The crystal structures of [Cu,(bipyam-H),CI,]-H,O (I ) and [Cu,(bipyam-H),Br,]-H,O (2) where bipyam-H = bis(2-pyridyl)amide, have been determined by X-ray analysis, in the orthorhrombic space group Pnn2: ( I ) , a = 14.092(3), b = 12.895(3), (c) = 1 1 .I 90(2) A, Z = 2, and R = 0.032 for 2 453 observed and 2 029 unique reflections; (2), a = 14.1 86(3), b = 13.040(3), c = 11.31 3(2) A,
This paper provides a description of initiatives and changes made in remote primary healthcare service delivery in Central Australia. These changes included the introduction of an orientation and Aboriginal cultural awareness program, revising the recruitment process to include communities in staff selection, developing policies and protocols to support practice, and increasing support for remote area staff through managers being out and about in remote areas. The change from centralised management to an increasingly decentralised participatory management model, and involving local communities and local staff in decision making, was initiated early in the change process and continues to be of prime importance. After 5 years of intensive effort, it is clear that despite these initiatives sustainable change has been elusive and some problems remain. Further change and development is necessary. A number of new initiatives are described, including a Menzies School of Health Research project that examines structural issues, which will provide direction for the future by providing better support for remote area staff and facilitating greater community participation.
This paper presents an analysis of a strategic change process. It identifies and reviews the critical factors that impact on, and need to be considered in order to successfully initiate and implement change.The problem was the narrow focus and priorities of a well-established research program. We undertook a stringent process to refocus the program to the areas of greatest need. The paper provides information on the process undertaken to achieve the change and other factors that impacted. The outcome has been considered successful in the first instance. However the long-term picture may not be as positive. Reviewing and presenting the process and influential factors provides the reader with the opportunity to compare this scenario with their own experience and thereby develop their own change strategies.
As a result of the National Health Priority Area Report on Cardiovascular Health and in particular, its remote and indigenous section, a consortium of five organisations ran a national workshop in Townsville inOctober 1999 on heart disease in Aboriginal peoples, Torres Strait Islanders and rural and remote populations. One of the priority areas identified at this workshop was the need for a more coordinated approach to chronic diseases and for the formation of an alliance of non-government organisations (NGOs) to work towards this and to undertake a lobbying and advocacy role.
As a result of the National Health Priority Area Report on Cardiovascular Health and in particular, its remote and indigenous section, a consortium of five organisations ran a national workshop in Townsville in October 1999 on heart disease in Aboriginal peoples, Torres Strait Islanders and rural and remote populations. One of the priority areas identified at this workshop was the need for a more coordinated approach to chronic diseases and for the formation of an alliance of non-government organisations (NGOs) to work towards this and to undertake a lobbying and advocacy role. A meeting of a wide range of NGOs working in chronic disease, led by the National Heart Foundation of Australia, was held in Sydney in May 2000. At the Sydney meeting it was agreed that an alliance of NGOs could be formed for the development of a chronic disease strategy for Aboriginal peoples, Torres Strait Islanders and rural and remote populations. The NGOs drafted a 'Statement of Intent', which would inform their work on both heart disease and on broader work to address chronic preventable disease in the target populations. There is a considerable amount of procedural work to be done before the proposed alliance becomes a reality but the prospect of closer collaboration between the NGOs working in chronic disease has much to offer, especially for the population groups that were the focus of the Townsville workshop. This 'alliance' initiative comes at a time when there are national and State/Territory moves on broader aspects of what could become a 'national chronic disease prevention and management strategy'.
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