The lived experience of diagnosis delivery in motor neurone disease: A sociological-phenomenological study

Relatively few previous studies of individuals receiving a diagnosis of Motor Neurone Disease within the UK health care system have employed qualitative approaches to examine the diagnostic journey from a patient perspective. A qualitative sociological study was undertaken, involving interviews with 42 participants diagnosed with MND, to provide insight into their experiences of undergoing testing and receiving a diagnosis. Adopting a sociological-phenomenological perspective, this article examines key themes that emerged from participant accounts surrounding the lived experience of the diagnostic journey. The key themes that emerged were: The diagnostic quest; living with uncertainty; hearing bad news; communication difficulties; and a reified body of medical interest. In general, doctor-patient communication both at pre and post diagnosis was experienced as highly stressful, distressing and profoundly upsetting. Participants reported such distress as being due to the mode of delivery and communication strategies used by health professionals. We therefore suggest that professional training needs to emphasize the importance to health professionals of fostering greater levels of tact, sensitivity and empathy towards patients diagnosed with devastating, life-limiting illnesses such as MND.

Recrudescent Infection Supports Hendra Virus Persistence in Australian Flying-Fox Populations

Zoonoses from wildlife threaten global public health. Hendra virus is one of several zoonotic viral diseases that have recently emerged from Pteropus species fruit-bats (flying-foxes). Most hypotheses regarding persistence of Hendra virus within flying-fox populations emphasize horizontal transmission within local populations (colonies) via urine and other secretions, and transmission among colonies via migration. As an alternative hypothesis, we explore the role of recrudescence in persistence of Hendra virus in flying-fox populations via computer simulation using a model that integrates published information on the ecology of flying-foxes, and the ecology and epidemiology of Hendra virus. Simulated infection patterns agree with infection patterns observed in the field and suggest that Hendra virus could be maintained in an isolated flying-fox population indefinitely via periodic recrudescence in a manner indistinguishable from maintenance via periodic immigration of infected individuals. Further, post-recrudescence pulses of infectious flying-foxes provide a plausible basis for the observed seasonal clustering of equine cases. Correct understanding of the infection dynamics of Hendra virus in flying-foxes is fundamental to effectively managing risk of infection in horses and humans. Given the lack of clear empirical evidence on how the virus is maintained within populations, the role of recrudescence merits increased attention.

Improved management of key northern region weeds: diverse problems, diverse solutions

The cropping region of northern Australia has a diverse range of cropping systems and weed flora. A fallow phase is commonly required between crops to enable the accumulation of stored soil water in these farming systems dominated by reduced tillage. During the fallow phase, weed control is important and is heavily reliant on herbicides. The most commonly used herbicide has been glyphosate. As a result of over-reliance on glyphosate, there are now seven confirmed glyphosate-resistant weeds and several glyphosate-tolerant species common in the region. As a result, the control of summer fallow weeds is become more complex. This paper outlines project work investigating improved weed control for summer fallows in the northern cropping region. Areas of research include weed ecology, chemical and non-chemical tactics, glyphosate resistance and resistance surveys. The project also has an economic and extension component. As a result of our research we have a better understanding of the ecology of major northern weeds and spread of glyphosate resistance in the region. We have identified and defined alternative herbicide and non-chemical approaches for the effective control of summer fallow weeds and have extended our research effectively to industry.

Early recovery signs of an Australian grassland following the management of Parthenium hysterophorus L

Parthenium weed (Parthenium hysterophorus L.) is believed to reduce the above- and below-ground plant species diversity and the above-ground productivity in several ecosystems. We quantified the impact of this invasive weed upon species diversity in an Australian grassland and assessed the resulting shifts in plant community composition following management using two traditional approaches. A baseline plant community survey, prior to management, showed that the above-ground community was dominated by P. hysterophorus, stoloniferous grasses, with a further high frequency of species from Malvaceae, Chenopodiaceae and Amaranthaceae. In heavily invaded areas, P. hysterophorus abundance and biomass was found to negatively correlate with species diversity and native species abundance. Digitaria didactyla Willd. was present in high abundance when P. hysterophorus was not, with these two species, contributing most to the dissimilarity seen between areas. The application of selective broad leaf weed herbicides significantly reduced P. hysterophorus biomass under ungrazed conditions, but this management did not yet result in an increase in species diversity. In the above-ground community, P. hysterophorus was partly replaced by the introduced grass species Cynodon dactylon L. (Pers.) 1 year after management began, increasing the above-ground forage biomass production, while D. didactyla replaced P. hysterophorus in the below-ground community. This improvement in forage availability continued to strengthen over the time of the study resulting in a total increase of 80% after 2 years in the ungrazed treatment, demonstrating the stress that grazing was imposing upon this grassland-based agro-ecosystem and showing that it is necessary to remove grazing to obtain the best results from the chemical management approach.

Evaluation of a workplace alcohol and other drug policy

BACKGROUND The current impetus for developing alcohol and/or other drugs (AODs) workplace policies in Australia is to reduce workplace AOD impairment, improve safety, and prevent AOD-related injury in the workplace. For these policies to be effective, they need to be informed by scientific evidence. Evidence to inform the development and implementation of effective workplace AOD policies is currently lacking. There does not currently appear to be conclusive evidence for the effectiveness of workplace AOD policies in reducing impairment and preventing AOD-related injury. There is also no apparent evidence regarding which factors facilitate or impede the success of an AOD policy, or whether, for example, unsuccessful policy outcomes were due to poor policy or merely poor implementation of the policy. It was the aim of this research to undertake a process, impact, and outcome evaluation of a workplace AOD policy, and to contribute to the body of knowledge on the development and implementation of effective workplace AOD policies. METHODS The research setting was a state-based power-generating industry in Australia between May 2008 and May 2010. Participants for the process evaluation study were individuals who were integral to either the development or the implementation of the workplace AOD policy, or both of these processes (key informants), and comprised the majority of individuals who were involved in the process of developing and/or implementing the workplace AOD policy. The sample represented the two main groups of interest—management and union delegates/employee representatives—from all three of the participating organisations. For the impact and outcome evaluation studies, the population included all employees from the three participating organisations, and participants were all employees who consented to participate in the study and who completed both the pre-and post-policy implementation questionnaires. Qualitative methods in the form of interviews with key stakeholders were used to evaluate the process of developing and implementing the workplace AOD policy. In order to evaluate the impact of the policy with regard to the risk factors for workplace AOD impairment, and the outcome of the policy in terms of reducing workplace AOD impairment, quantitative methods in the form of a non-randomised single group pre- and post-test design were used. Changes from Time 1 (pre) to Time 2 (post) in the risk factors for workplace AOD impairment, and changes in the behaviour of interest—(self-reported) workplace AOD impairment—were measured. An integration of the findings from the process, impact, and outcome evaluation studies was undertaken using a combination of qualitative and quantitative methods. RESULTS For the process evaluation study Study respondents indicated that their policy was developed in the context of comparable industries across Australia developing workplace AOD policies, and that this was mainly out of concern for the deleterious health and safety impacts of workplace AOD impairment. Results from the process evaluation study also indicated that in developing and implementing the workplace AOD policy, there were mainly ‗winners', in terms of health and safety in the workplace. While there were some components of the development and implementation of the policy that were better done than others, and the process was expensive and took a long time, there were, overall, few unanticipated consequences to implementing the policy and it was reported to be thorough and of a high standard. Findings also indicated that overall the policy was developed and implemented according to best-practice in that: consultation during the policy development phase (with all the main stakeholders) was extensive; the policy was comprehensive; there was universal application of the policy to all employees; changes in the workplace (with regard to the policy) were gradual; and, the policy was publicised appropriately. Furthermore, study participants' responses indicated that the role of an independent external expert, who was trusted by all stakeholders, was integral to the success of the policy. For the impact and outcome evaluation studies Notwithstanding the limitations of pre- and post-test study designs with regard to attributing cause to the intervention, the findings from the impact evaluation study indicated that following policy implementation, statistically significant positive changes with regard to workplace AOD impairment were recorded for the following variables (risk factors for workplace AOD impairment): Knowledge; Attitudes; Perceived Behavioural Control; Perceptions of the Certainty of being punished for coming to work impaired by AODs; Perceptions of the Swiftness of punishment for coming to work impaired by AODs; and Direct and Indirect Experience with Punishment Avoidance for workplace AOD impairment. There were, however, no statistically significant positive changes following policy implementation for Behavioural Intentions, Subjective Norms, and Perceptions of the Severity of punishment for workplace AOD impairment. With regard to the outcome evaluation, there was a statistically significant reduction in self-reported workplace AOD impairment following the implementation of the policy. As with the impact evaluation, these findings need to be interpreted in light of the limitations of the study design in being able to attribute cause to the intervention alone. The findings from the outcome evaluation study also showed that while a positive change in self-reported workplace AOD impairment following implementation of the policy did not appear to be related to gender, age group, or employment type, it did appear to be related to levels of employee general alcohol use, cannabis use, site type, and employment role. Integration of the process, impact, and outcome evaluation studies There appeared to be qualitative support for the relationship between the process of developing and implementing the policy, and the impact of the policy in changing the risk factors for workplace AOD impairment. That is, overall the workplace AOD policy was developed and implemented well and, following its implementation, there were positive changes in the majority of measured risk factors for workplace AOD impairment. Quantitative findings lend further support for a relationship between the process and impact of the policy, in that there was a statistically significant association between employee perceived fidelity of the policy (related to the process of the policy) and positive changes in some risk factors for workplace AOD impairment (representing the impact of the policy). Findings also indicated support for the relationship between the impact of the policy in changing the risk factors for workplace AOD impairment and the outcome of the policy in reducing workplace AOD impairment: positive changes in the risk factors for workplace AOD impairment (impact) were related to positive changes in self reported workplace AOD impairment (representing the main goal and outcome of the policy). CONCLUSIONS The findings from the research indicate support for the conclusion that the policy was appropriately implemented and that it achieved its objectives and main goal. The Doctoral research findings also addressed a number of gaps in the literature on workplace AOD impairment, namely: the likely effectiveness of AOD policies for reducing AOD impairment in the workplace, which factors in the development and implementation of a workplace AOD policy are likely to facilitate or impede the effectiveness of the policy to reduce workplace AOD impairment, and which employee groups are less likely to respond well to policies of this type. The findings from this research not only represent an example of translational, applied research—through the evaluation of the study industry's policy—but also add to the body of knowledge on workplace AOD policies and provide policy-makers with evidence which may be useful in the development and implementation of effective workplace AOD policies. Importantly, the findings espouse the importance of scientific evidence in the development, implementation, and evaluation of workplace AOD policies.

Policing online fraud in Australia: The emergence of a victim‐oriented approach

Online fraud is a global problem. Millions of individuals worldwide are losing money and experiencing the devastation associated with becoming a victim of online fraud. In 2014, Australians reported losses of $82 million as a result of online fraud to the Australian Competition and Consumer Commission (ACCC). Given that the ACCC is one of many agencies that receives victim complaints, and the extent of under‐reporting of online fraud, this figure is likely to represent only a fraction of the actual monetary losses incurred. The successful policing of online fraud is hampered by its transnational nature, the prevalence of false/stolen identities used by offenders, and a lack of resources available to investigate offences. In addition, police are restricted by the geographical boundaries of their own jurisdictions which conflicts with the lack of boundaries afforded to offenders by the virtual world. In response to this, Australia is witnessing the emergence of victim‐oriented policing approaches to counter online fraud victimisation. This incorporates the use of financial intelligence as a tool to proactively notify potential victims of online fraud. Using a variety of Australian examples, this paper documents the history to this new approach and considers the significance that such a shift represents to policing in a broader context. It also details the value that this approach can have to both victims and law enforcement agencies. Overall, it is argued that a victim‐oriented approach to policing online fraud can have substantial benefits to police and victims alike.

Moral expansiveness: Examining variability in the extension of the moral world

The nature of our moral judgments—and the extent to which we treat others with care—depend in part on the distinctions we make between entities deemed worthy or unworthy of moral consideration— our moral boundaries. Philosophers, historians, and social scientists have noted that people’s moral boundaries have expanded over the last few centuries, but the notion of moral expansiveness has received limited empirical attention in psychology. This research explores variations in the size of individuals’ moral boundaries using the psychological construct of moral expansiveness and introduces the Moral Expansiveness Scale (MES), designed to capture this variation. Across 6 studies, we established the reliability, convergent validity, and predictive validity of the MES. Moral expansiveness was related (but not reducible) to existing moral constructs (moral foundations, moral identity, “moral” universalism values), predictors of moral standing (moral patiency and warmth), and other constructs associated with concern for others (empathy, identification with humanity, connectedness to nature, and social responsibility). Importantly, the MES uniquely predicted willingness to engage in prosocial intentions and behaviors at personal cost independently of these established constructs. Specifically, the MES uniquely predicted willingness to prioritize humanitarian and environmental concerns over personal and national self-interest, willingness to sacrifice one’s life to save others (ranging from human out-groups to animals and plants), and volunteering behavior. Results demonstrate that moral expansiveness is a distinct and important factor in understanding moral judgments and their consequences.