The selection of population groups by age for a National Population Health Survey using objective measures

© Commonwealth of AustraliaThis paper identifies a range of age groups in the population that might be included in a proposed Australian Health Measurement Survey (AHMS) program

Early intervention – from evidence to implementation: The policymaker’s tale. A case study

© Commonwealth of AustraliaImplementing evidence from research, into policy, and then practice, is a challenging task, glistening with opportunities and fraught with practical difficulties and political realities. This case study describes a process of taking research evidence, embedding it into policy and then implementing and making it happen 'on the ground', as a 'live' early intervention program in South Australia. Evidence on the level of disadvantage of people living in particular geographic locations in metropolitan Adelaide, and research on effective early intervention programs for disadvantaged families with infants were used to support policy directions and to gain funding to establish a pilot program. A community development approach was adopted, and strategies used to ensure the participation of those communities in the design and establishment of the program are also discussed. A number of key criteria were identified to support the successful transition from research, to policy, to planning and practice, and these are reviewed in the light of experience. This is a sobering tale, with exciting outcomes but a number of important lessons, which may be helpful to others seeking to ensure the successful implementation of early intervention programs for children and their families in Australia

Ethical considerations arising from National Health Measurement Surveys: with particular reference to the Australian Health Measurement Survey (AHMS) program

© Commonwealth of AustraliaThe purpose of this paper is to identify a range of ethical considerations that may arise during the design and implementation of national health surveys that incorporate physical and biochemical measures. These surveys are able to provide important information on the prevalence of various health conditions and distributions of physical, mental and biochemical characteristics of the population, as well as providing data on the relationship between risk factors and selected conditions, and social and environmental determinants of health. In Australia, a program of national health measurement surveys that will collect a range of measures (physical and biochemical characteristics) has been proposed, the Australian Health Measurement Survey (AHMS) program. The ethical, legal and social issues that arise are numerous. A number of broad policy issues emerge that require further discussion. In order to ensure that survey programs are conducted within an ethical framework, these issues must be identified and discussed with communities and others, and broad agreement reached about the most appropriate ways to proceed

Ethical considerations for a proposed program of National Population Health Surveys using objective measures for Australia

Copyright © 2003 Commonwealth of AustraliaThe purpose of this paper is to identify a range of ethical considerations that arise as part of the design of a proposed program of national population health surveys using objective measures, the Australian Health Measurement Survey (AHMS) program. A number of broad issues emerge that require discussion and resolution

A National Biomedical Risk Factor Survey for Australia: issues for consideration

National population health surveys containing a component of physical measurement have been used both in Australia and overseas to add to the information about the state of health of a population and to complement research into particular issues, diseases or directions in health policy. This short paper outlines some of the issues that require consideration as part of the initial scoping of these types of surveys in general, and will report briefly on some of the models that have been used overseas

Is it working ... together? Linking research, policy and practice in relation to children and health inequalities in South Australia

Despite an increasing interest in the extent of child health inequalities in Australia and effective strategies to address them, there remains a significant gap between existing research evidence and its incorporation into planning, policy and practice in Australia. Researchers, policy-makers and practitioners face difficulties in bringing research into practice effectively, and local communities are often neglected in the processes. This paper presents a brief summary of data on child health inequalities in South Australia over the last decade. It then reviews the extent to which research findings have been incorporated into human services' policy and practice. Particular barriers for researchers, policy-makers, planners, practitioners and communities are discussed, drawing on local and overseas experience, and possible strategies for addressing some of the barriers are outlined

Atlas of Avoidable Hospitalisations in Australia: ambulatory care-sensitive conditions

Avoidable hospitalisations represent a range of conditions for which hospitalisation should be able to be avoided because the disease or condition has been prevented from occurring, or because individuals have had access to timely and effective primary care. This report addresses the level and extent of regional variation in Australia in a sub-set of avoidable hospitalisations, namely those arising from ambulatory care-sensitive (ACS) conditions. ACS conditions are certain conditions for which hospitalisation is considered potentially avoidable through preventive care and early disease management, usually delivered in a primary care setting, for example by a general medical practitioner, or at a community health centre

Inequality in South Australia: Key determinants of wellbeing, Volume 1: The Evidence

Copyright © 2003 State of South AustraliaThe purpose of this report, Inequality in South Australia - key determinants of wellbeing, Volume 1: The Evidence, is to deepen our understanding of the impact that social, physical and economic factors have on health and wellbeing, and to describe the distribution of some of these factors across the South Australian population. A number of indicators have been selected to describe different aspects of wellbeing of the population at the present time, and, by using them, to highlight the extent of some of the existing social and economic inequalities. The report contains detailed findings for each of the indicators. It is intended that a companion volume be published at a later date, containing examples of projects and programs that have been successful in addressing social inequality

Hyperlactation - How left-brained \u27rules\u27 for breastfeeding wreak havoc with a natural process

A variety of arbitrary and often unphysiological rules for breastfeeding are frequently suggested to breastfeeding mothers. Many of these rules duplicate strategies commonly used to increase milk supply, and thus, when undertaken by the many women who already have a generous milk supply, can lead to overproduction. Oversupply, or hyperlactation, is a frequent yet often unrecognized problem that can present with a variety of distressing symptoms for the breastfeeding mother and her infant. Infants may present with symptoms suggesting colic, milk protein allergies, or gastroesophageal reflux, or may present with unusually rapid or slow growth. Mothers may present with tender leaking breasts, sore infected nipples, plugged ducts or mastitis, or even the perception of insufficient milk supply. With an understanding of the pathophysiology of these symptoms, proper diagnosis and breastfeeding management can allow milk production to return to homeostatic levels and provide dramatic symptom relief. March 23, 2012: Author’s note 7 years after publication: Over the 7 years since we wrote this manuscript, we continue to see mothers and babies with these same clinical problems, and we are still learning. Here’s a quick look from 2012 at what we wrote in 2005. Specifics can be found in a link at this site soon. During the last 7 years our treatment strategies have become much more simple and flexible since our earlier strategies encouraged too much of the rigid and rule-based left-brained thinking that often causes or contributes to hyperlactation. In this manuscript, we never once mentioned using hands on the breasts as a strategy for preventing or resolving the problems of hyperlactation, and yet in recent years we’ve found this has revolutionized our management approach. We’ve found that when dealing with hyperlactation, pumping can often be counterproductive. Underweight slow weight gain babies are in a category of their own. Regardless of their symptoms, by definition the underweight baby is NOT drinking too much, and in our experience, typical strategies for addressing hyperlactation can be counterproductive or even dangerous. In particular, staying on one side “to get to the hindmilk” doesn’t work with these sleepy, flow-dependent babies. Side switching may be helpful, but is rarely sufficient, and medical attention is critical. While hyperlactation appears to be increasingly recognized by lactation professionals, left-brained strategies abound, and resolution is often elusive, even by those who correctly identify it. Much more research is needed in all of these areas, as well as in several interesting and related areas discussed in our longer note. Finally, the thoughts and suggestions given here cannot replace appropriate medical attention by a physician or other medical provider. We do not encourage self-treatment, particularly when symptoms are severe. Readers seeking lactation support can locate an International Board Certified Lactation Consultant (IBCLC) in their geographic area at www.ilca.org “Find a Lactation Consultant” http://www.ilca.org/i4a/pages/index.cfm?pageid=343