Academic literature on the topic 'Immigrants Services for Australia'
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Journal articles on the topic "Immigrants Services for Australia"
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Tran, Uyen N. T. L. "Vietnamese Immigrants in Brisbane, Australia: Perception of Parenting Roles, Child Development, Child Health, Illness, and Disability, and Health Service Utilisation." International Journal of Population Research 2012 (January 23, 2012): 1–12. http://dx.doi.org/10.1155/2012/932364.
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The limited research into Vietnamese immigrants suggests that this group may have different perceptions relating to parenting roles, child development, child health, illness, and disability, and differing patterns of health service utilisation. The author conducted a pilot study exploring how Vietnamese immigrants differ from Anglo-Australian in relation to these issues. The pilot, utilising a mixed quantitative and qualitative method, was conducted in Brisbane, Australia, with subjects being existing clients of a health centre. Two focus group discussions were conducted and a structured questionnaire developed from the discussions. Vietnamese immigrants in contrast to Australian-born Caucasians regard the general practitioner as the main health care provider and were less satisfied with English-speaking health services. This study highlights potentially important health-related issues for children of Vietnamese immigrants living in Brisbane, the importance of further research in this area, and the methodological challenges faced when conducting research into Vietnamese immigrants.
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Alzahrani, Mohammad Rajab Hasan. "Immigrants Services in Auburn :Local Government Area in Australia." مجلة بحوث کلیة الآداب . جامعة المنوفیة 29, no. 113 (April 1, 2018): 3537–81. http://dx.doi.org/10.21608/sjam.2018.144473.
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Hingorani, Anurag G., Lynne Freeman, and Michelle Agudera. "Impact of Immigration on Native and Ethnic Consumer Identity via Body Image." International Journal of Marketing Studies 9, no. 1 (January 16, 2017): 27. http://dx.doi.org/10.5539/ijms.v9n1p27.
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This research focuses on consumer identity of two under-researched but growing immigrant communities in Australia via the lens of the body image construct. Consistent with an emerging stream of research, body image is viewed as a part of identity. Given the variety of goods and services that have an impact on consumers’ perceptions of their body, and because consumers use products to create and convey desired identities, body image is also viewed as a part of consumer identity. Considering literature on identity, body image, and acculturation, exploratory research was undertaken to determine the impact of immigration on the identities of both immigrants and natives. Specifically, focus groups were conducted on two generations of Filipino- and Indian-Australian women as well as Anglo-Australian women. It was found that second generation immigrants have dual consumer identities where they balance the values, attitudes and lifestyles of both their home (i.e., native or heritage) and host cultures whereas first generation immigrants tend to retain their native consumer identity even if they appear to adopt values, attitudes, and lifestyles of the host culture. The impact of immigrants on consumer identities of native residents who are typically in the majority (i.e., the Anglo group) was not evident. Theoretical and practical implications including recommendations for marketing practitioners are then discussed followed by suggestions for future research.
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Kelaher, Margaret, and Lenore Manderson. "Migration and mainstreaming: matching health services to immigrants’ needs in Australia." Health Policy 54, no. 1 (November 2000): 1–11. http://dx.doi.org/10.1016/s0168-8510(00)00098-1.
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Young, C. "Health and welfare of immigrants and access to services in Australia." Scandinavian Journal of Social Welfare 3, no. 3 (July 1994): 121–32. http://dx.doi.org/10.1111/j.1468-2397.1994.tb00070.x.
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Mariño, Rodrigo, Victor Minichiello, Margot Schofield, and Clive Wright. "Oral Health through the Life Experiences of Older Greek and Italian Adults." Australian Journal of Primary Health 8, no. 3 (2002): 20. http://dx.doi.org/10.1071/py02040.
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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.
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Ashing, Kimlin Tam, Lenna Dawkins-Moultin, Marshalee George, Gerard M. Antoine, Marcella Nunez-Smith, and Eliseo J. Pérez-Stable. "Across borders: thoughts and considerations about cultural preservation among immigrant clinicians." International Journal for Quality in Health Care 31, no. 8 (January 11, 2019): G103—G105. http://dx.doi.org/10.1093/intqhc/mzy256.
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Abstract Immigrant clinicians make up 20–28% of the health workforce in many high-income countries, including Australia, Britain, Canada and the USA. Yet, the preserved culture of immigrant clinicians remains largely invisible in the medical literature and discourse. Research on immigrant clinicians primarily attends to medical professional requirements for the adopted country (medical board examination eligibility, fellowship training and licensing). Cultural preservation among immigrant clinicians has not been adequately considered or studied. This paper highlights this notable gap in healthcare delivery and health services research relevant to immigrant clinicians. We propose it is worthwhile to explore possible relationships between immigrant clinicians’ preserved culture and clinical practices and outcomes since immigrant clinicians cross borders with their academic training as well as their culture. The sparse literature regarding immigrant clinicians suggests culture influences health beliefs, attitudes about the meaning of illness and clinical practice decisions. Additionally, immigrant clinicians are more likely to serve rural, low-income populations; communities with high density of ethnic minorities and immigrants; and areas with primary care shortage. Therefore, cultural preservation among immigrant clinicians may have important implications for public health and health disparities. This area of inquiry is important, if not urgent, in health services research.
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Liamputtong Rice, Pranee. "Childhood Health and Illness: Cultural Beliefs and Practices among the Hmong in Victoria." Australian Journal of Primary Health 4, no. 4 (1998): 44. http://dx.doi.org/10.1071/py98060.
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This paper examines the cultural construction of childhood illness among Hmong refugees from Laos who are living in Australia. It focuses on traditional patterns of beliefs and practices related to health and illness of newborn infants and young children. The Hmong treat childhood health and illness seriously, and for them there are several causes of childhood illness, including nature, souls, supernatural beings and human aggression. The roles of traditional healers who play an important part in childhood health and illness are also discussed. Lastly, the paper attempts to make clear some implications for child health services for immigrants such as the Hmong in Australia and elsewhere. The paper intends to contribute an anthropological perspective on child health which is particularly important in a multicultural society. A clear understanding by health professionals of cultural beliefs and expectations is essential if misunderstanding is to be avoided, and culturally appropriate and sensitive health care for immigrant children, such as the Hmong to be available.
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Sayyad Abdi, Elham, Helen Partridge, Christine Bruce, and Jason Watson. "Skilled immigrants: a resettlement information literacy framework." Journal of Documentation 75, no. 4 (July 8, 2019): 892–908. http://dx.doi.org/10.1108/jd-02-2019-0034.
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Purpose The purpose of this paper is to provide an understanding of skilled immigrants’ lived experience of using information to learn about their new setting. Design/methodology/approach Thematic analysis was conducted on a qualitative data set collected through 16 semi-structured interviews with newly arrived skilled immigrants in Australia. Findings The study uncovered six different themes of experiencing using information to learn among skilled immigrants. The themes, presented as a framework, explain skilled immigrants learn about their new life through: attending to shared stories by others; getting engaged; researching; comparing and contrasting past and present; being reflective; and being directly educated. Research limitations/implications The study presents the theory-to-practice translation approach of “information experience design” that enables the enactment of theoretical understanding of information research. Originality/value The study invites, encourages and enables information professionals to take part in interdisciplinary conversations about integration of skilled immigrants in their host countries. Using the presented framework in the study, information professionals will be able to explain skilled immigrants’ learning about their new setting from an information lens. This provides information professionals an opportunity to work with immigration service stakeholders to help them incorporate the presented framework in their real-world practice and service. Such practice and services are of potential to support newly arrived skilled immigrants to become more information literate citizens of the host society who can participate more fully in their host society.
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Johnstone, Megan-Jane, Helen Rawson, Alison Margaret Hutchinson, and Bernice Redley. "Fostering trusting relationships with older immigrants hospitalised for end-of-life care." Nursing Ethics 25, no. 6 (September 21, 2016): 760–72. http://dx.doi.org/10.1177/0969733016664978.
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Background: Trust has been identified as a vital value in the nurse–patient relationship. Although increasingly the subject of empirical inquiries, the specific processes used by nurses to foster trust in nurse–patient relationships with older immigrants of non-English speaking backgrounds hospitalised for end-of-life care have not been investigated. Aims: To explore and describe the specific processes that nurses use to foster trust and overcome possible cultural mistrust when caring for older immigrants of non-English speaking backgrounds hospitalised for end-of-life care. Research design: A qualitative descriptive approach was used. Twenty-two registered nurses were recruited from four metropolitan health services in Melbourne, Australia. Ethical considerations: Research approval was granted by the Human Research Ethics Committees of the host institution and four participating health services. Findings: Thematic analysis revealed that fostering trust encompassed the following three commensurate stages: establishing trust, strengthening trust and sustaining trust. Underpinning the successful achievement of these stages was the nurses’ moral commitment (reflected in their intentional, conscious and conscientious approach) to fostering trust as an essential ingredient of quality end-of-life care. Discussion: This study has shown that while professional competencies are important to providing quality end-of-life care to older immigrant patients of non-English speaking backgrounds, it is a nurse’s moral commitment to fostering trust that may ultimately lay the foundations for a trusting quality care relationship to be established and sustained. Conclusion: This study has captured the processes used by nurses to foster trust as an essential element of quality end-of-life care in older immigrants. The characteristics of trust and the different factors influencing its expression in diverse cultural contexts are, however, under-researched. Accordingly, gaps remain in the knowledge and understanding of the specific cultural nuances and manifestations of trust across and within different cultures. This is an area that is germane to further cross-cultural and international collaborative scholarly inquiry and research.
Dissertations / Theses on the topic "Immigrants Services for Australia"
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Loewald, Uyen, of Western Sydney Hawkesbury University, and School of Social Ecology and Lifelong Learning. "Multicultural community development." THESIS_XXX_SELL_Loewald_U.xml, 1994. http://handle.uws.edu.au:8081/1959.7/341.
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This thesis is concerned with migrants’ experience of their acceptance and well-being in Australian society, particularly the unconscious processes reflected in dreams and communication patterns; the provision of services intended to be of help in settlement; and the relationship between the unconscious processes and the provision of services. Collaborating with clients, colleagues who share similar interests and concerns, people with special skills and cultural knowledge, and some Management Committee members of the Migrant Resource Centre of Canberra and Queanbeyan, Inc. the author has investigated the multicultural unconscious, government policies and guidelines related to services to recent arrivals and people of non-English-speaking backgrounds, measures to address gaps in services for appropriate improvement. The research approach is naturalistic with a strong emphasis on the author’s personal reflections and case studies of people and projects.Master of Science (Hons) Social Ecology
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Keel, Monique. "Refugee settlement: Acculturation, ethnic identity, ethnicity and social network development." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1999. https://ro.ecu.edu.au/theses/1269.
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Refugees arriving in Australia undergo a number of settlement processes including adaptation and acculturation, social support and network development, and an exploration of their ethnic identity. This research examines the settlement processes of mixed marriage refugees from what was Yugoslavia who arrived in Perth, Western Australia in the early to mid 1990's. A mixed marriage is one where the couple are from different ethnic backgrounds. This research has two main aims. The first aim is to examine the processes of acculturation and adaptation, the development of social support networks, and ethnic identity, within the refugees. These processes provide a framework from which to understand the settlement process. The second aim is to investigate the initial settlement programs and supports provided by Australia's government and community groups, and to provide recommendations for future service provision. Throughout the research, the experiences of the refugees are located within the sociopolitical context of the conflict in what was Yugoslavia and their migration. The impact of the refugees' ethnicity and ethnic identity is also considered. The research was comprised of a study in two stages. The first stage involved scoping interviews with critical participants and refugees to identify key conceptual domains for the purpose of guiding subsequent interviews. The second stage consisted of multiple-case, conversational interviews with 12 mixed marriage refugees from what was Yugoslavia. Data was analysed thematically and the results indicated that the participants were moving towards an acculturation outcome of bi-culturalism. The majority have taken out Australian citizenship, were proud of and grateful for it and saw it as a security for the future. The results also indicated that ethnicity impacts on the development of social networks. The participants generally socialised with other mixed marriage refugees as they felt comfortable and emotionally supported by them. Mainstream Australians provided more instrumental support. The participants referred to a feeling of belonging to Australia increasing with participation in the community and have made substantial efforts to understand the Australian way of life. Feeling part of the Australian community was a process that was taking time. The participants described their ethnic identity as either Yugoslav or Bosnian, regardless of their ethnicity. Whilst maintaining this identity, being Australian was also important and did not conflict with feeling Yugoslav or Bosnian. The links between the various settlement processes are discussed as well as the validity of the research process and recommendations for future research and for settlement programs. The results illustrated the diversity of experiences of the participants as well as a commonality resulting from their being in a mixed marriage. With respect to the second aim, the initial settlement experience is characterised by stress, due in part to the nature of the refugee experience and exacerbated by a lack of English, receiving confusing and untimely information, difficulties in finding work and difficulties in meeting mainstream Australians. The refugees who went through the On-Arrival Accommodation program felt less supported than those who went through the Community Resettlement Support Scheme, which offered a chance to meet Australians and provided better material assistance.
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Flanagan, Annette F. "Gender, Jobs and Geographic Origin of Australian Immigrants." Thesis, University of North Texas, 1999. https://digital.library.unt.edu/ark:/67531/metadc935699/.
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This thesis examines access to managerial jobs in the Australian labor market by immigrant women and men from five continents and five individual countries. Comparisons were not made only among both continent and country groups, but also between the women and men within each group, as a measure of occupational gender inequality. An index of managerial representation in the Australian labor market (MORI) was computed and nine independent variables were applied to measure immigrant representation in managerial occupations. Rank order correlates were used to calculate relationships between variables. Results indicate that women (with the exception of Vietnamese) from all countries were disproportionately underrepresented in managerial jobs and that the more dissimilar immigrant men are to native born Australians, the less likely they are to hold managerial jobs.
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Panameno, Javier Martín, and Carlos Morales. "Perceptions of social services among immigrants." CSUSB ScholarWorks, 2007. https://scholarworks.lib.csusb.edu/etd-project/3085.
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This project focused on immigrants' perceptions of social services and social workers. The study employed the post positivist paradigm. The project was conducted with legal and illegal immigrants who received services at Bilingual Family Counseling Service in the city of Ontario, CA. The study found that the immigrants' perceptions about social service agencies and social workers were multi-determined by at least three elements: knowledge, experiences, and attitudes. The dynamic interaction between experiences and attitudes shaped the immigrants' perceptions. Most of the respondents had a positive attitude toward social workers and social services agencies.
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Ho, Christina. "Migration as feminisation Chinese women's experiences of work and family in contemporary Australia /." Connect to full text, 2004. http://hdl.handle.net/2123/615.
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Thesis (Ph. D.)--University of Sydney, 2004.Title from title screen (viewed 8 May 2008). Submitted in fulfilment of the requirements for the degree of Doctor of Philosophy to the School of Economics and Political Science, Faculty of Economics and Business. Includes bibliographical references. Also available in print form.
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Nguyen, Chinh. "Supportive services for immigrants| A grant proposal." Thesis, California State University, Long Beach, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=1527019.
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The number of immigrants in the United States will increase by a projected 18.4 million per year. In Orange County, immigrants are the fastest growing segment with an estimated population of983,000. If immigration levels continue to increase and immigrant parents and children continue to live in poverty, then they are expected to demonstrate higher crime rates, parent-child relationship problems, child disciplinary or behavioral problems, lower academic performance, severe mental health issues, and more discrimination and prejudice.
The proposed program will provide education (for parents), counseling (for all participants), and mentorship (for adolescents, children, and transitional-aged youth). These culturally sensitive services will aim to: (a) alleviate the conflict within immigrant families, (b) mitigate the challenges and issues of acculturation and assimilation, and (c) empower positive life choices that enable them to maximize their potential. The actual submission of the proposal was not a requirement of the thesis.
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Ziaian, Tahereh. "The psychological effects of migration on Persian women immigrants in Australia /." Title page, contents and abstract only, 2000. http://web4.library.adelaide.edu.au/theses/09PH/09phz64.pdf.
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Ortiz, Valdez Miguel Alberto. "Integrating faith into social services for homeless immigrants." Online full text .pdf document, available to Fuller patrons only, 2003. http://www.tren.com.
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Liyanaratchi, Karunatissa Hal, and not supplied. "Employment problems of recent Sri Lankan skilled immigrants in Australia." RMIT University. Education, 2006. http://adt.lib.rmit.edu.au/adt/public/adt-VIT20070214.163019.
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The aim of this thesis is to examine the employment situation of recent Sri Lankan skilled immigrants in Victoria and whether they need further education and re-training in order to face emerging technological changes or to update their skills. The underemployment and unemployment problem faced by the Sri Lankan skilled immigrants is an issue for both the Australian economy and the migrants. The following set of premises has been used for the study; a) the migrants' educational qualifications, training and skills are recognised by the Department of Immigration Multicultural & Indigenous Affairs (DIMIA) of Australia, b) they are having difficulties in finding and keeping suitable jobs, although some have found employment commensurate with their qualifications, and c) the reason for their difficulties are many and complex. The essential format of the research is to identify and explain the many and complex reasons for such unemployment or underemployment. This study is based upon a survey of three contrasting Sri Lankan immigrant groups: a) trade persons and related workers with certificates or no qualifications b) technical or associate professionals with diploma or associate diploma level qualifications and c) professionals (engineers) with university degrees or their equivalent. Subjects for the surveys were through three relevant alumni organisations based in Melbourne, and through personal contact. The survey was supplemented with some applying qualitative methods that involved unstructured interviews, and small case studies. Recommendations have been proposed to assist in solving the issues that were identified through the study. Although the recommendations mentioned in the study provide a starting point, it is stressed that further research is needed to be undertaken before implementing such suggested solutions. Therefore, this thesis serves as a foundation in highlighting the loss of services of skilled immigrants within the labour market in Australia, particularly among the Sri Lankan community, and proposing recommendations to address this issue.
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Quinn, Cheryl Jane. "Attributions towards 'illegal immigrants', 'refugees' and 'asylum seekers' in Australia /." Title page, contents and abstract only, 2001. http://web4.library.adelaide.edu.au/theses/09SSPS/09sspsq73.pdf.
Full textBooks on the topic "Immigrants Services for Australia"
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1942-, Reid Janice, and Trompf Peggy 1944-, eds. The Health of immigrant Australia: A social perspective. Sydney: Orlando, 1990.
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The immigrant's guide to living in Australia. Doncaster, Victoria: Hymie Zawatzky, 2013.
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Archives, Australian, ed. Alien to citizen: Settling migrants in Australia, 1945-75. St. Leonards, NSW, Australia: Allen & Unwin, 1997.
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Gill, Alan. Orphans of the empire: The shocking story of child migration to Australia. Alexandria, NSW, Australia: Millennium, 1997.
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Gill, Alan. Orphans of the empire: The shocking story of child migration to Australia. Milsons Point, N.S.W: Random House Australia, 1998.
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Crock, Mary. Creating new futures: Settling children and youth from refugee backgrounds. Annandale, NSW: Federation Press, 2015.
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Philanthropy and settler colonialism. Houndmills, Basingstoke, Hampshire: Palgrave Macmillan, 2015.
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Cigler, Beryl. Australia, a land of immigrants. Milton, Qld: Jacaranda Press, 1985.
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Australia, a nation of immigrants. Frenchs Forest, N.S.W: Child & Associates, 1988.
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Colin, Doxford, ed. Australia, willkommen: A history of the Germans in Australia. Kensington, NSW, Australia: New South Wales University Press, 1989.
Find full textBook chapters on the topic "Immigrants Services for Australia"
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Gao, Jian, Ruitao Jia, and Qing Su. "Australia." In G20 Entrepreneurship Services Report, 45–57. Singapore: Springer Singapore, 2022. http://dx.doi.org/10.1007/978-981-16-6787-9_3.
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Richards, Eric. "Voices of British and Irish migrants in nineteenth-century Australia." In Migrants, Emigrants, Immigrants, 19–41. London: Routledge, 2022. http://dx.doi.org/10.4324/9781003172918-3.
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Eser, Oktay. "Beyond Australia: Turkey." In Understanding Community Interpreting Services, 117–34. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-55861-1_6.
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Kain, Jennifer S. "Introduction: ‘Lunatic Immigrants’." In Insanity and Immigration Control in New Zealand and Australia, 1860–1930, 1–11. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-030-26330-0_1.
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Krever, Richard, and Jonathan Teoh. "Loan Intermediary Services: Australia." In VAT and Financial Services, 51–66. Singapore: Springer Singapore, 2017. http://dx.doi.org/10.1007/978-981-10-3465-7_4.
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Collins, Jock, Branka Krivokapic-Skoko, Kirrily Jordan, Hurriyet Babacan, and Narayan Gopalkrishnan. "Minority Immigrants and the Australian Built Environment." In Cosmopolitan Place Making in Australia, 385–405. Singapore: Springer Singapore, 2020. http://dx.doi.org/10.1007/978-981-15-8041-3_5.
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Krever, Richard, and Jonathan Teoh. "GST and Insurance: Australia." In VAT and Financial Services, 319–35. Singapore: Springer Singapore, 2017. http://dx.doi.org/10.1007/978-981-10-3465-7_17.
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Strodthoff, Irene. "Immigrants and the Indigenous Peoples: Challenging Official Constructs of Social Cohesion." In Chile and Australia, 23–46. New York: Palgrave Macmillan US, 2014. http://dx.doi.org/10.1057/9781137479655_2.
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Minas, Harry. "Mental Health of Chinese Immigrants in Australia." In International and Cultural Psychology, 225–43. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-65161-9_16.
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Braithwaite, John. "Good and Bad Police Services and How to Pick Them." In Policing Australia, 11–39. London: Macmillan Education UK, 1992. http://dx.doi.org/10.1007/978-1-349-15143-1_2.
Full textConference papers on the topic "Immigrants Services for Australia"
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Penman, Joy, and Kerre A Willsher. "New Horizons for Immigrant Nurses Through a Mental Health Self-Management Program: A Pre- and Post-Test Mixed-Method Approach." In InSITE 2021: Informing Science + IT Education Conferences. Informing Science Institute, 2021. http://dx.doi.org/10.28945/4759.
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Aim/Purpose: This research paper reports on the evaluation of a mental health self-management program provided to immigrant nurses working at various rural South Australian aged care services. Background: The residential aged care staffing crisis is severe in rural areas. To improve immigrant nurses’ employment experiences, a mental health self-management program was developed and conducted in rural and regional health care services in South Australia. Methodology: A mixed approach of pre- and post-surveys and post workshop focus groups was utilized with the objectives of exploring the experiences of 25 immigrant nurses and the impact of the mental health program. Feminist standpoint theory was used to interpret the qualitative data. Contribution: A new learning environment was created for immigrant nurses to learn about the theory and practice of maintaining and promoting mental health. Findings: Statistical tests showed a marked difference in responses before and after the intervention, especially regarding knowledge of mental health. The results of this study indicated that a change in thinking was triggered, followed by a change in behaviour enabling participants to undertake self-management strategies. Recommendations for Practitioners: Include expanding the workshops to cover more health care practitioners. Recommendations for Researchers: Feminist researchers must actively listen and examine their own beliefs and those of others to create knowledge. Extending the program to metropolitan areas and examining differences in data. E technology such as zoom, skype or virtual classrooms could be used. Impact on Society: The new awareness and knowledge would be beneficial in the family and community because issues at work can impact on the ability to care for the family, and there are often problems around family separation. Future Research: Extending the research to include men and staff of metropolitan aged care facilities.
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"Study of Asian Immigrants' Information Behaviour in South Australia: Preliminary Results." In iConference 2014 Proceedings: Breaking Down Walls. Culture - Context - Computing. iSchools, 2014. http://dx.doi.org/10.9776/14316.
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Faria, Gerard. "DVB-T Hierarchical Modulation: An Opportunity for New Services?" In SMPTE Australia Conference. IEEE, 1999. http://dx.doi.org/10.5594/m001167.
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Point, Jean-Charles. "Interactive Services Protocol Standardisation for HFC and LMDS Networks: A Review." In SMPTE Australia Conference. IEEE, 1999. http://dx.doi.org/10.5594/m001181.
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Doube, Bernard. "Ecosystem services of dung beetles in Australia." In 2016 International Congress of Entomology. Entomological Society of America, 2016. http://dx.doi.org/10.1603/ice.2016.95293.
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Lim, Yu Jin, and M. Judith Lynam. "An Investigation of Older Korean Immigrants' Perspectives on Accessing Primary Health Care Services." In Annual Worldwide Nursing Conference. Global Science & Technology Forum (GSTF), 2015. http://dx.doi.org/10.5176/2315-4330_wnc15.128.
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De Poorter, Rob. "Integrating DVB/MPEG2 Technology with IP Based Protocols and Applications into Satellite Architectures – How can this Open a New Market for Satellite Multimedia Services?" In SMPTE Australia Conference. IEEE, 1999. http://dx.doi.org/10.5594/m001182.
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Kurnia, Sherah, Heejin Lee, and Song Yang. "Understanding Consumers' Expectations of Mobile Data Services in Australia." In International Conference on the Management of Mobile Business (ICMB 2007). IEEE, 2007. http://dx.doi.org/10.1109/icmb.2007.69.
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Shaon, Arif, Eamon Smallwood, Maude Frances, Shane Cox, and Luc Betbeder-Matibet. "Sustainable Services for Managing and Disseminating UNSW Australia Research Data." In 2014 IEEE 10th International Conference on e-Science (e-Science). IEEE, 2014. http://dx.doi.org/10.1109/escience.2014.24.
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Abbas, Roba. "An approach to studying location-based services regulation in Australia." In 2010 IEEE International Symposium on Technology and Society (ISTAS). IEEE, 2010. http://dx.doi.org/10.1109/istas.2010.5514649.
Full textReports on the topic "Immigrants Services for Australia"
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Shey Wiysonge, Charles. Which outreach strategies increase health insurance coverage for vulnerable populations? SUPPORT, 2016. http://dx.doi.org/10.30846/1608142.
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Health insurance refers to a health financing mechanism that involves the pooling of eligible, individual contributions in order to cover all or part of the cost of certain health services for all those who are insured. Health insurance scheme coverage in low-income countries is low, especially among vulnerable populations such as children, the elderly, women, low-income individuals, rural population, racial or ethnic minorities, immigrants, informal sector workers, and people with disability or chronic diseases. Consequently, thousands of vulnerable people suffer and die from preventable and treatable diseases in these settings.
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Hearn, Greg, Marion McCutcheon, Mark Ryan, and Stuart Cunningham. Australian Cultural and Creative Activity: A Population and Hotspot Analysis: Geraldton. Queensland University of Technology, August 2020. http://dx.doi.org/10.5204/rep.eprints.203692.
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Grassroots arts connected to economy through start-up culture Geraldton is a regional centre in Western Australia, with 39,000 people and a stable, diverse economy that includes a working port, mining services, agriculture, and the rock-lobster fishing industry (see Appendix). Tourism, though small, is growing rapidly. The arts and culture ecosystem of Geraldton is notable for three characteristics: - a strong publicly-funded arts and cultural strategy, with clear rationales that integrate social, cultural, and economic objectives - a longstanding, extensive ecosystem of pro-am and volunteer arts and cultural workers - strong local understanding of arts entrepreneurship, innovative business models for artists, and integrated connection with other small businesses and incubators
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Quak, Evert-jan. The Trend Of “De-Risking” In International Finance and Its Impact on Small Island Developing States. Institute of Development Studies, May 2022. http://dx.doi.org/10.19088/k4d.2022.079.
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This rapid review synthesises the literature from academic sources, knowledge institutions, non-governmental organisations (NGOs), and trusted independent media outlets on the challenges small island development states (SIDS) face when they lose correspondent banking relationships (CBRs). The rapid review concludes that, although the loss of CBRs is a global phenomenon, regions with SIDS, such as the Pacific and Caribbean, have seen the highest rates of withdrawals. During the last decade, local and regional banks in SIDS have lost and continue to lose bank accounts at large global banks to a critical level, sometimes having only one or none CBRs with banks in major economies, such as the Unites States, the United Kingdom, the European Union or Australia. This means that local banks have reduced access to financial services related to cross-border financial transactions, impacting on remittances and trade finance.
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McKenna, Patrick, and Mark Evans. Emergency Relief and complex service delivery: Towards better outcomes. Queensland University of Technology, June 2021. http://dx.doi.org/10.5204/rep.eprints.211133.
Full textAbstract:
Emergency Relief (ER) is a Department of Social Services (DSS) funded program, delivered by 197 community organisations (ER Providers) across Australia, to assist people facing a financial crisis with financial/material aid and referrals to other support programs. ER has been playing this important role in Australian communities since 1979. Without ER, more people living in Australia who experience a financial crisis might face further harm such as crippling debt or homelessness. The Emergency Relief National Coordination Group (NCG) was established in April 2020 at the start of the COVID-19 pandemic to advise the Minister for Families and Social Services on the implementation of ER. To inform its advice to the Minister, the NCG partnered with the Institute for Governance at the University of Canberra to conduct research to understand the issues and challenges faced by ER Providers and Service Users in local contexts across Australia. The research involved a desktop review of the existing literature on ER service provision, a large survey which all Commonwealth ER Providers were invited to participate in (and 122 responses were received), interviews with a purposive sample of 18 ER Providers, and the development of a program logic and theory of change for the Commonwealth ER program to assess progress. The surveys and interviews focussed on ER Provider perceptions of the strengths, weaknesses, future challenges, and areas of improvement for current ER provision. The trend of increasing case complexity, the effectiveness of ER service delivery models in achieving outcomes for Service Users, and the significance of volunteering in the sector were investigated. Separately, an evaluation of the performance of the NCG was conducted and a summary of the evaluation is provided as an appendix to this report. Several themes emerged from the review of the existing literature such as service delivery shortcomings in dealing with case complexity, the effectiveness of case management, and repeat requests for service. Interviews with ER workers and Service Users found that an uplift in workforce capability was required to deal with increasing case complexity, leading to recommendations for more training and service standards. Several service evaluations found that ER delivered with case management led to high Service User satisfaction, played an integral role in transforming the lives of people with complex needs, and lowered repeat requests for service. A large longitudinal quantitative study revealed that more time spent with participants substantially decreased the number of repeat requests for service; and, given that repeat requests for service can be an indicator of entrenched poverty, not accessing further services is likely to suggest improvement. The interviews identified the main strengths of ER to be the rapid response and flexible use of funds to stabilise crisis situations and connect people to other supports through strong local networks. Service Users trusted the system because of these strengths, and ER was often an access point to holistic support. There were three main weaknesses identified. First, funding contracts were too short and did not cover the full costs of the program—in particular, case management for complex cases. Second, many Service Users were dependent on ER which was inconsistent with the definition and intent of the program. Third, there was inconsistency in the level of service received by Service Users in different geographic locations. These weaknesses can be improved upon with a joined-up approach featuring co-design and collaborative governance, leading to the successful commissioning of social services. The survey confirmed that volunteers were significant for ER, making up 92% of all workers and 51% of all hours worked in respondent ER programs. Of the 122 respondents, volunteers amounted to 554 full-time equivalents, a contribution valued at $39.4 million. In total there were 8,316 volunteers working in the 122 respondent ER programs. The sector can support and upskill these volunteers (and employees in addition) by developing scalable training solutions such as online training modules, updating ER service standards, and engaging in collaborative learning arrangements where large and small ER Providers share resources. More engagement with peak bodies such as Volunteering Australia might also assist the sector to improve the focus on volunteer engagement. Integrated services achieve better outcomes for complex ER cases—97% of survey respondents either agreed or strongly agreed this was the case. The research identified the dimensions of service integration most relevant to ER Providers to be case management, referrals, the breadth of services offered internally, co-location with interrelated service providers, an established network of support, workforce capability, and Service User engagement. Providers can individually focus on increasing the level of service integration for their ER program to improve their ability to deal with complex cases, which are clearly on the rise. At the system level, a more joined-up approach can also improve service integration across Australia. The key dimensions of this finding are discussed next in more detail. Case management is key for achieving Service User outcomes for complex cases—89% of survey respondents either agreed or strongly agreed this was the case. Interviewees most frequently said they would provide more case management if they could change their service model. Case management allows for more time spent with the Service User, follow up with referral partners, and a higher level of expertise in service delivery to support complex cases. Of course, it is a costly model and not currently funded for all Service Users through ER. Where case management is not available as part of ER, it might be available through a related service that is part of a network of support. Where possible, ER Providers should facilitate access to case management for Service Users who would benefit. At a system level, ER models with a greater component of case management could be implemented as test cases. Referral systems are also key for achieving Service User outcomes, which is reflected in the ER Program Logic presented on page 31. The survey and interview data show that referrals within an integrated service (internal) or in a service hub (co-located) are most effective. Where this is not possible, warm referrals within a trusted network of support are more effective than cold referrals leading to higher take-up and beneficial Service User outcomes. However, cold referrals are most common, pointing to a weakness in ER referral systems. This is because ER Providers do not operate or co-locate with interrelated services in many cases, nor do they have the case management capacity to provide warm referrals in many other cases. For mental illness support, which interviewees identified as one of the most difficult issues to deal with, ER Providers offer an integrated service only 23% of the time, warm referrals 34% of the time, and cold referrals 43% of the time. A focus on referral systems at the individual ER Provider level, and system level through a joined-up approach, might lead to better outcomes for Service Users. The program logic and theory of change for ER have been documented with input from the research findings and included in Section 4.3 on page 31. These show that ER helps people facing a financial crisis to meet their immediate needs, avoid further harm, and access a path to recovery. The research demonstrates that ER is fundamental to supporting vulnerable people in Australia and should therefore continue to be funded by government.
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Arora, Sanjana, and Olena Koval. Norway Country Report. University of Stavanger, 2022. http://dx.doi.org/10.31265/usps.232.
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This report is part of a larger cross-country comparative project and constitutes an account and analysis of the measures comprising the Norwegian national response to the COVID-19 pandemic during the year of 2020. This time period is interesting in that mitigation efforts were predominantly of a non-medical nature. Mass vaccinations were in Norway conducted in early 2021. With one of the lowest mortality rates in Europe and relatively lower economic repercussions compared to its Nordic neighbours, the Norwegian case stands unique (OECD, 2021: Eurostat 2021; Statista, 2022). This report presents a summary of Norwegian response to the COVID-19 pandemic by taking into account its governance, political administration and societal context. In doing so, it highlights the key features of the Nordic governance model and the mitigation measures that attributed to its success, as well as some facets of Norway’s under-preparedness. Norway’s relative isolation in Northern Europe coupled with low population density gave it a geographical advantage in ensuring a slower spread of the virus. However, the spread of infection was also uneven, which meant that infection rates were concentrated more in some areas than in others. On the fiscal front, the affluence of Norway is linked to its petroleum industry and the related Norwegian Sovereign Wealth Fund. Both were affected by the pandemic, reflected through a reduction in the country’s annual GDP (SSB, 2022). The Nordic model of extensive welfare services, economic measures, a strong healthcare system with goals of equity and a high trust society, indeed ensured a strong shield against the impact of the COVID-19 pandemic. Yet, the consequences of the pandemic were uneven with unemployment especially high among those with low education and/or in low-income professions, as well as among immigrants (NOU, 2022:5). The social and psychological effects were also uneven, with children and elderly being left particularly vulnerable (Christensen, 2021). Further, the pandemic also at times led to unprecedented pressure on some intensive care units (OECD, 2021). Central to handling the COVID-19 pandemic in Norway were the three national executive authorities: the Ministry of Health and Care services, the National directorate of health and the Norwegian Institute of Public Health. With regard to political-administrative functions, the principle of subsidiarity (decentralisation) and responsibility meant that local governments had a high degree of autonomy in implementing infection control measures. Risk communication was thus also relatively decentralised, depending on the local outbreak situations. While decentralisation likely gave flexibility, ability to improvise in a crisis and utilise the municipalities’ knowledge of local contexts, it also brought forward challenges of coordination between the national and municipal level. Lack of training, infection control and protection equipment thereby prevailed in several municipalities. Although in effect for limited periods of time, the Corona Act, which allowed for fairly severe restrictions, received mixed responses in the public sphere. Critical perceptions towards the Corona Act were not seen as a surprise, considering that Norwegian society has traditionally relied on its ‘dugnadskultur’ – a culture of voluntary contributions in the spirit of solidarity. Government representatives at the frontline of communication were also open about the degree of uncertainty coupled with considerable potential for great societal damage. Overall, the mitigation policy in Norway was successful in keeping the overall infection rates and mortality low, albeit with a few societal and political-administrative challenges. The case of Norway is thus indeed exemplary with regard to its effective mitigation measures and strong government support to mitigate the impact of those measures. However, it also goes to show how a country with good crisis preparedness systems, governance and a comprehensive welfare system was also left somewhat underprepared by the devastating consequences of the pandemic.
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Rankin, Nicole, Deborah McGregor, Candice Donnelly, Bethany Van Dort, Richard De Abreu Lourenco, Anne Cust, and Emily Stone. Lung cancer screening using low-dose computed tomography for high risk populations: Investigating effectiveness and screening program implementation considerations: An Evidence Check rapid review brokered by the Sax Institute (www.saxinstitute.org.au) for the Cancer Institute NSW. The Sax Institute, October 2019. http://dx.doi.org/10.57022/clzt5093.
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Background Lung cancer is the number one cause of cancer death worldwide.(1) It is the fifth most commonly diagnosed cancer in Australia (12,741 cases diagnosed in 2018) and the leading cause of cancer death.(2) The number of years of potential life lost to lung cancer in Australia is estimated to be 58,450, similar to that of colorectal and breast cancer combined.(3) While tobacco control strategies are most effective for disease prevention in the general population, early detection via low dose computed tomography (LDCT) screening in high-risk populations is a viable option for detecting asymptomatic disease in current (13%) and former (24%) Australian smokers.(4) The purpose of this Evidence Check review is to identify and analyse existing and emerging evidence for LDCT lung cancer screening in high-risk individuals to guide future program and policy planning. Evidence Check questions This review aimed to address the following questions: 1. What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? 2. What is the evidence of potential harms from lung cancer screening for higher-risk individuals? 3. What are the main components of recent major lung cancer screening programs or trials? 4. What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Summary of methods The authors searched the peer-reviewed literature across three databases (MEDLINE, PsycINFO and Embase) for existing systematic reviews and original studies published between 1 January 2009 and 8 August 2019. Fifteen systematic reviews (of which 8 were contemporary) and 64 original publications met the inclusion criteria set across the four questions. Key findings Question 1: What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? There is sufficient evidence from systematic reviews and meta-analyses of combined (pooled) data from screening trials (of high-risk individuals) to indicate that LDCT examination is clinically effective in reducing lung cancer mortality. In 2011, the landmark National Lung Cancer Screening Trial (NLST, a large-scale randomised controlled trial [RCT] conducted in the US) reported a 20% (95% CI 6.8% – 26.7%; P=0.004) relative reduction in mortality among long-term heavy smokers over three rounds of annual screening. High-risk eligibility criteria was defined as people aged 55–74 years with a smoking history of ≥30 pack-years (years in which a smoker has consumed 20-plus cigarettes each day) and, for former smokers, ≥30 pack-years and have quit within the past 15 years.(5) All-cause mortality was reduced by 6.7% (95% CI, 1.2% – 13.6%; P=0.02). Initial data from the second landmark RCT, the NEderlands-Leuvens Longkanker Screenings ONderzoek (known as the NELSON trial), have found an even greater reduction of 26% (95% CI, 9% – 41%) in lung cancer mortality, with full trial results yet to be published.(6, 7) Pooled analyses, including several smaller-scale European LDCT screening trials insufficiently powered in their own right, collectively demonstrate a statistically significant reduction in lung cancer mortality (RR 0.82, 95% CI 0.73–0.91).(8) Despite the reduction in all-cause mortality found in the NLST, pooled analyses of seven trials found no statistically significant difference in all-cause mortality (RR 0.95, 95% CI 0.90–1.00).(8) However, cancer-specific mortality is currently the most relevant outcome in cancer screening trials. These seven trials demonstrated a significantly greater proportion of early stage cancers in LDCT groups compared with controls (RR 2.08, 95% CI 1.43–3.03). Thus, when considering results across mortality outcomes and early stage cancers diagnosed, LDCT screening is considered to be clinically effective. Question 2: What is the evidence of potential harms from lung cancer screening for higher-risk individuals? The harms of LDCT lung cancer screening include false positive tests and the consequences of unnecessary invasive follow-up procedures for conditions that are eventually diagnosed as benign. While LDCT screening leads to an increased frequency of invasive procedures, it does not result in greater mortality soon after an invasive procedure (in trial settings when compared with the control arm).(8) Overdiagnosis, exposure to radiation, psychological distress and an impact on quality of life are other known harms. Systematic review evidence indicates the benefits of LDCT screening are likely to outweigh the harms. The potential harms are likely to be reduced as refinements are made to LDCT screening protocols through: i) the application of risk predication models (e.g. the PLCOm2012), which enable a more accurate selection of the high-risk population through the use of specific criteria (beyond age and smoking history); ii) the use of nodule management algorithms (e.g. Lung-RADS, PanCan), which assist in the diagnostic evaluation of screen-detected nodules and cancers (e.g. more precise volumetric assessment of nodules); and, iii) more judicious selection of patients for invasive procedures. Recent evidence suggests a positive LDCT result may transiently increase psychological distress but does not have long-term adverse effects on psychological distress or health-related quality of life (HRQoL). With regards to smoking cessation, there is no evidence to suggest screening participation invokes a false sense of assurance in smokers, nor a reduction in motivation to quit. The NELSON and Danish trials found no difference in smoking cessation rates between LDCT screening and control groups. Higher net cessation rates, compared with general population, suggest those who participate in screening trials may already be motivated to quit. Question 3: What are the main components of recent major lung cancer screening programs or trials? There are no systematic reviews that capture the main components of recent major lung cancer screening trials and programs. We extracted evidence from original studies and clinical guidance documents and organised this into key groups to form a concise set of components for potential implementation of a national lung cancer screening program in Australia: 1. Identifying the high-risk population: recruitment, eligibility, selection and referral 2. Educating the public, people at high risk and healthcare providers; this includes creating awareness of lung cancer, the benefits and harms of LDCT screening, and shared decision-making 3. Components necessary for health services to deliver a screening program: a. Planning phase: e.g. human resources to coordinate the program, electronic data systems that integrate medical records information and link to an established national registry b. Implementation phase: e.g. human and technological resources required to conduct LDCT examinations, interpretation of reports and communication of results to participants c. Monitoring and evaluation phase: e.g. monitoring outcomes across patients, radiological reporting, compliance with established standards and a quality assurance program 4. Data reporting and research, e.g. audit and feedback to multidisciplinary teams, reporting outcomes to enhance international research into LDCT screening 5. Incorporation of smoking cessation interventions, e.g. specific programs designed for LDCT screening or referral to existing community or hospital-based services that deliver cessation interventions. Most original studies are single-institution evaluations that contain descriptive data about the processes required to establish and implement a high-risk population-based screening program. Across all studies there is a consistent message as to the challenges and complexities of establishing LDCT screening programs to attract people at high risk who will receive the greatest benefits from participation. With regards to smoking cessation, evidence from one systematic review indicates the optimal strategy for incorporating smoking cessation interventions into a LDCT screening program is unclear. There is widespread agreement that LDCT screening attendance presents a ‘teachable moment’ for cessation advice, especially among those people who receive a positive scan result. Smoking cessation is an area of significant research investment; for instance, eight US-based clinical trials are now underway that aim to address how best to design and deliver cessation programs within large-scale LDCT screening programs.(9) Question 4: What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Assessing the value or cost-effectiveness of LDCT screening involves a complex interplay of factors including data on effectiveness and costs, and institutional context. A key input is data about the effectiveness of potential and current screening programs with respect to case detection, and the likely outcomes of treating those cases sooner (in the presence of LDCT screening) as opposed to later (in the absence of LDCT screening). Evidence about the cost-effectiveness of LDCT screening programs has been summarised in two systematic reviews. We identified a further 13 studies—five modelling studies, one discrete choice experiment and seven articles—that used a variety of methods to assess cost-effectiveness. Three modelling studies indicated LDCT screening was cost-effective in the settings of the US and Europe. Two studies—one from Australia and one from New Zealand—reported LDCT screening would not be cost-effective using NLST-like protocols. We anticipate that, following the full publication of the NELSON trial, cost-effectiveness studies will likely be updated with new data that reduce uncertainty about factors that influence modelling outcomes, including the findings of indeterminate nodules. Gaps in the evidence There is a large and accessible body of evidence as to the effectiveness (Q1) and harms (Q2) of LDCT screening for lung cancer. Nevertheless, there are significant gaps in the evidence about the program components that are required to implement an effective LDCT screening program (Q3). Questions about LDCT screening acceptability and feasibility were not explicitly included in the scope. However, as the evidence is based primarily on US programs and UK pilot studies, the relevance to the local setting requires careful consideration. The Queensland Lung Cancer Screening Study provides feasibility data about clinical aspects of LDCT screening but little about program design. The International Lung Screening Trial is still in the recruitment phase and findings are not yet available for inclusion in this Evidence Check. The Australian Population Based Screening Framework was developed to “inform decision-makers on the key issues to be considered when assessing potential screening programs in Australia”.(10) As the Framework is specific to population-based, rather than high-risk, screening programs, there is a lack of clarity about transferability of criteria. However, the Framework criteria do stipulate that a screening program must be acceptable to “important subgroups such as target participants who are from culturally and linguistically diverse backgrounds, Aboriginal and Torres Strait Islander people, people from disadvantaged groups and people with a disability”.(10) An extensive search of the literature highlighted that there is very little information about the acceptability of LDCT screening to these population groups in Australia. Yet they are part of the high-risk population.(10) There are also considerable gaps in the evidence about the cost-effectiveness of LDCT screening in different settings, including Australia. The evidence base in this area is rapidly evolving and is likely to include new data from the NELSON trial and incorporate data about the costs of targeted- and immuno-therapies as these treatments become more widely available in Australia.
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Cunningham, Stuart, Marion McCutcheon, Greg Hearn, Mark Ryan, and Christy Collis. Australian Cultural and Creative Activity: A Population and Hotspot Analysis: Sunshine Coast. Queensland University of Technology, December 2020. http://dx.doi.org/10.5204/rep.eprints.136822.
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The Sunshine Coast (unless otherwise specified, Sunshine Coast refers to the region which includes both Sunshine Coast and Noosa council areas) is a classic regional hotspot. In many respects, the Sunshine Coast has assets that make it the “Goldilocks” of Queensland hotspots: “the agility of the region and our collaborative nature is facilitated by the fact that we're not too big, not too small - 330,000 people” (Paddenburg, 2019); “We are in that perfect little bubble of just right of about everything” (Erbacher 2019). The Sunshine Coast has one of the fastest-growing economies in Australia. Its population is booming and its local governments are working together to establish world-class communications, transport and health infrastructure, while maintaining the integrity of the region’s much-lauded environment and lifestyle. As a result, the Sunshine Coast Council is regarded as a pioneer on smart city initiatives, while Noosa Shire Council has built a reputation for prioritising sustainable development. The region’s creative economy is growing at a faster rate that of the rest of the economy—in terms of job growth, earnings, incomes and business registrations. These gains, however, are not spread uniformly. Creative Services (that is, the advertising and marketing, architecture and design, and software and digital content sectors) are flourishing, while Cultural Production (music and performing arts, publishing and visual arts) is variable, with visual and performing arts growing while film, television and radio and publishing have low or no growth. The spirit of entrepreneurialism amongst many creatives in the Sunshine Coast was similar to what we witnessed in other hotspots: a spirit of not necessarily relying on institutions, seeking out alternative income sources, and leveraging networks. How public agencies can better harness that energy and entrepreneurialism could be a focus for ongoing strategy. There does seem to be a lower level of arts and culture funding going into the Sunshine Coast from governments than its population base and cultural and creative energy might suggest. Federal and state arts funding programs are under-delivering to the Sunshine Coast.
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Smit, Amelia, Kate Dunlop, Nehal Singh, Diona Damian, Kylie Vuong, and Anne Cust. Primary prevention of skin cancer in primary care settings. The Sax Institute, August 2022. http://dx.doi.org/10.57022/qpsm1481.
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Overview Skin cancer prevention is a component of the new Cancer Plan 2022–27, which guides the work of the Cancer Institute NSW. To lessen the impact of skin cancer on the community, the Cancer Institute NSW works closely with the NSW Skin Cancer Prevention Advisory Committee, comprising governmental and non-governmental organisation representatives, to develop and implement the NSW Skin Cancer Prevention Strategy. Primary Health Networks and primary care providers are seen as important stakeholders in this work. To guide improvements in skin cancer prevention and inform the development of the next NSW Skin Cancer Prevention Strategy, an up-to-date review of the evidence on the effectiveness and feasibility of skin cancer prevention activities in primary care is required. A research team led by the Daffodil Centre, a joint venture between the University of Sydney and Cancer Council NSW, was contracted to undertake an Evidence Check review to address the questions below. Evidence Check questions This Evidence Check aimed to address the following questions: Question 1: What skin cancer primary prevention activities can be effectively administered in primary care settings? As part of this, identify the key components of such messages, strategies, programs or initiatives that have been effectively implemented and their feasibility in the NSW/Australian context. Question 2: What are the main barriers and enablers for primary care providers in delivering skin cancer primary prevention activities within their setting? Summary of methods The research team conducted a detailed analysis of the published and grey literature, based on a comprehensive search. We developed the search strategy in consultation with a medical librarian at the University of Sydney and the Cancer Institute NSW team, and implemented it across the databases Embase, MEDLINE, PsycInfo, Scopus, Cochrane Central and CINAHL. Results were exported and uploaded to Covidence for screening and further selection. The search strategy was designed according to the SPIDER tool for Qualitative and Mixed-Methods Evidence Synthesis, which is a systematic strategy for searching qualitative and mixed-methods research studies. The SPIDER tool facilitates rigour in research by defining key elements of non-quantitative research questions. We included peer-reviewed and grey literature that included skin cancer primary prevention strategies/ interventions/ techniques/ programs within primary care settings, e.g. involving general practitioners and primary care nurses. The literature was limited to publications since 2014, and for studies or programs conducted in Australia, the UK, New Zealand, Canada, Ireland, Western Europe and Scandinavia. We also included relevant systematic reviews and evidence syntheses based on a range of international evidence where also relevant to the Australian context. To address Question 1, about the effectiveness of skin cancer prevention activities in primary care settings, we summarised findings from the Evidence Check according to different skin cancer prevention activities. To address Question 2, about the barriers and enablers of skin cancer prevention activities in primary care settings, we summarised findings according to the Consolidated Framework for Implementation Research (CFIR). The CFIR is a framework for identifying important implementation considerations for novel interventions in healthcare settings and provides a practical guide for systematically assessing potential barriers and facilitators in preparation for implementing a new activity or program. We assessed study quality using the National Health and Medical Research Council (NHMRC) levels of evidence. Key findings We identified 25 peer-reviewed journal articles that met the eligibility criteria and we included these in the Evidence Check. Eight of the studies were conducted in Australia, six in the UK, and the others elsewhere (mainly other European countries). In addition, the grey literature search identified four relevant guidelines, 12 education/training resources, two Cancer Care pathways, two position statements, three reports and five other resources that we included in the Evidence Check. Question 1 (related to effectiveness) We categorised the studies into different types of skin cancer prevention activities: behavioural counselling (n=3); risk assessment and delivering risk-tailored information (n=10); new technologies for early detection and accompanying prevention advice (n=4); and education and training programs for general practitioners (GPs) and primary care nurses regarding skin cancer prevention (n=3). There was good evidence that behavioural counselling interventions can result in a small improvement in sun protection behaviours among adults with fair skin types (defined as ivory or pale skin, light hair and eye colour, freckles, or those who sunburn easily), which would include the majority of Australians. It was found that clinicians play an important role in counselling patients about sun-protective behaviours, and recommended tailoring messages to the age and demographics of target groups (e.g. high-risk groups) to have maximal influence on behaviours. Several web-based melanoma risk prediction tools are now available in Australia, mainly designed for health professionals to identify patients’ risk of a new or subsequent primary melanoma and guide discussions with patients about primary prevention and early detection. Intervention studies have demonstrated that use of these melanoma risk prediction tools is feasible and acceptable to participants in primary care settings, and there is some evidence, including from Australian studies, that using these risk prediction tools to tailor primary prevention and early detection messages can improve sun-related behaviours. Some studies examined novel technologies, such as apps, to support early detection through skin examinations, including a very limited focus on the provision of preventive advice. These novel technologies are still largely in the research domain rather than recommended for routine use but provide a potential future opportunity to incorporate more primary prevention tailored advice. There are a number of online short courses available for primary healthcare professionals specifically focusing on skin cancer prevention. Most education and training programs for GPs and primary care nurses in the field of skin cancer focus on treatment and early detection, though some programs have specifically incorporated primary prevention education and training. A notable example is the Dermoscopy for Victorian General Practice Program, in which 93% of participating GPs reported that they had increased preventive information provided to high-risk patients and during skin examinations. Question 2 (related to barriers and enablers) Key enablers of performing skin cancer prevention activities in primary care settings included: • Easy access and availability of guidelines and point-of-care tools and resources • A fit with existing workflows and systems, so there is minimal disruption to flow of care • Easy-to-understand patient information • Using the waiting room for collection of risk assessment information on an electronic device such as an iPad/tablet where possible • Pairing with early detection activities • Sharing of successful programs across jurisdictions. Key barriers to performing skin cancer prevention activities in primary care settings included: • Unclear requirements and lack of confidence (self-efficacy) about prevention counselling • Limited availability of GP services especially in regional and remote areas • Competing demands, low priority, lack of time • Lack of incentives.
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Hajarizadeh, Behzad, Jennifer MacLachlan, Benjamin Cowie, and Gregory J. Dore. Population-level interventions to improve the health outcomes of people living with hepatitis B: an Evidence Check brokered by the Sax Institute for the NSW Ministry of Health, 2022. The Sax Institute, August 2022. http://dx.doi.org/10.57022/pxwj3682.
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Background An estimated 292 million people are living with chronic hepatitis B virus (HBV) infection globally, including 223,000 people in Australia. HBV diagnosis and linkage of people living with HBV to clinical care is suboptimal in Australia, with 27% of people living with HBV undiagnosed and 77% not receiving regular HBV clinical care. This systematic review aimed to characterize population-level interventions implemented to enhance all components of HBV care cascade and analyse the effectiveness of interventions. Review questions Question 1: What population-level interventions, programs or policy approaches have been shown to be effective in reducing the incidence of hepatitis B; and that may not yet be fully rolled out or evaluated in Australia demonstrate early effectiveness, or promise, in reducing the incidence of hepatitis B? Question 2: What population-level interventions and/or programs are effective at reducing disease burden for people in the community with hepatitis B? Methods Four bibliographic databases and 21 grey literature sources were searched. Studies were eligible for inclusion if the study population included people with or at risk of chronic HBV, and the study conducted a population-level interventions to decrease HBV incidence or disease burden or to enhance any components of HBV care cascade (i.e., diagnosis, linkage to care, treatment initiation, adherence to clinical care), or HBV vaccination coverage. Studies published in the past 10 years (since January 2012), with or without comparison groups were eligible for inclusion. Studies conducting an HBV screening intervention were eligible if they reported proportion of people participating in screening, proportion of newly diagnosed HBV (participant was unaware of their HBV status), proportion of people received HBV vaccination following screening, or proportion of participants diagnosed with chronic HBV infection who were linked to HBV clinical care. Studies were excluded if study population was less than 20 participants, intervention included a pharmaceutical intervention or a hospital-based intervention, or study was implemented in limited clinical services. The records were initially screened by title and abstract. The full texts of potentially eligible records were reviewed, and eligible studies were selected for inclusion. For each study included in analysis, the study outcome and corresponding 95% confidence intervals (95%CIs) were calculated. For studies including a comparison group, odds ratio (OR) and corresponding 95%CIs were calculated. Random effect meta-analysis models were used to calculate the pooled study outcome estimates. Stratified analyses were conducted by study setting, study population, and intervention-specific characteristics. Key findings A total of 61 studies were included in the analysis. A large majority of studies (study n=48, 79%) included single-arm studies with no concurrent control, with seven (12%) randomised controlled trials, and six (10%) non-randomised controlled studies. A total of 109 interventions were evaluated in 61 included studies. On-site or outreach HBV screening and linkage to HBV clinical care coordination were the most frequent interventions, conducted in 27 and 26 studies, respectively. Question 1 We found no studies reporting HBV incidence as the study outcome. One study conducted in remote area demonstrated that an intervention including education of pregnant women and training village health volunteers enhanced coverage of HBV birth dose vaccination (93% post-intervention, vs. 81% pre-intervention), but no data of HBV incidence among infants were reported. Question 2 Study outcomes most relevant to the HBV burden for people in the community with HBV included, HBV diagnosis, linkage to HBV care, and HBV vaccination coverage. Among randomised controlled trials aimed at enhancing HBV screening, a meta-analysis was conducted including three studies which implemented an intervention including community face-to-face education focused on HBV and/or liver cancer among migrants from high HBV prevalence areas. This analysis demonstrated a significantly higher HBV testing uptake in intervention groups with the likelihood of HBV testing 3.6 times higher among those participating in education programs compared to the control groups (OR: 3.62, 95% CI 2.72, 4.88). In another analysis, including 25 studies evaluating an intervention to enhance HBV screening, a pooled estimate of 66% of participants received HBV testing following the study intervention (95%CI: 58-75%), with high heterogeneity across studies (range: 17-98%; I-square: 99.9%). A stratified analysis by HBV screening strategy demonstrated that in the studies providing participants with on-site HBV testing, the proportion receiving HBV testing (80%, 95%CI: 72-87%) was significantly higher compared to the studies referring participants to an external site for HBV testing (54%, 95%CI: 37-71%). In the studies implementing an intervention to enhance linkage of people diagnosed with HBV infection to clinical care, the interventions included different components and varied across studies. The most common component was post-test counselling followed by assistance with scheduling clinical appointments, conducted in 52% and 38% of the studies, respectively. In meta-analysis, a pooled estimate of 73% of people with HBV infection were linked to HBV clinical care (95%CI: 64-81%), with high heterogeneity across studies (range: 28-100%; I-square: 99.2%). A stratified analysis by study population demonstrated that in the studies among general population in high prevalence countries, 94% of people (95%CI: 88-100%) who received the study intervention were linked to care, significantly higher than 72% (95%CI: 61-83%) in studies among migrants from high prevalence area living in a country with low prevalence. In 19 studies, HBV vaccination uptake was assessed after an intervention, among which one study assessed birth dose vaccination among infants, one study assessed vaccination in elementary school children and 17 studies assessed vaccination in adults. Among studies assessing adult vaccination, a pooled estimate of 38% (95%CI: 21-56%) of people initiated vaccination, with high heterogeneity across studies (range: 0.5-93%; I square: 99.9%). A stratified analysis by HBV vaccination strategy demonstrated that in the studies providing on-site vaccination, the uptake was 78% (95%CI: 62-94%), significantly higher compared to 27% (95%CI: 13-42%) in studies referring participants to an external site for vaccination. Conclusion This systematic review identified a wide variety of interventions, mostly multi-component interventions, to enhance HBV screening, linkage to HBV clinical care, and HBV vaccination coverage. High heterogeneity was observed in effectiveness of interventions in all three domains of screening, linkage to care, and vaccination. Strategies identified to boost the effectiveness of interventions included providing on-site HBV testing and vaccination (versus referral for testing and vaccination) and including community education focussed on HBV or liver cancer in an HBV screening program. Further studies are needed to evaluate the effectiveness of more novel interventions (e.g., point of care testing) and interventions specifically including Indigenous populations, people who inject drugs, men who have sex with men, and people incarcerated.