Boyd Hunter

Background: Cancer pain affects approximately 44.5% of all patients with malignancy and up to 55–65% of those with advanced or metastatic disease; a substantial proportion remain inadequately controlled with conventional pharmacological approaches alone. Peripheral nerve stimulation (PNS), a minimally invasive neuromodulatory strategy, has emerged as a potential opioid-sparing analgesic option for the perioperative management of oncologic surgical patients. Objectives: This narrative review synthesizes current evidence on the application, mechanisms, clinical efficacy, safety, and integration of temporary and permanent PNS systems in cancer patients, with specific focus on cancer-specific pain syndromes, key clinical studies, opioid-sparing immunological implications, evidence quality, and directions for future research. Methods: As a narrative review, this work was structured in accordance with the Scale for the Assessment of Narrative Review Articles (SANRA) to ensure methodological transparency. A focused, non-systematic literature search of PubMed/MEDLINE, Embase, and the Cochrane Library was performed from database inception through March 2026, supplemented by hand-searching of reference lists and targeted retrieval of clinical practice guidelines. Sources were selected on the basis of relevance to PNS or closely analogous peripheral neurostimulation modalities in oncologic, perioperative, or chronic pain contexts. Evidence was synthesized narratively, with each cited study graded using the Oxford Centre for Evidence-Based Medicine (OCEBM) 2011 Levels of Evidence framework to enable transparent calibration of confidence. Results: Available preliminary and largely extrapolated evidence supports PNS as a promising but not yet established useful adjunct in oncologic perioperative care; because cancer-specific data rest substantially on a single pilot study (n = 12), one retrospective review (n = 15), and extrapolation from non-cancer populations, these conclusions should be regarded as hypothesis-generating. Randomized controlled trial data from non-cancer cohorts demonstrate opioid consumption reductions of approximately 80–90% in the PAINfRE trial, while the post-amputation trial demonstrated ≥50% pain-relief responder rates and reductions in pain interference, with clinically meaningful improvements in pain and function. Oncologic-specific pilot and retrospective evidence confirms feasibility and a 58–67% success rate across diverse cancer pain subtypes. Conclusions: The opioid-sparing properties of PNS carry additional biological plausibility for preserving perioperative antitumor immune function. High-quality prospective trials specifically designed for oncologic surgical populations remain needed to establish evidence-based recommendations.

This paper presents an analysis of Indigenous employment trends in Australia from 1981 to 2021, using nine iterations of 5-yearly Census data. It offers the most consistent long-term estimates available and situates these trends within broader shifts in the Australian labour market. Three key findings emerge. First, the overall increase in Indigenous employment over the 40-year period is primarily driven by the substantial rise in employment among Indigenous women, accounting for over 93% of the total growth. Second, employment rates for Indigenous men have remained largely stagnant, highlighting persistent structural barriers. Third, geographic and educational disparities continue to constrain Indigenous labour market participation, particularly in remote areas. From a long-term perspective, existing data sources offer valuable insights into employment trends and provide a foundational platform for understanding systemic patterns over time. At the same time, this long-term view invites critical reflection on the evolving nature of data collection and interpretation, particularly in relation to complex, identity-based variables. Recognizing both the contributions and limitations of current datasets underscores the importance of developing innovative, culturally responsive methodologies that can more accurately capture the multifaceted drivers of employment. This includes attending to dynamic factors such as the increasing visibility and self-determination of Indigenous identity, which may influence statistical representations and policy responses in nuanced ways.

The Economics and the Dreamtime was a landmark in Australian Economic History where Noel Butlin elevated awareness of the central importance of Indigenous economic history. It was a sprawling inter‐disciplinary work that used economic tools to understand Indigenous society before first contact and in the early colonial period. This article revisits that book to provide a critical evaluation of the major contributions of Butlin's research on Indigenous Australians. His primary contribution was to make Indigenous people more visible in the Australian economy in the early colonial period. He created a unique backcasting methodology that allowed Indigenous population to be estimated in the first six decades of the colony based on depopulation from disease, resource loss and frontier violence. I argue that the two main shortcomings of Butlin's research is that his method used colonial estimates of the population and that the population estimates are not sufficiently geographically differentiated. The main criticism of Butlin's research in the literature is that it is too speculative. However, his methodological innovation allows considerable transparency in the assumptions used and can create a range of plausible estimates that give us a sense of the unreliability of the existing population estimates. Alternative methodologies based on estimating population densities in 1788 from anthropological evidence are historically point estimates, which do not provide a sense of how uncertain the estimates might be. The way forward for this debate is to combine Butlin's demographic backcast methodology with population density estimates that take into account the selective mortality from disease and frontier violence. Finally, in order to create a truly Australian Economic History, it is necessary to also augment the methodology to incorporate Indigenous perspectives into the analysis and to utilise a local geography that acknowledges the diversity of Indigenous Australia.

Indigenous employment has been the subject of numerous policies in Australia, with governments aiming to increase the workforce participation rate amongst Indigenous people in recent years. Indigenous‐owned businesses, formally defined as businesses that are at least 50% Indigenous‐owned, have been demonstrated in previous research to maintain substantially higher levels of proportional Indigenous employment than non‐Indigenous businesses. This suggests that Indigenous‐owned businesses maintain work environments that are more supportive of and conducive to Indigenous employment, meriting the influence of Indigenous‐owned businesses' workplace practices in future Indigenous employment policy design. Using administrative data from two Indigenous business registries (Black Business Finder and Supply Nation), this paper provides an updated empirical analysis of the Indigenous business sector. This paper demonstrates that Indigenous‐owned businesses of all sizes, industries, locations and profit statuses consistently average proportional Indigenous employment rates higher than the Indigenous proportional population. Of all the people employed in Supply Nation‐listed businesses, over 35% are Indigenous. The potential impact of the Indigenous Procurement Policy is illustrated by differentials in the size of businesses and their capacity to employ Indigenous staff. This paper provides analysis of the Indigenous business sector that can inform future policy direction for both Indigenous employment and Indigenous business policies.

The digital divide between Indigenous and other Australians describes the unequal access to information and communications technology (ICT) between these groups. Historically, researchers have focused on acquiring new technology, but we argue that it is important to understand all the dynamics of digital usage, including the loss of access to ICT within a household. For long-lived technology such as internet access, it is particularly important to consider that retention of access to the technology. This paper conducts a longitudinal analysis of changes in internet usage for Indigenous and non-Indigenous Australian households using the Australian Census Longitudinal Dataset, 2006–2016. While earlier work analyses the digital divide in terms of ‘diffusion’ or adoption of ICT, this paper shows that the failure to retain internet access is also important in driving the digital divide. The dynamics of the digital divide have important and ongoing implications for addressing broader socioeconomic disadvantages experienced by Indigenous Australians. The COVID-19 pandemic underscores the urgency of policy addressing the digital divide, given the renewed momentum for remote learning and telecommuting.

Although the environmental and economic impacts of drought have been widely studied, few large‐scale studies have examined the broader social impacts of drought. To fill this knowledge gap, the Australian Institute of Family Studies undertook the Regional and Rural Families Survey in 2007, when a significant part of Australia was experiencing a severe drought. This paper analyses that survey to measure the extent to which drought affects a range of economic, health and social outcomes. Drought is found to have a substantial negative economic and health impact on farmers and others employed in the agricultural sector. There is some evidence that groups that are not employed in agriculture are adversely affected, with a widespread loss of services in drought‐affected areas and some marginal labour market groups (e.g. carers) experiencing poor employment outcomes in a drought‐affected local economy. Policymakers need to take these impacts into account in designing effective responses to future droughts.

We examine the high levels of financial stress among Indigenous populations in Australia. We estimate separate models for the determinants of financial stress for Indigenous and non‐Indigenous households and show the importance of separately considering Indigenous disadvantage. We use these models to build equivalence scales for both groups. We find evidence consistent with financial stress being exacerbated by demand sharing (‘humbugging’). The evidence also suggests that financial stress is reduced by engagement in traditional hunting and gathering activities.

Research about the demand for Indigenous labour and the relationship of Indigenous workers to their employers is relatively scarce. Even less is known about Indigenous businesses. Supply Nation defines an Indigenous business as those where Indigenous stakeholders hold majority equity, but some researchers have argued that this definition could be relaxed to include businesses in which Indigenous people hold only half the equity in the enterprise. This article uses data from the Industry Capability Network Queensland, which has collected basic business information on a large number of businesses operating in Queensland. The findings reveal that Indigenous businesses have substantially better outcomes for Indigenous employment than non-Indigenous businesses – a result that holds even when the definition of Indigenous business is relaxed. The article also documents how Indigenous employment is concentrated in larger businesses, in particular industry sectors. Non-Indigenous micro-businesses employ relatively few Indigenous workers, and future research can usefully explore why this is the case. To understand the issues involved, it will be necessary to collect multi-level data that link detailed information on employers and employees (including a substantial sample of Indigenous workers).