What do we know about preventing drug-related harm through social developmental intervention with children and young people

This chapter examines the evidence for the effectiveness of interventions aiming to reduce drug-related harm by improving conditions for healthy develeopment in the earliest years through adolescence. Of the interventions beginning prior to birth, there is efficacy evidence that family home visitation is a feasible strategy for implementation with disadvataged families and can reduce risk factors for early developmental deficits and thereby improve childhood development outcomes. There is efficacy evidence for strategies such as parent education and school preparation through the pre-school age period. Some of the strongest evidence for efficacy in reducing developmental pathways to drug-related harm comes from interventions delivered through the early school years to improve educational environments. Of the interventions targeting the high school age period, school drug education has been the most commonly evaluated. The evidence suggests that short term reduction in both drug use and progression to frequent drug use may be achievable through this strategy, but the prospects for longer-term and population-level behaviour change is still unclear. In overview, a range of prevention strategies have been developed and evaluated. Most of the exisiting evidence is restricted to efficacy studies and there are future challenges to progress evaluation through to studies of effectiveness. In general, prevention programmes appear more successful where they maintain intervention activities over a number of years and incorporate more than one strategy. Much of the existing research has been based in North America and evaluates discrete programmes. Future research should test effects in other countries, in different social contexts and seek to better understand the interrelated effects of combining interventions within the community. Developmental prevention programmes target different age periods and social settings, hence communities have the challenge of coordinating a mixture of programmes that address the local conditions that adversely influence child and youth development. There are opportunities in this work to coordinate prevention activities using funding from different jurisdictions (e.g., crime prevention, health promotion, mental health, education, substance abuse prevention).

Living alone, social support, and feeling lonely among the elderly

This study aimed to describe the characteristics of the elderly population living alone, and to examine how living alone relates to feeling lonely. Interviews were conducted with a stratified random sample of 4,859 elderly individuals living in Kaohsiung, Taiwan. Variables collected included demographic information, living alone or not, activities of daily living
(ADL), instrumental activities of daily living (IADL), Short Portable Mental Status Questionnaire (SPMSQ), chronic conditions, perceived social support, and a subjective measure of feeling lonely. Using logistic regression, it was found that factors associated with living alone included gender, marital status, occupation, source of income, religion, and IADL. Living alone was, in tum, related to decreased levels of both perceived social support
and feeling lonely after adjustment for potential confounders. Managing retired life is important for adult elders, particularly for men. Lack ofsocial support is common among the elderly community who live alone, which could wel1 be a main reason for this group to feel lonely. As loneliness is linked to physical and mental health problems, increasing social support and facilitating friendship should be factored into life-style management for
communities of elderly.

Global social justice at the WTO? The role of NGOs in constructing global social contracts

Over the past decade, international non-governmental organizations (NGOs) have been contesting the neo-liberal economic order in international politics by campaigning for normative conditions to bring about what Richard Falk calls 'humane governance'. However, the degree to which NGOs have contributed to the formation of global social contracts remains controversial. While NGO activists and various scholars advocate the establishment of such contracts, empirical testing of this normative argument is underdeveloped. Drawing upon this lack of empirical support, critics dismiss the global social contract concept and question the roles played by NGOs in international politics. This article addresses the controversy through a review, refinement and application of global social contract theory and an empirical study of two prominent international NGO campaigns directed at the World Trade Organization (WTO), an institution that represents a 'hard test case'. It explores the ways in which NGOs and their networks are challenging the neo-liberal basis of WTO agreements and contributing to the emergence of global social contracts. The article concludes that in some circumstances, NGOs have the capacity to inject social justice into international economic contracts and there is some basis for optimism regarding the formation of global social contracts involving NGOs, nation-states and international organizations.

Wellbeing, job satisfaction and commitment among Australian community health workers: the relationship with working conditions

The Australian community health sector has undergone extensive organisational reform in recent times, and, in the push to enhance efficiencies and contain costs, there are indications that these changes may have undermined the wellbeing of community health personnel and their ability to provide high quality illness-prevention services. The aim of this study was to examine the working environments experienced by community health service employees and identify conditions that are predictive of employee stress. The study was guided by a tailored version of the demand-control-support model, whereby the generic components of the model had been augmented by more situation-specific stressors. The results of multiple regression analyses indicated that job control, and, to a lesser extent, social support, were closely associated with the outcome variables (psychological health, job satisfaction and organisational commitment). The more situation-specific stressors also accounted for significant proportions of explained variance. Overall, the results suggest that working conditions, particularly job control, social support and specific job stressors, offer valuable opportunities for protecting and enhancingthe wellbeing of community health service personnel.

Leading educational re-design to sustain socially just schools under conditions of instability

There is now significant evidence that school and leadership redesign is necessary in order to achieve more socially just educational futures for all students and a productive and professionally rewarding environment for teachers. Redesign requires some fundamental shifts in how schools work; engagement with and through learning communities based on systematic critical inquiry; and inclusive leadership practices that address the complexities of the relationships between diversity, culture, gender and race in schooling. I argue that democratic leadership is most conducive to initiating and sustaining equitable outcomes. The article concludes with consideration of principles that could sustain leadership for social justice.

Job stress in the law enforcement sector: comparing the linear, non-linear and interaction effects of working conditions

This study addresses a gap in much of the research involving stress among high-risk occupations by investigating the effects of linear, non-linear and interaction models in a law enforcement organization that has undertaken a series of efficiency-driven organizational reforms. The results of a survey involving 2085 police officers indicated that the demand-control-support model provided good utility in predicting an officer's satisfaction, commitment and well-being. In particular, social support and job control were closely associated with all three outcome variables. Although the demand × control/support interactions were not identified in the data, there was some support for the curvilinear effects of job demands. The results have implications for the organizational conditions that need to be addressed in contemporary policing environments where new public management strategies have had widespread affects on the social and organizational context in which policing takes place.

Officer wellbeing, satisfaction and commitment : job conditions of Australian law enforcement personnel

Excessive job stress caused by unreasonably high employer demands, low control over one's own work and limited support can have far-reaching effects for the individual, organisation and community. The present study sought to investigate the relationship between officer working conditions and their self-reported levels of wellbeing, satisfaction and commitment using a well-known job strss model, the demand-control-support (DCS) model. Using a large (N= 2085) sample of law enforcement personnel, findings indicated that social support from work sources was the best predictor, whilst job control and workload both had significant influences on levels of employee wellbeing, satisfaction and commitment. Additionally, non-linear relationships were found between workload and wellbeing and satisfaction, indicating that both high and low levels of workload can produce negative outcomes. The results have implications for job design and management training programs, particularly in reference to social support training and workload models.

The Health Education Impact Questionnaire (heiQ): An outcomes and evaluation measure for patient education and self-management interventions for people with chronic conditions

Objective: This paper describes the development and validation of the Health Education Impact Questionnaire (heiQ). The aim was to develop a user-friendly, relevant, and psychometrically sound instrument for the comprehensive evaluation of patient education programs, which can be applied across a broad range of chronic conditions.

Methods: Item development for the heiQ was guided by a Program Logic Model, Concept Mapping, interviews with stakeholders and psychometric analyses. Construction (N = 591) and confirmatory (N = 598) samples were drawn from consumers of patient education programs and hospital outpatients. The properties of the heiQ were investigated using item response theory and structural equation modeling.

Results: Over 90 candidate items were generated, with 42 items selected for inclusion in the final scale. Eight independent dimensions were derived: Positive and Active Engagement in Life (five items, Cronbach's alpha (α) = 0.86); Health Directed Behavior (four items, α = 0.80); Skill and Technique Acquisition (five items, α = 0.81); Constructive Attitudes and Approaches (five items, α = 0.81); Self-Monitoring and Insight (seven items, α = 0.70); Health Service Navigation (five items, α = 0.82); Social Integration and Support (five items, α = 0.86); and Emotional Wellbeing (six items, α = 0.89).

Conclusion:The heiQ has high construct validity and is a reliable measure of a broad range of patient education program benefits.

Practice Implications: The heiQ will provide valuable information to clinicians, researchers, policymakers and other stakeholders about the value of patient education programs in chronic disease management.

Occupational and non-occupational physical activity and the social determinants of physical activity : results from the Health Survey for England

Background: This article aims to examine the relative contribution of occupational activity to English adults’ meeting of government recommendations for physical activity (PA).

Methods: Data were extracted from a cross-sectional survey of householders in the UK via the Health Survey for England.¹ In total, 14,018 adult participants were included in the analysis. Multivariate logistic regression was used to examine the odds of achieving PA recommendations with and without including occupational activity and to examine the contribution of gender and social and demographic characteristics.

Results: When occupational PA was included, 36% of men and 25% of women were active at the recommended level. Once occupational PA was removed, these proportions were 23% and 19%, respectively. These results were socially patterned, most notably by age and gender.

Conclusions: Occupational PA provides a substantial contribution to those meeting the government target for PA.

The impact of the work conditions of allied health professionals on satisfaction, commitment and psychological distress

BACKGROUND: Allied health professionals are integral to the effective delivery of hospital-based health care, yet little is known about the working conditions associated with the attitudinal and health outcomes of these employees.

PURPOSE: The purpose of this study was to investigate the extent to which the demand-control-support model, in combination with organizational justice variables, predicts the employee-level outcomes of allied health professionals.

METHODOLOGY/APPROACH: Allied health professionals from an Australian health care organization were surveyed, with 113 (52.6%) participating. The survey included measures of job demands, job control, social support, organizational justice, satisfaction, commitment and psychological distress.

FINDINGS: Multiple regression analyses reveal that the additive demand-control-support model predicts the outcome variables of job satisfaction, organizational commitment and psychological distress, whereas the organizational justice variables predicted organizational commitment and psychological distress. Further, both work and nonwork sources of support, in addition to specific justice dimensions, were closely associated with employee-level outcomes.

PRACTICAL IMPLICATIONS: When coupled with previous research involving social support and organizational justice, the findings from this study suggest that initiatives aimed at strengthening supervisor and nonwork support, while enhancing perceptions of organizational fairness, may offer useful avenues for increasing the levels of satisfaction, commitment and well-being experienced by allied health professionals.

Getting the complete picture : combining parental and child data to identify the barriers to social inclusion for children living in low socio-economic areas

Background: Childhood mental health problems are prevalent in Australian children (14–20%). Social exclusion is a risk factor for mental health problems, whereas being socially included can have protective effects. This study aims to identify the barriers to social inclusion for children aged 9–12 years living in low socio-economic status (SES) areas, using both child-report and parent-report interviews.

Methods: Australian-born English-speaking parents and children aged 9–12 years were sampled from a low SES area to participate in semi-structured interviews. Parents and children were asked questions around three prominent themes of social exclusion; exclusion from school, social activities and social networks.

Results: Many children experienced social exclusion at school, from social activities or within social networks. Overall, nine key barriers to social inclusion were identified through parent and child interviews, such as inability to attend school camps and participate in school activities, bullying and being left out, time and transport constraints, financial constraints and safety and traffic concerns. Parents and children often identified different barriers.

Discussion: There are several barriers to social inclusion for children living in low SES communities, many of which can be used to facilitate mental health promotion programmes. Given that parents and children may report different barriers, it is important to seek both perspectives.

Conclusion: This study strengthens the evidence base for the investments and action required to bring about the conditions for social inclusion for children living in low SES communities.

People's war under modern conditions : an investigation into Chinese defence strategy, 1977-2049

This thesis is an investigation of the relevance of ‘people's war’ to contemporary Chinese defence policy. This loose concept has been eroded by 'modernity’, but a guerilla-based defence remains the essential theme. Prior to China's acquisition of nuclear weapons, people's war was the sole element of the state's deterrent policy, aiming to swamp an invader with China's numerical strength. In the 1980s and beyond people's war finds effectiveness through a combination of materiel of middle range technology and the traditional usage of massive manpower. People's war under modern conditions remains essentially defensive, but now incorporates 'active defence’ with accent on greater mobility. However, the central thesis of this work relates to how the traditional strategy may influence nuclear doctrine. This thesis proposes that China could abandon long-range ballistic missiles and adopt a new concept in nuclear strategy: that of, Guerilla Nuclear Warfare. Trained in guerilla tactics and equipped with battlefield nuclear weapons, this would represent the logical extension of China's people's war strategy to the new nuclear conditions associated with superpower research into space-based ballistic missile defences and which, in full deployment, could nullify a Chinese nuclear deterrent based only on 'mid-tech' delivery systems. Guerilla Nuclear Warfare, as a strategy, would involve the irregular use of locally held and controlled tactical nuclear weapons, but it would also be a method of circumventing the proposed Soviet missile defence shield by not challenging it. Guerilla Nuclear Warfare does not exist in the late 1980s, but evidence exists to suggest its development. It cannot yet be proven as the new direction but China's strategic circumstances add weight to available indications: unless the Strategic Defence programs of the established superpowers are arrested then it appears the sole option available to the Chinese for the maintenance of a nuclear deterrent in the early part of the 21st Century.

Gender differences in personal, social and environmental influences on active travel to and from school for Australian adolescents

Active travel (walking or cycling for transport) is an important contributor to adolescents overall physical activity (PA). This study examines associations between personal, social and environmental variables and active travel to and from school using data from a large observational study to examine active travel in 2961 year 6 and 8 students (48.7% male), aged 10–14 years (M = 11.4, SD = 0.8 yrs) from 231 schools. Participants completed an on-line survey and all reported living within 2 km of school. Data collected included mode of travel to and from school, self-reported health, and PA variables. Social environmental variables included having playgrounds, parks or gyms close by, feeling safe to walk alone, barriers to walking in the neighbourhood (e.g. traffic, no footpaths), peer and family support for PA, existence of sports teams/scout groups, community disorder and perceived neighbourhood safety. Results showed that while more girls (44.3%) than boys (37.4%) walked to school, lower proportions rode bikes (8.3% vs 22.4%) and hence fewer were active travellers overall. Logistic regression models, adjusted for age, location and socio-economic status were conducted for active travel to/from school, separately for boys and girls. Predictors for boys and girls being ‘active travellers’ to/from school included recreational facilities close to home, higher perceived safety of the neighbourhood and higher community disorder. For boys, social support from friends, scout groups available and higher enjoyment of physical activity was also important. These findings suggest areas for future research and may be used to guide strategies to increase active travel to and from school.