Addressing healthy lifestyle behaviours amongst young people in out-of-home care

The aim of this thesis was to develop a program of research that evaluated enablers, barriers and pathways for establishing healthy lifestyle behaviours among young people living in residential out-of-home care. This included development of the Healthy Eating, Active Living (HEAL) intervention, and was the first program, nationally and internationally to evaluate a healthy lifestyle intervention in this setting.

Determination of long-run and short-run dynamics in EC-VARMA models via canonical correlations

This article studies a simple, coherent approach for identifying and estimating error-correcting vector autoregressive moving average (EC-VARMA) models. Canonical correlation analysis is implemented for both determining the cointegrating rank, using a strongly consistent method, and identifying the short-run VARMA dynamics, using the scalar component methodology. Finite-sample performance is evaluated via Monte Carlo simulations and the approach is applied to modelling and forecasting US interest rates. The results reveal that EC-VARMA models generate significantly more accurate out-of-sample forecasts than vector error correction models (VECMs), especially for short horizons.

The effect of sample and sample matrix on DNA processing: Mechanisms for the detection and management of inhibition in forensic samples

The presence of inhibitory substances in biological forensic samples has, and continues to affect the quality of the data generated following DNA typing processes. Although the chemistries used during the procedures have been enhanced to mitigate the effects of these deleterious compounds, some challenges remain. Inhibitors can be components of the samples, the substrate where samples were deposited or chemical(s) associated to the DNA purification step. Therefore, a thorough understanding of the extraction processes and their ability to handle the various types of inhibitory substances can help define the best analytical processing for any given sample. A series of experiments were conducted to establish the inhibition tolerance of quantification and amplification kits using common inhibitory substances in order to determine if current laboratory practices are optimal for identifying potential problems associated with inhibition. DART mass spectrometry was used to determine the amount of inhibitor carryover after sample purification, its correlation to the initial inhibitor input in the sample and the overall effect in the results. Finally, a novel alternative at gathering investigative leads from samples that would otherwise be ineffective for DNA typing due to the large amounts of inhibitory substances and/or environmental degradation was tested. This included generating data associated with microbial peak signatures to identify locations of clandestine human graves. Results demonstrate that the current methods for assessing inhibition are not necessarily accurate, as samples that appear inhibited in the quantification process can yield full DNA profiles, while those that do not indicate inhibition may suffer from lowered amplification efficiency or PCR artifacts. The extraction methods tested were able to remove >90% of the inhibitors from all samples with the exception of phenol, which was present in variable amounts whenever the organic extraction approach was utilized. Although the results attained suggested that most inhibitors produce minimal effect on downstream applications, analysts should practice caution when selecting the best extraction method for particular samples, as casework DNA samples are often present in small quantities and can contain an overwhelming amount of inhibitory substances.^

Diageo's 'Stop Out of Control Drinking' campaign in Ireland: an analysis

Background: It has been argued that the alcohol industry uses corporate social responsibility activities to influence policy and undermine public health, and that every opportunity should be taken to scrutinise such activities. This study analyses a controversial Diageo-funded ‘responsible drinking’ campaign (“Stop out of Control Drinking”, or SOOCD) in Ireland. The study aims to identify how the campaign and its advisory board members frame and define (i) alcohol-related harms, and their causes, and (ii) possible solutions. Methods: Documentary analysis of SOOCD campaign material. This includes newspaper articles (n = 9), media interviews (n = 11), Facebook posts (n = 92), and Tweets (n = 340) produced by the campaign and by board members. All material was coded inductively, and a thematic analysis undertaken, with codes aggregated into sub-themes. Results: The SOOCD campaign utilises vague or self-defined concepts of ‘out of control’ and ‘moderate’ drinking, tending to present alcohol problems as behavioural rather than health issues. These are also unquantified with respect to actual drinking levels. It emphasises alcohol-related antisocial behaviour among young people, particularly young women. In discussing solutions to alcohol-related problems, it focuses on public opinion rather than on scientific evidence, and on educational approaches and information provision, misrepresenting these as effective. “Moderate drinking” is presented as a behavioural issue (“negative drinking behaviours”), rather than as a health issue. Conclusions: The ‘Stop Out of Control Drinking’ campaign frames alcohol problems and solutions in ways unfavourable to public health, and closely reflects other Diageo Corporate Social Responsibility (CSR) activity, as well as alcohol and tobacco industry strategies more generally. This framing, and in particular the framing of alcohol harms as a behavioural issue, with the implication that consumption should be guided only by self-defined limits, may not have been recognised by all board members. It suggests a need for awareness-raising efforts among the public, third sector and policymakers about alcohol industry strategies

Efficacy and safety of out-of-hospital intravenous metoprolol administration in anterior ST-segment elevation acute myocardial infarction: insights from the METOCARD-CNIC trial

We seek to examine the efficacy and safety of prereperfusion emergency medical services (EMS)–administered intravenous metoprolol in anterior ST-segment elevation myocardial infarction patients undergoing eventual primary angioplasty. This is a prespecified subgroup analysis of the Effect of Metoprolol in Cardioprotection During an Acute Myocardial Infarction trial population, who all eventually received oral metoprolol within 12 to 24 hours. We studied patients receiving intravenous metoprolol by EMS and compared them with others treated by EMS but not receiving intravenous metoprolol. Outcomes included infarct size and left ventricular ejection fraction on cardiac magnetic resonance imaging at 1 week, and safety by measuring the incidence of the predefined combined endpoint (composite of death, malignant ventricular arrhythmias, advanced atrioventricular block, cardiogenic shock, or reinfarction) within the first 24 hours. From the total population of the trial (N=270), 147 patients (54%) were recruited during out-of-hospital assistance and transferred to the primary angioplasty center (74 intravenous metoprolol and 73 controls). Infarct size was smaller in patients receiving intravenous metoprolol compared with controls (23.4 [SD 15.0] versus 34.0 [SD 23.7] g; adjusted difference –11.4; 95% confidence interval [CI] –18.6 to –4.3). Left ventricular ejection fraction was higher in the intravenous metoprolol group (48.1% [SD 8.4%] versus 43.1% [SD 10.2%]; adjusted difference 5.0; 95% CI 1.6 to 8.4). Metoprolol administration did not increase the incidence of the prespecified safety combined endpoint: 6.8% versus 17.8% in controls (risk difference –11.1; 95% CI –21.5 to –0.6). Out-of-hospital administration of intravenous metoprolol by EMS within 4.5 hours of symptom onset in our subjects reduced infarct size and improved left ventricular ejection fraction with no excess of adverse events during the first 24 hours.

Out of Character? Legal responses to intimate partner homicides by men in Victoria 2005-2014

This report reviews 51 cases of intimate partner homicide by men in Victoria, from 2005-2014, to investigate how family violence is recognised in homicide prosecutions. Research and death reviews in Australia and overseas have found that systemic failures in legal responses to family violence contribute to intimate partner homicides. In 2010, Domestic Violence Resource Centre Victoria and Monash University began a project to explore the impact of the 2005 homicide law reforms on intimate partner homicides. The first phase of the project examined cases of women who killed their intimate partners, focusing on whether the reforms had improved the recognition of family violence victimisation as a factor. This report presents findings from the second phase, which examines legal responses to men who have killed in the context of sexual intimacy. In analysing the cases, it looks at key contextual factors, legal outcomes, family violence risk factors, how prior family violence is understood and discussed by legal professionals, how evidence of prior family violence is used by the prosecution and whether it is admitted as evidence, the types of arguments and narratives made in defence of the accused, the recognition of family violence through the sentencing process, and the use of provocation as a mitigating factor.

Out of touch

In June 2016, an Australian on minimum wage earned $656.90 per week. That is $34,159 a year, before tax. According to the Australian Tax Office’s ‘simple tax calculator’, the tax owed would be $3030, leaving a take-home salary of $31,128. Let’s call it $600 a week.It’s fair to say that many of us would struggle to make ends meet on that income – $600 a week does not go very far in modern Australia.

At home/out of place: young people’s multicultural belongings

What does it mean to come of age in an era of anti-multiculturalism? How does such an environment shape the ways young people of diverse backgrounds come to feel “at home”-in the nation, in the city, in their neighbourhoods, and in their national identity? Discussing findings from a study of youth in the multicultural suburbs of five Australian cities, this chapter explores how the politics of belonging is lived through the spatial practices of everyday civic life for those who have grown up during the multiculturalism backlash of the 1990s and 2000s. It examines the contradictory picture that emerges of a new generation claiming a right to multicultural citizenship and forging productive diversity within the urban multiculture, and yet simultaneously positioned as “out of place” within civic life.

Queer pedagogies out of place and time: redrawing the boundaries of youth, sexual and gender difference, and education

For this contribution to the "Cartographies" section of the special issue on "Mapping Queer Bioethics," the author focuses on the concept of spatialized time as made material in the location of historical places, in particular as it relates to a reconsideration of approaches to Australian queer/LGBT youth education. Accordingly, the author employs historical maps as illustrative examples of spatialized time, reflecting on the relationships between historical knowledge and queer youth education.

Field ‘work’ vs ‘feel’ trip : approaches to out-of-class experiences in geography education

Fieldwork is viewed as integral to geography teaching and acclaimed benefits often include holistic, student-driven learning, where all the senses are engaged and the impacts are more than cognitive. While these benefits are often assumed, in this paper, I argue that geography fieldwork in schools is often teacher-led and focused on the intellectual task of knowledge acquisition and skill development. Based on a qualitative content analysis of examples of fieldwork in a state geography teachers’ journal, I assert that the affective and sensory dimensions, are often used to promote the benefits of fieldwork, but seldom explicitly addressed through fieldwork pedagogy and learning activities in school geography. I contend that this is a missed opportunity for a deeper, more embodied and critical engagement with, and response to, the places visited.

Out-of-hours co-operatives: General practitioner satisfaction with governance and working arrangements

Objective. General practice co-operatives have led to significant improvements in quality of life for general practitioners. Little is known about general practitioners’ own experiences with the working arrangements and governance of co-operatives. This study investigates GP satisfaction, the working environment, governance and future developments in co-operatives. Methods. A questionnaire was sent to GPs in two co-operatives in the Republic of Ireland, covering mixed urban and rural areas. Results. Of 221 GPs in the co-operatives, 82% responded and confirmed the co-operatives’ positive effects on their lives. However, 57% still received requests for out-of-hours care while off duty, most commonly from patients who preferred to see their own doctor. Half felt overburdened by out-of-hours work, especially those over 40 y of age. Twenty-five per cent were dissatisfied with the GP complaints mechanism. The majority (63%) would prefer a GP/ health board partnership for the organization of out of hours, while 23% wanted sole responsibility. GPs indicated a strong need for better ancillary services such as nursing, mental health, dentistry, pharmacy and social work. Access to records is an important issue in terminal care and mental illness. Conclusion. While GP co-operatives are a success story for general practice, they will work better for general practitioners and their patients if nursing, mental health, dentistry, pharmacy and social services are improved. Support and training is needed in mental health, palliative and emergency care to increase competence and reduce stress. GPs are willing to work with health authorities in further co-operative development. More attention needs to be paid to the complaints and suggestions of GPs in the running and governance of their co-operatives.