Journal articles on the topic 'Respite care Victoria Melbourne'
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Bryson, Lois. "Talk to Residential Child Care Seminar – November 1984." Children Australia 9, no. 4 (1985): 23–25. http://dx.doi.org/10.1017/s0312897000007505.
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Volard, Jill, Christine Baxter, and Cliff da Costa. "Recruiting Out-of-Home Caregivers for Children with an Intellectual Disability in the Shared Family Care Program." Children Australia 18, no. 4 (1993): 23–27. http://dx.doi.org/10.1017/s1035077200003692.
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Recruiting caregivers for children with an intellectual disability who require out-of-home respite or longer-term care is a problem which has challenged service providers for many years. This paper summarises findings of a recent evaluation of Shared Family Care, a foster care program in Victoria for children with intellectual disabilities/developmental delay. Current recruiting is not succeeding in meeting the demand for either respite, short term or long term care. Findings of the evaluation suggest that factors such as use of appropriate media, and running effective recruitment campaigns is only part of the answer. It is also important at every stage to address caregiver satisfaction with the job and employ strategies to find potential caregivers in the community.
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Stajduhar, Kelli I., Elizabeth Lindsey, and Liza McGuinness. "A Qualitative Evaluation of an HIV/AIDS Respite Care Service in Victoria, Canada." Evaluation & the Health Professions 25, no. 3 (September 2002): 321–44. http://dx.doi.org/10.1177/0163278702025003005.
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Gazey, Angela, Shannen Vallesi, Karen Martin, Craig Cumming, and Lisa Wood. "The Cottage: providing medical respite care in a home-like environment for people experiencing homelessness." Housing, Care and Support 22, no. 1 (November 6, 2018): 54–64. http://dx.doi.org/10.1108/hcs-08-2018-0020.
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Purpose Co-existing health conditions and frequent hospital usage are pervasive in homeless populations. Without a home to be discharged to, appropriate discharge care and treatment compliance are difficult. The Medical Respite Centre (MRC) model has gained traction in the USA, but other international examples are scant. The purpose of this paper is to address this void, presenting findings from an evaluation of The Cottage, a small short-stay respite facility for people experiencing homelessness attached to an inner-city hospital in Melbourne, Australia. Design/methodology/approach This mixed methods study uses case studies, qualitative interview data and hospital administrative data for clients admitted to The Cottage in 2015. Hospital inpatient admissions and emergency department presentations were compared for the 12-month period pre- and post-The Cottage. Findings Clients had multiple health conditions, often compounded by social isolation and homelessness or precarious housing. Qualitative data and case studies illustrate how The Cottage couples medical care and support in a home-like environment. The average stay was 8.8 days. There was a 7 per cent reduction in the number of unplanned inpatient days in the 12-months post support. Research limitations/implications The paper has some limitations including small sample size, data from one hospital only and lack of information on other services accessed by clients (e.g. housing support) limit attribution of causality. Social implications MRCs provide a safe environment for individuals to recuperate at a much lower cost than inpatient admissions. Originality/value There is limited evidence on the MRC model of care outside of the USA, and the findings demonstrate the benefits of even shorter-term respite post-discharge for people who are homeless.
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WAPOLE, BRYAN. "The first national meeting of emergency medicine doctors JULY 1981 MELBOURNE: VICTORIA." Emergency Medicine 3 (August 26, 2009): 188–89. http://dx.doi.org/10.1111/j.1442-2026.1991.tb00730.x.
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Sethuraman, Kannan, and Devanath Tirupati. "Melbourne Pathology." Asian Case Research Journal 11, no. 01 (June 2007): 141–59. http://dx.doi.org/10.1142/s0218927507000850.
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Melbourne Pathology, a subsidiary of Sonic Health Care, provided a comprehensive range of pathology services as an aid in the diagnosis and treatment of patients in Melbourne and Central Victoria. In a capped funding and highly regulated market such as the pathology service market in Australia, the only way in which the sales of a provider could grow was usually at the expense of another provider. To combat this situation, Melbourne Pathology opted to compete by providing higher quality service and faster turnaround time. The recent results of Melbourne Pathology, however, indicated that although the average turnaround time was within the promised targets, significant percentage of jobs in routine category and over 10% of jobs in the urgent category failed to meet the established targets. The case is primarily intended to illustrate the impact of demand distortions in a service setting that arise due to lack of coordination among various entities in the service value chain and a failure to have an integrated perspective that aligns all departments towards a common goal. This phenomenon is similar to the bullwhip effect in supply chains of manufactured products which has received considerable attention during the past decade. The case provides opportunities for students to develop corrective actions to mitigate this problem.
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Ponsford, Jennie, John Olver, Michael Ponsford, and Michael Schönberger. "Two-Year Outcome Following Traumatic Brain Injury and Rehabilitation: A Comparison of Patients From Metropolitan Melbourne and Those Residing in Regional Victoria." Brain Impairment 11, no. 3 (December 1, 2010): 253–61. http://dx.doi.org/10.1375/brim.11.3.253.
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AbstractBackground and Objective:Victoria's trauma management system provides acute care and rehabilitation following traumatic brain injury (TBI), with care of more complex injuries generally provided in specialist centres in metropolitan Melbourne. Little is known about how the outcomes of TBI survivors living in metropolitan Melbourne compare to those who reside in regional Victoria once they return to their community, where support services may be less available. The aim of the present study was to compare, in TBI individuals who have been treated at an inner-city rehabilitation centre in Melbourne, the long-term outcomes of those who live in metropolitan Melbourne (termed ‘Metro’) with those who reside in regional Victoria, termed ‘Regional.’Design and participants:Comparative study with quantitative outcome measures. A total of 959 patients, of whom 645 were designated ‘metro’ and 314 ‘regional’, were followed-up routinely at 2 years post-injury.Outcome measures:Structured Outcome Questionnaire, Glasgow Outcome Scale — Extended, Sickness Impact Profile, Craig Handicap Assessment and Reporting Technique, Hospital Anxiety and Depression Scale, Alcohol Use Disorders Identification Test and Drug Abuse Screening Test.Results:Few differences in outcomes were found between groups. However, after controlling for group differences in age and injury severity, some non-significant trends were suggestive of better outcomes in terms of less social isolation and anxiety and fewer dysexecutive behaviours in regional dwellers.Conclusions:These findings suggest that outcomes in patients from regional areas are at least as good as those from metropolitan Melbourne.
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O'Neill, Cas. "Support in Kith and Kin Care: The Experience of Carers." Children Australia 36, no. 2 (June 1, 2011): 88–99. http://dx.doi.org/10.1375/jcas.36.2.88.
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As a home-based care option for children at risk of significant harm, kinship care placements are steadily increasing in Australia as they are in other western countries. This article describes a qualitative research study undertaken with 65 kin (relative) and kith (nonrelative) carers in Victoria in the years 2004–2007. The aims of the research were to explore the lived experience of carers and to understand their support needs. The findings distinguish similarities and differences between the experience of formal and informal grandparent carers, non-grandparent relative carers and nonrelative carers. The article discusses the role of caregiving for the different groups, family relationships, finances (having enough money, as well as having too little), relationships with government agencies, respite and peer support.
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Miller, Elizabeth M., Joanne E. Porter, and Rebecca Peel. "Palliative and End-of-Life Care in the Home in Regional/Rural Victoria, Australia: The Role and Lived Experience of Primary Carers." SAGE Open Nursing 7 (January 2021): 237796082110362. http://dx.doi.org/10.1177/23779608211036284.
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Introduction Palliative support services (generalist or specialist) can provide much-needed assistance to carers who are providing palliative and end-of-life care in their homes, but access to such services in regional and rural areas of Australia is poorly understood. Objectives This study aimed to explore the role and lived experience of primary carers who are providing palliative and end-of-life care in the home in regional/rural Victoria, Australia. Methods Nine female participants, of whom six were bereaved between 7 and 20 months were interviewed using a semistructured interview technique. Each interview was audio-recorded, transcribed verbatim, and analyzed thematically. Results Two themes emerged: “ Negotiating healthcare systems” which described the needs for multidisciplinary supports and “ The caring experience” which discussed daily tasks, relationships, mental and physical exhaustion, respite, isolation, medication management, and grief and loss. Findings show that regional/rural carers have an added burden of travel stress as well as feeling overwhelmed, isolated, and physically and emotionally exhausted. Carers would benefit from greater flexibility for short-term respite care. The engagement of specialist palliative care services assisted the participants to navigate the health care system. Some participants did not understand the value of palliative care, highlighting the need for general practitioners to conduct early conversations about this with their patients. Education is needed to build capacity within the primary palliative care workforce, confirming the importance of timely referrals to a specialist palliative care practitioner if pain or symptom control is not effectively managed. Conclusion Providing palliative and end-of-life care in the home is an exhausting and emotionally draining role for unpaid, primary carers. Multiple supports are needed to sustain primary carers, as they play an essential role in the primary health care system.
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King, Meredith A., and Jaclyn Yoong. "Palliative care nursing during the COVID-19 pandemic: reflections from Melbourne, Australia." International Journal of Palliative Nursing 29, no. 1 (January 2, 2023): 43–47. http://dx.doi.org/10.12968/ijpn.2023.29.1.43.
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Background: Nurses played a critical role in providing care for patients throughout the COVID-19 pandemic. Aim: This study aimed to explore perspectives of Australian palliative care nurses regarding the impact of COVID-19 on the provision of care for patients with advanced illness, or at the end of life. Methods: The authors conducted a survey of palliative care nurses in ward- and consultation-based roles at a metropolitan health service in Victoria, Australia. Findings: A total of 24 out of 39 nurses completed the survey. Responses included strong themes of fear of COVID-19 and sadness about separating dying patients from their families. Conclusion: Delivery of palliative care changed at an individual and service level. Importantly, there were strong themes of adapting to change and ‘soldiering on’ with the core business of palliative care.
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Cooper, Elizabeth, and Stephen Blarney. "A Norovirus Gastroenteritis Epidemic in a Long-Term–Care Facility." Infection Control & Hospital Epidemiology 26, no. 3 (March 2005): 256–58. http://dx.doi.org/10.1086/502535.
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AbstractBackground:In Victoria, Australia, from July to December 2002, 126 outbreaks of viral and suspected viral gastroenteritis were reported in healthcare institutions. Norovirus was found to account for at least 77 of the 126 outbreaks.Methods:In October 2002, the infection control unit investigated an outbreak of acute gastroenteritis on three wards in a 500-bed, long-term-care facility in Melbourne, Victoria, Australia. Cohorting and other infection control measures were initiated.Results:The outbreak was controlled 32 days after the first symptoms of acute gastroenteritis were identified. Fifty-two patients and 11 staf f members were affected. Norovirus genotype 2 was detected on two of the three wards. Norovirus was not isolated in the third ward but was suspected to be the causative organism.Conclusions:Outbreaks of viral gastroenteritis can cause significant morbidity in a long-term-care facility, affecting both patients and staff. In addition, the transmission of viral pathogens can be well established before there is recognition of an outbreak.
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Cheng, I.-Hao, Jacquie McBride, Miriam Decker, Therese Watson, Hannah Jakubenko, and Alana Russo. "The Asylum Seeker Integrated Healthcare Pathway: a collaborative approach to improving access to primary health care in South Eastern Melbourne, Victoria, Australia." Australian Journal of Primary Health 25, no. 1 (2019): 6. http://dx.doi.org/10.1071/py18028.
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It is important to address the health needs of asylum seekers within the early stages of their arrival in Australia, as this impacts all aspects of their resettlement. However, asylum seekers face a range of barriers to accessing timely and appropriate health care in the community. In 2012, the increasing number of asylum seekers in Australia placed additional demand on health and social services in high-settlement regions. Health providers experienced a substantial increase in Medicare ineligible clients and avoidable presentations to Emergency Departments, and the health needs of new asylum seeker arrivals were not being fully addressed. In response, South Eastern Melbourne Medicare Local, Monash Health, the Australian Red Cross and local settlement support agencies collaborated to develop an integrated healthcare pathway in South Eastern Melbourne to facilitate healthcare access for asylum seekers released from detention. From September 2012 to December 2014, a total of 951 asylum seekers transitioned through the pathway. Seventy-eight percent required primary healthcare assistance, and were provided with a service appointment within 3 weeks of their arrival in Melbourne. This initiative has demonstrated the value of partnership and collaboration when responding to emergent asylum seeker health needs.
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Breman, Rachel, Ann MacRae, and Dave Vicary. "‘The Hidden Victims’–Family Violence in Kinship Care in Victoria." Children Australia 43, no. 3 (May 16, 2018): 186–91. http://dx.doi.org/10.1017/cha.2018.15.
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Family violence is endemic. It has a dramatic and negative impact upon the victims and the family systems in which it occurs. While there is a growing evidence base to support our understanding, prevention and treatment of family violence, little is known about some of its “hidden victims” (e.g., kinship carers). In 2017, Baptcare commenced research with 101 kinship carers in Victoria to gain a better understanding of how family violence, perpetrated by the child's close family member once the placement started, was impacting on children and families. In this context, family violence means any act of physical violence, emotional/psychological violence, verbal abuse and property damage. The study utilised a mixed design methodology that specifically targeted kinship carers who had direct experience of family violence. Findings from this study demonstrated that (1) many kinship carers, and the children in their care, experienced family violence early in the placement, (2) that the violence occurred frequently and (3) the incidents of violence did not occur in isolation. Carers sought support from multiple sources to deal with the family violence, however, the study illustrated that the usefulness of these supports varied. Additionally, findings highlighted reasons why many kinship carers felt reluctant to file a report to end the violence. The study described in this paper is the first step in understanding and exposing this multifaceted issue and delineates some of the major issues confronting Victorian kinship carers experiencing family violence – and the support required to ensure the safety of them and the children they care for. This paper will describe the approach that Baptcare is taking to address family violence in kinship care in western metropolitan Melbourne. This is the second paper in a three-part series relating to family violence in kinship care.
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Rose, Louise, Sioban Nelson, Linda Johnston, and Jeffrey J. Presneill. "Decisions Made By Critical Care Nurses During Mechanical Ventilation and Weaning in an Australian Intensive Care Unit." American Journal of Critical Care 16, no. 5 (September 1, 2007): 434–43. http://dx.doi.org/10.4037/ajcc2007.16.5.434.
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Background Responsibilities of critical care nurses for management of mechanical ventilation may differ among countries. Organizational interventions, including weaning protocols, may have a variable impact in settings that differ in nursing autonomy and interdisciplinary collaboration. Objective To characterize the role of Australian critical care nurses in the management of mechanical ventilation. Methods A 3-month, prospective cohort study was performed. All clinical decisions related to mechanical ventilation in a 24-bed, combined medical-surgical adult intensive care unit at the Royal Melbourne Hospital, a university-affiliated teaching hospital in Melbourne, Victoria, Australia, were determined. Results Of 474 patients admitted during the 81-day study period, 319 (67%) received mechanical ventilation. Death occurred in 12.5% (40/319) of patients. Median durations of mechanical ventilation and intensive care stay were 0.9 and 1.9 days, respectively. A total of 3986 ventilation and weaning decisions (defined as any adjustment to ventilator settings, including mode change; rate or pressure support adjustment; and titration of tidal volume, positive end-expiratory pressure, or fraction of inspired oxygen) were made. Of these, 2538 decisions (64%) were made by nurses alone, 693 (17%) by medical staff, and 755 (19%) by nurses and staff in collaboration. Decisions made exclusively by nurses were less common for patients with predominantly respiratory disease or multiple organ dysfunction than for other patients. Conclusions In this unit, critical care nurses have high levels of responsibility for, and autonomy in, the management of mechanical ventilation and weaning. Revalidation of protocols for ventilation practices in other clinical contexts may be needed.
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Evert, Helen. "Ethnic Families, their Children with Disabilities and their Child Care Needs." Australasian Journal of Early Childhood 21, no. 3 (September 1996): 20–27. http://dx.doi.org/10.1177/183693919602100306.
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Action on Disability within Ethnic Communities (ADEC) was funded by the Department of Human Services and Health, Children's Services branch, to research the needs of families who are from a non-English speaking background and have a child with a disability. Twenty-two families were interviewed about their awareness and need for child care; whether there were any cultural or linguistic barriers in accessing services, and ways services could be improved. Families interviewed were from the Melbourne metropolitan area and represented a number of diverse religious and ethnic backgrounds. The main issues identified included a general lack of information about child care options. In particular, families had a poor knowledge of family day care and out of school hours care. Carers of school-aged children felt there was a need for out of school hours care, particularly over the holiday period. There was no relationship between parents who required a lot of assistance with the child with a disability and the amount of help received or the use of services according to a Spearman's correlation. Different child care options may need to be promoted more widely within ethnic communities. Some positive aspects of child care that need to be highlighted to the carers are the benefits to the child's social and intellectual development and as a form of respite care.
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Chia, A. C. L., M. G. Irwin, P. W. H. Lee, T. H. W. Lee, and S. F. Man. "Comparison of Stress in Anaesthetic Trainees between Hong Kong and Victoria, Australia." Anaesthesia and Intensive Care 36, no. 6 (November 2008): 855–62. http://dx.doi.org/10.1177/0310057x0803600617.
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A postal survey was sent to anaesthetic trainees in Hong Kong and Victoria, Australia to compare work-related stress levels. Demographic data were collected. Anaesthetist-specific stressors, Maslach Burnout Inventory and Global Job Satisfaction scores were used for psychological testing. The response rates from Hong Kong and Melbourne were 64 of 133 (48.1%) and 108 of 196 (55.1%), respectively. Victorian respondents were older with greater family commitments, but more advanced in fulfilling training requirements. Hong Kong respondents, being faced with both the challenge of dual College requirements, exhibited consistently higher indices of stress (P <0.001) and less job satisfaction (P <0.001). Common occupational stressors related to dealing with critically ill patients and medicolegal concerns. Higher stress scores observed in Hong Kong trainees related to service provision and a perceived lack of resources. Despite the complex nature of stress, its antecedents and manifestations, an inverse relationship between emotional exhaustion and job satisfaction was evident in correlation analysis (P <0.001). This survey suggests that stress was present in some trainees in both areas. Hong Kong trainees may benefit from local development to address mental wellbeing as being important to fulfil this highly competitive training program.
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Cox, Shelley, Rohan Martin, Piyali Somaia, and Karen Smith. "The development of a data-matching algorithm to define the ‘case patient’." Australian Health Review 37, no. 1 (2013): 54. http://dx.doi.org/10.1071/ah11161.
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Objectives. To describe a model that matches electronic patient care records within a given case to one or more patients within that case. Method. This retrospective study included data from all metropolitan Ambulance Victoria electronic patient care records (n = 445 576) for the time period 1 January 2009–31 May 2010. Data were captured via VACIS (Ambulance Victoria, Melbourne, Vic., Australia), an in-field electronic data capture system linked to an integrated data warehouse database. The case patient algorithm included ‘Jaro–Winkler’, ‘Soundex’ and ‘weight matching’ conditions. Results. The case patient matching algorithm has a sensitivity of 99.98%, a specificity of 99.91% and an overall accuracy of 99.98%. Conclusions. The case patient algorithm provides Ambulance Victoria with a sophisticated, efficient and highly accurate method of matching patient records within a given case. This method has applicability to other emergency services where unique identifiers are case based rather than patient based. What is known about the topic? Accurate pre-hospital data that can be linked to patient outcomes is widely accepted as critical to support pre-hospital patient care and system performance. What does this paper add? There is a paucity of literature describing electronic matching of patient care records at the patient level rather than the case level. Ambulance Victoria has developed a complex yet efficient and highly accurate method for electronically matching patient records, in the absence of a patient-specific unique identifier. Linkage of patient information from multiple patient care records to determine if the records are for the same individual defines the ‘case patient’. What are the implications for practitioners? This paper describes a model of record linkage where patients are matched within a given case at the patient level as opposed to the case level. This methodology is applicable to other emergency services where unique identifiers are case based.
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Jackson, Terri, and Petia Sevil. "Problems in counting and paying for multidisciplinary outpatient clinics." Australian Health Review 20, no. 3 (1997): 38. http://dx.doi.org/10.1071/ah970038.
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Policy-makers have always found it problematic to formulate fair and consistentcounting rules for public hospital outpatient activities. In the context of output-based funding, such rules have consequences which can affect patient care. This paper reviews the rationale for organising multidisciplinary clinics and reports on a series of focus groups convened in four Melbourne teaching hospitals to consider funding policy for such clinics. It discusses issues of targeting outpatient services, along with implications for payment policy. It evaluates counting rules in terms of intended andunintended consequences in the context of Victoria?s introduction of output-basedfunding for outpatient services.
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Samuel, Sophia, Jenny Advocat, and Grant Russell. "Health seeking narratives of unwell Sri Lankan Tamil refugees in Melbourne Australia." Australian Journal of Primary Health 24, no. 1 (2018): 90. http://dx.doi.org/10.1071/py17033.
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Sri Lankan Tamil refugees are among the largest group of refugees to resettle in Australia in the last decade. The aim of this study is to characterise the narratives of health-seeking among unwell Sri Lankan Tamil refugees in Melbourne, Victoria, Australia. Drawing on a qualitative, phenomenological perspective, we conducted in-depth interviews in Tamil and English with 12 participants who identified as being unwell for 6 months or more. Findings revealed three narratives of health-seeking: the search for the ‘good life’ that was lost or never experienced, seeking help from familiar channels in an unfamiliar context, and the desire for financial and occupational independence. These three narratives are undergirded by the metanarrative of a hope-filled recovery. These narratives of Tamil refugees’ lived experience provide new insights into clinical care and health service delivery.
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Campbell, Lynda. "The Families First Pilot Program in Victoria: Cuckoo or contribution?" Children Australia 19, no. 2 (1994): 4–10. http://dx.doi.org/10.1017/s1035077200003898.
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The Families First Pilot Program in the then Outer East metropolitan region of Melbourne began in mid-1991 as an intensive family preservation and reunification service for children on the verge of state care. The service offered was brief (4-6 week), intensive (up to 20 hours per week), home-based and flexible (24 hour a day, 7 day a week availability) and all members of the household or family were the focus of service even though the goals were clearly grounded in the protection of the child. This paper begins with some of the apprehension expressed both in the field and in Children Australia in 1993, and reports upon the now completed evaluation of the pilot, which covered the first 18 months of operation. The evaluation examined implementation and program development issues and considered the client population of the service against comparative data about those children at risk who were not included. The paper concludes that there is room for Families First in the Victorian system of protective and family services and points to several developmental issues.
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Crock, Elizabeth, and Judy-Ann Butwilowsky. "The HIV Resource Nurse Role at the Royal District Nursing Service (Melbourne): Making A Difference for People Living with HIV/AIDS in the Community." Australian Journal of Primary Health 12, no. 2 (2006): 83. http://dx.doi.org/10.1071/py06026.
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The care of people living with HIV/AIDS in the home and community can be complex and challenging, requiring high levels of knowledge, skill, preparedness and, importantly, the ability to engage with people belonging to marginalised groups. In 2003, the Royal District Nursing Service (RDNS) HIV/AIDS Team in Victoria, Australia, developed the new role of HIV Resource Nurse at two RDNS centres in Melbourne serving high numbers of people living with HIV/AIDS. Drawing from two case studies and interviews with two HIV Resource Nurses from one of the centres, this paper describes this practice innovation. Benefits (including a positive impact on client engagement with services, client care, relationships with other health care workers and job satisfaction) are outlined, along with challenges in the implementation and evolution of the role. Strategies to sustain and develop the HIV Resource Nurse role are proposed.
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Draper, Brian. "G Vernon Davies: unsung pioneer of old age psychiatry in Victoria." Australasian Psychiatry 30, no. 2 (November 8, 2021): 203–5. http://dx.doi.org/10.1177/10398562211045085.
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Objective: To provide a biography of G Vernon Davies who took up a career in old age psychiatry in 1955 at the age of 67 at Mont Park Hospital in an era when there few psychiatrists working in the field. Conclusion: In the 1950s and 1960s, Vernon Davies worked as an old age psychiatrist and published papers containing sensible practical advice informed by contemporary research and experience, broadly applicable to both primary and secondary care, presented in a compassionate and empathetic manner. His clinical research in old age psychiatry resulted in the first doctoral degree in psychiatry awarded at the University of Melbourne at the age of 79. Before commencing old age psychiatry, he served in the Australian Army Medical Corps as a Regimental Medical Officer and received the Distinguished Service Order. He spent 3 years as a medical missionary in the New Hebrides before settling at Wangaratta where he worked as a physician for over 30 years. He contributed to his local community in a broad range of activities. Vernon Davies is an Australian pioneer of old age psychiatry.
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Hall, Martin, and Bradley Christian. "A health-promoting community dental service in Melbourne, Victoria, Australia: protocol for the North Richmond model of oral health care." Australian Journal of Primary Health 23, no. 5 (2017): 407. http://dx.doi.org/10.1071/py17007.
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Despite the best efforts and commitment of oral health programs, there is no evidence that the current surgical output-based model of oral health care is delivering better oral health outcomes to the community. In fact, Australian evidence indicates the oral health of the community could be getting worse. It is now well-understood that this traditional surgical model of oral health care will never successfully manage the disease itself. It is proposed that a health-promoting, minimally invasive oral disease management model of care may lead to a sustainable benefit to the oral health status of the individual and community groups. The aim of this paper is to describe such a model of oral health care (MoC) currently being implemented by the North Richmond Community Health Oral Health (NRCH-OH) program in Melbourne, Victoria, Australia; this model may serve as a template for other services to re-orient their healthcare delivery towards health promotion and prevention. The paper describes the guiding principles and theories for the model and also its operational components, which are: pre-engagement while on the waitlist; client engagement at the reception area; the assessment phase; oral health education (high-risk clients only); disease management; and reviews and recall.
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Street, Annette F., Kate Wakelin, Amanda Hordern, Nicola Bruce, and Dell Horey. "Dignity and Deferral Narratives as Strategies in Facilitated Technology-Based Support Groups for People with Advanced Cancer." Nursing Research and Practice 2012 (2012): 1–7. http://dx.doi.org/10.1155/2012/647836.
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This paper examines the value of facilitated telephone and online support groups for palliative care. Telephone interviews were conducted with twenty people living with advanced cancer who had participated in either a telephone or online support group facilitated by the Cancer Council Victoria, Melbourne, Australia. Two dominant participant narratives emerged: a focus on dying with dignity or an interest in deferring discussion of death and dying to focus on the present. Despite the different approaches, participants found the technology-based support groups to be accessible and safe environments in which to discuss difficult topics in privacy. Technology-based strategies provide opportunities for health professionals to provide social and emotional care to more people by moving beyond individualised care and facilitate peer-to-peer support at the end of life, especially to those with specific needs. Such options are feasible for palliative care services to set up and acceptable to a group of clients, especially for younger clients or those socially or geographically isolated.
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Wiwatowski, Megan, Jane Page, and Sarah Young. "Examining early childhood teachers’ attitudes and responses to superhero play." Australasian Journal of Early Childhood 45, no. 2 (May 1, 2020): 170–82. http://dx.doi.org/10.1177/1836939120918486.
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Research highlights that early childhood teachers (ECTs) hold varied opinions on the value of superhero play (SP) to young children’s learning and development. This study sought to investigate how ECTs in Victoria are responding to superhero play, and to examine the beliefs that underpin their responses. Interviews were conducted with eight ECTs from the Bayside area in Melbourne. The study revealed that while the majority of the teachers interviewed responded to children’s superhero play in a variety of ways, there were a number of barriers to supporting superhero play in early childhood education and care settings. This paper concludes by identifying the value of ECTs engaging in critical reflection to ensure that their responses to superhero play are based on professional knowledge that is informed by theory and research.
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Rogers, Agatha. "The Tracing Problem: An aspect of outcome studies in Child Welfare." Children Australia 17, no. 1 (1992): 16–19. http://dx.doi.org/10.1017/s1035077200030108.
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Between the years 1960 and 1972, well over one thousand children in all spent a period of residence in the St. Vincent de Paul’s Children’s Homes situated at South Melbourne and Black Rock in Victoria. One wonders about the circumstances which bought these children into care and one also wonders where they are now, 20 or 30 years after leaving St. Vincent’s. How have they coped with the stresses of life during those years? Questions such as this led the author to embark on a research project. Few reports of research of this nature are to be found. The following description of one aspect of that project, the task of tracing the subjects, may go some way toward explaining the scarcity. It shows though, that tenacity can have some rewards.
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Eastwood, Kathryn, Dhanya Nambiar, Rosamond Dwyer, Judy A. Lowthian, Peter Cameron, and Karen Smith. "Ambulance dispatch of older patients following primary and secondary telephone triage in metropolitan Melbourne, Australia: a retrospective cohort study." BMJ Open 10, no. 11 (November 2020): e042351. http://dx.doi.org/10.1136/bmjopen-2020-042351.
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BackgroundMost calls to ambulance result in emergency ambulance dispatch (direct dispatch) following primary telephone triage. Ambulance Victoria uses clinician-led secondary telephone triage for patients identified as low-acuity during primary triage to refer them to alternative care pathways; however, some are returned for ambulance dispatch (secondary dispatch). Older adult patients are frequent users of ambulance services; however, little is known about the appropriateness of subsequent secondary dispatches.ObjectivesTo examine the appropriateness of secondary dispatch through a comparison of the characteristics and ambulance outcomes of older patients dispatched an emergency ambulance via direct or secondary dispatch.DesignA retrospective cohort study of ambulance patient data between September 2009 and June 2012 was conducted.SettingThe secondary telephone triage service operated in metropolitan Melbourne, Victoria, Australia during the study period.ParticipantsThere were 90 086 patients included aged 65 years and over who had an emergency ambulance dispatch via direct or secondary dispatch with one of the five most common secondary dispatch paramedic diagnoses.Main outcome measuresDescriptive analyses compared characteristics, treatment and transportation rates between direct and secondary dispatch patients.ResultsThe dispatch groups were similar in demographics, vital signs and hospital transportation rates. However, secondary dispatch patients were half as likely to be treated by paramedics (OR 0.51; CI 0.48 to 0.55; p<0.001). Increasing age was associated with decreasing treatment (p<0.005) and increasing transportation rates (p<0.005).ConclusionSecondary triage could identify patients who would ultimately be transported to an emergency department. However, the lower paramedic treatment rates suggest many secondary dispatch patients may have been suitable for referral to alternative low-acuity transport or referral options.
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Atwell, R., I. Correa‐Velez, and S. Gifford. "Ageing Out of Place: Health and Well‐Being Needs and Access to Home and Aged Care Services for Recently Arrived Older Refugees in Melbourne, Australia." International Journal of Migration, Health and Social Care 3, no. 1 (July 1, 2007): 4–14. http://dx.doi.org/10.1108/17479894200700002.
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Recently arrived older refugees in resettlement countries are a particularly vulnerable population who face many risks to their health and well‐being, and many challenges in accessing services. This paper reports on a project undertaken in Victoria, Australia to explore the needs of older people from 14 recently arrived refugee communities, and the barriers to their receiving health and aged care. Findings from consultations with community workers and service providers highlight the key issues of isolation, family conflict and mental illness affecting older refugees, and point to ways in which policy‐makers and service providers can better respond to these small but deserving communities.
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Pilcher, David V., Graeme Duke, Melissa Rosenow, Nicholas Coatsworth, Genevieve O’Neill, Tracey A. Tobias, Steven McGloughlin, et al. "Assessment of a novel marker of ICU strain, the ICU Activity Index, during the COVID-19 pandemic in Victoria, Australia." Critical Care and Resuscitation 23, no. 3 (September 6, 2021): 300–307. http://dx.doi.org/10.51893/2021.3.oa7.
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OBJECTIVES: To validate a real-time Intensive Care Unit (ICU) Activity Index as a marker of ICU strain from daily data available from the Critical Health Resource Information System (CHRIS), and to investigate the association between this Index and the need to transfer critically ill patients during the coronavirus disease 2019 (COVID-19) pandemic in Victoria, Australia. DESIGN: Retrospective observational cohort study. SETTING: All 45 hospitals with an ICU in Victoria, Australia. PARTICIPANTS: Patients in all Victorian ICUs and all critically ill patients transferred between Victorian hospitals from 27 June to 6 September 2020. MAIN OUTCOME MEASURE: Acute interhospital transfer of one or more critically ill patients per day from one site to an ICU in another hospital. RESULTS: 150 patients were transported over 61 days from 29 hospitals (64%). ICU Activity Index scores were higher on days when critical care transfers occurred (median, 1.0 [IQR, 0.4–1.7] v 0.6 [IQR, 0.3–1.2]; P < 0.001). Transfers were more common on days of higher ICU occupancy, higher numbers of ventilated or COVID-19 patients, and when more critical care staff were unavailable. The highest ICU Activity Index scores were observed at hospitals in north-western Melbourne, where the COVID-19 disease burden was greatest. After adjusting for confounding factors, including occupancy and lack of available ICU staff, a rising ICU Activity Index score was associated with an increased risk of a critical care transfer (odds ratio, 4.10; 95% CI, 2.34–7.18; P < 0.001). CONCLUSIONS: The ICU Activity Index appeared to be a valid marker of ICU strain during the COVID-19 pandemic. It may be useful as a real-time clinical indicator of ICU activity and predict the need for redistribution of critical ill patients.
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Perry, Alison R., and Margaret A. Shaw. "Evaluation of functional outcomes (speech, swallowing and voice) in patients attending speech pathology after head and neck cancer treatment(s): development of a multi-centre database." Journal of Laryngology & Otology 114, no. 8 (August 2000): 605–15. http://dx.doi.org/10.1258/0022215001906516.
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Since April 1997, in Melbourne, Australia, speech pathologists have collaborated to establish a prospective database of functional outcomes of speech, swallowing and voice for patients undergoing head and neck cancer treatments.Staff at eight acute care hospitals, all of which offer speech pathology for head and neck cancer services in Victoria, are contributing data, collated centrally, in an agreed pro forma.Early results are given (after 12 months’ data collection). The implications for clinically-based research, and the future potential for benchmarking outcomes – by expansion of the rehabilitation database beyond the current participating sites – is discussed.This paper outlines the rationale of establishing the database is multicentred, and explores some of the complexities involved, including the challenges inherent in long-term accurate data collection in the head and neck cancer patient population. This work represents the development of an appropriate, usable tool for data collection on functional outcomes.
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Angus, Jocelyn. "Leadership: a central tenet for postgraduate dementia services curricula development in Australia." International Psychogeriatrics 21, S1 (April 2009): S16—S24. http://dx.doi.org/10.1017/s1041610209008825.
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ABSTRACTBackground: In the next decades of the twenty-first century, the global aging of populations will challenge every nation's ability to provide leadership by qualified health professionals to reshape and improve health care delivery systems. The challenge for educators is to design and deliver courses that will give students the knowledge and skills they need to fill that leadership role confidently in dementia care services. This paper explores the ways in which a curriculum can develop graduates who are ready to become leaders in shaping their industry.Method: The Master of Health Science – Aged Services (MHSAS) program at Victoria University, Melbourne, Australia is applied as a case study to describe the process by which the concept of leadership is applied as the key driver in curriculum development, teaching practices and learning outcomes.Results: Evaluation instruments employed in a variety of purposes including teaching, curriculum planning and unit appraisal are discussed. Challenges for the future are proposed including the need for postgraduate programs in dementia to seek stronger national and international benchmarks and associations with other educational institutions to promote leadership and a vision of what is possible and desirable in dementia care provision.Conclusions: In the twenty-first century, effective service provision in the aged health care sector will require postgraduate curricula that equip students for dementia care leadership. The MHSAS program provides an established template for such curricula.
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Dwyer, Alison, and John McNeil. "Are Clinical Registries Actually Used? The Level of Medical Staff Participation in Clinical Registries, and Reporting within a Major Tertiary Teaching Hospital." Asia Pacific Journal of Health Management 11, no. 1 (March 16, 2016): 56–64. http://dx.doi.org/10.24083/apjhm.v11i1.245.
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Clinical Registries are established to provide a clinically credible means for monitoring and benchmarking healthcare processes and outcomes, to identify areas for improvement, and drive strategies for improving patient care. Clinical Registries are used to assess changes in clinical practice, appropriateness of care and health outcomes over time. The American Heart Association Policy Statement in April 2011 called for expanding the application for existing and future Clinical Registries, with well-designed Clinical Registry programs. Concurrently, in Australia, and similarly within the United States and United Kingdom, there has been an increased focus on performance measurement for quality and patient safety. Within Victoria, the Victorian Clinical Governance Policy Framework outlines clinical effectiveness as one of the four domains of Clinical Governance
As Clinical Registries evaluate effectiveness and safety of patient care by measuring patient outcomes compared with peers, the use of Clinical Registries data to improve a health service’s quality of care seems intuitive. A mixed methods approach was utilised, involving (1) semi-structured interviews and (2) documentation audit in this study conducted at Austin Health, a major tertiary teaching hospital in North-Eastern metropolitan Melbourne, affiliated with the University of Melbourne and various research institutes within Austin LifeSciences.
Although many studies have highlighted the benefits of data collected via individual Clinical Registries, [5,6] the level of voluntary medical staff participation in Clinical Registries at a health service level is yet to be established. The aim of this study was to document the level of medical staff involvement for Clinical Registries within a major tertiary teaching hospital, and the level of reporting into Quality Committees within the organisation.
This study demonstrates that along with a very high level of medical staff participation in Clinical Registries, there is a lack of systematic reporting of Registries data into quality committees beyond unit level, and utilisation of such data to reflect upon practice and drive quality improvement.
Abbreviations: CREPS – Centre for Excellence in Patient Safety; CSU – Clinical Services Unit; HOU – Heads of Unit; VASM – Victorian Audit of Surgical Mortality.
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Mcbride, L. J. "Spinal Anaesthesia—Early Australian Experience." Anaesthesia and Intensive Care 33, no. 1_suppl (June 2005): 39–44. http://dx.doi.org/10.1177/0310057x0503301s06.
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Australia in 1902 was a fledgling colony in its second year of Federation with a population of around 3.7 million. European settlement had been largely confined to the coastal margins of this enormous land mass, although some bold adventurers in search of gold and farmland had struggled their way into the interior. Horsham, situated 300 km northwest of Melbourne in the state of Victoria, was founded in June 1849. By 1902 the town, with a population of around 2500, had grown to boast a hospital, two doctors, a pharmacist and a dentist. It was at the Horsham Hospital on January 7, 1902 that Dr Robert Ritchie performed Australia's first recorded spinal anaesthetic. Ritchie performed a lumbar puncture at the L3–4 level, injected 2 ml of 2% cocaine solution and waited for a total of 20 minutes before realising that the sensation the patient was feeling when he pinched him was pressure, not pain. The 78-year-old man with a gangrenous right leg, prostatic obstruction and congestive cardiac failure was laid supine, and had his right leg amputated through the thigh while being administered brandy and water. Strychnine injections were administered four hourly postoperatively. The adoption of the technique of spinal anaesthesia spread quickly in Australia despite communication difficulties at that time.
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Cuthbert, Denise, and Marian Quartly. "Adoption, fostering, permanent care and beyond Re-thinking policy and practice on out-of-home care for children in Australia." Children Australia 35, no. 2 (2010): 2–5. http://dx.doi.org/10.1017/s1035077200000985.
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The papers published in this special issue of Children Australia were originally presented at a two day symposium held in Melbourne on 26 and 27 November 2009. The symposium, Adoption, fostering, permanent care and beyond: Re-thinking policy and practice on out-of-home care for children in Australia, was jointly convened by the Department of Human Services (DHS), Victoria and the School of Political and Social Inquiry at Monash University in conjunction with the History of Adoption in Australia project (Monash University 2009).The event was a partnership between professionals working in this area and university researchers. Each group brought different perspectives and imperatives to the table. For DHS and the sector, the immediate frame of the symposium was the major policy statement Directions for out-of-home care, announced in May 2009 by the Victorian Minister for Community Services after consultation with community service organisations and young people living in care (DHS 2009a). It announces a framework for change which incorporates action on seven fronts or ‘reform directions’. These are to support children to remain at home with their families; to provide a better choice of care placement; to promote wellbeing; to prepare young people who are leaving care to make the transition into adult life; to improve the education of children in care; to develop effective and culturally appropriate responses to the high numbers of Aboriginal children in our care; and to create a child-focused system and processes (DHS 2009a). The driving principle informing the reforms is to ensure that policy and service provision are centred on the needs and interests of children and young people, and to ensure that young people are consulted as to what their needs are (rather than assumptions being made by adults as to their needs).
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Needleman, Robert, Eric P. F. Chow, Janet M. Towns, Vincent J. Cornelisse, Tim Z. T. Yang, Marcus Y. Chen, Catriona S. Bradshaw, Ria Fortune, and Christopher K. Fairley. "Access to sexual health services after the rapid roll out of the launch of pre-exposure prophylaxis for HIV in Melbourne, Australia: a retrospective cross-sectional analysis." Sexual Health 15, no. 6 (2018): 528. http://dx.doi.org/10.1071/sh17182.
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Background On 26 July 2016, Victoria began a large study of HIV pre-exposure prophylaxis, called PrEPX, that involved the creation of around 2600 appointments over 3 months across multiple sites in Melbourne, Australia. At this time, the Melbourne Sexual Health Centre (MSHC) appeared to have a larger demand on its services. The aim of the present study was to determine whether this apparent increase in demand was substantially different from other demand fluctuations. Methods: Patients presenting to the MSHC from 2014 to 2016 were reviewed. Demographic characteristics, sexual risks and sexually transmitted infection diagnoses were extracted from the clinical database. Results: There were 115522 walk-in presentations for care and a rise in presentations in the week following the launch of the PrEPX study, but at least six similar peaks occurred that year. The peak coinciding with the launch of PrEPX was only apparent for men who have sex with men. There was a substantial increase in the proportion of patients who could not be seen (i.e. triaged out), from 10% in the week before PrEPX to 22.2% in the second week after, but this was primarily due to staff absences. At the time of the PrEPX study, data were collected on the duration of symptoms for common conditions and found no significant (P>0.29) change in the average duration of symptoms compared with that seen before the PrEPX launch. Conclusions: The increase in the number of medical consultations required for the PrEPX study did not result in excessive demand for public sexual health services.
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Young, Jesse T., Cheneal Puljević, Alexander D. Love, Emilia K. Janca, Catherine J. Segan, Donita Baird, Rachel Whiffen, Stan Pappos, Emma Bell, and Stuart A. Kinner. "Staying Quit After Release (SQuARe) trial protocol: a randomised controlled trial of a multicomponent intervention to maintain smoking abstinence after release from smoke-free prisons in Victoria, Australia." BMJ Open 9, no. 6 (June 2019): e027307. http://dx.doi.org/10.1136/bmjopen-2018-027307.
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IntroductionSmoke-free policies have been introduced in prisons internationally. However, high rates of relapse to smoking after release from prison indicate that these policies typically result in short-term smoking cessation only. These high rates of relapse, combined with a lack of investment in relapse prevention, highlight a missed opportunity to improve the health of a population who smoke tobacco at two to six times the rate of the general population. This paper describes the rationale and design of a randomised controlled trial, testing the effectiveness of a caseworker-delivered intervention promoting smoking cessation among former smokers released from smoke-free prisons in Victoria, Australia.Methods and analysisThe multicomponent, brief intervention consists of behavioural counselling, provision of nicotine spray and referral to Quitline and primary care to promote use of government-subsidised smoking cessation pharmacotherapy. The intervention is embedded in routine service delivery and is administered at three time points: one prerelease and two postrelease from prison. Control group participants will receive usual care. Smoking abstinence will be assessed at 1 and 3 months postrelease, and confirmed with carbon monoxide breath testing. Linkage of participant records to survey and routinely collected administrative data will provide further information on postrelease use of health services and prescribed medication.Ethics and disseminationEthical approval has been obtained from the Corrections Victoria Research Committee, the Victorian Department of Justice Human Research Ethics Committee, the Department of Human Services External Request Evaluation Committee and the University of Melbourne Human Research Ethics Committee. Results will be submitted to major international health-focused journals. In case of success, findings will assist policymakers to implement urgently needed interventions promoting the maintenance of prison-initiated smoking abstinence after release, to reduce the health disparities experienced by this marginalised population.Trial registration numberACTRN12618000072213; Pre-results.
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MacLean, Sarah. "Out-of-Home Care As an Institutional Risk Environment for Volatile Substance Use." Children Australia 37, no. 1 (March 2012): 23–30. http://dx.doi.org/10.1017/cha.2012.4.
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The exploratory study of meanings of volatile substance use (VSU) on which this article draws (involving 28 young people living in Melbourne, Victoria, Australa, aged from 13 to 24 years, each with experience of VSU, and 14 expert workers) was not designed to investigate any relationship between VSU and living in out-of-home care while subject to protective orders. However, when asked about their lives at the time they commenced or intensified VSU, 8 participants were adamant that living in out-of-home care was a significant factor. Two narratives reiterated by these young people are identified in the article: first that VSU is part of life in out-of-home care, and second that VSU ceases to be appropriate after leaving care. Young people who are living in out-of-home care report substantially higher levels of VSU than occur across the general population. This article shows how narrative accounts (even when expressed by small numbers of participants) provide insight into how VSU and other drug use may become embedded in particular institutional settings through assuming meanings and utility for users that are specific to these environments. While previous literature on the aetiology of VSU generally emphasises individual or familial risk factors, this article argues that out-of-home care may function, at least in some instances, as an institutional ‘risk environment’ for VSU and that this should be further explored through future research. Adjusting models of care may offer new strategies for responding to this form of drug use.
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Collins, Anna, Sue-Anne McLachlan, and Jennifer Philip. "Initial perceptions of palliative care: An exploratory qualitative study of patients with advanced cancer and their family caregivers." Palliative Medicine 31, no. 9 (April 3, 2017): 825–32. http://dx.doi.org/10.1177/0269216317696420.
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Background: Despite evidence for early integration of palliative care for people with advanced cancer and their families, patterns of late engagement continue. Prior research has focused on health professionals’ attitudes to palliative care with few studies exploring the views of patients and their carers. Aim: To explore initial perceptions of palliative care when this is first raised with patients with advanced cancer and their families in Australian settings. Design: Cross-sectional, prospective, exploratory qualitative design, involving narrative-style interviews and underpinned by an interpretative phenomenological framework. Setting/participants: Purposively sampled, English-speaking, adult patients with advanced cancer ( n = 30) and their nominated family caregivers ( n = 25) recruited from cancer services at a tertiary metropolitan hospital in Melbourne, Victoria, Australia. Results: Three major themes evolved which represent the common initial perceptions of palliative care held by patients with advanced cancer and their carers when this concept is first raised: (1) diminished care, (2) diminished possibility and (3) diminished choice. Palliative care was negatively associated with a system of diminished care which is seen as a ‘lesser’ treatment alternative, diminished possibilities for hope and achievement of ambitions previously centred upon cure and diminished choices for the circumstances of one’s care given all other options have expired. Conclusion: While there is an increasing move towards early integration of palliative care, this study suggests that patient and caregiver understandings have not equally progressed. A targeted public health campaign is warranted to disentangle understandings of palliative care as the ‘institutional death’ and to reframe community rhetoric surrounding palliative care from that of disempowered dying to messages of choice, accomplishment and possibility.
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Kong, F., C. Kyle-Link, J. Hocking, and M. Hellard. "11. SEX AND SPORT: A COMMUNITY BASED PROJECT OF CHLAMYDIA TESTING AND TREATMENT IN RURAL AND REGIONAL VICTORIA." Sexual Health 4, no. 4 (2007): 288. http://dx.doi.org/10.1071/shv4n4ab11.
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Chlamydia is the most common notifiable infectious disease in Australia with the number of notifications increasing 92% over the past 5 years. The "Sex and Sport" Project is piloting a community based chlamydia testing and treatment program reaching young people in a specific community setting, sporting clubs. This multifaceted approach utilises health education, population screening and collection of data on risk taking behaviour as the first steps in enhancing health and shaping future service provisions. The project's primary aim is to assess the feasibility of an outreach testing and treatment program. Secondary aims are to measure the prevalence of chlamydia and assess sexual risk behaviour in this population. Strong community collaborations and integration into local health services through the Primary Care Partnerships is important in the project's sustainability; in particular key community members respected by sporting clubs needed to be identified, capacity developed to deliver effective health promotion messages and improve young people's access to sexual health services. Additionally, local knowledge has guided overall program implementation and provides opportunities for capacity building to regionally based services. For example, poor access to sexual health services is being addressed by the participants being able to access services via telephone consultation with Melbourne Sexual Health Centre. Approximately 1000 Victorians aged 16-25 years from the Loddon Mallee region of Victoria will be tested between June and September 2007. This paper will report on the feasibility, challenges and possible solutions in establishing a community based outreach testing and treatment program.
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Polmear, C. M., H. Nathan, S. Bates, C. French, J. Odisho, E. Skinner, A. Karahalios, and F. McGain. "The Effect of Intensive Care Unit Admission on Smokers’ Attitudes and Their Likelihood of Quitting Smoking." Anaesthesia and Intensive Care 45, no. 6 (November 2017): 720–26. http://dx.doi.org/10.1177/0310057x1704500612.
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We sought to estimate the proportion of patients admitted to a metropolitan intensive care unit (ICU) who were current smokers, and the relationships between ICU survivors who smoked and smoking cessation and/or reduction six months post–ICU discharge. We conducted a prospective cohort study at a metropolitan level III ICU in Melbourne, Victoria. One hundred consecutive patients who met the inclusion criteria were included in the study. Inclusion criteria consisted of patients who were smokers at time of ICU admission, had an ICU length of stay greater than one day, survived to ICU discharge, and provided written informed consent. A purpose-designed questionnaire which included the Fagerstrom test for nicotine dependence and evaluation of patients’ attitude towards smoking cessation was completed by participants following ICU discharge and prior to hospital discharge. Participants were re-interviewed over the phone at six months post–ICU discharge. Of the 1,062 patients admitted to ICU, 253 (23%) were current smokers and 100 were enrolled. Six months post–ICU discharge, 28 (33%) of the 86 participants who were alive and contactable had quit smoking and 35 (41%) had reduced smoking. The median number of reported cigarettes smoked per day reduced by 40%. Participants who initially believed their ICU admission was smoking-related were more likely to have quit six months post–ICU discharge (odds ratio 2.98; 95% confidence intervals 1.07, 8.26; P=0.036). Six months post–ICU discharge, 63/86 (74%) of participants had quit or reduced their smoking. Further research into targeted smoking cessation counselling for ICU survivors is indicated.
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Tracy, Jane M. "People with an intellectual disability in the discourse of chronic and complex conditions: an invisible group?" Australian Health Review 33, no. 3 (2009): 478. http://dx.doi.org/10.1071/ah090478.
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TO THE EDITOR: Goddard et al, authors of ?People with an intellectual disability in the discourse of chronic and complex conditions: an invisible group??1 are to be congratulated for raising discussion about one of the most vulnerable groups in Australia with respect to their receipt of optimal health care. The authors conclude that ?developing interventions and strategies to increase the knowledge of health care workers . . . caring for people with intellectual disabilities will likely improve the health care needs of this population and their families?. In relation to this identified need for health professional education and training in the care of people with intellectual disabilities, we would like to draw the attention of your readers to some work undertaken by the Centre for Developmental Disability Health Victoria (CDDHV) to address this issue. The CDDHV works to improve the health and health care of people with developmental disabilities through a range of educational, research and clinical activities. In recent years there has been an increasing awareness of the need for health professional education in this area. Moreover, as people with disabilities often have chronic and complex health and social issues, focusing on their health care provides a platform for interprofessional education and a springboard for understanding the essential importance and value of interprofessional practice. Recently, the CDDHV has taken a lead role in developing a teaching and learning resource that focuses both on the health care of people with disabilities and on the importance and value of interprofessional practice. This resource promotes and facilitates interprofessional learning, and develops understanding of the health and health care issues experienced by people with disabilities and those who support them. ?Health and disability: partnerships in action? is a new video-based teaching and learning package, produced through an interprofessional collaboration between health professionals from medicine, nursing, occupational therapy, physiotherapy, paramedic practice, health science, social work, speech pathology, dietetics and dentistry. Those living with a disability are the experts on their own experience and so their direct involvement in and contribution to the education of health care professionals is essential. The collaboration between those featured in the video stories and health professionals has led to the development of a powerful resource that facilitates students and practitioners developing insights into the health and health care issues encountered by people with developmental disabilities. We also believe that through improving their understanding of, and health provision to, people with disabilities and those who support them, health professionals will acquire valuable attitudes, knowledge and skills applicable to many other patients in their practice population. Jane M Tracy Education Director Centre for Developmental Disability Health Victoria Melbourne, VIC
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James, Christopher, Carmel Delzoppo, James Tibballs, Siva Namachivayam, and Warwick Butt. "Adverse Events Sustained by Children in The Intensive Care Unit: Guiding local quality improvement." Asia Pacific Journal of Health Management 13, no. 3 (December 16, 2018): i20. http://dx.doi.org/10.24083/apjhm.v13i3.113.
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Objective: To determine the frequency, nature and consequence of adverse events sustained by children admitted to a combined general and cardiac paediatric intensive care unit (PICU).
Design: Retrospective analysis of data collected between January 1st 2008 and December 31st 2017 from PICU.
Setting: The Royal Children’s Hospital, a paediatric tertiary referral centre in Melbourne, Victoria, Australia. The PICU has thirty beds.
Results: During the study period, PICU received 15208 admissions, of which 73% sustained at least one adverse event with a frequency of 67 adverse events per 100 PICU-days and 3 per admission. One adverse event was sustained for every 35 hours of care. The risk of an adverse event was highest in children less than a month of age, or if mechanically ventilated, a high Pediatric Index of Mortality (PIM2) score, longer PICU length of stay, had a pre-existing disability or a high risk adjustment for congenital heart surgery (RACHS) score. Those patients who sustained an adverse event, as compared to those who did not, were mechanically ventilated for longer (80 hrs Vs. 7 hrs, p=<0.001), had a longer PICU length of stay (131 hrs Vs. 35 hrs, p=<0.001), had a longer hospital length of stay (484 hrs Vs. 206 hrs, p=<0.001) and had a higher mortality rate (3% vs. 0.1%, p=<0.001).
Conclusion: Whilst admission to PICU is an essential aspect of care for many patients, the risk of adverse events is high and is associated with significant clinical consequences. Monitoring of adverse events as part of quality improvement enables targeted intervention to improve patient safety.
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Zhang, Alexis Ceecee, and Laura E. Downie. "Preliminary Validation of a Food Frequency Questionnaire to Assess Long-Chain Omega-3 Fatty Acid Intake in Eye Care Practice." Nutrients 11, no. 4 (April 11, 2019): 817. http://dx.doi.org/10.3390/nu11040817.
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Clinical recommendations relating to dietary omega-3 essential fatty acids (EFAs) should consider an individual’s baseline intake. The time, cost, and practicality constraints of current techniques for quantifying omega-3 levels limit the feasibility of applying these methods in some settings, such as eye care practice. This preliminary validation study, involving 40 adults, sought to assess the validity of a novel questionnaire, the Clinical Omega-3 Dietary Survey (CODS), for rapidly assessing long-chain omega-3 intake. Estimated dietary intakes of long-chain omega-3s from CODS correlated with the validated Dietary Questionnaire for Epidemiology Studies (DQES), Version 3.2, (Cancer Council Victoria, Melbourne, Australia) and quantitative assays from dried blood spot (DBS) testing. The ‘method of triads’ model was used to estimate a validity coefficient (ρ) for the relationship between the CODS and an estimated “true” intake of long-chain omega-3 EFAs. The CODS had high validity for estimating the ρ (95% Confidence Interval [CI]) for total long-chain omega-3 EFAs 0.77 (0.31–0.98), docosahexaenoic acid 0.86 (0.54–0.99) and docosapentaenoic acid 0.72 (0.14–0.97), and it had moderate validity for estimating eicosapentaenoic acid 0.57 (0.21–0.93). The total long-chain omega-3 EFAs estimated using the CODS correlated with the Omega-3 index (r = 0.37, p = 0.018) quantified using the DBS biomarker. The CODS is a novel tool that can be administered rapidly and easily, to estimate long-chain omega-3 sufficiency in clinical settings.
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Teare, Sheldon, and Danielle Measday. "Pyrite Rehousing – Recent Case Studies at Two Australian Museums." Biodiversity Information Science and Standards 2 (June 13, 2018): e26343. http://dx.doi.org/10.3897/biss.2.26343.
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Two major collecting institutions in Australia, the Australian Museum (Sydney) and Museums Victoria (Melbourne), are currently undertaking large-scale anoxic rehousing projects in their collections to control conservation issues caused by pyrite oxidation. This paper will highlight the successes and challenges of the rehousing projects at both institutions, which have collaborated on developing strategies to mitigate loss to their collections. In 2017, Museums Victoria Conservation undertook a survey with an Oxybaby M+ Gas Analyser to assess the oxygen levels in all their existing anoxic microclimates before launching a program to replace failed microclimates and expand the number of specimens housed in anoxic storage. This project included a literature review of current conservation materials and techniques associated with anoxic storage, and informed the selection of the RP System oxygen scavenger and Escal Neo barrier film from Mitsubishi Gas Chemical Company as the best-practice products to use for this application. Conservation at the Australian Museum in Sydney was notified of wide-scale pyrite decay in the Palaeontology and Mineral collections. It was noted that many of the old high-barrier film enclosures, done more than ten years ago, were showing signs of failing. None of the Palaeontology specimens had ever been placed in microclimates. After consultation with Museums Victoria and Collection staff, a similar pathway used by Museums Victoria was adopted. Because of the scale of the rehousing project, standardized custom boxes were made, making the construction of hundreds of boxes easier. It is hoped that new products, like the tube-style Escal film, will extend the life of this rehousing project. Enclosures are being tested at the Australian Museum with a digital oxygen meter. Pyrite rehousing projects highlight the loss of Collection materials and data brought about by the inherent properties of some specimens. The steps undertaken to mitigate or reduce the levels of corrosion are linked to the preservation of both the specimens and the data kept with them (paper labels). These projects benefited from the collaboration of Natural Sciences conservators in Australia with Geosciences collections staff. Natural Science is a relatively recent specialization for the Australian conservation profession and it is important to build resources and capacity for conservators to care for these collections. This applied knowledge has already been passed on to other regions in Australia.
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Burke, David. "Dementia Care in Victoria: Building a Pathway to Excellence Final Report, Ministerial Taskforce on Dementia Services in Victoria. Melbourne, Australia: Aged, Community & Mental Health Division, Victorian Government Department of Human Services, 1997, 398 pp., No charge." International Psychogeriatrics 11, no. 1 (March 1999): 102–3. http://dx.doi.org/10.1017/s1041610299225628.
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Mitchell, Paul, Jennifer Soon, Joanne Kenny, and Katherine Simons. "What do doctors value about attending multi-disciplinary cancer case discussions?" Journal of Clinical Oncology 37, no. 15_suppl (May 20, 2019): e18324-e18324. http://dx.doi.org/10.1200/jco.2019.37.15_suppl.e18324.
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e18324 Background: Discussion of cancer cases at multi-disciplinary meetings (MDMs) for treatment planning is expected standard care in Australia. There has been rapid uptake of MDMs in the last 10 - 15 years and in the state of Victoria approximately 70% of cancer cases are discussed. MDMs have strong support from medical staff and we investigated their motivation in attending MDMs. Methods: Over 12 months, Austin Health in Melbourne, Victoria, hosted 452 cancer MDMs discussing 5943 patients. MDMs covered 15 tumour areas: 11 solid tumour, one lymphoma and three haematological. Over a 4-week period, medical staff attending MDMs were surveyed and asked to rank what they valued most about cancer MDMs, over and above the benefits for patients. Results: Responses were received from 84% of the 285 medical staff surveyed, which included consultants as well as trainees (registrars and fellows). For 75% of respondents the highest ranking was given to multi-disciplinary communication, 9% gave the highest ranking to quality assurance and governance, 5% ongoing learning for consultants, 5% collegiate relationships, 2% learning and teaching for non-consultant staff, 2% peer support 1% job satisfaction and 1% clinical trials engagement. Similar results were obtained for consultant staff and for registrars / fellows. For consultant medical staff, if multidisciplinary communication was excluded, 44% of respondents gave the highest ranking to quality assurance and governance, 23% to collegiate relationships, 20% ongoing learning for consultants, 10% peer support and 3% clinical trials engagement. Conclusions: When we asked doctors what they valued most about attending cancer MDMs, besides the benefits for patients, communication between disciplines was clearly the most valued aspect. The benefits for quality and governance was the next most valued, then collegiate relationships and peer support, and ongoing learning.
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Dixit, Sunil K., and Murali Sambasivan. "A review of the Australian healthcare system: A policy perspective." SAGE Open Medicine 6 (January 1, 2018): 205031211876921. http://dx.doi.org/10.1177/2050312118769211.
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This article seeks to review the Australian healthcare system and compare it to similar systems in other countries to highlight the main issues and problems. A literature search for articles relating to the Australian and other developed countries’ healthcare systems was conducted by using Google and the library of Victoria University, Melbourne. Data from the websites of the Commonwealth of Australia, the Australian Institute of Health and Welfare, the Australian Productivity Commission, the Organisation for Economic Co-operation and Development and the World Bank have also been used. Although care within the Australian healthcare system is among the best in the world, there is a need to change the paradigm currently being used to measure the outcomes and allocate resources. The Australian healthcare system is potentially dealing with two main problems: (a) resource allocation, and (b) performance and patient outcomes improvements. An interdisciplinary research approach in the areas of performance measurement, quality and patient outcomes improvement could be adopted to discover new insights, by using the policy implementation error/efficiency and bureaucratic capacity. Hospital managers, executives and healthcare management practitioners could use an interdisciplinary approach to design new performance measurement models, in which financial performance, quality, healthcare and patient outcomes are blended in, for resource allocation and performance improvement. This article recommends that public policy implementation error and the bureaucratic capacity models be applied to healthcare to optimise the outcomes for the healthcare system in Australia. In addition, it highlights the need for evaluation of the current reimbursement method, freedom of choice to patients and a regular scrutiny of the appropriateness of care.
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Catroppa, Cathy, Nikita Tuli Sood, Elle Morrison, Justin Kenardy, Suncica Lah, Audrey McKinlay, Nicholas Ryan, et al. "The Australian and New Zealand brain injury lifespan cohort protocol: Leveraging common data elements to characterise longitudinal outcome and recovery." BMJ Open 13, no. 1 (January 2023): e067712. http://dx.doi.org/10.1136/bmjopen-2022-067712.
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IntroductionCognitive, behavioural, academic, mental health and social impairments are common following paediatric traumatic brain injury (TBI). However, studies are often reliant on small samples of children drawn from narrow age bands, and employ highly variable methodologies, which make it challenging to generalise existing research findings and understand the lifetime history of TBI.Method and analysisThis study will synthesise common data sets from national (Victoria, New South Wales, Queensland) and international (New Zealand) collaborators, such that common data elements from multiple cohorts recruited from these four sites will be extracted and harmonised. Participant-level harmonised data will then be pooled to create a single integrated data set of participants including common cognitive, social, academic and mental health outcome variables. The large sample size (n=1816), consisting of participants with mild, moderate and severe TBI, will provide statistical power to answer important questions that cannot be addressed by small, individual cohorts. Complex statistical modelling, such as generalised estimation equation, multilevel and latent growth models, will be conducted.Ethics and disseminationEthics approval was granted by the Human Research Ethics Committee (HREC) of the Royal Children’s Hospital (RCH), Melbourne (HREC Reference Number 2019.168). The approved study protocol will be used for all study-related procedures. Findings will be translated into clinical practice, inform policy decisions, guide the appropriate allocation of limited healthcare resources and support the implementation of individualised care.
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Springall, Tanisha, Della Anne Forster, Helen L. McLachlan, Pamela McCalman, and Touran Shafiei. "Rates of breast feeding and associated factors for First Nations infants in a hospital with a culturally specific caseload midwifery model in Victoria, Australia: a cohort study." BMJ Open 13, no. 1 (January 2023): e066978. http://dx.doi.org/10.1136/bmjopen-2022-066978.
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ObjectivesThere is an urgent need to improve breast feeding rates for Australian First Nations (Aboriginal and Torres Strait Islander) infants. We explored breast feeding outcomes of women having a First Nations infant at three sites that introduced a culturally specific continuity of midwife care model.DesignWomen having a First Nations infant booking for pregnancy care between March 2017 and November 2020 were invited to participate. Surveys at recruitment and 3 months post partum were developed with input from the First Nations Advisory Committee. We explored breast feeding intention, initiation, maintenance and reasons for stopping and factors associated with breast feeding.SettingThree tertiary maternity services in Melbourne, Australia.ParticipantsOf 479/926 eligible women approached, 343 (72%) completed the recruitment survey, and 213/343 (62%) the postnatal survey.OutcomesPrimary: breast feeding initiation and maintenance. Secondary: breast feeding intention and reasons for stopping breast feeding.ResultsMost women (298, 87%) received the culturally specific model. Breast feeding initiation (96%, 95% CI 0.93 to 0.98) was high. At 3 months, 71% were giving ‘any’ (95% CI 0.65 to 0.78) and 48% were giving ‘only’ breast milk (95% CI 0.41 to 0.55). Intending to breast feed 6 months (Adj OR ‘any’: 2.69, 95% CI 1.29 to 5.60; ‘only’: 2.22, 95% CI 1.20 to 4.12), and not smoking in pregnancy (Adj OR ‘any’: 2.48, 95% CI 1.05 to 5.86; ‘only’: 4.05, 95% CI 1.54 to 10.69) were associated with higher odds. Lower education (Adj OR ‘any’: 0.36, 95% CI 0.13 to 0.98; ‘only’: 0.50, 95% CI 0.26 to 0.96) and government benefits as the main household income (Adj OR ‘any’: 0.26, 95% CI 0.11 to 0.58) with lower odds.ConclusionsBreast feeding rates were high in the context of service-wide change. Our findings strengthen the evidence that culturally specific continuity models improve breast feeding outcomes for First Nations women and infants. We recommend implementing and upscaling First Nations specific midwifery continuity models within mainstream hospitals in Australia as a strategy to improve breast feeding.
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Ruth, Denise, Rosalind Hurworth, and Nabil Sulaiman. "Moving towards meaningful local population health data: The service provider perspective." Australian Journal of Primary Health 11, no. 2 (2005): 113. http://dx.doi.org/10.1071/py05029.
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Increasingly, primary care services are required to use data to assess their local population's health needs and plan services. This paper reports focus group discussions of service providers' perceived current practice, issues and needs related to obtaining and using data for planning services in two local government areas of Melbourne. Six groups were conducted with nominees from two municipal councils, four divisions of general practice, three community health services, three hospital networks and eight community organizations. Two groups were conducted with planners and data providers from the Department of Human Services, Victoria. The 66 participants had a broad range of experience in using data to assess local population health needs. Participants reported that issues limiting the use of data related to: access to data (lack of awareness, contacting the right person, poor communication between data providers and users, resource constraints, lack of central access); gaps in data; quality of data (inconsistent definitions and collection, currency, ties to funding); applicability of data (unfriendly format, problems with aggregated versus small area data, non-matching data sets, lack of contextual information); and support for data use in local population health planning. If local population needs assessment is to lead to better health outcomes, service providers need access to high quality data presented in formats that are applicable to their communities. They also need practicable planning methods, skills training and support in using data for local population needs assessment and service planning.