Impact of telephone triage on emergency after hours GP Medicare usage: a time-series analysis

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The portrayal of mental health and illness in Australian non-fiction media

Objective: To provide a detailed picture of the extent, nature and quality of portrayal of mental health/illness in Australian non-fiction media. Method: Media items were retrieved from Australian newspaper, television and radio sources over a 1-year period, and identifying/descriptive data extracted from all items. Quality ratings were made on a randomly selected 10% of items, using an instrument based on criteria in Achieving the Balance (a resource designed to promote responsible reporting of mental health/illness). Results: Reporting of mental health/illness was common, with 4351 newspaper, 1237 television and 7801 radio items collected during the study period. Media items most frequently focused on policy/program initiatives in mental health (29.0%), or on causes/symptoms/treatment of mental illnesses (23.9%). Stories about mental health issues in the context of crime were relatively uncommon, accounting for only 5.6% of items. Most media items were of good quality on eight of the nine dimensions; the exception was that details of appropriate help services were only included in 6.4% of items. Conclusions: In contrast to previous research, the current study found that media reporting of mental health/illness was extensive, generally of good quality and focused less on themes of crime and violence than may have been expected. This is encouraging, since there is evidence that negative media portrayal of mental health/illness can detrimentally affect community attitudes. However, there are still opportunities for improving media reporting of mental health/illness, which should be taken up in future media strategies

Bloodstream infection surveillance in smaller hospitals

Infection Control (IC) nurses in 85 smaller (<100 acute care beds) public hospitals reported hospital acquired primary laboratory confirmed (LC) bloodstream infections (BSIs) over 26 months. The 'true' infection rate (as confirmed by two infectious diseases physicians) was 0.2 BSIs per 10,000 acute occupied bed days. Only 25% of the BSIs reported by the IC nurses were confirmed as 'true' infections. Staphylococcus aureus was the most commonly cultured causative micro-organism. The cause of the 12 confirmed BSIs may have been associated with the use of intravascular devices. The usefulness for smaller hospitals continuing this type of surveillance (particularly because hospital acquired primary LC BSIs are an infrequent, albeit serious event) is questionable

Helping smokers with depression to quit smoking: collaborative care with Quitline

Objectives: To report smokers' evaluations and uptake of Quitline-doctor comanagement of smoking cessation and depression, a key component of the Victorian Quitline's tailored call-back service for smokers with a history of depression and to explore its relationship to quitting success. Design, participants and setting: Prospective study followed Quitline clients disclosing doctor-diagnosed depression (n = 227). Measures were taken at baseline (following initial Quitline call), posttreatment (2 months) and 6 months from recruitment (77% and 70% response rates, respectively). Main outcome measures: Uptake of comanagement (initiated by fax-referral to Quitline), making a quit attempt (quit for 24 hours), sustained cessation (> 4 months at 6-month follow-up). Results: At 2-month follow-up, 83% thought it was a good idea to involve their doctor in their quit attempt, 74% had discussed quitting with their doctor, and 43% had received comanagement. In all, 72% made a quit attempt, 37% and 33% were abstinent posttreatment and at 6 months, respectively, and 20% achieved sustained cessation. Among participants who discussed quitting with their doctor, those receiving comanagement were more likely to make a quit attempt than those who did not receive comanagement (78% v 63%). Participants with comanagement also received more Quitline calls (mean 4.6 v 3.1)---a predictor of sustained cessation. Exacerbation of depression between baseline and 6 months was reported by 18% of participants but was not related to cessation outcome. Conclusion: Quitline-doctor comanagement of smoking cessation and depression is workable, is valued by smokers, and increases the probability of quit attempts. Smoking cessation did not increase the risk of exacerbation of depression

Evaluation of the Shepparton Health Heart Projct: project description, evaluation design and methodology

This paper describes the conduct of the Shepparton Healthy Heart Project (SHHP) and the design and methodology of its evaluation. The SHHP was a community-based, coronary heart disease primary prevention project, auspiced by the Victorian Division of the National Heart Foundation, in association with the residents of Shepparton, a medium-sized rural community in Central Victoria. It sought, through community participation, to modify its 'culture' and structures relevant to heart disease prevention (rather than focus exclusively on individual risk factor change). The SHHP had an overall Healthy Heart theme with three sequential phases relating to nutrition, physical exercise and smoking. There were additional subprograms directed at particular subpopulations (Koori and NESB) and community organisations (general medical practitioners, eating places, schools and pharmacies). The evaluation's overall design was quasi-experimental, based on a comparison of relevant changes in Shepparton and a comparable community, Mildura in North-Western Victoria across the project period, particularly through the use of baseline and follow-up instruments. Cognitive and behavioural changes in individuals as well as perceptions about change in local groups and the community was assessed using a self-administered mail questionnaire (to 1712 subjects aged 18-74 years at baseline). This was also studied using multiple focus groups. The level and nature of community participation in the SHHP was assessed based on interviews of key informants, document analysis and observations of the evaluation group. The response of the local media was assessed using a log of health-related items in the local newspapers across the project period. Evaluation of the SHHP's phases included self-administered questionnaires and a log of food purchasing behaviour at local supermarkets across the project period. Evaluation of subprograms aimed at schools, eating places and general practitioners involved onsite assessments, interviews or mail questionnaires. The two communities had very similar socio-demographic profiles and only minor differences in baseline levels of Heart Health parameters at baseline