Continuation rates and reasons for removal among Implanon® users accessing two family planning clinics in Queensland, Australia

Background - This study examined demographic profile, continuation rates and reasons for removal among Implanon^® users accessing two family planning clinics in Queensland, Australia. Study Design - A retrospective chart audit of 976 women who attended for implant insertion over a 3-year period between May 2001 and May 2004. Results - Continuation rates showed that at 6 months after insertion, 94% of women continued, 74% continued at 1 year and 50% continued at 2 years. Metropolitan women were more likely than rural women to discontinue use because of dissatisfaction with bleeding patterns. Cox regression analysis showed that those attending the regional clinic experienced significantly shorter time to removal. Conclusions - Implanon® continuation rates and reasons for removal differ between clinics in metropolitan and rural locations. A cooling-off period did not affect the likelihood of continuation with Implanon®. Preinsertion counselling should emphasize potential changes in bleeding patterns.

Non-resident workers: A comparison of family support services for resource, health, and defence communities

Non-resident workforces experience high labour turnover, which has an impact on organisational operations and affects worker satisfaction and, in turn, partners’ ability to cope with work-related absences. Research suggests that partner satisfaction may be increased by providing a range of support services, which include professional, practical, and social support. A search was conducted to identify support available for resources and health-industry non-resident workers. These were compared to the supports available to families of deployed defence personnel. They were used to compare and contrast the spread available for each industry. The resources industry primarily provided social support, and lacked an inclusion of professional and practical supports. Health-professional support services were largely directed towards extended locum support, rather than to Fly-In Fly-Out workers. Improving sources of support which parallel support provided to the Australian Defence Force is suggested as a way to increase partner satisfaction. The implications are to understand the level of uptake, perceived importance, and utilisation of such support services.

Family mediation and women’s services: Towards effective referral

Central to Government’s strategy for separating families is the management and resolution of disputes away from courts and litigation processes wherever this is achievable. A key group of players in facilitating this vision are workers within the wide range of women’s services. This study surveyed workers at a number of Victorian women’s services that provide advice, support, and referral for women and explored their understanding of mediation processes and outcomes. The results indicate that, while generally supportive of mediation as a process that could assist their clients, workers were concerned about its appropriateness when family violence was an issue. Some of these concerns appeared to be based upon a good understanding of the limitations of mediation practices, but it is also apparent that some concerns were influenced by a misunderstanding and limited knowledge of contemporary mediation practice. It is recommended that family mediation services work proactively with women’s services in order to better inform each other of the possibilities and constraints in working with postseparation disputes.

What parents value from formal support services in the context of identified child abuse

Parents whose children are identified as having experienced or being at risk of experiencing significant harm potentially provide an invaluable dimension to our understanding of the circumstances that result in child abuse or neglect and how best to respond to these invariably complex situations. This paper reports findings from a study of the experiences of six parents. In-depth interviews were conducted with four mothers and two fathers who had been referred to an intensive family support services by the Queensland statutory child protection authority. Using a critical ecological perspective, the study focused on identifying and understanding the experiences of the parents in using formal family support services, including aspects of service delivery that were helpful or unhelpful. Parents also commented on their experiences of statutory child protection services. Service components and worker qualities that parents identified as being helpful included being accessible, targeted and integrated and being able to meet a continuum of needs, from a micro to a broader level. Their reports provide invaluable insight into how formal family support services, including child protection services, can better meet the needs of parents in addressing the recurring problem of child maltreatment.

Efficacy of family mediation and the role of family violence: Study protocol

Background Family law reforms in Australia require separated parents in dispute to attempt mandatory family dispute resolution (FDR) in community-based family services before court attendance. However, there are concerns about such services when clients present with a history of high conflict and family violence. This study protocol describes a longitudinal study of couples presenting for family mediation services. The study aims to describe the profile of family mediation clients, including type of family violence, and determine the impact of violence profiles on FDR processes and outcomes, such as the type and durability of shared parenting arrangements and clients’ satisfaction with mediated agreements. Methods A mixed method, naturalistic longitudinal design is used. The sampling frame is clients presenting at nine family mediation centres across metropolitan, outer suburban, and regional/rural sites in Victoria, Australia. Data are collected at pre-test, completion of mediation, and six months later. Self-administered surveys are administered at the three time points, and a telephone interview at the final post-test. The key study variable is family violence. Key outcome measures are changes in the type and level of acrimony and violent behaviours, the relationship between violence and mediated agreements, the durability of agreements over six months, and client satisfaction with mediation. Discussion Family violence is a major risk to the physical and mental health of women and children. This study will inform debates about the role of family violence and how to manage it in the family mediation context. It will also inform decision-making about mediation practices by better understanding how mediation impacts on parenting agreements, and the implications for children, especially in the context of family violence.

Screening for partner violence among family mediation clients: Differentiating types of abuse

Family mediation is mandated in Australia for couples in dispute over separation and parenting as a first step in dispute resolution, except where there is a history of intimate partner violence. However, validation of effective well-differentiated partner violence screening instruments suitable for mediation settings is at an early phase of development. This study contributes to calls for better violence screening instruments in the mediation context to detect a differentiated range of abusive behaviors by examining the reliability and validity of both established scales, and newly developed scales that measured intimate partner violence by partner and by self. The study also aimed to examine relationships between types of abuse, and between gender and types of abuse. A third aim was to examine associations between types of abuse and other relationship indicators such as acrimony and parenting alliance. The data reported here are part of a larger mixed method, naturalistic longitudinal study of clients attending nine family mediation centers in Victoria, Australia. The current analyses on baseline cross-sectional screening data confirmed the reliability of three subscales of the Conflict Tactics Scale (CTS2), and the reliability and validity of three new scales measuring intimidation, controlling and jealous behavior, and financial control. Most clients disclosed a history of at least one type of violence by partner: 95% reported psychological aggression, 72% controlling and jealous behavior, 50% financial control, and 35% physical assault. Higher rates of abuse perpetration were reported by partner versus by self, and gender differences were identified. There were strong associations between certain patterns of psychologically abusive behavior and both acrimony and parenting alliance. The implications for family mediation services and future research are discussed.

Schizophrenia : an overview and practical handbook

Schizophrenia is a serious mental disorder currently undergoing a renaissance of scientific interest. This book summarizes current knowledge and details some of the recent developments. Divided into three sections, it presents an overview of the disorder, including its features, social impact and aetiology; reviews methods of assessing the symptoms and disabilities of schizophrenia and examining the sufferer's social environment; and discusses a range of interventions, from pharmacological treatment to skill training for individuals and families. Issues that arise in planning services for sufferers and their families are also reviewed. All of the chapters focus on clinical practice and many include guides to assessment and practice. This handbook should be particularly useful in training health professionals in psychiatric/mental health services and general practice. It also aims to offer practitioners and researchers a comprehensive update on schizophrenia that is both easy to read and practical in its focus.

Predictors of sexually transmitted infection in Australian women : evidence from the Australian longitudinal study on women’s health

This longitudinal study examined characteristics of women diagnosed with sexually transmitted infections (STI) for the first time in their later 20s and early 30s. Participants were 6,840 women (born 1973–1978) from the Australian Longitudinal Study on Women’s Health. Women aged 18–23 years were surveyed in 1996 (S1), 2000 (S2), 2003 (S3), and 2006 (S4). There were 269 women reporting an STI for the first time at S3 or S4. Using two multivariable logistic regression analyses (examining 18 predictor variables), these 269 women were compared (1) with 306 women who reported an STI at S2 and (2) with 5,214 women who never reported an STI across the four surveys. Women who reported an STI for the first time at S3 or S4 were less likely to have been pregnant or had a recent Pap smear compared to women reporting an STI at S2.Women reporting a first STI at S3 or S4 were less likely to have been pregnant or had a recent Pap smear compared to women reporting an STI at S2. Women were more likely to report an STI for the first time at S3 or S4 compared to women not reporting an STI at any survey if they were younger, unpartnered, had a higher number of sexual partners, had never been pregnant, were recently divorced or separated, and reported poorer access to Women’s Health or Family Planning Centres at S2. These findings demonstrate the value of longitudinal studies of sexual health over the life course beyond adolescence.

Epidemiologic characteristics of cases for influenza A(H7N9) virus infections in China

China's National Health and Family Planning Commission announced 3 deaths caused by avian-origin influenza A(H7N9) virus in March, which was the first time that the H7N9 strain has been found in humans [1]. This is of major public health significance and raises urgent questions and global concerns [2, 3]. To explore epidemic characteristics of human infections with H7N9 virus, data on individual cases from 19 February 2013 (onset date of first case) to 14 April 2013 were collected from the China Information System for Disease Control and Prevention, which included information about sex; age; occupation; residential address; and day of symptom onset, diagnosis, and outcome for each case. The definition of an unconfirmed probable H7N9 case is a patient with epidemiologic evidence of contact …

Raising levels of awareness of rights and obligations in the provision of financial product advice to retail clients

In September-December 2012, 548 financial planning retail clients and 77 financial advisers responded to online surveys addressing consumer satisfaction with financial planning services and the provision of information concerning regulatory and rights issues. Retail clients commented on areas related to the best interests duty in s 961B of the Corporations Act 2001 (Cth), in particular the extent to which advisers considered their clients’ financial objectives and lifestyle situations, and the client-centredness of the financial advice they received. Retail clients also indicated their level of awareness of their substantive rights in relation to receiving advice, the legal obligations imposed on advisers, and whether they would access internal and external complaints processes if warranted. Advisers reported on the extent to which they provide clients with information relating to their substantive rights, and complaints processes available to them. Responses were analysed in relation to client demographics (e.g., age, gender, education), and experience of financial advice. This article reports on the findings of the surveys and their implications for financial planners.

Youth off the Streets "Our Place, Walgett Youth and Young Families Project" Project Evaluation.

The Project: • YOTS is a major youth specific agency established in 1991. It is a non-denominational, non-discriminatory and not-for-profit organisation, providing a wide range of services and offering a full continuum of care. It seeks to build on the strengths and positive aspects of marginalised young people and communities. • The 'Our Place, Walgett Youth and Young Families Project' further develops an existing YOTS capacity to provide services to Aboriginal young people. • The project adopted an action-research and community development model in which YOTS worked in partnership with the Youth Sub-committee of the Walgett Interagency. • Specific goals/objectives of the program were to: Coordinate youth and young family activities in partnership with local services and the community to build self-esteem, pride, resilience, motivation and skills; Contribute to the prevention and reduction of homelessness, unstable and unsafe housing and disruptive mobility (Walgett/Redfern) in youth and young families; Increase and improve collaborative engagement between youth and family focused services; and, research, adapt and implement Australian and international best-practice homelessness prevention/reduction initiatives to contribute to new models of practice relevant to rural and regional areas. • The project centred around an out-reach model that focused on providing a safe space with relevant structured activities coordinated by YOTS youth and family workers. Through community and service provider consultation, it was proposed that local services could coordinate strategies and activities and run them, where possible, from the centre, providing ease of access in a safe and supportive context. • Specific activities included: Implementing regular meetings with the stakeholders and community representatives; Developing a Terms of Reference for YOTS presence in the Walgett community; Undertaking a community consultation prior to finalising program activities; Implementing a range of recreational activities (sports, music, arts and crafts) early on in the activity; Implementing young family support initiatives; implementing a volunteering program, including volunteer support to young families through intergenerational volunteering; running a series of Culture and Healing Camps in partnership with local Elders and other services; Running a series of Music Camps; Providing alternative education support and referrals in partnership with local schools; Researching, identifying and adapting other best-practice models.

Emergency department nurses' understanding and experiences of implementing discharge planning

Aim: This paper is a report of a study conducted to describe emergency department nurses' understanding and experiences of implementing discharge planning. ---------- Background: Discharge planning in the emergency department is an important issue because of increased healthcare costs and greater emphasis on continuity of care. When executed as a collaborative process involving a multi-disciplinary team with the patient and family, discharge planning provides continuity of care for patients, less demand on hospitals, improvement in community services and in the services of other healthcare organizations. ---------- Method: The qualitative approach of phenomenography was used in this study. Thirty-two emergency department nurses were recruited between July and September 2005. Semi-structured interviews were conducted. ---------- Findings: From interviewees' descriptions of implementing discharge planning, six categories were established: implementing discharge planning as 'getting rid of my patients', completing routines, being involved in patient education, professionally accountable practice, autonomous practice and demonstrating professional emergency department nursing care. The referential meaning of implementing discharge planning 'in the outcome space' was the professional commitment to emergency department provision of effective discharge services. ---------- Conclusion: The results of this research contribute to knowledge of emergency department nurses' experience in the implementation of the discharge planning process. Key requirements for the provision of manageable discharge services both in Taiwan and worldwide highlighted by this study include adequate workloads, sufficient time, clear policies and standards of discharge planning and enhancement of professional commitment.