Dental and Oral Health

Tooth and gum diseases affect the lives of many Australians; their job opportunities may be restricted, productivity and self-esteem reduced, speech impeded, and the pain, discomfort and difficulties with eating affect their health and quality of life.This paper was developed with the collaboration of the Australian Health Policy Institute at the University of Sydney

Dental and Oral Health

Tooth and gum diseases affect the lives of many Australians; their job opportunities may be restricted, productivity and self-esteem reduced, speech impeded, and the pain, discomfort and difficulties with eating affect their health and quality of life.This paper was developed with the collaboration of the Australian Health Policy Institute at the University of Sydney

Strategic approaches to enhanced health service delivery for Aboriginal and Torres Strait Islander people with chronic illness: a qualitative study

BACKGROUND Aboriginal and Torres Strait Islander people with chronic illness confront multiple challenges that contribute to their poor health outcomes, and to the health disparities that exist in Australian society. This study aimed to identify barriers and facilitators to care and support for Aboriginal and Torres Strait Islander people with chronic illness. METHODS Face-to-face in-depth interviews were conducted with Aboriginal and Torres Strait Islander people with diabetes, chronic heart failure or chronic obstructive pulmonary disease (n-16) and family carers (n = 3). Interviews were transcribed verbatim and the transcripts were analysed using content analysis. Recurrent themes were identified and these were used to inform the key findings of the study. RESULTS Participants reported both negative and positive influences that affected their health and well-being. Among the negative influences, they identified poor access to culturally appropriate health services, dislocation from cultural support systems, exposure to racism, poor communication with health care professionals and economic hardship. As a counter to these, participants pointed to cultural and traditional knowledge as well as insights from their own experiences. Participants said that while they often felt overwhelmed and confused by the burden of chronic illness, they drew strength from being part of an Aboriginal community, having regular and ongoing access to primary health care, and being well-connected to a supportive family network. Within this context, elders played an important role in increasing people's awareness of the impact of chronic illness on people and communities. CONCLUSIONS Our study indicated that non-Indigenous health services struggled to meet the needs of Aboriginal and Torres Strait Islander people with chronic illness. To address their complex needs, health services could gain considerably by recognising that Aboriginal and Torres Strait Islander patients have a wealth of cultural knowledge at their disposal. Strategies to ensure that this knowledge is integrated into care and support programs for Aboriginal and Torres Strait Islander people with chronic illness should achieve major improvements.This study was supported by the National Health and Medical Research Council which provided funding for the project

The Last Right: Australians take sides on the right to die

This is the text of an out-of-print book first published in 1995 by Mandarin Books, Port Melbourne. Edited by Professors Simon Chapman and Stephen Leeder, it features contributions from 63 prominent Australians both supportive and opposed to voluntary euthanasia. It was published at the time of the Northern Territory's Marshall Peron's attempt to introduce a voluntary enthanasia bill in the Territory parliament

The Desirability of Zero Tolerance for Procrastination

I choose the desirability of zero tolerance for procrastination as my topic because I have seen so many opportunities lost in health and medicine because of delays in taking action. Procrastination ranks alongside shortage of cash as an explanation of things not being done. It is, quintessentially, bad management

Perceptions of economic hardship and implications for illness management: a survey of general practitioners in western Sydney

The present study aimed to understand the options available to general practitioners (GPs) practising in Western Sydney to help patients experiencing economic hardship to manage their illnesses and the implications of these findings for policy

Disability income support design and mental illness: a summary of the grey literature

Aim: Mental illnesses have many distinctive features such as their fluctuating nature, invisibility and lack of diagnostic clarity that make determining eligibility for disability income support challenging. How do policy-makers deal with these features when designing disability income support? More specifically, ‘How do mental illnesses come to be considered eligible disabilities?’, ‘What tools are used to assess mental illness for eligibility?’, ‘What challenges exist in this process?’ and ‘What approaches are used to address these challenges?’ We aimed to determine what evidence is available to policy-makers in Australia and Ontario (Canada) to answer these questions. Methods: Ten electronic databases and grey literature in both jurisdictions were searched using key words including disability income support, disability pension, mental illness, mental disability, addiction, depression and schizophrenia for articles published between 1991 and June 2013 yielding 1,341 articles of which 20 met the inclusion criteria and were critically appraised. Results: Results revealed that there is limited evidence available on disability income support design and mental illness in the Australian and Ontarian setting. Most of the evidence available is from the grey literature and draws on evidence from case law. Many documents reviewed argued that current policy in Australia and Ontario is frequently based on negative assumptions about mental illnesses rather than available evidence (either peer-reviewed or grey literature). Results showed that problems related to mental illness are largely related to the interpretation of the definition rather than the definition itself. Conclusions: The review confirmed that mental illnesses present many challenges when designing disability income support and that academic as well as grey literature, especially case law, provide insight into these challenges. More research is needed on addressing these challenges identified, particularly in these contexts, with the intention that more evidence on this topic could lead to policies for those with mental illness that are well-informed and do not reinforce societal prejudices

A health policy for hearing impairment in older Australians: what should it include?

BACKGROUND: As in all western countries, Australia's older population experiences high levels of hearing impairment coupled with relatively low levels of hearing device usage. Poor hearing diminishes the quality of life of affected individuals and their families. This paper discusses how to improve Australian hearing health policies in order to better combat this impairment amongst older Australians. METHOD: We searched the databases Medline, Meditext and Web of Science to find articles that discussed strategies and innovations to assist the hearing health of older people, and related this material to observations made during the Blue Mountains Hearing Study in NSW between 1997 and 2003. RESULTS AND DISCUSSION: The literature search identified five areas for inclusion in a comprehensive hearing health policy in Australia. These are: early intervention; addressing of hearing aid expense; the use of assisted listening devices; hearing rehabilitation, and; screening and education. Further research in Australia is critical if we are to develop a strong approach to the increasing prevalence of age-related hearing loss. CONCLUSION: Australia needs to act now to address hearing impairment as it is a major cause of disability in those aged 55 and over. Federal and State governments should collaborate to construct a comprehensive hearing health policy that tackles poor levels of hearing health through early intervention, addressing hearing aid expense, encouraging the use of assisted listening devices, rehabilitation, screening and education. A good start would be to declare age related hearing impairment as a National Health Priority Area

Compliance With Protocols for Prevention of Neonatal Group B Streptococcal Sepsis: Practicalities and Limitations

Objective: To compare two protocols for intrapartum antibiotic prophylaxis (IAP) against neonatal group B streptococcal (GBS) sepsis, with respect to staff compliance, in a prospective cohort study in the obstetric units of a community hospital (A) and a university teaching hospital (B). Methods: Cohorts comprised about 500 women attending antenatal clinics at each hospital (total 1096). Women identified as GBS carriers at 26–32 weeks'gestation and those who had intrapartum clinical risk factors (CRF) were eligible for IAP. Compliance was defined as the proportion of women eligible for IAP who received it according to protocol–as determined by audit of case records–and compared between hospitals and according to indication. Results: Overall, 39% of women were eligible for IAP. Indications were GBS carriage alone (21%), CRF alone (13% ) and both (5% ). Compliance was similar for GBS carriers at both hospitals: 78% at Hospital A and 76% at Hospital B. However, because of the poor predictive value of screening before 32 weeks, only 65%of intrapartum GBS carriers actually received IAP. For women with CRF only, compliance was significantly lower at Hospital B than Hospital A (56 vs. 75%; p= 0.03). Conclusions: According to currently recommended protocols, about one-third of healthy women are eligible for intrapartum antibiotics to prevent neonatal GBS sepsis. In practice, antibiotics are often used inefficiently because of poor compliance with protocols and poor predictive values of selection criteria. Better implementation strategies should improve compliance, but GBS vaccines are needed to replace prophylactic antibiotic use, with its associated disadvantages