Australia's insurance crisis and the inequitable treatment of self-employed midwives

Based upon a review of articles published in Australia's major newspapers over the period January 2001 to December 2005, a case study approach has been used to investigate why, when compared with other small business operators, including medical specialists, Australian governments have appeared reluctant to protect the economic viability of the businesses of self-employed midwives. Theories of agenda setting and structuralism have been used to explore that inequity. What has emerged is a picture of the complex of factors that may have operated, and may be continuing to operate, to shape the policy agenda and thus prevent solutions to the insurance problems of self-employed midwives being found

United Nations Sustainable Development Goals: Promoting health and well-being through physical education partnerships

The United Nations recently approved the Sustainable Development Goals (SDGs) which forms a guideline policy for all nations. While the UN have strongly advised that partnerships are essential for the implementation of these global goals, within local communities there is little evidence of how this is best done or what it looks like in practice. This paper shares a health and wellbeing community initiative that achieves goals three and four of the SDGs, and in doing so models how to implement physical education partnerships as advocated by the UN. The highly successful innovative initiative is “Best Start: A community collaborative approach to lifelong health and wellness” (2011–2014).This paper shares a health and wellbeing partnership, modelling implementation of physical education (PE) advocated by the United Nations (UN). The Sustainable Development Goals (SDGs) exemplifies global efforts towards equality, specifically Goal 3 and 4 address health and wellbeing. The purpose of this paper is to provide insights into cross sector “partnerships”, identified as essential for the implementation of the SDGs. This is significant as the UN acknowledge a present gap of information on partnerships in action and a need for reporting from the ground level. The project “Best Start: A community collaborative approach to lifelong health and wellness”, began as a partnership between a university and nearby schools and quickly grew to involve Australian Registered Training Organisations, the local health industry, Education departments and sport governing bodies. The collaborations involved pre-service teachers teaching Health and PE lessons to children in a disadvantaged socio-economic area, creating valuable learning experiences for stakeholders. Local and global communities were involved in research and reform. The project creatively optimised resources available through state, Australian and international connections. International partnerships enabled identification of unique contextual opportunities. Programme planning was strengthened with data gathered from an England and Wales Ofsted awarded Primary Physical Education course. Various methods, including; semi-structured interviews, reflective journal, observations, document analysis, and Student Evaluation of Teaching Units (SETU) were adopted. SETU is valid and reliable data collected by the university for the purposes of research. The findings support that partnerships enable SDG implementation and the research paper offers direction for localisation

Efficacy of a multifaceted podiatry intervention to improve balance and prevent falls in older people: study protocol for a randomised trial

<p>Abstract</p> <p>Background</p> <p>Falls in older people are a major public health problem, with at least one in three people aged over 65 years falling each year. There is increasing evidence that foot problems and inappropriate footwear increase the risk of falls, however no studies have been undertaken to determine whether modifying these risk factors decreases the risk of falling. This article describes the design of a randomised trial to evaluate the efficacy of a multifaceted podiatry intervention to reduce foot pain, improve balance, and reduce falls in older people.</p> <p>Methods</p> <p>Three hundred community-dwelling men and women aged 65 years and over with current foot pain and an increased risk of falling will be randomly allocated to a control or intervention group. The "usual cae" control group will receive routine podiatry (i.e. nail care and callus debridement). The intervention group will receive usual care plus a multifaceted podiatry intervention consisting of: (i) prefabricated insoles customised to accommodate plantar lesions; (ii) footwear advice and assistance with the purchase of new footwear if current footwear is inappropriate; (iii) a home-based exercise program to strengthen foot and ankle muscles; and (iv) a falls prevention education booklet. Primary outcome measures will be the number of fallers, number of multiple fallers and the falls rate recorded by a falls diary over a 12 month period. Secondary outcome measures assessed six months after baseline will include the Medical Outcomes Study Short Form 12 (SF-12), the Manchester Foot Pain and Disability Index, the Falls Efficacy Scale International, and a series of balance and functional tests. Data will be analysed using the intention to treat principle.</p> <p>Discussion</p> <p>This study is the first randomised trial to evaluate the efficacy of podiatry in improving balance and preventing falls. The trial has been pragmatically designed to ensure that the findings can be generalised to clinical practice. If found to be effective, the multifaceted podiatry intervention will be a unique addition to common falls prevention strategies already in use.</p> <p>Trial registration</p> <p>Australian New Zealand Clinical Trials Registry: ACTRN12608000065392</p

Drowning deaths of zero- to five-year-old children in Victorian dams, 1989–2001

Objective: To examine drowning deaths of young children in Victorian dams to identify common contributing factors in order to develop strategies for future prevention.\ud \ud Design: Case records of children aged zero to five years from the State Coroner's Office Victoria were reviewed for the 13-year period 1989–2001. Cases where the child drowned in a dam were extracted for analysis.\ud \ud Results: During the 13-year period there were 27 deaths; 11 occurred on farms, five on hobby farms and 11 on properties where it was not specified whether the property was a farm. Almost three quarters of the children were male and the majority were aged between one year and three years. Half of the incidents occurred on the weekend and nearly half occurred during the summer months. Five major factors were common among incidents: stage of the child's development; absence of carer supervision; child playing outside the house; dam within 300 metres of where the child was playing; and lack of effective barriers between the dam and the child.\ud \ud Conclusion: The coronial information examined identified patterns of behaviour by both carers and young children that contributed to these deaths. The results support the implementation of strategies such as the promotion of child safe play areas and targeted public awareness campaigns for rural and regional aquatic environments