Spatial variation in cervical cancer screening participation and outcomes among Indigenous and non‐Indigenous Australians in Queensland

Indigenous women continue to experience a disproportionately higher burden of cervical cancer than non‐Indigenous women in Australia. The National Indigenous Cervical Screening Project used probabilistic record linkage to combine population‐based administrative databases and identify Indigenous women on Pap Smear Registers. This study aimed to quantify the spatial variation by local government areas (LGAs) for Indigenous and non‐Indigenous women in Queensland in cervical screening participation rates and related outcomes. Empirical Bayes local geostatistical smoothing was performed to reduce the likelihood of spurious variation between small areas. The cohort included 1,091,260 women (2 per cent Indigenous) aged 20 to 69 with 2,393,708 Pap smears between 2006 and 2011. Indigenous women had smoothed LGA‐specific 5‐year participation rates (interquartile range (IQR) 38.9–53.3 per 100 eligible women) consistently lower than non‐Indigenous women (IQR 80.7–85.3). The non‐overlapping confidence intervals of these rates suggest that the Indigenous differential was significant. Compared with Indigenous women, non‐Indigenous women had consistently lower and more stable prevalence rates of histologically confirmed high grade abnormalities (IQR 8.0–10.1 versus 15.0–21.3 per 1,000 screened women). Although the LGA‐specific rates also suggest that a higher proportion of non‐Indigenous women were followed‐up within two months of an abnormal screening result, the wide confidence intervals for these estimates limit our ability to draw definitive conclusions about spatial patterns for this outcome. These findings highlight the importance of continued monitoring and ongoing efforts to identify drivers of these patterns and develop effective strategies to improve participation and potentially reduce the cervical cancer burden among Indigenous women.     

Viewing obesogenic advertising in children's neighbourhoods using Google Street View

The advertising of unhealthy food and beverages forms an important component of obesogenic environments. Such marketing to children is a key health determinant because of its impact on dietary preference and food purchasing behaviour. The location of outdoor advertising is important in exploring obesogenic environments and children's neighbourhoods. The aim of this study is to explore issues involved in the use of Google Street View to examine outdoor food and beverage advertising. The implications for using Google Street View in the context of neighbourhood built environment research and grass‐roots advocacy are discussed. The study was conducted within walkable distances from 19 primary and intermediate schools in Auckland, New Zealand, where “walkable” was defined as limited by 800 m road network boundaries, which are equivalent to school buffer boundaries. Google Street View allows for centrality of data collection, coding, and storage. However, challenges exist with the method because 727 (29.4%) of a total of 2,474 outdoor advertisements that were identified were not able to be categorised because images were unclear, not in English, blocked, or at angles where detail cannot be deciphered. Specific to outdoor advertising for food and beverages, the results presented here show that children are exposed to a significantly greater number of unhealthy advertising than other advertising, P=0.001, eta‐squared statistic (0.45) indicates a large effect size. Overall, the results show promise for the use of Google Street View in the study of obesogenic environments.     

Akogare,Ideology, and ‘Charisma Man’ Mythology: Reflections on ethnographic research in English language schools in Japan

In light of recent reflexive ethnography based on frameworks of performativity, this work develops a phenomenological interpretation of my white, male, gaijin (foreign), English-speaking positionality inside Japan's private English conversation schools (eikaiwa). These eikaiwa are ubiquitous in modern urban areas. They are patronized predominantly by women who seek career enhancement, study and/or work abroad, and international romance. To understand the gendered participation patterns inside the eikaiwa I develop a phenomenological understanding of my positionality through a framework based on Occidentalism. This framework is grounded in the ideo-geographically specific notions of seken (surveillance) and akogare (desire). Akogare is instantiated and intensified inside eikaiwa by the performative aspects of staff, students and instructor practices in addition to eikaiwa texts and advertising and popular media discourses while seken, especially gender-normative seken, directed at women is minimized. This framework allows me to present a nuanced account of the interaction of my positionalities with those of the informants.     

‘That's What Being A Woman Is For’: Opposition To Marital Rape Law Reform In Late Twentieth‐Century Australia

From 1976 until 1994, Australian states and territories introduced a raft of reforms to sexual assault laws. Most of these were welcomed, and were seen to reflect women's changing status within a modernising society. One reform, however, was especially contentious. The British law had proclaimed that a woman could not be raped within marriage: the marital bond included a husband's right to sexual access to his wife. Following South Australia's lead, all Australian jurisdictions introduced changes to this law, making it a crime to rape a woman within marriage, either before or after separation. It was a fundamental challenge to the way familial authority was conceptualised, established and policed. In a period where feminism had infiltrated many layers of political and social life, we might expect that this change to the law would have been greeted with relief and even celebration. The response to changes to marital rape laws was, however, both muted and ambivalent. Even feminist groups did not offer unequivocal support, and in general public opinion was at best reserved. Further, many conservative groups understood the new laws as an assault on the sanctity of the family itself. Drawing on a wide range of sources in the mainstream and alternative media, as well as parliamentary debates, government enquiries, academic studies and legal reports, this paper will explore the multifarious responses to legislative change. It uncovers the complex ways sexual violence and female bodily autonomy were understood within and beyond the borders and boundaries of the home and family.     

The relative duties of a man: domestic medicine in England and France, ca. 1685-1740

Although much work is currently being done on early modern women and household medicine and on early modern masculinities, historians have generally overlooked men's roles within the home, particularly with respect to domestic medical activities. Using medical consultation letters, this article examines men's roles as domestic caregivers and their medical decision making. During this period, manly self-management and household order were closely linked; an ideal head of household would manage himself retain order within the household, and look after the welfare of his family.     

The theory of polynuclear urban regions and its application to central Scotland

The idea of strategic planning for networks of cities and towns, encapsulated in the polynuclear urban region concept, has attracted growing interest in many European regions. Key themes include cooperation between neighbouring cities and coordination between functional policies. This article explores the theoretical benefits, including increased economies of scale and improvements in the strength and quality of internal interactions. It also applies these arguments to Central Scotland. As the largest concentration of economic activity in Scotland, with a high level of organizational fragmentation but growing cross boundary issues and coincident growth pressures and deficiencies, there are potential gains from a common strategic perspective. These include improved communications for inter‐firm collaboration and trade, more efficient labour and housing market interactions, and an institutional framework for planning and marketing important regional assets. Closer cooperation within a regional perspective could help the Central Belt to function better as an economic unit and facilitate its ongoing development.