Inequitable provision of optimal services for patients with chronic heart failure : a national geo-mapping study

Objective : To compare the location and accessibility of current Australian chronic heart failure (CHF) management programs and general practice services with the probable distribution of the population with CHF. Design and setting : Data on the prevalence and distribution of the CHF population throughout Australia, and the locations of CHF management programs and general practice services from 1 January 2004 to 31 December 2005 were analysed using geographic information systems (GIS) technology. Outcome measures : Distance of populations with CHF to CHF management programs and general practice services. Results : The highest prevalence of CHF (20.3–79.8 per 1000 population) occurred in areas with high concentrations of people over 65 years of age and in areas with higher proportions of Indigenous people. Five thousand CHF patients (8%) discharged from hospital in 2004–2005 were managed in one of the 62 identified CHF management programs. There were no CHF management programs in the Northern Territory or Tasmania. Only four CHF management programs were located outside major cities, with a total case load of 80 patients (0.7%). The mean distance from any Australian population centre to the nearest CHF management program was 332 km (median, 163 km; range, 0.15–3246 km). In rural areas, where the burden of CHF management falls upon general practitioners, the mean distance to general practice services was 37 km (median, 20 km; range, 0–656 km). Conclusion : There is an inequity in the provision of CHF management programs to rural Australians.

Knowledge making by pre-service teachers on a professional placement experience in a remote Australian indigenous community

This paper reports on the preliminary investigations of an emerging program of research in which the authors are engaged. The program aims to generate new understandings for effective teacher education drawing on data from non-Indigenous pre-service teachers who undertook a teaching placement in remote Indigenous schools in Australia. The overall goals of this research gather around the notion of ‘building belonging’. The initial stage of this project sought to enable pre-service teachers to increase their awareness of the places and institutional practices operating within and between remote Indigenous communities and themselves. The twelve participants were interviewed while on three-week placements around Katherine and in Maningrida in the Northern Territory, Australia, during 2012. The paper elaborates various ways in which the remote placement experience began to challenge, positively disrupt, question and even (re) shape their professional learning and identities. Existing literature reporting on the experiences of largely white, middle class pre-service teachers in unfamiliar cultural contexts draws attention to themes of disruption, and the potential for meaningful and transformative professional learning experiences in such contexts (eg Gannon, 2010; Marble, 2012; Phillips, 2011; Ryan & Healy, 2009). Drawing on some of these insights from the literature, our preliminary reading of the data reveal the variety of ways and differing extents to which participants experienced disruptive, or potentially transformative professional learning moments during the placement. We conclude the paper by pointing towards some key areas for further investigation, in order to progress our research program around building belonging between pre-service teachers and remote Indigenous communities.

Independent and joint associations of TV viewing time and snack food consumption with the metabolic syndrome and its components; a cross-sectional study in Australian adults

Background:
Television (TV) viewing time is positively associated with the metabolic syndrome (MetS) in adults. However, the mechanisms through which TV viewing time is associated with MetS risk remain unclear. There is evidence that the consumption of energy-dense, nutrient poor snack foods increases during TV viewing time among adults, suggesting that these behaviors may jointly contribute towards MetS risk. While the association between TV viewing time and the MetS has previously been shown to be independent of adult’s overall dietary intake, the specific influence of snack food consumption on the relationship is yet to be investigated. The purpose of this study was to examine the independent and joint associations of daily TV viewing time and snack food consumption with the MetS and its components in a sample of Australian adults.

Methods:
Population-based, cross-sectional study of 3,110 women and 2,572 men (>35 years) without diabetes or cardiovascular disease. Participants were recruited between May 1999 and Dec 2000 in the six states and the Northern Territory of Australia. Participants were categorised according to self-reported TV viewing time (low: 0-2 hr/d; high: >2 hr/d) and/or consumption of snack foods (low: 0-3 serves/d; high: >3 serves/d). Multivariate odds ratios [95% CI] for the MetS and its components were estimated using gender-specific, forced entry logistic regression.

Results:
OR [95% CI] for the MetS was 3.59 [2.25, 5.74] (p≤0.001) in women and 1.45 [1.02, 3.45] (p = 0.04) in men who jointly reported high TV viewing time and high snack food consumption. Obesity, insulin resistance and hypertension (women only) were also jointly associated with high TV viewing time and high snack food consumption. Further adjustment for diet quality and central adiposity maintained the associations in women. High snack food consumption was also shown to be independently associated with MetS risk [OR: 1.94 (95% CI: 1.45, 2.60), p < 0.001] and hypertension [OR: 1.43 (95% CI: 1.01, 2.02), p = 0.05] in women only. For both men and women, high TV viewing time was independently associated with the MetS and its individual components (except hypertension).

Conclusion:
TV viewing time and snack food consumption are independently and jointly associated with the MetS and its components, particularly in women. In addition to physical activity, population strategies targeting MetS prevention should address high TV time and excessive snack food intake.

Failed state of health

This article reports research from the News Media and Indigenous Policymaking Project that documents the dynamic interplay between the news media and the Howard Government's policy intervention in the Northern Territory's Indigenous communities.

Increased mortality of naive varanid lizards after the invasion of non-native can toads (bufo marinus)

Exotic animal and plant species introduced into the Australian continent often imparted catastrophic effects on the indigenous fauna and flora. Proponents of biological control introduced the South American Cane Toad (Bufo marinus) into the sugar cane fields of Queensland in 1935. The Cane Toad is one of the most toxic bufonids and when seized by naive Australian predators, the toxin usually kills the attacker. One group of Australian squamate reptiles that are very susceptible to Cane Toad toxins is varanid lizards. Prior to Cane Toad invasion of our study area, the Adelaide River floodplain of the Northern Territory of Australia, annual mortality of adult male radio-tagged yellow-spotted Goannas (Varanus panoptes) was very low. After the arrival of toads in October 2005, all radio-tracked goannas were found dead in August 2006, most likely attempting to feed on the toads. Our results suggest that invasive Cane Toads place naive adult male Yellow-spotted Goannas at risk of possibly >90% mortality. This increase in mortality could reduce the genetic diversity and hamper long-term survival of these large carnivorous lizards.

Review : For love and punishment: who prepares the prisoners' meals?

Book review of: For love & punishment: who prepares the prisoners' meals? 1911-2011 Marking 100 years of International Women's Day and Commonwealth control of the Northern Territory, by Megg Kelham, 2011.

Did the late-2000s financial crisis influence construction labour productivity?

The late-2000s global financial crisis has wrought dramatic impacts on the construction industry. However, the issue of whether the crisis influenced the behaviours of the construction industry has not been addressed yet. This research presents an econometric approach to investigating the effects of the recent global financial crisis on construction labour productivity. By employing the error correction model and panel regression methods, the direct and indirect effects of the financial crisis on the changes in Australian construction labour productivity are explored at national and state levels. Neither the direct nor the indirect effects appear statistically significant. The results indicate that the direct effect of the financial crisis drives up construction labour productivity at the national level, while the indirect effect diminishes productivity. The effects of the financial crisis on the state construction labour productivity vary from state to state. The financial crisis influenced construction labour productivity directly and significantly in the northern and eastern regions, while the direct effects appear not significant in the other states and territories. The indirect effects of the financial crisis on productivity are statistically significant in three regions: the Australian Capital Territory, the Northern Territory and Western Australia. By comparison, the model with the financial effects fails to provide more accurate simulating results. As such, this research concludes that the influence of the late-2000s financial crisis on Australian national and state construction labour productivity is limited.

Urban to forest gradients: suitability for hollow bearing trees and implications for obligate hollow nesters

 Resource availability is a limiting factor influencing the distribution and composition of faunal communities. Globally, hollow bearing trees are a resource required by wildlife at all trophic levels, and are used for a diverse range of ecological functions. In the northern hemisphere avian species act as primary hollow excavators, whereas the southern hemisphere must rely on complex interactions between stochastic events, and eventual decay. Hollow formation is therefore a slow process in the southern hemisphere. In contrast, hollow loss is quite rapid and influenced greatly by anthropogenic impacts.To identify the ecological characteristics driving hollows over an urban to forest gradient as a resource for the powerful owl (Ninox strenua) and its prey we used presence-only modelling. The potential for an area to support tree hollows suitable for powerful owls and their prey was linked to the density of ephemeral rivers, land cover, tree cover and distance from riparian vegetation. The potential for large hollows throughout the landscape, suitable for the powerful owl, was also influenced by density of permanent rivers. Potential habitat for tree hollows, capable of supporting powerful owls and their prey was greatest in forested environments, declining with increased urbanization. However the urban region still supported some smaller tree hollows suitable for arboreal marsupials. Managing for urban dwelling species, is not as simple as retaining old hollow producing trees or providing alternate nesting structures. We also need to mitigate increased mortality associated with built environments (e.g. electrocution, collisions).

Australian Enterococcal Sepsis Outcome Programme annual report, 2013.

From 1 January to 31 December 2013, 26 institutions around Australia participated in the Australian Enterococcal Sepsis Outcome Programme (AESOP). The aim of AESOP 2013 was to determine the proportion of enterococcal bacteraemia isolates in Australia that are antimicrobial resistant, and to characterise the molecular epidemiology of the Enterococcus faecium isolates. Of the 826 unique episodes of bacteraemia investigated, 94.6% were caused by either E. faecalis (56.1%) or E. faecium (38.5%). Ampicillin resistance was not detected in E. faecalis but was detected in over 90% of E. faecium. Vancomycin non-susceptibility was reported in 0.2% and 40.9% of E. faecalis and E. faecium respectively and was predominately due to the acquisition of the vanB operon. Overall, 41.6% of E. faecium harboured vanA or vanB genes. The percentage of E. faecium bacteraemia isolates resistant to vancomycin in Australia is significantly higher than that seen in most European countries. E. faecium isolates consisted of 81 pulsed-field gel electrophoresis pulsotypes of which 72.3% were classified into 14 major pulsotypes containing five or more isolates. Multilocus sequence typing grouped the 14 major pulsotypes into clonal cluster 17, a major hospital-adapted polyclonal E. faecium cluster. Of the 2 predominant sequence types, ST203 (80 isolates) was identified across Australia and ST555 (40 isolates) was isolated primarily in the western and central regions (Northern Territory, South Australia and Western Australia) respectively. In conclusion, the AESOP 2013 has shown enterococcal bacteraemias in Australia are frequently caused by polyclonal ampicillin-resistant high-level gentamicin resistant vanB E. faecium, which have limited treatment options.

Behavioural flexibility allows an invasive vertebrate to survive in a semi-arid environment

Plasticity or evolution in behavioural responses are key attributes of successful animal invasions. In northern Australia, the invasive cane toad (Rhinella marina) recently invaded semi-arid regions. Here, cane toads endure repeated daily bouts of severe desiccation and thermal stress during the long dry season (April-October). We investigated whether cane toads have shifted their ancestral nocturnal rehydration behaviour to one that exploits water resources during the day. Such a shift in hydration behaviour could increase the fitness of individual toads by reducing exposure to desiccation and thermal stress suffered during the day even within terrestrial shelters. We used a novel method (acoustic tags) to monitor the daily hydration behaviour of 20 toads at two artificial reservoirs on Camfield station, Northern Territory. Remarkably, cane toads visited reservoirs to rehydrate during daylight hours, with peaks in activity between 9.00 and 17.00. This diurnal pattern of rehydration activity contrasts with nocturnal rehydration behaviour exhibited by adult toads in their native geographical range and more mesic parts of Australia. Our results demonstrate that cane toads phase shift a key behaviour to survive in a harsh semi-arid landscape. Behavioural phase shifts have rarely been reported in invasive species but could facilitate ongoing invasion success.

Validation of a body-worn accelerometer to measure activity patterns in octogenarians

OBJECTIVE: To determine the validity of a triaxial body-worn accelerometer for detection of gait and postures in people aged >80 years. DESIGN: Participants performed a range of activities (sitting, lying, walking, standing) in both a controlled and a home setting while wearing the accelerometer. Activities in the controlled setting were performed in a scripted sequence. Activities in the home setting were performed in an unscripted manner. Analyzed accelerometer data were compared against video observation as the reference measure. SETTING: Independent-living and long-term-care retirement village. PARTICIPANTS: Older people (N=22; mean age ± SD, 88.1±5y) residing in long-term-care and independent-living retirement facilities. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The level of agreement between video observation and the accelerometer for the total duration of each activity, and second-by-second correspondence between video observation and the accelerometer for each activity. RESULTS: The median absolute percentage errors between video observation and the accelerometer were <1% for locomotion and lying. The absolute percentage errors were higher for sitting (median, -22.3%; interquartile range [IQR], -62.8% to 10.7%) and standing (median, 24.7%; IQR, -7.3% to 39.6%). A second-by-second analysis between video observation and the accelerometer found an overall agreement of ≥85% for all activities except standing (median, 56.1%; IQR, 34.8%-81.2%). CONCLUSIONS: This single-device accelerometer provides a valid measure of lying and locomotion in people aged >80 years. There is an error of approximately 25% when discriminating sitting from standing postures, which needs to be taken into account when monitoring longer-term habitual activity in this age group.

Construction labor productivity convergence: a conditional frontier approach

Purpose-Understanding and simulating construction activities is a vital issue from a macro-perspective, since construction is an important contributor in economic development. Although the construction labor productivity frontier has attracted much research effort, the temporal and regional characteristics have not yet been explored. The purpose of this paper is to investigate the long-run equilibrium and dynamics within construction development under a conditional frontier context. Design/methodology/approach-Analogous to the simplified production function, this research adopts the conditional frontier theory to investigate the convergence of construction labor productivity across regions and over time. Error correction models are implemented to identify the long-run equilibrium and dynamics of construction labor productivity against three types of convergence hypotheses, while a panel regression method is used to capture the regional heterogeneity. The developed models are applied to investigate and simulate the construction labor productivity in the Australian states and territories. Findings-The results suggest that construction labor productivity in Australia should converge to stable frontiers in a long-run perspective. The dynamics of the productivity are mainly caused by the technology utilization efficiency levels of the local construction industry, while the influences of changes in technology level and capital depending appear limited. Five regional clusters of the Australian construction labor productivity are suggested by the simulation results, including New South Wales; Australian Capital Territory; Northern Territory, Queensland, and Western Australia; South Australia; and Tasmania and Victoria. Originality/value-Three types of frontier of construction labor productivity is proposed. An econometric approach is developed to identify the convergence frontier of construction labor productivity across regions over time. The specified model can provides accurate predictions of the construction labor productivity.

The development of bauxite at Gove, 1955–1975

In the early 1950s Australia mined little bauxite and produced no alumina, that being the chemically pure aluminium oxide which is extracted from bauxite and then smelted in electric furnaces to produce aluminium metal. The huge costs of aluminium production meant that, after World War II, six large companies dominated the aluminium industry worldwide, from mining bauxite through to fabricating and selling metal. These were Alcoa, Reynolds Metals and Kaiser in the United States, Alcan in Canada, Pechiney in France and Alusuisse in Switzerland. In the 1940s the Chifley government planned a small aluminium smelter in Tasmania largely for defence purposes, and originally dependent on imported bauxite. Government co-operation with industry to search for indigenous bauxite feedstock for the smelter saw two discoveries of bauxite at about the same time in northern Australia in the 1950s-the first at Gove in the Northern Territory and the second, much larger find, across the Gulf of Carpentaria in Queensland. These two discoveries and the proving of bauxite deposits of commercial grade in Western Australia a few years later meant that Australia possessed an astonishing one third of the world's bauxite by the early 1960s.