Mental health diversion courts: a two year recidivism study of a South Australian mental health court program.

The need to develop specialized judicial processes to deal with offenders with mental illnesses is now widely recognized and has led to the introduction of mental health court diversion programs around the world. At present, however, there is only limited evidence from which to assess the impact of these initiatives. This paper describes the South Australian model of diversion, with specific reference to the relationship between identified participant characteristics, program compliance rates, and re-offending outcomes. The results of a two-year recidivism study suggest that involvement with the program has a positive impact on recidivism, but that this is independent from the individual's level of success in the program. Lower risk offenders were more likely to achieve successful outcomes than those in the higher risk categories. The implications of these results, as well the factors that might inform the ongoing development of mental health court programs, are discussed.

On the fast track speeding nurses into the future: a two year Bachelor of Nursing for graduates of other disciplines

It has been suggested in nursing literature that a bachelor's degree should be the pre-requisite to professional nursing education and registration. The perceived advantages of graduates entering the nursing profession led faculty in the School of Nursing La Trobe University to introduce in 1997 an innovative two-year Bachelor of Nursing (BN) program, believed to be the first in Australia, for graduates of other disciplines. A problem-based learning (PBL) approach was selected to facilitate the teaching learning process. Data to evaluate the progress of the accelerated students were collected by examining their previous degree background, conducting a focus group discussion mid year and comparing the students' academic results with those completing the traditional three-year course. Findings indicate that students in the accelerated course were highly motivated but experienced significant stress. In part the stress emanated from the need to identify their own learning needs. However, despite their concerns most accelerated students scored at least as well both clinically and academically as traditional students. Moreover, in six of the seven final year subjects each group studied the accelerated students performed better.

Two-year combination antibiotic therapy with clarithromycin, rifabutin, and clofazimine for Crohn's disease

Background & Aims: Mycobacterium avium subspecies paratuberculosis has been proposed as a cause of Crohn’s disease. We report a prospective, parallel, placebo-controlled, double-blind, randomized trial of 2 years of clarithromycin, rifabutin, and clofazimine in active Crohn’s disease, with a further year of follow-up. Methods: Two hundred thirteen patients were randomized to clarithromycin 750 mg/day, rifabutin 450 mg/day, clofazimine 50 mg/day or placebo, in addition to a 16-week tapering course of prednisolone. Those in remission (Crohn’s Disease Activity Index ≤150) at week 16 continued their study medications in the maintenance phase of the trial. Primary end points were the proportion of patients experiencing at least 1 relapse at 12, 24, and 36 months. Results: At week 16, there were significantly more subjects in remission in the antibiotic arm (66%) than the placebo arm (50%; P = .02). Of 122 subjects entering the maintenance phase, 39% taking antibiotics experienced at least 1 relapse between weeks 16 and 52, compared with 56% taking placebo (P = .054). At week 104, the figures were 26% and 43%, respectively (P = .14). During the following year, 59% of the antibiotic group and 50% of the placebo group relapsed (P = .54). Conclusions: Using combination antibiotic therapy with clarithromycin, rifabutin, and clofazimine for up to 2 years, we did not find evidence of a sustained benefit. This finding does not support a significant role for Mycobacterium avium subspecies paratuberculosis in the pathogenesis of Crohn’s disease in the majority of patients. Short-term improvement was seen when this combination was added to corticosteroids, most likely because of nonspecific antibacterial effects.

Part-time employment trends for full-time undergraduate property and construction students : results of a two year sequential investigation

This paper reports on the initial findings of an investigation into the experiences and part-time work practices of undergraduates enrolled in the Bachelor of Property and Construction (BPC) and combined degree courses at the University of Melbourne. Initial data was collected from final year students during 2001 and for all four years of the course in 2002. The results suggest that students in earlier years of the course are more likely to work in non-industry (casual) related employment and work fewer hours. Students in later years of the BPC course are more likely to work in jobs in the construction industry and also to work longer hours than those in earlier years. An analysis of final year students shows that the students employed by contracting organisations work significantly more hours than students employed by other types of organisations including architectural practices. The consequences of part-time semester employment on academic performance and students' well-being are considered and proposals are put forward as to how to better manage the industry experience-University relationship.

Finding a common story : synthesising findings from two research programs

In this research the authors tackled the issue of synthesising the findings of two independent research programs with common themes into a coherent analysis of teaching and learning across disciplines and school sectors. Through an ongoing dialogue and iterative exploration of emerging themes a synthesis generated new understandings of the use of narrative pedagogies in maths, science and technology, and the aesthetic nature of such learning experiences. This process demonstrates how a comparative lens enables a higher level of analysis of both research programs and generates broader narratives that can be applied to contexts beyond the original research foci.

Two-year results of a randomized placebo-controlled trial of vertebroplasty for acute osteoporotic vertebral fractures

We previously reported the results of a randomized controlled trial that found no benefit of vertebroplasty over a sham procedure for acute osteoporotic vertebral fractures up to 6 months. We report here the 12-month and 24-month clinical outcomes of this trial. Eligible participants (n = 78) were randomly assigned to receive either vertebroplasty (n = 38) or a sham procedure (n = 40). Randomization was stratified by treatment center, sex, and symptom duration (<6 weeks or ≥6 weeks). Participants, investigators (except the treating radiologists), and outcome assessors were blinded to group assignments. Enrolment occurred between April 2004 and October 2008 with follow-up completed October 2010. The primary outcome was overall pain measured on a scale of 0 (no pain) to 10 (maximal imaginable pain). Secondary outcomes included pain at rest and at night, disability, quality of life, perceived recovery, and adverse events, including incident clinically apparent vertebral fractures. At 12 and 24 months, complete data were available for 67 (86%) and 57 (73%) participants, respectively. At 12 months participants in the active group improved by 2.4 ± 2.7 (mean ± SD) units in overall pain compared with 1.9 ± 2.8 units in the sham group, adjusted between-group mean difference (MD) 0.3 (95% confidence interval [CI], –0.9 to 1.5), whereas at 24 months participants in the active group had improved by 3.0 ± 3.1 units compared with 1.9 ± 3.0 units in the sham group, MD 1.1 (95% CI, –0.3 to 2.4). No significant between-group differences were observed for any of the secondary efficacy outcomes at 12 or 24 months. There were no between-group differences in incident clinical vertebral fractures up to 24 months (active: n = 14, sham: n = 13), although the study had inadequate power for this outcome. These results provide further evidence that the use of this treatment in routine care is unsupported.

Two-year outcomes of a population-based intervention for preschool language delay : an RCT

OBJECTIVE: We have previously shown short-term benefits to phonology, letter knowledge, and possibly expressive language from systematically ascertaining language delay at age 4 years followed by the Language for Learning intervention. Here, we report the trial's definitive 6-year outcomes. METHODS: Randomized trial nested in a population-based ascertainment. Children with language scores >1.25 SD below the mean at age 4 were randomized, with intervention children receiving 18 1-hour home-based therapy sessions. Primary outcome was receptive/expressive language. Secondary outcomes were phonological, receptive vocabulary, literacy, and narrative skills; parent-reported pragmatic language, behavior, and health-related quality of life; costs of intervention; and health service use. For intention-to-treat analyses, trial arms were compared using linear regression models. RESULTS: Of 1464 children assessed at age 4, 266 were eligible and 200 randomized; 90% and 82% of intervention and control children were retained respectively. By age 6, mean language scores had normalized, but there was little evidence of a treatment effect for receptive (adjusted mean difference 2.3; 95% confidence interval [CI] -1.2 to 5.7; P = .20) or expressive (0.8; 95% CI -1.6 to 3.2; P = .49) language. Of the secondary outcomes, only phonological awareness skills (effect size 0.36; 95% CI 0.08-0.65; P = .01) showed benefit. Costs were higher for intervention families (mean difference AU$4276; 95% CI: $3424 to $5128). CONCLUSIONS: Population-based intervention targeting 4-year-old language delay was feasible but did not have lasting impacts on language, possibly reflecting resolution in both groups. Long-term literacy benefits remain possible but must be weighed against its cost.

Equity-focused health impact assessment framework

Background to the Development of the Equity-Focused HIA Framework
The equity focused health impact assessment (EFHIA) framework arises out of a two year research project funded for the most part by the Australian Government’s Public Health Education Research Program (PHERP) Innovations Grants (Round 2) scheme. This project had as its primary objective the development of a framework for health inequalities impact assessment, subsequently renamed equity focused health impact assessment. A partnership between the University of Newcastle, Deakin University and the University of New South Wales (the Project Management Steering Committee) received the funding and the Australasian Collaboration for Health Equity Impact Assessment (ACHEIA) was formed to undertake appropriate background research and to develop, pilot test, modify and disseminate the framework. The work commenced in September 2002 and concluded in October 2004. Part of the funding included a capacity building workshop in August 2004. ACT Health and the Division of Medicine at the John Hunter Hospital, Newcastle, also provided financial support for the project. The August 2004 Workshop was supported by NSW Health. All participants and organisations involved in the project gave extensive in-kind support.
The aims of the workshop were to bring together an international collaboration of multidisciplinary investigators, public health experts, and key senior health managers working in national, state and local settings, to inform the further development of the framework and to provide training in its application. The initial goals of the project were to work collaboratively to develop a strategic framework to assess the health inequalities of public health-related policies, plans, strategies, decisions, programs and services. The EFHIA framework as presented at the August workshop was developed through:
1. an extensive review of the relevant literature
2. formal and informal consultation with members of ACHEIA (the international
reference group), members of the Project Management Steering Committee and
other relevant experts; and
3. testing of the draft EFHIA framework with the 5 case study partners – who applied the draft framework in a range of health settings (see
Acknowledgements).
The result of this work has been the development of an equity focused health impact assessment framework that can be used to determine the unanticipated and systemic health inequities that may exist within the decision making processes or activities of a range of organisations and sectors. The EFHIA framework provides one approach that can be used to assist decision makers to put equity and health on their agenda in a more obvious and systematic way. The framework represents a ‘moment in time’ rather than a definitive statement or ‘toolkit’ on the best way to proceed. Further practice, refinement and adjustment will be needed over many years to consolidate both HIA and EFHIA. As well as this guide to the framework, additional outputs from the project team include:
- A literature review
- A position paper
- A report on the five case studies
- An evaluation report.
With the consent of the Australian Government, a monograph will be made available to workshop participants at the end of October which contains the framework and the appropriate background papers.

The systematic influences on student evaluation of teaching in engineering education

BACKGROUND Student evaluation of teaching (SET) has a long history, has grown in prevalence and importance over a period of decades, and is now common-place in many universities internationally. SET data are collected for a range of purposes, including: as diagnostic feedback to improve the quality of teaching and learning; as an input to staff performance management processes and personnel decisions such as promotion for staff; to provide information to prospective students in their selection of courses and programs; and as a source of data for research on teaching. Rovai et al. (2006) report that while SET research provides mixed results, there is evidence that, for course-related factors, smaller classes are rated more favourably than large classes, upper-year-level classes are rated more favourably than lower-year classes, and that there are rating differences between discipline areas. While additional course-related factors are also noted, other reviews of the literature on SET also identify these three factors as commonly reported systematic influences on SET ratings. The School of Engineering at Deakin University in Australia offers undergraduate and postgraduate engineering programs, and these programs are delivered in both on-campus and off-campus modes.PURPOSEThe paper presents a quantitative investigation of SET data for the School of Engineering at Deakin University to identify whether the commonly reported systematic influences on SET ratings of class size and year level are also observed here. The influence of online mode of offer is also explored.DESIGN/METHOD Deakin University’s Student Evaluation of Teaching and Units (SETU) questionnaire is administered to students enrolled in every unit of study every time that unit is offered, unless it is specially exempted. Following data collation, summary results are reported via a public website. The publicly available SETU data for all School of Engineering units of study were collected for a two year period. The collected data were subjected to analysis of variance (ANOVA) analysis to identify any significant systematic influences on mean student SETU ratings.RESULTS SETU data from 100 separate units of study over the two year period were collected, representing 3375 sets of SETU ratings, and covering unit enrolment sizes from 12 to 462 students. Although this was a modest sized investigation, significantly higher mean ratings for some SETU items were observed for units with small enrolments, for postgraduate level units compared to undergraduate level units, and for units offered in conventional mode compared to online mode of offer. The presence of the commonly observed systematic influences on SET ratings was confirmed.CONCLUSIONS While the use of SET data may have originally been primarily for formative purposes to improve teaching and learning, they are also increasingly used for summative judgements of teaching quality and teaching staff performance that have implications for personnel decision making. There may be an acceptance of the need for SET, however there remains no universal consensus as to what constitutes quality in university teaching and learning, and the increasing use of SET for high-stakes decision making puts pressure on institutions to ensure that their SET practices are sound, equitable and defensible.

Balancing risk? First year performing arts students’ experience of a community arts event

This study examines participants’ responses to first year students’ street performances as a non-placement work-integrated learning (WIL) activity over a two year period. The purpose of the study was to determine: (1) community perception, (2) continuous improvement, and (3) future needs. Data was collected through surveying participants’ post-viewing of the street performances, students’ reflective notes, and a recorded focus group interview. The findings indicated that audience members require additional assistance to value the students’ street performances. The results revealed that students require more guidance around researching the sites of practice, understanding group work dynamics, relaxation methods, intra- and interpersonal skill development, conflict resolution and how to effectively build community relations with the local government Council. From the findings, specific recommendations for continual improvement are made. These include offering an explanation of the street performances’ historical and aesthetic connections to the building sites for audience members, affording battery operated body-microphones and light rostrum for improved sight lines, delivering group dynamics information and arranging opportunities for students to engage more effectively with the Council. While the recommendations in this study are intended to advance the field of research that evaluates non-placement WIL performing arts curriculum in higher education, the findings are relevant to any group-based performance activity in learning and teaching.

Environmental initiatives: towards triple-bottom line reporting

The objective of this study was to investigate the quantity and quality of voluntary environmental disclosures in the annual reports of firms listed by market capitalisation on the Australian Stock Exchange. The periods examined were those immediately prior and subsequent to the release of the Exposure Draft Coalition for Environmentally Responsible Economics (CERES) Global Reporting Initiatives (GRI) issued in March 1999. Using content analysis to focus on the environmental aspects, the study compared 425 annual reports over a two-year period and 60 environmental reports, in order to explore reporting practices in the periods surrounding this intervention. The results suggest a trend to triple-bottom reporting, and a significant change in the quality and quantity of environmental information, albeit in specific categories.

A lawyer's lawyer joins the high court of Australia

In November 2005, Susan Crennan was sworn in as the 45th justice of the High Court of Australia. This follows a brief two year period as a justice of the Federal Court of Australia. In this article, the author recounts the debate leading up to the latest appointment regarding what type of justice should be appointed to the Court, and reviews Crennan's Federal Court judgments in an attempt to provide some insight on the type of High Court justice Crennan will be. What is for certain is that Crennan is enchantingly mysterious.