The Neighbourhood Improvement Program, 1973-1983 : a national review of an intergovernmental initiative

vi, 95 p

Community economic development : an approach for urban-based economies

vi, 203 p

Remote medico-legal assessment by telephone during COVID-19: Monitoring safety and quality when documenting evidence of torture for UK asylum applicants

Due to the Covid-19 pandemic, we developed remote assessment to provide interim medicolegal reports, ensuring people could obtain medical evidence to support their asylum claim. The Freedom from Torture research ethics committee approved the project. To audit this new way of working we collected feedback from the doctors, interpreters, individuals being assessed, and senior medical and legal staff who reviewed the reports. This paper presents findings from the first 20 assessments. Individuals reported that the doctors developed good rapport, but in 35% of assessments reported that there were some experiences they felt unable to disclose. In 70% of assessments, doctors felt that rapport was not as good as when face-to-face. In a majority of assessments the doctor was unable to gain a full account of the torture or its impact. Doctors reported feeling cautious about pressing for more information on the telephone, mindful of individuals’ vulnerability and the difficulty of providing support remotely. Nevertheless, in 85% of assessments doctors felt able to assess the consistency of the account of torture that was given with the psychological findings, in accordance with the Istanbul Protocol. The surveys indicated factors that hindered the assessment: inability to observe body language, the person’s ill health, and confidentiality concerns.  The limitations of these assessments underline the need for a follow-up face-to-face assessment to expand the psychological assessment and undertake a physical assessment. This research indicates that psychological medico-legal reports can safely be produced by telephone assessment, but are more likely to be incomplete in terms of both full disclosure of torture experiences and psychological assessment

Acceptance and Continuance Usage Intention of Mixed Reality for Australian Healthcare Interprofessional Education

Virtual-Reality and augmented-reality are becoming innovative teaching and learning approaches across many industries, including healthcare, especially during the COVID-19 pandemic. However, the adoption rate of this technology is very low, especially in Australian healthcare Interprofessional Education. This study investigates factors influencing adoption and use of mixed-reality technology for Australian healthcare IPE. In this study, a theoretical model based on the Expectation and Confirmation Model and Task Technology Fit is developed and will be tested to determine Australian healthcare professionals’ intentions to continue using mixed-reality for Interprofessional Education through three validated surveys using a voluntary non-probability sampling strategy, over a 10-week period, targeting 124 healthcare professionals at the Tweed hospital, NSW Australia. The research outcome will assist in determining the validity of the proposed hybrid model in the context of MR healthcare training. It may assist in developing a more suitable theoretical framework and future characteristics of MR for healthcare training

An innovative approach to improve ear, nose and throat surgical access for remote living Cape York Indigenous children

Introduction: On a background of high rates of severe otitis media (OM) with associated hearing loss, children from the Torres Strait and Cape York region requiring ear, nose and throat (ENT) surgery, faced waiting times exceeding three years. After numerous clinical safety incidents were raised, indicating a failure of the current system to deliver appropriate care, the governing Hospital and Health service opted to deliver surgical care through an alternate process. ENT surgeries were performed on 16 consented children from two remote locations via the private health care system, funded by a health provider partnership. Methods: We examined the collaboration processes alongside clinical findings from this ENT surgery. Collated patient data, included patient demographics, clinical and audiometry presentation features were reviewed and compared pre and post-operatively. Cost savings associated with the use of TeleHealth post-operatively were briefly examined. Results: Surgeries were successfully completed in all 16 children. The reported mean waitlist time for ENT surgery was 1.2 years. Pre-surgery pure-tone average hearing thresholds were reported at left: 30.9 dB, right: 38.2 dB. The majority of presentations were for bilateral OM with Effusion (69%). Post-surgical follow up indicated successful clinical outcomes in 80% of patients and successful hearing outcomes in 88% of patients. Mean difference pure-tone average hearing thresholds, left: 8.4 dB and right: 11.2 dB. Furthermore, the majority of patients reported improved hearing and breathing. The use of TeleHealth for post-operative review enabled a minimum cost saving of AUD$21,664 for these 16 children. Overall, a high level of staffing resources was required to successfully coordinate this intense surgical activity. Conclusion: This innovative approach to a health system crisis enabled successful ENT surgical and hearing outcomes in 16 children, whose waitlisted time grossly exceeded state health recommendations. Using private health facilities funded by a health partnership, while unlikely to be a suitable model of care for routine service delivery; may be applied as an adjunct service model when blockages and delays lead to sub-standard service provision. This approach may be applicable to other health care facilities when facing extended elective surgery wait times in ENT or other specialty areas

GPs understanding of how depression affects gay and HIV positive men

In contrast to the broad literature on depression in the general population, little is known about the management of depression affecting gay men and HIV-positive men attending general practice clinics. GPs identified a range of features in their experience of managing depression in gay men and in HIV-positive men. Some were common to the care of other groups with depression, but this paper reports on features unique to this patient group. These include capitalizing on the high frequency of contact with this patient group, taking advantage of the specialist multidisciplinary teams who provide support, building upon the unusual willingness of this patient group to take medication, appreciating the central importance to many gay men of sexual functioning, and recreational drug use, responding to social isolation in this patient group and coping with increasing challenges for the HIV general practice workforce

Active ageing and employment in rural SA: a Health in All Policies project

The South Australian (SA) Health in All Policies (HiAP) initiative provides a framework and mandate for intersectoral policy work on the social determinants of health. Participation in decent and meaningful employment is a key social determinant of health, and is also an important strategy to promote ‘active ageing’ in the population. This paper reports on an intersectoral project undertaken by the Health In All Policies Unit and Country Health SA Local Health Network (CHSA LHN) in collaboration with Flinders University’s SA Community Health Research Unit and Southgate Institute for Health Society & Equity. The project Active Ageing and Employment in Regional South Australia aims to identify policy levers to increase the workforce retention and re-entry for rural people aged 45+. The project is designed to do this by building the capacity of the regional health workforce to address the social determinants of health in collaboration with agencies outside of the health system. The project partners have adopted a ‘learning by doing’ strategy with the focus on employment and ageing

Prevalence of and Barriers to Dual-Contraceptive Methods Use among Married Men and Women Living with HIV in India

Objective. To describe the prevalence and correlates of dual-contraceptive methods use (condoms and an effective pregnancy prevention method) and barriers to their use among married persons living with HIV (PLHIV) in India. Methods. We conducted a quantitative survey (93 men, 97 women), 25 in-depth interviews, seven focus groups, and five key informant interviews. Results. Prevalence of dual- contraceptive method use increased from 5% before HIV diagnosis to 23% after diagnosis (P < 0.001). Condoms were the most common contraceptive method, with prevalence increasing from 13% before diagnosis to 92% after diagnosis (P < 0.001). Barriers to using noncondom contraceptives were lack of discussion about noncondom contraceptives by health care providers, lack of acceptability of noncondom contraceptives among PLHIV, and lack of involvement of husbands in family planning counseling. Conclusion. There is a need for interventions, including training of health care providers, to increase dual-contraceptive methods use among married PLHIV

Subclinical infection of macaques and baboons with a baboon simarterivirus

Simarteriviruses (Arteriviridae: Simarterivirinae) are commonly found at high titers in the blood of African monkeys but do not cause overt disease in these hosts. In contrast, simarteriviruses cause severe disease in Asian macaques upon accidental or experimental transmission. Here, we sought to better understand the host-dependent drivers of simarterivirus pathogenesis by infecting olive baboons (n = 4) and rhesus monkeys (n = 4) with the simarterivirus Southwest baboon virus 1 (SWBV-1). Surprisingly, none of the animals in our study showed signs of disease following SWBV-1 inoculation. Three animals (two rhesus monkeys and one olive baboon) became infected and sustained high levels of SWBV-1 viremia for the duration of the study. The course of SWBV-1 infection was highly predictable: plasma viremia peaked between 1 × 107 and 1 × 108 vRNA copies/mL at 3–10 days post-inoculation, which was followed by a relative nadir and then establishment of a stable set-point between 1 × 106 and 1 × 107 vRNA copies/mL for the remainder of the study (56 days). We characterized cellular and antibody responses to SWBV-1 infection in these animals, demonstrating that macaques and baboons mount similar responses to SWBV-1 infection, yet these responses are ineffective at clearing SWBV-1 infection. SWBV-1 sequencing revealed the accumulation of non-synonymous mutations in a region of the genome that corresponds to an immunodominant epitope in the simarterivirus major envelope glycoprotein GP5, which likely contribute to viral persistence by enabling escape from host antibodies