Chronic ill health in a regional Victoria setting: A 13-year comparison
- Glenister, Kristen, Bourke, Lisa, Terry, Daniel, Simmons, David
- Authors: Glenister, Kristen , Bourke, Lisa , Terry, Daniel , Simmons, David
- Date: 2019
- Type: Text , Journal article
- Relation: Australian Journal of Rural Health Vol. 27, no. 6 (2019), p. 527-534
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- Description: Objective: High-quality data regarding the prevalence of chronic disease in rural areas are essential in understanding the challenges faced by rural populations and for informing strategies to address health care needs. This study compared the prevalence of a range of self-reported chronic conditions and utilisation of GP services and emergency department in a regional Victorian setting between two studies conducted in the same region in 2001-2003 and 2014. Design: Repeat cross-sectional studies conducted over a decade apart. Setting: The projects were conducted in the Goulburn Valley in regional Victoria. Participants: The earlier study randomly selected households from local government lists. The later study randomly selected householders from the telephone directory. Main outcome measures: Participants were asked whether they had been diagnosed with a range of chronic health conditions and how often they had visited a general practitioner or emergency department in the past 12 months. Results: The age-standardised prevalence of depression was higher in the 2014 study than the 2001-2003 study in men (increased by 8.0% (95% CI 4.5, 11.5%)) and women (increased by 13.7% (95% CI 8.4, 19.0%)). Similarly, the prevalence of age-standardised diabetes and hypertension was higher in 2014 than 2001-2003 (men increased by 3.6% (95% CI 0.7, 6.5% (diabetes)) and 13.6% (95% CI 8.6, 18.6% (hypertension)), women increased by 3.1% (95% CI 0.3, 6.5% (diabetes)) and 8.4% (95% CI 2.3, 14.5% (hypertension))). Conclusion: The results of this study indicate that the prevalence of self-reported depression, diabetes and hypertension has increased in this regional Victorian area over the past 13 years. The reasons for these observed increases and the subsequent impact on the health care needs of regional communities warrants further investigation. © 2019 National Rural Health Alliance Ltd.
- Authors: Glenister, Kristen , Bourke, Lisa , Terry, Daniel , Simmons, David
- Date: 2019
- Type: Text , Journal article
- Relation: Australian Journal of Rural Health Vol. 27, no. 6 (2019), p. 527-534
- Full Text:
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- Description: Objective: High-quality data regarding the prevalence of chronic disease in rural areas are essential in understanding the challenges faced by rural populations and for informing strategies to address health care needs. This study compared the prevalence of a range of self-reported chronic conditions and utilisation of GP services and emergency department in a regional Victorian setting between two studies conducted in the same region in 2001-2003 and 2014. Design: Repeat cross-sectional studies conducted over a decade apart. Setting: The projects were conducted in the Goulburn Valley in regional Victoria. Participants: The earlier study randomly selected households from local government lists. The later study randomly selected householders from the telephone directory. Main outcome measures: Participants were asked whether they had been diagnosed with a range of chronic health conditions and how often they had visited a general practitioner or emergency department in the past 12 months. Results: The age-standardised prevalence of depression was higher in the 2014 study than the 2001-2003 study in men (increased by 8.0% (95% CI 4.5, 11.5%)) and women (increased by 13.7% (95% CI 8.4, 19.0%)). Similarly, the prevalence of age-standardised diabetes and hypertension was higher in 2014 than 2001-2003 (men increased by 3.6% (95% CI 0.7, 6.5% (diabetes)) and 13.6% (95% CI 8.6, 18.6% (hypertension)), women increased by 3.1% (95% CI 0.3, 6.5% (diabetes)) and 8.4% (95% CI 2.3, 14.5% (hypertension))). Conclusion: The results of this study indicate that the prevalence of self-reported depression, diabetes and hypertension has increased in this regional Victorian area over the past 13 years. The reasons for these observed increases and the subsequent impact on the health care needs of regional communities warrants further investigation. © 2019 National Rural Health Alliance Ltd.
Competing food consumption discourses and proper gendered behaviour among over 50s: are you really what you eat?
- Malatzky, Christina, Terry, Daniel, Bourke, Lisa, Glenister, Kristen, Ervin, Kaye
- Authors: Malatzky, Christina , Terry, Daniel , Bourke, Lisa , Glenister, Kristen , Ervin, Kaye
- Date: 2018
- Type: Text , Journal article
- Relation: Journal of Research for Consumers Vol. , no. 32 (2018), p. 1-31
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- Description: The national narratives about proper food consumption and its relationship to health and wellbeing has been articulated in many Australian public health campaigns. These shape awareness, knowledge and behaviours as well as reporting on food consumption. This paper reports on the findings of a large-scale community health survey, conducted in four Victorian regional areas, related to the self-reported eating practices of respondents aged 50 years and over. It was found that women were more likely to report trying to eat a diet consistent with public health messages than men. Overall, however there was strong agreement amongst respondents that they tried to eat a healthy diet. These findings are contextualised within broader societal discourses, including the Australian national narrative about food consumption, proper gendered behaviour, good, moral, responsible citizenship, and the competing social meanings attached to food and food consumption. It is argued that understanding the social circumstances in which people report their dietary behaviours is essential to understanding why behavioural change is such a complex goal for public health and health promotion.
- Authors: Malatzky, Christina , Terry, Daniel , Bourke, Lisa , Glenister, Kristen , Ervin, Kaye
- Date: 2018
- Type: Text , Journal article
- Relation: Journal of Research for Consumers Vol. , no. 32 (2018), p. 1-31
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- Description: The national narratives about proper food consumption and its relationship to health and wellbeing has been articulated in many Australian public health campaigns. These shape awareness, knowledge and behaviours as well as reporting on food consumption. This paper reports on the findings of a large-scale community health survey, conducted in four Victorian regional areas, related to the self-reported eating practices of respondents aged 50 years and over. It was found that women were more likely to report trying to eat a diet consistent with public health messages than men. Overall, however there was strong agreement amongst respondents that they tried to eat a healthy diet. These findings are contextualised within broader societal discourses, including the Australian national narrative about food consumption, proper gendered behaviour, good, moral, responsible citizenship, and the competing social meanings attached to food and food consumption. It is argued that understanding the social circumstances in which people report their dietary behaviours is essential to understanding why behavioural change is such a complex goal for public health and health promotion.
The importance of adequate referrals for chronic kidney disease
- Wright, Julian, Glenister, Kristen, Thwaites, Rebecca, Terry, Daniel
- Authors: Wright, Julian , Glenister, Kristen , Thwaites, Rebecca , Terry, Daniel
- Date: 2018
- Type: Text , Journal article
- Relation: Australian journal of general practice Vol. 47, no. 1-2 (2018), p. 58-62
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- Description: DISCUSSION: Regional Australia remains a district of workforce shortage for nephrology. Thus, it is imperative that patients who have the greatest need for nephrologist services are effectively identified upon referral. The aim of this study was to assess referrals to a regional nephrology service against Australian guidelines by assessing the patient’s renal function and the information contained in the referral document at the time of first consultation. We conducted a retrospective study of all referrals to a regional Australian nephrology service between 2013 and 2015. The 582 referrals that met the inclusion criteria were compared with Australian nephrology referral guidelines. Less than half of the referral documents (n = 253; 43.5%) described a clinical situation that met referral guidelines, typically due to insufficient pathology investigation. However, after consideration of renal functional test results performed at the initial consultation, an additional 82 cases met referral guidelines (n = 335; 57.6%). More than 40% of nephrology referrals to a regional Australian service did not meet Australian nephrology referral guidelines. This has implications for a regional nephrology service that is experiencing workforce pressures, in addition to the health system more broadly, and for patients. Many referrals contained insufficient information to allow differentiation of patients who would benefit most from nephrology care from patients who could be appropriately managed within primary care.
- Authors: Wright, Julian , Glenister, Kristen , Thwaites, Rebecca , Terry, Daniel
- Date: 2018
- Type: Text , Journal article
- Relation: Australian journal of general practice Vol. 47, no. 1-2 (2018), p. 58-62
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- Description: DISCUSSION: Regional Australia remains a district of workforce shortage for nephrology. Thus, it is imperative that patients who have the greatest need for nephrologist services are effectively identified upon referral. The aim of this study was to assess referrals to a regional nephrology service against Australian guidelines by assessing the patient’s renal function and the information contained in the referral document at the time of first consultation. We conducted a retrospective study of all referrals to a regional Australian nephrology service between 2013 and 2015. The 582 referrals that met the inclusion criteria were compared with Australian nephrology referral guidelines. Less than half of the referral documents (n = 253; 43.5%) described a clinical situation that met referral guidelines, typically due to insufficient pathology investigation. However, after consideration of renal functional test results performed at the initial consultation, an additional 82 cases met referral guidelines (n = 335; 57.6%). More than 40% of nephrology referrals to a regional Australian service did not meet Australian nephrology referral guidelines. This has implications for a regional nephrology service that is experiencing workforce pressures, in addition to the health system more broadly, and for patients. Many referrals contained insufficient information to allow differentiation of patients who would benefit most from nephrology care from patients who could be appropriately managed within primary care.
Heterogeneity of rural consumer perceptions of health service access across four regions of Victoria
- Terry, Daniel, Crouch, Alan, Ervin, Kaye, Glenister, Kristen, Bourke, Lisa
- Authors: Terry, Daniel , Crouch, Alan , Ervin, Kaye , Glenister, Kristen , Bourke, Lisa
- Date: 2017
- Type: Text , Journal article
- Relation: Journal of Rural Social Sciences Vol. 32, no. 2 (2017), p. 125-145
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- Description: Access to a range of services, including healthcare, ranks among the key determinants of health and wellbeing. It varies with both health system supply factors and consumer demand characteristics. For rural populations, access to health services can be...
Heterogeneity of rural consumer perceptions of health service access across four regions of Victoria
- Authors: Terry, Daniel , Crouch, Alan , Ervin, Kaye , Glenister, Kristen , Bourke, Lisa
- Date: 2017
- Type: Text , Journal article
- Relation: Journal of Rural Social Sciences Vol. 32, no. 2 (2017), p. 125-145
- Full Text:
- Reviewed:
- Description: Access to a range of services, including healthcare, ranks among the key determinants of health and wellbeing. It varies with both health system supply factors and consumer demand characteristics. For rural populations, access to health services can be...
Integrated and consumer-directed care : a necessary paradigm shift for rural chronic ill health
- Ranson, Nicole, Terry, Daniel, Glenister, Kristen, Adam, Bill, Wright, Julian
- Authors: Ranson, Nicole , Terry, Daniel , Glenister, Kristen , Adam, Bill , Wright, Julian
- Date: 2016
- Type: Text , Journal article , Review
- Relation: Australian Journal of Primary Health Vol. 22, no. 3 (2016), p. 176-180
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- Description: Chronic ill health has recently emerged as the most important health issue on a global scale. Rural communities are disproportionally affected by chronic ill health. Many health systems are centred on the management of acute conditions and are often poorly equipped to deal with chronic ill health. Cardiovascular disease (CVD) is one of the most prominent chronic ill health conditions and the principal cause of mortality worldwide. In this paper, CVD is used as an example to demonstrate the disparity between rural and urban experience of chronic ill health, access to medical care and clinical outcomes. Advances have been made to address chronic ill health through improving self-management strategies, health literacy and access to medical services. However, given the higher incidence of chronic health conditions and poorer clinical outcomes in rural communities, it is imperative that integrated health care emphasises greater collaboration between services. It is also vital that rural GPs are better supported to work with their patients, and that they use consumer-directed approaches to empower patients to direct and coordinate their own care. © La Trobe University 2016.
- Authors: Ranson, Nicole , Terry, Daniel , Glenister, Kristen , Adam, Bill , Wright, Julian
- Date: 2016
- Type: Text , Journal article , Review
- Relation: Australian Journal of Primary Health Vol. 22, no. 3 (2016), p. 176-180
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- Description: Chronic ill health has recently emerged as the most important health issue on a global scale. Rural communities are disproportionally affected by chronic ill health. Many health systems are centred on the management of acute conditions and are often poorly equipped to deal with chronic ill health. Cardiovascular disease (CVD) is one of the most prominent chronic ill health conditions and the principal cause of mortality worldwide. In this paper, CVD is used as an example to demonstrate the disparity between rural and urban experience of chronic ill health, access to medical care and clinical outcomes. Advances have been made to address chronic ill health through improving self-management strategies, health literacy and access to medical services. However, given the higher incidence of chronic health conditions and poorer clinical outcomes in rural communities, it is imperative that integrated health care emphasises greater collaboration between services. It is also vital that rural GPs are better supported to work with their patients, and that they use consumer-directed approaches to empower patients to direct and coordinate their own care. © La Trobe University 2016.
A descriptive study of health, lifestyle and sociodemographic characteristics and their relationship to known dementia risk factors in rural Victorian communities
- Ervin, Kaye, Pallant, Julie, Terry, Daniel, Bourke, Lisa, Pierce, David, Glenister, Kristen
- Authors: Ervin, Kaye , Pallant, Julie , Terry, Daniel , Bourke, Lisa , Pierce, David , Glenister, Kristen
- Date: 2015
- Type: Text , Journal article
- Relation: Aims Medical Science Vol. 2, no. 3 (2015), p. 246-260
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- Description: It is essential to determine the key health risk factors among populations to specifically plan future services and explore interventions that modify risk factors for communities. This aims to reduce risks and delay the onset of chronic conditions, which frequently results in dementia, particularly for small rural communities which experience health workforce shortages, a higher proportion of those in the chronic conditions age group, and reduced access to care. The aim of the study was to determine existing rates of chronic disease, and current lifestyle and sociodemographic factors which may predispose the population to higher risk of dementia. Residents from three shires in rural Victoria, Australia were recruited by random and non-random sampling techniques to complete a survey regarding health perceptions, pre-existing illnesses, health behaviors and social activity in their community. A total of 1474 people completed the survey. Positive factors reported were social participation and low rates of smoking. Negative factors included low rates of physical activity, high rates of obesity and high rates of chronic conditions that indicate significant risk factors for dementia in these communities. Although some factors are modifiable, these communities also have a large population of older residents. This study suggests that community interventions could modify lifestyle risk factors in these rural communities. These lifestyle factors, age of residents and the current chronic conditions are also important for rural service planning to increase preventive actions, and warn of the likely increase in the number of people developing chronic conditions with predispositon to dementia.
- Authors: Ervin, Kaye , Pallant, Julie , Terry, Daniel , Bourke, Lisa , Pierce, David , Glenister, Kristen
- Date: 2015
- Type: Text , Journal article
- Relation: Aims Medical Science Vol. 2, no. 3 (2015), p. 246-260
- Full Text:
- Reviewed:
- Description: It is essential to determine the key health risk factors among populations to specifically plan future services and explore interventions that modify risk factors for communities. This aims to reduce risks and delay the onset of chronic conditions, which frequently results in dementia, particularly for small rural communities which experience health workforce shortages, a higher proportion of those in the chronic conditions age group, and reduced access to care. The aim of the study was to determine existing rates of chronic disease, and current lifestyle and sociodemographic factors which may predispose the population to higher risk of dementia. Residents from three shires in rural Victoria, Australia were recruited by random and non-random sampling techniques to complete a survey regarding health perceptions, pre-existing illnesses, health behaviors and social activity in their community. A total of 1474 people completed the survey. Positive factors reported were social participation and low rates of smoking. Negative factors included low rates of physical activity, high rates of obesity and high rates of chronic conditions that indicate significant risk factors for dementia in these communities. Although some factors are modifiable, these communities also have a large population of older residents. This study suggests that community interventions could modify lifestyle risk factors in these rural communities. These lifestyle factors, age of residents and the current chronic conditions are also important for rural service planning to increase preventive actions, and warn of the likely increase in the number of people developing chronic conditions with predispositon to dementia.
Glycaemic control among rural health consumers : a retrospective study of a diabetes center
- Terry, Daniel, Glenister, Kristen, Kilmartin, John, Kilmartin, Gloria, Sands, Rob, Fowler, Jeremy, Wright, Julian
- Authors: Terry, Daniel , Glenister, Kristen , Kilmartin, John , Kilmartin, Gloria , Sands, Rob , Fowler, Jeremy , Wright, Julian
- Date: 2015
- Type: Text , Journal article
- Relation: Advances in Diabetes and Metabolism Vol. 3, no. 2 (2015), p. 11-15
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- Description: Aim: The aim of this paper is to highlight the successes of and challenges faced by a publically funded diabetes center in a regional area. Methods: Demographic and laboratory cross sectional data were collected from electronic patient records. Data from a patient’s very first test undertaken when attending the hospital and the latest test undertaken at the dabetes center were noted and included age, sex, residential postcode and glycated haemoglobin (HbA1c) levels. Results: A third of patients reached the therapeutic guideline of ‘very good control’ for HbA1c levels. Females had lower Hb1Ac levels, while males and those that lived further away from the diabetes center had higher levels of HbA1c. However, a significant improvement in glycaemic control among men and those who lived ‘out of town’ was noted, while the corresponding pattern for women was not evident. Conclusion: The study demonstrated that there was an overall improvement in diabetes control among health consumers who attend the regional diabetes center, however, female patients residing in town showed a negligible change over time. At risk’ patient groups may need further targeting for intensive intervention to achieve optimal diabetes control, even within the diabetes center.
- Authors: Terry, Daniel , Glenister, Kristen , Kilmartin, John , Kilmartin, Gloria , Sands, Rob , Fowler, Jeremy , Wright, Julian
- Date: 2015
- Type: Text , Journal article
- Relation: Advances in Diabetes and Metabolism Vol. 3, no. 2 (2015), p. 11-15
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- Description: Aim: The aim of this paper is to highlight the successes of and challenges faced by a publically funded diabetes center in a regional area. Methods: Demographic and laboratory cross sectional data were collected from electronic patient records. Data from a patient’s very first test undertaken when attending the hospital and the latest test undertaken at the dabetes center were noted and included age, sex, residential postcode and glycated haemoglobin (HbA1c) levels. Results: A third of patients reached the therapeutic guideline of ‘very good control’ for HbA1c levels. Females had lower Hb1Ac levels, while males and those that lived further away from the diabetes center had higher levels of HbA1c. However, a significant improvement in glycaemic control among men and those who lived ‘out of town’ was noted, while the corresponding pattern for women was not evident. Conclusion: The study demonstrated that there was an overall improvement in diabetes control among health consumers who attend the regional diabetes center, however, female patients residing in town showed a negligible change over time. At risk’ patient groups may need further targeting for intensive intervention to achieve optimal diabetes control, even within the diabetes center.
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