Assessing the therapeutic climate of prisons

This study examined perceptions of the prison social climate in two Australian prisons from the perspective of both prison staff and prisoners. Ratings of social climate were compared between a specialist treatment prison that provides intensive rehabilitation programs to violent, sexual, and substance-using offenders and a mainstream prison that does not specialize in offender rehabilitation. The results suggested that staff and prisoners at the specialist treatment prison rated the social climate as more conducive to rehabilitation, although the differences were less pronounced for prisoners. These findings are discussed in relation to the development of specialist therapeutic prisons and how assessments of social climate might inform assessments of their success.

Provocation in New South Wales : the need for abolition

Over the past two decades significant debate has emerged surrounding the operation of the partial defence of provocation. Such debates have led to its abolition in several Australian and international jurisdictions where Government and Law Commission bodies have argued that provocation has operated in a gender biased way that is no longer reflective of community values and expectations of justice. In contrast to the Australian states of Tasmania, Victoria and Western Australia, who have transferred consideration of provocation to sentencing, New South Wales (NSW) has retained provocation as a partial defence to murder. Drawing upon in-depth interviews conducted with legal stakeholders and an analysis of recent case law, this article considers whether the operation of provocation in NSW is still in the best interests of justice, and, specifically, whether in practice it privileges one gender above the other. This research concludes that the continued operation of provocation in NSW raises key issues surrounding the legitimisation of male violence against women, the denial and minimisation of the harm caused by lethal domestic violence, and the continued inability of the law to appropriately respond to women who kill in the context of prolonged family violence.

The need to examine metastatic tissue at the time of progression of breast cancer : is re-biopsy a necessity or a luxury?

Knowledge of estrogen receptor (ER), progesterone receptor (PgR) and human epidermal growth factor receptor-2 (HER2) status is necessary for determining the optimal treatment of breast cancer patients. At the same time, the discordance between marker profiles (ER/PR and HER2) of primary and metastatic breast cancer is well documented. Whether discordant cases are secondary to “clonal selection” in the face of targeted anti-estrogen or anti-HER2 therapy or whether they are a laboratory artifact is still debated; both scenarios are likely. This article outlines current modalities for ER, PR, and HER2 testing in primary breast carcinoma and its metastases and reviews prospective and retrospective studies that have addressed these issues, as well as recent advances in the field.

Resolving controversies in hip fracture care : the need for large collaborative trials in hip fractures

Summary: Hip fractures are a significant cause of morbidity and mortality worldwide and the burden of disability associated with hip fractures globally vindicates the need for high-quality research to advance the care of patients with hip fractures. Historically, large, multi-centre randomized controlled trials have been rare in the orthopaedic trauma literature. Similar to other medical specialties, orthopaedic research is currently undergoing a paradigm shift from single centre initiatives to larger collaborative groups. This is evident with the establishment of several collaborative groups in Canada, in the United States, and in Europe, which has proven that multi-centre trials can be extremely successful in orthopaedic trauma research.

Despite ever increasing literature on the topic of his fractures, the optimal treatment of hip ftractures remains unknown and controversial. To resolve this controversy large multi-national collaborative randomized controlled trials are required. In 2005, the International Hip Fracture Research Collaborative was officially established following funding from the Canadian Institute of Health Research International Oppurtunity Program with the mandate of resolving controversies in hip fracture management. This manuscript will describe the need, the information, the organization, and the accomplishments to date of the International Hip Fracture Research Collaborative.

Assessing the effectiveness of the cognitive interview for children with severe intellectual disabilities

We examined whether the cognitive interview (CI) procedure increased event recall in children with severe intellectual disabilities (ID) compared with children with no ID. Forty-six children with and without ID watched a videotaped event; they were aged between eight and 11 years. The next day they were individually interviewed using the CI or a structured interview (SI). Interviews consisted of free recall and specific questions, some of which contained leading or misleading information. The leading and misleading questions determined children’s susceptibility to information presented after the event. Overall, children without ID reported more correct information than children with ID. For all children, the CI led to more correct recall than the SI without increases in incorrect details or confabulations. Although the CI did not decrease children’s susceptibility to the misleading questions compared with the SI, children without ID disagreed with more of the misleading suggestions than children with ID. These results suggest that the CI may indeed be a valuable tool to elicit information from very vulnerable witnesses.

The business of sexuality education : changing practice : the need for professional development

This paper reports on data collected from practicing sexuality education teachers following their participation in professional learning intervention in sexuality education. It explores whether the provision of effective professional development and classroom resources enables teachers to effectively address the sensitive issues of sexual diversity, gender and power.

Assessing the impact of diabetes on the quality of life of older adults living in a care home : validation of the ADDQoL senior

Aims  Around a quarter of UK care-home residents have diabetes. Diabetes is known to impact quality of life but existing diabetes-specific quality of life measures are unsuitable for elderly care-home residents. We aimed to develop and evaluate a new measure for use with older adults, to be particularly suitable for use with care-home residents: the Audit of Diabetes-Dependent Quality of Life (ADDQoL) Senior†.

Methods  Content and format changes were made to the 19-domain ADDQoL, informed by related measures for people with visual impairments (12 domain-specific items were retained, four items were revised/added and three items were removed). This revision was modified further following cognitive debriefing interviews with three older adults living in a care home. Psychometric evaluation of the newly developed 17-domain ADDQoL Senior was conducted using data from 90 care-home residents with diabetes who took part in a broader intervention study.

Results  The life domains most impacted by diabetes were ‘independence’ and ‘freedom to eat as I wish’. The ADDQoL Senior demonstrated good factor structure and internal consistency (Cronbach’s alpha = 0.924). Domain scores were, as expected, significantly intercorrelated.

Conclusions  The ADDQoL Senior measures the perceived impact of diabetes on quality of life in older adults, and has been found to be suitable for those living in care homes if administered by interview. The scale has demonstrated acceptability and excellent psychometric properties. It is anticipated that the number of items may be reduced in the future if our current findings can be replicated.

Assessing the use of milk fatty acids to infer the diet of the Australian sea lion (Neophoca cinerea)

Information on the diet of threatened species is important in devising appropriate management plans to ensure their conservation. The Australian sea lion (Neophoca cinerea) is Australia’s only endemic and globally one of the least numerous pinniped species. However, dietary information is currently limited because of the difficulty in using traditional methods (identification of prey hard parts from scats, regurgitates and stomach samples) to reliably provide dietary information. The present study assessed the use of fatty acid (FA) analysis to infer diet using milk samples collected from 11 satellite tracked Australian sea lions from Olive Island, South Australia. Satellite tracking revealed that females foraged in two distinct regions; ‘inshore’ regions characterised by shallow bathymetry (10.7 ± 4.8 m) and ‘offshore’ regions characterised by comparatively deep bathymetry (60.5 ± 13.4 m). Milk FA analysis indicated significant differences in the FA composition between females that foraged inshore compared with those that foraged offshore. The greatest differences in relative levels of individual FAs between the inshore and offshore groups were for 22 : 6n-3 (6.5 ± 1.2% compared with 16.5 ± 1.9% respectively), 20 : 4n-6 (6.1 ± 0.7 compared with 2.5 ± 0.7 respectively) and 22 : 4n-6 (2.4 ± 0.2% compared with 0.8 ± 0.2% respectively). Using discriminant scores, crustacean, cephalopod, fish and shark-dominated diets were differentiated. The discriminant scores from Australian sea lions that foraged inshore indicated a mixed fish and shark diet, whereas discriminant scores from Australian sea lions that foraged offshore indicated a fish-dominated diet, although results must be interpreted with caution due to the assumptions associated with the prey FA dataset. FA analysis in combination with satellite tracking proved to be a powerful tool for assessing broad-scale spatial dietary patterns.