Rural mental health a top priority (media release)

The mental wellbeing of farmers has emerged as a key issue on day one of the NSW Farmers’ Association’s Annual Conference in Sydney. Delegates to Conference have today voted unanimously to encourage the Federal Government to continue to provide funding for an on-farm counselling initiative.

NSW Farmers’ Association Rural Affairs Committee Chair Sarah Thompson says farmers facing difficult times are under a great deal of stress and need ongoing support. “Drought and isolation are two realities for farmers in NSW, and are two contributing factors to mental health and wellbeing,” Ms Thompson said.

A Healthier Future For All Australians - Final Report of the National Health and Hospitals Reform Commission - June2009

The Federal Government has released A Healthier Future For All Australians, the final report of the National Health and Hospitals Reform Commission. The Report provides the governments of Australia with a practical national plan for health reform and contains 123 recommendations covering the broad spectrum of health care. The report cites figures indicating Australians are forgoing two years of life because of waste and duplication in the health system. It argues that Australia could save $1bn in healthcare costs by preventing just half of these mistakes. Better care in the community, through general practice,community health centres and other frontline services, would also eliminate the need for 700,000 hospital admissions a year. The report identifies actions that can be taken by governments to reform the health system under three reform goals:

* Tackling major access and equity issues that affect health outcomes for people now;
* Redesigning our health system so that it is better positioned to respond to emerging challenges; and
* Creating an agile and self-improving health system for long-term sustainability.

The report focuses on five priorities for improving access and equity, as follows:
1. Improving health outcomes of Aboriginal and Torres Strait Islander people, including the establishment of a new National Aboriginal and Torres Strait Islander Health Authority (NATSIHA).
2. Improved care for people with serious mental illness, including an expansion of sub-acute services in the community and propose that all acute mental health services have a "rapid response outreach team", available 24 hours a day, which can provide intensive community
treatment and support, as an alternative to hospital-based treatment.
3. Support for people living in remote and rural areas, including a proposal to give under-served remote and rural communities top-up funding to an equivalent amount of funding on a per capita basis as communities with better access to medical, pharmaceutical and other primary health care services.
4. Improved access to dental health care, including establishing 'Denticare Australia' to give everyone access to basic dental services.
5. Timely access to quality care in public hospitals, including recommending that public hospitals with major emergency departments be funded to ensure beds are available at all times for people needing to be admitted from the emergency department.

ABC News coverage

AMA Response

Rural Doctors Association "Report forgets the bush"

A review of suicide statistics in Australia (AIHW)

A review of suicide statistics in Australia is a detailed report on the statistical processes used to track national suicide rates. Suicide is a matter of considerable public interest and policy significance so reliable statistical information on suicide occurrence is important. This report examines in detail the current methodologies used to track suicide rates, identifying issues with the process of suicide reporting and the extent of, and reason for, any under-enumeration of suicide. Revised estimates are provided and the report provides advice for the future statistical monitoring of suicide and self harm in Australia. This report provides a unique insight into the limitations of current data on suicide rates.

Manual handling of bariatric patients

Manual handling risks associated with the care, treatment and transportation of bariatric (severely obese) patients in Australia is the subject of a report, Manual handling and bariatric people, from the Australian Safety and Compensation Council (ASCC) by Steve Cowley and Susan Leggett. In 2004-05, some 41% of adult males and 25% of females in Australia were classified as overweight (BMI of between 25 and 30) and 18% of males and 17% of females were classified as obese (BMI over 30). Some consider a person with a Body Mass Index (BMI) that exceeds 30 to be bariatric, or morbidly obese, but the National Health and Medical Research Council(NHMRC) defines morbid obesity as a BMI of more than 40. The number of persons who may be considered bariatric is not known.

This report looks at the implications severe obesity for workplace health and safety and workers' compensation. "Morbidly obese patients are over represented in the use of healthcare. Further, there is a high mortality rate for these patients because of the patients' delay in accessing treatment. It is possible that this delay may be in part due to there being limited capacity within institutions to manage care." Four case studies are documented for the ambulance, fire, hospital and funeral occupations, where specific issues and possible solutions are examined.

Death of Sir William Refshauge

Sir William Refshauge, Companion of the Order of Australia, has died aged 96.
A former President and only Australian President of the WHO, former Director-General of Army Medical Services , former Director General of the Commonwealth Dept. of Health, former chair of the NHMRC and father of a NSW Minister for Health.

Coaching in Nursing Workbook (International Council of Nurses)

This workbook will help you improve your skills and incorporate coaching principles in to your practice - whether you are a clinician, administrator, educator or researcher. Coaching is a tool that if implemented strategically can affirm and develop professional competencies such as critical thinking, communication
and delivering improved patient-centered care. It also can foster scholarship in the clinical setting, provide a method of communicating practice knowledge and help novices integrate the use of theory in their practice.

Snapshot of Australian Primary Health Care Research 2009

The Hon. Mark Butler, Parliamentary Secretary for Health has launched the "Snapshot of Australian primary health care research 2009". Snapshot highlights research produced by some of Australia's leading primary health care researchers, and demonstrates the potential for this field of research to improve the health of Australians.

Design Guide for the Built Environment of Behavioral Health Facilities, National Association of Psychiatric Health Systems, 3rd ed., Spring 2009

This document is intended to address the built environment of the general adult inpatient behavioural healthcare unit. An indispensable guide for anyone designing or renovating mental health facilities.

Charting new roles for Australian general practice nurses

Practice nurses ease the strain on general practitioners, but not enough doctors and policy makers recognise their pivotal role, this report reveals.

There are, in essence, two health policy problems for which nurses in general practice can provide a solution: (1) the need to find new models of clinical care for changing patterns of disease and population demographics and (2) the need to expand the health workforce at a time when the numbers of available doctors are falling.

Indigenous health and wellbeing: the importance of country

A key aspect to improving Indigenous wellbeing is exploring the relationship between land and wellbeing. Evidence exists which suggests there are positive physical health outcomes from living or working on country.However, it has also been argued that Indigenous health cannot improve whilst Indigenous peoples continue to live outside urban areas. These competing views will lead to the adoption of very different strategies for addressing Indigenous health issues. Therefore, it is critical to develop an understanding of the value of native title, the return of lands generally, or the capacity to live or work on country, to Indigenous peoples' wellbeing.

The aim of this paper by Cynthia Ganesharajah of the Native Title Research Unit, Australian Institute for Aboriginal and Torres Strait Islander Studies, is to provide an overview of relevant material. The central argument is that Indigenous health strategies should take into consideration the importance of connection to country to maximise their effectiveness.

The impact of drought on mental health and alcohol use

Ben Edwards, Matthew Gray, Boyd Hunter Australian Institute of Family Studies

The most recent drought has been one of the most severe on record with large parts of southern and eastern Australia experiencing dry conditions since 1996. There have been few large studies that examine the impact of drought upon the mental health and alcohol use of people living in regional and rural areas of Australia or other developed countries.

This study uses the Rural and Regional Families study, a cross-sectional study of 8,000 people from rural and regional areas of Australia that interviewed people in areas that were in severe drought, drought, below average and above average rainfall. Working age people who were in drought (as defined by rainfall and also self report) were compared to those that were not in drought. Regression models are used to adjust for demographics that would not be expected to be affected by drought to estimate the impact of drought on the mental health problems, mental health, anti-depressant use for stress and alcohol use.

One of the primary mechanisms by which mental health and alcohol abuse problems arise during and after a drought is through the financial impact associated with decreased agricultural productivity in rural areas. While the drought of 2002-2007 had significant negative economic impact on the Australian economy it had particularly large effects on financial hardship in regions affected - especially among farmers (Edwards et al. 2009). The findings of the impact of drought on mental health and alcohol use in this context and the possible policy implications are discussed.

Medical Practitioners : education and training in Australia

The Australian Parliamentary Library has released a briefing paper by Dr Rhonda Jolly entitled, Medical Practitioners : education and training in Australia. Various government policies since the early 1990's have been implemented as a reaction to perceived oversupplies and shortages of trained doctors, such as capping the number of university places, addressing rural shortfalls in doctors with overseas recruitments and a more recent policy of creating more medical training opportunities.

The number of Commonwealth supported commencing places in medical courses in universities across Australia rose from 1403 in 2003 to an estimated 2544 in 2008. Jolly says that this change in policy direction will take a number of years to address current shortages due to the complexities of medical training. Her aim in this paper is to explain these complexities and why previous policies have often had a negative outcome. "Understanding better how the transformation from student to "specialist" medical practitioner works and the roles of those institutions which contribute to, and influence that transformation may help to lessen the possibility that these types of negative outcomes unnecessarily beleaguer the health system."

Refining national asthma indicators Delphi survey and correlation analysis (AIHW)

This report is the result of a systematic review undertaken by the Australian Centre for Asthma Monitoring (ACAM) to refine and simplify asthma monitoring in Australia. A Delphi survey and correlation analysis were used to review the currently recommended list of 24 national asthma indicators in order to identify a smaller set of core indicators, which provide the most important and relevant information and which are more effective at signalling change for future asthma monitoring activities.

General Practice - A Safe Place to Be. Tips and Tools

General Practice - A Safe Place to Be. Tips and Tools, Royal Australian College of General Practitioners, March 2009

This booklet outlines a range of practical strategies to assist general practices to appropriately minimise risks of violence, including means to:

* create a safe physical environment
* flag the files of patients with a history of violent behaviour within a practice
* assertively clinically manage patients at risk of violent behaviour
* work with other services to reduce the future risk of violence, and
* support the general practice team after experiences of violence.

Practice posters and a comprehensive background report are also available.

Australasian Health Facility Guidelines

The Australasian Health Facility Guidelines (AusHFG) are an initiative of the Australasian Health Infrastructure Alliance (AHIA.)The AusHFG enables health facilities throughout Australasia to use a common set of base elements as a guide and offers significant benefits including:
* Australasian best practice approach to health facility planning
* standard spatial components
* a highly flexible planning tool responsive to the dynamic changes in Health.

Capabilities for Supporting Prevention and Chronic Condition Self-Management: A Resource for Educators of Primary Health Care Professionals.

This new resource includes:

* Agreed definitions of chronic condition self-management (CCSM) related terms
* A framework for delivery of self-management education to the future health professional workforce
* Self-management support skills in the context of the Chronic Care Model (Wagner, et al., 2001); and
* Identification and definition of the knowledge, attitudes and skills required by the PHC workforce for prevention and CCSM support across the continuum of care from wellness, early detection and chronic condition management.

The document is intended to provide a resource for educators in universities and PHC service delivery settings, as well as regulatory and professional bodies. It will help guide the standards required by undergraduate and graduate programs for providing education and training in CCSM support to the existing and future PHC workforce.

Indigenous palliative care web resource now available

A new web resource containing information for people working, studying or interested in palliative care for Indigenous Australians is now available. This web resource includes information about relevant policies and strategies, publications, information about programs and projects (including contact details), relevant health promotion resources and organisations addressing the palliative care needs of Aboriginal and Torres Strait Islander peoples.

The above resource is one of a number of new features on the very useful Australian Indigenous HealthInfonet site. Another interesting new addition is a review of Indigenous kava use

General Practice in Australia, health priorities and policies 1998-2008 (AIHW)

This report looks extensively at changes in the activities of GPs from 1998 to 2008 in the light of numerous government initiatives and changes in the GP workforce and in the population. It shows that GP activity generally correlates well with health policy initiatives and clinical guidelines, notably with Type 2 diabetes and the control of asthma and high blood cholesterol levels. In some areas, however, there is less evidence of an effect so far. The report also raises some potential concerns about the costs from the continued rapid growth in orders for pathology testing and the overall challenge for the GP workforce in dealing with an ageing population with complex needs.
Click on the link to view the media release

2009-10 Federal Budget initiatives

From July 1 ;

- Expansion of the Rural Health Locum program.
- Expansion of the Training for Rural & Remote Procedural General Practitioners program
- Maintaining the existing funding for University Departments of Rural Health and the Dental Training Expanded Placements program.
- Additional funding for the Mental Health Services in Rural & Remote Areas program.
- Extension of the Mental Health Support for Drought Affected Communities program.

Breastfeeding and infants' time use

Being breastfed during infancy is known to improve developmental outcomes,but the pathways by which this occurs remain unclear. One possible yet unexplored mechanism is that breastfed infants may spend their time differently to infants who are not breastfed. This paper analyses infants' time use according to breastfeeding status in order to help inform the debate about how breastfeeding leads to improved child outcomes.

The analysis uses infants' time use data from the first wave (2004) of Growing Up in Australia: The Longitudinal Study of Australian Children (LSAC), derived from diaries completed by the parents of almost 3,000 Australian infants aged 3-14 months. It explores how much time infants spend in activities such as being held or cuddled, read or talked to, or crying, using data on whether or not infants were still breastfeeding, and taking into account other child and family characteristics. It also compares time spent in different social contexts. Finally, the paper uses the time use data to analyse which infants were still breastfeeding, and what factors are associated with differences in time spent breastfeeding.

The results show that breastfed infants spend more time being held or cuddled and being read or talked to, and less time sleeping, or eating, drinking or being fed other foods. They also cried slightly more, and watched television slightly less than infants who were not being breastfed. Those who breastfed spent more time with their parents, and in particular, almost one additional hour a day alone with their mother compared to non-breastfeeding infants.

These findings have important implications for how children grow, and show the value of time use data in exploring pathways to development for infants and young children. The possibility that cognitive advantages for breastfed children may arise from their distinct patterns of time use and social contexts during the breastfeeding phase is an important area for future research using survey data such as from LSAC.

Jennifer Baxter and Julie Smith Australian Institute of Family Studies, June 2009, Research paper no. 43

Young Women Talk - Aboriginal and Torres Strait Islander Women (DVD)

This DVD highlights 16 diverse stories from young Aboriginal and Torres Strait Islander Women from across Australia. It provides unique and personal perspectives that Security4Women (S4W) hope will create greater awareness among Australian government decision makers of the life experiences of young Aboriginal and Torres Strait Islander women. This DVD is part of a broader project, Young Women Talk, designed to provide opportunities for young women aged 18-29 years to share their personal stories of learning and working and their vision for women in Australia.

Young Women Talk was initiated by S4W a national network of non-profit organisations primarily concerned with improving the lifelong economic wellbeing of Australian women and undertaken by Kim Lawler on behalf of S4W over a four month period.

Effective care, not criminalisation

Released last month in Washington by the head of the UN Office on Drugs and Crime, with new US government drug tsar Gil Kerlikowske, The UN World Drug Report 2009 has direct implications for Australia. The report reveals that a significant shift is occurring in the way the world controls drugs. The ambition of ending drug use through law enforcement is giving way to a sobering realisation that we need to reduce demand for drugs, decrease incarceration of drug users and increase drug treatment programs.

"The Australian" report

Between the Rock and a hard place (Report)

Paul McGeough visited Mutitjulu - the crisis community that precipitated the Northern Territory intervention. He found mayhem and despair, but sparks of hope, too.

Special report.

GWAHS Men's Health Forum report

The 20 page report of the GWAHS Men's Health Network forum held in Dubbo on 16-10-08 and the 2009-11 Action Plan are available from Dubbo Librarian Michael Barnes michael.barnes@gwahs.health.nsw.gov.au

Overcoming Indigenous Disadvantage : Key indicators 2009 (Productivity Commission)

Today's Overcoming Indigenous Disadvantage Report by the Productivity Commission shows little progress has been made in closing the gap for Indigenous people but provides the strongest argument yet for the need for a new way of working with Indigenous people, Aboriginal and Torres Strait Islander Social Justice Commissioner Tom Calma has said.

The comprehensive report examines a wide range of areas including early child development, education, health, home environment, community safety and governance.

Australian Human Rights Commission Press Release

Occupational health and safety : free databases

Two databases you may not know about when you are looking for OH&S information including accident prevention are:

NIOSHTIC-2 (Free version) A free bibliographic database of occupational safety and health publications, documents, grant reports, and other communication products supported in whole or in part by the National Institute for Occupational Safety and Health part of the CDC.

CISDOC (Free version) CISDOC is the fruit of 30 years of screening the occupational safety and health literature of the world (in many languages) for interesting and useful books, articles and audiovisual materials that occupational safety and health specialists can use in their fight against workplace accidents and diseases. It already guides users to over 62,000 publications, and 2000 more references are added every year.

Reposted from NCAHS Library Clippings

Overcoming indigenous disadvantage : Final report

Final report of the NSW Parliamentary Inquiry into Overcoming Indigenous Disadvantage -Dec 08. The Government response of May 2009 is also accessible from this page


Also available : Overcoming indigenous disadvantage : key indicators 2007 which gives statistics on indigenous health and social indicators.

The state of our public hospitals, June 2009 report

The state of our public hospitals, June 2009 report provides a snapshot of public and private hospital activity in 2007-08. The 2009 report is based on data collected in 2007-08.

The 2009 report includes four feature chapters. The first feature is titled "Turning our public hospitals around" and provides information about hospital reform directions agreed between the Commonwealth and all State and Territory Governments. The second, titled "Our maternity services", provides information on the number and type of maternity services provided by hospitals and their associated costs. The third feature titled "Indigenous Australians in hospital" describes Indigenous hospital use compared to that of other Australians. The final feature is titled "State and territory public hospital performance reporting" and includes details of state and territory online hospital reporting.

Developing a NHMRC Strategic Plan - a national strategy for medical research and public health research

The National Health and Medical Research Council Act 1992 requires the NHMRC to present a Strategic Plan to government on a triennial basis. Each Strategic Plan must include a national strategy for medical research and public health research.

In preparation for the next Strategic Plan, which will cover the period January 2010- December 2012, NHMRC has prepared a Consultation Paper setting out a draft strategy for medical research and public health research.