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.     

Biomechanics of coaching maximal instep soccer kick for practitioners

Kicking in soccer has been the subject of scientific research for more than 40 years yet review articles summarizing the biomechanical fundamentals of kick optimization as a guide to coaching are scarcely to be found. The current review article aims to bridge the gap between scientific research into the maximal instep kick (including studies employing 3D motion capture and full-body biomechanical modelling) and the application of such research in coaching. It does so by supplying a scientifically founded, coaching-friendly article explaining identifiable characteristics and motor control sequencing that define this skill. Relevant biomechanical factors are identified in a way that should help coaches better develop training programmes and, at the same time, foster better understanding of the skill among athletes. Such information will contribute to both accelerated skill acquisition and, by concomitant gains in skill efficiency, the development of programmes that minimize risk of injury to athletes during training.     

New East Manchester: Urban Renaissance or Urban Opportunism?

In this paper we ask how a shrinking city responds when faced with a perforated urban fabric. Drawing on Manchester's response to its perforated eastern flank —and informed by a parallel study of Leipzig—we use the city's current approach to critique urban regeneration policy in England. Urban renaissance holds out the promise of delivering more sustainable—that is more compact, more inclusive and more equitable—cities. However, the Manchester study demonstrated that the attempt to stem population loss from the city is at best fragile, despite a raft of policies now in place to support urban renaissance in England. It is argued here that Manchester like Leipzig is likely to face an ongoing battle to attract residents back from their suburban hinterlands. This is especially true of the family market that we identify as being an important element for long-term sustainable population growth in both cities. We use the case of New East Manchester to consider how discourses linked to urban renaissance—particularly those that link urbanism with greater densities—rule out some of the options available to Leipzig, namely, managing the long-term perforation of the city. We demonstrate that while Manchester is inevitably committed to the urban renaissance agenda, in practice New East Manchester demonstrates a far more pragmatic—but equally unavoidable—approach. This we attribute to the gap between renaissance and regeneration described by Amin et al. (Cities for the Many Not for the Few. Bristol: Policy Press, 2000) who define the former as urbanism for the middle class and the latter as urbanism for the working class. While this opportunistic approach may ultimately succeed in producing development on the ground, it will not address the fundamental, and chronic, problem; the combination of push and pull that sees families relocating to suburban areas. Thus, if existing communities in East Manchester are to have their area buoyed up—or sustained—by incomers, and especially families, with greater levels of social capital and higher incomes urban policy in England will have to be challenged.