The MJA-Lancet Countdown on health and climate change in Australia was established in 2017 and produced its first national assessment in 2018 and annual updates in 2019, 2020 and 2021. It examines five broad domains: climate change impacts, exposures and vulnerability; adaptation, planning and resilience for health; mitigation actions and health co-benefits; economics and finance; and public and political engagement. In this, the fifth year of the MJA-Lancet Countdown, we track progress on an extensive suite of indicators across these five domains, accessing and presenting the latest data and further refining and developing our analyses. Within just two years, Australia has experienced two unprecedented national catastrophes - the 2019-2020 summer heatwaves and bushfires and the 2021-2022 torrential rains and flooding. Such events are costing lives and displacing tens of thousands of people. Further, our analysis shows that there are clear signs that Australia's health emergency management capacity substantially decreased in 2021. We find some signs of progress with respect to health and climate change. The states continue to lead the way in health and climate change adaptation planning, with the Victorian plan being published in early 2022. At the national level, we note progress in health and climate change research funding by the National Health and Medical Research Council. We now also see an acceleration in the uptake of electric vehicles and continued uptake of and employment in renewable energy. However, we also find Australia's transition to renewables and zero carbon remains unacceptably slow, and the Australian Government's continuing failure to produce a national climate change and health adaptation plan places the health and lives of Australians at unnecessary risk today, which does not bode well for the future.

Reviewed by: Henry Hamlet's Heart by Rhiannon Wilde Aaren Tucker Wilde, Rhiannon Henry Hamlet's Heart. Charlesbridge, 2022 [336p] Trade ed. ISBN 9781623543693 $18.99 E-book ed. ISBN 9781632893475 $10.99 Reviewed from digital galleys R Gr. 9-12 Henry Hamlet is many things: a good student, school captain, leader of the debate club. He is also the unfortunate possessor of the nickname "Spew Grant" after projectile vomiting on a girl's shoes. Although Henry has definitely learned that he and underage drinking are not a good mix, he nevertheless finds himself imbibing at another party he doesn't really want to attend. When someone dares Henry's best friend, Lennon Cane, to kiss Henry, their drunken lip-lock turns heated, and Henry suddenly has a new set of problems to cope with. Is it possible to turn your best friend into your boyfriend without losing the friendship you already have? And will commitment-phobic Len stick around or break Henry's heart? This Australian import and Wilde's debut is a sweet, if a little directionless, slice-of-life about two teens fumbling their way toward each other, with plenty of mistakes on both sides. Set in Brisbane in 2008, the not-so-distant past does not feel all that different from today; more unique is the location, and U.S. readers will find it interesting to compare Australian and American high school life. Minimalist dialogue can sometimes leave readers behind, but Henry's first-person narration fills in the gaps. Complete with grand romantic gestures and a slightly overwrought ending, this otherwise understated novel will delight romance fans, particularly those of Benjamin Alire Sáenz's Aristotle & Dante books. Copyright © 2022 The Board of Trustees of the University of Illinois

ObjectiveImproving the quality of life (QoL) of older people is a key priority for governments, clinicians, researchers and service providers worldwide. However, the lack of culturally appropriate QoL tools for First Nations people is a major barrier to such efforts. The purpose of this study was to evaluate the psychometric properties of the Good Spirit, Good Life (GSGL) QoL tool for older Aboriginal Australians.MethodsOne hundred and twenty older Aboriginal people living in Perth and Melbourne, Australia, were administered the GSGL tool, along with several other instruments assessing cognition (KICA‐Cog), depression (KICA‐Dep), anxiety (GAI‐SF), health and well‐being (EQ‐5D‐5L and ICECAP‐O) and resilience (ARRQ‐25). Associations between these instruments and the GSGL tool were explored to determine concurrent and known‐groups validity. Internal consistency was assessed with split‐half reliability and Cronbach's alpha. Exploratory factor analysis was performed to investigate construct validity.ResultsGSGL scores were positively correlated with ICECAP‐O and ARRQ‐25 scores, and negatively correlated with EQ‐5D‐5L score. GSGL scores differed significantly between participants with a probable anxiety disorder or depression, but not those with cognitive impairment. The Spearman–Brown prophecy estimate was 0.83 and Cronbach's alpha was 0.75. Principal component analysis identified two factors, which were labelled foundation and external.ConclusionsThe GSGL tool is a valid tool to assess quality of life in older Aboriginal Australians. The tool demonstrates acceptable convergent, concurrent and known‐groups validity. It was co‐designed at all stages with older Aboriginal people contributing to its strong face and content validity.

ABSTRACT COVID-19 has caused unprecedented impact on the lives of Australians, with significant influence on the mental health and well-being of adults. Initial estimates predict that there will be a decline in birth rates from 1.7 to 1.59 children per woman in Australia over the course of 2021. This study aimed to explore change in fertility intentions as a result of COVID-19 in Australian young adults. Sixty-seven adults (82% women) between the ages of 18–35 years participated in the online survey. The study collected socio-demographic data including relationship status, employment, education, income, and gender as well as three measures of wellbeing including hopelessness, anxiety, and coping. Results of the study indicated that employment status is a significant indicator of change in fertility intention. There was a strong effect for hopelessness, indicating that increased hope for the future is associated with a change in fertility intention. Anxiety and coping did not appear to significantly influence change. The results of this study indicate that the immediate impact of COVID-19 on wellbeing does not cause people to change fertility intention, however, hope for the future has a significant influence. Through the lens of the Theory of Planned Behavior, this may be because people evaluate the consequences of their actions based on predictions of the future, and therefore hope for the future most significantly impacts their attitudes toward having children. Future research should investigate how supporting the wellbeing of young adults can influence choice in fertility intention.

ObjectivesTo: (1) outline the research produced using linked data from the Registry of Senior Australians (ROSA) which informed the recommendations from Australia’s Royal Commission into Aged Care Quality and Safety (delivered February 2021); (2) describe the Australian Government Aged Care Roadmap Reforms (announced May 2021) resulting from the recommendations. ApproachROSA was established in 2017 and is led by a partnership of scientists, clinicians, aged care providers and consumer advocates from nine organisations seeking to improve the lives of Australians in aged care. ROSA is a Clinical Quality Registry comprised of linked national and cross-jurisdictional aged and health care data and includes a national historical de-identified cohort (3.5 million individuals, 2002-2020) and a prospectively enrolled cohort in the state of South Australia (26,600 individuals, 2018-current). This is a summary of ROSA’s high-quality evidence used by the Royal Commission and translation of this evidence into policy by leveraging existing data infrastructure. ResultsBetween 2019-2020 the ROSA team led the delivery of four in-depth reports for the Royal Commission, contributed data and expertise to an additional four published Commission reports. Examples of ROSA outputs informing the Commissions’ recommendations included: evidence of national increased psychotropic medication use following entry to residential aged care, evidence of higher risk of mortality and entry to permanent care while waiting for home care packages, development of quality indicators to monitor quality and safety of care nationally, and to facilitate international comparisons and benchmarking. Examples of recommendations included in the Australian Government Aged Care Roadmap: release of substantial funding to increase the availability of home care packages, public reporting system for quality and safety monitoring and several changes to medication management. ConclusionRegistries are key resources for high quality real-world evidence generation needed to inform national investigations, ultimately leading to significant sector reform. The ROSA experience highlights that cross-sectoral data linkages, together with technical expertise, informed by clinicians and consumers, are invaluable resources for system reform and policy generation.

PurposeCompare the health-related quality of life (HRQL) of the Australian general population during the COVID-19 pandemic (2020) with pre-pandemic data (2015–2016) and identify pandemic-related and demographic factors associated with poorer HRQL.MethodsParticipants were quota sampled from an online panel by four regions (defined by active COVID-19 case numbers); then by age and sex. Participants completed an online survey about their HRQL [EORTC QLQ-C30 questionnaire and General Health Question (GHQ)], demographic characteristics, and the impact of the pandemic on daily life. HRQL scores were compared to a 2015–2016 reference sample using independent t-tests, adjusted for multiple testing. Associations between 22 pre-specified factors (pandemic-related and demographic) and 15 QLQ-C30 domains and GHQ, were assessed with multiple regressions.ResultsMost domains were statistically significantly worse for the 2020 sample (n = 1898) compared to the reference sample (n = 1979), except fatigue and pain. Differences were largest for the youngest group (18–29 years) for cognitive functioning, nausea, diarrhoea, and financial difficulties. Emotional functioning was worse for 2020 participants aged 18–59, but not for those 60 +.All models were statistically significant at p < .001; the most variance was explained for emotional functioning, QLQ-C30 global health/QOL, nausea/vomiting, GHQ, and financial difficulties. Generally, increased workload, negative COVID-19 impacts, COVID-19-related worries, and negative attitudes towards public health order compliance were associated with poorer HRQL outcomes.ConclusionDuring the COVID-19 pandemic, Australians reported poorer HRQL relative to a pre-pandemic sample. Risk factors for poor HRQL outcomes included greater negative pandemic-related impacts, poorer compliance attitudes, and younger age.Trial registrationANZCTR number is: ACTRN12621001240831. Web address of your trial: https://www.anzctr.org.au/ACTRN12621001240831.aspx. Date submitted: 26/08/2021 2:56:53 PM. Date registered: 14/09/2021 9:40:31 AM. Registered by: Margaret-Ann Tait. Principal Investigator: Madeleine King.

BackgroundPhysical activity has numerous health benefits, but participation is lower in disadvantaged communities. ‘parkrun’ overcomes one of the main barriers for disadvantaged communities, the cost of activities, by providing a free, regular community-based physical activity event for walkers, runners and volunteers. This study assesses equity of access (in terms of distance to the nearest parkrun) stratified by socioeconomic deprivation, and identifies the optimal location for 100 new events to increase equity of access.MethodsWe combined information about population location and socioeconomic deprivation, with information about the location of 403 existing parkrun events, to assess the current level of access by deprivation quintile. We then used a two-step location-allocation analysis (minimising the sum of deprivation-weighted distances) to identify optimal regions, then optimal towns within those regions, as the ideal locations for 100 new parkrun events.ResultsCurrently, 63.1% of the Australian population lives within 5 km of an event, and the average distance to an event is 14.5 km. A socioeconomic gradient exists, with the most deprived communities having the largest average distance to an event (27.0 km), and the least deprived communities having the best access (living an average 6.6 km from an event). Access improves considerably after the introduction of new event locations with around 68% of the population residing within 5 km of an event, and the average distance to the nearest event approximately 8 km. Most importantly, the improvement in access will be greatest for the most deprived communities (now an average 11 km from an event).ConclusionsThere is a socioeconomic gradient in access to parkrun events. Strategic selection of new parkrun locations will improve equity of access to community physical activity events, and could contribute to enabling greater participation in physical activity by disadvantaged communities.

Australian life insurance companies can legally use genetic test results in underwriting, which can lead to genetic discrimination. In 2019, the Financial Services Council (Australian life insurance industry governing body) introduced a partial moratorium restricting the use of genetic testing in underwriting policies ≤ $500,000 (active 2019–2024). Health professionals (HPs), especially clinical geneticists and genetic counsellors, often discuss the implications of genetic testing with patients, and provide critical insights into the effectiveness of the moratorium. Using a sequential explanatory mixed methods design, we interviewed 23 Australian HPs, who regularly discuss genetic testing with patients and had previously completed an online survey about genetic testing and life insurance. Interviews explored views and experiences about the moratorium, and regulation, in greater depth. Interview transcripts were analysed using thematic analysis. Two key themes emerged from views expressed by HPs during interviews (about matters reported to or observed by them): 1) benefits of the moratorium, and 2) concerns about the moratorium. While HPs reported that the moratorium reassures some consumers, concerns include industry self-regulation, uncertainty created by the temporary time period, and the inadequacy of the moratorium’s financial limits for patients’ financial needs. Although a minority of HPs felt the current industry self-regulated moratorium is an adequate solution to genetic discrimination, the vast majority (19/23) expressed concern with industry self-regulation and most felt government regulation is required to adequately protect consumers. HPs in Australia are concerned about the adequacy of the FSC moratorium with regards to consumer protections, and suggest government regulation is required.

The 5th Indonesian Society of Limnology (MLI) Congress and International Conference 2021 is a biannual conference organized by the Indonesian Society of Limnology, with the theme is “Building synergies towards sustainable use of inland waters.” This year due to the COVID-19 pandemic, we hold the event virtually from 2nd to 3rd December. The objectives of this event are to (1) Connect, discuss, share and create a mutual network among communities from different backgrounds who are interested in inland waters ecosystem; (2) Disseminate science & technology and lessen the gap between scientific and common communities through fruitful discussion settings; (3) Underpin sustainable use and management of inland aquatic ecosystems.There were four keynotes speakers, four invited speakers, and 66 general presenters in the conference sessions. In total, 116 participants were registered and joined the conference. The first keynote speaker was Prof. Dr. Gadis Sri Haryani from the Research Center for Limnology and Water Resources, National Research and Innovation Agency of the Republic of Indonesia (BRIN), Indonesia, who presented research about Migratory freshwater fish in Indonesia: Threats and conservation efforts. The second presenter was Dr. Robert Walsh from the Australian Water Life, Australia, who presented research about Discover the world of Micro-invertebrates. The third keynote speaker was Dr. Khamla Inkhavilay from the National University of Laos, Lao PDR, who presented Persistent Organic Pollutants in Wetland of Mekong Basin. The fourth speaker was Dr. Kwanraree Joy Sirikanchana from the Chulabhorn Research Institute, Thailand, who presented Microbial Source Tracking and Quantitative Microbial Risk Assessment for Sustainable Water Pollution Management.In addition, the four invited speakers and 66 general presenters split into four rooms for parallel discussions which covered the latest research on inland water ecosystems, including; (1) Biotic resources, biodiversity, and conservation; (2) System Dynamic of inland waters; (3) Applied technology for the management and pollution control; (4) Modelling, system information, decision support tool, disaster risk reduction; (5) Management, policies, regulation, education, social, economy, and culture.We highly appreciate the generous support from Research Centre for Limnology-BRIN (Indonesia), Australian Water Life (Australia), Chulabhorn Research Institute (Thailand), National University of Laos (Lao PDR), Southeast Asian Limnological Network (SEALnet), Advisory Board, Steering and Organizing committee and all presenters and participants.List of Committees, Advisory Board, Steering Committee, Scientific Committee, Organizing Committee, Documentation, all photos are available in this pdf.

Simple SummaryWhen nine-week-old Azaria Chamberlain disappeared from a central Australian campsite in 1980, few accepted her mother’s claim that ‘A dingo’s got my baby’. Dingoes, it was popularly believed at this time, simply did not attack humans. A recent spate of dingo attacks has repudiated this widespread narrative—but when and why did it arise? Analysis of historical Australian print media shows that, in fact, dozens of accounts of dingo attacks were published between 1804 and 1928. It is difficult to separate the empirical events from the cultural milieu in which they were reported, but some of these historical accounts are credible, resembling those of modern attacks. It is also evident that up until the early 20th century it was a commonly held perception that dingoes did occasionally prey on humans. By the 1920s, however, a popular belief had taken hold that dingoes were far too timid to attack even children and had never represented a threat to human safety. This cultural shift in the image of the dingo may be traced to the reduced frequency of human–dingo interactions in the more settled regions of eastern Australia, where a veritable war of destruction waged by pastoralists nearly eradicated the population. Intensive shooting, trapping and poisoning may also have selected for dingoes that were more wary of humans, such that the changing public attitude towards the dingo reflected the reality of rural life.This paper investigates the origin of the once popular belief in Australian society that wild dingoes do not attack humans. To address this problem, a digital repository of archived newspaper articles and other published texts written between 1788 and 1979 were searched for references to dingoes attacking non-Indigenous people. A total of 52 accounts spanning the period between 1804 and 1928 was identified. A comparison of these historical accounts with the details of modern dingo attacks suggests that at least some of the former are credible. The paper also examined commonly held attitudes towards dingoes in past Australian society based on historical print media articles and other records. Early chroniclers of Australian rural life and culture maintained that dingoes occasionally killed and ate humans out of a predatory motivation. By the early decades of the 20th century, however, an opposing view of this species had emerged: namely, that dingoes were timid animals that continued to pose a danger to livestock, but never to people. This change in the cultural image of dingoes can possibly be linked to more than a century of lethal dingo control efforts greatly reducing the frequency of human–dingo interactions in the most populous parts of the country. This intensive culling may also have expunged the wild genetic pool of dingoes that exhibited bold behaviour around people and/or created a dingo population that was largely wary of humans.

Through examining Jessica White’s hybrid memoir Hearing Maud and my own work Hysteria: A Memoir of Illness, Strength and Women’s Stories Throughout History, I explore how archival research shapes a disabled writer’s work and written representation of the self. I particularly focus on how memoirists convey the embodied experience of disability through writing lived experience, as well as writing about disabled women they have found through archival research. I consider how writers’ conceptions of the self and body coalesce and depart from the women they are researching. I am intrigued about how, for writers, archival research shapes contemporary disability hybrid memoir writing. In addition, I suggest that imagination accompanies encounters with archival material. Writers imagine the past life of their historical subject(s), and in doing so, imagine beyond ableism. Further, a theme of institutions and how they impact individual lives throughout historical periods emerges.

Sleep disorders among Aboriginal Australians with Machado-Joseph Disease: Quantitative results from a multiple methods study to assess the experience of people living with the disease and their caregivers

Rheumatic heart disease (RHD) significantly impacts the lives of First Nations Australians. Failure to eliminate RHD is in part attributed to healthcare strategies that fail to understand the lived experience of RHD. To rectify this, a PhD study was undertaken in the Northern Territory (NT) of Australia, combining Aboriginal ways of knowing, being and doing with interviews (24 participants from clinical and community settings) and participant observation to privilege Aboriginal voices, including the interpretations and experiences of Aboriginal co-researchers (described in the adjunct article). During analysis, Aboriginal co-researchers identified three interwoven themes: maintaining good feelings; creating clear understanding (from good information); and choosing a good djalkiri (path). These affirm a worldview that prioritises relationships, positive emotions and the wellbeing of family/community. The findings demonstrate the inter-connectedness of knowledge, choice and behaviour that become increasingly complex in stressful and traumatic health, socioeconomic, political, historical and cultural contexts. Not previously heard in the RHD domain, the findings reveal fundamental differences between Aboriginal and biomedical worldviews contributing to the failure of current approaches to communicating health messages. Mitigating this, Aboriginal co-researchers provided targeted recommendations for culturally responsive health encounters, including: communicating to create positive emotions; building trust; and providing family and community data and health messages (rather than individualistic).

Background and AimsAlcohol consumption changes markedly over the life course, with important implications for health and social development. Assessment of these patterns often relies on cross‐sectional data, which cannot fully capture how individuals' drinking changes as they age. This study used data from 18 waves of a general population panel survey to measure drinking trajectories over the life course in Australia.Design and SettingLongitudinal survey data from the Household, Income and Labour Dynamics in Australia (HILDA) survey between 2001 and 2018.ParticipantsA total of 20 593 individuals ages 15 or above in two samples assessing quantity‐frequency (n = 20 569, 52.0% female) and risky single occasion drinking (RSOD), respectively, (n = 17 340, 52.5% female), interviewed as part of HILDA.MeasurementsUsual quantity of alcohol consumed per drinking occasion; frequency of drinking occasions per week; average daily consumption, calculated by combining reported usual quantity and frequency; and average reported frequency of RSOD per week.FindingsMultilevel, mixed effects models run with fractional polynomial terms found similar male and female alcohol consumption trajectories for quantity‐frequency and RSOD measures. Usual quantity of alcohol consumed per drinking occasion (5.4 drinks for men, 3.8 for women) and RSOD frequency (0.56 occasions/week for men, 0.38 for women) peaked in young adulthood, whereas frequency of drinking occasions (2.5 occasions/week for men, 1.7 for women) peaked in middle age. Middle‐age drinkers had the highest average daily consumption of alcohol (1.4 drinks/day for 54‐year‐old men, 0.6 drinks for 57‐year‐old women) and engaged in RSOD slightly less than young adults.ConclusionsAlcohol consumption in Australia appears to vary substantially over the life course, with usual quantity per drinking occasion and frequency of risky single occasion drinking peaking during early adulthood and average daily consumption and frequency of consumption peaking in middle age.

This essay discusses fire as a significant factor shaping Australian social and cultural life. It focuses first on the climate-change induced emotions such as eco-anxiety and anger that can be tied with the Australian landscape, and then moves on to a discussion of the presence and function of fire in selected contemporary Australian poetry. The reflection on the poetics of trauma in the second part of the essay is accompanied by a discussion of solastalgia connected with land dispossession as an experience of the First Nations expressed in the Aboriginal literature in English.

Global excess mortality caused by the COVID-19 pandemic1 can be clearly assessed from the perspective of years of life expectancy lost. The study by Aburto et al., on quantifying the impacts of the COVID-19 pandemic through life expectancy losses,2 presents changes in life expectancy between 2019 and 2020 for 29 populations with high-quality data, ranging from losses of - 1.7 and -2.2 years for American females and males, respectively, to small increases of 0.1 and 0.2 years for females and males in Denmark and Norway, respectively. However Australia, with its relatively strict COVID-19 containment measures of international border closures and lockdowns, resulting in just 898 COVID-19-related deaths in 2020, was not included in the study. Now official data are available (based on year of registration of death),3,4 and we present the results for Australia, with a comparison with Denmark and the USA which were clearly strong and poor performers, respectively, in terms of changes in life expectancy between 2019 and 2020.

People Versus Machines: The Impact of Being in an Automatable Job on Australian Worker's Mental Health and Life Satisfaction

Reviewed by: Fatal Contact: How Epidemics Nearly Wiped Out Australia's First Peoples by Peter Dowling Charmalne Robson (bio) Peter Dowling. Fatal Contact: How Epidemics Nearly Wiped Out Australia's First Peoples (Clayton: Monash University Publishing, 2021). ISBN: 9781922464460 (PB). xxx + 306 pp. The impact of imported infectious diseases on Indigenous Australians remains a vastly under-researched area of historical study, therefore a new book by Dr Peter Dowling with the bold title, Fatal Contact: How Epidemics Nearly Wiped Out Australia's First Peoples, promises to be a valuable addition to the field. Perhaps the neglect of this topic can be explained by the longstanding under-estimation by historians of the prevalence and ramifications of epidemics affecting Indigenous people in Australia's post-contact history. In contrast, frontier violence has received far greater scholarly attention. Henry Reynolds has recently stated that whereas the 1789 smallpox epidemic 'only affected one generation', fighting that began on the early Sydney frontier 'became a permanent feature of Australian life for 150 years' (Truth-telling: History, Sovereignty and the Uluru Statement, 2021). Dowling's book gives us cause to re-evaluate such a contrast. It documents a succession of different disease epidemics through the years from 1788 to 1919 and across the continent, and it highlights their consequences: population decline through death and infertility, the intense suffering of the afflicted and those around them, and the impairment of Indigenous cultures. Dowling also argues that disease, whether or not intentional, expedited the occupation of Indigenous land by Europeans. The book is organised into four parts, preceded by an introduction which gives a brief historical overview, explanations of Indigenous perspectives on illnesses, and other contextual information. Part 1, after a broad discussion of infectious diseases, explores the Australian epidemics of smallpox and measles that struck Indigenous communities from the late eighteenth to late nineteenth centuries. Part 2 focuses on the sexually transmitted diseases of syphilis and gonorrhoea, and Part 3 on the respiratory diseases of tuberculosis and influenza. The final chapter analyses three different case studies: diseases in Aboriginal settlements of southeastern Australia; a biomedical profile of Tasmanian Indigenous woman, Truganini; and, leaping into the twenty-first century, a discussion of COVID-19 and Indigenous Australians. Dowling has doctorates in archaeology and biological anthropology, and researches and presents his study with scientific rigour, but his book is accessible to everyone. The pathology and epidemiology of the different infectious diseases are patiently explained, as are his analyses of statistical data. The historical context he provides is vital for [End Page 149] understanding the scale of tragedy caused by the introduction of major diseases and, in some cases, their flourishing, among Indigenous people. As a population previously unexposed to these pathogens (a 'virginsoil population'), Indigenous Australians were especially vulnerable to their effects, as were the indigenes of the Americas in the sixteenth and seventeenth centuries after European invasions. These diseases could not be cured, nor did most doctors in the nineteenth centuiy understand their causation. Furthermore, attempted remedies sometimes made the patient worse, as was probably the case for Truganini who was prescribed a mercury-based medicament for a respiratory illness, and then exhibited a range of symptoms consistent with mercury toxicity. State and mission policies of forcibly concentrating people on settlements, often with crowding, and inadequate nutrition and shelter, created ideal conditions for the spread of respiratory diseases to these already vulnerable populations. At Oyster Cove and Wybalenna, influenza and pneumonia rapidly decimated the groups of Tasmanians removed there from their homes to make way for European settlers. For the sources, Dowling makes judicious use of accounts by medically qualified witnesses of the times to ascertain the presence of disease. He is aware of their limitations but argues for their reliability where collective reports agree on characteristics of particular epidemics. He has also obtained quantitative data for mortality and morbidity rates. This task was enabled by studying several Victorian and South Australian missions and settlements during the last quarter of the nineteenth century, as fairly detailed medical records were kept. Descriptions of the patients' symptoms and the course of their illness by settlement managers and doctors are poignant indicators of the toll of these diseases on the individual...

The nature of the increasingly ageing populations of developed countries places residential issues of these populations at the heart of urban policy. Retirement villages as housing options for older adults in Australia has been growing steadily in recent years; however, there have been a dearth of geographical studies looking into the distribution of existing retirement villages at the regional level. This study aims to reveal the geographical distributions and cluster patterns of retirement villages in the Greater Brisbane Region of Australia to better understand and serve the living requirements of current and potential retirement village residents. The geovisualization method was adopted to visually explore the distribution patterns of retirement villages. The Global Moran’s I and Local Moran’s I measures were employed to analyze the spatial correlation and the clusters of retirement villages in the study region. The study revealed that distribution of retirement villages was not random (z-score = 7.11; p &lt; 0.001), but clustered in nature and included hotspot patterns, especially along the coastline and Brisbane River areas. Moreover, for-profit and not-for-profit retirement villages have different distribution patterns and adopted significantly different tenure agreements. In the study region, the spatial distribution of retirement villages aligns with the aggregation trend of older residents. The findings of this study disclosed the spatial distribution patterns of retirement villages and will provide developers and policymakers with geographically referenced data for the choice of new development sites to meet the market demand of potential customers, forming aged-friendly development strategies, and eventually leading to improved quality of life for older Australians.

PurposeUnderstanding and responding to the supportive care needs of people with cirrhosis is essential to quality care. Indigenous Australians, Aboriginal and Torres Strait Islander people, are overrepresented amongst patients with cirrhosis. This study documented the nature and extent of supportive care needs of Indigenous Australians with cirrhosis, in comparison with non-Indigenous Australians.Patients and MethodsThe supportive care needs of adult patients diagnosed with cirrhosis attending public hospitals in Queensland were assessed through the Supportive Needs Assessment tool for Cirrhosis (SNAC). Patients indicated how much additional help they needed on four subscales: 1. psychosocial issues; 2. practical and physical needs; 3. information needs; and 4. lifestyle changes. We examined the rate of moderate-to-high unmet needs based on Indigenous status (Poisson regression; incidence rate ratio (IRR)).ResultsIndigenous (n=20) and non-Indigenous (n=438) patients included in the study had similar sociodemographic and clinical characteristics except for a lower educational level among Indigenous patients (p<0.01). Most Indigenous patients (85.0%) reported having moderate-to-high unmet needs with at least one item in the SNAC tool. Following adjustment for key sociodemographic and clinical factors, Indigenous patients had a greater rate of moderate-to-high unmet needs overall (IRR=1.5, 95% CI 1.31–1.72; p<0.001), and specifically for psychosocial issues (IRR=1.7, 95% CI 1.39–2.15; p<0.001), and practical and physical needs subscales (IRR=1.5, 95% CI 1.22–1.83; p<0.001), compared to non-Indigenous patients.ConclusionIndigenous Australians with cirrhosis more frequently had moderate-to-high unmet supportive care needs than non-Indigenous patients. Specific targeting of culturally appropriate supportive care for psychosocial, practical and physical needs may optimize cirrhosis care and improve the quality of life for Indigenous Australians with cirrhosis.