Thought processes associated with reluctance in gay men to be tested for HIV

This study explored the thought processes that are associated with reluctance in gay men to be tested for HIV antibodies. The sample comprised 97 men who had not been tested for at least four years; 69 had never been tested. They were asked to imagine that someone had suggested that they be tested very soon and to identify, from the list provided, any negative thoughts prompted by this suggestion. The most commonly reported thoughts were that testing was unnecessary because risks had not been taken, that it was unnecessary because there were no symptoms, and that there was no urgency to be tested. Data were explored by means of factor analysis and comparisons across subgroups differing in risk level. The results are interpreted as indicating the use of rationalizations to buttress a decision not to be tested, the powerful influence on HIV decision-making exerted by salient perceptible features, and the ‘status quo bias’. Techniques that could be used to encourage testing in gay men are discussed.

Ways in which theory and practice are integrated in the pre-service teacher education practicum

This paper reports on a study into pre-service teachers’ perceptions about their professional development during practicum. The study examined to what extent, and how effectively, one group of pre-service teachers was able to integrate theory and practice during a three-week practicum in the first year of their degree. Data for this mixed methods study were drawn from one cohort of first-year students undertaking the Master of Teaching (MTeach), a graduate-level entry program in the Faculty of Education at an urban Australian university. Although there is a strong field of literature around the practicum in pre-service teacher education, there has been a limited focus on how pre-service teachers themselves perceive their development during this learning period. Further, despite widespread and longstanding acknowledgement of the “gap” between theory and practice in teacher education, there is still more to learn about how well the practicum enables an integration of these two dimensions of teacher preparation. In presenting three major findings of the study, this paper goes some way in addressing these shortcomings in the literature. First, opportunities to integrate theory and practice were varied, with many participants reporting supervision and scheduling issues as impacting on their capacity to effectively enact theory in practice. Second, participants’ privileging of theory over practice, identified previously in the literature as commonly characteristic of the pre-service teacher, was found in this study to be particularly prevalent during practicum. Third, participants overwhelmingly supported the notion of linking university coursework assessment to the practicum as a means of bridging the gap between, on the one hand, the university and the school and, on the other hand, theory and practice. The discussion and consideration of findings such as those reported in this paper are pertinent and timely, given the ratification of both the National Professional Standards for Teachers and the Initial Teacher Education Program Standards by the Australian Federal Government earlier this year. Within a number of the seven Professional Standards, graduate teachers are required to demonstrate knowledge and skills associated with both the theory and practice of teaching and with their effective integration in the classroom. To be nationally accredited, pre-service teacher education programs must provide evidence of enabling pre-service teachers to acquire such knowledge and skills.

Efficacy of neuromuscular electrical stimulation in improving ankle kinetics during walking in children with cerebral palsy

Neuromuscular electrical stimulation (NMES) applied to the triceps surae muscle is claimed to be effective in improving gait in children with cerebral palsy. The main aim of this study was to determine the effect of NMES on the triceps surae muscle in improving the gait and function of children with cerebral palsy. Twelve children with spastic diplegia or hemiplegia were recruited and randomly assigned to the two experimental groups. The period of the study was 8 weeks (2-4-2 week design). The initial 2 weeks was the control period, in which usual treatment was given to both groups of patients with a pre- and post-treatment assessment. The middle 4 weeks was the experimental period, in which the Treadmill+NMES group received NMES plus treadmill walking training and the Treadmill group underwent treadmill walking training only. Assessment was performed at 2-week intervals. The final 2 weeks was the carryover period, in which treatment to be tested was stopped and reassessment performed again at the end of week 8. An additional treatment and post-treatment assessment were given at weeks 2, 4 and 6 to test for the immediate effect of treatment. Altogether, eight repeated measures with three-dimensional gait analysis and five clinical measurements using the gross motor function measure (GMFM) were performed. Kinetic changes in ankle moment quotient (AMQ) and ankle power quotient (APQ) were not significant either immediately or cumulatively in both groups. Improvement in trend was observed in both groups immediately but not cumulatively. Using the GMFM, functional changes were detected in standing (GMST, p < 0.001) and in walking (GMWK, p = 0.003) using a 'time' comparison. Significant interaction was also detected in GMWK using 'treatment by time' (p = 0.035). The difference between the two groups was not significant on 'treatment' comparison of both GMST and GMWK. Both groups showed improvement in GMST and GMWK cumulatively but there was no difference between the two groups. The effects in both groups could be carried over to 2 weeks after interventions stopped. Both the Treadmill+NMES and Treadmill groups showed improvement in functional outcomes. The trend in the changes of the GMFM score suggested that improvements were greater in the Treadmill+NMES group. There was also a trend showing some immediate improvement in AMQ and APQ.

Fire safety training: its importance in enhancing fire safety knowledge and response to fire

Fire-related accidents often result in injuries and sometimes death, which can be prevented through fire safety training. To estimate the extent to which fire safety training should be provided, it is essential to assess the current level of fire safety knowledge within the general community. Thus the objectives of the present study were to explore: (a) the level of fire safety knowledge among people of different age groups and investigate its relationship to the level of fire safety training, and (b) the manner in which people from different age groups would respond to a fire based on their fire safety training. Data from 158 participants aged between 18 and 80 years showed that fire safety training increases: (a) the level of fire safety knowledge and, (b) the accuracy of response to a fire. The results also show that middle-aged individuals would respond more accurately to a fire than younger and older adults. The findings demonstrate the importance of fire safety training in enhancing people's fire safety knowledge and their response in the event of a fire which could lead to a reduction in the rate of fire casualties. There are implications for incorporating fire safety training as part of health improvement programs to reduce the number of fire-related injuries and fatalities.

Market virtues and public failures : antecedents to public sector reform in the contract state

This paper considers the historical factors that have contributed to the pressures for reform in the Australian State of Victoria which proved to be more radical than paths taken by the Commonwealth Government and any other Australian states. As public management in Victoria made tentative steps towards market orientated practices, the inexperienced public officials, together with a mixture of political, economic, administrative and social factors made the government more vulnerable to a perceived need for reform. Australia, like the United Kingdom and New Zealand with which it shares similarities of government structure, commenced the path of reform in a tentative manner with major reforms being implemented by powerful leaders. Powerful reformers were Margaret Thatcher in the United Kingdom, a group of like minded politicians from Treasury in New Zealand and in the Australian State of Victoria, Jeff Kennett. Each capitalised on a sense of crises to move their reform agenda forward at a rapid pace. Victoria is offered as an illustration of how the past provides a means of understanding why Premier Jeff Kennett was able during the 1990's, to implement public sector reform into Victoria in such a dramatic way.

Foucault goes to the footy: professionalism, performance, prudentialism and playstations in the life of AFL footballers

This paper will report on a research project funded by the Australian Football League (AFL) that is exploring the emergence and evolution of a ‘professional identity’ for AFL footballers – an identity that has many facets including the emerging ideas that a professional leads a balanced life, and has a prudent orientation to the future. The research is informed by Foucault’s later work on the care of the Self to focus on the ways in which player identities are governed by coaches, club officials, player agents and the AFL Commission/Executive; and the manner in which players conduct themselves in ways that can be characterised as professional - or not. The paper explores elements of these processes by analysing the forms of risk management that Clubs use in the processes of List and Player management that they engage in as a consequence of AFL rules. Psychological testing and profiling of players is becoming more important in identifying, recruiting and managing players. The paper discusses how this testing is used to identify character or personality traits prior to initial recruitment in the draft or trading processes – and suggests that a number of issues related to workplace surveillance and identity emerge as a result.

Projections to the preoptic area from the paraventricular nucleus, acuate nucleus and the bed nucleus of the stria terminalis are unlikely to be involved in stress-induced suppression of GnRH secretion in sheep

Stress compromises reproductive function and the major physiological system activated during stress is the hypothalamo-pituitary-adrenal axis. Corticotrophin-releasing hormone and arginine vasopressin (AVP), which are produced in neurones of the paraventricular nucleus (PVN), drive the hypothalamo-pituitary-adrenal axis and are also implicated in the suppression of the reproductive axis. We used retrograde tracing and Fos labelling to map the projections from the PVN to the preoptic area (POA) where most gonadotrophin releasing hormone (GnRH) neurones are found. Fluorogold (FG) injections were made into the POA of gonadectomised male and female sheep (n = 5/sex), the animals were stressed and the brains recovered for histochemistry. All animals responded to stress with an increase in the number of Fos-labelled nuclei in the PVN. Few retrogradely labelled cells of the PVN were activated by stress. Dual labelling showed that very few FG-labelled cells also stained for corticotrophin-releasing hormone, none for AVP or enkephalin. Dual labelling for FG and Fos in the bed nucleus of the stria terminalis (BNST) and the arcuate nucleus showed that no FG-labelled cells in the BNST and only few in the ARC were activated by stress. No sex differences were observed in the activation of FG-labelled cells in any of the nuclei examined. We conclude that, although cells of the PVN, BNST and/or arcuate nucleus may affect reproduction via the GnRH cells of the POA, this is unlikely to involve direct input to the POA. If cells of these regions are involved in GnRH suppression during stress, this may occur via interneuronal pathways.

Provision of meals on wheels to the elderly : case studies in the era of local government reform

Australia’s ageing population is on the increase. It is predicted that by 2021 one quarter of Victoria’s elderly population will be aged 60 and over. Not only are people living longer, but they also wish to remain living in the community. The Home and Community Care (HACC) Program was established in 1985 to facilitate and assist the elderly and disabled to remain in their home. In Victoria around 51% of HACC funds are managed by local governments, a level of government that has recently undergone major reforms, which ultimately impacted on the manner in which services were provided. The HACC program funds Meals on Wheels, a service that provides meals for those elderly who no longer can prepare their own meals. The aim of this study was to assess the Meals on Wheels service provided by two Melbourne councils with different service philosophies. The study has four main components: (1) Menu analysis by food and variety; (2) Analysis of actual meals; (3) Clients assessment of Food Services; and (4) Client assessment of the organoleptic qualities of Meals on Wheels. Two Melbourne councils were chosen for their different approaches to service delivery. The City of South tendered out both meal production and delivery, while the City of North maintained its MOW service in-house. The case study method of research allowed for each council’s service to be assessed objectively and without comparison. Several methodologies were used for collecting data in this study. Menu analysis was carried out by comparing the MOW menus with the HACC menu planning guidelines together with general menu planning principles. Analysis of actual meals was in two stages. The weights of the meals were recorded and compared with the HACC recommended food serving portions and meal combinations over a five-day period were analysed for their nutrient contents. Face to face interviews were conducted with clients for their assessment of MOW and the assessment of the organoleptic qualities of the meals was carried out over a five-day period. The results concluded that both councils menus were based on sound menu planning principles, but did not conform with Home and Community Care menu planning guidelines fully and did not include a serve of bread, fruit and milk. The weight analysis of the meal combinations revealed some discrepancies between actual meals and Home and Community Care guidelines by not meeting the recommended serving sizes. Meal combinations generally met Home and Community Care standard for kilojoule and protein, but other nutrients, such as thiamin, riboflavin, magnesium, calcium and zinc were generally below the recommended levels for Meals On Wheels. The majority of study group lived alone and received four to five meals per week. Delivery times of meals, selective menus and food quality were issues raised by clients. Whilst the quality and variety of vegetables was raised by clients they generally rated the organoleptic qualities of the meals as satisfactory. This study examined the four components of the service. A simple method of evaluation the service was developed, which highlight discrepancies with HACC standards and encouraged the councils to set a customer satisfaction standard. A number of recommendations are made to ensure that meals are aesthetically pleasing, including a list of different methods for preparing vegetables. The provision of additional foods, such as a “snack pack” is recommended to improve the supply of essential nutrients that were below the Home and Community Care standards. Meals on Wheels is a vital support service for the elderly living in the community and as such should aim to provide a high quality service that meets the needs of its clients.

Organized blood pressure control programs to prevent stroke in Australia : would they be cost-effective?

Background and Purpose—: High blood pressure (BP) is the most important modifiable stroke risk factor. Worldwide high BP in many people is uncontrolled or people are unaware of their BP status. We aimed to assess whether a program of organized multidisciplinary care and medication would be cost-effective for improving BP control for the prevention of stroke.

Methods—: A novel aspect was to simulate the intervention to match recent primary care initiatives (eg, new Medicare reimbursement items) to ensure policy relevance. Current practice and additional costs of each intervention were included using the best available evidence. The differences in the cost per quality-adjusted life year (QALY) gained for the interventions were compared against current practice. Cost-effectiveness was defined as cost per QALY gained was less than Australian dollars (AUD) 50 000 (societal perspective; reference year 2004). The robustness of estimates was assessed with probabilistic multivariable uncertainty analysis.

Results—: For primary prevention, the median cost per QALY gained was AUD11 068 (95% uncertainty interval AUD5201 to AUD18 696) in those aged 75 years or older and was AUD17 359 (95% uncertainty interval AUD10 516 to AUD26 036) in those aged 55 to 84 years with >=15% absolute risk of stroke. Primary prevention interventions were not cost-effective if aged younger than 50 years. The median cost per QALY gained for secondary prevention was AUD1811 and AUD4704, depending on which medications were modeled.

Conclusions—: Organized care for BP control targeted at specific populations offers excellent value over current practice. Organized care for secondary prevention provided the greatest benefits and strongest cost-effectiveness. Translation into clinical practice requires improved use of relevant Medicare policy in Australia.

The country’s not what it used to be : research participants’ understandings of space, place and identity in rural Victoria

This chapter explores the various ways in which research participants from rural areas located in country Victoria, Australia, construct and reconstruct their understandings of themselves and their rural spaces in terms of place and identity. This chapter draws upon the data of two separate research projects that bought together a variety of researchers and research participants either growing up in, working in, or studying in rural areas.

A Rational Approach To Sentencing White- Collar Offenders in Australia

There are no overarching (and few settled) principles governing the sentencing of white-collar offenders. This is especially the situation in relation to the relevance of public opprobrium to the sentencing calculus and the manner in which employment deprivations stemming from the penalty impact on the sentence. To the extent that there is general convergence in the approach to sentencing white-collar offenders, the approach is often not sound. This is the case in relation to the minor sentencing discount accorded for previous good character, and the prevailing orthodoxy which assumes that offences targeted at major institutions, such as banks, meaningfully impair community confidence in such institutions. Fundamental reform of the manner in which white-collar offenders are sentenced is necessary in order to make this area of law more coherent and doctrinally sound. These reforms include providing a significant and pre-determined discount for restitution, reducing the weight given to general deterrence in the sentencing calculus, and providing a greater discount for previous good character and employment deprivations suffered as a direct result of the sentence. Further, crimes against individuals should be regarded as being more serious than those committed against large corporations or the public revenue. The article focuses on the existing law in Australia, however, the reform proposals and doctrinal analysis could be applied to all jurisdictions.

Teaching and learning in the crucible: Actors with disabilities as experts preparing pre-service teachers to be inclusive educators

Dorothy Heathcote understood teaching and learning to take place in a kind of ‘crucible’ in which participants, who are both teachers and learners, contribute to the mix sometimes resulting in a radical transformation. This paper reports the ways Heathcote’s ideas have influenced both research and practice in the Teaching for Diversity workshop - a drama workshop that brings together pre-service teachers, teacher educators and actors from Fusion Theatre, a community-based theatre company for people with intellectual disabilities.