BackgroundGlobally, the provision of equitable outcomes for women with breast cancer is a priority for governments. However, there is growing evidence that a socioeconomic status (SES) gradient exists in outcomes across the breast cancer continuum – namely incidence, diagnosis, treatment, survival and mortality. This systematic review describes this evidence and, because of the importance of place in defining SES, findings are limited to the Australian experience.MethodsAn on-line search of PubMed and the Web of Science identified 44 studies published since 1995 which examined the influence of SES along the continuum. The critique of studies included the study design, the types and scales of SES variable measured, and the results in terms of direction and significance of the relationships found. To aid in the interpretation of results, the findings were discussed in the context of a systems dynamic feedback diagram.ResultsWe found 67 findings which reported 107 relationships between SES within outcomes along the continuum. Results suggest no differences in the participation in screening by SES. Higher incidence was reported in women with higher SES whereas a negative association was reported between SES and diagnosis. Associations with treatment choice were specific to the treatment choice undertaken. Some evidence was found towards greater survival for women with higher SES, however, the evidence for a SES relationship with mortality was less conclusive.ConclusionsIn a universal health system such as that in Australia, evidence of an SES gradient exists, however, the strength and direction of this relationship varies along the continuum. This is a complex relationship and the heterogeneity in study design, the SES indicator selected and its representative scale further complicates our understanding of its influence. More complex multilevel studies are needed to better understand these relationships, the interactions between predictors and to reduce biases introduced by methodological issues.

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Economic justification for varying fertiliser inputs to match crop yield potential of different areas or zones in fields is limited by lack of understanding of the relationship between the extent of within-field yield variation and economic gains from zone vs. uniform management. We conducted a survey of yield monitor data from 199 fields on the northern sandplain of the wheatbelt in Western Australia in order to document the extent of sub-field yield variation and test if variation is related to attributes such as yield and field area. The economic significance to zone management of the yield variation found in the survey along with variation in size of management zones, costs and prices, and soil fertility status was then assessed using a simple nutrient response model. Considerable variation occurred in yield within fields. Standard deviation varied from 0.2 to 1.2 t/ha and the difference in yield between the highest and lowest yielding thirds of each field varied from 0.5 t/ha in the least to 3.3 t/ha in the most variable field. Both small and large (10 to 172 ha), and low and high (0.6 to 4.9 t/ha) yielding fields exhibited variation that was potentially worth managing from an economic standpoint. Model results showed that the larger the difference in potential yield between zones, the greater the economic benefit from zone management. While yield contrast within fields can be increased with more zones, the economic advantage of more zones was small for the cases studied here. The potential economic benefits (from <$5/ha to $44/ha) increased with higher grain and fertiliser prices and depended on levels of soil nutrients in the different zones. Capturing the full value of the economic benefits in practice requires an accurate indication of yield potential in the different zones at the time when the fertiliser decision is being made. Yield maps can be utilised by growers to give estimates of within-field variation in yield potential and hence potential economic gains from variable rate application of fertiliser.

Changing unsustainable natural resource use in agricultural landscapes is a complex social–ecological challenge that cannot be addressed through traditional reductionist science. More holistic and inclusive (or transdisciplinary) processes are needed. This paper describes a transdisciplinary project for natural resource management planning in two regions (Eyre Peninsula and South Australian Murray-Darling Basin) of southern Australia. With regional staff, we reviewed previous planning to gain an understanding of the processes used and to identify possible improvement in plan development and its operation. We then used an envisioning process to develop a value-rich narrative of regional aspirations to assist stakeholder engagement and inform the development of a land use management option assessment tool called the landscape futures analysis tool (LFAT). Finally, we undertook an assessment of the effectiveness of the process through semi-structured stakeholder interviews. The planning process review highlighted the opinion that the regional plans were not well informed by available science, that they lacked flexibility, and were only intermittently used after publication. The envisioning process identified shared values—generally described as a trust, language that is easily understood, wise use of resources, collaboration and inclusiveness. LFAT was designed to bring the best available science together in a form that would have use in planning, during community consultation and in assessing regional management operations. The LFAT provided spatially detailed but simple models of agricultural yields and incomes, plant biodiversity, weed distribution, and carbon sequestration associated with future combinations of climate, commodity and carbon prices, and costs of production. Stakeholders were impressed by the presentation and demonstration results of the software. While there was anecdotal evidence that the project provided learning opportunities and increased understanding of potential land use change associated with management options under global change, the direct evidence of influence in the updated regional plan was limited. This project had elements required for success in transdisciplinary research, but penetration seems limited. Contributing factors appear to be a complexity of climate effects with economic uncertainty, lack of having the project embedded in the plan revision process, limited continuity and capacity of end users and limited after project support and promotion. Strategies are required to minimise the controlling influence that these limitations can have.