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There is an urgent and unmet need for specialist palliative care services in residential aged care. The Specialist Palliative Care in Aged Care (SPACE) Project aimed to improve palliative and end-of-life care for older people living in residential aged care facilities in Queensland. A representative working group developed a series of service principles around palliative care practice in aged care (comprehensive resident-focused care, streamlined service, and capacity building). Funding was allocated by population to the health services in Queensland to adapt and implement models of care aligned with these principles. SPACE successfully implemented a variety of decentralised models of care across Queensland. The critical elements for the success of SPACE were the use of an expert working group to define the core innovation, networking and implementation support from the central project team and community of practice, and adaptable models of care led by local facilitators. Lessons learned from this real-world case study could be adopted to guide and ensure the successful implementation and sustainability of future complex interventions in healthcare settings, both nationally and internationally. What is known about the topic? There is limited palliative care support for the 36% of Australians who die in residential aged care. What does this paper add? This paper describes the development of the Specialist Palliative Care in Aged Care (SPACE) Project, using locally tailored models of care to improve palliative and end-of-life care in aged care facilities across Queensland. What are the implications for practitioners? Critical elements for improving residents' palliative and end-of-life care included creation of an expert working group to define the innovation state-wide, a central project team that supported implementation, a community of practice, and local facilitation. [ABSTRACT FROM AUTHOR]

Objectives: Cardiac rehabilitation (CR) provides evidence-based secondary prevention for people with heart disease (HD) (clients). Despite HD being the leading cause of mortality and morbidity, CR is under-utilised in Australia. This research investigated healthcare systems required to improve access to CR in rural and remote areas of North Queensland (NQ). Methods: A qualitatively dominant case study series to review management systems for CR in rural and remote areas of NQ was undertaken. Data collection was via semi-structured interviews in four tertiary hospitals and four rural or remote communities. An audit of discharge planning and CR referral, plus a review of community-based health services, was completed. An iterative and co-design process including consultation with healthcare staff and community members culminated in a systems-based model for improving access to CR in rural and remote areas. Results: Poorly organised CR systems, poor client/staff understanding of discharge planning and low referral rates for secondary prevention, resulted in the majority of clients not accessing secondary prevention, despite resources being available. Revised health systems and management processes were recommended for the proposed Heart: Road to health model, and given common chronic diseases risk factors it was recommended to be broadened into Chronic disease: Road to health. Conclusion: A Chronic disease: Road to health model could provide effective and efficient secondary prevention for people with chronic diseases in rural and remote areas. It is proposed that this approach could reduce gaps and duplication in current healthcare services and provide flexible, client-centred, holistic, culturally responsive services, and improve client outcomes. What is known about the topic? Cardiac rehabilitation is known to improve health outcomes and reduce hospitalisations, but referrals and attendance are low (30%). What does this paper add? A revised systems-based model for improved access to secondary prevention for people with heart and related chronic diseases in rural and remote areas of North Queensland is proposed: Chronic disease: Road to health. What are the implications for practitioners? A functional system from hospitalisation to local healthcare services has been designed to improve access to secondary prevention. Staff require support and education to improve skills, better manage care and improve job satisfaction. [ABSTRACT FROM AUTHOR]

This paper describes the development and implementation of a peer-support program Always There in a large public mental health service in Queensland, Australia. The program is modelled on Scott's three tier model of peer support, with trained responders providing emotional support to staff following a traumatic adverse event, or when experiencing acute or cumulative stress. Support is provided in complete confidentiality. Main lessons learned in the 2 years since the launch of the program are shared in this paper, outlining successes such as improvements in staff's perception of organisational culture, and challenges related to embedding the program to "business as usual". [ABSTRACT FROM AUTHOR]

In Queensland, use of preimplantation genetic diagnosis (PGD) and prenatal diagnostic testing (PND) is limited to the detection of and abstention from embryos or foetuses afflicted with "serious" disabilities. In the absence of a legislative definition or widespread consensus among physicians regarding those disablements which are sufficiently "serious", it begs the question: is Queensland's current regulation of PND and PGD inconsistent with the rule of law because it lacks clarity, stability, and certainty and thus arbitrarily restricts reproductive liberties? This article will demonstrate that the detection of genetic abnormalities via PGD and PND will lead to differing clinical outcomes pre- and post-implantation. While their utilisation for the therapeutic prevention of "serious" harm is a justifiable intrusion on reproductive autonomy, the medical professions' and disabled community's conceptualisations of disability are maligned. Queensland's adoption of a permissive licensing regime for PGD and the interactional model of disability by physicians administering PND is considered. [ABSTRACT FROM AUTHOR]

The health behaviours related to chronic diseases experienced by South Asian immigrants are interrelated with their culture and socioeconomic conditions. South Asian immigrants experience a disproportionate burden of chronic disease compared with non‐immigrants Australian‐born general population. The primary aim of this study was to gain an in‐depth understanding of health behaviours and healthcare access in the South Asian immigrant population of Australia. Five focus group discussions (FGDs) were conducted with South Asian immigrants (n = 29; 18 females) aged 27–50 years in Brisbane, Australia. Separate FGDs were conducted for males and females in the English language. Semi‐structured guided questions related to the perception, barriers and facilitators of health behaviours. Data were analysed with Nvivo‐12 following a thematic analysis. A conceptual model is proposed to provide a summarised understanding of barriers and facilitators of health behaviours in South Asian immigrants. The major reported constraints for participating in physical activity were cultural beliefs, lack of time, work stress and high fees of fitness activities, while parks and peer modelling were mentioned as a strong motivator for walking, cycling and participating in group sports activities. The cultural and religious connections, cost of cigarettes and drink driving penalties were the most mentioned facilitators for a healthy lifestyle. The important factors related to unhealthy eating habits were the traditional cooking methods, social interactions and the high cost of fruits and vegetables. Community perceptions and language barriers were also acknowledged as the main factors for the decrease in accessing health care services. This study illustrates that cultural beliefs, high cost of healthy food and facilities and social circumstances are mainly linked with the health behaviours and healthcare access in South Asian immigrant's lifestyles. [ABSTRACT FROM AUTHOR]

Purpose: Active school travel (AST) programmes aim to change commuting behaviour to improve children's physical and mental health. However, very limited health education programmes for children use segmentation to create tailored solutions that understand the specific characteristics of each group of children and their caregivers in order to yield better results. The aim of this study is to use a statistical segmentation analysis (two-step cluster analysis) to gain insights on the examination of specific groups to design future health education interventions and campaigns that can improve children's health. Design/methodology/approach: Guided by the Ecological and Cognitive Active Commuting (ECAC) framework, a market segmentation analysis was performed. An online survey was designed to collect data from caregivers of children between 5 and 12 years attending school and responsible for taking the child to and/or from school in Victoria and Queensland, Australia. Using 3,082 responses collected from Australian caregivers of primary school children, a two-step cluster analysis was performed. Findings: Analysis revealed the most important variables for group formation were previous child walking behaviour, distance from school and caregiver income. Perceived risk of the physical environment was the most important psychographic segmentation variable for group formation, followed by social norms. Four distinct groups with different characteristics were identified from the analysis. Originality/value: This is the first study that applies the ECAC framework to perform market segmentation in the AST context. Results revealed four market segments that demand different tailored solutions. Findings shed light on how to better design AST interventions and campaigns to promote children's health using segmentation techniques. [ABSTRACT FROM AUTHOR]