Ear microbiota and middle ear disease: a longitudinal pilot study of Aboriginal children in a remote south Australian setting

Background Otitis media (OM) is a major disease burden in Australian Aboriginal children, contributing to serious long-term health outcomes. We report a pilot analysis of OM in children attending an outreach ear and hearing clinic in a remote south Australian community over a two-year period. Our study focuses on longitudinal relationships between ear canal microbiota characteristics with nasopharyngeal microbiota, and clinical and treatment variables. Results Middle ear health status were assessed in 19 children (aged 3 months to 8 years) presenting in remote western South Australia and medical interventions were recorded. Over the two-year study period, chronic suppurative OM was diagnosed at least once in 7 children (37%), acute OM with perforation in 4 children (21%), OM with effusion in 11 children (58%), while only 1 child had no ear disease. Microbiota analysis of 19 children (51 sets of left and right ear canal swabs and nasopharyngeal swabs) revealed a core group of bacterial taxa that included Corynebacterium, Alloiococcus, Staphylococcus, Haemophilus, Turicella, Streptococcus, and Pseudomonas. Within-subject microbiota similarity (between ears) was significantly greater than inter-subject similarity, regardless of differences in ear disease (p = 0.0006). Longitudinal analysis revealed changes in diagnosis to be associated with more pronounced changes in microbiota characteristics, irrespective of time interval. Ear microbiota characteristics differed significantly according to diagnosis (P (perm) = 0.0001). Diagnoses featuring inflammation with tympanic membrane perforation clustering separately to those in which the tympanic membrane was intact, and characterised by increased Proteobacteria, particularly Haemophilus influenzae, Moraxella catarrhalis, and Oligella. While nasopharyngeal microbiota differed significantly in composition to ear microbiota (P (perm) = 0.0001), inter-site similarity was significantly greater in subjects with perforated tympanic membranes, a relationship that was associated with the relative abundance of H. influenzae in ear samples (rs = − 0.71, p = 0.0003). Longitudinal changes in ear microbiology reflected changes in clinical signs and treatment. Conclusions Children attending the ear and hearing clinic in a remote Aboriginal community present with a broad spectrum of OM conditions and severities, consistent with other remote Aboriginal communities. Ear microbiota characteristics align with OM diagnosis and change with disease course. Nasopharyngeal microbiota characteristics are consistent with the contribution of acute upper respiratory infection to OM aetiology.

Being a safe place: a qualitative study exploring perceptions as to how a rural community hospice could respond to enactment of voluntary assisted dying legislation

Background There is a lack of research to guide the implementation of voluntary assisted dying legislation within a hospice setting. Furthermore, there is limited published information related to the expectations of the community and staff to assist decision making regarding voluntary assisted dying in a community hospice. The aim of this study was to explore the expectations of staff, volunteers and members of the community as how a rural Australian community hospice could respond in relation to imminent enactment of Voluntary Assisted Dying legislation. Methods A total of 63 Hospice staff and volunteers and community members participated in 11 workshops. This qualitative study used the interpretive description method to analyse the workshop transcripts. Results While there was not a consensus view on community expectation, there was agreement among the participants for respect for a patient’s individuality and choices. Furthermore, care offered in hospice needs to remain non-judgemental and patient focused regardless of whether voluntary assisted dying policy was implemented or not. Both opportunities and risks associated with implementation were identified by the participants. Conclusion There was common ground around the respect for the dying person and the ideal of a “safe place” despite opposing views on what this may mean in practice. There is a need for clarity in organisational responses around policy, risk management, education, and staff support.

Dobbing: Australia’s favourite emergency pastime

While ‘dobbing’ is arguably viewed negatively, this behaviour has been on the rise during the COVID-19 pandemic. Drawing on examples from the First World War and the pandemic, this article argues that this increased activity is typical of the Australian community during emergencies, facilitated by extensive legal frameworks that encourage this type of reporting.

Computational Analysis of Climate Performance for Improving Design Strategies at an Australian Community

Nightingale 1 is a well-designed, community-led building for owner-occupiers in Brunswick, Melbourne, which is continuously awarded as the top five of the most livable cities in the world. To identify sustainability aspects of the Nightingale 1, the study will not only investigate local topographic characteristics and solar performance but also demonstrate the advantages or disadvantages of the current design related to the solar analysis. Based on the analysis, the study will propose improvements of thermal comfort in the housing project.

Australian Community and Health Professionals Perceptions of Equine-Assisted Psychotherapy

Mental health conditions are increasingly prevalent in the Australian population, and despite the large evidence-based support for contemporary treatments, there are barriers which inhibit their efficacy. Thus, there is a perceived need for therapists to consider other therapeutic options which have potential to enhance treatment outcomes. There is increasing acceptance for complementary and alternative medicines (CAM) among general practitioners and clients/general community. Specifically, more than 70% of Australians utilize CAM. Equine-assisted psychotherapy (EAP) is an underutilized, culturally sensitive, complementary therapy, which has the potential to mitigate barriers of conventional therapy. The present study aimed to determine the level of knowledge about and general acceptance of EAP as a treatment for general psychopathology symptomology within community members and health professionals. The current sample included 144 community members and 55 health professionals, all with Australian citizenship. Data analysis comprised the independent t-test and two hierarchical multiple regressions. Results indicated that community members are significantly more accepting of EAP as a treatment compared to health professionals. Of the predictors tested, higher social support and openness within community members were significant predictors of accepting perceptions, and rural location was the only significant predictor for health professional’s accepting perceptions of EAP. This is one of the first studies to investigate perceptions of EAP outside the EAP field and through comparison between community members and health professionals. The current study identifies the need for future research to further investigate perceptions of EAP among Australian health professionals.

In their own words: Understanding Australians’ priority concerns regarding mental health in the context of COVID-19

The COVID-19 pandemic, as well as the recent bushfires and flash floods, have resulted in significant and unprecedented mental health impacts in Australia. Despite the known impacts, there is a paucity of research directly asking Australian community members about their mental health experiences and what they perceive to be the most important mental health issues in the context of the pandemic. This study utilises qualitative data from Alone Together, a longitudinal mixed-methods study investigating the effects of COVID-19 on mental health in an Australian community sample (N = 2,056). Of the 1,350 participants who completed the first follow-up survey, a total of 1,037 participants, who ranged in sex (69.9% female), age (M = 40-49 years), state/territory of residence, and socioeconomic status, shared responses to two open-ended questions regarding the most important issues for mental health in Australia and the impact of COVID-19 on their individual mental health. Responses were analysed using thematic analysis. Participants described COVID-19 as primarily impacting their mental health through the disruption it posed to their social world and financial stability. A key concern for participants who reported having poor mental health was the existence of multiple competing barriers to accessing good mental health care. According to participant responses, the pandemic had pressurized an already over-burdened mental health service system, leaving many without timely, appropriate support. Further absent or stigmatising rhetoric around mental health, at both a political and community level, also prevented participants from seeking help. Insights gained from the present research provide opportunities for policymakers and health practitioners to draw on the expertise of Australians’ lived experience and address priority issues through targeted policy planning. This could ultimately support a more responsive, integrated and effective mental health system, during and beyond the COVID-19 pandemic.

No Appetite for Change: Culture, Liberalism, and Other Acts of Depoliticization in the Australian Obesity Debate

There is wealth of evidence that points to the pernicious ways in which inequities in food, bodies, and health are disproportionally borne. Equally, there is a wealth of evidence that critiques the role of neoliberal imperatives for individuals to take responsibility for their health, and how this tenet reproduces inequity. However, health interventions and public policy remain immune to addressing social determinants of health and ignore the cultural dynamics of power in food systems, interventions, and policy. Drawing from ethnographic research in an Australian community that has high levels of socioeconomic disadvantage and obesity, and the Australian Government’s response to the ‘obesity epidemic’, this article examines the processes and tactics of depoliticization that are used to elide political and sociocultural phenomenon. I leverage the work of Brown and Povinelli to argue that liberalism’s hold on universalisms, autonomy, and individual liberty in obesity discourses subjugates a comprehension of political relations, positioning liberal principles and culture as mutually antagonistic. It is precisely this acultural positioning of liberalism that makes it possible to remove recognition of the power that produces and contours the ‘metabolic rift’ between food systems, public health, and equity priorities. In conclusion, I consider how obesity policy might be different if we paid attention to this culturalization of politics.

Racial animus and its association with punitive sentencing and crime types: Do Australian community attitudes reflect the United States’?

The racial animus model argues that public support for punitive sentencing of criminal offenders is shaped by threat perceptions associated with cultural minority groups. This study applies the racial animus model to examine support for the punitive sentencing of criminal offenders in the United States and Australia. It also examines whether racial animus mediates the possible difference in punitive attitudes between each country toward different crime types. Online survey data were obtained in the US and Australia to assess racial animus and punitive attitudes using six different crime scenarios. Results indicate that (a) individuals with higher levels of racial animus demonstrate greater levels of punitiveness; (b) Australians have higher levels of racial animus as compared to their US counterparts; and (c) racial animus mediates the difference of punitive attitudes between the two countries. Overall, punitive attitudes and racial animus vary cross-culturally, with Australians demonstrating more racial animus. Our mediation model provides evidence for the importance of racial animus in the cross-cultural demand for the punishment of criminal offenders.