Program sustainability of a community-based intervention to prevent falls among older Australians

Multi-strategy interventions have been demonstrated to prevent falls among older people, but studies have not explored their sustainability. This paper investigates program sustainability of Stay on Your Feet (SOYF), an Australian multi-strategy falls prevention program (1992–1996) that achieved a significant reduction in falls-related hospital admissions. A series of surveys assessed recall, involvement and current falls prevention activities, 5 years post-SOYF, in multiple original SOYF stakeholder groups within the study area [general practitioners (GPs), pharmacists, community health (CH) staff, shire councils (SCs) and access committees (ACs)]. Focus groups explored possible behavioural changes in the target group. Surveys were mailed, except to CH staff and ACs, who participated in guided group sessions and were contacted via the telephone, respectively. Response rates were: GPs, 67% (139/209); pharmacists, 79% (53/67); CH staff, 63% (129/204); SCs, 90% (9/10); ACs, 80% (8/10). There were 73 older people in eight focus groups. Of 117 GPs who were practising during SOYF, 80% recalled SOYF and 74% of these reported an influence on their practice. Of 46 pharmacists operating a business during SOYF, 45% had heard of SOYF and 79% of these reported being ‘somewhat’ influenced. Of 76 community health staff (59%) in the area at that time, 99% had heard of SOYF and 82% reported involvement. Four SCs retained a SOYF resource, but none thought current activities were related. Seven ACs reported involvement, but no activities were sustained. Thirty-five focus group participants (48%) remembered SOYF and reported a variety of SOYF-initiated behaviour changes. Program sustainability was clearly demonstrated among health practitioners. Further research is required to assess long-term effect sustainability.

The adaptive significance of ontogenetic colour change in a tropical python

Ontogenetic colour change is typically associated with changes in size, vulnerability or habitat, but assessment of its functional significance requires quantification of the colour signals from the receivers' perspective. The tropical python, Morelia viridis, is an ideal species to establish the functional significance of ontogenetic colour change. Neonates hatch either yellow or red and both the morphs change to green with age. Here, we show that colour change from red or yellow to green provides camouflage from visually oriented avian predators in the different habitats used by juveniles and adults. This reflects changes in foraging behaviour and vulnerability as individuals mature and provides a rare demonstration of the adaptive value of ontogenetic colour change.

Bystander behaviour as an influence on bullying in high schools

In response to evidence that bullying in schools persists in the presence of bystanders, this study sought to add to the existing knowledge about its reinforcing effects. The objectives of this research project were to investigate non-intervention in bullying incidents by students. Unique approaches of this research are the multi-dimensional investigation of the emotional, cognitive and behavioural factors from the bystander's perspective, within the context of a co-educational Catholic high school, in a sample of eighteen Year 8 students. In-depth and group interviews, participant observation and the input of a focus group of teachers formed the data collection. Previous findings that fear prevents bystanders from taking action, were extended by this study which revealed was that there are several sources of this fear. The study found reasons for students' fear included embarrassment at making a mistake, the importance of the teachers' responses, the need to assimilate into the new school culture, to be 'cool' and to avoid a negative, conforming self-image. Importantly, the existing focus on fear does not explain why students do not anonymously report bullying. This study found that students resisted taking responsibility for intervening, and unexpected findings included that students categorised victims, only caring enough to report bullying if the victim were a friend or sibling; and also that the thrill of watching bullying was a strong deterrent to bystander intervention. The study suggests, therefore, information based anti-bullying policies will be ineffective unless students are motivated to intervene. It is crucial that programmes now address the emotional deterrents of fear, excitement and apathy before considering educational approaches, and that future policies need to examine the culture of the school, including teachers' responses to bullying, which dictates the behavioural code for incoming Year 8 students.

Studentship and oppositional behaviour within physical education teacher education : a case study ; and, Between the rings and under the gym mat : a narrative

This thesis represents a part of a program of study that is reaching a closure. The broadest brush that could be applied to my work is that it concerns Physical Education Teacher Education (PETE), that it focuses on aspects of professional socialisation, and that it involves various case studies utilising naturalistic inquiry. Whilst it would be impossible and naive to believe that the reading of these texts will produce the meanings that I encourage, or have internalised, nevertheless the order of reading is at least something that I can argue for. Read in the order I suggest throughout the thesis I am hopeful that my subjectivities, and the learning and understandings I have reached may become clear. The purpose of this two part thesis is an exploration of the interplay or dialectic that exists between PETE students, academic staff and the subject matter within PETE. I have had to come to understand the limitations and advantages of insider research as the work has been completed at my University in the School of Human Movement and Sports Science where I have worked for twenty years. This thesis examines the extent to which studentship and oppositional behaviour underlies the dialectic that exists between the students and the various discourses within the program. I have written the study in two very different formats, one, a collection of stories about PETE and the other, an interpretative case study conducted during 1993 and 1994. Within the case study, studentship and oppositional behaviour were viewed as a measure of the extent to which students react and push against the forces of socialisation within their PETE program that is seen to represent dominant discourses, The following broad research questions were considered to enable the above analysis. 1. What is the nature of studentship and oppositional behaviour in a high status subject within PETE compared to a subject that is seen by students to be of little relevance and of low status? 2. How are studentship and oppositional behaviour related to students subjective warrants? 3. How are the studentship and oppositional behaviours exhibited by students related to the pedagogy and discourses reflected in the knowledge, beliefs and practices within the two sites. The starting point for this research was a study conducted as a totally separate research task (Swan, 1992) that investigated the hierarchies of subject knowledge within a PETE site and investigated the influence of such hierarchies upon student intention. A great deal of meta analysis exists about the manner in which a technocratic rationality pervades PETE but very little case study material of what this means to students and academic staff within such institutions is available. The stories in Between The Rings And Under The Gym Mat, which is the second part of this thesis, represent ‘the data’ differently from the case study, but they speak their own truth. At times the nature of the story is indistinguishable from the reality of the case study. Wexler (1992) undertook an ethnographic study about identity formation in three very different high schools, and published the findings in a book entitled Becoming Somebody. His introductory words about the nature of the social story he tells, are significant to this study and story. Social history is recounted by creative intervention that can only be made from culturally accessible materials. Ethnography is neither an objective realist, nor subjective imaginist account. Rather, it is an historical artefact that is mediated by elaborated distancing of culturally embedded and internally contradictory (but seemingly independent and coherent) concepts that take on a life of their own as theory. So, this is not ‘news from nowhere,’ but a theoretically structured story where both the story and its structure are part of my times. (p.6) The case study before you is organised with an analysis of studentship and oppositional behaviour detailed in chapter one. The following chapter conceptualises studentship and oppositional behaviour in relation to particular themes of professional socialisation, resistance to oppression and youth culture. Chapter three locates the case study to the major paradigmatic debates about the value and nature of the subject matter content within PETE, Chapter four outlines the case site, the research process and the research dilemma’s confronted in this study. The remaining three chapters are the case record as I can best understand it. In Between the Rings and under the Gym Mat (part B) the story most directly concerned with studentship and oppositional behaviour, is called Tale of Two Classes’. It takes on a very different reality to the case study (part A) and much can be said about the reality of lived experience which can be portrayed in narrative form as opposed to a clinical case study. Many of the other stories pose similar images that are contradictory and never quite complete. I have written a separate methodological section for the narrative stories. It is my intention that the case study and the series of stories should be viewed as essentially complementary, but also a discrete representation of a part of PETE. As part of the Ed D program I have undertaken four discrete research tasks as the starting point for this research I have referred to the first one (Hierarchies of Subject knowledge within PETE). I also undertook an action research project about ‘Teaching Poorly by Choice.’ A further piece of research was a somewhat reflective effort to draw together what this has all meant to me from a subjective and reflexive perspective. Such efforts are often seen as being self indulgent, as subjectivity in the form of lived experience sits uneasily in academia. A final paper involved an evaluation of Between the Rings and Under the Gym Mat from a pedagogical perspective by PETE professionals around the world. And that's the way things turned out.

1948 and 1968 Czech refugee settlers in Australia : a comparison of the settlement and integration processes among two waves of settlers

Nearly eighteen years ago when I first became interested in the history and sociology of Australian immigration, I was particularly attracted by the fact and opportunity to incorporate immigration settlement, experience and accomplishments in my history teaching in secondary school. In particular it was the area of the settlement of Australia that needed a fuller understanding in the teaching of Australian history. By that I mean it was needed to show that there were many other ethnic groups besides the Anglo-Saxon group which had participated in the development of Australia since 1788. Since the end of World War II, the Australian population has doubled, the population structure and characteristics have changed and knowledge about the diverse groups forming the Australian nation is now sought. Sane ethnic groups, mainly the numerically large, have been studied and numerous reports are available. But many of the smaller groups have attracted little interest among Australian scholars. This was one of the reasons that I decided to research the behaviour of one of the smaller groups - the Czechs - to find out about their immigration history to Australia; their immigration processes such as re-settlement and re-establishment; and their community life since World War II. Because of the scarcity of written materials on Czechs in Australia, I had to rely on interviews, personal reminiscenses, letters and documents translated from the Czech language. I should like to express my gratitude to all people and officials of Czech ethnic organisations and clubs in Australia, who agreed to be interviewed and who provided me with documentary material so important for my work. Respecting the wishes of my interviewees their anonymity had to be preserved. In the course of my research, I have received substantial help and the encouragement from the Editor of the now extinct Czech language paper Newspaper Hlas domova, Mr. F.V., whose co-operation is gratefully recognised. I am also grateful to Associate Professor William D. Rubinstein for his help and encouragement in all stages of my work. The introductory part of the study is covered in Chapter One. She reasons for the need to increase Australia's population after World War II and an analysis of the development of settlement in Australia between 1947 and 1984 are discussed. The emigration of Czechs into Australia and their place in the post-war immigration scheme is introduced. To obtain an overview of how Czechs have emigrated around the world, the literature describing their settlement is compared. Also discussed in the literature on Czech settlement in Australia from an historical point of view. The studies on the concept of ethnicity and settlement in Australia are used to document the theoretical issues for an understanding of Australian society. This chapter also contains aspects of sources and research, shewing the processes of documentary research, interviews and related matters. In Chapter Two the history of Czech emigration is discussed, covering the period from the seventeenth to the twentieth century. The first contacts with Australia are highlighted, continuing into the inter-war period and finally the re-settlement of Czechs after World War II. To understand why Czechs left their ancestral country after World War II, the political situation in Czechoslovakia is analysed. The third chapter concentrates mainly in the 1948 wave of settlers, who left Czechoslovakia after the communist take-over in 1948. Their means of departure from their homeland, selection of Australia as a new homeland and their re-settlement and re-establishment are discussed. Their attitudes after their arrival and their later stages of their settlement are analysed. The formation of numerous Czech ethnic organisations which mushroomed between 1950 and 1954 led to an active community life which began to change about five years after their arrival. These charges led to disorganisation of Czech community's life. The causes of these changes which were influential for the failure of the 1948 group to establish a viable community in Australia are analysed. In Chapter Four the wave of 1968 is viewed, their arrival and settling is covered. The study of their group attitudes and formation of group institutions is the main part of this section. A comparison of my data of the two waves, 1948 and 1968, reveals the information that these two groups did not develop the harmonious relationship expected of them as members of the one ethnic group. Chapter Five discusses immigration typologies and concentrates on the differences between legal and illegal emigrants from the Czechoslovak point of view. The integration processes of Czechs and their incorporation into Australian society are discussed. The sixth chapter sums up the findings of this disertation and states the influences which were responsible for the divisions in Czech ethnic life in Australia in the 1980s.

Empowerment in early childhood intervention : perspectives of parents of children with disabilities

There have been various changes to the manner in which early intervention services for children with disabilities have been provided in recent decades. One of the most significant paradigm shifts that has accoured pertains to a change in the level of family involvement in early intervention, so that families are now required to be equal partners with professionals in the service provision process. It is now policy in Victoria that early intervention services follow a family-centred model of practice. Services adopting this model aim to empower parents, so that they may have impact on their lives, and the lives of their family members, both during and beyond the years of direct service participation. Much of what is known about empowerment to date is based on theory, author opinion, and research that is largely survey-based. There has been little interview-based research, particulary involving parents of children with disabilities, as well as little Australian research conducted regarding empowerment. To the researcher's knowledge, there has been no interview-based research that specifically asked parents of children with disabilities about their perspectives on empowerment and disempowerment. Parents of children with disabilities are not invited to contribute their opinions in services and research. Empowerment is an individual concept and this research provided parents with an opportunity to express their views on this topic. Parent's perspectives on empowerment are vital for service providers who aim to follow the intervention model required by policy. This research, which was guided by the principles of ecological theory and critical theory, involved to individual semi-structured interviews with 37 Victorian families of children with disabilities. Twenty-one of these families had children currently participating in early intervention services, and 16 families had children of mid-primary school age, who had previously participated in early intervention experiences; the factors that they believe influence empowerment and disempowerment; and helpful and unhelpful experiences with early intervention staff and other people in their lives. Data were analysed primarily inductively, in the context of grounded theory. Responses from the two groups of parents were then compared, as were different emergent themes according to helpfulness and empowerment. The nature of enduring empowerment, one of the key objectives of early childhood intervention, was also considered. From the analysis of data, several themes emerged as influential in the empowerment process for both groups of parents including: information, education and knowledge; meeting and talking with other families of children with disabilities; decision-making and choice; having confidence; participation, involvement and input; meeting or addressing families' practical needs; and having a child with a disability. The results of this research provide valuable information for parents, professionals, agencies, organisations, and the wider community, regarding how families can be supported more effectively and how power can be more equitably balanced.

Correlates of screening mammography for Italian and Anglo-Australian women

The first aim of the research was to determine the applicability of certain variables from the Health Belief Model (HBM), the Theory of Reasoned Action (TRA), the risk dimensions from the Psychometric Paradigm, the Common-Sense Model of Illness Representations and the Locus of Control to Italian women’s beliefs and behaviours in relation to screening mammography. These models have predominantly been derived and evaluated with English-speaking persons. The study used quantitative and qualitative methods to enable explanation of research-driven and participant-driven issues. The second aim was to include Italian women in health behaviour research and to contrast the Italian sample with the Anglo-Australian sample to determine if differences exist in relation to their beliefs. In Australia many studies in health behaviour research do not include women whose first language is not English. The third aim was to evaluate the Anti-Cancer Council of Victoria’s (ACCV) Community Language Program (CLP) by: (a) identifying the strengths and weaknesses of the program as seen by the participants; and (b) assessing the impact of the program on women’s knowledge and beliefs about breast cancer, early detection of breast cancer, self-reported and intended breast screening behaviours. The CLP is an information service that uses women’s first language to convey information to women whose first language is not English. The CLP was designed to increase knowledge about breast and cervical cancer. The research used a pre-test-intervention-post-test design with 174 Italian-born and 138 Anglo-Australian women aged 40 years and over. Interviews for the Italian sample were conducted in Italian. The intervention was an information session that related to breast health and screening mammography. Demographic variables were collected in the Pre-Test only. Qualitative open-ended questions that related specifically to the information session were collected in the Post-Test phase of the study. Direct logistic regression was used with the participants’ beliefs and behaviours to identify the relevant variables for language (Italian speaking and English-speaking), attendance to an information session, mammography screening and breast self-examination (BSE) behaviour. Pre- and Post-Test comparisons were conducted using chi-square tests for the non-parametric data and paired sample t-tests for the parametric data. Differences were found between the Italian and Anglo-Australian women in relation to their beliefs about breast cancer screening. The Italian women were: (1) more likely to state that medical experts understood the causes of breast cancer; (2) more likely to feel that they had less control over their personal risk of getting breast cancer; (3) more likely to be upset and frightened by thinking about breast cancer; (4) less likely to perceive breast cancer as serious; (4) more likely to only do what their doctor told them to do; and (5) less likely to agree that there were times when a person has cancer and they don’t know it. A pattern emerged for the Italian and Anglo-Australian women from the logistic regression analyses. The Italian women were much more likely to comply with medical authority and advice. The Anglo-Australian women were more likely to feel that they had some control over their health. Specifically, the risk variable ‘dread’ was more applicable to the Italian women’s behaviour and internal locus of control variable was more relevant to the Anglo-Australian women. The qualitative responses also differed for the two samples. The Italian women’s comments were more general, less specific, and more limited than that of the Anglo-Australian women. The Italian women talked about learning how to do BSE whereas the Anglo-Australian women said that attending the session had reminded them to do BSE more regularly. The key findings and contributions of the present research were numerous. The focus on one cultural group ensured comprehensive analyses, as did the inclusion of an adequate sample size to enable the use of multivariate statistics. Separating the Italian and Anglo-Australian samples in the analyses provided theoretical implications that would have been overlooked if the two groups were combined. The use of both qualitative and quantitative data capitalised on the strengths of both techniques. The inclusion of an Anglo-Australian group highlighted key theoretical findings, differences between the two groups and unique contributions made by both samples during the collection of the qualitative data. The use of a pre-test-intervention-post-test design emphasised the reticence of the Italian sample to participate and talk about breast cancer and confirmed and validated the consistency of the responses across the two interviews for both samples. The inclusion of non-cued responses allowed the researcher to identify the key salient issues relevant to the two groups. The limitations of the present research were the lack of many women who were not screening and reliance on self-report responses, although few differences were observed between the Pre- and Post-Test comparisons. The theoretical contribution of the HBM and the TRA variables was minimal in relation to screening mammography or attendance at the CLP. The applicability of these health behaviour theories may be less relevant for women today as they clearly knew the benefits of and the seriousness of breast cancer screening. The present research identified the applicability of the risk variables to the Italian women and the relevance of the locus of control variables to the Anglo-Australian women. Thus, clear cultural differences occurred between the two groups. The inclusion of the illness representations was advantageous as the responses highlighted ideas and personal theories salient to the women not identified by the HBM. The use of the illness representations and the qualitative responses further confirmed the relevance of the risk variables to the Italian women and the locus of control variables to the Anglo-Australian women. Attendance at the CLP did not influence the women to attend for mammography screening. Behavioural changes did not occur between the Pre- and Post-Test interviews. Small incremental changes as defined by the TTM and the stages of change may have occurred. Key practical implications for the CLP were identified. Improving the recruitment methods to gain a higher proportion of women who do not screen is imperative for the CLP promoters. The majority of the Italian and Anglo-Australian women who attended the information sessions were women who screen. The fact that Italian women do not like talking or thinking about cancer presents a challenge to promoters of the CLP. The key theoretical finding that Italian women dread breast cancer but comply with their doctor provides clear strategies to improve attendance at mammography screening. In addition, the inclusion of lay health advisors may be one way of increasing attendance to the CLP by including Italian women already attending screening and likely to have attended a CLP session. The present research identified the key finding that improving Anglo-Australian attendance at an information session is related to debunking the myth surrounding familial risk of breast cancer and encouraging the Anglo-Australian women to take more control of their health. Improving attendance for Italian women is related to reducing the fear and dread of breast cancer and building on the compliance pattern with medical authority. Therefore, providing an information session in the target language is insufficient to attract non-screeners to the session and then to screen for breast cancer. Suggestions for future research in relation to screening mammography were to include variables from more than one theory or model, namely the risk, locus of control and illness representations. The inclusion of non-cued responses to identify salient beliefs is advantageous. In addition, it is imperative to describe the profile of the cultural sample in detail, include detailed descriptions of the translation process and be aware of the tendency of Italian women to acquiesce with medical authority.

Elastic behaviour in mechanical draw presses

This thesis explores the elastic behaviour of the mechanical double action press and draw die system commonly used to draw sheet metal components in the automotive industry. High process variability in production and excessive time spent in die try-out are significant problems in automotive stamping. It has previously been suggested that the elastic behaviour of the system may contribute to these problems. However, the mechanical principles that cause the press system to affect the forming process have not been documented in detail. Due to a poor understanding of these problems in industry, the elasticity of the press and tools is currently not considered during the die design. The aim of this work was to explore the physical principles of press system elasticity and determine the extent to which it contributes to problems in try-out and production. On the basis of this analysis methods were developed for controlling or accounting for problems during the design process. The application of frictional restraining force to the edges of the blank during forming depends on the distribution and magnitude of the clamping force between the binders surfaces of the draw die. This is an important control parameter for the deep drawing process. It has been demonstrated in this work that the elasticity of the press and draw die can affect clamping force in two ways. The response of the press system, to the forces produced in the press during forming, causes the magnitude of clamping force to change during the stroke. This was demonstrated using measured data from a production press. A simple linear elastic model of the press system was developed to illustrate a definite link between the measured force variation and the elasticity of the press and tools. The simple model was extended into a finite element model of the complete press system, which was used to control a forming simulation. It was demonstrated that stiffness variation within the system could influence the final strains in a drawn part. At the conclusion of this investigation a method is proposed for assessing the sensitivity of a part to clamping force variation in the press during die design. A means of reducing variation in the press through the addition of a simple linear spring element is also discussed. The second part of the work assessed the influence of tool structure on the distribution of frictional restraining forces to the blank. A forming simulation showed that tool stiffness affects the distribution of clamping pressure between the binders. This was also shown to affect the final strains in a drawn part. However, the most significant influence on restraining force was the tendency of the blank to increase in thickness between the binders during forming. Using a finite element approximation of the try-out process it was shown that the structure of the tool would also contribute to the problems currently experienced in try-out where uneven contact pressure distributions are addressed by manually adjusting the tool surfaces. Finally a generalised approach to designing draw die structures was developed. Simple analysis methods were combined with finite element based topology optimisation techniques to develop a set of basic design guidelines. The aim of the guidelines was to produce a structure with uniform stiffness response to a pressure applied at the binder surface. The work concludes with a recommendation for introducing the methods developed in this thesis into the standard production process.

Effectiveness of a community-based osteoporosis education and self-management course : a wait list controlled trial

Summary : Osteoporosis is an increasing burden on individuals and health resources. The Osteoporosis Prevention and Self-Management Course (OPSMC) was designed to assist individuals to prevent and manage osteoporosis; however, it had not been evaluated in an Australian setting. This randomised controlled trial showed that the course increased osteoporosis knowledge.
Introduction and hypothesis : Osteoporosis is a major and growing public health concern. An OPSMC was designed to provide individuals with information and skills to prevent or manage osteoporosis, but its effectiveness has not previously been evaluated. This study aimed to determine whether OPSMC attendance improved osteoporosis knowledge, self-efficacy, self-management skills or behaviour.
Materials and methods : Using a wait list randomised controlled trial design, 198 people (92% female) recruited from the community and aged over 40 (mean age = 63) were randomised into control (n = 95) and intervention (n = 103) groups. The OPSMC consists of four weekly sessions which run for 2 h and are led by two facilitators. The primary outcome were osteoporosis knowledge, health-directed behaviour, self-monitoring and insight and self-efficacy.
Results : The groups were comparable at baseline. At 6-week follow-up, the intervention group showed a significant increase in osteoporosis knowledge compared with the control group; mean change 3.5 (p < 0.001) on a measure of 0–20. The intervention group also demonstrated a larger increase in health-directed behaviour, mean change 0.16 (p < 0.05), on a measure of 0–6.
Conclusion : The results indicate that the OPSMC is an effective intervention for improving understanding of osteoporosis and some aspects of behaviour in the short term.

Assessing behaviour support plans for people with intellectual disability before and after the Victorian Disability Act 2006

Background : This study sought to elucidate the extent to which behaviour support plans for people with intellectual disability are inclusive of best practice criteria, with a comparison made prior to and following proclamation of the Disability Act (2006) in Victoria, Australia.

Method : This study used a data collection instrument developed by the researchers incorporating best practice criteria as identified in the review of literature and Victorian legislative requirements. The instrument was used to assess a sample of behaviour support plans.

Results : Best practice criteria are inadequately included in behaviour support plans with little difference between pre- and post-Act plans.

Conclusion : The results of this study indicate that disability support staff are ill equipped to undertake the complex assessments, planning, and implementation associated with behaviour support strategies, despite the legislative framework that guides and directs this intervention

Contextual influences on femoral injecting behaviour in the UK Randomised Injectable Opiate Treatment Trial

Femoral injecting amongst participants of the Randomised Injectable Opiate Treatment Trial (RIOTT) has created a number of procedural, ethical and medical dilemmas for staff, clients and researchers. This study investigated the effect on femoral injecting behaviour of a drug consumption room (DCR) in the context of the RIOTT currently being conducted at the Maudsley Hospital, South London. It uses in-depth qualitative interviews with 10 RIOTT clients to investigate the effects of this environmental intervention on the injecting behaviour of individuals who injected femorally upon treatment entry. Interviewees were selected on the basis of membership in one of four groups: 1) never injected femorally, 2) injected femorally prior to trial and have ceased completely, 3) injected femorally prior to trial and have ceased within the DCR, and 4) have continued to inject femorally the inside and outside clinical settings. The paper uses case studies and clinical protocols to interpret changes in behaviour in injecting behaviour in regards to the goals of treatment. Preliminary results indicate that there are major advantages and disadvantages associated with femoral injecting. The most commonly reported reason for commencing femoral injecting was a lack of other viable veins and interviewee narratives illustrate how this issue use addressed within the context of the DCR. Within this setting, the paper explores the boundaries of harm reduction in the context of a traditional 'risk boundary' within the 'ideal' risk environment. Other issues explored include: gender differences in femoral injecting episodes, femoral injecting as a risk boundary and the importance of time pressures as a major predictor of choosing to inject femorally.

Internet-based cognitive behaviour therapy for erectile dysfunction

This thesis involved the development and evaluation of "Rekindle", an internet-based cognitive behaviour therapy (CBT) for erectile dysfunction (ED). For highly motivated couples, "Rekindle" was more effective than no treatment for improving sexual function and relationships. Most men who completed "Rekindle" had maintained treatment gains at 3-month follow-up. The professional portfolio presented 4 case studies which demonstrate that barriers to recovery from early psychosis are often complex and challenging issues, and that effective strategies need to be implemented to overcome these issues during treatment. When insufficient intervention is provided to address these barriers, the likelihood of successful outcome following early psychosis is significantly reduced.

Evaluation of a community pharmacy-based intervention for improving patient adherence to antihypertensives: a randomised controlled trial

Background
The majority of patients using antihypertensive medications fail to achieve their recommended target blood pressure. Poor daily adherence with medication regimens and a lack of persistence with medication use are two of the major reasons for failure to reach target blood pressure. There is no single intervention to improve adherence with antihypertensives that is consistently effective. Community pharmacists are in an ideal position to promote adherence to chronic medications. This study aims to test a specific intervention package that could be integrated into the community pharmacy workflow to enable pharmacists to improve patient adherence and/or persistence with antihypertensive medications - Hypertension Adherence Program in Pharmacy (HAPPY).

Methods/Design
The HAPPY trial is a multi-centre prospective randomised controlled trial. Fifty-six pharmacies have been recruited from three Australian states. To identify potential patients, a software application (MedeMine CVD) extracted data from a community pharmacy dispensing software system (FRED Dispense®). The pharmacies have been randomised to either 'Pharmacist Care Group' (PCG) or 'Usual Care Group' (UCG). To check for 'Hawthorne effect' in the UCG, a third group of patients 'Hidden Control Group' (HCG) will be identified in the UCG pharmacies, which will be made known to the pharmacists at the end of six months. Each study group requires 182 patients. Data will be collected at baseline, three and six months in the PCG and at baseline and six months in the UCG. Changes in patient adherence and persistence at the end of six months will be measured using the self-reported Morisky score, the Tool for Adherence Behaviour Screening and medication refill data.

Discussion
To our knowledge, this is the first research testing a comprehensive package of evidence-based interventions that could be integrated into the community pharmacy workflow to enable pharmacists to improve patient adherence and/or persistence with antihypertensive medications. The unique features of the HAPPY trial include the use of MedeMine CVD to identify patients who could potentially benefit from the service, control for the 'Hawthorne effect' in the UCG and the offer of the intervention package at the end of six months to patients in the UCG, a strategy that is expected to improve retention.

Trial Registration
Australian New Zealand Clinical Trial Registry ACTRN12609000705280

Creating digital divas-scaffolding perception change through secondary school and university alliances

Over the last 20 years much has been done to encourage female students to choose computing courses and computing careers. Some instances of positive effects have been reported, yet the proportional disparity in gender in this discipline continues to grow. This paper reports on a program called 'Digital Divas'. Digital Divas aims to scaffold positive perceptions around computing in the early years of secondary school by involving female students in upbeat computing experiences over a semester. It introduces university undergraduates to the secondary classroom to provide informal role models and mentors, as well as interactions with young computing professionals. This classroom environment enables computer applications to be more strongly linked with future careers. The commitment to a semester length unit was influential in changing perceptions about girls and computing, and the program was supported by the wider school community. We posit that this type of curriculum intervention is needed and has the potential to build technical human capital in female students.

Glass transition and free volume behaviour of poly(acrylonitrile)/LiCF3SO3 polymer-in-salt electrolytes compared to poly(ether urethane)/LiClO4 solid polymer electrolytes

Measurements of the glass transition temperature (T_g) and free volume behaviour of poly(acrylonitrile) (PAN) and PAN/lithium triflate (LiTf), with varying salt composition from 10 to 66 wt% LiTf, were made by positron annihilation lifetime spectroscopy (PALS). Addition of salt from 10 to 45 wt% LiTf resulted in an increase in the mean free volume cavity size at room temperature (r.t.) as measured by the orthoPositronium (oPs) pickoff lifetime, τ₃, with little change in relative concentration of free volume sites as measured by oPs pickoff intensity, I₃. The region from 45 to 66 wt% salt displayed no variation in relative free volume cavity size and concentration. This salt concentration range (45 wt%<[LiTf]<66 wt%) corresponds to a region of high ionic conductivity of order 10⁻⁵ to 10⁻⁶ S cm⁻¹ at T_g as measured by PALS. A percolation phenomenon is postulated to describe conduction in this composition region. Salt addition was shown to lower the T_g as measured by PALS; T_g was 115°C for PAN and 85°C for PAN/66 wt% LiTf. The T_g and free volume behaviour of this polymer-in-salt electrolyte (PISE) was compared to a poly(ether urethane)/LiClO₄ where the polymer is the major component, i.e. traditional solid polymer electrolyte (SPE). In contrast to the PISE, the T_g of the SPE was shown to increase with increasing salt concentration from 5.3 to 15.9 wt%. The relative free volume cavity size and concentration at r.t. were shown to decrease with increasing salt concentration. Ionic conductivity in this SPE was of order 10⁻⁵ S cm⁻¹ at r.t., which is over 60°C above T_g, 10⁻⁸ S cm⁻¹ at 25°C above T_g, and conductivity was not measurable at T_g.