http://hdl.handle.net/2123/7297 2013-05-22T12:23:22Z http://hdl.handle.net/2123/8968 Title: Women in contact with the Sydney gay and lesbian community: Report of the Sydney Women and Sexual Health (SWASH) Survey 2006, 2008 and 2010 Authors: Mooney-Somers, Julie; Deacon, Rachel M; Richters, Juliet; Price, Karen; Sophia, León de la Barra; Schneider, Karen; Prestage, Garrett; Clayton, Stevie; Parkhill, Nicolas Abstract: The Sydney Women and Sexual Health (SWASH) survey was first carried out in 1996. It was initiated by workers from two ACON projects, Women Partners of Gay and Bisexual Men and the Gay and Lesbian Injecting Drug Use Project, who were faced with a lack of empirical evidence on which to base their intervention work. While research on same-sex-attracted women’s health and wellbeing has increased since then, epidemiological data on sexual health, mental health, experiences of abuse and violence and behaviours such as screening, illicit drug use, alcohol and smoking that can leave women vulnerable to adverse health outcomes, is still scarce. Moreover, as long as the inclusion of sexuality questions in large epidemiological surveys remains patchy or data is reported only by sexuality and not by sexuality and gender, SWASH provides a unique and important source of health-related information in Australian lesbian, bisexual and queer (LBQ) women. SWASH has been run biennially since 1996 by a collaboration of ACON and researchers at the University of New South Wales (until 2009), and now the University of Sydney (since 2010). The survey is regularly revised to reflect the needs of the community and research needs identified through research literature. Over its lifetime, SWASH has become a comprehensive survey of sexual health and wellbeing, violence, mental health and levels of psychological distress, and a number of other important health issues relevant to LBQ women, such as illicit drug use, alcohol consumption, and cancer screening behaviours. Where possible, questions have been used from established national surveys such as the National Drug Strategy Household Survey (NDSHS), the Australian Study of Health and Relationships (ASHR), and the Australian Longitudinal Survey of Women’s Health (ALSWH). This report presents results from surveys collected at the Sydney Gay and Lesbian Mardi Gras Fair Day and other community events and venues during the Sydney Gay and Lesbian Mardi Gras seasons in 2006, 2008 and 2010. 2012-01-01T00:00:00Z http://hdl.handle.net/2123/8960 Title: Target the fence-sitters Authors: Leask, Julie Abstract: Past waves of vaccine rejection in industrialized nations have a lot to teach us about preventing future ones. 2011-05-26T00:00:00Z http://hdl.handle.net/2123/8694 Title: Women in contact with the Perth gay and lesbian community: Report of the Women’s West Australian Women and Sexual Health survey 2010 Authors: Mooney-Somers, Julie; Deacon, Rachel; Comfort, Jude Abstract: Report of the Women’s Western Australian Sexual Health (WWASH) Survey run in 2010 with comparison data provided by the 2010 Sydney Women and Sexual Health (SWASH) survey. The survey covers sexual health (sexual practices, STI testing and diagnosis, Pap smears); tobacco, alcohol and illicit drug use; experiences of domestic violence, sexual coercion, and anti-LGBTQ behaviour; and self-report measures of physical and mental health. 2012-10-10T00:00:00Z http://hdl.handle.net/2123/8421 Title: Strategic approaches to enhanced health service delivery for Aboriginal and Torres Strait Islander people with chronic illness: a qualitative study Authors: Aspin, Clive; Brown, Ngiare; Jowsey, Tanisha; Yen, Laurann; Leeder, Stephen Abstract: Background Aboriginal and Torres Strait Islander people with chronic illness confront multiple challenges that contribute to their poor health outcomes, and to the health disparities that exist in Australian society. This study aimed to identify barriers and facilitators to care and support for Aboriginal and Torres Strait Islander people with chronic illness.Methods Face-to-face in-depth interviews were conducted with Aboriginal and Torres Strait Islander people with diabetes, chronic heart failure or chronic obstructive pulmonary disease (n-16) and family carers (n = 3). Interviews were transcribed verbatim and the transcripts were analysed using content analysis. Recurrent themes were identified and these were used to inform the key findings of the study. Results Participants reported both negative and positive influences that affected their health and well- being. Among the negative influences, they identified poor access to culturally appropriate health services, dislocation from cultural support systems, exposure to racism, poor communication with health care professionals and economic hardship. As a counter to these, participants pointed to cultural and traditional knowledge as well as insights from their own experiences. Participants said that while they often felt overwhelmed and confused by the burden of chronic illness, they drew strength from being part of an Aboriginal community, having regular and ongoing access to primary health care, and being well-connected to a supportive family network. Within this context, elders played an important role in increasing people’s awareness of the impact of chronic illness on people and communities. Conclusions Our study indicated that non-Indigenous health services struggled to meet the needs of Aboriginal and Torres Strait Islander people with chronic illness. To address their complex needs, health services could gain considerably by recognising that Aboriginal and Torres Strait Islander patients have a wealth of cultural knowledge at their disposal. Strategies to ensure that this knowledge is integrated into care and support programs for Aboriginal and Torres Strait Islander people with chronic illness should achieve major improvements. 2012-01-01T00:00:00Z http://hdl.handle.net/2123/8361 Title: Lessons from an online debate about measles-mumps-rubella (MMR) immunization Authors: Nicholson, Michelle S.; Leask, Julie Abstract: OBJECTIVE: To provide strategies for immunization advocates on how best to participate in online discussion forums about immunization. METHODS: Content and thematic analysis of an online discussion forum held following the national screening of a documentary about the measles-mumps-rubella (MMR) vaccine and autism scare. A subsample of branches containing more than 20 posts was analysed. Each distinct message (a "post") was coded for the author's manifest position on immunization, author type, topic, and evidence presented or sought. RESULTS: From 103 distinct branches there were 1193 posts sent over a 3½h period. We selected the 13 longest branches containing 466 posts from 166 individuals. One third of these individuals were explicitly critical of MMR immunization and one third sought information. The remainder were ambivalent but seeking no information (5%), supportive (14%), or unstated (15%). Among five author categories, only 4% identified themselves as health professionals. Topics included alleged adverse effects of immunization (35%); autism spectrum disorders treatment and causes (31%); vaccine ingredients (12%); a conspiracy (9%); immunization policies (8%); and measles, mumps or rubella (4%). Scientific concepts of evidence failed to compete with lay concepts and personal anecdotes prevailed. CONCLUSIONS: Health professionals and other advocates of immunization should engage in similar types of post-broadcast online discussion forums in a planned and strategic manner that accounts for the decision processes of lay people. This involves expanding and diversifying the support base of people contributing to the forum; setting the agenda; introducing messages known to influence behaviour; not overselling vaccination; and avoiding personal attacks. 2012-05-01T00:00:00Z http://hdl.handle.net/2123/8339 Title: Handbook for Aboriginal Alcohol and Drug Work Authors: Lee, Kylie; Freeburn, Bradley; Ella, Steve; Miller, Warren; Perry, Jimmy; Conigrave, Kate Abstract: The Handbook for Aboriginal Alcohol and Drug Work is a practical tool written for Aboriginal drug and alcohol workers, mental health workers and others working in this field. It offers a detailed look at alcohol and drug work from clinical, through to prevention, early intervention and harm reduction. This handbook is also likely to help people working to improve policy and those advocating for change. The idea for it came from workers all over Australia. They told us that they needed an easy to use handbook that can help them respond to the range of alcohol and drug issues they face every day. They also told us that such a book needs to take into account the complex challenges facing workers when helping clients, their families and, sometimes, whole communities. 2012-01-01T00:00:00Z http://hdl.handle.net/2123/7296 Title: Pathology, professionalism, portfolios and progress Authors: Pryor, Wendy Abstract: Abstract Community-driven standards of professionalism must be addressed, worldwide, at all levels of medical education. The imperative to implement robust strategies to ensure that doctors embrace these standards to justify the autonomy afforded to the medical profession has been a key concern of specialist medical colleges in recent years. Pathologists face unique challenges. Rapid technological change and increasing commercialisation have distanced them further than ever before from patients and other clinicians, resulting in negative stereotypes that impede understanding of professional roles that may have adverse consequences for interdisciplinary communication and patient care. This study explores the socio-cultural and educational factors impacting on the development of professional identity in pathology specialist training in Australia and New Zealand, with the aim of recommending an educational model for the attainment of professionalism. Theories of social identity and education relating to self-regulated and situated learning informed the study and model. Textual data from interviews, surveys and discussions were captured over the course of a professional, college-led intervention that included a new curriculum addressing standards of professionalism in pathology, and an associated portfolio designed as a formative assessment tool. Based on these texts, hermeneutic phenomenological strategies were used to explore the experiences of pathology trainees, their supervisors, educators and clinicians. A pathologist’s professional identity is a self-constructed schema involving value orientations and commitment to goals that reflect beliefs about what it means to be a good pathologist. For many, these values do not correspond to the ideals of professionalism constructed by the community at large. In the face of many social and political pressures, pathologists have developed an identity that conforms to a stereotype in which technical knowledge and skills are strong values that may be detached from the need for competence in the broader, non-technical areas. This identity may be partly founded in career selection, but is perpetuated through interdisciplinary discourse, internalisation, role modelling, work practice and a curriculum and assessment structure that de-emphasises non-technical roles. Trainees are strongly influenced by the values displayed and feedback provided by supervisors who themselves may be subject to the influences of a negative culture. Conflicts between goals and values in technical and non-technical aspects of training can be de-motivating and may constrain the development of a reflective identity that embraces professionalism. Whilst competency-based frameworks such as CanMEDS have been invaluable in drawing attention to the place of non-technical competencies in formal curricula, they do not necessarily take account of the complex and powerful hidden curriculum that lies behind the formal curriculum and exists at the level of role-modelling, stereotyping, work practice and institutional policies. Developing a model of professionalism fit for the purpose of pathology training has involved deconstruction of the CanMEDS model and self-regulated learning processes to carefully examine their parts. The new model reassembles these elements in the situated learning environment and broader cultural and organisational structures applying to pathology. It emphasises alignment of goals, values and processes at all levels of the curriculum, both formal and hidden. The curriculum should integrate and operationalise technical and non-technical competencies with concretely-defined outcomes that are meaningful in the context of pathologists’ roles. Learning portfolios should be simple and flexible, requiring of more than tick-boxes to facilitate reflection. Formative assessment and guided self-assessment from supervisors are critical for the trainee to identify learning needs and to support development of capacity for self-regulation. Onerous formal assessments that devalue professionalism should be reviewed. The College and training institutions must demonstrate commitment to professional values through policy and provision of resources. The approach in this study, which strongly links professional identity development to the attainment of professionalism in medical specialty training, has implications for educators in understanding the many social and educational factors that must be considered in developing curricula for medical professionalism relevant to other disciplines and settings. Description: Doctor of Philosophy (PhD) 2010-01-01T00:00:00Z