Articoli di riviste sul tema "Returned Services League of Australia"

A survey, which achieved a 54% response rate, was completed to assess the availability and type of rehabilitation health services in Australia. 1044 surveys were sent out and 561 were returned. The details of a total of 346 rehabilitation services were obtained. There were more services in metropolitan compared with rural areas, more services in New South Wales and Victoria than in the other states, and a higher proportion of services led by health care workers other than rehabilitation physicians in rural compared with metropolitan areas. There is likely to be a need for additional rehabilitation services of all types across Australia. The majority of rural, regional and remote areas are likely to need additional physician-led, allied health and nursing services. Further work is needed to assess the size and catchment areas of services in the capital cities and other large population centres to assess whether additional services are also needed in these areas.

The problems for Australian Football League clubs in accessing medical services during the football season in Australia are escalating. This study surveyed medical officers, club officials and Sports Medicine Australia members nationally. Issues for all those involved were explored and any difficulties highlighted in regard to the reasons why doctors were reluctant to provide services to this sporting group. Overall, 132 Sports Medicine Australia members responded to the survey. In addition, 53 medical officers and 28 club officials were surveyed by telephone. This study revealed that there was a definite mismatch between club officials and medical officers as to what was important to doctors in deciding to provide services to a club. The main issues were time demands, the lack of equipment and facilities, remuneration, and impact on family life during the football season. The future of medical officers within Australian football clubs is in need of review if a shortage of trained medical officers providing services to the clubs is to avoid a crisis in the near future.

This paper outlines the basic characteristics of intensive family preservation programs which have very recently been introduced into the child welfare systems of most Australian States. Typically these programs have been used to prevent placement or to assist families whose children are being returned to their care. Highly intensive and with 24 hour availability these short-term services draw on a range of theoretical approaches and are delivered in the family's home and natural environment. It is argued that Australia should avoid both the ‘cultural cringe’ and the ‘Tall Poppy Syndrome’ in assessing what intensive family preservation services may have to offer us.

AbstractAnecdotally, there are frequent reports that peer-facilitated initiatives can be successfully used in employment services. However, in Australia, there is little information about how to effectively deliver peer support. In this paper, we discuss how peer-based interventions might be used to supplement formal return-to-work services and contribute to positive job-seeking outcomes. We illustrate the potential of vocational peer support using a real situation involving a young adult who successfully returned to work soon after sustaining a traumatic injury. Future research should explore the inclusion of various peer support structures and formats as a component of other employment services, to help people with long-term conditions and disabilities achieve a range of vocational outcomes and to guide practice in this area.

A voluntary survey questionnaire that assessed experience with and perception of the volunteering program was mailed to 62 current and 9 former volunteers and 47 staff members of Latrobe Regional Hospital (LRH). Sixty-one completed questionnaires were returned. The nature of hospital work attracted volunteers (57%) and most volunteers felt oriented to the hospital, supervised and supported. The volunteers enjoyed working with patients and felt they contributed to better services and staff and patient support. There was a need felt that more training and development, recognition, orientation and supervision would be beneficial. Overall, most volunteers rated their experience as good (60%) to excellent (25%). Staff rated the contribution from volunteers as good (41%) to excellent (47%). Volunteers identified several areas of improvement, including opportunities for further training and supervision. Volunteers play a crucial role within the health care system. There is tremendous scope for further development of the volunteer role and increasing opportunities for training and development, recognition and encouragement.

Limited progress in nutrition policy action is often blamed on the close relationships the food industry has with health policy decision-makers. This analysis sought to examine this belief through the analysis of health ministers’ diaries. Entries were downloaded from health ministers’ diaries from two states in Australia from January 2013 to June 2018. Entries were coded according to which interest group met with the minister or whether general parliamentary business was undertaken. Coding was also undertaken for any meeting topics related to nutrition policy. Analysis of health ministers’ diaries found that the food industry has limited documented interaction with the two state health ministers in Australia. Instead, medical associations, private hospitals and health services, and sporting associations (rugby league associations) had the most interactions with health ministers. Poor representation was seen on nutrition issues, and there was an apparent lack of nutrition advocates interacting with the health ministers. There are opportunities for nutrition advocates to increase their level of interaction with state health ministers. This could include building alliances with medical associations, as they are in a powerful position, to advocate directly to health ministers. Health ministers’ diaries can provide valuable insights into who is meeting officially with ministers. However, there are also limitations with the dataset.

Termination of pregnancy (TOP) is considered an important component of sexual and reproductive health internationally, but there are known barriers in Australia and countries worldwide. This study investigated the issues for GPs regarding aiding access to TOP and providing early medical abortion (EMA) services for Tasmanian women. Specifically, the aims of the study were to identify the knowledge and attitudes of Tasmanian GPs regarding TOP services and to determine which known barriers to providing EMA are most significant for GPs in Tasmania, Australia. A survey was developed and piloted based on previous qualitative research that identified known barriers to accessing TOP. Surveys were posted to all identified GPs in Tasmania with a reply-paid envelope. In all, 211 (27.4%) responses were returned. GPs identified difficulty accessing TOP services, particularly for rural women and those on a low income. Almost half the GPs, excluding conscientious objectors, indicated they would be interested in providing EMA services, but perceived barriers were significant. The most significant barriers related to accessing appropriate training and support. There was uncertainty around financial reward, support services, medical indemnity and access to the medical abortifacient medications mifepristone and misoprostol. In conclusion, accessing TOP remains an issue for Tasmanian women. Many Tasmanian GPs are interested in providing EMA services if barriers are addressed, but there is a lack of knowledge about the practicalities of implementing EMA. Providing practical support to GPs and increasing knowledge pertaining to EMA provision in general practice could improve access in primary care.

Abstract Background In 2018, the American Academy of Sleep Medicine (AASM) published practice guidelines for use of actigraphy in evaluating adult and paediatric patients with suspected sleep disorders. Whilst there is significant evidence of actigraphy use in research, this study aims to evaluate current and future intended use of actigraphy in paediatric clinical cohorts across Australia and New Zealand (NZ). Methods A 16-item survey was electronically distributed to medical leads from Australian and NZ paediatric sleep centres. Questions enquired on sleep centre logistics, current actigraphy practice behaviours and qualitative assessments on future use. Progress to date The survey was distributed on July 22nd. Thus far, 8 responses have been returned, representing a range of locales, centre types and actigraphy practices. Findings will be collated and presented. Intended outcome and impact This study will provide an understanding for the contemporary trends in actigraphy use through Australia and NZ. This is particularly relevant given changes across recent years with both an increase in commercial prevalence for consumer sleep health devices as well as a surge in ambulatory medical services following the COVID-19 pandemic. It will identify barriers limiting its universal utility and explore clinician preferences for future practice. Such findings can guide actions around improving clinical services, product design and government funding advocacy.

Alcohol and Other Drug (AOD) exposure during pregnancy is linked to serious adverse child outcomes, including Fetal Alcohol Spectrum Disorder (FASD). The Parent-Child Assistance Program (PCAP) supports women with problematic AOD use, who are pregnant or have young children, and are not effectively engaging with services. PCAP has been shown to reduce alcohol exposed pregnancies, promote AOD abstinence, increase employment and family planning and improve child outcomes. This manuscript reports the first pilot evaluation of the PCAP program delivered in Australia. A pre-post-intervention repeated measures design was used. Eleven women receiving PCAP from a not-for-profit organisation were invited to take part in the study, with eight providing complete pre-post data. Home visitation case management was provided by trained and experienced case-managers. Clients were assisted to engage with existing services effectively to meet their own goals via a combination of relational theory, motivational interviewing and harm reduction concepts. The PCAP Modified Addiction Severity Index 5th Edition was adapted for use in Australia and was used to measure domains of addiction severity related problems as the primary outcome. Secondary outcomes included client satisfaction and program fidelity. There were significant changes in composite addiction severity scores from baseline to one year. 80% of participants had periods of abstinence of longer than four months. All clients had better connection to services, no subsequent AOD exposed pregnancies, and were highly satisfied with the program. Four had children returned to their care. Implementation was similar to the original PCAP program with major differences including case-managers relying on training manuals only without undertaking in-person training; being more experienced; providing more direct AOD counselling; and having less supervision. The findings will inform future program delivery and methodology for a larger longitudinal study assessing outcomes at program exit.

An Australia-wide assessment of ~1000 estuaries and embayments undertaken by the National Land and Water Resources Audit of 1997–2002 indicated that ~30% were modified to some degree. The most highly degraded were in New South Wales, where ~40% were classified as ‘extensively modified’ and <10% were ‘near pristine’. Since that review, urban populations have continued to grow rapidly, and increasing pressures for industrial and agricultural development in the coastal zone have resulted in ongoing degradation of Australia's estuaries and embayments. This degradation has had serious effects on biodiversity, and commercial and recreational fishing. A business case is developed that shows that an Australia-wide investment of AU$350 million into repair will be returned in less than 5 years. This return is merely from improved productivity of commercial fisheries of a limited number of fish, shellfish and crustacean species. Estuary repair represents an outstanding return on investment, possibly far greater than most of Australia's previous environmental repair initiatives and with clearly demonstrated outcomes across the Australian food and services economies.

Background There are few reliable Australian abortion data. The aim was to investigate prevalence, sexual experiences and socioeconomic characteristics of women and men who report having had or being a partner in an abortion. Methods: A cross-sectional survey of women and men aged 18–50 years randomly selected from the Australian Electoral Roll was used. Weighted multivariable analyses were conducted. Results: Data from 2235 returned (of 15 480) mailed surveys were analysed. One in six women and one in 10 men had experienced or been a partner in an abortion. In adjusted analyses, for women, experience of sexual coercion [adjusted odds ratio (AOR) 2.18, 95% confidence interval (CI) 1.46, 3.24] was associated with significantly increased odds of abortion, and socioeconomic advantage (AOR = 0.57; 95% CI 0.39, 0.84), being comfortable negotiating contraceptive use (AOR 0.26; 95% CI 0.09, 0.73) and importance of religion in fertility choices (AOR = 0.55; 95% CI 0.35, 0.87) were associated with significantly reduced odds. For men, sexual coercion (AOR = 3.05; 95% CI 1.51, 6.18) and metropolitan residence (AOR = 1.70; 95% CI 1.06, 2.75) significantly increased the odds of reporting being a partner in an abortion. Conclusions: The findings contribute to scarce information about abortion in Australia. The high prevalence of abortion suggests that effective contraceptive counselling and accessible contraception services are not sufficient, and that there is a continuing need for universal pregnancy advice and abortion services. The association between sexual coercion and abortion warrants further investigation.

Opinion polls suggested that Australia’s Coalition (Liberal and National Party) government was likely to be replaced by a Labor government at the 2019 election. However, in fact the government was returned. Key issues in the 2019 election centred around managing the economy, including levels of taxation and issues of inequality; around spending on government services such as health and education; and around issues of climate change. There were elements of populism in both major parties’ campaigns, and two minor populist parties played a significant role in preference distribution. There were also some simmering issues that reflect the broader geopolitical and geo-economic changes that are impacting upon Australia. These include not only challenges for Australia’s economy and identity in the ‘Asian Century’, but also issues of Australia’s relationship with China.

Combustion methods for elemental analysis developed in Europewere adopted by Australian chemists, some of whom undertook training in the Pregl laboratory in Graz, the centre of microanalytical expertise. Microanalytical services developed slowly at the Universities of Sydney and Melbourne. After World War 2 the University of Melbourne and Australia's Council for Scientific and Industrial Research combined to bring German experts to Australia. One of them, Dr K. W. Zimmermann, headed the Australian Microanalytical Service in Melbourne that met the needs of Australian chemists and some overseas customers for four decades. Zimmermann also trained a chemist from Singapore, Mrs Tong Hee Keong, who returned to establish a microanalytical service there. Smaller facilities continued at some Australian universities but most of these closed as the need for micro analyses waned. Simple analyses could be conducted with modern auto-analyzers, but the use of mass spectroscopy to determine accurate molecular masses could obviate the need for combustion analysis. Two university services remain, and a microanalytical service in New Zealand has served Australian customers in recent years.

Pharmacist-managed therapeutic drug monitoring (TDM) services have demonstrated positive outcomes in the literature, including reduced duration of therapy and decreased incidence of the adverse effects of drug therapy. Although the evidence has demonstrated the benefits of these TDM services, this has predominately been within international healthcare systems. The extent to which pharmacist-managed TDM services exist within Australia, and the roles and responsibilities of the pharmacists involved compared to their counterparts in other countries, remains largely unknown. A cross-sectional online survey was conducted evaluating pharmacist-managed TDM programs within Australian hospital and healthcare settings. Pharmacist perceptions were also explored about the strengths, weaknesses, opportunities, and barriers associated with implementing a pharmacist-managed TDM service. A total of 92 surveys were returned, which represents a response rate of 38%. Pharmacist-managed TDM programs were present in 15% of respondents. It is only in the minority of hospitals where there is a pharmacist-managed service, with pharmacists involved in recommending pathology and medication doses. The programs highlighted improved patient outcomes but had difficulty maintaining the educational packages and training. For hospitals without a service, a lack of funding and time were highlighted as barriers. Based on the findings of this survey, there is minimal evidence of pharmacist-managed TDM models within Australian hospital and health services. A standardized national approach to pharmacist-managed TDM services and recognition of this specialist area for pharmacists could be a potential solution to this.

Environmental Management and Sustainable Development (EMSD) would like to thank the following reviewers for reviewing manuscripts from August 1, 2019, to November 1, 2019. Their comments and suggestions were of great help to the authors in improving the quality of their papers. Many authors, regardless of whether EMSD publishes their work, appreciate the helpful feedback provided by the reviewers. Macrothink Institute appreciates the following reviewers’ rigorous and conscientious efforts for this journal. Each of the reviewers listed below returned at least one review during this period. Christiane do Nascimento Monte, Universidade Federal Fluminense, BrazilFarhaoui Mohamed, National Office of Electricity and Drinking Water, MoroccoGiacomo Chiesa, Politecnico di Torino, ItalyHayssam Mohamed Ali, King Saud University, EgyptHebin Lin, International Environmental Management Services Ltd (IEMS), USAMona M. Amin Abdel-Fatah, National Research Center in Egypt, EgyptMurat Eyvaz, Gebze Institute of Technology, TurkeySattar Sattary, Southern Queensland University, Australia

This case study shows how Dramatherapy can engage clients with communication difficulties, which exclude them from standard mental health pathways in early intervention in psychosis services. Deliberately prioritising the client’s newfound modes of expression to shape the narrative within, it is evident Dramatherapy processes; embodiment, projection and role enabled this client to create and then inhabit his own playful metaphors. These metaphors continued to facilitate every-day life challenges. During his Dramatherapy relationship, the client within this case study transitioned from supported accommodation to his own property, progressed to residential rehabilitation for alcohol misuse and finally engaged in cognitive behavioural therapy. From feedback interviews we know he continued to create and use his own protective metaphors 10 months after drama therapy ended. He returned to education as part of his plan to seek appropriate employment and was discharged to his GP.

Objective: To survey rehabilitation physicians about management of patients with non-traumatic spinal cord injury (NTSCI). Methods: Postal and email survey of Australian physicians treating adult inpatients in neurological rehabilitation or Spinal Injury Units (SIUs). 59/69 returned surveys met inclusion criteria. 75% (44) of respondents were from neurological rehabilitation units (response rate 72%) and 25% (15) were from SIUs (response rate 94%). Outcomes were: incidence of NTSCI, opinion regarding ideal setting for NTSCI inpatient rehabilitation, and availability of key services for NTSCI patients in neurological rehabilitation units. Results: Estimated incidence of NTSCI was 26/million adults/year. 60% of NTSCI patients were managed in general neurological rehabilitation units. The majority of respondents (85% (50/59); 95% CI, 73%?92%) believed that the most appropriate setting for NTSCI rehabilitation was either an SIU or a neurological team that specialises in NTSCI patients. Neurological rehabilitation units offered NTSCI patients the following services: education regarding coping with NTSCI and preventing complications (55% [18/33]); specialised wheelchair and seating prescription (85% [28/33]); Environmental Control Unit training (36% [12/33]); and bladder training (97% [32/33]). Conclusions: The most appropriate setting for rehabilitation of NTSCI patients is either a dedicated SIU or a neurological rehabilitation team that specialises in NTSCI. The organisation of inpatient rehabilitation services for NTSCI patients in Australia should be improved.

Objective. To conduct a cross-sectional, community-based, point prevalence study of inflammatory joint disease and other rheumatic disorders in 12-year-old children in a metropolitan community. Methods. After completion of a pilot study of 816 10-year-old children, a cross-sectional prevalence study was performed 2 years later on a randomized sample of 2241 12-year-old children (including the cohort from the pilot study) from a community of approximately 221 700 children aged 12 years or younger, with 17 300 children aged approximately 12 years. A rheumatologic examination was performed on each child by a single observer after perusal of completed questionnaires from parents and children. Results. Three of 816 children in the pilot study were shown to have juvenile chronic arthritis (JCA), fulfilling the criteria of the European League Against Rheumatism for the diagnosis of JCA. Only 1 of 3 had a previous diagnosis of JCA. The prevalence was 3.7 per 1000. Of 2241 children examined 2 years later, 89% returned two questionnaires (one completed by the parent and one by the child). At examination, 38 swollen joints were identified in 32 children. Nine children were identified with JCA, of whom 7 had not had previous diagnoses. No questions from the questionnaires identified the 7 children with previously undiagnosed JCA. The point prevalence of JCA in this community was 4.0 per 1000. Although the children with newly diagnosed cases tended to have mild disease, it was associated with significant morbidity and the potential for serious morbidity. Conclusions. This is the first reported prevalence study of JCA in which case ascertainment was based on clinical examination by a rheumatologist of children within a community. The prevalence of 4.0 per 1000 was significantly higher than the accepted prevalence of 0.6 to 1.1 per 1000. A study based on known cases would have significantly underestimated the true prevalence of JCA in this community, with 7 of 9 cases being previously undiagnosed. Questionnaires were not effective in identifying children with undiagnosed JCA, clinical examination supported by a history from the parent and child providing the only reliable means of diagnosis. It is possible throughout the world that the numbers of undiagnosed cases of JCA significantly exceed the numbers of known cases, with the true prevalence being significantly higher than the levels currently accepted.

Background Acupuncture services form a significant part of the Australian healthcare setting, with national registration of acupuncture practitioners, public subsidies for acupuncture services and high use of acupuncture by the Australian public. Despite these circumstances, there has been little exploration of the interface between acupuncture providers and conventional primary healthcare practitioners in rural and regional Australia. Methods A 27-item questionnaire was sent by post in the second half of 2010 to all 1486 general practitioners (GPs) currently practising in rural and regional Divisions of General Practice in New South Wales, Australia to explore their practices and attitudes to a variety of complementary and alternative medicine (CAM) practices. Their responses on other therapies have been published previously; this report covers acupuncture. Results A total of 585 GPs completed the questionnaire; 49 were returned as ‘no longer at this address’, resulting in an adjusted response rate of 40.7%. Two-thirds of GPs (68.3%) referred patients to an acupuncturist at least a few times per year, while only 8.4% stated that they would not refer patients to an acupuncturist under any circumstances. GPs being older (OR=6.08), GPs being women (OR=2.94), GPs practising in a rural rather than remote area (OR=6.25), GPs having higher levels of self-reported knowledge of acupuncture (OR=5.54), the use of complementary medicine (CAM) by a GP for their personal health (OR=2.37), previous prescription of CAM to other patients (OR=2.99), lack of other treatment options (OR=4.31) and GPs using CAM practitioners as the major source of their CAM information (OR=3.05) were all predictive of increased referral to acupuncture among rural GPs. Conclusions There is a significant interface between acupuncture and Australian rural and regional general practice, with generally high levels of support for acupuncture.

The importance of volunteers within the fire service in most countries is unquestionable. However, the retention of volunteers is problematic and finding ways to retain experienced and qualified volunteers is becoming increasingly important. While previous international research has focused on volunteer retention and understanding why volunteers leave, very little is known about ‘boomerang’ volunteers: volunteers who return to the service after a break. These ‘boomerangs’ are a valuable staffing resource, as they tend to require less socialisation, onboarding and training. The latter is particularly relevant for the fire service, as the resources required to train and develop the necessary skills are significant. This study investigated volunteers in the Finnish Fire Service who have taken a break from the service and returned. Similar to Australia and New Zealand, Finland's emergency services are highly reliant on volunteers, particularly in rural areas. This research examined the reasons why breaks were taken and what volunteers experienced most helpful on their return. Drawing on these findings, practical recommendations are made for fire service organisations for effective volunteer practices that take boomerang behaviour into account.

Each year, in Australia, property estimated to be valued at between two and three billion dollars is stolen from homes, shops, cars, factories and warehouses. Little of this property is recovered and returned to its owners or retained by burglars and thieves for their personal use. The remainder is sold or bartered, but the nature and extent of the re-distributional system for stolen property is little understood. This article is an attempt to understand property as a market for goods and services, which, like any other market, is subject to the influences of supply and demand and government regulation. First, it aims to analyse the interactions between the parties in marketing terms by regarding the participants not as individual burglars, thieves, receivers and accessories, as but as suppliers, distributors, retailers and purchasers. Secondly, it argues that current public knowledge of markets for stolen goods and their dynamics are impoverished. Finally, it suggests that a broad range of regulatory strategies can be brought to bear on these markets in order to influence the behaviour of actors within them.

Background/Aims This study was conducted at a regional tertiary referral facility in Australia. It was part of a project to implement a new model of care for occupational therapy services on medical wards. Before the new model was implemented, focus groups were conducted to explore the perceived role of the occupational therapist on the acute medical ward, identify potential barriers to changing the service and garner support for the change in service. Methods Three focus groups were held. The groups consisted of nursing, physiotherapy and speech pathology staff who worked on acute medical wards. Participants were asked for their perception of the role of occupational therapy on the acute medical ward. Audio-recordings of the groups were transcribed and analysed. Results Qualitative content analysis highlighted the following themes: assessment of patient function; ‘safe discharge’; more than assessment; equipment and home modifications; collaboration and communication; delegating tasks to assistants; and specialist intervention strategies. Conclusions Multidisciplinary team members' overriding perception is that occupational therapists in acute care settings provide assessment of patient function for the specific purpose of safe discharge. Some participants recalled that occupational therapists had a greater role in ensuring patients returned to their chosen function through rehabilitation and home visits, suggesting support for a change to our proposed post-acute model of care. Concerns highlighted by focus group members regarding increased workload for multidisciplinary team members and loss of communication need to be addressed to ensure the change in service is successful.

Abstract Context.—Measurement of physicians' and patients' satisfaction with laboratory services has recently become a requirement of health care accreditation agencies in the United States. To our knowledge, this is the first customer satisfaction survey of anatomic pathology services to provide a standardized tool and benchmarks for subsequent measures of satisfaction. Objective.—This Q-Probes study assessed physician satisfaction with anatomic pathology laboratory services and sought to determine characteristics that correlate with a high level of physician satisfaction. Design.—In January 2001, each laboratory used standardized survey forms to assess physician customer satisfaction with 10 specific elements of service in anatomic pathology and an overall satisfaction rating based on a scale of rankings from a 5 for excellent to a 1 for poor. Data from up to 50 surveys returned per laboratory were compiled and analyzed by the College of American Pathologists. A general questionnaire collected information about types of services offered and each laboratory's quality assurance initiatives to determine characteristics that correlate with a high level of physician satisfaction. Setting.—Hospital-based laboratories in the United States (95.8%), as well as others from Canada and Australia. Participants.—Ninety-four voluntary subscriber laboratories in the College of American Pathologists Q-Probes quality improvement program participated in this survey. Roughly 70% of respondents were from hospitals with occupied bedsizes of 300 or less, 65% were private nonprofit institutions, just over half were located in cities, one third were teaching hospitals, and 19% had pathology residency training programs. Main Outcome Measures.—Overall physician satisfaction with anatomic pathology and 10 selected aspects of the laboratory service (professional interaction, diagnostic accuracy, pathologist responsiveness to problems, pathologist accessibility for frozen section, tumor board presentations, courtesy of secretarial and technical staff, communication of relevant information, teaching conferences and courses, notification of significant abnormal results, and timeliness of reporting). Results.—The database of 3065 physician surveys was derived from 94 laboratories. An average of 32.6 surveys (median 30) was returned per institution, with a range of 5 to 50 surveys per institution. The mean response rate was 35.6% (median 32.5%). The median (50th percentile) laboratory had an overall median satisfaction score of 4.4. The lowest satisfaction scores that were obtained all related to poor communication, which included timeliness of reporting, communication of relevant information, and notification of significant abnormal results. Statistically significant associations of customer satisfaction with certain institutional characteristics and laboratory performance improvement activities were identified. Conclusions.—The importance of this satisfaction survey lies not in its requirement as an exercise for accrediting agencies but in understanding the needs of the customer (in this case the physician) to direct performance improvement in the delivery of quality anatomic pathology laboratory services.

BackgroundMost calls to ambulance result in emergency ambulance dispatch (direct dispatch) following primary telephone triage. Ambulance Victoria uses clinician-led secondary telephone triage for patients identified as low-acuity during primary triage to refer them to alternative care pathways; however, some are returned for ambulance dispatch (secondary dispatch). Older adult patients are frequent users of ambulance services; however, little is known about the appropriateness of subsequent secondary dispatches.ObjectivesTo examine the appropriateness of secondary dispatch through a comparison of the characteristics and ambulance outcomes of older patients dispatched an emergency ambulance via direct or secondary dispatch.DesignA retrospective cohort study of ambulance patient data between September 2009 and June 2012 was conducted.SettingThe secondary telephone triage service operated in metropolitan Melbourne, Victoria, Australia during the study period.ParticipantsThere were 90 086 patients included aged 65 years and over who had an emergency ambulance dispatch via direct or secondary dispatch with one of the five most common secondary dispatch paramedic diagnoses.Main outcome measuresDescriptive analyses compared characteristics, treatment and transportation rates between direct and secondary dispatch patients.ResultsThe dispatch groups were similar in demographics, vital signs and hospital transportation rates. However, secondary dispatch patients were half as likely to be treated by paramedics (OR 0.51; CI 0.48 to 0.55; p<0.001). Increasing age was associated with decreasing treatment (p<0.005) and increasing transportation rates (p<0.005).ConclusionSecondary triage could identify patients who would ultimately be transported to an emergency department. However, the lower paramedic treatment rates suggest many secondary dispatch patients may have been suitable for referral to alternative low-acuity transport or referral options.

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

Background In Australia, Health Department policies differ on the recommended method of providing HIV results. Traditionally, all results have been provided in person. Our aim was to trial provision of HIV-negative test results by telephone to low-risk clients attending sexual health services and to assess clients’ preferences for delivery method. Methods: During 4 months in 2009 at two sexual health services in Sydney, all clients assessed as low-risk for HIV infection were invited to receive their HIV result by telephone. Non-receipt of results was defined as failure to receive results within 30 days of the test being performed. Results: Of 763 clients tested, 328 (43%) were excluded following risk assessment, 30 (4%) declined to participate and 405 (53%) were enrolled. Among enrolled clients, 86% received their HIV result by telephone within 30 days, 97% were satisfied with delivery of the result by telephone and 93% preferred telephone delivery for their next HIV result. Only one enrolled client returned a positive HIV result. Independent predictors of receiving results within the 30-day timeframe were clinic attendance for sexually transmissible infection screening (P = 0.021), lack of anogenital symptoms (P = 0.015) and not being a sex worker (P = 0.001). Conclusions: In this study of telephone provision of HIV results to low HIV-risk clients, there were no adverse events and clients expressed satisfaction with the process plus a strong preference for telephone delivery of future results. There was a decreased rate of failure to receive HIV results compared with other Australian studies.

Objective The COVID-19 pandemic significantly disrupted access to primary care in Australia. This could have negatively impacted reproductive health services rates such as intrauterine device insertion rates, and interest in seeking information about intrauterine devices by searching on Google. We aimed to assess the trends of, and the association between, the actual Medicare service utilization rates for intrauterine device insertion and searching about intrauterine devices on Google, before and during the COVID-19 pandemic. Methods We conducted systematic analyses of secondary data from June 2017 to May 2022, using Medicare and Google Trends data sources. We visualized the rates of intrauterine device insertion, plus Google's search volumes about ‘Intrauterine device’ and ‘Progestin IUDs’ as topics. Then, we assessed the correlation between intrauterine device insertion rates and Google search, using Spearman correlation. Results The average yearly rates of intrauterine device insertion increased noticeably from 25.1–26.3 in 2018–2019 to 29.3–31.2 per 100,000 population in 2020–2021 (12–18% increase). The highest monthly intrauterine device insertion rate nationally (37 per 100,000 population) was seen in March 2021. By June 2020, search term use for the two intrauterine device-related topics returned to much higher levels (50% increase for ‘Progestin IUDs’, and 54% for ‘Intrauterine device’, respectively). A moderately strong correlation was seen between actual intrauterine device insertion rates and search on Google about intrauterine devices (Spearman rho = 0.61, p < 0.000). Conclusion We demonstrated a moderately strong correlation between trends of intrauterine device insertion rates and search on Google about intrauterine devices, before and during the COVID-19 pandemic in Australia. Googling about intrauterine devices could, therefore, be a useful indicator to gauge future interest in actual intrauterine device insertion for months thereafter.

In response to the COVID-19 pandemic, elite sport leagues implemented hubs, or ‘bubbles’, which restricted athletes’ movements and social interactions in order to minimise the risk of athlete infection and allow competitions to continue. This was a new way of working and living for elite athletes and there was a dearth of literature on this topic. The main objective of the study was to investigate the impacts of the hub model on athletes over time, and what job demands and resources existed for athletes through the application of Demerouti et al. (2001) Job Demands-Resources Model. Multiple sequential semi-structured interviews were conducted with Women’s National Basketball League (WNBL) athletes during the 2020 season, which was held entirely in a hub in North Queensland, Australia. The key job demands in an elite sport hub identified were the volume of work, simultaneous overload and underload, and nature of work in the hub. The key resources that emerged include recovery services, control and player agency, and constructive social relations. Despite the presence of job resources, which work to counteract, or buffer job demands in order to reduce work stress and improve motivation, they were found to be insufficient for athletes and inequitably distributed between clubs. The intensity of the hub model also amplified demands present in all WNBL seasons. This research is therefore useful for planning of future elite sport leagues to improve the type and amount of resources available to athletes, thereby improving athlete wellbeing and performance both within and outside a hub model.

This study explored health and education professionals’ perceptions of the health benefits and barriers of different ear health programs used in lower primary school classes in two district education areas in the Goldfields South East Health Region, Western Australia. Health and education staff providing services to children in kindergarten to year three primary school classes were sent a questionnaire about ear health programs provided in their school. Sixty-one questionnaires were returned from 43 teachers, 14 community health nurses, three Aboriginal health workers and one teacher’s assistant. Some schools implemented all the ear health programs examined at all year levels while others implemented only one of the programs. Teachers, community health nurses and Aboriginal health workers identified that all ear health programs were beneficial to students. Reported physical health benefits included reduced ear infections, early detection of ear infections and improved hearing. Behavioural benefits included improved concentration, alertness and attention in the classroom. Barriers to implementing the programs were obtaining consent from parents/carers, student transience and attendance, time to implement and conduct the programs and human and physical resources. Evaluation methods used varied from no evaluation for the Breathe Blow Cough and tissue spearing programs to limited data collection for audiometry, otoscopy and ear toilet programs. Respondents perceived that ear health programs were effective in improving health and behavioural outcomes for children. A formal pre-post evaluation to provide objective data to confirm this is needed to inform policy around this important health issue.

Introduction. There is a higher prevalence of Parkinson’s disease (PD) in rural Australia and a poorer perceived quality of life of rural Australians with PD. Coordinated multidisciplinary teams specialised and experienced in the treatment of PD are recommended as the preferred model of care best able to manage the complexities of this disorder. There remains a lack of team-based specialised PD services in rural Australia available to people living with PD. This study aims to explore how the lack of specialised PD services impacts on the person’s experiences of the health care they receive in rural Victoria. This study compared the health-care experiences of two different cohorts of people with PD living in rural Victoria; one cohort living in East Gippsland have had an established comprehensive care model implemented with local trained teams and supported by a metropolitan PD centre, and the other cohort was recruited from the remainder of Victoria who had received standard rural care. Methods. This descriptive study used a survey to explore health-care experiences. Questionnaires were mailed to participants living in rural Victoria. Eligibility criteria included having a diagnosis of PD or Parkinsonism and sufficient English to respond to the survey. The validated Patient-Centred Questionnaire for PD was used to measure health-care experiences. The questions are grouped accordingly under one of the 6 subscales or domains. Outcomes from the questionnaire included summary experience scores (SES) for 6 subscales; overall patient-centeredness score (OPS); and quality improvement scores (QIS). Secondary outcomes included health-related quality of life using the disease-specific questionnaire PDQ39; disease severity using the Hoehn and Yahr staging tool; and disability using the Movement Disorders Society-Unified Parkinson’s Disease Rating Scale, part II. Results. Thirty-nine surveys were returned from the East Gippsland group and 68 from the rural group. The East Gippsland group rated significantly more positive the subscales “empathy and PD expertise,” P=0.02, and “continuity and collaboration of professionals,” P=0.01. The groups did not differ significantly for the remaining 4 subscales (P>0.05) nor for the OPS (P=0.17). The QIS showed both groups prioritised the health-care aspect “provision of tailored information” for improvement. Quality of life was greater (P<0.05) and impairment (P=0.012) and disability were less (P=0.002) in the East Gippsland group. Conclusion. Participants who received health care from the East Gippsland program had better key health-care experiences along with better QOL and less impairment and disability. Participants prioritised provision of information as needing further improvement.

Background Chlamydia trachomatis (chlamydia) is the most commonly notified sexually transmissible bacterial infection in Australia, where distance to health services can be a barrier. This study investigated the acceptability of a self-collection kit for chlamydia testing (sent by mail) and assessed the risk profiles of participants with respect to locality. Methods: In total, 2587 self-collection kits were distributed opportunistically or sent directly to participants upon request, as was a self-administered questionnaire. Results: The return rate was 13.2% (n = 341) for samples and questionnaires. The return rate did not differ with location (P = 0.522) but with mode of distribution (opportunistic: 9.7%; by request: 27.4%; P < 0.001). Although 37% of participants had previously been tested for chlamydia, 77.5% said that they would not have sought testing otherwise. The median age of participants was 22.6 years, 33.8% were male and 9.1% were of Aboriginal descent. Overall, 9.0% (95% confidence interval (CI) = 6.1–12.5) of participants were chlamydia-positive. Prevalence of chlamydia and Aboriginal participation increased with remoteness (P < 0.001), and self-reported condom use was significantly reduced for remote and very remote locations (P = 0.008). Within remote and very remote locations, 30.8% (95% CI = 9.1–61.4) of Aboriginal participants and 38.9% of nonIndigenous participants were chlamydia-positive (P = 0.718; 95% CI = 17.3–64.3). Discussion: Testing for chlamydia using a mailed self-collection kit opened access to a predominantly test-naïve population. The proposed model was able to reach remote populations. Actively requested kits were more likely to be returned.

The objectives of the study were, 1. To ascertain if sexual health physicians and practitioners believe a question concerning a past history of non-consensual sex should be asked routinely and are asking it. 2. To identify whether sexual health services have established protocols to integrate this question into practice. 3. To identify the barriers to this becoming part of a routine sexual health history. A questionnaire covering demographics, protocols and practice around asking the question and reasons for not asking was sent to all (20) sexual health clinics in New Zealand and 7 sexual health clinics in Australia, inviting participation from all staff who took routine sexual health histories. Twenty-seven sexual health clinics participated with a total of 122 (69% response rate) questionnaires completed and returned. One hundred and thirteen (93%) participants believed it was a relevant question to ask. Seventy-eight (63%) said asking the question was encouraged, and routinely or mostly asked the question. Only 40 (33%) identified their workplace had a written policy and 52 (43%) had not received specific training in asking the question. The majority who asked routinely said their client never or rarely objected and that it did not often add significantly to the time. The main reasons for not asking were the belief it was nothing to do with the person's presenting complaint, concern the client would find it too disturbing, inadequate training, and lack of time. Sexual health clinics should develop protocols and guidelines and provide appropriate training to ensure that routine questioning about non-consenting sex is integrated into safe practice.

ObjectivesInformation about younger people of working age (≤65 years), their post stroke outcomes and rehabilitation pathways can highlight areas for further research and service change. This paper describes: (1) baseline demographics; (2) post acute rehabilitation pathways; and (3) 12-month outcomes; disability, mobility, depression, quality of life, informal care and return to work of working age people across three geographic regions (Australasia (AUS), South East (SE) Asia and UK).DesignThis post hoc descriptive exploration of data from the large international very early rehabilitation trial (A Very Early Rehabilitation Trial (AVERT)) examined the four common post acute rehabilitation pathways (inpatient rehabilitation, home with community rehabilitation, inpatient rehabilitation then community rehabilitation and home with no rehabilitation) experienced by participants in the 3 months post stroke and describes their 12-month outcomes.SettingHospital stroke units in AUS, UK and SE Asia.ParticipantsPatients who had an acute stroke recruited within 24 hours who were ≤65 years.Results668 participants were ≤65 years; 99% lived independently, and 88% no disability (modified Rankin Score (mRS)=0) prior to stroke. We had complete data for 12-month outcomes for n=631 (94%). The proportion receiving inpatient rehabilitation was higher in AUS than other regions (AUS 52%; UK 25%; SE Asia 23%), whereas the UK had higher community rehabilitation (UK 65%; AUS 61%; SE Asia 39%). At 12 months, 70% had no or little disability (mRS 0–2), 44% were depressed, 28% rated quality of life as poor or worse than death. For those working prior to stroke (n=228), only 57% had returned to work. A noteworthy number of working age survivors received no rehabilitation services within 3 months post stroke.ConclusionsThere was considerable variation in rehabilitation pathways and post acute service use across the three regions. At 12 months, there were high rates of depression, poor quality of life and low rates of return to work.Trial registration numberAustralian New Zealand Clinical Trials Registry (ACTRN12606000185561).

Purpose This study examined a novel intervention, dignity therapy, designed to address psychosocial and existential distress among terminally ill patients. Dignity therapy invites patients to discuss issues that matter most or that they would most want remembered. Sessions are transcribed and edited, with a returned final version that they can bequeath to a friend or family member. The objective of this study was to establish the feasibility of dignity therapy and determine its impact on various measures of psychosocial and existential distress. Patients and Methods Terminally ill inpatients and those receiving home-based palliative care services in Winnipeg, Canada, and Perth, Australia, were asked to complete pre- and postintervention measures of sense of dignity, depression, suffering, and hopelessness; sense of purpose, sense of meaning, desire for death, will to live, and suicidality; and a postintervention satisfaction survey. Results Ninety-one percent of participants reported being satisfied with dignity therapy; 76% reported a heightened sense of dignity; 68% reported an increased sense of purpose; 67% reported a heightened sense of meaning; 47% reported an increased will to live; and 81% reported that it had been or would be of help to their family. Postintervention measures of suffering showed significant improvement (P = .023) and reduced depressive symptoms (P = .05). Finding dignity therapy helpful to their family correlated with life feeling more meaningful (r = 0.480; P = .000) and having a sense of purpose (r = 0.562; P = .000), accompanied by a lessened sense of suffering (r = 0.327; P = .001) and increased will to live (r = 0.387; P = .000). Conclusion Dignity therapy shows promise as a novel therapeutic intervention for suffering and distress at the end of life.

In Australia and elsewhere, chlamydia screening rates for those aged between 16 and 30 years continue to be low. Innovative, age-appropriate approaches are necessary to increase chlamydia screening among this target group to prevent short- and long-term consequences of the infection such as pelvic inflammatory disease, chronic pelvic pain, ectopic pregnancy and infertility. Studies have demonstrated that offering chlamydia screening in community pharmacies may be a useful adjunct to current screening services. Approximately 90% of Australians visit a pharmacy at least once a year. Chlamydia screening and education in community pharmacies with remuneration may provide another option for opportunistic testing as part of a national chlamydia screening scheme. Compensation is an accepted practice in the field of research and has been demonstrated to improve adherence to health promotion activities. In 2011, a cross-sectional study of community pharmacy-based chlamydia screening offered in conjunction with an A$10 cash incentive to participate was conducted in the Australian Capital Territory. As part of this study young people were asked about their experience of, and views about, pharmacy-based chlamydia screening. The views of consented participants were collected using the one-page questionnaire consisting of 10 closed questions and one open-ended question. Participants completed the questionnaire when they returned their urine sample and before being given the cash incentive. Overall participants were highly satisfied with the pharmacy-based chlamydia screening service. Over 60% of questionnaire respondents felt that the payment did affect their decision to have the chlamydia test, and 23% stated that it made no difference. Young people reported that pharmacy-based screening is acceptable and convenient. Accessibility and the small cash incentive played significant roles in increasing participation.

Introduction. In the 21st century, there is an active involvement of universities in inclusive processes; however, against the backdrop of increasing diversity, new types of inequality arise in higher education. The processes of transformation of organisational cultures in universities and their research agenda under the influence of inclusion need to be studied.The aim of the present research was to analyse the convergence of concepts of academic and inclusive excellence in foreign universities of the world level, the impact of convergence on their missions, the values expressed in official strategies, the research agenda and the infrastructure of scientific collaborations.Methodology and research methods. The authors conducted a content analysis of three strategies of world-class University associations (the Association of American Colleges and Universities, the Association of Universities in Canada, the League of European Research Universities), nine strategies for the development of universities in the USA and Canada, the European Union, and Australia. A scientometric analysis of Web of Science metadata was performed using the VOSViewer software.Results and scientific novelty. The current research confirms the convergence of values of academic excellence and inclusion in research universities. It is revealed that the concept of inclusive excellence of the university is an enriched version of its academic excellence and denotes a set of university strategies and practices aimed at achieving the best results in training, research and services through maintaining diversity and inclusive processes. The world's leading universities are actively involved in the process of creating an inclusive friendly environment and services, which are accessible to all members of the educational process, regardless of their social status and development characteristics. When universities reach academic heights, they recognise inclusion as the next level of their development. In turn, inclusion becomes a factor in the movement of the university towards academic excellence. The key characteristics and contradictions of the convergence of the concepts of inclusive and academic excellence of universities are identified. The local models of inclusive excellence of universities and the contexts, which influence these models, are described. The gaps between educational policies and research agendas of leading universities are revealed. The clusters of international studies on inclusive processes in higher education are highlighted.Practical significance. Russian universities, which implement the federal programme for improvement of international competitiveness based on the values of academic excellence, are developing in accordance with global trends. Therefore, the model of inclusive excellence of the university can be used in practical terms to implement inclusive strategies and overcome social inequality both at the university and outside of it within the framework of a new educational initiative of Russia on academic leadership.

Background:In 2019, EULAR launched the #Time2Work campaign [1] to raise awareness of the impact of rheumatic and musculoskeletal diseases on individuals, society, and the economy. Building on this theme, the Canadian Arthritis Patient Alliance (CAPA) developed a social media campaign and Twitter chat in collaboration with international patient advocates and organizations. The Twitter chat built upon CAPA’s successful development of workplace resources for people living with arthritis [2].Objectives:To deliver an international #ArthritisAtWork social media campaign on Twitter, in support of the #Time2Work campaign.Methods:A one-hour Twitter Chat was held on World Arthritis Day (October 12, 2019) on arthritis in the workplace (#ArthritisAtWork) from 18:00 to 19:00 UTC. The chat was hosted by CAPA and co-hosted by Simon Stones, a patient advocate from the United Kingdom (UK) and CreakyJoints, patient-driven arthritis organization in the United States (US). The Twitter Chat questions were co-developed in advance by the hosts, and blog posts were shared from CAPA’s website. Each host also promoted the Twitter Chat through their websites, newsletters and online communities. A social media analytical tool, Symplur, was used to measure audience engagement using the hashtag #ArthritisAtWork. In addition, pertinent Tweets before, during, and after the chat were obtained. The analysis of themes was undertaken to identify common issues and questions.Results:One hundred and ten users participated in the Twitter chat between 17:20 and 19:20 UTC. Participants included people living with arthritis, researchers, patient organizations, health information outlets and academic institutions. During this period, 565 tweets were shared between participants in Australia, Canada, Ireland, Spain, UK and US. There were 3.352 million Twitter impressions. This represents the number of times a tweet appears to users in either their timeline or search results. Emergent themes of the analysis include:common workplace challenges such as employer attitudes and stigma;effective workplace supports such as prioritizing tasks and requesting workplace accommodations; andareas of improvement such as instituting workplace policies, flexible workplace approaches and education for employees and managers.Conclusion:The social media campaign was successful in reaching a diverse audience and supporting the #Time2Work campaign. Social media tools can provide an important social support for people living with arthritis as they navigate workplace challenges. It also offers a more contemporary platform to engage the international community on issues of common interest. Working together, internationally helps expand reach and reduce barriers in communication. Research can be conducted to measure potential behavior change that leverages digital social support for people living with arthritis.References:[1]EULAR (2019). Press release “EULAR launches Time2Work campaign to highlight the importance of keeping people with rheumatic and musculoskeletal diseases in work. Available from:https://www.eular.org/sysModules/obxContent/files/www.eular.2015/1_42291DEB-50E5-49AE-5726D0FAAA83A7D4/time2work_campaign_press_release_final.pdf2. CAPA (2019). Arthritis in the Workplace: Resources for Patients by Patients. Available from:http://arthritispatient.ca/arthritis-in-the-workplace-resources-for-patients-by-patients/Disclosure of Interests:Laurie Proulx Grant/research support from: Sources of grants and support received by the Canadian Arthritis Patient Alliance (including in-kind support) in the last two years include: AbbVie Canada, Alliance for Safe Biologic Medicines, Amgen Canada, Arthritis Alliance of Canada, The Arthritis Society, Best Medicines Coalition, CADTH, Canadian Rheumatology Association, Eli Lilly Canada, European League Against Rheumatism, Janssen Canada, Manulife, Novartis Canada, Ontario Rheumatology Association, Pfizer Canada (including Pfizer Hospira), Purdue Pharma Canada, Sanofi, and UCB Pharma., Speakers bureau: I have provided speaking services to Sanofi and Eli Lilly. These engagements do not relate to this abstract., Simon Stones Consultant of: I have been a paid consultant for Envision Pharma Group and Parexel. This does not relate to this abstract., Speakers bureau: I have been a paid speaker for Actelion and Janssen. These do not relate to this abstract., Joseph Coe: None declared, Dawn Richards Grant/research support from: Sources of grants and support received by the Canadian Arthritis Patient Alliance (including in-kind support) in the last two years include: AbbVie Canada, Alliance for Safe Biologic Medicines, Amgen Canada, Arthritis Alliance of Canada, The Arthritis Society, Best Medicines Coalition, CADTH, Canadian Rheumatology Association, Eli Lilly Canada, European League Against Rheumatism, Janssen Canada, Manulife, Novartis Canada, Ontario Rheumatology Association, Pfizer Canada (including Pfizer Hospira), Purdue Pharma Canada, Sanofi, and UCB Pharma., Consultant of: Dawn has done small consulting projects on patient engagement for companies., Speakers bureau: Dawn has been a paid speaker for several companies., Linda Wilhelm Grant/research support from: Sources of grants and support received by the Canadian Arthritis Patient Alliance (including in-kind support) in the last two years include: AbbVie Canada, Alliance for Safe Biologic Medicines, Amgen Canada, Arthritis Alliance of Canada, The Arthritis Society, Best Medicines Coalition, CADTH, Canadian Rheumatology Association, Eli Lilly Canada, European League Against Rheumatism, Janssen Canada, Manulife, Novartis Canada, Ontario Rheumatology Association, Pfizer Canada (including Pfizer Hospira), Purdue Pharma Canada, Sanofi, and UCB Pharma., Nathalie Robertson Grant/research support from: Sources of grants and support received by the Canadian Arthritis Patient Alliance (including in-kind support) in the last two years include: AbbVie Canada, Alliance for Safe Biologic Medicines, Amgen Canada, Arthritis Alliance of Canada, The Arthritis Society, Best Medicines Coalition, CADTH, Canadian Rheumatology Association, Eli Lilly Canada, European League Against Rheumatism, Janssen Canada, Manulife, Novartis Canada, Ontario Rheumatology Association, Pfizer Canada (including Pfizer Hospira), Purdue Pharma Canada, Sanofi, and UCB Pharma., Janet Gunderson Grant/research support from: Sources of grants and support received by the Canadian Arthritis Patient Alliance (including in-kind support) in the last two years include: AbbVie Canada, Alliance for Safe Biologic Medicines, Amgen Canada, Arthritis Alliance of Canada, The Arthritis Society, Best Medicines Coalition, CADTH, Canadian Rheumatology Association, Eli Lilly Canada, European League Against Rheumatism, Janssen Canada, Manulife, Novartis Canada, Ontario Rheumatology Association, Pfizer Canada (including Pfizer Hospira), Purdue Pharma Canada, Sanofi, and UCB Pharma., Alexandra Sirois Grant/research support from: Sources of grants and support received by the Canadian Arthritis Patient Alliance (including in-kind support) in the last two years include: AbbVie Canada, Alliance for Safe Biologic Medicines, Amgen Canada, Arthritis Alliance of Canada, The Arthritis Society, Best Medicines Coalition, CADTH, Canadian Rheumatology Association, Eli Lilly Canada, European League Against Rheumatism, Janssen Canada, Manulife, Novartis Canada, Ontario Rheumatology Association, Pfizer Canada (including Pfizer Hospira), Purdue Pharma Canada, Sanofi, and UCB Pharma., Annette McKinnon Grant/research support from: Sources of grants and support received by the Canadian Arthritis Patient Alliance (including in-kind support) in the last two years include: AbbVie Canada, Alliance for Safe Biologic Medicines, Amgen Canada, Arthritis Alliance of Canada, The Arthritis Society, Best Medicines Coalition, CADTH, Canadian Rheumatology Association, Eli Lilly Canada, European League Against Rheumatism, Janssen Canada, Manulife, Novartis Canada, Ontario Rheumatology Association, Pfizer Canada (including Pfizer Hospira), Purdue Pharma Canada, Sanofi, and UCB Pharma.

Background: Suicide has been a major community concern in Esperance, a geographically isolated port on the south coast of Western Australia. Aims: To evaluate the effect of three evidence-based initiatives for the primary prevention of suicide: (i) providing suicide awareness sessions for staff members in health, education and social services; (ii) limiting the sale of over the counter analgesics (aspirin and paracetamol) to packets containing less than the minimum lethal dose; and (iii) implementing Commonwealth media guidelines in the reporting of suicides by media. Methods: Changes in knowledge, awareness, attitudes, comfort and use, before and after each intervention were assessed using standardized instruments and pro forma derived from previous work, such as the Youth Suicide Prevention Training Manual and Suicide Intervention Beliefs Scale. Percentage changes in the number of retail outlets selling over the counter analgesics to less than potentially lethal quantities (less than 8 g of paracetamol or aspirin) were also measured. Media representatives were interviewed to gain their perceptions of Commonwealth Guidelines for the reporting of suicide, and encouraged to consult the project team before reporting suicide related issues. Results: The baseline survey illustrated that mental health staff and general practitioners were more aware of suicide issues, risk factors for suicide and awareness of professional and ethical responses than staff from other services, and were more willing to raise the issue with a person at risk. Thirty-three subjects participated in suicide awareness training of whom 21 (66%) returned questionnaires. There were significant increases in awareness of suiciderelated issues and risk factors, as well as reported levels of knowledge of professional and ethical responses and comfort, competence and confidence levels when assisting a person at risk. Only three media representatives were aware of the Commonwealth Health Department Guidelines for reporting suicide and only one believed that the guidelines influenced their reporting. The local newspapers subsequently contacted the researchers to check that their reporting met the guidelines. As regards access to analgesics, one out of seven retailers agreed to implement the strategy (pending agreement from other retailers), another claimed increased awareness of the danger of analgesics, and three maintained that they would attempt to monitor excessive amounts sold to one individual. Conclusions: Local initiatives can improve the awareness and knowledge of staff in the assessment of suicide risk, as well as of local media. These need to be complemented by initiatives at State or Commonwealth level to produce change in statewide media, or sales of over the counter analgesics.

Covid 19 – living the experience As I sit at my desk at home in suburban Brisbane, following the dictates on self-isolation shared with so many around the world, I am forced to contemplate the limits of human prediction. I look out on a world which few could have predicted six months ago. My thoughts at that time were all about 2020 as a metaphor for perfect vision and a plea for it to herald a new period of clarity which would arm us in resolving the whole host of false divisions that surrounded us. False, because so many appear to be generated by the use of polarised labelling strategies which sought to categorise humans by a whole range of identities, while losing the essential humanity and individuality which we all share. This was a troublesome trend and one which seemed reminiscent of the biblical tale concerning the tower of Babel, when a single unified language was what we needed to create harmony in a globalising world. However, yesterday’s concerns have, at least for the moment, been overshadowed by a more urgent and unifying concern with humanity’s health and wellbeing. For now, this concern has created a world which we would not have recognised in 2019. We rely more than ever on our various forms of electronic media to beam instant shots of the streets of London, New York, Berlin, Paris, Hong Kong etc. These centres of our worldly activity normally characterised by hustle and bustle, are now serenely peaceful and ordered. Their magnificent buildings have become foregrounded, assuming a dignity and presence that is more commonly overshadowed by the mad ceaseless scramble of humanity all around them. From there however the cameras can jump to some of the less fortunate areas of the globe. These streets are still teeming with people in close confined areas. There is little hope here of following frequent extended hand washing practices, let alone achieving the social distance prescribed to those of us in the global North. From this desk top perspective, it has been interesting to chart the mood as the crisis has unfolded. It has moved from a slightly distant sense of superiority as the news slowly unfolded about events in remote Wuhan. The explanation that the origins were from a live market, where customs unfamiliar to our hygienic pre-packaged approach to food consumption were practised, added to this sense of separateness and exoticism surrounding the source and initial development of the virus. However, this changed to a growing sense of concern as its growth and transmission slowly began to reveal the vulnerability of all cultures to its spread. At this early stage, countries who took steps to limit travel from infected areas seemed to gain some advantage. Australia, as just one example banned flights from China and required all Chinese students coming to study in Australia to self-isolate for two weeks in a third intermediate port. It was a step that had considerable economic costs associated with it. One that was vociferously resisted at the time by the university sector increasingly dependent on the revenue generated by servicing Chinese students. But it was when the epicentre moved to northern Italy, that the entire messaging around the event began to change internationally. At this time the tone became increasingly fearful, anxious and urgent as reports of overwhelmed hospitals and mass burials began to dominate the news. Consequently, governments attracted little criticism but were rather widely supported in the action of radically closing down their countries in order to limit human interaction. The debate had become one around the choice between health and economic wellbeing. The fact that the decision has been overwhelmingly for health, has been encouraging. It has not however stopped the pressure from those who believe that economic well-being is a determinant of human well-being, questioning the decisions of politicians and the advice of public health scientists that have dominated the responses to date. At this stage, the lives versus livelihoods debate has a long way still to run. Of some particular interest has been the musings of the opinion writers who have predicted that the events of these last months will change our world forever. Some of these predictions have included the idea that rather than piling into common office spaces working remotely from home and other advantageous locations will be here to stay. Schools and universities will become centres of learning more conveniently accessed on-line rather than face to face. Many shopping centres will become redundant and goods will increasingly be delivered via collection centres or couriers direct to the home. Social distancing will impact our consumption of entertainment at common venues and lifestyle events such as dining out. At the macro level, it has been predicted that globalisation in its present form will be reversed. The pandemic has led to actions being taken at national levels and movement being controlled by the strengthening and increased control of physical borders. Tourism has ground to a halt and may not resume on its current scale or in its present form as unnecessary travel, at least across borders, will become permanently reduced. Advocates of change have pointed to some of the unpredicted benefits that have been occurring. These include a drop in air pollution: increased interaction within families; more reading undertaken by younger adults; more systematic incorporation of exercise into daily life, and; a rediscovered sense of community with many initiatives paying tribute to the health and essential services workers who have been placed at the forefront of this latest struggle with nature. Of course, for all those who point to benefits in the forced lifestyle changes we have been experiencing, there are those who would tell a contrary tale. Demonstrations in the US have led the push by those who just want things to get back to normal as quickly as possible. For this group, confinement at home creates more problems. These may be a function of the proximity of modern cramped living quarters, today’s crowded city life, dysfunctional relationships, the boredom of self-entertainment or simply the anxiety that comes with an insecure livelihood and an unclear future. Personally however, I am left with two significant questions about our future stimulated by the events that have been ushered in by 2020. The first is how is it that the world has been caught so unprepared by this pandemic? The second is to what extent do we have the ability to recalibrate our current practices and view an alternative future? In considering the first, it has been enlightening to observe the extent to which politicians have turned to scientific expertise in order to determine their actions. Terms like ‘flattening the curve’, ‘community transmission rates’, have become part of our daily lexicon as the statistical modellers advance their predictions as to how the disease will spread and impact on our health systems. The fact that scientists are presented as the acceptable and credible authority and the basis for our actions reflects a growing dependency on data and modelling that has infused our society generally. This acceptance has been used to strengthen the actions on behalf of the human lives first and foremost position. For those who pursue the livelihoods argument even bigger figures are available to be thrown about. These relate to concepts such as numbers of jobless, increase in national debt, growth in domestic violence, rise in mental illness etc. However, given that they are more clearly estimates and based on less certain assumptions and variables, they do not at this stage seem to carry the impact of the data produced by public health experts. This is not surprising but perhaps not justifiable when we consider the failure of the public health lobby to adequately prepare or forewarn us of the current crisis in the first place. Statistical predictive models are built around historical data, yet their accuracy depends upon the quality of those data. Their robustness for extrapolation to new settings for example will differ as these differ in a multitude of subtle ways from the contexts in which they were initially gathered. Our often uncritical dependence upon ‘scientific’ processes has become worrying, given that as humans, even when guided by such useful tools, we still tend to repeat mistakes or ignore warnings. At such a time it is an opportunity for us to return to the reservoir of human wisdom to be found in places such as our great literature. Works such as The Plague by Albert Camus make fascinating and educative reading for us at this time. As the writer observes Everybody knows that pestilences have a way of recurring in the world, yet somehow, we find it hard to believe in ones that crash down on our heads from a blue sky. There have been as many plagues as wars in history, yet always plagues and wars take people equally by surprise. So it is that we constantly fail to study let alone learn the lessons of history. Yet 2020 mirrors 1919, as at that time the world was reeling with the impact of the Spanish ‘Flu, which infected 500 million people and killed an estimated 50 million. This was more than the 40 million casualties of the four years of the preceding Great War. There have of course been other pestilences since then and much more recently. Is our stubborn failure to learn because we fail to value history and the knowledge of our forebears? Yet we can accept with so little question the accuracy of predictions based on numbers, even with varying and unquestioned levels of validity and reliability. As to the second question, many writers have been observing some beneficial changes in our behaviour and our environment, which have emerged in association with this sudden break in our normal patterns of activity. It has given us the excuse to reevaluate some of our practices and identify some clear benefits that have been occurring. As Australian newspaper columnist Bernard Salt observes in an article titled “the end of narcissism?” I think we’ve been re-evaluating the entire contribution/reward equation since the summer bushfires and now, with the added experience of the pandemic, we can see the shallowness of the so-called glamour professions – the celebrities, the influencers. We appreciate the selflessness of volunteer firefighters, of healthcare workers and supermarket staff. From the pandemic’s earliest days, glib forays into social media by celebrities seeking attention and yet further adulation have been met with stony disapproval. Perhaps it is best that they stay offline while our real heroes do the heavy lifting. To this sad unquestioning adherence to both scientism and narcissism, we can add and stir the framing of the climate rebellion and a myriad of familiar ‘first world’ problems which have caused dissension and disharmony in our communities. Now with an external threat on which to focus our attention, there has been a short lull in the endless bickering and petty point scoring that has characterised our western liberal democracies in the last decade. As Camus observed: The one way of making people hang together is to give ‘em a spell of the plague. So, the ceaseless din of the topics that have driven us apart has miraculously paused for at least a moment. Does this then provide a unique opportunity for us together to review our habitual postures and adopt a more conciliatory and harmonious communication style, take stock, critically evaluate and retune our approach to life – as individuals, as nations, as a species? It is not too difficult to hypothesise futures driven by the major issues that have driven us apart. Now, in our attempts to resist the virus, we have given ourselves a glimpse of some of the very things the climate change activists have wished to happen. With few planes in the air and the majority of cars off the roads, we have already witnessed clearer and cleaner air. Working at home has freed up the commuter driven traffic and left many people with more time to spend with their family. Freed from the continuing throng of tourists, cities like Venice are regenerating and cleansing themselves. This small preview of what a less travelled world might start to look like surely has some attraction. But of course, it does not come without cost. With the lack of tourism and the need to work at home, jobs and livelihoods have started to change. As with any revolution there are both winners and losers. The lockdown has distinguished starkly between essential and non-essential workers. That represents a useful starting point from which to assess what is truly of value in our way of life and what is peripheral as Salt made clear. This is a question that I would encourage readers to explore and to take forward with them through the resolution of the current situation. However, on the basis that educators are seen as providing essential services, now is the time to turn to the content of our current volume. Once again, I direct you to the truly international range of our contributors. They come from five different continents yet share a common focus on one of the most popular of shared cultural experiences – sport. Unsurprisingly three of our reviewed papers bring different insights to the world’s most widely shared sport of all – football, or as it would be more easily recognised in some parts of the globe - soccer. Leading these offerings is a comparison of fandom in Australia and China. The story presented by Knijnk highlights the rise of the fanatical supporters known as the ultras. The origin of the movement is traced to Italy, but it is one that claims allegiances now around the world. Kniijnk identifies the movement’s progression into Australia and China and, in pointing to its stance against the commercialisation of their sport by the scions of big business, argues for its deeper political significance and its commitment to the democratic ownership of sport. Reflecting the increasing availability and use of data in our modern societies, Karadog, Parim and Cene apply some of the immense data collected on and around the FIFA World Cup to the task of selecting the best team from the 2018 tournament held in Russia, a task more usually undertaken by panels of experts. Mindful of the value of using data in ways that can assist future decision making, rather than just in terms of summarising past events, they also use the statistics available to undertake a second task. The second task was the selection of the team with the greatest future potential by limiting eligibility to those at an early stage in their careers, namely younger than 28 and who arguably had still to attain their prime as well as having a longer career still ahead of them. The results for both selections confirm how membership of the wealthy European based teams holds the path to success and recognition at the global level no matter what the national origins of players might be. Thirdly, taking links between the sport and the world of finance a step further, Gomez-Martinez, Marques-Bogliani and Paule-Vianez report on an interesting study designed to test the hypothesis that sporting success within a community is reflected in positive economic outcomes for members of that community. They make a bold attempt to test their hypothesis by examining the relationship of the performance of three world leading clubs in Europe - Bayern Munich, Juventus and Paris Saint Germain and the performance of their local stock markets. Their findings make for some interesting thoughts about the significance of sport in the global economy and beyond into the political landscape of our interconnected world. Our final paper comes from Africa but for its subject matter looks to a different sport, one that rules the subcontinent of India - cricket. Norrbhai questions the traditional coaching of batting in cricket by examining the backlift techniques of the top players in the Indian Premier league. His findings suggest that even in this most traditional of sports, technique will develop and change in response to the changing context provided by the game itself. In this case the context is the short form of the game, introduced to provide faster paced entertainment in an easily consumable time span. It provides a useful reminder how in sport, techniques will not be static but will continue to evolve as the game that provides the context for the skilled performance also evolves. To conclude our pages, I must apologise that our usual book review has fallen prey to the current world disruption. In its place I would like to draw your attention to the announcement of a new publication which would make a worthy addition to the bookshelf of any international sports scholar. “Softpower, Soccer, Supremacy – The Chinese Dream” represents a unique and timely analysis of the movement of the most popular and influential game in the world – Association Football, commonly abbreviated to soccer - into the mainstream of Chinese national policy. The editorial team led by one of sports histories most recognised scholars, Professor J A Mangan, has assembled a who’s who of current scholars in sport in Asia. Together they provide a perspective that takes in, not just the Chinese view of these important current developments but also, the view of others in the geographical region. From Japan, Korea and Australia, they bring with them significant experience to not just the beautiful game, but sport in general in that dynamic and fast-growing part of the world. Particularly in the light of the European dominance identified in the Karog, Parim and Cene paper this work raises the question as to whether we can expect to see a change in the world order sooner rather than later. It remains for me to make one important acknowledgement. In my last editorial I alerted you to the sorts of decisions we as an editorial and publication team were facing with regard to ensuring the future of the journal. Debates as to how best to proceed while staying true to our vision and goals are still proceeding. However, I am pleased to acknowledge the sponsorship provided by The University of Macao for volume 42 and recognise the invaluable contribution made by ISCPES former president Walter Ho to this process. Sponsorship can provide an important input to the ongoing existence and strength of this journal and we would be interested in talking to other institutions or groups who might also be interested in supporting our work, particularly where their goals align closely with ours. May I therefore commend to you the works of our international scholars and encourage your future involvement in sharing your interest in and expertise with others in the world of comparative and international sport studies, John Saunders, Brisbane, May 2020

Objectives – To determine which strategies were most effective for encouraging general practitioners (GPs) to sign up for free access to an online evidence based information resource; and to determine whether those who accepted the offer differed in their sociodemographic characteristics from those who did not. Design – Descriptive marketing research study. Setting – Australia’s public healthcare system. Subjects – 14,000 general practitioners (GPs) from all regions of Australia. Methods – Subjects were randomly selected by Medicare Australia from its list of GPs that bill it for services. Medicare Australia had 18,262 doctors it deemed eligible; 14,000 of these were selected for a stratified random sample. Subjects were randomized to one of 7 groups of 2,000 each. Each group received a different letter offering two years of free access to BMJ Clinical Evidence, an evidence based online information tool. Randomization was done electronically, and the seven groups were stratified by age group, gender, and location. The interventions given to each group differed as follows: • Group 1: Received a letter offering 2 years of free access, with no further demands on the recipient. Evidence Based Library and Information Practice 2010, 5.4 84 • Group 2: Received a letter offering 2 years of free access, but on the condition that they complete an initial questionnaire and another one at 12 months, as well as allowing the publisher to provide de-personalized usage data to the researchers. • Group 3: Same as Group 2, but with the additional offer of an online tutorial to assist them with using the resource. • Group 4: Same as Group 2, but with an additional pamphlet with positive testimonials about the resource from Australian medical opinion leaders. • Group 5: Same as Group 2, but with an additional offer of professional development credits towards their required annual totals. • Group 6: Same as Group 2, but with an additional offer to be entered to win a prize of $500 towards registration at a conference of the winner’s choice. • Group 7: A combination of the above interventions. The group received the opinion leaders’ pamphlet, the online tutorial, and eligibility for professional development points. The online survey and usage data from Groups 2 through 7 was to be analyzed as part of a companion study, and is not reported in this article. To protect the privacy of individual subjects, Medicare Australia mailed out the offers and provided the authors with anonymized data, in table format, on response status by intervention group and by the following sociodemographic variables: age, gender, geographic remoteness as determined by the Accessibility/Remoteness Index of Australia (ARIA), country of graduation, and years since graduation. Baseline characteristics were compared between the intervention groups, and then response rates were also compared between intervention groups and between the above-mentioned variables to see whether any of these variables affected the likelihood of practitioners being interested in an online evidence based tool. All comparisons were done using a chi-square test. Main Results – Overall, 2,105 subjects returned their acceptance forms, out of the total sample of 14,000 (15%). The true acceptance rate was 12.5%, however, when adjusted for the number of subjects in Groups 2 through 7 who went on to complete the online questionnaire. There was a statistically significant difference in response rates between the seven groups, with the greatest acceptance rate (27%) coming from Group 1 (who received only the letter of offer, with no experimental demands). The other groups averaged a response rate of 10% collectively, with the lowest rates (8.0% and 8.5% respectively) from Group 5 (offer of professional development points) and Group 7 (combination of interventions). The large sample size offered adequate power to detect differences in characteristics between responders and non-responders. The study found that responders were more likely to be younger, male, recent graduates, and practising in less remote locations. Among responders, there were no statistically significant differences in most of these characteristics among the seven groups, with the exception of time since graduation, which varied somewhat. Conclusion – The authors conclude that funding of access to free online resources for large groups of practitioners may not be cost-effective if calculations of cost are based on total eligible populations rather than on the number of practitioners who may be interested. They also conclude that the low response rates generated by their offer indicate a need to find ways to increase GPs’ interest in using online evidence based tools and in accessing best practice evidence. Further research into how to achieve behaviour change among practitioners may be needed.

Objective The study aimed to explore Australian general practitioners’ (GPs) perceptions of falls risk screening, assessment and their referral practices with older people living in the community, and to identify any barriers or facilitators to implementing evidence-based falls prevention practice. Methods Hardcopy surveys and a link to an online survey were distributed to 508 GPs working at one Medicare Local (now part of a Primary Care Network) located in Sydney, Australia. Data were analysed using descriptive statistics and key themes were identified from open text responses. Results A total of 37 GPs returned the survey. Only 10 (27%) GPs routinely asked older people about falls, and five (13.5%) asked about fear of falls during clinical consultations. Barriers to managing falls risk were identified. GPs estimated that they made few referrals to allied health professionals for falls interventions. Conclusions GPs were knowledgeable about falls risk factors but this did not result in consistent falls risk screening, assessment or referral practices. Due to the small sample, further research is needed with a larger sample to augment these results. What is known about the topic? Falls are a common and serious health issue for older people and fall prevention is vital, especially in the primary care setting. General practitioners (GPs) are key health professionals to identify older people at risk of falls and refer them to appropriate health professionals for intervention. Evidence-based falls prevention interventions exist but are not easily or routinely accessed by older people. What does this paper add? GPs believe that previous falls are an important falls risk factor but they do not routinely ask about falls or fear of falls in clinical practice with older people. GP referral rates to allied health professionals for falls prevention are low, despite evidence-based falls prevention interventions being provided by allied health professionals. There are several barriers to GPs providing falls prevention assessment and intervention referrals, particularly using the current primary health systems. What are the implications for practitioners? GPs need to recognise their potential significant contribution to falls prevention in the community and may require tailored training. Sustainable evidence-based referral pathways need to be developed so that older people can be referred to allied health professionals for falls prevention interventions in the primary care setting, and better local networks need to be developed to allow this to occur. Policy makers may have to address the identified barriers to multidisciplinary practice and funding of services to facilitate effective falls prevention programs in primary care.

It was the Canadian philosopher Marshall McLuhan who first introduced the term ‘global village’ into the lexicon, almost fifty years ago. He was referring to the phenomenon of global interconnectedness of which we are all too aware today. At that time, we were witnessing the world just opening up. In 1946, British Airways had commenced a twice weekly service from London to New York. The flight involved one or two touch downs en-route and took a scheduled 19 hours and 45 minutes. By the time McLuhan had published his book “Understanding media; the extensions of man”, there were regular services by jet around the globe. London to Sydney was travelled in just under 35 hours. Moving forward to a time immediately pre-covid, there were over 30 non-stop flights a day in each direction between London and New York. The travel time from London to Sydney had been cut by a third, to slightly under 22 hours, with just one touchdown en-route. The world has well and truly ‘opened up’. No place is unreachable by regular services. But that is just one part of the picture. In 1962, the very first live television pictures were transmitted across the Atlantic, via satellite. It was a time when sports’ fans would tune in besides a crackling radio set to hear commentary of their favourite game relayed from the other side of the world. Today of course, not only can we watch a live telecast of the Olympic Games in the comfort of our own homes wherever the games are being held, but we can pick up a telephone and talk face to face with friends and relatives in real time, wherever they may be in the world. To today’s generation – generation Z – this does not seem in the least bit remarkable. Indeed, they have been nicknamed ‘the connected generation’ precisely because such a degree of human interconnectedness no longer seems worth commenting on. The media technology and the transport advances that underpin this level of connectedness, have become taken for granted assumptions to them. This is why the global events of 2020 and the associated public health related reactions, have proved to be so remarkable to them. It is mass travel and the closeness and variety of human contact in day-to-day interactions, that have provided the breeding ground for the pandemic. Consequently, moving around and sharing close proximity with many strangers, have been the activities that have had to be curbed, as the initial primary means to manage the spread of the virus. This has caused hardship to many, either through the loss of a job and the associated income or, the lengthy enforced separation from family and friends – for the many who find themselves living and working far removed from their original home. McLuhan’s powerful metaphor was ahead of its time. His thoughts were centred around media and electronic communications well prior to the notion of a ‘physical’ pandemic, which today has provided an equally potent image of how all of our fortunes have become intertwined, no matter where we sit in the world. Yet it is this event which seems paradoxically to have for the first time forced us to consider more closely the path of progress pursued over the last half century. It is as if we are experiencing for the first time the unleashing of powerful and competing forces, which are both centripetal and centrifugal. On the one hand we are in a world where we have a World Health Organisation. This is a body which has acted as a global force, first declaring the pandemic and subsequently acting in response to it as a part of its brief for international public health. It has brought the world’s scientists and global health professionals together to accelerate the research and development process and develop new norms and standards to contain the spread of the coronavirus pandemic and help care for those affected. At the same time, we have been witnessing nations retreating from each other and closing their borders in order to restrict the interaction of their citizens with those from other nations around the world. We have perceived that danger and risk are increased by international travel and human to human interaction. As a result, increasingly communication has been carried out from the safety and comfort of one’s own home, with electronic media taking the place of personal interaction in the real world. The change to the media dominated world, foreseen by McLuhan a half century ago, has been hastened and consolidated by the threats posed by Covid 19. Real time interactions can be conducted more safely and more economically by means of the global reach of the internet and the ever-enhanced technologies that are being offered to facilitate that. Yet at a geopolitical level prior to Covid 19, the processes of globalism and nationalism were already being recognised as competing forces. In many countries, tensions have emerged between those who are benefitting from the opportunities presented by the development of free trade between countries and those who are invested in more traditional ventures, set in their own nations and communities. The emerging beneficiaries have become characterised as the global elites. Their demographic profile is one associated with youth, education and progressive social ideas. However, they are counter-balanced by those who, rather than opportunities, have experienced threats from the disruptions and turbulence around them. Among the ideas challenged, have been the expected certainties of employment, social values and the security with which many grew up. Industries which have been the lifeblood of their communities are facing extinction and even the security of housing and a roof over the heads of self and family may be under threat. In such circumstances, some people may see waves of new immigrants, technology, and changing social values as being tides which need to be turned back. Their profile is characterised by a demographic less equipped to face such changes - the more mature, less well educated and less mobile. Yet this tension appears to be creating something more than just the latest version of the generational divide. The recent clashes between Republicans and Democrats in the US have provided a very potent example of these societal stresses. The US has itself exported some of these arenas of conflict to the rest of the world. Black lives Matter and #Me too, are social movements with their foundation in the US which have found their way far beyond the immediate contexts which gave them birth. In the different national settings where these various tensions have emerged, they have been characterised through labels such as left and right, progressive and traditional, the ‘haves’ versus the ‘have nots’ etc. Yet common to all of this growing competitiveness between ideologies and values is a common thread. The common thread lies in the notion of competition itself. It finds itself expressed most potently in the spread and adoption of ideas based on what has been termed the neoliberal values of the free market. These values have become ingrained in the language and concepts we employ every day. Thus, everything has a price and ultimately the price can be represented by a dollar value. We see this process of commodification around us on a daily basis. Sports studies’ scholars have long drawn attention to its continuing growth in the world of sport, especially in situations when it overwhelms the human characteristics of the athletes who are at the very heart of sport. When the dollar value of the athlete and their performance becomes more important than the individual and the game, then we find ourselves at the heart of some of the core problems reported today. It is at the point where sport changes from an experience, where the athletes develop themselves and become more complete persons experiencing positive and enriching interactions with fellow athletes, to an environment where young athletes experience stress and mental and physical ill health as result of their experiences. Those who are supremely talented (and lucky?) are rewarded with fabulous riches. Others can find themselves cast out on the scrap heap as a result of an unfair selection process or just the misfortune of injury. Sport as always, has proved to be a mirror of life in reflecting this process in the world at large, highlighting the heights that can be climbed by the fortunate as well as the depths that can be plumbed by the ill-fated. Advocates of the free-market approach will point to the opportunities it can offer. Figures can show that in a period of capitalist organised economies, there has been an unprecedented reduction in the amount of poverty in the world. Despite rapid growth in populations, there has been some extraordinary progress in lifting people out of extreme poverty. Between 1990 and 2010, the numbers in poverty fell by half as a share of the total population in developing countries, from 43% to 21%—a reduction of almost 1 billion people (The Economist Leader, June 1st, 2013). Nonetheless the critics of capitalism will continue to point to an increasing gap between the haves and don’t haves and specifically a decline in the ‘middle classes’, which have for so long provided the backbone of stable democratic societies. This delicate balance between retreating into our own boundaries as a means to manage the pandemic and resuming open borders to prevent economic damage to those whose businesses and employment depend upon the continuing movement of people and goods, is one which is being agonised over at this time in liberal democratic societies around the world. The experience of the pandemic has varied between countries, not solely because of the strategies adopted by politicians, but also because of the current health systems and varying social and economic conditions of life in different parts of the world. For many of us, the crises and social disturbances noted above have been played out on our television screens and websites. Increasingly it seems that we have been consuming our life experiences in a world dominated by our screens and sheltered from the real messiness of life. Meanwhile, in those countries with a choice, the debate has been between public health concerns and economic health concerns. Some have argued that the two are not totally independent of each other, while others have argued that the extent to which they are seen as interrelated lies in the extent to which life’s values have themselves become commodified. Others have pointed to the mental health problems experienced by people of all ages as a result of being confined for long periods of time within limited spaces and experiencing few chances to meet with others outside their immediate household. Still others have experienced different conditions – such as the chance to work from home in a comfortable environment and be freed from the drudgery of commuting in crowded traffic or public transport. So, at a national/communal level as well as at an individual level, this international crisis has exposed people to different decisions. It has offered, for many, a chance to recalibrate their lives. Those who have the resources, are leaving the confines of the big capital cities and seeking a healthier and less turbulent existence in quieter urban centres. For those of us in what can be loosely termed ‘an information industry’, today’s work practices are already an age away from what they were in pre-pandemic times. Yet again, a clear split is evident. The notion of ‘essential industries’ has been reclassified. The delivery of goods, the facilitation of necessary purchase such as food; these and other tasks have acquired a new significance which has enhanced the value of those who deliver these services. However, for those whose tasks can be handled via the internet or offloaded to other anonymous beings a readjustment of a different kind is occurring. So to the future - for those who have suffered ill-health and lost loved ones, the pandemic only reinforces the human priority. Health and well-being trumps economic health and wealth where choices can be made. The closeness of human contact has been reinforced by the tales of families who have been deprived of the touch of their loved ones, many of whom still don’t know when that opportunity will be offered again. When writing our editorial, a year ago, I little expected to be still pursuing a Covid related theme today. Yet where once we were expecting to look back on this time as a minor hiccough, with normal service being resumed sometime last year, it has not turned out to be that way. Rather, it seems that we have been offered a major reset opportunity in the way in which we continue to progress our future as humans. The question is, will we be bold enough to see the opportunity and embrace a healthier more equitable more locally responsible lifestyle or, will we revert to a style of ‘progress’ where powerful countries, organisations and individuals continue to amass increased amounts of wealth and influence and become increasingly less responsive to the needs of individuals in the throng below. Of course, any retreat from globalisation as it has evolved to date, will involve disruption of a different kind, which will inevitably lead to pain for some. It seems inevitable that any change and consequent progress is going to involve winners and losers. Already airline companies and the travel industry are putting pressure on governments to “get back to normal” i.e. where things were previously. Yet, in the shadow of widespread support for climate activism and the extinction rebellion movement, reports have emerged that since the lockdowns air pollution has dropped dramatically around the world – a finding that clearly offers benefits to all our population. In a similar vein the impossibility of overseas air travel in Australia has resulted in a major increase in local tourism, where more inhabitants are discovering the pleasures of their own nation. The transfer of their tourist and holiday dollars from overseas to local tourist providers has produced at one level a traditional zero-sum outcome, but it has also been accompanied by a growing appreciation of local citizens for the wonders of their own land and understanding of the lives of their fellow citizens as well as massive savings in foregone air travel. Continuing to define life in terms of competition for limited resources will inevitably result in an ever-continuing run of zero-sum games. Looking beyond the prism of competition and personal reward has the potential to add to what Michael Sandel (2020) has termed ‘the common good’. Does the possibility of a reset, offer the opportunity to recalibrate our views of effort and reward to go beyond a dollar value and include this important dimension? How has sport been experiencing the pandemic and are there chances for a reset here? An opinion piece from Peter Horton in this edition, has highlighted the growing disconnect of professional sport at the highest level from the communities that gave them birth. Is this just another example of the outcome of unrestrained commodification? Professional sport has suffered in the pandemic with the cancelling of fixtures and the enforced absence of crowds. Yet it has shown remarkable resilience. Sport science staff may have been reduced alongside all the auxiliary workers who go to make up the total support staff on match days and other times. Crowds have been absent, but the game has gone on. Players have still been able to play and receive the support they have become used to from trainers, physiotherapists and analysts, although for the moment there may be fewer of them. Fans have had to rely on electronic media to watch their favourites in action– but perhaps that has just encouraged the continuing spread of support now possible through technology which is no longer dependent on personal attendance through the turnstile. Perhaps for those committed to the watching of live sport in the outdoors, this might offer a chance for more attention to be paid to sport at local and community levels. Might the local villagers be encouraged to interrelate with their hometown heroes, rather than the million-dollar entertainers brought in from afar by the big city clubs? To return to the village analogy and the tensions between global and local, could it be that the social structure of the village has become maladapted to the reality of globalisation? If we wish to retain the traditional values of village life, is returning to our village a necessary strategy? If, however we see that today the benefits and advantages lie in functioning as one single global community, then perhaps we need to do some serious thinking as to how that community can function more effectively for all of its members and not just its ‘elites’. As indicated earlier, sport has always been a reflection of our society. Whichever way our communities decide to progress, sport will have a place at their heart and sport scholars will have a place in critically reflecting the nature of the society we are building. It is on such a note that I am pleased to introduce the content of volume 43:1 to you. We start with a reminder from Hoyoon Jung of the importance of considering the richness provided by a deep analysis of context, when attempting to evaluate and compare outcomes for similar events. He examines the concept of nation building through sport, an outcome that has been frequently attributed to the conduct of successful events. In particular, he examines this outcome in the context of the experiences of South Africa and Brazil as hosts of world sporting events. The mega sporting event that both shared was the FIFA world cup, in 2010 and 2014 respectively. Additional information could be gained by looking backwards to the 1995 Rugby World Cup in the case of South Africa and forward to the 2016 Olympics with regard to Brazil. Differentiating the settings in terms of timing as well as in the makeup of the respective local cultures, has led Jung to conclude that a successful outcome for nation building proved possible in the case of South Africa. However, different settings, both economically and socially, made it impossible for Brazil to replicate the South African experience. From a globally oriented perspective to a more local one, our second paper by Rafal Gotowski and Marta Anna Zurawak examines the growth and development, with regard to both participation and performance, of a more localised activity in Poland - the Nordic walking marathon. Their analysis showed that this is a locally relevant activity that is meeting the health-related exercise needs of an increasing number of people in the middle and later years, including women. It is proving particularly beneficial as an activity due to its ability to offer a high level of intensity while reducing the impact - particularly on the knees. The article by Petr Vlček, Richard Bailey, Jana Vašíčková XXABSTRACT Claude Scheuer is also concerned with health promoting physical activity. Their focus however is on how the necessary habit of regular and relevant physical activity is currently being introduced to the younger generation in European schools through the various physical education curricula. They conclude that physical education lessons, as they are currently being conducted, are not providing the needed 50% minimum threshold of moderate to vigorous physical activity. They go further, to suggest that in reality, depending on the physical education curriculum to provide the necessary quantum of activity within the child’s week, is going to be a flawed vision, given the instructional and other objectives they are also expected to achieve. They suggest implementing instead an ‘Active Schools’ concept, where the PE lessons are augmented by other school-based contexts within a whole school programme of health enhancing physical activity for children. Finally, we step back to the global and international context and the current Pandemic. Eric Burhaein, Nevzt Demirci, Carla Cristina Vieira Lourenco, Zsolt Nemeth and Diajeng Tyas Pinru Phytanza have collaborated as a concerned group of physical educators to provide an important international position statement which addresses the role which structured and systematic physical activity should assume in the current crisis. This edition then concludes with two brief contributions. The first is an opinion piece by Peter Horton which provides a professional and scholarly reaction to the recent attempt by a group of European football club owners to challenge the global football community and establish a self-governing and exclusive European Super League. It is an event that has created great alarm and consternation in the world of football. Horton reflects the outrage expressed by that community and concludes: While recognising the benefits accruing from well managed professionalism, the essential conflict between the values of sport and the values of market capitalism will continue to simmer below the surface wherever sport is commodified rather than practised for more ‘intrinsic’ reasons. We conclude however on a more celebratory note. We are pleased to acknowledge the recognition achieved by one of the members of our International Review Board. The career and achievements of Professor John Wang – a local ‘scholar’- have been recognised in his being appointed as the foundation E.W. Barker Professor in Physical Education and Sport at the Nanyang Technological University. This is a well-deserved honour and one that reflects the growing stature of the Singapore Physical Education and Sports Science community within the world of International Sport Studies. John Saunders Brisbane, June 2021

Introduction: Bubbles and Sport The ephemeral materiality of bubbles – beautiful, spectacular, and distracting but ultimately fragile – when applied to protect or conserve in the interests of sport-media profit, creates conditions that exacerbate existing inequalities in sport and society. Bubbles are usually something to watch, admire, and chase after in their brief yet shiny lives. There is supposed to be, technically, nothing inside them other than one or more gasses, and yet we constantly refer to people and objects being inside bubbles. The metaphor of the bubble has been used to describe the life of celebrities, politicians in purpose-built capital cities like Canberra, and even leftist, environmentally activist urban dwellers. The metaphorical and material qualities of bubbles are aligned—they cannot be easily captured and are liable to change at any time. In this article we address the metaphorical sporting bubble, which is often evoked in describing life in professional sport. This is a vernacular term used to capture and condemn the conditions of life of elite sportspeople (usually men), most commonly after there has been a sport-related scandal, especially of a sexual nature (Rowe). It is frequently paired with connotatively loaded adjectives like pampered and indulged. The sporting bubble is rarely interrogated in academic literature, the concept largely being left to the media and moral entrepreneurs. It is represented as involving a highly privileged but also pressurised life for those who live inside it. A sporting bubble is a world constructed for its most prized inhabitants that enables them to be protected from insurgents and to set the terms of their encounters with others, especially sport fans and disciplinary agents of the state. The Covid-19 pandemic both reinforced and reconfigured the operational concept of the bubble, re-arranging tensions between safety (protecting athletes) and fragility (short careers, risks of injury, etc.) for those within, while safeguarding those without from bubble contagion. Privilege and Precarity Bubble-induced social isolation, critics argue, encourages a loss of perspective among those under its protection, an entitled disconnection from the usual rules and responsibilities of everyday life. For this reason, the denizens of the sporting bubble are seen as being at risk to themselves and, more troublingly, to those allowed temporarily to penetrate it, especially young women who are first exploited by and then ejected from it (Benedict). There are many well-documented cases of professional male athletes “behaving badly” and trying to rely on institutional status and various versions of the sporting bubble for shelter (Flood and Dyson; Reel and Crouch; Wade). In the age of mobile and social media, it is increasingly difficult to keep misbehaviour in-house, resulting in a slew of media stories about, for example, drunkenness and sexual misconduct, such as when then-Sydney Roosters co-captain Mitchell Pearce was suspended and fined in 2016 after being filmed trying to force an unwanted kiss on a woman and then simulating a lewd act with her dog while drunk. There is contestation between those who condemn such behaviour as aberrant and those who regard it as the conventional expression of youthful masculinity as part of the familiar “boys will be boys” dictum. The latter naturalise an inequitable gender order, frequently treating sportsmen as victims of predatory women, and ignoring asymmetries of power between men and women, especially in homosocial environments (Toffoletti). For those in the sporting bubble (predominantly elite sportsmen and highly paid executives, also mostly men, with an array of service staff of both sexes moving in and out of it), life is reflected for those being protected via an array of screens (small screens in homes and indoor places of entertainment, and even smaller screens on theirs and others’ phones, as well as huge screens at sport events). These male sport stars are paid handsomely to use their skill and strength to perform for the sporting codes, their every facial expression and bodily action watched by the media and relayed to audiences. This is often a precarious existence, the usually brief career of an athlete worker being dependent on health, luck, age, successful competition with rivals, networks, and club and coach preferences. There is a large, aspirational reserve army of athletes vying to play at the elite level, despite risks of injury and invasive, life-changing medical interventions. Responsibility for avoiding performance and image enhancing drugs (PIEDs) also weighs heavily on their shoulders (Connor). Professional sportspeople, in their more reflective moments, know that their time in the limelight will soon be up, meaning that getting a ticket to the sporting bubble, even for a short time, can make all the difference to their post-sport lives and those of their families. The most vulnerable of the small minority of participants in sport who make a good, short-term living from it are those for whom, in the absence of quality education and prior social status, it is their sole likely means of upward social mobility (Spaaij). Elite sport performers are surrounded by minders, doctors, fitness instructors, therapists, coaches, advisors and other service personnel, all supporting athletes to stay focussed on and maximise performance quality to satisfy co-present crowds, broadcasters, sponsors, sports bodies and mass media audiences. The shield offered by the sporting bubble supports the teleological win-at-all-costs mentality of professional sport. The stakes are high, with athlete and executive salaries, sponsorships and broadcasting deals entangled in a complex web of investments in keeping the “talent” pivotal to the “attention economy” (Davenport and Beck)—the players that provide the content for sale—in top form. Yet, the bubble cannot be entirely secured and poor behaviour or performance can have devastating effects, including permanent injury or disability, mental illness and loss of reputation (Rowe, “Scandals and Sport”). Given this fragile materiality of the sporting bubble, it is striking that, in response to the sudden shutdown following the economic and health crisis caused by the 2020 global pandemic, the leaders of professional sport decided to create more of them and seek to seal the metaphorical and material space with unprecedented efficiency. The outcome was a multi-sided tale of mobility, confinement, capital, labour, and the gendering of sport and society. The Covid-19 Gilded Cage Sociologists such as Zygmunt Bauman and John Urry have analysed the socio-politics of mobilities, whereby some people in the world, such as tourists, can traverse the globe at their leisure, while others remain fixed in geographical space because they lack the means to be mobile or, in contrast, are involuntarily displaced by war, so-called “ethnic cleansing”, famine, poverty or environmental degradation. The Covid-19 global pandemic re-framed these matters of mobilities (Rowe, “Subjecting Pandemic Sport”), with conventional moving around—between houses, businesses, cities, regions and countries—suddenly subjected to the imperative to be static and, in perniciously unreflective technocratic discourse, “socially distanced” (when what was actually meant was to be “physically distanced”). The late-twentieth century analysis of the “risk society” by Ulrich Beck, in which the mysterious consequences of humans’ predation on their environment are visited upon them with terrifying force, was dramatically realised with the coming of Covid-19. In another iteration of the metaphor, it burst the bubble of twenty-first century global sport. What we today call sport was formed through the process of sportisation (Maguire), whereby hyper-local, folk physical play was reconfigured as multi-spatial industrialised sport in modernity, becoming increasingly reliant on individual athletes and teams travelling across the landscape and well over the horizon. Co-present crowds were, in turn, overshadowed in the sport economy when sport events were taken to much larger, dispersed audiences via the media, especially in broadcast mode (Nicholson, Kerr, and Sherwood). This lucrative mediation of professional sport, though, came with an unforgiving obligation to generate an uninterrupted supply of spectacular live sport content. The pandemic closed down most sports events and those that did take place lacked the crucial participation of the co-present crowd to provide the requisite event atmosphere demanded by those viewers accustomed to a sense of occasion. Instead, they received a strange spectacle of sport performers operating in empty “cathedrals”, often with a “faked” crowd presence. The mediated sport spectacle under the pandemic involved cardboard cut-out and sex doll spectators, Zoom images of fans on large screens, and sampled sounds of the crowd recycled from sport video games. Confected co-presence produced simulacra of the “real” as Baudrillardian visions came to life. The sporting bubble had become even more remote. For elite sportspeople routinely isolated from the “common people”, the live sport encounter offered some sensory experience of the social – the sounds, sights and even smells of the crowd. Now the sporting bubble closed in on an already insulated and insular existence. It exposed the irony of the bubble as a sign of both privileged mobility and incarcerated athlete work, both refuge and prison. Its logic of contagion also turned a structure intended to protect those inside from those outside into, as already observed, a mechanism to manage the threat of insiders to outsiders. In Australia, as in many other countries, the populace was enjoined by governments and health authorities to help prevent the spread of Covid-19 through isolation and immobility. There were various exceptions, principally those classified as essential workers, a heterogeneous cohort ranging from supermarket shelf stackers to pharmacists. People in the cultural, leisure and sports industries, including musicians, actors, and athletes, were not counted among this crucial labour force. Indeed, the performing arts (including dance, theatre and music) were put on ice with quite devastating effects on the livelihoods and wellbeing of those involved. So, with all major sports shut down (the exception being horse racing, which received the benefit both of government subsidies and expanding online gambling revenue), sport organisations began to represent themselves as essential services that could help sustain collective mental and even spiritual wellbeing. This case was made most aggressively by Australian Rugby League Commission Chairman, Peter V’landys, in contending that “an Australia without rugby league is not Australia”. In similar vein, prominent sport and media figure Phil Gould insisted, when describing rugby league fans in Western Sydney’s Penrith, “they’re lost, because the football’s not on … . It holds their families together. People don’t understand that … . Their life begins in the second week of March, and it ends in October”. Despite misgivings about public safety and equality before the pandemic regime, sporting bubbles were allowed to form, re-form and circulate. The indefinite shutdown of the National Rugby League (NRL) on 23 March 2020 was followed after negotiation between multiple entities by its reopening on 28 May 2020. The competition included a team from another nation-state (the Warriors from Aotearoa/New Zealand) in creating an international sporting bubble on the Central Coast of New South Wales, separating them from their families and friends across the Tasman Sea. Appeals to the mental health of fans and the importance of the NRL to myths of “Australianness” notwithstanding, the league had not prudently maintained a financial reserve and so could not afford to shut down for long. Significant gambling revenue for leagues like the NRL and Australian Football League (AFL) also influenced the push to return to sport business as usual. Sport contests were needed in order to exploit the gambling opportunities – especially online and mobile – stimulated by home “confinement”. During the coronavirus lockdowns, Australians’ weekly spending on gambling went up by 142 per cent, and the NRL earned significantly more than usual from gambling revenue—potentially $10 million above forecasts for 2020. Despite the clear financial imperative at play, including heavy reliance on gambling, sporting bubble-making involved special licence. The state of Queensland, which had pursued a hard-line approach by closing its borders for most of those wishing to cross them for biographical landmark events like family funerals and even for medical treatment in border communities, became “the nation's sporting hub”. Queensland became the home of most teams of the men’s AFL (notably the women’s AFLW season having been cancelled) following a large Covid-19 second wave in Melbourne. The women’s National Netball League was based exclusively in Queensland. This state, which for the first time hosted the AFL Grand Final, deployed sport as a tool in both national sports tourism marketing and internal pre-election politics, sponsoring a documentary, The Sporting Bubble 2020, via its Tourism and Events arm. While Queensland became the larger bubble incorporating many other sporting bubbles, both the AFL and the NRL had versions of the “fly in, fly out” labour rhythms conventionally associated with the mining industry in remote and regional areas. In this instance, though, the bubble experience did not involve long stays in miners’ camps or even the one-night hotel stopovers familiar to the popular music and sport industries. Here, the bubble moved, usually by plane, to fulfil the requirements of a live sport “gig”, whereupon it was immediately returned to its more solid bubble hub or to domestic self-isolation. In the space created between disciplined expectation and deplored non-compliance, the sporting bubble inevitably became the scrutinised object and subject of scandal. Sporting Bubble Scandals While people with a very low risk of spreading Covid-19 (coming from areas with no active cases) were denied entry to Queensland for even the most serious of reasons (for example, the death of a child), images of AFL players and their families socialising and enjoying swimming at the Royal Pines Resort sporting bubble crossed our screens. Yet, despite their (players’, officials’ and families’) relative privilege and freedom of movement under the AFL Covid-Safe Plan, some players and others inside the bubble were involved in “scandals”. Most notable was the case of a drunken brawl outside a Gold Coast strip club which led to two Richmond players being “banished”, suspended for 10 matches, and the club fined $100,000. But it was not only players who breached Covid-19 bubble protocols: Collingwood coaches Nathan Buckley and Brenton Sanderson paid the $50,000 fine imposed on the club for playing tennis in Perth outside their bubble, while Richmond was fined $45,000 after Brooke Cotchin, wife of team captain Trent, posted an image to Instagram of a Gold Coast day spa that she had visited outside the “hub” (the institutionally preferred term for bubble). She was subsequently distressed after being trolled. Also of concern was the lack of physical distancing, and the range of people allowed into the sporting bubble, including babysitters, grandparents, and swimming coaches (for children). There were other cases of players being caught leaving the bubble to attend parties and sharing videos of their “antics” on social media. Biosecurity breaches of bubbles by players occurred relatively frequently, with stern words from both the AFL and NRL leaders (and their clubs) and fines accumulating in the thousands of dollars. Some people were also caught sneaking into bubbles, with Lekahni Pearce, the girlfriend of Swans player Elijah Taylor, stating that it was easy in Perth, “no security, I didn’t see a security guard” (in Barron, Stevens, and Zaczek) (a month later, outside the bubble, they had broken up and he pled guilty to unlawfully assaulting her; Ramsey). Flouting the rules, despite stern threats from government, did not lead to any bubble being popped. The sport-media machine powering sporting bubbles continued to run, the attendant emotional or health risks accepted in the name of national cultural therapy, while sponsorship, advertising and gambling revenue continued to accumulate mostly for the benefit of men. Gendering Sporting Bubbles Designed as biosecurity structures to maintain the supply of media-sport content, keep players and other vital cogs of the machine running smoothly, and to exclude Covid-19, sporting bubbles were, in their most advanced form, exclusive luxury camps that illuminated the elevated socio-cultural status of sportsmen. The ongoing inequalities between men’s and women’s sport in Australia and around the world were clearly in evidence, as well as the politics of gender whereby women are obliged to “care” and men are enabled to be “careless” – or at least to manage carefully their “duty of care”. In Australia, the only sport for women that continued during the height of the Covid-19 lockdown was netball, which operated in a bubble that was one of sacrifice rather than privilege. With minimum salaries of only $30,000 – significantly less than the lowest-paid “rookies” in the AFL – and some being mothers of small children and/or with professional jobs juggled alongside their netball careers, these elite sportswomen wanted to continue to play despite the personal inconvenience or cost (Pavlidis). Not one breach of the netballers out of the bubble was reported, indicating that they took their responsibilities with appropriate seriousness and, perhaps, were subjected to less scrutiny than the sportsmen accustomed to attracting front-page headlines. National Netball League (also known after its Queensland-based naming rights sponsor as Suncorp Super Netball) players could be regarded as fortunate to have the opportunity to be in a bubble and to participate in their competition. The NRL Women’s (NRLW) Premiership season was also completed, but only involved four teams subject to fly in, fly out and bubble arrangements, and being played in so-called curtain-raiser games for the NRL. As noted earlier, the AFLW season was truncated, despite all the prior training and sacrifice required of its players. Similarly, because of their resource advantages, the UK men’s and boy’s top six tiers of association football were allowed to continue during lockdown, compared to only two for women and girls. In the United States, inequalities between men’s and women’s sports were clearly demonstrated by the conditions afforded to those elite sportswomen inside the Women’s National Basketball Association (WNBA) sport bubble in the IMG Academy in Florida. Players shared photos of rodent traps in their rooms, insect traps under their mattresses, inedible food and blocked plumbing in their bubble accommodation. These conditions were a far cry from the luxury usually afforded elite sportsmen, including in Florida’s Walt Disney World for the men’s NBA, and is just one of the many instances of how gendered inequality was both reproduced and exacerbated by Covid-19. Bursting the Bubble As we have seen, governments and corporate leaders in sport were able to create material and metaphorical bubbles during the Covid-19 lockdown in order to transmit stadium sport contests into home spaces. The rationale was the importance of sport to national identity, belonging and the routines and rhythms of life. But for whom? Many women, who still carry the major responsibilities of “care”, found that Covid-19 intensified the affective relations and gendered inequities of “home” as a leisure site (Fullagar and Pavlidis). Rates of domestic violence surged, and many women experienced significant anxiety and depression related to the stress of home confinement and home schooling. During the pandemic, women were also more likely to experience the stress and trauma of being first responders, witnessing virus-related sickness and death as the majority of nurses and care workers. They also bore the brunt of much of the economic and employment loss during this time. Also, as noted above, livelihoods in the arts and cultural sector did not receive the benefits of the “bubble”, despite having a comparable claim to sport in contributing significantly to societal wellbeing. This sector’s workforce is substantially female, although men dominate its senior roles. Despite these inequalities, after the late March to May hiatus, many elite male sportsmen – and some sportswomen - operated in a bubble. Moving in and out of them was not easy. Life inside could be mentally stressful (especially in long stays of up to 150 days in sports like cricket), and tabloid and social media troll punishment awaited those who were caught going “over the fence”. But, life in the sporting bubble was generally preferable to the daily realities of those afflicted by the trauma arising from forced home confinement, and for whom watching moving sports images was scant compensation for compulsory immobility. The ethical foundation of the sparkly, ephemeral fantasy of the sporting bubble is questionable when it is placed in the service of a voracious “media sports cultural complex” (Rowe, Global Media Sport) that consumes sport labour power and rolls back progress in gender relations as a default response to a global pandemic. Covid-19 dramatically highlighted social inequalities in many areas of life, including medical care, work, and sport. For the small minority of people involved in sport who are elite professionals, the only thing worse than being in a sporting bubble during the pandemic was not being in one, as being outside precluded their participation. Being inside the bubble was a privilege, albeit a dubious one. But, as in wider society, not all sporting bubbles are created equal. Some are more opulent than others, and the experiences of the supporting and the supported can be very different. The surface of the sporting bubble may be impermanent, but when its interior is opened up to scrutiny, it reveals some very durable structures of inequality. Bubbles are made to burst. They are, by nature, temporary, translucent structures created as spectacles. As a form of luminosity, bubbles “allow a thing or object to exist only as a flash, sparkle or shimmer” (Deleuze, 52). In echoing Deleuze, Angela McRobbie (54) argues that luminosity “softens and disguises the regulative dynamics of neoliberal society”. The sporting bubble was designed to discharge that function for those millions rendered immobile by home confinement legislation in Australia and around the world, who were having to deal with the associated trauma, risk and disadvantage. 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AbstractAs Australian imprisonment and recidivism rates continue to rise, it is increasingly important to better understand how to support “returning citizens” to adequately prepare them for post-release life. Using a case study approach focused on service provider perspectives, this article examines the consequences of removing a transitional accommodation support service on service providers and returning citizens. Participants highlighted significant consequences, such as: gaps in services; lack of support and housing; persons remaining in the system unnecessarily; persons being released without transitional support or accommodation; health implications; loss of relationships and trust; and suicide of returned citizens. Drawing on critical criminological theory, we argue that the most significant consequence was the loss of “floating support”—which involves a case worker who brokers support between agencies working with a single client—that was integrated into the program. Study findings suggest serious consequences of government decisions to defund programs in this sector.