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Welcome to a new podcast series on eco-social work practice: ‘Eco-Social Work in Australia.' PURPOSE: A key objective of this podcast project is to help grow a conversation and interest about eco-social work amongst listeners. The researcher and producer of the series, Andrew Nicholson, is a retired social worker and environmental educator. He and his guests want the series to expand over time to provide an audio record of evolutionary trends in eco-social work practice (ESW) adoption in Australia and elsewhere. They hope that this process will add to the knowledge base of ESW and make a contribution to increasing the speed of uptake of such practice amongst mainstream social work colleagues, in their workplaces, in professional groups, and in networking with other allied professionals. Andrew invites feedback from interested listeners. BACKGROUND: Recent climate disruption and pandemic disease impacts on public health and wellbeing in Australia and internationally have provided a stark illustration of the serious and often disproportionate vulnerabilities experienced by communities, including social work clients, produced through physical environmental impacts. On current greenhouse gas emission trends, we know that climate disruption impacts, for instance in the form of intensified weather events, are set to get worse; and that the COVID-19 pandemic is caused by just one of many other novel viruses which could pose considerable risks to human health in the future. Both the growing climate emergency and increased vulnerability to pandemic disease are the results of human caused physical environmental damage and disturbance. In the light of such threats, A recurrent theme in this series is the need for a greatly increased social work focus on the inextricable link between helping achieve client wellbeing and social justice outcomes, and the associated need to protect the wellbeing of the natural world, and to achieve environmental and ecological justice outcomes in that process. Professional association advocacy for a safer climate, and factoring climate disruption impacts into hospital-based, client health assessments, are just two examples of the physical environmental focus within an eco-social work approach. Another is working to help human communities develop more mutually supportive relationships with the other than human communities of the natural world, which underpin and are so crucial to human and other species wellbeing  Over the last fifteen to twenty years, starting from a low base, there is now an accelerating interest in eco-social work ideas and practice in Australia. Notwithstanding this progress, in 2021, eco-social work remains a marginal concern within mainstream professional practice in this country. At a time when all sectors of society need to make a full, fair and proportionate contribution to tackling interconnected physical environment, ecological and social justice challenges, it is important that we find ways to boost, rapidly, the level of mainstream social work adoption of eco-social work practice in this country and elsewhere, to ensure our profession makes that contribution - and this podcast series is one small attempt to help that process. FORMAT: Each podcast interview is loosely structured around four key questions put to guests: For you, what does eco-social work practice mean? How can eco-social work help tackle climate disruption and other ecological sustainability concerns in practical terms? Why should the social work mainstream here be involved with such concerns? What could or should the short to mid-term future (2-10 years) hold for eco-social work interventions as a body of practice within the Australian social work mainstream? DISTRIBUTION: The producer hopes that the series will be promoted across relevant networks as widely as possible. He aims for a minimum of twenty individual episodes and 1000 downloads achieved by mid-2022. The first twelve episodes of Eco-social work in Australia are available now on: PODBEAN  SPOTIFY  GOOGLE   STITCHER   PLAYERFM and APPLE PODCASTS For inquiries or feedback about the series, please contact the producer, Andrew Nicholson, at E: anicholsona@gmail.com or on M: 0413979414 . These details are repeated in the podcast episode text notes. Some individual guest speakers also supply contact details.

Background: Recent epidemiological studies suggest that chemotherapy has not contributed to a marked improvement of patient outcome during the last decades. In most randomized trials which investigated the efficacy of a 1st-line schedule for metastatic breast cancer (MBC), the median survival ranged between 18 and 24 months. The goal of the present study was to analyse the survival of patients with MBC treated in a single university outpatient clinic. Methods: Patients who had received their complete anti-cancer treatment for MBC in our outpatient clinic between 2000 and 2005 were analyzed for treatment and survival. Results: 232 patients [median age of 53, range 27-87 yrs; ER and/or PgR positive (HR+) n=174 (75%); HER2 over-expression (HER2+) n=79 (34%)] were included in the analysis. Endocrine sensitive patients received 1-2 (58.6%), 3-4 (37.4%) and 5-6 (2.3%) hormonal regimens. Of all patients 53.4% received up to 3 cytostatic agents in palliative intent, 4-6 regimens were applied in 22.1% and 12.9% received more than 6 subsequent regimens during the course of their disease. The median overall survival (OS) from time of diagnosis of metastatic disease was 44 months. Patients with HR positive tumours survived 46 months, whereas the survival of those with HR negative tumours was 34 months (p=0.07). HER2+ patients who received trastuzumab survived for a median of 44 months. Visceral involvement was associated with a shorter survival as compared to non-visceral disease (34 vs. 57 months, p

Background: Recent studies have shown an association between job insecurity and morbidity as well as mortality, however until now, knowledge about a potential association between job insecurity and overweight or obesity has been lacking. Methods: In order to identify a possible association between job insecurity and overweight or obesity, we analysed data from the German Socioeconomic Panel (GSOEP) 2004/2005, a longitudinal study of private households in Germany. In this representative cohort of the German adult population, living and working conditions were observed. Data on Body Mass Index (BMI) and self-perceived probability of job loss within the next 2 years were available for 10,747 adults either employed or attending training programs. Results: We identified 5,216 (49%) individuals as being overweight (BMI > 25 kg/m(2)) and 1,358(13%) individuals as being obese (BMI > 30 kg/m(2)). A total of 5,941 (55%) participants reported having concerns regarding job insecurity. In the multivariate analysis - after adjustment for relevant confounders - a statistically significant association between obesity and job insecurity (100% probability for losing the job in the following two years) could be observed with an adjusted odds ratio of 2.55 (95% confidence interval: 1.09-5.96). Conclusions: Because of these results, we were able to conclude that overweight and obese persons perceive job insecurity more often than their normal weight counterparts in Germany and that the concurrence of obesity and job insecurity might lead employees into a vicious cycle. Further research with an emphasis on the occupational setting might be necessary in order to establish useful preventive programmes at the workplace.

Background: Recent evidence suggests that distinction of subsets of rheumatoid arthritis (RA) depending on anticyclic citrullinated peptide antibody (anti-CCP) status may be helpful in distinguishing distinct aetiopathologies and in predicting the course of disease. HLA-DRB1 shared epitope (SE) and peptidylarginine deiminase type 4 (PADI4) genotype, both of which have been implicated in anti-CCP generation, are assumed to be associated with RA. Objectives: To elucidate whether PADI4 affects the clinical characteristics of RA, and whether it would modulate the effect of anti-CCPs on clinical course. The combined effect of SE and PADI4 on autoantibody profile was also analysed. Methods: 373 patients with RA were studied. SE, padi4_94C.T, rheumatoid factor, anti-CCPs and antinuclear antibodies (ANAs) were determined. Disease severity was characterised by cumulative therapy intensity classified into ordinal categories (CTI-1 to CTI-3) and by Steinbrocker score. Results: CTI was significantly associated with disease duration, erosive disease, disease activity score (DAS) 28 and anti-CCPs. The association of anti-CCPs with CTI was considerably influenced by padi4_94C.T genotype (C/C: ORadj=0.93, padj=0.92; C/T: ORadj=2.92, padj=0.093; T/T: ORadj=15.3, padj=0.002). Carriage of padi4_94T exhibited a significant trend towards higher Steinbrocker scores in univariate and multivariate analyses. An association of padi4_94C.T with ANAs was observed, with noteworthy differences depending on SE status (SE2: ORadj=6.20, padj,0.04; SE+: ORadj=0.36, padj=0.02) and significant heterogeneity between the two SE strata (p=0.006). Conclusions: PADI4 genotype in combination with anti- CCPs and SE modulates clinical and serological characteristics of RA.

Background: Recent reviews on placebo effects in clinical trials suggest that objective changes following placebo treatments may not exist or, at least, have been considerably overestimated. However, the possibility that yet unidentified subsets of parameters are responsive to placebo treatments has not been taken into account. Therefore, the aim of the present study is to examine the effects of placebo treatments on objectively measured outcome parameters by specifically focusing on peripheral disease processes. Methods: An initial dataset was collected from a MEDLINE search for placebo-controlled, randomized clinical trials. Trials with stable disease conditions were identified, and the effects of placebo treatments on peripheral outcome parameters were estimated by the changes from baseline in the placebo groups. An explorative data analysis was conducted in order to identify parameter classes with differential responsiveness to placebo treatments. A subgroup meta-analysis of a second dataset was performed to test whether the preliminary classification would also apply to placebo effects derived from the comparison of placebo groups with untreated control groups. Results: The explorative analysis of outcome parameters and strength of placebo effects yielded a classification into responsive "physical" versus non-responsive "biochemical" parameters. In total, 50% of trials measuring physical parameters showed significant placebo effects, compared with 6% of trials measuring biochemical parameters. A subgroup meta-analysis substantiated the differential response ( physical parameters: n = 14, Hedges' pooled effect size g = 0.34, 95% CI 0.22 to 0.46; biochemical parameters: n = 15, g = 0.03, 95% CI - 0.04 to 0.10). The subanalysis of the second dataset supported the classification and revealed a significant improvement for physical parameters ( n = 20, g = 0.22, 95% CI 0.07 to 0.36) and a deterioration for biochemical parameters ( n = 6, g = - 0.17, 95% CI - 0.31 to - 0.02). Conclusion: The results suggest that placebo interventions can improve physical disease processes of peripheral organs more easily and effectively than biochemical processes. This differential response offers a good starting point for theoretical considerations on possible mediating mechanisms, and for future investigations in this field.

Background: Recent studies showed the increasing importance of depressive disorders. Despite good treatment possibilities (pharmacological treatment and psychotherapy) only a minority of patients receive adequate treatment. One of the most dramatic consequences is a big number of suicides. Methods: Within the competence network on depression and suicidality (founded by the German Ministry for Education and Research) a multi-level program was carried out in 2001 and 2002: the “Nuremberg Alliance against Depression”. In the centre of the activities was the optimisation of diagnosis and therapy in primary care. Family doctors received continuous education and different screening tools were established. Brochures and videos were produced to improve patients` knowledge of symptoms, causes and treatment possibilities. Besides that an intense information campaign was started (posters, lectures, cinema spot, leaflets etc.). Moreover a close cooperation with other community facilitators (priests, geriatric nurses, teachers etc.) should improve awareness towards depression and suicidality. Finally, special support for patients and their relatives was provided. A telephone hotline for persons after suicide attempt offered help in the case of a further suicidal crisis. Main outcome criteria of the study was the reduction of suicidal acts (suicides and suicide attempts) in comparison to a baseline-year (2000) and a control region (Wuerzburg). Results: The results for the first year of intervention (2001) show a significant decrease of suicidal acts in Nuremberg compared to the baseline and to the control region. Suicidal acts dropped from 620 cases to 500 cases (p=0.046). The decrease of persons committing a suicide attempt was 21.6% (375 vs. 475 cases) and differed significantly from the control region (p=0.008). Completed suicides decreased from 100 to 75 (-25%) which was not significant compared to the control region where a similar reduction in suicide rates was observed.