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Sample records for australian health determinant

  1. To what extent do Australian child and youth health policies address the social determinants of health and health equity?: a document analysis study

    OpenAIRE

    Phillips, Clare; Fisher, Matt; Baum, Fran; MacDougall, Colin; Newman, Lareen; McDermott, Dennis

    2016-01-01

    Background There is a significant body of evidence that highlights the importance of addressing the social determinants of child and youth health. In order to tackle health inequities Australian governments are being called upon to take action in this area at a policy level. Recent research suggests that the health and well-being of children and youth in Australia is ‘middle of the road’ when compared to other OECD countries. To date, there have been no systematic analyses of Australian child...

  2. Development and preliminary validation of the 'Caring for Country' questionnaire: measurement of an Indigenous Australian health determinant

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    Gunthorpe Wendy

    2008-12-01

    Full Text Available Abstract Background 'Caring for Country' is defined as Indigenous participation in interrelated activities with the objective of promoting ecological and human health. Ecological services on Indigenous-owned lands are belatedly attracting some institutional investment. However, the health outcomes associated with Indigenous participation in 'caring for country' activities have never been investigated. The aims of this study were to pilot and validate a questionnaire measuring caring for country as an Indigenous health determinant and to relate it to an external reference, obesity. Methods Purposively sampled participants were 301 Indigenous adults aged 15 to 54 years, recruited during a cross-sectional program of preventive health checks in a remote Australian community. Questionnaire validation was undertaken with psychometric tests of internal consistency, reliability, exploratory factor analysis and confirmatory one-factor congeneric modelling. Accurate item weightings were derived from the model and used to create a single weighted composite score for caring for country. Multiple linear regression modelling was used to test associations between the caring for country score and body mass index adjusting for socio-demographic factors and health behaviours. Results The questionnaire demonstrated adequate internal consistency, test-retest validity and proxy-respondent validity. Exploratory factor analysis of the 'caring for country' items produced a single factor solution that was confirmed via one-factor congeneric modelling. A significant and substantial association between greater participation in caring for country activities and lower body mass index was demonstrated. Adjusting for socio-demographic factors and health behaviours, an inter-quartile range rise in caring for country scores was associated with 6.1 Kg and 5.3 Kg less body weight for non-pregnant women and men respectively. Conclusion This study indicates preliminary support for

  3. Association of social determinants of health with self-rated health among Australian gay and bisexual men living with HIV.

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    Koelmeyer, Rachel; English, Dallas R; Smith, Anthony; Grierson, Jeffrey

    2014-01-01

    Despite a vast improvement in the survival of people living with HIV (PLHIV) since the introduction of combination antiretroviral treatment (cART), little change in the self-rated health of PLHIV has been observed since the introduction of cART in Australia. Difficulties with attaining employment or achieving financial security have been noted as some of the key challenges still facing PLHIV in the post-cART era. As a result, we investigated the independent association of a number of key social determinants of health with self-rated health among HIV-positive gay and bisexual men in Australia. Data from two recent national, cross-sectional surveys of PLHIV (the HIV Futures 5 and 6 surveys) were used. Logistic regression was used to assess the independent association of ethnicity, region of residence, education level, employment status, after-tax income, experience of HIV-related discrimination, level of social support, relationship status and recent sexual activity with reporting good-excellent self-rated health, after adjusting for clinical factors and other social determinants of health. Multiple imputation was used to estimate missing data for variables with >5% missing data. Of the 1713 HIV-positive gay/bisexual men who responded to the HIV Futures 5 and 6 surveys, information on self-rated health was available for 99.3%. Close to three-quarters of these respondents (72.1%) reported their self-rated health as good or excellent; the remainder (27.9%) reported their self-rated health as poor or fair. In multivariable analysis involving 89.3% of respondents, being employed, reporting recent sexual activity, a greater number of sources of social support and a higher weekly after-tax income were found to be independently associated with reporting good-excellent self-rated health. Despite the inability of this study to detect causal associations, addressing barriers to employment and sexual activity, and mechanisms to increase social support, is likely to have

  4. The Portrayal of Indigenous Health in Selected Australian Media

    OpenAIRE

    Melissa J. Stoneham; Jodie Goodman; Mike Daube

    2014-01-01

    It is acknowledged that health outcomes for Australian Indigenous peoples are lower than those of non-Indigenous Australians. Research suggests negative media in relation to Indigenous Australians perpetuates racist stereotypes among the wider population and impacts on the health of Indigenous Australians. This study examined the media portrayal of Indigenous Australian public health issues in selected media over a twelve month period and found that, overwhelmingly, the articles were negative...

  5. The Asian currency crisis and the Australian health industry.

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    Barraclough, S

    1998-01-01

    This article identifies linkages between the Australian health industry and the global economy. It discusses some of the consequences of the Asian currency crisis of 1997-98 for the Australian economy and health industry, with special emphasis upon exports. Devaluation of the Australian dollar will increase the cost of most pharmaceutical and medical imports, but may offer competitive advantages to some Australian exporters. The nascent engagement with Asia of many health industry enterprises is likely to be stifled. It is therefore important for Australian governments, as well as the Australian health industry, to provide intelligence and encouragement to those enterprises that wish to continue their engagement with Asia or resume it when economic equilibrium returns. Markets throughout the world must also be further developed. The crisis may therefore provide the stimulus for re-thinking and re-stating Australian health export policy. PMID:10537568

  6. The Asian currency crisis and the Australian health industry.

    Science.gov (United States)

    Barraclough, S

    1998-01-01

    This article identifies linkages between the Australian health industry and the global economy. It discusses some of the consequences of the Asian currency crisis of 1997-98 for the Australian economy and health industry, with special emphasis upon exports. Devaluation of the Australian dollar will increase the cost of most pharmaceutical and medical imports, but may offer competitive advantages to some Australian exporters. The nascent engagement with Asia of many health industry enterprises is likely to be stifled. It is therefore important for Australian governments, as well as the Australian health industry, to provide intelligence and encouragement to those enterprises that wish to continue their engagement with Asia or resume it when economic equilibrium returns. Markets throughout the world must also be further developed. The crisis may therefore provide the stimulus for re-thinking and re-stating Australian health export policy.

  7. The Portrayal of Indigenous Health in Selected Australian Media

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    Melissa J. Stoneham

    2014-04-01

    Full Text Available It is acknowledged that health outcomes for Australian Indigenous peoples are lower than those of non-Indigenous Australians. Research suggests negative media in relation to Indigenous Australians perpetuates racist stereotypes among the wider population and impacts on the health of Indigenous Australians. This study examined the media portrayal of Indigenous Australian public health issues in selected media over a twelve month period and found that, overwhelmingly, the articles were negative in their portrayal of Indigenous health. A total of 74 percent of the coverage of Australian Indigenous related articles were negative, 15 percent were positive, and 11 percent were neutral. The most common negative subject descriptors related to alcohol, child abuse, petrol sniffing, violence, suicide, deaths in custody, and crime.

  8. Monitoring Coral Health to Determine Coral Bleaching Response at High Latitude Eastern Australian Reefs: An Applied Model for A Changing Climate

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    Andrew G. Carroll

    2011-09-01

    Full Text Available Limited information is available on the bleaching susceptibility of coral species that dominate high latitude reefs along the eastern seaboard of Australia. The main aims of this study were to: (i monitor coral health and spatial patterns of coral bleaching response at the Solitary Islands Marine Park (SIMP and Lord Howe Island Marine Park (LHIMP, to determine variability of bleaching susceptibility among coral taxa; (ii predict coral bleaching thresholds at 30 °S and 31.5 °S, extrapolated from published bleaching threshold data; and (iii propose a subtropical northern New South Wales coral bleaching model from biological and physical data. Between 2005 and 2007 minor bleaching was observed in dominant coral families including Pocilloporidae, Poritidae and Dendrophylliidae in the SIMP and Pocilloporidae, Poritidae and Acroporidae (Isopora and Montipora spp. in the LHIMP, with a clear difference in bleaching susceptibility found between sites, both within and between locations. Bleaching susceptibility was highest in Porites spp. at the most offshore island site within the SIMP during summer 2005. Patterns of subtropical family bleaching susceptibility within the SIMP and LHIMP differed to those previously reported for the central Great Barrier Reef (GBR. These differences may be due to a number of factors, including temperature history and/or the coral hosts association with different zooxanthellae clades, which may have lower thermal tolerances. An analysis of published estimates of coral bleaching thresholds from the Caribbean, South Africa, GBR and central and northern Pacific regions suggests that the bleaching threshold at 30–31.5 °S ranges between 26.5–26.8 °C. This predicted threshold was confirmed by an extensive coral bleaching event on the world’s southernmost coral reef at Lord Howe Island, during the 2010 austral summer season. These results imply that dominant coral taxa at subtropical reefs along the eastern Australian

  9. Intergenerational educational mobility is associated with cardiovascular disease risk behaviours in a cohort of young Australian adults: The Childhood Determinants of Adult Health (CDAH Study

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    Dwyer Terence

    2010-02-01

    Full Text Available Abstract Background Although educational disparity has been linked to single risk behaviours, it has not previously been studied as a predictor of overall lifestyle. We examined if current education, parental education or educational mobility between generations was associated with healthy lifestyles in young Australian adults. Methods In 2004-06, participant and parental education (high [bachelor degree or higher], intermediate [vocational training], low [secondary school only] were assessed. Educational mobility was defined as: stable high (participant and parent in high group, stable intermediate (participant and parent in intermediate group, stable low (participant and parent in low group, downwardly (lower group than parent and upwardly (higher group than parent mobile. We derived a lifestyle score from 10 healthy behaviours (BMI, non-smoking, alcohol consumption, leisure time physical activity and six components of diet. Scores >4 indicated a high healthy lifestyle score. We estimated the likelihood of having a high healthy lifestyle score by education (participant and parent and educational mobility. Results Complete data were available for 1973 participants (53% female, age range 26 to 36 years. Those with lower education were less likely to have healthy lifestyles. Parental education was not associated with having a high healthy lifestyle score after adjustment for participant's education. Those who moved upward or downward were as likely to have a high healthy lifestyle score as those in the group they attained. Conclusions We found clear disparities in health behaviour by participant education and intergenerational educational mobility. People attaining a higher level of education than their parents appeared protected from developing an unhealthy lifestyle suggesting that population-wide improvements in education may be important for health.

  10. Monitoring Coral Health to Determine Coral Bleaching Response at High Latitude Eastern Australian Reefs: An Applied Model for A Changing Climate

    OpenAIRE

    Andrew G. Carroll; Dalton, Steven J.

    2011-01-01

    Limited information is available on the bleaching susceptibility of coral species that dominate high latitude reefs along the eastern seaboard of Australia. The main aims of this study were to: (i) monitor coral health and spatial patterns of coral bleaching response at the Solitary Islands Marine Park (SIMP) and Lord Howe Island Marine Park (LHIMP), to determine variability of bleaching susceptibility among coral taxa; (ii) predict coral bleaching thresholds at 30 °S and 31.5 °S, extrapolate...

  11. Cerebral lateralization determines hand preferences in Australian parrots.

    Science.gov (United States)

    Brown, Culum; Magat, Maria

    2011-08-23

    Individual preference for the use of one limb over the other to explore the environment or manipulate objects is common trait among vertebrates. Here, we explore the hypothesis that limb preference is determined by the engagement of a particular cerebral hemisphere to analyse certain stimuli. We recorded the eye and foot preferences of 322 individuals from 16 species of Australian parrots while investigating potential food items. Across all species, eye preferences explained 99 per cent of the variation in foot use in Australian parrots. The vast majority of species showed significant relationships between eye and foot preferences at the population level.

  12. Factors Affecting Indigenous West Australians' Health Behavior: Indigenous Perspectives.

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    Waterworth, Pippa; Dimmock, James; Pescud, Melanie; Braham, Rebecca; Rosenberg, Michael

    2016-01-01

    The factors driving the disparity in health outcomes between Indigenous and non-Indigenous Australians include socio-economic factors, racism, and history. The current study focused on exploring Indigenous participants' perspectives of the factors that affect the health behavior of their community members. Participatory action research methodology and a grounded theory approach were utilized. In total, 120 members of two urban West Australian Indigenous communities participated in focus group discussions. There was substantial similarity between the themes that emerged within the discussions held in the two communities. Factors relating to culture, social connections, racism, communication, and personal aspects were particularly salient to health behavior of the participants. Several of the themes including culture, racism, communication, and distrust highlight the tension caused by being a member of a minority cultural group that has been marginalized by the practices and attitudes of the dominant cultural group. Personal choice was sometimes prioritized over health. PMID:25847855

  13. Cerebral lateralization determines hand preferences in Australian parrots

    OpenAIRE

    Brown, Culum; Magat, Maria

    2011-01-01

    Individual preference for the use of one limb over the other to explore the environment or manipulate objects is common trait among vertebrates. Here, we explore the hypothesis that limb preference is determined by the engagement of a particular cerebral hemisphere to analyse certain stimuli. We recorded the eye and foot preferences of 322 individuals from 16 species of Australian parrots while investigating potential food items. Across all species, eye preferences explained 99 per cent of th...

  14. A review of linked health data in Australian nephrology.

    Science.gov (United States)

    Kotwal, Sradha; Webster, Angela C; Cass, Alan; Gallagher, Martin

    2016-06-01

    Linked health data bring together data about one person from varying sources such as administrative health datasets, death registries and clinical registries using a process that maintains patient privacy. Linked health data have been used for burden of disease estimates and health-care planning and is being increasingly use as a research methodology to study health service utilisation and patient outcomes. Within Australian nephrology, there has been limited understanding and use of linked health data so far, but we expect that with the increasing availability of data and the growing complexity of health care, the use of such data will expand. This is especially pertinent for the growing elderly population with advanced kidney disease, who are poorly represented in other types of research studies. This article summarizes the history of linked health data in Australia, the nature of available datasets in Australia, the methods of access to these data, privacy and ethical issues, along with strengths, limitations and implications for the future.

  15. Associations between Indigenous Australian oral health literacy and self-reported oral health outcomes

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    Jamieson Lisa M

    2010-03-01

    Full Text Available Abstract Objectives To determine oral health literacy (REALD-30 and oral health literacy-related outcome associations, and to calculate if oral health literacy-related outcomes are risk indicators for poor self-reported oral health among rural-dwelling Indigenous Australians. Methods 468 participants (aged 17-72 years, 63% female completed a self-report questionnaire. REALD-30 and oral health literacy-related outcome associations were determined through bivariate analysis. Multivariate modelling was used to calculate risk indicators for poor self-reported oral health. Results REALD-30 scores were lower among those who believed teeth should be infrequently brushed, believed cordial was good for teeth, did not own a toothbrush or owned a toothbrush but brushed irregularly. Tooth removal risk indicators included being older, problem-based dental attendance and believing cordial was good for teeth. Poor self-rated oral health risk indicators included being older, healthcare card ownership, difficulty paying dental bills, problem-based dental attendance, believing teeth should be brushed infrequently and irregular brushing. Perceived need for dental care risk indicators included being female and problem-based dental attendance. Perceived gum disease risk indicators included being older and irregular brushing. Feeling uncomfortable about oro-facial appearance risk indicators included problem-based dental attendance and irregular brushing. Food avoidance risk indicators were being female, difficulty paying dental bills, problem-based dental attendance and irregular brushing. Poor oral health-related quality of life risk indicators included difficulty paying dental bills and problem-based dental attendance. Conclusions REALD-30 was significantly associated with oral health literacy-related outcomes. Oral health literacy-related outcomes were risk indicators for each of the poor self-reported oral health domains among this marginalised population.

  16. Sugar sweetened beverage consumption by Australian children: Implications for public health strategy

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    Hafekost Katherine

    2011-12-01

    Full Text Available Abstract Background High consumption of sugar sweetened beverages (SSBs has been linked to unhealthy weight gain and nutrition related chronic disease. Intake of SSB among children remains high in spite of public health efforts to reduce consumption, including restrictions on marketing to children and limitations on the sale of these products in many schools. Much extant literature on Australian SSB consumption is out-dated and lacks information on several key issues. We sought to address this using a contemporary Australian dataset to examine purchase source, consumption pattern, dietary factors, and demographic profile of SSB consumption in children. Methods Data were from the 2007 Australian National Children's Nutrition and Physical Activity Survey, a representative random sample of 4,834 Australian children aged 2-16 years. Mean SSB intake by type, location and source was calculated and logistic regression models were fitted to determine factors associated with different levels of consumption. Results SSB consumption was high and age-associated differences in patterns of consumption were evident. Over 77% of SSB consumed was purchased via supermarkets and 60% of all SSB was consumed in the home environment. Less than 17% of SSB was sourced from school canteens and fast food establishments. Children whose parents had lower levels of education consumed more SSB on average, while children whose parents had higher education levels were more likely to favour sweetened juices and flavoured milks. Conclusions SSB intake by Australian children remains high and warrants continued public health attention. Evidence based and age-targeted interventions, which also recognise supermarkets as the primary source of SSB, are recommended to reduce SSB consumption among children. Additionally, education of parents and children regarding the health consequences of high consumption of both carbonated and non-carbonated SSBs is required.

  17. Exploring Australian health promotion and environmental sustainability initiatives.

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    Patrick, Rebecca; Kingsley, Jonathan

    2016-04-01

    Issue addressed Health promotion practitioners have important roles in applying ecosystem approaches to health and actively promoting environmental sustainability within community-level practice. The present study identified the nature and scope of health promotion activities across Australia that tackle environmental sustainability. Methods A mixed-method approach was used, with 82 participants undertaking a quantitative survey and 11 undertaking a qualitative interview. Purposeful sampling strategies were used to recruit practitioners who were delivering community-level health promotion and sustainability programs in Australia. The data were analysed thematically and interpretation was guided by the principles of triangulation. Results Study participants were at various stages of linking health promotion and environmental sustainability. Initiatives focused on healthy and sustainable food, active transport, energy efficiency, contact with nature and capacity building. Conclusion Capacity building approaches were perceived as essential to strengthening this field of practice. Healthy and sustainable food and active transport were suitable platforms for simultaneously promoting community health and sustainability. There was potential for expansion of programs that emphasise contact with nature and energy issues, as well as interventions that emphasise systems thinking and interdisciplinary approaches. So what? It was promising that Australian health promotion programs have started to address complexity rather than single issues, as evidenced by explicit engagement with environmental sustainability. However, more effort is required to enable a shift towards ecosystem approaches to health. PMID:26650394

  18. Exploring Australian health promotion and environmental sustainability initiatives.

    Science.gov (United States)

    Patrick, Rebecca; Kingsley, Jonathan

    2016-04-01

    Issue addressed Health promotion practitioners have important roles in applying ecosystem approaches to health and actively promoting environmental sustainability within community-level practice. The present study identified the nature and scope of health promotion activities across Australia that tackle environmental sustainability. Methods A mixed-method approach was used, with 82 participants undertaking a quantitative survey and 11 undertaking a qualitative interview. Purposeful sampling strategies were used to recruit practitioners who were delivering community-level health promotion and sustainability programs in Australia. The data were analysed thematically and interpretation was guided by the principles of triangulation. Results Study participants were at various stages of linking health promotion and environmental sustainability. Initiatives focused on healthy and sustainable food, active transport, energy efficiency, contact with nature and capacity building. Conclusion Capacity building approaches were perceived as essential to strengthening this field of practice. Healthy and sustainable food and active transport were suitable platforms for simultaneously promoting community health and sustainability. There was potential for expansion of programs that emphasise contact with nature and energy issues, as well as interventions that emphasise systems thinking and interdisciplinary approaches. So what? It was promising that Australian health promotion programs have started to address complexity rather than single issues, as evidenced by explicit engagement with environmental sustainability. However, more effort is required to enable a shift towards ecosystem approaches to health.

  19. The Role of Health Co-Benefits in the Development of Australian Climate Change Mitigation Policies

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    Workman, Annabelle; Blashki, Grant; Karoly, David; Wiseman, John

    2016-01-01

    Reducing domestic carbon dioxide and other associated emissions can lead to short-term, localized health benefits. Quantifying and incorporating these health co-benefits into the development of national climate change mitigation policies may facilitate the adoption of stronger policies. There is, however, a dearth of research exploring the role of health co-benefits on the development of such policies. To address this knowledge gap, research was conducted in Australia involving the analysis of several data sources, including interviews carried out with Australian federal government employees directly involved in the development of mitigation policies. The resulting case study determined that, in Australia, health co-benefits play a minimal role in the development of climate change mitigation policies. Several factors influence the extent to which health co-benefits inform the development of mitigation policies. Understanding these factors may help to increase the political utility of future health co-benefits studies. PMID:27657098

  20. Overview of the CSIRO Australian Animal Health Laboratory.

    Science.gov (United States)

    Lowenthal, John

    2016-01-01

    Emerging infectious diseases arising from livestock and wildlife pose serious threats to global human health, as shown by a series of continuous outbreaks involving highly pathogenic influenza, SARS, Ebola and MERS. The risk of pandemics and bioterrorism threats is ever present and growing, but our ability to combat them is limited by the lack of available vaccines, therapeutics and rapid diagnostics. The use of high bio-containment facilities, such as the CSIRO Australian Animal Health Laboratory, plays a key role studying these dangerous pathogens and facilitates the development of countermeasures. To combat diseases like MERS, we must take a holistic approach that involves the development of early biomarkers of infection, a suite of treatment options (vaccines, anti-viral drugs and antibody therapeutics) and appropriate animal models to test the safety and efficacy of candidate treatments. PMID:27118215

  1. CAM practitioners in the Australian health workforce: an underutilized resource

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    Grace Sandra

    2012-11-01

    Full Text Available Abstract Background CAM practitioners are a valuable but underutilizes resource in Australian health care. Despite increasing public support for complementary and alternative medicine (CAM little is known about the CAM workforce. Apart from the registered professions of chiropractic, osteopathy and Chinese medicine, accurate information about the number of CAM practitioners in the workforce has been difficult to obtain. It appears that many non-registered CAM practitioners, although highly qualified, are not working to their full capacity. Discussion Increasing public endorsement of CAM stands in contrast to the negative attitude toward the CAM workforce by some members of the medical and other health professions and by government policy makers. The marginalisation of the CAM workforce is evident in prejudicial attitudes held by some members of the medical and other health professions and its exclusion from government policy making. Inconsistent educational standards has meant that non-registered CAM practitioners, including highly qualified and competent ones, are frequently overlooked. Legitimising their contribution to the health workforce could alleviate workforce shortages and provide opportunities for redesigned job roles and new multidisciplinary teams. Priorities for better utilisation of the CAM workforce include establishing a guaranteed minimum education standard for more CAM occupation groups through national registration, providing interprofessional education that includes CAM practitioners, developing courses to upgrade CAM practitioners' professional skills in areas of indentified need, and increasing support for CAM research. Summary Marginalisation of the CAM workforce has disadvantaged those qualified and competent CAM practitioners who practise evidence-informed medicine on the basis of many years of university training. Legitimising and expanding the important contribution of CAM practitioners could alleviate projected health

  2. Culture, history, and health in an Australian aboriginal community: the case of utopia.

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    Anderson, Heather; Kowal, Emma

    2012-01-01

    The poor health of Indigenous Australians is well established. However, the health of residents of one remote community in the Northern Territory of Australia called Utopia has been found recently to be much better than expected. In this article, we draw on historical anthropological research to explain this finding. We trace how cultural and social structures were maintained through changing eras of government policy from the 1930s, and show how these structures strengthened psychosocial determinants of health. We argue that the mainstream psychosocial determinants of social cohesion and self-efficacy are usefully reconceptualized in an Indigenous context as connectedness to culture and land, and collective efficacy, respectively. Continuity of cultural and social structures into the 1940s was facilitated by a combination of factors including the relatively late colonial occupation, the intercultural practices typical of the pastoral industry, the absence of a mission or government settlement, and the individual personalities and histories of those connected to Utopia. PMID:22881383

  3. Oral health and social and emotional well-being in a birth cohort of Aboriginal Australian young adults

    OpenAIRE

    Cairney Sheree J; Gunthorpe Wendy; Paradies Yin C; Jamieson Lisa M; Sayers Susan M

    2011-01-01

    Abstract Background Social and emotional well-being is an important component of overall health. In the Indigenous Australian context, risk indicators of poor social and emotional well-being include social determinants such as poor education, employment, income and housing as well as substance use, racial discrimination and cultural knowledge. This study sought to investigate associations between oral health-related factors and social and emotional well-being in a birth cohort of young Aborig...

  4. The new Australian Primary Health Networks: how will they integrate public health and primary care?

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    Booth, Mark; Hill, Graham; Moore, Michael J; Dalla, Danielle; Moore, Michael G; Messenger, Anne

    2016-01-01

    On 1 July 2015, the Australian Government established 31 new Primary Health Networks (PHNs), following a review by its former Chief Medical Officer, John Horvath, of 61 Medicare Locals created under the previous Labor administration. The Horvath review recommended, among other things, that new, larger primary health organisations be established to reduce fragmentation of care by integrating and coordinating health services, supporting the role of general practice, and leveraging and administering health program funding. The two main objectives of the new PHNs, as stated on the Department of Health's website, are "increasing the efficiency and effectiveness of medical services for patients, particularly those at risk of poor health outcomes, and improving coordination of care to ensure patients receive the right care in the right place at the right time". Below are three viewpoints, commissioned for this primary health care themed issue of Public Health Research & Practice, from the Australian Government Department of Health, the Public Health Association of Australia and a Sydney-based PHN. We asked the authors to focus particularly on how the newly established networks might help to integrate public health within the primary health care landscape. Our authors have pointed out the huge overlap between public health and primary care and looked at evidence showing the great benefits for health systems of collaboration between the two. Challenges ahead include a possible government focus on delivery of 'frontline' medical services, which may come at the expense of population health, and the complexity of dealing with all primary health care stakeholders, including health professionals, Local Health Districts, nongovernment organisations, research institutions and local communities. PMID:26863166

  5. Improving Health Promotion Using Quality Improvement Techniques in Australian Indigenous Primary Health Care.

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    Percival, Nikki; O'Donoghue, Lynette; Lin, Vivian; Tsey, Komla; Bailie, Ross Stewart

    2016-01-01

    Although some areas of clinical health care are becoming adept at implementing continuous quality improvement (CQI) projects, there has been limited experimentation of CQI in health promotion. In this study, we examined the impact of a CQI intervention on health promotion in four Australian Indigenous primary health care centers. Our study objectives were to (a) describe the scope and quality of health promotion activities, (b) describe the status of health center system support for health promotion activities, and (c) introduce a CQI intervention and examine the impact on health promotion activities and health centers systems over 2 years. Baseline assessments showed suboptimal health center systems support for health promotion and significant evidence-practice gaps. After two annual CQI cycles, there were improvements in staff understanding of health promotion and systems for planning and documenting health promotion activities had been introduced. Actions to improve best practice health promotion, such as community engagement and intersectoral partnerships, were inhibited by the way health center systems were organized, predominately to support clinical and curative services. These findings suggest that CQI can improve the delivery of evidence-based health promotion by engaging front line health practitioners in decision-making processes about the design/redesign of health center systems to support the delivery of best practice health promotion. However, further and sustained improvements in health promotion will require broader engagement of management, senior staff, and members of the local community to address organizational and policy level barriers. PMID:27066470

  6. Structural impediments to TQM in Australian health care.

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    Degeling, P; Carnegie, M

    1995-01-01

    The culture of quality called for by total quality management (TQM) has much to recommend it. Australian experience, however, suggests that it is not something that can easily be added to the profession-based structures and cultures prevailing in most Australian hospitals. Implementing TQM is not just a matter of advocating it. The institutional transformation implied by TQM requires additional action on multiple fronts, both internal and external to the hospital.

  7. Enacting Critical Health Literacy in the Australian Secondary School Curriculum: The Possibilities Posed by e-Health

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    McCuaig, Louise; Carroll, Kristie; Macdonald, Doune

    2014-01-01

    The teaching of health literacy in school-based health education (SBHE) is of international interest, yet there is less ready access to how conceptions of health literacy can be operationalised in school programmes. More specifically, while articulated in curriculum documents such as the incoming Australian Curriculum: Health and Physical…

  8. A health policy for hearing impairment in older Australians: what should it include?

    OpenAIRE

    Smith, Jennifer L.; Mitchell, Paul; Wang, Jie Jin; Leeder, Stephen R

    2005-01-01

    Background As in all western countries, Australia's older population experiences high levels of hearing impairment coupled with relatively low levels of hearing device usage. Poor hearing diminishes the quality of life of affected individuals and their families. This paper discusses how to improve Australian hearing health policies in order to better combat this impairment amongst older Australians. Method We searched the databases Medline, Meditext and Web of Science to find articles that di...

  9. Dietary glycaemic index and glycaemic load among Australian children and adolescents: results from the 2011-2012 Australian Health Survey.

    Science.gov (United States)

    Jones, Molly; Barclay, Alan W; Brand-Miller, Jennie C; Louie, Jimmy Chun Yu

    2016-07-01

    This study aimed to examine the dietary glycaemic index (GI) and glycaemic load (GL) of Australian children and adolescents, as well as the major food groups contributing to GL, in the recent 2011-2012 Australian Health Survey. Plausible food intake data from 1876 children and adolescents (51 % boys), collected using a multiple-pass 24-h recall, were analysed. The GI of foods was assigned based on a step-wise published method using values from common GI databases. Descriptive statistics were calculated for dietary GI, GL and contribution to GL by food groups, stratified by age group and sex. Linear regression was used to test for trends across age groups for BMI, dietary GI and GL, and intakes of energy, nutrients and food groups. Pearson's χ 2 test was used to test for differences between age groups for categorical subject characteristic variables. Mean dietary GI and GL of participants were 55·5 (sd 5·3) and 137·4 (sd 50·8), respectively. The main contributors to dietary GL were starchy foods: breads, cereal-based dishes, breakfast cereals, flours, grains and potatoes accounted for 41 % of total GL. Sweetened beverages, fruit and vegetable juices/drinks, cake-type desserts and sweet biscuits contributed 15 %. No significant difference (at P<0·001) was observed between sexes. In conclusion, Australian children and adolescents appear to consume diets with a lower GI than European children. Exchanging high-GI foods for low-GI alternatives within core and non-core foods may improve diet quality of Australian children and adolescents. PMID:27171604

  10. Incorporating health literacy in education for socially disadvantaged adults: an Australian feasibility study

    OpenAIRE

    Muscat, Danielle M.; Smith, Sian; Dhillon, Haryana M; Morony, Suzanne; Davis, Esther L.; Luxford, Karen; Shepherd, Heather L; Hayen, Andrew; Comings, John; Nutbeam, Don; McCaffery, Kirsten

    2016-01-01

    Background Adult education institutions have been identified as potential settings to improve health literacy and address the health inequalities that stem from limited health literacy. However, few health literacy interventions have been tested in this setting. Methods Feasibility study for an RCT of the UK Skilled for Health Program adapted for implementation in Australian adult education settings. Implementation at two sites with mixed methods evaluation to examine feasibility, test for ch...

  11. Health Literacy and the Australian Curriculum for Health and Physical Education: A Marriage of Convenience or a Process of Empowerment?

    Science.gov (United States)

    Alfrey, Laura; Brown, Trent D.

    2013-01-01

    The concept of "health literacy" is becoming increasingly prominent internationally, and it has been identified as one of the five key propositions that underpin the forthcoming Australian Curriculum: Health and Physical Education (ACHPE). The ACHPE is one of few national curricula to explicitly refer to health literacy, identifying it…

  12. Australian Curriculum Reform II: Health and Physical Education

    Science.gov (United States)

    Lynch, Timothy

    2014-01-01

    It is implied by governing organizations that Australia is presently experiencing its first national curriculum reform, when as the title suggests it is the second. However, until now Australian states and territories have been responsible for the education curriculum delivered within schools. The present national curriculum reform promises one…

  13. The Australian Defence Force Mental Health Prevalence and Wellbeing Study: design and methods.

    NARCIS (Netherlands)

    Hooff, M.V.; McFarlane, A.C.; Davies, C.E.; Searle, A.K.; Fairweather-Schmidt, A.K.; Verhagen, A.F.; Benassi, H.; Hodson, S.E.

    2014-01-01

    BACKGROUND: The Australian Defence Force (ADF) Mental Health Prevalence and Wellbeing Study (MHPWS) is the first study of mental disorder prevalence in an entire military population. OBJECTIVE: The MHPWS aims to establish mental disorder prevalence, refine current ADF mental health screening methods

  14. Access to eye health services among indigenous Australians: an area level analysis

    OpenAIRE

    Kelaher Margaret; Ferdinand Angeline; Taylor Hugh

    2012-01-01

    Abstract Background This project is a community-level study of equity of access to eye health services for Indigenous Australians. Methods The project used data on eye health services from multiple sources including Medicare Australia, inpatient and outpatient data and the National Indigenous Eye Health Survey. The analysis focused on the extent to which access to eye health services varied at an area level according to the proportion of the population that was Indigenous (very low = 0-1.0%, ...

  15. Determinants and gaps in preventive care for Indigenous Australians: a cross sectional analysis

    Directory of Open Access Journals (Sweden)

    Ross Stewart Bailie

    2016-03-01

    Full Text Available BackgroundPotentially preventable chronic diseases are the greatest contributor to the health gap between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians. Preventive care is important for earlier detection and control of chronic disease, and a number of recent policy initiatives have aimed to enhance delivery of preventive care. We examined documented delivery of recommended preventive services for Indigenous peoples across Australia, and investigated the influence of health center and client level factors on adherence to best practice guidelines. MethodsClinical audit data from 2012-2014 for 3623 well adult clients (aged 15-54 of 101 health centers from four Australian states and territories were analyzed to determine adherence to delivery of 26 recommended preventive services classified into five different modes of care on the basis of the way in which they are delivered (eg. basic measurement; laboratory tests and imaging; assessment and brief interventions, eye, ear and oral checks; follow-up of abnormal findings. Summary statistics were used to describe the delivery of each service item across jurisdictions. Multilevel regression models were used to quantify the variation in service delivery attributable to health center and client level factors and to identify factors associated with higher quality care.ResultsDelivery of recommended preventive care varied widely between service items, with good delivery of most basic measurements but poor follow-up of abnormal findings. Health center characteristics were associated with most variation. Higher quality care was associated with Northern Territory location, urban services and smaller service population size. Client factors associated with higher quality care included age between 25-34 years, female sex and more regular attendance. ConclusionsWide variation in documented preventive care delivery, poor follow-up of abnormal findings, and system factors that

  16. Differences between Irish and Australian psychiatric nurses' family-focused practice in adult mental health services

    LENUS (Irish Health Repository)

    Grant, Anne

    2016-04-01

    Psychiatric nurses\\' practice with parents who have mental illness, their children and families is an important issue internationally. This study provides a comparison of Irish and Australian psychiatric nurses\\' family-focused practices in adult mental health services. Three hundred and forty three nurses across Ireland and 155 from Australia completed the Family Focused Mental Health Practice Questionnaire. Cross-country comparisons revealed significant differences, in terms of family-focused skill, knowledge, confidence and practice. Australian psychiatric nurses engaged in higher family-focused practice compared to Irish nurses. The comparative differences between countries may be attributable to differences in training, workplace support and policy.

  17. Trajectories of Mental Health over 16 Years amongst Young Adult Women: The Australian Longitudinal Study on Women's Health

    Science.gov (United States)

    Holden, Libby; Ware, Robert S.; Lee, Christina

    2016-01-01

    This article used data from 5,171 young women participating in the Australian Longitudinal Study on Women's Health, a nationally representative longitudinal cohort study, to identify longitudinal trajectory patterns of mental health across 6 surveys over 16 years of early adulthood, from age 18-23 to age 34-39. In addition, we identified both…

  18. The Australian Defence Force Mental Health Prevalence and Wellbeing Study: design and methods

    OpenAIRE

    Van Hooff, Miranda; McFarlane, Alexander C; Christopher E. Davies; Searle, Amelia K.; Fairweather-Schmidt, A Kate; Verhagen, Alan; Benassi, Helen; Stephanie E Hodson

    2014-01-01

    Background: The Australian Defence Force (ADF) Mental Health Prevalence and Wellbeing Study (MHPWS) is the first study of mental disorder prevalence in an entire military population.Objective: The MHPWS aims to establish mental disorder prevalence, refine current ADF mental health screening methods, and identify specific occupational factors that influence mental health. This paper describes the design, sampling strategies, and methodology used in this study.Method: At Phase 1, approximately ...

  19. Improving healthcare for Aboriginal Australians through effective engagement between community and health services

    OpenAIRE

    Durey, Angela; McEvoy, Suzanne; Swift-Otero, Val; Taylor, Kate; Katzenellenbogen, Judith; Bessarab, Dawn

    2016-01-01

    Background Effectively addressing health disparities between Aboriginal and non-Aboriginal Australians is long overdue. Health services engaging Aboriginal communities in designing and delivering healthcare is one way to tackle the issue. This paper presents findings from evaluating a unique strategy of community engagement between local Aboriginal people and health providers across five districts in Perth, Western Australia. Local Aboriginal community members formed District Aboriginal Healt...

  20. A brief review of indigenous Australian health as it impacts on oral health.

    Science.gov (United States)

    Martin-Iverson, N; Phatouros, A; Tennant, M

    1999-06-01

    The indigenous population of Australia constitutes approximately 2 per cent of the total population. This group has faced significant cultural, economic and health changes since European settlement some 200 years ago. In this brief review some of the health changes that have influenced the oral health status of this community have been examined. Of major importance is the dietary change that the once nomadic indigenous community has undergone. Today's Western diet, high in sugar, low in proteins and vitamins, has resulted in a significant increase in the risk (and prevalence) of caries and periodontal disease. In addition, the high prevalence of diabetes also exacerbates the periodontal problem. The remoteness of a significant proportion of Australian indigenous communities from modern health care services and limited access to fluoridation increases the incidence of oral disease. It is also noted that the incidence of rheumatic heart disease is one of the highest in the world, thereby increasing the risk of bacterial endocarditis. It is clear that indigenous communities have unique oral health needs but the extent of these needs is not well documented. It is important that more research be undertaken to assess these needs so that appropriate oral health programmes can be developed. PMID:10452162

  1. ACHESS – The Australian study of child health in same-sex families: background research, design and methodology

    Directory of Open Access Journals (Sweden)

    Crouch Simon

    2012-08-01

    Full Text Available Abstract Background There are an increasing number of children in Australia growing up with same-sex attracted parents. Although children from same-sex parent families do in general perform well on many psychosocial measures recent research is beginning to consider some small but significant differences when these children are compared with children from other family backgrounds. In particular studies suggest that there is an association between the stigma that same-sex parent families experience and child wellbeing. Research to date lacks a holistic view with the complete physical, mental and social wellbeing of children not yet addressed. In addition, most studies have focused only on families with lesbian parents and have studied only small numbers of children. Methods/design The Australian Study of Child Health in Same-Sex Families (ACHESS is a national study that aims to determine the complete physical, mental and social wellbeing of Australian children under the age 18 years with at least one parent who self identifies as being same-sex attracted. There will be a particular focus on the impact that stigma and discrimination has on these families. Parent and child surveys will be used to collect data and will be available both online and in paper form. Measures have been chosen whenever possible that have sound conceptual underpinnings, robust psychometric properties and Australian normative data, and include the Child Health Questionnaire (CHQ, the Strengths and Difficulties Questionnaire (SDQ and the Kessler Psychological Distress Scale (K10. Discussion ACHESS aims to be the largest study of its kind and will for the first time produce a detailed quantitative analysis of Australian children with same-sex attracted parents. By inviting participants to take part in further research it will also establish a valuable cohort of children, and their families, to launch future waves of research that will help us better understand the health and

  2. Study protocol: Evaluating the impact of a rural Australian primary health care service on rural health

    Directory of Open Access Journals (Sweden)

    Buykx Penny

    2011-03-01

    Full Text Available Abstract Background Rural communities throughout Australia are experiencing demographic ageing, increasing burden of chronic diseases, and de-population. Many are struggling to maintain viable health care services due to lack of infrastructure and workforce shortages. Hence, they face significant health disadvantages compared with urban regions. Primary health care yields the best health outcomes in situations characterised by limited resources. However, few rigorous longitudinal evaluations have been conducted to systematise them; assess their transferability; or assess sustainability amidst dynamic health policy environments. This paper describes the study protocol of a comprehensive longitudinal evaluation of a successful primary health care service in a small rural Australian community to assess its performance, sustainability, and responsiveness to changing community needs and health system requirements. Methods/Design The evaluation framework aims to examine the health service over a six-year period in terms of: (a Structural domains (health service performance; sustainability; and quality of care; (b Process domains (health service utilisation and satisfaction; and (c Outcome domains (health behaviours, health outcomes and community viability. Significant international research guided the development of unambiguous reliable indicators for each domain that can be routinely and unobtrusively collected. Data are to be collected and analysed for trends from a range of sources: audits, community surveys, interviews and focus group discussions. Discussion This iterative evaluation framework and methodology aims to ensure the ongoing monitoring of service activity and health outcomes that allows researchers, providers and administrators to assess the extent to which health service objectives are met; the factors that helped or hindered achievements; what worked or did not work well and why; what aspects of the service could be improved and how

  3. Use of Equipment and Respite Services and Caregiver Health among Australian Families Living with Rett Syndrome

    Science.gov (United States)

    Urbanowicz, Anna; Downs, Jenny; Bebbington, Ami; Jacoby, Peter; Girdler, Sonya; Leonard, Helen

    2011-01-01

    This study assessed factors that could influence equipment and respite services use among Australian families caring for a girl/woman with Rett syndrome and examined relationships between use of these resources and the health of female caregivers. Data was sourced from questionnaires completed by families (n=170) contributing to the Australian…

  4. Life Transitions and Mental Health in a National Cohort of Young Australian Women

    Science.gov (United States)

    Lee, Christiana; Gramotnev, Helen

    2007-01-01

    Young adulthood, a time of major life transitions and risk of poor mental health, may affect emotional well-being throughout adult life. This article uses longitudinal survey data to examine young Australian women's transitions across 4 domains: residential independence, relationships, work and study, and motherhood. Changes over 3 years in…

  5. Some Determinants of Classroom Psychosocial Environment in Australian Catholic High Schools: A Multilevel Analysis

    Science.gov (United States)

    Dorman, Jeffrey P.

    2009-01-01

    This research investigated some determinants of classroom environment in Australian Catholic high schools. The Catholic School Classroom Environment Questionnaire (CSCEQ) was used to assess 7 dimensions of the classroom psychosocial environment: student affiliation, interactions, cooperation, task orientation, order and organization,…

  6. Health-related productivity losses increase when the health condition is co-morbid with psychological distress: findings from a large cross-sectional sample of working Australians

    Directory of Open Access Journals (Sweden)

    Vecchio Nerina

    2011-05-01

    Full Text Available Abstract Background The health condition of workers is known to impact on productivity outcomes. The relationship between health and productivity is of increasing interest amid the need to increase productivity to meet global financial challenges. Prevalence of psychological distress is also of growing concern in Australia with a two-fold increase in the prevalence of psychological distress in Australia from 1997-2005. Methods We used the cross-sectional data set from the Australian Work Outcomes Research Cost-benefit (WORC study to explore the impacts of health conditions with and without co-morbid psychological distress, compared to those with neither condition, in a sample of approximately 78,000 working Australians. The World Health Organisation Health and Performance Questionnaire was used which provided data on demographic characteristics, health condition and working conditions. Data were analysed using negative binomial logistic regression and multinomial logistic regression models for absenteeism and presenteeism respectively. Results For both absenteeism and presenteeism productivity measures there was a greater risk of productivity loss associated when health conditions were co-morbid with psychological distress. For some conditions this risk was much greater for those with co-morbid psychological distress compared to those without. Conclusions Co-morbid psychological distress demonstrates an increased risk of productivity loss for a range of health conditions. These findings highlight the need for further research to determine whether co-morbid psychological distress potentially exacerbates lost productivity.

  7. Strategies for piloting a breast health promotion program in the Chinese-Australian population.

    Science.gov (United States)

    Koo, Fung Kuen; Kwok, Cannas; White, Kate; D'Abrew, Natalie; Roydhouse, Jessica K

    2012-01-01

    In Australia, women from non-English-speaking backgrounds participate less frequently in breast cancer screening than English-speaking women, and Chinese immigrant women are 50% less likely to participate in breast examinations than Australian-born women. Chinese-born Australians comprise 10% of the overseas-born Australian population, and the immigrant Chinese population in Australia is rapidly increasing. We report on the strategies used in a pilot breast health promotion program, Living with Healthy Breasts, aimed at Cantonese-speaking adult immigrant women in Sydney, Australia. The program consisted of a 1-day education session and a 2-hour follow-up session. We used 5 types of strategies commonly used for cultural targeting (peripheral, evidential, sociocultural, linguistic, and constituent-involving) in a framework of traditional Chinese philosophies (Confucianism, Taoism, and Buddhism) to deliver breast health messages to Chinese-Australian immigrant women. Creating the program's content and materials required careful consideration of color (pink to indicate femininity and love), symbols (peach blossoms to imply longevity), word choice (avoidance of the word death), location and timing (held in a Chinese restaurant a few months after the Chinese New Year), communication patterns (the use of metaphors and cartoons for discussing health-related matters), and concern for modesty (emphasizing that all presenters and team members were female) to maximize cultural relevance. Using these strategies may be beneficial for designing and implementing breast cancer prevention programs in Cantonese-speaking Chinese immigrant communities. PMID:22172170

  8. Australian health policy on access to medical care for refugees and asylum seekers

    OpenAIRE

    Correa-Velez, Ignacio; Gifford, Sandra M; Bice, Sara J

    2005-01-01

    Since the tightening of Australian policy for protection visa applicants began in the 1990s, access to health care has been increasingly restricted to asylum seekers on a range of different visa types. This paper summarises those legislative changes and discusses their implications for health policy relating to refugees and asylum seekers in Australia. Of particular concern are asylum seekers on Bridging Visas with no work rights and no access to Medicare. The paper examines several key quest...

  9. Health, lifestyle and gender influences on aging well: An Australian longitudinal analysis to guide health promotion

    Directory of Open Access Journals (Sweden)

    Hal eKendig

    2014-07-01

    Full Text Available A primary societal goal for aging is enabling older people to continue to live well as long as possible. The evidence base around aging well (‘healthy’, ‘active’ and ‘successful’ aging has been constructed mainly from academic and professional conceptualizations of mortality, morbidity, functioning, and psychological well-being with some attention to lay views. Our study aims to inform action on health promotion to achieve aging well as conceptualized by qualitative research identifying what older Australians themselves value most: continuing to live as long as possible in the community with independence in daily living, and good self-rated health and psychological well-being. Multivariate survival analyses from the Melbourne Longitudinal Studies on Healthy Ageing (MELSHA program found that important threats to aging well for the total sample over a 12 year period were chronological age, multi-morbidity, low perceived social support, low nutritional score, and being underweight. For men, threats to aging well were low strain, perceived inadequacy of social activity, and being a current smoker. For women, urinary incontinence, low physical activity and being underweight were threats to aging well. The findings indicate that healthy lifestyles can assist aging well, and suggest the value of taking gender into account in health promotion strategies.

  10. Promoting Self-Determination for Better Health and Wellbeing for Adolescents Who Have an Intellectual Disability

    Science.gov (United States)

    Carrington, Suzanne; Lennox, Nicholas; O'Callaghan, Michael; McPherson, Lyn; Selva, Gitta

    2014-01-01

    The focus of this paper is on an Australian research project that evaluated the effectiveness of a resource called the "Ask Health Diary," which is used in the school curriculum to promote self-determination for better health and wellbeing for adolescents who have an intellectual disability. Education and health researchers used…

  11. The Australian experiment: how primary health care organizations supported the evolution of a primary health care system.

    Science.gov (United States)

    Nicholson, Caroline; Jackson, Claire L; Marley, John E; Wells, Robert

    2012-03-01

    Primary health care in Australia has undergone 2 decades of change. Starting with a vision for a national health strategy with general practice at its core, Australia established local meso-level primary health care organizations--Divisions of General Practice--moving from focus on individual practitioners to a professional collective local voice. The article identifies how these meso-level organizations have helped the Australian primary health care system evolve by supporting the roll-out of initiatives including national practice accreditation, a focus on quality improvement, expansion of multidisciplinary teams into general practice, regional integration, information technology adoption, and improved access to care. Nevertheless, there are still challenges to ensuring equitable access and the supply and distribution of a primary care workforce, addressing the increasing rates of chronic disease and obesity, and overcoming the fragmentation of funding and accountability in the Australian system. PMID:22403246

  12. Learning Wellness: How Ageing Australians Experience Health Information Literacy

    Science.gov (United States)

    Yates, Christine; Partridge, Helen; Bruce, Christine

    2009-01-01

    Given identified synergies between information use and health status greater understanding is needed about how people use information to learn about their health. This paper presents the findings of preliminary research into health information literacy. Analysis of data from semi-structured interviews revealed six different ways ageing Australians…

  13. Molecular marker suggests rapid changes of sex-determining mechanisms in Australian dragon lizards.

    Science.gov (United States)

    Ezaz, Tariq; Quinn, Alexander E; Sarre, Stephen D; O'Meally, Denis; Georges, Arthur; Graves, Jennifer A Marshall

    2009-01-01

    Distribution of sex-determining mechanisms across Australian agamids shows no clear phylogenetic segregation, suggesting multiple transitions between temperature-dependent (TSD) and genotypic sex determination (GSD). These taxa thus present an excellent opportunity for studying the evolution of sex chromosomes, and evolutionary transitions between TSD and GSD. Here we report the hybridization of a 3 kb genomic sequence (PvZW3) that marks the Z and W microchromosomes of the Australian central bearded dragon (Pogona vitticeps) to chromosomes of 12 species of Australian agamids from eight genera using fluorescence in-situ hybridization (FISH). The probe hybridized to a single microchromosome pair in 11 of these species, but to the tip of the long arm of chromosome pair 2 in the twelfth (Physignathus lesueurii), indicating a micro-macro chromosome rearrangement. Three TSD species shared the marked microchromosome, implying that it is a conserved autosome in related species that determine sex by temperature. C-banding identified the marked microchromosome as the heterochromatic W chromosome in two of the three GSD species. However, in Ctenophorus fordi, the probe hybridized to a different microchromosome from that shown by C-banding to be the heterochromatic W, suggesting an independent origin for the ZW chromosome pair in that species. Given the haphazard distribution of GSD and TSD in this group and the existence of at least two sets of sex microchromosomes in GSD species, we conclude that sex-determining mechanisms in this family have evolved independently, multiple times in a short evolutionary period. PMID:19172405

  14. Ethics and health promotion practice: exploring attitudes and practices in Western Australian health organisations.

    Science.gov (United States)

    Reilly, T; Crawford, G; Lobo, R; Leavy, J; Jancey, J

    2016-04-01

    Issue addressed Evidence-informed practice underpinned by ethics is fundamental to developing the science of health promotion. Knowledge and application of ethical principles are competencies required for health promotion practice. However, these competencies are often inconsistently understood and applied. This research explored attitudes, practices, enablers and barriers related to ethics in practice in Western Australian health organisations. Methods Semistructured, in-depth interviews were conducted with 10 health promotion practitioners, purposefully selected to provide a cross-section of government and non-government organisations. Interviews were recorded, transcribed and then themed. Results The majority of participants reported consideration of ethics in their practice; however, only half reported seeking Human Research Ethics Committee (HREC) approval for projects in the past 12 months. Enablers identified as supporting ethics in practice and disseminating findings included: support preparing ethics applications; resources and training about ethical practice; ability to access HRECs for ethics approval; and a supportive organisational culture. Barriers included: limited time; insufficient resourcing and capacity; ethics approval not seen as part of core business; and concerns about academic writing. Conclusion The majority of participants were aware of the importance of ethics in practice and the dissemination of findings. However, participants reported barriers to engaging in formal ethics processes and to publishing findings. So what? Alignment of evidence-informed and ethics-based practice is critical. Resources and information about ethics may be required to support practice and encourage dissemination of findings, including in the peer-reviewed literature. Investigating the role of community-based ethics boards may be valuable to bridging the ethics-evidence gap. PMID:27041127

  15. Ethics and health promotion practice: exploring attitudes and practices in Western Australian health organisations.

    Science.gov (United States)

    Reilly, T; Crawford, G; Lobo, R; Leavy, J; Jancey, J

    2016-04-01

    Issue addressed Evidence-informed practice underpinned by ethics is fundamental to developing the science of health promotion. Knowledge and application of ethical principles are competencies required for health promotion practice. However, these competencies are often inconsistently understood and applied. This research explored attitudes, practices, enablers and barriers related to ethics in practice in Western Australian health organisations. Methods Semistructured, in-depth interviews were conducted with 10 health promotion practitioners, purposefully selected to provide a cross-section of government and non-government organisations. Interviews were recorded, transcribed and then themed. Results The majority of participants reported consideration of ethics in their practice; however, only half reported seeking Human Research Ethics Committee (HREC) approval for projects in the past 12 months. Enablers identified as supporting ethics in practice and disseminating findings included: support preparing ethics applications; resources and training about ethical practice; ability to access HRECs for ethics approval; and a supportive organisational culture. Barriers included: limited time; insufficient resourcing and capacity; ethics approval not seen as part of core business; and concerns about academic writing. Conclusion The majority of participants were aware of the importance of ethics in practice and the dissemination of findings. However, participants reported barriers to engaging in formal ethics processes and to publishing findings. So what? Alignment of evidence-informed and ethics-based practice is critical. Resources and information about ethics may be required to support practice and encourage dissemination of findings, including in the peer-reviewed literature. Investigating the role of community-based ethics boards may be valuable to bridging the ethics-evidence gap.

  16. Mental health literacy as a function of remoteness of residence: an Australian national study

    Directory of Open Access Journals (Sweden)

    Jorm Anthony F

    2009-03-01

    Full Text Available Abstract Background Although there have been many population studies of mental health literacy, little is known about the mental health literacy of people who reside in rural areas. This study sought to determine the impact of remoteness on public knowledge of depression and schizophrenia. Methods The mental health literacy of residents of major cities, inner regional, and outer-remote (including outer regional, remote, and very remote regions were compared using data from a 2003–04 Australian national survey of the mental health literacy of 3998 adults. Measures included the perceived helpfulness of a range of professionals, non-professionals and interventions, and the causes, prognosis, and outcomes after treatment for four case vignettes describing depression, depression with suicidal ideation, early schizophrenia and chronic schizophrenia. Participant awareness of Australia's national depression initiative and depression in the media, their symptoms of depression and exposure to the conditions depicted in the vignettes were also compared. Results Mental health literacy was similar across remoteness categories. However, inner regional residents showed superior identification of the disorders depicted in the suicidal ideation and chronic schizophrenia vignettes. They were also more likely to report having heard of Australia's national depression health promotion campaign. Conversely, they were less likely than major city residents to rate the evidence-based treatment of psychotherapy helpful for depression. Both inner regional and outer-remote residents were less likely to rate psychologists as helpful for depression alone. The rural groups were more likely to rate the non-evidence based interventions of drinking and painkillers as helpful for a depression vignette. In addition, outer-remote residents were more likely to identify the evidence based treatment of antipsychotics as harmful for early schizophrenia and less likely to endorse

  17. Sexually transmitted infections and use of sexual health services among young Australian women: women's health Australia study.

    Science.gov (United States)

    Schofield, M J; Minichiello, V; Mishra, G D; Plummer, D; Savage, J

    2000-05-01

    Our objective was to examine associations between self-reported sexually transmitted infections (STIs) and sociodemographic, lifestyle, health status, health service use and quality of life factors among young Australian women; and their use of family planning and sexual health clinics and associations with health, demographic and psychosocial factors. The study sample comprised 14,762 women aged 18-23 years who participated in the mailed baseline survey for the Australian Longitudinal Study on Women's Health, conducted in 1996. The main outcome measures are self report of ever being diagnosed by a doctor with an STI, including chlamydia, genital herpes, genital warts or other STIs, and use of family planning and sexual health clinics. The self-reported incidence of STI was 1.7% for chlamydia, 1.1% genital herpes, 3.1% genital warts, and 2.1% other STIs. There was a large number of demographic, health behaviour, psychosocial and health service use factors significantly and independently associated with reports of having had each STI. Factors independently associated with use of family planning clinic included unemployment, current smoking, having had a Pap smear less than 2 years ago, not having ancillary health insurance, having consulted a hospital doctor and having higher stress and life events score. Factors independently associated with use of a sexual health clinic included younger age, lower occupation status, being a current or ex-smoker, being a binge drinker, having had a Pap smear, having consulted a hospital doctor, having poorer mental health and having higher life events score. This study reports interesting correlates of having an STI among young Australian women aged 18-23. The longitudinal nature of this study provides the opportunity to explore the long-term health and gynaecological outcomes of having STIs during young adulthood. PMID:10824940

  18. Australian senior adventure travellers to Peru: Maximising older tourists' travel health experience.

    Science.gov (United States)

    Bauer, Irmgard

    2012-03-01

    Financially comfortable, with ample spare time and much better health, older people travel more than ever and to more adventurous destinations. Taking Australian senior adventure travellers to Peru as an example, travel health preparations need to take into account the phenomenon 'senior traveller', the destination with its attractions and challenges, and age-related changes and restrictions. The need for routine travel health advice, vaccinations and prophylaxis remains unchanged. However, more emphasis should be placed on locality-specific issues so that age-appropriate advice and preparations maximize the chances for a safe and memorable travel experience. PMID:22459635

  19. Australian alcohol policy 2001–2013 and implications for public health

    OpenAIRE

    Howard, Steven J.; Gordon, Ross; Jones, Sandra C

    2014-01-01

    Background Despite a complex and multi-faceted alcohol policy environment in Australia, there are few comprehensive reviews of national and state alcohol policies that assess their effectiveness and research support. In mapping the Australian alcohol policy domain and evaluating policy interventions in each of the core policy areas, this article provides a useful resource for researchers. The implications for protecting public health emanating from this mapping and evaluation of alcohol polic...

  20. How acceptable are primary health care nurse practitioners to Australian consumers?

    Science.gov (United States)

    Parker, Rhian; Forrest, Laura; Ward, Nathaniel; McCracken, James; Cox, Darlene; Derrett, Julie

    2013-01-01

    International evidence indicates that nurses working in primary care can provide effective care and achieve positive health outcomes for patients similar to that provided by doctors. Nurse practitioners employed in primary health care perform some tasks previously exclusive to the GP role due to their advanced skills, knowledge and training. In November 2010 Medicare provider rights and Pharmaceutical Benefits Scheme rights were provided for nurse practitioners working in private practice, and in collaboration with a medical practitioner. However, there is limited evidence about how acceptable nurse practitioners are to Australian consumers and what knowledge consumers have of the nurse practitioner role in the delivery of primary health care. The aim of this study was to examine Australian health care consumers' perceptions of nurse practitioners working in primary health care. This paper reports on the results of seven focus groups (n = 77 participants) conducted around Australia. Focus groups participants were asked how acceptable nurse practitioners are as provides of primary health care. Although there was some confusion about the role of nurse practitioners and how this role differed from other primary health care nurses, participants in the focus groups were very positive about nurse practitioners and would find them acceptable in providing primary health care.

  1. Health Care Spending: Changes in the Perceptions of the Australian Public

    Science.gov (United States)

    2016-01-01

    Background Increasing demand for services and rising health care costs create pressures within the Australian health care system and result in higher health insurance premiums and out-of-pocket costs for consumers. Objective To measure changes in consumer views on the quality of the Australian health care system, contributors to rising costs and attitudes towards managing these costs. Methods Two computer-assisted telephone interviews were conducted in 2006 (533 respondents) and 2015 (1318 respondents) and results compared. Results More respondents in 2015 rated the Australian health care system ‘very adequate’ than in 2006 (22.3% vs 8.3%; Odds Ratio OR 3.2, 99% CI 2.1, 5.1) with fewer ‘concerned’ or ‘fairly concerned’ about the health care costs (69.0% vs 85.7%; OR 0.37, 99% CI 0.25, 0.53). The 2015 respondents were more likely to identify new treatments for cancer (77% vs 65.7%; OR 1.75, 99% CI 1.30, 2.35) and community expectations for access to the latest technologies (73.8% vs 67%; OR 1.39, 99% CI 1.04, 1.86) as contributors to rising health care costs. While more 2015 respondents agreed that patients should pay a greater part of the health care costs, this remained a minority view (37.9% vs 31.7%; OR 1.32, 99% CI 0.99, 1.76). They were less likely to agree that doctors should offer medical treatments regardless of the cost and chance of benefit (63.6% vs 82.9%; OR 0.36, 99% CI 0.25, 0.50). Conclusions Satisfaction with the Australian health care system has increased over time. Consumers recognise the cost pressures and have lower expectations that all services should be provided regardless of their costs and potential benefit. Public consultation on the allocation of health care resources and involvement in health care decision-making remains important. There should be community consultation about the principles and values that should guide resource allocation decisions. PMID:27294518

  2. ‘Let the Punishment Match the Offence’: Determining Sentences for Australian Terrorists

    Directory of Open Access Journals (Sweden)

    Nicola McGarrity

    2013-04-01

    Full Text Available To date, 38 men have been charged with terrorism offences in Australia. Twenty-six have been convicted. The article commences with an overview of the factual circumstances leading to these convictions. This provides important background for the following discussion of a largely unexplored issue in Australian anti-terrorism law and policy, namely, the difficulties faced by the Australian courts in adapting traditional sentencing principles to the (for the most part, preparatory terrorism offences enacted by the Commonwealth Parliament after the 9/11 terrorist attacks. Of particular interest are how the courts determine the objective seriousness of these offences and the respective weight placed upon deterrence (both specific and general and the rehabilitation of convicted terrorists.

  3. What research impacts do Australian primary health care researchers expect and achieve?

    Directory of Open Access Journals (Sweden)

    Reed Richard L

    2011-11-01

    Full Text Available Abstract Background Funding for research is under pressure to be accountable in terms of benefits and translation of research findings into practice and policy. Primary health care research has considerable potential to improve health care in a wide range of settings, but little is known about the extent to which these impacts actually occur. This study examines the impact of individual primary health care research projects on policy and practice from the perspective of Chief Investigators (CIs. Methods The project used an online survey adapted from the Buxton and Hanney Payback Framework to collect information about the impacts that CIs expected and achieved from primary health care research projects funded by Australian national competitive grants. Results and Discussion Chief Investigators (CIs provided information about seventeen completed projects. While no CI expected their project to have an impact in every domain of the framework used in the survey, 76% achieved at least half the impacts they expected. Sixteen projects had published and/or presented their work, 10 projects included 11 doctorate awards in their research capacity domain. All CIs expected their research to lead to further research opportunities with 11 achieving this. Ten CIs achieved their expectation of providing information for policy making but only four reported their research had influenced policy making. However 11 CIs achieved their expectation of providing information for organizational decision making and eight reported their research had influenced organizational decision making. Conclusion CIs reported that nationally funded primary health care research projects made an impact on knowledge production, staff development and further research, areas within the realm of influence of the research team and within the scope of awareness of the CIs. Some also made an impact on policy and organizational decision-making, and on localized clinical practice and service

  4. Uptake of health monitoring and disease self-management in Australian adults with neurofibromatosis type 1: strategies to improve care.

    Science.gov (United States)

    Crawford, H A; Barton, B; Wilson, M J; Berman, Y; McKelvey-Martin, V J; Morrison, P J; North, K N

    2016-03-01

    Lifelong health monitoring is recommended in neurofibromatosis type 1 (NF1) because of the progressive and unpredictable range of disabling and potentially life-threatening symptoms that arise. In Australia, strategies for NF1 health surveillance are less well developed for adults than they are for children, resulting in inequalities between pediatric and adult care. The aims of this study were to determine the uptake of health monitoring and capacity of adults with NF1 to self-manage their health. Australian adults with NF1 (n = 94, 18-40 years) participated in a semi-structured interview. Almost half reported no regular health monitoring. Thematic analysis of interviews identified four main themes as to why: (i) did not know where to seek care, (ii) unaware of the need for regular monitoring, (iii) futility of health monitoring as nothing can be done for NF1, and (iv) feeling healthy, therefore monitoring unnecessary. Overall, there were low levels of patient activation, indicating that adults with NF1 lacked knowledge and confidence to manage their health and health care. Findings are discussed in the context of service provision for adults with NF1 in New South Wales, Australia.

  5. Reducing the health disparities of Indigenous Australians: time to change focus

    Directory of Open Access Journals (Sweden)

    Durey Angela

    2012-06-01

    Full Text Available Abstract Background Indigenous peoples have worse health than non-Indigenous, are over-represented amongst the poor and disadvantaged, have lower life expectancies, and success in improving disparities is limited. To address this, research usually focuses on disadvantaged and marginalised groups, offering only partial understanding of influences underpinning slow progress. Critical analysis is also required of those with the power to perpetuate or improve health inequities. In this paper, using Australia as a case example, we explore the effects of ‘White’, Anglo-Australian cultural dominance in health service delivery to Indigenous Australians. We address the issue using race as an organising principle, underpinned by relations of power. Methods Interviews with non-Indigenous medical practitioners in Western Australia with extensive experience in Indigenous health encouraged reflection and articulation of their insights into factors promoting or impeding quality health care to Indigenous Australians. Interviews were audio-taped and transcribed. An inductive, exploratory analysis identified key themes that were reviewed and interrogated in light of existing literature on health care to Indigenous people, race and disadvantage. The researchers’ past experience, knowledge and understanding of health care and Indigenous health assisted with data interpretation. Informal discussions were also held with colleagues working professionally in Indigenous policy, practice and community settings. Results Racism emerged as a key issue, leading us to more deeply interrogate the role ‘Whiteness’ plays in Indigenous health care. While Whiteness can refer to skin colour, it also represents a racialized social structure where Indigenous knowledge, beliefs and values are subjugated to the dominant western biomedical model in policy and practice. Racism towards Indigenous patients in health services was institutional and interpersonal. Internalised

  6. Health inequality - determinants and policies

    DEFF Research Database (Denmark)

    Diderichsen, Finn; Andersen, Ingelise; Manual, Celie;

    2012-01-01

    The review ”Health inequality – determinants and policies” identifies key-areas to be addressed with the aim to reduce the social inequality in health. The general life expectancy has steadily been increasing, but the data reveals marked social inequalities in health as well as life expectancy....... The review seeks to identify the causes of this social inequality. The analysis finds 12 areas of great importance for the inequality in health. This is i.e. early child development, schooling and education, the health behavior of the population, and the role of the health system. Within each of the 12 areas...

  7. Risk indicators for severe impaired oral health among indigenous Australian young adults

    Directory of Open Access Journals (Sweden)

    Roberts-Thomson Kaye F

    2010-01-01

    Full Text Available Abstract Background Oral health impairment comprises three conceptual domains; pain, appearance and function. This study sought to: (1 estimate the prevalence of severe oral health impairment as assessed by a summary oral health impairment measure, including aspects of dental pain, dissatisfaction with dental appearance and difficulty eating, among a birth cohort of Indigenous Australian young adults (n = 442, age range 16-20 years; (2 compare prevalence according to demographic, socio-economic, behavioural, dental service utilisation and oral health outcome risk indicators; and (3 ascertain the independent contribution of those risk indicators to severe oral health impairment in this population. Methods Data were from the Aboriginal Birth Cohort (ABC study, a prospective longitudinal investigation of Aboriginal individuals born 1987-1990 at an Australian regional hospital. Data for this analysis pertained to Wave-3 of the study only. Severe oral health impairment was defined as reported experience of toothache, poor dental appearance and food avoidance in the last 12 months. Logistic regression models were used to evaluate effects of demographic, socio-economic, behavioural, dental service utilisation and clinical oral disease indicators on severe oral health impairment. Effects were quantified as odds ratios (OR. Results The percent of participants with severe oral health impairment was 16.3 (95% CI 12.9-19.7. In the multivariate model, severe oral health impairment was associated with untreated dental decay (OR 4.0, 95% CI 1.6-9.6. In addition to that clinical indicator, greater odds of severe oral health impairment were associated with being female (OR 2.0, 95% CI 1.2-3.6, being aged 19-20 years (OR 2.1, 95% CI 1.2-3.6, soft drink consumption every day or a few days a week (OR 2.6, 95% 1.2-5.6 and non-ownership of a toothbrush (OR 1.9, 95% CI 1.1-3.4. Conclusions Severe oral health impairment was prevalent among this population. The findings

  8. Physical Health of Young, Australian Women: A Comparison of Two National Cohorts Surveyed 17 Years Apart.

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    Ingrid J Rowlands

    Full Text Available Very little is known about the extent of physical health issues among young women in early adulthood and whether this is changing over time.We used data from two national samples of young women aged 18-23 years, surveyed 17 years apart, who participated in the Australian Longitudinal Study on Women's Health. We used multinomial logistic regression to compare the women's physical health (i.e., self-rated health, common symptoms and conditions and identify whether sociodemographic factors, health behaviours and stress explained any physical health differences between the samples.Women aged 18-23 years in 2013 (N = 17,069 were more likely to report poor self-rated health and physical symptoms (particularly urogenital and bowel symptoms than women aged 18-23 years in 1996 (N = 14,247. Stress accounted for a large proportion of the physical health differences between the cohorts, particularly for allergies, headaches, self-rated health, severe tiredness, skin problems, severe period pain and hypertension.Women's health appears to be changing, with young women born in more recent decades reporting greater physical symptom levels. Changing socio-cultural and economic conditions may place pressure on young adults, negatively affecting their health and wellbeing. Assessing the extent to which social structures and health care policies are offering adequate support to young women may offer avenues for promoting positive health and wellbeing.

  9. Primary health-care responses to methamphetamine use in Australian Indigenous communities.

    Science.gov (United States)

    MacLean, Sarah; Harney, Angela; Arabena, Kerry

    2015-01-01

    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. PMID:25704260

  10. Implementing US-style anti-fraud laws in the Australian pharmaceutical and health care industries.

    Science.gov (United States)

    Faunce, Thomas A; Urbas, Gregor; Skillen, Lesley

    2011-05-01

    This article critically analyses the prospects for introducing United States anti-fraud (or anti-false claims) laws in the Australian health care setting. Australian governments spend billions of dollars each year on medicines and health care. A recent report estimates that the money lost to corporate fraud in Australia is growing at an annual rate of 7%, but that only a third of the losses are currently being detected. In the US, qui tam provisions - the component of anti-fraud or anti-false claims laws involving payments to whistleblowers - have been particularly successful in providing critical evidence allowing public prosecutors to recover damages for fraud and false claims made by corporations in relation to federal and state health care programs. The US continues to strengthen such anti-fraud measures and to successfully apply them to a widening range of areas involving large public investment. Australia still suffers from the absence of any comprehensive scheme that not only allows treble damages recovery for fraud on the public purse, but crucially supports such actions by providing financial encouragement for whistleblowing corporate insiders to expose evidence of fraud. Potential areas of application could include direct and indirect government expenditure on health care service provision, pharmaceuticals, medical devices, defence, carbon emissions compensation and tobacco-related illness. The creation in Australia of an equivalent to US anti-false claims legislation should be a policy priority, particularly in a period of financial stringency.

  11. Aboriginal Australians' experience of social capital and its relevance to health and wellbeing in urban settings.

    Science.gov (United States)

    Browne-Yung, Kathryn; Ziersch, Anna; Baum, Fran; Gallaher, Gilbert

    2013-11-01

    Social capital has been linked to physical and mental health. While definitions of social capital vary, all include networks of social relationships and refer to the subsequent benefits and disadvantages accrued to members. Research on social capital for Aboriginal Australians has mainly focused on discrete rural and remote Aboriginal contexts with less known about the features and health and other benefits of social capital in urban settings. This paper presents findings from in-depth interviews with 153 Aboriginal people living in urban areas on their experiences of social capital. Of particular interest was how engagement in bonding and bridging networks influenced health and wellbeing. Employing Bourdieu's relational theory of capital where resources are unequally distributed and reproduced in society we found that patterns of social capital are strongly associated with economic, social and cultural position which in turn reflects the historical experiences of dispossession and disadvantage experienced by Aboriginal Australians. Social capital was also found to both reinforce and influence Aboriginal cultural identity, and had both positive and negative impacts on health and wellbeing. PMID:24161085

  12. An evaluation of the effects of the Australian Food and Health Dialogue targets on the sodium content of bread, breakfast cereals and processed meats.

    Science.gov (United States)

    Trevena, Helen; Neal, Bruce; Dunford, Elizabeth; Wu, Jason H Y

    2014-09-19

    The Australian Food and Health Dialogue set sodium reduction targets for three food categories (breads, ready-to-eat breakfast cereals and processed meats) to be achieved by December, 2013. Sodium levels for 1849 relevant packaged foods on the shelves of Australian supermarkets between 2010 and 2013 were examined. Changes in mean sodium content were assessed by linear mixed models, and the significance of differences in the proportion of products meeting targets was determined using chi-squared or McNemar's tests. The mean sodium level of bread products fell from 454 to 415 mg/100 g (9% lower, p food industry can reduce salt levels of processed foods and provide a strong case for broadening and strengthening of the Food and Health Dialogue (FHD) process.

  13. The challenge of nurse innovation in the Australian context of universal health care.

    Science.gov (United States)

    Cashin, Andrew

    2015-01-01

    As nursing pushes further into the realm of primary health care in Australia, an understanding of the challenges to achieving reasonable federal funding of nursing services needs to be understood. This understanding is underpinned by a comprehensive understanding of the concept of universal health care, how the concept relates to the Australian health care context, and the resultant challenges to innovation in health care service delivery in Australia. Universal health care is a global mission and was the most recent theme for the International Council of Nurses Congress in Australia. Universal health care as a concept represents a fundamental shift from the development and funding of discrete interventions or programmes, to that of developing systems of health care. The three critical elements required are a clear definition of what is considered health care and funded for who, how the system is financed, and evaluation. Australia has a system of universal health care and all three elements are addressed. Organised medicine, a key objector to the introduction of the current approach to universal health care in Australia, soon adapted to it, and now fiercely resists change. Medico centricity poses challenges to sustainability as innovation is inhibited. This challenge is illustrated through consideration of the implementation of the financial policy that gave Nurse Practitioners access as providers and prescribers within Medicare funded services. PMID:26552203

  14. Acceptability of participatory social network analysis for problem-solving in Australian Aboriginal health service partnerships

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    Fuller Jeffrey

    2012-06-01

    Full Text Available Abstract Background While participatory social network analysis can help health service partnerships to solve problems, little is known about its acceptability in cross-cultural settings. We conducted two case studies of chronic illness service partnerships in 2007 and 2008 to determine whether participatory research incorporating social network analysis is acceptable for problem-solving in Australian Aboriginal health service delivery. Methods Local research groups comprising 13–19 partnership staff, policy officers and community members were established at each of two sites to guide the research and to reflect and act on the findings. Network and work practice surveys were conducted with 42 staff, and the results were fed back to the research groups. At the end of the project, 19 informants at the two sites were interviewed, and the researchers conducted critical reflection. The effectiveness and acceptability of the participatory social network method were determined quantitatively and qualitatively. Results Participants in both local research groups considered that the network survey had accurately described the links between workers related to the exchange of clinical and cultural information, team care relationships, involvement in service management and planning and involvement in policy development. This revealed the function of the teams and the roles of workers in each partnership. Aboriginal workers had a high number of direct links in the exchange of cultural information, illustrating their role as the cultural resource, whereas they had fewer direct links with other network members on clinical information exchange and team care. The problem of their current and future roles was discussed inside and outside the local research groups. According to the interview informants the participatory network analysis had opened the way for problem-solving by “putting issues on the table”. While there were confronting and ethically

  15. Complementary Medicine Health Literacy among a Population of Older Australians Living in Retirement Villages: A Mixed Methods Study

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    Caroline A. Smith

    2016-01-01

    Full Text Available Background. Older Australians are consumers of high levels of complementary medicines. The aim of this study was to examine health literacy in a population of older Australians related to their use of complementary medicine. Methods. A two-phase sequential mixed method design incorporating quantitative and qualitative methods was used in this study. The first phase consisted of a cross-sectional survey using a validated health literacy questionnaire and follow-up interviews with 11 residents of retirement villages. Interviews explored low scoring domains on the health literacy questionnaire. Results. Health literacy competencies scored higher for the domains of having sufficient information to manage their health; felt understood and supported by health care providers; actively managed their health; and having social support for health. Three health literacy domains scored low including appraisal of health information; ability to find good information; and navigating the health care system. The findings suggest that participants had different experiences navigating the health care system to access information and services relating to complementary medicines. Two themes of “trust” and “try and see” provide insight into how this group of older Australians appraised health information in relation to complementary medicines. Conclusions. With a focus on self-care there is a need for improved health literacy skills.

  16. Complementary Medicine Health Literacy among a Population of Older Australians Living in Retirement Villages: A Mixed Methods Study.

    Science.gov (United States)

    Smith, Caroline A; Chang, Esther; Brownhill, Suzanne; Barr, Kylie

    2016-01-01

    Background. Older Australians are consumers of high levels of complementary medicines. The aim of this study was to examine health literacy in a population of older Australians related to their use of complementary medicine. Methods. A two-phase sequential mixed method design incorporating quantitative and qualitative methods was used in this study. The first phase consisted of a cross-sectional survey using a validated health literacy questionnaire and follow-up interviews with 11 residents of retirement villages. Interviews explored low scoring domains on the health literacy questionnaire. Results. Health literacy competencies scored higher for the domains of having sufficient information to manage their health; felt understood and supported by health care providers; actively managed their health; and having social support for health. Three health literacy domains scored low including appraisal of health information; ability to find good information; and navigating the health care system. The findings suggest that participants had different experiences navigating the health care system to access information and services relating to complementary medicines. Two themes of "trust" and "try and see" provide insight into how this group of older Australians appraised health information in relation to complementary medicines. Conclusions. With a focus on self-care there is a need for improved health literacy skills.

  17. Effects of acculturation on lifestyle and health status among older Vietnam-born Australians.

    Science.gov (United States)

    Tran, Duong Thuy; Jorm, Louisa; Johnson, Maree; Bambrick, Hilary; Lujic, Sanja

    2015-03-01

    Vietnamese immigrants represent a substantial culturally and linguistically diverse population of Australia, but little is known about the health-related effects of acculturation in this population. This study investigated the relationship between measures of acculturation and lifestyle behaviors and health status among 797 older Vietnam-born Australians who participated in the 45 and Up Study (www.45andup.org.au). The findings suggested that higher degrees of acculturation were associated with increased consumption of red meat, white meat, and seafood; higher levels of physical activities; and lower prevalence of overweight and obesity, type 2 diabetes, and smoking (in men). Targeted health messages could emphasize eating more vegetables, avoiding smoking and alcohol drinking, and increasing levels of physical activity.

  18. Responding to the Challenges of Providing Mental Health Services to Refugees: An Australian Case Report.

    Science.gov (United States)

    Kaplan, Ida; Stow, Hardy David; Szwarc, Josef

    2016-01-01

    There has been a growing recognition of the mental health needs of refugees in countries of settlement, as many are survivors of torture and other traumatic events experienced in countries of origin, during flight, and in places of temporary refuge. The challenges in providing access to services and quality mental health care arise not only from the fact that refugees generally come from cultures very different to the societies in which they settle and are not proficient in the languages of their new homes. Other significant barriers relate to the impact of the trauma and psychosocial stressors they experience despite finding apparent security. In response to the challenges, specialist agencies have developed ways of providing services that are trauma-informed, culture-informed, and holistic. This paper describes an Australian example of a mental health clinic as part of a community-based service for refugees who are survivors of torture and other traumatic events. PMID:27524758

  19. The impact of drought on the association between food security and mental health in a nationally representative Australian sample

    OpenAIRE

    Friel, S; Berry, H; Dinh, H.; O'Brien, L; Walls, HL

    2014-01-01

    Background The association between food insecurity and mental health is established. Increasingly, associations between drought and mental health and drought and food insecurity have been observed in a number of countries. The impact of drought on the association between food insecurity and mental health has received little attention. Methods Population-based study using data from a nationally representative panel survey of Australian adults in which participants report behaviour, health, soc...

  20. 'Disease, disaster and despair'? The presentation of health in low- and middle-income countries on Australian television.

    Directory of Open Access Journals (Sweden)

    Michelle Imison

    Full Text Available BACKGROUND: In high-income nations mainstream television news remains an important source of information about both general health issues and low- and middle-income countries (LMICs. However, research on news coverage of health in LMICs is scarce. PRINCIPAL FINDINGS: The present paper examines the general features of Australian television coverage of LMIC health issues, testing the hypotheses that this coverage conforms to the general patterns of foreign news reporting in high-income countries and, in particular, that LMIC health coverage will largely reflect Australian interests. We analysed relevant items from May 2005 - December 2009 from the largest health-related television dataset of its kind, classifying each story on the basis of the region(s it covered, principal content relating to health in LMICs and the presence of an Australian reference point. LMICs that are culturally proximate and politically significant to Australia had higher levels of reportage than more distant and unengaged nations. Items concerning communicable diseases, injury and aspects of child health generally consonant with 'disease, disaster and despair' news frames predominated, with relatively little emphasis given to chronic diseases which are increasingly prevalent in many LMICs. Forty-two percent of LMIC stories had explicit Australian content, such as imported medical expertise or health risk to Australians in LMICs. SIGNIFICANCE: Media consumers' perceptions of disease burdens in LMICs and of these nations' capacity to identify and manage their own health priorities may be distorted by the major news emphasis on exotic disease, disaster and despair stories. Such perceptions may inhibit the development of appropriate policy emphases in high-income countries. In this context, non-government organisations concerned with international development may find it more difficult to strike a balance between crises and enduring issues in their health programming and

  1. Types of social media (Web 2.0) used by Australian allied health professionals to deliver early twenty-first-century practice promotion and health care.

    Science.gov (United States)

    Usher, Wayne

    2011-01-01

    Types of social media (Web 2.0) usage associated with eight of Australia's major allied health professions (AHPs, n = 935) were examined. Australian AHPs are interacting with Web 2.0 technologies for personal use but are failing to implement such technologies throughout their health professions to deliver health care. Australian AHPs are willing to undertake online educational courses designed to up skill them about how Web 2.0 may be used for practice promotion and health care delivery in the early twenty-first century. Participants in this study indicated that educational courses that were offered online would be the preferred mode of delivery.

  2. Usability of patient experience surveys in Australian primary health care: a scoping review.

    Science.gov (United States)

    Gardner, Karen; Parkinson, Anne; Banfield, Michelle; Sargent, Ginny M; Desborough, Jane; Hehir, Kanupriya Kalia

    2016-01-01

    Monitoring patient experience is essential for stimulating innovation in health care and improving quality and accountability. Internationally, standardised approaches are used to collect patient experience information, but in Australian primary health care (PHC), little is known about which patient experience surveys are used and which aspects of experience they measure. This prevents routine inclusion of patient experience data in quality improvement or system performance measurement. A scoping review was undertaken to identify relevant surveys. Data on survey availability, psychometric properties, target population, method and frequency of administration were extracted. Survey items were mapped against six dimensions of patient experience described internationally. Ninety-five surveys were identified; 34 were developed for use in Australia. Surveys vary in content, size, aspects of experience measured and methods of administration. The quality of data collected and the extent to which it is used in quality improvement is unclear. Collection of patient experience data in Australian PHC is not well developed or standardised and there are few publicly available instruments. There is a need to clearly identify the purposes for which data are to be used and to develop an integrated approach that articulates these collections with other quality and performance data. Some options are discussed. PMID:27469275

  3. Health services utilisation disparities between English speaking and non-English speaking background Australian infants

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    Chen Jack

    2010-04-01

    Full Text Available Abstract Background To examine the differences in health services utilisation and the associated risk factors between infants from non-English speaking background (NESB and English speaking background (ESB within Australia. Methods We analysed data from a national representative longitudinal study, the Longitudinal Study of Australian Children (LSAC which started in 2004. We used survey logistic regression coupled with survey multiple linear regression to examine the factors associated with health services utilisation. Results Similar health status was observed between the two groups. In comparison to ESB infants, NESB infants were significantly less likely to use the following health services: maternal and child health centres or help lines (odds ratio [OR] 0.56; 95% confidence intervals [CI], 0.40-0.79; maternal and child health nurse visits (OR 0.68; 95% CI, 0.49-0.95; general practitioners (GPs (OR 0.58; 95% CI, 0.40-0.83; and hospital outpatient clinics (OR 0.54; 95% CI, 0.31-0.93. Multivariate analysis results showed that the disparities could not be fully explained by the socioeconomic status and language barriers. The association between English proficiency and the service utilised was absent once the NESB was taken into account. Maternal characteristics, family size and income, private health insurance and region of residence were the key factors associated with health services utilisation. Conclusions NESB infants accessed significantly less of the four most frequently used health services compared with ESB infants. Maternal characteristics and family socioeconomic status were linked to health services utilisation. The gaps in health services utilisation between NESB and ESB infants with regard to the use of maternal and child health centres or phone help, maternal and child health nurse visits, GPs and paediatricians require appropriate policy attentions and interventions.

  4. The 2003 Australian Breast Health Survey: survey design and preliminary results

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    Favelle Simone

    2008-01-01

    Full Text Available Abstract Background The Breast Health Surveys, conducted by the National Breast Cancer Centre (NBCC in 1996 and 2003, are designed to gain insight into the knowledge, attitudes and behaviours of a nationally representative sample of Australian women on issues relevant to breast cancer. In this article, we focus on major aspects of the design and present results on respondents' knowledge about mammographic screening. Methods The 2003 BHS surveyed English-speaking Australian women aged 30–69 without a history of breast cancer using computer-assisted telephone interviewing. Questions covered the following themes: knowledge and perceptions about incidence, mortality and risk; knowledge and behaviour regarding early detection, symptoms and diagnosis; mammographic screening; treatment; and accessibility and availability of information and services. Respondents were selected using a complex sample design involving stratification. Sample weights against Australian population benchmarks were used in all statistical analyses. Means and proportions for the entire population and by age group and area of residence were calculated. Statistical tests were conducted using a level of significance of 0.01. Results Of the 3,144 respondents who consented to being interviewed, 138 (4.4% had a previous diagnosis of breast cancer and were excluded leaving 3,006 completed interviews eligible for analysis. A majority of respondents (61.1% reported ever having had a mammogram and 29.1% identified mammography as being the best way of finding breast cancer. A majority of women (85.9% had heard of the BreastScreen Australia (BSA program, the national mammographic screening program providing free biennial screening mammograms, with 94.5% believing that BSA attendance was available regardless of the presence or absence of symptoms. There have been substantial gains in women's knowledge about mammographic screening over the seven years between the two surveys. Conclusion The

  5. Private health insurance and quality of life: perspectives of older Australians with multiple chronic conditions.

    Science.gov (United States)

    Jeon, Yun-Hee; Black, Annie; Govett, Janelle; Yen, Laurann; McRae, Ian

    2012-01-01

    A qualitative study was conducted to explore in-depth issues relating to the health costs of chronic illness as identified in a previous study. A key theme that emerged from interviews carried out was the benefits and challenges of private health insurance (PHI) membership, and choices older Australians with multimorbidity make in accessing health services, with and without PHI. This is the focus of this paper. Semistructured interviews were conducted with 40 older people with multiple chronic conditions. Data were analysed using content analysis. Key motivators for maintaining PHI included: fear of an inability to access timely health care; the opportunity to exercise choice in service provider; a belief of being 'better off' both medically and financially, which was often ill-founded; and the core values of self reliance and independence. Most described financial pressure caused by rising PHI premiums as well as other out-of-pocket health related expenses. Many older people who can ill afford PHI still struggle to maintain it, potentially at the cost of their quality of life, based on beliefs about costs of health care that they have never properly assessed. The findings highlight the degree to which people whose resources are constrained are prepared to go to maintain access to private hospital care. Attention should be given to assisting older people to make informed and valid choices of health insurance derived from the facts, rather than being based on fear and assumptions.

  6. The reliability of the Greulich-Pyle method in bone age determination among Australian children

    International Nuclear Information System (INIS)

    Bone age (BA) determination in skeletally immature children has been used as a measurement of growth for many years. The Greulich-Pyle (G&P) method of estimating BA is most commonly used. The standards used within this atlas were compiled from research conducted on normal white children in the United States, during the 1930s. The applicability of G&P beyond populations similar to its own can be variable. The aim of this study was to determine the accuracy of G&P in BA determination among Australian children. Hand X-rays of children under the age of 18, investigated for trauma, were recruited. Mean differences between BA, according to the standards of G&P, and chronological age (CA) were compared among all patients and subgroups according to age, gender and left versus right hand. Between January and December 2010, 654 children underwent hand X-rays, 406 of these were included (276 males and 130 females). Overall BA was 2.2 months less than CA (P-value=0.005). BA of males and females was estimated to be 1.5 months (P-value=0.142) and 3.7 months (P-value=0.002) less than their CA respectively. No statistically significant difference was identified with intra-observer (P-value=0.846) and inter-observer interpretations (P-value=0.102). Our results show that the standards of G&P are an accurate means of BA determination in Australian children.

  7. Oral health and social and emotional well-being in a birth cohort of Aboriginal Australian young adults

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    Cairney Sheree J

    2011-08-01

    Full Text Available Abstract Background Social and emotional well-being is an important component of overall health. In the Indigenous Australian context, risk indicators of poor social and emotional well-being include social determinants such as poor education, employment, income and housing as well as substance use, racial discrimination and cultural knowledge. This study sought to investigate associations between oral health-related factors and social and emotional well-being in a birth cohort of young Aboriginal adults residing in the northern region of Australia's Northern Territory. Methods Data were collected on five validated domains of social and emotional well-being: anxiety, resilience, depression, suicide and overall mental health. Independent variables included socio-demographics, dental health behaviour, dental disease experience, oral health-related quality of life, substance use, racial discrimination and cultural knowledge. Results After adjusting for other covariates, poor oral health-related items were associated with each of the social and emotional well-being domains. Specifically, anxiety was associated with being female, having one or more decayed teeth and racial discrimination. Resilience was associated with being male, having a job, owning a toothbrush, having one or more filled teeth and knowing a lot about Indigenous culture; while being female, having experienced dental pain in the past year, use of alcohol, use of marijuana and racial discrimination were associated with depression. Suicide was associated with being female, having experience of untreated dental decay and racial discrimination; while being female, having experience of dental disease in one or more teeth, being dissatisfied about dental appearance and racial discrimination were associated with poor mental health. Conclusion The results suggest there may be value in including oral health-related initiatives when exploring the role of physical conditions on Indigenous

  8. Access to eye health services among indigenous Australians: an area level analysis

    Directory of Open Access Journals (Sweden)

    Kelaher Margaret

    2012-09-01

    Full Text Available Abstract Background This project is a community-level study of equity of access to eye health services for Indigenous Australians. Methods The project used data on eye health services from multiple sources including Medicare Australia, inpatient and outpatient data and the National Indigenous Eye Health Survey. The analysis focused on the extent to which access to eye health services varied at an area level according to the proportion of the population that was Indigenous (very low = 0-1.0%, low = 1.1-3.0%, low medium = 3.1-6.0%, high medium = 6.1-10.0%, high = 10.1-20.0%, very high = 20 + %. The analysis of health service utilisation also took into account age, remoteness and the Socioeconomic Indices for Areas (SEIFA. Results The rate of eye exams provided in areas with very high Indigenous populations was two-thirds of the rate of eye exams for areas with very low indigenous populations. The cataract surgery rates in areas with high medium to very high Indigenous populations were less than half that reference areas. In over a third of communities with very high Indigenous populations the cataract surgery rate fell below the World Health Organization (WHO guidelines compared to a cataract surgery rate of 3% in areas with very low Indigenous populations. Conclusions There remain serious disparities in access to eye health service in areas with high Indigenous populations. Addressing disparities requires a co-ordinated approach to improving Indigenous people’s access to eye health services. More extensive take-up of existing Medicare provisions is an important step in this process. Along with improving access to health services, community education concerning the importance of eye health and the effectiveness of treatment might reduce reluctance to seek help.

  9. Reproductive health of male Australian veterans of the 1991 Gulf War

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    Glass Deborah C

    2007-05-01

    Full Text Available Abstract Background Since the 1991 Gulf War concerns have been raised about the effects of deployment to the Gulf War on veterans' health. Studies of the reproductive health of Gulf War veterans have reported varied findings. Methods We undertook a cross-sectional study of male Australian Gulf War veterans (n = 1,424 and a randomly sampled military comparison group (n = 1,548. The study was conducted from August 2000 to April 2002. A postal questionnaire included questions about difficulties achieving pregnancy, pregnancy outcomes including live births, stillbirths, miscarriages and terminations; and for all live births gestation, birth weight, sex, and any cancers, birth defects, chromosomal abnormalities or serious health problems. Results Male Gulf War veterans reported slightly increased risk of fertility difficulties following the Gulf War (odds ratio [OR] 1.4; 95% confidence interval [CI] 1.0–1.8, but were more successful at subsequently fathering a child (OR 1.8; 95% CI 1.3–2.6. The study groups reported similar rates of pregnancies and live births. There was no increased risk in veterans of miscarriage, stillbirth, or terminations. Children of male Gulf War veterans born after the period of the Gulf War were not at greater risk of being born prematurely, having a low birth weight, or having a birth defect or chromosomal abnormality (OR 1.0; 95% CI 0.6–1.6. The numbers of cancers and deaths in children were too small to draw any firm conclusions. Conclusion The results of this study do not show an increased risk of adverse reproductive outcome in Australian male Gulf War veterans.

  10. An Evaluation of the Effects of the Australian Food and Health Dialogue Targets on the Sodium Content of Bread, Breakfast Cereals and Processed Meats

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    Helen Trevena

    2014-09-01

    Full Text Available The Australian Food and Health Dialogue set sodium reduction targets for three food categories (breads, ready-to-eat breakfast cereals and processed meats to be achieved by December, 2013. Sodium levels for 1849 relevant packaged foods on the shelves of Australian supermarkets between 2010 and 2013 were examined. Changes in mean sodium content were assessed by linear mixed models, and the significance of differences in the proportion of products meeting targets was determined using chi-squared or McNemar’s tests. The mean sodium level of bread products fell from 454 to 415 mg/100 g (9% lower, p < 0.001, and the proportion reaching target rose from 42% to 67% (p < 0.005. The mean sodium content of breakfast cereals also fell substantially from 316 to 237 mg/100 g (25% lower, p < 0.001 over the study period. The decline in mean sodium content of bacon/ham/cured meats from 1215 to 1114 mg/100 g (8% lower, p = 0.001 was smaller, but associated with a rise in the proportion meeting the target from 28% to 47%. Declines in mean sodium content did not appreciably differ between companies that did and did not make public commitments to the targets. These data show that the Australian food industry can reduce salt levels of processed foods and provide a strong case for broadening and strengthening of the Food and Health Dialogue (FHD process.

  11. An Australian discrete choice experiment to value eq-5d health states.

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    Viney, Rosalie; Norman, Richard; Brazier, John; Cronin, Paula; King, Madeleine T; Ratcliffe, Julie; Street, Deborah

    2014-06-01

    Conventionally, generic quality-of-life health states, defined within multi-attribute utility instruments, have been valued using a Standard Gamble or a Time Trade-Off. Both are grounded in expected utility theory but impose strong assumptions about the form of the utility function. Preference elicitation tasks for both are complicated, limiting the number of health states that each respondent can value and, therefore, that can be valued overall. The usual approach has been to value a set of the possible health states and impute values for the remainder. Discrete Choice Experiments (DCEs) offer an attractive alternative, allowing investigation of more flexible specifications of the utility function and greater coverage of the response surface. We designed a DCE to obtain values for EQ-5D health states and implemented it in an Australia-representative online panel (n = 1,031). A range of specifications investigating non-linear preferences with respect to time and interactions between EQ-5D levels were estimated using a random-effects probit model. The results provide empirical support for a flexible utility function, including at least some two-factor interactions. We then constructed a preference index such that full health and death were valued at 1 and 0, respectively, to provide a DCE-based algorithm for Australian cost-utility analyses. PMID:23765787

  12. Health Status and Coping Strategies among Older Parent-Carers of Adults with Intellectual Disabilities in an Australian Sample

    Science.gov (United States)

    Llewellyn, Gwynnyth; McConnell, David; Gething, Lindsay; Cant, Rosemary; Kendig, Hal

    2010-01-01

    Background: Older parent-carers in Australia are the subject of increasing policy and practice attention due to concerns about their ongoing ability to care in the light of their own ageing and the ageing of their adult son or daughter. This paper examines health status and the coping strategies of a group of older Australian parents caring for an…

  13. Australian Children with Special Health Care Needs: Social-Emotional and Learning Competencies in the Early Years

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    Whiteford, Chrystal; Walker, Sue; Berthelsen, Donna

    2013-01-01

    This study examined the relationship between special health care needs and social-emotional and learning competence in the early years, reporting on two waves of data from the Kindergarten Cohort of "Growing up in Australia: The Longitudinal Study of Australian Children" (LSAC). Six hundred and fifty children were identified through the…

  14. A qualitative study of the determinants of dieting and non-dieting approaches in overweight/obese Australian adults

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    Leske Stuart

    2012-12-01

    Full Text Available Abstract Background Dieting has historically been the main behavioural treatment paradigm for overweight/obesity, although a non-dieting paradigm has more recently emerged based on the criticisms of the original dieting approach. There is a dearth of research contrasting why these approaches are adopted. To address this, we conducted a qualitative investigation into the determinants of dieting and non-dieting approaches based on the perspectives and experiences of overweight/obese Australian adults. Methods Grounded theory was used inductively to generate a model of themes contrasting the determinants of dieting and non-dieting approaches based on the perspectives of 21 overweight/obese adults. Data was collected using semi-structured interviews to elicit in-depth individual experiences and perspectives. Results Several categories emerged which distinguished between the adoption of a dieting or non-dieting approach. These categories included the focus of each approach (weight/image or lifestyle/health behaviours; internal or external attributions about dieting failure; attitudes towards established diets, and personal autonomy. Personal autonomy was also influenced by another category; the perceived knowledge and self-efficacy about each approach, with adults more likely to choose an approach they knew more about and were confident in implementing. The time perspective of change (short or long-term and the perceived identity of the person (fat/dieter or healthy person also emerged as determinants of dieting or non-dieting approaches respectively. Conclusions The model of determinants elicited from this study assists in understanding why dieting and non-dieting approaches are adopted, from the perspectives and experiences of overweight/obese adults. Understanding this decision-making process can assist clinicians and public health researchers to design and tailor dieting and non-dieting interventions to population subgroups that have preferences

  15. Change and stability in work-family conflict and mothers' and fathers' mental health: Longitudinal evidence from an Australian cohort.

    Science.gov (United States)

    Cooklin, A R; Dinh, H; Strazdins, L; Westrupp, E; Leach, L S; Nicholson, J M

    2016-04-01

    Work-family conflict (WFC) occurs when work or family demands are 'mutually incompatible', with detrimental effects on mental health. This study contributes to the sparse longitudinal research, addressing the following questions: Is WFC a stable or transient feature of family life for mothers and fathers? What happens to mental health if WFC increases, reduces or persists? What work and family characteristics predict WFC transitions and to what extent are they gendered? Secondary analyses of 5 waves of data (child ages 4-5 to 12-13 years) from employed mothers (n = 2693) and fathers (n = 3460) participating in the Longitudinal Study of Australian Children were conducted. WFC transitions, across four two-year intervals (Waves 1-2, 2-3, 3-4, and 4-5) were classified as never, conscript, exit or chronic. Significant proportions of parents experienced change in WFC, between 12 and 16% of mothers and fathers for each transition 'type'. Parents who remained in chronic WFC reported the poorest mental health (adjusted multiple regression analyses), followed by those who conscripted into WFC. When WFC was relieved (exit), both mothers' and fathers' mental health improved significantly. Predictors of conscript and chronic WFC were somewhat distinct for mothers and fathers (adjusted logit regressions). Poor job quality, a skilled occupation and having more children differentiated chronic fathers' from those who exited WFC. For mothers, work factors only (skilled occupation; work hours; job insecurity) predicted chronic WFC. Findings reflect the persistent, gendered nature of work and care shaped by workplaces, but also offer tailored opportunities to redress WFC for mothers and fathers. We contribute novel evidence that mental health is directly influenced by the WFC interface, both positively and negatively, highlighting WFC as a key social determinant of health. PMID:26986239

  16. Change and stability in work-family conflict and mothers' and fathers' mental health: Longitudinal evidence from an Australian cohort.

    Science.gov (United States)

    Cooklin, A R; Dinh, H; Strazdins, L; Westrupp, E; Leach, L S; Nicholson, J M

    2016-04-01

    Work-family conflict (WFC) occurs when work or family demands are 'mutually incompatible', with detrimental effects on mental health. This study contributes to the sparse longitudinal research, addressing the following questions: Is WFC a stable or transient feature of family life for mothers and fathers? What happens to mental health if WFC increases, reduces or persists? What work and family characteristics predict WFC transitions and to what extent are they gendered? Secondary analyses of 5 waves of data (child ages 4-5 to 12-13 years) from employed mothers (n = 2693) and fathers (n = 3460) participating in the Longitudinal Study of Australian Children were conducted. WFC transitions, across four two-year intervals (Waves 1-2, 2-3, 3-4, and 4-5) were classified as never, conscript, exit or chronic. Significant proportions of parents experienced change in WFC, between 12 and 16% of mothers and fathers for each transition 'type'. Parents who remained in chronic WFC reported the poorest mental health (adjusted multiple regression analyses), followed by those who conscripted into WFC. When WFC was relieved (exit), both mothers' and fathers' mental health improved significantly. Predictors of conscript and chronic WFC were somewhat distinct for mothers and fathers (adjusted logit regressions). Poor job quality, a skilled occupation and having more children differentiated chronic fathers' from those who exited WFC. For mothers, work factors only (skilled occupation; work hours; job insecurity) predicted chronic WFC. Findings reflect the persistent, gendered nature of work and care shaped by workplaces, but also offer tailored opportunities to redress WFC for mothers and fathers. We contribute novel evidence that mental health is directly influenced by the WFC interface, both positively and negatively, highlighting WFC as a key social determinant of health.

  17. Relationships between Psychosocial Resilience and Physical Health Status of Western Australian Urban Aboriginal Youth.

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    Katrina D Hopkins

    Full Text Available Psychosocial processes are implicated as mediators of racial/ethnic health disparities via dysregulation of physiological responses to stress. Our aim was to investigate the extent to which factors previously documented as buffering the impact of high-risk family environments on Aboriginal youths' psychosocial functioning were similarly beneficial for their physical health status.We examined the relationship between psychosocial resilience and physical health of urban Aboriginal youth (12-17 years, n = 677 drawn from a representative survey of Western Australian Aboriginal children and their families. A composite variable of psychosocial resilient status, derived by cross-classifying youth by high/low family risk exposure and normal/abnormal psychosocial functioning, resulted in four groups- Resilient, Less Resilient, Expected Good and Vulnerable. Separate logistic regression modeling for high and low risk exposed youth revealed that Resilient youth were significantly more likely to have lower self-reported asthma symptoms (OR 3.48, p<.001 and carer reported lifetime health problems (OR 1.76, p<.04 than Less Resilient youth.The findings are consistent with biopsychosocial models and provide a more nuanced understanding of the patterns of risks, resources and adaptation that impact on the physical health of Aboriginal youth. The results support the posited biological pathways between chronic stress and physical health, and identify the protective role of social connections impacting not only psychosocial function but also physical health. Using a resilience framework may identify potent protective factors otherwise undetected in aggregated analyses, offering important insights to augment general public health prevention strategies.

  18. The South Australian Allied Health Workforce survey: helping to fill the evidence gap in primary health workforce planning.

    Science.gov (United States)

    Whitford, Deirdre; Smith, Tony; Newbury, Jonathan

    2012-01-01

    There is a lack of detailed evidence about the allied health workforce to inform proposed health care reforms. The South Australian Allied Health Workforce (SAAHW) survey collected data about the demographic characteristics, employment, education and recruitment and retention of allied health professionals in South Australia. The SAAHW questionnaire was widely distributed and 1539 responses were received. The average age of the sample was 40 years; males were significantly older than females, the latter making up 82% of respondents. Three-quarters of the sample worked in the city; 60% worked full time and the remainder in part-time, casual or locum positions. 'Work-life balance' was the most common attraction to respondents' current jobs and 'Better career prospects' the most common reason for intending to leave. Practice in a rural location was influenced by rural background and rural experience during training. A greater proportion of Generation Y (1982-2000) respondents intended to leave within 2 years than Generation X (1961-81) or Baby Boomers (1943-60). Most respondents were satisfied with their job, although some reported lack of recognition of their knowledge and skills. Systematic, robust allied health workforce data are required for integrated and sustainable primary health care delivery. PMID:23069367

  19. Predictors of mental health in adults with congenital craniofacial conditions attending the Australian craniofacial unit.

    Science.gov (United States)

    Roberts, R M; Mathias, J L

    2013-07-01

    Objective : Adults with craniofacial conditions experience more psychosocial problems than adults in the general population, but little is known about the factors that render a person more or less susceptible to these problems. Guided by research on adults with other conditions that affect appearance, this study examined predictors of psychosocial outcome in adults with craniofacial conditions. Design : Single-sample cross-sectional design. Setting : The Australian Craniofacial Unit, Women's and Children's Hospital, Adelaide, one of the main craniofacial treatment centers in Australia. Participants : Adults (N  =  93; 36.9% of the potential sample) with congenital craniofacial conditions (excluding cleft lip and/or cleft palate) who were treated in the Australian Craniofacial Unit. Main Outcome Measures : All participants completed measures assessing anxiety, depression, and quality of life (Hospital Anxiety and Depression Scale, Short-Form Health Survey) and variables predicted to affect these outcomes (SF-36 Health Survey - Multidimensional Scale of Perceived Social Support, Rosenberg Self-Esteem Scale, Cleft Satisfaction Profile, Brief Fear of Negative Evaluation Scale, Derriford Appearance Scale). Results : Multiple regression analyses revealed that anxiety was predicted by social support, self-esteem, and fear of negative evaluation, while depression was predicted by self-esteem and social support. Physical quality of life was not predicted by any of the measures. Satisfaction with appearance, gender, age, and education were not related to outcome. Conclusions : Interventions designed to increase perceived social support and self-esteem and reduce fear of negative evaluation appear to be indicated and may assist in establishing a causal relationship between these variables. PMID:22324967

  20. Increase in caesarean deliveries after the Australian Private Health Insurance Incentive policy reforms.

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    Kristjana Einarsdóttir

    Full Text Available BACKGROUND: The Australian Private Health Insurance Incentive (PHII policy reforms implemented in 1997-2000 increased PHI membership in Australia by 50%. Given the higher rate of obstetric interventions in privately insured patients, the reforms may have led to an increase in surgical deliveries and deliveries with longer hospital stays. We aimed to investigate the effect of the PHII policy introduction on birth characteristics in Western Australia (WA. METHODS AND FINDINGS: All 230,276 birth admissions from January 1995 to March 2004 were identified from administrative birth and hospital data-systems held by the WA Department of Health. Average quarterly birth rates after the PHII introduction were estimated and compared with expected rates had the reforms not occurred. Rate and percentage differences (including 95% confidence intervals were estimated separately for public and private patients, by mode of delivery, and by length of stay in hospital following birth. The PHII policy introduction was associated with a 20% (-21.4 to -19.3 decrease in public birth rates, a 51% (45.1 to 56.4 increase in private birth rates, a 5% (-5.3 to -5.1 and 8% (-8.9 to -7.9 decrease in unassisted and assisted vaginal deliveries respectively, a 5% (-5.3 to -5.1 increase in caesarean sections with labour and 10% (8.0 to 11.7 increase in caesarean sections without labour. Similarly, birth rates where the infant stayed 0-3 days in hospital following birth decreased by 20% (-21.5 to -18.5, but rates of births with >3 days in hospital increased by 15% (12.2 to 17.1. CONCLUSIONS: Following the PHII policy implementation in Australia, births in privately insured patients, caesarean deliveries and births with longer infant hospital stays increased. The reforms may not have been beneficial for quality obstetric care in Australia or the burden of Australian hospitals.

  1. Health inequalities, physician citizens and professional medical associations: an Australian case study

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    Naccarella Lucio

    2007-08-01

    Full Text Available Abstract Background As socioeconomic health inequalities persist and widen, the health effects of adversity are a constant presence in the daily work of physicians. Gruen and colleagues suggest that, in responding to important population health issues such as this, defining those areas of professional obligation in contrast to professional aspiration should be on the basis of evidence and feasibility. Drawing this line between obligation and aspiration is a part of the work of professional medical colleges and associations, and in doing so they must respond to members as well as a range of other interest groups. Our aim was to explore the usefulness of Gruen's model of physician responsibility in defining how professional medical colleges and associations should lead the profession in responding to socioeconomic health inequalities. Methods We report a case study of how the Royal Australian College of General Practitioners is responding to the issue of health inequalities through its work. We undertook a consultation (80 interviews with stakeholders internal and external to the College and two focus groups with general practitioners and program and policy review of core programs of College interest and responsibility: general practitioner training and setting of practice standards, as well as its work in public advocacy. Results Some strategies within each of these College program areas were seen as legitimate professional obligations in responding to socioeconomic health inequality. However, other strategies, while potentially professional obligations within Gruen's model, were nevertheless contested. The key difference between these lay in different moral orientations. Actions where agreement existed were based on an ethos of care and compassion. Actions that were contested were based on an ethos of justice and human rights. Conclusion Colleges and professional medical associations have a role in explicitly leading a debate about values

  2. Barriers to the routine collection of health outcome data in an Australian community care organization

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    Nancarrow SA

    2013-01-01

    Full Text Available Susan A NancarrowSchool of Health and Human Sciences, Southern Cross University, East Lismore, NSW, AustraliaAbstract: For over a decade, organizations have attempted to include the measurement and reporting of health outcome data in contractual agreements between funders and health service providers, but few have succeeded. This research explores the utility of collecting health outcomes data that could be included in funding contracts for an Australian Community Care Organisation (CCO. An action-research methodology was used to trial the implementation of outcome measurement in six diverse projects within the CCO using a taxonomy of interventions based on the International Classification of Function. The findings from the six projects are presented as vignettes to illustrate the issues around the routine collection of health outcomes in each case. Data collection and analyses were structured around Donabedian's structure–process–outcome triad. Health outcomes are commonly defined as a change in health status that is attributable to an intervention. This definition assumes that a change in health status can be defined and measured objectively; the intervention can be defined; the change in health status is attributable to the intervention; and that the health outcomes data are accessible. This study found flaws with all of these assumptions that seriously undermine the ability of community-based organizations to introduce routine health outcome measurement. Challenges were identified across all stages of the Donabedian triad, including poor adherence to minimum dataset requirements; difficulties standardizing processes or defining interventions; low rates of use of outcome tools; lack of value of the tools to the service provider; difficulties defining or identifying the end point of an intervention; technical and ethical barriers to accessing data; a lack of standardized processes; and time lags for the collection of data. In no case was

  3. Oral health: equity and social determinants

    DEFF Research Database (Denmark)

    Kwan, Stella; Petersen, Poul Erik

    2010-01-01

    This book chapter discusses the social determinants of oral health, and identifies interventions that have been, or can be, used in addressing oral health inequities (e.g. oral health promotion, education programmes, improving access to oral health care).......This book chapter discusses the social determinants of oral health, and identifies interventions that have been, or can be, used in addressing oral health inequities (e.g. oral health promotion, education programmes, improving access to oral health care)....

  4. Farmers sun exposure, skin protection and public health campaigns: An Australian perspective

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    Christel Smit-Kroner

    2015-01-01

    Full Text Available Non-melanoma skin cancer is a common and costly cancer in agricultural populations. Prevention and early detection are an effective way to decrease the burden of disease and associated costs. To examine sun exposure and skin protection practices in agricultural workers and farmers a thematic review of the literature between 1983 and 2014 was undertaken. Comparison between studies was complicated by differences in study design, definitions of skin protection, and analytic methods used. Farmers are the most exposed to harmful ultraviolet (UV radiation of all outdoor workers and the level of reported skin protection by farmers is suboptimal. Years of public health campaigns have failed to adequately address farmers' specific needs. Increased rates of skin cancer and subsequent higher costs are expected. Estimates of sun exposure and skin protection practice indicate that protective clothing is the most promising avenue to improve on farmers' skin protection. Early detection needs to be part of public health campaigns. This review explores the quantitative data about Australian farmers and their skin protective behaviours. We investigate what the documented measurable effect of the public health campaign Slip!Slop!Slap! has had on agricultural workers and farmers and make recommendations for future focus.

  5. The health and health behaviours of Australian metropolitan nurses: an exploratory study

    OpenAIRE

    Perry, Lin; Gallagher, Robyn; Duffield, Christine

    2015-01-01

    Background Nurses make up the largest component of the health workforce and provide the majority of patient care. Most health education is delivered by nurses, who also serve as healthy living and behavioural role models. Anything that diminishes their health status can impact their credibility as role models, their availability and ability to deliver quality care, and is potentially disadvantageous for the health of the population. Study aims were to investigate nurses’ overall health and th...

  6. The health and cost implications of high body mass index in Australian defence force personnel

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    Peake Jonathan

    2012-06-01

    Full Text Available Abstract Background Frequent illness and injury among workers with high body mass index (BMI can raise the costs of employee healthcare and reduce workforce maintenance and productivity. These issues are particularly important in vocational settings such as the military, which require good physical health, regular attendance and teamwork to operate efficiently. The purpose of this study was to compare the incidence of injury and illness, absenteeism, productivity, healthcare usage and administrative outcomes among Australian Defence Force personnel with varying BMI. Methods Personnel were grouped into cohorts according to the following ranges for (BMI: normal (18.5 − 24.9 kg/m2; n = 197, overweight (25–29.9 kg/m2; n = 154 and obese (≥30 kg/m2 with restricted body fat (≤28% for females, ≤24% for males (n = 148 and with no restriction on body fat (n = 180. Medical records for each individual were audited retrospectively to record the incidence of injury and illness, absenteeism, productivity, healthcare usage (i.e., consultation with medical specialists, hospital stays, medical investigations, prescriptions and administrative outcomes (e.g., discharge from service over one year. These data were then grouped and compared between the cohorts. Results The prevalence of injury and illness, cost of medical specialist consultations and cost of medical scans were all higher (p  Conclusions High BMI in the military increases healthcare usage, but does not disrupt workforce maintenance. The greater prevalence of injury and illness, greater healthcare usage and lower productivity in obese Australian Defence Force personnel is not related to higher levels of body fat.

  7. Study protocol: Evaluating the impact of a rural Australian primary health care service on rural health

    OpenAIRE

    Buykx Penny; Kinsman Leigh; Humphreys John S; Tham Rachel; Asaid Adel; Tuohey Kathy

    2011-01-01

    Abstract Background Rural communities throughout Australia are experiencing demographic ageing, increasing burden of chronic diseases, and de-population. Many are struggling to maintain viable health care services due to lack of infrastructure and workforce shortages. Hence, they face significant health disadvantages compared with urban regions. Primary health care yields the best health outcomes in situations characterised by limited resources. However, few rigorous longitudinal evaluations ...

  8. Stress and health-promoting attributes in Australian, New Zealand, and Chilean dental students.

    Science.gov (United States)

    Gambetta-Tessini, Karla; Mariño, Rodrigo; Morgan, Mike; Evans, Wendell; Anderson, Vivienne

    2013-06-01

    This study investigated stress levels and health-promoting attributes (sense of coherence, social support, and coping strategies) in dental students using a Salutogenic approach. All dental students (n=2,049) from two Australian universities, two Chilean universities, and one New Zealand university were invited to participate in this cross-sectional study. The questionnaire covered sociodemographic and career choice questions, Perceived Stress Scale, Orientation to Life Questionnaire, Multidimensional Scale of Perceived Social Support, and Brief COPE scale. A total of 897 students participated, for a 44 percent response rate. Students' mean age was 22.1 (SD=2.7). The majority were females (59.3 percent). Students reported moderate stress, moderate sense of coherence (SOC), and high levels of social support. Significant differences in the SOC scores by country were reported. The linear regression model for stress explained 44 percent of the variance, in which SOC and social support are negatively associated with stress and the use of maladaptive coping strategies positively predicts high stress. These findings confirm that health-promoting attributes were negatively related to stress in these dental students. This is an initial approach to guide academics in the creation of Salutogenic programs that optimize students' chances to successfully cope with stress.

  9. Psychometric testing of the Jefferson Scale of Empathy Health Profession Students' version with Australian paramedic students.

    Science.gov (United States)

    Williams, Brett; Brown, Ted; Boyle, Malcolm; Dousek, Simon

    2013-03-01

    Evidence now suggests that improved empathic behaviors can have a positive impact on healthcare outcomes. Therefore, having psychometrically-sound empathy scales is important for healthcare educators. In this study, the factor structure of the 20-item Jefferson Scale Empathy-Health Profession Students' version, when completed by a group of undergraduate paramedic students from a large Australian university, was investigated. Data from the Scale completed by 330 paramedic students were analyzed using principal components analysis followed by a maximum likelihood confirmatory factor analysis to test goodness of fit to the sample data. Two factors emerged from the principal components analysis, "compassionate care" and "perspective taking", accounting for 44.2% of the total variance. The 17-item two-factor model produced good model fit and good reliability estimates. Three of the original items did not fit the model. Results from the confirmatory factor analysis suggest that the 17-item Jefferson Scale Empathy-Health Profession Students' version is a valid and reliable measure for undergraduate paramedic students' empathy levels.

  10. Mental health first aid responses of the public: results from an Australian national survey

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    Kitchener Betty A

    2005-02-01

    Full Text Available Abstract Background The prevalence of mental disorders is so high that members of the public will commonly have contact with someone affected. How they respond to that person (the mental health first aid response may affect outcomes. However, there is no information on what members of the public might do in such circumstances. Methods In a national survey of 3998 Australian adults, respondents were presented with one of four case vignettes and asked what they would do if that person was someone they had known for a long time and cared about. There were four types of vignette: depression, depression with suicidal thoughts, early schizophrenia, and chronic schizophrenia. Verbatim responses to the open-ended question were coded into categories. Results The most common responses to all vignettes were to encourage professional help-seeking and to listen to and support the person. However, a significant minority did not give these responses. Much less common responses were to assess the problem or risk of harm, to give or seek information, to encourage self-help, or to support the family. Few respondents mentioned contacting a professional on the person's behalf or accompanying them to a professional. First aid responses were generally more appropriate in women, those with less stigmatizing attitudes, and those who correctly identified the disorder in the vignette. Conclusions There is room for improving the range of mental health first aid responses in the community. Lack of knowledge of mental disorders and stigmatizing attitudes are important barriers to effective first aid.

  11. Success Factors Associated with Health Information Systems Implementation: A study of an Australian Regional Hospital

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    Carmine Sellitto

    2014-09-01

    Full Text Available This paper identifies five factors from the literature that are important for the successful implementation of health information systems (HIS. The HIS factors identified include stakeholder engagement, the support of management and local champions, understanding HIS imposed change, user training and the impact of government incentives. The paper further explored the introduction of a commonly used HIS (Medical Director® in a regional Australian hospital and used the implementation factors as a guide for reporting stakeholder perceptions of the system. The implementation of the HIS in view of the systems users was a failure with all factors except the training issues poorly addressed. The study also reports the practicalities encountered with the system’s introduction and documents several new operational factors that were found to be associated with HIS implementation. Overall, the factors provided a sound criterion on which to judge the implementation performance (success or otherwise of the HIS. The factors identified have the potential to be used as a guide by others who are engaged with information systems in the health area.

  12. THE IMPACT OF THE HEALTH SYSTEM DETERMINANTS

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    STAMATIN Ovidiu

    2012-12-01

    Full Text Available Social determinants usually identified as factors that influence health and health equity, including equity, such as housing, employment and education - factors of "upstream". More and more evidence from a variety of areas indicate that health systems are themselves factors of social determinants. They are seen more frequently as determinants of "downstream" type - as means of access to health services for disadvantaged groups, and this shows how health systems have significant influence, affecting the socio-political and economic environment

  13. Australians with osteoarthritis: satisfaction with health care providers and the perceived helpfulness of treatments and information sources

    OpenAIRE

    Basedow, Martin; Hibbert,Peter; Hooper,Tamara; Runciman, William; Esterman, Adrian

    2016-01-01

    Martin Basedow,1 Peter Hibbert,1 Tamara Hooper,1 William Runciman,1 Adrian Esterman,2 1School of Psychology, Social Work and Social Policy, 2School of Nursing and Midwifery, University of South Australia, Adelaide, SA, Australia Objective: The aim of this study was to evaluate the satisfaction of Australian patients who suffer from osteoarthritis (OA) with their health care providers and the perceived helpfulness of treatments and information sources. Methods: A self-administered questionnair...

  14. Mental health impacts of racial discrimination in Australian culturally and linguistically diverse communities: a cross-sectional survey

    OpenAIRE

    Ferdinand, Angeline S; Paradies, Yin; Kelaher, Margaret

    2015-01-01

    Background Racial discrimination denies those from racial and ethnic minority backgrounds access to rights such as the ability to participate equally and freely in community and public life, equitable service provision and freedom from violence. Our study was designed to examine how people from racial and ethnic minority backgrounds in four Australian localities experience and respond to racial discrimination, as well as associated health impacts. Methods Data were collected from 1,139 Austra...

  15. Consistency of denominator data in electronic health records in Australian primary healthcare services: enhancing data quality.

    Science.gov (United States)

    Bailie, Ross; Bailie, Jodie; Chakraborty, Amal; Swift, Kevin

    2015-01-01

    The quality of data derived from primary healthcare electronic systems has been subjected to little critical systematic analysis, especially in relation to the purported benefits and substantial investment in electronic information systems in primary care. Many indicators of quality of care are based on numbers of certain types of patients as denominators. Consistency of denominator data is vital for comparison of indicators over time and between services. This paper examines the consistency of denominator data extracted from electronic health records (EHRs) for monitoring of access and quality of primary health care. Data collection and analysis were conducted as part of a prospective mixed-methods formative evaluation of the Commonwealth Government's Indigenous Chronic Disease Package. Twenty-six general practices and 14 Aboriginal Health Services (AHSs) located in all Australian States and Territories and in urban, regional and remote locations were purposively selected within geographically defined locations. Percentage change in reported number of regular patients in general practices ranged between -50% and 453% (average 37%). The corresponding figure for AHSs was 1% to 217% (average 31%). In approximately half of general practices and AHSs, the change was ≥ 20%. There were similarly large changes in reported numbers of patients with a diagnosis of diabetes or coronary heart disease (CHD), and Indigenous patients. Inconsistencies in reported numbers were due primarily to limited capability of staff in many general practices and AHSs to accurately enter, manage, and extract data from EHRs. The inconsistencies in data required for the calculation of many key indicators of access and quality of care places serious constraints on the meaningful use of data extracted from EHRs. There is a need for greater attention to quality of denominator data in order to realise the potential benefits of EHRs for patient care, service planning, improvement, and policy. We

  16. Review of Australian health economic evaluation – 245 interventions: what can we say about cost effectiveness?

    Directory of Open Access Journals (Sweden)

    Mortimer Duncan

    2008-05-01

    Full Text Available Abstract Background There is an increasing body of published cost-utility analyses of health interventions which we sought to draw together to inform research and policy. Methods To achieve consistency in costing base and policy context, study scope was limited to Australian-based cost-effectiveness analyses. Through a comprehensive literature review we identified 245 health care interventions that met our study criteria. Results The median cost-effectiveness ratio was A$18,100 (~US$13,000 per QALY/DALY/LY (quality adjusted life year gained or, disability adjusted life year averted or life year gained. Some modalities tended to perform worse, such as vaccinations and diagnostics (median cost/QALY $58,000 and $68,000 respectively, than others such as allied health, lifestyle, in-patient interventions (median cost/QALY/DALY/LY all at ~A$9,000~US$6,500. Interventions addressing some diseases such as diabetes and impaired glucose tolerance or alcohol and drug dependence tended to perform well (median cost/QALY/DALY/LY 25 years (median cost/QALY/DALY/LY Conclusion For any given condition, modality or setting there are likely to be examples of interventions that are cost effective and cost ineffective. It will be important for decision makers to make decisions based on the individual merits of an intervention rather than rely on broad generalisations. Further evaluation is warranted to address gaps in the literature and to ensure that evaluations are performed in areas with greatest potential benefit.

  17. The Australian DREEM: evaluating student perceptions of academic learning environments within eight health science courses

    Directory of Open Access Journals (Sweden)

    Ted Brown

    2011-09-01

    Full Text Available Objectives: The purpose of this cross sectional study is to investigate student perceptions of learning environments at a major Australian University. Various aspects of environment are compared between courses, year levels, educational backgrounds and gender. Methods: The Dundee Ready Education Environment Measure (DREEM and a demographic questionnaire were completed by 548 undergraduate students enrolled in the emergency health, midwifery, radiography and medical imaging, occupational therapy, pharmacy, nutrition and dietetics, physiotherapy and social work courses at Monash University. Convenience sampling was used and scores were compared across grouping variables identified via demographic information. Results: Scores across the sample were fairly high (M = 137.3; SD = 18.3, indicating an overall positive perception of learning environments among students. Total scores were significantly higher for females (M = 138.8; SD = 17.2 than males (M = 132.3; SD = 20.7; t[sub](545[/sub] = 3.51; p = 0.002 and this trend was consistent across all aspects of perceived learning environment (although not always significant. Students who enrolled in their course directly after completing high school yielded less positive ratings on some DREEM subscales than students who did not enrol immediately after completing high school. Conclusions: The positive perception held by Monash University health science students towards their education and learning environments is hopefully indicative of similar courses within Australia and internationally. While future studies may help confirm this, the current findings offer a chance to explore the underlying causes of this positivity in more depth as well as compare similarities and differences between the specific health science disciplines.

  18. What matters for working fathers? Job characteristics, work-family conflict and enrichment, and fathers' postpartum mental health in an Australian cohort.

    Science.gov (United States)

    Cooklin, Amanda R; Giallo, Rebecca; Strazdins, Lyndall; Martin, Angela; Leach, Liana S; Nicholson, Jan M

    2015-12-01

    One in ten fathers experience mental health difficulties in the first year postpartum. Unsupportive job conditions that exacerbate work-family conflict are a potential risk to fathers' mental health given that most new fathers (95%) combine parenting with paid work. However, few studies have examined work-family conflict and mental health for postpartum fathers specifically. The aim of the present study was to identify the particular work characteristics (e.g., work hours per week, job quality) associated with work-family conflict and enrichment, and fathers' mental health in the postpartum period. Survey data from 3243 fathers of infants (aged 6-12 months) participating in the Longitudinal Study of Australian Children were analysed via path analysis, considering key confounders (age, education, income, maternal employment, maternal mental health and relationship quality). Long and inflexible work hours, night shift, job insecurity, a lack of autonomy and more children in the household were associated with increased work-family conflict, and this was in turn associated with increased distress. Job security, autonomy, and being in a more prestigious occupation were positively associated with work-family enrichment and better mental health. These findings from a nationally representative sample of Australian fathers contribute novel evidence that employment characteristics, via work-family conflict and work-family enrichment, are key determinants of fathers' postnatal mental health, independent from established risk factors. Findings will inform the provision of specific 'family-friendly' conditions protective for fathers during this critical stage in the family life-cycle, with implications for their wellbeing and that of their families.

  19. What matters for working fathers? Job characteristics, work-family conflict and enrichment, and fathers' postpartum mental health in an Australian cohort.

    Science.gov (United States)

    Cooklin, Amanda R; Giallo, Rebecca; Strazdins, Lyndall; Martin, Angela; Leach, Liana S; Nicholson, Jan M

    2015-12-01

    One in ten fathers experience mental health difficulties in the first year postpartum. Unsupportive job conditions that exacerbate work-family conflict are a potential risk to fathers' mental health given that most new fathers (95%) combine parenting with paid work. However, few studies have examined work-family conflict and mental health for postpartum fathers specifically. The aim of the present study was to identify the particular work characteristics (e.g., work hours per week, job quality) associated with work-family conflict and enrichment, and fathers' mental health in the postpartum period. Survey data from 3243 fathers of infants (aged 6-12 months) participating in the Longitudinal Study of Australian Children were analysed via path analysis, considering key confounders (age, education, income, maternal employment, maternal mental health and relationship quality). Long and inflexible work hours, night shift, job insecurity, a lack of autonomy and more children in the household were associated with increased work-family conflict, and this was in turn associated with increased distress. Job security, autonomy, and being in a more prestigious occupation were positively associated with work-family enrichment and better mental health. These findings from a nationally representative sample of Australian fathers contribute novel evidence that employment characteristics, via work-family conflict and work-family enrichment, are key determinants of fathers' postnatal mental health, independent from established risk factors. Findings will inform the provision of specific 'family-friendly' conditions protective for fathers during this critical stage in the family life-cycle, with implications for their wellbeing and that of their families. PMID:26520473

  20. The 1997 determination of the Australian standards of exposure and absorbed dose at {sup 60}Co

    Energy Technology Data Exchange (ETDEWEB)

    Huntley, R.B.; Boas, J.F. [Australian Radiation Laboratory, Yallambie, VIC (Australia); Van der Gaast, H. [Australian Nuclear Science and Technology Organisation, Lucas Heights, NSW (Australia)

    1998-05-01

    The arrangements for the maintenance of the Australian standards for {sup 60}Co are described in detail. The primary standards are a graphite cavity chamber for exposure/air kerma and a graphite calorimeter for absorbed dose. These secondary standards are described and their responses in corresponding {sup 90}Sr reference sources are reported. Accurate ratios between the Australian Radiation Laboratory (ARL) and Australian Nuclear Science and Technology (ANSTO) {sup 90}Sr reference sources are derived for use in future calibrations. The value of 28.8 years for the half-life of {sup 90}Sr is confirmed. The usefulness of {sup 90}Sr reference source measurements in quality assurance is discussed. The charge sensitivity and linearity of the ANSTO electrometers are reported by two different methods and are compared with previous results. Calibration factors for all the secondary standard ionization chambers are given, in terms of exposure, air kerma and absorbed dose to water. Calibration factors are also given for most of the chambers in terms of absorbed dose to graphite. The methods of deriving the calibration factors are explained in detail, including all the corrections applied to both the primary and secondary standard measurements. Three alternative methods of deriving the absorbed dose to water calibration factors are compared. The reported calibration factors are compared with previous results. Changes in the Australian units of exposure, air kerma and absorbed dose to graphite and water are derived from changes in the corresponding calibration factors. The Australian units of exposure and air kerma have not changed significantly since 1990. The Australian unit of absorbed dose to graphite is now 1.1 % smaller than in 1993 and 1.3 % smaller than in 1990. The Australian unit of absorbed dose to water is now 1.4 % smaller than in 1993, but is only 0.9 % smaller than in 1990. Comparisons of the Australian standards of exposure/air kerma and absorbed dose with

  1. Issues facing the Australian Health Technology Assessment Review of medical technology funding.

    Science.gov (United States)

    O'Malley, Susanne P

    2010-07-01

    The Australian Health Technology Assessment Review has the potential to have a major effect on the availability of new medical technology and the listing of associated medical procedures on the Medicare Benefits Schedule. Despite this, only about 15% of submissions to the Review came from "medical associations". Pharmaceutical and medical technologies are inherently different, and there are a number of difficulties associated with evaluating medical technology using the same process and evidence levels as those used for pharmaceuticals. The current sequential and lengthy processing of new medical technology and procedures is delaying access to beneficial medical technology and could be substantially reduced. There is currently no effective funding process for medical technology classified as capital equipment or consumables and disposables. This has created a perverse incentive in favour of using funded implantable prostheses based on access to funding rather than superior clinical effectiveness. The existing horizon scanning process could be better used to not only identify all potentially cost-effective new and emerging medical technology and procedures as early as possible, but also to identify gaps in the evidence. PMID:20618111

  2. The Impact of Neurofibromatosis Type 1 on the Health and Wellbeing of Australian Adults.

    Science.gov (United States)

    Crawford, Hilda A; Barton, Belinda; Wilson, Meredith J; Berman, Yemima; McKelvey-Martin, Valerie J; Morrison, Patrick J; North, Kathryn N

    2015-12-01

    The complications of neurofibromatosis type 1 (NF1) are widespread, unpredictable and variable and each person's experience of this disorder is unique. However, few studies have addressed the impact of NF1 from an individual's perspective. This qualitative study aims to identify the ways in which NF1 impacts upon affected Australian adults. Sixty adults with NF1, with a range of disease severity and visibility participated in a semi-structured interview about the ways in which NF1 impacted upon their life and health. Data were analyzed using grounded theory methodology. Results indicated that NF1 impacts upon affected adults in five major ways: 1) cosmetic burden of disease 2) learning difficulties 3) concerns about the risk of passing NF1 to offspring 4) uncertain disease progression, and 5) pain. Participants identified the aspects of NF1 that bothered them the most, creating a hierarchy of NF1 concerns within the cohort. Importantly, mildly affected adults shared many of the same concerns as those more severely affected. This study enhances our current understanding of the impact of NF1 in adulthood, and augments existing recommendations for the care of these patients.

  3. Mental health literacy as a function of remoteness of residence: an Australian national study

    OpenAIRE

    Jorm Anthony F; Christensen Helen; Griffiths Kathleen M

    2009-01-01

    Abstract Background Although there have been many population studies of mental health literacy, little is known about the mental health literacy of people who reside in rural areas. This study sought to determine the impact of remoteness on public knowledge of depression and schizophrenia. Methods The mental health literacy of residents of major cities, inner regional, and outer-remote (including outer regional, remote, and very remote) regions were compared using data from a 2003–04 Australi...

  4. Health beliefs and behavior: the practicalities of "looking after yourself" in an Australian aboriginal community.

    Science.gov (United States)

    Senior, Kate; Chenhall, Richard

    2013-06-01

    Recently, social determinants of health frameworks are receiving some criticism in that they do not engage with questions related to individual subjectivity and agency as they relate to health decision-making behavior. This article examines the different ways in which people living in a remote Arnhem Land community in the Northern Territory of Australia, take responsibility for their own health and the extent to which they are able to prevent illness. A number of related sub-questions are explored relating to how people perceive their health and their role in health care in their community, including their engagement with the health clinic, traditional medicines, and the influence of sorcery on ill health and sickness.

  5. A framework to support team-based models of primary care within the Australian health care system.

    Science.gov (United States)

    Naccarella, Lucio; Greenstock, Louise N; Brooks, Peter M

    2013-09-01

    Health systems with strong primary care orientations are known to be associated with improved equity, better access for patients to appropriate services at lower costs, and improved population health. Team-based models of primary care have emerged in response to health system challenges due to complex patient profiles, patient expectations and health system demands. Successful team-based models of primary care require a combination of interprofessional education and learning; organisational and management policies and systems; and practice support systems. To ensure evidence is put into practice, we propose a framework comprising five domains (theory, implementation, infrastructure, sustainability and evaluation) to assist policymakers, educators, researchers, managers and health professionals in supporting team-based models of primary care within the Australian health care system. PMID:25370088

  6. A framework to support team-based models of primary care within the Australian health care system.

    Science.gov (United States)

    Naccarella, Lucio; Greenstock, Louise N; Brooks, Peter M

    2013-09-01

    Health systems with strong primary care orientations are known to be associated with improved equity, better access for patients to appropriate services at lower costs, and improved population health. Team-based models of primary care have emerged in response to health system challenges due to complex patient profiles, patient expectations and health system demands. Successful team-based models of primary care require a combination of interprofessional education and learning; organisational and management policies and systems; and practice support systems. To ensure evidence is put into practice, we propose a framework comprising five domains (theory, implementation, infrastructure, sustainability and evaluation) to assist policymakers, educators, researchers, managers and health professionals in supporting team-based models of primary care within the Australian health care system.

  7. Does Further Education in Adulthood Improve Physical and Mental Health among Australian Women? A Longitudinal Study.

    Directory of Open Access Journals (Sweden)

    Leigh Tooth

    Full Text Available We analyzed whether further education in young adult and mid-life [adult educational mobility] influences physical functioning and depressive symptoms in women.14247 women born 1973-78 (younger cohort and 13715 women born 1946-51 (mid-aged cohort from the Australian Longitudinal Study on Women's Health were followed for 14-16 years. Measures were the Short-Form 36 Health Survey physical functioning subscale (SF-36 PF and Centre for Epidemiologic Studies 10-item Depression Scale (CESD-10. Linear mixed modelling, accounting for time varying covariates, assessed the influence of further education on physical functioning and depressive symptoms over time. Sensitivity analysis to assess the impact of missing data was conducted using multiple imputation.Compared to younger women with a pre-existing high level of education, women gaining further education (up to age 39 years from low levels had lower SF-36 PF scores (poorer physical functioning (fully adjusted beta estimates (95%CIs -1.52 (-2.59, -0.44 while those gaining further education from middle to high levels showed equivalent SF-36 PF scores (-0.08 (-0.61, 0.44. A similar pattern was shown for CESD-10 scores (0.78 (0.29, 1.25; -0.02 (-0.26, 0.21, respectively where higher scores represented more depressive symptoms. For mid-age women, further education from a middle to high level resulted in equivalent SF-36 PF scores (-0.61 (-1.93,0.71 but higher CESD-10 scores (0.49 (0.11, 0.86, compared to highly educated women.Women who delay further education until they are aged between their 40s and 60s can improve or maintain their physical functioning but may have missed the critical time to minimise depressive symptomatology. Public health policy should focus on encouraging women to upgrade their educational qualifications earlier in life in order to potentially offset the negative associations between their initial lower socio-economic position class of origin and their mental health.

  8. Development of a national burn network: providing a co-ordinated response to a burn mass casualty disaster within the Australian health system

    Directory of Open Access Journals (Sweden)

    AG Robertson

    2008-01-01

    Full Text Available With the threat of terrorist activity ever present since the incidents in Bali and Jakarta, the Australian health system must be prepared to manage another mass burn casualty disaster. The Australian and New Zealand Burns Association (ANZBA highlighted the lack of a national burn disaster response before the 2000 Olympics. With the limited number of burn beds available and the protracted length of stay after such injuries, any state or territory could be overwhelmed with relatively few patient admissions. In 2002, the Australian Health Minister's Conference called for a solution. The objective of this paper is to provide an overview of the process and development of the Australian National Burn Network, which underpins the National Burn Disaster Response (AUSBURNPLAN.

  9. Stressful life events, social health issues and low birthweight in an Australian population-based birth cohort: challenges and opportunities in antenatal care

    Directory of Open Access Journals (Sweden)

    Sutherland Georgina A

    2011-03-01

    Full Text Available Abstract Background Investment in strategies to promote 'a healthy start to life' has been identified as having the greatest potential to reduce health inequalities across the life course. The aim of this study was to examine social determinants of low birthweight in an Australian population-based birth cohort and consider implications for health policy and health care systems. Methods Population-based survey distributed by hospitals and home birth practitioners to >8000 women six months after childbirth in two states of Australia. Participants were women who gave birth to a liveborn infant in Victoria and South Australia in September/October 2007. Main outcome measures included stressful life events and social health issues, perceived discrimination in health care settings, infant birthweight. Results 4,366/8468 (52% of eligible women returned completed surveys. Two-thirds (2912/4352 reported one or more stressful life events or social health issues during pregnancy. Women reporting three or more social health issues (18%, 768/4352 were significantly more likely to have a low birthweight infant ( Conclusions There is a window of opportunity in antenatal care to implement targeted preventive interventions addressing potentially modifiable risk factors for poor maternal and infant outcomes. Developing the evidence base and infrastructure necessary in order for antenatal services to respond effectively to the social circumstances of women's lives is long overdue.

  10. Occupational risk of overweight and obesity: an analysis of the Australian Health Survey

    Directory of Open Access Journals (Sweden)

    Merom Dafna

    2010-06-01

    protect females in professional and associate professional occupations from overweight. For high-risk occupations lifestyle modification could be included in workplace health promotion programs. Further investigation of gender-specific occupational behaviors and additional lifestyle behaviors to those assessed in the current Australian Health Survey, is indicated.

  11. Australian health professionals' social media (Web 2.0) adoption trends: early 21st century health care delivery and practice promotion.

    Science.gov (United States)

    Usher, Wayne T

    2012-01-01

    This study was concerned with identifying reasons behind patterns of social media (Web 2.0) usage associated with eight of Australia's major health professions. Attention was given to uncovering some of the more significant motivations for the resistance or adoption of Web 2.0 technologies for health care delivery and practice promotion by Australian health professionals. Surveys were developed from a common set of questions with specific variations between professions negotiated with professional health societies. Survey questions were constructed in an attempt to identify Web 2.0 adoption trends. An online survey (www.limesurvey.org) was used to collect data. Initial data preparation involved the development of one integrated SPSS file to incorporate all responses from the eight surveys undertaken. Initial data analysis applied Frequencies and Crosstabs to the identified groups and provided a profile of respondents by key business and demographic characteristics. Of the 935 respondents, 9.5% of participants indicated that they used Web 2.0 for their professional work, 19.1% of them did not use it for work but used it for their personal needs and 71.3% of them did not use Web 2.0 at all. Participants have indicated that the main reason for 'choosing not to adopt' Web 2.0 applications as a way of delivering health care to their patients is due to the health professionals' lack of understanding of Web 2.0 (83.3%), while the main reason for 'choosing to adopt' Web 2.0 applications is the perception of Web 2.0 as a quick and effective method of communication (73.0%). This study has indicated that Australian health professionals 'choose not to adopt' Web 2.0 usage as a way of delivering health care primarily due to 'a lack of understanding as to how social media would be used in health care' (83.3%). This study identifies that Australian health professionals are interacting with Web 2.0 technologies in their private lives but are failing to see how such technologies

  12. Role of Dietary Pattern Analysis in Determining Cognitive Status in Elderly Australian Adults

    Directory of Open Access Journals (Sweden)

    Kimberly Ashby-Mitchell

    2015-02-01

    Full Text Available Principal Component Analysis (PCA was used to determine the association between dietary patterns and cognitive function and to examine how classification systems based on food groups and food items affect levels of association between diet and cognitive function. The present study focuses on the older segment of the Australian Diabetes, Obesity and Lifestyle Study (AusDiab sample (age 60+ that completed the food frequency questionnaire at Wave 1 (1999/2000 and the mini-mental state examination and tests of memory, verbal ability and processing speed at Wave 3 (2012. Three methods were used in order to classify these foods before applying PCA. In the first instance, the 101 individual food items asked about in the questionnaire were used (no categorisation. In the second and third instances, foods were combined and reduced to 32 and 20 food groups, respectively, based on nutrient content and culinary usage—a method employed in several other published studies for PCA. Logistic regression analysis and generalized linear modelling was used to analyse the relationship between PCA-derived dietary patterns and cognitive outcome. Broader food group classifications resulted in a greater proportion of food use variance in the sample being explained (use of 101 individual foods explained 23.22% of total food use, while use of 32 and 20 food groups explained 29.74% and 30.74% of total variance in food use in the sample, respectively. Three dietary patterns were found to be associated with decreased odds of cognitive impairment (CI. Dietary patterns derived from 101 individual food items showed that for every one unit increase in ((Fruit and Vegetable Pattern: p = 0.030, OR 1.061, confidence interval: 1.006–1.118; (Fish, Legumes and Vegetable Pattern: p = 0.040, OR 1.032, confidence interval: 1.001–1.064; (Dairy, Cereal and Eggs Pattern: p = 0.003, OR 1.020, confidence interval: 1.007–1.033, the odds of cognitive impairment decreased. Different

  13. Determinants of Oral Health: Does Oral Health Literacy Matter?

    OpenAIRE

    Mohammad Mehdi Naghibi Sistani; Reza Yazdani; Jorma Virtanen; Afsaneh Pakdaman; Heikki Murtomaa

    2013-01-01

    Objective. To evaluate oral health literacy, independent of other oral health determinants, as a risk indicator for self-reported oral health. Methods. A cross-sectional population-based survey conducted in Tehran, Iran. Multiple logistic regression analysis served to estimate the predictive effect of oral health literacy on self-reported oral health status (good versus poor) controlling for socioeconomic and demographic factors and tooth-brushing behavior. Results. In all, among 1031 partici...

  14. Accounting for Trust: A Conceptual Model for the Determinants of Trust in the Australian Public Accountant – SME Client Relationship

    Directory of Open Access Journals (Sweden)

    Michael Cherry

    2016-06-01

    Full Text Available This paper investigates trust as it relates to the relationship between Australia’s public accountants and their SME clients. It describes the contribution of the accountancy profession to the SME market, as well as the key challenges faced by accountants and their SME clients. Following the review of prior scholarly studies, a working definition of trust as it relates to this important relationship is also developed and presented. A further consequence of prior academic work is the development of a comprehensive conceptual model to describe the determinants of trust in the Australian public accountant – SME client relationship, which requires testing via empirical studies.

  15. Reducing psychological distress and obesity in Australian farmers by promoting physical activity

    OpenAIRE

    McCoombe Scott; Chandrasekara Ananda; Brumby Susan; Torres Susan; Kremer Peter; Lewandowski Paul

    2011-01-01

    Abstract Background Studies have confirmed that the rate of mental illness is no higher in rural Australians than that of urban Australians. However, the rate of poor mental health outcomes, and in particular suicide, is significantly raised in rural populations. This is thought to be due to lack of early diagnosis, health service access, the distance-decay effect, poor physical health determinants and access to firearms. Research conducted by the National Centre for Farmer Health between 200...

  16. Integrating relationship- and research-based approaches in Australian health promotion practice.

    Science.gov (United States)

    Klinner, Christiane; Carter, Stacy M; Rychetnik, Lucie; Li, Vincy; Daley, Michelle; Zask, Avigdor; Lloyd, Beverly

    2015-12-01

    We examine the perspectives of health promotion practitioners on their approaches to determining health promotion practice, in particular on the role of research and relationships in this process. Using Grounded Theory methods, we analysed 58 semi-structured interviews with 54 health promotion practitioners in New South Wales, Australia. Practitioners differentiated between relationship-based and research-based approaches as two sources of knowledge to guide health promotion practice. We identify several tensions in seeking to combine these approaches in practice and describe the strategies that participants adopted to manage these tensions. The strategies included working in an evidence-informed rather than evidence-based way, creating new evidence about relationship-based processes and outcomes, adopting 'relationship-based' research and evaluation methods, making research and evaluation useful for communities, building research and evaluation skills and improving collaboration between research and evaluation and programme implementation staff. We conclude by highlighting three systemic factors which could further support the integration of research-based and relationship-based health promotion practices: (i) expanding conceptions of health promotion evidence, (ii) developing 'relationship-based' research methods that enable practitioners to measure complex social processes and outcomes and to facilitate community participation and benefit, and (iii) developing organizational capacity.

  17. Integrating relationship- and research-based approaches in Australian health promotion practice.

    Science.gov (United States)

    Klinner, Christiane; Carter, Stacy M; Rychetnik, Lucie; Li, Vincy; Daley, Michelle; Zask, Avigdor; Lloyd, Beverly

    2015-12-01

    We examine the perspectives of health promotion practitioners on their approaches to determining health promotion practice, in particular on the role of research and relationships in this process. Using Grounded Theory methods, we analysed 58 semi-structured interviews with 54 health promotion practitioners in New South Wales, Australia. Practitioners differentiated between relationship-based and research-based approaches as two sources of knowledge to guide health promotion practice. We identify several tensions in seeking to combine these approaches in practice and describe the strategies that participants adopted to manage these tensions. The strategies included working in an evidence-informed rather than evidence-based way, creating new evidence about relationship-based processes and outcomes, adopting 'relationship-based' research and evaluation methods, making research and evaluation useful for communities, building research and evaluation skills and improving collaboration between research and evaluation and programme implementation staff. We conclude by highlighting three systemic factors which could further support the integration of research-based and relationship-based health promotion practices: (i) expanding conceptions of health promotion evidence, (ii) developing 'relationship-based' research methods that enable practitioners to measure complex social processes and outcomes and to facilitate community participation and benefit, and (iii) developing organizational capacity. PMID:24800758

  18. Health literacy and the social determinants of health

    DEFF Research Database (Denmark)

    Rowlands, Gillian; Shaw, Adrienne; Jaswal, Sabrena;

    2015-01-01

    Health literacy, 'the personal characteristics and social resources needed for individuals and communities to access, understand, appraise and use information and services to make decisions about health', is key to improving peoples' control over modifiable social determinants of health (SDH...... and culture. Basic (functional) health literacy skills were needed to gather and understand information. More complex interactive health literacy skills were needed to evaluate the importance and relevance of information in context, and make health decisions. Critical health literacy skills could be used......). This study listened to adult learners to understand their perspectives on gathering, understanding and using information for health. This qualitative project recruited participants from community skills courses to identify relevant 'health information' factors. Subsequently different learners put...

  19. Profiling the Australian Consumer of Complementary and Alternative Medicine: A Secondary Analysis of National Health Survey Data.

    Science.gov (United States)

    Leach, Matthew J

    2016-07-01

    Background • Consumers' interest in complementary and alternative medicine (CAM) has escalated in the past few decades. Some observers argue that the changing needs and expectations of consumers are driving the surge. Although some studies support that notion, much of the research has been limited methodologically. Profiling can provide important insights into the distinct needs of CAM consumers. Objective • The study intended to profile consumers of CAM in Australia. Design • The study was a secondary analysis of 5 Australian National Health Surveys conducted between 1989 and 2008. Outcome Measures • The study measured the differences between CAM users and nonusers in terms of: (1) predisposing factors (ie, the prevailing conditions that predispose an individual to use a health service, such as age); (2) enabling factors (ie, circumstances that facilitate or hinder health service use, such as income); (3) need factors (ie, an actual or perceived need for health services, such as poor health); and (4) personal health practices (ie, behaviors that influence health status, such as alcohol consumption). Results • The 5 surveys provided data for 181 549 Australian adults and children. Predisposing factors associated with CAM use were (1) being aged >40 y, (2) being female, (3) being married, and (4) holding a postsecondary school qualification. Significant enablers of CAM use were (1) high income, (2) private health insurance, and (3) employment. As for personal health practices, CAM users had significantly higher odds of (1) being physically active, (2) being a nonsmoker, and (3) meeting national recommendations for intake of fruits and vegetables. The prevalence of chronic disease and the use of pharmaceutical agents and health services were comparatively high among CAM users. Conclusions • CAM consumers reported relatively healthier lifestyles compared with nonusers, although some data indicated that CAM users might have greater health care needs. The

  20. Health-related expenditure patterns in selected migrant groups: data from the Australian Household Expenditure Survey, 1984.

    Science.gov (United States)

    Powles, J; Hage, B; Cosgrove, M

    1990-01-01

    Australians born in Italy, Greece and East and South East Asia all have substantially lower mortality levels than those born in Australia, the British Isles or Holland and Germany. Using data from the 1984 Household Expenditure Survey, the health-related consumption expenditure of these six groups was compared (excluding expenditure on medical care). The heterogeneity of household types was largely removed by confining attention to married couple households with dependent children. The two groups with mortality levels comparable to those of the Australian-born (British Isles and Holland/Germany) also shared a similar pattern of consumption expenditures. There was a tendency (not always fully consistent), for the low mortality groups to spend more on fruits, vegetables, cereal products and fish and substantially less on alcohol. Patterns that might be 'unexpected' in low mortality groups are the (presumptively) substantial expenditures on tobacco among males (especially in the Greek group) and the substantial expenditures on red meat in all three groups. Analysis of available data sets such as this can provide useful descriptions of the distribution of health-influencing behaviour in our population.

  1. Education resources in remote Australian Indigenous community dog health programs: a comparison of community and extra-community-produced resources.

    Science.gov (United States)

    Constable, Sophie Elizabeth; Dixon, Roselyn May; Dixon, Robert John

    2013-09-01

    Commercial dog health programs in Australian Indigenous communities are a relatively recent occurrence. Health promotion for these programs is an even more recent development, and lacks data on effective practices. This paper analyses 38 resources created by veterinary-community partnerships in Indigenous communities, to 71 resources available through local veterinary service providers. On average, community-produced resources used significantly more of the resource area as image, more imagery as communicative rather than decorative images, larger fonts and smaller segments of text and used images of people with a range of skin tones. As well as informal registers of Standard Australian English, community-produced resources used Aboriginal English and/or Creole languages in their text, while extra-community (EC)-produced resources did not. The text of EC resources had Flesh-Kincaid reading grade levels that excluded a large proportion of community recipients. Also, they did not cover some topics of importance in communities, used academic, formal and technical language, and did not depict people of a representative range of skin tones. As such, community-produced resources were more relevant to the unique situations in remote communities, while EC resources were often inappropriate and in some cases could even distance recipients by using inappropriate language, formats and imagery.

  2. Hardiness as a predictor of mental health and well-being of Australian army reservists on and after stability operations.

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    Orme, Geoffrey J; Kehoe, E James

    2014-04-01

    This study tested whether cognitive hardiness moderates the adverse effects of deployment-related stressors on health and well-being of soldiers on short-tour (4-7 months), peacekeeping operations. Australian Army reservists (N = 448) were surveyed at the start, end, and up to 24 months after serving as peacekeepers in Timor-Leste or the Solomon Islands. They retained sound mental health throughout (Kessler 10, Post-Traumatic Checklist-Civilian, Depression Anxiety Stress Scale 42). Ratings of either traumatic or nontraumatic stress were low. Despite range restrictions, scores on the Cognitive Hardiness Scale moderated the relationship between deployment stressors and a composite measure of psychological distress. Scatterplots revealed an asymmetric pattern for hardiness scores and measures of psychological distress. When hardiness scores were low, psychological distress scores were widely dispersed. However, when hardiness scores were higher, psychological distress scores became concentrated at a uniformly low level.

  3. The foot-health of people with diabetes in a regional Australian population: a prospective clinical audit

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    Perrin Byron M

    2012-03-01

    Full Text Available Abstract Background There is limited understanding of the foot-health of people with diabetes in Australian regional areas. The aim of this study was to document the foot-health of people with diabetes who attend publically funded podiatric services in a regional Australian population. Methods A three month prospective clinical audit was undertaken by the publically-funded podiatric services of a large regional area of Victoria, Australia. The primary variables of interest were the University of Texas (UT diabetic foot risk classification of each patient and the incidence of new foot ulceration during the study period. Age, gender, diabetes type, duration of diabetes and the podiatric service the patients attended were the other variables of interest. Results Five hundred and seventy six patients were seen during the three month period. Over 49% had a UT risk classification at a level at least peripheral neuropathy or more serious diabetes-related foot morbidity. Higher risk at baseline was associated with longer duration of diabetes (F = 31.7, p χ2 = 40.3, p 0.001 and type 1 diabetes (χ2 = 37.3, p 0.001. A prior history of foot pathology was the overwhelming predictor for incident ulceration during the time period (OR 8.1 (95% CI 3.6 to 18.2, p Conclusions The publically funded podiatric services of this large regional area of Australia deal with a disproportionally large number of people with diabetes at high risk of future diabetes-related foot complications. These findings may be useful in ensuring appropriate allocation of resources for future public health services involved in diabetic foot health service delivery in regional areas.

  4. Are Australian and United States Farmers Using Soil Information for Soil Health Management?

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    Lisa Lobry de Bruyn

    2016-03-01

    Full Text Available Soil health is an essential requirement of a sustainable, functioning agroecosystem. Tracking soil health to determine sustainability at the local level largely falls to farmers, even though they often lack access to critical information. We examine farmers’ participation in gathering soil information at the farm and paddock scale over the last two decades in Australia and the United States, by reviewing national-level reporting of farmer use of soil testing and farm planning as well as qualitative research on farmer perspectives. The level of participation in soil testing and farm planning has remained stable in the last two decades, with only 25% and 30% of landholders, respectively, participating nationally, in either country. The review revealed national-level reporting has a number of limitations in understanding farmers’ use of soil information and, in particular, fails to indicate the frequency and intensity of soil testing as well as farmer motivation to test soil or what they did with the soil information. The main use of soil testing is often stated as “determining fertilizer requirements”, yet data show soil testing is used less commonly than is customary practice. In Australia and in the United States, customary practice is three and half times more likely for decisions on fertilizer application levels. The rhetoric is heavy on the use of soil testing as a decision tool, and that it guides best practices. However, given that only a quarter of farmers are soil testing, and doing so infrequently and in low densities, the level of information on soil health is poor. While farmers report consistent monitoring of soil conditions, few have consistent records of such. In contrast to the information on the poor state of soil health, there is strong farmer interest in procuring soil health benefits through changes in farm practices such as conservation tillage or cover crops, even if they are unable to demonstrate these soil health

  5. Determination of Enantiomeric Distribution of Terpenes for Quality Assessment of Australian Tea Tree Oil.

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    Davies, Noel W; Larkman, Tony; Marriott, Philip J; Khan, Ikhlas A

    2016-06-15

    A number of papers have appeared in recent years proposing the use of enantiomeric ratios of key monoterpenes in Australian tea tree oil (TTO) for detection of adulterated oils. There are however a range of reported values, even from exactly the same suite of authentic oils, and we address here probable reasons for these differences and stress the importance of establishing reference ratios within each laboratory based on oils of known provenance. Any biological variation in the ratio for the key terpene terpinen-4-ol has been demonstrated to be effectively unmeasurable, because the standard deviation on multiple measurements of the same oil is of the same order as that of multiple authentic oils.

  6. Determining death anxiety among health school students

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    Gülay Taşdemir; Fadime Gök

    2012-01-01

    Aim: The descriptive study has been done in order to determination thoughts, feelings and death anxiety in health school students.Methods: The descriptive study has been done in order to determination death anxiety in students. This study includes 330 students attending Pamukkale University Denizli School of Health. Sample is comprised of 244 students who accepted to enrolled in the study between 01st-31th of May, 2009. Data have been collected with using a questionnaire and “Thorson-Powell ...

  7. Mental health first aid for Indigenous Australians: using Delphi consensus studies to develop guidelines for culturally appropriate responses to mental health problems

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    Hart, Laura M; Jorm, Anthony F; Kanowski, Leonard G; Kelly, Claire M; Langlands, Robyn L

    2009-01-01

    Background Ethnic minority groups are under-represented in mental health care services because of barriers such as poor mental health literacy. In 2007, the Mental Health First Aid (MHFA) program implemented a cultural adaptation of its first aid course to improve the capacity of Indigenous Australians to recognise and respond to mental health issues within their own communities. It became apparent that the content of this training would be improved by the development of best practice guidelines. This research aimed to develop culturally appropriate guidelines for providing first aid to an Australian Aboriginal or Torres Strait Islander person who is experiencing a mental health crisis or developing a mental illness. Methods A panel of Australian Aboriginal people who are experts in Aboriginal mental health, participated in six independent Delphi studies investigating depression, psychosis, suicidal thoughts and behaviours, deliberate self-injury, trauma and loss, and cultural considerations. The panel varied in size across the studies, from 20-24 participants. Panellists were presented with statements about possible first aid actions via online questionnaires and were encouraged to suggest additional actions not covered by the survey content. Statements were accepted for inclusion in a guideline if they were endorsed by ≥ 90% of panellists as essential or important. Each study developed one guideline from the outcomes of three Delphi questionnaire rounds. At the end of the six Delphi studies, participants were asked to give feedback on the value of the project and their participation experience. Results From a total of 1,016 statements shown to the panel of experts, 536 statements were endorsed (94 for depression, 151 for psychosis, 52 for suicidal thoughts and behaviours, 53 for deliberate self-injury, 155 for trauma and loss, and 31 for cultural considerations). The methodology and the guidelines themselves were found to be useful and appropriate by the

  8. Mental health first aid for Indigenous Australians: using Delphi consensus studies to develop guidelines for culturally appropriate responses to mental health problems

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    Kelly Claire M

    2009-08-01

    Full Text Available Abstract Background Ethnic minority groups are under-represented in mental health care services because of barriers such as poor mental health literacy. In 2007, the Mental Health First Aid (MHFA program implemented a cultural adaptation of its first aid course to improve the capacity of Indigenous Australians to recognise and respond to mental health issues within their own communities. It became apparent that the content of this training would be improved by the development of best practice guidelines. This research aimed to develop culturally appropriate guidelines for providing first aid to an Australian Aboriginal or Torres Strait Islander person who is experiencing a mental health crisis or developing a mental illness. Methods A panel of Australian Aboriginal people who are experts in Aboriginal mental health, participated in six independent Delphi studies investigating depression, psychosis, suicidal thoughts and behaviours, deliberate self-injury, trauma and loss, and cultural considerations. The panel varied in size across the studies, from 20-24 participants. Panellists were presented with statements about possible first aid actions via online questionnaires and were encouraged to suggest additional actions not covered by the survey content. Statements were accepted for inclusion in a guideline if they were endorsed by ≥ 90% of panellists as essential or important. Each study developed one guideline from the outcomes of three Delphi questionnaire rounds. At the end of the six Delphi studies, participants were asked to give feedback on the value of the project and their participation experience. Results From a total of 1,016 statements shown to the panel of experts, 536 statements were endorsed (94 for depression, 151 for psychosis, 52 for suicidal thoughts and behaviours, 53 for deliberate self-injury, 155 for trauma and loss, and 31 for cultural considerations. The methodology and the guidelines themselves were found to be useful

  9. Integrating collaborative place-based health promotion coalitions into existing health system structures: the experience from one Australian health coalition

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    Carolyn Ehrlich

    2015-12-01

    Full Text Available Background: Increasingly, place-based collaborative partnerships are being implemented to develop the capacity of communities to build supportive environments and improve population health outcomes. These place-based initiatives require cooperative and coordinated responses that can exist within social systems and integrate multiple responses. However, the dynamic interplay between co-existing systems and new ways of working makes implementation outcomes unpredictable. Method: We interviewed eight programme leaders, three programme teams and two advisory groups to explore the capacity of one social system to implement and normalise a collaborative integrated place-based health promotion initiative in the Logan and Beaudesert area in South East Queensland, Australia. The construct of capacity as defined in the General Theory of Implementation was used to develop a coding framework. Data were then placed into conceptually coherent groupings according to this framework until all data could be accounted for. Results: Four themes defined capacity for implementation of a collaborative and integrated response; namely, the ability to (1 traverse a nested and contradictory social landscape, (2 be a responsive and ‘good’ community partner, (3 establish the scaffolding required to work ‘in place’; and (4 build a shared meaning and engender trust. Overall, we found that the capacity of the system to embed a place-based health promotion initiative was severely limited by the absence of these features. Conclusion: Conflict, disruption and constant change within the context into which the place-based collaborative partnership was being implemented meant that existing relationships were constantly undermined and the capacity of the partners to develop trust-based coherent partnerships was constantly diminished. To enhance the likelihood that collaborative and integrated place-based health promotion initiatives will become established ways of working

  10. Integrating collaborative place-based health promotion coalitions into existing health system structures: the experience from one Australian health coalition

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    Carolyn Ehrlich

    2015-12-01

    Full Text Available Background: Increasingly, place-based collaborative partnerships are being implemented to develop the capacity of communities to build supportive environments and improve population health outcomes. These place-based initiatives require cooperative and coordinated responses that can exist within social systems and integrate multiple responses. However, the dynamic interplay between co-existing systems and new ways of working makes implementation outcomes unpredictable.Method: We interviewed eight programme leaders, three programme teams and two advisory groups to explore the capacity of one social system to implement and normalise a collaborative integrated place-based health promotion initiative in the Logan and Beaudesert area in South East Queensland, Australia. The construct of capacity as defined in the General Theory of Implementation was used to develop a coding framework. Data were then placed into conceptually coherent groupings according to this framework until all data could be accounted for.Results: Four themes defined capacity for implementation of a collaborative and integrated response; namely, the ability to (1 traverse a nested and contradictory social landscape, (2 be a responsive and ‘good’ community partner, (3 establish the scaffolding required to work ‘in place’; and (4 build a shared meaning and engender trust. Overall, we found that the capacity of the system to embed a place-based health promotion initiative was severely limited by the absence of these features.Conclusion: Conflict, disruption and constant change within the context into which the place-based collaborative partnership was being implemented meant that existing relationships were constantly undermined and the capacity of the partners to develop trust-based coherent partnerships was constantly diminished. To enhance the likelihood that collaborative and integrated place-based health promotion initiatives will become established ways of working

  11. 'Jumping around': exploring young women's behaviour and knowledge in relation to sexual health in a remote Aboriginal Australian community.

    Science.gov (United States)

    Ireland, Sarah; Narjic, Concepta Wulili; Belton, Suzanne; Saggers, Sherry; McGrath, Ann

    2015-01-01

    Sexual health indicators for young remote-living Aboriginal women are the worst of all of Australian women. This study aimed to describe and explore young women's behaviour and knowledge in relation to sexual health, as well as to provide health professionals with cross-cultural insights to assist with health practice. A descriptive ethnographic study was conducted, which included: extended ethnographic field work in one remote community over a six-year period; community observation and participation; field notes; semi-structured interviews; group reproductive ethno-physiology drawing and language sessions; focus-group sessions; training and employment of Aboriginal research assistants; and consultation and advice from a local reference group and a Cultural Mentor. Findings reveal that young women in this remote community have a very poor biomedical understanding of sexually transmitted infections and contraception. This is further compounded by not speaking English as a first language, low literacy levels and different beliefs in relation to body functions. In their sexual relationships, young women often report experiences involving multiple casual partners, marijuana use and violence. Together, the findings contribute to a better understanding of the factors underlying sexual health inequity among young Aboriginal women in Australia.

  12. The global financial crisis and psychological health in a sample of Australian older adults: a longitudinal study.

    Science.gov (United States)

    Sargent-Cox, Kerry; Butterworth, Peter; Anstey, Kaarin J

    2011-10-01

    Economic stress and uncertainty is argued to increase older adults' vulnerability to physical health decline and mental distress. Nevertheless, there is a paucity of research that examines the relationship between a large historical economic event, such as the recent global financial crisis (GFC), and health outcomes for older adults. This study provides a unique opportunity to compare self-reported health status and psychological functioning (number of depression and anxiety symptoms) in 1973 older Australian adults (mean age of 66.58 years (SD = 1.5)) prior to the GFC (2005-2006), with their status four years later during the GFC period (2009-2010). Latent difference score models revealed a significant difference in depression and anxiety symptoms over the two measurement occasions, indicating poorer psychological functioning for those who reported an impact as a result of the economic slowdown. These effects were not explained by demographic or socio-economic factors. Interaction effects showed that those participants who were surveyed within the acute salience period of the GFC (April to September 2009) were significantly less likely to report poorer psychological health over time compared to those who were surveyed after September 2009. This interesting timing effect is discussed in terms of potential time-lags in the negative effects of economic stress on health outcomes, as well as the possible protective effects of social norms that may be created by a large scale economic crisis. PMID:21831493

  13. Australian rural football club leaders as mental health advocates: an investigation of the impact of the Coach the Coach project

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    Dobell Jennifer

    2010-05-01

    Full Text Available Abstract Background Mental ill health, especially depression, is recognised as an important health concern, potentially with greater impact in rural communities. This paper reports on a project, Coach the Coach, in which Australian rural football clubs were the setting and football coaches the leaders in providing greater mental health awareness and capacity to support early help seeking behaviour among young males experiencing mental health difficulties, especially depression. Coaches and other football club leaders were provided with Mental Health First Aid (MHFA training. Method Pre-post measures of the ability of those club leaders undertaking mental health training to recognise depression and schizophrenia and of their knowledge of evidence supported treatment options, and confidence in responding to mental health difficulties were obtained using a questionnaire. This was supplemented by focus group interviews. Pre-post questionnaire data from players in participating football clubs was used to investigate attitudes to depression, treatment options and ability to recognise depression from a clinical scenario. Key project stakeholders were also interviewed. Results Club leaders (n = 36 who were trained in MHFA and club players (n = 275 who were not trained, participated in this evaluation. More than 50% of club leaders who undertook the training showed increased capacity to recognise mental illness and 66% reported increased confidence to respond to mental health difficulties in others. They reported that this training built upon their existing skills, fulfilled their perceived social responsibilities and empowered them. Indirect benefit to club players from this approach seemed limited as minimal changes in attitudes were reported by players. Key stakeholders regarded the project as valuable. Conclusions Rural football clubs appear to be appropriate social structures to promote rural mental health awareness. Club leaders, including many

  14. Applying what works: a systematic search of the transfer and implementation of promising Indigenous Australian health services and programs

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    McCalman Janya

    2012-08-01

    Full Text Available Abstract Background The transfer and implementation of acceptable and effective health services, programs and innovations across settings provides an important and potentially cost-effective strategy for reducing Indigenous Australians' high burden of disease. This study reports a systematic review of Indigenous health services, programs and innovations to examine the extent to which studies considered processes of transfer and implementation within and across Indigenous communities and healthcare settings. Methods Medline, Informit, Infotrac, Blackwells Publishing, Proquest, Taylor and Francis, JStor, and the Indigenous HealthInfoNet were searched using terms: Aborigin* OR Indigen* OR Torres AND health AND service OR program* OR intervention AND Australia to locate publications from 1992–2011. The reference lists of 19 reviews were also checked. Data from peer reviewed journals, reports, and websites were included. The 95% confidence intervals (95% CI for proportions that referred to and focussed on transfer were calculated as exact binomial confidence intervals. Test comparisons between proportions were calculated using Fisher's exact test with an alpha level of 5%. Results Of 1311 publications identified, 119 (9.1%; 95% CI: 7.6% - 10.8% referred to the transfer and implementation of Indigenous Australian health services or programs, but only 21 studies (1.6%; 95% CI: 1.0% - 2.4% actually focused on transfer and implementation. Of the 119 transfer studies, 37 (31.1%; 95% CI: 22.9 - 40.2% evaluated the impact of a service or program, 28 (23.5%; 95% CI: 16.2% - 32.2% reported only process measures and 54 were descriptive. Of the 37 impact evaluation studies, 28 (75.7%; 95% CI: 58.8% - 88.2% appeared in peer reviewed journals but none included experimental designs. Conclusion While services and programs are being transferred and implemented, few studies focus on the process by which this occurred or the effectiveness of the service or program

  15. E-Mental Health Innovations for Aboriginal and Torres Strait Islander Australians: A Qualitative Study of Implementation Needs in Health Services

    Science.gov (United States)

    Dingwall, Kylie M; Sweet, Michelle; Nagel, Tricia

    2016-01-01

    Background Electronic mental health (e-mental health) interventions offer effective, easily accessible, and cost effective treatment and support for mental illness and well-being concerns. However, e-mental health approaches have not been well utilized by health services to date and little is known about their implementation in practice, particularly in diverse contexts and communities. Objective This study aims to understand stakeholder perspectives on the requirements for implementing e-mental health approaches in regional and remote health services for Indigenous Australians. Methods Qualitative interviews were conducted with 32 managers, directors, chief executive officers (CEOs), and senior practitioners of mental health, well-being, alcohol and other drug and chronic disease services. Results The implementation of e-mental health approaches in this context is likely to be influenced by characteristics related to the adopter (practitioner skill and knowledge, client characteristics, communication barriers), the innovation (engaging and supportive approach, culturally appropriate design, evidence base, data capture, professional development opportunities), and organizational systems (innovation-systems fit, implementation planning, investment). Conclusions There is potential for e-mental health approaches to address mental illness and poor social and emotional well-being amongst Indigenous people and to advance their quality of care. Health service stakeholders reported that e-mental health interventions are likely to be most effective when used to support or extend existing health services, including elements of client-driven and practitioner-supported use. Potential solutions to obstacles for integration of e-mental health approaches into practice were proposed including practitioner training, appropriate tool design using a consultative approach, internal organizational directives and support structures, adaptations to existing systems and policies

  16. The validity of the SF-36 in an Australian National Household Survey: demonstrating the applicability of the Household Income and Labour Dynamics in Australia (HILDA Survey to examination of health inequalities

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    Crosier Timothy

    2004-10-01

    Full Text Available Abstract Background The SF-36 is one of the most widely used self-completion measures of health status. The inclusion of the SF-36 in the first Australian national household panel survey, the Household, Income and Labour Dynamics in Australia (HILDA Survey, provides an opportunity to investigate health inequalities. In this analysis we establish the psychometric properties and criterion validity of the SF-36 HILDA Survey data and examine scale profiles across a range of measures of socio-economic circumstance. Methods Data from 13,055 respondents who completed the first wave of the HILDA Survey were analysed to determine the psychometric properties of the SF-36 and the relationship of the SF-36 scales to other measures of health, disability, social functioning and demographic characteristics. Results Results of principle components analysis were similar to previous Australian and international reports. Survey scales demonstrated convergent and divergent validity, and different markers of social status demonstrated unique patterns of outcomes across the scales. Conclusion Results demonstrated the validity of the SF-36 data collected during the first wave of the HILDA Survey and support its use in research examining health inequalities and population health characteristics in Australia.

  17. Determinants of health disparities between Italian regions

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    Giannoni Margherita

    2010-06-01

    Full Text Available Abstract Background Among European countries, Italy is one of the countries where regional health disparities contribute substantially to socioeconomic health disparities. In this paper, we report on regional differences in self-reported poor health and explore possible determinants at the individual and regional levels in Italy. Methods We use data from the "Indagine Multiscopo sulle Famiglie", a survey of aspects of everyday life in the Italian population, to estimate multilevel logistic regressions that model poor self-reported health as a function of individual and regional socioeconomic factors. Next we use the causal step approach to test if living conditions, healthcare characteristics, social isolation, and health behaviors at the regional level mediate the relationship between regional socioeconomic factors and self-rated health. Results We find that residents living in regions with more poverty, more unemployment, and more income inequality are more likely to report poor health and that poor living conditions and private share of healthcare expenditures at the regional level mediate socioeconomic disparities in self-rated health among Italian regions. Conclusion The implications are that regional contexts matter and that regional policies in Italy have the potential to reduce health disparities by implementing interventions aimed at improving living conditions and access to quality healthcare.

  18. The role of Health Impact Assessment in the setting of air quality standards: An Australian perspective

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    Spickett, Jeffery, E-mail: J.Spickett@curtin.edu.au [WHO Collaborating Centre for Environmental Health Impact Assessment (Australia); Faculty of Health Sciences, School of Public Health, Curtin University, Perth, Western Australia (Australia); Katscherian, Dianne [WHO Collaborating Centre for Environmental Health Impact Assessment (Australia); Faculty of Health Sciences, School of Public Health, Curtin University, Perth, Western Australia (Australia); Harris, Patrick [CHETRE — UNSW Research Centre for Primary Health Care and Equity, University of New South Wales (Australia)

    2013-11-15

    The approaches used for setting or reviewing air quality standards vary from country to country. The purpose of this research was to consider the potential to improve decision-making through integration of HIA into the processes to review and set air quality standards used in Australia. To assess the value of HIA in this policy process, its strengths and weaknesses were evaluated aligned with review of international processes for setting air quality standards. Air quality standard setting programmes elsewhere have either used HIA or have amalgamated and incorporated factors normally found within HIA frameworks. They clearly demonstrate the value of a formalised HIA process for setting air quality standards in Australia. The following elements should be taken into consideration when using HIA in standard setting. (a) The adequacy of a mainly technical approach in current standard setting procedures to consider social determinants of health. (b) The importance of risk assessment criteria and information within the HIA process. The assessment of risk should consider equity, the distribution of variations in air quality in different locations and the potential impacts on health. (c) The uncertainties in extrapolating evidence from one population to another or to subpopulations, especially the more vulnerable, due to differing environmental factors and population variables. (d) The significance of communication with all potential stakeholders on issues associated with the management of air quality. In Australia there is also an opportunity for HIA to be used in conjunction with the NEPM to develop local air quality standard measures. The outcomes of this research indicated that the use of HIA for air quality standard setting at the national and local levels would prove advantageous. -- Highlights: • Health Impact Assessment framework has been applied to a policy development process. • HIA process was evaluated for application in air quality standard setting.

  19. Will the Australian nuclear medicine technologist workforce meet anticipated health care demands?

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    Adams, Edwina; Schofield, Deborah; Cox, Jennifer; Adamson, Barbara

    2008-05-01

    Determination of national nuclear medicine technologist workforce size was made from census data in 2001 and 1996 and from the professional body in 2004. A survey conducted by the authors in 2005 provided retention patterns in north-eastern Australia and suggested causes. Utilisation of nuclear medicine diagnostic services was established through the Medicare Benefits Schedule group statistics. More than half the nuclear medicine technologist workforce is under 35 years of age. Attrition commences from age 30, with very few workers over 55 years. In 2005 there was a 12% attrition of the survey workforce. In the past decade, service provision increased while workforce size decreased and the nuclear medicine technologist workforce is at risk of failing to meet the anticipated rise in health service needs. PMID:18447815

  20. Determinants of resilience to cigarette smoking among young Australians at risk: an exploratory study

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    Mikocka-Walus Antonina A

    2010-07-01

    Full Text Available Abstract Background Numerous researchers studied risk factors associated with smoking uptake, however, few examined protective factors associated with smoking resilience. This study therefore aims to explore determinants of smoking resilience among young people from lower socioeconomic backgrounds who are at risk of smoking. Methods Overall, 92 out of 92 vocational education students accepted invitation to participate in this exploratory study. The Adelaide Technical and Further Education (TAFE Arts campus was chosen for the study given the focus on studying resilience in young people of lower socioeconomic status i.e. resilient despite the odds. A self-report questionnaire comprising a measure of resilience: sense of coherence, sense of humour, coping styles, depression, anxiety and stress, and family, peers and community support, was distributed among participants aged 15 to 29. Additional factors researched are parental approval and disapproval, course type, and reasons for not smoking. Using the Statistical Package for the Social Sciences (SPSS, version 13.0, analyses were undertaken using frequencies, means, standard deviations, independent sample t-tests, correlations, analysis of variance, logistic regression, and chi-square test. Results Twenty five (27% out of 92 students smoked. Young people with peer support tended to smoke (p Conclusions The current study showed that most students chose 'health and fitness' as the reason for not smoking. Single anti-smoking messages cannot be generalised to all young people, but should recognise that people within different contexts, groups and subcultures will have different reasons for choosing whether or not to smoke. Future studies should use larger samples with a mixed methods design (quantitative and qualitative.

  1. The Determinants Of Population Health Spatial Disparities

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    Modranka Emilia

    2014-12-01

    Full Text Available Health of the population is one of the basic factors of social development. The results of empirical studies indicate a number of factors determining the level of health of the population related to access to health care services, the level of environmental pollution and the wealth of society. It must be assumed that the observed disparities in the health depend on distributions of particular determinants. The aim of the article is to assess the significance of the main factors affecting the occurrence of spatial disparities in the level of social development districts NTS-4 in terms of health of the population. The analysis was based on estimates of the Spatial Durbin Model (SDM which takes into account the impact of neighborhood spatial units on level of dependent variable and the explanatory variables. The size of the level of social development in terms of health of the population in the study was approximate by the aggregate value of the index, which is the local component of the Local Human Development Index LHDI.

  2. Effect of Health Literacy on Quality of Life amongst Patients with Ischaemic Heart Disease in Australian General Practice.

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    David Alejandro González-Chica

    Full Text Available Appropriate understanding of health information by patients with cardiovascular disease (CVD is fundamental for better management of risk factors and improved morbidity, which can also benefit their quality of life.To assess the relationship between health literacy and health-related quality of life (HRQoL in patients with ischaemic heart disease (IHD, and to investigate the role of sociodemographic and clinical variables as possible confounders.Cross-sectional study of patients with IHD recruited from a stratified sample of general practices in two Australian states (Queensland and South Australia between 2007 and 2009. Health literacy was measured using a validated questionnaire and classified as inadequate, marginal, or adequate. Physical and mental components of HRQoL were assessed using the Medical Outcomes Study Short Form (SF12 questionnaire. Analyses were adjusted for confounders (sociodemographic variables, clinical history of IHD, number of CVD comorbidities, and CVD risk factors using multiple linear regression.A total sample of 587 patients with IHD (mean age 72.0±8.4 years was evaluated: 76.8% males, 84.2% retired or pensioner, and 51.4% with up to secondary educational level. Health literacy showed a mean of 39.6±6.7 points, with 14.3% (95%CI 11.8-17.3 classified as inadequate. Scores of the physical component of HRQoL were 39.6 (95%CI 37.1-42.1, 42.1 (95%CI 40.8-43.3 and 44.8 (95%CI 43.3-46.2 for inadequate, marginal, and adequate health literacy, respectively (p-value for trend = 0.001. This association persisted after adjustment for confounders. Health literacy was not associated with the mental component of HRQoL (p-value = 0.482. Advanced age, lower educational level, disadvantaged socioeconomic position, and a larger number of CVD comorbidities adversely affected both, health literacy and HRQoL.Inadequate health literacy is a contributing factor to poor physical functioning in patients with IHD. Increasing health literacy

  3. A mental health first aid training program for Australian Aboriginal and Torres Strait Islander peoples: description and initial evaluation

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    Hart Laura M

    2009-06-01

    Full Text Available Abstract Background Mental Health First Aid (MHFA training was developed in Australia to teach members of the public how to give initial help to someone developing a mental health problem or in a mental health crisis situation. However, this type of training requires adaptation for specific cultural groups in the community. This paper describes the adaptation of the program to create an Australian Aboriginal and Torres Strait Islander Mental Health First Aid (AMHFA course and presents an initial evaluation of its uptake and acceptability. Methods To evaluate the program, two types of data were collected: (1 quantitative data on uptake of the course (number of Instructors trained and courses subsequently run by these Instructors; (2 qualitative data on strengths, weaknesses and recommendations for the future derived from interviews with program staff and focus groups with Instructors and community participants. Results 199 Aboriginal people were trained as Instructors in a five day Instructor Training Course. With sufficient time following training, the majority of these Instructors subsequently ran 14-hour AMHFA courses for Aboriginal people in their community. Instructors were more likely to run courses if they had prior teaching experience and if there was post-course contact with one of the Trainers of Instructors. Analysis of qualitative data indicated that the Instructor Training Course and the AMHFA course are culturally appropriate, empowering for Aboriginal people, and provided information that was seen as highly relevant and important in assisting Aboriginal people with a mental illness. There were a number of recommendations for improvements. Conclusion The AMHFA program is culturally appropriate and acceptable to Aboriginal people. Further work is needed to refine the course and to evaluate its impact on help provided to Aboriginal people with mental health problems.

  4. A mental health first aid training program for Australian Aboriginal and Torres Strait Islander peoples: description and initial evaluation

    Science.gov (United States)

    Kanowski, Len G; Jorm, Anthony F; Hart, Laura M

    2009-01-01

    Background Mental Health First Aid (MHFA) training was developed in Australia to teach members of the public how to give initial help to someone developing a mental health problem or in a mental health crisis situation. However, this type of training requires adaptation for specific cultural groups in the community. This paper describes the adaptation of the program to create an Australian Aboriginal and Torres Strait Islander Mental Health First Aid (AMHFA) course and presents an initial evaluation of its uptake and acceptability. Methods To evaluate the program, two types of data were collected: (1) quantitative data on uptake of the course (number of Instructors trained and courses subsequently run by these Instructors); (2) qualitative data on strengths, weaknesses and recommendations for the future derived from interviews with program staff and focus groups with Instructors and community participants. Results 199 Aboriginal people were trained as Instructors in a five day Instructor Training Course. With sufficient time following training, the majority of these Instructors subsequently ran 14-hour AMHFA courses for Aboriginal people in their community. Instructors were more likely to run courses if they had prior teaching experience and if there was post-course contact with one of the Trainers of Instructors. Analysis of qualitative data indicated that the Instructor Training Course and the AMHFA course are culturally appropriate, empowering for Aboriginal people, and provided information that was seen as highly relevant and important in assisting Aboriginal people with a mental illness. There were a number of recommendations for improvements. Conclusion The AMHFA program is culturally appropriate and acceptable to Aboriginal people. Further work is needed to refine the course and to evaluate its impact on help provided to Aboriginal people with mental health problems. PMID:19490648

  5. Engaging Australian Aboriginal narratives to challenge attitudes and create empathy in health care: a methodological perspective

    OpenAIRE

    Wain, Toni; Sim, Moira; Bessarab, Dawn; Mak, Donna; Hayward, Colleen; Rudd, Cobie

    2016-01-01

    Background Unconscious bias and negative attitudes towards minority groups have detrimental effects on the way health care is, or is not, provided to these groups. Recognition of racist attitudes and behaviours as well as understanding clients’ experiences of health and health care are pivotal to developing better health care strategies to positively impact on the quality and safety of care provided to Indigenous people. Indigenous research demands inclusive research processes and the use of ...

  6. Determination of the f parameter for k0-neutron activation analysis at the Australian 20 MW OPAL research reactor

    International Nuclear Information System (INIS)

    In the k0 method of standardisation in neutron activation analysis (k0-NAA), the ratio of thermal to epithermal neutrons, a value known as f, is fundamental in accurately determining the concentration of elements within the sample. Research into determining this f value via the cadmium ratio method was undertaken for two positions within the 20 MW Open Pool Australian Light water (OPAL) research reactor (Lucas Heights, NSW, Australia). A short irradiation and long irradiation position were assessed via two methods; the conventional cadmium ratio method based on the Hogdahl formalism, with f values of 2,666 ± 255 and 1,538 ± 258 being calculated respectively for the short and long positions, and an ASTM-INVAP-based cadmium ratio method, which allows for the higher neutron temperature of OPAL to be accounted for, with f values of 3,057 ± 318 and 1,755 ± 312 being calculated respectively. These values were validated by analysis of NIST standard reference materials (SRMTM), with good agreement between experimental values and reference and literature values being observed, showing the accuracy and suitability of these values for OPAL. Additionally, the high values of f shown endorse the strength of performing k0-NAA at OPAL. This manuscript publishes the first values of f from OPAL and provides a detailed description of the method employed.

  7. Australians with osteoarthritis: satisfaction with health care providers and the perceived helpfulness of treatments and information sources

    Science.gov (United States)

    Basedow, Martin; Hibbert, Peter; Hooper, Tamara; Runciman, William; Esterman, Adrian

    2016-01-01

    Objective The aim of this study was to evaluate the satisfaction of Australian patients who suffer from osteoarthritis (OA) with their health care providers and the perceived helpfulness of treatments and information sources. Methods A self-administered questionnaire was conducted with a sample of 560 Australian patients who suffer from OA with questions about satisfaction with health care providers and the helpfulness of different treatment options and information sources. Logistic regression models were used to assess potential predictors of satisfaction. Thematic analysis was undertaken for attitudinal factors associated with satisfaction. Results A total of 435 participants returned questionnaires (response rate 78%). Most respondents were highly satisfied with the care provided by their general practitioner (GP) (84%), communication with their GP (88%), time spent with their GP (84%), and their ability to talk freely with their GP about their medical problem (93%), but less satisfied with their ability to talk freely about associated emotional problems (77%). Satisfaction with pharmacists (80%), rheumatologists (76%), and orthopedic surgeons (72%) was high. Joint replacement surgery (91%), prescription anti-inflammatory medications (66%), aids and assistive devices (65%), intra-articular injections (63%), and prescription painkiller medications (62%) were perceived as effective treatments. Less highly rated treatments were exercise (48%), physiotherapy (43%), and complementary medicines (29%). A majority of patients were satisfied with the information to manage their OA (65%). From the multivariable logistic regression analysis, four GP satisfaction factors were found to be predictors of overall satisfaction with GP care: the amount of time that the GP spends with the patient (P=0.005), the information the GP provides about what to expect (P<0.001), the communication between patient and GP (P=0.001), and the information that the GP provides about medications

  8. Adopting a Proactive Approach to Good Health: A Way Forward for Rural Australians

    Science.gov (United States)

    Penman, Joy; Ellis, Bronwyn

    2010-01-01

    Minimising discrepancies between Australia's rural and the more favourable urban health status relates to more than workforce recruitment, retention and access to health services: A proactive strategy, using resources at hand, can empower people to improve their health. Academics from a nurse education unit have, therefore, regularly engaged with…

  9. Policy Levers Key for Primary Health Care Organizations to Support Primary Care Practices in Meeting Medical Home Expectations: Comparing Leading States to the Australian Experience

    Science.gov (United States)

    2016-01-01

    Abstract Several countries with highly ranked delivery systems have implemented locally-based, publicly-funded primary health care organizations (PHCOs) as vehicles to strengthen their primary care foundations. In the United States, state governments have started down a similar pathway with models that share similarities with international PHCOs. The objective of this study was to determine if these kinds of organizations were working with primary care practices to improve their ability to provide comprehensive, coordinated, and accessible patient-centered care that met quality, safety, and efficiency outcomes—all core attributes of a medical home. This qualitative study looked at 4 different PHCO models—3 from the United States and 1 from Australia—with similar objectives and scope. Primary and secondary data included semi-structured interviews with 26 PHCOs and a review of government documents. The study found that the 4 PHCO models were engaging practices to meet a number of medical home expectations, but the US PHCOs were more uniform in efforts to work with practices and focused on arranging services to meet the needs of complex patients. There was significant variation in level of effort between the Australian PHCOs. These differences can be explained through the state governments' selection of payment models and use of data frameworks to support collaboration and incentivize performance of both PHCOs and practices. These findings offer policy lessons to inform health reform efforts under way to better capitalize on the potential of PHCOs to support a high-functioning primary health foundation as an essential component to a reformed health system. PMID:26636485

  10. Cross-Cultural Understanding of Health Assessments for People with Intellectual Disability: An Australian resource in the Philippines

    Directory of Open Access Journals (Sweden)

    C. E. Brolan

    2015-12-01

    Full Text Available The Convention on the Rights of Persons with Disabilities has resulted in the involvement of high income countries in international development assistance to people with disabilities in low and middle income countries.  Healthcare tools designed in high income countries and delivered in low and middle income countries may not be appropriate to the context of the lives of people with disabilities.  We undertook a short qualitative study of participants’ views of an Australian-designed comprehensive health assessment tool, with participation from a WHO-Collaborating non-government organisation in regional Philippines. We also examined the participants’ perceptions of the barriers to healthcare for Filipinos with intellectual disabilities.  Responses to the comprehensive health assessment tool were positive although participants agreed that both linguistic and cultural translation would enhance wider use of the tool. The barriers identified included poverty, family isolation, stigma and communication issues as preventing appropriate healthcare delivery to Filipinos with intellectual disability. Consideration must be given to the complexities of transference of healthcare resources to a low and middle income country context, as well as the systemic and cultural barriers to appropriate healthcare provision to people with disabilities.

  11. External factors affecting decision-making and use of evidence in an Australian public health policy environment.

    Science.gov (United States)

    Zardo, Pauline; Collie, Alex; Livingstone, Charles

    2014-05-01

    This study examined external factors affecting policy and program decision-making in a specific public health policy context: injury prevention and rehabilitation compensation in the Australian state of Victoria. The aim was twofold: identify external factors that affect policy and program decision-making in this specific context; use this evidence to inform targeting of interventions aimed at increasing research use in this context. Qualitative interviews were undertaken from June 2011 to January 2012 with 33 employees from two state government agencies. Key factors identified were stakeholder feedback and action, government and ministerial input, legal feedback and action, injured persons and the media. The identified external factors were able to significantly influence policy and program decision-making processes: acting as both barriers and facilitators, depending on the particular issue at hand. The factors with the most influence were the Minister and government, lawyers, and agency stakeholders, particularly health providers, trade unions and employer groups. This research revealed that interventions aimed at increasing use of research in this context must target and harness the influence of these groups. This research provides critical insights for researchers seeking to design interventions to increase use of research in policy environments and influence decision-making in Victorian injury prevention and rehabilitation compensation. PMID:24632115

  12. Social Media and Mobile Apps for Health Promotion in Australian Indigenous Populations: Scoping Review

    OpenAIRE

    Brusse, Carl; Gardner, Karen; McAullay, Daniel; Dowden, Michelle

    2014-01-01

    Background Health promotion organizations are increasingly embracing social media technologies to engage end users in a more interactive way and to widely disseminate their messages with the aim of improving health outcomes. However, such technologies are still in their early stages of development and, thus, evidence of their efficacy is limited. Objective The study aimed to provide a current overview of the evidence surrounding consumer-use social media and mobile software apps for health pr...

  13. Employers’ Perspectives on Future Roles and Skills Requirements for Australian Health Librarians

    OpenAIRE

    Cheryl Hamill; Melanie Kammermann; Catherine Clark; Ann Ritchie; Gillian Hallam; Suzanne Lewis; Patrick O'Connor

    2011-01-01

    Objective – This study, which comprises one stage of a larger project (ALIA/HLA Workforce and Education Research Project), aimed to discover employers’ views on how (or whether) health librarians assist in achieving the mission-critical goals of their organizations; how health librarians contribute to the organization now and into the future; and what are the current and future skills requirements of health librarians.Methods – Each member of the project group approached between one and five ...

  14. Relationships between Psychosocial Resilience and Physical Health Status of Western Australian Urban Aboriginal Youth

    OpenAIRE

    Hopkins, Katrina D.; Shepherd, Carrington C. J.; Catherine L. Taylor; Stephen R Zubrick

    2015-01-01

    Background Psychosocial processes are implicated as mediators of racial/ethnic health disparities via dysregulation of physiological responses to stress. Our aim was to investigate the extent to which factors previously documented as buffering the impact of high-risk family environments on Aboriginal youths’ psychosocial functioning were similarly beneficial for their physical health status. Method and Results We examined the relationship between psychosocial resilience and physical health of...

  15. Fostering a hunger for health: Food and the self in ‘The Australian Women's Weekly'.

    OpenAIRE

    Schneider, Tanja; Davis, Teresa

    2010-01-01

    Over the past decade consumers in Australia and elsewhere have increasingly been confronted with a fast growing number of health food products. This profusion of health foods is accompanied by a proliferation in popular culture of professional nutritional advice on what is 'good to eat'. The genre of lifestyle magazines is one popular medium via which healthy practices and health foods are frequently reported. In this paper we use a visual discourse analysis of food-related editorial and adve...

  16. The impact of the Baby Friendly Health Initiative in the Australian health care system: a critical narrative review of the evidence.

    Science.gov (United States)

    Atchan, Marjorie; Davis, Deborah; Foureur, Maralyn

    2013-07-01

    Studies have identified that the practices of maternity facilities and health professionals are crucial to women's experience of support and breastfeeding 'success'. The Baby Friendly Hospital Initiative (BFHI) was launched globally in 1991 to protect, promote and support breastfeeding. While a direct causal effect has not been established and critics suggest the rhetoric conflicts with women's lived experiences as new mothers, a positive association between the Initiative and breastfeeding prevalence is apparent. Internationally, impact studies have demonstrated that where the Initiative is well integrated, there is an increase in rates of breastfeeding initiation and, to a lesser extent, duration. In consideration of the known health risks associated with the use of artificial baby milks this would suggest that BFHI implementation and accreditation should be a desirable strategy for committed health facilities. However, a variation in both BFHI uptake and breastfeeding prevalence between nations has been reported. This narrative review critically discusses a variety of issues relevant to the uptake and support of breastfeeding and the BFHI, utilising Australia as a case study. Whilst it enjoys 'in principle' policy support, Australia also suffers from a lack of uniformity in uptake and perception of the benefits of BFHI at all levels of the health system. Australian and international studies have identified similar enablers and barriers to implementation. PMID:23957177

  17. Adoption of Soil Health Improvement Strategies by Australian Farmers: I. Attitudes, Management and Extension Implications

    Science.gov (United States)

    Bennett, J. McL.; Cattle, S. R.

    2013-01-01

    Purpose: There is inconsistency in the design, understanding, implementation and monitoring of soil health programmes. Despite mounting scientific evidence for the credibility of certain soil health indicators, an increase in the reporting of programme benefits, and progress in communicating these benefits, many farmers remain hesitant to…

  18. Adoption of Soil Health Improvement Strategies by Australian Farmers: II. Impediments and Incentives

    Science.gov (United States)

    Bennett, J. McL.; Cattle, S. R.

    2014-01-01

    Purpose: Many farmers remain hesitant to implement structured management plans and strategies tailored to address soil health, irrespective of mounting scientific evidence for the credibility of certain soil health indicators, an increase in the reporting of program benefits and progress in communicating these benefits. Hence, the purpose of this…

  19. Constructing Health and Physical Education Curriculum for Indigenous Girls in a Remote Australian Community

    Science.gov (United States)

    Whatman, Susan L.; Singh, Parlo

    2015-01-01

    Background: Over the last 20 years, curriculum development in Health and Physical Education (HPE) (or Physical Education, Physical Education and Health, Sport Education as it is variously called) has repeatedly attempted to address issues of equity and social inclusion. Why then does systemic educational disadvantage persist, and why do the…

  20. Measuring the health impact of human rights violations related to Australian asylum policies and practices: a mixed methods study

    Directory of Open Access Journals (Sweden)

    Mulholland Kim

    2009-02-01

    Full Text Available Abstract Background Human rights violations have adverse consequences for health. However, to date, there remains little empirical evidence documenting this association, beyond the obvious physical and psychological effects of torture. The primary aim of this study was to investigate whether Australian asylum policies and practices, which arguably violate human rights, are associated with adverse health outcomes. Methods We designed a mixed methods study to address the study aim. A cross-sectional survey was conducted with 71 Iraqi Temporary Protection Visa (TPV refugees and 60 Iraqi Permanent Humanitarian Visa (PHV refugees, residing in Melbourne, Australia. Prior to a recent policy amendment, TPV refugees were only given temporary residency status and had restricted access to a range of government funded benefits and services that permanent refugees are automatically entitled to. The quantitative results were triangulated with semi-structured interviews with TPV refugees and service providers. The main outcome measures were self-reported physical and psychological health. Standardised self-report instruments, validated in an Arabic population, were used to measure health and wellbeing outcomes. Results Forty-six percent of TPV refugees compared with 25% of PHV refugees reported symptoms consistent with a diagnosis of clinical depression (p = 0.003. After controlling for the effects of age, gender and marital status, TPV status made a statistically significant contribution to psychological distress (B = 0.5, 95% CI 0.3 to 0.71, p ≤ 0.001 amongst Iraqi refugees. Qualitative data revealed that TPV refugees generally felt socially isolated and lacking in control over their life circumstances, because of their experiences in detention and on a temporary visa. This sense of powerlessness and, for some, an implicit awareness they were being denied basic human rights, culminated in a strong sense of injustice. Conclusion Government asylum policies

  1. The health and well-being of Indigenous drug and alcohol workers: results from a national Australian survey.

    Science.gov (United States)

    Roche, Ann M; Duraisingam, Vinita; Trifonoff, Allan; Tovell, Amanda

    2013-01-01

    The increasing demand for alcohol and other drug (AOD) treatment services among the Australian Indigenous population, complex organisational challenges and limitations, and high unemployment rates are likely to negatively impact Indigenous AOD workers' health and well-being. Building the capacity of Indigenous AOD workers is vital, as they play a crucial role in the delivery of treatment services and offer essential support to their communities. A national online survey was conducted to examine organisational, workplace and individual factors that might contribute to levels of stress and well-being among workers who provide services to Indigenous clients. A total of 294 eligible surveys were completed; 184 (63%) from Indigenous and 108 (37%) from non-Indigenous AOD workers. Multiple regression models were conducted to assess the significant predictors of mental health and well-being, job satisfaction, emotional exhaustion, and turnover intention. Indigenous AOD workers typically experienced above average levels of job satisfaction and relatively low levels of emotional exhaustion. However, 1 in 10 reported high levels of emotional exhaustion, a key predictor of turnover intention. Indigenous workers also experienced significantly lower levels of mental health and well-being and greater work/family imbalance, which was a significant contributor to emotional exhaustion. The findings highlight the importance of implementing workforce development strategies that focus on achieving culturally appropriate, equitable and supportive organisational conditions for Indigenous AOD workers. Preventing or managing levels of stress, ensuring adequate and equitable salaries and benefits, and providing more opportunities for career and personal growth may increase job satisfaction and reduce turnover intention among Indigenous workers in the drug and alcohol field. PMID:22425037

  2. Postpartum anxiety, depression and social health: findings from a population-based survey of Australian women

    Directory of Open Access Journals (Sweden)

    Brown Stephanie J

    2010-12-01

    Full Text Available Abstract Background Whilst the prevalence and correlates of postpartum depression are well established, far less is known about postpartum anxiety. Studies have described the association between socio-demographic factors and postpartum depression, yet few have explored the association between stressors in women's lives around the time of having a baby and maternal psychological morbidity. This study aimed to describe the population prevalence of postpartum depression, anxiety, co-morbid anxiety and depression and social health issues; and to examine the association between postpartum psychological and social health issues experienced in the six months following birth. Methods Population-based survey of all women who gave birth in Victoria and South Australia in September/October 2007. Women were mailed the survey questionnaire six months following birth. Anxiety and depression were measured using the Depression Anxiety Stress Scales (DASS-21. Results Questionnaires were completed by 4,366 women. At six months postpartum the proportion of women scoring above the 'normal' range on the DASS-21 was 12.7% for anxiety,17.4% for depression, and 8.1% for co-morbid depression and anxiety. Nearly half the sample reported experiencing stressful life events or social health issues in the six months following birth, with 38.3% reporting one to two and 8.8% reporting three or more social health issues. Women reporting three or more social health issues were significantly more likely to experience postnatal anxiety (Adj OR = 4.12, 95% CI 3.0-5.5 or depression (Adj OR = 5.11, 95% CI = 3.9-6.7 and co-morbid anxiety and depression (Adj OR = 5.41, 95% CI 3.8-7.6 than women who did not report social health issues. Conclusions Health care providers including midwives, nurses, medical practitioners and community health workers need to be alert to women's social circumstances and life events experienced in the perinatal period and the interplay between social and

  3. One Health approach to controlling a Q fever outbreak on an Australian goat farm

    OpenAIRE

    BOND, K. A.; Vincent, G.; Wilks, C R; Franklin, L.; Sutton, B; Stenos, J; Cowan, R.; Lim, K.; Athan, E.; O. Harris; MACFARLANE-BERRY, L.; Segal, Y.; FIRESTONE, S. M.

    2015-01-01

    SUMMARY A recent outbreak of Q fever was linked to an intensive goat and sheep dairy farm in Victoria, Australia, 2012-2014. Seventeen employees and one family member were confirmed with Q fever over a 28-month period, including two culture-positive cases. The outbreak investigation and management involved a One Health approach with representation from human, animal, environmental and public health. Seroprevalence in non-pregnant milking goats was 15% [95% confidence interval (CI) 7–27]; acti...

  4. Employers’ Perspectives on Future Roles and Skills Requirements for Australian Health Librarians

    Directory of Open Access Journals (Sweden)

    Cheryl Hamill

    2011-01-01

    Full Text Available Objective – This study, which comprises one stage of a larger project (ALIA/HLA Workforce and Education Research Project, aimed to discover employers’ views on how (or whether health librarians assist in achieving the mission-critical goals of their organizations; how health librarians contribute to the organization now and into the future; and what are the current and future skills requirements of health librarians.Methods – Each member of the project group approached between one and five individuals known to them to generate a convenience sample of 22 employers of health librarians. There were 15 semi-structured interviews conducted between October and November 2010 with employers in the hospital, academic, government, private, consumer health and not-for-profit sectors. The interview schedule was sent to each interviewee prior to the interview so that they had time to consider their responses. The researchers wrote up the interview notes using the interview schedule and submitted them to the principal researcher, who combined the data into one document. Content analysis of the data was used to identify major themes.Results – Employers expressed a clear sense of respect for the roles and responsibilities of library staff in their organizations. Areas of practice such as education and training, scientific research and clinical support were highlighted as critical for the future. Current areas of practice such as using technology and systems to manage information, providing information services to meet user needs and management of health information resources in a range of formats were identified as remaining highly relevant for the future. There was potential for health librarians to play a more active and strategic role in their organizations, and to repackage their traditional skill sets for anticipated future roles. Interpersonal skills and the role of health librarians as the interface between clinicians and information technology

  5. The Australian mental health system: An economic overview and some research issues

    Directory of Open Access Journals (Sweden)

    Williams Ruth FG

    2008-05-01

    Full Text Available Abstract This article is concerned with the key economic characteristics of Australia's mental health system. First, some brief conceptual and empirical descriptions are provided of Australia's mental health services, both as a total system, and of its two principal components, viz. public psychiatric institutions and private psychiatry services. Expenditures on public psychiatric hospitals clearly demonstrate the effect of deinstitutionalisation. Data from 1984 on private practice psychiatry indicate that per capita utilisation rates peaked in 1996 and have since fallen. Generally, since 1984 gross fees have not risen. However, for both utilisation and fees, there is evidence (of a statistical kind that there are significant differences between the states of Australia, in these two variables (utilisation and fees. Emphasis is also placed on the economic incentives that arise from health insurance and the heterogeneous nature of mental illness. The effects of these incentives are regarded as by-products of the health insurance mechanism; and another effect, "unmet need" and "met non-need", is a somewhat unique problem of an informational kind. Discussion of many of these issues concludes on a somewhat negative note, e.g. that no empirical results are available to quantify the particular effect that is discussed. This is a manifestation of the lacunae of economic studies of the mental health sector.

  6. Improving forensic mental health care to Indigenous Australians: theorizing the intercultural space.

    Science.gov (United States)

    Durey, A; Wynaden, D; O'Kane, M

    2014-05-01

    This paper uses the 'intercultural space' as an educational strategy to prepare nurses to work respectfully with Indigenous patients in a forensic mental health context; offers an educational approach that introduces nurses to Indigenous knowledge, beliefs and values, examines power relations in colonized countries between the dominant white cultural group and the Indigenous population and encourages nurses to critically reflect on their health care practice; and explores the intercultural space as a shared space between cultures fostering open and robust inquiry where neither culture dominates and new positions, representations and understandings can emerge. Given the disproportionately high number of Indigenous people imprisoned in colonized countries, this paper responds to research from Western Australia on the need to prepare forensic mental health nurses to deliver care to Indigenous patients with mental health disorders. The paper highlights the nexus between theory, research and education that can inform the design and implementation of programmes to help nurses navigate the complex, layered and contested 'intercultural space' and deliver culturally safe care to Indigenous patients. Nurses are encouraged to critically reflect on how beliefs and values underpinning their cultural positioning impact on health care to Indigenous patients. The paper draws on intercultural theory to offer a pedagogical framework that acknowledges the negative impacts of colonization on Indigenous health and well-being, repositions and revalues Indigenous cultures and knowledges and fosters open and robust inquiry. This approach is seen as a step towards working more effectively in the intercultural space where ultimately binary oppositions that privilege one culture over another and inhibit robust inquiry are avoided, paving the way for new, more inclusive positions, representations and understandings to emerge. While the intercultural space can be a place of struggle, tension

  7. Older lesbians and work in the Australian health and aged care sector.

    Science.gov (United States)

    Hughes, Mark; Kentlyn, Sujay

    2015-01-01

    While research has identified challenges lesbians face in the workplace, there is limited understanding of the particular experiences of older lesbians, especially those working in the health and aged care sector. This article draws on the stories of four women who participated in a narrative research project on lesbian and gay people's experiences of health and aged care. It highlights the need for future research to examine the complexity of identity expression and community affiliation, how people negotiate "coming out" in the workplace, the impact of discrimination, and the resources (such as friends) available to lesbians in the workplace. PMID:25575323

  8. Decolonising Australian Psychology: Discourses, Strategies, and Practice

    Directory of Open Access Journals (Sweden)

    Pat Dudgeon

    2015-08-01

    Full Text Available Colonisation in Australia has had a devastating and lasting impact on the wellbeing of Aboriginal and Torres Strait Islander peoples in Australia (herein referred to as Indigenous Australians. This paper discusses the role of psychology in Australia and the negative impact that certain disciplinary theories and practices have had on Indigenous Australians. The impact has been further exacerbated by the failure of mainstream policy makers and mental health practitioners to recognise the key, distinctive cultural and social determinants that contribute to Aboriginal health and wellbeing. There is a growing response by Aboriginal psychologists, critical social theorists, and their allies to decolonise psychological theory and practice to redress this situation. This paper outlines key decolonising strategies that have been effective in interrupting those aspects of psychology that are inimical to Aboriginal wellbeing.

  9. Is Health Practitioner Regulation Keeping Pace with the Changing Practitioner and Health-Care Landscape? An Australian Perspective.

    Science.gov (United States)

    Wardle, Jonathan Lee; Sibbritt, David; Broom, Alex; Steel, Amie; Adams, Jon

    2016-01-01

    Health-care delivery is undergoing significant evolution and change. Task substitution has resulted in some practitioner groups expanding their scope of practice by assuming more complex clinical roles, new practitioner groups have emerged, and consumer-driven demand has changed the way the public engage with health practitioners and the way many health-care services are delivered. Using Australia as a case study, this paper explores the issue of the hesitancy to include new professions in health professions regulation schemes. Despite the significant changes in the health-care delivery landscape, policy development in this area has remained relatively static, with active resistance to extending formal registration to new practitioner groups. Ignoring the issue of new practitioner groups in regulatory schemes is unacceptable from a public health perspective and runs against the key public protection objectives of health practitioner regulation. Development of pathways for the entry of new health practitioner groups into regulatory schemes must be developed as a matter of priority. PMID:27379222

  10. The Politics of Resistance to Workplace Cultural Diversity Education for Health Service Providers: An Australian Study

    Science.gov (United States)

    Johnstone, Megan-Jane; Kanitsaki, Olga

    2008-01-01

    This qualitative study has as its focus an exploration of health service providers' perceptions and experiences of the processes and implications of delivering workplace cultural diversity education for staff. Data were obtained from conducting in-depth individual and focus group interviews with a purposeful sample of 137 healthcare professionals,…

  11. Investigating children's spiritual experiences through the Health and Physical Education (HPE) learning area in Australian schools.

    Science.gov (United States)

    Lynch, Timothy

    2015-02-01

    The purpose of this study is to explore spirituality within the Health and Physical Education (HPE) learning area, through investigating children's experiences within three Brisbane Catholic Education primary schools (Queensland, Australia). There are seven dimensions of wellness: physical, intellectual, emotional, social, spiritual, environmental, and occupational, which are all strongly connected (Robbins et al. in A wellness way of life, 9th edition, McGraw Hill, USA, 2011). It is logical that HPE, which promotes students to adopt lifelong health and well-being, offers opportunities for spirituality to be experienced and warrants investigation. Data gathered in this qualitative research suggest that regular quality inclusive HPE lessons increased students' potential for spiritual experiences. PMID:24306452

  12. Developing an inter-organizational community-based health network: an Australian investigation.

    Science.gov (United States)

    Short, Alison; Phillips, Rebecca; Nugus, Peter; Dugdale, Paul; Greenfield, David

    2015-12-01

    Networks in health care typically involve services delivered by a defined set of organizations. However, networked associations between the healthcare system and consumers or consumer organizations tend to be open, fragmented and are fraught with difficulties. Understanding the role and activities of consumers and consumer groups in a formally initiated inter-organizational health network, and the impacts of the network, is a timely endeavour. This study addresses this aim in three ways. First, the Unbounded Network Inter-organizational Collaborative Impact Model, a purpose-designed framework developed from existing literature, is used to investigate the process and products of inter-organizational network development. Second, the impact of a network artefact is explored. Third, the lessons learned in inter-organizational network development are considered. Data collection methods were: 16 h of ethnographic observation; 10 h of document analysis; six interviews with key informants and a survey (n = 60). Findings suggested that in developing the network, members used common aims, inter-professional collaboration, the power and trust engendered by their participation, and their leadership and management structures in a positive manner. These elements and activities underpinned the inter-organizational network to collaboratively produce the Health Expo network artefact. This event brought together healthcare providers, community groups and consumers to share information. The Health Expo demonstrated and reinforced inter-organizational working and community outreach, providing consumers with community-based information and linkages. Support and resources need to be offered for developing community inter-organizational networks, thereby building consumer capacity for self-management in the community.

  13. The Effect of Heat Waves on Mental Health in a Temperate Australian City

    OpenAIRE

    Hansen, Alana; Bi, Peng; Nitschke, Monika; Ryan, Philip; Pisaniello, Dino; Tucker, Graeme

    2008-01-01

    Objective The goal of this study was to identify mental, behavioral, and cognitive disorders that may be triggered or exacerbated during heat waves, predisposing individuals to heat-related morbidity and mortality. Design Using health outcome data from Adelaide, South Australia, for 1993–2006, we estimated the effect of heat waves on hospital admissions and mortalities attributed to mental, behavioral, and cognitive disorders. We analyzed data using Poisson regression accounting for overdispe...

  14. Good governance of animal health systems and public-private partnerships: an Australian case study.

    Science.gov (United States)

    Black, P F

    2012-08-01

    The animal health system in Australia has evolved over more than 100 years and includes innovative public-private partnership arrangements. The establishment in 1996 of Animal Health Australia (AHA), a not-for-profit company, was a crucial development which formalised arrangements for shared decision-making and funding across both government and industry stakeholders. However, Federal and State governments retain legislative authority for animal health control. Accordingly, all programmes must recognise that the public sector remains an executive arm of government, accountable for its actions. Hence, much effort has been invested in ensuring that the governance arrangements within AHA are lawful and transparent. The Emergency Animal Disease Response Agreement (EADRA) is a very good example of governance arrangements that are sustainably financed, widely available, provided efficiently, without waste or duplication, and in a manner that is transparent and free of fraud or corruption. The benefits of EADRA include certainty and greater transparency of funding; greater efficiency through increased probability of a rapid response to an occurrence of any of 65 diseases; and industry participation in the management and financing of such a response.

  15. One Health approach to controlling a Q fever outbreak on an Australian goat farm.

    Science.gov (United States)

    Bond, K A; Vincent, G; Wilks, C R; Franklin, L; Sutton, B; Stenos, J; Cowan, R; Lim, K; Athan, E; Harris, O; Macfarlane-Berry, L; Segal, Y; Firestone, S M

    2016-04-01

    A recent outbreak of Q fever was linked to an intensive goat and sheep dairy farm in Victoria, Australia, 2012-2014. Seventeen employees and one family member were confirmed with Q fever over a 28-month period, including two culture-positive cases. The outbreak investigation and management involved a One Health approach with representation from human, animal, environmental and public health. Seroprevalence in non-pregnant milking goats was 15% [95% confidence interval (CI) 7-27]; active infection was confirmed by positive quantitative PCR on several animal specimens. Genotyping of Coxiella burnetii DNA obtained from goat and human specimens was identical by two typing methods. A number of farming practices probably contributed to the outbreak, with similar precipitating factors to the Netherlands outbreak, 2007-2012. Compared to workers in a high-efficiency particulate arrestance (HEPA) filtered factory, administrative staff in an unfiltered adjoining office and those regularly handling goats and kids had 5·49 (95% CI 1·29-23·4) and 5·65 (95% CI 1·09-29·3) times the risk of infection, respectively; suggesting factory workers were protected from windborne spread of organisms. Reduction in the incidence of human cases was achieved through an intensive human vaccination programme plus environmental and biosecurity interventions. Subsequent non-occupational acquisition of Q fever in the spouse of an employee, indicates that infection remains endemic in the goat herd, and remains a challenge to manage without source control.

  16. Mental health and other clinical correlates of euthanasia attitudes in an Australian outpatient cancer population.

    Science.gov (United States)

    Carter, G L; Clover, K A; Parkinson, L; Rainbird, K; Kerridge, I; Ravenscroft, P; Cavenagh, J; McPhee, J

    2007-04-01

    A majority of patients with cancer have been reported to endorse euthanasia and physician assisted suicide (PAS) in general and a substantial proportion endorse these for themselves. However, the potential influence of mental health and other clinical variables on these decisions is not well understood. This study of 228 outpatients attending an oncology clinic in Newcastle, Australia used a cross-sectional design and logistic regression modelling to examine the relationship of demographic, disease status, mental health and quality of life variables to attitudes toward euthanasia and PAS. The majority reported support for euthanasia (79%, n=179), for PAS (69%, n=158) and personal support for euthanasia/PAS (68%, n=156). However, few reported having asked their doctor for euthanasia (2%, n=5) or PAS (2%, n=5). Three outcomes were modelled: support for euthanasia was associated with active religious belief (adjusted odds ratio (AOR) 0.21, 95% CI: 0.10-0.46); support for PAS was associated with active religious belief (AOR 0.35, 95% CI: 18-0.70) and recent pain (AOR 0.87, 95% CI: 0.0.76-0.99); and personal support for euthanasia/PAS was associated with active religious belief (AOR 0.26, 95% CI: 0.14-0.48). Depression, anxiety, recent suicidal ideation, and lifetime suicide attempt were not independently associated with any of the three outcomes modelled.

  17. One Health approach to controlling a Q fever outbreak on an Australian goat farm.

    Science.gov (United States)

    Bond, K A; Vincent, G; Wilks, C R; Franklin, L; Sutton, B; Stenos, J; Cowan, R; Lim, K; Athan, E; Harris, O; Macfarlane-Berry, L; Segal, Y; Firestone, S M

    2016-04-01

    A recent outbreak of Q fever was linked to an intensive goat and sheep dairy farm in Victoria, Australia, 2012-2014. Seventeen employees and one family member were confirmed with Q fever over a 28-month period, including two culture-positive cases. The outbreak investigation and management involved a One Health approach with representation from human, animal, environmental and public health. Seroprevalence in non-pregnant milking goats was 15% [95% confidence interval (CI) 7-27]; active infection was confirmed by positive quantitative PCR on several animal specimens. Genotyping of Coxiella burnetii DNA obtained from goat and human specimens was identical by two typing methods. A number of farming practices probably contributed to the outbreak, with similar precipitating factors to the Netherlands outbreak, 2007-2012. Compared to workers in a high-efficiency particulate arrestance (HEPA) filtered factory, administrative staff in an unfiltered adjoining office and those regularly handling goats and kids had 5·49 (95% CI 1·29-23·4) and 5·65 (95% CI 1·09-29·3) times the risk of infection, respectively; suggesting factory workers were protected from windborne spread of organisms. Reduction in the incidence of human cases was achieved through an intensive human vaccination programme plus environmental and biosecurity interventions. Subsequent non-occupational acquisition of Q fever in the spouse of an employee, indicates that infection remains endemic in the goat herd, and remains a challenge to manage without source control. PMID:26493615

  18. Australian/New Zealand Bachelor of Oral Health students: sociodemographics and career decisions.

    Science.gov (United States)

    Mariño, R J; Barrow, S L; Morgan, M V

    2014-08-01

    This article describes the sociodemographic profile and factors affecting career decisions of Bachelor of Oral Health (BOH) students in Australia and New Zealand. Data were collected during the 2009 and 2011 academic years via online. A total of 271 students participated. The majority were female (87.8%), single (74.5%) and of Anglo-Saxon background (59.4%), and the average age was 23.7 years. The majority indicated that their fathers had at least secondary school education. The majority (52.8%) decided to study BOH after high school, and of those who commence after high school, 53.7% worked as a dental assistant/auxiliary. Career selection was self-motivated (70.2%) and a career to 'care for and help other people' (59.6%). Most respondents wished to work in a city (59.8%), in both the public and the private sectors (47.2%). This study represents a comprehensive assessment of BOH student profile in Australia and New Zealand. Findings indicate an overall different BOH student profile compared with other oral health profession students in Australia. A significant proportion had previous employment as a dental auxiliary staff and an increasing number of male students. Findings are relevant to educators, recruitment administrators and policy makers in the way the BOH profession is presented as a career option. PMID:24460660

  19. The Impact of Electronic Health Records on Risk Management of Information Systems in Australian Residential Aged Care Homes.

    Science.gov (United States)

    Jiang, Tao; Yu, Ping; Hailey, David; Ma, Jun; Yang, Jie

    2016-09-01

    To obtain indications of the influence of electronic health records (EHR) in managing risks and meeting information system accreditation standard in Australian residential aged care (RAC) homes. The hypothesis to be tested is that the RAC homes using EHR have better performance in meeting information system standards in aged care accreditation than their counterparts only using paper records for information management. Content analysis of aged care accreditation reports from the Aged Care Standards and Accreditation Agency produced between April 2011 and December 2013. Items identified included types of information systems, compliance with accreditation standards, and indicators of failure to meet an expected outcome for information systems. The Chi-square test was used to identify difference between the RAC homes that used EHR systems and those that used paper records in not meeting aged care accreditation standards. 1,031 (37.4%) of 2,754 RAC homes had adopted EHR systems. Although the proportion of homes that met all accreditation standards was significantly higher for those with EHR than for homes with paper records, only 13 RAC homes did not meet one or more expected outcomes. 12 used paper records and nine of these failed the expected outcome for information systems. The overall contribution of EHR to meeting aged care accreditation standard in Australia was very small. Risk indicators for not meeting information system standard were no access to accurate and appropriate information, failure in monitoring mechanisms, not reporting clinical incidents, insufficient recording of residents' clinical changes, not providing accurate care plans, and communication processes failure. The study has provided indications that use of EHR provides small, yet significant advantages for RAC homes in Australia in managing risks for information management and in meeting accreditation requirements. The implication of the study for introducing technology innovation in RAC in

  20. The Impact of Electronic Health Records on Risk Management of Information Systems in Australian Residential Aged Care Homes.

    Science.gov (United States)

    Jiang, Tao; Yu, Ping; Hailey, David; Ma, Jun; Yang, Jie

    2016-09-01

    To obtain indications of the influence of electronic health records (EHR) in managing risks and meeting information system accreditation standard in Australian residential aged care (RAC) homes. The hypothesis to be tested is that the RAC homes using EHR have better performance in meeting information system standards in aged care accreditation than their counterparts only using paper records for information management. Content analysis of aged care accreditation reports from the Aged Care Standards and Accreditation Agency produced between April 2011 and December 2013. Items identified included types of information systems, compliance with accreditation standards, and indicators of failure to meet an expected outcome for information systems. The Chi-square test was used to identify difference between the RAC homes that used EHR systems and those that used paper records in not meeting aged care accreditation standards. 1,031 (37.4%) of 2,754 RAC homes had adopted EHR systems. Although the proportion of homes that met all accreditation standards was significantly higher for those with EHR than for homes with paper records, only 13 RAC homes did not meet one or more expected outcomes. 12 used paper records and nine of these failed the expected outcome for information systems. The overall contribution of EHR to meeting aged care accreditation standard in Australia was very small. Risk indicators for not meeting information system standard were no access to accurate and appropriate information, failure in monitoring mechanisms, not reporting clinical incidents, insufficient recording of residents' clinical changes, not providing accurate care plans, and communication processes failure. The study has provided indications that use of EHR provides small, yet significant advantages for RAC homes in Australia in managing risks for information management and in meeting accreditation requirements. The implication of the study for introducing technology innovation in RAC in

  1. Australian Aboriginal Astronomy: Overview

    CERN Document Server

    Norris, Ray P

    2013-01-01

    The traditional cultures of Aboriginal Australians include a significant astronomical component, perpetuated through oral tradition, ceremony, and art. This astronomical component includes a deep understanding of the motion of objects in the sky, and this knowledge was used for practical purposes, such as constructing calendars. There is also evidence that traditional Aboriginal Australians made careful records and measurements of cyclical phenomena, paid careful attention to unexpected phenomena such as eclipses and meteorite impacts, and could determine the cardinal points to an accuracy of a few degrees.

  2. Ten steps or climbing a mountain: A study of Australian health professionals' perceptions of implementing the baby friendly health initiative to protect, promote and support breastfeeding

    Directory of Open Access Journals (Sweden)

    Sheehan Athena

    2011-08-01

    Full Text Available Abstract Background The Baby Friendly Hospital (Health Initiative (BFHI is a global initiative aimed at protecting, promoting and supporting breastfeeding and is based on the ten steps to successful breastfeeding. Worldwide, over 20,000 health facilities have attained BFHI accreditation but only 77 Australian hospitals (approximately 23% have received accreditation. Few studies have investigated the factors that facilitate or hinder implementation of BFHI but it is acknowledged this is a major undertaking requiring strategic planning and change management throughout an institution. This paper examines the perceptions of BFHI held by midwives and nurses working in one Area Health Service in NSW, Australia. Methods The study used an interpretive, qualitative approach. A total of 132 health professionals, working across four maternity units, two neonatal intensive care units and related community services, participated in 10 focus groups. Data were analysed using thematic analysis. Results Three main themes were identified: 'Belief and Commitment'; 'Interpreting BFHI' and 'Climbing a Mountain'. Participants considered the BFHI implementation a high priority; an essential set of practices that would have positive benefits for babies and mothers both locally and globally as well as for health professionals. It was considered achievable but would take commitment and hard work to overcome the numerous challenges including a number of organisational constraints. There were, however, differing interpretations of what was required to attain BFHI accreditation with the potential that misinterpretation could hinder implementation. A model described by Greenhalgh and colleagues on adoption of innovation is drawn on to interpret the findings. Conclusion Despite strong support for BFHI, the principles of this global strategy are interpreted differently by health professionals and further education and accurate information is required. It may be that the

  3. The prevalence and determinants of Chinese medicine use by Australian women: analysis of a cohort of 10,287 women aged 56-61 years.

    Science.gov (United States)

    Sibbritt, David; Adams, Jon; Murthy, Vijayendra

    2013-01-01

    This study aimed to examine the factors associated with Chinese medicine use amongst a sample of 10,287 Australian women aged 56-61 years. Data was obtained from a cross-sectional postal questionnaire conducted in 2007, this being the fifth survey of the Australian Longitudinal Study on Women's Health. This representative sample of 10,287 women was randomly selected from the Health Insurance Commission (Medicare) database. The outcome measure was the use of Chinese medicine in the previous 12 months. The predictive factors included demographics, health status measures and health service utilization measures. Statistical analyses included univariate chi-square and ANOVA tests and backward stepwise multiple logistic regression modelling. The use of Chinese medicine amongst women aged 56-61 years appears to be strongly influenced by their country of birth, consultation with a range of CAM practitioners, and the use of some self-prescribed CAM. Interestingly, severe tiredness was the only symptom or diagnosis that predicted Chinese medicine use. Given the substantial prevalence of Chinese medicine use and the finding that the use of Chinese medicine is heavily integrated alongside the use of many other CAM and conventional treatments, it is imperative for the safety of patients that health professionals (across complementary and conventional healthcare) fully recognise the possible Chinese medicine use amongst their practice populations. In order to help inform relevant practice and policy development it is also important that future research further examining women's decision-making, motivations and evaluations regarding Chinese medicine use considers such issues within the context of broader CAM and conventional health care utilization. PMID:23548119

  4. A single competency-based education and training and competency-based career framework for the Australian health workforce: discussing the potential value add.

    Science.gov (United States)

    Brownie, Sharon Mary; Thomas, Janelle

    2014-09-01

    This brief discusses the policy implications of a research study commissioned by Health Workforce Australia (HWA) within its health workforce innovation and reform work program. The project explored conceptually complex and operationally problematic concepts related to developing a whole-of-workforce competency-based education and training and competency-based career framework for the Australian health workforce and culminated with the production of three reports published by HWA. The project raised important queries as to whether such a concept is desirable, feasible or implementable - in short what is the potential value add and is it achievable? In setting the scene for discussion, the foundation of the project's genesis and focus of the study are highlighted. A summary of key definitions related to competency-based education and training frameworks and competency-based career frameworks are provided to further readers' commonality of understanding. The nature of the problem to be solved is explored and the potential value-add for the Australian health workforce and its key constituents proposed. The paper concludes by discussing relevance and feasibility issues within Australia's current and changing healthcare context along with the essential steps and implementation realities that would need to be considered and actioned if whole-of-workforce frameworks were to be developed and implemented.

  5. A Single Competency-Based Education and Training and Competency-Based Career Framework for the Australian Health Workforce: Discussing the Potential Value Add

    Directory of Open Access Journals (Sweden)

    Sharon Brownie

    2014-09-01

    Full Text Available This brief discusses the policy implications of a research study commissioned by Health Workforce Australia (HWA within its health workforce innovation and reform work program. The project explored conceptually complex and operationally problematic concepts related to developing a whole-of-workforce competency-based education and training and competency-based career framework for the Australian health workforce and culminated with the production of three reports published by HWA. The project raised important queries as to whether such a concept is desirable, feasible or implementable – in short what is the potential value add and is it achievable? In setting the scene for discussion, the foundation of the project’s genesis and focus of the study are highlighted. A summary of key definitions related to competency-based education and training frameworks and competency-based career frameworks are provided to further readers’ commonality of understanding. The nature of the problem to be solved is explored and the potential value-add for the Australian health workforce and its key constituents proposed. The paper concludes by discussing relevance and feasibility issues within Australia’s current and changing healthcare context along with the essential steps and implementation realities that would need to be considered and actioned if whole-of-workforce frameworks were to be developed and implemented.

  6. Determining death anxiety among health school students

    Directory of Open Access Journals (Sweden)

    Gülay Taşdemir Yiğitoğlu

    2012-07-01

    Full Text Available Aim: The descriptive study has been done in order to determination thoughts, feelings and death anxiety in health school students.Methods: The descriptive study has been done in order to determination death anxiety in students. This study includes 330 students attending Pamukkale University Denizli School of Health. Sample is comprised of 244 students who accepted to enrolled in the study between 01st-31th of May, 2009. Data have been collected with using a questionnaire and “Thorson-Powell Death Anxiety Scale”, T-Test, One-Way ANOVA, Kruskal-Wallis and Mann-Whitney U-Tests.Results: Average age of students who enrolled in the study was 21.44 ± 2.11. 65.6% of the students were girls, 26.6% were in 3rd class, 28.3% were seeing death as “ceasing to exist/ending”, 35.2% were feeling pain/sadness/anxiety when facing death. 63.1% had cared a dying patient, 17.2% felt sadness when they died, 23.0% continued caring in order to cope with death when they did, 43.9% didn’t felt himself enough when caring, 58.2% didn’t wan’t to take care of a dying patient, 63.9% didn’t have enough training at school in order to take care of a dying patient. There were significant relationship between death anxiety point average and students’ age groups, gender, attending class, perception of death, feelings/thoughts about death, feelings during care and wish to again take care of dying patient (p<0.05. In conclusion, male students, attending 3rd class, admitting to have felt helpless and feeling nothing while caring, students feeling adequate, willing to take care of another dying patient were found to have higher death anxiety. As a result of the study approached patients and their families with death while talking to students in addition to, the granting of student consulting services and topics with discussion of concrete cases has been proposed.

  7. Social Determinants of Immigrant Women’s Mental Health

    OpenAIRE

    Mahin Delara

    2016-01-01

    Migration is a population movement with enormous challenges for immigrant women that influence their mental health. Mental health is a social issue and its determinants need to be recognized for health policy making. This paper reviews and consolidates findings from the existing literature on social determinants of immigrant women’s mental health within a socioecological framework. Findings of this review revealed that mental health of immigrant women is an outcome of several interacting dete...

  8. Australian Extinctions

    Science.gov (United States)

    Science Teacher, 2005

    2005-01-01

    Massive extinctions of animals and the arrival of the first humans in ancient Australia--which occurred 45,000 to 55,000 years ago--may be linked. Researchers at the Carnegie Institution, University of Colorado, Australian National University, and Bates College believe that massive fires set by the first humans may have altered the ecosystem of…

  9. Determinants of Health Professionals’ Migration in Africa

    OpenAIRE

    Simplice A, Asongu

    2012-01-01

    How do economic prosperity, health expenditure, savings, price-stability, demographic change, democracy, corruption-control, press-freedom, government effectiveness, human development, foreign-aid, physical security, trade openness and financial liberalization play-out in the fight against health-worker crisis when existing emigration levels matter? Despite the acute concern of health-worker crisis in Africa owing to emigration, lack of relevant data has made the subject matter empirically vo...

  10. The impact of employee level and work stress on mental health and GP service use: an analysis of a sample of Australian government employees

    Directory of Open Access Journals (Sweden)

    Strazdins Lyndall

    2004-09-01

    Full Text Available Abstract Background This study sought to identify the extent to which employee level and work stressors were associated with mental health problems experienced by Australian government employees, and with their use of primary care services. Methods 806 government employees aged between 40 and 44 years were surveyed as part of an epidemiological study conducted in Australia. Data collected from participants included sociodemographic attributes, physical health, psychological measures and work stressors relating to job control, job demands, job security and skills discretion at work. For 88% of these participants, information on visits made to general practitioners (GPs for the six months before and after their survey interview was obtained from health insurance records. Results When work stress and personal factors were taken into account, men at more junior levels reported better mental health, more positive affect and used fewer GP services. Women at middle-management levels obtained less GP care than their more senior counterparts. Both men and women who reported higher levels of work stress were found to have poorer mental health and well-being. The impact of such stressors on GP service use, however, differed for men and women. Conclusion Measures of work stress and not employee level affect the mental health and well-being of government employees. For governments with responsibility for funding health care services, reducing work stress experienced by their own employees offers potential benefits by improving the health of their workforce and reducing outlays for such services.

  11. Are hygiene and public health interventions likely to improve outcomes for Australian Aboriginal children living in remote communities? A systematic review of the literature

    Directory of Open Access Journals (Sweden)

    Brewster David

    2008-05-01

    Full Text Available Abstract Background Australian Aboriginal children living in remote communities still experience a high burden of common infectious diseases which are generally attributed to poor hygiene and unsanitary living conditions. The objective of this systematic literature review was to examine the epidemiological evidence for a relationship between various hygiene and public health intervention strategies, separately or in combination, and the occurrence of common preventable childhood infectious diseases. The purpose was to determine what intervention/s might most effectively reduce the incidence of skin, diarrhoeal and infectious diseases experienced by children living in remote Indigenous communities. Methods Studies were identified through systematically searching electronic databases and hand searching. Study types were restricted to those included in Cochrane Collaboration Effective Practice and Organisation of Care Review Group (EPOC guidelines and reviewers assessed the quality of studies and extracted data using the same guidelines. The types of participants eligible were Indigenous populations and populations of developing countries. The types of intervention eligible for inclusion were restricted to those likely to prevent conditions caused by poor personal hygiene and poor living environments. Results The evidence showed that there is clear and strong evidence of effect of education and handwashing with soap in preventing diarrhoeal disease among children (consistent effect in four studies. In the largest well-designed study, children living in households that received plain soap and encouragement to wash their hands had a 53% lower incidence of diarrhoea (95% CI, 0.35, 0.59. There is some evidence of an effect of education and other hygiene behaviour change interventions (six studies, as well as the provision of water supply, sanitation and hygiene education (two studies on reducing rates of diarrhoeal disease. The size of these effects is

  12. Determinants of Consumer eHealth Information Seeking Behavior.

    Science.gov (United States)

    Sandefer, Ryan H; Westra, Bonnie L; Khairat, Saif S; Pieczkiewicz, David S; Speedie, Stuart M

    2015-01-01

    Patients are increasingly using the Internet and other technologies to engage in their own healthcare, but little research has focused on the determinants of consumer eHealth behaviors related to Internet use. This study uses data from 115,089 respondents to four years of the National Health Interview Series to identify the associations between one consumer eHealth behavior (information seeking) and demographics, health measures, and Personal Health Information Management (PHIM) (messaging, scheduling, refills, and chat). Individuals who use PHIM are 7.5 times more likely to search the internet for health related information. Just as health has social determinants, the results of this study indicate there are potential social determinants of consumer eHealth behaviors including personal demographics, health status, and healthcare access.

  13. Health as a Principal Determinant of Economic Growth

    OpenAIRE

    van Zon, A.H.; Muysken, J.

    2003-01-01

    For a long time economists have tended to ignore health as a relevant factor of production and important determinant of economic growth. The widely observed positive relationship between health expenditures and economic growth was considered the result of a strong positive income effect. However, gradually more and more economists have come to recognise that the relationship between health and economic growth is not only demand driven, but that health is also an important determinant of econo...

  14. Regional Differences in Correlates of Daily Walking among Middle Age and Older Australian Rural Adults: Implications for Health Promotion

    OpenAIRE

    James Dollman; Melissa Hull; Nicole Lewis; Suzanne Carroll; Dorota Zarnowiecki

    2016-01-01

    Rural Australians are less physically active than their metropolitan counterparts, and yet very little is known of the candidate intervention targets for promoting physical activity in rural populations. As rural regions are economically, socially and environmentally diverse, drivers of regular physical activity are likely to vary between regions. This study explored the region-specific correlates of daily walking among middle age and older adults in rural regions with contrasting dominant pr...

  15. Gender and the determinants of health: implications for health promotion policies

    OpenAIRE

    O’Connor, Mary

    2016-01-01

    The following paper brings together discussions of gender, health promotion and the determinants of health. It refers broadly to gender as a determinant of health using examples and statistics from Canada. Despite the importance of attending to the social determinants of health, it is argued there are dangers, if not only shortcomings, to a certain broad determinants approach which ignores the differences of the everyday context and lived realities of peoples’ lives. Since gender relations ha...

  16. Determinants of health insurance and hospitalization

    Directory of Open Access Journals (Sweden)

    Tadashi Yamada

    2014-12-01

    Full Text Available Our paper empirically examines how the decision to purchase private insurance and hospitalization are made based on household income, socio-demographic factors, and private health insurance factors in both Japan and the USA. Using these two data-sets, we found some similarities and dissimilarities between Japan and the United States. As income of households rises, households have a positive effect on purchasing health insurance as a normal good. Another similarity between the two countries is seen in the income effect on risk of hospitalization, which is negative for both Japanese and US cases. For dissimilarity, the insurance premium effect on risk of hospitalization is positive for the Japanese case, while negative for the US case. Since the Japanese insurance data had variables such as payments per day of hospitalization if household gets hospitalized, insurance payments upon death of an insured person, and annuity payments at maturity, we tested to see if these characteristics affect the risk of hospitalization for households; we do not eliminate a possibility of adverse selection. For the US pure health issuance characteristics, an increase in premium of health insurance policies cause individuals to substitute more health capital investment which causes lower risk of hospitalization.

  17. Exploring models for the roles of health systems’ responsiveness and social determinants in explaining universal health coverage and health outcomes

    OpenAIRE

    Valentine, Nicole Britt; Bonsel, Gouke J.

    2016-01-01

    Background: Intersectoral perspectives of health are present in the rhetoric of the sustainable development goals. Yet its descriptions of systematic approaches for an intersectoral monitoring vision, joining determinants of health, and barriers or facilitators to accessing healthcare services are lacking.Objective: To explore models of associations between health outcomes and health service coverage, and health determinants and health systems responsiveness, and thereby to contribute to moni...

  18. Students' Mental Health: Personal and University Determinants

    Science.gov (United States)

    Khodarahimi, Siamak; Rasti, Ali; Khajehie, Malihe; Sattar, Rea

    2009-01-01

    The present study was to examine the effects of personal and university bounded factors in students mental health in north of Fars province, Iran. The effects of these factors on university students' psychopathology within a survey design were investigated among 300 participants--94 males and 206 females, who were selected through random sampling…

  19. Determinants of health literacy and health behavior regarding infectious respiratory diseases: a pathway model

    OpenAIRE

    Sun, Xinying; Shi, Yuhui; Zeng, Qingqi; Wang, Yanling; Du, Weijing; Wei, Nanfang; Xie, Ruiqian; Chang, Chun

    2013-01-01

    Background Health literacy has been defined as the degree to which individuals have the capacity to obtain, process, and understand the basic health information and services needed to make appropriate health decisions. Currently, few studies have validated the causal pathways of determinants of health literacy through the use of statistical modeling. The purpose of the present study was to develop and validate a health literacy model at an individual level that could best explain the determin...

  20. HealthPaths: Using functional health trajectories to quantify the relative importance of selected health determinants

    Directory of Open Access Journals (Sweden)

    Michael Wolfson

    2014-10-01

    Full Text Available Background: It is widely known that that there is a significant dispersion in health status, as well as a strong correlation between health status and socio-economic status. But considerable uncertainty remains as to the quantitative importance of the various explanatory factors typically cited in this context. As health status is intrinsically a reflection of co-evolving dynamic processes, it is important to take a lifetime perspective when seeking to understand its determinants. The "bottom line" measure of overall population health is, though, health-adjusted life expectancy (HALE, which is an aggregation of individuals' health-adjusted life lengths (HALLs. Objective: In an exploratory mode, we intend to provide a realistic assessment of the relative importance of selected health determinants of HALE. Methods: This paper first draws on very detailed estimates of the covariates of vector-valued functional health trajectories, using the National Population Health Survey (Statistics Canada. We then use longitudinal microsimulation to draw out their implications by synthesising first a realistic base case -- specifically, a representative longitudinal population sample -- and then a series of exploratory counterfactual populations. Comparisons between and among counterfactuals and the base case are then used to estimate the quantitative importance of various factors in accounting for HALE. Results: Several surprising results emerged. Of the four risk factors explicitly examined, obesity had the smallest impacts on HALE: moving from the fifth to the 95th percentiles of BMI increased HALE 1.5 and 2.5 years for men and women, respectively. Eliminating smoking increased HALE by five and four years, while moving from the lowest to the highest levels of education had similar effects of about five years for both men and women. Perhaps surprisingly, moving from the fifth to the 95th percentiles of the psycho-social factor, Antonovsky's sense of coherence

  1. Luck Egalitarianism, Social Determinants and Public Health Initiatives

    DEFF Research Database (Denmark)

    Albertsen, Andreas

    2015-01-01

    People’s health is hugely affected by where they live, their occupational status and their socio-economic position. It has been widely argued that the presence of such social determinants in health provides good reasons to reject luck egalitarianism as a theory of distributive justice in health....... The literature provides different reasons why this responsibility-sensitive theory of distributive justice should not be applied to health. The critiques submit that (i) the social circumstances undermine or remove people’s responsibility for their health; (ii) responsibility sensitive health policies would...

  2. Determinants of consumer understanding of health claims

    DEFF Research Database (Denmark)

    Grunert, Klaus G; Scholderer, Joachim; Rogeaux, Michel

    2011-01-01

    as safe, risky or other. In addition to the open questions on claim understanding, respondents rated a number of statements on claim interpretation for agreement and completed scales on interest in healthy eating, attitude to functional foods, and subjective knowledge on food and health. Results showed...... that respondents with a positive attitude to functional foods are more likely to be classified as riskywith regard to their claim understanding, whereas respondents with negative or neutral attitudes are more likely to be classified into the other category. Implications for testing claim understanding...

  3. Australian Research Council

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    @@ Introduction The Australian Research Council(ARC) is the Australian Government's main agency for allocating research funding to academics and researchers in Australian universities.Its mission is to deliver policy and programs that advance Australian research and innovation globally and benefit the community.

  4. Social determinants of health, universal health coverage, and sustainable development: case studies from Latin American countries.

    Science.gov (United States)

    de Andrade, Luiz Odorico Monteiro; Pellegrini Filho, Alberto; Solar, Orielle; Rígoli, Félix; de Salazar, Lígia Malagon; Serrate, Pastor Castell-Florit; Ribeiro, Kelen Gomes; Koller, Theadora Swift; Cruz, Fernanda Natasha Bravo; Atun, Rifat

    2015-04-01

    Many intrinsically related determinants of health and disease exist, including social and economic status, education, employment, housing, and physical and environmental exposures. These factors interact to cumulatively affect health and disease burden of individuals and populations, and to establish health inequities and disparities across and within countries. Biomedical models of health care decrease adverse consequences of disease, but are not enough to effectively improve individual and population health and advance health equity. Social determinants of health are especially important in Latin American countries, which are characterised by adverse colonial legacies, tremendous social injustice, huge socioeconomic disparities, and wide health inequities. Poverty and inequality worsened substantially in the 1980s, 1990s, and early 2000s in these countries. Many Latin American countries have introduced public policies that integrate health, social, and economic actions, and have sought to develop health systems that incorporate multisectoral interventions when introducing universal health coverage to improve health and its upstream determinants. We present case studies from four Latin American countries to show the design and implementation of health programmes underpinned by intersectoral action and social participation that have reached national scale to effectively address social determinants of health, improve health outcomes, and reduce health inequities. Investment in managerial and political capacity, strong political and managerial commitment, and state programmes, not just time-limited government actions, have been crucial in underpinning the success of these policies. PMID:25458716

  5. Oral health of foreign domestic workers: exploring the social determinants.

    Science.gov (United States)

    Gao, Xiaoli; Chan, Chi Wai; Mak, Siu Lun; Ng, Zevon; Kwong, Wai Hang; Kot, Ching Ching Shirley

    2014-10-01

    Foreign domestic helpers constitute a significant proportion of migrant workers worldwide. This population subgroup provides an opportunity for understanding social determinants of oral health in immigrant community. A random sample of 122 Indonesian domestic helpers in Hong Kong completed a questionnaire on their demographic background, social characteristics (competency in local languages, immigration history, living condition, social connections, and leisure activities) and oral health behaviours (knowledge, attitudes, practice and self-efficacy). Their tooth status and periodontal health were assessed. Participants tended to start flossing after settling in Hong Kong. Favourable oral health knowledge was found in more acculturated participants, as indicated by proficiency in local languages and immigration history. Engagement in social and/or religious activities and decent living condition provided by employers were associated with favourable oral health behaviours and/or better oral health. Social determinants explained 13.2 % of variance in caries severity. Our findings support the significant impact of social circumstances on oral health of domestic workers.

  6. Luck Egalitarianism, Social Determinants and Public Health Initiatives

    DEFF Research Database (Denmark)

    Albertsen, Andreas

    2015-01-01

    People’s health is hugely affected by where they live, their occupational status and their socio-economic position. It has been widely argued that the presence of such social determinants in health provides good reasons to reject luck egalitarianism as a theory of distributive justice in health...... egalitarianism provides suitable answers. The literature on social determinants is no detriment to the project of applying luck egalitarianism to health........ The literature provides different reasons why this responsibility-sensitive theory of distributive justice should not be applied to health. The critiques submit that (i) the social circumstances undermine or remove people’s responsibility for their health; (ii) responsibility sensitive health policies would...

  7. Time's up. descriptive epidemiology of multi-morbidity and time spent on health related activity by older Australians: a time use survey.

    Directory of Open Access Journals (Sweden)

    Tanisha Jowsey

    Full Text Available Most Western health systems remain single illness orientated despite the growing prevalence of multi-morbidity. Identifying how much time people with multiple chronic conditions spend managing their health will help policy makers and health service providers make decisions about areas of patient need for support. This article presents findings from an Australian study concerning the time spent on health related activity by older adults (aged 50 years and over, most of whom had multiple chronic conditions. A recall questionnaire was developed, piloted, and adjusted. Sampling was undertaken through three bodies; the Lung Foundation Australia (COPD sub-sample, National Diabetes Services Scheme (Diabetes sub-sample and National Seniors Australia (Seniors sub-sample. Questionnaires were mailed out during 2011 to 10,600 older adults living in Australia. 2540 survey responses were received and analysed. Descriptive analyses were completed to obtain median values for the hours spent on each activity per month. The mean number of chronic conditions was 3.7 in the COPD sub-sample, 3.4 in the Diabetes sub-sample and 2.0 in the NSA sub-sample. The study identified a clear trend of increased time use associated with increased number of chronic conditions. Median monthly time use was 5-16 hours per month overall for our three sub-samples. For respondents in the top decile with five or more chronic conditions the median time use was equivalent to two to three hours per day, and if exercise is included in the calculations, respondents spent from between five and eight hours per day: an amount similar to full-time work. Multi-morbidity imposes considerable time burdens on patients. Ageing is associated with increasing rates of multi-morbidity. Many older adults are facing high demands on their time to manage their health in the face of decreasing energy and mobility. Their time use must be considered in health service delivery and health system reform.

  8. Psychosis, Socioeconomic Disadvantage, and Health Service Use in South Australia: Findings from the Second Australian National Survey of Psychosis.

    Science.gov (United States)

    Sweeney, Shaun; Air, Tracy; Zannettino, Lana; Galletly, Cherrie

    2015-01-01

    The association between mental illness and poor physical health and socioeconomic outcomes has been well established. In the twenty-first century, the challenge of how mental illnesses, such as psychosis, are managed in the provision of public health services remains complex. Developing effective clinical mental health support and interventions for individuals requires a coordinated and robust mental health system supported by social as well as health policy that places a priority on addressing socioeconomic disadvantage in mental health cohorts. This paper, thus, examines the complex relationship between socioeconomic disadvantage, family/social supports, physical health, and health service utilization in a community sample of 402 participants diagnosed with psychosis. The paper utilizes quantitative data collected from the 2010 Survey of High Impact Psychosis research project conducted in a socioeconomically disadvantaged region of Adelaide, SA, Australia. Participants (42% female) provided information about socioeconomic status, education, employment, physical health, contact with family and friends, and health service utilization. The paper highlights that socioeconomic disadvantage is related to increased self-reported use of emergency departments, decreased use of general practitioners for mental health reasons, higher body mass index, less family contact, and less social support. In particular, the paper explores the multifaceted relationship between socioeconomic disadvantage and poor health confronting individuals with psychosis, highlighting the complex link between socioeconomic disadvantage and poor health. It emphasizes that mental health service usage for those with higher levels of socioeconomic disadvantage differs from those experiencing lower levels of socioeconomic disadvantage. The paper also stresses that the development of health policy and practice that seeks to redress the socioeconomic and health inequalities created by this disadvantage be

  9. Social Determinants and Disparities in Health: Their Crucifixion, Resurrection, and Ultimate Triumph(?) in Health Policy.

    Science.gov (United States)

    House, James S

    2016-08-01

    David Mechanic has been a principal founder of modern sociological and social science approaches to health, especially in relation to health policy. These approaches have since the 1950s and 1960s resurrected ideas that had currency in the mid-nineteenth century but seemed crucified, dead, and buried by the rise of modern biomedicine from the mid-nineteenth century through the mid-twentieth century. Problems and lacunae in purely biomedical approaches to health in the later twentieth century, along with developments of new biopsychosocial approaches to health, have spawned a return toward ideas of Rudolf Virchow and mid-nineteenth-century social medicine that social determinants and disparities are major drivers of population health. Since individual health and population health constitute the major determinants of health care utilization and expenditures, social determinants and disparities in health are arguably the foundation of a new "demand-side" health policy that can resolve America's paradoxical health policy crisis of spending increasingly more than any nation on health care and insurance yet achieving increasingly worsening health outcomes relative to virtually all developed countries and some developing ones as well, something that current "supply-side" health policy, including Obamacare, cannot do, important as it is for expanding access to health insurance and care. PMID:27127266

  10. Precarious employment: understanding an emerging social determinant of health.

    Science.gov (United States)

    Benach, J; Vives, A; Amable, M; Vanroelen, C; Tarafa, G; Muntaner, C

    2014-01-01

    Employment precariousness is a social determinant that affects the health of workers, families, and communities. Its recent popularity has been spearheaded by three main developments: the surge in "flexible employment" and its associated erosion of workers' employment and working conditions since the mid-1970s; the growing interest in social determinants of health, including employment conditions; and the availability of new data and information systems. This article identifies the historical, economic, and political factors that link precarious employment to health and health equity; reviews concepts, models, instruments, and findings on precarious employment and health inequalities; summarizes the strengths and weaknesses of this literature; and highlights substantive and methodological challenges that need to be addressed. We identify two crucial future aims: to provide a compelling research program that expands our understanding of employment precariousness and to develop and evaluate policy programs that effectively put an end to its health-related impacts. PMID:24641559

  11. Development and implementation of an online hybrid model for teaching evidence-based practice to health professions: processes and outcomes from an Australian experience

    Directory of Open Access Journals (Sweden)

    Saravana Kumar

    2010-08-01

    Full Text Available Saravana Kumar, Luke Perraton, Zuzana Machotka.International Centre for Allied Health Evidence, School of Health Sciences, University of South Australia, Adelaide, South Australia.Abstract: Evidence-based practice is now considered to be a vital element of health care service delivery. The call to use evidence to inform other areas, such as teaching and learning, is growing. This paper reports on the processes used to integrate best evidence into teaching practices within an undergraduate health science program. An existing course within this program at an Australian tertiary institution was remodeled by a newly appointed course coordinator in response to critical feedback from student cohorts. A systematic, iterative, five-step approach was used in the development of the new course. The process of development was influenced by current research evidence, an audit of the existing course, and critical feedback from ­students. The new course was evaluated using quantitative and qualitative research methods for five study periods. In 2005, prior to implementing the changes, the overall student satisfaction rating for the course was zero (representing the lowest possible score. In 2006, the overall student satisfaction rating was 62.07, in 2007 it was 65.8, and in 2008 it was 55.7. Qualitative ­findings also supported these quantitative findings, indicating improvements in the structure and process of the new course. The outcomes from the evaluation of the remodeled course provide evidence of a consistent quality learning experience for students, and support the concept of using research evidence to guide the development of teaching and learning practices in the training of health professionals.Keywords: evidence-based teaching, learning, health care, qualitative, quantitative.

  12. Psychosis, Socioeconomic Disadvantage, and Health Service Use in South Australia: Findings from the Second Australian National Survey of Psychosis

    OpenAIRE

    Sweeney, Shaun; Air, Tracy; Zannettino, Lana; Galletly, Cherrie

    2015-01-01

    The association between mental illness and poor physical health and socioeconomic outcomes has been well established. In the twenty-first century, the challenge of how mental illnesses, such as psychosis, are managed in the provision of public health services remains complex. Developing effective clinical mental health support and interventions for individuals requires a coordinated and robust mental health system supported by social as well as health policy that places a priority on addressi...

  13. Determinants of the most significant characteristics of reproductive health

    Directory of Open Access Journals (Sweden)

    Miljković Snežana

    2010-01-01

    Full Text Available Introduction. Reproductive health of women is determined by females’ demographic and socio-economic characteristics, their behavior, and the complex of environmental factors. Objective. The paper examines the predictive impact of personal and environmental characteristics, health and healthcare characteristics regarding the most important aspects of reproductive health. Methods From a sample of 2,718 women, aged 20-49 years, we collected information on various characteristics using a structured questionnaire. Based on factorial analysis (principal components method, Kaisser Varimax criterion we selected representative variables (factors, describing personal (demographic and socio-economic characteristics of women, their environment (family, household, community, health (attitudes towards health, life-style, health status, healthcare (independent and the characteristics of reproductive health (dependent variables. The predictors were analyzed by multiple regression and correlation. Results. Sexual behavior was determined by socio-economic status, personal tidiness, rest, presence of risk factor(s, health evaluation and attitude toward personal responsibility, trust in physicians etc. The predictors of contraception involved satisfaction with one’s own health, serious health problems, health evaluation. The presence and number of abortions were determined by personal psychological maturity, rest, risk factors, life-style, health evaluation and its manifestations, and the continuity and timely healthcare. The predictors of adequate protection of reproductive health involved the cultural level of the community, financial standing of the household, satisfaction with one’s own life, tidiness and rest, presence of risk factors, health evaluation, attitude towards personal responsibility, and trust in physicians. HIV control was determined by satisfaction with one’s own life, physical activity of women, presence of serious health problems, and

  14. Urban liveability: emerging lessons from Australia for exploring the potential for indicators to measure the social determinants of health.

    Science.gov (United States)

    Badland, Hannah; Whitzman, Carolyn; Lowe, Melanie; Davern, Melanie; Aye, Lu; Butterworth, Iain; Hes, Dominique; Giles-Corti, Billie

    2014-06-01

    It has long been recognised that urban form impacts on health outcomes and their determinants. There is growing interest in creating indicators of liveability to measure progress towards achieving a wide range of policy outcomes, including enhanced health and wellbeing, and reduced inequalities. This review aimed to: 1) bring together the concepts of urban 'liveability' and social determinants of health; 2) synthesise the various liveability indicators developed to date; and 3) assess their quality using a health and wellbeing lens. Between 2011 and 2013, the research team reviewed 114 international academic and policy documents, as well as reports related to urban liveability. Overall, 233 indicators were found. Of these, 61 indicators were regarded as promising, 57 indicators needed further development, and 115 indicators were not useful for our purposes. Eleven domains of liveability were identified that likely contribute to health and wellbeing through the social determinants of health. These were: crime and safety; education; employment and income; health and social services; housing; leisure and culture; local food and other goods; natural environment; public open space; transport; and social cohesion and local democracy. Many of the indicators came from Australian sources; however most remain relevant from a 'global north' perspective. Although many indicators were identified, there was inconsistency in how these domains were measured. Few have been validated to assess their association with health and wellbeing outcomes, and little information was provided for how they should be applied to guide urban policy and practice. There is a substantial opportunity to further develop these measures to create a series of robust and evidence-based liveability indices, which could be linked with existing health and wellbeing data to better inform urban planning policies within Australia and beyond. PMID:24762261

  15. Social Determinants of Oral Health Status at Present

    Directory of Open Access Journals (Sweden)

    Judit Martínez Abreu

    2014-08-01

    Full Text Available The determinants of oral health must be closely related to the dynamic changes in society. This paper aims at reflecting on how the transformations in Cuban society might lead to conceptual changes in the analysis of the health situation. The need for more innovative models and methodologies applied to the Cuban context are discussed. The trends regarding social determinants will allow developing proper oral health intervention strategies in our context. Future epidemiological studies should pay special attention to social issues such as household income, family dynamics, gender equality, respect for diversity, employment, working conditions, social support networks and food security or proper diet.

  16. Psychosis, Socioeconomic Disadvantage and Health Service Use in South Australia: Findings from the Second Australian National Survey of Psychosis

    Directory of Open Access Journals (Sweden)

    Shaun eSweeney

    2015-11-01

    Full Text Available The association between mental illness and poor physical health and socioeconomic outcomes has been well established. In the twenty-first century, the challenge of how mental illnesses such as psychosis are managed in the provision of public health services remains complex. Developing effective clinical mental health support and interventions for individuals requires a coordinated and robust mental health system supported by social as well as health policy that places a priority on addressing socioeconomic disadvantage in mental health cohorts. This paper thus examines the complex relationship between socioeconomic disadvantage, family/social supports, physical health and health service utilisation in a community sample of 402 participants diagnosed with psychosis. The paper utilises quantitative data collected from the 2010 Survey of High Impact Psychosis research project conducted in a socioeconomically disadvantaged region of Adelaide, South Australia. Participants (42% female provided information about socio-economic status, education, employment, physical health, contact with family and friends, and health service utilisation. The paper highlights that socio-economic disadvantage is related to increased self-reported use of emergency departments, decreased use of general practitioners for mental health reasons, higher body mass index, less family contact and less social support. In particular, the paper explores the multifaceted relationship between socioeconomic disadvantage and poor health confronting individuals with psychosis, highlighting the complex link between socioeconomic disadvantage and poor health. It emphasizes that mental health service usage for those with higher levels of socioeconomic disadvantage differs from those experiencing lower levels of socioeconomic disadvantage. The paper also stresses that the development of health policy and practice that seeks to redress the socioeconomic and health inequalities created by

  17. A global history of Australian trees.

    Science.gov (United States)

    Bennett, Brett M

    2011-01-01

    Scholars studying the globalization of Australian trees have previously emphasized the rapid natural propagation of Australian trees outside of their native habitats, believing their success to be a reversal of "ecological imperialism" from the "new world" to the "old world." This article argues that the expansion of Australian trees should not be viewed as a biological phenomenon, but as the result of a long-term attempt by powerful states and state-sponsored scientists to select and breed Australian species that could grow in a variety of climates and ecological conditions. Five non-biological factors largely determined the success of these attempts to grow Australian trees: the abundance or paucity of natural forests, state power, the amount of scientific research directed to planting Australian trees, the cost of labor, and the ability to utilize hardwood timbers and bark. This paper compares the use of Australian trees in Australia, India, and South Africa to demonstrate that biology was not the determining factor in the long-term success of many Australian genera and species. PMID:20665086

  18. Access to general practitioner services amongst underserved Australians: a microsimulation study

    Directory of Open Access Journals (Sweden)

    Schofield Deborah J

    2012-01-01

    Full Text Available Abstract Background One group often identified as having low socioeconomic status, those living in remote or rural areas, are often recognised as bearing an unequal burden of illness in society. This paper aims to examine equity of utilisation of general practitioner services in Australia. Methods Using the 2005 National Health Survey undertaken by the Australian Bureau of Statistics, a microsimulation model was developed to determine the distribution of GP services that would occur if all Australians had equal utilisation of health services relative to need. Results It was estimated that those who are unemployed would experience a 19% increase in GP services. Persons residing in regional areas would receive about 5.7 million additional GP visits per year if they had the same access to care as Australians residing in major cities. This would be a 18% increase. There would be a 20% increase for inner regional residents and a 14% increase for residents of more remote regional areas. Overall there would be a 5% increase in GP visits nationally if those in regional areas had the same access to care as those in major cities. Conclusion Parity is an insufficient goal and disadvantaged persons and underserved areas require greater access to health services than the well served metropolitan areas due to their greater poverty and poorer health status. Currently underserved Australians suffer a double disadvantage: poorer health and poorer access to health services.

  19. Determining HER2 (ERBB2) amplification status in women with breast cancer: final results from the Australian in situ hybridisation program.

    Science.gov (United States)

    Morey, Adrienne L; Brown, Belinda; Farshid, Gelareh; Fox, Stephen B; Francis, Glenn D; McCue, Glenda; von Neumann-Cosel, Vita; Bilous, Michael

    2016-10-01

    Appropriate and accurate determination of HER2 status in women with breast cancer is critical for stratifying anti-HER2 therapies, and for access to subsidised treatment in the Australian setting. We conducted a regulated, nationwide program providing HER2 in situ hybridisation (ISH) testing for patients with newly diagnosed breast cancer. Cases with equivocal or non-diagnostic ISH test results at the local laboratory were sent to a high volume central testing laboratory for analysis using fluorescence ISH (FISH). We tested 78,408 early breast cancers and 3469 metastatic cancers using ISH. Of these, 12,405 early breast cancers (15.8%) and 798 metastatic cancers (23.0%) were HER2 positive. During the testing period, the proportion of core biopsy samples increased, the number of repeat tests remained stable and testing turnaround time declined. Discordant 3+ IHC, ISH negative results dropped from 20% to 13% in early breast cancers and from 35% to 8% among metastatic breast cancers. Following central laboratory FISH testing only 87 samples remained non-diagnostic (1.9% of FISH-tested samples, 0.1% of the whole cohort), most being decalcified specimens. This is a successful story of a cohesive service determining HER2 status in women with breast cancer in a 'real-world' setting.

  20. Scientific Advice, Traditional Practices and the Politics of Health-Care : The Australian Debate over Public Funding of Non-Therapeutic Circumcision, 1985

    Directory of Open Access Journals (Sweden)

    Robert Darby

    2011-12-01

    Full Text Available In 1985 the Australian Government sought to delete circumcision of infants from the benefits payable under its newly established universal health scheme, Medicare. Although the decision had been recommended by the government's health advisers and was welcomed by medical authorities, it was soon reversed after protests from Jewish community leaders. I present a detailed narrative of this affair and explain why a decision based on sound medical knowledge advice was rescinded after quite mild objections. The answer is found to lie partly in contingent factors, such as the details of the policy change, the personalities of the government figures involved, and problems with implementation and communication; and partly in the sensibilities of the ethnic/religious communities most directly affected. I dispel the misconception that the original decision aroused widespread opposition and show, on the contrary, that it was based on good advice, represented sound public policy, and was widely supported. I conclude that the episode may have useful lessons for other governments seeking to implement or resist policy changes that affect the sensitivities of cultural minorities.

  1. Building codes: An often overlooked determinant of health.

    Science.gov (United States)

    Chauvin, James; Pauls, Jake; Strobl, Linda

    2016-05-01

    Although the vast majority of the world's population spends most of their time in buildings, building codes are not often thought of as 'determinants of health'. The standards that govern the design, construction, and use of buildings affect our health, security, safety, and well-being. This is true for dwellings, schools, and universities, shopping centers, places of recreation, places of worship, health-care facilities, and workplaces. We urge proactive engagement by the global public health community in developing these codes, and in the design and implementation of health protection and health promotion activities intended to reduce the risk of injury, disability, and death, particularly when due to poor building code adoption/adaption, application, and enforcement. PMID:26935404

  2. Promoting fit bodies, healthy eating and physical activity among Indigenous Australian men: a study protocol

    Directory of Open Access Journals (Sweden)

    Ricciardelli Lina A

    2012-01-01

    Full Text Available Abstract Background Overall the physical health of Indigenous men is among the worst in Australia. Research has indicated that modifiable lifestyle factors, such as poor nutrition and physical inactivity, appear to contribute strongly to these poor health conditions. To effectively develop and implement strategies to improve the health of Australia's Indigenous peoples, a greater understanding is needed of how Indigenous men perceive health, and how they view and care for their bodies. Further, a more systematic understanding of how sociocultural factors affect their health attitudes and behaviours is needed. This article presents the study protocol of a community-based investigation into the factors surrounding the health and body image of Indigenous Australian men. Methods and design The study will be conducted in a collaborative manner with Indigenous Australian men using a participatory action research framework. Men will be recruited from three locations around Australia (metropolitan, regional, and rural and interviewed to understand their experiences and perspectives on a number of issues related to health and health behaviour. The information that is collected will be analysed using modified grounded theory and thematic analysis. The results will then be used to develop and implement community events in each location to provide feedback on the findings to the community, promote health enhancing strategies, and determine future action and collaboration. Discussion This study will explore both risk and protective factors that affect the health of Indigenous Australian men. This knowledge will be disseminated to the wider Indigenous community and can be used to inform future health promotion strategies. The expected outcome of this study is therefore an increased understanding of health and health change in Indigenous Australian men, the development of strategies that promote healthy eating and positive patterns of physical activity and, in

  3. Traumatic events, other operational stressors and physical and mental health reported by Australian Defence Force personnel following peacekeeping and war-like deployments

    Directory of Open Access Journals (Sweden)

    Waller Michael

    2012-07-01

    Full Text Available Abstract Background The association between stressful events on warlike deployments and subsequent mental health problems has been established. Less is known about the effects of stressful events on peacekeeping deployments. Methods Two cross sectional studies of the Australian Defence Force were used to contrast the prevalence of exposures reported by a group deployed on a peacekeeping operation (Bougainville, n = 1704 and those reported by a group deployed on operations which included warlike and non-warlike exposures (East Timor, n = 1333. A principal components analysis was used to identify groupings of non-traumatic exposures on deployment. Multiple regression models were used to assess the association between self-reported objective and subjective exposures, stressors on deployment and subsequent physical and mental health outcomes. Results The principal components analysis produced four groups of non-traumatic stressors which were consistent between the peacekeeping and more warlike deployments. These were labelled ‘separation’, ‘different culture’, ‘other people’ and ‘work frustration’. Higher levels of traumatic and non-traumatic exposures were reported by veterans of East Timor compared to Bougainville. Higher levels of subjective traumatic exposures were associated with increased rates of PTSD in East Timor veterans and more physical and psychological health symptoms in both deployed groups. In Bougainville and East Timor veterans some non-traumatic deployment stressors were also associated with worse health outcomes. Conclusion Strategies to best prepare, identify and treat those exposed to traumatic events and other stressors on deployment should be considered for Defence personnel deployed on both warlike and peacekeeping operations.

  4. Australian Cosmic Ray Modulation Research

    CERN Document Server

    Duldig, M L

    2000-01-01

    Australian research into variations of the cosmic ray flux arriving at the Earth has played a pivotal role for more than 50 years. The work has been largely led by the groups from the University of Tasmania and the Australian Antarctic Division and has involved the operation of neutron monitors and muon telescopes from many sites. In this paper the achievements of the Australian researchers are reviewed and future experiments are described. Particular highlights include: the determination of cosmic ray modulation parameters; the development of modelling techniques of Ground Level Enhancements; the confirmation of the Tail-In and Loss-Cone Sidereal anisotropies; the Space Ship Earth collaboration; and the Solar Cycle latitude survey.

  5. Equity, social determinants and public health programmes - the case of oral health

    DEFF Research Database (Denmark)

    Petersen, Poul Erik; Kwan, Stella

    2011-01-01

    is that means are available for breaking poverty and reduce if not eliminate social inequalities in oral health. Whether public health actions are initiated simply depends on the political will. The Ottawa Charter for Health Promotion (1986) and subsequent charters have emphasized the importance of policy......, health status, and access to health care. Most individuals and societies, irrespective of their philosophical and ideological stance, have limits as to how much unfairness is acceptable. In 2010, WHO published another important report on 'Equity, Social Determinants and Public Health Programmes......', with the aim of translating knowledge into concrete, workable actions. Poor oral health was flagged as a severe public health problem. Oral disease and illness remain global problems and widening inequities in oral health status exist among different social groupings between and within countries. The good news...

  6. The impact of population-based disease management services for selected chronic conditions: the Costs to Australian Private Insurance - Coaching Health (CAPICHe study protocol

    Directory of Open Access Journals (Sweden)

    Byrnes Joshua M

    2012-02-01

    available in late 2013. Discussion If positive, CAPICHe will represent a potentially cost-effective strategy to improve health outcomes in higher risk individuals with a chronic condition, in a private health insurance setting. Trial Registration Australian New Zealand Clinical Trials Registry reference: ACTRN12611000580976

  7. Effect of Health Literacy on Quality of Life amongst Patients with Ischaemic Heart Disease in Australian General Practice

    OpenAIRE

    David Alejandro González-Chica; Zandile Mnisi; Jodie Avery; Katherine Duszynski; Jenny Doust; Philip Tideman; Andrew Murphy; Jacquii Burgess; Justin Beilby; Nigel Stocks

    2016-01-01

    Background Appropriate understanding of health information by patients with cardiovascular disease (CVD) is fundamental for better management of risk factors and improved morbidity, which can also benefit their quality of life. Objectives To assess the relationship between health literacy and health-related quality of life (HRQoL) in patients with ischaemic heart disease (IHD), and to investigate the role of sociodemographic and clinical variables as possible confounders. Methods Cross-sectio...

  8. Australian and New Zealand contribution to international mental health research publications: a survey of high-impact journals

    OpenAIRE

    White, Joshua; Patel, Vikram; HERRMAN, HELEN

    2007-01-01

    Most mental health research published in high-impact journals originates from developed countries in North America and Western Europe and from Australia and New Zealand (ANZ), where only a minority of the world's population exists. We examined the contribution of the ANZ research community to the literature on international mental health in regard to countries outside this dominant group. A literature search was conducted with two phases: a PubMed search of mental health art...

  9. Social Determinants of Health: Perspective of the ALAMES Social Determinants Working Group

    Directory of Open Access Journals (Sweden)

    José Carlos Escudero

    2008-11-01

    Full Text Available Introduction The recent discussion of the social determinants of health, which has been promoted by the WHO as a way to approach global health conditions is neither a new nor a foreign subject for Latin American social medicine or collective health. Indeed, this approach to health derives from the principles of 19th century European social medicine which accepted that the health of the population is a matter of social concern, that social and economic conditions have an important bearing on health and disease, and that these relationships should be subjected to scientific enquiry. (Rosen, 1985:81 The specific socio-historical conditions of Latin America in the 1970’s fostered the development of an innovative, critical, and socially-based based health analysis, which was seen in an evolving theoretical approach with deep social roots. (Cohn, 2003 This analysis calls for scientific work which is committed to changing living and working conditions and to improving the health of the popular classes. (Waitzkin y col. 2001; Iriart y col. 2002. From its beginning, this school of socio-medical thought recognized that collective health has two main areas of research: 1 the distribution and determinants of health and disease and 2 the interpretation, technical knowledge, and specialized practices concerning health, disease, and death. The goal is to understand health and disease as differentiated moments in the human lifecycle, subject to permanent change, and expressing the biological nature of the human body under specific forms of social organization, all this in such a way as to allow discussion of causality and determination. (Breilh y Granda,1982; Laurell, 1982. Latin American social medicine criticized biomedical and conventional epidemiological approaches for isolating health and disease from social context, misinterpreting social processes as biological, conceptualizing health phenomena in individualistic terms, and adopting the methodological

  10. Vitamin D Status, Bone Mineral Density and Mental Health in Young Australian Women: The Safe-D Study

    Science.gov (United States)

    Reavley, Nicola; Garland, Suzanne M.; Gorelik, Alexandra; Wark, John D.

    2015-01-01

    Background. Vitamin D deficiency has been associated with both poor bone health and mental ill-health. More recently, a number of studies have found individuals with depressive symptoms tend to have reduced bone mineral density. To explore the interrelationships between vitamin D status, bone mineral density and mental-ill health we are assessing a range of clinical, behavioural and lifestyle factors in young women (Part A of the Safe-D study). Design and methods. Part A of the Safe-D study is a cross-sectional study aiming to recruit 468 young females aged 16-25 years living in Victoria, Australia, through Facebook advertising. Participants are required to complete an extensive, online questionnaire, wear an ultra-violet dosimeter for 14 consecutive days and attend a study site visit. Outcome measures include areal bone mineral measures at the lumbar spine, total hip and whole body, as well as soft tissue composition using dual energy x-ray absorptiometry. Trabecular and cortical volumetric bone density at the tibia is measured using peripheral quantitative computed tomography. Other tests include serum 25-hydroxyvitamin D, serum biochemistry and a range of health markers. Details of mood disorder/s and depressive and anxiety symptoms are obtained by self-report. Cutaneous melanin density is measured by spectrophotometry. Expected impact. The findings of this cross-sectional study will have implications for health promotion in young women and for clinical care of those with vitamin D deficiency and/or mental ill-health. Optimising both vitamin D status and mental health may protect against poor bone health and fractures in later life. Significance for public health Vitamin D deficiency, depression and osteoporosis are all major public health issues. Vitamin D deficiency has been associated with both reduced bone mineral density and depressive symptoms. Moreover, cohort studies have found that subjects with depression have lower bone mineral density when compared

  11. Australian radiation therapists' perceptions of the determinants of fitness to practise; a mixed methods focus group study

    International Nuclear Information System (INIS)

    Background: There is a lack of clarity as to what factors affect practitioners' fitness to practise (FTP). Purpose: The purpose of this study was to identify what radiation therapists perceived to be the key determinants of FTP and to establish the importance that they place on each determinant. Methods: A mixed methods approach using focus groups with a brainstorming activity was used for data collection. Qualitative analysis was informed by grounded theory, where the data was coded and assigned themes. Findings: Three focus groups were conducted with 21 participants. Twenty-one unique determinants of FTP were identified. Professional development, communication, competence, qualifications, ethics and professionalism were common themes in all focus groups. Knowledge, technical and professional skills were most frequently cited by participants as the three most important determinants. Self-awareness, values and ethics featured last on the list. Participants of higher seniority identified a greater variety of determinants with lesser emphasis on technical skills, when compared with junior participants. Nine determinant themes were identified initially and these were spliced to form three primary categories; Impairment, Competence, and Values/Ethics. Conclusion: The most important issues to radiation therapists were associated with technical and clinical competence. This indicates a need to further educate practitioners on the other determinants of FTP, such as values, ethics, probity, trust and criminal activity. Further investigation is required to assess practitioner behavioural responses to deviations from accepted practice and the socio-cultural context of FTP

  12. Learning Preferences and Impacts of Education Programs in Dog Health Programs in Five Rural and Remote Australian Indigenous Communities

    Science.gov (United States)

    Constable, Sophie; Dixon, Roselyn; Dixon, Robert

    2011-01-01

    As part of strategies to improve dog and community health in rural and remote Indigenous communities, this study investigated preferences and impacts of dog health education programs. Semistructured interviews with 63 residents from five communities explored learning preferences. Though each community differed, on average yarning was preferred by…

  13. The wider determinants of inequalities in health: a decomposition analysis

    Directory of Open Access Journals (Sweden)

    Scheller-Kreinsen David

    2011-07-01

    Full Text Available Abstract Background The common starting point of many studies scrutinizing the factors underlying health inequalities is that material, cultural-behavioural, and psycho-social factors affect the distribution of health systematically through income, education, occupation, wealth or similar indicators of socioeconomic structure. However, little is known regarding if and to what extent these factors can assert systematic influence on the distribution of health of a population independent of the effects channelled through income, education, or wealth. Methods Using representative data from the German Socioeconomic Panel, we apply Fields' regression based decomposition techniques to decompose variations in health into its sources. Controlling for income, education, occupation, and wealth, we assess the relative importance of the explanatory factors over and above their effect on the variation in health channelled through the commonly applied measures of socioeconomic status. Results The analysis suggests that three main factors persistently contribute to variance in health: the capability score, cultural-behavioural variables and to a lower extent, the materialist approach. Of the three, the capability score illustrates the explanatory power of interaction and compound effects as it captures the individual's socioeconomic, social, and psychological resources in relation to his/her exposure to life challenges. Conclusion Models that take a reductionist perspective and do not allow for the possibility that health inequalities are generated by factors over and above their effect on the variation in health channelled through one of the socioeconomic measures are underspecified and may fail to capture the determinants of health inequalities.

  14. Innovation in Australian Workplaces: An Empirical Analysis.

    Science.gov (United States)

    Rogers, Mark

    1999-01-01

    The determinants of innovation were examined using data from 698 Australian workplaces. Results suggest that better employee-management communications are associated with more change and that workplaces with higher levels of training undergo more change. (Author/JOW)

  15. Reflections on the role of less-than-comprehensive (exclusionary) private health insurance hospital products in the Australian healthcare system.

    Science.gov (United States)

    Thomas, Peter E

    2012-08-01

    The number of people in Australia that are currently covered by a hospital private health insurance product continues to rise every quarter. In September 2010, for the first time since the introduction of the public universal social insurance scheme, Medicare, more than 10million persons in Australia are covered by private health insurance. Although the number of persons covered by private health insurance continues to grow, the quality and level of cover that members are holding is changing significantly. In an effort to limit premium rises and to reduce the benefits paid for treatment, private health insurers have introduced, and moved a large number of existing members to, less-than-comprehensive private health insurance policies. These policies, known as 'exclusionary' policies, are changing the dynamics of private health insurance in Australia. After examining the emergence and prevalence of these products, this commentary gives three different examples to illustrate how such products are changing the nature of private health insurance in Australia and are now set to create a series of policy issues that will require future attention.

  16. Reflections on the role of less-than-comprehensive (exclusionary) private health insurance hospital products in the Australian healthcare system.

    Science.gov (United States)

    Thomas, Peter E

    2012-08-01

    The number of people in Australia that are currently covered by a hospital private health insurance product continues to rise every quarter. In September 2010, for the first time since the introduction of the public universal social insurance scheme, Medicare, more than 10million persons in Australia are covered by private health insurance. Although the number of persons covered by private health insurance continues to grow, the quality and level of cover that members are holding is changing significantly. In an effort to limit premium rises and to reduce the benefits paid for treatment, private health insurers have introduced, and moved a large number of existing members to, less-than-comprehensive private health insurance policies. These policies, known as 'exclusionary' policies, are changing the dynamics of private health insurance in Australia. After examining the emergence and prevalence of these products, this commentary gives three different examples to illustrate how such products are changing the nature of private health insurance in Australia and are now set to create a series of policy issues that will require future attention. PMID:22935116

  17. 'Health equity through action on the social determinants of health': taking up the challenge in nursing.

    Science.gov (United States)

    Reutter, Linda; Kushner, Kaysi Eastlick

    2010-09-01

    Reducing health inequities is a priority issue in Canada and worldwide. In this paper, we argue that nursing has a clear mandate to ensure access to health and health-care by providing sensitive empowering care to those experiencing inequities and working to change underlying social conditions that result in and perpetuate health inequities. We identify key dimensions of the concept of health (in)equities and identify recommendations to reduce inequities advanced in key global and Canadian documents. Using these documents as context, we advocate a 'critical caring approach' that will assist nurses to understand the social, political, economic and historical context of health inequities and to tackle these inequities through policy advocacy. Numerous societal barriers as well as constraints within the nursing profession must be acknowledged and addressed. We offer recommendations related to nursing practice, education and research to move forward the agenda of reducing health inequities through action on the social determinants of health. PMID:20712665

  18. Enhancing John Rawls's Theory of Justice to Cover Health and Social Determinants of Health1

    Science.gov (United States)

    Ekmekci, Perihan Elif; Arda, Berna

    2015-01-01

    The vast improvements in medical technology reviled the crucial role of social determinants of health for the etiology, prevalence and prognosis of diseases. This changed the content of the right to health concept from a demand of health services, to a claim of having access to all social determinants of health. Thus, the just allocation of scarce resources of health and social determinants of health became an issue of ethical theories. John Rawls developed a theory of justice. His theory suggests that the principles of justice should be determined by individuals in a hypothetic initial position. In the initial position, individuals agree on principles of justice. Rawls puts forth that the institutions of the society should be structured in compliance with these principles to reach a fair social system. Although Rawls did not justify right to health in his theory, the efforts to enlarge the theory to cover right to health flourished quite fast. In this paper first the basic components of Rawls theory is explained. Then the most outstanding approaches to enlarge his theory to cover right to health is introduced and discussed within the discourse of Rawls theory of justice. PMID:27340331

  19. Vitamin D Status, Bone Mineral Density and Mental Health in Young Australian Women: The Safe-D Study

    OpenAIRE

    Emma T. Callegari; Nicola Reavley; Suzanne M Garland; Alexandra Gorelik; Wark, John D.; on behalf of the Safe-D study team

    2015-01-01

    Background. Vitamin D deficiency has been associated with both poor bone health and mental ill-health. More recently, a number of studies have found individuals with depressive symptoms tend to have reduced bone mineral density. To explore the interrelationships between vitamin D status, bone mineral density and mental-ill health we are assessing a range of clinical, behavioural and lifestyle factors in young women (Part A of the Safe-D study). Design and methods. Part A of the Safe-D study i...

  20. Vitamin D status, bone mineral density and mental health in young Australian women: the Safe-D study

    Directory of Open Access Journals (Sweden)

    Emma T. Callegari

    2015-11-01

    Full Text Available Background. Vitamin D deficiency has been associated with both poor bone health and mental ill-health. More recently, a number of studies have found individuals with depressive symptoms tend to have reduced bone mineral density. To explore the interrelationships between vitamin D status, bone mineral density and mental-ill health we are assessing a range of clinical, behavioural and lifestyle factors in young women (Part A of the Safe-D study. Design and methods. Part A of the Safe-D study is a cross-sectional study aiming to recruit 468 young females aged 16-25 years living in Victoria, Australia, through Facebook advertising. Participants are required to complete an extensive, online questionnaire, wear an ultra-violet dosimeter for 14 consecutive days and attend a study site visit. Outcome measures include areal bone mineral measures at the lumbar spine, total hip and whole body, as well as soft tissue composition using dual energy x-ray absorptiometry. Trabecular and cortical volumetric bone density at the tibia is measured using peripheral quantitative computed tomography. Other tests include serum 25-hydroxyvitamin D, serum biochemistry and a range of health markers. Details of mood disorder/s and depressive and anxiety symptoms are obtained by self-report. Cutaneous melanin density is measured by spectrophotometry. Expected impact. The findings of this cross-sectional study will have implications for health promotion in young women and for clinical care of those with vitamin D deficiency and/or mental ill-health. Optimising both vitamin D status and mental health may protect against poor bone health and fractures in later life.

  1. AUSTRALIAN COMPETITION AND CONSUMER COMMISSION v ACN 117 372 915: SHOULD CONSUMER LAW REGULATE DOCTOR-PATIENT RELATIONS IN A CORPORATISED HEALTH CARE SYSTEM?

    Science.gov (United States)

    Wallace, Jessica; Pyman, Ella; Faunce, Thomas

    2015-09-01

    In April 2015, North J of the Federal Court of Australia made a finding of unconscionable conduct against Advanced Medical Institute, a promoter and provider of erectile dysfunction treatment, in a case concerning unfair contract terms (Australian Competition and Consumer Commission vACN 117 372 915 Pty Ltd (in liq) (formerly Advanced Medical Institute Pty Ltd) [2015] FCA 368). The contract required a minimum 12-month commitment, with costs exceeding treatments available from general practitioners, and made refunds available only after all possible treatment plans were exhausted which included penile injections. This column analyses that case, particularly in respect to the consumer law standards of practice under which it was litigated. Those standards refer to patients as "consumers" yet North J made extensive reference to the Good Medical Practice: A Code of Conduct for Doctors in Australia, a text which refers to "patients", as evidence of what constitutes appropriate professional conduct or practice for the health profession. This column considers whether legislative and judicial categorisation of patients (a class of people presumptively suffering, sick and vulnerable) as "consumers" undermines the formal and informal protections accorded to patients under normative systems of medical ethics such as those represented by the Code. The case, it is argued, also illuminates the contemporary tensions between the ethical, legal and human rights standards required of doctors in their treatment of patients and the commercial interests of businesses. PMID:26554198

  2. Promoting the health of Aboriginal Australians through empowerment: eliciting the components of the family well-being empowerment and leadership programme.

    Science.gov (United States)

    Laliberté, Arlene; Haswell, Melissa; Tsey, Komla

    2012-12-01

    Most policies addressing Aboriginal health in Australia promote initiatives that are based on empowerment principles. Articulated programme components are necessary to support personal and group empowerment and to assist individuals in gaining the sense of control and purposefulness needed to exert their political and personal power in the face of the severe stress and powerlessness faced by the Australian Aboriginal people. This paper aims to provide a detailed description of the mechanisms underpinning a 'bottom-up' empowerment initiative, the Family well-being empowerment and leadership programme (FWB), and to analyze how the programme supports empowerment. The five stages of FWB were described and the validity of this model was assessed through the combination of participatory observation, documentation analysis, literature review, semi-structured interviews and iterative feedback with different analytical perspectives. Our study results articulated four distinct programme components: the setting plus inter-relational, educational and experiential actions. FWB is an example of the promotion of both outcome and process pathways towards empowerment. Potential applications of the programme are discussed.

  3. AUSTRALIAN COMPETITION AND CONSUMER COMMISSION v ACN 117 372 915: SHOULD CONSUMER LAW REGULATE DOCTOR-PATIENT RELATIONS IN A CORPORATISED HEALTH CARE SYSTEM?

    Science.gov (United States)

    Wallace, Jessica; Pyman, Ella; Faunce, Thomas

    2015-09-01

    In April 2015, North J of the Federal Court of Australia made a finding of unconscionable conduct against Advanced Medical Institute, a promoter and provider of erectile dysfunction treatment, in a case concerning unfair contract terms (Australian Competition and Consumer Commission vACN 117 372 915 Pty Ltd (in liq) (formerly Advanced Medical Institute Pty Ltd) [2015] FCA 368). The contract required a minimum 12-month commitment, with costs exceeding treatments available from general practitioners, and made refunds available only after all possible treatment plans were exhausted which included penile injections. This column analyses that case, particularly in respect to the consumer law standards of practice under which it was litigated. Those standards refer to patients as "consumers" yet North J made extensive reference to the Good Medical Practice: A Code of Conduct for Doctors in Australia, a text which refers to "patients", as evidence of what constitutes appropriate professional conduct or practice for the health profession. This column considers whether legislative and judicial categorisation of patients (a class of people presumptively suffering, sick and vulnerable) as "consumers" undermines the formal and informal protections accorded to patients under normative systems of medical ethics such as those represented by the Code. The case, it is argued, also illuminates the contemporary tensions between the ethical, legal and human rights standards required of doctors in their treatment of patients and the commercial interests of businesses.

  4. BOOMERANG - the Australian light source

    International Nuclear Information System (INIS)

    A proposal has been prepared for the installation in Australia of a national high performance synchrotron light facility called Boomerang. The Boomerang proposal had its origin in the establishment of the Australian Synchrotron Research Program (ASRP) which was one of the seven Major National Research Facilities announced by the Federal Government in December 1995. The ASRP provides the opportunity and funding for Australian researchers to access international synchrotron facilities, specifically two consortia at the Advanced Photon Source (APS) at the Argonne National Laboratory, USA and continued interaction with the Photon Factory at the KEK Laboratory in Japan. The ASRP was the successor to the Australian National Beamline Facility project (ANBF) which began in 1991 following the ASTEC inquiry titled 'Small Country - Big Science'. The Federal Government also provided funding for a Feasibility Study to determine the value of establishing an Australian-based synchrotron radiation facility. The Feasibility Study was completed in August 1998 and endorsed by the institutional members of the ASRP and the research community in general. The study concluded that, on the data available in Australia, there was a strong case for the installation of an Australian-based facility. The study considered several options for an Australian-based facility and recommended that these options and the data supporting the general conclusions receive further investigation. A mission was arranged to a select group of overseas laboratories to explore these questions in detail. The review team included a mix of scientific and industrial experience and also represented the interests of the ASRP and an Industrial Synchrotron Consortium based in Victoria. Based on the conclusions of the overseas mission and incorporating the advice of all international specialists in the design and use of synchrotron facilities consulted during the mission, the most cost-effective option was an extended

  5. A State-Wide Survey of South Australian Secondary Schools to Determine the Current Emphasis on Ergonomics and Computer Use

    Science.gov (United States)

    Sawyer, Janet; Penman, Joy

    2012-01-01

    This study investigated the pattern of teaching of healthy computing skills to high school students in South Australia. A survey approach was used to collect data, specifically to determine the emphasis placed by schools on ergonomics that relate to computer use. Participating schools were recruited through the Department for Education and Child…

  6. Health Status and Health Determinants of Older Immigrant Women in Canada: A Scoping Review

    OpenAIRE

    Sepali Guruge; Birpreet Birpreet; Samuels-Dennis, Joan A.

    2015-01-01

    Increasing international migration in the context of aging populations makes a comprehensive understanding of older immigrant women’s health status and determinants of their health particularly urgent. Using Arksey and O’Malley’s framework, we conducted a scoping review to examine the available literature on the health of older immigrant women in Canada. We searched CINAHL, PsycINFO, Embase, Medline, and Cochrane databases for the period of 1990 to 2014 for Canadian-based, peer-reviewed studi...

  7. Responding to racism: insights on how racism can damage health from an urban study of Australian Aboriginal people.

    Science.gov (United States)

    Ziersch, Anna M; Gallaher, Gilbert; Baum, Fran; Bentley, Michael

    2011-10-01

    This paper examines responses to racism and the pathways through which racism can affect health and wellbeing for Aboriginal people living in an urban environment. Face-to-face interviews were conducted in 2006/07 with 153 Aboriginal people living in Adelaide, Australia. Participants were asked about their experience of, and responses to, racism, and the impact of these experiences on their health. Racism was regularly experienced by 93% of participants. Almost two thirds of people felt that racism affected their health. Using a thematic analysis with a particular focus on how agency and structure interacted, a number of key reactions and responses to racism were identified. These included: emotional and physiological reactions; and responses such as gaining support from social networks; confronting the person/situation; ignoring it; avoiding situations where they might experience racism; 'minimising' the significance or severity of racism or questioning whether incidents were racist; and consuming alcohol, tobacco and other drugs. A further theme was a conscious decision to not 'allow' racism to affect health. Our study found that most people used more than one of these coping strategies, and that strategies were selected with an awareness of positive and negative health impacts. While individuals demonstrated substantial agency in their responses, there were clear structural constraints on how they reacted and responded. We found that not only was racism potentially detrimental to health, but so too were some responses. However, while some strategies appeared 'healthier' than others, most strategies entailed costs and benefits, and these depended on the meanings of responses for individuals. This paper concludes that initiatives to promote health-protective responses to racism need to consider structural constraints and the overarching goal of reducing systemic racism. PMID:21835522

  8. Vicious cycles: digital technologies and determinants of health in Australia.

    Science.gov (United States)

    Baum, Fran; Newman, Lareen; Biedrzycki, Katherine

    2014-06-01

    Digital technologies are increasingly important as ways to gain access to most of the important social determinants of health including employment, housing, education and social networks. However, little is known about the impact of the new technologies on opportunities for health and well-being. This paper reports on a focus group study of the impact of these technologies on people from low socio-economic backgrounds. We use Bourdieu's theories of social inequities and the ways in which social, cultural and economic capitals interact to reinforce and reproduce inequities to examine the ways in which digital technologies are contributing to these processes. Six focus group discussions with 55 people were held to examine their access to and views about using digital technologies. These data are analysed in light of Bourdieu's theory to determine how people's existing capitals shape their access to and use of digital technologies and what the implications of exclusion from the technologies are likely to be for the social determinants of health. The paper concludes that some people are being caught in a vicious cycle whereby lack of digital access or the inability to make beneficial use reinforces and amplifies existing disadvantage including low levels of reading and writing literacy. The paper concludes with a consideration of actions health promoters could take to interrupt this cycle and so contribute to reducing health inequities. PMID:23144236

  9. A Framework for Educating Health Professionals to Address the Social Determinants of Health

    Science.gov (United States)

    National Academies Press, 2016

    2016-01-01

    The World Health Organization defines the social determinants of health as "the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life." These forces and systems include economic policies, development agendas, cultural and social norms, social policies,…

  10. Are there social determinants of health and disease?

    Science.gov (United States)

    Thisted, Ronald A

    2003-01-01

    The concept of a determinant is tied to the idea of a mechanism for action. Ideas from epidemiology, particularly the epidemiologic triad of agent, host, and environment, can help to make sense of factors that affect the absence of disease or that interfere with a mechanism that alters health. However, assembling convincing evidence for the existence of social determinants of health is a challenge, in part because of the difficulties of bridging the social and biological realms. While social contexts are measured using aggregates of individuals, disease and dysfunction occur at the individual level, leading to difficult problems of ecological inference. Although social factors have been shown to be associated with differences in mortality from specific causes, these factors account for only a small portion of the mortality from any individual cause. This suggests that the pathways through which social factors influence health are affected by their interactions with other factors. PMID:14563075

  11. Oral health investigations of indigenous participants in remote settings: a methods paper describing the dental component of wave III of an Australian Aboriginal birth cohort study

    Directory of Open Access Journals (Sweden)

    Sayers Susan M

    2008-08-01

    Full Text Available Abstract Background A prospective Aboriginal Birth Cohort (ABC study has been underway in Australia's Northern Territory since 1987. Inclusion of oral epidemiological information in a follow-up study required flexible and novel approaches with unconventional techniques. Documenting these procedures may be of value to researchers interested in including oral health components in remotely-located studies. The objectives are to compare and describe dental data collection methods in wave III of the ABC study with a more conventional oral health investigation. Methods The Australian National Survey of Adult Oral Health (NSAOH was considered the 'conventional' study. Differences between this investigation and the dental component of the ABC study were assessed in terms of ethics, location, recruitment, consent, privacy, equipment, examination, clinical data collection and replication. In the ABC study, recording of clinical data by different voice recording techniques were described and assessed for ease-of-use portability, reliability, time-efficiency and cost-effectiveness. Results Conventional investigation recruitment was by post and telephone. Participants self presented. Examinations took place in dental clinics, using customised dental chairs with standard dental lights attached. For all examinations, a dental assistant recorded dental data directly onto a laptop computer. By contrast, follow-up of ABC study participants involved a multi-phase protocol with reliance on locally-employed Indigenous advocates bringing participants to the examination point. Dental examinations occurred in settings ranging from health centre clinic rooms to improvised spaces outdoors. The dental chair was a lightweight, portable reclining camp chair and the dental light a fire-fighter's head torch with rechargeable batteries. The digital voice recorder was considered the most suitable instrument for clinical dental data collection in the ABC study in comparison with

  12. Long-term health effects of Vietnam-era military service: A quasi-experiment using Australian conscription lotteries.

    Science.gov (United States)

    Johnston, David W; Shields, Michael A; Siminski, Peter

    2016-01-01

    This paper estimates the long-term health effects of Vietnam-era military service using Australia's National conscription lotteries for identification. Our primary contribution is the quality and breadth of our health outcomes. We use several administrative sources, containing a near-universe of records on mortality (1994-2011), cancer diagnoses (1982-2008), and emergency hospital presentations (2005-2010). We also analyse a range of self-reported morbidity indicators (2006-2009). We find no significant long-term effects on mortality, cancer or emergency hospital visits. In contrast, we find significant detrimental effects on a number of morbidity measures. Hearing and mental health appear to be particularly affected. PMID:26705967

  13. Determination of Risky Health Behaviors of Immigrant and Nonimmigrant Adolescents

    Directory of Open Access Journals (Sweden)

    Asli Kalkim

    2014-08-01

    Full Text Available AiM: This study was planned as a descriptive study in order to investigate risky health behaviors of immigrant and non immigrant adolescents. METHODS: The study was performed in a high school situated Izmir between the dates of October and November 2008. Sample group of this research was included 293 immigrant and 813 non immigrant adolescents. Data were collected by using Socio-demographic question form and and Health Risk Behaviors Scale. Data were collected from students with a technical pencil-paper by researcher in classroom. Frequencies, one way anova (post-hoc bonferroni and independent t test were used with Stastical Package for Social Science 13.0 program for statistical analysis of data. Written consent was taken from Izmir Directorate of Education to carry out the study. Oral consent was taken from the school manager and the students. RESULTS: Mean age of adolescents was 15.42+/-0.03. It was determined that risky health behaviors mean score (t: 2.161, p: 0.031 and physical activity (t: 2.132, p: 0.033, nutrition (t:3.030, p: 0.003, hygiene (t: 3.850, p: 0.000 sub-scales mean scores of immigrant adolescent were statistically higher than non immigrant adolescents (p<0.05. CONCLUSiONS: Consequently, this study was important to health professionals worked primary health services and school health services The study have significant data about migration affects on health behaviors of adolescent to show health professionals worked primary care and school health services and to plan health services towards adolescents. [TAF Prev Med Bull 2014; 13(4.000: 289-294

  14. Educating Young People on Global Determinants of Health

    DEFF Research Database (Denmark)

    Bruselius-Jensen, Maria; Renwick, Kerry; Aagaard-Hansen, Jens;

    that are very different for the two groups. They mention different approaches to education, different food cultures, different patterns of gender and chores at home and a different family structure. Mirroring their own health practices in that of their peers from another culture appeared to support learning...... of the cosmopolitan person, we argue that educating young people to understand and act upon global social determinants of health, means building reflexivity on their own cultural roots, traditions and practices and simultaneously open their minds towards the world (Hansen 2009). Thus, education on global health must...... from Kenya and Denmark, with the aim to promote reflections on differences and similarities in the everyday living conditions across cultures and nations, and their impact on health practices. Based on the findings this presentation will discuss the merits of this kind of education as a way to promote...

  15. Interactive dissemination: engaging stakeholders in the use of aggregated quality improvement data for system-wide change in Australian Indigenous primary health care

    Directory of Open Access Journals (Sweden)

    Alison eLaycock

    2016-05-01

    Full Text Available BackgroundIntegrating theory when developing complex quality improvement interventions can help to explain clinical and organizational behavior, inform strategy selection and understand effects. This paper describes a theory-informed interactive dissemination strategy. Using aggregated quality improvement data, the strategy seeks to engage stakeholders in wide-scale data interpretation and knowledge sharing focused on achieving wide-scale improvement in primary health care quality. MethodsAn iterative process involving diverse stakeholders in Australian Aboriginal and Torres Strait Islander healthcare delivery uses aggregated audit data collected across key areas of care. Phases of reporting and online feedback are used to identify: 1 priority areas for improvement; 2 health centre, system and staff attributes that may be important in addressing the identified priority evidence-practice gaps, and; 3 strategies that could be introduced or strengthened to enable improvement. A developmental evaluation is being used to refine engagement processes and reports as the project progresses. DiscussionThis innovative dissemination approach is being used to encourage wide-scale interpretation and use of service performance data by policy-makers, managers and other stakeholders, and to document knowledge about how to address barriers to achieving change. Through the developmental evaluation, the project provides opportunities to learn about stakeholders’ needs in relation to the way data and findings are described and distributed, and elements of the dissemination strategy and report design that impact on the useability and uptake of findings.ConclusionsThe project can contribute to knowledge about how to facilitate interactive wide-scale dissemination and about using data to co-produce knowledge to improve healthcare quality.

  16. Review of Indigenous Health Curriculum in Nutrition and Dietetics at One Australian University: An Action Research Study

    Science.gov (United States)

    Wilson, Annabelle M.; Mehta, Kaye; Miller, Jacqueline; Yaxley, Alison; Thomas, Jolene; Jackson, Kathryn; Wray, Amanda; Miller, Michelle D.

    2015-01-01

    This article describes a review undertaken in 2012-2013 by Nutrition and Dietetics, Flinders University, to assess the Indigenous health curriculum of the Bachelor of Nutrition and Dietetics (BND) and Masters of Nutrition and Dietetics (MND). An action research framework was used to guide and inform inquiry. This involved four stages, each of…

  17. Knowledge of, and Attitudes towards Health-Related Biotechnology Applications amongst Australian Year 10 High School Students

    Science.gov (United States)

    van Lieshout, Emile; Dawson, Vaille

    2016-01-01

    Modern biotechnology has a large and rapidly increasing impact on society. New advances in genetics, stem cells and other areas hold great potential for human health but also presenting socioscientific issues that commonly divide public opinion. While knowledge is necessary to develop informed opinions about biotechnology, they may also be…

  18. Tobacco Health Warning Messages on Plain Cigarette Packs and in Television Campaigns: A Qualitative Study with Australian Socioeconomically Disadvantaged Smokers

    Science.gov (United States)

    Guillaumier, Ashleigh; Bonevski, Billie; Paul, Christine

    2015-01-01

    Television advertisements, packaging regulations and health warning labels (HWLs) are designed to communicate anti-smoking messages to large number of smokers. However, only a few studies have examined how high smoking prevalence groups respond to these warnings. This study explored how socioeconomically disadvantaged smokers engage with health…

  19. Prevalence of co-occurring alcohol and other drug use in an Australian older adult mental health service.

    Science.gov (United States)

    Searby, Adam; Maude, Phil; McGrath, Ian

    2016-04-01

    Co-occurring mental illness and substance use disorder, known as dual diagnosis, is a significant challenge to mental health services. Few older adult specific alcohol and other drug treatment services exist, meaning older adult mental health services may become the default treatment option for many. Evidence suggests that dual diagnosis leads to substandard treatment outcomes, including higher rates of psychiatric relapse, higher costs of care and poorer treatment engagement. This paper explores the prevalence of co-occurring alcohol and other drug (AOD) use in an older adult community mental health service in inner Melbourne, Australia. This aim was accomplished by using a retrospective file audit of clinical intake assessments (n = 593) performed on consumers presenting to the service over a two-year period, June 2012-2014. Of consumers presenting to the service, 15.5% (n = 92) were assessed by clinicians as having co-occurring AOD use. Depression predominated in the dual diagnosis group as the primary mental health disorder. Dual diagnosis consumers in this sample were statistically more likely to be male and younger than their non-dual diagnosis counterparts. A limitation of this audit was the lack of implementation of screening tools, leaving assessment to clinical judgement or the interest of the clinician. This may also explain the discrepancy between the results of this study and previous work. Although appearing to be a relatively small percentage of assessments, the results accounted for 92 individuals with complex mental health, AOD and medical issues. Poor screening procedures in a population that is traditionally difficult to assess need to be rectified to meet the future challenges inherent in the ageing baby boomer generation, changing drug use trends and extended lifespans through harm reduction initiatives and medical advancements. PMID:26834037

  20. Nutrition function, health and related claims on packaged Australian food products--prevalence and compliance with regulations.

    Science.gov (United States)

    Williams, Peter; Yeatman, Heather; Ridges, Leisa; Houston, Annalie; Rafferty, Jillianan; Ridges, Anna; Roesler, Leisa; Sobierajski, Megan; Spratt, Bronwyn

    2006-01-01

    Australia and New Zealand are currently reviewing the regulations governing nutrition function, health and related claims on foods. Health claims currently are not permitted on food labels, with one exception. The aim of this study was to describe the use of such claims on packaged food for sale in Australia (excluding nutrient content claims) prior to any changes to the regulations, and measure compliance with existing regulations. A survey was conducted of the labelling of 7850 products (including multiple pack sizes of individual foods) in 47 different food categories on sale in New South Wales in 2003. A total of 2098 nutrition function, health or related claims and 12 therapeutic claims were recorded. Fourteen percent of products carried some sort of claim. If nutrient function and general health maintenance claims are excluded, 8.1% of products carried a health or related claim. Using the claims categorisation proposed by Food Standards Australia New Zealand for a new standard on claims, general-level claims were found on 9.8% of products and high-level and therapeutic claims (illegal at the time) on 1.2%. The food categories with the highest proportion of products carrying claims were sports drinks (92%), energy drinks (84%), sports bars (57%) and breakfast cereals (54%). 118 high-level and therapeutic claims did not conform to current food standards and there were many general-level claims for ingredient benefits that were unlikely to be able to be scientifically substantiated. The results of this survey suggest that more than 5% of claims were not complying with the current regulations and that the standards were not being fully enforced. To be effective, the new standard will need to be accompanied by clear guidelines for manufacturers on requirements for substantiating claims. Comprehensive education and enforcement frameworks also will be needed, to reduce the number of illegal or apparently unsubstantiated claims.

  1. Prevalence of co-occurring alcohol and other drug use in an Australian older adult mental health service.

    Science.gov (United States)

    Searby, Adam; Maude, Phil; McGrath, Ian

    2016-04-01

    Co-occurring mental illness and substance use disorder, known as dual diagnosis, is a significant challenge to mental health services. Few older adult specific alcohol and other drug treatment services exist, meaning older adult mental health services may become the default treatment option for many. Evidence suggests that dual diagnosis leads to substandard treatment outcomes, including higher rates of psychiatric relapse, higher costs of care and poorer treatment engagement. This paper explores the prevalence of co-occurring alcohol and other drug (AOD) use in an older adult community mental health service in inner Melbourne, Australia. This aim was accomplished by using a retrospective file audit of clinical intake assessments (n = 593) performed on consumers presenting to the service over a two-year period, June 2012-2014. Of consumers presenting to the service, 15.5% (n = 92) were assessed by clinicians as having co-occurring AOD use. Depression predominated in the dual diagnosis group as the primary mental health disorder. Dual diagnosis consumers in this sample were statistically more likely to be male and younger than their non-dual diagnosis counterparts. A limitation of this audit was the lack of implementation of screening tools, leaving assessment to clinical judgement or the interest of the clinician. This may also explain the discrepancy between the results of this study and previous work. Although appearing to be a relatively small percentage of assessments, the results accounted for 92 individuals with complex mental health, AOD and medical issues. Poor screening procedures in a population that is traditionally difficult to assess need to be rectified to meet the future challenges inherent in the ageing baby boomer generation, changing drug use trends and extended lifespans through harm reduction initiatives and medical advancements.

  2. Soil formation rates determined from Uranium-series isotope disequilibria in soil profiles from the southeastern Australian highlands

    Science.gov (United States)

    Suresh, P. O.; Dosseto, A.; Hesse, P. P.; Handley, H. K.

    2013-10-01

    The sustainability of soil resources is determined by the balance between the rates of production and removal of soils. Samples from four weathering profiles at Frogs Hollow in the upper catchment area of the Murrumbidgee River (southeastern Australia) were analyzed for their uranium-series (U-series) isotopic composition to estimate soil production rates. Sequential leaching was conducted on sample aliquots to assess how U-series nuclides are distributed between primary and secondary minerals. Soil is increasingly weathered from bottom to top which is evident from the decrease in (234U/238U) ratios and increase in relative quartz content with decreasing soil depth. One soil profile shows little variation in mineralogy and U-series geochemistry with depth, explained by the occurrence of already extensively weathered saprolite, so that further weathering has minimal effect on mineralogy and geochemistry. Al2O3 is mobilized from these soils, and hence a silicon-based weathering index treating Al2O3 as mobile is introduced, which increases with decreasing soil depth, in all profiles. Leached and unleached aliquots show similar mineralogy with slight variation in relative concentrations, whereas the elemental and isotopic composition of uranium and thorium show notable differences between leached and unleached samples. Unleached samples show systematic variations in uranium-series isotopic compositions with depth compared to leached samples. This is most likely explained by the mobilization of U and Th from the samples during leaching. Soil residence times are calculated by modeling U-series activity ratios for each profile separately. Inferred timescales vary up to 30 kyr for unleached aliquots from profile F1 to up to 12 kyr for both leached and unleached aliquots from profile F2. Muscovite content shows a linear relationship with U-series derived soil residence times. This relationship provides an alternative method to estimate residence timescales for profiles with

  3. SU-E-P-03: The Australian Clinical Dosimetry Service, a Bespoke National Solution

    Energy Technology Data Exchange (ETDEWEB)

    Williams, I; Lye, J; Alves, A [Australian Clinical Dosimetry Service, Yallambie, Vic (Australia); Lehmann, J [University of Sydney, Sydney (Australia); Kenny, J [Epworth HealthCare, Richmond, VIC (Australia); Dunn, L [Royal Melbourne Institute of Technology, Melbourne (Australia); Kron, T [Peter MacCallum Cancer Instit., Melbourne (Australia)

    2015-06-15

    Purpose: The Australian Clinical Dosimetry Service, (ACDS) was a pilot program to enable the Australian Government to determine whether a locally designed audit program was suitable for mitigating dosimetric error risk to radiotherapy patients within Australia. The outcomes from four years of operations will be presented and discussed with a focus why and how the pilot requirements were met. The consequnces of success will be considered, the lessons learnt from the pilot program and how they are impacting the future ACDS design, operation and engagement with stakeholders. Methods: The ACDS was designed over 2010/11 by experts drawn from the three professions in consultation with the national Department of Health. The list of outcomes required over a three year pilot was expressed in a Memorandum of Understanding, (MoU) between Health and the Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) which hosted the ACDS. Results: The ACDS has achieved all the MoU requirements. This paper describes how the staff within the ACDS engaged with the professional clinical workforce and provided a successful and functioning audit service. It identifies the strengths and weaknesses within the MoU and the ACDS structure and how the ACDS resolved a number of conflicting issues. It identifies the successes within the ACDS and how these were achieved. It provides details to assist and advise those seeking to design or modify national or regional auditing programs. Finally the paper reviews potential futures for the ACDS. Conclusion: The raw number of audits and outcomes indicate that the ACDS has met the MoU auditing requirements. The reasons for the ACDS’ success are highly dependent on: attracting quality staff who can respond with agility to changing situations, a high level of communication with the professional community, a high level of engagement by the community and an interested and engaged Federal Department. The Australian Clinical Dosimetry Service is a

  4. SU-E-P-03: The Australian Clinical Dosimetry Service, a Bespoke National Solution

    International Nuclear Information System (INIS)

    Purpose: The Australian Clinical Dosimetry Service, (ACDS) was a pilot program to enable the Australian Government to determine whether a locally designed audit program was suitable for mitigating dosimetric error risk to radiotherapy patients within Australia. The outcomes from four years of operations will be presented and discussed with a focus why and how the pilot requirements were met. The consequnces of success will be considered, the lessons learnt from the pilot program and how they are impacting the future ACDS design, operation and engagement with stakeholders. Methods: The ACDS was designed over 2010/11 by experts drawn from the three professions in consultation with the national Department of Health. The list of outcomes required over a three year pilot was expressed in a Memorandum of Understanding, (MoU) between Health and the Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) which hosted the ACDS. Results: The ACDS has achieved all the MoU requirements. This paper describes how the staff within the ACDS engaged with the professional clinical workforce and provided a successful and functioning audit service. It identifies the strengths and weaknesses within the MoU and the ACDS structure and how the ACDS resolved a number of conflicting issues. It identifies the successes within the ACDS and how these were achieved. It provides details to assist and advise those seeking to design or modify national or regional auditing programs. Finally the paper reviews potential futures for the ACDS. Conclusion: The raw number of audits and outcomes indicate that the ACDS has met the MoU auditing requirements. The reasons for the ACDS’ success are highly dependent on: attracting quality staff who can respond with agility to changing situations, a high level of communication with the professional community, a high level of engagement by the community and an interested and engaged Federal Department. The Australian Clinical Dosimetry Service is a

  5. Determinants of Cat Choice and Outcomes for Adult Cats and Kittens Adopted from an Australian Animal Shelter

    Science.gov (United States)

    Zito, Sarah; Paterson, Mandy; Vankan, Dianne; Morton, John; Bennett, Pauleen; Phillips, Clive

    2015-01-01

    Simple Summary Commonly, more adult cats than kittens are euthanized in animal shelters. We surveyed 382 cat adopters to assess adoption outcomes and potential determinants of adopters’ choice of cat age group and price. Most adopters had benevolent motivations for adopting from the shelter and had put considerable thought into the adoption and responsible ownership requirements. However, adult cat adopters were more likely to have been influenced by price than kitten adopters. Adoption outcomes were generally positive in all age and adoption price groups. This study provides evidence to inform the design of strategies to encourage adult cat adoptions. Abstract The percentage of adult cats euthanized in animal shelters is greater than that of kittens because adult cats are less likely to be adopted. This study aimed to provide evidence to inform the design of strategies to encourage adult cat adoptions. One such strategy is to discount adoption prices, but there are concerns that this may result in poor adoption outcomes. We surveyed 382 cat adopters at the time of adoption, to assess potential determinants of adopters’ cat age group choice (adult or kitten) and, for adult cat adopters, the price they are willing to pay. The same respondents were surveyed again 6–12 months after the adoption to compare outcomes between cat age groups and between adult cats in two price categories. Most adopters had benevolent motivations for adopting from the shelter and had put considerable thought into the adoption and requirements for responsible ownership. However, adult cat adopters were more likely to have been influenced by price than kitten adopters. Adoption outcomes were generally positive for both adult cats and kittens and for adult cats adopted at low prices. The latter finding alleviates concerns about the outcomes of “low-cost” adoptions in populations, such as the study population, and lends support for the use of “low-cost” adoptions as an option for

  6. [METHODS FOR DETERMINING OF TRAINING NEEDS FOR HEALTH LEADERS].

    Science.gov (United States)

    Kalmatayeva, Zh; Kaliyeva, D

    2016-06-01

    The article presents the results of a study of health needs of the Republic of Kazakhstan leaders in basic and periodic training. The methodological basis of the study was to establish the relationship between the dynamics of the development of infrastructures of public and private health care organizations, on the one hand and the change in the number of their leaders, on the other. Analytical studies have allowed to develop a method for determining the needs of policy-makers in education to ensure long-term planning, adequate funding, and improve the quality of their training and retraining. PMID:27441546

  7. The determinants of health: structure, context and agency.

    Science.gov (United States)

    Williams, Gareth H

    2003-01-01

    The concept of social structure is one of the main building blocks of the social sciences, but it lacks any precise technical definition within general sociological theory. This paper reviews the way in which the concept has been deployed within medical sociology, arguing that in recent times it has been used primarily as a frame for the sociological interpretation of health inequalities and their social determinants. It goes on to examine the contribution that medical sociologists have made to the debate over health inequalities, giving particular attention to contributions to Sociology of Health and Illness. These have often provided a focus for discussions outside or critical of the mainstream debates that have been driven primarily by epidemiologists. The paper reviews some of the main points of criticism of epidemiological approaches, focusing in particular on the methodological constraints that limit the capacity of epidemiologists to develop more theoretically satisfactory accounts of the inter-relationships of social structure, context and agency in their impact on health and well being. Some recent examples from the Journal of more theoretically innovative and analytically fine-grained approaches to understanding the impact of social structure on health are then explored. The paper concludes with an argument for a more historically-informed analysis of the relationships between social structure and health, using the knowledgeable narratives of people in places as a window onto those relationships. PMID:14498934

  8. Female employees' perceptions of organisational support for breastfeeding at work: findings from an Australian health service workplace

    Directory of Open Access Journals (Sweden)

    Weber Danielle

    2011-11-01

    Full Text Available Abstract Background Women's return to work can be a significant barrier to continued breastfeeding. Workplace policies and practices to promote and support continued, and longer duration of, breastfeeding are important. In the context of the introduction of a new breastfeeding policy for Area Health Services in New South Wales, Australia, a baseline survey was conducted to describe current practices and examine women's reports of perceived organisational support on breastfeeding intention and practice. Methods A cross sectional survey of female employees of the Sydney South West Area Health Service was conducted in late 2009. A mailed questionnaire was sent to 998 eligible participants who had taken maternity leave over the 20-month period from January 2008 to August 2009. The questionnaire collected items assessing breastfeeding intentions, awareness of workplace policies, and the level of organisational and social support available. For those women who had returned to work, further questions were asked to assess the perceptions and practices of breastfeeding in the work environment, as well as barriers and enabling factors to combining breastfeeding and work. Results Returning to work was one of the main reasons women ceased breastfeeding, with 60 percent of women intending to breastfeed when they returned to work, but only 40 percent doing so. Support to combine breastfeeding and work came mainly from family and partners (74% and 83% respectively, with little perceived support from the organisation (13% and human resources (6%. Most women (92% had received no information from their managers about their breastfeeding options upon their return to work, and few had access to a room specially designated for breastfeeding (19%. Flexible work options and lactation breaks, as well as access to a private room, were identified as the main factors that facilitate breastfeeding at work. Conclusions Enabling women to continue breastfeeding at work has

  9. Training Australian military health care personnel in the primary care of maxillofacial wounds from improvised explosive devices.

    Science.gov (United States)

    Reed, B E; Hale, R G

    2010-06-01

    Severe facial wounds frequently result from improvised explosive devices (IEDs) as the face is still vulnerable despite advances in personal protection of soldiers. In contrast to the poor outcomes with civilian maxillofacial trauma management methods initially employed by the US Army for maxillofacial wounds from IEDs, advances in wound management methods for such injuries by the US Army have resulted in significant improvements in appearance and function. This article describes the features of a short course in the primary management of combat related maxillofacial wounds for deployed health care personnel who may not be facial specialists, including contemporary treatment techniques for those confronting wounds from IEDs which are explained in this course.

  10. Determination of awareness of health professionals about violence during pregnancy

    OpenAIRE

    Selma Sen; Nuray Egelioglu; Oya Kavlak; Umran Sevil

    2012-01-01

    Objective: To determine the awareness of medical professionals about violence during pregnancy.Methods: It was conducted in a Maternity Hospital, Izmir between 15th November 2007- 15th January 2008. 120 individuals participate in the research (midwives, nurses, doctors, N=160).Results: All of the participants defined the violence during pregnancy as a health problem and 66.7% of them find themselves adequate to diagnose the symptoms of violence. Answers for the physical and psychological find...

  11. Serious crisis in the practice of international health by the World Health Organization: the Commission on Social Determinants of Health.

    Science.gov (United States)

    Banerji, Debabar

    2006-01-01

    The Commission on Social Determinants of Health (CSDH) is the latest effort by the World Health Organization to improve health and narrow health inequalities through action on social determinants. The CSDH does not note that much work has already been done in this direction, does not make a sufficient attempt to analyze why earlier efforts failed to yield the desired results, and does not seem to have devised approaches to ensure that it will be more successful this time. The CSDH intends to complement the work of the earlier WHO Commission on Macroeconomics and Health, which has not had the desired impact, and it is unclear how the CSDH can complement work that suffers from such serious infirmities. Inadequacies of both commissions reflect a crisis in the practice of international health at the WHO, stemming from a combination of unsatisfactory administrative practices and lack of technical competence to provide insights into the problems afflicting the most needy countries. Often the WHO has ended up distorting the rudimentary health systems of the poor countries, by pressuring them into accepting health policies, plans, and programs that lack sound scientific bases. The WHO no longer seems to take into account historical and political factors when it sets out to improve the health situation in low-income countries--which is supposed to be the focus of the CSDH. An alternative approach is suggested. PMID:17175839

  12. Australian clinical guidelines for radiological event

    International Nuclear Information System (INIS)

    The Australian Health Protection Committee oversees national health protection priorities in: communicable disease outbreaks; chemical, biological or radiological incidents; mass casualty incidents; and deployment of Australian health teams overseas. The Australian Clinical Guidelines for a Radiological Event to complement existing national guidelines on chemical agents, anthrax, and smallpox. Other prompts included the need to revise the ARPANSA Guidance Manual, Medical Management of Individuals Involved in Radiation Accidents, 2000, and the requirement for specific therapeutic information regarding the indications and use of radiological decorporation agents held as part of the National Medical Stockpile. Matters identified by clinicians requiring specific guidance included: basic understanding of radiation; an approach to dose assessment; specific thresholds for initiating decorporation and other therapy; the role of gastric lavage, as contemporary practice considers this ineffective for other toxicological indications. rationale for, and detailed description of pulmonary lavage; advice on prenatal exposure to radiation; protocols for biodosimetry and other laboratory analysis. The objective was to produce a plain language guidance document for Australian clinicians on the diagnosis and management of radiation injury. It was to be based on evaluation of existing Australian documents, a literature review and consultation of appropriate specialists. Content areas included human health effects of radiation, scenario-based risk assessment and risk management, pre-hospital and hospital systems of care, management of specific injury types, radionuclide pathophysiology and decorporation protocols, biodosimetry options, individual psychological support 'and public health information, and Australian responsibilities under the Radiation Emergency Medical Preparedness and Assistance Network, of the World Health Organization. The range of resources utilised in preparing the

  13. Globalization and social determinants of health: Promoting health equity in global governance (part 3 of 3

    Directory of Open Access Journals (Sweden)

    Schrecker Ted

    2007-06-01

    Full Text Available Abstract This article is the third in a three-part review of research on globalization and the social determinants of health (SDH. In the first article of the series, we identified and defended an economically oriented definition of globalization and addressed a number of important conceptual and metholodogical issues. In the second article, we identified and described seven key clusters of pathways relevant to globalization's influence on SDH. This discussion provided the basis for the premise from which we begin this article: interventions to reduce health inequities by way of SDH are inextricably linked with social protection, economic management and development strategy. Reflecting this insight, and against the background of the Millennium Development Goals (MDGs, we focus on the asymmetrical distribution of gains, losses and power that is characteristic of globalization in its current form and identify a number of areas for innovation on the part of the international community: making more resources available for health systems, as part of the more general task of expanding and improving development assistance; expanding debt relief and taking poverty reduction more seriously; reforming the international trade regime; considering the implications of health as a human right; and protecting the policy space available to national governments to address social determinants of health, notably with respect to the hypermobility of financial capital. We conclude by suggesting that responses to globalization's effects on social determinants of health can be classified with reference to two contrasting visions of the future, reflecting quite distinct values.

  14. Prioritizing health: a systematic approach to scoping determinants in health impact assessment

    Directory of Open Access Journals (Sweden)

    Lindsay McCallum

    2016-08-01

    Full Text Available The determinants of health are those factors that have the potential to affect health, either positively or negatively, and include a range of personal, social, economic, and environmental factors. In the practice of Health Impact Assessment (HIA, the stage at which the determinants of health are considered for inclusion is during the scoping step. The scoping step is intended to identify how the HIA will be carried out and to set the boundaries (e.g., temporal and geographical for the assessment. There are several factors that can help to inform the scoping process, many of which are considered in existing HIA tools and guidance; however, a systematic method of prioritizing determinants was found to be lacking. In order to analyze existing HIA scoping tools that are available, a systematic literature review was conducted including both primary and grey literature. A total of 10 HIA Scoping tools met the inclusion/exclusion criteria and were carried forward for comparative analysis. The analysis focused on minimum elements and practice standards of HIA scoping that have been established in the field. The analysis determined that existing approaches lack a clear, systematic method of prioritization of health determinants for inclusion in HIA. This finding led to the development of a Systematic HIA Scoping tool that addressed this gap. The decision matrix tool uses factors such as impact, public concern and data availability to prioritize health determinants. Additionally, the tool allows for identification of data gaps and provides a transparent method for budget allocation and assessment planning. In order to increase efficiency and improve utility, the tool was programmed into Microsoft Excel. Future work in the area of HIA methodology development is vital to the ongoing success of the practice and utilization of HIA as a reliable decision-making tool.

  15. Prioritizing Health: A Systematic Approach to Scoping Determinants in Health Impact Assessment.

    Science.gov (United States)

    McCallum, Lindsay C; Ollson, Christopher A; Stefanovic, Ingrid L

    2016-01-01

    The determinants of health are those factors that have the potential to affect health, either positively or negatively, and include a range of personal, social, economic, and environmental factors. In the practice of health impact assessment (HIA), the stage at which the determinants of health are considered for inclusion is during the scoping step. The scoping step is intended to identify how the HIA will be carried out and to set the boundaries (e.g., temporal and geographical) for the assessment. There are several factors that can help to inform the scoping process, many of which are considered in existing HIA tools and guidance; however, a systematic method of prioritizing determinants was found to be lacking. In order to analyze existing HIA scoping tools that are available, a systematic literature review was conducted, including both primary and gray literature. A total of 10 HIA scoping tools met the inclusion/exclusion criteria and were carried forward for comparative analysis. The analysis focused on minimum elements and practice standards of HIA scoping that have been established in the field. The analysis determined that existing approaches lack a clear, systematic method of prioritization of health determinants for inclusion in HIA. This finding led to the development of a Systematic HIA Scoping tool that addressed this gap. The decision matrix tool uses factors, such as impact, public concern, and data availability, to prioritize health determinants. Additionally, the tool allows for identification of data gaps and provides a transparent method for budget allocation and assessment planning. In order to increase efficiency and improve utility, the tool was programed into Microsoft Excel. Future work in the area of HIA methodology development is vital to the ongoing success of the practice and utilization of HIA as a reliable decision-making tool. PMID:27597937

  16. Enhancing Educational Performance for Remote Aboriginal Australians: What Is the Impact of Attendance on Performance?

    Science.gov (United States)

    Jorgensen, Robyn

    2012-01-01

    The educational performance of Aboriginal Australians lags behind non-Indigenous Australians with the gap increasing the longer students remain at school. The Australian government has released its Closing the Gap policy with the specific intent to redress gaps in health, education and housing, as these are seen as key indicators to life success.…

  17. Nexus between preventive policy inadequacies, workplace bullying, and mental health: Qualitative findings from the experiences of Australian public sector employees.

    Science.gov (United States)

    Hurley, John; Hutchinson, Marie; Bradbury, Joanne; Browne, Graeme

    2016-02-01

    Public sector organizations have been shown to have high levels of workplace bullying, despite widespread adoption of zero-tolerance policy. Given the level of harm that stems from bullying, it has been suggested that it might be one of the most serious problems facing modern organizations. The qualitative findings from a large cross sectional study of public servants in Australia are reported in the present study. The results highlight palpable mental distress and illness stemming from exposure to workplace bullying. This distress was exacerbated by failures in prohibitive workplace procedures. Reporting bullying through formal organization processes did not lead to resolution of the problem; it instead highlighted feelings of powerlessness and mistrust. In light of the findings, we suggest that an alternative discourse is required, one that gives attention to enhancing employee resilience and self-healing behaviours to the emotional trauma of workplaces. Organizations might be better placed investing resources in fostering the resilience and emotional intelligence of their workforce, rather than continuing to invest resources in prohibitive policies that fail to address the problem. Employees should be supported to prioritize responsibility for their own mental health, rather than an overreliance on organizational responses. PMID:26752457

  18. The case for the World Health Organization's Commission on the Social Determinants of Health to address sexual orientation.

    Science.gov (United States)

    Logie, Carmen

    2012-07-01

    The World Health Organization's (WHO's) social determinants of health discussion underscores the need for health equity and social justice. Yet sexual orientation was not addressed within the WHO Commission on the Social Determinants of Health final report Closing the Gap in a Generation. This omission of sexual orientation as a social determinant of health stands in stark contrast with a body of evidence that demonstrates that sexual minorities are disproportionately affected by health problems associated with stigma and discrimination, such as mental health disorders. I propose strategies to integrate sexual orientation into the WHO's social determinants of health dialogue. Recognizing sexual orientation as a social determinant of health is an important first step toward health equity for sexual minorities.

  19. [Social determinants of health: community features and nurse work in family health care].

    Science.gov (United States)

    Sant'Anna, Cynthia Fontella; Cezar-Vaz, Marta Regina; Cardoso, Leticia Silveira; Erdmann, Alacoque Lorenzini; Soares, Jorgana Fernanda de Souza

    2010-03-01

    The purpose of this study is to identify the Social Determinants of Health Care which emerge in nurses' statements as they characterize the community, analyzing its relation to the work carried out by them. It is an exploratory and descriptive study containing a qualitative analysis in the theoretical categories of the determinants. We used a semi-structured interview, recorded with the permission of the 65 nurses of the Family Health Care, members of the 3rd Regional Health Care Coordination of Rio Grande do Sul, Brazil. It has been shown the inter- and intra-relation in the health determinant factors, obtaining 104 citations for the anatomo-physiological features of the corresponding individuals/community to the proximal correspondents and in association, mainly, to the work carried out by the nurses. For intermediate determinants there were 27 citations and, for distals, 166, with predominant reference to the territorial localization of communities in rural areas and peripheries. The nurses have stated a narrow relation between the proximal features and the work carried out by them, as well as the connection with other determinants in the relation with the process of getting sick. PMID:20839542

  20. Determinants of health insurance ownership among South African women

    Directory of Open Access Journals (Sweden)

    Mwabu Germano M

    2005-02-01

    Full Text Available Abstract Background Studies conducted in developed countries using economic models show that individual- and household- level variables are important determinants of health insurance ownership. There is however a dearth of such studies in sub-Saharan Africa. The objective of this study was to examine the relationship between health insurance ownership and the demographic, economic and educational characteristics of South African women. Methods The analysis was based on data from a cross-sectional national household sample derived from the South African Health Inequalities Survey (SANHIS. The study subjects consisted of 3,489 women, aged between 16 and 64 years. It was a non-interventional, qualitative response econometric study. The outcome measure was the probability of a respondent's ownership of a health insurance policy. Results The χ2 test for goodness of fit indicated satisfactory prediction of the estimated logit model. The coefficients of the covariates for area of residence, income, education, environment rating, age, smoking and marital status were positive, and all statistically significant at p ≤ 0.05. Women who had standard 10 education and above (secondary, high incomes and lived in affluent provinces and permanent accommodations, had a higher likelihood of being insured. Conclusion Poverty reduction programmes aimed at increasing women's incomes in poor provinces; improving living environment (e.g. potable water supplies, sanitation, electricity and housing for women in urban informal settlements; enhancing women's access to education; reducing unemployment among women; and increasing effective coverage of family planning services, will empower South African women to reach a higher standard of living and in doing so increase their economic access to health insurance policies and the associated health services.

  1. Sensitizing Future Health Professionals to Determinants of Childhood Obesity.

    Science.gov (United States)

    Rosemond, Tiara N; Blake, Christine E; Buff, Scotty M; Blake, Elizabeth W; Dunn, Brianne L; Browne, Teri; Bell, Bethany A; Iachini, Aidyn L

    2016-07-01

    Long-term solutions to the childhood obesity epidemic will require concerted interdisciplinary efforts that are sensitive to both individual and social determinants of health. The Junior Doctors of Health© (JDOH) program involves interprofessional education (IPE) with university students from health science fields (e.g., medicine, pharmacy, social work, public health) who deliver an interactive program in teams to at-risk school-aged youth. The purpose of this study was to assess the impact of participation in the JDOH IPE program on university students' beliefs about childhood obesity. Fifty-three of the 71 health sciences students enrolled in the JDOH IPE program between 2011 and 2013 participated in this study. Pre- and post-surveys assessed students' beliefs about the importance, causes of, and responsibility for reducing childhood obesity with both closed- and open-ended questions. In 2013, quantitative data were analyzed using Wilcoxon matched-pairs signed-rank tests and qualitative data were analyzed through open coding to identify emergent themes. Results indicate that after participation in the JDOH IPE program, students' identification of social and environmental causes of childhood obesity increased significantly. Further, students' ranking of the importance of obesity was initially higher than those of different issues typically portrayed as social or environmental (e.g., youth violence) but it was similarly ranked after participation in JDOH. This suggests a greater sensitivity to social and environmental challenges faced by youth. Findings suggest that IPE experiences that bring clinical and community-oriented health professions together to engage with disadvantaged youth foster sensitivity to the complexities of childhood obesity in low-income settings. PMID:26876771

  2. [Intersectoriality, social and environmental determinants and health promotion].

    Science.gov (United States)

    Silva, Kênia Lara; Sena, Roseni Rosângela; Akerman, Marco; Belga, Stephanie Marques Moura; Rodrigues, Andreza Trevenzoli

    2014-11-01

    The study seeks to analyze intersectoriality from the socio-environmental perspective on health promotion. Qualitative research was conducted in six municipalities in Belo Horizonte, Minas Gerais, Brazil. The data were obtained from the mapping of health promotion experiences considered successful by municipal managers, interviews with coordinators, professionals and participants and observations of participants of the practices. The data were subjected to thematic content analysis. Intersectoriality was revealed as a premise for the political definition of the majority of the practices. At the normative program level, the social assistance sector has shown greater potential to develop intersectorial practices and centrality in the implementation grid due to its involvement with the social and environmental determinants. The results indicate that there is a gap between the intention to practice intersectoriality, witnessed by the political decisions in the municipalities, and effective intersectorial action in everyday life. The conclusion reached is that there is potential for intersectorial interventions on the social and environmental determinants in favor of health promotion, but the lack of consistency between what occurs in practice and the political aspects reveal a challenge to be overcome.

  3. Media created violence: a social determinant of mental health.

    Science.gov (United States)

    Begum, Shamshad; Khowaja, Shaneela Sadruddin; Ali, Gulnar

    2012-12-01

    In today's high technological world, scientific discoveries contribute remarkable development to human life, but it could also have an adverse impact on mankind. Among all these advancements, media is one of the inventions which aims at capturing a countless group of viewers and transmit information via various mediums. Media violence is considered one of the hampering determinants which harms an individual psychologically. The primary goal of a health professional is to work for the maintenance of mental health. Therefore, it is imperative to create an understanding about the impact of media violence on mental health, particularly in the Pakistani context. Violence has become a major public health problem in Pakistan. The main cause of violence seems to be anger and frustration due to poverty, political conflicts, lack of education, and the overall governance approach in the country. Therefore, there is a prime need to think and work on this neglected area like conducting research and increasing public awareness, and to curb media violence. PMID:23866487

  4. Education determines a nation's health, but what determines educational outcomes? A cross-national comparative analysis.

    Science.gov (United States)

    Siddiqi, Arjumand; Kawachi, Ichiro; Berkman, Lisa; Hertzman, Clyde; Subramanian, S V

    2012-02-01

    This study is premised on the notion that public health policy should address not only health itself, but also primary determinants of health. We examined the effect of national policies on educational outcomes, in particular, on adolescent reading literacy (ARL). We compared the effect of traditional policy indicators--national income and educational spending--with income inequality, a measure of redistributive policies. We used Organization for Economic Cooperation and Development (OECD) data that provide a rare opportunity to test policy effects after accounting for competing individual-, school-, and country-level explanations. Our sample consisted of 119,814 students, 5126 schools, and 24 countries. Multilevel/Hierarchical regression findings were striking: GDP had a significant, but negligible effect on ARL scores (β=0.002, SE=0.0008), while educational spending had no significant effect. By contrast, income inequality exhibited a larger inverse association (β=-1.15, SE=0.57). Among the wealthy nations in OECD, additional economic prosperity and educational spending is trumped by distribution of income for its effect on ARL. Our study yielded a striking result about education, a major determinant of health. Not only is income inequality a significant determinant of ARL scores, but direct spending on education and overall national economic prosperity are not. PMID:22048059

  5. Explaining the role of the social determinants of health on health inequality in South Africa

    Directory of Open Access Journals (Sweden)

    John Ele-Ojo Ataguba

    2015-09-01

    Full Text Available Background: Action on the social determinants of health (SDH is relevant for reducing health inequalities. This is particularly the case for South Africa (SA with its very high level of income inequality and inequalities in health and health outcomes. This paper provides evidence on the key SDH for reducing health inequalities in the country using a framework initially developed by the World Health Organization. Objective: This paper assesses health inequalities in SA and explains the factors (i.e. SDH and other individual level factors that account for large disparities in health. The relative contribution of different SDH to health inequality is also assessed. Design: A cross-sectional design is used. Data come from the third wave of the nationally representative National Income Dynamics Study. A subsample of adults (18 years and older is used. The main variable of interest is dichotomised good versus bad self-assessed health (SAH. Income-related health inequality is assessed using the standard concentration index (CI. A positive CI means that the rich report better health than the poor. A negative value signifies the opposite. The paper also decomposes the CI to assess its contributing factors. Results: Good SAH is significantly concentrated among the rich rather than the poor (CI=0.008; p<0.01. Decomposition of this result shows that social protection and employment (contribution=0.012; p<0.01, knowledge and education (0.005; p<0.01, and housing and infrastructure (−0.003; p<0.01 contribute significantly to the disparities in good SAH in SA. After accounting for these other variables, the contribution of income and poverty is negligible. Conclusions: Addressing health inequalities inter alia requires an increased government commitment in terms of budgetary allocations to key sectors (i.e. employment, social protection, education, housing, and other appropriate infrastructure. Attention should also be paid to equity in benefits from

  6. Evaluating Strategies For Reducing Health Disparities By Addressing The Social Determinants Of Health.

    Science.gov (United States)

    Thornton, Rachel L J; Glover, Crystal M; Cené, Crystal W; Glik, Deborah C; Henderson, Jeffrey A; Williams, David R

    2016-08-01

    The opportunities for healthy choices in homes, neighborhoods, schools, and workplaces can have decisive impacts on health. We review scientific evidence from promising interventions focused on the social determinants of health and discuss how such interventions can improve population health and reduce health disparities. We found sufficient evidence of successful outcomes to support disparity-reducing policy interventions targeted at education and early childhood; urban planning and community development; housing; income enhancements and supplements; and employment. Cost-effectiveness evaluations show that these interventions lead to long-term societal savings, but the interventions require more routine attention to cost considerations. We discuss challenges to implementation, including the need for long-term financing to scale up effective interventions for implementation at the local, state, and national levels. PMID:27503966

  7. Evaluation of paediatric nursing-sensitive outcomes in an Australian population using linked administrative hospital data

    OpenAIRE

    Wilson, Sally; Bremner, Alexandra P.; Hauck, Yvonne; Finn, Judith

    2013-01-01

    Background Research into nursing-sensitive outcomes using administrative health data has focussed on hospitalised adults. However, we developed algorithms for the identification of 13 paediatric nursing-sensitive outcomes, which we seek to examine for clinical utility. The aims were to determine the rates of paediatric nursing-sensitive outcomes in a Western Australian hospital and ascertain sociodemographic and clinical characteristics associated with a greater risk of developing nursing-sen...

  8. Mental health priorities in Iranian women: overview of social determinants of mental health.

    Directory of Open Access Journals (Sweden)

    Monir Baradaran Eftekhari

    2014-12-01

    Full Text Available Mental health is an essential component for positive adaptation that enables people to cope with adversity to achieve their full potential and humanity. In this study, using a community based approach, the social determinants of mental health in Iranian women were extracted; and in addition, priority setting for interventional programs according to analytical framework of WHO was implemented.This study was a community based participatory research (CBPR in district 22 of Tehran (Iran. The target group was married females with age range of 18-65 years. In this study, mental health priorities were extracted by qualitative methods according to Essential National Health Research model (ENHR and the analytical framework of WHO. Data analysis was done based on content analysis by the open code 3.6 software.In the quantitative phase, according to secondary data, 1144 individuals (560 females and 584 males were selected, of whom 41 percent had impaired mental health based on General Health Questionnaire (GHQ (P<0.05. According to the qualitative phase, the first mental health priority in socioeconomic level was lack of insurance for unattended families, it was unemployment in differential exposure level and it was lack of knowledge and skills related to dealing with stress in the differential vulnerability level; in differential outcome and consequence levels, the priorities were lack of free counseling centers in the study area and lack of facilities for mental health rehabilitation.Providing training courses to improve the skills to deal with stress is considered one of the most important interventions for mental health promotion in women.

  9. Social determinants or social determination of health? Two paradigms in conflict

    Directory of Open Access Journals (Sweden)

    Silvia Támez González

    2015-01-01

    Full Text Available The article discusses the recent Ebola epidemic, declared by the World Health Organization as “a Public Health Emergency of international concern”. From the unicausal explanation and biologicist point of view of the health-disease, epidemic would be explained by characteristics that determine the high pathogenicity of the virus; however, before this statement arises the question: why the epidemic originates in the poorest and/or most unequal and inequitable countries in Africa? For this reason, the main features of the theory of social determination of the health-disease process are shown, afterwards the last outbreak of Ebola is analysed and its appearance is explained as caused by the capitalist and neoliberal model that by means of private enterprise and its invasion of the territory of the poorest countries in the African continent, has displaced the native population to ecosystem uninhabited by humans where the transmitter vector has lived for years. A reection on the unfavourable conditions of the African population is performed (sanitary systems dismantled by structural reforms that do not allow priority assistance to those infected. It is concluded that both the current outbreak as previous ones, have as fundamental cause, the uncontrolled exploitation of natural resources of the region, which thoroughly accelerates poverty levels, the asymmetric distribution of property and power, giving rise to the occurrence of forms of oppression that deepen social inequality.

  10. The protocol for the Be Our Ally Beat Smoking (BOABS study, a randomised controlled trial of an intensive smoking cessation intervention in a remote Aboriginal Australian health care setting

    Directory of Open Access Journals (Sweden)

    Marley Julia V

    2012-03-01

    Full Text Available Abstract Background Australian Aboriginal peoples and Torres Strait Islanders (Indigenous Australians smoke at much higher rates than non-Indigenous people and smoking is an important contributor to increased disease, hospital admissions and deaths in Indigenous Australian populations. Smoking cessation programs in Australia have not had the same impact on Indigenous smokers as on non-Indigenous smokers. This paper describes the protocol for a study that aims to test the efficacy of a locally-tailored, intensive, multidimensional smoking cessation program. Methods/Design This study is a parallel, randomised, controlled trial. Participants are Aboriginal and Torres Strait Islander smokers aged 16 years and over, who are randomly allocated to a 'control' or 'intervention' group in a 2:1 ratio. Those assigned to the 'intervention' group receive smoking cessation counselling at face-to-face visits, weekly for the first four weeks, monthly to six months and two monthly to 12 months. They are also encouraged to attend a monthly smoking cessation support group. The 'control' group receive 'usual care' (i.e. they do not receive the smoking cessation program. Aboriginal researchers deliver the intervention, the goal of which is to help Aboriginal peoples and Torres Strait Islanders quit smoking. Data collection occurs at baseline (when they enrol and at six and 12 months after enrolling. The primary outcome is self-reported smoking cessation with urinary cotinine confirmation at 12 months. Discussion Stopping smoking has been described as the single most important individual change Aboriginal and Torres Strait Islander smokers could make to improve their health. Smoking cessation programs are a major priority in Aboriginal and Torres Strait Islander health and evidence for effective approaches is essential for policy development and resourcing. A range of strategies have been used to encourage Aboriginal peoples and Torres Strait Islanders to quit

  11. Feeling angry about current health status: using a population survey to determine the association with demographic, health and social factors

    OpenAIRE

    Gill, Tiffany K; Price, K; Dal Grande, E.; Daly, A.; Taylor, A. W.

    2016-01-01

    Background Feeling angry about their health status may influence disease progression in individuals, creating a greater burden on the health care system. Identifying associations between different variables and feeling angry about health status may assist health professionals to improve health outcomes. This study used path analysis to explore findings from a population-based survey, informed by qualitative descriptions obtained from focus groups, to determine the prevalence of health-related...

  12. Determination of awareness of health professionals about violence during pregnancy

    Directory of Open Access Journals (Sweden)

    Selma Sen

    2012-01-01

    Full Text Available Objective: To determine the awareness of medical professionals about violence during pregnancy.Methods: It was conducted in a Maternity Hospital, Izmir between 15th November 2007- 15th January 2008. 120 individuals participate in the research (midwives, nurses, doctors, N=160.Results: All of the participants defined the violence during pregnancy as a health problem and 66.7% of them find themselves adequate to diagnose the symptoms of violence. Answers for the physical and psychological findings of violence were; 72.5% think of abuse when they see a bruise, bump or wound on pregnant women's body, 50.8%  don't think of abuse in case of insomnia complaint. Answers for pregnancy complications of violence were: 61.7% "sometimes" think of abuse in pregnant women who applied for preterm birth and 59.2%  don't think of abuse when fetus growth retardation is determined. Answers for questions about affectless use of healthy life behaviors of violence were; 55.0% "sometimes" think of abuse in pregnant women who applied for abortion and 60.8% don't think of abuse in the presence of genital infections in pregnant women.Conclusion: Medical professionals have problems in diagnosing the violence during pregnancy and perceive violence as a health problem; insufficient action is taken against violence cases.

  13. Psychiatric, Psychological, and Social Determinants of Health in the Nurses’ Health Study Cohorts

    Science.gov (United States)

    Chen, Ying; Singh, Ankura; Okereke, Olivia I.; Kubzansky, Laura D.

    2016-01-01

    Objectives. To review the contribution of the Nurses’ Health Studies (NHS) on factors that influence mental and physical health. Methods. Narrative review of all published articles using data from the NHS, the NHS II, and the Growing Up Today Study focusing on mental health conditions (e.g., depression, posttraumatic stress disorder, anxiety) and psychosocial resources and stressors (e.g., job strain, interpersonal violence, social relationships, sexual orientation) between 1990 and 2016. Results. Studies have considered a broad array of determinants (e.g., genes, biomarkers, air pollution) and consequent behavioral and disease-related outcomes (e.g., body weight, smoking, cardiometabolic diseases, cancer, autism). Findings suggest anxiety, posttraumatic stress disorder, childhood violence, caregiver burden, and job insecurity may increase the risk of coronary heart disease and diabetes, whereas findings with cancer are mixed. This work directly affects public health actions, as demonstrated by recent inclusion of a gender expression measure in state surveys. Conclusions. The NHS cohorts have produced novel and influential research on the interplay of psychological and social factors with health. Psychological and social variables are important contributors to the maintenance or decline of physical and mental health. PMID:27459447

  14. Ideological and organizational components of differing public health strategies for addressing the social determinants of health.

    Science.gov (United States)

    Raphael, Dennis; Brassolotto, Julia; Baldeo, Navindra

    2015-12-01

    Despite a history of conceptual contributions to reducing health inequalities by addressing the social determinants of health (SDH), Canadian governmental authorities have struggled to put these concepts into action. Ontario's-Canada's most populous province-public health scene shows a similar pattern. In statements and reports, governmental ministries, professional associations and local public health units (PHUs) recognize the importance of these issues, yet there has been varying implementation of these concepts into public health activity. The purpose of this study was to gain insight into the key features responsible for differences in SDH-related activities among local PHUs. We interviewed Medical Officers of Health (MOH) and key staff members from nine local PHUs in Ontario varying in SDH activity as to their understandings of the SDH, public health's role in addressing the SDH, and their units' SDH-related activities. We also reviewed their unit's documents and their organizational structures in relation to acting on the SDH. Three clusters of PHUs are identified based on their SDH-related activities: service-delivery-oriented; intersectoral and community-based; and public policy/public education-focused. The two key factors that differentiate PHUs are specific ideological commitments held by MOHs and staff and the organizational structures established to carry out SDH-related activities. The ideological commitments and the organizational structures of the most active PHUs showed congruence with frameworks adopted by national jurisdictions known for addressing health inequalities. These include a structural analysis of the SDH and a centralized organizational structure that coordinates SDH-related activities.

  15. What Do We Know about the Chancellors of Australian Universities?

    Science.gov (United States)

    O'Meara, Bernard; Petzall, Stanley

    2008-01-01

    This research attempts to explore the key social characteristics and demographics of Australian chancellors to determine who they are and where they come from. The chancellor of an Australian university wields an enormous amount of power, from overseeing the appointment of the Vice-Chancellor (VC) to fulfilling various statutory requirements.…

  16. Population and Australian development assistance.

    Science.gov (United States)

    Jones, R

    1992-07-01

    Australia's position on international population issues is consistent with the major international statements on population: the World Population Plan of Action (1974), the Mexico City Declaration (1984), and the Amsterdam Declaration (1989). Australia's policy emphasizes the importance of population policies as an integral part of social, economic, and cultural development aimed at improving the quality of life of the people. Factors that would promote smaller families include improving economic opportunities, old-age security, education and health (particularly for women), as well as improving the accessibility and quality of family planning services. The quality of care approach is directly complementary to the Australian International Development Assistance Bureau (AIDAB)'s Women-In-Development Policy and its Health Policy, which stresses the theme of Women And Their Children's Health (WATCH). Australia's support for population programs and activities has increased considerably over the last few years. Total assistance for the year 1990/91 was around $7 million out of a total aid program of $1216 million. In recent years AIDAB has funded family planning activities or health projects with family planning components in a number of countries in the Asia-Pacific region. In the South Pacific region AIDAB has funded a reproductive health video project taking into consideration the cultural sensitivities and customs of the peoples of the region. AIDAB has supported a UN Population Fund project in Thailand that aims to strengthen the capacity of the National Statistical Office to collect population data. The US currently accounts for around 40% of all population-related development assistance to improve the health of women and children through family planning. The other major donors are Japan, the Scandinavian countries, and the Netherlands. Funding for population has been a relatively low percentage of overall development assistance budgets in OECD countries. In the

  17. Heart failure among Indigenous Australians: a systematic review

    OpenAIRE

    Woods John A; Katzenellenbogen Judith M; Davidson Patricia M; Thompson Sandra C

    2012-01-01

    Abstract Background Cardiovascular diseases contribute substantially to the poor health and reduced life expectancy of Indigenous Australians. Heart failure is a common, disabling, progressive and costly complication of these disorders. The epidemiology of heart failure and the adequacy of relevant health service provision in Indigenous Australians are not well delineated. Methods A systematic search of the electronic databases PubMed, Embase, Web of Science, Cinahl Plus, Informit and Google ...

  18. "A deep fragrance of academia": the Australian Tobacco Research Foundation

    OpenAIRE

    Chapman, S; Carter, S.; Peters, M

    2003-01-01

    Objectives: (1) To review the history of the tobacco industry supported Australian Tobacco Research Foundation (ATRF)(1970–1994) for evidence of the industry's use of the Foundation to further its objectives that "more research was needed" on smoking and health and to promulgate the view that nicotine was not addictive. (2) To review efforts by public health advocates to discredit the ATRF as a public relations tool used by the Australian industry.

  19. The social determinants of child health: variations across health outcomes – a population-based cross-sectional analysis

    OpenAIRE

    Victorino Charlemaigne C; Gauthier Anne H

    2009-01-01

    Abstract Background Disparities in child health outcomes persist despite advances in medical technology and increased global wealth. The social determinants of health approach is useful in explaining the disparities in health. Our objective in this paper is four-fold: (1) to test whether the income relationship (and the related income gradient) is the same across different child health outcomes; (2) to test whether the association between income and child health outcomes persists after contro...

  20. A hybrid health service accreditation program model incorporating mandated standards and continuous improvement: interview study of multiple stakeholders in Australian health care.

    Science.gov (United States)

    Greenfield, David; Hinchcliff, Reece; Hogden, Anne; Mumford, Virginia; Debono, Deborah; Pawsey, Marjorie; Westbrook, Johanna; Braithwaite, Jeffrey

    2016-07-01

    The study aim was to investigate the understandings and concerns of stakeholders regarding the evolution of health service accreditation programs in Australia. Stakeholder representatives from programs in the primary, acute and aged care sectors participated in semi-structured interviews. Across 2011-12 there were 47 group and individual interviews involving 258 participants. Interviews lasted, on average, 1 h, and were digitally recorded and transcribed. Transcriptions were analysed using textual referencing software. Four significant issues were considered to have directed the evolution of accreditation programs: altering underlying program philosophies; shifting of program content focus and details; different surveying expectations and experiences and the influence of external contextual factors upon accreditation programs. Three accreditation program models were noted by participants: regulatory compliance; continuous quality improvement and a hybrid model, incorporating elements of these two. Respondents noted the compatibility or incommensurability of the first two models. Participation in a program was reportedly experienced as ranging on a survey continuum from "malicious compliance" to "performance audits" to "quality improvement journeys". Wider contextual factors, in particular, political and community expectations, and associated media reporting, were considered significant influences on the operation and evolution of programs. A hybrid accreditation model was noted to have evolved. The hybrid model promotes minimum standards and continuous quality improvement, through examining the structure and processes of organisations and the outcomes of care. The hybrid model appears to be directing organisational and professional attention to enhance their safety cultures. Copyright © 2015 John Wiley & Sons, Ltd.

  1. Addressing the Social Determinants of Health of Children and Youth: A Role for SOPHE Members

    Science.gov (United States)

    Allensworth, Diane D.

    2011-01-01

    The determinants of youth health disparities include poverty, unequal access to health care, poor environmental conditions, and educational inequities. Poor and minority children have more health problems and less access to health care than their higher socioeconomic status cohorts. Having more health problems leads to more absenteeism in school,…

  2. Adolescent Health Care Use: Investigating Related Determinants in Greece

    Science.gov (United States)

    Giannakopoulos, George; Tzavara, Chara; Dimitrakaki, Christine; Ravens-Sieberer, Ulrike; Tountas, Yannis

    2010-01-01

    The frequency of health care use is crucial for adolescent well-being and health systems. The present study was the first to test a set of variables in a representative sample of Greek adolescents in order to identify factors that predict health care use and contribute to improving health service planning. Questionnaires were administered to a…

  3. Policy approaches to address the social and environmental determinants of health inequity in Asia-pacific.

    Science.gov (United States)

    Friel, Sharon; Loring, Belinda; Aungkasuvapala, Narongsakdi; Baum, Fran; Blaiklock, Alison; Chiang, Tung-Liang; Cho, Youngtae; Dakulala, Paison; Guo, Yan; Hashimoto, Hideki; Horton, Kellie; Jayasinghe, Saroj; Matheson, Don; Nguyen, Huong Thanh; Otto, Caleb; Rao, Mala; Reid, Paaparangi; Surjadi, Charles

    2012-11-01

    Asia Pacific is home to over 60% of the world's population and the fastest growing economies. Many of the leadership in the Asia Pacific region is becoming increasingly aware that improving the conditions for health would go a long way to sustaining economic prosperity in the region, as well as improving global and local health equity. There is no biological reason why males born in Cambodia can expect to live 23 years less than males born in Japan, or why females born in Tuvalu live 23 years shorter than females in New Zealand or why non-Indigenous Australian males live 12 years longer than Indigenous men. The nature and drivers of health inequities vary greatly among different social, cultural and geo-political contexts and effective solutions must take this into account. This paper utilizes the CSDH global recommendations as a basis for looking at the actions that are taking place to address the structural drivers and conditions of daily living that affect health inequities in the Asia Pacific context. While there are signs of action and hope, substantial challenges remain for health equity in Asia Pacific. The gains that have been made to date are not equally distributed and may be unsustainable as the world encounters new economic, social and environmental challenges. Tackling health inequities is a political imperative that requires leadership, political courage, social action, a sound evidence base and progressive public policy. PMID:23070757

  4. Two heads are better than one: Australian tobacco control experts' and mental health change champions' consensus on addressing the problem of high smoking rates among people with mental illness.

    Science.gov (United States)

    Rowley, Della; Lawn, Sharon; Coveney, John

    2016-04-01

    Objective The aims of the present study were to explore the beliefs of Australian experts in tobacco control and change champions working in mental health and tobacco cessation, and to identify measures for addressing the problem of high smoking rates for people with mental illness. Methods Qualitative interviews were undertaken to explore participants' views, and the Delphi technique was used to achieve consensus on ways in which the problem would be best addressed. Results This consensus centred on the need for leadership within the mental health system. The problem was reconceptualised from being solely the responsibility of the mental health sector into an issue that requires the combined resources of a partnership and shared leadership between government and non-government services, public health leaders, policy makers and people with mental illness and their families. Conclusions Collaboration would raise the priority of the issue, reduce the debilitating effect of stigma and discrimination within the mental health sector and would place smoking reduction firmly on the political and public agenda. A recovery-orientated focus would increase the skill base and be inclusive of workers, families and carers of people with mental illness who face smoking issues on a daily basis. Reconceptualising this as an issue that would benefit from cooperation and partnerships would disrupt the notion that the problem is solely the responsibility of the mental health sector. What is known about the topic? Rates of smoking have remained high for people with mental illness despite population-wide public health strategies successfully reducing smoking rates in the general population. For people with mental illness, the benefits of quitting smoking for both their mental and physical health are overshadowed by concerns about the complexity of their needs. There is a lack of knowledge about how smoking cessation support can be improved to increase success rates in smokers with

  5. Determinants of health and nutritional status of rural Nigerian women.

    Science.gov (United States)

    Ene-Obong, H N; Enugu, G I; Uwaegbute, A C

    2001-12-01

    This study was undertaken to determine the effects of socioeconomic and cultural factors on the health and nutritional status of 300 women of childbearing age in two rural farming communities in Enugu State, Nigeria. The women were engaged in farming, trading, and teaching. A cross-sectional survey was conducted using both qualitative and quantitative data-collection methods. The study involved focus-group discussions (FGDs), interviews using a questionnaire, measurement of food/nutrient intake, assessment of activity patterns, anthropometry, and observations of clinical signs of malnutrition. The better-educated women had higher incomes than those with little or no education. Poor education was mainly attributed to lack of monetary support by parents (34%), marriage while in school (27%), and sex discrimination (21%). The teachers had significantly (p iron, riboflavin and niacin requirements. More cases of chronic energy deficiency were observed among the farmers (16%) and traders (13%) than among the teachers (5%). Generally, the women worked long hours with reported working hours (6-7 hours) being lower than the observed working hours (11 hours) for the traders and teachers. Income had a significant (p iron (r = 0.362), riboflavin (r = 0.364), and vitamin C (r = 0.476). Workload was negatively correlated with protein intake (r = 0.346; p < 0.05). Meal frequencies for more than 70% of the farmers and petty traders and 42% of the teachers were dependent on the availability of food in the household. Food taboos had no effect on their nutrient intake, since only 5-11% of women adhered to taboos. Although most women gave their children and husbands preference in food distribution, not much difference was found in the amount of food consumed by these women. The ratio of wife's portion to husband's was 1:1.4 for the farmers, 1:1.3 for the traders, and 1:1.2 for the teachers. FGDs revealed that sex discrimination in education prevailed where resources were limited. The

  6. The Social Determinants of Health: It's Time to Consider the Causes of the Causes

    OpenAIRE

    Braveman, Paula; Gottlieb, Laura

    2014-01-01

    During the past two decades, the public health community's attention has been drawn increasingly to the social determinants of health (SDH)—the factors apart from medical care that can be influenced by social policies and shape health in powerful ways. We use “medical care” rather than “health care” to refer to clinical services, to avoid potential confusion between “health” and “health care.” The World Health Organization's Commission on the Social Determinants of Health has defined SDH as “...

  7. Leveraging the Social Determinants of Health: What Works?

    Science.gov (United States)

    Taylor, Lauren A; Tan, Annabel Xulin; Coyle, Caitlin E; Ndumele, Chima; Rogan, Erika; Canavan, Maureen; Curry, Leslie A; Bradley, Elizabeth H

    2016-01-01

    We summarized the recently published, peer-reviewed literature that examined the impact of investments in social services or investments in integrated models of health care and social services on health outcomes and health care spending. Of 39 articles that met criteria for inclusion in the review, 32 (82%) reported some significant positive effects on either health outcomes (N = 20), health care costs (N = 5), or both (N = 7). Of the remaining 7 (18%) studies, 3 had non-significant results, 2 had mixed results, and 2 had negative results in which the interventions were associated with poorer health outcomes. Our analysis of the literature indicates that several interventions in the areas of housing, income support, nutrition support, and care coordination and community outreach have had positive impact in terms of health improvements or health care spending reductions. These interventions may be of interest to health care policymakers and practitioners seeking to leverage social services to improve health or reduce costs. Further testing of models that achieve better outcomes at less cost is needed. PMID:27532336

  8. Perceived sexism as a health determinant in Spain

    OpenAIRE

    Borrell, Carme; Artazcoz, Lucía; Gil González, Diana; Pérez, Glòria; Rohlfs, Izabella; Pérez, Katherine

    2010-01-01

    OBJECTIVES: The goals of the present study are to explore the association between perceived sexism and self-perceived health, health-related behaviors, and unmet medical care needs among women in Spain; to analyze whether higher levels of discrimination are associated with higher prevalence of poor health indicators and to examine whether these relationships are modified by country of origin and social class. MATERIALS AND METHODS: The study is based on a cross-sectional design using data fro...

  9. Determining Health Utilities through Data Mining of Social Media

    OpenAIRE

    Thompson, Christopher; Introne, Josh; Young, Clint

    2016-01-01

    'Health utilities' measure patient preferences for perfect health compared to specific unhealthy states, such as asthma, a fractured hip, or colon cancer. When integrated over time, these estimations are called quality adjusted life years (QALYs). Until now, characterizing health utilities (HUs) required detailed patient interviews or written surveys. While reliable and specific, this data remained costly due to efforts to locate, enlist and coordinate participants. Thus the scope, context an...

  10. Determining the factors associated with health research participation.

    Science.gov (United States)

    Gucciardi, Enza; Di Liao, Chen; Cameron, Jill I

    2010-01-01

    This study explores factors and attitudes that affect willingness to participate in health research in an ambulatory population of 175 individuals. Respondents reported on their sociodemographic characteristics and rated statements on a questionnaire regarding their likelihood to participate in and attitudes toward health research. Multivariate ordinal regression analysis revealed that having more positive and less negative attitudes toward health research, access to the Internet, previous participation experience, higher education, and being Canadian-born contribute to a greater willingness to participate in health research. Understanding factors that influence research participation can help identify and direct efforts to improve research volunteer recruitment. PMID:20539155

  11. Everything is connected: social determinants of pediatric health and disease.

    Science.gov (United States)

    Tarazi, Carine; Skeer, Margie; Fiscella, Kevin; Dean, Stephanie; Dammann, Olaf

    2016-01-01

    Carine Tarazi, MA, is an Assistant Editor for Pediatric Research in Boston, Massachusetts, USA. Margie Skeer, ScD, MPH, MSW, served as a Guest Editor for this special issue. Dr. Skeer is Assistant Professor of Public Health and Community Medicine at Tufts University. Her research focuses on adolescent substance misuse and sexual risk prevention, both from epidemiologic and intervention-development perspectives. Kevin Fiscella, MD, MPH, served as a Guest Editor for this special issue. Dr. Fiscella is Tenured Professor of Family Medicine, Public Health Sciences and Community Health at the University of Rochester Medical Center. Dr. Fiscella's research focuses on health and health care disparities, particularly practical strategies to improve health equity. Stephanie Dean, MBA, is Managing Editor of Pediatric Research and is based out of editorial office in The Woodlands, Texas. Olaf Dammann, MD, served as a Guest Editor for this special issue. Dr. Dammann is a Professor of Public Health and Community Medicine, Pediatrics, and Ophthalmology at Tufts University School of Medicine in Boston, Massachusetts, USA, as well as Professor of Perinatal Neuroepidemiology at Hannover Medical School, Hannover, Germany. His research interests include the elucidation of risk factors for brain damage and retinopathy in preterm newborns, the theory of risk and causation in biomedical and public health research, and the development of computational chronic disease models. PMID:26841091

  12. [Intimate partner violence: social and health determinants and responses].

    Science.gov (United States)

    Ruiz-Pérez, Isabel; Blanco-Prieto, Pilar; Vives-Cases, Carmen

    2004-01-01

    The present study aims to review the problem of intimate partner violence, as well as its causes and consequences. It will also specifically analyze the role of health professionals. In opposition to the classical epidemiological view of risk factors, Heise proposes an ecological framework to study violence against women. This framework analyzes the interplay among the personal, situational and sociocultural factors that combine to cause abuse. Regarding the frequency of intimate partner violence in Spain, in January 2003 there were 2.519 formal complaints and 69 women died between January and November 2003. No geographical patterns in mortality or the incidence of formal complaints of intimate partner violence or among the provinces with the highest incidence of formal complains and those with highest mortality were observed. The only national survey published in Spain was performed by the Women's Institute in 1999, which reported a prevalence of domestic violence of 9.2%. A frequency of 22.8% was found in a primary health care center in Granada. Health services can play a key role in helping victims of domestic violence, since most women contact the health services at some time in their lives. Professionals in administrative or managerial positions can contribute to raising awareness of this health problem, which is one of the main causes of poor health and disability. Evidently, beyond consciousness-raising and early detection campaigns, public health strategies should be designed to prevent this serious health problem the causes of which can be changed. PMID:15171840

  13. Culturally interpreting environment as determinant and experience of health.

    Science.gov (United States)

    Bent, Katherine N

    2003-10-01

    In minority communities, experiences of the environment and health disparities are frequently related. An important component of nursing practice in communities is to address these issues in cultural context to improve overall community health experiences. This present ethnographic study was conducted in an urban barrio community in which residents have responded to health threats posed by local environmental hazards with sustained community-focused health and development strategies. Data generation occurred during field visits in the community and included interviews, participant observation, field notes, participant-drawn maps, examination of artifacts and existing documents, and photography. Two dimensions define the community experience of the environment in this community: contamination and unhealthy community. The environment is a complex and multidimensional concept of central importance to community experiences. Environmental health cannot be addressed without first understanding that experience in cultural context. PMID:14535151

  14. Australian Curriculum Linked Lessons

    Science.gov (United States)

    Hurrell, Derek

    2013-01-01

    In providing a continued focus on tasks and activities that help to illustrate key ideas embedded in the new Australian Curriculum, the focus in this issue is on Measurement in the Measurement and Geometry strand. The small unit of work on measurement presented in this article has activities that can be modified to meet the requirements of…

  15. The Australian National University

    Institute of Scientific and Technical Information of China (English)

    李琳

    2007-01-01

    The Australian National University was established by Federal Parliament in 1946 with a mission to bring credit to the nation and to be one of the world’s great universities.It was the country’s only full-time research university at the time,and had no undergraduate teaching responsibilities.

  16. Australian Hackers and Ethics

    OpenAIRE

    Warren, M. J.; W. Hutchinson

    2003-01-01

    The aim of the paper is to look at the way hackers act and ways in which society can protect itself. The paper will show the current views and attitudes of hackers in an Australian context. The paper will also include a case study to show how a hacking incident can develop and how technology can be used to protect against hacking.

  17. Characteristics associated with self-rated health in the CARDIA study: Contextualising health determinants by income group.

    Science.gov (United States)

    Nayak, Shilpa; Hubbard, Alan; Sidney, Stephen; Syme, S Leonard

    2016-12-01

    An understanding of factors influencing health in socioeconomic groups is required to reduce health inequalities. This study investigated combinations of health determinants associated with self-rated health (SRH), and their relative importance, in income-based groups. Cross-sectional data from year 15 (2000 - 2001) of the CARDIA study (Coronary Artery Risk Development in Young Adults, USA) - 3648 men and women (mean 40 years) - were split into 5 income-based groups. SRH responses were categorized as 'higher'/'lower'. Health determinants (medical, lifestyle, and social factors, living conditions) associated with SRH in each group were analyzed using classification tree analysis (CTA). Income and SRH were positively associated (p social factors/living conditions. Profiles, and relative importance ranking, of multi-domain health determinants, in relation to SRH, differed by income group. The highest ranking variable for each income group was chronic burden-personal health problem (Social support, control over life, optimism, and resources for paying for basics/medical care/health insurance were greater (%) with higher income. SRH is a multidimensional measure; CTA is useful for contextualizing risk factors in relation to health status. Findings suggest that for lower income groups, addressing contributors to chronic burden is important alongside lifestyle/medical factors. In a proportionate universalism context, in addition to differences in intensity of public health action across the socioeconomic gradient, differences in the type of interventions to improve SRH may also be important. PMID:27413683

  18. Understanding Consumer Preferences for Australian Sparkling Wine vs. French Champagne

    Directory of Open Access Journals (Sweden)

    Julie Culbert

    2016-07-01

    Full Text Available Sparkling wine represents a small but significant proportion of the Australian wine industry’s total production. Yet, Australia remains a significant importer of French Champagne. This study investigated consumer preferences for Australian sparkling wine vs. French Champagne and any compositional and/or sensorial bases for these preferences. A range of French and Australian sparkling wines were analyzed by MIR spectroscopy to determine if sparkling wines could be differentiated according to country of origin. A subset of wines, comprising two French Champagnes, a French sparkling wine and three Australian sparkling wines, were selected for (i descriptive analysis to characterize their sensory profiles and (ii acceptance tests to determine consumer liking (n = 95 Australian wine consumers. Significant differences were observed between liking scores; on average, the $70 French Champagne was liked least and the $12 Australian sparkling wine liked most, but segmentation (based on individual liking scores identified clusters comprising consumers with distinct wine preferences. Interestingly, when consumers were shown wine bottle labels, they considered French wines to be more expensive than Australian wines, demonstrating a clear country of origin influence.

  19. Determinants of Choice Regarding Food with Nutrition and Health Claims

    OpenAIRE

    Aschemann, J.; Hamm, Ulrich

    2008-01-01

    Health is an increasingly important topic in the food market. The regulation (EC) No 1924/2006 on nutrition and health claims is meant to facilitate healthy food choices of consumers. However, research studies about claim perception and choice behaviour are scarce in Europe up to this point, especially those focusing on revealed preferences or a close-to-realistic study design. This contribution reports findings of realistically designed choice-tests accompanied by video-observation and follo...

  20. Oral health determinants among female addicts in Iran

    Directory of Open Access Journals (Sweden)

    S Jalal Pourhashemi

    2015-01-01

    Full Text Available Context: Addiction results in a range of health problems especially in the oral cavity. Aims: This study assessed the oral health status among women with a history of drug abuse in Tehran, Iran. Settings and Design: A cross-sectional study was conducted through structured interviews and clinical examinations of women at three rehabilitation centers in Tehran. Materials and Methods: Data on background characteristics, addiction history, knowledge, attitudes and behaviors, and oral health indices were collected. Statistical Analysis Used: We used MANOVA test and multiple logistic regression models to analyze the data. Results: We assessed 95 participants aged 37.88 ± 10.65 years. The most commonly reported drugs used prior to treatment were opiates (77.2%. The mean knowledge and attitude score among the patients was 80.83 ± 12.89 (37.5-100. Less than half of the dentate women reported tooth brushing as "rarely or never" (44.2%. Most of them (81.8% had never used dental floss and 76.1% were daily smokers. The mean score of dental caries index (decayed, missed and filled teeth of the participants was 20.2 ± 7.18 and 17 subjects were edentulous (17.9%. Factors such as age, drug type, duration of addiction, time of last dental visit, and frequency of brushing were associated with oral health status among these women. Conclusions: Women with a history of drug abuse in our study suffered from poor oral health. Although they had an acceptable level of knowledge and attitude toward oral health, their oral health, and hygiene was poor. These results call for more attention in designing and implementing oral health programs for addicts.

  1. Determinants of Regional Variation in Health Expenditures in Germany.

    Science.gov (United States)

    Göpffarth, Dirk; Kopetsch, Thomas; Schmitz, Hendrik

    2016-07-01

    Health care expenditure in Germany shows clear regional differences. Such geographic variations are often seen as an indicator for inefficiency. With its homogeneous health care system, low co-payments and uniform prices, Germany is a particularly suited example to analyse regional variations. We use data for the year 2011 on expenditure, utilization of health services and state of health in Germany's statutory health insurance system. This data, which originate from a variety of administrative sources and cover about 90% of the population, are enriched with a wealth of socio-economic variables, data on pollutants, prices and individual preferences. State of health and demography explains 55% of the differences as measured by the standard deviation while all control variables account for a total of 72% of the differences at county level. With other measures of variation, we can account for an even greater proportion. A higher proportion of variation than usually supposed can thus be explained. Whilst this study cannot quantify inefficiencies, our results contradict the thesis that regional variations reflect inefficiency. Copyright © 2015 John Wiley & Sons, Ltd. PMID:25962986

  2. Health and Maintenance Status Determination and Predictive Fault Diagnosis System Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The objective of this project is to demonstrate intelligent health and maintenance status determination and predictive fault diagnosis techniques for NASA rocket...

  3. Predictors of negative attitudes toward Indigenous Australians and a unit of study among undergraduate nursing students: A mixed-methods study.

    Science.gov (United States)

    Ramjan, Lucie; Hunt, Leanne; Salamonson, Yenna

    2016-03-01

    Indigenous people are the most disadvantaged population within Australia. The Bachelor of Nursing program at a large university in Western Sydney embedded Indigenous health into the undergraduate teaching program. This paper reviews the negative responses received towards course content on evaluation of the Indigenous health unit and explores the predictors for the negative attitudes towards Indigenous Australians. Two surveys were used (baseline and follow-up) to: 1. Determine the main predictors for negative attitudes towards Indigenous people and; 2. Explore students' perceptions of the educational quality of the Indigenous health unit. The surveys allowed collection of socio-demographic, academic data and included the 18 item 'Attitude Toward Indigenous Australians' (ATIA) scale and open-ended responses. Students who were: 1. Overseas born, 2. Enrolment category: International student and; 3. Whose primary source of information about Indigenous Australians were the media and school were significantly more likely to have higher negative attitudes towards Indigenous Australians. Qualitative data revealed some unfavourable comments dismissing the value and educational quality of the content within the Indigenous health unit. Community engagement is paramount to enhancing the student experience. Movement away from media driven 'hype' to an educated perspective is necessary to create an accurate portrayal of the Indigenous community. PMID:26775166

  4. Socio-Economic Determinants of Health in Croatia: Insights from Four Cross-Sectional Surveys

    Directory of Open Access Journals (Sweden)

    Šime Smolić

    2013-04-01

    Full Text Available The World Health Organization (WHO sees health as a resource for everyday life, a fundamental human right and, especially important for economists and social scientists, an essential component of the economic and social development of every modern society. Health determinants which could lead to better health outcomes can arise from both the social and economic side. The main goal of this paper is to exploit several cross-sectional socio-economic data sets available in Croatia to examine the extent to which individual health is related to certain demographic and economic determinants. In explaining health determinants, self-assessed health (SAH was used as a measure of health on the individual level, and the proportional odds model was applied for the ordinal outcome variable. Controlling for age and other socio-demographic characteristics, education was seen as the single most important determinant of better health. Poor health on the individual level is probably highly correlated with low education and lowest income levels. Public policy-makers should be aware that measures targeted at vulnerable population subgroups might be effective at improving health in the population. However, the identification of a causal relationship between health outcome and its determinants is of crucial importance in the design of future policies.

  5. Cohort Profile: Footprints in Time, the Australian Longitudinal Study of Indigenous Children

    OpenAIRE

    Thurber, Katherine A.; Banks, Emily; Banwell, Cathy

    2014-01-01

    Indigenous Australians experience profound levels of disadvantage in health, living standards, life expectancy, education and employment, particularly in comparison with non-Indigenous Australians. Very little information is available about the healthy development of Australian Indigenous children; the Longitudinal Study of Indigenous Children (LSIC) is designed to fill this knowledge gap. This dataset provides an opportunity to follow the development of up to 1759 Indigenous children. LSIC c...

  6. Patterns of care for patients with advanced soft tissue sarcoma: experience from Australian sarcoma services

    OpenAIRE

    Bae, Susie; Crowe, Philip; Gowda, Raghu; Joubert, Warren; Carey-Smith, Richard; Stalley, Paul; Desai, Jayesh

    2016-01-01

    Background There is a paucity of data on the current management of patients with advanced soft tissue sarcoma (STS) in the Australian health care setting. This study utilised the Australian sarcoma database to evaluate the patterns of care delivered to patients with advanced STS at Australian sarcoma services. Methods Prospectively collected data from six sarcoma centres in Australia were sourced to identify patients diagnosed with advanced STS between 1 January 2010 and 31 December 2012. Des...

  7. Australian nursing and midwifery educators delivering evidence-based education in Tanzania: A qualitative study.

    Science.gov (United States)

    Gower, Shelley; van den Akker, Jose; Jones, Mark; Dantas, Jaya A R; Duggan, Ravani

    2016-05-01

    Since 2011, Western Australian nursing and midwifery educators have been providing evidence-based continuing education to Tanzanian health professionals. Despite thorough preparation before departure, differences in local resource levels and available facilities have necessitated impromptu adaptation of curriculum content and delivery methods to ensure an effective program was delivered. This study explored the personal, cultural and teaching strategies utilised by Western Australian nursing and midwifery educators in Tanzania and examined if the transferability of education packages was influenced by the educators' cultural competence. Using a qualitative exploratory approach, data was collected from 15 Western Australian nursing and midwifery educators using a demographic survey and in-depth individual semi-structured interviews. The core themes identified from the analysis were Determination to learn, Assessing needs, Communication skills and Greater understanding. These findings are described using the conceptual framework of Campinha-Bacote's The Process of Cultural Competence in the Delivery of Healthcare Services. With appropriate levels of cultural competence, international health professionals can be effective at providing ongoing professional development to colleagues in developing country contexts, which may help address difficulties with retention and motivation of staff. It is essential that prior to departure cultural competence training is provided to educators to enhance their teaching capacity and effectiveness in international settings. PMID:27235561

  8. Determinants of participation in a web-based health risk assessment and consequences for health promotion programs

    NARCIS (Netherlands)

    M.A.J. Niessen (Maurice); E.L. Laan (Eva); S.J.W. Robroek (Suzan); M.L.E. Essink-Bot (Marie-Louise); N. Peek (Niels); R.A. Kraaijenhagen (Roderik); C.K. van Kalken (Coen); A. Burdorf (Alex)

    2013-01-01

    textabstractBackground: The health risk assessment (HRA) is a type of health promotion program frequently offered at the workplace. Insight into the underlying determinants of participation is needed to evaluate and implement these interventions. Objective: To analyze whether individual characterist

  9. Widening the Aim of Health Promotion to Include the Most Disadvantaged: Vulnerable Adolescents and the Social Determinants of Health

    Science.gov (United States)

    Mohajer, Nicole; Earnest, Jaya

    2010-01-01

    Growing numbers of adolescents are marginalized by social factors beyond their control, leading to poor health outcomes for their families and future generations. Although the role of the social determinants of health has been recognized for many years, there is a gap in our knowledge about the strategies needed to address these factors in health…

  10. [Community health as a determinant of the nursing curriculum].

    Science.gov (United States)

    Espino de Alayo, S

    1979-01-01

    This paper summarizes the experience acquired under the first university-level program for the basic training of nurses in Peru. It describes the gradual refining of the academic curriculum, which was designed not only to train people as competent professionals, but also to acquaint them with the country's basic social problems. Four levels of teaching-learning were defined in wide-ranging discussions in which various academic and professional sectors connected with the health field participated. Establishing a process of steps of increasing complexity has considerably facilitated the integration of community health, the scientific method, and mental health into the structure of the curriculum. The practice of community nursing was heavily emphasized, and it was endeavored to strike a balance between hospital experience and work in communities themselves. The program includes specific studies community groups spanning such aspects as control of the more common disease, epidemiologic surveillance, and accident and disaster prevention. Practical work in community health care earns the same credit as hospital internship. The paper closes with a description of the experience of a specific program conducted in the self-managed city of Villa El Salvador under an agreement between the community and the university. The writer also notes that the intense campaign to publicize the program is having an effect because most nurse-training institutions in Peru are tending to add community nursing to their curricula. PMID:393491

  11. Determinants of increased primary health care use in cancer survivors.

    NARCIS (Netherlands)

    Heins, M.; Schellevis, F.; Rijken, M.; Hoek, L. van der; Korevaar, J.

    2012-01-01

    Purpose: The number of cancer survivors is increasing, and patients with cancer often experience long-lasting consequences of cancer and its treatment. Because of the variety of health problems and high prevalence of comorbidity, primary care physicians (PCPs) seem obvious candidates to take care of

  12. Determining health care rights from behind a veil of ignorance.

    Science.gov (United States)

    Korobkin, R

    1998-01-01

    Should our society establish positive rights to health care that each citizen could claim, as many health policy analysts believe? Or should it provide only background rules of contract and property law and leave the provision of health care to the free market, as Richard Epstein advocates in Mortal Peril? In this article, Professor Korobkin argues that this question should be addressed from the Rawlsian "veil of ignorance" perspective. That is, the question should be answered by asking what kind of society would individuals agree to form if they had no knowledge of their individual skills or endowments; if they did not know whether they were rich or poor, healthy or sick, weak or strong. Professor Korobkin contends that individuals behind such a veil of ignorance would balance their inherent risk aversion (which favors a safety net of "rights") against the inefficient incentives created by rights regimes that would reduce net social wealth (which favors a free market). Whether they would choose to establish rights to health care or not is ultimately an empirical question that turns on how inefficient any particular right would be. The question thus requires a case-by-case analysis of proposed rights. The article then considers the policy issues of (1) community rating of private health insurance and (2) the mandated provision of emergency medical care. It concludes that in these cases the inefficient incentives created by establishing rights are probably smaller and/or controllable enough to lead individuals behind the veil of ignorance to favor a regime of positive rights.

  13. Food irradiation: an inquiry by the Australian Consumers' Association

    International Nuclear Information System (INIS)

    The Australian Consumers' Association's Inquiry into Food Irradiation was undertaken at the request of the Commonwealth Minister of Health, Dr N Blewett. The terms of reference of the Inquiry covered the implications of food irradiation in terms of consumer health, the environment, and the cost to the consumer

  14. Public health services, an essential determinant of health during crisis. Lessons from Cuba, 1989-2000

    OpenAIRE

    de Vos, P.; García-Fariñas, A.; Alvarez-Pérez, A.; Rodríguez-Salvá, A.; Bonet-Gorbea, M.; Van der Stuyft, P.

    2012-01-01

    During the 1990s, Cuba was able to overcome a severe crisis, almost without negative health impacts. This national retrospective study covering the years 1989-2000 analyses the country's strategy through essential social, demographic, health process and health outcome indicators. Gross domestic product (GDP) diminished by 34.76% between 1989 and 1993. In 1994 slow recuperation started. During the crisis, public health expenses increased. The number of family doctors rose from 9.22 to 27.03 pe...

  15. [Determination and causality in public health: some considerations on its epistemological foundations].

    Science.gov (United States)

    Rodríguez, Juan Manuel Mendoza; Soto, Edgar Carlos Jarillo

    2011-01-01

    The discussion on the determinants is extremely prolific in the area of health. However, we still have to think about the way in which the determination is defined and understood as a category that allows to question reality, from an overall and complex view, and the extent that they can have their application in public health. This article discusses the concepts of causality, which is dominant in the positivist vision as well as determination and historicity, used by some alternative views on health. Some arguments are exposed on the ontological and epistemological approach to address the study of health-disease process, from considerations of phenomenology. PMID:21503432

  16. Determinants of innovation within health care organisations: a literature review and Delphi-study

    NARCIS (Netherlands)

    Fleuren, M.A.H.; Wiefferink, C.H.; Paulussen, T.G.W.M.

    2004-01-01

    Purpose. When introducing innovations to health care, it is important to gain insight into determinants that may facilitate or impede the introduction, in order to design an appropriate strategy for introducing the innovation. To obtain an overview of determinants of innovations in health care organ

  17. Social Determinants of Racial/Ethnic Health Disparities in Children and Adolescents

    Science.gov (United States)

    Price, James H.; McKinney, Molly A.; Braun, Robert E.

    2011-01-01

    Too many racial/ethnic minorities do not reach their full potential for a healthy and rewarding life. This paper addresses the social determinants that impact, either directly or indirectly, child and adolescent health disparities. Understanding the role social determinants play in the life course of health status can help guide educational…

  18. The association between four citation metrics and peer rankings of research influence of Australian researchers in six fields of public health.

    Directory of Open Access Journals (Sweden)

    Gemma Elizabeth Derrick

    Full Text Available Doubt about the relevance, appropriateness and transparency of peer review has promoted the use of citation metrics as a viable adjunct or alternative in the assessment of research impact. It is also commonly acknowledged that research metrics will not replace peer review unless they are shown to correspond with the assessment of peers. This paper evaluates the relationship between researchers' influence as evaluated by their peers and various citation metrics representing different aspects of research output in 6 fields of public health in Australia. For four fields, the results showed a modest positive correlation between different research metrics and peer assessments of research influence. However, for two fields, tobacco and injury, negative or no correlations were found. This suggests a peer understanding of research influence within these fields differed from visibility in the mainstream, peer-reviewed scientific literature. This research therefore recommends the use of both peer review and metrics in a combined approach in assessing research influence. Future research evaluation frameworks intent on incorporating metrics should first analyse each field closely to determine what measures of research influence are valued highly by members of that research community. This will aid the development of comprehensive and relevant frameworks with which to fairly and transparently distribute research funds or approve promotion applications.

  19. An exploration of social determinants of health amongst internally displaced persons in northern Uganda

    Directory of Open Access Journals (Sweden)

    Geissler Wenzel

    2009-12-01

    Full Text Available Abstract Social determinants of health describe the conditions in which people are born, grow, live, work and age and their influence on health. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels, which are themselves influenced by policy choices. Armed conflict and forced displacement are important influences on the social determinants of health. There is limited evidence on the social determinants of health of internally displaced persons (IDPs who have been forced from their homes due to armed conflict but remain within the borders of their country. The aim of this study was to explore the social determinants of overall physical and mental health of IDPs, including the response strategies used by IDPs to support their health needs. Northern Uganda was chosen as a case-study, and 21 face-to-face semi-structured interviews with IDPs were conducted in fifteen IDP camps between November and December 2006. The findings indicated a number of key social determinants. Experiencing traumatic events could cause "over thinking" which in turn could lead to "madness" and physical ailments. Respondents also attributed "over thinking" to the spirit (cen of a killed person returning to disturb its killer. Other social determinants included overcrowding which affected physical health and contributed to an emotional sense of loss of freedom; and poverty and loss of land which affected physical health from lack of food and income, and mental health because of worry and uncertainty. Respondents also commented on how the conflict and displacement and led to changes in social and cultural norms such as increased "adultery", "defilement", and "thieving". Response strategies included a combination of biopsychosocial health services, traditional practices, religion, family and friends, and isolating. This study supports work exploring the political, environmental, economic, and socio

  20. The determinants of health expenditure in Malaysia: A time series analysis

    OpenAIRE

    Tang, Chor Foon

    2010-01-01

    The purpose of this study is to investigate the determinants of health expenditure in Malaysia within the time series framework from 1967 to 2007. This study employed the Johansen-Juselius cointegration test to examine the cointegration relationship. The results showed that health expenditure and its determinants are cointegrated. Consistent with economic theory, the TYDL and variance decomposition analysis reveals that the key explanatory variables in Malaysia’s health expenditure model are ...

  1. The Mexican experience in monitoring and evaluation of public policies addressing social determinants of health

    OpenAIRE

    Martinez Valle, Adolfo

    2016-01-01

    Monitoring and evaluation (M&E) have gradually become important and regular components of the policy-making process in Mexico since, and even before, the World Health Organization (WHO) Commission on Social Determinants of Health (CSDH) called for interventions and policies aimed at tackling the social determinants of health (SDH). This paper presents two case studies to show how public policies addressing the SDH have been monitored and evaluated in Mexico using reliable, valid, and comp...

  2. Australian Hackers and Ethics

    Directory of Open Access Journals (Sweden)

    M.J. Warren

    2003-05-01

    Full Text Available The aim of the paper is to look at the way hackers act and ways in which society can protect itself. The paper will show the current views and attitudes of hackers in an Australian context. The paper will also include a case study to show how a hacking incident can develop and how technology can be used to protect against hacking.

  3. Health Promoting Lifestyle and its Determinants Among University Students in Sabzevar, Iran

    OpenAIRE

    Ali Mehri; Mahnaz Solhi; Gholamreza Garmaroudi; Haidar Nadrian; Shirin Shahbazi Sighaldeh

    2016-01-01

    Background: Healthy lifestyle is a major strategy to promote current and subsequent health status. The aim of this study was to assess the status of health-promoting the lifestyle and its determinants among students. Methods: A stratified random sample of 500 students in a university in the city of Sabzevar, Iran participated in this cross-sectional study. Health-promoting lifestyle was measured using Walker′s health-promoting lifestyle profile II. Results: There was a significant cor...

  4. Determinants of mental health service use in the national mental health survey of the elderly in Singapore

    Directory of Open Access Journals (Sweden)

    Kua Ee

    2009-01-01

    Full Text Available Abstract Background Despite high prevalence of mental health problems, only a minority of elderly people seek treatment. Although need-for-care factors are primary determinants of mental health service use, personal predisposing or enabling factors including health beliefs are important but are not well studied. Method In the National Mental Health Survey of Elderly in Singapore, 2003, 1092 older adults aged 60 and above were interviewed for diagnosis of mental disorders (using Geriatric Mental State and treatment, and their health beliefs about the curability of mental illness, embarrassment and stigma, easiness discussing mental problems, effectiveness and safety of treatment and trust in professionals. Results The prevalence of mental disorders was 13%, but only a third of mentally ill respondents had sought treatment. Increased likelihood of seeking treatment was significantly associated with the presence of a mental disorder (OR = 5.27, disability from mental illness (OR = 79.9, and poor or fair self-rated mental health (OR = 2.63, female gender (OR = 2.25, and formal education (OR = 2.40. The likelihood of treatment seeking was lower in those reporting financial limitations for medical care (OR = 0.38, but also higher household income (OR = 0.31. Negative beliefs showed no meaningful associations, but the positive belief that 'to a great extent mental illness can be cured' was associated with increased mental health service use (OR = 6.89. The availability of family caregiver showed a negative association (OR = 0.20. Conclusion The determinants of mental health service use in the elderly included primary need factors, and female gender and socioeconomic factors. There was little evidence of influences by negative health beliefs, but a positive health belief that 'mental illness can be cured' is a strongly positive determinant The influence of family members and care-givers on senior's use of mental health service should be further explored.

  5. Huntington disease in indigenous Australians.

    Science.gov (United States)

    Panegyres, P K; McGrath, F

    2008-02-01

    Huntington disease (HD) in indigenous Australians is a poorly analysed and difficult problem. This study addresses the issue of HD in remote indigenous Australian populations in the north-west of Western Australia. Proband identification, clinical assessment, neurogenetic studies and pedigree analysis led to the discovery of HD in the 63-year-old male proband and his family. HD in remote indigenous Australian communities is a challenging diagnostic and management problem compounded by the complexity of distance. PMID:18290828

  6. Eclipses in Australian Aboriginal Astronomy

    CERN Document Server

    Hamacher, Duane W

    2011-01-01

    We explore 50 Australian Aboriginal accounts of lunar and solar eclipses to determine how Aboriginal groups understood this phenomenon. We summarise the literature on Aboriginal references to eclipses, showing that many Aboriginal groups viewed eclipses negatively, frequently associating them with bad omens, evil magic, disease, blood and death. In many communities, Elders or medicine men were believed to have the ability to control or avert eclipses by magical means, solidifying their role as provider and protector within the community. We also show that many Aboriginal groups understood the motions of the sun-earth-moon system, the connection between the lunar phases and tides, and acknowledged that solar eclipses were caused by the moon blocking the sun.

  7. Patterns of multimorbidity in working Australians

    Directory of Open Access Journals (Sweden)

    Ng Shu-Kay

    2011-06-01

    Full Text Available Abstract Background Multimorbidity is becoming more prevalent. Previously-used methods of assessing multimorbidity relied on counting the number of health conditions, often in relation to an index condition (comorbidity, or grouping conditions based on body or organ systems. Recent refinements in statistical approaches have resulted in improved methods to capture patterns of multimorbidity, allowing for the identification of nonrandomly occurring clusters of multimorbid health conditions. This paper aims to identify nonrandom clusters of multimorbidity. Methods The Australian Work Outcomes Research Cost-benefit (WORC study cross-sectional screening dataset (approximately 78,000 working Australians was used to explore patterns of multimorbidity. Exploratory factor analysis was used to identify nonrandomly occurring clusters of multimorbid health conditions. Results Six clinically-meaningful groups of multimorbid health conditions were identified. These were: factor 1: arthritis, osteoporosis, other chronic pain, bladder problems, and irritable bowel; factor 2: asthma, chronic obstructive pulmonary disease, and allergies; factor 3: back/neck pain, migraine, other chronic pain, and arthritis; factor 4: high blood pressure, high cholesterol, obesity, diabetes, and fatigue; factor 5: cardiovascular disease, diabetes, fatigue, high blood pressure, high cholesterol, and arthritis; and factor 6: irritable bowel, ulcer, heartburn, and other chronic pain. These clusters do not fall neatly into organ or body systems, and some conditions appear in more than one cluster. Conclusions Considerably more research is needed with large population-based datasets and a comprehensive set of reliable health diagnoses to better understand the complex nature and composition of multimorbid health conditions.

  8. A service-level action research intervention to improve identification and treatment of cannabis and related mental health issues in young Indigenous Australians: a study protocol

    OpenAIRE

    Bohanna, India; Bird, Katrina; Copeland, Jan; Roberts, Nicholas; Clough, Alan

    2014-01-01

    Introduction Regular cannabis use is associated with negative mental health impacts including psychosis, depression and anxiety. Rates of cannabis use have increased in Aboriginal and Torres Strait Islander communities in northern Australia within the last two decades, presenting a significant increased risk to young people's mental health in these regions. Improved screening, early detection and treatment for cannabis-related mental health issues are urgently required. This paper describes a...

  9. How do Australian maternity and early childhood health services identify and respond to the settlement experience and social context of refugee background families?

    OpenAIRE

    Yelland, Jane; Riggs, Elisha; Wahidi, Sayed; Fouladi, Fatema; Casey, Sue; Szwarc, Josef; Duell-Piening, Philippa; Chesters, Donna; Brown, Stephanie

    2014-01-01

    Background Refugees have poor mental, social and physical health related to experiences of trauma and stresses associated with settlement, however little is known about how refugee families experience maternity and early childhood services. The aim of this study was to explore the responsiveness of health services to the social and mental health of Afghan women and men at the time of having a baby. Method Participatory methods including community engagement and consultation with the Afghan co...

  10. Employment precariousness and poor mental health: evidence from Spain on a new social determinant of health

    OpenAIRE

    Alejandra Vives; Marcelo Amable; Montserrat Ferrer; Salvador Moncada; Clara Llorens; Carles Muntaner; Benavides, Fernando G.; Joan Benach

    2013-01-01

    Background. Evidence on the health-damaging effects of precarious employment is limited by the use of one-dimensional approaches focused on employment instability. This study assesses the association between precarious employment and poor mental health using the multidimensional Employment Precariousness Scale. Methods. Cross-sectional study of 5679 temporary and permanent workers from the population-based Psychosocial Factors Survey was carried out in 2004-2005 in Spain. Poor mental health w...

  11. Cracking the Code: Assessing Institutional Compliance with the Australian Code for the Responsible Conduct of Research

    Science.gov (United States)

    Morris, Suzanne E.

    2010-01-01

    This paper provides a review of institutional authorship policies as required by the "Australian Code for the Responsible Conduct of Research" (the "Code") (National Health and Medical Research Council (NHMRC), the Australian Research Council (ARC) & Universities Australia (UA) 2007), and assesses them for Code compliance. Institutional authorship…

  12. Post-Traumatic Stress Disorder and Quality of Life in Sexually Abused Australian Children

    Science.gov (United States)

    Gospodarevskaya, Elena

    2013-01-01

    The study used publicly available data on post-traumatic stress disorder in a sample of the Australian population with a history of sexual abuse to demonstrate how this evidence can inform economic analyses. The 2007 Australian Mental Health Survey revealed that 8.3% of 993 adolescents experienced childhood sexual abuse, of which 40.2% were…

  13. Public health services, an essential determinant of health during crisis. Lessons from Cuba, 1989-2000.

    Science.gov (United States)

    De Vos, Pol; García-Fariñas, Anaí; Álvarez-Pérez, Adolfo; Rodríguez-Salvá, Armando; Bonet-Gorbea, Mariano; Van der Stuyft, Patrick

    2012-04-01

    During the 1990s, Cuba was able to overcome a severe crisis, almost without negative health impacts. This national retrospective study covering the years 1989-2000 analyses the country's strategy through essential social, demographic, health process and health outcome indicators. Gross domestic product (GDP) diminished by 34.76% between 1989 and 1993. In 1994 slow recuperation started. During the crisis, public health expenses increased. The number of family doctors rose from 9.22 to 27.03 per 104 inhabitants between 1989 and 2000. Infant mortality rate and life expectancy exemplify a series of health indicators that continued to improve during the crisis years, whereas low birth weight and tuberculosis incidence are among the few indicators that suffered deterioration. GDP is inversely related to tuberculosis incidence, whereas the average salary is inversely related to low birth weight. Infant mortality rate has a strong negative correlation with the health expenses per inhabitant, the number of maternal homes, the number of family doctors and the proportion of pregnant women receiving care in maternal homes. Life expectancy has a strong positive correlation with health expenses, the number of nursing personnel and the number of medical contacts per inhabitant. The Cuban strategy effectively resolved health risks during the crisis. In times of serious socio-economic constraints, a well conceptualized public health policy can play an important role in maintaining the overall well-being of a population.

  14. Health and its Social Determinants: A Study on Health Inequalities among Tabriz Citizens

    Directory of Open Access Journals (Sweden)

    Hossein Benifatemeh

    2014-11-01

    The results of this study showed that, compared to women, men have higher levels of health scores (75/7 vs. 71/5, and people with high education have health scores higher than those with law education. This research proved the effectiveness of health awareness, education, healthy lifestyle and social protection of citizens on increase of health level. Also, an indirect and powerful correlation was observed among age and health related quality of life. This result shows that aging is a very important variable in health status of people. Aged people have mental health problems in particular. On the other hand, there were very significant differences between men and women in mental health scores. Women have a very bad condition in this regard. The results of this study showed the importance of social factors in health inequalities among citizens. As a result, attention should be paid to social factors and attempts should be made to diminish social and economic inequalities and discriminations in society.

  15. Mapping of capacities for research on health and its social determinants in Brazil

    Directory of Open Access Journals (Sweden)

    Elis Borde

    2014-10-01

    Full Text Available This article describes tendencies in research on social determinants of health (SDH and health inequities in Brazil (2005-2012 and maps research system structures to analyze capacities for research on health and its social determinants. Brazil has a strong national research system and counts on a wealth of research in the field of SDH drawing on a long tradition of research and political commitment in this area. While innovative strategies seeking to strengthen the links between research, policy and practice have been developed, the impact of SDH research continues to be largely restricted to the academic community with notable but still insufficient repercussions on public policy and the social determinants of health inequities. SDH research in Brazil will therefore need to become even more responsive to social urgencies and better attuned to political processes, enhancing its capacity to influence strategic policy decisions affecting health inequities and mobilize strategic agendas for health equity.

  16. Family-level AMBI is valid for use in the north-eastern Atlantic but not for assessing the health of microtidal Australian estuaries

    Science.gov (United States)

    Tweedley, James R.; Warwick, Richard M.; Clarke, K. Robert; Potter, Ian C.

    2014-03-01

    Analysis of benthic macroinvertebrate samples at a higher taxonomic level than species, e.g. family, potentially provides a more cost-effective protocol for environmental impact assessments and monitoring as it requires less time, funds and taxonomic expertise. Using the AMBI database, species ecological group scores are shown to be coherent within families. Faunal data from a wide range of environmental impact scenarios in the north-eastern Atlantic demonstrate that AMBI, calculated from mean values for families, exhibits a strong linear relationship with species-level AMBI, the correlation improving by using square-root transformed rather than untransformed abundances. In many regions of the world, however, the sensitivity of benthic macroinvertebrates to environmental perturbations is unknown, precluding the use of AMBI for environmental assessments. Yet the families are essentially the same as in the AMBI database. The utility of family-level AMBI is tested using data for four south-western Australian estuaries previously subjected to environmental quality assessments, but where only 17 species of the 144 taxa are included in the AMBI database. Although family-level AMBI scores reflect differences in environmental quality spatially and temporally within an estuary, they do not follow variations in environmental quality among estuaries. Indeed, south-western Australia estuaries are numerically dominated by families with high AMBI scores, probably due to the detrimental effects of natural accumulations of organic material in estuaries with long residence times. As taxonomic distinctness follows trends in environmental quality among estuaries, as well as temporally and spatially within a system, it provides an appropriate substitute for assessing the 'heath' of microtidal estuaries.

  17. USGS analysis of the Australian UNCLOS submission

    Science.gov (United States)

    Hutchinson, Deborah R.; Rowland, Robert W.

    2006-01-01

    In November 2004, the Government of Australia made a submission to the Commission on the Limits of the Continental Shelf (CLCS) for 10 extended continental shelf (ECS) regions, utilizing Article-76 of the United Nations Convention on the Law of the Sea (UNCLOS). With information provided in the Australian Executive Summary, the USGS examined the 10 regions of the submission from geological, morphological, and resource perspectives. By their own request, the Australians asked that CLCS take no action on the Australian-Antarctic Territory. The major limitation in this analysis is that no bathymetric soundings or detailed hydrographic profiles were provided in the Australian Executive Summary that might show why the Foot of the Slope (FOS) was chosen or where the 2,500-m contour is located. This represents a major limitation because more than half of the 4,205 boundary points utilize the bathymetric formula line and more than one-third of them utilize the bathymetric constraint line. CLCS decisions on the components of this submission may set a precedent for how ECSs are treated in future submissions. Some of the key decisions will cover (a) how a 'natural prolongation' of a continental margin is determined, particularly if a bathymetric saddle that appears to determine the prolongation is in deep water and is well outside of the 200-nm limit (Exmouth Plateau), (b) defining to what extent that plateaus, rises, caps, banks and spurs that are formed of oceanic crust and from oceanic processes can be considered to be 'natural prolongations' (Kerguelen Plateau), (c) to what degree UNCLOS recognizes reefs and uninhabited micro-islands (specifically, rocks and/or sand shoals) as islands that can have an EEZ (Middleton and Elizabeth Reefs north of Lord Howe Island), and (d) how the Foot of the Slope (FOS) is chosen (Great Australian Bight). The submission contains situations that are relevant to potential future U.S. submissions and are potentially analogous to certain

  18. Clustering of health-related behaviors and their determinants: Possible consequences for school health interventions

    NARCIS (Netherlands)

    Wiefferink, C.H.; Peters, L.; Hoekstra, F.; Ten Dam, G.; Buijs, G.J.; Paulussen, T.G.W.M.

    2006-01-01

    Characterizing school health promotion is its category-by-category approach, in which each separate health-related behavior is addressed independently. Such an approach creates a risk that extra-curricular activities become overloaded, and that teaching staff are distracted by continuous innovations

  19. Post-Secondary Students' Views on Health: Support for Individual and Social Health Determinants

    Science.gov (United States)

    Shyleyko, Robert; Godley, Jenny

    2012-01-01

    This paper examines how post-secondary students understand health, and whether opinions about health are correlated with area of study. We present results from an online survey administered in 2011 to 287 students at one post-secondary institution in Western Canada. Overall, the survey students are more likely to adopt an individualistic, rather…

  20. Early Childhood Experiences and Health. Exploring the Social Determinants of Health. Issue Brief #2

    Science.gov (United States)

    Braveman, Paula; Sadegh-Nobari, Tabashir; Egerter, Susan

    2011-01-01

    The earliest years of one's life are crucial in many ways, including how they set one on paths leading toward--or away from--good health. Family income, education, and neighborhood resources and other social and economic factors affect health at every stage of life, but the effects on young children are particularly dramatic. While all parents…

  1. Social determinants of health: poverty, national infrastructure and investment.

    Science.gov (United States)

    Douthit, Nathan T; Alemu, Haimanot Kasahun

    2016-01-01

    This case presentation of a 19-year-old Ethiopian woman diagnosed with nasopharyngeal carcinoma reveals the barriers the patient has to medical treatment, including poverty and a lack of national infrastructure. The patient lives a life of poverty, and the outcome of her illness is a result of her being unable to overcome barriers to accessing health care due to inability to afford transport, lodging and treatment. In this case, the patient's vulnerability to disease due to her poverty is not overcome because of lack of infrastructure. The infrastructure fails to develop because of inadequate investment and other delays in building. The end result is that the patient is vulnerable to disease. Her disease process impacts her family and their contribution to Ethiopia's development. PMID:27335366

  2. Radium in potable waters from Central Victoria : an application of the Australian drinking water guidelines

    International Nuclear Information System (INIS)

    Determinations of 226Ra and 228Ra in potable mineral waters from springs located in the Daylesford-Hepburn region of Victoria, Australia, were carried out. Concentrations ranged from 230-810 mBq L-1 for 228Ra. These levels approach or exceed the guideline limits recommended in the Australian Drinking Water Guidelines. The annual committed effective dose and health risks from radium in potable water is discussed. Assuming consumption of 2 L per day the average committed effective dose received from 226Ra was 0.087 mSv y-1 and from 228Ra was 0.10 mSv y-1. (author). 18 refs., 2 tabs

  3. Fostering Social Determinants of Health Transdisciplinary Research: The Collaborative Research Center for American Indian Health

    Directory of Open Access Journals (Sweden)

    Amy J. Elliott

    2015-12-01

    Full Text Available The Collaborative Research Center for American Indian Health (CRCAIH was established in September 2012 as a unifying structure to bring together tribal communities and health researchers across South Dakota, North Dakota and Minnesota to address American Indian/Alaska Native (AI/AN health disparities. CRCAIH is based on the core values of transdisciplinary research, sustainability and tribal sovereignty. All CRCAIH resources and activities revolve around the central aim of assisting tribes with establishing and advancing their own research infrastructures and agendas, as well as increasing AI/AN health research. CRCAIH is comprised of three divisions (administrative; community engagement and innovation; research projects, three technical cores (culture, science and bioethics; regulatory knowledge; and methodology, six tribal partners and supports numerous multi-year and one-year pilot research projects. Under the ultimate goal of improving health for AI/AN, this paper describes the overarching vision and structure of CRCAIH, highlighting lessons learned in the first three years.

  4. Fostering Social Determinants of Health Transdisciplinary Research: The Collaborative Research Center for American Indian Health.

    Science.gov (United States)

    Elliott, Amy J; White Hat, Emily R; Angal, Jyoti; Grey Owl, Victoria; Puumala, Susan E; Baete Kenyon, DenYelle

    2016-01-01

    The Collaborative Research Center for American Indian Health (CRCAIH) was established in September 2012 as a unifying structure to bring together tribal communities and health researchers across South Dakota, North Dakota and Minnesota to address American Indian/Alaska Native (AI/AN) health disparities. CRCAIH is based on the core values of transdisciplinary research, sustainability and tribal sovereignty. All CRCAIH resources and activities revolve around the central aim of assisting tribes with establishing and advancing their own research infrastructures and agendas, as well as increasing AI/AN health research. CRCAIH is comprised of three divisions (administrative; community engagement and innovation; research projects), three technical cores (culture, science and bioethics; regulatory knowledge; and methodology), six tribal partners and supports numerous multi-year and one-year pilot research projects. Under the ultimate goal of improving health for AI/AN, this paper describes the overarching vision and structure of CRCAIH, highlighting lessons learned in the first three years. PMID:26703683

  5. Psychosocial, behavioural, and health determinants of successful smoking cessation

    DEFF Research Database (Denmark)

    Osler, M; Prescott, E

    1998-01-01

    OUTCOME MEASURE: Smoking status (abstinent for one year or more) at follow up. RESULTS: At follow up 15% of the baseline smokers had been abstinent for one year or more. In multivariate analysis, successful smoking cessation was associated with older age, high social status, low prior tobacco consumption......OBJECTIVE: To examine the factors that determine whether or not smokers become long-term quitters, and to study whether determinants of successful cessation differ with levels of motivation to stop. DESIGN: In a cohort of men and women, aged 30-60 years at first examination in 1982/1984, smoking......, baseline motivation to stop smoking, and having a non-smoking spouse/cohabitant. The same result was obtained when the analyses were repeated separately for smokers with and without motivation to stop. CONCLUSIONS: Smokers motivated to stop are more likely to quit and remain abstinent than smokers...

  6. Towards health-equitable globalisation : rights, regulation and redistribution : final report to the Commission on Social Determinants of Health.

    OpenAIRE

    Labonté, Ronald; Blouin, Chantal; Chopra, Mickey; Lee, Kelley; Packer, Corinne; Rowson, Mike; Schrecker, Ted; WOODWARD, David; et al.

    2007-01-01

    Globalisation, in a broad sense, holds considerable potential for improving human health, while presenting many challenges. At base, the key challenge for the Commission is to understand how globalisation affects people’s access to social determinants of health (SDH) and, given an explicit concern with equity, how that access is distributed. The approach taken by the Globalisation Knowledge Network (GKN) to assist with this task emphasized the economic aspects of globalisation ...

  7. Addressing social determinants of health inequities through settings: a rapid review.

    Science.gov (United States)

    Newman, Lareen; Baum, Fran; Javanparast, Sara; O'Rourke, Kerryn; Carlon, Leanne

    2015-09-01

    Changing settings to be more supportive of health and healthy choices is an optimum way to improve population health and health equity. This article uses the World Health Organisation's (1998) (WHO Health Promotion Glossary. WHO Collaborating Centre for Health Promotion, Department of Public Health and Community Medicine, University of Sydney, NSW) definition of settings approaches to health promotion as those focused on modifying settings' structure and nature. A rapid literature review was undertaken in the period June-August 2014, combining a systematically conducted search of two major databases with targeted searches. The review focused on identifying what works in settings approaches to address the social determinants of health inequities, using Fair Foundations: the VicHealth framework for health equity. This depicts the social determinants of health inequities as three layers of influence, and entry points for action to promote health equity. The evidence review identified work in 12 settings (cities; communities and neighbourhoods; educational; healthcare; online; faith-based; sports; workplaces; prisons; and nightlife, green and temporary settings), and work at the socioeconomic, political and cultural context layer of the Fair Foundations framework (governance, legislation, regulation and policy). It located a relatively small amount of evidence that settings themselves are being changed in ways which address the social determinants of health inequities. Rather, many initiatives focus on individual behaviour change within settings. There is considerable potential for health promotion professionals to focus settings work more upstream and so replace or integrate individual approaches with those addressing daily living conditions and higher level structures, and a significant need for programmes to be evaluated for differential equity impacts and published to provide a more solid evidence base. PMID:26420808

  8. Determinants and outcomes of motivation in health professions education: a systematic review based on self-determination theory

    OpenAIRE

    Orsini, Cesar; Binnie, Vivian I; Wilson, Sarah L.

    2016-01-01

    Purpose: This study aimed at conducting a systematic review in health professions education of determinants, mediators and outcomes of students’ motivation to engage in academic activities based on the self-determination theory’s perspective. Methods: A search was conducted across databases (MEDLINE, CINHAL, EMBASE, PsycINFO, and ERIC databases), hand-search of relevant journals, grey literature, and published research profile of key authors. Quantitative and qualitative studies were included...

  9. Determinants and outcomes of motivation in health professions education: a systematic review based on self-determination theory

    OpenAIRE

    Orsini, Cesar; Binnie, Vivian I; Wilson, Sarah L.

    2016-01-01

    Purpose: This study aimed at conducting a systematic review in health professions education of determinants, mediators and outcomes of students’ motivation to engage in academic activities based on the self-determination theory’s perspective. Methods: A search was conducted across databases (MEDLINE, CINHAL, EMBASE, PsycINFO, and ERIC databases), hand-search of relevant journals, grey literature, and published research profile of key authors. Quantitative and qualitative studies were...

  10. Determinants of health among homeless population in the Czech Republic--an empirical study.

    Science.gov (United States)

    Dittrich, Ludwig O; Hava, Petr

    2009-12-01

    It is generally recognized, that the delivery of healthcare to homeless population presents a number of specific challenges. In this paper, we try to assess the impact of the homeless people experience with the institutional framework including the access to health services on the health status of the homeless population in the Czech Republic. Multivariate regression is used to evaluate the impact of various dimensions of life experience and other social and economic characteristics of homeless people on their health status. Preliminary results indicate that the experience homeless people have with the institutional framework and their access to health care services are important determinants of their health status.

  11. Employment Precariousness and Poor Mental Health: Evidence from Spain on a New Social Determinant of Health

    Directory of Open Access Journals (Sweden)

    Alejandra Vives

    2013-01-01

    Full Text Available Background. Evidence on the health-damaging effects of precarious employment is limited by the use of one-dimensional approaches focused on employment instability. This study assesses the association between precarious employment and poor mental health using the multidimensional Employment Precariousness Scale. Methods. Cross-sectional study of 5679 temporary and permanent workers from the population-based Psychosocial Factors Survey was carried out in 2004-2005 in Spain. Poor mental health was defined as SF-36 mental health scores below the 25th percentile of the Spanish reference for each respondent’s sex and age. Prevalence proportion ratios (PPRs of poor mental health across quintiles of employment precariousness (reference: 1st quintile were calculated with log-binomial regressions, separately for women and men. Results. Crude PPRs showed a gradient association with poor mental health and remained generally unchanged after adjustments for age, immigrant status, socioeconomic position, and previous unemployment. Fully adjusted PPRs for the 5th quintile were 2.54 (95% CI: 1.95–3.31 for women and 2.23 (95% CI: 1.86–2.68 for men. Conclusion. The study finds a gradient association between employment precariousness and poor mental health, which was somewhat stronger among women, suggesting an interaction with gender-related power asymmetries. Further research is needed to strengthen the epidemiological evidence base and to inform labour market policy-making.

  12. A simple measure with complex determinants: investigation of the correlates of self-rated health in older men and women from three continents

    Directory of Open Access Journals (Sweden)

    French Davina J

    2012-08-01

    Full Text Available Abstract Background Self-rated health is commonly employed in research studies that seek to assess the health status of older individuals. Perceptions of health are, however, influenced by individual and societal level factors that may differ within and between countries. This study investigates levels of self-rated health (SRH and correlates of SRH among older adults in Australia, United States of America (USA, Japan and South Korea. Methods Cross-sectional data were drawn from large surveys of older respondents (≥ 65 years in Australia (n = 7,355, USA (n = 10,358, Japan (n = 3,541 and South Korea (n = 3,971, collected between 2000 and 2006. Harmonized variables were developed to represent socioeconomic, lifestyle and health indicators. We then assessed whether these variables, and their potentially different impact in different countries, could account for cross-national differences in levels of SRH. Results SRH differed significantly between countries, with older Koreans reporting much poorer health than those in the other three nations. This was not the result of biases in response patterns (for example central versus extreme tendency. Health-related correlates of SRH were similar across countries; those with more medical conditions, functional limitations or poor mental health gave poorer ratings. After accounting for the differential impact of determinants in different national contexts, Australians reported better SRH than other nations. Conclusions We conclude that when examining correlates of SRH, the similarities are greater than the differences between countries. There are however differences in levels of SRH which are not fully accounted for by the health correlates. Broad generalizations about styles of responding are not helpful for understanding these differences, which appear to be country, and possibly cohort specific. When using SRH to characterize the health status of older people, it is important to

  13. New breeding objectives and selection indices for the Australian dairy industry.

    Science.gov (United States)

    Byrne, T J; Santos, B F S; Amer, P R; Martin-Collado, D; Pryce, J E; Axford, M

    2016-10-01

    This study comprises an update of the economic values for dairy traits for the Australian industry and the formulation of updated selection indices. An economic model, which calculates partial economic values for each trait individually, was developed to determine the economic implications of selective dairy breeding, based on the effect of trait changes on the profit of commercial dairy farms in Australia. Selection indices were developed from economic values, which were transformed into base economic weights by including the discounted genetic expressions coefficients. Economic weights (in Australian dollars) were 1.79, 6.92, -0.10, -5.44, 8.84, 7.68, 1.07, 4.86, 1.91, 3.51, 4.90, 0.31, 2.03, 2.00, and 0.59, for milk fat (kg), milk protein (kg), milk volume (L), body weight (kg), survival (%), residual survival (%), somatic cell count (cells/mL), fertility (%), mammary system [Australian Breeding Value (ABV) unit], temperament (ABV unit), milking speed (ABV unit), udder depth (%), overall type (%), fore udder attachment (%), and pin set (%), respectively. The updated economic weights presented in this study constituted the basis of the definition for 3 new indices. These indices were developed from combination of bioeconomic principles, patterns of farmer preferences for trait improvements, and desired gains approaches. The 3 indices, Balanced Performance Index, Health Weighted Index, and Type Weighted Index, have been released to the industry. PMID:27522425

  14. No germs on me: a social marketing campaign to promote hand-washing with soap in remote Australian Aboriginal communities.

    Science.gov (United States)

    McDonald, Elizabeth; Slavin, Nicola; Bailie, Ross; Schobben, Xavier

    2011-03-01

    A social marketing campaign promoting hand-washing with soap was implemented to reduce the high burden of infection experienced by Australian Aboriginal children living in remote communities. Epidemiological evidence of effect and other evidence were used to identify the hygiene intervention and health promotion approach for the project. We drew on the findings of: (i) a systematic literature review to identify the intervention for which there is strong effect in similar populations and contexts; and (ii) a narrative literature review to determine our health promotion approach. This process provided practitioners with confidence and understanding so they could address a complex problem in a politically and otherwise sensitive context. PMID:21721304

  15. Comprehensive determinants of health service utilisation for mental health reasons in a canadian catchment area

    Directory of Open Access Journals (Sweden)

    Fleury Marie-Josée

    2012-04-01

    Full Text Available Abstract Introduction This study sought to identify factors associated with health service utilisation by individuals with mental disorders in a Canadian catchment area. Methods To be included in the study, participants had to be aged between 15 and 65 and reside in the study location. Data was collected randomly from June to December 2009 by specially trained interviewers. A comprehensive set of variables (including geospatial factors was studied using the Andersen's behavioural health service model. Univariate, bivariate, and multivariate analyses were carried out. Results Among 406 individuals diagnosed with mental disorders, 212 reported using a mental health service at least once in the 12 months preceding the interviews. Emotional problems and a history of violence victimisation were most strongly associated with such utilisation. Participants who were middle-aged or deemed their mental health to be poor were also more likely to seek mental healthcare. Individuals living in neighbourhoods where rental accommodations were the norm used significantly fewer health services than individuals residing in neighbourhoods where homeownership was preponderant; males were also less likely to use services than females. Conclusions Our study broke new ground by uncovering the impact of longstanding violence victimisation, and the proportion of homeownership on mental health service utilisation among this population. It also confirmed the prominence of some variables (gender, age, emotional problems and self-perceived mental health as key enabling variables of health-seeking. There should be better promotion of strategies designed to change the attitudes of males and youths and to deal with violence victimisation. There is also a need for initiatives that are targeted to neighbourhoods where there is more rental housing.

  16. Establishment of an Australian National Genetic Heart Disease Registry.

    Science.gov (United States)

    Ingles, Jodie; McGaughran, Julie; Vohra, Jitendra; Weintraub, Robert G; Davis, Andrew; Atherton, John; Semsarian, Christopher

    2008-12-01

    A National Genetic Heart Disease Registry has recently been established, with the aim to enroll every family in Australia with a genetically determined cardiomyopathy or primary arrhythmic disorder. The Registry seeks to further our understanding of the impact and burden of disease in this population; increase awareness and provide education to health professionals and families; and establish a large cardiac genetic cohort as a resource for approved research studies. The Registry is currently recruiting families with inherited cardiomyopathies (e.g. hypertrophic cardiomyopathy) and primary arrhythmogenic disorders (e.g. long QT syndrome), with scope to expand this in the future. Affected individuals, as well as their first-degree (at-risk) family members are eligible to enroll. Participants are currently being recruited from cardiac genetics clinics in approved recruitment sites and hope to expand to other Australian centres including general cardiology practice in the future. A significant focus of the Registry is to improve understanding and create awareness of inherited heart diseases, which includes ensuring families are aware of genetic testing options and current clinical screening recommendations for at-risk family members. A Registry Advisory Committee has been established under the NHMRC Guidelines, and includes a representative from each major recruitment centre. This committee approves all decisions relating to the Registry including approval of research studies. A National Genetic Heart Disease Registry will provide a valuable resource to further our knowledge of the clinical and genetic aspects of these diseases. Since most of the current data about the prevalence, natural history and outcomes of genetic heart diseases has emanated from the United States and Europe, characterising these Australian populations will be of significant benefit, allowing for more informed and specific health care planning and resource provision.

  17. Telling stories: nurses, politics and Aboriginal Australians, circa 1900-1980s.

    Science.gov (United States)

    Forsyth, Sue

    2007-02-01

    The focus of this paper is stories by, and about, (mainly non-Aboriginal) Registered Nurses working in hospitals and clinics in remote areas of Australia from the early 1900s to the 1980s as they came into contact with, or cared for, Aboriginal people. Government policies that controlled and regulated Aboriginal Australians provide the context for these stories. Memoirs and other contemporary sources reveal the ways in which government policies in different eras influenced nurse's attitudes and clinical practice in relation to Aboriginal people, and helped institutionalise racism in health care. Up until the 1970s, most nurses in this study unquestioningly accepted firstly segregation, then assimilation policies and their underlying paternalistic ideologies, and incorporated them into their practice. The quite marked politicisation of Aboriginal issues in the 1970s in Australia and the move towards self-determination for Aboriginal people politicised many - but not all - nurses. For the first time, many nurses engaged in a robust critique of government policies and what this meant for their practice and for Aboriginal health. Other nurses, however, continued as they had before - neither questioning prevailing policy nor its effects on their practice. It is argued that only by understanding and confronting the historical roots of institutional racism, and by speaking out against such practices, can discrimination and racism be abolished from nursing practice and health care. This is essential for nursing's current and future professional development and for better health for Aboriginal Australians.

  18. Racism as a Determinant of Health: A Systematic Review and Meta-Analysis

    OpenAIRE

    Yin Paradies; Jehonathan Ben; Nida Denson; Amanuel Elias; Naomi Priest; Alex Pieterse; Arpana Gupta; Margaret Kelaher; Gilbert Gee

    2015-01-01

    Despite a growing body of epidemiological evidence in recent years documenting the health impacts of racism, the cumulative evidence base has yet to be synthesized in a comprehensive meta-analysis focused specifically on racism as a determinant of health. This meta-analysis reviewed the literature focusing on the relationship between reported racism and mental and physical health outcomes. Data from 293 studies reported in 333 articles published between 1983 and 2013, and conducted predominat...

  19. 77 FR 1495 - Criteria for Determining Priorities Among Correctional Facility Health Professional Shortage Areas

    Science.gov (United States)

    2012-01-10

    ...In accordance with the requirements of section 333A(b)(1) of the Public Health Service (PHS) Act, as amended by the Health Care Safety Net Amendments of 2002, 42 U.S.C. 254f-1(b)(1), the Secretary of HHS shall establish the criteria which she will use to make determinations under section 333A(a)(1)(A) of the health professional shortage areas (HPSAs) with the greatest shortages. This notice......

  20. Determinants of caregiving experiences and mental health of partners of cancer patients

    NARCIS (Netherlands)

    Nijboer, C; Triemstra, M; Sanderman, R; van den Bos, GAM

    1999-01-01

    BACKGROUND. Research regarding informal caregiving showed considerable individual variation in responses to cancer caregiving. The current longitudinal study examined determinants of caregiver outcomes in terms of caregiver experiences at 3 months and caregiver's mental health at 6 months after hosp

  1. Need for mental health care in adolescents and its determinants : The TRAILS Study

    NARCIS (Netherlands)

    Jansen, Danielle E. M. C.; Wiegersma, P.; Ormel, Johan; Verhulst, Frank C.; Vollebergh, Wilma A. M.; Reijneveld, Sijmen A.

    2013-01-01

    Background: Although a great deal of evidence is available on the patterns and determinants of unmet health care needs among adolescents with mental health problems, little is known about the factors that influence the need for care. The aim of this study is to assess the occurrence of need for care

  2. Policy-dependent determinants of several important health problems and related actors in policy-making

    NARCIS (Netherlands)

    Lucht F van der; Jansen J; NsPh; VTV

    2002-01-01

    The exploratory study reported on here investigated the possibilities offered by intersectoral (health) policy. The study consisted of two parts. First, a broad description was given of determinants of five health problems (cancer, Chronic non specific lung disease (CNSLD), heart disease, injury due

  3. Determinants of prenatal health care utilisation by low-risk women: a prospective cohort study.

    NARCIS (Netherlands)

    Feijen-de Jong, E.I.; Jansen, D.E.M.C.; Baarveld, F.; Boerleider, A.W.; Spelten, E.; Schellevis, F.; Reijneveld, S.A.

    2015-01-01

    Background: Prenatal health care is pivotal in providing adequate prevention and care to pregnant women. Aim: We examined the determinants of inadequate prenatal health care utilisation by low-risk women in primary midwifery-led care in the Netherlands. Methods: We used longitudinal data from the po

  4. Determinants of prenatal health care utilisation by low-risk women : A prospective cohort study

    NARCIS (Netherlands)

    Feijen-de Jong, Esther I.; Jansen, Danielle E. M. C.; Baarveld, Frank; Boerleider, Agatha W.; Spelten, Evelien; Schellevis, Francois; Reijneveld, Sijmen A.

    2015-01-01

    Background: Prenatal health care is pivotal in providing adequate prevention and care to pregnant women. Aim: We examined the determinants of inadequate prenatal health care utilisation by low-risk women in primary midwifery-led care in the Netherlands. Methods: We used longitudinal data from the po

  5. Determinants of health policy impact: a theoretical framework for policy analysis.

    NARCIS (Netherlands)

    Rütten, A.; Lüschen, G.; Lengerke, T. von; Abel, T.; Kannas, L.; Rodríguez Diaz, J.A.; Vinck, J.; Zee, J. van der

    2003-01-01

    This paper addresses the role of policy and evidence in health promotion. The concept of von Wright's 'logic of events' is introduced and applied to health policy impact analysis. According to von Wright (1979), human action can be explained by a restricted number of determinants: wants, abilities,

  6. Determinants and beliefs of health information mavens among a lower-socioeconomic position and minority population.

    Science.gov (United States)

    Kontos, Emily Z; Emmons, Karen M; Puleo, Elaine; Viswanath, K

    2011-07-01

    People of lower-socioeconomic position (SEP) and most racial/ethnic minorities face significant communication challenges which may negatively impact their health. Previous research has shown that these groups rely heavily on interpersonal sources to share and receive health information; however, little is known about these lay sources. The purpose of this paper is to apply the concept of a market maven to the public health sector with the aims of identifying determinants of high health information mavenism among low-SEP and racial/ethnic minority groups and to assess the information they may be sharing based on their own health beliefs. Data for this study were drawn from the baseline survey (n = 325) of a US randomized control intervention study aimed at eliciting an understanding of Internet-related challenges among lower-SEP and minority individuals. Regression models were estimated to distinguish significant determinants of health information mavenism among the sample. Similarly, bivariate and logistic multivariable models were estimated to determine the association between health information mavenism and accurate health beliefs relating to diet, physical activity and smoking. The data illustrate that having a larger social network, being female and being older were important factors associated with higher mavenism scores. Additionally being a moderate consumer of general media as well as fewer years in the US and lower language acculturation were significant predictors of higher mavenism scores. Mavens were more likely than non-mavens to maintain accurate beliefs regarding diet; however, there was no distinction between physical activity and smoking beliefs between mavens and non-mavens. These results offer a unique understanding of health information mavenism which could better leverage word-of-mouth health communication efforts among lower-SEP and minority groups in order to reduce communication inequalities. Moreover, the data indicate that health

  7. The association of demographic and socioeconomic determinants and self-perceived health

    Directory of Open Access Journals (Sweden)

    Janković Janko

    2012-01-01

    Full Text Available Introduction. Inequalities in health are evident in the whole world and present an important and consistent public health issue. The highest contribution to the inequality in heath is attributable to the demographic and socioeconomic determinants of health. Objective. The aim of this study was to analyze the association between the demographic (gender, age, marital status and type of settlement and socioeconomic determinants of health (education and Wealth Index, and self-perceived health. Methods. In the study the data from 2006 National Health Survey of the population of Serbia were used. The interview involved 14,522 adults aged ≥20 years. The association between the demographic and socioeconomic determinants of health as independent variables, and self-perceived health as dependent variable were examined using bivariate and multivariate logistic regression analyses. The minimum level of significance was p<0.05. Results. According to our study, the elderly and females significantly more often perceived their health as poor. Respondents living in rural settings were less likely to perceive their health as poor compared to those living in urban settings (odds ratio was 0.82 in males and 0.75 in females. Males with low education were three times more likely to perceive their health as poor (odds ratio was 3.46 in relation to males with high education. This association was more pronounced in females (odds ratio was 5.37. The same pattern was observed for Wealth Index. Conclusion. This study showed that demographic and socioeconomic inequalities in self-perceived health are present in Serbia. Comprehensive public health policies and interventions for reducing these inequalities are urgently needed with the primarily focus on the most disadvantaged socioeconomic groups.

  8. Determinants and outcomes of motivation in health professions education: a systematic review based on self-determination theory

    Directory of Open Access Journals (Sweden)

    Cesar Orsini

    2016-05-01

    Full Text Available Purpose: This study aimed at conducting a systematic review in health professions education of determinants, mediators and outcomes of students’ motivation to engage in academic activities based on the self-determination theory’s perspective. Methods: A search was conducted across databases (MEDLINE, CINHAL, EMBASE, PsycINFO, and ERIC databases, hand-search of relevant journals, grey literature, and published research profile of key authors. Quantitative and qualitative studies were included if they reported research in health professions education focused on determinants, mediators, and/or outcomes of motivation from the self-determination and if meeting the quality criteria. Results: A total of 17 studies met the inclusion and quality criteria. Articles retrieved came from diverse locations and mainly from medical education and to a lesser extent from psychology and dental education. Intrapersonal (gender and personality traits and interpersonal determinants (academic conditions and lifestyle, qualitative method of selection, feedback, and an autonomy supportive learning climate have been reported to have a positive influence on students’ motivation to engage in academic activities. No studies were found that tested mediation effects between determinants and students’ motivation. In turn, students’ self-determined motivation has been found to be positively associated with different cognitive, affective, and behavioural outcomes. Conclusion: This study has found that generally, motivation could be enhanced by changes in the educational environment and by an early detection of students’ characteristics. Doing so may support future health practitioners’ self-determined motivation and positively influence how they process information and their emotions and how they approach their learning activities.

  9. Cluster randomised-control trial for an Australian child protection education program: Study protocol for the Learn to be safe with Emmy and friends™

    OpenAIRE

    White, Codi; Shanley, Dianne C.; Zimmer-Gembeck, Melanie J.; Lines, Katrina; Walsh, Kerryann; Hawkins, Russell

    2016-01-01

    Background Child maltreatment has severe short-and long-term consequences for children’s health, development, and wellbeing. Despite the provision of child protection education programs in many countries, few have been rigorously evaluated to determine their effectiveness. We describe the design of a multi-site gold standard evaluation of an Australian school-based child protection education program. The intervention has been developed by a not-for-profit agency and comprises 5 1-h sessions d...

  10. Communication, social capital and workplace health management as determinants of the innovative climate in German banks

    OpenAIRE

    Köhler, Thorsten; Janßen, Christian; Plath, Sven-Christoph; Reese, Jens; Lay, Jann; Steinhausen, Simone; Gloede, Tristan; Kowalski, Christoph; Schulz-Nieswandt, Frank; Pfaff, Holger

    2010-01-01

    Objective The present study aims to measure the determinants of the innovative climate in German banks with a focus on workplace health management (WHM). Methods We analyze the determinants of innovative climate with multiple regressions using a dataset based on standardized telephone interviews conducted with health promotion experts from 198 randomly selected German banks. Results The regression analysis provided a good explanation of the variance in the dependent variable (R² = 55%). Commu...

  11. Addressing the social determinants of health through health system strengthening and inter-sectoral convergence: the case of the Indian National Rural Health Mission

    Directory of Open Access Journals (Sweden)

    Amit Mohan Prasad

    2013-03-01

    Full Text Available Background: At the turn of the 21st century, India was plagued by significant rural–urban, inter-state and inter-district inequities in health. For example, in 2004, the infant mortality rate (IMR was 24 points higher in rural areas compared to urban areas. To address these inequities, to strengthen the rural health system (a major determinant of health in itself and to facilitate action on other determinants of health, India launched the National Rural Health Mission (NRHM in April 2005. Methods: Under the NRHM, Rs. 666 billion (US$12.1 billion was invested in rural areas from April 2005 to March 2012. There was also a substantially higher allocation for 18 high-focus states2 and 264 high-focus districts, identified on the basis of poor health and demographic indicators. Other determinants of health, especially nutrition and decentralized action, were addressed through mechanisms like State/District Health Missions, Village Health, Sanitation and Nutrition Committees, and Village Health and Nutrition Days. Results: Consequently, in bigger high-focus states, rural IMR fell by 15.6 points between 2004 and 2011, as compared to 9 points in urban areas. Similarly, the maternal mortality rate in high-focus states declined by 17.9% between 2004–2006 and 2007–2009 compared to 14.6% in other states. Conclusion: The article, on the basis of the above approaches employed under NRHM, proposes the NRHM model to ‘reduce health inequities and initiate action on SDH’.

  12. Social Determinants, Race, and Brain Health Outcomes: Findings from the Chicago Health and Aging Project.

    Science.gov (United States)

    Aggarwal, Neelum T; Everson-Rose, Susan A; Evans, Denis A

    2015-01-01

    The broad spectrum of economic and cultural diversity in the U.S. population correlates with and affects the study of behavioral aspects of health. The purpose of this article is to provide a selective overview of research findings from the Chicago Health and Aging Project (CHAP), which covers a socio-demographically diverse population in Chicago, with a focus on role-related psychosocial factors and observed racial/ethnic differences in aging outcomes. CHAP is a longitudinal, epidemiological study of common chronic conditions of aging with an emphasis on medical, psychosocial, and environmental risk factors for the decline in cognitive function across the older adult lifespan. We briefly summarize the study design and methods used in the CHAP study and characterize the study population and describe the psychosocial data, noting black-white associations as they relate to three common brain health outcomes: cognitive function and Alzheimer's Disease, stroke, and subclinical vascular disease as noted on neuroimaging. PMID:26239039

  13. Training medical students in the social determinants of health: the Health Scholars Program at Puentes de Salud

    Directory of Open Access Journals (Sweden)

    O’Brien MJ

    2014-09-01

    Full Text Available Matthew J O’Brien,1–4 Joseph M Garland,4,5 Katie M Murphy,4,6,7 Sarah J Shuman,3,4 Robert C Whitaker,1,3,8 Steven C Larson4,9 1Center for Obesity Research and Education, Temple University, Philadelphia, PA, USA; 2Department of Medicine, Section of General Internal Medicine, Temple University of Medicine, Philadelphia, PA, USA; 3Department of Public Health, Temple University, Philadelphia, PA, USA; 4Puentes de Salud Health Center, Philadelphia, PA, USA; 5Department of Medicine, Division of Infectious Diseases, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; 6Master of Public Health Program, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; 7Graduate School of Education, University of Pennsylvania, Philadelphia, PA, USA; 8Department of Pediatrics, Temple University School of Medicine, Philadelphia, PA, USA; 9Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA Purpose: Given the large influence of social conditions on health, physicians may be more effective if they are trained to identify and address social factors that impact health. Despite increasing interest in teaching the social determinants of health in undergraduate medical education, few models exist. Participants and methods: We present a 9-month pilot course on the social determinants of health for medical and other health professional students, which is based at Puentes de Salud, Philadelphia, PA, USA, a community health center serving a Latino immigrant population. This service-learning course, called the Health Scholars Program (HSP, was developed and implemented by volunteer medical and public health faculty in partnership with the community-based clinic. The HSP curriculum combines didactic instruction with service experiences at Puentes de Salud and opportunities for critical reflection. The HSP curriculum also includes a longitudinal project where

  14. Determinación global y salud: el marco amplio de los determinantes de la salud/ Global determination and health: the broad framework of the determinants of health

    Directory of Open Access Journals (Sweden)

    Álvaro Franco-Giraldo

    2013-08-01

    Full Text Available El propósito de este ensayo plantea los desafíos de la salud mundial en la última etapa del desarrollo del capitalismo global y su relación con los determinantes socio-sanitarios de la salud, la vida humana y la Tierra, a partir de un concepto novedoso: el de la determinación global. Metodológicamente se desarrollan algunos ejes temáticos: determinación global y su relación con los determinantes sociales de la salud, consecuencias del capitalismo global, desafíos para la humanidad y la salud global, gobernanza y respuesta social global. Se discute la globalización del capitalismo como el principal determinante para la acción gubernamental, las políticas sociales y las políticas públicas en salud y sus consecuencias: la amenaza de las guerras, la crisis económica, el hambre, la degradación de la biosfera, los desplazamientos étnicos, ente otros. Propugna por enfrentar el deterioro de condiciones de vida y el aumento de desigualdades sociales, el gran desafío que explica los demás problemas de la salud global: la inequidades sociales, causantes efectivamente de la mala salud y de las desigualdades en salud. Dichas inequidades se manifiestan por razones geográficas, edad, género, etnia, educación y distribución del ingreso, pero devienen en última instancia de determinantes globales que se generan en la espera supranacional de la determinación. Se concluye defendiendo la acción global para superar la desigualdad y las inequidades que azotan al mundo actual y se propone una nueva categoría para entender los determinantes sociales: la de la determinación global, que tiene una capacidad explicativa mayor que las diferentes corrientes teóricas sobre determinantes y determinación social. The purpose of this essay is to present the challenges faced by global health during the last stage of the development of global capitalism and its relationship with the social and sanitary determinants of health, life and earth based on a

  15. AN EXPLORATORY STUDY OF FACTORS AFFECTING ADOPTION AND IMPLEMENTATION OF B2B E-COMMERCE IN AUSTRALIAN HEALTH CARE ORGANIZATIONS

    OpenAIRE

    Chad Lin; Yu-An Huang; Geoffrey Jalleh; Ying-Chieh Liu; Mei-Lien Tung

    2010-01-01

    For the health care industry, the adoption and implementation of business-to-business (B2B) electronic commerce (e-commerce) systems can lead to many benefits, such as an increased accessibility to providers, reduction in supply chain and inventory costs, and reduced medical errors. However, despite high expectations for realizing the benefits of B2B e-commerce in health care, its adoption remains poorly understood and is a relatively under-researched area. Although B2B e-commerce provides th...

  16. A Review of Programs That Targeted Environmental Determinants of Aboriginal and Torres Strait Islander Health

    Directory of Open Access Journals (Sweden)

    Kevin Rowley

    2013-08-01

    Full Text Available Objective: Effective interventions to improve population and individual health require environmental change as well as strategies that target individual behaviours and clinical factors. This is the basis of implementing an ecological approach to health programs and health promotion. For Aboriginal People and Torres Strait Islanders, colonisation has made the physical and social environment particularly detrimental for health. Methods and Results: We conducted a literature review to identify Aboriginal health interventions that targeted environmental determinants of health, identifying 21 different health programs. Program activities that targeted environmental determinants of health included: Caring for Country; changes to food supply and/or policy; infrastructure for physical activity; housing construction and maintenance; anti-smoking policies; increased workforce capacity; continuous quality improvement of clinical systems; petrol substitution; and income management. Targets were categorised according to Miller’s Living Systems Theory. Researchers using an Indigenous community based perspective more often identified interpersonal and community-level targets than were identified using a Western academic perspective. Conclusions: Although there are relatively few papers describing interventions that target environmental determinants of health, many of these addressed such determinants at multiple levels, consistent to some degree with an ecological approach. Interpretation of program targets sometimes differed between academic and community-based perspectives, and was limited by the type of data reported in the journal articles, highlighting the need for local Indigenous knowledge for accurate program evaluation. Implications: While an ecological approach to Indigenous health is increasingly evident in the health research literature, the design and evaluation of such programs requires a wide breadth of expertise, including local Indigenous

  17. Designing a Specialist Post-Graduate Qualification and Continuing Professional Development Structure for the Health Librarian Workforce of the Future

    Science.gov (United States)

    Ritchie, Ann; Hallam, Gillian; Hamill, C.; Lewis, S.; Foti, M.; O'Connor, P.; Clark, C.

    2010-01-01

    Through a grant received from the Australian Library and Information Association (ALIA), Health Libraries Australia (HLA) is conducting a twelve-month research project with the goal of developing a system-wide approach to education for the future health librarianship workforce. The research has two main aims: to determine the future skills,…

  18. 'Causes of causes': ethnicity and social position as determinants of health inequality in Irish Traveller men.

    Science.gov (United States)

    Hodgins, Margaret; Fox, Fergal

    2014-06-01

    This study sought to engage Traveller men in a discussion about their lives, their health and key determinants of their health, with a view to engaging Traveller men in health promotion initiatives. Irish Travellers are an indigenous ethnic minority, constituting 0.8% of the population. As a marginalized group, they experience significantly poorer health status than their counterparts in the settled community. Traveller men have 3.7 times the mortality of the males in the general population. Travellers are identified as a hard-to-reach group and Traveller men particularly so. Traveller men have rarely participated in the research studies on health and health service utilization, and the results of this study, in which Traveller men participated in three focus groups, are therefore of particular interest. The Traveller men, in discussing health, related it to the absence of specific illnesses and conditions, expressing a negative and a physical concept of health. The results of the study provide evidence for the role of social constructions of masculinity in determining the health and help-seeking behaviour of Traveller men, but also the influence of wider social determinants such as ethnicity and social status. The futility of approaches to health promotion that comprise simplistic health information/education interventions is outlined in this context. The study presents a challenge to both address hegemonic versions of masculinity and discrimination based on ethnic status, and rather than challenge the behaviour of men or of health services that they come into contact with, to changing the conditions of Traveller men's lives. PMID:23193193

  19. AN EXPLORATORY STUDY OF FACTORS AFFECTING ADOPTION AND IMPLEMENTATION OF B2B E-COMMERCE IN AUSTRALIAN HEALTH CARE ORGANIZATIONS

    Directory of Open Access Journals (Sweden)

    Chad Lin

    2010-12-01

    Full Text Available For the health care industry, the adoption and implementation of business-to-business (B2B electronic commerce (e-commerce systems can lead to many benefits, such as an increased accessibility to providers, reduction in supply chain and inventory costs, and reduced medical errors. However, despite high expectations for realizing the benefits of B2B e-commerce in health care, its adoption remains poorly understood and is a relatively under-researched area. Although B2B e-commerce provides these organizations a wealth of new opportunities and ways of doing business, it also presents a series of challenges. Hence, the case study approach was utilized (1 to identify B2B e-commerce adoption and implementation critical constraint-minimization factors for organizations within the health care industry; and (2 to develop a framework to manage these critical constraint-minimization factors. A key contribution of the paper is to propose a framework in which critical constraint-minimization factors faced by health care organizations undertaking B2B e-commerce activities can be identified, examined, and managed.

  20. Social stratification and health : Four essays on social determinants of health and wellbeing

    NARCIS (Netherlands)

    Praeg, Patrick

    2015-01-01

    The relationship between socioeconomic status, health, and wellbeing has puzzled researchers for decades. Individuals with higher education, a better job, or higher status, live longer and are healthier. The four essays in this book offer a fresh view on crucial aspects of this relationship. Drawing

  1. Advancing Sustainability through Urban Green Space: Cultural Ecosystem Services, Equity, and Social Determinants of Health

    Directory of Open Access Journals (Sweden)

    Viniece Jennings

    2016-02-01

    Full Text Available Urban green spaces provide an array of benefits, or ecosystem services, that support our physical, psychological, and social health. In many cases, however, these benefits are not equitably distributed across diverse urban populations. In this paper, we explore relationships between cultural ecosystem services provided by urban green space and the social determinants of health outlined in the United States Healthy People 2020 initiative. Specifically, we: (1 explore connections between cultural ecosystem services and social determinants of health; (2 examine cultural ecosystem services as nature-based health amenities to promote social equity; and (3 recommend areas for future research examining links between urban green space and public health within the context of environmental justice.

  2. Advancing Sustainability through Urban Green Space: Cultural Ecosystem Services, Equity, and Social Determinants of Health.

    Science.gov (United States)

    Jennings, Viniece; Larson, Lincoln; Yun, Jessica

    2016-02-05

    Urban green spaces provide an array of benefits, or ecosystem services, that support our physical, psychological, and social health. In many cases, however, these benefits are not equitably distributed across diverse urban populations. In this paper, we explore relationships between cultural ecosystem services provided by urban green space and the social determinants of health outlined in the United States Healthy People 2020 initiative. Specifically, we: (1) explore connections between cultural ecosystem services and social determinants of health; (2) examine cultural ecosystem services as nature-based health amenities to promote social equity; and (3) recommend areas for future research examining links between urban green space and public health within the context of environmental justice.

  3. Advancing Sustainability through Urban Green Space: Cultural Ecosystem Services, Equity, and Social Determinants of Health.

    Science.gov (United States)

    Jennings, Viniece; Larson, Lincoln; Yun, Jessica

    2016-02-01

    Urban green spaces provide an array of benefits, or ecosystem services, that support our physical, psychological, and social health. In many cases, however, these benefits are not equitably distributed across diverse urban populations. In this paper, we explore relationships between cultural ecosystem services provided by urban green space and the social determinants of health outlined in the United States Healthy People 2020 initiative. Specifically, we: (1) explore connections between cultural ecosystem services and social determinants of health; (2) examine cultural ecosystem services as nature-based health amenities to promote social equity; and (3) recommend areas for future research examining links between urban green space and public health within the context of environmental justice. PMID:26861365

  4. Diabetes Education Needs of Chinese Australians: A Qualitative Study

    Science.gov (United States)

    Choi, Tammie S. T.; Walker, Karen Z.; Ralston, Robin A.; Palermo, Claire

    2015-01-01

    Objective: The aim of this study was to evaluate a type 2 diabetes education programme for Chinese Australians, based on the experience of participants and by exploring the unique needs of Chinese patients, their health beliefs and their cultural behaviours. Design and setting: A qualitative ethnographic study was undertaken in a community health…

  5. Australian Rural Education Award 1996 and Recipient's Speech.

    Science.gov (United States)

    Young, Judy

    1996-01-01

    Short descriptions and contact information for the 14 programs nominated for the 1996 Australian Rural Education Award. The winner's acceptance speech describes the Students at Risk Program at East Kalgoorlie Public School (Western Australia), a transportation and health support program developed from discussions with children and parents that…

  6. Australians as International Students--Where They Go, What They Do and Why They Do It

    Science.gov (United States)

    Nerlich, Steve

    2013-01-01

    Current published information on the Australian student mobility offshore is reviewed as part of a long-term project aiming to determine the current propensity of Australian higher education students to study overseas and the return on investment that they can expect to achieve. It was found that limited data are available on the current extent of…

  7. 7 CFR 2902.8 - Determining life cycle costs, environmental and health benefits, and performance.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 15 2010-01-01 2010-01-01 false Determining life cycle costs, environmental and... DESIGNATING BIOBASED PRODUCTS FOR FEDERAL PROCUREMENT General § 2902.8 Determining life cycle costs, environmental and health benefits, and performance. (a) Providing information on life cycle costs...

  8. Determinants of health-related quality of life in the postpartum period after obstetric complications

    NARCIS (Netherlands)

    Prick, Babette W.; Bijlenga, Denise; Jansen, A. J. Gerard; Boers, Kim E.; Scherjon, Sicco A.; Koopmans, Corine M.; van Pampus, Marielle G.; Essink-Bot, Marie-Louise; van Rhenen, Dick J.; Mol, Ben W.; Duvekot, Johannes J.

    2015-01-01

    Objective: To determine the influence of socio-demographic, clinical parameters and obstetric complications on postpartum health-related quality of life (HRQoL). Study design: We used data of three randomized controlled trials to investigate HRQoL determinants in women after an obstetric complicatio

  9. Checklist determinanten van innovaties in gezondheidszorgorganisaties [Checklist for determinants of innovations in health care organizations

    NARCIS (Netherlands)

    Fleuren, M.A.H.; Wiefferink, K.; Paulussen, T.G.W.M.

    2012-01-01

    In 2006 we published an article on 50 determinants of innovations in health care organizations. A brief description of all determinants and their influence was given. Implementation researchers and implementation consultants or advisors have asked us repeatedly to publish a full description of the d

  10. Mental health help seeking patterns and associations among Australian same sex attracted women, trans and gender diverse people: a survey-based study

    OpenAIRE

    McNair, Ruth P.; Bush, Rachel

    2016-01-01

    Background Same sex attracted women (SSAW) are disproportionately affected by depression and anxiety, due to experiences of sexuality and gender based discrimination. They access mental health services at higher rates than heterosexual women, however with lower levels of satisfaction. This study examined the range of professional and social help seeking by same-sex attracted women, and patterns according to sexual orientation and gender identity subgroup. Methods Eight key stakeholders were i...

  11. Improving the uptake of pre-travel health advice amongst migrant Australians: exploring the attitudes of primary care providers and migrant community groups

    OpenAIRE

    Seale, Holly; Kaur, Rajneesh; Mahimbo, Abela; MacIntyre, C. Raina; Zwar, Nicholas; Smith, Mitchell; Worth, Heather; Heywood, Anita E

    2016-01-01

    Background Migrant travellers who return to their country of origin to visit family and friends (VFR) are less likely to seek travel-related medical care and are less likely to adhere to recommended medications and travel precautions. Through this study, we aimed to get an understanding of the views of stakeholders from community migrant centres and primary care providers on barriers for migrants, particularly from non-English speaking backgrounds, in accessing travel health advice and the st...

  12. The impact of population-based disease management services for selected chronic conditions: the Costs to Australian Private Insurance - Coaching Health (CAPICHe) study protocol

    OpenAIRE

    Byrnes Joshua M; Goldstein Stan; Venator Benjamin; Pollicino Christine; Ng Shu-Kay; Veroff David; Bennett Christine; Scuffham Paul A

    2012-01-01

    Abstract Background Recent evidence from a large scale trial conducted in the United States indicates that enhancing shared decision-making and improving knowledge, self-management, and provider communication skills to at-risk patients can reduce health costs and utilisation of healthcare resources. Although this trial has provided a significant advancement in the evidence base for disease management programs it is still left for such results to be replicated and/or generalised for population...

  13. Logistic support provided to Australian disaster medical assistance teams: results of a national survey of team members

    OpenAIRE

    Aitken, Peter; Leggat, Peter; Harley, Hazel; Speare, Richard; Leclercq, Muriel

    2012-01-01

    Background: It is likely that calls for disaster medical assistance teams (DMATs) continue in response to international disasters. As part of a national survey, the present study was designed to evaluate the Australian DMAT experience and the need for logistic support. Methods: Data were collected via an anonymous mailed survey distributed via State and Territory representatives on the Australian Health Protection Committee, who identified team members associated with Australian DMAT deployme...

  14. Why do some countries spend more for health? An assessment of sociopolitical determinants and international aid for government health expenditures.

    Science.gov (United States)

    Liang, Li-Lin; Mirelman, Andrew J

    2014-08-01

    A consensus exists that rising income levels and technological development are among key drivers of total health spending. Determinants of public sector health expenditure, by contrast, are less well understood. This study examines a complex relationship across government health expenditure (GHE), sociopolitical risks, and international aid, while taking into account the impacts of national income, debt and tax financing and aging populations on health spending. We apply a fixed-effects two-stage least squares regression method to a panel dataset comprising 120 countries for the years 1995 through 2010. Our results show that democratic accountability has a diminishing positive correlation with GHE, and that levels of GHE are higher when government is more stable. Corruption is associated with less GHE in developing countries, but with higher GHE in developed countries. We also find that development assistance for health (DAH) is fungible with domestically financed government health expenditure (DGHE). For an average country, a 1% increase in DAH to government is associated with a 0.03-0.04% decrease in DGHE. Furthermore, the degree of fungibility of DAH to government is higher in countries where corruption or ethnic tensions are widespread. However, DAH to non-governmental organizations is not fungible with DGHE.

  15. Racism as a Determinant of Health: A Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Yin Paradies

    Full Text Available Despite a growing body of epidemiological evidence in recent years documenting the health impacts of racism, the cumulative evidence base has yet to be synthesized in a comprehensive meta-analysis focused specifically on racism as a determinant of health. This meta-analysis reviewed the literature focusing on the relationship between reported racism and mental and physical health outcomes. Data from 293 studies reported in 333 articles published between 1983 and 2013, and conducted predominately in the U.S., were analysed using random effects models and mean weighted effect sizes. Racism was associated with poorer mental health (negative mental health: r = -.23, 95% CI [-.24,-.21], k = 227; positive mental health: r = -.13, 95% CI [-.16,-.10], k = 113, including depression, anxiety, psychological stress and various other outcomes. Racism was also associated with poorer general health (r = -.13 (95% CI [-.18,-.09], k = 30, and poorer physical health (r = -.09, 95% CI [-.12,-.06], k = 50. Moderation effects were found for some outcomes with regard to study and exposure characteristics. Effect sizes of racism on mental health were stronger in cross-sectional compared with longitudinal data and in non-representative samples compared with representative samples. Age, sex, birthplace and education level did not moderate the effects of racism on health. Ethnicity significantly moderated the effect of racism on negative mental health and physical health: the association between racism and negative mental health was significantly stronger for Asian American and Latino(a American participants compared with African American participants, and the association between racism and physical health was significantly stronger for Latino(a American participants compared with African American participants. Protocol PROSPERO registration number: CRD42013005464.

  16. Racism as a Determinant of Health: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Paradies, Yin; Ben, Jehonathan; Denson, Nida; Elias, Amanuel; Priest, Naomi; Pieterse, Alex; Gupta, Arpana; Kelaher, Margaret; Gee, Gilbert

    2015-01-01

    Despite a growing body of epidemiological evidence in recent years documenting the health impacts of racism, the cumulative evidence base has yet to be synthesized in a comprehensive meta-analysis focused specifically on racism as a determinant of health. This meta-analysis reviewed the literature focusing on the relationship between reported racism and mental and physical health outcomes. Data from 293 studies reported in 333 articles published between 1983 and 2013, and conducted predominately in the U.S., were analysed using random effects models and mean weighted effect sizes. Racism was associated with poorer mental health (negative mental health: r = -.23, 95% CI [-.24,-.21], k = 227; positive mental health: r = -.13, 95% CI [-.16,-.10], k = 113), including depression, anxiety, psychological stress and various other outcomes. Racism was also associated with poorer general health (r = -.13 (95% CI [-.18,-.09], k = 30), and poorer physical health (r = -.09, 95% CI [-.12,-.06], k = 50). Moderation effects were found for some outcomes with regard to study and exposure characteristics. Effect sizes of racism on mental health were stronger in cross-sectional compared with longitudinal data and in non-representative samples compared with representative samples. Age, sex, birthplace and education level did not moderate the effects of racism on health. Ethnicity significantly moderated the effect of racism on negative mental health and physical health: the association between racism and negative mental health was significantly stronger for Asian American and Latino(a) American participants compared with African American participants, and the association between racism and physical health was significantly stronger for Latino(a) American participants compared with African American participants. Protocol PROSPERO registration number: CRD42013005464.

  17. Racism as a Determinant of Health: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Paradies, Yin; Ben, Jehonathan; Denson, Nida; Elias, Amanuel; Priest, Naomi; Pieterse, Alex; Gupta, Arpana; Kelaher, Margaret; Gee, Gilbert

    2015-01-01

    Despite a growing body of epidemiological evidence in recent years documenting the health impacts of racism, the cumulative evidence base has yet to be synthesized in a comprehensive meta-analysis focused specifically on racism as a determinant of health. This meta-analysis reviewed the literature focusing on the relationship between reported racism and mental and physical health outcomes. Data from 293 studies reported in 333 articles published between 1983 and 2013, and conducted predominately in the U.S., were analysed using random effects models and mean weighted effect sizes. Racism was associated with poorer mental health (negative mental health: r = -.23, 95% CI [-.24,-.21], k = 227; positive mental health: r = -.13, 95% CI [-.16,-.10], k = 113), including depression, anxiety, psychological stress and various other outcomes. Racism was also associated with poorer general health (r = -.13 (95% CI [-.18,-.09], k = 30), and poorer physical health (r = -.09, 95% CI [-.12,-.06], k = 50). Moderation effects were found for some outcomes with regard to study and exposure characteristics. Effect sizes of racism on mental health were stronger in cross-sectional compared with longitudinal data and in non-representative samples compared with representative samples. Age, sex, birthplace and education level did not moderate the effects of racism on health. Ethnicity significantly moderated the effect of racism on negative mental health and physical health: the association between racism and negative mental health was significantly stronger for Asian American and Latino(a) American participants compared with African American participants, and the association between racism and physical health was significantly stronger for Latino(a) American participants compared with African American participants. Protocol PROSPERO registration number: CRD42013005464. PMID:26398658

  18. Social determinants of health in Canada: Are healthy living initiatives there yet? A policy analysis

    Directory of Open Access Journals (Sweden)

    Gore Dana

    2012-08-01

    Full Text Available Abstract Introduction Preventative strategies that focus on addressing the social determinants of health to improve healthy eating and physical activity have become an important strategy in British Columbia and Ontario for combating chronic diseases. What has not yet been examined is the extent to which healthy living initiatives implemented under these new policy frameworks successfully engage with and change the social determinants of health. Methods Initiatives active between January 1, 2006 and September 1, 2011 were found using provincial policy documents, web searches, health organization and government websites, and databases of initiatives that attempted to influence to nutrition and physical activity in order to prevent chronic diseases or improve overall health. Initiatives were reviewed, analyzed and grouped using the descriptive codes: lifestyle-based, environment-based or structure-based. Initiatives were also classified according to the mechanism by which they were administered: as direct programs (e.g. directly delivered, blueprints (or frameworks to tailor developed programs, and building blocks (resources to develop programs. Results 60 initiatives were identified in Ontario and 61 were identified in British Columbia. In British Columbia, 11.5% of initiatives were structure-based. In Ontario, of 60 provincial initiatives identified, 15% were structure-based. Ontario had a higher proportion of direct interventions than British Columbia for all intervention types. However, in both provinces, as the intervention became more upstream and attempted to target the social determinants of health more directly, the level of direct support for the intervention lessened. Conclusions The paucity of initiatives in British Columbia and Ontario that address healthy eating and active living through action on the social determinants of health is problematic. In the context of Canada's increasingly neoliberal political and economic policy, the

  19. Occupational exposure to radon in Australian Tourist Caves an Australian-wide study of radon levels

    Energy Technology Data Exchange (ETDEWEB)

    Solomon, S.B.; Langroo, R.; Peggie, J.R. [Australian Radiation Laboratory. Yallambie, VIC (Australia); Lyons, R.G. [University of Auckland, Auckland, (New Zealand). Department of Physics; James, J.M. [University of Sydney, Sydney, NSW (Australia). Department of Chemisty

    1996-02-01

    The study described in this report sets out to determine which Australian show caves have long- term radon levels in excess of the proposed action level of 1000 Bq m{sup -3}. The collaborative study between the Australian Radiation Laboratory (ARL), the University of Sydney and the University of Auckland, was carried out with the support of a Research Grant from Worksafe Australia. The aims of this study were to measure radon levels for each season over a period of one year, at representative sites in all developed show caves around Australia, to determine yearly average radon levels for each cave tour, based on these site measurements, to estimate the radiation doses to the tour guides employed in these caves, and to identify caves with radon concentrations in excess of the action level. (authors) 7 refs., 10 tabs., 2 figs.

  20. Occupational exposure to radon in Australian Tourist Caves an Australian-wide study of radon levels

    International Nuclear Information System (INIS)

    The study described in this report sets out to determine which Australian show caves have long- term radon levels in excess of the proposed action level of 1000 Bq m-3. The collaborative study between the Australian Radiation Laboratory (ARL), the University of Sydney and the University of Auckland, was carried out with the support of a Research Grant from Worksafe Australia. The aims of this study were to measure radon levels for each season over a period of one year, at representative sites in all developed show caves around Australia, to determine yearly average radon levels for each cave tour, based on these site measurements, to estimate the radiation doses to the tour guides employed in these caves, and to identify caves with radon concentrations in excess of the action level. (authors)

  1. Using organization theory to understand the determinants of effective implementation of worksite health promotion programs.

    Science.gov (United States)

    Weiner, Bryan J; Lewis, Megan A; Linnan, Laura A

    2009-04-01

    The field of worksite health promotion has moved toward the development and testing of comprehensive programs that target health behaviors with interventions operating at multiple levels of influence. Yet, observational and process evaluation studies indicate that such programs are challenging for worksites to implement effectively. Research has identified several organizational factors that promote or inhibit effective implementation of comprehensive worksite health promotion programs. However, no integrated theory of implementation has emerged from this research. This article describes a theory of the organizational determinants of effective implementation of comprehensive worksite health promotion programs. The model is adapted from theory and research on the implementation of complex innovations in manufacturing, education and health care settings. The article uses the Working Well Trial to illustrate the model's theoretical constructs. Although the article focuses on comprehensive worksite health promotion programs, the conceptual model may also apply to other types of complex health promotion programs. An organization-level theory of the determinants of effective implementation of worksite health promotion programs. PMID:18469319

  2. Chinese Rebalancing and Australian Exports

    OpenAIRE

    Gerard Kelly

    2014-01-01

    The Chinese authorities plan to gradually rebalance the composition of Chinese economic growth from investment towards household consumption. This article uses the World Input-Output Database (WIOD) to give a general sense of how this rebalancing might affect Australian exports and economic activity. Dollar for dollar, Chinese investment appears to absorb more than twice as much Australian value-added output as Chinese household consumption. This largely reflects the significant role of resou...

  3. An Australian Sense of Xenophobia

    OpenAIRE

    Linda Burney

    2009-01-01

    Linda Burney of the Wiradjuri Nation and Minister for Community Services in New South Wales discusses how xenophobia has manifested itself as forms of political and institutional racism in Australian history. She asks us to think of Australia as a giant and beautiful mosaic with over 200 Aboriginal Nations and for the rest of the Australian population to welcome ways to work with all its nation's people.

  4. In vitro investigations of the potential health benefits of Australian-grown faba beans (Vicia faba L.): chemopreventative capacity and inhibitory effects on the angiotensin-converting enzyme, α-glucosidase and lipase.

    Science.gov (United States)

    Siah, Siem D; Konczak, Izabela; Agboola, Samson; Wood, Jennifer A; Blanchard, Christopher L

    2012-08-01

    The functional properties, including antioxidant and chemopreventative capacities as well as the inhibitory effects on angiotensin-converting enzyme (ACE), α-glucosidase and pancreatic lipase, of three Australian-grown faba bean genotypes (Nura, Rossa and TF(Ic*As)*483/13) were investigated using an array of in vitro assays. Chromatograms of on-line post column derivatisation assay coupled with HPLC revealed the existence of active phenolics (hump) in the coloured genotypes, which was lacking in the white-coloured breeding line, TF(Ic*As)*483/13. Roasting reduced the phenolic content, and diminished antioxidant activity by 10-40 % as measured by the reagent-based assays (diphenylpicrylhydrazyl, 2,2'-azino-bis(3-ethylbenzthiazoline-6-sulphonic acid) and oxygen radical absorbance capacity) in all genotypes. Cell culture-based antioxidant activity assay (cellular antioxidant activity) showed an increase of activity in the coloured genotypes after roasting. Faba bean extracts demonstrated cellular protection ability against H₂O₂-induced DNA damage (assessed using RAW264.7 cells), and inhibited the proliferation of all human cancer cell lines (BL13, AGS, Hep G2 and HT-29) evaluated. However, the effect of faba bean extracts on the non-transformed human cells (CCD-18Co) was negligible. Flow cytometric analyses showed that faba bean extracts successfully induced apoptosis of HL-60 (acute promyelocytic leukaemia) cells. The faba bean extracts also exhibited ACE, α-glucosidase and pancreatic lipase inhibitory activities. Overall, extracts from Nura (buff-coloured) and Rossa (red-coloured) were comparable, while TF(Ic*As)*483/13 (white-coloured) contained the lowest phenolic content and exhibited the least antioxidant and enzyme inhibition activities. These results are important to promote the utilisation of faba beans in human diets for various health benefits. PMID:22916808

  5. Poster Determinants for Oral-Health-Related Quality of Life among Danish adults

    DEFF Research Database (Denmark)

    Christensen, Lisa Bøge; Hede, Børge; Fiehn, Nils-Erik;

    Objectives To identify and analyze determinants for oral-health-related quality of life among adults admitted to a Danish research program on general health and lifestyle (DANHES 2007-2008) Materials and methods Study population of the present (dental) study: 4402 volunteers invited among...... participants of main study (n18065) covering 12 different Danish cities. Age 18-96 years (average 54) Structured interviews (from main study and dental study) and clinical oral examination Oral-Health-Related Quality of Life measured by a 10 item index Non-parametric statistical methods, chi-square, simple...... and multivariate logistic regression Data are not representative to the Danish population, however, associations between outcome and independent variables are considered valid. Regular dental visits and high number of natural teeth are determinants for a high level of Oral-Health-Related Quality of Life Untreated...

  6. Alcohol, tobacco and illicit drug use amongst same-sex attracted women: results from the Western Australian Lesbian and Bisexual Women's Health and Well-Being Survey

    Directory of Open Access Journals (Sweden)

    McManus Alexandra

    2009-09-01

    Full Text Available Abstract Background The prevalence of alcohol, tobacco and illicit drug use has been reported to be higher amongst lesbian and bisexual women (LBW than their heterosexual counterparts. However, few studies have been conducted with this population in Australia and rates that have been reported vary considerably. Methods A self-completed questionnaire exploring a range of health issues was administered to 917 women aged 15-65 years (median 34 years living in Western Australia, who identified as lesbian or bisexual, or reported having sex with another woman. Participants were recruited from a range of settings, including Perth Pride Festival events (67.0%, n = 615, online (13.2%, n = 121, at gay bars and nightclubs (12.9%, n = 118, and through community groups (6.9%, n = 63. Results were compared against available state and national surveillance data. Results LBW reported consuming alcohol more frequently and in greater quantities than women in the general population. A quarter of LBW (25.7%, n = 236 exceeded national alcohol guidelines by consuming more than four standard drinks on a single occasion, once a week or more. However, only 6.8% (n = 62 described themselves as a heavy drinker, suggesting that exceeding national alcohol guidelines may be a normalised behaviour amongst LBW. Of the 876 women who provided data on tobacco use, 28.1% (n = 246 were smokers, nearly double the rate in the female population as a whole. One third of the sample (33.6%, n = 308 reported use of an illicit drug in the previous six months. The illicit drugs most commonly reported were cannabis (26.4%, n = 242, meth/amphetamine (18.6%, n = 171, and ecstasy (17.9%, n = 164. Injecting drug use was reported by 3.5% (n = 32 of participants. Conclusion LBW appear to use alcohol, tobacco and illicit drugs at higher rates than women generally, indicating that mainstream health promotion messages are not reaching this group or are not perceived as relevant. There is an urgent

  7. The effect of a periodontal intervention on cardiovascular risk markers in Indigenous Australians with periodontal disease: the PerioCardio study

    Directory of Open Access Journals (Sweden)

    Brown Alex

    2011-09-01

    Full Text Available Abstract Background Indigenous Australians experience an overwhelming burden of chronic disease, including cardiovascular diseases. Periodontal disease (inflammation of the tissues surrounding teeth is also widespread, and may contribute to the risk of cardiovascular diseases via pathogenic inflammatory pathways. This study will assess measures of vascular health and inflammation in Indigenous Australian adults with periodontal disease, and determine if intensive periodontal therapy improves these measures over a 12 month follow-up. The aims of the study are: (i to determine whether there is a dose response relationship between extent and severity of periodontal disease and measures of vascular health and inflammation among Indigenous Australian adults with moderate to severe periodontal disease; and (ii to determine the effects of periodontal treatment on changes in measures of vascular health and inflammation in a cohort of Indigenous Australians. Methods/Design This study will be a randomised, controlled trial, with predominantly blinded assessment of outcome measures and blinded statistical analysis. All participants will receive the periodontal intervention benefits (with the intervention delayed 12 months in participants who are randomised to the control arm. Participants will be Indigenous adults aged ≥25 years from urban centres within the Top End of the Northern Territory, Australia. Participants assessed to have moderate or severe periodontal disease will be randomised to the study's intervention or control arm. The intervention involves intensive removal of subgingival and supragingival calculus and plaque biofilm by scaling and root-planing. Study visits at baseline, 3 and 12 months, will incorporate questionnaires, non-fasting blood and urine samples, body measurements, blood pressure, periodontal assessment and non-invasive measures of vascular health (pulse wave velocity and carotid intima-media thickness. Primary outcome

  8. Self-assessed health as a key determinant of lifestyles: An application to tobacco consumption in Argentina

    OpenAIRE

    Conte Grand, Mariana; D Elia, Vanesa

    2008-01-01

    The relationship between lifestyle choices and health has been widely studied in the epidemiological and economic literature. In the last years, empirical research was directed towards the use of recursive systems with structural equations for a health production function and reduced form equations for lifestyles. As a result, behaviors toward health are taken to be determined by exogenous socio-economic variables. In this article, we show that health is a key determinant of health habits. Wh...

  9. Health promoting lifestyle and its determinants among University students in Sabzevar, Iran

    Directory of Open Access Journals (Sweden)

    Ali Mehri

    2016-01-01

    Full Text Available Background: Healthy lifestyle is a major strategy to promote current and subsequent health status. The aim of this study was to assess the status of health-promoting the lifestyle and its determinants among students. Methods: A stratified random sample of 500 students in a university in the city of Sabzevar, Iran participated in this cross-sectional study. Health-promoting lifestyle was measured using Walker′s health-promoting lifestyle profile II. Results: There was a significant correlation between all domains of health-promoting the lifestyle. The highest score among the domains was for an interpersonal relationship (70.8%, and the lowest score was for nutrition (53.6%, and physical activity (53.4%. Significant differences were found in physical activity by gender (P ≤ 0.05. There were significant differences in health responsibility, spiritual growth and body mass index by marital status (P < 0.01. Conclusions: Since one out of five students in this study were overweight/obese, health program planning to promote lifestyle, especially physical activity and nutrition among students is recommended. Our findings may be helpful for faculty administrators, curriculum planners, and health educators in designing guidelines to structuralize a healthier campus and to develop health promotion programs supporting healthy choices among students.

  10. Determinants of suboptimal breastfeeding practices in Nigeria: evidence from the 2008 demographic and health survey

    OpenAIRE

    Ogbo, Felix A; Kingsley E. Agho; Page, Andrew

    2015-01-01

    Background In Nigeria, suboptimal breastfeeding practices are contributing to the burden of childhood diseases and mortality. This study identified the determinants of key suboptimal breastfeeding practices among children 0–23 months in Nigeria. Method Data on 10,225 children under-24 months were obtained from the 2008 Nigeria Demographic and Health Survey (NDHS). Socio-economic, health service and individual factors associated with key breastfeeding indicators (early initiation of breastfeed...

  11. Health at the borders: Bayesian multilevel analysis of women’s malnutrition determinants in Ethiopia

    OpenAIRE

    Delbiso, Tefera Darge; Rodriguez-Llanes, Jose Manuel; Altare, Chiara; Masquelier, Bruno; Guha-Sapir, Debarati

    2016-01-01

    Background: Women’s malnutrition, particularly undernutrition, remains an important public health challenge in Ethiopia. Although various studies examined the levels and determinants of women’s nutritional status, the influence of living close to an international border on women’s nutrition has not been investigated. Yet, Ethiopian borders are regularly affected by conflict and refugee flows, which might ultimately impact health.Objective: To investigate the impact of living close to borders ...

  12. The impact of cash transfers on social determinants of health and health inequalities in Sub-Saharan Africa: a systematic review protocol

    OpenAIRE

    Owusu-Addo, Ebenezer; Andre M. N. Renzaho; Mahal, Ajay S.; Smith, Ben J

    2016-01-01

    Background There is increasing pressure to address the social determinants of health (SDoH) and health inequities through the implementation of culturally acceptable interventions particularly in Sub-Saharan Africa (SSA) where health outcomes are generally poor. Available evaluation research on cash transfers (CTs) suggests that the programs may influence the wider determinants of health in SSA; yet, there has been no attempt to synthesize the evidence regarding their contribution to tackling...

  13. "Community vital signs": incorporating geocoded social determinants into electronic records to promote patient and population health.

    Science.gov (United States)

    Bazemore, Andrew W; Cottrell, Erika K; Gold, Rachel; Hughes, Lauren S; Phillips, Robert L; Angier, Heather; Burdick, Timothy E; Carrozza, Mark A; DeVoe, Jennifer E

    2016-03-01

    Social determinants of health significantly impact morbidity and mortality; however, physicians lack ready access to this information in patient care and population management. Just as traditional vital signs give providers a biometric assessment of any patient, "community vital signs" (Community VS) can provide an aggregated overview of the social and environmental factors impacting patient health. Knowing Community VS could inform clinical recommendations for individual patients, facilitate referrals to community services, and expand understanding of factors impacting treatment adherence and health outcomes. This information could also help care teams target disease prevention initiatives and other health improvement efforts for clinic panels and populations. Given the proliferation of big data, geospatial technologies, and democratization of data, the time has come to integrate Community VS into the electronic health record (EHR). Here, the authors describe (i) historical precedent for this concept, (ii) opportunities to expand upon these historical foundations, and (iii) a novel approach to EHR integration. PMID:26174867

  14. "Community vital signs": incorporating geocoded social determinants into electronic records to promote patient and population health.

    Science.gov (United States)

    Bazemore, Andrew W; Cottrell, Erika K; Gold, Rachel; Hughes, Lauren S; Phillips, Robert L; Angier, Heather; Burdick, Timothy E; Carrozza, Mark A; DeVoe, Jennifer E

    2016-03-01

    Social determinants of health significantly impact morbidity and mortality; however, physicians lack ready access to this information in patient care and population management. Just as traditional vital signs give providers a biometric assessment of any patient, "community vital signs" (Community VS) can provide an aggregated overview of the social and environmental factors impacting patient health. Knowing Community VS could inform clinical recommendations for individual patients, facilitate referrals to community services, and expand understanding of factors impacting treatment adherence and health outcomes. This information could also help care teams target disease prevention initiatives and other health improvement efforts for clinic panels and populations. Given the proliferation of big data, geospatial technologies, and democratization of data, the time has come to integrate Community VS into the electronic health record (EHR). Here, the authors describe (i) historical precedent for this concept, (ii) opportunities to expand upon these historical foundations, and (iii) a novel approach to EHR integration.

  15. Caste-, work-, and descent-based discrimination as a determinant of health in social epidemiology.

    Science.gov (United States)

    Patil, Rajan R

    2014-01-01

    Social epidemiology explores health in the context of broad social determinants of health, where the boundary lines between health and politics appear increasingly blurred. Social determinants of health such as caste, discrimination, and social exclusion are inherently political in nature, hence it becomes imperative to look at health through a broader perspective of political philosophy, ideology, and caste that imposes enormous obstacles to a person's full attainment of civil, political, economic, social, and cultural rights. Caste is descent based and hereditary in nature. It is a characteristic determined by one's birth into a particular caste, irrespective of the faith practiced by the individual. Caste denotes a system of rigid social stratification into ranked groups defined by descent and occupation. Under various caste systems throughout the world, caste divisions also dominate in housing, marriage, and general social interaction divisions that are reinforced through the practice and threat of social ostracism, economic boycotts, and even physical violence-all of which undermine health equality. PMID:24871772

  16. Social determinants of health information seeking among Chinese adults in Hong Kong.

    Directory of Open Access Journals (Sweden)

    Man Ping Wang

    Full Text Available BACKGROUND: Health communication inequalities were observed in Western population but less is known about them among the Chinese. We investigated health information seeking behaviours and its social determinants among Chinese adults in Hong Kong. METHODS: Probability-based sample surveys over telephone were conducted in 2009, 2010/11 and 2012 to monitor family health and information use. Frequency of health information seeking from television, radio, newspapers/magazines and Internet were recorded and dichotomised as ≥1 time/month and <1 time/month (reference. Logistic regression was used to yield adjusted odds ratios (aOR of health information seeking for different demographic characteristics, socioeconomic status (education, employment and income, chronic disease and behaviours (smoking, drinking and physical activity. RESULTS: Among 4553 subjects in all surveys, most (85.1% had sought health information monthly from newspapers/magazines (66.2%, television (61.4%, radio (35.6% or Internet (33.2%. Overall, being male, lower education attainment, lower household income, ever-smoking and physical inactivity were associated with less frequent health information seeking (all P <0.05. Compared with younger people, older people were less likely to search health information from Internet but more like to obtain it from radio (both P for trend <0.001. Having chronic diseases was associated with frequent health information seeking from television (aOR  =  1.25, 95% CI: 1.07-1.47 and Internet (aOR  =  1.46, 95% CI: 1.24-1.73. CONCLUSIONS: This study has provided the first evidence on health information inequalities from a non-Western population with advanced mass media and Internet penetration. Socioeconomic inequalities and behavioural clustering of health information seeking suggested more resources are needed for improving health communication in disadvantage groups.

  17. Health-related beliefs and consumer knowledge as determinants of fish consumption

    DEFF Research Database (Denmark)

    Pieniak, Zuzanna; Verbeke, Wim; Scholderer, Joachim

    2010-01-01

    contributed, both directly and indirectly through knowledge, to explain fish consumption behaviour. However, the path coefficients in the estimated model were relatively low, which indicates that fish consumption frequency was also determined by factors other than health-related beliefs and consumers......' knowledge. Conclusions: The findings of the present study suggest that communication should focus on health-related benefits other than fish consumption alone. Communicating that eating fish is healthy and stressing the health benefits of fish alone, as is still commonly performed (e.g. in generic promotion...

  18. Determinants of Health Spending Efficiency: a Tobit Panel Data Approach Based on DEA Efficiency Scores

    Directory of Open Access Journals (Sweden)

    Douanla Tayo Lionel

    2015-08-01

    Full Text Available This study aims at identifying the determinants of health expenditure efficiency over the period 2005-2011 using a Tobit Panel Data Approach based on DEA Efficiency Scores. The study was made on 150 countries, where we had 45 high income countries, 40 upper middle income countries, 36 lower middle income countries and 29 low income countries. The estimated results show that Carbon dioxide emission, gross domestic product per capita, improvement in corruption, the age composition of the population, population density and government effectiveness are significant determinants of health expenditure efficiency. Thus, low income countries should promote green growth and all the income groups should intensively fight against poverty.

  19. Psychosocial, Socio-Demographic and Health Determinants in Information Communication Technology Use by Older-Adults

    OpenAIRE

    Berner, Jessica

    2014-01-01

    The aim of the thesis was to investigate factors influencing ICT use by older-adults. A selection of psycho-social, socio-demographic and health determinants were investigated with Internet use. Data were collected through questionnaires (Studies I-III) and interviews (Study IV). Univariate and multivariate analyses were conducted, investigating Internet use as a dichotomous variable, with the aforementioned factors. The results indicated that psycho-social determinants did not affect older-a...

  20. Relationship between lifestyle and health factors and severe lower urinary tract symptoms (LUTS in 106,435 middle-aged and older Australian men: population-based study.

    Directory of Open Access Journals (Sweden)

    David P Smith

    Full Text Available BACKGROUND: Despite growing interest in prevention of lower urinary tract symptoms (LUTS through better understanding of modifiable risk factors, large-scale population-based evidence is limited. OBJECTIVE: To describe risk factors associated with severe LUTS in the 45 and Up Study, a large cohort study. DESIGN, SETTING, AND PARTICIPANTS: A cross-sectional analysis of questionnaire data from 106,435 men aged ≥ 45 years, living in New South Wales, Australia. OUTCOME MEASURES AND STATISTICAL ANALYSIS: LUTS were measured by a modified version of the International Prostate Symptom Score (m-IPSS. The strength of association between severe LUTS and socio-demographic, lifestyle and health-related factors was estimated, using logistic regression to calculate odds ratios, adjusted for a range of confounding factors. RESULTS: Overall, 18.3% reported moderate, and 3.6% severe, LUTS. Severe LUTS were more common among men reporting previous prostate cancer (7.6%, total prostatectomy (4.9% or having part of the prostate removed (8.2%. After excluding men with prostate cancer or prostate surgery, the prevalence of moderate-severe LUTS in the cohort (n = 95,089 ranged from 10.6% to 35.4% for ages 45-49 to ≥ 80; the age-related increase was steeper for storage than voiding symptoms. The adjusted odds of severe LUTS decreased with increasing education (tertiary qualification versus no school certificate, odds ratio (OR = 0.78 (0.68-0.89 and increasing physical activity (high versus low, OR = 0.83 (0.76-0.91. Odds were elevated among current smokers versus never-smokers (OR = 1.64 (1.43-1.88, obese versus healthy-weight men (OR = 1.27 (1.14-1.41 and for comorbid conditions (e.g., heart disease versus no heart disease, OR = 1.36 (1.24-1.49, and particularly for severe versus no physical functional limitation (OR = 5.17 (4.51-5.93. CONCLUSIONS: LUTS was associated with a number of factors, including modifiable risk factors, suggesting potential targets for

  1. Linear and Non-Linear Associations of Gonorrhea Diagnosis Rates with Social Determinants of Health

    Directory of Open Access Journals (Sweden)

    Hazel D. Dean

    2012-09-01

    Full Text Available Identifying how social determinants of health (SDH influence the burden of disease in communities and populations is critically important to determine how to target public health interventions and move toward health equity. A holistic approach to disease prevention involves understanding the combined effects of individual, social, health system, and environmental determinants on geographic area-based disease burden. Using 2006–2008 gonorrhea surveillance data from the National Notifiable Sexually Transmitted Disease Surveillance and SDH variables from the American Community Survey, we calculated the diagnosis rate for each geographic area and analyzed the associations between those rates and the SDH and demographic variables. The estimated product moment correlation (PMC between gonorrhea rate and SDH variables ranged from 0.11 to 0.83. Proportions of the population that were black, of minority race/ethnicity, and unmarried, were each strongly correlated with gonorrhea diagnosis rates. The population density, female proportion, and proportion below the poverty level were moderately correlated with gonorrhea diagnosis rate. To better understand relationships among SDH, demographic variables, and gonorrhea diagnosis rates, more geographic area-based estimates of additional variables are required. With the availability of more SDH variables and methods that distinguish linear from non-linear associations, geographic area-based analysis of disease incidence and SDH can add value to public health prevention and control programs.

  2. Australian food life style segments and elaboration likelihood differences

    DEFF Research Database (Denmark)

    Brunsø, Karen; Reid, Mike

    As the global food marketing environment becomes more competitive, the international and comparative perspective of consumers' attitudes and behaviours becomes more important for both practitioners and academics. This research employs the Food-Related Life Style (FRL) instrument in Australia...... in order to 1) determine Australian Life Style Segments and compare these with their European counterparts, and to 2) explore differences in elaboration likelihood among the Australian segments, e.g. consumers' interest and motivation to perceive product related communication. The results provide new...... insights into cross-cultural similarities and differences, into elaboration likelihood differences among consumer segments, and show how the involvement construct may be used as basis for communication development....

  3. Globalization and social determinants of health: The role of the global marketplace (part 2 of 3

    Directory of Open Access Journals (Sweden)

    Schrecker Ted

    2007-06-01

    Full Text Available Abstract Globalization is a key context for the study of social determinants of health (SDH: broadly stated, SDH are the conditions in which people live and work, and that affect their opportunities to lead healthy lives. In the first article in this three part series, we described the origins of the series in work conducted for the Globalization Knowledge Network of the World Health Organization's Commission on Social Determinants of Health and in the Commission's specific concern with health equity. We identified and defended a definition of globalization that gives primacy to the drivers and effects of transnational economic integration, and addressed a number of important conceptual and methodological issues in studying globalization's effects on SDH and their distribution, emphasizing the need for transdisciplinary approaches that reflect the complexity of the topic. In this second article, we identify and describe several, often interacting clusters of pathways leading from globalization to changes in SDH that are relevant to health equity. These involve: trade liberalization; the global reorganization of production and labour markets; debt crises and economic restructuring; financial liberalization; urban settings; influences that operate by way of the physical environment; and health systems changed by the global marketplace.

  4. Globalization and social determinants of health: The role of the global marketplace (part 2 of 3).

    Science.gov (United States)

    Labonté, Ronald; Schrecker, Ted

    2007-06-19

    Globalization is a key context for the study of social determinants of health (SDH): broadly stated, SDH are the conditions in which people live and work, and that affect their opportunities to lead healthy lives. In the first article in this three part series, we described the origins of the series in work conducted for the Globalization Knowledge Network of the World Health Organization's Commission on Social Determinants of Health and in the Commission's specific concern with health equity. We identified and defended a definition of globalization that gives primacy to the drivers and effects of transnational economic integration, and addressed a number of important conceptual and methodological issues in studying globalization's effects on SDH and their distribution, emphasizing the need for transdisciplinary approaches that reflect the complexity of the topic. In this second article, we identify and describe several, often interacting clusters of pathways leading from globalization to changes in SDH that are relevant to health equity. These involve: trade liberalization; the global reorganization of production and labour markets; debt crises and economic restructuring; financial liberalization; urban settings; influences that operate by way of the physical environment; and health systems changed by the global marketplace.

  5. Slum Sanitation and the Social Determinants of Women’s Health in Nairobi, Kenya

    Directory of Open Access Journals (Sweden)

    Jason Corburn

    2015-01-01

    Full Text Available Inadequate urban sanitation disproportionately impacts the social determinants of women’s health in informal settlements or slums. The impacts on women’s health include infectious and chronic illnesses, violence, food contamination and malnutrition, economic and educational attainment, and indignity. We used household survey data to report on self-rated health and sociodemographic, housing, and infrastructure conditions in the Mathare informal settlement in Nairobi, Kenya. We combined quantitative survey and mapping data with qualitative focus group information to better understand the relationships between environmental sanitation and the social determinants of women and girls’ health in the Mathare slum. We find that an average of eighty-five households in Mathare share one toilet, only 15% of households have access to a private toilet, and the average distance to a public toilet is over 52 meters. Eighty-three percent of households without a private toilet report poor health. Mathare women report violence (68%, respiratory illness/cough (46%, diabetes (33%, and diarrhea (30% as the most frequent physical burdens. Inadequate, unsafe, and unhygienic sanitation results in multiple and overlapping health, economic, and social impacts that disproportionately impact women and girls living in urban informal settlements.

  6. Slum Sanitation and the Social Determinants of Women's Health in Nairobi, Kenya

    Science.gov (United States)

    Corburn, Jason; Hildebrand, Chantal

    2015-01-01

    Inadequate urban sanitation disproportionately impacts the social determinants of women's health in informal settlements or slums. The impacts on women's health include infectious and chronic illnesses, violence, food contamination and malnutrition, economic and educational attainment, and indignity. We used household survey data to report on self-rated health and sociodemographic, housing, and infrastructure conditions in the Mathare informal settlement in Nairobi, Kenya. We combined quantitative survey and mapping data with qualitative focus group information to better understand the relationships between environmental sanitation and the social determinants of women and girls' health in the Mathare slum. We find that an average of eighty-five households in Mathare share one toilet, only 15% of households have access to a private toilet, and the average distance to a public toilet is over 52 meters. Eighty-three percent of households without a private toilet report poor health. Mathare women report violence (68%), respiratory illness/cough (46%), diabetes (33%), and diarrhea (30%) as the most frequent physical burdens. Inadequate, unsafe, and unhygienic sanitation results in multiple and overlapping health, economic, and social impacts that disproportionately impact women and girls living in urban informal settlements. PMID:26060499

  7. Healthy housing as social determinant of health: international and national experiences

    Directory of Open Access Journals (Sweden)

    Mara Rejane Barroso Barcelos

    2011-06-01

    Full Text Available Objectives: To promote a reflection on the problem of the evolution of the city and the existence of a technological paradigm, for despite the knowledge of technologies, they are not accessible to the entire population. It also discusses the need to build healthy housingand how these translate into social determinants of health. Data Synthesis: A literature review based on the themes “healthy housing” and “social determinants of health” to present the experiences of the programs Red Interamericana de la Vivienda Saludable (Red VIVSALUD and Rede Brasileira de Habitação Saudável (Brazilian Network for Healthy Housing. The program, developed since 1995 by Red VIVSALUD, an international initiative of the Pan American Health Organization and the precursor of healthy housing initiative, is effective in Brazil through the Brazilian Network for Healthy Housing. This network has become a movement to incorporate human resources training, development of research with community participation and interventions through the dissemination of the concept and practice of health promotion policy within the housing. Conclusion: With the development of urban space, there is a significant deterioration in quality of life due to lack of health infrastructure, shortage of housing and health inequalities. A healthy housing mentions to a space characterized by a set of conditions that influence the processes of restoration, protection and health promotion. Its construction will be successful if the initiative is embedded in programs and projects of housing and urban development, undertaken bygovernments.

  8. Dawes Review 5: Australian Aboriginal Astronomy and Navigation

    CERN Document Server

    Norris, Ray P

    2016-01-01

    The traditional cultures of Aboriginal Australians include a significant astronomical component, perpetuated through oral tradition, ceremony, and art. This astronomical knowledge includes a deep understanding of the motion of objects in the sky, which was used for practical purposes such as constructing calendars and for navigation. There is also evidence that traditional Aboriginal Australians made careful records and measurements of cyclical phenomena, recorded unexpected phenomena such as eclipses and meteorite impacts, and could determine the cardinal points to an accuracy of a few degrees. Putative explanations of celestial phenomena appear throughout the oral record, suggesting traditional Aborig- inal Australians sought to understand the natural world around them, in the same way as modern scientists, but within their own cultural context. There is also a growing body of evidence for sophisticated navigational skills, including the use of astronomically based songlines. Songlines are effectively oral ...

  9. Persons Living with HIV/AIDS: Employment as a Social Determinant of Health

    Science.gov (United States)

    Hergenrather, Kenneth C.; Zeglin, Robert J.; Conyers, Liza; Misrok, Mark; Rhodes, Scott D.

    2016-01-01

    Purpose: For persons living with HIV/AIDS (PLWHA), the advent of highly active antiretroviral therapy has increased their longevity and quality of life. As HIV progresses, many PLWHA present declined domains of functioning that impede their ability to work. The authors explore employment as a social determinant of health to identify issues…

  10. Reporting suicide attempts : consistency and its determinants in a large mental health study

    NARCIS (Netherlands)

    Eikelenboom, Merijn; Smit, Johannes H.; Beekman, Aartjan T. F.; Kerkhof, Ad J. F. M.; Penninx, Brenda W. J. H.

    2014-01-01

    A lifetime history (LTH) of suicide attempts (SAs) is frequently assessed in mental health surveys. However, little is known about the reliability of assessing a LTH of SA. This study examined the consistency and its determinants of reporting a LTH of SA in a large cohort of persons with a history o

  11. Determinants of health policy impact: comparative results of a European policymaker study.

    NARCIS (Netherlands)

    Rütten, A.; Lüschen, G.; Lengerke, T. von; Abel, T.; Kannas, L.; Rodríguez Diaz, J.A.; Vinck, J.; Zee, J. van der

    2003-01-01

    OBJECTIVES: This article will use a new theoretical framework for the analysis of health policy impact introduced by Rutten et al. (2003). In particular, it will report on a comparative European study of policymakers' perception and evaluation of specific determinants of the policy impact, both in t

  12. Enhancing Curriculum through Service Learning in the Social Determinants of Health Course

    Science.gov (United States)

    Rooks, Ronica Nicole; Rael, Christine Tagliaferri

    2013-01-01

    Service learning bridges classroom learning and community volunteerism and is anchored in the curriculum, classroom discussion, and community. We incorporated service learning projects (SLP) into three Social Determinants of Health courses (2008-2010) to promote: experiential learning; undergraduate scholarship; faculty career development through…

  13. Perception of Lay People Regarding Determinants of Health and Factors Affecting It: An Aggregated Analysis from 29 Countries

    Directory of Open Access Journals (Sweden)

    Aqeela ZAHRA

    2015-12-01

    Full Text Available Background: This study aimed to evaluate the perception of lay people regarding determinants of health at global level and factors affecting it. Methods: Data was collected from International Social Survey Program (ISSP and World Bank website. Multilevel regression analysis was done and lay people’s perception regarding health behavior, environment, poverty and genes as health determinants was assessed. Various socio demographic factors were used as independent variables. Results: The highest percentage of people agreed environment as determinant of health. An inverse relationship was observed between GNI quartiles and an individual’s agreement with poverty, health behavior, and environment as health determinant. There was a significant negative association of females with health damaging behavior (P<0.05 and positive association with environment and genes (P<0.05 as health determinants. Elderly people agreed with poverty as determinant of health (P<0.05. GNI was negatively related to environment (P<0.05 and poverty (P<0.05 as health determinant. Conclusion: The common public is now becoming aware of a broadened concept of health and people belonging to different backgrounds have different perceptions regarding determinants of health. Our results show that highest percentage of people agreed with environment as determinant of health, which is consistent with scientific view of increased burden of disease, caused by environmental factors. Thus, tailored health programs and policies that address an individual's specific problems are likely to induce a change in behavior and attitude, hence decreasing the disease burden.eywords: ISSP, Determinants of health, Multilevel analysis, Tailored approach

  14. ASA24-Australian Version (Under Development)

    Science.gov (United States)

    In collaboration with the National Cancer Institute (NCI), a consortium of Australian Researchers is adapting the ASA24 system to the Australian context to account for variations in food consumed, portion sizes, and nutrient composition.

  15. Aligning IT and Business Strategy: An Australian University Case Study

    Science.gov (United States)

    Dent, Alan

    2015-01-01

    Alignment with business objectives is considered to be an essential outcome of information technology (IT) strategic planning. This case study examines the process of creating an IT strategy for an Australian university using an industry standard methodology. The degree of alignment is determined by comparing the strategic priorities supported by…

  16. We Need Action on Social Determinants of Health – but Do We Want It, too? Comment on “Understanding the Role of Public Administration in Implementing Action on the Social Determinants of Health and Health Inequities”

    OpenAIRE

    Evelyne de Leeuw

    2016-01-01

    Recently a number of calls have been made to mobilise the arsenal of political science insights to investigate – and point to improvements in – the social determinants of health (SDH), and health equity. Recently, in this journal, such a rallying appeal was made for the field of public administration. This commentary argues that, although scholarly potential should justifiably be redirected to resolve these critical issues for humanity, a key ingredient in taking action may have b...

  17. We Need Action on Social Determinants of Health – but Do We Want It, too? Comment on “Understanding the Role of Public Administration in Implementing Action on the Social Determinants of Health and Health Inequities”

    OpenAIRE

    Evelyne de Leeuw

    2016-01-01

    Recently a number of calls have been made to mobilise the arsenal of political science insights to investigate – and point to improvements in – the social determinants of health (SDH), and health equity. Recently, in this journal, such a rallying appeal was made for the field of public administration. This commentary argues that, although scholarly potential should justifiably be redirected to resolve these critical issues for humanity, a key ingredient in taking action may have been neglecte...

  18. The Lunar Environment: Determining the Health Effects of Exposure to Moon Dusts

    Science.gov (United States)

    Khan-Mayberry, Noreen

    2007-01-01

    The moon's surface is covered with a thin layer of fine, charged, reactive dust capable of layer of fine, charged, reactive dust capable of capable of entering habitats and vehicle compartments, where it can result in crewmember health problems. NASA formed the Lunar Airborne Dust Toxicity Advisory Group (LADTAG) to study the effects of exposure to Lunar Dust on human health. To date, no scientifically defensible toxicological studies have been performed on lunar dusts, specifically the determination of exposure limits and their affect on human health. The multi-center LADTAG (Lunar Airborne Dust Toxicology center LADTAG (Lunar Airborne Dust Toxicology Advisory Group) was formed in response to the Office of the Chief Health and Medical Office s (OCHMO) request to develop recommendations for defining risk (OCHMO) request to develop recommendations for defining risk defining risk criteria for human lunar dust exposure.

  19. Determinants of employment-based private health insurance coverage in Denmark

    Directory of Open Access Journals (Sweden)

    Astrid Kiil

    2011-10-01

    Full Text Available This study estimates the determinants of having employment-based private health insurance (EPHI based on data from a survey of the Danish workforce conducted in 2009. The study contributes to the literature by exploring the role of satisfaction with the tax-financed health care system as a potential determinant of EPHI ownership and by taking into account that some employees receive EPHI free of charge, while others pay the premium out of their pre-tax income and thus make an actual choice. The results indicate that the probability of having EPHI is positively affected by private sector employment, size of the workplace, whether the workplace has a health scheme, income, being employed as a white-collar worker, and age until the age of 49, while the presence of subordinates, gender, education level, membership of 'denmark' and living in the capital region are not significantly associated with EPHI coverage. As expected, the characteristics related to the workplace are by far the quantitatively most important determinants. The association between EPHI and self-assessed health is found to be quadratic such that individuals in good self-assessed health are more likely to be covered by EPHI than those in excellent and fair, poor or very poor self-assessed health, respectively. Finally, the probability of having EPHI is found to be negatively related to the level of satisfaction with the tax-financed health care system. The findings of the study are not affected notably by distinguishing empirically between employees who receive EPHI free of charge and those who pay the premium out of their pre-tax income. Link to Appendix

  20. Social determinants of health and health equity policy research: exploring the use, misuse, and nonuse of policy analysis theory.

    Science.gov (United States)

    Embrett, Mark G; Randall, G E

    2014-05-01

    Despite a dramatic growth in SDH/HE (social determinants of health/health equity) public policy research and demonstrated government interest in promoting equity in health policies, health inequities are actually growing among some populations and there is little evidence that "healthy public policies" are being adopted and implemented. Moreover, these issues are typically failing to even reach governments' policy agendas, which is a critical step towards serious debate and the identification of policy options. This systematic review pursues three main objectives. First, is to identify barriers to SDH/HE issues reaching the government policy agenda. Second, to evaluate the characteristics of peer-reviewed research articles that utilize common policy analysis theories. And third, to determine the extent to which the SDH/HE literature utilizes common policy analysis theories. Our systematic review, conducted in June 2012, identified 6200 SDH/HE related articles in the peer-reviewed literature; however, only seven articles explicitly used a commonly recognized policy analysis theory to inform their analysis. Our analysis revealed that the SDH/HE policy literature appears to be focused on advocacy rather than analysis and that the use of policy analysis theory is extremely limited. Our results also suggest that when such theories are incorporated into an analysis they are often not comprehensively employed. We propose explanations for this non-use and misuse of policy analysis theory, and conclude that researchers may have greater influence in helping to get SDH/HE issues onto government policy agendas if they gain a greater understanding of the policy process and the value of incorporating policy analysis theories into their research. Using a policy analysis lens to help identify why healthy public policies are typically not being adopted is an important step towards moving beyond advocacy to understanding and addressing some of the political barriers to reforms. PMID

  1. Non-dental primary care providers’ views on challenges in providing oral health services and strategies to improve oral health in Australian rural and remote communities: a qualitative study

    Science.gov (United States)

    Barnett, Tony; Hoang, Ha; Stuart, Jackie; Crocombe, Len

    2015-01-01

    Objectives To investigate the challenges of providing oral health advice/treatment as experienced by non-dental primary care providers in rural and remote areas with no resident dentist, and their views on ways in which oral health and oral health services could be improved for their communities. Design Qualitative study with semistructured interviews and thematic analysis. Setting Four remote communities in outback Queensland, Australia. Participants 35 primary care providers who had experience in providing oral health advice to patients and four dental care providers who had provided oral health services to patients from the four communities. Results In the absence of a resident dentist, rural and remote residents did present to non-dental primary care providers with oral health problems such as toothache, abscess, oral/gum infection and sore mouth for treatment and advice. Themes emerged from the interview data around communication challenges and strategies to improve oral health. Although, non-dental care providers commonly advised patients to see a dentist, they rarely communicated with the dentist in the nearest regional town. Participants proposed that oral health could be improved by: enabling access to dental practitioners, educating communities on preventive oral healthcare, and building the skills and knowledge base of non-dental primary care providers in the field of oral health. Conclusions Prevention is a cornerstone to better oral health in rural and remote communities as well as in more urbanised communities. Strategies to improve the provision of dental services by either visiting or resident dental practitioners should include scope to provide community-based oral health promotion activities, and to engage more closely with other primary care service providers in these small communities. PMID:26515687

  2. “Pick the Tick” The Impact of Health Endorsements on Consumers’ Food Choices

    OpenAIRE

    Mueller, Simone C.; Umberger, Wendy J.

    2010-01-01

    To determine the efficiency of health-related endorsements in influencing consumer choice we report findings from two separate, unique discrete choice experiments (DCEs) involving fresh packaged beef steaks and seafood. In addition to quality and production-related attributes, the beef and seafood products also displayed a health endorsement: the Australian National Heart Foundation “Pick the Tick” certification. Another, more recently introduced health claim, “2 Serves a Week” was also inclu...

  3. SELECTED SOCIAL DETERMINANTS OF HEALTH AMONG FAMILIES WITH CHILDREN WITH DISABILITIES

    Directory of Open Access Journals (Sweden)

    Mojžíšová Adéla

    2014-05-01

    Full Text Available The article presents information on the social determinants of health that affect families with children with disabilities. Results are based on a study of the project: Social determinants of health in the selected target groups. The qualitative study using in-depth interview. File sub-research consisted of six complete families with a child with disabilities in the age range of 6-15 years. Families were selected by stratified purposive sampling. The aim of the qualitative study using in-depth interviews to identify the key social determinants of health for families caring for a child with a disability and their subsequent examination of quantitative research strategies within the project ZSF JU. Significant issues have proven to social support, stress and social status. Stress of mothers of children with intellectual disabilities is not affected by the sex of the child and is not dependent on the age of the mother. Social networkof families is made up of close family, friends, community and the professionals who assist them in the care of children with disabilities. Parents consider it very important need to share their difficulties, both at the institutional level and a personal level. Central to the care of their children consider quality social and health services, provided primarily to non-profit sector or sectors of church organizations. Based on the results of qualitative research on families with a child with disabilities, it is clear that the most important for respondents to maintain the social status of the permanence of at least one family member full-time and given the age of the child with disabilities and other children in the family and the opportunity to find part-time the second member of the family. Social and health services are those instruments from the perspective of the social determinants of health, thanks to which can effectively prevent the risk of social exclusion of families with children with disabilities.

  4. We Need Action on Social Determinants of Health - but Do We Want It, too? Comment on "Understanding the Role of Public Administration in Implementing Action on the Social Determinants of Health and Health Inequities".

    Science.gov (United States)

    de Leeuw, Evelyne

    2016-02-27

    Recently a number of calls have been made to mobilise the arsenal of political science insights to investigate - and point to improvements in - the social determinants of health (SDH), and health equity. Recently, in this journal, such a rallying appeal was made for the field of public administration. This commentary argues that, although scholarly potential should justifiably be redirected to resolve these critical issues for humanity, a key ingredient in taking action may have been neglected. This factor is 'community.' Community health has been a standard element of the public health and health promotion, even political, repertoire for decades now. But this commentary claims that communities are insufficiently charged, equipped or appreciated to play the role that scholarship attributes (or occasionally avoids to identify) to them. Community is too important to not fully engage and understand. Rhetorical tools and inquiries can support their quintessential role.

  5. Determinants of microcomputer technology use: implications for education and training of health staff.

    Science.gov (United States)

    Jayasuriya, R

    1998-06-01

    In hospitals and other Healthcare settings, increasingly, hands-on computer use is becoming an important behaviour for effective job performance. The literature has identified differences that relate to computer use between occupational categories in health services. The objectives of this study were to identify factors that determine computer acceptance among occupational groups in Community Health and to predict the factors that relate to computer use. A survey was administered to all Community Health staff in one health service area. Health administrators were found to have a significantly higher training in computers, a higher frequency of use and a higher level of skill for both applications (word processing (WP) and database (DB)) than nurses. The results of a regression analysis shows that about 55% of the variation in the use of WP is explained by computer skills, perceived usefulness (PU) and designation. In the case of DB use, PU was the only significant predictor explaining 53% of the variation. Both level of education and prior training were not significant predictors. The implication for health informatics education (and service training) of these findings is that, in the workplace, health professionals would use computers when they perceive it to be useful for performance in their jobs. PMID:9726511

  6. Determining the relevance of a certification exam to home health care nursing practice.

    Science.gov (United States)

    Holland, D E

    1999-01-01

    Home health care is enjoying increased use and popularity. Unfortunately, in today's cost-cutting environment, home healthcare is also subject to increased scrutiny and inevitable reimbursement limitations. This is borne out by the impact on home healthcare as a result of the Balanced Budget Act of 1997. Berke (1998) reports that those at greatest risk for cutbacks in care are those that can least afford it--the oldest, sickest, poorest, and most frail. Compounding the financial dilemma that home health care clients face are multiple providers of care, an unrealistic media presentation of health care, and less time for anyone to provide psychosocial-focused care (Simmons, 1990). Home health care clients have a desperate need for an advocate to provide expert navigation through the health care system. Home health care providers are aware of and often responsible for bridging gaps in health, medical benefits, and social services. This article describes a process for determining the relevance of a certification to community nursing clinical practice--using the Advanced Certification in Continuity of Care (A-CCC) exam as the example. PMID:10695177

  7. Involvement of stakeholders in determining health priorities of adolescents in rural South Africa

    Directory of Open Access Journals (Sweden)

    Rhian Twine

    2016-03-01

    Full Text Available Background: When developing intervention research, it is important to explore issues from the community perspective. Interventions that promote adolescent health in South Africa are urgently needed, and Project Ntshembo (‘hope’ aims to improve the health of young women and their offspring in the Agincourt sub-district of rural northeast South Africa, actively using stakeholder involvement throughout the research process. Objective: This study aimed to determine adolescent health priorities according to key stakeholders, to align stakeholder and researcher priorities, and to form a stakeholder forum, which would be active throughout the intervention. Design: Thirty-two stakeholders were purposefully identified as community members interested in the health of adolescents. An adapted Delphi incorporating face-to-face discussions, as well as participatory visualisation, was used in a series of three workshops. Consensus was determined through non-parametric analysis. Results: Stakeholders and researchers agreed that peer pressure and lack of information, or having information but not acting on it, were the root causes of adolescent health problems. Pregnancy, HIV, school dropout, alcohol and drug abuse, not accessing health services, and unhealthy lifestyle (leading to obesity were identified as priority adolescent health issues. A diagram was developed showing how these eight priorities relate to one another, which was useful in the development of the intervention. A stakeholder forum was founded, comprising 12 of the stakeholders involved in the stakeholder involvement process. Conclusions: The process brought researchers and stakeholders to consensus on the most important health issues facing adolescents, and a stakeholder forum was developed within which to address the issues. Stakeholder involvement as part of a research engagement strategy can be of mutual benefit to the researchers and the community in which the research is taking place.

  8. Employment as a Social Determinant of Health: A Systematic Review of Longitudinal Studies Exploring the Relationship between Employment Status and Physical Health

    Science.gov (United States)

    Hergenrather, Kenneth C.; Zeglin, Robert J.; McGuire-Kuletz, Maureen; Rhodes, Scott D.

    2015-01-01

    Purpose: To explore employment as a social determinant of health through examining the relationship between employment status and physical health. Method: The authors explored the causal relationship between employment status and physical health through conducting a systematic review of 22 longitudinal studies conducted in Finland, France, the…

  9. Changing Patterns of Governance for Australian Universities

    Science.gov (United States)

    Harman, Kay; Treadgold, Elaine

    2007-01-01

    Dissatisfaction with the "corporate" model for university governance, a model advocated by both sides of the Australian parliament and adopted by Australian universities over the past two decades, prompted the Australian Vice-Chancellors' Committee (AVCC) in 2003 to suggest an alternative "trusteeship" model. The paper discusses how this model…

  10. Depression, anxiety, and stress in partners of Australian combat veterans and military personnel: a comparison with Australian population norms.

    Science.gov (United States)

    MacDonell, Gail V; Bhullar, Navjot; Thorsteinsson, Einar B

    2016-01-01

    Partners of Australian combat veterans are at an increased risk of experiencing mental health problems. The present study provides a comparative analysis of the mental health of partners of veterans with that of the Australian normative data. To compare different types of groups of partners, the study samples comprised: (a) partners of Australian combat veterans (Sample 1: n = 282, age M = 60.79, SD = 5.05), (b) a sub-sample of partners of Australian combat veterans from the previous sample (Sample 2: n = 50; M = 60.06, SD = 4.80), (c) partners of Special Air Services Regiment (SASR) personnel (Sample 3: n = 40, age M = 34.39SD = 7.01), and (d) partners of current serving military (non-SASR) personnel (Sample 4: n = 38, age M = 32.37, SD = 6.20). Respondents completed measures assessing their reported levels of depression, anxiety, and stress. Samples 1 and 2 comprised partners of Australian military veterans who reported significantly greater symptoms of depression, anxiety, and stress than the comparative population norms. The sample of SASR personnel partners (Sample 3) reported significantly lower levels of depression and anxiety, whereas the sample with non-SASR personnel partners (Sample 4) reported a significantly greater stress symptomatology than the comparative norms. Number of deployments was found to be associated with depression, anxiety, and stress in partners of non-SASR veterans (Sample 4). Lessons and protective factors can be learnt from groups within the current military as to what may assist partners and families to maintain a better level of psychosocial health. PMID:27635339

  11. A Sophisticated Architecture Is Indeed Necessary for the Implementation of Health in All Policies but not Enough Comment on “Understanding the Role of Public Administration in Implementing Action on the Social Determinants of Health and Health Inequities”

    OpenAIRE

    Eric Breton

    2016-01-01

    In this commentary, I argue that beyond a sophisticated supportive architecture to facilitate implementation of actions on the social determinants of health (SDOH) and health inequities, the Health in All Policies (HiAP) project faces two main barriers: lack of awareness within policy networks on the social determinants of population health, and a tendency of health actors to neglect investing in other sectors’ complex problems.

  12. A Sophisticated Architecture Is Indeed Necessary for the Implementation of Health in All Policies but not Enough: Comment on "Understanding the Role of Public Administration in Implementing Action on the Social Determinants of Health and Health Inequities"

    OpenAIRE

    Eric Breton

    2016-01-01

    In this commentary, I argue that beyond a sophisticated supportive architecture to facilitate implementation of actions on the social determinants of health (SDOH) and health inequities, the Health in All Policies (HiAP) project faces two main barriers: lack of awareness within policy networks on the social determinants of population health, and a tendency of health actors to neglect investing in other sectors’ complex problems.

  13. A Sophisticated Architecture Is Indeed Necessary for the Implementation of Health in All Policies but not Enough Comment on "Understanding the Role of Public Administration in Implementing Action on the Social Determinants of Health and Health Inequities".

    Science.gov (United States)

    Breton, Eric

    2016-01-01

    In this commentary, I argue that beyond a sophisticated supportive architecture to facilitate implementation of actions on the social determinants of health (SDOH) and health inequities, the Health in All Policies (HiAP) project faces two main barriers: lack of awareness within policy networks on the social determinants of population health, and a tendency of health actors to neglect investing in other sectors' complex problems. PMID:27285517

  14. Determinants of health in recently arrived young migrants and refugees: a review of the literature

    Directory of Open Access Journals (Sweden)

    Eva Pfarrwaller

    2012-09-01

    Full Text Available

    Background: adolescent migrants are in a state of double vulnerability because of their age and migration experience. The purpose of this review was to identify risk and protective factors serving as a base for health promotion of young recent migrants.

    Methods: we assessed 95 papers identified through a MEDLINE search. Thirty-five papers were retained for review and analysed within the following themes: general health, mental health, cigarette smoking and sexual health.

    Results: young migrants’ health was considered good at arrival, but deteriorated with length of stay due to factors linked to migration. Mental health was determined by pre-migration factors, such as violence, and was strongly related to post-migration factors, such as asylum procedures, discrimination and low socio-economic status. Social support and family cohesion were identified as protective factors. We found a lack in epidemiologic data about tobacco use and sexual health issues. Results from North America indicated less frequent smoking in certain groups of immigrants. Some data suggested more frequent teenage pregnancies and abortions in young refugee women as compared to the host population. We also found some evidence about increased risk of sexually transmitted infections and HIV/AIDS in certain immigrant populations.

    Conclusions: migrant adolescents are generally healthy at arrival. The migration process and social inequalities after arrival influence their long-term health. A comprehensive approach to health promotion is necessary, taking into account risk and protective factors. More research is needed, in order to obtain more specific epidemiologic data about adolescent migrants, as well as longitudinal and qualitative data.

  15. Determinants of marginalization and inequitable maternal health care in North–Central Vietnam: a framework analysis

    Directory of Open Access Journals (Sweden)

    Pauline Binder-Finnema

    2015-07-01

    Full Text Available Background: Vietnam has achieved great improvements in maternal healthcare outcomes, but there is evidence of increasing inequity. Disadvantaged groups, predominantly ethnic minorities and people living in remote mountainous areas, do not gain access to maternal health improvements despite targeted efforts from policymakers. Objective: This study identifies underlying structural barriers to equitable maternal health care in Nghe An province, Vietnam. Experiences of social inequity and limited access among child-bearing ethnic and minority women are explored in relation to barriers of care provision experienced by maternal health professionals to gain deeper understanding on health outcomes. Design: In 2012, 11 focus group discussions with women and medical care professionals at local community health centers and district hospitals were conducted using a hermeneutic–dialectic method and analyzed for interpretation using framework analysis. Results: The social determinants ‘limited negotiation power’ and ‘limited autonomy’ orchestrate cyclical effects of shared marginalization for both women and care professionals within the provincial health system’s infrastructure. Under-staffed and poorly equipped community health facilities refer women and create overload at receiving health centers. Limited resources appear diverted away from local community centers as compensation to the district for overloaded facilities. Poor reputation for low care quality exists, and professionals are held in low repute for causing overload and resulting adverse outcomes. Country-wide reforms force women to bear responsibility for limited treatment adherence and health insight, but overlook providers’ limited professional development. Ethnic minority women are hindered by relatives from accessing care choices and costs, despite having advanced insight about government reforms to alleviate poverty. Communication challenges are worsened by non

  16. The Mexican experience in monitoring and evaluation of public policies addressing social determinants of health.

    Science.gov (United States)

    Valle, Adolfo Martinez

    2016-01-01

    Monitoring and evaluation (M&E) have gradually become important and regular components of the policy-making process in Mexico since, and even before, the World Health Organization (WHO) Commission on Social Determinants of Health (CSDH) called for interventions and policies aimed at tackling the social determinants of health (SDH). This paper presents two case studies to show how public policies addressing the SDH have been monitored and evaluated in Mexico using reliable, valid, and complete information, which is not regularly available. Prospera, for example, evaluated programs seeking to improve the living conditions of families in extreme poverty in terms of direct effects on health, nutrition, education and income. Monitoring of Prospera's implementation has also helped policy-makers identify windows of opportunity to improve the design and operation of the program. Seguro Popular has monitored the reduction of health inequalities and inequities evaluated the positive effects of providing financial protection to its target population. Useful and sound evidence of the impact of programs such as Progresa and Seguro Popular plus legal mandates, and a regulatory evaluation agency, the National Council for Social Development Policy Evaluation, have been fundamental to institutionalizing M&E in Mexico. The Mexican experience may provide useful lessons for other countries facing the challenge of institutionalizing the M&E of public policy processes to assess the effects of SDH as recommended by the WHO CSDH.

  17. The Mexican experience in monitoring and evaluation of public policies addressing social determinants of health

    Directory of Open Access Journals (Sweden)

    Adolfo Martinez Valle

    2016-02-01

    Full Text Available Monitoring and evaluation (M&E have gradually become important and regular components of the policy-making process in Mexico since, and even before, the World Health Organization (WHO Commission on Social Determinants of Health (CSDH called for interventions and policies aimed at tackling the social determinants of health (SDH. This paper presents two case studies to show how public policies addressing the SDH have been monitored and evaluated in Mexico using reliable, valid, and complete information, which is not regularly available. Prospera, for example, evaluated programs seeking to improve the living conditions of families in extreme poverty in terms of direct effects on health, nutrition, education and income. Monitoring of Prospera's implementation has also helped policy-makers identify windows of opportunity to improve the design and operation of the program. Seguro Popular has monitored the reduction of health inequalities and inequities evaluated the positive effects of providing financial protection to its target population. Useful and sound evidence of the impact of programs such as Progresa and Seguro Popular plus legal mandates, and a regulatory evaluation agency, the National Council for Social Development Policy Evaluation, have been fundamental to institutionalizing M&E in Mexico. The Mexican experience may provide useful lessons for other countries facing the challenge of institutionalizing the M&E of public policy processes to assess the effects of SDH as recommended by the WHO CSDH.

  18. Globalization and social determinants of health: Introduction and methodological background (part 1 of 3).

    Science.gov (United States)

    Labonté, Ronald; Schrecker, Ted

    2007-06-19

    Globalization is a key context for the study of social determinants of health (SDH). Broadly stated, SDH are the conditions in which people live and work, and that affect their opportunities to lead healthy lives.In this first article of a three-part series, we describe the origins of the series in work conducted for the Globalization Knowledge Network of the World Health Organization's Commission on Social Determinants of Health and in the Commission's specific concern with health equity. We explain our rationale for defining globalization with reference to the emergence of a global marketplace, and the economic and political choices that have facilitated that emergence. We identify a number of conceptual milestones in studying the relation between globalization and SDH over the period 1987-2005, and then show that because globalization comprises multiple, interacting policy dynamics, reliance on evidence from multiple disciplines (transdisciplinarity) and research methodologies is required. So, too, is explicit recognition of the uncertainties associated with linking globalization - the quintessential "upstream" variable - with changes in SDH and in health outcomes.

  19. Globalization and social determinants of health: Introduction and methodological background (part 1 of 3

    Directory of Open Access Journals (Sweden)

    Schrecker Ted

    2007-06-01

    Full Text Available Abstract Globalization is a key context for the study of social determinants of health (SDH. Broadly stated, SDH are the conditions in which people live and work, and that affect their opportunities to lead healthy lives. In this first article of a three-part series, we describe the origins of the series in work conducted for the Globalization Knowledge Network of the World Health Organization's Commission on Social Determinants of Health and in the Commission's specific concern with health equity. We explain our rationale for defining globalization with reference to the emergence of a global marketplace, and the economic and political choices that have facilitated that emergence. We identify a number of conceptual milestones in studying the relation between globalization and SDH over the period 1987–2005, and then show that because globalization comprises multiple, interacting policy dynamics, reliance on evidence from multiple disciplines (transdisciplinarity and research methodologies is required. So, too, is explicit recognition of the uncertainties associated with linking globalization – the quintessential "upstream" variable – with changes in SDH and in health outcomes.

  20. Barriers to addressing the social determinants of health: insights from the Canadian experience.

    Science.gov (United States)

    Raphael, Dennis; Curry-Stevens, Ann; Bryant, Toba

    2008-12-01

    Despite Canada's reputation as a leader in health promotion and population health, implementation of public policies in support of the social determinants of health has been woefully inadequate. The continuing presence of income, housing, and food insecurity has led to Canada being the subject of a series of rebukes from the United Nations for failing to address child and family poverty, discrimination against women and Aboriginal groups, and most recently the crisis of homelessness and housing insecurity. In this article we consider some of the reasons why this might be the case. These include the epistemological dominance of positivist approaches to the health sciences, the ideology of individualism prevalent in North America, and the increasing influence on public policy of the marketplace. Various models of public policy provide pathways by which these barriers can be surmounted. Considering that the International Commission on the Social Determinants of Health will soon be releasing its findings and recommendations, such an analysis seems especially timely for understanding both the Canadian scene and developments in other nations.