More than mateship: exploring how Australian male expatriates, longer-term and frequent travellers experience social support.

PURPOSE: Those travelling overseas for work or leisure including male expatriates, longer-term and frequent travellers (ELoFTs) may be at heightened risk for a range of health and wellbeing issues. Social support may mediate this risk. However, from a public health perspective, little is written about how ELoFTs access health information and support and the role of their social networks in facilitating health and wellbeing outcomes. This research was part of a study examining social network processes of Australian male ELoFTs travelling, living, or working in Southeast Asia (SEA). METHODS: Symbolic Interactionism and Grounded Theory were the conceptual framework and methodology supporting semi-structured, in-depth interviews (n = 25) conducted in Australia and Thailand with Australian male ELoFTs to SEA, aged 18 years or older. RESULTS: Findings highlight supports that assist ELoFT transition and adjustment to country of destination or manage their transnational experience. Influential places, people, and points in the migration journey mediated engagement with social support. CONCLUSIONS: ELoFT social networks and the support provided within them may provide a mechanism for intervention across a range of public health issues. Findings may support the development of policy and practice across industries charged with supporting successful ELoFT adjustment.

The influence of population mobility on changing patterns of HIV acquisition: lessons for and from Australia.

Investment, bipartisan support and involvement from affected communities have characterised Australia's HIV response, and helped maintain a low prevalence epidemic. Patterns of HIV acquisition are changing, with an increasing number of infections acquired overseas by migrant and mobile populations. A coordinated national response is required to address HIV acquisition in the context of population mobility.

Ethical considerations in investigating youth alcohol norms and behaviours: a case for mature minor consent.

Mature minor consent only became available in Australia in 2007. There is neither an explicitly defined protocol, nor a clear definition evident in the literature relating to use of the mature minor concept in health research. Due to difficulties in defining fixed age ranges to varying levels of maturity and vulnerability, there is a lack of clarity surrounding when it might be reasonable and ethical to apply for or grant a waiver for parental consent. This paper describes the challenges faced and solutions created when gaining approval for use of mature minor consent in a respondent-driven sampling (RDS) study to explore the social norms and alcohol consumption among 14-17-year-old adolescents (n = 1012) in the community. The University's Human Research Ethics Committee granted mature minor consent for this study, and the techniques applied enabled recruitment of adolescents from community-based settings through use of RDS to achieve the required sample. This paper has relevance for research that requires a waiver for parental consent; it presents a case study for assessing mature minors and makes recommendations on how ethical guidelines can be improved to assist human research ethics application processes.

The acceptability of different HIV testing approaches: cross-sectional study among GMSM in Australia.

BACKGROUND: We explored the attitudes of Australian gay and other men who have sex with men (GMSM) about the current standard-of-care (non-rapid tests at healthcare settings) and alternative approaches (rapid tests and testing in non-healthcare settings) to better understand the acceptability of alternative testing approaches. METHODS: The Contemporary Norms in Networks and Communities of GMSM study enrolled GMSM in Sydney, Melbourne and Perth in 2011-2012 using peer referrals. We explored the self-reported preferences for testing: rapid versus non-rapid and in non-healthcare settings (community-based or home-based testing) versus in healthcare settings, and examined factors associated with preferences for these approaches. Analyses of associations used standard univariate and age-adjusted logistic regression models. RESULTS: Among 827 sexually active non-HIV-positive participants, 89% had been tested for HIV. Most preferred by participants was home rapid testing (46%), followed by standard-of-care (23%) and rapid testing in healthcare (20%) or community settings (7%). About 73% of participants preferred rapid over non-rapid testing, and 56% preferred testing in non-healthcare settings rather than in healthcare settings. Preference for rapid testing was associated with being fully employed (adjusted OR (aOR): 1.81; 95% CI 1.16 to 2.82), managerial/professional occupation (aOR: 2.03; 95% CI 1.19 to 3.46) and engaging in unprotected anal intercourse with casual partners (aOR: 1.89; 95% CI 1.29 to 2.78). The same factors were associated with preference for testing in non-healthcare settings. CONCLUSIONS: Australian GMSM prefer alternative testing approaches, possibly due to their convenience. The availability of new testing approaches may provide more options for GMSM at risk for HIV infection, improve access to HIV testing and potentially increase HIV testing rates.

Academic and personal problems among Australian university students who drink at hazardous levels: web-based survey.

ISSUE ADDRESSED: Australian university students consume large amounts of alcohol. There is little published information about personal and academic problems associated with this behaviour. We sought to estimate the prevalence, and identify variables associated with, alcohol-related problems among undergraduate hazardous drinkers. METHODS: The control group members (942 undergraduates, 53.3% male, mean age 19.4 years) of an internet-based intervention trial, who scored ≥8 on the Alcohol Use Disorders Identification Test, completed two validated questionnaires about their experience of alcohol-related problems in the preceding 4 weeks. Regression models were used to identify associations between individual characteristics and alcohol-related problems. RESULTS: One-quarter of participants had missed a class (25.6%) and/or had been unable to concentrate in class (25.7%), and 45% reported that their drinking had impacted negatively on their learning or grades. The most frequent non-academic problems were hangovers (74.8%), blackouts (44.8%), emotional outbursts (30.5%), vomiting (28.1%), arguments (20.2%) and drink-driving (23.2%). Male gender, lower age, being a smoker, being in the Faculty of Health (versus Humanities) and living in shared housing (versus with parents/guardians) were each associated with alcohol-related problems, whereas year of study had no association. CONCLUSIONS: There is a high prevalence of preventable alcohol-related problems among undergraduates drinking at hazardous levels and a need for restriction of the availability and promotion of alcohol as well as intervention for individuals at high risk. SO WHAT?: Universities have a duty of care to large populations of young people drinking at hazardous levels and should make greater efforts to address hazardous alcohol consumption.

Risk assessment of dietary exposure to methylmercury in fish in the UK.

Risk assessment of chemicals in food is generally based upon the results of toxicological studies in laboratory animals, allowing for uncertainties relating to interspecies differences, human variability, and gaps in the database. Use of quantitative human data is preferable if available, as in the example of methylmercury. Methylmercury is a neurotoxic environmental contaminant, for which fish is the main source of dietary exposure. Human data from poisoning incidents and epidemiological studies have been used by expert committees to derive a guideline intake level for methylmercury, based on the susceptibility of the most sensitive lifestage, the developing fetus. In the UK, an expert group of nutritionists and toxicologists was formed to review the benefits and risks associated with fish consumption. A formal risk-benefit analysis was not possible because the nutritional data were not sufficiently quantitative. The Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment (COT), therefore, modified the risk assessment approach to derive different guideline intake levels for different subgroups of the population. The COT opinion was used to provide targeted advice on how much fish can be consumed without undue risk from the contaminants. Consumption by adults of one weekly portion (140 g) of shark, swordfish or marlin, would lead to an exceedance of the guideline intake for methylmercury of 40-90%, set to protect the developing fetus, without considering intake from the rest of the diet. Pregnant women and women who may become pregnant within 1 year were, therefore, advised to avoid consumption of these species. Intakes in other adults would be within a higher guideline intake, set to protect groups of the population other than the developing fetus. However, consumption by children of one weekly portion of these species could lead to an exceedance of this guideline intake by up to 60%, without considering intake from the rest of the diet. It was, therefore, advised that consumption of these species by children should be avoided.

Sex in two cities--gay men, risk and HIV in Perth and Sydney.

After massive and sustained reductions in HIV risk behaviour amongst Australian gay men in the 1980's and early 1990's, since 1996 there have been signs of small but significant increases in unprotected analintercourse. Gay communities are responding to a post crisis context. However, is this response constant across different locations? This paper investigates changes in sexual negotiation and behaviour amongst gay men in the relatively small Australian city of Perth between 1998 and 2002 and compares these results to similar studies in Sydney, an Australian HIV epicentre city. A number of important similarities and differences between the Perth and Sydney samples are identified, particularly in casual contexts and disclosure of HIV status, identifying that isolated or smaller cities may experience similar phenomena to larger cities, but these may be due to different reasons. The findings point to the need for complementary qualitative research and cautions health promotion practitioners to test their assumptions when developing responses to prevent HIV transmission.

Training patterns and sports injuries in triathletes.

Sports-related injuries are a significant health problem within Australia, and constitute a national health priority. There is limited Australian research data available on factors that contribute to triathlon injuries, and in particular on how training patterns relate to injury risk. This study examined the association between training patterns and injury in mostly non-elite triathletes. A cross-sectional survey of 258 triathletes completed a questionnaire that focused on injuries they had sustained during the previous three triathlon seasons. Statistical associations were found between hours of training and sustaining an injury. These associations were U shaped, with those triathletes training at low levels and at high levels more likely to sustain an injury. The results suggest that, for non-elite triathletes, the likelihood of sustaining an injury is least when training for a total of 8 to 10 hrs per week, specifically cycling for five to six hrs and running for three to four hrs weekly. Time spent on swimming training does not appear to affect injury risk. This research is seen as a contribution towards assisting triathletes in the planning of training programs aimed at reducing the risk of injury.

A decision-making model for health promotion advocacy: the case for advocacy of drunk driving control measures.

This paper presents a decision-making model which can help public health professionals justify their decision to advocate for a particular intervention. The model is demonstrated by a case study related to advocacy of Random Breath Testing (RBT). For the purpose of this paper advocacy is a "catch-all word for the set of skills used to create a shift in public opinion and mobilise the necessary resources and forces to support an issue, policy, or constituency..." (Wallack, Dorfman, Jernigan & Themba, 1994).

'Weddings, parties, anythingellipsis', a qualitative analysis of ecstasy use in Perth, Western Australia.

This study investigates the patterns of use, the meanings associated with use, the perception of risk and the strategies adopted to reduce these risks for a sample of ecstasy users in Perth, Western Australia. The sample was purposively chosen to represent the heterogeneous nature of ecstasy users in Perth. Data were collected from 31 ecstasy users and 157 h of participant observation in a variety of settings. The study found that users exhibited a reasonable degree of control over their consumption, incorporating a series of risk reduction strategies. Application of these strategies was inconsistent, with a large percentage of the sample indulging in occasional binges, spontaneous purchases, polydrug use and purchasing from unknown individuals in clubs/pubs. As users became more experienced, they tended to become less concerned about the risks associated with use and exhibited greater risk taking behaviour. Understanding the beliefs and events that influence the adoption (or non-adoption) of harm reduction strategies and the heterogeneous nature of ecstasy users is important for future health promotion interventions and policy.

Current perspectives on anabolic steroids.

Steroids are used outside the realm of competitive athletics in Australia among a wide variety of groups with different motivations and goals. This paper provides an overview of the reasons for use; rates of usage; physical and psychological side effects; and sources of steroids. Issues associated with injecting steroids; their current legal status; and drug education and prevention programmes are reviewed briefly. Research involving identified sub-populations is needed to determine user profiles and prevalence rates of users and potential users. Studies of Australian users are also needed to obtain baseline information on areas of potential harm associated with steroids use, e.g. aggressive behaviour, needle-sharing behaviour, physical side effects and potential for dependency. It is concluded that future deterrence strategies should focus more on demand reduction, rather than supply.

Restraint, disinhibition, hunger and negative affect eating.

The Three-Factor Eating Questionnaire (Stunkard & Messick, 1985) contains factors measuring dietary restraint, disinhibition, and hunger. In this study, the ability of these factors to predict eating responses to negative affect was tested. The Velten mood induction procedure was used to produce neutral or depressed moods in normal weight college students. Subjects were encouraged to sample candy which was made available during the mood induction procedure. The results indicated that the Hunger factor was the only significant predictor of negative affect eating. Depressed, high-hunger subjects were more likely to eat than subjects in other conditions and, in on of two analyses of amount of candy consumed, were found to eat the most candy as well. The possibility that these results could be explained by an overlap between the Hunger factor and the construct of external responsiveness was considered. Implications of the overall findings for theories of emotional eating were briefly discussed.