Outcome measurement of community based mental health services in Western Australia: literature and concept summary

The paper aims to provide a brief overview of key ideas related to outcome measurement relevant to community based mental health services and their consumers in WA. Due to the breadth of scope of the paper, it is not an extensive or rigorous literature review but provides a scan of the literature that could shape a more thorough literature review in any of the content areas. The paper has been written with the aim of informing the sector of key ideas, issues, concepts and approaches.

From institutional care to living in South Australia: intercountry adoption

The adoptees' narratives have illustrated the difficulties that they were confronted with when transitioning to a new world. Their remarkable use of self-efficacy enabled them in overcoming deprivation and abuse and leading a better life in Australia. The quality of the post-institutional care was directly related to the adoption outcomes.

Utilisation of general practitioner services and achievement of guideline targets by people with diabetes who joined a peer-support program in Victoria, Australia

This paper describes the use of general practitioner (GP) services and achievement of guideline targets by 285 adults with type 2 diabetes in urban and regional areas of Victoria, Australia. Anthropometric and biomedical measures and responses to a self-administered questionnaire were collected. Findings indicate that almost all participants had visited a GP and had had their hypoglycated haemoglobin (HbA1c) measured in the past 6 months; less than one-third had visited a practice nurse. Fifty per cent achieved a HbA1c target of ≤7.0%; 40%, a total cholesterol ≤4.00 mmol/L; 39%, BP Systolic ≤130 mmHg; 51%, BP Diastolic ≤80 mmHg; 15%, body mass index ≤25 kg/m2; and 34% reported a moderately intense level of physical activity, that is, ≥30 min, 5 days a week. However, 39% of individuals achieved at least two targets and 18% achieved at least three of these guideline targets. Regional participants were more likely to report having a management plan and having visited a practice nurse, but they were less likely to have visited other health professionals. Therefore, a more sustained effort that also includes collaborative care approaches is required to improve the management of diabetes in Australia.

Adaptation to climate change in regional Australia : a decision-making framework for modelling policy for rural production

A decision-making framework was developed and applied in regional Australia to identify adaptation issues arising in agricultural systems and rural production as a consequence of climate change. Australian agriculture is very susceptible to the adverse impacts of climate change, with major shifts in temperature and rainfall projected. An advantage of the framework is that it provides a suite of tools to aid in the formulation of strategies for sustainable regional development and adaptation. The decision-making framework uses a participatory approach that integrates land suitability analysis with uncertainty analysis and spatial optimisation to determine optimal agricultural land use (at a regional scale) for current and possible future climatic conditions. It thus provides a robust analytic approach to (i) recognise regions under threat of productivity declines, (ii) identify alternative cropping systems better adapted to likely future climatic conditions and (iii) investigate policy actions to improve the sub-optimal situations created by climate change. The decision-making framework and its methods were applied in a case study of the South West Region of Victoria.

A history of wastewater irrigation in Melbourne, Australia

Reclamation of wastewater for irrigation has had an important role to play in Melbourne’s struggle to manage water resources as effectively as possible. Rapid growth within the first few years of the founding of the city led to a sanitary crisis, which provided the impetus for the construction of a large sewerage system. Interest in using the effluent from sewage treatment plants for irrigation gained attention in the late 1970s, but despite some activity in the early 1980s, it was not until 2005 that large-scale wastewater irrigation schemes became a reality. Successful to a degree, there have also been problems, and the future viability of one large irrigation scheme for commercial vegetable production is threatened by high salt concentrations in the treated wastewater. Greywater irrigation at the household level has also become commonplace in Melbourne over the last decade, but it is difficult to regulate and the health risks urgently need to be quantified. More recently, several third-pipe schemes, where treated wastewater is reticulated to households, have been commissioned with plans for many more, and treated stormwater is growing in popularity, particularly for irrigation of public open spaces.

Improving transfer of mental health care for rural and remote consumers in South Australia

In Australia, it is commonplace for tertiary mental health care to be provided in large regional centres or metropolitan cities. Rural and remote consumers must be transferred long distances, and this inevitably results in difficulties with the integration of their care between primary and tertiary settings. Because of the need to address these issues, and improve the transfer process, a research project was commissioned by a national government department to be conducted in South Australia. The aim of the project was to document the experiences of mental health consumers travelling from the country to the city for acute care and to make policy recommendations to improve transitions of care. Six purposively sampled case studies were conducted collecting data through semistructured interviews with consumers, country professional and occupational groups and tertiary providers. Data were analysed to produce themes for consumers, and country and tertiary mental healthcare providers. The study found that consumers saw transfer to the city for mental health care as beneficial in spite of the challenges of being transferred over long distances, while being very unwell, and of being separated from family and friends. Country care providers noted that the disjointed nature of the mental health system caused problems with key aspects of transfer of care including transport and information flow, and achieving integration between the primary and tertiary settings. Improving transfer of care involves overcoming the systemic barriers to integration and moving to a primary care-led model of care. The distance consultation and liaison model provided by the Rural and Remote Mental Health Services, the major tertiary provider of services for country consumers, uses a primary care-led approach and was highly regarded by research participants. Extending the use of this model to other primary mental healthcare providers and tertiary facilities will improve transfer of care.

Meta-analysis and research synthesis in education

This bibliography begins with this introduction followed by a general overview of meta-analysis and research synthesis methods in education. The third section cites references to illustrate how the concept of statistical integration of research findings dates back to early 20th century. Citations in the fourth section highlight early calls from educational researchers to recognize the process of synthesizing research as a scholarly endeavor in its own right. As evident from the citations in the fifth section, it was in the 1980s when monographs exclusively devoted to research synthesis methods started to be published. Since then, a number of books have been published on research synthesis methods. The sixth section cites some of the most comprehensive books on research synthesis methods and includes contributions from key players of meta-analysis current at the time. The citations in the seventh section illustrate how meta-analysis has become very popular over time. Several large organizations have been set up and software developed to support systematic reviews of research. These are cited in the eighth section. Citations in the ninth section illustrate critiques of systematic reviews. As qualitative research is becoming popular in education, sophisticated discussions of issues associated with synthesizing qualitative research have also been published, some of which are cited in the tenth section. The eleventh section presents a methodologically inclusive account of current developments in research synthesis methods. The final section cites examples of journals exclusively devoted to publishing research reviews and exemplary research synthesis with different methodologies. Individual methods of research synthesis are discussed chronologically as they became popular in educational research. Accordingly, this bibliography starts with a discussion of statistical methods of integrating research that parallels the dominance of quantitative research in education until the 1970s. As the popularity and diversity of qualitative research methods have been increasing in educational research, more methodologically inclusive discussions of research synthesis methods are becoming popular as described in the later sections of this bibliography.

Correlates of criminal victimisation among police cell detainees in Victoria, Australia

People with mental illness are more likely to be crime victims than others; however, little is known about the relationship between offending and victimisation among mentally ill offenders. This study investigated the rates and types of victimisation among people detained in police cells (N = 764), with and without histories of mental illness. Those with mental disorders were 1.56 times (95% CI = 1.11–2.17) more likely to be victims of violent crimes than other detainees. Some subgroups of people with mental disorders were not over-represented as victims, raising the possibility that they were less inclined to report certain types of crimes. Implications are discussed with reference to police practice.

Patterns and perceptions of physical activity and sedentary time in male transport drivers working in regional Australia

 Abstract

Objective: To objectively measure physical activity (PA) patterns and sedentary time, and explore perceptions of workplace PA opportunities in regional male transport workers.

Methods: A multi-method study involving 28 drivers (52.4±9.69years) working at a bus company in South-East Queensland, Australia. PA was measured using accelerometers (n=23) to determine the proportion of time spent in sedentary (<150 cpm), light (151–2,689 cpm) and moderate+ (≥2,690 cpm) intensity categories. Paired sample t-tests were used to evaluate differences between categories on a workday/off-workday (n=16), and during work/non-work time (n=15). Interviews were conducted with 28 drivers and six managers to explore perceptions and ideas relating to workplace PA opportunities.

Results: Sedentary time was significantly higher on off-work (64% of wear time) than work (52%) days (p<0.05), while the opposite was the case for light intensity time (off-workday=33%; workday=44%; p<0.05). On workdays, sedentary time was significantly lower when employees were working (44%) than when not working (60%; p<0.05). No significant differences were found for time spent in moderate+ PA. Driver perceptions indicated that PA opportunities (walking club and corporate gym membership) were being adopted by some drivers. However, at this depot, perceived health issues and organisational barriers (shift work and irregular driving routines), tended to preclude some drivers from engaging with these opportunities.

Conclusions: Findings contest the notion that a sedentary occupation such as driving necessitates an inactive work environment.

Implications: This research informs ongoing intervention efforts to target inactive drivers who are struggling to take advantage of existing workplace-related PA opportunities.