Demographic and socio-cultural correlates of medical mistrust in two Australian states:Victoria and South Australia

Studies on medical mistrust have mainly focused on depicting the association between medical mistrust and access/utilization of healthcare services. The effect of broader socio-demographic and psycho-social factors on medical mistrust remains poorly documented. The study examined the effect of broader socio-demographic factors, acculturation, and discrimination on medical mistrust among 425 African migrants living in Victoria and South Australia, Australia. After adjusting for socio-demographic factors, low medical mistrust scores (i.e., more trusting of the system) were associated with refugee (β=−4.27, p<0.01) and family reunion (β=−4.01, p<0.01) migration statuses, being Christian (β=−2.21, p<0.001), and living in rural or village areas prior to migration (β=−2.09, p<0.05). Medical mistrust did not vary by the type of acculturation, but was positively related to perceived personal (β=0.43, p<0.001) and societal (β=0.38, p<0.001) discrimination. In order to reduce inequalities in healthcare access and utilisation and health outcomes, programs to enhance trust in the medical system among African migrants and to address discrimination within the community are needed.

Prospect of renewable energy sources and integrating challenges in Victoria, Australia

The Australian Government has targeted 20% of electricity generation from renewable energy sources by 2020. The 20% renewable energy target (RET) for Australia will be around 45000GWH in 2020. Renewable energy of Victoria also includes as part of support to achieve 20% RET in Australia. In Victoria wind and solar resources are abundant as compared to other sources of renewable energy. Solar radiation and wind speed data for Victoria State was collected from NASA surface meteorology and solar energy web site. A feasibility analysis has been carried out to explore the potentialities of wind and solar energy for Victoria State using hybrid optimization model of electric renewable (HOMER) software. This paper also represents the estimation analysis of RET for Victoria and describes the integrating challenges of renewable energy sources to the utility grid.

Environmental and cultural change on the Mt Eccles lava-flow landscapes of southwest Victoria, Australia

The Gunditjmara people developed a socio-economic system based on the modification of wetland ecosystems associated with the Mt Eccles lava flow primarily for sustainable production and management of the highly nutritious shortfin eel (Anguilla australis). This paper examines the environmental history of these landscapes since their inception about 30 000 years ago, through palaeoecological analysis of sediment cores from associated lakes and swamps, in order to contribute to an understanding of the causes and timing of cultural transformation. Two records cover the whole of the 30 000 year history of the landscape while two others provide evidence of change within the Holocene. A great deal of variation within the landscape is revealed, both temporally and spatially, with opportunities for human exploitation through the whole recorded period. Although most features of the records can be explained by natural landscape development and climate change, some human modification can be suggested from around the Pleistocene—Holocene transition while more obvious indications of management relating to eel aquaculture are evident from about 4000 cal. yr BP that appear to include adaptations to the onset of a drier and more variable climate. The study has implications for the explanation of intensification of settlement in Australia more generally within the mid to late Holocene.

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.

Bulletin: ASME Victoria: from the Chair

 Letter from the ASME Vic Chair