36426650
Development of the Australian Society of Forensic Odontology disaster victim identification forensic odontology guide.
The need for documented procedures and protocols are important in every specialist group to ensure a consistent service to the community. They provide guidance to members of the specialist group about responsibilities and appropriate practices, and confidence to the community that the services are of the highest possible standard. In a Disaster Victim Identification (DVI) incident, by enabling the process to be audited, they also serve to ensure that identifications are reliable. Following the Bali Bombings of 2002 and the 2004 Asian Tsunami the Australian Society of Forensic Odontology recognised the need for a practice guide to assist the management of their members in DVI incidents. 31 members of the Australian Society of Forensic Odontology participated in the development of a guideline document for Disaster Victim Identification using a Delphi based model. The advantage of using the iterative Delphi process is that it encouraged participants to think about the processes used in the forensic odontology aspects of a DVI incident and their expectations of a guiding document. The document developed as a result of this project is comprehensive in coverage and places the Australian Society of Forensic Odontology at the vanguard of professionalism in the forensic odontology and DVI community.
20106361
A brief history of forensic odontology and disaster victim identification practices in Australia.
Today we consider forensic odontology to be a specialised and reliable method of identification of the deceased, particularly in multiple fatality incidents. While this reputation has been gained from the application of forensic odontology in both single identification and disaster situations over a number of years, the professional nature of the discipline and its practices have evolved only recently. This paper summarises some of early uses of forensic odontology internationally and in Australia and discusses the development of both forensic odontology and Disaster Victim Identification (DVI) practices in each of the states and territories of Australia. The earliest accounts of the use of forensic odontology in Australia date to the 1920's and 30's, and were characterised by inexperienced practitioners and little procedural formality. An organised and semi-formal service commenced in most states during the 1960's although its use by police forces was spasmodic. Today the service provided by qualified and experienced forensic odontologists is highly professional and regularly utilised by police and coronial services. The development of DVI Practices in Australia began following the crash of a Vickers Viscount aircraft into Botany Bay in 1961 and, as with practices internationally, have evolved into an equally professional and reliable specialist discipline of policing in which forensic odontology plays a significant part.
22359555
Dental hygiene student experiences in external placements in Australia.
While placements in external locations are being increasingly used in dental education globally, few studies have explored the student learning experience at such placements. The purpose of this study was to investigate student experiences while on external placement in a baccalaureate dental hygiene program. A self-reporting questionnaire was distributed to final-year dental hygiene students (n=77) at the University of Newcastle, Australia, in 2010. The questionnaire included questions regarding the type of placement, experiences offered, supervision, resources available, and lasting impressions. Responding students were generally positive about their external placement experience and indicated that the majority of facilities provided them with the opportunity to provide direct patient care and perform clinical tasks typical of a practicing hygienist. However, there was a statistically significant difference in their opinions about discipline-focused and community placements. Students indicated that their external placement experience provided opportunities to learn more about time and patient management, including hands-on experience with specific clinical tasks. Ongoing evaluations are necessary to ensure that external placements meet both student needs and intended learning outcomes within dental hygiene programs.
20101328
Community participation in organising rural general practice: is it sustainable?
OBJECTIVE
We analysed community participation in organising rural general medical practice in order to suggest ways to extend and sustain it.


DESIGN
A multisite, embedded case-study design collecting data through semistructured interviews, non-participation observation and a document analysis.


SETTING
One remote and two rural communities in Australia.


PARTICIPANTS
Community members, GPs, health professionals, government officers and rural medical workforce consultants.


RESULTS
High levels of community participation in recruiting and retaining GPs, organising the business model, and contributing to practice infrastructure were evident. Community participation in designing health care was uncommon. Participation was primarily to ensure viable general practice services necessary to strengthen the social and economic fabric of the community. There were factors about the decision-making and partnership processes in each of the communities that threatened the viability of community participation.


CONCLUSIONS
We recommend that a concept of community development and explicit facilitation of the processes involved is necessary to strengthen participation, create effective partnerships and ensure inclusive decision-making.
42040828
The Station Community Mental Health Centre Inc: nurturing and empowering.
INTRODUCTION
Consumer-driven community mental health services play an important role in rehabilitation, recovery, and advocacy in rural and remote Australia. The origins of services often lie in the need to provide options for people with mental illness and their carers when there is a lack of on-the-ground support. This article adds to the information about the strengths and limitations of consumer-driven mental health services by presenting the findings of an evaluation of The Station Inc. in rural South Australia. This consumer-driven mental health service provides a safe and supportive environment, social connections, and activities for its members (those with a lived experience of mental illness). Using a realist evaluation approach, the evaluation identified the contextual factors and the program mechanisms that produce positive outcomes for members.


METHOD
The evaluation was conducted as participatory action research with The Station members, volunteers, management committee members, and staff involved in all phases of the research process. Because of the complexity of The Station's functioning a realist evaluation using qualitative data was conducted to identify how the program worked, for whom, and in what circumstances. Twenty-five in-depth interviews were conducted with participants who were randomly selected from within the groups identified above. Interviews focused on The Station's role in assisting recovery from mental illness, the limitations and strengths of the program, and relationships with the mental health system. The Station's goals, policies and procedures, and the role of stakeholders were analysed in order to identify any links among these contextual factors, program mechanisms, and program outcomes. Qualitative data were entered into descriptive categories in N6 software (QSR; www.qsr.international.com). Data from the stakeholder analysis were entered into Microsoft Excel. Using an iterative approach to include the three data sets, a model was developed that identified important contextual factors that linked with two groups of program mechanisms that produced positive outcomes for members.


RESULTS
Program mechanisms are categorised by descriptive themes referred to as 'nurturing' and 'empowering'. Nurturing' is experienced as feeling of belonging and being accepted 'as one is' and 'empowerment' mechanisms engender a belief in oneself. Respondents identified features of The Station's program, policies, atmosphere, connections and networks, stakeholder relationships, and staff and volunteers that are nurturing and empowering. Five key contextual factors enable the program mechanisms to work. The Station's coordinators ensure that nurturing and empowerment processes are highlighted through careful facilitation. The governance arrangements, policies, and administrative systems at The Station are well developed but flexibly implemented so that they support the nurturing and empowerment processes. Support and legitimacy for the program is obtained from the mental health system at state and local levels. The Station obtains resources and connections to its rural community through key stakeholders and a peak organisation One Voice Network acts as an advocate.


CONCLUSIONS
Information about the benefits and limitations of consumer-driven mental health services in rural and remote Australia is in short supply. Increasing the available information about the contribution these services make may result in services being legitimised, understood, and resourced within mental health systems thus making the services sustainable. The benefits of consumer-driven services are that they provide flexibility and adaptation, an ability to capture the energy and passion of rural communities to improve the wellbeing of community members, and they overcome the power differential that exists between professionals and 'patients' or 'clients'.
24886138
Comparison and characteristics of motor vehicle accident (MVA) and non-MVA driving fears.
Prior research has revealed the diagnostic complexity among people who report driving fears. However, the focus on survivors of motor vehicle accidents (MVAs) and diagnostic samples may have inadvertently led to a relative neglect of the broader driving-fearful population. No studies could be located that compared MVA survivors with those who had not experienced an MVA. The aim of the present study was to address these deficits by comparing the characteristics of MVA and non-MVA driving-fearfuls and also exploring a range of characteristics associated with driving fears. One hundred and ninety media-recruited driving-fearfuls completed a questionnaire that assessed severity of anxiety and avoidance associated with a variety of driving situations. It was found that fear levels were similar to samples of driving phobics and MVA victims. There were no significant differences between MVA and non-MVA respondents on various measures of fear severity. In addition, the sample rated a high level of anxiety when driving with someone who criticizes their driving. Implications of the findings are discussed, along with suggestions for assessment and treatment of those with driving-related fears.
21804822
Protein biofortified sorghum: effect of processing into traditional african foods on their protein quality.
Protein biofortification into crops is a means to combat childhood protein-energy malnutrition (PEM) in developing countries, by increasing the bioavailability of protein in staple plant foods and ensuring sustainability of the crop. Protein biofortification of sorghum has been achieved by both chemically induced mutation and genetic engineering. For this biofortification to be effective, the improved protein quality in the grain must be retained when it is processed into staple African foods. Suppression of kafirin synthesis by genetic engineering appeared to be superior to improved protein digestibility by chemical mutagenesis, because both the lysine content and protein digestibility were substantially improved and maintained in a range of African foods. For the genetically engineered sorghums, the protein digestibility corrected amino acid score was almost twice that of their null controls and considerably higher than the high protein digestibility sorghum type. Such protein biofortified sorghum has considerable potential to alleviate PEM.
14002416
Strong and weak male mutation bias at different sites in the primate genomes: insights from the human-chimpanzee comparison.
Male mutation bias is a higher mutation rate in males than in females thought to result from the greater number of germ line cell divisions in males. If errors in DNA replication cause most mutations, then the magnitude of male mutation bias, measured as the male-to-female mutation rate ratio (alpha), should reflect the relative excess of male versus female germ line cell divisions. Evolutionary rates averaged among all sites in a sequence and compared between mammalian sex chromosomes were shown to be indeed higher in males than in females. However, it is presently unknown whether individual classes of substitutions exhibit such bias. To address this issue, we investigated male mutation bias separately at non-CpG and CpG sites using human-chimpanzee whole-genome alignments. We observed strong male mutation bias at non-CpG sites: alpha in the X-autosome comparison was approximately 6-7, which was similar to the male-to-female ratio in the number of germ line cell divisions. In contrast, mutations at CpG sites exhibited weak male mutation bias: alpha in the X-autosome comparison was only approximately 2-3. This is consistent with the methylation-induced and replication-independent mechanism of CpG transitions, which constitute the majority of mutations at CpG sites. Interestingly, our study also indicated weak male mutation bias for transversions at CpG sites, implying a spontaneous mechanism largely not associated with replication. Male mutation bias was equally strong at CpG and non-CpG sites located within unmethylated "CpG islands," suggesting the replication-dependent origin of these mutations. Thus, we found that the strength of male mutation bias is nonuniform in the primate genomes. Importantly, we discovered that male mutation bias depends on the proportion of CpG sites in the loci compared. This might explain the differences in the magnitude of primate male mutation bias observed among studies.