Health and safety issues in contemporary dental practice

Under current workplace health and safety legislation, the owners and managers of a dental practice have a legal responsibility to provide staff with a safe working environment. In this article, the emphasis will be on four common areas of risk: posture when seated, handling scalpel blades, flooring and lighting.

Mental health nursing standards and practice indicators for Australia: a review of current literature

There are many changes and challenges facing the mental health care professional working in Australia in the 21st Century. Given the significance of their number and the considerable extent to which care is delivered by them, mental health nurses in particular must be at the forefront of the movement to enhance and improve mental health care. Mental health nurses in Australia must not only keep up with the changes, we should be setting the pace for others across the profession worldwide. The increasingly complex field of mental health nursing demands nurses who are not only equipped to face the challenges but are confident in doing so. Definitive guidelines for practice, clear expectations regarding outcomes and specific means by which to evaluate both practice and outcomes are vital. Strengthening the role and vision of mental health nursing so that there is clarity about both and highlighting core values by which to perform will enable us to become focused on our future and what we can expect to both give to and receive from our chosen profession and how we can, and do, contribute to mental health care. The role of the mental health nurse is undergoing expansion and there are new hurdles to overcome along with the new benefits this brings. To support this, nationally adopted, formalised standards of practice and means by which to measure these, i.e., practice indicators formerly known as clinical indicators, are required. It is important to have national standards and practice indicators because of the variances in the provision of mental health across Australia – different legislation regarding mental health policies and processes, different nursing registration bodies and Nursing Councils, for example – which create additional barriers to cohesion and uniformity. Improvements in the practice of mental health nursing lead to benefits for consumer outcomes as well as the overall quality of mental health care available in Australia. The emphasis on rights-based care, particularly consumer and carer rights, demands evidence-based, up-to-date mental health care delivered by competent, capable professionals. Documented expectations for performance by nurses will provide all involved with yardsticks by which to evaluate outcomes. Flowing on from these benefits are advances in mental health care generally and enhancements to Australia’s reputation and position within the health care arena throughout the world. Currently, the ‘Standards for Practice’ published by the Australian New Zealand College of Mental Health Nurses (ANZCMHN) in 1995 and the practice indicators developed by Skews et al. (2000) provide a less formal guide for mental health nurses working in Australia. While these earlier standards and practice indicators have played some role in supporting mental health nurses they have not been nationally or enthusiastically adopted and there are a multitude of reasons for this. This report reviews the current literature available on practice indicators and standards for practice and describes an evidence-based rationale as to why a review and renewal of these is required and why it is important, not just for mental health nurses but to the field of mental health in general. The term ‘practice indicator’ is used, except where a quotation utilises ‘clinical indicator’, to more accurately reflect the broad spectrum of nursing roles, i.e. not all mental health nursing work involves a clinical role.

Perceptions of mental health service delivery among staff and Indigenous consumers: it's still about communication

Objective: A needs analysis was undertaken to determine the quality and effectiveness of mental health services to Indigenous consumers within a health district of Southern Queensland. The study focussed on identifying gaps in the service provision for Indigenous consumers. Tools and methodologies were developed to achieve this. Method: Data were collected through the distribution of questionnaires to the target populations: district health service staff and Indigenous consumers. Questionnaires were developed through consultation with the community and the Steering Committee in order to achieve culturally appropriate wording. Of prime importance was the adaptation of questionnaire language so it would be fully understood by Indigenous consumers. Both questionnaires were designed to provide a balanced perspective of current mental health service needs for Indigenous people within the mental health service. Results: Results suggest that existing mental health services do not adequately meet the needs of Indigenous people. Conclusions: Recommendations arising from this study indicate a need for better communication and genuine partnerships between the mental health service and Indigenous people that reflect respect of cultural heritage and recognises the importance of including Indigenous people in the design and management of mental health services. Attention to the recommendations from this study will help ensure a culturally appropriate and effective mental health service for Indigenous consumers.

Should the health community promote smokeless tobacco (snus) as a harm reduction measure?

Background to the debate: The tobacco control community is divided on whether or not to inform the public that using oral, smokeless tobacco (Swedish snus) is less hazardous to health than smoking tobacco. Proponents of 'harm reduction' point to the Swedish experience. Snus seems to be widely used as an alternative to cigarettes in Sweden, say these proponents, contributing to the low overall prevalence of smoking and smoking-related disease. Harm reduction proponents thus argue that the health community should actively inform inveterate cigarette smokers of the benefits of switching to snus. However, critics of harm reduction say that snus has its own risks, that no form of tobacco should ever be promoted, and that Sweden’s experience is likely to be specific to that culture and not transferable to other settings. Critics also remain deeply suspicious that the tobacco industry will use snus marketing as a 'gateway' to promote cigarettes. In the interests of promoting debate, the authors (who are collaborators on a research project on the future of tobacco control) have agreed to outline the strongest arguments for and against promoting Swedish snus as a form of harm reduction.

Using FCD Mapper Software and Landsat Images to Assess Forest Canopy Density in Landscapes in Australia and the Philippines

Using Landsat imagery, forest canopy density (FCD) estimated with the FCD Mapper®, was correlated with predominant height (PDH, measured as the average height of the tallest 50 trees per hectare) for 20 field plots measured in native forest at Noosa Heads, south-east Queensland, Australia. A corresponding image was used to calculate FCD in Leyte Island, the Philippines and was validated on the ground for accuracy. The FCD Mapper was produced for the International Tropical Timber Organisation and estimates FCD as an index of canopy density using reflectance characteristics of Landsat Enhanced Thematic (ETM) Mapper images. The FCD Mapper is a ‘semi-expert’ computer program which uses interactive screens to allow the operator to make decisions concerning the classification of land into bare soil, grass and forest. At Noosa, a positive strong nonlinear relationship (r2 = 0.86) was found between FCD and PDH for 15 field plots with variable PDH but complete canopy closure. An additional five field plots were measured in forest with a broken canopy and the software assessed these plots as having a much lower FCD than forest with canopy closure. FCD estimates for forest and agricultural land in the island of Leyte and subsequent field validation showed that at appropriate settings, the FCD Mapper differentiated between tropical rainforest and banana or coconut plantation. These findings suggest that in forests with a closed canopy this remote sensing technique has promise for forest inventory and productivity assessment. The findings also suggest that the software has promise for discriminating between native forest with a complete canopy and forest which has a broken canopy, such as coconut or banana plantation.

The Reflectance Signature of Canopy Components: Implications for the Interpretation of Remotely Sensed Images

The reflectance signatures of plantation pine canopy and understorey components were measured using a spectro-radiometer. The aim was to establish whether differences observed in the reflectance signature of stressed and unstressed pine needles were consistent with observed differences in the reflectance of multispectral Landsat Thematic Mapper (TM) images of healthy and stressed forest. Because overall scene reflectance includes the contribution of each scene component, needle reflectance may not be representative of canopy reflectance. In this investigation, a limited dataset of reflectance signatures from stressed and unstressed needles confirmed the negative relationship between pine needle health and reflectance which was observed in visible red wavelengths. However, the reflectance contribution from bushes, pine needle litter and bare soil tended to reinforce this relationship suggesting that in this instance, overall scene reflectance is comprised of the proportional reflectance of each scene component. In near infrared wavelengths, differences between healthy and stressed needle reflectance suggested a strong positive relationship between reflectance and tree health. For Landsat TM images, previous research had only observed a weak positive relationship between stand health and near infrared reflectance in these pine canopies. This suggests that for multispectral Landsat TM images, reflectance of near infrared light from pine canopies may be affected by other factors which may include the scattering of light within canopies. These results are seen as promising for the use of hyperspectral images to detect stand health, provided that pixel reflectance is not influenced by other scene components.

Combining GIS and Expert Opinion to Model Landscapes for a Smallholder Forest Extension Program in Leyte, the Philippines

A Geographic Information System (GIS) was used to model datasets of Leyte Island, the Philippines, to identify land which was suitable for a forest extension program on the island. The datasets were modelled to provide maps of the distance of land from cities and towns, land which was a suitable elevation and slope for smallholder forestry and land of various soil types. An expert group was used to assign numeric site suitabilities to the soil types and maps of site suitability were used to assist the selection of municipalities for the provision of extension assistance to smallholders. Modelling of the datasets was facilitated by recent developments of the ArcGIS® suite of computer programs and derivation of elevation and slope was assisted by the availability of digital elevation models (DEM) produced by the Shuttle Radar Topography (SRTM) mission. The usefulness of GIS software as a decision support tool for small-scale forestry extension programs is discussed.

Language policy spread: Learning from health and social policy models

Except for a few large scale projects, language planners have tended to talk and argue among themselves rather than to see language policy development as an inherently political process. A comparison with a social policy example, taken from the United States, suggests that it is important to understand the problem and to develop solutions in the context of the political process, as this is where decisions will ultimately be made.