The complex and highly individualised needs of this growing client group, together with their slow rate of recovery and persisting long-term dependency and disability have exceeded the current capacity of the health service system to respond.

The Acquired Brain Injury: Slow to Recover (ABI: STR) Program has been developed by the Human Services Department in conjunction with professionals in the field of acquired brain injury to remedy this situation.

Following a competitive tendering process, the ABI: STR Program is now established as a permanent program under the auspices of the Network. A report which documents its achievements to date and standards for future service delivery was launched by the Minister for Health the Hon. Rob Knowles at MMC in February.

The program provides each client with a total package of care that is responsive to their needs as they regain function and as they age, supporting families who provide long-term care. The success of the program over its first two years has exceeded expectations, with many clients achieving unanticipted levels of function, independence, and reintegration into their communities and families.

Living with a chronic illness and coming to terms with being ill can be especially difficult for an adolescent.

But a newly established program at Monash Medical Centre aims to help young people with a chronic illness who live in the south-east.

ChIPS is open to people aged between 13 and 24 years suffering from illness such as asthma, diabetes, cystic fibrosis, epilepsy, haemophilia, juvenile arthritis, Crohns disease, cancer and many others.

It allows adolescents to meet others who are experiencing similar pressures through school, parents, siblings, medication, relationships, socialising, pain, fear, hospitals or doctors.

The first step is an eight-week discussion and recreational program, with participants meeting weekly at Ronald Macdonald House, adjacent to Monash Medical Centre.

There is usually a theme organised for each week that may cover any of the pressures the person is experiencing. The group is led by a professional support worker and a trained adolescent "ChIPS leader", who has a chronic illness.

The main elements of ChIPS are talking with peers about how to cope with having a chronic illness whilst having fun and making new friends.

After the eight-week program, the graduate ChIPer can participate in any of the social activities organised by the Reference group at the Centre for Adolescent Health, Royal Children's Hospital, or other social activities organised through our newly established group at Monash.

ChIPers can train to become peer leaders and then assist in the leadership of new programs. Monash now has seven trained leaders.

If you are interested in joining the ChIPS Program please contact Marg McKenzie c/o Play Education, MMC, ph. 9594 6666, and ask for pager 930 or ph. 9594 6951 and leave a message.

Dr Stocky is Acting Director of the Adult Mental Health Service of Middle South (the Adult Psychiatry Service centred at MMC) and was a speaker at the campaign launch, sharing a stage with both the Minister of Health and an actor from Home and Away.

The Awareness Campaign is designed to combat ignorance and stigma around schizophrenia. A recent survey revealed that 15% of people would not recommend a person with schizophrenia see a doctor, and many believed psychiatric medications were harmful.

Modern research proves these attitudes are wrong. As Dr Stocky explained, relapse rates are shown to shrink with coordinated community based care, early intervention, meticulous relapse prevention, involved general practitioners, modern medications and community support.

For example, involving families in psycho-education of the person with schizophrenia can reduce relapse by 25%. Studies consistently show the success of good compliance with modern medication strategies.

Ignorance about schizophrenia is a major problem in providing care according to Dr Stocky.

Schizophrenia is a severe and debilitating psychotic illness in which people appear to lose touch with reality and have trouble distinguishing fantasy from reality. It is usually associated with disruption in social roles and personal relationships.

Schizophrenia is both common, and affects young people, with a significant impact on suicide statistics.

Schizophrenia affects about 190,000 Australians, of whom 38,000 will attempt suicide, and 19,000 are likely to die by suicide. Around three-quarters of a million Australians are directly affected by schizophrenia, through a close family member or friend.

The annual financial cost to Australia is about two and half billion dollars.

But this campaign is about hope.

Hope lies in early intervention - the earlier schizophrenia is recognised and help received the better the chances for a far more normal life.

This hope is brighter because we are combating the stigma and educating the public. The campaign particularly targeted the family GP who is usually best placed to know the person within the family and almost always the first to be told that something serious, baffling and frightening is happening to someone in the community.

Modern medications are offering real hope. They generally are more effective, more likely to combat depression and the negative symptoms, with fewer side effects. They are therefore likely to be taken earlier, for longer and with much better compliance.

There is also hope because modern management is focussing on keeping people integrated within their families, schools, workplaces and communities.

The AMHS, according to Dr Stocky, is a community focussed service that works hard to minimise hospitalisations, and to maximise the achievements of each client within their communities.

It meets the needs of about 150,000 adults in Monash, Brighton, Moorabbin, Mordialloc, Oakleigh and Sandringham. It provides a broad range of acute inpatient, residential and community-based services.

"The challenges we are facing up to as a service", according to Dr Stocky, "are how to improve community mental health services, to work better with community agencies, and to support, educate, protect and work better with families."

"Relapses are far less likely if an individual feels supported, is connected with other people, is not taking any illicit drugs, and has opportunities to experience both challenges and achievements as part of being part of the community. Expert psychiatric care, as we offer with our service, and excellent compliance with modern medication strategies, greatly improve long-term outcomes."

• The Centre for Population Health and Nutrition led by Professor Kerin O'Dea
• The Centre for Clinical Effectiveness led by Associate Professor Jeremy Anderson
• The Monash University Health Economics Unit led by Professor Jeff Richardson
• The Centre for Graduate Studies in Clinical Nursing led by Ms Anne Nolan
• The Centre for Medical Informatics led by Associate Professor Branko Cesnik
• The Centre for Health Services Research (including the Australasian Cochrane Centre) led by the Institute Director, Professor Chris Silagy.

  

  MOVING ON SEXUAL ASSUAULT

  The South East Centre Against Sexual Assault is offering a series of free dance therapy programs for women survivors of sexual assault.

  The eight-week "Moving On" programs explore issues related to sexual assault as determined by each group, but may cover guilt, anger or body image.

  The programs aim to help female survivors of sexual assault gain better self-understanding and restore positive feelings about their bodies.

  "Movement can help women articulate contemporary life experience, reveal personality and is useful in finding out about and relating to others and the environment," says SECASA Counsellor Sarah McGregor.

  "This program not only promotes a healthy lifestyle, but aims to raise women’s awareness of their creative and aesthetic self, bridging thoughts and feeling in a physical way."

  The sessions are run in association with Dance Therapist Sue Mullane and are held in St Kilda and Dandenong. For more information contact Sarah McGregor at SECASA on 9928 8741.

  

  PHOTOGRAPHIC EXHIBITION TO MARK INTERNATIONAL NURSES DAY

  "The committee opposed a proposal to require all applicants to have passed the matriculation examination. Circumstances sometimes made the examination impossible, and it seemed clear that many who were not successful at the routine of study would find a true vocation as trained nurses; a high standard would be secured more surely by good conditions and enlightened attitude than by insisting upon academic certificates. The proposal has been revived from time to time, but has not been generally accepted."

  From "Queen Victoria Memorial Hospital. The First Fifty Years", by Gwendolen H. Swinburne, 1951

  "The committee opposed a proposal to require all applicants to have passed the matriculation examination. Circumstances sometimes made the examination impossible, and it seemed clear that many who were not successful at the routine of study would find a true vocation as trained nurses; a high standard would be secured more surely by good conditions and enlightened attitude than by insisting upon academic certificates. The proposal has been revived from time to time, but has not been generally accepted."

  From "Queen Victoria Memorial Hospital. The First Fifty Years", by Gwendolen H. Swinburne, 1951

   "…..the training of nurses altered drastically over the second half of this century. During this time they saw nurses move from being comfort-givers to care-givers, and saw nurses' jobs involve many of the tasks previously performed by doctors. There is now an emphasis on the 'science' of nursing' which never existed in earlier decades."

  From "Bricks or Spirit. The Queen Victoria Hospital Melbourne," by Emma Russell, 1997.

    A photographic exhibition entitled "Trends in Nurse Education" will be held at Monash Medical Centre to mark International Nursing Day on May 12^th.

  The exhibition draws on photographs and memorabilia of the Centre’s Historical Collection and highlights the changes in nurse education which have occurred this century.

  Visitors are more than welcome to view the exhibition which will run from Monday May 10^th until Monday May 17^th in the Good Samaritan Corridor, Monash Medical Centre, 246 Clayton Road, Clayton.

  

  NEW SUPPORT GROUP AND SOCIAL NETWORK FOR GAY MEN WHO HAVE A PERSONAL EXPERIENCE OF SEXUAL ABUSE

  The South East Centre Against Sexual Assault (SECASA) launches two new services for gay men in late May.

  These new services are a sexual abuse survivors group and a weekly luncheon club/social network.

  These new services are specifically for gay men.

  The survivors group is a support group for victim/survivors of childhood or recent sexual abuse and will commence at 6 pm on Monday 24th May, at VAC/GMHC, 6 Claremont Street, South Yarra and will run between 8 and 12 weeks.

  This group has been developed to be a safe environment in which participants are able to discuss and share issues in a friendly and supportive way, which is very sensitive to their needs.

  In the same week, the SECASA Men's Service are launching a gay male social and support network for men who have a personal experience of childhood or recent sexual abuse, or who are gay partners or carers of gay men who have this experience.

  This new social network will meet as a luncheon or coffee club each Thursday, commencing on 26th May at 2:00pm at a yet to be finalised venue in Prahran.

  Further information on these new initiatives can be obtained from Greg (Survivors Group) and David (Social Network) at SECASA on 9928 8741, or via e-mail: g.adkins@shcn.com.au

  

  Drug discovery holds new hope for prem babies

  Researchers at the Southern Health Care Network have discovered a previously unnoticed and potentially beneficial effect of a drug that is commonly prescribed to mothers at risk of giving birth to a premature baby.

  The drug, betamethasone, is usually prescribed to help the unborn baby develop mature lungs and increase its chance of survival after birth.

  However as principal researcher Dr Euan Wallace and his team at Monash Medical Centre and Monash University discovered it appears the drug also improved blood flow to the unborn.

  "Approximately 12000 pregnancies a year in Australia are complicated by impaired fetal growth. In many of these pregnancies the main reason for the growth restriction is poor blood flow through the placenta to the fetus. While we have long known about this potentially serious problem for these babies up until now there has been no way overcome it," he said. "This discovery opens up a new line of research and new clues to how we may help."

  Dr Wallace’s team studied 28 pregnant women using an ultrasound technique known as pulsed-wave doppler ultrasound, observing an improvement in placental blood flow in a significant number of women after receiving betamethasone.

  "We’re not sure yet why this should be so," says Dr Wallace. "It may be that the drug is improving the heart function of the unborn child or lowering resistance to blood flow within the placenta."

  While it also remains uncertain whether the observed changes will translate into improved fetal outcomes it is likely that at least in the acute phase oxygen supply to the fetus will be improved.

  "This effect in itself may sufficiently improve outcomes if delivery is appropriately timed, says Dr Wallace.

  "We have already commenced the next phase of our research and are excited by the new possibilities that may exist for these very high risk pregnancies. We are exploring whether the changes we are seeing in blood flow are accompanied by improvements in the fetus and we are trying to understand more about how the changes actually occur"