Australian Society Research Articles

Controversies in the management of proximal deep vein thrombosis.

Controversies in the management of proximal deep vein thrombosis.

“Actual Political Affiliations Are of Secondary Importance”: Communism and Women's Entangled Loyalties in the Australian Anti‐Nuclear Movement, 1945–65

The 1950s in Australia began with the newly elected Menzies Government's campaign to ban the Communist Party of Australia, feeding into and sustaining growing anti‐communist rhetoric in the post‐war nation. Fears of communist infiltration coloured the actions of the Australian peace movement, with public commentators and political figures condemning the movement as a communist fifth column intent on destroying Australian society. Peace activists had to manage such perceptions of their work while navigating their own beliefs on politics and ideology. Using the women of the anti‐nuclear movement of the 1950s and 1960s as a case study, this paper demonstrates that while the movement would often be publicly characterised — both in contemporary sources and more recent literature — as divided along ideological lines, individual alliances were far more complex and entangled. Though Cold War divisions appeared to be upheld in public nuclear disarmament sentiment, private sentiments were far more nuanced. These women had to decide what was more important to them: the cause or the image. Ultimately, for many, communism was a pressing issue, but nuclear disarmament was more pressing still.

Popery, Politics, and Prejudice: Anti-Catholic Sentiment during Australia’s Great War Conscription Debates

Historians have tended to treat the anti-Catholicism of the conscription controversies of 1916–17 as a homogeneous phenomenon. Consequently, the sectarian undercurrents of wartime Australian society have been presented as a unified whole, obscured behind an ill-defined characterisation of Protestant bigotry. This article addresses this problem by distinguishing themes within the broader anti-Catholic dynamic. It tracks the expression and consolidation of anti-papal enmities, racial prejudices, and political suspicions as underlying themes of anti-Catholic ideology in the wartime community. Although these prejudicial strands overlapped, by examining each in isolation we get a clearer picture of both the broader sectarian phenomenon and the conscription debates’ sustaining of the issue.

Novel "Thetis" antigen-presenting cells promote early life gut immune tolerance.

Immunology & Cell BiologyAccepted Articles Research HighlightsFree Access Novel “Thetis” antigen presenting cells promote early life gut immune tolerance Alkeiver S Cannon, Alkeiver S Cannon Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115 USA Contribution: Conceptualization, Writing - original draftSearch for more papers by this authorAddelynn Sagadevan, Addelynn Sagadevan Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115 USA Contribution: Conceptualization, Writing - original draftSearch for more papers by this authorMurugaiyan Gopal, Corresponding Author Murugaiyan Gopal mgopal@rics.bwh.harvard.edu Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115 USA Correspondence Murugaiyan Gopal, Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, 60 Fenwood Road Boston, MA 02115, USA, E-mail: mgopal@rics.bwh.harvard.edu Contribution: Conceptualization, Writing - original draft, Writing - review & editingSearch for more papers by this author Alkeiver S Cannon, Alkeiver S Cannon Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115 USA Contribution: Conceptualization, Writing - original draftSearch for more papers by this authorAddelynn Sagadevan, Addelynn Sagadevan Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115 USA Contribution: Conceptualization, Writing - original draftSearch for more papers by this authorMurugaiyan Gopal, Corresponding Author Murugaiyan Gopal mgopal@rics.bwh.harvard.edu Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115 USA Correspondence Murugaiyan Gopal, Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, 60 Fenwood Road Boston, MA 02115, USA, E-mail: mgopal@rics.bwh.harvard.edu Contribution: Conceptualization, Writing - original draft, Writing - review & editingSearch for more papers by this author First published: 05 November 2022 https://doi.org/10.1111/imcb.12605 This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi:10.1111/imcb.12605 AboutPDF ToolsExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Accepted ArticlesAccepted, unedited articles published online and citable. The final edited and typeset version of record will appear in the future. Journal of the Australian and New Zealand Society for Immunology RelatedInformation

Beyond Digital Literacy in Australian Prisons: Theorizing “Network Literacy,” Intersectionality, and Female Incarcerated Students

Incarcerated students, especially women and Indigenous Australians in custody, are among the most marginalized, oppressed, and invisible identities in Australian society today. These prison-based university students experience not only multi-layered disadvantages that derive from intersecting experiences of oppression, including race, gender, and class, but they are also further disadvantaged by the experience of incarceration itself, despite their attempts to improve their life chances and social positioning through distance education. This is partly due to the challenges of learning within prison environments, including disruptions, disparities, and disconnections in terms of access to digital technologies, digital literacies, and digital channels. The majority of Australian prisoners have no direct access to the internet, smartphones, or internet-enabled devices which means they are disconnected from social media and other networked communication platforms. Although significant gains have been made in developing and delivering prison-based non-networked digital devices, digital learning platforms and digital education to Australian incarcerated students over the past decade, more work must be done to adequately prepare incarcerated students, with multi-faceted needs, to live and learn as empowered agents within the informational capitalism of the contemporary “network society.” The purpose of this article is to argue for a new form of “network literacy” education over and above “digital literacy” skills for female Australian incarcerated students, through an intersectional theoretical lens which addresses the multidimensional disadvantages experienced by women in custody within Australian prisons.

Geoffrey Kaye Oration 2021: Challenges and cherished moments in Australian anaesthesia, as seen by the women Presidents of the Australian Society of Anaesthetists

Geoffrey Kaye Oration 2021: Challenges and cherished moments in Australian anaesthesia, as seen by the women Presidents of the Australian Society of Anaesthetists

Celebrating the women Presidents of the Australian Society of Anaesthetists

Celebrating the women Presidents of the Australian Society of Anaesthetists

Consensus guidelines for sarcopenia prevention, diagnosis and management in Australia and New Zealand.

Sarcopenia is an age-associated skeletal muscle condition characterized by low muscle mass, strength, and physical performance. There is no international consensus on a sarcopenia definition and no contemporaneous clinical and research guidelines specific to Australia and New Zealand. The Australian and New Zealand Society for Sarcopenia and Frailty Research (ANZSSFR) Sarcopenia Diagnosis and Management Task Force aimed to develop consensus guidelines for sarcopenia prevention, assessment, management and research, informed by evidence, consumer opinion, and expert consensus, for use by health professionals and researchers in Australia and New Zealand. A four-phase modified Delphi process involving topic experts and informed by consumers, was undertaken between July 2020 and August 2021. Phase 1 involved a structured meeting of 29 Task Force members and a systematic literature search from which the Phase 2 online survey was developed (Qualtrics). Topic experts responded to 18 statements, using 11-point Likert scales with agreement threshold set a priori at >80%, and five multiple-choice questions. Statements with moderate agreement (70%-80%) were revised and re-introduced in Phase 3, and statements with low agreement (<70%) were rejected. In Phase 3, topic experts responded to six revised statements and three additional questions, incorporating results from a parallel Consumer Expert Delphi study. Phase 4 involved finalization of consensus statements. Topic experts from Australia (n=62, 92.5%) and New Zealand (n=5, 7.5%) with a mean±SD age of 45.7±11.8years participated in Phase 2; 38 (56.7%) were women, 38 (56.7%) were health professionals and 27 (40.3%) were researchers/academics. In Phase 2, 15 of 18 (83.3%) statements on sarcopenia prevention, screening, assessment, management and future research were accepted with strong agreement. The strongest agreement related to encouraging a healthy lifestyle (100%) and offering tailored resistance training to people with sarcopenia (92.5%). Forty-seven experts participated in Phase 3; 5/6 (83.3%) revised statements on prevention, assessment and management were accepted with strong agreement. A majority of experts (87.9%) preferred the revised European Working Group for Sarcopenia in Older Persons (EWGSOP2) definition. Seventeen statements with strong agreement (>80%) were confirmed by the Task Force in Phase 4. The ANZSSFR Task Force present 17 sarcopenia management and research recommendations for use by health professionals and researchers which includes the recommendation to adopt the EWGSOP2 sarcopenia definition in Australia and New Zealand. This rigorous Delphi process that combined evidence, consumer expert opinion and topic expert consensus can inform similar initiatives in countries/regions lacking consensus on sarcopenia.

Practice Pointer: "My feelings are not on mute - ZOOM and Balint Practice Pointers".

Practice Pointer: "My feelings are not on mute - ZOOM and Balint Practice Pointers".

What do geriatricians think about Comprehensive Geriatric Assessment? A survey of Australian and New Zealand geriatricians.

Despite Comprehensive Geriatric Assessment (CGA) being central to the work of geriatricians, little is known about geriatricians' views on CGA. This study was designed to understand how geriatricians conceptualise and practise CGA, and whether differences exist between groups (more experienced geriatricians vs. less experienced geriatricians and registrars; those practising in rural vs. metropolitan environments; in private vs. public sectors). An anonymous 90-item electronic questionnaire was emailed to members of the Australian and New Zealand Society for Geriatric Medicine. There were 243 respondents (response rate 19%). Respondents stated that core features of CGA were multidimensional assessment (89%), implementation of a management plan (84%), and involvement of a geriatrician (70%). Important features in predicting CGA success were ability to implement health management recommendations (55%), and ease of communication with general practitioners (46%), and with the multidisciplinary team (45%). Functional decline (88%) and frailty (88%) were thought to predict patients likely to benefit from CGA, compared to age (48%) or multimorbidity (19%). Junior consultants and registrars were less likely to prioritise the importance of clinical leadership (10% vs. 30%), and more likely to report the importance of a structured format (17% vs. 7%) to CGA effectiveness. There was some agreement about the core features of CGA and who is likely to benefit, but little agreement on features that predict CGA success. Further research that explores these points of difference would be helpful.

Abstracts for the Australian and New Zealand Society of Blood Transfusion (ANZSBT) stream of the BLOOD 2022 Meeting 11th - 14th September 2022, Sydney, Australia.

Abstracts for the Australian and New Zealand Society of Blood Transfusion (ANZSBT) stream of the BLOOD 2022 Meeting 11th - 14th September 2022, Sydney, Australia.

Fighting for Life: Class, Community and Care in Labour History: The 17th Biennial Conference of the Australian Society for the Study of Labour History, Bendigo, 22–24 April 2022

Fighting for Life: Class, Community and Care in Labour History: The 17th Biennial Conference of the Australian Society for the Study of Labour History, Bendigo, 22–24 April 2022

Australian Society for the Study of Labour History

Australian Society for the Study of Labour History

Twelve-month mortality outcomes for Indigenous and non-Indigenous people admitted to intensive care units in Australia: a registry-based data linkage study.

To compare longer term (12-month) mortality outcomes for Indigenous and non-Indigenous people admitted to intensive care units (ICUs) in Australia. Retrospective registry-based data linkage cohort study; analysis of all admissions of adults (16 years or older) to Australian ICUs, 1 January 2017 - 31 December 2019, as recorded in the Australian and New Zealand Intensive Care Society (ANZICS) Adult Patient Database (APD), linked using the SLK-581 key to National Death Index data. Unadjusted and adjusted mortality risk, censored at twelve months from the start of index ICU admission. Secondary outcomes were unadjusted and adjusted mortality twelve months from admission to the ICU. The APD recorded 330 712 eligible ICU admissions during 2017-2019 (65% of all ICU admissions registered), of which 11 322 were of Indigenous people (3.4%). Median age at admission was lower for Indigenous patients (51.2 [IQR, 36.7-63.6] years) than for non-Indigenous patients (66.5 [IQR, 52.7-76.1] years). Unadjusted mortality risk was similar for Indigenous and non-Indigenous patients (hazard ratio, 1.01; 95% CI, 0.97-1.06), but was higher for Indigenous patients after adjusting for age, admission diagnosis, illness severity, hospital type, jurisdiction, remoteness and socio-economic status (adjusted hazard ratio, 1.20; 95% CI, 1.14-1.27). Twelve-month mortality was higher for Indigenous than non-Indigenous patients (adjusted odds ratio, 1.24; 95% CI, 1.16-1.33). Twelve-month mortality outcomes are poorer for people admitted to ICUs in Australia than for the general population. Further, after adjusting for age and other factors, survival outcomes are poorer for Indigenous than non-Indigenous people admitted to ICUs. Critical illness may therefore contribute to shorter life expectancy among Indigenous Australians.

A vision of a One Health system for Australia: on the need to rethink our health system.

A vision of a One Health system for Australia: on the need to rethink our health system.

The evolving disparities in location and socioeconomics of an ageing Australian society.

It is well known that there are associations between overall health, age, socioeconomic status and rural residency. The objective of this study was to determine the distribution of Australia's aged population by socioeconomic status, as well as remoteness. The study employed the Australian Statistical Geography Standard (Statistical Area Level 1 and Remoteness Areas). The database of the geographic boundaries was integrated into the ageing population and socioeconomic data using the Geographic Information System. The socioeconomic data was analysed through the Index of Relative Socioeconomic Disadvantage. Over a decade, the older population in Australia has increased noticeably. In 2016, there was a high percentage of older people (≥65years) in Tasmania (Tas), 19%, while the lowest percentage was recorded in the Northern Territory (NT), 7%. Across the country, Tasmania had the highest percentage of older citizens living in the most disadvantaged areas since 2006, with 48% recorded in 2016. There was an association between the remoteness areas and the education and income levels of the ageing cohort. However, this association differed between the states and territories. This socioeconomic gap becomes more evident in the very remote areas of the country. The ageing population in Australia is increasing rapidly; this was associated with an evolving socioeconomic disparity among this ageing society. Our results demonstrated that socioeconomic inequalities were to be found among the older people based on their distribution over the remoteness areas in Australia. This information should be used to target healthcare and ageing policies that meet the specific needs of older people.

Impact of frailty on clinical outcomes in patients with and without COVID-19 pneumonitis admitted to intensive care units in Australia and New Zealand: a retrospective registry data analysis

BackgroundIt is unclear if the impact of frailty on mortality differs between patients with viral pneumonitis due to COVID-19 or other causes. We aimed to determine if a difference exists between patients with and without COVID-19 pneumonitis.MethodsThis multicentre, retrospective, cohort study using the Australian and New Zealand Intensive Care Society Adult Patient Database included patients aged ≥ 16 years admitted to 153 ICUs between 01/012020 and 12/31/2021 with admission diagnostic codes for viral pneumonia or acute respiratory distress syndrome, and Clinical Frailty Scale (CFS). The primary outcome was hospital mortality.ResultsA total of 4620 patients were studied, and 3077 (66.6%) had COVID-19. The patients with COVID-19 were younger (median [IQR] 57.0 [44.7–68.3] vs. 66.1 [52.0–76.2]; p < 0.001) and less frail (median [IQR] CFS 3 [2–4] vs. 4 [3–5]; p < 0.001) than non-COVID-19 patients. The overall hospital mortality was similar between the patients with and without COVID-19 (14.7% vs. 14.9%; p = 0.82). Frailty alone as a predictor of mortality showed only moderate discrimination in differentiating survivors from those who died but was similar between patients with and without COVID-19 (AUROC 0.68 vs. 0.66; p = 0.42). Increasing frailty scores were associated with hospital mortality, after adjusting for Australian and New Zealand Risk of Death score and sex. However, the effect of frailty was similar in patients with and without COVID-19 (OR = 1.29; 95% CI: 1.19–1.41 vs. OR = 1.24; 95% CI: 1.11–1.37).ConclusionThe presence of frailty was an independent risk factor for mortality. However, the impact of frailty on outcomes was similar in COVID-19 patients compared to other causes of viral pneumonitis.Graphical

Vascular surgery patients in intensive care: a bi-national cohort study over 15 years.

To describe the characteristics and outcomes of patients admitted to Intensive Care following vascular surgery, and their subsequent usage of Intensive Care resources, over a 15-year period in Australia and New Zealand. This was a retrospective, bi-national study of 69 676 adult patients admitted to 179 Intensive Care Unit (ICUs) following vascular surgery between January 2005 and December 2019, using the Australian and New Zealand Intensive Care Society Adult Patient Database. The proportion of ICU bed days used by vascular surgery patients decreased during the study period from 3.6% in 2005 to 2.9% in 2019 (P< 0.001). The cohort had a median age of 73 years, and were most frequently admitted after a carotid endarterectomy (22%) or elective open aneurysm repair (20%). A total of 5.2% of patients did not survive to discharge. Mean annual adjusted mortality decreased during the study period from 6.1% in 2005 to 3.7% in 2019 (P< 0.001). Multiple factors were associated with higher mortality, including gender, hospital case volume and hospital type. Between 2005 and 2019 survival for vascular surgery patients requiring ICU admission in Australia and New Zealand improved. During the same time the proportion of ICU bed days used by these patients decreased.

A survey of orthodontic clear aligner practices among orthodontists

The purpose of this cross-sectional study was to survey orthodontic clear aligner therapy (CAT) practices among orthodontists in Australia. A pilot-tested electronic questionnaire was distributed to 434 full members of the Australian Society of Orthodontists. Questions were related to demographics, use and choice of aligners, digital treatment planning, patient selection, treatment protocols, refinements/finishing, retention, and patient-reported aligner issues. Factors regarding the decision not to provide CAT were also surveyed. The response rate was 54.6%. Most orthodontists (93.13%) provided CAT, which made up 24.17% of their annual orthodontic caseload. The median percentage of initial digital treatment plans (DTP) approved without changes was 0, with 4-6 changes reported by 24.14%. Orthodontists reported a mean of 2.02 ± 1.76 refinements per patient. Orthodontists were least comfortable treating patients with bilateral crossbite (71.28%) and deep overbite (62.56%). DTP challenges regarding tooth attachments and tooth positions and issues regarding patient compliance with CAT wear protocols were commonly reported. More than 1 CAT system was used by most (63.92%), with in-house systems used by 21.63%. Orthodontists rarely or never (63.68%) performed premolar extraction treatment with CAT. Adjunctive interproximal reduction was reportedly mostly carried out to relieve crowding and reduce open gingival embrasures. The view that fixed appliances provide better outcomes was a major influence (71.43%) on the decision for those who did not provide any CAT. CAT practices among orthodontists varied. Further research is required to investigate the challenges in effective CAT provision highlighted in this survey.

Mothering, Migration and Intercultural Mediation in Anna Maria Dell’oso’s Songs of the Suitcase

ABSTRACT This article explores representations of mothering practices in Songs of the Suitcase (1998) by second-generation Italian Australian writer Anna Maria Dell’oso. This collection of short stories devotes special attention to the interlinks between mothering and mediation among culturally diverse groups in modern Australian society. Theoretical frameworks provided by scholars in translation, interpreting and child language brokering are used to shed light on how Dell’oso succeeds in voicing Italian Australian women migrants’ abilities to negotiate and mediate between various cultural groups, ethnicities and generations, especially when it comes to mothering and maternal care. How does Dell’oso configure mothering as the most invaluable caregiving practice, vis-à-vis global mobility and circulation of values? How does she represent and problematize the role of mothers and daughters in modern Australia? How does she challenge families’ views on how to mother? How does she interpret the role of the mediator of cultural memories and family beliefs? By displaying the author’s fictional alter egos as the most privileged sites of exploration, Dell’oso reflects on the impact of migration upon mothering practices and the mother-daughter dyad. Finally, she offers thought-provoking views on how Italian Australian mothering practices, as social values, are confronted with and fashioned by ever-changing communities of migrants.