Student reflections in a first year public health and health promotion unit

While reflective practice has been used extensively in nursing and teaching education over many years, the introduction of reflective practice into other disciplines is more recent. This paper provides an overview of the use of reflective practice as an assessment task in a first year, first trimester, undergraduate health promotion and public health unit. Reflective practice is included in this unit as a way for students to deal with challenges that arise during learning. This study used a coding scheme to determine the level of reflection of student journals, as well as a qualitative approach of thematic analysis to investigate themes within the student’s reflective journals. Findings of this study suggest a low level of student reflection, however; thematic analysis results in rich data that describe student aspirations for future careers.

Evaluating a school-based alcohol program: the WARP experience

The Western Alcohol Reduction Program (WARP) is a community designed and lead, secondary school-based, program that seeks to address issues related to alcohol use by young people in the Melbourne western metropolitan region. Taking a whole-of community approach, the program consisted of six programs for a class of 20 students from schools in western Melbourne. The program sought to highlight negative influences of alcohol on life outcomes, and addresses the issues of alcohol-related behaviour in assaults, injuries and preventable consequences of risk-taking behaviour. The findings of this evaluation suggest that students have modified some of their drinking behaviours over the program, have modified some of their risky behaviours and have increased their knowledge in some areas. This program, designed specifically to meet the needs of the local school and students, has the potential to increase the alcohol- and drug-related knowledge of students, while also having a positive impact on alcohol-related behaviours.

Food security among asylum seekers in Melbourne

Objectives: This research explores food insecurity among asylum seekers who are members of the Asylum Seeker Resource Centre (ASRC) in Melbourne, Australia. Methods: Structured person-assisted questionnaires were conducted with 56 asylum seekers. The questionnaires examined issues around access to food, cultural appropriateness of available food, transport issues, use of the ASRC Foodbank and questions about general health. Results: Findings suggest that: 1) almost all asylum seekers in this study were food insecure; 2) most of the asylum seekers using the ASRC Foodbank have no access to food other than that provided at the centre; and 3) the reason that most asylum seekers are food insecure is related to structural problems associated with limitations imposed by different visas. Conclusions and implications: The ability of asylum seekers to achieve food security is limited by their restricted access to welfare and government or work-related income. Given that the current policy situation is likely to continue, providers such as the ASRC will find continuing demands on their services and increasing pressures to provide more than a 'supplemental' food supply.

Health literacy and the Internet: a study on the readability of Australian online health information

OBJECTIVE: Almost 80% of Australian Internet users seek out health information online so the readability of this information is important. This study aimed to evaluate the readability of Australian online health information and determine if it matches the average reading level of Australians. METHODS: Two hundred and fifty-one web pages with information on 12 common health conditions were identified across sectors. Readability was assessed by the Flesch-Kincaid (F-K), Simple Measure of Gobbledygook (SMOG) and Flesch Reading Ease (FRE) formulas, with grade 8 adopted as the average Australian reading level. RESULTS: The average reading grade measured by F-K and SMOG was 10.54 and 12.12 respectively. The mean FRE was 47.54, a 'difficult-to-read' score. Only 0.4% of web pages were written at or below grade 8 according to SMOG. Information on dementia was the most difficult to read overall, while obesity was the most difficult among government websites. CONCLUSIONS AND IMPLICATIONS: The findings suggest that the readability of Australian health websites is above the average Australian levels of reading. A quantifiable guideline is needed to ensure online health information accommodates the reading needs of the general public to effectively use the Internet as an enabler of health literacy.

Economic evaluation of a psychological intervention for high distress cancer patients and carers: costs and quality-adjusted life years

OBJECTIVE: This study compared the cost-effectiveness of a psychologist-led, individualised cognitive behavioural intervention (PI) to a nurse-led, minimal contact self-management condition for highly distressed cancer patients and carers.

METHODS: This was an economic evaluation conducted alongside a randomised trial of highly distressed adult cancer patients and carers calling cancer helplines. Services used by participants were measured using a resource use questionnaire, and quality-adjusted life years were measured using the assessment of quality of life - eight-dimension - instrument collected through a computer-assisted telephone interview. The base case analysis stratified participants based on the baseline score on the Brief Symptom Inventory. Incremental cost-effectiveness ratio confidence intervals were calculated with a nonparametric bootstrap to reflect sampling uncertainty. The results were subjected to sensitivity analysis by varying unit costs for resource use and the method for handling missing data.

RESULTS: No significant differences were found in overall total costs or quality-adjusted life years (QALYs) between intervention groups. Bootstrapped data suggest the PI had a higher probability of lower cost and greater QALYs for both carers and patients with high distress at baseline. For patients with low levels of distress at baseline, the PI had a higher probability of greater QALYs but at additional cost. Sensitivity analysis showed the results were robust.

CONCLUSIONS: The PI may be cost-effective compared with the nurse-led, minimal contact self-management condition for highly distressed cancer patients and carers. More intensive psychological intervention for patients with greater levels of distress appears warranted.

Co-ingestion of energy drinks with alcohol and other substances among a sample of people who regularly use ecstasy

INTRODUCTION AND AIMS: Despite the potential harms of mixing unregulated drugs with energy drinks (ED), research to date has primarily been focused on EDs co-ingested with alcohol. Consequently, the aim of the present study was to explore the rate of use, harms and correlates of EDs co-ingested with alcohol and other drugs among a sample of people who regularly use illicit stimulant drugs. DESIGN AND METHODS: In 2010, 693 Australians who regularly used ecstasy completed a 1-h interview about their past six-month ED and drug use. RESULTS: Three-quarters of the sample (77%) had recently consumed EDs with other substances, primarily alcohol (70%) and ecstasy (57%). People who consumed ED with alcohol versus those who had consumed ED with ecstasy and with alcohol (only 8% reported only consuming ED with ecstasy) had similar profiles in regards to demographics, drug use, mental health and drug-related problems. Primary motives for consuming ED with alcohol included increased alertness (59%), the taste (25%), to party for longer (23%) and to combat fatigue (16%). One-half (52%) and one-quarter (27%) of participants who consumed EDs with alcohol and with ecstasy respectively had recently experienced adverse outcomes post-consumption, primarily headaches (24% and 11%) and heart palpitations (21% and 14%). DISCUSSION AND CONCLUSIONS: Co-ingestion of EDs with licit and illicit drugs is common among people who regularly use ecstasy and related drugs. Adverse outcomes of co-ingestion suggest that targeted education regarding negative interactive drug effects is crucial for harm reduction. [Peacock A, Sindicich N, Dunn M, Whittaker E, Sutherland R, Entwistle G, Burns L, Bruno R. Co-Ingestion of Energy Drinks with Alcohol and Other Substances among a Sample of People Who Regularly Use Ecstasy. Drug Alcohol Rev 2015].

Do performance and image enhancing drug users in regional Queensland experience difficulty accessing health services?

INTRODUCTION AND AIM: To understand health service access and needs of people who use performance and image enhancing drugs (PIED) in regional Queensland. DESIGN AND METHODS: Semi-structured interviews were conducted with 21 people (n = 19 men) who reported the use of a range of PIEDs, including anabolic-androgenic steroids, human chorionic gonadotropin, growth hormone, clenbuterol, tamoxifen, insulin and peptides. RESULTS: Participants reported accessing a range of services, including needle and syringe programs and pharmacies, for sterile injecting equipment. While PIEDs users attributed some stigma to needle and syringe programs, they were seen as an important service for injecting equipment. Participants reported receiving either positive care from health-care providers, such as general practitioners (GP), or having negative experiences due to the stigma attached with PIED use. Few participants reported disclosing their PIED use to their GP not only because of the concerns that their GP would no longer see them but also because they felt their GP was not knowledgeable about these substances. DISCUSSION AND CONCLUSION: Participants in the study reported no difficulty in accessing health services based on living in a regional area, with their concern focused more upon how they were viewed and treated by service staff. [Dunn M, Henshaw R, Mckay F. H. Do performance and image enhancing drug users in regional Queensland experience difficulty accessing health services? Drug Alcohol Rev 2015;00:000-000].

Disability studies: educating for inclusion

Education systems worldwide will only successfully serve the needs of people with disability when we inclusively examine and address disabling issues that currently exist at school level education as well as further and higher education and beyond. The chapters contributing to this edited volume are presented to assist readers with a critical examination of contemporary practice and offer a concerted response to improving inclusive education. The chapters address a range of important topics related to the field of critical disability studies in education and include sections dedicated to Schools, Higher Education, Family and Community and Theorising. The contributors entered into discussions during the 2014 AERA Special Interest Group annual meeting hosted by Victoria University in Australia. The perspectives offered here include academic, practitioner, student and parent with contributions from Australia, New Zealand, Nigeria, the UK and the US, providing transnational interest. This book will appeal to readers who are interested in innovative theoretical approaches, practical applications and personal narratives. The book is accessible for scholars and students in disciplines including education, sociology, psychology, social work, youth studies, as well as public and allied health. The Introduction by Professor Roger Slee (The Victoria Institute, Victoria University, Australia) and Afterword by Professor David Connor (City University of New York) provide insightful and important commentary. Cover photograph by Paul Dunn and design by Hendrik Jacobs.

Tinindo Trincando: contracultura e rock no samba dos Novos Baianos

Artigo é produto da pesquisa "Experimentalismo e inovação na música popular brasileira nos anos 1970", sob o patrocínio da Fapesp. Texto foi apresentado no 34º Congresso da Intercom (Recife-PE).

Analgesia em pós-operatório de toratomias : estudo prospectivo e randomizado

Introdução: A dor é um importante fator de incremento da morbidade e mortalidade em pacientes submetidos a procedimentos cirúrgicos que incluem toracotomias. Diversos fatores contribuem para que esses pacientes apresentem um alto grau de dor no pós-operatório, entre os quais a secção da pele, músculos e pleura, retração dos músculos e ligamentos pelo afastador de Finochietto, irritação da pleura e nervos intercostais pelos drenos tubulares torácicos e fraturas ocasionais dos arcos costais. O aumento das taxas de morbidade e mortalidade é dado principalmente à respiração superficial decorrente da pouca mobilidade da parede torácica e conseqüente à dor e pela perda da efetividade do principal mecanismo de eliminação de secreções da árvore traqueobrônquica (tosse), resultando em atelectasias, inadequado gradiente ventilação / perfusão, hipoxemia e pneumonia. Uma vez caracterizada a necessidade de atenuação da dor como fator primordial na melhora dos índices de morbidade e mortalidade no período pós-operatório de cirurgia torácica, torna-se imperiosa uma análise das terapêuticas disponíveis na atualidade para tanto. Objetivos: Avaliar a utilização de três diferentes métodos de analgesia: 1. bloqueio peridural com morfina (BPM); 2. morfina parenteral (MP); e 3. bloqueio intercostal extrapleural contínuo com lidocaína” (BIC), em pacientes submetidos a procedimentos que incluíram toracotomias em sua execução, além de analisar o custo financeiro desses métodos. Materiais e métodos: Trata-se de um estudo prospectivo, randomizado, no qual foram analisados 79 pacientes, submetidos a toracotomias, subdivididos de forma aleatória em três grupos, de acordo com a modalidade terapêutica instituída: 25 pacientes no grupo BIC, 29 pacientes no grupo BPM e 25 pacientes no grupo MP. Cada paciente foi observado e analisado por profissionais de enfermagem previamente treinados. As variáveis analisadas foram a dor e a sedação. (quantificadas através de escores e analisadas através do método de Kruskal-Wallis com correção pelo teste de Dunn), além do custo financeiro de cada método e da necessidade de administração de opióides adicionais. Resultados: As variáveis dor e sedação foram obtidas através das seguintes medianas, respectivamente: grupos BIC (2,5 e 0); BPM (4 e 0) e MP (3,5 e 0). O custo financeiro foi de US$ 78,69 para o grupo BIC; US$ 28,61 para o grupo BPM e US$ 11,98 para o grupo MP. A necessidade adicional de opióide foi de 4,2 mg/dia para o grupo BIC; 5,7 mg/dia para o grupo BPM e 10,7 mg/dia para o grupo MP. Conclusões: A intensidade da dor foi significativamente menor no grupo BIC, quando comparado ao grupo MP. Não foram identificadas diferenças significativas de intensidade da dor quando comparados os grupos BIC versus BPM e BPM versus MP. A intensidade de sedação foi significativamente maior no grupo MP quando comparado aos grupos BIC e BPM. Não foram evidenciadas diferenças significativas quanto à sedação entre os grupos BIC e BPM. O custo financeiro do grupo MP foi sensivelmente menor quando comparado aos grupos BIC e BPM. A necessidade adicional de morfina foi significativamente maior no grupo MP, quando comparados aos grupos BIC e BPM.