Australian Health Ministers Advisory Council Research Articles

The need for improved Australian data on social determinants of health inequities

The need for improved Australian data on social determinants of health inequities

Aboriginal dental assistants can safely apply fluoride varnish in regional, rural and remote primary schools in New South Wales, Australia.

There are significant inequalities in oral health status between Aboriginal and non-Aboriginal children in Australia, particularly where the children have insufficient access to various forms of fluoride. There has been a growing interest in seeing fluoride varnish programs used more widely for Aboriginal children due to proven effectiveness. Despite this, there has been limited scale-up of these programs in Australia. This study investigates the feasibility of using Aboriginal dental assistants to provide regular fluoride varnish applications for Aboriginal children in the primary school setting. A mixed-methods approach including auditing the number of Aboriginal dental assistants were trained and then approved by the NSW Chief Health Officer to apply fluoride varnish, and collection and reporting of participant data on the each of the fluoride varnish days in the local patient management system. Six Aboriginal Community Controlled Health Services from regional NSW were invited to participate in the study. They also nominated a primary school and an Aboriginal dental assistant to participate in the study. Data were obtained from four 'fluoride varnish days' held at the schools over a 12-month period between December 2017 and December 2018. The number of Aboriginal dental assistants were trained and then approved by the NSW Chief Health Officer to apply fluoride varnish is also reported. In total, 8 Aboriginal dental assistants were trained to apply fluoride varnish during the study. Overall, students participating in the study received three or more fluoride varnish applications. Results showed that Aboriginal dental assistants are able to safely and effectively apply fluoride varnish in a school setting with remote supervision. This program can be scaled at the state level in NSW, and this could provide the basis for a nationally consistent program. Initial discussions have been held with several jurisdictions to lead this process via the Australian Health Ministers Advisory Council (AHMAC) based on the results of this study and the support of key stakeholders. The Poche Centre as part of its scale-up planning for the Fluoride Varnish Program is examining the feasibility of including the apply fluoride varnish skillset in its existing Aboriginal Dental Assistant Scholarship Program.

VP14 Screening Recommendations For Socioeconomic Disadvantages In Pregnancy

INTRODUCTION:In 2015, 18.3 percent of the Austrian population were at risk of poverty and social exclusion - about 211,000 (20 percent) women aged 20–39 years were affected. International studies report that poverty may lead to an increased risk of complications and pathologies during pregnancy. Further, children who grow up in poverty often have poorer long-term health outcomes.METHODS:In order to identify recent guidelines (2011-2016) a comprehensive handsearch was conducted in the guideline databases National Guideline Clearinghouse (NGC) and Guidelines International Network (GIN). Moreover, a handsearch for systematic reviews and primary studies was conducted in PubMed.RESULTS:Two guidelines, the British National Institute for Health and Clinical Excellence (NICE) Guideline “Pregnancy and Complex Social Factors”, as well as the Australian Health Ministers' Advisory Council (AHMAC) Guideline “Antenatal Care”, address socioeconomic disadvantages of women during antenatal care. The recommendation of the AHMAC is that pregnancy care should be offered to all pregnant women. In addition, an individual approach will help to pay particular attention to socioeconomic factors and to incorporate them in routine examinations. NICE recommends in its guideline, affected women should be supported in order to ensure adequate prenatal care. NICE also defines criteria which are used to identify pregnant women who are in greater need of support. The only identified study developed and tested a tool for the identification of patients affected by poverty. The authors of this Canadian pilot study concluded that the defined questions helped to identify socioeconomically disadvantaged persons during anamnesis without stigmatizing.CONCLUSIONS:Due to the proven link between poverty and health risks, special attention must be paid to socioeconomically disadvantaged pregnant women. Research on non-stigmatizing instruments, which can identify vulnerable women, is of great importance. In addition to social policy measures, it is necessary to ensure that low-threshold services are available for socioeconomic disadvantaged women and their children.

Making and managing policies about neonatal screening

Policies relating to Newborn Screening Programs (NBSP) in Australia are State based. A Human Genetics Society of Australia (HGSA) / Royal Australasian College of Physicians (RACP) Joint Committee on Newborn Screening sets laboratory and clinical standards for NBSP. An Australian Health Ministers' Advisory Council (AHMAC) advisory group failed to achieve consensus between States. The importance of the inclusion of health professionals actively involved in NBSP in any policy making body was highlighted by this exercise. Controlled studies of NBSP are difficult because the disorders are rare, requiring vast numbers of screened infants and lengthy follow up periods to demonstrate benefit. The problems of requiring published data before instituting NBSP are well demonstrated by screening for congenital adrenal hyperplasia, as the technologies used in published studies have become superseded before publication, and by the comparison of NBSPs in Australia and the United Kingdom regarding expanded newborn screening. There have been recent challenges to the Wilson and Jungner guidelines for selection of screened disorders with the value of genetic knowledge for families, even if there are no accepted treatments, being promoted. Conditions such as Duchenne muscular dystrophy, for which treatments have been developed for only certain genotypes, and lysosomal storage disorders, for which treatment is very expensive and very burdensome, will provide challenges for NBSP in the immediate future.

Comprehensive systematic review of age-friendly nursing interventions in the management of older people in Emergency Departments.

Review Objective: To identify the best available evidence on age-friendly nursing interventions used in the management of older people (over 65) during their stay in the Emergency Department Review Questions: 1. What is the effectiveness of age-friendly nursing interventions used in the management of older people (over 65) during their stay in the Emergency Department? 2. What are the recommended policies regarding age-friendly nursing interventions for the management of older people (over 65) during their stay in the Emergency Department? Inclusion criteria: Types of participants: This review will consider men and women over the age of 65 presenting to the Emergency Department. Types of intervention(s)/phenomena of interest: The review will consider any age-friendly nursing interventions in the management of older patients during their stay in the Emergency Department. These may include nursing interventions to enhance comfort, nutrition, hydration, pressure area care, pain management and communication. The opinion part of the review will consider the policies and recommendations related to age-friendly nursing interventions. Types of outcomes: Outcomes of interest for the quantitative part of the review are: pressure area status, hydration status, nutritional status and pain status measured during their stay in the emergency department. The text and opinion part of the review will focus on the recommended policies for age-friendly nursing interventions.

THE EMERGENCE OF RURAL HEALTH RESEARCH IN AUSTRALIA

The late 1980s saw a renewed interest in rural health in its own right with State jurisdictions establishing defined rural health units. There was recognition that health professionals in rural communities often needed training to fulfil their roles in rural and remote communities. Simultaneously, the number of regional universities increased. A number of such universities grouped to form a consortium and were funded through the Australian Health Ministers' Advisory Council (AHMAC) to form the Australian Rural Health Research Institute. Consequently, a series of conferences specifically addressing rural health research needs occurred, and the Australian Journal of Rural Health was established. Through both of these avenues a trend towards more research presentations and publications can be seen. The National Health and Medical Research Council, under the auspices of AHMAC, has provided an overview of the state of rural health research in Australia and developed recommendations, which form the framework for a future strategy for rural health research. These recommendations have been endorsed by AHMAC, which has now funded the initiation of the implementation of the strategy.

Scoping practice issues in the Australian mental health nursing workforce.

This is the third of four articles on the scoping study of the Australian mental health nursing workforce conducted on behalf of the Australian and New Zealand College of Mental Health Nurses (ANZCMHN) for the Australian Health Ministers Advisory Council (AHMAC) National Working Group on Mental Health (NWGMH). Its purpose is to focus on factors that significantly affect mental health nursing practice. The issues of advanced practice, regulation of nursing, accreditation, credentialing and demarcation with other disciplines are addressed.

Scoping the Australian mental health nursing workforce.

This is the second of four articles on the Scoping Study of the Australian mental health nursing workforce conducted on behalf of the Australian and New Zealand College of Mental Health Nurses (ANZCMHN) for the Australian Health Ministers Advisory Council (AHMAC) National Working Group on Mental Health (NWGMH). Its purpose is to focus on overlooked issues in planning the mental health nursing workforce. Whereas it is acknowledged that there are problems in the supply of mental health nurses, it is argued that equal attention needs to be given to addressing the working conditions and rewards of mental health nurses.

Scoping mental health nursing education.

In late 1999 the National Mental Health Working Group of the Australian Health Ministers Advisory Council commissioned the Australian and New Zealand College of Mental Health Nurses to undertake a scoping study of mental health nursing. A final report will be submitted to the National Mental Health Working Group in February 2000. The purpose of this article is to draw attention to some of the systemic problems that confront the education of mental health nurses in Australia. Shortcomings in the preparation of undergraduate students of nursing for commencing practice in mental health nursing are described and comments are given on issues affecting the quality of postgraduate mental health nursing education.

Medical workforce planning in Australia

The Australian Medical Workforce Advisory Committee (AMWAC) was established by the Australian Health Ministers' Advisory Council (AHMAC) in 1995 to provide information and analysis to AHMAC and the profession about the medical workforce to inform the policy process. This article provides a brief history of the events leading to the formation of AMWAC and of the work of this committee, particularly its approach to medical workforce planning and the outcomes of some of its research. The paper concludes that the forces leading to and maintaining workforce geographic and structural maldistribution are better understood as a result of AMWAC studies and the work of other stakeholders. Further research is required to improve understanding of the hospital medical workforce and the factors influencing the career decisions of young doctors and to monitor the impact of strategies to improve workforce distribution.

Australian Medical Workforce Advisory Committee (AMWAC) Working Party to Review Psychiatry Workforce

As part of its 1998/99 work plan the Australian Medical Workforce Advisory Committee (AMWAC) has been asked to provide advice to the Australian Health Ministers' Advisory Council (AHMAC) on the characteristics, distribution and adequacy of the current psychiatry workforce. In addition, the working party has been asked to recommend strategies for the promotion of an adequate supply and appropriate distribution of psychiatrists for the next decade. It is anticipated that the working party will provide a final report to the first meeting of AMWAC in 1999, probably around March or April.

The Australian Health Ministers' Advisory Council (AHMAC) and the National Mental Health Reforms

The Australian Health Ministers' Advisory Council (AHMAC) and the National Mental Health Reforms