Academic literature on the topic 'Rural Victoria Gippsland'

Introduction. There is a higher prevalence of Parkinson’s disease (PD) in rural Australia and a poorer perceived quality of life of rural Australians with PD. Coordinated multidisciplinary teams specialised and experienced in the treatment of PD are recommended as the preferred model of care best able to manage the complexities of this disorder. There remains a lack of team-based specialised PD services in rural Australia available to people living with PD. This study aims to explore how the lack of specialised PD services impacts on the person’s experiences of the health care they receive in rural Victoria. This study compared the health-care experiences of two different cohorts of people with PD living in rural Victoria; one cohort living in East Gippsland have had an established comprehensive care model implemented with local trained teams and supported by a metropolitan PD centre, and the other cohort was recruited from the remainder of Victoria who had received standard rural care. Methods. This descriptive study used a survey to explore health-care experiences. Questionnaires were mailed to participants living in rural Victoria. Eligibility criteria included having a diagnosis of PD or Parkinsonism and sufficient English to respond to the survey. The validated Patient-Centred Questionnaire for PD was used to measure health-care experiences. The questions are grouped accordingly under one of the 6 subscales or domains. Outcomes from the questionnaire included summary experience scores (SES) for 6 subscales; overall patient-centeredness score (OPS); and quality improvement scores (QIS). Secondary outcomes included health-related quality of life using the disease-specific questionnaire PDQ39; disease severity using the Hoehn and Yahr staging tool; and disability using the Movement Disorders Society-Unified Parkinson’s Disease Rating Scale, part II. Results. Thirty-nine surveys were returned from the East Gippsland group and 68 from the rural group. The East Gippsland group rated significantly more positive the subscales “empathy and PD expertise,” P=0.02, and “continuity and collaboration of professionals,” P=0.01. The groups did not differ significantly for the remaining 4 subscales (P>0.05) nor for the OPS (P=0.17). The QIS showed both groups prioritised the health-care aspect “provision of tailored information” for improvement. Quality of life was greater (P<0.05) and impairment (P=0.012) and disability were less (P=0.002) in the East Gippsland group. Conclusion. Participants who received health care from the East Gippsland program had better key health-care experiences along with better QOL and less impairment and disability. Participants prioritised provision of information as needing further improvement.

Integrated assessment in Victoria, Australia is held to be a new and innovative process, but in Gippsland, Victoria, integrated assessment has been a reality for the past four years. The purpose of this paper is to identify the elements of integrated assessment in a rural setting. The research has found that identifying the components of such a model was a key factor in achieving the ideals of integrated assessment. The paper suggests that integrated assessment may be more easily achieved in rural areas than its metropolitan counterparts.

The Getting It Together Rural Health Promotion project was established by a group of community health providers in Gippsland, Victoria. The overall aim of Getting It Together was to extend and improve health promotion practice amongst participating organisations. This was achieved through collaboration around health promotion training and planning. Complementary strategies addressing Cardio-Vascular Disease (CVD) were developed across four Local Government Areas (LGAs). Central resourcing was provided for coordination of the project, and for marketing and network support tasks. The project was based on an integrated and coordinated health promotion model, which contained overlapping strategies combining to create a broadly based partnership of action. At the commencement of the project, health promotion workers from each LGA were provided with a three-day training course conducted by the Royal Melbourne Institute of Technology University (RMIT). Participants developed Action Plans based around the three driving strategies of community wide-strategies, targeted strategies and marketing. A special feature of Getting It Together was a common media strategy, to support and reinforce action at the local level. An overall slogan was adopted, 'Slicker Ticker - A Gippsland Healthy Heart Project'. Uniting themes included 'Stress Less Week' and 'Gippsland Get Up and Go'. Latrobe Community Health Service facilitated the project and senior managers from the partnering agencies formed a Steering Committee, which met at key intervals to monitor the project.

Objective This study explored the roles and competencies of Support Facilitators (SFs) engaged in the implementation of the Partners in Recovery initiative in a rural region of Victoria. Methods Semi-structured interviews were conducted with 32 stakeholders involved in the initiative, of which 15 were SFs. Results Two main themes and 10 subthemes emerged from the data: (1) SF competencies (which included an understanding of local services as well as administrative and social skills); and (2) the SF role (which included them being a single point of contact, providing care coordination, assisting the client to become self-reliant, achieving good outcomes for clients with confronting behaviours, judiciously using flexible funding, clearly outlining their role with clients and maintaining boundaries and performing a different role from that of the mental health case manager). Conclusions The roles and competencies of the SF in the Partners in Recovery initiative in Gippsland were congruent with the defined characteristics of a care coordination approach. The results highlight how the SF role differs from that of traditional clinical case managers. These findings are important for future mental health service policy development, education and training of mental health practitioners and recruitment of personnel to care coordination roles. What is known about the topic? There is a growing body of literature highlighting the importance of care coordination in delivery of positive outcomes for people with chronic and complex health problems. However, little is documented about the care coordination role of SFs as part of the Partners in Recovery initiative in Australia. What does this paper add? This paper identifies the roles and competencies of SFs in the Partners in Recovery initiative in a rural region of Victoria. The paper highlights that the emergent competencies and role functions are congruent with the defined characteristics of a care coordination approach but differ from that of mental health case managers. What are the implications for practitioners? These findings are important for future mental health service policy development, education and training of mental health practitioners and recruitment of personnel to care coordination roles.

Health literacy is a major issue for improving health outcomes of clients. In rural Victoria, Australia, the Gippsland Health Literacy Project (GHLP) educated local health services staff about health literacy and provided tools and techniques for health literacy implementation in services. This paper reports the outcomes of this project. Participants’ change in knowledge was measured through pre- and post-project surveys and interviews. Descriptive analysis of survey data and analysis of interviews using qualitative description enabled exploration of individual and organisational shifts in health literacy perspectives. Healthcare professionals’ knowledge of health literacy has improved as a result of the health literacy education. Health service organisations are also taking greater responsibility for health literacy responsiveness in their services. Systematic changes to policy and procedures that support health literacy are required. Although health literacy education provides more accessible health care for consumers, where projects had executive-level support the changes implemented were more likely to be successful and sustainable. What is known about this topic? Low health literacy is a strong predictor of health status and it is important for health organisations to ensure they provide health care and information in a way that can be understood, interpreted and acted on by all clients, regardless of their health literacy levels. What does this paper add? This paper presents findings on staff training and resources that can effectively support staff to improve health literacy practices. What are the implications for practitioners? Addressing health literacy issues appears to result in more accessible health care for consumers. Executive support and health literacy champions are key requirements to successfully address health literacy issues.

Background: Several childhood stressors related to immigration have been documented, and it is important for clinicians to understand and address the various factors that may lead to or act as maintaining factors of mental disorders in children and adolescents. Aims: To describe the cultural profile of transcultural patients presenting to a Child and Adolescent Mental Health Service (CAMHS) in regional Victoria and identify the most common disorders and psychosocial stressors they presented with. Method: Descriptive analysis was applied to 101 case records of patients with a transcultural background who attended the CAMHS of Latrobe Regional Hospital in Gippsland Victoria from 2013 to 2017. The Adverse Childhood Experience questionnaire was retrospectively applied to capture psychosocial stressors such as ‘bullying’, ‘racism’ and ‘family conflict’, sexual abuse, physical violence, parents with mental illness and parental substance use. Results: Almost 60% of patients were male and over 46% Aboriginal. Those from a non-Aboriginal background belonged to 19 different cultural entities, the most common of which was a mixed Asian and European heritage. The most common diagnoses were disruptive mood dysregulation disorder (38.6%), attention-deficit hyperactivity disorder (32.7%) and developmental trauma disorder (26.7%). The most common psychosocial stressors were conflict and death in the family (44.6%), domestic violence (41.6%) and emotional abuse (34.7%). ‘Parent in jail’ and ‘domestic violence’ were associated with having an Aboriginal background ( p < .005). ‘Cultural differences with parent’ was associated with a non-Aboriginal background ( p < .005). Conclusion: This study provides a snapshot of challenges faced by children from different cultural backgrounds while adjusting in a rural area in Australia. A broad-based formulation and cultural awareness by clinicians can enable a better understanding of the complexities, guide management plans and inform public health policies for primary prevention and early intervention.

Objective To date, there are few data on pharmacy-specific placement programs and their impact on students’ work after graduation. The present study evaluated an innovative rural pharmacy placement program targeted at influencing students to work and live in rural areas after graduation. A secondary aim of the study was to explore the students’ intentions to come back and practice in rural areas as a result of their involvement in the rural pharmacy program. Methods A questionnaire was distributed, by hand, to a total of 58 third and fourth (final) year pharmacy students undertaking their rural placement in the Gippsland region, in rural Victoria in 2011 and 2012. Results Fifty-seven responses were returned (response rate = 98%). Students stated that understanding pharmacy practice from a rural perspective, visits to rural health professionals and sites and the attitude of their preceptors were essential to their satisfaction with their rural placements. A significant number of students (72%) intend to seek employment in rural areas if opportunities arise as a result of their increased rural awareness. The key components for a successful rural placement program were described by the surveyed students as social awareness, recognising job opportunities and interprofessional learning. Conclusion The evaluation of the rural placement program revealed that students valued their visits to rural sites and their interaction with other rural health professionals the most. What is known about the topic? Rural undergraduate student programs have been initiated as a result of several Australian government strategies to address shortages in rural health workforce. Subsequently, various rural placement programs have been integral parts of several disciplines, including medicine, dentistry, nursing, occupational therapy and pharmacy among others. To date, there are few data on pharmacy-specific placement programs and their impact on students’ work after graduation What does this paper add? The rural pharmacy program is important in influencing students’ perceptions and interest in a career in rural areas. The key components for a successful rural placement program were described by the surveyed students as social awareness, recognising job opportunities and interprofessional learning. What are the implications for practitioners? Interprofessional learning and collaboration are inevitable due to the shortage of health professionals and the move towards holistic management of patients in healthcare settings. The development of an interprofessional rural education that combines rural medical and pharmacy students together highlights the importance of an interprofessional approach to preparing students to work in rural areas.

The Black Summer of 2019/2020 saw the forests of southeast Australia go up in flames. The fire season started early, in September 2019, and by March 2020 fires had burned over 12.6 million hectares (Werner and Lyons). The scale and severity of the fires was quickly confirmed by scientists to be “unprecedented globally” (Boer et al.) and attributable to climate change (Nolan et al.).The fires were also a media spectacle, generating months of apocalyptic front-page images and harrowing broadcast footage. Media coverage was particularly preoccupied by the cause of the fires. Media framing of disasters often seeks to attribute blame (Anderson et al.; Ewart and McLean) and, over the course of the fire period, blame for the fires was attributed to climate change in much media coverage. However, as the disaster unfolded, denialist discourses in some media outlets sought to veil this revelation by providing alternative explanations for the fires. Misinformation originating from social media also contributed to this obscuration.In this article, we investigate the extent to which media coverage of the 2019/2020 bushfires functioned both to precipitate a climate change epiphany and also to support refutation of the connection between catastrophic fires and the climate crisis.Environmental Communication and RevelationIn its biblical sense, revelation is both an ending and an opening: it is the apocalyptic end-time and also the “revealing” of this time through stories and images. Environmental communication has always been revelatory, in these dual senses of the word – it is a mode of communication that is tightly bound to crisis; that has long grappled with obfuscation and misinformation; and that disrupts power structures and notions of the status quo as it seeks to reveal what is hidden. Climate change in particular is associated in the popular imagination with apocalypse, and is also a reality that is constantly being “revealed”. Indeed, the narrative of climate change has been “animated by the revelations of science” (McNeish 1045) and presented to the public through “key moments of disclosure and revelation”, or “signal moments”, such as scientist James Hansen’s 1988 US Senate testimony on global warming (Hamblyn 224).Journalism is “at the frontline of environmental communication” (Parham 96) and environmental news, too, is often revelatory in nature – it exposes the problems inherent in the human relationship with the natural world, and it reveals the scientific evidence behind contentious issues such as climate change. Like other environmental communicators, environmental journalists seek to “break through the perceptual paralysis” (Nisbet 44) surrounding climate change, with the dual aim of better informing the public and instigating policy change. Yet leading environmental commentators continually call for “better media coverage” of the planetary crisis (Suzuki), as climate change is repeatedly bumped off the news agenda by stories and events deemed more newsworthy.News coverage of climate-related disasters is often revelatory both in tone and in cultural function. The disasters themselves and the news narratives which communicate them become processes that make visible what is hidden. Because environmental news is “event driven” (Hansen 95), disasters receive far more news coverage than ongoing problems and trends such as climate change itself, or more quietly devastating issues such as species extinction or climate migration. Disasters are also highly visual in nature. Trumbo (269) describes climate change as an issue that is urgent, global in scale, and yet “practically invisible”; in this sense, climate-related disasters become a means of visualising and realising what is otherwise a complex, difficult, abstract, and un-seeable concept.Unsurprisingly, natural disasters are often presented to the public through a film of apocalyptic rhetoric and imagery. Yet natural disasters can be also “revelatory” moments: instances of awakening in which suppressed truths come spectacularly and devastatingly to the surface. Matthewman (9–10) argues that “disasters afford us insights into social reality that ordinarily pass unnoticed. As such, they can be read as modes of disclosure, forms of communication”. Disasters, he continues, can reveal both “our new normal” and “our general existential condition”, bringing “the underbelly of progress into sharp relief”. Similarly, Lukes (1) states that disasters “lift veils”, revealing “what is hidden from view in normal times”. Yet for Lukes, “the revelation tells us nothing new, nothing that we did not already know”, and is instead a forced confronting of that which is known yet difficult to engage with. Lukes’ concern is the “revealing” of poverty and inequality in New Orleans following the impact of Hurricane Katrina, yet climate-related disasters can also make visible what McNeish terms “the dark side effects of industrial civilisation” (1047). The Australian bushfires of 2019/2020 can be read in these terms, primarily because they unveiled the connection between climate change and extreme events. Scorching millions of hectares, with a devastating impact on human and non-human communities, the fires revealed climate change as a physical reality, and—for Australians—as a local issue as well as a global one. As media coverage of the fires unfolded and smoke settled on half the country, the impact of climate change on individual lives, communities, landscapes, native animal and plant species, and well-established cultural practices (such as the summer camping holiday) could be fully and dramatically realised. Even for those Australians not immediately impacted, the effects were lived and felt: in our lungs, and on our skin, a physical revelation that the impacts of climate change are not limited to geographically distant people or as-yet-unborn future generations. For many of us, the summer of fire was a realisation that climate change can no longer be held at arm’s length.“Revelation” also involves a temporal collapse whereby the future is dragged into the present. A revelatory streak of this nature has always existed at the heart of environmental communication and can be traced back at least as far as the environmentalist Rachel Carson, whose 1962 book Silent Spring revealed a bleak, apocalyptic future devoid of wildlife and birdsong. In other words, environmental communication can inspire action for change by exposing the ways in which the comforts and securities of the present are built upon a refusal to engage with the future. This temporal rupture where the future meets the present is particularly characteristic of climate change narratives. It is not surprising, then, that media coverage of the 2019/2020 bushfires addressed not just the immediate loss and devastation but also dread of the future, and the understanding that summer will increasingly hold such threats. Bushfires, Climate Change and the MediaThe link between bushfire risk and climate change generated a flurry of coverage in the Australian media well before the fires started in the spring of 2019. In April that year, a coalition of 23 former fire and emergency services leaders warned that Australia was “unprepared for an escalating climate threat” (Cox). They requested a meeting with the new government, to be elected in May, and better funding for firefighting to face the coming bushfire season. When that meeting was granted, at the end of Australia’s hottest and driest year on record (Doyle) in November 2019, bushfires had already been burning for two months. As the fires burned, the emergency leaders expressed frustration that their warnings had been ignored, claiming they had been “gagged” because “you are not allowed to talk about climate change”. They cited climate change as the key reason why the fire season was lengthening and fires were harder to fight. "If it's not time now to speak about climate and what's driving these events”, they asked, “– when?" (McCubbing).The mediatised uncovering of a bushfire/climate change connection was not strictly a revelation. Recent fires in California, Russia, the Amazon, Greece, and Sweden have all been reported in the media as having been exacerbated by climate change. Australia, however, has long regarded itself as a “fire continent”: a place adapted to fire, whose landscapes invite fire and can recover from it. Bushfires had therefore been considered part of the Australian “normal”. But in the Australian spring of 2019, with fires having started earlier than ever and charring rainforests that did not usually burn, the fire chiefs’ warning of a climate change-induced catastrophic bushfire season seemed prescient. As the fires spread and merged, taking homes, lives, landscapes, and driving people towards the water, revelatory images emerged in the media. Pictures of fire refugees fleeing under dystopian crimson skies, masked against the smoke, were accompanied by headlines like “Apocalypse Now” (Fife-Yeomans) and “Escaping Hell” (The Independent). Reports used words like “terror”, “nightmare” (Smee), “mayhem”, and “Armageddon” (Davidson).In the Australian media, the fire/climate change connection quickly became politicised. The Deputy Prime Minister Michael McCormack interviewed by the ABC, responding to a comment by Greens leader Adam Bandt, said connecting bushfire and climate while the fires raged was “disgraceful” and “disgusting”. People needed help, he said, not “the ravings of some pure enlightened and woke capital city greenies” (Goloubeva and Haydar). Gladys Berejiklian the NSW Premier also described it as “inappropriate” (Baker) and “disappointing” (Fox and Higgins) to talk about climate change at this time. However Carol Sparks, Mayor of bushfire-ravaged Glen Innes in rural NSW, contradicted this stance, telling the ABC (Australian Broadcasting Corporation) “Michael McCormack needs to read the science”. Climate change, she said, was “not a political thing” but “scientific fact” (Goloubeva and Haydar).As the fires merged and intensified, so did the media firestorm. Key Australian media became a sparring ground for issue definition, with media predictably split down ideological lines. Public broadcasters the ABC and SBS (Special Broadcasting Service), along with The Age, The Sydney Morning Herald and The Guardian Australia, predominantly framed the catastrophe as wrought by climate change. The Guardian, in an in-depth investigation of climate science and bushfire risk, stated that “despite the political smokescreen” the connection between the fires and global warming was “unequivocal” (Redfearn). The ABC characterised the fires as “a glimpse of the horrors of climate change’s crescendoing impact” (Rose). News outlets owned by Rupert Murdoch’s News Corp Australia, however, actively sought to play down the fires’ seriousness. On 2 January, as front pages of newspapers across the world revealed horrifying fiery images, Murdoch’s Australian ran an upbeat shot of New Year’s Day picnic races as its lead, relegating discussion of the fires to page 4 (Meade). More than simply obscuring the fires’ significance, News Corp media actively sought to convince readers that the fires were not out of the ordinary. For example, as the fires’ magnitude was becoming clear on the last day of 2019, The Australian ran a piece comparing the fires with previous conflagrations, claiming such conditions were “not unprecedented” and the fires were “nothing new” (Johnstone). News Corp’s Sky News also used this frame: “climate alarmists”, “catastrophise”, and “don’t want to look at history”, it stated in a segment comparing the event to past major bushfires (Kenny).As the fires continued into January and February 2020, the refutation of the climate change frame solidified around several themes. Conservative media continued to insist the fires were “normal” for Australia and attributed their severity to a lack of hazard reduction burning, which they blamed on “Greens policies” (Brown and Caisley). They also promoted the argument, espoused by Energy Minister Angus Taylor, that with only “1.3% of global emissions” Australia “could not have meaningful impact” on global warming through emissions reductions, and that top-down climate mitigation pressure from the UN was “doomed to fail” (Lloyd). Foreign media saw the fires in quite different terms. From the outside looking in, the Australian fires were clearly revealed as fuelled by global heating and exacerbated by the Australian government’s climate denialism. Australia was framed as a “notorious climate offender” (Shield) that was—as The New York Times put it—“committing climate suicide” (Flanagan) with its lack of coherent climate policy and its predilection for mining coal. Ouest-France ran a headline reading “High on carbon, rich Australia denies global warming” in which it called Scott Morrison’s position on climate change “incomprehensible” (Guibert). The LA Times called the Australian fires “a climate change warning to its leaders—and ours”, noting how “fossil fuel friendly Morrison” had “gleefully wielded a fist-sized chunk of coal on the floor of parliament in 2017” (Karlik). In the UK, the Independent online ran a front page spread of the fires’ vast smoke plume, with the headline “This is what a climate crisis looks like” (Independent Online), while Australian MP Craig Kelly was called “disgraceful” by an interviewer on Good Morning Britain for denying the fires’ link to climate change (Good Morning Britain).Both in Australia and internationally, deliberate misinformation spread by social media additionally shaped media discourse on the fires. The false revelation that the fires had predominantly been started by arson spread on Twitter under the hashtag #ArsonEmergency. While research has been quick to show that this hashtag was artificially promoted by bots (Weber et al.), this and misinformation like it was also shared and amplified by real Twitter users, and quickly spread into mainstream media in Australia—including Murdoch’s Australian (Ross and Reid)—and internationally. Such misinformation was used to shore up denialist discourses about the fires, and to obscure revelation of the fire/climate change connection. Blame Framing, Public Opinion and the Extent of the Climate Change RevelationAs studies of media coverage of environmental disasters show us, media seek to apportion blame. This blame framing is “accountability work”, undertaken to explain how and why a disaster occurred, with the aim of “scrutinizing the actions of crisis actors, and holding responsible authorities to account” (Anderson et al. 930). In moments of disaster and in their aftermath, “framing contests” (Benford and Snow) can emerge in which some actors, regarding the crisis as an opportunity for change, highlight the systemic issues that have led to the crisis. Other actors, experiencing the crisis as a threat to the status quo, try to attribute the blame to others, and deny the need for policy change. As the Black Summer unfolded, just such a contest took place in Australian media discourse. While Murdoch’s dominant News Corp media sought to protect the status quo, promote conservative politicians’ views, and divert attention from the climate crisis, other Australian and overseas media outlets revealed the fires’ link to climate change and intransigent emissions policy. However, cracks did begin to show in the News Corp stance on climate change during the fires: an internal whistleblower publicly resigned over the media company’s fires coverage, calling it a “misinformation campaign”, and James Murdoch also spoke out about being “disappointed with the ongoing denial of the role of climate change” in reporting the fires (ABC/Reuters).Although media reporting on the environment has long been at the forefront of shaping social understanding of environmental issues, and news maintains a central role in both revealing environmental threats and shaping environmental politics (Lester), during Australia’s Black Summer people were also learning about the fires from lived experience. Polls show that the fires affected 57% of Australians. Even those distant from the catastrophe were, for some time, breathing the most toxic air in the world. This personal experience of disaster revealed a bushfire season that was far outside the normal, and public opinion reflected this. A YouGov Australia Institute poll in January 2020 found that 79% of Australians were concerned about climate change—an increase of 5% from July 2019—and 67% believed climate change was making the bushfires worse (Australia Institute). However, a January 2020 Ipsos poll also found that polarisation along political lines on whether climate change was indeed occurring had increased since 2018, and was at its highest levels since 2014 (Crowe). This may reflect the kind of polarised media landscape that was evident during the fires. A thorough dissection in public discourse of Australia’s unprecedented fire season has been largely eclipsed by the vast coverage of the coronavirus pandemic that so quickly followed it. In May 2020, however, the fires were back in the media, when the Bushfires Royal Commission found that the Black Summer “played out exactly as scientists predicted it would” and that more seasons like it were now “locked in” because of carbon emissions (Hitch). It now remains to be seen whether the revelatory extent of the climate change blame frame that played out in media discourse on the fires will be sufficient to garner meaningful action and policy change—or whether denialist discourses will again obscure climate change revelation and seek to maintain the status quo. References Anderson, Deb, et al. "Fanning the Blame: Media Accountability, Climate and Crisis on the Australian ‘Fire Continent’." 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Nature Climate Change 10.3 (2020): 171-72.Brown, Greg, and Olivia Caisley. “Greens Policies Increasing Bushfire Threat, Barnaby Joyce Says.” The Australian 11 Nov. 2019. <https://www.theaustralian.com.au/nation/politics/deputy-pm-michael-mccormack-slams-raving-innercity-lunatics-for-linking-climate-change-to-fires/news-story/5c3ba8d3e72bc5f10fcf49a94fc9be85>.Carson, Rachel. Silent Spring. 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Flanagan, Richard. “Australia Is Committing Climate Suicide.” The New York Times 3 Jan. 2020. <https://www.nytimes.com/2020/01/03/opinion/australia-fires-climate-change.html>.Fox, Aine, and Hannah Higgins. “Climate Talks for Another Day: NSW Premier.” 7 News 11 Nov. 2019. <https://7news.com.au/news/disaster-and-emergency/climate-change-talk-inappropriate-premier-c-55045>.Goloubeva, Jenya, and Nour Haydar. “Regional Mayors Criticise Politicians for Failing to Link Climate Change and Deadly Bushfires.” ABC News 11 Nov. 2019. <https://www.abc.net.au/news/2019-11-11/carol-sparks-climate-change-federal-government-claire-pontin/11691444>.Good Morning Britain. “Interview with Craig Kelly MP.” ITV 6 Jan. 2020.Guibert, Christelle. “Dopée au Charbon, la Riche Australie Nie le Réchauffement Climatique.” Ouest France 20 Dec. 2019. <https://www.ouest-france.fr/monde/australie/dopee-au-charbon-la-riche-australie-nie-le-rechauffement-climatique-6664289>.Hamblyn, Richard. “The Whistleblower and the Canary: Rhetorical Constructions of Climate Change.” Journal of Historical Geography 35 (2009): 223–36.Hansen, Anders. 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Statistics show that Australia has an ageing population which will experience radical changes over the next 50 years due to the progression into retirement of generations born in the ‘baby boom’ years (1945-1965). Statistics also show that the proportion of Australian people over 65 is increasing and, as the majority of deaths occur in this age group the demand for palliative care, or care of the dying, is also likely to increase. Many retiring baby boomers looking for a sea change, gravitate towards coastal and rural areas may well be contributing to Foskey’s (1998) notion of ‘Aged Care Ghettos’ where these areas may not have the desired infrastructure to deal with an increased demand for health services including palliative care services. An increasing focus on, and public interest in palliative care research will likely emerge in keeping with the changing needs of an ageing population. It will become particularly important that relevant research undertakings are initiated to establish a clearer understanding of the issues and problems surrounding palliative care. At the present time there exists a limited research base in relation to palliative care and related services in Australia. While there has been a concentration of palliative support services in urban settings this has not been the case in rural based settings. Palliative Care Australia (2000) reported that half of the people receiving palliative care in Victoria in 1997 died in rural and regional areas, which may be attributed to harsher living environments, poor access to health services, specialists, and health professionals, lower socio-economic status and employment levels, and exposure to occupational hazards. This thesis is concerned with examining palliative care services and related needs in a selected rural area within the Australian state of Victoria. The overall aim of this research was to investigate the availability of palliative care services, trends in ageing and to examine the relationship between the two. Methodology used in this research incorporated a sequential mixed methods approach of quantitative and then qualitative methodology to determine the relationship between the needs of an ageing population and rural palliative care service delivery in Australia. The data collection included demographic statistics from the Australian Bureau of Census and Statistics and Palliative Care Australia, and were used for descriptive purposes to inform and support this research. Other ordinal data were obtained using a questionnaire. These data were analysed in the context of the research. Qualitative data were obtained through interviews with focus groups. The Gippsland area provided an excellent area for this research and the findings of this research would appear to be consistent with the literature relating to access and equity issues faced in rural areas. Other rural areas may replicate the data gathering used in this research. A number of conclusions are able to be drawn from this research based on the review of literature and examination of the emerging issues, results and findings. Statistical projections into ageing indicate that the health of all Australians will have significant consequences for our society as we generally live longer and healthier lives. Health and ageing predictions and projections should prompt key stakeholders including baby boomers, the aged cohorts of the future, to plan and prepare, perhaps redefining ageing in the attempt. Findings further show that planning should include preparations for the expected rise of dementia related diseases and the implications of gender on health which will have ramifications for an ageing population, and in particular for women as carers in our society. As a result of this research recommendations are made for a model for the delivery of palliative care services in rural areas, which is specific to the needs of an ageing population. These recommendations are made in acknowledgement and with respect and consideration for the concerns of the rural community where feedback from focus group participants suggests that rather than another ‘model’, a hospice is what is needed to meet the current and future needs of rural communities. “Another ‘Model’ is the last thing we need, it’s not the how we are doing things, it’s the where – we desperately need a hospice down here” and, “It’s bricks and mortar we want down here, not more theories”. Evidence collected from this research also suggests that a ‘rural attitude’ to death and dying may prevail. In its simplest form, this attitude emerges in statements such as: ‘it’s the country you expect to get less’ and ‘we just look after our own when we can’. It is also apparent that while people in rural areas have the same medical and palliative care needs as those in metropolitan areas, this research shows that they are differentially disadvantaged when it comes to accessing palliative care services. This research has found that a negative relationship exists between ageing trends in a selected rural area of Australia chosen for this study and the availability of palliative care services.