Articles de revues sur le sujet « United States. National Advisory Council for Career Education »

The national mandate to improve health equity in the United Sates is advancing. Racial and ethnic disparities in various aspects of health care have been clearly delineated, and sources of such disparities have been identified. However, implementing solution-focused interventions to eradicate such disparities, thereby achieving health equity in all US communities, has remained a daunting challenge, and no area more so, than with neurologic diseases. To assure success with bridging prominent disparities in neurologic outcomes, the pipeline of neurologic disparities researchers needs to be broadened, numbers of mid-career and senior disparities scientists sustained, partnerships with community stakeholders enhanced, incentivization of academic organizations pursued, education of all neurologic researchers conducted, and exemplary training of funding agency staff prioritized. To improve the current state of neurologic disparities, the National Institute of Neurological Disorders and Stroke assembled a working group of its advisory council. (2020–2022) to examine the state of health disparity training and research. Through consensus building, we present identified gaps and recommendations to the current state of underrepresented groups in medicine in health disparity research and its training and curricula in the United States.

Retaining high quality school-based agricultural education teachers is a growing concern across the United States. This study focused on mid-career agricultural education teachers’ perceptions of job stress, burnout, job satisfaction, and professional development needs related to National Quality Program Standards for Secondary Agriculture Education (The National Council for Agricultural Education, 2009). The target population for this study was participants in the 2013 NAAE eXcellence in Leadership for Retention (XLR8) professional development program. Overall, XLR8 participants indicated the highest levels of job stress related to Standard 2 – Experiential Learning and Standard 7 – Program Planning and Evaluation. Participants were least stressed over Standard 6 – Certified Agriculture Teachers and Professional Growth, which also ranked lowest in terms of desired professional development. The most sought-after area of professional development included Standard 2 – Experiential Learning and Standard 1 – Program Planning and Instruction. Findings suggest XLR8 participants experience “moderate” levels of burnout in each of three categories measured by the Maslach Burnout Inventory for Educators, however are generally satisfied with their job.

Abstract Pamela W Duncan, PT, PhD, FAPTA Dr Duncan has actively participated in and contributed to physical therapist practice, physical therapist professional education, professional preparation of other health care providers, national policy development related to rehabilitation after stroke and aging, and scientific investigation. She has served several government appointments and provides leadership within several organizations. She served as co-chair of the Consensus Panel on Establishing Guidelines for Stroke Rehabilitation for the Agency for Health Care Policy, Research, and Education. She was a panel member on the National Institutes of Health's Total Hip Replacement Consensus Conference and served on the Strategic Planning Group for Stroke Research for the National Institute of Neurological Disorders and Stroke. She recently was appointed to serve on the Steering Committee of the Department of Education's National Institute on Disability and Rehabilitation Research and is currently on the Executive Leadership Council of the American Stroke Foundation and the Advisory Committee of the Canadian Stroke Network. She has served on committees and panels for the American Heart Association and was president of APTA's Neurology section. Dr Duncan's research activities focus on geriatric rehabilitation, stroke rehabilitation, and health outcomes measurement. She developed the Functional Reach Test, used to assess balance in older adults. In the past 20 years, she has received $13 million in research awards as principal investigator or co-investigator from agencies such as the National Institutes of Health, National Institute on Aging, American Heart Association, Department of Veteran's Affairs, and National Center for Medical Rehabilitation Research and from multiple private funding sources. Dr Duncan has disseminated her research findings in more than 80 peer-reviewed articles in 20 different journals, and she has written a book and 12 book chapters. Dr Duncan's work has influenced the care and rehabilitation of patients in the United States and worldwide. Physical therapy education programs across the country incorporate her findings and professional vision into the preparation of the next generation of physical therapists. APTA has awarded Dr Duncan the Marian Williams Award for Research in Physical Therapy, the Catherine Worthingham Fellowship Award, and the Mary McMillan Scholarship Award. She has also received research awards from the APTA Neurology Section, Sports Physical Therapy Section, and Section on Geriatrics, as well as a service award from the Neurology Section. She is an elected fellow of the Stroke Council of the American Heart Association and has given 8 invited lectureships at universities across the United States.

Abstract Background The Coronavirus disease of 2019 (COVID-19) global health crisis has resulted in an unprecedented strain on healthcare systems, reorganization of medical training programs and disruption in professional and personal lives of medical trainees. The impact of COVID-19 on infectious disease (ID) fellows, who are frontline healthcare professionals, has not been assessed. Methods We conducted a national survey of adult and pediatric ID fellows to assess impact on educational activities, availability of personal protective equipment (PPE), well-being, and career prospects. Anxiety and burnout were assessed by 7-item generalized anxiety disorder scale and abbreviated Maslach burnout inventory respectively. Invitations to participate in the survey were sent via email to all ID fellows through Accreditation Council for Graduate Medical Education (ACGME) fellowship directors. Survey responses collected from August 1 to September 30, 2020 have been reported. Results 136 fellows completed the survey (Table 1). 84% reported their institution had provided evidence-based didactics for management of COVID-19 and 53% indicated their general ID didactics were affected by the pandemic. 86% of fellows were involved in care of patients with COVID-19, and 31% reported a shortage of PPE affecting their clinical duties. Those living in highly impacted states (CA, FL, NY, TX) at the time of the survey were 1.70 times as likely to experience moderate to severe anxiety (vs. minimal to moderate) than those in other states; similarly, those who saw ≥11 COVID-19 patients weekly and reported PPE shortages were 2.5 and 2.0 times as likely, respectively, to experience moderate to severe anxiety compared to their peers who took care of 10 or fewer COVID-19 patients and did not experience PPE shortages. Burnout scores were not significant (Table 2). Table 1. Demographics, Responses to Personal Exposure, Educational Activities and Career Prospects Table 2. Stress, Burnout, Anxiety , Sleep and Quality of Life Among Survey Participants. Conclusion It is imperative that ID fellows feel adequately protected and supported during this pandemic. Pandemic preparedness should be included in the ID fellowship curriculum. Interventions for anxiety and burnout reduction should be implemented. ID fellowship programs should continue to accept feedback from fellows to ensure their ongoing safety, well-being, and education as we navigate this pandemic. Disclosures All Authors: No reported disclosures

It has been four decades since the beginning of undergraduate medical education in Nepal and more than three decades of postgraduate medical education.1 Currently, Institute of Medicine of Tribhuwan University and Kathmandu University are major institutions providing medical education in Nepal with the help of their affiliated medical colleges. Two other deemed universities, B P Koirala Institute of Health Sciences and Patan Academy of Health Sciences also have major contributions in producing medical doctors in Nepal. National Academy of Medical Sciences (NAMS) provides postgraduate and super specialty training for doctors. Nepal Medical Council is the regulatory body that lays down the guidelines, provides accreditation and supervises to ensure that the regulations are being followed.2 It also conducts licensing examination for medical doctors.Educationalists worldwide vary in their opinions on the aim of education3-8 but Salomon precisely includes almost all of them as “The aim (of education) is to equip the learner with portable chunks of knowledge, skill, and understandings that can serve in other contexts.”9 Adkoli has analyzed migration of health workers in south Asia 10 and found that there was no systematically collected data regarding the extent of migration of healthcare workers and its possible impact on health care in Nepal. Nepal government spends a significant chunk of its financial resources to train doctors but many students who avail this benefit of ‘scholarship’ take part in the migration described in the article. Ironically, many doctors who are currently serving their motherland were either trained overseas or the ones who did study within Nepal but without availing any support from the government. When the first medical school was established in Nepal, the idea was to develop doctors who can prevent, diagnose and treat medical ailments prevalent in Nepal (Community based curriculum) and the career planning was designed in such a way that doctors were inevitably retained in Nepal. The philosophy of this system was contrary to the definition laid down by Salomon9 but it did benefit the society and the country in the long run11. Things changed gradually over time and currently the doctors produced by oldest and state funded medical colleges of Nepal are ideal for health job markets of first world countries. This suitability coupled with adverse socieo-economic and political factors of our country has led most students who become doctors by state funding opting to serve in first world countries like United States, United Kingdom, Australia and Canada.Brain drain in Health sector is a global phenomenon12, 13, but developing countries like Nepal receive maximum brunt. Lately, Nepalese medical education sector has been receiving a fair share of attention from all including media. However, it is saddening that this issue of ‘brain drain’ is something that had not gained any attention. Coming back to Adkoli’s work, we don't even have a data on how many doctors we are losing every year?10 There have been certain restrictions and bondages but these sorts of legislations have been seen to work contrarily. What is found to be lacking is the sense of belonging and development of the feeling that ‘I am important to this society and I must work for its betterment’. Most young doctors have a feeling that ‘there is no one taking me seriously anyway and it doesn't really matter weather I stay or Leave’.It is high time policy makers ensure that the medical doctors that we produce from the common men’s hard earned money serve the country. In addition to the legislations in the form of bondage, we should be able to install the feeling of belonging and sense of importance in the hearts and minds of these young doctors. To begin with, it would be a good idea if we start maintaining the database of the medical graduates that were and will be produced from Nepalese medical colleges; taking examples from many colleges from other countries that are doing it currently.14-16 Zimmerman’s study cited earlier provides an interesting insight that medical students with pre-medical education as paramedics were twice as likely to be working in Nepal and 3.5 times as likely to be in rural Nepal, compared with students with a college science background.11 We can also include into the undergraduate medical curriculum the concepts of social ethics, moral values, social justice and the long-term benefits of serving the society and the country that has invested so much for their education.

Background Acute painful vasoocclusive episodes (VOEs) are the most common reason for hospitalization for adults with sickle cell disease (SCD) and significant predictors of mortality. The facilitators and barriers to providing quality care for adults with SCD in the inpatient setting are largely unknown. We aimed to explore inpatient SCD delivery models in the US, including access (or lack thereof) to quality care and sickle cell disease expertise. Methods We conducted a multi-site rapid qualitative research study in order to evaluate a construct informed by literature review and clinical experience: variability between hospitals in the characteristics on models of inpatient SCD care delivery. We used virtual focus groups of practicing hospitalists in partnership with the Hospital Medicine Reengineering Network from across the United States. We developed an interview guide with open-ended questions and prompts through an iterative process to explore how inpatient SCD care is currently delivered in US hospitals with a focus on how these models of care delivery affect hospitalist practice (Figure). The open-ended questions explored topics ranging from hospitalists' training and experienceto the design of the health care system. Trained facilitators conducted four semi-structured focus groups with 11 hospitalists and one patient and family advisory council member. The facilitators took observation notes. Moderators summarized their group's overall findings for report to the larger group, serving as an opportunity for member checking and pattern identification. The focus groups lasted 35 minutes and report-out summaries lasted an additional 15 minutes. Recordings were de-identified and transcribed. We used rapid qualitative methods to explore perspectives of hospital-based healthcare providers including: having facilitators with expertise in the content area, collecting and analyzing data via multiple team members, and using templated summaries for each focus group question. Group summaries and transcripts were analyzed with thematic coding by two independent coders with feedback from the focus group moderators. Results Participants were from 12 adult university-based or university-affiliated hospitals. All hospitalists had experience taking care of hospitalized patients with SCD during their career, but many described how a change in practice location resulted in only seeing 1-2 patients with SCD per year. Hospitalists described a range of inpatient SCD care models from no specific model to a specific cohorted unit with associated providers. Participants unanimously expressed having provider and unit continuity of SCD care, and having accessible SCD expertise, as an ideal state. Individualized care plans were cited as a helpful tool for inpatient SCD care, but there were considerable challenges to their routine use. Primary themes are presented in the Table with explanations and correlative illustrative quotes. Discussion and Future Directions Hospitalists described wide variation in inpatient SCD care models. More inpatient SCD care support and infrastructure like individualized care plans were more commonly referenced by those hospitalists whose patients had access to a sickle cell center or SCD expert. We are using these data to inform a national survey to further describe and understand inpatient SCD care, if and how care plans are used, and determine next steps for improving inpatient SCD care quality.

Abstract Background The pathogenesis of inflammatory bowel disease (IBD) which includes Crohn’s disease (CD) and ulcerative colitis (UC), is believed to involve activation of the intestinal immune system in response to the gut microbiome among genetically susceptible hosts. IBD has been historically regarded as a disease of developed nations, though in the past two decades there has been a reported shift in the epidemiological pattern of disease. High-income nations with known high prevalence of disease are seeing a stabilization of incident cases, while a rapid rise of incident IBD is being observed in developing nations. This suggests that environmental exposures may play a role in mediating the risk of developing IBD. The potential environmental determinants of IBD across various regions is vast, though medications have been increasingly recognized as one broad category of risk factors. Purpose Several medications have been considered to contribute to the etiology of IBD. This study assessed the association between medication use and risk of developing IBD using the Prospective Urban Rural Epidemiology (PURE) cohort. Method This was a prospective cohort study of 133,137 individuals between the ages of 20-80 from 24 countries. Country-specific validated questionnaires documented baseline and follow-up medication use. Participants were followed prospectively at least every 3 years. The main outcome was development of IBD, including CD and UC. Short-term (baseline but not follow-up use) and long-term use (baseline and subsequent follow-up use) was evaluated. Results are presented as adjusted odds ratios (aOR) with 95% confidence intervals (CI). Result(s) During the median follow-up of 11.0 years [interquartile range (IQR) 9.2-12.2], we recorded 571 incident cases of IBD (143 CD and 428 UC). Higher risk of incident IBD was associated with baseline antibiotic use [aOR: 2.81 (95% CI: 1.67-4.73), p=0.0001] and hormonal medication use [aOR: 4.43 (95% CI: 1.78-11.01), p=0.001]. Among females, previous or current oral contraceptive use was also associated with IBD development [aOR: 2.17 (95% CI: 1.70-2.77), p=5.02E-10]. NSAID users were also observed to have increased risk of IBD [aOR: 1.80 (95% CI: 1.23-2.64), p=0.002], which was driven by long-term users [aOR: 5.58 (95% CI: 2.26-13.80), p<0.001]. All significant results were consistent in direction for CD and UC with low heterogeneity. Conclusion(s) Antibiotics, hormonal medications, oral contraceptives, and long-term NSAID use were associated with increased odds of incident IBD after adjustment for covariates. Please acknowledge all funding agencies by checking the applicable boxes below Other Please indicate your source of funding below: Salim Yusuf is supported by the Heart & Stroke Foundation/Marion W. Burke Chair in Cardiovascular Disease. The PURE Study is an investigator-initiated study funded by the Population Health Research Institute, the Canadian Institutes of Health Research (CIHR), Heart and Stroke Foundation of Ontario, support from CIHR’s Strategy for Patient Oriented Research (SPOR) through the Ontario SPOR Support Unit, as well as the Ontario Ministry of Health and Long-Term Care and through unrestricted grants from several pharmaceutical companies, with major contributions from AstraZeneca (Canada), Sanofi-Aventis (France and Canada), Boehringer Ingelheim (Germany and Canada), Servier, and GlaxoSmithkline, and additional contributions from Novartis and King Pharma and from various national or local organisations in participating countries; these include: Argentina: Fundacion ECLA; Bangladesh: Independent University, Bangladesh and Mitra and Associates; Brazil: Unilever Health Institute, Brazil; Canada: Public Health Agency of Canada and Champlain Cardiovascular Disease Prevention Network; Chile: Universidad de la Frontera; China: National Center for Cardiovascular Diseases; Colombia: Colciencias, grant number 6566-04-18062; India: Indian Council of Medical Research; Malaysia: Ministry of Science, Technology and Innovation of Malaysia, grant numbers 100 -IRDC/BIOTEK 16/6/21 (13/2007) and 07-05-IFN-BPH 010, Ministry of Higher Education of Malaysia grant number 600 -RMI/LRGS/5/3 (2/2011), Universiti Teknologi MARA, Universiti Kebangsaan Malaysia (UKM-Hejim-Komuniti-15-2010); occupied Palestinian territory: the UN Relief and Works Agency for Palestine Refugees in the Near East, occupied Palestinian territory; International Development Research Centre, Canada; Philippines: Philippine Council for Health Research & Development; Poland: Polish Ministry of Science and Higher Education grant number 290/W-PURE/2008/0, Wroclaw Medical University; Saudi Arabia: the Deanship of Scientific Research at King Saud University, Riyadh, Saudi Arabia (research group number RG -1436-013); South Africa: the North-West University, SANPAD (SA and Netherlands Programme for Alternative Development), National Research Foundation, Medical Research Council of SA, The SA Sugar Association (SASA), Faculty of Community and Health Sciences (UWC); Sweden: grants from the Swedish state under the Agreement concerning research and education of doctors; the Swedish Heart and Lung Foundation; the Swedish Research Council; the Swedish Council for Health, Working Life and Welfare, King Gustaf V’s and Queen Victoria Freemasons Foundation, AFA Insurance, Swedish Council for Working Life and Social Research, Swedish Research Council for Environment, Agricultural Sciences and Spatial Planning, grant from the Swedish State under the Läkar Utbildnings Avtalet agreement, and grant from the Västra Götaland Region; Turkey: Metabolic Syndrome Society, AstraZeneca, Turkey, Sanofi Aventis, Turkey; United Arab Emirates (UAE): Sheikh Hamdan Bin Rashid Al Maktoum Award For Medical Sciences and Dubai Health Authority, Dubai UAE. Disclosure of Interest C. Pray: None Declared, N. Narula Grant / Research support from: Neeraj Narula holds a McMaster University Department of Medicine Internal Career Award. Neeraj Narula has received honoraria from Janssen, Abbvie, Takeda, Pfizer, Merck, and Ferring, E. C. Wong: None Declared, J. K. Marshall Grant / Research support from: John K. Marshall has received honoraria from Janssen, AbbVie, Allergan, Bristol-Meyer-Squibb, Ferring, Janssen, Lilly, Lupin, Merck, Pfizer, Pharmascience, Roche, Shire, Takeda and Teva., S. Rangarajan: None Declared, S. Islam: None Declared, A. Bahonar: None Declared, K. F. Alhabib: None Declared, A. Kontsevaya: None Declared, F. Ariffin: None Declared, H. U. Co: None Declared, W. Al Sharief: None Declared, A. Szuba: None Declared, A. Wielgosz: None Declared, M. L. Diaz: None Declared, R. Yusuf: None Declared, L. Kruger: None Declared, B. Soman: None Declared, Y. Li: None Declared, C. Wang: None Declared, L. Yin: None Declared, M. Erkin: None Declared, F. Lanas: None Declared, K. Davletov: None Declared, A. Rosengren: None Declared, P. Lopez-Jaramillo: None Declared, R. Khatib: None Declared, A. Oguz: None Declared, R. Iqbal: None Declared, K. Yeates: None Declared, Á. Avezum: None Declared, W. Reinisch Consultant of: Speaker for Abbott Laboratories, Abbvie, Aesca, Aptalis, Astellas, Centocor, Celltrion, Danone Austria, Elan, Falk Pharma GmbH, Ferring, Immundiagnostik, Mitsubishi Tanabe Pharma Corporation, MSD, Otsuka, PDL, Pharmacosmos, PLS Education, Schering-Plough, Shire, Takeda, Therakos, Vifor, Yakult, Consultant for Abbott Laboratories, Abbvie, Aesca, Algernon, Amgen, AM Pharma, AMT, AOP Orphan, Arena Pharmaceuticals, Astellas, Astra Zeneca, Avaxia, Roland Berger GmBH, Bioclinica, Biogen IDEC, Boehringer-Ingelheim, Bristol-Myers Squibb, Cellerix, Chemocentryx, Celgene, Centocor, Celltrion, Covance, Danone Austria, DSM, Elan, Eli Lilly, Ernest & Young, Falk Pharma GmbH, Ferring, Galapagos, Genentech, Gilead, Grünenthal, ICON, Index Pharma, Inova, Janssen, Johnson & Johnson, Kyowa Hakko Kirin Pharma, Lipid Therapeutics, LivaNova, Mallinckrodt, Medahead, MedImmune, Millenium, Mitsubishi Tanabe Pharma Corporation, MSD, Nash Pharmaceuticals, Nestle, Nippon Kayaku, Novartis, Ocera, Omass, Otsuka, Parexel, PDL, Periconsulting, Pharmacosmos, Philip Morris Institute, Pfizer, Procter & Gamble, Prometheus, Protagonist, Provention, Robarts Clinical Trial, Sandoz, Schering-Plough, Second Genome, Seres Therapeutics, Setpointmedical, Sigmoid, Sublimity, Takeda, Therakos, Theravance, Tigenix, UCB, Vifor, Zealand, Zyngenia, and 4SC, Advisory board member for Abbott Laboratories, Abbvie, Aesca, Amgen, AM Pharma, Astellas, Astra Zeneca, Avaxia, Biogen IDEC, Boehringer-Ingelheim, Bristol-Myers Squibb, Cellerix, Chemocentryx, Celgene, Centocor, Celltrion, Danone Austria, DSM, Elan, Ferring, Galapagos, Genentech, Grünenthal, Inova, Janssen, Johnson & Johnson, Kyowa Hakko Kirin Pharma, Lipid Therapeutics, MedImmune, Millenium, Mitsubishi Tanabe Pharma Corporation, MSD, Nestle, Novartis, Ocera, Otsuka, PDL, Pharmacosmos, Pfizer, Procter & Gamble, Prometheus, Sandoz, Schering-Plough, Second Genome, Setpointmedical, Takeda, Therakos, Tigenix, UCB, Zealand, Zyngenia, and 4SC, P. Moayyedi: None Declared, S. Yusuf: None Declared

Executive Summary 1 This report analyzes the US Refugee Admissions Program (USRAP), leveraging data from a national survey of resettlement stakeholders conducted in 2020. 2 The survey examined USRAP from the time that refugees arrive in the United States. Its design and questionnaire were informed by three community gatherings organized by Refugee Council USA in the fall and winter of 2019, extensive input from an expert advisory group, and a literature review. This study finds that USRAP serves important purposes, enjoys extensive community support, and offers a variety of effective services. Overall, the survey finds a high degree of consensus on the US resettlement program’s strengths and objectives, and close alignment between its services and the needs of refugees at different stages of their settlement and integration. Because its infrastructure and community-based resettlement networks have been decimated in recent years, the main challenges of subsequent administrations, Congresses, and USRAP stakeholders will be to rebuild, revitalize, and regain broad and bipartisan support for the program. This article also recommends specific ways that USRAP’s programs and services can be strengthened. Among the study’s findings: 3 Most refugee respondents identified USRAP’s main purpose(s) as giving refugees new opportunities, helping them to integrate, offering hope to refugees living in difficult circumstances abroad, and saving lives. High percentages of refugees reported that the program allowed them to support themselves soon after arrival (92 percent), helped them to integrate (77 percent), and has a positive economic impact on local communities (71 percent). Refugee respondents also reported that the program encourages them to work in jobs that do not match their skills and credentials (56 percent), does not provide enough integration support after three months (54 percent), does not offer sufficient financial help during their first three months (49 percent), and reunites families too slowly (47 percent). Respondents identified the following main false ideas about the program: refugees pose a security risk (84 percent), use too many benefits and drain public finances (83 percent), and take the jobs of the native-born (74 percent). Refugee respondents reported using public benefits to meet basic needs, such as medical care, food, and housing. Non-refugee survey respondents believed at high rates that former refugees (69 percent) and refugee community advocate groups (64 percent) should be afforded a voice in the resettlement process. Non-refugee respondents indicated at high rates that the program’s employment requirements limit the time needed for refugees to learn English (65 percent) and limit their ability to pursue higher education (59 percent). Eighty-six percent of non-refugee respondents indicated that the Reception and Placement program is much too short (56 percent) or a little too short (30 percent). Respondents identified a wide range of persons and institutions as being very helpful to refugees in settling into their new communities: these included resettlement staff, friends, and acquaintances from refugees’ country of origin, members of places of worship, community organizations led by refugees or former refugees, and family members. Refugee respondents identified finding medical care (61 percent), housing (52 percent), and a job (49 percent) as the most helpful services in their first three months in the country. Refugees reported that the biggest challenge in their first year was to find employment that matched their educational or skill levels or backgrounds. The needs of refugees and the main obstacles to their successful integration differ by gender, reflecting at least in part the greater childcare responsibilities borne by refugee women. Refugee men reported needing assistance during their first three months in finding employment (68 percent), English Language Learning (ELL) courses (59 percent), and orientation services (56 percent), while refugee women reported needing orientation services (81 percent) and assistance in securing childcare (64 percent), finding ELL courses (53 percent), and enrolling children in school (49 percent). To open-response questions, non-refugee respondents identified as obstacles to the integration of men: digital literacy, (lack of) anti–domestic violence training, the need for more training to improve their jobs, the new public benefit rule, transportation to work, low wages, the need for more mental health services, cultural role adjustment, and lack of motivation. Non-refugee respondents identified as obstacles to the integration of women: lack of childcare and affordable housing, the different cultural roles of women in the United States, lack of affordable driver’s education classes, a shortage of ELL classes for those with low literacy or the illiterate, digital literacy challenges, difficulty navigating their children’s education and school systems, transportation problems, poorly paying jobs, and lack of friendships with US residents. Non-refugee respondents report that refugee children also face unique obstacles to integration, including limited funding or capacity to engage refugee parents in their children’s education, difficulties communicating with refugee families, and the unfamiliarity of teachers and school staff with the cultures and backgrounds of refugee children and families. LGBTQ refugees have many of the same basic needs as other refugees — education, housing, employment, transportation, psychosocial, and others — but face unique challenges in meeting these needs due to possible rejection by refugees and immigrants from their own countries and by other residents of their new communities. Since 2017, the number of resettlement agencies has fallen sharply, and large numbers of staff at the remaining agencies have been laid off. As a result, the program has suffered a loss in expertise, institutional knowledge, language diversity, and resettlement capacity. Resettlement agencies and community-based organizations (CBOs) reported at high rates that to accommodate pre-2017 numbers of refugees, they would need higher staffing levels in employment services (66 percent), general integration and adjustment services (62 percent), mental health care (44 percent) and medical case management (44 percent). Resettlement agencies indicated that they face immense operational and financial challenges, some of them longstanding (like per capita funding and secondary migration), and some related to the Trump administration’s hostility to the program. Section I introduces the article and provides historic context on the US refugee program. Section II outlines the resettlement process and its constituent programs. Section III describes the CMS Refugee Resettlement Survey: 2020. Section IV sets forth the study’s main findings, with subsections covering USRAP’s purpose and overall strengths and weaknesses; critiques of the program; the importance of receiving communities to resettlement and integration; the effectiveness of select USRAP programs and services; integration metrics; and obstacles to integration. The article ends with a series of recommendations to rebuild and strengthen this program.

BACKGROUND AND OBJECTIVES: The Accreditation Council for Graduate Medical Education has approved 117 neurological surgery residency programs which develop and educate neurosurgical trainees. We present the current landscape of neurosurgical training in the United States by examining multiple aspects of neurological surgery residencies in the 2022–2023 academic year and investigate the impact of program structure on resident academic productivity. METHODS: Demographic data were collected from publicly available websites and reports from the National Resident Match Program. A 34-question survey was circulated by e-mail to program directors to assess multiple features of neurological surgery residency programs, including curricular structure, fellowship availability, recent program changes, graduation requirements, and resources supporting career development. Mean resident productivity by program was collected from the literature. RESULTS: Across all 117 programs, there was a median of 2.0 (range 1.0-4.0) resident positions per year and 1.0 (range 0.0-2.0) research/elective years. Programs offered a median of 1.0 (range 0.0-7.0) Committee on Advanced Subspecialty Training–accredited fellowships, with endovascular fellowships being most frequently offered (53.8%). The survey response rate was 75/117 (64.1%). Of survey respondents, the median number of clinical sites was 3.0 (range 1.0-6.0). Almost half of programs surveyed (46.7%) reported funding mechanisms for residents, including R25, T32, and other in-house grants. Residents received a median academic stipend of $1000 (range $0-$10 000) per year. Nearly all programs (93.3%) supported wellness activities for residents, which most frequently occurred quarterly (46.7%). Annual academic stipend size was the only significant predictor of resident academic productivity (R2 = 0.17, P = .002). CONCLUSION: Neurological surgery residency programs successfully train the next generation of neurosurgeons focusing on education, clinical training, case numbers, and milestones. These programs offer trainees the chance to tailor their career trajectories within residency, creating a rewarding and personalized experience that aligns with their career aspirations.

In this study, we explored how high school students’ participation in a local history research project about a historically Black cemetery in the Southeast United States contributed to their demonstration of historical empathy. Major findings show that students displayed historical empathy in research activities that occur beyond the traditional classroom through their examination of perspectives concerning representations of race and diversity in the social studies curriculum, the historical contexts about the impact of enslavement and Jim Crow segregation in their community, and affective connections they made to their identities as citizens. We recommend that future studies focus on how social studies teachers, community organizations, and other educational providers can collaborate to promote historical empathy in and outside of schools with equity frameworks and curricular initiatives such as the National Council for the Social Studies College, Career, and Civic Life (C3) Framework.

This report covers calendar 1991. Since 1983 the Forest Research Advisory Council of Canada (FRACC) has advised Forestry Canada on forestry research priorities and policies. In 1987 the Canadian Council of Forest Ministers (CCFM) agreed to establish forest research advisory groups in each jurisdiction, and requested FRACC to coordinate an annual countrywide review of forestry research priorities and concerns. Since then, and with the assistance and cooperation of the provincial and territorial research advisory bodies, FRACC has prepared an annual overview of forestry research priorities for CCFM; this report has subsequently been published in The Forestry Chronicle.Forestry Canada made its first annual report to Parliament in 1991. Council considers it a good beginning for a process that will be valuable in alerting Members of Parliament and the public to forestry issues and the importance of forestry research. During the year Forestry Canada made good progress in preparing mission statements for its establishments. Not only are these statements important in explaining the Department's role, but also the process of preparing them is equally important in building support and esprit de corps. FRACC is pleased to see Forestry Canada taking positive initiatives in other areas, namely, the inclusion of major research components in the new forestry agreements with the provinces; the Green Plan with its elements of forestry research and model forests; the progress made in biotechnology; and the development of the strategic research partnerships program with involvement of the Natural Science and Engineering Research Council and industry.Council makes the following recommendations:1. To better define the perceived scarcity of forestry scientists, Forestry Canada should promptly undertake or sponsor a study of the supply and demand for scientists in the various disciplines that make up forestry research.2. To foster a greater appreciation of the possibilities of a research career and to aid in establishing young scientists, Forestry Canada should provide more employment opportunities for undergraduate students through summer employment, participate fully with the universities in cooperative programs for graduate and undergraduate students, and enhance its "apprentice" type of programs for recent Ph.D. s such as post-doctorate fellowships both in-house and at the universities.3. Forestry Canada should expand the useful initiative of setting aside a relatively small portion of its budget in a fund to be used for following up quickly on promising new research approaches.4. To help ensure the sustainability of Canadian forest management, Forestry Canada should expand its in-house and cooperative research programs directed at a better understanding of the way forest ecosystems function.5. To expand research on integrated forest management, particularly the policy and socio-economic aspects, Forestry Canada should consult widely and explore the possibility of mounting cooperative research programs at national and regional levels involving its own forces, universities, provinces, industry, and non-government bodies such as the Institute for Research on Public Policy.6. Council strongly supports Forestry Canada's current effort to improve its technology transfer program to promote the application of research results; however, to meet the growing public demand for technical information on forestry and environmental matters, Forestry Canada should increase its emphasis on this aspect of technical information.7. To encourage scientists to work toward the application of their results, Forestry Canada should evaluate and modify, where possible, the scientists' rewards system so that it gives full recognition to technology transfer work including the preparation of effective "how-to" publications.8. Forestry Canada should ensure that research advisory bodies are in place for all its establishments, and should broaden the range of forest stakeholders who participate in these research advisory bodies and in those at the regional, provincial, and national levels.9. Forestry Canada should continue its emphasis on promoting high staff morale through participatory management, and should provide strong support to inter-establishment travel and dialogue, and for attendance at significant scientific conferences and workshops.10. To help prevent stagnation and encourage greater research productivity, Forestry Canada should increase opportunities for working sabbaticals and retraining of scientists and technical staff.11. To foster more long-range forestry research at universities in Canada, Forestry Canada should explore every avenue for implementing a program similar to the McIntyre-Stennis program in the United States.12. Forestry Canada should develop a method for bringing economic and social criteria to bear on selection of research projects and should incorporate this into its research planning process.Council will hold three meetings in 1992 and will give attention to the updating of the Forestry Research Inventory initiated in 1987 by Dr. A.J. Kayll; research execution, mechanisms, structures, and funding as distinct from planning processes; the document Sustainable Forests, A Canadian Commitment, with emphasis on the research aspects; further conclusions that might be drawn from the meetng with young scientists; means to encourage, support, and strengthen provincial and territorial research advisory bodies; further steps to strengthen technology transfer; Forestry Canada's headquarters forest economics program; forest workers' attitudes and training vis-à-vis environmental considerations in their daily work planning and execution; visiting a forest company's woodlands operations to learn their perceptions of research needs and views on research priority setting and management of research and technology transfer; and the major trends affecting the future of forestry and the implications for forestry research.

Purpose: The purpose of this study was to provide relative citation ratio (RCR) benchmark data for cornea and external diseases specialists. Design: This is a cross-sectional bibliometric analysis. Subjects: Subjects included were fellowship-trained cornea and external diseases faculty at Accreditation Council for Graduate Medical Education–accredited institutions in the United States. Methods: Academic specialists were indexed using the National Institutes of Health iCite Web site. Publication count, mean RCR score, and weighted RCR score were obtained between October 2022 and January 2023 by examining PubMed-listed publications from 1980 to 2022. Data were compared by sex, career duration, academic rank, and acquisition of a Doctor of Philosophy. Main outcome measures: The main outcome measures were publication count, mean RCR value, and weighted RCR value. Results: The cohort included 602 specialists from 112 Accreditation Council for Graduate Medical Education–accredited institutions. These clinician–scientists produced highly impactful research with a median publication count of 15 (interquartile ranges 4–41), median RCR of 1.4 (interquartile ranges 0.91–1.88), and median-weighted RCR of 20.28 (5.3–66.69). Both academic rank and career length were associated with greater publication count and RCR values. Male sex was also associated with greater publications counts and RCR scores compared with female faculty. Acquisition of a Doctor of Philosophy was associated with greater publication counts and weighted RCR scores but no difference in mean RCR scores. Conclusions: Academic cornea and external diseases specialists conduct high-impact research, with a median RCR of 1.4, exceeding the NIH standard value of 1. These data provide RCR benchmark data for the field to inform self, institutional, and departmental evaluations. These results also highlight a significant gender disparity in the field necessitating efforts to increase female representation and ensure equal opportunities.

Background: National and international policies on parental leave for physician trainees are inconsistent. Physician trainees, including nephrology fellows, may be at higher risk of pregnancy complications. Physician trainees face barriers in meeting their breastfeeding goals and in finding childcare due to nontraditional work hours with extended or unpredictable shifts. Here, we examine awareness of current policies in United States (US) nephrology fellowship programs regarding parental leave, pregnancy/breastfeeding accommodations, and fellows’ perspectives on family planning. Methods: An anonymous, on-line survey of US nephrology fellows was undertaken from June 9 to August, 24, 2023. Results: One hundred twenty nephrology fellows submitted the survey. A majority of fellow respondents were unaware of parental leave policies of their training programs (63%), Accreditation Council for Graduate Medical Education (ACGME) (75%), and/or American Board of Medical Specialties(ABMS) (75%). Forty two percent were unaware of the duration of parental leave at their program. Nearly 45% of all respondents were unsure if their program limited night shifts or shifts greater than 24 hours for pregnant trainees. Forty three percent reported they were unsure of lactation accommodations, and 40% were unsure of access to subsidized childcare. When fellows received work accommodations for pregnancy or parenthood, their work obligations were largely covered by co-fellows (60%) or attendings (38%). Over 60% of fellows agreed or strongly agreed that they would avoid a pregnancy in fellowship due to concern they would have to extend their training. Of the 40 fellows who chose to pursue pregnancy or parenthood during medical training, 75% did not change their career plans as a result. Conclusions: Most nephrology fellows were unaware of parental leave policies and pregnancy/lactation accommodations. While the topic itself has a broad impact to all physician trainees, there is need for improved awareness about national and local program policies among trainees across individual nephrology programs.

Introduction: Stroke is a leading cause of disability in the United States. Disparities in stroke care between metropolitan and rural areas have long been recognized. Access to high-level timely stroke expertise improves outcomes, but in rural areas this is limited by sparse availability of stroke specialists. Since 2006, the Nebraska Stroke Advisory Council, a statewide coalition of stroke experts and stakeholders, began implementing strategies to improve stroke care. In 2016, the Nebraska legislature approved Bill 722, mandating the development of stroke systems of care. In 2018, the AHA and the Helmsley Charitable Trust launched Mission: Lifeline Stroke, a coordinated 3-year program to enhance stroke systems of care in Nebraska. Purpose: To assess advances in acute stroke care in Nebraska after implementing a statewide stroke system of care focused on rural areas. Methods: The Council joined with AHA to expand public and professional stroke education offerings including workshops, conferences, and EMS trainings. They developed state specific treatment guidelines and created educational reinforcement materials. From 2016 to 2019 Get With The Guidelines® (GWTG) was used for stroke data collection and quality improvement in Nebraska. GWTG participating hospitals expanded from 7 to 40 sites (21 critical access). Results: The number of stroke and Transient Ischemic Attack cases reported more than doubled from 2016 to 2019 (1848 to 3987 cases). The door to CT initiated in < 25 minutes improved by 13%. IV alteplase therapy gains included: utilization increased from 8.7% to 11.3%; median door to drug time reduced from 54 to 42 minutes; and door to drug within 60 minutes of arrival increased from 67% to 80.4%.The number of alteplase monitored patients doubled and mechanical thrombectomy cases increased from 77 in 2017 to 138 in 2019. Conclusion: Implementation of strategies in Nebraska, with an emphasis on rural critical access hospitals, led to significant improvements in acute stroke care. This work represents the authors’ independent analysis of local or multicenter data gathered using the AHA Get With The Guidelines® Patient Management Tool but is not an analysis of the national GWTG dataset and does not represent findings from the AHA GWTG National Program

Women in federal politics are under-represented today and always have been. At no time in the history of the federal parliament have women achieved equal representation with men. There have never been an equal number of women in any federal cabinet. Women have never held an equitable number of executive positions of the Australian Labor Party (ALP) or the Liberal Party. Australia has had only one female Prime Minister, Julia Gillard, and she was the recipient of sexist treatment in the parliament and the media. A 2019 report by Plan International found that girls and women, were “reluctant to pursue a career in politics, saying they worry about being treated unfairly.” The Report author said the results were unsurprisingwhen you consider how female politicians are still treated in Parliament and the media in this country, is it any wonder the next generation has no desire to expose themselves to this world? Unfortunately, in Australia, girls grow up seeing strong, smart, capable female politicians constantly reduced to what they’re wearing, comments about their sexuality and snipes about their gender.What voters may not always see is how women in politics respond to sexist treatment, or to bullying, or having to vote against their principles because of party rules, or to having no support to lead the party. Rather than being political victims and quitting, there is a ground-swell of women who are fighting back. The rage they feel at being excluded, bullied, harassed, name-called, and denied leadership opportunities is being channelled into rage against the structures that deny them equality. The rage they feel is building resilience and it is building networks of women across the political divide. This article highlights some female MPs who are “maintaining the rage”. It suggests that the rage that is evident in their public responses is empowering them to stand strong in the face of adversity, in solidarity with other female MPs, building their resilience, and strengthening calls for social change and political equality.Her-story of Women’s MovementsThroughout the twentieth century, women stood for equal rights and personal empowerment driven by rage against their disenfranchisement. Significant periods include the early 1900s, with suffragettes gaining the vote for women. The interwar period of 1919 to 1938 saw women campaign for financial independence from their husbands (Andrew). Australian women were active citizens in a range of campaigns for improved social, economic and political outcomes for women and their children.Early contributions made by women to Australian society were challenges to the regulations and of female sexuality and reproduction. Early twentieth century feminist organisations such The Women’s Peace Army, United Association of Women, the Australian Federation of Women’s Societies for Equal Citizenship, the Union of Australian Women, the National Council of Women, and the Australian Federation of Women Voters, proved the early forerunners to the 1970s Women’s Liberation Movement (WLM). It was in many of these early campaigns that the rage expressed in the concept of the “personal is political” (Hanisch) became entrenched in Australian feminist approaches to progressive social change. The idea of the “personal is political” encapsulated that it was necessary to challenge and change power relations, achievable when women fully participated in politics (van Acker 25). Attempts by women during the 1970s to voice concerns about issues of inequality, including sexuality, the right to abortion, availability of childcare, and sharing of household duties, were “deemed a personal problem” and not for public discussion (Hanisch). One core function of the WLM was to “advance women’s positions” via government legislation or, as van Acker (120) puts it, the need for “feminist intervention in the state.” However, in advocating for policy reform, the WLM had no coherent or organised strategy to ensure legislative change. The establishment of the Women’s Electoral Lobby (WEL), together with the Femocrat strategy, sought to rectify this. Formed in 1972, WEL was tasked with translating WLM concerns into government policy.The initial WEL campaign took issues of concern to WLM to the incoming Whitlam government (1972-1975). Lyndall Ryan (73) notes: women’s liberationists were the “stormtroopers” and WEL the “pragmatic face of feminism.” In 1973 Whitlam appointed Elizabeth Reid, a member of WLM, as Australia’s first Women’s Advisor. Of her appointment, Reid (3) said, “For the first time in our history we were being offered the opportunity to attempt to implement what for years we had been writing, yelling, marching and working towards. Not to respond would have felt as if our bluff had been called.” They had the opportunity in the Whitlam government to legislatively and fiscally address the rage that drove generations of women to yell and march.Following Reid were the appointments of Sara Dowse and Lyndall Ryan, continuing the Femocrat strategy of ensuring women were appointed to executive bureaucratic roles within the Whitlam government. The positions were not well received by the mainly male-dominated press gallery and parliament. As “inside agitators” (Eisenstein) for social change the central aim of Femocrats was social and economic equity for women, reflecting social justice and progressive social and public policy. Femocrats adopted a view about the value of women’s own lived experiences in policy development, application and outcome. The role of Senator Susan Ryan is of note. In 1981, Ryan wrote and introduced the Sex Discrimination Bill, the first piece of federal legislation of its type in Australia. Ryan was a founding member of WEL and was elected to the Senate in 1975 on the slogan “A woman’s place is in the Senate”. As Ryan herself puts it: “I came to believe that not only was a woman’s place in the House and in the Senate, as my first campaign slogan proclaimed, but a feminist’s place was in politics.” Ryan, the first Labor woman to represent the ACT in the Senate, was also the first Labor woman appointed as a federal Minister.With the election of the economic rationalist Hawke and Keating Governments (1983-1996) and the neoliberal Howard Government (1996-2007), what was a “visible, united, highly mobilised and state-focused women’s movement” declined (Lake 260). This is not to say that women today reject the value of women’s voices and experiences, particularly in politics. Many of the issues of the 1970s remain today: domestic violence, unequal pay, sexual harassment, and a lack of gender parity in political representation. Hence, it remains important that women continue to seek election to the national parliament.Gender Gap: Women in Power When examining federal elections held between 1972 and 2016, women have been under-represented in the lower house. In none of these elections have women achieved more than 30 per cent representation. Following the 1974 election less that one per cent of the lower house were women. No women were elected to the lower house at the 1975 or 1977 election. Between 1980 and 1996, female representation was less than 10 per cent. In 1996 this rose to 15 per cent and reached 29 per cent at the 2016 federal election.Following the 2016 federal election, only 32 per cent of both chambers were women. After the July 2016 election, only eight women were appointed to the Turnbull Ministry: six women in Cabinet and two women in the Outer Cabinet (Parliament of Australia). Despite the higher representation of women in the ALP, this is not reflected in the number of women in the Shadow Cabinet. Just as female parliamentarians have never achieved parity, neither have women in the Executive Branch.In 2017, Australia was ranked 50th in the world in terms of gender representation in parliament, between The Philippines and South Sudan. Globally, there are 38 States in which women account for less than 10 per cent of parliamentarians. As at January 2017, the three highest ranking countries in female representation were Rwanda, Bolivia and Cuba. The United Kingdom was ranked 47th, and the United States 104th (IPU and UNW). Globally only 18 per cent of government ministers are women (UNW). Between 1960 and 2013, 52 women became prime ministers worldwide, of those 43 have taken office since 1990 (Curtin 191).The 1995 United Nations (UN) Fourth World Conference on Women set a 30 per cent target for women in decision-making. This reflects the concept of “critical mass”. Critical mass proposes that for there to be a tipping balance where parity is likely to emerge, this requires a cohort of a minimum of 30 per cent of the minority group.Gender scholars use critical mass theory to explain that parity won’t occur while there are only a few token women in politics. Rather, only as numbers increase will women be able to build a strong enough presence to make female representation normative. Once a 30 per cent critical mass is evident, the argument is that this will encourage other women to join the cohort, making parity possible (Childs & Krook 725). This threshold also impacts on legislative outcomes, because the larger cohort of women are able to “influence their male colleagues to accept and approve legislation promoting women’s concerns” (Childs & Krook 725).Quotas: A Response to Gender InequalityWith women representing less than one in five parliamentarians worldwide, gender quotas have been introduced in 90 countries to redress this imbalance (Krook). Quotas are an equal opportunity measure specifically designed to re-dress inequality in political representation by allocating seats to under-represented groups (McCann 4). However, the effectiveness of the quota system is contested, with continued resistance, particularly in conservative parties. Fine (3) argues that one key objection to mandatory quotas is that they “violate the principle of merit”, suggesting insufficient numbers of women capable or qualified to hold parliamentary positions.In contrast, Gauja (2) suggests that “state-mandated electoral quotas work” because in countries with legislated quotas the number of women being nominated is significantly higher. While gender quotas have been brought to bear to address the gender gap, the ability to challenge the majority status of men has been limited (Hughes).In 1994 the ALP introduced rule-based party quotas to achieve equal representation by 2025 and a gender weighting system for female preselection votes. Conversely, the Liberal Party have a voluntary target of reaching 50 per cent female representation by 2025. But what of the treatment of women who do enter politics?Fig. 1: Portrait of Julia Gillard AC, 27th Prime Minister of Australia, at Parliament House, CanberraInside Politics: Misogyny and Mobs in the ALPIn 2010, Julia Gillard was elected as the leader of the governing ALP, making her Australia’s first female Prime Minister. Following the 2010 federal election, called 22 days after becoming Prime Minister, Gillard was faced with the first hung parliament since 1940. She formed a successful minority government before losing the leadership of the ALP in June 2013. Research demonstrates that “being a female prime minister is often fraught because it challenges many of the gender stereotypes associated with political leadership” (Curtin 192). In Curtin’s assessment Gillard was naïve in her view that interest in her as the country’s first female Prime Minister would quickly dissipate.Gillard, argues Curtin (192-193), “believed that her commitment to policy reform and government enterprise, to hard work and maintaining consensus in caucus, would readily outstrip the gender obsession.” As Curtin continues, “this did not happen.” Voters were continually reminded that Gillard “did not conform to the traditional.” And “worse, some high-profile men, from industry, the Liberal Party and the media, indulged in verbal attacks of a sexist nature throughout her term in office (Curtin 192-193).The treatment of Gillard is noted in terms of how misogyny reinforced negative perceptions about the patriarchal nature of parliamentary politics. The rage this created in public and media spheres was double-edged. On the one hand, some were outraged at the sexist treatment of Gillard. On the other hand, those opposing Gillard created a frenzy of personal and sexist attacks on her. Further attacking Gillard, on 25 February 2011, radio broadcaster Alan Jones called Gillard, not only by her first-name, but called her a “liar” (Kwek). These attacks and the informal way the Prime Minister was addressed, was unprecedented and caused outrage.An anti-carbon tax rally held in front of Parliament House in Canberra in March 2011, featured placards with the slogans “Ditch the Witch” and “Bob Brown’s Bitch”, referring to Gillard and her alliance with the Australian Greens, led by Senator Bob Brown. The Opposition Leader Tony Abbott and other members of the Liberal Party were photographed standing in front of the placards (Sydney Morning Herald, Vertigo). Criticism of women in positions of power is not limited to coming from men alone. Women from the Liberal Party were also seen in the photo of derogatory placards decrying Gillard’s alliances with the Greens.Gillard (Sydney Morning Herald, “Gillard”) said she was “offended when the Leader of the Opposition went outside in the front of Parliament and stood next to a sign that said, ‘Ditch the witch’. I was offended when the Leader of the Opposition stood next to a sign that ascribed me as a man’s bitch.”Vilification of Gillard culminated in October 2012, when Abbott moved a no-confidence motion against the Speaker of the House, Peter Slipper. Abbott declared the Gillard government’s support for Slipper was evidence of the government’s acceptance of Slipper’s sexist attitudes (evident in allegations that Slipper sent a text to a political staffer describing female genitals). Gillard responded with what is known as the “Misogyny speech”, pointing at Abbott, shaking with rage, and proclaiming, “I will not be lectured about sexism and misogyny by this man” (ABC). Apart from vilification, how principles can be forsaken for parliamentary, party or electoral needs, may leave some women circumspect about entering parliament. Similar attacks on political women may affirm this view.In 2010, Labor Senator Penny Wong, a gay Member of Parliament and advocate of same-sex marriage, voted against a bill supporting same-sex marriage, because it was not ALP policy (Q and A, “Passion”). Australian Marriage Equality spokesperson, Alex Greenwich, strongly condemned Wong’s vote as “deeply hypocritical” (Akersten). The Sydney Morning Herald (Dick), under the headline “Married to the Mob” asked:a question: what does it now take for a cabinet minister to speak out on a point of principle, to venture even a mild criticism of the party position? ... Would you object if your party, after fixing some areas of discrimination against a minority group of which you are a part, refused to move on the last major reform for that group because of ‘tradition’ without any cogent explanation of why that tradition should remain? Not if you’re Penny Wong.In 2017, during the postal vote campaign for marriage equality, Wong clarified her reasons for her 2010 vote against same-sex marriage saying in an interview: “In 2010 I had to argue a position I didn’t agree with. You get a choice as a party member don’t you? You either resign or do something like that and make a point, or you stay and fight and you change it.” Biding her time, Wong used her rage to change policy within the ALP.In continuing personal attacks on Gillard, on 19 March 2012, Gillard was told by Germaine Greer that she had a “big arse” (Q and A, “Politics”) and on 27 August 2012, Greer said Gillard looked like an “organ grinder’s monkey” (Q and A, “Media”). Such an attack by a prominent feminist from the 1970s, on the personal appearance of the Prime Minister, reinforced the perception that it was acceptable to criticise a woman in this position, in ways men have never been. Inside Politics: Leadership and Bullying inside the Liberal PartyWhile Gillard’s leadership was likely cut short by the ongoing attacks on her character, Liberal Deputy leader Julie Bishop was thwarted from rising to the leadership of the Liberal Party, thus making it unlikely she will become the Liberal Party’s first female Prime Minister. Julie Bishop was Australia’s Minister for Foreign Affairs from 2013 to 2018 and Deputy Leader of the Liberal Party from 2007 to 2018, having entered politics in 1998.With the impending demise of Prime Minister Turnbull in August 2018, Bishop sought support from within the Liberal Party to run for the leadership. In the second round of leadership votes Bishop stood for the leadership in a three-cornered race, coming last in the vote to Peter Dutton and Scott Morrison. Bishop resigned as the Foreign Affairs Minister and took a seat on the backbench.When asked if the Liberal Party would elect a popular female leader, Bishop replied: “When we find one, I’m sure we will.” Political journalist Annabel Crabb offered further insight into what Bishop meant when she addressed the press in her red Rodo shoes, labelling the statement as “one of Julie Bishop’s chilliest-ever slapdowns.” Crabb, somewhat sardonically, suggested this translated as Bishop listing someone with her qualifications and experience as: “Woman Works Hard, Is Good at Her Job, Doesn't Screw Up, Loses Out Anyway.”For political journalist Tony Wright, Bishop was “clearly furious with those who had let their testosterone get the better of them and their party” and proceeded to “stride out in a pair of heels in the most vivid red to announce that, despite having resigned the deputy position she had occupied for 11 years, she was not about to quit the Parliament.” In response to the lack of support for Bishop in the leadership spill, female members of the federal parliament took to wearing red in the parliamentary chambers signalling that female members were “fed up with the machinations of the male majority” (Wright).Red signifies power, strength and anger. Worn in parliament, it was noticeable and striking, making a powerful statement. The following day, Bishop said: “It is evident … that there is an acceptance of a level of behaviour in Canberra that would not be tolerated in any other workplace across Australia" (Wright).Colour is political. The Suffragettes of the early twentieth century donned the colours of purple and white to create a statement of unity and solidarity. In recent months, Dr Kerryn Phelps used purple in her election campaign to win the vacated seat of Wentworth, following Turnbull’s resignation, perhaps as a nod to the Suffragettes. Public anger in Wentworth saw Phelps elected, despite the electorate having been seen as a safe Liberal seat.On 21 February 2019, the last sitting day of Parliament before the budget and federal election, Julie Bishop stood to announce her intention to leave politics at the next election. To some this was a surprise. To others it was expected. On finishing her speech, Bishop immediately exited the Lower House without acknowledging the Prime Minister. A proverbial full-stop to her outrage. She wore Suffragette white.Victorian Liberal backbencher Julia Banks, having declared herself so repelled by bullying during the Turnbull-Dutton leadership delirium, announced she was quitting the Liberal Party and sitting in the House of Representatives as an Independent. Banks said she could no longer tolerate the bullying, led by members of the reactionary right wing, the coup was aided by many MPs trading their vote for a leadership change in exchange for their individual promotion, preselection endorsements or silence. Their actions were undeniably for themselves, for their position in the party, their power, their personal ambition – not for the Australian people.The images of male Liberal Members of Parliament standing with their backs turned to Banks, as she tended her resignation from the Liberal Party, were powerful, indicating their disrespect and contempt. Yet Banks’s decision to stay in politics, as with Wong and Bishop is admirable. To maintain the rage from within the institutions and structures that act to sustain patriarchy is a brave, but necessary choice.Today, as much as any time in the past, a woman’s place is in politics, however, recent events highlight the ongoing poor treatment of women in Australian politics. Yet, in the face of negative treatment – gendered attacks on their character, dismissive treatment of their leadership abilities, and ongoing bullying and sexism, political women are fighting back. They are once again channelling their rage at the way they are being treated and how their abilities are constantly questioned. They are enraged to the point of standing in the face of adversity to bring about social and political change, just as the suffragettes and the women’s movements of the 1970s did before them. The current trend towards women planning to stand as Independents at the 2019 federal election is one indication of this. Women within the major parties, particularly on the conservative side of politics, have become quiet. Some are withdrawing, but most are likely regrouping, gathering the rage within and ready to make a stand after the dust of the 2019 election has settled.ReferencesAndrew, Merrindahl. Social Movements and the Limits of Strategy: How Australian Feminists Formed Positions on Work and Care. Canberra. 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Ed. Jocelynne Scutt. Ringwood: Penguin 1987. 107-120.Ryan, L. “Feminism and the Federal Bureaucracy 1972-83.” Playing the State: Australian Feminist Interventions. Ed. Sophie Watson. Sydney: Allen and Unwin 1990.Ryan, Susan. “Fishes on Bicycles.” Papers on Parliament 17 (Sep. 1992). 1 Mar. 2018 <https://www.aph.gov.au/~/~/link.aspx?_id=981240E4C1394E1CA3D0957C42F99120>.Sydney Morning Herald. “‘Pinocchio Gillard’: Strong Anti-Gillard Emissions at Canberra Carbon Tax Protest.” 23 Mar. 2011. 12 Sep. 2016 <http://www.smh.com.au/environment/climate-change/pinocchio-gillard-strong-antigillard-emissions-at-canberra-carbon-tax-protest-20110323-1c5w7.html>.———. “Gillard v Abbott on the Slipper Affair.” 10 Oct. 2012. 12 Sep. 2016 <http://www.abc.net.au/news/2012-10-09/gillard-vs-abbott-on-the-slipper-affair/4303618>.United Nations Women. Facts and Figures: Leadership and Political Participation. 2017. 1 Mar. 2018 <http://www.unwomen.org/en/what-we-do/leadership-and-political-participation/facts-and-figures>.Van Acker, Elizabeth. Different Voices: Gender and Politics in Australia. Melbourne: MacMillan Education Australia, 1999.Wright, Tony. “No Handmaids Here! Liberal Women Launch Their Red Resistance.” Sydney Morning Herald 17 Sep. 2018. 20 Jan. 2019 <https://www.smh.com.au/politics/federal/no-handmaids-here-liberal-women-launch-their-red-resistance-20180917-p504bm.html>.Wong, Penny. “Marriage Equality Plebiscite.” Interview Transcript. The Project 1 Aug. 2017. 1 Mar. 2018 <https://www.pennywong.com.au/transcripts/the-project-2/>.

The constantly changing healthcare landscape requires the health workforce to enhance their competencies and respond to the complex needs of the population they serve. In the Philippines, Universal Health Care (UHC) is a national priority, which aims to ensure equitable access to affordable and quality health services for all Filipinos. The UHC Act (Republic Act No. 11223)1 stresses that the health system provides comprehensive services across the spectrum of health promotion, illness prevention, health restoration, rehabilitation, and palliation. Moreover, the UHC primarily requires health service delivery to be people-centered, cognizant of their necessities, culture, and values. Primary Health Care, which involves accessible, continuous, and comprehensive care from initial patient contact, together with coordinated care among healthcare workers, is the most inclusive and effective means to achieve UHC.2 Therefore, an adequately supplied and well-equipped human health resources are crucial to guarantee that population’s healthcare needs are appropriately recognized, prioritized, and addressed. The Philippines continues to face health problems as it aims to achieve UHC, considering the underserved populations suffering from high prevalence of communicable and non-communicable diseases, adolescents and young adults confronting the epidemic of sexually transmitted infections, mothers and newborns dying from preventable causes, and older adults requiring increased healthcare demands. While policymakers continue to explore reasonable means to address these problems, what is clear is that the status quo in the current health system cannot be allowed to persist. Rather, health agencies should be reoriented, and the healthcare workforce supported to respond to the growing, yet preventable healthcare problems. Nurses are critically positioned to advance the universal health care of Filipinos. With almost half of the health workforce both locally and globally,3 nurses can significantly contribute to the country’s objective of achieving better health outcomes – by promoting health and preventing illnesses among the well and at-risk groups, supporting the treatment of the sick and disabled, and empowering families and communities to attain health and well-being. As nurses provide quality care in various settings, particularly in primary health care, enabling nurses to practice their profession fully can contribute to the goal of “Health for All”. Hence, we enjoin the call for the development and implementation of advanced practice nursing in the Philippines, aiming to provide safe, quality, accessible, and affordable healthcare. An advanced practice nurse (APN), as defined by the International Council of Nurses, is one who has an “expert knowledge base, complex decision-making skills, and clinical competencies for expanded nursing practice,” wherein such qualities are influenced by the country or context where the person is certified to practice.3 The last phrase emphasizes that the APN scope of practice is heterogeneous across nations and is shaped by the local healthcare situation. Nonetheless, it should be stressed that the APN is essentially a nursing role and is rooted in principles inherent in the profession. Therefore, APNs should not be perceived as substituting for another practice role, competing with other professionals, or obtaining domain expertise from other healthcare disciplines. Instead of utilizing the traditional biomedical model, APNs are guided by interdisciplinary knowledge and nursing, which places the patient at the center of healthcare. This is because the APN role is grounded on the core of nursing – caring. 4 Notably, facilitating a holistic approach, fostering effective communication, and building therapeutic relationships are crucial to human caring practice, which can be articulated well through advanced practice.4 APNs aim to manage not only the physical domains of persons nursed, but also their psychosocial or spiritual needs across the health continuum. Such aspects of care are consistent in achieving UHC through primary health care, that is, meeting the health needs of persons across the lifespan with accessible and comprehensive healthcare services delivery. A recent global survey of low- and middle-income countries incorporating advanced practice nursing in their health systems revealed that the primary reason for developing APN roles was the need to care for underserved populations.5 This is particularly relevant to the Philippines, where healthcare access remains a significant challenge for those in geographically isolated and economically disadvantaged communities. Meanwhile, a country-wide study by the Department of Health and the United States Agency for International Development (USAID) in 2019 revealed that primary care workers, including nurses and midwives, performed their duties beyond their professional training due to significant taskshifting and sharing, thereby recommending the need to revise their scopes of practice.6 In particular, a study in this Nursing Issue reported that nurses working in some underserved areas prescribed and administered medications for common illnesses, ordered laboratory examinations, sutured skin lacerations, and facilitated labor and deliveries, upon collaborative agreements with the physicians.7 With the literature reporting positive results in client satisfaction, cost-effectiveness, consultation waiting times, and chronic disease management from APN-facilitated care,8 the development and integration of APNs in the local health system could be a promising means to promote better healthcare access for all Filipinos. The country’s progression toward the integration of APNs in the health system requires support from various stakeholders, including professionals, healthcare and educational institutions, and government agencies. This is because additional education, training, certification, and regulation are needed for APNs to provide health services effectively and legally. Moreover, the perennial shortage of health workers is another potential barrier toward this endeavor. Nevertheless, advanced practice nursing might promote better career advancement and salary opportunities for our Filipino nurses, which could aid in improving their recruitment and retention. This is consistent with the recommendations of a national policy dialog to support the resilience and retention of healthcare workers beyond the COVID-19 pandemic, which is reported in this Nursing Issue.9 The Philippines can learn from more than 70 countries on how to facilitate the development and integration of APNs in our health systems.3 It should be noted that such numbers include developing countries in Asia and Africa, as they realized the importance of APNs in delivering quality and accessible health services to their constituents. Today more than ever, nurses provide safe and quality care to patients beyond the hospital walls – building relationships and fostering partnerships with communities to empower them towards better health. Thus, we reiterate the call among various local and national agencies to support the advancement of nursing practice to provide primary care across communities, which will contribute to forwarding UHC in the country. As underscored by the WHO Declaration of Astana in 2018,10 Health for All could be realized by investing in the education, development, recruitment, and retention of health human resources prepared to deliver primary health care to the population.

It is now almost 15 years since the world witnessed one of modern history’s most devastating terrorist attacks on the United States on 11 September 2001. Despite all its promises, the so called ‘War on Terror’ failed to combat a growing tide of violent extremism. 11 years after the US led offensive on Iraq in 2003, the rise of terrorism by non-state actors in the Arab world presents a significant concern to international security and world peace. Since 2001 Australian Muslims have consistently been called upon to openly reject terrorism committed by a minority of Muslims who adhere to an extreme interpretation of Islamic doctrine that justifies attacks on civilians both in the Arab world and abroad.The responsibility placed on Australian Muslims to actively reject terrorism comes from both official channels through government funded programs under the banner of counter terrorism and countering violent extremism and the public through the popular media. Yet, Muslims in Australia who do speak out against religiously motivated non-state terrorism find themselves in an impossible bind. They are expected to speak out as representatives of a fragmented, heterogeneous and diverse mix of communities and ideologies. Often, when they do speak out, they are viewed with suspicion and presumed to be ‘apologists for Islam’ whose claim to tolerance and the peaceful nature of Islamic doctrine purposefully ignores its true nature. Such responses render these spokespersons illegitimate- both as representatives of Muslim communities and as Australian citizens. The question “Why don’t moderate Muslims speak out against terrorism?” is often raised in the popular media in response to attacks against Western interests by jihadi groups. On 15 August 2014 an article in the Daily Telegraph by well-known conservative journalist Piers Akerman raised the question in relation to the Australian government’s announcement of increased powers for law enforcement agencies to deal with the issue of returned foreign fighters who had joined the Islamic State’s conflict in Iraq and Syria. The article, titled “It’s Time for Muslim Leaders to Speak Up” reiterated much of the construction of the silent Muslim majority that has pervaded the Australian popular media since 2001. Akerman states: “They [the Australian government] should be making it clear to Australian Muslims that they expect their leaders to speak out more vehemently against those who groom terrorists from the among the young and stupidly impressionable in their communities”. While he continues by acknowledging that Muslims in Australia are diverse in ethnicity and religious views and that the vast majority of Muslims do not support terrorism, he concludes by stating that “the few are costing the majority of Australians millions in security and those who enjoy leadership titles must accept that some responsibility attaches to their position or they should abdicate in favour of individuals who are prepared to consent to the obligations inherent in their station” (Piers Akerman). The same sentiments were expressed by Pia Ackerman in the Australian who wrote that “AUSTRALIA’S Muslim leaders need to speak out against Islamic State terrorists or risk losing their credibility and ability to reach young men attracted to the extremists’ cause” (Pia Akerman).Other responses in the popular media present a different argument. In an article titled “The Moderate Muslims Are Talking If Only You Will Listen”, David Penberthy of the Herald Sun cites examples of Muslim Australians who are speaking out including the case of prominent Sydney GP Jamal Rifi whose condemnation of terrorist activities in the Arab world has earned him death threats from members of the Islamic State (Penberthy). Yet, as Penberthy rightly acknowledges the questions “where are the moderates? Where are the decent Muslims? Are there any? Why aren’t they speaking out?” are still the most salient questions being asked of Muslims in the public sphere. For Australian Muslims at least, they are questions that pervade their everyday lives. It is these questions for example that leads Muslim women who wear the tradition head covering or hijab to challenge media representations of themselves as complicit actors in terrorism by acting as alternative sources of truth for curious co-workers and members of the broader community (see Aly, A Study).Muslim women who do not wear the hijab can face even more barriers to speaking out because they do not pass the test of ‘legitimate’ Muslims: those who fit the stereotype of the angry bearded male and the oppressed female shrouded in black. This author, who has in the past written about extremist interpretations of Islam, has faced condemnation from anti- Islamic groups who questioned her authenticity as a Muslim. By speaking out as a Muslim against the violent actions of some Muslims in other parts of the world, I was being accused of misinformed. Ironically, those who are vehemently anti- Islamic espouse the very same ideological world view and interpretations of Islamic doctrine as those Muslims they claim to oppose. Both groups rely on an extreme and minority version of Islam that de-legitimises more mainstream, nuanced interpretations and both groups claim legitimacy to the truth that Islam can only ever be violent, aggressive and oppositional.It is not just in the public and media discourses that Muslims who speak out against terrorism face being branded illegitimate. The policy response to home-grown terrorism — acts of violence carried out by Australian citizens within Australia — has, albeit inadvertently, created the conditions through which Muslims must verify their legitimate claims to being Australian by participating in the governments’ program of counter terrorism.In the wake of the 2005 London bombings, the Prime Minister met with selected representatives from Muslim communities to discuss the development of a Muslim Community Reference Group. The Group was charged with assisting the Australian Government by acting as an advisory group and by working with Muslim communities “promote harmony, mutual understanding and Australian values and to challenge violence, ignorance and rigid thinking”. This was iterated through a Statement of Principles that committed members of Muslim communities to pursue “moderate’ Islam (Prime Minister, “Meeting”). The very need for a Muslim summit and for the development of a Statement of Principles (later endorsed by the Council of Australian Governments, COAG), sends a lucid message to the Australian public that not only are Australian Muslims responsible for terrorism but that they also have the capacity to prevent or minimise the threat of an attack in Australia.In 2005, the policy response to terrorism took its first step towards linking the social harmony agenda to the securitisation of the state in the form of the National Action Plan to Build Social Cohesion, Harmony and Security. The stated purpose of the National Action Plan (NAP) notably conflated national security with social cohesion and harmony and clearly indicated an understanding that violent extremism could be addressed through programs designed to reinforce Australian values, social harmony, interfaith understanding and tolerance: “The purpose of this National Action Plan (NAP) is to reinforce social cohesion, harmony and support the national security imperative in Australia by addressing extremism, the promotion of violence and intolerance…”(Commonwealth of Australia, National Action Plan).Between 2005 and 2010, the National Action Plan provided funding for 83 community based projects deemed to meet the Plan’s criteria of addressing extremism and the promotion of violence. Of the 83 projects funded, 33 were undertaken by associations that identified as Muslim or Islamic (some applicants received funding for more than one project or in more than one round). The remaining 50 organisations funded included universities and vocational training organisations (4), multicultural social services or migrant resource centres (14), interfaith groups (3), local councils (4), ethnic organisations (specifically African, East African, Afghan, Hazara, Arabic and Pakistani), sporting clubs (4) and miscellaneous social clubs and service providers. The kinds of projects that were funded were predominantly aimed at Muslim communities, most notably youth and women, and the provision of services, programs, education, information and dialogue. Sixty five of the projects funded were explicitly aimed at Muslim communities and identified their target groups variously as: ‘African Muslim’; ‘Muslim youth’; ‘Muslim women’; ‘at risk Muslims’; ‘young Muslims’; ‘Iraqi Muslims’; ‘Lebanese Muslims’ and ‘young Muslim men from Arabic speaking backgrounds’. Seven projects were described as involving ‘interfaith’ elements, though a further 13 projects described some form of interaction between Muslim and non-Muslim communities and groups through activities such as sport, dialogue, fashion parades, workshops, art and craft programs, music workshops. 29 projects involved some form of leadership training for Muslims: youth, women and young men. Overall, the range of projects funded under the National Action Plan in the five years of its operation reflect a policy approach that specifically identifies Muslim communities (including ethno specific and new and emerging Muslim communities) as the primary target of Australia’s broader security strategy.The National Action Plan was succeeded by the Building Community Resilience (BCR) Program. Despite the positive steps taken in attempting to move the BCR program away from the social harmony policy agenda, it continued to reflect an underlying preoccupation with the assumptions of its predecessor. Between 2011- 2013 it funded 51 community based projects. Of these, 7 projects were undertaken by Islamic or Muslim associations. Ten of the projects specifically target Muslims or Muslim communities, with 6 of these being Muslim youth leadership and/or mentoring programs. The remaining 4 Muslim focussed projects include a project designed to encourage Muslim youth to build positive connections with the broader community, the development of a Common Curriculum Framework for teaching Islamic Studies in Australian Islamic primary and secondary schools, a project to address misconceptions about Islam and promote cultural understanding and the production of a DVD for schools to address misperceptions about Muslims. Notably, only one project specifically targets white supremacist violent extremism. The Australian governments’ progressive policy approach to countering violent extremism at home has disproportionately focussed on the Australian Muslim communities. In an environment where Muslims are viewed with suspicion and as having the primary responsibility as both perpetrators and gatekeepers of terroristic ideologies, Muslims in diaspora communities have been forced to make legitimate claims to their innocence. In order to do this they are required to reaffirm their commitment to Australian values, not just by speaking out against terrorism but also by participating in programs that are based on false assumptions about the nature of Muslim citizenship in Australia and the premise that Muslim Australians are, both individually and collectively, opposed to such values by virtue of their religious affiliation. In 2014 and in response to growing concerns about the number of Australians travelling to Iraq and Syria to fight alongside the Islamic State, the government made a bold move by declaring its intention to overhaul existing terror laws. The new laws would reverse the onus of proof on those who travelled to certain countries deemed to be terrorist hotspots to prove that they were not partaking in armed conflict or terrorist training. They would also give more powers to law enforcement and surveillance agencies by lowering the threshold of arrest without a warrant. The announcement of the new laws by the Prime Minister coincided with the news that the Government would abandon its controversial plans to drop section 18c from the Racial Discrimination Act which makes it unlawful to "offend, insult, humiliate or intimidate another person or a group of people" because of their race or ethnicity" (Aston). The announcement was made under the guise of a press conference on terror laws and inferred that the back down on the Racial Discrimination Act reforms were a measure to win over the Muslim communities cooperation on the new terror laws. Referring to a somewhat curious notion of “team Australia”, the Prime Minister stated “I want to work with the communities of our country as team Australia here” (Aston). “Team Australia” has since become the Government’s narrative frame for garnering public support for its proposed new terrorism laws. Echoing his predecessor John Howard, whose narrative of Australian values pervaded much of the political discourse during his term in office, Prime Minister Abbott stated in a radio interview that "everyone has got to put this country, its interests, its values and its people first, and you don't migrate to this country unless you want to join our team". He followed this statement by emphasising that "What we need to do is to encourage the moderate mainstream to speak out" (Cox).Shortly after the release of a horrific image on social media showing Australian jihadists proudly flaunting the severed heads of their victims, the Australian government reacted with an even bolder move to introduce legislation that would see the government cancelling the welfare payments of persons “identified by national security agencies as being involved in extremist conduct.” According to the Government the reforms would “enable the Department of Human Services to cancel a person’s welfare payment if it receives advice that a person has been assessed as a serious threat to Australia’s national security.”(Prime Minister of Australia) The move was criticised by several groups including academics who argued that it would not only alienate the already disenfranchised Muslim communities, but could also result in greater radicalisation (Ireland). In response to the raft of new measures perceived to be targeting Muslim communities, Australian Muslims took measured steps to voice their opposition through written statements and media releases stating that, among other things: These proposals come in the same style as those which have preceded [sic] since the Howard era. An alleged threat is blown out of all proportion as the pretext, further "tightening" of the laws is claimed necessary and rushed through, without proper national debate or community consultation. The reality of the alleged threat is also exposed by the lack of correspondence between the official 'terror threat' level, which has remained the same since 2001, and the hysterical rhetoric from government ministers. (ABC News, "Australian Muslims")Australian Muslim leaders also boycotted government meetings including a planned meeting with the Prime Minister to discuss the new laws. The Prime Minister promptly branded the boycott “foolish” (ABC News, "Tony Abbott") yet refused to acknowledge the legitimacy of the claims made in the media statements and messages by Muslim organisations that prompted the boycotts. As Australian Muslims continue to grapple with ways to legitimize their claims to citizenship, the developing discourse on national security and terrorism continues to define them as the objects of terror. Notably, the media discourse is showing some signs of accommodating the views of Muslim Australians who have found some space in the public sphere. Recent media reporting on terror activities in the Middle East has given some consideration to the voices of Muslim leaders who openly oppose violent extremism. Yet Muslims in Australia are still battling for legitimacy. Those who speak out against the hijacking of their religion by a minority who espouse a rigid and uncompromising ideology in order to justify violence often find themselves the subjects of intense scrutiny. From within their communities they are seen to be mouth pieces for an unfair and unjust government agenda that targets Muslims as objects of fear. From outside their communities they are seen to be apologists for Islam whose authenticity should be questioned if not denied. Attempts by Muslim Australians to have their voices heard through political practices that define the very nature of democracy including peaceful demonstrations, boycotts and written statements have not been taken seriously. As a result, Muslim voices in Australia are deemed illegitimate regardless of the forms or platforms through which they seek to be heard. ReferencesABC News. “Australian Muslims Denounce Proposed 'Anti-Terror' Laws”. ABC Religion and Ethics, 21 Aug. 2014. 23 Aug. 2014 .ABC News. “Tony Abbott Says Muslim Leaders 'Foolishly Boycotted' Counterterrorism Law Meeting.” 22 Aug. 2014. 24 Aug. 2014 .Akerman, Pia. “Muslim Leaders Must Speak Out against Extremists, Academic Warns.” The Australian 13 Aug. 13 2014. 20 Aug. 2014 . Akerman, Piers. “It's Time for Muslim Leaders to Speak Up.” Daily Telegraph 15 Aug. 2014. 20 Aug. 2014 .Alynne, A. A Study of Audience Responses to the Media Discourse about the ‘Other’: The Fear of Terrorism between Australian Muslims and the Broader Community. Lampeter: Edwin Mellen, 2010.Aly, Anne. “Media Hegemony, Activism and Identity: Muslim Women Re-Presenting Muslim Women.” Beyond the Hijab Debates: New Conversations on Gender, Race and Religion, eds. T. Dreher and C. Ho. Cambridge: Cambridge Scholars, 2009.Aly, Anne, and Mark Balnaves. “The Atmosfear of Terror: Affective Modulation and the War on Terror.” M/C Journal 8.6 (2005).Aly, Anne, and Lelia Green. “‘Moderate Islam’: Defining the Good Citizen.” M/C Journal 10.6/11.1 (2008). 13 April 2008 ‹http://journal.media-culture.org.au/0804/08aly-green.php›.Aston, H. “Tony Abbott Dumps Controversial Changes to 18C Racial Discrimination Laws.” Sydney Morning Herald 5 Aug. 2014. 24 Aug. 2014 .Australian Government, Attorney General's Department. Building Community Resilience Grants Program. n.d. 24 July 2014 . Commonwealth of Australia. Transnational Terrorism White Paper: The Threat to Australia. Canberra: Department of Prime Minister and Cabinet, 2004. . Commonwealth of Australia. National Action Plan to Build Social Cohesion, Harmony and Security. Canberra: Department of Immigration and Citizenship, 2006. .Commonwealth of Australia. Counter Terrorism White Paper: Securing Australia, Protecting our Community. Canberra: Department of Prime Minister and Cabinet, 2010. 19 Nov. 2011 .Cox, L. “'You Don't Migrate to This Country unless You Want to Join Our Team': Tony Abbott Renews Push on National Security Laws.” Sydney Morning Herald 18 Aug. 2014. 24 Aug. 2014 . Ireland, J. “Extremism Warning on Coalition's Move to Cut Welfare Payments.” Sydney Morning Herald 19 Aug. 2014. 24 Aug. 2014 .Penberthy, D. “The Moderate Muslims Are Talking If Only You Will Listen. Herald Sun 17 Aug. 2014 .Prime Minister of Australia. “New Counter-Terrorism Measures for a Safer Australia - Cancelling Welfare Payments to Extremists”. 16 Aug. 2014. 23 Aug. 2014 .Prime Minister of Australia. “Meeting with Islamic Community Leaders, Statement of Principles.” 23 Aug. 2005. July 2008 .

Introduction I think the Privacy Act is a huge edifice to protect the minority of things that could go wrong. I’ve got a good example for you, I’m just trying to think … yeah the worst one I’ve ever seen was the Balga Youth Program where we took these students on a reward excursion all the way to Fremantle and suddenly this very alienated kid started to jump under a bus, a moving bus so the kid had to be restrained. The cops from Fremantle arrived because all the very good people in Fremantle were alarmed at these grown-ups manhandling a kid and what had happened is that DCD [Department of Community Development] had dropped him into the program but hadn’t told us that this kid had suicide tendencies. No, it’s just chronically bad. And there were caseworkers involved and … there is some information that we have to have that doesn’t get handed down. Rather than a blanket rule that everything’s confidential coming from them to us, and that was a real live situation, and you imagine how we’re trying to handle it, we had taxis going from Balga to Fremantle to get staff involved and we only had to know what to watch out for and we probably could have … well what you would have done is not gone on the excursion I suppose (School Principal, quoted in Balnaves and Luca 49). These comments are from a school principal in Perth, Western Australia in a school that is concerned with “at-risk” students, and in a context where the Commonwealth Privacy Act 1988 has imposed limitations on their work. Under this Act it is illegal to pass health, personal or sensitive information concerning an individual on to other people. In the story cited above the Department of Community Development personnel were apparently protecting the student’s “negative right”, that is, “freedom from” interference by others. On the other hand, the principal’s assertion that such information should be shared is potentially a “positive right” because it could cause something to be done in that person’s or society’s interests. Balnaves and Luca noted that positive and negative rights have complex philosophical underpinnings, and they inform much of how we operate in everyday life and of the dilemmas that arise (49). For example, a ban on euthanasia or the “assisted suicide” of a terminally ill person can be a “positive right” because it is considered to be in the best interests of society in general. However, physicians who tacitly approve a patient’s right to end their lives with a lethal dose by legally prescribed dose of medication could be perceived as protecting the patient’s “negative right” as a “freedom from” interference by others. While acknowledging the merits of collaboration between people who are working to improve the wellbeing of students “at-risk”, this paper examines some of the barriers to collaboration. Based on both primary and secondary sources, and particularly on oral testimonies, the paper highlights the tension between privacy as a negative right and collaborative helping as a positive right. It also points to other difficulties and dilemmas within and between the institutions engaged in this joint undertaking. The authors acknowledge Michel Foucault’s contention that discourse is power. The discourse on privacy and the sharing of information in modern societies suggests that privacy is a negative right that gives freedom from bureaucratic interference and protects the individual. However, arguably, collaboration between agencies that are working to support individuals “at-risk” requires a measured relaxation of the requirements of this negative right. Children and young people “at-risk” are a case in point. Towards Collaboration From a series of interviews conducted in 2004, the school authorities at Balga Senior High School and Midvale Primary School, people working for the Western Australian departments of Community Development, Justice, and Education and Training in Western Australia, and academics at the Edith Cowan and Curtin universities, who are working to improve the wellbeing of students “at-risk” as part of an Australian Research Council (ARC) project called Smart Communities, have identified students “at-risk” as individuals who have behavioural problems and little motivation, who are alienated and possibly violent or angry, who under-perform in the classroom and have begun to truant. They noted also that students “at-risk” often suffer from poor health, lack of food and medication, are victims of unwanted pregnancies, and are engaged in antisocial and illegal behaviour such as stealing cars and substance abuse. These students are also often subject to domestic violence (parents on drugs or alcohol), family separation, and homelessness. Some are depressed or suicidal. Sometimes cultural factors contribute to students being regarded as “at-risk”. For example, a social worker in the Smart Communities project stated: Cultural factors sometimes come into that as well … like with some Muslim families … they can flog their daughter or their son, usually the daughter … so cultural factors can create a risk. Research elsewhere has revealed that those children between the ages of 11-17 who have been subjected to bullying at school or physical or sexual abuse at home and who have threatened and/or harmed another person or suicidal are “high-risk” youths (Farmer 4). In an attempt to bring about a positive change in these alienated or “at-risk” adolescents, Balga Senior High School has developed several programs such as the Youth Parents Program, Swan Nyunger Sports Education program, Intensive English Centre, and lower secondary mainstream program. The Midvale Primary School has provided services such as counsellors, Aboriginal child protection workers, and Aboriginal police liaison officers for these “at-risk” students. On the other hand, the Department of Community Development (DCD) has provided services to parents and caregivers for children up to 18 years. Academics from Edith Cowan and Curtin universities are engaged in gathering the life stories of these “at-risk” students. One aspect of this research entails the students writing their life stories in a secured web portal that the universities have developed. The researchers believe that by engaging the students in these self-exploration activities, they (the students) would develop a more hopeful outlook on life. Though all agencies and educational institutions involved in this collaborative project are working for the well-being of the children “at-risk”, the Privacy Act forbids the authorities from sharing information about them. A school psychologist expressed concern over the Privacy Act: When the Juvenile Justice Department want to reintroduce a student into a school, we can’t find out anything about this student so we can’t do any preplanning. They want to give the student a fresh start, so there’s always that tension … eventually everyone overcomes [this] because you realise that the student has to come to the school and has to be engaged. Of course, the manner and consequences of a student’s engagement in school cannot be predicted. In the scenario described above students may have been given a fair chance to reform themselves, which is their positive right but if they turn out to be at “high risk” it would appear that the Juvenile Department protected the negative right of the students by supporting “freedom from” interference by others. Likewise, a school health nurse in the project considered confidentiality or the Privacy Act an important factor in the security of the student “at-risk”: I was trying to think about this kid who’s one of the children who has been sexually abused, who’s a client of DCD, and I guess if police got involved there and wanted to know details and DCD didn’t want to give that information out then I’d guess I’d say to the police “Well no, you’ll have to talk to the parents about getting further information.” I guess that way, recognising these students are minor and that they are very vulnerable, their information … where it’s going, where is it leading? Who wants to know? Where will it be stored? What will be the outcomes in the future for this kid? As a 14 year old, if they’re reckless and get into things, you know, do they get a black record against them by the time they’re 19? What will that information be used for if it’s disclosed? So I guess I become an advocate for the student in that way? Thus the nurse considers a sexually abused child should not be identified. It is a positive right in the interest of the person. Once again, though, if the student turns out to be at “high risk” or suicidal, then it would appear that the nurse was protecting the youth’s negative right—“freedom from” interference by others. Since collaboration is a positive right and aims at the students’ welfare, the workable solution to prevent the students from suicide would be to develop inter-agency trust and to share vital information about “high-risk” students. Dilemmas of Collaboration Some recent cases of the deaths of young non-Caucasian girls in Western countries, either because of the implications of the Privacy Act or due to a lack of efficient and effective communication and coordination amongst agencies, have raised debates on effective child protection. For example, the British Laming report (2003) found that Victoria Climbié, a young African girl, was sent by her parents to her aunt in Britain in order to obtain a good education and was murdered by her aunt and aunt’s boyfriend. However, the risk that she could be harmed was widely known. The girl’s problems were known to 6 local authorities, 3 housing authorities, 4 social services, 2 child protection teams, and the police, the local church, and the hospital, but not to the education authorities. According to the Laming Report, her death could have been prevented if there had been inter-agency sharing of information and appropriate evaluation (Balnaves and Luca 49). The agencies had supported the negative rights of the young girl’s “freedom from” interference by others, but at the cost of her life. Perhaps Victoria’s racial background may have contributed to the concealment of information and added to her disadvantaged position. Similarly, in Western Australia, the Gordon Inquiry into the death of Susan Taylor, a 15 year old girl Aboriginal girl at the Swan Nyungah Community, found that in her short life this girl had encountered sexual violation, violence, and the ravages of alcohol and substance abuse. The Gordon Inquiry reported: Although up to thirteen different agencies were involved in providing services to Susan Taylor and her family, the D[epartment] of C[ommunity] D[evelopment] stated they were unaware of “all the services being provided by each agency” and there was a lack of clarity as to a “lead coordinating agency” (Gordon et al. quoted in Scott 45). In this case too, multiple factors—domestic, racial, and the Privacy Act—may have led to Susan Taylor’s tragic end. In the United Kingdom, Harry Ferguson noted that when a child is reported to be “at-risk” from domestic incidents, they can suffer further harm because of their family’s concealment (204). Ferguson’s study showed that in 11 per cent of the 319 case sample, children were known to be re-harmed within a year of initial referral. Sometimes, the parents apply a veil of secrecy around themselves and their children by resisting or avoiding services. In such cases the collaborative efforts of the agencies and education may be thwarted. Lack of cultural education among teachers, youth workers, and agencies could also put the “at-risk” cultural minorities into a high risk category. For example, an “at-risk” Muslim student may not be willing to share personal experiences with the school or agencies because of religious sensitivities. This happened in the UK when Khadji Rouf was abused by her father, a Bangladeshi. Rouf’s mother, a white woman, and her female cousin from Bangladesh, both supported Rouf when she finally disclosed that she had been sexually abused for over eight years. After group therapy, Rouf stated that she was able to accept her identity and to call herself proudly “mixed race”, whereas she rejected the Asian part of herself because it represented her father. Other Asian girls and young women in this study reported that they could not disclose their abuse to white teachers or social workers because of the feeling that they would be “letting down their race or their Muslim culture” (Rouf 113). The marginalisation of many Muslim Australians both in the job market and in society is long standing. For example, in 1996 and again in 2001 the Muslim unemployment rate was three times higher than the national total (Australian Bureau of Statistics). But since the 9/11 tragedy and Bali bombings visible Muslims, such as women wearing hijabs (headscarves), have sometimes been verbally and physically abused and called ‘terrorists’ by some members of the wider community (Dreher 13). The Howard government’s new anti-terrorism legislation and the surveillance hotline ‘Be alert not alarmed’ has further marginalised some Muslims. Some politicians have also linked Muslim asylum seekers with terrorists (Kabir 303), which inevitably has led Muslim “at-risk” refugee students to withdraw from school support such as counselling. Under these circumstances, Muslim “at-risk” students and their parents may prefer to maintain a low profile rather than engage with agencies. In this case, arguably, federal government politics have exacerbated the barriers to collaboration. It appears that unfamiliarity with Muslim culture is not confined to mainstream Australians. For example, an Aboriginal liaison police officer engaged in the Smart Communities project in Western Australia had this to say about Muslim youths “at-risk”: Different laws and stuff from different countries and they’re coming in and sort of thinking that they can bring their own laws and religions and stuff … and when I say religions there’s laws within their religions as well that they don’t seem to understand that with Australia and our laws. Such generalised misperceptions of Muslim youths “at-risk” would further alienate them, thus causing a major hindrance to collaboration. The “at-risk” factors associated with Aboriginal youths have historical connections. Research findings have revealed that indigenous youths aged between 10-16 years constitute a vast majority in all Australian States’ juvenile detention centres. This over-representation is widely recognised as associated with the nature of European colonisation, and is inter-related with poverty, marginalisation and racial discrimination (Watson et al. 404). Like the Muslims, their unemployment rate was three times higher than the national total in 2001 (ABS). However, in 1998 it was estimated that suicide rates among Indigenous peoples were at least 40 per cent higher than national average (National Advisory Council for Youth Suicide Prevention, quoted in Elliot-Farrelly 2). Although the wider community’s unemployment rate is much lower than the Aboriginals and the Muslims, the “at-risk” factors of mainstream Australian youths are often associated with dysfunctional families, high conflict, low-cohesive families, high levels of harsh parental discipline, high levels of victimisation by peers, and high behavioural inhibition (Watson et al. 404). The Macquarie Fields riots in 2005 revealed the existence of “White” underclass and “at-risk” people in Sydney. Macquarie Fields’ unemployment rate was more than twice the national average. Children growing up in this suburb are at greater risk of being involved in crime (The Age). Thus small pockets of mainstream underclass youngsters also require collaborative attention. In Western Australia people working on the Smart Communities project identified that lack of resources can be a hindrance to collaboration for all sectors. As one social worker commented: “government agencies are hierarchical systems and lack resources”. They went on to say that in their department they can not give “at-risk” youngsters financial assistance in times of crisis: We had a petty cash box which has got about 40 bucks in it and sometimes in an emergency we might give a customer a couple of dollars but that’s all we can do, we can’t give them any larger amount. We have bus/metro rail passes, that’s the only thing that we’ve actually got. A youth worker in Smart Communities commented that a lot of uncertainty is involved with young people “at-risk”. They said that there are only a few paid workers in their field who are supported and assisted by “a pool of volunteers”. Because the latter give their time voluntarily they are under no obligation to be constant in their attendance, so the number of available helpers can easily fluctuate. Another youth worker identified a particularly important barrier to collaboration: because of workers’ relatively low remuneration and high levels of work stress, the turnover rates are high. The consequence of this is as follows: The other barrier from my point is that you’re talking to somebody about a student “at-risk”, and within 14 months or 18 months a new person comes in [to that position] then you’ve got to start again. This way you miss a lot of information [which could be beneficial for the youth]. Conclusion The Privacy Act creates a dilemma in that it can be either beneficial or counter-productive for a student’s security. To be blunt, a youth who has suicided might have had their privacy protected, but not their life. Lack of funding can also be a constraint on collaboration by undermining stability and autonomy in the workforce, and blocking inter-agency initiatives. Lack of awareness about cultural differences can also affect unity of action. The deepening inequality between the “haves” and “have-nots” in the Australian society, and the Howard government’s harshness on national security issues, can also pose barriers to collaboration on youth issues. Despite these exigencies and dilemmas, it would seem that collaboration is “the only game” when it comes to helping students “at-risk”. To enhance this collaboration, there needs to be a sensible modification of legal restrictions to information sharing, an increase in government funding and support for inter-agency cooperation and informal information sharing, and an increased awareness about the cultural needs of minority groups and knowledge of the mainstream underclass. Acknowledgments The research is part of a major Australian Research Council (ARC) funded project, Smart Communities. The authors very gratefully acknowledge the contribution of the interviewees, and thank *Donald E. Scott for conducting the interviews. References Australian Bureau of Statistics. 1996 and 2001. Balnaves, Mark, and Joe Luca. “The Impact of Digital Persona on the Future of Learning: A Case Study on Digital Repositories and the Sharing of Information about Children At-Risk in Western Australia”, paper presented at Ascilite, Brisbane (2005): 49-56. 10 April 2006. http://www.ascilite.org.au/conferences/brisbane05/blogs/proceedings/ 06_Balnaves.pdf>. Dreher, Tanya. ‘Targeted’: Experiences of Racism in NSW after September 11, 2001. Sydney: University of Technology, 2005. Elliot-Farrelly, Terri. “Australian Aboriginal Suicide: The Need for an Aboriginal Suicidology”? Australian e-Journal for the Advancement of Mental Health, 3.3 (2004): 1-8. 15 April 2006 http://www.auseinet.com/journal/vol3iss3/elliottfarrelly.pdf>. Farmer, James. A. High-Risk Teenagers: Real Cases and Interception Strategies with Resistant Adolescents. Springfield, Ill.: C.C. Thomas, 1990. Ferguson, Harry. Protecting Children in Time: Child Abuse, Child Protection and the Consequences of Modernity. London: Palgrave Macmillan, 2004. Foucault, Michel. Power/Knowledge: Selected Interviews and Other Writings, 1972-1977. Ed. Colin Gordon, trans. Colin Gordon et al. New York: Pantheon, 1980. Kabir, Nahid. Muslims in Australia: Immigration, Race Relations and Cultural History. London: Kegan Paul, 2005. Rouf, Khadji. “Myself in Echoes. My Voice in Song.” Ed. A. Bannister, et al. Listening to Children. London: Longman, 1990. Scott E. Donald. “Exploring Communication Patterns within and across a School and Associated Agencies to Increase the Effectiveness of Service to At-Risk Individuals.” MS Thesis, Curtin University of Technology, August 2005. The Age. “Investing in People Means Investing in the Future.” The Age 5 March, 2005. 15 April 2006 http://www.theage.com.au>. Watson, Malcolm, et al. “Pathways to Aggression in Children and Adolescents.” Harvard Educational Review, 74.4 (Winter 2004): 404-428. Citation reference for this article MLA Style Kabir, Nahid, and Mark Balnaves. "Students “at Risk”: Dilemmas of Collaboration." M/C Journal 9.2 (2006). echo date('d M. Y'); ?> <http://journal.media-culture.org.au/0605/04-kabirbalnaves.php>. APA Style Kabir, N., and M. Balnaves. (May 2006) "Students “at Risk”: Dilemmas of Collaboration," M/C Journal, 9(2). Retrieved echo date('d M. Y'); ?> from <http://journal.media-culture.org.au/0605/04-kabirbalnaves.php>.

Photograph by Gonzalo Echeverria (2010)We need to get some broad-based support, to capture the public’s imagination … so we have to offer up scary scenarios, make simplified, dramatic statements and make little mention of any doubts … each of us has to decide what the right balance is between being effective and being honest (Hulme 347). Acclaimed climate scientist, the late Stephen Schneider, made this comment in 1988. Later he regretted it and said that there are ways of using metaphors that can “convey both urgency and uncertainty” (Hulme 347). What Schneider encapsulates here is the great conundrum for those attempting to communicate climate change to the everyday public. How do scientists capture the public’s imagination and convey the desperation they feel about climate change, but do it ethically? If scientific findings are presented carefully, in boring technical jargon that few can understand, then they are unlikely to attract audiences or provide an impetus for behavioural change. “What can move someone to act?” asks communication theorists Susan Moser and Lisa Dilling (37). “If a red light blinks on in a cockpit” asks Donella Meadows, “should the pilot ignore it until in speaks in an unexcited tone? … Is there any way to say [it] sweetly? Patiently? If one did, would anyone pay attention?” (Moser and Dilling 37). In 2010 Tim Flannery was appointed Panasonic Chair in Environmental Sustainability at Macquarie University. His main teaching role remains within the new science communication programme. One of the first things Flannery was emphatic about was acquainting students with Karl Popper and the origin of the scientific method. “There is no truth in science”, he proclaimed in his first lecture to students “only theories, hypotheses and falsifiabilities”. In other words, science’s epistemological limits are framed such that, as Michael Lemonick argues, “a statement that cannot be proven false is generally not considered to be scientific” (n.p., my emphasis). The impetus for the following paper emanates precisely from this issue of scientific uncertainty — more specifically from teaching a course with Tim Flannery called Communicating climate change to a highly motivated group of undergraduate science communication students. I attempt to illuminate how uncertainty is constructed differently by different groups and that the “public” does not necessarily interpret uncertainty in the same way the sciences do. This paper also analyses how doubt has been politicised and operates polemically in media coverage of climate change. As Andrew Gorman-Murray and Gordon Waitt highlight in an earlier issue of M/C Journal that focused on the climate-culture nexus, an understanding of the science alone is not adequate to deal with the cultural change necessary to address the challenges climate change brings (n.p). Far from being redundant in debates around climate change, the humanities have much to offer. Erosion of Trust in Science The objectives of Macquarie’s science communication program are far more ambitious than it can ever hope to achieve. But this is not necessarily a bad thing. The initiative is a response to declining student numbers in maths and science programmes around the country and is designed to address the perceived lack of communication skills in science graduates that the Australian Council of Deans of Science identified in their 2001 report. According to Macquarie Vice Chancellor Steven Schwartz’s blog, a broader, and much more ambitious aim of the program is to “restore public trust in science and scientists in the face of widespread cynicism” (n.p.). In recent times the erosion of public trust in science was exacerbated through the theft of e-mails from East Anglia University’s Climate Research Unit and the so-called “climategate scandal” which ensued. With the illegal publication of the e-mails came claims against the Research Unit that climate experts had been manipulating scientific data to suit a pro-global warming agenda. Three inquiries later, all the scientists involved were cleared of any wrongdoing, however the damage had already been done. To the public, what this scandal revealed was a certain level of scientific hubris around the uncertainties of the science and an unwillingness to explain the nature of these uncertainties. The prevailing notion remained that the experts were keeping information from public scrutiny and not being totally honest with them, which at least in the short term, damaged the scientists’s credibility. Many argued that this signalled a shift in public opinion and media portrayal on the issue of climate change in late 2009. University of Sydney academic, Rod Tiffen, claimed in the Sydney Morning Herald that the climategate scandal was “one of the pivotal moments in changing the politics of climate change” (n.p). In Australia this had profound implications and meant that the bipartisan agreement on an emissions trading scheme (ETS) that had almost been reached, subsequently collapsed with (climate sceptic) Tony Abbott's defeat of (ETS advocate) Malcolm Turnbull to become opposition leader (Tiffen). Not long after the reputation of science received this almighty blow, albeit unfairly, the federal government released a report in February 2010, Inspiring Australia – A national strategy for engagement with the sciences as part of the country’s innovation agenda. The report outlines a commitment from the Australian government and universities around the country to address the challenges of not only communicating science to the broader community but, in the process, renewing public trust and engagement in science. The report states that: in order to achieve a scientifically engaged Australia, it will be necessary to develop a culture where the sciences are recognized as relevant to everyday life … Our science institutions will be expected to share their knowledge and to help realize full social, economic, health and environmental benefits of scientific research and in return win ongoing public support. (xiv-xv) After launching the report, Innovation Minister Kim Carr went so far as to conflate “hope” with “science” and in the process elevate a discourse of technological determinism: “it’s time for all true friends of science to step up and defend its values and achievements” adding that, "when you denigrate science, you destroy hope” (n.p.). Forever gone is our naïve post-war world when scientists were held in such high esteem that they could virtually use humans as guinea pigs to test out new wonder chemicals; such as organochlorines, of which DDT is the most widely known (Carson). Thanks to government-sponsored nuclear testing programs, if you were born in the 1950s, 1960s or early 1970s, your brain carries a permanent nuclear legacy (Flannery, Here On Earth 158). So surely, for the most part, questioning the authority and hubristic tendencies of science is a good thing. And I might add, it’s not just scientists who bear this critical burden, the same scepticism is directed towards journalists, politicians and academics alike – something that many cultural theorists have noted is characteristic of our contemporary postmodern world (Lyotard). So far from destroying hope, as the former Innovation Minister Kim Carr (now Minister for Innovation, Industry, Science and Research) suggests, surely we need to use the criticisms of science as a vehicle upon which to initiate hope and humility. Different Ways of Knowing: Bayesian Beliefs and Matters of Concern At best, [science] produces a robust consensus based on a process of inquiry that allows for continued scrutiny, re-examination, and revision. (Oreskes 370) In an attempt to capitalise on the Macquarie Science Faculty’s expertise in climate science, I convened a course in second semester 2010 called SCOM201 Science, Media, Community: Communicating Climate Change, with invaluable assistance from Penny Wilson, Elaine Kelly and Liz Morgan. Mike Hulme’s provocative text, Why we disagree about climate change: Understanding controversy, inaction and opportunity provided an invaluable framework for the course. Hulme’s book brings other types of knowledge, beyond the scientific, to bear on our attitudes towards climate change. Climate change, he claims, has moved from being just a physical, scientific, and measurable phenomenon to becoming a social and cultural phenomenon. In order to understand the contested nature of climate change we need to acknowledge the dynamic and varied meanings climate has played in different cultures throughout history as well as the role that our own subjective attitudes and judgements play. Climate change has become a battleground between different ways of knowing, alternative visions of the future, competing ideas about what’s ethical and what’s not. Hulme makes the point that one of the reasons that we disagree about climate change is because we disagree about the role of science in today’s society. He encourages readers to use climate change as a tool to rigorously question the basis of our beliefs, assumptions and prejudices. Since uncertainty was the course’s raison d’etre, I was fortunate to have an extraordinary cohort of students who readily engaged with a course that forced them to confront their own epistemological limits — both personally and in a disciplinary sense. (See their blog: https://scom201.wordpress.com/). Science is often associated with objective realities. It thus tends to distinguish itself from the post-structuralist vein of critique that dominates much of the contemporary humanities. At the core of post-structuralism is scepticism about everyday, commonly accepted “truths” or what some call “meta-narratives” as well as an acknowledgement of the role that subjectivity plays in the pursuit of knowledge (Lyotard). However if we can’t rely on objective truths or impartial facts then where does this leave us when it comes to generating policy or encouraging behavioural change around the issue of climate change? Controversial philosophy of science scholar Bruno Latour sits squarely in the post-structuralist camp. In his 2004 article, “Why has critique run out of steam? From matters of fact to matters of concern”, he laments the way the right wing has managed to gain ground in the climate change debate through arguing that uncertainty and lack of proof is reason enough to deny demands for action. Or to use his turn-of-phrase, “dangerous extremists are using the very same argument of social construction to destroy hard-won evidence that could save our lives” (Latour n.p). Through co-opting (the Left’s dearly held notion of) scepticism and even calling themselves “climate sceptics”, they exploited doubt as a rationale for why we should do nothing about climate change. Uncertainty is not only an important part of science, but also of the human condition. However, as sociologist Sheila Jasanoff explains in her Nature article, “Technologies of Humility”, uncertainty has become like a disease: Uncertainty has become a threat to collective action, the disease that knowledge must cure. It is the condition that poses cruel dilemmas for decision makers; that must be reduced at all costs; that is tamed with scenarios and assessments; and that feeds the frenzy for new knowledge, much of it scientific. (Jasanoff 33) If we move from talking about climate change as “a matter of fact” to “a matter of concern”, argues Bruno Latour, then we can start talking about useful ways to combat it, rather than talking about whether the science is “in” or not. Facts certainly matter, claims Latour, but they can’t give us the whole story, rather “they assemble with other ingredients to produce a matter of concern” (Potter and Oster 123). Emily Potter and Candice Oster suggest that climate change can’t be understood through either natural or cultural frames alone and, “unlike a matter of fact, matters of concern cannot be explained through a single point of view or discursive frame” (123). This makes a lot of what Hulme argues far more useful because it enables the debate to be taken to another level. Those of us with non-scientific expertise can centre debates around the kinds of societies we want, rather than being caught up in the scientific (un)certainties. If we translate Latour’s concept of climate change being “a matter of concern” into the discourse of environmental management then what we come up with, I think, is the “precautionary principle”. In the YouTube clip, “Stephen Schneider vs Skeptics”, Schneider argues that when in doubt about the potential environmental impacts of climate change, we should always apply the precautionary principle. This principle emerged from the UN conference on Environment and Development in Rio de Janeiro in 1992 and concerns the management of scientific risk. However its origins are evident much earlier in documents such as the “Use of Pesticides” from US President’s Science Advisory Committee in 1962. Unlike in criminal and other types of law where the burden of proof is on the prosecutor to show that the person charged is guilty of a particular offence, in environmental law the onus of proof is on the manufacturers to demonstrate the safety of their product. For instance, a pesticide should be restricted or disproved for use if there is “reasonable doubt” about its safety (Oreskes 374). Principle 15 of the Rio Declaration on Environment and Development in 1992 has its foundations in the precautionary principle: “Where there are threats of serious or irreversible environmental damage, lack of full scientific certainty should not be used as a reason for postponing measures to prevent environmental degradation” (n.p). According to Environmental Law Online, the Rio declaration suggests that, “The precautionary principle applies where there is a ‘lack of full scientific certainty’ – that is, when science cannot say what consequences to expect, how grave they are, or how likely they are to occur” (n.p.). In order to make predictions about the likelihood of an event occurring, scientists employ a level of subjectivity, or need to “reveal their degree of belief that a prediction will turn out to be correct … [S]omething has to substitute for this lack of certainty” otherwise “the only alternative is to admit that absolutely nothing is known” (Hulme 85). These statements of “subjective probabilities or beliefs” are called Bayesian, after eighteenth century English mathematician Sir Thomas Bayes who developed the theory of evidential probability. These “probabilities” are estimates, or in other words, subjective, informed judgements that draw upon evidence and experience about the likelihood of event occurring. The Intergovernmental Panel on Climate Change (IPCC) uses Bayesian beliefs to determine the risk or likelihood of an event occurring. The IPCC provides the largest international scientific assessment of climate change and often adopts a consensus model where viewpoint reached by the majority of scientists is used to establish knowledge amongst an interdisciplinary community of scientists and then communicate it to the public (Hulme 88). According to the IPCC, this consensus is reached amongst more than more than 450 lead authors, more than 800 contributing authors, and 2500 scientific reviewers. While it is an advisory body and is not policy-prescriptive, the IPCC adopts particular linguistic conventions to indicate the probability of a statement being correct. Stephen Schneider convinced the IPCC to use this approach to systemise uncertainty (Lemonick). So for instance, in the IPCC reports, the term “likely” denotes a chance of 66%-90% of the statement being correct, while “very likely” denotes more than a 90% chance. Note the change from the Third Assessment Report (2001), indicating that “most of the observed warming in over the last fifty years is likely to have been due to the increase in greenhouse gas emissions” to the Fourth Assessment (February 2007) which more strongly states: “Most of the observed increase in global average temperatures since the mid twentieth century is very likely due to the observed increase in anthropogenic greenhouse gas concentrations” (Hulme 51, my italics). A fiery attack on Tim Flannery by Andrew Bolt on Steve Price’s talkback radio show in June 2010 illustrates just how misunderstood scientific uncertainty is in the broader community. When Price introduces Flannery as former Australian of the Year, Bolt intercedes, claiming Flannery is “Alarmist of the Year”, then goes on to chastise Flannery for making various forecasts which didn’t eventuate, such as that Perth and Brisbane might run out of water by 2009. “How much are you to blame for the swing in sentiment, the retreat from global warming policy and rise of scepticism?” demands Bolt. In the context of the events of late 2009 and early 2010, the fact that these events didn’t materialise made Flannery, and others, seem unreliable. And what Bolt had to say on talkback radio, I suspect, resonated with a good proportion of its audience. What Bolt was trying to do was discredit Flannery’s scientific credentials and in the process erode trust in the expert. Flannery’s response was to claim that, what he said was that these events might eventuate. In much the same way that the climate sceptics have managed to co-opt scepticism and use it as a rationale for inaction on climate change, Andrew Bolt here either misunderstands basic scientific method or quite consciously misleads and manipulates the public. As Naomi Oreskes argues, “proof does not play the role in science that most people think it does (or should), and therefore it cannot play the role in policy that skeptics demand it should” (Oreskes 370). Doubt and ‘Situated’ Hope Uncertainty and ambiguity then emerge here as resources because they force us to confront those things we really want–not safety in some distant, contested future but justice and self-understanding now. (Sheila Jasanoff, cited in Hulme, back cover) In his last published book before his death in mid-2010, Science as a contact sport, Stephen Schneider’s advice to aspiring science communicators is that they should engage with the media “not at all, or a lot”. Climate scientist Ann Henderson-Sellers adds that there are very few scientists “who have the natural ability, and learn or cultivate the talents, of effective communication with and through the media” (430). In order to attract the public’s attention, it was once commonplace for scientists to write editorials and exploit fear-provoking measures by including a “useful catastrophe or two” (Moser and Dilling 37). But are these tactics effective? Susanne Moser thinks not. She argues that “numerous studies show that … fear may change attitudes … but not necessarily increase active engagement or behaviour change” (Moser 70). Furthermore, risk psychologists argue that danger is always context specific (Hulme 196). If the risk or danger is “situated” and “tangible” (such as lead toxicity levels in children in Mt Isa from the Xstrata mine) then the public will engage with it. However if it is “un-situated” (distant, intangible and diffuse) like climate change, the audience is less likely to. In my SCOM201 class we examined the impact of two climate change-related campaigns. The first one was a short film used to promote the 2010 Copenhagen Climate Change Summit (“Scary”) and the second was the State Government of Victoria’s “You have the power: Save Energy” public awareness campaign (“You”). Using Moser’s article to guide them, students evaluated each campaign’s effectiveness. Their conclusions were that the “You have the power” campaign had far more impact because it a) had very clear objectives (to cut domestic power consumption) b) provided a very clear visualisation of carbon dioxide through the metaphor of black balloons wafting up into the atmosphere, c) gave viewers a sense of empowerment and hope through describing simple measures to cut power consumption and, d) used simple but effective metaphors to convey a world progressed beyond human control, such as household appliances robotically operating themselves in the absence of humans. Despite its high production values, in comparison, the Copenhagen Summit promotion was more than ineffective and bordered on propaganda. It actually turned viewers off with its whining, righteous appeal of, “please help the world”. Its message and objectives were ambiguous, it conveyed environmental catastrophe through hackneyed images, exploited children through a narrative based on fear and gave no real sense of hope or empowerment. In contrast the Victorian Government’s campaign focused on just one aspect of climate change that was made both tangible and situated. Doubt and uncertainty are productive tools in the pursuit of knowledge. Whether it is scientific or otherwise, uncertainty will always be the motivation that “feeds the frenzy for new knowledge” (Jasanoff 33). Articulating the importance of Hulme’s book, Sheila Jasanoff indicates we should make doubt our friend, “Without downplaying its seriousness, Hulme demotes climate change from ultimate threat to constant companion, whose murmurs unlock in us the instinct for justice and equality” (Hulme back cover). The “murmurs” that Jasanoff gestures to here, I think, can also be articulated as hope. And it is in this discussion of climate change that doubt and hope sit side-by-side as bedfellows, mutually entangled. Since the “failed” Copenhagen Summit, there has been a distinct shift in climate change discourse from “experts”. We have moved away from doom and gloom discourses and into the realm of what I shall call “situated” hope. “Situated” hope is not based on blind faith alone, but rather hope grounded in evidence, informed judgements and experience. For instance, in distinct contrast to his cautionary tale The Weather Makers: The History & Future Impact of Climate Change, Tim Flannery’s latest book, Here on Earth is a biography of our Earth; a planet that throughout its history has oscillated between Gaian and Medean impulses. However Flannery’s wonder about the natural world and our potential to mitigate the impacts of climate change is not founded on empty rhetoric but rather tempered by evidence; he presents a series of case studies where humanity has managed to come together for a global good. Whether it’s the 1987 Montreal ban on CFCs (chlorinated fluorocarbons) or the lesser-known 2001 Stockholm Convention on POP (Persistent Organic Pollutants), what Flannery envisions is an emerging global civilisation, a giant, intelligent super-organism glued together through social bonds. He says: If that is ever achieved, the greatest transformation in the history of our planet would have occurred, for Earth would then be able to act as if it were as Francis Bacon put it all those centuries ago, ‘one entire, perfect living creature’. 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In recent years ecological thinking has been applied to a range of social, cultural, and aesthetic systems, including performing arts as a living system of policy makers, producers, organisations, artists, and audiences. Ecological thinking is systems-based thinking which allows us to see the performing arts as a complex and protean ecosystem; to explain how elements in this system act and interact; and to evaluate its effects on Australia’s social fabric over time. According to Gallasch, ecological thinking is “what we desperately need for the arts.” It enables us to “defeat the fragmentary and utilitarian view of the arts that dominates, to make connections, to establish overviews of the arts that can be shared and debated” (Gallasch NP). The ecological metaphor has featured in debates about the performing arts in Brisbane, Australia, in the last two or three years. A growing state capital on Australia’s eastern seaboard, Brisbane is proud of its performing arts culture. Its main theatre organisations include the state flagship Queensland Theatre Company; the second major presenter of adapted and new text-based performances La Boite Theatre Company; venues which support local and touring performances such as the Judith Wright Centre for Contemporary Arts and the Brisbane Powerhouse; emerging talent incubator Metro Arts; indigenous companies like Kooemba Jdarra; independent physical theatre and circus companies such as Zen Zen Zo and Circa; and contemporary play-producing company 23rd Productions (cf. Baylis 3). Brisbane aspires to be a cultural capital in Australia, Australasia, and the Asia Pacific (Gill). Compared to Australia’s southern capitals Sydney and Melbourne, however, Brisbane does have a relatively low level of performing arts activity across traditional and contemporary theatre, contemporary performance, musicals, circus, and other genres of performance. It has at times been cast as a piecemeal, potentially unsustainable arts centre prone to losing talent to other states. In 2009, John Baylis took up these issues in Mapping Queensland Theatre, an Arts Queensland-funded survey designed to map practices in Brisbane and in Queensland more broadly, and to provide a platform to support future policy-making. This report excited debate amongst artists who, whilst accepting the tenor of Baylis’s criticisms, also lamented the lack of nuanced detail and contextualised relationships its map of Queensland theatre provided. In this paper we propose a new approach to mapping Brisbane’s and Queensland’s theatre that extends Baylis’s “value chain” into a “value ecology” that provides a more textured picture of players, patterns, relationships, and activity levels. A “value chain” approach emphasises linear relationships and gaps between production, distribution, and consumption in a specific sector of the economy. A “value ecology” approach goes further by examining a complex range of rhizomatic relationships between production, distribution, and consumption infrastructure and how they influence each other within a sector of the economy such as the performing arts. Our approach uses a “value ecology” model adapted from Hearn et al. and Cherbo et al. to map and interpret information from the AusStage performing arts database, the Australian Bureau of Statistics, and other sources such as previews, reviews, and an ongoing local blogosphere debate. Building upon Baylis’s work, our approach produces literal and conceptual maps of Queensland’s performing arts as they change over time, with analysis of support, infrastructure, and relationships amongst government, arts organisations, artists, and audiences. As debate on Mapping Queensland Theatre gives way to more considered reflection, and as Baylis develops a follow-up report, our approach captures snapshots of Queensland’s performing arts before, during, and after such policy interventions. It supports debate about how Queensland artists might manage their own sustainability, their own ability to balance artistic, cultural, and economic factors that influence their work in a way that allows them to survive long term, and allows policy makers, producers, and other players to better understand, articulate, assess, and address criticisms. The Ecological Metaphor In recent years a number of commentators have understood the performing arts as an “ecology,” a system characterised by interacting elements, engagements, flows, blockages, breaks, and breakthroughs whose “health” (synonymous in this context with sustainability) depends on relationships between players within and without the system. Traditionally, performing arts policies in Australia have concentrated on singular elements in a system. They have, as Hunt and Shaw argue, “concentrate[d] on individual companies or an individual artist’s practice rather than the sector as a whole” (5, cf. 43). The focus has been on how to structure, support, and measure the success—the aesthetic and social benefits—of individual training institutions, artists, administrators, and arts organisations. The “health” of singular elements has been taken as a sign of the “health” of the system. An ecologies approach, by contrast, concentrates on engagements, energies, and flows as signs of health, and thus sustainability, in a system. Ecological thinking enables policy makers, practitioners, and scholars to go beyond debate about the presence of activity, the volume of activity, and the fate of individual agents as signs of the health or non-health of a system. In an ecologies context, level of activity is not the only indicator of health, and low activity does not necessarily equate with instability or unsustainability. An ecological approach is critical in Brisbane, and in Queensland more broadly, where attempts to replicate the nature or level of activity in southern capitals are not necessarily the best way to shore up the “health” of our performing arts system in our own unique environment. As the locus of our study Queensland is unique. While Queensland has 20% of Australia’s population (OESR; ABS ‘ Population Projections’), and is regularly recognised as a rapidly growing “lifestyle superstate” which values innovation, creativity, and cultural infrastructure (Cunningham), it is still home to significantly less than 20% of Australia’s performing arts producers, and many talented people continue to migrate to the south to pursue career opportunities (Baylis 4, 28). An ecologies approach can break into oft-cited anxieties about artist, activity, and audience levels in Brisbane, and in Queensland, and create new ideas about what a “healthy” local performing arts sector might look like. This might start to infuse some of the social media commentary that currently tends to emphasise the gaps in the sector. Ecologies are complex systems. So, as Costanza says, when we consider ecosystem health, we must consider the overall performance of the system, including its ability to deal with “external stress” (240) from macro-level political, legal, social, cultural, economic, or technological currents that change the broader society this particular sector or ecosystem sits within. In Brisbane, there is a growing population and a desire to pursue a cultural capital tag, but the distinctive geographic, demographic, and behavioural characteristics of Brisbane’s population—and the associated ‘stresses’, conditions, or constraints—mean that striving to replicate patterns of activity seen in Sydney or Melbourne may not be the straightest path to a “healthy” or “sustainable” sector here. The attitudes of the players and the pressures influencing the system are different, so this may be like comparing rainforests with deserts (Costanza), and forgetting that different elements and engagements are in fact “healthy” in different ecosystems. From an ecologies point of view, policy makers and practitioners in Brisbane and in Queensland more broadly might be well advised to stop trying to match Sydney or Melbourne, and to instead acknowledge that a “healthy” ecosystem here may look different, and so generate policy, subsidy, and production systems to support this. An ecological approach can help determine how much activity is in fact necessary to ensure a healthy and sustainable local performing arts sector. It can, in other words, provide a fresh approach that inspires new ideas and strategies for sector sustainability. Brisbane, Baylis and the Blogosphere Debate The ecological metaphor has clearly captured the interest of policy makers as they consider how to make Queensland’s performing arts more sustainable and successful. For Arts Queensland: The view of the sector as a complex and interdependent ‘ecosystem’ is forging new thinking, new practices and new business models. Individual practitioners and organisations are rethinking where they sit within the broader ecology, and what they contribute to the health and vitality of the sector, and how they might address the gaps in services and skills (12). This view informed the commissioning of Mapping Queensland Theatre, an assessment of Queensland’s theatre sector which offers a framework for allocation of resources under the Queensland Arts & Cultural Sector Plan 2010-2013. It also offers a framework for negotiation with funded organisations to ensure “their activities and focus support a harmonious ecology” (Baylis 3) in which all types and levels of practice (emerging, established, touring, and so on) are functioning well and are well represented within the overall mix of activities. Utilising primary and secondary survey sources, Mapping Queensland Theatre seeks: to map individuals, institutions, and organisations who have a stake in developing Queensland’s professional theatre sector; and to apply a “value chain” model of production from supply (training, creation, presentation, and distribution) to demand (audiences) to identify problems and gaps in Queensland’s professional theatre sector and recommend actions to address them. The report is critical of the sector. Baylis argues that “the context for great theatre is not yet in place in Queensland … therefore works of outstandingly high quality will be rare” (28).Whilst acknowledging a lack of ready answers about how much activity is required in a vibrant theatre culture, Baylis argues that “comparisons are possible” (27) and he uses various data sets to compare numbers of new Australian productions in different states. He finds that “despite having 20% of the Australian population, [Queensland] generates a dramatically lower amount of theatre activity” (4, cf. 28). The reason, according to Baylis (20, 23, 25, 29, 32, 40-41, 44), is that there are gaps in the “value chain” of Queensland theatre, specifically in: Support for the current wave of emerging and independent artistsSpace for experimentation Connections between artists, companies, venues and festivals, between and within regional centres, and between Queensland companies and their (inter)national peers Professional development for producers to address the issue of market distributionAudience development “Queensland lacks a critical mass of theatre activity to develop a sustainable theatre culture” (48), and the main gap is in pathways for independent artists. Quality new work does not emerge, energy dissipates, and artists move on. The solution, for Baylis, is to increase support for independent companies (especially via co-productions with mainstage companies), to improve (inter)national touring, and to encourage investment in audience development. Naturally, Queensland’s theatre makers responded to this report. Responses were given, for example, in inaugural speeches by new Queensland Theatre Company director Wesley Enoch and new La Boite Theatre Company director David Berthold, in the media, and in blogosphere commentary on a range of articles on Brisbane performing arts in 2010. The blogosphere debate in particular raged for months and warrants more detailed analysis elsewhere. For the purposes of this paper, though, it is sufficient to note that blogosphere debate about the health of Queensland theatre culture acknowledged many of the deficits Baylis identified and called for: More leadershipMore government supportMore venuesMore diversityMore audience, especially for risky work, and better audience engagementMore jobs and retention of artists Whilst these responses endorse Baylis’s findings and companies have since conceived programs that address Baylis’s criticisms (QTC’s introduction of a Studio Season and La Boite’s introduction of an Indie program in 2010 for example) a sense of frustration also emerged. Some, like former QTC Chair Kate Foy, felt that “what’s really needed in the theatre is a discussion that breaks out from the old themes and encourages fresh ideas—approaches to solving whatever problems are perceived to exist in ‘the system’.” For commentators like Foy the blogosphere debate enacted a kind of ritual rehearsal of an all-too-familiar set of concerns: inadequate and ill-deployed funding, insufficient venues, talent drain, and an impoverished local culture of theatre going. “Value Chains” versus “Value Ecologies” Why did responses to this report demand more artists, more arts organisations, more venues, and more activities? Why did they repeat demands for more government-subsidised venues, platforms, and support rather than drive toward new seed- or non- subsidised initiatives? At one level, this is to do with the report’s claims: it is natural for artists who have been told quality work is “rare” amongst them to point to lack of support to achieve success. At another level, though, this is because—as useful as it has been for local theatre makers—Baylis’s map is premised on a linear chain from training, to first productions, to further developed productions (involving established writers, directors, designers and performers), to opportunities to tour (inter)nationally, etc. It provides a linear image of a local performing arts sector in which there are individuals and institutions with potential, but specific gaps in the production-distribution-consumption chain that make it difficult to deliver work to target markets. It emphasises gaps in the linear pathway towards “stability” of financial, venue, and audience support and thus “sustainability” over a whole career for independent artists and the audiences they attract. Accordingly, asking government to plug the gaps through elements added to the system (venues, co-production platforms, producer hubs, subsidy, and entrepreneurial endeavours) seems like a logical solution. Whilst this is true, it does not tell the whole story. To generate a wider story, we need to consider: What the expected elements in a “healthy” ecosystem would be (e.g. more versus alternative activity);What other aesthetic, cultural, or economic pressures affect the “health” of an ecosystem;Why practices might need to cycle, ebb, and flow over time in a “healthy” ecosystem. A look at the way La Boite works before, during, and after Baylis’s analysis of Brisbane theatre illustrates why attention to these elements is necessary. A long-running company which has made the transition from amateur to professional to being a primary developer of new Australian work in its distinctive in-the-round space, La Boite has recently shifted its strategic position. A focus on text-based Australian plays has given way to adapted, contemporary, and new work in a range of genres; regular co-productions with companies in Brisbane and beyond; and an “Indie” program that offers other companies a venue. This could be read as a response to Baylis’s recommendation: the production-distribution-consumption chain gap for Brisbane’s independents is plugged, the problem is solved, the recommendation has led to the desired result. Such a reading might, though, overlook the range of pressures beyond Brisbane, beyond Queensland, and beyond the Baylis report that drive—and thus help, hinder, or otherwise effect—the shift in La Boite’s program strategies. The fact that La Boite recently lost its Australia Council funding, or that La Boite like all theatre companies needs co-productions to keep its venue running as costs increase, or that La Boite has rebranded to appeal to younger audiences interested in postdramatic, do-it-your-self or junkyard style aesthetics. These factors all influence what La Boite might do to sustain itself, and more importantly, what its long-term impact on Brisbane’s theatre ecology will be. To grasp what is happening here, and get beyond repetitive responses to anxieties about Brisbane’s theatre ecology, detail is required not simply on whether programs like La Boite’s “plugged the gap” for independent artists, but on how they had both predicted and unpredicted effects, and how other factors influenced the effects. What is needed is to extend mapping from a “value chain” to a full ”value ecology”? This is something Hearn et al. have called for. A value chain suggests a “single linear process with one stage leading to the next” (5). It ignores the environment and other external enablers and disregards a product’s relationship to other systems or products. In response they prefer a “value creating ecology” in which the “constellation of firms are [sic] dynamic and value flow is multi-directional and works through clusters of networks” (6). Whilst Hearn et al. emphasise “firms” or companies in their value creating ecology, a range of elements—government, arts organisations, artists, audiences, and the media as well as the aesthetic, social, and economic forces that influence them—needs to be mapped in the value creating ecology of the performing arts. Cherbo et al. provide a system of elements or components which, adapted for a local context like Brisbane or Queensland, can better form the basis of a value ecology approach to the way a specific performing arts community works, adapts, changes, breaks down, or breaks through over time. Figure 1 – Performing Arts Sector Map (adapted from Cherbo et. al. 14) Here, the performing arts sector is understood in terms of core artistic workers, companies, a constellation of generic and sector specific support systems, and wider social contexts (Cherbo et al. 15). Together, the shift from “value chain” to “value ecology” that Hearn et al. advocate, and the constellation of ecology elements that Cherbo et al. emphasise, bring a more detailed, dynamic range of relations into play. These include “upstream” production infrastructure (education, suppliers, sponsors), “downstream” distribution infrastructure (venues, outlets, agents), and overall public infrastructure. As a framework for mapping “value ecology” this model offers a more nuanced perspective on production, distribution, and consumption elements in an ecology. It allows for analysis of impact of interventions in dozens of different areas, from dozens of perspectives, and thus provides a more detailed picture of players, relationships, and results to support both practice and policy making around practice. An Aus-e-Stage Value Ecology To provide the more detailed, dynamic image of local theatre culture that a value ecology approach demands—to show players, relations between players, and context in all their complexity—we use the Aus-e-Stage Mapping Service, an online application that maps data about artists, arts organisations, and audiences across cityscapes/landscapes. We use Aus-e-Stage with data drawn from three sources: the AusStage database of over 50,000 entries on Australian performing arts venues, productions, artists, and reviews; the Australian Bureau of Statistics (ABS) data on population; and the Local Government Area (LGA) maps the ABS uses to cluster populations. Figure 2 – Using AusStage Interface Figure 3 – AusStage data on theatre venues laid over ABS Local Government Area Map Figure 4 – Using Aus-e-Stage / AusStage to zoom in on Australia, Queensland, Brisbane and La Boite Theatre Company, and generate a list of productions, dates and details Aus-e-Stage produces not just single maps, but a sequential series of snapshots of production ecologies, which visually track who does what when, where, with whom, and for whom. Its sequences can show: The way artists, companies, venues, and audiences relate to each other;The way artists’ relationship to companies, venues, and audiences changes over time;The way “external stressors” changes such as policy, industrial, or population changes affect the elements, roles, and relationships in the ecology from that point forward. Though it can be used in combination with other data sources such as interviews, the advantage of AusStage data is that maps of moving ecologies of practice are based not on descriptions coloured by memory but clear, accurate program, preview, and review data. This allows it to show how factors in the environment—population, policy, infrastructure, or program shifts—effect the ecology, effect players in the ecology, and prompt players to adapt their type, level, or intensity of practice. It extends Baylis’s value chain into a full value ecology that shows the detail on how an ecology works, going beyond demands that government plug perceived gaps and moving towards data- and history- based decisions, ideas and innovation based on what works in Brisbane’s performing arts ecology. Our Aus-e-Stage mapping shows this approach can do a number of useful things. It can create sequences showing breaks, blockages, and absences in an individual or company’s effort to move from emerging to established (e.g. in a sudden burst of activity followed by nothing). It can create sequences showing an individual or company’s moves to other parts of Australia (e.g. to tour or to pursue more permanent work). It can show surprising spaces, relations, and sources of support artists use to further their career (e.g. use of an amateur theatre outside the city such as Brisbane Arts Theatre). It can capture data about venues, programs, or co-production networks that are more or less effective in opening up new opportunities for artists (e.g. moving small-scale experiments in Metro Arts’ “Independents” program to full scale independent productions in La Boite’s “Indie” program, its mainstage program, other mainstage programs, and beyond). It can link to program information, documentation, or commentary to compare anticipated and actual effects. It can lay the map dates and movements across significant policy, infrastructure, or production climate shifts. In the example below, for instance, Aus-e-Stage represents the tour of La Boite’s popular production of a new Australian work Zig Zag Street, based on the Brisbane-focused novel by Nick Earls about a single, twentysomething man’s struggles with life, love, and work. Figure 5 – Zig Zag Street Tour Map In the example below, Aus-e-Stage represents the movements not of a play but of a performer—in this case Christopher Sommers—who has been able to balance employment with new work incubator Metro Arts, mainstage and indie producer La Boite, and stage theatre company QTC with his role with independent theatre company 23rd Productions to create something more protean, more portfolio-based or boundary-less than a traditional linear career trajectory. Figure 6 – Christopher Sommers Network Map and Travel Map This value of this approach, and this technology, is clear. Which independents participate in La Boite Indie (or QTC’s “Studio” or “Greenroom” new work programs, or Metro’s emerging work programs, or others)? What benefits does it bring for artists, for independent companies, or for mainstage companies like La Boite? Is this a launching pad leading to ongoing, sustainable production practices? What do artists, audiences or others say about these launching pads in previews, programs, or reviews? Using Aus-e-Stage as part of a value ecology approach answers these questions. It provides a more detailed picture of what happens, what effect it has on local theatre ecology, and exactly which influences enabled this effect: precisely the data needed to generate informed debate, ideas, and decision making. Conclusion Our ecological approach provides images of a local performing arts ecology in action, drawing out filtered data on different players, relationships, and influencing factors, and thus extending examination of Brisbane’s and Queensland’s performing arts sector into useful new areas. It offers three main advances—first, it adopts a value ecology approach (Hearn et al.), second, it adapts this value ecology approach to include not just companies by all up- and down- stream players, supporters and infrastructure (Cherbo et. al.), and, thirdly, it uses the wealth of data available via Aus-e-Stage maps to fill out and filter images of local theatre ecology. It allows us to develop detailed, meaningful data to support discussion, debate, and development of ideas that is less likely to get bogged down in old, outdated, or inaccurate assumptions about how the sector works. Indeed, our data lends itself to additional analysis in a number of ways, from economic analysis of how shifts in policy influence productivity to sociological analysis of the way practitioners or practices acquire status and cultural capital (Bourdieu) in the field. Whilst descriptions offered here demonstrate the potential of this approach, this is by no means a finished exercise. Indeed, because this approach is about analysing how elements, roles, and relationships in an ecology shift over time, it is an ever-unfinished exercise. As Fortin and Dale argue, ecological studies of this sort are necessarily iterative, with each iteration providing new insights and raising further questions into processes and patterns (3). Given the number of local performing arts producers who have changed their practices significantly since Baylis’s Mapping Queensland Theatre report, and the fact that Baylis is producing a follow-up report, the next step will be to use this approach and the Aus-e-Stage technology that supports it to trace how ongoing shifts impact on Brisbane’s ambitions to become a cultural capital. This process is underway, and promises to open still more new perspectives by understanding anxieties about local theatre culture in terms of ecologies and exploring them cartographically. References Arts Queensland. Queensland Arts & Cultural Sector Plan 2010-2013. Brisbane: Arts Queensland, 2010. 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