bluuebunny/crossref_metadata_2025 huggingface dataset:
Enuresis: Myths, Misunderstandings and Solutions
Authors: Knapp Martin
Published: August 2009

Advice on enuresis has been provided by a range of individuals. Many myths and misunderstandings have been responsible for the confusing range of opinions given to those who seek help. Management should be based on an understanding of the physiology of the condition and the established facts about its treatment. There is still a lack of awareness about how effective are the management strategies now proposed by those who base their practise on the extensive research that is now documented. The best results are obtained with conditioning therapy, when this is supervised and supported. There is an important role for 'wetness' alarms in conditioning. There are now body-worn mini-alarms, established by over a decade of use, that are inexpensive and reliable. There is a decreasing role for tricyclic medication. The recently introduced pharmaceutical Minirin (desmopressin) is useful in short-term management to get dryness on social occasions and, in selected individuals, might have a role in long-term control of enuresis, when conditioning has not been effective. There is an important need to provide advice and treatment facilities for all those with enuresis - a treatable condition.
An Outreach Midwifery Program for Homeless, Pregnant Young Women in the Northern Metropolitan Region of Melbourne
Authors: Sageman Elischka , Cook Sharleen
Published: August 2009

In this paper, the background, planning, and implementation of an outreach midwifery service for homeless, pregnant, young women in the northern metropolitan area of Melbourne is described. Research in the north east region of Melbourne had shown the large number of pregnant, homeless, young women, particularly in the West Heidelberg area (McDonald, 1992). Conventional antenatal services were not accessed by these women. They did not attend ante or postnatal classes and frequently missed hospital and medical appointments due to their transient lifestyle and lack of transport. This diminished the opportunity for favourable obstetric outcomes and could have undermined the ability for adequate parenting. The aim of the outreach program was to access the women in the appropriate settings, which might be a school, a refuge, a special accommodation centre, or in some cases a detention centre. The midwife would provide ante and postnatal education and support tailored to individual needs, make appropriate referrals to other agencies, provide practical assistance, such as transport, and be an advocate on behalf of the women where necessary. The main achievements of the program have been the provision of accessible and appropriate ante and postnatal care to a group of young women, who would not otherwise have accessed such services. Further, valuable links have been established with a variety of community agencies, enabling a more co-ordinated approach to client care.
The Smoke-Free Project
Authors: Broomhall Helen , Hare Jon , Watts William
Published: August 2009

Limiting the sale of cigarettes to tobacconists and substantial increases in price are two measures most likely to reduce or prevent adolescent smoking. Continuing education about the dangers and other undesirable aspects of smoking, whilst not sufficient in itself to deter teenage smoking, is also important. This pilot study had two major aims: (1) to inform primary school children (grades 5 to 7) about the risks of smoking, and to do this in an innovative manner, involving both parents and teachers; and (2) to gauge the degree of support from parents for increased restrictions in the sale of tobacco products and for substantial increases in price. Such support is essential to enable the political decisions necessary to restrict sales and increase prices. A majority of parents surveyed supported restrictions in the sale of cigarettes and increases in price. The innovative educational method used in this study was very well received by the children and their teachers. Suggestions are made for further development of the educational method and extension of the study.
Better Health for Blokes¾A Community-Based Men's Health Program
Authors: Yelland Michael , Penrose Penny
Published: August 2009

In recognition of the specific health problems and needs of men, a community-based health program was set up at the Inala Community Health Centre in Brisbane in late 1994. This program aimed to create a supportive environment in which men with long term health problems could improve health awareness, attitudes and skills and their quality of life. The program involves a group of men who meet fortnightly to discuss health topics, assisted by facilitators and invited resource people. The group determines its own topics, activities and rules, and is working towards becoming independent of the facilitators. A qualitative evaluation of the group after seven months, confirmed that it has provided a supportive environment in which health concerns can be discussed and health knowledge can be improved. During this period a number of the men reported a reduction or cessation of smoking, improvement in dietary habits and an improved ability to relax and to communicate with people. The group has moved consistently towards independence, aided by reflection on group processes. Quantitatively, the group has shown a significant improvement in a quality of life index, from 4.95 +/- 0.79 at the start of the program to 5.68 +/- 0.74 after three months. This was maintained at 5.65 +/- 0.39 after seven months.
Building a Gymnasium¾Building Health in Lake Cargelligo
Authors: Northey Joy
Published: August 2009

Lake Cargelligo is a small, isolated rural community in the centre of New South Wales with a population of 2000, of these 60% live in the town. The project to build a gymnasium was the result of a combined approach to improve the health and fitness of the community by hospital and community health staff and by the community at large. It was the outcome of a series of innovative approaches to addressing local health issues.
Yawning Cows and other Projects for Young People
Authors: Weight Paul
Published: August 2009

The Yawning Cows Youth Group was formed in 1994. 'Yawning' represents the boredom felt by young people, and 'Cows' the rural image of where they live. The group, with 40 members, creates opportunities for young adults in the Grampians region of rural Victoria and meets at the Grampians Community Health Centre in Stawell. The group organises projects and fundraising events, such as rock concerts, for young people, and gives the valuable opportunity to learn team building and organisation skills. Many of its projects are in conjunction with other youth programs developed from the Health Centre.
Progress in Queensland: from Service Centres to Centres of Service
Authors: Nagle Gabrielle
Published: August 2009

Planning the development of new community facilities is a challenge. The knowledge required to provide a framework in which to establish a functional structure go beyond that of architecture, construction, health service provision, and facility management. What is required is an ability to create a centre, not only based on its internal and external appearance, but also on whether it is responsive and flexible enough to incorporate future needs and services beyond immediate planning.
Best Practice in Health Care: Confusion and Contribution?
Authors: Renhard Russell
Published: August 2009

As the health care industry adopts the language of more commercially oriented industries, terms such as best practice emerge in the health literature (Health and Community Services Victoria, 1995). This occurs often without qualification or definition and in different contexts. Consequently, there is a need to develop consistency in the use of such terms and some understanding of the concepts. This discussion revolves around the answers to questions which it is hoped will provide a framework for consistency in the use of the term best practice. As language evolves, meanings change as understanding increases and the context of usage alters. Therefore, it is neither claimed that this analysis is unchallengeable, nor that the definition is absolute. It is simply an attempt to create a degree of order in the debate on best practice; a term which has been used loosely. The two principal questions to be addressed are: what is the meaning of best practice? and is it a concept that has anything of value to offer health service management and service delivery?
Men's Health Policy: Report on the Draft National Men's Health Policy
Authors: Butler Paul
Published: August 2009

On 18 January 1996 at the Glen Waverley Returned and Services League (RSL), the Minister for Human Services and Health, Dr Carmen Lawrence released the Draft National Men's Health Policy.
Exercise in Pregnancy: Psychological Benefits
Authors: Kirkby Robert , Birmingham Rachael
Published: August 2009

Research findings have indicated that involvement in exercise can be beneficial to a pregnant woman and to the child she is carrying. Despite the apparent importance of this topic, researchers have directed little attention to the behavioural consequences of exercise for pregnant women. Furthermore, most of the investigations in this area have been vulnerable to serious criticisms of design, analysis, or interpretation. Notwithstanding these criticisms, the literature suggests that involvement in exercise during pregnancy is associated with perception of reduced negative symptoms, improvements in general mood, reduced depression, and increased self-esteem. As well, studies of childbirth stress have indicated that women who exercise during pregnancy reported less effort and lowered experience of pain in the birth process. In terms of best clinical practice it was recommended that health professionals should focus on the processes of informing, educating, and encouraging women about exercise in pregnancy, screening at-risk women, and identifying appropriate activities.
Community Expectations of Ethnic Health Workers: Implications for Best Practice
Authors: Fuller Jeff
Published: August 2009

The manner in which people from non-English speaking background (NESB) communities seek health services in Australia is not well understood. Hence, best practices in immigrant health service delivery are not well articulated. This paper is a report of a study that explored what members of ethnic communities want from ethnic health workers. Interviews and focus group discussions were held with key informants and members of the Cambodian, Greek, Italian, Vietnamese and Chinese communities in Adelaide. The main themes identified from the research data were: the understanding of the role of the ethnic health worker; important attributes of an ethnic health worker; and the length of time an ethnic health worker is needed in a community. Participants reported that ethnic health workers were expected to help out with a broad range of problems, but were needed principally to mediate between clients and the bureaucracy for health and other matters. A client's ability to communicate with the ethnic health worker and to develop a trusting relationship determined how the ethnic health worker was used. Practical matters related to settlement in Australia set the priority for assistance in the early stages of residence. although ongoing language differences created a demand for special assistance even after 20-40 years. Implications for best practice are discussed, and the paper concludes with suggestions for changes to improve how health services are provided.
Best Practice in Community Midwifery: The Safe Care of Non-English Speaking Background Women
Authors: Carberry Clare , Carey Ann
Published: August 2009

In view of the 'sunsetting' of restrictive regulations, which for years have obstructed comprehensive midwifery practice in Victoria, it is timely for the nature of midwifery care in a primary health care setting to be explicated. A best practice framework is employed to examine the pre-conditions and key process factors which facilitate and potentiate quality of midwifery care in the North Richmond Community Health Centre's shared care maternity program. The process of care is considered in detail, while outcomes and client perceptions are outlined. The nature of safe midwifery practice at the individual client/practitioner level�the micro dimension of care�is explored in the context of broader societal issues which directly and indirectly affect health status and outcomes for clients�the macro dimension. This discussion seeks not only to delineate best practice but also to challenge accepted notions of what constitutes safe care.
Standards of Practice for Speech Pathologists in Community Health: Towards a Formal Program of Continuing Professional Development
Authors: Bayley Louise , Bevan Melissa , Butzkueven Sally , Mackenzie Jan
Published: August 2009

The current accreditation system existing in community health � CHASP � is concerned with finding ways of ensuring quality of service within community health centres, but falls short of assessing the quality of specific professional areas. A group of speech pathologists accepted an offer to prepare a demonstration document of Speech Pathology standards that could be incorporated into a Professional Accreditation Module. The standards document was presented to the Victorian Department of Health and Community Services with the aim of securing further funding for the completion of the project. Although, verbal feedback indicated in principle support for the development of Professional Accreditation Modules for all community health disciplines, no provision of resources was made to fully develop the project during the 1995-1996 budget. A description of the process of arriving at the draft set of 26 standards is presented and the outcomes and future directions are discussed.
Management for Primary Health Care
Authors: Johnson Sally
Published: August 2009

This paper is about the implementation of primary health care and particularly about the role of management in this approach to health care. Just as the organisation for primary health care has a very different 'look' from that of conventional health care systems so does its management. One of the reasons for this is the strong commitment in primary health care to community participation which grounds it solidly in the people whose health is at stake. Best practice in management for primary health care is about shared management, strong organisation with shared meanings, and the making of strategic alliances. The discussion focuses on some of the skills needed by a primary health care manager, and the effective use of these skills for the primary health care organisation. There is no doubt that the role of the manager in the implementation and maintenance of primary health care is critical to achieving best practice in this approach to health care.
Zero Tolerance in South Australia: A Statewide Community Initiative
Authors: Buchanan Fiona
Published: August 2009

The Zero Tolerance Campaign against violence to women and children is a hard hitting, controversial campaign designed to raise public awareness and provoke debate about male abuse of power in the areas of domestic violence, rape and sexual assault, and child sexual abuse. Zero Tolerance is also an example of best practice in cross sectoral co-operation. The campaign comprises a statewide initiative involving the Health Promotion Unit of the South Australian Health Commission, the Domestic Violence Resource Unit, Family and Community Services, community health workers and local community action groups throughout the state. The process of bringing together a wide range of individuals from very different backgrounds and differing perspectives to work collaboratively on a controversial, innovative project led to extensive examination and defining of the issues involved. The planning process included a microcosm of the debate which Zero Tolerance intends to generate in the community. Resolution of the issues raised, employed many of the strategies developed and identified as best practice in the field of primary health care. The paper explores the challenges and rewards in the context of working collaboratively through the planning of a controversial initiative and identifies the merits of a campaign which has built on a diverse range of knowledge. Zero Tolerance, as a campaign, has the scope to be adapted in a variety of culturally and socially diverse initiatives as it becomes identified as an example of international best practice developed to stop violence against women and children.
Editorial
Authors: Gardner Heather
Published: August 2009

Much of the material in this issue is concerned with communication, but communication is much more than simply a means whereby information and knowledge is transferred between people. It is influenced by culture and by the social and policy contexts in which it takes place. In the primary health care area, meaningful communication is possibly even more important and more difficult than in any other area of the health system. It is more difficult, for example, because of the principles of primary health care to which practitioners subscribe, including the empowerment of those who would seek access to the system, re-orienting the health sector, and intersectoral co-operation in attempting to improve health and health services. The contributors demonstrate that in primary health care and in thinking about what is health, what influences it, how is it perceived, and how is it to be improved, there are theoretical and practical ways of and approaching such issues.
Knowledge, Language and Mortality: Communicating Health Information in Aboriginal Communities in the Northern Territory
Authors: Weeramanthri Tarun
Published: August 2009

Here the difficulties that non-Aboriginal health professionals experience in discussing health information with Aboriginal people in the Northern Territory are considered. Communication of information is seen as critical to the process of primary health care but beset by problems of language, different ways of 'knowing' and different values. Specific examples of communication difficulties are given from a five year research project that focused on the social and medical issues behind a series of adult Aboriginal deaths. The purpose of providing information at a community level is two-fold: first, to demystify an issue, process or structure and second, to get people talking. It is useful in communicative practice to view health information as having two equally important components: statistics and stories. All statistics are built up from individual stories, and effective information programs incorporate the story approach. Suggestions are made as to how primary health care practitioners can improve their communication practices. Before practitioners ask 'What do people need?' or 'What are their problems and how can they be addressed?', they need to ask first 'What do people know?' and second 'What do people value?'
Health Service Restructuring: Changes in the Roles of General Practitioners
Authors: Peterson Chris
Published: August 2009

As part of the general restructuring of the health system in Australia, the role of the general practitioner (GP) is undergoing some changes. Experience in a number of countries has been to broaden the GP role and for some GP skills to be performed by other health professionals, and for GPs to subsume some specialist tasks. Some time ago the Federal government undertook initiatives to strengthen the position of GPs and to upgrade their status in the health system. This has had an impact in their role in co-ordinating care, as gatekeepers and case managers, and in potentially taking over some skills areas which specialists have performed for some time. Here it is proposed that the GP role needs to become more flexible to be able to account for changes in payment systems and moves towards fundholding arrangements. Some specialist skills can be subsumed into the GP role and maximum effort needs to be directed towards integrating the GP into the wider field of health service provision.
Reported Consequences Following Road Accidents
Authors: Jeavons Sue , Greenwood Kenneth , Horne David
Published: August 2009

The literature on the sequelae of road accidents is limited but generally focuses on psychiatric diagnoses. Reported here are the results of a survey that assessed the degree of physical, social and occupational effects, counselling received, and perceptions of treatment of road accident victims, up to two years after the accident. There was a poor response rate and some methodological weaknesses, but results showed that there were marked effects in these aspects of people's lives and that few had received counselling or follow-up.
A Communitarian Correction for Health Outcomes in New South Wales?
Authors: Rissel Chris
Published: August 2009

For over a decade, there has been a growing focus on health outcomes in the Australian health care system at a national and state level. Designed to improve population health, health outcomes programs are an attempt to re-orient health services. In Australia, New South Wales (NSW) is probably the most advanced state in implementing a health outcomes approach. What is the role of communities in the model of health outcomes proposed by the NSW Health Department? A theoretical perspective of 'community' is presented, which is then used to analyse major policy documents and publications from the NSW Department of Health that advance a health outcomes approach. The interface between health services and communities is particularly important from the perspective of NSW Health Areas and Districts which must implement programs to improve the health outcomes of the communities in their catchment areas. The contribution to improved health outcomes that is possible by working with communities should not be lost in any re-orientation of health services.
Financial Counselling and Problem Gambling Counselling: Exploration Of A Service Model
Authors: Pentland Jan , Drosten Pauline
Published: August 2009

How can financial counsellors and problem gambling counsellors work effectively together to provide the best service outcomes for their gambling clients? A brief overview of the work of the financial counselling and problem gambling counselling services based at West Heidelberg Community Health Centre is presented here. In particular, it focusses on the practice of one financial counsellor and one problem gambling counsellor and the cases that they worked on together. It seeks to identify strategies which might facilitate effective joint casework with gamblers.
The Association of Health Professionals
Authors: Paul Lindsay
Published: August 2009

Community health is by definition multidisciplinary, and the assumption that there is mutual respect and co-operation within these disciplines is integral to its philosophy. Many members of a community health 'team' are, however, also professionals, and as such expect to enjoy the traditional prestige and autonomy which is associated with professionalism. Nevertheless, this might be problematic, as there are ideological differences between professionalism and community health values, which is exacerbated by the number of different professions involved. The issue is further complicated by the use of modern management techniques in the public sector by contemporary governments, where the philosophies which inform these techniques can be inherently incompatible with professionalism and community health values. A degree of compromise by professionals and management must be reached if they are to coexist and function effectively in community health. The sociology of the professions and the ideologies of professionalism, community health and the organisational structures encountered in community health are reviewed here. It is suggested that greater awareness of these ideologies and their practical implications may result in more flexibility in the association of occupations which constitute community health.
On Line Primary Health Care
Authors: M Green Rosemary , L Parker Margaret
Published: August 2009

Primary health care provided via a telephone service allows parents ready access to health services and health information. This paper reports the findings of a survey of 4169 users of a 24 hour Child and Youth Health Telephone Advice Service. The purpose was to establish baseline data of parents who telephoned. It sought to determine how often parents rang, why they used the service in preference to other services, the reasons for telephoning and details about the caller and the child they phoned about, as well as use of the service by country parents. The results highlighted that the service is primarily used by parents of children under 12 months of age and the main reasons for phoning were for information and advice regarding feeding, sleeping and illness. Results also showed a higher usage of Telephone Advice by parents living in higher socio-economic areas and a corresponding lower use in lower socio-economic areas. It was evident that parents preferred to use the telephone service because of ease of access and not having to make an appointment. Some parents used the service as their only source of child health information.
Community Health and the Environment
Authors: Fabb Linda
Published: August 2009

Case Study One: The Lead Project: Public Health On The Ground: Doutta Galla Community Health Service (DGCHS) is located in Victoria, in Melbourne's inner West. It aims to provide health care services, and health education and promotion to a culturally diverse and changing community. It currently services two local council areas and a population of 146,000 people, with a further 249,000 coming into the area daily for work, study or shopping. It covers four of Melbourne's largest public housing estates and large groups of people from Non-English Speaking Background including South America, the Horn of Africa, Turkey, Vietnam and China.
Editorial
Authors: Gardner Heather
Published: August 2009

The Australian Journal of Primary Health - Interchange was launched on 11 December 1995 by the Honorable Mr Rob Knowles, Victorian Minister for Health, and Ms Kerry Ferguson, the then Dean of the Faculty of Health Sciences, La Trobe University. The Australian Journal of Primary Health - Interchange is now one year old.
Veterans, Part of the Net: Trends in Community Health Programs
Authors: Barr Felicity
Published: August 2009

The Department of Veterans' Affairs (DVA) has moved from being a provider of primary health care, through ownership of Repatriation General Hospitals in each state, to being a major purchaser of community-based health care services. Departmental programs are more outwardly focussed than in the past and are more stringently evaluated to ensure the effective delivery of best practice standard services. DVA is committed to recognising the nation's special debt to the veteran community through appropriate compensation and health care programs. In this paper, the range of Departmental community health care programs, including those which focus on the innovative delivery of services through joint initiatives with community self help organisations, are discussed.
Community Health Services and Managerialism
Authors: Baum Fran
Published: August 2009

In this paper, the impact is described of the introduction of the new public management (NPM) on community health services in Australia. From the late 1980s NPM techniques, modelled largely on private sector practices, have been popular with federal and state governments and have affected the management of community health services. Services have been amalgamated, asked to evaluate their work in inappropriate ways and been pressured to a quasi market form of operation. Three fundamantal differences between a primary health care and NPM approach to management are defined and discussed: whether the focus is on individuals or societies, whether it is on public service or profit, and whether it is on meaningful outcomes or those which appear measurable. The paper concludes with a call for the evaluation of the NPM and a return to a more civic and socially focussed public management.
Women, Work and Health
Authors: Skues Jennifer , J. Kirkby Robert
Published: August 2009

Work stress is costly, not only to the well-being of the individual but also to the efficiency of the employing agency and ultimately to the community at large. Although the last half century has seen a substantial increase in women in the paid workforce, investigations into work stress has focused predominantly on the effectiveness and health of males. Although it appears that, in general, women benefit from paid employment, working women can suffer from the increased responsibilities of maintaining both employment and the expected role in the home. Epidemiological data have indicated that not only do women in the larger community have lower mortality and higher morbidity than do men, but also that this pattern holds for those in paid employment. It has been reported that, in particular, health workers are vulnerable to occupational stressors. Given the high proportions of females working in health care, these findings have important implications for these professions. It is hoped that future research workers will pay increased attention to the particular needs of women in the workforce to manage stress.
Meningitis Outbreak Management: Measurement of the Cost of Public Health Intervention in Queensland
Authors: R. Lairson David , R. Staines Donald , Howell Tegwen
Published: August 2009

The aims of this study are to estimate the cost of non-vaccination preventable meningococcal meningitis outbreak management. The ingredients method of cost estimation was applied retrospectively from the perspective of Queensland public health services. Administrative data on resources and their monetary value were collected during a two month period following disease outbreaks in two child care centres. Staff were interviewed to determine their time allocation. Short term hospital cost of treating a case of meningitis was obtained from a hospital clinical costing information system and contrasted with the case-mix payment for the relevant DRG category. A multi-disciplinary public health team identified 48 adults and 240 children who were close contacts of the index cases in the centres. All were counseled, administered an initial dose of chemoprophylaxis, and given followup doses and instructions. The cost of the intervention was about $8,000 for each child care centre. The top three items comprised 88 percent of the cost; 60 percent for health personnel, 16 percent for administration, and 12 percent for the prophylactic agents. The total cost for the public health management of each outbreak is only $500 greater than the estimated cost of a single hospital episode of care for meningitis. The study illustrates a costing method for local public health level services. Cost information assists in identifying areas for efficiency improvement, negotiation of service performance contracts, and economic evaluation for resource allocation and service production decisions.
Grampians Community Health Centre: A Day in the Life of a Community Health Centre
Authors: Measday Jane
Published: August 2009

It is just before nine o'clock in the morning and before the receptionist has turned on all the lights, the 'phone begins to ring. Staff enter, soft music plays and the building makes settling noises as staff run up and down stairs, and the doors open and shut as people enter with purpose.
Book Reviews: 'Program Evaluation Methods and Case Studies', 'In transition: A guide to the menopause', 'Disability Awareness Package: Resource Manual (2nd ed.)', 'Drug-Nutrient Interactions: The Manual'
Authors: Polgar Stephen , Paul Lindsay , Ristevski Elica , Ballinger Megan
Published: August 2009

Providers of human services are aware of the necessity for systematic outcome evaluations as an integral part of program delivery. Posavac and Carey (1997) have written a compact and well organised text for introducing the reader to the practical aspects of designing, implementing and communicating the results of program evaluations in the broad (health, education, welfare) area of human services. This is the fifth edition of the book, an indication that readers have, for over fifteen years, found it a useful introductory text.
How Should We Organise Community Health Services?
Authors: Swerissen Hal
Published: August 2009

This paper reviews the organisation of Victorian community health services in the context of the general direction of reform for the Australian and Victorian health systems. It notes that the emphasis has shifted to a greater focus on improving the efficiency of the relationship between needs, resources, services and outcomes. Within this context, in addition to public health measures, national reforms have advocated the creation of funding and organisational arrangements around three service functions: general care, acute care and co-ordinated care. It is argued that the organisation of community services should be driven by these functional relations, not vice versa. The efficiency of vertical and horizontal integration and the creation of community health networks is considered in relation to transaction costs, organisational scale, transition costs and distributional equity. It is concluded that community health networks offer the most efficient model for the delivery of community based public health and general, acute and co-ordinated care services.
Self Help, Not Self Pity': Caring for People with Diabetes in a Voluntary Organisation
Authors: Ristevski Elica , Gardner Heather
Published: August 2009

The importance of the voluntary sector in providing services for people with a chronic illness has been increasingly recognised. A consumer organisation in the voluntary sector, which provides services for people with diabetes, was selected to explore the role of voluntary organisations in service provision. The investigation revealed that voluntary organisations provide support services such as information and education, advocacy, health promotion, the encouragement of research, social activities, and aids and appliances. These services focus on the individual, social, financial and economic needs of people with diabetes and fill the gaps in programs provided by public sector organisations, which are largely targeted toward acute care, are less flexible, and increasingly concerned with cost efficiency. With the shift towards decentralising services to the community and the increased participation of consumers in health care, the work of voluntary organisations will become even more indispensable in Australia.
Breast for Me: A Developmental Health Education Strategy for Women with a Disability
Authors: O'Shea Maggie
Published: August 2009

I need assistance with getting undressed. I need assistance with getting positioned properly for the machine and I need assistance with getting dressed and comfortable again. And sure the clinics say 'Yes, we'll help', but most of them have never dealt with a person in a wheelchair before and they don't really understand that you really need assistance ... And it's that whole education process that I find really uncomfortable and tedious. And embarrassing really. I suppose that's the real reason, because I get embarrassed' ('Margaret' in Breast for Me video, on what stops her from accessing health services).
Working 'With' Communities, Not 'On' Them: A Changing Focus for Local Government Health Planning in Queensland
Authors: Chapman Paula , Davey Peter
Published: August 2009

The challenges facing public health professionals in the twenty first century are likely to encompass a pressing need to address effectively new health dilemmas posed by rapid urbanisation, environmental degradation, massive social change and economic instability. The Healthy Cities movement was initiated in 1986 to implement the health promotion action areas of the Ottawa Charter in local settings. It offers a meaningful framework and set of principles to construct a socio-ecological approach to the planning for future healthy and sustainable communities. The parameters of a socio-ecological approach to health and its congruence with the philosophy and principles of the Healthy Cities movement are described. The application of this approach to health planning in nine local communities in Queensland is illustrated through the development of local government facilitated Municipal Public Health Plans (MPHPs). An overview of the seven stages of the planning process underpinned by Healthy Cities principles, reveals the specific tasks of working 'with' communities as opposed to working 'on' them. These stages are identified as: (i) doing the groundwork, (ii) managing the project, (iii) community needs assessment, (iv) setting priorities, (v) developing strategies, (vi) writing the draft plan, and (vii) monitoring and reviewing the plan. Specific difficulties encountered by the projects during the process are identified, as well as achievements. The challenges faced by those intending to formulate similar plans are listed, and how primary health care professionals can have a significant partnership in the design and implementation of locally relevant Municipal Public Health Plans is discussed.
Goals and Targets: Applicability to Primary Health Care
Authors: Smith Debra
Published: August 2009

The importance of outcomes in evaluating and judging health care programs is increasing, particularly in New South Wales. A review of the literature suggests the relevance of outcomes to primary health care might be limited. A small survey of primary care staff working out of Community Health Centres in rural New South Wales (NSW) revealed that staff believe they are often involved in population focus work, while health education and promotion are carried out by staff working with individuals. The identification of the use of primary care strategies is not high unless staff have had experience in a particular area, and the NSW Health Improvement Program is not particularly well understood.
Ageing and Health
Authors: Campbell-Smith Mollie
Published: August 2009

The influence of our mental state on the process of ageing and the interaction of attitude to health is not well documented. Ageing is a subject fraught with fear and negativity ? fear of being useless, unwanted, unloved.
Health and the New World Order: An International Conference in South Africa and its Implications for Australia
Authors: Baum Fran , Butler Paul
Published: August 2009

In January 1997, 400 delegates from more than 20 countries gathered in Cape Town at an International Conference focusing on the impact of the new world economic order on health and health care. The themes of the conference were: (i) challenges facing Primary Health Care (ii) Health for All - innovative local programs and global strategies (iii) The Global Crisis - economic structural adjustment programs and environmental destruction, and (iv) the World Bank - 'Investing in Health' or prescription for under-development? In this paper some of the proceedings and outcomes from the Conference are described and some of the implications for Australia discussed. The issues include wealth and racism as major public health issues in Australia; Australian Aid funding; how to maintain the principles of primary health care; and the importance of global progressive networks in an era of multi-national companies.
Working with People with Eating Disorders: How Do Professional Attitudes Affect Approaches to Early Intervention?
Authors: Cameron Prue , Willis Karen , Richter Delia
Published: August 2009

Preliminary research conducted in 1995 in Tasmania examined the perceptions, knowledge and beliefs held by health workers about eating disorders, specifically anorexia and bulimia. The study used a combination of focus groups and individual interviews with school health nurses, adolescent health workers, dietitians and students of both nursing and dietetics. The study found that professional and lay knowledges around this issue are not categorically distinct. Rather, health workers bring to their professional roles, social and personal knowledges that construct and shape their interpretations of anorexia nervosa and bulimia. Initial findings indicated that these health workers commonly held contradictory, often negative, ideas with strongly moralistic judgements about people with eating disorders. It is argued that such views might constrain their ability to respond effectively in a preventive context.
When I'm 64' Public Policy Influences on Wellbeing in Retirement
Authors: Fudge Elizabeth
Published: August 2009

Findings from a qualitative study of recently retired non-professional men in the southern metropolitan area of Adelaide, South Australia, highlighted policies that contributed to the men's feelings of increased autonomy and acceptance of retirement as a life stage; factors they related strongly to their experience of wellbeing in retirement. The policies aimed for full employment, high levels of home ownership, financial security in retirement, centralised wage fixing, high minimum wages and optional retirement age. However, the discourse of economic rationalism of Australian governments since the late 1980s appears to be placing many of these policies in jeopardy. Health workers are in a prime position to review, report and act on the effects on the health of citizens of such major policy changes. This article challenges them to do so in collaboration with the communities with whom they work.
The Continuing Challenge: Nursing's Response to Primary Health Care
Authors: Clare Judith , Mann Susan , Power Charmaine , Byrnes Tess , n'ha Winifreyda Ailsa
Published: August 2009

An innovative project which aims to balance acute care and community health care in the clinical experience for students in a generic baccalaureate nursing program, is outlined. The ways in which nurses in community practice and academia can work together to ensure that primary health care (PHC) becomes a philosophy used for guiding nursing practice, is demonstrated. The aims of the project are to gather sufficient information on which to base curricula change to the undergraduate baccalaureate nursing program, as well as to assess the employment outcomes for this group of graduate nurses. The paper sets the context for the project by providing a brief historical review that highlights the relevance and necessity of PHC as a framework for nursing. The ways in which nurses in community practice and nurses in academia can work together to ensure that primary health care (PHC) becomes a philosophy used for guiding nursing practice is discussed. Through an innovative partnership between the School of Nursing, Flinders University of South Australia (FUSA) and Noarlunga Health Services, curriculum changes ensure that nursing students experience a balance of theory and practice in both the community and acute clinical fields, and that the curriculum is underpinned by PHC philosophy and principles.
Developing a Mental Health Resource for Consumers
Authors: Saltman Deborah , Veale Bronwyn , Bloom Gina
Published: August 2009

Little is known about how consumers select mental health providers. In the literature there is an absence of information to assist consumers and referral agencies including general practitioners, in making informed choices. This paper reports the research process undertaken to develop such a resource. Interviews were conducted with representatives from a variety of groups identified by consumers and providers as supplying mental health services, including: general practitioners, psychiatrists, psychologists, social workers, Relationships Australia (NSW), Alcoholics Anonymous (AA), postnatal depression self-help groups, Lifeline, the Gay and Lesbian Counselling Service of NSW, spiritual healers, and, consumer consultants. The interviews covered issues of cost, type of services provided, goals of management, limitations of therapy, consumer information about the process, sessions, therapist credentials, training, background and experience, professional and personal development, quality assurance, research, referral, access, and confidentiality. Indicators for ascertaining effectiveness of the therapist's work were also delineated. Although there was a great deal of similarity in views concerning the nature of therapy held by a range of providers of mental health services, differences of approach did emerge that need to be brought to the awareness of consumers. Comparing responses of mental health providers to the same questions allows other issues such as priorities and access to be gauged by comparing these responses. The strength of this approach is that it allows the presentation of information in a manner that allows consumers to make comparisons and choices based on information obtained in a context similar to the therapeutic situation.
Back to Bikes
Authors: Laing Bronwyn
Published: August 2009

The 'Back to Bikes' health promotion initiative was planned and implemented by the Generalist Community Nurses working in the Health Centres of Wallerawang and Portland New South Wales.
1997 Awards for Innovation and Excellence in Primary Health Care - Direct Care: Clockwork Young People's Health Service
Authors: Rowe Leanne
Published: August 2009

The Program: The Clockwork Young People's Health Service provides a youth health service for Geelong involving many local General Practitioners(GPs), a community health nurse, and a psychologist. The Service is situated in a youth culture venue (The Courthouse Project) in central Geelong which is close to youth workers employed by the City of Greater Geelong and to the youth information centre. The 'drop in' service provides free, long individual consultations, discussion of preventative health issues, emotional and physical health, and education. The target age group is between 12 and 24 years. The Program was implemented between 1995 and 1996 and consolidation has occurred in 1997.
1997 Awards for Innovation and Excellence in Primary Health Care - Management Initiatives: Health Promotion Plan for Darebin Community Health Centres Collaboration
Authors: Hurley Bruce
Published: August 2009

The Program: East Preston and Northcote Community Health Centres committed themselves to producing a Health Promotion Plan for Darebin (HPP) for 1997 and beyond. The HPP is based on an analysis of Darebin's health data and demographics, current health promotion thinking, and analysis of best practice examples of health promotion in Community Health Centres and other settings, and on consultation with the staff and Boards of both Centres, other key agencies and the local community.
The Sociological Implications of Voluntary Redundancy: The South Australian Experience
Authors: Coombs Carolyn
Published: August 2009

The experience of voluntary redundancy on the current scale is fairly new in Australia and its impact on workers and society is only just beginning to be observed and interpreted. Under the economic rationalist policies of successive federal governments which promoted a free market economy driven by privatisation, deregulation and de-institutionalisation, Australia has undergone considerable structural change in the 1990s. This change has been marked by government-supported labour restructuring, within both the private and public sectors of industry. The purpose of the study was to explore the concept of voluntary redundancy, whether mature-aged workers were being targeted, and the sociological implications of voluntary redundancy for workers in South Australia.