Journal articles on the topic 'Preventive Victoria Melbourne'

Sir Frank Macfarlane Burnet was born in Traralgon, Victoria, in 1899. He received his medical degree in 1924 from the University of Melbourne and performed research (1925-27) at the Lister Institute of Preventive Medicine, London. After receiving his PhD from the University of London (1928), Burnet ? usually known as Mac ? became Assistant Director of the Walter and Eliza Hall Institute of Medical Research at Royal Melbourne Hospital. From 1944-65 he was Director of the Institute and Professor of Experimental Medicine at the University of Melbourne.

The aims of the present study were to understand enablers to participation in postgraduate education for primary care nurses (PCNs), and to explore how postgraduate education has advanced their nursing practice. Cross-sectional questionnaires were mailed out in April 2012 to current and past students undertaking postgraduate studies in primary care nursing at The University of Melbourne, Victoria, Australia. Questionnaires were returned by 100 out of 243 nurses (response rate 41%). Ninety-one per cent (91/100) of the respondents were first registered as nurses in Australia. Fifty-seven per cent were hospital trained and 43% were university educated to attain their initial nurse qualification. The respondents reported opportunities to expand scope of practice (99%; 97/98), improve clinical practice (98%; 97/99), increase work satisfaction (93%; 91/98) and increase practice autonomy (92%; 89/97) as factors that most influenced participation in postgraduate education in primary care nursing. Major enablers for postgraduate studies were scholarship access (75%; 71/95) and access to distance education (74%; 72/98). Many respondents reported an increased scope of practice (98%; 95/97) and increased job satisfaction (71%; 70/98) as an education outcome. Only 29% (28/97) cited an increase in pay-rate as an outcome. Of the 73 PCNs currently working in general practice, many anticipated an increase in time spent on the preparation of chronic disease management plans (63%; 45/72), multidisciplinary care plans (56%; 40/72) and adult health checks (56%; 40/72) in the preceding 12 months. Recommendations emerging from findings include: (1) increased access to scholarships for nurses undertaking postgraduate education in primary care nursing is imperative; (2) alternative modes of course delivery need to be embedded in primary care nursing education; (3) the development of Australian primary care policy, including policy on funding models, needs to more accurately reflect the educational level of PCNs, PCN role expansion and the extent of interprofessional collaboration that is evident from research undertaken to date. Nurses with postgraduate education have the potential to increase their scope of practice, take on a greater teaching role and provide more preventive and chronic disease services in primary care. Policies aimed at increasing access to education for nurses working in primary care would strengthen the primary care nursing profession, and enhance the delivery of primary health care services in Australia.

This article explores the role that elite sport has played in the State Government of Victoria’s (Australia) neoliberal agenda of creating an environment conducive to commercial activity. Adopting an urban entrepreneurial approach of selling the ‘city’ as an attractive place for cross-border investment, the state government has strategically invested public funds into major sporting events in Melbourne. Four specific sporting events were examined: i) construction and redevelopments of ‘Melbourne Park’ to host the Australian Open Tennis Championships; ii) hosting the 2006 Commonwealth Games; iii) acquisition of the Australian Formula One Grand Prix and continued political, corporate and media support for the event; and iv) construction of an urban football stadium. Newspaper reports and parliament transcripts between 1984 and 2014 were collected to highlight issues of contest in the ‘sport city’ in conjunction with a thematic analysis of interviews with influential cultural producers of the ‘sport city’ – most notably state premiers, members of parliament, CEOs of public sports trusts and newspaper journalists. Findings illustrate that the Victorian state has successively re-regulated a neoliberal urban entrepreneurial strategy, often preventing dissident groups from resisting neoliberal activities, and that in Melbourne sport operates as ‘cultural glue’ to establish the logic of neoliberalism in an embodied sense.

IntroductionSystems science methodologies have been used in attempts to address the complex and dynamic causes of childhood obesity with varied results. This paper presents a protocol for the Reflexive Evidence and Systems interventions to Prevention Obesity and Non-communicable Disease (RESPOND) trial. RESPOND represents a significant advance on previous approaches by identifying and operationalising a clear systems methodology and building skills and knowledge in the design and implementation of this approach among community stakeholders.Methods and analysisRESPOND is a 4-year cluster-randomised stepped-wedge trial in 10 local government areas in Victoria, Australia. The intervention comprises four stages: catalyse and set up, monitoring, community engagement and implementation. The trial will be evaluated for individuals, community settings and context, cost-effectiveness, and systems and implementation processes. Individual-level data including weight status, diet and activity behaviours will be collected every 2 years from school children in grades 2, 4 and 6 using an opt-out consent process. Community-level data will include knowledge and engagement, collaboration networks, economic costs and shifts in mental models aligned with systems training. Baseline prevalence data were collected between March and June 2019 among >3700 children from 91 primary schools.Ethics and disseminationEthics approval: Deakin University Human Research Ethics Committee (HREC 2018-381) or Deakin University’s Faculty of Health Ethics Advisory Committee (HEAG-H_2019-1; HEAG-H 37_2019; HEAG-H 173_2018; HEAG-H 12_2019); Victorian Government Department of Education and Training (2019_003943); Catholic Archdiocese of Melbourne (Catholic Education Melbourne, 2019-0872) and Diocese of Sandhurst (24 May 2019). The results of RESPOND, including primary and secondary outcomes, and emerging studies developed throughout the intervention, will be published in the academic literature, presented at national and international conferences, community newsletters, newspapers, infographics and relevant social media.Trial registration numberACTRN12618001986268p.

ObjectivesCompensable injury increases the likelihood of having persistent pain after injury. Three-quarters of patients report chronic pain after traumatic injury, which is disabling for about one-third of patients. It is important to understand why these patients report disabling pain, in order to develop targeted preventative interventions. This study examined the experience of pain and disability, and investigated their sequential interrelationships with, catastrophising, kinesiophobia and self-efficacy 1 year after compensable and non-compensable injury.DesignObservational registry-based cohort study.SettingMetropolitan Trauma Service in Melbourne, Victoria, Australia.ParticipantsParticipants were recruited from the Victorian State Trauma Registry and Victorian Orthopaedic Trauma Outcomes Registry. 732 patients were referred to the study, 82 could not be contacted or were ineligible, 217 declined and 433 participated (66.6% response rate).Outcome measuresThe Brief Pain Inventory, Glasgow Outcome Scale, EuroQol Five Dimensions questionnaire, Pain Catastrophising Scale, Pain Self-Efficacy Questionnaire, Injustice Experience Questionnaire and the Tampa Scale of Kinesiophobia.MethodsDirect and indirect relationships (via psychological appraisals of pain/injury) between baseline characteristics (compensation, fault and injury characteristics) and pain severity, pain interference, health status and disability were examined with ordinal, linear and logistic regression, and mediation analyses.ResultsInjury severity, compensable injury and external fault attribution were consistently associated with moderate-to-severe pain, higher pain interference, poorer health status and moderate-to-severe disability. The association between compensable injury, or external fault attribution, and disability and health outcomes was mediated via pain self-efficacy and perceived injustice.ConclusionsGiven that the associations between compensable injury, pain and disability was attributable to lower self-efficacy and higher perceptions of injustice, interventions targeting the psychological impacts of pain and injury may be especially necessary to improve long-term injury outcomes.

IntroductionSmoke-free policies have been introduced in prisons internationally. However, high rates of relapse to smoking after release from prison indicate that these policies typically result in short-term smoking cessation only. These high rates of relapse, combined with a lack of investment in relapse prevention, highlight a missed opportunity to improve the health of a population who smoke tobacco at two to six times the rate of the general population. This paper describes the rationale and design of a randomised controlled trial, testing the effectiveness of a caseworker-delivered intervention promoting smoking cessation among former smokers released from smoke-free prisons in Victoria, Australia.Methods and analysisThe multicomponent, brief intervention consists of behavioural counselling, provision of nicotine spray and referral to Quitline and primary care to promote use of government-subsidised smoking cessation pharmacotherapy. The intervention is embedded in routine service delivery and is administered at three time points: one prerelease and two postrelease from prison. Control group participants will receive usual care. Smoking abstinence will be assessed at 1 and 3 months postrelease, and confirmed with carbon monoxide breath testing. Linkage of participant records to survey and routinely collected administrative data will provide further information on postrelease use of health services and prescribed medication.Ethics and disseminationEthical approval has been obtained from the Corrections Victoria Research Committee, the Victorian Department of Justice Human Research Ethics Committee, the Department of Human Services External Request Evaluation Committee and the University of Melbourne Human Research Ethics Committee. Results will be submitted to major international health-focused journals. In case of success, findings will assist policymakers to implement urgently needed interventions promoting the maintenance of prison-initiated smoking abstinence after release, to reduce the health disparities experienced by this marginalised population.Trial registration numberACTRN12618000072213; Pre-results.

Words not only describe and define events, but also describe and define those who use them. Recent media coverage of the rescue of an American Air Force Captain from Serb-held Northern Bosnia, and the slaughter of a family in Melbourne by a severely disturbed man used the term ‘Rambo’ for both stories. In the same newspaper, the activities of child molesters in Asia were described under the heading ‘Child love’. The importance of the words used to describe assaults on children was recognised in a recent Victorian Crime Prevention committee report.

Introduction: Burns fuelled by petrol are a major cause of injury in Australia and New Zealand. The same quality of explosive ignition that makes petrol so valuable as a fuel can cause injuries when handled carelessly or used for a purpose for which it was not intended. Methods: This was a retrospective cohort study that examined the epidemiology of patients admitted to the Victorian Adult Burns Service (VABS) based at the Alfred Hospital, Melbourne. Data were extracted from the VABS Database on patients presenting over a seven-year period, between 1st July 2009 to 30th June 2016. Results: During the study period, 378 out of 1927 burns (19.6%) admissions were related to petrol use. Males aged 20 – 29 years were most at risk, contributing to 25.4% of petrol related burn injuries. A large portion of burns, 31.0%, occurred during a leisure activity. The mean total body surface area burnt in this cohort was 19.3% and surgery was required in 70.4% of cases. Petrol related burns injuries is estimated to cost AU$ 5,484,834 annually and had a mortality rate of 7.4%. Conclusion: Misuse of petrol contributed to a substantial injury burden to Victorians. Raising community awareness through preventive strategies targeted at high-risk groups of at-risk behaviours is warranted to reduce the incidence of petrol related burn injuries.

Family violence is endemic. It has a dramatic and negative impact upon the victims and the family systems in which it occurs. While there is a growing evidence base to support our understanding, prevention and treatment of family violence, little is known about some of its “hidden victims” (e.g., kinship carers). In 2017, Baptcare commenced research with 101 kinship carers in Victoria to gain a better understanding of how family violence, perpetrated by the child's close family member once the placement started, was impacting on children and families. In this context, family violence means any act of physical violence, emotional/psychological violence, verbal abuse and property damage. The study utilised a mixed design methodology that specifically targeted kinship carers who had direct experience of family violence. Findings from this study demonstrated that (1) many kinship carers, and the children in their care, experienced family violence early in the placement, (2) that the violence occurred frequently and (3) the incidents of violence did not occur in isolation. Carers sought support from multiple sources to deal with the family violence, however, the study illustrated that the usefulness of these supports varied. Additionally, findings highlighted reasons why many kinship carers felt reluctant to file a report to end the violence. The study described in this paper is the first step in understanding and exposing this multifaceted issue and delineates some of the major issues confronting Victorian kinship carers experiencing family violence – and the support required to ensure the safety of them and the children they care for. This paper will describe the approach that Baptcare is taking to address family violence in kinship care in western metropolitan Melbourne. This is the second paper in a three-part series relating to family violence in kinship care.

Background: To determine the prevalence of chlamydia and understand sexual risk behaviour in 16–29 year olds in rural Victoria through a chlamydia testing program undertaken at local sporting clubs. Methods: Young people were recruited from the Loddon Mallee region of Victoria, Australia between May and September 2007. After a night of sporting practice, participants provided a first pass urine sample and completed a brief questionnaire about sexual risk behaviour. Those positive for chlamydia were managed by telephone consultation with a practitioner from Melbourne Sexual Health Centre. Results: A total of 709 young people participated (77% male, 23% female) in the study; 77% were sexually active. Overall chlamydia prevalence in sexually active participants was 5.1% (95% confidence interval [CI]: 3.4–7.3); 7.4% in females (95% CI: 3.5–13.6) and 4.5% in males (95% CI: 2.7–6.9). Approximately 60% of males and 20% of females consumed alcohol at high ‘Risky Single Occasion Drinking’ levels at least weekly and 60% had used an illicit drug in their lifetime. Nearly 45% reported having sex in the past year when they usually wouldn’t have because they were too drunk or high. Sexually transmissible infection (STI) knowledge was generally poor and only 25% used a condom the last time they had sex. Conclusion: Chlamydia prevalence was high in our study population. Many participants had poor knowledge about STIs and low condom use. These findings combined with high levels of risky alcohol use and having sex while intoxicated highlights the need for programs in rural and regional Victoria that combine both STI testing and prevention and education programs.

Background Tuberculosis preventive treatment (TPT) is strongly recommended for children following infection with Mycobacterium tuberculosis because of their high risk of progression to active tuberculosis, including severe disseminated disease. We describe the implementation of TPT for children and adolescents with evidence of tuberculosis infection (TBI) at Victoria’s largest children’s hospital and examine factors affecting treatment completion. Methods We conducted a retrospective clinical audit of all children and adolescents aged <18 years diagnosed with latent TBI at the Royal Children’s Hospital, Melbourne, between 2010 and 2016 inclusive. The primary outcome was treatment completion, defined as completing TPT to within one month of a target duration for the specified regimen (for instance, at least five months of a six-month isoniazid course), confirmed by the treating clinician. Factors associated with treatment adherence were evaluated by univariate and multivariate analysis. Results Of 402 participants with TBI, 296 (74%) met the criteria for treatment “complete”. The most common TPT regimen was six months of daily isoniazid (377, 94%). On multivariate logistic regression analysis, treatment completion was more likely among children and adolescents who had refugee health screening performed (OR 2.31, 95%CI 1.34–4.00) or who were also treated for other medical conditions (OR 1.67 95%CI 1.0–2.85), and less likely among those who experienced side-effects (OR 0.32, 95%CI 0.11–0.94). However, TPT was generally well tolerated with side-effects reported in 15 participants (3.7%). Conclusion Identification of factors associated with TPT completion and deficiencies in the existing care pathway have informed service provision changes to further improve outcomes for Victorian children and adolescents with TBI.

Objectives: Patients with chronic mental illnesses constitute an important risk group for HIV infection overseas. This study aimed to determine the prevalence of risk behaviours associated with HIV transmission and factors associated with HIV testing in psychiatric patients in Melbourne. Methods: Inpatients and outpatients completed an interviewer-administered questionnaire which covered demographics, psychiatric diagnosis, risk behaviour, and HIV education and testing. Results: Of 145 participants, 60% were male and 55.2% had schizophrenia. Injecting drug use (IDU) was reported by 15.9%, a figure approximately 10 times that found in other population surveys. Most patients reported sex in the last decade and over 20% had multiple sexual partners in the last year. Of males, 12.6% reported sex with another male (9.2% anal sex); 19.0% of females reported sex with a bisexual male. Nearly half of the males reported sex with a prostitute, 2.5 times that in a population sample. Only 15.9% reported ever having someone talk to them specifically about HIV and its transmission, although one-third had been tested for HIV. In multivariate analysis, male-male sex, paying for sex, and IDU were associated with HIV testing, but those whose primary language was not English were less likely to be tested. Those who had received HIV education were more likely to have used a condom last time they had sex (OR 4.52, 95%C11.49–14.0). Conclusions: This study provides evidence that those with serious mental illness in Victoria have higher rates of participation in risk behaviour for HIV infection than those in the general community. Attention to HIV education and prevention in this group has been inappropriately scant; strategies to encourage safer behaviour are urgently needed.

Despite the best efforts and commitment of oral health programs, there is no evidence that the current surgical output-based model of oral health care is delivering better oral health outcomes to the community. In fact, Australian evidence indicates the oral health of the community could be getting worse. It is now well-understood that this traditional surgical model of oral health care will never successfully manage the disease itself. It is proposed that a health-promoting, minimally invasive oral disease management model of care may lead to a sustainable benefit to the oral health status of the individual and community groups. The aim of this paper is to describe such a model of oral health care (MoC) currently being implemented by the North Richmond Community Health Oral Health (NRCH-OH) program in Melbourne, Victoria, Australia; this model may serve as a template for other services to re-orient their healthcare delivery towards health promotion and prevention. The paper describes the guiding principles and theories for the model and also its operational components, which are: pre-engagement while on the waitlist; client engagement at the reception area; the assessment phase; oral health education (high-risk clients only); disease management; and reviews and recall.

Background The characteristics associated with incident hepatitis B (HBV) infection in HIV-positive individuals are not well described in the Australian setting. The aim of this study is to determine the characteristics of and risk factors for HBV infection within HIV-infected individuals in a Melbourne cohort between 1985 and 2011. Methods: Individuals susceptible to HBV at their HIV diagnosis were identified using their HBV serology stored within the Victorian HIV database. Within this group, those who had a subsequent positive test for hepatitis B surface antigen or hepatitis B core antibody were identified as infected with HBV after their HIV diagnosis. Incident cases were matched with controls from the initially susceptible group who did not seroconvert for analysis. An incidence rate was calculated from the number of seroconversions and the cumulative time at risk (in 1000 patient-years of follow-up). Results: Of the 4711 patients with HIV seen more than once, 3223 had HBV testing. Of the 174 with positive HBV test results, 39 individuals met the definition of seroconversion after HIV diagnosis, representing the incident cases. The estimated HBV incidence rate was 1.81 (95% confidence interval: 1.28–2.47) per 1000 patient-years at risk. These individuals form the basis of a detailed case series and case–control study. Data collected include demographic details, immunological and virological characteristics, antiretroviral treatment and vaccination history. Conclusions: HIV-infected individuals should be screened for HBV and monitored for incident infection. Optimal control of HIV and improved vaccination coverage provide the best opportunity for prevention.

Aim. Receiving professional help early can reduce long-term harms associated with substance use. However, little is known about the factors that influence help-seeking for substance use problems during early-mid adolescence, prior to the emergence of disorder. Given that beliefs regarding help-seeking are likely to develop early, understanding adolescent views of help-seeking during this period is likely to provide important information for prevention and intervention efforts. The current study identifies perceptions that would facilitate or prevent adolescents from seeking support for substance use problems from formal and informal help sources. Method. Thirty-four 12- to 16-year-olds from two schools in Melbourne, Victoria, Australia, were recruited. A qualitative interpretative design was used, incorporating semistructured, audio-recorded interviews. Results. Three overlapping themes that reflected barriers or enablers to help-seeking were identified: approachability, confidentiality and trustworthiness, and expertise. Help-seeking was facilitated when adolescents believed that the help source would be supportive and understanding, would keep information confidential, and had expertise in the alcohol and drug field. Conversely, adolescents were reluctant to seek help from sources they believed would be judgmental, lacked expertise, or would inform their parents. Conclusions. These findings highlight perceptions that may influence help-seeking for alcohol and drug problems during adolescence. Further research is needed to determine if help-seeking can be facilitated by improving parents’ and peers’ knowledge and promoting health professionals’ expertise in working with young people’s alcohol and drug issues.

A key part of native forest management in designated wood production areas is identifying locations which must be exempt from logging. Forest laws, government regulations, and codes of practice specify where logging is and is not permitted. Assessing compliance with these regulations is critical but can be expensive and time consuming, especially if it entails field measurements. In some cases, spatial data products may help reduce the costs and increase the transparency of assessing compliance. However, different spatial products can vary in their accuracy and resolution, leading to uncertainty in forest management. We present the results of a detailed case study investigating the compliance of logging operations with laws preventing cutting on slopes exceeding 30°. We focused on two designated water catchments in the Australian State of Victoria which supply water to the city of Melbourne. We compared slopes that had been logged on steep terrain using spatial data based on a Digital Elevation Model (DEM) derived from LiDAR, a 1 arc second DEM derived from the Shuttle Radar Topography Mission, and a Digital Terrain Model (DTM) with a resolution of 10m. While our analyses revealed differences in slope measurements among the different spatial products, all three datasets (and the on-site slope measurements) estimated the occurrence of widespread logging of forests on slopes >30° in both water catchments. We found the lowest resolution Shuttle Radar Topography Mission DEM underestimated the steepness of slopes, whilst the DTM was variable in its estimates. As expected, the LiDAR generated slope calculations provided the best fit with on-site measurements. Our study demonstrates the value of spatial data products in assessing compliance with logging laws and codes of practice. We suggest that LiDAR DEMs, and DTMs also can be useful in proactive forest planning and management by helping better identify which areas should be exempt from cutting before logging operations commence.

Abstract Sleep disturbances in women with and without polycystic ovary syndrome (PCOS) and their association with lifestyle factors (diet, physical activity and sitting time) Bennett C1, Mansfield DR2, Mo L2, Hodge A3, Joham A4, 5, Cain SW6, Blumfield M1, Teede H4, 5, Moran LJ4 1. Be Active Sleep and Eat (BASE) Facility, Department of Nutrition and Dietetics, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria 2. Monash Lung and Sleep, Monash Health, Clayton, Victoria 3. Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria 4. Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria 5. Diabetes and Vascular Medicine Unit, Monash Health, Clayton, Victoria 6. Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Clayton, Victoria Sleep disturbances are a risk factor for poorer lifestyle behaviours. While PCOS is associated with a higher prevalence of sleep disturbances, the relationship between sleep and lifestyle behaviours is unknown in PCOS. Self-reported data from the Australian Longitudinal Study on Women’s Health young cohort (31–36 years, n=6067, n=464 PCOS, n=5603 non-PCOS) were collected on PCOS, anthropometry, physical activity, sedentary behaviour, diet (74-item validated food frequency questionnaire) and sleeping behaviour (sleep quantity and adverse sleep symptoms). Multivariate regression models controlled for sleeping behaviour, BMI, age, marital status, education, income and area of residence. Women with PCOS reported greater adverse sleep symptoms, higher energy intake, diet quality (dietary guidelines index (DGI)), fibre intake and sedentary time and lower glycaemic index, compared to women without PCOS. This was not maintained for energy intake and sedentary behaviour on adjustment for confounders. For diet quality, there was an interaction between PCOS and sleep disturbances. Only for women with fewer sleep disturbances (~8 hours sleep/no adverse sleep symptoms) was PCOS associated with better diet quality (DGI higher by 3.14±0.86, p&lt;0.001), with no differences in diet quality for women with poorer sleep. Lifestyle behaviours in women with PCOS appear to be influenced by sleep quality and quantity. Nothing to disclose: CB, DM, LM, AH, AJ, SC, MB, HT, LM

The Australian Asthma Conference held this year in Melbourne, was hosted by the Asthma Foundation of Victoria. The conference attracted over 300 participants from all states and internationally, and was headed by a range of keynote speakers representing national and international leaders in the various aspects of asthma management from prevention through to clinical care. Participants included the full spectrum of health professionals, with a large number of asthma educators represented.

Background: Research has indicated the neuroprotective potential of the Mediterranean diet. Adherence to the Mediterranean diet has shown preventative potential for Alzheimer’s disease incidence and prevalence, yet few studies have investigated the impact of Mediterranean diet adherence on the hallmark protein; beta-amyloid. Objectives: To investigate the association between Mediterranean diet adherence and beta-amyloid deposition in a cohort of healthy older Australian women. Design: This study was a cross-sectional investigation of participants from the longitudinal, epidemiologically sourced Women’s Healthy Ageing Project which is a follow-up of the Melbourne Women’s Midlife Health Project. Setting: Assessments were conducted at the Centre for Medical Research, Royal Melbourne Hospital in Melbourne, Australia. F-18 Florbetaben positron emission tomography scanning was conducted at the Austin Centre for PET in Victoria, Australia. Participants: One hundred and eleven Women’s Healthy Ageing Project participants were included in the study. Measurements: Mediterranean diet adherence scores for all participants were calculated from the administration of a validated food frequency questionnaire constructed by the Cancer Council of Victoria. Beta-amyloid deposition was measured using positron emission tomography standardised uptake value ratios. Results: Gamma regression analysis displayed no association between Mediterranean diet adherence and beta-amyloid deposition. This result was consistent across APOE-ε4 +/- cohorts and with the inclusion of covariates such as age, education, body mass index and cognition. Conclusions: This study found no association between adherence to the Mediterranean diet and beta-amyloid deposition in a cohort of healthy Australian women.

Abstract Purpose Rail level crossing removals to improve transport performance across metropolitan Melbourne (state of Victoria) resulted in new rail fencing and grade-separation of tracks from the surrounding environment at several sites. These design changes restricted pedestrian access to the rail tracks, which is a countermeasure known to prevent railway suicide in other settings. We examined whether any such suicide prevention effect followed the removals. Methods We used a multiple-arm pre-post design to test whether a decrease in monthly frequency of railway suicides occurred at level crossing removal sites (intervention sites), compared to randomly matched sites where level crossings had not yet been removed (control sites). We used data available in the Victorian Suicide Register covering the period 1st January 2008 to 30th June 2021. Results The mean monthly number of railway suicides decreased by 68% within a 500 m radius of intervention sites (RR: 0.32; CI 95% 0.11–0.74) and by 61% within a 1000 m radius of intervention sites (RR: 0.39; CI 95% 0.21–0.68). There was no evidence that the mean monthly number of railway suicides changed at the control sites, either within a 500 m radius (RR: 0.88; CI 95% 0.47–1.56) or a 1000 m radius (RR: 0.82; CI 95% 0.52–1.26). Conclusion The reduction in railway suicides at locations where level crossings were removed, demonstrates the suicide prevention benefits that can be derived from a major infrastructure project even if not initially intended. Planning for major infrastructure projects should include consideration of these benefits, with designs incorporating features to maximise suicide prevention impact.

Introduction: Stroke utilizes a large portion of hospital resources. Little is known about the frequency of contacts with hospitals prior to first-ever stroke and potentially missed opportunities for stroke prevention. In addition, re-admissions may indicate failed secondary prevention. Hypothesis: Many patients have had a presentation or admission to hospital in the year prior to a first-ever stroke event. Methods: Data from the prospective, national Australian Stroke Clinical Registry (AuSCR) obtained between 15 June 2009 and 31 December 2010 from a large hospital in Melbourne, Victoria (Australia) were linked to the Victorian government emergency department (ED) and hospital discharge datasets for a 3 year ‘look-back’ period and any re-presentation up until February 2011 using stepwise deterministic linkage methods. Descriptive statistics are presented. Results: Matched linkage to ED (731/788) and hospital discharge (736/788) datasets was achieved in 93% of AuSCR registrants, of whom 513 were first-ever strokes (51% male, average age 74 [±16] years, 82% ischemic). Prior to the first-ever stroke, 221 (47%) registrants had ED presentations and 283 had a hospital admission on average 2.9 months before stroke. The mean number of ED presentations within 3 years of AuSCR registration for a first-ever event was 2.1 (SD 1.6); and 48/466 (10%) occurred in the month prior to stroke. Among first-ever stroke registrants, 200 were re-admitted on average within 5 months following discharge; 3.5% for recurrent stroke/TIA. Conclusion: Contact with hospitals was common (~50%) before first stroke, raising opportunities to screen and intervene in people at risk of stroke. As one in 5 hospital re-admissions is for recurrent stroke, a closer monitoring of secondary prevention measures in the early post-discharge period may be warranted.

AbstractRecognition is increasing globally that urban planning interventions to improve neighbourhood liveability enable healthy sustainable lifestyles and assist in the prevention and management of chronic disease. We present the spatial urban liveability index (ULI) as a tool to inform localised interventions that would create healthier, more sustainable cities and examine its associations with cardiometabolic and wellbeing-related health outcomes. The ULI and associated indicators were calculated for Melbourne address points and spatially linked with health outcomes for participants from the 2014 Victorian Population Health Survey. Residing in higher liveability areas was found to be positively associated with a more physically active lifestyle and negatively associated with BMI—more so than for a comparable walkability index. Although walkable neighbourhoods underpin a liveable city, areas with diverse ‘community, culture and leisure’ destinations displayed strongest beneficial associations with cardiometabolic health outcomes, suggesting that access to diverse local destinations may encourage more active sustainable living.

Pressure injuries (PIs) substantively impact quality of care during hospital stays, although only when they are severe or acquired as a result of the hospital stay are they reported as quality indicators. Globally, researchers have repeatedly highlighted the need to invest more in quality improvement, risk assessment, prevention, early detection, and care for PI to avoid the higher costs associated with treatment of PI. Coders' perspectives on quality assurance of the clinical coded PI data have never been investigated. This study aimed to explore challenges that hospital coders face in accurately coding and reporting PI data and subsequently, explore reasons why data sources may vary in their reporting of PI data. This article is based upon data collected as part of a multi-phase collaborative project to build capacity for optimizing PI prevention across Monash Partners health services. We have conducted 16 semi-structured phone interviews with clinical coders recruited from four participating health services located in Melbourne, Australia. One of the main findings was that hospital coders often lacked vital information in clinicians' records needed to code PI and report quality indicators accurately and highlighted the need for quality improvement processes for PI clinical documentation. Nursing documentation improvement is a vital component of the complex capacity building programs on PI prevention in acute care services and is relied on by coders. Coders reported the benefit of inter-professional collaborative workshops, where nurses and coders shared their perspectives. Collaborative workshops had the potential to improve coders' knowledge of PI classification and clinicians' understanding of what information should be included when documenting PI in the medical notes. Our findings identified three methods of quality assurance were important to coders to ensure accuracy of PI reporting: (1) training prior to initiation of coding activity and (2) continued education, and (3) audit and feedback communication about how to handle specific complex cases and complex documentation. From a behavioral perspective, most of the coders reported confidence in their own abilities and were open to changes in coding standards. Transitioning from paper-based to electronic records highlighted the need to improve training of both clinicians and coders.

Abstract Background Certain migrant groups are at an increased risk of psychotic disorders compared to the native-born population; however, research to date has mainly been conducted in Europe. Less is known about whether migrants to other countries, with different histories and patterns of migration, such as Australia, are at an increased risk for developing a psychotic disorder. We tested this for first-generation migrants in Melbourne, Victoria. Methods This study included all young people aged 15–24 years, residing in a geographically-defined catchment area of north western Melbourne who presented with a first episode of psychosis (FEP) to the Early Psychosis Prevention and Intervention Centre (EPPIC) between 1 January 2011 and 31 December 2016. Data pertaining to the at-risk population were obtained from the Australian 2011 Census and incidence rate ratios were calculated and adjusted for age, sex and social deprivation. Results In total, 1220 young people presented with an FEP during the 6-year study period, of whom 24.5% were first-generation migrants. We found an increased risk for developing psychotic disorder in migrants from the following regions: Central and West Africa (adjusted incidence rate ratio [aIRR] = 3.53, 95% CI 1.58–7.92), Southern and Eastern Africa (aIRR = 3.06, 95% CI 1.99–4.70) and North Africa (aIRR = 5.03, 95% CI 3.26–7.76). Migrants from maritime South East Asia (aIRR = 0.39, 95% CI 0.23–0.65), China (aIRR = 0.25, 95% CI 0.13–0.48) and Southern Asia (aIRR = 0.44, 95% CI 0.26–0.76) had a decreased risk for developing a psychotic disorder. Conclusion This clear health inequality needs to be addressed by sufficient funding and accessible mental health services for more vulnerable groups. Further research is needed to determine why migrants have an increased risk for developing psychotic disorders.

Abstract Objective: To assess the price promotions offered by major quick service restaurant (QSR) chains in Australia from an obesity prevention perspective. Design: Cross-sectional audit of ten of the largest QSR chains in Australia. We collected information regarding temporary price promotions and ‘combination deals’ offered by each chain over thirteen consecutive weeks in 2019–2020. We assessed the type of promotions, the magnitude of discount, and the energy content and healthiness of items promoted (based on Victorian Government criteria). Setting: Melbourne, Australia. Participants: Ten major QSR chains. Results: Temporary price promotions (n 196) and combination deals (n 537 on regular menus, n 36 on children’s menus) were observed across the ten selected QSR chains. In relation to temporary price promotions, the mean magnitude of discount for main menu items (n 75) was 41·7 %. The price reductions and energy content of combination deals varied substantially the by chain, the meal size and the sides/drinks selected as part of the ‘deal’. When the lowest-energy options (e.g. small chips, small sugar-free drink) were included as part of each combination deal, the mean energy content was 2935 kJ, compared to 5764 kJ when the highest-energy options (e.g. large fries, large sugar-sweetened drink) were included. Almost all available products were classified as unhealthy. Conclusion: Price promotions are ubiquitous in major QSR chains in Australia and provide incentives to consume high levels of energy. The action to restrict price promotions on unhealthy foods and ensure lower-energy default items as part of combination deals should be included as part of efforts to improve population diets and address obesity in Australia.

Abstract Background The emergency department has been a major focus for the implementation of Australia’s national electronic health record, known as My Health Record. However, the association between use of My Health Record in the emergency department setting and patient care is largely unknown. The aim of this study was to explore the perspectives of emergency department clinicians regarding My Health Record use frequency, the benefits of My Health Record use (with a focus on patient care) and the barriers to use. Methods All 393 nursing, pharmacy, physician and allied health staff employed within the emergency department at a tertiary metropolitan public hospital in Melbourne were invited to participate in a web-based survey, between 1 May 2021 and 1 December 2021, during the height of the Delta and Omicron Covid-19 outbreaks in Victoria, Australia. Results Overall, the survey response rate was 18% (70/393). Approximately half of the sample indicated My Health Record use in the emergency department (n = 39, 56%, confidence interval [CI] 43–68%). The results showed that users typically only engaged with My Health Record less than once per shift (n = 15, 39%, CI 23–55%). Just over half (n = 19/39, 54%, CI 32–65%) of all participants who use My Health Record agreed they could remember a time when My Health Record had been critical to the care of a patient. Overall, clinicians indicated the biggest barrier preventing their use of My Health Record is that they forget to utilise the system. Conclusion The results suggest that My Health Record has not been adopted as routine practice in the emergency department, by the majority of participants. Close to half of self-identified users of My Health Record do not associate use as being critical to patient care. Instead, My Health Record may only be used in scenarios that clinicians perceive will yield the greatest benefit—which clinicians in this paper suggest is patients with chronic and complex conditions. Further research that explores the predictors to use and consumers most likely to benefit from use is recommended—and strategies to socialise this knowledge and educate clinicians is desperately required.

“There is nothing more public than privacy.” (Berlant and Warner, Sex) How did it come to this? How did it happen that a one-off, two-hour event at a public swimming pool in a suburb of outer Melbourne ignited international hate mail and generated media-fanned political anguish and debate about the proper use of public spaces? In 2010, women who attend a women’s only swim session on Sunday evenings at the Dandenong Oasis public swimming pool asked the pool management and the local council for permission to celebrate the end of Ramadan at the pool during the time of their regular swim session. The request was supported by the pool managers and the council and promoted by both as an opportunity for family and friends to get together in a spirit of multicultural learning and understanding. Responding to criticisms of the event as an unreasonable claim on public facilities by one group, the Mayor of the City of Greater Dandenong, Jim Memeti, rejected claims that this event discriminates against non-Muslim residents of the suburb. But here’s the rub. The event, to be held after hours at the pool, requires all participants older than ten years of age to follow a dress code of knee-length shorts and T-shirts. This is a suburban moment that is borne of but exceeds the local. It reflects and responds to a contemporary global conundrum of great political and theoretical significance—how to negotiate and govern the relations between multiculturalism, religion, gender, sexual freedom, and democracy. Specifically this event speaks to how multicultural democracy in the public sphere negotiates the public presence and expression of different cultural and religious frameworks related to gender and sexuality. This is demanding political stuff. Situated in the messy political and theoretical terrains of the relation between public space and the public sphere, this local moment called for political judgement about how cultural differences should be allowed to manifest in and through public space, giving consideration to the potential effects of these decisions on an inclusive multicultural democracy. The local authorities in Dandenong engaged in an admirable process of democratic labour as they puzzled over how to make decisions that were responsible and equitable, in the absence of a rulebook or precedents for success. Ultimately however this mode of experimental decision-making, which will become increasingly necessary to manage such predicaments in the future, was foreclosed by unwarranted and unhelpful media outrage. "Foreclosed" here stresses the preemptive nature of the loss; a lost opportunity for trialing approaches to governing cultural diversity that may fail, but might then be modified. It was condemned in advance of either success or failure. The role of the media rather than the discomfort of the local publics has been decisive in this event.This Multicultural SuburbDandenong is approximately 30 kilometres southeast of central Melbourne. Originally home to the Bunorong People of the Kulin nation, it was settled by pastoralists by the 1800s, heavily industrialised during the twentieth century, and now combines cultural diversity with significant social disadvantage. The City of Greater Dandenong is proud of its reputation as the most culturally and linguistically diverse municipality in Australia. Its population of approximately 138,000 comprises residents from 156 different language groups. More than half (56%) of its population was born overseas, with 51% from nations where English is not the main spoken language. These include Vietnam, Cambodia, Sri Lanka, India, China, Italy, Greece, Bosnia and Afghanistan. It is also a place of significant religious diversity with residents identifying as Buddhist (15 per cent) Muslim (8 per cent), Hindu (2 per cent) and Christian (52 per cent) [CGD]. Its city logo, “Great Place, Great People” evokes its twin pride in the placemaking power of its diverse population. It is also a brazen act of civic branding to counter its reputation as a derelict and dangerous suburb. In his recent book The Bogan Delusion, David Nichols cites a "bogan" website that names Dandenong as one of Victoria’s two most bogan areas. The other was Moe. (p72). The Sunday Age newspaper had already depicted Dandenong as one of two excessively dangerous suburbs “where locals fear to tread” (Elder and Pierik). The other suburb of peril was identified as Footscray.Central Dandenong is currently the site of Australia’s largest ever state sponsored Urban Revitalisation program with a budget of more than $290 million to upgrade infrastructure, that aims to attract $1billion in private investment to provide housing and future employment.The Cover UpIn September 2010, the Victorian and Civil and Administrative Appeals Tribunal (VCAT) granted the YMCA an exemption from the Equal Opportunity Act to allow a dress code for the Ramadan event at the Oasis swimming pool that it manages. The "Y" sees the event as “an opportunity for the broader community to learn more about Ramadan and the Muslim faith, and encourages all members of Dandenong’s diverse community to participate” (YMCA Ramadan). While pool management and the municipal council refer to the event as an "opening up" of the closed swimming session, the media offer a different reading of the VCAT decision. The trope of the "the cover up" has framed most reports and commentaries (Murphy; Szego). The major focus of the commentaries has not been the event per se, but the call to dress "appropriately." Dress codes however are a cultural familiar. They exist for workplaces, schools, nightclubs, weddings, racing and sporting clubs and restaurants, to name but a few. While some of these codes or restrictions are normatively imposed rather than legally required, they are not alien to cultural life in Australia. Moreover, there are laws that prohibit people from being meagerly dressed or naked in public, including at beaches, swimming pools and so on. The dress code for this particular swimming pool event was, however, perceived to be unusual and, in a short space of time, "unusual" converted to "social threat."Responses to media polls about the dress code reveal concerns related to the symbolic dimensions of the code. The vast majority of those who opposed the Equal Opportunity exemption saw it as the thin edge of the multicultural wedge, a privatisation of public facilities, or a denial of the public’s right to choose how to dress. Tabloid newspapers reported on growing fears of Islamisation, while the more temperate opposition situated the decision as a crisis of human rights associated with tolerating illiberal cultural practices. Julie Szego reflects this view in an opinion piece in The Age newspaper:the Dandenong pool episode is neither trivial nor insignificant. It is but one example of human rights laws producing outcomes that restrict rights. It raises tough questions about how far public authorities ought to go in accommodating cultural practices that sit uneasily with mainstream Western values. (Szego)Without enquiring into the women’s request and in the absence of the women’s views about what meaning the event held for them, most media commentators and their electronically wired audiences treated the announcement as yet another alarming piece of evidence of multicultural failure and the potential Islamisation of Australia. The event raised specific concerns about the double intrusion of cultural difference and religion. While the Murdoch tabloid Herald Sun focused on the event as “a plan to force families to cover up to avoid offending Muslims at a public event” (Murphy) the liberal Age newspaper took a more circumspect approach, reporting on its small vox pop at the Dandenong pool. Some people here referred to the need to respect religions and seemed unfazed by the exemption and the event. Those who disagreed thought it was important not to enforce these (dress) practices on other people (Carey).It is, I believe, significant that several employees of the local council informed me that most of the opposition has come from the media, people outside of Dandenong and international groups who oppose the incursion of Islam into non-Islamic settings. Opposition to the event did not appear to derive from local concern or opposition.The overwhelming majority of Herald Sun comments expressed emphatic opposition to the dress code, citing it variously as unAustralian, segregationist, arrogant, intolerant and sexist. The Herald Sun polled readers (in a self-selecting and of course highly unrepresentative on-line poll) asking them to vote on whether or not they agreed with the VCAT exemption. While 5.52 per cent (512 voters) agreed with the ruling, 94.48 per cent (8,760) recorded disagreement. In addition, the local council has, for the first time in memory, received a stream of hate-mail from international anti-Islam groups. Muslim women’s groups, feminists, the Equal Opportunity Commissioner and academics have also weighed in. According to local reports, Professor of Islamic Studies at the University of Melbourne, Shahram Akbarzadeh, considered the exemption was “nonsense” and would “backfire and the people who will pay for it will be the Muslim community themselves” (Haberfield). He repudiated it as an example of inclusion and tolerance, labeling it “an effort of imposing a value system (sic)” (Haberfield). He went so far as to suggest that, “If Tony Abbott wanted to participate in his swimwear he wouldn’t be allowed in. That’s wrong.” Tasneem Chopra, chairwoman of the Islamic Women’s Welfare Council and Sherene Hassan from the Islamic Council of Victoria, both expressed sensitivity to the group’s attempt to establish an inclusive event but would have preferred the dress code to be a matter of choice rather coercion (Haberfield, "Mayor Defends Dandenong Pool Cover Up Order"). Helen Szoke, the Commissioner of the Victorian Equal Opportunity and Human Rights Commission, defended the pool’s exemption from the Law that she oversees. “Matters such as this are not easy to resolve and require a balance to be achieved between competing rights and obligations. Dress codes are not uncommon: e.g., singlets, jeans, thongs etc in pubs/hotels” (in Murphy). The civil liberties organisation, Liberty Victoria, supported the ban because the event was to be held after hours (Murphy). With astonishing speed this single event not only transformed the suburban swimming pool to a theatre of extra-local disputes about who and what is entitled to make claims on public space and publically funded facilities, but also fed into charged debates about the future of multiculturalism and the vulnerability of the nation to the corrosive effects of cultural and religious difference. In this sense suburbs like Dandenong are presented as sites that not only generate fear about physical safety but whose suburban sensitivities to its culturally diverse population represent a threat to the safety of the nation. Thus the event both reflects and produces an antipathy to cultural difference and to the place where difference resides. This aversion is triggered by and mediated in this case through the figure, rather than the (corpo)reality, of the Muslim woman. In this imagining, the figure of the Muslim woman is assigned the curious symbolic role of "cultural creep." The debates around the pool event is not about the wellbeing or interests of the Muslim women themselves, nor are broader debates about the perceived, culturally-derived restrictions imposed on Muslim women living in Australia or other western countries. The figure of the Muslim woman is, I would argue, simply the ground on which the debates are held. The first debate relates to social and public space, access to which is considered fundamental to freedom and participatory democracy, and in current times is addressed in terms of promoting inclusion, preventing exclusion and finding opportunities for cross cultural encounters. The second relates not to public space per se, but to the public sphere or the “sphere of private people coming together as a public” for political deliberation (Habermas 21). The literature and discussions dealing with these two terrains have remained relatively disconnected (Low and Smith) with public space referring largely to activities and opportunities in the socio-cultural domain and the public sphere addressing issues of politics, rights and democracy. This moment in Dandenong offers some modest leeway for situating "the suburb" as an ideal site for coalescing these disparate discussions. In this regard I consider Iveson’s provocative and productive question about whether some forms of exclusions from suburban public space may actually deepen the democratic ideals of the public sphere. Exclusions may in such cases be “consistent with visions of a democratically inclusive city” (216). He makes his case in relation to a dispute about the exclusion of men exclusion from a women’s only swimming pool in the Sydney suburb of Coogee. The Dandenong case is similarly exclusive with an added sense of exclusion generated by an "inclusion with restrictions."Diversity, Difference, Public Space and the Public SphereAs a prelude to this discussion of exclusion as democracy, I return to the question that opened this article: how did it come to this? How is it that Australia has moved from its renowned celebration and pride in its multiculturalism so much in evidence at the suburban level through what Ghassan Hage calls an “unproblematic” multiculturalism (233) and what others have termed “everyday multiculturalism” (Wise and Velayutham). Local cosmopolitanisms are often evinced through the daily rituals of people enjoying the ethnic cuisines of their co-residents’ pasts, and via moments of intercultural encounter. People uneventfully rub up against and greet each other or engage in everyday acts of kindness that typify life in multicultural suburbs, generating "reservoirs of hope" for democratic and cosmopolitan cities (Thrift 147). In today’s suburbs, however, the “Imperilled Muslim women” who need protection from “dangerous Muslim men” (Razack 129) have a higher discursive profile than ethnic cuisine as the exemplar of multiculturalism. Have we moved from pleasure to hostility or was the suburban pleasure in racial difference always about a kind of “eating the other” (bell hooks 378). That is to ask whether our capacity to experience diversity positively has been based on consumption, consuming the other for our own enrichment, whereas living with difference entails a commitment not to consumption but to democracy. This democratic multicultural commitment is a form of labour rather than pleasure, and its outcome is not enrichment but transformation (although this labour can be pleasurable and transformation might be enriching). Dandenong’s prized cultural precincts, "Little India" and the "Afghan bazaar" are showcases of food, artefacts and the diversity of the suburb. They are centres of pleasurable and exotic consumption. The pool session, however, requires one to confront difference. In simple terms we can think about ethnic food, festivals and handicrafts as cultural diversity, and the Muslim woman as cultural difference.This distinction between diversity and difference is useful for thinking through the relation between multiculturalism in public space and multicultural democracy of the public sphere. According to the anthropologist Thomas Hylland Eriksen, while a neoliberal sensibility supports cultural diversity in the public space, cultural difference is seen as a major cause of social problems associated with immigrants, and has a diminishing effect on the public sphere (14). According to Eriksen, diversity is understood as aesthetic, or politically and morally neutral expressions of culture that are enriching (Hage 118) or digestible. Difference, however, refers to morally objectionable cultural practices. In short, diversity is enriching. Difference is corrosive. Eriksen argues that differences that emerge from distinct cultural ideas and practices are deemed to create conflicts with majority cultures, weaken social solidarity and lead to unacceptable violations of human rights in minority groups. The suburban swimming pool exists here at the boundary of diversity and difference, where the "presence" of diverse bodies may enrich, but their different practices deplete and damage existing culture. The imperilled Muslim woman of the suburbs carries a heavy symbolic load. She stands for major global contests at the border of difference and diversity in three significant domains, multiculturalism, religion and feminism. These three areas are positioned simultaneously in public space and of the public sphere and she embodies a specific version of each in this suburban setting. First, there a global retreat from multiculturalism evidenced in contemporary narratives that describe multiculturalism (both as official policy and unofficial sensibility) as failed and increasingly ineffective at accommodating or otherwise dealing with religious, cultural and ethnic differences (Cantle; Goodhart; Joppke; Poynting and Mason). In the UK, Europe, the US and Australia, popular media sources and political discourses speak of "parallel lives,"immigrant enclaves, ghettoes, a lack of integration, the clash of values, and illiberal cultural practices. The covered body of the Muslim woman, and more particularly the Muslim veil, are now read as visual signs of this clash of values and of the refusal to integrate. Second, religion has re-emerged in the public domain, with religious groups and individuals making particular claims on public space both on the basis of their religious identity and in accord with secular society’s respect for religious freedom. This is most evident in controversies in France, Belgium and Netherlands associated with banning niqab in public and other religious symbols in schools, and in Australia in court. In this sense the covered Muslim woman raises concerns and indignation about the rightful place of religion in the public sphere and in social space. Third, feminism is increasingly invoked as the ground from which claims about the imperilled Muslim woman are made, particularly those about protecting women from their dangerous men. The infiltration of the Muslim presence into public space is seen as a threat to the hard won gains of women’s freedom enjoyed by the majority population. This newfound feminism of the public sphere, posited by those who might otherwise disavow feminism, requires some serious consideration. This public discourse rarely addresses the discrimination, violation and lack of freedom experienced systematically on an everyday basis by women of majority cultural backgrounds in western societies (such as Australia). However, the sexism of racially and religiously different men is readily identified and decried. This represents a significant shift to a dubious feminist register of the public sphere such that: “[w]omen of foreign origin, ...more specifically Muslim women…have replaced the traditional housewife as the symbol of female subservience” (Tissot 41–42).The three issues—multiculturalism, religion and feminism—are, in the Dandenong pool context, contests about human rights, democracy and the proper use of public space. Szego’s opinion piece sees the Dandenong pool "cover up" as an example of the conundrum of how human rights for some may curtail the human rights of others and lead us into a problematic entanglement of universal "rights," with claims of difference. In her view the combination of human rights and multiculturalism in the case of the Dandenong Pool accommodates illiberal practices that put the rights of "the general public" at risk, or as she puts it, on a “slippery slope” that results in a “watering down of our human rights.” Ideas that entail women making a claim for private time in public space are ultimately not good for "us."Such ideas run counter to the West's more than 500-year struggle for individual freedom—including both freedom of religion and freedom from religion—and for gender equality. Our public authorities ought to be pushing back hardest when these values are under threat. Yet this is precisely where they've been buckling under pressure (Szego)But a different reading of the relation between public and private space, human rights, democracy and gender freedom is readily identifiable in the Dandenong event—if one looks for it. Living with difference, I have already suggested, is a problem of democracy and the public sphere and does not so easily correspond to consuming diversity, as it demands engagement with cultural difference. In what remains, I explore how multicultural democracy in the public sphere and women’s rights in public and private realms relate, firstly, to the burgeoning promise of democracy and civility that might emerge in public space through encounter and exchange. I also point out how this moment in Dandenong might be read as a singular contribution to dealing with this global problematic of living with difference; of democracy in the public sphere. Public urban space has become a focus for speculation among geographers and sociologists in particular, about the prospects for an enhanced civic appreciation of living with difference through encountering strangers. Random and repetitious encounters with people from all cultures typify contemporary urban life. It remains an open question however as to whether these encounters open up or close down possibilities for conviviality and understanding, and whether they undo or harden peoples’ fears and prejudices. There is, however, at least in some academic and urban planning circles, some hope that the "throwntogetherness" (Massey) and the "doing" of togetherness (Laurier and Philo) found in the multicultural city may generate some lessons and opportunities for developing a civic culture and political commitment to living with difference. Alongside the optimism of those who celebrate the city, the suburb, and public spaces as forging new ways of living with difference, there are those such as Gill Valentine who wonder how this might be achieved in practice (324). Ash Amin similarly notes that city or suburban public spaces are not necessarily “the natural servants of multicultural engagement” (Ethnicity 967). Amin and Valentine point to the limited or fleeting opportunities for real engagement in these spaces. Moreover Valentine‘s research in the UK revealed that the spatial proximity found in multicultural spaces did not so much give rise to greater mutual respect and engagement, but to a frustrated “white self-segregation in the suburbs.” She suggests therefore that civility and polite exchange should not be mistaken for respect (324). Amin contends that it is the “micro-publics” of social encounters found in workplaces, schools, gardens, sports clubs [and perhaps swimming pools] rather than the fleeting encounters of the street or park, that offer better opportunities for meaningful intercultural exchange. The Ramadan celebration at the pool, with its dress code and all, might be seen more fruitfully as a purposeful event engaging a micro-public in which people are able to “break out of fixed relations and fixed notions” and “learn to become different” (Amin, Ethnicity 970) without that generating discord and resentment.Micropublics, Subaltern Publics and a Democracy of (Temporary) ExclusionsIs this as an opportunity to bring the global and local together in an experiment of forging new democratic spaces for gender, sexuality, culture and for living with difference? More provocatively, can we see exclusion and an invitation to share in this exclusion as a precursor to and measure of, actually existing democracy? Painter and Philo have argued that democratic citizenship is questionable if “people cannot be present in public spaces (streets, squares, parks, cinemas, churches, town halls) without feeling uncomfortable, victimized and basically ‘out of place’…" (Iveson 216). Feminists have long argued that distinctions between public and private space are neither straightforward nor gender neutral. For Nancy Fraser the terms are “cultural classifications and rhetorical labels” that are powerful because they are “frequently deployed to delegitimate some interests, views and topics and to valorize others” (73). In relation to women and other subordinated minorities, the "rhetoric of privacy" has been historically used to restrict the domain of legitimate public contestation. In fact the notion of what is public and particularly notions of the "public interest" and the "public good" solidify forms of subordination. Fraser suggests the concept of "subaltern counterpublics" as an alternative to notions of "the public." These are discursive spaces where groups articulate their needs, and demands are circulated formulating their own public sphere. This challenges the very meaning and foundational premises of ‘the public’ rather than simply positing strategies of inclusion or exclusion. The twinning of Amin’s notion of "micro-publics" and Fraser’s "counterpublics" is, I suggest, a fruitful approach to interpreting the Dandenong pool issue. It invites a reading of this singular suburban moment as an experiment, a trial of sorts, in newly imaginable ways of living democratically with difference. It enables us to imagine moments when a limited democratic right to exclude might create the sorts of cultural exchanges that give rise to a more authentic and workable recognition of cultural difference. I am drawn to think that this is precisely the kind of democratic experimentation that the YMCA and Dandenong Council embarked upon when they applied for the Equal Opportunity exemption. I suggest that by trialing, rather than fixing forever a "critically exclusive" access to the suburban swimming pool for two hours per year, they were in fact working on the practical problem of how to contribute in small but meaningful ways to a more profoundly free democracy and a reworked public sphere. In relation to the similar but distinct example of the McIver pool for women and children in Coogee, New South Wales, Kurt Iveson makes the point that such spaces of exclusion or withdrawal, “do not necessarily serve simply as spaces where people ‘can be themselves’, or as sites through which reified identities are recognised—in existing conditions of inequality, they can also serve as protected spaces where people can take the risk of exploring who they might become with relative safety from attack and abuse” (226). These are necessary risks to take if we are to avoid entrenching fear of difference in a world where difference is itself deeply, and permanently, entrenched.ReferencesAmin, Ash. “Ethnicity and the Multicultural City: Living with Diversity.” Environment and Planning A 34 (2002): 959–80.———. “The Good City.” Urban Studies 43 (2006): 1009–23.Berlant, Lauren, and Michael Warner. “Sex in Public.” Critical Inquiry 24 (1998): 547–66.Cantle, Ted. Community Cohesion: A Report of the Independent Review Team. London, UK Home Office, 2001.Carey, Adam. “Backing for Pool Cover Up Directive.” The Age 17 Sep. 2010. ‹http://www.theage.com.au/victoria/backing-for-pool-coverup-directive-20100916-15enz.html›.Elder, John, and Jon Pierick. “The Mean Streets: Where the Locals Fear to Tread.” The Sunday Age 10 Jan. 2010. ‹http://www.theage.com.au/national/the-mean-streets-where-the-locals-fear-to-tread-20100109-m00l.html?skin=text-only›.Eriksen, Thomas Hyland. “Diversity versus Difference: Neoliberalism in the Minority Debate." The Making and Unmaking of Difference. Ed. Richard Rottenburg, Burkhard Schnepel, and Shingo Shimada. Bielefeld: Transaction, 2006. 13–36.Fraser, Nancy. “Rethinking the Public Sphere: A Contribution to the Critique of Actually Existing Democracy.” Social Text 25/26 (1990): 56–80.Goodhart, David. “Too Diverse.” Prospect 95 (2004): 30-37.Haberfield, Georgie, and Gilbert Gardner. “Mayor Defends Pool Cover-up Order.” Dandenong Leader 16 Sep. 2010 ‹http://dandenong-leader.whereilive.com.au/news/story/dandenong-oasis-tells-swimmers-to-cover-up/›.Habermas, Jürgen. The Structural Transformation of the Public Sphere: An Inquiry into a Category of Bourgeois Society. Cambridge, MA: MIT P, 2001.Hage, Ghassan. White Nation: Fantasies of White Supremacy in a Multicultural Society. Sydney: Pluto, 1998.hooks, bell. "Eating the Other: Desire and Resistance." Media and Cultural Studies Keyworks. Eds. Meenakshi Gigi and Douglas Kellner. Malden, MA: Blackwell, 2001. 366-380.Iveson, Kurt. "Justifying Exclusion: The Politics of Public Space and the Dispute over Access to McIvers Ladies' Baths, Sydney.” Gender, Place and Culture 10.3 (2003): 215–28.Joppke, Christian. “The Retreat of Multiculturalism in the Liberal State: Theory and Policy.” The British Journal of Sociology 55.2 (2004): 237–57.Laurier, Chris, and Eric Philo. “Cold Shoulders and Napkins Handed: Gestures of Responsibility.” Transactions of the Institute of British Geographers 31 (2006): 193–207.Low, Setha, and Neil Smith, eds. The Politics of Public Space. London: Routledge, 2006.Massey, Doreen. For Space. London: Sage, 2005.Murphy, Padraic. "Cover Up for Pool Even at Next Year's Ramadan.” Herald Sun 23 Sep. 2010. ‹http://www.heraldsun.com.au/news/victoria/cover-up-for-pool-event-during-next-years-ramadan/story-e6frf7kx-1225924291675›.Nichols, David. The Bogan Delusion. Melbourne: Affirm Press, 2011.Poynting, Scott, and Victoria Mason. "The New Integrationism, the State and Islamophobia: Retreat from Multiculturalism in Australia." International Journal of Law, Crime and Justice 36 (2008): 230–46.Razack, Sherene H. “Imperilled Muslim Women, Dangerous Muslim Men and Civilised Europeans: Legal and Social Responses to Forced Marriages.” Feminist Legal Studies 12.2 (2004): 129–74.Szego, Julie. “Under the Cover Up." The Age 9 Oct. 2010. < http://www.theage.com.au/victoria/under-the-coverup-20101008-16c1v.html >.Thrift, Nigel. “But Malice Afterthought: Cities and the Natural History of Hatred.” Transactions of the Institute of British Geographers 30 (2005): 133–50.Tissot, Sylvie. “Excluding Muslim Women: From Hijab to Niqab, from School to Public Space." Public Culture 23.1 (2011): 39–46.Valentine, Gill. “Living with Difference: Reflections on Geographies of Encounter.” Progress in Human Geography 32.3 (2008): 323–37.Wise, Amanda, and Selveraj Velayutham, eds. Everyday Multiculturalism. Houndsmills: Palgrave Macmillan, 2009.YMCA. “VCAT Ruling on Swim Sessions at Dandenong Oasis to Open Up to Community During Ramadan Next Year.” 16 Sep. 2010. ‹http://www.victoria.ymca.org.au/cpa/htm/htm_news_detail.asp?page_id=13&news_id=360›.

Introduction Most developed countries, including Australia, have a strong focus on national, state and local strategies for emergency management and response in the face of disasters and crises. This framework can include coping with catastrophic dislocation, service disruption, injury or loss of life in the face of natural disasters such as major fires, floods, earthquakes or other large-impact natural events, as well as dealing with similar catastrophes resulting from human actions such as bombs, biological agents, cyber-attacks targeting essential services such as communications networks, or other crises affecting large populations. Emergency management frameworks for crisis and disaster response are distinguished by their focus on the domestic context for such events; that is, how to manage and assist the ways in which civilian populations, who are for the most part inexperienced and untrained in dealing with crises and disasters, are able to respond and behave in such situations so as to minimise the impacts of a catastrophic event. Even in countries like Australia that demonstrate a strong public commitment to cultural pluralism and social cohesion, ethno-cultural diversity can be seen as a risk or threat to national security and values at times of political, natural, economic and/or social tensions and crises. Australian government policymakers have recently focused, with increasing intensity, on “community resilience” as a key element in countering extremism and enhancing emergency preparedness and response. In some sense, this is the result of a tacit acknowledgement by government agencies that there are limits to what they can do for domestic communities should such a catastrophic event occur, and accordingly, the focus in recent times has shifted to how governments can best help people to help themselves in such situations, a key element of the contemporary “resilience” approach. Yet despite the robustly multicultural nature of Australian society, explicit engagement with Australia’s cultural diversity flickers only fleetingly on this agenda, which continues to pursue approaches to community resilience in the absence of understandings about how these terms and formations may themselves need to be diversified to maximise engagement by all citizens in a multicultural polity. There have been some recent efforts in Australia to move in this direction, for example the Australian Emergency Management Institute (AEMI)’s recent suite of projects with culturally and linguistically diverse (CALD) communities (2006-2010) and the current Australia-New Zealand Counter-Terrorism Committee-supported project on “Harnessing Resilience Capital in Culturally Diverse Communities to Counter Violent Extremism” (Grossman and Tahiri), which I discuss in a longer forthcoming version of this essay (Grossman). Yet the understanding of ethno-cultural identity and difference that underlies much policy thinking on resilience remains problematic for the way in which it invests in a view of the cultural dimensions of community resilience as relic rather than resource – valorising the preservation of and respect for cultural norms and traditions, but silent on what different ethno-cultural communities might contribute toward expanded definitions of both “community” and “resilience” by virtue of the transformative potential and existing cultural capital they bring with them into new national and also translocal settings. For example, a primary conclusion of the joint program between AEMI and the Australian Multicultural Commission is that CALD communities are largely “vulnerable” in the context of disasters and emergency management and need to be better integrated into majority-culture models of theorising and embedding community resilience. This focus on stronger national integration and the “vulnerability” of culturally diverse ethno-cultural communities in the Australian context echoes the work of scholars beyond Australia such as McGhee, Mouritsen (Reflections, Citizenship) and Joppke. They argue that the “civic turn” in debates around resurgent contemporary nationalism and multicultural immigration policies privileges civic integration over genuine two-way multiculturalism. This approach sidesteps the transculturational (Ortiz; Welsch; Mignolo; Bennesaieh; Robins; Stein) aspects of contemporary social identities and exchange by paying lip-service to cultural diversity while affirming a neo-liberal construct of civic values and principles as a universalising goal of Western democratic states within a global market economy. It also suggests a superficial tribute to cultural diversity that does not embed diversity comprehensively at the levels of either conceptualising or resourcing different elements of Australian transcultural communities within the generalised framework of “community resilience.” And by emphasising cultural difference as vulnerability rather than as resource or asset, it fails to acknowledge the varieties of resilience capital that many culturally diverse individuals and communities may bring with them when they resettle in new environments, by ignoring the question of what “resilience” actually means to those from culturally diverse communities. In so doing, it also avoids the critical task of incorporating intercultural definitional diversity around the concepts of both “community” and “resilience” used to promote social cohesion and the capacity to recover from disasters and crises. How we might do differently in thinking about the broader challenges for multiculturalism itself as a resilient transnational concept and practice? The Concept of Resilience The meanings of resilience vary by disciplinary perspective. While there is no universally accepted definition of the concept, it is widely acknowledged that resilience refers to the capacity of an individual to do well in spite of exposure to acute trauma or sustained adversity (Liebenberg 219). Originating in the Latin word resilio, meaning ‘to jump back’, there is general consensus that resilience pertains to an individual’s, community’s or system’s ability to adapt to and ‘bounce back’ from a disruptive event (Mohaupt 63, Longstaff et al. 3). Over the past decade there has been a dramatic rise in interest in the clinical, community and family sciences concerning resilience to a broad range of adversities (Weine 62). While debate continues over which discipline can be credited with first employing resilience as a concept, Mohaupt argues that most of the literature on resilience cites social psychology and psychiatry as the origin for the concept beginning in the mid-20th century. The pioneer researchers of what became known as resilience research studied the impact on children living in dysfunctional families. For example, the findings of work by Garmezy, Werner and Smith and Rutter showed that about one third of children in these studies were coping very well despite considerable adversities and traumas. In asking what it was that prevented the children in their research from being negatively influenced by their home environments, such research provided the basis for future research on resilience. Such work was also ground-breaking for identifying the so-called ‘protective factors’ or resources that individuals can operationalise when dealing with adversity. In essence, protective factors are those conditions in the individual that protect them from the risk of dysfunction and enable recovery from trauma. They mitigate the effects of stressors or risk factors, that is, those conditions that predispose one to harm (Hajek 15). Protective factors include the inborn traits or qualities within an individual, those defining an individual’s environment, and also the interaction between the two. Together, these factors give people the strength, skills and motivation to cope in difficult situations and re-establish (a version of) ‘normal’ life (Gunnestad). Identifying protective factors is important in terms of understanding the particular resources a given sociocultural group has at its disposal, but it is also vital to consider the interconnections between various protective mechanisms, how they might influence each other, and to what degree. An individual, for instance, might display resilience or adaptive functioning in a particular domain (e.g. emotional functioning) but experience significant deficits in another (e.g. academic achievement) (Hunter 2). It is also essential to scrutinise how the interaction between protective factors and risk factors creates patterns of resilience. Finally, a comprehensive understanding of the interrelated nature of protective mechanisms and risk factors is imperative for designing effective interventions and tailored preventive strategies (Weine 65). In short, contemporary thinking about resilience suggests it is neither entirely personal nor strictly social, but an interactive and iterative combination of the two. It is a quality of the environment as much as the individual. For Ungar, resilience is the complex entanglements between “individuals and their social ecologies [that] will determine the degree of positive outcomes experienced” (3). Thinking about resilience as context-dependent is important because research that is too trait-based or actor-centred risks ignoring any structural or institutional forces. A more ecological interpretation of resilience, one that takes into a person’s context and environment into account, is vital in order to avoid blaming the victim for any hardships they face, or relieving state and institutional structures from their responsibilities in addressing social adversity, which can “emphasise self-help in line with a neo-conservative agenda instead of stimulating state responsibility” (Mohaupt 67). Nevertheless, Ungar posits that a coherent definition of resilience has yet to be developed that adequately ‘captures the dual focus of the individual and the individual’s social ecology and how the two must both be accounted for when determining the criteria for judging outcomes and discerning processes associated with resilience’ (7). Recent resilience research has consequently prompted a shift away from vulnerability towards protective processes — a shift that highlights the sustained capabilities of individuals and communities under threat or at risk. Locating ‘Culture’ in the Literature on Resilience However, an understanding of the role of culture has remained elusive or marginalised within this trend; there has been comparatively little sustained investigation into the applicability of resilience constructs to non-western cultures, or how the resources available for survival might differ from those accessible to western populations (Ungar 4). As such, a growing body of researchers is calling for more rigorous inquiry into culturally determined outcomes that might be associated with resilience in non-western or multicultural cultures and contexts, for example where Indigenous and minority immigrant communities live side by side with their ‘mainstream’ neighbours in western settings (Ungar 2). ‘Cultural resilience’ considers the role that cultural background plays in determining the ability of individuals and communities to be resilient in the face of adversity. For Clauss-Ehlers, the term describes the degree to which the strengths of one’s culture promote the development of coping (198). Culturally-focused resilience suggests that people can manage and overcome stress and trauma based not on individual characteristics alone, but also from the support of broader sociocultural factors (culture, cultural values, language, customs, norms) (Clauss-Ehlers 324). The innate cultural strengths of a culture may or may not differ from the strengths of other cultures; the emphasis here is not so much comparatively inter-cultural as intensively intra-cultural (VanBreda 215). A culturally focused resilience model thus involves “a dynamic, interactive process in which the individual negotiates stress through a combination of character traits, cultural background, cultural values, and facilitating factors in the sociocultural environment” (Clauss-Ehlers 199). In understanding ways of ‘coping and hoping, surviving and thriving’, it is thus crucial to consider how culturally and linguistically diverse minorities navigate the cultural understandings and assumptions of both their countries of origin and those of their current domicile (Ungar 12). Gunnestad claims that people who master the rules and norms of their new culture without abandoning their own language, values and social support are more resilient than those who tenaciously maintain their own culture at the expense of adjusting to their new environment. They are also more resilient than those who forego their own culture and assimilate with the host society (14). Accordingly, if the combination of both valuing one’s culture as well as learning about the culture of the new system produces greater resilience and adaptive capacities, serious problems can arise when a majority tries to acculturate a minority to the mainstream by taking away or not recognising important parts of the minority culture. In terms of resilience, if cultural factors are denied or diminished in accounting for and strengthening resilience – in other words, if people are stripped of what they possess by way of resilience built through cultural knowledge, disposition and networks – they do in fact become vulnerable, because ‘they do not automatically gain those cultural strengths that the majority has acquired over generations’ (Gunnestad 14). Mobilising ‘Culture’ in Australian Approaches to Community Resilience The realpolitik of how concepts of resilience and culture are mobilised is highly relevant here. As noted above, when ethnocultural difference is positioned as a risk or a threat to national identity, security and values, this is precisely the moment when vigorously, even aggressively, nationalised definitions of ‘community’ and ‘identity’ that minoritise or disavow cultural diversities come to the fore in public discourse. The Australian evocation of nationalism and national identity, particularly in the way it has framed policy discussion on managing national responses to disasters and threats, has arguably been more muted than some of the European hysteria witnessed recently around cultural diversity and national life. Yet we still struggle with the idea that newcomers to Australia might fall on the surplus rather than the deficit side of the ledger when it comes to identifying and harnessing resilience capital. A brief example of this trend is explored here. From 2006 to 2010, the Australian Emergency Management Institute embarked on an ambitious government-funded four-year program devoted to strengthening community resilience in relation to disasters with specific reference to engaging CALD communities across Australia. The program, Inclusive Emergency Management with CALD Communities, was part of a wider Australian National Action Plan to Build Social Cohesion, Harmony and Security in the wake of the London terrorist bombings in July 2005. Involving CALD community organisations as well as various emergency and disaster management agencies, the program ran various workshops and agency-community partnership pilots, developed national school education resources, and commissioned an evaluation of the program’s effectiveness (Farrow et al.). While my critique here is certainly not aimed at emergency management or disaster response agencies and personnel themselves – dedicated professionals who often achieve remarkable results in emergency and disaster response under extraordinarily difficult circumstances – it is nevertheless important to highlight how the assumptions underlying elements of AEMI’s experience and outcomes reflect the persistent ways in which ethnocultural diversity is rendered as a problem to be surmounted or a liability to be redressed, rather than as an asset to be built upon or a resource to be valued and mobilised. AEMI’s explicit effort to engage with CALD communities in building overall community resilience was important in its tacit acknowledgement that emergency and disaster services were (and often remain) under-resourced and under-prepared in dealing with the complexities of cultural diversity in emergency situations. Despite these good intentions, however, while the program produced some positive outcomes and contributed to crucial relationship building between CALD communities and emergency services within various jurisdictions, it also continued to frame the challenge of working with cultural diversity as a problem of increased vulnerability during disasters for recently arrived and refugee background CALD individuals and communities. This highlights a common feature in community resilience-building initiatives, which is to focus on those who are already ‘robust’ versus those who are ‘vulnerable’ in relation to resilience indicators, and whose needs may require different or additional resources in order to be met. At one level, this is a pragmatic resourcing issue: national agencies understandably want to put their people, energy and dollars where they are most needed in pursuit of a steady-state unified national response at times of crisis. Nor should it be argued that at least some CALD groups, particularly those from new arrival and refugee communities, are not vulnerable in at least some of the ways and for some of the reasons suggested in the program evaluation. However, the consistent focus on CALD communities as ‘vulnerable’ and ‘in need’ is problematic, as well as partial. It casts members of these communities as structurally and inherently less able and less resilient in the context of disasters and emergencies: in some sense, as those who, already ‘victims’ of chronic social deficits such as low English proficiency, social isolation and a mysterious unidentified set of ‘cultural factors’, can become doubly victimised in acute crisis and disaster scenarios. In what is by now a familiar trope, the description of CALD communities as ‘vulnerable’ precludes asking questions about what they do have, what they do know, and what they do or can contribute to how we respond to disaster and emergency events in our communities. A more profound problem in this sphere revolves around working out how best to engage CALD communities and individuals within existing approaches to disaster and emergency preparedness and response. This reflects a fundamental but unavoidable limitation of disaster preparedness models: they are innately spatially and geographically bounded, and consequently understand ‘communities’ in these terms, rather than expanding definitions of ‘community’ to include the dimensions of community-as-social-relations. While some good engagement outcomes were achieved locally around cross-cultural knowledge for emergency services workers, the AEMI program fell short of asking some of the harder questions about how emergency and disaster service scaffolding and resilience-building approaches might themselves need to change or transform, using a cross-cutting model of ‘communities’ as both geographic places and multicultural spaces (Bartowiak-Théron and Crehan) in order to be more effective in national scenarios in which cultural diversity should be taken for granted. Toward Acknowledgement of Resilience Capital Most significantly, the AEMI program did not produce any recognition of the ways in which CALD communities already possess resilience capital, or consider how this might be drawn on in formulating stronger community initiatives around disaster and threats preparedness for the future. Of course, not all individuals within such communities, nor all communities across varying circumstances, will demonstrate resilience, and we need to be careful of either overgeneralising or romanticising the kinds and degrees of ‘resilience capital’ that may exist within them. Nevertheless, at least some have developed ways of withstanding crises and adapting to new conditions of living. This is particularly so in connection with individual and group behaviours around resource sharing, care-giving and social responsibility under adverse circumstances (Grossman and Tahiri) – all of which are directly relevant to emergency and disaster response. While some of these resilient behaviours may have been nurtured or enhanced by particular experiences and environments, they can, as the discussion of recent literature above suggests, also be rooted more deeply in cultural norms, habits and beliefs. Whatever their origins, for culturally diverse societies to achieve genuine resilience in the face of both natural and human-made disasters, it is critical to call on the ‘social memory’ (Folke et al.) of communities faced with responding to emergencies and crises. Such wellsprings of social memory ‘come from the diversity of individuals and institutions that draw on reservoirs of practices, knowledge, values, and worldviews and is crucial for preparing the system for change, building resilience, and for coping with surprise’ (Adger et al.). Consequently, if we accept the challenge of mapping an approach to cultural diversity as resource rather than relic into our thinking around strengthening community resilience, there are significant gains to be made. For a whole range of reasons, no diversity-sensitive model or measure of resilience should invest in static understandings of ethnicities and cultures; all around the world, ethnocultural identities and communities are in a constant and sometimes accelerated state of dynamism, reconfiguration and flux. But to ignore the resilience capital and potential protective factors that ethnocultural diversity can offer to the strengthening of community resilience more broadly is to miss important opportunities that can help suture the existing disconnects between proactive approaches to intercultural connectedness and social inclusion on the one hand, and reactive approaches to threats, national security and disaster response on the other, undermining the effort to advance effectively on either front. This means that dominant social institutions and structures must be willing to contemplate their own transformation as the result of transcultural engagement, rather than merely insisting, as is often the case, that ‘other’ cultures and communities conform to existing hegemonic paradigms of being and of living. In many ways, this is the most critical step of all. A resilience model and strategy that questions its own culturally informed yet taken-for-granted assumptions and premises, goes out into communities to test and refine these, and returns to redesign its approach based on the new knowledge it acquires, would reflect genuine progress toward an effective transculturational approach to community resilience in culturally diverse contexts.References Adger, W. Neil, Terry P. Hughes, Carl Folke, Stephen R. Carpenter and Johan Rockström. “Social-Ecological Resilience to Coastal Disasters.” Science 309.5737 (2005): 1036-1039. ‹http://www.sciencemag.org/content/309/5737/1036.full> Bartowiak-Théron, Isabelle, and Anna Corbo Crehan. “The Changing Nature of Communities: Implications for Police and Community Policing.” Community Policing in Australia: Australian Institute of Criminology (AIC) Reports, Research and Policy Series 111 (2010): 8-15. Benessaieh, Afef. “Multiculturalism, Interculturality, Transculturality.” Ed. A. Benessaieh. Transcultural Americas/Ameriques Transculturelles. Ottawa: U of Ottawa Press/Les Presses de l’Unversite d’Ottawa, 2010. 11-38. Clauss-Ehlers, Caroline S. “Sociocultural Factors, Resilience and Coping: Support for a Culturally Sensitive Measure of Resilience.” Journal of Applied Developmental Psychology 29 (2008): 197-212. Clauss-Ehlers, Caroline S. “Cultural Resilience.” Encyclopedia of Cross-Cultural School Psychology. Ed. C. S. Clauss-Ehlers. New York: Springer, 2010. 324-326. Farrow, David, Anthea Rutter and Rosalind Hurworth. Evaluation of the Inclusive Emergency Management with Culturally and Linguistically Diverse (CALD) Communities Program. Parkville, Vic.: Centre for Program Evaluation, U of Melbourne, July 2009. ‹http://www.ag.gov.au/www/emaweb/rwpattach.nsf/VAP/(9A5D88DBA63D32A661E6369859739356)~Final+Evaluation+Report+-+July+2009.pdf/$file/Final+Evaluation+Report+-+July+2009.pdf>.Folke, Carl, Thomas Hahn, Per Olsson, and Jon Norberg. “Adaptive Governance of Social-Ecological Systems.” Annual Review of Environment and Resources 30 (2005): 441-73. ‹http://arjournals.annualreviews.org/doi/pdf/10.1146/annurev.energy.30.050504.144511>. Garmezy, Norman. “The Study of Competence in Children at Risk for Severe Psychopathology.” The Child in His Family: Children at Psychiatric Risk. Vol. 3. Eds. E. J. Anthony and C. Koupernick. New York: Wiley, 1974. 77-97. Grossman, Michele. “Resilient Multiculturalism? Diversifying Australian Approaches to Community Resilience and Cultural Difference”. Global Perspectives on Multiculturalism in the 21st Century. Eds. B. E. de B’beri and F. Mansouri. London: Routledge, 2014. Grossman, Michele, and Hussein Tahiri. Harnessing Resilience Capital in Culturally Diverse Communities to Counter Violent Extremism. Canberra: Australia-New Zealand Counter-Terrorism Committee, forthcoming 2014. Grossman, Michele. “Cultural Resilience and Strengthening Communities”. Safeguarding Australia Summit, Canberra. 23 Sep. 2010. ‹http://www.safeguardingaustraliasummit.org.au/uploader/resources/Michele_Grossman.pdf>. Gunnestad, Arve. “Resilience in a Cross-Cultural Perspective: How Resilience Is Generated in Different Cultures.” Journal of Intercultural Communication 11 (2006). ‹http://www.immi.se/intercultural/nr11/gunnestad.htm>. Hajek, Lisa J. “Belonging and Resilience: A Phenomenological Study.” Unpublished Master of Science thesis, U of Wisconsin-Stout. Menomonie, Wisconsin, 2003. Hunter, Cathryn. “Is Resilience Still a Useful Concept When Working with Children and Young People?” Child Family Community Australia (CFA) Paper 2. Melbourne: Australian Institute of Family Studies, 2012.Joppke, Christian. "Beyond National Models: Civic Integration Policies for Immigrants in Western Europe". West European Politics 30.1 (2007): 1-22. Liebenberg, Linda, Michael Ungar, and Fons van de Vijver. “Validation of the Child and Youth Resilience Measure-28 (CYRM-28) among Canadian Youth.” Research on Social Work Practice 22.2 (2012): 219-226. Longstaff, Patricia H., Nicholas J. Armstrong, Keli Perrin, Whitney May Parker, and Matthew A. Hidek. “Building Resilient Communities: A Preliminary Framework for Assessment.” Homeland Security Affairs 6.3 (2010): 1-23. ‹http://www.hsaj.org/?fullarticle=6.3.6>. McGhee, Derek. The End of Multiculturalism? Terrorism, Integration and Human Rights. Maidenhead: Open U P, 2008.Mignolo, Walter. Local Histories/Global Designs: Coloniality, Subaltern Knowledges, and Border Thinking. Princeton: Princeton U P, 2000. Mohaupt, Sarah. “Review Article: Resilience and Social Exclusion.” Social Policy and Society 8 (2009): 63-71.Mouritsen, Per. "The Culture of Citizenship: A Reflection on Civic Integration in Europe." Ed. R. Zapata-Barrero. Citizenship Policies in the Age of Diversity: Europe at the Crossroad." Barcelona: CIDOB Foundation, 2009: 23-35. Mouritsen, Per. “Political Responses to Cultural Conflict: Reflections on the Ambiguities of the Civic Turn.” Ed. P. Mouritsen and K.E. Jørgensen. Constituting Communities. Political Solutions to Cultural Conflict, London: Palgrave, 2008. 1-30. Ortiz, Fernando. Cuban Counterpoint: Tobacco and Sugar. Trans. Harriet de Onís. Intr. Fernando Coronil and Bronislaw Malinowski. Durham, NC: Duke U P, 1995 [1940]. Robins, Kevin. The Challenge of Transcultural Diversities: Final Report on the Transversal Study on Cultural Policy and Cultural Diversity. Culture and Cultural Heritage Department. Strasbourg: Council of European Publishing, 2006. Rutter, Michael. “Protective Factors in Children’s Responses to Stress and Disadvantage.” Annals of the Academy of Medicine, Singapore 8 (1979): 324-38. Stein, Mark. “The Location of Transculture.” Transcultural English Studies: Fictions, Theories, Realities. Eds. F. Schulze-Engler and S. Helff. Cross/Cultures 102/ANSEL Papers 12. Amsterdam and New York: Rodopi, 2009. 251-266. Ungar, Michael. “Resilience across Cultures.” British Journal of Social Work 38.2 (2008): 218-235. First published online 2006: 1-18. In-text references refer to the online Advance Access edition ‹http://bjsw.oxfordjournals.org/content/early/2006/10/18/bjsw.bcl343.full.pdf>. VanBreda, Adrian DuPlessis. Resilience Theory: A Literature Review. Erasmuskloof: South African Military Health Service, Military Psychological Institute, Social Work Research & Development, 2001. Weine, Stevan. “Building Resilience to Violent Extremism in Muslim Diaspora Communities in the United States.” Dynamics of Asymmetric Conflict 5.1 (2012): 60-73. Welsch, Wolfgang. “Transculturality: The Puzzling Form of Cultures Today.” Spaces of Culture: City, Nation World. Eds. M. Featherstone and S. Lash. London: Sage, 1999. 194-213. Werner, Emmy E., and Ruth S. Smith. Vulnerable But Invincible: A Longitudinal Study of\ Resilience and Youth. New York: McGraw Hill, 1982. NotesThe concept of ‘resilience capital’ I offer here is in line with one strand of contemporary theorising around resilience – that of resilience as social or socio-ecological capital – but moves beyond the idea of enhancing general social connectedness and community cohesion by emphasising the ways in which culturally diverse communities may already be robustly networked and resourceful within micro-communal settings, with new resources and knowledge both to draw on and to offer other communities or the ‘national community’ at large. In effect, ‘resilience capital’ speaks to the importance of finding ‘the communities within the community’ (Bartowiak-Théron and Crehan 11) and recognising their capacity to contribute to broad-scale resilience and recovery.I am indebted for the discussion of the literature on resilience here to Dr Peta Stephenson, Centre for Cultural Diversity and Wellbeing, Victoria University, who is working on a related project (M. Grossman and H. Tahiri, Harnessing Resilience Capital in Culturally Diverse Communities to Counter Violent Extremism, forthcoming 2014).

Introduction The highly contagious COVID-19 virus has presented particularly difficult public policy challenges. The relatively late emergence of an effective treatments and vaccines, the structural stresses on health care systems, the lockdowns and the economic dislocations, the evident structural inequalities in effected societies, as well as the difficulty of prevention have tested social and political cohesion. Moreover, the intrusive nature of many prophylactic measures have led to individual liberty and human rights concerns. As noted by the Victorian (Australia) Ombudsman Report on the COVID-19 lockdown in Melbourne, we may be tempted, during a crisis, to view human rights as expendable in the pursuit of saving human lives. This thinking can lead to dangerous territory. It is not unlawful to curtail fundamental rights and freedoms when there are compelling reasons for doing so; human rights are inherently and inseparably a consideration of human lives. (5) These difficulties have raised issues about the importance of social or community capital in fighting the pandemic. This article discusses the impacts of social and community capital and other factors on the governmental efforts to combat the spread of infectious disease through the maintenance of social distancing and household ‘bubbles’. It argues that the beneficial effects of social and community capital towards fighting the pandemic, such as mutual respect and empathy, which underpins such public health measures as social distancing, the use of personal protective equipment, and lockdowns in the USA, have been undermined as preventive measures because they have been transmogrified to become a salient aspect of the “culture wars” (Peters). In contrast, states that have relatively lower social capital such a China have been able to more effectively arrest transmission of the disease because the government was been able to generate and personify a nationalist response to the virus and thus generate a more robust social consensus regarding the efforts to combat the disease. Social Capital and Culture Wars The response to COVID-19 required individuals, families, communities, and other types of groups to refrain from extensive interaction – to stay in their bubble. In these situations, especially given the asymptomatic nature of many COVID-19 infections and the serious imposition lockdowns and social distancing and isolation, the temptation for individuals to breach public health rules in high. From the perspective of policymakers, the response to fighting COVID-19 is a collective action problem. In studying collective action problems, scholars have paid much attention on the role of social and community capital (Ostrom and Ahn 17-35). Ostrom and Ahn comment that social capital “provides a synthesizing approach to how cultural, social, and institutional aspects of communities of various sizes jointly affect their capacity of dealing with collective-action problems” (24). Social capital is regarded as an evolving social type of cultural trait (Fukuyama; Guiso et al.). Adger argues that social capital “captures the nature of social relations” and “provides an explanation for how individuals use their relationships to other actors in societies for their own and for the collective good” (387). The most frequently used definition of social capital is the one proffered by Putnam who regards it as “features of social organization, such as networks, norms and social trust that facilitate coordination and cooperation for mutual benefit” (Putnam, “Bowling Alone” 65). All these studies suggest that social and community capital has at least two elements: “objective associations” and subjective ties among individuals. Objective associations, or social networks, refer to both formal and informal associations that are formed and engaged in on a voluntary basis by individuals and social groups. Subjective ties or norms, on the other hand, primarily stand for trust and reciprocity (Paxton). High levels of social capital have generally been associated with democratic politics and civil societies whose institutional performance benefits from the coordinated actions and civic culture that has been facilitated by high levels of social capital (Putnam, Democracy 167-9). Alternatively, a “good and fair” state and impartial institutions are important factors in generating and preserving high levels of social capital (Offe 42-87). Yet social capital is not limited to democratic civil societies and research is mixed on whether rising social capital manifests itself in a more vigorous civil society that in turn leads to democratising impulses. Castillo argues that various trust levels for institutions that reinforce submission, hierarchy, and cultural conservatism can be high in authoritarian governments, indicating that high levels of social capital do not necessarily lead to democratic civic societies (Castillo et al.). Roßteutscher concludes after a survey of social capita indicators in authoritarian states that social capital has little effect of democratisation and may in fact reinforce authoritarian rule: in nondemocratic contexts, however, it appears to throw a spanner in the works of democratization. Trust increases the stability of nondemocratic leaderships by generating popular support, by suppressing regime threatening forms of protest activity, and by nourishing undemocratic ideals concerning governance (752). In China, there has been ongoing debate concerning the presence of civil society and the level of social capital found across Chinese society. If one defines civil society as an intermediate associational realm between the state and the family, populated by autonomous organisations which are separate from the state that are formed voluntarily by members of society to protect or extend their interests or values, it is arguable that the PRC had a significant civil society or social capital in the first few decades after its establishment (White). However, most scholars agree that nascent civil society as well as a more salient social and community capital has emerged in China’s reform era. This was evident after the 2008 Sichuan earthquake, where the government welcomed community organising and community-driven donation campaigns for a limited period of time, giving the NGO sector and bottom-up social activism a boost, as evidenced in various policy areas such as disaster relief and rural community development (F. Wu 126; Xu 9). Nevertheless, the CCP and the Chinese state have been effective in maintaining significant control over civil society and autonomous groups without attempting to completely eliminate their autonomy or existence. The dramatic economic and social changes that have occurred since the 1978 Opening have unsurprisingly engendered numerous conflicts across the society. In response, the CCP and State have adjusted political economic policies to meet the changing demands of workers, migrants, the unemployed, minorities, farmers, local artisans, entrepreneurs, and the growing middle class. Often the demands arising from these groups have resulted in policy changes, including compensation. In other circumstances, where these groups remain dissatisfied, the government will tolerate them (ignore them but allow them to continue in the advocacy), or, when the need arises, supress the disaffected groups (F. Wu 2). At the same time, social organisations and other groups in civil society have often “refrained from open and broad contestation against the regime”, thereby gaining the space and autonomy to achieve the objectives (F. Wu 2). Studies of Chinese social or community capital suggest that a form of modern social capital has gradually emerged as Chinese society has become increasingly modernised and liberalised (despite being non-democratic), and that this social capital has begun to play an important role in shaping social and economic lives at the local level. However, this more modern form of social capital, arising from developmental and social changes, competes with traditional social values and social capital, which stresses parochial and particularistic feelings among known individuals while modern social capital emphasises general trust and reciprocal feelings among both known and unknown individuals. The objective element of these traditional values are those government-sanctioned, formal mass organisations such as Communist Youth and the All-China Federation of Women's Associations, where members are obliged to obey the organisation leadership. The predominant subjective values are parochial and particularistic feelings among individuals who know one another, such as guanxi and zongzu (Chen and Lu, 426). The concept of social capital emphasises that the underlying cooperative values found in individuals and groups within a culture are an important factor in solving collective problems. In contrast, the notion of “culture war” focusses on those values and differences that divide social and cultural groups. Barry defines culture wars as increases in volatility, expansion of polarisation, and conflict between those who are passionate about religiously motivated politics, traditional morality, and anti-intellectualism, and…those who embrace progressive politics, cultural openness, and scientific and modernist orientations. (90) The contemporary culture wars across the world manifest opposition by various groups in society who hold divergent worldviews and ideological positions. Proponents of culture war understand various issues as part of a broader set of religious, political, and moral/normative positions invoked in opposition to “elite”, “liberal”, or “left” ideologies. Within this Manichean universe opposition to such issues as climate change, Black Lives Matter, same sex rights, prison reform, gun control, and immigration becomes framed in binary terms, and infused with a moral sensibility (Chapman 8-10). In many disputes, the culture war often devolves into an epistemological dispute about the efficacy of scientific knowledge and authority, or a dispute between “practical” and theoretical knowledge. In this environment, even facts can become partisan narratives. For these “cultural” disputes are often how electoral prospects (generally right-wing) are advanced; “not through policies or promises of a better life, but by fostering a sense of threat, a fantasy that something profoundly pure … is constantly at risk of extinction” (Malik). This “zero-sum” social and policy environment that makes it difficult to compromise and has serious consequences for social stability or government policy, especially in a liberal democratic society. Of course, from the perspective of cultural materialism such a reductionist approach to culture and political and social values is not unexpected. “Culture” is one of the many arenas in which dominant social groups seek to express and reproduce their interests and preferences. “Culture” from this sense is “material” and is ultimately connected to the distribution of power, wealth, and resources in society. As such, the various policy areas that are understood as part of the “culture wars” are another domain where various dominant and subordinate groups and interests engaged in conflict express their values and goals. Yet it is unexpected that despite the pervasiveness of information available to individuals the pool of information consumed by individuals who view the “culture wars” as a touchstone for political behaviour and a narrative to categorise events and facts is relatively closed. This lack of balance has been magnified by social media algorithms, conspiracy-laced talk radio, and a media ecosystem that frames and discusses issues in a manner that elides into an easily understood “culture war” narrative. From this perspective, the groups (generally right-wing or traditionalist) exist within an information bubble that reinforces political, social, and cultural predilections. American and Chinese Reponses to COVID-19 The COVID-19 pandemic first broke out in Wuhan in December 2019. Initially unprepared and unwilling to accept the seriousness of the infection, the Chinese government regrouped from early mistakes and essentially controlled transmission in about three months. This positive outcome has been messaged as an exposition of the superiority of the Chinese governmental system and society both domestically and internationally; a positive, even heroic performance that evidences the populist credentials of the Chinese political leadership and demonstrates national excellence. The recently published White Paper entitled “Fighting COVID-19: China in Action” also summarises China’s “strategic achievement” in the simple language of numbers: in a month, the rising spread was contained; in two months, the daily case increase fell to single digits; and in three months, a “decisive victory” was secured in Wuhan City and Hubei Province (Xinhua). This clear articulation of the positive results has rallied political support. Indeed, a recent survey shows that 89 percent of citizens are satisfied with the government’s information dissemination during the pandemic (C Wu). As part of the effort, the government extensively promoted the provision of “political goods”, such as law and order, national unity and pride, and shared values. For example, severe publishments were introduced for violence against medical professionals and police, producing and selling counterfeit medications, raising commodity prices, spreading ‘rumours’, and being uncooperative with quarantine measures (Xu). Additionally, as an extension the popular anti-corruption campaign, many local political leaders were disciplined or received criminal charges for inappropriate behaviour, abuse of power, and corruption during the pandemic (People.cn, 2 Feb. 2020). Chinese state media also described fighting the virus as a global “competition”. In this competition a nation’s “material power” as well as “mental strength”, that calls for the highest level of nation unity and patriotism, is put to the test. This discourse recalled the global competition in light of the national mythology related to the formation of Chinese nation, the historical “hardship”, and the “heroic Chinese people” (People.cn, 7 Apr. 2020). Moreover, as the threat of infection receded, it was emphasised that China “won this competition” and the Chinese people have demonstrated the “great spirit of China” to the world: a result built upon the “heroism of the whole Party, Army, and Chinese people from all ethnic groups” (People.cn, 7 Apr. 2020). In contrast to the Chinese approach of emphasising national public goods as a justification for fighting the virus, the U.S. Trump Administration used nationalism, deflection, and “culture war” discourse to undermine health responses — an unprecedented response in American public health policy. The seriousness of the disease as well as the statistical evidence of its course through the American population was disputed. The President and various supporters raged against the COVID-19 “hoax”, social distancing, and lockdowns, disparaged public health institutions and advice, and encouraged protesters to “liberate” locked-down states (Russonello). “Our federal overlords say ‘no singing’ and ‘no shouting’ on Thanksgiving”, Representative Paul Gosar, a Republican of Arizona, wrote as he retweeted a Centers for Disease Control list of Thanksgiving safety tips (Weiner). People were encouraged, by way of the White House and Republican leadership, to ignore health regulations and not to comply with social distancing measures and the wearing of masks (Tracy). This encouragement led to threats against proponents of face masks such as Dr Anthony Fauci, one of the nation’s foremost experts on infectious diseases, who required bodyguards because of the many threats on his life. Fauci’s critics — including President Trump — countered Fauci’s promotion of mask wearing by stating accusingly that he once said mask-wearing was not necessary for ordinary people (Kelly). Conspiracy theories as to the safety of vaccinations also grew across the course of the year. As the 2020 election approached, the Administration ramped up efforts to downplay the serious of the virus by identifying it with “the media” and illegitimate “partisan” efforts to undermine the Trump presidency. It also ramped up its criticism of China as the source of the infection. This political self-centeredness undermined state and federal efforts to slow transmission (Shear et al.). At the same time, Trump chided health officials for moving too slowly on vaccine approvals, repeated charges that high infection rates were due to increased testing, and argued that COVID-19 deaths were exaggerated by medical providers for political and financial reasons. These claims were amplified by various conservative media personalities such as Rush Limbaugh, and Sean Hannity and Laura Ingraham of Fox News. The result of this “COVID-19 Denialism” and the alternative narrative of COVID-19 policy told through the lens of culture war has resulted in the United States having the highest number of COVID-19 cases, and the highest number of COVID-19 deaths. At the same time, the underlying social consensus and social capital that have historically assisted in generating positive public health outcomes has been significantly eroded. According to the Pew Research Center, the share of U.S. adults who say public health officials such as those at the Centers for Disease Control and Prevention are doing an excellent or good job responding to the outbreak decreased from 79% in March to 63% in August, with an especially sharp decrease among Republicans (Pew Research Center 2020). Social Capital and COVID-19 From the perspective of social or community capital, it could be expected that the American response to the Pandemic would be more effective than the Chinese response. Historically, the United States has had high levels of social capital, a highly developed public health system, and strong governmental capacity. In contrast, China has a relatively high level of governmental and public health capacity, but the level of social capital has been lower and there is a significant presence of traditional values which emphasise parochial and particularistic values. Moreover, the antecedent institutions of social capital, such as weak and inefficient formal institutions (Batjargal et al.), environmental turbulence and resource scarcity along with the transactional nature of guanxi (gift-giving and information exchange and relationship dependence) militate against finding a more effective social and community response to the public health emergency. Yet China’s response has been significantly more successful than the Unites States’. Paradoxically, the American response under the Trump Administration and the Chinese response both relied on an externalisation of the both the threat and the justifications for their particular response. In the American case, President Trump, while downplaying the seriousness of the virus, consistently called it the “China virus” in an effort to deflect responsibly as well as a means to avert attention away from the public health impacts. As recently as 3 January 2021, Trump tweeted that the number of “China Virus” cases and deaths in the U.S. were “far exaggerated”, while critically citing the Centers for Disease Control and Prevention's methodology: “When in doubt, call it COVID-19. Fake News!” (Bacon). The Chinese Government, meanwhile, has pursued a more aggressive foreign policy across the South China Sea, on the frontier in the Indian sub-continent, and against states such as Australia who have criticised the initial Chinese response to COVID-19. To this international criticism, the government reiterated its sovereign rights and emphasised its “victimhood” in the face of “anti-China” foreign forces. Chinese state media also highlighted China as “victim” of the coronavirus, but also as a target of Western “political manoeuvres” when investigating the beginning stages of the pandemic. The major difference, however, is that public health policy in the United States was superimposed on other more fundamental political and cultural cleavages, and part of this externalisation process included the assignation of “otherness” and demonisation of internal political opponents or characterising political opponents as bent on destroying the United States. This assignation of “otherness” to various internal groups is a crucial element in the culture wars. While this may have been inevitable given the increasingly frayed nature of American society post-2008, such a characterisation has been activity pushed by local, state, and national leadership in the Republican Party and the Trump Administration (Vogel et al.). In such circumstances, minimising health risks and highlighting civil rights concerns due to public health measures, along with assigning blame to the democratic opposition and foreign states such as China, can have a major impact of public health responses. The result has been that social trust beyond the bubble of one’s immediate circle or those who share similar beliefs is seriously compromised — and the collective action problem presented by COVID-19 remains unsolved. Daniel Aldrich’s study of disasters in Japan, India, and US demonstrates that pre-existing high levels of social capital would lead to stronger resilience and better recovery (Aldrich). Social capital helps coordinate resources and facilitate the reconstruction collectively and therefore would lead to better recovery (Alesch et al.). Yet there has not been much research on how the pool of social capital first came about and how a disaster may affect the creation and store of social capital. Rebecca Solnit has examined five major disasters and describes that after these events, survivors would reach out and work together to confront the challenges they face, therefore increasing the social capital in the community (Solnit). However, there are studies that have concluded that major disasters can damage the social fabric in local communities (Peacock et al.). The COVID-19 epidemic does not have the intensity and suddenness of other disasters but has had significant knock-on effects in increasing or decreasing social capital, depending on the institutional and social responses to the pandemic. In China, it appears that the positive social capital effects have been partially subsumed into a more generalised patriotic or nationalist affirmation of the government’s policy response. Unlike civil society responses to earlier crises, such as the 2008 Sichuan earthquake, there is less evidence of widespread community organisation and response to combat the epidemic at its initial stages. This suggests better institutional responses to the crisis by the government, but also a high degree of porosity between civil society and a national “imagined community” represented by the national state. The result has been an increased legitimacy for the Chinese government. Alternatively, in the United States the transformation of COVID-19 public health policy into a culture war issue has seriously impeded efforts to combat the epidemic in the short term by undermining the social consensus and social capital necessary to fight such a pandemic. Trust in American institutions is historically low, and President Trump’s untrue contention that President Biden’s election was due to “fraud” has further undermined the legitimacy of the American government, as evidenced by the attacks directed at Congress in the U.S. capital on 6 January 2021. As such, the lingering effects the pandemic will have on social, economic, and political institutions will likely reinforce the deep cultural and political cleavages and weaken interpersonal networks in American society. Conclusion The COVID-19 pandemic has devastated global public health and impacted deeply on the world economy. Unsurprisingly, given the serious economic, social, and political consequences, different government responses have been highly politicised. Various quarantine and infection case tracking methods have caused concern over state power intruding into private spheres. The usage of face masks, social distancing rules, and intra-state travel restrictions have aroused passionate debate over public health restrictions, individual liberty, and human rights. Yet underlying public health responses grounded in higher levels of social capital enhance the effectiveness of public health measures. In China, a country that has generally been associated with lower social capital, it is likely that the relatively strong policy response to COVID-19 will both enhance feelings of nationalism and Chinese exceptionalism and help create and increase the store of social capital. 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The Leichhardt Highway is a six hundred-kilometre stretch of sealed inland road that joins the Australian Queensland border town of Goondiwindi with the Capricorn Highway, just south of the Tropic of Capricorn. Named after the young Prussian naturalist Ludwig Leichhardt, part of this roadway follows the route his party took as they crossed northern Australia from Morton Bay (Brisbane) to Port Essington (near Darwin). Ignoring the usual colonial practice of honouring the powerful and aristocratic, Leichhardt named the noteworthy features along this route after his supporters and fellow expeditioners. Many of these names are still in use and a series of public monuments have also been erected in the intervening century and a half to commemorate this journey. Unlike Leichhardt, who survived his epic trip, some contemporary travellers who navigate the remote roadway named in his honour do not arrive at their final destinations. Memorials to these violently interrupted lives line the highway, many enigmatically located in places where there is no obvious explanation for the lethal violence that occurred there. This examination profiles the memorials along Leichhardt’s highway as Gothic practice, in order to illuminate some of the uncanny paradoxes around public memorials, as well as the loaded emotional terrain such commemorative practices may inhabit. All humans know that death awaits them (Morell). Yet, despite this, and the unprecedented torrent of images of death and dying saturating news, television, and social media (Duwe; Sumiala; Bisceglio), Gorer’s mid-century ideas about the denial of death and Becker’s 1973 Pulitzer prize-winning description of the purpose of human civilization as a defence against this knowledge remains current in the contemporary trope that individuals (at least in the West) deny their mortality. Contributing to this enigmatic situation is how many deny the realities of aging and bodily decay—the promise of the “life extension” industries (Hall)—and are shielded from death by hospitals, palliative care providers, and the multimillion dollar funeral industry (Kiernan). Drawing on Piatti-Farnell’s concept of popular culture artefacts as “haunted/haunting” texts, the below describes how memorials to the dead can powerfully reconnect those who experience them with death’s reality, by providing an “encrypted passageway through which the dead re-join the living in a responsive cycle of exchange and experience” (Piatti-Farnell). While certainly very different to the “sublime” iconic Gothic structure, the Gothic ruin that Summers argued could be seen as “a sacred relic, a memorial, a symbol of infinite sadness, of tenderest sensibility and regret” (407), these memorials do function in both this way as melancholy/regret-inducing relics as well as in Piatti-Farnell’s sense of bringing the dead into everyday consciousness. Such memorialising activity also evokes one of Spooner’s features of the Gothic, by acknowledging “the legacies of the past and its burdens on the present” (8).Ludwig Leichhardt and His HighwayWhen Leichhardt returned to Sydney in 1846 from his 18-month journey across northern Australia, he was greeted with surprise and then acclaim. Having mounted his expedition without any backing from influential figures in the colony, his party was presumed lost only weeks after its departure. Yet, once Leichhardt and almost all his expedition returned, he was hailed “Prince of Explorers” (Erdos). When awarding him a significant purse raised by public subscription, then Speaker of the Legislative Council voiced what he believed would be the explorer’s lasting memorial —the public memory of his achievement: “the undying glory of having your name enrolled amongst those of the great men whose genius and enterprise have impelled them to seek for fame in the prosecution of geographical science” (ctd. Leichhardt 539). Despite this acclaim, Leichhardt was a controversial figure in his day; his future prestige not enhanced by his Prussian/Germanic background or his disappearance two years later attempting to cross the continent. What troubled the colonial political class, however, was his transgressive act of naming features along his route after commoners rather than the colony’s aristocrats. Today, the Leichhardt Highway closely follows Leichhardt’s 1844-45 route for some 130 kilometres from Miles, north through Wandoan to Taroom. In the first weeks of his journey, Leichhardt named 16 features in this area: 6 of the more major of these after the men in his party—including the Aboriginal man ‘Charley’ and boy John Murphy—4 more after the tradesmen and other non-aristocratic sponsors of his venture, and the remainder either in memory of the journey’s quotidian events or natural features there found. What we now accept as traditional memorialising practice could in this case be termed as Gothic, in that it upset the rational, normal order of its day, and by honouring humble shopkeepers, blacksmiths and Indigenous individuals, revealed the “disturbance and ambivalence” (Botting 4) that underlay colonial class relations (Macintyre). On 1 December 1844, Leichhardt also memorialised his own past, referencing the Gothic in naming a watercourse The Creek of the Ruined Castles due to the “high sandstone rocks, fissured and broken like pillars and walls and the high gates of the ruined castles of Germany” (57). Leichhardt also disturbed and disfigured the nature he so admired, famously carving his initials deep into trees along his route—a number of which still exist, including the so-called Leichhardt Tree, a large coolibah in Taroom’s main street. Leichhardt also wrote his own memorial, keeping detailed records of his experiences—both good and more regretful—in the form of field books, notebooks and letters, with his major volume about this expedition published in London in 1847. Leichhardt’s journey has since been memorialised in various ways along the route. The Leichhardt Tree has been further defaced with numerous plaques nailed into its ancient bark, and the town’s federal government-funded Bicentennial project raised a formal memorial—a large sandstone slab laid with three bronze plaques—in the newly-named Ludwig Leichhardt Park. Leichhardt’s name also adorns many sites both along, and outside, the routes of his expeditions. While these fittingly include natural features such as the Leichhardt River in north-west Queensland (named in 1856 by Augustus Gregory who crossed it by searching for traces of the explorer’s ill-fated 1848 expedition), there are also many businesses across Queensland and the Northern Territory less appropriately carrying his name. More somber monuments to Leichhardt’s legacy also resulted from this journey. The first of these was the white settlement that followed his declaration that the countryside he moved through was well endowed with fertile soils. With squatters and settlers moving in and land taken up before Leichhardt had even arrived back in Sydney, the local Yeeman people were displaced, mistreated and completely eradicated within a decade (Elder). Mid-twentieth century, Patrick White’s literary reincarnation, Voss of the eponymous novel, and paintings by Sidney Nolan and Albert Tucker have enshrined in popular memory not only the difficult (and often described as Gothic) nature of the landscape through which Leichhardt travelled (Adams; Mollinson, and Bonham), but also the distinctive and contrary blend of intelligence, spiritual mysticism, recklessness, and stoicism Leichhardt brought to his task. Roadside Memorials Today, the Leichhardt Highway is also lined with a series of roadside shrines to those who have died much more recently. While, like centotaphs, tombstones, and cemeteries, these memorialise the dead, they differ in usually marking the exact location that death occurred. In 43 BC, Cicero articulated the idea of the dead living in memory, “The life of the dead consists in the recollection cherished of them by the living” (93), yet Nelson is one of very few contemporary writers to link roadside memorials to elements of Gothic sensibility. Such constructions can, however, be described as Gothic, in that they make the roadway unfamiliar by inscribing onto it the memory of corporeal trauma and, in the process, re-creating their locations as vivid sites of pain and suffering. These are also enigmatic sites. Traffic levels are generally low along the flat or gently undulating terrain and many of these memorials are located in locations where there is no obvious explanation for the violence that occurred there. They are loci of contradictions, in that they are both more private than other memorials, in being designed, and often made and erected, by family and friends of the deceased, and yet more public, visible to all who pass by (Campbell). Cemeteries are set apart from their surroundings; the roadside memorial is, in contrast, usually in open view along a thoroughfare. In further contrast to cemeteries, which contain many relatively standardised gravesites, individual roadside memorials encapsulate and express not only the vivid grief of family and friends but also—when they include vehicle wreckage or personal artefacts from the fatal incident—provide concrete evidence of the trauma that occurred. While the majority of individuals interned in cemeteries are long dead, roadside memorials mark relatively contemporary deaths, some so recent that there may still be tyre marks, debris and bloodstains marking the scene. In 2008, when I was regularly travelling this roadway, I documented, and researched, the six then extant memorial sites that marked the locations of ten fatalities from 1999 to 2006. (These were all still in place in mid-2014.) The fatal incidents are very diverse. While half involved trucks and/or road trains, at least three were single vehicle incidents, and the deceased ranged from 13 to 84 years of age. Excell argues that scholarship on roadside memorials should focus on “addressing the diversity of the material culture” (‘Contemporary Deathscapes’) and, in these terms, the Leichhardt Highway memorials vary from simple crosses to complex installations. All include crosses (mostly, but not exclusively, white), and almost all are inscribed with the name and birth/death dates of the deceased. Most include flowers or other plants (sometimes fresh but more often plastic), but sometimes also a range of relics from the crash and/or personal artefacts. These are, thus, unsettling sights, not least in the striking contrast they provide with the highway and surrounding road reserve. The specific location is a key component of their ability to re-sensitise viewers to the dangers of the route they are travelling. The first memorial travelling northwards, for instance, is situated at the very point at which the highway begins, some 18 kilometres from Goondiwindi. Two small white crosses decorated with plastic flowers are set poignantly close together. The inscriptions can also function as a means of mobilising connection with these dead strangers—a way of building Secomb’s “haunted community”, whereby community in the post-colonial age can only be built once past “murderous death” (131) is acknowledged. This memorial is inscribed with “Cec Hann 06 / A Good Bloke / A Good hoarseman [sic]” and “Pat Hann / A Good Woman” to tragically commemorate the deaths of an 84-year-old man and his 79-year-old wife from South Australia who died in the early afternoon of 5 June 2006 when their Ford Falcon, towing a caravan, pulled onto the highway and was hit by a prime mover pulling two trailers (Queensland Police, ‘Double Fatality’; Jones, and McColl). Further north along the highway are two memorials marking the most inexplicable of road deaths: the single vehicle fatality (Connolly, Cullen, and McTigue). Darren Ammenhauser, aged 29, is remembered with a single white cross with flowers and plaque attached to a post, inscribed hopefully, “Darren Ammenhauser 1971-2000 At Rest.” Further again, at Billa Billa Creek, a beautifully crafted metal cross attached to a fence is inscribed with the text, “Kenneth J. Forrester / RIP Jack / 21.10.25 – 27.4.05” marking the death of the 79-year-old driver whose vehicle veered off the highway to collide with a culvert on the creek. It was reported that the vehicle rolled over several times before coming to rest on its wheels and that Forrester was dead when the police arrived (Queensland Police, ‘Fatal Traffic Incident’). More complex memorials recollect both single and multiple deaths. One, set on both sides of the road, maps the physical trajectory of the fatal smash. This memorial comprises white crosses on both sides of road, attached to a tree on one side, and a number of ancillary sites including damaged tyres with crosses placed inside them on both sides of the road. Simple inscriptions relay the inability of such words to express real grief: “Gary (Gazza) Stevens / Sadly missed” and “Gary (Gazza) Stevens / Sadly missed / Forever in our hearts.” The oldest and most complex memorial on the route, commemorating the death of four individuals on 18 June 1999, is also situated on both sides of the road, marking the collision of two vehicles travelling in opposite directions. One memorial to a 62-year-old man comprises a cross with flowers, personal and automotive relics, and a plaque set inside a wooden fence and simply inscribed “John Henry Keenan / 23-11-1936–18-06-1999”. The second memorial contains three white crosses set side-by-side, together with flowers and relics, and reveals that members of three generations of the same family died at this location: “Raymond Campbell ‘Butch’ / 26-3-67–18-6-99” (32 years of age), “Lorraine Margaret Campbell ‘Lloydie’ / 29-11-46–18-6-99” (53 years), and “Raymond Jon Campbell RJ / 28-1-86–18-6-99” (13 years). The final memorial on this stretch of highway is dedicated to Jason John Zupp of Toowoomba who died two weeks before Christmas 2005. This consists of a white cross, decorated with flowers and inscribed: “Jason John Zupp / Loved & missed by all”—a phrase echoed in his newspaper obituary. The police media statement noted that, “at 11.24pm a prime mover carrying four empty trailers [stacked two high] has rolled on the Leichhardt Highway 17km north of Taroom” (Queensland Police, ‘Fatal Truck Accident’). The roadside memorial was placed alongside a ditch on a straight stretch of road where the body was found. The coroner’s report adds the following chilling information: “Mr Zupp was thrown out of the cabin and his body was found near the cabin. There is no evidence whatsoever that he had applied the brakes or in any way tried to prevent the crash … Jason was not wearing his seatbelt” (Cornack 5, 6). Cornack also remarked the truck was over length, the brakes had not been properly adjusted, and the trip that Zupp had undertaken could not been lawfully completed according to fatigue management regulations then in place (8). Although poignant and highly visible due to these memorials, these deaths form a small part of Australia’s road toll, and underscore our ambivalent relationship with the automobile, where road death is accepted as a necessary side-effect of the freedom of movement the technology offers (Ladd). These memorials thus animate highways as Gothic landscapes due to the “multifaceted” (Haider 56) nature of the fear, terror and horror their acknowledgement can bring. Since 1981, there have been, for instance, between some 1,600 and 3,300 road deaths each year in Australia and, while there is evidence of a long term downward trend, the number of deaths per annum has not changed markedly since 1991 (DITRDLG 1, 2), and has risen in some years since then. The U.S.A. marked its millionth road death in 1951 (Ladd) along the way to over 3,000,000 during the 20th century (Advocates). These deaths are far reaching, with U.K. research suggesting that each death there leaves an average of 6 people significantly affected, and that there are some 10 to 20 per cent of mourners who experience more complicated grief and longer term negative affects during this difficult time (‘Pathways Through Grief’). As the placing of roadside memorials has become a common occurrence the world over (Klaassens, Groote, and Vanclay; Grider; Cohen), these are now considered, in MacConville’s opinion, not only “an appropriate, but also an expected response to tragedy”. Hockey and Draper have explored the therapeutic value of the maintenance of “‘continuing bonds’ between the living and the dead” (3). This is, however, only one explanation for the reasons that individuals erect roadside memorials with research suggesting roadside memorials perform two main purposes in their linking of the past with the present—as not only sites of grieving and remembrance, but also of warning (Hartig, and Dunn; Everett; Excell, Roadside Memorials; MacConville). Clark adds that by “localis[ing] and personalis[ing] the road dead,” roadside memorials raise the profile of road trauma by connecting the emotionless statistics of road death directly to individual tragedy. They, thus, transform the highway into not only into a site of past horror, but one in which pain and terror could still happen, and happen at any moment. Despite their increasing commonality and their recognition as cultural artefacts, these memorials thus occupy “an uncomfortable place” both in terms of public policy and for some individuals (Lowe). While in some states of the U.S.A. and in Ireland the erection of such memorials is facilitated by local authorities as components of road safety campaigns, in the U.K. there appears to be “a growing official opposition to the erection of memorials” (MacConville). Criticism has focused on the dangers (of distraction and obstruction) these structures pose to passing traffic and pedestrians, while others protest their erection on aesthetic grounds and even claim memorials can lower property values (Everett). While many ascertain a sense of hope and purpose in the physical act of creating such shrines (see, for instance, Grider; Davies), they form an uncanny presence along the highway and can provide dangerous psychological territory for the viewer (Brien). Alongside the townships, tourist sites, motels, and petrol stations vying to attract customers, they stain the roadway with the unmistakable sign that a violent death has happened—bringing death, and the dead, to the fore as a component of these journeys, and destabilising prominent cultural narratives of technological progress and safety (Richter, Barach, Ben-Michael, and Berman).Conclusion This investigation has followed Goddu who proposes that a Gothic text “registers its culture’s contradictions” (3) and, in profiling these memorials as “intimately connected to the culture that produces them” (Goddu 3) has proposed memorials as Gothic artefacts that can both disturb and reveal. Roadside memorials are, indeed, so loaded with emotional content that their close contemplation can be traumatising (Brien), yet they are inescapable while navigating the roadway. Part of their power resides in their ability to re-animate those persons killed in these violent in the minds of those viewing these memorials. In this way, these individuals are reincarnated as ghostly presences along the highway, forming channels via which the traveller can not only make human contact with the dead, but also come to recognise and ponder their own sense of mortality. While roadside memorials are thus like civic war memorials in bringing untimely death to the forefront of public view, roadside memorials provide a much more raw expression of the chaotic, anarchic and traumatic moment that separates the world of the living from that of the dead. While traditional memorials—such as those dedicated by, and to, Leichhardt—moreover, pay homage to the vitality of the lives of those they commemorate, roadside memorials not only acknowledge the alarming circumstances of unexpected death but also stand testament to the power of the paradox of the incontrovertibility of sudden death versus our lack of ability to postpone it. In this way, further research into these and other examples of Gothic memorialising practice has much to offer various areas of cultural study in Australia.ReferencesAdams, Brian. Sidney Nolan: Such Is Life. Hawthorn, Vic.: Hutchinson, 1987. Advocates for Highway and Auto Safety. “Motor Vehicle Traffic Fatalities & Fatality Rate: 1899-2003.” 2004. Becker, Ernest. The Denial of Death. New York: Simon & Schuster, 1973. Bisceglio, Paul. “How Social Media Is Changing the Way We Approach Death.” The Atlantic 20 Aug. 2013. Botting, Fred. Gothic: The New Critical Idiom. 2nd edition. Abingdon, UK: Routledge, 2014. 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In the last months of his life, 86-year-old Albert Facey became a best-selling author and revered cultural figure following the publication of his autobiography, A Fortunate Life. Released on Anzac Day 1981, it was praised for its “plain, unembellished, utterly sincere and un-self-pitying account of the privations of childhood and youth” (Semmler) and “extremely powerful description of Gallipoli” (Dutton 16). Within weeks, critic Nancy Keesing declared it an “Enduring Classic.” Within six months, it was announced as the winner of two prestigious non-fiction awards, with judges acknowledging Facey’s “extraordinary memory” and “ability to describe scenes and characters with great precision” (“NBC” 4). A Fortunate Life also transformed the fortunes of its publisher. Founded in 1976 as an independent, not-for-profit publishing house, Fremantle Arts Centre Press (FACP) might have been expected, given the Australian average, to survive for just a few years. Former managing editor Ray Coffey attributes the Press’s ongoing viability, in no small measure, to Facey’s success (King 29). Along with Wendy Jenkins, Coffey edited Facey’s manuscript through to publication; only five months after its release, with demand outstripping the capabilities, FACP licensed Penguin to take over the book’s production and distribution. Adaptations soon followed. In 1984, Kerry Packer’s PBL launched a prospectus for a mini-series, which raised a record $6.3 million (PBL 7–8). Aired in 1986 with a high-rating documentary called The Facey Phenomenon, the series became the most watched television event of the year (Lucas). Syndication of chapters to national and regional newspapers, stage and radio productions, audio- and e-books, abridged editions for young readers, and inclusion on secondary school curricula extended the range and influence of Facey’s life writing. Recently, an option was taken out for a new television series (Fraser).A hundred reprints and two million readers on from initial publication, A Fortunate Life continues to rate among the most appreciated Australian books of all time. Commenting on a reader survey in 2012, writer and critic Marieke Hardy enthused, “I really loved it [. . .] I felt like I was seeing a part of my country and my country’s history through a very human voice . . .” (First Tuesday Book Club). Registering a transformed reading, Hardy’s reference to Australian “history” is unproblematically juxtaposed with amused delight in an autobiography that invents and embellishes: not believing “half” of what Facey wrote, she insists he was foremost a yarn spinner. While the work’s status as a witness account has become less authoritative over time, it seems appreciation of the author’s imagination and literary skill has increased (Williamson). A Fortunate Life has been read more commonly as an uncomplicated, first-hand account, such that editor Wendy Jenkins felt it necessary to refute as an “utter mirage” that memoir is “transferred to the page by an act of perfect dictation.” Sidonie Smith and Julia Watson argue of life narratives that some “autobiographical claims [. . .] can be verified or discounted by recourse to documentation outside the text. But autobiographical truth is a different matter” (16). With increased access to archives, especially digitised personnel records, historians have asserted that key elements of Facey’s autobiography are incorrect or “fabricated” (Roberts), including his enlistment in 1914 and participation in the Gallipoli Landing on 25 April 1915. We have researched various sources relevant to Facey’s early years and war service, including hard-copy medical and repatriation records released in 2012, and find A Fortunate Life in a range of ways deviates from “documentation outside of the text,” revealing intriguing, layered storytelling. We agree with Smith and Watson that “autobiographical acts” are “anything but simple or transparent” (63). As “symbolic interactions in the world,” they are “culturally and historically specific” and “engaged in an argument about identity” (63). Inevitably, they are also “fractured by the play of meaning” (63). Our approach, therefore, includes textual analysis of Facey’s drafts alongside the published narrative and his medical records. We do not privilege institutional records as impartial but rather interpret them in terms of their hierarchies and organisation of knowledge. This leads us to speculate on alternative readings of A Fortunate Life as an illness narrative that variously resists and subscribes to dominant cultural plots, tropes, and attitudes. Facey set about writing in earnest in the 1970s and generated (at least) three handwritten drafts, along with a typescript based on the third draft. FACP produced its own working copy from the typescript. Our comparison of the drafts offers insights into the production of Facey’s final text and the otherwise “hidden” roles of editors as transformers and enablers (Munro 1). The notion that a working man with basic literacy could produce a highly readable book in part explains Facey’s enduring appeal. His grandson and literary executor, John Rose, observed in early interviews that Facey was a “natural storyteller” who had related details of his life at every opportunity over a period of more than six decades (McLeod). Jenkins points out that Facey belonged to a vivid oral culture within which he “told and retold stories to himself and others,” so that they eventually “rubbed down into the lines and shapes that would so memorably underpin the extended memoir that became A Fortunate Life.” A mystique was thereby established that “time” was Albert Facey’s “first editor” (Jenkins). The publisher expressly aimed to retain Facey’s voice, content, and meaning, though editing included much correcting of grammar and punctuation, eradication of internal inconsistencies and anomalies, and structural reorganisation into six sections and 68 chapters. We find across Facey’s drafts a broadly similar chronology detailing childhood abandonment, life-threatening incidents, youthful resourcefulness, physical prowess, and participation in the Gallipoli Landing. However, there are also shifts and changed details, including varying descriptions of childhood abuse at a place called Cave Rock; the introduction of (incompatible accounts of) interstate boxing tours in drafts two and three which replace shearing activities in Draft One; divergent tales of Facey as a world-standard athlete, league footballer, expert marksman, and powerful swimmer; and changing stories of enlistment and war service (see Murphy and Nile, “Wounded”; “Naked”).Jenkins edited those sections concerned with childhood and youth, while Coffey attended to Facey’s war and post-war life. Drawing on C.E.W. Bean’s official war history, Coffey introduced specificity to the draft’s otherwise vague descriptions of battle and amended errors, such as Facey’s claim to have witnessed Lord Kitchener on the beach at Gallipoli. Importantly, Coffey suggested the now famous title, “A Fortunate Life,” and encouraged the author to alter the ending. When asked to suggest a title, Facey offered “Cave Rock” (Interview)—the site of his violent abuse and humiliation as a boy. Draft One concluded with Facey’s repatriation from the war and marriage in 1916 (106); Draft Two with a brief account of continuing post-war illness and ultimate defeat: “My war injuries caught up with me again” (107). The submitted typescript concludes: “I have often thought that going to War has caused my life to be wasted” (Typescript 206). This ending differs dramatically from the redemptive vision of the published narrative: “I have lived a very good life, it has been very rich and full. I have been very fortunate and I am thrilled by it when I look back” (412).In The Wounded Storyteller, Arthur Frank argues that literary markets exist for stories of “narrative wreckage” (196) that are redeemed by reconciliation, resistance, recovery, or rehabilitation, which is precisely the shape of Facey’s published life story and a source of its popularity. Musing on his post-war experiences in A Fortunate Life, Facey focuses on his ability to transform the material world around him: “I liked the challenge of building up a place from nothing and making a success where another fellow had failed” (409). If Facey’s challenge was building up something from nothing, something he could set to work on and improve, his life-writing might reasonably be regarded as a part of this broader project and desire for transformation, so that editorial interventions helped him realise this purpose. Facey’s narrative was produced within a specific zeitgeist, which historian Joy Damousi notes was signalled by publication in 1974 of Bill Gammage’s influential, multiply-reprinted study of front-line soldiers, The Broken Years, which drew on the letters and diaries of a thousand Great War veterans, and also the release in 1981 of Peter Weir’s film Gallipoli, for which Gammage was the historical advisor. The story of Australia’s war now conceptualised fallen soldiers as “innocent victims” (Damousi 101), while survivors were left to “compose” memories consistent with their sacrifice (Thomson 237–54). Viewing Facey’s drafts reminds us that life narratives are works of imagination, that the past is not fixed and memory is created in the present. Facey’s autobiographical efforts and those of his publisher to improve the work’s intelligibility and relevance together constitute an attempt to “objectify the self—to present it as a knowable object—through a narrative that re-structures [. . .] the self as history and conclusions” (Foster 10). Yet, such histories almost invariably leave “a crucial gap” or “censored chapter.” Dennis Foster argues that conceiving of narration as confession, rather than expression, “allows us to see the pathos of the simultaneous pursuit and evasion of meaning” (10); we believe a significant lacuna in Facey’s life writing is intimated by its various transformations.In a defining episode, A Fortunate Life proposes that Facey was taken from Gallipoli on 19 August 1915 due to wounding that day from a shell blast that caused sandbags to fall on him, crush his leg, and hurt him “badly inside,” and a bullet to the shoulder (348). The typescript, however, includes an additional but narratively irreconcilable date of 28 June for the same wounding. The later date, 19 August, was settled on for publication despite the author’s compelling claim for the earlier one: “I had been blown up by a shell and some 7 or 8 sandbags had fallen on top of me, the day was the 28th of June 1915, how I remembered this date, it was the day my brother Roy had been killed by a shell burst.” He adds: “I was very ill for about six weeks after the incident but never reported it to our Battalion doctor because I was afraid he would send me away” (Typescript 205). This account accords with Facey’s first draft and his medical records but is inconsistent with other parts of the typescript that depict an uninjured Facey taking a leading role in fierce fighting throughout July and August. It appears, furthermore, that Facey was not badly wounded at any time. His war service record indicates that he was removed from Gallipoli due to “heart troubles” (Repatriation), which he also claims in his first draft. Facey’s editors did not have ready access to military files in Canberra, while medical files were not released until 2012. There existed, therefore, virtually no opportunity to corroborate the author’s version of events, while the official war history and the records of the State Library of Western Australia, which were consulted, contain no reference to Facey or his war service (Interview). As a consequence, the editors were almost entirely dependent on narrative logic and clarifications by an author whose eyesight and memory had deteriorated to such an extent he was unable to read his amended text. A Fortunate Life depicts men with “nerve sickness” who were not permitted to “stay at the Front because they would be upsetting to the others, especially those who were inclined that way themselves” (350). By cross referencing the draft manuscripts against medical records, we can now perceive that Facey was regarded as one of those nerve cases. According to Facey’s published account, his wounds “baffled” doctors in Egypt and Fremantle (353). His medical records reveal that in September 1915, while hospitalised in Egypt, his “palpitations” were diagnosed as “Tachycardia” triggered by war-induced neuroses that began on 28 June. This suggests that Facey endured seven weeks in the field in this condition, with the implication being that his debility worsened, resulting in his hospitalisation. A diagnosis of “debility,” “nerves,” and “strain” placed Facey in a medical category of “Special Invalids” (Butler 541). Major A.W. Campbell noted in the Medical Journal of Australia in 1916 that the war was creating “many cases of little understood nervous and mental affections, not only where a definite wound has been received, but in many cases where nothing of the sort appears” (323). Enlisted doctors were either physicians or surgeons and sometimes both. None had any experience of trauma on the scale of the First World War. In 1915, Campbell was one of only two Australian doctors with any pre-war experience of “mental diseases” (Lindstrom 30). On staff at the Australian Base Hospital at Heliopolis throughout the Gallipoli campaign, he claimed that at times nerve cases “almost monopolised” the wards under his charge (319). Bearing out Facey’s description, Campbell also reported that affected men “received no sympathy” and, as “carriers of psychic contagion,” were treated as a “source of danger” to themselves and others (323). Credentialed by royal colleges in London and coming under British command, Australian medical teams followed the practice of classifying men presenting “nervous or mental symptoms” as “battle casualties” only if they had also been wounded by “enemy action” (Loughran 106). By contrast, functional disability, with no accompanying physical wounds, was treated as unmanly and a “hysterical” reaction to the pressures of war. Mental debility was something to be feared in the trenches and diagnosis almost invariably invoked charges of predisposition or malingering (Tyquin 148–49). This shifted responsibility (and blame) from the war to the individual. Even as late as the 1950s, medical notes referred to Facey’s condition as being “constitutional” (Repatriation).Facey’s narrative demonstrates awareness of how harshly sufferers were treated. We believe that he defended himself against this with stories of physical injury that his doctors never fully accepted and that he may have experienced conversion disorder, where irreconcilable experience finds somatic expression. His medical diagnosis in 1915 and later life writing establish a causal link with the explosion and his partial burial on 28 June, consistent with opinion at the time that linked concussive blasts with destabilisation of the nervous system (Eager 422). Facey was also badly shaken by exposure to the violence and abjection of war, including hand-to-hand combat and retrieving for burial shattered and often decomposed bodies, and, in particular, by the death of his brother Roy, whose body was blown to pieces on 28 June. (A second brother, Joseph, was killed by multiple bayonet wounds while Facey was convalescing in Egypt.) Such experiences cast a different light on Facey’s observation of men suffering nerves on board the hospital ship: “I have seen men doze off into a light sleep and suddenly jump up shouting, ‘Here they come! Quick! Thousands of them. We’re doomed!’” (350). Facey had escaped the danger of death by explosion or bayonet but at a cost, and the war haunted him for the rest of his days. On disembarkation at Fremantle on 20 November 1915, he was admitted to hospital where he remained on and off for several months. Forty-one other sick and wounded disembarked with him (HMAT). Around one third, experiencing nerve-related illness, had been sent home for rest; while none returned to the war, some of the physically wounded did (War Service Records). During this time, Facey continued to present with “frequent attacks of palpitation and giddiness,” was often “short winded,” and had “heart trouble” (Repatriation). He was discharged from the army in June 1916 but, his drafts suggest, his war never really ended. He began a new life as a wounded Anzac. His dependent and often fractious relationship with the Repatriation Department ended only with his death 66 years later. Historian Marina Larsson persuasively argues that repatriated sick and wounded servicemen from the First World War represented a displaced presence at home. Many led liminal lives of “disenfranchised grief” (80). Stephen Garton observes a distinctive Australian use of repatriation to describe “all policies involved in returning, discharging, pensioning, assisting and training returned men and women, and continuing to assist them throughout their lives” (74). Its primary definition invokes coming home but to repatriate also implies banishment from a place that is not home, so that Facey was in this sense expelled from Gallipoli and, by extension, excluded from the myth of Anzac. Unlike his two brothers, he would not join history as one of the glorious dead; his name would appear on no roll of honour. Return home is not equivalent to restoration of his prior state and identity, for baggage from the other place perpetually weighs. Furthermore, failure to regain health and independence strains hospitality and gratitude for the soldier’s service to King and country. This might be exacerbated where there is no evident or visible injury, creating suspicion of resistance, cowardice, or malingering. Over 26 assessments between 1916 and 1958, when Facey was granted a full war pension, the Repatriation Department observed him as a “neuropathic personality” exhibiting “paroxysmal tachycardia” and “neurocirculatory asthenia.” In 1954, doctors wrote, “We consider the condition is a real handicap and hindrance to his getting employment.” They noted that after “attacks,” Facey had a “busted depressed feeling,” but continued to find “no underlying myocardial disease” (Repatriation) and no validity in Facey’s claims that he had been seriously physically wounded in the war (though A Fortunate Life suggests a happier outcome, where an independent medical panel finally locates the cause of his ongoing illness—rupture of his spleen in the war—which results in an increased war pension). Facey’s condition was, at times, a source of frustration for the doctors and, we suspect, disappointment and shame to him, though this appeared to reduce on both sides when the Repatriation Department began easing proof of disability from the 1950s (Thomson 287), and the Department of Veteran’s Affairs was created in 1976. This had the effect of shifting public and media scrutiny back onto a system that had until then deprived some “innocent victims of the compensation that was their due” (Garton 249). Such changes anticipated the introduction of Post-Traumatic Shock Disorder (PTSD) to the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1980. Revisions to the DSM established a “genealogy of trauma” and “panic disorders” (100, 33), so that diagnoses such as “neuropathic personality” (Echterling, Field, and Stewart 192) and “soldier’s heart,” that is, disorders considered “neurotic,” were “retrospectively reinterpreted” as a form of PTSD. However, Alberti points out that, despite such developments, war-related trauma continues to be contested (80). We propose that Albert Facey spent his adult life troubled by a sense of regret and failure because of his removal from Gallipoli and that he attempted to compensate through storytelling, which included his being an original Anzac and seriously wounded in action. By writing, Facey could shore up his rectitude, work ethic, and sense of loyalty to other servicemen, which became necessary, we believe, because repatriation doctors (and probably others) had doubted him. In 1927 and again in 1933, an examining doctor concluded: “The existence of a disability depends entirely on his own unsupported statements” (Repatriation). We argue that Facey’s Gallipoli experiences transformed his life. By his own account, he enlisted for war as a physically robust and supremely athletic young man and returned nine months later to life-long anxiety and ill-health. Publication transformed him into a national sage, earning him, in his final months, the credibility, empathy, and affirmation he had long sought. Exploring different accounts of Facey, in the shape of his drafts and institutional records, gives rise to new interpretations. In this context, we believe it is time for a new edition of A Fortunate Life that recognises it as a complex testimonial narrative and theorises Facey’s deployment of national legends and motifs in relation to his “wounded storytelling” as well as to shifting cultural and medical conceptualisations and treatments of shame and trauma. ReferencesAlberti, Fay Bound. Matters of the Heart: History, Medicine, and Emotions. Oxford: Oxford UP, 2010. Butler, A.G. Official History of the Australian Medical Services 1814-1918: Vol I Gallipoli, Palestine and New Guinea. Canberra: Australian War Memorial, 1930.Campbell, A.W. “Remarks on Some Neuroses and Psychoses in War.” Medical Journal of Australia 15 April (1916): 319–23.Damousi, Joy. “Why Do We Get So Emotional about Anzac.” What’s Wrong with Anzac. Ed. Marilyn Lake and Henry Reynolds. Sydney: UNSWP, 2015. 94–109.Dutton, Geoffrey. “Fremantle Arts Centre Press Publicity.” Australian Book Review May (1981): 16.Eager, R. “War Neuroses Occurring in Cases with a Definitive History of Shell Shock.” British Medical Journal 13 Apr. 1918): 422–25.Echterling, L.G., Thomas A. Field, and Anne L. Stewart. “Evolution of PTSD in the DSM.” Future Directions in Post-Traumatic Stress Disorder: Prevention, Diagnosis, and Treatment. Ed. Marilyn P. Safir and Helene S. Wallach. New York: Springer, 2015. 189–212.Facey, A.B. A Fortunate Life. 1981. Ringwood: Penguin, 2005.———. Drafts 1–3. University of Western Australia, Special Collections.———. Transcript. 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