The increasing cost of the basic foods required to promote health in Queensland

Objective: To assess changes in the cost and availability of a standard basket of healthy food items (the Healthy Food Access Basket [HFAB]) in Queensland over time. Design and participants: A series of four cross-sectional surveys (in 1998, 2000, 2001 and 2004) describing the cost and availability of foods in the HFAB over time. In the latest survey, 97 Queensland food stores across the five Australian Bureau of Statistics remoteness categories were compared. Main outcome measures: Cost comparisons for HFAB items by remoteness category for the 97 stores surveyed in 2004; changes in cost and availability of foods in the 81 stores surveyed since 2000; comparisons of food prices in the 56 stores surveyed in 1998, 2000, 2001 and 2004. Results: In 2004, the Queensland mean cost of the HFAB was $395.28 a fortnight. The cost of the HFAB was 29.6%($113.89) higher in “very remote” areas than in “major cities” (P<0.001). Between 2001 and 2004, the Queensland mean cost of the HFAB increased by 14.0% ($48.45), while in very remote areas the cost increased by 18.0% ($76.93) (P<0.001). Since 2000, the annualised per cent increase in cost of the HFAB has been higher than the increase in Consumer Price Index for food in Brisbane. The cost of healthy foods has risen more than the cost of some less nutritious foods, so that the latter are now relatively more affordable. Conclusions: Consumers, particularly those in very remote locations, need to pay substantially more for basic healthy foods than they did a few years ago. Higher prices are likely to be a barrier to good health among people of low socioeconomic status and other vulnerable groups. Interventions to make basic healthy food affordable and accessible to all would help reduce the high burden of chronic disease.

Food availability, cost disparity and improvement in relation to accessibility and remoteness in Queensland

This study is the first to describe disparity and change in the food supply between metropolitan, rural and remote stores by Accessibility/Remoteness Index of Australia (ARIA)1 category. A total of 92 stores (97% response rate) within five aggregate ARIA categories participated throughout Queensland in 2000. There was a strong association between ARIA category and the cost of the basket of basic foods, with prices being significantly higher (20% and 31% respectively) in the ‘remote’ and ‘very remote’ categories than in the ‘highly accessible’ category. The association with ARIA was less marked for fruit and vegetables than for other food groups, but not for tobacco and take-away food items. Basic food items were less available in the more remote stores. Over the past two years, relative improvements in food prices have been seen in stores in the ‘very remote’ category, with observed increases less than the consumer price index (CPI) for food. Some factors which may have contributed to this improvement are discussed.

Queensland diabetic foot hospitalisations (2005-10) : in what state is our foot hospital problem?

Background Diabetes foot complications are a leading cause of overall avoidable hospital admissions. Since 2006, the Queensland Diabetes Clinical Network has implemented programs aimed at reducing diabetes-related hospitalisation. The aim of this retrospective observational study was to determine the incidence of diabetes foot-related hospital admissions in Queensland from 2005 to 2010. Methods Data on all primary diabetes foot-related admissions in Queensland from 2005-2010 was obtained using diabetes foot-related ICD-10-AM (hospital discharge) codes. Queensland diabetes foot-related admission incidences were calculated using general population data from the Australian Bureau of Statistics. Furthermore, diabetes foot-related sub-group admissions were analysed. Chi-squared tests were used to assess changes in admissions over time. Results Overall, 24,917 diabetes foot-related admissions occurred, resulting in the use of 260,085 bed days or 1.4% of all available Queensland hospital bed days (18,352,152). The primary reasons for these admissions were foot ulcers (49.8%), cellulitis (20.7%), peripheral vascular disease (17.8%) and osteomyelitis (3.8%). The diabetes foot-related admission incidence among the general population (per 100,000) reduced by 22% (103.0 in 2005, to 80.7 in 2010, p < 0.001); bed days decreased by 18% (1,099 to 904, p < 0.001). Conclusion Diabetes foot complications appear to be the primary reason for 1.4 out of every 100 hospital beds used in Queensland. There has been a significant reduction in the incidence of diabetes foot-related admissions in Queensland between 2005 and 2010. This decrease has coincided with a corresponding decrease in amputations and the implementation of several diabetes foot clinical programs throughout Queensland.

Reduction in the incidence of diabetes lower extremity amputations in Queensland : 2005-2010

Background Lower extremity amputation is a common end stage complication among people with diabetes. Since 2006, the Queensland Diabetes Clinical Network has implemented programs aimed at reducing diabetes-related amputations. The aim of this retrospective observational study was to determine the incidence of diabetes lower extremity amputations in Queensland from 2005 to 2010. Methods Data on all Queensland diabetes-related lower extremity amputation admissions from 2005-2010 was obtained using diabetes amputation-related ICD-10-AM (hospital discharge) codes. Queensland diabetes amputation incidences were calculated for both general and diabetes populations using population data from the Australian Bureau of Statistics and National Diabetes Services Scheme respectively. Chi-squared tests were used to assess changes in amputation incidence over time. Results Overall, 4,443 admissions for diabetes-related amputation occurred; 32% (1,434) were major amputations. The diabetes-related amputation incidence among the general population (per 100,000) reduced by 18% (18.2 in 2005, to 15.0 in 2010, p < 0.001); major amputations decreased by 24% (6.6 to 4.7, p < 0.01). The incidence among the diabetes population (per 1,000) reduced by 40% (6.7 in 2005, to 4.0 in 2010, p < 0.001); major amputations decreased by 45% (2.3 to 1.2, p < 0.001). Conclusion This paper appears to be the first to report a significant reduction in diabetes amputation incidence in an Australian state. This decrease has coincided with the implementation of several diabetes foot clinical programs throughout Queensland. Whilst these results are encouraging in the Australian context, further efforts are required to decrease to levels reported internationally.

Is the clinical Queensland High Risk Foot Form valid or reliable for research?

Background High-risk foot complications such as neuropathy, ischaemia, deformity, infections, ulcers and amputations consume considerable health care resources and typically result from chronic diseases. This study aimed to develop and test the validity and reliability of a Queensland High Risk Foot Form (QHRFF) tool. Methods Phase one involved developing a QHRFF using an existing diabetes high-risk foot tool, literature search, expert panel and several state-wide stakeholder groups. Phase two tested the criterion-related validity along with inter- and intra-rater reliability of the final QHRFF. Three cohorts of patients (n = 94) and four clinicians, representing different levels of expertise, were recruited. Validity was determined by calculating sensitivity, specificity and positive predictive values (PPV). Kappa and intra-class correlation (ICC) statistics were used to establish reliability. Results A QHRFF tool containing 46-items across seven domains was developed and endorsed. The majority of QHRFF items achieved moderate-to-perfect validity (PPV = 0.71 – 1) and reliability (Kappa/ICC = 0.41 – 1). Items with weak validity and/or reliability included those identifying health professionals previously attending the patient, other (non-listed) co-morbidity, previous foot ulcer, foot deformity, optimum offloading and optimum footwear. Conclusions The QHRFF had moderate-to-perfect validity and reliability across the majority of items, particularly identifying individual co-morbidities and foot complications. Items with weak validity or reliability need to be re-defined or removed. Overall, the QHRFF appears to be a valid and reliable tool to assess, collect and measure clinical data pertaining to high-risk foot complications for clinical or research purposes.

Changes in the site distribution of common melanoma subtypes in Queensland, Australia over time: implications for public health campaigns

Abstract BACKGROUND: An examination of melanoma incidence according to anatomical region may be one method of monitoring the impact of public health initiatives. OBJECTIVES:   To examine melanoma incidence trends by body site, sex and age at diagnosis or body site and morphology in a population at high risk. MATERIALS AND METHODS:   Population-based data on invasive melanoma cases (n = 51473) diagnosed between 1982 and 2008 were extracted from the Queensland Cancer Registry. Age-standardized incidence rates were calculated using the direct method (2000 world standard population) and joinpoint regression models were used to fit trend lines. RESULTS:   Significantly decreasing trends for melanomas on the trunk and upper limbs/shoulders were observed during recent years for both sexes under the age of 40 years and among males aged 40-59years. However, in the 60 and over age group, the incidence of melanoma is continuing to increase at all sites (apart from the trunk) for males and on the scalp/neck and upper limbs/shoulders for females. Rates of nodular melanoma are currently decreasing on the trunk and lower limbs. In contrast, superficial spreading melanoma is significantly increasing on the scalp/neck and lower limbs, along with substantial increases in lentigo maligna melanoma since the late 1990s at all sites apart from the lower limbs. CONCLUSIONS:   In this large study we have observed significant decreases in rates of invasive melanoma in the younger age groups on less frequently exposed body sites. These results may provide some indirect evidence of the impact of long-running primary prevention campaigns.

Grand tours in the glare of the sun : harnessing digital media to develop cultural tourism in Queensland, Australia

It has been well established that highlighting the cultural attributes of a region through stories of place, local histories, and the creative arts boosts tourism income to a region. Cultural tourism also serves to promote the creative industries to visitors and residents alike and, by enhancing a region’s cultural identity, fosters new opportunities for the arts. It can therefore offer considerable potential benefit to the creative economy in Australia. However, in comparison with Europe, where cultural tourism can rely upon an established historical, artistic and literary cultural identity that stretches back to Grand Tours of the seventeenth century, in Queensland, Australia the relatively new enterprise of cultural tourism must compete with visitor expectations of sun, surf and the natural landscapes, which have become the mainstay of tourism advertising. Moreover, in Queensland, it is essential to connect vast distances, diverse communities and a variety of cultural experiences. We must also take account of the expectations of contemporary tourists, who anticipate a digitally mediated travel experience and increasingly seek to connect with local communities in authentic ways. In this paper we consider the unique considerations that must be taken into account in the Queensland context and propose approaches to developing an integrated identity that embraces both the ‘great outdoors’ and the region’s cultural attributes. We make recommendations for providing the types of digitally mediated ‘local’ experiences that cultural tourists now expect, and illustrate the design principles we propose through early, tentative approaches to smart phones, locative media and augmented reality applications for cultural tourism in the region. We conclude by proposing additional ways to formulate a digital strategy in line with the recommendations we make.

Footprints to pathways : reconciliation action planning in industry to sustain Indigenous employment in Queensland

This paper provides an introductory discussion to a study focusing on industry Reconciliation Action Plans (RAP) and sustaining Indigenous employment in Queensland. Indigenous people continue to experience deep and persistent disadvantage in employment, which limits their life prospects (McLachlan, Gilgillan & Gordon, 2013). A major contributing factor to this detriment is irregular employment and or unemployment. A reasonable standard of living has been found to be determined by access to economic resources such as income and wealth. Denial of this access, denies access to income streams, social status, and engagement in meaningful activities. Hence, job loss and joblessness are triggers of disadvantage (McLachlan, et al., 2013). For young Indigenous people, lack of access has lasting effects particularly if they have multiple characteristics that place them at risk of disadvantage. The project aims to develop knowledge and understanding of Industry RAPs mediate employment opportunities for Indigenous people and how young Indigenous people conceive of their employment options and the processes by which employers can best support Indigenous people. It adopts two theoretical frameworks to investigate the aim of the study : (1) Lave and Wenger’s (1991) theory of communities of practice and, (2) Sen’s (1993) capability approach which provides a structure for examining individual well-being in the context of societal inequality. This paper discusses the first research question of the study: What are Industry Reconciliation Action Plans? What is included in RAPs? Why do Industries develop RAPs? How do RAPs attract, recruit, retain, and tenure Indigenous people? The project’s significance rests with its focus on Industry, employers, policies and practices that aid the attraction and retention of Indigenous people in employment.

Crisis Communication in Natural Disasters : The Queensland Floods and Christchurch Earthquakes

Over the past decade, social media have gone through a process of legitimation and official adoption, and they are now becoming embedded as part of the official communications apparatus of many commercial and public-sector organisations— in turn, providing platforms like Twitter with their own sources of legitimacy. Arguably, the demonstrated utility of social media platforms and tools in times of crisis—from civil unrest and violent crime through to natural disasters like bushfires, earthquakes, and floods—has been a crucial driver of this newfound legitimacy. In the mid-2000s, user-created content and ‘Web 2.0’ platforms were known to play a role in crisis communication; back then, the involvement of extra-institutional actors in providing and sharing information around such events involved distributed, ad hoc, or niche platforms (like Flickr), and was more likely to be framed as ‘citizen journalism’ or ‘crowdsourcing’ (see, for example, Liu, Palen, Sutton, Hughes, & Vieweg, 2008, on the then-emerging role of photo-sharing in disasters). Since then, the dramatically increased take-up of mainstream social media platforms like Facebook and Twitter means that the pool of potential participants in online crisis communication has broadened to include a much larger proportion of the general population, as well as traditional media and official emergency response organisations.

Re-visioning the Queensland Youth Sector : principles to inform the Queensland Government's youth strategy and review process

This discussion paper has been provided to assist the Department of Communities, Child Safety and Disability Services (DOCCSDS) in developing the Queensland Government’s Youth Strategy and inform the review of state government funded youth services. The paper lists a number of key concepts and social determinants which need to be considered in this undertaking. Additionally, it proposes a number key concepts and principles pertinent to understanding and working with young people, and for quality youth service provision.

Prevalence of health behaviours in pregnancy at service entry in a Queensland health service district

Objective: Limited prevalence data for unhealthy pregnancy health behaviours make it difficult to prioritise primary prevention efforts for maternal and infant health. This study's objective was to establish the prevalence of cigarette smoking, sufficient fruit and vegetable intake and sufficient physical activity among women accessing antenatal clinics in a Queensland (Australia) health service district. Method: Cross-sectional self-reported smoking status, daily fruit and vegetable intake, weekly physical activity and a range of socio-demographic variables were obtained from women recruited at their initial antenatal clinic visit, over a three-month recruitment phase during 2007. Results: Analyses were based on 262 pregnant women. The study sample was broadly representative of women giving birth in the district and state, with higher representation of women with low levels of education and high income. More than one quarter of women were smoking. Few women met the guidelines for sufficient fruit (9.2%), vegetables (2.7%) or physical activity (32.8%) during pregnancy. Conclusions: There were low levels of adherence to health behaviour recommendations for pregnancy in this sample. Implications: There is a clear need to develop and evaluate effective pregnancy behaviour interventions to improve primary prevention in maternal and infant health. Brief minimal contact interventions that can be delivered through primary care to create a greater primary prevention focus for maternal and infant health would be worth exploring.

Queensland small towns Documentary project

This photographic documentary project explores diverse stories of Queensland mining towns. Images compare the interplay between communities, commerce and natural resources. The project is a collaboration between three Brisbane universities (Queensland University of Technology, Griffith University and University of Queensland) and is supported by the Brisbane Powerhouse and the State Library of Queensland. Funded by a $50,000 Arts Queensland grant.

Investigating well-being and mental health in Queensland fire-fighters

This thesis used survey and interview methods to examine how organisational and interpersonal factors impact on the mental health of fire and rescue workers. It was the first published research to assess and predict multiple indicators of mental health; psychological distress, well-being, posttraumatic growth and posttraumatic stress disorder symptoms. The results provide valuable information for supporting fire and rescue workers through psychoeducation and proactive intervention programs.