Academic literature on the topic 'Australian community care'
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Journal articles on the topic "Australian community care"
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Cheng, I.-Hao, Sayed Wahidi, Shiva Vasi, and Sophia Samuel. "Importance of community engagement in primary health care: the case of Afghan refugees." Australian Journal of Primary Health 21, no. 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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Benrimoj, Shalom I., and Alison S. Roberts. "Providing Patient Care in Community Pharmacies in Australia." Annals of Pharmacotherapy 39, no. 11 (November 2005): 1911–17. http://dx.doi.org/10.1345/aph.1g165.
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OBJECTIVE To describe Australia's community pharmacy network in the context of the health system and outline the provision of services. DATA SYNTHESIS The 5000 community pharmacies form a key component of the healthcare system for Australians, for whom health expenditures represent 9% of the Gross Domestic Product. A typical community pharmacy dispenses 880 prescriptions per week. Pharmacists are key partners in the Government's National Medicines Policy and contribute to its objectives through the provision of cognitive pharmaceutical services (CPS). The Third Community Pharmacy Agreement included funding for CPS including medication review and the provision of written drug information. Funding is also provided for a quality assurance platform with which the majority of pharmacies are accredited. Fifteen million dollars (Australian) have been allocated to research in community pharmacy, which has focused on achieving quality use of medicines (QUM), as well as developing new CPS and facilitating change. Elements of the Agreements have taken into account QUM principles and are now significant drivers of practice change. Although accounting for 10% of remuneration for community pharmacy, the provision of CPS represents a significant shift in focus to view pharmacy as a service provider. Delivery of CPS through the community pharmacy network provides sustainability for primary health care due to improvement in quality presumably associated with a reduction in healthcare costs. CONCLUSIONS Australian pharmacy practice is moving strongly in the direction of CPS provision; however, change does not occur easily. The development of a change management strategy is underway to improve the uptake of professional and business opportunities in community pharmacy.
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McBride, Tony, and Viola Korczak. "Community consultation and engagement in health care reform." Australian Health Review 31, no. 5 (2007): 13. http://dx.doi.org/10.1071/ah070s13.
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In advocating for significant reform of the health care system, the Australian Health Care Reform Alliance (AHCRA) supports a process of citizen engagement that will allow the wider community to have a say in the future direction of their health care system. Models that have engaged community opinions have been successful overseas, and this article calls for similar processes in Australia.
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Reilly, Stephen P. "Australian Sojourn." Bulletin of the Royal College of Psychiatrists 9, no. 8 (August 1985): 155–56. http://dx.doi.org/10.1192/pb.9.8.155.
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Community psychiatry means different things to different people. Since the 1970s the American model of community psychiatry based on mental health clinics has attracted heavy criticism, whilst the UK concept of rooting community psychiatric services firmly within primary health care has gained increasing support. The need for community-orientated psychiatric services is generally agreed upon but definition of community and the mode of delivery are not. In Australia both free and private health care are available; community health centres and community mental health clinics exist (sometimes literally) side by side.
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Bourke, Sharon L., Claire Harper, Elianna Johnson, Janet Green, Ligi Anish, Miriam Muduwa, and Linda Jones. "Health Care Experiences in Rural, Remote, and Metropolitan Areas of Australia." Online Journal of Rural Nursing and Health Care 21, no. 1 (May 4, 2021): 67–84. http://dx.doi.org/10.14574/ojrnhc.v21i1.652.
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Background: Australia is a vast land with extremes in weather and terrain. Disparities exist between the health of those who reside in the metropolitan areas versus those who reside in the rural and remote areas of the country. Australia has a public health system called Medicare; a basic level of health cover for all Australians that is funded by taxpayers. Most of the hospital and health services are located in metropolitan areas, however for those who live in rural or remote areas the level of health service provision can be lower; with patients required to travel long distances for health care.
Purpose: This paper will explore the disparities experienced by Australians who reside in regional and remote areas of Australia.
Method: A search of the literature was performed from healthcare databases using the search terms: healthcare, rural and remote Australia, and social determinants of health in Australia.
Findings: Life in the rural and remote areas of Australia is identified as challenging compared to the metropolitan areas. Those with chronic illnesses such as diabetes are particularly vulnerable to morbidities associated with poor access to health resources and the lack of service provision.
Conclusion: Australia has a world class health system. It has been estimated that 70% of the Australian population resides in large metropolitan areas and remaining 30% distributed across rural and remote communities. This means that 30% of the population are not experiencing their health care as ‘world-class’, but rather are experiencing huge disparities in their health outcomes.
Keywords: rural and remote, health access, mental health issues, social determinants
DOI: https://doi.org/10.14574/ojrnhc.v21i1.652
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Lavoie, Josée G., and Judith Dwyer. "Implementing Indigenous community control in health care: lessons from Canada." Australian Health Review 40, no. 4 (2016): 453. http://dx.doi.org/10.1071/ah14101.
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Objective Over past decades, Australian and Canadian Indigenous primary healthcare policies have focused on supporting community controlled Indigenous health organisations. After more than 20 years of sustained effort, over 89% of eligible communities in Canada are currently engaged in the planning, management and provision of community controlled health services. In Australia, policy commitment to community control has also been in place for more than 25 years, but implementation has been complicated by unrealistic timelines, underdeveloped change management processes, inflexible funding agreements and distrust. This paper discusses the lessons from the Canadian experience to inform the continuing efforts to achieve the implementation of community control in Australia. Methods We reviewed Canadian policy and evaluation grey literature documents, and assessed lessons and recommendations for relevance to the Australian context. Results Our analysis yielded three broad lessons. First, implementing community control takes time. It took Canada 20 years to achieve 89% implementation. To succeed, Australia will need to make a firm long term commitment to this objective. Second, implementing community control is complex. Communities require adequate resources to support change management. And third, accountability frameworks must be tailored to the Indigenous primary health care context to be meaningful. Conclusions We conclude that although the Canadian experience is based on a different context, the processes and tools created to implement community control in Canada can help inform the Australian context. What is known about the topic? Although Australia has promoted Indigenous control over primary healthcare (PHC) services, implementation remains incomplete. Enduring barriers to the transfer of PHC services to community control have not been addressed in the largely sporadic attention to this challenge to date, despite significant recent efforts in some jurisdictions. What does this paper add? The Canadian experience indicates that transferring PHC from government to community ownership requires sustained commitment, adequate resourcing of the change process and the development of a meaningful accountability framework tailored to the sector. What are the implications for practitioners? Policy makers in Australia will need to attend to reform in contractual arrangements (towards pooled or bundled funding), adopt a long-term vision for transfer and find ways to harmonise the roles of federal and state governments. The arrangements achieved in some communities in the Australian Coordinated Care Trials (and still in place) provide a model.
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Swerissen, Hal. "Editorial: CoAG and Primary Health Reform." Australian Journal of Primary Health 12, no. 1 (2006): 6. http://dx.doi.org/10.1071/py06001.
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Chronic disease prevention and management, integration and community care continue to be key themes for primary health and community care as the papers in this issue of the Journal attest. Three quarters of Australians have an ongoing chronic illness (Australian Bureau of Statistics, 2006). The Council of Australian Governments has recently emphasised the importance of health promotion and disease prevention (Council of Australian Governments, 2006), but to date proposals for action have been disappointing. There is now a plethora of research on these issues and innovative policy and practice to deal with them. There is little doubt that primary health and community care programs are important for the effective delivery of chronic disease prevention. Yet, it remains difficult to get concrete progress towards a national policy framework for primary health and community care. Instead we have incremental, piecemeal attempts at reform. Why is this so?
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MacLean, Sarah, Angela Harney, and Kerry Arabena. "Primary health-care responses to methamphetamine use in Australian Indigenous communities." Australian Journal of Primary Health 21, no. 4 (2015): 384. http://dx.doi.org/10.1071/py14126.
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Crystal methamphetamine (commonly known as ‘ice’) use is currently a deeply concerning problem for some Australian Indigenous peoples and can cause serious harms to individual, families and communities. This paper is intended to support best practice responses by primary health-care staff working with Australian Indigenous people who use methamphetamine. It draws on a systematic search of relevant databases to identify literature from January 1999 to February 2014, providing an overview of prevalence, treatment, education and harm reduction, and community responses. The prevalence of methamphetamine use is higher in Indigenous than non-Indigenous communities, particularly in urban and regional settings. No evidence was identified that specifically related to effective treatment and treatment outcomes for Indigenous Australians experiencing methamphetamine dependence or problematic use. While studies involving methamphetamine users in the mainstream population suggest that psychological and residential treatments show short-term promise, longer-term outcomes are less clear. Community-driven interventions involving Indigenous populations in Australia and internationally appear to have a high level of community acceptability; however, outcomes in terms of methamphetamine use are rarely evaluated. Improved national data on prevalence of methamphetamine use among Indigenous people and levels of treatment access would support service planning. We argue for the importance of a strength-based approach to addressing methamphetamine use, to counteract the stigma and despair that frequently accompanies it.
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Davis, Jenny, Amee Morgans, and Stephen Burgess. "Information management in the Australian aged care setting." Health Information Management Journal 46, no. 1 (July 26, 2016): 3–14. http://dx.doi.org/10.1177/1833358316639434.
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Background: Information management systems and processes have an impact on quality and safety of care in any setting and particularly in the complex care setting of aged care. Few studies have comprehensively examined information management in the Australian aged care setting. Objective: To (i) critically analyse and synthesize evidence related to information management in aged care, (ii) identify aged care data collection frameworks and (iii) identify factors impacting information management. Methods: An integrative review of Australian literature published between March 2008 and August 2014 and data collection frameworks concerning information management in aged care were carried out. Results: There is limited research investigating the information-rich setting of aged care in Australia. Electronic systems featured strongly in the review. Existing research focuses on residential settings with community aged care largely absent. Information systems and processes in the setting of aged care in Australia are underdeveloped and poorly integrated. Conclusions: Data quality and access are more problematic within community aged care than residential care settings. The results of this review represent an argument for a national approach to information management in aged care to address multiple stakeholder information needs and more effectively support client care.
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Yan, Charles, Bing Guo, and Paula Corabian. "PP97 Delineating Key Components Of Community Paramedicine Programs." International Journal of Technology Assessment in Health Care 34, S1 (2018): 102–3. http://dx.doi.org/10.1017/s0266462318002416.
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Introduction:Population growth, epidemiological and demographic transition, and a shortage of healthcare workers are affecting health care systems in Australia, Canada, the United Kingdom (UK), and the United States (US). Community paramedicine (CP) programs provide a bridge between primary care and emergency care to address the needs of patients with low acuity but lack of access to primary care. However, how to capture the key characteristics of these programs and present them in a meaningful way is still a challenge. The objective of this presentation is to identify and describe the characteristics of currently existing CP programs in the four countries to inform policy-making on CP program development in Alberta.Methods:Information was obtained from systematic reviews, health technology assessments, general reviews, and government documents identified through a comprehensive literature search. The characteristics of the CP programs are described using a framework originally developed in Australia with three categories: (i) the primary health care model, (ii) the health integration model (in Australia, called the substitution model), and (iii) the community coordination model.Results:In general, Australia emphasizes rural/remote paramedics, whereas Canada, the UK, and the US implement expanded paramedic practice within different environments including rural, remote, regional, and metropolitan settings. Extended care provider programs have been intensively investigated and widely implemented in the UK. While the identified CP programs vary in terms of program components, designation of providers, skill mix, target population, and funding model, the majority of these CP programs fall under the primary health care category of the Australian framework.Conclusions:Transitioning from hospital-based to community-based health care requires careful consideration of all key factors that could contribute to future program success. Delineating key components of CP programs using the Australian framework will help Alberta decision-makers design, develop, and implement appropriate CP programs that adequately address local needs.
Dissertations / Theses on the topic "Australian community care"
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Mee, Jenny. "Australian home care quality : a political tango." Thesis, Federation University Australia, 2020. http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/179509.
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The performance of Australian home care and how it is enacted has been significantly impacted by the economic and political challenges since the announcement of the Aged Care Reforms in July 2012 and the launch of the National Disability Insurance Scheme in July 2013. As a result, the home care business arena has changed, and the effects are being felt as the marketplace shifts, and businesses adapt to new policy directions. The purpose of this research study was to investigate the social context of Australian home care, and to collect information regarding how home care (under the various auspices of government funded and privately funded) service provision is enacted in terms of quality during this time of change. The qualitative research process for this study involved critical reflexive practice and face-to-face semi-structured interviews of 10 home care business leaders from the states of Queensland and Victoria. In listening to the voices of the participants, this research study sought to develop new discursive approaches in order to understand the practice of caring for the Australian community’s most vulnerable people – those who are frail, aged, and for those who have ill-health or a disability. The analytical framework adopted for this study used a post-structural discourse analysis, which was informed by the work of French philosopher Michel Foucault and other contemporary theorists. The philosophical framework of governmentality and discourse analysis helped to situate the voice of the participants at a time when new ideas and the ways of conducting the business of home care are emerging. In using this approach to analyse the data, it became apparent that the discursive practices that had been instituted by government in the home care sector had been constructed to remove progressive inclusionary policies that were contrary to the democratic principles of governing. The research study’s findings reveal the problematic changes that impact on business but more so for consumers as the rules are interpreted. By using the metaphor of ice dancing, the study problematized the leadership of government and the challenges participants faced in maintaining quality service provision in the home care arena. What emerged was the dance of a political tango. These leaders in the arena revealed the importance of knowing when to lead and when to push back. Like the different genres of tango, there are different ways of viewing the world of home care and performing in its different spaces, and there are other ways of viewing quality in caring service provisions. By participating in the research, the participants highlighted the need of being inclusive to hearing and seeing all performers in the arena of home care regardless of social or geographical positioning. This research concludes that hearing and acting on the voices from the wider home care arena continues to be necessary in order to inform future policy direction for quality performance improvements for Australia’s consumers of home care and to move away from home care traditions of governing and ruling. The research additionally advocates for more inclusive governing approaches through more even distribution of power in consultative processes, research, oversight in the marketplace and access to resources for all groups. This thesis is a contribution to creating a new political dance in the space of Australia’s home care politics.Doctor of Philosophy
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Brown, Katrina. "Unwrapping packages: Power politics and place in the delivery of community aged care." Thesis, University of Ballarat, 2010. http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/31539.
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The thesis analyses the delivery of the Community Aged Care Packages Program, revealing the flaws in the program’s design and the consequences of this programmatic design for service providers in rural VictoriaDoctor of Philosophy
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Van, Loggerenberg Valerie. "Australian volunteers in the health sector : antecedents to volunteers' intention to leave /." Murdoch University Digital Theses Program, 2008. http://wwwlib.murdoch.edu.au/adt/browse/view/adt-MU20090409.113755.
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Wynaden, Dianne Gaye. "The primary carer's experience of caring for a person with a mental disorder in the Western Australian community: a grounded theory study." Thesis, Curtin University, 2002. http://hdl.handle.net/20.500.11937/883.
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One in five Australians has a mental disorder and it is estimated that one in four families have a member who has a mental disorder. Since the 1960s there has been an 80 percent decrease in Australian institution-based mental health care. The majority of people who have a mental disorder are now treated in their local community and many of them live with their families. The change in the delivery of mental health care has seen the family emerge as one of the most important supports to their ill family member. While the changes in the delivery of mental health care have been based on human rights concerns, changes in mental health legislature, and economic factors, the multi-dimensional experience of being a primary carer of a person with a mental disorder remains relatively unexplored. The need for empirical evidence on the primary carer's experience is noted in both the scientific literature and from carers themselves and the principal aim of conducting this research was to address the identified need. This qualitative study, using grounded theory methodology, presents the findings of interviews with 27 primary carers and memos documented throughout the study. In addition, existing literature of relevance to the findings of this study is presented. A substantive theory of seeking balance to overcome being consumed is presented in this thesis. Using the grounded theory method the constant comparative analysis of data revealed that the basic social psychological problem shared by all participants was the experience of "being consumed". The problem of being consumed consisted of two stages: "disruption of established lifestyle" and a "sustained threat to self-equilibrium". Six conditions were identified as influencing participants' experience of being consumed.In order to address the problem of being consumed, participants engaged in a basic social psychological process of "seeking balance". When participants were engaged in this process they moved from a state of being consumed to one whereby they established and consolidated a balanced life perspective that incorporated their caregiving role. The process of seeking balance consisted of three phases: "utilising personal strategies to reduce the problem of being consumed', "restoring self- identity", and "reaching out to make a difference". In addition, data analysis identified the presence of a three phase sub-process entitled "trying to make sense of what was happening". Phases one of the core and sub- processes occurred primarily in the period prior to the time when a psychiatric diagnosis was made on the affected family member. Participants became engaged in the remaining two phases of the core and sub-processes when they became aware that their affected family member had a mental disorder. At the time of being interviewed for this study some participants were not yet engaged in the final phase of the process of seeking balance. Participants' experience of seeking balance was not related to the length of their caregiving experience but rather to their experience of seeking balance and the conditions influencing that process. Four conditions were identified as influencing participants' experience of seeking balance.This thesis presents the substantive theory of seeking balance to overcome being consumed. While the findings support existing scientific literature, the substantive theory also presents a new insight on caring from the primary carer's perspective. In particular, the findings challenge health professionals to actively pursue strategies to reduce carers' experience of being consumed. The findings of this study have implications for service provision and clinical practice, policy and planning, research, education, the general population, mental health consumers, and carers.
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Wynaden, Dianne Gaye. "The primary carer's experience of caring for a person with a mental disorder in the Western Australian community: a grounded theory study." Curtin University of Technology, School of Nursing and Midwifery, 2002. http://espace.library.curtin.edu.au:80/R/?func=dbin-jump-full&object_id=15910.
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One in five Australians has a mental disorder and it is estimated that one in four families have a member who has a mental disorder. Since the 1960s there has been an 80 percent decrease in Australian institution-based mental health care. The majority of people who have a mental disorder are now treated in their local community and many of them live with their families. The change in the delivery of mental health care has seen the family emerge as one of the most important supports to their ill family member. While the changes in the delivery of mental health care have been based on human rights concerns, changes in mental health legislature, and economic factors, the multi-dimensional experience of being a primary carer of a person with a mental disorder remains relatively unexplored. The need for empirical evidence on the primary carer's experience is noted in both the scientific literature and from carers themselves and the principal aim of conducting this research was to address the identified need. This qualitative study, using grounded theory methodology, presents the findings of interviews with 27 primary carers and memos documented throughout the study. In addition, existing literature of relevance to the findings of this study is presented. A substantive theory of seeking balance to overcome being consumed is presented in this thesis. Using the grounded theory method the constant comparative analysis of data revealed that the basic social psychological problem shared by all participants was the experience of "being consumed". The problem of being consumed consisted of two stages: "disruption of established lifestyle" and a "sustained threat to self-equilibrium". Six conditions were identified as influencing participants' experience of being consumed.In order to address the problem of being consumed, participants engaged in a basic social psychological process of "seeking balance". When participants were engaged in this process they moved from a state of being consumed to one whereby they established and consolidated a balanced life perspective that incorporated their caregiving role. The process of seeking balance consisted of three phases: "utilising personal strategies to reduce the problem of being consumed', "restoring self- identity", and "reaching out to make a difference". In addition, data analysis identified the presence of a three phase sub-process entitled "trying to make sense of what was happening". Phases one of the core and sub- processes occurred primarily in the period prior to the time when a psychiatric diagnosis was made on the affected family member. Participants became engaged in the remaining two phases of the core and sub-processes when they became aware that their affected family member had a mental disorder. At the time of being interviewed for this study some participants were not yet engaged in the final phase of the process of seeking balance. Participants' experience of seeking balance was not related to the length of their caregiving experience but rather to their experience of seeking balance and the conditions influencing that process. Four conditions were identified as influencing participants' experience of seeking balance.
This thesis presents the substantive theory of seeking balance to overcome being consumed. While the findings support existing scientific literature, the substantive theory also presents a new insight on caring from the primary carer's perspective. In particular, the findings challenge health professionals to actively pursue strategies to reduce carers' experience of being consumed. The findings of this study have implications for service provision and clinical practice, policy and planning, research, education, the general population, mental health consumers, and carers.
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Paul, David. "Casting shadows and struggling for control : silence, resistance and negotiation in Australian Aboriginal health." University of Western Australia. School of Primary, Aboriginal and Rural Health Care, 2007. http://theses.library.uwa.edu.au/adt-WU2008.0015.
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Self determination has been recognised as a basic human right both internationally and, to an extent, locally, but it is yet to be fully realised for Aboriginal Peoples in Australia. The assertion of Aboriginal community control in Aboriginal health has been at the forefront of Aboriginal peoples' advocacy for self determination for more than thirty years. Aboriginal Community Controlled Health Services and their representative organisations have been the site of considerable resistance and contestation in the struggles involved in trying to improve Aboriginal health experiences. Drawing on some of these experiences I explore the apparent inability of policy and decision makers to listen to systematic voices calling for change from the Aboriginal Community Controlled Health sector. It is government inability to act more fully on clear and repeated messages that is a source of much disquiet within representative Aboriginal organisations. Such disquiet is grounded in a belief that colonial notions continue to influence decision making at policy, practice and research levels resulting in a significant impediment to the realisation of self determination and associated human rights in Aboriginal health matters and Aboriginal Affairs more broadly.
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Bullen, Heatheranne. "Pandemic Influenza at Oodnadatta, 1919 : Aspects of treatment and care in a multiracial community." Thesis, Federation University Australia, 2018. http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/169879.
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On 24 January 1919, a thirty-two-year-old nurse from Sydney, Jean Williamson, disembarked at the railway station at Oodnadatta in the far north of South Australia to commence her new role as sister in charge of the Australian Inland Mission (AIM) hostel. On 18 April that year, Williamson greeted thirty-four-year-old minister from Melbourne, Coledge Harland, who had arrived by train to take up a three-year post as padre for the AIM’s central Australian parish. Just over a month later, an influenza pandemic that had already killed untold numbers of people worldwide reached the isolated township. Drawing on primary documents, including an extensive collection of previously unseen photographs, letter and diaries from Harland and Williamson, this thesis examines the management and care of pandemic influenza at Oodnadatta from May to late July 1919. Intercultural aspects of the management and care of European, Afghan, Chinese and Aboriginal patients are examined in the context of the health and lifestyle of local residents, nursing practices, medicines, foods, accommodation and the contribution of individuals, groups and their roles. This intimate microhistory sheds light on a relatively unknown, yet important group of people in Australia’s frontier history: the missioners and others who cared for seriously ill Aboriginal and non-Aboriginal patients at Oodnadatta, provided culturally sensitive care that afforded respect, dignity and compassion to all. At the time, the gravity of the world wide situation and the sheer need to provide care saw individual efforts go unnoticed; however, in hindsight, it is possible to see and appreciate the significance of what they achieved under the most difficult of circumstances.Masters by Research
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Helen, Maureen. "Other people's country: A memoir; and, Developing a trustworthy narrator: An essay." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2006. https://ro.ecu.edu.au/theses/1796.
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This thesis comprises two interrelated sections. The first section is a substantial piece of creative writing, which l have cailed 'Other People's Country: A Memoir, in the genre of travel memoir, and an essay. The memoir borrows techniques from fiction, drama and poetry to tell a story of a middle-aged, middle-class city nurse, who travels to a remote settlement at the edge of the Western Desert of Western Australia to provide health care for a fluctuating population of around 400 people, for whom English is a third or fourth language.
Writing that includes stories about vulnerable people from another culture, whose lives have touched those of the writer, demands sensitivity to differences, as well as an ethical approach. Writing about Aboriginal people also demands an awareness of what is appropriate when writing about cultural material. To achieve the voice of a trustworthy narrator is a challenge that faces all writers of narrative non-fiction, including memoir. The truth is subjective; perception is unreliable; memory can be distorted; error slips in unwittingly; deliberate falsification is possible. In spite of all this, a writer of memoir makes a contract with the reader that the story is significant, and that it is the writer's truth, told as honestly as possible. The pivotal concern of this thesis is the question, 'What are some of the important considerations for a memoirist who is attempting to develop the voice of an ethical and trustworthy narrator writing about experiences encountered when living and working within an unfamiliar culture?
The second part of the thesis is an essay which develops a theoretical framework in response to some of the major dilemmas I encountered in this undertaking. It embraces memory, aspects of Aboriginal vulnerability, and ethics through which to explore the concepts of truth and honesty in memoir-writing.
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Alexander, Kathy. "Promoting health at the local level : a management and planning model for primary health care services /." Title page, contents and introduction only, 1994. http://web4.library.adelaide.edu.au/theses/09PH/09pha376.pdf.
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Davis, Kierrynn, University of Western Sydney, Faculty of Social Inquiry, and School of Social Ecology. "Cartographies of rural community nursing and primary health care: mapping the in-between spaces." THESIS_FSI_SEL_Davis_K.xml, 1998. http://handle.uws.edu.au:8081/1959.7/470.
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This postmodern feminist ethnographies research aimed to explore the everyday meanings of primary health care (PHC) held by rural community nurses. Secondly, the research aimed to explore the everyday meanings of care held by the clients of the rural community nurses who participated in the study. The representation of this research is written in four voices which converse with each other to varying degrees in each chapter. This writing strategy is a deliberate one aimed at destabilising the usual approach to representation of research. It is also a strategy which seeks methodological coherence. The third aim therefore is to deliberately trouble the acceptable grounds concerning how nursing research is represented. The research utilised dialogical (conversational)and participant observation methods concerning the everyday meanings of nurses and their clients.The meanings I made of the information were created from a deconstruction of the texts. These texts included fieldnotes of participant observations and transcripts of conversations with nurses and their clients. The form of deconstruction utilised was informed from multiple sources and involved three levels of analysis. A realist interpretation was followed by an oppositional interpretation and then a reconstructive movement. The results revealed that rural community nurses practice is both spatio-temporally contextualised and metaphorically situated in an in-between space. This in-between space is situated between margin and the centre. Rural community nurses working on the margins traverse this space in order to overcome further marginalisation whilst working with Indigenous Australians and the aged. Moreover, the in-between space encompasses and creates opportunities to mutually exchange the gift of desire that being - empowering and compassionate relationships with clients and colleagues. Futhermore, whilst rural community nurses are strongly committed to the philosophy of PHC, their evryday working life is discursively constructed by powerful discourses which result in oppositional tensions. The tensions and the 'in-between' space allow the rhetoric of PHC to be resisted and reframed. Consequently, the oppositional constructs of their practice were displaced. Moreover, this necessitated the negotiation of space and place, and required the reconstruction of subjectivity, intersubjectivity and becomingDoctor of Philosophy (PhD)
Books on the topic "Australian community care"
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1964-, Sexton Michael, ed. Mama Jude: An Australian nurses's extraordinary other life in Africa. Pymble, NSW: ABC Books/HarperCollins Publishers, 2009.
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Cramer, Jennifer. Sounding the alarm: Remote area nurses and Aboriginals at risk. Crawley, W.A: University of Western Australia Press, 2005.
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Patterson, Rob. From Vietnam to Timor: Misfit, missionary or mercenary. Loftus [N.S.W.]: Australian Military History Publications, 2006.
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Office, Australian Audit. Department of Community Services and Health: Home and Community Care Program. Canberra: Australian Govt. Pub. Service, 1988.
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Bureaucrats and bleeding hearts: Indigenous health in northern Australia. Sydney: University of New South Wales Press, 2008.
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Bartleet, Brydie-Leigh. Sound links: Community music in Australia. Brisbane, Qld]: Griffith University, 2009.
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Finn, Judith. An overview of community health services provided in Western Australia during 1995. Western Australia: Health Information Centre, Health Dept. of Western Australia, 1996.
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Delivery of home and community care services by local government. Melbourne: Govt. Printer, 2004.
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Linn, Rob. Angels of Mercy: District nursing in South Australia, 1894-1994. Norwood, SA [S. Aust.]: Royal District Nursing Society of SA, 1993.
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McBride, Nyanda. Making schools healthy: Western Australian School Health Project. [Bentley, W.A.]: National Centre for Research into the Prevention of Drug Abuse, 1993.
Find full textBook chapters on the topic "Australian community care"
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Luckett, Tim, Meera Agar, and Jane Phillips. "Australian Palliative Care for Chronic Cancer Patients in the Community." In Palliative Care for Chronic Cancer Patients in the Community, 575–81. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-54526-0_52.
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Ridgway, Avis, Gloria Quiñones, and Liang Li. "Toddlers’ Outdoor Play, Imagination and Cultural Formation." In International Perspectives on Early Childhood Education and Development, 23–42. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-72595-2_2.
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AbstractDiscussion on toddlers’ outdoor play practices in various cultural spaces is rare in literature. In Australia, toddlers’ physical development and well-being is promoted but less attention is given to cultural nuances of outdoor play. We ask the question: How does outdoor play impact on toddlers’ imagination and cultural formation? Conducted in three Australian long day care (LDC) sites, an ethically approved project “Studying babies and toddlers: Cultural worlds and transitory relationships” examines the process of three Australian toddlers’ outdoor enculturation. The concepts of imagination and play from Vygotsky’s cultural-historical theory are drawn upon in relation to Hedegaard’s institutional practices model, to link contextual relations between society, community and family. Cultural formation processes in toddlers’ outdoor play, we argue, are more completely understood when daily life across home and local community is acknowledged. Data findings illustrate complexity of movement and experimentations in cultural conditions, where different spaces hold possibilities for imaginative transformations in toddler’s play. Implications suggest toddlers’ imaginative and culturally responsive outdoor play aligns with availability of interested adult/peers, shared family and community values, and varied local spaces. In this way, affective and dynamic outdoor interactions imbue cultural formation of toddler’s play and imagination with local personal meaning.
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Dodd, Elizabeth, Paul Hawting, Eleanor Horton, Mohanraj Karunanithi, and Anne Livingstone. "Australian Community Care Experience on the Design, Development, Deployment and Evaluation of Implementing the Smarter Safer Homes Platform." In 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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Johnson, Kelley. "The Mirror Cracked: Care in the Community in Victoria, Australia." In Community Care in Perspective, 146–56. London: Palgrave Macmillan UK, 2007. http://dx.doi.org/10.1057/9780230596528_10.
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Kotze, Beth. "The Policy Context and Governance." In Longer-Term Psychiatric Inpatient Care for Adolescents, 161–67. Singapore: Springer Nature Singapore, 2022. http://dx.doi.org/10.1007/978-981-19-1950-3_18.
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AbstractThe Walker Unit opened in 2009 as the first of its kind in Australia to provide an intensive longer stay secure psychiatric inpatient rehabilitation programme for adolescents with severe mental illness who had not benefited from at least one but generally repeated admissions or prolonged care in other tertiary inpatient unit settings. Unusually, this happened at a time when the focus of reform in mental health at a State and National level is on community models, early intervention and community residential care rather than extended inpatient care in the specialist clinical sector. As a first of its kind, the Unit is an important innovation in inpatient mental health care and has garnered a reputation in the clinical sector for creating value in mental health care.
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Le Couteur, Travis. "Library Technician in Charge, Mobile Branch Library, Lifestyle and Community, City of Gold Coast, Australia." In Literacy and Reading Programmes for Children and Young People: Case Studies from Around the Globe, 175–87. New York: Apple Academic Press, 2021. http://dx.doi.org/10.1201/9781003189275-17.
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Le Couteur, Travis. "Library Technician in Charge, Mobile Branch Library, Lifestyle and Community, City of Gold Coast, Australia." In Literacy and Reading Programmes for Children and Young People: Case Studies from Around the Globe, 175–87. New York: Apple Academic Press, 2021. http://dx.doi.org/10.1201/9781003189275-17.
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Soar, Jeffrey, and Rob Eley. "Changing ICT for Client/Patient Management and Clinical Information in Residential and Community Aged Care Services in Regional Australia: Structured Interviews with Service Managers." In Lecture Notes in Computer Science, 113–20. Berlin, Heidelberg: Springer Berlin Heidelberg, 2010. http://dx.doi.org/10.1007/978-3-642-13778-5_14.
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Collins, Patricia, Julie Greathouse, Brendan Myhill, and Lauren Gough. "Australian Palliative Social Work." In The Oxford Textbook of Palliative Social Work, edited by Terry Altilio, Shirley Otis-Green, and John G. Cagle, 474–78. Oxford University Press, 2022. http://dx.doi.org/10.1093/med/9780197537855.003.0045.
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Australian palliative social work is dynamic, responding to changing contexts and system challenges. Work in Australia requires an understanding of the history and experience of Aboriginal and Torres Strait Islander Australians, along with the many other cultural groups who have arrived since 1788 to make up Australia’s multicultural community. Palliative care and bereavement service delivery varies across the country, meaning social workers must be flexible and able to adapt in their roles, while assisting patients and their families to navigate systems in their local context. Therapeutic knowledge and interventions underpin the work of palliative social work in Australia; counseling and therapeutic work are often delivered alongside skilled practical resourcing, care planning, and provision.
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Clark, Eileen, and Terence McCann. "The aged care sector: residential and community care." In Understanding the Australian Health Care System, 83–93. Elsevier, 2009. http://dx.doi.org/10.1016/b978-0-7295-3861-9.10008-0.
Full textConference papers on the topic "Australian community care"
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Smith, Wally, Greg Wadley, Oliver Daly, Marianne Webb, Jo Hughson, John Hajek, Anna Parker, Robyn Woodward-Kron, and David Story. "Designing an app for pregnancy care for a culturally and linguistically diverse community." In OzCHI '17: 29th Australian Conference on Human-Computer Interaction. New York, NY, USA: ACM, 2017. http://dx.doi.org/10.1145/3152771.3152807.
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Penman, Joy, and Kerre A Willsher. "New Horizons for Immigrant Nurses Through a Mental Health Self-Management Program: A Pre- and Post-Test Mixed-Method Approach." In 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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Stevens, Quentin. "A Brief History of the Short-Term Parklet in Australia." In The 38th Annual Conference of the Society of Architectural Historians Australia and New Zealand. online: SAHANZ, 2022. http://dx.doi.org/10.55939/a4018pognw.
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This paper examines the history within Australia of the ‘parklet’, a small architecturally-framed open space installed temporarily on an on-street car-parking space. The paper traces parklets’ varied and evolving forms, materials, production processes and functions. It examines how parklets have adapted to rapidly-changing social needs and priorities for economic activity, health, safety, socialising and on-street parking, and changes in street function. The contemporary parklet began in 2005 as a localised, grassroots activity to temporarily reclaim street space for public leisure, as part of the wider movement of ‘tactical urbanism’. Parklets rapidly became a worldwide phenomenon. Starting in 2008, parklets were absorbed into institutional urban planning practice, as a strategic tool to enhance community engagement, test possibilities, and win support for longer-term spatial transformations. From 2012, commercial parklet programs were developed in Australian cities to encourage local businesses to expand into street parking spaces, to calm traffic and enhance pedestrian amenity. A new generation of commercial ‘café parklets’ has emerged during the COVID-19 pandemic, facilitated by local governments, to support the heavily-impacted hospitality industry. Their design and construction show ongoing innovation, increasing scale and professionalism, but also standardisation. This paper draws on diverse Australian parklet examples to chart the emergence of varying approaches to their design and construction, which draw upon different materials, skills, local government strategies and international precedents. The findings also illustrate several convergences in the evolution of parklet design across different Australian cities, due to strong similarities in the spatial contexts, needs, risk factors, and technologies that have defined this practice.
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Carroll, Francis, and Jan Hayes. "Effective Risk Management for In Service Pipelines: Achieving ALARP by Pressure Management and Slab Protection." In 2018 12th International Pipeline Conference. American Society of Mechanical Engineers, 2018. http://dx.doi.org/10.1115/ipc2018-78170.
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In Australia (and the UK), pipeline operating companies have a regulatory obligation to ensure that their assets are designed, constructed, operated and maintained so that risk to people and the environment is as low as reasonably practicable (ALARP). In many routine cases, demonstration that risk is ALARP is a matter of compliance with relevant technical standards. There are some cases, however, that are more complex. If a pipeline has been subject to significant urban encroachment and does not conform to current design standards for this service, how does a pipeline operator decide whether risk controls are sufficient? In Australia, rather than either ‘grandfathering’ requirements or mandating retrospective compliance with new standards, operators are required to ensure pipelines are safe and that risk levels are acceptable. The answer in cases such as this is a matter of judgment and we have legal, moral and reputational responsibilities to get decisions such as this right. There is currently no formal requirement in the US for pipeline risks to be ALARP, although the concept is gradually being introduced to US industry safety law. Examples include US offshore well control rules, California refinery safety regulations and the nuclear sector concept of ‘as low as reasonably achievable’. In this paper, we demonstrate application of the ALARP process to a case study pipeline built in the 1960s that has been heavily encroached by urban development. The Australian risk-based approach required formal ALARP assessment including consideration of options to reduce pressure, relocate or replace the pipeline, or increase the level of physical or procedural protection. Current and predicted operating conditions on this existing pipeline allowed reduction in operating pressure in some of the encroached segments, sufficient to achieve the equivalent of current Australian requirements for ‘No Rupture’ in high consequence areas for new pipelines. In other areas this was not achievable and a lesser degree of pressure reduction was instigated, in combination with physical barrier protection. The physical barrier slabbing comprised over 7 km of 20 mm thick high-density polyethylene (HDPE) slabs, buried above the pipeline. This approach was new in Australia and required field trials to confirm effectiveness against tiger tooth excavators and rotary augers. These upgrades to the case study pipeline have significantly decreased the risk of pipeline failure, by reducing both likelihood and consequences of accidental impact. In combination with rigorous procedural controls such as patrol surveillance and community liaison, real risk reduction has been achieved and ALARP has been demonstrated.
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Nolan, Huw, Adele Nye, Nikki Rumpca, and Ariella Van Luyn. "Learning to research in distance mode: Technologies for building higher degree research community online." In ASCILITE 2021: Back to the Future – ASCILITE ‘21. University of New England, Armidale, 2021. http://dx.doi.org/10.14742/ascilite2021.0125.
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Higher Degree Researchers (HDRs) in Australia tertiary education programs must achieve mastery of complex skills, theories, and concepts. Non-traditional HDRs, especially those enrolled part time and remotely, face barriers to achieving these outcomes. This concise paper uses the case study of a regional university in Australia to investigate the theoretical underpinnings of technology use to promote HDR communities of learning, especially for part time and remote researchers.
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Clark, Andrew, and John Lewis. "The challenges in developing a seamless model of aged and disability community care in Australia within a mixed economy of service providers." In 2012 IEEE Conference on Technology and Society in Asia (T&SA). IEEE, 2012. http://dx.doi.org/10.1109/tsasia.2012.6397982.
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Saputri, Eviana Maya. "Urgency of Violence Screening in Pregnant Women: A Scoping Review." In The 7th International Conference on Public Health 2020. Masters Program in Public Health, Universitas Sebelas Maret, 2020. http://dx.doi.org/10.26911/the7thicph.03.61.
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ABSTRACT Background: Partner violence during pregnancy might contribute to the clinical conditions of pregnant women. Early assessment and supportive response are required to improve clinical diagnosis and subsequent care. This scoping review aimed to identify the partner violence screening practices of community-based health care providers in pregnant women. Subjects and Method: A scoping review method was conducted in eight stages including (1) Identification of study problems; (2) Determining priority problem and study question; (3) Determining framework; (4) Literature searching; (5) Article selection; (6) Critical appraisal; (7) Data extraction; and (8) Mapping. The search included PubMed, Science Direct, EBSCO, Wiley Online Library, and ProQuest databases. The inclusion criteria were English-language and full-text articles published between 2010 and 2020. A total of 580 articles were obtained by the searched database. After the review process, eight articles were eligible for this review. The critical appraisal for searched articles were measured by Mix Methods Appraisal Tools (MMAT). The data were reported by the PRISMA flow chart. Results: Two articles from developing countries (Zimbabwe and Kenya) and six articles from developed countries (Australia, Norway, Italy, and Sweden) met the inclusion criteria with a mixed-method, qualitative, and quantitative (cross-sectional) studies. The existing studies revealed that violence screening in pregnant women was effective to increase awareness of violence by their partners. Screening practice had an empowering effect on women to disclose the violence experienced. Barriers to the health care providers performing partner violence screening included: lack of knowledge, experience and training, confidence in undertaking the screening, taboo cultural practices, and absence of domestic violence screening policies. Conclusion: Partner violence screening practice should be strongly considered at antenatal care visits. Further insights of community-based health care providers are required to perform effective screening. Keywords: partner violence screening, pregnant women, health care providers Correspondence: Eviana Maya Saputri. Universitas ‘Aisyiyah Yogyakarta. Jl. Siliwangi No. 63, Nogotirto, Gamping, Sleman, Yogyakarta, 55292. Email: evianamaya34@gmail.com. Mobile: +6281367470323. DOI: https://doi.org/10.26911/the7thicph.03.61
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Sila Ahmad, Kham, Fay Sudweeks, and Jocelyn Armarego. "Learning English Vocabulary in a Mobile Assisted Language Learning (MALL) Environment: A Sociocultural Study of Migrant Women." In InSITE 2015: Informing Science + IT Education Conferences: USA. Informing Science Institute, 2015. http://dx.doi.org/10.28945/2166.
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This paper reports on a case study of a group of six non-native English speaking migrant women’s experiences learning English vocabulary in a mobile assisted language learning (MALL) environment at a small community centre in Western Australia. A sociocultural approach to learning vocabulary was adopted in designing the MALL lessons that the women undertook. The women provided demographic information, responded to questions in a pre-MALL semi-structured interview, attended the MALL lessons, and completed a post-MALL semi-structured interview. This study explores the sociocultural factors that affect migrant women’s language learning in general, and vocabulary in particular. The women’s responses to MALL lessons and using the tablet reveal a positive effect in their vocabulary learning. A revised version of this paper was published in Interdisciplinary Journal of e-Skills and Life Long Learning Volume 11, 2015
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Wolff-Boenisch, Domenik. "A case study on student perception of online lecturing." In Seventh International Conference on Higher Education Advances. Valencia: Universitat Politècnica de València, 2021. http://dx.doi.org/10.4995/head21.2021.12710.
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This case study looks at implications of transitioning live to recorded lectures, a subject that has acquired an acute importance given COVID19 and the unexpected need to move lectures online. Over a period of six years, from 2015 to 2020, a questionnaire was handed out at the end of a ‘unit’ on environmental geoscience; a ‘unit’ at Australian universities represents a ‘course’ in the European and American tertiary system. This is a 2nd semester, 3rd year core unit of an Applied Geology course meaning that (most of) the polled students were about to acquire a bachelor of science finishing their undergraduate studies. The students were asked multiple questions related to iLectures and their attitude towards this asynchronous content delivery approach as integral part of a flipped classroom. Provided that such a STEM unit with 40-120 students can be deemed representative of the wider student community, the findings indicate that students in general have come to terms with online lectures, way before COVID19 gave them no other choice. Acceptance rates for iLectures were over 50 % across all years, except for 2020, a clear indication that COVID19 marred the online experience, probably due to oversaturation and isolation. The majority of the students saw benefits in this asynchronous lecturing approach, irrespective of whether the rationale behind it had been explained in detail. Despite seeing benefits of the flipped classroom and recorded lectures, one out of three students preferred live lectures. This number has increased after COVID19 to 40 %, yet another sign of the negative impact of the pandemic on online lecturing. This inference is unrelated to the quality of the recordings which was deemed high. Other than the conspicuous pandemic effect, the data show enough scatter to rule out any sustained trend of student attitudes across the years. This demonstrates the heterogeneous demographics of the students taking this unit. Finally, the importance of meaningful extended lecture notes to complement the recordings is highlighted.
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"Transition to First Year University Study: A Qualitative Descriptive Study on the Psychosocial and Emotional Impacts of a Science Workshop." In InSITE 2019: Informing Science + IT Education Conferences: Jerusalem. Informing Science Institute, 2019. http://dx.doi.org/10.28945/4188.
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[This Proceedings paper was revised and published in the 2019 issue of the journal Issues in Informing Science and Information Technology, Volume 16] Aim/purpose The purpose of this article is to discuss the psychosocial and emotional outcomes of an introductory health science workshop designed to support and assist incoming health science students before starting their university study. Background For the past two decades, a South Australian university offered an on-campus face to face workshop titled ‘Preparation for Health Sciences’ to incoming first-year students from eleven allied health programs such as Nursing, Physiotherapy and Medical Imaging. While many were locals, a good number came from regional and rural areas, and many were international students also. They consisted of both on-campus and off-campus students. The workshop was created as a new learning environment that was available for students of diverse age groups, educational and cultural backgrounds to prepare them to study sciences. The content of the four-day workshop was developed in consultation with the program directors of the allied health programs. The objectives were to: introduce the assumed foundational science knowledge to undertake health sciences degree; gain confidence in approaching science subjects; experience lectures and laboratory activities; and become familiar with the University campus and its facilities. The workshop was delivered a week before the orientation week, before first-year formal teaching weeks. The topics covered were enhancing study skills, medical and anatomical terminology, body systems, basic chemistry and physics, laboratory activities, and assessment of learning. Methodology In order to determine the outcomes of the workshop, a survey was used requiring participants to agree or disagree about statements concerning the preparatory course and answer open-ended questions relating to the most important information learned and the best aspects of the workshop. Several students piloted this questionnaire before use in order to ascertain the clarity of instructions, terminology and statements. The result of the 2015-2018 pre- and post-evaluation showed that the workshop raised confidence and enthusiasm in commencing university and that the majority considered the workshop useful overall. The findings of the survey are drawn upon to examine the psychosocial and emotional impacts of the workshop on participants. Using secondary qualitative analysis, the researchers identified the themes relating to the psychosocial and emotional issues conveyed by the participants. Contribution The contributions of the article are in the areas of improving students’ confidence to complete their university degrees and increasing the likelihood of academic success. Findings Of the 285 students who participated in the workshops from 2015 to 2018, 166 completed the survey conducted at the conclusion of the initiative, representing a 58% response rate. The workshops achieved the objectives outlined at the outset. While there were many findings reported (Thalluri, 2016), the results highlighted in this paper relate to the psychosocial and emotional impacts of the workshop on students. Three themes emerged, and these were Increased preparedness and confidence; Networking and friendships that enhanced support, and Reduced anxiety to study sciences. Some drawbacks were also reported including the cost, time and travel involved. Recommendations for practitioners Students found the introductory workshop to be psychosocially and emotionally beneficial. It is recommended that the same approach be applied for teaching other challenging fields such as mathematics and physics within the university and in other contexts and institutions. Recommendations for researchers Improving and extending the workshop to provide greater accessibility and autonomy is recommended. A longitudinal study to follow up the durability of the workshop is also proposed. Impact on society The impacts in the broader community include: higher academic success for students; improved mental health due to social networking and friendship groups and reduced anxiety and fear; reduced dropout rate in their first year; greater potential to complete educational degrees; reduced wastage in human and financial resources; and increased human capital. Future research Addressing the limitations of cost, time and travel involved, and following-up with the participants’ academic and workplace performance are future directions for research.
Reports on the topic "Australian community care"
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Smit, Amelia, Kate Dunlop, Nehal Singh, Diona Damian, Kylie Vuong, and Anne Cust. Primary prevention of skin cancer in primary care settings. The Sax Institute, August 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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Marshall, Amber, Krystle Turner, Carol Richards, Marcus Foth, Michael Dezuanni, and Tim Neale. A case study of human factors of digital AgTech adoption: Condamine Plains, Darling Downs. Queensland University of Technology, December 2021. http://dx.doi.org/10.5204/rep.eprints.227177.
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As global agricultural production methods and supply chains have become more digitised, farmers around the world are adopting digital AgTech such as drones, Internet of Things (IoT), remote sensors, blockchain, and satellite imagery to inform their on-farm decision-making. While early adopters and technology advocates globally are spruiking and realising the benefits of digital AgTech, many Australian farmers are reluctant or unable to participate fully in the digital economy. This is an important issue, as the Australian Government has said that digital farming is essential to meeting its target of agriculture being a $100billion industry by 2030. Most studies of AgTech adoption focus on individual-level barriers, yielding well-documented issues such as access to digital connectivity, availability of AgTech suppliers, non-use of ICTs, and cost-benefit for farmers. In contrast, our project took an ‘ecosystems’ approach to study cotton farmers in the Darling Downs region in Queensland, Australia who are installing water sensors, satellite imagery, and IoT plant probes to generate data to be aggregated on a dashboard to inform decision-making. We asked our farmers to map their local ecosystem, and then set up interviewing different stakeholders (such technology providers, agronomists, and suppliers) to understand how community-level orientations to digital agriculture enabled and constrained on-farm adoption. We identified human factors of digital AgTech adoption at the macro, regional and farm levels, with a pronounced ‘data divide’ between farm and community level stakeholders within the ecosystem. This ‘data divide’ is characterised by a capability gap between the provision of the devices and software that generate data by technology companies, and the ability of farmers to manage, implement, use, and maintain them effectively and independently. In the Condamine Plains project, farmers were willing and determined to learn new, advanced digital and data literacy skills. Other farmers in different circumstances may not see value in such an undertaking or have the necessary support to take full advantage of the technologies once they are implemented. Moreover, there did not seem to be a willingness or capacity in the rest of the ecosystem to fill this gap. The work raises questions about the type and level of new, digital expertise farmers need to attain in the transition to digital farming, and what interventions are necessary to address the significant barriers to adoption and effective use that remain in rural communities. By holistically considering how macro- and micro-level factors may be combined with community-level influences, this study provides a more complete and holistic account of the contextualised factors that drive or undermine digital AgTech adoption on farms in rural communities. This report provides insights and evidence to inform strategies for rural ecosystems to transition farms to meet the requirements and opportunities of Agriculture 4.0 in Australia and abroad.
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Mahling, Alexa, Michelle LeBlanc, and Paul A. Peters. Report: Rural Resilience and Community Connections in Health: Outcomes of a Community Workshop. Spatial Determinants of Health Lab, Carleton University, December 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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Hajarizadeh, Behzad, Jennifer MacLachlan, Benjamin Cowie, and 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, August 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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McKenna, Patrick, and Mark Evans. Emergency Relief and complex service delivery: Towards better outcomes. Queensland University of Technology, June 2021. http://dx.doi.org/10.5204/rep.eprints.211133.
Full textAbstract:
Emergency Relief (ER) is a Department of Social Services (DSS) funded program, delivered by 197 community organisations (ER Providers) across Australia, to assist people facing a financial crisis with financial/material aid and referrals to other support programs. ER has been playing this important role in Australian communities since 1979. Without ER, more people living in Australia who experience a financial crisis might face further harm such as crippling debt or homelessness. The Emergency Relief National Coordination Group (NCG) was established in April 2020 at the start of the COVID-19 pandemic to advise the Minister for Families and Social Services on the implementation of ER. To inform its advice to the Minister, the NCG partnered with the Institute for Governance at the University of Canberra to conduct research to understand the issues and challenges faced by ER Providers and Service Users in local contexts across Australia. The research involved a desktop review of the existing literature on ER service provision, a large survey which all Commonwealth ER Providers were invited to participate in (and 122 responses were received), interviews with a purposive sample of 18 ER Providers, and the development of a program logic and theory of change for the Commonwealth ER program to assess progress. The surveys and interviews focussed on ER Provider perceptions of the strengths, weaknesses, future challenges, and areas of improvement for current ER provision. The trend of increasing case complexity, the effectiveness of ER service delivery models in achieving outcomes for Service Users, and the significance of volunteering in the sector were investigated. Separately, an evaluation of the performance of the NCG was conducted and a summary of the evaluation is provided as an appendix to this report. Several themes emerged from the review of the existing literature such as service delivery shortcomings in dealing with case complexity, the effectiveness of case management, and repeat requests for service. Interviews with ER workers and Service Users found that an uplift in workforce capability was required to deal with increasing case complexity, leading to recommendations for more training and service standards. Several service evaluations found that ER delivered with case management led to high Service User satisfaction, played an integral role in transforming the lives of people with complex needs, and lowered repeat requests for service. A large longitudinal quantitative study revealed that more time spent with participants substantially decreased the number of repeat requests for service; and, given that repeat requests for service can be an indicator of entrenched poverty, not accessing further services is likely to suggest improvement. The interviews identified the main strengths of ER to be the rapid response and flexible use of funds to stabilise crisis situations and connect people to other supports through strong local networks. Service Users trusted the system because of these strengths, and ER was often an access point to holistic support. There were three main weaknesses identified. First, funding contracts were too short and did not cover the full costs of the program—in particular, case management for complex cases. Second, many Service Users were dependent on ER which was inconsistent with the definition and intent of the program. Third, there was inconsistency in the level of service received by Service Users in different geographic locations. These weaknesses can be improved upon with a joined-up approach featuring co-design and collaborative governance, leading to the successful commissioning of social services. The survey confirmed that volunteers were significant for ER, making up 92% of all workers and 51% of all hours worked in respondent ER programs. Of the 122 respondents, volunteers amounted to 554 full-time equivalents, a contribution valued at $39.4 million. In total there were 8,316 volunteers working in the 122 respondent ER programs. The sector can support and upskill these volunteers (and employees in addition) by developing scalable training solutions such as online training modules, updating ER service standards, and engaging in collaborative learning arrangements where large and small ER Providers share resources. More engagement with peak bodies such as Volunteering Australia might also assist the sector to improve the focus on volunteer engagement. Integrated services achieve better outcomes for complex ER cases—97% of survey respondents either agreed or strongly agreed this was the case. The research identified the dimensions of service integration most relevant to ER Providers to be case management, referrals, the breadth of services offered internally, co-location with interrelated service providers, an established network of support, workforce capability, and Service User engagement. Providers can individually focus on increasing the level of service integration for their ER program to improve their ability to deal with complex cases, which are clearly on the rise. At the system level, a more joined-up approach can also improve service integration across Australia. The key dimensions of this finding are discussed next in more detail. Case management is key for achieving Service User outcomes for complex cases—89% of survey respondents either agreed or strongly agreed this was the case. Interviewees most frequently said they would provide more case management if they could change their service model. Case management allows for more time spent with the Service User, follow up with referral partners, and a higher level of expertise in service delivery to support complex cases. Of course, it is a costly model and not currently funded for all Service Users through ER. Where case management is not available as part of ER, it might be available through a related service that is part of a network of support. Where possible, ER Providers should facilitate access to case management for Service Users who would benefit. At a system level, ER models with a greater component of case management could be implemented as test cases. Referral systems are also key for achieving Service User outcomes, which is reflected in the ER Program Logic presented on page 31. The survey and interview data show that referrals within an integrated service (internal) or in a service hub (co-located) are most effective. Where this is not possible, warm referrals within a trusted network of support are more effective than cold referrals leading to higher take-up and beneficial Service User outcomes. However, cold referrals are most common, pointing to a weakness in ER referral systems. This is because ER Providers do not operate or co-locate with interrelated services in many cases, nor do they have the case management capacity to provide warm referrals in many other cases. For mental illness support, which interviewees identified as one of the most difficult issues to deal with, ER Providers offer an integrated service only 23% of the time, warm referrals 34% of the time, and cold referrals 43% of the time. A focus on referral systems at the individual ER Provider level, and system level through a joined-up approach, might lead to better outcomes for Service Users. The program logic and theory of change for ER have been documented with input from the research findings and included in Section 4.3 on page 31. These show that ER helps people facing a financial crisis to meet their immediate needs, avoid further harm, and access a path to recovery. The research demonstrates that ER is fundamental to supporting vulnerable people in Australia and should therefore continue to be funded by government.
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McEntee, Alice, Sonia Hines, Joshua Trigg, Kate Fairweather, Ashleigh Guillaumier, Jane Fischer, Billie Bonevski, James A. Smith, Carlene Wilson, and Jacqueline Bowden. Tobacco cessation in CALD communities. The Sax Institute, June 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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Boyle, Maxwell, and Elizabeth Rico. Terrestrial vegetation monitoring at Cape Hatteras National Seashore: 2019 data summary. National Park Service, January 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, and 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, October 2019. http://dx.doi.org/10.57022/clzt5093.
Full textAbstract:
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.