Sport safety policies and practices in two rural Victorian communities

Australian football and netball are the predominant sports played in rural Victoria, Australia. This exploratory study is the first to report the sport safety policies and practices adopted by junior Australian football and netball clubs in small rural communities. Eleven informants from four clubs completed a semi-structured interview and survey. Whilst the clubs performed a range of injury prevention activiities, they did not have formal sports safety policies. Generally, netball informants reported fewer safety practices than football informants. Crucial factors influencing safety policies and practices were the reliance on volunteers and a lack of senior players. Barriers towards the adoption of safety policies and practices appeared to be related to rural population declines, a lack of qualified people and attitudes to injury in rural areas. Future research needs to identify how widespread this lack of sport safety policies and practices is across rural Australia and to identify strategies to overcome barriers to implementing them.

Food intake patterns among Australian adolescents

Objectives: This study aimed 10 evaluate the food intake pattens of adolescents with respect to the Australian Guide to Healthy Eating, and to examine variations in food intake patterns by age, gender and region of residence.
Design: Cross-sectional online food survey administered through schools. Participants and setting: In 2004-2005,3841 secondary students in years seven (12-13 years) and nine (14-15 years) drawn from 37 secondary schools in Victoria, Australia completed an online food intake patterns survey.
Outcome measures: Food intake was measured by a Food Frequency Questionnaire (FFQ), and categorized according to the five basic food groups (fruit, vegetables, meat, daily, cereal) and the 'extra' food group as defined by the Australian Guide to Healthy Eating (AGHE). The foods groups were examined in the study population and compared across age, gender and region.
Results: Many adolescents in this sample reported food intakes that deviated substantially from recommendations of the AGHE. For example, two-thirds of participants failed to consume foods from the five recommended food groups daily; over a third reported eating fruit 'rarely or never'; and 22% reported eating fast foods every day. Food intakes were generally more in line with dietary guidelines among girls than boys.
Regional differences were less consistent, and there were few differences by age.
Conclusion: A significant proportion of adolescents have food intakes that fall short of the recommendations outlined in the Australian Guide to Healthy Eating. This highlights the need for public health initiatives to promote healthier food intake pattens among adolescents.

Emotional toil: psychosocial care in rural settings for patients with cancer

Aim. This paper is a report of a study to identify experienced rural nurses' perceptions of key issues related to the provision of effective psychosocial care for people with cancer in rural settings.

Background. A cancer diagnosis has a major impact on psychological and emotional wellbeing, and psychosocial support provided by nurses is an integral part of ensuring that people with cancer have positive outcomes. Although, ideally, people with cancer should be managed in specialist settings, significant numbers are cared for in rural areas.

Methods. Using a qualitative descriptive approach, three focus groups were conducted in 2005 with 19 nurses in three hospitals in rural Victoria, Australia.

Findings. Participants indicated that a key issue in providing psychosocial care to patients with cancer in the rural setting was their own 'emotional toil'. This Global Theme encapsulated three Organizing Themes– task vs. care, dual relationships and supportive networks – reflective of the unique nature of the rural environment. Nurses in rural Australia are multi-skilled generalists and they provide care to patients with cancer without necessarily having specialist knowledge or skill. The fatigue and emotional exhaustion that the nurses described often has a major impact on their own well-being.

Conclusion. In the rural context, it is proposed that clinical supervision may be an important strategy to support clinicians who face emotional exhaustion as part of their cancer nursing role.

Public health nutrition : from principles to practice

A systematic, research-based overview of the central principles and practice issues in the growing field of public health nutrition. With chapters by leading international experts, this is essential reading for practitioners and students in public health, nutrition, health policy and related fields.

A rural model for delivering regional continuing nurse education by videoconference : a pilot project

Background : The South West Alliance of Rural Health (SWARH) is an alliance of 33 health care agencies scattered across South West Victoria over a total area of approximately 46 000 square kilometres. SWARH was established to develop and install information technology (IT) infrastructure, hardware and software for all acute public hospitals in the region. The Rural Intercampus Learning Environment Project (March 2003-March 2004) piloted the use of the SWARH regional area IT network to deliver a program of continuing education to Division 1 registered nurses, utilising the expertise of local health professionals. The study was funded by the Department of Human Services, Victoria.

Aims & rationale/Objectives : Establish partnerships for multi-site delivery of programs.
Develop existing educational programs and resources for video and intranet delivery (including IT training and change management).
Collaboratively deliver educational programs utilising SWARHnet to six rural sites.
Explore issues related to the use of the technology in continuing education for rural nurses and the implications for practice.

Methods : Key informant interviews, paper-based audits, and focus groups informed the development of the schedule of the program. Session participants completed a 2-page evaluation questionnaire.

Principal findings : Participants must own the process.
Videoconferencing should be considered an adjunct to traditional education programs.
Videoconferencing most suitable for short education sessions as opposed to full-day workshops.
IT problems are unpredictable and frustrating for all concerned.
IT awareness/training of staff is essential.

Implications : The project proposes a model for coordinating and delivering regional continuing education which has been shown to improve access to education programs across multiple sites. It provides a sustainable organisational framework for the program, which could be applied in continuing professional education programs of other rural health professions, such as dentistry, medicine, allied health and pharmacy.

Presentation type : Poster

People, places and public health : evaluating the benefits of civic environmentalism in an urban local government context

Recent political, economic and social trends pose threats to the sustainability both of ecosystems and of human health. Australia’s environmental management record is poor, and while by international standards Australians enjoy good health, this is variable (AIHW, 2000). Within developed nations, heart disease, depression, alcohol dependence and stroke are major health issues (Mathers et al. 2002). In Australia, mental disorder is the number one contributor to the disease burden (Vos & Mathers 2000). Recent research has highlighted the role of social capital as a key determinant of health (Kawachi et al., 1997). Despite this, Putnam (1995) observes that social connectedness and civic engagement are in decline. People have less time for leisure and for volunteering, as many juggle paid work and caring for children. Anecdotal evidence suggests that engagement in civic environmentalism has human health benefits, relating to a combination of exposure to natural environments and increased social capital (Maller, Brown, Townsend & St. Leger, 2002). This link is supported by Furnass (1996) who defines well-being as including: satisfactory human relationships, meaningful occupation, opportunities for contact with nature, creative expression, and making a positive contribution to human society. Research conducted by Deakin University confirms the efficacy of linking people and places through civic environmentalism for addressing both ecosystem sustainability and human health and wellbeing. The research has included a pilot study to explore the human health benefits of membership of a local parkland ‘Friends’ group, and a more detailed follow-up study. The aims of the pilot study included:- To identify the range of motivations for joining the Friends group;- To document members’ perceptions of the benefits gained from membership of the group;- To assess the potential for Friends groups to be used as an ‘upstream’ health promotion measure.Face-to-face interviews were conducted with eleven members of a ‘Friends’ group in the eastern suburbs of Melbourne. Data was analysed thematically and key findings included:- Motivations: environmental; social; and pragmatic.- General benefits: community belonging; personal satisfaction; learning opportunities; physical activity; and better environment.- Health benefits: physical health; mental health; and social support. There was unanimous support for the use of ‘Friends’ groups as a tool for health promotion.The follow-up study, in the western suburbs of Melbourne, expanded on the pilot study by measuring the group’s social capital and by collecting self-report data on levels of health service usage. Data was collected through face-to-face interviews and a questionnaire. The findings were similar to the pilot study in relation to the motivations, benefits and the health promotion potential of such groups. However, health service usage data highlighted an apparent anomaly: while respondents perceived significant health benefits, some were nevertheless utilising health services at a relatively high level. This poses some questions requiring further exploration: Is this due to the poorer baseline health of the high health service usage members compared with their fellow members? Does involvement in the group offer health benefits that enable people who would otherwise be too unhealthy to participate in community groups to continue such involvement?If this is the case, then we may do well to look to locally-based mechanisms for promoting ecological sustainability as a tool also for promoting human health. Instead of prescribing a pill, connecting people and places through engagement with a local friends group may address our health problems at the same time as addressing local environmental problems.

The need for best practice standards in electronic governance of patient medical records to facilitate innovation

Background : Optimising the use of electronic data offers many opportunities to health services, particularly in rural and remote areas. These include reducing the effect of distance on access to clinical information and sharing information where there are multiple service providers for a single patient. The increasing compilation of large electronic databases of patient information and the ease with which electronic information can be transferred has raised concerns about the privacy and confidentiality of such records.
Aims & rationale/Objectives : This review aims to identify legal and ethical standards for areas of electronic governance where a lack of clarity may currently impede innovation in health service delivery.
Methods : This paper describes best practices for storage and transfer of electronic patient data based on an examination of Australian legislative requirements and a review of a number of current models. This will firstly allow us to identify basic legal requirements of electronic governance as well as areas of ambiguity not fully addressed by legislation. An examination of current models will suggest recommendations for best practice in areas lacking sufficient legal guidance.
Principal findings : We have identified the following four areas of importance, and shall discuss relevant details:
1) Patients' right of ownership to electronic patient records. 2) Custodial issues with data stored in centralised health care institutions 3) IT Security, including hierarchical level access, data encryption, data transfer standards and physical security 4) Software applications usage.
Discussion : Our examination of several models of best practice for the transfer of electronic patient data, both in Australia and internationally, identifies and clarifies many unresolved issues of electronic governance. This paper will also inform future policy in this area.
Implications : Clarification will facilitate the future development of beneficial technology-based innovations by rural health services.
Presentation type : Poster