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Aim: To examine the influence of redeveloping two parks based on consultation with local community and stakeholders on park visitation rates and activity levels of park users. Subject and methods: Pre–post design. Two local neighbourhood parks located in low socioeconomic areas in the regional city of Bundaberg, Australia. Number of park visitors and park users' activity levels were assessed using SOPARC pre (April–August 2013) and post (April–May 2014) park redevelopment. Park data were pooled for analysis. Pre–post differences in the park visitors and park user activity levels were examined overall and also by sex and age group (children, teen, adults, seniors) using a negative binomial generalised linear model (Stata MP 15.1, α = 0.05). Results: Average daily visitors (baseline: 5.08; follow-up: 45.09; p < 0.001) and the number of child, teen, adult, and senior visitors increased from baseline to follow-up. The daily number of park users engaged in sedentary (baseline: 1.56; follow-up: 8.30; p < 0.001), moderate-intensity (baseline: 2.61; follow-up: 26.23; p < 0.001) and vigorous activity (baseline: 0.91; follow-up: 10.56; p < 0.001) also increased. Conclusion: Redeveloping local parks, informed by community, local government and researcher stakeholder consultations increased the number of and activity levels of park users. [ABSTRACT FROM AUTHOR]

Objective: Access to services and workforce shortages are major challenges in rural areas worldwide. In order to improve access to mental health care, it is imperative to understand what services are available, what their capacity is and where existing funds might be spent to increase availability and accessibility. The aim of this study is to investigate mental health service provision in a selection of rural and remote areas across Australia by analysing service availability, placement capacity and diversity. Method: This research studies the health regions of Western New South Wales and Country Western Australia and their nine health areas. Service provision was analysed using the DESDE-LTC system for long-term care service description and classification that allows international comparison. Rates per 100,000 inhabitants were calculated to compare the care availability and placement capacity for children and adolescents, adults and older adults. Results: The lowest diversity was found in northern Western Australia. Overall, Western New South Wales had a higher availability of non-acute outpatient services for adults, but hardly any acute outpatient services. In Country Western Australia, substantially fewer non-acute outpatient services were found, while acute services were much more common. Acute inpatient care services were more common in Western New South Wales, while sub-acute inpatient services and non-acute day care services were only found in Western New South Wales. Conclusion: The number and span of services in the two regions showed discrepancies both within and between regions, raising issues on the equity of access to mental health care in Australia. The standard description of the local pattern of rural mental health care and its comparison across jurisdictions is critical for evidence-informed policy planning and resource allocation. [ABSTRACT FROM AUTHOR]

Introduction: Research suggests that flexible models of care which include across-discipline support and practices can overcome the limitations caused by scattered populations and fewer health practitioners in rural and remote areas across Australia. Innovative models of care bring together the clinician and the individual to plan and manage chronic disease to prevent hospital admissions, promote medication compliance and improve service provision. However, models of care cannot stand alone as effective tools for the management and minimisation of chronic diseases in any given area. A sound knowledge of what services are currently available within any given catchment is necessary in planning, commissioning and coordinating chronic care. Pinpointing the core activities of specific services on the ground can assist with integrating service provision. Practice Change: A recent pilot project has been completed to compile an Integrated Atlas of Chronic Care for Dubbo and Coonamble, providing the first detailed service provision description for a specific geographic region within Australia. Based on the international DESDE-LTC classification system, this document goes beyond simply listing services in a directory, toward being able to understand the functional service delivery teams working in a region, where there may be gaps in service provision and where the greatest need for care may be. Highlights: Furthermore, the consistent classification system employed by the atlas methodology allows for later comparison of service provision with other regions. The utility of a validated, comparable and transferable classification system enables policy makers, service planners and commissioning bodies to make informed decisions related to service provision based on the current service provision patterns. Conclusion: In order to ensure rural and remote communities are more likely to have their health needs met, there needs to be a comprehensive understanding of not only what communities need but also what services are currently available that could cooperate to meet the needs in appropriate ways. Locally relevant information on services therefore has a key role in improving rural and remote health. [ABSTRACT FROM AUTHOR]

Objective: Variation exists in the patterns of alcohol and other drug (AOD) use and related impacts across geographic locations and over time. Understanding the existing AOD service system and the local context that it operates within is fundamental to optimize service provision. This article describes and compares the availability, placement capacity, and diversity of AOD services in urban and rural regions in Australia., Method: The Description and Evaluation of Services and DirectoriEs (DESDE) tool was used to categorize the service delivery system for AOD care in selected urban and rural regions in Australia., Results: This study found that although AOD services (303 main types of care) were available across all study regions, there was consistently very limited availability of services targeting young people (n = 39, 13%) or older adults (n = 1, <1%). There were also very limited services addressing comorbidities. Availability and diversity of services varied across study areas. Outpatient and residential care were the most available services, whereas day care services were absent in most areas., Conclusions: By describing the capacity of identified available services within the study regions, this study provides baseline information to inform changes to policy and practice and a foundation for monitoring and modeling service changes over time. This information provides evidence useful for optimal planning. However, it should be combined with local knowledge and stakeholder expertise to ensure that local area service needs are addressed.

Health promotion core competencies are used for a variety of reasons. Recently there have been moves to gain international consensus regarding core competencies within health promotion. One of the main reasons put forward for having core competencies is to guide curriculum development within higher education institutions. This article outlines the endeavours of one institution to develop undergraduate and postgraduate curricula around the Australian core competencies for health promotion practitioners. It argues that until core competencies have been agreed upon internationally, basing curricula on these carries a risk associated with change. However, delaying curricula until such risks are ameliorated decreases opportunities to deliver dynamic and current health promotion education within higher institutions.

Objective: The aim of this study was to investigate the association between early menstrual characteristics, before symptom onset, and later diagnosis of endometriosis., Study Design: This was a case-control study of 268 Australian women with surgically confirmed moderate-to-severe endometriosis (cases) and 244 women without endometriosis (controls). Early menstrual cycle characteristics, before age at symptom onset, were analyzed., Results: Menarche after age 14 years was strongly and inversely associated with endometriosis (odds ratio, 0.3; 95% confidence interval, 0.1-0.6). A history of dysmenorrhea was associated with subsequent endometriosis (odds ratio, 2.6; 95% confidence interval, 1.1-6.2). Despite a suggestive trend, shorter menstrual cycle length was not associated with endometriosis. Duration of natural menstruation and heaviness of flow were not associated with subsequent risk of endometriosis; neither was the reported type of sanitary protection used nor history of sexual intercourse during menstruation., Conclusion: There is a decreased risk of endometriosis with late age at menarche and an increased risk in women who report an early history of dysmenorrhea., (Copyright 2010 Mosby, Inc. All rights reserved.)