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1
Rée, Hugo. "National HIV Strategy in Australia." AIDS Patient Care and STDs 13, no. 11 (November 1999): 639. http://dx.doi.org/10.1089/apc.1999.13.639.
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Chan, D. J., and D. L. Bradford. "A sexual health strategy for Australia — time for action." Sexual Health 1, no. 4 (2004): 197. http://dx.doi.org/10.1071/sh04008.
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Australia still does not have a national sexual health strategy. Sexually transmissible infections such as chlamydia continue to plague the community, and the incidence of HIV is increasing. But a cohesive sexual health strategy cannot merely be disease-focussed, it must include the broader social and cultural aspects of sexual behaviour and sexuality. We propose a public health framework for the development of a national sexual health strategy that will bring Australia in line with the United Kingdom and New Zealand.
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Duckett, Stephen. "Responding to Health Inequalities in Australia: A Proposed Strategy." Australian Journal of Primary Health 4, no. 2 (1998): 9. http://dx.doi.org/10.1071/py98016.
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This paper uses data from Australian Institute of Health and Welfare research on health inequalities to highlight the importance of moving beyond a simple risk factor approach to health promotion, to focus on the broader contextual factors which influence disparities in health within the Australian population. It argues that addressing health inequalities requires a focus on location (geography) and hence a first step in reducing health disparities is to develop national, state, and local health promotion plans.
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Doyal, Lesley. "Keynote Addresses: What Makes Women Sick? Promoting Women's Health: The Changing Agenda for Health Promotion." Australian Journal of Primary Health 4, no. 3 (1998): 8. http://dx.doi.org/10.1071/py98027.
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The creation of a National Women's Health Policy in 1989 put Australia at the forefront of developments in women's health. By contrast, in the United Kingdom there is still no clear strategy for improving gender equity in the health service, and many of the principles taken for granted in Australia are not even on the National Health Service agenda. The current reforms of our health service do reflect a backing away from the 'quasi markets' of the Conservative era. However, little attention has been paid during this process to the specific needs of women. So Australia is still ahead, with Victoria in particular playing a key role in disseminating examples of good practice, both at home and internationally. The Australian Women's Health Policy and Program provides a fertile environment for innovation in good practice, but this does not mean that there is nothing left to achieve. Indeed, it may well require considerable effort just to maintain what has already been put in place. To move forward will mean continuing to confront those challenges in trying to improve women's health around the world. These are addressed by looking at three key themes: reconfiguring medicine; dealing with diversity; and gendering the social model of health. In each case these themes are placed in a global context.
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Anderson, Ian, Harriet Young, Milica Markovic, and Lenore Manderson. "Koori Primary Health Care in Victoria: Developments in Service Planning." Australian Journal of Primary Health 6, no. 4 (2000): 24. http://dx.doi.org/10.1071/py00031.
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The Alma Ata 1978 Declaration on primary health care has conventionally been applied in developing countries, where medically trained personnel and other highly skilled health professionals and medical infrastructure are limited. Although such concepts have salience in relatively resource rich countries such as Australia, it is in Aboriginal and Torres Strait Islander health policy that they have become pivotal. A growing national focus on the development of Aboriginal primary health care capacity followed the release of the National Aboriginal Health Strategy (NAHS) in 1989 (Anderson, 1997). This focus consolidated further, following the evaluation of the National Aboriginal Health Strategy implementation in 1994 which preceded the transfer of administrative responsibility for the Commonwealth Aboriginal health program from the Aboriginal and Torres Strait Islander Commission (ATSIC) to the Commonwealth Health portfolio (DHFS, 1994). Within the strategic framework provided by federal state agreements, the development of primary health care services is a priority. In the current national policy framework domains of policy and strategy development have been identified as key developmental themes.
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Bernard, Diana, Susan Kippax, and Don Baxter. "Effective partnership and adequate investment underpin a successful response: key factors in dealing with HIV increases." Sexual Health 5, no. 2 (2008): 193. http://dx.doi.org/10.1071/sh07078.
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Background: Australia has mounted an effective response to HIV and AIDS by investing in evidence-informed policy. Recently, in response to increases in HIV in some states in Australia, the New South Wales Department of Health set up a ‘think tank’ to examine differences in epidemiological and behavioural data, policies, strategies and community responses in order to account for state-based differences and ensure an effective ongoing response to HIV. Methods: The National Centre in HIV Social Research undertook key informant interviews with major stakeholders to help understand differences in responses by the three states most affected by HIV in Australia – Queensland, New South Wales and Victoria. In parallel, the Australian Federation of AIDS Organisations completed an analysis of the investments in HIV-prevention activities targeting gay men in all jurisdictions in Australia. The Australian Federation of AIDS Organisations also analysed the strategic contexts and government responses to HIV in the three states. Results: There were significant differences between New South Wales, Queensland and Victoria in the way the HIV partnership functions. Type of prevention strategy and level of financial investment in prevention activities appear to be related to the effectiveness of the ongoing response to HIV. Conclusions: An active commitment to and adequate resourcing of HIV prevention by all stakeholders in the HIV partnership – government and non-government departments, researchers and gay community organisations – is crucial if Australia is to respond effectively to HIV among gay and other men who have sex with men.
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Brotherton, Julia M. L., John M. Kaldor, and Suzanne M. Garland. "Monitoring the control of human papillomavirus (HPV) infection and related diseases in Australia: towards a national HPV surveillance strategy." Sexual Health 7, no. 3 (2010): 310. http://dx.doi.org/10.1071/sh09137.
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This paper describes a possible multifaceted approach to human papillomavirus (HPV) related surveillance in Australia following implementation of a national HPV vaccination program. We describe eight main components: monitoring of vaccine coverage, vaccine safety, type-specific HPV infection surveillance, cervical cytology (Pap screening) coverage and screen detected lesion prevalence, cervical cancer incidence and mortality, genital wart incidence, incidence of recurrent respiratory papillomatosis, and knowledge, attitudes and beliefs about HPV and HPV vaccination. Australia is well placed to monitor the impact of its HPV vaccination program as well as to measure vaccine effectiveness with existing HPV vaccines, cervical screening and cancer registries.
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Marriott, Jennifer, Susan Taylor, Maree Simpson, Rosalind Bull, Kirstie Galbraith, Helen Howarth, Anne Leversha, Dawn Best, and Miranda Rose. "Australian national strategy for pharmacy preceptor education and support." Australian Journal of Rural Health 13, no. 2 (April 2005): 83–90. http://dx.doi.org/10.1111/j.1440-1854.2005.00659.x.
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Long, S. A., and R. A. Tinker. "Australian action to reduce health risks from radon." Annals of the ICRP 49, no. 1_suppl (August 3, 2020): 77–83. http://dx.doi.org/10.1177/0146645320931983.
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In Australia, worker exposure to radon in underground uranium mines has been a focus of policy makers and regulators, and has been well controlled in the industry sector. That cannot be said for public exposure to radon. Radon exposure studies in the late 1980s and early 1990s demonstrated that the levels of radon in Australian homes were some of the lowest in the world. The International Basic Safety Standards, published by the International Atomic Energy Agency, requires the government to establish and implement an action plan for controlling public exposure due to radon indoors. When considering different policy options, it is important to develop radon prevention and mitigation programmes reflecting elements that are unique to the region or country. The Australian Radon Action Plan is being considered at a national level, and presents a long-range strategy designed to reduce radon-induced lung cancer in Australia, as well as the individual risk for people living with high concentrations of radon. In Australia, workers who are not currently designated as occupationally exposed are also considered as members of the public. In the Australian context, there are only a limited set of scenarios that might give rise to sufficiently high radon concentrations that warrant mitigation. These include highly energy efficient buildings in areas of high radon potential, underground workplaces, workplaces with elevated radon concentrations (e.g. spas using natural spring waters), and enclosed workspaces with limited ventilation. The key elements for a successful plan will rely on collaboration between government sectors and other health promotion programmes, cooperative efforts involving technical and communication experts, and partnering with building professionals and other stakeholders involved in the implementation of radon prevention and mitigation.
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Chen, Marcus Y., and Basil Donovan. "Genital Chlamydia trachomatis infection in Australia: epidemiology and clinical implications." Sexual Health 1, no. 4 (2004): 189. http://dx.doi.org/10.1071/sh04027.
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Over the last decade, notification rates for genital Chlamydia trachomatis infection in Australia have been rising progressively. While chlamydia is common and possibly increasing in the general population, heterosexual adolescents, indigenous Australians in remote settings, and homosexually active men are at particular risk of infection. Few studies are available on the extent of morbidity from chlamydia-associated diseases. Australia urgently needs a national strategy to control chlamydia, with widespread, selective screening as a key component. As general practitioners have an important role to play, we proffer guidelines for selective testing in primary care.
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Piat, Myra, and Judith Sabetti. "The Development of a Recovery-Oriented Mental Health System in Canada: What the Experience of Commonwealth Countries Tells Us." Canadian Journal of Community Mental Health 28, no. 2 (September 1, 2009): 17–33. http://dx.doi.org/10.7870/cjcmh-2009-0020.
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This article examines how the recovery concept has been introduced into national mental health policies in New Zealand, Australia, and England. Five overall themes are identified as critical in shifting to a recovery-oriented system: restructuring of mental health services, promoting mental health and preventing mental illness, developing and training the workforce, cultivating consumer participation and leadership, and establishing outcome-oriented and measurable practices. These issues are vital in the uptake of recovery and should guide the overall direction of the Canadian Mental Health Commission's mental health strategy.
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Bennett, Sonya. "Responding to the pandemic at a national and state public health level." Microbiology Australia 42, no. 1 (2021): 13. http://dx.doi.org/10.1071/ma21005.
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Australia’s planning and preparedness for a health emergency response has served us well in the response to the COVID-19 pandemic. Despite this, rapid and agile decisions were required to manage the public health impact. In the face of uncertainty and the seemingly evolving nature of the virus, we have seen precautionary actions and outcomes beyond that articulated in planning. The timely closure of international borders, requiring 14-day quarantine of returning travellers in designated facilities, is one such outcome; yet potentially the single most effective measure in controlling the pandemic in Australia. Our testing strategy, case and contact management, social restrictions and community measures have successfully suppressed the virus to a level of no domestic community transmission. The framework for this success was the effective utilisation of existing public health committees, whole of government leadership and responsiveness at all levels and community support. With the impending commencement of the COVID-19 vaccine program, this framework continues to support navigating our way out of the pandemic.
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Fitzgerald, John L. "The Australian National Council on Drugs (ANCD) and Governance in the Australian Drug Policy Arena." Contemporary Drug Problems 32, no. 2 (June 2005): 259–93. http://dx.doi.org/10.1177/009145090503200205.
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The Australian National Council on Drugs (ANCD) was introduced into the Australian drug policy community in 1997 by the Howard conservative government as part of its “Tough on Drugs” policy initiative. Support in 1997 by the states and territories through the Ministerial Council on Drug Strategy (MCDS) for a trial of prescribed heroin prompted the prime minister to attempt to directly control drug policy by changing national drug-policy-making processes. It has been suggested that the ANCD was introduced to short-circuit the power of the states and territories to structure national drug strategy, signaling a shift from consensus decision making through a policy community approach to centralized executive decision making through the prime minister's office. Interviews with key policy makers during 1999–2000 and findings from recent evaluations point to a climate of distrust, over-bureaucratization, slow decision making, and overt paranoia about the presence of new players in the drug policy arena, resulting not from inadequacies in governance but as a resistant response from policy makers to the introduction of the ANCD. This shift in the model of decision making may lead to an obsolete national drug strategy (NDS) and undermine a unified approach to national drug policy.
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Feng, Y., and A. Elshaug. "The Association of Neighbourhood Built and Social Environment and Cancer: Evidence From Australia." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 135s. http://dx.doi.org/10.1200/jgo.18.75400.
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Background and context: Australia is among the worst countries in terms of cancer incidence and displays substantial variations in cancer outcomes across multiple geographic scales. Aim: This research project aims to examine how neighborhood social and environmental attributes interact with individual risk factors, affect cancer outcomes and contribute to the geographic variations in cancer outcomes. Specifically, it will answer the following research questions: What neighborhood built and social environment attributes are associated with individual health outcomes? How do neighborhood features influence cancer outcomes, at multiple geographic scales? At what geographical scales the variations in cancer outcomes are the most pronounced and how much is contributed by neighborhood attributes? What initiatives and guidelines should be developed and at what level: local neighborhood, regional, state, national level? Strategy/Tactics: Innovative geospatial techniques will be developed to analyze cancer risk factors and variations at multiple spatial levels utilizing population-based hospital inpatient data in NSW, Australia Program/Policy process: The study is the first population-based study evaluating how neighborhood influences cancer outcomes from multiple scales in the Australian context. The project has tangible potentials to be translated into initiatives and practices. This includes various levels such as local neighborhood, state and national level for the prevention and control of cancer and ultimately improve cancer outcomes in Australia. Outcomes: A large proportion of geographic variations in cancer outcomes are contributed by differences in the neighborhood built and social environment characteristics, which interact with individual risk factors and have synergistic effects on cancer outcomes. What was learned: Neighborhood physical and social environment has a strong effect on cancer outcomes. Through modification of neighborhood attributes, we can reduce the exposure to neighborhood risk factors and promote healthy lifestyle choices, which, in turn, reduce cancer incidence and improve survival rates. Effective initiatives and guidelines for cancer control should be developed and at all government levels including the local neighborhood, regional, state, national level.
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Reid, Amanda, Michael Lynskey, and Jan Copeland. "Cannabis use among Australian adolescents: findings of the 1998 National Drug Strategy Household Survey." Australian and New Zealand Journal of Public Health 24, no. 6 (December 2000): 596–602. http://dx.doi.org/10.1111/j.1467-842x.2000.tb00523.x.
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Jansson, James, Cliff C. Kerr, and David P. Wilson. "Predicting the population impact of increased HIV testing and treatment in Australia." Sexual Health 11, no. 2 (2014): 146. http://dx.doi.org/10.1071/sh13069.
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Introduction The treatment as prevention strategy has gained popularity as a way to reduce the incidence of HIV by suppressing viral load such that transmission risk is decreased. The effectiveness of the strategy also requires early diagnosis. Methods: Informed by data on the influence of diagnosis and treatment on reducing transmission risk, a model simulated the impact of increasing testing and treatment rates on the expected incidence of HIV in Australia under varying assumptions of treatment efficacy and risk compensation. The model utilises Australia’s National HIV Registry data, and simulates disease progression, testing, treatment, transmission and mortality. Results: Decreasing the average time between infection and diagnosis by 30% is expected to reduce population incidence by 12% (~126 cases per year, 95% confidence interval (CI): 82–198). Treatment of all people living with HIV with CD4 counts <500 cells μL–1 is expected to reduce new infections by 30.9% (95% CI: 15.9–37.6%) at 96% efficacy if no risk compensation occurs. The number of infections could increase up to 12.9% (95% CI: 20.1–7.4%) at 26% efficacy if a return to prediagnosis risk levels occur. Conclusion: Treatment as prevention has the potential to prevent HIV infections but its effectiveness depends on the efficacy outside trial settings among men who have sex with men and the level of risk compensation. If antiretroviral therapy has high efficacy, risk compensation will not greatly change the number of infections. If the efficacy of antiretroviral therapy is low, risk compensation could lead to increased infections.
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Greenfield, Thomas K., William C. Kerr, Jason Bond, Yu Ye, and Tim Stockwell. "Improving Graduated Frequencies Alcohol Measures for Monitoring Consumption Patterns: Results from an Australian National Survey and a US Diary Validity Study." Contemporary Drug Problems 36, no. 3-4 (September 2009): 705–33. http://dx.doi.org/10.1177/009145090903600320.
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We investigate several types of graduated frequency (GF) instruments for monitoring drinking patterns. Two studies with 12-month GF measures and daily data were used: (i) the Australian 2004 National Drug Strategy Household Survey (NDSHS) (n = 24,109 aged 12+; 22,546 with GF and over 8000 with yesterday data) and (ii) a US methodological study involving a 28-day daily diary plus GF summary measures drawn from the National Alcohol Survey (NAS) (n = 3,025 screened, 119 eligible study completers). The NDSHS involved (i) “drop and collect” self-completed forms with random sampling methods; the Measurement study (ii) screened 3+ drinkers by telephone and collected 28-day drinking diaries and pre- and post-diary 28-day GFs. We compared mean values for the GF quantity ranges from yesterday's drinks (study i) and 28-day diaries (study ii), also examining volume influence. Using “yesterday's” drinking, Australian results showed GF quantity range means close to arithmetic midpoints and volume effects only for the lowest two levels (1–2, and 3–4 drinks; p < .001). U.S. calibration results on the GF using 28-day diaries were similar, with a volume effect only at these low quantity levels (p < .001). Means for the highest quantity thresholds were 23.5 drinks for the 20+ (10 gram) drink level (Australia) and 15.5 drinks for the 12+ (14 g) drink level (US). In the US study, summary GF frequency and volume were highly consistent with diary-based counterparts. A conclusion is that algorithms for computing volume may be refined using validation data. We suggest measurement methods may be improved by taking better account of empirical drink ethanol content.
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Mitchell, Rebecca J., Kate Curtis, and Kim Foster. "A 10-year review of child injury hospitalisations, health outcomes and treatment costs in Australia." Injury Prevention 24, no. 5 (July 27, 2017): 344–50. http://dx.doi.org/10.1136/injuryprev-2017-042451.
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BackgroundChildhood injury is a leading cause of hospitalisation, yet there has been no comprehensive examination of child injury and survival over time in Australia. To examine the characteristics, temporal trend and survival for children who were hospitalised as a result of injury in Australia.MethodA retrospective examination of linked hospitalisation and mortality data for injured children aged 16 years or less during 1 July 2001 to 30 June 2012. Negative binomial regression examined change in injury hospitalisation trends. Cox proportional hazard regression examined the association of risk factors on 30-day survival.ResultsThere were 6 86 409 injury hospitalisations, with an age-standardised rate of 1489 per 1 00 000 population (95% CI 1485.3 to 1492.4) in Australia. Child injury hospitalisation rates did not change over the 10-year period. For every severely injured child, there are at least 13 children hospitalised with minor or moderate injuries. The total cost of child injury hospitalisations was $A2.1 billion (annually $A212 million). Falls (38.4%) were the most common injury mechanism. Factors associated with a higher risk of 30-day mortality were: child was aged ≤10 years, higher injury severity, head injury, injured in a transport incident or following drowning and submersion or other threats to breathing, during self-harm and usual residence was regional/remote Australia.ConclusionsChildhood injury hospitalisation rates have not reduced in 10 years. Children’s patterns of injury change with age, and priorities for injury prevention alter according to developmental stages. The development of a national multisectorial childhood injury monitoring and prevention strategy in Australia is long overdue.
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Darr, Jenifer Olive, Richard C. Franklin, Kristin Emma McBain-Rigg, Sarah Larkins, Yvette Roe, Kathryn Panaretto, Vicki Saunders, and Melissa Crowe. "Quality management systems in Aboriginal Community Controlled Health Services: a review of the literature." BMJ Open Quality 10, no. 3 (July 2021): e001091. http://dx.doi.org/10.1136/bmjoq-2020-001091.
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BackgroundA national accreditation policy for the Australian primary healthcare (PHC) system was initiated in 2008. While certification standards are mandatory, little is known about their effects on the efficiency and sustainability of organisations, particularly in the Aboriginal Community Controlled Health Service (ACCHS) sector.AimThe literature review aims to answer the following: to what extent does the implementation of the International Organisation for Standardization 9001:2008 quality management system (QMS) facilitate efficiency and sustainability in the ACCHS sector?MethodsThematic analysis of peer-reviewed and grey literature was undertaken from Australia and New Zealand PHC sector with a focus on First Nations people. The databases searched included Medline, Scopus and three Informit sites (AHB-ATSIS, AEI-ATSIS and AGIS-ATSIS). The initial search strategy included quality improvement, continuous quality improvement, efficiency and sustainability.ResultsSixteen included studies were assessed for quality using the McMaster criteria. The studies were ranked against the criteria of credibility, transferability, dependability and confirmability. Three central themes emerged: accreditation (n=4), quality improvement (n=9) and systems strengthening (n=3). The accreditation theme included effects on health service expenditure and clinical outcomes, consistency and validity of accreditation standards and linkages to clinical governance frameworks. The quality improvement theme included audit effectiveness and value for specific population health. The theme of systems strengthening included prerequisite systems and embedded clinical governance measures for innovative models of care.ConclusionThe ACCHS sector warrants reliable evidence to understand the value of QMSs and enhancement tools, particularly given ACCHS (client-centric) services and their specialist status. Limited evidence exists for the value of standards on health system sustainability and efficiency in Australia. Despite a mandatory second certification standard, no studies reported on sustainability and efficiency of a QMS in PHC.
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Ash, Thalia, Lester Mascarenhas, John Furler, and Meredith Temple-Smith. "Hepatitis B contact tracing: what works?" Australian Journal of Primary Health 24, no. 6 (2018): 470. http://dx.doi.org/10.1071/py17087.
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In 2012, over 239000 people were living in Australia with chronic hepatitis B (CHB). Australia’s Second National Hepatitis B Strategy (2014) recommends testing contacts to increase identification of people with CHB, but it is generally poorly performed. CHB prevalence in Australia is increasing and contact tracing (CT) remains an untapped strategy for identifying infected individuals. A systematic CT system has been established in a government-funded primary health centre in Melbourne, which services 2000 refugees. This mixed-methods study aimed to describe the structure of the CT system, determine its effectiveness and identify enablers of success. The CT system’s structure was elicited from field notes. CT effectiveness (proportion of contacts traced and serologically confirmed as infected or immune to HBV) was determined by auditing clinical records. Semi-structured interviews with seven health professionals were thematically analysed to identify enablers of CT success. Overall, 122 CHB index cases had 420 contacts. And 90.0% (n=380) of 420 contacts were successfully traced, 68.0% (n=83) of index cases had 100% of their contacts successfully traced and 80.7% (n=339) of all contacts were immune; 28.8% (n=121) had evidence of previous exposure and 55.0% (n=231) had evidence of vaccination. Also, 8.1% (n=34) were chronically infected. Interviews elicited seven themes important to the success of the CT system: Teamwork; Organisation; Health professional expertise; Patient education; Centralisation of the system; Influence of patient culture; and Use of nurses in CT. Teamwork and Organisation were previously unidentified in the literature. This CT system is successful and could be implemented elsewhere, provided an organised, cohesive, nurse-led team is established.
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Giglia, Roslyn Carmel, and Tracy Reibel. "Has a national policy guideline influenced the practice of raising the topic of alcohol and breastfeeding by maternal healthcare practitioners?" Australian Journal of Primary Health 25, no. 3 (2019): 275. http://dx.doi.org/10.1071/py18103.
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Globally, the public health recommendation for exclusive breastfeeding to the first 6 months of life is not being achieved by many low- and middle-income countries. Many factors have been determined to affect the early cessation of breastfeeding; however, little attention has been paid to the role of alcohol, an increasingly favoured commodity, particularly in these Westernised nations. Maternal healthcare practitioners play a pivotal role in a woman’s breastfeeding journey by providing timely advice that can help support continued breastfeeding. Maternal healthcare practitioners (MHP) from across Australia were invited to take part in a semi-structured telephone interview (n = 19) to elicit their knowledge of a national alcohol policy guideline on alcohol and breastfeeding, their confidence to provide information on this topic, and if they were routinely incorporating conversations on alcohol and breastfeeding into their practice. The results affirmed that the majority of MHP were not aware of the national policy providing direction for safely consuming alcohol during lactation and were not incorporating this information into their practice. This study suggests having a national policy guideline for safe alcohol consumption during lactation has not promoted awareness of this topic among MHP as a potential strategy to support long-term breastfeeding duration.
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Brown, Lynsey J., and Ellen L. McIntyre. "The contribution of Primary Health Care Research, Evaluation and Development-supported research to primary health care policy and practice." Australian Journal of Primary Health 20, no. 1 (2014): 47. http://dx.doi.org/10.1071/py12058.
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The importance of primary health care (PHC) research is well understood yet conducting this research can be challenging. Barriers include a lack of funding, support and opportunity. In 2000 the Australian government introduced the Primary Health Care Research, Evaluation and Development (PHCRED) Strategy to address the gap in high-quality research. One component of the strategy, the Research Capacity Building Initiative, provided funding to university departments of general practice and rural health, allowing them to expand their pool of researchers and produce more research relevant to policy and practice. This study investigates the impact of phase two of the PHCRED Strategy by analysing peer-reviewed publications from PHCRED-supported departments. Research output was recorded from 2006 to 2010 incorporating 661 publications in 212 journals. Rural departments often had fewer resources than urban departments yet demonstrated steady research contributions focusing on issues relevant to their community. Since its inception the PHCRED Strategy has enabled development of research capacity and contributed to the body of PHC knowledge. While PHC is a diverse field, reflected in the publications produced, the themes underlying much of this work were representative of current health reform and the priority areas and building blocks of the National PHC Strategy.
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Olsen, Anna, Jack Wallace, and Lisa Maher. "Responding to Australia's National Hepatitis B Strategy 2010–13: gaps in knowledge and practice in relation to Indigenous Australians." Australian Journal of Primary Health 20, no. 2 (2014): 134. http://dx.doi.org/10.1071/py12162.
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The Australian National Hepatitis B Strategy 2010–13 outlines five priority areas for developing a comprehensive response to the hepatitis B virus (HBV): building partnerships and strengthening community action; preventing HBV transmission; optimising diagnosis and screening; clinical management of people with chronic hepatitis B (CHB); and developing health maintenance, care and support for people with HBV. A scoping study was used to map the main sources and types of evidence available on the epidemiology and natural history of HBV among Indigenous Australians as well as public health responses published since 2001 (January 2001–May 2013). Gaps in current knowledge were identified. While the literature documents the success of universal infant immunisation and indicates the potential for screening initiatives to identify infected and susceptible individuals, prevalence of CHB and hepatocellular cancer remain high in Indigenous Australians. Significant gaps in knowledge and practice were identified in relation to each of the five National Hepatitis B Strategy priority action areas. Successful implementation of the strategy in Indigenous communities and reducing the burden of HBV and hepatocellular cancer in Indigenous Australians will require increased investment in research and knowledge transfer across all priority areas.
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Kang, M., A. Rochford, A. Mindel, S. R. Skinner, M. Webb, L. Hillier, and T. Usherwood. "12. YOUNG PEOPLE GET CLUED UP ABOUT CHLAMYDIA: AN INTERNET BASED RANDOMISED CONTROLLED TRIAL." Sexual Health 4, no. 4 (2007): 289. http://dx.doi.org/10.1071/shv4n4ab12.
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Young people (16-25 years) are a target group for the prevention of Chlamydia trachomatis in the Australian national STI strategy. This study is a randomized controlled trial of an innovative internet-based intervention which aims to increase Chlamydia testing and treatment among at risk young people living in Australia. Study participation is via a website developed in consultation with young people and linked to an evaluated health promotion website. Young people in the intervention group receive personalised, confidential emails from a nurse or doctor while those in the control group receive automated emails. Follow up at 6 months will measure self-reported Chlamydia testing and other outcomes. By 5 June 2007, 359 young people of a target sample of 1000 were enrolled (83% female). Mean age is 20 years (range 16-25). Participants reside across all states and territories. Thirty percent of participants in the intervention group are in active email dialogue with the research nurse, e.g. “The research and...site was...really good,...it's kinda scared me into getting a test and just to get over the embarrassment... will the test be able to be part of just a normal appointment?” Zero participants in the control group have responded to the automated email. Baseline data and examples of the email interaction will be presented.
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Edgar, B., N. Schofield, and A. Campbell. "Informing river management policies and programs with science." Water Science and Technology 43, no. 9 (May 1, 2001): 185–95. http://dx.doi.org/10.2166/wst.2001.0536.
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Conventional wisdom has it that we already have enough science to address the problems causing degradation of our environment, including rivers. This is not true. However it is the case that we could be using existing knowledge better, and that we could be doing more to learn the lessons from the huge sums being spent on river restoration and management. Informing good policy and practical on-ground management with R&D outputs has proven to be is difficult, but essential. This paper reviews some of the history of water and river management in Australia and how perceptions of rivers have evolved. It discusses the challenge of enhancing the linkages between science, policy and practice in river management. It outlines the knowledge exchange, R&D and capacity building strategies of the National Rivers Consortium - a new initiative whose founding partners are LWRRDC, the MDBC, CSIRO Land and Water and the Western Australian Waters and Rivers Commission. This strategic collaboration between policy makers, river managers and scientists brings together organisations with responsibility and expertise to improve the health and management of Australian rivers. The National Rivers Consortium is making a major investment in knowledge exchange and capacity building, based on direct personal contact and learning by doing. The Consortium is establishing a program of training activities targeting river managers and policy makers, based on the best available science and high quality information products. It will support river managers as they plan and implement river restoration and protection projects. The paper concludes with a discussion of the key knowledge gaps that remain impediments to the better management of Australia's unique and diverse river landscapes.
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Biggs, Laura J., Helen L. McLachlan, Touran Shafiei, Rhonda Small, and Della A. Forster. "Peer supporters’ experiences on an Australian perinatal mental health helpline." Health Promotion International 34, no. 3 (January 16, 2018): 479–89. http://dx.doi.org/10.1093/heapro/dax097.
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SummaryPerinatal mental health is an important public health issue, and peer support is a potentially important strategy for emotional well-being in the perinatal period. PANDA Perinatal Anxiety & Depression Australia provides support to individuals impacted by perinatal mental health issues via the National Perinatal Anxiety & Depression Helpline. Callers receive peer support from volunteers and counselling from paid professional staff. The views and experiences of PANDA peer support volunteers have not previously been studied. We conducted two focus groups and an online survey to explore the experiences of women providing volunteer peer support on the Helpline. Data collection took place in October and November 2013. Two social theories were used in framing and addressing the study aims and in interpreting our findings: the Empathy–Altruism Hypothesis, and the Helper Therapy Principle. All PANDA volunteers were invited to participate (n = 40). Eight volunteers attended a focus group, and 11 survey responses were received. Descriptive statistics were used to analyse quantitative data. All survey respondents ‘strongly agreed’ that they felt positive about being part of PANDA. Thematic analysis of data from focus groups and open-ended survey responses identified the following themes: motivated to help others, supported to support callers, helping to make a difference and emotional impacts for volunteers. Respondents described a strong desire to support others experiencing emotional distress as a motivator to volunteer. Although perinatal peer support services are designed to benefit those who receive support, this study suggests volunteers may also experience personal benefits from the role.
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Nagel, Tricia, Gary Robinson, Thomas Trauer, and John Condon. "An Approach to Treating Depressive and Psychotic Illness in Indigenous Communities." Australian Journal of Primary Health 14, no. 1 (2008): 17. http://dx.doi.org/10.1071/py08003.
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This study is one of the activities of a multi-site research program, the Australian Mental Health Initiative (AIMhi), funded by the National Health and Medical Research Council. AIMhi in the Northern Territory collaborated with Aboriginal mental health workers and Northern Territory remote service providers in developing a range of resources and strategies to promote improved Indigenous mental health outcomes. A brief intervention that combines the principles of motivational interviewing, problem solving therapy and chronic disease self-management is described. The intervention has been integrated into a randomised controlled trial. Early findings suggest that the strategy and its components are well received by clients with chronic mental illness, and their carers, in remote communities.
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McConachy, Diana, and Karalyn McDonald. "Issues for Primary, Informal, Home-based Carers of People Living with AIDS." Australian Journal of Primary Health 5, no. 1 (1999): 30. http://dx.doi.org/10.1071/py99004.
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Central to the Australian national strategic response to HIV/AIDS is the need for training and support for volunteer carers of people with HIV/AIDS. However, the role of primary, informal, home-based carers of people with AIDS (PWA) is not clearly defined and the research about carers undertaken in Australia has not specifically looked at this group. The aim of the study described was to examine the experiences of primary, home-based carers of people with AIDS in order to inform policy and program development. Data were collected from 47 carers in New South Wales and Victoria between August and November, 1996. A short self-administered questionnaire collecting demographic information was followed by a longer questionnaire with mostly closed questions on preparation for caregiving, caregiving tasks, symptom management, service use, coping strategies, and impact of caregiving. Open-ended questions were about the provision of emotional support by the carer to the PWA, the carer's health and positive aspects of caregiving. Two key findings emerge from the content and thematic analyses. The first relates to the study respondents, who differ from the national profile of informal carers in two areas, gender and age. The second relates to the diverse nature of the caregiving experience, including the vast array of symptoms and diseases that an AIDS diagnosis can entail, the complexity of the relationship between the carer and care recipient and the experience of multiple caregiving. These findings highlight the difficulty in identifying simple, singular strategies for carer support and information.
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Briggs, David. "In This Issue." Asia Pacific Journal of Health Management 16, no. 1 (February 28, 2021): 1. http://dx.doi.org/10.24083/apjhm.v16i1.695.
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This issue of the journal commences with an editorial that provides some discussion about the current approaches to Covid and the tensions that exists in that context..... Editorial SettingsCovid-19: A strife of interests for us all and what problem are we attempting to solve? Research Articles Gender Equity in Australian Health Leadership Research Articles Assessing Quality of Healthcare Delivery When Making Choices: National Survey on Health Consumers’ Decision Making Practices Research Articles The Case for a Reciprocal Health Care Agreement between Australia and South Korea Commentary COVID-19 and Working Within Health Care Systems: the future is flexible Review Articles Review of Public Private Partnership in the Health Care in Hong Kong Viewpoint Article Hong Kong’s Growing Need for Palliative Care Services and the Role of the Nursing Profession Commentary Vietnam’s Healthcare System Decentralization: how well does it respond to global health crises such as covid-19 pandemic? Research Articles Publicly Financed Health Insurance Schemes and Horizontal Inequity in Inpatient Service Use in India Research Articles Distress and Quality of Life among Type II Diabetic Patients: Role of physical activity Viewpoint Article Achievements and Challenges of Iran Health System after Islamic Revolution: Structural reforms at the second step Research Articles Strategic Analysis of Community Participation in Primary Health Care in Iran and Presentation of Promotion Strategies Using Internal and External Environment Assessment Techniques Research Articles Utilization of Healthcare Services & Healthcare Expenditure Patterns in the Rural Households of Nepal
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Goode, N., C. Spencer, F. Archer, D. McArdle, PM Salmon, and R. McClure. "HAVE WE LEARNT THE LESSONS FROM DISASTER INQUIRIES? THEMES FROM RECENT AUSTRALIAN DISASTER INQUIRIES IN THE CONTEXT OF THE NATIONAL STRATEGY FOR DISASTER RESILIENCE." Injury Prevention 18, Suppl 1 (October 2012): A75.2—A75. http://dx.doi.org/10.1136/injuryprev-2012-040580g.10.
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Abal, E. G., W. C. Dennison, and P. F. Greenfield. "Managing the Brisbane River and Moreton Bay: an integrated research/management program to reduce impacts on an Australian estuary." Water Science and Technology 43, no. 9 (May 1, 2001): 57–70. http://dx.doi.org/10.2166/wst.2001.0508.
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The Brisbane River and Moreton Bay Study, an interdisciplinary study of Moreton Bay and its major tributaries, was initiated to address water quality issues which link sewage and diffuse loading with environmental degradation. Runoff and deposition of fine-grained sediments into Moreton Bay, followed by resuspension, have been linked with increased turbidity and significant loss of seagrass habitat. Sewage-derived nutrient enrichment, particularly nitrogen (N), has been linked to algal blooms by sewage plume maps. Blooms of a marine cyanobacterium, Lyngbya majuscula, in Moreton Bay have resulted in significant impacts on human health (e.g., contact dermatitis) and ecological health (e.g., seagrass loss), and the availability of dissolved iron from acid sulfate soil runoff has been hypothesised. The impacts of catchment activities resulting in runoff of sediments, nutrients and dissolved iron on the health of the Moreton Bay waterways are addressed. The Study, established by 6 local councils in association with two state departments in 1994, forms a regional component of a national and state program to achieve ecologically sustainable use of the waterways by protecting and enhancing their health, while maintaining economic and social development. The Study framework illustrates a unique integrated approach to water quality management whereby scientific research, community participation and the strategy development were done in parallel with each other. This collaborative effort resulted in a water quality management strategy which focuses on the integration of socioeconomic and ecological values of the waterways. This work has led to significant cost savings in infrastructure by providing a clear focus on initiatives towards achieving healthy waterways. The Study's Stage 2 initiatives form the basis for this paper.
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Haskins, Robin, Judith M. Henderson, and Nikolai Bogduk. "Health professional consultation and use of conservative management strategies in patients with knee or hip osteoarthritis awaiting orthopaedic consultation." Australian Journal of Primary Health 20, no. 3 (2014): 305. http://dx.doi.org/10.1071/py13064.
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The aim of this study was to determine the extent to which patients with hip and knee osteoarthritis (OA) referred for orthopaedic consultation at a large Australian public hospital reported using conservative management strategies as recommended by current practice guidelines. A therapist-assisted questionnaire was employed within the context of a standard physiotherapy assessment in a consecutive cohort of patients with hip or knee OA. Two hundred and two patients with hip or knee OA comprised the included sample. Thirty-nine percent (n = 79) reported having only previously consulted their general practitioner. Only 20% (n = 41) felt that they had been sufficiently educated about the diagnosis, their treatment options and prognosis. Thirty-three percent (n = 66) had not previously engaged in any non-pharmacological management strategy considered a core clinical practice guideline recommendation. The findings of this study suggest that several inconsistencies may exist between current Australian clinical practice and OA clinical guideline recommendations. Identification of the barriers to the use of conservative management requires timely investigation coupled with a national implementation framework to support the translation of guideline recommendations into practice.
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Perkins, David, and David Lyle. "Is the Far West Mental Health Integration Project Making a Difference? The General Practitioner Perspective." Australian Journal of Primary Health 11, no. 3 (2005): 32. http://dx.doi.org/10.1071/py05040.
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This paper reports on the evaluation of an Australian Government and NSW State funded Mental Health Integration Project in remote far western NSW. The project was part of the Mental Health Integration Program, developed from the Second National Mental Health Plan. The project implemented a model of community-based mental health services and used innovative financing arrangements to allow the provision of community-based specialist mental health teams to remote communities and to recruit visiting psychiatrists to support the local primary care providers. The evaluation strategy included a survey of general practitioners (GPs) in the Upper Western Sector and Broken Hill, designed to investigate their level and type of contact with psychiatrists and community-based specialist mental health care teams, their perceptions about the impact of the new services, and their interest in further professional development in mental health care.The project has shown that visiting specialists can be deployed in a primary care setting with a focus on meeting the needs of local GPs, primary health care staff and their patients.
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Treloar, Susan A., Christine A. McDonald, and Nicholas G. Martin. "Genetics of early cancer detection behaviours in Australian female twins." Twin Research 2, no. 1 (February 1, 1999): 33–42. http://dx.doi.org/10.1375/twin.2.1.33.
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AbstractEarly detection of cervical and breast cancers is an important component of women's health strategy. Screening programmes, health professional interventions and preventive behaviours such as breast self-examination provide the means to this end. Our twin study sought to identify the relative influence of environmental and genetic factors on liability to early cancer detection behaviours, including use of cervical smear tests, mammograms, and breast examination. Additive genetic and random environmental effects models gave the best, most parsimonious fit to the data for each early cancer detection behaviour. The heritability of liability to Pap smear use was 66%, mammogram use 50%, breast examination by a doctor or nurse 38% and breast self-examination 37%. Genetic influences were behaviour-specific; there was no evidence for a common genetic influence on the four behaviours. Potential covariates investigated included age, amount of contact between co-twins, educational level and personality traits such as harm avoidance, novelty seeking, reward dependence, neuroticism, anxiety, depression, self-esteem, perceived control, interpersonal dependency and ways of coping. None were significant. The study was carried out before the implementation of national screening programmes with media campaigns to increase participation rates. Hence follow-up investigation, including data on regularity of behaviours, would be informative
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Siahpush, M., G. Heller, and G. Singh. "Lower levels of occupation, income and education are strongly associated with a longer smoking duration: Multivariate results from the 2001 Australian National Drug Strategy Survey." Public Health 119, no. 12 (December 2005): 1105–10. http://dx.doi.org/10.1016/j.puhe.2005.03.004.
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Townsend, Belinda, Sharon Friel, Phillip Baker, Fran Baum, and Lyndall Strazdins. "How can multiple frames enable action on social determinants? Lessons from Australia’s paid parental leave." Health Promotion International 35, no. 5 (September 16, 2019): 973–83. http://dx.doi.org/10.1093/heapro/daz086.
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Abstract How do public health advocates and practitioners encourage policy actors to address the social determinants of health? What strategies can be used to elevate healthy social policies onto government agendas? In this paper, we examine the case of Australia’s first national paid parental leave scheme, announced in 2009 after decades of policy advocacy. This scheme provides job-protected leave and government-funded pay at the minimum wage for 18 weeks for eligible primary care givers on the birth of an infant, and has been shown to reduce health inequities. Drawing on documentary sources and interviews (n = 25) with key policy actors, this paper traces the evolution of this landmark social policy in Australia, focusing on the role of actors, institutions and policy framings in setting the policy agenda. We find that advocates strategically deployed three different framings—for economy, gender equality and health—to drive paid parental leave onto the Government’s agenda. They navigated barriers linked to power, gender ideology and cost, shifting tactics along the way by adopting different frames in various institutional settings and broadening their coalitions. Health arguments varied in different institutional settings and, at times, advocates selectively argued the economic or gender equality framing over health. The case illustrates the successful use of strategic pragmatism to provoke action, and raises broader lessons for advancing action on the social determinants of health. In particular, the case highlights the importance of adopting multiple synergistic policy framings to draw support from non-traditional allies and building coalitions to secure public policy change.
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Spokes, P., M. Bartlett, and K. Stewart. "19. INFECTIOUS SYPHILIS ELIMINATION FOR ABORIGINAL PEOPLE IN NSW: CHALLENGES AND OPPORTUNITIES." Sexual Health 4, no. 4 (2007): 292. http://dx.doi.org/10.1071/shv4n4ab19.
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Elimination of syphilis within Aboriginal communities is one of the stated goals of the NSW Sexually Transmissible Infections Strategy 2006-2009. In 2007, a project was undertaken to inform strategy development to achieve the goal of elimination of infectious syphilis in Aboriginal communities. Australian and international literature on elimination strategies for syphilis, STIs and other diseases was reviewed. Surveillance data were accessed through the National Notifiable Diseases Surveillance System and NSW Notifiable Disease Database and analysed to describe the current burden of disease. Key informants were consulted for advice on elimination strategies for infectious syphilis for Aboriginal people and possible barriers to the goal. Infectious syphilis notifications for Aboriginal people have decreased significantly from 64% of all infectious syphilis cases in 1995 to 3% in 2006. For the rest of the population notifications have increased. Changes in male to female ratios and an increase in metropolitan notifications have been noted in recent years. Improvements in recording of Aboriginality information for infectious syphilis in NSW have allowed greater confidence in interpreting these trends. The role of accurate and complete surveillance information will play an important role in planning and directing the implementation of interventions to achieve the goal of syphilis elimination for Aboriginal people in NSW. Challenges to the goal of elimination and the feasibility of a disease elimination strategy specific for Aboriginal people include issues of access to services for testing, diagnosis and treatment; cross-border mobility of Aboriginal people; prevalence of syphilis in the wider community; and continued access to accurate information. Lessons learned from international and Australian elimination strategies; burden of disease information; definition of elimination and target rates; challenges and strategies for achieving the goal of syphilis elimination and will be discussed.
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Giles, Glenn, Merridy Malin, and Peter Harvey. "The Centre of Clinical Research Excellence in Aboriginal and Torres Strait Islander Health: An Operational Rationale and Some Reflections on Progress so far." Australian Journal of Primary Health 12, no. 2 (2006): 97. http://dx.doi.org/10.1071/py06028.
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The Centre of Clinical Research Excellence (CCRE) in Aboriginal and Torres Strait Islander Health was established in late 2003 through a major National Health and Medical Research Council (NHMRC) grant involving collaboration between the Aboriginal Health Council of South Australia (AHCSA), Flinders University, and Aboriginal Health Services. Our foundation research communities are the Aboriginal communities served by these Aboriginal Health Services in the Spencer Gulf / Eyre Peninsula region. In recent years a number of collaborative research programs involving chronic illness management, self-management and coordinated care have been implemented in these communities and this work is the basis of the initial CCRE activities. Key objectives of the CCRE are to improve the health status of Indigenous people through conducting relevant and meaningful Aboriginal controlled health research, providing formal training for Indigenous health researchers and developing innovative approaches to health care that can be readily translated and applied to support communities. The inclusion, empowerment and engagement of Indigenous people in the process of managing community health represent tangible strategies for achieving more equitable health outcomes for Aboriginal people. This paper outlines the CCRE operational rationale and presents early activities and outcomes across the three strategic areas of CCRE operations: research, education and training, and translation. Some critical reflections are offered on the progress and experience of the CCRE thus far. A common obstacle this CCRE has encountered is that the limited (especially staff) resources available to the Aboriginal Health Services with which we are collaborating make it difficult for them to engage with and progress the projects we are pursuing.
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Mills, SL, and E. Vanden. "Workshop report - International roundtable on the self-management support of chronic conditions." Chronic Diseases and Injuries in Canada 31, no. 4 (September 2011): 176–79. http://dx.doi.org/10.24095/hpcdp.31.4.07.
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An international roundtable on self-management support (SMS) for persons living with chronic conditions (CCs) was held in Vancouver, Canada, in June 2009. It brought together 23 leading researchers, policy makers, health care practitioners and consumers from Canada, Australia, New Zealand, the United Kingdom and the United States. It also provided a forum for critically reflecting on SMS approaches and for building consensus on how to move forward in the self-management field. The deliberations resulted in a draft international framework that identifies key definitions, principles and strategic directions and also outlines sample strategies to guide those working to develop SMS capacities at the local, regional or national level. The framework is a mechanism for knowledge exchange that will hopefully act as a catalyst to shift SMS-related policy, practice and research directions to better serve the needs of all CC populations. More than 400 multi-level stakeholders in the Canadian and international community have been invited to review the framework using an e-consultation process. The final framework is scheduled for release in the late fall of 2011.
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Lim, Hok, Lena Sanci, Susan Webster, Alyce N. Wilson, and Phyllis Lau. "‘No-Frills Prils’: GPs’ views on drug costs and therapeutic interchange of angiotensin-converting enzyme inhibitors: a qualitative study." Australian Journal of Primary Health 27, no. 2 (2021): 152. http://dx.doi.org/10.1071/py20208.
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Medications form a significant portion of spending in primary health care. Angiotensin-converting enzyme inhibitors (ACE-Is) are among the most prescribed blood pressure medications in general practice. Medications within this class are considered therapeutically equivalent, but the cost of each ACE-I varies. Our aim was to explore cost and other factors that influence general practitioners (GPs) to prescribe a specific ACE-I and understand their views on therapeutic interchange within this drug class. We conducted a qualitative study of Australian GPs using thematic analysis. We found that GPs were aware of therapeutic equivalency within the ACE-I class, but unaware of the cost differences. Although GPs tended to adopt a prescribing preference, they were open to fewer prescribing options if there was a decreased cost to patients and the PBS, or potential to minimise prescribing error. Our findings have immediate relevance for national prescribing policies and the Pharmaceutical Benefits Scheme (PBS). The wide selection of ACE-Is that are available results in diverse prescribing patterns and may not be cost-effective for patients or the PBS. Restricting the number of drug options within the ACE-I class in primary care appears to be an acceptable drug cost-containment strategy according to our sample of GPs.
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Girgis, Afaf, Philip Clarke, Robert C. Burton, and Rob W. Sanson—Fisher. "Screening for Melanoma by Primary Health Care Physicians: A Cost—Effectiveness Analysis." Journal of Medical Screening 3, no. 1 (March 1996): 47–53. http://dx.doi.org/10.1177/096914139600300112.
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Background and design— Australia has the highest rates of skin cancer in the world, and the incidence is estimated to be doubling every 10 years. Despite advances in the early detection and treatment of melanoma about 800 people still die nationally of the disease each year. A possible strategy for further reducing the mortality from melanoma is an organised programme of population screening for unsuspected lesions in asymptomatic people. Arguments against introducing melanoma screening have been based on cost and the lack of reliable data on the efficacy of any screening tests. To date, however, there has been no systematic economic assessment of the cost effectiveness of melanoma screening. The purpose of this research was to determine whether screening may be potentially cost effective and, therefore, warrants further investigation. A computer was used to simulate the effects of a hypothetical melanoma screening programme that was in operation for 20 years, using cohorts of Australians aged 50 at the start of the programme. Based on this simulation, cost—effectiveness estimates of melanoma screening were calculated. Results— Under the standard assumptions used in the model, and setting the sensitivity of the screening test (visual inspection of the skin) at 60%, cost effectiveness ranged from Aust$6853 per life year saved for men if screening was undertaken five yearly to $12137 if screening was two yearly. For women, it ranged from $11 102 for five yearly screening to $20 877 for two yearly screening. Conclusion— The analysis suggests that a melanoma screening programme could be cost effective, particularly if five yearly screening is implemented by family practitioners for men over the age of 50.
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van Gemert, Caroline, Wayne Dimech, Mark Stoove, Rebecca Guy, Jess Howell, Scott Bowden, Suellen Nicholson, et al. "Tracking the uptake of outcomes of hepatitis B virus testing using laboratory data in Victoria, 2011–16: a population-level cohort study." Sexual Health 16, no. 4 (2019): 358. http://dx.doi.org/10.1071/sh18102.
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Background A priority area in the 2016 Victorian Hepatitis B Strategy is to increase diagnostic testing. This study describes hepatitis B testing and positivity trends in Victoria between 2011 and 2016 using data from a national laboratory sentinel surveillance system. Methods: Line-listed diagnostic and monitoring hepatitis B testing data among Victorian individuals were collated from six laboratories participating in the Australian Collaboration for Coordinated Enhanced Sentinel Surveillance (ACCESS) of sexually transmissible infections and blood-borne viruses. Diagnostic tests included hepatitis B surface antigen (HBsAg)-only tests and guideline-based hepatitis B tests (defined as a single test event for HBsAg, hepatitis B surface antibody and hepatitis B core antibody). Using available data, the outcomes of testing and/or infection were further classified. Measures reported include the total number of HBsAg and guideline-based tests conducted and the proportion positive, classified as either HBsAg positive or chronic hepatitis B infection. Results: The number of HBsAg tests decreased slightly each year between 2011 and 2016 (from 91043 in 2011 to 79664 in 2016; P < 0.001), whereas the number of guideline-based hepatitis B tests increased (from 8732 in 2011 to 16085 in 2016; P <0.001). The proportion of individuals classified as having chronic infection decreased from 25% in 2011 to 7% in 2016, whereas the proportion classified as susceptible and immune due to vaccination increased (from 29% to 39%, and from 27% to 34%, respectively; P < 0.001). Conclusions: The study findings indicate an increased uptake of guideline-based hepatitis B testing. The ongoing collection of testing data can help monitor progress towards implementation of the Victorian Hepatitis B Strategy.
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Borisova, Daria S., Gennadiy B. Yeremin, Anton M. Nikulenkov, and Natalya A. Mozzhukhina. "Foreign legislation in the field of drinking groundwater protection (literature review)." Hygiene and sanitation 100, no. 8 (August 31, 2021): 797–802. http://dx.doi.org/10.47470/0016-9900-2021-100-8-797-802.
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The need to protect underground sources of drinking and household water supply. Many reasons, including climatic changes, an increase in anthropogenic pressure, and an increase in the need for drinking water, dictate the need to protect underground sources of drinking and domestic water supply. The USSR was the pioneer in the field of drinking water protection in the world. Already in 1956, USSR put an instruction on the establishment of sanitary protection zones (SPZ) into effect. The United States took the first steps in resolving this issue only seven years later. Along with Soviet developments, the USA and German guidelines are still fundamental and contain fundamental recommendations for groundwater protection. The requirements related to the protection of water intakes in the legislative acts of various states have been implemented at the international level (Directive 2000/60 / EU, Directive 2006/118 / EU), nationally (Australian National Strategy, USA Safe Drinking Water Law, PRC Law on Drinking Water Pollution Prevention and Control) and Local Levels (New Jersey safeguard zone (SGZ) Guidelines). Among the standard features is the allocation of belts in the S with different permitted use regimes: belt I (strict regime) - 10-50 m, belt II -50 days -10 years, belt III - the entire catchment area. Conclusions. Despite the fact that each country uses different approaches to protecting groundwater, in general, there is a similarity in the establishment and organization of SGZ for groundwater intakes, in which certain activities are prohibited or restricted. In the Russian Federation, it seems important to formalize the results of scientific research and existing experience in the protection of underground sources of drinking water supply in the form of Guidelines to allow ensuring optimal management of drinking water resources and preserve the quality of drinking water, to guarantee their availability in the future.
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Taylor, S., A. Cairns, and B. Glass. "Application of the PRECEDE-PROCEED model for the development of a community pharmacy ear health intervention for rural populations." International Journal of Pharmacy Practice 29, Supplement_1 (March 26, 2021): i14—i15. http://dx.doi.org/10.1093/ijpp/riab016.018.
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Abstract Introduction The World Health Organisation has identified ear disease to be a major public health problem in rural and remote communities, with access to services an identified barrier. (1) Rural community pharmacists are recognised as highly skilled, accessible and trusted health professionals. An innovative service “LISTEN UP” (Locally Integrated Screening and Testing Ear aNd aUral Program) has been implemented in two remote community pharmacies in Australia. The service involves patients with an ear complaint self-presenting to a participating pharmacy and receiving a clinical examination by a pharmacist, who has completed accredited training in ear health, otoscopy and tympanometry. “LISTEN UP” has been developed using the PRECEDE-PROCEED planning model.(2) The PRECEDE component of the model assesses social, epidemiological, behavioural, environmental, educational and ecological factors to inform the development of an intervention.(2) The PROCEED-component consists of pilot testing and evaluation. Aim To describe an ecological approach to health promotion via the application of the PRECEDE-PROCEED planning model to develop a rural community pharmacy-based ear health intervention. Methods PRECEDE (Predisposing, Reinforcing, and Enabling Constructs in Educational Diagnosis) provided a framework to plan and develop a locally relevant and community focused program. This included research and engagement via meetings, surveys and interviews of consumers, pharmacists, health professionals and stakeholders. PROCEED (Policy, Regulatory, and Organisational Constructs in Educational and Environmental Development) outlined the structure for implementing and evaluating the intervention that was developed in the PRECEDE process. A pilot study has been included in PROCEED segment to allow improvement before implementing and evaluating the final model. Data will be collected in the pilot study via semi-structured interviews and surveys. This will be analysed using descriptive statistics and thematic analysis of qualitative data. Results As part of the PRECEDE segment a social assessment was undertaken via mixed method studies of rural consumers, pharmacists and health professionals. Hearing testing was ranked as the seventh (from twenty-six) most important expanded pharmacy service by both consumer and health professional groups. An epidemiological assessment found extensive ear disease in rural and remote locations resulting in complications and hearing loss. Behavioural and environment assessments identified eleven ear health interventions which include hearing screening [3], otoscopy pilot studies [2], audiometry services [1], specific education for undergraduate pharmacy students [2] and a pharmacy-based clinic [3]. However none of the interventions described a framework for continued service provision. Policy and regulation assessment was undertaken to align the intervention within the regulatory framework. The application of this model is partially complete with the study protocol for the intervention developed and the initial pilot study in progress. This study’s strengths include its applicability to rural populations and the limited evidence base that currently exists. It is however limited by the small size of the pilot study and application of this model to a national intervention would be useful for future. Conclusions The application of the PRECEDE-PROCEED model demonstrates the applicability of this planning model for developing and evaluating an ear health intervention with a particular focus on community pharmacies in rural and remote locations. References 1. World Health Organisation. Deafness and hearing loss; 2020. Available from: https://www.who.int/health-topics/hearing-loss#tab=tab_1 [Accessed: 15/9/2020] 2. Binkley CJ, Johnson KW. Application of the PRECEDE-PROCEED Planning Model in Designing an Oral Health Strategy. J Theory Pract Dent Public Health. 2013;1(3):http://www.sharmilachatterjee.com/ojs-2.3.8/index.php/JTPDPH/article/view/89
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Smith, James. "A National Men’s Health Strategy in Australia: Tips for Implementation." International Journal of Mens Social and Community Health 1, no. 1 (October 22, 2018): e15-e21. http://dx.doi.org/10.22374/ijmsch.v1i1.15.
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Robinson, Jo, Patrick McGorry, Meredith G. Harris, Jane Pirkis, Philip Burgess, Ian Hickie, and Alan Headey. "Australia's National Suicide Prevention Strategy: the next chapter." Australian Health Review 30, no. 3 (2006): 271. http://dx.doi.org/10.1071/ah060271.
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Australia?s National Suicide Prevention Strategy (NSPS) is about to move into a new funding phase. In this context this paper considers the emphasis of the NSPS since its inception in 1999. Certain high-risk groups (particularly people with mental illness and people who have selfharmed) have been relatively neglected, and some promising approaches (particularly selective and indicated interventions) have been under-emphasised. This balance should be redressed and the opportunity should be taken to build the evidence-base regarding suicide prevention. Such steps have the potential to maximise the impact of suicide prevention activities in Australia.
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Selman, Paul H. "Implementation of a national conservation strategy: The case of Australia." Environmentalist 8, no. 1 (March 1988): 7–17. http://dx.doi.org/10.1007/bf02240307.
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Daly, John, Geraldine (Ged) Kearney, and Caroline Homer. "Reflections on the Australia 2020 summit long-term national health strategy." Collegian 15, no. 4 (October 2008): 123–24. http://dx.doi.org/10.1016/j.colegn.2008.09.002.
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Gidding, Heather. "Australia?s national serosurveillance program." New South Wales Public Health Bulletin 14, no. 5 (2003): 90. http://dx.doi.org/10.1071/nb03027.
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Spigelman, Allan D., Shane Rendalls, Mary-Louise McLaws, and Ashleigh Gray. "Antimicrobial stewardship: Australia." International Journal of Health Governance 21, no. 3 (September 5, 2016): 139–49. http://dx.doi.org/10.1108/ijhg-02-2016-0010.
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Purpose – The purpose of this paper is to provide an overview of the context for strategies to overcome antimicrobial resistance in Australia, which may provide valuable learnings for other jurisdictions. Design/methodology/approach – Non-systematic review of literature from websites of national, state and territory health departments and interviews with key stakeholders for Australian strategies to reduce antimicrobial resistance. Findings – In July 2015 all states and territories in Australia adopted the National Antimicrobial Resistance Strategy 2015-2019, which is built on the World Health Organization policy package to combat antimicrobial resistance. This strategy represents “the collective, expert views of stakeholders on how best to combat antimicrobial resistance in Australia. It will also support global and regional efforts, recognising that no single country can manage the threat of antimicrobial resistance alone”. It combines quantitative and qualitative monitoring strategies with frameworks and guidelines to improve management of the use of antimicrobial resistant drugs. Prior to this, health services and states developed and implemented initiatives aimed at monitoring and improving prescribing practices. Development of the national strategy has encouraged and fostered debate within the Australian health system and a raft of new policy initiatives. Research limitations/implications – Surveillance strategies are in place to monitor impact and trends at jurisdictional and sector levels. However, actual impact on antimicrobial resistance and prescribing practices remains to be seen as existing initiatives are expanded and new initiatives implemented. Practical implications – This overview of key Australian initiatives balancing quantitative and qualitative surveillance, accreditation, research, education, community awareness and price signals on antibiotic prescribing practices may be valuable to health systems in developing local strategies. Originality/value – The authors provide an up to date overview of the context, strategies and aims of antimicrobial stewardship in Australia.