Back to normal: A retrospective, cross-sectional study of the multi-factorial determinants of normal birth in Queensland, Australia

Background Currently, care providers and policy-makers internationally are working to promote normal birth. In Australia, such initiatives are being implemented without any evidence of the prevalence or determinants of normal birth as a multidimensional construct. This study aimed to better understand the determinants of normal birth (defined as without induction of labour, epidural/spinal/general anaesthesia, forceps/vacuum, caesarean birth, or episiotomy) using secondary analyses of data from a population survey of women in Queensland, Australia. Methods Women who birthed in Queensland during a two-week period in 2009 were mailed a survey approximately three months after birth. Women (n=772) provided retrospective data on their pregnancy, labour and birth preferences and experiences, socio-demographic characteristics, and reproductive history. A series of logistic regressions were conducted to determine factors associated with having labour, having a vaginal birth, and having a normal birth. Findings Overall, 81.9% of women had labour, 66.4% had a vaginal birth, and 29.6% had a normal birth. After adjusting for other significant factors, women had significantly higher odds of having labour if they birthed in a public hospital and had a pre-existing preference for a vaginal birth. Of women who had labour, 80.8% had a vaginal birth. Women who had labour had significantly higher odds of having a vaginal birth if they attended antenatal classes, did not have continuous fetal monitoring, felt able to ‘take their time’ in labour, and had a pre-existing preference for a vaginal birth. Of women who had a vaginal birth, 44.7% had a normal birth. Women who had a vaginal birth had significantly higher odds of having a normal birth if they birthed in a public hospital, birthed outside regular business hours, had mobility in labour, did not have continuous fetal monitoring, and were non-supine during birth. Conclusions These findings provide a strong foundation on which to base resources aimed at increasing informed decision-making for maternity care consumers, providers, and policy-makers alike. Research to evaluate the impact of modifying key clinical practices (e.g., supporting women׳s mobility during labour, facilitating non-supine positioning during birth) on the likelihood of a normal birth is an important next step.

Mid-Holocene Aboriginal occupation of offshore islands in northern Australia? A reassessment of Wurdukanhan, Mornington Island, southern Gulf of Carpentaria, Australia

Claims for mid-Holocene Aboriginal occupation at the shell matrix site of Wurdukanhan, Mornington Island, Gulf of Carpentaria, Australia, are reassessed through an analysis of the excavated assemblage coupled with new surveys and an extensive dating program. Memmott et al. (2006, pp. 38, 39) reported basal ages of c.5000–5500 years from Wurdukanhan as 'the oldest date yet obtained for any archaeological site on the coast of the southern Gulf of Carpentaria' and used these dates to argue for 'a relatively lengthy occupation since at least the mid-Holocene'. If substantiated, with the exception of western Torres Strait, these claims make Mornington Island the only offshore island used across northern Australia in the mid-Holocene where it is conventionally thought that Aboriginal people only (re)colonised islands after sea-level maximum was achieved after the mid-Holocene. Our analysis of Wurdukanhan demonstrates high shellfish taxa diversity, high rates of natural shell predation and high densities of foraminifera throughout the deposit demonstrating a natural origin for the assemblage. Results are considered in the context of other dated shell matrix sites in the area and a geomorphological model for landscape development of the Sandalwood River catchment.

Key opportunities for the future of roads to contribute to Australia's climate change response

Road agencies face growing pressure to respond to a range of issues associated with climate change and the reliance on fossil fuels. A key part of this response will be to reduce the dependency on fossil fuel based energy (and the associated greenhouse gas emissions) of transport, both vehicles and infrastructure. This paper presents findings of investigations into three key areas of innovative technologies and processes, namely the inclusion of onsite renewable energy generation technologies as part of road and transport infrastructure, the potential for automated motorways to reduce traffic fuel consumption (referred to as 'Smart Roads'), and the reduction of energy demand from route and signal lighting. The paper then concludes with the recommendation for the engineering profession to embrace sustainability performance assessment and rating tools as the basis for enhancing and communicating the contribution to Australia's response to climate change. Such tools provide a rigorous structure that can standardise approaches to key issues across entire sectors and provide clarity on the evidence required to demonstrate leading performance. The paper has been developed with funding and support provided by Australia's Sustainable Built Environment National Research Centre (SBEnrc), working with partners including Main Roads Western Australia, NSW Roads and Maritime Services, Queensland Department of Transport and Main Roads, John Holland Group, the Infrastructure Sustainability Council of Australia, Roads Australia, and the CRC for Low Carbon Living.

Current practice in nutrition diagnosis and intervention for the management of Parkinson's disease in Australia and Canada

Aim To document current practice by dietitians in Australia and Canada in the nutrition management of Parkinson's disease. This will help identify priority areas for review and development of practice guidelines and direct future research. Methods Current practice in the phases of the Nutrition Care Plan was captured using an online survey distributed to Dietitians Association of Australia members and Practice-Based Evidence in Nutrition subscribers through their email newsletters. The results of the diagnosis, intervention and monitoring phases are presented here. Results Eighty-four dietitians responded. There was consistency in practice for nutrition issues that are encountered in other populations, such as malnutrition and constipation. There was more variation in practice in the nutrition issues that are more specific to Parkinson's disease, such as nutrition and meal interactions with medication. A lack of awareness of emerging treatments, such as deep brain stimulation surgery, appears to exist in the responding dietitians. Conclusions The variation in practice that was present for the nutrition issues specific to Parkinson's disease may reflect the lack of quality evidence and subsequently evidence-based guidelines in these areas. Work to provide background information about treatment options and to translate current evidence for the nutrition issues that are specific to Parkinson's disease into practice recommendations should be completed.

Practice patterns of radiation therapy technology in Australia: Results of a national audit

This article presents the results of a single-day census of radiation therapy (RT) treatment and technology use in Australia. The primary aim of the study was to ascertain patterns of RT practice and technology in use across Australia. These data were primarily collated to inform curriculum development of academic programs, thereby ensuring that training is matched to workforce patterns of practice. Methods: The study design was a census method with all 59 RT centres in Australia being invited to provide quantitative summary data relating to patient case mix and technology use on a randomly selected but common date. Anonymous and demographic-free data were analysed using descriptive statistics. Results: Overall data were provided across all six Australian States by 29 centres of a possible 59, yielding a response rate of 49% and representing a total of 2743 patients. Findings from this study indicate the increasing use of emerging intensity-modulated radiotherapy (IMRT), image fusion and image-guided radiation therapy (IGRT) technology in Australian RT planning and delivery phases. IMRT in particular was used for 37% of patients, indicating a high uptake of the technology in Australia when compared to other published data. The results also highlight the resource-intensive nature of benign tumour radiotherapy. Conclusions: In the absence of routine national data collection, the single-day census method offers a relatively convenient means of measuring and tracking RT resource utilisation. Wider use of this tool has the potential to not only track trends in technology implementation but also inform evidence-based guidelines for referral and resource planning.

Evaluating the potential use of direct evaporative cooling in Australia

Greenhouse gas emissions and associated global climate change are a significant and growing concern for the world community. In order to improve building energy efficiency, the use of evaporative cooling systems is attracting growing attention. Using a climate assessment tool, the potential use of direct evaporative coolers over different Australian climates is evaluated. It is found that overall, the potential use of direct evaporative cooling is very significant in Australian climates. Among all the eight capital cities across Australia, except for Darwin, the need of hybrid cooling for other cities is found to be insignificant,and is less than 5% if appropriate air circulation is provided on hot/warm days. It is also found that the potential use of evaporative cooling can be significantly influenced by a change in the applications or design parameters. In Brisbane, it is estimated that with an increase of sensible cooling load from 30 W/m2 to 40 W/m2 in the conditioned space, the requirement in hours of hybrid cooling can increase significantly, from 4.06% to 14.89%.

External auditors’ perceptions of cloud computing adoption in Australia

Adopting a multi-theoretical approach, I examine external auditors’ perceptions of the reasons why organizations do or do not adopt cloud computing. I interview forensic accountants and IT experts about the adoption, acceptance, institutional motives, and risks of cloud computing. Although the medium to large accounting firms where the external auditors worked almost exclusively used private clouds, both private and public cloud services were gaining a foothold among many of their clients. Despite the advantages of cloud computing, data confidentiality and the involvement of foreign jurisdictions remain a concern, particularly if the data are moved outside Australia. Additionally, some organizations seem to understand neither the technology itself nor their own requirements, which may lead to poorly negotiated contracts and service agreements. To minimize the risks associated with cloud computing, many organizations turn to hybrid solutions or private clouds that include national or dedicated data centers. To the best of my knowledge, this is the first empirical study that reports on cloud computing adoption from the perspectives of external auditors.

Submission to: Strategic Review of Health and Medical Research (Australia) otherwise known as the McKeon Review

Public submission # 247 to the McKeon Review. The submission addresses the terms of reference on: How can we optimise translation of health and medical research into better health and wellbeing? (Terms of Reference 4, 8, 9, 10 and 11)

Heavy metals in the sediments of Northern Moreton Bay, Queensland, Australia

This project was the first comprehensive assessment of heavy metals to be conducted in the sediments of Northern Moreton Bay since the 1970s and found that shipping and shipping related activities contributed significantly to the level of sediment contamination in the area. The study was also used to develop and test new methods of assessing heavy metal sediment quality.

Cane Weevil Borer, Rhabdoscelus obscurus (Coleoptera: Curculionidae), a pest of palms in Northern Queensland, Australia

In recent years the cultivation of ornamental palms (Arecaceae) has increased markedly in northern Queensland. Consequently, several insects have become important pests, particularly Rhabdoscelus obscurus (Boisduval), the cane weevil borer. The larvae of this beetle feed on various species of palms, making the plants unsaleable. Death or lodging of the trees may also result. This paper documents its pest status, derived from information in the literature and from consultation with local growers.

Modelling Mortality and Reproduction Rates for Management of Sheep Flocks in Northern Australia

By quantifying the effects of climatic variability in the sheep grazing lands of north western and western Queensland, the key biological rates of mortality and reproduction can be predicted for sheep. These rates are essential components of a decision support package which can prove a useful management tool for producers, especially if they can easily obtain the necessary predictors. When the sub-models of the GRAZPLAN ruminant biology process model were re-parameterised from Queensland data along with an empirical equation predicting the probability of ewes mating added, the process model predicted the probability of pregnancy well (86% variation explained). Predicting mortality from GRAZPLAN was less successful but an empirical equation based on relative condition of the animal (a measure based on liveweight), pregnancy status and age explained 78% of the variation in mortalities. A crucial predictor in these models was liveweight which is not often recorded on producer properties. Empirical models based on climatic and pasture conditions estimated from the pasture production model GRASP, predicted marking and mortality rates for Mitchell grass (Astrebla sp.) pastures (81% and 63% of the variation explained). These prediction equations were tested against independent data from producer properties and the model successfully validated for Mitchell grass communities.

Root-lesion nematodes (Pratylenchus thornei and P. neglectus): A review of recent progress in managing a significant pest of grain crops in northern Australia

Two species of root-lesion nematode (predominantly Pratylenchus thornei but also P. neglectus) are widespread pathogens of wheat and other crops in Australia's northern grain belt, a subtropical region with deep, fertile clay soils and a summer-dominant rainfall pattern. Losses in grain yield from P. thornei can be as high as 70% for intolerant wheat cultivars. This review focuses on research which has led to the development of effective integrated management programs for these nematodes. It highlights the importance of correct identification in managing Pratylenchus species, reviews the plant breeding work done in developing tolerant and resistant cultivars, outlines the methods used to screen for tolerance and resistance, and discusses how planned crop sequencing with tolerant and partially resistant wheat cultivars, together with crops such as sorghum, sunflower, millets and canaryseed, can be used to reduce nematode populations and limit crop damage. The declining levels of soil organic matter in cropped soils are also discussed with reference to their effect on soil health and biological suppression of root-lesion nematodes.

Clonal propagation and storage of subtropical pines in Queensland, Australia

Clonal forestry is the approach used for deployment of Pinus elliottii x P. caribaea hybrids in Queensland, Australia. Clonal forestry relies on the ability to maintain juvenility of stock plants while selections are made in field tests, so that genetic gains are not eroded by the effects of stock plant maturation. Two parallel approaches are employed in Queensland to maintain juvenility of clonal material. Firstly, the ortet and several ramets of each clone are maintained as archive hedges <20-cm height for the duration of field tests. Secondly, shoots from archive hedges are stored in tissue culture at low temperature and low irradiance to slow growth and slow maturation. Once the best clones have been identified, production hedges are derived from both archive hedges and tissue culture shoots. About 6 million rooted cuttings are produced annually, representing almost the entire planting program of Pinus in subtropical Queensland.

Spatial and temporal variation and effects of changes in management in discard rates from the commercial reef line fishery of the Great Barrier Reef, Australia

Discarding in commercially exploited fisheries has received considerable attention in the last decade, though only more recently in Australia. The Reef Line fishery (RLF) of the Great Barrier Reef (GBR) in Australia is a large-scale multi-sector, multi-species, highly regulated hook and line fishery with the potential for high levels of discarding. We used a range of data sources to estimate discard rates and discard quantities for the two main target groups of the RLF, the coral trout, Plectropomus spp, and the red throat emperor, Lethrinus miniatus, and investigated possible effects on discarding of recent changes in management of the fishery. Fleet-wide estimates of total annual quantities discarded from 1989 to 2003 were 292-622 t and 33-95 t for coral trout and red throat emperor, respectively. Hypothetical scenarios of high-grading after the introduction of a total allowable commercial catch for coral trout resulted in increases in discard quantities up to 3895 t, while no high-grading still meant 421 t were discarded. Increasing the minimum size limit of red throat emperor from 35 to 38 cm also increased discards to an estimated 103 t. We provide spatially and temporally explicit estimates of discarding for the two most important species in the GBR RLF of Australia to demonstrate the importance of accounting for regional variation in quantification of discarding. Effects of management changes on discarding are also highlighted. This study provides a template for exploring discarding levels for other species in the RLF and elsewhere.

New species of Laxotela Winterton & Irwin from Australia (Diptera: Therevidae: Agapophytinae)

Two new species of the endemic Australian stiletto fly genus Laxotela Winterton & Irwin are described and figured. Laxotela elongata sp. nov. is described from Queensland while Laxotela plata sp. nov. is described from south-eastern mainland Australia. Laxotela ornata (Krober) comb. nov. (originally Spatulipalpa Krober) was recently placed as incertae sedis within Therevidae, but is herein transferred to Laxotela. A revised key to Laxotela species is presented.