Australia's health 2000 : the seventh biennial report of the Australian Institute of Health and Welfare

Australia's Health 2000 is the seventh biennial health report of the Australian Institute of Health and Welfare. It is the nation's authoritative source of information on patterns of health and illness, determinants of health, the supply and use of health services, and health services costs and performance.This 2000 edition serves as a summary of Australia's health record at the end of the twentieth century. In addition, a special chapter is presented on changes in Australia's disease profile over the last 100 years.Australia's Health 2000 is an essential reference and information source for all Australians with an interest in health.

Extending the paramedic role in rural Australia : a story of flexibility and innovation

Introduction: This article identifies trends in the evolving practice of rural paramedics and describes key characteristics, roles and expected outcomes for a Rural Expanded Scope of Practice (RESP) model.

Methods: A multiple case study methodology was employed to examine the evolution of rural paramedic practice. Paramedics, volunteer ambulance officers and other health professionals were interviewed in four rural regions of south-eastern Australia where innovative models of rural paramedic practice were claimed to exist. The research team collected and thematically analysed the data using the filter of a sociological framework throughout 2005 and 2006.

Results: The study found that paramedics are increasingly becoming first line primary healthcare providers in small rural communities and developing additional professional responsibilities throughout the cycle of care.

Conclusions: Adoption of the RESP model would mean that paramedics undertake four broad activities as core components of their new role: (1) rural community engagement; (2) emergency response; (3) situated practice; and (4) primary health care. The model’s key feature is a capacity to integrate existing paramedic models with other health agencies and health professionals to ensure that paramedic care is part of a seamless system that provides patients with well-organized and high quality care. This expansion of paramedics’ scope of practice offers the potential to improve patient care and the general health of rural communities.

The influence seekers : political lobbying in Australia

In this book specialists and professionals reflect on political lobbying in Australia, examining its history and growth and recent changes in its practice and regulation. The changing relationship between lobbying and the media and the role of lobbying in the business of government are closely analysed. Case studies of powerful lobby groups, such as the Pharmacy Guild of Australia and Business Council of Australia, are included. The authors’ view of the lobbyist is fresh and informative, and may serve to correct common misconceptions.

The role of social support in families coping with childhood brain tumor

Previous studies suggest that support from social networks is a protective factor buffering the negative effects of stressful events, such as having a child with a chronic illness. The literature highlights the need for more systematic examination of parents’ social support networks across the disease trajectory, to obtain a more complete understanding of how a family's support system affects adjustment over time. This was attempted in this study of 88 parents of children with brain tumors, recruited from hospitals in Australia, Singapore, and New Zealand. It employed a longitudinal design, tracking families for 2 years postdiagnosis to examine the relationship between social support and coping. As in previous research this study showed that different types of support are needed at different stages in the illness trajectory. The study also identified the use of various coping strategies by families, directed at the maintenance and enhancement of existing supports and the securing of new supports. The study failed to establish a statistically significant relationship between level of coping and social support, however, suggesting that parents were using primarily “internal” familial modes of coping, including preexisting patterns of coping, with external social support being an adjunct to their coping rather than being a major contributor.

Young adults' management of type 1 diabetes during life transitions

Aim. To identify life transitions likely to impact diabetes self-care among young adults with Type 1 diabetes and their coping strategies during transition events.

Background. Relationships among psychosocial stress, adjustment, coping and metabolic control affect clinical outcomes and mental health. Life transitions represent major change and are associated with stress that temporarily affects individuals’ problem-solving, coping abilities and blood glucose levels.

Design. A qualitative interpretive inquiry.

Method. Semi-structured interviews were conducted with 20 young adults with Type 1 diabetes and a constant comparative analysis method. Data and analysis was managed using QSR_ NVIVO 7 software.

Results. Participants identified two significant transition groups: life development associated with adolescence, going through the education system, entering new relationships, motherhood and the workforce and relocating. Diabetes-related transitions included being diagnosed, developing diabetes complications, commencing insulin pump treatment and going on diabetes camps. Participants managed transitions using ‘strategic thinking and planning’ with strategies of ‘self-negotiation to minimise risks’; ‘managing diabetes using previous experiences’; ‘connecting with others with diabetes’; ‘actively seeing information to ‘patch’ knowledge gaps’; and ‘putting diabetes into perspective’.

Conclusions. Several strategies are used to manage diabetes during transitions. Thinking and planning strategically was integral to glycaemic control and managing transitions. The impact of transitions on diabetes needs to be explored in larger and longitudinal studies to identify concrete strategies that assist diabetes care during life transitions.

Relevance to clinical practice. It is important for health professionals to understand the emotional, social and cognitive factors operating during transitions to assist young adults with Type 1 diabetes to achieve good health outcomes by prioritising goals and plan flexible, timely, individualised and collaborative treatment.

Is the migrant house in Australia an Australian vernacular architecture?

This report seeks to understand the meaning of the migrant house in Melbourne, Australia. Following a discussion of the Australian vernacular house, it asks what it is that makes the migrant house a unique category, different from other, nonmigrant houses in Australia. Reporting on research on seventeen migrant houses in the suburbs of Melbourne, it then shows how three architectural elements - the facade, the terrace, and the back yard - differentiate these houses from other examples of the Australian vernacular. Finally, it argues that, through their different "migrant aesthetics," the three architectural elements illustrate how soda-spatial features have facilitated and eased the adaptation of migrants to life in Australia.

Nurses report a healthy culture: Results of the Practice Environment Scale (Australia) in an Australian hospital seeking Magnet recognition

The Magnet Recognition Program requires evidence that the nursing practice environment supports staff to provide optimal care, access professional development opportunities and participate in hospital affairs. This research aimed to assess clinical nurses’ work environment at a leading private hospital in Sydney, Australia using a version of the Practice Environment Scale of the Nursing Work Index modified for the Australian context. Our results were comparable to Magnet hospitals for two subscales and significantly higher than Magnet results for the remaining three subscales and the composite scale. This was especially pleasing in relation to the hospital's preparation for Magnet recognition. Hospitals across Australasia might find administration of the Practice Environment Scale (modified for use in the Australian context) a useful exercise both as a stimulus to preparation and an indicator of readiness for Magnet recognition.

The descent of Morgan in Australia: kinship representation from the Australian colonies

Morgan had two extraordinary disciples in Lorimer Fison and Alfred Howitt in Australia. They were inspired by Morgan’s kinship schedule and were profoundly engaged in the method and theory of the collection of kinship data and its interpretation. Fison began using the schedule in Fiji in 1869. Soon after his first contact with Howitt, in 1873, they changed the method of collection of kinship terminologies. This paper traces the shift from tabulated kinship lists to family trees and the use of sticks to represent relationships (nearly twenty years before Rivers’ celebrated ‘genealogical method’), as well as efforts to find new means of representing kinship through experimentation with ‘ graphic formulae’ inspired by chemical equations. These innovations first occurred through the gathering of kinship data about the Kŭnai of Gippsland, Victoria, and crucially involved close collaboration between Howitt and his Kŭnai consultant Tulaba. What was revealed in this process was an indigenous kinship system quite different from that found in other parts of colonial Australia known at the time. Fison and Howitt explained this system as transitional between two stages in terms of Morgan’s evolutionary scheme, but at the same time challenged the assumption that the general scheme could be applied to Australia. While the details of Morgan’s evolutionary stages have faded from view, the methods of collection, representation, transmission, comparison and interpretation of kinship data are still live issues in anthropology today. The kind of kinship system discovered in Gippsland involved neutralisation of the cross-parallel distinctions, distinctions that are otherwise typical of Australia. Such neutralisation can now be shown to occur elsewhere in Australia. There does indeed seem to have been a transition from a Dravidianate system with cross-parallel distinctions to ‘overlays’ of cross-parallel neutralisation, and finally a complete loss in some generations of such distinctions in the terminology. These discoveries open up possibilities of rebuilding a diachronic theory of kinship change and evolution, incorporating some of the insights of Fison and Howitt, though without their specific hypotheses, either of local developments in Gippsland or the grand scheme of Morgan.

Acting alone to act together: diversifying approaches to North Korea

Strategic discussions about North Korea’s proliferation comprise a number of dimensions. The core assumption underlying this article is that the ideational aspects of North Korea’s decision making are important and give rise to a range of strategic considerations. This is not to underplay the strategic, materialist elements in North Korea’s provocative and at times belligerent behaviour. Rather, it is to argue that Australia is well placed to concentrate on the social dimensions of strategic discussions. As a less important middle power, a regional player, yet geographically distant from the threat, Australia is in a position to provide a point of differentiation from other, more entrenched players such as the United States or the Republic of Korea (ROK). A good starting point for developing this sort of engagement is to enhance non-state, track two cooperation between the two countries, which has been stalled since the early 2000s. In this article I will first canvass the ongoing debate taking place in Australian academic and policy circles regarding Australia’s place in the world. Of particular concern, is the question how Australia should balance its most important strategic relationship – that with the United States – with geographic and economic realities. I then sketch some of the limitations of current thinking, concentrating particularly on discourse that portrays North Korea as a rogue state and finish with a discussion of how non-state activity can act as a helpful precursor to more constructive relationships between states, and the types of creative engagement strategies currently taking place in the United States, despite the volatile political environment.

Lessons from large-scale conservation networks in Australia

Australia has seen a rapid growth in the establishment of networks of lands managed for connectivity conservation across tenures, at landscape and sub-continental scales. Such networks go under a variety of names, including biosphere reserves, biolinks, wildlife corridors and conservation management networks. Their establishment has varied from state government-led initiatives to those initiated by non-government organizations and interested landholders. We surveyed existing major landscape scale conservation initiatives for successes, failures and future directions and synthesized common themes. These themes included scale, importance of social and economic networks, leadership, governance, funding, conservation planning, the role of protected areas and communication. We discuss the emergence of national policy relating to National Wildlife Corridors in Australia and the relationship of this policy to the long standing commitment to build a comprehensive, adequate and representative National Reserve System. Finally we outline areas for further research for connectivity conservation projects in Australia.

Critical factors to the success of alliances in Australia

Governments in Australia face the challenge of meeting the growing demand for new infrastructure, which can be delivered more quickly in an increasingly complex environment. Alliance Contracting has been introduced to overcome some of the challenges by, aligning the incentives of the partners, clearly defining their rights and responsibilities, and providing the means for resolving disputes when they arise. The purpose of this research was to explore the critical success factors of Alliance Contracting in order to understand the roles of the various terms and conditions and how they fit together to create a relationship-based contract. A qualitative technique of semi-structured in-depth interviews was used to gather primary data in response to the research questions. The research aimed to develop an in-depth understanding of Alliance Contracting. The results show that the key contributor to the success or failure of Alliances is whether all the partners benefit equitably from the venture. Analysis of the data indicates that, in general, trusting attitudes/behaviour is perceived to be the most important critical success factor for Alliance Contracting in the broader construction industry. The second most popular critical success factor was shared and aligned goals. The third issue was the evidence of open behaviour, and the final issue was the presence of shared knowledge. The implication of this research is that there are several key factors that were necessary preconditions for successful Alliances.

Households' perceptions on sustainable home behaviour and improvements in Australia

The consumption of energy in the residential building is a major contributor to Australia's stationary energy greenhouse gas emissions. With the aim of investigating the householders' motivations and perspectives on sustainable home improvements, this study, by using an online survey instrument, collected more than 500 sets of questionnaire data from households in the state of New South Wales, Australia. Through statistical analysis of the data collected, this research has found that construction cost and government incentive were considered as major influence factors on achieving energy efficient residential building development, and the lower bills from reduced energy and water consumption were considered as the most important benefits from the households' perspectives. The research also found that although many households exhibited a high level of awareness or had implemented some sustainability improvements, the total number of potential improvements scored poorly. A suggestion, based on these research findings, is that the government should promote the reasons and benefits for sustainability home improvements that are identified in this research paper, and try to reduce material costs and improve government incentives.