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"NEW SOUTH WALES"
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Protests, land rights and riots
The 1970s saw the Aboriginal people of Australia struggle for recognition of their postcolonial rights. Rural communities, where large Aboriginal populations lived, were provoked as a consequence of social fragmentation, unparalleled unemployment, and other major economic and political changes. The ensuing riots, protests, and law-and-order campaigns in New South Wales captured the tense relations that existed between indigenous people, the police, and the criminal justice system. InProtests, Land Rights, and Riots, Barry Morris shows how neoliberal policies in Australia targeted those who were least integrated socially and culturally, and who enjoyed fewer legitimate economic opportunities. Amidst intense political debate, struggle, and conflict, new forces were unleashed as a post-settler colonial state grappled with its past. Morris provides a social analysis of the ensuing effects of neoliberal policy and the way indigenous rights were subsequently undermined by this emerging new political orthodoxy in the 1990s.
eBook
Discovering Monaro ; a study of man's impact on his environment
'Discovering Monaro,' a fascinating local history of an Australian region, is at the same time a contribution to the current debate on the environment and man's manipulation of it.
Book
Male-Partner Treatment to Prevent Recurrence of Bacterial Vaginosis
The addition of combined oral and topical antimicrobial therapy for male partners to treatment of women for bacterial vaginosis resulted in a lower rate of recurrence within 12 weeks than treatment of the woman alone.
Journal Article
Investigating the effect of enhanced cleaning and disinfection of shared medical equipment on health-care-associated infections in Australia (CLEEN): a stepped-wedge, cluster randomised, controlled trial
There is a paucity of high-quality evidence based on clinical endpoints for routine cleaning of shared medical equipment. We assessed the effect of enhanced cleaning and disinfection of shared medical equipment on health-care-associated infections (HAIs) in hospitalised patients.
We conducted a stepped-wedge, cluster randomised, controlled trial in ten wards of a single hospital located on the central coast of New South Wales, Australia. Hospitals were eligible for inclusion if they were classified as public acute group A according to the Australian Institute of Health and Welfare, were located in New South Wales, had an intensive care unit, had a minimum of ten wards, and provided care for patients aged 18 years or older. Each cluster consisted of two randomly allocated wards (by use of simple randomisation), with a new cluster beginning the intervention every 6 weeks. Wards were informed of their allocation 2 weeks before commencement of intervention exposure, and the researcher collecting primary outcome data and audit data was masked to treatment sequence allocation. In the control phase, there was no change to environmental cleaning practices. In the intervention phase, a multimodal cleaning bundle included an additional 3 h per weekday for the dedicated cleaning and disinfection of shared medical equipment by 21 dedicated cleaning staff, with ongoing education, audit, and feedback. The primary outcome was the number of confirmed cases of HAI, as assessed by a fortnightly point prevalence survey and measured in all patients admitted to the wards during the study period. The completed trial is registered with Australia New Zealand Clinical Trials Registry (ACTRN12622001143718).
The hospital was recruited on July 31, 2022, and the study was conducted between March 20 and Nov 24, 2023. We assessed 220 hospitals for eligibility, of which five were invited to participate, and the first hospital to formally respond was enrolled. 5002 patients were included in the study (2524 [50·5%] women and 2478 [49·5%] men). In unadjusted results, 433 confirmed HAI cases occurred in 2497 patients (17·3%, 95% CI 15·9 to 18·8) in the control phase and 301 confirmed HAI cases occurred in 2508 patients (12·0%, 10·7 to 13·3) in the intervention phase. In adjusted results, there was a relative reduction of –34·5% (–50·3 to –17·5) in HAIs following the intervention (odds ratio 0·62, 95% CI 0·45 to 0·80; p=0·0006), corresponding to an absolute reduction equal to –5·2% (–8·2 to –2·3). No adverse effects were reported.
Improving the cleaning and disinfection of shared medical equipment significantly reduced HAIs, underscoring the crucial role of cleaning in improving patient outcomes. Findings emphasise the need for dedicated approaches for cleaning shared equipment.
National Health and Medical Research Council.
Journal Article
Esther : the extraordinary true story of the First Fleet girl who became first lady of the colony
\"Esther Abrahams was one of the first Jewish women to arrive in the new land. Through her we meet some of the key people who helped shape the nation. Her life is an extraordinary rags-to-riches story. Aged 16, she stood trial at the Old Bailey in London for stealing 24 yards of black silk lace. Her sentence was transportation to New South Wales. She embarked on the perilous journey on the First Fleet as a convict, with no idea of what lay ahead. Once on shore, she became the servant and, in time, the wife of the young first lieutenant George Johnston. Much like another, better-known colonial woman, Elizabeth Macarthur, Esther successfully managed her husband's property and became a significant figure in the new colony. George Johnston, her husband, as leader of the Rum Rebellion against Governor Bligh, appropriated the office of Lieutenant-Governor of NSW, making Esther First Lady of the colony, a remarkable rise in society for a former convict.\" -- Unedited summary from book.
Book
Use of dietary linoleic acid for secondary prevention of coronary heart disease and death: evaluation of recovered data from the Sydney Diet Heart Study and updated meta-analysis
Objective To evaluate the effectiveness of replacing dietary saturated fat with omega 6 linoleic acid, for the secondary prevention of coronary heart disease and death.Design Evaluation of recovered data from the Sydney Diet Heart Study, a single blinded, parallel group, randomized controlled trial conducted in 1966-73; and an updated meta-analysis including these previously missing data.Setting Ambulatory, coronary care clinic in Sydney, Australia.Participants 458 men aged 30-59 years with a recent coronary event.Interventions Replacement of dietary saturated fats (from animal fats, common margarines, and shortenings) with omega 6 linoleic acid (from safflower oil and safflower oil polyunsaturated margarine). Controls received no specific dietary instruction or study foods. All non-dietary aspects were designed to be equivalent in both groups.Outcome measures All cause mortality (primary outcome), cardiovascular mortality, and mortality from coronary heart disease (secondary outcomes). We used an intention to treat, survival analysis approach to compare mortality outcomes by group.Results The intervention group (n=221) had higher rates of death than controls (n=237) (all cause 17.6% v 11.8%, hazard ratio 1.62 (95% confidence interval 1.00 to 2.64), P=0.05; cardiovascular disease 17.2% v 11.0%, 1.70 (1.03 to 2.80), P=0.04; coronary heart disease 16.3% v 10.1%, 1.74 (1.04 to 2.92), P=0.04). Inclusion of these recovered data in an updated meta-analysis of linoleic acid intervention trials showed non-significant trends toward increased risks of death from coronary heart disease (hazard ratio 1.33 (0.99 to 1.79); P=0.06) and cardiovascular disease (1.27 (0.98 to 1.65); P=0.07).Conclusions Advice to substitute polyunsaturated fats for saturated fats is a key component of worldwide dietary guidelines for coronary heart disease risk reduction. However, clinical benefits of the most abundant polyunsaturated fatty acid, omega 6 linoleic acid, have not been established. In this cohort, substituting dietary linoleic acid in place of saturated fats increased the rates of death from all causes, coronary heart disease, and cardiovascular disease. An updated meta-analysis of linoleic acid intervention trials showed no evidence of cardiovascular benefit. These findings could have important implications for worldwide dietary advice to substitute omega 6 linoleic acid, or polyunsaturated fats in general, for saturated fats.Trial registration Clinical trials NCT01621087.
Journal Article
Trends and outcomes of postpartum haemorrhage, 2003-2011
Background
While rates of postpartum haemorrhage (PPH) have continued to rise, it is not clear if the association with other morbidity and transfusion has changed over time. This study explores the recent trend in postpartum haemorrhage and whether postpartum haemorrhage is associated with increased transfusions or adverse outcomes over time.
Methods
Linked birth and hospital data were used to examine ICD-10 AM coded PPH and outcomes in maternal birth admission records, 2003-–2011 in hospitals in New South Wales (NSW), Australia (
N
= 818,965 pregnancies). Trends were calculated on the whole population, and among subgroups, and tested using the Cochran Armitage test for trend. Logistic regression models were developed separately for vaginal and caesarean births, and for a maternal morbidity composite indicator (excluding transfusion) and red cell transfusion. Adjusted odds ratios (aOR) for each year relative to 2003 and 95 % confidence intervals (CI) are presented with adjustment for maternal (eg. age, country of birth) and pregnancy factors (eg. parity, interventions, pregnancy complications).
Results
Overall, there was a significant increase in the PPH rate, from 6.1 % in 2003 to 8.3 % in 2011 (
p
< 0.0001). Crude rates of postpartum haemorrhage with transfusion increased from 0.75 % (
n
= 636) to 1.21 % (
n
= 1145) (
p
< 0.0001) while crude rates of postpartum haemorrhage with maternal morbidity increased from 0.18 % (
n
= 149) to 0.23 % (
n
= 221) (
p
= 0.02). Having accounted for maternal and pregnancy factors, there were significant overall decreases in the odds of
morbidity
among women with a PPH delivering vaginally (in 2006, 2007 and 2010, aORs were 0.70 (95 % CI 0.52, 0.96) 0.69 (0.51, 0.94) and 0.64 (0.47, 0.87) relative to 2003;
p
< 0.05), and no significant decrease among women delivered by caesarean section (aOR 0.87 (0.58, 1.29) in 2011;
p
= 0.37). Among women with a PPH delivering vaginally, there was a trend towards a non-linear increase in the adjusted odds of transfusion by birth year. Compared to women who had vaginal births with PPH in 2003, the adjusted odds for transfusion was between 1.1 and 1.2 fold higher for those with a PPH delivering vaginally in 2007, 2009, 2010 and 2011. However there was no significant trend amongst caesarean births (aOR 0.84 (0.66, 1.06) in 2011;
p
= 0.29).
Conclusions
PPH has become more frequent, however this has not been associated with a clear pattern of increased severe maternal morbidity. This suggests that the increase in PPH may represent fewer severe haemorrhages, better management of severe haemorrhage or better recording of PPH. The increase in transfusions following vaginal births with PPH warrants further investigation.
Journal Article