Reproductive health: findings from the Australian Longitudinal Study on Women’s Health. Chapter 5: fertility and infertility

Chapter 5: Fertility and infertility. p52-70. This section describes patterns of fertility across Surveys 1 to 4 among the cohort of women who were born in 1973-1978. This section includes the examination of pregnancy outcomes including both live births and pregnancy losses (stillbirths, miscarriages, terminations and ectopic pregnancies). This section also examines the prevalence of self-reported problems with fertility and whether these women sought advice and/or treatment. As women age they are more likely to experience infertility and, with little other data available, the ALSWH provides an important opportunity to examine this problem and the related use of health services. 1. Pregnancy losses are common. Half of the women who report a pregnancy outcome at Survey 4 have experienced a pregnancy loss. 2. More than one third (39%) of women who have experienced a live birth by Survey 4 have also experienced a pregnancy loss. 3. For every ten women aged 28-33 years in 2006: four women had not had been pregnant, five women had a live birth (with or without a recognised pregnancy loss), and one woman had a recognised pregnancy loss only. 4. Among women who had tried to conceive or had been pregnant, one-in-six had experienced infertility. (i.e. tried unsuccessfully to get pregnant for 12 months or more) 5. The most significant factors associated with having infertility, seeking advice and using treatment were: polycystic ovary syndrome, endometriosis and miscarriage. 6. Of the women who reported infertility, two-thirds sought advice but only half used treatment. 7. Most of the women who used fertility treatment had used low cost and non-invasive methods.

The social construction of prostitution in Californian 'John' Schools

The existence of prostitution in society continues to be a highly contested issue in both political and social arenas. With traditional criminal justice methods to address prostitution focussing predominantly on sex workers, newly formed initiatives have been created to target the demand side of prostitution. ‘John Schools’ – diversionary programs for clients, or ‘johns’ who have been arrested for prostitution offences – aim to educate participants on the various harms and risks associated with such behaviour and claim to provide an innovative means to reduce prostitution by decreasing demand for sexual services. It is evident however, that these programs perpetuate traditional social constructions of prostitution, characterising the act, and the actors, as sexually deviant. This paper examines the curriculum of these programs in order to identify how prostitution is constructed, firstly through the depiction of the victims in the program, and secondly through the characterisation of prostitution offenders. This paper argues that such initiatives merely extend the charge of sexual deviance from the sellers of sex to the buyers, and fail to acknowledge autonomy and choice for sex workers and clients.

Extreme architecture : can architects future proof us against fire and flood.

In the face of Australia’s disaster-prone environment, architects Ian Weir and James Davidson are reconceptualising how our residential buildings might become more resilient to fire, flood and cyclone. With their first-hand experience of natural disasters, James, director of Emergency Architects Australia (EAA), and Ian, one of Australia’s few ‘bushfire architects’, discuss the ways we can design with disaster in mind. Dr Ian Weir is one of Australia’s few ‘bushfire architects’. Exploring a holistic ‘ground up’ approach to bushfire where landscape, building design and habitation patterns are orchestrated to respond to site-specific fire characteristics. Ian’s research is developed through design studio teaching at QUT and through built works in Western Australia’s fire prone forests and heathlands.

Children, toxic chemicals and Australia's intergenerational obligations

The high volume and widespread use of industrial chemicals, the backlog of internationally untested chemicals, the uptake of synthetic chemicals found in babies’ in utero, cord blood, and in breast milk, and the lack of a unified and comprehensive regulatory framework, all underscore the importance of developing policies that protect the most vulnerable in our society – our children. Australia’s failure to do so raises profound intergenerational ethical issues. This paper tells a story of international policy, and where Australia is falling down. This paper highlights the need for significant policy reforms in the area of chemical regulation in Australia. We argue that we can learn much from countries already taking critical steps to reduce the toxic chemical exposure, and the development of a comprehensive, child-centered chemical regulation framework is central to turning this around.

Post-orogenic Mesozoic basins and magmatism

This chapter describes the later Mesozoic history of Queensland, when the broad epicratonic basins that underlie most of the state west of the Great Dividing Range received the greater part of their sediment infill after ~210 Ma(middle Norian). The final major orogenic event—the Hunter Bowen Orogeny—had abated in the Tasmanides. These basins preserve relatively thin sedimentary successions that extend over about two-thirds of the area of the state...

Six theories of Neoliberalism

This paper takes as its starting point the observation that neoliberalism is a concept that is ‘oft-invoked but ill-defined’ (Mudge 2008: 703). It provides a taxonomy of uses of the term neoliberalism to include: (1) an all-purpose denunciatory category; (2) ‘the way things are’; (3) a particular institutional framework characterizing Anglo-American forms of national capitalism; (4) a dominant ideology of global capitalism; (5) a form of governmentality and hegemony; and (6) a variant within the broad framework of liberalism as both theory and policy discourse. It is argued that this sprawling set of definitions are not mutually compatible, and that uses of the term need to be dramatically narrowed from its current association with anything and everything that a particular author may find objectionable. In particular, it is argued that the uses of the term by Michel Foucault in his 1978-79 lectures, found in The Birth of Biopolitics (Foucault, 2008) are not particularly compatible with its more recent status as a variant of dominant ideology or hegemony theories.

Mobius markets : professional families in rural educational markets

Australia has many isolated communities that require human services provided by qualified professionals. Maintaining a viable and equitable spread of such educational capital across space as a public good is a challenge. Reports investigating this problem repeatedly point to ‘family issues’ such as limited options for children’s education, and limited access to ongoing professional development, as deterrents for rural/remote employment despite lucrative incentive schemes. This paper draws on semi-structured interviews with 30 parents of school-aged children, who work as doctors, nurses, teachers and police in six rural/remote towns in Queensland. We asked them how their family units reconcile career opportunities with educational strategy for family members over time and space. This paper considers these issues as a sociology of education problem in a context of educational marketisation and spiralling credentialism. This paper offers the concept of ‘mobius markets’ to capture the cyclical and intergenerational process underway in middle class professional families of investing in educational capitals, maintaining or maximising their value and profiting from them. A mobius strip is the topological anomaly of a single loop with one twist in it, whereby the loop becomes one continuous surface, not the double-sided shape it appears to be. This project is interested in how the middle class professional family is similarly on a constant circuit, investing in educational capitals, upgrading their currency/value, and profiting from them. This elaborated sense of educational markets extends the more usual sociological focus on school choice.

A Process and Outcome Evaluation of the Under the Limit (UTL) Therapeutic Drink Driving Program for Recidivist and High Range Offenders

Drink driving is a major public health issue and this report examines the experiences of convicted offenders who participated in an established drink driving rehabilitation program Under the Limit (UTL). Course completers were surveyed at least three months after they had finished the 11-week UTL course. The aim of this study was to examine whether the UTL program reduced the level of alcohol consumption either directly as a result of participation in the UTL drink driving program or through increased use of community alcohol program by participants. The research involved a self-report outcome evaluation to determine whether the self-reported levels of alcohol use after the course had changed from the initial alcohol use reported by offenders. The findings are based on the responses of 30 drink-driving offenders who had completed the UTL program (response rate: 20%). While a process evaluation was proposed in the initial application, the low response rate meant that this follow up research was not feasible. The response rate was low for two reasons, it was difficult to: recruit participants who consented to follow up, and subsequently locate and survey those who had consented to involvement.

The birds of the Bush Heritage, Cravens Peak Reserve

Bird communities were studied in two subregional areas of Cravens Peak, the Toko Plains and the Simpson-Strzelecki Dunefields, using the point counts method. A total of 42 2ha 20 minute surveys, 46 five-hundred metre radius area surveys and 170 5km drive through area surveys were conducted and observations made. Bird species were identified, counted and recorded. The data were compared in the two subregions and, as a whole, considering species groups according to land system on which the ecosystem occurs, the specific ecosystem and according to their general feeding habits (insectivore, omnivore, frugivore, granivore, nectarivore and carnivore). Species richness and species relative abundance were compared using Simpson’s Diversity Index and the data revealed that species are distributed largely on the basis of habitat. In general, areas with a greater number of vegetation strata recorded greater species diversity. Overall, the Tall Open Acacia georginae Shrubland on alluvial floodplains has a greater diversity of birds in a 2ha area (0.87, Simpson’s Index of Diversity 1-D) compared to the other survey sites.

Unravelling the maze : Hepatitis C, psychosocial factors and access to antiviral therapy

In this paper we present an examination of the literature on the psychosocial aspects of hepatitis C (HCV), and ask what are the implications for patients and clinicians regarding access to treatment? Hepatitis C (HCV) is a blood-borne communicable disease that was identified in 1988. In Australia, an estimated 217,000 people live with HCV. The virus causes serious liver inflammation, can lead to liver cirrhosis and a small percentage of sufferers will develop hepatocellular carcinoma. Reports about the psychosocial aspects of HCV appeared from around 1994 indicating a similar set of societal responses to people with HIV; stigmatisation and discrimination. A number of calls were made for the establishment of counselling and support services to address the specific mental health needs of people with HCV. We conducted a systematic review of the literature between 2002-2012 about the psychosocial aspects of HCV and its relationship to access to treatment and identified a number of key issues that suggest the anticipated progress in this area has not been made. The majority of people with HCV already experience marginalisation, and the diagnosis of HCV further compounds their marginalisation through stigma and discrimination and complicates clinical decision-making around treatment. We conclude that the need for mental health services that are capable of addressing the complexities of the psychosocial aspects of HCV remains. Concomitantly, primary care clinicians require greater clarity and consistency about the clinical guidelines for HCV to meet the increasing expectations on them to deliver comprehensive patient management within primary care. (248 words)

Aliens, borders and social citizens : Health and community services for trafficked women

Australian policy makers recognise women who are trafficked to Australia (and these are largely for the purposes of sexual exploitation) primarily as victims of crime. The main public mechanism by which the "problem" of trafficked people in Australia is managed is the criminal law. At the same time, however, as a signatory to the UN Protocol on Trafficking and the Declaration of Human Rights, the Australian Government also recognises the rights of women trafficked to Australia to access health and community services in the wake of the health damage and trauma they often incur as a consequence of their experience. Current evidence suggests that trafficked women in Australia face considerable barriers in being able to avail themselves of such a right and of the services that accompany it. This paper explores the tensions posed by Australian policy and service approaches to trafficked women in light of the concept of social citizenship and the ways in which it is mediated in the Australian context by national border protection policy.

College, shared house, or home? The impact of living situation on university students’ drinking

University students are recognised as a heavy drinking group who are at risk of both short and long term harms from their alcohol consumption. This paper explores the social dynamics of drinking and the key differences between three core groups of university students – those who live at home, those living in college and those who live independently. We draw on a large scale survey of Australian university students on alcohol consumption and harm minimisation and extensive qualitative individual and focus group interviews with university students in Victoria, New South Wales and Queensland. Our data suggests that living at home supports safer drinking in comparison to the less regulated college context or living independently in shared households.

Digital PWM waveform generation using adders, not counters

An alternative approach to digital PWM generation using an adder rather than a counter is presented. This offers several advantages. The resolution and gain of the pulse width modulator remain constant regardless of the module clock frequency and PWM output frequency. The PWM resolution also becomes fixed at the register width. Even at high PWM frequencies, the resolution remains high when averaged over a number of PWM cycles. An inherent dithering of the PWM waveform introduced over successive cycles blurs the switching spectra without distorting the modulating waveform. The technique also lends itself to easily generating several phase shifted PWM waveforms suitable for multilevel converter modulation.

Harmonic quality of multilevel cascade inverters with random carrier phase pulse width modulation

The output harmonic quality of N series connected full-bridge dc-ac inverters is investigated. The inverters are pulse width modulated using a common reference signal but randomly phased carrier signals. Through analysis and simulation, probability distributions for inverter output harmonics and vector representations of N carrier phases are combined and assessed. It is concluded that a low total harmonic distortion is most likely to occur and will decrease further as N increases.