ORCID Profile
0000-0002-4823-5832
Current Organisation
Monash University
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Research Topics
In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Top 5 Research Topics
ANZSRC Field of Research (FoR)
Demography | Family And Household Studies | Australian History (excl. Aboriginal and Torres Strait Islander History) | Fertility | Mortality | Historical Studies | History: Australian | History and Theory of the Built Environment (excl. Architecture) | Family and Household Studies | Epidemiology | Causes and Prevention of Crime | Aboriginal and Torres Strait Islander History | Economic History | Applied Economics | Demography not elsewhere classified | Population Trends And Policies |
ANZSRC Socio-Economic Objective (SEO)
Expanding Knowledge in History and Archaeology | Families | Demography | Understanding Australia's Past | Studies in human society | Evaluation of Health Outcomes | Expanding Knowledge through Studies of Human Society | Infectious diseases | Health related to ageing | Finance Services | Behaviour and Health | Consumption patterns, population issues and the environment | Disease distribution and transmission | Health status (e.g. indicators of “well-being”)
Related Links
Publications
Response to Re: Patient specific advice for in‐hospital cardiac arrest survival rates
Publisher: Wiley
Date: 07-04-2020
Level and correlates of social support in a community‐based sample of Australians who primarily smoke methamphetamine
Publisher: Hindawi Limited
Date: 14-07-2022
DOI: 10.1111/HSC.13907
General Practice Supervisory Relationship Measure (Registrars) - handscored instrument
Publisher: Figshare
Date: 2018
Random case analysis in general practice clinical team meetings
Publisher: The Royal Australian College of General Practitioners
Date: 10-2021
Taking stock: parents’ reasons for and against having a third child
Publisher: Informa UK Limited
Date: 11-2009
Factors associated with increasing rural doctor supply in Asia-Pacific LMICs: a scoping review
Publisher: Springer Science and Business Media LLC
Date: 12-2020
DOI: 10.1186/S12960-020-00533-4
Abstract: More than 60% of the world’s rural population live in the Asia-Pacific region. Of these, more than 90% reside in low- and middle-income countries (LMICs). Asia-Pacific LMICs rural populations are more impoverished and have poorer access to medical care, placing them at greater risk of poor health outcomes. Understanding factors associated with doctors working in rural areas is imperative in identifying effective strategies to improve rural medical workforce supply in Asia-Pacific LMICs. We performed a scoping review of peer-reviewed and grey literature from Asia-Pacific LMICs (1999 to 2019), searching major online databases and web-based resources. The literature was synthesized based on the World Health Organization Global Policy Recommendation categories for increasing access to rural health workers. Seventy-one articles from 12 LMICs were included. Most were about educational factors (82%), followed by personal and professional support (57%), financial incentives (45%), regulatory (20%), and health systems (13%). Rural background showed strong association with both rural preference and actual work in most studies. There was a paucity in literature on the effect of rural pathway in medical education such as rural-oriented curricula, rural clerkships and internship however, when combined with other educational and regulatory interventions, they were effective. An additional area, atop of the WHO categories was identified, relating to health system factors, such as governance, health service organization and financing. Studies generally were of low quality—frequently overlooking potential confounding variables, such as respondents’ demographic characteristics and career stage—and 39% did not clearly define ‘rural’. This review is consistent with, and extends, most of the existing evidence on effective strategies to recruit and retain rural doctors while specifically informing the range of evidence within the Asia-Pacific LMIC context. Evidence, though confined to 12 countries, is drawn from 20 years’ research about a wide range of factors that can be targeted to strengthen strategies to increase rural medical workforce supply in Asia-Pacific LMICs. Multi-faceted approaches were evident, including selecting more students into medical school with a rural background, increasing public-funded universities, in combination with rural-focused education and rural scholarships, workplace and rural living support and ensuring an appropriately financed rural health system. The review identifies the need for more studies in a broader range of Asia-Pacific countries, which expand on all strategy areas, define rural clearly, use multivariate analyses, and test how various strategies relate to doctor’s career stages.
A ‘call for help’ list for Australian general practice registrars
Publisher: The Royal Australian College of General Practitioners
Date: 05-2020
A Framework to Guide the Implementation of Best Practice Clinical Learning Environments in Community General Practice: Australia
Publisher: MDPI AG
Date: 04-02-2021
Abstract: Clinical education/training is increasingly being expanded to community general practice settings (primary care clinics led by doctors). This plays an important role in developing a skilled “primary-care ready” workforce. However, there is limited information to guide the implementation of high-quality learning environments suitable for the range of general practices and clinical learners they oversee. We aimed to develop a consensus-based framework to address this. A co-design participatory action research method involved working with stakeholders to agree a project plan, collect and interpret data and endorse a final framework. As a starting point, an initial draft framework was adapted from an existing framework, the Best Practice Clinical Learning Environment (BPCLE) Framework. We gathered feedback about this from a national GP Supervisor Liaison Officer Network (SLON) (experienced GP clinical supervisors) during a 90-minute face-to-face focus group. They rated their agreement with the relevance of objectives and elements, advising on clear terminology and rationale for including/excluding various components. The resulting framework was refined and re-tested with the SLON and wider GP educational stakeholders until a final graphically designed version was endorsed. The resulting “GP Clinical Learning Environment” (GPCLE) Framework is applicable for planning and benchmarking best practice learning environments in general practice.
The Short and the Tall: Comparing Stature and Socioeconomic Status for Male Prison and Military Populations
Publisher: Cambridge University Press (CUP)
Date: 2020
DOI: 10.1017/SSH.2020.14
Abstract: Over the last four decades, historians and social scientists have become increasingly interested in the way in which information about stature might be used to explore the impact of environmental factors on the physical growth and well-being of past populations. A particular problem encountered by many researchers is that height data is only available for selected populations, typically military recruits or those admitted to correctional institutions. Evidence from Australian military and prison records demonstrate how the two social groups, soldiers and prisoners, differed from each other and from the wider population in terms of age, birthplace, occupation, and stature. Different patterns of observable characteristics conceal additional differences in intergenerational experience. We trace male prisoners and soldiers born between 1870 and 1899 in Tasmania to their birth records and thence to the marriages of their parents. This allows us to contrast social and occupational change from father to son for both prisoners and soldiers. We conclude that evidence arising from these institutionalized populations can be used to estimate wider societal trends, although caution needs to be exercised.
Parental loss in young convicts transported to Van Diemen’s Land (Tasmania), 1841–53
Publisher: Informa UK Limited
Date: 09-09-2018
What's love got to do with it? Homogamy and dyadic approaches to understanding marital instability
Publisher: Springer Science and Business Media LLC
Date: 20-07-2013
Household and Family Formation in Nineteenth-Century Tasmania, 1838-1899: Marriages
Publisher: No publisher found
Date: 2008
Should I stay or should I go? Observation post-vaccination during the COVID-19 pandemic and the law of unintended consequences
Publisher: CSIRO Publishing
Date: 08-09-2022
DOI: 10.1071/PY22074
Abstract: Background Standard practice after all vaccinations in Australia is to observe patients for 15 min. During the coronavirus disease 2019 (COVID-19) pandemic, could the risk of contracting and dying from COVID-19 acquired in the waiting room be greater than the risk of dying from post-vaccine anaphylaxis when leaving immediately? Methods The risks are modelled for a patient aged 70+ years attending for annual influenza vaccination in a typical Australian general practice clinic. The risk of death from anaphylaxis is estimated based on known rates of anaphylaxis shortly after influenza vaccination. The risk of acquiring COVID-19 during a 15-min wait and then dying from that infection is estimated using the COVID-19 Aerosol Transmission Estimator and COVID-19 Risk Calculator. Results Other than at times of extremely low COVID-19 prevalence, the risk of death from anaphylaxis for a patient aged 70+ years leaving immediately after influenza vaccine is less than the risk of death from COVID-19 acquired via aerosol transmission during a 15-min wait. The risk of death from COVID-19 is greatest for the unimmunised and when masks are not worn. Conclusions A more nuanced approach to advice post-vaccination is recommended that considers current COVID-19 prevalence and virulence, the characteristics of the waiting room, the risk of anaphylaxis, and the patient’s susceptibility to death from COVID-19. There are many circumstances where it would be safer for a patient to leave immediately after vaccination.
Enabling uptake and sustainability of supervision roles by women GPs in Australia: a narrative analysis of interviews
Publisher: Springer Science and Business Media LLC
Date: 23-05-2022
DOI: 10.1186/S12909-022-03459-8
Abstract: Worldwide, the proportion of women entering careers in medicine is increasing. To ensure ersity and capacity in the general practice (“GP”) supervision workforce, a greater understanding from the perspective of women GPs engaged in or considering the clinical supervision of trainee doctors is important. This narrative inquiry aims to explore the uptake and sustainability of supervision roles for women GPs in the Australian context. Qualitative interviews with Australian women GPs were conducted between July and September 2021. Women GPs were selected to represent a range of demographics, practice contexts, and supervision experience to promote broad perspectives. Narrative analysis drew on participant perspectives, allowing emergent stories to be explored using story arcs based on the characters, settings, problems, actions, and resolutions. These stories were evaluated by a broad research team and a high level of agreement of the final narratives and counter-narratives was achieved. Of the 25 women who enrolled, 17 completed interviews. Six narratives emerged, including: power and control, pay, time, other life commitments, quality of supervision, and supervisor identity. These represented significant intersecting issues with the potential to impact the uptake and sustainability of supervision by women GPs. Some women GPs reported a lack of agency to make decisions about their role in supervision and were not remunerated for teaching. Uptake and sustainability of supervision was constrained by other life commitments, which could be buffered by team-sharing arrangements and a supportive practice. Although adding a burden of time atop their complex and sensitive consultations, women GPs were committed to being available to registrars and supervising at a high standard. To foster high quality supervision, women GPs were interested in up-skilling resources, building experience and harnessing support networks. Women sensed imposter syndrome when negotiating a supervisor identity, which could be managed by explicitly valuing their contribution. The findings can inform the development of more specific resources, supports and structures to enable women GPs in Australia to uptake and sustain the supervision of trainee doctors at a level they find both acceptable and rewarding.
Principals’ reports of adults’ alcohol use in Australian secondary schools
Publisher: Springer Science and Business Media LLC
Date: 29-02-2016
Research note: The founders and survivors project
Publisher: Informa UK Limited
Date: 29-10-2010
Parental preference for sons and daughters in a Western Industrial setting: evidence and implications
Publisher: Cambridge University Press (CUP)
Date: 07-2007
DOI: 10.1017/S0021932006001477
Abstract: This paper considers whether sex composition of existing children in Australian families is an important factor in parity progression. Using census data from 1981, 1986, 1991, 1996 and 2001, women are linked with their co-resident children, allowing investigation of family sex composition and its changing impact over time on the propensity to have another child. The study finds that parents are much more likely to have a third and fourth birth if existing children are all of the same sex, indicating a strong preference for children of both sexes. This increased propensity has added around three per cent to the fertility of recent cohorts. The paper concludes with a discussion of the potential impact of sex-selection technologies on fertility. The authors argue that future widespread use of reliable sex-selection technologies might act to increase fertility in the short term, but would lead to a long-term reduction in fertility.
'Incorrect, loose and coarse terms': classifying nineteenth-century English-language causes of death for modern use. An example using Tasmanian data
Publisher: Springer Science and Business Media LLC
Date: 26-05-2011
Adapting the supervisory relationship measure for general medical practice
Publisher: Springer Science and Business Media LLC
Date: 27-11-2018
Marriage patterns of Irish convict women in nineteenth-century Tasmania
Publisher: Informa UK Limited
Date: 08-05-2022
Public support for alcohol policies associated with knowledge of cancer risk
Publisher: Elsevier BV
Date: 04-2015
DOI: 10.1016/J.DRUGPO.2014.08.006
Abstract: Several options are advocated by policy experts to mitigate alcohol-related harms, although the most effective strategies often have the least public support. While knowledge of tobacco-related health risks predicts support for relevant public health measures, it is not known whether knowledge of alcohol health risks is similarly associated with the acceptability of policies intended to reduce alcohol consumption and related harms. This study aims to gauge public support for a range of alcohol policies and to determine whether or not support is associated with knowledge of a long-term health risk of alcohol consumption, specifically cancer. 2482 adults in New South Wales (NSW), Australia, participated in an online survey. Logistic regression analysis was used to examine the association between demographic data, alcohol consumption, smoking status, knowledge of alcohol as a risk factor for cancer and support for alcohol-related policies. Most participants were supportive of health warnings, restricting access to internet alcohol advertising to young people, and requiring information on national drinking guidelines on alcohol containers. Almost half of participants supported a ban on sport sponsorship, while less than 41% supported price increases, volumetric taxation, or reducing the number of retail outlets. Only 47% of participants identified drinking too much alcohol as a risk factor for cancer. Knowledge of alcohol as a risk factor for cancer was a significant predictor of support for all policies, while level of alcohol consumption had a significant inverse relationship with policy support. The finding that support for alcohol management policies is associated with awareness that drinking too much alcohol may contribute to cancer could assist in the planning of future public health interventions. Improving awareness of the long term health risks of alcohol consumption may be one avenue to increasing public support for effective alcohol harm-reduction policies.
High and growing disapproval of sex-selection technology in Australia
Publisher: Springer Science and Business Media LLC
Date: 06-09-2018
Adaptation and initial examination of the psychometric properties of the Short Supervisory Relationship Questionnaire (SSRQ) for use with general practice registrars
Publisher: Informa UK Limited
Date: 20-08-2020
Rural medical students' self‐reported perceptions of preparedness to practice in the Aboriginal and Torres Strait Islander Health Context
Publisher: Wiley
Date: 04-2021
DOI: 10.1111/AJR.12721
The field of Indigenous health and the role of colonisation and history
Publisher: Springer Science and Business Media LLC
Date: 03-2016
Household and Family Formation in Nineteenth-Century Tasmania, 1838-1899: Births
Publisher: Australian Data Archive
Date: 2008
Interventions to support parents who use methamphetamine: A narrative systematic review
Publisher: Elsevier BV
Date: 08-2022
Mortality under and after sentence of male convicts transported to Van Diemen's Land (Tasmania), 1840–1852
Publisher: Informa UK Limited
Date: 18-03-2015
The life-course demography of convict transportation to Van Diemen’s Land
Publisher: Informa UK Limited
Date: 10-12-2019
The case for parity and birth-order statistics
Publisher: Wiley
Date: 06-2006
Demographic modeling of a predator-prey system and its implication for the Gombe population of Procolobus rufomitratus tephrosceles
Publisher: Springer Science and Business Media LLC
Date: 04-2008
Climate change and population policy: towards a just and transformational approach
Publisher: Oxford University Press (OUP)
Date: 25-05-2010
Scenarios for the future population of Sydney
Publisher: Informa UK Limited
Date: 11-2002
The setting of the rising sun? A recent comparative history of life expectancy trends in Japan and Australia
Publisher: Public Library of Science (PLoS)
Date: 28-03-2019
Australian age-sex-specific COVID-19 mortality in international comparative perspective, to June 2020
Publisher: Australian Population Studies
Date: 14-11-2020
DOI: 10.37970/APS.V4I2.71
Abstract: No abstract
Australian attitudes toward sex-selection technology
Publisher: Elsevier BV
Date: 04-2011
DOI: 10.1016/J.FERTNSTERT.2010.11.050
Abstract: Previous research based on analysis of fertility behavior and expressed preferences shows that many Australian parents want both a son and a daughter. However, most respondents to a representative survey of Australians did not approve of IVF or abortion for sex-selection purposes, and most did not think a hypothetical blue or pink pill to select sex of a child should be legal.
Parents' level of support for adults' purchase and consumption of alcohol at primary school events when children are present
Publisher: Wiley
Date: 29-12-2015
DOI: 10.1111/DAR.12231
Abstract: Environmental and societal factors are significant determinants of children's initiation to and use of alcohol. Schools are important settings for promoting well-being and substantial resources have been devoted to curriculum-based alcohol programs, but the effects of these in reducing the misuse of alcohol have been modest. Adults can and do consume alcohol at school events when students are present, but there is a dearth of evidence about parents' level of support for the practice. The aim of this study was to examine parents' level of support for the purchase and consumption of alcohol at primary school fundraising events when children are present. Four hundred seventy-nine Australian parents of children aged 0-12 years participated in an online survey. Logistic regression was used to assess the impact of parent characteristics on the level of agreement with parental purchase and consumption of alcohol at school fundraising events when children are present. The majority of parents (60%) disagreed/strongly disagreed with the practice of adults being able to purchase and consume alcohol at school fundraising events when children were present. The 21% of parents who supported the practice were more likely to be daily smokers and/or have higher (>6) Alcohol Use Disorders Identification Test-alcohol consumption scores. Despite the fact that the majority of parents disagree with this practice, published reports suggest that adults' use of alcohol at primary school events is an emerging issue. It is important that school decision-makers are mindful of the financial and educational value of fundraising activities.
The balance of the sexes: the feminisation of Australia's population, 1901-2008
Publisher: Wiley
Date: 04-10-2012
DOI: 10.1002/PSP.691
Closer supervision in Australian general practice training: planning major system change
Publisher: CSIRO Publishing
Date: 2020
DOI: 10.1071/PY19156
Abstract: Major system change involving closer supervision of trainee GP registrars in Australia is warranted. Change management guidelines recommend involving stakeholders in developing change. The views of those involved in general practice training about current and potential supervisory practice were explored. Semi-structured interviews were conducted with a lead medical educator from nine Australian regions. Focus groups were conducted with GP supervisors and GP registrars. Transcripts from the interviews and focus groups were analysed using conventional content analysis, with themes emerging inductively from the data. The findings were that over 1–3 months, a registrar could progress from their supervisor observing all consultations through to the registrar only calling when they identify the need for help. There is strong support from registrars for this change to closer supervision, but less support from supervisors and educators. Barriers to the proposed change include high clinical demand competing with teaching capacity, inadequate payment for closer supervision and supervisors lacking skills or motivation to have a more active role in registrar supervision. If funding and logistic barriers to change are addressed, a change to a closer level of supervision is possible. A pilot study to further refine the change is indicated.
Household and Family Formation in Nineteenth-Century Tasmania, 1838-1899: Deaths
Publisher: No publisher found
Date: 2008
Patient specific advice for in‐hospital cardiac arrest survival rates
Publisher: Wiley
Date: 13-12-2020
Acceptability of alcohol supply to children - associations with adults' own age of initiation and social norms
Publisher: Wiley
Date: 02-11-2017
DOI: 10.1071/HE16013
By what age do people experience familial death, and how has that changed over time?
Publisher: Australian Population Studies
Date: 22-07-2022
Abstract: No abstract.
A critical review of definitions of rural areas in Indonesia and implications for health workforce policy and research
Publisher: Springer Science and Business Media LLC
Date: 27-04-2022
DOI: 10.1186/S12961-022-00847-W
Abstract: Choosing the appropriate definition of rural area is critical to ensuring health resources are carefully targeted to support the communities needing them most. This study aimed at reviewing various definitions and demonstrating how the application of different rural area definitions implies geographic doctor distribution to inform the development of a more fit-for-purpose rural area definition for health workforce research and policies. We reviewed policy documents and literature to identify the rural area definitions in Indonesian health research and policies. First, we used the health policy triangle to critically summarize the contexts, contents, actors and process of developing the rural area definitions. Then, we compared each definition’s strengths and weaknesses according to the norms of appropriate rural area definitions (i.e. explicit, meaningful, replicable, quantifiable and objective, derived from high-quality data and not frequently changed had on-the-ground validity and clear boundaries). Finally, we validated the application of each definition to describe geographic distribution of doctors by estimating doctor-to-population ratios and the Theil-L decomposition indices using each definition as the unit of analysis. Three definitions were identified, all applied at different levels of geographic areas: “urban/rural” villages (Central Bureau of Statistics [CBS] definition), “remote/non-remote” health facilities (Ministry of Health [MoH] definition) and “less/more developed” districts (presidential/regulated definition). The CBS and presidential definitions are objective and derived from nationwide standardized calculations on high-quality data, whereas the MoH definition is more subjective, as it allows local government to self-nominate the facilities to be classified as remote. The CBS and presidential definition criteria considered key population determinants for doctor availability, such as population density and economic capacity, as well as geographic accessibility. Analysis of national doctor data showed that remote, less developed and rural areas (according to the respective definitions) had lower doctor-to-population ratios than their counterparts. In all definitions, the Theil-L-within ranged from 76 to 98%, indicating that inequality of doctor density between these districts was attributed mainly to within-group rather than between-group differences. Between 2011 and 2018, Theil-L-within decreased when calculated using the MoH and presidential definitions, but increased when the CBS definition was used. Comparing the content of off-the-shelf rural area definitions critically and how the distribution of health resource differs when analysed using different definitions is invaluable to inform the development of fit-for-purpose rural area definitions for future health policy.
Comparing rural and regional migration patterns of Australian medical general practitioners with other professions: implications for rural workforce strategies
Publisher: Australian Population Studies
Date: 19-11-2017
DOI: 10.37970/APS.V1I1.12
Abstract: Background: The shortage of professional workers in rural and regional Australia continues as a major policy challenge. There has been substantially more strategy investment for the medical general practitioner (GP) profession than for other professions, particularly at the start of their careers. Aims: To examine differences between domestic migration patterns of GPs and other professionals to rural and regional zones in Australia for younger, mid-life and older workers. Data and methods: Data from the Australian Bureau of Statistics (ABS) 2011 Census were used to examine five-year migration rates for professionals in five ABS occupational classifications: generalist medical practitioners (GPs) engineering professionals legal professionals education professionals and other health professionals. Migration volumes were benchmarked for GPs and compared both for other professions and career stage. Results: GPs were less likely than other professionals to migrate from major urban to rural zones, regional to rural zones, or rural to regional zones. Younger GPs had the highest rural migration rates, while mid-life and older GPs were least likely to migrate to rural and regional zones. In contrast, increasingly age was associated positively with migration to rural zones for those in the other four professions. Conclusions: Despite concerted policy efforts to encourage more GPs to move to rural areas, overall rural migration rates for GPs are lower than for other professionals, especially for older workers. Further investigation of the links between GP migration patterns and workforce policies needs to be undertaken to inform the application or otherwise of workforce strategies used by other professions.
Reconstructing a Longitudinal Dataset for Tasmania
Publisher: International Institute of Social History
Date: 16-08-2021
DOI: 10.51964/HLCS10912
Abstract: This article describes the formation of The Tasmanian Historical Dataset a longitudinal data resource spanning the 19th and early 20th century. This resource contains over 1.6 million records drawn from digitised prison and hospital admission registers, military enlistment papers, births, deaths and marriages, census and muster records, arrival and departure lists, bank accounts and property valuations, maps and plans and meteorological observations. As well as providing an account of the many different sources that have been digitised coded and linked as part of this initiative, the article outlines current and past research uses to which this data has been put. Further information on tables and key variables is provided in an appendix.
Long term survival following a medical emergency team call at an Australian regional hospital
Publisher: Elsevier BV
Date: 06-2022
DOI: 10.51893/2022.2.OA6
Abstract: OBJECTIVE: To investigate the long term survival of medical emergency team (MET) patients at an Australian regional hospital and describe associated patient and MET call characteristics. DESIGN: Retrospective cohort study. Data linkage to the statewide death registry was performed to allow for long term survival analysis, including multivariable Cox proportional hazards regression and production of Kaplan–Meier survival curves. SETTING: A large Australian regional hospital. PARTICIPANTS: Adult patients who received a MET call from 1 July 2012 to 3 March 2020. MAIN OUTCOME MEASURES: Survival to 30, 90 and 180 days one year and 5-years after index MET call. RESULTS: The study included 6499 eligible patients. The cohort median age was 71 years, and 52.4% of the patients were female. Surgical (39.6%) and medical (36.9%) patients comprised most of the cohort. Thirty-day survival was 86.5% one-year survival was 66.1%. Among patients aged 75 years, factors independently associated with significantly higher long term mortality included age (hazard ratio [HR], 3.26 [95% CI, 2.63–4.06] for patients aged 65–74 v 18–54 years), male sex (HR, 0.71 [95% CI, 0.61–0.83] for females) and pre-existing limitation of medical therapy (HR, 2.76 95% CI, 2.28–3.35). Among patients aged ≥ 75 years, factors independently associated with significantly higher long term mortality included age (HR, 1.46 [95% CI, 1.29–1.65] for patients aged ≥ 85 years), male sex (HR, 0.74 [95% CI, 0.66–0.83] for females), and altered MET criteria (HR, 1.33 95% CI, 1.03–1.71). CONCLUSIONS: Long term survival probabilities of MET call patients are affected by factors including age, sex, and limitation of medical therapy status. These data may be useful for clinicians conducting end-of-life discussions with patients.
Population and health
Publisher: Cambridge University Press
Date: 05-11-2013
Using split-population models to examine predictors of the probability and timing of parity progression
Publisher: Springer Science and Business Media LLC
Date: 18-12-2010
Liquor licences issued to Australian schools
Publisher: Springer Science and Business Media LLC
Date: 08-2017
General Practice Supervisory Relationship Measure (Supervisors) - handscored instrument
Publisher: Figshare
Date: 2018
Stress urinary incontinence in the mesh complication era: current Australian trends.
Publisher: Wiley
Date: 18-12-2021
DOI: 10.1111/BJU.15302
Abstract: To examine available data relating to the surgical management of stress urinary incontinence (SUI) in Australia before, during and after a well-publicized Senate Inquiry into transvaginal mesh use and to consider outcomes in the context of global guideline changes. The annual number of surgical procedures for the management of SUI by procedure type and age group for the years 2008/2009-2017/2018 was obtained from the Australian Government Department of Human Services database using Medicare Benefits Schedule item numbers. The data extracted were limited to women aged 25 years and older. These data were used to calculate age-specific and age-standardized rates, so as to accurately analyse trends in the usage of different procedures. Hospital Episode Statistics for mid-urethral sling (MUS) insertions were obtained for England's National Health Service from the Health and Social Care Information Centre for the years 2008/2009-2016/2017. These data were also used to calculate annual age-standardized rates for comparison purposes. Rates declined for most SUI procedures over time (MUS, colposuspension, fascial slings) except for urethral bulking agents. The absolute number of MUSs implanted in 2008/2009 was 5729, which decreased to 3127 in the 2017/2018 financial year. Over the decade, the annual rate for MUS implantation per 100 000 population halved from 78 to 36. Over this same period, the rate of usage of bulking agents doubled, although represented a low volume of procedures (overall numbers increased from 304 to 698, representing an increase from four to eight procedures per 100 000 population). The age-specific peak rate for MUS and Burch colposuspension changed over the decade from 55-64 years to 65-74 years, suggesting that women are deferring surgical treatment until later in life. Over the last decade, the total number of surgical procedures performed in Australia to treat SUI has decreased markedly from 6812 to 4279. This represents a decrease in the annual rate per 100 000 population from 93 to 49. There are clear changes evident for SUI management in the past decade in Australia, including an overall decline in operative numbers, which correlate with international advisory notifications and local investigations. The results of the Australian Senate inquiry, including removal of single-incision mini-slings, greater availability of patient resources, and greater regulation of SUI procedures, will probably have ongoing effects. Surgeons need to ensure that sufficient training and patient education continue in order to maintain appropriate access to treatment of SUI in the future.
Applications of the Cumulative Rate to Kidney Cancer Statistics in Australia
Publisher: Springer International Publishing
Date: 2018
The unusually diverse mortality patterns in the Pacific region during the 1918-21 influenza pandemic: reflections at the pandemic's centenary.
Publisher: Elsevier BV
Date: 10-2018
Exploring attributes of high-quality clinical supervision in general practice through interviews with peer-recognised GP supervisors
Publisher: Springer Science and Business Media LLC
Date: 20-08-2021
DOI: 10.1186/S12909-021-02882-7
Abstract: Clinical supervision in general practice is critical for enabling registrars (GP trainees) to provide safe medical care, develop skills and enjoy primary care careers. However, this largely depends on the quality of supervision provided. There has been limited research describing what encompasses quality within GP clinical supervision, making it difficult to promote best practice. This study aimed to explore the attributes of high-quality clinical supervision for GP registrars. In 2019–20, 22 semi-structured interviews were conducted with GP supervisors who were peer-nominated as best practice supervisors, by Regional GP Training Organisations and GP Colleges in Australia. Purposeful s ling sought respondents with erse characteristics including gender and career stage, practice size, state/territory and rurality. Interviews were conducted by video-consultation and recorded. De-identified transcripts were independently coded using iterative, inductive thematic analyses to derive themes that reflected quality in GP supervision. Seven themes emerged. Participants understood the meaning of quality supervision based on their experience of being supervised when they were a registrar, and from reflecting and learning from other supervisors and their own supervision experiences. Quality was reflected by actively structuring GP placements to optimise all possible learning opportunities, building a secure and caring relationship with registrars as the basis for handling challenging situations such as registrar mistakes. Quality also encompassed sustaining and enhancing registrar learning by drawing on the input of the whole practice team who had different skills and supervision approaches. Strong learner-centred approaches were used, where supervisors adjusted support and intervention in real-time, as registrar competence emerged in different areas. Quality also involved building the registrar’s professional identity and capabilities for safe and independent decision-making and encouraging registrars to reflect on situations before giving quality feedback, to drive learning. This study, although exploratory, provides a foundation for understanding the quality of clinical supervision in general practice, from the perspective of peer-recognised GP supervisors. Understanding and adopting quality within GP supervision may be improved by GPs sharing exemplars of best practice and having opportunities for professional reflection. The findings could be used as a point of reference for devising GP supervisor curriculum, resources and professional development activities.
Parent and child co-resident status among an Australian community-based sample of methamphetamine smokers.
Publisher: Wiley
Date: 08-09-2020
DOI: 10.1111/DAR.13155
Abstract: Children in families where there is substance misuse are at high risk of being removed from their parents' care. This study describes the characteristics of a community s le of parents who primarily smoke meth hetamine and their child or children's residential status. Baseline data from a prospective study of meth hetamine smokers (‘VMAX’). Participants were recruited via convenience, respondent‐driven and snowball s ling. Univariable and multivariable logistic regression analyses were used to estimate associations between parental status fathers' or mothers' socio‐demographic, psychosocial, mental health, alcohol, meth hetamine use dependence, alcohol use and child or children's co‐residential status. Of the 744 participants, 394 (53%) reported being parents 76% (88% of fathers, 57% of mothers) reported no co‐resident children. Compared to parents without co‐resident children, parents with co‐resident children were more likely to have a higher income. Fathers with co‐resident children were more likely to be partnered and not to have experienced violence in the previous 6 months. Mothers with co‐resident children were less likely to have been homeless recently or to have accessed treatment for meth hetamine use. The prevalence of non‐co‐resident children was much higher than previously reported in studies of parents who use meth hetamine irrespective of whether in or out of treatment. There is a need for accessible support and services for parents who use meth hetamine irrespective of their child or children's co‐residency status. Research is needed to determine the longitudinal impact of meth hetamine use on parents' and children's wellbeing and to identify how parents with co‐resident children (particularly mothers) can be supported.
Host and viral genetic diversity can help explain mortality during the 1918-21 influenza pandemic in the Pacific region - Authors' reply.
Publisher: Elsevier BV
Date: 08-2018
Sarah Bellamy, the women transported to Botany Bay, biographical genres and the Australian Dictionary of Biography
Publisher: ANU Press
Date: 03-12-2020
Long-term outcomes of hospital survivors following an ICU stay: A multi-centre retrospective cohort study
Publisher: Public Library of Science (PLoS)
Date: 28-03-2022
DOI: 10.1371/JOURNAL.PONE.0266038
Abstract: The focus of much Intensive Care research has been on short-term survival, which has demonstrated clear improvements over time. Less work has investigated long-term survival, and its correlates. This study describes long-term survival and identifies factors associated with time to death, in patients who initially survived an Intensive Care admission in Victoria, Australia. We conducted a retrospective cohort study of adult patients discharged alive from hospital following admission to all Intensive Care Units (ICUs) in the state of Victoria, Australia between July 2007 and June 2018. Using the Victorian Death Registry, we determined survival of patients beyond hospital discharge. Comparisons between age matched cohorts of the general population were made. Cox regression was employed to investigate factors associated with long-term survival. A total of 130,775 patients from 23 ICUs were included (median follow-up 3.6 years post-discharge). At 1-year post-discharge, survival was 90% compared to the age-matched cohort of 98%. All sub-groups had worse long-term survival than their age-matched general population cohort, apart from elderly patients admitted following cardiac surgery who had better or equal survival. Multiple demographic, socio-economic, diagnostic, acute and chronic illness factors were associated with long-term survival. Australian patients admitted to ICU who survive to discharge have worse long-term survival than the general population, except for the elderly admitted to ICU following cardiac surgery. These findings may assist during goal-of-care discussions with patients during an ICU admission.
Dynamics of Indigenous demographic fluctuations: lessons from sixteenth-century Cusco, Peru
Publisher: University of Chicago Press
Date: 06-2011
DOI: 10.1086/660010
Tell me if there is a problem: safety in early general practice training
Publisher: Informa UK Limited
Date: 26-05-2019
DOI: 10.1080/14739879.2019.1610078
Abstract: In contrast to other comparable countries, trainees commencing general practice in Australia can see patients without being required to contact their supervisor. To understand how patient safety in early training is managed a qualitative study design using semi-structured interviews was used. A lead medical educator from each of the nine Australian Regional Training Organisations (RTOs) was interviewed. Transcriptions of interviews were analysed to identify themes. RTOs do not mandate a period of direct observation of trainees and the use of safety checklists for supervision is variable and not monitored. The oversight of training practices by RTOs mirrors that of trainees by supervisors. The onus falls on those being supervised to identify the need for assistance. Despite this, lead medical educators still consider the commencement of general practice training to be safe. Other factors found potentially to impact on safety include the variability of training practices and supervision the complex RTO-practice relationship quota-driven selection of doctors into general practice and the negative impact on education of the funding model. Patient safety may be improved by a period of direct observation of potential trainees prior to the commencement of general practice training and the use of checklists to encourage supervision of high risk activities.
Factors Associated With Working in Remote Indonesia: A National Cross-Sectional Study of Early-Career Doctors
Publisher: Frontiers Media SA
Date: 13-05-2021
Abstract: Background: Doctor shortages in remote areas of Indonesia are amongst challenges to provide equitable healthcare access. Understanding factors associated with doctors' work location is essential to overcome geographic maldistribution. Focused analyses of doctors' early-career years can provide evidence to strengthen home-grown remote workforce development. Method: This is a cross-sectional study of early-career (post-internship years 1–5) Indonesian doctors, involving an online self-administered survey on demographic characteristics, and locations of upbringing, medical clerkship (placement during medical school), internship, and current work. Multivariate logistic regression was used to test factors associated with current work in remote districts. Results: Of 3,176 doctors actively working as clinicians, 8.9% were practicing in remote districts. Compared with their non-remote counterparts, doctors working in remote districts were more likely to be male (OR 1.5,CI 1.1–2.1) or unmarried (OR 1.9,CI 1.3–3.0), have spent more than half of their childhood in a remote district (OR 19.9,CI 12.3–32.3), have completed a remote clerkship (OR 2.2,CI 1.1–4.4) or internship (OR 2.0,CI 1.3–3.0), currently participate in rural incentive programs (OR 18.6,CI 12.8–26.8) or have previously participated in these (OR 2.0,CI 1.3–3.0), be a government employee (OR 3.2,CI 2.1–4.9), or have worked rurally or remotely post-internship but prior to current position (OR 1.9,CI 1.2–3.0). Conclusion: Our results indicate that building the Indonesian medical workforce in remote regions could be facilitated by investing in strategies to select medical students with a remote background, delivering more remote clerkships during the medical course, deploying more doctors in remote internships and providing financial incentives. Additional considerations include expanding government employment opportunities in rural areas to achieve a more equitable geographic distribution of doctors in Indonesia.
Net transition probabilities: An approach to subnational level projections of households and housing demand based on census data
Publisher: Wiley
Date: 2006
DOI: 10.1002/PSP.424
Short and long-term survival following an in-hospital cardiac arrest in a regional hospital cohort
Publisher: Elsevier BV
Date: 10-2019
DOI: 10.1016/J.RESUSCITATION.2019.08.028
Abstract: Evidence about the immediate survival from in-hospital cardiac arrest (IHCA) is well established, however, beyond discharge there is very little describing the long-term outcomes of these patients. Of the few existing studies, all have been conducted in metropolitan centres. Therefore, this study describes survival from IHCA in both the short and long-term in a large regional hospital cohort. A retrospective cohort study was conducted including all adult patients who suffered an IHCA between 1 February 2000 and 31 December 2017 in a large regional (non-metropolitan) hospital in Victoria, Australia. Characteristics of the arrest and patient were sourced from a prospectively collected database that captures all of the arrests occurring in the hospital. Mortality data after discharge were sourced from the state death registry, censored on 31 January 2018. A total of 629 patients were included in the study. Of these, 357 (57%) survived the event, and 213 (34%) survived to discharge. At one-year post-arrest 27% of the original cohort were still alive. The age of the patient, arrest rhythm, location and duration of resuscitation were all significantly associated with long-term survival. Both short and long-term survival following an IHCA in a regional hospital are similar to previously described rates in metropolitan hospitals. Further research is required on the post-discharge correlates of long-term survival.
The prevalence of drug driving and being caught for a drug driving offense among community-recruited people who use methamphetamine in metropolitan and rural Victoria, Australia
Publisher: Informa UK Limited
Date: 20-01-2023
Correlates of anxiety and depression in a community cohort of people who smoke methamphetamine
Publisher: SAGE Publications
Date: 24-09-2022
DOI: 10.1177/00048674211048152
Abstract: Anxiety and depression are the most common mental health disorders experienced by Australians. These disorders are commonly found in people who use meth hetamine however, much of this research has involved participants recruited from treatment settings who inject meth hetamine. We therefore explored (1) the prevalence of moderate to severe anxiety and depression in a community-recruited cohort who smoked meth hetamine and (2) examined potential factors associated with moderate to severe anxiety or depression in this cohort. Data were derived from baseline surveys of 725 participants of the prospective ‘VMAX’ study, recruited from metropolitan and non-metropolitan areas of Victoria, Australia, via snowball and respondent-driven s ling. Anxiety and depression were measured using the Generalized Anxiety Disorder-7 and the Patient Health Questionnaire-9 instruments. Independent associations between moderate to severe scores on these measures and demographic, socio-economic, substance use and other health and social characteristics were examined using multivariable logistic regression. More than half (60%) of the participants were classified as experiencing moderate to severe anxiety and/or depression. In the multivariable models, having poor/very poor self-rated health, meth hetamine dependence and being unemployed were associated with higher odds of experiencing both moderate to severe depression and moderate to severe anxiety. Living in a large rural town, identifying as Aboriginal and Torres Strait Islander and smoking meth hetamine were associated with lower odds of experiencing moderate to severe depression. Being female was associated with higher odds of experiencing moderate to severe anxiety. The high rates of anxiety and/or depression found in the VMAX cohort were associated with demographic, socio-economic, substance use and other health and social factors. The prevalence of moderate to severe anxiety is a novel finding that warrants further study. Further work is needed to determine how anxiety and depression change over time among people who smoke meth hetamine, to help identify key intervention points.
Should I stay or should I go? Observation post-vaccination during the COVID-19 pandemic and the law of unintended consequences
Publisher: Cold Spring Harbor Laboratory
Date: 12-04-2022
DOI: 10.1101/2022.04.05.22273373
Abstract: Background Standard practice after all vaccinations in Australia is to observe patients for 15 minutes. During the COVID-19 pandemic, could the risk of contracting and dying from COVID-19 acquired in the waiting room be greater than the risk of dying from post-vaccine anaphylaxis when leaving immediately? Methods The risks are modelled for a patient aged 70+ years attending for annual influenza vaccination in a typical Australian general practice clinic. The risk of death from anaphylaxis is estimated based on known rates of anaphylaxis shortly after influenza vaccination. The risk of acquiring COVID-19 during a 15-minute wait and then dying from that infection is estimated using the COVID-19 Aerosol Transmission Estimator and COVID-19 Risk Calculator. Results Other than at times of extremely low COVID-19 prevalence, the risk of death from anaphylaxis for a patient aged 70+ years leaving immediately after influenza vaccine is less than the risk of death from COVID-19 acquired via aerosol transmission during a 15-minute wait. The risk of death from COVID-19 is greatest for the unimmunised and when masks are not worn. Conclusions A more nuanced approach to advice post-vaccination is recommended that considers current COVID-19 prevalence and virulence, the characteristics of the waiting room, the risk of anaphylaxis, and the patients susceptibility to death from COVID-19. There are many circumstances where it would be safer for a patient to leave immediately after vaccination
Convict bastards, common-law unions, and shotgun weddings: premarital conceptions and ex-nuptial births in ninteenth-century Tasmania
Publisher: SAGE Publications
Date: 08-2011
Abstract: This article uses reconstituted family data from birth, death, and marriage registers to measure ex-nuptial fertility and premarital pregnancies in nineteenth-century Tasmania. It also examines the extent to which convict origins of European society on the island caused a departure from English norms of family formation behavior, during a period when men greatly outnumbered women. Illegitimacy was high during the convict period. From the mid-1850s, after the convict system collapsed, levels of ex-nuptial births were relatively constant until the end of the century, as indicated both by the illegitimacy rate and by the proportion of marriages associated with prenuptial births. By the end of the nineteenth century, rates of illegitimacy and prenuptial conceptions in Tasmania were well within the range of those of contemporary English-speaking populations.
Identification of cancer risk and associated behaviour: implications for social marketing campaigns for cancer prevention
Publisher: Springer Science and Business Media LLC
Date: 17-08-2017
Is sibling rivalry fatal? Siblings and mortality clustering
Publisher: MIT Press - Journals
Date: 02-2012
DOI: 10.1162/JINH_A_00305
Abstract: Evidence drawn from nineteenth-century Belgian population registers shows that the presence of similarly aged siblings competing for resources within a household increases the probability of death for children younger than five, even when controlling for the preceding birth interval and multiple births. Furthermore, in this period of Belgian history, such mortality tended to cluster in certain families. The findings suggest the importance of segmenting the mortality of siblings younger than five by age group, of considering the presence of siblings as a time-varying covariate, and of factoring mortality clustering into analyses.
Health Service Use for Mental Health Reasons in a Cohort of People Who Use Methamphetamine Experiencing Moderate to Severe Anxiety or Depression
Publisher: Springer Science and Business Media LLC
Date: 25-07-2022
DOI: 10.1007/S11469-022-00889-9
Abstract: This study examined health service use for mental health reasons in a cohort of people who use meth hetamine and experience anxiety or depression. Data were derived from baseline surveys of a subset of 429 participants from the ‘VMAX’ study. Anxiety and depression were measured using the Generalized Anxiety Disorder-7 instruments and the Patient Health Questionnaire-9. Sequential logistic regression determined correlates of health service use for mental health reasons. Lower odds of health service use for mental health reasons were evident for those living in a medium/small rural town (aOR = 0.27, CI = 0.12, 0.62), ≥ weekly meth hetamine use (aOR = 0.51, CI = 0.27, 0.99), and not utilising professional support for meth hetamine use in the 12 months prior (aOR = 0.19, CI = 0.12, 0.30). People who use meth hetamine frequently use health services for mental health issues. Further work is needed to determine the effectiveness of these services for this population.
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