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Kinds of Adelaide Selected AbstractsThe characteristics of heroin users entering treatment: findings from the Australian Treatment Outcome Study (ATOS)DRUG AND ALCOHOL REVIEW, Issue 5 2005JOANNE ROSS Abstract The current study aimed to describe the characteristics (demographics, drug use, mental and physical health) of entrants to treatment for heroin dependence in three treatment modalities; and to compare these characteristics with heroin users not in or seeking treatment. Participants were 825 current heroin users recruited from Sydney, Adelaide and Melbourne: 277 entering methadone/buprenorphine maintenance treatment (MT), 288 entering detoxification (DTX), 180 entering drug-free residential rehabilitation (RR) and 80 not in treatment (NT). Treatment entrants were generally long-term heroin users with previous treatment experience. The majority of the sample (55%) were criminally active in the month preceding interview. Injection-related health problems (74%) and a history of heroin overdose (58%) were commonly reported. There were high degrees of psychiatric co-morbidity, with 49% reporting severe psychological distress, 28% having current major depression, 37% having attempted suicide and 42% having a lifetime history of post-traumatic stress disorder. Personality disorders were also prevalent, with 72% meeting criteria for antisocial personality disorder and 47% screening positive for borderline personality disorder. Striking similarities were noted between the non-treatment and treatment groups in length of heroin use career, drug use and treatment histories. [source] Impact of the heroin ,drought' on patterns of drug use and drug-related harmsDRUG AND ALCOHOL REVIEW, Issue 2 2004Dr MARIE C. LONGO Senior Research Officer Abstract Since late 2000, anecdotal reports from drug users and health professionals have suggested that there was a reduction in the supply of heroin in Adelaide in the first half of 2001, referred to as a heroin ,drought'. The aim of this paper was to critically review evidence for this, using data obtained from 100 injecting drug users surveyed for the 2001 Illicit Drug Reporting System (IDRS). This project is carried out annually in all Australian jurisdictions, and collects up-to-date information on the markets for heroin, methamphetamine, cocaine and cannabis. This paper also investigates the possible implications of this ,drought' on patterns of drug use and drug-related harms. The 2001 IDRS found consistent reports by users of an increase in the price of heroin, together with decreases in purity and availability. These factors resulted in a decrease in the frequency of self-reported heroin use among those surveyed in 2001, and a concomitant increase in the use of other drugs, in particular methamphetamine and morphine. The heroin ,drought' appears to have had a substantial impact on several indices of drug-related harm. There was a marked decrease in the number of opioid-related fatalities, and hospital data also showed reductions in heroin-related presentations. Treatment service data showed an increase in the number of admissions related to amphetamines. There is a need for health promotion and education on the adverse effects of methamphetamine use, and the development of improved treatment protocols for methamphetamine abuse and dependence. [source] Paediatric and adolescent horse-related injuries: Does the mechanism of injury justify a trauma response?EMERGENCY MEDICINE AUSTRALASIA, Issue 4 2008John A Craven Objective: To identify the frequency, variety and disposition of horse-related injury presentations to the ED and to use this information to evaluate the existing institutional trauma team activation criteria following horse-related injuries. Methods: A retrospective case analysis was performed of all horse-related injury presentations to the ED of Women's and Children's Hospital, Adelaide, Australia, in the 5 year period between January 1999 and December 2003. Results: A total of 186 children presented with horse-related injuries during the 5 year study period. The median age of injury was 9 years (range 1,17 years), with 81% of presentations female and 60% of patients hospitalized. The mechanism of injury was divided into four groups: 148 falls (79%), 28 kicks (15%), 7 tramples (4%) and 5 bites (3%). There was one death. Seven presentations rated an Injury Severity Score >15, with full trauma team activation occurring for two of these presentations. Conclusion: Although horse-related injury presentations are uncommon, severe injuries do occur. Patients presenting with severe horse-related injuries do not always activate a full trauma team response based on current trauma team activation criteria. These severe injury presentations are supported by a limited trauma team response, which activates on the mechanism of injury. The effectiveness of this as a contingency system needs to be evaluated. [source] Improving clinical assessment: evaluating students' ability to identify and apply clinical criteriaEUROPEAN JOURNAL OF DENTAL EDUCATION, Issue 3 2010C. Redwood Abstract Aim:, There is ongoing concern by health educators over the inability of professionals to accurately self-assess their clinical behaviour and standards, resulting in doubts over a key expectation of effective self-regulation in the health professions. Participation by students in the assessment process has been shown to increase the understanding of assessment criteria in written assessment tasks. How this might transfer to the clinical setting is the focus of this study. This paper is part of an ongoing investigation of the impact on learning of a series of activities that provides students with opportunities to discuss and apply criteria and standards associated with self-assessment in clinical dentistry. Our aim was to evaluate whether participation in these assessment activities improved the ability of first-year dental students to recognise behaviours demonstrated by ,peers' in videos of clinical scenarios and to relate these to the assessment criteria. Materials and methods:, A series of three workshops in conjunction with weekly clinical assessment activities in Semesters 1 and 2 were use to support first-year students' learning of clinical assessment criteria. The design of the workshops was based on the principles of social constructivist theories of learning and the concept of tacit knowledge. Accordingly workshop activities were planned around videos that were specifically constructed to illustrate procedures and behaviours typical of those observed by staff and tutors in the first year of the dental course at The University of Adelaide, Australia. First-year students viewed the videos prior to and after the workshops and recorded observed behaviours that related to the assessment criteria that were used in their clinical practice course. Student learning outcomes were assessed 10,14 weeks after the initial workshop and again up to 42 weeks later. To check whether learning resulted from repeated viewing of the videos without formal discussion, a reference group of third-year students who did not attend the workshops also viewed the videos two times, separated by 12 weeks, and recorded observations in the same way. Results:, There was no consistent evidence that repeat viewing of the videos in isolation resulted in improved recognition of ,peer' behaviours by third-year dental students. Results for the first-year students indicated that the workshops and clinical assessment activities had a significantly positive effect on the ability of students to identify ,peer' behaviours related to the criteria used for clinical assessment. In particular, students' recognition in others of knowledge and professional behaviours improved significantly. This improvement was retained over the year and students were able to recognise these behaviours in other scenarios relevant to their year level. Conclusions:, This early exposure to the process of clinical assessment, coupled with ongoing self-assessment and tutor feedback throughout first year, improved the ability of first-year students to identify and apply some key assessment criteria to observed ,peer' behaviour, and this ability was retained over time. [source] Short- and long-range dispersal of medfly, Ceratitis capitata (Dipt., Tephritidae), and its invasive potentialJOURNAL OF APPLIED ENTOMOLOGY, Issue 8 2007A. Meats Abstract:, Data were obtained from mark recapture trials pertaining to the dispersal of medfly, Ceratitis capitata (Dipt., Tephritidae), over both short (10,160 m) and very long distances (0.5,9.5 km) within the surveillance trapping array in Adelaide, Australia. They could be related to previously reported data sets by expressing the capture rates of each set in common terms that corrected for differences in recapture rate resulting from type of trap, season or climate. The mean capture rate at each distance from the point of release in each data set was expressed as a percentage of the real or inferred rate of that set at a distance of 100 m. The resulting distribution of dispersal distances conformed to both an inverse power model and a modified Cauchy model regardless of whether the present and previous data were combined or not. The modified Cauchy model inferred that the median distance flown was extremely short and 90% of flies displaced only 400,700 m despite the fact that a consistent trend in declining catch rates was obtained up to 9.5 km. The spread of invading propagules in quarantined zones in the first generation is likely to be limited by a decline to non-viable density within 1 km or less of the incursion point and the spread of larger infestations could be limited by the longevity of the dispersers. The results also have significance to the ability of surveillance trapping arrays to detect infestations and also to methods of distributing insects for the ,sterile insect technique'. [source] Adolescents with Type 1 Diabetes: transition between diabetes servicesJOURNAL OF CLINICAL NURSING, Issue 6 2006Kate Visentin MN Aim., The research aimed to develop a sustainable and coordinated approach to facilitating the transition between diabetes services for adolescents. The objectives were to: (1) involve key diabetes health delivery stakeholders in expressing their concerns and issues about current service delivery and ways to improve same, and (2) reveal from the perspective of the adolescents living with Type 1 Diabetes their experiences surrounding the process of transition. Background., This paper presents research that sought to identify the major concerns and issues that stakeholders had about transition and to reveal the experience of transition for the adolescent with Type 1 Diabetes. Key representatives from seven public diabetes services in Adelaide, South Australia worked collaboratively to answer the objectives of this inquiry. Approach., Interview data were generated and analysed using a response focus framework provided by fourth generation evaluation research. In this study, the focus was on common concerns, claims and issues raised by health care professionals (n = 21) and adolescents (n = 10) aged between 15 and 18 years about transferring from children's to adult diabetes services. Findings., Data revealed education and dietetic advice was reactive rather than proactive and that the paediatric model of care is philosophically and practically different to the adult model of diabetes care. Three phases of transition were identified: preparation, formal transition and evaluation. Our findings indicated that these stages of transition were not being fully implemented in health units. Conclusion., The project findings have set the scene to establish a multidisciplinary working party to work collaboratively across agencies to develop effective transition pathways. Relevance to clinical practice., The role of diabetes nurse educators and dietitians in South Australia is under-used throughout the transition process. Diabetes nurse educators are in an ideal position to prepare, coordinate and evaluate transitional processes. [source] Negative consequences of community group participation for women's mental health and well-being: Implications for gender aware social capital buildingJOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY, Issue 3 2009Katy Osborne Abstract Participation in community groups is argued to be an important way to create health-promoting social capital. However, relatively little attention has been paid to the ways in which gender affects the health promotion potential of participation. This paper reports on a qualitative study of women's experiences of participation in a diverse range of community groups, and considers how such involvement can potentially have a negative impact upon mental well-being. In-depth interviews were conducted with 30 women in Adelaide, South Australia. Women's accounts of their group involvement reflected that their identities as mothers were particularly important in shaping their participation. Some women reported difficulties in combining group involvement with their family responsibilities. Stress attached to negotiating social interaction within groups was also raised as an issue. It was found that participation can reinforce gender inequality and potentially have severe negative consequences for mental health, issues that need to be considered alongside the potential health benefits. The findings are considered in light of Bourdieu's critical conceptualization of social capital. Copyright © 2008 John Wiley & Sons, Ltd. [source] Characteristic Features of Pediatric Firearm Fatalities,Comparisons Between Australia and the United StatesJOURNAL OF FORENSIC SCIENCES, Issue 5 2009Roger W. Byard M.D. Abstract:, Gunshot deaths in children less than 17 years of age from Adelaide, SA, Australia (1969,2005) and from San Diego County, CA, United States (1988,2005) were compared. Forty-two pediatric gunshot fatalities occurred in South Australia (1.1 cases/year; M:F = 30:12). There were 6 accidents (14%), 14 suicides (33%), and 22 homicides (52%). In San Diego there were 185 cases (c.10 cases/year; M:F = 148:37). There were 6 accidents (3%), 42 suicides (23%), 130 homicides (70%), and 7 undetermined cases (4%). The incidence of homicide was significantly higher in San Diego County compared to Adelaide (p < 0.001), with a higher proportion of murder,suicides occurring in Adelaide. There were markedly more accidents and suicides involving males in Adelaide and a far higher number of male homicide victims in San Diego County compared to females. Rifles of 0.22-caliber were preferred weapons in South Australia, compared to handguns in San Diego County. [source] The natural history and osteodystrophy of mucolipidosis types II and IIIJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 6 2010Grace David-Vizcarra Aim: To assess the natural history and impact of the secondary bone disease observed in patients with mucolipidosis (ML) II and III. Methods: Affected children and adults were ascertained from clinical genetics units around Australia and New Zealand. Diagnoses were confirmed by the National Referral Laboratory in Adelaide. The study encompassed all patients ascertained between 1975 and 2005. Data focussing on biochemical parameters at diagnosis, and longitudinal radiographic findings were sought for each patient. Where feasible, patients underwent clinical review and examination. Examinations included skeletal survey, bone densitometry, and measurement of serum and urine markers of bone metabolism. In a subset of patients, functional assessment using the Pediatric Evaluation and Disability Inventory (PEDI) and molecular analysis of GNPTAB were performed. Results: Twenty-five patients with mucolipidosis were ascertained over a 30-year period. Morbidity and functional outcomes on living patients were described. Serum calcium and phosphate were normal. All, but one patient, had normal alkaline phosphatase. Serum osteocalcin and urine deoxypyridinoline/creatinine were elevated. Two radiological patterns were observed (i) transient neonatal hyperparathyroidism in infants with ML II and (ii) progressive osteodystrophy in patients with ML intermediate and ML III. Molecular analyses of GNPTAB in nine subjects are reported. Conclusion: ML is characterised by a progressive bone and mineral disorder which we describe as the ,osteodystrophy of mucolipidosis'. The clinical and radiographic features of this osteodystrophy are consistent with a syndrome of ,pseudohyperparathyroidism'. Much of the progressive skeletal and joint pathology is attributable to this bone disorder. [source] Infant bath seats, drowning and near-drowningJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 5-6 2004RW Byard Objective: To investigate the possible role of infant bathtub seats in drowning and near-drowning episodes in infants. Methods: A review was conducted of the files of the Forensic Science Centre and Child Protection Unit, Women's and Children's Hospital, Adelaide, South Australia, for significant immersion incidents in infants involving bathtub seats from January 1998 to December 2003. Results: A total of six cases of drowning occurred over the 6-year period of the study in children under 2 years of age, including two infants. One of these cases, a 7-month-old boy, had been left unattended for some time in an adult bath in a bathtub seat. He was found drowned, having submerged after slipping down and becoming trapped in the seat. Three near-drowning episodes occurred in children under the age of 2 years, including two boys aged 7 and 8 months, both of whom had been left for some time in adult baths in bath seats. Both were successfully resuscitated and treated in hospital. Conclusions: These cases demonstrate the vulnerability of infants to immersion incidents when left unattended in bathtubs. Bathtubs are particularly dangerous for infants as the slippery and smooth surfaces predispose to loss of balance and make escape from water difficult. Infant bathtub seats may give parents and child carers a false sense of security leading to infants being left unattended. Unfortunately, however, infants may fall out of, or slip and become trapped in, such seats. Infants and young children cannot be left unsupervized in water, and devices used as bathing aids such as bathtub seats may contribute to immersion incidents. [source] Death due to electrocution in childhood and early adolescenceJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 1 2003RW Byard Objectives: To delineate the clinicopathological features of fatal childhood electrocutions and to identify specific risk factors. Methods: Coronial files in Adelaide (Australia) were searched from 1967 to 2001 and Medical Examiners' files in San Diego (USA) were searched from 1988 to 2001, for cases of deaths of children and adolescents younger than 16 years attributed to electrocution. Results: Sixteen cases were identified aged between 10 months and 15 years (mean 8.0 years) with a male : female ratio of 5 : 3. Deaths were due to accidents occurring while playing with or near faulty electrical equipment at home or at school (n = 8), electrical equipment while in the bath (n = 2), damaged outdoor electrical equipment (n = 1), overhead wires (n = 1), and a high voltage electricity substation (n = 1). In addition, one death was due to suicide involving an electrical appliance placed in a bath, and two other deaths occurred in older children who were moving equipment under overhead wires. No homicides were identified. Conclusions: Childhood deaths due to electrocution are rare and are more likely to occur when children are playing around electrical wires or equipment, and often result from either faulty apparatus, or a lack of understanding of the potential dangers involved. The majority of deaths (11/16; 69%) occur in the home environment. In contrast to adult electrical deaths, high-voltage electrocutions, suicides and workplace deaths are uncommon. Strategies for eliminating childhood electrocution should concentrate on ensuring safe domestic environments with properly maintained electrical devices. [source] Analysis of the breath hydrogen test for carbohydrate malabsorption: Validation of a pocket-sized breath test analyserJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 4 2000Ws Lee Objective: To assess the validity and clinical application of a hand-held breath hydrogen (H2) analyzer (BreatH2, Europa Scientific, Crewe, UK). Methodology: Breath samples of patients referred to the Gastroenterology Unit, Women's and Children's Hospital, North Adelaide, South Australia, for confirmation of the diagnosis of carbohydrate malabsorption were analysed with the Quintron microlyzer (Quintron Instrument Co., Milwaukee, USA) and the BreatH2 analyser, using the Quintron microlyzer as the gold standard. Results: Twenty-nine breath H2 tests (BHT) were performed in 29 patients aged 2 months to 61 years. The sensitivity and specificity of the BreatH2 analyser in detecting a positive BHT using the Quintron microlyser as the gold standard were 0.90 and 0.95 with positive and negative predictive values of 0.90 and 0.95, respectively. There was one false positive and one false negative reading. Bland,Altman plots showed a high degree of agreement between the values obtained with two different methods. Conclusions: The diagnosis of carbohydrate malabsorption, using a portable breath H2 analyser (BreatH2), achieved an acceptable degree of sensitivity and specificity, enabling it to be used where no alternative is available. [source] Refractory calcium-aluminum-rich inclusions and aluminum-diopside-rich chondrules in the metal-rich chondrites Hammadah al Hamra 237 and Queen Alexandra Range 94411METEORITICS & PLANETARY SCIENCE, Issue 9 2001Alexander N. KROT Forty CAIs and CAI fragments and seven Al-diopside-rich chondrules were identified in HH 237 and QUE 94411/94627. The CAIs, ,50,400 ,m in apparent diameter, include (a) 22 (56%) pyroxene-spinel ± melilite (+forsterite rim), (b) 11 (28%) forsterite-bearing, pyroxene-spinel ± melilite ± anorthite (+forsterite rim) (c) 2 (5%) grossite-rich (+spinel-melilite-pyroxene rim), (d) 2 (5%) hibonite-melilite (+spinel-pyroxene ± forsterite rim), (e) 1 (2%) hibonite-bearing, spinel-perovskite (+melilite-pyroxene rim), (f) 1 (2%) spinel-melilite-pyroxene-anorthite, and (g) 1 (2%) amoeboid olivine aggregate. Each type of CAI is known to exist in other chondrite groups, but the high abundance of pyroxene-spinel ± melilite CAIs with igneous textures and surrounded by a forsterite rim are unique features of HH 237 and QUE 94411/94627. Additionally, oxygen isotopes consistently show relatively heavy compositions with ,17O ranging from ,6%0 to ,10%0 (1, = 1.3%0) for all analyzed CAI minerals (grossite, hibonite, melilite, pyroxene, spinel). This suggests that the CAIs formed in a reservoir isotopically distinct from the reservoir(s) where "normal", 16O-rich (,17O < ,20%0) CAIs in most other chondritic meteorites formed. The Al-diopside-rich chondrules, which have previously been observed in CH chondrites and the unique carbonaceous chondrite Adelaide, contain Al-diopside grains enclosing oriented inclusions of forsterite, and interstitial anorthitic mesostasis and Al-rich, Ca-poor pyroxene, occasionally enclosing spinel and forsterite. These chondrules are mineralogically similar to the Al-rich barred-olivine chondrules in HH 237 and QUE 94411/94627, but have lower Cr concentrations than the latter, indicating that they may have formed during the same chondrule-forming event, but at slightly different ambient nebular temperatures. Aluminum-diopside grains from two Al-diopside-rich chondrules have O-isotopic compositions (,17O , ,7 ± 1.1 %0) similar to CAI minerals, suggesting that they formed from an isotopically similar reservoir. The oxygen-isotopic composition of one Ca, Al-poor cryptocrystalline chondrule in QUE 94411/94627 was analyzed and found to have ,17O , ,3 ± 1.4%0. The characteristics of the CAIs in HH 237 and QUE 94411/94627 are inconsistent with an impact origin of these metal-rich meteorites. Instead they suggest that the components in CB chondrites are pristine products of large-scale, high-temperature processes in the solar nebula and should be considered bona fide chondrites. [source] Exploring parents' perceptions of television food advertising directed at children: A South Australian studyNUTRITION & DIETETICS, Issue 1 2007Joyce IP Abstract Objective:, To increase our understanding of parents' perceptions of the influence of television food advertising on children's food choices. Design:, Five focus group discussions. Subjects:, Thirty-two parents (24 women and eight men) of children attending primary school. Setting: Adelaide, South Australia. Data analyses:, The focus group discussions were taped and transcribed and coded as themes. Transcripts were verified and coding was audited. All researchers met regularly to analyse data and reach consensus on emergent themes (researcher triangulation). Results:, Parents who participated in the study indicated that television is a powerful source of information for children's food choices. Parents expressed concern about the negative influence of television food advertising on children's food preferences. They suggested that the current regulations governing television food advertising were not adequately enforced. Parents wanted to see an overall reduction in the volume of food advertisements directed at children, and an increase in advertisements promoting healthy foods. Parents expressed mixed views about banning food advertisements directed at children. Conclusion:, In order for television food advertising to be health-enhancing for children, parents in the study suggested the need for restrictions on advertising practices, tighter enforcement of existing regulations and an increase in healthy food advertisements. The present research shows that parents want to see changes in the current arrangements governing television food advertising to children. [source] Reproductive patterns of Caloglossa species (Delesseriaceae, Rhodophyta) from Australia and New Zealand: multiple origins of asexuality in C. leprieurii.PHYCOLOGICAL RESEARCH, Issue 3 2001Literature review on apomixis, bisexuality, mixed-phase, sexual compatibility SUMMARY Reproduction and life history patterns in culture of five Caloglossa speaes from Australia and New Zealand are compared. Caloglossa adhaerens King et Puttock and Caloglossa bengalensis (Martens) King et Puttock have a Polyslphonla-type sexual life history (P-type, isomorphic alternation of generations). Caloglossa monosticha Kamiya occurs only in Western Australia (WA) and is a P-type. Caloglossa ogasawaraensis Okamura occurs in WA, Northern Territory (NT), Queensland (QLD), New South Wales (NSW), Victoria (VIC) and South Australia (SA) and is for the most part a P-type in culture. A few isolates have bisexual gametophytes that are self-compatible, while most are unisexual. Caloglossa ogasawaraensis from Adelaide, SA and from Wilsons Promontory, VIC are new records for these States. In Australia, Caloglossa postiae (King et Puttock) Kamiya et King occurs in NSW, NT and QLD. All nine isolates are P-type. Isolates of Caloglossa leprieurii (Montagne) G. Martens from NSW, NT, QLD, Tasmania, VIC and New Zealand are P-type except for the freshwater isolates in which tetraspore germlings do not reproduce. In some isolates mixed-phase reproduction is seen with male gametophytes producing both viable spermatia and tetrasporangia and female gametophytes producing procarps and sori with non-dividing sporangia. All isolates of C. leprieurii irom Spencer Gulf and Gulf of St Vincent, SA and one isolate from QLD give rise to successive asexual generations of tetrasporophytes. Based on RuBisCO spacer DNA data an asexual life history has arisen several times in the C. leprieurii complex. The literature on apomixis, mixed-phase reproduction, bisexuality and sexual compatibility in red algae is surveyed. [source] Trial of nurse-run asthma clinics based in general practice versus usual medical careRESPIROLOGY, Issue 3 2004Louis S. PILOTTO Objective: The aim of this study was to assess the ability of nurse-run asthma clinics based in general practice compared with usual medical care to produce at least a moderate improvement in the quality of life of adults with asthma. Methodology: A randomized controlled trial involving 80 asthma clinic and 90 usual medical care asthma participants, aged 18 years and older was conducted in 11 general practices in Adelaide. The main outcome measure was the St George's respiratory questionnaire (SGRQ), from which quality-of-life scores were used to assess therapeutic benefit. Lung function measurements and health services utilization data were also collected. Results: One hundred and fifty-three participants (90%) were reviewed at follow up after 6,9 months. There was little difference between groups in baseline measures or for the 6-month follow-up, outcomes,, including, the, mean, difference, in, total, SGRQ, scores, (,0.5,, 95%, confidence, interval, (CI) ,4.0, 2.9) and the mean difference in percentage predicted FEV1 (2.3%, 95% CI ,0.7, 5.3 pre-bronchodilator; 0.4%, 95% CI ,5.1, 5.9 post-bronchodilator). Trends in health services utilization were noted. Conclusions: Nurse-run asthma clinics based in general practice and usual medical care were similar in their effects on quality of life and lung function in adults. These findings cannot be generalized to hospital outpatients and other clinics that manage more severe asthmatic patients. [source] Multiculturalism, Latin Americans and ,Indigeneity' in AustraliaTHE AUSTRALIAN JOURNAL OF ANTHROPOLOGY, Issue 1 2003Erez Cohen What are the relations between the discourse of ,multiculturalism' and that of ,indigeneity' in Australia? In problematising these relations this paper explores the affiliations that Latin American migrants and political refugees living in Adelaide have with the notion of indigeneity. For some Latin Americans affiliations with the struggle of Aboriginal people and indigeneity is a product of strong political identification with the political left and the struggle for human rights in their countries of origin. At the same time references to Latin Americans' indigeneity are often evoked within Australian multicultural settings and performances that promote ,cultural diversity' and are consumed by White Australians for their exotic otherness and as forms of cultural enrichment. Such representations work to marginalise further the migrants (and the ,indigenous') into a cultural sphere which marks them as the tolerated ethnic ,Other'. [source] Revising the surgical registrar on-call rosterANZ JOURNAL OF SURGERY, Issue 7-8 2010A. Peter Wysocki Abstract Background:, The work hours of junior doctors have been in the spotlight since the mid-1980s. Rostering and the structure of surgical units aim to balance quality and continuity of patient care with reasonable working hours. Methods:, Actual hours worked during two 12-week surgical registrar rosters were compared. Compliance of each roster with fatigue recommendations was assessed with Fatigue Audit InterDyne (FAID, InterDynamics Pty Ltd, Adelaide, Australia) software. Workload was determined from an electronic prospective surgical audit. Impact of the roster change was discussed with consultants and registrars. The traditional roster started on 16 July 2007 and the fatigue-friendly roster on 14 July 2008. Results:, The total number of hours worked reduced by 11% (from 5085.17 h in 2007 to 4530.85 h in 2008). Fatigue was eliminated (from 133.25 h in 2007 to 0 h in 2008). Over the 12-month period, the operative workload for the Department of General Surgery increased by 18%. FAID compliance improved from 67.3 to 91.2%. Consultant and registrar satisfaction with the new roster was high. Conclusions:, Safe working hours have been achieved for surgical registrars by restructuring the surgical units and implementing a new on-call rota without a perceived effect on patient care. [source] Outcome following surgery for squamous cell carcinoma of the oesophagusANZ JOURNAL OF SURGERY, Issue 10 2009En Loon C. Yong Abstract Introduction:, This study was undertaken to determine the outcomes of patients treated for squamous cell carcinoma (SCC) of the oesophagus. Methods:, The study group consisted of 61 patients (median age: 64 years) with invasive SCC of the oesophagus who underwent resection between 1987 and 2007 in Adelaide, South Australia. Thirty-two (52%) were female. Survival data were available for all patients. The log rank test was performed to identify prognostic factors for survival. Results:, The 5-year overall survival rate was 33% (median: 24 months). Of 61 patients, 42 (69%) received neoadjuvant therapy prior to surgery. The overall resection rate was 95%. Significant post-operative morbidity occurred in 47%, and the in-hospital mortality was 5% (30-day mortality: 3%). No overall survival benefit was seen in patients undergoing neoadjuvant therapy prior to surgical resection. However, patients who had a complete pathological response to neoadjuvant therapy had a better 5-year survival than patients who did not receive neoadjuvant therapy: 47% versus 30%, respectively. Conclusions:, Oesophagectomy following neoadjuvant therapy for SCC of the oesophagus can be performed with low perioperative mortality. A complete response to neoadjuvant therapy was followed by an improved survival outcome. [source] Endoscopic stapling for pharyngeal pouch: does it make the cut?ANZ JOURNAL OF SURGERY, Issue 3 2004Ahmad Aly Background: Endoscopic stapling to treat pharyngeal pouch is a relatively new technique with the potential to reduce the morbidity associated with the open approach for pharyngeal pouch. Despite enthusiasm for the endoscopic approach there have been no series reported in Australia, and descriptions of outcomes and benefits are currently anecdotal. The aim of the present study was to determine the outcome associated with endoscopic stapling of pharyngeal pouch in an Australian setting. Methods: All patients admitted for endoscopic stapling for a pharyngeal pouch between 1998 and 2002 by surgeons from the Adelaide and Flinders Universities were identified, and their medical records were reviewed for clinical and operative details. All patients were interviewed by telephone using a structured questionnaire to determine symptom resolution and patient satisfaction. The Likert scale was used to assess the impact of preoperative and postoperative symptoms upon quality of life. Results: A total of 31 patients were identified. The mean age of the group was 75 years (range: 35,91 years) and half the patients had an American Society of Anesthesiologists physical status score of 3 or greater. In four patients the procedure was abandoned; (for three because of inability to pass the diverticuloscope and for one because the pouch was too small). Standard open surgery was undertaken in these patients. Of the 27 procedures completed endoscopically, interview follow up was obtained in 23, at a mean follow up of 17 months (range: 2,68 months). Outcome was very good or excellent in 21 (91%), with significant symptom resolution, reduction in Likert scores and high patient satisfaction. Three patients had previously had pouch surgery and endoscopic stapling was straightforward in these patients. Recurrence of a symptomatic pouch occurred in three patients. There was no significant morbidity related to the procedure. Conclusions: The early experience of endoscopic stapling for pharyngeal pouch in Adelaide is encouraging. The procedure achieves excellent control of symptoms and can be undertaken with minimal morbidity. Recurrence may be a problem, although repeat endoscopic stapling can be undertaken without difficulty. [source] Inspection time predicts individual differences in everyday functioning among elderly adults: Testing discriminant validityAUSTRALASIAN JOURNAL ON AGEING, Issue 2 2009Tess Gregory Aim:, Inspection time (IT) is a processing speed measure, recently investigated as a biomarker of ageing. This study examined whether earlier IT predicts subsequent problems in everyday functioning in community-dwelling elderly people. Methods:, Participants completed IT at baseline, 6 months and 18 months. At 42 months, two groups of 15 elderly people matched for education and age (74,88 years) and selected for slower or faster baseline IT, completed a fourth estimate of IT and a practical assessment of everyday functioning (Timed Instrumental Activities of Daily Living , Adelaide). Results:, At 42 months, the group with slower baseline IT had significantly poorer performance (slower completion, higher errors) on more than half of the everyday functioning tasks. Conclusion:, Slower IT predicts difficulties up to 4 years later in everyday functioning of elderly adults, providing discriminant validation for IT as a biomarker for future changes. [source] Independence and self-provision in old age: how realistic are these goals?AUSTRALASIAN JOURNAL ON AGEING, Issue 3 2004Rob Ranzijn Objectives:,The aim of the present paper was to examine the relationship between perceived choices in work and retirement in middle age and financial security and confidence about the future in old age. Methods:,A qualitative study of 30 middle-aged adults in Adelaide and Whyalla in South Australia, either presently employed, unemployed or retired, were interviewed about their work histories, the factors in their work changes, their perceived options concerning future work and retirement, and their anticipated financial security and sources of income in retirement. Results:,In general, participants with a history of continuous stable employment believed they were in a good financial situation and were confident about their future, but many of the participants had a history of precarious employment, no financial security, and expected to rely primarily on government support in their old age. Conclusion:,A substantial proportion of older adults may not be able to provide for themselves in later life without public policies which are more interventionist. [source] The 2010 Arthur Wilson Oration The Ascent of Woman From Queen Adelaide to Queen CamillaAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 3 2010Alastair H MacLENNAN First page of article [source] Who remains undelivered more than seven days after a single course of prenatal corticosteroids and gives birth at less than 34 weeks?AUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 4 2002KJ McLaughlin ABSTRACT Minimal information exists as to how women who give birth more than seven days after initial corticosteroid treatment, who may benefit from repeat prenatal corticosteroids, differ from women who give birth within seven days, at < 34 weeks gestation. OBJECTIVES To examine the differences, if any, between women who received a single course of prenatal corticosteroids and remained undelivered more than seven days later and women who gave birth within seven days of treatment, at < 34 weeks gestation. DESIGN Retrospective cohort. Setting Women's and Children's Hospital, Adelaide. Population Women who gave birth at < 34 weeks gestation from 1 January 1994 to 31 December 1996. Methods Data were extracted from medical records and retrieved from the hospital's database. Main potential predictors collected Prenatal corticosteroid exposure, reason for risk of preterm birth, maternal demographics and previous and current obstetric history. Results Of the 506 women, 122 (24%) remained undelivered more than seven days following prenatal corticosteroid therapy. Initial corticosteroid treatment was given on average 1.6 weeks earlier to women who remained undelivered more than seven days after treatment. Women who were given prenatal corticosteroids for placenta praevia (RR 6.03, 95% CI 2.67-13.61, p < 0.01) or cervical incompetence (RR 3.40, 95% CI 1.06-10.95, p = 0.04) were more likely to give birth more than seven days after corticosteroid treatment. Conclusions Women who give birth very preterm, who remain undelivered more than seven days after prenatal corticosteroids, differ in the reasons for and timing of their first course from women who give birth within seven days. [source] Comparing self-reported and measured high blood pressure and high cholesterol status using data from a large representative cohort studyAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 4 2010Anne Taylor Abstract Objective: To examine the relationship between self-reported and clinical measurements for high blood pressure (HBP) and high cholesterol (HC) in a random population sample. Method: A representative population sample of adults aged 18 years and over living in the north-west region of Adelaide (n=1537) were recruited to the biomedical cohort study in 2002/03. In the initial cross-sectional component of the study, self-reported HBP status and HC status were collected over the telephone. Clinical measures of blood pressure were obtained and fasting blood taken to determine cholesterol levels. In addition, data from a continuous chronic disease and risk factor surveillance system were used to assess the consistency of self-reported measures over time. Result: Self-report of current HBP and HC showed >98% specificity for both, but sensitivity was low for HC (27.8%) and moderate for HBP (49.0%). Agreement between current self-report and clinical measures was moderate (kappa 0.55) for HBP and low (kappa 0.30) for HC. Demographic differences were found with younger people more likely to have lower sensitivity rates. Self-reported estimates for the surveillance system had not varied significantly over time. Conclusion: Although self-reported measures are consistent over time there are major differences between the self-reported measures and the actual clinical measurements. Technical aspects associated with clinic measurements could explain some of the difference. Implications: Monitoring of these broad population measures requires knowledge of the differences and limitations in population settings. [source] The geography of melanoma in South AustraliaAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 2 2009Adrian R. Heard Abstract Objective: We sought to determine the distribution of melanoma in South Australia with respect to the relative incidence and mortality in coastal/river versus inland areas and metropolitan versus regional/remote areas, and to outline the public health implications of this distribution. Methods: All melanoma cases and deaths for the period 1985-2004 for Adelaide and 11 regional centres were geo-coded and then allocated to ABS collection districts. Collection districts with a centroid within 2 km of the coast or River Murray were determined using mapping software. Results: Melanoma incidence is higher in coastal South Australia (OR=1.19) and near the River Murray (OR=1.25) than in inland South Australia. This geographical effect remains after adjustment for age and socio-economic status. Incidence is also higher in metropolitan Adelaide than in regional areas (OR=1.10). For melanoma mortality there is no significant effect of living near the coast or river, and no effect of living in regional areas. Conclusion: Living near the coast or River Murray in South Australia is associated with an increased risk of being diagnosed with melanoma. Implications: Melanoma prevention and acute care programs can be usefully targeted at persons living in coastal and riverine areas, where there is a significant excess of melanoma incidence. This target population is older than inland populations and will require interventions appropriate for aged communities. [source] Social factors associated with Major Depressive Disorder in homosexually active, gay men attending general practices in urban AustraliaAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 1 2009Limin Mao Abstract Objectives: Social factors associated with Major Depressive Disorder (MDD) were identified among gay men attending high HIV caseload general practices in Sydney and Adelaide. Methods: Men who visited four participating practices were invited to self-complete a survey. A self-screening tool (PHQ-9), based on the Diagnostic and Statistical Manual of Mental Disorders, version four (DSM-IV), was used to measure depressive disorders. Results: The rate of MDD (PHQ-9 score 10 or above) among the 195 HIV-positive gay men was significantly higher than that among the 314 non-HIV-positive gay men (31.8% vs 20.1%, p=0.002). Current MDD was independently associated with younger age, lower income, recent major adverse life events, adopting denial and isolation as coping strategies, less social support, less gay community involvement and recent sexual problems. HIV-status, however, was not independently associated with MDD. Conclusion: Socio-economic hardship, interpersonal isolation and personal withdrawal were significantly and independently associated with major depression in this population of gay men. Implications: The study provides further evidence of health inequity affecting gay men in Australia. Structural health promotion approaches focused on homophobia and discrimination, as well as community-engaged primary health care responses are called for to mitigate this inequity. [source] Patterns and costs of treatment for heroin dependence over 12 months: fndings from the Australian Treatment Outcome StudyAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 4 2006Marian Shanahan Objective: To determine patterns and costs of treatment for heroin dependence over a 12-month period among a cohort of heroin users seeking treatment. Methods: The design was a longitudinal cohort study of heroin users seeking treatment who participated in the Australian Treatment Outcome Study (ATOS), which was conducted in Sydney, Melbourne and Adelaide, Australia. Treatment for heroin dependence, for those who were followed up at 12 months, was recorded and costed. Unit costs, obtained from secondary sources, were used to estimate the cost of treatment. This study does not include wide societal costs and only includes personal costs as they pertain to treatment. Results: A follow-up rate of 81% at 12 months was achieved, resulting in data for 596 participants. Participants spent an average of 188 days in treatment over 2.7 episodes. Sixty-nine per cent of the sample reported at least one episode of treatment following their index treatment. There was a noticeable trend for subjects who received maintenance or residential rehabilitation as their index treatment to return to the same form of treatment for subsequent episodes. In contrast, those who received detoxifcation as index treatment accessed a wider variety of treatment types over the follow-up period. The cost of treatment over the 12-month follow-up totalled 3,901,416, with a mean of 6,517 per person. Conclusions and Implications: This study demonstrates that individuals seeking treatment have multiple treatment episodes throughout a 12-month period, with a tendency to return to the same form of treatment. This study also demonstrates that it is feasible and affordable to provide ongoing treatment for a group of heroin users seeking treatment. [source] Hepatitis C in the workplace: a survey of occupational health and safety knowledge and practice in the beauty therapy industryAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 3 2004Madeleine J. Murtagh Objective:To examine current knowledge and practice of occupational health and safety (OH&S) regarding hepatitis C in beauty therapy practice. Methods: A questionnaire was sent to all beauty therapy practices identified through the Telstra Yellow Pages and distributed via beauty therapy product agencies. Results: 119 questionnaires were completed by employers and employees in 99 beauty therapy practices in metropolitan Adelaide. Beauty therapists reported carrying out many practices that had exposed them to blood in the past. More than 80% of the procedures carried out by beauty therapists in the previous week were reported to have led to exposure to blood. 39.5% of respondents had not received information about OH&S practices related to blood spills and 77.5% of respondents had received no OH&S information about hepatitis C. Knowledge of hepatitis C and its transmission was poor, with 62% of respondents incorrectly identifying the prevalence of hepatitis C and respondents incorrectly identifying sneezing (28%), kissing (46%) and sharing coffee cups (42%) as a modes of transmission. 80% of beauty therapy practices had no OH&S representative. Conclusion: Beauty therapy practice can expose both operator and client to blood and is therefore a potential site for the transmission of blood-borne diseases including hepatitis C. OH&S information is inadequate in this industry and knowledge of hepatitis C is poor. Implications: Health promotion information about hepatitis C and OH&S practice to prevent transmission of blood-borne diseases is required. [source] Physical Activity: Patterns of active transport in 11,12 year old Australian childrenAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 2 2004Nathan Marten Objectives: To describe the habitual transport patterns of 11 to 12-year-old children in Australia, to determine the personal and environmental factors associated with active transport (AT), and to quantify how much AT contributes to overall daily energy expenditure (EE). Methods: The participants in this study were 136 children aged 11,12 year olds from eight randomly chosen primary schools in Adelaide, South Australia. Each child recalled their trips on two school days and a non-school day. Mass and stature were measured, and children completed a computerised activity recall and a neighbourhood satisfaction questionnaire. Trips were categorised according to their destination, child and parent dissatisfaction with the neighbourhood, and the gender, socio-economic status (SES), BMI and activity levels of the children undertaking them. These categories, along with the distance to the destination, were used as independent variables in a logistic regression model, with trip mode (passive versus active) as the dependent variable. Results: Children made an average of 1.0 active trips per day, with a median trip length of 0.63 km, while the median total distance covered actively per child per day was 0.61 km. Twenty-six per cent of children did no AT over the three days, and 67% did no AT on a weekend day. Distance was by far the strongest predictor of the likelihood that a trip would be active. Trips made by girls were less likely to be active compared with boys. Trips to the shops were less likely to be active than trips to school. Children's AT accounted for 1.3% of their daily EE. Conclusions and Implications: The active transport levels of children were very low. Interventions should focus on making neighbourhoods safer and more accessible to children and should promote bicycle use. [source] | |||||||||||||||||||