In many, varied and important ways, schools are microcosms of the communities and societies in which they exist. It is likely that students, and indeed teachers, share attitudes and values that pervade a school’s social context. In Australia, it is not uncommon for some of these attitudes to be unsupport-ive, if not prejudicial, toward students from minority groups. This chapter examines the impact of school climate and prevailing community attitudes on minority students, in relation to gender and ethnicity, and particularly sexual orientation in the Australian context. The chapter concludes by considering programs that can be implemented to overcome negative effects of social prejudices so that schools are better able to cater for individual needs of students to promote positive learning environments. Whole school approaches emphasize social inclusion for all students in order that they may reach their full potential and contribute to social development.

In many, varied and important ways, schools are microcosms of the communities and societies in which they exist. It is likely that students, and indeed teachers, share attitudes and values that pervade a school's social context. In Australia, it is not uncommon for some of these attitudes to be unsupportive, if not prejudicial, toward students from minority groups. This chapter examines the impact of school climate and prevailing community attitudes on minority students, in relation to gender and ethnicity, and particularly sexual orientation in the Australian context. The chapter concludes by considering programs that can be implemented to overcome negative effects of social prejudices so that schools are better able to cater for individual needs of students to promote positive learning environments. Whole school approaches emphasize social inclusion for all students in order that they may reach their full potential and contribute to social development.

In the past 50 years, acceptance of divergent sexual orientations has been boldly advocated in many parts of the world (Byard, Kosciw, & Bartkiewicz, 2013). These sexual orientations include homosexuality and bisexuality, as well as the gender identity of transgender, all of which can be grouped under the colloquial term of "queer." During this same period, steps have been taken to reduce prejudice and discrimination against individuals who identify as queer, however this sexual minority group continues to experience harassment and social exclusion.

Objectives: To investigate patients' views about two common outcome measures used for back pain: Numerical Rating Scales for pain and the Roland-Morris Disability Questionnaire.Subjects: Thirty-six working adults who had previously sought primary care for back pain and who could speak and read English.Method: Eight focus groups were conducted to explore participants' views about the 11-point Numerical Rating Scales and the 24-item Roland-Morris Disability Questionnaire. Each group was led by a facilitator and an interview topic guide was used. Audio recordings of focus groups were transcribed verbatim. Framework analysis was used to chart participants' views and an interpretive analysis performed to explain the findings.Results: Participants reported that neither the Roland-Morris nor the Numerical Rating Scales captured the complex personal experience of pain or relevant changes in their condition. The time-frame of assessment was identified as particularly problematic and the Roland-Morris did not capture relevant functional domains.Conclusion: This study provides empirical data that working adults with persistent back pain consider these clinical outcome measures largely inadequate. These measures currently used for back pain may contribute to misleading conclusions about treatment efficacy and patient recovery.

PURPOSE/OBJECTIVES:To describe in greater detail women's experiences receiving advice about arm care and exercise after breast cancer treatment.DESIGN:Cross-sectional survey.SETTING:Three hospitals in Sydney, Australia.SAMPLE:175 patients with breast cancer recruited 6-15 months after their surgery.METHODS:Patients completed a survey about their perceptions of arm activity after breast cancer and were asked to respond to an open-ended question about their experience receiving advice about arm care and exercise. Comments from 48 women (27%) who volunteered responses were collated and categorized.MAIN RESEARCH VARIABLES:Patients' experience with arm care and exercise advice after breast cancer surgery.FINDINGS:Topics raised by respondents included perceptions of inadequate and conflicting advice, lack of acknowledgment of women's concerns about upper limb impairments, an unsupported search for information about upper limb impairments, fear of lymphedema, women's demand for follow-up physiotherapy, and some positive experiences with supportive care.CONCLUSIONS:Upper limb impairments are problematic for some breast cancer survivors, and these concerns are not always taken seriously by health professionals. To date, standardized advice is provided that does not meet the needs and expectations of a cohort of women after breast cancer surgery.IMPLICATIONS FOR NURSING:Health professionals could better address patients' concerns about upper limb impairments by providing accurate advice relevant to the surgery.

PURPOSE/OBJECTIVESTo explore the factors that contribute to women's intention to avoid strenuous arm activity after breast cancer surgery.DESIGNCross-sectional survey.SETTINGThree hospitals located in eastern Australia.SAMPLE175 patients with breast cancer.METHODSA survey, based on Protection Motivation Theory, was used to assess whether treatment variables, demographic variables, arm advice, fear, or coping attributes predicted women's intentions to avoid strenuous arm activity.MAIN RESEARCH VARIABLESIntention to avoid strenuous arm activity, presence of arm or chest symptoms, receipt of arm care advice, and fear of lymphedema.FINDINGSSeventy percent of participants reported an intention to avoid strenuous activity with their affected arm and reported more arm and chest symptoms than participants who did not avoid strenuous arm activity. Women who perceived that they were vulnerable to lymphedema and women who received advice about arm care were more likely to avoid strenuous arm activity.CONCLUSIONSFear of lymphedema and receipt of arm care advice motivated women's intention to avoid strenuous arm activity.IMPLICATIONS FOR NURSINGInformation about lymphedema distributed to patients by healthcare professionals should be updated to reflect evidence and address the risk of developing lymphedema relevant to the patients' surgery.

OBJECTIVETo explore patients' perceptions of recovery from low back pain, about which little is known.METHODSA qualitative study was conducted in which 36 participants, either recovered or unrecovered from low back pain, participated in focus groups. Interviews were audiorecorded and transcribed verbatim. Framework analysis was used to identify emergent themes and domains of recovery.RESULTSPatients' views of recovery encompassed a range of factors that can be broadly classified into the domains of symptom attenuation, improved capacity to perform a broad scope of self-defined functional activities, and achievement of an acceptable quality of life. An interactive model is proposed to describe the relationships between these domains, cognitive appraisal of the pain experience, and self-rated recovery. Pain attenuation alone was not a reliable indicator of recovery.CONCLUSIONThe construct of recovery for typical back pain patients seeking primary care is more complex than previously recognized and is a highly individual construct, determined by appraisal of the impact of symptoms on daily functional activities as well as quality of life factors. These findings will be valuable for reassessing how to optimize measures of recovery from low back pain by addressing the spectrum of factors patients consider meaningful.

Using the stories of two men interviewed for The Aging Men's Health Project, this article highlights how mainstream aged care and gay community support services need to be aware that nonpartnered o...

Preventive medicine is an important element of the Australian health care system. An essential aspect of the biomedical model of health care is screening for the early detection of disease in otherwise asymptomatic people. There is ample evidence that acceptance levels of western medicine vary and that a variety of health epistemologies and health practices coexist. To examine the extent to which Chinese-Australian women integrate western medicine practices in their health seeking behaviour, a qualitative study was conducted, which involved in-depth interviews in Cantonese with 20 women. Although adherence to western health beliefs and practices varied, in general these Chinese-Australian women sought medical help only after they felt unwell. Commonly, they first tried traditional remedies for minor diseases. Many saw no reason to participate in screening when they were asymptomatic. Direct communication with health care providers who speak the same language appears to be important to many Chinese-Australian women when seeking health care services. It is recommended that ethnic health workers should participate in screening programmes and other health promotion activities.

BACKGROUND:Current research evidence indicates that women should return to normal use of their arm after breast cancer surgery. However, it appears some women continue to hold the view that they are supposed to protect their arm from strenuous activities because of the risk of lymphoedema. Many factors contribute to women's perceptions about lymphoedema and their ability to use their affected arm, and it is the aim of this study to explore and understand these perceptions.METHODS/DESIGN:A survey, based on the Protection Motivation Theory, has been developed and tested. The survey assesses whether subjective norms, fear and/or coping attributes predict women's intention to use their affected arm. In addition, the survey includes questions regarding cancer treatment and demographic characteristics, arm and chest symptoms, and arm function. Recruitment of 170 breast cancer survivors has begun at 3 cancer treatment sites in Sydney, Australia.DISCUSSION:This study will identify perceptions that help predict the extent women use their affected arm. The results will also determine whether upper limb impairments arise secondary to over-protection of the affected arm. Identification of factors that limit arm use will enable appropriate prevention and better provision of treatment to improve upper limb outcomes.

This article considers the impact, in terms of life and death choices, of the economic exclusion of young people in Australia, where suicide is the leading cause of death by injury. In the two decades from 1980 there was a dramatic increase in suicide rates for young males. Research demonstrates a correlation between youth suicide and unemployment but the complex relationship between the two has not been fully investigated. This article explores the perceptions of young people, parents and service providers of the cultural context of suicide and how it comes to be constructed as an option for young people experiencing economic marginalisation.

9054 Background: Post-operative education of women with breast cancer is inconsistent as guidelines provide conflicting advice regarding how vigorously women can use their arm. Current post-operative advice about lymphoedema focuses on the avoidance of strenuous arm activity and exercise, but common physiotherapy practice advocate this to address possible impairments after surgery such as loss of shoulder range and weakness. Methods: A 30-minute survey based on the Protection Motivation Theory was developed to explore the relationship between patients’ perception of what they can do with their affected arm following breast cancer treatment and their intention to use their affected arm. In addition, patients’ cancer and treatment characteristics, demographics, arm and chest symptoms, and arm function were assessed by the survey. The survey was pre-tested, and then distributed to 175 consecutive breast cancer survivors at 6–15 months after breast cancer treatment. Results: Of the women surveyed, 91(52%) had sentinel node biopsies, 67 (38%) had axillary dissection, 14 (8%) had no surgery to the lymph nodes, and 3 (2%) were unknown. There was a high incidence of shoulder restriction and upper limb pain in both women who had sentinel node biopsies and women who had axillary dissections ( Table 1 ). The majority of women who had sentinel node biopsies (51%) and axillary dissections (61%) perceived it was necessary for them to avoid strenuous arm activity. Overall, women who intended to avoid strenuous arm activity were found to have a greater likelihood of reporting upper limb swelling (LR=17.6, p=0.000) and weakness (LR=10.9, p=0.001). Conclusion: Women who had sentinel node biopsies intended to avoid strenuous arm activities even though they have a negligible risk of lymphoedema, placing them at risk of developing secondary musculoskeletal problems. [Table: see text] No significant financial relationships to disclose.

There is a dilemma within the suicide prevention field about the extent to which suicide should be openly discussed as a community issue. Some fear provoking imitation while others think it is essential in order to improve awareness, understanding and appropriate responses to young people's distress. While youth suicide is widely recognised to be an important issue within Australian society, little research has been undertaken on the sociocultural context that shapes how it is constructed. This article reports on the findings of research within an urban and a regional community in which samples of young people, adults and service providers were interviewed about how youth suicide was viewed as an issue. The study revealed how different rural and urban community identities were connected to suicide through the circulation of media reports, personal stories and the (mis) use of statistics. Youth suicide was constructed through the process of young people talking about it with peers, and adults talking with each other, in ways that often emphasised selfishness, individual failing and stereotyping of marginalised groups. In contrast, professionals largely drew upon notions of risk to identify particular groups. In conclusion, we argue that dominant constructions can have a negative effect on access to services, community mobilisation and support around the issue of youth suicide. There is value in considering how to create dialogue between adults and young people who might benefit from engaging with views other than those of their young friends and classmates. We also recommend a more careful appraisal of the literature on normalisation and imitation.

Despite an emphasis on mammographic screening in Australia, Chinese Australian women have low participation rates. This qualitative study investigated how concepts of health and health promotion influence Chinese Australian women's decisions to participate in cancer screening, which is an important issue for nurses who work with multicultural populations. In-depth interviews were conducted with 20 Chinese Australian women. Using thematic data analysis, the findings showed that health and illness are taken-for-granted experiences of everyday life. When they were asymptomatic, most informants saw no reason to suspect that they may have diseases. Consistent with these health beliefs, the women focused on preserving and promoting health and overall well-being in everyday life rather than attempting to detect hidden disease by screening. These ideas and practices influenced behavior in relation to cancer diagnosis and in particular toward mammography.

the relationship between humor, embarrassment and social control throughout his book. Billig’s treatment of laughter, humor and ridicule will most likely be appreciated by any psychologists who believe as Billig thinks they do and anyone interested in a history of humor theories. All readers, however, must be aware of the wide variety of existing research that illustrates the ways in which humor can be used not only for disciplinary purposes but for any communicative purpose for which we might also use a serious key. Finally, while discussion of a typographical error may seem captious, out of respect for this particular group, it should be noted that the name of the New Guineans studied by Bambi Schieffelin (e.g. 1990) is not correct in the main text of this volume. They are the Kaluli.

OBJECTIVE:Exploring how cultural meanings of the breast impact on perceived images of breast cancer and breast health practices. METHODS:In-depth interviews were conducted with 20 Chinese-Australian women in their native language (Cantonese). RESULTS:The findings revealed that the meanings of the breast are constructed within the women's social and cultural context where breasts are associated with sex; and talking about, being concerned with or expressing curiosity about breasts is considered inappropriate. These views have a significant impact on (1) the way the informants viewed breast cancer; (2) perceptions of breast health practices; and (3) the explanations of breast cancer and associated risk perception. CONCLUSION:Understanding the nature of culturally-based barriers to utilization of breast cancer screening is the first step to discovering solutions for making screening tests more acceptable to women from other cultures. PRACTICE IMPLICATIONS:This study provides insight about obstacles for breast health promotion practices and for developing culturally appropriate health education programs and counselling strategies.

Language barriers may adversely affect outcomes in healthcare provision for clients from non-English speaking backgrounds. In order to assess the need for education on this topic, this study identified the strategies used by physiotherapists to communicate with clients who have limited English proficiency. Detailed interviews and observations were conducted at three hospitals in New South Wales, Australia. Six physiotherapists were interviewed and the clinical practice of several others was observed. Despite recommendations by the health authorities to use Healthcare Interpreters when communicating with clients who do not speak English, the results showed physiotherapists frequently used other communication strategies. These strategies included family interpreters, non-verbal communication, simplified English, simplified community language and bilingual staff. With the exception of professional interpreters, physiotherapists need to be aware that many communication methods used with clients whose comprehension of English is limited, can lead to inaccuracy, bias and misinterpretation, resulting in ineffective treatments, potential litigation and discrimination against these clients. One way this issue could be addressed would be for the education of physiotherapists at university and in clinical situations, to include appraisal of these risks and training on how to work effectively with professional interpreters, such that their use becomes the norm for interaction with any client who has limited English proficiency.

The present article reports on a study of the attitudes and behaviour of young people towards help-seeking during times of emotional distress and, in particular, when contemplating suicide. Twent- one young people aged between 16 and 24 years, as well as six parents and 14 youth service providers who lived in 'Subcity', a metropolitan community, were interviewed about their understandings of youth suicide and effective interventions. Nearly all the young people, service providers and parents identified a range of barriers that impede or prevent young people from asking for help when they need it most, including issues related to trust and confidentiality, parental support and fear, stigma and perceived loss of esteem. Implications for social work practice include an emphasis on developing parenting skills and community development related to education about suicide and the provision of appropriate support services.