Standardised methods for collaborative long-term monitoring and management of cetaceans in Wales

Monitoring long terms trends of species abundance is a fundamental requirement for effective conservation. Surveying wildlife creates a baseline to measure changes in the population and to detect and manage specific abiotic and biotic threats. However, long term monitoring is not always effective or achievable because of insufficient finances, resources, planning or limited project focus. Establishing a collaborative network of scientists to bring together similar research may provide the solution as seen with networks on seagrass, aquatic macrophytes and avian populations. Frequently there are many organisations working in isolation using multiple approaches on similar species. This case study specifically investigates the social barriers leading to a lack of collaborative efforts in cetacean monitoring in Wales where there are four organisations independently undertaking systematic long-term monitoring. Here, I produce, trial and analyse a simple low-cost standardised methodology that could be used for long-term monitoring by multiple organisations and review the potential of a collaborative acoustics project to enable simple comparisons of encounter rates for cetaceans Wales-wide. An online questionnaire to stakeholders revealed that primary barriers to collaborative research were personality differences and funding competition; participants indicated that the re-establishment of a marine mammal working group by Natural Resources Wales would enable development of personal relationships and fair access to resources. Similar working groups have been established in terrestrial and aquatic ecology which have attempted to overcome the challenges in effective long-term monitoring. It is anticipated that this research could be duplicated to other species to assess any barriers and solutions to collaborative working and establish more cohesive long-term monitoring strategies in ecology

Development and implementation of a nurse-led walk-in centre: evidence lost in translation?

Objectives: The design of the first Australian public nurse-led primary care walk-in centre was modelled on those established in the English National Health Service (NHS). An independent evaluation of the first 12 months of operation of the Australian Ca

Nurse delivered lifestyle interventions in primary health care to treat chronic disease risk factors associated with obesity:

Nurses in primary health care (PHC) provide an increasing proportion of chronic disease management and preventive lifestyle advice. The databases MEDLINE, CINAHL, EMBASE and PsychINFO were searched and the articles were systematically reviewed for articles describing controlled adult lifestyle intervention studies delivered by a PHC nurse, in a PHC setting. Thirty-one articles describing 28 studies were analysed by comparison group which revealed: (i) no difference of effect when the same intervention was delivered by a PHC nurse compared to other health professionals in PHC (n = 2); (ii) the provision of counselling delivered by a PHC nurse was more effective than health screening (n = 10); (iii) counselling based on behaviour change theory was more effective than the same dose of non-behavioural counselling when at least three counselling sessions were delivered (n = 3). The evidence supports the effectiveness of lifestyle interventions delivered by nurses in PHC to affect positive changes on outcomes associated with the prevention of chronic disease including: weight, blood pressure, cholesterol, dietary and physical activity behaviours, patient satisfaction, readiness for change and quality of life. The strength of recommendations is limited by the small number of studies within each comparison group and the high risk of bias of the majority of studies

Stakeholder perceptions of a nurse led walk-in centre

BACKGROUND As many countries face primary care medical workforce shortages and find it difficult to provide timely and affordable care they seek to find new ways of delivering first point of contact health care through developing new service models. In common with other areas of rural and regional Australia, the Australian Capital Territory (ACT) is currently experiencing a general practitioner (GP) workforce shortage which impacts significantly on the ability of patients to access GP led primary care services. The introduction of a nurse led primary care Walk-in Centre in the ACT aimed to fulfill an unmet health care need in the community and meet projected demand for health care services as well as relieve pressure on the hospital system. Stakeholders have the potential to influence health service planning and policy, to advise on the potential of services to meet population health needs and to assess how acceptable health service innovation is to key stakeholder groups. This study aimed to ascertain the views of key stakeholders about the Walk-in Centre. METHODS Stakeholders were purposively selected through the identification of individuals and organisations which had organisational or professional contact with the Walk-in Centre. Semi structured interviews around key themes were conducted with seventeen stakeholders. RESULTS Stakeholders were generally supportive of the Walk-in Centre but identified key areas which they considered needed to be addressed. These included the service's systems, full utilisation of the nurse practitioner role and adequate education and training. It was also suggested that a doctor could be available to the Centre as a source of referral for patients who fall outside the nurses' scope of practice. The location of the Centre was seen to impact on patient flows to the Emergency Department. CONCLUSION Nurse led Walk-in Centres are one response to addressing primary health care medical workforce shortages. Whilst some stakeholders have reservations about the model others are supportive and see the potential the model has to provide accessible primary health care. Any further developments of nurse-led Walk-in Centres need to take into account the views of key stakeholders so as to ensure that the model is acceptable and sustainable.This study was funded by Australian Capital Territory (ACT) Health

Patient initiated aggression and violence in the Australian general practice setting

This is the first national study to be conducted in Australia examining the incidence and prevalence of violence against general practitioners and general practice staff.The research reported in this paper is a project of the Australian Primary Health Care Research Institute, which is supported by a grant from the Australian Government Department of Health and Ageing under the Primary Health Care Research, Evaluation and Development Strategy

Nurse delivered lifestyle interventions in primary health care to treat chronic disease risk factors associated with obesity: a systematic review

Nurses in primary health care (PHC) provide an increasing proportion of chronic disease management and preventive lifestyle advice. The databases MEDLINE, CINAHL, EMBASE and PsychINFO were searched and the articles were systematically reviewed for articles describing controlled adult lifestyle intervention studies delivered by a PHC nurse, in a PHC setting. Thirty-one articles describing 28 studies were analysed by comparison group which revealed: (i) no difference of effect when the same intervention was delivered by a PHC nurse compared to other health professionals in PHC (n=2); (ii) the provision of counselling delivered by a PHC nurse was more effective than health screening (n=10); (iii) counselling based on behaviour change theory was more effective than the same dose of non-behavioural counselling when at least three counselling sessions were delivered (n=3). The evidence supports the effectiveness of lifestyle interventions delivered by nurses in PHC to affect positive changes on outcomes associated with the prevention of chronic disease including: weight, blood pressure, cholesterol, dietary and physical activity behaviours, patient satisfaction, readiness for change and quality of life. The strength of recommendations is limited by the small number of studies within each comparison group and the high risk of bias of the majority of studies