Is client-centred care planning for chronic disease sustainable? Experience from rural South Australia

This qualitative evaluation of a chronic disease self-management project in rural South Australia considers the sustainability of client-centred care planning under current organisational and funding arrangements. The study involved consultation with a range of five stakeholder types over two stages (40 in the beginning stage and 39 in the middle stage) about their satisfaction with the care planning and self-management approach used in the project. All stakeholder types valued the client-centred approach because they perceived that clients were better able to accept and deal with the long-term management of their condition. However, this required that care planning should deal with a wider range of issues than just medical management, and so it took longer, which raised its sustainability in general practice under the current funding through the national health insurance programme (Medicare). The study concludes that sustainability may be addressed through further research into the role of and funding for peer-led self-management groups and the employment of care planners in organisational settings that are conducive to a client-centred approach.

Recreational drug use within the employees of the mariculture and seafood industry in South Australia

A study of recreational drug use among workers in the Port Lincoln mariculture and seafood industries was conducted by self report questionnaire. High rates of cannabis and alcohol use were revealed during the shore based fish farming season. The occupational health and safety implications of these findings in one of Australia's most dangerous industries are significant. Further research could inform the development of industry specific harm minimisation policies.

The impact of coordinated care : Eyre region, South Australia 1997-1999

The SA HealthPlus Coordinated Care Trial in the Eyre Region began in fortuitous circumstances. First, it coincided with the completion of the Eyre Regional Health Service (ERHS) needs assessment in 1996, which highlighted outstanding health service needs and community concerns in relation to health care across the region. Second, although conceived as a formal trial, using standard research techniques, scientific processes and formal control groups to test significant differences between intervention and control groups, the trial did not conform strictly to the rules of social science or pure science and became more an exercise in action research. More significantly still, the Eyre Region became involved in the process, not so much as a way of proving a concept (the SA Health Plus hypotheses around utilisation, funding and health outcomes), but as a way of creating opportunities for change in the regional health system. If nothing else, the region stood to benefit from the implementation of the trial and involvement in the trial process. The present paper outlines the impact of the Eyre Coordinated Care Trial, not in terms of hypotheses and data analysis, but in terms of the impact of the trial processes on systems change and the evolution of an outcome-based health system. Such a system has the potential to deliver improved health outcomes to communities within existing financial resources and make much more effective use of resources by integrating care delivery and encouraging collaboration between health providers. In addition, the success of the change process in Eyre also supports the notion that change is not necessarily predicated upon scientific processes and research outcomes alone, but also upon the human and social structures associated with such endeavours. This perspective also contributes to the debate about the nature and role of science in the advancement of knowledge.

The politics of public sector change: trends in health and education sector change in South Australia

BACKGROUND: As the changes underpinning the Coordinated Care Trials in South Australia have become more apparent, similarities have emerged between the rationalisation of public schooling in the mid 1980s and the transformation of public health in the 1990s.

OBJECTIVE: This article aims to discuss the evolution of health services in South Australia and help us answer the question of how best to manage our public and private health infrastructure in a changing economic and social context.

DISCUSSION: Both strategies in education and health share common elements of cost cutting, attempts at improving efficiencies, a flirting with the private sector and the attendant risk of reduced quality of services to the public. This situation in both sectors is indicative of a shift in public policy and a growth in the belief that private management of public sector infrastructure can help resolve the funding crises around our education and health systems.

Investigating the factors associated with job satisfaction of construction workers in South Australia

The purpose of this paper is twofold. Firstly, its aim is to ascertain the major aspects of job satisfaction for South Australian construction workers including the main ramifications of job satisfaction in the working environment. Secondly, it investigates the influence of key age-related factors i.e. chronological age, organisational age and length of service on major aspects of job satisfaction. The collected data for this study comprised 72 questionnaires completed by construction practitioners working at operational levels in the South Australian construction industry. Based on the responses from the target group, this study deduced that job dissatisfaction was predominantly related to the adverse impact on personal health and quality of life. In addition, indifference and the perception of dejection in the workplace are the main consequences of low levels of job satisfaction. Inferential analyses revealed that none of the age-related factors could significantly affect the major aspects of job satisfaction of construction workers in the South Australian context. The study concludes with providing practical suggestions for redesigning human resources practices for increasing the level of job satisfaction within the South Australian construction industry.

Risk management in research and development (R&D) projects: the case of South Australia

A definition of the effective methods of risk management in R&D projects has remained elusive. Similarly, there have been calls to devise effective risk management methods in R&D projects. To develop this area further, the purpose of this study is twofold. First, it validates the veracity of claims about the urgency of introducing effective methods of risk management to R&D projects in South Australia based on nine unstructured interviews with experts. Second, the study presents the outcomes of two case studies that deployed the extended version of the failure mode and effect analysis, namely, the RFMEA method in a South Australian organisation, to investigate how the method can facilitate the identification of effective contingency plans to mitigate high-priority risks. The findings showed that the RFMEA method would be effective for project managers in dealing with risk management issues in R&D projects. The discussions presented will provide guidelines for practitioners in the industry.

Child Abuse and Neglect: A Socio-legal Study of Mandatory Reporting in Australia - Report for the South Australian Government

This report presents the results of a study exploring the law and practice of mandatory reporting of child abuse and neglect in South Australia. Government administrative data over a decade (2003-2012) were accessed and analysed to map trends in reporting of different types of child abuse and neglect (physical abuse, sexual abuse, emotional abuse, and neglect) by different reporter groups (both mandated reporters e.g., police, teachers, doctors, nurses; and non-mandated reporters e.g., family members, neighbours), and the outcomes of these reports (whether investigated, and whether substantiated or not). The study was funded by the Australian Government and administered through the Government of Victoria.

DDT and metabolites residues in the southern bent-wing bat (Miniopterus schreibersii bassanii) of south-eastern Australia

The southern bent-wing bat (Miniopterus schreibersii bassanii) is an insectivorous, obligate cave dwelling species found in south-eastern South Australia and western Victoria, Australia. In recent times, the finger of blame for an apparent population decline at Bat Cave, Naracoorte (one of only two known maternity roosts for this species, the other being Starlight Cave, Warrnambool) has been pointed at pesticide use in the region, following the finding of organochlorine and organophosphate insecticide residues in bat guano. This study sampled juvenile southern bent-wing bats from Bat Cave and Starlight Cave, and determined DDT, DDD and DDE concentrations in liver, pectoral muscle, brain and back-depot fat tissues.

New species of Otionellina and Selenaria (Bryozoa-Cheilostomata) from the South West Shelf, Western Australia

Recent sediment samples recovered from the mid-latitude South West Shelf (SWS) of Western Australia (23°- 32° S) by a scientific team aboard the RV Franklin have produced large numbers of free-living, lunulitiform bryozoans. Among these are three undescribed species, Otionellina boneae sp. nov., Selenaria kayae sp. nov., and Selenaria meganae sp. nov. The Australasian lunulite fauna is both diverse and abundant and the new species bring the total of described taxa to sixty (P. Cook unpub.). Twelve lunulite species have been recorded from the SWS. These findings have extended the known geographical range of several lunulite species.

Overweight, obesity and metabolic syndrome in rural south-eastern Australia

Aims & rationale/Objectives : To measure the prevalence of overweight, obesity and the metabolic syndrome in rural Australia.</p>

Methods :Two cross-sectional population surveys of chronic disease risk factors were carried out in rural Victoria (Corangamite Shire) and South Australia (Limestone Coast) in 2004-05. For both surveys, a stratified random sample of the population aged 25 to 74 years was drawn from the electoral roll. The surveys comprised a self-administered questionnaire, physical measurements and laboratory tests.</p>

Principal findings : A total of 841 individuals had complete questionnaire, health check and measured MetS data. The prevalence of overweight and obesity was 75% in males and 64.7% in females defined by BMI. Using waist circumference, the prevalence of overweight and obesity was higher in females (72.9%) than in males (63.2%). The overall prevalence of obesity of was 30.1% when defined by BMI, but 44.8% when defined by waist circumference. The prevalence of metabolic syndrome according to NCEP ATP III 2005 criteria was 29.0% in males and 28.5% in females. According to IDF criteria, the prevalence for males and females were 30.5% and 36.3%, respectively. The prevalence of metabolic syndrome and central (abdominal) obesity, hyperglycaemia, hypertension, and hypertriglyceridaemia increased with age.

Discussion : The prevalence of overweight and obesity, in particular central obesity, in rural Australia is very high as is the prevalence of metabolic syndrome.

Implications : Urgent population wide action is required to turn this trend around and regular monitoring of the trends in response to such action is essential.

Anthropogenic aerosol emissions and rainfall decline in South-West Australia - accompanying model results in NetCDF format

It is commonly understood that the observed decline in precipitation in South-West Australia during the 20th century is caused by anthropogenic factors. Candidates therefore are changes to large-scale atmospheric circulations due to global warming, extensive deforestation and anthropogenic aerosol emissions - all of which are effective on different spatial and temporal scales. This contribution focusses on the role of rapidly rising aerosol emissions from anthropogenic sources in South-West Australia around 1970. An analysis of historical longterm rainfall data of the Bureau of Meteorology shows that South-West Australia as a whole experienced a gradual decline in precipitation over the 20th century. However, on smaller scales and for the particular example of the Perth catchment area, a sudden drop in precipitation around 1970 is apparent. Modelling experiments at a convection-resolving resolution of 3.3km using the Weather and Research Forecasting (WRF) model version 3.6.1 with the aerosol-aware Thompson-Eidhammer microphysics scheme are conducted for the period 1970-1974. A comparison of four runs with different prescribed aerosol emissions and without aerosol effects demonstrates that tripling the pre-1960s atmospheric CCN and IN concentrations can suppress precipitation by 2-9%, depending on the area and the season. This suggests that a combination of all three processes is required to account for the gradual decline in rainfall seen for greater South-West Australia and for the sudden drop observed in areas along the West Coast in the 1970s: changing atmospheric circulations, deforestation and anthropogenic aerosol emissions.

Narratives of mitigation : sentencing Indigenous criminal defendants in South Australia’s Higher Courts

In their statistical analyses of higher court sentencing in South Australia, Jeffries and Bond (2009) found evidence that Indigenous offenders were treated more leniently than non-Indigenous offenders, when they appeared before the court under similar numerical circumstances. Using a sample of narratives for criminal defendants convicted in South Australia’s higher courts, the current article extends Jeffries and Bond’s (2009) prior statistical work by drawing on the ‘focal concerns’ approach to establish whether, and in what ways, Indigeneity comes to exert a mitigating influence over sentencing. Results show that the sentencing stories of Indigenous and non-Indigenous offenders differed in ways that may have reduced assessments of blameworthiness and risk for Indigenous defendants. In addition, judges highlighted a number of Indigenous-specific constraints that potentially could result in imprisonment being construed as an overly harsh and costly sentence for Indigenous offenders.