Alcohol consumption and intoxication among people involved in police-recorded incidents of violence and disorder in non-metropolitan New South Wales.

OBJECTIVE: To describe, based on routinely recorded police data, the prevalence and characteristics of alcohol consumption among people involved in violence and disorder incidents in non-metropolitan New South Wales (NSW). METHODS: A descriptive analysis was conducted of people involved in violence and disorder incidents over 24 months (2003-05) across 21 non-metropolitan police commands. The prevalence of alcohol involvement was reported as: the annual population rate of people involved in incidents who had consumed alcohol; the proportion of people involved in such incidents who had consumed alcohol; and the proportion of such people who were intoxicated. Variation in alcohol involvement was described by: geographic area; day of week; time of day; and location alcohol was last consumed. RESULTS: Annually, one in 118 people in the population consumed alcohol prior to involvement in a violence incident, and one in 476 people did so prior to a disorder incident. At least 71% of such people were intoxicated. Late Saturday evening was the peak time for alcohol involvement. Prior drinking in private residences and licensed premises was associated with violence and disorder incidents (respectively). The prevalence of alcohol consumption rose with increased geographic remoteness. All characteristics displayed geographic variation. CONCLUSIONS: The high prevalence of alcohol consumption, particularly intoxication, in violence and disorder incidents represents a significant public health issue for non-metropolitan NSW. IMPLICATIONS: Geographic variability in the prevalence and characteristics of alcohol-related crime suggests a need for locally targeted, yet evidence-based, interventions to reduce such harm.

Improving communicable disease outbreak preparedness in residential aged care facilities using an interventional interview strategy.

OBJECTIVE: To improve the capacity of residential aged care facilities (RACFs) to respond to communicable disease outbreaks. METHODS: Three computer-assisted telephone interviews were conducted with RACFs. The first survey gathered baseline information. Outbreak prevention resources were then offered to address identified weaknesses. Subsequent surveys enabled the facilities' progress to be monitored. Before the third survey, RACFs were sent a personalized scorecard documenting their standing against 19 readiness criteria. RESULTS: RACFs reporting an outbreak management plan increased from 58 to 98%, and facilities reporting 16 or more of the 19 readiness criteria rose from 24 to 43% (P < 0.0006) at the second interview and 73% at the third interview (P < 0.0001). CONCLUSIONS: The strategy resulted in a significant improvement in reported outbreak readiness.

Persistence of unmet need for care among people with systemic lupus erythematosus: a longitudinal study.

PURPOSE: The extent and variability of unmet care needs over time of people with systemic lupus erythematosus (SLE) has not been previously reported. A prospective study was undertaken to determine the variability over time of such needs. METHOD: A 97-item SLE needs questionnaire (SLENQ) was completed on two occasions 6 months apart by 233 members of a lupus support association. Levels of unmet need for each individual, and a mean symptom score were calculated. RESULTS: Overall level of unmet need increased, decreased or stayed the same for 18%, 37%, and 45% of participants respectively. Ninety-four percent of participants at time 1 and 95% of participants at time 2 reported an unmet need for care for at least one item. The prevalence of unmet need for care remained the same for 82 of the 97 items. The mean unmet need score declined significantly between time 1 (0.78) and time 2 (0.69). The mean unmet need scores were significantly correlated with mean symptom score. CONCLUSIONS: The results of the study suggest an unacceptable persistence of care needs not being met. There is an ongoing need to identify mechanisms to enhance care delivery so that the care needs of people with SLE are more effectively addressed.

Development and psychometric analysis of the systemic lupus erythematosus needs questionnaire (SLENQ).

This study aims to develop a self-administered needs assessment questionnaire for people with systemic lupus erythematosus (SLE), assess its face, content and construct validity and test the reliability of the instrument. Eighty-four people with SLE, registered with a Lupus Resource Centre in New South Wales, Australia participated in a series of focus groups and pre and pilot testing phases in the development of a needs instrument and 594 people from a SLE support association were sent the SLE needs questionnaire (SLENQ) and the MOS-SF-36 and asked to complete both. Face and content validity were found to be high following pre and pilot testing. Principal components analysis identified seven factors with eigenvalues greater than 1, which together accounted for 53% of the total variance (psychological/spiritual/existential, health services, health information, physical, social, daily living and employment/financial needs). Internal reliability coefficients (Cronbach's alpha) of all seven factor-based scales were found to be substantial, ranging from 0.77 to 0.96. Moderately significant correlation between the domains of the SLENQ and the MOS SF-36 were supportive in ascertaining concurrent validity. These findings suggest that the SLENQ provides a reliable and valid index of the global needs of people with SLE.

System-wide adoption of health promotion practices by schools: evaluation of a telephone and mail-based dissemination strategy in Australia.

Schools can potentially benefit from system-wide approaches to the dissemination of health promotion practices. This intervention study undertaken in the Hunter Region of NSW, Australia, used a pre-post design to assess whether a phone and mail intervention dissemination strategy was associated with an increase in the proportion of 218 primary schools undertaking eight health promotion practices. Health promotion practices addressed the prevention of harm associated with five agreed health issues-smoking, nutrition, playground safety, asthma and infectious diseases. The study also assessed acceptability of the dissemination strategy to schools, cost and whether intervention schools' characteristics were associated with uptake of health promotion practices. Compared to baseline a significant improvement in prevalence was observed at both 1 and 2 year follow-up for seven of the eight health promotion practices addressed. The greatest improvement occurred in the first year of the project. There was a greater uptake of the practice of providing information regarding passive smoking in urban schools. The dissemination strategy was found to have a cost per adopted practice of 121 Australian dollars and to be acceptable to the large majority (>90%) of schools. The results suggest that the dissemination strategy may represent a relatively low cost method of enhancing health promotion practices in schools and of monitoring such practices. Further research addressing the methodological issues of this study is needed to confirm these findings.

Prevalence and correlates of perceived unmet needs of people with systemic lupus erythematosus.

To assess the prevalence and correlates of perceived unmet need among people with systemic lupus erythematosus (SLE) 386 people with SLE, recruited from a support association in NSW, Australia, completed a mail-back survey that included 97 items measuring perceived unmet needs across seven domains: physical, daily living, psychological/spiritual/existential, health services, health information, social support and employment/financial. Ninety-four percent of participants had at least one unmet need. The highest levels of unmet need were tiredness (81%); pain (73%); not being able to do things one used to (72%); fear of exacerbation (72%); sleeping problems (70%); anxiety and stress (69%); and feeling down (68%). Five of the highest levels of unmet needs were in the psychological domain. Researchers concluded that current health care delivery is not adequately meeting some of the needs of people with SLE. A comprehensive needs assessment questionnaire for all SLE patients could help providers manage protocols more effectively.

Strategies and outcomes in translating alcohol harm reduction research into practice: the Alcohol Linking Program.

Harm associated with consumption of alcohol on licensed premises is an issue of community concern. Interventions to reinforce responsible sale of alcohol such as server training and accords between licensees, police and health advocates are well known. However, while generally supported by police and licensees as 'a good thing', evaluations demonstrating that they reduce alcohol-related harm are rare. Lack of enforcement is often an issue. This paper reports on system intervention to enhance police enforcement of liquor laws by providing data-based feedback to police and licensees about alcohol-related crime following drinking on specific licensed premises. The system has been shown to contribute to a reduction of alcohol-related crime and has been adopted into routine practice by NSW police state-wide. It is a good example of how research can be conducted in a way that bridges the gap between policy research and policy practice.