Medicine and Health Sciences Commons^™

Dementia And Driving: An Approach For General Practice, John Carmody, Victoria Traynor, Donald C. Iverson

Faculty of Health and Behavioural Sciences - Papers (Archive)

Background As our population ages, the proportion of drivers with dementia will continue to rise. Increasingly, health professionals are faced with the clinical dilemma of determining fitness to drive. Unfortunately, the management of drivers with dementia is fraught with hazards.

Objective This article attempts to provide an overview of the complex issue of driving and dementia as it relates to general practitioners in Australia. In addition, an evidence based management strategy is proposed.

Discussion When determining an individual’s fitness to drive, a clinician’s input may have legal, ethical, emotional and social ramifications. At present, a clear consistent national protocol detailing …

Translation Of Tobacco Policy Into Practice In Disadvantaged And Marginalized Subpopulations: A Study Of Challenges And Opportunities In Remote Australian Indigenous Communities, Jan A. Robertson, Katherine M. Conigrave, Rowena Ivers, Kim Usher, Alan R. Clough

Faculty of Health and Behavioural Sciences - Papers (Archive)

Background: In Australia generally, smoking prevalence more than halved after 1980 and recently commenced to decline among Australia's disadvantaged Indigenous peoples. However, in some remote Indigenous Australian communities in the Northern Territory (NT), extremely high rates of up to 83% have not changed over the past 25 years. The World Health Organisation has called for public health and political leadership to address a global tobacco epidemic. For Indigenous Australians, unprecedented policies aim to overcome disadvantage and close the 'health gap' with reducing tobacco use the top priority. This study identifies challenges and opportunities to implementing these important new tobacco initiatives …

Practice Guidelines Need To Address The 'How' And The 'What' Of Implementation, Kenneth D. Walsh, Jackie Crisp, Ann Mckillop

Faculty of Health and Behavioural Sciences - Papers (Archive)

Aim: The aim of this study was to explore the realities of everyday nursing practice associated with the implementation of a guideline for the assessment and management of cardiovascular risk. Background: The use of clinical practice guidelines is pivotal to improving health outcomes. However, the implementation of guidelines into practice is complex, unpredictable and, in spite of much investigation, remains resistant to explanation of what works and why. Exploration of the nature of guideline implementation has the potential to illuminate the complexities of guideline implementation by focussing on the nature of practice. Nurses are well placed at the front line …

Do Australian Adolescent Female Fake Tan (Sunless Tan) Users Practice Better Sun-Protection Behaviors Than Non-Users?, Melinda Williams, Sandra C. Jones, Peter Caputi, Donald C. Iverson

Faculty of Health and Behavioural Sciences - Papers (Archive)

Objective: To determine differences in sun-protection behaviours, and incidence of sunburn, between Australian adolescent female fake tan users and non-users. Design: Cross sectional survey. Method: 398 adolescent females aged 12 to 18 years participated in a survey at public venues, schools, and online. The main outcome measures were self-reported fake tan usage in the past 12 months, frequency of sunburns and habitual sun-protection behaviours. Setting: Surveys were completed in New South Wales, Australia. Results: The prevalence of self-reported use of fake tanning products in the past 12 months among Australian adolescent females was 34.5%. Female fake tan users were significantly …

The Application Of Coach Leadership Models To Coaching Practice: Current State And Future Directions, Stewart Vella, Lindsay G. Oades, Trevor P. Crowe

Faculty of Health and Behavioural Sciences - Papers (Archive)

No abstract provided.

Preparing For An Ageing Population: A Survey Of Older Patients' Attitudes To General Practice Registrars, Andrew D. Bonney, Sandra C. Jones, Lyn Phillipson, Donald C. Iverson

Faculty of Health and Behavioural Sciences - Papers (Archive)

The ageing population makes it imperative to provide appropriate training for general practice registrars (GPRs) in the community-based care of older patients. However, data suggest that older patients may be less willing to consult GPRs for chronic/complex care; adversely affecting training opportunities and potentially the satisfaction of older patients in training practices. This cross-sectional study was undertaken to investigate this concern in the Australian context and develop models of older patient-GPR interaction that are acceptable to patients.

Calculating Clinically Significant Change: Applications Of The Clinical Global Impressions (Cgi) Scale To Evaluate Client Outcomes In Private Practice, Peter Kelly

Faculty of Health and Behavioural Sciences - Papers (Archive)

The Clinical Global Impressions (CGI) scale is a therapist-rated measure of client outcome that has been widely used within the research literature. The current study aimed to develop reliable and clinically significant change indices for the CGI, and to demonstrate its application in private psychological practice. Following the guidelines developed by Clement, a file review was conducted of the authors’ first six years working in private practice. A reliable change on the CGI required the participants score to change by 2-points. Depending on the method used to calculate the clinical change indices, between 23% and 50% of the total participants …

General Practice Registrars: Attitudes Of Older Patients, Andrew D. Bonney, Sandra C. Jones, Lyn Phillipson, Donald C. Iverson

Faculty of Health and Behavioural Sciences - Papers (Archive)

Previous research indicates that older patients may be less willing to consult general practice registrars (GPRs), reducing training opportunities in chronic/complex care. This survey explores older patients’ attitudes in order to inform models of interaction that would be acceptable to patients. METHODS Ten training general practices distributed questionnaires for self completion to 50 patients aged 60 years and over. Chi-square, Spearman’s rho and logistic regression were used for analysis. RESULTS The response rate was 47%. Ninetysix percent wanted ongoing contact with their general practitioner if they saw a GPR. Twenty-four percent were comfortable with GPR chronic/complex care, increasing to 73% …

Patients' Attitudes To General Practice Registrars: A Review Of The Literature, Andrew D. Bonney, Lyn Phillipson, Samantha Reis, Sandra C. Jones, Donald Iverson

Faculty of Health and Behavioural Sciences - Papers (Archive)

Introduction With the population ageing, it is imperative for training practices to provide GP registrars with sound experience in managing the health problems of older persons, especially chronic conditions. However, it is reported that a significant proportion of these patients will be resistant to consulting registrars, with concerns regarding disruption of continuity of care being a significant factor. The challenge for training practices is to identify approaches to engage registrars in the management of older patients whilst maintaining patient satisfaction. This paper presents a review of the literature on patient attitudes to general practice registrars to better understand the nature …

Older Patients' Attitudes To General Practice Registrars: A Qualitative Study, Andrew D. Bonney, Lyn Phillipson, Sandra C. Jones, Donald Iverson

Faculty of Health and Behavioural Sciences - Papers (Archive)

Background Research suggests that older patients may be reluctant to engage general practice registrars (GPRs) in their care. The authors undertook a qualitative study of the attitudes of older patients to GPRs to investigate this issue. Method Thirty-eight patients aged 60 years and over from three training practices participated in semistructured telephone interviews, which explored patients responses to GPRs. The interviews were recorded, transcribed and analysed using a template analysis approach. Results Analysis of the interviews produced five major themes concerning patient attitudes to GPRs: desire for continuity, desire for access, openness, trust and a desire for meaningful communication. Discussion …

Meals In Science And Practice: Interdisciplinary Research And Business Applications, Anthony Worsley

Faculty of Health and Behavioural Sciences - Papers (Archive)

This is the book for those of us who subscribe to the maxim ‘People don’t eat nutrients, they eat food!’ Underlying all of our nutrition science is the simple fact that people eat combinations of foods at certain times during the day in a multitude of cultural, social and physical contexts. They eat meals. If we are to have any chance of influencing people’s food choices we have to understand meals. This is no mean task and Meiselman and his highly expert fellow authors have spent much of their working lives tormenting themselves trying to make sense of this most …

Mental Health Education For Nurses In General Practice, Kathryn Godwin

Faculty of Health and Behavioural Sciences - Papers (Archive)

Over the last seven years practice nurse numbers have grown across Australia to over 7,824 (est.) in 2007, with at least 60% of general practices now employing a practice nurse (APNA 2008). Nurses hav~ helped many GPs with overwhelming workloads which include dealing with complex mental health complaints, such as depression and anxiety related to chronic disease conditions. Practice nurses are a key component in primary health care with one nurse to every 2.3 GPs in 2007 (APNA 2008

Working With Substance Misuse Problems In Private Practice, Peter Kelly

Faculty of Health and Behavioural Sciences - Papers (Archive)

Individuals experiencing alcohol and other drug (AOD) problems have typically been under represented within private practice. For example, in the general population the prevalence of substance use disorders (7.7%) is comparable to that of anxiety (9.7%) and affective disorders (5.8%; Andrews, Hall, Teesson & Henderson, 1999). However, a recent APS survey showed that while 48 per cent of people treated by psychologists under the Better Access initiative presented with anxiety or depression, only 6 per cent presented for assistance with substance misuse problems (Giese, Littlefield & Mathews, 2008). Recent changes to the Medicare system have largely reduced financial barriers, presenting …

Toward The Science-Informed Practice Of Clinical Supervision: The Australian Context, Craig J. Gonsalvez, Hamish Mcleod

Faculty of Health and Behavioural Sciences - Papers (Archive)

Although supervision of clinical practice is mandatory for trainee psychologists, surprisingly little is known about the key ingredients of effective supervision and the relationship between supervision and patient outcomes. The purpose of this paper was to review current regulations that shape supervision in Australia and explore the links between these regulations and the components of effective supervision. Although recent developments including supervisor training and other quality control programs are an indication of progress, there are several empirical and conceptual issues in the supervision literature that require resolution. The second part of this paper identifies the gaps in the supervision literature …

Conceptualising The Policy Practice And Behavioural Research Relationship, Mark Lawrence, Heather Yeatman

Faculty of Health and Behavioural Sciences - Papers (Archive)

Background: Policy is frequently identified in the behavioural nutrition and physical activity research literature as a necessary component of effective research and practice. The purpose of this commentary is to promote a dialogue to contribute towards the further development of conceptual understandings and theories of the relationship between policy practice and behavioural research and how these twoactivities might work synergistically to improve public health outcomes.Methods: Drawing on policy and public health literature, this commentary presents a conceptual model of the interaction and mediation between nutrition and physical activity-relevant policy and behavioural nutrition and physical activity research, environments, behaviours and public …

Non-Advertising Alcohol Promotions In Licensed Premises: Does The Code Of Practice Ensure Responsible Promotion Of Alcohol?, Sandra C. Jones, Melissa Lynch

Faculty of Health and Behavioural Sciences - Papers (Archive)

Introduction and Aims. Binge drinking is a major public health issue in Australia, particularly among young people. There has been a considerable focus on alcohol advertising, among both researchers and policy makers, resulting in efforts to bring about some level of regulation of unacceptable advertising practices. However - despite the existence of a Code of Practice for Responsible Promotion of Liquor Products which provides 'a framework of practices which are considered acceptable and reasonable' for licensed premises - there are few, if any, data on the nature and extent of promotions which could arguably fall under either 'acceptable' or 'unacceptable' …

Collaborative Goal Technology: Theory & Practice, Samantha Clarke, Lindsay G. Oades, Trevor P. Crowe, Frank P. Deane

Faculty of Health and Behavioural Sciences - Papers (Archive)

Goal striving promotes hope and enhances motivation, which is important for psychosocial rehabilitation and recovery. The Collaborative Goal Technology (CGn is a new goal striving intervention that is used to support the autonomy and recovery processes of the person with a psychiatric disability. The CGT protocol and its utility are outlined. Theory and research from goal striving, motivation and mental health recovery domains that informed the development of CGT are described. A case example is also provided.

Predictors Of Men's Acceptance Of Modern Contraceptive Practice: Study In Rural Vietnam, Bui Thi Thu Ha, Rohan Jayasuriya, Neville Owen

Faculty of Health and Behavioural Sciences - Papers (Archive)

Studies have shown family planning adoption is likely to be more effective for women when men are actively involved. The transtheoretical model of behavior change was used to examine mens involvement in general contraception and intrauterine device (IUD) use by their wives. The study was carried out in rural Vietnam with 651 eligible participants. Cons of IUD use for men in precontemplation and contemplation/preparation were significantly higher than those in the action/maintenance stages, whereas the reverse was true for pros of IUD. The self-efficacy for convincing wife to have IUD in precontemplation was significantly lower than for those in higher …

Dealing With Diversity: Incorporating Cultural Sensitivity Into Professional Midwifery Practice, Moira Williamson, Lindsey Harrison

Faculty of Health and Behavioural Sciences - Papers (Archive)

In the Australian College of Midwives, Code of Ethics, Section 11. Practice of Midwifery, the following is stated "A. Midwives provide care for women and childbearing families with respect for cultural diversity while also working to eliminate harmful practices within those same cultures." However, it is difficult to know what is meant by "respect for cultural diversity". This paper presents the results of a critical review of the health literature. There is surprisingly little consensus about the meaning of terms such as cultural sensitivity and cultural appropriate care. Nor are there reflections on incorporating these concepts into practice. It could …

A Study Of Headache In North American Primary Care: Report For The Ambulatory Sentinel Practice Network, L A. Becker, Donald C. Iverson, F M. Read, N Calogne, R S. Miller, W L. Freeman

Faculty of Health and Behavioural Sciences - Papers (Archive)

Headache is a common symptom in primary care about which surprisingly little is known. Over a 14-month period 3847 patients making 4940 consecutive visits for headache to 38 primary care practices in the USA and Canada were studied. The clinical characteristics of patients, as well as the diagnostic and therapeutic strategies employed by their doctors, were examined. Visits for headache represented 1.5% of all visits during this period. Most patients (72.0%) made only one visit, and nearly half of the headaches reported were new. Only a small number of patients (3.0%) received a computerized tomographic scan; other investigations were used …