Successful application of a simple specimen transport method for the conduct of respiratory virus surveillance in remote Indigenous communities in Australia

Objective Surveillance programs and research for acute respiratory infections in remote Aboriginal communities are complicated by difficulties in the storage and transport of frozen samples to urban laboratories for testing. This study assessed the sensitivity of a simple method for transporting respiratory samples from a remote setting for viral PCR compared with frozen specimens. Methods We sampled every individual who presented to a remote Aboriginal community clinic in a non-epidemic respiratory season. Two anterior nasal swabs were collected from each participant. The left nare specimen was mailed to the laboratory via routine postal services. The right nare specimen was transported frozen. Testing for 16 viruses was undertaken using real-time multiplex PCR. Results A total of 140 participants were enrolled who contributed 150 study visits. Respiratory illnesses accounted for 10% of the reasons for presentation. Sixty-one viruses were identified in 50 (33.3%) presentations for 40 (28.6%) individuals; bocavirus and rhinovirus were the most common viruses identified (14.0% and 12.6% of episodes respectively). The sensitivity for any virus detected in mailed specimens was 67.2% (95%CI 55.4, 78.9) compared to 65.6% (95%CI 53.7, 77.5) for frozen specimens. Conclusion The mailing of unfrozen nasal specimens from remote communities does not compromise the viability of the specimen for viral studies.

Building Healthy Communities : GP Network, Medicare Local and Primary Health Care in the Wheatbelt Region of Western Australia

• Government reports consistently recognise the importance of Primary Health Care to an efficient health system. Barriers identified in Australia’s Primary Health Care include workforce pressures, increase rate of chronic disease, and equitable access to Primary Health Care services. • General Practitioners (GPs) are the key to the successful delivery of Primary Health Care especially in rural and remote regions such as the Wheatbelt region in Western Australia (WA). • The Wheatbelt region of WA is vast: some 72,500 residents spread across 150,000km2 in 43 Local Government Authorities catchments. Majority of the Wheatbelt residents live in small towns. There is a higher reported rates of chronic disease, more at risk of chronic diseases and less utilisation of Primary Health Care services in this region. • General practice patients in the Wheatbelt are among those most in need of Primary Health Care services. • Wheatbelt GP Network (the “Network”) was established in 1998. It is a key health service delivery stakeholder in the Wheatbelt. • The Network has responded to the health needs of the community by creating a mobile Allied Health Team that works closely with GPs and is adaptive to ensure priority needs are met. • The Medicare Local model introduced by the Australian Government in 2011 aimed to improve the delivery of Primary Health Care services by improved health planning and coordinating service delivery. • Little if any recognition has been given to the outstanding work that many Divisions of General Practice have done in improving the delivery of Primary Health Care services such as the Network. • The Network has continued to support GPs and general practices and created a complementary system that integrated general practice with the work of an Allied Health Team. Its program mix is extensive. • The Network has consistently delivered on-required contract outputs and has a fifteen (15) years history of operating successfully in a large geographical area comprising in the main smaller communities that cannot support the traditional health services model. • The complexity of supporting International Medical Graduates in the region requires special attention. • The introduction of the Medicare Local in the South West of WA and their intention to take over the delivery of health services, thus effectively shutting the Network will have catastrophic consequences and cannot be supported economically. • The Network proposes to create a new model, built on its past work that increases the delivery of Primary Health Care services through its current Allied Health Team. • The proposal uses the Wheatbelt GP Super Clinic currently under construction in Northam, part of the Network and funded by the Australian Government is a key to the proposed new model. • Wheatbelt GP Super Clinic is different from existing models of GP Super Clinics around Australia which focus predominately on co-location of services. Wheatbelt GP Super Clinic utilises a hub and spoke model of service outreach to small rural towns to ensure equitable Primary Health Care coverage and continuum of care in a financially responsible and viable manner. In particular, the Wheatbelt GP Super Clinic recognises the importance of Allied Health Professionals and will involve them in a collaborative model with rural general practice. • The proposed model advocated by the Network aims to substitute the South West WA Medicare Local direct service delivery proposed for the Wheatbelt. The Network’s proposed model is to expand on the current hub and spoke model of Primary Health Care delivery to otherwise small unviable Wheatbelt towns. A flexible and adaptive skill mix of Allied Health Professionals, Nurse Practitioners and GPs ensure equitable access to service. Expanded scope of practices are utilised to reduce duplication of service and concentration of services in major towns. This involves a partnership approach. • If the proposed model not funded, the Network and the Wheatbelt region will stand to lose 16 Allied Health Professionals and defeats the purpose of Australian Government current funding for the construction of the Wheatbelt GP Super Clinic. • The Network has considered how its model can best be funded. It proposes a re-allocation of funds made available to the South West WA Medicare Local. • This submission argues that the proposal for the South West WA Medicare Local to take over the service delivery of Primary Health Care services in the Wheatbelt makes no economic sense when an existing agency (the Network) has the infrastructure in place, is experienced in working in this geographical area that has special needs and is capable to expand its programs to meet demand.

Learning about being effective mentors : professional learning communities and mentoring

This study aimed to explore experienced mentors’ understandings about professional learning communities (PLCs), mentoring and leadership. This research analyses audio-taped transcripts and written responses from 27 experienced mentors who operate in varied roles (e.g., university academics, school executives, teachers, learning support personnel). Findings indicated that PLCs can provide professional renewal for existing teachers and that mentoring within PLCs can further advance knowledge about effective practices. PLCs can include other staff members and key stakeholders (e.g., preservice teachers, teacher aides) who can contribute to the learning within the group. Mentoring and PLCs can be cost-effective strategic levers for advancing professional knowledge.

Consequences of introducing mandatory reporting legislation for child sexual abuse

To improve detection of child sexual abuse, many jurisdictions have enacted mandatory reporting laws requiring selected persons to report known and suspected cases. In Ireland, the Child First approach previously incorporated only a policy-based approach to reporting. Due to a perceived lack of efficacy, the Children First Bill was drafted in 2012 to shift this policy guidance to a legislative approach. What effects will the new legislative reporting duties have on numbers of reports, and outcomes of reports, of suspected child sexual abuse? This paper will shed light on these important questions by presenting results of analyses of the introduction of legislative reporting obligations in two Australian States. Three questions will be explored: 1. Does introducing reporting legislation result in enhanced detection of child sexual abuse? 2. Do different reporter groups have different patterns of reporting? 3. What do the patterns of report numbers and outcomes indicate for child protection systems and communities?

Storylines of institutional responses to climate change as a transformative stressor : the case of regional planning in South East Queensland, Australia

Institutional responses to climate change stresses through planning will require new and amended forms of governance. Institutional framing of change imperatives can significantly condition associated governance responses. This paper builds on scholarly conversations concerning the conceptual role of ‘storylines’ in shaping institutional responses to climate change through governance. It draws on conceptual perspectives of climate change as a ‘transformative stressor’, which can compel institutional transformation within planning. The concepts of storylines and transformative stressors are conceptually linked. The conceptual approach is applied to an empirical enquiry focused on the regional planning regime of South East Queensland (SEQ), Australia. This paper reports and examines three institutional storylines of responding to climate change through planning governance in SEQ. It concludes that the manifestation of climate change as a transformative stressor in SEQ prompted institutional transformation, leading to a dominant storyline focused on climate adaptation as an important facet of regional planning governance.

Finding Carpentaria

Invited – and inspired – by Rikki Gunn of GhostNets Australia, in September 2008 sixteen Queensland University of Technology (QUT) design and engineering students and four staff set off on a 2488km journey to spend a fortnight in Karumba on the Gulf of Carpentaria. We went to undertake a strategic planning project we called Linking Karumba, to encourage social, economic, environmental and cultural linkages across the town. During this visit, we and our local project partners realised there should be a second half to the project, in the other Carpentaria Shire town of Normanton, which saw another group of us travelling north again in 2010 to undertake Get EnGulfed: Normanton2020, looking back and forwards to propose strategies to strengthen local and regional identities. The responsiveness of our students’ work to the character of Carpentarian culture and environment indicate remarkable levels of immersion, and the community expressed their enjoyment of the process and outcomes. As for us - QUT staff and students - we had a marvellous time doing these projects, and this little book is the story of our finding of the landscapes and communities of Carpentaria “where the outback meets the sea”, and of the project work we did together with locals in the two towns. We go to press as news arrives of the official opening of the Karumba Walking track, linking the two parts of the town. We can’t wait to return and make the walk. Shannon Satherley, 2013

Commentary on Nutrition and older Indigenous Australians : service delivery implications in remote communities. A narrative review

Indigenous Australians are the most socially and economically disadvantaged population group in Australia and have the poorest health status. The statistics describe and highlight the degree of sicknesses and disadvantage along with lower life expectancy, elevated mortality rate and increased risk of cardiovascular disease, cancer, diabetes, respiratory disease and kidney disease. While these statistics reflect poor health status and a high level of illness within Indigenous communities, it is known that individual, family and community behaviours play a key role in Indigenous health and wellbeing outcomes. These behavioural issues include use of tobacco, alcohol and other substances along with lack of physical activity and poor nutrition. The paper Nutrition and older Indigenous Australians: Service delivery implications in remote communities. A narrative view explores some of the issues specific to nutrition. Bronwyn Fredericks was invited to provide this commentary by the Editor of the Australasian Journal on Aging.

The innovation potential of living-labs to strengthen small and medium enterprises in regional Australia

The small and medium enterprise (SME) sector has been the major source of well-being and employment opportunities in regional Australia. Consequently, fostering the innovative capacity of SMEs in regions that are struggling to grow their economies and distribute the growth fairly while not degrading the environment has never been more important. While SMEs generally face more uncertainties in relation to resources (e.g. financial, human and social capital) when compared to larger businesses, collaborative, cuttingedge mechanisms to enhance innovation capabilities of regional SMEs are lacking. This paper responds to this gap and proposes a Living Laboratory – an open, multi-disciplinary and multi-stakeholder action research platform where innovations can be co-created, tested and evaluated in the every-day environment of SMEs – as a way to strengthen the SME sector in regional Australia.

Developing cultural responsiveness in environmental design students through digital storytelling and photovoice

As the Latino population in the United States grows, it will become increasingly important for undergraduate students in environmental design and related disciplines to become more culturally responsive and learn how to understand and address challenges faced by population groups, such as Latino youth. To this end, we involved environmental design undergraduate students at the University of Colorado in a service-learning class to mentor Latino youth in the creation of multimedia narratives using photovoice and digital storytelling techniques. The introduction of technology was used as a bridge between the two groups and to provide a platform for the Latino youth to reveal their community experiences. Based on focus group results, we describe the impact on the undergraduate students and provide recommendations for similar programs that can promote cultural responsiveness through the use of digital technology and prepare environmental design students to work successfully in increasingly diverse communities.

The effect of retail store managers on aboriginal diet in remote communities

Key nutrient densities of the diet of two remote northern coastal Aboriginal communities were measured using the store-turnover method during the periods that three store managers were responsible for each store respectively. Individual store managers were a greater determinant of nutrient density than the community itself. Furthermore, nutrient densities tended to be highest in both communities when their stores were administered by one particular store manager. The results support the notion that store managers wield considerable power over the food supply of remote Aboriginal communities, and raise questions concerning the ability of Aboriginal community members to influence their own food supplies in retail stores. However, the study also confirms that store managers can be important allies in efforts to improve Aboriginal dietary intake.

Community media 2.0 : a report from the 'Co-Creative Communities' forum

Participatory digital culture presents major challenges to all traditional media outlets, but it presents very direct challenges to the community broadcast sector, which was established from the outset as local, community-driven and participatory. These and other issues were the focus of a recent forum at the Australian Centre for the Moving Image in Melbourne (Co-Creative Communities, 8–9 November 2012). The forum was part of a national research project, which has been exploring how Australian community arts and media organisations are responding to participatory digital culture, social media and user-led innovation. Focusing on the organisations who presented at the symposium, the paper examines how community-interest media is making the most of new and social media platforms. It considers examples of participatory digital media that have emerged from the community broadcast sector, but it also considers local, collaborative, community-interest media projects developed by public broadcasters and organisations involved in arts, social justice and development. Drawing on forum transcripts and follow-up research the essay describes some of the key trends shaping how community-interest media organisations and independent producers are working with participatory digital culture, and with what success.

Rural masculinities and the internalisation of violence in agricultural communities

This article is based on research we conducted in two agricultural communities as part of a broader study that included mining communities in rural Australia. The data from the agricultural locations tell a different story to that of the mining communities. In the latter, alcohol-fuelled, male-on-male assaults in public places caused considerable anxiety among informants. By contrast, people in the agricultural communities seemed more troubled by hidden violent harms which were largely privatised and individualised, including self-harm, suicide, isolation and threats to men’s general wellbeing and mental health; domestic violence; and other forms of violence largely unreported and thus unacknowledged within the wider community (including sexual assault and bullying linked to homophobia). We argue one reason for the different pattern in the agricultural communities is the decline of pub(lic) masculinity, and with this, the increasing isolation of rural men and the increasing propensity to internalise violence. We argue that the relatively high rates of suicide in agricultural communities experiencing rural decline are symptomatic of the internalisation of violence.

Predator Crown-of-Thorns Starfish (Acanthaster planci) Outbreak, Mass Mortality of Corals, and Cascading Effects on Reef Fish and Benthic Communities

Outbreaks of the coral-killing seastar Acanthaster planci are intense disturbances that can decimate coral reefs. These events consist of the emergence of large swarms of the predatory seastar that feed on reef-building corals, often leading to widespread devastation of coral populations. While cyclic occurrences of such outbreaks are reported from many tropical reefs throughout the Indo-Pacific, their causes are hotly debated, and the spatio-temporal dynamics of the outbreaks and impacts to reef communities remain unclear. Based on observations of a recent event around the island of Moorea, French Polynesia, we show that Acanthaster outbreaks are methodic, slow-paced, and diffusive biological disturbances. Acanthaster outbreaks on insular reef systems like Moorea's appear to originate from restricted areas confined to the ocean-exposed base of reefs. Elevated Acanthaster densities then progressively spread to adjacent and shallower locations by migrations of seastars in aggregative waves that eventually affect the entire reef system. The directional migration across reefs appears to be a search for prey as reef portions affected by dense seastar aggregations are rapidly depleted of living corals and subsequently left behind. Coral decline on impacted reefs occurs by the sequential consumption of species in the order of Acanthaster feeding preferences. Acanthaster outbreaks thus result in predictable alteration of the coral community structure. The outbreak we report here is among the most intense and devastating ever reported. Using a hierarchical, multi-scale approach, we also show how sessile benthic communities and resident coral-feeding fish assemblages were subsequently affected by the decline of corals. By elucidating the processes involved in an Acanthaster outbreak, our study contributes to comprehending this widespread disturbance and should thus benefit targeted management actions for coral reef ecosystems.

Developing sustainable ‘liveable’ buildings, cities and communities for a sub-tropical context : residents’ perspectives

A key challenge for the 21st Century is to make our cities more liveable and foster economically sustainable, environmentally responsible, and socially inclusive communities. Design thinking, particularly a human-centred approach, offers a way to tackle this challenge. Findings from two recent Australian research projects highlight how facilitating sustainable, liveable communities in a humid sub-tropical environment requires an in-depth understanding of people’s perspectives, experiences and practices. Project 1 (‘Research House’) documents the reflections of a family who lived in a ‘test’ sustainable house for two years, outlining their experience and evaluations of universal design and sustainable technologies. The study family was very impressed with the natural lighting, natural ventilation, spaciousness and ease of access, which contributed significantly to their comfort and the liveability of their home. Project 2 (‘Inner-Urban High Density Living’) explored Brisbane residents’ opinions about high-density living, through a survey (n=636), interviews (n=24), site observations (over 300 hours) and environmental monitoring, assessing opinions on the liveability of their individual dwelling, the multi-unit host building and the surrounding neighbourhood. Nine areas, categorised into three general domains, were identified as essential for enhancing high density liveability. In terms of the dwelling, thermal comfort/ventilation, natural light, noise mitigation were important; shared space, good neighbour protocols, and support for environmentally sustainable behaviour were desired in the building/complex; and accessible/sustainable transport, amenities and services, sense of community were considered important in the surrounding neighbourhood. Combined, these findings emphasise the importance and complexity associated with designing liveable building, cities and communities, illustrating how adopting a design thinking, human-centred approach will help create sustainable communities that will meet the needs of current and future generations.