Study protocol : establishing good relationships between patients and health care providers while providing cardiac care. Exploring how patient-clinician engagement contributes to health disparities between indigenous and non-indigenous Australians in South Australia

Abstract Background: Studies that compare Indigenous Australian and non-Indigenous patients who experience a cardiac event or chest pain are inconclusive about the reasons for the differences in-hospital and survival rates. The advances in diagnostic accuracy, medication and specialised workforce has contributed to a lower case fatality and lengthen survival rates however this is not evident in the Indigenous Australian population. A possible driver contributing to this disparity may be the impact of patient-clinician interface during key interactions during the health care process. Methods/Design: This study will apply an Indigenous framework to describe the interaction between Indigenous patients and clinicians during the continuum of cardiac health care, i.e. from acute admission, secondary and rehabilitative care. Adopting an Indigenous framework is more aligned with Indigenous realities, knowledge, intellects, histories and experiences. A triple layered designed focus group will be employed to discuss patient-clinician engagement. Focus groups will be arranged by geographic clusters i.e. metropolitan and a regional centre. Patient informants will be identified by Indigenous status (i.e. Indigenous and non-Indigenous) and the focus groups will be convened separately. The health care provider focus groups will be convened on an organisational basis i.e. state health providers and Aboriginal Community Controlled Health Services. Yarning will be used as a research method to facilitate discussion. Yarning is in congruence with the oral traditions that are still a reality in day-to-day Indigenous lives. Discussion: This study is nestled in a larger research program that explores the drivers to the disparity of care and health outcomes for Indigenous and non-Indigenous Australians who experience an acute cardiac admission. A focus on health status, risk factors and clinical interventions may camouflage critical issues within a patient-clinician exchange. This approach may provide a way forward to reduce the appalling health disadvantage experienced within the Indigenous Australian communities. Keywords: Patient-clinician engagement, Qualitative, Cardiovascular disease, Focus groups, Indigenous

Nature's line : George Goyder over South Australia

A biographical work presenting 19th century South Australian surveyor general and founder of Darwin, George Goyder, as a significant figure in colonial environmental history. Focuses on tracing the growth of experience and insight which enabled him to map, as Goyder's line, his insight into the importance of rainfall variability.

Demographic and socio-cultural correlates of medical mistrust in two Australian states:Victoria and South Australia

Studies on medical mistrust have mainly focused on depicting the association between medical mistrust and access/utilization of healthcare services. The effect of broader socio-demographic and psycho-social factors on medical mistrust remains poorly documented. The study examined the effect of broader socio-demographic factors, acculturation, and discrimination on medical mistrust among 425 African migrants living in Victoria and South Australia, Australia. After adjusting for socio-demographic factors, low medical mistrust scores (i.e., more trusting of the system) were associated with refugee (β=−4.27, p<0.01) and family reunion (β=−4.01, p<0.01) migration statuses, being Christian (β=−2.21, p<0.001), and living in rural or village areas prior to migration (β=−2.09, p<0.05). Medical mistrust did not vary by the type of acculturation, but was positively related to perceived personal (β=0.43, p<0.001) and societal (β=0.38, p<0.001) discrimination. In order to reduce inequalities in healthcare access and utilisation and health outcomes, programs to enhance trust in the medical system among African migrants and to address discrimination within the community are needed.

The Composition of Holocene Aeolianites; Western Eyre Peninsula, Great Australian Bight, South Australia

The Australian southern continental margin is the world’s largest site of cool-water carbonate deposition, and the Great Australian Bight is its largest sector. The Eyre Peninsula is fringed by coastal beaches with aeolianites and marks the eastern edge of the Great Australian Bight. Five shoreline transects of varying lengths spanned a 150km longitudinal distance and at each the intertidal, beach, dune and secondary dune environments were sampled, for a total of 18 samples. Sediments are a mixture of modern, relict, and Cenozoic carbonates, and quartz grains. Carbonate aeolianites on the western Eyre Peninsula are mostly composed of modern carbonate grains: predominantly molluscs (23-33%) and benthic foraminifera (10-26%), locally abundant coralline algae (3-28%), echinoids (2-22%), and bryozoans (2-14%). Cenozoic grain abundance ranges from 1-6% whereas relict grain abundance ranges from 0-17%. A southward increase in bryozoan particles correlates with a nutrient element abundance and decrease in temperature due to a large seasonal coastal upwelling system that drives 2-3 major upwelling events per year, bringing cold, nutrient rich, Sub-Antarctic Surface Water (<12°C) onto the shelf. In southern, mostly wind protected locations, the beach and dune sediment compositions are similar, indicating that wind energy has successfully carried all sediment components of the beach into the adjacent dunes. In northern, exposed locations, the composition is not the same everywhere, and trends indicate that relative wind energy has the ability to impact grain composition through preferential wind transport. Aeolianite composition is therefore a function of both upwelling and the degree of coastal exposure.

The land of promise : being an authentic and impartial history of the rise and progress of the new British province of South Australia ... : embracing also a full account of the South Australian Company ... /

Published anonymously; written by John Stephens. Cf. Halkett & Laing (2nd ed.)

Outlines of a grammar, vocabulary, and phraseology, of the aboriginal language of South Australia, spoken by the natives in and for some distance around Adelaide.

pt. 1. Outlines of a grammar.--pt. 2. Vocabulary, &c., &c.

The Composition of Holocene Aeolianites; Western Eyre Peninsula, Great Australian Bight, South Australia

The Australian southern continental margin is the world’s largest site of cool-water carbonate deposition, and the Great Australian Bight is its largest sector. The Eyre Peninsula is fringed by coastal beaches with aeolianites and marks the eastern edge of the Great Australian Bight. Five shoreline transects of varying lengths spanned a 150km longitudinal distance and at each the intertidal, beach, dune and secondary dune environments were sampled, for a total of 18 samples. Sediments are a mixture of modern, relict, and Cenozoic carbonates, and quartz grains. Carbonate aeolianites on the western Eyre Peninsula are mostly composed of modern carbonate grains: predominantly molluscs (23-33%) and benthic foraminifera (10-26%), locally abundant coralline algae (3-28%), echinoids (2-22%), and bryozoans (2-14%). Cenozoic grain abundance ranges from 1-6% whereas relict grain abundance ranges from 0-17%. A southward increase in bryozoan particles correlates with a nutrient element abundance and decrease in temperature due to a large seasonal coastal upwelling system that drives 2-3 major upwelling events per year, bringing cold, nutrient rich, Sub-Antarctic Surface Water (<12°C) onto the shelf. In southern, mostly wind protected locations, the beach and dune sediment compositions are similar, indicating that wind energy has successfully carried all sediment components of the beach into the adjacent dunes. In northern, exposed locations, the composition is not the same everywhere, and trends indicate that relative wind energy has the ability to impact grain composition through preferential wind transport. Aeolianite composition is therefore a function of both upwelling and the degree of coastal exposure.

Bariatric patients and the use of mobile hoists : user experiences from three hospitals in South Australia

Nursing personnel are consistently identified as one of the occupational groups most at risk of work-related musculoskeletal disorders. During the moving and handling of bariatric patients, the weight of the patient combined with atypical body mass contributes to a significant risk of injury to the care provider and patient. This is further compounded by the shape, mobility and co-operation of the patient. The aim of this study was determine user experiences and design requirements for mobile hoists with bariatric patients. Structured interviews were conducted with six experienced injury management staff from the Manual Task Services department of three hospitals in Adelaide, South Australia. All staff had experience in patient handling, the use of patient handling equipment and the provision of patient handling training. A series of open-ended questions were structured around five main themes: 1) patient factors; 2) building/vehicle space and design; 3) equipment and furniture; 4) communication; and 5) staff issues. Questions focussed on the use of mobile hoists for lifting and transferring bariatric patients. Interviews were supplemented with a walk-through of the hospital to view the types of mobile hoists used, and the location and storage of equipment. Across the three hospitals there were differing classification systems to define bariatric patients. Ensuring patient dignity, respect and privacy were viewed as important in the management and rehabilitation of bariatric patients. Storage and space constraints were considered factors restricting the use of mobile floor hoists, with ceiling hoists being the preferred method for patient transfers. When using mobile floor hoists, the forces required to push, pull and manoeuvre, as well as sudden unstable movements of the hoist were considered important risks factors giving rise to a risk of injury to the care provider. Record keeping and purchasing policies appeared to inhibit the effective use of patient handling equipment. The moving and handling of bariatric patients presents complex and challenging issues. A co-ordinated and collaborative approach for moving and handling bariatric patients is needed across the range of care providers. Designers must consider both user and patient requirements.

Thorough assessment of DNA preservation from fossil bone and sediments excavated from a late Pleistocene–Holocene cave deposit on Kangaroo Island, South Australia

Fossils and sediments preserved in caves are an excellent source of information for investigating impacts of past environmental changes on biodiversity. Until recently studies have relied on morphology-based palaeontological approaches, but recent advances in molecular analytical methods offer excellent potential for extracting a greater array of biological information from these sites. This study presents a thorough assessment of DNA preservation from late Pleistocene–Holocene vertebrate fossils and sediments from Kelly Hill Cave Kangaroo Island, South Australia. Using a combination of extraction techniques and sequencing technologies, ancient DNA was characterised from over 70 bones and 20 sediment samples from 15 stratigraphic layers ranging in age from >20 ka to ∼6.8 ka. A combination of primers targeting marsupial and placental mammals, reptiles and two universal plant primers were used to reveal genetic biodiversity for comparison with the mainland and with the morphological fossil record for Kelly Hill Cave. We demonstrate that Kelly Hill Cave has excellent long-term DNA preservation, back to at least 20 ka. This contrasts with the majority of Australian cave sites thus far explored for ancient DNA preservation, and highlights the great promise Kangaroo Island caves hold for yielding the hitherto-elusive DNA of extinct Australian Pleistocene species.

Posthumous conception in South Australia : the case continues in Re H, AE (No 3) [2013] SASC 196

This editorial considers the issue of posthumous conception as discussed in the case of Re H, AE (No 3) [2013] SASC 196, which involved an application by a South Australian woman to the Supreme Court for authorisation to export her deceased partner's sperm to the Australian Capital Territory, for use in an assisted reproductive technology procedure.