Refractive errors in students from Middle Eastern backgrounds living and undertaking schooling in Australia

Background:  Environmental factors associated with schooling systems in various countries have been implicated in the rising prevalence of myopia, making the comparison of prevalence of refractive errors in migrant populations of interest. This study aims to determine the prevalence of refractive errors in children of Middle Eastern descent, raised and living in urban Australia but actively maintaining strong ties to their ethnic culture, and to compare them with those in the Middle East where myopia prevalence is generally low.Methods:  A total of 354 out of a possible 384 late primary/early secondary schoolchildren attending a private school attracting children of Middle Eastern background in Melbourne were assessed for refractive error and visual acuity. A Shin Nippon open-field NVision-K5001 autorefractor was used to carry out non-cycloplegic autorefraction while viewing a distant target. For statistical analyses students were divided into three age groups: 10–11 years (n = 93); 12–13 years (n = 158); and 14–15 years (n = 102).Results:  All children were bilingual and classified as of Middle Eastern (96.3 per cent) or Egyptian (3.7 per cent) origin. Ages ranged from 10 to 15 years, with a mean of 13.17 ± 0.8 (SEM) years. Mean spherical equivalent refraction (SER) for the right eye was +0.09 ± 0.07 D (SEM) with a range from -7.77 D to +5.85 D. The prevalence of myopia, defined as a spherical equivalent refraction 0.50 D or more of myopia, was 14.7 per cent. The prevalence of hyperopia, defined as a spherical equivalent refraction of +0.75 D or greater, was 16.4 per cent, while hyperopia of +1.50 D or greater was 5.4 per cent. A significant difference in SER was seen as a function of age; however, no significant gender difference was seen.Conclusions:  This is the first study to report the prevalence of refractive errors for second-generation Australian schoolchildren coming from a predominantly Lebanese Middle Eastern Arabic background, who endeavour to maintain their ethnic ties. The relatively low prevalence of myopia is similar to that found for other metropolitan Australian school children but higher than that reported in the Middle East. These results suggest that lifestyle and educational practices may be a significant influence in the progression of myopic refractive errors.

Patient participation in quality pain management during an acute care admission

The objective of the study was to explore patient participation in the context of pain management during a hospital admission for a cardiac surgical intervention of patients with cardiovascular disease. This is a single-institution study, with a case-study design. The unit of analysis was a cardiothoracic ward of a major metropolitan, tertiary referral hospital in Melbourne, Australia. Multiple methods of data collection were used including preadmission and predischarge patient interviews (n=98), naturalistic observations (n=48), and focus group interviews (n=2).

Patient participation in medication safety during an acute care admission

Background : Patient participation in medication management during hospitalization is thought to reduce medication errors and, following discharge, improve adherence and therapeutic use of medications. There is, however, limited understanding of how patients participate in their medication management while hospitalized.Objective : To explore patient participation in the context of medication management during a hospital admission for a cardiac surgical intervention of patients with cardiovascular disease.Design : Single institution, case study design. The unit of analysis was a cardiothoracic ward of a major metropolitan, tertiary referral hospital in Melbourne, Australia. Multiple methods of data collection were used including pre-admission and pre-discharge patient interviews (n = 98), naturalistic observations (n = 48) and focus group interviews (n = 2).Results : All patients had changes made to their pre-operative cardiovascular medications as a consequence of surgery. More patients were able to list and state the purpose and side-effects of their cardiovascular medications at pre-admission than prior to discharge from hospital. There was very little evidence that nurses used opportunities such as medication administration times to engage patients in medication management during hospital admission.Discussion and Conclusions : Failure to engage patients in medication management and provide opportunities for patients to learn about changes to their medications has implications for the quality and safety of care patients receive in hospital and when managing their medications once discharged. To increase the opportunity for patients to participate in medication management, a fundamental shift in the way nurses currently provide care is required.

Identification of mental illness in police cells: a comparison of police processes, the brief jail mental health screen and the jail screening assessment tool

The study investigated current police practices employed to identify those with a mental illness in police custody, and to evaluate the predictive utility of the Brief Jail Mental Health Screen (BJMHS) and the Jail Screening Assessment Tool (JSAT). One hundred and fifty detainees were recruited from two police stations in Melbourne, Australia. Measures included the Structured Clinical Interview for DSM-IV-TR, BJMHS and JSAT. Axis-I disorders were compared with police decisions regarding identification of mental illness based on their usual practices. Participants were classified as requiring referral for further mental health evaluation according to the screening tools. Results indicated that current police practices produced high false negatives, with many of those experiencing mental illness not identified. There was no significant difference in performance between BJMHS (AUC =0.722) and JSAT (AUC =0.779) in identifying those with a serious mental illness (p=0.109). However, JSAT performed significantly better at identifying any Axis-I disorder, excluding substance use disorders, as compared with BJMHS (AUC =0.815, vs AUC =0.729; p=0.018). Given the high prevalence of mental illness among detainees, there is a pressing need to introduce standardised screening tools for mental illness in police custody. This can assist the police in managing detainees appropriately and securing mental health services as required.

Psychopathology in police custody: The role of importation, deprivation and interaction models

People experiencing mental illness are over-represented among police cell detainees, however limited work has sought to investigate the occurrence of psychopathology in police custody. The present study sought to examine the predictive power of personal factors (e.g., history of psychiatric hospitalisation), situational factors (e.g., police cell conditions), and their interactive effects to explain the occurrence of psychopathology in police custody. A total of 150 detainees were recruited from two metropolitan police stations in Melbourne, Australia. Personal factors were significantly associated with psychiatric symptomatology, with situational factors and interaction terms yielding no association. Detainees with preexisting vulnerabilities and those unsatisfied with police cell conditions demonstrated the highest levels of psychopathology. While all detainees experience some difficulties in police cells, it is those with pre-existing vulnerabilities that suffer the most. This may be due to the exacerbation of vulnerabilities by police cell conditions. The implications of these findings for provision of health care services in police cells are discussed.

Psychiatric disorders and unmet needs in Australian police cells

To determine the prevalence of current psychiatric disorders and unmet needs in a sample of police cell detainees in Victoria. A cross-sectional descriptive study was conducted, including data linkage with the Victoria Police database and the Victorian Psychiatric Case Register. In Melbourne, Australia, 150 detainees were recruited from two busy metropolitan police stations. Outcome measures included estimated rates of psychiatric disorders, using the Structured Clinical Interview for DSM-IV-TR, and individual needs, using the Camberwell Assessment of Need – Forensic Version. One quarter (n = 32, 25.4%) of detainees had a prior admission to a psychiatric hospital, and three quarters met current criteria for a diagnosable mental disorder. The most common disorders were substance dependence (n = 81, 54%) and mood disorders (n = 60, 40%). A third met diagnostic criteria for both a mental illness and a substance use disorder. The odds of being classified with mood (OR = 10.1), anxiety (OR = 2.2), psychotic (OR = 15.4) and substance use disorders (OR = 26.3) were all significantly higher in the current sample as compared with the general population. Detainees with a mental illness identified significantly more needs and significantly more unmet needs (e.g. psychological distress) than those who did not rate as having a current mental illness. There remains a pressing need to evaluate standardized screening tools for mental illnesses in police cells to provide timely access to assessment and treatment services. The need for functional interagency collaborations are highlighted and discussed.

Crossing borders as Mestizas and Coyotes: recognising older Somali women's shifting subjectivities in Australia

Early years education in the primary years programme: implementation strategies and programme outcomes

This mixed-methods study investigated implementation strategies and child learning outcomes in early years education in the Primary Years Programme. Researchers from Deakin University evaluated processes and outcomes in four early years programmes, two in Singapore and two in Melbourne, Australia. Researchers collected qualitative data through classroom observations, drawings and writing produced by children, and interviews with educators, coordinators and parents. Quantitative data was collected through assessments of children’s literacy, developmental school readiness and learning skills. Three of the early years programmes appeared to support the development of learner profile attributes through inquiry-led learning and play-based approaches, while one site in Singapore was still in a developmental stage of implementing the programme. The study suggested that literacy skills at all sites were fairly developed; that children were performing at levels commensurate with or better in terms of school readiness; and that children were developing learning skills at higher rates than a comparative sample.

More than a game : the impact of sport-based youth mentoring schemes on developing resilience toward violent extremism

This paper draws upon the findings of an evaluation of “More than a Game”, a sport-focused youth mentoring program in Melbourne, Australia that aimed to develop a community-based resilience model using team-based sports to address issues of identity, belonging, and cultural isolation amongst young Muslim men in order to counter forms of violent ex-tremism. In this essay we focus specifically on whether the intense embodied encounters and emotions experienced in team sports can help break down barriers of cultural and religious difference between young people and facilitate ex-periences of resilience, mutual respect, trust, social inclusion and belonging. Whilst the project findings are directly rel-evant to the domain of countering violent extremism, they also contribute to a growing body of literature which con-siders the relationship between team-based sport, cross-cultural engagement and the development of social resilience, inclusion and belonging in other domains of youth engagement and community-building.

Jill Meagher CCTV gothic tendencies in narratives of violence and gender justice

This article initiates an encounter, for feminist media studies, with some of theevidentiary artefacts appropriated for public consumption from the Jill Meagher rape andmurder case. While Jill Meagher was abducted, raped and killed on September 22, 2012, in Melbourne, Australia, the story of her violent death traverses time and place.

Comparing mortality outcomes of major burns and toxic epidermal necrolysis in a tertiary burns centre

 Introduction
Our aim was to provide descriptive information to burn clinicians, who have extensive experience treating major burns and determining prognosis, as to whether significant differences in mortality exist between major burns injuries and the comparatively less common toxic epidermal necrolysis for a given age and total body surface area percentage.

Methods
Retrospective data was analyzed of all deceased patients admitted to the Victorian Adult Burns Service in Melbourne, Australia over a period of 10 years with greater than 30% total body surface area burned or greater than 30% total body surface area epidermal detachment in the case of toxic epidermal necrolysis. Retrospective data was also collected on all patients, survivors and deceased, with toxic epidermal necrolysis and these patients were matched with burns patients by age and % total body surface area burned. Comparisons in outcomes were performed with mortality being the primary variable of interest.

Results
Toxic epidermal necrolysis patients that died were older (median: 68.5 vs 57 yrs; P = 0.04), had a longer length of hospital stay (36.5 vs 0.8 days; P = 0.001) and significantly longer periods of mechanical ventilation (1404 vs 14.5 h; P = 0.011) than major burns patients that died. When toxic epidermal necrolysis patients were matched to major burns patients by age and total body surface area burned, there were no significant differences between the two groups with respect to mortality.

Conclusion
Palliative care approaches are more frequently administered at the time of presentation for major burns patients in comparison to toxic epidermal necrolysis patients. This may be due to a perception that if toxic epidermal necrolysis patients can survive their initial systemic injury, they are likely to survive, as opposed to major burns patients who often undergo extensive surgery and for whom other factors should be taken into account in the context of end-of-life decision making.

The role of teachers in delivering education about respectful relationships: exploring teacher and student perspectives.

The focus of this article is a school-based respectful relationships (RRs) pilot project involving grade 8 and 9 students. The project sought to develop a primary prevention approach to gender-based violence (GBV) in Australia. Of particular concern is the curriculum delivery component of a whole school approach that was piloted over a 10-week period in four High Schools in Melbourne, Victoria in 2010. Using data collected from teachers and students through survey, focus group interviews and student written reflections, the article identifies the key role of the teacher, the curriculum materials and the curriculum context in assisting teachers to teach about GBV. Although there was opposition to teaching specifically about GBV by some male teachers, the data indicate that this did not detract from teachers exploring these issues under a 'RRs' framework. Through 'supported risk taking', and the adoption of participatory teaching approaches and affirming and inclusive classrooms, teachers and students ended up with a positive experience of teaching and learning about GBV.

Sex-biased space-use response to urbanization in an endemic urban adapter

Urbanization impacts on the composition and distribution of wildlife. The tawny frogmouth (Podargus strigoides) is an endemic, nocturnal bird species widespread throughout Australia with recent research highlighting high densities within urban environments. The aim of this study was to investigate homerange size and land-use in response to a gradient of urbanization by determining (a) the key land-use types influencing home-range size and location in the urban landscape (b) whether urbanization impacts on home-range size; and (c) whether the response to urbanization is gender specific. Twelve birds, seven male and five female were radio-tracked within a study zone located in Melbourne, Australia. We used minimum convex polygons (MCP) 95% and 50% fixed-kernel isopleths to calculate home-range size and areas of core use within each home-range. In both the landscape and core areas of their home-range, birds positioned their home-range in areas with more trees, avoiding impervious surfaces and utilizing grassed areas. Male mean kernel home-range was 17.65 ± 4.35 ha and female 6.55 ± 1.40 ha. Male home-ranges contained higher levels of impervious surfaces than females. Modelling demonstrated that as urbanization intensified the home-range size of males increased whereas female home-ranges remained static in size. This research identifies land-use selection and highlights the possibility that spatial behaviour in the species is sex-biased in response to a gradient of urbanization. © 2014 Elsevier B.V.

Impossible triangles: flat actors in telematic theatre

In fact, in this scene, both A and B are online. A is in a classroom at the University of Amsterdam in The Netherlands, and B is in a television studio at Deakin University in Melbourne, Australia. The two locations are connected through video conference and, in each space, a local audience watches the local performer in the room, and the remote performer projected on a screen. The performers are captured in profile, and appear to be looking at computer screens in front of them but cannot actually see one another. The text is consciously banal, composed to replicate the broken rhythms and sequences, flattened tone and repetitions of scrolling words in a text box on a screen. Information about presence and absence (A or B is offline or online) is spoken as text. Although the two performers speak in accents that declare their different language/ cultures, the vernacular is generic 'internetslang'. The relatively monotonous and unpunctuated delivery of the textual rhythms is interrupted and counterpointed by a sound lag of nearly a second, and by a faint audio echo as one voice 'lands' in the second location. Its orchestration allows the sound fracture and dispersal in some moments. In other moments, the actors anticipate or absorb the gaps in transmission, driving the speech rhythms through so that the utterance 'arrives' precisely at the end of the prompt line.

Achieving socially inclusive practice: analysing power dynamics in a participatory approach to service development

The paper is concerned with what works and why in relation to socially inclusive practice in diverse community services settings. Drawing on the findings from a research study involving a participatory evaluation and service development project in a large community services organisation in Melbourne, Australia, the paper asserts that organisations can become more inclusive by paying attention to the ways in which they perpetuate existing oppression and by intentionally challenging associated limiting power/knowledge formations. The study was situated in rights-based approaches to health and social development and drew on Foucauldian conceptualisations of power that see the point of operation of power as the point of resistance, and therefore containing the possibility for change. The researchers worked in three diverse service contexts: children and families experiencing homelessness, people with disabilities, and older people with a history of homelessness and exclusion. The ongoing analysis of the power relations between and within the different stakeholder groups was important in ensuring that the development of the process did not reinscribe oppression and marginalisation. Within the growing body of work that theorises participatory and inclusive practices, the application of a Foucauldian framework offers new insights for anti-oppressive practice in the context of service development.