Aboriginal Assimilation and Nyungar Health 1948-72

The policy of assimilation in mid-twentieth-century Australia holds a major place in the history of Aboriginal health. For the first time Australian governments endorsed equal citizenship for Aboriginal people with full access to mainstream medical and hospital services previously denied to them. After decades of neglect Aboriginal families could look forward to better health. Politicians were convinced that disparities in Aboriginal health would be readily assimilated into the profile of the general population. However, this case study of assimilation’s mainstreaming of health services for Nyungar people in Western Australia demonstrates that the outcome was a mix of significant advances and enduring legacies of discrimination. Improvements were frustrated by endemic racism, contested understandings of assimilation, and the government’s failure to meet its promises. A consequence was a legacy of suspicion and anxiety that continues to impact adversely on Nyungar health today

Marked bodies: a corporeal history of colonial Australia

Western imaginings about marked ‘primitive’ bodies have a long history, yet studies of these practices have remained largely a-historical. Drawing on recent scholarship addressing the history and cultural meanings of the corporeal surface of the Western body this paper presents a preliminary historical analysis of the remaking of Indigenous corporeal surfaces and subjectivities under colonialism in Australia as part of the nineteenth century ‘civilising project’

South West Aboriginal studies bibliography : with annotations and appendices

The south west of Western Australia was the first region of the state to experience the impact of European settlement, when the Swan River Colony was founded in 1829. Yet the Aborigines of this unique area have remained largely obscured in its history for almost a full 150 years. This is ironical, as their counterparts of the Pilbara, Goldfields and Kimberleys, feature prominently in literature, and have captured the imagination of artists, writers and academic researchers alike. There are several reasons for the neglect of the original inhabitants of the south west by observers of the day, and later by other scholars. Firstly, the number of Aborigines declined dramatically under the impact of European encroachment. Never very numerous, they achieved a population density no greater than one person to four square miles (Radcliffe-Brown 1930; Hallam 1977). In some centres in the early days of European settlement, this ratio may have increased. Aborigines became attracted to settled areas as they were made dependent on grain rations, with the usurpation of their own lands by the newcomers. Governor James Stirling estimated one person per square mile in the \u27settled\u27 districts in 1832 (Swan River Papers 9/36-39)

Patient-specific instrumentation does not improve radiographic alignment or clinical outcomes after total knee arthroplasty: A meta-analysis

Background and purpose: Patient-specific instrumentation (PSI) for total knee arthroplasty (TKA) has been introduced to improve alignment and reduce outliers, increase efficiency, and reduce operation time. In order to improve our understanding of the outcomes of patient-specific instrumentation, we conducted a meta-analysis. Patients and methods: We identified randomized and quasi-randomized controlled trials (RCTs) comparing patient-specific and conventional instrumentation in TKA. Weighted mean differences and risk ratios were determined for radiographic accuracy, operation time, hospital stay, blood loss, number of surgical trays required, and patient-reported outcome measures. Results: 21 RCTs involving 1,587 TKAs were included. Patient-specific instrumentation resulted in slightly more accurate hip-knee-ankle axis (0.3°), coronal femoral alignment (0.3°, femoral flexion (0.9°), tibial slope (0.7°), and femoral component rotation (0.5°). The risk ratio of a coronal plane outlier (\u3e 3° deviation of chosen target) for the tibial component was statistically significantly increased in the PSI group (RR = 1.64). No significance was found for other radiographic measures. Operation time, blood loss, and transfusion rate were similar. Hospital stay was significantly shortened, by approximately 8 h, and the number of surgical trays used decreased by 4 in the PSI group. Knee Society scores and Oxford knee scores were similar. Interpretation: Patient-specific instrumentation does not result in clinically meaningful improvement in alignment, fewer outliers, or better early patient-reported outcome measures. Efficiency is improved by reducing the number of trays used, but PSI does not reduce operation time

Effectiveness and costs of helicopter-based shooting of deer

Context: Helicopter-based shooting has been widely used to harvest deer or control overabundant populations in Australasia, but the effectiveness and cost of this method as a deer control tool has seldom been evaluated.Aims: We evaluated the effectiveness and costs of helicopter-based shooting of fallow deer (Dama dama) and chital deer (Axis axis) in eastern Australia by quantifying (1) reductions in density, (2) the relationship between numbers killed per hour and deer density (i.e. the functional response), (3) the costs of control and (4) the effort–outcome and cost–outcome relationships.Methods: We evaluated the costs and effectiveness of 12 aerial shooting operations aiming to reduce fallow deer (n = 8) or chital deer (n = 4) population densities at nine sites in eastern Australia. Sites were characterised by fragmented woodland, and all but one operation aimed to reduce grazing competition with livestock. We used pre-control population density estimates and operational monitoring data to estimate the costs and outcomes of each operation. We combined data from all operations to estimate the relationship between shooting effort and population reduction, as well as costs associated with different levels of effort.Key results: Population reductions for operations ranged from 5% to 75% for fallow deer, and from 48% to 88% for chital deer. The greatest population reductions occurred when effort per unit area was greatest, and the largest reductions in deer density occurred when shooting was conducted in consecutive years. The functional response of hourly kills to deer density was best described by a modified Ivlev model, with the asymptotic kill rate estimated to be 50 deer per hour. There was no support for the existence of a prey refuge, that is, a threshold population density below which no deer could be shot. Helicopter charter was the primary cost of helicopter-based shooting programs, followed by labour; firearm and ammunition costs were relatively minor.Conclusions: Helicopter-based shooting can rapidly reduce deer populations over large geographic areas, but the magnitude of the reduction depends on the effort (hours of shooting) per deer per km2.Implications: Aerial shooting operations should include a pre-control population survey so that (1) measurable objectives can be established, (2) the likely level of effort and cost required for objectives to be met can be estimated and planned for, and (3) the realised population reduction can be estimated

Delineating the autistic phenotype in children with neurofibromatosis type 1

Background Existing research has demonstrated elevated autistic behaviours in children with neurofibromatosis type 1 (NF1), but the autistic phenotype and its relationship to other neurodevelopmental manifestations of NF1 remains unclear. To address this gap, we performed detailed characterisation of autistic behaviours in children with NF1 and investigated their association with other common NF1 child characteristics. Methods Participants were drawn from a larger cross-sectional study examining autism in children with NF1. The population analysed in this study scored above threshold on the Social Responsiveness Scale-Second Edition (T-score ≥ 60; 51% larger cohort) and completed the Autism Diagnostic Interview-Revised (ADI-R) and/or the Autism Diagnostic Observation Schedule-Second Edition (ADOS-2). All participants underwent evaluation of their intellectual function, and behavioural data were collected via parent questionnaires. Results The study cohort comprised 68 children (3–15 years). Sixty-three per cent met the ADOS-2 ‘autism spectrum’ cut-off, and 34% exceeded the more stringent threshold for ‘autistic disorder’ on the ADI-R. Social communication symptoms were common and wide-ranging, while restricted and repetitive behaviours (RRBs) were most commonly characterised by ‘insistence on sameness’ (IS) behaviours such as circumscribed interests and difficulties with minor changes. Autistic behaviours were weakly correlated with hyperactive/impulsive attention deficit hyperactivity disorder (ADHD) symptoms but not with inattentive ADHD or other behavioural characteristics. Language and verbal IQ were weakly related to social communication behaviours but not to RRBs. Limitations Lack of genetic validation of NF1, no clinical diagnosis of autism, and a retrospective assessment of autistic behaviours in early childhood. Conclusions Findings provide strong support for elevated autistic behaviours in children with NF1. While these behaviours were relatively independent of other NF1 comorbidities, the importance of taking broader child characteristics into consideration when interpreting data from autism-specific measures in this population is highlighted. Social communication deficits appear similar to those observed in idiopathic autism and are coupled with a unique RRB profile comprising prominent IS behaviours. This autistic phenotype and its relationship to common NF1 comorbidities such as anxiety and executive dysfunction will be important to examine in future research. Current findings have important implications for the early identification of autism in NF1 and clinical management

Aboriginal and Torres Strait Islander Suicide in Context

Aboriginal and Torres Strait Islander suicide has been an issue of national public health and mental health concern for only one decade, having increased dramatically from levels that were very low in the late 1980s to levels of young adult male suicide that are now substantially higher than for the non-indigenous population. In this review the authors socially and historically contextualize these changes, identifying the causal frameworks adopted in developing interventions, and present an explanation in narrative and pictorial form that draws on critical family-centered trauma