The origins of contemporary primary health care

This chapter begins by exploring the concept of primary health care (PHC), linking this to relevant international and national policy documents, and introducing the concept of PHC developed by the World Health Organization. The chapter then focuses on the UK. It explains how PHC is not just found within the NHS, reviews the different sectors involved in PHC, and then discusses the current structure of PHC in the NHS. Key concepts, including the primary health care team, primary care trusts and integrated heath and social care trusts, and the relevant current UK policy documents are introduced.

The chapter then moves on to discuss four important issues in the provision of primary health care in the community: health promotion; tackling health inequalities; health and regeneration; and, tackling domestic violence. The subsection on each of these will explain why the issue is of particular significance and review briefly a number of studies/projects which illustrate what is happening/can be done; this will introduce a range of current research. The chapter concludes with a short review of challenges for the future, emphasising the important role that the nursing profession has to play in meeting these challenges.

Putting woman-centered care into practice : a new (ANEW) approach to psychosocial risk assessment during pregnancy

Background: When antenatal care is provided, identification and management of challenging problems, such as depression, domestic violence, child abuse, and substance abuse, are absent from traditional midwifery and medical training. The main objective of this project was to provide an alternative to psychosocial risk screening in pregnancy by offering a training program (ANEW) in advanced communication skills and common psychosocial issues to midwives and doctors, with the aim of improving identification and support of women with psychosocial issues in pregnancy.

Methods: ANEW used a before‐and‐after survey design to evaluate the effects of a 6‐month educational intervention for health professionals. The setting for the project was the Mercy Hospital for Women in Melbourne, Australia. Surveys covered issues, such as perceived competency and comfort in dealing with specific psychosocial issues, self‐rated communication skills, and open‐ended questions about participants' experience of the educational program.

Results: Educational program participants (n = 22/27) completed both surveys. After the educational intervention, participants were more likely to ask directly about domestic violence (p = 0.05), past sexual abuse (p = 0.05), and concerns about caring for the baby (p = 0.03). They were less likely to report that psychosocial issues made them feel overwhelmed (p = 0.01), and they reported significant gains in knowledge of psychosocial issues, and competence in dealing with them. Participants were highly positive about the experience of participating in the program.

Conclusions:The program increased the self‐reported comfort and competency of health professionals to identify and care for women with psychosocial issues.

Community's attitudes towards intimate partner homicide

The thesis aimed to explore the Victorian Community's attitudes towards intimate partner homicide committed in the context of jealousy and domestic violence. Results revealed that the immediacy of the accused's actions, the gender of the accused, and the gender of the participant interacted to influence participants' verdict and blame responses. The portfolio explored the complexities and challenges that face mental health professionals in deciding the appropriate weighting of child's wishes in child protection assessments. The four case studies presented were chosen due to the attention that was paid to the child's wishes throughout the assessments.

Murder or manslaughter? NSW ponders the provocation problem

In Parliament last week, NSW took steps towards better understanding, and potentially solving, the problems posed by the partial defence of provocation. This comment analyses key arguments presented to the Parliamentary Select Committee for the retention and abolition of the partial defence of provocation.

Legal loophole protecting violent men : why the defence of provocation needs to change

This comment analyses the successful use of the provocation defence in New South Wales in cases of male perpetrated intimate homicide. In doing so, it makes an argument for why the defence should be abolished.

The Role of TAFE as an Equity Pathway to Social Inclusion, Employment, and to University : a submission from The Deakin University Social Work/Gordon TAFE Community Services Work, Geelong Based Project Team

Executive Summary

The Deakin University Social Work/Gordon TAFE Community Services Work Geelong Based Project Team (the Project Team) was assisted by Higher Education Partnership and Participation funding made available through Deakin University Participation and Partnerships Program (DUPPP) to carry out research and project work in 2012/13.

In the following submission to the House of Representatives Inquiry into the role of Technical and Further Education (TAFE) system and its operation, this Project Team seeks to establish a case for:

1. Funding to enable TAFE to continue as:

a) an equity pathway to social inclusion, employment, and to university, particularly in regional areas.
b) an integral complement to the University education sector to deliver on the ambitious objectives of the Federal Government’s widening participation agenda, as a mechanism to deliver the skills, knowledge and workforce needed now, and in the future, in the Australian economy.
2. Increased resources for separate and joint sector development
a) Publicly funded TAFEs need funding to be restored and increased to enable them to maintain the high quality education they provide and to maintain their successful work in supporting communities, regions and disadvantaged individuals to gain skills, training and employment.
b) Universities need increased funding to increase staffing levels and therefore free up teaching staff to spend the necessary time to develop relationships with and provide support to students. This is important for the achieving the goals of the widening participation agenda of increasing access without increasing attrition at the same time.
c) TAFEs and Universities need funding to do the work required to further develop and formalise diploma-degree pathways so that disadvantaged individuals can exit into employment at the diploma level or be supported in an efficient and seamless way to undertake further study.
3. Active use of localised and nuanced partnership approaches by education institutions. This includes:
• Cross teaching by TAFEs and Universities in courses that can be articulated, such as professional practice diplomas and degrees
• Programs negotiated and designed according to the needs of students in each location. TAFEs and Universities need resources in order to do this work
• Focus on regional centres where there is a particular opportunity for government to make an impact on TAFE pathways to employment and/or further education
• Workforce development in regional areas due to new industries is a particular area of need
4. Recognise and capitalise on the complementary and symbiotic nature of each sector’s skills, strengths and capacities.
The submission responds to the second, third and fifth points of the Terms of Reference of the Inquiry and is based on the research work carried out by the Project Team in 2012/13.

We provide evidence of Gordon TAFE in Geelong working as an equity mechanism in the particular case of the welfare/ community services diploma to social work degree pathway. The project team considers that there is a strong case for additional resourcing of TAFE to enable it to continue what it does well. TAFE is the key training and education sectorthe ‘education and social hub’that can successfully attract, retain, and graduate people who may not otherwise access education due to one or more combinations of:

1. having a low SES current or past background;
2. living in regional areas;
3. receiving interrupted primary and secondary education;
4. having disabilities;
5. being sole parents;
6. being from refugee backgrounds;
7. having English as an additional language/culture;
8. retrenchment from employment in dying industries;
9. short, medium and long term unemployment;
10. past and/or current caring roles;
11. marriage/relationship breakdowns;
12. domestic violence;
13. gender, class, age, race/ethnicity and dis/ability discriminations; and
14. socialised expectations and fears.

The recommendations in this submission are based on research findings about important similarities and differences between Gordon TAFE welfare and Deakin University social work students in Geelong, and their respective institutional organisations and contexts. The two institutions employ a repertoire of diverse administrative, teaching, learning and support approaches to meet different mission goals, requirements and needs.

Filicide and parental separation and divorce

This paper discusses the findings of a ten-year study of filicide in Victoria, Australia, using the data from selected case files held in the Victorian coroner's office for the period 2000–09. The study sought to examine whether separation is a factor in filicide cases, as well as the role of other factors, such as domestic violence and mental illness. Also, the study sought to identify whether filicide perpetrators had contact with support services, including family and friends, general practitioners, mental health services and child protection services, in order to ascertain how these services might more appropriately identify those families most at risk prior to the filicide. The study found that while separation was a factor identified in a significant number of cases, more cases analysed showed evidence of mental illness, mainly depression. These findings suggest the need for improved strategies in preventing filicide by identifying risk factors and improving service responses for victims prior to these tragic events.

Out of Character? Legal responses to intimate partner homicides by men in Victoria 2005-2014

This report reviews 51 cases of intimate partner homicide by men in Victoria, from 2005-2014, to investigate how family violence is recognised in homicide prosecutions. Research and death reviews in Australia and overseas have found that systemic failures in legal responses to family violence contribute to intimate partner homicides. In 2010, Domestic Violence Resource Centre Victoria and Monash University began a project to explore the impact of the 2005 homicide law reforms on intimate partner homicides. The first phase of the project examined cases of women who killed their intimate partners, focusing on whether the reforms had improved the recognition of family violence victimisation as a factor. This report presents findings from the second phase, which examines legal responses to men who have killed in the context of sexual intimacy. In analysing the cases, it looks at key contextual factors, legal outcomes, family violence risk factors, how prior family violence is understood and discussed by legal professionals, how evidence of prior family violence is used by the prosecution and whether it is admitted as evidence, the types of arguments and narratives made in defence of the accused, the recognition of family violence through the sentencing process, and the use of provocation as a mitigating factor.

Using domestic law in the fight against obesity : an introductory guide for the Pacific

Contents: Acknowledgements -- What is the purpose of this introductory guide? -- Why use domestic laws in the fight against obesity? -- What must be considered when using domestic laws in the fight against obesity? -- The Agreement on Agriculture -- The SPS Agreement -- The TBT Agreement -- Which approach is best used in the fight against obesity? -- Pricing controls -- Restrictions on supply -- Labelling requirement -- How might a regulatory approach be justified? -- Where to from here? -- Conclusion -- References

Engaging men in men's violence prevention : exploring the tensions, dilemmas and possibilities

The aim of this discussion paper is to raise some questions and to encourage debate about the impact on gender equality of increasing men's involvement in campaigns to end men's violence against women. To address this issue, I have conducted a critical review of the literature on working with men as partners in violence prevention projects. I have also located this literature within theoretical debates about men's privilege, men's interests and men's resistance to change.