Countering disablism: An alternative universal income support system based on egalitarianism

The long-term vision of economic security and social participation for people with a disability held by disability activists and policy-makers has not been realised on a global scale. This is despite the implementation of various poverty alleviation initiatives by international and national governments. Indeed within advanced Western liberal democracies, the inequalities and poverty gaps have widened rather than closed. This article is based on findings from a historical-comparative policy and discourse analysis of disability income support system in Australia and the Basic Income model. The findings suggest that a model such as Basic Income, grounded in principles of social citizenship, goes some way to maintaining an adequate level of subsistence for people with a disability. The article concludes by presenting some challenges and a commitment to transforming income support policy.

Australian data do not support current pharmaceutical benefits scheme criteria for use of tumour necrosis factor-α inhibitors in ankylosing spondylitis

On the basis of local data, we write in support of the conclusions of Smith and Ahern that current Pharmaceu- tical Benefits Scheme (PBS) criteria for tumour necrosis factor (TNF)-a inhibitors in ankylosing spondylitis (AS) are not evidence-based. 1 As a prerequisite to the appropriate use of biological therapy in AS, three aspects of the disease need to be defined: (i) diagnosis, (ii) activity and (iii) therapeutic failure (Table 1)....

Support services for higher degree research students: A survey of three Australian universities

A survey was conducted across three Australian universities to identify the types and format of support services available for higher degree research (HDR, or MA and Ph.D.) students. The services were classified with regards to availability, location and accessibility. A comparative tool was developed to help institutions categorise their services in terms of academic, administrative, social and settlement, language and miscellaneous (other) supports. All three universities showed similarities in the type of academic support services offered, while differing in social and settlement and language support services in terms of the location and the level of accessibility of these services. The study also examined the specific support services available for culturally and linguistically diverse (CALD) students. The three universities differed in their emphases in catering to CALD needs, with their allocation of resources reflecting these differences. The organisation of these services within the universities was further assessed to determine possible factors that may influence the effective delivery of these services, by considering HDR and CALD student specific issues. The findings and tools developed by this study may be useful to HDR supervisors and university administrators in identifying key support services to better improve outcomes for the HDR students and universities.

A continuum to characterise and support teacher interpretation of an innovative curriculum

A continuum for describing the degree to which teachers interpret the various features of a curriculum is presented. The continuum has been developed based upon the observation of classroom practices and discussions with a group of teachers who are using an innovative junior secondary mathematics curriculum. It is anticipated that the ongoing use of the continuum will lead to its improvement as well as the refinement of the curriculum, more focussed support for the teachers,improved student learning, and the building of explanatory theory regarding mathematics teaching and learning.

Governance and regional planning outcomes: Using governance indicators to support a policy implementation approach

Regional planning faces numerous decision making uncertainties related to the complex interdependencies between urban and regional centres. Questions about how to achieve sustainable planning solutions across regions are a key uncertainty and relate to a lack of information about the actual achievement of outcomes as proposed by the objectives of a plan. Regional plan implementation and its impact on environmental, social and economic outcomes have been little explored within Australian urban and regional planning research. Despite a desire to improve the conditions across Australian regions, ambiguity persists regarding the results of regional planning efforts. Of the variables affecting regional planning, scholars argue that governance has a significant impact on achieving outcomes (see Pahl-Wostl 2009). In order to better analyse the impact of governance, we propose a set of governance indicators to examine decisions across regional planning institutions and apply this to governance models across Queensland’s regions. We contend that these governance indicators can support a more rigorous assessment of the impacts of governance models on plan implementation and outcomes. We propose that this is a way to better understand the relationship between planning and outcomes across urban and regional areas.

PW376 A pilot study of a post-discharge nurse-led, educational intervention on cardiac self-efficacy and anxiety in post-PCI patients

Introduction Hospitalisation for percutaneous coronary intervention (PCI) is often short, with limited nurse-teaching time and poor information absorption. Currently, patients are discharged home only to wait up to 4-8 weeks to commence a secondary prevention program and visit their cardiologist. This wait is an anxious time for patients and confidence or self-efficacy (SE) to self-manage may be low. Objectives To determine the effects of a nurse-led, educational intervention on participant SE and anxiety in the early post-discharge period. Methods A pilot study was undertaken as a randomised controlled clinical trial. Thirty-three participants were recruited, with n=13 randomised to the intervention group. A face-to-face, nurse-led, educational intervention was undertaken within the first 5-7 days post-discharge. Intervention group participants received standard post-discharge education, physical assessment, with a strong focus on the emotional impact of cardiovascular events and PCI. Early reiteration of post-discharge education was offered, along with health professional support with the aim to increase patients’ SE and to effectively manage their post-discharge health and well being, as well as anxieties. Self-efficacy to return to normal activities was measured to gauge participants’ abilities to manage post-PCI after attending the intervention using the cardiac self-efficacy (CSE) scale. State and trait anxiety was also measured using the State-Trait Anxiety Inventory (STAI) to determine if an increase in SE would influence participant anxiety. Results There were some increases in mean CSE scores in the intervention group participants over time. Areas of increase included return to normal social activities and confidence to change diet. Although reductions were observed in mean state and trait anxiety scores in both groups, an overall larger reduction in intervention group participants was observed over time. Conclusion It is essential that patients are given the education, support, and skills to self-manage in the early post-discharge period so that they have greater SE and are less anxious. This study provides some initial evidence that nurse-led support and education during this period, particularly the first week following PCI, is beneficial and could be trialled using alternate modes of communication to support remote and rural PCI patients and extend to other cardiovascular patients.

Acute myocardial infarction: The spouse's experience

Given the marked changes in length of hospital stay and the number of CAB procedures being performed, it is essential that health professionals are aware of the potential impact these changes could have on the spouses of patients who have undergone CAB surgery. Results from numerous quantitative studies suggest that spouses of patients undergoing CAB surgery experience both physical and emotional stress before and after their partners surgery. While such studies have contributed to our understanding, they fail to capture the qualitative experience of what it is like to be a spouse of a partner who has undergone CAB surgery, specifically in the context of changes in the length of hospital stay. The objective of this study was to describe the experience of spouses of patients who had recently undergone CAB surgery. This study utilised a qualitative methodology and was guided by Husserl's phenomenological approach. Data was obtained from four participants by in depth open ended interviews. This study has implications for all health professionals involved in the care of patients and their families undergoing CAB surgery. If health professionals are to provide holistic care, they need to understand more fully the qualitative experience of spouses of critically ill patients. The purpose of this study was to describe the experience of spouses whose partner's had suffered an acute myocardial infarction (MI). The study was guided by a phenomenological approach. This qualitative type of study is new to nursing inquiry, therefore this investigation creates links with understanding the notion of psychosocial nursing processes with the leading cause of death in Australia. Literature concerning the spouses of myocardial infarction patients has predominantly employed quantitative methods, as such results have centred on structured data collection, and categorised outcomes. Such methods have failed to capture the insight of what it is like to be a spouse of a patient who has had an MI. In-depth interviews were conducted with three participants (2 females and 1 male) about their experiences. The major findings of the study were categorised under the headings of uncertainty, emotional turmoil, support information and lifestyle change. Conclusions suggest that spouses are neglected by health professionals and they require as much psychosocial support as their partner in terms of cardiac discharge planning. Spouses need to be granted special consideration, as they progress through a grieving and readjustment process in coming to terms with: (1) the need to support and care for their partner, (2) changes in their roles and (3) adjustments to their current lifestyles.

Nutritional support in children with end-stage liver disease : a randomized crossover trial of a branched-chain amino acid supplement

Malnutrition is common in children with end-stage liver disease (ESLD) awaiting orthotopic liver transplantation (OLT), and nutritional support is assuming an important role in preoperative management. To evaluate preoperative nutritional therapy, 19 children (median age 1.25 y) with ESLD awaiting OLT were prospectively studied. Two high-energy, isoenergetic and isonitrogenous nutritional formulations delivered nasogastrically were compared: a branched-chain amino acid (BCAA)-enriched semielemental formulation and a matched standard semielemental formulation. Twelve of 19 patients completed a randomized controlled study before OLT and 10 of 19 completed a full crossover study. Improvements in weight and height occurred during the BCAA supplements, with no statistical change on the standard formulation. Significant increases in total body potassium, midupper arm circumference, and subscapular skinfold thickness occurred during the BCAA supplements, whereas no significant changes occurred during the standard formulation period. Significantly fewer albumin infusions were required during the BCAA supplement. These findings suggest that BCAA-enriched formulas have advantages over standard semielemental formulas in improving nutritional status in children with ESLD. and are deserving of wider application and study.

Support Frameworks for the Use of Social Media by Emergency Management Organisations

Social media platforms such as Facebook and Twitter are now widely recognised as playing an increasingly important role in the dissemination of information during crisis events. They are used by emergency management organisations as well as by the public to share information and advice. However, the official use of social media for crisis communication within emergency management organisations is still relatively new and ad hoc, rather than being systematically embedded within or effectively coordinated across agencies. This policy report suggests a more effectively coordinated approach to leverage social media use, involving stronger networking between social media staff within emergency management organisations. This could be realised by establishing a national network of social media practitioners managed by the Australia-New Zealand Emergency Management Committee (ANZEMC), reinforced by a Federal government task force that promotes further policy initiatives in this space.

Pre-operative nutritional support in children with end-stage liver disease accepted for liver transplantation: An approach to management

Pre-operative nutritional support was studied in 28 children with end-stage liver disease awaiting orthotopic liver transplantation. Nasogastric supplemental administration of a standard semi-elemental enteral nutritional formula was compared with a similar formula enriched with branched chain amino acids, and with a group receiving oral nutrition only. The duration of treatment in all groups was similar (mean 90 days). Energy intakes in the supplemented groups were 120-150% of recommended daily intakes (RDI), whereas ad libitum intakes in the oral group ranged 58-100% RDI. A significant improvement in mean Z-score for body weight (denoting catch-up) was noted only in those children who received nasogastric supplements enriched with branched-chain amino acids. The standard enterally-fed group maintained their body weight and Z-scores did not change significantly. In contrast, body weight Z-scores in those fed orally declined significantly. Nutritional supportive therapy of malnourished children with end-stage liver disease can minimize or improve nutritional status in children awaiting liver transplantation. The use of nutritional formulae rich in branche-chain amino acids may have nutritional advantages in children with chronic liver disease which require further study and evaluation.

Transition to fatherhood: A cross-cultural comparison

A prospective study was conducted of fathers' transition to parenthood from mid-pregnancy to 6 weeks postpartum. The subjects were 198 fathers from Greece (Athens) and 142 from Britain (Bristol). Social class, age and parity distributions were similar between the two populations. The culture and social structure experienced by each varied widely, however, and was a focus of interest. Two major themes in fatherhood across the two populations were explored: first, the father's instrumental role in provision of emotional and practical support to his partner and care for his child; and second the father's emotional reaction to his partner's pregnancy, the birth of his child and early parenthood. In both cultures fathers reported that they took an active instrumental role in supporting their partner and in participating in childcare. Markedly more British fathers attended the delivery. There were no overall differences in the degree to which fathers participated in childcare though the nature of this participation varied. British fathers more commonly took on housework duties. During their partner's pregnancy Greek fathers experienced significantly higher malaise than their British counterparts and also reported feeling that they had less social support. Common to many fathers in both cultures during this time were fears that their partner might change or be damaged by the pregnancy. After the birth, there was no difference in emotional well-being between the Greek and British fathers. Reactions to fatherhood and enjoyment of the child were similar for the two cultures also. Patterns of correlation between variables both within and across the antenatal and postnatal time periods were, for the most part, similar for the two cultures. Social support, however, was found to relate to father's emotional and instrumental reaction to parenthood only in the case of the British sample. Findings are discussed in terms of each culture's point on the continuum of social change.

We need to support paedophiles to prevent child sex offending

The sexual abuse of children is, understandably, a key concern for the public. Child sexual abuse can cause long-lasting harms for victims, ranging from relationship difficulties to eating disorders. But misperceptions about those who perpetrate it abound in public debate. Although the terms “paedophile” and “child sex offender” are often used interchangeably, the two are distinct. Paedophiles are sexually attracted to young children. They have either acted on this attraction or fear they might. But not all paedophiles act on their attraction – and this is where support services can help reducing offending. Conversely, not everyone who offends sexually against a child is a paedophile. Some may have a sexual interest in and/or offend against both children and adults. Others do not have a sexual attraction to children but instead act opportunistically...

Supporting mindful planners in a mindless system: Limitations to the emotional turn in planning practice

Despite widespread acknowledgment within planning scholarship that emotion – both present in knowledge and a form of knowledge – is integral to lived experience and the judgement of planners, it is often sidelined within planning practice. The extent to which mainstream planning has been able or willing to accommodate emotions remains constrained and the emotions of planners and the public remain an unacknowledged but pervasive presence. Antonio Ferreira recently highlighted in this journal the importance of attending to emotions at the level of the individual planner through the concept of mindfulness. We argue this approach must be complemented by an acknowledgement of the structural and institutional limitations of including emotions in planning practice. Drawing from the emotional geographies literature to describe a social-spatial conceptualisation of emotion, we highlight ontological and practical tensions associated with the achievement of the ‘emotional turn’ and advance a more purposeful engagement with emotion in mainstream planning practice.

Developing a best practice pathway to support improvements in Indigenous Australians' mental health and well-being: A qualitative study

Objective: There is a need to adapt pathways to care to promote access to mental health services for Indigenous people in Australia. This study explored Indigenous community and service provider perspectives of well-being and ways to promote access to care for Indigenous people at risk of depressive illness. Design: A participatory action research framework was used to inform the development of an agreed early intervention pathway; thematic analysis Setting: 2 remote communities in the Northern Territory. Participants: Using snowball and purposive sampling, 27 service providers and community members with knowledge of the local context and the diverse needs of those at risk of depression were interviewed. 30% of participants were Indigenous. The proposed pathway to care was adapted in response to participant feedback. Results: The study found that Indigenous mental health and well-being is perceived as multifaceted and strongly linked to cultural identity. It also confirms that there is broad support for promotion of a clear pathway to early intervention. Key identified components of this pathway were the health centre, visiting and community-based services, and local community resources including elders, cultural activities and families. Enablers to early intervention were reported. Significant barriers to the detection and treatment of those at risk of depression were identified, including insufficient resources, negative attitudes and stigma, and limited awareness of support options. Conclusions: Successful early intervention for wellbeing concerns requires improved understanding of Indigenous well-being perspectives and a systematic change in service delivery that promotes integration, flexibility and collaboration between services and the community, and recognises the importance of social determinants in health promotion and the healing process. Such changes require policy support, targeted training and education, and ongoing promotion.

Survey of dental clinic patients: Smoking and preferences for cessation support

Background: Smoking cessation interventions delivered by dental practitioners can be as effective as those delivered by general medical practitioners. However, concern that addressing smoking may cause offence to their patients is a reason cited by dental practitioners for not regularly addressing patient smoking behaviours, despite believing they should play a role in smoking cessation. This study aimed to elicit the smoking behaviour and smoking cessation preferences of dental patients to determine if these concerns accurately reflect patient attitudes. Methods: We surveyed 726 adult dental patients attending the University of Queensland’s School of Dentistry Dental Clinics, Brisbane Dental Hospital, and four private dental practices in South East Queensland. Results: Most (80%) current daily smokers had tried to quit smoking. Smokers and non-smokers both agreed that dentists should screen for smoking behaviour and are qualified to offer smoking cessation advice (99% and 96% respectively). Almost all participants (96%) said they would be comfortable with their dentist asking about their smoking and that if their smoking was affecting their oral health their dentist should advise them to quit. Conclusions: Patients are receptive to dental practitioners inquiring about smoking behaviour and offering advice on quitting. Smoking patients showed considerable motivation and interest in quitting smoking, particularly in the context of health problems related to smoking being identified. These results should encourage dentists to raise the issue with their patients.