The Quest for Integration: Australian Approaches to Security and Development in the Pacific Islands

With the deployment of the Regional Assistance Mission to Solomon Islands in July 2003, the former Howard Government initiated its robust new engagement with Australia's Pacific island neighbours. Interventions with an initial security focus have been portals to broader and ambitious state-building exercises. The quest to integrate security and development agendas lies at the heart of 'the new interventionism'. This article examines the evolution and character of this approach, as well as reviewing its implementation in the two case studies of Solomon Islands (RAMSI) and Papua New Guinea (ECP). It also discusses the significance for Australia/Pacific relations of the recent change of government in Canberra and the differences (and similarities) to be anticipated under Prime Minister Rudd's Labor Government

Leadership models in the Pacific

"This discussion paper seeks to provide an overview of the anthropological and other relevant literature on leadership in the Pacific. It also examines the ways in which cultural understandings of leadership penetrate contemporary institutions and considers the intersections between local leadership practices and the requirements of good governance. The review is presented in four main sections. Section one examines the key concepts of culture, leadership and good governance. Section two outlines the ways in which these concepts are employed in Melanesia, Polynesia and Micronesia, and section three demonstrates the intersections between local practices of leadership and the requirements of good governance. In conclusion, section four suggests practical measures for the development of Pacific leadership programs. The author draws upon her first hand knowledge of the Pacific, particularly Melanesia, in order to contextualise the literature and highlight key issues ..."- page 1AusAI

Aspects of conflict in the contemporary Papua New Guinea Highlands

To the foreign observer, Papua New Guinea is readily associated with violent gang crime, tribal fighting and electoral violence. In the Highlands region, high-powered weapons render tribal fighting increasingly problematic, particularly in provinces hosting large-scale resource extraction operations such as Southern Highlands Province and Enga. This discussion paper, based on presentations made to an AusAID seminar, provides an overview of aspects of conflict in the contemporary Papua New Guinea Highlands. Beginning in the Southern Highlands, Weiner explores the nature of conflict in areas surrounding the Kutubu Oil Project, examining not only contemporary land disputes, but also the cultural milieu in which they occur. Moving to Enga, Yala investigates the similarities and differences between ‘traditional’ and contemporary conflict in the Highlands, drawing primarily upon his personal experiences of conflict in Enga. McLeod then provides perspectives on conflict in Simbu Province, with a particular focus upon the nature of ‘social rules’ in that area. Collectively, these essays, all of which are based upon the authors’ extensive experiences in Papua New Guinea, seek to provide an insight into the nature of contemporary conflict in the Papua New Guinea Highlands.AusAI

Politicking and voting in the highlands: the 2002 Papua New Guinea national elections

This discussion paper contains three studies relating to the 2002 National Elections in Papua New Guinea (PNG). Drawing upon firsthand observations and fieldwork experience, the authors focus on aspects of the elections in Enga, Southern Highlands and Simbu Provinces respectively. They each discuss the extent to which the elections were democratic, describe how election campaigns and polls were conducted, analyse ongoing or emergent trends and consider the implications of these for future elections.AusAI

Perceptions of Professionals, Faculty, and Students Regarding the Implementation of an Agricultural Communications Degree Program in the United Kingdom

The purpose of this study was to determine the perceptions of professionals, faculty, and students regarding the implementation of an agricultural communications degree program in the United Kingdom (U.K). It aimed to gather detailed opinions to aid in the planning of future agricultural communications curricula in the U.K., where no formal academic programs in this discipline exist in higher education. This study used a qualitative approach in the form of interviews to gain in-depth opinions on four different research objectives. Participants were pooled from three different demographic groups in the U.K: industry professionals, faculty, and students. These stakeholder expressed that writing and journalistic skills were extremely important for agricultural communications graduates to possess. Interpersonal skills were also useful. A generalized knowledge of agriculture was preferred. The study found that experiential learning placements would be a beneficial addition to a potential program, and those could be customized to fit the needs of the student. It also found that degree programs in the discipline would fit well into a bachelor’s or master’s program, or single modules could be integrated into existing programs in related disciplines. Recommendations of the study focused on the layout of a potential degree program. They also focused on conducting further research on potential placement opportunities and on the impact an agricultural communications degree program could have on females in agriculture

In search of stool donors: a multicenter study of prior knowledge, perceptions, motivators, and deterrents among potential donors for fecal microbiota transplantation

Introduction: Fecal microbiota transplantation (FMT) is a highly effective therapy for recurrent Clostridium difficile infection. Stool donors are essential, but difficult to recruit and retain. We identified factors influencing willingness to donate stool.Methods: A 32-item questionnaire targeted young adults and health care workers via social media and university email lists in Edmonton and Kingston, Canada; London and Nottingham, England; and Indianapolis and Boston, USA. Items included baseline demographics and FMT knowledge and perception. Investigated motivators and deterrents included economic compensation, screening process, time commitment, and stool donation logistics. Logistic regression and linear regression models estimated associations of study variables with self-assessed willingness to donate stool.Results: 802 respondents completed our questionnaire: 387 (48.3%) age 21–30 years, 573 (71.4%) female, 323 (40%) health care workers. Country of residence, age and occupation were not associated with willingness to donate stool. Factors increasing willingness to donate were: already a blood donor (OR 1.64), male, altruism, economic benefit, knowledge of how FMT can help patients (OR 1.32), and positive attitudes towards FMT (OR 1.39). Factors decreasing willingness to donate were: stool collection unpleasant (OR 0.92), screening process invasive (OR 0.92), higher donation frequency, negative social perceptions of stool, and logistics of collecting/transporting feces.Discussion: Blood donors and males are more willing to consider stool donation. Altruism, economic compensation, and positive feedback are motivators. Screening process, high donation frequency, logistics of collecting/transporting feces, lack of public awareness, and negative social perception are deterrents. Considering these variables could maximize donor recruitment and retention

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Effect of remote ischaemic conditioning on clinical outcomes in patients with acute myocardial infarction (CONDI-2/ERIC-PPCI): a single-blind randomised controlled trial.

BACKGROUND: Remote ischaemic conditioning with transient ischaemia and reperfusion applied to the arm has been shown to reduce myocardial infarct size in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). We investigated whether remote ischaemic conditioning could reduce the incidence of cardiac death and hospitalisation for heart failure at 12 months. METHODS: We did an international investigator-initiated, prospective, single-blind, randomised controlled trial (CONDI-2/ERIC-PPCI) at 33 centres across the UK, Denmark, Spain, and Serbia. Patients (age >18 years) with suspected STEMI and who were eligible for PPCI were randomly allocated (1:1, stratified by centre with a permuted block method) to receive standard treatment (including a sham simulated remote ischaemic conditioning intervention at UK sites only) or remote ischaemic conditioning treatment (intermittent ischaemia and reperfusion applied to the arm through four cycles of 5-min inflation and 5-min deflation of an automated cuff device) before PPCI. Investigators responsible for data collection and outcome assessment were masked to treatment allocation. The primary combined endpoint was cardiac death or hospitalisation for heart failure at 12 months in the intention-to-treat population. This trial is registered with ClinicalTrials.gov (NCT02342522) and is completed. FINDINGS: Between Nov 6, 2013, and March 31, 2018, 5401 patients were randomly allocated to either the control group (n=2701) or the remote ischaemic conditioning group (n=2700). After exclusion of patients upon hospital arrival or loss to follow-up, 2569 patients in the control group and 2546 in the intervention group were included in the intention-to-treat analysis. At 12 months post-PPCI, the Kaplan-Meier-estimated frequencies of cardiac death or hospitalisation for heart failure (the primary endpoint) were 220 (8·6%) patients in the control group and 239 (9·4%) in the remote ischaemic conditioning group (hazard ratio 1·10 [95% CI 0·91-1·32], p=0·32 for intervention versus control). No important unexpected adverse events or side effects of remote ischaemic conditioning were observed. INTERPRETATION: Remote ischaemic conditioning does not improve clinical outcomes (cardiac death or hospitalisation for heart failure) at 12 months in patients with STEMI undergoing PPCI. FUNDING: British Heart Foundation, University College London Hospitals/University College London Biomedical Research Centre, Danish Innovation Foundation, Novo Nordisk Foundation, TrygFonden