Australia's National Bowel Cancer Screening Program: does it work for Indigenous Australians?

<p>Abstract</p> <p>Background</p> <p>Despite a lower incidence of bowel cancer overall, Indigenous Australians are more likely to be diagnosed at an advanced stage when prognosis is poor. Bowel cancer screening is an effective means of reducing incidence and mortality from bowel cancer through early identification and prompt treatment. In 2006, Australia began rolling out a population-based National Bowel Cancer Screening Program (NBCSP) using the Faecal Occult Blood Test. Initial evaluation of the program revealed substantial disparities in bowel cancer screening uptake with Indigenous Australians significantly less likely to participate in screening than the non-Indigenous population.</p> <p>This paper critically reviews characteristics of the program which may contribute to the discrepancy in screening uptake, and includes an analysis of organisational, structural, and socio-cultural barriers that play a part in the poorer participation of Indigenous and other disadvantaged and minority groups.</p> <p>Methods</p> <p>A search was undertaken of peer-reviewed journal articles, government reports, and other grey literature using electronic databases and citation snowballing. Articles were critically evaluated for relevance to themes that addressed the research questions.</p> <p>Results</p> <p>The NBCSP is not reaching many Indigenous Australians in the target group, with factors contributing to sub-optimal participation including how participants are selected, the way the screening kit is distributed, the nature of the test and comprehensiveness of its contents, cultural perceptions of cancer and prevailing low levels of knowledge and awareness of bowel cancer and the importance of screening.</p> <p>Conclusions</p> <p>Our findings suggest that the population-based approach to implementing bowel cancer screening to the Australian population unintentionally excludes vulnerable minorities, particularly Indigenous and other culturally and linguistically diverse groups. This potentially contributes to exacerbating the already widening disparities in cancer outcomes that exist among Indigenous Australians. Modifications to the program are recommended to facilitate access and participation by Indigenous and other minority populations. Further research is also needed to understand the needs and social and cultural sensitivities of these groups around cancer screening and inform alternative approaches to bowel cancer screening.</p

Preliminary spatiotemporal analysis of the association between socio-environmental factors and suicide

<p>Abstract</p> <p>Background</p> <p>The seasonality of suicide has long been recognised. However, little is known about the relative importance of socio-environmental factors in the occurrence of suicide in different geographical areas. This study examined the association of climate, socioeconomic and demographic factors with suicide in Queensland, Australia, using a spatiotemporal approach.</p> <p>Methods</p> <p>Seasonal data on suicide, demographic variables and socioeconomic indexes for areas in each Local Government Area (LGA) between 1999 and 2003 were acquired from the Australian Bureau of Statistics. Climate data were supplied by the Australian Bureau of Meteorology. A multivariable generalized estimating equation model was used to examine the impact of socio-environmental factors on suicide.</p> <p>Results</p> <p>The preliminary data analyses show that far north Queensland had the highest suicide incidence (e.g., Cook and Mornington Shires), while the south-western areas had the lowest incidence (e.g., Barcoo and Bauhinia Shires) in all the seasons. Maximum temperature, unemployment rate, the proportion of Indigenous population and the proportion of population with low individual income were statistically significantly and positively associated with suicide. There were weaker but not significant associations for other variables.</p> <p>Conclusion</p> <p>Maximum temperature, the proportion of Indigenous population and unemployment rate appeared to be major determinants of suicide at a LGA level in Queensland.</p

Enacting Resilience: A Performative Account of Governing for Urban Resilience

Resilience is an increasingly important urban policy discourse that has been taken up at a rapid pace. Yet there is an apparent gap between the advocacy of social-ecological resilience in scientific literature and its take-up in policy discourse on the one hand, and the demonstrated capacity to govern for resilience in practice on the other. This paper explores this gap by developing a performative account of how social-ecological resilience is dealt with in practice through case study analysis of how protection of biodiversity was negotiated in response to Melbourne’s recent metropolitan planning initiative. It is suggested that a performative account expands the possible opportunities for governing for social-ecological resilience beyond the concept’s use as a metaphor, measurement, cognitive frame or programmatic statement of adaptive management/co-management and has the potential to emerge through what has been called the everyday ‘mangle of practice’ in response to social-ecological feedback inherent to policy processes

Towards a re-conceptualisation of risk in early childhood education

© The Author(s) 2019. Children’s engagement in risk-taking has been on the agenda for early childhood education for the past 10–15 years. At a time when some say the minority world has become overly risk averse, early childhood education aims to support confident, competent and resilient children through the inclusion of beneficial risk in early childhood education. The concept of risk is a complex phenomenon. Beneficial risk is engaging in experiences that take a person outside of their comfort zone and include outcomes that may be beneficial to learning, development and life satisfaction. To date, research on beneficial risk in early childhood has focused on children’s risk-taking in outdoor play. This focus has led to a predominant conceptualisation of beneficial risk in early childhood as an outdoor physical play activity for children. In this article, the authors problematise this conceptualisation. Drawing on both broad and early childhood education specific literature, the authors explore the current discourse on risk in both childhood and early childhood education. The authors identify the development of the current conceptualisation of risk as an experience for children within play, outdoors and as a physical activity, and highlight the limitations of this conceptualisation. The authors argue that for risk-taking to be in line with the predominantly holistic approach of early childhood education, a broad view of risk is needed. To achieve this broad view, the authors argue for a re-conceptualisation of risk that encompasses a wide range of risk experiences for both children and educators. The authors suggest further research is needed to expand our understanding of beneficial risk in early childhood education. They propose further research will offer a significant contribution to the early childhood sector