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Artykuły w czasopismach na temat "Australian health care"
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Choy Flannigan, Alison, i Prue Power. "Health Care Governance: Introduction". Australian Health Review 32, nr 1 (2008): 7. http://dx.doi.org/10.1071/ah080007.
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IN RECOGNITION OF the importance and the complexity of governance within the Australian health care sector, the Australian Healthcare and Hospitals Association has established a regular governance section in Australian Health Review. The aim of this new section is to provide relevant and up-to-date information on governance to assist those working at senior leadership and management levels in the industry. We plan to include perspectives on governance of interest to government Ministers and senior executives, chief executives, members of boards and advisory bodies, senior managers and senior clinicians. This section is produced with the assistance of Ebsworth & Ebsworth lawyers, who are pleased to team with the Australian Healthcare and Hospitals Association in this important area. We expect that further articles in this section will cover topics such as: � Principles of good corporate governance � Corporate governance structures in the public health sector in Australia � Legal responsibilities of public health managers � Governance and occupational health and safety � Financial governance and probity. We would be pleased to hear your suggestions for future governance topics.
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Keleher, Helen, i Virginia Hagger. "Health Literacy in Primary Health Care". Australian Journal of Primary Health 13, nr 2 (2007): 24. http://dx.doi.org/10.1071/py07020.
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Health literacy is fundamental if people are to successfully manage their own health. This requires a range of skills and knowledge about health and health care, including finding, understanding, interpreting and communicating health information, seeking of appropriate care and making critical health decisions. A primary health system that is appropriate and universally accessible requires an active agenda based on research of approaches to address low health literacy, while health care providers should be alert to the widespread problems of health literacy which span all age levels. This article reviews the progress made in Australia on health literacy in primary health care since health literacy was included in Australia's health goals and targets in the mid-1990s. A database search of published literature was conducted to identify existing examples of health literacy programs in Australia. Considerable work has been done on mental health literacy, and research into chronic disease self-management with CALD communities, which includes health literacy, is under way. However, the lack of breadth in research has led to a knowledge base that is patchy. The few Australian studies located on health literacy research together with the data about general literacy in Australia suggests the need for much more work to be done to increase our knowledge base about health literacy, in order to develop appropriate resources and tools to manage low health literacy in primary health settings.
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Day, Gary. "Book Review: The Australian health care system". Australian Health Review 32, nr 2 (2008): 371. http://dx.doi.org/10.1071/ah080371.
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THIS IS THE THIRD edition of one of the seminal local texts on the Australian health care system. Over the last seven years, this text has proved a basis for helping students, casual readers and health professionals understand Australia?s sometimes difficult to understand health care system. The text is divided into ten chapters that deal with key aspects of Australia?s health care system, namely: � Frameworks for analysis � The Australian population and its health � Financing health care � The health workforce � Departmental and intergovernmental structures � Hospitals � Public health � Primary and community care � Pharmaceuticals � Policy challenges for the Australian health care system. There are several key reasons why this text has been widely used in the past and will continue to be of value well into the future. The author has been able to accurately describe the complexities of the Australian health care system in an easily digestible way. This is a feat in itself and worthy of praise. There is an appropriate use of tables and figures to support the written content. Finally, the author provides excellent conclusions that bring together the salient points and issues in each chapter. The publisher promotes that this edition includes new material on health workforce, patient safety and medical and health insurance. The Australian health care system delivers on this claim, providing useful insights and a deeper understanding of the issues that confront the future direction and delivery of health services in this country. This text is a useful addition to any library as well as a staple for students needing to more clearly understand the complexities and challenges of the Australian health care system. My only suggestion is that the text could have been enhanced by the inclusion of revision or reflective questions at the end of each chapter. In summary, a must-have as part of a good health-related library.
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Maruyama, Shiko. "Australian Health Care System". Iryo To Shakai 18, nr 1 (2008): 49–72. http://dx.doi.org/10.4091/iken.18.49.
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Van Der Weyden, Martin B. "Reforming Australian health care". Medical Journal of Australia 191, nr 7 (październik 2009): 367. http://dx.doi.org/10.5694/j.1326-5377.2009.tb02840.x.
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Chater, Alan B. "Looking after health care in the bush". Australian Health Review 32, nr 2 (2008): 313. http://dx.doi.org/10.1071/ah080313.
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LOOKING AFTER health care in rural Australia involves providing adequate services to meet the urgent and non-urgent needs of rural patients in a timely, cost-effective and safe manner. The very provision of these services requires an appropriate workforce and facilities in rural areas. This provides challenges for clinicians, administrators and medical educators. While preventive medicine has made some significant gains globally in reducing the need for acute care and hospitalisation in some areas of medicine such as infectious disease and asthma, these demands have been replaced by an increase in trauma, chronic disease and mental illness1 which, with an ageing population, eventually means presentations at an older age which can require hospitalisation. Rural patients have always had to deal with a relative undersupply of health practitioners. Rural people have coped valiantly with this. The legendary stoicism of rural people has been shown by Schrapnel2 and Davies to be a prominent feature of the rural personality. This both allowed them to cope with lack of services and to suffer in silence while their health status fell below the Australian average.3 Rural Australians use fewer Medicare services and see the doctor less per annum than the Australian average.
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Walker, Judi, i Grant Lennox. "Duelling Band-aids: Debating and Debunking Issues Affecting Primary Health Care to Achieve Deliverance for Australia's Health". Australian Journal of Primary Health 6, nr 4 (2000): 147. http://dx.doi.org/10.1071/py00048.
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The constant pressure for growth on all areas of health spending is not matched by the country's capacity to pay. Despite a progressive shift to a primary health care approach that promotes health and wellbeing, illness prevention, healthy lifestyles, early detection, rehabilitation and public health strategies, not all segments of Australian society enjoy good health. In this paper, general indications of the health and wellbeing of Australians are described, and the health and wellbeing of two important population groups: rural and remote and Indigenous populations are discussed, providing a review of Australia's health system. Anomalies in the status of the health of Australians are apparent. Models of primary healthcare, individual health and urban health are compared with models of acute and institutional care, population health and rural health.
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Cheng, I.-Hao, Sayed Wahidi, Shiva Vasi i Sophia Samuel. "Importance of community engagement in primary health care: the case of Afghan refugees". Australian Journal of Primary Health 21, nr 3 (2015): 262. http://dx.doi.org/10.1071/py13137.
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Refugees can experience problems accessing and utilising Australian primary health care services, resulting in suboptimal health outcomes. Little is known about the impact of their pre-migration health care experiences. This paper demonstrates how the Afghan pre-migration experiences of primary health care can affect engagement with Australian primary care services. It considers the implications for Australian primary health care policy, planning and delivery. This paper is based on the international experiences, insights and expert opinions of the authors, and is underpinned by literature on Afghan health-seeking behaviour. Importantly, Afghanistan and Australia have different primary health care strategies. In Afghanistan, health care is predominantly provided through a community-based outreach approach, namely through community health workers residing in the local community. In contrast, the Australian health care system requires client attendance at formal health service facilities. This difference contributes to service access and utilisation problems. Community engagement is essential to bridge the gap between the Afghan community and Australian primary health care services. This can be achieved through the health sector working to strengthen partnerships between Afghan individuals, communities and health services. Enhanced community engagement has the potential to improve the delivery of primary health care to the Afghan community in Australia.
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Ohr, Se Ok, Vicki Parker, Sarah Jeong i Terry Joyce. "Migration of nurses in Australia: where and why?" Australian Journal of Primary Health 16, nr 1 (2010): 17. http://dx.doi.org/10.1071/py09051.
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The Australian health care workforce has benefited from an increasing migration of nurses over the past decades. The nursing profession is the largest single health profession, making up over half of the Australian health care workforce. Migration of nurses into the Australian nursing workforce impacts significantly on the size of the workforce and the capacity to provide health care to the Australian multicultural community. Migration of nurses plays an important role in providing a solution to the ongoing challenges of workforce attraction and retention, hence an understanding of the factors contributing to nurse migration is important. This paper will critically analyse factors reported to impact on migration of nurses to Australia, in particular in relation to: (1) globalisation; (2) Australian society and nursing workforce; and (3) personal reasons. The current and potential implications of nurse migration are not limited to the Australian health care workforce, but also extend to political, socioeconomic and other aspects in Australia.
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Ragg, Mark. "Australian health-care policy changes". Lancet 343, nr 8901 (kwiecień 1994): 843–44. http://dx.doi.org/10.1016/s0140-6736(94)92034-6.
Pełny tekst źródłaRozprawy doktorskie na temat "Australian health care"
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Grace, Sandra. "Integrative Medicine in Contemporary Australian Health Care". Thesis, The University of Sydney, 2008. http://hdl.handle.net/2123/4048.
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ABSTRACT Integrative medicine (IM) is a dynamic and increasingly prevalent model of primary health care that combines complementary and alternative medicine with mainstream medicine. This research is about the practice of IM and its value to primary health care in Australia. It locates IM within Australian health care by revealing its processes and outcomes in terms of: practice styles, interactions between practitioners and clients and among practitioners, range of diagnostic and treatment options, and health benefits. In this research I examine the nature of integrative medicine (IM) in co-located primary health care practices and consider the influence that integrating mainstream medicine and CAM can have on the perceived quality of primary health care in Australia. My goal was to contribute the knowledge of the phenomenon of IM through a deeper understanding and interpretation of IM gained by investigating the perceptions of core stakeholders, in this case clients and practitioners of IM. This research was situated in the interpretive paradigm and used two research methodologies: hermeneutics (to interpret the value of IM as reported in the literature) and hermeneutic phenomenology (to understand meanings and significance that clients and practitioners attach to their experiences of IM). Data collection involved the collation of existing literature texts and by cumulative case studies (using semi-structured interviews and observation), focus groups, and key informant interviews. Using a blend of methodologies provided a rich and powerful means of understanding the processes and outcomes of IM through the interpretations of its core stakeholders’ lived experiences. In particular I sought perceptions of clients and practitioners of IM about their health and health care including assessment and treatment options, health outcomes, congruence with beliefs and values, collaborative practices and power sharing. Data analysis was conducted concurrently with and subsequent to data collection so that questioning, observation and textual interpretation were progressively guided by the data. A set of meta-themes emerged from the fusion of findings from all phases of the research. These meta-themes represented answers to key research questions. They are: • Power/authority • Mutual respect • Professionalism • Ontological perspectives • Duty of care. This thesis identifies IM practice styles according to different levels of client agency and degrees of power sharing that exist among CAM and mainstream medical practitioners. A theorised model based on the research findings which depicts quality of health care as a variable consequence of diverse practice styles of IM is produced in two parts: Part 1 acknowledges that IM is a variable phenomenon in practice with different levels of collaboration, power-sharing and quality of health care; Part 2 presents an optimum mode of IM practice. Authentically client-centred health care is at the core of all of these practice styles. This thesis has significant implications for the way IM is practised and for primary health care delivery more broadly. IM that is mutually respectful and genuinely collaborative is flexible, inclusive, and socially relevant and has a substantial and far-reaching contribution to make to the quality of primary health care.
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Grace, Sandra. "Integrative Medicine in Contemporary Australian Health Care". Faculty of Health Sciences, The University of Sydney, 2008. http://hdl.handle.net/2123/4048.
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Doctor of PhilosophyABSTRACT Integrative medicine (IM) is a dynamic and increasingly prevalent model of primary health care that combines complementary and alternative medicine with mainstream medicine. This research is about the practice of IM and its value to primary health care in Australia. It locates IM within Australian health care by revealing its processes and outcomes in terms of: practice styles, interactions between practitioners and clients and among practitioners, range of diagnostic and treatment options, and health benefits. In this research I examine the nature of integrative medicine (IM) in co-located primary health care practices and consider the influence that integrating mainstream medicine and CAM can have on the perceived quality of primary health care in Australia. My goal was to contribute the knowledge of the phenomenon of IM through a deeper understanding and interpretation of IM gained by investigating the perceptions of core stakeholders, in this case clients and practitioners of IM. This research was situated in the interpretive paradigm and used two research methodologies: hermeneutics (to interpret the value of IM as reported in the literature) and hermeneutic phenomenology (to understand meanings and significance that clients and practitioners attach to their experiences of IM). Data collection involved the collation of existing literature texts and by cumulative case studies (using semi-structured interviews and observation), focus groups, and key informant interviews. Using a blend of methodologies provided a rich and powerful means of understanding the processes and outcomes of IM through the interpretations of its core stakeholders’ lived experiences. In particular I sought perceptions of clients and practitioners of IM about their health and health care including assessment and treatment options, health outcomes, congruence with beliefs and values, collaborative practices and power sharing. Data analysis was conducted concurrently with and subsequent to data collection so that questioning, observation and textual interpretation were progressively guided by the data. A set of meta-themes emerged from the fusion of findings from all phases of the research. These meta-themes represented answers to key research questions. They are: • Power/authority • Mutual respect • Professionalism • Ontological perspectives • Duty of care. This thesis identifies IM practice styles according to different levels of client agency and degrees of power sharing that exist among CAM and mainstream medical practitioners. A theorised model based on the research findings which depicts quality of health care as a variable consequence of diverse practice styles of IM is produced in two parts: Part 1 acknowledges that IM is a variable phenomenon in practice with different levels of collaboration, power-sharing and quality of health care; Part 2 presents an optimum mode of IM practice. Authentically client-centred health care is at the core of all of these practice styles. This thesis has significant implications for the way IM is practised and for primary health care delivery more broadly. IM that is mutually respectful and genuinely collaborative is flexible, inclusive, and socially relevant and has a substantial and far-reaching contribution to make to the quality of primary health care.
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MURPHY, CATHRYN LOUISE School of Health Services Management UNSW. "INFECTION CONTROL IN THE AUSTRALIAN HEALTH CARE SETTING". Awarded by:University of New South Wales. School of Health Services Management, 1999. http://handle.unsw.edu.au/1959.4/17600.
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1,708 members of the Australian Infection Control Association were surveyed to describe the practices of Australian infection control practitioners. The study details the methods infection control practitioners use to co-ordinate and measure nosocomial infections as clinical outcomes of Australian infection surveillance and control programs. Administrators' and clinicians' perceptions of the elements and infrastructure of infection surveillance and control programs and the role of the infection control were measured in 316 hospitals in New South Wales, Australia. A literature review found that the development of Australian infection surveillance and control programs is behind that of U.S.A and the United Kingdom. The survey of the infection control practitioners identified that their role and duties varied between facilities as did the time allocated to infection control tasks. The survey of infection control practitioners demonstrated variation in their levels of skill, education and experience. Infection control practitioners' use and application of evidence and associated skills was examined and found to be limited in relation to clinical decision making and policy development. The survey also examined the methods infection control practitioners use to undertake surveillance of nosocomial infections. The methods reported indicated non-standard approaches to surveillance activity. A survey of administrators and clinicians in NSW hospitals was undertaken to identify variation in administrator and clinician perceptions and to describe their level of support for recommended essential infrastructure and criteria for infection surveillance and control programs and the role of the infection control practitioner in accordance with Scheckler's model. The survey indicated divergent views regarding the role of the infection control practitioner and the essential elements of infection surveillance and control programs. The study identified that education of infection control practitioners is necessary to facilitate standard approaches to co-ordinating infection surveillance and control activity. The development of Australian infection surveillance and control programs require a strategic alliance between stakeholders. to define essential elements of infection surveillance and control programs. In addition, the role of the infection control practitioner must be defined before key stakeholders can agree on the minimum skills, qualifications and experience required by an infection control practitioner.
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Badrick, Tony Cecil. "Implementing total quality management in Australian health care organizations". Thesis, Queensland University of Technology, 1997.
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McCabe, Helen, i res cand@acu edu au. "The Ethical Implications of Incorporating Managed Care into the Australian Health Care Context". Australian Catholic University. School of Philosophy, 2004. http://dlibrary.acu.edu.au/digitaltheses/public/adt-acuvp48.29082005.
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AIMS Managed care is a market model of health care distribution, aspects of which are being incorporated into the Australian health care environment. Justifications for adopting managed care lie in purported claims to higher levels of efficiency and greater ‘consumer’ choice. The purpose of this research, then, is to determine the ethical implications of adapting this particular administrative model to Australia’s health care system. In general, it is intended to provide ethical guidance for health care administrators and policy-makers, health care practitioners, patients and the wider community. SCOPE Managed care emerges as a product of the contemporary, neo-liberal market with which it is inextricably linked. In order to understand the nature of this concept, then, this research necessarily includes a limited account of the nature of the market in which managed care is situated and disseminated. While a more detailed examination of the neo-liberal market is worthy of a thesis in itself, this project attends, less ambitiously, to two general concerns. Firstly, against a background of various histories of health care distribution, it assesses the market’s propensity for upholding the moral requirements of health care distributive decision-making. This aspect of the analysis is informed by a framework for health care morality the construction of which accompanies an inquiry into the moral nature of health care, including a deliberation about rights-claims to health care and the proper means of its distribution. Secondly, by way of offering a precautionary tale, it examines the organisational structures and regulations by which its expansionary ambitions are promoted and realised. CONCLUSIONS As a market solution to the problem of administering health care resources, the pursuit of cost-control, if not actual profit, becomes the primary objective of health care activity under managed care. Hence, the moral purposes of health care provision, as pursued within the therapeutic relationship and expressed through the social provision of health care, are displaced by the economic purposes of the ‘free’ market. Accordingly, the integrity of both health care practitioners and communities is corrupted. At the same time, it is demonstrated that the claims of managed care proponents to higher levels of efficiency are largely unfounded; indeed, under managed care, health care costs have continued to rise. At the same time, levels of access to health care have deteriorated. These adverse outcomes of managed care are borne, most particularly, by poorer members of communities. Further, contrary to the claims of its proponents, choice as to the availability and kinds of health care services is diminished. Moreover, the competitive market in which managed care is situated has given rise to a plethora of bankruptcies, mergers and alliances in the United States where the market is now characterised by oligopoly and monopoly providers. In this way, a viable market in health care is largely disproved. Nonetheless, when protected within a non-market context and subject to the requirements of justice, a limited number of managed care techniques can assist Australia’s efforts to conserve the resources of health care. However, any more robust adoption of this concept would be ethically indefensible.
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McCabe, Helen Mary. "The ethical implications of incorporating managed care into the Australian health care context". Phd thesis, Australian Catholic University, 2004. https://acuresearchbank.acu.edu.au/download/d50b168254fc36e931bd3b650cbb4c07af91aa95b70a93080a6ccdbd53a2d651/2401581/64983_downloaded_stream_208.pdf.
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AIMS Managed care is a market model of health care distribution, aspects of which are being incorporated into the Australian health care environment. Justifications for adopting managed care lie in purported claims to higher levels of efficiency and greater 'consumer' choice. The purpose of this research, then, is to determine the ethical implications of adapting this particular administrative model to Australia's health care system. In general, it is intended to provide ethical guidance for health care administrators and policy-makers, health care practitioners, patients and the wider community. SCOPE Managed care emerges as a product of the contemporary, neo-liberal market with which it is inextricably linked. In order to understand the nature of this concept, then, this research necessarily includes a limited account of the nature of the market in which managed care is situated and disseminated. While a more detailed examination of the neo-liberal market is worthy of a thesis in itself, this project attends, less ambitiously, to two general concerns. Firstly, against a background of various histories of health care distribution, it assesses the market's propensity for upholding the moral requirements of health care distributive decision-making. This aspect of the analysis is informed by a framework for health care morality the construction of which accompanies an inquiry into the moral nature of health care, including a deliberation about rights-claims to health care and the proper means of its distribution. Secondly, by way of offering a precautionary tale, it examines the organisational structures and regulations by which its expansionary ambitions are promoted and realised. CONCLUSIONS As a market solution to the problem of administering health care resources, the pursuit of cost-control, if not actual profit, becomes the primary objective of health care activity under managed care.;Hence, the moral purposes of health care provision, as pursued within the therapeutic relationship and expressed through the social provision of health care, are displaced by the economic purposes of the 'free' market. Accordingly, the integrity of both health care practitioners and communities is corrupted. At the same time, it is demonstrated that the claims of managed care proponents to higher levels of efficiency are largely unfounded; indeed, under managed care, health care costs have continued to rise. At the same time, levels of access to health care have deteriorated. These adverse outcomes of managed care are borne, most particularly, by poorer members of communities. Further, contrary to the claims of its proponents, choice as to the availability and kinds of health care services is diminished. Moreover, the competitive market in which managed care is situated has given rise to a plethora of bankruptcies, mergers and alliances in the United States where the market is now characterised by oligopoly and monopoly providers. In this way, a viable market in health care is largely disproved. Nonetheless, when protected within a non-market context and subject to the requirements of justice, a limited number of managed care techniques can assist Australia's efforts to conserve the resources of health care. However, any more robust adoption of this concept would be ethically indefensible.
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Lansingh, Van Charles. "Primary health care approach to trachoma control in Aboriginal communities in Central Australia". Connect to thesis, 2005. http://repository.unimelb.edu.au/10187/984.
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This study concerned a primary health care approach to trachoma control in two Central Australian Aboriginal communities. The World Health Organization (WHO) has advocated that the best method to control trachoma is the SAFE strategy (Surgery, Antibiotics, Facial hygiene, and Environmental improvements), and this approach was adopted.The communities, Pipalyatjara and Mimili, with populations slightly less than 300 each, are located in the Anangu Pitjantjatjara (AP) lands of Central Australia, in the northwest corner of the South Australia territory. At Pipalyatjara, a full SAFE-type intervention was undertaken, with the ‘E’ component designed and implemented by the NHC (Nganampa Health Council Inc.). At Mimili, only a SAF-type of intervention was implemented.
Baseline data was gathered for 18 months from March 1999 through September 2000 (five visits to Pipalyatjara and four at Mimili), and included determining trachoma prevalence levels using the WHO system, facial cleanliness, and nasal discharge parameters. A trachoma health program was implemented at the end of this period and a one-time dose of azithromycin was given in September of 2000. The chief focus of the study was children under 15 years of age.
Improvements in road sealing, landscaping, and the creation of mounds were started to improve dust control. Concurrently, efforts were made in the houses of the residents to improve the nine healthy living practices, which were scored in two surveys, in March 1999 and August 2001. Trachoma prevalence, and levels of facial cleanliness and nasal discharge were determined at 3, 6, and 12 months following antibiotic administration.
In children less than 15 years of age, the pre-intervention prevalence level of TF (Trachoma Follicular) was 42% at Pipalyatjara, and 44% at Mimili. For the 1-9 year age group, the TF prevalence was 47% and 54% respectively. For TI (Trachoma Intense), the pre-intervention prevalence was 8% for Pipalyatjara, and 9% for Mimili. The TF prevalence, adjusted for clustering, and using only individuals present at baseline and follow-up (3, 6, and 12 months post-intervention), was 41.5%, 21.2%, 20.0%, and 20.0% at Pipalyatjara respectively. For Mimili, the corresponding prevalence figures were 43.5%, 18.2%, 18.2%, and 30%.
In the 1-9 year age group, a lower TF prevalence existed between the pre-intervention and 12-month post-intervention points at Pipalyatjara compared to Mimili. The TF prevalence after the intervention was also lower for males compared to females, when the cohorts were grouped by gender, rather than community. It is posited that reinfection was much higher at Mimili within this age group, however, in both communities, there appeared to be a core of females whose trachoma status did not change. This is speculated as mainly being caused by prolonged inflammation, though persistent infection C. Trachomatis cannot be ruled out.
Facial cleanliness and nasal discharge continued to improve throughout the intervention at both communities, but at the 3-month post-intervention point no longer became a good predictor of trachoma.
It is not known whether the improvements in the environment at Pipalyatjara were responsible for the reduction in trachoma prevalence 12 months after the intervention, relative to Mimili.
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Clarke, Susan Elizabeth. "Gatekeeping and General Practice in the Australian Health System". Thesis, The University of Sydney, 2020. https://hdl.handle.net/2123/24623.
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General practice is central to primary care in the Australian health system, yet difficulties proving the value of general practice are ongoing. Advocates of general practice often refer to a key role general practitioners (GPs) play in health system gatekeeping to emphasise the importance of general practice within the system. However, the concept of gatekeeping lacks clarity, and this may lead to unintended consequences for general practice.
This thesis explores the concept of gatekeeping within the Australian health system by considering the expectations of general practice held by policymakers, advocacy groups and general practitioners concerning general practice as the controller of economic value in health care. The study analysed media releases from policymakers and advocacy groups and conducted interviews with 19 GPs. Using a methodology which attempts to reflect a general practice approach to problem solving, the study considered the discourse of policymakers, GPs and advocacy groups concerning waste within the system, to determine attitudes towards gatekeeping.
The study found that policymakers, influenced by neoliberal ideas, equate good health with good economics and have an expectation that GPs will consider cost when making clinical decisions. GPs, while thoughtful of cost, prioritise patient well-being in treatment. Policymaker and GP expectations of care are opposed. While gatekeeping has appeal in a neoliberal environment, failure to meet economic expectations exposes GPs to accusations of poor practice. Advocacy for general practice should recognise the value of general practice in the Australian health system extends beyond reductionist financial expectations and re-centring policy discourse on health outcomes rather than economic outcomes is likely to have most success in improving the status of general practice within the system.
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McLaine, Catherine Clare. "Diabetes and oral health complications: Australian diabetes health care professionals' knowledge and scope of practice". Thesis, Curtin University, 2013. http://hdl.handle.net/20.500.11937/2373.
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The research investigated Australian diabetes health professionals’ (DHPs’) knowledge and their intervention, health promotion, and care management of oral health issues which impact upon the person with diabetes. Results identified the need for enhanced provision of diabetes-specific oral health education, clinical resource tools, and the delivery of oral health services. The findings were discussed within the context of the current health system policies and their impact upon DHPs’ management of diabetes related oral health complications.
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Boyce, Rosalie A. "The organisation of allied health professionals in Australian general hospitals". Thesis, Queensland University of Technology, 1996. https://eprints.qut.edu.au/107083/1/T%28BS%29%20134%20The%20organisation%20of%20allied%20health%20professionals%20in%20Australian%20general%20hospitals.pdf.
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This research is a case study in the sociology of professions. It reports on the Australian allied health professions, a group that has rarely been the subject
of sustained research. The central purpose of the research is to examine the impact of local workplace organisation in Australian general hospitals in the public sector on the position of the allied health professions and their
autonomy. Further, the research seeks to unbundle the competing claims about the utility of alternative organisational approaches and to examine how the allied health professions negotiate inter-professional relationships as a consequence of particular organisational approaches. The research draws on Eliot Freidson's professional dominance theory (medical dominance theory) as the underpinning theoretical framework. Medical dominance theory portrays the allied health professions as inevitably subject to medical dominance and subordination, a proposition which is critically appraised through a contemporary analysis of local workplace arrangements.
To address these issues three models of allied health profession organisation were identified; the classical medical model, division of allied health model and
the unit dispersement model. The research method involved a comparative case study approach and included fifty-three interviews, document analysis, observation strategies and key informants over a two year period. Data collection was guided by seventeen themes of inquiry which were identified
from a multiple methods approach as likely to be important in a comparative analysis of the organisation of the allied health professions.
Książki na temat "Australian health care"
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The Australian health care system. Wyd. 2. South Melbourne, Vic: Oxford University Press, 2004.
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The Australian health care system. Wyd. 4. South Melbourne, Vic: Oxford University Press, 2011.
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Australian Health Ministers' Advisory Council. Health Targets and Implementation (Health for All) Committee. Health for all Australians: Report to the Australian Health Ministers' Advisory Council and the Australian Health Ministers' Conference. Canberra: Australian Government Publishing Service, 1988.
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Willis, Eileen. Understanding the Australian health care system. Wyd. 2. Chatswood, N.S.W: Churchill Livingstone, 2012.
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Ethics for health care. Melbourne: Oxford University Press, 1998.
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McLeod, Ross H. Empty bed blues: Australian health-care policy. Perth, W.A: Australian Institute for Public Policy, 1987.
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1956-, Short Stephanie D., red. Health care & public policy: An Australian analysis. South Melbourne: Macmillan Company of Australia, 1989.
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Palmer, George R. Health care & public policy: An Australian analysis. Wyd. 2. South Melbourne: Macmillan Education Australia, 1994.
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Palmer, George R. Health care and public policy: An Australian analysis. Wyd. 4. South Yarra, Vic: Palgrave Macmillan, 2010.
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H, Mooney Gavin, i Scotton R. B, red. Economics and Australian health policy. St Leonards, NSW, Australia: Allen & Unwin, 1999.
Znajdź pełny tekst źródłaCzęści książek na temat "Australian health care"
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Palmer, George R., i Stephanie D. Short. "The Australian Health Care System". W Health Care & Public Policy, 5–20. London: Macmillan Education UK, 1989. http://dx.doi.org/10.1007/978-1-349-11092-6_2.
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Quadrio, Carolyn. "Institutional abuse of children – an Australian perspective". W Humanising Mental Health Care in Australia, 112–21. Abingdon, Oxon; New York, NY: Routledge, 2018.: Routledge, 2019. http://dx.doi.org/10.4324/9780429021923-8.
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Parry, Yvonne, i Didy Button. "Nursing and tensions within the Australian health care system". W Nursing in Australia, 11–20. Milton Park, Abingdon, Oxon; New York, NY: Routledge, 2021.: Routledge, 2020. http://dx.doi.org/10.4324/9781003120698-3.
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Cooper, John, i Nicole Sadler. "Trauma-informed mental health care for Australian Defence Force personnel and veterans". W Humanising Mental Health Care in Australia, 355–66. Abingdon, Oxon; New York, NY: Routledge, 2018.: Routledge, 2019. http://dx.doi.org/10.4324/9780429021923-27.
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Vimalachandran, Pasupathy, Yanchun Zhang, Jinli Cao, Lili Sun i Jianming Yong. "Preserving Data Privacy and Security in Australian My Health Record System: A Quality Health Care Implication". W Web Information Systems Engineering – WISE 2018, 111–20. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-030-02925-8_8.
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Vines, Robyn F., i Ross Wilson. "Integrated Primary Mental Health Care in Rural and Remote Contexts: The Australian Experience". W Handbook of Rural, Remote, and very Remote Mental Health, 1–25. Singapore: Springer Singapore, 2020. http://dx.doi.org/10.1007/978-981-10-5012-1_9-1.
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Vines, Robyn F., i Ross Wilson. "Integrated Primary Mental Health Care in Rural and Remote Contexts: The Australian Experience". W Handbook of Rural, Remote, and very Remote Mental Health, 191–215. Singapore: Springer Singapore, 2021. http://dx.doi.org/10.1007/978-981-15-6631-8_9.
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Dodd, Elizabeth, Paul Hawting, Eleanor Horton, Mohanraj Karunanithi i Anne Livingstone. "Australian Community Care Experience on the Design, Development, Deployment and Evaluation of Implementing the Smarter Safer Homes Platform". W Inclusive Smart Cities and e-Health, 282–86. Cham: Springer International Publishing, 2015. http://dx.doi.org/10.1007/978-3-319-19312-0_23.
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Ward, Harriet, Lynne Moggach, Susan Tregeagle i Helen Trivedi. "Adult Outcomes". W Outcomes of Open Adoption from Care, 223–65. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-76429-6_8.
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AbstractThe chapter focuses exclusively on the 60 adoptees aged over 18 who completed the follow-up survey. It draws on data collected through survey responses and interviews focusing on 24 adult adoptees. It explores their outcomes across a range of dimensions that together contribute to a composite measure of adult functionality. It presents the outcomes the adoptees achieved on each of these key domains and explores how they compared both with those of the normative Australian population and a contemporaneous cohort of care leavers. The adoptees showed more evidence of poor mental health than care leavers, but often did better in terms of education and employment. The presence of a committed adoptive parent appears to have acted as a powerful protective factor, and only extreme indicators of vulnerability at entry to the adoptive home correlated with poor adult outcomes.
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Isbel, Stephen, Maggie Jamieson i Craig Greber. "Australia’s health and health care system". W Occupational Therapy in Australia, 14–30. Wyd. 2. Second edition. | Milton Park, Abingdon, Oxon ; New York, NY : Routledge, 2021.: Routledge, 2021. http://dx.doi.org/10.4324/9781003150732-3.
Pełny tekst źródłaStreszczenia konferencji na temat "Australian health care"
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Eftekhari, P., P. M. Forder, M. L. Harris i J. E. Byles. "Health Care Use by Older Australian Women with Asthma". W American Thoracic Society 2019 International Conference, May 17-22, 2019 - Dallas, TX. American Thoracic Society, 2019. http://dx.doi.org/10.1164/ajrccm-conference.2019.199.1_meetingabstracts.a3022.
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Keirnan, Alen, Andrew Murphy, Sonja Pedell i Flavia Marcello. "Exploring emotions for technology and service design in health care setting waiting rooms". W the 28th Australian Conference. New York, New York, USA: ACM Press, 2016. http://dx.doi.org/10.1145/3010915.3010990.
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Valery, Patricia C., Vanessa L. Beesley, Catherine Jacka, Monika Janda, Lisa Whop, Peter O'Rourke, Adele Green i Gail Garvey. "Abstract B4: Supportive care needs survey for Australian indigenous cancer patients". W Abstracts: AACR International Conference on the Science of Cancer Health Disparities‐‐ Sep 30-Oct 3, 2010; Miami, FL. American Association for Cancer Research, 2010. http://dx.doi.org/10.1158/1055-9965.disp-10-b4.
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Prosser, Brenton J. "The Policy Success Heuristic and Social Policy: A case from Australian primary health care reform". W 3rd Annual International Conference on Political Science, Sociology and International Relations (PSSIR 2013). Global Science and Technology Forum Pte Ltd, 2013. http://dx.doi.org/10.5176/2251-2403_pssir13.34.
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Penman, Joy, i Kerre A Willsher. "New Horizons for Immigrant Nurses Through a Mental Health Self-Management Program: A Pre- and Post-Test Mixed-Method Approach". W InSITE 2021: Informing Science + IT Education Conferences. Informing Science Institute, 2021. http://dx.doi.org/10.28945/4759.
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Aim/Purpose: This research paper reports on the evaluation of a mental health self-management program provided to immigrant nurses working at various rural South Australian aged care services. Background: The residential aged care staffing crisis is severe in rural areas. To improve immigrant nurses’ employment experiences, a mental health self-management program was developed and conducted in rural and regional health care services in South Australia. Methodology: A mixed approach of pre- and post-surveys and post workshop focus groups was utilized with the objectives of exploring the experiences of 25 immigrant nurses and the impact of the mental health program. Feminist standpoint theory was used to interpret the qualitative data. Contribution: A new learning environment was created for immigrant nurses to learn about the theory and practice of maintaining and promoting mental health. Findings: Statistical tests showed a marked difference in responses before and after the intervention, especially regarding knowledge of mental health. The results of this study indicated that a change in thinking was triggered, followed by a change in behaviour enabling participants to undertake self-management strategies. Recommendations for Practitioners: Include expanding the workshops to cover more health care practitioners. Recommendations for Researchers: Feminist researchers must actively listen and examine their own beliefs and those of others to create knowledge. Extending the program to metropolitan areas and examining differences in data. E technology such as zoom, skype or virtual classrooms could be used. Impact on Society: The new awareness and knowledge would be beneficial in the family and community because issues at work can impact on the ability to care for the family, and there are often problems around family separation. Future Research: Extending the research to include men and staff of metropolitan aged care facilities.
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Causer, L., L. Watchirs-Smith, A. Saha, H. Wand, K. Smith, S. Badman, B. Hengel i in. "P171 From trial to program: TTANGO2 scale-up and implementation sustains STI point-of-care testing in regional and remote Australian Aboriginal health services". W Abstracts for the STI & HIV World Congress, July 14–17 2021. BMJ Publishing Group Ltd, 2021. http://dx.doi.org/10.1136/sextrans-2021-sti.269.
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"Health Policy Reform Poor Rural Primary Health Care Delivery in Australia". W 2018 International Conference on Education, Psychology, and Management Science. Francis Academic Press, 2018. http://dx.doi.org/10.25236/icepms.2018.175.
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Karim, Shakir, Ergun Gide i Raj Sandu. "The Impact of Big Data on Health Care Services in Australia". W the 2019 International Conference. New York, New York, USA: ACM Press, 2019. http://dx.doi.org/10.1145/3348400.3348414.
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Ukoha, Chukwuma, i Andrew Stranieri. "Revisiting Social Media in Health Care: A Bakhtinian Carnival Perspective". W ACSW 2022: Australasian Computer Science Week 2022. New York, NY, USA: ACM, 2022. http://dx.doi.org/10.1145/3511616.3513127.
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Rajput, Vije, i Steve Cropper. "83 Fashioning change in health care: the adoption and assimilation of technology". W Preventing Overdiagnosis Abstracts, December 2019, Sydney, Australia. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/bmjebm-2019-pod.95.
Pełny tekst źródłaRaporty organizacyjne na temat "Australian health care"
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Smit, Amelia, Kate Dunlop, Nehal Singh, Diona Damian, Kylie Vuong i Anne Cust. Primary prevention of skin cancer in primary care settings. The Sax Institute, sierpień 2022. http://dx.doi.org/10.57022/qpsm1481.
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Overview Skin cancer prevention is a component of the new Cancer Plan 2022–27, which guides the work of the Cancer Institute NSW. To lessen the impact of skin cancer on the community, the Cancer Institute NSW works closely with the NSW Skin Cancer Prevention Advisory Committee, comprising governmental and non-governmental organisation representatives, to develop and implement the NSW Skin Cancer Prevention Strategy. Primary Health Networks and primary care providers are seen as important stakeholders in this work. To guide improvements in skin cancer prevention and inform the development of the next NSW Skin Cancer Prevention Strategy, an up-to-date review of the evidence on the effectiveness and feasibility of skin cancer prevention activities in primary care is required. A research team led by the Daffodil Centre, a joint venture between the University of Sydney and Cancer Council NSW, was contracted to undertake an Evidence Check review to address the questions below. Evidence Check questions This Evidence Check aimed to address the following questions: Question 1: What skin cancer primary prevention activities can be effectively administered in primary care settings? As part of this, identify the key components of such messages, strategies, programs or initiatives that have been effectively implemented and their feasibility in the NSW/Australian context. Question 2: What are the main barriers and enablers for primary care providers in delivering skin cancer primary prevention activities within their setting? Summary of methods The research team conducted a detailed analysis of the published and grey literature, based on a comprehensive search. We developed the search strategy in consultation with a medical librarian at the University of Sydney and the Cancer Institute NSW team, and implemented it across the databases Embase, MEDLINE, PsycInfo, Scopus, Cochrane Central and CINAHL. Results were exported and uploaded to Covidence for screening and further selection. The search strategy was designed according to the SPIDER tool for Qualitative and Mixed-Methods Evidence Synthesis, which is a systematic strategy for searching qualitative and mixed-methods research studies. The SPIDER tool facilitates rigour in research by defining key elements of non-quantitative research questions. We included peer-reviewed and grey literature that included skin cancer primary prevention strategies/ interventions/ techniques/ programs within primary care settings, e.g. involving general practitioners and primary care nurses. The literature was limited to publications since 2014, and for studies or programs conducted in Australia, the UK, New Zealand, Canada, Ireland, Western Europe and Scandinavia. We also included relevant systematic reviews and evidence syntheses based on a range of international evidence where also relevant to the Australian context. To address Question 1, about the effectiveness of skin cancer prevention activities in primary care settings, we summarised findings from the Evidence Check according to different skin cancer prevention activities. To address Question 2, about the barriers and enablers of skin cancer prevention activities in primary care settings, we summarised findings according to the Consolidated Framework for Implementation Research (CFIR). The CFIR is a framework for identifying important implementation considerations for novel interventions in healthcare settings and provides a practical guide for systematically assessing potential barriers and facilitators in preparation for implementing a new activity or program. We assessed study quality using the National Health and Medical Research Council (NHMRC) levels of evidence. Key findings We identified 25 peer-reviewed journal articles that met the eligibility criteria and we included these in the Evidence Check. Eight of the studies were conducted in Australia, six in the UK, and the others elsewhere (mainly other European countries). In addition, the grey literature search identified four relevant guidelines, 12 education/training resources, two Cancer Care pathways, two position statements, three reports and five other resources that we included in the Evidence Check. Question 1 (related to effectiveness) We categorised the studies into different types of skin cancer prevention activities: behavioural counselling (n=3); risk assessment and delivering risk-tailored information (n=10); new technologies for early detection and accompanying prevention advice (n=4); and education and training programs for general practitioners (GPs) and primary care nurses regarding skin cancer prevention (n=3). There was good evidence that behavioural counselling interventions can result in a small improvement in sun protection behaviours among adults with fair skin types (defined as ivory or pale skin, light hair and eye colour, freckles, or those who sunburn easily), which would include the majority of Australians. It was found that clinicians play an important role in counselling patients about sun-protective behaviours, and recommended tailoring messages to the age and demographics of target groups (e.g. high-risk groups) to have maximal influence on behaviours. Several web-based melanoma risk prediction tools are now available in Australia, mainly designed for health professionals to identify patients’ risk of a new or subsequent primary melanoma and guide discussions with patients about primary prevention and early detection. Intervention studies have demonstrated that use of these melanoma risk prediction tools is feasible and acceptable to participants in primary care settings, and there is some evidence, including from Australian studies, that using these risk prediction tools to tailor primary prevention and early detection messages can improve sun-related behaviours. Some studies examined novel technologies, such as apps, to support early detection through skin examinations, including a very limited focus on the provision of preventive advice. These novel technologies are still largely in the research domain rather than recommended for routine use but provide a potential future opportunity to incorporate more primary prevention tailored advice. There are a number of online short courses available for primary healthcare professionals specifically focusing on skin cancer prevention. Most education and training programs for GPs and primary care nurses in the field of skin cancer focus on treatment and early detection, though some programs have specifically incorporated primary prevention education and training. A notable example is the Dermoscopy for Victorian General Practice Program, in which 93% of participating GPs reported that they had increased preventive information provided to high-risk patients and during skin examinations. Question 2 (related to barriers and enablers) Key enablers of performing skin cancer prevention activities in primary care settings included: • Easy access and availability of guidelines and point-of-care tools and resources • A fit with existing workflows and systems, so there is minimal disruption to flow of care • Easy-to-understand patient information • Using the waiting room for collection of risk assessment information on an electronic device such as an iPad/tablet where possible • Pairing with early detection activities • Sharing of successful programs across jurisdictions. Key barriers to performing skin cancer prevention activities in primary care settings included: • Unclear requirements and lack of confidence (self-efficacy) about prevention counselling • Limited availability of GP services especially in regional and remote areas • Competing demands, low priority, lack of time • Lack of incentives.
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Toloo, Sam, Ruvini Hettiarachchi, David Lim i Katie Wilson. Reducing Emergency Department demand through expanded primary healthcare practice: Full report of the research and findings. Queensland University of Technology, styczeń 2022. http://dx.doi.org/10.5204/rep.eprints.227473.
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Demand for public hospital emergency departments’ services and care is increasing, placing considerable restraint on their performance and threatens patient safety. Many factors influence such demand including individual characteristics (e.g. perceptions, knowledge, values and norms), healthcare availability, affordability and accessibility, population aging, and internal health system factors (e.g patient flow, discharge process). To alleviate demand, many initiatives have been trialled or suggested, including early identification of at-risk patients, better management of chronic disease to reduce avoidable ED presentation, expanded capacity of front-line clinician to manage sub-acute and non-urgent care, improved hospital flow to reduce access block, and diversion to alternate site for care. However, none have had any major or sustained impact on the growth in ED demand. A major focus of the public discourse on ED demand has been the use and integration of primary healthcare and ED, based on the assumption that between 10%–25% of ED presentations are potentially avoidable if patients’ access to appropriate primary healthcare (PHC) services were enhanced. However, this requires not only improved access but also appropriateness in terms of the patients’ preference and PHC providers’ capacity to address the needs. What is not known at the moment is the extent of the potential for diversion of non-urgent ED patients to PHC and the cost-benefits of such policy and funding changes required, particularly in the Australian context. There is a need to better understand ED patients’ needs and capacity constraint so as to effect delivery of accessible, affordable, efficient and responsive services. Jennie Money Doug Morel
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Hesketh, Kylie. 2022 Active Healthy Kids Australia report card on physical activity for children and young people. Deakin University, 2022. http://dx.doi.org/10.21153/ahka2022.
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Hajarizadeh, Behzad, Jennifer MacLachlan, Benjamin Cowie i Gregory J. Dore. Population-level interventions to improve the health outcomes of people living with hepatitis B: an Evidence Check brokered by the Sax Institute for the NSW Ministry of Health, 2022. The Sax Institute, sierpień 2022. http://dx.doi.org/10.57022/pxwj3682.
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Background An estimated 292 million people are living with chronic hepatitis B virus (HBV) infection globally, including 223,000 people in Australia. HBV diagnosis and linkage of people living with HBV to clinical care is suboptimal in Australia, with 27% of people living with HBV undiagnosed and 77% not receiving regular HBV clinical care. This systematic review aimed to characterize population-level interventions implemented to enhance all components of HBV care cascade and analyse the effectiveness of interventions. Review questions Question 1: What population-level interventions, programs or policy approaches have been shown to be effective in reducing the incidence of hepatitis B; and that may not yet be fully rolled out or evaluated in Australia demonstrate early effectiveness, or promise, in reducing the incidence of hepatitis B? Question 2: What population-level interventions and/or programs are effective at reducing disease burden for people in the community with hepatitis B? Methods Four bibliographic databases and 21 grey literature sources were searched. Studies were eligible for inclusion if the study population included people with or at risk of chronic HBV, and the study conducted a population-level interventions to decrease HBV incidence or disease burden or to enhance any components of HBV care cascade (i.e., diagnosis, linkage to care, treatment initiation, adherence to clinical care), or HBV vaccination coverage. Studies published in the past 10 years (since January 2012), with or without comparison groups were eligible for inclusion. Studies conducting an HBV screening intervention were eligible if they reported proportion of people participating in screening, proportion of newly diagnosed HBV (participant was unaware of their HBV status), proportion of people received HBV vaccination following screening, or proportion of participants diagnosed with chronic HBV infection who were linked to HBV clinical care. Studies were excluded if study population was less than 20 participants, intervention included a pharmaceutical intervention or a hospital-based intervention, or study was implemented in limited clinical services. The records were initially screened by title and abstract. The full texts of potentially eligible records were reviewed, and eligible studies were selected for inclusion. For each study included in analysis, the study outcome and corresponding 95% confidence intervals (95%CIs) were calculated. For studies including a comparison group, odds ratio (OR) and corresponding 95%CIs were calculated. Random effect meta-analysis models were used to calculate the pooled study outcome estimates. Stratified analyses were conducted by study setting, study population, and intervention-specific characteristics. Key findings A total of 61 studies were included in the analysis. A large majority of studies (study n=48, 79%) included single-arm studies with no concurrent control, with seven (12%) randomised controlled trials, and six (10%) non-randomised controlled studies. A total of 109 interventions were evaluated in 61 included studies. On-site or outreach HBV screening and linkage to HBV clinical care coordination were the most frequent interventions, conducted in 27 and 26 studies, respectively. Question 1 We found no studies reporting HBV incidence as the study outcome. One study conducted in remote area demonstrated that an intervention including education of pregnant women and training village health volunteers enhanced coverage of HBV birth dose vaccination (93% post-intervention, vs. 81% pre-intervention), but no data of HBV incidence among infants were reported. Question 2 Study outcomes most relevant to the HBV burden for people in the community with HBV included, HBV diagnosis, linkage to HBV care, and HBV vaccination coverage. Among randomised controlled trials aimed at enhancing HBV screening, a meta-analysis was conducted including three studies which implemented an intervention including community face-to-face education focused on HBV and/or liver cancer among migrants from high HBV prevalence areas. This analysis demonstrated a significantly higher HBV testing uptake in intervention groups with the likelihood of HBV testing 3.6 times higher among those participating in education programs compared to the control groups (OR: 3.62, 95% CI 2.72, 4.88). In another analysis, including 25 studies evaluating an intervention to enhance HBV screening, a pooled estimate of 66% of participants received HBV testing following the study intervention (95%CI: 58-75%), with high heterogeneity across studies (range: 17-98%; I-square: 99.9%). A stratified analysis by HBV screening strategy demonstrated that in the studies providing participants with on-site HBV testing, the proportion receiving HBV testing (80%, 95%CI: 72-87%) was significantly higher compared to the studies referring participants to an external site for HBV testing (54%, 95%CI: 37-71%). In the studies implementing an intervention to enhance linkage of people diagnosed with HBV infection to clinical care, the interventions included different components and varied across studies. The most common component was post-test counselling followed by assistance with scheduling clinical appointments, conducted in 52% and 38% of the studies, respectively. In meta-analysis, a pooled estimate of 73% of people with HBV infection were linked to HBV clinical care (95%CI: 64-81%), with high heterogeneity across studies (range: 28-100%; I-square: 99.2%). A stratified analysis by study population demonstrated that in the studies among general population in high prevalence countries, 94% of people (95%CI: 88-100%) who received the study intervention were linked to care, significantly higher than 72% (95%CI: 61-83%) in studies among migrants from high prevalence area living in a country with low prevalence. In 19 studies, HBV vaccination uptake was assessed after an intervention, among which one study assessed birth dose vaccination among infants, one study assessed vaccination in elementary school children and 17 studies assessed vaccination in adults. Among studies assessing adult vaccination, a pooled estimate of 38% (95%CI: 21-56%) of people initiated vaccination, with high heterogeneity across studies (range: 0.5-93%; I square: 99.9%). A stratified analysis by HBV vaccination strategy demonstrated that in the studies providing on-site vaccination, the uptake was 78% (95%CI: 62-94%), significantly higher compared to 27% (95%CI: 13-42%) in studies referring participants to an external site for vaccination. Conclusion This systematic review identified a wide variety of interventions, mostly multi-component interventions, to enhance HBV screening, linkage to HBV clinical care, and HBV vaccination coverage. High heterogeneity was observed in effectiveness of interventions in all three domains of screening, linkage to care, and vaccination. Strategies identified to boost the effectiveness of interventions included providing on-site HBV testing and vaccination (versus referral for testing and vaccination) and including community education focussed on HBV or liver cancer in an HBV screening program. Further studies are needed to evaluate the effectiveness of more novel interventions (e.g., point of care testing) and interventions specifically including Indigenous populations, people who inject drugs, men who have sex with men, and people incarcerated.
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Mahling, Alexa, Michelle LeBlanc i Paul A. Peters. Report: Rural Resilience and Community Connections in Health: Outcomes of a Community Workshop. Spatial Determinants of Health Lab, Carleton University, grudzień 2020. http://dx.doi.org/10.22215/sdhlab/2020.1.
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Canadians living in rural communities are diverse, with individual communities defined by unique strengths and challenges that impact their health needs. Understanding rural health needs is a complex undertaking, with many challenges pertaining to engagement, research, and policy development. In order to address these challenges, it is imperative to understand the unique characteristics of rural communities as well as to ensure that the voices of rural and remote communities are prioritized in the development and implementation of rural health research programs and policy. Effective community engagement is essential in order to establish rural-normative programs and policies to improve the health of individuals living in rural, remote, and northern communities. This report was informed by a community engagement workshop held in Golden Lake, Ontario in October 2019. Workshop attendees were comprised of residents from communities within the Madawaska Valley, community health care professionals, students and researchers from Carleton University in Ottawa, Ontario, and international researchers from Australia, Sweden, and Austria. The themes identified throughout the workshop included community strengths and initiatives that are working well, challenges and concerns faced by the community in the context of health, and suggestions to build on strengths and address challenges to improve the health of residents in the Madawaska Valley.
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Pessino, Carola, i Teresa Ter-Minassian. Addressing the Fiscal Costs of Population Aging in Latin America and the Caribbean, with Lessons from Advanced Countries. Inter-American Development Bank, kwiecień 2021. http://dx.doi.org/10.18235/0003242.
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This paper presents projections for 18 Latin America and Caribbean countries of pensions and health expenditures over the next 50 years, compares them to advanced countries, and calculates estimates of the fiscal gap due to aging. The exercise is crucial since life expectancy is increasing and fertility rates are declining in virtually all advanced countries and many developing countries, but more so in Latin America and the Caribbean. While the populations of many of the regions countries are still relatively young, they are aging more rapidly than those in more developed countries. The fiscal implications of these demographic trends are severe. The paper proposes policy and institutional reforms that could begin to be implemented immediately and that could help moderate these trends in light of relevant international experience to date. It suggests that LAC countries need to include an intertemporal numerical fiscal limit or rule to the continuous increase in aging spending while covering the needs of the more vulnerable. They should consider also complementing public pensions with voluntary contribution mechanisms supported by tax incentives, such as those used in Australia, New Zealand (Kiwi Saver), and the United States (401k). In addition, LAC countries face an urgent challenge in curbing the growth of health care costs, while improving the quality of care. Efforts should focus on improving both the allocative and the technical efficiency of public health spending.
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McEntee, Alice, Sonia Hines, Joshua Trigg, Kate Fairweather, Ashleigh Guillaumier, Jane Fischer, Billie Bonevski, James A. Smith, Carlene Wilson i Jacqueline Bowden. Tobacco cessation in CALD communities. The Sax Institute, czerwiec 2022. http://dx.doi.org/10.57022/sneg4189.
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Background Australia is a multi-cultural society with increasing rates of people from culturally and linguistically diverse (CALD) backgrounds. On average, CALD groups have higher rates of tobacco use, lower participation in cancer screening programs, and poorer health outcomes than the general Australian population. Lower cancer screening and smoking cessation rates are due to differing cultural norms, health-related attitudes, and beliefs, and language barriers. Interventions can help address these potential barriers and increase tobacco cessation and cancer screening rates among CALD groups. Cancer Council NSW (CCNSW) aims to reduce the impact of cancer and improve cancer outcomes for priority populations including CALD communities. In line with this objective, CCNSW commissioned this rapid review of interventions implemented in Australia and comparable countries. Review questions This review aimed to address the following specific questions: Question 1 (Q1): What smoking cessation interventions have been proven effective in reducing or preventing smoking among culturally and linguistically diverse communities? Question 2 (Q2): What screening interventions have proven effective in increasing participation in population cancer screening programs among culturally and linguistically diverse populations? This review focused on Chinese-, Vietnamese- and Arabic-speaking people as they are the largest CALD groups in Australia and have high rates of tobacco use and poor screening adherence in NSW. Summary of methods An extensive search of peer-reviewed and grey literature published between January 2013-March 2022 identified 19 eligible studies for inclusion in the Q1 review and 49 studies for the Q2 review. The National Health and Medical Research Council (NHMRC) Levels of Evidence and Joanna Briggs Institute’s (JBI) Critical Appraisal Tools were used to assess the robustness and quality of the included studies, respectively. Key findings Findings are reported by components of an intervention overall and for each CALD group. By understanding the effectiveness of individual components, results will demonstrate key building blocks of an effective intervention. Question 1: What smoking cessation interventions have been proven effective in reducing or preventing smoking among culturally and linguistically diverse communities? Thirteen of the 19 studies were Level IV (L4) evidence, four were Level III (L3), one was Level II (L2), none were L1 (highest level of evidence) and one study’s evidence level was unable to be determined. The quality of included studies varied. Fifteen tobacco cessation intervention components were included, with most interventions involving at least three components (range 2-6). Written information (14 studies), and education sessions (10 studies) were the most common components included in an intervention. Eight of the 15 intervention components explored had promising evidence for use with Chinese-speaking participants (written information, education sessions, visual information, counselling, involving a family member or friend, nicotine replacement therapy, branded merchandise, and mobile messaging). Another two components (media campaign and telephone follow-up) had evidence aggregated across CALD groups (i.e., results for Chinese-speaking participants were combined with other CALD group(s)). No intervention component was deemed of sufficient evidence for use with Vietnamese-speaking participants and four intervention components had aggregated evidence (written information, education sessions, counselling, nicotine replacement therapy). Counselling was the only intervention component to have promising evidence for use with Arabic-speaking participants and one had mixed evidence (written information). Question 2: What screening interventions have proven effective in increasing participation in population cancer screening programs among culturally and linguistically diverse populations? Two of the 49 studies were Level I (L1) evidence, 13 L2, seven L3, 25 L4 and two studies’ level of evidence was unable to be determined. Eighteen intervention components were assessed with most interventions involving 3-4 components (range 1-6). Education sessions (32 studies), written information (23 studies) and patient navigation (10 studies) were the most common components. Seven of the 18 cancer screening intervention components had promising evidence to support their use with Vietnamese-speaking participants (education sessions, written information, patient navigation, visual information, peer/community health worker, counselling, and peer experience). The component, opportunity to be screened (e.g. mailed or handed a bowel screening test), had aggregated evidence regarding its use with Vietnamese-speaking participants. Seven intervention components (education session, written information, visual information, peer/community health worker, opportunity to be screened, counselling, and branded merchandise) also had promising evidence to support their use with Chinese-speaking participants whilst two components had mixed (patient navigation) or aggregated (media campaign) evidence. One intervention component for use with Arabic-speaking participants had promising evidence to support its use (opportunity to be screened) and eight intervention components had mixed or aggregated support (education sessions, written information, patient navigation, visual information, peer/community health worker, peer experience, media campaign, and anatomical models). Gaps in the evidence There were four noteworthy gaps in the evidence: 1. No systematic review was captured for Q1, and only two studies were randomised controlled trials. Much of the evidence is therefore based on lower level study designs, with risk of bias. 2. Many studies provided inadequate detail regarding their intervention design which impacts both the quality appraisal and how mixed finding results can be interpreted. 3. Several intervention components were found to have supportive evidence available only at the aggregate level. Further research is warranted to determine the interventions effectiveness with the individual CALD participant group only. 4. The evidence regarding the effectiveness of certain intervention components were either unknown (no studies) or insufficient (only one study) across CALD groups. This was the predominately the case for Arabic-speaking participants for both Q1 and Q2, and for Vietnamese-speaking participants for Q1. Further research is therefore warranted. Applicability Most of the intervention components included in this review are applicable for use in the Australian context, and NSW specifically. However, intervention components assessed as having insufficient, mixed, or no evidence require further research. Cancer screening and tobacco cessation interventions targeting Chinese-speaking participants were more common and therefore showed more evidence of effectiveness for the intervention components explored. There was support for cancer screening intervention components targeting Vietnamese-speaking participants but not for tobacco cessation interventions. There were few interventions implemented for Arabic-speaking participants that addressed tobacco cessation and screening adherence. Much of the evidence for Vietnamese and Arabic-speaking participants was further limited by studies co-recruiting multiple CALD groups and reporting aggregate results. Conclusion There is sound evidence for use of a range of intervention components to address tobacco cessation and cancer screening adherence among Chinese-speaking populations, and cancer screening adherence among Vietnamese-speaking populations. Evidence is lacking regarding the effectiveness of tobacco cessation interventions with Vietnamese- and Arabic-speaking participants, and cancer screening interventions for Arabic-speaking participants. More research is required to determine whether components considered effective for use in one CALD group are applicable to other CALD populations.
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Gordoncillo, Mary Joy N., Ronello C. Abila i Gregorio Torres. The Contributions of STANDZ Initiative to Dog Rabies Elimination in South-East Asia. O.I.E (World Organisation for Animal Health), styczeń 2016. http://dx.doi.org/10.20506/standz.2789.
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A Grant Agreement between the Government of Australia and the World Organisation for Animal Health (OIE), the Stop Transboundary Animal Diseases and Zoonoses (STANDZ), initiative includes a rabies component with an overarching intended outcome of reducing dog rabies incidence in targeted areas. This initiative envisaged regional rabies activities in South-East Asia as well as specifically designed pilot projects in the Philippines, Myanmar and Cambodia. While remaining anchored to the envisioned outcome, its implementation from 2013 to 2016 also leveraged on the resources made available through the initiative to strategically generate tools, materials and examples that can potentially bridge long-standing gaps on dog rabies elimination in the region. This included developing approaches on rabies communication strategy, risk-based approach for the prioritization of mass dog vaccination, rabies case investigation, post-vaccination monitoring, building capacity through pilot vaccination projects, One Health operationalization at the grass-root level, and reinforcing high-level political support through regional and national rabies strategy development. These are briefly described in this paper and are also further detailed in a series of publications which individually document these approaches for future utility of the countries in the region, or wherever these may be deemed fitting. The STANDZ rabies initiative leaves behind a legacy of materials and mechanisms that can potentially contribute in strategically addressing rabies in the region and in achieving the global vision of eliminating dog-mediated human rabies by 2030.
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Boyle, Maxwell, i Elizabeth Rico. Terrestrial vegetation monitoring at Cape Hatteras National Seashore: 2019 data summary. National Park Service, styczeń 2022. http://dx.doi.org/10.36967/nrr-2290019.
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The Southeast Coast Network (SECN) conducts long-term terrestrial vegetation monitoring as part of the nationwide Inventory and Monitoring Program of the National Park Service (NPS). The vegetation community vital sign is one of the primary-tier resources identified by SECN park managers, and monitoring is currently conducted at 15 network parks (DeVivo et al. 2008). Monitoring plants and their associated communities over time allows for targeted understanding of ecosystems within the SECN geography, which provides managers information about the degree of change within their parks’ natural vegetation. The first year of conducting this monitoring effort at four SECN parks, including 52 plots on Cape Hatteras National Seashore (CAHA), was 2019. Twelve vegetation plots were established at Cape Hatteras NS in July and August. Data collected in each plot included species richness across multiple spatial scales, species-specific cover and constancy, species-specific woody stem seedling/sapling counts and adult tree (greater than 10 centimeters [3.9 inches {in}]) diameter at breast height (DBH), overall tree health, landform, soil, observed disturbance, and woody biomass (i.e., fuel load) estimates. This report summarizes the baseline (year 1) terrestrial vegetation data collected at Cape Hatteras National Seashore in 2019. Data were stratified across four dominant broadly defined habitats within the park (Maritime Tidal Wetlands, Maritime Nontidal Wetlands, Maritime Open Uplands, and Maritime Upland Forests and Shrublands) and four land parcels (Bodie Island, Buxton, Hatteras Island, and Ocracoke Island). Noteworthy findings include: A total of 265 vascular plant taxa (species or lower) were observed across 52 vegetation plots, including 13 species not previously documented within the park. The most frequently encountered species in each broadly defined habitat included: Maritime Tidal Wetlands: saltmeadow cordgrass Spartina patens), swallow-wort (Pattalias palustre), and marsh fimbry (Fimbristylis castanea) Maritime Nontidal Wetlands: common wax-myrtle (Morella cerifera), saltmeadow cordgrass, eastern poison ivy (Toxicodendron radicans var. radicans), and saw greenbriar (Smilax bona-nox) Maritime Open Uplands: sea oats (Uniola paniculata), dune camphorweed (Heterotheca subaxillaris), and seabeach evening-primrose (Oenothera humifusa) Maritime Upland Forests and Shrublands: : loblolly pine (Pinus taeda), southern/eastern red cedar (Juniperus silicicola + virginiana), common wax-myrtle, and live oak (Quercus virginiana). Five invasive species identified as either a Severe Threat (Rank 1) or Significant Threat (Rank 2) to native plants by the North Carolina Native Plant Society (Buchanan 2010) were found during this monitoring effort. These species (and their overall frequency of occurrence within all plots) included: alligatorweed (Alternanthera philoxeroides; 2%), Japanese honeysuckle (Lonicera japonica; 10%), Japanese stilt-grass (Microstegium vimineum; 2%), European common reed (Phragmites australis; 8%), and common chickweed (Stellaria media; 2%). Eighteen rare species tracked by the North Carolina Natural Heritage Program (Robinson 2018) were found during this monitoring effort, including two species—cypress panicgrass (Dichanthelium caerulescens) and Gulf Coast spikerush (Eleocharis cellulosa)—listed as State Endangered by the Plant Conservation Program of the North Carolina Department of Agriculture and Consumer Services (NCPCP 2010). Southern/eastern red cedar was a dominant species within the tree stratum of both Maritime Nontidal Wetland and Maritime Upland Forest and Shrubland habitat types. Other dominant tree species within CAHA forests included loblolly pine, live oak, and Darlington oak (Quercus hemisphaerica). One hundred percent of the live swamp bay (Persea palustris) trees measured in these plots were experiencing declining vigor and observed with symptoms like those caused by laurel wilt......less
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Rankin, Nicole, Deborah McGregor, Candice Donnelly, Bethany Van Dort, Richard De Abreu Lourenco, Anne Cust i Emily Stone. Lung cancer screening using low-dose computed tomography for high risk populations: Investigating effectiveness and screening program implementation considerations: An Evidence Check rapid review brokered by the Sax Institute (www.saxinstitute.org.au) for the Cancer Institute NSW. The Sax Institute, październik 2019. http://dx.doi.org/10.57022/clzt5093.
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Background Lung cancer is the number one cause of cancer death worldwide.(1) It is the fifth most commonly diagnosed cancer in Australia (12,741 cases diagnosed in 2018) and the leading cause of cancer death.(2) The number of years of potential life lost to lung cancer in Australia is estimated to be 58,450, similar to that of colorectal and breast cancer combined.(3) While tobacco control strategies are most effective for disease prevention in the general population, early detection via low dose computed tomography (LDCT) screening in high-risk populations is a viable option for detecting asymptomatic disease in current (13%) and former (24%) Australian smokers.(4) The purpose of this Evidence Check review is to identify and analyse existing and emerging evidence for LDCT lung cancer screening in high-risk individuals to guide future program and policy planning. Evidence Check questions This review aimed to address the following questions: 1. What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? 2. What is the evidence of potential harms from lung cancer screening for higher-risk individuals? 3. What are the main components of recent major lung cancer screening programs or trials? 4. What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Summary of methods The authors searched the peer-reviewed literature across three databases (MEDLINE, PsycINFO and Embase) for existing systematic reviews and original studies published between 1 January 2009 and 8 August 2019. Fifteen systematic reviews (of which 8 were contemporary) and 64 original publications met the inclusion criteria set across the four questions. Key findings Question 1: What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? There is sufficient evidence from systematic reviews and meta-analyses of combined (pooled) data from screening trials (of high-risk individuals) to indicate that LDCT examination is clinically effective in reducing lung cancer mortality. In 2011, the landmark National Lung Cancer Screening Trial (NLST, a large-scale randomised controlled trial [RCT] conducted in the US) reported a 20% (95% CI 6.8% – 26.7%; P=0.004) relative reduction in mortality among long-term heavy smokers over three rounds of annual screening. High-risk eligibility criteria was defined as people aged 55–74 years with a smoking history of ≥30 pack-years (years in which a smoker has consumed 20-plus cigarettes each day) and, for former smokers, ≥30 pack-years and have quit within the past 15 years.(5) All-cause mortality was reduced by 6.7% (95% CI, 1.2% – 13.6%; P=0.02). Initial data from the second landmark RCT, the NEderlands-Leuvens Longkanker Screenings ONderzoek (known as the NELSON trial), have found an even greater reduction of 26% (95% CI, 9% – 41%) in lung cancer mortality, with full trial results yet to be published.(6, 7) Pooled analyses, including several smaller-scale European LDCT screening trials insufficiently powered in their own right, collectively demonstrate a statistically significant reduction in lung cancer mortality (RR 0.82, 95% CI 0.73–0.91).(8) Despite the reduction in all-cause mortality found in the NLST, pooled analyses of seven trials found no statistically significant difference in all-cause mortality (RR 0.95, 95% CI 0.90–1.00).(8) However, cancer-specific mortality is currently the most relevant outcome in cancer screening trials. These seven trials demonstrated a significantly greater proportion of early stage cancers in LDCT groups compared with controls (RR 2.08, 95% CI 1.43–3.03). Thus, when considering results across mortality outcomes and early stage cancers diagnosed, LDCT screening is considered to be clinically effective. Question 2: What is the evidence of potential harms from lung cancer screening for higher-risk individuals? The harms of LDCT lung cancer screening include false positive tests and the consequences of unnecessary invasive follow-up procedures for conditions that are eventually diagnosed as benign. While LDCT screening leads to an increased frequency of invasive procedures, it does not result in greater mortality soon after an invasive procedure (in trial settings when compared with the control arm).(8) Overdiagnosis, exposure to radiation, psychological distress and an impact on quality of life are other known harms. Systematic review evidence indicates the benefits of LDCT screening are likely to outweigh the harms. The potential harms are likely to be reduced as refinements are made to LDCT screening protocols through: i) the application of risk predication models (e.g. the PLCOm2012), which enable a more accurate selection of the high-risk population through the use of specific criteria (beyond age and smoking history); ii) the use of nodule management algorithms (e.g. Lung-RADS, PanCan), which assist in the diagnostic evaluation of screen-detected nodules and cancers (e.g. more precise volumetric assessment of nodules); and, iii) more judicious selection of patients for invasive procedures. Recent evidence suggests a positive LDCT result may transiently increase psychological distress but does not have long-term adverse effects on psychological distress or health-related quality of life (HRQoL). With regards to smoking cessation, there is no evidence to suggest screening participation invokes a false sense of assurance in smokers, nor a reduction in motivation to quit. The NELSON and Danish trials found no difference in smoking cessation rates between LDCT screening and control groups. Higher net cessation rates, compared with general population, suggest those who participate in screening trials may already be motivated to quit. Question 3: What are the main components of recent major lung cancer screening programs or trials? There are no systematic reviews that capture the main components of recent major lung cancer screening trials and programs. We extracted evidence from original studies and clinical guidance documents and organised this into key groups to form a concise set of components for potential implementation of a national lung cancer screening program in Australia: 1. Identifying the high-risk population: recruitment, eligibility, selection and referral 2. Educating the public, people at high risk and healthcare providers; this includes creating awareness of lung cancer, the benefits and harms of LDCT screening, and shared decision-making 3. Components necessary for health services to deliver a screening program: a. Planning phase: e.g. human resources to coordinate the program, electronic data systems that integrate medical records information and link to an established national registry b. Implementation phase: e.g. human and technological resources required to conduct LDCT examinations, interpretation of reports and communication of results to participants c. Monitoring and evaluation phase: e.g. monitoring outcomes across patients, radiological reporting, compliance with established standards and a quality assurance program 4. Data reporting and research, e.g. audit and feedback to multidisciplinary teams, reporting outcomes to enhance international research into LDCT screening 5. Incorporation of smoking cessation interventions, e.g. specific programs designed for LDCT screening or referral to existing community or hospital-based services that deliver cessation interventions. Most original studies are single-institution evaluations that contain descriptive data about the processes required to establish and implement a high-risk population-based screening program. Across all studies there is a consistent message as to the challenges and complexities of establishing LDCT screening programs to attract people at high risk who will receive the greatest benefits from participation. With regards to smoking cessation, evidence from one systematic review indicates the optimal strategy for incorporating smoking cessation interventions into a LDCT screening program is unclear. There is widespread agreement that LDCT screening attendance presents a ‘teachable moment’ for cessation advice, especially among those people who receive a positive scan result. Smoking cessation is an area of significant research investment; for instance, eight US-based clinical trials are now underway that aim to address how best to design and deliver cessation programs within large-scale LDCT screening programs.(9) Question 4: What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Assessing the value or cost-effectiveness of LDCT screening involves a complex interplay of factors including data on effectiveness and costs, and institutional context. A key input is data about the effectiveness of potential and current screening programs with respect to case detection, and the likely outcomes of treating those cases sooner (in the presence of LDCT screening) as opposed to later (in the absence of LDCT screening). Evidence about the cost-effectiveness of LDCT screening programs has been summarised in two systematic reviews. We identified a further 13 studies—five modelling studies, one discrete choice experiment and seven articles—that used a variety of methods to assess cost-effectiveness. Three modelling studies indicated LDCT screening was cost-effective in the settings of the US and Europe. Two studies—one from Australia and one from New Zealand—reported LDCT screening would not be cost-effective using NLST-like protocols. We anticipate that, following the full publication of the NELSON trial, cost-effectiveness studies will likely be updated with new data that reduce uncertainty about factors that influence modelling outcomes, including the findings of indeterminate nodules. Gaps in the evidence There is a large and accessible body of evidence as to the effectiveness (Q1) and harms (Q2) of LDCT screening for lung cancer. Nevertheless, there are significant gaps in the evidence about the program components that are required to implement an effective LDCT screening program (Q3). Questions about LDCT screening acceptability and feasibility were not explicitly included in the scope. However, as the evidence is based primarily on US programs and UK pilot studies, the relevance to the local setting requires careful consideration. The Queensland Lung Cancer Screening Study provides feasibility data about clinical aspects of LDCT screening but little about program design. The International Lung Screening Trial is still in the recruitment phase and findings are not yet available for inclusion in this Evidence Check. The Australian Population Based Screening Framework was developed to “inform decision-makers on the key issues to be considered when assessing potential screening programs in Australia”.(10) As the Framework is specific to population-based, rather than high-risk, screening programs, there is a lack of clarity about transferability of criteria. However, the Framework criteria do stipulate that a screening program must be acceptable to “important subgroups such as target participants who are from culturally and linguistically diverse backgrounds, Aboriginal and Torres Strait Islander people, people from disadvantaged groups and people with a disability”.(10) An extensive search of the literature highlighted that there is very little information about the acceptability of LDCT screening to these population groups in Australia. Yet they are part of the high-risk population.(10) There are also considerable gaps in the evidence about the cost-effectiveness of LDCT screening in different settings, including Australia. The evidence base in this area is rapidly evolving and is likely to include new data from the NELSON trial and incorporate data about the costs of targeted- and immuno-therapies as these treatments become more widely available in Australia.