Ann Larson | The Australian National University (original) (raw)
Papers by Ann Larson
Evaluation
International development assistance is increasingly being seen as operating within complex adapt... more International development assistance is increasingly being seen as operating within complex adaptive systems. Evaluators have been developing new methods and approaches that are compatible with the dynamic and unpredictable realities of complex adaptive systems, which are composed of many separate but interacting agents and groups. However, these new methods are not easily implemented in a conventional commissioned end-of-program evaluation. This article builds on what is known about how complex adaptive systems’ properties affect program performance to propose eight evaluation questions. The findings from the questions will reveal if implementers were aware of and responded effectively to complex adaptive systems’ properties. The eight questions can be incorporated within a conventional evaluation to create a plausible narrative for program impact and inform the design and implementation of other programs.
African Affairs
... 32. CP Freeman, et al., 'Microeliza HIV antibody testing in two areas of Liberia... more ... 32. CP Freeman, et al., 'Microeliza HIV antibody testing in two areas of Liberia, West Africa,' IV International Conference on AIDS, Stockholm ... made some women rich, the majority of urban women so employed faced derision and ostracism and these attitudes towards city women ...
The Australian Journal of Indigenous Education, 2010
Aboriginal children appear to be more likely to be involved in bullying than non-Aboriginal child... more Aboriginal children appear to be more likely to be involved in bullying than non-Aboriginal children. This paper describes part of the “Solid Kids Solid Schools” research process and discusses some of the results from this three year study involving over 260 Aboriginal children, youth, elders, teachers and Aboriginal Indigenous Education Officers (AIEO's), and an Aboriginal led and developed Steering Committee. It is the first study that contextualises Aboriginal bullying, using a socio-ecological model where the individual, family, community and society are all interrelated and influence the characteristics and outcomes of bullying.This paper demonstrates that for Aboriginal children and youth in one region of Western Australia, bullying occurs frequently and is perpetuated by family and community violence, parental responses to bullying and institutional racism. Addressing bullying requires actions to reduce violence, foster positive cultural identity and reduce socio-economic...
Social Science Medicine, Sep 30, 1994
This paper describes a method of estimating the size of a population based on matching the indivi... more This paper describes a method of estimating the size of a population based on matching the individuals from the population appearing in two or more nonrandom samples. The method has been developed by population biologists and demographers who have shown that the simple estimates based on only two samples are very sensitive to the assumption that the two samples are independent. This assumption is rarely met with human populations. However, estimates based on three or more samples can be derived by fitting a loglinear model to a 2' contingency table. The method is applied to a data set of heroin users seeking treatment or counselling or arrested on drug charges in 1988 or 1989 in a small Australian city. The method produced a stable estimate of 1250 heroin users. This includes only users who are vulnerable to arrest and/or interested in seeking treatment. Although estimates produced by this method should be validated with other techniques it provides a simple, quick method to estimate the numbers of people in other hidden populations which are difficult to access.
Journal of the Australian Population Association, 1997
ABSTRACT
A project of this magnitude requires the help of many hands. The team included Dr Caroline Fallon... more A project of this magnitude requires the help of many hands. The team included Dr Caroline Fallon, who was responsible for data collection and Ms Melissa Barrett, Prof Timothy Skinner and Ms Glenda Taylor who gave valuable input into the initial scoping of the project. Child health expertise provided by Prof Linda Shields and Ms Alisa Munn of Curtin University. Ms Jan Hall was a critical reader and assisted with final editing. Ms Holly Buykx prepared the map and the estimates of program coverage.
Learning objectives • Describe how connectivity and connectedness might improve the quality of da... more Learning objectives • Describe how connectivity and connectedness might improve the quality of day-today rural health care delivery. • Describe the variety of face-to-face and virtual connections that enable rural and remote practice in Australia. • Describe how research opportunities may stem from electronic medical records and other forms of connectivity and connectedness. • Explain specific electronic or collegial resources that will facilitate rural health providers' professional development.
... 2004 Peter Shaw1 and Sandra Pullman Ann Larson Jessica Scott Prepared for Maureen Bradford Ma... more ... 2004 Peter Shaw1 and Sandra Pullman Ann Larson Jessica Scott Prepared for Maureen Bradford Manager Information Resources, Department of Health, Western Australia by Combined Universities Centre for Rural Health. ...
Landscape Series, 2010
Thirty per cent of Australians live outside of major cities and 20% of them live in towns which a... more Thirty per cent of Australians live outside of major cities and 20% of them live in towns which are declining in population. Like residents of other rural communities, they experience poorer health and have less access to health services than those living in cities. In addition, declining rural communities have a higher proportion of vulnerable groups with high health care
Australian family physician, 2010
This study trialled the outcome for asthma patients of a brief, nurse led, patient education sess... more This study trialled the outcome for asthma patients of a brief, nurse led, patient education session with general practice review of an Asthma Action Plan. Prospective cohort with before-after measures conducted in six rural general practices. Outcome measures were changes over 12 months in self reported asthma control, quality of life, device use, and unscheduled general practice and emergency department visits for asthma exacerbation. Eighty-three patients participated. Mean asthma control score decreased but did not reach statistical significance (p=0.124). Quality of life improved for adults (Wilcoxon rank signed test for two related samples p<0.001). The proportion of patients who had one or more unscheduled visits to their general practitioner over 12 months decreased from 23% to 13% (p=0.178) and emergency department presentations decreased from 9% to 4% (p=0.102). Structured general practice based education appears to be an effective preventive health care program, with t...
Australian family physician, 2009
Tight glucose, blood pressure and lipid control in patients with diabetes can reduce morbidity an... more Tight glucose, blood pressure and lipid control in patients with diabetes can reduce morbidity and mortality from macro- and micro-vascular complications. However, treatment targets are not being met in a large proportion of patients. Clinical audit involves cycles of evaluation of current activity against standards. It allows problems to be identified and action to be taken to address them. Annual retrospective audits over 3 years of random samples of up to 20 patient medical records from 13 general practitioners in the midwest region of Western Australia (n=807). Statistical tests compared the second and third audits with the first in regard to completeness of screening, health indicators, and the proportion of patients within The Royal Australian College of General Practitioners and Diabetes Australia guidelines targets. While there was a significant improvement in lipid monitoring over the study period (p<0.001), monitoring of HbA1c and blood pressure (BP) remained unchanged....
Rural and remote health
In the rural Midwest region of Western Australia (WA), wound care is a major burden on the health... more In the rural Midwest region of Western Australia (WA), wound care is a major burden on the healthcare system. Optimal wound care was found to be impeded by issues that included the involvement of multiple healthcare providers, incomplete and inconsistent documentation, and limited access to expert review. A telehealth solution was trailed in 2007. To describe the systemic barriers encountered in implementing a telehealth program in rural WA and to provide recommendations for future telehealth initiatives. This study trialled the use of a shared electronic wound imaging and reporting system in combination with an expert remote wound consultation service for the management of patients with chronic wounds in the Midwest of WA. The trial sites included rural hospital out-patient clinics, a private domiciliary nursing service, residential aged care facilities, general practices and a podiatry clinic. The implementation conformed to accepted best practice in introducing telehealth initiat...
Rural and remote health
... Print Version] [Author Details] GP Proceduralists: &#x27;the hidden heart&#x2... more ... Print Version] [Author Details] GP Proceduralists: &#x27;the hidden heart&#x27; of rural and regional health in Australia M Robinson, GM Slaney, GI Jones and ... Details] Obesity, energy intake and physical activity in rural and urban New Zealand children E Hodgkin, MJ Hamlin, JJ Ross and F ...
Rural and remote health
This article describes a unique, remote, water safety-training program delivered to 11 remote Aus... more This article describes a unique, remote, water safety-training program delivered to 11 remote Australian communities during 2006-2007. The program, known as 'Water Safety in the Bush', was developed by Combined Universities Centre for Rural Health in Geraldton Western Australia in consultation with the Commonwealth Government Department of Health and Ageing, and the Royal Life Saving Society of Australia. Drowning and near drowning are major causes of childhood death and injury in rural and remote Australia, making improved water safety awareness and skills a public health priority. Water Safety in the Bush employed a flexible, community development model to meet the special requirements of remote and isolated communities. The model had three elements: coordination by a local organisation; a water safety instruction program based on a Royal Life Saving Society of Australia curriculum adapted to meet local priorities; and strategies for sustainability. In the delivery of the ...
Rural and remote health
Videoconferencing is now a firmly established feature of rural health care in Australia. However,... more Videoconferencing is now a firmly established feature of rural health care in Australia. However, the health sector has not used videoconferencing extensively outside the provision of clinical care. This article describes a program of education and support to rural carers via videoconferencing which demonstrates its potential in promoting health. Semi-structured interviews were conducted with six service providers, eight carers who participated in sessions and the facilitator of the sessions. Attendance and financial records augmented the interview data. Videoconferencing was well accepted by carers and the facilitator. Carers reported having a positive interaction with the facilitator and other participants despite being at a distance, and the facilitator found the technology offered her more ways to observe non-verbal cues discretely. Carers demonstrated that they had retained information provided and that they had made small behaviour changes. They credited the success to sharing...
Australian family physician, 2006
Diabetes affects 1 million Australians and is the seventh leading cause of death in Australia. Ge... more Diabetes affects 1 million Australians and is the seventh leading cause of death in Australia. General practitioners play an important role in the management of diabetes, especially in rural areas where there is limited access to specialist providers and services.
Australian family physician, 2006
Rural and remote health
Demography is the study of the size and composition of populations. Populations change size throu... more Demography is the study of the size and composition of populations. Populations change size through births, deaths and net-migration. Over time, mortality, fertility and migration patterns create populations that may be large or small, young or old, growing or declining. Rural and remote Australia has a unique demography that determines its health problems and health service needs. The tendency of young adults to leave rural and remote areas for cities means that they leave behind communities which are, on average, older than those found in the cities. Rural and remote women have slightly more children at significantly younger ages, but because of out-migration, the actual number of babies born outside of the cities is smaller than would be expected. Most rural and remote areas already have a high proportion of their population over 65 years old. Many communities with an older population are declining in absolute numbers but the need for health services may be greater than required ...
Journal of the Australian Population Association, 1988
The Marriege Question, hotly debated during the late Victoria era, concerned whether the younger ... more The Marriege Question, hotly debated during the late Victoria era, concerned whether the younger generation was marrying at the "proper time", neither irresponsibly too early nor selfishly too late. Data for the colony of Victoria show modest rises in male end female age at marriage from 1861 to 1901. This article uses Melbourne marriage certificates from 1868 to 1896 to compare urban and rural marriage trends and study the individuel determinants of the timing of first marriage; on the whole, urban brides and grooms were likely to be younger than rurel ones. Economic conditions, es measured by occupation, played a more important role in men's timing of marriage then in women's. The fact thet prenuptiel pregnancy led couples to marry several years before their peers suggests that family commitments and other personal, unmeasured, factors affected marriage age.
Evaluation
International development assistance is increasingly being seen as operating within complex adapt... more International development assistance is increasingly being seen as operating within complex adaptive systems. Evaluators have been developing new methods and approaches that are compatible with the dynamic and unpredictable realities of complex adaptive systems, which are composed of many separate but interacting agents and groups. However, these new methods are not easily implemented in a conventional commissioned end-of-program evaluation. This article builds on what is known about how complex adaptive systems’ properties affect program performance to propose eight evaluation questions. The findings from the questions will reveal if implementers were aware of and responded effectively to complex adaptive systems’ properties. The eight questions can be incorporated within a conventional evaluation to create a plausible narrative for program impact and inform the design and implementation of other programs.
African Affairs
... 32. CP Freeman, et al., &#x27;Microeliza HIV antibody testing in two areas of Liberia... more ... 32. CP Freeman, et al., &#x27;Microeliza HIV antibody testing in two areas of Liberia, West Africa,&#x27; IV International Conference on AIDS, Stockholm ... made some women rich, the majority of urban women so employed faced derision and ostracism and these attitudes towards city women ...
The Australian Journal of Indigenous Education, 2010
Aboriginal children appear to be more likely to be involved in bullying than non-Aboriginal child... more Aboriginal children appear to be more likely to be involved in bullying than non-Aboriginal children. This paper describes part of the “Solid Kids Solid Schools” research process and discusses some of the results from this three year study involving over 260 Aboriginal children, youth, elders, teachers and Aboriginal Indigenous Education Officers (AIEO's), and an Aboriginal led and developed Steering Committee. It is the first study that contextualises Aboriginal bullying, using a socio-ecological model where the individual, family, community and society are all interrelated and influence the characteristics and outcomes of bullying.This paper demonstrates that for Aboriginal children and youth in one region of Western Australia, bullying occurs frequently and is perpetuated by family and community violence, parental responses to bullying and institutional racism. Addressing bullying requires actions to reduce violence, foster positive cultural identity and reduce socio-economic...
Social Science Medicine, Sep 30, 1994
This paper describes a method of estimating the size of a population based on matching the indivi... more This paper describes a method of estimating the size of a population based on matching the individuals from the population appearing in two or more nonrandom samples. The method has been developed by population biologists and demographers who have shown that the simple estimates based on only two samples are very sensitive to the assumption that the two samples are independent. This assumption is rarely met with human populations. However, estimates based on three or more samples can be derived by fitting a loglinear model to a 2' contingency table. The method is applied to a data set of heroin users seeking treatment or counselling or arrested on drug charges in 1988 or 1989 in a small Australian city. The method produced a stable estimate of 1250 heroin users. This includes only users who are vulnerable to arrest and/or interested in seeking treatment. Although estimates produced by this method should be validated with other techniques it provides a simple, quick method to estimate the numbers of people in other hidden populations which are difficult to access.
Journal of the Australian Population Association, 1997
ABSTRACT
A project of this magnitude requires the help of many hands. The team included Dr Caroline Fallon... more A project of this magnitude requires the help of many hands. The team included Dr Caroline Fallon, who was responsible for data collection and Ms Melissa Barrett, Prof Timothy Skinner and Ms Glenda Taylor who gave valuable input into the initial scoping of the project. Child health expertise provided by Prof Linda Shields and Ms Alisa Munn of Curtin University. Ms Jan Hall was a critical reader and assisted with final editing. Ms Holly Buykx prepared the map and the estimates of program coverage.
Learning objectives • Describe how connectivity and connectedness might improve the quality of da... more Learning objectives • Describe how connectivity and connectedness might improve the quality of day-today rural health care delivery. • Describe the variety of face-to-face and virtual connections that enable rural and remote practice in Australia. • Describe how research opportunities may stem from electronic medical records and other forms of connectivity and connectedness. • Explain specific electronic or collegial resources that will facilitate rural health providers' professional development.
... 2004 Peter Shaw1 and Sandra Pullman Ann Larson Jessica Scott Prepared for Maureen Bradford Ma... more ... 2004 Peter Shaw1 and Sandra Pullman Ann Larson Jessica Scott Prepared for Maureen Bradford Manager Information Resources, Department of Health, Western Australia by Combined Universities Centre for Rural Health. ...
Landscape Series, 2010
Thirty per cent of Australians live outside of major cities and 20% of them live in towns which a... more Thirty per cent of Australians live outside of major cities and 20% of them live in towns which are declining in population. Like residents of other rural communities, they experience poorer health and have less access to health services than those living in cities. In addition, declining rural communities have a higher proportion of vulnerable groups with high health care
Australian family physician, 2010
This study trialled the outcome for asthma patients of a brief, nurse led, patient education sess... more This study trialled the outcome for asthma patients of a brief, nurse led, patient education session with general practice review of an Asthma Action Plan. Prospective cohort with before-after measures conducted in six rural general practices. Outcome measures were changes over 12 months in self reported asthma control, quality of life, device use, and unscheduled general practice and emergency department visits for asthma exacerbation. Eighty-three patients participated. Mean asthma control score decreased but did not reach statistical significance (p=0.124). Quality of life improved for adults (Wilcoxon rank signed test for two related samples p<0.001). The proportion of patients who had one or more unscheduled visits to their general practitioner over 12 months decreased from 23% to 13% (p=0.178) and emergency department presentations decreased from 9% to 4% (p=0.102). Structured general practice based education appears to be an effective preventive health care program, with t...
Australian family physician, 2009
Tight glucose, blood pressure and lipid control in patients with diabetes can reduce morbidity an... more Tight glucose, blood pressure and lipid control in patients with diabetes can reduce morbidity and mortality from macro- and micro-vascular complications. However, treatment targets are not being met in a large proportion of patients. Clinical audit involves cycles of evaluation of current activity against standards. It allows problems to be identified and action to be taken to address them. Annual retrospective audits over 3 years of random samples of up to 20 patient medical records from 13 general practitioners in the midwest region of Western Australia (n=807). Statistical tests compared the second and third audits with the first in regard to completeness of screening, health indicators, and the proportion of patients within The Royal Australian College of General Practitioners and Diabetes Australia guidelines targets. While there was a significant improvement in lipid monitoring over the study period (p<0.001), monitoring of HbA1c and blood pressure (BP) remained unchanged....
Rural and remote health
In the rural Midwest region of Western Australia (WA), wound care is a major burden on the health... more In the rural Midwest region of Western Australia (WA), wound care is a major burden on the healthcare system. Optimal wound care was found to be impeded by issues that included the involvement of multiple healthcare providers, incomplete and inconsistent documentation, and limited access to expert review. A telehealth solution was trailed in 2007. To describe the systemic barriers encountered in implementing a telehealth program in rural WA and to provide recommendations for future telehealth initiatives. This study trialled the use of a shared electronic wound imaging and reporting system in combination with an expert remote wound consultation service for the management of patients with chronic wounds in the Midwest of WA. The trial sites included rural hospital out-patient clinics, a private domiciliary nursing service, residential aged care facilities, general practices and a podiatry clinic. The implementation conformed to accepted best practice in introducing telehealth initiat...
Rural and remote health
... Print Version] [Author Details] GP Proceduralists: &#x27;the hidden heart&#x2... more ... Print Version] [Author Details] GP Proceduralists: &#x27;the hidden heart&#x27; of rural and regional health in Australia M Robinson, GM Slaney, GI Jones and ... Details] Obesity, energy intake and physical activity in rural and urban New Zealand children E Hodgkin, MJ Hamlin, JJ Ross and F ...
Rural and remote health
This article describes a unique, remote, water safety-training program delivered to 11 remote Aus... more This article describes a unique, remote, water safety-training program delivered to 11 remote Australian communities during 2006-2007. The program, known as 'Water Safety in the Bush', was developed by Combined Universities Centre for Rural Health in Geraldton Western Australia in consultation with the Commonwealth Government Department of Health and Ageing, and the Royal Life Saving Society of Australia. Drowning and near drowning are major causes of childhood death and injury in rural and remote Australia, making improved water safety awareness and skills a public health priority. Water Safety in the Bush employed a flexible, community development model to meet the special requirements of remote and isolated communities. The model had three elements: coordination by a local organisation; a water safety instruction program based on a Royal Life Saving Society of Australia curriculum adapted to meet local priorities; and strategies for sustainability. In the delivery of the ...
Rural and remote health
Videoconferencing is now a firmly established feature of rural health care in Australia. However,... more Videoconferencing is now a firmly established feature of rural health care in Australia. However, the health sector has not used videoconferencing extensively outside the provision of clinical care. This article describes a program of education and support to rural carers via videoconferencing which demonstrates its potential in promoting health. Semi-structured interviews were conducted with six service providers, eight carers who participated in sessions and the facilitator of the sessions. Attendance and financial records augmented the interview data. Videoconferencing was well accepted by carers and the facilitator. Carers reported having a positive interaction with the facilitator and other participants despite being at a distance, and the facilitator found the technology offered her more ways to observe non-verbal cues discretely. Carers demonstrated that they had retained information provided and that they had made small behaviour changes. They credited the success to sharing...
Australian family physician, 2006
Diabetes affects 1 million Australians and is the seventh leading cause of death in Australia. Ge... more Diabetes affects 1 million Australians and is the seventh leading cause of death in Australia. General practitioners play an important role in the management of diabetes, especially in rural areas where there is limited access to specialist providers and services.
Australian family physician, 2006
Rural and remote health
Demography is the study of the size and composition of populations. Populations change size throu... more Demography is the study of the size and composition of populations. Populations change size through births, deaths and net-migration. Over time, mortality, fertility and migration patterns create populations that may be large or small, young or old, growing or declining. Rural and remote Australia has a unique demography that determines its health problems and health service needs. The tendency of young adults to leave rural and remote areas for cities means that they leave behind communities which are, on average, older than those found in the cities. Rural and remote women have slightly more children at significantly younger ages, but because of out-migration, the actual number of babies born outside of the cities is smaller than would be expected. Most rural and remote areas already have a high proportion of their population over 65 years old. Many communities with an older population are declining in absolute numbers but the need for health services may be greater than required ...
Journal of the Australian Population Association, 1988
The Marriege Question, hotly debated during the late Victoria era, concerned whether the younger ... more The Marriege Question, hotly debated during the late Victoria era, concerned whether the younger generation was marrying at the "proper time", neither irresponsibly too early nor selfishly too late. Data for the colony of Victoria show modest rises in male end female age at marriage from 1861 to 1901. This article uses Melbourne marriage certificates from 1868 to 1896 to compare urban and rural marriage trends and study the individuel determinants of the timing of first marriage; on the whole, urban brides and grooms were likely to be younger than rurel ones. Economic conditions, es measured by occupation, played a more important role in men's timing of marriage then in women's. The fact thet prenuptiel pregnancy led couples to marry several years before their peers suggests that family commitments and other personal, unmeasured, factors affected marriage age.