bluuebunny/crossref_metadata_2025 huggingface dataset:
Examples of Exemplary Practice in Adolescent Primary Health Care
Authors: Merkes Monika
Published: August 2009

As one of seven projects funded by the Victorian Government Department of Human Services to investigate exemplary practice in adolescent health, a study was undertaken in the Department's office in the Northern Metropolitan Region that examined two existing primary health projects: the Keeping in Touch with Schools (KITS) Project, auspiced by the Eltham Community Health Centre and Diamond Valley Secondary College in the City of Nillumbik, and the Youth Counselling Awareness and Support (YCAS) Project, auspiced by Kildonan Family Services in the City of Whittlesea. Proiect features that were explored included elements and type of service, referral pathways and linkages, consumer satisfaction and other service outcomes, elements critical to success, obstacles, supervision and staff training, standards and guidelines, planning and evaluation, promotion of the service, and organisational structure. The study found that a combination of characteristics contributed to the success of the two projects that were examined. These pertain to skills and expertise of staff, flexibility of the service, cost, the type of service model, co-location with other services, linkages and partnerships, outputs and outcomes, feedback, management structure, standards and guidelines, planning processes, and evaluation.
Primary Health Care Response to the Treatment of Chronic Diarrhoea in Aboriginal Children
Authors: Badenoch Rosemary
Published: August 2009

This paper explores the issue of chronic diarrhoea in Australian Aboriginal children from a primary health care perspective. It discusses the nature of the problem and factors which influence its perpetuation as a dominant health issue for this population. A variety of primary health care solutions are suggested, including those in relation to basic sanitation, improvements to local environmental conditions, education, collaborative health care planning, resourcing implications and the empowerment of local communities.
Delivering Health Services for Ethnic Minorities in Regional Australia
Authors: Moxham Lorna , Pegg Shane
Published: August 2009

Recent articles in the print media have served to highlight the fact that health services in regional Australia are inadequately servicing the needs of ethnic minorities. Despite an increased awareness of the need for culturally appropriate services in more recent years, Australia, as one of the most ethno-culturally diverse nations in the world, still largely relies on the patriarchal biomedical model of health care, which has a pathogenic approach, focusing on why people fall sick and on treatment, rather than on communication between the client and the professional health care worker. Such practice, while well-intentioned, detracts from the ability of regional health services to adequately service the needs of a culturally diverse client group and, in turn, de-emphasises the clear link which has now been established between culture and health.
Sharpening the Focus on Ageing with Longterm Physical Disability
Authors: Cooper Margaret
Published: August 2009

Ageing with long term physical disability is largely uncharted territory. This review focuses primarily on the experiences of the people who incurred some paralytic effects following polio or spinal cord injury. It is suggested that the concentrated medical debate on specific syndromes, such as the post-polio syndrome, might be unproductive and that more effective knowledge might be obtained by studying the implications of ageing on the emerging group of older people who have been physically disabled for decades. With such knowledge, lifespan health care models and health promotion strategies can be developed to assist people who are ageing and have physical disabilities to stay healthy and productive members of the community.
Cervical Screening in Iranian Migrants
Authors: Rissel Chris , Khavarpour Freidoon
Published: August 2009

The cervical screening status of small and geographically diverse migrant communities is particularly difficult to assess. Usual approaches to migrant research such as telephone surveys using ethnically identifiable names or cluster sampling might not be feasible. Snowball sampling, although sometimes criticised for problems of inference with non-probability samples, might be the only cost-effective and viable alternative. Snowball sampling is the method of choice by sociologists studying networks and group interactions and has been shown to yield similar estimates of attitudes and demographic characteristics as probability sampling methods (Rumbaut, Chavez, Moser, Pickwell, & Wishik, 1988; Welch, 1975).
Responding to Health Inequalities in Australia: A Proposed Strategy
Authors: Duckett Stephen
Published: August 2009

This paper uses data from Australian Institute of Health and Welfare research on health inequalities to highlight the importance of moving beyond a simple risk factor approach to health promotion, to focus on the broader contextual factors which influence disparities in health within the Australian population. It argues that addressing health inequalities requires a focus on location (geography) and hence a first step in reducing health disparities is to develop national, state, and local health promotion plans.
The Environment and Health: An Alternative Perspective
Authors: Lewis Jennifer
Published: August 2009

A theoretical approach which may be used to increase understanding of the dynamics of environmental and health policy is outlined. The approach deals with conceptualisations or 'ways of knowing', and, as such, tends to raise questions for debate, rather than advance policy solutions. First, it considers ways in which people have thought about and 'known' the world around them and traces how this has been important in shaping our attitudes and values in relation to it, especially in influencing environmental and health policy. Three aspects are considered: the legacy of Enlightenment and Romantic philosophical frameworks, the significance of underlying contradictory assumptions within these frameworks, and some of the implications of this for public policy. Second, it advances a specific theoretical approach ? the dialectic ? as a means of exploring the relationship between ways of thought and providing insight into the complex dynamics of policy making. It looks briefly at the example of sewage disposal policy before arguing that a dialectic approach may be applied to a range of environmental and health policy situations.
The Political Appropriation of Social Capital
Authors: Paul Lindsay
Published: August 2009

Social capital, both as an abstract and a quantifiable concept, has seized the imagination and interest of social scientists, economists and politicians. Social capital can be regarded as an entity which facilitates the accessibility of the resources in a community. Some current ideas and research in this area are examined to see how these notions can be exploited for political or social advantage. The 1998 conference of the National Carers' Association of Australia provided an opportunity to observe these processes in action. Putnam's theory of social capital and its relation to democracy, some criticisms of his theory and the application of the concept in the context of informal caring are discussed.
A Task-Weighted Approach to Determining Authorship
Authors: Watts Jenny , Jackson Terri
Published: August 2009

Collaborative research is important in that it recognises the input and skills of a range of players participating in and contributing to health care programs. These players include academic researchers, practitioners, policy makers and evaluators. Questions relating to research publication arise across the spectrum of health-related research activities. The importance of establishing, at the commencement of research projects, expectations for claiming authorship is highlighted. Inevitably, collaborative research projects are a social enterprise and thus authorship determination can never be reduced to an objective process. This paper has emphasised that there are two dimensions for this negotiation.
Keynote Addresses: What Makes Women Sick? Promoting Women's Health: The Changing Agenda for Health Promotion
Authors: Doyal Lesley
Published: August 2009

The creation of a National Women's Health Policy in 1989 put Australia at the forefront of developments in women's health. By contrast, in the United Kingdom there is still no clear strategy for improving gender equity in the health service, and many of the principles taken for granted in Australia are not even on the National Health Service agenda. The current reforms of our health service do reflect a backing away from the 'quasi markets' of the Conservative era. However, little attention has been paid during this process to the specific needs of women. So Australia is still ahead, with Victoria in particular playing a key role in disseminating examples of good practice, both at home and internationally. The Australian Women's Health Policy and Program provides a fertile environment for innovation in good practice, but this does not mean that there is nothing left to achieve. Indeed, it may well require considerable effort just to maintain what has already been put in place. To move forward will mean continuing to confront those challenges in trying to improve women's health around the world. These are addressed by looking at three key themes: reconfiguring medicine; dealing with diversity; and gendering the social model of health. In each case these themes are placed in a global context.
Facing Facts, Facing Futures: Challenges to Women's Health
Authors: Broom Dorothy
Published: August 2009

For people with a long history of involvement in progressive politics, these are times to try the soul. The achievements of the 1970s and '80s are looking vulnerable and many have been rolled back. The gap between rich and poor is widening internationally and nationally, youth suicide, already alarming, is on the increase, indigenous rights are being eroded and indigenous health remains poor (perhaps these trends are related), unemployment persists at stubbornly high levels, and many women's services, including health services, are being de-funded, out-sourced, amalgamated or mainstreamed. Governments are becoming corporations and citizens are being asked to become customers.
The Current Policy Environment and Predictions for the Future
Authors: Murnane Mary
Published: August 2009

A brief overview of the Australian health system is followed by an outline of current health policy, focusing on the Government's reform agenda and its commitment to women's health. The growing emphasis on an evidence-based approach to policy development, and collaborations across health and other sectors, is discussed. The focus is on Australia's response to a particular women's health issue as an example of evidence-based policy development. Any predictions for the future must recognise that many of the causal factors of ill health lie outside the control of the health system, and take into account the growing opportunities for change through innovations and reforms in the health system, and through collaborations with other sectors.
Health Issues for Women of Non-English Speaking Backgrounds
Authors: Thomas Trang
Published: August 2009

The shift away from focusing only on physical factors in health to more on psycho-social factors means that, in a multicultural society like Australia, we have to pay attention to the influence of cultural factors in health and health promotion. Living healthily in a culturally diverse society is a challenge. Issues concerning cultural factors in maintaining and promoting the health of women of non-English speaking backgrounds are discussed here. Cultural differences and knowledge gaps create difficulties not only for the people in need of service, but for service providers as well. There is a need for bilingual and culturally sensitive trained professionals. Access to health care, especially preventive measures, and the role of ethnic women as carers are discussed. Another issue for attention is mental health. Risk factors in developing mental illness, and barriers to effective diagnosis and treatment are identified. Difficulties in handling health crises bring serious problems. Many women came from countries with traditional ways of handling crises which may not be possible or appropriate in Australia.
Health Outcome Planning for Women's Health: Fad or Future Imperative?
Authors: Stratigos Susan
Published: August 2009

The answer to the question of whether planning for women's health is fad or future imperative is probably that it is both. A focus on achieving a desired outcome through a specified intervention is hardly new. From pre-Hellenic times to the era of goals and targets era of the early 1990s, clients have understandably kept a sharp eye on the results of health services. The focus shifted from outputs and outcomes to the resources that go into health care when large scale public funding and powerful institutions became so important in the twentieht century.
Healthy, Wealthy & Wise? The Health Implications of Gambling for Women
Authors: Brown Sarah , Johnson Kelley , Jackson Alun , Wyn Johanna
Published: August 2009

The paper examines the health implications of gambling for women living in the Western Metropolitan Region of Melbourne. The research is unique in that it focuses on the health impact of gambling for women from different cultures and age groups within one regional setting. It seeks to explore how women view gambling in their lives and to develop and evaluate strategies to assist women and health agencies to reduce the negative impacts of gambling on women's health. The paper focuses on the findings of the study to date and the methodological and political difficulties involved in researching a sensitive women's health issue.
Stress and Health Implications
Authors: Kotsirilos Vicki
Published: August 2009

The aim of this paper is to review the current literature of the effects of stress on health, including other factors, such as lifestyle and loneliness. It also aims to explore methods of dealing with stress. Stress plays a large role in, and is the basis of many medical conditions, and appears to be the common cause of relapse towards unhealthy behavior patterns. Chronic stress may manifest as: a number of physical and psychosocial symptom presentations; unhealthy behaviour patterns; immune system dysfunction; and some medical conditions. A number of techniques can be used to help alleviate stress, for example, meditation. Apart from stress, other factors known to precipitate or aggravate illnesses include: social isolation (loneliness); a lack of love, meaning and purpose in life; a lack of joy, humour and laughter; a lack of expression of emotions; and negative attitudes and belief system. Studies demonstrate that the mind has a direct influence on the physical body. There is good evidence that optimism, hope and a sense of control can improve the quality of a person's life and their health.
Ports in a Storm: A Postnatal Depression Rural Support Services Project
Authors: Basinski Dee
Published: August 2009

This nine-month action-research project was conducted in 1996 by NEWomen Goulburn North-Eastern Women's Health Service and aimed to improve the system of services and support for women suffering postnatal depression (PND) in the Wangaratta district. The challenge was to influence existing mainstream and community service providers to bring about an effective system of service provision. The project included research, consultation and community education. Major findings were that PND was under-detected in some instances through inadequate knowledge and detection skills. Some women with PND experienced difficulty in receiving suitable services in a co-ordinated and timely way. Important outcomes were the review of the existing service system and consequent improvements. Working relations, co-operation and networking between various services were enhanced, as through the Project, providers supported: establishing a PND self-help group; distributing a PND information brochure; training recovered women to provide volunteer home-visiting support to women experiencing depression; trialing a 'screening' and co-ordinated referral approach and identifying good practice models. Another significant outcome was the opportunity for personal development as women participated in the project as interviewees, media commentators, support group members and home-visiting trainees. This paper highlights developments and ongoing challenges since the 1996 project.
Beyond Sexual Abuse: A Project to Enhance GP's Responses to Victim/Survivors of Sexual Abuse
Authors: Hughes Bernadette
Published: August 2009

Research (e.g. Mazza, Dennerstein, & Ryan, 1996) has demonstrated that general practitioners (GPs) are seeing female victims of sexual abuse in their practices but that the majority of victim/survivors do not disclose their trauma history to their GP. Consistent with this, referrals from GPs to the Western Region Centre Against Sexual Abuse (WestCASA) represented a small percentage of total referrals and anecdotal evidence suggested GPs were not adequately skilled to respond confidently to victim/survivors of sexual abuse. In 1997, WestCASA embarked upon a joint project with the Western Melbourne Division of General Practice for the enhancement of GP's awareness and skills in the identification, assessment and management of victim/survivors of sexual abuse, and to improve the networking and referral between WestCASA and GPs. The project resulted in GPs being more aware, skilled and confident in the assessment and continuing care of victim/survivors of sexual abuse with a marked increase in the number of referrals and secondary consultation with GPs. This project is presented as a model of best practice and the paper details the five stages of the project, including the training and relationship building strategies employed. Key factors contributing to the project's success are outlined and it is argued that projects such as this are vital in improving the quality of care provided by GPs, enhancing collaborative work between GPs and specialist, community agencies and improving the overall health and well being of survivors of sexual abuse.
Gender Issues in Falls in Older Community Dwelling Adults
Authors: Browning Colette , Hill Keith , Kendig Hal , Osborne Deborah
Published: August 2009

Falls are the leading cause of injury and hospitalisation for people aged 65 and over. It has been estimated that 20% of hospital admissions in this age group are a result of falls and Fildes (1994) reported that the costs of falls is about $2369 million annually in Victoria. The purpose of this paper is to present a profile of gender differences in the frequency and location of falls, fear of falling, and predictors of falls in community dwelling older adults.
Older Aboriginal Women's Experiences of Medications in Urban South Australia
Authors: de Crespigny Charlotte , Grbich Carol , Watson Jennifer
Published: August 2009

Older women are more likely to live alone in poverty than others in the community. They are also likely to maintain their independence well into older life. Recent Australian research into women's health issues has not investigated older women's direct experiences associated with their medication use, or any related interactions with health professionals such as general practitioners, pharmacists or registered nurses. This is despite significant funding, policy and research in most other areas of women's health in the 1990s. Similarly, the medication experiences of older Aboriginal women have been neglected. This paper reports on a cohort of older Aboriginal women (N-10) from a recent South Australian qualitative study into medication use of diverse groups of older women (N-142). In-depth, semi-structured, face to face interviews were conducted, predominantly in participants' suburban homes, and in a community setting. Thematic analysis of the data was undertaken, and comparisons were made with other cohorts in the overall study. Results showed that the experiences and perspectives of the urban Aboriginal women highlighted their connectedness with family, services and community, and that this was largely due to their access to particular Aboriginal services, and to indigenous cultural affiliations and practices. Despite this connectedness, and regular contact with general practitioners and pharmacists, there were significant deficits in their knowledge and skills in managing their medication. It became clear that there is an urgent need for culturally safe medication information, education and support for older Aboriginal women. There is also an urgent need for better education, training and support of all health workers who have critical roles and responsibilities in assisting this group in the community.
A Health Service and Aboriginal & Torres Strait Islander Partnership to Develop and Plan Mental Health Services
Authors: Salisbury Christine
Published: August 2009

The aim of this study was to examine the effects of an action research partnership between the Tweed Valley Health Service (TVHS) and the Aboriginal & Torres Strait Islander community for the development and delivery of Aboriginal & Torres Strait Islander Mental Health Services. This partnership was based upon Labonte's (1989) view of empowerment where it is suggested that to be empowered means to have increased capacity to define, analyse and act upon one's problems. It was proposed that the establishment of a 'partnership' based upon these principles would assist in operationalising Indigenous community participation in TVHS planning. To achieve this type of 'partnership', the health service had to be willing to enter the partnership and to give the authority to the Aboriginal & Torres Strait Islander Health Outcome Council to seek and trial solutions on Aboriginal & Torres Strait Islander Mental Health matters. Key outcomes were defined as the extent to which the re-organised services proved to be acceptable and utilised by the local Aboriginal & Torres Strait Islander population. Outcomes were operationalised through measures of service utilisation and consumer satisfaction with accessibility, process and outcomes. The study trialed participatory action research as a method for Indigenous participation in Mental Health Service planning and development and concludes that it is a valid model for cross cultural research and health service development in a complex medical setting.
Language Difficulties and Health Consequences for Older Italian-Australians in Ascot Vale
Authors: J. MacKinnon Valerie
Published: August 2009

A qualitative needs analysis, undertaken with 33 older Italian-Australians living in Ascot Vale, identified a number of language related difficulties that had actual or potential health consequences. Indeed health services utilisation was a problem for most participants and although they all attended a general practitioner, there was usually little or no contact with agencies that provide home care, support or health enhancing information, either because of a lack of awareness on the part of participants or because they believed the services were linguistically (or culturally) inappropriate. Language support, at best, was provided by family members because the health interpreter service was rarely used. The findings suggest a lack of structural and practitioner commitment to addressing the language needs of LOTE immigrants, especially: the current financial and administrative disincentives to community based practitioners using the health interpreter services; an apparent lack of commitment on the part of health workers to use the health interpreter services; and a failure to develop mechanisms for providing them with health related information. It appears that the equity debates of the 1970s that focused on language barriers should be revisited, because the findings of this study suggest language competence is a necessary prerequisite to these older participants effectively accessing health related information or services, or participating, either individually or collectively, in the planning or implementation of their health care.
Childhood Health and Illness: Cultural Beliefs and Practices among the Hmong in Victoria
Authors: Liamputtong Rice Pranee
Published: August 2009

This paper examines the cultural construction of childhood illness among Hmong refugees from Laos who are living in Australia. It focuses on traditional patterns of beliefs and practices related to health and illness of newborn infants and young children. The Hmong treat childhood health and illness seriously, and for them there are several causes of childhood illness, including nature, souls, supernatural beings and human aggression. The roles of traditional healers who play an important part in childhood health and illness are also discussed. Lastly, the paper attempts to make clear some implications for child health services for immigrants such as the Hmong in Australia and elsewhere. The paper intends to contribute an anthropological perspective on child health which is particularly important in a multicultural society. A clear understanding by health professionals of cultural beliefs and expectations is essential if misunderstanding is to be avoided, and culturally appropriate and sensitive health care for immigrant children, such as the Hmong to be available.
Health Consequences of the Asian Currency Crisis: Continuing Imperatives for a Primary Health Care Approach
Authors: Barraclough Simon , Morrow Martha
Published: August 2009

The Asian currency crisis and its attendant socio-economic problems in several Asian countries have had serious health consequences, especially for the poor. The scale of these problems has varied between countries due to their differing levels of economic development. Indonesia faces a malor emergency with the threat of widespread malnutrition and rapidly increasing rates of poverty. In this article, some of these health issues are discussed and the response of national governments and international agencies described. To date, the most significant players have been the supra-national financial institutions, which have urged national governments to maintain real levels of expenditure on essential health and education services. These institutions have provided substantial loans to prop up the ailing economies of South Korea, Thailand and Indonesia. Social development programmes, including health, have been an element in each of these loan schemes. It is argued that pressure should be maintained on the IMF, World Bank and Asian Development Bank to support measures to reduce the impact of the crisis on the poor. Such measures must include protection of public expenditure on primary health care. The currency crisis will also provide opportunities to reassert the vital importance of primary health care and to carry out reforms to strengthen it.
Integration of General Practitioners with Hospitals and Community Health Services: A Qualitative Examination
Authors: Fridgant Yelena , P. Powell Davies Gawaine , I. O'Toole Brian , Betbeder-Matibet Luc , F. Harris Mark
Published: August 2009

A series of focus groups was conducted with general practitioners (GPs), community health workers, hospital staff and consumers to examine the issue of integration of general practice within the wider Australian health system. Groups were held in various urban and rural locations to provide coverage of urban and rural conditions. The groups had representation from managerial as well as service provider staff and included GPs, hospital discharge planners, and emergency department staff, and from community health staff, nurses, physiotherapists, mental health workers, occupational therapists, and educators. Agreement was widespread that enhanced integration would confer benefits to patients, GPs, other health professionals, and to the health system generally. However, the health system was seen to be limited in its ability to integrate services. General practice, as small business working within the public health system, had different procedures and methods of remuneration than other health system components. Barriers to integration included structural, procedural and organisational factors, and included communication difficulties, variability in the roles and expectations of various service providers, and resource allocation and methods of funding. It is necessary to examine the barriers to integration more closely within the context of each type of service, to investigate effective ways of overcoming these barriers, and to describe and quantify the benefits that might arise from increased integration.
Work Stress, Coping, and Gender
Authors: J. Kirkby Robert , Skues Jenifer
Published: August 2009

Women constitute an increasingly large segment of the paid workforce. Nevertheless, investigators of work stress have focused predominantly on men and, largely, have ignored possible gender differences. This has led to findings, based on the study of male workers, being incorrectly applied to females. Further, the limited amount of research into work stress and coping that has been published has been vulnerable to criticisms. An analysis of research in this area suggested that gender moderates work stress in three ways: men and women are vulnerable to different stressors relating to work; they utilise different coping strategies to cope with these stressors, and they vary in their perceptions of the resources that they have available to help them to cope. It is important to direct research resources to further investigation of gender differences in these three dimensions. Such research is necessary for the development of effective preventative and treatment programs for occupational stress.
Obtaining and Using Client Feedback in Community Health Services
Authors: Jolley Gwyneth , Kalucy Libby , McNamara Joanne
Published: August 2009

Client feedback is an important component of two primary health care strategies: participation and evaluation. Workers need feedback from clients to ensure that their practice meets the criterion of providing affordable, accessible and appropriate services to enhance the health of their communities. Telephone interviews were conducted with thirty staff and thirty clients from women's and community health services in South Australia, to identify current practice in obtaining and using feedback from users of one-to-one services and group health promotion and community development activities. Factors which encourage feedback to be given and used include: trust and effective communications between all stakeholders; and supportive organisational philosophies, culture and practices. Client feedback is more likely to be used when given in written form. Collection and use of feedback are discouraged by inappropriate methods and timing, rapid organisational change, and clients' lack of awareness of, or confidence in, giving feedback about the services they receive. Verbal feedback, although preferred by many clients, is less likely to be recorded and used in service planning and evaluation. Client feedback is a valuable tool to reinforce the notion of partnership and power sharing between clients and health care workers. Staff at all levels should be engaged in obtaining feedback and the information gained should be disseminated throughout the agency in order to improve the quality and effectiveness of services. The challenge is now for service providers and users to adopt new, and support currently successful, ways of obtaining and using feedback so that service providers and users are engaged in working in partnership to ensure the needs of the community are best met.
Guest Editorial: Community Participation in Community Health: A PHACS Information Resource
Authors: McCoppin Brigid
Published: August 2009

In his foreword to the recent Department of Human Services (DHS) publication Community participation in community health: A PHACS information resource 3 (1999), the Parliamentary Secretary to the Victorian Minister for Health says that the 'heart' of the current primary health and community support (PHACS) reforms is to ensure that the 'locally based alliances' which are to emerge from them will be responsive to client needs, and notes also that the proposed PHACS demonstration projects will have to include plans for community participation. The aim of this Information Resource in the series Towards a stronger primary health and community support system from the Department of Human Services Victoria, is to guide workers in community health agencies, and in the other PHACS services, in developing ways of encouraging community participation. As such, the document provides both a rationale and practical suggestions, and should be a useful resource for board members and staff of community agencies, as well as for those either teaching or studying in such fields as health promotion and health education, where engaging the interest of members of the public is a central purpose.
Issues for General Practitioners Caring for Dying Patients in the Home
Authors: Street Annette , Blackford Jeanine , Turley Anne , Kelso Judy
Published: August 2009

General practitioners have a central role in the provision of quality health care to the terminally ill patient and family in their own homes. Staff from the Department of Human Services were concerned that GPs were experiencing stress through their increasing role in the provision of palliative care and that there was a need for a fee-for-service stress counselling program for them. A small qualitative study was conducted to verify this perceived need. Semi-structured telephone interviews were conducted with 50 GPs selected from a sample of metropolitan attendees at postgraduate educational activities or doctors known to palliative care services. GPs faced a number of issues in their care for terminally ill people in the community but a fee-for-service counselling program was deemed unnecessary. Evidence from the study confirmed that effective communication strategies between GPs, palliative care services and acute hospitals, an interdisciplinary team approach, and improved understanding between health professionals would enhance the quality of care for dying people and their caregivers.
Integration of General Practitioners and Mental Health Services: The Northern Queensland Integrated Mental Health Program
Authors: Alsop Maureen , Battye Kristine
Published: August 2009

The Integrated Mental Health Program is a joint initiative of the Northern Queensland Rural Division of General Practice, Townsville Division of General Practice, and the Townsville District Integrated Mental Health Service (IMHS).The program seeks to empower general practitioners (GPs) to meet current gaps in mental health service delivery in North Queensland, and establish better liaison and integration of services provided by GPs and by hospital and community based mental health professionals. Sixty-three GPs and twenty-four mental health professionals were interviewed across the two divisions to identify barriers encountered in the management of people with mental health problems. The barriers identified fell into three broad categories: those related to referral, to discharge, and to communication. A two-week audit of the IMHS intake and discharge processes provided further data to clarify the difficulties involved in the integrated management of patients with mental health problems. Two-week audits are to be conducted at six monthly intervals throughout the course of the program as a tool for evaluation of the program's effectiveness. General findings from the audit indicate that, although the levelof GP referrals judged by mental health professionals to be inappropriate is low, the lack of information GPs provide when referring may create ambiguity regarding the appropriateness of their referrals, thus creating the perception that they make inappropriate referrals at a higher rate than is in fact the case. Strategies for improving communication between GPs and existing mental health services are being explored, with early initiatives towards a system of shared care being developed.
Treatment Options for Depression: Women and Primary Service Providers
Authors: Hood Bernadette , Egan Ronnie , Gridley Heather , Brew Christine
Published: August 2009

A substantive quantitative research literature base exists exploring aspects of treatment for depression. Major themes to emerge from this literature include the use of general practitioners (GPs) in preference to psychiatrists for treatment and the negative public attitudes toward the use of pharmacological treatment strategies for depression. The study reported in this paper utilises a qualitative methodology to explore the experiences and attitudes of women currently being treated for depression. Specifically the paper focusses on the women's attitudes toward psychological versus medical treatment options for the disorder. Attitudes toward treatment modalities of medical and non-medical primary service providers are also investigated. Several significant findings emerged from the study. Women interviewed expressed a sense of personal responsibility for both the occurrence and management of depression.Consequent to this belief psychosocial interventions were critical to 'getting well'. Medication was viewed positively by all women, not as a treatment for depression, rather as a means of relieving the extreme symptoms of the illness, therefore providing space for psychosocial interventions. Medical and non-medical service providers expressed an acceptance of the need for integrating psychological and pharmacological treatment strategies though all providers acknowledged their lack of skills in incorporating treatments outside of their professional training. The study provides insight into the belief structures which influence participants' behaviours, presenting a less polarised view of attitudes toward psychological and pharmacological interventions than suggested by the current quantitative literature.
Women's Health in Melbourne's Print Media: A Content Analysis
Authors: g Jo Shug , Liamputtong Rice Pranee
Published: August 2009

This paper examines the portrayal of women's health issues in two newspapers: The Age and The Herald Sun. It aims to discover the frequency in Melbourne's print media of coverage of women's health issues, the placement of these articles, the variety of women's health topics covered, and the underlying messages in articles on women's health. It also aims to investigate the level of public reaction to the area of women's health by monitoring the Letters to the Editor and Your Say columns. The study employed an unobtrusive method and was conducted over a three month period: May to July 1998. It found that 38.46% of health articles published between May and July were specifically related to women's health, and that 22.17% of public reaction responses to health over the same period were related to women's health. There was little variety in the coverage of women's health, as many of the articles and public reaction responses centred on women and their ability to conceive and raise children. This implies that women are still portrayed by the media as 'mothers' in Australian society.
Menopause into the Millennium: Development of a Training Program for General Practitioners in Menopausal Medicine
Authors: J. Andrews Fiona
Published: August 2009

Recent studies suggest that general practitioners (GPs) are voicing a need for continuing medical education to help them in their role as primary health care providers for women going through the menopause. The study describes the development and evaluation of a pilot training program for GPs in menopausal medicine. Key features of the program include: the importance of GPs in the development of the program; recognition of adult learning principles; the incorporation of women's views; the accessibility of the program; and the recognition that providing GPs with high, quality, relevant education on the menopause should ultimately benefit women seeking their help. Evaluation of the pilot program found that GPs were very satisfied with the content and delivery of the program. The material presented was found to be relevant to GP practices and a substantial proportion of GPs suggested that the information would change the way they practiced.
Cycling and Walking: Why Don't Hospitals Provide Facilities for Healthy Transport?
Authors: Owen Harry , H. Day Rosalie , Scullion Paul
Published: August 2009

Physical activity is essential for health but modern lifestyles have become increasingly sedentary. Walking and cycling for transport is exercise that can readily become an habitual everyday activity. Health policy recognises the value of walking and cycling but government policy generally promotes personal car use and transport planning encourages this mode. Hospitals should be at the forefront of promoting healthy transport policy and this study was undertaken to assess the attitudes in hospitals to health-promoting transport and the facilities provided to support it. A questionnaire about attitudes to physical activity, health promotion and walking and cycling was sent to 15 hospitals in metropolitan Adelaide. This was followed up with site visits. Although respondents were aware of the beneficial effects of physical activity only a third translated this into any action. No hospital encouraged walking or cycling for transport. All hospitals had car parking but few had bicycle parking and fewer had facilities that met Australian Standards. In many hospitals overseas, walking and cycling are actively encouraged through improved access, appropriate facilities and even incentives. Hospitals in Adelaide could have a positive health impact by moving beyond 'treatment' and promoting walking and cycling for transport and health.
The New Health for All: Environments for Health or Primary Health Care is Alive and Well
Authors: Macdonald John
Published: August 2009

Comprehensive Primary Health Care, and Comprehensive Health Promotion, is as relevant today as it ever was. Its approach and philosophy are useful and even necessary tools in all societies where there is still concern to build a rational and humane health care system.
Disability in the Australian Aboriginal Population
Authors: Maher Patrick
Published: August 2009

There is a general lack of information, both quantitative and qualitative, which considers the issues affecting Aboriginal people with disabilities. This article summarises data in regard to the burden of ill health experienced by Aboriginal people and the extent and nature of disability within the Aboriginal community. This information provides the background to a discussion of the attitudes of Aboriginal people to disability. Until there is sufficient quantitative and qualitative information available regarding Aboriginal people with disabilities the ability of service providers to deliver optimal services to Aboriginal people will be compromised.
Capacity Building and Community Enrichment: Evaluation for Sustainability
Authors: Mann Susan , Byrnes Tess
Published: August 2009

Evaluation is a continuing dilemma in health promotion initiatives. However, for projects to be sustained effective indicators and tools need to be implemented in order for resources and funding to be channeled into such enterprises. The capacity building model developed by New South Wales Health (1998) provided one model for evaluating a collaborative endeavor between the School of Nursing, Flinders University and Noarlunga Health Services, a generic community health centre in the southern urban/rural area of South Australia. The Community Enrichment Program (CEP), is in the final year of a four year funded project that aimed, in part, to determine what impact an integrated knowledge of Primary Health Care (PHC) would have on students and new graduates' nursing practice and, whether enough evidence would be generated to effect ongoing curriculum change. This paper considers capacity building in relation to the CEP and how the Ottawa Charter and the Jakarta Declaration are supported by this ideal. Argument is forwarded that workforce development, organizational structure and resource allocation, seen as tenets of capacity building, have been demonstrated in the CEP. Recommendations flowing from the project include the allocation of resources into a sustained, overt and integration of PHC philosophy and health promotion principles into nursing curriculum.
Evaluation of the Interface Between General Practice and Population Health in Research funded by the General Practice Evaluation Program
Authors: Rogers Wendy , Veale Bronwyn , Weller David
Published: August 2009

The purpose of this study was to identify the fields of population health covered by General Practice Evaluation Program (GPEP) research and to evaluate the population health findings and implications of this research. The research method was to conduct a review of 150 GPEP project reports completed between 1992-1998, using a framework developed to identify research with population health content and/or relevance. A total of 65 projects were identified in the following areas: health promotion; disease prevention and screening; systematic illness care; integration of health services; data collection; and research on specific populations. The majority of the research was descriptive in nature (53 out of 65 projects). Strengths of the existent research lie in documenting the use of interventions to improve systematic illness care, and in GP activities directed towards disease prevention and screening. However, the analysis identified a number of problem areas. Recording and collection of information about GP activities is variable, in part due to a lack of consensus about the kind of information that should be collected. Our analysis highlights the need for a national approach to the assessment, adoption, dissemination and implementation of guidelines, and for critical evaluation of this process. There is a lack of evidence for the efficacy of many GP interventions for improving population health. The research demonstrated examples of collaboration between GPs and other health care providers, and of general practice research using a population health approach. It was concluded that GPEP is an innovative funding program which has the potential to make substantial contributions to population health and to strengthen the links between general practice and population health. To date it has focussed on systematic illness care with current practice providing models for future development. However, there is a need for systematic approaches to data set definition, data collection and guideline use.
Rural and Metropolitan Community Health: Celebrating the Strengths
Authors: Littleford Angela , Martin Debbie , Martinez Lee , May Angela
Published: August 2009

The paper outlines the strengths, similarities and differences of metropolitan and rural community health sectors. Case studies are used to look at the history of community health in South Australia, its current status is described and some future directions are proposed. Perspectives are drawn from the authors' collective experiences. Rural and metropolitan community health services in South Australia have developed from different models since they were established in the 1970s. Rural community health services have invariably been established as entities within hospitals and health services, although metropolitan community health services have generally been established as stand alone facilities independent of the acute sector. To illustrate this, two case studies are used to demonstrate the evolution of metropolitan and rural community health services.