The interface of acute and aged care: the role of the nurse in provincial area

Objective: This study was to investigate issues that arose from pre-admission to post-discharge, for people in Toowoomba, Queensland over the age of 65 admitted to an acute facility. This paper concentrates on a significant concern that emerged from the latge amount of data collected during this project, that is, the role of the nurse in the continuum of health care involving elderly people.

Method: The study involved a multi-site, multi-agency and multi-method (qualitative and quantitative) approach. Data was collected from regional service providers, the Department of Health and Aged Care (DHAC), the Australian Bureau of Statistics (ABS), Home and Community Care (HACC), the Aged Care Assessment Team (ACAT), elderly people who had been discharged from regional hospitals and their carers, residents of regional aged care facilities, area health professionals and elderly regional hospital inpatients.

Results: The data indicated that nurses in this provincial area currently play a limited role in preadmission planning, being mostly concerned with elective surgery, especially joint replacements. While nurses deliver the majority of care during hospitalisation, they do not appear to be cognizant of the needs of the elderly regarding post-acute discharge.

Conclusion: The recent introduction of the model of nurse case management in the acute sector appears to be a positive development that will streamline and optimise the health care of the elderly across the continuum in the Toowoomba area. The paper recommends some strategies, such as discharge liaison nurses based in Emergency Departments and the expansion of the nurse case management role, which would optimise care for the elderly person at the interface of care.

Education as a determinant of health and well-being

This chapter is concerned with education as a factor in shaping life opportunities.  Education affects, and is affected by, individual and collective health and well-being.  It is now well established that the health and well-being of students impacts on their educational experience and outcomes, and that those experiences and outcomes impact on students' occupational futures, their future health and well-being and their level of participation as citizens.  Policy makers and practitioners are incresingly attentive to the relationship between education and health because of evidence highlighting the cyclical relationship between the economic and social conttext of schools, poor health and the well-being of students, and educational under-acheivement.

Modelling of birds and locust-control operations in Eastern Australia

Locust outbreaks provide an abundant, but unpredictable food source for many native species in Australia. For economic reasons, locust control is unavoidable and can affect a considerable area in Eastern Australia. Depending on the pesticide applied, locust control operations may affect birds in treated areas, either directly through intoxication of the predator, or indirectly, through elimination of its prey. As a preliminary step in identifying the potential impact of these operations on native species, the co-occurrence of birds and locust control operations was assessed using GIS mapping techniques. Data from the Birds of Australia New Atlas provided information about species' distribution between latitudes 17 and 37 degree S, and longitudes 136 and 152 degree E. Of the 834 species present in this region, 292 were chosen on the basis of their geographical distribution and occurrence west of the Great Dividing Range. Sightings for each species were mapped using reporting rates and number of observations per half-degree grid cells. Birds were categorised by habitat, distribution, movement and feeding habits and those species reported to consume Orthopterans were noted. APLC locust survey (1987–2000) and spraying data (1977–2002) were analysed and overlapped with soil and vegetation maps obtained from Geoscience Australia and Environment Australia to find significant hotspots for locust occurrence. These maps were then overlayed with bird distributions to identify the species most likely to be in areas of locust presence and spraying operations.

Approaching responsivity : the Victorian Department of Justice and Indigenous Offenders

Offender rehabilitation has developed a stronghold on correctional practice in the past two decades. Further strengthening this grip have been three main  principles for effective practice; risk, needs and responsivity. This paper will focus on the responsivity principle, which dictates that effective rehabilitation involves consideration of an offender's cognitive behavioural characteristics and appropriate program delivery. In particular, this paper will analyse how this task has been approached by the Victorian Department of Justice in relation to  Indigenous offenders. Drawing on recent interviews with Justice staff, it will be  shown that Justice's approach to being responsive to the needs of Victorian Indigenous offenders is more complex than addressing cognitive behavioural characteristics and program delivery. It involves meaningful interactions that extend beyond the Department of Justice and Indigenous offenders to include Indigenous communities.

Approaching responsivity : The Victorian Department of Justice and indigenous offenders

Effective rehabilitation involves consideration of offender's cognitive behavioural characteristics and appropriate program delivery - approach by the Victorian Department of Justice in relation to Aboriginal offenders - interviews with staff members show approach is more complex than addressing behavioural characteristics - involves interaction extending beyond the Department and offenders to include indigenous communities.

The Australian longitudinal study of health and relationships

Background

Ensuring the sexual and reproductive health of the population is essential for the wellbeing of a nation. At least three aspects of sexual and reproductive health are among the key policy issues for present Australian governments: maintaining and increasing the birth rate; reducing the abortion rate; and preventing and controlling Chlamydia infections.

The overall aim of the Australian Longitudinal Study of Health and Relationships is to document the natural history of the sexual and reproductive health of the Australian adult population.
Methods/design

A nationally representative sample of Australian adults 16–64 years of age was selected in a two-phase process in 2004–2005. Eligible households were identified through random digit dialling. We used separate sampling frames for men and women; where there was more than one eligible person in a household the participant was selected randomly. Participants completed a computer-assisted telephone interview that typically took approximately 25 minutes to complete. The response rate was 56%. A total of 8,656 people were interviewed, of whom 95% (8243) agreed to be contacted again 12 months later. Of those, approximately 82% have been re-contacted and re-interviewed in 2006–07 (Wave Two), with 99% of those agreeing to be contacted again for Wave Three.
Discussion

ALSHR represents a significant advance for research on the linked topics of sexual and reproductive health. Its strengths include the large sample size, the inclusion of men as well as women, and the wide age range of the participants.

Reliability and validity of psychosocial and environmental correlates measures of physical activity and screen-based behaviors among Chinese children in Hong Kong

Background : Insufficient participation in physical activity and excessive screen time have been observed among Chinese children. The role of social and environmental factors in shaping physical activity and sedentary behaviors among Chinese children is under-investigated. The purpose of the present study was to assess the reliability and validity of a questionnaire to measure child- and parent-reported psychosocial and environmental correlates of physical activity and screen-based behaviors among Chinese children in Hong Kong.

Methods : A total of 303 schoolchildren aged 9-14 years and their parents volunteered to participate in this study and 160 of them completed the questionnaire twice within an interval of 10 days. Intraclass correlation coefficients (ICCs), kappa statistics, and percent agreement were performed to evaluate test-retest reliability of the continuous and categorical variables, respectively. Exploratory factor analyses (EFAs) were conducted to assess convergent validity of the emergent scales. Cronbach's alpha and ICCs were performed to assess internal and test-retest reliability of the emergent scales. Criterion validity was assessed by correlating psychosocial and environmental measures with self-reported physical activity and screen-based behaviors, measured by a validated questionnaire.

Results : Reliability statistics for both child- and parent-reported continuous variables showed acceptable consistency for all of the ICC values greater than 0.70. Kappa statistics showed fair to perfect test-retest reliability for the categorical items. Adequate internal consistency and test-retest reliability were observed in most of the emergent scales. Criterion validity assessed by correlating psychosocial and environmental measures with child-reported physical activity found associations with physical activity in the self-efficacy scale (r = 0.25, P < 0.05), the peer support for physical activity scale (r = 0.25, P < 0.05) and home physical activity environmental (r = 0.14, P < 0.05). Children's screen-based behaviors were associated with the family support for physical activity scale (r = -0.22, P < 0.05) and parental role modeling of TV (r = 0.12, P = 0.053).

Conclusions : The findings provide psychometric support for using this questionnaire for examining psychosocial and environmental correlates of physical activity and screen-based behaviors among Chinese children in Hong Kong. Further research is needed to develop more robust measures based on the current questionnaire, especially for peer influence on physical activity and parental rules on screen-based behaviors.