Rural community pharmacists integrating care for people with complex health needs

The project involves rural/regional community pharmacists integrating care for complex needs patients and delivering a range of services, based on a care plan developed collaboratively with the GP and the consumer. The pharmacist will coordinate other services based on the multidisciplinary care plan. This research follows a successful pilot project and offers an opportunity to investigate new health service delivery in rural areas for patients at greater health related risk. Care integration will be compared to usual care, with outcomes relating to medication and health service usage, as well as clinical and quality of life outcomes being compared

PAHs, PCDD/Fs, PCBs and HCB in leaves from Brisbane, Australia

The concentrations of SOCs in leaves of an evergreen Australian native tree (Melaleuca leucadendra) and grass collected in Brisbane, Australia were determined. The concentrations of PCDD/Fs and PAHs in the leaf tissue were comparable to those reported for urbanised areas in other industrialised countries. A distinct difference in the compound profiles between the leaves of the two species was observed, with higher concentrations of the lower molecular mass PAHs and PCDD/Fs and lower concentrations of the higher molecular mass PAHs and PCDD/Fs in the Melaleuca leaves relative to the grass leaves. The interspecies differences are explained on the basis of the larger size of the lipophilic compartment (for compounds with low K-OA) and the lower ratio of surface area to volume in the Melaleuca leaves. (C) 2001 Elsevier Science Ltd. All rights reserved.

Mental health telemedicine programmes in Australia

A national survey of mental health telemedicine programmes was conducted and data collected on their catchment areas, organizational structure, equipment, clinical and non-clinical activity, and use by populations who traditionally have been poorly served by mental health services in Australia. Of 25 programmes surveyed, information was obtained for 23. Sixteen programmes had dealt with a total of 526 clients during the preceding three months. Of these, 397 (75%) were resident in rural or remote locations at the time of consultation. Thirty-seven (7%) were Aboriginals or Torres Strait Islanders. Only 19 (4%) were migrants from non-English-speaking backgrounds. The programmes provided both direct clinical and secondary support services. Overall, the number of videoconferencing sessions devoted to clinical activity was low, the average being 123 sessions of direct clinical care per programme per year. Videoconferencing was also used for professional education, peer support., professional supervision, administration and linking families. The results of the study suggest that telehealth can increase access to mental health services for people in rural and remote areas, particularly those who have hitherto been poorly served by mental health services in Australia.

A clinical audit of the prescribing of celecoxib and rofecoxib in Australian rural general practice

Aims The new cyclooxygenase-2 (COX-2) selective inhibitors, celecoxib (Celebrex®) and rofecoxib (Vioxx®), have been widely prescribed since their launch. No reviews currently appear in the literature of prescribing patterns in Australia. This paper describes a self-audit of the clinical use of selective COX-2 inhibitor therapy undertaken with rural general practitioners (GPs) in Australia. Methods A structured audit form was developed and distributed to interested GPs. The form was self-administered and focused on issues about COX-2 inhibitors and the types of patients who were receiving them, e.g. indications, patient demographics, risk factors and drug interactions. Results A total of 627 patients were recruited (569 celecoxib and 58 rofecoxib). A range of doses was prescribed. Osteoarthritis was the most common indication (68.1%). Risk factors known for the nonselective nonsteroidal anti-inflammatory drugs were identified in 65.1% of patients, with the most common being advanced age, hypertension and previous peptic ulcer disease. Potential drug interactions were common. A variety of reasons for initiation of therapy was identified; these included perceived increased efficacy, safety and failure of other treatment. Conclusions These results show that COX-2 inhibitors are being prescribed for patients with multiple risk factors that may place the patient at increased risk of adverse drug reactions to a COX-2 inhibitor. The perception of improved safety and efficacy was common and is of concern. Limitations of the study include the reliance on self-reporting.

Diversity and change in Australia's rangelands: a post-productivist transition with a difference?

Australia's rangelands are experiencing a post-productivist transition at a tempo comparable to Western Europe's, but in contexts that ensure marked divergence in impulses, actors, processes and outcomes. In Australia's most marginal lands, a flimsy mode of pastoral occupance is being displaced by renewed indigenous occupance, conservation and tourism, with significant changes in land ownership, property rights, investment sources and power relations, but also with structural problems arising from fugitive income streams. The sharp delineation between structurally coherent commodity-oriented regions and emerging amenity-oriented regions can provisionally be mapped at a national scale. A comparison of Australia with Western Europe indicates that three distinct but interconnected driving forces are propelling the rural transition, namely: agricultural overcapacity; the emergence of amenity-oriented uses; and changing societal values.

Evaluating Australia's National Medicines Policy using geographical mapping

Background: There has been a proliferation of quality use of medicines activities in Australia since the 1990s. However, knowledge of the nature and extent of these activities was lacking. A mechanism was required to map the activities to enable their coordination. Aims: To develop a geographical mapping facility as an evaluative tool to assist the planning and implementation of Australia's policy on the quality use of medicines. Methods: A web-based database incorporating geographical mapping software was developed. Quality use of medicines projects implemented across the country was identified from project listings funded by the Quality Use of Medicines Evaluation Program, the National Health and Medical Research Council, Mental Health Strategy, Rural Health Support, Education and Training Program, the Healthy Seniors Initiative, the General Practice Evaluation Program and the Drug Utilisation Evaluation Network. In addition, projects were identified through direct mail to persons working in the field. Results: The Quality Use of Medicines Mapping Project (QUMMP) was developed, providing a Web-based database that can be continuously updated. This database showed the distribution of quality use of medicines activities by: (i) geographical region, (ii) project type, (iii) target group, (iv) stakeholder involvement, (v) funding body and (vi) evaluation method. At September 2001, the database included 901 projects. Sixty-two per cent of projects had been conducted in Australian capital cities, where approximately 63% of the population reside. Distribution of projects varied between States. In Western Australia and Queensland, 36 and 73 projects had been conducted, respectively, representing approximately two projects per 100 000 people. By comparison, in South Australia and Tasmania approximately seven projects per 100 000 people were recorded, with six per 100 000 people in Victoria and three per 100 000 people in New South Wales. Rural and remote areas of the country had more limited project activity. Conclusions: The mapping of projects by geographical location enabled easy identification of high and low activity areas. Analysis of the types of projects undertaken in each region enabled identification of target groups that had not been involved or services that had not yet been developed. This served as a powerful tool for policy planning and implementation and will be used to support the continued implementation of Australia's policy on the quality use of medicines.

Assessing forest fire as a potential PCDD/F source in Queensland, Australia

Forest fires are suggested as a potential and significant source of polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans (PCDD/Fs), even though no studies to date provide sufficient evidence to confirm forest fires as a source of PCDD/Fs. Recent investigations in Gueensland, Australia have identified a widespread contamination of PCDDs (in particular OND) in soils and sediments in the coastal region from an unknown source of PCDD/Fs. Queensland is predominately rural; it has few known anthropogenic sources of PCDD/Fs, whereas forest fires are a frequent occurrence. This study was conducted to assess forest fires as a potential source of the unknown PCDD/F contamination in Queensland. A combustion experiment was designed to assess the overall mass of PCDD/Fs before and after a simulated forest fire. The results from this study did not identify an increase in Sigma-PCDD/Fs or OCDD after the combustion process. However, specific non-2,3,7,8 substituted lower chlorinated PCDD/Fs were elevated after the combustion process, suggesting formation from a precursor. The results from this study indicate that forest fires are unlikely to be the source of the unknown PCDD contamination in Gueensland, rather they are a key mechanism for the redistribution of PCDD/Fs from existing sources and precursors.

La diplomacia cultural como herramienta para el mejoramiento de la relación económica de Colombia con Corea del Sur y Australia

Esta investigación se preocupa por dilucidar la función de la diplomacia cultural como herramienta para mejorar la relación económica de Colombia con Corea del Sur y Australia. Así, se analiza a la diplomacia cultural y lo que hace Colombia en esta materia en ambos países; así como el estado de la relación económica de Colombia en un periodo de ocho años con dichos países, y cómo las acciones culturales colombianas podrían llegar a mejorar dicha relación económica. De esta manera además del desarrollo conceptual de diplomacia cultural y los indicadores económicos, a saber; exportaciones; Inversión Extranjera Directa y turismo; se corrió un modelo de regresión lineal para saber si efectivamente hay relación entre ambas variables y una contribución final que consiste en una propuesta de generación de indicadores de gestión a utilizarse al momento de implementar la diplomacia cultural como herramienta en política exterior.

De la escuela rural a las escuelas del mundo.

Resumen tomado de la publicación

Rural Development & the Countryside.

Este libro cubre las necesidades básicas del programa de geografía del nivel AS/A2 de enseñanza secundaria. El libro se divide en cuatro partes: El papel de las zonas rurales ( Definiendo ruralidad, contrastando la geografía rural en países desarrollados, el estudio de tres casos: Australia, Gran Bretaña y los Andes), entornos cambiantes (cambios en la población, cambios en el mundo desarrollado, movimientos migratorios, el impacto del turismo en los servicios, cambios en el empleo), conflictos en el campo (las disputas por el agua en Tanzania), el futuro rural (el papel de la tecnología en el desarrollo de las zonas rurales, el uso del teléfono móvil en Sudáfrica).