Journal articles on the topic 'Rural population Victoria'
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Rezaei-Darzi, Ehsan, Janneke Berecki-Gisolf, and Dasamal Tharanga Fernando. "How representative is the Victorian Emergency Minimum Dataset (VEMD) for population-based injury surveillance in Victoria? A retrospective observational study of administrative healthcare data." BMJ Open 12, no. 12 (December 2022): e063115. http://dx.doi.org/10.1136/bmjopen-2022-063115.
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ObjectiveThe Victorian Emergency Minimum Dataset (VEMD) is a key data resource for injury surveillance. The VEMD collects emergency department data from 39 public hospitals across Victoria; however, rural emergency care services are not well captured. The aim of this study is to determine the representativeness of the VEMD for injury surveillance.DesignA retrospective observational study of administrative healthcare data.Setting and participantsInjury admissions in 2014/2015–2018/2019 were extracted from the Victorian Admitted Episodes Dataset (VAED) which captures all Victorian hospital admissions; only cases that arrived through a hospital’s emergency department (ED) were included. Each admission was categorised as taking place in a VEMD-contributing versus a non-VEMD hospital.ResultsThere were 535 477 incident injury admissions in the study period, of which 517 207 (96.6%) were admitted to a VEMD contributing hospital. Male gender (OR 1.13 (95% CI 1.10 to 1.17)) and young age (age 0–14 vs 45–54 years, OR 4.68 (95% CI 3.52 to 6.21)) were associated with VEMD participating (vs non-VEMD-participating) hospitals. Residing in regional/rural areas was negatively associated with VEMD participating (vs non-VEMD participating) hospitals (OR=0.11 (95% CI 0.10 to 0.11)). Intentional injury (assault and self-harm) was also associated with VEMD participation.ConclusionsVEMD representativeness is largely consistent across the whole of Victoria, but varies vastly by region, with substantial under-representation of some areas of Victoria. By comparison, for injury surveillance, regional rates are more reliable when based on the VAED. For local ED-presentation rates, the bias analysis results can be used to create weights, as a temporary solution until rural emergency services injury data is systematically collected and included in state-wide injury surveillance databases.
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Loughnan, Margaret, Neville Nicholls, and Nigel Tapper. "Mortality–temperature thresholds for ten major population centres in rural Victoria, Australia." Health & Place 16, no. 6 (November 2010): 1287–90. http://dx.doi.org/10.1016/j.healthplace.2010.08.008.
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Ansari, Z., MJ Ackland, NJ Carson, and BCK Choi. "Small Area Analysis of Diabetes Complications: Opportunities for Targeting Public Health and Health Services Interventions." Australian Journal of Primary Health 11, no. 3 (2005): 72. http://dx.doi.org/10.1071/py05045.
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The objective of this paper is to present small area analyses of diabetes complications in Victoria, Australia, and to illustrate their importance for targeting public health and health services interventions. Local government areas in Victoria were aggregated into 32 Primary Care Partnerships (PCP), which are voluntary alliances of primary care providers. The 32 PCP areas were used as the basic geographic units for small area analyses. Admission rates for diabetes complications were age and sex standardised using the direct method and the 1996 Victorian population as the reference. Admission rate ratios were calculated using the Victorian admission rates as the reference. The 95 per cent confidence intervals for the standardised admission rate ratios were based on the Poisson distribution. There was a wide variation (almost fivefold) in admission rates for diabetes complications across the PCP catchments, with the lowest standardised rate ratio of 0.37 and the highest of 1.75. There were 11 PCPs (seven metropolitan, four rural) with admission rate ratios significantly higher than the Victorian average. The seven metropolitan PCPs contributed more than 43% of all admissions and bed days for diabetes complications in Victoria. Small area analyses of diabetes complications are an exciting new development aimed at stimulating an evidence-based dialogue between local area health service providers, planners and policy-makers. The purpose is to provide opportunities to target public health and health services interventions at the local level to improve the management of diabetes complications in the community.
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Ore, Timothy. "Musculoskeletal malignant neoplasms hospitalisation in Victoria." Journal of Epidemiological Research 1, no. 1 (July 27, 2015): 33. http://dx.doi.org/10.5430/jer.v1n1p33.
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The paper describes factors associated with 2,605 hospital admissions for musculoskeletal malignant neoplasms (MMN) over oneyear. The rates per 10,000 population increased significantly (t=5.3, p<.01) with age, with men (4.5 per 10,000 population, 95% CI 4.1-5.0) at greater risk than women (3.3 per 10,000 population, 95% CI 2.8-3.7). The 30-day readmission rate was 19%, thethird highest of all admission categories. The average length of stay was significantly (t=4.5, p<.01) shorter in the metropolitanarea (8.2 days) than in rural communities (10.8 days). The age-standardised rates varied inversely (r=-0.28) with socioeconomicstatus. Communities with high MMN admission rates had high rates of heart failure admissions (r=0.35), alcohol consumption(r=0.34) and receiving Disability Support Pension (r=0.32). There was a significant (t=13.8, p<.001) monthly variability inMMN hospitalisation rates. As a leading cause of hospital readmission and disability, the condition requires closer analysis.
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Ward, Bernadette, Julie Ellis, and Karen Anderson. "Barriers to the provision of home and community care services to culturally and linguistically diverse populations in rural Australia." Australian Journal of Primary Health 11, no. 2 (2005): 147. http://dx.doi.org/10.1071/py05033.
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In 2002, qualitative methods in the form of in-depth interviews and focus groups were used to gather data from culturally and linguistically diverse (CALD) population residents, service providers and key stakeholders across rural Victoria, to identify and describe barriers to the effective delivery of home services to people from CALD populations in rural Australia. Barriers to the provision of Home and Community Care (HACC) services to CALD populations in rural areas were not specific to HACC programs. For CALD residents, barriers included lack of information about the range of available services, cultural factors, and negative past and recent experiences in dealing with both the broader community and service providers. Service providers indicated lack of information about the profile of the local CALD population and lack of experience in working with these groups to be barriers. Communication was also an issue both for CALD residents and service providers, in terms of cultural factors and specific communication strategies such as inadequate printed material and under-utilisation of existing resources such as interpreter services. As one of the world?s most ethno-culturally diverse nations, Australia has a responsibility to provide health services that are culturally responsive and acceptable. Greater attention needs to be given to the needs of rural CALD population groups in accessing home services.
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Tobin, Margaret J. "Rural Psychiatric Services." Australian & New Zealand Journal of Psychiatry 30, no. 1 (February 1996): 114–23. http://dx.doi.org/10.3109/00048679609076079.
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Objective: The objective was to describe and evaluate a community mental health service developed during 1991–1992 in an attempt to meet the mental illness needs of an isolated rural community. The setting was the Grampians health region in Western Victoria: this region has an area of 45,000 square kilo-metres and a population of 182,000. Method: The method involved firstly describing the evolution of the service delivery model. This comprised a team of travelling psychiatrists and community psychiatric nurses which succeeded in providing a combined inpatient and outpatient service which was integrated with general practitioners. Secondly, diagnostic and case load descriptions of patients receiving service were compared for both the inpatient and outpatient settings. Results: The results were that reduced reliance on inpatient beds and increased consumer satisfaction were achieved. Conclusion: It was concluded that on initial evaluation of the service it was seen to be meeting its objective of treating the seriously mentally ill in an isolated rural community based setting.
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Chang, Susan Soon Mee, and Joan Ozanne-Smith. "Drowning mortality in children aged 0–14 years in Victoria, Australia: detailed epidemiological study 2001–2016." Injury Prevention 26, no. 6 (August 17, 2019): 593–98. http://dx.doi.org/10.1136/injuryprev-2019-043307.
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BackgroundMajor reductions in child drowning mortality rates have been observed historically in Victoria, Australia, for the period 1863–2000. Despite this trend, drowning remains the leading cause of unintentional child death in Victoria. This study investigates the residual fatal drowning problem in the Victorian child population (0–14 years) for the period 2001–2016.AimsDescribe the epidemiology of child drowning deaths in the Victorian population in 2001–2016; investigate risk factors and direct antecedents to these deaths.MethodsPopulation-based retrospective case data were extracted from the National Coronial Information System for 16 years (January 2001–December 2016), and case-by-case analysis was conducted. Associated factors were determined using univariate and Poisson analyses.Results88 of 97 cases had information available for analysis, pools were the most frequent location (30%); 70% of all cases occurred between 08:00 and 17:00; most victims were not deliberately in the body of the water (73%), for example, the pool. Supervision lapses included carers leaving the room when the child was in the bath (16/18), siblings left to supervise the child in private pools (7/23), inadequate pool fences (8/23) or faulty/open gates (4/23), or neighbours’ pool spa (4/23). Delays in finding the child occurred when searches occurred elsewhere, before the body of water (21/88) and when carers were asleep (5/88). Fourteen of the 88 children had an intellectual disability or predisposing medical condition. The grouped Poisson analysis demonstrated that age 0–4 years, male gender and rural place of residence were significant. A downward trend in drowning rate continued in this period.Discussion and conclusionsA case-by-case analysis of a drowned population of children identified details of risk factors and antecedents not previously described. Missing data on antecedents were common, likely resulting in undercounting. Further enhancements to systematic data collection are needed. The results support a systems approach to drowning prevention.
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Bergin, R., J. Emery, R. Bollard, A. Falborg, H. Jensen, D. Weller, U. Menon, et al. "Rural-Urban Variation in Time to Diagnosis and Treatment of Colorectal or Breast Cancer in Victoria, Australia." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 47s. http://dx.doi.org/10.1200/jgo.18.10700.
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Background: Rural-urban disparities in cancer outcomes are found in many countries, though these vary by cancer type. In Victoria, Australia, survival is poorer for rural patients with colorectal cancer, but not breast cancer. Delayed diagnosis and treatment may contribute to disparities, but previous studies have not compared the timeliness of rural and urban pathways to treatment of these common cancers. Aim: We investigated whether time to diagnosis and treatment differed for rural and urban patients with colorectal or breast cancer in Victoria, Australia. Methods: Population-based, cross-sectional surveys examining events and dates on the pathway to treatment completed by patients aged ≥ 40 and approached within six months of diagnosis, their general practitioner (GP) and specialist. Data were collected from 2013 to 2014 as part of the International Cancer Benchmarking Partnership, Module 4. Six intervals were explored: patient (symptom to presentation), primary care (presentation to referral), diagnostic (presentation/screening to diagnosis), treatment (diagnosis to treatment), health system (presentation to treatment) and total intervals (symptom/screening to treatment). Rural-urban differences were examined for each cancer using quantile regression (50th, 75th and 90th percentiles) models including age, gender, health insurance and socioeconomic status. Results: 433 colorectal (48% rural) and 489 breast (42% rural) patients, 621 GPs and 370 specialists completed surveys. Compared with urban patients, symptomatic colorectal cancer patients from rural areas had a significantly longer total interval at all percentiles: 50th (18 days longer, 95% confidence interval (CI): 9-27), 75th (53, 95% CI: 47-59) 90th (44, 95% CI: 40-48). These patients also had longer health system intervals, ranging 7-85 days longer. This appeared mostly due to longer diagnostic intervals (range: 6-54 days longer). Results were similar when including screen-detected cases. In contrast, breast cancer intervals were similar for rural and urban patients, except the patient interval, which was shorter for rural patients. Conclusion: Consistent with variation in survival, we found longer total and diagnostic intervals for rural compared with urban patients with colorectal cancer, but not breast cancer. The lack of rural-urban differences observed for breast cancer suggest that inequities in the timeliness of colorectal cancer pathways can be ameliorated, and may improve clinical outcomes. Indeed, based on previous research, delays observed in this study could result in stage progression and hence reduced survival. From our results, interventions targeting the time from presentation to colorectal cancer diagnosis in rural populations should be pursued. Countries seeking to understand cancer disparities in their local context may also consider using a pathways approach to identify possible targets for policy intervention.
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Zhou, Y., B. D. Hambly, D. Simmons, and C. S. McLachlan. "Sex-specific educational attainment is associated with telomere length in an Australian rural population." QJM: An International Journal of Medicine 113, no. 7 (February 19, 2020): 469–73. http://dx.doi.org/10.1093/qjmed/hcaa031.
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Abstract Background There is limited understanding on whether and how socioeconomic status (SES), particularly educational attainment and household income, impacts on telomere length in an Australian rural context. Additionally, it is unknown whether access to health services via the Australian public or private health system influences telomere length. Aim This study investigates whether there is a relationship between telomere length and SES indicators (income, education) as well as health insurance status in a rural Australian population. Methods Samples were drawn from the Australian Rural Victoria cross-sectional Crossroads Study. Leucocyte telomere length (LTL) was measured using a multiplex quantitative polymerase chain reaction method. Results Among 1424 participants, we did not find a significant main effect association with LTL across education, income level and health insurance. An exploratory finding was sex may influence the relationship between educational attainment and LTL (P = 0.021). In males, but not females, higher education was associated with longer LTL by 0.033 [95% confidence interval (CI) 0.002–0.063, P = 0.035]; in those with low education attainment, male participants had shorter LTL by 0.058 (95% CI −0.086 to −0.029) than female participants (P < 0.0001). Conclusion Being male and having lower education attainment was associated with shorter telomere length in our rural population. Evidence from our study supports the importance of education on LTL in males in rural Australia. Our studies also support previous findings that LTL in later life may not be closely associated with indicators of SES.
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Kong, Fabian Y. S., Jane S. Hocking, Chris Kyle Link, Marcus Y. Chen, and Margaret E. Hellard. "Sex and sport: sexual risk behaviour in young people in rural and regional Victoria." Sexual Health 7, no. 2 (2010): 205. http://dx.doi.org/10.1071/sh09071.
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Background: To determine the prevalence of chlamydia and understand sexual risk behaviour in 16–29 year olds in rural Victoria through a chlamydia testing program undertaken at local sporting clubs. Methods: Young people were recruited from the Loddon Mallee region of Victoria, Australia between May and September 2007. After a night of sporting practice, participants provided a first pass urine sample and completed a brief questionnaire about sexual risk behaviour. Those positive for chlamydia were managed by telephone consultation with a practitioner from Melbourne Sexual Health Centre. Results: A total of 709 young people participated (77% male, 23% female) in the study; 77% were sexually active. Overall chlamydia prevalence in sexually active participants was 5.1% (95% confidence interval [CI]: 3.4–7.3); 7.4% in females (95% CI: 3.5–13.6) and 4.5% in males (95% CI: 2.7–6.9). Approximately 60% of males and 20% of females consumed alcohol at high ‘Risky Single Occasion Drinking’ levels at least weekly and 60% had used an illicit drug in their lifetime. Nearly 45% reported having sex in the past year when they usually wouldn’t have because they were too drunk or high. Sexually transmissible infection (STI) knowledge was generally poor and only 25% used a condom the last time they had sex. Conclusion: Chlamydia prevalence was high in our study population. Many participants had poor knowledge about STIs and low condom use. These findings combined with high levels of risky alcohol use and having sex while intoxicated highlights the need for programs in rural and regional Victoria that combine both STI testing and prevention and education programs.
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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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Adams, Jessie, Susan Brumby, Kate Kloot, Tim Baker, and Mohammadreza Mohebbi. "High-Heat Days and Presentations to Emergency Departments in Regional Victoria, Australia." International Journal of Environmental Research and Public Health 19, no. 4 (February 14, 2022): 2131. http://dx.doi.org/10.3390/ijerph19042131.
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Heat kills more Australians than any other natural disaster. Previous Australian research has identified increases in Emergency Department presentations in capital cities; however, little research has examined the effects of heat in rural/regional locations. This retrospective cohort study aimed to determine if Emergency Department (ED) presentations across the south-west region of Victoria, Australia, increased on high-heat days (1 February 2017 to 31 January 2020) using the Rural Acute Hospital Data Register (RAHDaR). The study also explored differences in presentations between farming towns and non-farming towns. High-heat days were defined as days over the 95th temperature percentile. International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM) codes associated with heat-related illness were identified from previous studies. As the region has a large agricultural sector, a framework was developed to identify towns estimated to have 70% or more of the population involved in farming. Overall, there were 61,631 presentations from individuals residing in the nine Local Government Areas. Of these presentations, 3064 (5.0%) were on days of high-heat, and 58,567 (95.0%) were of days of non-high-heat. Unlike previous metropolitan studies, ED presentations in rural south-west Victoria decrease on high-heat days. This decrease was more prominent in the farming cohort; a potential explanation for this may be behavioural adaption.
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Graymore, Michelle, Anne Wallis, and Kevin O'Toole. "Understanding drivers and barriers: the key to water use behaviour change." Water Supply 10, no. 5 (December 1, 2010): 679–88. http://dx.doi.org/10.2166/ws.2010.125.
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In southwest Victoria, like many other regions in Australia, drought, climate change and population growth have exposed gaps in water supply. To develop effective demand management strategies for rural and regional areas, this paper investigates the drivers and barriers to water saving in southwest Victoria. Although the majority of people felt water saving was important, the drivers for water saving differed between different groups. Residential users were saving water for altruistic reasons, while for farmers the drivers were farm viability and productivity. Although the barriers differed between property types, common barriers included lack of understanding of the impact their water use has on supplies, lack of knowledge, the pricing system and distrust of the water authority. The findings provide information for effective demand management strategies for the region.
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McIntosh, Kate, Amanda Kenny, Mohd Masood, and Virginia Dickson-Swift. "Social inclusion as a tool to improve rural health." Australian Journal of Primary Health 25, no. 2 (2019): 137. http://dx.doi.org/10.1071/py17185.
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Health inequalities between metropolitan and rural areas persist despite a range of interventions over recent years. Social inclusion is often linked to health outcomes, yet few studies examine social inclusion across different geographic areas. In this study, a set of indicators of social inclusion were drawn together and sourced data were aligned to these indicators, which are readily available to primary health practitioners and population health planners. Through this process, a useful framework that provides a nuanced understanding to guide primary health policy and practice has been produced. Using Victoria as an example, 11 domains of social inclusion were explored using population data across 79 local government areas. Analysis highlighted significant differences in several indicators, with rural and regional local government areas ranking higher on measures of social participation, trust and social resources. The use of a diversity of data sources provided information on the social, economic, and education issues of an area, along with relational factors such as safety, trust, community resources and civic participation. A social inclusion lens can inform action to address the rural–urban primary health divide by determining and exploring the social inclusion characteristics of communities.
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Onyango, Dancan O., Christopher O. Ikporukpo, John O. Taiwo, and Stephen B. Opiyo. "Monitoring the extent and impacts of watershed urban development in the Lake Victoria Basin, Kenya, using a combination of population dynamics, remote sensing and GIS techniques." Environmental & Socio-economic Studies 9, no. 2 (June 1, 2021): 11–25. http://dx.doi.org/10.2478/environ-2021-0007.
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Abstract Several urban centres of different sizes have developed over time, and continue to grow, within the basin of Lake Victoria. Uncontrolled urban development, especially along the lake shore, puts environmental pressure on Lake Victoria and its local ecosystem. This study sought to monitor the extent and impacts of urban development (as measured by population growth and built-up land use/land cover) in the Lake Victoria basin, Kenya, between 1978 and 2018. Remote sensing and GIS-based land use/land cover classification was conducted to extract change in built-up areas from Landsat 3, 4, 5 and 8 satellite imagery obtained for the month of January at intervals of ten years. Change in population distribution and density was analysed based on decadal census data from the Kenya National Bureau of Statistics between 1979 and 2019. A statistical regression model was then estimated to relate population growth to built-up area expansion. Results indicate that the basin’s built-up area has expanded by 97% between 1978 and 2018 while the population increased by 140% between 1979 and 2019. Urban development was attributed to the rapidly increasing population in the area as seen in a positive statistical correlation (R2=0.5744) between increase in built-up area and population growth. The resulting environmental pressure on the local ecosystem has been documented mainly in terms of degradation of lake water quality, eutrophication and aquatic biodiversity loss. The study recommends the enactment and implementation of appropriate eco-sensitive local legislation and policies for sustainable urban and rural land use planning in the area. This should aim to control and regulate urban expansion especially in the immediate shoreline areas of the lake and associated riparian zones.
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Kennedy, Alison, Jessie Adams, Jeremy Dwyer, Muhammad Aziz Rahman, and Susan Brumby. "Suicide in Rural Australia: Are Farming-Related Suicides Different?" International Journal of Environmental Research and Public Health 17, no. 6 (March 18, 2020): 2010. http://dx.doi.org/10.3390/ijerph17062010.
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Rural Australians experience a range of health inequities—including higher rates of suicide—when compared to the general population. This retrospective cohort study compares demographic characteristics and suicide death circumstances of farming- and non-farming-related suicides in rural Victoria with the aim of: (a) exploring the contributing factors to farming-related suicide in Australia’s largest agricultural producing state; and (b) examining whether farming-related suicides differ from suicide in rural communities. Farming-related suicide deaths were more likely to: (a) be employed at the time of death (52.6% vs. 37.7%, OR = 1.84, 95% CIs 1.28–2.64); and, (b) have died through use of a firearm (30.1% vs. 8.7%, OR = 4.51, 95% CIs 2.97–6.92). However, farming-related suicides were less likely to (a) have a diagnosed mental illness (36.1% vs. 46.1%, OR=0.66, 95% CIs 0.46–0.96) and, (b) have received mental health support more than six weeks prior to death (39.8% vs. 50.0%, OR = 0.66, 95% CIs 0.46–0.95). A range of suicide prevention strategies need adopting across all segments of the rural population irrespective of farming status. However, data from farming-related suicides highlight the need for targeted firearm-related suicide prevention measures and appropriate, tailored and accessible support services to support health, well-being and safety for members of farming communities.
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Graham, Susan K., and Ian D. Cameron. "A survey of rehabilitation services in Australia." Australian Health Review 32, no. 3 (2008): 392. http://dx.doi.org/10.1071/ah080392.
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A survey, which achieved a 54% response rate, was completed to assess the availability and type of rehabilitation health services in Australia. 1044 surveys were sent out and 561 were returned. The details of a total of 346 rehabilitation services were obtained. There were more services in metropolitan compared with rural areas, more services in New South Wales and Victoria than in the other states, and a higher proportion of services led by health care workers other than rehabilitation physicians in rural compared with metropolitan areas. There is likely to be a need for additional rehabilitation services of all types across Australia. The majority of rural, regional and remote areas are likely to need additional physician-led, allied health and nursing services. Further work is needed to assess the size and catchment areas of services in the capital cities and other large population centres to assess whether additional services are also needed in these areas.
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Pendrey, Catherine G. A., Marion Carey, and Janet Stanley. "Impacts of extreme weather on the health and well-being of people who are homeless." Australian Journal of Primary Health 20, no. 1 (2014): 2. http://dx.doi.org/10.1071/py13136.
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This letter responds to the article by Cusack et al., ‘Extreme weather-related health needs of people who are homeless’ (Australian Journal of Primary Health, 2013, 19(3), 250–255), which addressed the impacts of extreme weather on the health of the homeless population in inner city Adelaide. We compare the findings of Cusack et al. to our own original research, based on interviews with service providers to the homeless in urban and rural Victoria. We further place this issue in the broader context of climate change, which is crucial given the expected increase in extreme weather events and associated health impacts.
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Tham, Rachel, Penny Buykx, Leigh Kinsman, Bernadette Ward, John S. Humphreys, Adel Asaid, Kathy Tuohey, and Rohan Jenner. "Staff perceptions of primary healthcare service change: influences on staff satisfaction." Australian Health Review 38, no. 5 (2014): 580. http://dx.doi.org/10.1071/ah14015.
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Strong primary healthcare (PHC) services are efficient, cost-effective and associated with better population health outcomes. However, little is known about the role and perspectives of PHC staff in creating a sustainable service. Staff from a single-point-of-entry primary health care service in Elmore, a small rural community in north-west Victoria, were surveyed. Qualitative methods were used to collect data to show how the key factors associated with the evolution of a once-struggling medical service into a successful and sustainable PHC service have influenced staff satisfaction. The success of the service was linked to visionary leadership, teamwork and community involvement while service sustainability was described in terms of inter-professional linkages and the role of the service in contributing to the broader community. These factors were reported to have a positive impact on staff satisfaction. The contribution of service delivery change and ongoing service sustainability to staff satisfaction in this rural setting has implications for planning service change in other primary health care settings. What is known about this topic? Integrated PHC services have an important role to play in achieving equitable population health outcomes. Many rural communities struggle to maintain viable PHC services. Innovative PHC models are needed to ensure equitable access to care and reduce the health differential between rural and metropolitan people. What does this paper add? Multidisciplinary teams, visionary leadership, strong community engagement combined with service partnerships are important factors in the building of a rural PHC service that substantially contributes to enhanced staff satisfaction and service sustainability. What are the implications for practitioners? Understanding and engaging local community members is a key driver in the success of service delivery changes in rural PHC services.
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de Silva, Andrea M., Jacqueline Martin-Kerry, Alexandra Geale, and Deborah Cole. "Flying blind: trying to find solutions to Indigenous oral health." Australian Health Review 40, no. 5 (2016): 570. http://dx.doi.org/10.1071/ah15157.
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Objective The aim of the present study was to identify all published evidence about oral health in Indigenous children in Australia and to determine trends in Indigenous oral health over time. Methods PubMed was used to search for published peer-reviewed articles that reported caries (decay) prevalence rates and/or caries experience (based on caries indices) in Indigenous children. Studies included in the analysis needed to report clinical oral health data (not self-reported dental experiences), and articles were excluded if they reported caries in only a select, specific or targeted sample (e.g. only children undergoing hospital admissions for dental conditions). Results The review identified 32 studies that met the inclusion criteria. These studies reported data from the Northern Territory (n = 14), Western Australia (n = 7), South Australia (n = 7), Queensland (n = 7), New South Wales (n = 1), Australian Capital Territory (n = 1) and Tasmania (n = 1). Of the studies, 47% were in rural locations, 9% were in urban locations and 44% were in both rural and urban locations. Data are limited and predominantly for Indigenous children living in rural locations, and there are no published studies on caries in Indigenous children living in Victoria. Conclusions The present study documents the published prevalence and severity of caries in Indigenous children living in Australia and highlights that limited oral health data are available for this priority population. Although risk factors for oral disease are well known, most of the studies did not analyse the link between these factors and oral disease present. There is also inconsistency in how caries is reported in terms of age and caries criteria used. We cannot rely on the available data to inform the development of policies and programs to address the oral health differences in Indigenous populations living contemporary lives in metropolitan areas. What is known about the topic? Many studies report that Indigenous people have poorer general health in Australia compared with non-Indigenous people. What does this paper add? This paper documents the available published prevalence and experience of caries for Indigenous children in Australia. It demonstrates significant limitations in the data, including no Victorian data, inconsistency with reporting methods and most data being for Indigenous children who are living in rural locations. What are the implications for practitioners? It is important for practitioners to have access to oral health data for Indigenous children in Australia. However, the present study highlights significant knowledge gaps for this population group and identifies ways to collect data in future studies to enable more meaningful comparisons and policy development.
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Marunda, Edmond, and Taka Munyanyiwa. "Tourism and Hospitality Curriculum for Rural Communities Neighbouring National Parks in Zimbabwe." Australian Journal of Business and Management Research 03, no. 10 (October 1, 2013): 46–53. http://dx.doi.org/10.52283/nswrca.ajbmr.20130310a03.
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The tourism and hospitality industry in Zimbabwe today, is the third largest foreign currency earner after agricultural exports and mining products. The industry is grounded on the country’s unique cultural and natural heritage which is made up of sensitive ecosystems encompassing national parks and wildlife. The growth of tourism stimulating increasing investments in the industry may trigger adverse long term effects of developments in biodiversity and loss of wildlife. It is therefore vital that communities living next to tourist attractions be educated so that they practise eco-tourism or sustainable tourism as a matter of priority. The focus of this article is to identify a curriculum for the education of communities living in and around tourist attractions in Zimbabwe. Such a curriculum should equip the communities with the requisite understanding to preserve and protect their environment effectively applying contemporary and traditional knowledge systems. In a bid to come up with an education curriculum and training programmes incorporating tourism and hospitality education, some 145 out of a population of 300 respondents were interviewed in and around the tourist resort areas of Nyanga, Harare, Bulawayo and Victoria Falls. The article extends a realistic and practical framework for the development of a curriculum and training-programme-guideline for communities incorporating “Tourism and Hospitality” as a subject.
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Serena, M., and T. R. Grant. "Effect of flow on platypus (Ornithorhynchus anatinus) reproduction and related population processes in the upper Shoalhaven River." Australian Journal of Zoology 65, no. 2 (2017): 130. http://dx.doi.org/10.1071/zo17025.
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The platypus (Ornithorhynchus anatinus) occupies a wide range of aquatic habitats, feeding mainly on benthic macroinvertebrates. In this study, we investigated how flow affects platypus reproduction in the unregulated upper Shoalhaven River in rural New South Wales. In a mainly dry period, the population occurred at relatively high density (12.4 animals km–1) and was strongly female-biased (84% of resident animals); mean annual loss and recruitment of resident females were respectively estimated to be 12% and 14%. Percentage lactation was 17–71% (n = 23 years), and annual reproductive success (defined as the mean number of juveniles captured per adult/subadult female from February to April) varied from 0 to 1.5 juveniles female–1 (n = 21 years). A significant positive linear relationship was evident between percentage lactation and antecedent discharge in the five months before breeding (March–July) and a positive curvilinear relationship was evident between percentage lactation and mean litter size. Conversely, reproductive success was compromised by high poststorm discharge in the period when juveniles are confined to a nesting burrow, especially from late November to early January. The relationships identified in our study between flow and reproduction also appear to apply to platypus populations occupying urban streams in Victoria, suggesting that they may be widely relevant to this species.
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F Jelinek, Herbert, Clare Wilding, and Paul Tinely. "An innovative Multi-disciplinary Diabetes Complications Screening Program in a Rural Community: A Description and Preliminary Results of the Screening." Australian Journal of Primary Health 12, no. 1 (2006): 14. http://dx.doi.org/10.1071/py06003.
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This paper describes an innovative multi-disciplinary pilot project for people living in rural north-east Victoria and southern New South Wales that focused on screening for diabetes complications. Participants enrolled for the diabetes screening through media announcements. A total of 91 participants were screened, 14 with diabetes. Screening tests included 12-lead ECG, ankle-brachial index, monofilament sensitivity, retinal photography as well as blood biochemistry. Twenty-six participants were referred to their general practitioners with cardiovascular anomalies, eight had retinal vasculature changes indicating diabetes, and 26 had foot problems that warranted podiatric assessment. This project illustrates that a university-based screening clinic is feasible, can be operated in conjunction with major research projects and results in significant community benefit. Serious health issues were identified in 31% of the study population. Without involvement in the screening, these people?s medical conditions may have otherwise remained hidden, potentially leading to significant health problems.
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Falk, Joern, Björn Globisch, Martin Angelmahr, Wolfgang Schade, and Heike Schenk-Mathes. "Drinking Water Supply in Rural Africa Based on a Mini-Grid Energy System—A Socio-Economic Case Study for Rural Development." Sustainability 14, no. 15 (August 2, 2022): 9458. http://dx.doi.org/10.3390/su14159458.
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Water is an essential resource required for various human activities such as drinking, cooking, growing food, and personal hygiene. As a key infrastructure of public services, access to clean and safe drinking water is an essential factor for local socio-economic development. Despite various national and international efforts, water supply is often not guaranteed, especially in rural areas of Africa. Although many water resources are theoretically available in these areas, bodies of water are often contaminated with dangerous pathogens and pollutants. As a result, people, often women and children, have to travel long distances to collect water from taps and are exposed to dangers such as physical violence and accidents on their way. In this article, we present a socio-economic case study for rural development. We describe a drinking water treatment plant with an annual capacity of 10,950 m3 on Kibumba Island in Lake Victoria (Tanzania). The plant is operated by a photovoltaic mini-grid system with second-life lithium-ion battery storage. We describe the planning, the installation, and the start of operation of the water treatment system. In addition, we estimate the water prices achievable with the proposed system and compare it to existing sources of drinking water on Kibumba Island. Assuming a useful life of 15 years, the installed drinking water system is cost-neutral for the community at a cost price of 0.70 EUR/m3, 22% less than any other source of clean water on Kibumba Island. Access to safe and clean drinking water is a major step forward for the local population. We investigate the socio-economic added value using social and economic key indicators like health, education, and income. Hence, this approach may serve as a role model for community-owned drinking water systems in sub-Saharan Africa.
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Cloney, Thomas, Jessele Vinluan, Andrew Chen, Claudia Retegan, and Philip McCahy. "Stakeholder’s perceived value of surgical audit data provided by the Victorian Audit of Surgical Mortality." Health Information Management Journal 50, no. 1-2 (November 29, 2019): 55–63. http://dx.doi.org/10.1177/1833358319885223.
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Background: Clinical audits can vary in their effectiveness depending on how the information is provided and the relationship between those giving and receiving feedback. In the Australian state of Victoria, the Victorian Audit of Surgical Mortality (VASM) is a state-wide mortality audit that, prior to this study, did not have a bidirectional feedback mechanism in place to gauge perception of the audit held by its stakeholders. Objective: We aimed to investigate the perceived quality of the audit’s information and the effectiveness of the audit’s communication strategies from the stakeholder population. Methods: We used a mixed methods approach to provide open-ended explorations into stakeholders’ views while also providing structured tools for conducting annual reviews. The qualitative data were analysed using an inductive content analysis. Results: Between 2015 and 2017, 240 VASM stakeholders were contacted, of whom 82 (34.2%) agreed to be interviewed. The VASM’s data were perceived to be of high quality and used in a variety of ways. The audit’s communication strategies were seen to be adequate but could be more targeted to the stakeholder. There is a perception that the audit might not be relevant to hospital stakeholders that are not themselves clinicians, despite direct involvement with the audit. Conclusion: This study helps to explain the role the audit plays among its stakeholders and offers three overarching recommendations for improvement strategies: produce data sharing strategies that are relevant to rural or highly specialised surgical centres, improve communication to be targeted at stakeholders and explore methods to provide feedback to hospital management with more individualised feedback.
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Di Leo, A., and M. Tallini. "Irrigation, groundwater exploitation and cult of water in the rural settlements of Sabina, Central Italy, in Roman times." Water Supply 7, no. 1 (March 1, 2007): 191–99. http://dx.doi.org/10.2166/ws.2007.022.
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Archaeological surveys conducted in Sabina, about 50 km away from Rome, intended to reconstruct the ancient agricultural and pastoral landscape. They identified interesting remains of roman small family farms at Montenero Sabino and Mompeo (province of Rieti), villages located near Via Salaria (the “salt way”) and the Farfa stream, a tributary of the Tiber River, which in ancient times, both were the main trade routes of central Italy, linking Rome to the Apennines and to the Adriatic coast. There a network of underground channels and tanks, fictile water pipes and pools, at times connected to one another, was found. Many of them are still used today, given the low population growth and the lack of modern industrial development of this area and to its isolation, in spite of its proximity to Rome. Moreover the study area holds a votive stone dedicated to the Sabine-Roman goddess of water Vacuna, a multiform Sabine and Central-Italic goddess with many characteristics and functions, known also as Minerva-Bellona-Victoria, Feronia, Caerere, or as Angerona-Angitia. It was related to an agricultural-pastoral shrine for the cult of water whose anthropological relevance still survives in yearly livestock fairs and in the local worship of the Holy Mary of parturients.
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Stubbins, Ryan J., Lauren Lee, Yasser Abou Mourad, Michael J. Barnett, Raewyn Broady, Donna L. Forrest, Alina S. Gerrie, et al. "Older Adults with Acute Myeloid Leukemia in Rural Areas Are Less Likely to Receive Azacitidine with Worsened Overall Survival." Blood 132, Supplement 1 (November 29, 2018): 3989. http://dx.doi.org/10.1182/blood-2018-99-111532.
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Abstract Introduction Acute myeloid leukemia (AML) in older adults is a challenging clinical problem with a poor prognosis. Hypomethylating agents, such as azacitidine, improve survival in this population. (Oran B, Haematologica 2012) These treatments can be challenging to deliver, particularly in patients far from tertiary care centres. We examined whether residence outside of a major metropolitan area impacted referral patterns, treatments, and outcomes in a population-based cohort of AML patients over age 60 in British Columbia (BC), Canada. Methods Patients with ICD-10 diagnoses of AML were identified from the population based BC Cancer registry and BC Cancer pharmacy database. Diagnoses between 2010 and 2016 were included. Exclusion criteria included diagnosis age less than 60 years, any treatment outside BC, or APL. The diagnosis of AML was verified by chart review. Azacitidine was available at our institution in 2010, and is used primarily for patients with bone marrow blast counts below 30%. Patients were defined as having a hematologist/oncologist assessment if a provider with these credentials was listed in notes or pathology reports. Patients were defined as having received a treatment if it was dispensed at least once, with a date after AML diagnosis. Patients were defined as urban if they had a mailing address in a center of >/= 100,000 people, per the Statistics Canada definition, and rural if they had a mailing address elsewhere. Urban residences included greater Vancouver, Victoria and Kelowna, which comprise 71.5% of the population. (Statistics Canada, 2016 census) Between group differences were assessed by 2-tailed t-test or chi-square tests. Overall survival (OS) was assessed by Kaplan-Meier, with a log-rank test, and Cox regression. A p < 0.05 was significant. Results A total of 879 patients over age 60 with AML, excluding APL, were identified. Of these, 525 (60%) resided in urban areas vs 354 (40%) residing in rural areas. These groups were similar for median age at diagnosis (urban 75.9 years, rural 74.3 years, p = 0.067), adverse cytogenetic profile (urban 56%, rural 44%, p = 0.356), NPM1 positivity (urban 69%, rural 31%, p = 0.101) and FLT3 positivity (urban 76%, rural 24%, p = 0.052). Rural residents were less likely to have a documented hematologist/oncologist assessment (urban 84%, rural 65%, p < 0.001). Few patients overall received induction chemotherapy (151, 17%), with no difference between rural and urban residency (p = 0.524). Similarly, few patients underwent hematopoietic stem cell transplantation (38, 4%), with no difference with place of residence (p = 1.000). Median OS for patients treated with induction chemotherapy was 11.0 months (95% CI 9.0 - 13.1 mo). Median OS for patients treated with subcutaneous (SC) azacitidine was 7.1 months (95% CI 4.8 - 9.5 mo) vs 4.7 months (95% CI 3.3 - 6.1 mo) with SC cytarabine. With best supportive care, the median OS was 1.7 months (95% CI 1.5 - 1.9 mo). Median follow-up was 43.7 months (95% CI 39.2 - 48.2 mo), with 706 (97%) of patients deceased at last follow-up. Amongst the 728 patients who did not receive induction chemotherapy, 82 (11%) received SC cytarabine and 127 (17%) received SC azacitidine. Place of residence did not impact whether patients received SC cytarabine (urban 10%, rural 13%, p = 0.285). Rural residents were, however, less likely to receive SC azacitidine (urban 21%, rural 12%, p = 0.002). In patients not undergoing induction, rural residents had a worse OS by Kaplan-Meier analysis (p = 0.021), with a hazard ratio of 1.2 (95% CI 1.026 - 1.387, p = 0.022) on univariate Cox regression. Conclusions Older adults with a diagnosis of AML who reside in rural areas of BC are less likely to have a documented hematologist/oncologist assessment, and are less likely to receive SC azacitidine. This group also has a worsened OS, though the effect size is modest. There was no difference in rates of treatment with potentially curative regimens, although this approach applied to a minority of patients. We hypothesize that this difference may be partially due to the travel burdens placed on rural patients who receive SC azacitidine, which must be administered in a healthcare facility, unlike SC cytarabine. Less access to supportive care in rural areas is also likely a contributing factor. Policymakers should direct additional resources for rural oncologic healthcare delivery, and the importance of low burden drug formulations is AML should be emphasized. Disclosures No relevant conflicts of interest to declare.
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Koo, Kendrick, Nathan Papa, Melanie Evans, Michael Jefford, Maarten J. IJzerman, and Jeremy Laurence Millar. "Mapping geographical disparities in population-level patient-reported quality of life following prostate cancer management." Journal of Clinical Oncology 39, no. 15_suppl (May 20, 2021): e18531-e18531. http://dx.doi.org/10.1200/jco.2021.39.15_suppl.e18531.
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e18531 Background: Prostate cancer patients generally have good survival outcomes, but some survivors have poor functional outcomes with persisting symptoms and poor quality of life (QoL). Socio-economic status (SES), access to specialist care and place of residence (including rural, remote areas) are associated with poor survival. These variables may also impact survivorship outcomes, including QoL. This study aimed to identify and visualise geographical disparities in QoL outcomes for prostate cancer survivors. Methods: We extracted complete data for 7690 patients, including patient-reported EPIC-26 QoL questionnaire results (12 months post-treatment), from the Prostate Cancer Outcomes Registry–Victoria (PCOR-VIC), a population-based clinical quality outcomes registry. Patient-matched geographic coordinates were obtained through the Victorian Cancer Registry. Scores from each of the 5 EPIC-26 functional domains were visualised using geospatial maps and correlated to the Index of Relative Socio-economic Advantage and Disadvantage (IRSAD) and geographical remoteness. A composite score condensing all 5 domains into a single number (range 5 – 20) was created for succinct visualisation of functional outcomes. We analysed hotspots using the Getis-Ord Gi* statistic. Results: Scores in all 5 functional domains were positively correlated to IRSAD, which remained an independent predictor of low functional score when controlling for age, disease stage, treatment modality and geographical remoteness (p < 0.001 for all). Geographical remoteness predicted low functional score in all domains (p < 0.05) except Urinary Irritative but was not statistically significant when adjusted for IRSAD. The constructed composite score was significantly correlated to IRSAD and remoteness in a univariate model (p < 0.001). In a multivariate model, remoteness was not an independent predictor of outcome, but the composite score rose by 0.13 for each IRSAD decile (p < 0.001), with patients in the bottom decile of IRSAD more likely to have composite scores below median ( < 14) than those in the top decile (OR 1.8 CI 1.4-2.2 p < 0.001). The composite score allowed visualisation of functional outcomes in a single figure and identification of geographic hotspots with poor outcome. Conclusions: Systematic collection of long-term patient-reported outcomes is feasible. Geographical disparities in QoL outcome following prostate cancer treatment correlated with SES and remoteness, and we note the relative importance of SES over remoteness. A single composite score for EPIC-26 showed face-validity. Our results will allow targeted efforts to further understand the drivers of these findings and improve equity in survivorship outcomes for prostate cancer survivors. The methods developed in this study can be extended and re-deployed to evaluate outcomes in other jurisdictions and cancer types.
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Bravo Avalos, María Belén, Maritza Vaca Cárdenas, José Luis López Salazar, María Fernanda Herrera Chico, and Jenny Margoth Villamarín Padilla. "Analysis of rural egg production to improve the economy of the Andean communities in Ecuador." F1000Research 8 (November 13, 2019): 1919. http://dx.doi.org/10.12688/f1000research.21023.1.
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Background: An economically active population refers to people involved in any economic activity, such as agriculture, livestock, or industry. This activity can supply benefits to its owners and may generate the growth of small businesses. Our study presents a qualitative analysis of the egg production in Ecuadorian Andean communities (Tzimbuto, Bayushig "La Liberad," and La Victoria "Pusuca.") Methods: Analysis was performed using a random sample of 81 hens and 29 eggs obtained from 65 producers, belonging to 50 farming families at the Utopia Community Fair. Zoometric characterization of the hens was carried out according to FAO protocols, and egg yolk quality, egg width and weight, and egg shell weight and thickness were calculated. The 65 producers were interviewed to answer questions pertaining to selling eggs, costs of production, and realized profit. The profit/cost indicator was calculated from the ratio of expenditure (egress) and total revenue of egg sales. Results: 84% of surveyed participants indicated that they purchase eggs for their nutritional value, 12% because the animals are raised with organic food, and 4% showed preference for the eggs’ special flavor. The quality analysis of the eggs sold at the Fair demonstrated that the average weight of the eggs was 47.24 g; the length was 55.24 mm; and the width was 41.66 mm; weight and thickness of the shell were 4.90 g and 0.42 mm, respectively. The color of the yolk had a brightness of 57.62 L*, 5.53 a* for red/green tones and 47.15 b* for yellow/blue tones. The costs to produce the eggs for the Fair was US$0.21 with a profit/cost of US$0.04 per egg; the unit sale price is US$0.25. Conclusions: 84% of surveyed participants indicated that they purchase eggs for their nutritional value, revealing the need to train the communities toward more efficient egg production.
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Hardman, Ruth, Stephen Begg, and Evelien Spelten. "Multimorbidity and its effect on perceived burden, capacity and the ability to self-manage in a low-income rural primary care population: A qualitative study." PLOS ONE 16, no. 8 (August 9, 2021): e0255802. http://dx.doi.org/10.1371/journal.pone.0255802.
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Introduction Multimorbidity is increasing in prevalence, especially in low-income settings. Despite this, chronic conditions are often managed in isolation, potentially leading to burden-capacity imbalance and reduced treatment adherence. We aimed to explore, in a low-income population with common comorbidities, how the specific demands of multimorbidity affect burden and capacity as defined by the Cumulative Complexity Model. Materials and methods Qualitative interviews with thirteen rural community health centre patients in Victoria, Australia. Participants were aged between 47–72 years and reported 3–10 chronic conditions. We asked about perceived capacity and burden in managing health. The Theory of Patient Capacity was used to analyse capacity and Normalisation Process Theory to analyse burden. All data specifically associated with the experience of multimorbidity was extracted from each burden and capacity domain. Results The capacity domains of biography, resource mobilisation and work realisation were important in relation to multimorbidity. Conditions causing functional impairment (e.g. chronic pain, depression) interacted with physical, psychological and financial capacity, leading to biographical disruption and an inability to realise treatment and life work. Despite this, few people had a treatment plan for these conditions. Participants reported that multimorbidity affected all burden domains. Coherence and appraisal were especially challenging due to condition interactions, with clinicians providing little guidance. Discussion The capacity and burden deficits highlighted by participants were not associated with any specific diagnosis, but were due to condition interactions, coupled with the lack of health provider support to navigate interactions. Physical, psychological and financial capacities were inseparable, but rarely addressed or understood holistically. Understanding and managing condition and treatment interactions was a key burden task for patients but was often difficult, isolating and overwhelming. This suggests that clinicians should become more aware of linkages between conditions, and include generic, synergistic or cross-disciplinary approaches, to build capacity, reduce burden and encourage integrated chronic condition management.
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de Silva, Andrea M., Jacqueline M. Martin-Kerry, Katherine McKee, and Deborah Cole. "Caries and periodontal disease in Indigenous adults in Australia: a case of limited and non-contemporary data." Australian Health Review 41, no. 4 (2017): 469. http://dx.doi.org/10.1071/ah15229.
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Objective The aim of the present study was to identify all evidence about the prevalence and severity of clinically measured caries and periodontal disease in Indigenous adults in Australia published in peer-reviewed journals and to summarise trends over time. In addition, we examined whether the studies investigated associations between putative risk factors and levels of caries and periodontal disease. Methods PubMed was searched in September 2014, with no date limitations, for published peer-reviewed articles reporting the prevalence rates and/or severity of caries and periodontal disease in Indigenous adults living in Australia. Articles were excluded if measurement was not based on clinical assessment and if oral disease was reported only in a specific or targeted sample, and not the general population. Results The search identified 18 papers (reporting on 10 primary studies) that met the inclusion criteria. The studies published clinical data about dental caries and/or periodontal disease in Australian Indigenous adults. The studies reported on oral health for Indigenous adults living in rural (40%), urban (10%) and both urban and rural (50%) locations. Included studies showed that virtually all Indigenous adults living in rural locations had periodontal disease. The data also showed caries prevalence ranged from 46% to 93%. Although 10 studies were identified, the peer-reviewed literature was extremely limited and no published studies were identified that provided statistics for a significant proportion of Australia (Victoria, Tasmania, Queensland or the Australian Capital Territory). There were also inconsistencies in how the data were reported between studies, making comparisons difficult. Conclusions This review highlights a lack of robust and contemporary data to inform the development of policies and programs to address the disparities in oral health in Indigenous populations living in many parts of Australia. What is known about the topic? Many studies report that Indigenous people in Australia have poorer general health compared with non-Indigenous people. What does this paper add? This paper documents the available caries and periodontal disease prevalence and experience for Indigenous adults in Australia published in peer-reviewed journals. It demonstrates significant limitations in the data, including no data in several large Australian jurisdictions, inconsistency with reporting methods and most data available being for Indigenous adults living in rural locations. Therefore, the oral health data available in the peer-reviewed literature do not reflect the situation of all Indigenous people living in Australia. What are the implications for practitioners? It is important for oral health practitioners to have access to current and relevant statistics on the oral health of Indigenous Australians. However, we have highlighted significant evidence gaps for this population group within the peer-reviewed literature and identified the limitations of the available data upon which decisions are currently being made. This paper also identifies ways to capture and report oral health data in the future to enable more meaningful comparisons and relevance for use in policy development.
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Xie, J., A. Turkiewicz, G. Collins, M. Englund, V. Y. Strauss, C. Reyes, and D. Prieto-Alhambra. "OP0280 TEMPORAL TRENDS OF OPIOID USE AMONG INCIDENT OSTEOARTHRITIS PATIENTS IN CATALONIA, 2007-2016: A POPULATION-BASED COHORT STUDY." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 174.1–175. http://dx.doi.org/10.1136/annrheumdis-2020-eular.3070.
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Background:Opioids are not recommended as first-line treatments for chronic pain management in osteoarthritis (OA), but recent data suggest they are commonly used in routine practice in North America and northern Europe.Objectives:To characterise the secular trends of opioid and strong opioids use in patients with incident OA from 2007 to 2016, and to explore the impact of patient characteristics on the use of opioid/s for OA.Methods:Data was obtained from the SIDIAP (The System for the Development of Research in Primary Care) database, which contains primary care records and pharmacy dispensing data for 80 % of the population in Catalonia (~ 6 million people). All persons aged 18 or older at the beginning of each calendar year with an incident OA diagnosis (including both peripheral and central joints) in the study period were included. Index date was the date of first OA diagnosis, and the observation period of opioid use was 1-year after index date. Opioids considered included codeine, tramadol, fentanyl, and morphine, with the latter three classified as strong opioids. The period prevalence of any opioid use was estimated in whole and sub-population stratified by sex, age, socio-economic status (U1 – U5, higher values of the indicator equivalent to deprivation) and residence area (rural/urban).Results:The 1-year prevalence of any opioid use among incident OA patients was around 15% from 2007 to 2012. After that, this figure grew by 10% approaching 25% in 2016. However, strong opioid use increased continuously to nearly triple, from 8% in 2007 to 20% in 2016. The different subgroups followed similar trends over time, with women 4% higher than men, oldest 10% higher than youngest, most deprived 6% higher than least deprived, and rural 1% higher than urban.Conclusion:The use of opioids (and especially strong opioids) has substantially increased in recent years among newly diagnosed OA patients in Catalonia. Our findings call for urgent action for safe opioid prescribing to avoid opioid abuse in OA patients especially amongst older women living in deprived areas.Figure 1.Trends of 1-year prevalence of opioid/s use among incident OA patients, whole and subgroup population.Disclosure of Interests:Junqing Xie: None declared, Aleksandra Turkiewicz: None declared, Gary Collins: None declared, Martin Englund Consultant of: Advisory Board 1 day (2019) Pfizer (Tanezumab)., Victoria Y Strauss: None declared, Carlen Reyes: None declared, Daniel Prieto-Alhambra Grant/research support from: Professor Prieto-Alhambra has received research Grants from AMGEN, UCB Biopharma and Les Laboratoires Servier, Consultant of: DPA’s department has received fees for consultancy services from UCB Biopharma, Speakers bureau: DPA’s department has received fees for speaker and advisory board membership services from Amgen
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Oyaro, HO, CO Gor, M. Ocaido, EO Okul, and E. Okuto. "Determinants of acceptability of cricket consumption and adoption for improved food security among riparian communities of the Victoria basin, Kenya." African Journal of Food, Agriculture, Nutrition and Development 22, no. 5 (July 19, 2022): 20383–400. http://dx.doi.org/10.18697/ajfand.110.21650.
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The dynamics of weather variation have overstretched animal protein from already overburdened environment; malnutrition is likely to be on the rise with human population growth projected at 9.7 billion by 2050. This has seen cricket consumption for household food security increasing in the past decade. Cricket (acheta domesticus) farming can contribute positively to solving malnutrition problems being experienced among the riparian communities in the Kenyan Lake Victoria Basin. Cricket farming presents a livelihood diversification strategy that can help buffer rural households against food insecurity and provide an alternative source of income. However, its adoption as an alternative source of protein for improved household food security has remained low among smallholder farmers. The study investigated determinants of acceptability of cricket consumption and its influence on adoption for farming as an alternative source of food. The study employed a mixed methods research approach to collect quantitative and qualitative data from 120 trained cricket farmers from selected riparian counties including Siaya, Kisumu and Homa Bay in Kenyan Victoria basin. Descriptive statistics and logistic regression model were used to summarize quantitative data while content analysis was used to analyze qualitative data by thematic arrangements and similarities across different investigation areas. Based on data analyzed, the results indicated that cultural beliefs, perception and attitude such as cultural value attached to cricket consumption (p = 0.021), crickets are sweet and tender than poultry (p = 0.037) as well as age with a p<0.028, had statistical significance on acceptability to cricket consumption. On the other hand, regression β coefficient of awareness, access and availability were found to have no association with the adoption of cricket farming. The study recommended that: first, the government formulates a policy on farming edible insects as mini-livestock and improved food security. Secondly, further study is needed to determine possible strategies for changing attitude towards cricket consumption for increased adoption by smallholder farmers. Key words: Food security, malnutrition, cricket, acceptability, consumption, culture, attitude, communities, adoption
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Harper, Stephanie, and Ingrid HE Rutishauser. "What do users of reduced-fat dairy products know about the fat in their diets?" Public Health Nutrition 4, no. 2 (April 2001): 227–32. http://dx.doi.org/10.1079/phn200066.
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AbstractObjectivesTo assess the fat intake and knowledge about the fat content of foods consumed by a sample of self reported users of reduced-fat dairy products.DesignCross-sectional study of a population-based sample of women shoppers.SettingA small, rural town (population approximately 6000) in central Victoria, Australia.SubjectsSeventy-eight women aged 25–50 years, who regularly used at least one reduced-fat dairy product.ResultsMean reported intake of total fat was lower while intake of dairy fat was similar to that of a national sample of women of the same age both in the whole sample and when under-reporters were excluded. The ability to identify major sources of fat in the diet as reported appeared to be limited. Less than half of the subjects were able to correctly estimate the fat content of reduced-fat dairy products relative to regular products and about one quarter of subjects reported replacing one kind of oil or fat with another as a strategy to reduce fat intake. Subjects were generally aware of the need to ‘eat less fat’ but few could articulate specific recommendations. A number of subjects reported using low fat diets to control their weight but few subjects appeared to understand the connection between fat intake and energy intake.ConclusionsThe findings of this study raise important questions about how nutrition advice is understood and implemented by consumers, particularly the message to reduce fat intake and the role of energy balance in weight management. They also highlight the difficulty of interpreting information on food intake, in subjects who have modified their diet by reducing intake of specific foods.
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Roos, Nanna, Md Abdul Wahab, Mostafa Ali Reza Hossain, and Shakuntala Haraksingh Thilsted. "Linking Human Nutrition and Fisheries: Incorporating Micronutrient-Dense, Small Indigenous Fish Species in Carp Polyculture Production in Bangladesh." Food and Nutrition Bulletin 28, no. 2_suppl2 (June 2007): S280—S293. http://dx.doi.org/10.1177/15648265070282s207.
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Background Fish and fisheries are important for the livelihoods, food, and income of the rural population in Bangladesh. Increased rice production and changing agricultural patterns have resulted in a large decline in inland fisheries. Implementation of carp pond polyculture has been very successful, whereas little focus has been given to the commonly consumed small indigenous fish species, some of which are rich in vitamin A and minerals, such as calcium, iron, and zinc, and are an integral part of the rural diet. Objective The overall objective of the research and capacity-building activities described in this paper is to increase the production, accessibility, and intake of nutrient-dense small indigenous fish species, in particular mola ( Amblypharyngodon mola), in order to combat micronutrient deficiencies. The large contribution from small indigenous fish species to recommended intakes of vitamin A and calcium and the perception that mola is good for or protects the eyes have been well documented. Methods An integrated approach was conducted jointly by Bangladeshi and Danish institutions, linking human nutrition and fisheries. Activities included food-consumption surveys, laboratory analyses of commonly consumed fish species, production trials of carp–mola pond polyculture, teaching, training, and dissemination of the results. Results No decline in carp production and thus in income was found with the inclusion of mola, and increased intake of mola has the potential to combat micronutrient deficiencies. Teaching and training of graduates and field staff have led to increased awareness of the role of small indigenous fish species for good nutrition and resulted in the promotion of carp–mola pond polyculture and research in small indigenous fish species. The decline in accessibility, increase in price, and decrease in intake of small indigenous fish species by the rural poor, as well as the increased intake of silver carp ( Hypophthalmichthys molitrix), the most commonly cultured fish species, which is poor in micronutrients and not preferred for consumption, are being addressed, and some measures taken by inland fisheries management have been discussed. Conclusions The successful linking of human nutrition and fisheries to address micronutrient deficiencies has relevance for other countries with rich fisheries resources, such as Cambodia and countries in the Lake Victoria region of Africa.
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Nicodemus Osoro, Odhiambo, Paul Obade, and Gathuru Gathuru. "Anthropogenic Impacts on Land Use and Land Cover Change in Ombeyi wetland, Kisumu County, Kenya." International Journal of Regional Development 6, no. 1 (August 18, 2019): 57. http://dx.doi.org/10.5296/ijrd.v6i1.15292.
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Land use and land cover change as a result of human-induced transitions is a major environmental challenge in Lake Victoria Basin. The study adopted a mixed-method consisting of remote sensing and GIS-based analysis, key informant interviews, and household survey consisting of 384 households to asses Land Use and Land Cover Dynamics and associated human-induced transformations in Ombeyi wetland. The study aimed at generating a characterized area estimate of Ombeyi wetlands land use and land cover change schema for the study period (1990-2017), and examining the spatial and temporal characteristics of anthropogenic impacts and their relationship with land use and land cover change in Ombeyi wetland. The gis-based analysis revealed that built-up area/settlements and agricultural lands extensively increased in area at the expense of wetland vegetation. Key informants attributed the changes to population increase (29.2%) and an associated demand for land and natural resources as the major driving forces for the changes. Analysis of household-survey results validated the observed patterns during the remotely sensed data analysis phase of the research, as 90.1% (n=384) of the respondents reported to own land within the wetland through inheritance. 92.2% of the respondents are farmers practicing farming in the wetland with 72.4% of the same respondents attaining primary level education and below. Poverty and education levels were significant factors in influencing unsustainable land use and land cover changes observed in this study. The present state of land cover and its dynamics have had negative impacts on the riparian rural livelihoods and natural resource management.
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Callaly, Thomas, Carmel A. Ackerly, Mary E. Hyland, Seetal Dodd, Melissa O'Shea, and Michael Berk. "A qualitative evaluation of a regional Early Psychosis Service 3 years after its commencement." Australian Health Review 34, no. 4 (2010): 382. http://dx.doi.org/10.1071/ah08731.
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Objective. To outline the major findings of a qualitative evaluation of an Early Psychosis Service 3 years after its establishment. Design. Data to evaluate the service were collected from team meetings, focus groups, individual interviews and questionnaires administered to clinicians, school staff, patients, carers and families. Setting. Barwon Health; Mental Health, Drug and Alcohol Services provide public mental health care to the Geelong, Victoria, region (population 270 000), which is a mixed urban and rural setting. The Early Psychosis Service model implemented involved the placement of two early psychosis workers into each of five adult geographically based Area Mental Health Teams rather than the establishment of a single Early Psychosis Team. Results. The service was found not to adhere to its original design in several key respects. Caseloads and periods of case management were found to be lower and shorter respectively than was originally planned for, caseworkers often experienced isolation and resentment from their adult service coworkers, the service was perceived to be difficult to access and premises not to be youth friendly and communication and engagement with external agencies and service providers was perceived to be poor. Conclusions. The choice of service model, inadequate consultation with stakeholders and inadequate promotion of the service contributed to its failure to reach early expectations. Because of these and other issues, including difficulties distinguishing between early psychosis and non-psychosis, a decision was made to restructure youth services and a separate youth mental health service, which incorporated the Early Psychosis Service function, was established.
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LONG, JASON. "Rural-Urban Migration and Socioeconomic Mobility in Victorian Britain." Journal of Economic History 65, no. 1 (March 2005): 1–35. http://dx.doi.org/10.1017/s0022050705050011.
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This article analyzes rural-urban migration in Great Britain in the latter half of the nineteenth century. Using a new dataset of 28,000 individuals matched between the 1851 and 1881 population censuses, I examine the selection process and treatment effect of migration, controlling for the endogeneity of the migration decision. I find that urban migrants were positively selected—the best of the rural labor pool—and that the economic benefits of migration were substantial. Migrants responded to market signals, and labor markets were largely efficient; however, not all gains from migration were exploited, potentially indicating some degree of inefficiency.
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Brown, Geoff W., Andrew F. Bennett, and Joanne M. Potts. "Regional faunal decline - reptile occurrence in fragmented rural landscapes of south-eastern Australia." Wildlife Research 35, no. 1 (2008): 8. http://dx.doi.org/10.1071/wr07010.
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Many species of reptiles are sedentary and depend on ground-layer habitats, suggesting that they may be particularly vulnerable to landscape changes that result in isolation or degradation of native vegetation. We investigated patterns of reptile distribution and abundance in remnant woodland across the Victorian Riverina, south-eastern Australia, a bioregion highly modified (>90%) by clearing for agriculture. Reptiles were intensively surveyed by pitfall trapping and censuses at 60 sites, stratified to sample small (<30 ha) and large (>30 ha) remnants, and linear strips of roadside and streamside vegetation, across the regional environmental gradient. The recorded assemblage of 21 species was characterised by low abundance and patchy distribution of species. Reptiles were not recorded by either survey technique at 22% of sites and at a further 10% only a single individual was detected. More than half (53%) of all records were of two widespread, generalist skink species. Multivariate models showed that the distribution of reptiles is influenced by factors operating at several levels. The environmental gradient exerts a strong influence, with increasing species richness and numbers of individuals from east (moister, higher elevation) to west (drier, lower elevation). Differences existed between types of remnants, with roadside vegetation standing out as important; this probably reflects greater structural heterogeneity of ground and shrub strata than in remnants subject to grazing by stock. Although comparative historical data are lacking, we argue that there has been a region-wide decline in the status of reptiles in the Victorian Riverina involving: (1) overall population decline commensurate with loss of >90% of native vegetation; (2) disproportionate decline of grassy dry woodlands and their fauna (cf. floodplains); and (3) changes to populations and assemblages in surviving remnants due to effects of land-use on reptile habitats. Many species now occur as disjunct populations, vulnerable to changing land-use. The status of reptiles in rural Australia warrants greater attention than has been given to date. Effective conservation of this component of the biota requires better understanding of the population dynamics, habitat use and dispersal capacity of species; and a commitment to landscape restoration coupled with effective ecological monitoring.
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Moore, Renae L., and Stana H. Sargood. "Using the Telephone in the delivery of early intervention programs in Rural Victoria." Australasian Journal of Special Education 17, no. 2 (January 1993): 27–32. http://dx.doi.org/10.1017/s1030011200022880.
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Families living in rural areas who have a young child with a developmental disability often face difficulties in accessing early intervention services due to geographical isolation and restricted options to specialist services. Lack of services has been reported in a number of surveys of early intervention programs across Australia (Watt, Elkins, Conrad, Andrews, Apelt, Hayes, Calder, Coulston, & Willis, 1982; Barrie & Tomlinson, 1985). Watt et al found only five programs operating in rural areas with populations of 10,000 or less across Australia with a further 15 in towns of 10,000 to 30,000. Hayes and Livingstone (1986) found only rudimentary services in country areas often necessitating the placement of child in an urban facility to receive services.
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Rodríguez-Munguía, Tirzo Jesús, Rodrigo Barquera, Carmen Adalid-Sáinz, Diana Iraíz Hernández-Zaragoza, Esteban Arrieta-Bolaños, Stephen Clayton, Guadalupe Aquino-Rubio, et al. "Genetic diversity of HLA system in two populations from Tamaulipas, Mexico: Ciudad Victoria and rural Tamaulipas." Human Immunology 81, no. 9 (September 2020): 525–27. http://dx.doi.org/10.1016/j.humimm.2019.07.288.
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SC Lim, Megan, Kavitha Sundaram, Campbell K Aitken, and Margaret E Hellard. "Blood-borne Viruses and Risk Behaviours among Injecting Drug Users Recruited from Needle and Syringe Programs in Victoria's Eastern Metropolitan Region." Australian Journal of Primary Health 13, no. 3 (2007): 69. http://dx.doi.org/10.1071/py07040.
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Little has been reported about the risk behaviour and service accessibility of injecting drug users (IDU) living beyond the inner suburbs of Melbourne. This study describes IDUs in the Department of Human Services' Eastern metropolitan region (EMR), including the prevalence of blood-borne viruses and risk behaviours. Fifty-two IDUs were recruited directly from EMR Needle and Syringe Programs (NSP) and through snowball recruitment. IDUs completed a questionnaire and provided a finger-prick blood specimen that was tested for the presence of HIV and Hepatitis C virus (HCV) antibodies. No participants were HIV antibody positive; 29 (56%) were HCV antibody positive. HCV seropositivity was associated with having a tattoo in univariate analysis. The prevalence of HCV in surveyed EMR IDUs was similar to that of Victorian IDUs surveyed in the National Needle and Syringe Program Survey; however, the EMR sample exhibited significantly greater levels of risk behaviour, including the sharing of needles and other injecting equipment, and unsafe sex. Similarly, EMR IDUs from outer and rural suburbs reported greater levels of risk behaviours and lower levels of HCV infection than those from the inner EMR. This study shows that with high levels of risk behaviour and relatively low access to NSP services, Victoria's EMR IDU population is vulnerable to future blood-borne virus outbreaks.
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Costa, Nadia, Mary Sullivan, Rae Walker, and Kerin M. Robinson. "Emergency Department Presentations of Victorian Aboriginal and Torres Strait Islander People." Health Information Management Journal 37, no. 3 (October 2008): 15–25. http://dx.doi.org/10.1177/183335830803700303.
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This paper explains how routinely collected data can be used to examine the emergency department attendances of Victorian Aboriginal and Torres Strait Islander people. The data reported in the Victorian Emergency Minimum Dataset (VEMD) for the 2006/2007 financial year were analysed. The presentations of Aboriginal and Torres Strait Islander and non-Aboriginal people were compared in terms of age, gender, hospital location (metropolitan and rural) and presenting condition. Aboriginal and Torres Strait Islander people were found to attend the emergency department 1.8 times more often than non-Aboriginal people. While the emergency department presentation rates of metropolitan Aboriginal and Torres Strait Islander and non-Aboriginal people were similar, rural Aboriginal and Torres Strait Islander people presented to the emergency department 2.3 times more often than non-Aboriginal people. The injuries or poisonings, respiratory conditions and mental disorders presentation rates of the Aboriginal and Torres Strait Islander and non-Aboriginal population were compared. No previous studies have assessed the accuracy of the Indigenous status and diagnosis fields in the VEMD; therefore the quality of this data is unknown.
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Mclaren, Suzanne, and Lisa M. Hopes. "Rural-Urban Differences in Reasons for Living." Australian & New Zealand Journal of Psychiatry 36, no. 5 (October 2002): 688–92. http://dx.doi.org/10.1046/j.1440-1614.2002.01047.x.
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Objective: The suicide rate in Australia is cause for concern, especially the increase in attempted and completed suicides in rural and regional locations. The present study examined reasons for choosing not to commit suicide as a function of residential location. Method: The study involved 655 Victorian residents from four population-based strata; urban, regional city, regional town, and rural. Results: Results from the Reasons for Living Inventory revealed significant differences as a function of residential location. Overall, residents in rural locations reported having significantly more to live for than their urban counterparts. Further analysis of six reasons for living (child, family, moral, social, coping and death-related concerns) showed a pattern whereby residents in rural locations reported having the most to live for, followed by regional residents, and urban residents who reported having the least to live for. Conclusions: These findings are in contrast to increase of suicide rates in rural areas, and highlight the need for a greater understanding of the mechanisms underlying suicidal behaviour.
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Evans, Melissa, Leanne Lester, Richard Midford, Helen Walker Cahill, David Foxcroft, Robyn Waghorne, and Lynne Venning. "The impact of gender, socioeconomic status and locality on the development of student patterns of alcohol consumption and harm." Health Education 119, no. 4 (June 3, 2019): 309–18. http://dx.doi.org/10.1108/he-08-2018-0037.
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Purpose The consequences of problematic alcohol consumption fall heavily on Australian adolescents, with this population at increased risk of death, serious injury and other harm. Research regarding whether gender, socioeconomic status (SES) or locality play a role in young people’s alcohol consumption and related harm is limited in Australia. The purpose of this paper is to determine whether Victorian students’ patterns of alcohol uptake, consumption and related harm differed between gender, SES and locality. Design/methodology/approach The study involved secondary analysis of student data from the Drug Education in Victorian Schools harm minimisation drug education programme, undertaken in 21 Victorian government schools over three years The initial cohort of 1,752 students was followed during Years 8, 9 and 10, when their average age would have, respectively, been 13, 14 and 15 years. Findings There were no gender differences in drinking uptake, consumption or harm. Students with low SES were more likely to have consumed a full drink of alcohol and also experienced more alcohol-related harm. Students living in a regional/rural area were more likely to have engaged in high alcohol consumption. Originality/value The findings of this study highlighted that different student demographics have an impact on patterns of alcohol consumption, vulnerability and harm. Students with low SES, living in a regional/rural area, are more at risk than students with higher SES living in a fringe metro/major regional or metro area. Future school harm minimisation drug education programmes should consider the needs of students with demographics that make them more susceptible to higher consumption and harm.
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Greaves, Peter. "Regional differences in the mid-Victorian diet and their impact on health." JRSM Open 9, no. 3 (March 2018): 205427041775186. http://dx.doi.org/10.1177/2054270417751866.
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Summary The aim of this study was to examine the impact of regional diets on the health of the poor in mid-Victorian Britain. Contemporary surveys of regional diets and living condition were reviewed. This information was compared with mortality data from Britain over the same period. Although there was an overall improvement in life expectancy during the latter part of the 19th century, there were large regional differences in lifestyle, diet and mortality rates. Dietary surveys showed that the poor labouring population in isolated rural areas of England, in the mainland and islands of Scotland and in the west of Ireland enjoyed the most nutritious diets. These regions also showed the lowest mortality rates in Britain. This was not simply the result of better sanitation and less mortality from food and waterborne infections but also fewer deaths from pulmonary tuberculosis, which is typically associated with better nutrition. These more isolated regions where a peasant-style culture provided abundant locally produced cheap foodstuffs such as potatoes, vegetables, whole grains, and milk and fish, were in the process of disappearing in the face of increasing urbanisation. This was to the detriment of many rural poor during the latter half of the century. Conversely, increasing urbanisation, with its improved transport links, brought greater availability and diversity of foods to many others. It was this that that led to an improved nutrition and life expectancy for the majority in urbanising Britain, despite the detrimental effects of increasing food refinement.
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Chalada, Melissa, Charmaine A. Ramlogan-Steel, Bijay P. Dhungel, Amanda Y. Goh, Samuel Gardiner, Christopher J. Layton, and Jason C. Steel. "Differences in Uveal Melanoma Age-Standardized Incidence Rates in Two Eastern States of Australia Are Driven by Differences in Rurality and Ultraviolet Radiation." Cancers 13, no. 23 (November 23, 2021): 5894. http://dx.doi.org/10.3390/cancers13235894.
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Uveal melanoma (UM) is the second-most-common melanoma in humans and has a high age-standardized incidence rate (ASR) in Australia. Regional patterns of UM ASRs in Australia are unknown. The aim of this study was to determine and compare UM ASRs in two geographically disparate eastern states, Queensland (QLD) and Victoria (VIC), by using cancer registry data that was obtained from 2001 to 2013. World-standardized UM ASRs and incidence-rate ratios (IRRs) were calculated. Higher UM ASR was also observed in anterior UM compared to posterior UM ASR. UM ASR remained unchanged from 2001 to 2013 in QLD but decreased in VIC. A south-to-north latitude trend in UM ASR along the east of Australia is weakly evident, and rural populations have higher UM ASRs than major city populations in both states. Differences in ultraviolent radiation (UVR) susceptibility, indigenous populations, social behaviours, chemical exposure, and socioeconomic status could all be contributing to differences in UM rates between QLD and VIC and between rural compared to major city areas. It is possible that a minority of cases in QLD and VIC might be prevented by sun-protective behaviours. This is important, because these findings suggest that QLD, which is already known to have one of the highest cutaneous melanoma (CM) ASRs in the world, also has one of the highest UM ASRs.
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Coates, TD, and CJ Wright. "Predation of southern brown bandicoots Isoodon obesulus by the European red fox Vulpes vulpes in south-east Victoria." Australian Mammalogy 25, no. 1 (2003): 107. http://dx.doi.org/10.1071/am03107.
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PREDATION by European red foxes (Vulpes vulpes) has been identified as at least partially responsible for local declines of populations of many small to medium-sized mammals in Australia and is listed as a ‘key threatening process’ under the Victorian Flora and Fauna Guarantee Act, 1988 and the Federal Environment Protection and Biodiversity Conservation Act, 1999. Foxes occur in large numbers throughout urban, suburban and rural areas where they opportunistically take carrion, small to medium-sized mammals, birds, insects and fruit (Menkhorst 1995; Marks and Bloomfield 1999). They also kill poultry and larger mammals such as macropod species and sheep (Menkhorst 1995). In many conservation areas, particularly in near-urban locations where fox densities are high, they are thought to pose a serious threat to biodiversity conservation (Menkhorst 1995; Friend et al. 2001; Mahon 2001).
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Colvin, Emma. "Postcode (in)justice: location and bail support services." Journal of Criminological Research, Policy and Practice 5, no. 4 (November 21, 2019): 307–18. http://dx.doi.org/10.1108/jcrpp-01-2019-0002.
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Purpose The purpose of this paper is to explore the impact of location on access to justice for vulnerable defendants seeking bail. Design/methodology/approach Qualitative interviews were conducted with legal practitioners from rural, suburban and urban areas as part of a larger study into bail support services in Victoria, Australia. Findings Interview participants identified a dearth of bail support resources in rural, regional and remote (RRR) areas compared to their urban counterparts. This dearth impacted negatively on some defendants’ outcomes in the justice system, particularly for young people and those experiencing homelessness. Practical implications This study helps in improving policy through greater understanding of issues with RRR service provision; adds to knowledge for service providers on access to justice; highlights specific areas of concern for vulnerable populations; and provides a more nuanced understanding of location-based issues. Originality/value This research found that resourcing issues cannot be understood simply through an RRR/urban binary and that more complex factors impacting access to justice and access to services for vulnerable people should be incorporated into future analysis and policy development. This more nuanced understanding is useful across national and international contexts when developing policies to improve bail support service provision.
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Willis, Eileen M., Judith Dwyer, Kei Owada, Leah Couzner, Debra King, and Jo Wainer. "Indigenous women's expectations of clinical care during treatment for a gynaecological cancer: rural and remote differences in expectations." Australian Health Review 35, no. 1 (2011): 99. http://dx.doi.org/10.1071/ah09800.
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Objectives. To report on differences in Indigenous women’s expectations of clinical care during treatment for a gynaecological cancer in rural and remote regions. Design. Qualitative interviews were conducted in New South Wales, Victoria, South Australia and the Northern Territory in 2008 with 37 clinicians working in gynaecological cancer and 24 women with a gynaecological cancer. Three of the participants were Indigenous women living in large rural towns (others were non-Indigenous), whereas six of the 37 clinicians interviewed worked closely with Indigenous women in remote settings. Indigenous women were contacted through an Indigenous researcher. Interviews were analysed for emerging themes, then compared with each other and with the research literature for similarities and differences. Results. There is considerable variation between clinician observations of the expectations of Indigenous women in remote regions, and the views of Aboriginal women in rural settings. Conclusion. Indigenous women in rural settings have specific views about quality medical care. These include expectations of timely and culturally appropriate care, and strong ties to family and kin, but do not accord with other research findings that suggest Aboriginal women must receive care from same sex clinicians or that care is often delayed. The paper alerts practitioners to the fact that culturally appropriate care will vary from group to group, particularly between remote, rural and urban populations. What is known about this topic? Cross-cultural health care research recognises that health professionals need to be attuned to the cultural preferences and needs of Indigenous patients. What does this paper add? This study warns against assuming all Indigenous people are the same, or have the same expectations about quality health care. It notes that little guidance is offered to clinicians on how Indigenous responses to Western bio-medical care might differ across the country. The paper identifies some differences and proposes strategies for understanding local preferences. What are the implications for practitioners? This paper alerts practitioners to the fact that although Indigenous patients share many cultural similarities, clinicians should not make assumptions about what is appropriate culturally safe care. Culturally appropriate care will vary from group to group, particularly between remote, rural and urban populations in terms of timely access, culturally appropriate care and educational materials, the role of family and Aboriginal Health Workers, and sex preferences.