Nurse-led pre-exposure prophylaxis: a non-traditional model to provide HIV prevention in a resource-constrained, pragmatic clinical trial

Sexual Health ◽  
2018 ◽  
Vol 15 (6) ◽  
pp. 595 ◽  
Author(s):  
Heather-Marie A. Schmidt ◽  
Ruthy McIver ◽  
Rebecca Houghton ◽  
Christine Selvey ◽  
Anna McNulty ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
New South ◽  
New South Wales ◽  
Models Of Care ◽  
Rapid Expansion ◽  
Local Health ◽  
South Wales ◽  
Public Clinics ◽  
Sexual Health Clinics ◽  
Exposure Prophylaxis

There is little evidence and no standardised model for nurse-led HIV pre-exposure prophylaxis (PrEP). In 2016, public sexual health clinics in the state of New South Wales (NSW), Australia, participating in the population-scale PrEP access trial Expanded PrEP Implementation In Communities in New South Wales (EPIC-NSW) were authorised to adopt a nurse-led model of PrEP provision in order to facilitate the rapid expansion of PrEP access to more than 8000 participants in under 2 years without additional resources. The model has been implemented successfully in public clinics in 10 of 14 local health districts, with widespread support and no serious safety events reported. With the increasing importance of PrEP as an HIV prevention tool, non-traditional models of care, including nurse-led PrEP, are needed.

Cultural safety in hospitals: validating an empirical measurement tool to capture the Aboriginal patient experience

2020 ◽  
Vol 44 (2) ◽  
pp. 205
Author(s):  
Elissa Elvidge ◽  
Yin Paradies ◽  
Rosemary Aldrich ◽  
Carl Holder
Keyword(s):  
Patient Perspective ◽  
New South ◽  
New South Wales ◽  
Performance Measure ◽  
Cultural Safety ◽  
Measurement Tool ◽  
Local Health ◽  
Validity And Reliability ◽  
South Wales ◽  
Aboriginal Patient

ObjectiveThe aim of the present study was to develop a scale to measure cultural safety in hospitals from an Aboriginal patient perspective. MethodsThe Cultural Safety Survey was designed to measure five key characteristics of cultural safety that contribute to positive hospital experiences among Aboriginal hospital patients. Investigators developed a range of different methods to assess the validity and reliability of the scale using a sample of 316 participants who had attended a New South Wales hospital in the past 12 months. Targeted recruitment was conducted at two hospital sites. Opportunistic recruitment took place through a local health district, discharge follow-up service and online via social media. ResultsThe Cultural Safety Survey Scale was a robust measurement tool that demonstrated a high level of content and construct validity. ConclusionThe Cultural Safety Survey Scale could be a useful tool for measuring cultural safety in hospitals from the Aboriginal patient perspective. What is known about the topic?There are increasing calls by governments around the world for health institutions to enhance the cultural safety of their services as one way of removing access barriers and increasing health equity. However, currently there are no critical indicators or systematic methods of measuring cultural safety from the patient perspective. What does this paper add?The cultural safety scale, an Australian first, presents the first empirically validated tool that measures cultural safety from the Aboriginal patient perspective. What are the implications for practitioners?This measurement model will allow hospitals to measure the cultural safety of their services and ascertain whether current efforts aimed to improve cultural safety are resulting in Aboriginal patients reporting more culturally safe experiences. Over time it is hoped that the tool will be used to benchmark performance and eventually be adopted as a performance measure for hospitals across New South Wales.

scholarly journals A multi-organisation aged care emergency service for acute care management of older residents in aged care facilities

2015 ◽  
Vol 39 (5) ◽  
pp. 514 ◽  
Author(s):  
Jane Conway ◽  
Sophie Dilworth ◽  
Carolyn Hullick ◽  
Jacqueline Hewitt ◽  
Catherine Turner ◽  
...  
Keyword(s):  
New South ◽  
Point Of Care ◽  
New South Wales ◽  
Aged Care ◽  
Residential Aged Care ◽  
Local Health ◽  
South Wales ◽  
Care Assessment ◽  
Care Facilities ◽  
Aged Care Facilities

This case study describes a multi-organisation aged care emergency (ACE) service. The service was designed to enable point-of-care assessment and management for older people in residential aged care facilities (RACFs). Design of the ACE service involved consultation and engagement of multiple key stakeholders. The ACE service was implemented in a large geographical region of a single Medicare Local (ML) in New South Wales, Australia. The service was developed over several phases. A case control pilot evaluation of one emergency department (ED) and four RACFs revealed a 16% reduction in presentations to the ED as well as reductions in admission to the hospital following ED presentation. Following initial pilot work, the ACE service transitioned across another five EDs and 85 RACFs in the local health district. The service has now been implemented in a further 10 sites (six metropolitan and four rural EDs) across New South Wales. Ongoing evaluation of the implementation continues to show positive outcomes. The ACE service offers a model shown to reduce ED presentations and admissions from RACFs, and provide quality care with a focus on the needs of the older person.

scholarly journals Accessibility and acceptability of public sexual health clinics for adult clients in New South Wales, Australia

Sexual Health ◽  
2008 ◽  
Vol 5 (3) ◽  
pp. 305 ◽  
Author(s):  
Vijayasarathi Ramanathan ◽  
Melissa Kang ◽  
Sarangapany Jeganathan ◽  
Eva Jackson ◽  
Katerina Lagios ◽  
...  
Keyword(s):  
Sexual Health ◽  
New South ◽  
New South Wales ◽  
Health Clinics ◽  
South Wales ◽  
Sexual Health Clinics

Junior clinical academic psychiatrists in Australia: The University of New South Wales initiative

2018 ◽  
Vol 27 (3) ◽  
pp. 241-244 ◽  
Author(s):  
Adith Mohan ◽  
Adam Bayes ◽  
Perminder S Sachdev ◽  
Gordon Parker ◽  
Philip B Mitchell
Keyword(s):  
New South ◽  
New South Wales ◽  
Local Health ◽  
Specialty Training ◽  
Research Engagement ◽  
Track Record ◽  
South Wales ◽  
Entry Points ◽  
The University ◽  
Health Districts

Objective: We examined current pathways of training for junior clinical academic psychiatrists in Australia. An initiative of the School of Psychiatry, University of New South Wales, is described from the perspective of two junior clinical academics. Conclusions: Australia has limited defined clinical academic pathways for psychiatrists when compared internationally. Numerous challenges for junior psychiatrists entering academia include tensions between clinical and academic roles, reduced remuneration, difficulty building a competitive track record and a scarcity of funding. Potential solutions lie with universities and local health districts partnering to fund clinical academic roles and offering flexible entry points across specialty training. Fostering research engagement in junior psychiatrists will develop the next generation of clinical academics with benefit for clinical and academic domains.

Pedigree Dorset Horn sheep in Australia. 1. Breed expansion and other vital statistics

1978 ◽  
Vol 18 (91) ◽  
pp. 165 ◽  
Author(s):  
NM Fogarty
Keyword(s):  
New South ◽  
New South Wales ◽  
South Australia ◽  
Vital Statistics ◽  
Rapid Expansion ◽  
Western Region ◽  
Flock Size ◽  
South Wales ◽  
The Mean

The Dorset Horn in Australia is maintained almost exclusively for producing rams for crossbreeding in the prime lamb industry. Flock Book records have been used to assess the expansion and other statistics of the breed. Dorset Horn sheep were first imported in 1895 with the first flock registered in 1920. The number of pedigree flocks increased to 1298 in 1958 and total ewes to 11 3,762 in 1968. Flocks declined to 61 4 and ewes to 60,801 in 1973, during which there was a rapid expansion in Poll Dorset flocks and ewes. Early expansion of the Dorset Horn occurred in South Australia and Victoria but over 85 per cent of flocks and ewes were located in New South Wales and Victoria in 1973. In 1973,40 per cent of flocks contained less than 51 ewes with only 2.8 per cent having more than 400 ewes. The mean age of studs in 1973 was 15.3 years, with 22 per cent established for 0 to 5 years, compared with 7.1 years and 62 per cent respectively in 1958. Stud dispersals have increased dramatically in recent years to 19.7 per cent of extant studs in 1973. Examination of flocks present in 1969 but dispersed prior to 1974, showed the proportion of dispersed flocks decreased with increasing flock size and increasing stud age, up to 40 years. Migration of sires between all regions was low, but of the migrant sires, South Australia supplied 76 per cent in 1954 and the central western region of New South Wales 57 per cent in 1974. Approximately half of the rams sampled had sires bred in the same stud.

HIV results: practice at public sexual health clinics in New South Wales

Sexual Health ◽  
2011 ◽  
Vol 8 (2) ◽  
pp. 264 ◽  
Author(s):  
Loretta M. Healey ◽  
David J. Templeton
Keyword(s):  
Sexual Health ◽  
New South ◽  
New South Wales ◽  
National Guidelines ◽  
Patient Acceptability ◽  
Health Clinics ◽  
South Wales ◽  
Risk Patients ◽  
Sexual Health Clinics ◽  
Positive Results

New South Wales (NSW) Health guidelines recommend all HIV results be given in person, however this practice fails to achieve high levels of result collection. Fourteen of all 38 NSW public sexual health clinics (37%) surveyed offer HIV results by telephone to low-risk patients, although all positive results are given in person. Efficiency of result-giving, accessibility to results, patient acceptability and awareness of more flexible national guidelines were cited as reasons for varying practice from state guidelines. NSW guidelines require revision to allow clinicians to determine the most effective and efficient mode of HIV result delivery to their patients.

Effective partnership and adequate investment underpin a successful response: key factors in dealing with HIV increases

Sexual Health ◽  
2008 ◽  
Vol 5 (2) ◽  
pp. 193 ◽  
Author(s):  
Diana Bernard ◽  
Susan Kippax ◽  
Don Baxter
Keyword(s):  
Hiv Prevention ◽  
Social Research ◽  
New South ◽  
New South Wales ◽  
Hiv And Aids ◽  
Effective Response ◽  
Financial Investment ◽  
Gay Community ◽  
South Wales ◽  
Prevention Activities

Background: Australia has mounted an effective response to HIV and AIDS by investing in evidence-informed policy. Recently, in response to increases in HIV in some states in Australia, the New South Wales Department of Health set up a ‘think tank’ to examine differences in epidemiological and behavioural data, policies, strategies and community responses in order to account for state-based differences and ensure an effective ongoing response to HIV. Methods: The National Centre in HIV Social Research undertook key informant interviews with major stakeholders to help understand differences in responses by the three states most affected by HIV in Australia – Queensland, New South Wales and Victoria. In parallel, the Australian Federation of AIDS Organisations completed an analysis of the investments in HIV-prevention activities targeting gay men in all jurisdictions in Australia. The Australian Federation of AIDS Organisations also analysed the strategic contexts and government responses to HIV in the three states. Results: There were significant differences between New South Wales, Queensland and Victoria in the way the HIV partnership functions. Type of prevention strategy and level of financial investment in prevention activities appear to be related to the effectiveness of the ongoing response to HIV. Conclusions: An active commitment to and adequate resourcing of HIV prevention by all stakeholders in the HIV partnership – government and non-government departments, researchers and gay community organisations – is crucial if Australia is to respond effectively to HIV among gay and other men who have sex with men.

Case Study

2011 ◽  
pp. 191-203
Author(s):  
E. Saurman ◽  
D. Perkins ◽  
D. Lyle ◽  
M. Patfield ◽  
R. Roberts
Keyword(s):  
Mental Health ◽  
Health Service ◽  
New South ◽  
New South Wales ◽  
Health Staff ◽  
Local Health ◽  
Rural And Remote ◽  
South Wales ◽  
Western Area ◽  
Area Health

The MHEC-RAP project involves the innovative application of video conferencing to mental health assessment in rural NSW. The preliminary evaluation findings of the project are presented. Mental health emergencies in rural and remote settings cause particular problems and are not amenable to conventional health service solutions. Patients and local health care staff may be isolated from specialist mental health staff and from acute inpatient services. Decisions to transport patients for specialist assessments or treatment may be required at night or at weekends and may involve families, police, ambulance services and local health staff. Such decisions need to be made promptly but carefully and the ability to obtain a specialist assessment may assist in making a decision about how best to care for the patient bearing in mind the need to provide a responsive, high quality and safe service to patients and local clinicians. In this chapter we examine a novel approach which uses audio-visual technology to conduct remote emergency mental health patient assessment interviews and provide consultations to local clinicians in rural communities in western NSW. The Mental Health Emergency Care – Rural Access Project or ‘MHEC-RAP’ was developed in 2007 following a series of consultations held in rural towns and implemented in 2008 within the Greater Western Area Health Service (GWAHS), New South Wales, Australia. GWAHS is a primary example of a rural and remote health service. It serves 287,481 people (8.3% of whom are Indigenous Australians) in an area that is 445,197sq km or 55% of the state of New South Wales (Australian Bureau of Statistics, 2001; Greater Western Area Health Service, 2007, 2009). The communities within GWAHS are mostly small, the towns are widely dispersed and local services are “limited by distance, expense, transport, and the difficulty of recruiting health professionals to these areas” (Dunbar, 2007 page 587). The chapter focuses on the design of the service, its implementation and its performance in the first year. We conclude with a discussion about the service, its broader relevance, transferability and its sustainability.

scholarly journals Allele Surfing and Holocene Expansion of an Australian Fig (Ficus—Moraceae)

Diversity ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 250
Author(s):  
Brendan C. Wilde ◽  
Susan Rutherford ◽  
Jia-Yee S. Yap ◽  
Maurizio Rossetto
Keyword(s):  
New South ◽  
New South Wales ◽  
Genomic Analysis ◽  
Field Work ◽  
Rapid Expansion ◽  
Environmental Niche ◽  
Niche Modelling ◽  
Southeastern Australia ◽  
South Wales ◽  
Suitable Habitats

The creek sandpaper fig of southeastern Australia, Ficus coronata Spin, is culturally significant to Australian traditional owners who made use of the leaves to smooth timber and ate the fruit. The species is thought to have a long history on the continent, with some suggesting a Gondwanan origin. However, distributional patterns and overall ecology suggest a recent expansion across suitable habitats. We used landscape genomic techniques and environmental niche modelling to reconstruct its history and explore whether the species underwent a recent and rapid expansion along the east coast of New South Wales. Genomic analysis of 178 specimens collected from 32 populations throughout the species’ New South Wales distribution revealed a lack of genetic diversity and population structure. Some populations at the species’ southern and western range limits displayed unexpected diversity, which appears to be the result of allele surfing. Field work and genetic evidence suggest a Holocene expansion which may have increased since European colonisation. We also present a novel method for detecting allele surfing—MAHF (minor allele at highest frequency).

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