Scaling up diabetes prevention in Victoria, Australia: policy development, implementation and evaluation

Objective
The Australian lifestyle intervention program Life! is only the second reported, large-scale diabetes prevention program. This paper describes the genesis and the successful establishment of Life! and its key outcomes for participants and implementation.

Research
Design and Methods Life!, a behavior change intervention, comprises six group sessions over eight months. The Victorian Department of Health funded Diabetes Australia-Victoria to implement the program. Experience of the Greater Green Triangle diabetes prevention implementation trial was used for intervention design, workforce development, training and infrastructure. Clinical and anthropometric data from participants, used for program evaluation, was recorded on a central database.

Results
Life! has a state-wide workforce of 302 trained facilitators within 137 organizations. 29,000 Victorians showed interest in Life! and 15,000 individuals have been referred to the program. In total, 8,412 participants commenced a Life! program between October 2007 and June 2011. 37% of the original participants completed the eight month program. Participants completing sessions one to five lost an average of 1·4 kg weight (p<0·001) and waist circumference of 2·5cm (p<0.001). Those completing six sessions lost an average of 2·4 kg weight (p<0·001) and waist circumference of 3·8 cm (p<0·001). The weight loss of 2.4 kg represents 2.7% of participants’ starting body weight.

Conclusion
The impact of Life! is attributable to applying available evidence for the systems design of the intervention, and collaboration between policy makers, implementers and evaluators using the principles of continuous quality improvement to support successful, large scale recruitment and implementation.

Job strain — attributable depression in a sample of working Australians: assessing the contribution to health inequalities

Background The broad aim of this study was to assess the contribution of job strain to mental health inequalities by (a) estimating the proportion of depression attributable to job strain (low control and high demand jobs), (b) assessing variation in attributable risk by occupational skill level, and (c) comparing numbers of job strain–attributable depression cases to numbers of compensated 'mental stress' claims. Methods Standard population attributable risk (PAR) methods were used to estimate the proportion of depression attributable to job strain. An adjusted Odds Ratio (OR) of 1.82 for job strain in relation to depression was obtained from a recently published meta-analysis and combined with exposure prevalence data from the Australian state of Victoria. Job strain exposure prevalence was determined from a 2003 population-based telephone survey of working Victorians (n = 1101, 66% response rate) using validated measures of job control (9 items, Cronbach's alpha = 0.80) and psychological demands (3 items, Cronbach's alpha = 0.66). Estimates of absolute numbers of prevalent cases of depression and successful stress-related workers' compensation claims were obtained from publicly available Australian government sources. Results Overall job strain-population attributable risk (PAR) for depression was 13.2% for males [95% CI 1.1, 28.1] and 17.2% [95% CI 1.5, 34.9] for females. There was a clear gradient of increasing PAR with decreasing occupational skill level. Estimation of job strain–attributable cases (21,437) versus "mental stress" compensation claims (696) suggest that claims statistics underestimate job strain–attributable depression by roughly 30-fold. Conclusion Job strain and associated depression risks represent a substantial, preventable, and inequitably distributed public health problem. The social patterning of job strain-attributable depression parallels the social patterning of mental illness, suggesting that job strain is an important contributor to mental health inequalities. The numbers of compensated 'mental stress' claims compared to job strain-attributable depression cases suggest that there is substantial under-recognition and under-compensation of job strain-attributable depression. Primary, secondary, and tertiary intervention efforts should be substantially expanded, with intervention priorities based on hazard and associated health outcome data as an essential complement to claims statistics.

Aboriginal health promotion through addressing employment discrimination

The Localities Embracing and Accepting Diversity (LEAD) program aimed to improve the mental health of Aboriginal Victorians by addressing racial discrimination and facilitating social and economic participation. As part of LEAD, Whittlesea Council adopted the Aboriginal Employment Pathways Strategy (AEPS) to increase Aboriginal employment and retention within the organisation. The Aboriginal Cultural Awareness Training Program was developed to build internal cultural competency and skills in recruiting and retaining Aboriginal staff. Analysis of surveys conducted before (pre; n=124) and after (post; n=107) the training program indicated a significant increase in participant understanding across all program objectives and in support of organisational policies to improve Aboriginal recruitment and retention. Participants ended the training with concrete ideas about intended changes, as well as how these changes could be supported by their supervisors and the wider organisation. Significant resources have since been allocated to implementing the AEPS over 5 years. In line with principles underpinning the National Aboriginal and Torres Strait Islander Health Plan 2013-23, particularly the focus on addressing racism as a determinant of health, this paper explores the AEPS and training program as promising approaches to health promotion through addressing barriers to Aboriginal employment. Possible implications for other large organisations are also considered.

If the land is healthy… it makes the people healthy

This PhD explores the connection Aboriginal Victorian people have to their traditional lands (known as Country) and its relationship with health. Findings identify the deep connection Aboriginal Victorian people have to their Country and the need for public health clinicians to engage with diverse Indigenous practices and knowledge when applicable.

The Great War In Victorian Private Life - Mildura

Join Dr Bart Ziino as he examines the private experience of the Great War in Victoria, drawing on personal letters and diaries to tell a story of the war as an individual, familial, and communal trial. Through an examination of anxieties over loved ones at the front, and tensions over who was bearing the greater burden. This talk offers new ways of understanding the costs of the war, the capacities of Victorians to meet and endure its demands, and its increasingly corrosive social effects within their communities.

At home with the war: The Great War in Victorian private life. The 2014 Augustus Wolskel lecture

This article examines the Great War in Victoria through the lens of private sentiment. It exposes not only the diversity of perspectives and sentiment surrounding the war, but also the stresses endured by Victorians trying to reconcile their commitment to the war with personal and familial needs.Their experience was dominated by a confrontation with powerful currents of anxiety over the war and their loved ones, and increasing tensions within their communities over who was bearing the greater burdens of the war. Investigating private experience of total war at home allows us to see how Victorians made as well as endured the Great War, as their communities struggled to remain cohesive, and individuals struggled to cope with its demands.

Concepções da sexualidade romana na Inglaterra vitoriana: a leitura sobre Ovídio

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Latest contemporary portraits,

"Second printing, April, 1928."

Latest contemporary portraits,

David Graham Phillips: the greatest American novelist.--Eleonora Duse.--Henri Barbusse.--Lord Bryce.--George Russell (A.E.)--Mrs. Humphry Ward.--Eugene V. Debs.--Charles Schwab: the master of Bethlehem.--Prince Peter Kropotkin.--Paul Bourget.--Thomas Hardy.--Ehrlich of "606".--Louis Sullivan: a great architect.--Eugene Fromentin: the painter writer.--Sir Herbert Tree.--Flaubert and his letters.--Hatred in art: Leon Bloy.--Three generations of Morgans.--The brothers de Goncourt and realism.--Lord Hartington.--Ambassador Bernstorff.--A talk with A.E. Housman.--Paul Deschanel.--Frederic Harrison: the last of the Victorians.--Annie Besant: rebel and reformer.--John Churton Collins.--Hyndman, the communist.--Horace Traubel.--Joseph Caillaux.

Histories and Historiographies of Juvenile Delinquency in Nineteenth-Century England

This thesis explores the history of juvenile delinquency in England during the decades bracketing the nineteenth century’s turn and how modern historians have analyzed this period. The purported birth of juvenile delinquency during this tumultuous period is widely attributed by both historians and Victorians to the explosive growth in England’s urban population. Contemporary statistics of criminal prosecutions confirmed emergent literary tropes that viewed childhoods spent on city streets as inevitably corrupting. Public policy and private charity for more than a century thereafter would recommend removal from the city’s corrupting cultural influences to a highly romanticized vision of rural space as healing innocence. This thesis challenges the juxtaposition of country and city on which such explanations of juvenile delinquency rest. Utilizing the neglected testimony of magistrates, constables, rural residents, and juvenile criminals themselves, it will demonstrate that rural England also suffered from increasing juvenile crime in this period. It will illuminate the complex social, economic, and political dynamics responsible for the oft-cited statistical gap between rural and urban arrest rates, showing that the latter were in neither case transparent measures of criminal activity. Crime was on the rise in English rural counties as transformed by industrial capitalism as were England’s booming cities, suggesting that historians who continue to emphasize the dichotomy between the city and the country have not only recycled a Victorian narrative but also limited their own understandings of the time.

Crime and Punishment.

The study of Victorian crime and punishment is a rich area of research that has attracted the interest not only of literary scholars but also of social historians, legal historians, and criminologists. Related scholarship therefore often situates itself at the intersection of traditional disciplinary boundaries, facilitating interdisciplinary conversation. Crime and punishment was a pressing issue for the Victorians and provoked a wealth of responses from contemporaneous commentators in literature, culture, and science. As a new phase of industrialization brought immense wealth for some and abject poverty for others, Victorian urban centers in particular were afflicted by crime. Without an effective system of social welfare in place, social inequality and deprivation drove women, men, and children into petty crime and more serious offenses, resulting in severe punishment ranging from incarceration via penal transportation to hanging. Public executions, not abolished until 1868, attracted huge crowds of spectators, including authors such as Charles Dickens and William Thackeray, who wrote about these experiences. A forerunner of the popular press, street literature conveyed and illustrated these events for a broad audience. Execution broadsides of famous cases, printing the alleged last lamentations of convicts on the scaffold in verse, are estimated to have sold by the million. As the legal system was undergoing reform (comprising changes in legal evidence procedure, divorce law, women’s property rights, and punishment for sexual offenses, for example), sensational trials caused furor and stimulated commentary in literature and the media. Crime and punishment was discussed in a range of literary and popular genres, poetry, and reformist writing. The “Newgate School” of fiction was accused of glamorizing crime, and the popular penny dreadfuls were feared to corrupt public morals. Sensational fiction in the 1860s, which often drew on real-life criminal cases and newspaper reports, depicted the supposedly respectable middle-class family home as a center of transgression. Similarly, detective fiction typically focused on crime in the world of the middle classes. For the student new to the subject of crime and punishment, this area’s interdisciplinary nature can pose an initial challenge.

Morbidity patterns among the underweight, overweight and obese between 2 and 18 years: population-based cross-sectional analyses

CONTEXT: No study has documented how symptomatic morbidity varies across the body mass index (BMI) spectrum (underweight, normal weight, overweight and obese) or across the entire child and adolescent age range. OBJECTIVE: To (1) quantify physical and psychosocial morbidities experienced by 2-18-year-olds according to BMI status and (2) explore morbidity patterns by age. DESIGN, SETTING AND PARTICIPANTS: Cross-sectional data from two Australian population studies (the Longitudinal Study of Australian Children and the Health of Young Victorians Study) were collected during 2000-2006. Participants were grouped into five age bands: 2-3 (n=4606), 4-5 (n=4983), 6-7 (n=4464), 8-12 (n=1541) and 13-18 (n=928) years. MAIN MEASURES: Outcomes-Parent- and self-reported global health; physical, psychosocial and mental health; special health-care needs; wheeze; asthma and sleep problems. Exposure-measured BMI (kg m(-2)) categorised using standard international cutpoints. ANALYSES: The variation in comorbidities across BMI categories within and between age bands was examined using linear and logistic regression models. RESULTS: Comorbidities varied with BMI category for all except sleep problems, generally showing the highest levels for the obese category. However, patterns differed markedly between age groups. In particular, poorer global health and special health-care needs were associated with underweight in young children, but obesity in older children. Prevalence of poorer physical health varied little by BMI in 2-5-year-olds, but from 6 to 7 years was increasingly associated with obesity. Normal-weight children tended to experience the best psychosocial and mental health, with little evidence that the U-shaped associations of these variables with BMI status varied by age. Wheeze and asthma increased slightly with BMI at all ages. CONCLUSIONS: Deviation from normal weight is associated with health differences in children and adolescents that vary by morbidity and age. As well as lowering risks for later disease, promoting normal body weight appears central to improving the health and well-being of the young.

Papel de la comunidad internacional en la resocialización de niños soldados desvinculados del ejército de resistencia del señor en Uganda (2002-2013)

El objetivo de esta investigación diagnóstica es evaluar las acciones de la Comunidad Internacional en materia de resocialización de niños soldados desvinculados del Ejército de Resistencia del Señor (ERS) en Uganda durante el periodo de 2002 a 2013. Para ello, se hace un análisis de las causas de la existencia de niños soldados, donde se tiene en cuenta la evolución del concepto de la infancia y las particularidades que éste representa en el contexto africano. Así mismo, son analizados los alcances y limitaciones del modelo de asistencia humanitaria para la protección de la niñez enfatizando en los procesos de resocialización brindados a los niños desvinculados del ERS. Esto con el fin de evidenciar las limitaciones de la actuación de la Comunidad Internacional, y brindar una serie de recomendaciones para la implementación de programas de resocialización enfocados en la infancia.