The role of the print media in informing the community about safety in public hospitals in Victoria, Australia: the case of `golden staph`

Objective. In this article the authors explore how the print media contribute to information and education of the community on issues of safety and quality in the health services, since this is an important avenue of such information and education for many members of the community. Study design. The authors undertook a qualitative study of a random sample of articles in the Australian print press between 1996 and 2004 where ‘golden staph’ was presented as a major issue of risk to the safety of consumers of health services. The content of each article was examined with reference to several criteria including title, the source of the article, and the metaphorical language employed by the journalist.
Results. Results show that while the articles are substantially accurate as sources of information on concrete events, they do not serve as sources of education on issues of safety, typically apportioning blame and serving to maintain the status quo.
Conclusion. The authors conclude that print media are not a good source of community education in areas of safety and quality and do not assist members of the community to participate in addressing issues of safety in health services.

Environmental factors associated with adults' participation in physical activity- a review

Background: Promoting physical activity is a public health priority, and changes in the environmental contexts of adults’ activity choices are believed to be crucial. However, of the factors associated with physical activity, environmental influences are among the least understood. Method: Using journal scans and computerized literature database searches, we identified 19 quantitative studies that assessed the relationships with physical activity behavior of perceived and objectively determined physical environment attributes. Findings were categorized into those examining five categories: accessibility of facilities, opportunities for activity, weather, safety, and aesthetic attributes. Results: Accessibility, opportunities, and aesthetic attributes had significant associations with physical activity. Weather and safety showed less-strong relationships. Where studies pooled different categories to create composite variables, the associations were less likely to be statistically significant. Conclusions: Physical environment factors have consistent associations with physical activity behavior. Further development of ecologic and environmental models, together with behavior-specific and context-specific measurement strategies, should help in further  understanding of these associations. Prospective studies are required to identify possible causal relationships.

Levels of physical activity for colon cancer prevention compared with generic public health recommendations: population prevalence and sociodemographic correlates

Background: The proportion of Australian adults achieving physical activity levels believed to be sufficient for colon cancer prevention was estimated, and sociodemographic correlates (age, gender, educational attainment, occupation, marital status, and children in household) of meeting these levels of activity were analyzed.

Methods: Data from the 2000 National Physical Activity Survey were used to estimate the prevalence of participation in physical activity in relation to three criteria: generic public health recommendations, weekly amount of at least moderate-intensity physical activity currently believed to reduce risk of colon cancer, and weekly amount of vigorous-intensity physical activity believed to reduce risk of colon cancer.

Results: Overall, 46% of adults met the generic public health criterion, 26% met the colon cancer criterion based on participation in at least moderate-intensity physical activity, and 10% met the colon cancer criterion based on vigorous-intensity physical activity. Women were less likely than men to meet the colon cancer criteria. Younger and more educated persons were more likely to meet all three criteria. The most pronounced differences between gender, age, and educational attainment groups were found for meeting the amount of vigorous-intensity physical activity believed to reduce risk of colon cancer.

Conclusions: The population prevalence for meeting proposed physical activity criteria for colon cancer prevention is low and much lower than that related to the more generic public health recommendations. If further epidemiologic studies confirm that high volumes and intensities of activity are required, the public health challenges for colon cancer will be significant.

Sustainability and health : supporting global ecological integrity in public health

Radical changes in the biosphere and human interaction with the environment are increasingly impacting on the health of populations across the world. Diseases are crossing the species barrier, and spreading rapidly through globalized transport systems. From new patterns of cancer to the threat of global pandemics, it is imperative that public health practitioners acknowledge the interdependence between the sustainability of the environment and the sustainability of the human species.* Why are issues of global and local sustainability of increasing importance to the public's health?* Why do issues of sustainability require new practices within the professions of public health?* How can future and current public health practitioners develop those new practices?Drawing on scientific evidence of global and local environmental changes, Sustainability and Health offers a thorough background and practical solutions to the overlapping issues in environment and health. It examines potential and existing responses to global and local environment and health issues, involving individuals, community, industry and government. The authors introduce a range of emerging conceptual frameworks and theoretical perspectives, link IT and epidemiology and explain how scoping can link program design, delivery, data collection and evaluation in projects from their very beginning. Public health practitioners need to be able to manage health issues that cut across environmental, economic and social systems and to develop the capacity for leadership in facilitating change. Incorporating learning activities, readings, international case studies and an open learning approach, this is a valuable resource for students of public and environmental health, as well as medical, environmental and health science professionals.

Australia local government and e-governance : from administration to citizen participation

This chapter analyses local government’s response to the pressure to modernise its structures through its use of Information Communication Technologies (ICT) to execute its broad range of tasks. The chapter begins by discussing Chadwick and May’s (2003) three basic models of e-government; managerial, consultative and participatory. Using data collected from an analysis of 658 local government websites in Australia together with existing survey research the chapter then analyses the extent to which local government sites fit into the three models. The chapter concludes with a discussion of the issues and problems faced by local government in its attempt to develop e-governance as both an extension of administrative as well as democratic functions.

How socio-economic status contributes to participation in leisure-time physical activity

The aim of this cross-sectional study was to identify individual, social, and environmental contributors (mediators) to individual- and area-level differences in leisure-time physical activity across socio-economic groups. A two-stage stratified sampling design was used to recruit 20–65 year old adults (N = 2194) living in 154 census collection districts of Adelaide, Australia (overall response rate: 12%). Participants completed two surveys six months apart (response rate on the second survey: 83%). Individual-level socio-economic status (SES) was assessed using self-report measures on educational attainment, household income, and household size. Area-level SES was assessed using census data on median household income and household size for each selected census district. Bootstrap generalized linear models were used to examine associations between SES, potential mediators, and leisure-time physical activity. The product-of-coefficient test was used to estimate mediating effects. All SES measures were independently associated with potential individual and social mediators of the SES-activity relationships. Individual- and area-level income was also associated with perceived neighborhood attributes. Self-efficacy and social support for physical activity explained virtually all of the differences in physical activity across educational attainment groups. Physical barriers to walking and access to public open space contributed in part to the explanation of differences in recreational walking across income groups. Yet, self-efficacy and social support were the key mediators of the observed relationships between individual- and area-level income and physical activity. This study suggests that in order to increase physical activity participation in the more disadvantaged segments of the population, comprehensive, multilevel interventions targeting activity-related attitudes and skills as well as social and physical environments are needed.

Individual, social and environmental determinants of participation in physical activity for prostate cancer survivors

Participation in physical activity helps prostate cancer survivors to cope with the side effects of treatment, enhances quality of life and decreases the risks of many of the comorbidities to which survivors are highly susceptible. Prostate cancer survivors, however, are less likely than other cancer survivors (e.g., breast and colorectal) to increase physical activity after diagnosis. Interventions have been only modestly successful at increasing participation in physical activity for prostate cancers survivors and more research is needed to increase our understanding of the determinants of physical activity for this group. Using a social ecological framework, this qualitative research sought to examine the individual, social and environmental determinants of participation in physical activity for prostate cancer survivors. In-depth interviews were conducted with 20 survivors of prostate cancer aged between 35 and 75 years. Participants were drawn from a public and a private health service and from a range of treatment types. We are currently collecting data for this study and preliminary themes will be discussed at the conference (abstract will be updated once findings are known).

Life-change events and participation in physical activity : a systematic review

Physical inactivity and related diseases are of global public health concern. In many developing countries, levels of health promoting physical activity (PA) are falling despite government initiatives. Previous work has identified that periods of transition across a life course, or ‘life-change events’ have implications for drop out from PA. As yet, there has been little work to understand the life course as a whole and to furnish a complete list of possible life changes that might affect participation in PA. Our paper presents a review of the published literature in which life events have been studied in relation to their effect on participation in PA. A literature search was conducted for papers published between 1977 and April 2007 and referenced in Pubmed. Papers were reviewed if they; reported the effect of a life-change event; had PA as an outcome; reported results in English; and reported results from observational studies. The references for studies identified during this first phase were searched for further papers. Eighty-seven papers were identified as potentially relevant on the basis of title, of which 19 papers met the inclusion criteria on the basis of full text. Five life changes were identified; change in employment status; change in residence; change in physical status; change in relationships; and change in family structure. It was noted that few longitudinal studies examined PA both before and after a life event. A list of possible life events which might effect participation in PA is presented. This paper represents a first step towards a detailed programme of work on life-change events and PA.

Parental exercise is associated with Australian children's extracurricular sports participation and cardiorespiratory fitness : a cross-sectional study

Background: The relationship between parental physical activity and children's physical activity and cardiorespiratory fitness has not been well studied in the Australian context. Given the increasing focus on physical activity and childhood obesity, it is important to understand correlates of children's physical activity. This study aimed to investigate whether parental exercise was associated with children's extracurricular sports participation and cardiorespiratory fitness.

Methods: The data were drawn from a nationally representative sample (n = 8,484) of 7–15 year old Australian schoolchildren, surveyed as part of the Australian Schools Health and Fitness Survey in 1985. A subset of 5,929 children aged 9–15 years reported their participation in extracurricular
sports and their parents' exercise. Cardiorespiratory fitness was measured using the 1.6 km (1- mile) run/walk and inaddition for children aged 9, 12 or 15 years, using a physical work capacity test (PWC170).

Results: While the magnitude of the differences were small, parental exercise was positively associated with children's extracurricular sports participation (p < 0.001), 1.6 km run/walk time (p < 0.001) and, in girls only, PWC170 (p = 0.013). In most instances, when only one parent was active, the sex of that parent was not an independent predictor of the child's extracurricular sports participation and cardiorespiratory fitness.

Conclusion: Parental exercise may influence their children's participation in extracurricular sports and their cardiorespiratory fitness levels. Understanding the correlates of children's extracurricular sport participation is important for the targeting of health promotion and public health interventions, and may influence children's future health status.

Exploring the relationship between media coverage and participation in entrepreneurship : initial global evidence and research implications

Using a set of variables measured in the Global Entrepreneurship Monitor (GEM) study, our empirical investigation explored the influence of mass media through national culture on national entrepreneurial participation rates in 37 countries over 4 years (2000 to 2003). We found that stories about successful entrepreneurs, conveyed in mass media, were not significantly associated with the rate of nascent (opportunity searching) or the rate of actual (business activities commenced up to 3 months old) start-up activity, but that there was a significant positive association between the volume of entrepreneurship media stories and a nation’s volume of people running a young business (that is in GEM terminology, a business aged greater than 3 but less than 42 months old). More particularly, such stories had strong positive association with opportunity oriented operators of young businesses. Together, these findings are compatible with what in the mass communications theory literature may be called the ‘reinforcement model’. This argues that mass media are only capable of reinforcing their audience’s existing values and choice propensities but are not capable of shaping or changing those values and choices. In the area covered by this paper, policy-makers are committing public resources to media campaigns of doubtful utility in the absence of an evidence base. A main implication drawn from this study is the need for further and more sophisticated investigation into the relationship between media coverage of entrepreneurship, national culture and the rates and nature of people’s participation in the various stages of the entrepreneurial process.

Public and stakeholder values and knowledge of wildlife in Victoria, Australia

Prompted by a lack of human dimensions research in Australia, this study investigated the values and knowledge relating to wildlife held by members of the public within distinct demographic subsets of the Victorian population and members of wildlife management stakeholder groups; and compared these characteristics with how Victorian wildlife managers perceive these groups. A combination of semi-structured interviews and postal questionnaires were used. Fifteen in-depth interviews were conducted to explore how wildlife managers perceive the values and knowledge of wildlife held by members of various subsets of the Victorian population. A total of 1,431 questionnaires were completed by members of 13 public and stakeholder groups throughout Victoria, and these were analysed to explore values and knowledge relating to wildlife in Victoria. The findings of this study suggest that Victorian people have a strong emotional attachment to individual animals (the humanistic value), and an interest in learning about wildlife (the curiosity/learning/interacting value). The dominionistic/wildlife-consumption, utilitarian-habitat, aesthetic and negativistic values were not expressed by the majority of respondents from the public samples. The data also suggest that Victorian people have relatively low levels of factual knowledge about Australian wildlife. Thus, wildlife managers should expect support for wildlife management objectives that reflect the strong humanistic orientation of Victorians and tailor management and education programs to appeal to this value and Victorians' interest in learning about wildlife. Members of the Field Naturalists Club of Victoria (FNCV), Bird Observers Club of Australia (BOCA), Australian Conservation Foundation (ACF) stakeholder groups and management agency Parks Victoria expressed a strong interest in learning about wildlife. Members of the Royal Society for the Prevention of Cruelty to Animals (RSPCA) obtained high humanistic value scores; and members of the Victorian Field and Game Association (VFGA) obtained high domimomstic/wildlife-consumption value scores. Importantly, the humanistic and curiosity/learning/interacting values were the most strongly expressed values in all six groups and these values could be the key to more effective communication and collaboration between groups. Relationships between demographic factors, and values and knowledge relating to wildlife were found. For example, rural Victorians held a stronger dominionistic/ wildlife-consumption value than urban Victorians; females held stronger humanistic, curiosity/learning/interacting and negativistic values than males; young Victorians (18-34 years) held a lower curiosity/learning/interacting value and lower factual knowledge of wildlife than older Victorians; and more highly educated Victorians were more knowledgeable about wildlife than people with less formal education. No statistically significant differences were found between the values and knowledge of wildlife held by different income classes. While relationships between demographic factors, and values and knowledge relating to wildlife were found, they were generally much smaller than expected based on wildlife managers' perceptions and previous research. For example, the results suggest that Victorian females have a slightly stronger humanistic value of wildlife than males do. However, the important message emerging from the data is that males and females both express a strong emotional attachment to individual animals. Importantly, the results indicate that the effects of demographic factors on values and knowledge relating to wildlife are not always consistent across different geographic locations and stakeholder groups. For example, the slightly stronger interest in learning about wildlife among females when compared with males was observed in the rural and urban-fringe samples but not in the urban samples. This suggests that caution must be used when generalising the findings from human dimensions studies from one type of community or stakeholder group to another. Management programs should be tailored to the specific characteristics of the target audience. The findings also indicate that Victorian wildlife managers have diverse perceptions about the values and knowledge of wildlife held by members of different publics and stakeholder groups, and that the perceptions held by wildlife managers are not always consistent with the actual values and knowledge of wildlife held by members of different publics and stakeholders. For example, counter to the perceptions expressed by the interviewed wildlife managers, the interest in and factual knowledge of wildlife held by members of voluntary conservation groups equalled or surpassed that of wildlife managers; young Victorian adults (18-34 years) held a slightly lower curiosity/learning/interacting value and slightly lower level of factual knowledge of wildlife than older Victorians; and rural and urban communities in Victoria held low dominionistic and utilitarian values. Such discrepancies highlight the importance of investigating the actual values and knowledge held by members of such groups, so that appropriate and effective wildlife management programs can be implemented. Inaccurate perceptions and assumptions may contribute to ineffective communication between managers, stakeholders and publics; and adversely effect the success of wildlife management programs.

Geelong community's priorities and expectations of public health care

Abstract This thesis set out to achieve the following objectives: (1) To identify the priorities and expectations that the Geelong community has of its public health care system. (2) To determine if there is a common view on the attributes of a just health system. (3) To consider a method of utilising the data in the determination of health care priority setting in Barwon Health. (4) To determine a model of community participation which enables ongoing input into the decision making processes of Barwon Health. The methodology involved a combination of qualitative and quantitative research. The qualitative work involved the use of focus groups that were conducted with 64 members of the Geelong community. The issues raised informed the development of the interview schedule that was the basis of the quantitative study, which surveyed a representative sample of 400 members of the Geelong community. Prior to reporting on this work, the areas of distributive justice, scarcity and community participation in health care were considered. The research found that timely access to public hospitals, emergency care and aged care services were the major priorities; for many people, the cost was less relevant than a quality service. Shorter waiting times and increased staffing levels were strongly supported. Increased taxes were nominated as the best means of financing the health system they sought. Community based services were less relevant than hospital services but health education was supported. An egalitarian approach to resource distribution was favoured although the community was prepared to discriminate in favour of younger people and against older people. There was strong support for the community to be involved in decision making in the public health care system through surveys or focus groups but very little support was given to priorities being determined by politicians, administrators and to a lesser extent, medical professionals.

Improving collaboration between private psychiatrists, the public mental health sector and general practitioners : evaluation of the Partnership Project

Objectives: We describe the evaluation of the Partnership Project, which was designed to improve linkages between public and private sector mental health services. We consider the Project's key elements: a Linkage Unit, designed to improve collaborative arrangements for consumers and promote systems-level and cultural change; and the expansion of private psychiatrists' roles to include supervision and training, case conferencing and secondary consultation. The evaluation aimed to describe the impacts and outcomes of these elements.

Method: The evaluation used de-identified data from the Linkage Unit database, the Project's billing system, and the Health Insurance Commission (HIC). It drew on consultations with key stakeholders (semistructured interviews with 36 key informants, and information from a forum attended by over 40 carers and a meeting of five public sector and three private sector psychiatrists) and a series of case studies.

Results: The Linkage Unit facilitated 224 episodes of collaborative care, many of which had positive outcomes for providers, consumers and carers. It had a significant impact at a systems level, raising consciousness about collaboration and influencing procedural changes. Thirty-two private psychiatrists consented to undertaking expanded roles, and the Project was billed $78 032 accordingly. Supervision and training were most common, involving 16 psychiatrists and accounting for approximately 80% of the total hours and cost. Commonwealth expenditure on private psychiatrists' participation in the expanded roles was not associated with a reduction in benefits paid by the HIC. Key informants were generally positive about the expanded roles.

Conclusions: The Project represented a considered, innovative approach to dealing with poor collaboration between the public mental health sector, private psychiatrists and GPs. The Linkage Unit achieved significant systems-level and cultural change, which has the potential to be sustained. Expanded roles for private psychiatrists, particularly supervision and training, may improve collaboration, and warrant further exploration in terms of costs and benefits.