Contemporary Australian Context Research Articles

Renewing the Australian asthma agenda: lessons from the Finnish 10-year Asthma Program

The Finnish Asthma Program, which ran between 1994 and 2004, has long been heralded as a benchmark of success in how to improve management and reduce asthma-related health service utilization. In Australia, there were 38,792 asthma hospitalizations in 2017–18, and 80% of these were considered avoidable (J Asthma Allergy. 2021;14:797–808. doi: 10.2147/JAA.S311721). To address this issue, Asthma Australia has set a strategic objective of halving avoidable asthma presentations to hospital by 2030. This article provides an overview of the Finnish Asthma Program, including an evaluation of critical success factors, outputs, and outcomes, followed by a synthesis of these findings for relevance and applicability to the contemporary Australian context that will inform policy and practice recommendations. Early diagnosis, effective anti-inflammatory medication, guided self-management, and monitoring disease control are still the keys to mitigating asthma burden. In the spirit of the Finnish Program, the digital transformation of healthcare and social media is enabling a new kind of systematic approach, both for patients and professionals.

Pathways to progress? – collective conscientisation and progressive school reform in Aboriginal education

ABSTRACT Setting in train various forms of curriculum and pedagogic change in schools whilst seeking to improve both teaching strategies and Aboriginal educational outcomes in Australia is a complex business. This involves a sustained effort to equip the next generation of educators with the skills and knowledges to identify, diagnose, and devise remedies for the ‘problems’ that are sometimes ascribed to Aboriginal learners. The work of Paolo Freire is a point of reference here. However, the halo around Freire and his work may occlude thinking about how to evoke his concepts, (specifically conscientisation) in the contemporary Australian context. We discuss the strengths and weaknesses of Freire’s work in this light. We also discuss the Culturally Nourishing Schooling (CNS) project, a whole school reform model where teachers are encouraged to shift their reflective gaze onto themselves and on the settings in which they work. We argue that for ‘success’ in education to no longer be defined by deficit thinking, firstly, conscientisation must be a collective process. To change teachers and their practice and schooling requires a different conception of both change and of conscientisation.

Alcohol and Tobacco Use Among Lesbian, Bisexual, and Queer Identifying Women: A Longitudinal Qualitative Study Protocol

Background: Lesbian, bisexual, and queer (LBQ) women exhibit high rates of alcohol and tobacco use, yet there is limited qualitative research examining why. Previous research has focused on minority stress explanations, linking alcohol and tobacco use to experiences of discrimination. However, other work considers the social contexts and cultural practices associated with alcohol and tobacco consumption. This confirms the need for more in-depth understandings of LBQ women’s lived experiences in a contemporary Australian context. Aims: To address gaps in existing research, this project aims to develop a more nuanced contemporaneous theorising of what alcohol and tobacco mean to LBQ women in Australia. Drawing on feminist and critical drugs studies, this research will examine the complexities of alcohol and tobacco in LBQ women’s lives, including how patterns of use change over time. We will also critically consider how LBQ women understand risk in relation to these substances, including factors leading to harm reduction and help-seeking. Method: We will employ a longitudinal qualitative approach to explore LBQ women’s experiences over time, including three waves of semi-structured interviews and participant photography. We aim to recruit approximately 60 women in Victoria and New South Wales. Interview and visual data will be analysed using a range of narrative and thematic techniques. Conclusion: This study seeks to explore the complexities of individual experiences with alcohol and tobacco use, including pleasure and support-seeking, and to provide a nuanced understanding of the cultural dimensions of use that may change over time. In doing so, we propose a shift from deficit approaches to LBQ women’s substance use towards more meaningful strengths-based engagement with the function of substances for LBQ women. Findings will be significant in their contribution to the current understandings of substance use patterns among LBQ women and the implications for harm reduction and health interventions.

Perspectives on teacher standards in the mentoring process: insights from mentors and early career teachers in an Australian context

ABSTRACT Mentoring programmes are considered a core component of professional learning approaches for early career teachers (ECTs) as they commence in and progress through the first few years in the profession. Mentoring in the contemporary Australian context, however, is situated within a culture of high teacher standardisation, as is the case in numerous countries across the word. The Australian Professional Standards for Teachers (“the Standards”), for example, are the measuring device against which full teacher registration of ECTs is awarded as well as being put forward as the framework that informs teacher goal setting and development. In such circumstances, lines between mentoring purposed for teacher growth and for accountability may be blurred, and mentoring may be delimited to teachers’ work privileged in the Standards. In this paper, we report on data collected and thematically analysed from semi-structured interviews with 15 mentors and 15 ECTs from eight independent schools across Queensland and New South Wales in Australia about the role of the Standards in their mentoring work. Findings demonstrated that these mentors and ECTs address the Standards during mentoring ranging from regulatory to developmental to cursory. These findings have implications for the development of mentoring programmes, in Australia and elsewhere, where mentoring occurs in neoliberal cultures of audit.

‘These people are conning us’: Australia’s Medevac laws and the biopolitical production of the ‘malingering’ refugee

This article examines the effect Australia’s ‘Medevac’ legislation had on the way refugees were depicted by the Liberal-National Coalition and Australian Labor Party in their debate about immigration detention and border security. I argue that by enabling medical evacuations for people detained offshore, Medevac shifted debate about refugees and border security into the realm of the biomedical. I maintain this resulted in the biopolitical production of the figure of the malingering refugee, who falsifies illness to cross the border. While both parties produced this pejorative category, what distinguished them was the degree to which they believed malingering applicants could be rendered ‘ known’ via the medical border. For the ALP, Medevac could recruit the purported ‘objectivity’ of biomedicine, such that malingering applicants could be identified, and border security thereby supposedly maintained. Conversely, for the LNP, no such guarantee could be established, meaning for them, Medevac rendered the border and therefore the nation vulnerable to malingering applicants. Despite their differences, I argue both parties articulated the figure of the malingering refugee for similar nationalistic purposes. Namely, to justify the violence of the Australian border protection regime, while nevertheless simultaneously depicting themselves and the nation as fundamentally ‘good’: not in spite of, but because of their harsh border policing practices. In concluding, this article considers the applicability of its analysis both to the contemporary Australian context and abroad, such as the United States and UK, where similar border protection policies and discourses have emerged.

Setting Fire to the Poetic Correspondence of Multispecies Relationships

This poetic work is a multispecies love letter seeking to make the reader aware of the strange aporia of human ‘love’ for animals.[1] Contradictory human expressions of love, care, indifference, and harm towards animals can be seen in words that change perceptions of animals (as individuals, groups or in general). Consider the changing status of a ‘pet’ cat being discarded and becoming ‘feral’. Is ‘it’ a ‘pest’ to be ‘culled’, not even ‘killed’ or ‘put to sleep’ or can ‘they’ be ‘rescued’? This work explores multiple and conflicting affective outcomes words have on building compassion, understanding and support for animals, or adding to misconceptions which can result in disregard or violent treatment. The words we use to represent animals and express our relationships to them can reduce animals to iconic national symbols and supportive anthropocentric tools, or to draw out the diversity, multiplicity and intrinsic value of animal being and create space for animals in the text.
 The poem focuses on the contemporary Australian context for the aporia of human love for animals. It grounds the work in place and time by using Australian phrases, idioms, slang, associations, terms and names for animals, plants, and places while concentrating on recent events of bushfires, droughts, floods, and pandemic isolation. It references ongoing Australian settler-colonial practices where human animal entanglements and conflicts are highlighted, including horse racing, hunting, bushwalking, fishing, and farming.
 Repetition and wordplay are used to amplify, destabilize, complicate, confuse and decentre human perspectives. The method is informed by the fictocritical work of Ania Walwicz in horse utilizing ‘The process of associative thought and reflection. Improvisation and analysis. The flight of thought, a trajectory and reflection, retrieval, recoil. The use of multilevel text comprising poetics, theory and appropriated text’ (5). The poet aims to draw attention to the ways our relationships with animals are constructed and circulated through our use of language which forms an inherently anthropocentric frame of reference. Unresolved contradictions between intimacy and distance in human animal relationships are used to create a space of questioning to provoke thought.
 Work Cited
 Walwicz, Ania. horse: A Psychodramatic Enactment of a Fairytale. Crawley, Western Australia: UWAP, 2018. Print.
 [1]Although encompassing both, ‘animals’ is used here to differentiate ‘animals of different species’ from ‘human animals.’ Terms like ‘nonhuman animals’ and ‘other animals’ are definitions centring humans, in terms of what is not human rather than what are these beings. Words like ‘beast’ also have othering meanings.

Drug and alcohol intoxication in major trauma: Associations, trends and outcomes over a decade.

Drug and alcohol intoxication is common among injured patients altering trauma presentation and characteristics. However, uncertainty exists regarding the effect of intoxication on injury severity, as well as outcomes. The present study aims to provide an update on substance-use patterns and their association with traumatic presentation and outcome within a contemporary Australian context. All major trauma patients captured in our centre's Trauma Registry between July 2010 and June 2020 were included. Demographic, injury characteristic, outcome and substance-use data were collected. Differences in injury severity and characteristics were explored using χ2 tests, while outcomes were modelled using adjusted binomial logistic regression. Among 9700 patients, 9% were drug-intoxicated prior to injury, while 9.4% were alcohol-intoxicated. Drug use almost tripled between 2010 (4.8%) and 2020 (13.3%), while alcohol intoxication fell, from 11.7% to 7.3%, over the same period. Although there were significant differences in trauma mechanism among intoxicated patients, group comparison found no difference in Injury Severity Score for any group. Regarding outcomes, all intoxication resulted in significantly greater odds (odds ratio 1.62-2.41) of ICU admission. No difference in mortality was found among individual substance-use groups; however, polysubstance-intoxicated patients had 3.52 times greater odds of dying (95% confidence interval 1.21-10.23) compared to non-intoxicated patients. Within this contemporary Australian population, we demonstrate escalating rates of drug intoxication and declining rates of alcohol intoxication prior to trauma. Intoxication was associated with more frequent violent and non-accidental injury, and despite no difference in severity, it was associated with worse outcomes.

Cost Analysis of Intramedullary Screw versus Plate Osteosynthesis for Phalangeal and Metacarpal Fractures: An Observational Study.

Background: To compare the observed healthcare and societal costs of intramedullary screw (IMS) and plate fixation of extra-articular metacarpal and phalangeal fractures in a contemporary Australian context. Methods: A retrospective analysis, based on previously published data, was performed utilising information from Australian public and private hospitals, the Medicare Benefits Schedule (MBS) and the Australian Bureau of Statistics. Results: Plate fixation demonstrated longer surgical lengths (32 minutes, compared to 25 minutes), greater hardware costs (AUD 1,088 vs. AUD 355), more extended follow-up requirements (6.3 months, compared to 5 months) and higher rates of subsequent hardware removal (24% compared to 4.6%), resulting in an increased healthcare expenditure of AUD 1,519.41 in the public system, and AUD 1,698.59 in the private sector. Wage losses were estimated at AUD 15,515.78 when the fracture cohort is fixed by a plate, and AUD 13,542.43 when using an IMS - a differential of AUD 1,973.35. Conclusions: There is a substantial saving to both the health system and the patient when using IMS fixation over dorsal plating for the fixation of extra-articular metacarpal and phalangeal fractures. Level of Evidence: Level III (Cost Utility).

Trends in management of adult tarsometatarsal joint injuries in a contemporary Australian context: a nationwide study of claims data over 20 years.

Traumatic tarsometatarsal joint (TMTJ) injuries are uncommon, but can cause significant morbidity due to delayed or missed diagnosis. Recent evidence highlights the importance of achieving anatomical reduction via operative management. This study aims to analyse trends in rates of open reduction internal fixation (ORIF) for Lisfranc injuries in Australia according to Nationwide claims data. Claims according to the Medicare Benefits Schedule (MBS) on ORIF of traumatic TMTJ injuries were collated for the period from January 2000 to December 2020. Paediatric patients were excluded. Two negative binomial models were utilized to analyse the trends in TMTJ injuries over time after controlling for sex, age group and population changes. Results were absolute and per 100 000 population. 7840 patients underwent TMTJ ORIF over the period studied. There was a mean yearly increase of 12% (P < 0.001). Age group (P < 0.001) and year (P < 0.001) were significant predictors for TMTJ fixation, whilst sex was not (P = 0.48). Patients older than 65 years were noted to have a 53% lower rate of TMTJ ORIF per person, when compared to the reference group of 25-34 year-olds (P < 0.001). Five-year block analysis revealed increases in rate of fixation for all age groups. Rates of operative fixation for TMTJ injuries are increasing in Australia. This is likely due to improved diagnostics, understanding of optimal treatment goals, and increased orthopaedic subspecialisation. Further studies with clinical and patient reported outcomes, as well as comparing rates of operative intervention to incidence, will be useful.

Investigating the National Adult Reading Test (NART-2) and Wechsler Test of Adult Reading Test (WTAR) in predicting Wechsler Abbreviated Scale of Intelligence – Second edition (WASI-II) scores in an Australian sample

ABSTRACT Objective: The NART-2 and WTAR are used to estimate premorbid intellectual functioning. There are concerns about their accuracy. Our aim was to develop models predicting WASI-II scores from the NART-2 and WTAR variables and evaluate their accuracy within an Australian sample. Method: The sample included 145 adults aged 18.91 to 70.64 years (M = 34.70, SD = 13.30), of which 78 were female. Analyses examined the reliability of the word reading tasks and estimated WASI-II sores with multiple linear regression. Comparison of estimated scores were made with actual WASI-II scores. Results: WASI-II scores were moderately related to word reading tasks (r = .33 to.51, p < .01) and weakly related to age, years of education, and occupation. Models were identified for the four WASI-II index scores (with R2 = .20 to .36) and their accuracy checked. 24%-48%, 61%-73% and 80%-88% were correctly estimated within five, 10 and 15 points, respectively. Conclusions: Models for predicting WASI-II scores from the NART-2 and WTAR and demographic variables had adequate strength and accuracy. However, they were likely to be limited to those with FSIQ>79. Further development of word reading tasks for the prediction of premorbid intellectual functioning in the contemporary Australian context is warranted. Key Points What is already known about this topic: (1) The estimation of premorbid intellectual functioning is important in cognitive assessment, for which tests such as the National Adult Reading Test (NART-2) and Wechsler Test of Adult Reading Test (WTAR) were developed. (2) Research has pointed to potential problems with using the ageing norms and predictive models of the NART-2 and WTAR and recent Australian research has presented new models for predicting current Wechsler Adult Intelligence Scale (WAIS-IV) scores. (3) No evaluation of the NART-2 or WTAR has examined the accuracy of these models in predicting the shorter Wechsler Abbreviated Scales of Intelligence – Second Edition (WASI-II) scores in the Australian context. What this topic adds: (1) This study provides norms for the NART-2 and WTAR utilising Australian pronunciation rules, consistent with the Macquarie Dictionary. (2) Equations are presented for predicting WASI-II scores from NART-2 and WTAR scores and simple demographic variables, based on a healthy sample of Australian adults. (3) Evaluation of these predictive models shows they are likely to have adequate strength and accuracy, but were limited to predicting ability to within the low average range and above (FSIQ>79).

Comparative Theology in the Contemporary Australian Context

Abstract This essay examines the practice of comparative theology within the culturally and religiously plural landscape of contemporary Australia. Tracing the early stages of the discipline in Australia to the Faculty of Theology and Philosophy at Australian Catholic University (acu) in 2012, the paper tracks its subsequent progress in the vibrant Asia-Pacific region. For the sake of clarity, I investigate a specific example of comparative theology, testing the feasibility of an engagement between Anglo-Celtic Christians and Indigenous Australian peoples. Seeking greater theological depth, I isolate a precise theme—the creation of the universe—and position the Indigenous viewpoint within the oral ‘Dreaming’ myths of the central Australian desert. The Christian perspective derives from written Biblical sources.

Role of bone marrow biopsy for fever of unknown origin in the contemporary Australian context

Bone marrow biopsy (BMB) is an accepted investigation in fever of unknown origin (FUO) to uncover haematological malignancies, such as lymphoma, and sometimes infections. With the advance in imaging modalities, such as 18-fluoro-2-deoxyglucose positron emission tomography (FDG-PET) to identify the focus of lymphoma, BMB may not contribute to the diagnosis when there are no other clinical features to suggest an underlying haematological disease. To investigate the utility of BMB in determining the cause of FUO, when there are no other indications for BMB. Medical records of adult patients who had BMB performed for FUO or febrile illness from 1 January 2005 to 31 December 2014 in four metropolitan tertiary hospitals in Melbourne, Australia were reviewed. Patients with other concurrent indications for BMB, known human immunodeficiency virus infection and previously diagnosed connective tissue diseases were excluded. Seventy-three patients were included in the study. Fifty-one patients had a final diagnosis for fever (systemic inflammatory diseases, infective, malignancy or other) while 22 patients had no diagnoses. In only 10 patients (13.7%) did BMB contribute to the diagnosis, finding either malignancy or granulomata. However, all these diagnoses could have been made without BMB. Two patients with diffuse large B-cell lymphoma had normal BMB. FDG-PET was helpful in making a diagnosis in eight (25%) out of 32 patients. Performing BMB in patients with FUO and no other haematological abnormalities is of very limited value, and other investigations, such as FDG-PET, may be more likely to help establish a definitive diagnosis.

The Rhetoric of “The Mandate” in Contemporary Australian Context

The “electoral mandate” serves a useful function as a political weapon in competitive party democracies, notwithstanding the ambiguities, multi‐layered complexities and uncertainty of many of the issues which the concept involves. The diverse uses of “mandate” indicate competing ideas in Australian politics about the responsibilities of parties to pursue commitments made during campaigns and the extent of rights to govern. This article portrays mandate not as a “theory” or “doctrine”, but as a rhetorical device that needs to be examined in the context of “contested word use” in political speech. The renewed interest in the study of rhetoric reflects the usefulness of examining multiple and layered meanings that exist under what ostensibly may appear as “empty rhetoric”, and to understand how rhetoric is used to persuade an audience of the validity of a particular action or viewpoint. While mandate often comes under attack as “meaningless”, it is a useful persuasive tool employed by politicians to consolidate their legitimacy and justify their rights to implement a political agenda and, as such, it contributes to public discourses relating to the nature of political representation.

‘Am I not beautiful?’: cultural identity and the process of co-authorship

ABSTRACTThis case study of a community youth theatre project interweaves reflective descriptions of practice, data excerpts and analysis to examine young people’s exploration of cultural identity through theatre in a regional city in Australia. The process undertaken to create this work is theorised in relation to concepts of cultural difference and cultural diversity, cultural representation and local identity. The article examines the process of generating group authorship of a play, the role and responsibilities of a practitioner in this process and the ‘real life’ consequences of creating applied theatre works that address issues of race, culture and identity in a contemporary Australian context.

Metaphysical revolt in the face of faith, examined through the play Insular: A contemporary Australian context

Abstract Metaphysical revolt arises from conscious awareness of the divorce between the experience of life and the emptiness of reason for it. To explore this, the play Insular is situated within the philosophical framework of Albert Camus’ approach of atheistic absurdism. The first part of this volume is an exegesis of qualitative practice-led research that applies a hybrid methodology of performative, bricolage and hermeneutic praxes. It includes a literary review of Islam, tragicomedy, metaphysics and Camus. This study demonstrates distinct correlations in applying tragicomedy to investigate the experience of the absurd in a twenty-first century Australian context with theatrical conventions of Brecht’s twentieth-century Epic Theatre. The creative practice of writing the play Insular (the second part of this volume), explores metaphysical revolt through framing a tragicomic narrative around experiences of an Australian Muslim character living in a contemporary Australian context. This volume undertakes a comparative examination of the contrast between the concepts of the ideal of God and hegemonic corruptions of versions of the ideal by all too human societal and theological practices.

A small speech community with many small languages: The role of receptive multilingualism in supporting linguistic diversity at Warruwi Community (Australia)

At Warruwi Community (pop. 400), nine very different Indigenous languages are still widely used, which is unusual in the contemporary Australian Indigenous context. Using the receptive multilingual mode, speakers frequently address one another in different languages. This mode offers speakers of small languages such as Mawng (ca. 400 speakers) an alternative to accommodating to larger languages such as Yolngu-matha (ca. 2000 speakers). Although not unique to Warruwi, receptive multilingual practices are part of a set of “mutually constituting ideologies and practices” (Nakassis, 2016) that co-construct a speech community where many small languages flourish.

“Be Careful, Cowboy”: The Translation and Mutation of the Western Genre in Red Hill

The western genre has long been hailed as an iconic expression of the United States’ history and culture. However, the 2010 Australian film Red Hill (dir. Patrick Hughes, 2010) actively engages the genre’s tropes, styles, and conventions. In doing so, the film converts the ideas of a ruggedly individualistic frontier, key to the western genre and the popularised notions of nineteenth-century United States expansion, to the contemporary Australian context, providing a translation and mutation of the western genre. This paper argues that, through disassociation of the western genre from the United States, Red Hill’s frontier is made Australian over the course of the film, exploring the lingering traumas and ongoing violence of a specific colonisation process. Drawing on theories of genre, history, and postcolonialism, this paper investigates the exploration of national character, history, and boundaries through the western genre. In doing so, this paper situates the western genre as having a nationalistic function in general, rather than one associated with any particular nation, and as providing a touchstone for ideas of history and themes of colonial expansion in a contentious landscape of class, race, and society.

Australia’s supervising teachers: motivators and challenges to inform professional learning

ABSTRACTThis paper offers an overview of what motivates and challenges Australian supervising teachers to work with preservice teachers in their classrooms. In the contemporary Australian context of new National Professional Standards for Teachers, a new national curriculum and new standards for Initial Teacher Education programs, what motivates and challenges supervising teachers becomes a focus for professional learning through analysis presented in this paper. Data are reported from a national data set that includes 314 responding supervising teachers who took the Mentoring Perspectives Inventory from 2012–2014. The MPI data are aggregated in this paper to suggest that the wider system of teacher education could benefit from attention at various levels of interest to develop the underlying knowledge base of supervising teachers and our understanding of how they are challenged and motivated in their work with preservice teachers.

Mediating literary borders: Sri Lankan writing in Australia

The current Australian political and news-media agenda is very much about “outside” views, tending to treat migrants – including refugees and asylum seekers, for example – as one category of “others” devoid of race, culture or psychological specificities. A compelling aspect of literature’s power is that it transforms such encompassing public issues into humanist stories whose affective and cognitive resonances transcend the limits of political propaganda. It can communicate transculturally, establishing intimate, interpersonal and intercommunal conversations across time and space. Framed by theories of multiculturalism and cosmopolitanism in the contemporary Australian context, this article looks at the recent work of two Sri Lankan-born Australian novelists – Michelle de Kretser and Channa Wickremesekera, who write about migrants, refugees and asylum seekers – with the aim of exploring their alternative understanding of multiculturalism in Australia.

Supporting the risk management process with land information: a case study of Australia.

It is frequently argued that, at the parcel level, stakeholders are capable of and well supported in managing their land-related risks. Yet, evidence from the contemporary Australian context suggests otherwise: numerous large-scale disaster events have revealed that citizens are ill-prepared to respond and recover adequately. This paper begins with the premise that information, specifically land information, could better support parcel-level risk preparation, mitigation, response, and recovery. State land administration organisations in Australia primarily maintain this information and make it accessible. Land information is used regularly across all levels of government to support risk management activities; however, such application has not always occurred at the parcel and citizen level. Via a case study approach, this paper initially explores the land information available in Australia to stakeholders interested in parcel-level detail, and then goes on to propose how the utilisation of parcel-level land information could serve to enhance risk management practices.