ORCID Profile
0000-0003-0411-6193
Current Organisation
University of Melbourne
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
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.
Public Health and Health Services | Other Studies in Human Society | Aboriginal and Torres Strait Islander Health | Studies In Human Society Not Elsewhere Classified | Atomic, Molecular, Nuclear, Particle and Plasma Physics | Primary Health Care | Health Care Administration | Health and Community Services | Rural Sociology | Human Geography Not Elsewhere Classified | Public Health And Health Services Not Elsewhere Classified | Human Geography | Primary Health Care | Sociology | Education And Extension | Applied Sociology, Program Evaluation And Social Impact Assessment | Social And Cultural Geography | Degenerate Quantum Gases and Atom Optics | Condensed Matter Imaging | Atomic and Molecular Physics | Urban And Regional Studies
Studies in human society | Rural Health | Indigenous Health not elsewhere classified | Rural health | Expanding Knowledge in Technology | Environmental education and awareness | Aboriginal and Torres Strait Islander Health - Health System Performance (incl. Effectiveness of Interventions) | Expanding Knowledge in the Physical Sciences | Other social development and community services | Health status (e.g. indicators of “well-being”) | Health Inequalities | Health Related to Specific Ethnic Groups | Regional planning |
Publisher: Wiley
Date: 25-05-2018
DOI: 10.1111/AJR.12436
Abstract: To examine the effects of dominant knowledge in rural health, including how they shape issues central to rural health. In particular, this article examines the roles of: (i) deficit knowledge of rural health workforce (ii) dominant portrayals of generalism and (iii) perceptions of inferiority about rural communities in maintaining health disparities between rural- and metropolitan-based Australians. A Foucauldian framework is applied to literature, evidence, case studies and key messages in rural health. Three scenarios are used to provide practical ex les of specific knowledge that is prioritised or marginalised. The analysis of three areas in rural health identifies how deficit knowledge is privileged despite it undermining the purpose of rural health. First, deficit knowledge highlights the workforce shortage rather than the type of work in rural practice or the oversupply of workforce in metropolitan areas. Second, the construction of generalist practice as less skilled and more monotonous undermines other knowledge that it is erse and challenging. Third, dominant negative stereotypes of rural communities discourage rural careers and highlight undesirable aspects of rural practice. The privileging of deficit knowledge pertaining to rural health workforce, broader dominant discourses of generalism and the nature of rural Australian communities reproduces many of the key challenges in rural health today, including persisting health disparities between rural- and metropolitan-based Australians. To disrupt the operations of power that highlight deficit knowledge and undermine other knowledge, we need to change the way in which rural health is currently constructed and understood.
Publisher: Wiley
Date: 29-11-2022
DOI: 10.1111/AJR.12952
Abstract: To explore health student perspectives of rural and remote placements during the early stages of the COVID‐19 pandemic. Australia. Allied health, nursing and medical students with a planned rural or remote placement between February and October 2020. Semi‐structured interviews ( n = 29) with data thematically analysed. Five main themes emerged from student experiences: (1) ‘Do we go? Don't we go? Like how much risk is involved?’ related to student concerns regarding acquiring and transmitting COVID‐19 on placement (2) ‘We are sort of just standing at the door trying to watch’ encompassed student perceptions of missed clinical learning opportunities in response to health and safety measures related to COVID‐19 (3) ‘I, as a student, sort of fell under the radar’ related to student perceptions of suboptimal supervision (4) ‘It was a bit more difficult to engage with that wider community’ recognised student feelings of social disconnection and their lack of opportunity for community immersion and (5) ‘We felt like we got something that is more than we expected’ emerged from student reflections on training during the pandemic and alternative placements (virtual, simulated and non‐clinical) that exceeded expectations for learning. Although most students were willing and able to undertake their rural or remote placement in some form during the early stages of the pandemic and identified unanticipated learning benefits, students recognised lost opportunities to build clinical skills, become culturally aware and connect with rural communities. It remains unknown how these rural and remote placement experiences will impact rural intention and in turn, rural workforce development.
Publisher: American Chemical Society (ACS)
Date: 22-09-2023
Publisher: Wiley
Date: 02-2022
DOI: 10.1111/AJR.12836
Abstract: To investigate students' perceptions of the impact of coronavirus SARS‐CoV‐2 on rural and remote placements facilitated by 16 University Departments of Rural Health in Australia in 2020. A mixed‐method design comprising an online survey and semi‐structured interviews. Australia. Allied health, nursing and medical students with a planned University Departments of Rural Health‐facilitated rural or remote placement between February and October 2020. A planned rural or remote placement in 2020 facilitated by a University Departments of Rural Health, regardless of placement outcome. Questionnaire included placement outcome (completed or not), discipline of study (nursing, allied health, medicine), and Likert measures of impact to placement (including supervision, placement tasks, location, accommodation, client contact and student learning) and placement experience (overall, support, supervision, university support). Semi‐structured interviews asked about placement planning, outcome, decisions, experience and student perceptions. While coronavirus SARS‐CoV‐2 reportedly impacted on the majority of planned placements, most students (80%) were able to complete their University Departments of Rural Health‐facilitated placement in some form and were satisfied with their placement experience. Common placement changes included changes to tasks, setting, supervisors and location. Allied health students were significantly more likely to indicate that their placement had been impacted and also felt more supported by supervisors and universities than nursing students. Interview participants expressed concerns regarding the potential impact of cancelled and adapted placements on graduation and future employment. The coronavirus SARS‐CoV‐2 pandemic was reported to impact the majority of University Departments of Rural Health‐facilitated rural and remote placements in 2020. Fortunately, most students were able to continue to undertake a rural or remote placement in some form and were largely satisfied with their placement experience. Students were concerned about their lack of clinical learning and graduating on time with adequate clinical competence.
Publisher: Informa UK Limited
Date: 10-2002
DOI: 10.5172/JFS.8.2.197
Publisher: American Diabetes Association
Date: 06-2019
DOI: 10.2337/DB19-1629-P
Abstract: Objective: Diabetes screening and management guidelines have changed over the last 15 years. We compared diabetes prevalence, management, metabolic control and complications in 2 surveys, conducted 15 years apart. Methods: Repeat cross-sectional studies 2001-2003 (XRDS1) and 2016-2018 (XRDS2) across 4 rural Australian towns with previously low access to primary care, involving a household survey followed by biomedical assessments (including OGTTs) among randomly selected in iduals. Results: Overall, household survey/clinic responses were & % involving 4464/1042 and 2315/748 residents in XRDS1 and 2 respectively. The prevalence of known diabetes increased overall (5.4% to 10.4% p& .001), in those & , 50-59, 70+ years but not 60-69 years (2.5% vs. 4.8% p& .001, 6.5% vs. 9.7% p& .05, 9.9% vs. 18.4% p& .001 12.8% vs.13.4%). Proportions with undiagnosed diabetes and IFG/IGT were not significantly different (2.3% vs. 1.5% 11.7% vs. 10.0%). Diabetes screening increased from 48.9% to 59.5% (p& .001). Among those with known diabetes age (59±16 vs. 63±16 p& .01), lipid testing (84.8% vs. 92.8% p& .05), hypertension (52.2% vs. 65.8% p& .01) and dyslipidaemia (21.9% vs. 55.8% p& .001) diagnoses, increased. Age at diagnosis (53±15 vs. 52±16 years), BMI (30.4±6.9 vs. 30.8±7.1 kg/m2), glycaemia testing (97.1 vs. 95.3%) and BP testing (98.4% vs. 98.2%) were similar. Mean HbA1c and diastolic BP were similar but systolic BP (143±24 vs. 136±19 mm Hg p& .05) and total cholesterol (4.8±0.9 vs. 4.4±1.1 mmol/l p& .05) were lower. Complication rates were similar (nephropathy 27.8% vs. 22.4%, non-fatal stroke 6.2% vs. 5.0%) or increased (depression 14.1% vs. 33.5% p& .01 cardiac condition 24.1% vs. 32.4% p& .05). Conclusions: Over 15 years, diabetes prevalence increased, CVD risk management improved but complications were unchanged or increased. Further work is required to understand the extent to which changing survival, migration, access to care and ageing have contributed to these patterns. D. Simmons: Speaker's Bureau Self Sanofi-Aventis. Other Relationship Self Medtronic. K. Glenister: None. D.J. Magliano: None. L. Bourke: None. National Health and Medicine Research Council of Australia
Publisher: Wiley
Date: 26-11-2012
DOI: 10.1111/J.1440-1584.2012.01312.X
Abstract: To demonstrate the usefulness of a conceptual framework to increase the understanding of rural and remote health by applying it to specific rural and remote health scenarios. A conceptual framework was applied to two case studies illustrative of key issues in rural health to reflect different contexts, issues and responses. Application of the framework to both case studies highlighted that changes in rural and remote health are erse. While power was a key element of the framework, the interaction of all framework components underpinned changes. The framework facilitated understanding of change in these rural scenarios and demonstrated that improvement in rural health requires change at both the local and structural levels.
Publisher: Informa UK Limited
Date: 06-2002
Abstract: While participatory research is now strongly advocated as progressive, ethical and useful, consultation with participants and other stakeholders can raise issues which compromise research or which create conflicting choices in research protocols. This paper discusses some of the issues raised by a participatory research project undertaken to assess the needs of women with breast cancer in northern Victoria. The participatory process has meant that despite some compromises, there were positive outcomes from the research process that would not have otherwise been achieved.
Publisher: Hindawi Limited
Date: 07-09-2020
DOI: 10.1111/HSC.13152
Abstract: This paper contributes to scholarship on the medicalisation of mental health support for young people through a case study of a multidisciplinary mental health service in rural Australia. All staff (n = 13) working at the service participated in semi-structured, in idual interviews. Transcripts of interview data were read and selectively coded and interpreted in relation to the overarching question of how participants view and experience mental health care provision to a erse range of young people. Following analytical reflection, codes pertaining to engagement, accessibility and care provision were re-examined using the concept of medicalisation to understand the biomedical underpinning of mental healthcare and how this plays out in the experiences and perceived challenges participants talked about in responding to the mental health concerns of erse young people. The resulting analysis is presented under five theme headings: (a) privileging clinical expertise and priorities within service provision, which was an important source of conflict for some participants (b) 'multidisciplinary' teams-a 'difficult kind of culture at times' (c) articulations of where cultural barriers lie (d) the tracks along which young people are directed to 'engage' with 'mental health' and (e) a clinical 'feel' to space. We suggest that service and system investment needs to be given to alternative ways of thinking about and approaching mental health and care provision that are cognisant of, and engage with, the inherent connections between in idual circumstance and social, place, cultural, economic and political contexts. This is particularly relevant to the provision of care in rural contexts because of limited service options and the complexities of access and providing care to a erse range of young people living in isolated environments. Interdisciplinary frameworks need to be enacted and services must acknowledge their own cultural positions for alternative ways of working to become possibilities.
Publisher: Informa UK Limited
Date: 18-05-2018
Publisher: Informa UK Limited
Date: 16-06-1997
Publisher: Rural and Remote Health
Date: 30-06-2017
DOI: 10.22605/RRH3832
Publisher: Wiley
Date: 12-1996
Publisher: Wiley
Date: 09-1994
Publisher: Elsevier BV
Date: 06-2016
Publisher: SAGE Publications
Date: 13-11-2015
Abstract: The use of information technologies by young people is commonly understood to be a separate, often risky, activity and a distinct form of sociality. Challenging the dominant understanding, this article applies Haraway’s cyborg theory to explore how Facebook-mediated relationships are interconnected with material relationships and daily social life. Young people’s perspectives are privileged through 40 face-to-face interviews in two rural Victorian towns. The cyborg metaphor highlights the fluid melding of various conceptual dualisms altered in the overlap between the virtual environs of Facebook and the material, everyday lives of the young participants, analysed here using the cyborg metaphor. In this sense, Facebook can be best understood as an in idualised extension of young people’s broader social lives, part of a larger suite of information technologies, social media and other mediated sociality that is interconnected with materially based, face-to-face interactions.
Publisher: Elsevier BV
Date: 06-2023
Publisher: Rural and Remote Health
Date: 28-11-2005
DOI: 10.22605/RRH460
Publisher: Wiley
Date: 28-08-2007
DOI: 10.1111/J.1440-1584.2007.00903.X
Abstract: To comprehensively describe diabetes-related risk factors, quality of care and patient-perceived barriers to care in a rural community. Cross-sectional mail study, self-completed survey and retrospective chart review. Community and health services in Corryong, rural Victoria, Australia. Ninety-seven patients with diabetes and 495 with other diseases in the mail study, 84 with diabetes in the self-completed survey and 101 diabetic patient chart reviews. Self-reported lifestyle activities, uptake of health checks, metabolic measures and uptake of medication, and self-reported barriers to diabetes care. Most residents without diabetes had recently had their blood pressure and cholesterol checked 60.4% were trying to control their weight and 73.9% were exercising regularly (although only 30.7% to an adequate level). Those with diabetes reported a greater uptake of healthy living messages, and had a mean HbA1c of 7.3%, total cholesterol of 5.0 mmol L(-1) 12.9% had a diastolic blood pressure > or =85 mmHg. Foot checks were infrequent (18%). There was substantial room to increase antiplatelet, blood pressure, antihyperglycaemia and lipid-lowering therapy. Most patients reported psychological (84.5%) and educational (82.1%) barriers to care, with few perceiving physical barriers to care. Living in a rural area with predominantly GP care can be associated with comparatively good metabolic control, although psycho-educational barriers are frequently present. In the wider community, risk factors for diabetes remain common, and the majority have been screened for components of the metabolic syndrome in the previous year.
Publisher: BMJ
Date: 07-2013
Publisher: Springer Science and Business Media LLC
Date: 30-05-2018
Publisher: Wiley
Date: 06-2007
Publisher: Wiley
Date: 15-02-2020
DOI: 10.1002/NOP2.457
Publisher: MDPI AG
Date: 12-06-2023
DOI: 10.3390/HEALTHCARE11121721
Abstract: It is unclear how well self-rated oral health (SROH) reflects actual oral health status in the rural Australian population. Therefore, this study aimed to compare the clinically assessed oral health status and SROH of adults living in rural Australia. The data were from 574 participants who took part in the Crossroads II cross-sectional study. Three trained and calibrated dentists evaluated the oral health status of participants based on WHO criteria. SROH was assessed with the question ‘Overall, how would you rate the health of your teeth and gums?’, with a score ranging from excellent = 5 to poor = 1. A logistic regression analysis (LRA) was performed, allowing us to assess factors associated with SROH. The mean age of participants was 59.2 years (SD 16.3), and 55.3% were female. The key results from the LRA show poorer SROH in those with more missing teeth (OR = 1.05 95% CI 1.01–1.08), more decayed teeth (OR = 1.28 95% CI: 1.11–1.46), and more significant clinical attachment loss of periodontal tissue (6mm or more) (OR = 2.63 95% CI: 1.29–5.38). This study found an association between negative SROH and clinical indicators used to measure poor oral health status, suggesting that self-rated oral health is an indicator of oral health status. When planning dental healthcare programs, self-reported oral health should be considered a proxy measure for oral health status.
Publisher: Springer International Publishing
Date: 2021
Publisher: The Society for the Provision of Education in Rural Australia (SPERA)
Date: 07-04-2020
Abstract: Australia's rural health services commonly face serious and protracted workforce shortages. To help address such shortages in rural and remote areas, a range of programs exist to support university students to undertake placements in a rural setting. In particular, University Departments of Rural Health (UDRHs) are funded to support nursing and allied health students to undertake a rural placement. As UDRHs encourage students to 'go rural' and as they coordinate and facilitate placements in rural settings, a range of enablers and barriers emerge. This study investigates the lived experiences of nursing and allied health students on placement in public health services in rural and regional Victoria. Its purpose was to identify the enablers and barriers most strongly affecting placement satisfaction and personal wellbeing. The intended outcome was to identify modifiable factors that could potentially improve the rural placement experience. Eighteen students were interviewed by a student undertaking her placement. Interviews were 45-60 minutes in length and all face-to-face. The 18 participants were from five universities and were undertaking their placement at one of seven public hospitals operating in northeast Victoria. The researcher recruited participants by attending scheduled debrief meetings at their placement organisation, briefly discussing the research and inviting students to participate. Data were analysed using a thematic analysis approach. The study found that most participants were positive and enthusiastic about their rural placement, both professionally and personally. Three key enablers were identified: 1) enjoyment of the rural environment and community 2) working in a positive, friendly and supportive workplace and 3) exposure to broad practice and enhanced learning opportunities. Simultaneously many had also experienced significant barriers before, during or as a consequence of undertaking their placement, and these negatively affected placement satisfaction and personal wellbeing. Identified barriers were: 1) increased financial stress 2) travel and accommodation challenges and concerns 3) study-work-life balance and isolation issues 4) encountering stressful work situations and/or personal events while on placement and 5) communication issues with universities. The findings are strongly consistent with those identified in the extant literature. The findings add to previous research by deepening understanding about the financial burden and barriers experienced by nursing and allied health students as a result of undertaking rural placements. Disruption to students' lives socially, psychologically, financially and in terms of employment were significant. The study identified some important aspects of the placement experience, suggesting that nursing and allied health students can be dissatisfied with increased financial stress, isolation and inflexibility from universities.
Publisher: Elsevier BV
Date: 06-2021
Publisher: American Diabetes Association
Date: 07-2018
DOI: 10.2337/DB18-1515-P
Abstract: In the mid-2000s in Australia, national guidelines were introduced to promote diabetes screening in people aged 40+ years. We have tested whether diabetes screening has increased, and the prevalence of undiagnosed diabetes has decreased since the introduction of these guidelines. ’Crossroads’ is a repeat cross-sectional study conducted between 2000-2003 (Crossroads-I) and then 2016-2018 (Crossroads-II) in rural Australia (the Goulburn Valley, Victoria). Households visited were randomly selected, and the same households were then revisited in Crossroads-II, alongside proportionately randomly selected new houses. All adult residents are interviewed face to face by trained research assistants. Questions enquire about diabetes status, occurrence of diabetes screening in last 2 years and primary care utilisation. Randomly selected participants are invited to attend a ’clinic’ including a glucose tolerance test. The Crossroads-I cohort (n=3787) was younger and had a higher proportion of male participants than the Crossroads-II cohort (n=1733) (44 ± 17 vs. 53 ± 19 years p& .0001, 46% vs. 42% male, p& .0001). The age standardised prevalence of self-reported diabetes (7.0% vs. 5.4%, p& .05), and age standardised screening rates (56.5% vs. 49.7%, p& .05) were higher in Crossroads-II than Crossroads-I. Crude undiagnosed diabetes prevalence was also higher in Crossroads-II than Crossroads-I (17/430 (3.9%) vs. 15/814 (1.8%) p& .05). Primary care utilisation was higher in Crossroads-II than I (6.4 vs. 4.7 visits in past 12 months, p& .0001) and waiting times were shorter (3.0 vs. 3.9 days, p& .0001). We conclude that diabetes screening has increased in this area in association with improved access to primary care, and guideline changes. Despite this, rates of undiagnosed diabetes have also increased in line with the overall prevalence of diabetes. Additional strategies are required to reduce undiagnosed diabetes rates further. D. Simmons: Speaker's Bureau Self Roche Diabetes Care Health and Digital Solutions, AstraZeneca, Novo Nordisk Inc., Medtronic. K. Glenister: None. D.J. Magliano: None. S.J. Wright: None. L. Bourke: None.
Publisher: Wiley
Date: 25-10-2019
DOI: 10.1111/AJR.12565
Abstract: High-quality data regarding the prevalence of chronic disease in rural areas are essential in understanding the challenges faced by rural populations and for informing strategies to address health care needs. This study compared the prevalence of a range of self-reported chronic conditions and utilisation of GP services and emergency department in a regional Victorian setting between two studies conducted in the same region in 2001-2003 and 2014. Repeat cross-sectional studies conducted over a decade apart. The projects were conducted in the Goulburn Valley in regional Victoria. The earlier study randomly selected households from local government lists. The later study randomly selected householders from the telephone directory. Participants were asked whether they had been diagnosed with a range of chronic health conditions and how often they had visited a general practitioner or emergency department in the past 12 months. The age-standardised prevalence of depression was higher in the 2014 study than the 2001-2003 study in men (increased by 8.0% (95% CI 4.5, 11.5%)) and women (increased by 13.7% (95% CI 8.4, 19.0%)). Similarly, the prevalence of age-standardised diabetes and hypertension was higher in 2014 than 2001-2003 (men increased by 3.6% (95% CI 0.7, 6.5% (diabetes)) and 13.6% (95% CI 8.6, 18.6% (hypertension)), women increased by 3.1% (95% CI 0.3, 6.5% (diabetes)) and 8.4% (95% CI 2.3, 14.5% (hypertension))). The results of this study indicate that the prevalence of self-reported depression, diabetes and hypertension has increased in this regional Victorian area over the past 13 years. The reasons for these observed increases and the subsequent impact on the health care needs of regional communities warrants further investigation.
Publisher: Informa UK Limited
Date: 10-2014
Publisher: Elsevier BV
Date: 12-2003
DOI: 10.1016/S0277-9536(03)00069-8
Abstract: Australia has one of the highest rates of youth suicide in the western world, especially among rural men. This paper discusses the social construction of this issue in Australia and explores the issue through interviews with 30 young people and 12 key informants from a rural town in NSW. Findings suggest that young people struggle to deal with conflict in social relationships, that community discourses shape young people's understandings and that suicide is talked about in reference to depression. Implications for youth suicide prevention in Australian rural communities are discussed.
Publisher: Informa UK Limited
Date: 09-1998
Publisher: Informa UK Limited
Date: 12-2009
Publisher: Wiley
Date: 03-2022
DOI: 10.1111/AJR.12855
Abstract: As the coronavirus pandemic unfolded during 2020, widespread financial uncertainty emerged amongst university students across the globe. What is not yet clear is how Australian health students were financially impacted during the initial stages of the pandemic and whether this influenced their ability to undertake planned rural or remote placements. To examine (a) financial concern amongst health students during COVID‐19, (b) the financial implications of changes to planned rural or remote placements and (c) the impact of these factors on students' ability to undertake placements during the pandemic. Mixed‐methods design involving an online survey ( n = 1210) and semi‐structured interviews ( n = 29). Nursing, medical and allied health students with a planned University Department of Rural Health‐facilitated rural or remote placement between February and October 2020 were invited to participate. 54.6% of surveyed students reported financial concern during COVID‐19. Financial concern correlated with both changes in financial position and employment, with 36.6% of students reporting a reduction in income and 43.1% of students reporting a reduction in, or cessation of regular employment. Placement changes yielded a range of financial implications. Cancelled placements saved some students travel and accommodation costs, but left others out of pocket if these expenses were prepaid. Placements that went ahead often incurred increased accommodation costs due to limited availability. Financial concern and/or financial implications of placement changes ultimately prevented some students from undertaking their rural or remote placement as planned. Many nursing, allied health and medical students expressed financial concern during COVID‐19, associated with a loss of regular employment and income. Placement changes also presented unforeseen financial burden for students. These factors ultimately prevented some students from undertaking their planned rural or remote placement. Universities need to consider how best to align financially burdensome placements with the personal circumstances of students during periods of economic uncertainty.
Publisher: Informa UK Limited
Date: 09-1994
Publisher: American Institute of Mathematical Sciences (AIMS)
Date: 2017
Publisher: Informa UK Limited
Date: 04-05-2015
Publisher: Wiley
Date: 10-2004
DOI: 10.1111/J.1440-1854.2004.00601.X
Abstract: This study presents a set of concepts underpinning rural practice that could assist teaching health and medical students. Five concepts, important in distinguishing rural health practice, are presented and discussed. These are rural-urban health differentials, access, confidentiality, cultural safety and team practice. Together these concepts impact the ways in which rural health professionals provide care, due to fewer services, greater distances, smaller populations, less choice of services and smaller workforce. These concepts introduce students to some of the positive and negative aspects of rural practice, as well as opportunities for rural practitioners to have a erse practice, to become involved in all aspects of health and to initiate change. They provide an understanding of rurality from which health students can learn from their practical experiences during rural placements.
Publisher: Elsevier BV
Date: 11-2021
Publisher: American Institute of Mathematical Sciences (AIMS)
Date: 2015
Publisher: Informa UK Limited
Date: 09-2001
Publisher: CSIRO Publishing
Date: 2008
DOI: 10.1071/PY08027
Abstract: In rural Australia, models of primary health care are as erse as the communities themselves. Differing facilities, health disciplines, in idual providers, local contexts, funding models and reporting make measuring quality of care very difficult. This paper proposes that quality can be measured in three ways - through industry driven benchmarks, through consumer satisfaction, and through consumer and community decision-making. Further, this paper argues that quality of care needs to include a consumer domain. If consumers are able to influence how they receive support, care and/or treatment, they are more likely to receive appropriate services and interventions and have positive outcomes. A case study is presented to discuss how the three levels of quality are applied within a rural organisation, highlighting the challenges and effort required to sustain genuine community participation. The paper concludes with a discussion of these issues and the many challenges embedded in consumer-driven approaches to quality of care.
Publisher: Wiley
Date: 30-05-2012
DOI: 10.1002/TOX.21787
Abstract: The potential genotoxicity (nuclear anomalies, damage to single-strand DNA) and pinocytic adherence activity of two (glyphosate-based and paraquat-based) commercial herbicides to earthworm coelomocytes (immune cells in the coelomic cavity) were assessed. Coelomocytes were extracted from earthworms (Pheretima peguana) exposed to concentrations <LC50 of glyphosate-based or paraquat-based herbicides on filter paper for 48 h. Three assays were performed: Micronucleus (light microscopy count of micronuclei, binuclei, and trinuclei), Comet (epifluorescent microscope and LUCIA image analyzer measure of tail DNA %, tail length, and tail moment), and Neutral Red (to detect phagocytic or pinocytic activity). The LC50 value for paraquat was 65-fold lower than for glyphosate indicating that paraquat was far more acutely toxic to P. peguana. There were significant (P < 0.05) differences from the control group in total coelomocyte micronuclei, binuclei, and trinuclei frequencies of earthworms exposed to glyphosate at 25 × 10(-1) (10(-3) LC50) and paraquat at 39 × 10(-5) (10(-4) LC50) μg cm(-2) filter paper. In earthworms exposed to glyphosate, no differences in tail DNA%, tail length, and tail moment of coelomocytes were detected. In contrast, for paraquat at 10(-1) LC50 concentration, there were significant (P < 0.05) differences between tail DNA % and tail length, and at LC50 concentration, tail moment was also significantly different when compared with controls. A decline in pinocytic adherence activity in coelomocytes occurred on exposure to glyphosate or paraquat at 10(-3) LC50 concentration. This study showed that, at concentrations well below field application rates, paraquat induces both clastogenic and aneugenic effects on earthworm coelomocytes whereas glyphosate causes only aneugenic effects and therefore does not pose a risk of gene mutation in this earthworm.
Publisher: Wiley
Date: 25-07-2023
DOI: 10.1111/AJR.13025
Abstract: The emergence of COVID‐19 in 2020 led to an increase in stressors for students on rural placements, but little is known about how this impacted their mental health and well‐being. To explore self‐reported mental health, stress and well‐being concerns among allied health, nursing and medical students who completed a scheduled University Department of Rural Health (UDRH)‐faciliated rural placement in Australia between February and October 2020 (n = 1066). Cross‐sectional design involving an online survey measuring mental health, stress and well‐being concerns. The survey was distributed via email by the 16 UDRHs across Australia. A total of 42.9%, 63.8% and 41.1% of survey respondents reported concerns about their mental health, levels of stress and well‐being, respectively, during the early stages of the pandemic. Multiple logistic regression models found clinical training, course progression and financial concerns were predictive of negative mental health, increased stress and reduced well‐being, while feeling connected was predictive of positive mental health, reduced stress and increased well‐being. Universities, UDRHs and health placement sites all have a responsibility to support the mental health and well‐being of students undertaking rural placements. This support needs to encompass strategies to reduce financial stress, protect learning opportunities and increase connectedness. Ensuring adequate resourcing and support for those providing rural placement opportunities will safeguard quality rural placements during times of pandemic disruption.
Publisher: Elsevier BV
Date: 05-2012
DOI: 10.1016/J.HEALTHPLACE.2012.02.009
Abstract: People living in rural and remote areas face challenges in accessing appropriate health services, many of which struggle to recruit and retain staff. While researchers have documented these issues in Australia and internationally, rural health remains reactive to current problems and lacks comprehensive understanding. This paper presents a conceptual framework that can be used to better understand specific rural and remote health situations. The framework consists of six key concepts: geographic isolation, the rural locale, local health responses, broader health systems, social structures and power. Viewed through Giddens' theory of structuration, the framework suggests that rural health is understood as spatial and social relations among local residents as well as the actions of local health professionals/consumers that are both enabled and constrained by broader health systems and social structures. The framework provides a range of stakeholders with a guide to understanding rural and remote health.
Publisher: Wiley
Date: 25-07-2023
DOI: 10.1111/AJR.13023
Publisher: Informa UK Limited
Date: 04-2012
Publisher: Informa UK Limited
Date: 1998
Publisher: Wiley
Date: 23-09-2012
Publisher: MDPI AG
Date: 28-10-2022
DOI: 10.3390/NU14214557
Abstract: This study examined the changes in the prevalence of obesity and associated lifestyle factors using data from repeated cross-sectional, self-reported surveys (Crossroads I: 2001–2003 and Crossroads II: 2016–2018, studies) and clinic anthropometric measurements collected from regional and rural towns in the Goulburn Valley, Victoria. Given that past community studies have only focused categorically on dietary intake, or assessed caloric energy intake, we examined the difference in broad dietary practices at two different times. Clinical assessments from randomly selected household participants aged ≥18 years were analyzed. Differences in obesity prevalence were calculated for each in idual variable. Logistic regression was used to determine the odds ratios (95% confidence intervals (CI)) with and without adjustment for key lifestyle factors. There were 5258 participants in Crossroads I and 2649 in Crossroads II surveys. Obesity prevalence increased from 28.2% to 30.8% over 15 years, more among those who ate fried food, but decreased significantly among rural dwellers (31.7: 27.0, 36.8% versus 25.1: 22.9, 27.5%) and those who had adequate fruit intake (28.5: 25.0, 32.3% to 23.9: 21.8, 26.2%). Obesity was associated with older age (≥35 years), use of fat-based spreads for bread (adjusted odds ratio, aOR:1.26: 1.07, 1.48) and physical inactivity. The increase in obesity prevalence especially in the rural towns, was associated with unhealthy dietary behaviour which persisted over 15 years. Understanding and addressing the upstream determinants of dietary intake and choices would assist in the development of future health promotion Programs.
Publisher: Society for Neuroscience
Date: 02-03-2011
DOI: 10.1523/JNEUROSCI.6256-10.2011
Abstract: We probed for improvement of visual sensitivity in human participants using transcranial magnetic stimulation (TMS). Stimulation of visual cortex can induce an illusory visual percept known as a phosphene. It is known that TMS, delivered at intensities above the threshold to induce phosphenes, impairs the detection of visual stimuli. We investigated how the detection of a simple visual stimulus is affected by TMS applied to visual cortex at or below the phosphene threshold. Participants performed the detection task while the contrast of the visual stimulus was varied from trial to trial according to an adaptive staircase procedure. Detection of the stimulus was enhanced when a single pulse of TMS was delivered to the contralateral visual cortex 100 or 120 ms after stimulus onset at intensities just below the phosphene threshold. No improvement in visual sensitivity was observed when TMS was applied to the visual cortex in the opposite hemisphere (ipsilateral to the visual stimulus). We conclude that TMS-induced neuronal activity can sum with stimulus-evoked activity to augment visual perception.
Publisher: Springer Science and Business Media LLC
Date: 05-04-2023
DOI: 10.1186/S12913-023-09265-2
Abstract: The COVID-19 pandemic increased the use of telehealth consultations by telephone and video around the world. While telehealth can improve access to primary health care, there are significant gaps in our understanding about how, when and to what extent telehealth should be used. This paper explores the perspectives of health care staff on the key elements relating to the effective use of telehealth for patients living in remote Australia. Between February 2020 and October 2021, interviews and discussion groups were conducted with 248 clinic staff from 20 different remote communities across northern Australia. Interview coding followed an inductive approach. Thematic analysis was used to group codes into common themes. Reduced need to travel for telehealth consultations was perceived to benefit both health providers and patients. Telehealth functioned best when there was a pre-established relationship between the patient and the health care provider and with patients who had good knowledge of their personal health, spoke English and had access to and familiarity with digital technology. On the other hand, telehealth was thought to be resource intensive, increasing remote clinic staff workload as most patients needed clinic staff to facilitate the telehealth session and complete background administrative work to support the consultation and an interpreter for translation services. Clinic staff universally emphasised that telehealth is a useful supplementary tool, and not a stand-alone service model replacing face-to-face interactions. Telehealth has the potential to improve access to healthcare in remote areas if complemented with adequate face-to-face services. Careful workforce planning is required while introducing telehealth into clinics that already face high staff shortages. Digital infrastructure with reliable internet connections with sufficient speed and latency need to be available at affordable prices in remote communities to make full use of telehealth consultations. Training and employment of local Aboriginal staff as digital navigators could ensure a culturally safe clinical environment for telehealth consultations and promote the effective use of telehealth services among community members.
Publisher: Informa UK Limited
Date: 22-11-2020
DOI: 10.1080/14461242.2020.1846581
Abstract: Although health services in Australia have an aim to provide inclusive care for their patients/clients, this study highlights how barriers to care can lie at the centre of patient-provider interactions. Racial microaggression is a subtle form of racism that can occur in health settings, leading to further exclusion for First Nations Australians, immigrants and refugees. This paper is guided by Derrida's approach to deconstructionism by unpacking how language is used by health professionals - as holders of organisational power - and how they construct 'truths' or discourses about clients that historically have been marginalised by health services and system. Data comprise 21 interviews with staff from two rural health services. It identified three racial microaggressions were used to justify the challenges of providing care to people from First Nations, immigrant and refugee backgrounds: (1) Participants problematised culture(s) of service users (2) participants implied cultural superiority in their conceptualisation of 'other' cultures and (3) participants shared stories of inactions, discomfort and relegating of responsibility. The findings identified these discourses as forms of racial microaggression that can potentially lead to further exclusion of people seeking services and support.
Publisher: Elsevier BV
Date: 11-2013
DOI: 10.1016/J.HEALTHPLACE.2013.08.005
Abstract: In Australia, a ersity of perspectives of rural health have produced a deficit discourse as well as multidisciplinary perspectives that acknowledge ersity and blend in social, cultural and public health concepts. Interviews with 48 stakeholders challenged categories of rural and remote, and discussed these concepts in different ways, but invariably marginalised Aboriginal voices. Respondents overwhelmingly used a deficit discourse to plead for more resources but also blended erse knowledge and at times reflected a relational understanding of rurality. However, mainstream perspectives dominated Aboriginal voices and racial exclusion remains a serious challenge for rural/remote health in Australia.
Publisher: Wiley
Date: 07-05-2019
DOI: 10.1111/AJR.12513
Abstract: The need for more Remote Area Nurses in the Northern Territory is clear. This paper investigates the perspectives of Remote Area Nurse workforce issues among multiple stakeholders. The aim is to identify how Remote Area Nurse staffing issues are perceived by clinic managers, Remote Area Nurses themselves, Aboriginal colleagues and community members in seven remote communities in the Northern Territory. This is a qualitative study that uses interviews and focus groups to identify key messages of local stakeholders about Remote Area Nurse workforce issues. A content analysis was used for data analysis. Seven erse remote Aboriginal communities in the Northern Territory with government-run health clinics were visited. Non-random s ling techniques were used to target staff at the clinics at the time of field work. Staff and community members, who agreed to participate, were interviewed either in idually or in groups. Interviews were conducted with 5 Managers, 29 Remote Area Nurses, 12 Aboriginal staff (some clinics did not have Aboriginal staff) and 56 community residents. Twelve focus groups were conducted with community members. Content analysis revealed that participants thought having the "right" nurse was more important than having more nurses. Participants highlighted the need for Remote Area Nurses to have advanced clinical and cultural skills. While managers and, to a lesser extent, Remote Area Nurses prioritised clinical skills, Aboriginal staff and community residents prioritised cultural skills. Participants identified the importance of clinical and cultural skills and reiterated that getting the "right" Remote Area Nurse was more important than simply recruiting more nurses. Thus, retention strategies need to be more targeted and cultural skills prioritised in recruitment.
Publisher: Springer Science and Business Media LLC
Date: 08-04-2016
Publisher: Wiley
Date: 08-08-2023
DOI: 10.1111/AJR.12914
Abstract: To estimate the prevalence of atrial fibrillation (AF) in regional Victoria at two time points (2001–2003 and 2016–2018), and to assess the use of electrocardiogram rhythm strips in a rural, community‐based study for AF investigation. Repeated cross‐sectional design involving survey of residents of randomly selected households and a clinic. Predictors of AF were assessed using Firth penalised logistic regression, as appropriate for rare events. Goulburn Valley, Victoria. Household residents aged ≥16 years. Non‐pregnant participants aged 18+ were eligible for the clinic. Atrial fibrillation by 12 lead electrocardiogram (earlier study) or electrocardiogram rhythm strip (AliveCor® device) (recent study). The age standardised prevalence of AF was similar between the two studies (1.6% in the 2001–2003 study and 1.8% in the 2016–2018 study, 95% confidence interval of difference −0.010, 0.014, p = 0.375). The prevalence in participants aged ≥65 years was 3.4% (1.0% new cases) in the recent study. Predictors of AF in the earlier study were male sex, older age and previous stroke, while in the recent study they were previous stroke and self‐reported diabetes. AliveCor® traces were successfully classified by the in‐built algorithm (91%) vs physician (100%). The prevalence of AF among community‐based participants in regional Victoria was similar to predominantly metropolitan‐based studies, and was unchanged over time despite increased rates of risk factors. Electrocardiogram rhythm strip investigation was successfully utilised, and particularly benefited from physician overview.
Publisher: No publisher found
Date: 2001
DOI: 10.1046/J.1440-1584.2001.00299.X
Abstract: The present paper explores the characteristics of rural residents and issues facing rural consumers. Analysis of census data and a survey of 499 rural residents across Australia suggests that cost is their major concern. Rural consumers indicated that they would like to access information through a variety of sources, but local media was the most preferred source. While many would like more consumer information, they would like to know how to access information when needed rather than have it on hand. Most were not concerned about complaint procedures, but many were found to be unaware of where to redress problems with health services.
Publisher: Elsevier BV
Date: 07-1997
Publisher: Elsevier BV
Date: 12-2020
Publisher: Research Square Platform LLC
Date: 10-07-2020
DOI: 10.21203/RS.3.RS-38624/V1
Abstract: Background: Most Australians visit a General Practitioner annually and are free to choose their General Practitioner and/or practice on each occasion. A proportion of people visit multiple general practices, which can reduce continuity of care, a core value of general practice. Utilisation of multiple general practices is associated with metropolitan residence and younger age. However, it is unclear which factors are associated with utilisation of multiple general practices in rural areas, where there are often General Practitioner workforce shortages and higher proportions of patients who may benefit from continuity of care such as older people or those with chronic disease. The aim of this study was to compare the characteristics of people in a rural Australian area who accessed multiple general practices in the previous year. Methods: A cross-sectional survey assessed self-reported utilisation and perspective of general practice services, uses of multiple practices, associated reasons, lifestyle advice and screening services received in four regional Victorian towns. Households were randomly selected and residents aged 16 + were eligible to participate. Results: Compared with utilisation of a single general practice, multiple general practice attendance in the past year (14.3%) was associated with younger age (adjusted odds ratio (aOR 95% confidence interval) 0.98 per year (0.97–0.99), residence in the regional centre aOR 2.90(2.22–3.78), emergency department (ED) attendance in the last 12 months aOR 1.65(1.22–2.21) and no out of pocket costs aOR 1.36(1.04–1.79)). Reasons for multiple general practice attendance included availability of appointments, cost and access to specific services. Compared with multiple general practice attendance, those attending single practices reported more screening tests but similar frequency of lifestyle advice. People who accessed multiple practices were less likely to report very high satisfaction (51.7% vs 62.9% p 0.001) or excellent degree of confidence in their doctor (42.0% vs 49.8% p = 0.006) than single practice attendees. Conclusions: Those attending single practices report higher satisfaction and confidence in their GP and were less likely to attend ED. Further studies are required to test whether increasing availability of appointments and reducing out-of-pocket expenses would increase single practice attendance and/or decrease healthcare costs overall.
Publisher: Wiley
Date: 10-2010
DOI: 10.1111/J.1440-1584.2010.01155.X
Abstract: Rural and remote health research has highlighted the many problems experienced in the bush. While attention to problems has raised awareness of the needs of rural and remote health, embedding a deficit perspective in research has stereotyped rural and remote health as poor environments to work in and as inherently problematic. The objectives of this paper are to challenge this thinking and suggest that a more balanced approach, acknowledging strengths, is beneficial. This discussion identifies why the deficit approach is problematic, proposes a strengths-based approach and identifies some key strengths of rural and remote health. This study suggests alternative ways of thinking about rural and remote practice, including the rewards of rural and remote practice, that rural and remote communities can act as change agents, that these disciplines actively address the social determinants of health, that rural and remote areas have many innovative primary health care services and activities and that rural and remote contexts provide opportunities for evaluation and research. It is proposed that rural and remote health can be viewed as problem-solving, thus dynamic and improving rather than as inherently problematic. Critical of a deficit approach to rural and remote health, this paper provides alternatives ways of thinking about these disciplines and recommends a problem-solving perspective of rural and remote health.
Publisher: Hindawi Limited
Date: 12-10-2021
DOI: 10.1111/HSC.13195
Publisher: Research Square Platform LLC
Date: 11-12-2020
DOI: 10.21203/RS.3.RS-38624/V4
Abstract: Background: Most Australians visit a General Practitioner annually and are free to choose their General Practitioner and/or practice on each occasion. A proportion of people visit multiple general practices, which can reduce continuity of care, a core value of general practice. Utilisation of multiple general practices is associated with metropolitan residence and younger age. However, it is unclear which factors are associated with utilisation of multiple general practices in rural areas, where there are often General Practitioner workforce shortages and higher proportions of patients who may benefit from continuity of care such as older people or those with chronic disease. The aim of this study was to compare the characteristics of people in a rural Australian area who accessed multiple general practices in the previous year. Methods: A cross-sectional survey assessed self-reported utilisation and perspective of general practice services, uses of multiple practices, associated reasons, lifestyle advice and screening services received in four regional Victorian towns. Households were randomly selected and residents aged 16+ were eligible to participate. Results: Compared with utilisation of a single general practice, multiple general practice attendance in the past year (14.3%) was associated with younger age (adjusted odds ratio (aOR 95% confidence interval) 0.98 per year (0.97-0.99), residence in the regional centre aOR 2.90(2.22-3.78), emergency department (ED) attendance in the last 12 months aOR 1.65(1.22-2.21) and no out of pocket costs aOR 1.36(1.04-1.79)). Reasons for multiple general practice attendance included availability of appointments, cost and access to specific services. Compared with multiple general practice attendance, those attending single practices reported more screening tests but similar frequency of lifestyle advice. People who accessed multiple practices were less likely to report very high satisfaction (51.7% vs 62.9% p .001) or excellent degree of confidence in their doctor (42.0% vs 49.8% p=0.006) than single practice attendees. Conclusions: Those attending single practices report higher satisfaction and confidence in their GP and were less likely to attend ED. Further studies are required to test whether increasing availability of appointments and reducing out-of-pocket expenses would increase single practice attendance and/or decrease healthcare costs overall.
Publisher: Research Square Platform LLC
Date: 29-10-2020
DOI: 10.21203/RS.3.RS-38624/V3
Abstract: Background: Most Australians visit a General Practitioner annually and are free to choose their General Practitioner and/or practice on each occasion. A proportion of people visit multiple general practices, which canaBackground:Most people in Australia visit a General Practitioner each year and are free to choose their General Practitioner and/or practice on each occasion. A proportion of people visit multiple general practices, which can reduce continuity of care, a core value of general practice. Utilisation of multiple general practices is associated with metropolitan residence and younger age. However, it is unclear which factors are associated with utilisation of multiple general practices in rural areas, where there are often General Practitioner workforce shortages and higher proportions of patients who may benefit from continuity of care, including older people and people living with chronic disease. The aim of this study was to compare the characteristics of people in a rural Australian area who accessed multiple general practices in the previous year with people who had accessed one practice, or none. Methods: A cross-sectional survey assessed self-reported utilisation and perspective of general practice services, uses of multiple practices, associated reasons, lifestyle advice and screening services received in four regional Victorian towns. Households were randomly selected and residents aged 16+ were eligible to participate in the adult survey. Results: Most people had attended a single general practice (78.9%), while 14.4% attended more than one practice and 6.7% attended no practices in the previous 12 months. Compared with utilisation of a single general practice, multiple general practice attendance in the previous year was associated with younger age (adjusted odds ratio (aOR 95% confidence interval) 0.98 per year (0.97-0.99), residence in the regional centre aOR 2.90(2.22-3.78), emergency department (ED) attendance in the last 12 months aOR 1.65(1.22-2.21) and no out of pocket costs aOR 1.36(1.04-1.79)). Reasons for multiple general practice attendance included availability of appointments, cost and access to specific services. Compared with multiple general practice attendance, those attending single practices reported more screening tests but similar frequency of lifestyle advice. People who accessed multiple practices were less likely to report very high satisfaction (51.7% vs 62.9% p .001) or excellent degree of confidence in their doctor (42.0% vs 49.8% p=0.006) than single practice attendees. Conclusions: Those attending single practices report higher satisfaction and confidence in their GP and were less likely to attend ED. Further studies are required to test whether increasing availability of appointments and reducing out-of-pocket expenses would increase single practice attendance and/or decrease healthcare costs overall. reduce continuity of care, a core value of general practice. Utilisation of multiple general practices is associated with metropolitan residence and younger age. However, it is unclear which factors are associated with utilisation of multiple general practices in rural areas, where there are often General Practitioner workforce shortages and higher proportions of patients who may benefit from continuity of care such as older people or those with chronic disease. The aim of this study was to compare the characteristics of people in a rural Australian area who accessed multiple general practices in the previous year. Methods A cross-sectional survey assessed self-reported utilisation and perspective of general practice services, uses of multiple practices, associated reasons, lifestyle advice and screening services received in four regional Victorian towns. Households were randomly selected and residents aged 16+ were eligible to participate. Results Compared with utilisation of a single general practice, multiple general practice attendance in the past year (14.3%) was associated with younger age (adjusted odds ratio (aOR 95% confidence interval) 0.98 per year (0.97-0.99), residence in the regional centre aOR 2.90(2.22-3.78), emergency department (ED) attendance in the last 12 months aOR 1.65(1.22-2.21) and no out of pocket costs aOR 1.36(1.04-1.79)). Reasons for multiple general practice attendance included availability of appointments, cost and access to specific services. Compared with multiple general practice attendance, those attending single practices reported more screening tests but similar frequency of lifestyle advice. People who accessed multiple practices were less likely to report very high satisfaction (51.7% vs 62.9% p .001) or excellent degree of confidence in their doctor (42.0% vs 49.8% p=0.006) than single practice attendees. Conclusions Those attending single practices report higher satisfaction and confidence in their GP and were less likely to attend ED. Further studies are required to test whether increasing availability of appointments and reducing out-of-pocket expenses would increase single practice attendance and/or decrease healthcare costs overall.
Publisher: Research Square Platform LLC
Date: 21-09-2020
DOI: 10.21203/RS.3.RS-38624/V2
Abstract: Background: Most people in Australia visit a General Practitioner each year and are free to choose their General Practitioner and/or practice on each occasion. A proportion of people visit multiple general practices, which can reduce continuity of care, a core value of general practice. Utilisation of multiple general practices is associated with metropolitan residence and younger age. However, it is unclear which factors are associated with utilisation of multiple general practices in rural areas, where there are often General Practitioner workforce shortages and higher proportions of patients who may benefit from continuity of care such as older people or those with chronic disease. The aim of this study was to compare the characteristics of people in a rural Australian area who accessed multiple general practices in the previous year with people who had accessed one practice or none.Methods: A cross-sectional survey assessed self-reported utilisation and perspective of general practice services, uses of multiple practices, associated reasons, lifestyle advice and screening services received in four regional Victorian towns. Households were randomly selected and residents aged 16+ were eligible to participate in the adult survey.Results: Most people had attended a single general practice (78.9%), while 14.4% attended more than one practice and 6.7% attended no practices in the previous 12 months. Compared with utilisation of a single general practice, multiple general practice attendance in the previous year was associated with younger age (adjusted odds ratio (aOR 95% confidence interval) 0.98 per year (0.97-0.99), residence in the regional centre aOR 2.90(2.22-3.78), emergency department (ED) attendance in the last 12 months aOR 1.65(1.22-2.21) and no out of pocket costs aOR 1.36(1.04-1.79)). Reasons for multiple general practice attendance were reported as availability of appointments, cost and access to specific services. Compared with multiple general practice attendance, those attending single practices reported more screening tests but similar frequency of lifestyle advice. People who accessed multiple practices were less likely to report very high satisfaction (51.7% vs 62.9% p .001) or excellent degree of confidence in their doctor (42.0% vs 49.8% p=0.006) than single practice attendees.Conclusions: Those attending single practices report higher satisfaction and confidence in their GP and were less likely to attend ED. Further studies are required to test whether increasing availability of appointments and reducing out-of-pocket expenses would increase single practice attendance and/or decrease healthcare costs overall.
Publisher: Wiley
Date: 26-01-2014
DOI: 10.1111/AJR.12078
Abstract: To propose a model of mentoring suitable for rural and remote health professionals. Given the rural and remote health workforce shortage, mentoring is proposed as a workforce retention strategy. Mentoring literature was reviewed aspects of mentoring highlighted in the literature were considered to ascertain their suitability for rural and remote health professionals. A total of 39 mentoring papers were reviewed to outline key factors in mentoring rural and remote health professionals. Using this literature, key ways that rural and remote practice enhance or are barriers to mentoring were identified. From this, a model for mentoring rural and remote health practitioners, students and academics was developed. Four models of mentoring were identified: the cloning, nurturing, friendship and apprenticeship models. The apprenticeship model was identified as suitable for students, the nurturing model as suited to new health professionals to rural and remote settings and the friendship model for senior practitioners/academics. Factors more likely to enable mentoring in rural and remote settings were identified as feelings of obligation by senior practitioners, strong relationships between staff, blurred work/social boundaries, lack of hierarchy, inter-professional practice and technology. The barriers identified included workloads, access to mentors, fee-for-service system for some practitioners, conflicts which could jeopardise working and business relationships, and feelings of being judged. A model of mentoring for rural and remote health professionals was presented. Given the potential to strengthen and increase the rural and remote health workforce, trialling such a model is worthwhile and evaluation would identify its impact.
Publisher: Wiley
Date: 26-01-2014
DOI: 10.1111/AJR.12077
Abstract: To examine the availability of and previous engagement with health services among rural young people and compare barriers and facilitators to using face-to-face and online sexual health testing and treatment. Participants were recruited for focus groups and were asked to discuss their access to local sexual health services (what services they used, when, why and how) and then shown a website and asked to provide feedback about online STI testing. Community sporting clubs in two small country towns in Victoria. Seven focus groups with fifty participants, grouped by gender and age, were conducted. Participants views of accessible and acceptable services for STI testing. Three main themes emerged from the analysis: (i) readiness to seek sexual health services (ii) barriers and facilitators to using the local general practitioner and (iii) barriers and facilitators to online testing, including 'using the mail during online STI testing' and 'cost of the online service'. In general, the participants described some concerns about accessing sexual health services locally. This was less discussion about availability of services and more about privacy, trust, reliability and using generalist health care providers for sexual health needs. Free online testing services address issues of access for rural young people. While barriers external to rural sexual health services may remain, free online STI testing services are acceptable to these rural young people.
Publisher: Elsevier BV
Date: 05-2009
DOI: 10.1016/J.NEDT.2008.09.002
Abstract: Career opportunities have been limited for enrolled nurses (ENs) working in small, rural health services. Medication endorsement offers ENs expanded scope of practice which may lead to improved job satisfaction. This small study compared job satisfaction between a group of ENs with recent medication endorsement and a group who elected not to undertake the course in a small, isolated health service. A questionnaire was designed to measure job satisfaction containing the measure of job satisfaction (MJS) scale and other information regarding the course in medication administration. Interviews were also conducted with medication endorsed nurses to gain a greater understanding about the course and their expanded scope of practice. Medication endorsed nurses were newer to nursing and their current job, and reported higher job satisfaction on all five factors. Non-medication endorsed nurses cited lack of confidence and ability as key reasons for not undertaking the course while medication endorsed nurses reported professional and personal reasons for expanding their scope of practice. Most enjoyed the responsibility and reported satisfaction from distributing medications and responding to pain while one viewed it as added work. The findings from this small study suggest that providing local education will improve job satisfaction of ENs.
Publisher: AMPCo
Date: 24-05-2021
DOI: 10.5694/MJA2.51096
Publisher: OMICS Publishing Group
Date: 2012
Publisher: JMIR Publications Inc.
Date: 03-10-2016
DOI: 10.2196/RESPROT.5831
Publisher: Wiley
Date: 10-2021
DOI: 10.1111/AJR.12805
Abstract: To describe the population distribution and socio‐economic position of residents across all states and territories of Australia, stratified using the 7 Modified Monash Model classifications. The numerical summary, and the methods described, can be applied by a variety of end users including workforce planners, researchers, policy‐makers and funding bodies for guiding future investment under different scenarios, and aid in evaluating geographically focused programs. The Commonwealth Department of Health is transitioning to the Modified Monash Model to objectively describe geographical access. This change applies to the Rural Health Multidisciplinary Training Program, one of the Australian Government's key policies to address the maldistribution of the rural health workforce. Unlike the previously applied Australian Statistical Geography Standard‐Remoteness Areas, a summary of the population in each Modified Monash Model classification is not available, nor is a socio‐economic overview of the communities within these areas. Spatial analysis of Australian Bureau of Statistics data (Modified Monash Model, population data and the Index of Relative Socio‐economic Advantage and Disadvantage collected or derived from the 2016 census) at the Statistical Area 1—the smallest unit for the release of census data. Linking the Modified Monash Model, a socio‐economic index and granular population data at the national level highlights the disadvantage of many residents in small rural towns (Modified Monash 5). The Modified Monash Model does not exhibit a continuum of the largest population residing in the most accessible classification and the smallest population residing in the least accessible classification that is seen in the Australian Statistical Geography Standard‐Remoteness Areas. Coupled with policy relevance, the advantage of using the Modified Monash Model as the basis for analysis is that it highlights areas that have both a critical mass of residents and differing levels of socio‐economic advantage and disadvantage. This will help end users to target funding to those regions where there is potential to improve access to services for the greatest number of rural residents.
Publisher: Wiley
Date: 23-03-2018
DOI: 10.1111/AJR.12409
Abstract: The sickest Australians are often those belonging to non-privileged groups, including Indigenous Australians, gay, lesbian, bisexual, transsexual, intersex and queer people, people from culturally and linguistically erse backgrounds, socioeconomically disadvantaged groups, and people with disabilities and low English literacy. These consumers are not always engaged by, or included within, mainstream health services, particularly in rural Australia where health services are limited in number and tend to be generalist in nature. The aim of this study was to present a new approach for improving the sociocultural inclusivity of mainstream, generalist, rural, health care organisations. This approach combines a modified Continuous Quality Improvement framework with Participatory Action Research principles and Foucault's concepts of power, discourse and resistance to develop a change process that deconstructs the power relations that currently exclude marginalised rural health consumers from mainstream health services. It sets up processes for continuous learning and consumer responsiveness. The approach proposed could provide a Continuous Quality Improvement process for creating more inclusive mainstream health institutions and fostering better engagement with many marginalised groups in rural communities to improve their access to health care. The approach to improving cultural inclusion in mainstream rural health services presented in this article builds on existing initiatives. This approach focuses on engaging on-the-ground staff in the need for change and preparing the service for genuine community consultation and responsive change. It is currently being trialled and evaluated.
Publisher: Springer Science and Business Media LLC
Date: 02-01-2021
DOI: 10.1186/S12875-020-01341-4
Abstract: Most people in Australia visit a General Practitioner each year and are free to choose their General Practitioner and/or practice on each occasion. A proportion of people visit multiple general practices, which can reduce continuity of care, a core value of general practice. Utilisation of multiple general practices is associated with metropolitan residence and younger age. However, it is unclear which factors are associated with utilisation of multiple general practices in rural areas, where there are often General Practitioner workforce shortages and higher proportions of patients who may benefit from continuity of care, including older people and people living with chronic disease. The aim of this study was to compare the characteristics of people in a rural Australian area who accessed multiple general practices in the previous year with people who had accessed one practice, or none. A cross-sectional survey assessed self-reported utilisation and perspective of general practice services, uses of multiple practices, associated reasons, lifestyle advice and screening services received in four regional Victorian towns. Households were randomly selected and residents aged 16+ were eligible to participate in the adult survey. Most people had attended a single general practice (78.9%), while 14.4% attended more than one practice and 6.7% attended no practices in the previous 12 months. Compared with utilisation of a single general practice, multiple general practice attendance in the previous year was associated with younger age (adjusted odds ratio (aOR 95% confidence interval) 0.98 per year (0.97–0.99), residence in the regional centre aOR 2.90(2.22–3.78), emergency department (ED) attendance in the last 12 months aOR 1.65(1.22–2.21) and no out of pocket costs aOR 1.36(1.04–1.79)). Reasons for multiple general practice attendance included availability of appointments, cost and access to specific services. Compared with multiple general practice attendance, those attending single practices reported more screening tests but similar frequency of lifestyle advice. People who accessed multiple practices were less likely to report very high satisfaction (51.7% vs 62.9% p 0.001) or excellent degree of confidence in their doctor (42.0% vs 49.8% p = 0.006) than single practice attendees. Those attending single practices report higher satisfaction and confidence in their GP and were less likely to attend ED. Further studies are required to test whether increasing availability of appointments and reducing out-of-pocket expenses would increase single practice attendance and/or decrease healthcare costs overall.
Publisher: Springer International Publishing
Date: 2022
Publisher: Wiley
Date: 24-03-2010
DOI: 10.1111/J.1440-1584.2010.01125.X
Abstract: This paper argues that rural and remote health is in need of theoretical development. Based on the authors' discussions, reflections and critical analyses of literature, this paper proposes key reasons why rural and remote health warrants the development of theoretical frameworks. The paper cites five reasons why theory is needed: (i) theory provides an approach for how a topic is studied (ii) theory articulates key assumptions in knowledge development (iii) theory systematises knowledge, enabling it to be transferable (iv) theory provides predictability and (v) theory enables comprehensive understanding. This paper concludes with a call for theoretical development in both rural and remote health to expand its knowledge and be more relevant to improving health care for rural Australians.
Publisher: Informa UK Limited
Date: 09-1995
Publisher: Wiley
Date: 12-08-2023
DOI: 10.1111/JGH.16314
Abstract: Non‐alcoholic fatty liver disease (NAFLD) is the most prevalent liver condition globally. The aim of this study was to evaluate the change in age‐ and sex‐standardized prevalence of NAFLD in regional Victoria over a 15‐year period and explore the underlying factors associated with differences over time. Repeated comparative cross‐sectional studies in four towns in regional Victoria, Australia. In iduals randomly selected from households from residential address lists from local government organizations in 2001–2003 (CrossRoads I [CR1]) and 2016–2018 (CrossRoads II [CR2]) with 1040 (99%) and 704 (94%) participants from CR1 and CR2 having complete data for analysis. Primary outcome was change in prevalence estimates of NAFLD (defined by a fatty liver index ≥ 60 in the absence of excess alcohol and viral hepatitis) between 2003 and 2018. Crude prevalence of NAFLD increased from 32.7% to 38.8% ( P 0.01), while age‐standardized/sex‐standardized prevalence increased from 32.4% to 35.4% ( P 0.01). Concurrently, prevalence of obesity defined by BMI and elevated waist circumference increased 28% and 25%, respectively. Women had a greater increase in the prevalence of NAFLD than men, in parallel with increasing prevalence of obesity. Proportion of participants consuming takeaway food greater than once weekly increased significantly over time. Up to 60% of NAFLD patients require additional tests for assessment of significant fibrosis. Crude and age‐standardized/sex‐standardized prevalence of NAFLD have both increased significantly over the last 15 years, particularly among women, in association with a parallel rise in the prevalence of obesity.
Publisher: School of Human Services and Social Work, Griffith University
Date: 31-08-2018
DOI: 10.36251/JOSI129
Abstract: Australia’s mainstream health services located in rural contexts are mandated to provide health care to the entire local population. However, complex power relations embedded and reflected within the cultures of mainstream generalist health services are excluding the most marginalised residents from health care. This paper argues that unless inclusion in rural, generalist mainstream health services is improved, the health experiences of these residents will not substantially change and Australia will continue to report significant health differentials within its population. The concept of culturally inclusive health care is difficult for Australian mainstream generalist health practitioners to engage with because there is limited understanding of what culture is and how it operates within erse communities. This makes it challenging for many in mainstream health institutions to begin deconstructing how it is that exclusion occurs. Frequently, ‘culture’ is assigned to ‘Others’, and there is little recognition that all people, including White, mainstream Australians, are cultural beings, and that health disciplines, services and systems have particular cultures that make assumptions about how to be in the world. Consequently, current approaches to the provision of culturally inclusive health care are not shifting the power relations that (re)produce exclusion. In this paper, we outline a new interdisciplinary methodology that operationalises Foucault’s concepts of power, resistance and discourse within a Participatory Action Research (PAR) design and utilises Continuous Quality Improvement (CQI) processes to respond to these power relations and provide health institutions with a process to improve their inclusivity, specifically for Australia’s most marginalised residents. It is suggested that employing this new methodology will promote a different way of thinking and acting in health institutions, producing a deconstructed process for health services to adapt to improve their inclusivity.
Publisher: SAGE Publications
Date: 06-2023
DOI: 10.1177/08982643231180045
Abstract: Objectives: To determine the prevalence of frailty among community-dwelling older adults in regional Victoria, Australia. Methods: Frailty status of 376 participants from the Crossroads II cross-sectional study was assessed by selected markers of frailty. The selected variables were psychometrically tested. Associations between frailty and socio-demographic, environmental and health factors were analysed using chi-square, ANOVA and binary logistic regression (BLR). Results: Estimated prevalence of frailty was 39.4%. BLR indicated that frailty decreased with higher educational attainment, (OR = .23 95% CI: .10–.51) increased for orced/separated participants (OR = 2.68 95% CI: 1.29–5.56) and when having three (OR = 3.27 95% CI: 1.07–9.98), four (OR = 7.20 95% CI: 2.22–23.31) or five or more chronic conditions (OR = 9.18 95% CI: 2.83–29.72). Discussion: Frailty in this Australian regional community-dwelling s le was higher than other studies conducted in urban areas of Australia. Present results highlight the importance of exploring the multidimensionality of the frailty construct to have a better understanding which factors are associated with the development of this syndrome.
Publisher: Springer Science and Business Media LLC
Date: 12-2019
DOI: 10.1186/S12960-019-0432-Y
Abstract: Residents of remote communities in Australia and other geographically large countries have comparatively poorer access to high-quality primary health care. To inform ongoing policy development and practice in relation to remote area health service delivery, particularly in remote Indigenous communities, this review synthesizes the key findings of (1) a comprehensive study of workforce turnover and retention in remote Northern Territory (NT) of Australia and (2) a narrative review of relevant international literature on remote and rural health workforce retention strategies. This synthesis provides a valuable summary of the current state of international knowledge about improving remote health workforce retention. Annual turnover rates of NT remote area nurses (148%) and Aboriginal health practitioners (80%) are very high and 12-month stability rates low (48% and 76%, respectively). In remote NT, use of agency nurses has increased substantially. Primary care costs are high and proportional to staff turnover and remoteness. Effectiveness of care decreases with higher turnover and use of short-term staff, such that higher staff turnover is always less cost-effective. If staff turnover in remote clinics were halved, the potential savings would be approximately A$32 million per annum. Staff turnover and retention were affected by management style and effectiveness, and employment of Indigenous staff. Review of the international literature reveals three broad themes: Targeted enrolment into training and appropriate education designed to produce a competent, accessible, acceptable and ‘fit-for-purpose’ workforce addressing broader health system issues that ensure a safe and supportive work environment and providing ongoing in idual and family support . Key educational initiatives include prioritising remote origin and Indigenous students for university entry maximising training in remote areas contextualising curricula providing financial, pedagogical and pastoral support and ensuring clear, supported career pathways and continuing professional development. Health system initiatives include ensuring adequate funding providing adequate infrastructure including fit-for-purpose clinics, housing, transport and information technology offering flexible employment arrangements whilst ensuring a good ‘fit’ between in idual staff and the community (especially with regard to cultural skills) optimising co-ordination and management of services that empower staff and create positive practice environments and prioritising community participation and employment of locals. In idual and family supports include offering tailored financial incentives, psychological support and ‘time out’. Optimal remote health workforce stability and preventing excessive ‘avoidable’ turnover mandates alignment of government and health authority policies with both health service requirements and in idual health professional and community needs. Supportive underpinning policies include: Strong intersectoral collaboration between the health and education sectors to ensure a fit-for-purpose workforce A funding policy which mandates the development and implementation of an equitable, needs-based formula for funding remote health services Policies that facilitate transition to community control, prioritise Indigenous training and employment, and mandate a culturally safe work context and An employment policy which provides flexibility of employment conditions in order to be able to offer in idually customised retention packages There is considerable extant evidence from around the world about effective retention strategies that contribute to slowing excessive remote health workforce turnover, resulting in significant cost savings and improved continuity of care. The immediate problem comprises an ‘implementation gap’ in translating empirical research evidence into actions designed to resolve existing problems. If we wish to ameliorate the very high turnover of staff in remote areas, in order to provide an equitable service to populations with arguably the highest health needs, we need political and executive commitment to get the policy settings right and ensure the coordinated implementation of multiple strategies, including better linking existing strategies and ‘filling the gaps’ where necessary.
Publisher: BMJ
Date: 08-2021
DOI: 10.1136/BMJOPEN-2020-043902
Abstract: Access to high-quality primary healthcare is limited for remote residents in Australia. Increasingly, remote health services are reliant on short-term or ‘fly-in, fly-out/drive-in, drive-out’ health workforce to deliver primary healthcare. A key strategy to achieving health service access equity, particularly evident in remote Australia, has been the development of Aboriginal Community Controlled Health Services (ACCHSs). This study aims to generate new knowledge about (1) the impact of short-term staffing in remote and rural ACCHSs on Aboriginal and Torres Strait Islander communities (2) the potential mitigating effect of community control and (3) effective, context-specific evidence-based retention strategies. This paper describes a 3-year, mixed methods study involving 12 ACCHSs across three states. The methods are situated within an evidence-based programme logic framework for rural and remote primary healthcare services. Quantitative data will be used to describe staffing stability and turnover, with multiple regression analyses to determine associations between independent variables (population size, geographical remoteness, resident staff turnover and socioeconomic status) and dependent variables related to patient care, service cost, quality and effectiveness. Qualitative assessment will include interviews and focus groups with clinical staff, clinic users, regionally-based retrieval staff and representatives of jurisdictional peak bodies for the ACCHS sector, to understand the impact of short-term staff on quality and continuity of patient care, as well as satisfaction and acceptability of services. The study has ethics approval from the Human Research Ethics Committee of the Northern Territory Department of Health and Menzies School of Health Research (project number DR03171), Central Australian Human Research Ethics Committee (CA-19-3493), Western Australian Aboriginal Health Ethics Committee (WAAHEC-938) and Far North Queensland Human Research Ethics Committee (HREC/2019/QCH/56393). Results will be disseminated through peer-reviewed journals, the project steering committee and community/stakeholder engagement activities to be determined by each ACCHS.
Publisher: Wiley
Date: 25-03-2009
DOI: 10.1111/J.1440-1584.2008.01022.X
Abstract: To analyse self-reported health behaviours of young people from a rural community and the factors influencing their behaviours. Interviews were conducted with 19 young people, 11 parents and 10 key informants from a small rural Victorian community, asking about teenage health behaviours and the factors influencing these behaviours. Young people ate both healthy and unhealthy foods, most participated in physical activity, few smoked and most drank alcohol. The study found that community level factors, including community norms, peers, access issues and geographic isolation, were particularly powerful in shaping health behaviours, especially alcohol consumption. Smoking was influenced by social participation in the community and national media health c aigns. Diet and exercise behaviour were influenced by access and availability, convenience, family, peers and local and non-local cultural influences. The rural context, including less access to and choice of facilities and services, lower incomes, lack of transport and local social patterns (including community norms and acceptance), impact significantly on young people's health behaviours. Although national health promotion c aigns are useful aspects of behaviour modification, much greater focus on the role and importance of the local contexts in shaping health decisions of young rural people is required.
Publisher: Informa UK Limited
Date: 08-2008
Publisher: CSIRO Publishing
Date: 05-06-2020
DOI: 10.1071/AH19189
Abstract: Objective The aim of this study was to understand, from the perspective of policy makers, who holds the responsibility for driving evidence-based policy to reduce the high burden of cardiovascular disease (CVD) in rural Australia. Methods Qualitative interviews were conducted with policy makers at the local, state and federal government levels in Australia (n = 21). Analysis was conducted using the Conceptual Framework for Understanding Rural and Remote Health to understand perceptions of policy makers around who holds the key responsibility in driving evidence-based policy. Results At all levels of government, there were multiple ex les of disconnect in the understanding of who is responsible for driving the generation of evidence-based policy to reduce CVD in rural areas. Policy makers suggested that the rural communities themselves, health services, health professionals, researchers and the health sector as a whole hold large responsibilities in driving evidence-based policy to address CVD in rural areas. Within government, there was also a noticeable disconnect, with local participants feeling it was the federal government that held this responsibility however, federal government participants suggested this was largely a local government issue. Overall, there seemed to be a lack of responsibility for CVD policy, which is reflected in a lack of action in rural areas. Conclusion There was a lack of clarity about who is responsible for driving evidence-based policy generation to address the high burden of CVD in Australia, providing one possible explanation for the lack of policy action. Clarity among policy makers over shared roles and leadership for policy making must be addressed to overcome the current burden of CVD in rural communities. What is known about the topic? Rural health inequalities, such as the increased burden of CVD in rural Australia are persistent. Such health inequalities are unjust, with global theory suggesting political processes have facilitated, in part, the inequalities. With similar ex les observed internationally in rural areas, little is known about the influence of the perspectives of policy makers regarding who is responsible for addressing health issues in rural areas, in the government context. What does this paper add? This paper provides empirical evidence, for all levels of government in Australia, that there is a lack of clarity in policy roles and responsibilities to address the unequal burden of CVD in rural Australia, at all levels of government. The paper provides evidence to support the urgent need for clarity within government around policy stakeholder roles. Without such clarity, it is unlikely that national-level progress in addressing rural health inequalities will be achieved in the near future. What are the implications for practitioners? Addressing ambiguity around who is responsible for the development of evidence-based policy to address the high burden of CVD in rural areas must be a high priority to ensure health disparities do not persist for future Australian generations. The results reported here are highly relevant to the Australian context, but also reflect similar findings internationally, namely that a lack of clarity among policy stakeholders appears to contribute to reduced action in addressing preventable health inequalities in disadvantaged populations. This paper provides evidence for policy makers and public health professionals to advocate for clear policy roles and direction in rural Australia.
Publisher: AMPCo
Date: 05-2002
DOI: 10.5694/J.1326-5377.2002.TB04520.X
Abstract: The Department of Rural Health, University of Melbourne, has developed a framework for conducting research in partnership with Indigenous communities. The framework addresses past inappropriate research practices, incorporates cultural understandings, and outlines culturally appropriate protocols. The four parts of the framework are a committee to initiate, direct and oversee all research projects a Koorie Team to guide research a set of research guidelines and a policy for the department. The framework has been used to develop strong relations with Koorie communities and conduct various health projects.
Publisher: Wiley
Date: 19-08-2017
DOI: 10.1002/AJS4.16
Publisher: Elsevier BV
Date: 11-2016
DOI: 10.1016/J.PUHE.2007.02.024
Abstract: The main challenges today are complex systems problems, with equally complex solutions there are problems that have the potential to affect all in iduals at different levels, affecting health, the sustainability of health services, and potentially the long-term economic prosperity of the country. The evidence shows that unless people themselves are engaged, releasing their potential for action, supporting a cultural shift towards a health promoting society, it is unlikely that the necessary sustainable impact on obesity, diabetes and other chronic diseases will be achieved. By reflecting on experience in England, this article will provide an insight into the potential for change that can be generated by rebalancing the relationship between the state, the in idual and civil society.
Publisher: Wiley
Date: 07-2014
DOI: 10.5694/MJA13.11329
Abstract: To determine whether a short-term placement of metropolitan medical students in a rural environment can improve their knowledge of, and change their attitudes to, rural health issues. Medical students taking part in the March and May 2013 3-week Rural Health Modules (RHMs) were invited to participate in focus groups and complete questionnaires before undertaking the RHM, after a 2-day rural orientation and at the end of the RHM. Students were asked to comment on a range of issues affecting rural health care including their attitude to pursuing a rural career. Focus group transcripts were thematically analysed and questionnaire data were statistically analysed. The RHM is a 3-week program designed and run by the University of Melbourne's Rural Health Academic Centre. Responses to questionnaire items from before and after completing the RHM, scored on a seven-point Likert scale. 69 of the 101 RHM students took part in this study. The focus groups identified five main themes in rural health care: access teamwork, models of care and generalist practice overlapping relationships indigenous health and working in a rural career. In all five areas, a change was seen in the depth of knowledge students had about these issues and in the students' attitudes towards rural health care. The questionnaires also showed a significant shift in the students' appreciation of, and positivity towards, rural health issues. Undertaking a 3-week RHM changed students' perceptions of rural health and significantly improved their knowledge of issues facing rural health practitioners and patients.
Publisher: Elsevier BV
Date: 04-2019
Publisher: Informa UK Limited
Date: 12-2010
DOI: 10.5172/RSJ.20.1.2
Publisher: CSIRO Publishing
Date: 2002
DOI: 10.1071/PY02006
Abstract: Consumer involvement is at the heart of improving health care, but involving consumers is difficult. This paper documents a process of developing a consumer reference group in northern Victoria to assist in developing a proposal for a coordinated care trial. The Goulburn Valley Consumer Reference Group was developed, maintained and able to meet its objective of developing a model of coordinated care. The group developed good relationships, which fostered commitment, open discussion and debate, and input from all group members. The group identified key issues in rural and regional health care, including access, information, staff shortages, cost, communication and coordination. Although the group is not 'representative', it includes the perspectives of some who do not typically have high rates of participation in health. The success of and problems raised by this process can be used to inform models of consumer participation in health.
Publisher: CSIRO Publishing
Date: 2004
DOI: 10.1071/PY04027
Abstract: One in 12 Australian women will experience breast cancer. While the focus on physical and clinical issues has improved clinical care, less attention has been given to the psychosocial issues associated with a breast cancer diagnosis. The experience of breast cancer is emotional as much as it is a physical illness. This paper is one effort to address the dearth of literature analysing the psychosocial impacts of breast cancer. Questionnaires were distributed by health professionals to women in the Hume Health region in northern Victoria who had been treated for breast cancer between 1996 and 2001. A total of 219 were returned (an estimated third of this population). Women were generally happy with clinical services but indicated that emotional issues were at the fore, and more psychosocial support services are needed in this region. Further, women identified that the social and psychological issues resulting from a breast cancer diagnosis are life-changing and long-term, and that this is not well understood by health care providers or local communities.
Publisher: Wiley
Date: 04-11-2022
DOI: 10.1111/JGH.15723
Abstract: Clinical and public health implications of the recent redefining of non-alcoholic fatty liver disease (NAFLD) to metabolic-associated fatty liver disease (MAFLD) remain unclear. We sought to determine the prevalence and compare MAFLD with NAFLD in a well-defined cohort. A cross-sectional study was conducted in regional Victoria with participants from randomly selected households. Demographic and health-related clinical and laboratory data were obtained. Fatty liver was defined as a fatty liver index ≥ 60 with MAFLD defined according to recent international expert consensus. A total of 722 participants were included. Mean age was 59.3 ± 16 years, and 55.3% were women with a median body mass index of 27.8 kg/m Metabolic-associated fatty liver disease is a highly prevalent condition within this large community cohort. Application of the MAFLD definition increased prevalence of fatty liver disease by including people with dual etiologies of liver disease.
Publisher: Elsevier BV
Date: 2012
Publisher: Wiley
Date: 30-11-2010
Publisher: Springer Science and Business Media LLC
Date: 20-06-2023
DOI: 10.1186/S12888-023-04931-5
Abstract: Research suggests that rates of mental illness are similar in rural and urban Australia, although there are significant workforce shortages in rural regions along with higher rates of chronic disease and obesity and lower levels of socioeconomic status. However, there are variations across rural Australia and limited local data on mental health prevalence, risk, service use and protective factors. This study describes the prevalence of self-reported mental health problems of psychological distress and depression, in a rural region in Australia and aims to identify the factors associated with these problems. The Crossroads II study was a large-scale cross-sectional study undertaken in the Goulburn Valley region of Victoria, Australia in 2016–18. Data were collected from randomly selected households across four rural and regional towns and then screening clinics from in iduals from these households. The main outcome measures were self-reported mental health problems of psychological distress assessed by the Kessler 10 and depression assessed by Patient Health Questionnaire-9. Unadjusted odd ratios and 95% confidence intervals of factors associated with the two mental health problems were calculated using simple logistic regression with multiple logistic regression using hierarchical modelling to adjust for the potential confounders. Of the 741 adult participants (55.6% females), 67.4% were aged ≥ 55 years. Based on the questionnaires, 16.2% and 13.6% had threshold-level psychological distress and depression, respectively. Of those with threshold-level K-10 scores, 19.0% and 10.5% had seen a psychologist or a psychiatrist respectively while 24.2% and 9.5% of those experiencing depression had seen a psychologist or a psychiatrist, respectively in the past year. Factors such as being unmarried, current smoker, obesity, were significantly associated with a higher prevalence of mental health problems whereas physical activity, and community participation reduced the risk of mental health problems. Compared to rural towns, the regional town had higher risk of depression which was non-significant after adjusting for community participation and health conditions. The high prevalence of psychological distress and depression in this rural population was consistent with other rural studies. Personal and lifestyle factors were more relevant to mental health problems than degree of rurality in Victoria. Targeted lifestyle interventions could assist in reducing mental illness risk and preventing further distress.
Publisher: Wiley
Date: 03-2020
DOI: 10.1002/AJS4.107
Publisher: Informa UK Limited
Date: 22-01-2017
Publisher: Springer Science and Business Media LLC
Date: 21-07-2006
Publisher: School of Human Services and Social Work, Griffith University
Date: 31-08-2018
DOI: 10.36251/JOSI.129
Start Date: 2017
End Date: 06-2021
Amount: $765,500.00
Funder: Australian Research Council
View Funded ActivityStart Date: 08-2019
End Date: 12-2023
Amount: $796,931.00
Funder: Australian Research Council
View Funded ActivityStart Date: 06-2017
End Date: 11-2020
Amount: $298,500.00
Funder: Australian Research Council
View Funded ActivityStart Date: 07-2007
End Date: 12-2009
Amount: $170,000.00
Funder: Australian Research Council
View Funded ActivityStart Date: 05-2009
End Date: 07-2011
Amount: $89,000.00
Funder: Australian Research Council
View Funded ActivityStart Date: 2004
End Date: 12-2004
Amount: $30,000.00
Funder: Australian Research Council
View Funded ActivityStart Date: 2005
End Date: 12-2010
Amount: $1,500,000.00
Funder: Australian Research Council
View Funded ActivityStart Date: 01-2004
End Date: 12-2004
Amount: $10,000.00
Funder: Australian Research Council
View Funded Activity