Dissertations / Theses: 'Public health – Australia'

1

Wright, Trudy, and n/a. "Primary health care : the health care system and nurse education in Australia, 1985-1990." University of Canberra. Education, 1994. http://erl.canberra.edu.au./public/adt-AUC20061110.171759.

Full text

Abstract:

Primary health care as a model for the provision of health services was introduced by the World Health Organization In the mid 1970s. Initially viewed as a means of health promotion and advancement of wellness in developing countries., it was soon to be adopted by industrialised countries to assist in relieving the demand on acute care services. This was to be achieved through education of the community towards good health practices and the preparation of nurses to practice in the community, outside of the acute care environment Australian nurses were slow to respond to this philosophy of health care and this study has sought to examine why this is so. It has been found that there are a multitude of reasons for the lack of action In the decade or more following the Declaration of Alma Ata and the major Issues have been identified and elaborated. Some of the major reports of the time that were associated with and had some Influence on health care and nurse education have been examined to identify recommendations and how much they support the ethos of primary health care. These include the Sax committee report of 1978 and a submission by the Department of Employment and Industrial Relations In 1987. As part of the investigation, nursing curricula from around Australia in the mid 1980s have been examined to determine the degree of the primary health care content according to guidelines recommended by the World Health Organization. It was found that generally at that time, there was a deficit In the preparation of undergraduate students of nursing for practice In the area of primary health care when the world, including industrialised nations, was making moves towards this model of health care delivery. Factors Influencing the slow response of nursing have been examined and finally recommendations for further studies have been put forward.

APA, Harvard, Vancouver, ISO, and other styles

2

Hughes, Roger, and n/a. "Public Health Nutrition Workforce Development: An Intelligence-Based Blueprint for Australia." Griffith University. School of Health Science, 2004. http://www4.gu.edu.au:8080/adt-root/public/adt-QGU20040615.120233.

Full text

Abstract:

Public health nutrition workforce development is a capacity building strategy identified as a priority in the Australian National Public Health Nutrition Strategy (Eat Well Australia). Systematic and scholarly approaches to workforce development that enhance the capacity of the health system and the broader community to effectively address public health nutrition issues, are limited in Australia. The associated lack of intelligence and a range of methodological difficulties similar to those encountered in broader public health workforce research, provide the need for, and motivation for, this study. The specific objectives of this study relate to the development of workforce development intelligence that: Fills gaps in the knowledge base to inform effective workforce development ; Provides baseline data (benchmarks) for ongoing workforce development planning, evaluation, monitoring and surveillance ; and, Contributes to international scholarship regarding public health nutrition workforce development ; and, Enables the development of a strategic framework for workforce development planning in the national context. The case study research strategy used in this study involved an emergent, multi-method design involving methodological triangulation of data and consensus development. The focus of inquiry was based on a problem-based conceptual framework developed to identify intelligence needs for workforce development strategy planning. Quantitative and qualitative data were collected using five different methods including literature review, interviews with advanced-level public health nutritionists in Australia, a national public health nutrition workforce survey, an analysis of position descriptions and consensus assessment and development via a Delphi survey of an international expert panel. The collection, analysis and interpretation of data in this study focused on developing an intelligence base on six main issues pertinent to public health nutrition workforce development, including: Definitions of public health nutrition; Workforce size and composition; Workforce practices; Core workforce functions needed; Competencies required for effective public health nutrition practice; and, Continuing competency development needs. Data from these multiple methods were used to describe and interpret the determinants of workforce capacity, assisted by triangular analysis. This analysis identified a range of determinants limiting the capacity of the Australian public health nutrition workforce including; A small designated specialist public health nutrition workforce; Workforce instability associated with unsecured funding and staff turnover; Limited collaboration and partnership building practices by the existing workforce; Disorganisation of the workforce in terms of location, accountability, service mandates and support; Workforce practices are not consistent with the required work; Limited access to, and use of, public health nutrition intelligence; A workforce practice culture that does not promote research and dissemination; A lack of practice improvement and learning systems; Limited access to public health nutrition mentors; Limited incentives for practice excellence; An absence of consensus about the required work and competencies required for effective public health nutrition practice; Barriers to continuing competency development; and, Inadequate workforce preparation. This interpretive analysis provided the basis for developing a strategic framework that addresses workforce quantity, quality and performance concerns, based on workforce development strategy categories including: Building human resource infrastructure (quantity); Organisational systems and policy (performance); Intelligence support (performance); Learning systems (quality) and; Workforce preparation. This research has also provided data that can for the basis of tools such as definitions, core function statements, position descriptions and competency standards to assist public health nutrition workforce development in Australia and internationally.

APA, Harvard, Vancouver, ISO, and other styles

3

Hughes, Roger. "Public Health Nutrition Workforce Development: An Intelligence-Based Blueprint for Australia." Thesis, Griffith University, 2004. http://hdl.handle.net/10072/366114.

Full text

Abstract:

Public health nutrition workforce development is a capacity building strategy identified as a priority in the Australian National Public Health Nutrition Strategy (Eat Well Australia). Systematic and scholarly approaches to workforce development that enhance the capacity of the health system and the broader community to effectively address public health nutrition issues, are limited in Australia. The associated lack of intelligence and a range of methodological difficulties similar to those encountered in broader public health workforce research, provide the need for, and motivation for, this study. The specific objectives of this study relate to the development of workforce development intelligence that: Fills gaps in the knowledge base to inform effective workforce development ; Provides baseline data (benchmarks) for ongoing workforce development planning, evaluation, monitoring and surveillance ; and, Contributes to international scholarship regarding public health nutrition workforce development ; and, Enables the development of a strategic framework for workforce development planning in the national context. The case study research strategy used in this study involved an emergent, multi-method design involving methodological triangulation of data and consensus development. The focus of inquiry was based on a problem-based conceptual framework developed to identify intelligence needs for workforce development strategy planning. Quantitative and qualitative data were collected using five different methods including literature review, interviews with advanced-level public health nutritionists in Australia, a national public health nutrition workforce survey, an analysis of position descriptions and consensus assessment and development via a Delphi survey of an international expert panel. The collection, analysis and interpretation of data in this study focused on developing an intelligence base on six main issues pertinent to public health nutrition workforce development, including: Definitions of public health nutrition; Workforce size and composition; Workforce practices; Core workforce functions needed; Competencies required for effective public health nutrition practice; and, Continuing competency development needs. Data from these multiple methods were used to describe and interpret the determinants of workforce capacity, assisted by triangular analysis. This analysis identified a range of determinants limiting the capacity of the Australian public health nutrition workforce including; A small designated specialist public health nutrition workforce; Workforce instability associated with unsecured funding and staff turnover; Limited collaboration and partnership building practices by the existing workforce; Disorganisation of the workforce in terms of location, accountability, service mandates and support; Workforce practices are not consistent with the required work; Limited access to, and use of, public health nutrition intelligence; A workforce practice culture that does not promote research and dissemination; A lack of practice improvement and learning systems; Limited access to public health nutrition mentors; Limited incentives for practice excellence; An absence of consensus about the required work and competencies required for effective public health nutrition practice; Barriers to continuing competency development; and, Inadequate workforce preparation. This interpretive analysis provided the basis for developing a strategic framework that addresses workforce quantity, quality and performance concerns, based on workforce development strategy categories including: Building human resource infrastructure (quantity); Organisational systems and policy (performance); Intelligence support (performance); Learning systems (quality) and; Workforce preparation. This research has also provided data that can for the basis of tools such as definitions, core function statements, position descriptions and competency standards to assist public health nutrition workforce development in Australia and internationally.
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Health Sciences
Full Text

APA, Harvard, Vancouver, ISO, and other styles

4

Sinclair, Andrew. "The primary health care experiences of gay men in Australia." Connect to this title online, 2006. http://adt.lib.swin.edu.au/public/adt-VSWT20060713.084655/.

Full text

APA, Harvard, Vancouver, ISO, and other styles

5

Sinclair, Andrew James, and n/a. "The primary health care experiences of gay men in Australia." Swinburne University of Technology, 2006. http://adt.lib.swin.edu.au./public/adt-VSWT20060713.084655.

Full text

Abstract:

The present research, consisting of two studies, was designed to examine the primary health care experiences of gay men in Australia and assess doctors? attitudes and training with regard to gay men and their health care. In the first study, 195 gay men were surveyed regarding their health issues and their primary health care experiences. The most important health concerns of gay men were stress and depression followed by HIV/AIDS, body image disorder and other sexually transmissible infections. Including those participants who were unsure, approximately one-half reported experiencing homophobia and almost one?quarter reported experiencing discrimination in the provision of health care. Despite this, respondents were generally satisfied with their primary health care, although respondents felt that all GPs should receive additional undergraduate medical education regarding gay men?s health. In the second study, 25 doctors (13 gay specialists and 12 non-gay specialists) were surveyed regarding their knowledge of gay men?s health and their comfort working with gay men. Non-gay specialist GPs were less comfortable treating gay men, reported poorer communication and were more homophobic than their gay specialist counterparts. Further, doctors perceived their medical education regarding gay men?s health has been inadequate. Together, the results of the two current studies suggest that disclosure of sexuality is an important issue for both gay men and doctors, and has the potential to impact on the quality of health care that gay men receive. In order to improve the level of disclosure, the pervasiveness of homophobia and discrimination in primary health care must be reduced. Finally, the results indicate that medical education must be updated to reflect current knowledge regarding the health issues of gay men. Failure to address these issues will condemn gay men to continued health inequality.

APA, Harvard, Vancouver, ISO, and other styles

6

Fleming, Brian James. "The social gradient in health : trends in C20th ideas, Australian Health Policy 1970-1998, and a health equity policy evaluation of Australian aged care planning /." Title page, abstract and table of contents only, 2003. http://web4.library.adelaide.edu.au/theses/09PH/09phf5971.pdf.

Full text

APA, Harvard, Vancouver, ISO, and other styles

7

Leon, de la Barra Sophia. "Building research capacity for indigenous health : a case study of the National Health and Medical Research Council : the evolution and impact of policy and capacity building strategies for indigenous health research over a decade from 1996 to 2006." Thesis, The University of Sydney, 2007. http://hdl.handle.net/2123/3538.

Full text

Abstract:

As Australia’s leading agency for funding health research (expending over $400 million in 2006), the National Health and Medical Research Council (NHMRC) has a major responsibility to improve the evidence base for health policy and practice. There is an urgent need for better evidence to guide policy and programs that improve the health of Indigenous peoples. In 2002, NHMRC endorsed a series of landmark policy changes to acknowledge its ongoing role and responsibilities in Indigenous health research—adopting a strategic Road Map for research, improving Indigenous representation across NHMRC Council and Principal Committees, and committing 5% of its annual budget to Indigenous health research. This thesis examines how these policies evolved, the extent to which they have been implemented, and their impact on agency expenditure in relation to People Support. Additionally, this thesis describes the impact of NHMRC policies in reshaping research practices among Indigenous populations.

APA, Harvard, Vancouver, ISO, and other styles

8

Leon, de la Barra Sophia. "Building research capacity for indigenous health : a case study of the National Health and Medical Research Council : the evolution and impact of policy and capacity building strategies for indigenous health research over a decade from 1996 to 2006." University of Sydney, 2007. http://hdl.handle.net/2123/3538.

Full text

Abstract:

Master of Philosophy
As Australia’s leading agency for funding health research (expending over $400 million in 2006), the National Health and Medical Research Council (NHMRC) has a major responsibility to improve the evidence base for health policy and practice. There is an urgent need for better evidence to guide policy and programs that improve the health of Indigenous peoples. In 2002, NHMRC endorsed a series of landmark policy changes to acknowledge its ongoing role and responsibilities in Indigenous health research—adopting a strategic Road Map for research, improving Indigenous representation across NHMRC Council and Principal Committees, and committing 5% of its annual budget to Indigenous health research. This thesis examines how these policies evolved, the extent to which they have been implemented, and their impact on agency expenditure in relation to People Support. Additionally, this thesis describes the impact of NHMRC policies in reshaping research practices among Indigenous populations.

APA, Harvard, Vancouver, ISO, and other styles

9

McGuiness, Clare Frances. "Client perceptions : a useful measure of coordination of health care." View thesis entry in Australian Digital Theses Program, 2001. http://thesis.anu.edu.au/public/adt-ANU20020124.141250/index.html.

Full text

APA, Harvard, Vancouver, ISO, and other styles

10

Cullerton, Katherine B. "An exploration of the factors influencing public health nutrition policymaking in Australia." Thesis, Queensland University of Technology, 2017. https://eprints.qut.edu.au/109095/1/Katherine_Cullerton_Thesis.pdf.

Full text

Abstract:

This thesis was an exploration of the factors that influence nutrition policymaking in Australia which resulted in strategies that could be used by poorly-resourced health organisations to gain traction in public health nutrition policymaking. Insight into these strategies was gained through a social network analysis exploring the power of interest groups and their influence on nutrition policy in Australia and in-depth interviews with these key influencers.

APA, Harvard, Vancouver, ISO, and other styles

11

Walker, Agnes Emilia, and Agnes Walker@anu edu au. "Modelling the links between socioeconomic status and health in Australia: a dynamic microsimulation approach." The Australian National University. National Centre for Epidemiology and Population Health, 2005. http://thesis.anu.edu.au./public/adt-ANU20060127.120857.

Full text

Abstract:

This thesis concerns the modelling of individuals health over the life course, within the framework set by the now substantial international literature on the relationship between socioeconomic status and health. The focus is on people with long term illnesses and related disabilities, on inequalities in health by socioeconomic status (SES) and on the impact of health on employment.¶ The main tool of analysis is a dynamic microsimulation model of the Australian population which tracks the demographic, socioeconomic and financial characteristics of individuals and their families over the life course. Its original form, developed at the National Centre for Socioeconomic Modelling, University of Canberra, is based on a one per cent representative sample of the Australian population (around 150,000 individuals), with a series of life course events simulated for individuals and their families up to 2050 - such as births, deaths, migration, taxes, education, labour force participation, earned income, wealth accumulation and government transfers. The model is written in the C programming language and was initially used on a UNIX system. The dramatic increases in the speed and memory size of PCs over the past five years has led to a PC version now being available.¶ Despite their relatively short existence and long development phases, dynamic microsimulation models are now used in many developed countries for example, the USA, UK, Canada, France, Sweden, Norway and Italy. In recognition of their ability to analyse distributional and financial issues in considerably greater depth than what is possible with traditional methods, their use by government for policy analysis is rapidly increasing.¶ In this thesis two new modules were added to the original Australian dynamic microsimulation model namely: a Health_SES module and a Health State Transitions module. The former makes the study of health inequalities across socioeconomic groups possible. The latter provides a link between health status and the ability of individuals to carry out every day activities as the severity of their ill-health increases with age. A major advantage of adding these new modules to an existing main model is that it allows much more comprehensive studies over the life courses of individuals than the alternative would allow that is the building of two stand-alone models developed exclusively for health-SES and health state transition types of applications.¶ The main data sources used to construct the two new modules were an extract from the Australian Institute of Health and Welfares Mortality database covering the 1995-97 period, and the Australian Bureau of Statistics 1998 survey of Disability, Ageing and Carers. The analysis of the mortality data was handled using EXCEL, and that of the much larger Disability survey unit record dataset - over 40,000 individuals and 100s of variables using the SAS programming language.¶ While most of the methodologies used in constructing the new modules are in line with what became the norm for dynamic microsimulation model development, the thesis contains several innovations. The main ones are: a quantitative assessment of the suitability of different types of SES indicators for studies of health inequalities; the modelling of the progression of peoples health from illness-free status to mild and severe disability; the development of a methodology for estimating health state transition probabilities from cross-sectional data (in the absence of longitudinal data); and the linking of health status to individuals ability to stay in the labour force.¶ As with most models, there are a number of limitations. These are discussed in the thesis, together with areas of possible future improvements.¶ The thesis also presents two novel and topical though at this stage illustrative applications of the enhanced dynamic microsimulation model. The first simulates the impact of a narrowing in health inequalities in Australia as health is lifted nationally to the level currently enjoyed by the most affluent 20% of the population. The findings are that, if such a policy change were implemented, close to half a million fewer Australians would be disabled, around 180,000 life years would be saved, health care costs would be around A$1 billion lower per year and the government could save close to A$700 million on the Disability Support Pension.¶ The second application quantifies the likely impacts of longer working lives in future, which may arise from changes such as: more favourable labour market conditions; government incentives to remain in the labour force longer (eg the lifting of the pension age); and general improvements in health. This application estimates the probability that Australians aged 65-70 would work more than 15 hours per week, had such changes eventuated. The decision to retire is modelled as a function of each individuals own health, socioeconomic status, age, sex and family composition. The impacts are simulated in a world in which current patterns of health by age, sex and SES remain unchanged over time the Base case; and a world replicating the narrower health inequalities scenario of the first application. Under the Base case an additional 450,000 persons aged 65-70 years were estimated to remain in the workforce - with the related earnings totalling up to $20 billion in 1998 ($35 billion in 2018) and savings by government on the age pension of around $2 billion ($4 billion in 2018). Under the narrower health inequalities scenario the numbers working, their earnings and the related savings on the age pension were estimated to be around 7% higher. Much of the original research carried out for this thesis has appeared, or is yet to appear, in refereed publications.¶

APA, Harvard, Vancouver, ISO, and other styles

12

Norrie, Philip Anthony. "Wine and health through the ages with special reference to Australia /." View thesis, 2005. http://library.uws.edu.au/adt-NUWS/public/adt-NUWS20060420.102152/index.html.

Full text

Abstract:

Thesis (PhD.)-- University of Western Sydney, School of Social Ecology and Lifelong Learning, 2005.
"A thesis submitted in fulfillment of the requirements for the degree of Doctor of Philosophy, School of Social Ecology and Lifelong Learning, University of Western Sydney." Includes bibliographical references and index.

APA, Harvard, Vancouver, ISO, and other styles

13

Holland, Kate E., and n/a. "Conformity and resistance: Discursive struggles in the Australian mental health field." University of Canberra. Communication, 2007. http://erl.canberra.edu.au./public/adt-AUC20081022.153830.

Full text

Abstract:

This research explores areas of contention in the mental heath field in Australia through a qualitative analysis of voices and practices that can broadly be seen as talking with and talking back to psychiatry. The thesis is informed by key shifts in thinking that underpin postpsychiatry and analyses a set of materials through an interpretive lens of reading psychiatry against the grain (Bracken & Thomas, 2005; Lewis, 2006). In particular, it examines a failed ethics application to conduct research with people diagnosed with a mental illness, an anti-stigma campaign, the practices of some prominent mental health organisations in Australia, a conversation with two members of an emerging consumer/survivor network in Australia, and a television documentary and online discussion forum about an antidepressant medication. The research draws from discourse analytic methods and concepts from social movement framing research to identify factors shaping conformity and resistance to psychiatric doxa in the Australian mental health field. The research identifies the discursive repertoires that characterise the mental health field as a "game" in which competing perspectives vie for recognition. In relation to research ethics committees, the thesis argues that deference to clinical expertise is a potential barrier to cultural studies of psychiatry and a more inclusive agenda in mental heath research and practice. Some practices for ethics committees to consider when reviewing research that involves people who may have been diagnosed with a mental illness are proposed. The research also identifies problematic features of anti-stigma campaigns that direct their efforts toward protecting and promoting the discourse of biomedical psychiatry. A critique of this type of campaign is offered in relation to perspectives from postpsychiatry and social constructionism. On the basis of this research, it is argued that organisations that champion "mental health literacy" are limited in their ability to give voice to the goals and priorities of those who are calling for a more open, reflexive and democratic debate in mental health. The central argument of this thesis is that elevating first-person and postpsychiatry perspectives is necessary in order to interrogate and address the dominance of the medical model in psychiatry and its consequences.

APA, Harvard, Vancouver, ISO, and other styles

14

Ramanathan, Vijayasarathi, Virginia Furner, Sarangapany Jeganathan, Katerina Lagios, Melissa Kang, and Eva Jackson. "Accessibility and Acceptability of Public Sexual Health Clinics for Adult Clients in New South Wales, Australia." Thesis, Masters in Medicine (STD/HIV) The University of Sydney, 2006. http://hdl.handle.net/2123/3573.

Full text

Abstract:

The objectives of this study were to examine the accessibility of public sexual health clinics (SHCs), identify the service preferences of clients and assess whether the services delivered by public SHCs were acceptable (suitable) to users’ expectations. Participants were adult clients attending public SHCs in 4 different geographical regions of New South Wales (NSW). A self completed anonymous questionnaire survey was employed in this study and the data was collected over a two week period per clinic. The overall participation rate was 89%. Three hundred and two clients participated of which 68.2% and 31.8% were males and females respectively. Geographical proximity to residence or work was the single most common reason cited to choose a particular clinic by all clients. The main source of information about public SHCs for young and middle aged clients was their personal contacts, whereas for older individuals it was health professional’s referral. Of the total sample, nearly 59% vs. 32% of clients used private and public transport to get to the clinic. About 80% of private transport users of the city and suburban clinics had indicated some difficulty with parking facilities. For more than two thirds of clients, the time taken to get to the clinic was less than 30 minutes. Overall, more clients preferred an appointment (56%) compared to a walk-in (32%) system. Nearly 65% of all clients preferred to attend the clinic during the weekdays and about 11% preferred weekends. Of those clients who had a preference for a time to attend a clinic, 83.3% attended clinic in their preferred time. Overall, more than one third (39%) of all clients preferred a same gender health care worker (HCW) whereas 13% of clients did not prefer a same gender HCW. Among clients who had a clear preference, more than 90% of all females and nearly 80% of overseas born males preferred a same gender HCW. More females (81%) than males (59%) were actually able to have a consultation with a HCW of their preferred gender. The majority (79%) of clients preferred to consult the same doctor in the follow up visits and only a few clients (5%) preferred a separate male and female waiting room. The vast majority (97%) of clients had no difficulty with language during consultation. About 93% of clients had rated the services delivered by public SHCs to be either excellent or good. The public SHCs were found to be accessible and acceptable to the clients who currently utilise them. Designated parking spaces for the city and suburban clinic users and providing an option for female and overseas born male clients to select a HCW of their preferred gender need to be considered. Further research is required to examine accessibility and acceptability aspects of public SHCs for the potential clients who either currently use other services or do not access any form of services.

APA, Harvard, Vancouver, ISO, and other styles

15

Walker, Agnes Emilia. "Modelling the links between socioeconomic status and health in Australia : a dynamic microsimulation approach /." View thesis entry in Australian Digital Theses Program, 2005. http://thesis.anu.edu.au/public/adt-ANU20060127.120857/index.html.

Full text

APA, Harvard, Vancouver, ISO, and other styles

16

White, Jasmin. "Oral health problems of elderly women in Australia : an holistic approach." Thesis, The University of Sydney, 1996. http://hdl.handle.net/2123/4630.

Full text

APA, Harvard, Vancouver, ISO, and other styles

17

Hanna, Elizabeth Gayle (Liz), and lizhanna@netc net au. "Environmental health and primary health care: towards a new workforce model." La Trobe University. School of Public Health, 2005. http://www.lib.latrobe.edu.au./thesis/public/adt-LTU20061110.152550.

Full text

Abstract:

Public health was once synonymous with environmental health. However, as living conditions improved the two fields diverged. Environmental factors are again re-emerging as hazards human health. Increasing global reliance on agricultural and veterinary chemicals (AgVets) over recent decades has is now a serious public health concern. Evidence of their toxicity has prompted international efforts to minimize, monitor and manage exposure risks. Direct involvement of the primary health care workforce is seen as critical to this process, yet little data exists on the health burden on Australian rural communities imposed by these chemicals. The study presented here attempts to explore the impact of these chemicals on two rural communities in Victoria, and ascertain the how the existing primary heath care system responds to AgVet exposure issues. Health determinants are complex, and inter-related, and the client �provider interface is not an entity acting in isolation from other frameworks. The provider-client service relationship has evolved against a background of legislation and provider training. Many external factors also impinge, such as the structure and focus of the health sector, and Australia�s systematic approach to environmental and chemical management. Examination of this underlying infrastructure in Australia provided the background against which the issue of exposure to agricultural and veterinary chemicals was explored. A brief summary of international developments in this area served to provide insight as to what interventions may be introduced to address the issue of chemical exposure. A CATI (Computer Assisted Telephone Interview) survey of 1050 households sought the perspectives from two Victorian agricultural communities to gather self-reported AgVet exposure patterns and health data, and whether respondents perceived their health problems were linked to exposure. Respondents were also asked to comment on the primary health care service experiences from local providers, and which services they preferred to seek for health advice. Perspectives were then sought from all primary health care providers servicing these communities. Information was sought on their level of expertise in diagnosing, and managing exposure related illness, via face-to-face interviews, focus groups and paper surveys. The study revealed rural communities have a long history of hazardous exposure to toxic AgVets. Awareness of toxicity risks is growing, yet further scope exists to improve safe handling of chemicals. High levels of illnesses known be associated with AgVet exposure exist among rural populations. Many believe their own ill-health is linked to exposure, and express strong dissatisfaction with the apparent lack of environmental health expertise especially among their GPs. Health providers demonstrated limited understanding of the health impacts of AgVet exposure. The lack of environmental health expertise among the existing primary health care workforce means that health conditions associated with exposure to AgVets are not being identified, and the absence of health intelligence hampers health planning. In Australia, the health, environment and primary industries sectors function in effect, as distinct silos, with little cross-fertilisation. The United States has combined its agricultural chemical legislative authority to develop a focus on human health, establish direct links, and biomonitoring programs to protect human heath. The U.S. has also developed environmental health expertise at the primary health care level to address community needs as they arise. Strategies are required in Australia to connect the environment, chemical management and health portfolios, with respect to the emerging environmental issues of chemical exposure. There is a need also in Australia to inject environmental health capacity into the primary health care practice.

APA, Harvard, Vancouver, ISO, and other styles

18

Watts, Christina. "Tobacco industry interference in supply-side policies in Australia." Thesis, The University of Sydney, 2021. https://hdl.handle.net/2123/24682.

Full text

Abstract:

Tobacco smoking rates in Australia are at a historic low, largely due to decades of tobacco control policy reforms aimed at reducing consumer demand for tobacco products. However, while some conditions have been placed on the sale of tobacco, such measures are not explicitly aimed at reducing the supply of tobacco products by restricting their sale. Tobacco therefore remains one of the most widely available consumer goods on the market in Australia, which contributes to a perception that tobacco is a normal part of everyday life. The widespread retail availability of tobacco in Australia undermines smokers quit attempts and increase impulse purchases, which ultimately increases tobacco consumption. Regulating the supply of tobacco in Australia is an essential next step to achieving future reductions in smoking prevalence. However at present, the lack of regulation on the “supply-side” of tobacco control presents opportunities for the tobacco industry to exploit loopholes, undermine tobacco control policies and exert its power and influence. Tobacco companies and tobacco retailers both play a unique and interrelated role in the sale of tobacco in Australia and it is critical that research exploring supply-side tobacco control policies investigates the motivations and activities of both tobacco companies and retailers, and how they work together. This is particularly paramount in light of the tobacco industry’s increasing attempts to reframe its corporate image alongside efforts to undermine and influence the public health policy landscape. This body of work will establish an understanding of attitudes, beliefs and experiences of retailers in regards to selling tobacco and uncover the ways in which tobacco companies manage relationships with retailers to covertly market their products to maximise profitability. It will also investigate the tobacco industry’s tactics to interfere with and influence policy through a corporate social responsibility agenda and explore the implications of this on tobacco retail reform in the future.

APA, Harvard, Vancouver, ISO, and other styles

19

Duldig, Paul. "The extent of private health insurance coverage in Australia : public problem or private choice? /." Title page, contents and introduction only, 1985. http://web4.library.adelaide.edu.au/theses/09EC/09ecd881.pdf.

Full text

APA, Harvard, Vancouver, ISO, and other styles

20

MURPHY, CATHRYN LOUISE School of Health Services Management UNSW. "INFECTION CONTROL IN THE AUSTRALIAN HEALTH CARE SETTING." Awarded by:University of New South Wales. School of Health Services Management, 1999. http://handle.unsw.edu.au/1959.4/17600.

Full text

Abstract:

1,708 members of the Australian Infection Control Association were surveyed to describe the practices of Australian infection control practitioners. The study details the methods infection control practitioners use to co-ordinate and measure nosocomial infections as clinical outcomes of Australian infection surveillance and control programs. Administrators' and clinicians' perceptions of the elements and infrastructure of infection surveillance and control programs and the role of the infection control were measured in 316 hospitals in New South Wales, Australia. A literature review found that the development of Australian infection surveillance and control programs is behind that of U.S.A and the United Kingdom. The survey of the infection control practitioners identified that their role and duties varied between facilities as did the time allocated to infection control tasks. The survey of infection control practitioners demonstrated variation in their levels of skill, education and experience. Infection control practitioners' use and application of evidence and associated skills was examined and found to be limited in relation to clinical decision making and policy development. The survey also examined the methods infection control practitioners use to undertake surveillance of nosocomial infections. The methods reported indicated non-standard approaches to surveillance activity. A survey of administrators and clinicians in NSW hospitals was undertaken to identify variation in administrator and clinician perceptions and to describe their level of support for recommended essential infrastructure and criteria for infection surveillance and control programs and the role of the infection control practitioner in accordance with Scheckler's model. The survey indicated divergent views regarding the role of the infection control practitioner and the essential elements of infection surveillance and control programs. The study identified that education of infection control practitioners is necessary to facilitate standard approaches to co-ordinating infection surveillance and control activity. The development of Australian infection surveillance and control programs require a strategic alliance between stakeholders. to define essential elements of infection surveillance and control programs. In addition, the role of the infection control practitioner must be defined before key stakeholders can agree on the minimum skills, qualifications and experience required by an infection control practitioner.

APA, Harvard, Vancouver, ISO, and other styles

21

Madzokere, Eugene T. "The Current Status, Evolution and Spread of Arboviruses Circulating in Australia." Thesis, Griffith University, 2022. http://hdl.handle.net/10072/417227.

Full text

Abstract:

Arboviruses circulating in Australia are of clinical importance as they cause painful, often chronic musculoskeletal arthritic or fatal dengue disease. They include Ross River virus (RRV), Barmah Forest virus (BFV), chikungunya virus (CHIKV) and dengue virus (DENV). This dissertation assessed the seroprevalence, diversity, evolution, spread and strategies for controlling infection caused by these arboviruses. The overall aim of research presented in this dissertation was to improve public health responses such as nationwide surveillance, diagnosis, and infection control. Research undertaken in chapter 2 achieved this through systematic review and statistical synthesis of human seroprevalence data for RRV, BFV and DENV. I have shown that many factors influence the reporting of human seroprevalences for these three arboviruses. Among these factors is the choice of assay method, timeframe, and sampling strategy. I have also presented findings showing that the spatiotemporal range and median seroprevalences reported for DENV and RRV are wider and higher than those for BFV. This indicates that the risk of exposure to DENV and RRV is significantly higher and extends overseas, however this risk relates to the distribution of the transmitting vectors. My analysis highlighted that DENV presents the highest risk of exposure but its incidence in Australia is declining due to successful implementation of Wolbachia-DENV control programs which have restricted the distribution of Aedes aegypti. Most serosurveys reviewed reported a positive association between age and seroprevalence, and increasing seroprevalence with gender. However, studies reporting gender-seroprevalence data did not do statistical analysis to show the significance of outcomes. This dissertation therefore recommends streamlining, standardization and statistical synthesis of serosurveys data to better quantify risk of exposure, identify risk factors, at-risk groups/populations, associations between seroprevalence and risk factors and at-risk groups/populations. In chapter 3, I characterised the phylogenetic relationship among 193 RRV near whole genomes sourced from multiple hosts, nationwide and the Pacific, in-between 1959-2018. Eight-six of these genomes were generated in this dissertation. My assessment revealed that the four RRV genotypes display high levels of intra-genomic diversity, as I was able to characterise the virus into eight additional sublineages within genotypes G1 (n = 2), G3 (n = 5) and G4 (n = 1). This characterisation brings the total number of known RRV sublineages to 13. Only three of these sublineages (G3D, G4A and G4B) contain viruses that have circulated in Australia within the last decade. The last sampling of genotype 1 and 2 (G1 and G2) viruses was in 1976 and 1995 from Queensland and Western Australia. These viruses may no longer be in circulation within Australia. Sublineages G4A and G4B the most dominant circulating variants of RRV in recent times but they are spatially restricted to Eastern and Western Australia. My phylogenetic analysis suggests that a human traveller likely introduced RRV into the PICTs from northern rather than eastern Australia causing the explosive 1979-80 epidemic. This hypothesis builds upon the one postulated by authors of previous studies who used genomic datasets for RRV isolates sampled from a few locations and not nationwide as I did. Future studies are required to determine differences between RRV sublineages, factors driving lineage replacement, and understand the role of positively selected codon site to RRV evolution. For chapter 4, I studied the evolution, dissemination and phylogenetic relation between 87 BFV near whole genomes sourced nationwide and from Papua New Guinea from three hosts; humans, mosquitoes and a macropod, during 1974-2018. Fifty-four of these genomes were generated in this dissertation and were sampled throughout Australia. Despite the addition of these new genomes to the BFV phylogeny, results obtained indicate that BFV still consists of three genotypes with most new genomes generated from isolates sampled from northern, eastern, and Western Australia grouping in genotype G3. This dissertation reconstructed the most plausible and statistically supported dissemination pathways for BFV and identified the PNG as the most likely source of the virus. The impacts of nucleotide variation within repeat sequence elements and positive selection with the nsP1 Mtase-Gtase domain on virus replication and host range need to be investigated further. For Chapter 4 and 5, I showed that BFV and RRV have a synonymous codon usage bias toward A or C at the 3rd codon position; an abundance of CA and UG, and suppression of CG and UA dinucleotides; display coincidental and antagonistic synonymous codon usage bias with their respective mosquito and vertebrate hosts. In chapter 7, I also showed that amino acid coevolution and compositional biases are prevalent within protein coding regions belonging to RRV and BFV. I found translational selection to be the most influential evolutionary force driving RRV codon usage patterns (chapter 5). Mutational pressure was a close second. I also identified host motifs associated with RRV and BFV coevolving sites. Altogether these results indicate that many factors drive RRV and BFV evolution, among them virus and host related influences. Investigation of the clinical relevance of these findings (chapters 4, 5, and 7) is required. In chapters 6 of this dissertation, I identified five drugs [Anidulafungin (an antifungal), Fondaparinux (an anticoagulant), Rifabutin (an antibiotic), Deslanoside (a cardiac glycoside), and Temsirolimus (an antineoplastic agent)] that bind with high affinity, potency and efficiency to the RRV, BFV and CHIKV capsid. Their role as capsid inhibitors and potential treatments for RRV, BFV and CHIKV infection needs validating through functional and preclinical studies. In chapter 8, I proposed a strategy for generating integrated species distribution modelling frameworks to improve prediction of mosquito-vector habitat shifts in the future. Such modelling frameworks do not currently exist and so their generation and evaluation as an additional component to existing vector and arbovirus surveillance initiatives in Australia is required. This dissertation has addressed its research aims and hypothesis. It has demonstrated that robust nationwide surveillance, review and synthesis of seroprevalence, genomic, host, and environmental data for RRV, BFV and DENV enhances the understanding and management of arbovirus epidemics, virus characterisation and discovery, and infection control in Australia. This research has also shown that some of the factors driving alphavirus evolution, can be exploited for vaccine development. In addition, this dissertation has also presented five approved medicines with potential for repurposing as anti-alphaviral treatments. More broadly, this dissertation has generated new strategies and concepts for improving arbovirus surveillance and infection control in Australia.
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
Institute for Glycomics
Griffith Health
Full Text

APA, Harvard, Vancouver, ISO, and other styles

22

Chalmers, Jane. "The oral health of older adults with dementia." Title page, contents and abstract only, 2001. http://web4.library.adelaide.edu.au/theses/09PH/09phc438.pdf.

Full text

Abstract:

Bibliography: leaves 347-361. Presents results of 2 longitudinal studies investigating the oral health of older adults with dementia, using questionnaires and clinical inspections at baseline and one year. Groups studied were nursing home residents and those living in the community, with moderate to severe dementia or no dementia diagnosis. Caries experience was related to dementias severity and not to specific dementia diagnoses. Coronal and root caries experience was higher in dementia participants with moderate-severe dementia, the socio-economically disadvantaged, more functionally dependent, taking neuroleptic medications with high anticholinergic adverse effects, with eating and swallowing problems, were not attending the dentist, who needed assistance and were behaviourally difficult during oral hygiene care and whose carers were burdened.

APA, Harvard, Vancouver, ISO, and other styles

23

Stewart, Anthony Paul. "[Epidemiology : reports and papers]." Master's thesis, Canberra, ACT : The Australian National University, 1993. http://hdl.handle.net/1885/142697.

Full text

APA, Harvard, Vancouver, ISO, and other styles

24

Chisholm, Cameron. "Bloodmeal analysis of urban Western Australian mosquito species for improved public health outcomes." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2022. https://ro.ecu.edu.au/theses/2504.

Full text

Abstract:

Ross River virus & Barmah Forest virus are the two most prevalent arboviruses in Australia. Bloodmeal studies assist in improving the understanding of disease transmission cycles, which can consequently inform disease mitigation measures. This study involved the capture and analysis of bloodfed mosquitoes within metropolitan Perth to determine their bloodmeal source. Mosquitoes were captured by a combination of sampling methods using carbon dioxide baited light traps, completed by local governments as a part of their standard mosquito control programs, and by aspiration conducted by the researcher. The DNA contained within mosquito bloodmeals was extracted and amplified by Polymerase Chain Reaction using a universal vertebrate primer. The data from sampling was analysed to determine if there were any geospatial trends and to determine the implications for Ross River Virus transmission cycles within the Perth Metropolitan area. Of the 21 bloodfed samples obtained 17 were found to have fed on humans, one on a crow, one on a common brushtail possum and the remainder were inconclusive. This study suggests that humans are a common source of bloodmeals within urban settings and may form a part of disease transmission cycles. It also further affirms the suggestions that Aedes notoscriptus is a vector of significance within urban areas. This study highlights the need for further bloodmeal studies to be conducted to better understand RRV transmission within urban areas.

APA, Harvard, Vancouver, ISO, and other styles

25

Oliffe, John, and mikewood@deakin edu au. "Prostate cancer : Anglo-Australian heterosexual perspectives." Deakin University. School of Health and Social Development, 2003. http://tux.lib.deakin.edu.au./adt-VDU/public/adt-VDU20050712.095519.

Full text

Abstract:

Prostate cancer is one of the most prominent diseases in mens health. It is inherently 'male', given the exclusivity of the prostate gland to mens bodies and its physiological connection to testosterone and male sexuality. The biomedical complexities of prostate cancer continue to be unravelled and researched and are often connected to identifying causes, the virtues of screening and treatment modalities. However, despite the biological male 'sex' link, most of the prostate cancer research is not connected with research on gender relations, men and masculinities. The net outcome is that mens lives and illness experiences are absent in much of the prostate cancer research. This PhD thesis Prostate cancer: Anglo-Australian heterosexual perspectives, is an ethnographic study of thirty-five Anglo-Australian men diagnosed with prostate cancer. Participants shared their experiences of living with prostate cancer in the context of health promotion, health services and in relation to their sexuality and intimate relationships. Through participant photographic novella and in-depth semi-structured interviews, rich cultural insights are provided. A social constructionist gender analysis is used in this research that shows how the social constructions of masculinity interconnect and occasionally collide with prostate cancer throughout the illness trajectory.

APA, Harvard, Vancouver, ISO, and other styles

26

Sorensen, Ros Public Health &amp Community Medicine Faculty of Medicine UNSW. "The dilemma of health reform : managing the limits of policymaking, managerialism and professionalism in health care reform." Awarded by:University of New South Wales. School of Public Health and Community Medicine, 2002. http://handle.unsw.edu.au/1959.4/33194.

Full text

Abstract:

Hospitals worldwide are under pressure to perform and models abound to remedy poor performance. Reform, however, is contested, uneven and slow. One reason is that few models address a core issue in reform: the management of clinical work. A further reason is that stakeholder groups, specifically policymakers, managers and clinicians, limit opportunities for collaborative problem solving as they seek to impose their own frame of reference in the struggle for control. I hypothesise that performance will be relatively better in hospitals that have in place strategies of agreement to set the objectives of reform, such as participative problem identification, problem solving and decision making, together with a method to manage clinical work. This hypothesis was tested in twelve public hospitals in three Australian states between 1999 and 2001 using both quantitative and qualitative research methods. Government and hospital policy documents were assessed and semi-structured interviews were conducted to gauge the attitudes and practices of managers and clinicians regarding health care reform. The results of the research show that hospitals with inclusive strategies for change, principally strategies of agreement, joint education and skills development, team-based incentives to direct and reward effort and a method of clinical work management, performed better than those without. Findings indicate that policy was developed and communicated as a rational top-down process that tended to exclude diverse views. Although the effect of different jurisdictional policy processes on hospital performance was not clear, they had considerable impact on the environment of reform. Cost containment and patient safety dominated as policy objectives. These alone did not engage clinician interest or address service quality. The connection between the quality of care and its cost did not appear to be understood. Organisational structures and processes necessary to support reform, that is communication forums for objective setting and performance review, integrated clinical and corporate accountability systems and organisational capacity building were not in place in the majority of hospitals studied. An organisational model of clinical work management was developed to improve cost-effectiveness by balancing clinical autonomy and clinical accountability based on the research results.

APA, Harvard, Vancouver, ISO, and other styles

27

Ohtsuka, Thai, and thai_ohtsuka@hotmail com. "Impact of cultural change and acculturation on the health and help seeking behaviour of Vietnamese-Australians." Swinburne University of Technology, 2005. http://adt.lib.swin.edu.au./public/adt-VSWT20051013.095125.

Full text

Abstract:

This study investigated the influence of cultural change and acculturation on health-related help seeking behaviour of Vietnamese-Australians. Using convenience sampling, 94 Vietnamese-Australians, 106 Anglo-Australians, and 49 Vietnamese in Vietnam participated in the study. Beliefs about health and health-related help-seeking behaviours were assessed through measures of common mental health symptoms, illness expression (somatisation, psychologisation), symptom causal attributions (environmental, psychological, biological), and choice of help seeking (self-help, family/friends, spiritual, mental health, Western medicine, Eastern medicine).Vietnamese-Australian data was compared with that of the Anglo-Australian and Vietnamese-in Vietnam. Results revealed that the help seeking behaviours and health related cognitions of Vietnamese-Australians, while significantly different from those of Anglo-Australians, were similar to those of Vietnamese in Vietnam. Specifically, both Vietnamese groups were less likely than Anglo-Australians to somatise and psychologise or attribute the cause of symptoms to environmental, psychological or biological causes. However, the two Vietnamese groups were not different from each other in their style of illness expression or in their symptom causal attributions. The Vietnamese-Australians reported experiencing more mental health symptoms than the Vietnamese in Vietnam but fewer than the Anglo-Australians. In relation to help seeking, the Anglo-Australians chose self-help more than the Vietnamese, but there were few other differences between the cultural groups. To investigate the influence of acculturation on health-related beliefs and help seeking behaviour, Vietnamese-Australians were compared according to their modes of acculturation (integration, assimilation, separation, and marginalisation). Generally, results showed a distinct pattern of response. Those with high levels of acculturation towards the Australian culture (the integration and the assimilation) were found to be most similar (in that they scored the highest in most areas measured) to the Anglo-Australians, while few differences were found between the separated and the marginalised groups. Further, cultural orientation was a powerful predictor of help seeking. In that, original cultural orientation predicted selection of help seeking from Western and Eastern medicine, whereas, the host cultural orientation was a more robust predictor of the other variables. However, neither cultural orientation predicted preference for mental health help. Finally, the study found that, although the combination of symptom score, modes of illness expression, and symptom causal attribution were strong predictors of choice of help seeking of Vietnamese-Australians, acculturation scores further improved predictive power. The results were discussed in terms of the various limitations and constraints on interpretation of this complex data set.

APA, Harvard, Vancouver, ISO, and other styles

28

Przezdziecka, Krystyna. "Profile of Australian dentistry." Thesis, The University of Sydney, 1995. http://hdl.handle.net/2123/4687.

Full text

APA, Harvard, Vancouver, ISO, and other styles

29

van, der Heide George, and n/a. "Effective strategies for conducting school development in health education programs." University of Canberra. Professional & Community Education, 1998. http://erl.canberra.edu.au./public/adt-AUC20060427.131945.

Full text

Abstract:

Thesis Statement The thesis argument is that theory can be developed about the implementation, maintenance and dissemination of school health education based on a school development approach. Such theory development can assist teachers to design programs appropriate to the needs of their classrooms, schools and communities. Thesis Setting The implementation and maintenance of school health education programs has not usually been the focus of research and as a consequence is rarely reported in the literature. The research in this thesis draws upon many disciplines and fields but in order to answer the thesis questions methodological processes were required that were consistent with current school situations. The earlier School Development in Health Education (SDHE) program's work in research, development and dissemination provided the setting for the thesis. Methodology of the Research The methodology of the research study involved a case study approach using both multiple and single case studies. Data have been drawn from SDHE schools in South Australia undertaking health, sexuality and drug education. The methodology adopted for the studies in this thesis is a case study design incorporating an iterative theory-study-theory sequence in which an initial theory statement derived from the literature guides the development of a multiple case study which, in effect, 'tests' the theory in a qualitative way. The finding of the case study then informs development and elaboration of the theory statement in its second version. This is then used to test the next multiple case study which leads to further development of the theory in its third version. The third iteration of the theory is tested in a single case study that leads to the fourth and final version of the theory. Data analysis was aided by the use of the Q.S.R. NUD.IST computer package that helped to manage and explore the thesis ideas about the data. In establishing these syntheses the chain of evidence in the data sets was maintained. The analysis also allowed the thesis findings to be used to test theories about the data that answered the thesis questions. Thesis Findings The findings of the thesis are contained in the final version of the theory. The theory is structured around program drivers, phases, types and processes that together produce implementation, maintenance and dissemination. This final theory statement is the basis for drawing the thesis conclusions. Thesis Conclusions It was concluded that patterns of factors that enhance and inhibit the implementation, maintenance and dissemination of school health education programs could be placed in a theoretical framework that can guide practice in school health education. To be successful school health education programs have to include three critical elements: leadership, action research and funding. Leaders or program drivers need to be identified and resourced; they may be principals or designated teaching staff with access to decision making, policy processes and resource allocation in schools. Teachers need to engage in a reflective action research process to develop, modify and sustain their curriculum development work. Programs require adequate funding resources for teachers' professional development, including action research, and the purchase of human and material resources. Schools planning to introduce programs may learn from the experience of others but they must themselves engage in the critical and essential program features identified in the final version of the theory. Implications The thesis conclusions imply the need to use more efficient ways of bringing schools' and teachers' hidden competence to the fore to support school health education program through varied patterns of professional development, technical support and curriculum development and implementation, and through funding of enhanced professional practice for health literacy. A major implication for the health sector is that many health workers need to learn collaborative skills since there is a tendency to take control and attempt to direct what teachers should do rather than work with and support them. An implication for programs in complex social environments is the need for careful planning in collaboration with other stakeholders. The critical elements developed in this thesis also apply - leadership, action research and funding. Evaluation can adopt a case study approach as a more suitable method for examining what happens in programs than an overly simplistic approach of assessing goals and objectives which ignores the differences in program implementation for different sites with the necessary localisation. Further Research Further research suggested by the thesis findings are in the areas of school health education in the changing administrative and management environment today, and of the use of various types of case study research in tandem to answer comprehensive and complex program performance questions.

APA, Harvard, Vancouver, ISO, and other styles

30

Polley, Anne. "An exploration of the critical success factors associated with implementing a Public Health Plan in Local Governments within Western Australia." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2019. https://ro.ecu.edu.au/theses/2227.

Full text

Abstract:

Public Health planning in local governments in Western Australia (WA) is a relatively new approach to addressing local health needs. The Western Australian Public Health Act came into effect in 2016. The Public Health Act 2016 encompasses a range of legislative requirements, some of which include the development of Local Public Health Plans. A range of roles within the local government workforce therefore are likely to require support to plan and implement Public Health Plans, which in the past have not directly been a component of their role. There is limited understanding and evidence of the barriers and enablers that contribute to effective implementation of Public Health Plans in the Western Australian context. The research aims to determine the critical success factors associated with implementing Public health Plans in local governments within Western Australia. This exploratory study encompassed a series of case studies from local governments in Western Australia that had implemented a Public Health Plan. Data was collected via in-depth interviews and document analysis. The results of this study articulate local government staff perspectives about the challenges and barriers faced when implementing a Public Health Plan. This study informs discussion around the training and resource requirements of staff in local governments in WA tasked with the development and implementation of Local Public Health Plans.

APA, Harvard, Vancouver, ISO, and other styles

31

Sherriffs, Natalie J. "Risk factors for coronary heart disease and mediation by socio-economic status : An analysis of the 1995 National Health Survey." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2002. https://ro.ecu.edu.au/theses/748.

Full text

Abstract:

As the leading cause of death and disease in Australia, Coronary Heart Disease (CHD) places a significant burden on society. There are many lifestyle factors that are known to increase the risk of CHD. This study looks at both risk factors and protective factors of CHD. Research also shows CHD prevalence to be predicted by socio-economic status (SES) variables. This study aims to identify the extent to which risk and protective factors predict CHD prevalence in an Australian National survey and whether the association between risk factors and CHD is confounded by SES variables. This study used data from the 1995 National Health Survey (NHS/1995) to evaluate known risk factors as well as the mediating effect of SES factors. Risk factors included regular cigarette smoking, physical activity and alcohol consumption. SES variables are education, income, occupation, and an index of socio-economic disadvantage based on residence. Two dependent variables for CHO used in the analysis are the first health condition reported in medical consultation and the reported use of Heart Disease I Blood Pressure (HD/BP) medications. The results indicated that ex-smokers were more likely to report CHD than those who had never smoked and those who were current smokers. Those who engaged in regular exercise were less likely to report CHD. There were no conclusive results for alcohol consumption. While income and SEIFA index, a measure of SES of residential areas, are associated with CHD prevalence, these associations are independent of the risk and protective factor associations. There is no evidence from this study that SES variables confound the effects of known risk and protective factors. The implications of these results are discussed.

APA, Harvard, Vancouver, ISO, and other styles

32

Backhouse, Peter. "Medical knowledge, medical power : doctors and health policy in Australia /." Title page, contents and abstract only, 1994. http://web4.library.adelaide.edu.au/theses/09PH/09phb126.pdf.

Full text

APA, Harvard, Vancouver, ISO, and other styles

33

Jacklyn, Gemma. "The benefits and harms of breast cancer screening in Australia." Thesis, The University of Sydney, 2017. http://hdl.handle.net/2123/17977.

Full text

Abstract:

The introduction of screening mammography in Australia has been associated with an increase in the incidence of early-stage breast cancer. Concern is growing about the problems caused when women are diagnosed with breast cancer and undergo treatments that do not benefit them because their cancer would not progress, or would progress, but would not become symptomatic within the remaining lifetime of the patient. This is known as overdiagnosis. Screening mammography aims to decrease breast cancer morbidity and mortality by advancing in time the diagnosis and thereby increasing the chance of successful treatment. But overdiagnosis and the consequent overtreatment can cause serious lifelong harm and are therefore considered the major downsides of breast screening. Mounting evidence of the extent of overdiagnosis has led to the recognition that the benefits and harms of breast screening are finely balanced, and women need to know the magnitude of the trade-offs. The extent of overdiagnosis due to breast screening is contested, with published estimates ranging from 1% to 57%. There is a critical need for research investigating the harm to benefit ratio in Australia and quantification of the effects of screening mammography on the incidence of stage-specific breast cancer and overdiagnosis. Individual women require information about the impact of regularly attending screening mammography on breast cancer mortality and overdiagnosis to make informed decisions. A challenge to estimating this in a randomised controlled trial is nonadherence to the trial protocol. Previous systematic reviews have provided estimates of the effect of receiving an invitation to screening on the risk of dying due to breast cancer. Chapter 2 presents a meta-analysis of the screening mammography trials using a simple adjustment that estimates the probability of a reduction in breast cancer mortality and risk of overdiagnosis due to the effect of receiving screening by regularly participating in a breast screening program. Adjustment for nonadherence increased the size of the size of the effect by up to 50%. The prevented fraction of breast cancer mortality at 13-year follow-up increased from 0.22 to 0.30 with deattenuation. The percentage risk of overdiagnosis during the screening period in women invited to screening increased from 19.0% to 29.7%. From 2013 through 2017, the Australian national breast cancer screening programme gradually invited women aged 70 to 74 years to attend screening, following a policy decision to extend invitations to older women. Yet no formal evaluation of the effects of the change in policy on outcomes for women was undertaken. Building on my meta-analysis, in Chapter 3 I used a Markov model and applied the breast cancer mortality reduction and overdiagnosis estimates reported in Chapter 2 to Australian breast cancer incidence and mortality data to estimate the benefits and harms of the new package of biennial screening from age 50 to 74 compared with the previous programme of screening from age 50 to 69. I found that the extra five years of screening results in approximately seven more overdiagnosed cancers to avert one more breast cancer death. Thus extending screening mammography in Australia to older women results in a less favourable harm to benefit ratio than stopping at age 69. To identify temporal trends in stage-specific breast cancer in Australia, I used an observational study design to analyse data on women who received a diagnosis of breast cancer from 1972 to 2012 as recorded in the New South Wales Cancer Registry (Chapter 4). I explored trends in stage-specific incidence before screening and compared them to periods after screening began. I found that screening was not associated with lower incidence of late-stage breast cancer at diagnosis and incidence for all stages remained higher than prescreening levels. In women aged 50 to 69 years, the incidence of carcinoma in situ, localised and regional breast cancer has more than doubled compared to the prescreening era. The data presented in Chapter 4 indicate that excess detection of breast cancer is a problem in New South Wales. Thus I designed an ecological study to quantify overdiagnosis. I estimated the background trend of increasing incidence using two approaches, the first based on the prescreening trend in women of screening age (50 years and older), and the second based on the contemporary trend in women too young to be screened (40 to 44 years of age). From these trends, I estimated the expected age-standardised incidence of breast cancer, by stage at diagnosis, in the absence of screening, for women aged 50 years and over in the years since the national screening mammography program, BreastScreen, was introduced (1988 to 2012). I then calculated the difference in observed and expected incidence rates to determine the excess incidence of early-stage breast cancer and reduction in the incidence of late-stage disease. I found that screening mammography has resulted in overdiagnosis of early-stage and regional breast cancer. I estimate that around six additional cases of early and regional breast cancer are detected for every distant metastatic breast cancer prevented. Due to the substantial increase in detection of carcinoma in situ of the breast observed in Chapter 4, I explored sub-types and causes of this. Chapter 6 presents a descriptive analysis of temporal trends in the incidence of ductal carcinoma in situ (DCIS) and lobular carcinoma in situ (LCIS) in women who received a diagnosis from 1972 to 2012, recorded in the NSW Cancer Registry. Carcinoma in situ as a proportion of all breast cancer increased dramatically, and incidence of DCIS across all ages rose from 0.15 per 100,000 during 1972 to 1983 to 16.81 per 100,000 over 2006 to 2012, with the greatest increase seen among women in the target age group for screening (50 to 69 years). DCIS incidence has not stabilized despite screening being well established for over 20 years, and participation rates in the target age range remaining stable. Our observational estimate of overdiagnosis from Chapter 5 is different to those from meta-analyses of randomised controlled trials of screening mammography and some other observational studies. Thus the final paper in this thesis presents a Cochrane Protocol on Overdiagnosis due to screening mammography for women aged 40 years and older (Chapter 7). We present methodology to identify and evaluate all primary epidemiological studies that have quantified overdiagnosis resulting from screening mammography and provide estimates of its frequency (including randomised and observational studies). An approach to assessing the risk of bias due to lead time is also discussed. Trying to quantify the benefits and harms of screening mammography and present them to women using natural frequencies should better enable informed choice, and is consistent with the international shift towards promoting and supporting shared decision making for screening. This thesis provides valuable new evidence about the trade-offs of screening mammography in Australia. The finding that risk of harm is greater than the chance of benefit is consistent with international studies of breast screening and demonstrates the importance of continuing this work to better quantify overdiagnosis for women, clinicians, and policymakers.

APA, Harvard, Vancouver, ISO, and other styles

34

Wang, Wei Chun, and wwang@swin edu au. "A comparison of alternative estimation methods in confirmatory factor analyses of the general health questionnaire across four groups of Australian immigrants." Swinburne University of Technology, 2005. http://adt.lib.swin.edu.au./public/adt-VSWT20051025.122616.

Full text

Abstract:

This thesis examines the implications of using different correlation input matrices and estimation techniques in confirmatory factor analyses (CFAs) when analyzing ordinal, nonnormal data derived from responses of recently arrived Australian immigrants to the 12-item General Health Questionnaire (GHQ-12). The GHQ-12 is one of the most widely used instruments for determining wellbeing in populations. The response format of the GHQ-12 comprises four ordinal categories and underlying distributions of data obtained invariably do not approximate univariate or multivariate normality. Owing to these data properties, consideration should be given to the application of appropriate statistical approaches for analyzing this type of data sets. This study also investigates the extent to which the GHQ-12 is invariant across gender and cultural groups. A three-dimensional measurement model for the GHQ-12 was initially examined for four groups of Australian immigrants who originated from Hong Kong (n = 201), Mainland China (n =213), former Yugoslavia (n = 259), and the United Kingdom (n = 428). A series of CFAs using either a Pearson�s product-moment or a polychoric correlation input matrix and employing either maximum likelihood (ML), weighted least squares (WLS) or diagonally weighted least squares (DWLS) estimation methods was conducted on the data. A comparison of the parameter estimates and goodness-of-fit statistics obtained for the different analyses provided support for using polychoric correlation input matrices and DWLS estimation in CFAs when analyzing ordinal, nonnormal data with smaller sample sizes. Invariance tests across gender and cultural groups were conducted on a second-order measurement model for the GHQ-12, culminating in significant differences between the two Asian and two European cohorts. The GHQ-12 was invariant for immigrants from Hong Kong and Mainland China, as well as for males and females from the United Kingdom. Partial invariance of the GHQ-12 was found for immigrants from Asia, the United Kingdom, and former Yugoslavia and for Asian males and females. Findings from the present study suggest that estimating models based on nonnormal ordinal responses using polychoric correlations with DWLS is more likely to result in a solution with higher parameter estimates and better indices of fit than other approaches. Further research should be conducted on real and simulated data to investigate the efficacy of WLS and DWLS estimation in CFAs when using polychoric correlations as the input data for varying categorical response formats, with a range of model and sample sizes.

APA, Harvard, Vancouver, ISO, and other styles

35

Kelman, Christopher William, and christopher kelman@cmis csiro au. "Monitoring Health Care Using National Administrative Data Collections." The Australian National University. National Centre for Epidemiology and Population Health, 2001. http://thesis.anu.edu.au./public/adt-ANU20020620.151547.

Full text

Abstract:

With the inevitable adoption of information technology into all areas of human pursuit, the potential benefits for health care should not be overlooked. In Australia, details of most health care encounters are currently recorded for administrative purposes. This results in an impressive electronic data-bank that could provide a national resource for health service evaluation. ¶ Evaluation of health services has become increasingly important to provide indicators of the benefits, risks and cost-effectiveness of treatments. However, if administrative data are to be used for this purpose, several questions must first be addressed: Are the current data collections accessible? What outcome measures can be derived from these data? Can privacy issues be managed? Could the quality of the data be improved? Is the existing infrastructure adequate to supply data for evaluation purposes? Could the existing system provide a basis for the development of an integrated health information system? ¶ The aims of the project were: · To examine the potential for using administrative data to generate outcome measures and surveillance indicators. · To investigate the logistics of gaining access to these data for the purpose of research. This to be achieved within the current ethical, political and financial framework. · To compare the Australian health-service data system with the current international state-of-the-art. · To develop suggestions for expansion of the present system as part of an integrated health record and information system. This system to manage patient records and provide data for quality management, treatment surveillance and cost-effectiveness evaluation as a routine activity. ¶ The thesis is presented in two parts. In the first part, a historical cohort study is described that involved patients with implantable medical devices. The potential to evaluate outcomes was investigated using all national health-service information currently available in electronic form. Record linkage techniques were used to combine and augment the existing data collections. Australias national health databases are to varying degrees, amenable to such linkage and cover doctor visits, pharmaceuticals, hospital admissions and deaths. The study focused on medical devices as an illustrative case but the results are applicable to the routine assessment of all medical and surgical interventions. ¶ For the Australian Medical Devices study, the records of 5,316 patients who had medical device implants in 1993-94 were selected from the archives of a major private health insurer. Five groups of medical implants were studied: heart valves, pacemakers, hips, vascular grafts and intra-optic lenses. Outcomes for these patients, including death, re-operation and health service utilisation, were compared and analysed. ¶ A comparison study was performed using data from the Manitoba Health database in Winnipeg, Canada. Manitoba provides a very similar demographic group to that found in Australia and is an example of a prototype integrated-health-information system. One of the principal advantages for research is that personally identified data about medical and hospital services are collected for all patients. Selection bias is eliminated because individual consent is not required for this type of research and all selected patients could be included in the study. ¶ The two studies revealed many barriers to the use of administrative data for health outcomes research. Service event data for the Australian cohort could be collected but only after long delays and hospital morbidity data were not available for the entire cohort. In contrast to the situation in Australia, the Manitoba data were both accessible and complete, but were lacking in detail in some areas. ¶ Analysis of the collected data demonstrated that without the addition of clinical data only general indications of trends could be deduced. However, with minimal supplementary clinical data, it was possible to examine differences in performance between brands of medical devices thus indicating one of the uses for this type of data collection. ¶ In the second part of the thesis, conclusions are presented about the potential uses and limitations of the existing system and its use as a basis for the development of a national Integrated Health Record and Information System (IHRIS). The need for the establishment of a systemic quality management system for health care is discussed. ¶ The study shows that linked administrative data can provide information about health outcomes which is not readily available from other sources. If expanded and integrated, the system that is currently used to collect and manage administrative data, could provide the basis for a national health information system. This system would provide many benefits for health care. Benefits would include the monitoring, surveillance and cost-effectiveness analysis of new and existing treatments involving medical devices, drugs and surgical procedures. An integrated health information system could thus provide for both clinical and administrative needs, while in addition providing data for research. ¶ Unfortunately, in Australia, the use of administrative data for this purpose is not currently feasible. The principal barrier is the existence of a culture within the Australian health care system which is not supportive of research and is deficient in quality and safety measures. ¶ Recent initiatives by both the Commonwealth and state governments have supported the introduction of measures to improve quality and safety in health care. It is argued here that an Integrated Health Record and Information System (IHRIS) would provide an essential component of any such scheme. The results of this study have important policy implications for health care management in both the administrative and clinical domains.

APA, Harvard, Vancouver, ISO, and other styles

36

Parker, Lisa Michelle. "An empirical ethics analysis of breast cancer screening in Australia." Thesis, The University of Sydney, 2016. http://hdl.handle.net/2123/15596.

Full text

Abstract:

Breast screening is controversial. Despite many supporters and a large evidence base, some experienced breast screening experts disagree with selected policies and practices. I sought to examine the reasoning of people who have influenced breast screening in Australia. I used an empirical ethics approach, combining empirical study with theoretical analysis. I interviewed Australians with expertise and influence in breast screening across a range of professional roles. I found that participants drew on values as well as evidence when talking and reasoning about breast screening. Participants expressed a range of interpretations and prioritisations for each value and experts’ disagreements were based, at least in part, on these differences. Experts did not always acknowledge the role of values in shaping their views or recognise different ways of conceptualising or prioritising values. I recommend including values in decision making for breast screening policy and practice. I provide guidance about formats for values based discussions. I conclude that values play an important but often unrecognised role in shaping breast screening policy and practice, and propose regular review of values to deliver breast screening in the most ethically sound manner.

APA, Harvard, Vancouver, ISO, and other styles

37

Osborne, Sonya Ranee, and n/a. "Compliance with standard precautions and occupational exposure reporting among operating room nurses in Australia." University of Canberra. Nursing, 2002. http://erl.canberra.edu.au./public/adt-AUC20060823.161225.

Full text

Abstract:

Occupational exposures of healthcare workers tend to occur because of inconsistent compliance with standard precautions. Also, incidence of occupational exposure is underreported among operating room personnel. The purpose of this project was to develop national estimates for compliance with standard precautions and occupational exposure reporting practices among operating room nurses in Australia. Data was obtained utilizing a 96-item self-report survey. The Standard Precautions and Occupational Exposure Reporting survey was distributed anonymously to 500 members of the Australian College of Operating Room Nurses. The Health Belief Model was the theoretical framework used to guide the analysis of data. Data was analysed to examine relationships between specific constructs of the Health Belief Model to identify factors that might influence the operating room nurse to undertake particular health behaviours to comply with standard precautions and occupational exposure reporting. Results of the study revealed compliance rates of 55.6% with double gloving, 59.1% with announcing sharps transfers, 71.9% with using a hands-free sharps pass technique, 81.9% with no needle recapping and 92.0% with adequate eye protection. Although 31.6% of respondents indicated receiving an occupational exposure in the past 12 months, only 82.6% of them reported their exposures. The results of this study provide national estimates of compliance with standard precautions and occupational exposure reporting among operating room nurses in Australia. These estimates can now be used as support for the development and implementation of measures to improve practices in order to reduce occupational exposures and, ultimately, disease transmission rates among this high-risk group.

APA, Harvard, Vancouver, ISO, and other styles

38

Li, Vincy. "Health promotion in Australia: An empirical study into the approaches adopted and evidence used by practitioners in their practice." Thesis, The University of Sydney, 2017. http://hdl.handle.net/2123/18849.

Full text

Abstract:

Background: Health promotion is commonly defined as “the process of enabling people to increase control over, and to improve, their health”. This definition was originally found in the Ottawa Charter, which was written in 1986 and has been widely considered to be the founding document for health promotion practice. The existing health promotion literature suggests that practitioners have strong commitments to the values and principles presented in the Ottawa Charter and other iconic documents, but their practice contexts may not support the translation and implementation of those values and principles. We currently lack an empirical understanding of how the values and principles underpinning health promotion are conceptualised by practitioners and translated into practice. Methods: A qualitative study was conducted with health promotion practitioners in New South Wales, Australia. 58 semi-structured interviews and 250 hours of participant and non-participant observation were conducted with 54 practitioners. Interviews were recorded and transcribed, and field notes were written during the observations; these were analysed thematically. Results: Health promotion practitioners were committed to improving people’s health effectively and fairly and, to achieve this, worked iteratively between providing people with opportunities for healthy living and enabling them to use the opportunities available to them, concentrating on disadvantaged communities. Practitioners were also committed to evidence-based practice and used different types of evidence for different practical and strategic purposes. Their ideal evidence met both substantive and procedural criteria for evaluating evidence and was primarily generated by practitioners because they found it to be the most useful and relevant to their practice. However, this evidence was lacking in the current evidence base and was not often valued by the system they worked in. Conclusion: This thesis describes practitioners’ conceptualisation of health promotion and how it is translated into their day-to-day practice. It also clarifies the way evidence is valued and used by practitioners, and offers an empirically-based contribution to the ongoing discussions on what and how evidence should be used to guide health promotion practice.

APA, Harvard, Vancouver, ISO, and other styles

39

Kennard, Mark. "A quantitative basis for the use of fish as indicators of river health in eastern Australia." Connect to this title online, 2005. http://www4.gu.edu.au:8080/adt-root/public/adt-QGU20051004.155737/.

Full text

APA, Harvard, Vancouver, ISO, and other styles

40

Polimeni, Anne-Maree, and Anne-Maree Polimeni@dhs vic gov au. "Narrative of women's hospital experiences the impact of powerlessness on personal identity." Swinburne University of Technology, 2004. http://adt.lib.swin.edu.au./public/adt-VSWT20050309.143640.

Full text

Abstract:

Since women dominate the health care system as consumers, it is important to understand how women want to be treated by medical staff, and the factors that contribute to satisfactory hospital experiences. The present research comprised two separate but integrated studies exploring these issues. The first study adopted an atheoretical approach. Qualitative and quantitative methods were used to examine the importance of hospital experiences in the lives of women, and the role of power within those experiences. Closed answer items about hospital experiences were completed by 124 women who had had a hospital stay of at least one night. In addition, ten of the women provided open-ended oral and written comments about their hospital experiences, which were used as the basis of the qualitative data. The majority of the women were satisfied with their hospital stay, but a small group recalled experiences of powerlessness associated with the non-medical aspects of their treatment, such as behaviours on the part of health professionals that influenced participants� sense of control as hospital inpatients. The qualitative data reflected similar issues to the quantitative data and provided �process� information by demonstrating how health professionals� behaviour could contribute to patients� feelings of powerlessness. The results suggested that hospital experiences were a salient part of these women�s lives. The richness of the qualitative data suggested that qualitative methodology would be a productive way to further study this area. The second study was an extension of the first via in-depth interviews with 19 women who perceived their hospital experiences as life-altering. The interview content and the analysis were based on a narrative approach that used the theoretical framework of McAdams� (1993) Life Story Model of Identity. Using McAdams� methodology enabled the researcher to evaluate how women constructed meaning from their hospital experiences, and the main issues they faced. The life story interview also proved a useful way to explore issues of loss and self-growth in the face of traumatic hospital experiences. Transcripts of descriptions of positive and negative experiences were analysed according to McAdams� themes of agency (sense of power and control) and communion (relationships with others), and sequences of redemption and contamination. Redemption sequences involve the storyline moving from a bad, affectively negative life scene, to a good, affectively positive life scene. In a contamination sequence, the narrator describes a change from a good, affectively positive life scene, to a subsequently bad, affectively negative life scene (McAdams & Bowman, 2001). Participants also rated their experiences according to Hermans� (Hermans & Oles, 1999) list of affects. There was strong agreement between McAdams� coding of agency and communion and Hermans� agentic and communal indices: the women�s hospital stories strongly emphasised the negative or opposite of McAdams� agentic theme �Self Mastery through Control�, which indicated powerlessness, and Hermans� affects, which involved low self-enhancement. It may be useful for future studies to conceptualise McAdams� themes as bipolar by incorporating currently coded themes and their reverse; in particular, by expanding ideas of agency to incorporate powerlessness, as this theme was pervasive in women�s hospital experiences. The rating of affects added to the findings as this showed a latent dimension of communion manifested as isolation. The common agency and communion themes were apparent in the two distinct but related aspects of hospitalisation that affect patients� sense of control: the medical condition and the manner in which patients are treated by medical staff. The findings of the main study built on the pilot study by showing how ideas of control and powerlessness can inform better practice. For example, respectful, dignified and fair treatment by health professionals played a part in determining redemption sequences; women also indicated this was how they wanted to be treated. Due to the vulnerability of the �sick role�, disrespectful or offhand treatment by health professionals had particularly distressing effects evident in contamination sequences, such as negative changes to sense of self and attitudes toward the health care system. In some cases, such treatment led to participants� avoiding subsequent interactions with doctors and to sustained feelings of helplessness. The present thesis demonstrates that doctors, nurses and other health professionals need to allow time to attend to the affective as well as the medical aspects of the encounter. Health professionals need a good bedside manner, compassion, and communication skills, as these characteristics play a part in maintaining female patients� sense of self and their faith in and satisfaction with the health care system.

APA, Harvard, Vancouver, ISO, and other styles

41

van, Eyk Helen, and helen vaneyk@health sa gov au. "Power, Trust and Collaboration: A case study of unsuccessful organisational change in the South Australian health system." Flinders University. Medicine, 2005. http://catalogue.flinders.edu.au./local/adt/public/adt-SFU20060130.095828.

Full text

Abstract:

Internationally, health systems have been undergoing an extended period of endemic change, where one effort at health system reform inevitably seems to lead to further attempts to make adjustments, re-direct the focus of the reform effort, or bring about further, sometimes very different changes. This phenomenon is described as churning in this thesis. Churning is a result of continual efforts to adjust and ï¿½improveï¿½ health systems to address intractable ï¿½wickedï¿½ problems, often through applying solutions based on neo-liberal reform agendas that have influenced public sector reform in developed countries since the early 1980s. Consistent with this, the South Australian health system has been caught up in a cycle of change and restructuring for almost thirty years. This qualitative study explores a case study of unsuccessful organisational change initiated by a group of health care agencies in the southern metropolitan area of Adelaide, South Australia, which took place between 1996 and 2001. The agencies sought to develop and establish a regional health service through a process they called ï¿½Designing Better Health Care in the Southï¿½ which aimed to improve the way that services were provided in the area, and to enable the agencies to manage the increasing budgetary and workload pressures that they were all experiencing. A significant policy shift at the state government level meant that this initiative was no longer supported by the central bureaucracy and could not proceed. The agencies reverted from a focus on regional planning and service delivery to an institutional focus. The changes that are described within the scope of the case study are universally recognisable, including centralisation, decentralisation, managerialism and integration. The experience of Designing Better Health Care in the South as an unsuccessful attempt to implement change that was overtaken by other changes is also a universal phenomenon within health systems. This study locates the case study within its historical and policy contexts. It then analyses the key themes that emerge from consideration of the case study in order to understand the reasons for constant change, and the structural and systemic impediments to successful reform within the South Australian health system as an example of health systems in developed countries. As a case study of organisational change, Designing Better Health Care in the South was a story of frustration and disappointment, rather than of successful change. The case study of Designing Better Health Care in the South demonstrates the tensions between the differing priorities of central bureaucracy and health care agencies, and the pendulum swing between the aims of centralisation and regionalisation. The study uses the theory of negotiated order to understand the roles of the key themes of trust, partnership and collaboration, and power and control within the health system, and to consider how these themes affect the potential for the successful implementation of health care reform. Through analysis of the case study, this thesis contributes to an understanding of the difficulties of achieving effective reform within health systems in advanced economies, such as the South Australian health system, because of the complex power and trust relations that contribute to the functioning of the health system as a negotiated order. The study is multidisciplinary and qualitative, incorporating a number of social science disciplines including sociology, political science, historical analysis and organisational theory. Data collection methods for the study included interviews, focus groups, document analysis and a survey.

APA, Harvard, Vancouver, ISO, and other styles

42

Munns, Ailsa M. "Young families' utilisation, self-perceived requirements, and satisfaction with child health services in the City of Belmont, Western Australia." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1998. https://ro.ecu.edu.au/theses/1426.

Full text

Abstract:

The expectations of young families regarding care they would like to receive from community nurses working in the child health area is affected by the relationship between those expectations, utilisation and sociocultural factors such as family type, family composition and ethnicity. These factors influence family dynamics, needs, functioning and interactions with the wider community. A descriptive study with both quantitative and qualitative components was used to identify and analyse the self-identified requirements of young families utilising Child Health Services in the Belmont area, Western Australia, and their patterns of utilisation. Twenty five women who had a child or children under 5 years of age were interviewed. The study was guided by a conceptual framework provided by the Ottawa Charter (World Health Organisation-Health and Welfare Canada-Canadian Public Health Organisation, 1996). The three main themes that emerged from the data showed that the young families identified knowledge acquisition, reassurance of normal growth and development and accessibility as their key self-perceived requirements of Child Health Services. Family type, family composition and ethnicity were examined within the contexts of these themes, resulting in a greater understanding of the child health issues relating to all types of family groups. The challenge for the providers of Child Health Services is to provide culturally appropriate Child Health Services based on the principles of primary health care within an environment experiencing fiscal restraint The long term benefits to the families and the health care system are not easily evaluated but have important and wide ranging positive effects on the health and wellbeing of the community.

APA, Harvard, Vancouver, ISO, and other styles

43

Thielking, Monica, and n/a. "An investigation of attitudes towardss the practice of school-based psychological services." Swinburne University of Technology, 2006. http://adt.lib.swin.edu.au./public/adt-VSWT20060814.091430.

Full text

Abstract:

The provision of school based psychological services in Victorian primary and secondary schools dates back to well before the Second World War. Since then, however, the activities that make up the role of school psychologists have changed substantially. School psychologists' roles have become more varied than the original psychometric focus and reflect a more systemic approach to the conceptualization of student problems. Within Australia, school psychologists can be found servicing single or multiple schools in the government, independent and Catholic school sectors, fulfilling a range of functions and dealing with a diversity of student issues. However, Australian academic research into the professional practice issues associated with the provision of school-based psychological services is rare. Therefore, this thesis sought to investigate a range of professional issues associated with the provision of school-based psychological services for Victorian school psychologists working in single and multiple schools in the government and non-government primary and secondary school sectors. In addition to surveying Victorian school psychologists, principals and teachers were also surveyed in order to ascertain their attitudes towards school-based psychological services. The sample consisted of 81 school psychologists, 21 principals and 86 teachers. The results revealed that school psychologists participate in a variety of activities, including a number of activities that reflect a systemic model of service delivery. They also deal with a broad range of student issues, some of which are quite serious in nature. However, the study also revealed a number of professional issues that were in need of improvement. Some of these included a lack of participation in regular supervision for school psychologists, school psychologists' dissatisfaction with some industrial and professional conditions associated with their role and differences in attitudes between psychologists, principals and teachers regarding the activities and responsibilities of school psychologists. Results from the study provide plausible evidence for the need to support school psychologists in the valuable work that they do within schools through improved industrial conditions, appropriate professional development, and regular supervision. Furthermore the results also reveal a need to educate and participate in dialogue with the educational community in order to increase understanding of school psychologists' roles and professional responsibilities.

APA, Harvard, Vancouver, ISO, and other styles

44

Harvey, Clare Lynette Eden, and clare harvey@flinders edu au. "Through the Looking Glass: The Politics of Advancing Nursing and the Discourses on Nurse Practitioners in Australia." Flinders University. School of Nursing and Midwifery, 2010. http://catalogue.flinders.edu.au./local/adt/public/adt-SFU20100708.110421.

Full text

Abstract:

Nursing has a tradition of subservience and obedience. History provides an account of secular and religious orders of nursing shaping a view of virtuous and tireless dedication in carrying out the doctors orders. Nurse Practitioners were first introduced to the health care system in the 1960s as a solution to the medical shortage being experienced in United States of America at that time. They assumed clinical tasks, traditionally regarded as doctors work. Since then the Nurse Practitioner movement has expanded globally. Australia introduced the Nurse Practitioner role in 1998, heralding a new era in the health system of that country. Its introduction has created diverging views which are influence role implementation. This study examines social and political discourses that are affecting the development of Nurse Practitioners in Australia, using text and language to identify discursive practices. It has set out to determine whether Nurse Practitioners have the autonomy that professional nursing leaders have described in policy, or whether the introduction of the role has merely shifted nursings sphere of influence within a traditional health care system. Using Faircloughs notion of power behind discourse, the language and discourses of Nurse Practitioners were explored in relation to what was happening around role development and how Nurse Practitioners positioned themselves within the environment where they worked. The use of a Critical Discourse Analysis has allowed for the various social, historical and political perspectives of nursing to be examined. Faircloughs three levels of social organisation have been used to identify the divergent discourses between the truths of implementation of the role at individual and organisational level and comparing it to that of the rhetoric of health policy. The discourses surrounding the creation of this advanced nursing role have been the focus of analysis. This analysis has revealed how role development is controlled by powerful groups external to the nursing profession. The dominant discourses use the traditional health care divisions of labour to maintain control through a financially driven focus on health care which does not necessarily revolve around clinical need. Further complicating the position of Nurse Practitioners is the internalisation of those dominant discourses by the nurses themselves. It reinforces Faircloughs view that the dominant power lies behind the discourse, using the system itself to maintain a status quo, rather than overtly opposing it. Nurse Practitioners, despite being held out by the nursing profession as clinical leaders, are not able to influence change in health care or in their own roles. The results have further shown that nursing managers do not have an influence over the direction that health care and nursing takes. Further research is necessary to examine the broader leadership role of nursing within health care nationally and internationally, in order to establish the real position of nursing within the decision making framework of health care service development.

APA, Harvard, Vancouver, ISO, and other styles

45

Macfarlane, Chelsea Elizabeth. "A comparison of the predictors of hepatitis B vaccination acceptance amongst health care and public safety workers in Australia /." View thesis, 2001. http://library.uws.edu.au/adt-NUWS/public/adt-NUWS20031222.150943/index.html.

Full text

Abstract:

Thesis (Ph.D.) -- University of Western Sydney, 2001.
"A thesis submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy, University of Western Sydney" Bibliography : leaves 193-208.

APA, Harvard, Vancouver, ISO, and other styles

46

Hallam, Adrienne Louise, and n/a. "Globalisation, Human Genomic Research and the Shaping of Health: An Australian Perspective." Griffith University. School of Science, 2003. http://www4.gu.edu.au:8080/adt-root/public/adt-QGU20040812.114745.

Full text

Abstract:

This thesis examines one of the premier "big science" projects of the contemporary era - the globalised genetic mapping and sequencing initiative known as the Human Genome Project (HGP), and how Australia has responded to it. The study focuses on the relationship between the HGP, the biomedical model of health, and globalisation. It seeks to examine the ways in which the HGP shapes ways of thinking about health; the influence globalisation has on this process; and the implications of this for smaller nations such as Australia. Adopting a critical perspective grounded in political economy, the study provides a largely structuralist analysis of the emergent health context of the HGP. This perspective, which embraces an insightful nexus drawn from the literature on biomedicine, globalisation and the HGP, offers much utility by which to explore the basis of biomedical dominance, in particular, whether it is biomedicine's links to the capitalist infrastructure, or its inherent efficacy and efficiency, that sustains the biomedical paradigm over "other" or non-biomedical health approaches. Additionally, the perspective allows for an assessment of whether there should be some broadening of the way health is conceptualised and delivered to better account for social, economic, and environmental factors that affect living standards and health outcomes, and also the capacity of globalisation to promote such change. These issues are at the core of the study and provide the theoretical frame to examine the processes by which Australian policy makers have given an increasing level of support to human genomic research over the past decade and also the implications of those discrete policy choices. Overall, the study found that globalisation is renewing and extending the dominance of the biomedical model, which will further marginalise other models of health while potentially consuming greater resources for fewer real health outcomes. While the emerging genomic revolution in health care may lead to some wondrous innovations in the coming decades, it is also highly likely to exacerbate the problems of escalating costs and diminishing returns that characterise health care systems in industrialised countries, and to lead to greater health inequities both within and between societies. The Australian Government has chosen to underwrite human genomic research and development. However, Australia's response to the HGP has involved both convergences and variations from the experiences of more powerful industrial nations. The most significant divergence has been in industry and science policy, where until the mid-1990s, the Australian Government displayed no significant interest in providing dedicated research funding, facilities, or enabling agencies to the emerging field. Driven by the threat of economic marginalisation and cultural irrelevance, however, a transformation occurred. Beginning with the Major National Research Facilities Program of the Department of Industry, Science and Technology, and then the landmark Health and Medical Research Strategic Review, support for human genomic research grew strongly. Comprehensive policy settings have recently been established to promote the innovation, commercialisation, promotion and uptake of the products of medical biotechnology and genomics. As such, local advocates of a broader model of health will be forced to compete on the political and economic stage with yet another powerful new area of biomedicine, and thus struggle to secure resources for perhaps more viable and sustainable approaches to health care in the 21st century.

APA, Harvard, Vancouver, ISO, and other styles

47

Sonderegger, Robi, and n/a. "Patterns of Cultural Adjustment Among Young Former-Yugoslavian and Chinese Migrants To Australia." Griffith University. School of Applied Psychology, 2003. http://www4.gu.edu.au:8080/adt-root/public/adt-QGU20030918.153743.

Full text

Abstract:

Australia is a culturally diverse country with many migrant and refugee families in need of mental health services. Yet, surveys indicate that many culturally diverse community members do not feel comfortable in accessing mental health services, often due to a limited understanding of current western practices and the lack of practitioner cultural sensitivity. Despite the apparent need, few investigations have been conducted with migrant families to understand their different values and needs, and identify how they adjust to a new culture. The paucity of empirical research is largely due to the number of variables associated with the process of cultural change, and the fact that culture itself may lend different meaning to symptom experience, and the expression thereof. Moreover, because migrant adaptation is a complex and multifaceted phenomenon, it is often rendered difficult to investigate. Cultural groups have been observed to exhibit differences in the pathogenesis and expressions of psychological adjustment, thus making culturally sensitive assessment a particularly arduous yet important task. Although the number of studies conducted on cultural adaptation trends of adult migrants is growing, few investigations have examined the acculturation experiences of children and adolescents. Moreover, the link between acculturation and mental health has confounded researchers and practitioners alike. Considering assessment procedures largely influence therapeutic strategies, it is deemed essential that Australian health care professionals understand language, behavioural, and motivational differences between ethnic groups. In response to appeals for empirical data on culture-specific differences and developmental pathways of emotional resiliency and psychopathology, the present research program examines the complex interplay between situational factors and internal processes that contribute to mental health among young migrants and refugees. The research focuses particularly on anxiety, which is not only the most common form of childhood psychopathology but also frequently coincides with stressful life events such as cultural relocation. Two hundred and seventy-three primary and high school students (comprised of former-Yugoslavian and Chinese cultural groups) participated in this research program. Primary (n=131) and high school (n=142) students completed self-report measures of acculturation, internalising symptoms, social support, self-concept/esteem, ethnic identity, and future outlook, and were compared by cultural group, heterogenic ethnicity, school level, gender, and residential duration variables. Specifically, Study 1 aimed to map the cultural adjustment patterns of migrant youth so as to determine both situational and internal process risk and protective factors of emotional distress. The main findings from Study 1 indicate: (1) patterns of cultural adjustment differ for children and adolescents according to cultural background, gender, age, and length of stay in the host culture; (2) former-Yugoslavian migrants generally report greater identification and involvement with Australian cultural norms than Chinese migrant youth; and (3) the divergent variables social support and bicultural adjustment are not universally paired with acculturative stress, as previously indicated in other adult migrant and acculturation studies. These outcomes highlight the importance of addressing the emotional and psychological needs of young migrants from unique age-relevant cultural perspectives. Building on these outcomes, the aim of Study 2 was to propose an organisational structure for a number of single risk factors that have been linked to acculturative stress in young migrants. In recognising that divergent situational characteristics (e.g., school level, gender, residential duration in Australia, social support, and cultural predisposition) are selectively paired with internal processing characteristics (e.g., emotional stability, self-worth/acceptance, acculturation/identity, and future outlook), a top-down path model of acculturative stress for children and adolescents of Chinese and former-Yugoslavian backgrounds was proposed and tested. To determine goodness of model fit, path analysis was employed. Specific cross-cultural profiles, application for the proposed age and culture sensitive models, and research considerations are discussed.

APA, Harvard, Vancouver, ISO, and other styles

48

Macfarlane, Chelsea E., University of Western Sydney, and School of Applied Social and Human Sciences. "A comparison of the predictors of hepatitis B vaccination acceptance amongst health care and public safety workers in Australia." THESIS_XXX_ASH_MacFarlane_C.xml, 2001. http://handle.uws.edu.au:8081/1959.7/784.

Full text

Abstract:

This thesis examines the results of a hepatitis B vaccination questionnaire study that was completed by medical officers, nurses, carers of the developmentally disabled, and correctional officers in the Greater Western Sydney area of New South Wales, Australia. The main aim of the study was to contrast these four high risk occupational groups for their acceptance of hepatitis B vaccination, seroconversion status, and behavioural, attitudinal, motivational and institutional determinants of their vaccination status. The results of the thesis revealed that medical officers and nurses were the most likely to be tested and vaccinated for seroconversion, while DD carers and correctional officers had the largest number of Not Vaccinated respondents. The findings of the questionnaire are discussed in some detail. It is also suggested that groups differ in the degree of hepatitis risk anxiety they experience as well as the degree of control felt over their health status. A number of indications for personal, institutional and governmental interventions to increase vaccination levels are discussed.
Doctor of Philosophy (PhD)

APA, Harvard, Vancouver, ISO, and other styles

49

Pugh, Judith D. "Controlling and constraining the participation of the hepatitis C-affected community in Australia: A critical discourse analysis of the first national hepatitis C strategy and selected news media texts." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2006. https://ro.ecu.edu.au/theses/94.

Full text

Abstract:

The construction of texts that place hepatitis C-positive persons at social risk (Candlin, 1989, p. ix), informs this study of the ways in which public health policy makers and journalists in Australia communicate about hepatitis C. The institutions of public health and the news media form part of the cultural context within which persons construct their illness narratives. The privileged perspectives and framing of public health policy and news media discourses; the discursive practices associated with the institutions of public health and the media around hepatitis C and hepatitis C-positive persons, the “objects” of knowledge (Foucault, 1969/2002, p. 81); and the subject and social positions available to hepatitis C-positive people and spokespersons of non-government organisations (NGOs) representing the hepatitis C-affected community are examined. The place afforded the voices of individuals living with hepatitis C in these forums to discuss topics of public concern is considered.

APA, Harvard, Vancouver, ISO, and other styles

50

Ibell, Bernadette Mary, and res cand@acu edu au. "An Analysis of Mental Health Care in Australia From a Social Justice and Human Rights Perspective, With Special Reference to the Influences of England and the United States of America: 1800-2004." Australian Catholic University. School of Philosophy, 2004. http://dlibrary.acu.edu.au/digitaltheses/public/adt-acuvp113.25102006.

Full text

Abstract:

The aim of this thesis is to analyze mental health care in Australia from a social justice and human rights perspective, in order to demonstrate that social justice as a philosophical manifestation of justice and fairness, is an essential ingredient in the theory and practice of mental health care. It is contended that the needs of the mentally ill would be most appropriately answered by the utilization of a Natural Law model, based on Finnis’s Natural Law theory. The Scope of the Thesis.The needs and care of the mentally ill are discussed, together with the treatment meted out to these vulnerable members of society since, approximately, the year 1800. Neither the criminally insane, nor the intellectually disabled are included in this discourse. Each group of people merits a thesis on its own: criminal insanity requires a debate to include the history, psychiatric and legal approaches to the subject, and current management of the insane. The intellectually disabled are not mentally ill; their ability to function as all round, naturally competent individuals is diminished by an inadequacy and/or impairment of their intellectual capacities. The needs of these two groups are far too broad and demanding to be included within the current thesis. Rationale for the Timeframe The timeframe, 1800 until 2004, has been established because it approximates to the transition from the end of the Classical through the Modern Age to the Post Modern Age, together with the predominance of Enlightenment philosophical theories, and the development of a scientific approach to medicine. Further, many politico-economic and social changes were taking place, associated with the Industrial Revolution. All are shown to have affected the introduction of asylumdom, and the institutionalization of those unable to participate actively in the industrial workforce. Of significant importance to the development of institutionalization for such marginal groups is the philosophy of Jeremy Bentham. Bentham espoused Classical Utilitarianism which will be shown to believe that the ultimate standard of utility is not the individual’s happiness but the greatest amount of happiness altogether. The thesis will demonstrate that this philosophical view prevailed from the beginning of the Industrial Revolution, with Benthamism influencing the sequestration of the unemployable into institutional life. Development of the Thesis.The thesis is developed against a background of prevailing philosophical, and other changes as stated above, including the medicalization of mental illness and the development of psychiatry as a branch of medicine. There is manifestation of many social injustices to those incarcerated in the asylum in all three countries under consideration: England, USA, and Australia. It is demonstrated that social justice and human rights of their work forces were disregarded by many employers at the time of the Industrial Revolution. Such values were, therefore, unlikely to prevail with regard to the mentally ill. Asylumdom continued with few changes in its practices until after World War II. It is shown that the predominance of post Enlightenment theories, together with further politico-economic, social and pharmaceutical revolutionary change followed the Second World War. Encouraged also by the founding of the United Nations and World Health Organizations as well as provision of the Declaration of Human Rights, circumstances led to the process of de-institutionalization of the mentally ill. The latter were decanted with apparently unseemly haste into a community ill prepared for such a change, and with little evidence of infra- structure to support the move. Need to conduct a National Inquiry. There was, then, a need to investigate what was now an overt issue of mental health care. The two subsequent inquiries by the Australian Health Ministers Advisory Council, (AHMAC) and the Burdekin Report, both focused on social justice issues, and addressed epidemiological, economic, sociological and justice considerations. Within the thesis, both investigations are critiqued against a Natural Law model, using Finnis’s Natural Law theory. It is demonstrated that contrary to Enlightenment principles of social justice as described by Miller, such a theory is eminently practical, and answers the needs of all members of the community, providing not merely ‘the greatest happiness for the greatest number’ but the common good of all Conclusion. Evidence shows that such a Natural Law theory is required to give a firm foundation to the needs of the mentally ill, especially at a time when relativism, economic rationalism and negative aspects of globalization prevail. Without such a basis the mentally ill are left insecure, uncertain and adrift in a world uncaring of their plight, while all the earnest exhortations espoused by Reports remain platitudes, subject to the whims of whatever government is in power. Our responsibilities to all our fellow human beings demand better from us than this.

APA, Harvard, Vancouver, ISO, and other styles

Dissertations / Theses on the topic 'Public health – Australia'

Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles