A nurse managed kidney disease program in regional and remote Australia

Health services that aim to prevent and manage chronic kidney disease (CKD) in rural and remote Aboriginal communities in Australia, including the Goldfields region of Western Australia (WA), require innovative approaches. Nursing roles can significantly improve access to renal services in rural and remote areas as they are able to address a range of renal health promotion and prevention activities, and provide renal clinical education and support to Aboriginal people. The Goldfields Kidney Disease Nursing Management Program (GKDNMP), funded through the Council of Australian Governments (COAG) National Partnership Agreements, was developed to provide a comprehensive approach to primary health care that incorporates a range of health promotion and disease management activities. In the first year, the program increased home dialysis rates and decreased patient travel due to expanded access to renal care within the region. Context-specific health programs generated in response to local needs can be successful in addressing specific health care challenges in rural and remote health.

Does the shortage of diabetes specialists in regional and rural Australia matter? Results from Diabetes MILES – Australia.

Aim: To investigate differences in access to services and health outcomes between people living with Type 1 (T1DM) and Type 2 (T2DM) diabetes in rural/regional and metropolitan areas.

Methods: Diabetes MILES—Australia was a national postal/online survey of persons registered with the National Diabetes Services Scheme. Selected variables, including utilisation of health care services and self-care indicators, were analysed for 3338 respondents with T1DM (41%) or T2DM (59%).

Results: Respondents from rural/regional (n=1574, 48%) and metropolitan areas were represented equally (n=1700, 52%). After adjusting for diabetes duration, demographic and socioeconomic variables, rural/regional respondents with T1DM (RR 0.90, 95% CI 0.83–0.97) and T2DM (RR 0.69, 95% CI 0.59–0.81) were less likely to report consulting an endocrinologist during the past 12 months. Rural/regional respondents with T1DM were more than twice as likely to have accessed a community/practice nurse for diabetes care (RR 2.22, 95% CI 1.25–3.93) while those with T2DM were more likely to have accessed a diabetes educator (RR 1.21, 95% CI 1.07–1.36) or dietician (RR 1.17, 95% CI 1.07–1.36). For the T1DM and T2DM groups were no differences between rural/regional and metropolitan respondents in self-reported hypoglycaemic events during past week and the majority of self-care indicators.

Conclusions: Despite a lack of access to medical specialists, respondents with T1DM and T2DM living in rural/regional areas did not report worse health or self-care indicators. The results suggest that multidisciplinary primary services in rural areas may be providing additional care for people with diabetes, compensating for poor access to specialists.

Demographic and socio-cultural correlates of medical mistrust in two Australian states:Victoria and South Australia

Studies on medical mistrust have mainly focused on depicting the association between medical mistrust and access/utilization of healthcare services. The effect of broader socio-demographic and psycho-social factors on medical mistrust remains poorly documented. The study examined the effect of broader socio-demographic factors, acculturation, and discrimination on medical mistrust among 425 African migrants living in Victoria and South Australia, Australia. After adjusting for socio-demographic factors, low medical mistrust scores (i.e., more trusting of the system) were associated with refugee (β=−4.27, p<0.01) and family reunion (β=−4.01, p<0.01) migration statuses, being Christian (β=−2.21, p<0.001), and living in rural or village areas prior to migration (β=−2.09, p<0.05). Medical mistrust did not vary by the type of acculturation, but was positively related to perceived personal (β=0.43, p<0.001) and societal (β=0.38, p<0.001) discrimination. In order to reduce inequalities in healthcare access and utilisation and health outcomes, programs to enhance trust in the medical system among African migrants and to address discrimination within the community are needed.

Sociodemographic factors associated with healthy eating and food security in socio-economically disadvantaged groups in the UK and Victoria, Australia

Objective
To investigate the associations between sociodemographic factors and both diet indicators and food security among socio-economically disadvantaged populations in two different (national) contextual settings.

Design
Logistic regression was used to determine cross-sectional associations between nationality, marital status, presence of children in the household, education, employment status and household income (four low income categories) with daily fruit and vegetable consumption, low-fat milk consumption and food security.

Setting
Socio-economically disadvantaged neighbourhoods in the UK and Australia.

Subjects
Two samples of low-income women from disadvantaged neighbourhoods: (i) in the UK, the 2003–05 Low Income Diet and Nutrition Survey (LIDNS; n 643); and (ii) in Australia, the 2007–08 Resilience for Eating and Activity Despite Inequality (READI; n 1340).

Results
The influence of nationality, marital status and children in the household on the dietary outcomes varied between the two nations. Obtaining greater education qualifications was the most telling factor associated with healthier dietary behaviours. Being employed was positively associated with low-fat milk consumption in both nations and with fruit consumption in the UK, while income was not associated with dietary behaviours in either nation. In Australia, the likelihood of being food secure was higher among those who were born outside Australia, married, employed or had a greater income, while higher income was the only significant factor in the UK.

Conclusions
The identification of factors that differently influence dietary behaviours and food security in socio-economically disadvantaged populations in the UK and Australia suggests continued efforts need to be made to ensure that interventions and policy responses are informed by the best available local evidence.

Correspondences: A personal photographic journey between past/Iran and present/Australia

This project is an autobiographical photography series entitled: Correspondences; A personal photographic journey between past/Iran and present/Australia. This series of photographs are partly influenced by being born at the beginning of 1979 Islamic revolution in Iran . Also, having the experience of living almost thirty years in Iran and immigrating to Australia afterwards. This display consists of presentation of photographic images and will be presented in two series.

Mathematical thinking of preschool children in rural and regional Australia : research and practice

At what age do young children begin thinking mathematically? Can young children work on mathematical problems? How do early childhood educators ensure young children feel good about mathematics? Where do early childhood educators learn about suitable mathematics activities?

A good early childhood start in mathematics is critical for later mathematics success. Parents, carers and early childhood educators are teaching mathematics, either consciously or unconsciously, in any social interaction with a child.

Mathematical Thinking of Preschool Children in Rural and Regional Australia is an extension of a conference of Australian and New Zealand researchers that identified a number of important problems related to the mathematical learning of children prior to formal schooling. A project team of 11 researchers from top Australian universities sought to investigate how early childhood education can best have a positive influence on early mathematics learning.

The investigation complements and extends the work of Project Good Start by focusing attention on critical aspects of parents, carers and early childhood educators who care for young children. Early childhood educators from regional and rural New South Wales, Queensland and Victoria were interviewed, following a set of structured questions. The questions focused on: children’s mathematics learning; support for mathematics teaching; use of technology; attitudes to mathematics; and assessment and record keeping.

The researchers also reviewed research focusing on the mathematical capacities and potential foundations for further mathematical development in young children (0–5 years) published in the last decade and produced an annotated bibliography. This should provide a good basis for further research and reading.

Based upon the results of this investigation, the researchers make 11 recommendations for improving the practices of early childhood education centres in relation to young children’s mathematical thinking and development. The implications for policy and decision makers are outlined for teacher education, the provision of resources and further research.

Scholarships and Connections: Australia, Indonesia and Papua New Guinea, 1960-2010

For over fifty years Australia has welcomed students from Indonesia and Papua New Guinea to study at our tertiary institutions on government scholarships. An important premise behind the scholarship program has been the hope that the connections with Australia developed by these students will be long-lasting and mutually beneficial to Australia and partner governments. The research project ‘Scholarships and Connections’ investigates the life stories and experiences of students from Indonesia and Papua New Guinea who were sponsored for Australian-based tertiary study from 1950s-2010. By recording the personal experiences of scholarship recipients and investigating their networks of influence, this research deepens our understanding of scholarship programs and whether or not they produce outcomes that are consistent with the objective of building mutually beneficial linkages between Australia and partner countries. It examines whether the outcomes are enduring or change over time. The project is especially interested in the experiences of former scholarship-holders in positions of leadership and any networks and ongoing connections they have with Australia. This research provides a better understanding of the personal and professional networks of scholarship alumni, and encourages the sharing of experiences. The interviews will be permanently retained in appropriate repositories and drawn on for use in biographies, radio and television programs, internet applications and educational curricula for schools and leadership programs. This research promotes the values of historical research and scholarship among Indonesians and Papua New Guineans and points to the value of oral testimony from past and recent generations of mobile students for current generations facing important challenges and choices.

Questionnaire data for 'Scholarships and Connections: Australia, Indonesia and Papua New Guinea, 1960-2010'

For over fifty years Australia has welcomed students from Indonesia and Papua New Guinea to study at our tertiary institutions on government scholarships. An important premise behind the scholarship program has been the hope that the connections with Australia developed by these students will be long-lasting and mutually beneficial to Australia and partner governments. The research project ‘Scholarships and Connections’ investigates the life stories and experiences of students from Indonesia and Papua New Guinea who were sponsored for Australian-based tertiary study from 1950s-2010. By recording the personal experiences of scholarship recipients and investigating their networks of influence, this research deepens our understanding of scholarship programs and whether or not they produce outcomes that are consistent with the objective of building mutually beneficial linkages between Australia and partner countries. It examines whether the outcomes are enduring or change over time. The project is especially interested in the experiences of former scholarship-holders in positions of leadership and any networks and ongoing connections they have with Australia. This research provides a better understanding of the personal and professional networks of scholarship alumni, and encourages the sharing of experiences. The interviews will be permanently retained in appropriate repositories and drawn on for use in biographies, radio and television programs, internet applications and educational curricula for schools and leadership programs. This research promotes the values of historical research and scholarship among Indonesians and Papua New Guineans and points to the value of oral testimony from past and recent generations of mobile students for current generations facing important challenges and choices.

Longitudinal effects of school drug policies on student marijuana use in Washington State and Victoria, Australia

OBJECTIVES: We examined the longitudinal effect of schools' drug policies on student marijuana use. METHODS: We used data from the International Youth Development Study, which surveyed state-representative samples of students from Victoria, Australia, and Washington State. In wave 1 (2002), students in grades 7 and 9 (n = 3264) and a school administrator from each participating school (n = 188) reported on school drug policies. In wave 2 (2003), students reported on their marijuana use. We assessed associations between student-reported and administrator-reported policy and student self-reported marijuana use 1 year later. RESULTS: Likelihood of student marijuana use was higher in schools in which administrators reported using out-of-school suspension and students reported low policy enforcement. Student marijuana use was less likely where students reported receiving abstinence messages at school and students violating school policy were counseled about the dangers of marijuana use. CONCLUSIONS: Schools may reduce student marijuana use by delivering abstinence messages, enforcing nonuse policies, and adopting a remedial approach to policy violations rather than use of suspensions.