Australian Country Research Articles

Haiku and Country: The connect between First Nations Country and Bashō's enduring principles for the writing of Haiku

Examining the sense of embodiment in the art and culture of Australian First Nations and Country and how this is paralleled in the poetics and practice of writing haiku as it originated in Japan.

Australian country paper: Integrated approaches to irrigation management in the future

AbstractIrrigation in Australia expanded dramatically during the early to mid‐twentieth century under an economic and social development regime of government. This led to overallocation and overuse of many of the country's water resources to the detriment of the rivers and riverine environments. To address this degradation federal and state governments have come together to implement a range of reforms at national, basin and catchment level to return water to the rivers but not at the expense of rural communities and a range of policy reforms to implement water resource best management practice including cost recovery pricing, accuracy in measurement (resource availability and extraction). The three most significant components of these reforms are the Murray–Darling Basin Plan, the National Water Initiative and the Sustainable Rural Water Use and Infrastructure Programme (SRWUIP). These actions are complemented by infrastructure and management improvements at on‐ and off‐farm levels and examples are documented.

Connecting conservation & culture: The importance of Indigenous Knowledge in conservation decision-making and resource management of migratory marine species

Migratory marine species (e.g., seabirds, marine mammals, fish, and sea turtles) cross and connect distant communities and ecosystems throughout their transboundary journeys. Due to their multi-jurisdictional and cross-cultural movements, studying, managing, and protecting migratory marine species as well as their habitats and migration routes are deeply political and geographically complex tasks. Despite a place-based cultural connection to migratory marine species; inherent rights, responsibilities, and authority to manage Sea Country (marine territory), Indigenous communities are far too often excluded from marine conservation decision-making. In this paper we conduct a narrative review and synthesis of relevant literature and analyze four community-driven case studies (both terrestrial and marine) that recognize the incorporation of Indigenous knowledge to support the governance and management of a culturally significant migratory species. The case studies are presented from an Australian Sea Country context as well as from a Canadian marine territory setting. Together these case studies highlight how Indigenous knowledge can increase the understanding of connectivity as well as provide a spatio-temporal baseline for species with limited science-based knowledge. It is essential that Indigenous communities as rights holders to Sea Country (marine territory) and owners of vast amounts of relevant marine knowledge be at the forefront of migratory marine species conservation decision-making for both coastal and distant offshore areas such as Areas Beyond National Jurisdiction. Bringing Indigenous knowledge and scientific monitoring data together has the potential to respond to Indigenous priorities for Sea Country and further contribute to the understanding of migratory marine species distribution, abundance, life cycles, threats, and oceanic connectivity.

Beyond job placement: careers for refugees.

In this article, we highlight the Australian country context to advocate for career support that extends beyond initial job placement in a segmented labor market to strengthen refugees' skills and knowledge and future career development. We address systemic barriers while advocating for access to skilled career development practitioners, whose important expertise as members of multidisciplinary teams could enhance resettlement assistance. Strengthening the preparation of career development practitioners is essential for providing career support to refugees and for building capacity in the provision of resettlement services. We encourage debate within and between country contexts about ways to enhance refugees' career development.

Disputes over Coal Mining and Gas Drilling in an Australian Country Town

This paper explores the repatterning of civil society, the social technologies of persuasion and information, and the role of socio-political contexts in Narrabri (an Australian country town, in Western New South Wales), and its surrounding region between 2018 and 2020. In Narrabri the consequences of Carbon Oligarchy are observed, as the oligarchy promoted new gas fields and expansions of a coal mine in the region. This expansion is justified by supposedly offering a solution to Narrabri’s apparent economic, agricultural and population decline problems, but for many local people, it worsens those problems. Conflict has been generated as a result, and the town has suffered painful fractures making the problems seem harder to solve because of the resulting disunity. The paper explores how the contest to justify the extraction also reduces the legitimacy of that extraction.

ANZARD Data Linkage – Agreement Between Births Recorded by Clinics and in NSW Perinatal Data Collection

Background: Fertility clinics submit treatment data on all ART cycles to the Australian and New Zealand Assisted Reproductive Technology Database (ANZARD) as part of their accreditation. The National Perinatal Epidemiology and Statistics Unit (NPESU), who manages ANZARD, is undertaking a study involving the linkage of ANZARD to state and commonwealth datasets to investigate health outcomes of infants born from fertility treatments. Aim: To describe the creation and performance of the linked dataset and to evaluate the agreement between births recorded by clinics and those recorded in state perinatal data collections (PDC). Method: The linked dataset was created by linking the ANZARD to NSW and ACT administrative datasets (performed by NSW Centre for Health Record Linkage (CHeReL)) and to Medicare Benefits Scheme and Pharmaceutical Benefits Schedule (performed by AIHW). The CHeReL’s Master Linkage Key (MLK) was used as a bridge between ANZARD’s statistical linkage key and state administrative datasets. Linkage rates and concordance between births recorded in ANZARD and PDCs was evaluated. Results: A 96.7% linkage rate was achieved between women recorded in ANZARD and CHeReL’s MLKs. A reconciliation of ANZARD-recorded births among NSW residents found that 94.2% (95% CI: 93.9-94.4%) of births were also recorded in NSW/ACT PDCs. A proportion of the missing births could be to women who had ART treatment in NSW but birthed in a different Australian state or country. A high concordance rate (>99%) was found in plurality status and birth outcome between ANZARD and PDCs. Conclusion: High linkage rates can be achieved with partially identifiable data and population spines, such as the CHeReL’s MLK, can be successfully used to link clinical registries and administrative datasets. This linkage resource will provide invaluable information on the safety of the ART and non-ART treatment, and the role of subfertility on the fertility treatments for Australia and beyond.

O25 - Contemporary Maternity Research Priorities for the Nation’s Biggest Health Service: Results of a Delphi Study

Western Australian Country Health Service (WACHS) is one of the world’s largest health service by area. The diversity of resourcing, population density and remote locations results in distinctive challenges and opportunities in the provision of maternity care. The aim of this Delphi study was to establish a collaborative, interdisciplinary evidence-based consensus regarding maternity research priorities across the service. A three-round Delphi survey method was used. Maternity professionals employed by WACHS (including midwives, obstetricians, GP obstetricians, Aboriginal maternity workers, remote area nurses and midwifery managers / leaders) were invited to participate. The first round collected demographic data and had free text fields, encouraging participants to create a list of ideas, problems and opportunities that could be addressed through research. Responses from the first questionnaire were grouped and summarised. A total of 52 key concepts were identified which were classified across five domains: Clinical Care; Aboriginal Health; Workforce and Education, Logistics and Health Systems; and, Health Equity. The second-round survey sought ranking of the importance and perceived priority of each research topic proposed. The top 15 ranked research topics from round two were then circulated to all WACHS maternity professionals in a round three survey and a final priority ranking to guide the focus of future research activities at WACHS was obtained. The final results will be available in May 2022 and will report the first-ever systematic and scientific consensus of maternity research priorities identified by the maternity professionals working in the unique settings presented in rural and remote Western Australia. The Delphi will offer an evidence-informed list of research priorities as identified by WACHS maternity professionals. It is anticipated that the study will enhance engagement, collaboration and enthusiasm within the interdisciplinary maternity team to undertake research locally, potentially, with multi-site collaborations within WA or nationally.

SCARRED TREES AND BECOMING-WITNESS

What happens when the landscape looks back? How is it that the landscape sees? This essay goes in search of material-semiotic signs of Australian Indigenous Country, overlooked and actively unseen through the history and enduring violence of European invasion. Whether in the form of eel traps, fishing weirs, remnants of stone huts, scarred trees, or else discovered in the notebook sketches of early explorers who wondered at the park-like composition of the landscape they were newly encountering, such evidence offers testimony to an Indigenous environmental knowledge we are in great need of today, grappling as we are with the concatenating effects of the climate crisis. The acknowledgement of sites of Indigenous significance across Australia, often threatened by mining interests and infrastructural projects, is discussed here in relation to the cultural and ritual artefact that is the scarred tree. This article explores the entangled act of witnessing via the more-than-human becomings of the landscape, or what Indigenous custodians call “Country,” and through the protean figure of the becoming-witness. Drawing on the theories of feminist ethnographers and philosophers while paying crucial heed to the voices of Indigenous scholars, I situate myself as a non-Indigenous scholar between the fields of architecture and philosophy. Venturing into the deceptively mundane suburban hinterlands of Melbourne, Australia in search of scarred trees, I attempt to broach a careful dialogue between Indigenous and non-Indigenous modes of what Deborah Bird Rose and Thom van Dooren call “Storying” as a process of learning with Country.

Maternity research priorities in country Western Australia: a Delphi study.

Objective Health research priorities are commonly identified and resourced by strategic leaders. The importance of recognising the expertise of clinician-researchers is being prioritised by a national funding shift towards applied research. There is a dearth of evidence regarding research priorities for maternity care in rural and remote health in Australia. This study aimed to develop an evidence-based consensus of maternity research priorities in regional, rural, and remote areas of Australia's largest rural health service (by land area) in Western Australia. Methods A three-phased Delphi method was selected to achieve an interdisciplinary, evidence-based consensus on maternity research priorities within Western Australian Country Health Service. Results Across three study phases, 432 participants responded. Representation was from seven regions and all stakeholder roles within the regions. Phase 1 included 173 responses yielding 53 concepts categorised under five domains. Phase 2 involved 161 participants who prioritised concepts under domains of (i) workforce and education; (ii) health equity; (iii) Aboriginal health; (iv) logistics and health systems; and (v) clinical. Phase 3 included 96 participants revealing 15 maternity research priorities with the top four ranked concepts: 'recruitment and retention of staff'; 'care for women and families with vulnerabilities', 'models of care offering continuity' and 'systems efficiencies'. Conclusions The novel evidence provided in this study, in conjunction with a strong consensus on research priorities and an interdisciplinary approach, strengthens the findings of this study and amplifies the mandate of action without delay.

Evaluating the Effectiveness of a Clinical Practice Intervention in Increasing Obesity Data Recording at a Western Australian Country Health Service Hospital: A Quasi-Experimental Controlled Trial.

PurposeIdentification and mitigation of obesity-related risks to staff and healthcare organisations can occur using patient obesity data; however, a 2017/18 audit of obesity data accuracy was assessed to be poor. This study investigates the results of an intervention to improve obesity data recording and coding accuracy at an Australian hospital.BackgroundIncreasing population obesity rates result in increased organisational and financial risks to hospitals. Australian obesity prevalence has steadily increased since 1995, and 42% of the Australian population is predicted to be obese in 2035. To reduce risks to healthcare staff who care for obese patients, complete and accurate obesity recording is required.MethodsFollowing a previous audit of obesity recording and coding accuracy of patients admitted to hospital with Type II diabetes, a 12-month intervention was undertaken, comprising staff education, introduction of tape measures and obesity decision-making tools, recording of patient volunteered height, regular reinforcement of obesity recording requirements and enhanced clinical coding of obesity. A re-audit was subsequently conducted to determine if the intervention impacted obesity recording and coding at the previously audited site.ResultsImproved recording of obesity-related measures and obesity data accuracy were observed, including increased patient BMI, impacted by increased patient height measurements and increased patient weight measurements. Obesity recording accuracy increased due to the intervention, including increased sensitivity, increased negative predictive values and reduced false negatives.ConclusionThe obesity recording intervention was successful; however, as hospitals increasingly use electronic health records, improvement opportunities should be considered such as compulsory recording of patient weight and height, embedded BMI calculators and “check boxes” for recording impacts of obesity conditions on treatment. Immediate improvement of obesity recording in manual patient files can be achieved in the meantime by implementing targets of 100% weight, height and BMI recording, introducing education programs and auditing compliance.

“My box of memories”: An Australian Country Girl Goes to London

In 1954 a young country woman from New South Wales, Shirley Dunk, ex- ercised her agency and travelled to London. This was a journey to the home of her fore- fathers and copied the activities of other country women who made similar journeys. Some of the earliest of these journeys were undertaken by the wives and daughters of the 19th-century rural gentry. This research project will use a qualitative approach in an examination of Shirley’s journey archive complemented with supplementary interviews and stories of other travellers. Shirley nostalgically recalled the sense of adventure that she experienced as she left Sydney for London by ship and travelled through the United Kingdom and Europe. The article will address questions posed by the journey for Shirley and her travelling companion, Beth, and how they dealt with these forces as tourists and travellers. Shirley’s letters home were reported in the country press and reminiscent of soldier’s wartime letters home that described their tales as tourists in foreign lands. The narrative will show that Shirley, as an Australian country girl, was exposed to the cosmo- politan nature of the metropole, as were other women. The paper will explore how Shirley was subject to the forces of modernity and consumerism at a time when rural women were often limited to domesticity.

Estimated Financial Impacts of Inaccurate Obese Patient Data Recorded by the Western Australian Country Health Service.

PurposePressure on Australia’s healthcare system is increasing annually due to corresponding increases in chronic diseases such as obesity and rapidly ageing population growth across Australia, resulting in requirements for increased funding. This study investigates the financial impact to hospitals due to inaccurate obese patient recording and coding.BackgroundAustralian healthcare organisations receive Activity-Based Funding (ABF) which provides reimbursement of costs relating to the type of patient care delivered and the resources required for the patient treatment. Accurate healthcare data are essential to ensure accuracy of ABF and appropriate reimbursement of costs incurred by hospitals that manage obese patients. Managing obese patients results in operational funding requirements such as increased staffing and purchasing of equipment such as hoists, bariatric wheelchairs and bariatric beds, and hospitals must ensure that these clinical requirements are documented accurately in order to be reimbursed of these costs by way of ABF.MethodsThis study identifies the financial implications of inaccurate obesity data within the Western Australian Country Health Service (WACHS) and examines factors that may affect obesity data recording accuracy. The study involves 85 cases of identified obesity data recording inaccuracy that were adjusted by entering corrected obesity codes, which then adjusted Diagnosis-related Groups, National Weighted Activity Units and Activity-Based Funding results.ResultsThe study demonstrated estimated annual lost funding opportunities of $2.23 million due to obesity coding inaccuracy. An annual average of 616 cases of obesity data inaccuracy was calculated with an average lost funding opportunity of $3625 per case.ConclusionImprovements are required in the clinical recording and coding of patient obesity, such as mandatory recording of patient weight and height data and automated BMI calculations within electronic patient records. Enhanced obesity recording and coding accuracy will result in increased funding opportunities and reduced cost burdens that hospitals currently experience when required to fund obesity-related clinical and safety requirements within operational budgets.

The Fencing of Wanderowna by Rolf Boldrewood: How Much Fact, How Much Fiction?

ABSTRACT From 1864 to 1867, Australian novelist Rolf Boldrewood (Thomas Alexander Browne) was resident manager of the Riverina sheep run Bundidjaree. During this time, he fenced the run but left penniless after droughts and falling prices broke him. These experiences formed the background to his 12-part serial, The Fencing of Wanderowna: A Tale of Squatting Life, published anonymously in the Australian Town and Country Journal from June to August 1873. In 1898, he compiled the serial into a novella: The Fencing of Wandaroona: A Riverina Reminiscence. In the novella, Scottish gentlemen squatters, brothers Gilbert and Hobbie Elliot, transition from shepherding to paddocking sheep. The story includes details of managing a sheep run, decision-making prior to fencing and during droughts, and a financial analysis comparing shepherding and fencing. Contemporaneous reviews in both England and Australia criticised the writing but accepted the authenticity of the narrative; however, while omitting many details, and containing flaws in the financial analysis, the story does contain some accurate, and often missing, information about life on a Riverina sheep run in the 1860s.

An audit of obesity data and concordance with diagnostic coding for patients admitted to Western Australian Country Health Service hospitals

Objective: Accurate patient obesity data can be used to identify and mitigate patient manual handling risks to healthcare staff. This study investigates the accuracy of patient obesity data within the Western Australian Country Health Service (WACHS) and examines factors potentially affecting obesity data accuracy. Background: Risk of injuries to healthcare staff are increasing due to rising patient obesity. Consistent increases in the prevalence of obesity in Australia have been recorded since 1995 and Australian obesity projections predict that 42% of the population will be obese in 2035. To manage the increased risks of injuries to healthcare workers due to obese patient management, accurate healthcare data relating to patient obesity is required. Design: Researchers examined records of patients admitted to WACHS hospitals with Type II Diabetes, which has confirmed links with obesity. Manual data extraction and comparison of obesity related data within patient medical records and electronic patient admission data was conducted to determine accuracy. Results: Analysis of the patient data examination demonstrated poor recording of weight (67%), height (24%) and Body Mass Index (BMI) when weight and height measurements were recorded (10%). Poor obesity data accuracy was also determined by low sensitivity results (40%), high false negative results (60%) and a Cohen’s kappa value of 0.44. Discussion: The sensitivity result demonstrates that only 40% of obese patients were coded as obese when obesity is recorded in their medical files, and the false negative result demonstrates that where obesity notations were present in medical files, 60% of these cases were incorrectly coded as ‘normal weighted’. There was only moderate agreement between the occurrences of coded obesity and the recorded obese patient notations in the medical files. Conclusion: Further research is required to inform enhancements to improve obesity recording and coding accuracy, which will increase the collection of reliable obesity data that could be used to reduce obese patient handling risks to nurses and other healthcare staff. What is already known about the topic? Increasing Australian population obesity rates have been previously demonstrated, this increase corresponds with increasing numbers of obese patients being admitted into hospitals. Healthcare staff who care for obese patients are at increased risk of injuries when conducting patient handling tasks. What this paper adds: A model to measure obesity accuracy utilising 14 data accuracy indicators was used, revealing poor obesity data accuracy and poor completeness of obesity data. Completeness of obesity data is influenced by time demands and workload of clinicians, breadth of clinical recording requirements, lack of organisational direction for the need of obesity data, and challenges in obtaining height measurements of patients who are mobility impaired, bed-ridden or unable to stand. Complete and accurate obesity data collections will result in increased ability to mitigate safety risks to healthcare staff who manage obese patients and may improve healthcare funding accuracy.

Effectiveness and cost-effectiveness of TeleStroke consultations to support the care of patients who had a stroke presenting to regional emergency departments in Western Australia: an economic evaluation case study protocol

IntroductionThe Western Australia (WA) Acute TeleStroke Programme commenced incrementally across regional WA during 2016–2017. Since the introduction of the TeleStroke Programme, there has been monitoring of service outputs, including regional...

Biosecurity hygiene in the Australian high country: footwear cleaning practices, motivations, and barriers among visitors to Kosciuszko National park

ABSTRACT Conservation areas face growing visitor numbers and heightened biosecurity risks from vectors such as bushwalkers and mountain bikers. For mountain areas, such pressures, with climate change, may be increasing in vulnerability to invasive species. Strategies to manage these risks include encouraging visitors to undertake biosecurity hygiene practices such as cleaning footwear at trailhead cleaning stations. However, limited social science biosecurity hygiene research has been undertaken. We address the issue by using a survey based on a social marketing approach to assess footwear cleaning practices among walkers in Kosciuszko National Park in south-eastern Australia. We identified perceived barriers and benefits to footwear cleaning among walkers, finding a low level of cleaning but that most walkers identified addressing biosecurity risks as a benefit from cleaning. Barriers to cleaning included queues and station maintenance. We use elements from the Theory of Planned Behaviour as a heuristic to reflect on walker behaviour and responses. Outcomes suggest strategies for station installation and design, and the value of further research into visitor norms and behaviour. We reflect on the use of social marketing and what it asks of both visitors and managers.

Shrine: War Memorials and the Digital Age

Shrine: War Memorials and the Digital Age

Review of Aboriginal child health services in remote Western Australia identifies challenges and informs solutions

BackgroundDespite a national focus on closing the gap between Aboriginal and non-Aboriginal child health outcomes in Australia, there remain significant challenges, including provision of health services in very remote communities. We aimed to identify and map child health services in the very remote Fitzroy Valley, West Kimberley, and document barriers to effective service delivery.MethodsIdentification and review of all regional child health services and staffing in 2013. Verification of data by interview with senior managers and staff of key providers in the Western Australian Country Health Service, Kimberley Population Health Unit, Nindilingarri Cultural Health Services and non-government providers.ResultsWe identified no document providing a comprehensive overview of child health services in the Fitzroy Valley. There were inadequate numbers of health professionals, facilities and accommodation; high staff turnover; and limited capacity and experience of local health professionals. Funding and administrative arrangements were complex and services poorly coordinated and sometimes duplicated. The large geographic area, distances, extreme climate and lack of public and private transport challenge service delivery. The need to attend to acute illness acts to deprioritise crucial primary and preventative health care and capacity for dealing with chronic, complex disorders. Some services lack cultural safety and there is a critical shortage of Aboriginal Health Workers (AHW).ConclusionsServices are fragmented and variable and would benefit from a coordinated approach between government, community-controlled agencies, health and education sectors. A unifying model of care with emphasis on capacity-building in Aboriginal community members and training and support for AHW and other health professionals is required but must be developed in consultation with communities. Innovative diagnostic and care models are needed to address these challenges, which are applicable to many remote Australian settings outside the Fitzroy Valley, as well as other countries globally. Our results will inform future health service planning and strategies to attract and retain health professionals to work in these demanding settings. A prospective audit of child health services is now needed to inform improved planning of child health services with a focus on identifying service gaps and training needs and better coordinating existing services to improve efficiency and potentially also efficacy.

Interactive web mapping of 90 Years of Fire History Across South Australia

Abstract. Fire is a significant part of South Australian history and integral to the state’s ecosystems. Small prescribed fires are an essential part of ecosystem management and health. However, large, uncontrollable bushfires during South Australia’s hot, dry summers often cause loss of property, damage to the environment and fatalities. An awareness of this fire history enables effective management and encourages residents to better prepare for catastrophic fire events. The South Australian Country Fire Service provides data on the burn extents of more than 5500 prescribed and accidental fire events across the state from 1931 to 2018. This work presents the development of an open-source interactive web mapping tool, allowing residents, managers, and other map users to intuitively explore the state’s fire history without the need for advanced software and skills. This web map application aims to clearly show the state’s complex fire history at any zoom level from the entire state to a medium sized rural property. To clearly symbolise areas with extensive fire history, events are shown as both polygons and centroid points. Points are symbolised using scale dependant clustering with cluster symbols including counts. This communicates both the number of fires and the extent of area burnt for regions of interest at all zoom levels. Statistics for the state’s fire districts are also portrayed using a choropleth symbology. Popups provide further information on all point and polygon data. All processing is done by the browser, with GeoJSON polygon geometry simplified and tiled using the geojson-vt library to ensure a responsive experience. Whilst resulting in a large initial download and requiring a mid-range PC for display this approach means data can be freely provided on static hosting with very little pre-upload processing required. Fire data can thus easily be updated as new incidents occur. To allow responsive filtering of the over 5500 fire features an index system is implemented, using indices calculated both when data is loaded and on the fly in response to interface changes. The unique IDs given features within the fire GeoJSON are assigned to their leaflet layer representation. Lists of IDs of all features returning true when toggles are set to true are created on data load using a combination of the filter and map functions. Similar lists are created on the fly based on the status of range inputs. Intersect, union and difference functions are implemented using the Set data type allowing fast comparisons between filter results, visible, and not visible features to determine specific features to be shown or hidden. This index system is utilised to provide a time series animation and a range of dual handle slider and checkbox interface elements allowing comprehensive data exploration based on event type, size, season, and year. When data is filtered by individual decade a textual historic summary of the decade is also displayed. The visualisation performs well on mid to high end desktop computers and thus demonstrates the potential client-side web technology has for providing comprehensive and accessible data exploration.

Cultural and linguistic diversity of people living with chronic hepatitis B in 2011–2016: changing migration, shifting epidemiology

ObjectiveTo estimate the cultural and linguistic diversity in Australians currently living with chronic hepatitis B (CHB), the majority of whom were born overseas, and to identify trends in this diversity over time. MethodsEstimates were generated by combining Australian census country of birth information with seroprevalence data generated from antenatal serology linked with surveillance notifications. The number of people living with CHB was assessed according to country of birth using the 2011 and 2016 censuses. ResultsThe total number of Australian residents living with CHB increased by 20% between 2011 and 2016, substantially outpacing population growth. The most common country of birth continued to be China, with the number of Chinese‐born Australians living with CHB increasing by 60% in the 5‐year period. Decreased numbers were observed for people born in European countries. ConclusionsThe epidemiology of chronic hepatitis B in Australia has shifted over time due to changing migration patterns, with increases in many countries in the Asia‐Pacific, African and Middle Eastern regions. Implications for public healthInterventions to improve the health of people living with CHB are imperative, and these up‐to‐date estimates identify priority groups and communities, which are constantly changing.