A review of three years experience using email and videoconferencing for the delivery of post-acute burns care to children in Queensland

A virtual outpatient service has been established in Queensland for the delivery of post-acute burns care to children living in rural and remote areas of the state. The integration of telepaediatrics as a routine service has reduced the need for patient travel to the specialist burns unit situated in Brisbane. We have conducted 293 patient consultations over a period of 3 years. A retrospective review of our experience has shown that post-acute burns care can be delivered using videoconferencing, email and the telephone. Telepaediatric bums services have been valuable in two key areas. The first area involves a programme of routine specialist clinics via videoconference. The second area relates to ad-hoc patient consultations for collaborative management during acute presentations and at times of urgent clinical need. The families of patients have expressed a high degree of satisfaction with the service. Telepaediatric services have helped improve access to specialist services for people living in rural and remote communities throughout Queensland. (C) 2003 Elsevier Ltd and ISBI. All rights reserved.

Type of housing predicts rate of readmission to hospital but not length of stay in people with schizophrenia on the Gold Coast in Queensland

Accommodation is considered to be important by institutions interested in mental health care both in Australia and internationally. Some authorities assert that no component of a community mental health system is more important than decent affordable housing. Unfortunately there has been little research in Australia into the consequences of discharging people with a primary diagnosis of schizophrenia to different types of accommodation. This paper uses archival data to investigate the outcomes for people with schizophrenia discharged to two types of accommodation. The types of accommodation chosen are the person's own home and for-profit boarding house. These two were chosen because the literature suggests that they are respectively the most and least desirable types of accommodation. Results suggest that people with schizophrenia who were discharged to boarding houses are significantly more likely to be readmitted to the psychiatric unit of Gold Coast Hospital although their length of stay in hospital is not significantly different. (author abstract)

Attracting, recruiting and retaining male teachers: policy issues in the male teacher debate

Frequent calls for more male teachers are being made in English-speaking countries. Many of these calls are based upon the fact that the teaching profession has become (even more) 'feminized' and the presumption that this has had negative effects for the education of boys. The employment of more male teachers is sometimes suggested as a way to re-masculinize schools so they become more 'boy-friendly' and thus contribute to improving boys' school performance. The focus of this paper is on an Australian education policy document in the state of Queensland that is concerned with the attraction, recruitment and retention of male teachers in the government education system. It considers the failure of this document, as with many of the calls for more male teachers, to take into account complex matters of gender raised by feminism and the sociology of masculinities. The paper then critiques the primary argument given for the need for more male teachers: that is, that male teachers provide boys with much needed role models.

Social inclusion, new regionalism and associational governance: The Queensland experience

In recent years there has been a resurgence of decentralized social governance concerned with the spatial dimensions of disadvantage. This article examines aspects of this resurgence in the Australian state of Queensland where, after the hasty birth of 'place management' in response to the rise of 'Hansonism', a plethora of 'joined-up' policy initiatives were undertaken in relation to the regional dimensions of poverty. We propose that these trends reflect in part new ways of thinking about the spatial aspects of disadvantage which have emerged in recent years and which have the potential to take regional policy beyond the narrow confines imposed by neoliberal economic orthodoxy. These new ways of thinking have arisen in social policy through the refraining of disadvantage in terms of social exclusion and in regional economic policy through the influence of the so-called 'new regionalism'. The article shows how together these bodies of theory point us towards a new model of 'associational governance'. The article reviews recent Queensland experience and indicates those features of 'associational governance' which have become characteristic of locality-based social policy ideas in Queensland. 'Joined-up' and regional policy aspirations of the Queensland State government have shown the influence of these new approaches. The political and policy sustainability of these trends, however, is uncertain. The lingering shadow of managerialism and neoliberal policy frameworks remains a significant barrier to the innovation and viability of these approaches. More directly, the inherent limits of the 'local' or 'regional' initiatives in the face of broader national and global factors will significantly constrain the capacity of associational governance systems to deliver positive democratic, social and economic outcomes. The article examines recent Queensland policy refors in light of this complex set of factors and concludes by offering directions for future research and policy development.

Diagnosis of autistic spectrum disorders in Queensland: Variations in practice

Objective: For both paediatricians and child psychiatrists, referrals to assess possible autistic spectrum disorders (ASD) are increasing. This study examines current practices of medical specialists in the assessment of these disorders. Methods: An anonymous, self-report questionnaire was sent to all Queensland paediatricians and child psychiatrists. The survey elicited frequencies of consultation for ASD, diagnostic method, advice provided and perceived adequacy of training for this work. Results: Responses were received from 79 (85%) eligible paediatricians and 26 (58%) eligible child psychiatrists. For one-third of all clinicians, new consultations for possible ASD occurred as often as 2-3 times per week. Most specialists approached the clinical diagnosis of ASD by considering history from different sources and professional assessments. Paediatricians (86%) were more likely than child psychiatrists (62%) to request genetic studies for children with severe autism (P = 0.01). Both general paediatricians and developmental paediatricians perceived level of training for possible ASD consultations was significantly worse than child psychiatrists (P < 0.001 and P = 0.02, respectively), but no difference was found between paediatric groups (P = 0.27). Perceived adequacy of specialist training was not associated with length of experience in clinical practice. Conclusion: Medical practice in Queensland around diagnosis of ASD is characterized by considerable variability. There is still a long way to go if we are to achieve consistency around medical issues of organic diagnosis and practices impacting on health as well as consideration of differential developmental diagnoses. The finding that recently trained paediatricians felt just as unprepared for this work as their older colleagues suggests that the graduate training response to this 'new morbidity' has not been adequate.

Effectiveness of screening for risk of medical emergencies in the elderly

Study objective: UK government policy mandates the introduction of 'intermediate care services' to reduce emergency admissions to hospital from the population aged 75 years or more. We evaluated one of these initiatives-the Keep Well At Home (KWAH) Project-in a West London Primary Care Trust. Design: KWAH involves a two-phase screening process, including a home visit by a community nurse. We employed cohort methods to determine whether KWAH resulted in fewer emergency attendances and admissions to hospital in the target population, from October 1999 to December 2002. Results: estimated levels of coverage in the two phases of screening were 61 and 32%, respectively. The project had not maintained records of which additional health and social care services had been delivered following screening. The rates of emergency admissions to hospital in the 9 months before screening were similar in practices that did and did not join the project (rate ratio (RR) = 1.05; 95% CI 0.95-1.17), suggesting absence of volunteer bias. Over the first 37 months of the project, there was no significant impact on either attendances at Accident & Emergency departments (RR = 1.02; 95% CI 0.97-1.06) or emergency admissions of elderly patients (RR = 0.98; 95% CI 0.93-1.05). Conclusion: the KWAH Project has been ineffective in reducing emergency admissions among the elderly. Significant questions arise in relation to selection of the screening instruments, practicality of achieving higher coverage of the eligible population, and creation of a new postcode lottery.

Stress in veterinary science students: A study at the University of Queensland

This paper reports on the results of a survey of selected University of Queensland (UQ) veterinary students aimed at elucidating factors causing stress during the five undergraduate years of the program. Students from each of the five years were asked to form six- or seven-member focus groups. Each focus group was then interviewed and their opinions sought on causes of ongoing stress and the ranking of those causes into predetermined categories. They were also asked to give their opinions on counseling services available within the university and what, if any, services they would like to see in place to help students with stress-related problems. Students in the first, third, and fourth years of the program rated academic issues as the most likely causes of ongoing stress, while students in the second and fifth years of the program ranked lifestyle and financial issues as more likely to cause ongoing stress. in most cases, students coped well with these causes of stress and tended not to use counseling services available to all UQ students. When faced with stressful issues, students looked to their classmates or family members for help and not to university counseling services. Students were also happy to approach staff members in the Veterinary School when faced with a problem. The authors nevertheless conclude that mechanisms set in place at the undergraduate level to help veterinary students cope with stress should particularly benefit those students when they become new graduates and are faced with the stresses of veterinary practice.

On measuring wealth: A case study on the state of Queensland

In order for policy makers to plan effectively for sustainable development, there is a need for measures of welfare that consider changes in the natural capital stock. Current measures based on conventional national accounting are flawed because they are based solely on flow measures and do not account for environmental effects. In this paper, we use an expanded measure of wealth to estimate the value of natural capital for Queensland. The state's stock of natural capital is valued at A$355.6 billion, of which non-timber forest resources account for 45.3%, ecosystem services 20.0%, and mineral resources 17.6%. This figure is a conservative estimate of the true value since some significant components such as the ecological and life-support functions of the environment are excluded. The estimates highlight the relative importance of different forms of natural capital and can be used to draw the attention of policymakers to the need to give adequate weight to the value of such services in decision-making processes. (c) 2005 Elsevier Ltd. All rights reserved.

How useful is the genuine savings rate as a sustainability indicator for regions within countries? Australia and Queensland compared

This article shows how macroeconomic indicators of sustainable development can be applied to the Queensland economy. While recognising the complex and contentious theoretical and practical issues in deriving the Genuine Savings Rate (GSR) to serve as such an indicator, we use the World Bank's methodology, which includes only mineral depletion, deforestation and carbon dioxide emissions as environmental terms, to estimate GSRs for Queensland for the period 1989 to 1999, and compare these to World Bank estimates of Australia's GSR for the same period. We find that Queensland has a higher rate of natural resource depletion and a lower GSR than the whole of Australia. We also examine how well the World Bank GSR performs as a 'headline' measure of overall sustainability, review criticisms of the GSR, and compare its implicit policy implications with those of net state savings, and of the GSR plus a suite of other indicators.

Think global, act global: Corporate content streaming and Australian media policy

Australia ’s media policy agenda has recently been dominated by debate over two key issues: media ownership reform, and the local content provisions of the Australia–United States Free Trade Agreement. Challenging the tendency to analyse these issues separately, the article considers them as interlinked indicators of fundamental shifts occurring in the digital media environment. Converged media corporations increasingly seek to achieve economies of scale through ‘content streaming’: multi-purposing proprietary content across numerous digitally enabled platforms. This has resulted in rivalries for control of delivery technologies (as witnessed in media ownership debates) as well as over market access for corporate content (in the case of local content debates). The article contextualises Australia’s contemporary media policy flashpoints within international developments and longer-term industry strategising. It further questions the power of media policy as it is currently conceived to deal adequately with the challenges raised by a converging digital media marketplace.