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Objectives To describe the burden of bone and joint problems (BJP) in a defined regional population, and to identify characteristics and service-usage patterns. Methods In 2010, a health census of adults aged ≥15 years was conducted in Port Lincoln, South Australia. A follow-up computer-assisted telephone interview provided more specific information about those with BJP. Results Overall, 3350 people (42%) reported current BJP. General practitioners (GP) were the most commonly used provider (85%). People with BJP were also 85% more likely to visit chiropractors, twice as likely to visit physiotherapists and 34% more likely to visit Accident and Emergency or GP out of hours (compared with the rest of the population). Among the phenotypes, those with BJP with co-morbidities were more likely to visit GP, had a significantly higher mean pain score and higher levels of depression or anxiety compared with those with BJP only. Those with BJP only were more likely to visit physiotherapists. Conclusions GP were significant providers for those with co-morbidities, the group who also reported higher levels of pain and mental distress. GP have a central role in effectively managing this phenotype within the BJP population including linking allied health professionals with general practice to manage BJP more efficiently. What is known about the topic? As a highly prevalent group of conditions that are likely to impact on health-related quality of life and are a common cause of severe long-term disability, musculoskeletal conditions place a significant burden on individuals and the health system. However, far less is known about access and usage of musculoskeletal-related health services and programs in Australia. What does this paper add? As a result of analysing the characteristics of the overall BJP population, as well as phenotypes within it, a greater understanding of patterns of health service interactions, care pathways and opportunities for targeted improvements in delivery of care may be identified. The results emphasise that participants with BJP utilised the services of a narrow range of providers, which may have workforce implications for these sectors. The funding models for physiotherapists and chiropractors in Australia involve a mix of private and fees for service, which limits access to those who have private health insurance or can pay directly for these services. What are the implications for practitioners? These analyses indicate the importance of linking allied health professionals with general practice to manage BJP more efficiently. Alternative and appropriate care pathways need to be more strongly developed and identified for effective management of these conditions rather than relying on a traditional range of practitioners. Alternatively, greater ease of access to allied health practitioners may enable more effective treatment and improved quality of life for those with BJP. There is an urgent need to develop an effective population-based model of integrated care for BJP within regional Australia. [ABSTRACT FROM AUTHOR]

Individuals with substance use disorders (SUDs) have consistently been shown to report elevated levels of anger and rates of violence perpetration. Given that heightened anger can increase risk for violence and also impede treatment for SUD, it is important to identify correlates of anger and violence among individuals in SUD treatment settings. While previous research has identified factors associated with anger and violence among individuals with SUD, these studies tend not to adequately address the role of comorbidity or trait aggression in their samples. This is particularly important given that comorbid mental health disorders, for example post traumatic stress disorder (PTSD), have been shown to be associated with anger and violence perpetration among individuals with SUD. This paper aims to examine demographic and mental health correlates of anger and violence among individuals in treatment for SUD. Structured interviews were carried out with 58 participants recruited from a residential detoxification clinic. Findings indicate that individuals with comorbid mental health symptoms, particularly symptoms of anxiety, are also likely to present with elevated levels of anger. In addition, a history of childhood trauma exposure and high levels of trait aggression were significantly associated with violence perpetration in the sample. This information can assist clinicians in identifying individuals prone to anger and violence and aid in the development of interventions designed to reduce anger and the likelihood of violence among individuals entering substance use treatment. [ABSTRACT FROM PUBLISHER]

The Australian government's commitment to health service reform has placed general practice at the centre of its agenda to manage chronic disease. Concerns about the capacity of GPs to meet the growing chronic disease burden has stimulated the implementation and testing of new models of care that better utilise practice nurses (PN). This paper reports on a mixed-methods study nested within a larger study that trialled the feasibility and acceptability of a new model of nurse-led chronic disease management in three general practices. Patients over 18 years of age with type 2 diabetes, hypertension or stable ischaemic heart disease were randomised into PN-led or usual GP-led care. Primary outcomes were self-reported quality of life and perceptions of the model's feasibility and acceptability from the perspective of patients and GPs. Over the 12-month study quality of life decreased but the trend between groups was not statistically different. Qualitative data indicate that the PN-led model was acceptable and feasible to GPs and patients. It is possible to extend the scope of PN care to lead the routine clinical management of patients' stable chronic diseases. All GPs identified significant advantages to the model and elected to continue with the PN-led care after our study concluded. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this paper is to assess Australian young people’s awareness of mental health services available for their age group. Of particular interest was awareness of headspace, which was created in 2006 to provide youth-oriented mental health services, and has expanded to 30 centres nationally in 5 years.Method: In 2011, a telephone interview was conducted with a national sample of 3021 Australians aged between 15 and 25 years. Participants were asked questions about awareness of mental health organizations, where they would seek help for themselves and how they would assist a peer with a mental health problem.Results: There were very low frequencies of spontaneous mentions of headspace as a mental health organization, or as a service where respondents would seek help for themselves or refer a peer to. However, when prompted, about half of respondents recognized headspace as a mental health organization. Living within a headspace service area predicted better recognition of headspace. However, past-year psychological distress was unrelated to recognition of headspace as a mental health organization.Conclusions: In order to reach them more effectively, young people need to be aware of youth-oriented services that are available to them and their peers. Awareness campaigns need to be targeted to the subgroups of young people who have the greatest need for headspace services, namely those with recent mental health problems. [ABSTRACT FROM PUBLISHER]