Queensland Residents Research Articles

Contemporary Australian Profile of Rheumatic Fever: Results From Multiple Jurisdictions

Introduction: Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) rates among Indigenous Australian communities are among the highest globally, yet no national reliable data exist on the burden. We aim to provide the first quasi-national description of ARF in Australia. Methods: Northern Territory (NT), Queensland, Western Australia and South Australia residents (NSW data forthcoming) with a diagnosis of ARF were identified from person-linked jurisdiction-specific in-patient hospital (ICD codes I00–I02) and ARF register data 2015–2017. ARF records were categorised into 3-month episodes. First-ever ARF was determined through interrogation of register/hospitalisation ARF/RHD dates and by applying a 13.5-year look-back period to hospital data. Age-specific (10-year age groups, 0–54 years), age-standardised first-ever and total ARF incidence rates were calculated by Indigenous status, and sex, with incident rate ratios (IRR) used for comparison across sub-populations. Recurrences per person-years were calculated for first-ever cases. Results: 1401 episodes (91% Indigenous, 55% female, 82% first-ever) pertaining to 1297 people were identified, predominantly from NT (56%) and Queensland (28%). First-ever incidence rates peaked at 5–14 years (46/100,000) and 15–24 years (19/100,000). Compared with non-Indigenous, Indigenous age-standardised first-ever rates (0–54 years) were significantly higher (IRR(all) = 113.7; IRR(females) = 137.7; IRR(males) = 90.8). Total IRRs were even higher. Recurrence rates were highest among females, people aged 5–14 years and NT residents. Conclusion: These findings confirm the unacceptably high risk of ARF among Indigenous Australians. The study provides the first incidence data using integrated/linked data from registers and hospitals, providing a comprehensive baseline from which to assess much-needed multi-sectoral policies to end ARF/RHD in Australia.

Resilient and Sustainable Communities

This research advances our understanding of sustainable community development in relation to complex economic phenomena and psychological processes. The last decade has seen regional and global communities transition through unprecedented economic change. Community resilience offers a framework to guide regional development and explore the sustainability of social, economic and environmental systems to manage change. However, the fundamental constructs of community resilience are still not well known, such as the critical role of emotional stability and residents’ perceptions of change. This research explores this relationship in economies undergoing transformations by presenting the results of a survey administered to 663 Mackay and Whitsunday residents in Queensland, Australia. The findings add substantial depth to community resilience theory by demonstrating a positive relationship between emotional stability and resilience and a negative relationship between resilience and perceptions of change. The results also provide insight into the sustainable characteristics of communities to build resilience and manage the transformation process. Future research should focus on further testing the relationship between resilience, emotional stability and perceptions of change within communities at different stages of the transformation process.

Road deaths relating to the attendance of medical appointments in Queensland.

Objective This study sought to estimate and observe the risks imposed on patients as they travel to hospital for referred treatment. Factors such as distance and remoteness were compared to understand how they affect this risk. Methods This study focused on Queensland residents attending specialist out-patient appointments in a Queensland public hospital throughout 2016. Deidentified information on all recipients of a specialist out-patient appointment in 2016 (n=2946584) were included in the study. This study also contained a theoretical component: using a data model to estimate the number of fatalities that could be expected from a travelling population of this size and complexity. The modelling results were compared with the frequency of actual fatalities among individuals travelling to receive treatment, as determined by a review of the Queensland Police Road Database. The data model and empirical values from police reports were used to independently measure what risk, if any, individuals travelling to obtain specialist out-patient treatment are exposed to. Differences between the model and observed values were evaluated using statistical tests. Results A direct relationship between increasing remoteness and travel risk was established in both the model and observed data (CV(RMSD)=0.660773). Conclusion Fatal risk is present in any road journey regardless of distance, duration or the purpose of travel. Individuals living in regional and remote Queensland are exposed to a larger risk than those living in the major cities of Queensland when travelling to obtain public health care. What is already known on this subject? Road safety remains one of Australia's most serious public health issues, with 1295 road-related fatalities recorded throughout Australia in 2016. Although the potential dangers of road travel are well understood, extended journeys by road to attend hospital appointments are often undertaken despite available alternatives to travel in some instances. What this paper adds? Travelling to attend medical appointments exposes a patient to a small but potentially catastrophic risk that can be observed in state road crash data. This risk is measurably greater for individuals in regional Queensland. What are the implications for practitioners? Clinical models of care that reduce patient travel may represent a new standard in patient safety when of the risks associated travel are considered.

Electricity consumers in regional Australia: Social acceptance of coal-fired power and renewable energy

The purpose of this study is to explore the concept of 'social acceptance' and examine public opinions on climate change, renewable energy and fossil fuels in regional Australia. Understanding public opinion is critical given the need for governments to transition energy production away from fossil fuels and towards renewable energy in order to meet obligations under the 2015 UN Paris Agreement on Climate Change. Design/methodology/approach This empirical study examines people's beliefs on climate change, attitudes towards energy and support for both renewable and non-renewable energy resources. A survey was developed and respondents (n= 325) were recruited face-to-face in a regional city in Northern Australia. Data was then analysed using IBM SPSS 20 software. Frequency distributions, cross tabulations and non-parametric tests were performed. Findings Respondent-completed questionnaires reveal positive attitudes towards renewable energy. Overall, respondents agree that climate change is occurring and that society has a responsibility to act to minimise its effects. Surprisingly, consumers who support coal-fired power show strong support for renewable energy, despite being undecided on the climate change issue and not perceiving a connection between electricity usage in the home and climate change. Consumers who are opposed to coal-fired power show low support for all fossil fuels, despite the fact that they will continue to underpin the Australian energy system for some time to come. In addition, demographic variables, notably gender and education, along with political affiliation, are associated with varying levels of support for particular energy technologies. Limitations The findings are based on a convenience sample of mostly urban North Queensland residents and hence is not fully representative of Queensland's population. The study is descriptive in nature and there is a need for explanatory research to validate key findings on demographics. Implications The research has several policy implications. The cost competitiveness of both solar and wind technology over coal-fired generation needs to be emphasised. Furthermore, altruistic appeals such as benefiting future generations may also be effective. Commercial marketing techniques may be useful in boosting support for emerging renewable energy resources, such as geo-thermal and fuel cell technology, amongst females. It is recommended that misconceptions about coal-fired power be addressed, for instance through community-based programs, if Australia is to make a transition to a low-carbon electricity market. Contribution This article represents an attempt to examine the attitudes of regional Australians towards a wide range of energy resources and show, by drawing on the literature on social acceptance, the key factors that underpin support for renewable energy.

Incidence of emergency department presentations for traumatic brain injury in Indigenous and non-Indigenous residents aged 15\u201364 over the 9-year period 2007\u20132015 in North Queensland, Australia

BackgroundTraumatic brain injury (TBI) is a leading cause of disability worldwide. Previous studies have shown that males have a higher incidence than females, and Indigenous populations have a higher rate than non-Indigenous. To date, no study has compared the incidence rate of TBI between Indigenous and non-Indigenous Australians for any cause. Here we add to this rather sparse literature.MethodsRetrospective analysis of data from North Queensland Emergency Departments between 2007 and 2015 using Australian Bureau of Statistics population estimates for North Queensland residents aged 15–64 years as denominator data. Outcome measures include incidence rate ratios (IRR) for TBI presentations by Indigenous status, age, sex, year of presentation, remoteness, and socio-economic indicator.ResultsOverall incidence of TBI presentations per 100,000 population was 97.8. Indigenous people had an incidence of 166.4 compared to an incidence in the non-Indigenous population of 86.3, providing an IRR of 1.93 (95% CI 1.77–2.10; p < 0.001). Males were 2.29 (95% CI 2.12–2.48; p < 0.001) times more likely to present than females. Incidence increased with year of presentation only in the Indigenous male population.ConclusionsThe greater burden of ED presentations for TBI in the Indigenous compared with the non-Indigenous population is of concern. Importantly, the need to provide quality services and support to people living with TBI in remote and very remote areas, and the major role of the new National Disability Insurance Scheme is discussed.

Chemotherapy in patients with unresected pancreatic cancer in Australia: A population-based study of uptake and survival.

Palliative chemotherapy improves symptom control and prolongs survival in patients with unresectable pancreatic cancer, but there is a paucity of data describing its use and effectiveness in everyday practice. We explored patterns of chemotherapy use in patients with unresected pancreatic cancer in Australia and the impact of use on survival. We reviewed the medical records of residents of New South Wales or Queensland, Australia, diagnosed with unresectable pancreatic adenocarcinoma between July 2009 and June 2011. Associations between receipt of chemotherapy and sociodemographic, clinical and health service factors were evaluated using logistic regression. We used Cox proportional hazards models to analyze associations between chemotherapy use and survival. Data were collected for 1173 eligible patients. Chemotherapy was received by 44% (n=184/414) of patients with localized pancreatic cancer and 53% (n=406/759) of patients with metastases. Chemotherapy receipt depended on clinical factors, such as performance status and comorbidity burden, and nonclinical factors, such as age, place of residence, multidisciplinary team review and the type of specialist first encountered. Consultation with an oncologist mitigated most of the sociodemographic and service-related disparities in chemotherapy use. The receipt of chemotherapy was associated with prolonged survival in patients with inoperable pancreatic cancer, including after adjusting for common prognostic factors. These findings highlight the need to establish referral pathways to ensure that all patients have the opportunity to discuss treatment options with a medical oncologist. This is particularly relevant for health care systems covering areas with a geographically dispersed population.

Residents of Central Queensland, Australia Are Aware of Healthy Eating Practices but Consume Unhealthy Diets.

We aimed to determine nutritional knowledge and behaviors of normal weight, overweight, and obese residents of Central Queensland, Australia. Data were collected as part of the 2010 Central Queensland Social Survey (N = 1289). Residents were asked questions assessing nutritional knowledge and behaviors. Statistical analyses were performed to examine differences in nutritional knowledge and behaviors by body mass index (BMI) classification: normal weight, overweight, and obese. Independent of BMI, residents ate fewer than the recommended daily servings of vegetables (p < 0.05) and fruits (p < 0.05) with no differences found between BMI classifications. Overweight (OR: 1.52; 95% CI: 1.13–2.04) and obese (OR: 1.43; 95% CI: 1.04–1.98) residents were more likely to have eaten fast food the week of the survey than normal weight residents. Residents correctly identified the amount of kilocalories required to maintain current body weight with no differences between BMI classifications. Each BMI classification underestimated the amount of kilojoules required to maintain current body weight (p < 0.05). Nutritional knowledge may not be the limiting factor preventing residents from making proper nutritional choices.

Illicit Love: Interracial Sex and Marriage in the United States and Australia

Ann McGrath's ambitious comparative study of interracial marriage in the early national United States and Australia joins a burgeoning and theoretically sophisticated body of scholarship focused on the relations between colonial settlers and indigenous peoples. Representing fifteen years of archival research in two countries, Illicit Love probes the uses of marriage prohibitions and the impact of interracial marriage for national identity and sovereignty in two very different contexts: that of the Cherokee nation during the U.S. early republic, and that of indigenous residents of Queensland, Australia. Her comparison, she acknowledges, is asymmetrical: two elite Cherokee male–white female couples provide the main story line for the U.S. analysis but several cohorts of the reverse pairing—indigenous women and white frontiersmen—form the basis for the sections on Queensland. The Queensland portion of the narrative is stronger, in part, because of its focus on patterns of intimacy rather than on the relationships of a few notable individuals.

Association between change in employment participation and quality of life in middle-aged colorectal cancer survivors compared with general population controls.

This study aimed to examine the association between change in employment participation for a 12-month period and quality of life among individuals with colorectal cancer compared with general population controls. This was a prospective, registry-based study that enrolled middle-aged (45-64years) residents of Queensland, Australia, who were in the paid workforce, and newly diagnosed with colorectal cancer. Participants completed structured telephone interviews at 6 and 12months after diagnosis assessing quality of life and employment status ("retired/ceased work," "increased work," "decreased work," and "maintained work"). Survivors were matched on demographic and occupation characteristics in a 1:2 ratio with individuals from the general population who had participated in both Wave 10 (2010) and 11 (2011) of the Household, Income and Labour Dynamics in Australia survey. Almost half (66/148, 45%) of colorectal cancer survivors ceased or decreased work during the study period, compared with 27% in the control group (79/295, P=.001). Physical and mental well-being did not fluctuate over time in the general population. However, there were significant improvements in physical well-being, functional well-being, and overall quality of life during the study period for participants with colorectal cancer. At 12months postdiagnosis, participants with colorectal cancer who maintained or increased work had significantly better functional well-being and overall quality of life compared with those who decreased work or retired. A diagnosis of colorectal cancer often impairs the ability of a person to maintain work. The impairments are predominantly physical and functional. Interventions to assist with occupational rehabilitation should be trialed.

Calvary or limbo?

Almost 5,000 Italians were interned in Australia during World War II, a high proportion of them Queensland residents. Internment was a pivotal experience for the Italian community, both locally and nationally, complicating Italian Australians’ sense of belonging to their adopted country. Through an examination of two migrant autobiographical narratives of internment, Osvaldo Bonutto’s A Migrant’s Story and Peter Dalseno’s Sugar, Tears and Eyeties, this article explores the impact of internment on the experience and articulation of cultural and civic belonging to Australian society. It finds that internment was a ‘trial’ or ‘transitional’ phase for these internees’ personal and civic identities, and that the articulation of these identities and sense of belonging is historically contingent, influenced by the shift from assimilation to multiculturalism in settlement ideology, as well as Italian Australians’ changing place in Australian society throughout the twentieth century.

The first comprehensive report on Indigenous Australian women's inequalities in cervical screening: A retrospective registry cohort study in Queensland, Australia (2000-2011).

BACKGROUNDThe Australian National Cervical Screening Program, introduced more than 20 years ago, does not record the Indigenous status of screening participants. This article reports the first population‐based estimates of participation in cervical screening for Indigenous and non‐Indigenous Australian women.METHODSThis was a retrospective, population‐based study of 1,334,795 female Queensland residents, aged 20 to 69 years, who participated in cervical screening from 2000 to 2011; 26,829 were identified as Indigenous through linkage to hospitalization records. Participation rates were calculated as the number of women screened divided by the average estimated resident population, with adjustments made for hysterectomies, for each 2‐, 3‐, and 5‐year screening period. Multivariate logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs), which were adjusted for age group, place of residence, and socioeconomic disadvantage.RESULTSIn 2010‐2011, the 2‐year participation rate was 55.7% (95% CI, 55.6%‐55.9%) for non‐Indigenous women and 33.5% (95% CI, 32.9%‐34.1%) for Indigenous women; this represented a decrease from 2000‐2001 (57.7% [95% CI, 57.6%‐57.9%] and 35.3% [95% CI, 34.5%‐36.1%], respectively). The difference between Indigenous and non‐Indigenous women was greatest for those aged 45 to 49 years. The 3‐ and 5‐year participation rates were higher within both groups, and the absolute differences between the 2 groups were larger. Significant interactions between the Indigenous status and the place of residence and socioeconomic disadvantage highlight that the Indigenous/non‐Indigenous differential was evident in all places of residence except for very remote areas (OR, 0.99; 95% CI, 0.95‐1.02) and was greatest in the most affluent areas (OR, 0.26; 95% CI, 0.24‐0.27).CONCLUSIONSIndigenous Australian women participate less than non‐Indigenous women, and this gap has not closed. These results provide important benchmarks for the new Australian cervical screening program commencing in 2017, which will provide opportunities to reduce inequities for Indigenous women and address longstanding data deficiencies in the collection of the Indigenous status. Cancer 2016;122:1560–9. © 2016 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.

Who Leaves Suicide Notes? An Exploration of Victim Characteristics and Suicide Method of Completed Suicides in Queensland

The objective of this study is to address the question: are those who leave suicide notes representative of the larger population of those who commit suicide? The method involves an analysis of a full population of suicides by residents of Queensland, Australia for the full year of 2004, with the information drawn from Coronial files. Our overall results suggest that, and in support of previous research, the population who leaves suicide notes are remarkably similar to those who do not. Differences are identified in four areas: first, and in contrast to prior research, females are less likely to leave a suicide note; second, and in support of previous research, Aboriginal Australians are less likely to leave suicide notes; third, and in support of some previous research, those who use gas as a method of suicide are more likely to leave notes, while those who use a vehicle or a train are less likely to leave notes; finally, our findings lend support to research which finds that those with a diagnosed mental illness are less likely to leave notes. The discussion addresses some of the reasons these disparities may have occurred, and continues the debate over the degree to which suicide notes give insight into the larger suicide population.

Ten years of suicide mortality in Australia: Socio-economic and psychiatric factors in Queensland

BackgroundWith the exception of the United States, in recent years suicide rates have been declining in most western countries. Notoriously, suicide rates fluctuate – especially in males – in response to a range of socio-political and environmental factors, some of them difficult to identify. Our aim was to obtain an updated profile of main commonalities in suicide cases of Queensland residents between 2002 and 2011 to inform prevention strategies. MethodsData were obtained from the Queensland Suicide Register (QSR), including police and toxicology reports, post-mortem autopsy and Coroner's findings. Data are crosschecked with records from the National Coronial Information System. Age-standardised rates (ASR) of suicide, Poisson regression and Chi2 tests are presented. ResultsA total of 5752 suicides by Queensland residents was registered between 2002 and 2011; 76.9% by males and 23.1% by females. The average ASR was 14.3 per 100,000, with a significant decrease between 2002 and 2011. Rates declined significantly in males, not in females. On average, rates were 3.41-times higher in males. ASR for Aboriginal and Torres Strait Islander peoples was significantly higher than for other Australians. Overall, male suicide rates were particularly high in remote areas, as well as in the most disadvantaged ones. One third of suicide cases presented history of previous suicidal behaviour, and half a detected and treated mental disorder. Hanging was the most common method. ConclusionsSuicide rates have declined in Queensland, Australia. It is problematic to say if this was due to suicide prevention programs or other factors.

P08.18 Regional variation in emergency department presentation rates of chlamydia related morbidity in four states of australia

Background Pelvic inflammatory disease (PID) and ectopic pregnancy among women and epididymitis among men are important sequelae of chlamydia. In Australia, chlamydia prevalence is higher among younger populations, Indigenous Australians, and in regional and remote areas. The burden of chlamydia sequelae by Australian region is unknown. We assessed if rates of emergency department (ED) presentations in Australia for chlamydia sequelae vary by remoteness of residence. Methods Age and sex specific ED rates per 100,000 population of PID, ectopic pregnancy or epididymitis among 15–44 year-old Victorian, New South Wales, Queensland and South Australian residents were calculated for the years 2009 and 2010 using hospital and Australian Bureau of Statistics estimated resident population data. Logistic regression was used to assess regional variation in rates and adjusted for age, remoteness and socio-economic group (SES) of residential postcode in deciles. Results During 2009–2010, overall ED rates per 100,000 among 15–44 year-old residents from all four states were 76.8 (95% CI: 74.8–78.8) for PID, 73.0 (95% CI: 71.1–75.0) for ectopic pregnancy and 86.4 (95% CI: 84.3–88.4) for epididymitis. Multivariable analysis showed that PID rates in female residents: were higher in inner-regional (AOR = 1.6; 95% CI: 1.5–1.7) and outer regional/remote areas (AOR = 2.1; 95% CI: 1.9–2.3) compared with metropolitan areas; increased by 6%(95% CI: 5%–7%) per decile of increasing disadvantage of postcode; and were higher in women aged 15–24 (AOR = 2.4,95% CI: 2.3–2.6) and 25–34 years (AOR = 1.7; 95% CI: 1.6–1.8) compared with 35–45 years. Ectopic pregnancy rates in females were higher in inner-regional (AOR = 1.3; 95% CI: 1.2–1.4) and outer regional/remote (AOR = 1.7; 95% CI: 1.5–1.8) areas; increased by 6% (95% CI: 5%–7%) per decile of increasing disadvantage; and were highest among 25–34 year-old women (AOR: 2.1; 95% CI: 2.0–2.3). In men, epididymitis rates were higher in inner-regional (AOR = 1.6; 95% CI: 1.5–1.7) and outer regional/remote (AOR = 2.3; 95% CI: 2.2–2.5) areas and did not differ by age or SES. Conclusion Possible explanations for higher ED rates of chlamydia sequelae in non-metropolitan Australian residents could be higher chlamydia prevalence or variable access to primary healthcare in these areas. Disclosure of interest statement These data are being analysed as part of the Australian Chlamydia Control Effectiveness Pilot (ACCEPt) study funded by the Commonwealth Department of Health and the National Health and Medical Research Council.

Drowning in Aboriginal and Torres Strait Islander children and adolescents in Queensland (Australia).

BackgroundAboriginal and Torres Strait Islander (Indigenous) children are at greater risk of drowning than other children, however little is known about drowning of Indigenous children. This study identifies the previously unpublished incidence and characteristics of fatal and non-fatal drowning in Indigenous children and adolescents.MethodsRetrospective data (Jan 2002-Dec 2008) on fatal and non-fatal drowning events among Indigenous and Non-Indigenous Queensland residents aged 0-19 years were obtained from multiple sources across the continuum of care (pre-hospital; emergency department; admitted patients; fatality) and manually linked. Crude incidence rates for fatal and non-fatal events were calculated using population data from the Australian Bureau of Statistics.ResultsThere were 87 (6.7 % of all events) fatal and non-fatal (combined) Indigenous drowning events yielding a crude Incidence Rate of 16.8/100,000/annum. This is 44 % higher than the incidence rate for Non-Indigenous children. For every fatality, nine others were rescued and sought medical treatment (average 12 per year). There were no significant changes in Indigenous drowning incidents over the study period. Drowning rates were higher for Indigenous females than males. Overall incidence was higher among Indigenous children and adolescents than Non-Indigenous children for every calendar year and age-group (0-4 years; 5-9 years; 10-14 years) except those aged 15-19 years where no drowning events were recorded for males.Location of drowning sites was similar in both populations 0-19 years, however there were slight differences in frequency at each of the locations. The three leading drowning locations for Indigenous 0-19 years olds were pool (48 %), bath (21 %) and natural water (16 %), and for non-Indigenous 0-19 years the leading locations were pool (66 %), natural water (13 %) and bath (12 %) (p < .01). Except for pool drowning, Indigenous drowning occurred more often in geographic areas of relative disadvantage. Among Indigenous children drowning location varied with age (p < .001). Most frequent locations by age were: <1 year bath (71 %); 1-4 years pools (80 %); 5-9 years pools (75 %) and 10-19 years beach/ocean (36 %). Severity of event differed statistically with Indigenous status and by remoteness with all fatal drowning events occurring in Regional or Remote areas, and none in Major Cities.ConclusionsFor every fatal drowning among Indigenous children in Queensland aged 0-19 years there are nine non-fatal events. This previously unreported survival ratio of 9:1 indicates the non-fatal injury burden in Indigenous children aged 0-19 years. Although higher Indigenous drowning rates prevailed, no significant changes over time are concerning. Equally the apparent over-representation of Indigenous adolescent females should be weighed against the absence of drowning among Indigenous male adolescents in the same age group in consecutive years of the study. Further investigation around behaviour and culture may highlight protective factors. Culturally specific prevention strategies which take into account social and demographic indicators identified in this study should be delivered to carers and peers of vulnerable age groups who frequent specific locations. Females, swimming ability, supervision and the young are areas which need to be incorporated into Indigenous-specific interventions for drowning prevention.

Examining an Australian physical activity and nutrition intervention using RE-AIM.

Translating evidence-based interventions into community practice is vital to health promotion. This study used the RE-AIM framework to evaluate the larger dissemination of the ManUp intervention, an intervention which utilized interactive web-based technologies to improve the physical activity and nutrition behaviors of residents in Central Queensland, Australia. Data were collected for each RE-AIM measure (Reach, Effectiveness, Adoption, Implementation, Maintenance) using (i) computer-assisted telephone interview survey (N = 312) with adults (18 years and over) from Central Queensland, (ii) interviews with key stakeholders from local organizations (n = 12) and (iii) examination of project-related statistics and findings. In terms of Reach, 47% of participants were aware of the intervention; Effectiveness, there were no significant differences between physical activity and healthy nutrition levels in those aware and unaware; Adoption, 73 participants registered for the intervention and 25% of organizations adopted some part of the intervention; Implementation, 26% of participants initially logged onto the website, 29 and 17% started the web-based physical activity and nutrition challenges, 33% of organizations implemented the intervention, 42% considered implementation and 25% reported difficulties; Maintenance, an average of 0.57 logins and 1.35 entries per week during the 12 week dissemination and 0.27 logins and 0.63 entries per week during the 9-month follow-up were achieved, 22 and 0% of participants completed the web-based physical activity and nutrition challenges and 33.3% of organizations intended to continue utilizing components of the intervention. While this intervention demonstrated good reach, effectiveness, adoption and implementation warrant further investigation.

How is acceptance of the brain disease model of addiction related to Australians’ attitudes towards addicted individuals and treatments for addiction?

BackgroundWe investigated whether beliefs about addiction being a ‘disease’ or ‘brain disease’, and holding certain beliefs about addiction aetiology, are associated with public views about addicted persons and support for different types of treatment, coerced treatment and punishment for addiction.MethodsData were collected as part of the 2012 Queensland Social Survey, a computer assisted telephone interview of 1263 residents of Queensland, Australia. Participants were presented with scenarios of two addicted males, one who was addicted to heroin and the other addicted to alcohol. Participants were then asked a series of questions for both characters.ResultsThere was widespread support for all treatment modalities (alcohol: 80.8-98.0%, heroin: 89.9-97.2%). There was less support for coerced treatment for alcohol than heroin addiction (alcohol: 41%, heroin: 71%, χ2 = 273.90, p < 0.001). Being 35 years of age or older (alcohol: OR = 0.58 (0.37-0.91), heroin: OR = 0.49 (0.28-0.85)) and having 15 or more years of education (alcohol: OR = 0.60 (0.44-0.81), heroin: 0.55 (0.40-0.75)) predicted less support for coerced treatment. 31.7% of respondents agreed heroin use should be punished by imprisonment and being 35 years of age or older (OR = 0.51 (0.33-0.80)) predicted lack of support. The sample agreed that an alcohol or heroin dependent person would suffer career damage (alcohol: 96.2%, heroin: 98.9%), marriage breakdown (alcohol: 92.2%, heroin: 97.3%) and get in trouble with the law (alcohol: 92.3%, heroin: 98.9%). Respondents expressed more comfort with encountering alcohol rather than heroin addicted persons in the workplace or at a dinner party. Beliefs that addiction was a ‘brain disease’ or a ‘disease’ did not predict any of these attitudes. Beliefs about addiction aetiology were inconsistent predictors of outcomes measured.ConclusionsAge and educational attainment were the most consistent predictors of stigmatising beliefs and beliefs about coercion and punishment. Beliefs that addiction is a ‘disease’ or a ‘brain disease’ were not associated with an overall reduction in beliefs about stigma, coercion or punishment. Beliefs in different causes of addiction were not consistent predictors of beliefs about stigma, coercion or punishment.

Are Queensland Residents Willing and Able to Respond to Time‐Varying Electricity Prices?

AbstractAre Queensland residents willing and able to respond to varying electricity prices to reduce demand in peak times? To answer this, Energex and Ergon Energy conducted one of the largest tariff trials in Australia. The trial investigated time of use, dynamic peak pricing and load capacity tariffs across three climatic regions. This article presents empirical and participant survey results from the 27‐month trial. Results show participants across all regions achieved approximately a 19 per cent reduction in consumption during peak times on event days. Trial findings shed light on and challenge some long‐held views regarding pricing structures.

Public attitudes in Australia towards the claim that addiction is a (brain) disease

We investigated the Australian public's understandings of addiction to alcohol and heroin and the factors predicting support for the idea that these types of addiction are 'diseases' and specifically 'brain diseases'. Data were collected as part of the 2012 Queensland Social Survey, a computer-assisted telephone interview of 1263 residents of Queensland, Australia. Participants were presented with scenarios of two addicted persons, one who was addicted to heroin and the other addicted to alcohol. Participants were asked a series of questions about different definitions and causes of addiction for both characters. Over half of the respondents thought that addiction is a disease (alcohol: 67%, heroin: 53%), but fewer (alcohol: 34%, heroin: 33%) believed that addiction is a brain disease. Belief that addiction has biological causes predicted agreement that addiction is a disease [alcohol: odds ratio (OR) = 3.05 (2.15-4.31), heroin: OR = 3.99 (2.82-5.65)] and a brain disease [alcohol: OR = 4.97 (3.42-7.22), heroin: OR = 14.12 (9.23-21.61)]. Women were more likely than men to agree that addiction is a disease [alcohol: OR = 1.79 (1.35-2.38), heroin: OR = 1.40 (1.09-1.81)] as were those 35 years of age and older [alcohol: OR = 2.25 (1.50-3.40), heroin: OR = 1.50 (1.01-2.24)]. There is more public support for the idea that addiction is a 'disease' than for the more specific claim that it is a 'brain disease'. Support for a biological aetiology of addiction predicted higher levels of agreement with both disease concepts.

Did the Big Stick Work? An Empirical Assessment of Scale Economies and the Queensland Forced Amalgamation Program

In 2007, the Queensland Government imposed forced amalgamation with the number of local authorities falling from 157 to just 73 councils. Amalgamation was based inter alia on the assumption that increased economies of scale would generate savings. This paper empirically examines pre- and post-amalgamation (2006/07 and 2009/10) for scale economies. For the 2006/07 data, evidence of economies of scale was found for councils with populations up to 98,000, and thereafter diseconomies of scale. Eight percent of councils in 2006/07 (ten councils) – representing 64% of the state’s population – exhibited diseconomies of scale. For the 2009/10 data, the average cost curve remained almost stationary at 99,000 residents per council, but almost 25% of all councils (thirteen councils) were now found to exhibit diseconomies of scale. The compulsory merger program thus increased the proportion of Queensland residents in councils operating with diseconomies of scale to 84%.