In a paper published in 2017, Doherty et al [...].

Introduction COVID-19 vaccines using messenger RNA (mRNA) technologies have been commercially available since 2021. The platform is being used to develop new vaccines for people and animals, but not without controversy. Pockets of public resistance to COVID-19 vaccines has contributed to the slowing of mRNA research in some countries (e.g. the United States), while others (e.g. Australia) are poised to approve new vaccines. We set out to understand 1) whether Australians express different attitudes to mRNA vaccines compared to conventional vaccines, 2) about willingness to be vaccinated with mRNA vaccines in the event of a future infectious disease emergency, and 3) attitudes towards consumption of beef and milk from mRNA vaccinated cattle. Methods Cross-sectional, self-administered online survey of the Australian public aged over 18. We performed descriptive statistics analyses on all variables. Associations between variables was assessed using chi-squared tests. Variables associated with willingness to have an mRNA vaccine in future with a significance level of p < 0.25 were entered into a backward stepwise logistic regression model, using a significance level of p < 0.05. Missing data was not included in multivariate analyses. Sentiment and thematic analyses conducted on open text responses. Results Support for vaccination was high, but there was stronger support for traditionally manufactured vaccines than for mRNA-based vaccines, which are not well understood. Acceptance of mRNA vaccination in an emergency is associated with voluntariness, understanding and higher trust. Animal vaccination is not well understood and support for consumption of meat and milk products from mRNA vaccinated cattle was mixed. Conclusions Vaccine manufacturers, public health and animal health policy makers should anticipate the potential for lower public acceptance of mRNA vaccines and milk and meat products from mRNA vaccinated cattle. Enthusiasm for scientific development of new vaccine technologies must be matched by enthusiastic public acceptability if new vaccines are to be optimally used.

This paper examines the dynamic interplay between norms, practices, and food environments through the concept of 'normal food practices'. Drawing on Georges Canguilhem's theory of vital norms and social practice theory, we distinguish between descriptive (common), evaluative (proper), and creative (norm-generating) dimensions of food practices. We argue that food-related behaviors are not only shaped by existing norms but also actively produce new ones in response to environmental, technological, and socio-political conditions. We develop three empirical case studies that illustrate how norms are negotiated and transformed: playful resistance to food restrictions in hotel quarantine, decolonial food growing in settler-colonial Australia, and contested norms of purity and care in automated food systems. These examples reveal how food practices mediate agency, belonging, and health, challenging disciplinary models of biopolitical governance. We conclude in arguing that normal food practices are not fixed but are continually enacted and reshaped through everyday actions, offering new possibilities for ethical and political engagement with food.

In equestrian competitions, a measuring device passing beneath the noseband on the dorsal nasal bone is used to determine noseband laxity. A supplementary location may be useful should the horse become distressed, or if it is apparent that the outcome of the noseband check is influenced by underlying dorsal nasal anatomy. The study aimed to (1) design and evaluate the application of a lateral noseband measuring tool; and (2) quantify equine head morphology beneath the noseband. A lateral measuring tool was designed (equivalent to 1.5 finger equivalent (Fe)) and tested on thirty-one horses. The lateral tool was inserted beneath the noseband at two locations: the lateral nasal bone and lateral maxilla (rostral to the facial crest). With three repeats per location, the outcome (pass/fail) was recorded. In a subset of twelve randomly selected horses, a 20-mm marker was placed rostral to the noseband. Maxilla morphology beneath the noseband was determined using 3D light scanning. Differences between the left and right sides of the maxilla were determined in 1-cm intervals caudal to the dorsal nasal bone. Compared with 2.0 Fe, the number of unsuccessful lateral tool passes increased significantly in the lateral nasal region at 1.0/0.5/0.0 Fe (all P < 0.001). For the lateral maxilla, a significant increase occurred only at 0.0 Fe (P < 0.001). Significant inter-horse lateral anatomical variations existed, but minimal left-right anatomical differences for the lateral nasal bone were found (P = 0.478). Lateral locations were subject to considerable anatomical variability and false positives and are therefore not recommended for determining the laxity of the noseband.

Several countries have revised their policies to make vaccine refusal more difficult. The role of the public in this process has seldom been examined. We analysed the public consultation process for the Australian government's 2016 'No Jab No Pay' mandatory childhood vaccination policy to better understand who participated, their arguments, and how their contributions were incorporated into the legislative process. Publicly available submissions and hearing transcripts were categorised by submitter type, stance on the legislation, and writing style. We undertook a qualitative reflexive thematic analysis of the submissions' structure and content and compared our findings with the Inquiry Report. Most public submissions (95 %) opposed the legislation. Vaccine-rejecting submitters focused on safety arguments to argue the legislation was unjustified, unethical or ineffective. Vaccine-supportive submitters focused on the importance of vaccination but supported or opposed the legislation based on positions that weighed collective goods against individual rights. The findings of this analysis differed somewhat from the Inquiry Report that analysed the same evidence. The Report identified similar key legislation-specific concerns, but the committee's explicit position on the importance of vaccines meant that vaccination concerns were not considered relevant. The Report drew heavily on supportive arguments from academics, medical organisations, and government, while minimising critical arguments. Our findings suggest a process that epistemically privileged expert opinion in favour of mandates and discounted testimony driven by experiences, emotion, and beliefs of opponents. Future consultations on vaccination policy might consider approaches which are designed to connect high quality evidence with the plural values of citizens.

This paper examines the experiences of teachers in Australia during the COVID-19 pandemic from a care ethics perspective. While pandemic preparedness plans prioritised continuity of services and infection control, they failed to anticipate the relational and moral labour required of frontline workers in non-clinical roles. Paradoxically, otherwise prudent and precautionary responses to the risks posed by the pandemic established new barriers to care and human connection and exacerbated existing ones. Drawing on 32 qualitative interviews with teachers, we analyse how they engaged in improvised, context-specific practices of care. We distinguish between care initiated by workers and care requested of them, highlighting asymmetries. We argue that the pandemic exposed and intensified structurally patterned inequities in the distribution and valuation of care work and that existing accounts of care ethics do not sufficiently explain community care performed by teachers. The paper calls for pandemic planners to explicitly anticipate the needs that public health restrictions create and acknowledge and centre care as a communal good. This is because when care is invisible, it is not planned for, acknowledged or supported. Ignoring it exposes persistent institutional failures to recognise and sustain the everyday labour that holds society together in times of crisis.

BACKGROUND:From 2020 to 2022 Australia supressed community transmission of SARS-CoV-2 by imposing a range of population-level measures. This limited mortality and created time to achieve high levels of vaccination, but also caused indirect harms. Our study aimed to capture lay perspectives on the implications of using lockdowns, masking mandates, and school and border closures to supress transmission in future pandemics. METHODS:We report on 9 dialogue groups (n = 53) with residents of Sydney, Melbourne and Adelaide. Each location had different epidemiological conditions and health policy settings during the pandemic. Dialogue group methods allow data collection on questions in applied ethics. RESULTS:We found that mandating masking indoors was broadly accepted in all group discussions, but attitudes to other measures varied depending on participants' past experiences. All groups accepted lockdowns and school closures might be necessary but wanted greater flexibility in policy implementation based on a broader range of health and social risks. Groups from cities that experienced the tightest public health controls during COVID-19 tended to have greater tolerance of future use of stringent measures (with conditions). CONCLUSIONS:Public compliance during future infectious disease emergencies likely depends on trust in institutions and expertise, and perceptions of the necessity, effectiveness and fairness of interventions. Rather than assuming public acquiescence, defiance or disinterest, in preparing for the next pandemic it is important to devote resources to understanding the public acceptability and perceived legitimacy of implementing any or all these measures.

BackgroundMitochondrial donation (MD) is a reproductive technique that aims to allow individuals at-risk of having a child with mitochondrial DNA disease avoid this outcome. Research to inform possible clinical use of MD is underway in Australia and births following the use of this technique have been announced in the United Kingdom. However, how the availability of MD will be funded in the mid- to long-term remains uncertain. One factor impacting funding decisions is public sentiment, yet there is scant evidence globally regarding attitudes toward MD funding. We sought to discern attitudes of informed members of the Australian public to how the provision of MD should be funded.MethodsWe held three community juries to gauge public views on how MD should be funded. A community jury involves providing a diverse group of citizens with expert testimony and facilitating deliberation to arrive at a position.ResultsForty-two jurors participated across three juries. All juries voted by majority to support public funding for MD. Each jury made slightly different funding choices: one preferred full public funding, another preferred co-payment, while the third was divided among full public funding, co-payment, and no public funding. Reasons in favour of public funding comprised value for money, equity (i.e., the fair and just distribution of MD) and promoting innovation. Reasons against were opportunity cost, that MD wasn't necessary, and ethical objections to MD. Jurors also devised conditions for future funding: external review, capped services, better funding for alternative interventions and means testing.ConclusionsShould the current Australian MD research trial enable clinical provision, assuming that our participants' views are consistent with those of most Australians when informed of the trade-offs, benefits and costs, then it is likely that there will be strong public support for governments to fund access. However, some people may object to this expenditure.

Much is changing in our understanding of animals in relation to acknowledging their nonhumancentric intelligence and sentience. Alongside emerging attitudes toward animal welfare, these changes have led to criticism of traditional coaching pedagogies in equestrianism. Elucidating an ecological process of learning in horse-human dyads may be valuable for guiding the development of a contemporary equestrian pedagogy. This study used thematic analysis to identify influential constraints on 11 elite show jumpers in the United Kingdom. Thematic analysis revealed common themes of: (a) becoming attuned to horses (organismic constraints), (b) becoming skillful through active problem-solving (task constraints), (c) pervasive sociocultural and historical narratives influencing affordance salience (environmental constraints), and (d) participants' perceptions of current trends in coaching. Results suggest that sociocultural and historical narratives, rather than a lack of care or attentiveness, may shape affordance perception, perpetuating many practices currently embedded in British equestrian sports. Participant insights suggest that the development of a pedagogical framework for equestrian activities should foreground the relational and problem-solving nature of the horse-rider dyadic system. These perceptions imply that skill development is a process of ongoing coadaptation between horse and rider with riders both learning from and teaching horses.

During the COVID-19 pandemic, virtually all countries used a range of measures to mitigate the risks of virus introduction and onward transmission via international travel. Quarantine was a key international travel measure (ITM) used by governments to achieve public health goals. However, the highly varied ways in which quarantine was implemented makes lesson learning for future pandemics challenging. Moreover, most studies overlook the secondary impacts of ITMs on individuals and populations including potential inequities in their distribution. This paper comparatively analyses five countries deemed exemplary in their implementation of quarantine during COVID-19. Building on Damschroder's Consolidated Framework for Implementation Research, we apply eight variables to identify similarities and differences in quarantine use. We drew on our standardized coding of ITMs in the WHO Public Health and Social Measures dataset, and additional on-line searches, to compile data on each variable. Findings show that the five countries were early adopters of quarantine, applied them relatively stringently, and maintained them throughout the emergency phase of the pandemic to effectively advance public health goals. However, the countries differed in how secondary impacts were managed, resulting in the inequitable distribution of opportunity and burden for some individuals and populations. We conclude that exemplary implementation of quarantine during future public health emergencies should consider both public health goals and the equity of secondary impacts.

Essential workers generate and maintain basic services that populations must receive, without interruption, to sustain a healthy, functional society. When SARS-COV-2 spread around the world, mundane low-paid work in essential non-healthcare industries such as supermarkets, became high risk, makeshift and unpredictable. Drawing on recent scholarship in the sociology of work, we conducted 32 interviews to capture how supermarket workers in Australia navigated the trade-offs and moral choices entailed in performing essential roles in non-health settings during a pandemic. We found that, as key assumptions about the resilience of globalised modernity and its supporting systems were tested, supermarket workers found themselves at the centre of experiments and public debates about the effectiveness and appropriateness of different infection control measures. Compensating for a lack of preparedness by governments and corporations, they were forced to accept, and then tasked with resolving inconsistencies between the political economy of low paid work and the moral economy of social provision. Given the experiences of those who found themselves in essential roles outside healthcare, there is an urgent need to reconceptualize what ‘successful’ pandemic preparedness and response entails. Reflecting on their experiences, these workers told us that expressions of solidarity and concern, from those not sharing their position of biological and financial precarity, were of little value. Drawing on the market logics that define their employment as essential and replaceable, the workers we spoke to observed that fair renumeration for risks and better protections were the most important considerations in recasting how societies prepare for future pandemics.

INTRODUCTION:This article reviews the ethical issues surrounding obesity in public health and clinical contexts. We examine how obesity intersects with medical and social norms that raise questions of liberty, fairness, safety, and effectiveness or consequences. SOURCES OF DATA:PubMed, Cochrane Library, and Google Scholar. AREAS OF AGREEMENT:We identify three main areas of agreement that are pertinent to ethical analysis of obesity: stigma is considered harmful, there needs to be a more-than personal responsibility approach, and a general acceptance of a global rise in body weight. AREAS OF CONTROVERSY:There are many areas of controversy, we limit our focus to four: conflicts of interest in the creation of guidelines and policies, mortality rates, whether weight is a meaningful proxy for health, and how to treat childhood obesity. AREAS TIMELY FOR DEVELOPING RESEARCH:Post-genomic explanations, such as exposure to endocrine disrupting toxins, and development of epigenomics and microbiomics in the form of personalized nutrition are two developing areas we identify.

ABSTRACTIntroductionAccess to culturally appropriate healthcare is vital to ensure refugee and migrant women receive optimal care, particularly during the perinatal period. Refugee and migrant women report lower satisfaction with pregnancy care due to language barriers and a perceived lack of understanding of their needs. The aim of this study is to explore how to improve the experiences of migrant and refugee women with maternal health services through the lens of cultural humility.MethodsWorking collaboratively with maternal health service providers and managers and local refugee and migrant women, this research project used a World Café methodology to provide these stakeholders with an opportunity to discuss maternal healthcare in the region. World Café participants (n = 34) included women from multicultural backgrounds (n = 20), maternal healthcare providers such as midwives, social workers and management (n = 5) multicultural healthcare providers (n = 7) and a community‐based birth educator (n = 1). Data were analysed thematically.ResultsA key finding of the World Café was the need for staff training that is co‐designed and co‐delivered with members of multicultural communities and healthcare providers to enhance the practice of cultural humility. Training should focus on women's stories that capture the cultural nuances around pregnancy and birthing, their support needs including trauma‐informed care, and the importance of effective cross‐cultural communication.ConclusionThis research gave refugee and migrant women a voice in future decision‐making, specifically in maternal health staff training. The refugee and migrant women shared their perspectives on how to enhance cultural humility practices in maternity services for them. The research has led to opportunities such as community‐based antenatal classes and improvements in maternity services development strategies.Public ContributionThe project actively engaged with maternal healthcare providers, multicultural and refugee healthcare providers and women from multicultural communities in the design of the project and as participants. Their expertise and experience have been invaluable and have informed pilot programmes that emerged from this study.

Residential aged care facilities (RACF) are sites of high antibiotic use in Australia. Misuse of antimicrobial drugs in RACF contributes to antimicrobial resistance (AMR) burdens that accrue to individuals and the wider public, now and in the future. Antimicrobial stewardship (AMS) practices in RACF, e.g. requiring conformation of infection, are designed to minimise inappropriate use of antibiotics. We conducted dialogue groups with 46 participants with a parent receiving aged care to better understand families’ perspectives on antibiotics and care in RACF. Participants grappled with value trade offs in thinking about their own parents’ care, juggling imagined population and future harms with known short term comfort of individuals and prioritising the latter. Distributive justice in AMR relies on collective moral responsibility and action for the benefit of future generations and unknown others. In RACF, AMS requires value trade-offs and compromise on antimicrobial use in an environment that is heavily reliant on antimicrobial drugs to perform caring functions. In the context of aged care, AMS is a technical solution to a deeply relational and socio-structural problem and there is a risk that carers (workers, families) are morally burdened by system failures that are not addressed in AMS solutions.

In their 2010 book, Lorna Weir and Eric Mykhalovskiy conceptualised the role of vigilance in unknown and emerging infectious disease threats. Theirs is a macro-level account which draws on empirical data to describe vigilance as a set of technical and political arrangements that govern collection, analysis, interpretation and communication of data as it pertains to unknown threats. In this paper we expand their work to detail a conceptual analysis of the role of vigilance at the micro-level during periods of high infectious disease threat. Our data are daily press conferences and associated non-discursive tools in New South Wales (NSW), Australia during times of heightened COVID-19 risk. This paper is a conceptual analysis that draws on theories of vigilance and related concepts to show how a key aspect of vigilance is making previously unseen threats visible or present. Communications formulated and encouraged three types of vigilance as a set of governing relations: institutional or authority-based; individual outward-facing; and individual inward-facing. We also describe the relationship between vigilance and related concepts that are used in response to anticipated public threats. Authority based vigilance involved contact tracing and policing of movement and behaviours. In individual outward facing vigilance people were asked to be alert to, analyse, and react to risk in their immediate environment. Inward facing vigilance required people to gather and react to information about their own behaviours and within their own bodies. There was a relationship between different types of vigilance; as risk increased and authority-based vigilance was less successful in containing the spread of infection, individual vigilance had a stronger role to play. This extension of vigilance at the micro-level sees some of the same unintended consequences as Weir and Mykhalovskiy describe at the global level, particularly in how burdens are inequitably distributed and experienced.