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\"Long before space travel was possible, the idea of life beyond Earth transfixed humans. In this fascinating book, astronomer Jon Willis explores the science of astrobiology and the possibility of locating other life in our own galaxy. Describing the most recent discoveries by space exploration missions, including the Kepler space telescope, the Mars Curiosity rover, and the New Horizons probe, Willis asks readers to imagine--and choose among--five scenarios for finding life. He encourages us to wonder whether life might exist within Mars's subsoil ice. He reveals the vital possibilities on the water ice moons Europa and Enceladus. He views Saturn's moon Titan through the lens of our own planet's ancient past. And he even looks beyond our solar system, investigating the top candidates for a \"second Earth\" in a myriad of exoplanets and imagining the case of a radio signal arriving from deep space. Covering the most up-to-date research, this accessibly written book provides readers with the basic knowledge necessary to decide where they would look for alien life.\"-- Dust jacket.

Background Clinical pathways are tools used to guide evidence-based healthcare that have been implemented internationally since the 1980s. However, there is widespread lack of agreement on the impact of clinical pathways on hospital resources and patient outcomes. This can be partially attributed to the confusion for both researchers and healthcare workers regarding what constitutes a clinical pathway. This paper describes efforts made by a team of Cochrane Review authors to develop criteria to assist in the objective identification of clinical pathway studies from the literature. Methods We undertook a four-stage process aiming to develop criteria to define a clinical pathway: (1) identify publications exploring the definition of a clinical pathway; (2) derive draft criteria; (3) pilot test the criteria; and (4) modify criteria to maximise agreement between review authors. Results Previous literature and liaison with the European Pathways Association resulted in five criteria being used to define a clinical pathway: (1) the intervention was a structured multidisciplinary plan of care; (2) the intervention was used to translate guidelines or evidence into local structures; (3) the intervention detailed the steps in a course of treatment or care in a plan, pathway, algorithm, guideline, protocol or other 'inventory of actions'; (4) the intervention had timeframes or criteria-based progression; and (5) the intervention aimed to standardise care for a specific clinical problem, procedure or episode of healthcare in a specific population. After pilot testing it was decided that if an intervention met the first criteria (a structured multidisciplinary plan of care) plus three out of the other four criteria then it was included as a clinical pathway for the purposes of this review. In all, 27 studies were included in the final review. The authors of the included studies referred to these interventions as 'clinical pathways', 'protocols', 'care model', 'care map', 'multidisciplinary care', evidence-based care' and 'guideline'. Conclusions The criteria used for the identification of relevant studies for this Cochrane Review can be used as a foundation for the development of a standardised, internationally accepted definition of a clinical pathway.

An astronomer explores the science of astrobiology in this \" serious but accessible examination of the prospects for finding life elsewhere in the universe\" (Sean Carroll, author of  The Big Picture ). Describing the most recent discoveries made with space exploration technology, including the Kepler space telescope, the Mars  Curiosity rover, and the  New Horizons probe, astronomer Jon Willis asks readers to consider five possible scenarios for finding extraterrestrial life. He reviews what we know and don't know about the life-sustaining potential of Mars's subsoil ice and the water-ice moons Europa and Enceladus. He also looks at Saturn's moon Titan through the lens of our own planet's ancient past. In this concise yet far-reaching volume, Willis even looks beyond our solar system, investigating the top candidates for a \"second Earth\" in a myriad of exoplanets.   \"Through humorous, concise, accessible writing, Willis eloquently presents the growing—though still circumstantial—evidence that we are not alone.\"— Publishers Weekly (starred review)

The notion of sport as a cultural offset has gained great popularity over the past few decades as a symbol of self-determination and empowerment for Indigenous peoples in Australia. This article involves an examination of Indigenous ways of using sport to culturally offset the effects of colonization from Indigenous perspectives. As such, this account offers insights into the elements that encompass Indigenous resistance: racial injustice; the enactment of a sometimes-negative oppositional culture; cultural maintenance; the reformulation of a positive Indigenous identity; the development of Indigenous political movements; and resistance to sport as a weapon in the arsenal of colonization. This consideration of sport as a site of resistance against the hegemony of the State is informed by Indigenous voices, including that of the first Author, so as to offer a more nuanced understanding of the intersections between sport, development, and Indigenous peoples in Australia.

Background This study describes chlamydia and gonorrhoea testing, positivity, treatment, and retesting among individuals aged ≥15years attending an urban Aboriginal Community Controlled Health Service during the period 2016-2021. Method Utilising routinely collected clinical data from the ATLAS program (a national sentinel surveillance network), a retrospective time series analysis was performed. The study assessed testing rates, positivity, treatment efficacy, retesting and trends over time within an urban Aboriginal Community Controlled Health Service. Results Testing rates for chlamydia and gonorrhoea varied between 10 and 30% over the study period, and were higher among clients aged 15-29years and among females. Positivity rates for both infections varied by age, with clients aged 15-24years having higher positivity than older clients. Gonorrhoea positivity rates decreased after 2016. Treatment and retesting practices also showed sex disparities, with men having a slightly higher treatment rate within 7days, whereas females had significantly higher retesting rates within 2-4months, indicating differences in follow-up care between sexes. Conclusion The study emphasises the need for clinical and public health interventions within urban Aboriginal and Torres Strait Islander populations to further reduce chlamydia and gonorrhoea. Prioritising improved access to testing, timely treatment and consistent retesting can significantly contribute to lowering STI prevalence and enhancing sexual health outcomes in these communities.

Background People living in rural Australia are more likely to die in hospital following an acute myocardial infarction than those living in major cities. While several factors, including time taken to access hospital care, contribute to this risk, it is also partially attributable to the lower uptake of evidence-based guidelines for the administration of thrombolytic drugs in rural emergency departments where up to one-third of eligible patients do not receive this life-saving intervention. Clinical pathways have the potential to link evidence to practice by integrating guidelines into local systems, but their impact has been hampered by variable implementation strategies and sub-optimal research designs. The purpose of this study is to determine the impact of a five-step clinical pathways implementation process on the timely and efficient administration of thrombolytic drugs for acute myocardial infarctions managed in rural Australian emergency departments. Methods/Design The design is a two-arm, cluster-randomised trial with rural hospital emergency departments that treat and do not routinely transfer acute myocardial infarction patients. Six rural hospitals in the state of Victoria will participate, with three in the intervention group and three in the control group. Intervention hospitals will participate in a five-step clinical pathway implementation process: engagement of clinicians, pathway development according to local resources and systems, reminders, education, and audit and feedback. Hospitals in the control group will each receive a hard copy of Australian national guidelines for chest pain and acute myocardial infarction management. Each group will include 90 cases to give a power of 80% at 5% significance level for the two primary outcome measures: proportion of those eligible for thrombolysis receiving the drug and time to delivery of thrombolytic drug. Discussion Improved compliance with thrombolytic guidelines via clinical pathways will increase acute myocardial infarction survival rates in rural hospitals and thereby help to reduce rural-urban mortality inequalities. Such knowledge translation has the potential to be adapted for a range of clinical problems in a wide array of settings. Trial registration Australia New Zealand Clinical Trials Registry code ACTRN12608000209392.

Background To gain an understanding of chlamydia (CT) and gonorrhoea (NG) testing conducted within an annual health check (AHC) and in standard clinical consultations for clients aged 15-29years attending an urban Aboriginal Community Controlled Health Service in the period 2016-2021. Methods De-identified electronic medical record data were extracted and analysed on CT and NG testing by sex, age, Indigenous status and the context of testing (conducted within an AHC or not). An access, testing, and diagnosis cascade for CT and NG, inclusive of an AHC, was constructed. Results Combined testing within an AHC and outside an AHC for CT and NG ranged between 30 and 50%, except for the year 2021. Males were twice as likely to receive a CT and NG test within an AHC consultation as females. Females were almost equally likely to have a CT and NG test, both as part of an AHC consult and during other clinical consultations. Females had the highest CT positivity in 2018 (11%) and 2019 (11%), with a dip in 2020 (5%), whereas NG diagnoses remained stable at 2%. Conclusion The study demonstrates the potential of the AHC to facilitate greater coverage of CT and NG testing in an urban Aboriginal Community Controlled Health Service. Screening conducted within an AHC alongside screening in clinical consultations might be enough to reduce CT prevalence over a sustained period.

This paper describes findings from fieldwork conducted among Pitjantjatjara tribespeople of Central Australia between 1989 and 1997. The study examined the impact of a distinctive gender system and practices of masculinity, particularly sexual and ritual practices, on the risk of contracting sexually transmissible infections and other blood-borne diseases. The research was designed as an ethnography of masculinity, conducted via participant observation, life history interviews, ritual analysis, and critical reflection on the work of early ethnographers. The paper presents selected field data, examined in the light of early twentieth century anthropological description of Pitjantjatjara sexuality. It identifies a systematic deflection of male same-sex attraction away from possible resolution through sexual practices between men. Key components of this deflection are the ritual construction of a culturally distinctive masculinity, the inextricable linkage between masculinity rites and the system for arranging marriages, and the cultural coding of the penis during ritual. The paper concludes that although men may feel erotic attraction for each other, the gender and kinship systems of the Pitjantjatjara conspire to limit completely the possibilities for the physical, sexual expression of this attraction. The findings reported here add to our understanding of the cultural basis of heteronormativity.

This paper reports on ethnographic research on the culture-specific barriers that masculinity poses to preventing HIV transmission in the sexual lives of Pitjantjatjara men. The investigation had three objectives: Investigating how the Pitjantjatjara people model the physical and social development of adult male bodies; describing the nature, range and cultural dynamics of sexual practice among Pitjantjatjara men; and delineating health and infection risks posed by sexual practice. The study used classical ethnographic approaches to investigate the deployment of men's bodies within systems of cultural production and reproduction, and post-Foucauldian analysis to examine culture-specific technologies of the self. Data were collected using participant observation, key informant interviews, and sexual life history interviews. Key findings are that the Pitjantjatjara deploy the capacities for reproduction and pleasure of men's bodies in culturally specific ways, and that men are trained in culturally approved uses of these capacities in ways that are resistant to change. The introduction of safe sex technologies in this context requires close attention to the specific content and methods by which men's self understandings are developed. Cet article rend compte d'une recherche ethnographique sur les obstacles spécifiquement culturels à la prévention du VIH dans la vie sexuelle des hommes pitjantjatjara, liés à la masculinité. La recherche avait trois objectifs: examiner comment le peuple pitjantjatjara modélise le développement physique et social du corps adulte masculin; décrire la nature, la gamme et la dynamique culturelle des pratiques sexuelles chez les hommes pitjantjatjara; et déterminer les risques pour la santé auxquels exposent ces pratiques. L'étude a employé des approches ethnographiques classiques pour enquêter sur le développement des corps masculins dans des systèmes de production et de reproduction culturelles, et une analyse post-foucaldienne pour examiner les technologies spécifiques à la culture du moi. Les données proviennent d'une observation participante, d'entretiens avec des informateurs clé, et d'entretiens centrés sur les récits de vie sexuelle. Le résultat principal de l'étude est que les Pitjantjatjara développent les capacités des corps masculins à la reproduction et au plaisir de manière spécifiquement culturelle, et que les hommes sont formés à des usages culturellement approuvés de ces capacités, résistants aux changements. L'introduction de méthodes de sexe sans risque dans ce contexte requiert une attention particulière vis à vis du contenu et des méthodes spécifiques par lesquels la compréhension du moi se développe chez ces hommes. En este documento se reporta un estudio etnográfico en el que se analizaron los obstáculos culturales que plantea la masculinidad para prevenir la transmisión del virus del sida en la vida sexual de los hombres de etnia Pitjantjatjara. La investigación tenía tres objetivos: estudiar que tipo de modelo tiene el pueblo Pitjantjatjara para el desarrollo físico y social de los cuerpos de hombres adultos; describir la dinámica cultural, la naturaleza y el alcance de las prácticas sexuales entre los hombres Pitjantjatjara; y definir los riesgos de infección y a la salud de las prácticas sexuales. Los enfoques etnográficos clásicos utilizados en este estudio sirvieron para investigar qué uso se hace de los cuerpos masculinos dentro de los sistemas de producción y reproducción cultural y examinar, según un análisis post-foucauldianos, las tecnologías específicamente culturales del Yo. Se recabaron datos a partir de la observación de participante, entrevistas a informantes claves y entrevistas sobre relatos de la vida sexual. Los resultados principales muestran que los Pitjantjatjara utilizan las capacidades reproductoras y el placer de los cuerpos masculinos de una manera determinada por su cultura y que los hombres están educados para hacer un uso, culturalmente aprobado, de esas capacidades, de formas que son muy difíciles cambiar. En este contexto, cuando se trata de introducir técnicas que aseguren relaciones sexuales sin riesgos hay que prestar atención al contenido y a los métodos específicos por los que se desarrollan la autoconciencia de los hombres.

Abstract Background: Complementary and alternative medicines (CAMs) are being used increasingly across the world. In Australia, community pharmacists are a major supplier of these products but knowledge of the products and interactions with other medicines is poor. Information regarding the use of CAMs by metropolitan pharmacists has been documented by the National Prescribing Service (NPS) in Australia but the views of rural/regional community pharmacists have not been explored. The aim of this pilot study was to explore the knowledge, attitudes and information seeking of a cohort of rural community pharmacists towards CAMs and to compare the findings to the larger NPS study. Methods: A cross sectional self-administered postal questionnaire was mailed to all community pharmacists in one rural/regional area of Australia. Using a range of scales, data was collected regarding attitudes, knowledge, information seeking behaviour and demographics. Results: Eighty eligible questionnaires were returned. Most pharmacists reported knowing that they should regularly ask consumers if they are using CAMs but many lacked the confidence to do so. Pharmacists surveyed for this study were more knowledgeable in regards to side effects and interactions of CAMs than those in the NPS survey. Over three quarters of pharmacists surveyed reported sourcing CAM information at least several times a month. The most frequently sought information was drug interactions, dose, contraindications and adverse effects. A variety of resources were used to source information, the most popular source was the internet but the most useful resource was CAM text books. Conclusions: Pharmacists have varied opinions on the use of CAMs and many lack awareness of or access to good quality CAMs information. Therefore, there is a need to provide pharmacists with opportunities for further education. The data is valuable in assisting interested stakeholders with the development of initiatives to address the gaps in attitudes, knowledge and to improve effectiveness of information seeking behaviour.