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Describes the contribution of a series of focus groups and a revised discussion paper to the evolution of health care reform in South Australia. Impact of health care reform on health care agencies; Reasons for the struggles of evaluators to evaluate health care reform programs; Relationships between bureaucracy and health care service providers.

John Davies Thomas (1844-1893) described a two-ounce drop-bottle for chloroform in 1872 while he was a resident medical officer at University College Hospital, London. After working as a ship's surgeon, he settled in Australia. In May 1875, Thomas presented a paper on the mortality from ether and chloroform at a meeting of the Medical Society of Victoria in Melbourne, Victoria. Surveys conducted in Europe and North America had established that the mortality from chloroform was eight to ten times higher than that from ether. At that time, chloroform was the most widely administered anaesthetic in Australia. Thomas' paper was published in The Australian Medical Journal and reprinted by the Medical Society of Victoria for distribution to hospitals in the Colony of Victoria. Later that year, Thomas moved to Adelaide, South Australia, where he may have been influential at the Adelaide Hospital in ensuring that ether was administered more often than chloroform. It does not appear that Thomas' papers on anaesthesia had a significant effect on the conduct of anaesthesia in Victoria or New South Wales. [ABSTRACT FROM AUTHOR]

This paper provides an unexpected and extraordinary example of research data from a Photovoice project conducted with ex-prisoners in South Australia. It focusses on the contribution made by one of the participants who chose the pseudonym 'Deer'. Deer joins me as a co-author, her voice shines in this paper, albeit through a pseudonym she chose for the project. Photovoice, a qualitative research method, uses a feminist framework and typically produces rich thick accounts of lives and experiences that cannot be adequately captured by quantitative research. Both qualitative and quantitative methods of research data collection each have merits, but qualitative approaches tend to engage the researcher, participant and later the reader on a more personal level. Moreover, unexpected findings are more likely to arise when researchers ask participants to express what they believe is important to their experience. This paper provides such an example, where the unexpected gift of poetry adds a deeper dimension to research findings. [ABSTRACT FROM AUTHOR]

Using a Design Thinking (DT) approach, the ChallenGE Project in South Australia (SA) was an innovative professional learning (PL) program that was developed, implemented, and researched by three Senior Educational Consultants from the Association of Independent Schools of South Australia (AISSA) and one academic from Flinders University over three years. The aim was to support participating schools (n=27) to improve outcomes for their highly able learners (HALs). The ChallenGE Design- Based Research (DBR) project developed principles and a framework for contextualised PL in gifted education through an inductive qualitative manual coding analysis of participants' self-reported learning. This paper, applying the format for reporting DBR studies recommended by Jen et al. (2015) explains the goals and elements of the innovation, the setting within which it was implemented, a description of each phase, the outcomes, and the lessons learned. This research study contributes to an expanded view of effective PL in gifted education using insights gained from a DT approach. [ABSTRACT FROM AUTHOR]

Objectives: The COVID-19 pandemic poses significant risks to the vulnerable patient population supported by community mental health (CMH) teams in South Australia. This paper describes a plan developed to understand and mitigate these risks.Methods: Public health and psychiatric literature was reviewed and clinicians in CMH teams and infectious disease were consulted. Key risks posed by COVID-19 to CMH patients were identified and mitigation plans were prepared.Results: A public health response plan for CMH teams was developed to support vulnerable individuals and respond to the COVID-19 pandemic. This plan will be reviewed regularly to respond to changes in public health recommendations, research findings and feedback from patients and clinicians.Conclusions: The strategic response plan developed to address risks to vulnerable patients from COVID-19 can assist other CMH services in managing the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Migration is a complex experience that differs from one migrant group to the other. Migrants have often been mistakenly seen as one homogenous group with shared experience, overlooking the diversity that exists within their visa conditions, cultural backgrounds and gender category. The generalization of the migration experience among all migrant groups usually overlooks the very specific issues arising within different types of migration and within different migrant groups. Generally, research on migrant women often portrays a victim image of them and neglects their strength and resilience. This paper addresses some of the gaps in the literature concerned with generalization and concepts of resilience. Utilizing a qualitative feminist methodology, conversations were made with eight Iraqi sponsored women living in Adelaide who arrived in Australia holding a Temporary Spouse Visa (TSV), with no specified period of entry. Within the focus on Iraqi women, the paper explores two concepts: challenges of a TSV within marriage migration and patterns of resilience amongst Iraqi sponsored women. The core argument of this paper is that the Australian TSV category which facilitates marriage migration is politically discriminative against women and significantly contributes to women's vulnerability to abuse. [ABSTRACT FROM AUTHOR]

Home and belonging are emerging areas of social work research. Very few studies in the social work discipline critically examine how home is broadly experienced or understood. Whilst the notion of home is contested, social work researchers can explore meanings of home in their quest to understand how social workers can contribute to developing a sense of community and belonging. This article presents the findings of an intersectional qualitative study that explored meanings of home in a capital city of Australia, drawing implications for social work. A thematic analysis of 13 semi-structured interviews found that home was experienced as both a material and emotional place. Home was associated with (1) the material security of housing, including homeownership and the safety of suburbs and neighbourhoods; (2) a connection to multiple homes and the making of home in migration, such as when re-settling in a new country; (3) belonging to a family, including emotional connections to lost family members or acknowledging a supportive family and (4) religious, ethnic and cultural self-expression. This paper argues that researching meanings of home is relevant to social work as a discipline that espouses human rights and social justice because a sense of home is central to the politics of belonging to a safe community and society. [ABSTRACT FROM AUTHOR]

Summary: This article reports on a project that explored the complexities of engaging and working with men when domestic violence is noticed in a couple counselling context. There are concerns and controversy surrounding domestic violence and couple counselling; however, it has also been noted that many couples want to remain together and voluntarily approach services for couple counselling. The project reported on in this paper adopted a qualitative methodological design influenced by participatory action research ideas and memory work methods to analyse engagement of men used by nine social work family relationship counsellors. Findings: Counsellors used narrative therapy ideas to maintain a stance of curiosity when working with couples when domestic violence was noticed. Curiosity was described as a way of opening up conversations to explore power differences and gender relations and as a method to balance safety with engagement. Specific engagement strategies identified included identifying ethics as a conversation point to explore the effects of power, violence and fear perpetrated by the male partners; exploring dynamics of power and control in relationships and exploring other possibilities in relationships. Applications: Alongside debates about the effectiveness and success in domestic violence men's perpetration intervention programmes, there is a need to look at engagement of men more broadly. Family relationship counselling can be viewed as an opportunity to engage with men where domestic violence is noticed. Engagement of men is an important piece of practice that can potentially set up effective and successful behaviour change when responding to domestic violence. [ABSTRACT FROM AUTHOR]

Objectives:: Facilitated Learning Groups (FLGs) were introduced by the South Australian Psychiatry Branch Training Committee in 2016 to provide support for trainees. These incorporated Balint group principles but also had roles that extended beyond a traditional Balint group. This paper reports an evaluation of these groups after their first 12 months.Methods:: An evaluation form was sent to all trainee participants, seeking quantitative and qualitative feedback about their experience.Results:: The majority of trainees found the FLGs to be beneficial. A thematic analysis of the written feedback revealed several key benefits for the participants, including having access to a senior psychiatrist who was outside of training and supervision, mixing with trainees across years and regions, and the capacity to discuss difficult work environments.Conclusions:: A forum for trainees to develop reflective practice and discuss challenging issues, which is not involved in their assessment, was experienced positively by the majority of participants and should be considered for wider adoption across Australia and New Zealand. [ABSTRACT FROM AUTHOR]

Objectives: This paper reports a pilot study exploring the benefits of offering sensory modulation within a mental health emergency setting for consumers experiencing distress during a psychiatric presentation.Methods: Seventy-four consumers with a mental health presentation reported on their sensory modulation use experiences during their stay in a South Australian tertiary teaching hospital emergency department. An evaluation form was used to document use of items, self-reported distress pre and post sensory modulation use, and other consumer experiences.Results: Consumers used between one and six sensory items for a median duration of 45 min. There was a statistically significant reduction ( t(73) = 15.83, p < .001) in self-reported distress post sensory modulation use, and consumers also reported that use was helpful, distracting, calming and assisted in managing negative emotions and thoughts.Conclusions: The results demonstrate the potential value of sensory-based interventions in reducing behavioural and emotional dysregulation in an emergency setting whilst also promoting consumer self-management strategies. [ABSTRACT FROM AUTHOR]

This paper is the second in a series looking at understanding the factors controlling and predicting marine aerosol concentration on land. It looks at results from three transects across the Australian continent. In each transect, the airborne salinity was measured, using the wet candle method at distances from 10 m to 40-300 km from the coast. The positions of the transects were selected to give a significant variation in the factors controlling salt production and transport. For example, one transect in South Australia was established where both high whitecap activity is likely to promote salt production and flat terrain and prevailing winds are likely to favour transport. Another, in Queensland, was established where calm seas will limit salt production and very seasonal winds and high relative humidity and rainfall will limit transport. On the basis of this experimental study, the general validity of the fundamental concepts put forward in Part 1 is assessed. Further, the feasibility of building a mathematical model to predict salinity is determined and the main factors causing variations in salinity on land are outlined. The results are then used to assist in the interpretation of previous work in the literature. [ABSTRACT FROM AUTHOR]

Objectives: This paper outlines the use of psychodynamic psychotherapy as an adjunct to treatment as usual for addressing challenging behaviours in a patient with schizophrenia under the care of a community mental health team (CMHT) in South Australia.Methods: Ms P suffered from schizophrenia and demonstrated challenging behaviours in the context of being administered depot medication under a community treatment order (CTO). Multiple attempts at addressing non-compliance and consistently disruptive behaviour through conventional methods had failed. Consequently, the novel approach of fortnightly psychodynamic psychotherapy sessions was trialled for 5 months, augmenting treatment as usual.Results: Psychodynamic psychotherapy proved effective for this patient. With treatment, she showed an improved compliance and overall engagement. Additionally, consequent to regularly receiving medication, her mental state improved and hospitalisations decreased.Conclusions: Further research could lead to a better understanding of how and in what contexts, psychodynamic therapy and psychodynamic thinking can be utilised in the public health system. [ABSTRACT FROM AUTHOR]

The paper examines the socio-ecological effects of formal and infor mal regulatory strategies in and around a South Australian Marine Park. It discusses some of the problematic dichotomies these regulations are founded on and help to perpetuate. The paper employed a single case study methodology and relied particularly on the data derived through qualitative field work. Data sources for the study included legislation, field notes, media promotions, photographs, brochures and phone inter views. Data was obtained directly from the principle research site and from key agencies involved in regulating activities at this site. A key con clusion of the study is that Park infrastructures and prescriptions help reinforce the idea that 'humans' and 'nature' are discrete entities rather than part of a continuous flow of matter-energy. In addition, it was con cluded that this delineation has serious implications for the way human/environment interactions are regulated 'outside' these areas. [ABSTRACT FROM AUTHOR]

This paper discusses an ethnographic engagement with Southern Sudanese men and their experiences of resettlement as refugees in Adelaide, Australia. They use the phrase ‘walking the line’ to convey the multiple challenges of reconciling one's past within thepresent contexts of life in a new host country. This geographic metaphor hints at the contested borderlands of masculinity, social relations and raising children that highlight the dynamic complexities related to gender and institutional power. The participant voices provide helpful perspectives on the endeavour of forging one's identity in forced migration and resettlement contexts. [ABSTRACT FROM PUBLISHER]

Objective: The aim of this paper was to identify attitudes towards higher degrees by research (PhDs and Masters) among psychiatrists in South Australia, with the objective of identifying possible ways to increase the uptake of higher degrees in that population. Method: A survey questionnaire was designed, piloted and sent to all members of the Royal Australian and New Zealand College of Psychiatrists in South Australia. Results: The response rate was 54.9% (n == 179). The sample included 99 individuals who had completed or considered completing a higher degree and 80 individuals who had not considered this. Responses to items were collated separately according to these two groups. Qualitative data were analysed thematically across the sample. Service demands, financial pressures and time constraints, along with a number of other factors including a lack of mentors and role models, were identified as issues in both quantitative and qualitative data. Conclusions: A number of positive attitudes were expressed regarding higher degrees by research, but a number of negative opinions were also expressed. The study achieved its aim of identifying attitudes, but ways in which to increase higher degrees by research for psychiatrists remains an area for further exploration. [ABSTRACT FROM AUTHOR]

Current approaches to valuing nature within environmental and natural resource management are based on and limited by Eurocentric knowledge and experience of northern temperate nature. Methods based on separation and domination marginalise other ways of knowing nature and thinking about value. The aims of this paper are to unsettle current ways of thinking about water values; to decentre Eurocentric thinking about water management; and to present a different way of thinking about values associated with water, based on an empirical study of the Lake Eyre Basin in central Australia. The paper takes a multidisciplinary approach, drawing on multiple knowledges of Australian water, including indigenous, local settler, and scientific knowledge, and on lessons from Australian Aboriginal people and the academic discourse of Aboriginal Studies. In particular, it considers how a focus on variability--a concept emerging from the Australian landscape (rather than from northern temperate landscapes)--might foster different thinking about water and value. Variability takes as a starting point the diversity, change, and complexity of water and values, as opposed to separation and domination. This focus highlights two points currently marginalised in dominant practice of environmental valuation: that the variability of Australian water regimes is valued, and that values themselves are characterised by variability. [ABSTRACT FROM AUTHOR]

Objective: The aim of this paper is to provide a viewpoint regarding the marketing of pharmaceutical agents to psychiatrists and examine the results of a brief survey of the nature of booths, and gifts they offered, during 2009 RANZCP Congress in Adelaide. Conclusions: The pharmaceutical industry is highly organized and scientifically sophisticated. Efforts to influence our prescribing are likely to have a proven scientific base and to be responsive to evidence. [ABSTRACT FROM AUTHOR]

Background Self-management is seen as a primary mechanism to support the optimization of care for people with chronic diseases such as symptomatic vascular disease. There are no established and evidence-based stroke-specific chronic disease self-management programs. Our aim is to evaluate whether a stroke-specific program is safe and feasible as part of a Phase II randomized-controlled clinical trial. Methods Stroke survivors are recruited from a variety of sources including: hospital stroke services, local paper advertisements, Stroke South Australia newsletter (volunteer peer support organization), Divisions of General Practice, and community service providers across Adelaide, South Australia. Subjects are invited to participate in a multi-center, single-blind, randomized, controlled trial. Eligible participants are randomized to either; • standard care, • standard care plus a six week generic chronic condition self-management group education program, or, • standard care plus an eight week stroke specific self-management education group program. Interventions are conducted after discharge from hospital. Participants are assessed at baseline, immediate post intervention and six months. Study Outcomes The primary outcome measures determine study feasibility and safety, measuring, recruitment, participation, compliance and adverse events. Secondary outcomes include: • positive and active engagement in life measured by the Health Education Impact Questionnaire, • improvements in quality of life measured by the Assessment of Quality of Life instrument, • improvements in mood measured by the Irritability, Depression and Anxiety Scale, • health resource utilization measured by a participant held diary and safety. Conclusion The results of this study will determine whether a definitive Phase III efficacy trial is justified. [ABSTRACT FROM AUTHOR]

Objective: The aim of this paper is to examine the role of consumers as service providers and to describe the successful employment of peer support workers in a public mental health service. Conclusions: The Peer Support Worker program in Adelaide, South Australia is consistent with evidence obtained from previous research in demonstrating the successful training and employment of consumers as peer workers in a public mental health service. [ABSTRACT FROM AUTHOR]

Objective: The aim of this paper is to examine an 1862 report of the Adelaide Lunatic Asylum and commentary on its establishment. Conclusions: Many of the administrative issues surrounding psychiatric practice then remain pertinent today. [ABSTRACT FROM AUTHOR]

Objective: In the current climate of growing concern for the harmful effects of cigarette smoking and passive smoking, the high prevalence of this activity within psychiatric settings can no longer be ignored. This paper reviews the findings of research in a public stand-alone psychiatric facility in South Australia where significant legal and occupational health, safety and welfare (OHSW) concerns were apparent for both patients and staff as a consequence of the strong culture of smoking in that setting. The aim of this paper is to raise awareness of this significant health and legal issue and to inform policy and practice change. Method: This paper reviews legal issues associated with smoking in psychiatric settings and presents relevant findings from previous studies in which in-depth interviews and observations in community and inpatient psychiatric settings were conducted. Results: Significant legal and OHSW concerns were apparent for both patients and staff in all settings. The potential for future litigation was high. Conclusions: There are a number of legal and OHSW implications of continued smoking by staff and patients within mental health settings. Several administrative, clinical and cultural practices need to change within this system of care in order to improve overall patient wellbeing and to avoid the potential for litigation by patients and staff. [ABSTRACT FROM AUTHOR]

This paper summarises the results of a case study undertaken at a polymetallic deposit in South Australia. Multivariate geostatistical techniques were used to predict better the block sulphur grades. The necessity to utilise a multivariate geostatistical approach was dictated by the presence of two different generations of sulphur assays. The integration of these data sets was undertaken using the kriging with external drift and collocated co-kriging methods. Efficiencies of the multivariate methods have been tested using various combinations between data generations. Results of these tests have been compared with the conventional ordinary kriging estimates and reconciled against the drill hole data. This study shows that both tested multivariate methods – kriging with external drift and collocated cokriging – significantly improved the accuracy of grade estimation when compared with conventional ordinary kriging. In particular, a global average grade of the study area estimated by the multivariate methods was similar to expected true values even when the amount of new data available is less than 10% of all samples. The ordinary kriging technique when applied to such datasets containing less than 10% of the new samples and more than 90% of the old (biased) samples yields biased results which are largely affected by the more abundant old (biased) assays. [ABSTRACT FROM AUTHOR]

Alternative dispute resolution (ADR) is attracting increasing attention in the United States as a means of allowing both unionized and nonunionized employees to discuss their grievances in the presence of outside third parties. Public interest groups have looked for mechanisms to accomplish this objective. For some time, South Australia has used a dispute resolution system that provides both mediation and arbitration for individual workers. As good as this system is in overall intent, it falls short of putting people back on their jobs or providing adequate compensation in cases of unfair dismissal. This paper discusses the operation of the mediation step in the unfair-dismissal process of South Australia. [ABSTRACT FROM AUTHOR]

The article presents information regarding the annual meeting of the Australia and New Zealand Division of the International Association for Dental Research (IADR) that was held in Adelaide, Australia, from September 27, 1999 through September 29, 1999. A list of people who took part in the event is presented, as are abstracts for papers that were presented.

Rehabilitation of incarcerated men is a primary focus of correctional systems across the world. The present pilot study examined the effect of participation in the South Australian Violence Prevention Program (VPP) on recidivism trajectories. Individuals who participated in the VPP were significantly less likely to engage in violent recidivism, with the greatest effect observed between Aboriginal and/or Torres Strait Islanders relative to similarly matched comparators. In addition, the types of violent crimes committed were less severe for those who engaged in treatment relative to the comparison group. No differences were observed between groups in overall rates of reoffending, or the length of time following release before reoffending. The study also quantified the economic impacts of treatment and found it was associated with a positive cost–benefit ratio of Aus$1.13. The results provide evidence that the VPP does reduce the rate of violent recidivism, and that these results translate into economic benefits for society. [ABSTRACT FROM AUTHOR]

Employment and work-related exploitation and discrimination are important social determinants of health. However, little is known about the experiences of people on temporary visas in Australia, particularly those on refugee visas. This article reports on a study of people living on temporary visas in South Australia and their experiences of workforce exploitation and discrimination and impacts on health. Interviews were conducted with 30 people: 11 on non-refugee temporary visas and 19 on refugee temporary visas. Data was analyzed thematically. Analysis identified experiences of exploitation and discrimination in the Australian labor market that included difficulties securing work, underpayment, overwork, and hazardous workplaces. These experiences had negative health effects, particularly on mental health. None had made a formal complaint about their treatment, citing the precarity of their visas, difficulties finding an alternative job, and lack of knowledge about what to do. The impacts were especially evident for refugees who were also grappling with pre-settlement trauma and ongoing uncertainties about their future protection. Overall, these findings of discrimination and exploitation in the workplace and subsequent ill health highlight the pervasive impact of neoliberal agendas and stress the need for industrial, immigration, and welfare reform to protect workers on temporary visas. [ABSTRACT FROM AUTHOR]

SAMAG, Ltd., a wholly owned subsidiary of Pima Mining NL, has acquired exclusive world rights to the Dow Magnesium process and is applying it at the 65000 t/year Port Pirie project in South Australia. Studies undertaken by the company led to the conclusion that the Dow process not only incurs the lowest operating cost, lowest capital cost and lowest risk of the electrolytic processes for the production of magnesium metal but also offers the best chance of achieving design capacity on time and on budget. [ABSTRACT FROM AUTHOR]

There is a gap in the evidence on telerehabilitation (TR) for people with fragility fractures. It is unclear whether this group with recent falls who are often frail with cognitive changes will accept tele-rehabilitation and functional gains can be achieved using this approach. Prospective observational study of consecutive patients admitted with femoral or pelvic fracture to a hospital-based home rehabilitation service (HRS) between January and November 2017. Using tablets, multidisciplinary rehabilitation was provided via videoconferencing and use of exercise apps. Patients chose a face-to-face visit or TR. Information on demographic characteristics, functional levels, the total number of therapy sessions, TR episodes, reasons for non-acceptance of TR, and patient-reported experience using TR was collected. Fifty-two patients with hip and pelvic fractures were admitted to the HRS and 35 (67.3%) received TR. Patients who did not accept TR were older, frailer and more likely to be female than those who received TR. Of the 17 who did not receive TR, 6 were deemed unsuitable by staff due to hearing, vision or cognitive problems and 3 refused. The TR group achieved acceptable functional gains. In the TR group on average, participants had 13.63 (± 7.29) home visits however they only elected to have 3.43 (± 2.48) sessions delivered via TR. TR was acceptable to a subset of hip fracture patients but face-to-face was the preferred mode of delivery. More research is needed to understand patients' preferences and beliefs, and the influence of clinician attitudes on uptake of TR. [ABSTRACT FROM AUTHOR]

Until relatively recently, processes of health application (app) design have been understudied and this has resulted in a lack of critical reflection on app creation, including curtailing opportunities to share insights and possible pitfalls that could inform best practice in the field. In response, this article contributes to a growing body of literature that addresses this lacuna by exploring the experiences of the research and design team that developed a health app for pregnant women attending a large tertiary hospital in South Australia. Our analysis pays particular attention to the designer–researcher–user nexus exhibited in the 'co-design' process and in doing so, draws on Rittel's notion of 'wicked problems'. Ultimately, we show that app design is a problem-solving process that is reflective of a high degree of sociality, fluidity, accommodations and compromises. [ABSTRACT FROM AUTHOR]

Objective: To analyse the smaller Australian state/territory service impact of the introduction of new COVID-19 psychiatrist video and telephone telehealth Medicare Benefits Schedule (MBS) items. Method: MBS item service data were extracted for COVID-19 psychiatrist video and telephone telehealth item numbers corresponding to the pre-existing in-person consultations for the Australian Capital Territory (ACT), Northern Territory (NT), South Australia (SA) and Tasmania. Results: The overall rate of consultations (face-to-face and telehealth) increased during March and April 2020, compared to the monthly face-to-face consultation average, excepting Tasmania. Compared to an annual monthly average of in-person consultations for July 2018–June 2019, total telepsychiatry consultations were higher for April than May. For total video and telephone telehealth consultations combined, video consultations were lower in April and higher in May. As a percentage of combined telehealth and in-person consultations, telehealth was greater for April and lower for May compared to the monthly face-to-face consultation average. Conclusions: In the smaller states/territories, the private practice workforce rapidly adopted COVID-19 MBS telehealth items, with the majority of psychiatric consultation shifting to telehealth initially, and then returning to face-to-face. With a second wave of COVID-19 in Australia, telehealth is likely to remain a vital part of the national mental health strategy. [ABSTRACT FROM AUTHOR]

This article explores women's experiences of the women's safety services associated with a South Australian integrated program for male perpetrators of domestic and family violence. As small scale and exploratory, the study aimed to understand impact of such services on women's perceptions of safety. Interviews were conducted by telephone, using a semi-structured format, with 14 women whose partners or ex-partners had been referred to a perpetrator intervention program. Informed by a feminist standpoint perspective, thematic analysis was used to explore each woman's experience and perception of safety. The findings of the study suggest that integrated domestic and family violence programs can improve women's feelings of safety through the application of practical safety planning, timely intervention, emotional support, and trauma-focused practice. Importantly, while the behaviors and actions of perpetrators were clearly relevant to women's perceived safety, it was apparent that focusing on women's strengths and capacity for recovery can significantly impact on their continued sense of safety and well-being. This article also reiterates the importance of women's perspectives in evaluating the effectiveness of perpetrator interventions. [ABSTRACT FROM AUTHOR]

Objective: To examine the effect of a mass media campaign designed to increase bowel cancer screening participation. Methods: We assessed weekly participation, from January 2015 to December 2017, in the Australian National Bowel Cancer Screening Program in Victoria, where a seven-week campaign aired in mid-2017, and in the adjacent comparison state of South Australia. Participation, defined as the number of immunochemical faecal occult blood tests returned out of those invited by the Screening Program in the past 16 weeks, was analysed using negative binomial regression. Results: Compared with non-campaign weeks, there was an increase in the return rate in the campaign state during campaign weeks (adjusted return rates non-campaign weeks = 34.4% vs. campaign weeks = 45.3%, p < 0.01), not observed in the comparison state (38.3% vs. 40.3%, p > 0.05). The increase in the return rate was significantly greater in the campaign state (Rate Ratio of Campaign/Non-Campaign weeks = 1.31, p < 0.01) than the comparison state (1.05, p > 0.05, interaction p < 0.001), and did not differ significantly by age, sex or socio-economic area. The relative increase was greater among never-participants (Rate Ratio of Campaign/Non-Campaign weeks = 1.24) than previous-participants (1.16), interaction p < 0.001). Conclusions: This mass media campaign increased bowel cancer screening participation, including from never and low participation subgroups. To maximize participation and ensure equitable population benefit, repeated campaigns that reach eligible people about bowel cancer risks and potential life-saving benefits of screening should be standard. [ABSTRACT FROM AUTHOR]

Objective: A mentoring programme was established in South Australia in 2014 by psychiatry trainees, with the goal of reducing stress and burnout amongst first-year trainees. All first-year trainees are offered the opportunity to have a senior trainee as a mentor. This article describes the mentoring programme, presents feedback from participants and identifies areas for further development.Method: The majority (72/76) of first-year trainees entering psychiatry training in South Australia from 2014-2018 were allocated a mentor. Surveys were sent out in 2014, 2015 and 2017. Twenty of 42 (48%) mentors and 17 of 42 (40%) of mentees completed a 10-item questionnaire, with free text responses.Results: Mentee feedback was mostly positive, reporting that mentors offered them reassurance and support. The most common challenges were advice about training, managing work-life balance and issues with supervision. The main barrier to the mentoring programme was lack of time to meet. Mentors identified that they would have liked more training in mentoring.Conclusion: The trainee mentoring programme has been a useful initiative. As consultant psychiatrists are likely to provide mentoring for more junior colleagues, the authors propose that training in mentoring should be part of the Royal Australian and New Zealand College of Psychiatrists education programme. [ABSTRACT FROM AUTHOR]

Objective: Cervical cancer mortality has halved in Australia since the national cervical screening program began in 1991, but elevated mortality rates persist for Aboriginal and Torres Strait Islander women (referred to as Aboriginal women in this report). We investigated differences by Aboriginal status in abnormality rates predicted by cervical cytology and confirmed by histological diagnoses among screened women. Methods: Using record linkage between cervical screening registry and public hospital records in South Australia, we obtained Aboriginal status of women aged 20–69 for 1993–2016 (this was not recorded by the registry). Differences in cytological abnormalities were investigated by Aboriginal status, using relative risk ratios from mixed effect multinomial logistic regression modelling. Odds ratios were calculated for histological high grade results for Aboriginal compared with non-Aboriginal women. Results: Of 1,676,141 linkable cytology tests, 5.8% were abnormal. Abnormal results were more common for women who were younger, never married, and living in a major city or socioeconomically disadvantaged area. After adjusting for these factors and numbers of screening episodes, the relative risk of a low grade cytological abnormality compared with a normal test was 14% (95% confidence interval 5–24%) higher, and the relative risk of a high grade cytological abnormality was 61% (95% confidence interval 44–79%) higher, for Aboriginal women. The adjusted odds ratio of a histological high grade was 76% (95% confidence interval 46–113%) higher. Conclusions: Ensuring that screen-detected abnormalities are followed up in a timely way by culturally acceptable services is important for reducing differences in cervical cancer rates between Aboriginal and non-Aboriginal women. [ABSTRACT FROM AUTHOR]

Background: Chronic breathlessness syndrome in the context of advancing disease is distressing for all concerned. Oxygen is commonly prescribed in this setting; however, little is known about the perspectives of breathless people who either are on oxygen or are yet to have it prescribed. Aim: To understand and describe the perspectives and experiences of breathless people towards oxygen use at home. Design: This qualitative study utilised an interpretive description approach using semi-structured interviews and thematic analysis. Setting/participants: A total of 19 people with chronic breathlessness syndrome living in South Australia participated in semi-structured interviews. Participants were divided into sub-groups according to whether they were chronically breathless and (1) not using home oxygen (n = 6), (2) using funded home oxygen for severe hypoxaemia (n = 7) and (3) using home oxygen for palliation outside of funding guidelines (n = 6). Results: Three main themes were identified: (1) managing distress and living with chronic breathlessness syndrome, with or without oxygen, requires a range of self-management strategies; (2) expectations of oxygen use: 'Not as good as I thought it would be'; and (3) the stigma of using oxygen: the visible and invisible. Conclusion: People living with chronic breathlessness struggle daily with both the progression of the underlying disease and the distressing nature of the syndrome. While oxygen does provide benefit for some people, its use and the perceptions of its use are often associated with both the visible and invisible manifestations of stigma. Clinicians need to promote self-management strategies and give careful thought to the prescribing of home oxygen, especially outside the current funding guidelines. [ABSTRACT FROM AUTHOR]

Following increased interest in and use of new public management (NPM), greater regulation has been introduced into many Western health systems. Yet, the effects have revealed the negative aspects of NPM. Positive organizational scholars have argued that adversity can give rise to positive deviance. Yet as a form of noncompliance, positive deviance can be difficult to examine. This methodological article demonstrates how the combined methodologies of positive organizational scholarship in healthcare (POSH) and video reflexive ethnography (VRE) can help examine positive deviance. This study illustrates the methodological utility of POSH VRE to respectfully study the impact of NPM-inspired expectations on public health clinicians, positively reframe how clinicians constructively respond to and manage obstruction, and reveal the unintended effects of NPM-inspired expectations. As a participatory methodology, POSH VRE can promote trust between researchers and clinicians, thereby unveiling instances of positive deviance to NPM in healthcare. [ABSTRACT FROM AUTHOR]

Background: Providing care at end of life has consequences for caregivers' bereavement experience. 'Difficulty moving on with life' is an informative and unbiased symptom of prolonged grief disorder. Predictors of bereaved caregivers' ability to 'move on' have not been examined across the population. Aim: To identify the characteristics of bereaved hands-on caregivers who were, and were not, able to 'move on' 13-60 months after the 'expected' death of someone close. Design: The South Australian Health Omnibus is an annual, random, cross-sectional community survey. From 2000 to 2007, respondents were asked about providing care for someone terminally ill and their subsequent ability to 'move on'. Multivariable logistic regression models explored the characteristics moving on and not moving on. Setting: Respondents were aged ≥15 years and lived in households within South Australia. They had provided care to someone who had died of terminal illness in the preceding 5 years. Results: A total of 922 people provided hands-on care. In all, 80% of caregivers (745) had been able to 'move on'. Closeness of relationship to the deceased, increasing caregiver age, caregiver report of needs met, increasing time since loss, sex and English-speaking background were significantly associated with 'moving on'. A closer relationship to the deceased, socioeconomic disadvantage and being male were significantly associated with not 'moving on'. Conclusion: These results support the relevance of 'moving on' as an indicator of caregivers' bereavement adjustment. Following the outcomes of bereaved caregivers longitudinally is essential if effective interventions are to be developed to minimise the risk of prolonged grief disorder. [ABSTRACT FROM AUTHOR]

One purpose of a longitudinal study is to gain a better understanding of how an outcome of interest changes among a given population over time. In what follows, a trajectory will be taken to mean the series of measurements of the outcome variable for an individual. Group-based trajectory modelling methods seek to identify subgroups of trajectories within a population, such that trajectories that are grouped together are more similar to each other than to trajectories in distinct groups. Group-based trajectory models generally assume a certain structure in the covariances between measurements, for example conditional independence, homogeneous variance between groups or stationary variance over time. Violations of these assumptions could be expected to result in poor model performance. We used simulation to investigate the effect of covariance misspecification on misclassification of trajectories in commonly used models under a range of scenarios. To do this we defined a measure of performance relative to the ideal Bayesian correct classification rate. We found that the more complex models generally performed better over a range of scenarios. In particular, incorrectly specified covariance matrices could significantly bias the results but using models with a correct but more complicated than necessary covariance matrix incurred little cost. [ABSTRACT FROM AUTHOR]

Background: Globally, most care for people with life-limiting illnesses is provided by informal caregivers. Identifying characteristics of caregivers that may have unmet needs and negative outcomes can help provide better support to facilitate adjustment. Aim: We compared characteristics, expressed unmet needs and outcomes for spousal caregivers, with other caregivers at the end of life, by gender and age. Design: The South Australian Health Omnibus is an annual, random, face-to-face, cross-sectional survey wherein respondents are asked about end-of-life care. Setting/participants: Participants were aged over 15 years, resided in households in South Australia and had someone close to them die from a terminal illness in the last 5 years. Results: Of the 1540 respondents who provided hands-on care for someone close at the end of life, 155 were widows/widowers. Bereaved spousal caregivers were more likely to be older, female, better educated, have lower incomes, less full-time work, English as second language, sought help with grief and provided more day-to-day care for longer periods. Spousal caregivers were less likely to be willing to take on caregiving again, less able to 'move on' with life and needed greater emotional support and information about illness and services. The only difference between widows and widowers was older age of spouse in women. Younger spousal caregivers perceived greater unmet emotional needs and were significantly less likely to be able to'move on'. Conclusion: Spousal caregivers are different from other caregivers, with more intense needs that are not fully met. These have implications for bereavement, health and social services. [ABSTRACT FROM AUTHOR]

This article provides an account of the possibilities of using Photovoice as a research method that can empower participants by foregrounding the data produced by Ruby (a pseudonym) to highlight women’s unique experiences of imprisonment and release.Designed using an anti-oppressive, critical social work perspective, this project aims to gain a greater understanding of the post-release experiences of ex-prisoners in South Australia. Participants were posed with the research question ‘if you were able to spend 15 minutes with a politician or policy maker, what would you want to tell them about your experiences?’ Through her lens, Ruby returns the gaze of surveillance, commenting on the disempowerment women experience in prison and their attempts at reclaiming their rights and dignity.Ruby’s data discredit some of the pervasive myths surrounding criminalised women, while calling for fair medical treatment and equal opportunities for women to prepare for their release. This article concludes that the solidarity built between women in prison helps them to tolerate undignified spaces and that their freedom is tempered with an enduring concern for those left behind. [ABSTRACT FROM AUTHOR]

Our study examined three potential predictors of self-objectification in female adolescents, namely media exposure, extracurricular activities, and appearance-related comments (both positive and negative). Participants were 1,087 female adolescents ranging in age from 12 to 16, who completed questionnaire measures of media exposure (television, magazines, Internet, and social networking), time spent on extracurricular activities, positive and negative appearance-related comments, self-objectification, self-surveillance, body shame, and disordered eating. Tests of the hypothesized path model revealed that self-reported exposure to magazines and social networking sites each independently was associated positively with self-objectification. In addition, positive appearance-related comments were shown to be associated positively with self-objectification. On the other hand, time spent on extracurricular activities was not related to self-objectification. The results offer support for the role of media exposure and appearance-related comments in the development of self-objectification in female adolescents. In particular, the results suggest that positive appearance-related comments (compliments) may be just as, or even more, likely to give rise to self-objectification as negative appearance-related comments. The findings suggest practical strategies for the potential protection of the development of self-objectification and its deleterious consequences. [ABSTRACT FROM AUTHOR]

There is limited understanding at the current time about the nature of relationships between women and their children in contexts of domestic violence. This is particularly the case in relation to maternal protectiveness, which tends to be seen in simplistic terms of whether women stay in violence or leave to protect their children. This article reports on a qualitative research study that explores mother–child relationships in the context of domestic violence. We conducted semi-structured interviews with 14 women and two men who were raised in contexts of domestic violence. Thematic analysis revealed complexities between the former children’s perceptions of their own needs and their mothers’ vulnerabilities in the context of violence, as well as shifting understandings over time that involved development of deeper insights into the impact of violence on their mothers and themselves. The nuances of maternal protectiveness identified through this analysis can help social workers appreciate the multiple factors that impact on children’s relationships with their mothers in contexts of violence. The findings therefore have practice implications for social work with women who mother in domestic violence as well as children and adults who grow up in these environments. [ABSTRACT FROM PUBLISHER]

The article discusses the diagnosis of dementia to all automobile drivers which affect the performance and safety of the drivers and passengers in the road. It highlights the importance of several factors for a better driving performance including cognitive executive function, attention and operational control to a dynamic environment.

People's views of landscape can have significant impact on their land use choices. This in turn can have climate implications. In the literature, there is significant attention paid to the effect of climate on landscape, but as well, there are more examples than one might expect of the effects of landscape change on climate. I present evidence of this from Western Australia and Africa, and some conjectured negative and positive effects in two locations in South Australia. I argue that the land use change affecting the landscape and thus affecting the climate emanates from one's view of landscape. There are also some personal reflections of perceptions of landscape from someone who started life in a climate and landscape far removed from the South Australian environment within which he has chosen to live. [ABSTRACT FROM AUTHOR]

Significant improvements in population health are likely to arise when the social determinants of health are addressed. This creates a challenge for health systems, as the policy levers to influence the determinants largely lie outside of their direct control. Health agencies have been attempting to develop responses that affect these policy levers with mixed success. Success often requires particular conditions or 'windows of opportunity' to be present before even small systemic change can be made. The government of South Australia has developed a practical, policy-oriented response to address the determinants of health-Health in All Policies-and has been successfully working across government for the past five years, using a policy learning process to implement this approach. This article will focus on how the South Australian Health in All Policies initiative started and the conditions that enabled South Australia to establish a centralized governance structure, harness a group of cross-sector policy entrepreneurs, and conduct health lens projects across a range of policy issues. The authors will comment on the nature of these conditions and their relevance for other governments struggling to reduce the burden of chronic disease and growing health budgets by addressing the social determinants of health. [ABSTRACT FROM AUTHOR]

The article offers information on a study related to breast cancer risk factors in participants and non-participants of population-based mammography screening. It informs that the study also aimed to find whether the mammography screening for breast cancer leads to over diagnosis. It states that screening programs can lead to risks which effect over diagnosis for women who under go with this procedure.

The article discusses a 3-phase study which developed, implemented and evaluated an education program supporting a palliative approach to motor neurone disease (MND) care. Educational workshops were held as a part of the study for the health professionals. Most attending individuals were nurses from the aged care and palliative care sectors. It improved MND knowledge, palliative care knowledge and enhanced communication, psychosocial care and symptom management between patients and caregivers.

This article aims to identify and analyze the key benefits of adopting Guaranteed Maximum Price and Target Cost Contracts (GMP/TCC) over and above the traditional lump-sum contractual arrangement through an empirical questionnaire survey conducted in South Australia and compared with the findings in Hong Kong. The Mann-Whitney U Test indicated differences in perception between the two groups of respondents on the majority of the identified benefits. The study has provided an in-depth understanding of the perceived benefits of the GMP/TCC scheme, hence leading to a wider application of those alternative integrated procurement strategies in both regions for reference by the construction community at large. [ABSTRACT FROM AUTHOR]