Australian Family Research Articles

Australia’s Asian Garrisons: Decolonisation and the Colonial Dynamics of Expatriate Military Communities in Cold War Asia

Focused on Australia’s Royal Australian Air Force and Army garrison communities in Malaysia from the late 1950s, this article probes the creation and management of a complex power dynamic between the hosts in a postcolonial nation and an expatriate community modelled along colonial lines. These overseas military communities comprised Australian service personnel, their family members and schoolteachers. Thousands of locally employed civilians worked on Australian military bases, or for Australian families as amahs, cooks and gardeners, and Malaysian businesspeople capitalised on the Australian presence. The article tracks the political, social and cultural implications of the cross-cultural encounters enabled by Australia’s Asian garrisons, taking into account the perspective of both Australians and Malaysians, to argue that these communities had a marked impact on regional engagement. Negotiations of military, political, economic and personal power were constant and ongoing; Malaysian demands, far from being subordinated, were often both articulated and met.

A history of the use of the concept of parental alienation in the Australian family law system: contradictions, collisions and their consequences

ABSTRACTThis paper presents insights into the history and current deployment of the concept of parental alienation in the Australian family law system. It begins in 1989, when an article on parental alienation syndrome was first published in an Australian law journal. It then traces aspects of the socio-legal and social science research, gender politics, law reform and jurisprudence of the following 30 years, paying attention to moments of significant change. The impacts of major amendments that emphasise the desirability of post-separation shared parenting outcomes in 1996 and 2006 are specifically considered. More recently, in 2012, reforms intended to improve the family law system’s response to domestic and family violence were introduced. The history reveals an irreconcilable tension between the ‘benefit’ of ‘meaningful’ post-separation parent-child relationships and the protection of children from harm. When mothers’ allegations of violence in the family are disbelieved, minimised or dismissed, they are transformed from victims of abuse into perpetrators of abuse – alienators of children from their fathers. Their actions and attitudes collide with the shared parenting philosophy. This is arguably an inescapable consequence of a family law system that struggles to deal effectively with family violence in the context of a strong shared parenting regime.

The Protection of Confidentiality in Australian Family Law

This paper identifies and discusses the legislative provisions which protect confidentiality in family law proceedings in Australia. The purpose of discussing these protections is two‐fold: firstly, to identify the scope and operation of these protections for Australian legal practitioners; secondly, to allow comparison of Australian protections to those offered in other jurisdictions. This paper will consider duties of confidentiality and evidential privileges in the context of settlement negotiation, mediation, arbitration, lawyer‐client relationships and medical, counselling and other therapeutic relationships. The rationale for the protection of confidentiality in some of these relationships and circumstances, but not in others, will also be considered in an attempt to understand why it is so.

Pama-Nyungan grandparent systems change with grandchildren, but not cross-cousin terms or social norms.

Kinship is a fundamental and universal aspect of the structure of human society. The kinship category of 'grandparents' is socially salient, due to grandparents' investment in the care of the grandchildren as well as to older generations' control of wealth and cultural knowledge, but the evolutionary dynamics of grandparent terms has yet to be studied in a phylogenetically explicit context. Here, we present the first phylogenetic comparative study of grandparent terms by investigating 134 languages in Pama-Nyungan, an Australian family of hunter-gatherer languages. We infer that proto-Pama-Nyungan had, with high certainty, four separate terms for grandparents. This state then shifted into either a two-term system that distinguishes the genders of the grandparents or a three-term system that merges the 'parallel' grandparents, which could then transition into a different three-term system that merges the 'cross' grandparents. We find no support for the co-evolution of these systems with either community marriage organisation or post-marital residence. We find some evidence for the correlation of grandparent and grandchild terms, but no support for the correlation of grandparent and cross-cousin terms, suggesting that grandparents and grandchildren potentially form a single lexical category but that the entire kinship system does not necessarily change synchronously.

591 The Australian Genetic Heart Disease Registry: 13 Years on

The Australian Genetic Heart Disease (AGHD) Registry was established in 2007 with the goal to recruit every Australian family with a genetic heart disease. It has become an invaluable resource for patient education, research studies and raising awareness of genetic heart diseases. The AGHD Registry is supported by 7 specialised clinics across Australia. Patients and at-risk relatives are recruited from clinics or self-referral. Written informed consent is required. Clinical and genetic information are collected and entered in to a central registry database. Families with inherited cardiomyopathies (e.g. hypertrophic cardiomyopathy [HCM], familial dilated cardiomyopathy [DCM], arrhythmogenic right ventricular cardiomyopathy [ARVC], isolated left ventricular noncompaction [LVNC]), or primary arrhythmogenic disorders (e.g. long QT syndrome [LQTS], catecholaminergic polymorphic VT [CPVT], Brugada syndrome [BrS]) and familial valve diseases are eligible. A website and Facebook page have been created. To date, 2407 individuals from 1432 families have enrolled. Of these, 1241 (52%) are male and 1724 (72%) have a clinical diagnosis of disease while 683 (28%) are at-risk relatives. Those with HCM contribute the biggest subgroup, 969 (40%), with other diseases comprising smaller sub-groups [DCM, 144 (6%); ARVC, 65 (3%); LVNC, 72 (3%), LQTS, 276 (12%), CPVT, 53 (2%), and BrS, 88 (4%)]. More than ten collaborative studies have been published using the Registry cohorts to date. The AGHD Registry is a unique resource understanding genetic heart diseases in Australia. It provides accurate information for families, health professionals and researchers, and has contributed to building an evidence-base to improve management of families with genetic heart diseases.

Perspectives of Australian family carers of people with dementia on the 'cottage' model of respite: Compared to traditional models of residential respite provided in aged care facilities.

The majority of people living with dementia reside in the community and are often reliant on the support of informal carers to do so. Family carers face many challenges in supporting the person with dementia to remain at home, and short‐term respite care is a valued service that offers a temporary break from the role. Respite cottages provide short‐term care in a residential home‐like setting with a limited number of clients and is a more flexible approach to accessing the service. Disproportionate use of cottage respite in Australia suggests this model is preferred over traditional respite within residential aged care facility (RACF) settings, yet limited research exists to compare these models. This study sought to understand the perceptions of carers who had used cottage respite in comparison to other models, and explore the contribution of cottage respite for supporting carers to continue in their role and maintain their care recipient (CR) living at home. Semi‐structured interviews were conducted with 126 family carers who had used one of two New South Wales‐based respite cottages within a 2‐year period; 67 of whom had also used RACF respite. Thematic analysis revealed four main themes around the benefits of cottage respite: (a) an effective essential service, (b) flexibility, (c) familiarity and (d) appropriateness, especially for early stage or younger onset dementia. Carers indicated that the more homely, familiar and intimate cottage model of respite care was preferential to that of the larger, institutional‐style RACF respite setting. Carers credited the cottage model of respite service with delaying their need for permanent residential placement by over 12 months. The cottage respite model provides an important avenue to supporting the individual needs of dementia dyads, with potential to delay permanent placement, and should be offered more broadly to provide people with more choice about their care.

Mapping Experiences of Serodiscordance: Using Visual Methodologies to Construct Relationality in Families Living With or Affected by Stigmatized Infectious Disease.

The "my health, our family" research project was established to document stories of what serodiscordance (mixed infection status) means for Australian families affected by HIV, hepatitis B, and/or hepatitis C. A family mapping exercise was developed for the start of interviews as a way to conceptualize serodiscordance as a movement of "closeness" and "distance" within the relational networks that participants defined as "family," the outcome of which was originally intended as a guide to explore the contributions of each family member in the in-depth qualitative interviews that followed. Such static representations of family were soon revealed to be inadequate for capturing the contingent, flexible, and multifaceted nature of familial relationality in the management of these infections. In this article, we explore these shifts for the conceptual openness mapping methods facilitate, and the constraints they reveal, for spatializing family relations in ways that heed diverse experiences of serodiscordance.

Shrine: War Memorials and the Digital Age

Shrine: War Memorials and the Digital Age

Family Law Court orders for supervised contact in custodial disputes – unanswered questions

AbstractThe focus of this study was on the application of orders for supervised access made by the Australian Family Law Court in cases that involved conflicting claims by custodial and noncustodial parents. Based on accessible Court transcripts for the 28-month period ending in early 2019, 103 cases involving 172 children were identified in which orders required supervision for visitation and/or changeovers. The patterns found through thematic analysis suggest that there is a shift to increasing use of final orders involving supervision through child contact centers as either an indeterminate or permanent arrangement. This shift has significant implications for current models of supervised access/changeover, and a greater understanding in terms of the outcomes being achieved is required.

Intergenerational exchange of healthful eating encouragement: Consideration of family ancestry and disease history.

Improving diet is a prime target for the prevention and management of chronic disease. The communal coping model suggests that families can mitigate shared risk of chronic disease through encouragement of healthful eating, eliciting preventive behaviors. Using network data from 69 Australian families across three ancestry groups (Anglo, Italian, and Asian) with varied family health histories, the present study applied social network analysis to identify patterns of intergenerational encouragement of healthful eating behavior within families, and assess whether patterns varied by family ancestry or disease density. Findings indicated variation in patterns of health encouragement by ancestry such that Asian-Australian families were most distinct from the other ancestry groups. While there was no main effect of familial disease history, it moderated the effect of Italian ancestry on intergenerational encouragement patterns. These results provide important context for future family based interventions that leverage normative patterns of intergenerational exchange of encouragement or aim to modify such patterns in an effort to improve family health. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The flow of family transitions of Australian families

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Theme 13 Clinical management and support

Background: Pathogenic variants in ALS genes are known to be present in up to 70% of familial and 10% of apparently sporadic ALS cases, and can be associated with risks for ALS only, or risks for other neurodegenerative diseases (eg. frontotemporal dementia). While there are no changes to medical management for patients confirmed as pathogenic variant carriers, genetic testing may be important for future drug trials. Confirmation of a pathogenic variant also provides relatives with the opportunity to consider predictive and/or reproductive genetic testing. Genetic counselling is an important aspect of testing decision-making as it enables individuals to make informed decisions about genetic testing while minimising adverse psychological, ethical and legal outcomes. Few studies have explored how individuals decide whether to pursue testing, nor the needs and experiences of familial ALS families.Objective: To identify factors that influence patient and family member decision-making about genetic testing for ALS genes, assess the impact of familial disease on the patient and their family, and identify information and support needs.Methods: In-depth, semi-structured interviews with individuals from Australian ALS families with known pathogenic gene variants explored experiences of familial ALS, and factors that influenced genetic testing decision-making. Interviews were analysed using an inductive approach.Results: Thirty-four individuals from 24 families were interviewed and included patients (n = 4), spouses (n = 4), and asymptomatic at-risk relatives (n = 26). Life stage, experience of disease, costs, research opportunities, and attitudes to familial ALS and/or reproductive options influenced decision-making. Some patients and relatives experienced difficulty gaining accurate information from their health professionals about the costs and implications of genetic counselling or testing, resulting in a reluctance to proceed.Discussion and conclusion: This study provides new insight into the Australian experience of genetic testing and counselling for familial ALS. It highlights the need to work together with other health professionals to ensure the complexities of genetic testing decision-making, and referral pathways are better understood.

Taxonomic shortfalls in digitised collections of Australia’s flora

Rapid growth in the digitisation of the world’s natural history collections substantially simplifies scientific access to taxonomic and biogeographic information. Despite recent efforts to collate more than two centuries of biodiversity inventories into comprehensive databases, these collections suffer limitations across spatial, temporal and taxonomic dimensions. We assessed taxonomic shortfalls in preserved specimens from 296 plant families native to Australia, for which records have been collated into the Australasian Virtual Herbarium (AVH), specifically addressing the following questions: (1) Based on the number of specimen records per species, which Australian native plant families are under- or over-represented in the collection of preserved specimens digitised in the AVH? (2) To what extent does the distribution of collectors among plant families, or the area occupied by plant families, explain patterns of taxonomic representativeness? We found that the number of preserved specimens per family is not proportional to the family’s known species richness. For 29% of Australia’s plant families (i.e. 86), the number of digitised records constitutes < 50% of the number expected given species richness within those families. Further, only 34% of families (100) have at least 20 specimens digitised for each species recorded in the AVH. Families occupying small areas (< 200 grid cells) are more likely to be under-represented taxonomically, while there is a strong positive correlation between the number of unique collectors and the extent of taxonomic over-representation. A sound understanding of biodiversity is critical for megadiverse countries such as Australia, and identifying biases in digital inventories may help with establishing future sampling and digitisation strategies to enhance taxonomic representation.

A Study of the Food Environment at Australian Family Day Care.

Overweight and obesity in childhood is a significant public health issue. Family day care (FDC) offers a setting where good eating habits can be nurtured in young children, yet often the food environment is unhealthy. This study aims to determine FDC educators’ knowledge and confidence about nutrition and the barriers and enablers to supporting healthy food environments. Australian FDC educators were recruited to a mixed methods study using self-administered e-surveys and qualitative in-depth interviews. The survey data (n = 188) revealed good knowledge about sugary foods, but poor knowledge of protein-rich foods. Nutrition knowledge was not associated with confidence to make nutrition recommendations. Interviews (n = 9) revealed parents’ dietary choices and educators’ personal beliefs as barriers to healthy food environments, although importantly, the FDC educator role was identified as being pivotal in supporting the health and wellbeing of children and their families. This study highlights that FDC-specific nutrition education and support is vital to ensure children at FDC and their families are exposed to healthy food environments. Research to investigate specific avenues for nutrition education promotion programs specifically designed to support the unique role played by FDC educators is needed, in order to support the long-term health and welfare of the next generation of Australians.

Domesticating International Military Engagements: Everyday Internationalism Through the Prism of the Malayan Emergency

ABSTRACTThis article explores media representations of a group of Australians in the period of the Cold War, when a key mode of engagement with Asia was in the form of military regional occupations and interactions. The story that the article analyses centres on overseas military postings in the 1950s and 1960s, during the Malayan Emergency and the Borneo Intervention, emphasising how these internationalised events were experienced in interpersonal ways. As such, this article examines the media representations of Australian military families, particularly women, to provide a different reading of the international than is typically seen in the dominant military (and masculine) accounts of Australian involvement in Asia.

Development and external validation study of a melanoma risk prediction model incorporating clinically assessed naevi and solar lentigines.

Melanoma risk prediction models could be useful for matching preventive interventions to patients' risk. To develop and validate a model for incident first-primary cutaneous melanoma using clinically assessed risk factors. We used unconditional logistic regression with backward selection from the Australian Melanoma Family Study (461 cases and 329 controls) in which age, sex and city of recruitment were kept in each step, and we externally validated it using the Leeds Melanoma Case-Control Study (960 cases and 513 controls). Candidate predictors included clinically assessed whole-body naevi and solar lentigines, and self-assessed pigmentation phenotype, sun exposure, family history and history of keratinocyte cancer. We evaluated the predictive strength and discrimination of the model risk factors using odds per age- and sex-adjusted SD (OPERA) and the area under curve (AUC), and calibration using the Hosmer-Lemeshow test. The final model included the number of naevi ≥2mm in diameter on the whole body, solar lentigines on the upper back (a six-level scale), hair colour at age 18 years and personal history of keratinocyte cancer. Naevi was the strongest risk factor; the OPERA was 3·51 [95% confidence interval (CI) 2·71-4·54] in the Australian study and 2·56 (95% CI 2·23-2·95) in the Leeds study. The AUC was 0·79 (95% CI 0·76-0·83) in the Australian study and 0·73 (95% CI 0·70-0·75) in the Leeds study. The Hosmer-Lemeshow test P-value was 0·30 in the Australian study and <0·001 in the Leeds study. This model had good discrimination and could be used by clinicians to stratify patients by melanoma risk for the targeting of preventive interventions. What's already known about this topic? Melanoma risk prediction models may be useful in prevention by tailoring interventions to personalized risk levels. For reasons of feasibility, time and cost many melanoma prediction models use self-assessed risk factors. However, individuals tend to underestimate their naevus numbers. What does this study add? We present a melanoma risk prediction model, which includes clinically-assessed whole-body naevi and solar lentigines, and self-assessed risk factors including pigmentation phenotype and history of keratinocyte cancer. This model performs well on discrimination, the model's ability to distinguish between individuals with and without melanoma, and may assist clinicians to stratify patients by melanoma risk for targeted preventive interventions.

The common characteristics and behaviors of child occupants in motor vehicle travel

Objective: Child occupant behavior and head position when travelling in child restraint systems (CRS) may have an effect on injury risk in the event of a motor vehicle crash. The current study aimed to describe the common characteristics and behaviors of child occupants during everyday, real-world motor vehicle travel in a sample of Australian families to identify potential safety implications of observed behaviors and head position within the CRS.Methods: Two instrumented study vehicles were used by 42 families for approximately two weeks. Continuous video and audio data were collected across 1,651 trips (over 600 hours). An online survey provided additional parent, familial and child occupant data. The characteristics and behaviors of 72 child occupants (aged 14 months to 9 years) who travelled in a forward-facing CRS (FFCRS) or a belt-positioning booster seat (BS) were observed and recorded by manual review of a sample of the video/audio recordings. One quarter of all trips (n = 414) was randomly selected for coding/analysis and, within each trip, one child occupant was selected who was travelling in a FFCRS or BS. Child occupant behaviors, head position within the FFCRS or BS, and other relevant information was coded for each trip during nine discrete five second intervals or ‘epochs’ (5%, 17%, 25%, 30%, 50%, 53%, 75%, 89% and 95% of trip duration).Results: In the majority of epochs (74%), child occupants’ heads were observed to be ‘optimally’ positioned within the FFCRS or BS. For more than half of the epochs, child occupants were observed to be: correctly restrained (58%) and involved in an interaction with another vehicle occupant (59%). Bivariate analyses revealed that children travelling in a FFCRS were significantly more likely to be observed to have optimal head positions than those travelling in a BS (78% vs. 62%), χ2 (1) = 86.00, p < 0.001. Child occupants who were observed to be ‘correctly’ restrained were significantly more likely to be observed to have optimal head positions than those who were observed to be ‘incorrectly’ restrained (80% vs. 20%), χ2 (1) = 10.33, p < 0.01.Conclusions: This is the first naturalistic driving study (NDS) to specifically explore the factors associated with child occupants’ head position when travelling in a CRS. Findings from the current study can be used to inform the positioning of anthropometric test dummies (ATD) in CRS testing, guide improvements to CRS/vehicle design, and develop targeted educational strategies to improve child occupant safety.

Parenting and child behaviour as predictors of toothbrushing difficulties in young children.

Oral disease is one of the most prevalent chronic health conditions affecting children. Twice-daily toothbrushing is recommended to promote good oral health; however, a large proportion of Australian families are not meeting this recommendation. This study aimed to identify important barriers to regular toothbrushing for young children. In this study, 239 parents of 0- to 4-year-old children completed an online survey that investigated child, family, and parent factors associated with child toothbrushing. Hierarchical linear regression was used to identify predictors of toothbrushing frequency in children and perceived difficulty of the task by parents. We found that parent factors, specifically oral health knowledge, were the most significant predictors of toothbrushing frequency. Conversely, parent factors did not contribute significantly to the prediction of perceived difficulty of toothbrushing once family and child factors were taken into account. Oral health knowledge and use of routines were identified as the most important predictors of toothbrushing frequency, whereas resistant child behaviour and household organisation were found to be the most important predictors of perceived difficulty of regular toothbrushing. The findings of the study have implications for behavioural interventions to support parents, as well as directions for future research.

Pathogenic Abnormal Splicing Due to Intronic Deletions that Induce Biophysical Space Constraint for Spliceosome Assembly

A precise genetic diagnosis is the single most important step for families with genetic disorders to enable personalized and preventative medicine. In addition to genetic variants in coding regions (exons) that can change a protein sequence, abnormal pre-mRNA splicing can be devastating for the encoded protein, inducing a frameshift or in-frame deletion/insertion of multiple residues. Non-coding variants that disrupt splicing are extremely challenging to identify. Stemming from an initial clinical discovery in two index Australian families, we define 25 families with genetic disorders caused by a class of pathogenic non-coding splice variant due to intronic deletions. These pathogenic intronic deletions spare all consensus splice motifs, though they critically shorten the minimal distance between the 5' splice-site (5'SS) and branchpoint. The mechanistic basis for abnormal splicing is due to biophysical constraint precluding U1/U2 spliceosome assembly, which stalls in A-complexes (that bridge the 5'SS and branchpoint). Substitution of deleted nucleotides with non-specific sequences restores spliceosome assembly and normal splicing, arguing against loss of an intronic element as the primary causal basis. Incremental lengthening of 5'SS-branchpoint length in our index EMD case subject defines 45-47 nt as the critical elongation enabling (inefficient) spliceosome assembly for EMD intron 5. The 5'SS-branchpoint space constraint mechanism, not currently factored by genomic informatics pipelines, is relevant to diagnosis and precision medicine across the breadth of Mendelian disorders and cancer genomics.

Preventive Evidence into Practice: what factors matter in a facilitation intervention to prevent vascular disease in family practice?

BackgroundA perennial challenge of primary care quality improvement is to establish why interventions work in some circumstances, but not others. This study aimed to identify factors explaining variations in the impact on clinical practice of a facilitation led vascular health intervention in Australian family practice.MethodsOur mixed methods study was embedded within a cluster randomised controlled trial of a facilitation intervention designed to increase the uptake of evidence-based prevention of vascular disease in family practices. The study was set in four Australian states using eight of the study’s 16 intervention practices. Facilitators worked with intervention practices to develop and implement improvements in preventive care informed by a vascular risk factor audit. We constructed case studies of each practice’s “intervention narrative” from semi-structured interviews with clinicians, facilitators and other staff, practice observation, and document analysis of facilitator diaries. The intervention narratives were combined with pre- and post-intervention audit data to generate typologies of practice responses to the intervention.ResultsWe found substantial variability between practices in the changes made to vascular risk recording. Context (i.e. practice size), adaptive reserve (i.e. interpersonal relationships, manager and nurse involvement), and occasional data idiosyncrasies interacted to influence this variability.ConclusionThe findings emphasise the importance of tailoring facilitation interventions to practice size, clinician engagement and, critically, the organisation of, and relationships between, the members of the practice team.Trial registrationThe trial was registered with the Australian and New Zealand Clinical Trials Registry (ANZCTR): ACTRN12612000578808 (29/5/2012). This trial registration is retrospective as our first patient returned their consent on the 21/5/2012. Patient recruitment was ongoing until 31/10/2012.