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Objective To describe the rehabilitation services available for people with stroke and hip fracture across New South Wales/Australian Capital Territory metropolitan and rural/regional public hospitals in Australia. Design A cross-...
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Objective To describe the rehabilitation services available for people with stroke and hip fracture across New South Wales/Australian Capital Territory metropolitan and rural/regional public hospitals in Australia. Design A cross-sectional study design was used. Setting New South Wales/Australian Capital Territory public hospital providing rehabilitation services for stroke and hip fracture. Participants Delegates from 59 eligible hospitals. Intervention Information about the type, number and availability of inpatient and outpatient rehabilitation services at each hospital was collected via survey. Main outcome measures Counts, percentages, mean (SD), median (IQR) were used to quantify the number and type of inpatient and outpatient services available. Results Across inpatient rehabilitation units, reduced availability was noted in the number of clinical disciplines available, availability of neuropsychology and social work in rural units. Across outpatient rehabilitation services, reduced availability was noted in the number of disciplines available, availability of occupational therapy, psychology, rehabilitation physicians, specialist nursing, geriatricians, and podiatry in rural services. Five rural hospitals had no access to outpatient rehabilitation. Conclusion There was reduced availability of rehabilitation services and health disciplines in rural/regional settings. A follow-up study is underway investigating relationships between reduced outpatient service availability and inpatient length of stay in rural/regional versus metropolitan hospitals.
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Rural mental health outcomes have been persistently poorer than those in larger cities suggesting that the prevailing investments to improve matters are not working. Mental health researchers and service providers from New South W...
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Rural mental health outcomes have been persistently poorer than those in larger cities suggesting that the prevailing investments to improve matters are not working. Mental health researchers and service providers from New South Wales, Victoria, Western Australia and the Australian Capital Territory met in Orange in October 2018 to explore issues pertaining to rural mental health and well-being. The group recognised and acknowledged that rural residents experience a series of interconnected geographical, demographic, social, economic and environmental challenges which are not addressed adequately by the current mix of services. This declaration has been endorsed by those listed below and we welcome further support. We list ten interrelated problems and ten solutions. As a group, we take this declaration as an opportunity to invite discussion about how we can collectively improve the mental health of rural residents through research, service design and delivery. We invite the reader to consider endorsing this declaration. A short summary of supporting evidence is available online at .
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Objective Geographic mal-distribution towards urban over rural medical practice exists worldwide. The James Cook University medical school has focused its selection and curriculum on selecting and training students to address medi...
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Objective Geographic mal-distribution towards urban over rural medical practice exists worldwide. The James Cook University medical school has focused its selection and curriculum on selecting and training students to address medical workforce needs for local regional, rural and remote areas. This study investigates final-year James Cook University medical students' intended rural practice modality and association with rurality of upbringing. Design, setting & participants Cross-sectional survey of final-year James Cook University medical students in 2018 (n = 147; response rate = 76%). Main outcome measure Association between students' rurality of hometown at entry to medical school and self-reported intentions for rural practice. Results Overall, final-year students' preferred rural practice modality was "for a specific number of years" (38, 25%), followed by "periodic short-term locum" (33, 23%), "permanently based" (26, 18%), "orbiting" (21, 14%), "none" (14, 10%), "long-term shared position" (9, 6%) and "specialist outreach clinics" (6, 4%). Urban hometown at entry to medical school was associated with students preferring periodic rural practice, with rural-origin students contrastingly preferring more permanent rural practice. Conclusion Only 10% of James Cook University medical students did not want a rural career in any form, suggesting the majority, regardless of urban or rural hometown, are open to some type of rural practice. Urban-origin medical students around Australia might be a significant, untapped resource for periodic and more permanent rural practice if they can be provided with extended, immersive rural placements experiences. Government funding models should provide increased funding for immersive rural placements, and promotion of orbiting and longer-term job share practice modalities.
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ObjectiveTo examine how the rates of the use of particular face-to-face primary mental health care services changed in the first 4 years (2006-2010) of the Better Access initiative in both urban and rural regions of South Australia.
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Objective: To describe the use of telemedicine in cancer care (teleoncology model of care) for rural patients in North Queensland. Design: This is a descriptive study. Data on demographical and clinical factors were retrieved from...
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Objective: To describe the use of telemedicine in cancer care (teleoncology model of care) for rural patients in North Queensland. Design: This is a descriptive study. Data on demographical and clinical factors were retrieved from the teleoncology database of Townsville Hospital and review of medical records for the period between May 2007 and May 2011. Setting and Participants: The medical oncologists at the Townsville Cancer Centre, a regional cancer centre in North Queensland, have been providing their services to rural hospitals in Townsville and Mt Isa districts via videoconferencing since 2007. Intervention: Cancer care delivery to rural sites via Townsville teleoncology model. Main Outcome Measures: The ability of the teleoncology model to provide the following services to rural towns: (i) specialist consultations; (ii) urgent specialist medical care; (iii) care for Indigenous patients; and (iv) remote supervision of chemotherapy administration. Results: Between May 2007 and May 2011, 158 patients from 18 rural towns received a total of 745 consultations. Ten of these patients were consulted urgently and treatment plans initiated locally, avoiding interhospital transfers. Eighteen Indigenous patients received consultative services, being accompanied by more than four to six family members. Eighty-three patients received a range of intravenous and oral chemotherapy regimens in Mt Isa and oral agents in other towns through remote supervision by medical oncologists from Townsville. Conclusion: Teleoncology model of care allows rural and Indigenous cancer patients to receive specialist consultations and chemotherapy treatments closer to home, thus minimising the access difficulties faced by the rural sector.
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ObjectiveIntegration of mental health services is a prominent Australian mental health policy goal; however, there is little detail in the literature of how integrated mental health services are established or function. This study...
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ObjectiveIntegration of mental health services is a prominent Australian mental health policy goal; however, there is little detail in the literature of how integrated mental health services are established or function. This study aimed to describe a nurse practitioner-led primary healthcare rural mental health service and evidence of how the service was integrated with other services and the community.
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A prospective study investigated the psychological wellbeing and quality of life of older rural men after a community-based screening for abdominal aortic aneurysm (AAA). Five hundred and sixteen men aged 65-74 years attended the ...
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A prospective study investigated the psychological wellbeing and quality of life of older rural men after a community-based screening for abdominal aortic aneurysm (AAA). Five hundred and sixteen men aged 65-74 years attended the screening program; 53 had an abnormal aorta detected. These and a subsample of men with a normal aorta were followed up 6 months post-screening. All men completed a pre-screening questionnaire including the Medical Outcomes Short Form 36v 2 (MOSF36) and Hospital Anxiety and Depression Scale (HADS). Six months after screening all 53 men with an abnormal and 130 with a normal aorta were sent a questionnaire including MOSF36 and HADS. Baseline and 6 month scores for both MOSF36 and HADS scores were compared between the two groups and within each group. Baseline scores for both MOSF36 and HADS were not significantly different between men who were subsequently diagnosed with an abnormal aorta and those with a normal aorta. After 6 months there was no difference in HADS scores but a significant increase in the MOSF36 dimension of general health. Those with a normal aorta reported better general health, social functioning andgreater freedom from bodily pain. AAA screening appears highly acceptable to men in the target age group and future research should focus on implementation, cost effectiveness and collateral benefits of AAA screening.
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Abstract Paramedic services in Australia and New Zealand (Australasia) share many characteristics, with both offering versions of the Anglo‐American system of emergency medical response. Their industry and professional bodies are...
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Abstract Paramedic services in Australia and New Zealand (Australasia) share many characteristics, with both offering versions of the Anglo‐American system of emergency medical response. Their industry and professional bodies are transnational and as a result have similar industry standards and professional expectations. The major difference been the two countries is their sources of funding, with Australian paramedic services generally receiving more government funding than those in New Zealand. Both countries provide a range of services that use a mix of volunteer and professional staff and employ state‐of‐the‐art communications and medical technology to provide high‐level clinical services. In common with other higher income countries, they face the challenge of rising usage associated with ageing populations. Both countries are adapting to this through broadening their response models, from a focus on emergency medical response to the provision of a mobile health service that will see the emergence of more practitioners paramedic roles. These emerging models challenge the core missions of paramedic services, as well as the professional identity of paramedics. Despite these trends towards higher level and well‐integrated paramedic services in Australia and New Zealand, communities and many other health professionals have limited knowledge or understanding of how paramedic services are organised, the characteristics of paramedics and allied staff and limited appreciation of their potential to make greater contributions to the health and well‐being of communities. This article provides an introduction to how paramedics, as members of multidisciplinary teams, are well placed to contribute to improvements in health outcomes.
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Aim: The aim of this study is to explore pharmacist perspectives of the implementation of a community pharmacy-based ear health service in rural communities. Method: A community pharmacy-based health service model was designed and...
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Aim: The aim of this study is to explore pharmacist perspectives of the implementation of a community pharmacy-based ear health service in rural communities. Method: A community pharmacy-based health service model was designed and developed to provide an accessible ear care service (LISTEN UP—Locally Integrated Screening and Testing Ear aNd aUral Program) and pharmacist’s perspectives of the implementation of LISTEN UP were explored. Thematic analysis was conducted and data coded according to the Consolidated Framework for Implementation Research. Results: A total of 20 interviews were conducted with 10 pharmacists, averaging 30 min. Visualistion of the ear canal was reported as the greatest advantage of the service, whilst the time required for documentation reported as a complexity. The number of pharmacists working at one time and the availability of a private consultation room were identified as the two limiting factors for execution. On reflection, the need for government funding for service viability and sustainability was highlighted. Discussion/Conclusion: Expanded pharmacy practice is emerging for the Australian pharmacy profession. Rural community pharmacists are recognised as integral members of healthcare teams, providing accessible medication supply and health advice to seven million people in Australia who call rural and remote regions home. However, there are no structured models supporting them to provide expanded services to improve health outcomes in their communities. This study provides lessons learnt to guide future design and development of expanded models of pharmacy practice.
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