Primary health care nurse perception and men’s expectation of the role of the primary health care nurse in providing men’s health services in the primary care setting in Victoria

 This study adds significantly to the current paucity of knowledge around men's health in Australian primary care and in particular stresses the need for men's health care education to be more reliable and systematic foundation for men's sexual health, mental health and health promotion.

"Music therapy helped me get back doing": perspectives of music therapy participants in mental health services

BACKGROUND: Mental health service development internationally is increasingly informed by the collaborative ethos of recovery. Service user evaluation of experiences within music therapy programs allows new phenomena about participation in services to be revealed that might otherwise remain unnoticed. OBJECTIVE: The aim of this study was to demonstrate how asking service users about their experience of music therapy can generate useful information, and to reflect upon the feedback elicited from such processes in order to gain a deeper understanding of how music therapy is received among service users in mental health. METHODS: Six mental health service users described their experiences of music therapy in one or two individual interviews. Transcripts of interviews were analyzed using the procedures and techniques of Interpretative Phenomenological Analysis. RESULTS: Interviews with mental health service users provided rich, in-depth accounts reflecting the complex nature of music therapy participation. Super-ordinate themes refer to the context in which music therapy was offered, the rich sound world of music in music therapy, the humanity of music therapy, and the strengths enhancing opportunities experienced by service users. CONCLUSIONS: Participants indicated that they each experienced music therapy in unique ways. Opinions about the value of music therapy were revealed through an interview process in which the researcher holds an open attitude, welcoming all narrative contributions respectfully. These findings can remind practitioners of the importance of closely tuning into the perspectives and understandings of those who have valuable expertise to share about their experience of music therapy services in mental health.

Utilisation of maternal health services in Ethiopia: a key informant research project

This article explores the application of key informant research to examine barriers and facilitators to maternal health services in rural and pastoralist Ethiopia. The key informants were health extension workers (HEWs) who assist women with birth preparedness and facilitate timely referral to health centres for birth. While women encounter many barriers to giving birth in health facilities, where HEWs are supported by their communities and health centre staff, they can effectively encourage women to travel to health centres to give birth with skilled birth attendants rather than at home with unskilled relatives or traditional birth attendants.

Comparison of medication policies to guide nursing practice across seven Victorian health services

Objectives The objective of this paper is to review and compare the content of medication management policies across seven Australian health services located in the state of Victoria. Methods The medication management policies for health professionals involved in administering medications were obtained from seven health services under one jurisdiction. Analysis focused on policy content, including the health service requirements and regulations governing practice. Results and Conclusions The policies of the seven health services contained standard information about staff authorisation, controlled medications and poisons, labelling injections and infusions, patient self-administration, documentation and managing medication errors. However, policy related to individual health professional responsibilities, single- and double-checking medications, telephone orders and expected staff competencies varied across the seven health services. Some inconsistencies in health professionals' responsibilities among medication management policies were identified. What is known about the topic? Medication errors are recognised as the single most preventable cause of patient harm in hospitals and occur most frequently during administration. Medication management is a complex process involving several management and treatment decisions. Policies are developed to assist health professionals to safely manage medications and standardise practice; however, co-occurring activities and interruptions increase the risk of medication errors. What does this paper add? In the present policy analysis, we identified some variation in the content of medication management policies across seven Victorian health services. Policies varied in relation to medications that require single- and double-checking, as well as by whom, nurse-initiated medications, administration rights, telephone orders and competencies required to check medications. What are the implications for practitioners? Variation in medication management policies across organisations is highlighted and raises concerns regarding consistency in governance and practice related to medication management. Lack of practice standardisation has previously been implicated in medication errors. Lack of intrajurisdictional concordance should be addressed to increase consistency. Inconsistency in expectations between healthcare services may lead to confusion about expectations among health professionals moving from one healthcare service to another, and possibly lead to increased risk of medication errors.

Aligning multiple knowledge perspectives in a health services system : a case study

This chapter reports the results of a feasibility study into electronic collection of service data at “point of delivery” for disability programs. The investigation revealed that while the proposed system would have produced more fine-grained data, it would not have improved any actor’s knowledge of service delivery. The study illustrated the importance of context in the transition from data to knowledge; the diffused and fragmented organisational structure of social service administration was shown to be a major barrier to effective building and sharing of knowledge. There was some value in the collection of detailed service data but this would have damaged the web of relationships which underpinned the system of service delivery and on which the smooth functioning of that system depended. The study recommended an approach to managing the informal and tacit knowledge distributed among many stakeholders, which was not especially technologically advanced but which supported, in a highly situated manner, the various stakeholders in this multi-organisational context.

An `upside-down` view of rural health care

Access to high quality health care services plays an important part in the health of rural communities and individuals. This fact is reflected in efforts by governments to improve the quality of such services through better targeting of funds and more efficient management of services. In Australia, the difficulties experienced by rural communities in attracting and retaining doctors has long been recognized as a contributing factor to the relatively higher levels of morbidity and mortality in rural areas. However, this paper, based on a study of two small rural communities in Australia, suggests that resolving the health problems of rural communities will require more than simply increasing the quality and accessibility of health services. Health and well-being in such communities relates as much to the sense of community cohesion as it does to the direct provision of medical services. Over recent years, that cohesion has diminished, undermined in part by government policies that have fuelled an exodus from small rural communities to urban areas. Until governments begin to take an 'upside-down' perspective, focusing on building healthy communities rather than simply on building hospitals to make communities healthy, the disadvantages faced by rural people will continue to be exacerbated.

Relationship between body mass index and the use of healthcare services in Australia

Objective: To examine the relationship between body mass index (BMI) and the use of medical and preventive health services. Research Methods and Procedures: This study involved secondary analysis of weighted data from the Australian 1995 National Health Survey. The study was a population survey designed to obtain national benchmark information about a range of health-related issues. Data were available from 17,033 men and 17,174 women, 20 years or age. BMI, based on self-reported weight and height, was analyzed in relation to the use of medical services and preventive health services. Results: A positive relationship was found between BMI and medical service use, such as medication use, visits to hospital accident and emergency departments (for women only); doctor visits, visits to a hospital outpatient clinics; and visits to other health professionals (for women only). A negative relationship was found in women between BMI and preventive health services. Underweight women were found to be significantly less likely to have Papanicolaou smear tests, breast examinations, and mammograms. Discussion: This research shows that people who fall outside the healthy weight range are more likely to use a range of medical services. Given that the BMI of industrialized populations appears to be increasing, this has important ramifications for health service planning and reinforces the need for obesity prevention strategies at a population level.

The role and theoretical evolution of knowledge translation and exchange in public health

Background There is an increased emphasis in public health research on effective models and strategies to support knowledge translation (KT), the exchange, synthesis and ethically sound application of research findings within a complex set of interactions among researchers and knowledge users. In other words, KT can be seen as an acceleration of the knowledge cycle—an acceleration of the natural transformation of knowledge into use (Canadian Institutes of Health Services Research. Knowledge Translation Strategy, 2004). The most recent conceptualizations consider the complexities of public health decision-making. The role of practitioners and communities is increasingly considered.

Methods We identify, describe and discuss the theoretical underpinnings of KT and recommend a way forward to build the evidence for more effective practice.

Results Theoretical perspectives increasingly influence research on KT in public health. A range of innovative work is being conducted to explore methods for KT using practical tools, often with the support of government.

Conclusions KT describes a crucial and to date under-developed element of the research process. There is an important gap in theoretically informed empirical studies of effectiveness of proposed approaches in public health, health promotion and preventive medicine, and thus much of the debate remains abstract. There is clearly an urgent policy need to establish the effectiveness of KT models in a range of contexts. This must include both the consideration of development and the utilization of knowledge.

Extending social marketing to emergency services organisations

Social marketing theory is examined in relation to an organisational context which has received little attention. This paper examines the development of an integrated social marketing campaign for a State Emergency Service, and focusses on a particularly serious scenario where the penalty for miscommunication may be death, widespead injury or substantial property damage. The researchers take an action research approach, identifying community perceptions of risk to determine appropriate communication message development. The study identifies the factors contributing to risk perception beyond traditional concepts of involvement which are common in studies of consumer behaviour. Additionally, this paper provides an investigation of some of the issues that affect communication effectiveness, such as the influence of stakeholders, the poor performance of traditional communications methods, the utility of social marketing principles, and segmentation requirements, as well as influential ideas from the general risk communication literature.

The status of health-promoting schools in Hong Kong and implications for further development

An evaluation framework, called the Hong Kong Healthy Schools Award, has been developed to enable comprehensive collection and analysis of data reflecting the status of health-promoting schools (HPS) in Hong Kong. The key findings revealed a high prevalence of emotional problems, unhealthy eating habits, physical inactivity and risk-taking behaviours, leading to both intentional and unintentional injuries among students with higher prevalence among secondary school students. The results indicated a substantial lack of health policies in schools; it also indicated health services in schools not readily accessible to students and staff, and insufficient staff training in health promotion and education. However, most schools have made initiatives in environmental protection, established safety guidelines and strategies for managing students with emotional problems. The success of HPS depends largely on teachers' understanding of its building blocks. Evidence from the comprehensive mapping of the status of HPS in Hong Kong and from student surveys does show encouraging outcomes as well as identifying priority issues to be addressed in the next 5 years.

Promoting community capacity through university-community engagement: the Deakin University / Department of Human Services (Barwon South West) Partnership

The formal Partnership between Deakin University and the Victorian Department of Human Services (Barwon-South Western Region), based in Geelong, aims to bring together the knowledge, experience and resources of the Department and Deakin University for the benefit of the people living in that region, as well as for the mutual benefit of both organisations. A recent review process featured stakeholder interviews and focus groups. A special workshop on university-community engagement was also held for interested stakeholders in late 2006. This was facilitated by Prof. Judith Ramaley, President of Winona State University, during her visit to Deakin University as a Fulbright Visiting Senior Specialist. Visioning and strategic planing have continued throughout 2007.

This paper will describe the efforts and achievements of the Partnership through the complementary lenses of Healthy Cities, health-promoting universities and community capacity. This framework will be used to describe how the Partnership coordinators have used Prof Ramaley’s insights to establish a draft Business Plan that espouses a more mature form of collaboration and embraces shared, transformative goals. The paper will describe how the notion of community capacity is being used to evaluate the Partnership’s overall contribution to community engagement.

Strategies for the marketing of higher education with comparative contextual references between Australia and Turkey

Education is now a global product with institutions worldwide competing for students and finding ever more creative ways to satisfy student needs and preferences. With the continuing rise in the preference for flexible distance learning, educational institutions are finding that when students and faculty have significantly different cultural backgrounds and learning styles that the expectations of the learning experience can be unfulfilled. In Australia, international students have made education Australia’s third largest service export, earning $5.8 billion. This means that student populations have moved from being homogenous and captive to domestic constraints and expectations, to being multi-cultural, dispersed and subject to a plethora of constraints and expectations. Today in Turkey, education is the responsibility of government however, in recent years, the private sector has entered the market providing educational services at all levels. In particular, after the 1990s, private higher education institutions (HEIs) with a commercial focus have mushroomed.

In 2007, there are 25 private universities in Turkey with more than 2.000.000 students enrolled in these universities. Of these students, more than 1.000.000 are registered in distance education faculties. With such large student numbers competition between private universities for students has intensified particularly over the last 15 years. As a consequence the need to develop strategies for attracting students has become more important. Marketing strategies in Turkey have tended to concentrate on three distinct categories: strategies between governmental HEIs, private HEIs and distance education HEIs. The contribution of technologies to education processes has been immense with students and faculty each learning to adapt to an environment of continuous change and opportunities. This paper seeks to explore the notion that a competitive advantage in marketing of higher education can be attained by customizing learning experiences for particular student cohorts in a pro-active and constructive way.

A proposed smart-card solution for Australian health services : the problems encountered

This case study describes the experience of a state government health department in evaluating the use of smart card technology to redesign health benefits programs for the disabled in Australia. The social and political context of the system is explained in detail, and the potential benefits and risks accruing to the government, health care intermediaries and the community are examined.

Parenting a preterm infant: experiences in a regional neonatal health services programme

In an Australian regional health service, parents’ experiences of the neonatal intensive care (NICU), neonatal nurseries and a community discharge programme were investigated. Parents from 12 families participated in an in-depth interview. Three themes captured a partial, yet significant, view of these parents’ experiences as they strived to develop their identity and competence as parents. The findings are explored as they reveal issues associated with the provision of family centred, developmental care in neonatal services. Opportunities for nurses in this context to expand and clarify their role in ways that are responsive to parenting needs are discussed.

Re-visioning cultural competence in community health services in Victoria

There are few studies exploring the need to develop and manage culturally competent health services for refugees and migrants from diverse backgrounds. Using data from 50 interviews with service providers from 26 agencies, and focus group discussion with nine different ethnic groups, this paper examines how the Victorian state government funding and service agreements negatively impact on the quest to achieve cultural competence. The study found that service providers have adopted 'one approach fits all' models of service delivery. The pressure and competition for resources to address culturally and linguistically diverse communities' needs allows little opportunity for partnership and collaboration between providers, leading to insufficient sharing of information and duplication of services, poor referrals, incomplete assessment of needs, poor compliance with medical treatment, underutilisation of available services and poor continuity of care. This paper outlines a model for cultural consultation and developing needs-led rather than service-led programs.