Hot Summers and Heart Failure: Seasonal Variations in Morbidity and Mortality in Australian Heart Failure Patients (1994-2005)

Background There are minimal reports of seasonal variations in chronic heart failure (CHF)-related morbidity and mortality beyond the northern hemisphere. Aims and methods We examined potential seasonal variations with respect to morbidity and all-cause mortality over more than a decade in a cohort of 2961 patients with CHF from a tertiary referral hospital in South Australia subject to mild winters and hot summers. Results Seasonal variation across all event-types was observed. CHF-related morbidity peaked in winter (July) and was lowest in summer (February): 70 (95% CI: 65 to 76) vs. 33 (95% CI: 30 to 37) admissions/1000 at risk (p<0.005). All-cause admissions (113 (95% CI: 107 to 120) vs. 73 (95% CI 68 to 79) admissions/1000 at risk, p<0.001) and concurrent respiratory disease (21% vs. 12%,p<0.001) were consistently higher in winter. 2010 patients died, mortality was highest in August relative to February: 23 (95% CI: 20 to 27) vs. 12 (95% CI: 10 to 15) deaths per 1000 at risk, p<0.001. Those aged 75 years or older were most at risk of seasonal variations in morbidity and mortality. Conclusion Seasonal variations in CHF-related morbidity and mortality occur in the hot climate of South Australia, suggesting that relative (rather than absolute) changes in temperature drive this global phenomenon.

Learning from episodes of degradation and recovery in variable Australian rangelands

Land-change science emphasizes the intimate linkages between the human and environmental components of land management systems. Recent theoretical developments in drylands identify a small set of key principles that can guide the understanding of these linkages. Using these principles, a detailed study of seven major degradation episodes over the past century in Australian grazed rangelands was reanalyzed to show a common set of events: (i) good climatic and economic conditions for a period, leading to local and regional social responses of increasing stocking rates, setting the preconditions for rapid environmental collapse, followed by (ii) a major drought coupled with a fall in the market making destocking financially unattractive, further exacerbating the pressure on the environment; then (iii) permanent or temporary declines in grazing productivity, depending on follow-up seasons coupled again with market and social conditions. The analysis supports recent theoretical developments but shows that the establishment of environmental knowledge that is strictly local may be insufficient on its own for sustainable management. Learning systems based in a wider community are needed that combine local knowledge, formal research, and institutional support. It also illustrates how natural variability in the state of both ecological and social systems can interact to precipitate nonequilibrial change in each other, so that planning cannot be based only on average conditions. Indeed, it is this variability in both environment and social subsystems that hinders the local learning required to prevent collapse.

History in the Australian Curriculum F-10 : providing answers without asking questions

This paper examines the most recent version of the Australian Curriculum: History F-10. It does so in two ways. First, it explores some of the strengths and weaknesses of this curriculum with reference to the decision to frame aspects of Australian history within the context of a world history approach. Whilst the positioning of Indigenous Histories is applauded, the curriculum’s lack of attention to the significance of the recent history of Australia’s Asian neighbours, and Australia’s relationship with them, is critiqued. This part of the paper also emphasises the need for comparative approaches and calls for greater emphasis on providing students with opportunities to critique and contest the construction of narratives about the past. Second, the paper introduces four invited articles that examine different aspects of the Australian Curriculum: History. Collectively these papers reiterate the significance of the richness of integrated and child-centred approaches and the importance of developing historical thinking, empathy and the historical imagination in the classroom.

Good faith in contractual performance and enforcement : Australian doctrinal hurdles

In the ongoing and spirited debate about the relative merits of an obligation of good faith in contractual performance and enforcement, widely divergent views have been expressed about the appropriateness and content of the putative obligation. However, relatively less time has been devoted to discussion of the sparseness of tools available to facilitate doctrinal development and the hurdles necessarily imposed by such limited doctrinal resources. This article seeks to examine the Australian doctrinal position against the backdrop of good faith as it finds application in the wider global context.

Funding and employment conditions : critical issues for Australian music therapy beyond 2009

As the Australian Journal of Music Therapy celebrates its 20th year of publication, it is evident that the profession of music therapy in Australia, has made substantial progress over these last 20 years. Jobs are regularly advertised on the website, there is a greater public awareness of what music therapy is, there are government recognised salary awards applicable in several states of the country, working conditions have generally improved, and many Australian music therapists are recognised on the international stage as leaders in their field of expertise. You can even go to a party and tell someone you are a music therapist and there is a good chance they will say 'oh yeah, I know someone who does that at the hospital / school / community centre / nursing home' instead of saying 'oh, so like, a what?'. Despite the impressive leaps and bounds that have been made, and the success of many programs in Australia to date, there is still a great deal of room for improvement. What are the critical issues ahead for the development of music therapy in Australia? In particular, how do music therapists develop going forward and secure funding for clinical initiatives? In reflecting on this question, this article identifies two key areas, amongst the many, that can be addressed by music therapists over the next 20 years: funding and employment conditions. Examples from the national early intervention music therapy program 'Sing and Grow' are used to illustrate the potential impact of addressing these two issues on the positive development of the profession into the future.