Differences in Treatment and Management of Indigenous and Non-Indigenous Patients Presenting with Chest Pain: Results of the Heart Protection Partnership (HPP) Study

BACKGROUND: Indigenous patients with acute coronary syndromes represent a high-risk group. There are however few contemporary datasets addressing differences in the presentation and management of Indigenous and non-Indigenous patients with chest pain. METHODS: The Heart Protection Project, is a multicentre retrospective audit of consecutive medical records from patients presenting with chest pain. Patients were identified as Indigenous or non-Indigenous, and time to presentation and cardiac investigations as well as rates of cardiac investigations and procedures were compared between the two groups. RESULTS: Of the 2380 patients included, 199 (8.4%) identified as Indigenous, and 2174 (91.6%) as non-Indigenous. Indigenous patients were younger, had higher rates hyperlipidaemia, diabetes, smoking, known coronary artery disease and a lower rate of prior PCI; and were significantly less likely to have private health insurance, be admitted to an interventional facility or to have a cardiologist as primary physician. Following adjustment for difference in baseline characteristics, Indigenous patients had comparable rates of cardiac investigations and delay times to presentation and investigations. CONCLUSIONS: Although the Indigenous population was identified as a high-risk group, in this analysis of selected Australian hospitals there were no significant differences in treatment or management of Indigenous patients in comparison to non-Indigenous.

What is the impact of land tenure on the sustainability of retirement village communities in Australia?

In 2005, 17.3% of Australians were aged 60 years and older according to the Australian Bureau of statistics (ABS). According to aBS this situation mirrors the poulation profile of other developed countries such as Canada, New Zealand, the United States of America and to some extent the United Kingdom (ABS). Self contained independent living units in retirement Villages are now contributing to the dwellings available for those aged 55 years and over in Australia and the retirement village sector has become a significant sector within the residential property market. However, the method of operaton of many retirement villages, and the lack of freehold tenure, impacts on the desireability of retirement village life to potential residents. This paper focuses on sustainability from the perspective of the ongoing viability of retirement village operations in light of the impact of land tenure and operational issues on the perceptions of potential residents.

Connected Communities and Creative Economy; Clash, cluster, complexity, creativity

After a brief personal orientation, this presentation offers an opening section on „clash, cluster, complexity, cities‟ – making the case that innovation (both creative and economic) proceeds not only from incremental improvements within an expert-pipeline process, but also from the clash of different systems, generations, and cultures. The argument is that cultural complexity arises from such clashes, and that clustering is the solution to problems of complexity. The classic, 10,000-year-old, institutional form taken by such clusters is … cities. Hence, a creative city is one where clashing and competitive complexity is clustered… and, latterly, networked.

Globalization, suburbanization, and the creative workforce : Findings from Australian suburban communities

This paper considers the changing relationship between economic prosperity and Australian suburbs, noting that what has been termed “the first suburban nation” in experiencing an intensification of suburban growth in the 2000s, in the context of economic globalization. The paper reports on a three-year Australian Research Council funded project into “Creative Suburbia”, identifying the significant percentage of the creative industries workforce who live in suburban areas. Drawing on case studies from suburbs in the Australian cities of Brisbane and Melbourne, it notes the contrasts between the experience of these workers, who are generally positive towards suburban life, and the underlying assumptions of “creative cities” policy discourse that such workers prefer to be concentrated in high density inner urban creative clusters.

Psychometric validation of the growth and empowerment measure (GEM) applied with Indigenous Australians

Objective: Empowerment is a complex process of psychological, social, organizational and structural change. It allows individuals and groups to achieve positive growth and effectively address the social and psychological impacts of historical oppression, marginalization and disadvantage. The Growth and Empowerment Measure (GEM) was developed to measure change in dimensions of empowerment as defi ned and described by Aboriginal Australians who participated in the Family Well Being programme.---------- Method: The GEM has two components: a 14-item Emotional Empowerment Scale (EES14) and 12 Scenarios (12S). It is accompanied by the Kessler 6 Psychological Distress Scale (K6), supplemented by two questions assessing frequency of happy and angry feelings. For validation, the measure was applied with 184 Indigenous Australian participants involved in personal and/or organizational social health activities.---------- Results: Psychometric analyses of the new instruments support their validity and reliability and indicate two-component structures for both the EES (Self-capacity; Inner peace) and the 12S (Healing and enabling growth, Connection and purpose). Strong correlations were observed across the scales and subscales. Participants who scored higher on the newly developed scales showed lower distress on the K6, particularly when the two additional questions were included. However, exploratory factor analyses demonstrated that GEM subscales are separable from the Kessler distress measure.---------- Conclusion: The GEM shows promise in enabling measurement and enhancing understanding of both process and outcome of psychological and social empowerment within an Australian Indigenous context.

Responses to 2008 Apology : Digital story collection

On 13 February 2008 Prime Minister Kevin Rudd made an apology to Australia’s Indigenous People on behalf of the Parliament of Australia. The State Library of Queensland, with assistance from Queensland University of Technology and Queensland’s Aboriginal and Torres Strait Islander communities, captured responses to this historic event in a collection of digital stories. Stories were created with: Tiga Bayles; Jeremy Robertson; Natalie Alberts; Sam Wagan Watson Jr; Nadine McDonald-Dowd; Anna Bligh; and Quentin Bryce.

The CAPA Indigenous Project. Indigenous postgraduate education: A project into the barriers which indigenous students must overcome in postgraduate studies: A short history 1993-2000.

This brief paper outlines some of the early work undertaken in Indigenous postgraduate activism in Australia. In particular, the work undertaken in the lead up to the 'Project into the Barriers which Indigenous Students must Overcome in Postgraduate Studies'.

Virtual communities as tools to support teaching practicum

The impact of Web 2.0 and social networking tools such as virtual communities, on education has been much commented on. The challenge for teachers is to embrace these new social networking tools and apply them to new educational contexts. The increasingly digitally-abled student cohorts and the need for educational applications of Web 2.0 are challenges that overwhelm many educators. This chapter will make three important contributions. Firstly it will explore the characteristics and behaviours of digitally-abled students enrolled in higher education. An innovation of this chapter will be the appli- cation of Bourdieu’s notions of capital, particularly social, cultural and digital capital to understand these characteristics. Secondly, it will present a possible use of a commonly used virtual community, Facebook©. Finally it will offer some advice for educators who are interested in using popular social networking communities, similar to Facebook©, in their teaching and learning.

Medication warnings about driving : risk perceptions among French and Australian Communities

Increased crash risk is associated with sedative medications and researchers and health-professionals have called for improvements to medication warnings about driving. The tiered warning system in France since 2005 indicates risk level, uses a color-coded pictogram, and advises the user to seek the advice of a doctor before driving. In Queensland, Australia, the mandatory warning on medications that may cause drowsiness advises the user not to drive or operate machinery if they self-assess that they are affected, and calls attention to possible increased impairment when combined with alcohol. Objectives The reported aims of the study were to establish and compare risk perceptions associated with the Queensland and French warnings among medication users. It was conducted to complement the work of DRUID in reviewing the effectiveness of existing campaigns and practice guidelines. Methods Medication users in France and Queensland were surveyed using warnings about driving from both contexts to compare risk perceptions associated with each label. Both samples were assessed for perceptions of the warning that carried the strongest message of risk. The Queensland study also included perceptions of the likelihood of crash and level of impairment associated with the warning. Results Findings from the French study (N = 75) indicate that when all labels were compared, the majority of respondents perceived the French Level-3 label as the strongest warning about risk concerning driving. Respondents in Queensland had significantly stronger perceptions of potential impairment to driving ability, z = -13.26, p <.000 (n = 325), and potential chance of having a crash, z = -11.87, p < .000 (n = 322), after taking a medication that displayed the strongest French warning, compared with the strongest Queensland warning. Conclusions Evidence suggests that warnings about driving displayed on medications can influence risk perceptions associated with use of medication. Further analyses will determine whether risk perceptions influence compliance with the warnings.

Improved design method for biosecurity surveillance and early detection of non-indigenous rats

A recent advance in biosecurity surveillance design aims to benefit island conservation through early and improved detection of incursions by non-indigenous species. The novel aspects of the design are that it achieves a specified power of detection in a cost-managed system, while acknowledging heterogeneity of risk in the study area and stratifying the area to target surveillance deployment. The design also utilises a variety of surveillance system components, such as formal scientific surveys, trapping methods, and incidental sightings by non-biologist observers. These advances in design were applied to black rats (Rattus rattus) representing the group of invasive rats including R. norvegicus, and R. exulans, which are potential threats to Barrow Island, Australia, a high value conservation nature reserve where a proposed liquefied natural gas development is a potential source of incursions. Rats are important to consider as they are prevalent invaders worldwide, difficult to detect early when present in low numbers, and able to spread and establish relatively quickly after arrival. The ‘exemplar’ design for the black rat is then applied in a manner that enables the detection of a range of non-indigenous species of rat that could potentially be introduced. Many of the design decisions were based on expert opinion as data gaps exist in empirical data. The surveillance system was able to take into account factors such as collateral effects on native species, the availability of limited resources on an offshore island, financial costs, demands on expertise and other logistical constraints. We demonstrate the flexibility and robustness of the surveillance system and discuss how it could be updated as empirical data are collected to supplement expert opinion and provide a basis for adaptive management. Overall, the surveillance system promotes an efficient use of resources while providing defined power to detect early rat incursions, translating to reduced environmental, resourcing and financial costs.

Punitiveness and the criminalisation of the other : State wards, unlawful non-citizens and Indigenous youth

This paper explores the genealogies of bio-power that cut across punitive state interventions aimed at regulating or normalising several distinctive ‘problem’ or ‘suspect’ deviant populations, such as state wards, non-lawful citizens and Indigenous youth. It begins by making some general comments about the theoretical approach to bio-power taken in this paper. It then outlines the distinctive features of bio-power in Australia and how these intersected with the emergence of penal welfarism to govern the unruly, unchaste, unlawful, and the primitive. The paper draws on three examples to illustrate the argument – the gargantuan criminalisation rates of Aboriginal youth, the history of incarcerating state wards in state institutions, and the mandatory detention of unlawful non-citizens and their children. The construction of Indigenous people as a dangerous presence, alongside the construction of the unruly neglected children of the colony — the larrikin descendants of convicts as necessitating special regimes of internal controls and institutions, found a counterpart in the racial and other exclusionary criteria operating through immigration controls for much of the twentieth century. In each case the problem child or population was expelled from the social body through forms of bio-power, rationalised as strengthening, protecting or purifying the Australian population.

Minority activism : trends informing political participation across Australian communities

In the late 1990’s, intense and vigorous debate surrounded the impact of minority communities on Australia’s mainstream society. The rise of far-right populism took the stage with the introduction to the political landscape of Pauline Hanson and her One Nation party, whilst John Howard’s Liberal-National Coalition Government took the fore on debate over immigration issues corresponding with an influx of irregular arrivals. In 2001, following the September 11 terrorist attacks in the United States of America and subsequent attacks on western targets globally, many of these issues continued to be debated through the security posturing that followed. In recent years, much effort has been afforded to countering the threat of terrorism from home grown assailants. The Government has introduced stringent legislative responses whilst researchers have studied social movements and trends within Australian communities, particularly with respect to minorities. In 2008, the Scanlon Foundation, in association with Monash University and various government entities, released its findings into its survey approach to mapping social cohesion in Australia. It identified a number of spheres of exploration which it believed were essential to measuring cohesiveness of Australian communities generally including, economic, political and socio-cultural factors (Markus and Dharmalingam, 2008). This doctoral project report will explore the political sphere as identified in the Mapping Social Cohesion project and apply it to identified minority ethnic communities. The Scanlon Foundation project identified political participation as one of a number of true indicators of social cohesion. This project acknowledges that democracy in Australia is represented predominantly by two political entities representing a vast majority of constituents under a compulsory voting regime. This essay will identify the levels of political activism achieved by minority ethnic communities and access to democratic participation within the Australian political structure. It will define a ten year period from 1999 to 2009, identifying trends and issues within minority communities that have proactively and reactively promoted engagement in achieving a political voice, framed within a mainstream-dominated political system. It will research social movements and other influential factors over that period to enrich existing knowledge in relation to political participation rates across Australian communities.

A sense of control : virtual communities for people with mobility impairments

The purpose of this book is to show why we should be concerned about virtual communities for people with physical, or more particularly mobility, impairments. The well-being model through a virtual community introduced here goes towards advancing the work begun by others, by adding for example a socio-political component. The model presented here provides practical insights into how strategic community investment can support people with disabilities and their families. Virtual communities are about engagement, quality of life and support, not just about information. The role of information technology in building and raising community capacity and social capital in socially and economically disadvantaged communities is also examined. Practical insights are offered into community support for people with chronic illness.

Critical literacies in place : teachers who work for just and sustainable communities

This chapter draws upon theories of social justice, critical literacy and place-based pedagogies and two research projects to discuss how teachers are working ethically and creatively towards a sustainable and just society in their place(s).