creating highly structured and genetically differentiated populations that are susceptible to population crashes. Here we use seven polymorphic microsatellite markers to assess connectivity and population structure of S. australis across a large part of its geographic range in Australia. Little genetic differentiation was found between sampling locations. Overall, FST was low (0.005, 95% CI≤<0.001-0.011) and we detected no significant genetic differentiation between any of the locations sampled. There was no strong relationship between genetic and geographical distance, and our neighbour joining analysis did not show clustering of clades based on geographical locations. Similarly, network analysis showed strong connectivity amongst most locations, in particular, Tasmania appears to be well connected with several other locations and may act as an important source population. High levels of gene flow and connectivity between S. australis sampling sites across Australia are important for this short-lived species, ensuring resilience against spatial and temporal mortality fluctuations.

The new Keynesian Phillips curve in a small open economy: empirical evidence from Australia

This study estimates the new Keynesian Phillips curve (NKPC) ofGali and Monacelli for a small open economy using Australian data.Our detailed investigation hinges on estimating the structuralparameters in five different variants of the Gali–Monacelli NKPC,which relates the inflation process to terms of trade and the realexchange rate; the marginal cost and output gap as proxies for realeconomic activity and the hybrid version incorporating bothforward- and backward-looking inflation expectations. The analysisand extensive robustness checks overwhelmingly establish that theGali–Monacelli NKPC cannot explain the dynamics of inflation andis rejected by the Australian data.

Deluges that have gone before: floods in Australian history

As flash floods, tidal surges, cyclones, burst riverbanks and downpours have impacted on much of Eastern Australia, we've heard many references to the floods that have gone before. These floods stand as markers and reference points, in both practical and symbolic ways. But what do we really know of these past floods? And what happens as we move beyond lived memory? Using the Brisbane floods of 1974 and 1893 as reference points, Rear Vision traces some of the stories of flood, and asks what is remembered, whose stories remain, and whether the murky state of collective memory obscures other stories, and other floods.

Trendyville. the battle for Australia's inner cities

Australia’s inner cities experienced an upheaval in the 1960s and 70s which left them changed forever. People from all walks of life who valued their suburbs – places like Balmain, Battery Point, Carlton, Indooropilly, North Adelaide or Subiaco – resisted large-scale development projects for freeways, ‘slum clearance’ and mass-produced high-rise. Unlikely alliances of post-war migrants, university students and staff, construction workers and their unions, long-term residents and city workers,challenged land-grabs and inappropriate development.When the dust settled, Australian cities were different. Many suburbs kept their village qualities. Shopping strips were revived and cultures celebrated. While areas like Fitzroy or Redcliff were derided as ‘Trendyville’, the fate many American cities suffered – a ‘hollow core’ – had been avoided. In the process, heritage conservation, party politics, and Australian assumptions about domestic life, education and lifestyle had all been transformed. This book is an in-depth examination of the causes and consequences of urban protest in a democracy. It shows how it changed the built environment as well as its participants, and resonated in many of our institutions including politics, media and multiculturalism.

Movement ecology and conservation implications for riverine fishes of south-eastern Australia

 This thesis investigates the movement ecology of four riverine fish species in south-eastern Australia and has filled key knowledge gaps that can directly their assist conservation and management. The findings highlight the need to understand species-specific details of fish behaviour and life history for the development of effective conservation and management strategies.

Book review: The High Commissioners: Australia's representatives in the United Kingdom, 1910-2010

The post of Australian High Commissioner in London has always been one of the most important and prestigious of Australia’s diplomatic posts. Indeed, as The High Commissioners demonstrates, for much of the one hundred years for which the post has existed it was an influential link between two parts of the British Empire, rather than a diplomatic mission in a foreign nation. It was for a long time a diplomatic post, but of a hybrid nature; an evolving child of empire. This handsomely produced book is a scholarly study of the position and of the many high commissioners. The chapters, which examine all the high commissioners and a range of related subjects, have been authored by many of Australia’s leading historians of empire and of foreign policy, with the most recent high commissioners covered by former government officials. While the book is designed as a celebration of the centenary of the Australian High Commission in London it is not a work of hagiography. Important analyses are presented of the strengths and weaknesses of many of the key high commissioners, such as George Reid, Andrew Fisher, S.M. Bruce, Alexander Downer senior and John Armstrong. Indeed, the book leaves the strong impression that some of the high commissioners, especially after the Second World War, were often well behind the Australian people in appreciating how the relationship between Australia and the United Kingdom was changing. The research and writing is of a uniformly high standard with each chapter providing many interesting insights into the history of Australian foreign policy.

Book review: Australia's own cold war: The waterfront under Menzies

In recent years, political debate about industrial relations has been dominated by the Howard government’s tendency to strengthen the position of employers against employees. As Tom Sheridan’s fine book, Australia’s Own Cold War: The Waterfront Under Menzies, demonstrates, there has been nothing new in Australian history in the Howard government’s concentration on the relationship between business and labour. The long era of the Menzies governments during the 1950s and 1960s was also dominated by industrial struggles and ideological conflict in the workplace.

War and its resistance in Canada and Australia

This thesis is a comparative history of Canada and Australia’s experience of war and war resistance spanning four centuries. It explores the meaning of war and its historical practice for both colonial societies, offering critical insight into the meaning of nationalism and the evolution of popular and public democracy.

How many times can the same image change? The history of the image in Murujuga

In this paper, I will analyze the history of the image in Murujuga, located in Western Australia, through three stages: creation, preservation and destruction. I will argue that each stage is linked to a turning point in the history of Australia. The first stage is linked to the Dreamtime, a time where Aboriginal cosmology sets the origin of the world. The second stage is linked to the arrival of the white settlers and colonialist practices, where surprisingly the images were neither appropriated nor destroyed, but neglected. The third stage is linked to destruction, where the Aboriginal images from Murujuga does not find a place, and instead are excluded from the multicultural frame of heritage, that Australia boasts. The conclusion will give me the opportunity to discuss how these changes have affected the meaning and perception of these specific images (Aboriginal rock art), by contesting the concept of heritage.