Changing parental behaviour to reduce risky drinking among adolescents: current evidence and future directions

Aims: Risky drinking among young people is an issue of public concern globally. In Australia and elsewhere, there has been a steady increase in alcohol-related harms among young people in recent years. The aims of this study were to review the nature of parental supply of alcohol to adolescents aged 13–17 years, explore parental social networks as a potential avenue for intervention, and propose future directions for research with a view to informing public policy and the development of interventions to reduce risky drinking. Methods: Narrative review. Results: While a large literature exists concerning parental influence on children's drinking, exploration of the volume of alcohol and context of parental supply is lacking. Results from cross-sectional and longitudinal studies on the impact of parental factors such as monitoring, rule setting, alcohol supply and supervision of drinking present an unclear picture. Consequently, translation of research findings into advice for parents is problematic. Conclusion: We propose that future research seeks to (a) gain a better understanding of the volume and contexts of parental supply of alcohol, (b) explore the structure of social networks among adolescents and their parents, (c) determine the accuracy of parents' perceptions of other parents' behaviours and beliefs, (d) develop an analytic approach for quantifying aspects of parental networks and (e) evaluate low-intensity parental interventions including web programmes

Extradural haemorrhage: strategies for management in remote places

A study of 109 cases of extradural haemorrhage (EDH) treated in South Australia over a period of 7 years showed that 35 cases (32.1 per cent) presented in country areas at considerable distances from a neurosurgical service: the mortality in these country cases was 22.9 per cent, comparing unfavourably with a mortality of 12.2 per cent in metropolitan cases. The country series contained a disproportionately large number of cases with multiple intracranial haemorrhages, which are known to have a poorer outcome; when these cases were excluded, the rural mortality (12.5 per cent) was only a little over the metropolitan mortality (9.7 per cent). These data suggest that it is possible to manage extradural haemorrhages successfully even in places remote from a neurosurgical centre, if communications and air transport are used effectively. However, it was found that emergency operations carried out in country hospitals were sometimes inadequate or done too late. Medical retrieval teams based on city hospitals were sent out on 15 occasions, either to assist a general surgeon to complete an emergency operation, or to provide intensive care during transfer to a neurosurgical unit. Osmotherapy (mannitol and/or frusemide) has been useful in gaining time for transfer; the choice between immediate operation and transfer may be difficult, and decisions should take transfer time, clinical state and rate of deterioration into account.D. A. Simpson, J. S. Heyworth, A. J. McLean, J. E. Gilligan and J. B. Northhttp://www.elsevier.com/wps/find/journaldescription.cws_home/30428/description#descriptio

PRIME: a programme to reduce the treatment gap for mental disorders in five low- and middle-income countries

The majority of people living with mental disorders in low- and middle-income countries do not receive the treatment that they need. There is an emerging evidence base for cost-effective interventions, but little is known about how these interventions can be delivered in routine primary and maternal health care settings. The aim of the Programme for Improving Mental Health Care (PRIME) is to generate evidence on the implementation and scaling up of integrated packages of care for priority mental disorders in primary and maternal health care contexts in Ethiopia, India, Nepal, South Africa, and Uganda. PRIME is working initially in one district or sub-district in each country, and integrating mental health into primary care at three levels of the health system: the health care organisation, the health facility, and the community. The programme is utilising the UK Medical Research Council complex interventions framework and the “theory of change” approach, incorporating a variety of qualitative and quantitative methods to evaluate the acceptability, feasibility, and impact of these packages. PRIME includes a strong emphasis on capacity building and the translation of research findings into policy and practice, with a view to reducing inequities and meeting the needs of vulnerable populations, particularly women and people living in poverty

Civility, gender and the law: critical reflections on the judgments in Monis v The Queen

Law sets the bounds of civility within any given society. Setting those bounds so as to reflect evolving community expectations and understandings requires frank, open and inclusive discussion. Through an analysis of the male and female judgments in the recent High Court decision of Monis v The Queen (2013) 249 CLR 92, this article exposes a worrying, uncritical endorsement of incivility in public and political discourse that may undermine the inclusivity and therefore value of this discussion. The case provides an opportunity for reflection on the nature of political discourse within the Australian system and more particularly on the role of gender in setting the standards of that discourse.Gabrielle Appleby & Ngaire Naffin