Are health expenditures and GDP characterized by asymmetric behaviour? Evidence from 11 OECD countries

In this article, we examine whether per-capita health expenditures and per-capita GDP for 11 OECD countries can be characterized by asymmetric behaviour. We achieve this goal by using the nonparametric Triples test suggested by Randles et al. (1980). We examine two forms of asymmetries, namely deepness and steepness. Our main finding is that for 6 out of 11 countries, namely for the USA, the UK, Japan, Spain, Finland and Iceland, either per-capita health expenditures or per-capita GDP are characterized by asymmetric behaviour. This finding to some extent casts doubt on those studies that model the relationship between health and GDP using unit-root and cointegration tests that assume symmetric disturbances.

Investigating health, economic and socio-political factors that need consideration when establishing Victorian Aboriginal land management projects

This article focuses on three Victorian Aboriginal¹ groups (Bangerang, Boonwurrung and Yorta Yorta) to explore elements that provide or discourage development of land management projects. Results from this small qualitative study show that a number of distinct health, socio-political and economic factors need to be considered when developing Aboriginal land management projects. This study indicates that a greater involvement in Aboriginal land management projects -- critical to Aboriginal peoples' health, economic and social structures - will only occur through increased community consultation, respect, training, consistency between all stakeholders involved, resources and the provision of employment opportunities. Further research is required to strengthen this evidence, allowing policy-makers to be progressive when developing land management projects for Aboriginal Victorian people as a health promoting tool.

Cardiovascular health behaviours and health needs among people with psychiatric disabilities

Recent research in Australia has found that people with a mental illness experience higher mortality rates from preventable illnesses, such as cardiovascular disease, respiratory disease and diabetes compared to the general population. Lifestyle and other behavioural factors contribute significantly to these illnesses. Lifestyle behaviours that affect these illnesses include lack of physical activity, consumption of a poor diet and cigarette smoking. Research on the influence of these factors has been mainly directed towards the mainstream population in Australia. Consequently, there remains limited understanding of health behaviours among individuals with psychiatric disabilities, their health needs, or factors influencing their participation in protective health behaviours. This thesis presents findings from two studies. Study 1 evaluated the utility of the main components of Roger’s (1983) Protection Motivation Theory (PMT) to explain health behaviours among people with a mental illness. A clinical population of individuals with schizophrenia (N=83), Major Depressive Disorder (MDD) (N=70) and individuals without a mental illness (N=147) participated in the study. Respondents provided information on intentions and self-reported behaviour of engaging in physical activity, following a low-fat diet, and stopping smoking. Study 2 investigated the health care service needs of people with psychiatric disabilities (N=20). Results indicated that the prevalence of overweight, cigarette smoking and a sedentary lifestyle were significantly greater among people with a mental illness compared to that reported for individuals without a mental illness. Major predictors of the lack of intentions to adopt health behaviours among individuals with schizophrenia and MDD were high levels of fear of cardiovascular disease, lack of knowledge of correct dietary principles, lower self-efficacy, a limited social support network and a high level of psychiatric symptoms. In addition, findings demonstrated that psychiatric patients are disproportionately higher users of medical services, but they are under-users of preventive medical care services. These differences are primarily due to a lack of focus on preventive health, feelings of disempowerment and lower satisfaction of patient-doctor relationships. Implications of these results are discussed in terms of designing education and preventive programs for individuals with schizophrenia and MDD.

Motherhood and health : perception and practice

[No Abstract]

Train the trainer model : implications for health professionals and farm family health in Australia

Australia is a large country with 60% of land used for agricultural production. Its interior is sparsely populated, with higher morbidity and mortality recorded in rural areas, particularly farmers, farm families, and agricultural workers. Rural health professionals in addressing health education gaps of farming groups have reported using behavioralist approaches. These approaches in isolation have been criticized as disempowering for participants who are identified as passive learners or 'empty vessels.' A major challenge in rural health practice is to develop more inclusive and innovative models in building improved health outcomes. The Sustainable Farm Families Train the Trainer (SFFTTT) model is a 5-day program developed by Western District Health Service designed to enhance practice among health professionals working with farm families in Australia. This innovative model of addressing farmer health asks health professionals to understand the context of the farm family and encourages them to value the experience and existing knowledge of the farmer, the family and the farm business. The SFFTTT program has engaged with health agencies, community, government, and industry groups across Australia and over 120 rural nurses have been trained since 2005. These trainers have successfully delivered programs to 1000 farm families, with high participant completion, positive evaluation, and improved health indicators. Rural professionals report changes in how they approach health education, clinical practice, and promotion with farm families and agricultural industries. This paper highlights the success of SFFTTT as an effective tool in enhancing primary health practice in rural and remote settings. The program is benefiting not only drought ravaged farmers but assisting rural nurses, health agencies, and health boards to engage with farm families at a level not identified previously. Furthermore, nurses and health professionals are now embracing a more 'farmer-centered model of care.'

Perceptions of health, illness and physiotherapy of Maori identifying with Ngati Tama iwi

The purpose of this study was to explore the perceptions of health, illness and the delivery of physiotherapy amongst a group of contemporary Maori. The methodology was established in collaboration with Kaumatua of the Ngati iwi. This resulted in the data collection consisting of semi-structured interviews, which used open-ended questions. As with other studies of cultural health issues both quantitative and qualitative data were collected. Nineteen people identifying with this iwi volunteered to participate. The majority of participants had some involvement in the Maori culture. All participants had used the western orthodox health system, with approximately 50% of them having also used traditional Maori methods of healing. Their perceptions of health and illness beliefs reflected a mixture of western orthodox medicine theories and traditional Maori beliefs. Despite only 10 participants having experienced physiotherapy, the majority had a good understanding of what physiotherapy is. While those who had received physiotherapy regarded it positively, there was a general feeling amongst the participants that it could be delivered in a more culturally sensitive manner. This did not necessarily mean that Maori people wanted to be treated at a clinic on the Marae or by Maori physiotherapists.

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.

Dancing with death : risk, health promotion and injecting drug users

The thesis investigated ambivalent attitudes towards death in injecting drug users, factors that may lead to such ambivalent attitudes and implications for health promotion campaigns. It was found that this relationship with death was principally attributable to government drug policy in Australia.

Health beliefs and behaviours of home economics teachers in Victoria

Data from questionnaires mailed to post-primary home economics teachers suggests that they possess untapped knowledge and expertise that could be used in intersectoral approaches to health promotion outside classroom teaching.

Stress, health, work and family in the Australian hospitality industry

Hospitality was found to be a potentially high stress occupation. Potential work and family stressors, symptoms, affective factors, coping strategies and resources were identified. A stress-psychological health model was developed. Possible implications for stress research, measurement, prevention and management in the hospitality industry were proposed.