Rurality bites: The social and environmental transformation of rural Australia

Current agricultural and rural policy in Australia, among governments and major industry groups alike, is a recipe for continued rural decline and the increasing dominance of agriculture by global agribusiness. Indeed, so is a retreat to the past. Rurality Bites is the first comprehensive book on the social and environmental transformation sweeping rural Australia at the beginning of the 21st century. Rurality Bites proposes that the society of the future in rural Australia is an increasingly knowledge intensive one and the concerns, issues and identities of these Australians must be addressed if a positive future is to be realised. In this book, it is apparent that the seeds of a new apprach - one that acknowledges the increasingly globalised context for all activity, but also builds social and natural capital locally - have already been sown. The issue now is to nurture them and ensure that they allow for new enterprises, forms of knowledge, types of community service and forms of governance to develop, and evolve, in the face of ever shifting circumstances

Prevalence of atrial fibrillation in a regional Victoria setting, findings from the crossroads studies (2001–2003 and 2016–2018)

Objective: To estimate the prevalence of atrial fibrillation (AF) in regional Victoria at two time points (2001-2003 and 2016-2018), and to assess the use of electrocardiogram rhythm strips in a rural, community-based study for AF investigation. Design: Repeated cross-sectional design involving survey of residents of randomly selected households and a clinic. Predictors of AF were assessed using Firth penalised logistic regression, as appropriate for rare events. Setting: Goulburn Valley, Victoria. Participants: Household residents aged >= 16years. Non-pregnant participants aged 18+ were eligible for the clinic. Main outcome measures: Atrial fibrillation by 12 lead electrocardiogram (earlier study) or electrocardiogram rhythm strip (AliveCor (R) device) (recent study). Results: The age standardised prevalence of AF was similar between the two studies (1.6% in the 2001-2003 study and 1.8% in the 2016-2018 study, 95% confidence interval of difference -0.010, 0.014, p = 0.375). The prevalence in participants aged >= 65years was 3.4% (1.0% new cases) in the recent study. Predictors of AF in the earlier study were male sex, older age and previous stroke, while in the recent study they were previous stroke and self-reported diabetes. AliveCor (R) traces were successfully classified by the in-built algorithm (91%) vs physician (100%). Conclusion: The prevalence of AF among community-based participants in regional Victoria was similar to predominantly metropolitan-based studies, and was unchanged over time despite increased rates of risk factors. Electrocardiogram rhythm strip investigation was successfully utilised, and particularly benefited from physician overview

Heterogeneity of rural consumer perceptions of health service access across four regions of Victoria

Access to a range of services, including healthcare, ranks among the key determinants of health and wellbeing. It varies with both health system supply factors and consumer demand characteristics. For rural populations, access to health services can be..

Heterogeneity of Rural Consumer Perceptions of Health Service Access Across Four Regions of Victoria

Access to a range of services, including health care, ranks among the key determinants of health and wellbeing. It varies with both health system supply factors and consumer demand characteristics. For rural populations, access to health services can be restricted for a variety of reasons, contributing to poorer health outcomes compared with metropolitan populations. Access to health care differs between communities, despite commonly being seen as homogenous in terms of lack of service and poor access. This article seeks to examine consumer perceptions of access to health service in four shires in rural Victoria and explore differences between rural areas. These insights may assist health services to reorient their modes of service provision to be more accessible to rural health consumers. A confidential self-administered questionnaire was mailed to randomly selected households in the four shires. A total of 1,271 questionnaires were returned (35 percent response rate) with 75 percent of respondents reporting good access to health care overall. Many factors contributed significantly to the perception of health access; however, these factors were unique to each rural community. The implication of this heterogeneity is that rural health care services must be tailored to promote equitable, quality health care outcomes with attention to local community needs at the core of efforts. Only locally-targeted actions will achieve optimal health service planning and delivery

Draft Close Out Report

The Large Complex Banking Organization (LCBO) team is made up of Federal Reserve employees across the regional Federal Reserve Banks

Telehealth in remote Australia : a supplementary tool or an alternative model of care replacing face-to-face consultations?

Background: The COVID-19 pandemic increased the use of telehealth consultations by telephone and video around the world. While telehealth can improve access to primary health care, there are significant gaps in our understanding about how, when and to what extent telehealth should be used. This paper explores the perspectives of health care staff on the key elements relating to the effective use of telehealth for patients living in remote Australia. Methods: Between February 2020 and October 2021, interviews and discussion groups were conducted with 248 clinic staff from 20 different remote communities across northern Australia. Interview coding followed an inductive approach. Thematic analysis was used to group codes into common themes. Results: Reduced need to travel for telehealth consultations was perceived to benefit both health providers and patients. Telehealth functioned best when there was a pre-established relationship between the patient and the health care provider and with patients who had good knowledge of their personal health, spoke English and had access to and familiarity with digital technology. On the other hand, telehealth was thought to be resource intensive, increasing remote clinic staff workload as most patients needed clinic staff to facilitate the telehealth session and complete background administrative work to support the consultation and an interpreter for translation services. Clinic staff universally emphasised that telehealth is a useful supplementary tool, and not a stand-alone service model replacing face-to-face interactions. Conclusion: Telehealth has the potential to improve access to healthcare in remote areas if complemented with adequate face-to-face services. Careful workforce planning is required while introducing telehealth into clinics that already face high staff shortages. Digital infrastructure with reliable internet connections with sufficient speed and latency need to be available at affordable prices in remote communities to make full use of telehealth consultations. Training and employment of local Aboriginal staff as digital navigators could ensure a culturally safe clinical environment for telehealth consultations and promote the effective use of telehealth services among community members

Network model of immune responses reveals key effectors to single and co-infection dynamics by a respiratory bacterium and a gastrointestinal helminth

Co-infections alter the host immune response but how the systemic and local processes at the site of infection interact is still unclear. The majority of studies on co-infections concentrate on one of the infecting species, an immune function or group of cells and often focus on the initial phase of the infection. Here, we used a combination of experiments and mathematical modelling to investigate the network of immune responses against single and co-infections with the respiratory bacterium Bordetella bronchiseptica and the gastrointestinal helminth Trichostrongylus retortaeformis. Our goal was to identify representative mediators and functions that could capture the essence of the host immune response as a whole, and to assess how their relative contribution dynamically changed over time and between single and co-infected individuals. Network-based discrete dynamic models of single infections were built using current knowledge of bacterial and helminth immunology; the two single infection models were combined into a co-infection model that was then verified by our empirical findings. Simulations showed that a T helper cell mediated antibody and neutrophil response led to phagocytosis and clearance of B. bronchiseptica from the lungs. This was consistent in single and co-infection with no significant delay induced by the helminth. In contrast, T. retortaeformis intensity decreased faster when co-infected with the bacterium. Simulations suggested that the robust recruitment of neutrophils in the co-infection, added to the activation of IgG and eosinophil driven reduction of larvae, which also played an important role in single infection, contributed to this fast clearance. Perturbation analysis of the models, through the knockout of individual nodes (immune cells), identified the cells critical to parasite persistence and clearance both in single and co-infections. Our integrated approach captured the within-host immuno-dynamics of bacteria-helminth infection and identified key components that can be crucial for explaining individual variability between single and co-infections in natural populations

A new age of believing women? Judging rape narratives online

Book synopsis: This book critically examines the last few decades of discussion around sex and violence in the media, on social media, in the courtroom and through legislation. The discursive struggles over what constitutes "sexual violence", "victims" and "offenders" is normally determined through narratives: a selective ordering of events and participants. Centrally, the book investigates the social processes involved in the telling of stories of rape and its political implications. From a multidisciplinary feminist perspective, this volume explores what narratives about sexual violence are deemed legitimate at this historical juncture. This volume brings together feminist scholars working in a wide variety of disciplines including law, legal studies, history, gender studies, ethnology, media, criminology and social work from across the globe. Through situated empirical work, these scholars seek to understand currents movements between the criminal justice system and the cultural imagination

Anderson's ethical vulnerability: animating feminist responses to sexual violence

Pamela Sue Anderson argues for an ethical vulnerability which “activates an openness to becoming changed” that “can make possible a relational accountability to one another on ethical matters”. In this essay I pursue Anderson’s solicitation that there is a positive politics to be developed from acknowledging and affirming vulnerability. I propose that this politics is one which has a specific relevance for animating the terms of feminist responses to sexual violence, something which has proved difficult for feminist theorists and activists alike. I will demonstrate the contribution of Anderson’s work to such questions by examining the way in which “ethical vulnerability” as a framework can illuminate the intersectional feminist character of Tarana Burke’s grassroots Me Too movement when compared with the mainstream, viral version of the movement. I conclude by arguing that Anderson’s “ethical vulnerability” contains ontological insights which can allay both activist and academic concerns regarding how to respond to sexual violence