The epidemiology of invasive group A streptococcal disease in Victoria, Australia

Objective To estimate the incidence and severity of invasive group A streptococcal infection in Victoria, Australia. Design Prospective active surveillance study. Setting Public and private laboratories, hospitals and general practitioners throughout Victoria. Patients eople in Victoria diagnosed with group A streptococcal disease notified to the surveillance system between 1 March 2002 and 31 August 2004. Main outcome measure Confirmed invasive group A streptococcal disease. Results We identified 333 confirmed cases: an average annualised incidence rate of 2.7 (95% CI, 2.3-3.2) per 100000 population per year. Rates were highest in people aged 65 years and older and those younger than 5 years. The case-fatality rate was 7.8%. Streptococcal toxic shock syndrome occurred in 48 patients (14.4%), with a case-fatality rate of 23%. Thirty cases of necrotising fasciitis were reported; five (17%) of these patients died. Type 1 (23%) was the most frequently identified emm sequence type in all, age groups. All tested isolates were susceptible to penicillin and clindamycin. Two isolates (4%) were resistant to erythromycin. Conclusion The incidence of invasive group A streptococcal disease in temperate Australia is greater than previously appreciated and warrants greater public health attention, including its designation as a notifiable disease.

Victoria's Child FIRST and IFS differential response system : progress and issues

Differential response has long been utilized by statutory child protection systems in Australia. This article describes the advent and history of Victoria's differential response system, with a particular focus on the Child FIRST and IFS programme. This program entails a partnership arrangement between the Department of Human Services child protection services and community-based, not-for-profit agencies to provide a diverse range of early intervention and prevention services. The findings of a recent external service system evaluation, a judicial inquiry, and the large-scale Child and Family Services Outcomes Survey of parents/carers perspectives of their service experiences are used to critically examine the effectiveness of this differential response approach. Service-user perspectives of the health and wellbeing of children and families are identified, as well as the recognized implementation issues posing significant challenges for the goal of an integrated partnership system. The need for ongoing reform agendas is highlighted along with the policy, program and structural tensions that exist in differential response systems, which are reliant upon partnerships and shared responsibilities for protecting children and assisting vulnerable families. Suggestions are made for utilizing robust research and evaluation that gives voice to service users and promotes their rights and interests.

Slippage: Reclaiming personal family history through contemporary photomedia

This paper addresses the role of photography as a documentary medium and how this forms a basis for my practice-led studio investigations. In it, I will explore how photography is used to create histories and sustain specific notions of ‘legacy’ within the context of the family photo album. Family history is often based on stories to which the photo album provides a visual point of reference. Despite the ostensible ‘objectivity’ of the family photograph though it is nonetheless as subjective as the stories that surround it. In this way, the photo album perpetuates a hegemony of truth that obscures the fragmentary and highly selective nature of these documents and stories. The result is that every photo album implicitly documents the gaps or voids present in understandings of our own histories. Homi Bhabha refers to these kinds of voids as ‘disjunctive historical spaces’ – spaces of slippage that create the opportunity for new narratives and understandings to occur. Using Bhabha’s ideas as a chief point of reference, I will explore how these voids or gaps in information – and the opportunities for re-examination that they open up - can be explored through contemporary photomedia. Digital technologies such as camera phones and scanners generate a space in which photography’s own documentary conventions can be turned in on themselves to create a subterfuge. My current studio-based research involves using the scanner to navigate through my family’s sometimes-‘occulted’ history, in order to explore, document and recover my connection to this narrative. I am primarily interested in the scanner as a tool for capturing not simply surfaces, but objects, moments or movements in time. Objects or moments captured by the scanner can often be simultaneously distorted and consolidated, blurred and sharpened. This paper will propose that this ‘slippage’, literally expressed in the disruption of the pixelated field, can be used to create a space in which alternative readings or understandings of past events can be explored and new narratives produced.

How many inpatients in our hospitals have foot complications? The foot disease in inpatients study

Background Foot complications have been found to affect large proportions of hospital in patients with diabetes. However, no studies have investigated the proportion of foot complications affecting all people in general inpatient populations. The aims of this cross-sectional study were to investigate the point-prevalence of different foot complications in general inpatient populations, analyse differences in diabetes and non-diabetes sub-groups, and examine characteristics of people primarily admitted for a foot complication. Methods Eligible participants were all adults admitted overnight, for any reason, into five diverse hospitals on one day; excluding maternity, mental health and cognitively impaired patients. All participants underwent a physical foot examination, by trained podiatrists using validated measures, to clinically diagnose different foot complications; including foot wounds, infections, deformity, peripheral arterial disease (PAD) and peripheral neuropathy (PN). Data were also collected on participants' primary reason for admission and a range of demographic, social determinant, medical history, foot complication history, self-care and footwear risk factors. Results Overall, 733 participants consented (83% of eligible participants); mean(±SD) age 62(±19) years, 480 (55.8%) male and 172 (23.5%) had diabetes. Foot complication prevalence included: wounds 9.0% (95% CI) (5.1-8.7), infections 3.3% (2.2-4.9), deformity 22.4% (19.5-26.7), PAD 21.0% (18.2-24.1) and PN 22.0% (19.1-25.1). Diabetes populations had significantly more foot complications than non-diabetes (p < 0.01); wounds (15.7% vs 7.0%), infections (7.1% vs 2.2%), deformity (30.5% vs 19.9%), PAD (35.1% vs 16.7%) and PN (43.3% vs 15.4%). Foot complications were the primary reason for admission in 7.4% (95% CI) (5.7-9.5) of all participants. In a backwards stepwise multivariate analysis having a foot complication as the primary reason for admission was independently associated (OR (95% CI) with foot wounds (18.9 (7.3-48.7)), foot infections (6.0 (1.6-22.4)), history of amputation (4.7 (1.3-17.0) and PAD (2.9 (1.3-6.6)). Conclusions Findings of this study indicate one in every ten hospital inpatients had an active foot wound or infection. In patients with diabetes had significantly higher proportions of foot complications than non-diabetes inpatients. Remarkably one in every thirteen inpatients in this study were primarily hospitalised for a foot complication. Further research and policy is required to tackle this seemingly large inpatient foot complication burden.

Some aspects of the ecology and reproduction of the small pelagic cyprinid, Rastrineobola argentea in Lake Victoria

This study concentrated on the reproductive biology of the small pelagic cyprinid Rastrineobola argentea. The results indicate that this fish is an inshore spawning species, which agrees with other recent studies. It was also found that in areas where fishing intensity was likely to be relatively high, the size at first maturity of R. argentea was reduced, which is likely to be an effect of the fish altering its reproductive strategy according to life history theory. The CPUE results showed a general trend of decreasing with distance from shore, however areas less than one kilometer from the shore were not sampled. Evidence was also found suggesting that the cestode parasite, Ligula intestinalis had an adverse effect on the maturation and fecundity of R. argentea. Some management options concerning the findings in this study are also briefly discussed. (PDF has 82 pages)

The regulators and the regulated: fisheries management, options and dynamics in Kenya's Lake Victoria fishery

The study divides the history of the fishery into five 'regulatory periods': the pre-colonial fishery (pre-1901), the colonial fishery (1901-1963), the post indipendence fishery (1963-1980), the Nile perch 'boom' years (1980-1989), and finally the fishery in the 1990's. Within each of these periods, the nature of and the relationship between, formal and informal regulations differs and changes with time. In the pre-colonial period, the outcome of formal and informal regulations largely sustained the fishery in a productive and species diverse state. However, at no time since then have formal regulations worked, with the result that the nature of production from the fishery changes over time and is dependent on a number of factors, amongst which the most important are effort level increases, technological introductions, species introductions, changes in regional and national job markets, the change from community-based controls to state-based controls within the fishery, and finally, considerable changes to the fish markets.

The small pelagic Rastrineobola argentea: successful survivor in Lake Victoria

The small cyprinid dagaa (Rastreneobola argentea) is the only indigenous species from Lake Victoria which still supports an important fishery after the population boom of the introduced Nile perch (Lates niloticus), while at the same time it is a major prey species of the perch. The observed life-history tactics and the shift from juvenile to adult exploitation mortality made dagaa a successful survivor in a disrupted ecosystem. Although the prospects for a sustainable fishery are good, the current increase in the use of mosquito seines is dangerous. Not only do mosquito seines yield a lower catch per unit of effort than alternative gear, but they also show a strong selection for juvenile dagaa.

The History of Oyster Farming in Australia

Aboriginal Australians consumed oysters before settlement by Europeans as shown by the large number of kitchen middens along Australia's coast. Flat oysters, Ostrea angasi, were consumed in southeastern Australia, whereas both flat and Sydney rock oysters, Saccostrea glomerata, are found in kitchen middens in southern New South Wales (NSW), but only Sydney rock oysters are found in northern NSW and southern Queensland. Oyster fisheries began with the exploitation of dredge beds, for the use of oyster shell for lime production and oyster meat for consumption. These natural oyster beds were nealy all exhausted by the late 1800's, and they have not recovered. Oyster farming, one of the oldest aquaculture industries in Australia, began as the oyster fisheries declined in the late 1800's. Early attempts at farming flat oysters in Tasmania, Victoria, and South Australia, which started in the 1880's, were abandoned in the 1890's. However, a thriving Sydney rock oyster industry developed from primitive beginnings in NSW in the 1870's. Sydney rock oysters are farmed in NSW, southern Queensland, and at Albany, Western Australia (WA). Pacific oysters, Crassostrea gigas, are produced in Tasmania, South Australia, and Port Stephens, NSW. FLant oysters currently are farmed only in NSW, and there is also some small-scale harvesting of tropical species, the coarl rock or milky oyster, S. cucullata, and th black-lip oyster, Striostrea mytiloides, in northern Queensland. Despite intra- and interstate rivalries, oyster farmers are gradually realizing that they are all part of one industry, and this is reflected by the establishment of the national Australian Shellfish Quality Assuarance Program and the transfer of farming technology between states. Australia's oyster harvests have remained relatively stable since Sydney rock oyster production peaked in the mid 1970's at 13 million dozen. By the end of the 1990's this had stabilized at around 8 million dozen, and Pacific oyster production reached a total of 6.5 million dozen from Tasmania, South Australia, and Port Stephens, a total of 14.5 million dozen oysters for the whole country. This small increase in production during a time of substantial human population growth shows a smaller per capita consumption and a declining use of oysters as a "side-dish."

The biology, ecology and impact of the Nile perch, Lates niloticus in lakes Victoria, Kyoga and Nabugabo and the future of the fisheries

Nile perch (Mputa), Lates niloticus was introduced into Lakes Victoria and Kyoga from lake Albert to increase fish production of these lakes by feeding on and converting the small sized haplochromines (Nkejje) which were abundant in these lakes into a larger table fish. It was, however, feared that Nile perch would prey on and deplete stocks of the native fishes and affect fish species diversity. Nile perch became well established and is currently among the three most important commercial species. It is presently the most important export fish commodity from Uganda. Considerable changes have taken place in fishery yield, and in life history characteristics of the Nile perch itself since the predator got established in Lakes Victoria and Kyoga.

The major aquatic systems of the Victoria and Kyoga lake basins

The Victoria and Kyoga lake basins form the major aquatic system of this study (Fig. I). The two lake basins share a common evolutionary history and have similar native fish faunas (Graham 1929, Worthington 1929). The two main lakes have also had similar impacts by introduction of Nile perch Lates niloticus and therefore these two lakes can be considered to be similar for ichiogeographical purposes. These lake basins have many satellite lakes isolated from one another and from the main lakes Victoria and Kyoga by swamps and other barriers. Some of these satellite lakes still possess stocks of endemic fish species which are almost extinct from the main water bodies. It was therefore considered that understanding of these lakes would contribute to the knowledge base required to solve some of the problems experienced in Lake Victoria and Kyoga especially the loss in trophic diversity arising. The study was carried out in these two main water bodies (Kyoga and Victoria) and on other satellite lakes e.g Wamala, Kachera, Mburo, Kayanja and Kayugi in the Victoria lake basin and lakes Nawampasa, Nyaguo, Agu, Gigate, Lemwa and Kawi in the Kyoga lake basin (Figs. 2, 3, 4, 5 & 6).

The diversity of amphibians, reptiles and mammals and their importance in the Victoria and Kyoga lake basins

The shore margins of Lakes in the Victoria basin are highly dented and mostly swampy, fringed by Papyrus and other wetland vegetation types important habitats for herpetofauna and wetland adapted mammals. Of recent, the extent of the 'wetland' has been extended in several places by the Water Hyacinth (Eichornia cryaseps). Ecologically, amphibians are important in many ways; they are mostly predators, acting as primary and secondary carnivores. Their prey consists mostly of insects, some of which are pests to crops or disease vectors. They are also inter-inked in food chains, often acting as food for other vertebrates, such as pigs, birds, snakes and sometimes man. Because of their ectothermic physiology, the life history and ecology of amphibians often differ markedly from that of birds or mammals (McCollough el ai, (992).Amphibians are known to be an easily recognisable taxon in given habitats; and populations are sometimes specialised within a narrow habitat. This makes it easy and practical to monitor changes in composition over time, given different onditions (Heyer el al 1994, Phillips 1990). Impacts on their habitat are reflected in changes in numbers and species diversity in a short time. These are some of the factors that have made amphibians to be recognised, nowadays, as good indicators of habitat change

The biology and ecology of the Nile perch, Lates niloticus, and the future of its fishery in Lakes Victoria, Kyoga and Nabugabo

Lakes Victoria, Kyoga and Nabugabo had a similar native fish fauna of high species diversity. stocks of most of the native species declined rapidly and some completely disappeared after Nile perch was introduced and became well established. Although, overexploitation of the fish stocks, competition between introduced and native tilapiines and environmental degradation contributed to the reduction in fish stocks, predation by the Nile perch has contributed much to the recent drastic reductions in fish stock and could even drive the stocks to a total collapse. Nile perch is also currently the most important commercial species in Lakes victoria, Kyoga and Nabugabo and the stability of its stocks is important in the overall sustainability of the fisheries of these lakes. The question that was to be examined in this paper was whether the fisheries of Lakes Victoria, Kyogaand Nabugabo would stabilize and sustain production in the presence of high predation pressure by the Nile perch or whether the Nile perch would drive the fish stocks including itself to a collapse. I t was assumed that Nile perch driven changes in Lakes Victoria, Kyoga and Nabugabo would be driven to a level beyond which they would not change further. This would be followed by recovery and stability or the changes would continue to a point of collapse. It was assumed that Lake Albert represented the ideal stable state. The changes in the new habitats expected to be driven through a major change due to Nile perch predation to a stage where there would be no further changes. After this, a feedback mechanism would move the driven variable towards recovery. The variables would then stabilize and oscillate will an amplitude which approximates to what would be recorded in Lake Albert. Alternatively, the changes would proceed to a stage where the fishery would collapse. The specific hypothesis was that fish species composition and diversity, prey selection by the Nile perch and life history characteristics of the Nile perch in the new habitats would change and stabilize

Management from the viewpoint of Lake Victoria fisheries

Fisheries science is concerned with ultimate yield prediction and control. The subject deals with the study of natural history of stocks and the dynamics of fish populations. The multiple species fisheries of Lake Victoria are undergoing rapid development. Already, some of the highly valued fish species have been reduced to very low population levels. The most abundant but less relished Haplochromis spp. remain underutilized. The real problem in management is to win acceptance for regulations that foster increasing productivity in the industry, without slavish adherence to status quo.

The origins of the Irish hospitals' sweepstake

This article examines the two main reasons for the setting up of the Irish sweepstakes in 1930; the financial crisis facing voluntary hospitals and the tradition of using sweepstake gambling to raise funds for charitable purposes. Such gambling, although technically illegal, was prevalent and widely tolerated during the late 19th and early 20th centuries. The change of government that accompanied Irish independence in 1921 led to much confusion surrounding the law on gambling and large-scale sweepstakes proliferated during the early 1920s, many of them selling tickets illegally in Britain. At the same time the Irish voluntary hospitals faced a financial crisis that threatened their future, brought about by the adverse impact of war-time inflation on the value of their endowments, the emigration of supporters of the Protestant voluntary hospitals after independence, the political upheaval of the revolutionary period, the decline in fees from medical students and the increasing cost of and demand for hospital treatment. This article provides a detailed account of the enactment of the sweepstake legislation and of the first sweepstake on the 1930 Manchester November Handicap.

'A terrible danger to the morals of the country': The Irish hospitals' sweepstake in Great Britain, 1930-87

This paper examines the importance of British contributions to the success of the Irish hospitals sweepstake. In its early years, up to three-quarters of these tickets were sold in Britain, bringing millions of pounds into Ireland annually to improve and expand the state's hospitals. The vast amount of money leaving Britain in this way angered the British government and forced it to introduce new legislation to curtail the activities of the Irish sweep. The paper will highlight the extent to which the success of the sweepstake depended on the market for tickets in Britain; the threat to the sweep's survival posed by the restriction of its activities in Britain after 1935; the role of the sweepstake controversy in exacerbating further already strained relations between Britain and the Irish Free State in the 1930s; how the success of the sweep raised the issue of legalising a British lottery; and the eventual decline of the sweepstake as a force in British gambling in the post-war years.