2015 November Newsletter - intouch

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Newsletter of the Public Health Association of Australia Inc.

Understanding the link: Gambling and Depression By Chris Mordue, Program Manager at South Pacific Private

In our Australian culture various forms of gambling are accepted social activities and many people can enjoy gambling without any negative consequences. However, for some people, gambling in moderation is just not possible. Research has shown that nearly 75 per cent of Australian adults gamble in any year and about 300,000 Australians have a gambling problem that may also affect many parts of their lives, including physical and emotional health, relationships, study, finances and work. People may not see a connection between their gambling Chris Mordue and their health, but gambling addiction is associated with a range of mental health problems, including depression. Depression is more than just a low mood – it is a serious illness and this can be an emotional and physical burden for the patient. Gambling is a ‘process’ addiction. When a person is addicted, they experience urges or cravings to engage in the process or behaviour, which heighten until the person carries out the process or behaviour again, resulting in feelings of relief and / or elation. There are four types of gambling activities that can lead to problems - they include gaming (poker machines and cards), betting (racing and sports bets), lottery (Lotto and scratchies) and speculation (stocks and share trading).

Vol 32, No 10 November 2015

Inside this issue… Understanding the link: Gambling and Depression

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Autism or intellectual disability in the children of women with a psychiatric disorder 2 Professor Elizabeth (Liz) Waters 3 Watch this space...working with the Bubup Wilam children 4 The Population Health Congress: One Vision, Many Voices A student perspective 6 Highlights from the 2015 Population Health Congress

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Second Tony McMichael Public Health Ecology and Environment Award 8 Childhood oral health, the silent epidemic 9 Office Bearers

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Welcome to our New Members October 2015

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A person can develop an addiction to these gambling activities in three stages: 1.

Experimentation: often begins in the teenage years

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Habitual patterning: normalising the patterns of gambling in your life

3.

Dependency: becoming increasingly dependent on gambling in order to manage your day to day lifestyle

Engaging in excessive gambling activities can often lead to a multitude of emotional symptoms. Studies have shown that people with a gambling problem are nearly 2.5 times more likely to be depressed. The presence of two or more diseases in the same person at one time, also known Continued on next page The Public Health Association of Australia is the major organisation for public health practitioners in Australia with more than 40 health related disciplines represented in its membership. The Association makes a major contribution to health policy in Australia and has branches in every state and territory. Any person who supports the objectives of the Association is invited to join.

www.phaa.net.au


Understanding the link: Gambling and Depression Continued from previous page as comorbidity, is a growing concern in the mental health field in Australia and overseas. These dual diagnosis cases, like gambling addiction and depression, presents a complex set of challenges to treatment as the treatment team need a high degree of clinical experience and a specialised approach to address the co-occurring problems effectively and to support sustainable long term recovery. Evidently, there is a strong link between compulsive gambling and depression. In extreme cases it has led patients to have thoughts of ending their own lives due to feelings of helplessness and hopelessness. Not only does this addiction affect the gambler, but the gambler’s loved ones can also be affected emotionally, physically and financially. Like many other forms of addiction, gambling and depression are most effectively treated in a therapeutic environment supported by addiction specialist health professionals. Withdrawing from addictive behaviours can be difficult, uncomfortable and even dangerous when attempting it alone. For this reason, a professionally supervised treatment program is strongly recommended. For more information visit our website at: www.southpacificprivate.com.au

Autism or intellectual disability in the children of women with a psychiatric disorder By Jenny Fairthorne of the Telethon Kids Institute, Perth Western Australia Psychiatric disorders are more common in mothers of children with autism spectrum disorder or intellectual disability (autism/ID) after the birth of their child. We don’t know why. The excess might be because women with a child with autism/ID have more psychiatric disorders before the birth, because of the increased challenges of parenting a child with autism/ID, or the excess might be due to a combination of these hypotheses. We wanted to find out if these women had more psychiatric disorders before the onset of the increased challenges provided by their child with autism/ID. Hence, we aimed to assess the relationship between women’s outpatient psychiatric contacts and having a subsequent child with autism/ID. We linked three Western Australian registers and investigated the existence of a maternal outpatient psychiatric contact and the odds of autism/ID in a subsequent child.

Jenny Fairthorne

Women with a previous outpatient psychiatric contact were more than twice as likely to have a child with autism and nearly two and a half times as likely to have a child with ID. This adds to existing evidence that pre-existing psychiatric disorders are more common in mothers of children with autism than other mothers. It also provides new evidence that pre-existing maternal psychiatric disorders are more common in mothers of children with ID. This study focused on the risk of maternal psychiatric disorder before the birth of a child with autism/ID. Our research was recently published in the Journal of Autism and Developmental Disorders. We hope that this publication will encourage further research into the use of anti-psychotic and anti-epileptic medication during pregnancy and autism/ID in the child, along with the common genetics of autism, ID and psychiatric disorders. Increased understanding of these debilitating disorders might give more children the opportunity of a healthy life.

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Professor Elizabeth (Liz) Waters This tribute was compiled by Professor Helen Keleher with the assistance of Liz’s team at the University of Melbourne and the PHAA Child Health Special Interest Group.

Sadly, the public health world lost a friend and colleague when Liz Waters died recently after a long illness. Liz was the Director of the Jack Brockhoff Child Health and Wellbeing Program, in the Melbourne School of Population & Global Health at The University of Melbourne, serving as the Coordinating Editor of the Cochrane Public Health Group of the Cochrane Collaboration. She was also an active member of the Child Health Field, the Non-Randomised Studies Methods Working Group, Evidence Aid, the Quality of Life Methods Working Group, and an author with many other Cochrane Groups. She represented Cochrane on the WHO-Cochrane Partnership Group, represented Cochrane and public health within the WHO Global Commission on Social Determinants, and was invited to represent Cochrane public health interests on the WHO Clinical Trial Registration and Reporting, and Guidelines for Review Committee. Liz was on scientific advisory committees for NHMRC, ESRC, MRC, ARC, Department of Veterans Affairs, UNICEF and CDC. At the 2014 Colloquium in Hyderabad, Liz was honoured to receive the Anne Anderson award in recognition of her role as a visible and fearless role model for women, helping to bring about changes that have promoted women in leadership in Cochrane. She was passionate about children’s health and made major contributions to the fields of child and family health. Equipped with experience at the Royal Children’s Hospital, VicHealth, Oxford and Deakin Universities, Liz joined the University of Melbourne in 2007 with a team of researchers passionate about government and community partnership approaches to preventative health. She led work that tackled childhood obesity, improving oral Liz Waters health, disaster recovery, quality of life for children with disabilities, and social inclusion for those with a refugee/migrant background. Her work built understanding of social and environmental risk and protective factors affecting child and family health and wellbeing, always conducted in partnership with colleagues in education, law, social work, and psychology as well as with partners from government, community health, cultural organisations, and service agencies to develop and test solutions that are effective and sustainable. Her expertise was recognised nationally and internationally through invitations to WHO, EU and UNICEF as expert advisor. In Australia, Liz was an expert consultant to the National Health and Medical Research Council (NHMRC) for over 10 years including membership of the NHMRC Health Advisory Committee 2004 - 2007. She was an active member of the Australian Research Alliance for Children and Youth (ARACY) initiative, Engaging families in the early childhood development story. In many different ways, the legacy of her work will continue to support the work of others to make evidence based decisions to promote health and wellbeing, both in Australia and internationally. She is already deeply missed by her many, many friends and colleagues and we at the Public Health Association offer our deepest sympathies to her family and her work colleagues particularly at the University of Melbourne.

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Watch this space … working with the Bubup Wilam children (Bubup Wilam means ‘Children’s Place’ in Woi Wurrung language of the Wurundjeri people) By Tanya Perrin, Co-ordinator, Immunisation Programs, City of Whittlesea

The Aboriginal community is an important part of the City of Whittlesea and is one of our fastest growing communities. Prior to European settlement the Wurundjeri Willum clan lived on the land that now forms the City of Whittlesea and the northern suburbs of Melbourne. Today Whittlesea has the fourth highest Aboriginal population in metropolitan Melbourne with a population of approximately 1,200 Aboriginal people. One of the challenges with this community is low vaccination rates. Across Victoria, Aboriginal immunisation rates are as low as 79% - 89%. To combat this, Council wrote a successful submission to the Sanofi Pasteur Australia Vaxigrant program to improve vaccination coverage rates. Using Thomastown’s Bubup Wilam Early Learning Centre and their established ties to the community, our immunisation team has built a good rapport with parents and children over the past 5 months. The project has been so successful in improving children’s immunisation status that we have now branched out into wider education and awareness of the benefits of immunisation and other health issues, such as how to contain a cold virus by wiping noses, washing hands and throwing away tissues. We are currently working on a children’s storybook aimed at pre-schoolers on the importance of ‘jabs for the mob’ to ‘not get sick’. The children will be asked many questions like: What are germs? Who’s had a needle? What was it for? How did it feel? Were you brave? Highlighting the answers to these important questions, a story book will be created using traditional animals as some of the characters including emus, kangaroos and koalas. The book will be illustrated by a local Aboriginal artist and published and distributed across the state for all providers to use as a tool for the Aboriginal community to raise awareness about the importance of immunisation and where to access it.

If you would like to know more about this project, please contact Council’s Immunisation Coordinator, Tanya Perrin on (03) 9217 2276 or email tanya.perrin@whittlesea.vic.gov.au

Jedda and Eliza from Bubup Wilam Early Learning

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The Population Health Congress: One Vision, Many Voices – A student perspective By Jade Northcott, PHAA student member

The 3rd Population Health Congress in Hobart 2015 was an incredibly enriching, exciting and educational conference. Over 900 health professionals were gathered to share ideas and research covering a diverse range of important public health topics. I was lucky enough to have the opportunity to attend this conference as a 3-day delegate through a PHAA student scholarship. As the first conference I had ever attended, I went into it with the aim of learning and absorbing as much as I could whilst also networking and meeting with many new and inspiring people. The first night started with a welcome reception, where I was able to visualise just how many people had gathered from all over the country and the globe to discuss key public health challenges. It was initially a bit daunting not knowing anybody and feeling so new to the conference world, but I was quickly able to meet several fellow La Trobe University students and staff and have some great conversations with other newcomers. During my time at the conference, I attended all plenary sessions, the congress oration, as well as sessions on mental health, e-health, food and nutrition, alcohol and different settings, wicked problems, and alcohol policy and advocacy. I chose to attend these particular sessions as they align with passions of mine and I was looking to find out more Jade Northcott about theses areas and the current work being pursued. I thoroughly enjoyed all sessions and left each one feeling inspired. I also viewed the range of informative posters on presentation daily, which were captivating reads during the lunch and break periods. After reflecting on my time there were, however, some particularly fascinating highlights for me: •

The E-Health session had Lareen Newman presenting ideas around supporting online social networking to improve the health and wellbeing for rural youth with disabilities. I really respected the points made about how some young people with disabilities utilise screen time as their only form of engaging social time. To the general public, screen time is negatively portrayed for being associated with increased obesity. We need to look at screen time more comprehensively and not forget the irreplaceable social benefits it can have. The question Lareen asked was ‘Where does entertainment and health intersect?’

The Grand Challenges and Wicked Problems plenary session had Professor Trevor Hancock presenting about population health in the anthropocene. This session left me with a strong message on my mind - that population health needs not only to focus on the social determinants of health, but also on the ecological determinants such as air, food, waste recycling, a livable climate etc. Professor Hancock proposed the idea of integrating these ecological determinants into population health frameworks, and moving towards an eco-social model for public health action.

A specific poster that will also stay in my mind as I finish my public health degree and move out into the field Continued on next page

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The Population Health Congress: One Vision, Many Voices – A student perspective Continued from previous page is the poster ‘The Perfect Storm: Creating favourable conditions for change’ authored by Dirkis H., Pokhrel R., Kerr E., Varas K., and Whelan A. from NSW Health. This poster presents the value of building on the Ottawa Charter for Health Promotion and the Jakarta Declaration to emphasise the value and importance of considering settings in health promotion to achieve the most positive change. Attendance at this conference was an experience I will never forget. I left feeling motivated and with a confirmed sense that pursuing a career in the field of public health is a real passion of mine. I hope to attend more conferences like this in the future to grow my knowledge, strengthen my networks, and widen my perspectives.

Highlights from the 2015 Population Health Congress By Chrystal Yam, National Nutrition Programs Manager, SecondBite The 2015 Population Health Congress set in beautiful Tasmania presented me with the opportunity to step away from my day-to-day role, immerse myself in the latest public health research, and reflect on my public health practices. True to the theme of ‘many voices’, over the course of the three day conference I had many discussions with new and familiar faces, debated the challenges and opportunities in public health nutrition, and shared ideas for the future. The opening plenary set the scene for the conference and there was a buzz in the air as presenters spoke of the changing dialogue around health, a shared vision for health equity and an engaged model of health. Dr Ruth Hussey’s introduction to public health in Wales challenged us as public health professionals to move from talking about illness to wellness, and Dr Alessandro Demaio injected energy into the conference by urging attendees to empower communities and change the future through food. Chronic disease prevention and the cost effectiveness of prevention initiatives was a recurring theme among the keynote speakers, and this was also reflected in many of the concurrent sessions. I attended several presentations on grass roots community programs and learnt of numerous innovative initiatives across Australia striving to develop knowledge and skills within targeted members of the community. I am grateful for the opportunity to adopt recommendations from these presenters who shared their experience of program development, delivery and evaluation to ensure that SecondBite can continue to build capacity within the emergency food relief sector and support members of the community experiencing food insecurity through evidence-based practice. The closing plenary did not disappoint. I walked away from the conference invigorated by the passionate speakers who reinforced the importance of advocacy, described by Dr Ines Rugani Ribeiro De Castro as “…an extension of our social commitment.” In his closing remarks Todd Harper reminded us that “…bad things happen when good people remain silent.” In my role as a public health nutritionist this message rings true with many nutrition wins a result of effective and collaborative advocacy. Despite limited advocacy training for public health professionals, I believe it is important to recognise that all of us have the ability to be effective influencers even if only within our workplaces. This is critical to ensure we protect the individuals and communities we support. Many thanks to the Victorian PHAA Branch for granting me a scholarship to attend the 2015 Population Health Congress, and to the Congress Organising Committee for coordinating a stellar program of engaging presenters, keynote speakers and a fabulous conference dinner.

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Second Tony McMichael Public Health Ecology and Environment Award By Peter Tait, Ecology and Environment SIG Convenor This year two worthy recipients, Jeff Spickett and Phil Weinstein, were presented with a Tony McMichael Public Health Ecology and Environment (TMPHEE) Award at the PHAA AGM in Hobart. Jeff’s contribution to environmental and public health spans his over 35 year career as a chemist, researcher and health advocate. Jeff has made a significant contribution to research, teaching and community service in the field of environment and health at the national and international level. Throughout his career, Jeff has worked consistently to advocate for the advancement of public and environmental health through his individual work and collaborative partnerships. He has undertaken a broad range of research and capacity building to address the needs of environmental health including occupational health and toxicology, with an early interest in environmental contaminants. This led to studies in the environmental impacts of endocrine disrupting substances and other contaminants from exploration in the oil and gas industry. Phil is a champion of the field of ecological and environmental health, promoting the study to both students and policy makers alike. In his roles with the University of Western Australia and the University of Queensland, Phil has been instrumental in the development of new courses for students focusing on the links between ecology and human health, climate change and epidemiology. A student said of his teaching: “his enthusiasm for the subject matter and his dedication to the field is unlike any professor I have known.” Phil is a member of the editorial board of the journal EcoHealth and he is an active media commentator and has presented a number of public lectures as well as involving himself with school outreach activities for community advocacy. Phil’s current research aims to quantify the relationship between health outcomes and ecological disruptions, particularly in the area of emerging infectious disease both in Australia and abroad. His prior research in the field has contributed significantly to the development of collaborative ‘whole of ecosystem’ approach to management practices that benefit both the environment and human health concurrently. His aim is to promote a healthy and ecologically sustainable human society in the face of global warming, environmental change and population growth.

Make your career move Advance your career with flexible options to study at your own pace and integrate learning with your work. Choose from short courses to master or research degrees to achieve your personal and professional goals. For more information contact Associate Professor Kerry Thoirs on 08 8302 2903 or visit unisa.edu.au/health/postgrad

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Childhood oral health, the silent epidemic By Tan Nguyen, Oral Health Therapist, Melbourne Dental School, The University of Melbourne Childhood dental caries remains one of the most prevalent largely preventable chronic diseases related to high levels of hospital admissions. Yet, since the introduction of School Dental Service was inspired by Gough Whitlam’s leadership speech in 1974, oral health has remained a silent epidemic for decades. In the State of Victoria, this service merged into community dental services in 2007, which has created new challenges in public health dentistry. Both Federal and State/Territory governments continue to invest funding directly for late-stage oral disease management. The continued demand for surgical interventions for dental caries, rather than social marketing the norms of preventive dental care and addressing the social determinants of health, remains problematic to the health system. Tan Nguyen I have had the privilege and opportunity to lead the pilot Children’s Dental Program, a joint collaborative between Plenty Valley Community Health, the eviDent Foundation and The University of Melbourne. The Program is a school-based dental check-up program involving children aged between 3 and 12 years old in a socioeconomic disadvantaged area of northern metropolitan Melbourne. Our team found a large proportion of children did not have access to regular dental care; 74% of children who were referred to public dental services returned for dental treatment as compared to the highest reported in academic literature of 53%. To date, our study was the first to quantify the program in terms of health economic evaluation. The challenge for Australia is to include oral health services within Medicare, however the costs for dentistry are considered expensive. We anticipate confirming our findings that outreach targeted school-based dental check-up programs are more effective and less costly than passive standard care dental services. The expanded project consists of two public health agencies, and health measures to include quality-adjusted life years and body mass index. The social inequalities of oral health in Australia have primarily become an individualistic one of personal responsibility. This is driven by the current supply of dental practitioners predominately working in the private sector (approximately 80% of dentists work in private practice), and the lack of government priority as oral health is omitted from the National Health and Medical Research Council Strategic Plan. I am passionate about advancing public health dentistry because many academics and the general public have a poor understanding of the importance of oral health, the burden and substantial costs associated with oral diseases, and association with other health co-morbidities like cardiovascular diseases and diabetes. Dental practitioners account for a very small proportion of the health workforce. There are opportunities for other health professionals to get involved with public oral health. Developing the evidence-base for health promotion interventions with appropriate measures using economic evaluation techniques is also important for critical appraisal by policy makers. My experiences from this project illustrates the importance to review the existing academic literature to guide and formulate a study design that addresses the unmet need of the community with due consideration for achieving health system sustainability through health promotion approaches.

The Public Health Association of Australia Inc. wishes to thank the following organisations for their support to the Second National Complex Needs Conference being held at the Canberra Rex Hotel, Canberra on 17-18 November 2015.

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The Public Health Association of Australia Inc. wishes to thank the following organisations for their support to the National Primary Health Care Conferennce 2015 being held in Canberra Convention Centre from 2-4 November 2015.

Public Health 2017 DL postcard ART_Layout 1 6/10/15 11:26 AM Page 1

15th World Congress on Public Health

3-6 April 2017 Melbourne Australia www.wcph2017.com

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Office Bearers The Board

SIG Convenors

President Heather Yeatman: hyeatman@uow.edu.au Vice President - (Policy) Marion Carey: mariongc@bigpond.com Vice President - (Development) David Templeman: davidtempleman1@live.com Vice President - (Finance) Richard Franklin: richard.franklin@jcu.edu.au Vice President - (Aboriginal & Torres Strait Islander Health) Carmen Parter: carmen.parter@sydney.edu.au SIG Convenors’ representatives Yvonne Luxford: yvonne.luxford@gmail.com Peter Tait: aspetert@bigpond.com Branch Presidents’ representatives Russell McGowan: lazaruss@bigpond.com Gillian Mangan: gillian.mangan@heartfoundation.org.au

Aboriginal & Torres Strait Islander Health Co-convenors Summer Finlay: summermayfinlay@gmail.com Yvonne Luxford: yvonne.luxford@gmail.com Alcohol Mike Daube: M.Daube@curtin.edu.au Julia Stafford: J.Stafford@curtin.edu.au Child Health Co-convenors Colin Macdougall: colin.macdougall@flinders.edu.au Ecology and Environment Peter Tait: aspetert@bigpond.com Evidence, Research & Policy in Complementary Medicine Jon Adams: jon.adams@uts.edu.au Food & Nutrition Co-convenors Julie Woods: j.woods@deakin.edu.au Helen Vidgen: h.vidgen@qut.edu.au Health Promotion Carmel Williams: Carmel.Williams@health.sa.gov.au Immunisation Co-convenors Angela Newbound: Angela.Newbound@yahoo.com Michelle Wills: michjwills@gmail.com Injury Prevention Co-convenors Richard Franklin: richard.franklin@jcu.edu.au Lyndal Bugeja: lyndal.c.bugeja@coronerscourt.vic.gov.au International Health Jaya Earnest: j.earnest@curtin.edu.au Brahm Marjadi: B.Marjadi@uws.edu.au Justice Health Co-convenors Tony Butler: tbutler@nchecr.unsw.edu.au Stuart Kinner: s.kinner@unimelb.edu.au Mental Health Co-convenors Michael Smith: mikejohnsmith@hotmail.com Kristy Sanderson: Kristy.Sanderson@utas.edu.au One Health (Zoonoses) Simon Reid: simon.reid@uq.edu.au Oral Health

ANZJPH Editors Editor in Chief John Lowe: jlowe@usc.edu.au Editors Priscilla Robinson: priscilla.robinson@latrobe.edu.au Anna Ziersch: anna.ziersch@flinders.edu.au Melissa Stoneham: M.Stoneham@curtin.edu.au Bridget Kool:b.kool@auckland.ac.nz Roxanne Bainbridge: roxanne.bainbridge@jcu.edu.au Luke Wolfenden: Luke.Wolfenden@hnehealth.nsw.gov.au Branch Presidents ACT Russell McGowan: lazaruss@bigpond.com NSW Jude Page: judepage1@gmail.com NT Rosalie Schultz: rosalieschultz20a@gmail.com QLD Paul Gardiner: p.gardiner@sph.uq.edu.au SA Narelle Berry: narelle.berry@flinders.edu.au TAS Gillian Mangan: gillian.mangan@heartfoundation.org.au VIC Brian Vandenberg: Brian.Vandenberg@monash.edu WA (Acting) Jillian Abraham: Jillian.Abraham@health.wa.gov.au

Bruce Simmons: simmonsbruce@hotmail.com Political Economy of Health Deborah Gleeson: d.gleeson@latrobe.edu.au Primary Health Care Co-convenors Jacqui Allen: jacqui.allen@deakin.edu.au Gwyn Jolley: gwyn.jolley@flinders.edu.au Women’s Health Catherine Mackenzie: catherine.mackenzie@flinders.edu.au

Chief Executive Officer Michael Moore: ph (02) 6285 2373 mmoore@phaa.net.au

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Welcome to our new members

October 2015 NEW SOUTH WALES Ms Heather McCormack Mr Josh Hunt Mr Nishan Subedi Ms Mieke Snijder Miss Caroline Nyongesa Mrs Arwa Sultan Ms Sarah Garland Mrs Camille Neyhouser Mr Will Gold Miss Samantha Cornell Mrs Bushra Khan Mr Barry Taylor A Prof Leigh Wilson Ms Sharon Jacobs Miss Phillippa Ebelt Mrs Katherine Dabich Ms Fiona Napier SOUTH AUSTRALIA Mr Alexander Webb Miss Yimei Li Miss Ashleigh Wilson Mr Bien-Aime John-Baptist Murhimanya Mrs Joanne Rayner WESTERN AUSTRALIA Ms Laura Barkla Miss Melanie Griffiths Miss Kaitlyn Barker Ms Sharon Swaney Ms Vilma FitzGerald Miss Cherie Determes Mr Suraj Puri A/Prof Gina Ambrosini Mrs Kate Cross Professor Colleen Fisher Ms Shelley Gower Mrs Glenda Brown TASMANIA Siobhan Harpur AUSTRALIAN CAPITAL TERRITORY Ms Emma Ereaut Ms Thelma Johnson Ms Sharon Tuffin

VICTORIA Ms Carly Eaton Mrs Libby Williams Dr Win Naing Miss Jacinta Martin Dr Nang Su War Ms Sarah Rockefeller Miss Kara Spivey Mr Shefton Parker Dr Mathias Seviiri Mrs Candice Carter Dr Tessa Hillgrove Dr Simon Firestone Ms Amanda Proposch Dr Alex Donaldson Ms Karen Peterson QUEENSLAND Mrs Sara Dixon Mr Anastase Ndahayo Mr Ikenna Nwaozuzu Miss Brigitte Rodgers Miss Gina Thompson Ms Sophie Miller Miss Hannah Olufson Mrs Natalie Glasgow Ms Kylie Straube Ms Emma Esdaile Mrs Katie Lyndon Dr Nikki Percival Miss Anne Maree Ridley Mrs Deanne Wooden Miss Allison Marshall Mrs Renee Evans Mrs Christiana King

OVERSEAS Mrs Jodie Allison, Abu Dhabi NORTHERN TERRITORY Miss Jaimie Watson Ms Judy Davis Mrs Donna MacMahon

Editors: Jacky Hony & Pippa Burns Articles appearing in intouch do not necessarily reflect the views of the PHAA but are intended to inform and stimulate thought, discussion and comment. Contributions are welcome and should be sent to: The Publications Coordinator, intouch, PHAA email: publications@phaa.net.au

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How to join PHAA ONLINE MEMBERSHIP is available at: www.phaa.net.au or enquiries to: Membership Coordinator, PHAA PO Box 319, Curtin ACT 2605 Tel 02 6285 2373 Fax 02 6282 5438 email: membership@phaa.net.au