Is there a relationship between screening for diabetes related foot complications and limb amputation?

Background From the conservative estimates of registrants with the National Diabetes Supply Scheme, we will be soon passing 1.1 Million Australians affected by all types of diabetes. The diabetes complications of foot ulceration and amputation are costly to all. These costs can be reduced with appropriate prevention strategies, starting with identifying people at risk through primary care diabetic foot screening. Yet levels of diabetic foot screening in Australia are difficult to quantify. This presentation aims to report on foot screening rates as recorded in existing academic literature, national health surveys and national database reports. Methods Literature searches included diabetic foot screening that occurred in the primary care setting for populations over 2000 people from 2002 to 2014. Searches were performed using Medline and CINAHL as well as internet searches of Organisations for Economic Co-operation and Development (OECD) countries health databases. The focus is on type 1 and type 2 diabetes in adults, and not gestational diabetes or children. The two primary outcome measures were foot -screening rates as a percentage of adult diabetic population and major lower limb amputation incidence rates from standardised OECD data. Results The most recent and accurate level for Australian population review was in the AUSDIAB (Australian Diabetes and lifestyle survey) from 2004. This survey reported screening in primary care to be as low as 50%. Countries such as the United Kingdom and United States of America have much higher reported rates of foot screening (67-86%) recorded using national databases and web based initiatives that involve patients and clinicians. By comparison major amputation rates for Australia were similar to the United Kingdom at 6.5 versus 5.1 per 100,000 population, but dis-similar to the United States of America at 17 per 100,000 population. Conclusions Australian rates of diabetic foot screening in primary care centres is ambiguous. There is no direct relationship between foot screening levels in a primary care environment and major lower limb amputation, based on national health survey's and OECD data. Uptake of national registers, incentives and web-based systems improve levels of diabetic foot assessment, which are the first steps to a healthier diabetic population.

Roseate spoonbill

A poem

Recognising change and seeking affirmation: Themes for embeddding Indigenous knowledges on teaching practicum

The imperative for Indigenous education in Australia is influenced by national political, social and economic discourses as Australian education systems continue to grapple with an agreed aspiration of full participation for Aboriginal and Torres Strait Islander students. Innovations within and policies guiding our education systems are often driven by agendas of reconciliation, equity, equality in participation and social justice. In this paper, we discuss key themes that emerged from a recent Australian Office for Learning and Teaching (OLT) research project which investigated ways in which preservice teachers from one Australian university embedded Indigenous knowledges (IK) on teaching practicum . Using a phenomenological approach, the case involved 25 preservice teacher and 23 practicum supervisor participants, over a 30 month investigation. Attention was directed to the nature of subjective (lived) experiences of participants in these pedagogical negotiations and thus preservice and supervising teacher voice was actively sought in naming and analysing these experiences. Findings revealed that change, knowledge, help and affirmation were key themes for shaping discourses around Indigenous knowledges and perspectives in the Australian curriculum and defined the nature of the pedagogical relationships between novice and experienced teachers. We focus particularly on the need for change and affirmation by preservice teachers and their teaching practicum supervisors as they developed their pedagogical relationships whilst embedding Indigenous knowledges in learning and teaching.

Bitou bush and boneseed eradication and containment in Australia

Bitou bush and boneseed (Chrysanthemoides monilifera subsp. rotundata (DC.) T.Norl. and C. monilifera subsp. monilifera (L.) T.Norl., respectively) are highly invasive environmental weeds that pose a serious threat to Australia’s natural ecosystems and biota. Bitou bush threatens coastal plant communities in New South Wales (NSW), eastern Victoria and southeast Queensland (Qld), while boneseed threatens inland and coastal native plant communities across NSW, South Australia (SA), Tasmania, Victoria, and Western Australia (WA). Over 200 plant species and ecological communities in Australia are negatively impacted by these weeds (ARMCANZ et al. 2000, DEC 2006) and over 15% (approx. 120 million ha) of Australia is susceptible to invasion (see maps in Weiss et al 2008). In 2000, the National Bitou Bush and Boneseed Strategic Plan (ARMCANZ et al. 2000) was approved as part of the Commonwealth’s Weeds of National Significance initiative. A key goal of this plan is to prevent the spread of bitou bush and boneseed in Australia. A national program sponsored by the Australian Government and the affected states has resulted in the development of national containment and eradication zones that prevent the spread of bitou bush and boneseed. This paper presents an overview of these bitou bush and boneseed containment and eradication programs.

Tospoviruses - An Australian perspective

The detection, distribution, molecular and biological properties, vector relations and control of tospoviruses present in Australia, including Tomato spotted wilt virus (TSWV), Capsicum chlorosis virus (CaCV) and Iris yellow spot virus (IYSV), are reviewed. TSWV occurs throughout Australia where it has caused serious sporadic epidemics since it was first described in the 1920s. The frequency and distribution of outbreaks has increased in the 1990s, with the arrival and dispersal of the western flower thrips (Frankliniella occidentalis) being one factor favouring this situation. The crops most frequently and severely affected are capsicum, lettuce, tomato, potato and several species of ornamentals. Minimal differences were found between the nucleocapsid (N) gene amino acid sequences of Australian isolates and these were most closely related to a clade of northern European isolates. CaCV was first detected in Australia in 1999 and is most closely related to Watermelon silver mottle virus, a serogroup IV tospovirus. The natural hosts include capsicum, tomato, peanut and Hoya spp. The virus also occurs in Thailand and Taiwan. IYSV was first found in Australia in 2003, infecting onion and leek, with the distribution in three States suggesting that the virus has been present for some time.