Academic literature on the topic 'Guam. Dept. of Public Health and Social Services'

Abstract Abstract 254 Clinical experience and research with sickle cell patients and those with other genetic diseases suggests that the period of “transition,” in which patients move from pediatric care to adult-centered clinical care, is a period of high health services utilization. Young adult patients may not have learned to effectively manage disease symptoms and may not be connected to a “medical home” or have established a relationship with a primary care physician or adult hematologist. Further, these patients may not have insurance coverage previously provided by parents or by public pediatric insurance programs. As part of a collaborative agreement through the Centers for Disease Control and Prevention (CDC) and the National Heart, Lung & Blood Institute (NHLBI), California and five other states are conducting epidemiologic surveillance to determine the prevalence of hemoglobinopathies as well as health services utilization. Such data are essential to inform allocation of resources to meet the medical and social service needs of patients. Within the state, this project is a collaborative effort among the CA Dept. of Public Health Genetic Disease Screening Program, Children's Hospital Los Angeles and Children's Hospital & Research Center Oakland. Using administrative data obtained as a part of this effort, we describe emergency room (ER) utilization patterns among young adults with sickle cell disease. The CA Office of Statewide Health Planning and Development has collected data on ER utilization for the years 2005 – 2008. Using ICD 9 codes beginning with 282.6 to identify sickle cell-related ER visits during those years, we report usage patterns by patient age, gender, and payer type. To calculate risk of repeat ER visits, we used a negative binomial regression model (with 1 visit as the baseline for analysis, rather than 0 visits, due to the limitations of the data set). The following means and counts are adjusted to account for this shift. Analyses were conducted using SAS 9.1. The mean number of ER visits among sickle cell patients in the data set was 3.36 per year and 54% of visits were made by women, but gender differences in average visits per year per patient (3.18 female, 3.60 male) were not statistically significant. Medi-Cal (Medicaid) was the primary payer for 47% of visits during this time frame, and patients with Medi-Cal averaged nearly one additional visit per year (3.82 visits) compared to patients with other forms of payment (3.04 visits). Among patients seen at any time during the four years and controlling for gender and payer type, we found a 78% increase (IRR 1.78, 95% CI 1.59, 2.00) in risk of visiting the ER a second or subsequent time in a given year among the 20 to 30 year old group compared to all other age groups, a four fold increase (IRR 4.22, 95% CI 3.61, 4.93) in risk of a second or subsequent visit in a year compared to the group aged 10 to 20 years, and a 30% increase (IRR 1.34, 95% CI 1.16, 1.55) compared to the group 30 to 40 years of age. Average number of visits in the transition age group was 4.53 per year, compared to 1.93 per year in the 10 to 20y group and 3.56 in the 30 to 40y age group. The number of individuals visiting the ER per year was higher in this age group compared to the two adjoining age groups (520 individuals on average per year for 20 – 30y, vs. 311 per year for 10 – 20y and 355 for 30 to 40y). The increase in visits per year of age can be seen (Figure 1) to begin at age 18 or 19 and continue to approximately age 30. The proportion of patients with no insurance coverage increased from 8% in the 10 to 20y age category to 19% of patients in the 20 to 30y age category, and remains high for the subsequent age categories (11 to 17%). The transition period from pediatric care to adult care in California sickle cell patients is marked by a dramatic increase in emergency room visits (both more patients visiting and more visits per patient) compared to other age groups. ERs are also visited significantly more often by uninsured sickle cell patients in this age group than other age groups. Patients in this age group would likely benefit from access to a medical home model of care.Figure 1.Mean Annual Number of Visits by Age of Patient among Those Seen in ER with SCD-related ICD 9 Codes, California, 2005–2008Figure 1. Mean Annual Number of Visits by Age of Patient among Those Seen in ER with SCD-related ICD 9 Codes, California, 2005–2008 Disclosures: Coates: Novartis: Research Funding, Speakers Bureau.

Special needs dentistry, also known as special care dentistry, is a specialty of dentistry concerned with the oral health ofpeople who have intellectual disability, or who are affected by other medical, physical, or psychiatric issues. Their additionalneeds may be due directly to their impairment or disability, or to some aspect of their medical history that affects theiroral health, or because their social, environmental or cultural context disables them with reference to their oral health.1According to data from the Indonesian Medical Council, there was an increasing number of Indonesians experiencing chronicdiseases including cancer, stroke, heart disease, renal disease, and diabetes mellitus from 2013 to 2018.2Unfortunately, therewas no data describing other special needs condition aside from medically challenged. This absence of data might makedentists and authorities complacent about this need. Even in the developed country, we found that people with disabilitieswere rarely identified as a priority population group in the public health policy and practice.3Along with increasing awareness of parents and careers, supporting facilities and education such as physiotherapy, speechtherapy, management behavior are much in demand. Though, dental treatment is still not popular. They are prioritizinggeneral health instead of dental and oral health to support short term impact.4Meanwhile, special need persons are proneto poor oral health. People with developmental disabilities have higher rates of cavities, gum disease and tooth loss and thecause is often heartbreakingly simple.5Many of these persons are physically unable to brush their teeth, and many won’t allowsomeone else do it for them.6Others are hampered by medical conditions, or by the side effects of medications they take,which is why regular dental checkups and cleanings are so important.General dentists are reluctant of taking care of special need patientsWe recognized that there are only a few oral health professions that work to improve the oral health of people withspecial needs.7Not only is their access to care almost non-existent in comparison to the general population, but also thefacilities are inadequate and staff lack awareness of oral health matters that may impact those with special needs.8Moreover,parents and careers are confronted with different problems such as, dentists who lack skills and competency in managingpeople with disabilities. Dentists reported having difficulty treating such patients. The complexity in treating patients withspecial needs, the variety of medical conditions or disabilities that require more time or altered delivery methods than theroutine delivery of dental care for the general population,9and sometimes patients required special methods and techniquesto treat their oral health conditions has led to low preparedness and willingness of oral health professionals to treat patientswith special needs.10 It requires a holistic approach that is dentist led in order to meet the complex requirements of peoplewith impairments. It may impact access and thus their oral health, while other complications include inconvenient locationsof dental clinics, transport issues, and cost of dental treatment.11All patients with special needs should have equal access andhigh-quality treatment that focuses on patient safety, patient-centered care, and treatment of all dental needs. Thus, oral healthprofessional needs to have training or special education to handle patients with special needs in an effort to increase oral anddental health of this population.Dental student training improvement is neededIt is written in standard competency of Indonesian dental doctor released by Indonesian Medical Council thatundergraduate dental student must be able to ascertain congenital and hereditary abnormalities in oral cavity, and maintainingoral soft tissue health in patients with compromised medical condition. In fact, there are limitation of opportunity forthem to meet those special patients. Dentists who treat patients with special needs are dental pediatrics; there are no dentalspecialists who specifically manage patients who are adults with special needs.12 Furthermore, for the undergraduate basis,dental school are not well equipped with staff and tools to support that competency. Of the 11 dental schools that have beenaccredited ”A” in Indonesia, there are only 4 dental schools who have structured dental courses on taking care of oral and dentalhealth for person with special needs. This program is restricted to postgraduate student only. There is no syllabus or programfor undergraduate dental students. Lack of training and experience of undergraduate dental students in dealing with patientswith special needs was one of the most reported issues that inhibits the treatment of these patients. Therefore, the access ofdental student to gain knowledge and experience in this major should be improved.Indeed, it is well known that good oral health is conducive to overall well-being. Due to increasing demand of treatingspecial care persons with their complexities, oral health professionals need to improve their skill and knowledge.
 
 Tania Saskianti, DDS, PhD, Ped DentChairperson, Joint Scientific Meeting in Special Care DentistryLecturer, Department of Pediatric DentistryFaculty of Dental Medicine, Universitas Airlangga
 
 REFERENCES1. Friel S, Jamieson L. Political economy, trade relations and health inequalities: lessons from general health. Community Dent Health. 2019; 36(2),152–156 (2019).2. National Institute of Health Research and Development of Ministry of Health Indonesia. Main Result of Basic Health Research 2018. 2018.3. Victorian Health Promoting Foundation. Disability and health inequalities in Australia. VicHealth. 2012; 1–11.4. Anders PL, Davis EL. Oral health of patients with intellectual disabilities: A systematic review. Spec Care Dentist. 2010; 30(3):110–7.5. Minihan PM, Morgan JP, Park A, Yantsides KE, Nobles CJ, Finkelman MD, et al. At-home oral care for adults with developmental disabilities A surveyof caregivers. J Am Dent Assoc. 2014; 145(10):1018–25.6. Eijsink AM, Schipper G, Vermaire JH. A Q-methodology study among caregivers of people with moderate intellectual disabilities on their clients’health care: An example in oral health. J Appl Res Intellect. Disabil. 2018; 31(5):915–26.7. Wyne AH, Hammad N, Splieth C. Oral health knowledge of health care workers in special children’s center. Pak J Med Sci. 2015; 31(1):164–8.8. Hewson ND. Submission 552 - Australian Dental Association Inc - Disability Care and Support - Public inquiry. Aust Dent Assoc. 2010; 1–20.9. Wilson NJ, Lin Z, Villarosa A, Lewis P, Philip P, Sumar B, et al. Countering the poor oral health of people with intellectual and developmentaldisability: a scoping literature review. BMC Public Health. 2019; 19(1):1530.10. Alumran A, Almulhim L, Almolhim B, Bakodah S, Aldossary H, Alakrawi Z. Preparedness and willingness of dental care providers to treat patientswith special needs. Clin Cosmet Investig Dent. 2018; 10:231–6.11. Steinberg BJ. Issues and challenges in special care dentistry. J Dent Educ. 2005; 69:323–4.12. Vertel N, Harrison RL, Campbell KM. Access to Dental Services for Children with Special Health Care Needs: A Pilot Study at the DentalDepartment of BC Children’s Hospital. J Can Dent Assoc. 2017; 83:h6.

Introduction The aim of this paper is to examine whether recent catastrophic tsunamis have driven a cultural shift in the awareness of Australians to the danger associated with this natural hazard and whether the media have contributed to the emergence of “tsunami” as a new Australian catastrophe. Prior to the devastating 2004 Indian Ocean Tsunami disaster (2004 IOT), tsunamis as a type of hazard capable of generating widespread catastrophe were not well known by the general public and had barely registered within the wider scientific community. As a university based lecturer who specialises in natural disasters, I always started my public talks or student lectures with an attempt at a detailed description of what a tsunami is. With little high quality visual and media imagery to use, this was not easy. The Australian geologist Ted Bryant was right when he named his 2001 book Tsunami: The Underrated Hazard. That changed on 26 December 2004 when the third largest earthquake ever recorded occurred northwest of Sumatra, Indonesia, triggering the most catastrophic tsunami ever experienced. The 2004 IOT claimed at least 220,000 lives—probably more—injured tens of thousands, destroyed widespread coastal infrastructure and left millions homeless. Beyond the catastrophic impacts, this tsunami was conspicuous because, for the first time, such a devastating tsunami was widely captured on video and other forms of moving and still imagery. This occurred for two reasons. Firstly, the tsunami took place during daylight hours in good weather conditions—factors conducive to capturing high quality visual images. Secondly, many people—both local residents and westerners who were on beachside holidays and at the coast at multiple locations impacted by the tsunami—were able to capture images of the tsunami on their cameras, videos, and smart phones. The extensive media coverage—including horrifying television, video, and still imagery that raced around the globe in the hours and days after the tsunami, filling our television screens, homes, and lives regardless of where we lived—had a dramatic effect. This single event drove a quantum shift in the wider cultural awareness of this type of catastrophe and acted as a catalyst for improved individual and societal understanding of the nature and effects of disaster landscapes. Since this event, there have been several notable tsunamis, including the March 2011 Japan catastrophe. Once again, this event occurred during daylight hours and was widely captured by multiple forms of media. These events have resulted in a cascade of media coverage across television, radio, movie, and documentary channels, in the print media, online, and in the popular press and on social media—very little of which was available prior to 2004. Much of this has been documentary and informative in style, but there have also been numerous television dramas and movies. For example, an episode of the popular American television series CSI Miami entitled Crime Wave (Season 3, Episode 7) featured a tsunami, triggered by a volcanic eruption in the Atlantic and impacting Miami, as the backdrop to a standard crime-filled episode ("CSI," IMDb; Wikipedia). In 2010, Warner Bros Studios released the supernatural drama fantasy film Hereafter directed by Clint Eastwood. In the movie, a television journalist survives a near-death experience during the 2004 IOT in what might be the most dramatic, and probably accurate, cinematic portrayal of a tsunami ("Hereafter," IMDb; Wikipedia). Thus, these creative and entertaining forms of media, influenced by the catastrophic nature of tsunamis, are impetuses for creativity that also contribute to a transformation of cultural knowledge of catastrophe. The transformative potential of creative media, together with national and intergovernmental disaster risk reduction activity such as community education, awareness campaigns, community evacuation planning and drills, may be indirectly inferred from rapid and positive community behavioural responses. By this I mean many people in coastal communities who experience strong earthquakes are starting a process of self-evacuation, even if regional tsunami warning centres have not issued an alert or warning. For example, when people in coastal locations in Samoa felt a large earthquake on 29 September 2009, many self-evacuated to higher ground or sought information and instruction from relevant authorities because they expected a tsunami to occur. When interviewed, survivors stated that the memory of television and media coverage of the 2004 IOT acted as a catalyst for their affirmative behavioural response (Dominey-Howes and Thaman 1). Thus, individual and community cultural understandings of the nature and effects of tsunami catastrophes are incredibly important for shaping resilience and reducing vulnerability. However, this cultural shift is not playing out evenly.Are Australia and Its People at Risk from Tsunamis?Prior to the 2004 IOT, there was little discussion about, research in to, or awareness about tsunamis and Australia. Ted Bryant from the University of Wollongong had controversially proposed that Australia had been affected by tsunamis much bigger than the 2004 IOT six to eight times during the last 10,000 years and that it was only a matter of when, not if, such an event repeated itself (Bryant, "Second Edition"). Whilst his claims had received some media attention, his ideas did not achieve widespread scientific, cultural, or community acceptance. Not-with-standing this, Australia has been affected by more than 60 small tsunamis since European colonisation (Dominey-Howes 239). Indeed, the 2004 IOT and 2006 Java tsunami caused significant flooding of parts of the Northern Territory and Western Australia (Prendergast and Brown 69). However, the affected areas were sparsely populated and experienced very little in the way of damage or loss. Thus they did not cross any sort of critical threshold of “catastrophe” and failed to achieve meaningful community consciousness—they were not agents of cultural transformation.Regardless of the risk faced by Australia’s coastline, Australians travel to, and holiday in, places that experience tsunamis. In fact, 26 Australians were killed during the 2004 IOT (DFAT) and five were killed by the September 2009 South Pacific tsunami (Caldwell et al. 26). What Role Do the Media Play in Preparing for and Responding to Catastrophe?Regardless of the type of hazard/disaster/catastrophe, the key functions the media play include (but are not limited to): pre-event community education, awareness raising, and planning and preparations; during-event preparation and action, including status updates, evacuation warnings and notices, and recommendations for affirmative behaviours; and post-event responses and recovery actions to follow, including where to gain aid and support. Further, the media also play a role in providing a forum for debate and post-event analysis and reflection, as a mechanism to hold decision makers to account. From time to time, the media also provide a platform for examining who, if anyone, might be to blame for losses sustained during catastrophes and can act as a powerful conduit for driving socio-cultural, behavioural, and policy change. Many of these functions are elegantly described and a series of best practices outlined by The Caribbean Disaster Emergency Management Agency in a tsunami specific publication freely available online (CDEMA 1). What Has Been the Media Coverage in Australia about Tsunamis and Their Effects on Australians?A manifest contents analysis of media material covering tsunamis over the last decade using the framework of Cox et al. reveals that coverage falls into distinctive and repetitive forms or themes. After tsunamis, I have collected articles (more than 130 to date) published in key Australian national broadsheets (e.g., The Australian and Sydney Morning Herald) and tabloid (e.g., The Telegraph) newspapers and have watched on television and monitored on social media, such as YouTube and Facebook, the types of coverage given to tsunamis either affecting Australia, or Australians domestically and overseas. In all cases, I continued to monitor and collect these stories and accounts for a fixed period of four weeks after each event, commencing on the day of the tsunami. The themes raised in the coverage include: the nature of the event. For example, where, when, why did it occur, how big was it, and what were the effects; what emergency response and recovery actions are being undertaken by the emergency services and how these are being provided; exploration of how the event was made worse or better by poor/good planning and prior knowledge, action or inaction, confusion and misunderstanding; the attribution of blame and responsibility; the good news story—often the discovery and rescue of an “iconic victim/survivor”—usually a child days to weeks later; and follow-up reporting weeks to months later and on anniversaries. This coverage generally focuses on how things are improving and is often juxtaposed with the ongoing suffering of victims. I select the word “victims” purposefully for the media frequently prefer this over the more affirmative “survivor.”The media seldom carry reports of “behind the scenes” disaster preparatory work such as community education programs, the development and installation of warning and monitoring systems, and ongoing training and policy work by response agencies and governments since such stories tend to be less glamorous in terms of the disaster gore factor and less newsworthy (Cox et al. 469; Miles and Morse 365; Ploughman 308).With regard to Australians specifically, the manifest contents analysis reveals that coverage can be described as follows. First, it focuses on those Australians killed and injured. Such coverage provides elements of a biography of the victims, telling their stories, personalising these individuals so we build empathy for their suffering and the suffering of their families. The Australian victims are not unknown strangers—they are named and pictures of their smiling faces are printed or broadcast. Second, the media describe and catalogue the loss and ongoing suffering of the victims (survivors). Third, the media use phrases to describe Australians such as “innocent victims in the wrong place at the wrong time.” This narrative establishes the sense that these “innocents” have been somehow wronged and transgressed and that suffering should not be experienced by them. The fourth theme addresses the difficulties Australians have in accessing Consular support and in acquiring replacement passports in order to return home. It usually goes on to describe how they have difficulty in gaining access to accommodation, clothing, food, and water and any necessary medicines and the challenges associated with booking travel home and the complexities of communicating with family and friends. The last theme focuses on how Australians were often (usually?) not given relevant safety information by “responsible people” or “those in the know” in the place where they were at the time of the tsunami. This establishes a sense that Australians were left out and not considered by the relevant authorities. This narrative pays little attention to the wide scale impact upon and suffering of resident local populations who lack the capacity to escape the landscape of catastrophe.How Does Australian Media Coverage of (Tsunami) Catastrophe Compare with Elsewhere?A review of the available literature suggests media coverage of catastrophes involving domestic citizens is similar globally. For example, Olofsson (557) in an analysis of newspaper articles in Sweden about the 2004 IOT showed that the tsunami was framed as a Swedish disaster heavily focused on Sweden, Swedish victims, and Thailand, and that there was a division between “us” (Swedes) and “them” (others or non-Swedes). Olofsson (557) described two types of “us” and “them.” At the international level Sweden, i.e. “us,” was glorified and contrasted with “inferior” countries such as Thailand, “them.” Olofsson (557) concluded that mediated frames of catastrophe are influenced by stereotypes and nationalistic values.Such nationalistic approaches preface one type of suffering in catastrophe over others and delegitimises the experiences of some survivors. Thus, catastrophes are not evenly experienced. Importantly, Olofsson although not explicitly using the term, explains that the underlying reason for this construction of “them” and “us” is a form of imperialism and colonialism. Sharp refers to “historically rooted power hierarchies between countries and regions of the world” (304)—this is especially so of western news media reporting on catastrophes within and affecting “other” (non-western) countries. Sharp goes much further in relation to western representations and imaginations of the “war on terror” (arguably a global catastrophe) by explicitly noting the near universal western-centric dominance of this representation and the construction of the “west” as good and all “non-west” as not (299). Like it or not, the western media, including elements of the mainstream Australian media, adhere to this imperialistic representation. Studies of tsunami and other catastrophes drawing upon different types of media (still images, video, film, camera, and social media such as Facebook, Twitter, and the like) and from different national settings have explored the multiple functions of media. These functions include: providing information, questioning the authorities, and offering a chance for transformative learning. Further, they alleviate pain and suffering, providing new virtual communities of shared experience and hearing that facilitate resilience and recovery from catastrophe. Lastly, they contribute to a cultural transformation of catastrophe—both positive and negative (Hjorth and Kyoung-hwa "The Mourning"; "Good Grief"; McCargo and Hyon-Suk 236; Brown and Minty 9; Lau et al. 675; Morgan and de Goyet 33; Piotrowski and Armstrong 341; Sood et al. 27).Has Extensive Media Coverage Resulted in an Improved Awareness of the Catastrophic Potential of Tsunami for Australians?In playing devil’s advocate, my simple response is NO! This because I have been interviewing Australians about their perceptions and knowledge of tsunamis as a catastrophe, after events have occurred. These events have triggered alerts and warnings by the Australian Tsunami Warning System (ATWS) for selected coastal regions of Australia. Consequently, I have visited coastal suburbs and interviewed people about tsunamis generally and those events specifically. Formal interviews (surveys) and informal conversations have revolved around what people perceived about the hazard, the likely consequences, what they knew about the warning, where they got their information from, how they behaved and why, and so forth. I have undertaken this work after the 2007 Solomon Islands, 2009 New Zealand, 2009 South Pacific, the February 2010 Chile, and March 2011 Japan tsunamis. I have now spoken to more than 800 people. Detailed research results will be presented elsewhere, but of relevance here, I have discovered that, to begin with, Australians have a reasonable and shared cultural knowledge of the potential catastrophic effects that tsunamis can have. They use terms such as “devastating; death; damage; loss; frightening; economic impact; societal loss; horrific; overwhelming and catastrophic.” Secondly, when I ask Australians about their sources of information about tsunamis, they describe the television (80%); Internet (85%); radio (25%); newspaper (35%); and social media including YouTube (65%). This tells me that the media are critical to underpinning knowledge of catastrophe and are a powerful transformative medium for the acquisition of knowledge. Thirdly, when asked about where people get information about live warning messages and alerts, Australians stated the “television (95%); Internet (70%); family and friends (65%).” Fourthly and significantly, when individuals were asked what they thought being caught in a tsunami would be like, responses included “fun (50%); awesome (75%); like in a movie (40%).” Fifthly, when people were asked about what they would do (i.e., their “stated behaviour”) during a real tsunami arriving at the coast, responses included “go down to the beach to swim/surf the tsunami (40%); go to the sea to watch (85%); video the tsunami and sell to the news media people (40%).”An independent and powerful representation of the disjunct between Australians’ knowledge of the catastrophic potential of tsunamis and their “negative” behavioral response can be found in viewing live television news coverage broadcast from Sydney beaches on the morning of Sunday 28 February 2010. The Chilean tsunami had taken more than 14 hours to travel from Chile to the eastern seaboard of Australia and the ATWS had issued an accurate warning and had correctly forecast the arrival time of the tsunami (approximately 08.30 am). The television and radio media had dutifully broadcast the warning issued by the State Emergency Services. The message was simple: “Stay out of the water, evacuate the beaches and move to higher ground.” As the tsunami arrived, those news broadcasts showed volunteer State Emergency Service personnel and Surf Life Saving Australia lifeguards “begging” with literally hundreds (probably thousands up and down the eastern seaboard of Australia) of members of the public to stop swimming in the incoming tsunami and to evacuate the beaches. On that occasion, Australians were lucky and the tsunami was inconsequential. What do these responses mean? Clearly Australians recognise and can describe the consequences of a tsunami. However, they are not associating the catastrophic nature of tsunami with their own lives or experience. They are avoiding or disallowing the reality; they normalise and dramaticise the event. Thus in Australia, to date, a cultural transformation about the catastrophic nature of tsunami has not occurred for reasons that are not entirely clear but are the subject of ongoing study.The Emergence of Tsunami as a “New Australian Catastrophe”?As a natural disaster expert with nearly two decades experience, in my mind tsunami has emerged as a “new Australian catastrophe.” I believe this has occurred for a number of reasons. Firstly, the 2004 IOT was devastating and did impact northwestern Australia, raising the flag on this hitherto, unknown threat. Australia is now known to be vulnerable to the tsunami catastrophe. The media have played a critical role here. Secondly, in the 2004 IOT and other tsunamis since, Australians have died and their deaths have been widely reported in the Australian media. Thirdly, the emergence of various forms of social media has facilitated an explosion in information and material that can be consumed, digested, reimagined, and normalised by Australians hungry for the gore of catastrophe—it feeds our desire for catastrophic death and destruction. Fourthly, catastrophe has been creatively imagined and retold for a story-hungry viewing public. Whether through regular television shows easily consumed from a comfy chair at home, or whilst eating popcorn at a cinema, tsunami catastrophe is being fed to us in a way that reaffirms its naturalness. Juxtaposed against this idea though is that, despite all the graphic imagery of tsunami catastrophe, especially images of dead children in other countries, Australian media do not and culturally cannot, display images of dead Australian children. Such images are widely considered too gruesome but are well known to drive changes in cultural behaviour because of the iconic significance of the child within our society. As such, a cultural shift has not yet occurred and so the potential of catastrophe remains waiting to strike. Fifthly and significantly, given the fact that large numbers of Australians have not died during recent tsunamis means that again, the catastrophic potential of tsunamis is not yet realised and has not resulted in cultural changes to more affirmative behaviour. Lastly, Australians are probably more aware of “regular or common” catastrophes such as floods and bush fires that are normal to the Australian climate system and which are endlessly experienced individually and culturally and covered by the media in all forms. The Australian summer of 2012–13 has again been dominated by floods and fires. If this idea is accepted, the media construct a uniquely Australian imaginary of catastrophe and cultural discourse of disaster. The familiarity with these common climate catastrophes makes us “culturally blind” to the catastrophe that is tsunami.The consequences of a major tsunami affecting Australia some point in the future are likely to be of a scale not yet comprehensible. References Australian Broadcasting Corporation (ABC). "ABC Net Splash." 20 Mar. 2013 ‹http://splash.abc.net.au/media?id=31077›. Brown, Philip, and Jessica Minty. “Media Coverage and Charitable Giving after the 2004 Tsunami.” Southern Economic Journal 75 (2008): 9–25. Bryant, Edward. Tsunami: The Underrated Hazard. First Edition, Cambridge: Cambridge UP, 2001. ———. Tsunami: The Underrated Hazard. Second Edition, Sydney: Springer-Praxis, 2008. Caldwell, Anna, Natalie Gregg, Fiona Hudson, Patrick Lion, Janelle Miles, Bart Sinclair, and John Wright. “Samoa Tsunami Claims Five Aussies as Death Toll Rises.” The Courier Mail 1 Oct. 2009. 20 Mar. 2013 ‹http://www.couriermail.com.au/news/samoa-tsunami-claims-five-aussies-as-death-toll-rises/story-e6freon6-1225781357413›. CDEMA. "The Caribbean Disaster Emergency Management Agency. Tsunami SMART Media Web Site." 18 Dec. 2012. 20 Mar. 2013 ‹http://weready.org/tsunami/index.php?Itemid=40&id=40&option=com_content&view=article›. Cox, Robin, Bonita Long, and Megan Jones. “Sequestering of Suffering – Critical Discourse Analysis of Natural Disaster Media Coverage.” Journal of Health Psychology 13 (2008): 469–80. “CSI: Miami (Season 3, Episode 7).” International Movie Database (IMDb). ‹http://www.imdb.com/title/tt0534784/›. 9 Jan. 2013. "CSI: Miami (Season 3)." Wikipedia. ‹http://en.wikipedia.org/wiki/CSI:_Miami_(season_3)#Episodes›. 21 Mar. 2013. DFAT. "Department of Foreign Affairs and Trade Annual Report 2004–2005." 8 Jan. 2013 ‹http://www.dfat.gov.au/dept/annual_reports/04_05/downloads/2_Outcome2.pdf›. Dominey-Howes, Dale. “Geological and Historical Records of Australian Tsunami.” Marine Geology 239 (2007): 99–123. Dominey-Howes, Dale, and Randy Thaman. “UNESCO-IOC International Tsunami Survey Team Samoa Interim Report of Field Survey 14–21 October 2009.” No. 2. Australian Tsunami Research Centre. University of New South Wales, Sydney. "Hereafter." International Movie Database (IMDb). ‹http://www.imdb.com/title/tt1212419/›. 9 Jan. 2013."Hereafter." Wikipedia. ‹http://en.wikipedia.org/wiki/Hereafter (film)›. 21 Mar. 2013. Hjorth, Larissa, and Yonnie Kyoung-hwa. “The Mourning After: A Case Study of Social Media in the 3.11 Earthquake Disaster in Japan.” Television and News Media 12 (2011): 552–59. ———, and Yonnie Kyoung-hwa. “Good Grief: The Role of Mobile Social Media in the 3.11 Earthquake Disaster in Japan.” Digital Creativity 22 (2011): 187–99. Lau, Joseph, Mason Lau, and Jean Kim. “Impacts of Media Coverage on the Community Stress Level in Hong Kong after the Tsunami on 26 December 2004.” Journal of Epidemiology and Community Health 60 (2006): 675–82. McCargo, Duncan, and Lee Hyon-Suk. “Japan’s Political Tsunami: What’s Media Got to Do with It?” International Journal of Press-Politics 15 (2010): 236–45. Miles, Brian, and Stephanie Morse. “The Role of News Media in Natural Disaster Risk and Recovery.” Ecological Economics 63 (2007): 365–73. Morgan, Olive, and Charles de Goyet. “Dispelling Disaster Myths about Dead Bodies and Disease: The Role of Scientific Evidence and the Media.” Revista Panamericana de Salud Publica-Pan American Journal of Public Health 18 (2005): 33–6. Olofsson, Anna. “The Indian Ocean Tsunami in Swedish Newspapers: Nationalism after Catastrophe.” Disaster Prevention and Management 20 (2011): 557–69. Piotrowski, Chris, and Terry Armstrong. “Mass Media Preferences in Disaster: A Study of Hurricane Danny.” Social Behavior and Personality 26 (1998): 341–45. Ploughman, Penelope. “The American Print News Media Construction of Five Natural Disasters.” Disasters 19 (1995): 308–26. Prendergast, Amy, and Nick Brown. “Far Field Impact and Coastal Sedimentation Associated with the 2006 Java Tsunami in West Australia: Post-Tsunami Survey at Steep Point, West Australia.” Natural Hazards 60 (2012): 69–79. Sharp, Joanne. “A Subaltern Critical Geopolitics of The War on Terror: Postcolonial Security in Tanzania.” Geoforum 42 (2011): 297–305. Sood, Rahul, Stockdale, Geoffrey, and Everett Rogers. “How the News Media Operate in Natural Disasters.” Journal of Communication 37 (1987): 27–41.