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1
Rodley, Cassandra. "Changes in the Medical Record Service across the Hunter Area Health Service." Australian Medical Record Journal 22, no. 2 (June 1992): 67–69. http://dx.doi.org/10.1177/183335839202200208.
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Waring, Trevor, Trevor Hazell, Philip Hazell, and Jane Adams. "Youth Mental Health Promotion in the Hunter Region." Australian & New Zealand Journal of Psychiatry 34, no. 4 (August 2000): 579–85. http://dx.doi.org/10.1080/j.1440-1614.2000.00763.x.
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Objective: To describe the work of the Hunter Institute of Mental Health, with special emphasis on its role in mental health promotion and prevention with adolescents. Method and Results: The Ottawa Charter for Health Promotion is used as a framework to describe the varied functions of this organisation. Four youth mental health promotion programs are given as examples of the Institute's work. Results of preliminary evaluation of the Youth Suicide Prevention — National University Curriculum Project are provided. Conclusion: The Hunter Institute of Mental Health, a self-funding unit of the Hunter Area Health Service, provides innovative health promotion programs as part of its role as a provider of mental health education and training. The model may be particularly applicable to mental health services in regional Australia.
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Sankaranarayanan, Anoop, Kerry Allanson, and Dinesh K. Arya. "What do general practitioners consider support? Findings from a local pilot initiative." Australian Journal of Primary Health 16, no. 1 (2010): 87. http://dx.doi.org/10.1071/py09040.
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This paper reports the findings of a local pilot that was aimed to assess if making a local psychiatrist available would improve GP satisfaction with regard to responsiveness and access to specialist mental health services. A psychiatrist was made available via a telephone advice line for 1 h every day. Pre- and post-survey of all GPs was conducted to elicit GP satisfaction and suggestions. The pilot was conducted from Maitland, the base of Hunter Valley Mental Health Service. A total of 202 GPs in the area were contacted and surveyed; 17% responded to the pre-survey and 27% to the post-survey. Only 8% of the GPs used the telephone advice service. Despite low use, most responding GPs indicated that they would like to see the services continue. Most of the responding GPs (both users and non-users of this service) were not aware of or had not used the Royal Australian College of General Practitioners’ GP Psych Support initiative. Results from this pilot indicate that making a local psychiatrist available improves GP satisfaction with regard to responsiveness and access, despite low use. Further research is needed to establish if such a service can be made available at an area level and whether this would be cost effective.
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Warner, Alexandra, Anne Saxton, Kathleen Fahy, Devon Indig, and Leanne Horvat. "Women's experience of early pregnancy care in five emergency departments in Hunter New England Area Health Service." Australasian Emergency Nursing Journal 14 (January 2011): S16. http://dx.doi.org/10.1016/j.aenj.2011.09.042.
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Freckelton, Ian. "Liability of Psychiatrists for Failure to Certify: Presland v Hunter Area Health Service and Dr Nazarian [2003] NSWSC 754." Psychiatry, Psychology and Law 10, no. 2 (June 2003): 397–404. http://dx.doi.org/10.1375/pplt.2003.10.2.397.
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Wiggers, John, Robyn Considine, Trevor Hazell, Melanie Haile, Maria Rees, and Justine Daly. "Increasing the Practice of Health Promotion Initiatives by Licensed Premises." Health Education & Behavior 28, no. 3 (June 2001): 331–40. http://dx.doi.org/10.1177/109019810102800307.
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Licensees of all licensed premises in the Hunter Region of New South Wales, Australia, were offered free services to encourage adoption of health promotion initiatives relating to responsible service of alcohol, environmental tobacco smoke, healthy food choices, breast and cervical cancer prevention, and the prevention of HIV/AIDS. A total of 239 premises participated in the follow-up survey. Increases in prevalence ranged between 11% and 59% for alcohol-related initiatives. The prevalence of smoke-free areas and healthy food choices increased from 32% to 65% and 42% to 96%, respectively, and the provision of cancer prevention information increased from 3% to 59%. Licensed premises represent a particularly challenging sector for health promotion practitioners to work in. The results of this study suggest that the adoption of health promotion initiatives by licensed premises can be increased. A considerable opportunity therefore exists for health promotion practitioners to become more actively involved in facilitating the adoption of such initiatives in this setting.
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Griffin, Cassandra, Ricardo Vilain, Simon King, Sandy Nixon, Alisha Gooley, Samara Bray, James Lynam, Marjorie M. Walker, Rodney J. Scott, and Christine Paul. "Mind Over Matter: Confronting Challenges in Post-Mortem Brain Biobanking for Glioblastoma Multiforme." Biomarker Insights 16 (January 2021): 117727192110133. http://dx.doi.org/10.1177/11772719211013359.
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Over the past 10 years, there has been limited progress for the treatment of brain cancer and outcomes for patients are not much improved. For brain cancer researchers, a major obstacle to biomarker driven research is limited access to brain cancer tissue for research purposes. The Mark Hughes Foundation Brain Biobank is one of the first post-mortem adult brain banks in Australia to operate with protocols specifically developed for brain cancer. Located within the Hunter New England Local Health District and operated by Hunter Cancer Biobank, the boundaries of service provided by the Brain Bank extend well into the surrounding regional and rural areas of the Local Health District and beyond. Brain cancer biobanking is challenging. There are conflicting international guidelines for best practice and unanswered questions relating to scientific, psychosocial and operational practices. To address this challenge, a best practice model was developed, informed by a consensus of existing data but with consideration of the difficulties associated with operating in regional or resource poor settings. The regional application of this model was challenged following the presentation of a donor located in a remote area, 380km away from the biobank. This required biobank staff to overcome numerous obstacles including long distance patient transport, lack of palliative care staff, death in the home and limited rural outreach services. Through the establishment of shared goals, contingency planning and the development of an informal infrastructure, the donation was facilitated within the required timeframe. This experience demonstrates the importance of collaboration and networking to overcome resource insufficiency and geographical challenges in rural cancer research programmes.
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Hunter, Donna, Gerry McCartney, Susan Fleming, and Fiona Guy. "Improving the Health of Looked after Children in Scotland: 1. Using a Specialist Nursing Service to Improve the Health Care of Children in Residential Accommodation." Adoption & Fostering 32, no. 4 (December 2008): 51–56. http://dx.doi.org/10.1177/030857590803200407.
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The first of two studies reported here by Donna Hunter, Gerry McCartney, Susan Fleming and Fiona Guy investigated whether a specialist nursing service could improve the health care of 162 children in residential care in Renfrewshire, West Dunbartonshire and Argyll & Bute. It found that after the introduction of the service, the proportion of children with completed carer-held health records (BAAF health record booklets) increased from three per cent to 77 per cent; the proportion receiving a ‘pre-admission medical’ increased from 38 per cent to 48 per cent; the proportion adequately immunised increased from nine per cent to 56 per cent; the proportion with at least one outstanding medical referral decreased by at least four per cent; the number registered with a dentist increased from 14 per cent to 62 per cent and the proportion who received a ‘comprehensive health assessment’ increased from 17 per cent to 58 per cent. Thematic analysis of free text journals suggested that universal health services were much more accessible in Argyll & Bute due to well-developed interagency working, low numbers of children in residential care and low rates of staff turnover. In the more urban areas, the main advantage of the service was thought to be in the facilitation of interagency working. The service was received positively by residential care workers and children in residential establishments. This study suggests that the provision of a specialist nursing service can improve the health care of children in residential accommodation.
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Scott, Russ. "Hunter Area Health Services v Presland: Liability of Mental Health Services for Failing to Admit or Detain a Patient With Mental Illness." Psychiatry, Psychology and Law 13, no. 1 (July 2006): 49–59. http://dx.doi.org/10.1375/pplt.13.1.49.
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Dawood, Fatimah S., Craig B. Dalton, David N. Durrheim, and Kirsty G. Hope. "Rates of hospitalisation for acute respiratory illness and the emergence of pandemic (H1N1) 2009 virus in the Hunter New England Area Health Service." Medical Journal of Australia 191, no. 10 (November 2009): 573–74. http://dx.doi.org/10.5694/j.1326-5377.2009.tb03318.x.
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Reith, David M., Ian Whyte, Greg Carter, and Michelle McPherson. "Adolescent Self-Poisoning." Crisis 24, no. 2 (March 2003): 79–84. http://dx.doi.org/10.1027//0227-5910.24.2.79.
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Abstract: Previous self-harm has been identified as a risk factor for subsequent suicide by adolescents. The objective of the study was to identify further risk factors for subsequent premature death and suicide in a population of adolescents presenting with self-poisoning. A longitudinal cohort design using data-linkage of consecutive adolescent patients presenting to the Hunter Area Toxicology Service, a regional toxicology service for Newcastle, Australia, with the National Death Index of the Australian Institute of Health and Welfare was used. A total of 441 adolescents aged 10 to 19 years presented with self-poisoning over 5 years from January 1991 to December 1995, with follow-up to March 2001. There were 14 deaths total, eight of which were likely suicides. There was a 22-fold increase in suicide rate for males and a 14-fold increase for females compared with age-normalized population rates. Adjusted hazard ratios (95% CI) for premature death were male gender 3.77 (1.11-12.78), nonaffective psychotic disorders 16.3 (3.83-69.34) and the mental illnesses of childhood 6.12 (1.68-22.23). There was a similar pattern for suicide: Male gender, nonaffective psychotic disorders, and the mental illnesses of childhood confer greater risk for subsequent suicide or premature death in this population.
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Briggs, David Stewart, Richard Nankervis, John Baillie, Catherine Turner, Kevin Rigby, and Lorin Livingstone. "Innovation to improve patient care in Australian Primary Health Network: an insider’s perspective." Public Administration and Policy 22, no. 2 (December 2, 2019): 111–24. http://dx.doi.org/10.1108/pap-09-2019-0017.
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Purpose The purpose of this paper is to review the establishment of Primary Health Network (PHN) in Australia and its utility in commissioning Primary Health Care (PHC) services. Design/methodology/approach This study is an analysis of management practice about the establishment and development of a PHN as a case study over the three-year period. The PHN is the Hunter New England and Central Coast PHN (HNECCPHN). The study is based on “insiders perspectives” drawing from documentation, reports and evaluations undertaken. Findings HNECCPHN demonstrates a unique inclusive organisation across a substantial diverse geographic area. It has taken an innovative and evidence-based approach to its creation, governance and operation. HNECCPHN addresses the health challenges of a substantial Aboriginal and/or Torres Strait Islander population. It contains significant and diverse urban, coastal and distinct rural, regional and remote populations. It can be described as a “virtual” organisation, using a distributed network of practice approach to engage clinicians, communities and providers. The authors describe progress and learning in the context of theories of complex organisations, innovation, networks of practice, knowledge translation and social innovation. Research limitations/implications The study provides initial publication into the establishment phase of a PHN in Australia. Practical implications The study describes the implementation and progress in terms of relevant international practice and theoretical concepts. This paper demonstrates significant innovative practice in the short term. Social implications The study describes significant engagement and the importance of that with and between communities, service providers and health professionals. Originality/value This is the first study of the results of the implementation of an important change in the funding and delivery of PHC in Australia.
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Carter, Greg, David M. Reith, Ian M. Whyte, and Michelle McPherson. "Repeated self-poisoning: increasing severity of self-harm as a predictor of subsequent suicide." British Journal of Psychiatry 186, no. 3 (March 2005): 253–57. http://dx.doi.org/10.1192/bjp.186.3.253.
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BackgroundPrediction of suicide risk is difficult in clinical practice.AimsTo identify changes in clinical presentation predictive of suicide in patients treated for repeated episodes of self-poisoning.MethodA nested case–control study used the Hunter Area Toxicology Service database to identify exposure variables and the National Death Index to identify suicide. Cases were patients who had hospital treatment on more than one occasion between 15 January 1987 and 31 December 2000.ResultsThere were 31 cases, for which 93 controls were selected. Study variables associated with an increased risk of subsequent suicide were an increase in the number of drugs ingested (odds ratio 2.59, 95% CI 1.48–4.51), an increase in the dose ingested (OR1.33, 95% CI 1.01–1.76), an increase in coma score (OR 1.71, 95% CI 1.11–2.66), a decrease in Glasgow Coma Score (OR 1.21, 95% CI 1.03–1.43) and an increase in drug or alcohol misuse (OR 2.33, 95% CI 1.06–5.10).ConclusionsPatients who have escalating severity of self-poisoning episodes are at high risk of completed suicide.
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Brown, Wendy J., and Julie E. Byles. "A Collaborative Approach to Cervical Cancer Screening." Journal of Medical Screening 3, no. 3 (September 1996): 146–53. http://dx.doi.org/10.1177/096914139600300308.
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Objectives –The main objective of this project was to evaluate a collaborative nurse and general practitioner approach to improve screening for cervical cancer. Design—Multiple group time series design. Setting –Six postal areas in the Hunter Valley of New South Wales, Australia, chosen as intervention sites because of very low Pap test rates compared with the rest of NSW (fewer than 50% of women screened). Six regions of similar size and with similar baseline screening levels were selected as comparison sites. Subjects—All women selected in the resident postal areas. Interventions –Women's health nurses worked in collaboration with general practitioners within the communities selected from within the Hunter area to prond provide screening for cervical cancer. Main Outcome Measures –Qualitative information on initial expectations and impressions of the collaborative processes were collected at the start of the project period. Process data on client characteristics and Pap test results were obtained from minimum data collections; client satisfaction was assessed from client surveys. Outcome data on the increase in the number of women in each community who were screened for cervical cancer were obtained from Health Insurance Commission claims for screening Pap tests (and from nurses' records where Pap tests were examined under block funding arrangements). Results –This project showed that nurses and general practitioners can collaborate to provide appropriate and highly acceptable cervical cancer screening services for women. Many of the women screened by the nurses were in the high risk age range for cervical cancer (40 years and older) and had only basic education levels, thus representing women who are most likely to have poor screening rates. Further, 33.1% of the women screened had not had a Pap test in the past four years or had never been screened. The number of women having a Pap test during the first six months of the project, compared with the number expected from preintervention patterns, was significantly greater in four intervention areas (P < 0.01). No corresponding increase was seen in comparison areas with similar screening rates at baseline. Conclusions –There is great potential for nurses to work in collaboration with general practitioners to improve the availability and coverage of community cervical cancer screening programmes.
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Nugroho, Hunggul Yudono Setio Hadi, Fitri Nurfatriani, Yonky Indrajaya, Tri Wira Yuwati, Sulistya Ekawati, Mimi Salminah, Hendra Gunawan, et al. "Mainstreaming Ecosystem Services from Indonesia’s Remaining Forests." Sustainability 14, no. 19 (September 25, 2022): 12124. http://dx.doi.org/10.3390/su141912124.
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With 120 million hectares of forest area, Indonesia has the third largest area of biodiversity-rich tropical forests in the world, and it is well-known as a mega-biodiversity country. However, in 2020, only 70 percent of this area remained forested. The government has consistently undertaken corrective actions to achieve Sustainable Development Goal targets, with a special focus on Goals #1 (no poverty), #2 (zero hunger), #3 (good health and well-being), #7 (affordable and clean energy), #8 (decent work and economic growth), #13 (climate action), and #15 (life on land). Good environmental governance is a core concept in Indonesia’s forest management and includes mainstreaming ecosystem services as a framework for sustainable forest management. This paper analyzes efforts to mainstream Indonesia’s remaining forest ecosystem services. We review the state of Indonesia’s forests in relation to deforestation dynamics, climate change, and ecosystem service potential and options and provide recommendations for mainstreaming strategies regarding aspects of policy, planning, and implementation, as well as the process of the articulation of ecosystem services and their alternative funding.
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Aylward, Aileen, Timothy Platts-Mills, Liane Wardlow, Conor Sullivan, Jessa Engelberg Anderson, Andrea Morris, and Rayad Shams. "A Screening and Referral Intervention for Food Insecurity Among Older Emergency Department Patients." Innovation in Aging 4, Supplement_1 (December 1, 2020): 37. http://dx.doi.org/10.1093/geroni/igaa057.121.
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Abstract Food insecurity is prevalent among older adults, negatively impacts health, and may increase healthcare utilization. Risk factors include poverty, lack of transportation, and social isolation. Community-based services may mitigate food insecurity and other social risk factors. However, identifying those at risk and connecting them to services can be challenging. We implemented a screening and referral program in an Emergency Department (ED) to identify older adults facing food insecurity and connect them to a local Area Agency on Aging (AAA), which arranged and tracked delivery of community-based services. ED nursing assistants used the Hunger Vital Sign screener to assess food insecurity in patients aged 60 years and older. ED Care Managers (CMs) saw all who screened positive and made referrals to the AAA. The AAA conducted an intake assessment and arranged services. Patients were contacted three months after their ED visit to evaluate health, quality of life, and satisfaction with services. Of 423 patients screened over 7 months, 45 (11%) reported food insecurity. Of those, 25 were referred to the AAA. Patients were not referred to the AAA due to CM inability to make a referral (7), declining services (4), or other reasons (11). The AAA reached 21 patients and 9 received at least one service. Of those, 5 were reached for follow-up and reported satisfaction with services. The most frequently requested service was Meals on Wheels (10). Food insecurity is common among older ED patients. An ED-AAA partnership is feasible and connects older adults to beneficial services in their communities.
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Carter, Greg, David M. Reith, Ian M. Whyte, and Michelle Mcpherson. "Non-Suicidal Deaths Following Hospital-Treated Self-Poisoning." Australian & New Zealand Journal of Psychiatry 39, no. 1-2 (January 2005): 101–7. http://dx.doi.org/10.1080/j.1440-1614.2005.01515.x.
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Objective: To quantify the non-suicidal mortality subsequent to hospital treated selfpoisoning, and to identify risk factors for non-suicidal death. Method: A prospective longitudinal cohort design was used, with data-linkage between the Hunter Area Toxicology Service database and the National Death Index. All patients with deliberate self-poisoning for a 10-year period (1991–2000) were studied and the first episode in the period was used as the index episode. The outcomes were: accidental, ‘natural’ and non-suicidal death, with follow-up for the study duration. Results: There were 4044 patients studied, and 170 (4.2%) of these had non-suicidal death; 64 were accidental and 106 were ‘natural’ cause deaths. The standardized mortality ratio (95% CI) for non-suicidal death for males, females and combined were 4.98 (4.08–6.07), 3.78 (3.0–4.75) and 4.20 (3.62–4.88), respectively. The increased mortality was apparent for both males and females, and was more marked in the younger age groups. For non-suicidal death the adjusted hazard ratio (95% CI) for increased risk were: increasing age 1.07 (1.06–1.08), male gender 1.77 (1.24–2.52), psychiatric diagnosis of substance related disorder 1.49 (1.03–2.16), prescription of a respiratory drug 2.69 (1.31–5.55), and prescription of an antidiabetic drug 1.95 (0.93–4.07), while psychiatric diagnosis of adjustment disorder 0.64 (0.38–1.053) was associated with decreased risk. Conclusions: Patients who present with self-poisoning have increased mortality from accidental and ‘natural’ causes. Long-term treatment goals for these patients need to address non-suicide mortality in addition to suicide mortality.
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Martin Reith, David, Ian Whyte, and Greg Carter. "Repetition Risk for Adolescent Self-Poisoning: A Multiple Event Survival Analysis." Australian & New Zealand Journal of Psychiatry 37, no. 2 (April 2003): 212–18. http://dx.doi.org/10.1046/j.1440-1614.2003.01114.x.
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Objectives: To examine risk factors associated with re-presentation (event rates) following an initial episode of hospital treated self-poisoning. Method: A longitudinal cohort study using the Hunter Area Toxicology Service (HATS) database of all presentations to hospital of self-poisoned patients aged 10–19 in Newcastle and Lake Macquarie Regions of New South Wales from January 1991 to December 1995. The study factors were: age, gender, employment status, ‘substance abuse’ and psychiatric diagnosis at index (first documented episode during the study time-period) admission. The main outcome measure was re-presentations per unit time. Time-event analysis (multivariate) was used to compare re-presentation rates per person-year exposure to the study factors. Results: There were 450 patients who presented on a total of 551 occasions. The median and modal age at initial presentation was 17. Three hundred and nine (69%) were female and 141 (31%) were male. The probability (95% CI) of a patient re-presenting within one year of an index admission with self poisoning was 0.09 (0.07–0.12) and within 5 years was 0.16 (0.12–0.21). The adjusted rate ratios for episodes of re-presentation were: any ‘substance abuse (ever)’ 3.87 (2.08–7.21), ‘alcohol abuse’ 2.32 (1.15–4.68),‘benzodiazepine abuse’ 4.89 (1.63–14.62), schizophrenia and other psychotic disorders (DSM-IV) 2.85 (1.2–6.79), and any personality disorder (DSM-IV) 2.68 (1.73–4.16). Conclusions: Interventions to decrease recurrence rates for adolescent self poisoning should be directed towards substance (particularly alcohol or benzodiazepine) abuse, nonaffective psychoses and personality disorder.
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Smoyer, Amy B., and Giza Lopes. "Hungry on the inside: Prison food as concrete and symbolic punishment in a women’s prison." Punishment & Society 19, no. 2 (September 19, 2016): 240–55. http://dx.doi.org/10.1177/1462474516665605.
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Women’s perceptions of the prison experience and the punishing dimensions of their confinement are under-examined. To expand knowledge in this area, Sexton’s theory of penal consciousness is used to analyze formerly incarcerated women’s narratives about prison food. This analysis builds understanding about the lived experience of incarceration by explicating one dimension of prisoners’ understandings and perceptions of punishment. Women’s narratives describe both concrete and symbolic punishments associated with food. Participants spoke about poorly designed, sloppy food systems that left them feeling uncared for, ignored, frustrated, and humiliated. Women articulate experiences of hunger that reflect both a deprivation of adequate food and a rationing of humane attentions. These punishing perceptions may inhibit the efforts of social service and health providers to engage incarcerated and formerly incarcerated women in care. In contrast, exceptional participant narratives about positive, non-punishing food experiences suggest that ameliorated food systems could improve the lived experience of incarceration and promote the engagement in services that is needed to improve the outcomes of incarcerated and formerly incarcerated women.
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McGill, Katie, Sarah A. Hiles, Tonelle E. Handley, Andrew Page, Terry J. Lewin, Ian Whyte, and Gregory L. Carter. "Is the reported increase in young female hospital-treated intentional self-harm real or artefactual?" Australian & New Zealand Journal of Psychiatry 53, no. 7 (December 5, 2018): 663–72. http://dx.doi.org/10.1177/0004867418815977.
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Background: The Australian Institute of Health and Welfare has reported an increased rate of hospital-treated intentional self-harm in young females (2000–2012) in Australia. These reported increases arise from institutional data that are acknowledged to underestimate the true rate, although the degree of underestimation is not known. Objective: To consider whether the reported increase in young females’ hospital-treated intentional self-harm is real or artefactual and specify the degree of institutional underestimation. Methods: Averages for age- and gender-standardised event rates for hospital-treated intentional self-harm (national: Australian Institute of Health and Welfare; state: New South Wales Ministry of Health) were compared with sentinel hospital event rates for intentional self-poisoning (Hunter Area Toxicology Service, Calvary Mater Newcastle) in young people (15–24 years) for the period 2000–2012. A time series analysis of the event rates for the sentinel hospital was conducted. Results: The sentinel hospital event rates for young females of 444 per 100,000 were higher than the state (378 per 100,000) and national (331 per 100,000) rates. There was little difference in young male event rates – sentinel unit: 166; state: 166 and national: 153 per 100,000. The sentinel hospital rates showed no change over time for either gender. Conclusion: There was no indication from the sentinel unit data of any increase in rates of intentional self-poisoning for young females. The sentinel and state rates were higher than the national rates, demonstrating the possible magnitude of underestimation of the national data. The reported increases in national rates of hospital-treated self-harm among young females might be due to artefactual factors, such as changes in clinical practice (greater proportion admitted), improved administrative coding of suicidal behaviours or possibly increased hospital presentations of community self-injury cases, but not intentional self-poisoning. A national system of sentinel units is needed for the accurate and timely monitoring of all hospital-treated self-harm.
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Fairweather-Tait, Susan J. "Human nutrition and food research: opportunities and challenges in the post-genomic era." Philosophical Transactions of the Royal Society of London. Series B: Biological Sciences 358, no. 1438 (October 29, 2003): 1709–27. http://dx.doi.org/10.1098/rstb.2003.1377.
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Sequencing of the human genome has opened the door to the most exciting new era for nutritional science. It is now possible to study the underlying mechanisms for diet–health relationships, and in the near future dietary advice (and possibly tailored food products) for promoting optimal health could be provided on an individual basis, in relation to genotype and lifestyle. The role of food in human evolution is briefly reviewed, from palaeolithic times to modern–day hunter–gatherer societies. The aetiology of ‘diseases of modern civilization’, such as diabetes, heart disease and cancer, and the effect of changes in dietary patterns are discussed. The risk of disease is often associated with common single nucleotide polymorphisms, but the effect is dependent on dietary intake and nutritional status, and is often more apparent in intervention studies employing a metabolic challenge. To understand the link between diet and health, nutritional research must cover a broad range of areas, from molecular to whole body studies, and is an excellent example of integrative biology, requiring a systems biology approach. The annual cost to the National Health Service of diet–related diseases is estimated to be in excess of £15 billion, and although diet is a key component of any preventative strategy, it is not given the prominence it deserves. For example, less than 1% of the £1.6 billion budget for coronary heart disease is spent on prevention. The polygenic and multifactorial nature of chronic diseases requires substantial resources but the potential rewards, in terms of quality of life and economics, are enormous. It is timely therefore to consider investing in a long–term coordinated national programme for nutrition research, combining nutritional genomics with established approaches, to improve the health of individuals and of the nation.
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Mills, S., K. Khehra, P. Ghuman, D. Au, C. L. Koehn, R. Maynard, N. Clark, et al. "POS0298 UNDERSERVED POPULATIONS IDENTIFY BARRIERS AND PROPOSE SOLUTIONS FOR SELF-MANAGING ARTHRITIS AND CHRONIC CONDITIONS." Annals of the Rheumatic Diseases 80, Suppl 1 (May 19, 2021): 374.1–374. http://dx.doi.org/10.1136/annrheumdis-2021-eular.2211.
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Background:Underserved populations, such as ethnic minorities, low-income adults, and Indigenous people living with arthritis are more likely to have lower health literacy, higher rates of multi-morbidity, and face challenges in accessing care1-3. Self-management support (SMS) can help to mitigate the impacts of living with arthritis4. However, we require a more in-depth understanding of the daily barriers underserved communities face in living with arthritis in order to develop effective SMS that can meaningfully improve well-being and quality of life.Objectives:The study objective was to bring together underserved people living with arthritis to identify common barriers they face in taking care of their conditions in daily life, and to identify their solutions to the identified challenges.Methods:A team of researchers from several universities, nurse practitioners, physicians, policy makers, an arthritis consumer-patient leader and our community partners (Multi-lingual Orientation Service Association for Immigrant Communities and the Portland Hotel Society Community Services Society) engaged in a Community-based Participatory and Concept Mapping (CM) study5-7 where participants from underserved communities identified major barriers they face in managing arthritis, agreed on key themes that emerged, and determined priorities for actions. This involved three key CM activities: 1) brainstorming ideas; 2) sorting and rating ideas; and 3) analyzing and interpreting concept maps8. Data was collected through face-to-face interviews and prioritized and interpreted in workshop settings.Results:Sixty-three individuals who were ethnic minorities, immigrants, refugees, low-income, over 65, and/or housing insecure and living with arthritis identified 35 common barriers and made recommendations in the areas of financial difficulties, social services, access to health services, quality of health services, lack of knowledge, and mental health. Additional funding has been sought through Community-University Engagement Support Funding to enable our community partners to prioritize the recommendations in their communities, and to develop mechanisms for implementation using already existing community structures, processes, and services.Conclusion:Persons living with arthritis in diverse underserved communities face significant health and social inequities, including lack of access to basic life necessities such as food, housing, employment, and safety, which creates barriers to self-managing arthritis and other chronic conditions in daily life. SMS for these communities needs to address these social and environmental barriers shaping capacity for self-management, and ultimately, quality of life and well-being.References:[1]Ackerman I, Busija L. Access to self-management education, conservative treatment and surgery for arthritis according to socioeconomic status. Best Pr Res Clin Rheumatol. 2012;26(5):561–83.[2]Shadmi E. Multimorbidity and equity in health. Int J Equity Heal. 2013;12(59):59.[3]Foster M, Kendall E, Dickson P, Chaboyer W, Hunter B, Gee T. Participation and chronic disease self-management: are we risking inequitable resource allocation? Aust J Prim Health. 2003;9(3):132–40.[4]Brady T, Anderson L, Kobau R. Chronic disease self-management support: public health perspectives. Front Public Heal. 2015;2(234).[5]Trochim W. An introduction to concept mapping for planning and evaluation. Eval Progr Plann. 1989;12(1):1–16.[6]Anderson L, Day K, Vandenberg A. Using a concept map as a tool for strategic planning: the healthy brain initiative. Prev Chronic Dis. 2011;8(5):A117.[7]Petrucci C, Quinlan K. Bridging the research practice gap: concept mapping as a mixed methods strategy in practice-based research and evaluation. J Soc Serv Res. 2007;34(2):25–42.[8]Kane M, Trochim W. Concept mapping for planning and evaluation. Thousand Oaks (CA): SAGE Publications; 2007.Disclosure of Interests:None declared
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Balakrishnan, Mundanthra, and Dora E. Ndhlovu. "Wildlife Utilization and Local People: A Case-study in Upper Lupande Game Management Area, Zambia." Environmental Conservation 19, no. 2 (1992): 135–44. http://dx.doi.org/10.1017/s0376892900030617.
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Wildlife culling is the most preferred form of wildlife utilization in ULGMA. Nevertheless, the frequency of game-meat consumption by local people is low, partly due to the problem of irregular meat sales from the culling scheme and partly due to the low purchasing capability of villagers. LIRDP needs to improve the distribution routine of meat sale at lower prices if the culling scheme is to fulfil its objective of providing game-meat to local people. It is also essential to spread comprehension of the use of benefits from wildlife utilization among the local residents. Any increase in the allocation of the wildlife harvest quota should be considered with caution in order that species are not harvested at a rate beyond their reproductive capacity.There is resentment against safari hunting, based on the opinion that it gives to foreigners the opportunities to utilize wildlife resources while the local people are forbidden access to them. Appreciation of benefits from safari hunting is minimal, and option for reduction of the off-take allocation quota is strong. Although safari hunting is the most prominent revenue-generating form of utilization, benefits from it are not visible to local communities. Exchange of information between LIRDP and the local communities concerned with the use of revenue from wildlife utilization programmes needs to be reinforced. This would be instrumental not only in minimizing misconceptions about safari hunting, but also in establishing cooperation between LIRDP and local communities. An increase in the number that may be taken of the more numerous species during DGL hunting could well be considered, so as to enable more local people to utilize wildlife resources legally.Control shooting has a marginal effect in reducing crop damage. Even though electric fencing could be an effective barrier against large animals such as Elephants, it would be better to encourage traditional methods of self-defence. Control shooting is advocated only if and when the problem gets out of hand. Subsistence poaching is widely successful, due to the skills of the practitioners, the use of appropriate traditional technology, and the low operating costs. These features may be considered favourably in wildlife culling operations. Through allocation of a sustainable off-take quota to local hunter cooperatives, their services could be used to provide game-meat to local communities.Continued confrontation with commercial poachers through regular and more intensive patrols is essential, particularly in vulnerable areas. LIRDP should maximize the services of Village Scouts stationed at Miliyoti and Kauluzi wildlife camps by providing adequate firearms and ammunition for more effective anti-poaching patrols in the game management areas than currently exist. To gain local support, LIRDP may consider an increased wildlife offtake quota for the Malaila Kunda traditional ceremony. This would serve to sustain local culture and would help to develop enthusiasm among local people for due conservation of animal wildlife and other natural resources.
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Wolfenden, Luke, Sze Lin Yoong, Christopher M. Williams, Jeremy Grimshaw, David N. Durrheim, Karen Gillham, and John Wiggers. "Embedding researchers in health service organizations improves research translation and health service performance: the Australian Hunter New England Population Health example." Journal of Clinical Epidemiology 85 (May 2017): 3–11. http://dx.doi.org/10.1016/j.jclinepi.2017.03.007.
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Puech, Michele, and Helen Moore. "NSW Area Health Service Health Status Profiles." New South Wales Public Health Bulletin 10, no. 6 (1999): 62. http://dx.doi.org/10.1071/nb99030.
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Magdaleno, R., E. A. Chaim, and E. R. Turato. "The eating impulse after bariatric surgery: A clinical-qualitative study in a public outpatient service in Southeast Brazil." European Psychiatry 26, S2 (March 2011): 733. http://dx.doi.org/10.1016/s0924-9338(11)72438-5.
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IntroductionBariatric surgery provokes post-operative experiences which the patients are unprepared to deal with. This study aims at understanding the alteration of the eating impulse and how patients try to reorganize themselves emotionally after bariatric surgery.MethodClinical-qualitative method.ResultsAfter surgery, hunger starts to be experienced in a different way, as an emptiness, a pain, a weakness, that are attempts to describe primitive emotional sensations. The compulsive eating impulse is still present after the surgery. Areas of symbolic deficiency in obese patients brings serious mental consequences and limits the capacity of the morbidly obese to deal with the impact of the drive demand, leaving only the direct path of the discharge through the ingestion of food. Satiety is altered by the surgery, whereas satiation is not.ConclusionsThe hunger of operated patients is diminished; however, the sensation of satiation is not achieved, leading to feelings of anguish, emptiness and weakness, which often end in the patients seeking alternative means to obtain satisfaction. That which the patients referred to as hunger before the surgery is a complex of physical and emotional sensations. These are transformed into vague sensations, through lack of psychic elements that could make an elaboration of the anguish possible, keep the patient imprisoned in a vicious circle of dissatisfaction and seeking of food. It is crucial to provide to patients psychosocial guidance, clinical and psychiatric care. In these patients we have to deal with mental representation's emptiness and therefore help them in the task of creating symbols.
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Miles, Thais, and Chris Wilkinson. "Immunisation status of two-year-old children in the Hunter area." New South Wales Public Health Bulletin 7, no. 10 (1996): 117. http://dx.doi.org/10.1071/nb96037.
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Miles, Thaïs A., and W. Hugh Merrell. "An outbreak of measles in the Hunter area of New South Wales." Australian Journal of Public Health 16, no. 3 (February 12, 2010): 302–4. http://dx.doi.org/10.1111/j.1753-6405.1992.tb00070.x.
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Abubakar, Mohammed I. "Nutritional and Health Benefits of Peanut (Arachis Hypogaea)-based Therapeutic Foods as Well as its Effects on Child Health Services Delivery in North-West Nigeria." TEXILA INTERNATIONAL JOURNAL OF PUBLIC HEALTH 10, no. 3 (September 30, 2022): 128–37. http://dx.doi.org/10.21522/tijph.2013.10.03.art012.
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Hunger and malnutrition are some of the pressing challenges facing the health systems in the developing world today, and more innovative interventions are needed as a solution to these challenges. The aim of this study is to identify the nutritional and health benefits of peanut-based therapeutic foods in children suffering from malnutrition and assess the effects of this specific therapeutic food on the outcomes of child health services delivery in North-West Nigeria. A cross-sectional survey was conducted to measure multiple factors and identify the nutritional and health benefits of peanut-based therapeutic foods and assess its acceptability among individuals and families of malnourished children in North-West Nigeria. The effects of PBTF on the delivery of child health services in Sabon Gari Local Government Area in Kaduna state, North-West Nigeria. A total of 396 (97.5%) of mothers and caregivers believe that PBTF is making their child better. Up to 305 (75.1%) reported that the general health of their child has improved and 77 (19%) said their child gained weight, 13 (3.2%) reported that their child’s appetite has increased while 8 (2%) had noticed an increase in the activity of the child. Most respondents (96.5%) believe eating peanuts alone or with food is beneficial to their health. In conclusion, Peanut-Based Therapeutic Foods have valuable nutritional and health benefits and PBTF drives the performance of child health services delivery in North-West Nigeria. Keywords: Child health Services Delivery, Malnutrition, Peanut-based therapeutic food, Ready-to-use therapeutic foods.
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Stewart Williams, Jenny A., Julia M. Lowe, and Paula M. Candlish. "Using pilot studies to inform health services." Australian Health Review 29, no. 4 (2005): 478. http://dx.doi.org/10.1071/ah050478.
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A pilot study was conducted at the John Hunter Hospital, Newcastle, Australia in 1998?99 to inform a randomised controlled trial (RCT) for a cardiac rehabilitation intervention for patients with congestive heart failure (CHF). Although the RCT did not proceed, the pilot study results raised a number of issues. In this paper, the pilot is used to demonstrate how estimates of population benefit need to take into account patient eligibility, consent and adherence, and also how non-clinical data can inform the planning and development of health service interventions.
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Falconer, J., W. Giles, and H. Villanueva. "Realtime ultrasound diagnosis over a wide-area network (WAN) using off-the-shelf components." Journal of Telemedicine and Telecare 3, no. 1_suppl (June 1997): 28–30. http://dx.doi.org/10.1258/1357633971930265.
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A trial system was developed for relaying realtime ultrasound images from an obstetric referral centre, the Maitland Hospital, to a tertiary-care centre, the John Hunter Hospital in Newcastle. The sites were approximately 30 km apart and connected by a microwave link at 2 Mbit/s. The pilot study demonstrated the feasibility of realtime ultrasound transmission using commonly available components.
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Krikov, S., R. C. Price, S. A. Matney, K. Allen-Brady, and J. C. Facelli. "Enabling GeneHunter as a Grid Service." Methods of Information in Medicine 50, no. 04 (2011): 364–71. http://dx.doi.org/10.3414/me10-01-0005.
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SummaryBackground: A cursory analysis of the biomedical grid literature shows that most projects emphasize data sharing and the development of new applications for the grid environment. Much less is known about the best practices for the migration of existing analytical tools into the grid environment.Objectives: To make GeneHunter available as a grid service and to evaluate the effort and best practices needed to enable a legacy application as a grid service when addressing semantic integration and using the caBIG tools.Methods: We used the tools available in the caBIG environment because these tools are quite general and they may be used to deploy services in similar biomedical grids that are OGSA-compliant.Results: We achieved semantic integration of GeneHunter within the caBIG by creating a new UML model, LinkageX, for the LINKAGE data format. The LinkageX UML model has been published in the caDSR and it is publically available for usage with Gene-Hunter or any other program using this data format.Conclusions: While achieving semantic interoperability is still a time-consuming task, the tools available in caBIG can greatly enhance productivity and decrease errors.
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Harroff-Tavel, Marion. "Violence and humanitarian action in urban areas: new challenges, new approaches." International Review of the Red Cross 92, no. 878 (June 2010): 329–50. http://dx.doi.org/10.1017/s1816383110000421.
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AbstractA number of states are faced with the challenge of ensuring the harmonious development of rapidly expanding cities and of offering a growing population public services worthy of the name in the fields of security, health, and education. That challenge is even more difficult and more pressing because violence may erupt (hunger riots, clashes between territorial gangs or ethnic communities, acts of xenophobic violence directed against migrants, and so on) – violence that does not generally escalate to the point of becoming an armed conflict but that is murderous nevertheless.On the basis of the experience of the International Committee of the Red Cross and of its partners, as well as reports by academic specialists, this article describes the vulnerability of the poorest and of migrants in urban areas. It presents the difficulties with which humanitarian organizations, which are often accustomed to working in rural areas, have to contend. Lastly, it describes innovative responses, from which much can be learned: income-generating micro-projects, aid in the form of cash or vouchers, urban agriculture, and the establishment of violence-prevention or health-promotion programmes to protect those affected by armed violence in disadvantaged areas.
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Aldrich, Rosemary, Billie Bonevski, and Amanda Wilson. "A case study on determining and responding to health managers' priorities for research to assist health service decision making." Australian Health Review 30, no. 4 (2006): 435. http://dx.doi.org/10.1071/ah060435.
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The Newcastle Institute of Public Health (NIPH) is a collaboration of health service and public health research groups in the Hunter Region of New South Wales, Australia which aims to promote the use of evidence in decision making. However, use of research evidence in decision making is a complex process, with many barriers and enablers described in the literature. Informed by strategies described in the literature around developing priority-driven research, NIPH researchers undertook to determine whether asking local health decision-makers about their needs for research information might lead to greater use of the resulting research evidence to inform health service management decisions. This paper describes a process used by NIPH to determine the research needs of 11 local senior health managers, our response to specific research questions, the communication of this research information, and the outcome.
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Eyeson-Annan, Margo, and Lara Harvey. "Release of the 2002 Area Health Service Reports." New South Wales Public Health Bulletin 14, no. 6 (2003): 119. http://dx.doi.org/10.1071/nb03035.
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Isleib, T. G., H. E. Pattee, and P. W. Rice. "A Laboratory Colorimeter Method to Measure Pod Brightness in Virginia-Type Peanuts." Peanut Science 24, no. 2 (July 1, 1997): 81–84. http://dx.doi.org/10.3146/i0095-3679-24-2-4.
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Abstract Pod brightness is an important characteristic that influences consumers to purchase in-shell peanuts. A method is needed to quantitate pod brightness. Studies were conducted to determine whether pod color measurements were related to visual aesthetics rated by a panel representing seven virginia peanut shelling companies and to determine the effect of the optical aperture of the colorimeter on the measurements obtained. Forty-eight virginia-type pod lots were separated into fancy and jumbo fractions using a standard Federal-State Inspection Service grading peanut sizer. Pod color was measured for three subsamples of each fraction using a Hunterlab D25-PC2 colorimeter equipped with the D25-2RAL Reduced Area Viewing for L optical sensor (51-mm diameter sample area). The 96 samples also were rated by 11 Virginia-Carolina area shellers for pod color and size. Sheller ratings for the two traits were highly correlated (r > 0.6, P ≤ 0.01). Hunter L and b scores were strongly correlated with sheller color ratings. The colorimeter is a useful tool for measuring pod brightness as an adjunct to breeding for improved pod brightness. Use of a 95 mm aperture resulted in greater average Hunter L, a, and b scores and significantly reduced the variance among subsamples. The larger aperture should be used when the quantity of pods available for measurement permits.
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Whyte, Ian M., Barbara Francis, and Andrew H. Dawson. "Safety and efficacy of intravenous N‐acetylcysteine for acetaminophen overdose: analysis of the Hunter Area Toxicology Service (HATS) database." Current Medical Research and Opinion 23, no. 10 (August 15, 2007): 2359–68. http://dx.doi.org/10.1185/030079907x219715.
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Miles, Thaïs A. "The integrity of the vaccine cold chain in the Hunter area of New South Wales." Australian Journal of Public Health 17, no. 2 (February 12, 2010): 169–71. http://dx.doi.org/10.1111/j.1753-6405.1993.tb00127.x.
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Muthayya, Sumithra, Andrew Brown, Simone Sherriff, Darryl Wright, Tangerene Ingram, and Jacqueline Davison. "Applying Community-Based system Dynamics to Address Food Insecurity in Non-Remote Indigenous Populations in Australia." Current Developments in Nutrition 4, Supplement_2 (May 29, 2020): 250. http://dx.doi.org/10.1093/cdn/nzaa043_101.
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Abstract Objectives There is a growing crisis of hunger and food inequality among Indigenous people in Australia who are increasingly urbanized. They experience substantially higher rates of food insecurity than the general population which impacts on diet-sensitive chronic disease risk and life expectancy. This project aimed to apply systems tools to identify systemic challenges to achieving food security and possible local actions to address the problem in two large Aboriginal communities. Methods A qualitative system dynamics method used group model building (GMB) in two regional and outer urban communities involving participants from Aboriginal Community Controlled Health Services, food relief charities, council, educational groups and some food industry partners in the two local areas. The GMB enabled the participants to consider all the connections between contributing factors, feedback and reinforcing loops to produce a map of food insecurity linked to the local food system. This project was done in collaboration with the Study of Environment of Aboriginal Resilience and Child Health (SEARCH), Australia's largest cohort study into the health of urban Aboriginal children. Results The GMB workshops resulted in causal loop diagrams that mapped the complexities of the food insecurity challenge. The maps highlighted the impact of low incomes and unemployment that influenced the communities’ ability to budget and afford healthy food, thereby leading to a reliance on convenience food outlets. This, in turn, influenced communities’ healthy food preferences, which negatively impacted on food security. Additionally, community education around healthy food choices, meal planning and financial literacy were factors that also directly impacted food security. A distinct loop reflected that a lack of coordination between agencies was leading to duplication and confusion about available food relief services and the ability to access these services. Conclusions These analyses elicited local understanding of the potential levers within the system to address food insecurity in Indigenous people. They are being used to develop community-level workplans to shift the high prevalence of food insecurity and its longer-term impact on preventable chronic disease. Funding Sources This work was funded by the Australian Prevention Partnership Centre and the Sax Institute, Sydney.
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Carnahan, Leslie R., Chibuzor Abalsalim, Jeanette Santana González, Mari Goudy, Hunter Holt, Jessica Madrigal, Thrishka McKinnor, et al. "Abstract B020: “Access to these screenings have been a gift”: A mixed methods assessment of a community navigation program for breast and cervical in the era of COVID-19." Cancer Epidemiology, Biomarkers & Prevention 32, no. 1_Supplement (January 1, 2023): B020. http://dx.doi.org/10.1158/1538-7755.disp22-b020.
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Abstract Background: The COVID-19 pandemic exacerbated health inequities among systematically marginalized populations. At the onset of the pandemic, routine cancer screenings were effectively halted; from March to May 2021, there was a deficit of 9.3 million screens. Early evidence suggests that non-White patients, compared to White, have experienced even greater declines in breast and cervical cancer screenings. Consequences of missed or late screenings include later stage diagnosis and poor outcomes. Community navigation programs have been used to promote engagement in cancer screenings in under-resourced communities, but these too were interrupted as restrictions were put in place to mitigate the spread of COVID-19.Objective: To use a mixed methods approach to describe the challenges, strengths, and lessons learned of implementing a community navigation program for breast and cervical cancer screening during the COVID-19 pandemic. Methods: In 2019, The University of Illinois Cancer Screening, Access, Awareness, and Navigation (UI CAAN) intervention was established to address breast and cervical cancer disparities on Chicago’s West side, an area with large Black and Latinx populations. The intervention included community navigators who worked in partnership with community-based safety net hospitals and organizations. Participants were recruited at community events and through clinical referrals and were eligible if they were overdue for a guideline concordant breast or cervical cancer screening. Quantitative navigation and screening data were collected by the navigators in a REDCap database. Qualitative data, four focus groups with participants and partners, were also collected to broaden our understanding of impact of COVID-19 on the community navigation intervention. For these analyses, we describe participants’ navigation and screening outcomes and use content analysis methods for the focus groups. We then triangulate the findings to understand the challenges, strengths, and lessons learned of the UI CAAN. Results: From 2019-2022, a total of 366 individuals were navigated for breast and cervical cancer screenings. Of these, 68% (n = 248) received a breast and/or cervical cancer screening. Among those who were screened, 75% were Latinx and 23% were Black, 92% were uninsured, and 86% did not have a primary care provider. Concerning services received, 30% had a mammogram and a pap smear, 37% a pap smear only, and 33% a mammogram only. At the height of the pandemic, navigators coordinated with community and clinical partners to deliver 500 meals, held 9 PPE distribution events, distributed 3000 masks, and conducted 2 webinars about COVID-19. Conclusion: Despite the challenges of the COVID-19 pandemic, the UI CAAN community navigation program was able to shift its efforts at the height of the pandemic to assist its community and clinical partners. The continued collaboration allowed for a successful resumption of navigation and screening efforts once healthcare systems were able to re-engage patients in cancer screenings. Citation Format: Leslie R. Carnahan, Chibuzor Abalsalim, Jeanette Santana González, Mari Goudy, Hunter Holt, Jessica Madrigal, Thrishka McKinnor, Tigist Mersha, Theresa Mobley, Maria Olivero, Mary Rinder, Barbara Williams, Vida Henderson. “Access to these screenings have been a gift”: A mixed methods assessment of a community navigation program for breast and cervical in the era of COVID-19 [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B020.
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Connor, Melissa. "Jackson Lake Archaelogical Project." UW National Parks Service Research Station Annual Reports 12 (January 1, 1988): 87–92. http://dx.doi.org/10.13001/uwnpsrc.1988.2707.
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The Jackson Lake Archaeological Project completed its 5th and final field season in late October, 1988. While the current drought caused many problems, the lowered water levels in Jackson Lake allowed more archaeological work to be accomplished than imagined at the inception of the project in 1984. Funded by the Bureau of Reclamation, the work was completed by crews from the Midwest Archaeological Center of the National Park Service. During the project, 109 archaeological sites were recorded. This is the highest density of sites in any area in the Grand Teton-Yellowstone area and is presently reshaping the thinking of archaeologists about the importance of this area in prehistoric times. The materials found range in time from Paleo-Indian materials (ca. 11,000 - 9,000 years before present) to a historic trapper/hunter cabin (ca. A.D. 1875-1910). Much of the prehistoric material is badly disturbed by wave action due to the reservoir. However, survey, testing, and excavation by the Park Service crews, study of the landforms by U.S. Geological Survey geologist Dr. Ken Pierce, and backhoe trenching by the University of Wyoming succeeded in defining a significant amount of information.
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Ling, Rod, Andrew Searles, Jacqueline Hewitt, Robyn Considine, Catherine Turner, Susan Thomas, Kelly Thomas, et al. "Cost analysis of an integrated aged care program for residential aged care facilities." Australian Health Review 43, no. 3 (2019): 261. http://dx.doi.org/10.1071/ah16297.
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Objective To compare annual costs of an intervention for acutely unwell older residents in residential age care facilities (RACFs) with usual care. The intervention, the Aged Care Emergency (ACE) program, includes telephone clinical support aimed to reduce avoidable emergency department (ED) presentations by RACF residents. Methods This costing of the ACE intervention examines the perspective of service providers: RACFs, Hunter Medicare Local, the Ambulance Service of New South Wales, and EDs in the Hunter New England Local Health District. ACE was implemented in 69 RACFs in the Hunter region of NSW, Australia. Analysis used 14 weeks of ACE and ED service data (June–September 2014). The main outcome measure was the net cost and saving from ACE compared with usual care. It is based on the opportunity cost of implementing ACE and the opportunity savings of ED presentations avoided. Results Our analysis estimated that 981 avoided ED presentations could be attributed to ACE annually. Compared with usual care, ACE saved an estimated A$921214. Conclusions The ACE service supported a reduction in avoidable ED presentations and ambulance transfers among RACF residents. It generated a cost saving to health service providers, allowing reallocation of healthcare resources. What is known about the topic? Residents from RACFs are at risk of further deterioration when admitted to hospital, with high rates of delirium, falls, and medication errors. For this cohort, some conditions can be managed in the RACF without hospital transfer. By addressing avoidable presentations to EDs there is an opportunity to improve ED efficiency as well as providing care that is consistent with the resident’s goals of care. RACFs generate some avoidable ED presentations for residents who may be more appropriately treated in situ. What does this paper add? Telephone triaging with nursing support and training is a means by which ED presentations from RACFs can be reduced. One of the consequences of this intervention is ‘cost avoided’, largely through savings on ambulance costs. What are the implications for practitioners? Unnecessary transfer from RACFs to ED can be avoided through a multicomponent program that includes telephone support with cost-saving implications for EDs and ambulance services.
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Kaszyński, Hubert, and Piotr Harhaj. "Service usersinvolvement (SUI) in the area of mental health." Praca Socjalna 37, no. 4 (December 31, 2022): 93–105. http://dx.doi.org/10.5604/01.3001.0016.1860.
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The authors present the key aspects of establishing cooperation with people experiencing a mental health crisis, referred to in the literature as service users involvement (SUI); not only drawing attention to the theoretical context of the SUI approach, but also illustrating it with a practice developed in Gdynia social welfare, which is unique on a national scale. The aim of the study, which combines theoretical reflection and a description of a case study of the activity of the local community, is to draw attention to the participatory approach important for the identity of social workers, referred to as service users involvement (SUI). The source of the generalizations presented in the article is the authors' systematic reflection on mental health care-oriented practice.
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Quaine, Julianne, Peter Sainsbury, and Margaret Williamson. "Getting population health research to influence health service practice: Use of area health service questions in the NSW Health Survey." New South Wales Public Health Bulletin 12, no. 8 (2001): 229. http://dx.doi.org/10.1071/nb01076.
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Jim, Melissa A., Elizabeth Arias, Dean S. Seneca, Megan J. Hoopes, Cheyenne C. Jim, Norman J. Johnson, and Charles L. Wiggins. "Racial Misclassification of American Indians and Alaska Natives by Indian Health Service Contract Health Service Delivery Area." American Journal of Public Health 104, S3 (June 2014): S295—S302. http://dx.doi.org/10.2105/ajph.2014.301933.
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Scott, Jan, Mel Normanton, and Julie McKenna. "Developing a community orientated mental health service." Psychiatric Bulletin 16, no. 3 (March 1992): 150–52. http://dx.doi.org/10.1192/pb.16.3.150.
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This paper describes the development of a community orientated mental health service including the introduction of a community-based admission unit. The catchment area is a compact conurbation with a population of 56,000 in a deprived part of North Tyneside. Most people come from social classes IV and V and less than 1 % are from ethnic minorities. The male unemployment rate varies from 16–24% and the area is ranked 58th (out of 192) on the Jarman deprivation indices. The primary health care services suffer from many of the problems of inner-city general practices, with the Family Practitioners Committee being the highest prescriber in the country.
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Snowdon, John. "Bed Requirements for an Area Psychogeriatrlc Service." Australian & New Zealand Journal of Psychiatry 25, no. 1 (March 1991): 56–62. http://dx.doi.org/10.3109/00048679109077719.
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Psychiatric services for the elderly are being developed in various areas in Australia, but guidelines on the number of beds needed are largely based on overseas experience. A review of all admissions of elderly people to the three psychiatric units in one part of Sydney over a ten-year period (1977–1987) allows an estimate of acute and medium-stay bed requirements. There were 444 male and 952 female admissions of persons aged 65 or more during the ten years. Mean length of stay was estimated to be 33.5 days, those with depressive disorders staying longest (41.7 days). Caution is needed when drawing conclusions about bed requirements, since they vary according to management practices, alternative support services, demographics, etc. Tentatively it is suggested that for a population of 32,000 persons aged 65 or more a minimum of 22 acute psychiatric beds are required.
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Reeve, Carole, John Humphreys, John Wakerman, Vicki Carroll, Maureen Carter, Tim O'Brien, Carol Erlank, Rafik Mansour, and Bec Smith. "Community participation in health service reform: the development of an innovative remote Aboriginal primary health-care service." Australian Journal of Primary Health 21, no. 4 (2015): 409. http://dx.doi.org/10.1071/py14073.
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The aim of this study was to describe the reorientation of a remote primary health-care service, in the Kimberley region of Australia, its impact on access to services and the factors instrumental in bringing about change. A unique community-initiated health service partnership was developed between a community-controlled Aboriginal health organisation, a government hospital and a population health unit, in order to overcome the challenges of delivering primary health care to a dispersed, highly disadvantaged Aboriginal population in a very remote area. The shared goals and clear delineation of responsibilities achieved through the partnership reoriented an essentially acute hospital-based service to a prevention-focussed comprehensive primary health-care service, with a focus on systematic screening for chronic disease, interdisciplinary follow up, health promotion, community advocacy and primary prevention. This formal partnership enabled the primary health-care service to meet the major challenges of providing a sustainable, prevention-focussed service in a very remote and socially disadvantaged area.
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Bisson, Jonathan I., Neil Roberts, and Gavin S. Macho. "Service innovations." Psychiatric Bulletin 27, no. 4 (April 2003): 145–47. http://dx.doi.org/10.1192/pb.27.4.145.
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There remains uncertainty on how best to respond to the psychological needs of individuals following traumatic events. Various approaches have been tried, but there is now a growing body of research in this area that allows us to plan appropriate responses in an evidence-based and coordinated manner. This paper describes the development of a local initiative through a partnership between the local traumatic stress service and the emergency planning department.
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Foster, Nicola, and Andrew Lee. "Service innovations." Psychiatric Bulletin 28, no. 6 (June 2004): 216–17. http://dx.doi.org/10.1192/pb.28.6.216.
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This article describes the establishment of a monthly meeting of a group of psychiatrists and other agencies involved in the delivery of emergency out-of-hours care in general adult and old age psychiatry. The meetings are a source of advice, information, opinion and support regarding on-call issues. The scheme has been running for over 2 years in the Portsmouth area, and has proved to be a valuable educational forum.