Discordant age and sex-specific trends in the incidence of a first coronary heart disease event in Western Australia from 1996 to 2007

OBJECTIVE: To determine age- and sex-specific population trends in fatal and non-fatal first coronary heart disease (CHD) events in Western Australia from 1996 to 2007. DESIGN: Longitudinal retrospective population study. SETTING: State-wide population. PATIENTS: All residents aged 35-84 years during 1996-2007 who died or were hospitalised with a principal diagnosis of acute CHD. DATA SOURCES: Person-linked file of mortality and morbidity records. MAIN OUTCOME MEASURES: Age-standardised (35-84 years) and age-specific (35-54, 55-69, 70-84 years) rates by gender for a first CHD event were calculated with a 10-year lead-in period to define first events. RESULTS: From 1996 to 2007 there were 36 631 first CHD events, including 8518 (23%) fatal cases in those aged 35-84 years. Overall, age-adjusted rates for fatal first CHD declined 5.3%/year in men (95% CI -6.1% to -4.6%) and 6.5%/year in women (95% CI -7.5% to -5.5%). However, age-specific fatal first CHD rates were neutral in both men aged 35-54 years (0.1%/year; 95% CI -1.8% to 2.1%) and women of the same age, (-1.6%/year; 95% CI -5.6% to 2.5%). Age-specific trends in non-fatal CHD rates reflected the same trends in fatal CHD events in men and women, with rates reportedly increasing in women aged 35-54 years (2.5%/year (95% CI 1.1% to 3.9%). CONCLUSION: The age-specific decline in fatal and non-fatal first CHD rates in older men and women was not observed in those aged 35-54 years. These novel findings provide evidence for a levelling in the CHD incidence rates in younger adults and puts renewed importance on primary prevention in this group.

Gestures of judgement and welcome in public spaces: hypervisible migrant newcomers in Darwin, Australia

This paper draws on ethnographic research to show how pigmentation intensities of skin and facial characteristics make bodies of colour recognisable in public spaces of Darwin, a small multiethnic and multiracial north Australian city. This paper shows that the visibility of newcomers, in particular, humanitarian migrants from countries in Africa, the Middle East and Asia, circulates negative sentiments of fear, anxiety and discomfort in public spaces when instantaneous judgements are made. These judgements of misrecognition made by residents of diverse ethnic and racial backgrounds lead to simmering tensions that unfold as visceral events of vulnerability in public spaces such as bus interchanges, neighbourhood streets, shopping centres and car parks. These events that have the potential to wound and numb bodies contribute to the “urban unconscious” of Darwin as a city where public spaces are safe with heightened surveillance. This paper argues, however, that events of hypervisibility, judgement and interracial tensions can unfold quite differently in public spaces if humanitarian migrants sense gestures of welcome, particularly from Aboriginals. Such fleeting moments of welcome in Darwin have the potential to bring together bodies with different histories and geographies of racialisation, so that multiple publics emerge through everyday habits of living with difference.

Community perceptions of orangutan conservation and palm oil in Melbourne, Australia

This study examined Greater Melbourne residents’ perspectives toward orangutan conservation through a mixed mode survey method, using postal surveys (N = 108, response rate = 11.8%) and telephone interviews (N = 50, response rate = 51%). Differences were found between knowledge levels about orangutans, attitudes towards orangutans and behavioural intentions. It appears probable that when an individual is educated about how human beings impact orangutans and holds positive attitudes towards them, most would try to reduce their impact.

Dietary overlap between sympatric dingoes and feral cats at a semiarid rangeland site in Western Australia

Abstract. The diet of sympatric dingoes and feral cats was studied in the semiarid southern rangelands of Western Australia. A total of 163 scats were collected over a period of 19 months. Rabbit remains were the most common food item in cat scats, followed by reptiles, small mammals and birds. Macropod remains were the most common food item in dingo scats, followed by rabbits and birds. Dingo scats did not contain small mammal remains, and infrequently contained arthropod and reptile remains. Cat and dingo scats contained remains from 11 and six mammal species, respectively. Of the small mammals, cat scats contained rodent remains more frequently than those of dasyurids. Dietary diversity of cats was higher than for dingoes and dietary overlap between the two species was relatively low.

Social connections and suicidal behaviour in young Australian adults: Evidence from a case-control study of persons aged 18-34 years in NSW, Australia

Purpose: There is evidence that social isolation is a risk factor for suicide, and that social connections are protective. Only a limited number of studies have attempted to correlate the number of social connections a person has in their life and suicidal behaviour. Method: Two population-based case-control studies of young adults (18-34 years) were conducted in New South Wales, Australia. Cases included both suicides (n=84) and attempts (n=101). Living controls selected from the general population were matched to cases by age-group and sex. Social connections was the main exposure variable (representing the number of connections a person had in their life). Suicide and attempts as outcomes were modelled separately and in combination using conditional logistic regression modelling. The analysis was adjusted for marital status, socio-economic status, and diagnosis of an affective or anxiety disorder. Results: Following adjustment for other variables, those who had 3-4 social connections had 74% lower odds of suicide deaths or attempts (OR=0.26, 95% CI 0.08, 0.84, p=0.025), and those with 5-6 connections had 89% lower odds of suicide deaths or attempts (OR=0.11 95% CI 0.03, 0.35, p<0.001), compared to those with 0-2 social connections. With the number of social connection types specified as a continuous variable, the odds ratio was 0.39 per connection (95% CI 0.27, 0.56, p<0.001). Conclusions: A greater number of social connections was significantly associated with reduced odds of suicide or attempt. This suggests that suicide prevention initiatives that promote increased social connections at an individual, familial, and wider social levels might be effective.

Informed options trading prior to takeovers - Does the regulatory environment matter?

We investigate the prevalence of informed options trading prior to takeover announcements, when the legal prohibition against insider trading is strictest. Although insider trading laws apply equally to the options and stock markets, the options market is considerably more transparent than the equity market, which makes insider trading in options more easily detectable. We find that privately informed investors trade in the options market prior to takeover announcements; however, their transactions are limited to liquid call options and options with high inherent leverage. Furthermore, we find that prior to takeover announcements, informed investors trade on their private information in the options market only when a SEC investigation of insider trading is unlikely to occur. Our results suggest that even prior to takeover announcements informed investors are attracted to the options market, which increases profit making potential due the greater leverage it affords, although they trade in a way which minimizes the likelihood of detection.

Gender difference in the use of coronary interventions for patients with acute coronary syndrome: experience from a major metropolitan hospital in Melbourne, Australia

BACKGROUND: Literature suggests an ongoing gender disparity in the use of coronary angiography and subsequent interventions among patients with acute coronary syndrome (ACS). OBJECTIVES: The study aimed to examine gender differences in the use of coronary interventions amongst patients with acute coronary syndrome (ACS) admitted to a major metropolitan hospital in Melbourne during the period 2009-2012. METHODS: We undertook a retrospective analysis of a hospital database of 2096 ACS patients. ACS included unstable angina (UA), ST-segment-elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI). RESULTS: The mean age of the patients was 64.3 years and 624 (30%) were women. Half of them were diagnosed as NSTEMI, 23% as STEMI and 25% as UA. Compared to men, women were older at admission, less likely to be diagnosed with STEMI and less likely to smoke. No gender difference was observed for severe co-morbidities or use of coronary angiography. Women diagnosed with STEMI were 39% less likely to receive an angioplasty stent (adjusted odds ratio 0.61, 95% confidence intervals 0.39-0.96) and 66% less likely to receive grafts (adjusted OR 0.34, 95% CIs 0.13-0.93). Women diagnosed with NSTEMI were 44% less likely to receive grafts (adjusted OR 0.56, 95% CIs 0.37-0.83). Younger women aged 35-49 years were less likely to receive an angioplasty stent, and older women >50 years were less likely to receive grafts. CONCLUSIONS: Adherence to guideline based treatment will help to ensure knowledge translation from guideline to practice. Further research investigating symptom presentation, use of non-invasive tests and medical management of ACS by gender may further explain gender difference for coronary interventions.

Gender differences in presentation, coronary intervention, and outcomes of 28,985 acute coronary syndrome patients in Victoria, Australia

BACKGROUND: Differences in demographics, presenting characteristics, and treatment of heart disease in women may contribute to adverse outcomes. The purpose of this paper was to describe gender differences in the epidemiology, treatment, and outcomes of all admissions for acute coronary syndrome (ACS) in Victoria that occurred between June 2007 and July 2009. METHODS: We undertook a retrospective cohort study of all patients admitted to Victorian hospitals with a first time diagnosis of ACS. Use of angiograms, percutaneous coronary intervention (PCI), coronary artery bypass graft (CABG), and adverse outcomes (death and/or unplanned readmission) were compared by gender and hierarchical logistic regression models were used to account for confounding variables. RESULTS: Of a total of 28,985 ACS patients, 10,455 (36%) were women. Compared with men, women were older (aged ≥75 years: 54% vs 31%; p < .001), more likely to present with multiple comorbidities (>1 comorbidity: 53% vs 46%; p < .001), and more likely to be diagnosed with non-ST-segment elevation ACS (86% vs 80%; p < .001). Women were less likely to receive coronary interventions (angiogram: adjusted odds ratio [aOR], 0.71; 95% CI, 0.66-0.75; PCI: aOR, 0.73; 95% CI, 0.66-0.80; CABG: aOR, 0.58; 95% CI, 0.53-0.64). Adverse outcomes were similar in women and men after accounting for confounding variables. CONCLUSIONS: Our results show that women in Victoria were less likely to receive coronary interventions after an admission for ACS. Clinicians should be wary of inherent gender bias in decisions to refer patients for angiography.

Recreational drug use within the employees of the mariculture and seafood industry in South Australia

A study of recreational drug use among workers in the Port Lincoln mariculture and seafood industries was conducted by self report questionnaire. High rates of cannabis and alcohol use were revealed during the shore based fish farming season. The occupational health and safety implications of these findings in one of Australia's most dangerous industries are significant. Further research could inform the development of industry specific harm minimisation policies.

The politics of public sector change: trends in health and education sector change in South Australia

BACKGROUND: As the changes underpinning the Coordinated Care Trials in South Australia have become more apparent, similarities have emerged between the rationalisation of public schooling in the mid 1980s and the transformation of public health in the 1990s.

OBJECTIVE: This article aims to discuss the evolution of health services in South Australia and help us answer the question of how best to manage our public and private health infrastructure in a changing economic and social context.

DISCUSSION: Both strategies in education and health share common elements of cost cutting, attempts at improving efficiencies, a flirting with the private sector and the attendant risk of reduced quality of services to the public. This situation in both sectors is indicative of a shift in public policy and a growth in the belief that private management of public sector infrastructure can help resolve the funding crises around our education and health systems.

Family violence in domestic homicides: a case study of women who killed intimate partners post-legislative reform in Victoria, Australia

This article examines the impact of legislative reforms enacted in 2005 in Victoria, Australia, on legal responses to women charged with murder for killing their intimate partner. The reforms provided for a broader understanding of the context of family violence to be considered in such cases, but we found little evidence of this in practice. This is partly attributable to persistent misconceptions among the legal profession about family violence and why women may believe it necessary to kill a partner. We recommend specialized training for legal professionals and increased use of family violence evidence to help ensure women's claims of self-defense receive appropriate responses from Victorian courts.

Applying stock indicators for assessment of a recreational surf clam (Donax deltoides) fishery in Victoria, Australia

The aim of this study was to apply indicators for monitoring the impacts of harvest in a recreational surf clam fishery. We investigated trends in abundance, biomass and size structure and proportion of sexual maturity for the pipi (Donax deltoides) in Venus Bay, Australia. The surf clam stock was sampled during the peak harvesting season in the Australian summer (November to February) at four sites exposed to varying degrees of recreational harvest. Sampling was based on three transects at each site; with 0.027 m3 (0.3 m × 0.3 m × 0.3 m) quadrats stratified within transects by tidal position. Restricted maximum likelihood mixed model analyses were used to examine fixed effect combinations after including a priori random effect for transect within site. Results demonstrated that relative abundance varied significantly (P = 0.0090) among sampling months but not among sites. Relative abundance declined across the peak summer harvest season. The proportion of maturity varied significantly (P = 0.00026) among sites whereas relative biomass varied significantly (P = 0.0043) among months by sites. Relative biomass and the proportion of maturity were considerably higher at the site exposed to minimal harvest compared to other sites. This study demonstrates that a suite of indictors including biomass, size–frequency and proportion of maturity are likely to provide a more accurate assessment of stock status in recreationally fished surf clam populations, than relative abundance. This highlights the need to develop methods to estimate relative biomass in surf clam populations that are not exploited commercially.

Nurturing the next generation of early childhood teachers in Victoria, Australia: the role of mentoring

The research literature points to the fact that making the transition from preservice teacher to beginning teacher is a challenging experience. New to the profession teachers can experience self-doubt and feelings of anxiety about meeting expectations, inadequacy and disillusionment. What is valued at the start of their career is support, especially if it is ongoing and tailored to meet their needs. This chapter presents data from the first mentoring program for new to the profession early childhood teachers in Victoria, Australia - the State-wide Mentoring Program for Early Childhood Teachers (SWMP) (2011-2014). The chapter provides an overview of this mentoring program highlighting aspects considered most effective in supporting beginning early childhood teachers. It proposes that developing a mentoring program incorporating respectful, responsive, reciprocal and reflective elements, can enhance both mentor's and mentee's professional growth and professional identity. The impact of this program is evidenced by the voices of those involved - the mentors and mentees.