Rural and Isolated Practice Registered Nurse (RIPRN)-Emergency nurses of the Queensland `bush'

The Rural and Isolated practice endorsement for Queensland Registered Nurses has attracted interest from other state health authorities with respect to expanding the scope of practice of nurses working in rural and remote Australia. This discussion article outlines the endorsement program and sheds a spotlight on the program for the emergency and greater nursing community. The paper draws a similarity between rural and emergency nursing and stimulates the notion that other states could look to Queensland's model, for scope of practice expansion in other specialties such as emergency Nursing.

Impulses towards a multifunctional transition in rural Australia: Gaps in the research agenda

The direction, complexity and pace of rural change in affluent, western societies can be conceptualized as a multifunctional transition, in which a variable mix of consumption and protection values has emerged, contesting the former dominance of production values, and leading to greater complexity and heterogeneity in rural occupance at all scales. This transition is propelled by three dominant driving forces, namely: agricultural overcapacity; the emergence of market-driven amenity values; and growing societal awareness of sustainability and preservation issues. Australia's generous supply of land and sparse investment in agriculture has facilitated local transitions towards enhanced consumption and protection values, enabling a clearer delineation of emerging differentiated modes of rural occupance than in more contested locales. In Australia seven distinctive modes of occupance can be identified, according to the relative precedence given to production, consumption or protection values. These modes are described as: productivist agricultural; rural amenity; small farm (or pluriactive); peri-metropolitan; marginalized agricultural; conservation; and indigenous. Within these seven modes, alternative trajectories are identified, indicating variability in the intensity and type of resource use. Articulation of the transition concept may provide synergy between discrete discourses in rural research. (c) 2005 Elsevier Ltd. All rights reserved.

Healthy waterways: Healthy catchments - An integrated research/management program to understand and reduce impacts of sediments and nutrients on waterways in Queensland, Australia

The Moreton Bay Waterways and Catchments Partnership, now branded the Healthy Waterways Partnership, has built on the experience of the past 15 years here in South East Queensland (SEQ). It focuses on water quality and the ecosystem health of our freshwater, estuarine and marine systems through the implementation of actions by individual partners and the collective oversight of a regional work program that assists partners to prioritise their investments and address emerging issues. This regional program includes monitoring, reporting, marketing and communication, development of decision support tools, research that is directed to problem solving, and maintaining extensive consultative and engagement arrangements. The Partnership has produced information-based outcomes which have led to significant cost savings in the protection of water quality and ecosystem resources by its stakeholders. This has been achieved by: – providing a clear focus for management actions that has ownership of governments, industry and community; – targeted scientific research to address issues requiring appropriate management actions; – management actions based on a sound understanding of the waterways and rigorous public consultation; and, – development and implementation of a strategy that incorporates commitments from all levels of stakeholders. While focusing on our waterways, the Partnership’s approach includes addressing catchment management issues particularly relating to the management of diffuse pollution sources in both urban and rural landscapes as well as point source loads. We are now working with other stakeholders to develop a framework for integrated water management that will link water quality and water quantity goals and priorities.

Never-married childless women in Australia: Health and social circumstances in older age

A growing proportion of women reach older age without having married or having children. Assumptions that these older women are lonely, impoverished, and high users of social and health services are based on little evidence. This paper uses data from the Older cohort of the Australian Longitudinal Study on Women's Health to describe self-reported demographics, physical and emotional health, and use of services among 10,108 women aged 73-78, of whom 2.7% are never-married and childless. The most striking characteristic of this group is their high levels of education, which are associated with fewer reported financial difficulties and higher rates of private health insurance. There are few differences in self-reported physical or emotional health or use of health services between these and other groups of older women. Compared with older married women with children, they make higher use of formal services such as home maintenance and meal services, and are also more likely to provide volunteer services and belong to social groups. Overall, there is no evidence to suggest that these women are a problem group. Rather, it seems that their life experiences and opportunities prepare them for a successful and productive older age. (c) 2005 Elsevier Ltd. All rights reserved.

Impact of Australia's Better Outcomes in Mental Health Care program on psychologists

The aim of this paper was to consider the impact on psychologists of one component of the Australian Government's Better Outcomes in Mental Health Care (BOiMHC) program, namely the Access to Allied Psychological Services (ATAPS) component. This supports psychologists and general practitioners (GPs) to work together to provide optimal mental health care, via 102 projects being conducted by Divisions of General Practice. The paper was informed by data from five sources: a project-based minimum dataset; local project evaluation reports; a forum; a survey of projects: and a survey of Australian Psychological Society (APS) members. Taken together, the data from these sources showed that a significant number of psychologists are providing services through the projects, and the majority are finding it a positive and professionally rewarding experience. There is considerable variability regarding models of retaining, locating and referring to psychologists, and there are pros and cons associated with each. The major problem identified by psychologists is the level of remuneration. BOiMHC is currently moving into a new phase of continuation and expansion, and consideration was given to whether the data point to any changes that could be made to the ATAPS projects during this period of transition. In the main, the data suggest that the status quo should be retained, but the issue of remuneration must be addressed.

Should future health-care costs be discounted? The case of diabetes in Australia [Editorial]

No Abstract

Socioeconomic disadvantage and changes in health risk behaviours in Australia: 1989-90 to 2001

Objective. Lower socioeconomic status (SES) is associated in industrialized countries with unhealthy lifestyle characteristics, such as smoking, physical inactivity and being overweight or obese. This paper examines changes over time in the association between SES and smoking status, physical activity and being overweight or obese in Australia. Methods. Data were taken from three successive national health surveys in Australia carried out in 1989-90 (n = 54 576), 1995 (n = 53 828) and 2001 (n = 26 863). Participants in these surveys were selected using a national probability sampling strategy, and aggregated data for geographical areas are used to determine the changing association between SES and lifestyle over time. Findings. Overall, men had less healthy lifestyles, In 2001 inverse SES trends for both men and women showed that those living in lower SES areas were more likely to smoke and to be sedentary and obese, There were some important socioeconomic changes over the period 1989-90 to 2001. The least socioeconomically disadvantaged areas had the largest decrease in the percentage of people smoking tobacco (24% decrease for men and 12% for women) and the largest decrease in the percentage of people reporting sedentary activity levels (25% decrease for men and 22% for women). While there has been a general increase in the percentage over time of those who are overweight or obese, there is a modest trend for being overweight to have increased (by about 16% only among females) among those living in areas of higher SES. Conclusion. Socioeconomic inequalities have been increasing for several key risk behaviours related to health; this suggests that T specific population-based prevention strategies intended to reduce health inequalities are needed.

General practice in Australia 2020: "robust and ready" or "rudderless and reeling"?

The future role and structure of Australian general practice remains uncertain, despite a decade of seemingly constant change following the release of the National Health Strategy papers. Some of the suggested change strategies (such as rural Practice Incentive Payments and practice accreditation) have been implemented; others (such as general practitioner involvement with area health authorities in delivering national goals and targets for communities) still await attention. An overarching vision for our health care system in 2020 and general practice's role within it are still to be clearly enunciated. Australia is at variance with other Western countries, such as the United Kingdom, Canada and New Zealand, which have spent significant time refocusing their health systems to deal with an ageing population with an increased burden of chronic disease. Health bureaucrats and governments need to invest strategically in operational primary care now. This will require the active commitment of general practice's national bodies to articulate and actively promote a shared vision for Australian general practice.

Do adults in contact with Australia's public sector mental health services get better

This paper describes the outcomes of episodes of care for adults in public sector mental health services across Australia, with a view to informing the debate on service quality. Health of the Nation Outcome Scales (HoNOS) change scores and effect sizes were calculated for 14,659 acute inpatient episodes and 23,692 community episodes. The results showed that people in contact with public sector mental health services generally do get better, although the magnitude of improvement depends on the setting and episode type. This confirmatory finding is particularly positive, given current community concerns about the quality and effectiveness of mental health services.