Climate information needs of Gascoyne-Murchison pastoralists: a representative study of the Western Australian grazing industry

The Gascoyne-Murchison region of Western Australia experiences an arid to semi-arid climate with a highly variable temporal and spatial rainfall distribution. The region has around 39.2 million hectares available for pastoral lease and supports predominantly catle and sheep grazing leases. In recent years a number of climate forecasting systems have been available offering rainfall probabilities with different lead times and a forecast period; however, the extent to which these systems are capable of fulfilling the requirements of the local pastoralists is still ambiguous. Issues can range from ensuring forecasts are issued with sufficient lead time to enable key planning or decisions to be revoked or altered, to ensuring forecast language is simple and clear, to negate possible misunderstandings in interpretation. A climate research project sought to provide an objective method to determine which available forecasting systems had the greatest forecasting skill at times of the year relevant to local property management. To aid this climate research project, the study reported here was undertaken with an overall objective of exploring local pastoralists' climate information needs. We also explored how well they understand common climate forecast terms such as 'mean', median' and 'probability', and how they interpret and apply forecast information to decisions. A stratified, proportional random sampling was used for the purpose of deriving the representative sample based on rainfall-enterprise combinations. In order to provide more time for decision-making than existing operational forecasts that are issued with zero lead time, pastoralists requested that forecasts be issued for May-July and January-March with lead times counting down from 4 to 0 months. We found forecasts of between 20 and 50 mm break-of-season or follow-up rainfall were likely to influence decisions. Eighty percent of pastoralists demonstrated in a test question that they had a poor technical understanding of how to interpret the standard wording of a probabilistic median rainfall forecast. this is worthy of further research to investigate whether inappropriate management decisions are being made because the forecasts are being misunderstood. We found more than half the respondents regularly access and use weather and climate forecasts or outlook information from a range of sources and almost three-quarters considered climate information or tools useful, with preferred methods for accessing this information by email, faxback service, internet and the Department of Agriculture Western Australia's Pastoral Memo. Despite differences in enterprise types and rainfall seasonality across the region we found seasonal climate forecasting needs were relatively consistent. It became clear that providing basic training and working with pastoralists to help them understand regional climatic drivers, climate terminology and jargon, and the best ways to apply the forecasts to enhance decision-making are important to improve their use of information. Consideration could also be given to engaging a range of producers to write the climate forecasts themselves in the language they use and understand, in consultation with the scientists who prepare the forecasts.

A journey access tool to facilitate better health outcomes for people with disabilities

- Background One of the three objectives of the WHO Global Disability Action Plan 2014–2021 is removal of barriers and improved access to health services and programmes. Access to transport contributes to positive health outcomes; however, people with disabilities leaving their dwellings are confronted with barriers to their mobility. Mobility restrictions, sensory or other disabilities increase their vulnerability as road users, exposing them to higher risks of injury. PHSW and CARRS-Q have been collaborating with Handicap International Cambodia (HIC) on a Journey Access Tool (JAT). - Aims Use of the JAT is to (1) Identify transport and journey safety and barriers for people with disability and (2) Evaluation and modification of the tool after trailing to for use by NGOs and government agencies in prioritising actions around barriers. - Methodology The tool has undergone initial proof-of-concept testing in India and Viet Nam, and was trialled in Cambodia in February and May, 2015. Five teams were formed comprising a person with disability (physical, sensory or intellectual), researchers from QUT, staff from HIC, and local university students. The JAT was completed by each team and then discussed and evaluated. Two further Cambodian trials are scheduled for 2015. - Results The JAT is responsive to rural and urban contexts, and has utility for people with different disabilities. Two tools have been developed: a short version for people with a disability to complete independently, or with assistance; and a version for NGOs, DPOs and government. The tool has efficacy for advocacy.   - Conclusion The JAT has potential to assist the Mekong region with: (1) evaluating access for people with disability and other vulnerable members of the community including older people; (2) developing plans for changes to the routes in consultation with local authorities; (3) evaluating the effectiveness of implemented changes in terms of access and health; (4) inputting into policy; (5) The tool can be used for advocacy for change.

Oireista puhuminen lääkärin vastaanotolla : Keskustelunanalyyttinen tutkimus lääkärin kysymyksistä

Talking about symptoms during medical consultation. A conversation analytical study of doctors questions This linguistically oriented conversation analytic study investigates doctors questions and patients answers during medical consultation. The focus is on 1) the syntactic constructions of the doctors questions concerning the patients symptoms, 2) the function of different types of syntactic constructions, and 3) the sequential placement of the questions. The data used in the study consist of 57 videotaped doctor patient encounters in Finnish primary health care. The study shows that the traditional division between open and closed questions is vague and needs to be examined further. Open wh-questions and closed yes/no questions form heterogeneous classes: some of the closed questions can be treated as open and vice versa. Wh-questions which occur during the physical examination are often constructed to elicit short answers. These questions can consist of one word (e.g. milloin when ) which does not move to a new topic but supports the unfinished activity of palpation. During the verbal examination, wh-questions are formulated to elicit long descriptions as answers. For example, by asking mites + X ( what about + X), the doctor can open up a new topic and simultaneously give the patient the opportunity to discuss the topic from his/her perspective. Almost half of the yes/no questions project longer than just a minimal answer (e.g. a short confirmation or rejection). In these questions, the doctors use verbal elements which show that more than just a minimal answer is required. They can, for example, add an indefinite element (joku some or mitään any ) to a yes/no question, add a conjunctive vai ( or ) to the end of the question and thus open a space for various types of answers, or add a suggested answer to the question. In addition, the results show that declarative questions not only check understanding, but display the doctor s diagnosing process, check whether the doctor can move on to the next topic or action, and display implicitly the doctor s idea of what is connected and what is relevant. One aim of the study is to describe how different syntactic structures work together. A typical question chain consists of two or three questions. The first question is an open wh-question that elicits a new topic and creates different types of presuppositions. Contingent questions are constructed as yes/no questions that seek an affirmative answer or as declarative sentences that seek confirmation. Contingent questions can function as repair initiators and thus support achieving mutual understanding. Therefore, they are tools for the doctor to construct a description of the medical problem collaboratively with the patient. The results add to the results of previous studies on questions in medical consultation, but also suggest some corrections. They provide additional evidence for the idea that different types of syntactic constructions are useful in different types of settings. However, they also show that the variety of questions that doctors use is more manifold and diverse than the variety introduced in earlier studies and textbooks.

Opettajan ja vanhemman vuorovaikutus ja keskustelun kehykset koululaisen kehityskeskusteluissa

The aim of the study is to describe the consultation discussions between the teacher, parents and the student. The structure and the interaction of the conversation is in the focus of the study. The study explicates the organization of the interaction and orientation of the participants in the conversation. The study approaches conversation as a dynamic activity and studies it from the point of view of the participants. Assessment is one of the themes involved in the teacher-parent-student consultation discussions. Assessment as a duty of the school brings an institutional aspect in the conversation, but the ways it is implemented and expressed varies in the conversational situations. Participants communication and interaction in the situation influences the ways the consultation discussions are carried out. The framework of the study is based on the ethno methodological approach where a social situation and its meaning is seen negotiated by the participants. The interest of the study is to find out how the participants implement mutual understanding and how it can be observed in their interaction. Quantitatively, the interaction of the participants is described in the framework of the interaction analysis and linked to the socio-emotional and rational aspects of the interaction. The empirical part of the study consists of data collected with questionnaires and videotaped conversations. The main research problems of the study are, how the teachers and parents described the consultation discussions and how the interaction of the teacher, the parent and the student is organized during the conversation. The background of the study is linked to the previous studies concerning co-operation between the teacher and the parent and home-school relationship. This part of the study aims to enlighten how the consultation discussions are part of the co-operation in the school context. The questionnaires link the consultation discussions to the every day co-operation between the teacher and the family. Expectations and results described by the parents and teachers are analysed. Videotaped data is both analysed quantitatively based on interaction analysis and approached with the ethno methodological interpretation. The interest of my study is, how people participate in the situation of consultation discussion, how they orientate in it and influence the conversation. The analyses of the consultation discussions are based on the both quantitative interaction analysis and ethno methodological frame analysis. With the theoretical approach of my study I want to describe and enlighten the organization of the interaction and ways of orientation of the participants in consultation discussions. Keywords: consultation discussion, interaction, evaluation, orientation in the conversation, home-school cooperation, quantitative interaction analysis, frame analysis

Coastal Wetlands Resources Investigation of the Burdekin Delta for declaration as fisheries reserves. Report to Ocean Rescue 2000

A project to investigate the coastal wetland resources of the Burdekin Delta, north Queensland, was undertaken as part of the long-term assessment of the coastal fisheries resources of Queensland. Extending from November 1993 to May 1995, fieldwork was undertaken in November 1993 and August 1994. The scope of the coastal wetlands resources investigation of the Burdekin Delta for declaration as a Fish Habitat Area was: 1. To document and map the marine wetland vegetation communities in the Burdekin River delta. 2. To document levels of existing disturbance to wetlands, existing recreational and commercial fisheries resources, and existing fishing activities. 3. To evaluate the conservation values of the areas investigated from the viewpoint of fisheries productivity and as habitat for important/threatened species. 4. To initiate Fish Habitat Area declaration under Section 120 of the Queensland Fisheries Act 1994 with formal consultation to all stakeholders. This report concentrates on Points 1 and 3, the documentation of the marine wetland vegetation communities and the evaluation of conservation values from a fisheries viewpoint. Dataset URL Link: Queensland Coastal Wetlands Resources Mapping data. [Dataset]

Development of profitable milk production systems for northern Australia: a field assessment of the productivity of five potential farming systems using farmlets.

Farmlets, each of 20 cows, were established to field test five milk production systems and provide a learning platform for farmers and researchers in a subtropical environment. The systems were developed through desktop modelling and industry consultation in response to the need for substantial increases in farm milk production following deregulation of the industry. Four of the systems were based on grazing and the continued use of existing farmland resource bases, whereas the fifth comprised a feedlot and associated forage base developed as a greenfield site. The field evaluation was conducted over 4 years under more adverse environmental conditions than anticipated with below average rainfall and restrictions on irrigation. For the grazed systems, mean annual milk yield per cow ranged from 6330 kg/year (1.9 cows/ha) for a herd based on rain-grown tropical pastures to 7617 kg/year (3.0 cows/ha) where animals were based on temperate and tropical irrigated forages. For the feedlot herd, production of 9460 kg/cow.year (4.3 cows/ha of forage base) was achieved. For all herds, the level of production achieved required annual inputs of concentrates of similar to 3 t DM/animal and purchased conserved fodder from 0.3 to 1.5 t DM/animal. This level of supplementary feeding made a major contribution to total farm nutrient inputs, contributing 50% or more of the nitrogen, phosphorus and potassium entering the farming system, and presents challenges to the management of manure and urine that results from the higher stocking rates enabled. Mean annual milk production for the five systems ranged from 88 to 105% of that predicted by the desktop modelling. This level of agreement for the grazed systems was achieved with minimal overall change in predicted feed inputs; however, the feedlot system required a substantial increase in inputs over those predicted. Reproductive performance for all systems was poorer than anticipated, particularly over the summer mating period. We conclude that the desktop model, developed as a rapid response to assist farmers modify their current farming systems, provided a reasonable prediction of inputs required and milk production. Further model development would need to consider more closely climate variability, the limitations summer temperatures place on reproductive success and the feed requirements of feedlot herds.

Enabling people to ‘see what they can be’… The Community Aspirations Program (CAP-ED)

The Community Aspirations Program in Education (CAP-ED) was delivered by CQUniversity’s Office of Indigenous Engagement to increase Aboriginal and Torres Strait Islander student participation in higher education. CAP-ED was developed through scoping studies of six individual communities within the CQuniversity footprint, including a designated Aboriginal and Torres Strait Islander community and rural and regional communities. The scoping process included developing community profiles and extensive consultation with Traditional Owners, Elders, community members and key stakeholders. This process proved to be an essential component of CAP-ED’s success, resulting in Indigenous participation in the program’s networking lunches, through to the delivery of information and workshop sessions. Moreover, it witnessed engagement with people in communities as partners in the program’s delivery and co-presenters in workshops and other events. The CAP-ED workshops focus on identity, culture, aspirations and assist participants to see that they have the potential to participate in higher education. The other essential components of the program’s success have included enabling people to ‘see what they can be’, offering opportunities for people to ask questions, voice honest concerns, and build confidence. The flexibility of delivery was paramount in accommodating the varying needs of each community and the differences in cultural protocols and community approaches, while the face to face engagement between knowledgeable and skilled staff and community members proved to be vital. Over the life of the project, CAP-ED has developed into a broad based strategy that has successfully matched community needs and university based responses through the process of community engagement.

Development and feasibility testing of an education program to improve knowledge and self-care among Aboriginal and Torres Strait Islander patients with heart failure

Background/Aim There is a 70% higher age-adjusted incidence of heart failure (HF) amongst Aboriginal and Torres Strait Islander people, three times more hospitalisations and twice as many deaths than non-Aboriginal people. There is a need to develop holistic yet individualised approaches in accord with the values of Aboriginal community healthcare to support patient education and self-care. The aim of this study was to re-design an existing HF educational resource (Fluid Watchers-Pacific Rim©) to be culturally safe for Aboriginal and Torres Strait Islander peoples, working in collaboration with the local community, and to conduct feasibility testing. Methods This study was conducted in two phases and utilised a mixed methods approach (qualitative and quantitative). Phase 1 of this study used action research methods to develop a culturally safe electronic resource to be provided to Aboriginal HF patients via a tablet computer. A HF expert panel adapted the existing resource to ensure it was evidence-based and contained appropriate language and images that reflects Aboriginal culture. A stakeholder group (which included Aboriginal workers and HF patients, as well as researchers and clinicians) then reviewed the resources and changes were made accordingly. In Phase 2, the new resource was tested on a sample of Aboriginal HF patients to assess feasibility and acceptability. Patient knowledge, satisfaction and self-care behaviours were measured using a before and after design with validated questionnaires. As this was a pilot test to determine feasibility, no statistical comparisons were made. Results - Phase 1: Throughout the process of resource development, two main themes emerged from the stakeholder consultation. These were the importance of identity, meaning that it was important to ensure that the resource accurately reflected the local community, with the appropriate clothing, skin tone and voice. The resource was adapted to reflect this and of the local community voiced the recordings for the resource. The other theme was comprehension; images were important and all text was converted to the first person and used plain language. - Phase 2: Five Aboriginal participants, mean age 61.6 ± 10.0 years, with NYHA Class III and IV heart failure were enrolled. Participants reported a high level of satisfaction with the resource (83.0%). HF knowledge (percentage of correct responses) increased from 48.0 ± 6.7% to 58.0 ± 9.7%, a 20.8% increase and results of the self-care index indicated that the biggest change was in patient confidence for self-care with a 95% increase in confidence score (46.7 ± 16.0 to 91.1 ± 11.5). Changes in management and maintenance scores varied between9275 patients. Conclusion By working in collaboration with HF experts, Aboriginal researchers and patients, a culturally safe HF resource has been developed for Aboriginal and Torres Strait Islander patients. Engaging Aboriginal researchers, capacity-building, and being responsive to local systems and structures enabled this pilot study to be successfully completed with the Aboriginal community and positive participant feedback demonstrated that the methodology used in this study was appropriate and acceptable; participants were able to engage with willingness and confidence.

Now that I have had this experience I am looking at studying…

The Community Aspirations Program in Education (CAP-ED) was started by CQUniversity’s Office of Indigenous Engagement in 2013. CAP-ED’s aim was to focus on building aspirations through small manageable learning projects, and to increase Aboriginal and Torres Strait Islander students’ participation in higher education. Initially the scope of the project was to develop and deliver an accredited certificate-level program to help Indigenous students transition into tertiary education by a) improving pathways and b) addressing their current knowledge gaps. However, the initial investigatory process and community consultation found that a more localised, targeted and intimate approach would work more effectively. In addition, a free or affordable certificate course that would meet community needs was beyond the financial scope of the project. From here, the Office of Indigenous Engagement began to explore other possibilities.

Australian Property Institute Inc, Submission to the Productivity Commission on Intellectual Property Arrangements – Issues Paper

This submission responds to the document Intellectual Property Arrangements Issues Paper (Issues Paper) released by the Productivity Commission in October 2015 for public consultation and input by 30 November 2015. The API is grateful for the extension of time granted by the Commission to complete and lodge this submission. The overall need for an inquiry into intellectual property is supported by API. In particular it is noted with approval that the Commission states in its Issues Paper that it is to consider the appropriate balance between “incentives for innovation and investments, and the interests of both individuals and businesses in assessing products”.1 However, API is of the view that intellectual property in the area of real property presents a number of issues which are not fully canvassed in the abovementioned Issues Paper. Intellectual property embedded in valuation and other property-related reports of API members involves the acquisition of information which may possibly be confidential. Yet, when engaged in banks and financial institutions the intellectual property in such valuations and/ or reports is commonly required to be passed to the client bank or financial institution. In the Issues Paper it is proposed that there are seven different forms of intellectual property rights.2 It is the view of API that an eight form exists, namely private agreements. The Issues Paper, however, regards private agreements between firms as alternatives to intellectual property rights. The API considers that “secrecy or confidentiality arrangements”3 as identified in the Issues Paper form a much larger part of the manner in which intellectual property is maintained in Australia for the purposes of trade secrecy or more often, financial confidentiality...

Best management practices for sustainable and safe playing surface of Australian Football League sports fields

In 2002, AFL Queensland and the Brisbane Lions Football Club approached the Department of Primary Industries and Fisheries (Queensland) for advice on improving their Premier League sports fields. They were concerned about player safety and dissatisfaction with playing surfaces, particularly uneven turf cover and variable under-foot conditions. They wanted to get the best from new investments in ground maintenance equipment and irrigation infrastructure. Their sports fields were representative of community-standard, multi-use venues throughout Australia; generally ‘natural’ soil fields, with low maintenance budgets, managed by volunteers. Improvements such as reconstruction, drainage, or regular re-turfing are generally not affordable. Our project aimed to: (a) Review current world practice and performance benchmarks; (b) Demonstrate best-practice management for community-standard fields; (c) Adapt relevant methods for surface performance testing; (d) Assess current soils, and investigate useful amendments; (e) Improve irrigation system performance; and (e) Build industry capacity and encourage patterns for ongoing learning. Most global sports field research focuses on elite, sand-based fields. We adjusted elite standards for surface performance (hardness, traction, soil moisture, evenness, sward cover/height) and maintenance programs, to suit community-standard fields with lesser input resources. In regularly auditing ground conditions across 12 AFLQ fields in SE QLD, we discovered surface hardness (measured by Clegg Hammer) was the No. 1 factor affecting player safety and surface performance. Other important indices were turf coverage and surface compaction (measured by penetrometer). AFLQ now runs regularly audits affiliated fields, and closes grounds with hardness readings greater than 190 Gmax. Aerating every two months was the primary mechanical practice improving surface condition and reducing hardness levels to < 110 Gmax on the renovated project fields. With irrigation installation, these fields now record surface conditions comparable to elite fields. These improvements encouraged many other sporting organisations to seek advice / assistance from the project team. AFLQ have since substantially invested in an expanded ground improvement program, to cater for this substantially increased demand. In auditing irrigation systems across project fields, we identified low maintenance (with < 65% of sprinklers operating optimally) as a major problem. Retrofitting better nozzles and adjusting sprinklers improved irrigation distribution uniformity to 75-80%. Research showed that reducing irrigation frequency to weekly, and preparedness to withhold irrigation longer after rain, reduced irrigation requirement by 30-50%, compared to industry benchmarks of 5-6 ML/ha/annum. Project team consultation with regulatory authorities enhanced irrigation efficiency under imposed regional water restrictions. Laboratory studies showed incorporated biosolids / composts, or topdressed crumb rubber, improved compaction resistance of soils. Field evaluations confirmed compost incorporation significantly reduced surface hardness of high wear areas in dry conditions, whilst crumb rubber assisted turf persistence into early winter. Neither amendment was a panacea for poor agronomic practices. Under the auspices of the project Trade Mark Sureplay®, we published > 80 articles, and held > 100 extension activities involving > 2,000 participants. Sureplay® has developed a multi-level curator training structure and resource materials, subject to commercial implementation. The partnerships with industry bodies (particularly AFLQ), frequent extension activities, and engagement with government/regulatory sectors have been very successful, and are encouraged for any future work. Specific aspects of sports field management for further research include: (a) Understanding of factors affecting turf wear resistance and recovery, to improve turf persistence under wear; (b) Simple tests for pinpointing areas of fields with high hardness risk; and (c) Evaluation of new irrigation infrastructure, ‘water-saving’ devices, and irrigation protocols, in improving water use and turf cover outcomes.

Geriatrician interventions on medication prescribing for frail older people in residential aged care facilities

Objective: In Australian residential aged care facilities (RACFs), the use of certain classes of high-risk medication such as antipsychotics, potent analgesics, and sedatives is high. Here, we examined the prescribed medications and subsequent changes recommended by geriatricians during comprehensive geriatric consultations provided to residents of RACFs via videoconference. Design: This is a prospective observational study. Setting: Four RACFs in Queensland, Australia, are included. Participants: A total of 153 residents referred by general practitioners for comprehensive assessment by geriatricians delivered by video-consultation. Results: Residents’ mean (standard deviation, SD) age was 83.0 (8.1) years and 64.1% were female. They had multiple comorbidities (mean 6), high levels of dependency, and were prescribed a mean (SD) of 9.6 (4.2) regular medications. Ninety-one percent of patients were taking five or more medications daily. Of total medications prescribed (n=1,469), geriatricians recommended withdrawal of 9.8% (n=145) and dose alteration of 3.5% (n=51). New medications were initiated in 47.7% (n=73) patients. Of the 10.3% (n=151) medications considered as high risk, 17.2% were stopped and dose altered in 2.6%. Conclusion: There was a moderate prevalence of potentially inappropriate high-risk medications. However, geriatricians made relatively few changes, suggesting either that, on balance, prescription of these medications was appropriate or, because of other factors, there was a reluctance to adjust medications. A structured medication review using an algorithm for withdrawing medications of high disutility might help optimize medications in frail patients. Further research, including a broader survey, is required to understand these dynamics.

Konsumerismi, potilaiden ja kuluttajien aktiivinen toiminta sekä erityisesti lääkäreiden kokemukset ja näkemykset potilaista kuluttajina

Consumerism emphasises the patient s position and freedom of choice. Consumerism is being promoted by a range of phenomena occurring in society and health care. Different actors hold different views on the patient as a consumer and on his or her participation. Consumer demand is created outside the patient physician relationship and the commercialisation of services generates new expectations with respect to physician s work. More and more patients may be interested in adopting a more equal position in the care relationship, and trying to negotiate with the physician or to even dictate how he or she should be cared for. In Finland, very little research has been conducted on patients and consumers organising themselves at national system level, patients as choosers, and physicians attitudes to various consumerist phenomena or the choice made by the patient. In the empirical data for this study, the term consumer-patient refers to active consumers and patients making choices related to their clinical care prior to a physician s diagnosis. Consumer-patients are also represented by consumer and patient organisations and movements. The main research question is: How do physicians regard the care choice made by the patient? This question is addressed from a perspective encompassing patients and consumers organised activities and individuals active behaviour in health care as well as physicians experiences and their views on patients as consumers making choices related to their care. The first part (Study I), examines the patient organisation field, information sources used including the websites of such organisations, files from Finland s Slot Machine Association, RAY, a survey conducted by a Finnish television news department and interviews of patient organisations. Based on observation and a physician survey, Study II examines physicians attitudes to the idea that patients could obtain information through consumer movements about physicians care practices before seeking medical care. Studies III−IV use a physician survey to examine physicians attitudes to direct-to-consumer-advertising of prescription drugs (DTCA) and their experiences and views of patient requests related to treatments and examinations. Study V uses comparative surveys to examine the attitudes of health care professionals and the population to the introduction of new technologies in health care, using genetic screenings and tests as an example. The number of patient organisations increased, with a particular escalation as of the 1990s. The characteristics and operating methods of the organisations varied greatly. Physicians organisations adopted a negative or neutral attitude towards the consumer movements idea of distributing information on care practices, whereas individual physicians attitudes were slightly more positive. Physicians regarded direct-to-consumer-advertising of prescription drugs as negative, but took a more permissive attitude towards indirect advertising. More than every third physician considered drug advertisements in general to be harmful or useless in the distribution of drug information to patients or consumers. More than half of physicians conducting patient work reported that they (very) often encountered patients who stated upon arrival for a consultation that they wanted specific treatments or examinations, and that the number of such situations had increased. Such situations were viewed as positive with regard to the care relationship by every fifth physician and as negative by two fifths. Physicians justified a reserved attitude to the patients consumer role by referring to their medical expertise and position as care decision-makers, the patient physician relationship and the public health care system. Reasons for a positive attitude included the patient s participation and co-operation, the patient physician relationship and the patient s knowledge. Professionals were more reserved than lay people about the introduction and extension of genetic technologies in health care. A significant minority of the physicians did not take a clear pro or con attitude to the patients consumer role or to the use of new technologies in health care. The physicians age, gender, place of work and specialisation influenced their attitudes to the patient s consumer role, and private physicians viewed it in a more positive light than those working in public health care. Active consumer-patients challenge the society to hold a discussion of the patient s choice, participation in care decision-making and participation in health care policy in general. Their transformation into customers and consumers implies not only a new division of individuals roles and powers, but also contributes to changing relationships between system level roles: between citizens and the state and between public and private health care. This phenomenon raises various issues related to health care policy. In conclusion, topics are presented for discussion, practical measures and further research. Keywords: health care, consumerism, distribution of technologies, commercialisation, physicians, patients, consumers, patient s choice, patient s role.

Australia’s first Pharmacists Immunisation Pilot – about the service

Background: The first phase of the Queensland Pharmacist Immunisation Pilot (QPIP) ran between April and August 2014, to pilot pharmacists administering influenza vaccinations for the flu season for the first time in Australia. Aim: An aim was to investigate factors facilitating implementation of a pharmacist vaccination service in the community pharmacy setting. Method: The QPIP pharmacies were divided into two arms; the South East Queensland arm consisting of 51 Terry White Chemists (TWCs), and 29 pharmacies in the North Queensland (NQ) arm. The TWCs featured pharmacies which previously provided a vaccination service and that were experienced with using an online booking system, providing an opportunity to capture booking data. Results: The TWCs delivered 9902 (90%) of the influenza vaccinations in QPIP. Of these, 48.5% of the vaccines were delivered via appointments made using the online booking system, while 13.3% were in-store bookings. Over one-third (38.2%) of the vaccinations delivered in were “walk-ins” where the vaccination was delivered ‘on the spot’ as spontaneous or opportunistic vaccinations. The absence of a booking system meant all vaccinations delivered in the NQ arm were “walk-ins”. The online-booking data showed 10:00 am and Tuesday being the most popular time and day for vaccinations. Patients preferred having their vaccinations in private consultation rooms, over areas which used a screen to partition off a private area. Discussion: The presence of an online booking system appeared to increase the efficiency and penetration of the of vaccine service delivery. Also, as the level of privacy afforded to patients increased, the number of patients vaccinated also increased. Conclusions: As pharmacist-delivered vaccination services start to progressively roll out across Australia; these findings pave the way for more efficient and effective implementation of the service.

Beyond vaccination: The benefits of having a pharmacist behind the syringe

Background: The Queensland Pharmacist Immunisation Pilot which ran in 2014 was Australia’s first to allow pharmacists to administer vaccinations. Aim: An aim of the pilot was to investigate the benefits of trained pharmacists administering vaccinations in a community pharmacy setting. Methods: Participant demographics and previous influenza vaccination experiences were recorded using GuildCare software. Participants also completed a ‘post-vaccination satisfaction survey’ following their influenza vaccination. Results: A total of 10889 participant records and 8737 satisfaction surveys were analysed. Overall, 1.9% of participants lived with a chronic illness, and 22.5% took concomitant medications. As part of the consultation before receiving the influenza vaccination, participants acknowledged the opportunity to discuss other aspects of their health with the pharmacist, including concerns about their general health, allergies, and other medications they were taking. It was worth noting that 17.5% of people would not have received an influenza vaccination if the pharmacist vaccination service was unavailable. Additionally, approximately 10% of all participants were eligible to receive a free vaccination from the National Immunisation Program, but still opted to receive their vaccine from a pharmacist. Conclusion: The findings from this pilot demonstrate the benefit of a pharmacist vaccination program in increasing vaccination rates, and have helped pave the way for expanding the scope of practice for pharmacists.