bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical Pathways: The Care Link Between Primary Health Services
Authors: Miles Gail
Published: August 2009

The continually changing health environment requires service providers to review constantly the way services are provided. It is important that effective and sustainable service partnerships are developed to ensure that the primary health needs of Victorians are met. The aim of these partnerships is to provide a coordinated approach to health care and achieve the best health outcomes. Services will need to develop innovative processes and systems to ensure that coordinated care is achieved in a way that ensures Victorians receive the best primary health care. Clinical pathways are an innovative process that provides a framework around which coordinated care can be managed. Effective management is achieved by organising and integrating all levels of health care delivered by different providers from a number of different disciplines. They are management plans, which identify desired client outcomes and provide the sequence of events necessary to achieve these outcomes. Clinical pathways provide a framework for clinicians to guide them in the provision of care through the identification of interventions and measurable outcomes along a timeline. Within the changing health environment, service providers must develop systems at all levels that will enable the concept of integrated and coordinated care to be operationalised. At the level of care provision to individual clients, clinical pathways are a system that is worthy of consideration. They provide a coordinated care approach, a documentation system, a teaching tool, and a resource for quality management and research. They create a client-focused link between service providers, which is otherwise difficult to achieve. Coordinated and integrated care thus becomes a lived reality for the clinician and for the client.
Service Coordinators in the NECC Trial: An RDNS perspective
Authors: Kerr Megan , Cramond Janine , Scott Maggie
Published: August 2009

The Royal District Nursing Service (RDNS) became involved in the North-Eastern Coordinated Care Trial in October 1997. The purpose of this was to assist the trial in exploring the hypothesis, that for people with chronic or complex care needs, care coordination will provide improved outcomes at the same or a reduced cost. There are a number of areas, which help to clarify the process involved in the trial and the benefits for clients: how the coordinators were chosen; the role of the Care and Service Coordinators: benefits experienced by the professionals; benefits experienced by clients: and discussion points.
Population Based Approaches to the Integration of Primary and Secondary Care
Authors: Simmons David
Published: August 2009

Health systems have become increasingly fragmented. Conditions such as diabetes, which require a multidisciplinary approach to care involving both the primary and secondary care sectors, have been particularly affected by the lack of coordination. In order to integrate care around the needs of the patient, a complex process is required to gain agreement on how care should be delivered. Using diabetes as a case study, and by applying the Delphi technique and access to the available evidence, we have shown that patients, doctors, nurses and allied health workers can agree upon the scope of care required for a given clinical scenario and with the criteria for referral between those with different skills. These agreements can form the basis of Care-maps, which in turn allow the definition of gaps in care, required educational materials, needed assessment pro forma, tools for enhancing communication between health workers, and training activities. Existing integrated care approaches in the United Kingdom and the United States, focusing on quality of care rather than resource, have been associated with improvements in health care delivery. Those working in primary care should consider this approach for stimulating enhancements in both clinical quality and efficiency.
Duelling Band-aids: Debating and Debunking Issues Affecting Primary Health Care to Achieve Deliverance for Australia's Health
Authors: Walker Judi , Lennox Grant
Published: August 2009

The constant pressure for growth on all areas of health spending is not matched by the country's capacity to pay. Despite a progressive shift to a primary health care approach that promotes health and wellbeing, illness prevention, healthy lifestyles, early detection, rehabilitation and public health strategies, not all segments of Australian society enjoy good health. In this paper, general indications of the health and wellbeing of Australians are described, and the health and wellbeing of two important population groups: rural and remote and Indigenous populations are discussed, providing a review of Australia's health system. Anomalies in the status of the health of Australians are apparent. Models of primary healthcare, individual health and urban health are compared with models of acute and institutional care, population health and rural health.
Black and White Learning Interchange
Authors: A. Lawler L. M. , Logan-Sinclair P. A. , Holland L. E. , n G. Troutma
Published: August 2009

The unchanging status of Aboriginal health initiated the need for changes to training for Aboriginal Health Workers. Charles Sturt University, in partnership with the Remote and Rural Health Training Unit (RARHTU) initiated, in consultation with the local Indigenous community, a program for upgrading qualifications of Aboriginal Health Workers to degree level. Several unique features were incorporated in the program design: an educational facilitator without a health career background; a challenging first subject based upon student's familial personal history; specialist sessions provided by professional health workers; recognition of prior learning taking into account the many varied levels of existing regional health services training. This paper discusses the course design and evaluation results, including the impact of the program upon lecturer's teaching style, students' personal and working lives and the effects the course may have regarding the status of Aboriginal health in the local area. Results of the initial program evaluation are presented and discussed in this paper.
Setting the Standards: A report on a GP/Mental Health Service Liaison Project in a Rural Area
Authors: Philip Tina , Welch Mark , Aldridge Greg , Fisher Helen , Cross Marjorie
Published: August 2009

One of the most discussed, yet open areas of change and re-evaluation in contemporary mental health care is the coworking relationship between general practitioners (GPs) and local Mental Health Services. It is crucial to the role of general practitioners and central to mental health services which have seen large-scale deinstitutionalisation, a shift to primary and community care, and the twin thrusts of government policy (NSW Department of Health, 1998) of prevention and partnerships. This paper outlines a liaison project developed jointly by the South-East Division of General Practitioners and Southern Area Mental Health Service to address these issues. It will describe the response to the findings of a needs analysis by the development of Basic Standards for GP/MHS liaison which were relevant to a rural area, practical, pragmatic and possible, and, when fully established, would be the foundation of effective, efficient and efficacious shared care in mental health.
Primary Health Care with Immigrant and Refugee Populations: Issues and Challenges
Authors: Nerad Sonja , Janczur Axelle
Published: August 2009

Ontario's community health centres (CHCs) are leaders in providing community based health care programs and services. One of the primary objectives of the CHC program is to promote access to health care for populations that have traditionally experienced barriers for reasons such as language, culture and age, or for populations that are at high risk for illness such as persons living in poverty or those who are homeless. Funded by the provincial Ministry of Health and Long Term Care, Access Alliance Multicultural Community Health Centre is located in downtown Toronto, and is mandated to work specifically with immigrants and refugees to promote health and better access to health care. This paper describes the complexity of issues facing newcomers, the Centre's programs and services, as well as the organisation's struggle to define its role and value within the health and social service sector and to newcomer communities.
Coordination and Integration in the Bentleigh Bayside Community Health Service
Authors: Collins Lillith , Turner John
Published: August 2009

The paper examines the development of coordinated and integrated primary care services through the establishment of community health centres in Victoria, with specific reference to the Bentleigh Bayside Community Health Service. In 1985 a random sample of 412 case records indicated that 52.4% of patients had seen more than one discipline at the Centre, and 34.7% of these patients received integrated care through case planning meetings. Fourteen criteria derived from the current literature were used to evaluate the integration and coordination of treatments and of health promotion activities. A repeat study demonstrated gains in health promotion, especially with respect to establishing support groups and the local coordination of community interventions. Integrated casework with external agencies has not changed. The analysis provides a base line for examining the effects of policy developments such as Primary Care Partnerships that address the issues of common assessments, exchange of client information and health promotion. Primary Care Partnerships are an extension of the structures in Community Health Centres. Primary Care Partnerships need to encourage personal contacts between agencies in order for individual and community health plans to be as effective as possible.
Development of the 2000-2005 Victorian Women's Health Plan: A Case Study
Authors: Beaumont Marilyn
Published: August 2009

The paper describes and assesses the development of the 2000 to 2005 Victorian Women's Health Plan; a policy overtaken by a range of political processes. It provides a working example of health promotion policy development including mapping the history and context behind the development of the policy. The paper is written from the author's view that good health policy behind funding arrangements is critical for good health practice. It is also important for health service providers to have an understanding of the politics and processes surrounding health policy development and implementation surrounding their practice and to work with this understanding to improve health outcomes. This is particularly the case with health promotion policy because outcomes are generally only identifiable in the longer term. Within Victoria, during the period 1995-1998, a number of things occurred to provide an environment for renewal of interest and potential for progress in women's health policy development. This included an increasing understanding of the relationship between gender and health outcomes. The complex economic, political and environmental elements, understanding of opportunities available, actions developed and taken, and the results are all expanded upon in the paper. The activity resulted in the launch, in August 1999, of the five-year Victorian Women's Health Plan. It was hailed by the then Victorian Premier on the launch occasion as the 'first comprehensive women's health plan to be developed by any Australian state, which leads the way for other States to follow'. The launch coincided with the calling of a State government election. Four weeks later there was a change of government and the process to develop policy has began again.
Guest Editorial: Fourth Australian Women's Health Conference: Politics, Action and Renewal, 19-20 February, 2001, Adelaide
Authors: Oberin Julie
Published: August 2009

The Fourth Australian Women's Health Conference, Politics, Action & Renewal, organised by the Australian Women's Health Network, was held in Adelaide between 19 and 21 February, 2001. Conference organisers were delighted with an attendance of more than 500 delegates from a diverse range of service sectors and occupational groups, geographic areas and cultural backgrounds. The Conference was targeted at a wide audience of consumers, health practitioners, academics, government workers, politicians, community organisations and women's health activists.
Support Funding for Australian Rural and Remote Health Workforce: A Medical - Nursing Mismatch
Authors: Hanna Liz
Published: August 2009

Successive Australian federal governments have introduced numerous strategies aimed at reducing the differentials in health status between rural and remote populations and their metropolitan counterparts. Foremost among these strategies have been those focused on increasing the numbers of medical practitioners in rural and remote areas (Australian Institute of Health and Welfare, 1998a). The paper challenges the prioritisation of this strategy, identified as a "planning priority" by the Commonwealth government. The 1999-2000 Federal Budget allocated $171 million to "significantly improve access to services in rural and remote areas of Australia and to strengthen the rural workforce". Nurses provide 90% of the health services to these populations yet receive only 0.9% of funding in direct role specific support. This systematic neglect of nursing services results in high turnover as nurses desert their posts, frustrated by lack of organisational support, and subsequent inability to provide adequate care in the difficult circumstances in which they must function. Interruptions to clinical health care provision and health promotion activities diminish health enhancement opportunities for the communities with demonstrated high levels of need (Australian Institute of Health and Welfare [AIHW], 1999; Commonwealth Department of Health & Aged Care, 2000; Kreger, 1991; NSW Health Department, 1998).
Achieving Control over Sleepiness in Narcolepsy
Authors: Bruck Dorothy , Broughton Roger
Published: August 2009

Using unstructured interviews, and informed by a grounded theory approach, this qualitative study sought to conceptualise adaptive processes that people with narcolepsy use in coping with their daytime sleepiness. From the interview data of 20 informants, two conceptual frameworks were developed. The core category that emerged was control. One conceptual framework considered factors that affect success in controlling sleep-wake behaviour in narcolepsy, while another focused on behavioural strategies. A descriptive narrative illustrated these frameworks and included quotes indicative of features relevant to coping with sleepiness. This article provides a more positive, person-orientated dimension than may be found in quantitative studies of the implications of this disorder. The findings are potentially an important resource from which professionals can draw in providing therapy to people with a disorder of daytime sleepiness.
A Review of the Physiological, Neurological and Behavioural Aspects of Addiction
Authors: Adams Jeremy , J. Kirkby Robert
Published: August 2009

Modern psychological and physiological theories of addiction are defined and reviewed. As well, the concept of an addictive personality is addressed and evaluated. On the one hand, psychological theories of addiction are described as either withdrawal driven, disorders of appetite, or motivational process disorders. Physiological theories, on the other hand, suggest that behavioural or pharmacological overstimulation of brain areas, such as the mesolimbic dopamine system, can explain addictive behaviour. Both dependence and withdrawal have been explained in terms of biological research, however, behavioural terminology (operant conditioning theory) has been cited in conjunction with biological theory. Further, a review of research pertaining to an addictive personality shows that the concept of an addictive personality is contentious, with investigations in this area showing a substantial number of methodological errors. Nevertheless, some investigators suggest that a stable trait can influence a person's addictive behaviour.
Development and Validation of the Primary Care Consumer Opinion Survey
Authors: Swerissen Hal , Tilgner Linda
Published: August 2009

Using past measures of consumer feedback, the aim of the present study was to construct a consumer opinion survey for use in community health centre settings; to pilot the survey instrument across a number of community health centres; and to validate the instrument. A total of 950 consumers attending one of six targeted services (physiotherapy, dental, podiatry, counselling/social work, dietetics, and speech pathology) across four northern metropolitan community health centres in Victoria were invited to participate. Returned surveys were analysed using principal component analysis and the extracted scales were tested for internal consistency and validity. Out of the 950 surveys distributed 471 were returned (response rate of 50%). The survey instrument was found to measure consumer opinion regarding satisfaction with centre environment and satisfaction with service provision. The centre environment scale consisted of one factor, with a Cronbach alpha of .80. The service provision scale consisted of two factors: 'aspects of the service provider' and 'benefits of the visit'. Reliability for the total scale was .93. The two scales correlated moderately with a validity item measuring overall satisfaction. The Primary Health Care Consumer Opinion Survey is a reliable and valid measure, which provides the potential for the establishment of norms to assess consumer opinion.
Trust in Relationships Between Primary Health Care Organisations
Authors: Adam Jenny , Walker Rae
Published: August 2009

In Victoria the primary health care sector is in a period of change intended to strengthen the integration of a complex service system through a process of partnership development based on collaboration. The partnerships are voluntary alliances of the primary care service providers, usually within a locality of two to three local government areas. Their purpose is to improve the health and wellbeing of the local population by strengthening inter-agency coordination in the areas of needs identification, planning and service delivery. Trust is a key issue in this process. This paper is a report of the first stage of a study to explore trust in the context of relationships between organisations in the primary care sector.
Child Health Surveillance: Its Place in Child Health Promotion
Authors: Lamont-Herps Lesley , Robson Barbara
Published: August 2009

The health of children is first and foremost a parental responsibility, however, society has a vested interest in ensuring that the rights and needs of children are respected. Promoting and caring for the health and welfare of children is an investment in the future and Child Health Surveillance (CHS) is a vital component of this process. CHS is an aspect of health care, which is often misunderstood, maligned and considered a soft (less important) option compared with acute medical care. The aim of this article is to demonstrate otherwise by clarifying what it is, why it is done, what CHS programs consist of and who should do them. In conclusion, consideration is given to the future of CHS.
Care Coordination: A Case Study Linking Primary Health Care
Authors: M. Lancaster Monica , P. Thow David
Published: August 2009

The purpose of this project is to demonstrate, through a case study, how York Community Services (YCS) is a leader in the delivery of primary health care through its integration of health, legal and social services. YCS is located in Toronto, Ontario, Canada. YCS's mandate is to serve populations that have traditionally been on the margins of society and therefore have had difficulty accessing the health care system. These include victims of domestic violence, the isolated senior, those with severe mental illness and children living in poverty. Care coordination is a unique model developed by YCS whose main goal is to provide a forum for the client's providers to meet, discuss and coordinate relevant information. Care coordination is used to maintain continuity of care among providers.
A Dispersed Refuge Model for Women Escaping Domestic Violence: A Regional Case Study
Authors: McDonald John , Green Rosemary
Published: August 2009

Refuges for women escaping domestic violence have traditionally been communal residences located in metropolitan areas. More recently, alternative service models have been funded to provide for clients with multiple and complex needs. This paper evaluates the first year of operation of an innovative refuge model for women and their children. "Marg's Place" is a statewide, high security, dispersed accommodation support model located in a regional setting. Evaluation methods included interviews, surveys, and analysis of client databases and program documents. Thirty-five women and 42 children used the service for an average stay of 20 days during the first 12 months. The main findings were that the dispersed model can cater for a wide range of service users, including those with multiple and complex needs, who would be unlikely to be successfully accommodated in a communal refuge. There was little evidence that the dispersed model contributes to feelings of isolation or loneliness for women or children. The regional setting presented both advantages and disadvantages for women wanting to resettle in the area. Women reported significantly enhanced levels of empowerment, and the high security provisions met their needs for safety. Overall, this refuge model provides an accessible, responsive and effective service.
A Framework for Best Practice Health Promotion in Primary Health Care
Authors: Swaby Meredith , Biesot Amanda
Published: August 2009

ISIS Primary Care provides health and welfare services to the municipalities of Brimbank, Hobsons Bay and Wyndham. An organisational commitment was made to establish an integrated approach to health promotion that would result in best practice health promotion within the community and in partnership with other agencies. To achieve this it was necessary to develop internal organisational skills and processes as well as formalise the relationships with agencies within the catchment. A "framework for best practice health promotion" was developed with a number of interrelated components occurring concurrently at several levels within the organisation and externally. This encompasses a structural framework with a Health Promotion Reference Group of key intersectoral stakeholders, as well as six Health Promotion Working Groups across the organisation each focussing on identified health issues. The strategic framework is a procedural document outlining processes for planning, implementation and evaluation of health promotion at an organisational level. The supporting framework includes detailed program planning and evaluation guidelines and workforce development. The implementation of this framework has resulted in a coordinated and sustainable approach to health promotion across the catchment with opportunities for successful partnerships, capacity building, resource sharing and increased program reach in meeting the perceived needs of the community.
Integrated Assessment: A Rural Model in Practice
Authors: J. Mann Leona
Published: August 2009

Integrated assessment in Victoria, Australia is held to be a new and innovative process, but in Gippsland, Victoria, integrated assessment has been a reality for the past four years. The purpose of this paper is to identify the elements of integrated assessment in a rural setting. The research has found that identifying the components of such a model was a key factor in achieving the ideals of integrated assessment. The paper suggests that integrated assessment may be more easily achieved in rural areas than its metropolitan counterparts.
Keepin Ya Mob Healthy: Aboriginal Community Participation and Aboriginal Health Worker Training in Victoria
Authors: Adams Karen , Spratling Merilyn
Published: August 2009

This article outlines the development of accredited Aboriginal Health Worker training in Victoria. The processes of community consultation are presented as the primary reason for the successful implementation of the training program in its first year of delivery. The most important community consultation processes involved the active input of Elders and Aboriginal Health Workers. The training was seen as more credible by other Koorie people because of the input of these groups. The supportive role played by both the State and Commonwealth governments as well as industry groups are also explored. The successful implementation of the Aboriginal Health Worker training program demonstrates that Aboriginal people know what is best for them and can effectively initiate, organise and deliver their own culturally appropriate training programs.
Improving Youth Mental Health & Suicide Prevention Program: Improving Young People's Access to Health Care Through General Practice
Authors: Hargreaves Bronwen , Bailey Alison
Published: August 2009

The Improving Youth Mental Health & Suicide Prevention Program is a program designed to be used within the school and community setting, with young people as the agents for change. Young People are trained as peer educators which provides them with accurate and up-to-date information they can then pass on to their peers in both informal and formal ways. The peer education process has given the peer educators the opportunity to develop skills in identifying mental health risk factors and to develop networks of general practitioners and other youth service providers that they can use successfully to gain help and assistance. The program is designed to increase young people's access to health care through General Practice. It is based on a collaborative approach encompassing the whole community.
Editorial
Authors: Gardner Heather
Published: August 2009

In this the second issue of the new look Australian Journal of Primary Health, the papers continue to show the range of issues in the primary health field. We are very pleased that we have been able to maintain publication of papers on our diverse population and to consider seriously through research their needs and how they experience issues that affect their health and wellbeing. A number of papers look at health risks and how these can be better identified and overcome, and at how changes in the organisation of primary health care and partnerships might assist in this aim.
Pregnancy, Prenatal Testing, and Abortion: A Perspective from Muslim Women in Australia
Authors: Tsianakas Vicki , Liamputtong Pranee
Published: August 2009

We examine the influence of Islam on women's perceptions of pregnancy, the use of prenatal testing, and abortion. It is based on an in-depth interview study on women's perceptions and experiences of prenatal testing conducted in Melbourne, Australia in 1999. It is clear that Islam has a marked influence on women's perceptions and practices relating to pregnancy, prenatal testing, and abortion. Pregnancy is encouraged and praised by Islam. Women who become mothers are seen as followers who spread Islam in the world. Islam encourages prenatal technology, which will not harm the individual's health and wellbeing. If the possibility exists that technology could have a harmful effect on the foetus, it is not acceptable. Islam in general, prohibits abortion. However, abortion is acceptable by Islam if the mother's health is endangered or the foetus has severe defects to the extent that it would be unable to function as a human being. Health care providers who work with women from Islamic background during their pregnancies need to be aware of women's religious beliefs so that a better understanding can be achieved, and hence culturally sensitive care can be provided. This might make the experience of pregnancy for Muslim women in their new homeland a more enjoyable one.
Changes in Mood during Exercise
Authors: D. O'Halloran Paul , J. Kirkby Robert , E. Webster Kate
Published: August 2009

The purpose of this study was to investigate changes in mood during exercise. Twenty recreational runners were administered the instrument, Profile of Mood States, at 5, 15, 25, and 35 minutes during a 40-minute treadmill run. Half of the sample ran at 65% of their age-predicted maximum heart rate and half ran at 85% of their age-predicted maximum heart rate. An additional 10 runners were assessed during an equivalent period of quiet reading. Analysis by a series of 2-way Repeated Measures ANOVAs with post hoc tests revealed that mood did not change during the condition in which participants ran at 65% of their maximum heart rate. During the run conducted at 85% of maximum heart rate, levels of fatigue were significantly higher, relative to prerun levels, by 15 minutes into the run and remained elevated at each of the subsequent assessment points (at 25 and 35 minutes and 10 minutes following the run). No alterations in mood were reported during the control condition. It was also noteworthy that mood was generally more negative at the assessment designed to familiarise participants with the testing procedure than it was at the later precondition (baseline) assessment. The present findings supported reports linking negative mood with demanding physical activity and emphasised the importance of using a familiarisation assessment of mood prior to preexercise measures.
Why Primary Health Care Offers a more Comprehensive Approach to Tackling Health Inequities than Primary Care
Authors: Keleher Helen
Published: August 2009

As governments attempt to focus more intently on how to deal with alarming measures of health disadvantage and inequities, a reformist gaze seems to have settled on the primary care sector. Simultaneously, in literature about this area, whether intended or not, primary health care and primary care are terms that are increasingly interchanged. This article argues that the slippage in language is counter-productive, first because it disguises the transformative potential of strategies and approaches that can make the fundamental changes necessary to improve health status, and second because the structures and practices of the primary care sector are not necessarily compatible with notions of comprehensive primary health care. There is much to be lost if primary health care and health promotion are disguised as primary care, and not understood for their capacity to make a difference to health inequities although of course in some circumstances, comprehensive primary health care is interdependent with services provided by primary care. In this article, characteristics of primary care and primary health care are juxtaposed to show that if the strengths and limitations of each model are understood, they can be mobilised in collaborative partnerships to deal more effectively with health inequities, than our system has so far been able to do.
Ballarat Health Consortium: A Case Study of Influential Factors in the Development and Maintenance of a Health Partnership
Authors: McDonald John , Murphy Angela , Payne Warren
Published: August 2009

Intersectoral partnerships in health have a central role in current policy and programs. Partnerships are seen to be an effective strategy for maximising health outcomes. However, theoretical models of health partnerships are underdeveloped. Moreover, the research literature contains inconsistent findings about their effectiveness, and there has been very little evaluative research on health partnerships in this country. This paper reports on a case study of an intersectoral consortium using a health promotion approach to cardiovascular disease. A model of partnership formation and development is presented. From this, a research strategy was devised and carried out. Results indicate that the health consortium was formed in response to a critical health issue, and as a separate legal entity without recurrent funding, it has been sustained through the commitment of individual members. Project funding has, in large part, dictated its operations. The case study reveals the strengths, vulnerabilities and achievements of this consortium over five years. To produce sustainable health outcomes, the researchers conclude, partnerships require strategic management to capitalise on individual endeavours, organisational alignments, and government or funder priorities. Ideological zeal for intersectoral health partnerships must be balanced by rigorous evaluation; together with more sophisticated indicators for measuring success in partnerships in health promotion. Theoretical development of models of health partnerships will also contribute to their enhanced effectiveness.
Knowledge of and Attitudes towards Prostate Cancer among Italo-Australian Men
Authors: J. N. Drummond Murray , A. Laws Tom , Poljak-Fligic Jelena
Published: August 2009

Information surrounding the treatment of prostate cancer is not clearly defined by medical science. Consequently, health professionals are divided with respect to the most appropriate method of screening and detection. The assumption that if health professionals are not clear, what are the perceptions of Australian males in terms of prostate cancer detection and treatment options? Further, what does it mean to men from non-Australian cultures with language and cultural barriers impacting on choices and decisions relating to health? (Laws et al., 2000). This paper provides insight into the lives of 20 Italo-Australian men. It attempts to draw on their perceptions and understandings of prostate cancer and prostate cancer awareness from their unique perspectives. It will highlight some of the significant issues with respect to being an Italian born man living in Australia and how this impacts on health issues, and specifically prostate cancer awareness. The intention of this paper is to provide in-depth qualitative data to emphasise Italo-Australian men?s health perspectives and experiences.
Asthma Education and Support: An Inner City Study of Strategies that Best Meet Needs
Authors: R. Lowe Gillian , O'Neill Cas
Published: August 2009

The Asthma Linking Project was a joint project of the Royal Children?s Hospital and North Richmond Community Health Centre, in Melbourne. The primary aim of this longitudinal project was to evaluate the effectiveness of community based asthma education and support provided to culturally and linguistically diverse families and those with other complex health and social needs. The project, which took place between 1996 and 2000, evaluated a range of health and quality of life outcomes for 50 children and their families, using a triangulated approach incorporating quantitative and qualitative research methods. This paper presents five qualitative themes which were identified as important contributors to optimal asthma education and support with this inner city population: time and timing; language and cultural appropriateness; tailoring education and support to needs; collaboration and coordination of care; and educator-participant relationship. These themes are likely to be relevant to other health promotion and community development projects with similar populations.
Visual Art and Non-verbal Sensitivity: A Teaching-learning Program in Nurse Education
Authors: Wikström Britt-Maj
Published: August 2009

This study introduced paintings, reproductions of works of art, alongside textbooks in student nurses? education. The aim was to study non-verbal language. Student nurses (N=436) at three university colleges of health sciences in Sweden served as study population. In written interpretations the students combined experiences and theoretical knowledge of non-verbal language with new impressions from the depicted persons. The findings pointed at paintings as a valuable source of knowledge of the non-verbal language. Student nurses expressed their existing insights of non-verbal language in a modulated way. Awareness of non-verbal sensitivity was developed.
Health Service Provision for Community-Dwelling People Suffering Urinary Incontinence: A Case Study of Neglect
Authors: St John Winsome , James Heather , McKenzie Shona
Published: August 2009

Access to health services for common health problems is a fundamental principle of primary health care. Although there have been few Australian prevalence studies, it is estimated that about 900,000 adult Australians suffer from incontinence (National Health and Medical Research Council, 1994). The purpose of this study was to investigate urinary continence services for community-dwelling people in the Gold Coast region of Australia, prior to implementing new services. A case study design was used, including: a survey of general medical practitioners, specialist medical practitioners, physiotherapists, hospitals, and home visiting agencies in the region; a focus group with key stakeholders; and a critical review of the literature in relation to prevalence, treatment-seeking behaviour and service provision. Health practitioners were asked about services provided, policies, clinical pathways, referrals, and their views on what services they would like to see offered in the region. Results showed that while there were some existing continence-specific services in the region, they were inadequate to provide for the numbers of people in need. Many generalist health practitioners demonstrated a lack of interest in and knowledge of the plight of those suffering from incontinence. Links between services were found to be ad hoc, with inconsistent referral patterns between health professionals. These findings are consistent with international studies. It was concluded that, in general, community-dwelling people suffering incontinence were poorly served by health professionals due an inability of available services to meet demand, and a lack of knowledge and/or interest by many generalist health practitioners.
Who Should Get Personal Alarms? The Development of Instruments for the Assessment of Need
Authors: J. Mayhew-Rankcom Vanessa , A. Lindeman Melissa , D. Hill Keith , A. Smith Robyn
Published: August 2009

Personal alarms or Personal Response Systems (PRSs) are electronic systems designed to enable frail older people and people with disabilities living at home to summon help in an emergency. The demand for government subsidised PRSs in Victoria (called Personal Alert Victoria) currently exceeds supply (Department of Human Services, 1998) but until now there has been no consistently applied method to ensure that those at highest risk had access to the service. Instruments to aid assessment and determining relative priority for receiving a PRS were developed for the Victorian Department of Human Services (DHS). The development of the instruments was largely informed by the published literature on PRSs and falls risk factors. Three major areas were identified as important in assessing for relative priority to receive a PRS: the client?s assessed risk of being involved in a critical incident requiring immediate assistance, such as a fall; the availability of alternative means of accessing immediate assistance; and the expected impact that a PRS would have on the client?s and/or carer?s wellbeing and their ability to engage in important activities. The process for selecting the items used to determine need in each of these key areas is described, as is the recommended method for determining relative priority. The process for assessing clients to receive a PRS is outlined, emphasising that a PRS is one potential service outcome of an assessment of need.
Capacity Building and the Inter-organisational Field: The Rural Health Promotions Development Program
Authors: Keating T. P. , n L. Sherida
Published: August 2009

In the Australian context, inter-organisational collaboration is complex because the Health and Welfare service delivery structure is fragmented and diffuse. Capacity building offers a way forward that values the diversity of organisations involved in the delivery of programs and services. The experience of attempting to build capacity in the inter-organisational field through the Rural Health Promotions Development Program, is examined with particular reference to issues of context, regulation, leadership, governance and sustainability.
Exploring the Links between Community Health Services and Non-Government Organisations in Two Regions of South Australia
Authors: M. Jolley Gwyneth , Masters Stacey
Published: August 2009

This paper describes the links between community health services and non-government organisations in two regions of South Australia, and the factors impacting on these collaborative ventures. Changes in the organisation and funding of human services have created both opportunities and challenges for community health services and non-government organisations, as distinct entities and in relationship with one another. This study confirms that there are primary promoters of, and requisites for, effective collaboration, such as shared client group, similar values and approaches, and capacity at individual and organisational levels. Time and resource constraints are revealed as the most significant barriers to collaboration. Government policy and practice have a powerful influence on collaboration between community health services and non-government organisations. Government policy directions and models of funding may act to support or inhibit collaboration and the effects of these should be evaluated in terms of their impact on the capacity of organisations to work together to provide integrated and coordinated care.
Double Jeopardy: Disadvantage and Drug Problems
Authors: de Crespigny Charlotte
Published: August 2009

This discussion paper provides an overview of drug use and the inter-relationship between drug problems and social disadvantage. It may be of use for consumers and those working in community services, primary health care services and drug and alcohol services. The paper draws from the literature, key reports and anecdotal evidence as a way of raising and illustrating key issues relating to the vulnerability of people who are disadvantaged in our community. While this paper can only offer a partial exploration of this complex issue there may be some insights into how we can be more aware of, and effective in responding to, drug problems in the context of disadvantage. It may also stimulate further research into this so far poorly understood area of people's lives.
Recent Developments Concerning Men's Health in Australia
Authors: Macdonald John , Crawford David
Published: August 2009

The term men's health has become part of mainstream health lexicon in Australia, yet in terms of policy and programs the field is still very much an emergent one. Despite obvious need (the high rates of male suicide illustrate this), there is no national men's health policy, little consensus on research priorities or an agenda, and minimal public funding. The Moving Forward in Men's Health Statement of the NSW Department of Health provides a landmark, a guiding framework for men's health for public agencies in the state. No other government presently has a specific men's health policy or funding program. Despite the release of an independent report in 1999 by the Federal Health Department, there is no broad agreement amongst stakeholders about a men's health research agenda. There is a pressing need to encourage discussion of what is health enhancing about men's and boys' lives in their various environments. The paper proposes a social population health approach, which adopts a salutogenic (life-enhancing) perspective, encouraging environments for men and boys that build good health.
Conceptions of Health and Illness Held by Australian Aboriginal, Torres Strait Islander, and Papua New Guinea Health Science Students
Authors: Boulton-Lewis Gillian , Pillay Hitendra , Wilss Lynn , Lewis David
Published: August 2009

Health is considered to be a fundamental human right and developing a better understanding of health is assumed to be a global social goal (Bloom, 1987). Yet many third-world countries and some sub-populations within developed countries do not enjoy a healthy existence. The research reported in this paper examined the conceptions of health and conceptions of illness for a group of Aboriginal, Torres Strait Islander, and Papua New Guinea university students studying health science courses. Results found three conceptions of health and three conceptions of illness that indicated these students held a mix of traditional/cultural and Western beliefs. These findings may contribute to overcoming the dissonance between traditional and Western beliefs about health and the development of health care courses that are more specific to how these students understand health. This may also serve to improve the educational status of Aboriginal and Torres Strait Islander people and potentially improve the health status within these communities.
Improving Primary Health Care in Thailand: The Role of the National Medicinal Drug Policy
Authors: Phanouvong Souly , Barraclough Simon , Harvey Ken
Published: August 2009

For two decades Thailand's National Medicinal Drug Policy has sought to make effective and safe drugs of good quality available and affordable to all, and to promote the rational use of drugs. Using original policy documents, secondary sources and interviews with Thai informants, the history of the development and implementation of the policy are examined and salient issues associated with primary health and medicinal drugs in Thailand are identified. It is argued that the policy improved the accessibility and quality of essential drugs. However, further action is needed to reduce the level of irrational usage, to foster the use of traditional medicines and to encourage national self-reliance in the production of essential drugs. This discussion of policy development provides lessons for other countries working to establish their own medicinal drug policies.
Mental Health in Sri Lanka: Challenges for Primary Health Care
Authors: Fernandopulle Sudarshini , Thalagala Neil , Barraclough Simon
Published: August 2009

Using a societal approach to the determinants of mental health, a survey of knowledge about mental health problems in Sri Lanka is presented, including the consequences of years of civil and military conflict and economic retardation. Sri Lanka has the highest suicide rate for females, and one of the highest rates for males, in the world. Mental health care services and their limitations are described. Major problems include under-funding of services and medicinal drugs, overcrowded institutions, shortages of trained personnel, and under-developed community health services. Desirable policy and planning reforms are identified; in particular the need for expanded primary mental health care.
Driver Road Rule Knowledge and Attitudes towards Cyclists
Authors: Rissel Chris , Campbell Fiona , Ashley Bruce , Jackson Lisa
Published: August 2009

Many potential cyclists do not cycle on the road because of safety concerns. Drivers' knowledge of road rules and attitudes towards cyclists on the road were assessed. A telephone survey of 105 randomly selected adults in Sydney, Australia, with a current driver's licence was conducted. Less than half the sample (43%) was aware of recent changes to the Australian road rules. The majority of respondents (76%) reported high perceptions of danger associated with cycling, although respondents who had recently cycled on the road were significantly less likely to report these concerns of danger.