bluuebunny/crossref_metadata_2025 huggingface dataset:
Farm Safety - A Family Priority: The Implementation of a Collaborative Approach to Primary Health Care in a Rural Setting
Authors: Francis Diane , McEvoy Anne , Roney Tracey , Gibson L. Michelle
Published: August 2009

Farm Safety - A Family Priority' was a collaborative, integrated primary health care promotion conducted during Rural Health Week, starting 27th May 1999 in the rural town of Elmore, Victoria. Five primary schools in surrounding districts were invited to participate: Goornong, Colbinabbin, Drummartin, Our Lady of the Sacred Heart, Elmore, and Elmore Primary School. Involving 113 children and five teachers, issues concerning safety on the farm included riding on tractors, horses and agriculture bikes, the safe use and storage of chemicals, safe places to play, the importance of displaying emergency telephone numbers, and a demonstration on Expired Air Resuscitation. By using a demonstration and an interactive teaching method it was envisaged that student participation would be encouraged and learning through practical application reinforced. Further, students were provided with ample time to ask questions of the demonstrators regarding any displays and activities. At the conclusion of the day a questionnaire was distributed to all children while teachers' perceptions were recorded by interview. Children took away some clear messages about farm safety, and the coordination and content of the activities impressed teachers. The activity clearly demonstrated the need for more integrated, collaborative approaches in promoting primary health care in rural settings, that are relevant to the community concerned in order to create a sustainable healthy community.
MAN Model: Health Promotion
Authors: Denner Bernard
Published: August 2009

Despite the efforts of the health care industry to raise men's awareness and participation in attending to their own health needs, men continue to be very poor consumers of health care services (Gibson & Denner, 2000). The MAN model is a model of disease prevention and health promotion that seeks to improve and create pathways for men and adolescents to better access the Health Care System (Gibson & Denner, 2000). If men at present do not come to the health services, then men's health programs may need to journey to where men are gathered. The MAN Model was developed to address specifically this problem of reaching men and getting them to discuss their health concerns in a culturally relevant way. Apart from social and sporting venues, the workplace also represents another significant culturally relevant site for men's health discussions. Men's health in the workplace is subject to the same social, economic, cultural and environmental factors as health in the community (Noblet & Murphy, 1995). The MAN Model has developed a pathway for the education and empowerment of males to deal with their health needs preventively rather than reactively both in the community and the workplace.
Participation and Success among Sydney Community Action Groups
Authors: Rissel Christopher , Khavarpour Freidoon , Butler Catherine
Published: August 2009

Community participation and action are important foundations of public health. The objective of this study was to identify characteristics of resident action groups in metropolitan Sydney which predict achievement of a group's objectives and higher group potency. A stratified random sample of 32 groups registered with local councils surveyed in 1997 were followed up two years later. Measures of community empowerment (assessed by the achievement of a group's objectives and higher group potency) were linked with aggregated baseline group data. Of the 32 groups that provided baseline data, 21 (66%) were still meeting two years after initial contact. Group potency was negatively associated with the mean number of activities with which groups were involved (p=0.04). A higher level of mean perceived benefits (p=0.02), and a higher ratio of benefits to cost (p=0.04) were positively associated with group potency. Success in achieving group objectives was positively associated with higher baseline group potency (p=0.03), higher baseline achievement of success (p<0.01), and higher baseline expectations of success (p=0.04). The lower the proportion of meetings attended, the more likely the group's objectives were to have been achieved (p=0.05). These findings suggest that quality of participation may be more important than amount of participation for community empowerment. A larger study is needed to better identify the inter-relationships of key aspects of participation and community empowerment.
The Incorporation of a Complementary Therapy by Australian General Practitioners: The Case of Acupuncture
Authors: Easthope Gary , Tranter Bruce , Gill Gerard
Published: August 2009

Complementary therapies may be rejected by doctors as quackery or incorporated as part of their practice, although such incorporation may be limited. In Australia acupuncture has been incorporated as a normal part of general practice, although it is not accepted as an orthodox technique. This incorporation is demonstrated through analysis of national data on acupuncture usage and through analysis of two surveys of general practitioners undertaken independently in the states of Tasmania and Victoria, Australia. Further, it is argued, from examination of interview and focus group responses, that experienced doctors turn to acupuncture to deal with patients who do not respond to orthodox therapies. This move is possible because the valuing of clinical judgement allows practitioners to suspend their scientific judgement of the therapy although they are uneasy about doing so.
The Multipurpose Service Program: The Best Health Service Option for Rural Australia
Authors: Hoodless Mary , Evans Frank
Published: August 2009

Small relatively isolated rural communities in Australia have been provided with the opportunity to address the difficulties surrounding the provision of health services. The Multi Purpose Services (MPS) program was initiated in 1991 when it was identified that small rural communities have been disadvantaged by separated Commonwealth and state funding arrangements and the criteria for these arrangements where services were often unable to be sustained separately. The MPS program provided the opportunity for sustainability through flexibility and pooling of resources. The application of a primary health care framework would enable more community consultation and participation in reorientating rural health services. Upper Murray Health and Community Services (UMH&CS), a small rural health service in North East Victoria, embraced the concept and undertook a rigorous Evidence Based Needs Assessment to reorientate its health service. The needs assessment combined a sociodemographic, epidemiological and community consultative approach. Evidence of best practice was identified and the recommendations were used for ongoing service development. UMH&CS represents a highly integrated health service and as such a number of strategies are used to enable the continuum of care. These include point of contact advocacy, continuum and coordination of care and the use of a standardised multidisciplinary assessment and outcome based care plan. This paper expands on these processes and the opportunities the MPS has provided to address the health needs of small rural communities.
Sharing Power: Principles for Community Participation in Health Promotion
Authors: Llewellyn-Jones Lorraine
Published: August 2009

A literature search was conducted from which six principles were formulated, and these raise issues that health professionals and organisations should be considering when conducting health promotion activities. Some of the issues identified were that: there is strong evidence that involvement of community members in health promotion activities creates more effective outcomes; health professionals need to give up their authority and share their sources of power, knowledge and skills; health professionals need to accept the agenda set by the community and to take on roles that facilitate and mobilise community action; health professionals need to acquire the skills to facilitate effectively community participation; organisations should be committed to community participation and reflect this in the allocation of resources; community structures and values that inhibit or facilitate participation need to be identified; social trust is essential for community cooperation and mobilisation; and that community capacity should be developed and fostered.
"We Saw We Could Do It Ourselves": Koorie Cultural Regeneration Project
Authors: Basinski Dee , Parkinson Debra
Published: August 2009

The Koorie Cultural Regeneration Project was the result of a partnership between Women's Health Goulburn North East and Mungabareena Aboriginal Corporation. The project was located in Wodonga and aimed to strengthen the community in terms of its Aboriginal identity. A range of activities provided opportunities for elders to share traditional skills and knowledge about Aboriginal culture particularly beliefs, men's business and women's business, dance and bush knowledge. A further dimension of the project was education of the mainstream community through presentations and workshops at schools, childcare centres, workplaces, festivals and universities. Immediate outcomes of the project included clear evidence of the power of experiential learning, a deepening understanding of culture, and the importance of story and connectedness. Eighteen months after the conclusion of the project, members of Mungabareena Aboriginal Corporation met with Women's Health Goulburn North East workers to reflect on the long term outcomes of the project. The value of cultural regeneration was affirmed and it was identified that the project raised the profile of the Koorie community in Wodonga and beyond. While the Koorie Cultural Regeneration Project has increased community understanding and pride in Aboriginal heritage and is working well, the lack of continued funding means it is not ongoing. The challenge now is to move forward with cultural regeneration with respect, integrity, care and wisdom.
Improving Koori Access to Darebin Community Health Service
Authors: Firebrace Shirley , Hammond Melinda , Bell Barbara , Mathison Peggy , Watson Anne , Hurley Bruce
Published: August 2009

While Koori Liaison positions have existed in tertiary health settings in Victoria for some time, the employment of a Koori worker in a broad-based primary health care service is a relatively new initiative. The advantages of locating a Koori access worker in a community health service are numerous: the worker is well positioned to work very closely with the local Koori community at a grass-roots level, with multi-disciplinary health professionals within the organisation, and also with external agencies, both Aboriginal and non-Aboriginal. The role of the access worker is to advocate for improved Koori access to Darebin Community Health services, local health and welfare agencies and local general practitioners. An early emphasis of the position was to establish a strong relationship with the local Koori community and to build effective working relationships with and referral pathways to health care providers.
Minimising the Health Impacts of Gambling: Horn of Africa Community
Authors: Brown Sarah , Johnson Kelley , Wyn Johanna
Published: August 2009

This paper describes a project with women from the Horn of Africa who were concerned about the impacts of gambling on their community's health. It draws on a two-year action research study, which examined the health implications of gambling for women living in Melbourne's Western Metropolitan Region. Members of the Horn of Africa community designed ways of consulting with their communities and were trained and employed as co-researchers and cultural consultants to the project. They then conducted focus groups, assisted in the data analysis and used the findings to develop and implement strategies, which were aimed at reducing the negative effects of gambling. Women were then trained and employed as peer educators. The project involved collaboration between women, community elders and mainstream support services. The community undertook management of the project and the women evaluated the project themselves.
The Art of Falling is Never Landing The Multi-strategic Maribyrnong Falls Prevention Project, Move Safely - Age Well Transmits its Message via a Collaborative Community Circus Project
Authors: Leber Sylvie , Hawthorne Susan , Baston Kim
Published: August 2009

In 1998, a unique collaboration commenced between the Performing Older Women's Circus (POW), older residents of the municipality of Maribyrnong, and the Maribyrnong City Council. This collaboration culminated in the circus show The Art of Falling is Never Landing. The show, combines a positive ageing message with the message that falls amongst older people are preventable in a way that crosses linguistic and cultural barriers.
Chatty Cats: Bereavement Work with Nine to Fifteen Year Olds
Authors: Hind-Roff Judie , Withers Debbie
Published: August 2009

Bereavement group work provides an opportunity for young people to deal with the responses to their loss and to learn skills that will support them in adjusting to other losses that they may experience throughout their lives. The group uses adolescent acceptable modalities like self-assessment, mentoring, experimenting with coping, including such things as massage, pottery and music. This provides a variety of ways to encourage the expression, and then acceptance, of the complex range of emotions evoked by a significant loss. Group work aims to build resilience and to create positive health outcomes for young people now and into adulthood and perhaps even "generationally" as they become parents.
"Chasing Money" and "Damaged Health": Korean Men in Australia, Part II, Skilled and Business Migrants
Authors: Han Gil-Soo , Chesters Janice
Published: August 2009

This paper is the second of two papers that explore subjective explanations for ill health among Korean migrant men in Australia. The "amnesty" and skilled migrants believe they have suffered from physical ill health because of their heavy involvement in manual work and the stress of migrant life. Business migrants say they enjoy better physical health because they spend considerable amounts of time on sporting activities, such as golf. However, all three groups reported experiencing mental health problems. The focus of the first paper was "amnesty migrants" while this paper is about Korean skilled and business migrants.
The Influence of Demographic, Behavioural and Treatment Characteristics on Problem Gambling Counselling Outcomes
Authors: R. Crisp Beth , A. Thomas Shane , C. Jackson Alun , Thomason Neil
Published: August 2009

The paper considers the influence of client characteristics and gambling behaviour as well as treatment modality on the resolution of gambling behaviour for 591 clients who sought help from the publicly-funded BreakEven counselling services in the state of Victoria between 1 July 1996 and 30 June 1997. Statistical data about clients and their consultations was collected in the form of a Minimum Data Set. On their own, client demographics accounting for 12% of the variance were identified as discriminating between problem gamblers who achieved some resolution of their gambling behaviour and those whose behaviour did not change. Variables associated with gambling behaviour accounted for 10% of variance and treatment variables for 12% of variance in treatment outcomes. Collectively, the three types of data could explain 26% of the variance in problem resolution. Importantly, these findings demonstrate that the resolution of problematic gambling behaviour is affected by a complex interplay of client characteristics, their gambling behaviour and the treatment they receive. It is argued that the evaluation of treatment programs for problem gambling, and potentially all counselling programs in the primary health arena, needs to include measures from each of these domains.
Financial Issues in Caring for Someone with Terminal Cancer at Home
Authors: Parker Deborah , Grbich Carol , Maddocks Ian
Published: August 2009

For the majority of patients with terminal cancer their preferred place of death is at home. Many factors determine this choice, in particular the availability of a carer, the patient's physical condition and adequate services. A factor often underestimated is the financial impact of caring for someone at home. This paper examines the financial concerns of carers of terminally ill cancer patients and whether current Australian health care policy is able to address these concerns. Two main categories of cost were identified, those related to the patients physical care needs and those that impacted on carer lifestyle. The current government allowances to assist carers in these costs are limited by carers either being unaware that the benefits existed or by the strict qualifying criteria that restrict access to those who care for the terminally ill.
Pastoral Carers in the Hospital Context
Authors: Barletta John , Thomsen Michael
Published: August 2009

Pastoral care in hospitals has developed considerably since the middle of last century, when it was almost the exclusive domain of the ordained minister, who typically made sacramental visits along with some theologically considered words of comfort. With the beginning of this century, professionally trained lay pastoral carers now at least balance the numbers of visiting clergy, if not exceed their presence. The emerging research appears to support the efforts of these pastoral carers, in their diverse roles and functions, as they increase patient recovery rates. Yet despite the apparent positive impact they make in the clinical setting, many continue to struggle to gain the status, identity and visibility they desire within the hospital structure. The article provides an overview of the current situation relative to pastoral care, and argues that quality research, consultancy, and training are imperative if it is to thrive and be considered an integral part of health care system.
A Case Study Using the "Problems and Goals Approach" in a Coordinated Care Trial: SA HealthPlus
Authors: W. Battersby Malcolm , Ask Alex , M. Reece Marion , J. Markwick Mignon , P. Collins James
Published: August 2009

The problems and goals approach (P&G) is a therapeutic assessment and intervention used in the behavioural psychotherapy field. P&G is a patient-centred, pragmatic technique in which the patient and health professional determine the patient?s problems and formulate realistic medium term goals based on measurable outcomes. P&G was utilised in the SA HealthPlus first round Coordinated Care Trial in South Australia with intervention patients who had chronic medical conditions. This article presents a case study from SA HealthPlus. The aim of this article is to introduce the practical workings of P&G and provide some observations about this technique.
What About the Mother and Family when an Infant Doesn't Sleep?
Authors: Rolls Colleen , Hanna Barbara
Published: August 2009

Becoming a new parent is a time of enormous change in the lifestyle of women, particularly as women are expected to take on prime responsibly for caring for the child. Motherhood can be exhausting and lonely as women cope with the demands of a new baby. These demands are exacerbated when infants do not sleep. This causes many parents to seek professional intervention with persistent infant sleep problems. Through focus group interviews, this study sought to understand the experiences of 28 women and families in how they coped with and managed an infant with sleep problems. Results indicated that women experienced major role confusion as they internalised the image that ?a good mother does it all?. Persistent infant crying and their own sleep deprivation exacerbated their loss of identity and shattered their self-image, and caused anger and confusion in some partners. Each woman sought primary health care support through a five-day residential stay in an Early Parenting Centre in Victoria. The women found that this professional support facilitated confidence building and feelings of normality. Most important, staff encouraged the women to feel good about themselves and their ability to manage future sleep problems.
Australian Health Care Workers Use of a Telephone Advice Line
Authors: G. M. Bolton Patrick , M. Parker Sharon , Chera Jag
Published: August 2009

An evaluation of the Health Resource Line (HRL), a telephone information service for use by General Practitioners and Area Health employees in Northern and Central Sydney Area Health Services, was conducted following an eight month pilot. This evaluation found that no more than half of the target population were aware of the service, and that fewer than a third of these had trialed the service. This is consistent with the experience in other published trials of this kind. The experience of health care providers using the service was generally positive, but despite this, overall levels of use were low and declined after an initial peak. The low level of use brings into question the cost effectiveness of such a service and the need for possible alternatives.
Aboriginal Community Controlled Comprehensive Primary Health Care: The Central Australian Aboriginal Congress
Authors: Bartlett Ben , Boffa John
Published: August 2009

Aboriginal community controlled PHC services have led the way in Australia in developing a model of PHC service that is able to address social issues and the underlying determinants of health alongside high quality medical care. This model is characterised by a comprehensive style rather than the selective PHC model that tends to be more common in mainstream services. Central to comprehensive PHC is community control, which is critical to the bottom up approach rather than the top down approach of selective PHC. The expansion of Aboriginal Community Controlled Health Services (ACCHSs) in Australia is a product of the colonial relationship that persists between Aboriginal and non-Aboriginal Australia. It is this relationship that explains why community control has been a feature of Aboriginal PHC services while similar attempts in the dominant society have tended to be incorporated into the mainstream. The mechanisms of control occur through community processes and should not be confused with day to day management processes, although the two are related. The Core Functions of PHC is a framework that reflects the experience of ACCHSs and allows for the development and assessment of comprehensive PHC. This framework is applied to a case study of the Central Australian Aboriginal Congress (Congress) which is the major Aboriginal health service in central Australia. The case study illustrates increasing utilisation of PHC services by Aboriginal people, and the capacity of community controlled organisations to respond to demographic and health pattern changes in their client populations.
Respect, Protect, Connect: A Workshop Program for Young People in Schools
Authors: Pratt Russell , Pyke Carol
Published: August 2009

The Respect, Protect, Connect Program, (formerly Respect Yourself, Protect Yourself for Females, and Respecting Ourselves, Respecting Others for Males), is an injury-prevention focused workshop project based in secondary schools in the South East Region of Melbourne. Peer education principles are utilised in single-sex workshops with year 7-10 students. The aims of the workshops are the development of harm reduction and violence prevention strategies by young people. Students develop an understanding of the way violence impacts upon their lives and those around them. Through discussion, roleplays and interactive group work, young people are empowered and resourced to take more control of their life circumstances. The origins and current status of the project are discussed along with reflections of project workers about working with class-sized groups of young people.
Reforming Primary Care in Victoria: Will Primary Care Partnerships Do the Job?
Authors: Klein Harald
Published: August 2009

Spiralling medical costs and escalating demand for health services are putting primary care reform firmly on the agenda for governments around the world. A more coordinated and prevention-oriented approach must be adopted now to avoid a looming crisis in health care. In Victoria, the Primary Care Partnership (PCP) Strategy aims to improve health outcomes and better manage the demand for services by functionally integrating health and community support services. This paper provides an overview of the key factors that have shaped primary care reform in the State of Victoria; the logic of the PCP Strategy; a summary of the results of the strategy after 18 months; and a critical assessment of the key challenges for the strategy in the future. The paper concludes that the strategy has already led to much stronger collaboration between agencies, more integrated service planning and emerging models for service coordination. For these achievements to translate to improved health outcomes, the systems changes being initiated by PCPs need to be translated into the way services are provided in the community. This cannot be achieved by collaboration between service providers alone. It is now time for all relevant parts of government to support PCP objectives and initiatives in the way they plan and fund services.
Primary Health Care: Concept and Challenges for its Implementation
Authors: Teresa Dawson Maria
Published: August 2009

Since the Alma-Ata (WHO) declaration of primary health in 1978 and the Ottawa Charter for Health Promotion in 1986, the concept of primary health care has become central to the definition of health care. Public health professionals have generally embraced the WHO's broadened definition of primary health care and have encouraged governments to reformulate national health policies to reflect this new orientation. However, although the rhetoric of primary health care has expanded beyond the traditional focus on general practitioners and hospitals to include a focus on community-based health care, intersectoral collaboration and community participation, a review of experiences in America and Europe suggests that national health systems are still struggling to implement this broader notion of health care.
Health Consumer Participation in Coordinated Care: A Case Study in the Goulburn Valley
Authors: Bourke Lisa
Published: August 2009

Consumer involvement is at the heart of improving health care, but involving consumers is difficult. This paper documents a process of developing a consumer reference group in northern Victoria to assist in developing a proposal for a coordinated care trial. The Goulburn Valley Consumer Reference Group was developed, maintained and able to meet its objective of developing a model of coordinated care. The group developed good relationships, which fostered commitment, open discussion and debate, and input from all group members. The group identified key issues in rural and regional health care, including access, information, staff shortages, cost, communication and coordination. Although the group is not 'representative', it includes the perspectives of some who do not typically have high rates of participation in health. The success of and problems raised by this process can be used to inform models of consumer participation in health.
General Practitioners' Collaboration with Service Coordinators: What Makes it Work? Lessons from the SA HealthPlus Coordinated Care Trial
Authors: Hurley Catherine , Kalucy Elizabeth , Battersby Malcolm
Published: August 2009

In the past, a number of factors have been identified that discourage collaboration between GPs and other health professionals in providing care to patients with chronic illness. These include financing arrangements, lack of time and lack of knowledge of the role of other professions. This paper uses data from the independent evaluation of the SA HealthPlus Coordinated Care Trial to examine the factors that encourage and inhibit collaboration between general practitioners (GPs) and Service Coordinators (a role introduced by the trial and carried out by nurses and allied health professionals). Both quantitative and qualitative methods were used to evaluate the role of the GP and the Service Coordinator in the trial. These data were analysed to determine what factors encouraged and inhibited collaboration. Results indicated that effective communications, knowledge of and respect for each other's roles and responsibilities, and a clearly perceived benefit from collaboration were the most important predictors of successful collaboration for both parties. These results also suggest strategies for increasing the likelihood of collaboration between GPs and others such as the location of the Service Coordinator in the practice and ways of dealing with GP workloads and communication needs. These findings are relevant to recent policy initiatives including the MBS Enhanced Primary Care item numbers, the employment of practice nurses, and allied health staff via Divisions of General Practice.
An Evaluation of the Care Planning Process in Coordinated Care Trials: What Difference Do Care Plans Make to Service Provision?
Authors: d A. Hear , y E. Kaluc , n D. Richardso , Battersby M. W. , h P. Frit , n C. McGowa
Published: August 2009

Care planning was an integral part of the SA HealthPlus Coordinated Care trial. This paper reports on the usefulness of care planning as a reminder system to GPs and patients in ensuring that chronically ill patients received planned services. Two thousand and seventy one (2071) intervention patients and 1317 control patients were eligible for the study. Data were collected from all sources recording the delivery of medical services, and the percentage of intervention and control patients receiving the service was compared. Two planned services - lipids tests and bowel cancer screening - were used in the analyses. A higher percentage of intervention patients than control patients received the lipid test and the bowel cancer screening test. Care planning has proved a useful means of increasing the delivery of at least two best practice services to a needy group of people with chronic illnesses.
From Streets to Sidewalks: Developments in Primary Care Services for Injecting Drug Users
Authors: McDonald Paul
Published: August 2009

Primary Health Care for the Injecting Drug User (IDU) has been established in Victoria in recognition of the serious health needs of IDUs, which require a relevant and effective response. Research shows the medical consequences that flow from drug abuse, ranging from the onset of blood borne viruses to cardiovascular conditions, and the propensity of drug users to access health services only through accident and emergency areas of hospitals. In 1999, the Victorian government announced the funding of five Local Drug Strategies in five of Melbourne's 'hotspot' street drug areas to address both the needs of users and communities in relation to substance abuse. This funding was an impetus to establish and trial the concept of primary health services, combining both a fixed site and a mobile outreach service. These services are designed to meet the primary health needs of street-based injecting drug users who are at high risk of experiencing overdose or other forms of drug-related harm.
Stress and Worry are Central issues for Indigenous Heart Attack Survivors in the Northern Territory
Authors: A. Ong Michael , S. Weeramanthri Tarun
Published: August 2009

Ischaemic heart disease impacts heavily on the Indigenous population of the Northern Territory, and late presentation may explain part of the mortality differential compared to the non-Indigenous population. We report here on a study that utilised qualitative interview techniques to explore the barriers to presentation in a group of Indigenous heart attack survivors. In particular we focused on their health beliefs, heart attack experiences and views on the health system. Stress and worry were frequently identified issues - as a perceived cause of heart disease, and as a complicating factor in managing heart disease. Practitioners working with Indigenous heart attack survivors need to explicitly identify and address stress-related issues, and preventive community programs need to recognise that heart disease and stress are intimately related, with heart disease often seen as a symbol of contemporary social problems and uncertain community direction.
Can Health and Wellbeing Come in All Shapes and Sizes? Dieting: The Big Con. A Harm Minimisation Program
Authors: Mann Susan , Harmer Helen
Published: August 2009

Stress, low self-esteem, mental illness issues and physical debility are recognised outcomes for women striving for an ideal body image (Paxton 2000). However, the prevailing discourse remains that healthy lifestyle relates to specific body size and shape. This message is evident throughout the media, which clearly links healthy people to slim bodies imbued with youth, vitality and good looks. Community health nurses, concerned for women in the community who were deemed overweight by the Body Mass Index scale and engaged in cyclic patterns of dieting, initiated a health promotion program, aimed at challenging such discourse. A multidisciplinary group involving expertise from nursing, nutrition, psychology and community members was established to develop and run a program for women, which focused on body image, healthy lifestyles and eating patterns. This paper discusses the outcomes of these programs, which challenge the argument that body size and shape determines health.
Factors Related to the Mental Health of Elderly Chinese Immigrants in Australia
Authors: Leung Cynthia
Published: August 2009

The present study aimed to examine the factors related to the mental health of elderly Chinese-Australians. Using the framework of Berry (1997), the study examined how individual variables such as social support, length of time in Australia, English competency, self-efficacy and sense of personal control were related to the life satisfaction of elderly Chinese-Australians. The participants consisted of 157 elderly Chinese male and female immigrants (aged 50 or above) recruited through various community groups. Participants completed a questionnaire with several scales on the above issues, and a section on demographic information. The results indicated that life satisfaction was related to age, age at migration, English proficiency, locus of control, social support, and self-efficacy. Implications for service provision were also discussed.
Work Stress and Quality of Work Performance in Australian General Practitioners
Authors: R. Winefield Helen , M. Veale Bronwyn
Published: August 2009

The relationship between work stress and work performance has received little empirical attention in professional areas such as health care where measurement of work quality is difficult. In health sciences there is growing concern about work errors, although little is known about the determinants and prevention of these in primary care. This study aimed to explore connections between workload, work stress in terms of burnout, job satisfaction and retirement age intentions, and reported mistakes at work, in general practice. A randomly-selected sample of mid-career General Practitioners (aged 35-45 years) was approached and 86% agreed to participate (N = 30). Satisfaction with work supports was a better predictor of work stress indicators than was workload. There was no evidence of the hypothesised association between work stress and severity of mistakes. Although response biases are a likely threat to the validity of mistakes as a quality indicator, results can be seen as supporting the need for a systems-level analysis of primary care work performance.
The Limits of Medicine and the Social Consequences for Sufferers of Chronic Fatigue Syndrome
Authors: Pinikahana Jaya , Holloway Geoff , Millen Neville
Published: August 2009

Chronic Fatigue Syndrome (CFS) appears to be made up of several clusters of illness categories acting alone or in tandem to cause the decline of health through; fatigue/exhaustion, sensitivity/allergies, pain, general muscle and joint pains, cognitive impairment and gastro-intestinal problems. This study investigated how patients interpret, evaluate and respond to the complex and varied symptoms of Chronic Fatigue Syndrome. Data were collected from persons with CFS using a survey (n=90) and an interview (n=45). The researchers investigated how chronic fatigue syndrome is diagnosed by medical practitioners, how the label of CFS is determined and the social consequences for the patient. The results confirm the limited ability of the biomedical paradigm to diagnose adequately and treat effectively 'socially constructed' and medically ambiguous illnesses like CFS. In the absence of a legitimated regime of medical treatment for CFS, a range of often expensive treatments are employed by CFS sufferers, from formal use of pharmaceutical drugs through to 'alternative' therapies, including herbal, vitamin, homeopathic, esoteric meditative techniques, spiritual healing and general counselling are taken in no particular order.
A Content Analysis of Contemporary Men's Health Books Marketed to the Health Professional
Authors: A. Laws Tom , Drummond Murray
Published: August 2009

The concept of "men's health" per se has followed on from the development of substantial social theories that coherently supported the women's health movement and women's health policy. Subsequently, literature on women's health took a variety of forms and has had time to meet the growing needs of that market. While men's health literature is a burgeoning area the needs and derivations of the market are yet to be fully understood. This review of three men's health books intended for health professionals and easily located in Australian bookshops or on-line marketing, shows that there are numerous gaps in content that are likely to frustrate the health professional who is wanting salient knowledge and appropriate guidelines on social and health practice. We argue that the reason for the mismatch between what is supplied and what is demanded by the health professional can, to a great extent, be attributed to two important factors. That is, the domination of the biomedical model as a means of structuring and presenting information and a rhetorical approach that attempts to extrapolate theories about masculinity to men's health issues. We further suggest that a more vibrant rhetoric is about to take place with the emergence of a more critical appraisal of where the men's movement is heading.
Oral Health through the Life Experiences of Older Greek and Italian Adults
Authors: Mariño Rodrigo , Minichiello Victor , Schofield Margot , Wright Clive
Published: August 2009

Little is known about the oral health of immigrant groups in Australia, particularly older immigrants, or about their individual life experience with oral health care services. This study was concerned with understanding the social meaning of the oral health experience of older adults from Greek and Italian backgrounds living in Melbourne, Australia. A qualitative approach was selected to allow participants to describe their lived experiences and perceptions regarding oral health. Seventeen focus group interviews were conducted between June and July 2000, with 172 participants recruited from Italian and Greek senior clubs in Melbourne. All of the participants were born overseas. Transcripts were analysed using key words and concepts. The results indicate that the participants' experiences as immigrants, and of growing up within a set of stories about oral health and interactions with dentistry, is critical to shaping their views about oral health. The various meanings surrounding their oral health experiences are partly shaped within the context of pre- and post-migration, socio-cultural environments, and historical changes in oral health treatment philosophies and approaches. The data shows that early experiences of oral health and dentistry services are highly salient in the form of memories, shared stories and folk beliefs, and may serve to influence current oral health practices even today. The study suggests that if oral health professionals are able to identify and understand specific social traditions and life experiences with dentistry, this knowledge could more successfully engage older immigrant groups with oral health promotion activities and treatments, and he useful for designing and evaluating culturally appropriate oral health interventions for older migrant groups.
A Spirituality Quintessentially of the Ordinary': Non-Religious Meaning-making and Its Relevance to Primary Health Care
Authors: McGrath Pam
Published: August 2009

Increasingly, there is a call within the literature for research to clarify the notion of spirituality, and document its relevance to health care. The research presented in this article is one response to this call. The phenomenological research involved the collection of data through open-ended interviews with twelve survivors of a haematological malignancy who were at least three years post-treatment. The results indicate that maintaining the intimate connection with life through family, home, friends, leisure, and work is just as spiritually important to individuals as meaning making (transcendent or otherwise). As a consequence, it is argued that the most important spiritual response for patients and their carers is to ensure that they are able to remain, where possible, in the comfort of their own homes surrounded by their intimate network of family and friends. The findings thus have direct implications for primary health care. Primarily, individuals do not need to talk with counsellors in an institutional setting about their intimate world outside the hospital. Rather, they need active, multi-disciplinary support to remain in their own home whenever possible. An informed spiritual response is predominantly about the provision of choice through the development of community-based health care services, from the point of diagnosis along the continuum, from cure to palliation.
Mental Health Professionals' Knowledge and Perceptions of Problematic Alcohol and Substance Use: A Questionnaire Survey
Authors: Carta Bill , HappeIl Brenda , Pinikahana Jaya
Published: August 2009

The drug and alcohol related knowledge and perceptions of clinicians were examined in order for the Substance Use and Mental Illness Treatment Team to develop a relevant training curriculum for clinicians. A questionnaire on knowledge, skills, attitudes, and practices was distributed to 378 clinicians in Victoria. One hundred and seventy-three clinicians returned the questionnaire giving an overall response rate of 46%. The survey results showed that, although both a knowledge and skills gap exists in assessment and management of alcohol and drug problems, knowledge levels were of an adequate standard overall. Notable areas of weakness included basic knowledge of alcohol and drugs, such as the number of grams of alcohol in a standard drink and the number of alcohol-free days per week recommended by the National Health and Medical Research Council. While positive attitudes towards problematic drug and alcohol issues were expressed, specific educational programs to enhance skills in assessment and management of problematic drug and alcohol users are needed.
Issues in Quality Use of Medicines in two Non-English Speaking Background Communities
Authors: Bolton Patrick , Hammoud Sekneh , Leung Joanne
Published: August 2009

Compliance is a policy issue in the quality use of medicine that has attracted much interest; however, there is little research about medication compliance issues in people of non-English speaking backgrounds. This paper describes a qualitative data collection that was used to identify compliance issues, and possible approaches to these issues, in an area of South-Eastern Sydney with a high non-English speaking population. Two parallel, iterative, series of GP and consumer focus groups were held in Arabic and Chinese communities. Later focus groups built on the findings of earlier groups and sought to engage GPs and consumers in identifying issues in compliance, and possible approaches to these issues. The paper compares and contrasts the results from these two communities and suggests that the approach might be used to identify compliance issues in other communities. Communication around appropriate medication use was the key issue common to both communities. The Chinese community was otherwise much more critical of Western medicine than the Arahic community, perhaps because of the strength of traditional medicine in that culture.
Editorial: Recording Excellence in Primary Care Practice
Authors: Walker Rae , Swerissen Hal
Published: August 2009

In this issue of the Australian Journal of Primary Health we publish papers that reflect the diverse approaches to knowledge characteristic of primary health care. There are articles on policy and management at the system level (for example, Primary health care research and evaluation development strategy in the Northern Territory), critical reviews of programs and community activities (for example, Motor racing in Australia: Health damaging or health promoting), and the community experiences of health and health services (for example, Communication and control in the co-construction of depression ...). The range of research valued in primary care is reflected in these articles.
Building Research Capacity in Primary Health Care Settings in the Northern Territory
Authors: Grundy John , Johnston Fay
Published: August 2009

The Centre for Remote Health Alice Springs (a University Department of Rural Health) was contracted by the then Commonwealth Department of Health and Aged Care to develop a submission to strengthen research and evaluation capacity at the primary level of care in the Northern Territory. This paper describes the process and outcomes of the research that formed the basis for the development of the strategy. Methods: National and international literature was reviewed. Interviews, consultations and workshops were conducted over a three-month period in the two major regions of the Northern Territory. Results: Stakeholders identified major barriers to research and evaluation implementation at the primary level of care. Barriers to implementation were identified in terms of the organisational structure of primary care and the professional culture of the research and health service communities. Three strategic directions were identified for research capacity building. These included (1) strengthening research collaborations; (2) trialling models of care that take into account the social determinants of health; and (3) developing the skills of general practitioners, other primary care providers, Indigenous researchers and communities to develop project proposals based on locally developed research priorities and questions. Conclusion: The central aim of the Primary Health Care Research, Evaluation and Development Strategy reflects an expressed need to bring research and evaluation capacity closer to the practice and community level. In doing so, the strategy has the potential to fill major identified gaps in applied and interventions-based research. The shift to community-based and prioritised research and evaluation was viewed as a strategy that has the potential to address the fundamental issue of widening health inequalities in the Northern Territory.
Governance in Victorian Community Health Centres
Authors: McCoppin Brigid
Published: August 2009

Recently, Governments of both parties in Victoria have differed on the method of selecting members for the boards of management of community health centres, but have given less attention to how and in what ways these boards contribute to the work of the organisations over which they preside-organisations that have become both larger and more complex in the last 10 years. In this paper, community health presidents and Chief Executive Officers discuss board responsibilities and the ways in which boards execute them. The conclusion is that boards appear to be carrying out their varied responsibilities effectively, and according to government requirements.