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Medical education curricula have the potential to impact the gender attitudes of future healthcare providers. This study investigated whether gender-biased imagery from anatomy textbooks had an effect on the implicit and explicit gender attitudes of students. We used an online experimental design in which students (N = 456; 55% female) studying anatomy were randomly assigned to a visual priming task using either gender-neutral or gender-biased images. The impact of this priming task on implicit attitudes was assessed using the Implicit Association Test (IAT) and the impact on explicit attitudes was measured using the Gender Bias in Medical Education Scale. Viewing biased images was significantly positively associated with implicit gender bias as indicated by higher IAT scores in the treatment compared to the control condition (mean IAT difference = 43 milliseconds; Cohen's d = 0.33). In contrast, there was no significant effect of gender-biased images on explicit gender attitudes.

Patients leave ED for a variety of reasons and at all stages of care. In Australian law, clinicians and health services owe a duty of care to people presenting to the ED for care, even if they have not yet entered a treatment space. There is also a positive duty to warn patients of material risks associated with their condition, proposed treatment(s), reasonable alternative treatment options and the likely effect of their healthcare decisions, including refusing treatment. This extends to a decision to leave the ED before care is completed. The form of that warning may vary based on what is known about the patient's condition and the associated risks at the time. Specific documentation of warnings given is essential. [ABSTRACT FROM AUTHOR]

We reviewed Australian mental health legislation to determine what obligations it places on psychiatrists to facilitate second opinions for compulsory patients who request them. Only four jurisdictions—Australian Capital Territory, Queensland, Victoria, and Western Australia—have legislated for 'patient-initiated' second opinions. Within these four regimes, there is variation in important aspects of the second opinion process, and there is a general absence of direction given to the second opinion providers. Based on research showing the variability of second opinion provision under New Zealand mental health legislation, we argue that this absence is likely to result in significant variation in the quality and depth of second opinions provided in Australia. We argue that New South Wales, the Northern Territory, South Australia, and Tasmania should consider formal provision for patient-initiated second opinions in their mental health legislation. We believe that such legislation ought to be aware of the barriers patients may face in accessing second opinions, and avoid exacerbating these barriers as Queensland's legislation appears to. Also, we argue that research on current practice in Australia should be conducted to better understand the effects of legislation on second opinions, and to help determine what amounts to best practice. [ABSTRACT FROM AUTHOR]

Objective: Pregnancy is often described as a pivotal life stage for women, where regular contact with health professionals may play an important role in lifestyle awareness. This study explored the knowledge, practices, and beliefs of health professionals and pregnant women regarding physical activity and weight management during the antenatal period. Methods: A qualitative study was undertaken in southeastern Australia using individual interviews. Recruitment sought women of gestation >12 weeks, experiencing an uncomplicated pregnancy (n = 6), and antenatal health professionals including midwives (n = 4) and an obstetrician (n = 1). Data were analysed using Interpretive Phenomenological Analysis. Results: Three major themes emerged: (1) women rely on multiple sources of pregnancy-related healthy lifestyle information; (2) discussions around healthy lifestyle behaviours are low priority and often inconsistent; and (3) lifestyle-related topics perceived as sensitive make some conversations and actions difficult. Conclusions: Pregnant women expressed gaps in lifestyle-related knowledge and education being provided by health professionals. In turn, health professionals expressed difficulty discussing sensitive topics such as weight with pregnant women and had limited knowledge of pregnancy-specific physical activity guidelines. The themes generated by this study may form the foundation for further research to inform clinical policy and practice regarding advice in antenatal care. [ABSTRACT FROM AUTHOR]

In Australia, regulations governing data, including formal legislation and policies promulgated by private and public agencies, are often seen as a barrier to data sharing. This sharing can include between institutions, as well as across jurisdictional borders in a federated jurisdiction such as Australia. In some cases, these regulations place a barrier to sharing data across borders or between institutions without a prerequisite requirement. In other cases, these regulations may be perceived as a justification not to share data. The objective of this review was to analyse published literature from Australia to see what regulations were used to justify not sharing data, along with any other factors that might discourage data sharing. We searched PubMed, Scopus and Web of Science for empirical and policy articles discussing data sharing in Australia. We then filtered these results via abstract and conducted a full text assessment to include 33 articles for analysis. Although there are a few areas of notable regulatory divergence with respect to legislation governing health data, most regulations in Australia are relatively consistent. Further, the absence of uniform ethics approval between sites in different states was frequently cited as a barrier to data sharing. [ABSTRACT FROM AUTHOR]

Exposure to rising sublethal temperatures can affect development and somatic condition, and thereby Darwinian fitness. In the context of climate warming, these changes could have implications for population viability, but they can be subtle and consequently difficult to quantify. Using telomere length (TL) as a known biomarker of somatic condition in early life, we investigated the impact of pre‐hatching and nestling climate on six cohorts of wild nestling superb fairy wrens (Malurus cyaneus) in temperate south‐eastern Australia. Models incorporating only climate information from the nestling phase were best supported compared to those including the (pre‐)laying to incubation phase (previously shown to affect mass) or both phases combined. This implies that nestling TL is most sensitive to ambient climate in the nestling phase. The top model showed a negative relationship between early‐life TL and nestling mean daily minimum temperature when rainfall was low which gradually became positive with increasing rainfall. In addition, there was a positive relationship between TL and the frequency of hot days (daily maximum temperature ≥35°C), although these temperatures were rare and short‐term. Including other pre‐hatching and nestling period, climate variables (e.g., mean daily maximum temperature and mean diurnal temperature variability) did not improve the prediction of nestling TL. Overall, our results suggest that cooler nights when conditions are dry and short‐term temperature spikes above 35°C during development are conducive for somatic maintenance. While these findings indicate a potential pathway for climate warming to impact wildlife fitness, they emphasize the need to elucidate the mechanisms underlying these complex associations. [ABSTRACT FROM AUTHOR]

Objective: This research aimed to examine the legal and regulatory obligations of authorities and healthcare professionals in the provision of prison emergency health services and to identify problems in the provision of emergency care to prisoners by using case examples from coronial findings. Methods: Review of legal and regulatory obligations and a search of coronial cases for deaths related to the provision of emergency healthcare in prisons in the past 10 years in Victoria, New South Wales and Queensland. Results: The case review identified several themes – issues with prison authority policies and procedures that delay access to timely healthcare or compromise the quality of care, operational and logistical factors, clinical issues and stigmatic issues including prison staff attitudes to prisoners requesting urgent healthcare assistance. Conclusion: Coronial findings and royal commissions have repeatedly identified deficiencies in the emergency healthcare provided to prisoners in Australia. These deficiencies are operational, clinical and stigmatic and not limited to a single prison or jurisdiction. Applying a health quality of care framework focussed on prevention and chronic health management, appropriate assessment and escalation when urgent medical assistance is requested, and a structured audit framework could avoid future preventable deaths in prisons. [ABSTRACT FROM AUTHOR]

Brood-parasitic cuckoos lay their eggs in the nests of other birds, abandoning parental care to their hosts. Many host species have evolved defences to escape or reduce the costs associated with cuckoo parasitism. Superb Fairy-wrens Malurus cyaneus, which are a host to several cuckoo species in Australia, can distinguish cuckoo eggs based on their size or shape, or by using indirect cues such as the timing of egg laying or the presence of an adult cuckoo near the nest. They have previously been shown to reject cuckoo eggs by methods of egg burial or abandonment. These methods are likely to be costlier than ejecting the cuckoo egg from the nest (as seen in some other host species), because of the complete failure of the reproductive attempt, in addition to the costs associated with renesting. In this study, we document with photograph and video footage an incident of a Fan-tailed Cuckoo Cacomantis flabelliformis parasitising a nest of a Superb Fairy-wren in the Australian National Botanic Gardens, Canberra. Shortly after the parasitism event occurred, we recorded the female Fairywren returning to the nest and ejecting the single Cuckoo egg. To our knowledge, this footage represents the first evidence of ejection of a cuckoo egg in this species. [ABSTRACT FROM AUTHOR]

Expert evidence plays a central role in establishing the relevant standard of care in medical litigation. In Australia, little is known about the expert witnesses who provide evidence about the standard of care provided in ED. A sample of recent published case law suggests that a proportion of expert evidence about breach of the standard of reasonable care in ED is provided by medical practitioners who are not emergency physicians and/or have no recent practice experience in an ED. This may potentially distort the identification of the relevant standard of care. In the United States, the American College of Emergency Physicians has attempted to address this issue by developing and promulgating expert witness guidelines. Is there a case for the Australasian College for Emergency Medicine to assume an advocacy role and/or develop standards in this area? [ABSTRACT FROM AUTHOR]

Climate warming has been shown to affect the timing of the onset of breeding of many bird species across the world. However, for multi‐brooded species, climate may also affect the timing of the end of the breeding season, and hence also its duration, and these effects may have consequences for fitness. We used 28 years of field data to investigate the links between climate, timing of breeding, and breeding success in a cooperatively breeding passerine, the superb fairy‐wren (Malurus cyaneus). This multi‐brooded species from southeastern Australia has a long breeding season and high variation in phenology between individuals. By applying a "sliding window" approach, we found that higher minimum temperatures in early spring resulted in an earlier start and a longer duration of breeding, whereas less rainfall and more heatwaves (days > 29°C) in late summer resulted in an earlier end and a shorter duration of breeding. Using a hurdle model analysis, we found that earlier start dates did not predict whether or not females produced any young in a season. However, for successful females who produced at least one young, earlier start dates were associated with higher numbers of young produced in a season. Earlier end dates were associated with a higher probability of producing at least one young, presumably because unsuccessful females kept trying when others had ceased. Despite larger scale trends in climate, climate variables in the windows relevant to this species' phenology did not change across years, and there were no temporal trends in phenology during our study period. Our results illustrate a scenario in which higher temperatures advanced both start and end dates of individuals' breeding seasons, but did not generate an overall temporal shift in breeding times. They also suggest that the complexity of selection pressures on breeding phenology in multi‐brooded species may have been underestimated. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Head and neck cancer treatment affects quality of life. There are differences in quality of life outcomes and perceived supportive care needs between cancer patients living in metropolitan and regional–remote areas. This study investigated quality of life over the first 6 months following head and neck cancer diagnosis and observed differences in quality of life by geographical location. Design: Prospective observational study. Setting: Tertiary hospital in Brisbane, Australia. Participants: Newly diagnosed patients who were referred for the diagnosis, and/or treatment of head and neck cancer. Main outcome measure(s): Quality of life was measured by the University of Washington Quality of Life Survey, version 4 (UW‐QoL). Participants completed the UW‐QoL questionnaire prior to starting treatment, 1 month and 6 months post treatment. Metropolitan and regional or remote status was classified according to the Australian Standard Geographic Classification‐Remoteness Area system. Results: Ninety‐five participants were included at baseline; 49 and 41 participants completed the 1‐month and 6‐month follow‐ups, respectively. Scores in most UW‐QoL domains decreased between baseline and 1 month post treatment and increased towards pre‐treatment scores at the 6‐month follow‐up (except for anxiety and saliva). Pain at baseline was significantly worse in the regional–remote participants compared with metropolitan participants. No other statistically significant differences in UW‐QoL score by geographical location were observed. Conclusion: The findings generally did not support significant differences in quality of life outcome between metropolitan and regional–remote head and neck cancer patients. The difference in pain experience between metropolitan and regional–remote groups requires further investigation. [ABSTRACT FROM AUTHOR]

This article reports the findings of the first study in Australia to compare the responses of judges and jurors in 122 real cases who were asked to identify the appropriate relevance and weight that should be given to some of the most commonly listed aggravating and mitigating factors in sentencing. The research reveals that, while jurors and judges in Victoria are alike in giving more weight to aggravating factors than mitigating factors and in supporting an individualised approach to sentencing, jurors give less weight than judges to some mitigating factors, including good character, being a first offender, youth, old age and physical illness. Jurors also adopted broader interpretations of aggravating factors like breach of trust and the relevance of prior convictions. They also preferred a different rationale for discounting sentences due to family hardship. [ABSTRACT FROM AUTHOR]

Background/objectives: While beverages are an important dietary source of water and some essential nutrients, consumption of sweet beverages has increasingly been linked to adverse health outcomes. Currently there is a paucity of longitudinal consumption data on beverage consumption in Australian children.Subjects/methods: The Longitudinal Study of Australian Children has run biennially since 2004. Twenty four-hour recall data collected over 6 waves from the birth cohort (aged 0-1 year at baseline) was analysed and demographics were assessed for associations.Results: Five thousand one hundred and seven children participated at baseline, with a 71-90% retention of participants at each wave. Water consumption remained consistent with age over time, with more than 90% consuming more than one glass in the last 24-h. Proportions of fruit juice consumers decreased overall. Soft drink and cordial consumer proportions increased from 1% (0-1 year), to 28% (2 years) and 43% (10 years). Between 2 and 10 years, proportions of consumption of full-cream milk decreased by 8% and for skim milk this proportion increased by 51%. High proportions of consumers of soft drink/cordial was significantly associated with older children, males, children with a medical condition, living in a rural area, low socio-economic status and Indigenous Australians.Conclusions: Water consumption remained consistently high across the ages, while fruit juice was commonly introduced into the diet early childhood. While proportions of fruit juice consumers decreased after the age of 2 years, proportions of soft drink consumers increased. The findings from this study should assist with surveillance data and inform policy and interventions aimed at reducing consumption of sweet beverages. [ABSTRACT FROM AUTHOR]

Plagiarism in the context of the law is a highly nuanced and complex concept, involving consideration of academic integrity and disciplinary rules and assessments of intent, which colour the responses of both universities and courts when confronted by the misuse of others' words and ideas without appropriate referencing. Within academia, plagiarism is treated as 'a capital offence'. In the context of admission as a lawyer, professional admissions boards in Australia use findings of major plagiarism at university as a reason for denying or delaying admission to practice on two grounds: firstly, if it amounts to cheating per se, as being indicative of a character flaw inconsistent with the character requirements of officers of the court; and secondly on the related basis that it is (or is assumed to be) a reliable predictor of future professional misconduct. Given this, Australian universities must educate students about academic integrity and referencing (particularly in the digital age, where sources and opportunities for misconduct are escalating), provide law students with training and practice in appropriate use of others' material, and provide relevant information to students about the implications of findings of misconduct being made against them. This is important because, while there is a widespread perception that plagiarism ceases to be a consideration after admission as a lawyer, this is not supported by the decided cases. [ABSTRACT FROM AUTHOR]

Objectives The symptoms of multiple sclerosis ( MS) can affect oral care and access to dental services, but there is limited literature describing the oral health and perceived oral healthcare needs of people with MS. This study aimed to explore the oral health experiences, oral health behaviours and barriers to accessing dental care perceived by people living with MS in Australia. Methods Six focus groups were held across two metropolitan areas (Brisbane, Queensland and Melbourne, Victoria) and one regional area (Toowoomba, Queensland). Focus group data were analysed using thematic analysis. Results Living with MS was a highly individual experience due to the range of symptoms that may be experienced. In addition to having different symptom experiences to others with MS, individual symptoms also differed on a daily basis as the disease relapsed and remitted. The physical expressions of MS directly and indirectly affected the oral health of participants. Additionally, oral health was affected by the side effects of medications and orofacial pain symptoms. Depending on the symptoms experienced by the individual, personal oral hygiene was affected and professional dental appointments were difficult. Participants also experienced structural barriers to accessing professional dental care including difficulty accessing transport to-and-from dental appointments, space limitations in the dental surgery and financial barriers to care. Discussion Dental care was perceived to be inflexible and was not tailored to individual experiences of MS, which contributed to perceptions of poor quality and appropriateness of care. It is important for dental professionals to offer tailored and individualized dental care when treating people with MS. Our findings suggest that there needs to be greater interprofessional communication and referral to manage atypical dental pain symptoms. Oral health education for people with MS should include altered strategies to performing daily oral hygiene, the management of xerostomia and advice regarding low cariogenic diets suitable for dysphagia. Additionally, policy and strategies to improve the oral health of people with MS should focus on enhancing access through transport, reducing the cost of dental services to the individual and providing domiciliary oral health care. [ABSTRACT FROM AUTHOR]

The areti0cle offers information on the history, benefits, and significant role of the expert evidence in litigation of cases related to negligence by medical practitioners in various jurisdictions of Australia. It informs that the Supreme Court of New South Wales issued the Professional Negligence List under the Civil Procedure Act 2005 in order to guide the legal practitioner and the medical expert witness medical negligence claims.

The article discusses the legal challenges posed by surrogacy agreements in Australia. Topics covered include the reluctance to acknowledge surrogacy as an appropriate arrangement, the decision issues on a case where the surrogacy agreement was unproblematic and the need for a carefully crafted legislation in addressing surrogacy relationships. Also mentioned are the legal duties following the discharge of mental health patients.

To understand which populations and species are most sensitive to climate change, studies correlate time series of climate variables with those of traits important for population dynamics, and subsequently compare which aspects of a species' ecology or life-history best explain variation in climate sensitivity. Often large-scale oceanic climate indices (LOCIs) are used as a proxy for local climatic drivers, with many studies reporting geographic gradients in climate sensitivity to LOCIs (e.g. suggesting that species living further from the equator are relatively climate sensitive). However, the relationship between LOCIs and local weather variables also varies geographically, raising the possibility that apparent intra- and inter-specific differences in climate sensitivity to LOCIs could also reflect geographic variation in how well LOCIs function as a proxy for local climatic drivers. This hypothesis is rarely tested due to lack of knowledge about the specific local climatic drivers. Here we show, using reproductive and climate data from 16 long-term population studies of 7 Australian fairy-wren species ( Malurus genus), that the use of LOCIs can result in 1) strong overestimation of the amount of inter-specific variation in climate sensitivity and 2) spurious patterns, particularly geographic gradients. Consequently a paradox emerges: LOCIs often explain much of the temporal variation in traits important for population dynamics, but the common usage of LOCIs may prevent meaningful intra- and inter-specific comparisons of climate sensitivities over large spatial scales. Our results thus may offer an alternative interpretation of the widely reported geographic gradients in sensitivity to LOCIs. Future progress will likely require better knowledge about the identity and temporal features of local environmental drivers of population dynamics. [ABSTRACT FROM AUTHOR]

Knowledge of population structure and patterns of connectivity is required to implement effective conservation measures for the purple-crowned fairy-wren (Malurus coronatus), a threatened endemic of northern Australia. This study aimed to identify barriers to dispersal across the distribution of M. coronatus, investigate the impact that the recent declines may have on population connectivity, and propose conservation actions to maintain natural patterns of gene flow. Analysis of mitochondrial DNA sequences from 87 M. coronatus identified two phylogenetic clusters that corresponded with the phenotypically defined western (M. c. coronatus) and eastern (M. c. macgillivrayi) subspecies. The genetic divergence between these subspecies was consistent with isolation by a natural barrier to gene flow, and supports their separate conservation management. Within the declining M. c. coronatus, the lack of genetic divergence and only slight morphological difference between remnant populations indicates that populations were recently linked by gene flow. It is likely that widespread habitat degradation and the recent extirpation of M. c. coronatus from the Ord River will disrupt connectivity between, and dynamics within, remnant populations. To prevent further declines, conservation of M. coronatus must preserve areas of quality habitat and restore connectivity between isolated populations. Genetic and morphological divergence between the two subspecies of Malurus coronatus provides support for their separate conservation management. Historically high levels of dispersal between catchments, indicated by a lack of genetic structure and slight morphological difference between remnant populations of the western subspecies, may be disrupted by recent habitat degradation. [ABSTRACT FROM AUTHOR]

The availability of compensation for loss of chance in clinical negligence cases appeared to be available in Australia for a time, even after the conclusion reached by the House of Lords in Gregg v Scott. However, the issue only recently came for consideration by Australia's highest appellate court, which in Tabet v Gett adopted an approach more closely aligned with the majority in Greg v Scott. Unlike the factual background to Gregg v Scott, in Tabet v Gett the patient's physical condition had already crystallized. For that reason, the Australian decision may be of interest to readers in the United Kingdom as some commentators have suggested that a factual scenario similar to that in the Australian case may have given rise to a different outcome. [ABSTRACT FROM AUTHOR]

Post-traumatic stress disorder (PTSD) in veterans is well documented, less so the long-term impact on the health of their partners and families. The perceived health and wellbeing of women partners of Australian Vietnam veterans who were members of partners of veterans support groups is reported. This qualitative study used data from 76 participants in 10 focus groups in metropolitan, regional, and rural and remote areas of New South Wales (NSW). The data were tape-recorded, transcribed and thematically analysed using constant comparison methods. The impact of living with a partner with war-related PTSD appears to be significant and ongoing with women drawing parallels to living in a war zone. The biggest negative impact was on their mental health. They felt burdened as carers and struggled to find explanations for their husbands' problems. Support groups were very helpful. There are implications for partners of veterans who have returned from active military duty and from peacekeeping in current conflicts. [ABSTRACT FROM AUTHOR]

This study aims to develop a self-administered needs assessment questionnaire for people with systemic lupus erythematosus (SLE), assess its face, content and construct validity and test the reliability of the instrument. Eighty-four people with SLE, registered with a Lupus Resource Centre in New South Wales, Australia participated in a series of focus groups and pre and pilot testing phases in the development of a needs instrument and 594 people from a SLE support association were sent the SLE needs questionnaire (SLENQ) and the MOS-SF-36 and asked to complete both. Face and content validity were found to be high following pre and pilot testing. Principal components analysis identified seven factors with eigenvalues greater than 1, which together accounted for 53% of the total variance (psychological/spiritual/existential, health services, health information, physical, social, daily living and employment/financial needs). Internal reliability coefficients (Cronbach's alpha) of all seven factor-based scales were found to be substantial, ranging from 0.77 to 0.96. Moderately significant correlation between the domains of the SLENQ and the MOS SF-36 were supportive in ascertaining concurrent validity. These findings suggest that the SLENQ provides a reliable and valid index of the global needs of people with SLE. [ABSTRACT FROM AUTHOR]

Background : Given the high prevalence of mental health problems in midlife women it is important to understand the factors that motivate and inhibit seeking professional help. Aim : To identify factors associated with and barriers to seeking professional help for psychological distress amongst midlife Australian women. Method : Qualitative and quantitative data were gathered using semi-structured telephone interviews in NSW Australia. Results : Seeking help from a GP was associated with poorer mental ( p  = 0.002) and physical health scores ( p  = 0.005). But in contrast seeking help from a mental health professional was associated with being out of paid employment ( p  = 0.035), being mostly able to talk about one's deepest problems ( p  = 0.015), being dissatisfied with family relationships ( p  = 0.008), and feeling understood by family/friends ( p  = 0.002). The barriers to seek help for these women were thinking they should cope alone (64%); thinking the problem would get better by itself (43%); embarrassment (35%); believing no help available (34%); not knowing where to go for help (30%); and fear of what others might think (28%). Qualitative data also highlighted attitudinal barriers to help-seeking. Conclusions : Although level of need predicted GP contacts, attitudinal factors were more important in contacts with mental health services. These attitudinal barriers need to be addressed to enable midlife women to more easily seek and access mental health care when needed. Declaration of interest : There are no known conflicts of interest. [ABSTRACT FROM AUTHOR]

Examines the trends and scope of home-based management of heart failure (HF) patients in Australia. Epidemiology of HF in Australia during the 1990s; Advantages of home-based HF care; Features of home-based HF services; Delivery of skilled nursing care for HF patients within the home environment.

Summary 1. We describe patterns of post-fledging care, dispersal and recruitment in four cohorts of brown thornbills Acanthiza pusilla. We examine what factors influence post-fledging survival and determine how post-fledging care and the timing of dispersal influence the probability of recruitment in this small, pair breeding, Australian passerine. 2. Fledgling thornbills were dependent on their parents for approximately 6 weeks. Male fledglings were more likely than female fledglings to survive until independence. For both sexes, the probability of reaching independence increased as nestling weight increased and was higher for nestlings that fledged later in the season. 3. The timing of dispersal by juvenile thornbills was bimodal. Juveniles either dispersed by the end of the breeding season or remained on their natal territory into the autumn and winter. Juveniles that delayed dispersal were four times more likely to recruit into the local breeding population than juveniles that dispersed early. 4. Delayed dispersal was advantageous because individuals that remained on their natal territory suffered little mortality and tended to disperse only when a local vacancy was available. Consequently, the risk of mortality associated with obtaining a breeding vacancy using this dispersal strategy was low. 5. Males, the more philopatric sex, were far more likely than females to delay dispersal. Despite the apparent advantages of prolonged natal philopatry, however, only 54% of pairs that raised male fledglings to independence had sons that postponed dispersal, and most of these philopatric sons gained vacancies before their parents bred again. Consequently, few sons have the opportunity to help their parents. Constraints on delayed dispersal therefore appear to play a major role in the evolution of pair-breeding in the brown thornbill. [ABSTRACT FROM AUTHOR]

The object of this study was to evaluate whether an integrated training package improved the consistency and accuracy of advice about breast cancer to callers of Cancer Information Services (CIS) in Australia. The study followed a pre-/post-evaluation design and the participants were all CIS officers from the state-based CIS. A computerized database was used which contained the current best advice about breast cancer combined with a 1-day interactive training workshop for all officers of participating CIS. The proportion of responses that accorded with predetermined model answers for each of five scenarios employed by simulated callers during normal working hours at pre-and post-evaluation were then calculated. There were 95 simulated calls during pre-evaluation, and 104 calls post-evaluation. In some cases, such as breast reconstruction, accordance with model answers was high at both pre- and post-test. The proportion of responses on an item that related to a description of lymphoedaema differed from pre-to post-test with P = 0.007; while an item on the appropriateness of discussing genetic testing with general practitioners differed from pre-to post-test with P = 0.003. There was less concordance, both pre- and post-test, for issues related to surgery, hospitalization, familial aspects and Tamoxifen. We concluded that the intervention presents a method of disseminating consistent information across a number of independent CIS. Some areas were identified that require more targeted intervention. [ABSTRACT FROM AUTHOR]

The article reports on a strategy that was developed to increase participation in screening mammography. 668 randomly selected women were interviewed from the target population of an Australian pilot screening mammography program. The aims of the study were to use cross-sectional data to determine factors which predicted women's intentions regarding attendance at the Program. Some of the variables that entered the final regression model are the intensity of thought about getting breast cancer; a belief that early detection is extremely desirable and that screening mammograms are accurate; having had a Pap test within the last 2 years; and a feeling of personal susceptibility to breast cancer.