Papers by Janice Chesters
Deinstitutionalisation: An unrealised desire
Health Sociology Review, 2005
Abstract The mental illness reform movement of the 1960s and 1970s or'anti-psychiatry&am... more Abstract The mental illness reform movement of the 1960s and 1970s or'anti-psychiatry'produced a rich critique of institutional responses to mental illness. One consequence of this movement was a powerful commitment from across the political ...
Delaying sexual debut amongst out-of-school adolescents in rural southwest Uganda
This paper focuses on ‘sexual debut’ among out-of-school youth in Masaka District, Uganda, factor... more This paper focuses on ‘sexual debut’ among out-of-school youth in Masaka District, Uganda, factors influencing its timing and assistance young people feel they need to delay sexual initiation. Data were drawn from a sexual health needs assessment using applied anthropological techniques with young people aged 13–19 years. Parents, guardians and community leaders were also consulted. All participants felt that young people begin their sexual lives too early. Young men feel under pressure from friends and older men to prove their masculinity. Most delay further activity after debut and want assistance to resist the pressure. Young women's debut after physical maturation prompts ‘pestering’ for sex from boys and men who offer gifts. After debut, young women remain sexually active but believe younger women need assistance to resist pressure. Programmes are needed to help young people achieve these goals. Structurally, the community needs to develop means of preventing men from peste...
Quality in qualitative research Criteria for authors and assessors in the submission and assessment of qualitative research articles for the Medical Journal of Australia
Qualitative research most commonly involves the systematic collection, ordering, description and ... more Qualitative research most commonly involves the systematic collection, ordering, description and interpretation of textual data generated from talk, observation or documentation. • A report of qualitative research should address the following criteria: æ Clarification and justification; æ Procedural rigour; æ Representativeness; æ Interpretative rigour; æ Reflexivity and evaluative rigour; and æ Transferability. • Because of the limitations on article length
Quality in qualitative research
The Medical journal of Australia, Jan 18, 2008
Qualitative research most commonly involves the systematic collection, ordering, description and ... more Qualitative research most commonly involves the systematic collection, ordering, description and interpretation of textual data generated from talk, observation or documentation. A report of qualitative research should address the following criteria: Clarification and justification; Procedural rigour; Representativeness; Interpretative rigour; Reflexivity and evaluative rigour; and Transferability. Because of the limitations on article length for the Medical Journal of Australia, authors should focus on only a couple of aspects of the research, rather than trying to present a simplified description of multiple aspects.
INVITED COMMENTARY Interprofessional Education and the Health Care Team Challenge: An interview with Monash University paramedic student, Tegwyn Bath
Sexual and reproductive health information sources preferred by out-of-school adolescents in rural southwest Uganda
Sex Education, 2010
This paper defines how out-of-school adolescents from Masaka District in rural southwest Uganda c... more This paper defines how out-of-school adolescents from Masaka District in rural southwest Uganda currently receive sexual and reproductive health information and how they would prefer to receive that information. Information adolescents feel they lack falls into three broad categories: sexual and reproductive health issues, the negotiation of sex and sexual relationships, and making the transition to adulthood. The preferred source for information depends on the type of information to be delivered, the overriding principle being that the ...
Outside - Looking In: Evaluating a community capacity building project
Rural Society, 2004
Abstract The Alberton Project was a three-year community capacity building project that ran from ... more Abstract The Alberton Project was a three-year community capacity building project that ran from 1999 until 2002. It aimed to revitalise the local community surrounding the small Victorian town of Yarram. Evaluation of the project involved participant observation, monitoring of media reports, surveys and interviews. Outcomes are reported with reference to four capacity building domains of vision and leadership, structure and partnerships, community engagement, and resources. The Project demonstrated a high level of ...
“You Still Need to Give Her a Token of Appreciation”: The Meaning of the Exchange of Money in the Sexual Relationships of Out-of-School Adolescents in Rural Southwest Uganda
Journal of Sex Research, 2010
This article challenges the pervasive assumption that exchanging gifts and money in adolescent se... more This article challenges the pervasive assumption that exchanging gifts and money in adolescent sexual relationships is transactional. Data were derived from a multi-method, qualitative sexual health needs assessment of 31 out-of-school adolescents in rural southwest Uganda. Grounded theory analysis allows contextual meanings of exchange to emerge. Adolescents have developed gendered courting and exchange models that parallel marital relationships in this cultural context. Whereas exchange is considered transactional and immoral in some types of relationships, in adolescent relationships, it is not. Young women are not ashamed of, or stigmatized by, the exchange; they are proud of it. The exchange signifies several things: self-respect and a partner's willingness to wait for the relationships to become sexual and, therefore, that they are valued and respected by their partners. This demonstrates commitment from a partner, whose role is as a provider. To expect no gift or to have sex for pleasure are the hallmarks of the worst kind of woman-a malaya. "Need" is the only acceptable rationale for extramartial sex for any woman in this sexual value system. Interventions promoting longer courting and sustained support for one partner would encourage a delay in debut for young women and encourage greater monogamy in young men.
“The Young Ones are the Condom Generation”: Condom Use amongst Out-of-School Adolescents in Rural Southwest Uganda
Journal of Sex Research, 2012
This article reports on factors influencing condom use among out-of-school adolescents in rural s... more This article reports on factors influencing condom use among out-of-school adolescents in rural southwest Uganda. Despite an abundance of negative discourses and myths about condoms in the community, these adolescents believe condoms protect them from sexually transmitted infections, HIV, and premarital pregnancies. Girls want partners to use condoms, but most lack the confidence to insist. Girls aged 13 to 14 reported the least difficulty asking for condoms; older girls attributed this to coming-of-age in the era of AIDS when condom use is the norm. Boys under 16 years want to use condoms, but lack confidence in application skills. Boys over 17 years always use condoms with casual partners, but only occasionally for pregnancy prevention with steady partners. Girls need skills training to improve confidence in negotiating condom use. Younger boys require training to improve confidence in skills with condom application. These findings are compared with studies conducted with in-school adolescents in the same study area. Health promotions that provide this skills training and focus on the need to think of the health of future family would be most effective for out-of-school adolescents. This study shows that it is self-confidence, rather than years of schooling, that has the greatest impact on condom use in this cohort.
The PUC-CAM-Q: A New Questionnaire for Delving into The Use of Complementary And Alternative Medicines
The Journal of Alternative and Complementary Medicine, 2007
This paper reports on the design and testing of a new questionnaire, &amp... more This paper reports on the design and testing of a new questionnaire, "Perspectives on the Use in Communities of CAM" (the PUC-CAM-Q [questionnaire]). The questionnaire consisted of scales and questions for 27 concepts considered to affect complementary and alternative medicine (CAM) usage. Scales encompassed 13 beliefs about nature, scientific medicine, and the environment, as well as personal characteristics, such as stoicism and resilience. A matrix provided space for respondents to indicate their use, or likelihood of use, of 23 of the most commonly available CAM modalities. Also included were questions about the reasons for CAM use and sources of health information. The questionnaire was mailed to a randomly selected sample of people in a pilot study of two metropolitan and five rural localities in Victoria, Australia. The response rate was 40% (n = 459). The majority of the questionnaires were completed consistently, and the reliability and validity and questions were satisfactory. Seven (7) of the 13 scales that explored the beliefs and concerns about CAM use and the characteristics of the respondents had Cronbach alphas of above 0.7. Refinement of the other six scales resulted in alphas of between 0.6 and 0.7, with good corrected item-total correlations for included questions. Responses to the matrix question on the use, or likelihood of use, of individual CAM modalities were also good. However, some adjustments to the layout would provide more comprehensive information for future use of the PUC-CAM-Q. This questionnaire provided good data that were appropriate for the exploratory nature of this PUC-CAM study. After more attention to the scales, as well as some refinement of some nonscale questions, the PUC-CAM-Q would be a practical instrument for further studies on CAM use.
Delaying sexual debut amongst out-of-school youth in rural southwest Uganda
Culture, Health & Sexuality, 2010
This paper focuses on 'se... more This paper focuses on 'sexual debut' among out-of-school youth in Masaka District, Uganda, factors influencing its timing and assistance young people feel they need to delay sexual initiation. Data were drawn from a sexual health needs assessment using applied anthropological techniques with young people aged 13-19 years. Parents, guardians and community leaders were also consulted. All participants felt that young people begin their sexual lives too early. Young men feel under pressure from friends and older men to prove their masculinity. Most delay further activity after debut and want assistance to resist the pressure. Young women's debut after physical maturation prompts 'pestering' for sex from boys and men who offer gifts. After debut, young women remain sexually active but believe younger women need assistance to resist pressure. Programmes are needed to help young people achieve these goals. Structurally, the community needs to develop means of preventing men from pestering young women for sex and of redeveloping both the social role and pathway to marriage for young women who are marrying later than is traditional.
People's Choice: Complementary and Alternative Medicine Modalities
Complementary Health Practice Review, 2007
The diversity within CAM use in the community, and the beliefs, concerns, and char-acteristics of... more The diversity within CAM use in the community, and the beliefs, concerns, and char-acteristics of the users of individual CAM modalities was explored via a survey mailed to a randomly selected sample of 1,308 people in different metropolitan and rural local-ities in Victoria, Australia. ...
BMC Psychiatry, 2007
Background: Depression amongst adolescents is a costly societal problem. Little research document... more Background: Depression amongst adolescents is a costly societal problem. Little research documents the effectiveness of public mental health services in mapping this problem. Further, it is not clear whether usual care in such services can be improved via clinician training in a relevant evidence based intervention. One such intervention, found to be effective and easily learned amongst novice clinicians, is Interpersonal Psychotherapy (IPT). The study described in the current paper has two main objectives. First, it aims to investigate the impact on clinical care of implementing Interpersonal Psychotherapy for Adolescents for the treatment of adolescent depression within a rural mental health service compared with Treatment as Usual (TAU). The second objective is to record the process and challenges (i.e. feasibility, acceptability, sustainability) associated with implementing and evaluating an evidence-based intervention within a community service. This paper outlines the study rationale and design for this community based research trial.
Australian Journal of Rural Health, 2000
This paper explores the relationship between rural places and mental health. It begins with a def... more This paper explores the relationship between rural places and mental health. It begins with a definition of mental health and an outline of the data that have led to the current concern with promoting positive mental health. We then consider aspects of rural life and place that contribute to positive mental health or increase the likelihood of mental health problems. Issues identified include environment, place, gender identity, violence and dispossession and the influence of the effects of structural changes in rural communities. The paper concludes with a discussion of some of the determinants of resilience in rural places, including social connectedness, valuing diversity and economic participation.
Chasing Money" and "Damaged Health": Korean Men in Australia, Part I, "Amnesty Migrants
Australian Journal of Primary Health, 2001
Building Healthy Communities: The Rural Chronic Disease Initiative
Australian Journal of Primary Health, 2006
Australian Health Review, 2003
Medical education in Australia is currently entering a new era, including support for the signifi... more Medical education in Australia is currently entering a new era, including support for the significant extension of medical students and general practitioner (GP) registrars' training programs in rural communities. This commitment to rural medical student and general practitioner recruitment and retention has made the provision of accommodation in rural communities a vital issue. This study has found that approximately half of all medical students on placement with rural GPs are currently accommodated with their GP supervisor or with other practice staff. This is a burden for many GPs and when the anticipated increase in the frequency and length of rural placements occurs what is currently a burden will become unsustainable. The changing gender and cultural demographics of medical students and rural general practitioners will also contribute to stresses on this accommodation system. It is important to have a systematic approach towards more appropriate and sustainable models of accommodation for both medical students and GP registrars.
Preparing for a Clinical Trial in a Rural Child and Adolescent Mental Health Service
Australasian Psychiatry, 2008
ANZ Journal of Surgery, 2006
ANZ Journal of Surgery, 2007
Background: Within surgery the debate about the place of evidence-based medicine (EBM) has focuse... more Background: Within surgery the debate about the place of evidence-based medicine (EBM) has focused on the nature and compatibility of EBM with surgical practice with an inevitable polarization of opinion. However, EBM techniques are being embedded into undergraduate medical curricula and surgical training programs across Australia. The Monash University Department of Surgery at Monash Medical Centre implemented a pilot study to explore current knowledge, attitudes and behaviours of practising surgeons towards EBM techniques. Methods: Descriptive survey of surgeons based in a tertiary care environment. Results: The results from the surgeons surveyed suggest that (i) they believe that EBM marginalizes patient involvement in decision-making; (ii) they believe that EBM-generated knowledge is useful and is commonly used in daily clinical decisionmaking -however, not using EBM does not adversely affect their daily clinical decision-making; (iii) they have high confidence in their own judgement compared with low confidence in clinical practice guidelines and other sources of evidence; and (iv) journal summaries of the latest research related to a subject are the most useful resources in clinical practice above clinical practice guidelines. Conclusion: The importance of incorporating concepts of the 'culture' of surgery as an important factor in understanding and developing new ways to mobilize Australian surgeons to adopt EBM into their practice is discussed.
Uploads
Papers by Janice Chesters