Fear and loathing in public policy : ethical issues in laws for sex offenders

Laws intended to increase protection from sex offenders are often prompted by sensational crimes that provoke public outrage. As public policy, questions have been raised about the legality and effectiveness of these legislative initiatives as enacted in North America, Australasia and the UK since the early 1990s. Mental health professionals involved in the implementation of these laws are faced with ethical concerns that distinguish this area of forensic practice from other clinical roles. This article presents a brief description of the impetus for specific laws allowing for involuntary civil commitment, extended supervision and community notification of sex offenders in different jurisdictions. A model of human rights is then used to consider the ways in which these laws threaten the rights of offenders, and provides a framework for identifying ethical concerns inherent in professional practice in this area.

Gambling, society and the evolution of risk-taking

Gambling is emerging as a major industry around the world at a time when many of the more traditional economic pursuits are becoming less productive, but while the burgeoning gambling industry is certainly profitable and provides good investment opportunities and economic benefits for business and communities alike, it is timely that we look more closely at the overall benefits and costs of this phenomenon in modern society.

In this book about the modern gambling business, a motif of the Colorado River and the Boulder/Hoover Dam is explored in the opening section, likening the benefits and risks of gambling to those of the damming of the Colorado to irrigate California. There can be no doubt that the project wrested many Americans from poverty and unemployment in the depression, built a world-leading engineering structure that served to help the desert bloom, so to speak, including, of course, the re-making of Las Vegas. With the wisdom of hindsight and our increasing environmental awareness, the choking of the Colorado has had its downsides as does the gambling industry as we already know.

From the metaphorical re-examination of Fear and Loathing in Las Vegas, this current book focuses on some of the central aspects of the gambling industry in Australia and around the world, exploring how the industry is traveling in the 21st Century and asking why we are becoming so pre-occupied at this time with the processes of gambling. The prevalence of problem gambling is discussed; the numbers and how they are measured, along with various approaches to treatment and remediation for people affected adversely by their gambling behaviour.

Beyond the ‘bricks and mortar’ gambling and the electronic gaming machines of the latter part of the twentieth century, however, the development of new on-line gambling technologies is introducing different types of products, inducting new consumers to gambling products, changing the face of gambling in society, driving greater profits and potentially spawning more associated problems. While we are still struggling to understand the mechanisms through which more traditional gambling mechanisms affect consumers of these products and how best to remediate or treat such problems, a new form of the gambling phenomenon is being loosed upon modern consumers.

To return to the Hoover Dam metaphor; perhaps this new flood will be too strong for the dam or perhaps it will bring profits and benefits for all concerned. Before we can arrive at a decision about such potential costs and benefits, however, it will be important for us to see just whose money fuels this next phase of industry expansion and whether the profits of the industry are won at the cost of people with gambling problems; people who can’t afford to play the game, let along lose. Will the players in Macau, Singapore, Hong Kong, Vegas, Atlantic City, Sydney and other emerging markets in Asia, along with the new generation of consumers of on-line gambling products, at the end of the day see that their play has been worth the price paid or will the losses to individuals and communities out-weigh the benefits that flow, paradoxically, from this complex industry?

Fear and overprotection in Australian residential aged care facilities: the inadvertent impact of regulation on quality continence care

Aim: Most residents in residential aged care facilities are incontinent. This study explored how continence care was provided in residential aged care facilities, and describes a subset of data about staffs' beliefs and experiences of the quality framework and the funding model on residents' continence care.

Methods: Using grounded theory methodology, 18 residential aged care staff members were interviewed and 88 hours of field observations conducted in two facilities. Data were analysed using a combination of inductive and deductive analytic procedures.

Results: Staffs' beliefs and experiences about the requirements of the quality framework and the funding model fostered a climate of fear and risk adversity that had multiple unintended effects on residents' continence care, incentivising dependence on continence management, and equating effective continence care with effective pad use.

Conclusion: There is a need to rethink the quality of continence care and its measurement in Australian residential aged care facilities.

In search of best practices in responsible gambling ( RG ) : a report on a comparative study of RG among Macau, Las Vegas, and Melbourne, presented to the MSAR Bureau of Gaming Inspection and Coordination (DICJ).

This is a project sponsored by the Asia Pacific Association for Gambling Studies (APAGS) and supported by funds from the MSAR’s Bureau of Gambling Inspection and Coordination (DICJ). The research team comprises as Chief Investigators: Prof. Zhidong Hao of the University of Macau; Prof. Linda Hancock of Deakin University, Australia, and Prof. William Thompson, University of Las Vegas (UNLV). The project research was conducted between the end of December 2012 and July 2013.
The starting point for the research was to select four out of the six casino companies licensed to operate in Macau that also operate transnationally, that is, either in Las Vegas or Melbourne. Hence, the Venetian, Wynn, MGM, and the Melco-Crown Entertainment are the focus of research. The main objectives of the project are to explore how responsible gambling is framed in each of the three jurisdictions (Macau, Las Vegas and Melbourne); how it is approached cross-jurisdictionally by each of the companies; and to assess current approaches within a broader comparative context against international best practice. The research explores Responsible Gambling measures taken by a range of stakeholders including the government/regulators in each of the three jurisdictions, casino managements, problem gambling counselling services, unions and community organizations. The research emphasizes what problems prevail, and the implications of this research for enhancing Responsible Gambling in Macau.

The role of fear of self and responsibility in obsessional doubt processes: a bayesian hierarchical model

The literature concerning obsessive-compulsive disorder (OCD) indicates that obsessions frequently imply negative evaluative beliefs regarding the self. The construct of the feared self has been used to describe the set of harmful attributes an individual worries they may possess. This study aimed to partially replicate previous research that demonstrated a relationship between feared-self beliefs and obsessional doubt in OCD-relevant contexts. The relationship between perceptions of personal responsibility and associated levels of doubt was also examined. Nonclinical participants (N = 221; 155 female; Mage = 26.4, SD = 9.2) were presented with vignettes related to checking and non OCD-relevant themes, which quantified doubt through the presentation of alternating reality-based (i.e., sensory) and possibility-based information. Of the total sample, 112 participants were randomly allocated to a personally relevant condition (in which the action implied in the vignettes was completed by the reader), and 109 were allocated to a second, other-relevant, condition (in which the action implied in the vignettes was completed by a proximal other). The results provided support for reasoning processes implicated in OCD, suggesting that feared-self beliefs may partially contribute to heightened levels of doubt in response to possibility vs. reality-based information in OCD-relevant contexts. Personal relevance contributed to greater baseline levels of doubt, but not to greater responses to the reality- and possibility-based statements accompanying the OCD-relevant vignette. Implications for theory and future research are discussed.

Cultural racism, language prejudice and discrimination in hospital contexts : an Australian study

This article explores the idea that racial and ethnic disparities in healthcare may be expressive of unacknowledged practices of cultural racism. In conducting this exploration, the researchers identify, describe and discuss the practice of language prejudice and discrimination by health service providers, discovered serendipitously in the context of a broader study exploring cultural safety and cultural competency in an Australian healthcare context. The original study involved individual and focus groups interviews with 145 participants recruited from over 17 different organisational and domestic home sites. Participants included health service managers, ethnic liaison officers, qualified health interpreters, cultural trainers/educators, ethnic welfare organisation staff, registered nurses, allied health professionals, and healthcare consumers. Participants self-identified as being from over 27 different ethnocultural and language backgrounds.

Analysis of the data revealed that English language proficiency, like skin colour, was used as a social marker to classify, categorise, and negatively evaluate people of non-English speaking backgrounds (NESB) in the contexts studied. Negative evaluations, in turn, were used to justify the exclusion of NESB people from healthcare relationships and resources. Further data analysis revealed that underpinning the negative attitudes and behaviours in hospital domains concerning people who spoke accented English or who did not speak English proficiently were a dislike of difference, fear of difference, intolerance of difference, fear of competition for scarce healthcare resources, repressed hostility toward difference, and ignorance.

Highlighting the implications of language prejudice for the safety and quality care of NESB people, the researchers call for further internationally comparative research and debate on the subject.

Lived experience of gay men caring for others with HIV/AIDS : living, loving and dying in the era of HIV/AIDS

This thesis explored gay male carers’ experience of caring for their partner, brother or friend who had HIV/AIDS. Through using phenomenological methodology (van Manen, 1990), the day-to-day caring experiences were uncovered. The data gathered were then analysed through a nursing ‘lens’, with the concept of stigma as an anchoring point. The dual stigmas of homophobia and AIDS phobia impacted on the daily lives of these men as they cared for their loved one. The research identified six themes. These were: 1) the relationship; 2) coping with HIV and AIDS; 3) the corporal impact of HIV/AIDS; 4) experiences of carers including the absence of others; 5) living daily with the virus: Demands of people living with HIV/AIDS (PLWHA); and 6) saying goodbye, but wanting to keep the memory alive. The caring these men undertook, for which they were frequently unprepared, was intensive and complex, but because of their commitment and love they battled on. Because of a sense of shame associated with AIDS phobia on the part of the PLWHA, the carer often had to undertake this care in isolation, without support from family, friends or home health care agencies. The carers struggled with not only the demands of day-to-day care, but also with non-acceptance from family, both of the nature of the relationship with their partner and of their homosexuality. Family members were forced, often with great difficulty, to acknowledge the close commitment the men had to each other. Recognition that one had a terminal disease, HIV/AIDS was also required. The fear of potential transmission was high among carers, friends and family members. Notably, there was an absence of blame on the part of the carer towards his partner for contracting HIV/AIDS. The physical decline and marking of the body further stigmatised the PLWHA, which added to carers’ burdens. They endeavoured to minimise the physical decline in their partner, so he could continue to pass as healthy, and attempted to make the day-to-day living as normal as possible. The methods of combating weight loss and opportunistic infections meant frequent medical appointments, complex intensive medical procedures and help with personal care, which was undertaken at home largely without support from health care staff. Carers frequently struggled also with their partner’s denial of being ill. One strategy all carers used was to escape with their partners from their everyday life in Melbourne and attempt metaphorically to leave the HIV/AIDS behind; this was a time when they could rekindle their life together as it was before HIV/AIDS came into their lives. Some carers chose to holiday without their partner, to give themselves a break from the day-to-day caring, while others planned and took holidays with their partner. The decline of the health in the PLWHA meant that family members had to recognise and accept both the nature of the relationship and the presence of the disease. This recognition and acceptance often came only when the partner was very ill, even at the point of dying. Carers and their partners discussed the potential use of euthanasia, as a means of ending the final phase of life with some dignity. One carer and his partner used euthanasia, despite its illegal status. The main concern for all carers was providing comfort and a reduction in the pain associated with HIV/AIDS for the partner. The widespread grief associated with HIV/AIDS was evident amongst these carers. All had known other gay men who had died, some carers own partner had died, or was about to die. There was an overwhelming sense of grief, which at times was repressed as a means of coping day-to-day. All carers felt it was important and necessary to remember those lost to HIV/AIDS through the various public memorials, as they did not want their partner to be just another faceless person lost to this disease. This phenomenological study of carers’ experience highlights the need for health care workers to be aware of the differing strategies that gay men use to cope with HIV/AIDS. While it may seem that the carers are coping with care of their partner, the outer façade is not always an accurate portrayal of the true situation. Health care workers should enquire as to the assistance these carers need from health care services in order to continue to care for their loved one. Such assistance can be the simple recognition of the partner and acceptance of them as part of the PLWHA’s network; this inclusion and acceptance is half the battle.

Presbyterian ethos and environment in the novels of John Buchan : a religious and historical study

The aim of this thesis is to establish, from a historical and religious perspective, that the Presbyterian ethos and environment in which John Buchan was reared was the predominating influence in the writing of his novels. Presbyterianism was not the only influence on Buchan that determined the character of his stories. Buchan was by temperament a romantic, and this had considerable influence on his literature. His novels are romances, peopled by romantic figures who pursue romantic adventures. There are the signs of Buchan's romantic nature in the contents of the novels: creative imagination, sensitivity to nature, and expectations of the intrusion of other worlds, with destiny-determining events to follow. But Buchan had also an acquired classicism. His studies at Glasgow and Oxford Universities brought him in touch with a whole range of the master-pieces of classical literature, especially the works of Plato and Virgil. This discipline gave him clarity and conciseness in style, and balanced the romantic element in him, keeping his work within the bounds of reason. At the heart of Buchan's life and work, however, was his deeply religious nature and this, while influenced by romanticism and classicism, was the dominant force behind his work. Buchan did not accept in its entirety the Presbyterian doctrine conveyed to him by his father and his Church. He was moderate by temperament and shrank from excesses in religious matters, and, being a romantic, he shied away from any fixed creeds. He did embrace the fundamentals of Christianity, however, which he learned from his father and his Church, even if he did put aside the Rev. John's orthodox Calvinism. The basic Christianity which underlies all Buchan's novels has the stamp of Presbyterianism upon it, and that stamp is evident in his characters and their adventures. The expression of Christianity which Buchan embraced was the Christian Platonism of seventeenth century theologians, who taught and preached at Cambridge University, They gave prominence to the place of reason and conscience in man's search for God, They believed that reason and conscience were the ‘candle of the Lord’ which was existed every one. It was their conviction that, if that light was followed, it would lead men and women to God. They were against superstition and fanaticism in religion, against all forms of persecution for religious beliefs, and insisted that God could only be known by renouncing evil and setting oneself to live according to God’s will. This teaching Buchan received, but the stamp of his Presbyterianism was not obliterated. The basic doctrines which arose from his father's Presbyterianism and are to be found in Buchan's novels are as follows: a. the fear (or awe) of God, as life's basic religious attitude; b. the Providence of God as the ultimate determinative force in the outcome of events; c. the reality, malignity and universality of evil which must be forcefully and constantly resisted; d. the dignity of human beings in bearing God's image; e. the conviction that life has meaning and that its ultimate goal, therefore, is a spiritual one - as opposed to the accumulation of wealth, the achieving of recognition from society, and the gaining access to power; f. the necessity of challenge in life for growth and fulfilment, and the importance of fortitude in successfully meeting such challenge; g. the belief that, in the purpose of God, the weak confound the strong. These emphases of Presbyterianism are to be found in all Buchan's novels, to a greater or lesser degree. All his characters are serious people, with a moral purpose in life. Like the pilgrims of the Bible, they seek a country: true fulfilment. This quest becomes more spiritual and more dearly defined as Buchan grows in age and maturity. The progress is to be traced from his early novels, where fulfilment is sought in honour and self-approving competence, as advocated by classicism; to the novels of his middle years, where fulfilment is sought in adventures suggested by romanticism. In his final novel Sick Heart River. Buchan appears to have moved somewhat from his earlier classicism and his romanticism as the road to fulfilment. In this novel, Buchan expresses what, for him, is ultimate fulfilment: a conversion to God that produces self-sacrificing love for others. The terminally-ill Edward Leithen sets out on a romantic adventure that will enable him to die with dignity, and so, in classic style, justify his existence. He has a belief in God, but in a God who is almighty, distant and largely irrelevant to Leithen's life. In the frozen North of Canada, where he expects to find his meagre beliefs in God's absolute power confirmed by the icy majesty of mountain and plain, he finds instead God's mercy and it melts his heart. In a Christ-like way, he brings life to others through his death, believing that, through death, he will find life. There is sufficient evidence to give plausibility to the view that Buchan is describing in Leithen his own pilgrimage. If so, it means that Buchan found his way back to the fundamental experience of the Christian life, conversion, so strongly emphasised in his orthodox Presbyterianism home and Church. However, Buchan reaches this conclusion in a Christian Platonist way, through the natural world, rather than through the more orthodox pathway of Scripture.

The way home : concealment and revelation in The War Is Over

Through an examination of the cinematography and the editing style of the film, the article will show how these elements coalesce to serve both the story and characters, while underscoring the film’s themes of loss, uncertainty and fear. The film-maker’s mastery of her craft ultimately confronts us with the realization that for Marco and his family the war is far from over.

Writing blah, blah, blah: lecturers’ approaches and challenges in supporting international students

The increase in numbers of international students who have English as a second language (ESL) and are studying in English-medium universities has renewed the emphasis of English language development in higher education, particularly concerning academic writing. Much of the discussion has concentrated on developing best practices in providing support via Language and Academic Support (LAS) programs. However, the main challenge in recent years has focused on integrating disciplinary and language learning. What has been largely missing from the discussion are the views of lecturers and students regarding the strategies they use to develop academic writing in the discipline. This paper addresses this issue. The analysis reveals that academic writing within the disciplines is largely an individual endeavour for both lecturers and their students. Lecturers focus on explaining what skills students are required to demonstrate in their assignments, but students are more concerned with understanding how they can develop these skills. The implications are discussed concerning the development of a whole institutional approach for integrating language and disciplinary teaching.

Exploring motivation and confidence in taking prescribed medicines in coexisting diseases: a qualitative study

Aims and objectives: To explore the motivation and confidence of people with coexisting diabetes, chronic kidney disease (CKD) and hypertension to take their medicines as prescribed. Background: These comorbidities are major contributors to disease burden globally. Self-management of individuals with these coexisting diseases is much more complicated than that of those with single diseases and is critical for improved health outcomes. Design: Motivational interviewing telephone calls were made with participants with coexisting diabetes, CKD and hypertension. Methods: Patients aged ≥18 years with diabetes, CKD and systolic hypertension were recruited from outpatient clinics of an Australian metropolitan hospital between 2008-2009. An average of four motivational interviewing telephone calls was made with participants (n = 39) in the intervention arm of a randomised controlled trial. Data were thematically analysed using the modified Health Belief Model as a framework. Results: Participants' motivation and confidence in taking prescribed medicines was thwarted by complex medicine regimens and medical conditions. Participants wanted control over their health and developed various strategies to confront threats to health. The perceived barriers of taking recommended health action outweighed the benefits of taking medicines as prescribed and were primarily related to copious amounts of medicines. Conclusion: Taking multiple prescribed medicines in coexisting diabetes, CKD and hypertension is a perpetual vocation with major psychosocial effects. Participants were overwhelmed by the number of medicines that they were required to take. The quest for personal control of health, fear of the future and the role of stress and gender in chronic disease management have been highlighted. Participants require supportive emotional interventions to self-manage their multiple medicines on a daily basis. Relevance to clinical practice: Reducing the complexity of medicine regimens in coexisting diseases is paramount. Individualised psychosocial approaches that address the emotional needs of patients with regular follow-up and feedback are necessary for optimal chronic disease self-management. © 2013 John Wiley & Sons Ltd.

Gestures of judgement and welcome in public spaces: hypervisible migrant newcomers in Darwin, Australia

This paper draws on ethnographic research to show how pigmentation intensities of skin and facial characteristics make bodies of colour recognisable in public spaces of Darwin, a small multiethnic and multiracial north Australian city. This paper shows that the visibility of newcomers, in particular, humanitarian migrants from countries in Africa, the Middle East and Asia, circulates negative sentiments of fear, anxiety and discomfort in public spaces when instantaneous judgements are made. These judgements of misrecognition made by residents of diverse ethnic and racial backgrounds lead to simmering tensions that unfold as visceral events of vulnerability in public spaces such as bus interchanges, neighbourhood streets, shopping centres and car parks. These events that have the potential to wound and numb bodies contribute to the “urban unconscious” of Darwin as a city where public spaces are safe with heightened surveillance. This paper argues, however, that events of hypervisibility, judgement and interracial tensions can unfold quite differently in public spaces if humanitarian migrants sense gestures of welcome, particularly from Aboriginals. Such fleeting moments of welcome in Darwin have the potential to bring together bodies with different histories and geographies of racialisation, so that multiple publics emerge through everyday habits of living with difference.