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McLachlan F. The Rurality of Intimate Partner Femicide: Examining Risk Factors in Queensland. Violence Against Women 2024; 30:1683-1707. [PMID: 36815208 PMCID: PMC10998431 DOI: 10.1177/10778012231158105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
While violence against women and domestic violence can be seen throughout Australia, emerging evidence suggests that intimate partner femicide (IPF) is more common in rural spaces than urban ones. This study examined 100 IPF cases to determine the rate of femicide and frequency of common risk factors in rural areas of Queensland, Australia. The study also explored how victims accessed services and the characteristics of rural IPF and male offenders. Findings indicated that IPF is more common in rural areas and associated risk factors are similar between urban and rural cases. Rural IPF was more likely to occur during a current relationship and offenders were found to be less likely to conceal their actions. These differences suggest that the physical and social isolation of rural spaces may facilitate higher rates IPF. Implications discuss the need for rural-focused policies and responses.
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Affiliation(s)
- Freya McLachlan
- Queensland University of Technology, Brisbane, Queensland, Australia
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2
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Areed WD, Price A, Thompson H, Malseed R, Mengersen K. Spatial non-parametric Bayesian clustered coefficients. Sci Rep 2024; 14:9677. [PMID: 38678077 DOI: 10.1038/s41598-024-59973-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 04/17/2024] [Indexed: 04/29/2024] Open
Abstract
In the field of population health research, understanding the similarities between geographical areas and quantifying their shared effects on health outcomes is crucial. In this paper, we synthesise a number of existing methods to create a new approach that specifically addresses this goal. The approach is called a Bayesian spatial Dirichlet process clustered heterogeneous regression model. This non-parametric framework allows for inference on the number of clusters and the clustering configurations, while simultaneously estimating the parameters for each cluster. We demonstrate the efficacy of the proposed algorithm using simulated data and further apply it to analyse influential factors affecting children's health development domains in Queensland. The study provides valuable insights into the contributions of regional similarities in education and demographics to health outcomes, aiding targeted interventions and policy design.
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Affiliation(s)
- Wala Draidi Areed
- School of Mathematical Science, Centre for Data Science, Queensland University of Technology, Brisbane, QLD, Australia.
| | - Aiden Price
- School of Mathematical Science, Centre for Data Science, Queensland University of Technology, Brisbane, QLD, Australia
| | - Helen Thompson
- School of Mathematical Science, Centre for Data Science, Queensland University of Technology, Brisbane, QLD, Australia
| | - Reid Malseed
- Children's Health Queensland, Brisbane, QLD, Australia
| | - Kerrie Mengersen
- School of Mathematical Science, Centre for Data Science, Queensland University of Technology, Brisbane, QLD, Australia
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3
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Huang A, Cooke SM, Garsden C, Behne C, Borkoles E. Transitioning to sustainable, climate-resilient healthcare: insights from a health service staff survey in Australia. BMC Health Serv Res 2024; 24:475. [PMID: 38627700 PMCID: PMC11022411 DOI: 10.1186/s12913-024-10882-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 03/19/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND More than 80 countries, including Australia, have made commitments to deliver climate-resilient and low carbon healthcare. Understanding how healthcare workers view their own and their organization's efforts to achieve sustainable and climate-resilient healthcare practice is vital to inform strategies to accelerate that transition. METHODS We conducted an online staff survey in a large state government hospital-and-health-service organisation in Queensland, Australia, to ascertain attitudes and practices towards environmentally sustainable, climate-resilient healthcare, and views about the organizational support necessary to achieve these goals in their workplace. RESULTS From 301 participants showed staff strongly support implementing sustainable and climate-resilient healthcare but require significantly more organizational support. Participants identified three categories of organizational support as necessary for the transition to environmentally sustainable and climate-resilient health services and systems: (1) practical support to make sustainability easier in the workplace (e.g. waste, energy, water, procurement, food, transport etc.); (2) training and education to equip them for 21st century planetary health challenges; and (3) embedding sustainability as 'business as usual' in healthcare culture and systems. CONCLUSIONS The research provides new insight into health workforce views on how organizations should support them to realize climate and sustainability goals. This research has implications for those planning, managing, implementing, and educating for, the transition to environmentally sustainable and climate-resilient health services and systems in Queensland, Australia, and in similar health systems internationally.
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Affiliation(s)
| | | | - Christine Garsden
- Sunshine Coast Hospital and Health Service, Queensland Health, Sunshine Coast, Australia
| | | | - Erika Borkoles
- Griffith Business School, Griffith University, Brisbane, Australia
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4
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Roberts E, Ng WY, Sanjeewa M, De Silva J. Acute primary CMV infection complicated by pneumonitis and ITP in young immunocompetent woman in a regional Queensland Hospital. BMJ Case Rep 2024; 17:e259136. [PMID: 38594194 PMCID: PMC11015259 DOI: 10.1136/bcr-2023-259136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024] Open
Abstract
We present the first published case of simultaneous pneumonitis and immune thrombocytopenic purpura secondary to primary cytomegalovirus (CMV) infection in an immunocompetent patient. Treatment with oral valganciclovir for 2 weeks successfully led to complete clinical recovery. CMV is traditionally associated with infection in immunocompromised patients and neonates; however, evidence of severe CMV infections in immunocompetent hosts is emerging. It is important to highlight the broad range of clinical presentations of CMV infections to prevent diagnostic delay and associated morbidity and expense.
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Affiliation(s)
- Emma Roberts
- Queensland Health, Mackay, Queensland, Australia
| | - Wei Yao Ng
- Queensland Health, Mackay, Queensland, Australia
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5
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Beeston SL, Poropat SF, Mannion PD, Pentland AH, Enchelmaier MJ, Sloan T, Elliott DA. Reappraisal of sauropod dinosaur diversity in the Upper Cretaceous Winton Formation of Queensland, Australia, through 3D digitisation and description of new specimens. PeerJ 2024; 12:e17180. [PMID: 38618562 PMCID: PMC11011616 DOI: 10.7717/peerj.17180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 03/11/2024] [Indexed: 04/16/2024] Open
Abstract
Skeletal remains of sauropod dinosaurs have been known from Australia for over 100 years. Unfortunately, the classification of the majority of these specimens to species level has historically been impeded by their incompleteness. This has begun to change in the last 15 years, primarily through the discovery and description of several partial skeletons from the Cenomanian-lower Turonian (lower Upper Cretaceous) Winton Formation in central Queensland, with four species erected to date: Australotitan cooperensis, Diamantinasaurus matildae, Savannasaurus elliottorum, and Wintonotitan wattsi. The first three of these appear to form a clade (Diamantinasauria) of early diverging titanosaurs (or close relatives of titanosaurs), whereas Wintonotitan wattsi is typically recovered as a distantly related non-titanosaurian somphospondylan. Through the use of 3D scanning, we digitised numerous specimens of Winton Formation sauropods, facilitating enhanced comparison between type and referred specimens, and heretofore undescribed specimens. We present new anatomical information on the holotype specimen of Diamantinasaurus matildae, and describe new remains pertaining to twelve sauropod individuals. Firsthand observations and digital analysis enabled previously proposed autapomorphic features of all four named Winton Formation sauropod species to be identified in the newly described specimens, with some specimens exhibiting putative autapomorphies of more than one species, prompting a reassessment of their taxonomic validity. Supported by a specimen-level phylogenetic analysis, we suggest that Australotitan cooperensis is probably a junior synonym of Diamantinasaurus matildae, but conservatively regard it herein as an indeterminate diamantinasaurian, meaning that the Winton Formation sauropod fauna now comprises three (rather than four) valid diamantinasaurian species: Diamantinasaurus matildae, Savannasaurus elliottorum, and Wintonotitan wattsi, with the latter robustly supported as a member of the clade for the first time. We refer some of the newly described specimens to these three species and provide revised diagnoses, with some previously proposed autapomorphies now regarded as diamantinasaurian synapomorphies. Our newly presented anatomical data and critical reappraisal of the Winton Formation sauropods facilitates a more comprehensive understanding of the mid-Cretaceous sauropod palaeobiota of central Queensland.
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Affiliation(s)
- Samantha L. Beeston
- Department of Earth Sciences, University College London, University of London, London, United Kingdom
- Faculty of Science, Engineering and Technology, Swinburne University of Technology, Hawthorn, Victoria, Australia
- Australian Age of Dinosaurs Museum of Natural History, Winton, Queensland, Australia
| | - Stephen F. Poropat
- Western Australian Organic and Isotope Geochemistry Centre, School of Earth and Planetary Science, Curtin University of Technology, Bentley, Western Australia, Australia
| | - Philip D. Mannion
- Department of Earth Sciences, University College London, University of London, London, United Kingdom
| | - Adele H. Pentland
- Australian Age of Dinosaurs Museum of Natural History, Winton, Queensland, Australia
- Western Australian Organic and Isotope Geochemistry Centre, School of Earth and Planetary Science, Curtin University of Technology, Bentley, Western Australia, Australia
| | | | - Trish Sloan
- Australian Age of Dinosaurs Museum of Natural History, Winton, Queensland, Australia
| | - David A. Elliott
- Australian Age of Dinosaurs Museum of Natural History, Winton, Queensland, Australia
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6
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Graves T. Voluntary assisted dying in Queensland, the first year. Emerg Med Australas 2024; 36:326-328. [PMID: 38413383 DOI: 10.1111/1742-6723.14386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 02/13/2024] [Indexed: 02/29/2024]
Affiliation(s)
- Timothy Graves
- Emergency Department, Bundaberg Base Hospital, Bundaberg, Queensland, Australia
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7
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Guan TL, Kutzko JH, Lunn DP, Dunn NA, Burmeister BH, Dadwal P, Tran N, Holt TR. Utility of 30-day mortality as a quality metric for palliative radiation treatment: A population-based analysis from Queensland, Australia. J Med Imaging Radiat Oncol 2024; 68:316-324. [PMID: 38500454 DOI: 10.1111/1754-9485.13633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 02/23/2024] [Indexed: 03/20/2024]
Abstract
INTRODUCTION Palliative radiotherapy (PRT) is frequently used to treat symptoms of advanced cancer, however benefits are questionable when life expectancy is limited. The 30-day mortality rate after PRT is a potential quality indicator, and results from a recent meta-analysis suggest a benchmark of 16% as an upper limit. In this population-based study from Queensland, Australia, we examined 30-day mortality rates following PRT and factors associated with decreased life expectancy. METHODS Retrospective population data from Queensland Oncology Repository was used. Study population data included 22,501 patients diagnosed with an invasive cancer who died from any cause between 2008 and 2017 and had received PRT. Thirty-day mortality rates were determined from the date of last PRT fraction to date of death. Cox proportional hazards models were used to identify factors independently associated with risk of death within 30 days of PRT. RESULTS Overall 30-day mortality after PRT was 22.2% with decreasing trend in more recent years (P = 0.001). Male (HR = 1.20, 95% CI = 1.13-1.27); receiving 5 or less radiotherapy fractions (HR = 2.97, 95% CI = 2.74-3.22 and HR = 2.17, 95% CI = 2.03-2.32, respectively) and receiving PRT in a private compared to public facility (HR = 1.61, 95% CI = 1.51-1.71) was associated with decreased survival. CONCLUSION The 30-day mortality rate in Queensland following PRT is higher than expected and there is scope to reduce unnecessarily protracted treatment schedules. We encourage other Australian and New Zealand centres to examine and report their own 30-day mortality rate following PRT and would support collaboration for 30-day mortality to become a national and international quality metric for radiation oncology centres.
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Affiliation(s)
- Tracey L Guan
- Cancer Alliance Queensland, Brisbane, Queensland, Australia
| | - Justin H Kutzko
- Queensland Cancer Control Safety and Quality Partnership, Radiation Oncology Sub-Committee, Brisbane, Queensland, Australia
- William Osler Health System, Brampton, Ontario, Canada
- University of Queensland, Brisbane, Queensland, Australia
| | - Dominic P Lunn
- Queensland Cancer Control Safety and Quality Partnership, Radiation Oncology Sub-Committee, Brisbane, Queensland, Australia
- ICON, Gold Coast University Hospital, Brisbane, Queensland, Australia
- ICON, Greenslopes Hospital, Brisbane, Queensland, Australia
| | - Nathan Am Dunn
- Cancer Alliance Queensland, Brisbane, Queensland, Australia
| | - Bryan H Burmeister
- Queensland Cancer Control Safety and Quality Partnership, Radiation Oncology Sub-Committee, Brisbane, Queensland, Australia
- GenesisCare, St Stephen's Hospital (Oncology), Hervey Bay, Queensland, Australia
- University of Queensland Rural Clinical School, Hervey Bay, Queensland, Australia
| | - Parvati Dadwal
- Cairns Hospital, Cairns, Queensland, Australia
- James Cook University, Townsville, Queensland, Australia
| | - Nancy Tran
- Cancer Alliance Queensland, Brisbane, Queensland, Australia
| | - Tanya R Holt
- Queensland Cancer Control Safety and Quality Partnership, Radiation Oncology Sub-Committee, Brisbane, Queensland, Australia
- University of Queensland, Brisbane, Queensland, Australia
- ICON, Greenslopes Hospital, Brisbane, Queensland, Australia
- Princess Alexandra Hospital - ROPART, Brisbane, Queensland, Australia
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Raymer M, Swete Kelly P, O'Leary S. Developing and embedding an advanced practice musculoskeletal physiotherapy service in public specialist outpatient services in Queensland: A health service masterclass. Musculoskelet Sci Pract 2024; 70:102917. [PMID: 38309180 DOI: 10.1016/j.msksp.2024.102917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 01/20/2024] [Indexed: 02/05/2024]
Abstract
INTRODUCTION The Musculoskeletal Physiotherapy Screening Clinic and Multi-disciplinary Service (MPSC&MDS) is an advanced practice physiotherapist-led model of care developed initially to address overburdened specialist orthopaedic outpatient public hospital services across Queensland, Australia. PURPOSE This Masterclass explores the experiences and success of embedding the MPSC&MDS state-wide across the Queensland public health system and its expansion in scale and reach to other specialist services. Key characteristics and development strategies are described that have collectively underpinned the expansion and sustainability of the service, using relevant stream sections and themes from a recommended musculoskeletal model of care framework. IMPLICATIONS The aim of this masterclass is to be informative for readers involved in the future development or refinement of similar models of care.
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Affiliation(s)
- Maree Raymer
- Physiotherapy Department, Royal Brisbane and Women's Hospital, Herston, Brisbane, QLD 4029, Australia.
| | - Patrick Swete Kelly
- Physiotherapy Department, Royal Brisbane and Women's Hospital, Herston, Brisbane, QLD 4029, Australia.
| | - Shaun O'Leary
- Physiotherapy Department, Royal Brisbane and Women's Hospital, Herston, Brisbane, QLD 4029, Australia; University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, QLD 4072, Australia.
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9
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Barnes RSK, Hamylton SM, Borburgh L. Microscale dispersion of intertidal seagrass macrofauna. Mar Environ Res 2024; 196:106385. [PMID: 38309245 DOI: 10.1016/j.marenvres.2024.106385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 02/05/2024]
Abstract
Previous studies of dispersion of intertidal seagrass-associated macrobenthos in subtropical Moreton Bay, Queensland, showed that patchiness characterised its assemblage abundance with scale-invariant magnitude across areas ranging from >8000 to 0.1 m2. Those studies were here continued across the smaller scales (down to 0.014 m2) arguably more relevant to the dominant 2-10 mm long animals, using 16 replicate blocks of 5x5 contiguous 0.0024 m2 cores nested within the previously studied site. At microscales ≥0.09 m2, the earlier congruence of conclusions derived from patchiness indices and spatial autocorrelation broke down. At >0.014 m2, adjacent points (cores) no longer together formed larger spatial units of related abundance (i.e. showed no autocorrelation), but point abundances were still highly disparate (as reflected in patchiness indices). Congruent indications of patchiness only manifested at 0.014 m2 spatial scales. Assemblage dispersion pattern was partly consequent on one microgastropod (Pseudoliotia) occurring superabundantly in scattered 0.0024 m2 hotspots.
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Affiliation(s)
- R S K Barnes
- School of the Environment & Centre for Marine Science, University of Queensland, Brisbane, Queensland, 4072, Australia; Department of Zoology & Conservation Research Institute, University of Cambridge, Cambridge, UK.
| | - Sarah M Hamylton
- School of Earth, Atmospheric and Life Sciences, University of Wollongong, Wollongong, New South Wales, 2522, Australia
| | - Liz Borburgh
- School of the Environment & Centre for Marine Science, University of Queensland, Brisbane, Queensland, 4072, Australia
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10
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Warzywoda S, Dyda A, Fitzgerald L, Mullens A, Debattista J, Durham J, Gu Z, Wenham K, Ariana A, Gilks CF, Bell SFE, Dean JA. A cross-sectional investigation of the factors associated with awareness of PEP and PrEP among Queensland university students. Aust N Z J Public Health 2024; 48:100136. [PMID: 38432178 DOI: 10.1016/j.anzjph.2024.100136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 01/11/2024] [Accepted: 02/08/2024] [Indexed: 03/05/2024] Open
Abstract
OBJECTIVE University creates unique social environments for many young people that can result in behaviour changes that can impact sexual health-related risks and facilitate transmission of HIV. Little is known about HIV knowledge, risk, and awareness of pre-exposure prophylaxis/post-exposure prophylaxis (PrEP/PEP) among Australian university students. METHODS A 2019 online survey distributed through Queensland universities, using active recruitment/snowball sampling. Descriptive and logistical regression analysis investigated HIV knowledge/risk and PrEP/PEP awareness. RESULTS Of the 4,291 responses, 60.4% were 20-29 years old, 57.0% identified as heterosexual, and 31.8% were born-overseas. Mean HIV knowledge score was 9.8/12. HIV risk scores were higher among men-who-have-sex-with-men (MSM) (mean=5.2/40) compared to all other sexual behaviours (mean=3.1/40). Logistic regression indicated PrEP and PEP awareness was associated with older age (p<0.05), being non-binary/gender-diverse (p<0.05), and MSM (p<0.05). Lower odds of PrEP awareness were associated with international student status (p<0.05). CONCLUSION This study highlights the need for future health promotion targeting younger Australians at risk of HIV to increase uptake of PrEP/PEP, particularly among overseas-born young people and those ineligible for appropriate health care in Australia. IMPLICATIONS FOR PUBLIC HEALTH Addressing these gaps will improve sexual health outcomes for young Australians at risk of HIV and work towards virtual elimination of HIV transmission in Australia.
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Affiliation(s)
- Sarah Warzywoda
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
| | - Amalie Dyda
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Lisa Fitzgerald
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Amy Mullens
- School of Psychology and Wellbeing, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Australia
| | - Joseph Debattista
- Metro North Public Health Unit, Metro North Hospital and Health Service, Australia
| | - Jo Durham
- School of Public Health and Social Work, Queensland University of Technology, Australia
| | - Zhihong Gu
- Ethnic Communities Council of Queensland, Australia
| | - Kathryn Wenham
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Australia
| | - Armin Ariana
- School of Medicine and Dentistry, Griffith University, Australia
| | - Charles F Gilks
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Sara F E Bell
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Judith A Dean
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
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Chow WK, Cooper RD, Lokhorst M, Zalucki MP, Ambrose L, Beebe NW. Comparative assessment of a novel fan box trap for collecting Anopheles farauti and culicine mosquitoes alive in tropical north Queensland, Australia. J Med Entomol 2024; 61:491-497. [PMID: 38236068 PMCID: PMC10936180 DOI: 10.1093/jme/tjad156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 11/10/2023] [Accepted: 12/20/2023] [Indexed: 01/19/2024]
Abstract
During preliminary mosquito surveys at Cowley Beach Training Area in north Queensland, Australia, it was found that the utility of the standard encephalitis virus surveillance (EVS) trap for collecting the malaria vector Anopheles farauti (Laveran) adults was compromised by the harsh tropical conditions. With the aim of increasing the survival rate of mosquitoes, we designed a downdraft fan box trap (FBT) that incorporated a screened fan at the bottom of the trap, so mosquitoes did not have to pass through a fan. The FBT was tested against the EVS and Centers for Disease Control (CDC) light traps, where mosquitoes do pass through a fan, and a nonpowered passive box trap (PBT). We conducted 4 trials to compare the quantity and survival of An. farauti and culicine mosquitoes were collected in these traps. Although not significant, the FBT collected more An. farauti than the EVS trap and PBT and significantly less An. farauti than the CDC light trap. However, the FBT improved on the CDC light trap in terms of the survival of An. farauti adults collected, with a significantly higher percentage alive in the FBT (74.6%) than in the CDC light trap (27.5%). Thus, although the FBT did not collect as many anophelines as the CDC, it proved to be superior to current trap systems for collecting large numbers of live and relatively undamaged mosquitoes. Therefore, it is recommended that FBTs be used for collecting An. farauti adults in northern Australia, especially when high survival and sample quality are important.
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Affiliation(s)
- Weng K Chow
- Australian Defence Force Malaria and Infectious Disease Institute, Enoggera, Queensland, Australia
| | - Robert D Cooper
- Australian Defence Force Malaria and Infectious Disease Institute, Enoggera, Queensland, Australia
| | - Matthew Lokhorst
- Australian Defence Force Malaria and Infectious Disease Institute, Enoggera, Queensland, Australia
| | - Myron P Zalucki
- School of the Environment, The University of Queensland, St Lucia, Queensland, Australia
| | - Luke Ambrose
- School of the Environment, The University of Queensland, St Lucia, Queensland, Australia
| | - Nigel W Beebe
- School of the Environment, The University of Queensland, St Lucia, Queensland, Australia
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12
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Baysari MT, Van Dort BA, Stanceski K, Hargreaves A, Zheng WY, Moran M, Day RO, Li L, Westbrook J, Hilmer SN. Qualitative study of challenges with recruitment of hospitals into a cluster controlled trial of clinical decision support in Australia. BMJ Open 2024; 14:e080610. [PMID: 38479736 PMCID: PMC10936458 DOI: 10.1136/bmjopen-2023-080610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 02/28/2024] [Indexed: 03/26/2024] Open
Abstract
OBJECTIVE To identify barriers to hospital participation in controlled cluster trials of clinical decision support (CDS) and potential strategies for addressing barriers. DESIGN Qualitative descriptive design comprising semistructured interviews. SETTING Five hospitals in New South Wales and one hospital in Queensland, Australia. PARTICIPANTS Senior hospital staff, including department directors, chief information officers and those working in health informatics teams. RESULTS 20 senior hospital staff took part. Barriers to hospital-level recruitment primarily related to perceptions of risk associated with not implementing CDS as a control site. Perceived risks included reductions in patient safety, reputational risk and increased likelihood that benefits would not be achieved following electronic medical record (EMR) implementation without CDS alerts in place. Senior staff recommended clear communication of trial information to all relevant stakeholders as a key strategy for boosting hospital-level participation in trials. CONCLUSION Hospital participation in controlled cluster trials of CDS is hindered by perceptions that adopting an EMR without CDS is risky for both patients and organisations. The improvements in safety expected to follow CDS implementation makes it challenging and counterintuitive for hospitals to implement EMR without incorporating CDS alerts for the purposes of a research trial. To counteract these barriers, clear communication regarding the evidence base and rationale for a controlled trial is needed.
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Affiliation(s)
- Melissa T Baysari
- Biomedical Informatics and Digital Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Bethany Annemarie Van Dort
- Biomedical Informatics and Digital Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Kristian Stanceski
- Biomedical Informatics and Digital Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | | | - Wu Yi Zheng
- Black Dog Institute, Randwick, New South Wales, Australia
| | - Maria Moran
- Biomedical Informatics and Digital Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Richard O Day
- Department of Clinical Pharmacology & Toxicology, St Vincent's Hospital Sydney, Darlinghurst, New South Wales, Australia
- St Vincent's Clinical Campus, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Ling Li
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Faculty of Medicine and Health Sciences, Macquarie University, New South Wales, Australia
| | - Johanna Westbrook
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Faculty of Medicine and Health Sciences, Macquarie University, New South Wales, Australia
| | - Sarah N Hilmer
- Clinical Pharmacology and Aged Care, Royal North Shore Hospital, St Leonards, New South Wales, Australia
- Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Kolling Institute of Medical Research, St Leonards, New South Wales, Australia
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13
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D'Arrietta LM, Vangaveti VN, Crowe MJ, Malau-Aduli BS. Exploring the motivation of health professionals to engage with research at various career stages. BMC Health Serv Res 2024; 24:305. [PMID: 38454474 PMCID: PMC10921689 DOI: 10.1186/s12913-024-10772-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 02/22/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND Research is crucial for improved healthcare and better patient outcomes, but there is a current shortage of clinician-researchers who can connect research and practice in the health professions field. This study aimed to investigate the effect of career stage, previous training and involvement in research on health professionals' (HPs) motivations to engage in research while in public hospital clinical roles. HPs' perceived motivation concerning the importance, value, and barriers attributed to research during different career stages were examined. METHODS A mixed methods study design was adopted for this research. An online survey developed based on the Expectancy-Value-Cost (EVC) theory was distributed to HPs (doctors, nurses, midwives, and allied health professionals) in three North Queensland Public Hospitals. Data analysis included descriptive and inferential statistics for the quantitative data and content analysis for the qualitative text responses. RESULTS Three hundred and fifty-five responses were received. Prior research training and involvement in research influenced respondents' perceptions about the importance, attitude, motivators, and barriers to research. Attainment value was the overarching motivation for involvement in research and research training for all career stages and all professional HP groups. Positive attitude to research was significantly higher (P = 0.003) for the allied health group (27.45 ± 4.05), followed by the medical (26.30 ± 4.12) and then the nursing and midwifery group (25.62 ± 4.21). Perceived importance and attitude attributed to research were significantly higher (P < 0.05) for those who had research training (26.66 ± 3.26 and 28.21 ± 3.73) compared to those who did not have research training (25.77 ± 3.77 and 23.97 ± 3.53). Significantly higher (P < 0.05) perceptions of organisational and individual barriers were reported among early career (50.52 ± 7.30) respondents compared to their mid-career (48.49 ± 8.14) and late career (47.71 ± 8.36) counterparts. CONCLUSION The findings from this study provide valuable insights into the factors that influence HPs' motivation for research. The results underscore the importance of professional group, involvement in research, exposure to research training, career stage, gender, and organisational support in shaping HPs' attitudes, values, and perceived barriers to research. Understanding these factors can inform the development of targeted strategies to enhance research engagement among HPs and promote evidence-based practice in healthcare.
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Affiliation(s)
- Louisa M D'Arrietta
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, 4811, Australia.
- Library Services, Townsville University Hospital, Townsville Hospital and Health Service, Townsville, QLD, Australia.
| | - Venkat N Vangaveti
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, 4811, Australia
- Townsville Institute of Health Research and Innovation, Townsville University Hospital, Townsville Hospital and Health Service, Townsville, QLD, Australia
| | - Melissa J Crowe
- College of Healthcare Sciences, James Cook University, Townsville, QLD, Australia
| | - Bunmi S Malau-Aduli
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, 4811, Australia
- School of Medicine and Public Health, University of Newcastle, New South Wales, Australia
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Biello R, Ghirotto S, Schmidt DJ, Fuselli S, Roberts DT, Espinoza T, Hughes JM, Bertorelle G. Unravelling the mystery of endemic versus translocated populations of the endangered Australian lungfish (Neoceratodus forsteri). Mol Ecol 2024; 33:e17266. [PMID: 38240411 DOI: 10.1111/mec.17266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 12/24/2023] [Accepted: 01/04/2024] [Indexed: 02/22/2024]
Abstract
The Australian lungfish is a primitive and endangered representative of the subclass Dipnoi. The distribution of this species is limited to south-east Queensland, with some populations considered endemic and others possibly descending from translocations in the late nineteenth century shortly after European discovery. Attempts to resolve the historical distribution of this species have met with conflicting results based on descriptive genetic studies. Understanding if all populations are endemic or some are the result of, or influenced by, translocation events, has implications for conservation management. In this work, we analysed the genetic variation at three types of markers (mtDNA genomes, 11 STRs and 5196 nuclear SNPs) using the approximate Bayesian computation (ABC) algorithm to compare several demographic models. We postulated different contributions of Mary River and Burnett River gene pools into the Brisbane River and North Pine River populations, related to documented translocation events. We ran the analysis for each marker type separately, and we also estimated the posterior probabilities of the models combining the markers. Nuclear SNPs have the highest power to correctly identify the true model among the simulated datasets (where the model was known), but different marker types typically provided similar answers. The most supported demographic model able to explain the real dataset implies that an endemic gene pool is still present in the Brisbane and North Pine Rivers and coexists with the gene pools derived from past documented translocation events. These results support the view that ABC modelling can be useful to reconstruct complex historical translocation events with contemporary implications, and will inform ongoing conservation efforts for the endangered and iconic Australian lungfish.
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Affiliation(s)
- Roberto Biello
- Department of Life Sciences and Biotechnology, University of Ferrara, Ferrara, Italy
- Department of Crop Genetics, John Innes Centre, Norwich, UK
| | - Silvia Ghirotto
- Department of Life Sciences and Biotechnology, University of Ferrara, Ferrara, Italy
| | - Daniel J Schmidt
- Australian Rivers Institute, Griffith University, Brisbane, Queensland, Australia
| | - Silvia Fuselli
- Department of Life Sciences and Biotechnology, University of Ferrara, Ferrara, Italy
| | | | - Tom Espinoza
- Burnett Mary Regional Group, Bargara, Queensland, Australia
| | - Jane M Hughes
- Australian Rivers Institute, Griffith University, Brisbane, Queensland, Australia
| | - Giorgio Bertorelle
- Department of Life Sciences and Biotechnology, University of Ferrara, Ferrara, Italy
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15
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Lui PSC, Singh K, Nguyen T, Kurth B, Phan T, Nelson A, Danisevska R, De Ambrosis T. Determinants of cancer screenings participation in Queensland: a scoping review. J Prim Health Care 2024; 16:70-77. [PMID: 38546768 DOI: 10.1071/hc23012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 05/29/2023] [Indexed: 04/02/2024] Open
Abstract
Introduction Cancer screening programmes for cervical, breast, and colorectal cancer have successfully reduced mortality rates among target groups. However, a large proportion of women and men are unscreened. Aim This review aims to provide an overview of the literature regarding the determinants of cancer screening participation among target groups in Queensland. Methods Electronic databases were searched for studies on determinants of cancer screening participation in Queensland. Retrieved studies were screened, and eligible articles were selected for data extraction. Both peer-reviewed and grey literature studies were included. The determinants of cancer screening participation were classified according to the I-Change model. Results Sixteen out of 75 articles were selected and analysed. Information factors, such as the lack of tailored strategies, determined cancer screening participation. Age, gender, cultural beliefs, fear and past experiences were the most reported predisposing factors to cancer screening participation. Lack of knowledge, misconceptions, low awareness, timely access to service, privacy and confidentiality were mainly reported awareness and motivation factors. Encouragement from health professionals, providing more information and interactions with communities would result in different effects on cancer screening participation among the target groups. Discussion The I-Change model is a valuable tool in mapping the current determinants of cancer screening participation programs. Further research may be needed to fully understand the barriers and facilitators of cancer screening programs.
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Affiliation(s)
- Paraniala Silas C Lui
- Darling Downs and West Moreton Primary Health Network, Level 1, 162 Humes Street, Toowoomba, QLD 4350, Australia; and Darling Downs Health Innovation and Research Collaborative, Level 2 Administration Building, Baillie, Henderson Hospital, Toowoomba, QLD 4350, Australia; and Centre for Health Research, University of Southern Queensland, Springfield Campus, 37 Sinnathambly Boulevard, QLD 4300, Australia
| | - Kamal Singh
- School of Health, Federation University, Brisbane Campus, PO Box 5274, Brisbane, QLD 4000, Australia
| | - Tam Nguyen
- Darling Downs and West Moreton Primary Health Network, Level 1, 162 Humes Street, Toowoomba, QLD 4350, Australia; and Darling Downs Health Innovation and Research Collaborative, Level 2 Administration Building, Baillie, Henderson Hospital, Toowoomba, QLD 4350, Australia
| | - Brian Kurth
- Darling Downs and West Moreton Primary Health Network, Level 1, 162 Humes Street, Toowoomba, QLD 4350, Australia; and Darling Downs Health Innovation and Research Collaborative, Level 2 Administration Building, Baillie, Henderson Hospital, Toowoomba, QLD 4350, Australia
| | - Thuc Phan
- Darling Downs and West Moreton Primary Health Network, Level 1, 162 Humes Street, Toowoomba, QLD 4350, Australia; and Darling Downs Health Innovation and Research Collaborative, Level 2 Administration Building, Baillie, Henderson Hospital, Toowoomba, QLD 4350, Australia
| | - Ashleigh Nelson
- Darling Downs and West Moreton Primary Health Network, Level 1, 162 Humes Street, Toowoomba, QLD 4350, Australia; and Darling Downs Health Innovation and Research Collaborative, Level 2 Administration Building, Baillie, Henderson Hospital, Toowoomba, QLD 4350, Australia
| | - Renata Danisevska
- Darling Downs and West Moreton Primary Health Network, Level 1, 162 Humes Street, Toowoomba, QLD 4350, Australia; and Darling Downs Health Innovation and Research Collaborative, Level 2 Administration Building, Baillie, Henderson Hospital, Toowoomba, QLD 4350, Australia
| | - Tony De Ambrosis
- Darling Downs and West Moreton Primary Health Network, Level 1, 162 Humes Street, Toowoomba, QLD 4350, Australia; and Darling Downs Health Innovation and Research Collaborative, Level 2 Administration Building, Baillie, Henderson Hospital, Toowoomba, QLD 4350, Australia
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Gavaghan B, Finch J, Clarke K. Creating a framework for change: transitioning to value-based healthcare in Queensland. AUST HEALTH REV 2024; 48:AH24001. [PMID: 38522434 DOI: 10.1071/ah24001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 03/04/2024] [Indexed: 03/26/2024]
Abstract
Value-based healthcare has been described as the sustainable, equitable and transparent use of healthcare resources to achieve improved experiences and outcomes for people and communities. It is supported by all levels of government in Australia, with recent initiatives championing a shift away from traditional, clinician-centric care delivery to a more contemporary, value-based approach. To date, however, efforts in Queensland have focused on smaller scale siloed models of care and have not extended to the transformational change required to create equitable and sustainable healthcare delivery. The Queensland Health Allied Health Framework for Value-Based Health Care (the Framework) builds on contemporary frameworks with reference to the local context in Queensland and provides a structure and starting point for clinicians and managers to work together with consumers to transform services to focus on preventative health and wellbeing, shifting the focus of care to the community and sustainably improving the quality of care delivered. The Framework outlines key considerations for the design and implementation of new services, including understanding the care pathway, supporting an outcome driven workplace culture, measuring what matters and designing for outcomes. Several key lessons were learnt during the development of the Framework, including the importance of early and sustained consumer partnerships, of establishing a shared definition of value-based healthcare that enables integration across the care pathway and the need for leadership at all levels to actively support the change management process. While developed for Queensland public allied health services, the Framework is intended to be a system-wide tool relevant to all health professionals and services.
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17
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Roe Y, Allen J, Haora P, Hickey S, Briggs M, Wilkes L, Nelson C, Watego K, Coddington R, Ireland S, Kruske S, Gao Y, Kildea S. Enabling the context for Aboriginal and Torres Strait Islander Community Controlled Birthing on Country services: Participatory action research. Women Birth 2024; 37:368-378. [PMID: 38097448 DOI: 10.1016/j.wombi.2023.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 11/24/2023] [Accepted: 11/24/2023] [Indexed: 03/05/2024]
Abstract
PROBLEM Establishment of Birthing on Country services owned and governed by Aboriginal and Torres Strait Islander Community Controlled Health Services has been slow. BACKGROUND Birthing on Country services have demonstrated health and cost benefits and require redesign of maternity care. During the Building On Our Strengths feasibility study, use of endorsed midwives and licensing of birth centres has proven difficult. QUESTION What prevents Community Controlled Health Services from implementing Birthing on Country services in Queensland and New South Wales? METHODS Participatory action research identified implementation barriers. We conducted iterative document analysis of instruments to inform government lobbying through synthesis of policy, economic, social, technological, legal, and environmental factors. FINDINGS Through cycles of participatory action research, we analysed 17 documents: 1) policy barriers prevent Community Controlled Health Services from employing endorsed midwives to provide intrapartum care in public hospitals; 2) economic barriers include lack of sustainable funding stream and inadequate Medicare-billing for endorsed midwives; and 3) legal barriers require a medical practitioner in a birth centre. While social barriers (e.g., colonisation, medicalisation) underpin regulations, these were beyond the scope; technological and environmental barriers were not identified. DISCUSSION Findings are consistent with the literature on barriers to midwifery practice. Recommendations include a national audit of barriers to Birthing on Country services including healthcare practice insurance, and development of a funding stream. Additionally, private maternity facility regulation must align with evidence on safe birth centre operation. CONCLUSION Government can address barriers to scale-up of Aboriginal and Torres Strait Islander Community Controlled Birthing on Country services.
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Affiliation(s)
- Yvette Roe
- Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, Australia
| | - Jyai Allen
- Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, Australia.
| | - Penny Haora
- Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, Australia
| | - Sophie Hickey
- Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, Australia
| | - Melanie Briggs
- Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, Australia; Waminda South Coast Women's Health and Welfare Aboriginal Corporation, Nowra, Australia
| | - Liz Wilkes
- Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, Australia; My Midwives, Brisbane, Australia
| | - Carmel Nelson
- Institute for Urban Indigenous Health, Brisbane, Australia
| | - Kristie Watego
- Institute for Urban Indigenous Health, Brisbane, Australia
| | - Rebecca Coddington
- Waminda South Coast Women's Health and Welfare Aboriginal Corporation, Nowra, Australia
| | - Sarah Ireland
- Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, Australia
| | - Sue Kruske
- Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, Australia
| | - Yu Gao
- Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, Australia
| | - Sue Kildea
- Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, Australia
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18
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Wellington M, Whiting E, Searle D, Kreis M, Cross E. Driving value-based healthcare through a new vision for Queensland's health system. AUST HEALTH REV 2024; 48:AH24002. [PMID: 38493763 DOI: 10.1071/ah24002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 02/27/2024] [Indexed: 03/19/2024]
Abstract
The purpose of this case study is to explain the development of Queensland's strategic approach to health system reform, which promotes partnership across the health system to better deliver integrated and value-based health care across the continuum of care. The new health system vision was informed by undertaking literature searches on national and international health system approaches to reform and supported by extensive consultation across Queensland with more than 1100 stakeholders. Thematic analysis was undertaken to identify key themes that were translated into a high-level vision document that communicated Queensland's renewed focus on wellness and delivering more care in the community. This was circulated to stakeholders for iterative and collaborative refinement before final approvals. Collaboratively and iteratively developing the new health system vision for Queensland with key stakeholders has contributed to a shared understanding and ownership of a vision that is committed to system reform, focused on delivering high-value care that reflects what is important to consumers and health system stakeholders.
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Affiliation(s)
- Madeleine Wellington
- Reform Office, Strategy, Policy and Reform Division, Queensland Health, 33 Charlotte Street, Brisbane, Qld 4000, Australia
| | - Elizabeth Whiting
- Reform Office, Strategy, Policy and Reform Division, Queensland Health, 33 Charlotte Street, Brisbane, Qld 4000, Australia; and Department of Medicine, The Prince Charles Hospital, Rode Road, Chermside, Brisbane, Qld 4032, Australia; and Faculty of Medicine, University of Queensland, St Lucia, Brisbane, Qld 4067, Australia
| | - Damien Searle
- Reform Office, Strategy, Policy and Reform Division, Queensland Health, 33 Charlotte Street, Brisbane, Qld 4000, Australia
| | - Megan Kreis
- Reform Office, Strategy, Policy and Reform Division, Queensland Health, 33 Charlotte Street, Brisbane, Qld 4000, Australia
| | - Emily Cross
- Reform Office, Strategy, Policy and Reform Division, Queensland Health, 33 Charlotte Street, Brisbane, Qld 4000, Australia
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19
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Smith R, Merlo G, Broadbent AM, Lock C, Mickan S, Morgan N. Development and implementation of the Specialist Palliative Care in Aged Care (SPACE) Project across Queensland. AUST HEALTH REV 2024; 48:AH23272. [PMID: 38467110 DOI: 10.1071/ah23272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 02/20/2024] [Indexed: 03/13/2024]
Abstract
There is an urgent and unmet need for specialist palliative care services in residential aged care. The Specialist Palliative Care in Aged Care (SPACE) Project aimed to improve palliative and end-of-life care for older people living in residential aged care facilities in Queensland. A representative working group developed a series of service principles around palliative care practice in aged care (comprehensive resident-focused care, streamlined service, and capacity building). Funding was allocated by population to the health services in Queensland to adapt and implement models of care aligned with these principles. SPACE successfully implemented a variety of decentralised models of care across Queensland. The critical elements for the success of SPACE were the use of an expert working group to define the core innovation, networking and implementation support from the central project team and community of practice, and adaptable models of care led by local facilitators. Lessons learned from this real-world case study could be adopted to guide and ensure the successful implementation and sustainability of future complex interventions in healthcare settings, both nationally and internationally.
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Affiliation(s)
- Rebecca Smith
- Townsville University Hospital, Douglas, Qld, Australia; and Healthcare Improvement Unit, Clinical Excellence Queensland, Queensland Health, Brisbane, Qld, Australia
| | - Gregory Merlo
- Healthcare Improvement Unit, Clinical Excellence Queensland, Queensland Health, Brisbane, Qld, Australia
| | - Andrew M Broadbent
- Healthcare Improvement Unit, Clinical Excellence Queensland, Queensland Health, Brisbane, Qld, Australia; and Gold Coast Hospital and Health Service, Southport, Qld, Australia; and Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Qld, Australia
| | - Caitlin Lock
- Voluntary Dying Unit, Clinical Excellence Queensland, Queensland Health, Brisbane, Qld, Australia
| | - Sharon Mickan
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Qld, Australia
| | - Nicola Morgan
- Healthcare Improvement Unit, Clinical Excellence Queensland, Queensland Health, Brisbane, Qld, Australia; and Gold Coast Hospital and Health Service, Southport, Qld, Australia; and Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Qld, Australia
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20
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Senanayake S, Barnett A, Brain D, Allen M, Powell EE, O'Beirne J, Valery P, Hickman IJ, Kularatna S. A discrete choice experiment to elicit preferences for a chronic disease screening programme in Queensland, Australia. Public Health 2024; 228:105-111. [PMID: 38354579 DOI: 10.1016/j.puhe.2024.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 12/25/2023] [Accepted: 01/09/2024] [Indexed: 02/16/2024]
Abstract
OBJECTIVE Patient-centred care, increasingly highlighted in healthcare strategies, necessitates understanding public preferences for healthcare service attributes. We aimed to understand the preferences of the Australian population regarding the attributes of chronic disease screening programmes. STUDY DESIGN The preferences were elicited using the discrete choice experiment (DCE) methodology. METHODS A DCE was administered to a sample of the Australian general population. Respondents were asked to make choices, each offering two hypothetical screening scenarios defined by screening conduct, quality and accuracy of the test results, cost to the patient, wait time and source of information. Data were analysed using a panel mixed multinomial logit model. RESULTS A strong preference for highly accurate screening tests and nurse-led screenings at local health clinics was evident. They expressed disutility for waiting time and out-of-pocket costs but were indifferent about the source of information. Their preference for a nurse-led programme was highlighted by the fact that they were willing to pay $81 and $88 to get a nurse-led programme when they were offered a general practitioner-led and a specialist-led programme, respectively. Furthermore, they were willing to pay $32 to reduce a week of waiting time and $205 for a 95% accurate test compared to a 75% accurate test. Preferences remained consistent irrespective of the respondent's place of residence. CONCLUSIONS Our findings highlight the importance of diagnostic test accuracy and nurse-led service delivery in chronic disease screening programmes. These insights could guide the development of patient-centric services by enhancing test accuracy, reducing waiting times and promoting nurse-led care models.
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Affiliation(s)
- S Senanayake
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD 4001, Australia; Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - A Barnett
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD 4001, Australia
| | - D Brain
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD 4001, Australia.
| | - M Allen
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD 4001, Australia
| | - E E Powell
- The University of Queensland, St Lucia, QLD 4072, Australia; Centre for Liver Disease Research, Translational Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, Australia; Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - J O'Beirne
- University of the Sunshine Coast, Locked Bag 4, Maroochydore DC, QLD 4558, Australia
| | - P Valery
- QIMR Berghofer Medical Research Institute, Royal Brisbane Hospital, Herston, QLD 4029, Australia
| | - I J Hickman
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, QLD 4102, Australia; The University of Queensland, St Lucia, QLD 4072, Australia
| | - S Kularatna
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD 4001, Australia; Health Services and Systems Research, Duke-NUS Medical School, Singapore
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Abstract
This project explored the needs of mothers beyond the immediate postnatal period in Queensland, Australia, for the development of improved models of care. Data were collected through group and individual interviews. A qualitative methodology using thematic analysis captured the experience of 58 participants. Four key themes were generated: Caring for self, Being connected, Getting direction and Having options. Being connected with care providers and peers was highly valued by participants as was having a sense of direction. Having a relationship with a carer who knew them personally throughout pregnancy and postnatal care avoided retelling stories and facilitated information sharing. Relationship-based care enabled mothers to better meet their personal needs necessary to fulfil the parenting role. Yet, many points of disconnect were identified including inconsistencies in information and gaps in care. These findings demonstrate a range of unmet needs, situated within a lack of relational continuity. Maternity and child health professionals, service managers and policy makers must reorient systems by listening, acknowledging and keeping the voice of mothers at the centre of care.
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Affiliation(s)
- Robyn A Penny
- Children's Health Queensland Hospital and Health Service, South Brisbane, QLD, Australia
| | - Leah Hardiman
- Mothers and Babies Queensland, Brisbane, QLD, Australia
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22
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Pohle A, Jell P, Klug C. Plectronoceratids (Cephalopoda) from the latest Cambrian at Black Mountain, Queensland, reveal complex three-dimensional siphuncle morphology, with major taxonomic implications. PeerJ 2024; 12:e17003. [PMID: 38436030 PMCID: PMC10909373 DOI: 10.7717/peerj.17003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 02/05/2024] [Indexed: 03/05/2024] Open
Abstract
The Plectronoceratida includes the earliest known cephalopod fossils and is thus fundamental to a better understanding of the origin and early evolution of this group of molluscs. The bulk of described material comes from the late Cambrian Fengshan Formation in North China with isolated occurrences in South China, Laurentia, Kazakhstan and Siberia. Knowledge of their morphology and taxonomy is limited in that most specimens were only studied as longitudinal sections, which are prone to misinterpretations due to variations in the plane of section. We describe more than 200 new specimens, which exceeds the entire hitherto published record of plectronoceratids. The material was collected by Mary Wade and colleagues during the 1970s and 1980s, from the lower Ninmaroo Formation at Black Mountain (Mount Unbunmaroo), Queensland, Australia. Despite the collecting effort, diverse notes and early incomplete drafts, Mary Wade never published this material before her death in 2005. The specimens provide novel insights into the three-dimensional morphology of the siphuncle based on abundant material, prompting a general revision of the order Plectronoceratida. We describe Sinoeremoceras marywadeae sp. nov. from numerous, well-preserved specimens, allowing investigation of ontogenetic trajectories and intraspecific variability, which in turn enables improved interpretations of the three-dimensional siphuncle morphology. The siphuncle of S. marywadeae sp. nov. and other plectronoceratids is characterised by highly oblique segments, an elongated middorsal portion of the septal neck (= septal flap) and laterally expanded segments that extend dorsally relative to the septal flap (= siphuncular bulbs). We show that this complex siphuncular structure has caused problems of interpretation because it was studied mainly from longitudinal sections, leading to the impression that there were large differences between specimens and supposed species. We revise the order Protactinoceratida and the families Protactinoceratidae and Balkoceratidae as junior synonyms of the Plectronoceratida and Plectronoceratidae, respectively. We reduce the number of valid genera from eighteen (including one genus formerly classified as an ellesmeroceratid) to three: Palaeoceras Flower, 1954, Plectronoceras Kobayashi, 1935 and Sinoeremoceras Kobayashi, 1933. We accept 10 valid species to which the 68 previously established species may be assigned. Sinoeremoceras contains 8 of the 10 plus the new species. Two species, previously referred to ellesmeroceratid genera, are transferred to Sinoeremoceras. This revised scheme groups plectronoceratids into distinct geographically and stratigraphically separated species, which better reflects biological realities and removes bias caused by preparation techniques. North China remains important containing the highest known diversity and was likely a centre of cephalopod diversification.
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Affiliation(s)
- Alexander Pohle
- Palaeontological Institute and Museum, University of Zurich, Zürich, Switzerland
- Institute of Geology, Mineralogy and Geophysics, Ruhr University Bochum, Bochum, Germany
| | - Peter Jell
- School of Earth Sciences, University of Queensland, St. Lucia, Queensland, Australia
| | - Christian Klug
- Palaeontological Institute and Museum, University of Zurich, Zürich, Switzerland
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Thomas R, Marchant JM, Goyal V, Masters IB, Yerkovich ST, Chang AB. Clinical utility of elective paediatric flexible bronchoscopy and impact on the quality of life: protocol for a single-centre, single-blind, randomised controlled trial. BMJ Open Respir Res 2024; 11:e001704. [PMID: 38413121 PMCID: PMC10900573 DOI: 10.1136/bmjresp-2023-001704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 02/09/2024] [Indexed: 02/29/2024] Open
Abstract
INTRODUCTION Elective flexible bronchoscopy (FB) is now widely available and standard practice for a variety of indications in children with respiratory conditions. However, there are no randomised controlled trials (RCTs) that have examined its benefits (or otherwise).Our primary aim is to determine the impact of FB on the parent-proxy quality-of-life (QoL) scores. Our secondary aims are to determine if undertaking FB leads to (a) change in management and (b) improvement of other relevant patient-reported outcome measures (PROMs). We also quantified the benefits of elective FB (using 10-point Likert scale). We hypothesised that undertaking elective FB will contribute to accurate diagnosis and therefore appropriate treatment, which will in turn improve QoL and will be deemed to be beneficial from patient and doctor perspectives. METHODS AND ANALYSIS Our parallel single-centre, single-blind RCT (commenced in May 2020) has a planned sample size of 114 children (aged <18 years) recruited from respiratory clinics at Queensland Children's Hospital, Brisbane, Australia. Children are randomised (1:1 concealed allocation) within two strata: age (≤2 vs >2 years) and indication for FB (chronic cough vs other indications) to either (a) early arm (intervention where FB undertaken within 2 weeks) or (b) delayed (control, FB undertaken at usual wait time). Our primary outcome is the difference between groups in their change in QoL at the T2 timepoint when the intervention group has had the FB and the control group has not. Our secondary outcomes are change in management, change in PROMs, adverse events and the Likert scales. ETHICS AND DISSEMINATION The human research ethics committee of the Queensland Children's Hospital granted ethical clearance (HREC/20/QCHQ/62394). Our RCT is conducted in accordance with Good Clinical Practice and the Australian legislation. Results will be disseminated through conference presentations, teaching avenues, workshops, websites and publications. REGISTRATION Australia New Zealand Clinical Trial Registry ACTRN12620000610932.
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Affiliation(s)
- Rahul Thomas
- Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, South Brisbane, Queensland, Australia
- Australian Centre for Health Services Innovation, Kelvin Grove, Queensland, Australia
| | - Julie M Marchant
- Australian Centre for Health Services Innovation, Kelvin Grove, Queensland, Australia
- Department of Respiratory Medicine, Queensland Children's Hospital, South Brisbane, Queensland, Australia
| | - Vikas Goyal
- Australian Centre for Health Services Innovation, Kelvin Grove, Queensland, Australia
- Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, South Brisbane, Queensland, Australia
| | - Ian Brent Masters
- Australian Centre for Health Services Innovation, Kelvin Grove, Queensland, Australia
- Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, South Brisbane, Queensland, Australia
| | - Stephanie T Yerkovich
- Australian Centre for Health Services Innovation, Kelvin Grove, Queensland, Australia
- Child Health Division, Menzies School of Health Research, Casuarina, Australia
| | - Anne B Chang
- Respiratory Medicine, Australian Centre for Health Services Innovation, Kelvin Grove, Queensland, Australia
- Child Health Division, Menzies School of Health Research, Casuarina, Australia
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McGrail M, Woolley T, Pinidiyapathirage J, Paton K, Smith D, Brumpton K, Teague PA. Exploring recent trends (2014-21) in preferencing and accepting Queensland medical internships in rural hospitals. BMC Health Serv Res 2024; 24:236. [PMID: 38395849 PMCID: PMC10885368 DOI: 10.1186/s12913-024-10683-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 02/05/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Medical internship is a key transition point in medical training from student to independent (junior) doctor. The national Regional Training Hubs (RTH) policy began across Australia in late 2017, which aims to build medical training pathways for junior doctors within a rural region and guide students, interns and trainees towards these. This study aims to explore preferencing and acceptance trends for rural medical internship positions in Queensland. Moreover, it focuses on internship preference and acceptance outcomes prior to and following the establishment of RTHs, and their association with key covariates such as rural training immersions offered by medical schools. METHODS Data from all applicants to Queensland Health intern positions between 2014-2021 were available, notably their preference order and location of accepted internship position, classified as rural or metropolitan. Matched data from Queensland's medical schools were added for rural training time and other key demographics. Analyses explored the statistical associations between these factors and preferencing or accepting rural internships, comparing pre-RTH and post-RTH cohorts. RESULTS Domestic Queensland-trained graduates first preferencing rural intern positions increased significantly (pre-RTH 21.1% vs post-RTH 24.0%, p = 0.017), reinforced by a non-significant increase in rural acceptances (27.3% vs 29.7%, p = 0.070). Rural interns were more likely to have previously spent ≥ 11-weeks training in rural locations within medical school, be rurally based in the year applying for internship, or enrolled in the rural generalist pathway. CONCLUSIONS The introduction of the RTH was associated with a moderate increase of graduates both preferencing and accepting a rural internship, though a richer understanding of the dominant reasons for and against this remain less clear. An expansion of graduates who undertook longer periods of undergraduate rural training in the same period did not diminish the proportion choosing a rural internship, suggesting there remains an appetite for these opportunities. Overall, domestic graduates are identified as a reliable source of intern recruitment and retention to rural hospitals across Queensland, with entry to the rural generalist pathway and extended rural placement experiences enhancing uptake of rural practice.
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Affiliation(s)
- Matthew McGrail
- The University of Queensland, Rural Clinical School, Rockhampton, QLD, 4700, Australia.
| | - Torres Woolley
- James Cook University, College of Medicine & Dentistry, Townsville, QLD, 4811, Australia
| | - Janani Pinidiyapathirage
- Griffith University, School of Medicine and Dentistry, Southport, QLD, 4222, Australia
- Rural Medical Education Australia, Toowoomba, QLD, 4350, Australia
| | - Kath Paton
- James Cook University, College of Medicine & Dentistry, Townsville, QLD, 4811, Australia
| | - Deborah Smith
- James Cook University, College of Medicine & Dentistry, Townsville, QLD, 4811, Australia
| | - Kay Brumpton
- Griffith University, School of Medicine and Dentistry, Southport, QLD, 4222, Australia
- Rural Medical Education Australia, Toowoomba, QLD, 4350, Australia
| | - Peta-Ann Teague
- James Cook University, College of Medicine & Dentistry, Townsville, QLD, 4811, Australia
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Lacy-Nichols J, Cullerton KB. Baby steps in lobbying reform: opportunities and challenges in Queensland. Med J Aust 2024; 220:60-64. [PMID: 38149343 DOI: 10.5694/mja2.52187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 10/17/2023] [Indexed: 12/28/2023]
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Dhakal P, Wiesner R, Maraseni T. The interplay between the entrepreneurial leadership identity, entrepreneurial leadership competency and venture growth intentions of women in rural Australia. PLoS One 2024; 19:e0296865. [PMID: 38306323 PMCID: PMC10836661 DOI: 10.1371/journal.pone.0296865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 12/22/2023] [Indexed: 02/04/2024] Open
Abstract
Cultivating business growth intentions in rural, regional, and remote women entrepreneurs is crucial, considering the unique challenges they face in rural areas. The growth intentions of rural, regional, and remote women entrepreneurs remain understudied. This study pioneers research on the interplay between entrepreneurial leadership competency, identity, and growth intentions of rural, regional, and remote Australian women. We surveyed rural, regional, and remote women entrepreneurs in Queensland, Australia, using structural equation modeling for analysis. Results revealed a positive relationship between entrepreneurial leader identity, business growth intentions, and entrepreneurial leadership competency. Moreover, entrepreneurial leadership competency positively correlated with growth intentions. The study indicated that entrepreneurial leadership competency partially mediates the link between identity and growth intentions. This research addresses a theoretical gap by introducing a new model showcasing the relationships between entrepreneurial leadership identity, entrepreneurial leadership competency, and venture growth intentions. From a practical standpoint, our findings strengthen the business case for improving tailor-made rural, regional, and remote entrepreneurial development programs.
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Affiliation(s)
- Purushottam Dhakal
- School of Business, University of Southern Queensland, Toowoomba, Queensland, Australia
| | - Retha Wiesner
- School of Business, University of Southern Queensland, Toowoomba, Queensland, Australia
| | - Tek Maraseni
- Centre for Sustainable Agricultural Systems, University of Southern Queensland, Toowoomba, Queensland, Australia
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Bendotti H, Lawler S, Gartner C, Ireland D, Marshall HM. Smoking Cessation Counseling in Practice: A Qualitative Analysis of Quitline Conversations in Queensland, Australia. Health Educ Behav 2024; 51:43-53. [PMID: 37846946 PMCID: PMC10785561 DOI: 10.1177/10901981231206068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
Telephone-based services are a practical and effective behavioral support for smoking cessation, yet no in-depth analyses of this counseling have been conducted. Understanding the general content of Quitline conversations can help to improve current practices and may inform future interventions. Therefore, we aimed to independently explore conversation themes, topics, and client questions during Quitline counseling sessions with Quitline clients in Queensland, Australia. A purposive sample of 30 recorded counseling sessions, completed between January and March 2019, were de-identified, transcribed, and thematically analyzed. Seven themes, encompassing 35 topics, were derived from 26 initial calls and four follow-up calls: (1) Client details and building rapport; (2) Client history and motivation to quit; (3) Pharmacotherapy; (4) Behavioral aspects of quitting and relationship with smoking; (5) Understanding nicotine dependence and other important considerations; (6) Additional support and smoking cessation resources; and (7) Planning, goal setting and follow-up. Three themes emerged from 18 client questions including (1) Pharmacotherapy safety and contraindications; (2) Pharmacotherapy instructions and mechanism of action; and (3) Physiology of nicotine dependence. This is the first qualitative analysis of the content of Quitline counseling sessions in Australia. Counselors collect and deliver a breadth of information to provide tailored, evidence-based health care, while building rapport and trust. Findings may be translatable into personalized self-help interventions that are more accessible or appealing to people reluctant to contact Quitline. Harnessing educational opportunities regarding pharmacotherapy adherence and misconceptions can improve client confidence in the product and smoking cessation outcomes. Further research will map conversations to motivational interviewing and behavior change techniques.
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Affiliation(s)
- Hollie Bendotti
- Thoracic Research Centre, Faculty of Medicine, The University of Queensland, Chermside, Australia
- The Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Herston, Queensland, Australia
| | - Sheleigh Lawler
- School of Public Health, The University of Queensland, Herston, Australia
| | - Coral Gartner
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, Faculty of Medicine, The University of Queensland, Herston, Australia
| | - David Ireland
- The Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Herston, Queensland, Australia
| | - Henry M. Marshall
- Thoracic Research Centre, Faculty of Medicine, The University of Queensland, Chermside, Australia
- The Prince Charles Hospital, Metro North Hospital and Health Service, Chermside, Queensland, Australia
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Greenup EP, Page M, Best D, Best T, Gibbs C. Patterns in the Use of Emergency Telemedicine Support in the Management of Traumatic Road Crashes. Telemed J E Health 2024; 30:579-584. [PMID: 37624653 DOI: 10.1089/tmj.2023.0125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2023] Open
Abstract
Objective: The introduction of emergency telemedicine care models is a common theme in health jurisdictions that include rural and remote populations. How the availability of these models influences the way clinicians manage traumatic road crashes is not yet fully understood. This study seeks to compare road crashes where telemedicine was and was not used and to identify any variables that may increase the likelihood of telemedicine usage by treating clinicians. Methods: Road crashes reported in the state Department of Transport and Main Roads (Queensland, Australia) crash database between January 1, 2019, and November 30, 2020 (n = 23,734) were compared to videoconferencing call logs to determine which crashes resulted in treatment that was supported by telemedicine (n = 204). Analysis was performed to examine differences in characteristics related to the crash depending on whether telemedicine support was requested. Results: Road crashes where telemedicine support was requested on average involved more casualties (1.6 vs. 1.41; t(11,287) = -3.26, p < 0.001, relative risk = 1.13). Crashes that occurred in rural settings accounted for most requests for telemedicine (65.68%; X2 = 159.2, p < 0.001) and a greater percentage of crashes in remote locations (3.36% vs. 2.35%; X2 = 256.97, p < 0.001, relative risk = 1.43). The use of telemedicine support for crashes was associated with a 13% increase in the mean number of casualties, compared to crashes where telemedicine support was not used. Conclusion: Telemedicine support is requested by clinicians providing emergency treatment in the management of road crashes that produce more severe injuries, involve multiple casualties, and take place in more rural settings or remote locations.
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Affiliation(s)
| | - Matthew Page
- Clinical Excellence Queensland, Queensland Health, Brisbane, Australia
| | - Daniel Best
- Clinical Excellence Queensland, Queensland Health, Brisbane, Australia
| | - Tiffany Best
- Retrieval Services Queensland, Queensland Health, Brisbane, Australia
| | - Clinton Gibbs
- Retrieval Services Queensland, Queensland Health, Brisbane, Australia
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Everson G, Spring B, Middleton J, Richardson A, Gardiner FW. Culturally appropriate psychotherapy and its retention: An example from Far North Queensland (Australia). Acta Psychol (Amst) 2024; 242:104122. [PMID: 38145592 DOI: 10.1016/j.actpsy.2023.104122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/05/2023] [Accepted: 12/20/2023] [Indexed: 12/27/2023] Open
Abstract
BACKGROUND Culturally appropriate mental health care is essential in remote Australia. However, while associated with the development of an effective therapeutic alliance, current literature insufficiently reports the retention and psychotherapy outcomes of Indigenous adults. We aimed to describe the characteristics and retention of clients attending the Far North Mental Health and Wellbeing Service (FNS). METHODS We conducted a retrospective cross-sectional study on clients who received one or more psychotherapy consultations between 1st July 2019 and 31st December 2020. Population, entrance, and treatment characteristics were described, with retention compared between the major cultural groups. Entrance characteristics comprised referral pathway and reason for presentation and were investigated as alternative predictors of client retention. FINDINGS There were 186 non-Indigenous (68.3 % female) and 174 Indigenous (62.6 % female) clients, with a median number of 3.0 consultations (IQR 2.0-5.3). Indigenous status did not significantly predict retention. Referral pathway significantly predicted the number of consultations (Wald X2(6) = 17.67, p = .0071) and immediate discontinuation (Wald X2(6) = 12.94, p = .044), with self-referred clients having the highest retention. Initial presentation reason significantly predicted the number of consultations (Wald X2(5) = 13.83, p = .017), with clients with potential health hazards related to socioeconomic and psychosocial circumstances having the lowest retention. Significantly more Indigenous clients presented for this reason (20.1 % vs 4.3 %). INTERPRETATION Comparable retention of Indigenous clients suggests cultural appropriateness of the psychotherapy being delivered by the FNS. Services might use the described therapeutic approach as a guide for culturally appropriate care.
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Affiliation(s)
- George Everson
- The ANU School of Medicine and Psychology, Australian National University, ACT, Canberra, Australia
| | - Breeanna Spring
- Royal Flying Doctor Service of Australia, 10-12 Brisbane Avenue, Barton, ACT, Australia; Molly Wardaguga Research Centre, Faculty of Health, Charles Darwin University, Darwin, NT, Australia
| | - Jocelyn Middleton
- Royal Flying Doctor Service of Australia, 12 Casuarina Street, Brisbane Airport, QLD, Australia
| | - Alice Richardson
- The Statistical Support Network, Australian National University, ACT, Canberra, Australia
| | - Fergus W Gardiner
- The ANU School of Medicine and Psychology, Australian National University, ACT, Canberra, Australia; Royal Flying Doctor Service of Australia, 10-12 Brisbane Avenue, Barton, ACT, Australia; The Rural Clinical School of Western Australia, The University of Western Australia, WA, Australia.
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Carrigan B, Bass L, Pinidiyapathirage J, Walters S, Woodall H, Brumpton K. Connectivity is the key to longer rural placement: Retaining students on rural longitudinal integrated clerkships. Med Teach 2024; 46:225-231. [PMID: 37557884 DOI: 10.1080/0142159x.2023.2243025] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
PURPOSE Recruitment and retention of medical practitioners to rural practice is an ongoing global issue. Rural longitudinal integrated clerkships (LIC) are an innovative solution to this problem, which are known to increase rural workforce. Crucially this association increases with time on rural placement. This study examines factors that promote retention in a Rural LIC. METHODS A two-phased, sequential design qualitative study in a cohort of students enrolled in a rural LIC at Griffith University, Queensland, Australia. Phase I consisted of an open-ended questionnaire and phase II follow-up focus groups from the same cohort. Data was transcribed and analysed using an iterative, six-step thematic analysis process to identify salient themes. RESULTS Twenty-four students were invited to participate, of which eight respond in phase I and thirteen participated in phase II. Participants described retention being driven by connectivity within three broad themes: current practice, future practice (immediate internship and career intention), and social networks. Participant proposals to increase connectivity were also suggested including peer-led solutions and short rotations in metropolitan hospitals. CONCLUSION Connectivity is key to retention on rural longitudinal integrated clerkships. Programs which enhance connectivity with current practice, future practice, and social networks will increase retention on rural medical programs.
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Affiliation(s)
- Brendan Carrigan
- Rural Medical Education Australia, Toowoomba, Australia
- School of Medicine and Dentistry, Griffith University, Southport, Australia
| | - Lucy Bass
- School of Medicine and Dentistry, Griffith University, Southport, Australia
| | - Janani Pinidiyapathirage
- Rural Medical Education Australia, Toowoomba, Australia
- School of Medicine and Dentistry, Griffith University, Southport, Australia
| | - Sherrilyn Walters
- Rural Medical Education Australia, Toowoomba, Australia
- School of Medicine and Dentistry, Griffith University, Southport, Australia
| | - Hannah Woodall
- Rural Medical Education Australia, Toowoomba, Australia
- School of Medicine and Dentistry, Griffith University, Southport, Australia
| | - Kay Brumpton
- Rural Medical Education Australia, Toowoomba, Australia
- School of Medicine and Dentistry, Griffith University, Southport, Australia
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Haworth N. Learning about crash causation from countermeasure evaluation: The example of the Queensland minimum passing distance rule. Accid Anal Prev 2024; 195:107401. [PMID: 38007878 DOI: 10.1016/j.aap.2023.107401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 10/03/2023] [Accepted: 11/21/2023] [Indexed: 11/28/2023]
Abstract
Close passes by motor vehicles endanger both the safety and comfort of bicycle riders. Governments in many countries have introduced laws requiring drivers to maintain at least a minimum distance between their vehicle and the cyclist they are passing, despite relatively poor understanding of the causes of bicycle overtaking crashes at the time. Queensland was the first state in Australia to introduce such a law, with a two-year trial commencing in April 2014. The data collected during the evaluation of the trial were later analysed to answer two main questions: "Under what circumstances do close passes occur?" and "Why do drivers pass too close?". The first question was largely approached by analysing the video observations of more than 18,000 riders (including 2,000 passing events) at 15 locations on Queensland roads and examining the infrastructure, traffic and road user characteristics that influenced passing distances. The second question was addressed in experimental studies which used the video observations as stimuli. This paper demonstrates how the political need for evaluation of a countermeasure can act as a stimulus for research funding that then allows data collection, analysis and better understanding of crash causation. Logically, introduction of a countermeasure should be based on a rigorous understanding of crash causation. But when this does not occur, evaluation may provide data that can be used to answer questions about crash causation - or at least pose new questions.
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Affiliation(s)
- Narelle Haworth
- Queensland University of Technology (QUT), Centre for Accident Research and Road Safety-Queensland (CARRS-Q), 130 Victoria Park Road, Kelvin Grove, QLD 4059, Australia.
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Fleming J, Prescott S, Claridge L, Doig E, Copley A, Finch E, Kerr C, Henry J. Capacity building for providers of cognitive rehabilitation in Queensland: a needs analysis survey. BRAIN IMPAIR 2024; 25:IB23062. [PMID: 38566286 DOI: 10.1071/ib23062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 01/28/2024] [Indexed: 04/04/2024]
Abstract
Background Cognitive rehabilitation of people with traumatic brain injury is a complex and challenging area of practice. Practitioners working in cognitive rehabilitation require ongoing training to stay abreast of new research and best practice interventions. A needs analysis was conducted to inform the development of a capacity building program for cognitive rehabilitation providers. Methods A cross-sectional online survey of providers of cognitive rehabilitation services in Queensland collected data on demographic information, perceptions of knowledge, skills and confidence in cognitive rehabilitation, previously completed training, desired training opportunities and delivery methods, and barriers and facilitators to engaging in training. Results The 103 respondents included 67 occupational therapists, 17 speech pathologists, 12 psychologists and seven social workers with a broad range of practice experience. Participants perceived a need for further training, with executive function and functional cognition the most desired topics. The number of topics previously trained on was significantly correlated with levels of knowledge, skills and confidence (P Conclusion Cognitive rehabilitation providers in Queensland reported a need for further training, delivered flexibly, with a focus on managing complex cognitive impairments.
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Affiliation(s)
- Jennifer Fleming
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Sarah Prescott
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Larissa Claridge
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Emmah Doig
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia; and Surgical Treatment and Rehabilitation Service (STARS) Education and Research Alliance, The University of Queensland and Metro North Health, Brisbane, Australia
| | - Anna Copley
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Emma Finch
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia; and Speech Pathology, Princess Alexandra Hospital, Brisbane, Qld, Australia; and Research and Innovation, West Moreton Health, Ipswich, Qld, Australia
| | | | - Julie Henry
- School of Psychology, The University of Queensland, Brisbane, Australia
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Maurer C, Alexander I, Nezic L, Woods S, Humphries B. A mixed-method approach to examining the experiences of allied health clinicians and managers of the performance, appraisal and development framework in a regional health care service. Aust J Rural Health 2024; 32:103-116. [PMID: 38009892 DOI: 10.1111/ajr.13068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 10/10/2023] [Accepted: 11/13/2023] [Indexed: 11/29/2023] Open
Abstract
INTRODUCTION Evaluating employee performance is important for organisational success however, limited research exists across the allied health workforce. OBJECTIVE This study investigated allied health clinician and manager experiences and perceptions of the appropriateness of the performance and development (PAD) framework. DESIGN A mixed methods design with purposive sampling was conducted in a medium size hospital and health service in regional Queensland to investigate the appropriateness of the PAD framework. A 29 item online survey collected likert scale and open ended responses. Identified respondents also completed a semi-structured interview. Aggregated satisfaction scores identifying PAD alignment, processes, education, resources and perceptions were analysed to identify organisational PAD appropriateness. Themes from interviews provided concurrent experiential data. FINDINGS Eighty-five respondents completed the online survey and 20 interviews were conducted. A Chi-Square Goodness of Fit test revealed a significant (p < 0.05) clinician (n = 75) response of moderate dissatisfaction (36%) for the PAD framework, while managers (n = 10) were neither dissatisfied nor satisfied (50%) or moderately satisfied (40%). Clinician aggregated agreement responses were significantly (p < 0.05) higher for PAD alignment (45%), processes (63%), education (49%) and lower for feedback (33%) and resources (28%). Manager aggregated agreement responses were high for PAD alignment (85%), processes (55%), education (57%), feedback (65%) and perceptions (50%). Interviews (n = 20) revealed three themes: uncertainty around PAD framework; expectations for experienced leadership and importance of discipline specific knowledge. DISCUSSION This study draws on both clinician and manager input to assess the overall PAD framework with responses favouring clinician dissatisfaction to the current process. CONCLUSION The PAD framework is valuable for staff development when there is positive rapport and discipline alignment between both clinician and manager. Successful staff appraisals require efficient and appropriate documentation that promotes individual development, clinical performance and organisational priorities.
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Affiliation(s)
- Carly Maurer
- Central Queensland Hospital and Health Services, Allied Health Unit, Rockhampton, Queensland, Australia
| | - Inga Alexander
- Central Queensland Hospital and Health Services, Allied Health Unit, Rockhampton, Queensland, Australia
| | - Lucija Nezic
- Central Queensland Hospital and Health Services, Allied Health Unit, Rockhampton, Queensland, Australia
| | - Sharon Woods
- Gold Coast Hospital and Health Services, Allied Health Unit, Southport, Queensland, Australia
| | - Brendan Humphries
- Central Queensland Hospital and Health Services, Allied Health Unit, Rockhampton, Queensland, Australia
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Hewitt J, Alsaba N, May K, Cartwright C, Willmott L, White BP, Marshall AP. The role of law in end-of-life decision-making in emergency departments and intensive care units: a retrospective review of current practice in a Queensland health service. AUST HEALTH REV 2024; 48:95-102. [PMID: 38081044 DOI: 10.1071/ah23160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 11/17/2023] [Indexed: 02/02/2024]
Abstract
Objective There is limited evidence about how legal frameworks that underpin end-of-life decisions are applied in practice. This study aimed to identify how end-of-life decisions are made and documented in emergency departments and intensive care units. The secondary aim was to explore the extent to which the legal processes featured in these decisions. Methods A retrospective chart audit of 85 adult patients who died in the emergency departments and intensive care units of a Queensland health service was undertaken. Quantitative data were analysed and reported using descriptive statistics. Qualitative textual data were analysed using inductive content analysis. Results Nearly all admissions were unplanned (97.6%), and most patients (74.1%) were admitted from home. Only one patient had an advance health directive, although all had an eligible substitute decision-maker. The qualitative analysis revealed two main concepts - 'healthcare professionals choreograph the end of life' and 'patients and families are carried on an unplanned journey'. Conclusions There was limited documentation related to the application of the legal framework in these decisions. Healthcare professionals relied on their clinical judgment about what was in the best interest of the patient. It was common for there to be a substantial effort to achieve consensus in decision-making which coincidently complied with the law.
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Affiliation(s)
- Jayne Hewitt
- School of Nursing and Midwifery, Griffith University, Gold Coast Campus, Parklands Drive, Southport, Qld 4222, Australia; and Griffith University, Law Futures Centre, Gold Coast Campus, Parklands Drive, Southport, Qld 4222, Australia; and Gold Coast University Hospital, 1 Hospital Boulevard, Southport, Qld 4215, Australia
| | - Nemat Alsaba
- Gold Coast University Hospital, 1 Hospital Boulevard, Southport, Qld 4215, Australia; and Faculty of Health Science and Medicine, Bond University, 14 University Drive, Robina, Qld 4226, Australia
| | - Katya May
- School of Nursing and Midwifery, Griffith University, Gold Coast Campus, Parklands Drive, Southport, Qld 4222, Australia; and Gold Coast University Hospital, 1 Hospital Boulevard, Southport, Qld 4215, Australia
| | - Colleen Cartwright
- Faculty of Health, Southern Cross University, Southern Cross Drive, Bilinga, Qld 4225, Australia
| | - Lindy Willmott
- Faculty of Business and Law, Queensland University of Technology, Gardens Point campus, 2 George Street, Brisbane, Qld 4000, Australia
| | - Ben P White
- Faculty of Business and Law, Queensland University of Technology, Gardens Point campus, 2 George Street, Brisbane, Qld 4000, Australia
| | - Andrea P Marshall
- School of Nursing and Midwifery, Griffith University, Gold Coast Campus, Parklands Drive, Southport, Qld 4222, Australia; and Gold Coast University Hospital, 1 Hospital Boulevard, Southport, Qld 4215, Australia
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Ertl NG, Anderson TK, Pardo CJ, Maidment TI, Murray GL, Bradshaw CS, Whiley DM, Sweeney EL. Concurrent parC and gyrA fluoroquinolone resistance mutations and associated strains in Mycoplasma genitalium in Queensland, Australia. J Antimicrob Chemother 2024; 79:467-469. [PMID: 38102067 PMCID: PMC10832590 DOI: 10.1093/jac/dkad373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023] Open
Affiliation(s)
- Nicole G Ertl
- The University of Queensland Centre for Clinical Research (UQCCR), Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Taylah K Anderson
- The University of Queensland Centre for Clinical Research (UQCCR), Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Carolyn J Pardo
- The University of Queensland Centre for Clinical Research (UQCCR), Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Toby I Maidment
- The University of Queensland Centre for Clinical Research (UQCCR), Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Gerald L Murray
- The Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia
- Centre for Women’s Infectious Diseases, The Royal Women’s Hospital, Parkville, Victoria, Australia
- Molecular Microbiology Research Group, Murdoch Children’s Research Institute, Parkville, Victoria, Australia
| | - Catriona S Bradshaw
- Melbourne Sexual Health Centre, Alfred Hospital and Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - David M Whiley
- The University of Queensland Centre for Clinical Research (UQCCR), Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Department of Microbiology, Pathology Queensland Central Laboratory, Brisbane, Queensland, Australia
| | - Emma L Sweeney
- The University of Queensland Centre for Clinical Research (UQCCR), Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
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Clark B, Green S, Gill N. The socio-demographics and clinical profile of patients referred to the GP liaison psychiatry service within a metropolitan Aboriginal medical service. Australas Psychiatry 2024; 32:79-83. [PMID: 37967815 DOI: 10.1177/10398562231214130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
OBJECTIVE This study aimed to describe the social demographics and clinical profile of patients referred to the psychiatry service within the local Queensland metropolitan Aboriginal Medical Service (AMS). METHOD This was a retrospective cohort study of patients referred to the psychiatry service provided at three clinics of a metropolitan AMS, over an 18-month period. Medical records were accessed to determine demographic and diagnostic information. RESULTS Diagnostically, 53% of patients had mood/anxiety disorders, 10% psychosis, 23% substance use and 14% with other diagnoses. There was approximately 50% non-attendance rate with no statistical difference between gender and age groups. The highest proportion of non-attenders within age groups was males 45-54 years old. The patients needed to travel an average of 20 km to attend the AMS. CONCLUSION The high non-attendance rates, and proportionately more males within the age group 45-54 years who were more likely to not attend their mental health appointments, suggested a target area for outreach services which have been implemented in the AMS. Some of the recommended solutions included confirming attendance the day prior and supporting with transport. This study highlighted the large distance that Aboriginal and Torres Strait Islander people must travel to access culturally appropriate service.
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Affiliation(s)
- Belinda Clark
- Mental Health and Specialist Services, Gold Coast Health, Gold Coast, QLD, Australia
- School of Medicine and Dentistry, Griffith University, Southport, QLD, Australia
| | - Sonya Green
- Mental Health and Specialist Services, Gold Coast Health, Gold Coast, QLD, Australia
- School of Medicine and Dentistry, Griffith University, Southport, QLD, Australia
| | - Neeraj Gill
- Mental Health and Specialist Services, Gold Coast Health, Gold Coast, QLD, Australia
- School of Medicine and Dentistry, Griffith University, Southport, QLD, Australia; and
- Mental Health Policy Unit, Health Research Institute, University of Canberra, Canberra, ACT, Australia
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Azizoğlu F, Terzi B. Research topics on pressure injury prevention and measurement tools from 1997 to 2023: A bibliometric analysis using VOSviewer. Intensive Crit Care Nurs 2024; 80:103557. [PMID: 37804817 DOI: 10.1016/j.iccn.2023.103557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/18/2023] [Accepted: 09/22/2023] [Indexed: 10/09/2023]
Abstract
OBJECTIVES To identify and visualize studies on pressure injuries in intensive care units, prevention of pressure injuries and measurement tools, and reveal the global trends in this field. RESEARCH METHODOLOGY/DESIGN Descriptive and bibliometric analysis method study. SETTING Data were obtained from the "Web of Science Core Collection" database on July 12th, 2023. For bibliometric data, the Web of Science database was searched with the keywords "intensive care unit," "pressure injury," "prevention," "risk assessment tools," and critical care." Performance analysis, scientific mapping, and bibliometric analyses were completed using the VOSviewer (1.6.15) software program for a total of 326 publications. MAIN OUTCOME MEASURES Publication, cluster, link and network map on pressure injury, prevention and risk measurement tools. RESULTS As a result of the analysis, the most used keywords were "pressure injury," "pressure ulcer," "critical care," "pressure ulcers," "intensive care unit," and "pressure injuries." The journal with the highest number of publications (n = 55) was "Journal of Wound Ostomy Continence Nursing", the highest number of articles (n = 47) was published in 2022, the most active institution was "Queensland University of Technology Qut" (20 articles), the country that published the most was the United States of America (171 articles), the institution that provided the most funding was the "National Institutes of Health NIH USA" (20 articles), and Cox J. was the author who published the most articles. CONCLUSION This study highlights popular fields of research in pressure injury prevention and risk measurement tools aimed at improving quality of care in intensive care units. IMPLICATIONS FOR CLINICAL PRACTICE The bibliometric analysis method used in the study can lead nurses to conduct research to prevent pressure injuries in critical care patients and develop risk measurement tools to overcome deficiencies such as prevention tools and objective risk measurement tools in this field.
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Affiliation(s)
- Fatma Azizoğlu
- Haliç University, Faculty of Health Sciences, 5.Levent Mahallesi, 15 Temmuz Şehitler Caddesi, No: 14/12 34060, Eyüpsultan/İstanbul, Turkey
| | - Banu Terzi
- Akdeniz University, Faculty of Nursing, Fundamentals of Nursing Department, Akdeniz Üniversitesi Dumlupınar Bulvarı, Akdeniz Üniversitesi Yerleşkesi Konyaaltı, 07070 Antalya, Turkey.
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Hu Y, Allen J, Ellwood D, Slavin V, Gamble J, Toohill J, Callander E. The financial impact of offering publicly funded homebirths: A population-based microsimulation in Queensland, Australia. Women Birth 2024; 37:137-143. [PMID: 37524616 DOI: 10.1016/j.wombi.2023.07.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 07/17/2023] [Accepted: 07/19/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND Despite strong evidence of benefits and increasing consumer demand for homebirth, Australia has failed to effectively upscale it. To promote the adoption and expansion of homebirth in the public health care system, policymakers require quantifiable results to evaluate its economic value. To date, there has been limited evaluation of the financial impact of birth settings for women at low risk of pregnancy complications. OBJECTIVE This study aimed to examine the difference in inpatient costs around birth between offering homebirth in the public maternity system versus not offering public homebirth to selected women who meet low-risk pregnancy criteria. METHODS We used a whole-of-population linked administrative dataset containing all women who gave birth in Queensland (one Australian State) between 01/07/2012 and 30/06/2018 where publicly funded homebirth is not currently offered. We created a static microsimulation model to compare the inpatient cost difference for mother and baby around birth based on the women who gave birth between 01/07/2017 and 30/06/2018 (n = 36,314). The model comprised of a base model - representing standard public hospital care, and a counterfactual model - representing a hypothetical scenario where 5 % of women who gave birth in public hospitals planned to give birth at home prior to the onset of labour (n = 1816). Costs were reported in 2021/22 AUD. RESULTS In our hypothetical scenario, after considering the effect of assumptive place and mode of birth for these planned homebirths, the estimated State-level inpatient cost saving around birth (summed for mother and babies) per pregnancy were: AU$303.13 (to Queensland public hospitals) and AU$186.94 (to Queensland public hospital funders). This calculates to a total cost saving per annum of AU$11 million (to Queensland public hospitals) and AU$6.8 million (to Queensland public hospital funders). CONCLUSION A considerable amount of inpatient health care costs around birth could be saved if 5 % of women booked at their local public hospitals, planned to give birth at home through a public-funded homebirth program. This finding supports the establishment and expansion of the homebirth option in the public health care system.
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Affiliation(s)
- Yanan Hu
- Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Jyai Allen
- Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia; Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, Australia
| | - David Ellwood
- School of Medicine & Dentistry, Griffith University, Gold Coast, Australia; Gold Coast University Hospital, Gold Coast Hospital and Health Service, Southport, Australia
| | - Valerie Slavin
- Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia; Gold Coast University Hospital, Gold Coast Hospital and Health Service, Southport, Australia; School of Nursing and Midwifery, Griffith University, Gold Coast, Australia
| | - Jenny Gamble
- School of Nursing and Midwifery, Griffith University, Gold Coast, Australia; School of Nursing, Midwifery and Health, Coventry University, Coventry, United Kingdom
| | - Jocelyn Toohill
- School of Nursing, Midwifery and Health, Coventry University, Coventry, United Kingdom; Clinical Excellence Division, Queensland Health, Queensland, Australia
| | - Emily Callander
- Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.
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Thorn G, Cox J. Improving Health Equity to Primary Care for First Nations Peoples Living in Northern Queensland. Stud Health Technol Inform 2024; 310:1562-1563. [PMID: 38269746 DOI: 10.3233/shti231294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
With only 13.75% of the identified Aboriginal and Torres Strait Islander population of northern Queensland accessing a billed 715 Health Assessment over a 12-month period, Northern Queensland Primary Health Network (NQPHN) is embarking on an ambitious 12-month program to dramatically improve access to health assessments, and integrated and coordinated care for First Nations' people within its region. By supporting primary care providers with targeted education, training, and digital health literacy bundles and tools, NQPHN aims to facilitate quality and culturally safe 715 Health Assessments to manage chronic conditions. Success of the program will be measured using regional and practice-level data, focusing on the number of Health Assessments and Management Plans for identified chronic conditions.
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Affiliation(s)
- Gilyan Thorn
- Northern Queensland Primary Health Network, Australia
| | - Janine Cox
- Northern Queensland Primary Health Network, Australia
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Diouf I, Grimes J, O'Brien MJ, Hassanzadeh H, Truran D, Ngo H, Raniga P, Lawley M, Bauer DC, Hansen D, Khanna S, Reguant R. An Approach for Generating Realistic Australian Synthetic Healthcare Data. Stud Health Technol Inform 2024; 310:820-824. [PMID: 38269923 DOI: 10.3233/shti231079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
Healthcare data is a scarce resource and access is often cumbersome. While medical software development would benefit from real datasets, the privacy of the patients is held at a higher priority. Realistic synthetic healthcare data can fill this gap by providing a dataset for quality control while at the same time preserving the patient's anonymity and privacy. Existing methods focus on American or European patient healthcare data but none is exclusively focused on the Australian population. Australia is a highly diverse country that has a unique healthcare system. To overcome this problem, we used a popular publicly available tool, Synthea, to generate disease progressions based on the Australian population. With this approach, we were able to generate 100,000 patients following Queensland (Australia) demographics.
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Affiliation(s)
- Ibrahima Diouf
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Australia
| | - John Grimes
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Australia
| | - Mitchell J O'Brien
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Australia
| | - Hamed Hassanzadeh
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Australia
| | - Donna Truran
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Australia
| | - Hoa Ngo
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Australia
| | - Parnesh Raniga
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Australia
| | - Michael Lawley
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Australia
| | - Denis C Bauer
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Australia
- Macquarie University, Department of Biomedical Sciences, Faculty of Medicine and Health Science, Macquarie Park, Australia
- Macquarie University, Applied BioSciences, Faculty of Science and Engineering, Macquarie Park, Australia
| | - David Hansen
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Australia
| | - Sankalp Khanna
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Australia
| | - Roc Reguant
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Australia
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Wright BR, Casteriano A, Muir YSS, Hulse L, Simpson SJ, Legione AR, Vaz PK, Devlin JM, Krockenberger MB, Higgins DP. Expanding the known distribution of phascolartid gammaherpesvirus 1 in koalas to populations across Queensland and New South Wales. Sci Rep 2024; 14:1223. [PMID: 38216613 PMCID: PMC10786818 DOI: 10.1038/s41598-023-50496-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 12/20/2023] [Indexed: 01/14/2024] Open
Abstract
Koala populations across the east coast of Australia are under threat of extinction with little known about the presence or distribution of a potential pathogen, phascolartid gammaherpesvirus 1 (PhaHV-1) across these threatened populations. Co-infections with PhaHV-1 and Chlamydia pecorum may be common and there is currently a limited understanding of the impact of these co-infections on koala health. To address these knowledge gaps, archived clinical and field-collected koala samples were examined by quantitative polymerase chain reaction to determine the distribution of PhaHV-1 in previously untested populations across New South Wales and Queensland. We detected PhaHV-1 in all regions surveyed with differences in detection rate between clinical samples from rescued koalas (26%) and field-collected samples from free-living koalas (8%). This may reflect increased viral shedding in koalas that have been admitted into care. We have corroborated previous work indicating greater detection of PhaHV-1 with increasing age in koalas and an association between PhaHV-1 and C. pecorum detection. Our work highlights the need for continued surveillance of PhaHV-1 in koala populations to inform management interventions, and targeted research to understand the pathogenesis of PhaHV-1 and determine the impact of infection and co-infection with C. pecorum.
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Affiliation(s)
- Belinda R Wright
- Sydney School of Veterinary Science, University of Sydney, Camperdown, NSW, 2006, Australia.
| | - Andrea Casteriano
- Sydney School of Veterinary Science, University of Sydney, Camperdown, NSW, 2006, Australia
| | - Yasmine S S Muir
- Sydney School of Veterinary Science, University of Sydney, Camperdown, NSW, 2006, Australia
| | - Lyndal Hulse
- School of Agriculture and Food Sciences, The University of Queensland, St Lucia, QLD, 4072, Australia
| | - Sarah J Simpson
- Sydney School of Veterinary Science, University of Sydney, Camperdown, NSW, 2006, Australia
| | - Alistair R Legione
- Melbourne Veterinary School, Faculty of Science, Asia Pacific Centre for Animal Health, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Paola K Vaz
- Melbourne Veterinary School, Faculty of Science, Asia Pacific Centre for Animal Health, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Joanne M Devlin
- Melbourne Veterinary School, Faculty of Science, Asia Pacific Centre for Animal Health, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Mark B Krockenberger
- Sydney School of Veterinary Science, University of Sydney, Camperdown, NSW, 2006, Australia
| | - Damien P Higgins
- Sydney School of Veterinary Science, University of Sydney, Camperdown, NSW, 2006, Australia
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Shamsi S, Nelson L, Gordon A, Markham K, Francis N, Suthar J, Zhu X. Multidisciplinary approach to the diagnosis of Contracaecum magnipapillatum infections in Australian black noddies, Anous minutus (Charadriiformes: Laridae). Parasitol Res 2024; 123:90. [PMID: 38195805 PMCID: PMC10776730 DOI: 10.1007/s00436-023-08050-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 11/03/2023] [Indexed: 01/11/2024]
Abstract
We provide the incidental necropsy findings associated with anisakid nematode infections of black noddy terns, Anous minutus Boie, 1844 (Charadriiformes: Laridae), from offshore islands in the southern Great Barrier Reef, Queensland, Australia. Specimens collected from the proventriculi were identified morphologically as Contracaecum magnipapillatum Chapin, 1925 (Rhabditida: Anisakidae), using light and scanning electron microscopy (SEM). The entire nuclear ribosomal DNA internal transcribed spacer (ITS) region (ITS1-5.8S-ITS2) was amplified by polymerase chain reaction (PCR) and sequenced to provide reference sequences for morphologically well-identified voucher specimens. Interestingly, after an alignment with closely related taxa using BLAST, sequences of the ITS1 and ITS2 were 100% identical to the sequences assigned to Contracaecum septentrionale Kreis, 1955, from a razorbill, Alca torda Linnaeus, 1758 (Charadriiformes: Alcidae), from Spain. These results either raise questions about the ITS as a genetic marker for some members of Contracaecum, or the identity of the specimens assigned to C. septentrionale, given that no supporting morphological data was associated with them. We highlight the need for a combined morphological and molecular approach to parasite diagnostics and the use of multiple genetic loci to resolve the molecular taxonomy of cryptic species. Morphological identifications should be taxonomically robust, transparent and precede the deposition of molecular barcodes in public repositories. The gross and histopathological findings of our investigation concur with previous reports of widespread Contracaecum infections in black noddies and support the contention that Contracaecum spp. are an unlikely primary cause of mortality.
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Affiliation(s)
- Shokoofeh Shamsi
- School of Agricultural, Environmental and Veterinary Sciences, Gulbali Institute, Charles Sturt University, Locked Bag 588, Wagga Wagga, NSW, 2678, Australia.
| | - Leanne Nelson
- Biosecurity Sciences Laboratory, Queensland Department of Agriculture and Fisheries, Archerfield BC QLD, PO Box 156, Brisbane, 4108, Australia.
| | - Anita Gordon
- Biosecurity Sciences Laboratory, Queensland Department of Agriculture and Fisheries, Archerfield BC QLD, PO Box 156, Brisbane, 4108, Australia
| | - Kathryn Markham
- Biosecurity Sciences Laboratory, Queensland Department of Agriculture and Fisheries, Archerfield BC QLD, PO Box 156, Brisbane, 4108, Australia
| | - Nidhish Francis
- School of Agricultural, Environmental and Veterinary Sciences, Gulbali Institute, Charles Sturt University, Locked Bag 588, Wagga Wagga, NSW, 2678, Australia
| | - Jaydipbhai Suthar
- School of Agricultural, Environmental and Veterinary Sciences, Gulbali Institute, Charles Sturt University, Locked Bag 588, Wagga Wagga, NSW, 2678, Australia
| | - Xiaocheng Zhu
- School of Agricultural, Environmental and Veterinary Sciences, Gulbali Institute, Charles Sturt University, Locked Bag 588, Wagga Wagga, NSW, 2678, Australia
- NSW Department of Primary Industries, Wagga Wagga Agricultural Institute, Wagga Wagga, NSW, 2650, Australia
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Carrandi A, Bull C, Hu Y, Grzeskowiak LE, Teede H, Black K, Callander E. Patterns in the provision of government-subsidised hormonal postpartum contraception in Queensland, Australia between 2012 and 2018: a population-based cohort study. BMJ Sex Reprod Health 2024; 50:13-20. [PMID: 37353310 DOI: 10.1136/bmjsrh-2023-201830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 06/07/2023] [Indexed: 06/25/2023]
Abstract
BACKGROUND Short birth intervals and unintended pregnancy are associated with poorer maternal and infant outcomes. There is a risk of pregnancy during the immediate postpartum period unless contraception is initiated. This retrospective cohort study aimed to capture the current patterns of hormonal contraceptive provision within 12 months postpartum in a high-income country. METHODS We used a linked administrative dataset comprising all women who gave birth in Queensland, Australia between 1 July 2012 and 30 June 2018 (n=339 265 pregnancies). We described our cohort by whether they were provided with government-subsidised hormonal contraception within 12 months postpartum. The associations between hormonal postpartum contraceptive provision and demographic and clinical characteristics were examined using univariate and multivariate logistic regression and presented in terms of crude and adjusted odds ratios with 95% confidence intervals. RESULTS A majority of women (60.2%) were not provided with government-subsidised hormonal postpartum contraception within 12 months postpartum. Women who were younger (<25 years), were overweight or obese, smoked, were born in Australia, were non-Indigenous, gave birth in a public hospital, or were in the lowest socioeconomic status group were more likely to be provided with postpartum contraception after adjusting for other covariates, compared with their counterparts. CONCLUSIONS Strategies to increase the provision and uptake of contraception in the immediate postpartum period are needed to prevent short birth intervals and unintended pregnancy and ensure women's fertility intentions are enacted. Ongoing research is needed to examine the factors influencing women's access to contraceptive services and, further, the types of contraception provided.
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Affiliation(s)
- Alayna Carrandi
- Monash Centre for Health Research and Implementation, Clayton, Victoria, Australia
| | - Claudia Bull
- Monash Centre for Health Research and Implementation, Clayton, Victoria, Australia
| | - Yanan Hu
- Monash Centre for Health Research and Implementation, Clayton, Victoria, Australia
| | - Luke E Grzeskowiak
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
- Monash University Faculty of Pharmacy and Pharmaceutical Sciences, Parkville, Victoria, Australia
| | - Helena Teede
- Monash Centre for Health Research and Implementation, Clayton, Victoria, Australia
| | - Kirsten Black
- Faculty of Medicine and Health, The University of Sydney School of Medicine, Sydney, New South Wales, Australia
| | - Emily Callander
- School of Public Health, University of Technology Sydney, Sydney, NSW, Australia
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Larsen EN, Marsh N, Rickard CM, Mihala G, Walker RM, Byrnes J. Health-related quality of life and experience measures, to assess patients' experiences of peripheral intravenous catheters: a secondary data analysis. Health Qual Life Outcomes 2024; 22:1. [PMID: 38167165 PMCID: PMC10762939 DOI: 10.1186/s12955-023-02217-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 12/07/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Peripheral intravenous catheters (PIVCs) are essential for successful administration of intravenous treatments. However, insertion failure and PIVC complications are common and negatively impact patients' health-outcomes and experiences. We aimed to assess whether generic (not condition-specific) quality of life and experience measures were suitable for assessing outcomes and experiences of patients with PIVCs. METHODS We undertook a secondary analysis of data collected on three existing instruments within a large randomised controlled trial, conducted at two adult tertiary hospitals in Queensland, Australia. Instruments included the EuroQol Five Dimension - Five Level (EQ5D-5L), the Functional Assessment of Chronic Illness Therapy - Treatment Satisfaction - General measure (FACIT-TS-G, eight items), and the Australian Hospital Patient Experience Question Set (AHPEQS, 12 items). Responses were compared against two clinical PIVC outcomes of interest: all-cause failure and multiple insertion attempts. Classic descriptives were reported for ceiling and floor effects. Regression analyses examined validity (discrimination). Standardised response mean and effect size (ES) assessed responsiveness (EQ5D-5L, only). RESULTS In total, 685 participants completed the EQ5D-5L at insertion and 526 at removal. The FACIT-TS-G was completed by 264 and the AHPEQS by 262 participants. Two FACIT-TS-G items and one AHPEQS item demonstrated ceiling effect. Instruments overall demonstrated poor discrimination, however, all-cause PIVC failure was significantly associated with several individual items in the instruments (e.g., AHPEQS, 'unexpected physical and emotional harm'). EQ5D-5L demonstrated trivial (ES < 0.20) responsiveness. CONCLUSIONS Initial investigation of an existing health-related quality of life measure (EQ5D-5L) and two patient-reported experience measures (FACIT-TS-G; AHPEQS) suggest they are inadequate (as a summary measure) to assess outcomes and experiences for patients with PIVCs. Reliable instruments are urgently needed to inform quality improvement and benchmark standards of care.
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Affiliation(s)
- Emily N Larsen
- School of Nursing and Midwifery, Griffith University, Nathan, Australia.
- Nursing and Midwifery Research Centre, Royal Brisbane and Women's Hospital, Building 34, Corner Bowen Bridge Rd and Butterfield St, Herston, QLD, 4029, Australia.
- Patient-Centred Health Services, Menzies Health Institute Queensland, NHMRC Centre of Research Excellence in Wiser Wound Care, Griffith University, Nathan, Australia.
- Alliance for Vascular Access Teaching and Research, Griffith University, Nathan, Australia.
- School of Nursing, Midwifery and Social Work, The University of Queensland Centre for Clinical Research, Herston, QLD, Australia.
| | - Nicole Marsh
- School of Nursing and Midwifery, Griffith University, Nathan, Australia
- Nursing and Midwifery Research Centre, Royal Brisbane and Women's Hospital, Building 34, Corner Bowen Bridge Rd and Butterfield St, Herston, QLD, 4029, Australia
- Patient-Centred Health Services, Menzies Health Institute Queensland, NHMRC Centre of Research Excellence in Wiser Wound Care, Griffith University, Nathan, Australia
- Alliance for Vascular Access Teaching and Research, Griffith University, Nathan, Australia
- School of Nursing, Midwifery and Social Work, The University of Queensland Centre for Clinical Research, Herston, QLD, Australia
| | - Claire M Rickard
- School of Nursing and Midwifery, Griffith University, Nathan, Australia
- Nursing and Midwifery Research Centre, Royal Brisbane and Women's Hospital, Building 34, Corner Bowen Bridge Rd and Butterfield St, Herston, QLD, 4029, Australia
- Patient-Centred Health Services, Menzies Health Institute Queensland, NHMRC Centre of Research Excellence in Wiser Wound Care, Griffith University, Nathan, Australia
- Alliance for Vascular Access Teaching and Research, Griffith University, Nathan, Australia
- School of Nursing, Midwifery and Social Work, The University of Queensland Centre for Clinical Research, Herston, QLD, Australia
- Herston Infectious Diseases Institute, Metro North Health, Herston, QLD, Australia
| | - Gabor Mihala
- Alliance for Vascular Access Teaching and Research, Griffith University, Nathan, Australia
- Centre for Applied Health Economics, School of Medicine and Dentistry, Griffith University, Nathan, QLD, Australia
| | - Rachel M Walker
- School of Nursing and Midwifery, Griffith University, Nathan, Australia
- Patient-Centred Health Services, Menzies Health Institute Queensland, NHMRC Centre of Research Excellence in Wiser Wound Care, Griffith University, Nathan, Australia
- Alliance for Vascular Access Teaching and Research, Griffith University, Nathan, Australia
- Division of Surgery, Princess Alexandra Hospital, Metro South Health, Brisbane, QLD, Australia
| | - Joshua Byrnes
- Alliance for Vascular Access Teaching and Research, Griffith University, Nathan, Australia
- Centre for Applied Health Economics, School of Medicine and Dentistry, Griffith University, Nathan, QLD, Australia
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Gallo LA, Steane SE, Young SL, de Jersey S, Schoenaker DAJM, Borg DJ, Lockett J, Collins CE, Perkins AV, Kumar S, Clifton VL, Wilkinson SA. Dietary supplements, guideline alignment and biochemical nutrient status in pregnancy: Findings from the Queensland Family Cohort pilot study. Matern Child Nutr 2024; 20:e13589. [PMID: 37947159 PMCID: PMC10750014 DOI: 10.1111/mcn.13589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 10/16/2023] [Accepted: 10/24/2023] [Indexed: 11/12/2023]
Abstract
In high-income nations, multiple micronutrient (MMN) supplementation during pregnancy is a common practice. We aimed to describe maternal characteristics associated with supplement use and daily dose of supplemental nutrients consumed in pregnancy, and whether guideline alignment and nutrient status are related to supplement use. The Queensland Family Cohort is a prospective, Australian observational longitudinal study. Maternal characteristics, nutrient intake from food and supplements, and biochemical nutrient status were assessed in the second trimester (n = 127). Supplement use was reported by 89% of participants, of whom 91% reported taking an MMN supplement. Participants who received private obstetric care, had private health insurance and had greater alignment to meat/vegetarian alternatives recommendations were more likely to report MMN supplement use. Private obstetric care and general practitioner shared care were associated with higher daily dose of supplemental nutrients consumed compared with midwifery group practice. There was high reliance on supplements to meet nutrient reference values for folate, iodine and iron, but only plasma folate concentrations were higher in MMN supplement versus nonsupplement users. Exceeding the upper level of intake for folic acid and iron was more likely among combined MMN and individual supplement/s users, and associated with higher plasma concentrations of the respective nutrients. Given the low alignment with food group recommendations and potential risks associated with high MMN supplement use, whole food diets should be emphasized. This study confirms the need to define effective strategies for optimizing nutrient intake in pregnancy, especially among those most vulnerable where MMN supplement use may be appropriate.
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Affiliation(s)
- Linda A. Gallo
- School of HealthUniversity of the Sunshine CoastPetrieQLDAustralia
- School of Biomedical SciencesThe University of QueenslandSt LuciaQLDAustralia
| | - Sarah E. Steane
- School of Biomedical SciencesThe University of QueenslandSt LuciaQLDAustralia
- Mater Research InstituteThe University of QueenslandSouth BrisbaneQLDAustralia
| | - Sophia L. Young
- School of HealthUniversity of the Sunshine CoastPetrieQLDAustralia
| | - Susan de Jersey
- Department of Dietetics and Foodservices, Royal Brisbane and Women's HospitalMetro North Hospital and Health ServiceBrisbaneQLDAustralia
- Centre for Health Services ResearchThe University of QueenslandHerstonQLDAustralia
| | - Danielle A. J. M. Schoenaker
- School of Human Development and Health, Faculty of MedicineUniversity of SouthamptonSouthamptonUK
- MRC Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
- NIHR Southampton Biomedical Research CentreUniversity Hospital Southampton NHSSouthamptonUK
| | - Danielle J. Borg
- Mater Research InstituteThe University of QueenslandSouth BrisbaneQLDAustralia
| | - Jack Lockett
- Mater Research InstituteThe University of QueenslandSouth BrisbaneQLDAustralia
| | - Clare E. Collins
- School of Health Sciences, College of Health, Medicine and WellbeingUniversity of NewcastleCallaghanNSWAustralia
- Hunter Medical Research InstituteNew Lambton HeightsNSWAustralia
| | | | - Sailesh Kumar
- Mater Research InstituteThe University of QueenslandSouth BrisbaneQLDAustralia
| | - Vicki L. Clifton
- Mater Research InstituteThe University of QueenslandSouth BrisbaneQLDAustralia
| | - Shelley A. Wilkinson
- School of PharmacyThe University of QueenslandSt LuciaQLDAustralia
- Department of Obstetric MedicineMater Mothers HospitalSouth BrisbaneQLDAustralia
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Nicoll E, Wilkinson SA, Braithwaite S, de Jersey S. A prospective observational evaluation of an online health care professional training program to promote healthy pregnancy weight gain. Health Promot J Austr 2024; 35:90-99. [PMID: 36896565 DOI: 10.1002/hpja.715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 02/03/2023] [Accepted: 03/06/2023] [Indexed: 03/11/2023] Open
Abstract
ISSUE ADDRESSED A lack of programs to develop clinician knowledge and confidence to address weight gain within pregnancy is a barrier to the provision of evidence-based care. AIM To examine the reach and effectiveness of the Healthy Pregnancy Healthy Baby online health professional training program. METHODS A prospective observational evaluation applied the reach and effectiveness elements of the RE-AIM framework. Health professionals from a range of disciplines and locations were invited to complete questionnaires before and after program completion assessing objective knowledge and perceived confidence around aspects of supporting healthy pregnancy weight gain, and process measures. RESULTS There were 7577 views across all pages over a year period, accessed by participants across 22 Queensland locations. Pre- and post- training questionnaires were completed 217 and 135 times, respectively. The proportion of participants with scores over 85% and of 100% for objective knowledge was higher post training (P ≤ .001). Perceived confidence improved across all areas for 88%-96% of those who completed the post- training questionnaire. All respondents would recommend the training to others. CONCLUSIONS Clinicians from a range of disciplines, experience and locations accessed and valued the training, and knowledge of, and confidence in delivering care to support healthy pregnancy weight gain improved after completion. SO WHAT?: This effective program to build the capacity of clinicians to support healthy pregnancy weight gain offers a model for online, flexible training highly valued by clinicians. Its adoption and promotion could standardise the support provided to women to encourage healthy weight gain during pregnancy.
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Affiliation(s)
- Evelyn Nicoll
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- School of Human Movements and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Shelley A Wilkinson
- School of Human Movements and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Simone Braithwaite
- Prevention Strategy Branch, Queensland Department of Health, Brisbane, Queensland, Australia
| | - Susan de Jersey
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Queensland, Australia
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Abedi M, Aplin T, Gane E, Johnston V. "No Man's Land": the experiences of persons injured in a road traffic crash wanting to return to work in Queensland, Australia. Disabil Rehabil 2024; 46:48-57. [PMID: 36469639 DOI: 10.1080/09638288.2022.2153178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 11/24/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE This study aimed to explore individuals' experiences of return to work (RTW) following minor to serious road traffic injury (RTI) in Queensland, Australia; seek their recommendations if any, on how to provide support for RTW after RTI; and identify the strategies and resources used to return and remain at work after their RTI. METHODS The interpretive description methodological approach was used. Semi-structured interviews were conducted with eligible participants (n = 18) aged 18-65 y who had experienced a minor to serious RTI at least 6 months earlier. Thematic analysis was used to analyse the data. RESULTS Five themes emerged: (1) physical and mental consequences of RTI negatively impact RTW; (2) money matters; (3) RTW support makes a difference; (4) feeling alone and confused in the RTW process; and (5) several strategies and resources helped with return/stay at work after RTI. Regular contact and cooperation with employers and insurers, job modifications, and using social media to obtain information and social support were helpful RTW strategies. Participants recommended timely and appropriate medical care, financial assistance, and educational support. CONCLUSIONS Policy changes to reduce financial stress, increase employer support, and improve injured individuals' knowledge following a RTI are recommended in jurisdictions operating a fault-based scheme.IMPLICATIONS FOR REHABILITATIONThis study identified several factors that can influence return to work (RTW) following minor to serious road traffic injuries (RTIs) in a jurisdiction operating a fault-based compensation scheme.Legislative changes that provide financial assistance to all injured people regardless of their fault-status could reduce financial stress arising from reduced work ability following a road traffic injury.Increasing employer' awareness of the importance of return to work for those with road traffic injuries and reimbursement for possible expenses of providing RTW support for these individuals could increase employability of injured people following RTI.Improving injured individuals' knowledge about return-to-work processes after a road traffic injury could accelerate recovery and return to work.
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Affiliation(s)
- Masoumeh Abedi
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Tammy Aplin
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Allied Health Research Collaborative, The Prince Charles Hospital, Brisbane, Australia
| | - Elise Gane
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Physiotherapy Department, Princess Alexandra Hospital, Brisbane, Australia
- Centre for Functioning and Health Research, Metro South Health, Brisbane, Australia
| | - Venerina Johnston
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
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Webber AL, Toomey M, Keay L, Dai S, Gole GA, Newcomb D, McKinlay L. Building and maintaining interprofessional collaborative practice in eyecare: Learnings from the Queensland Paediatric Optometry Alignment Program. Ophthalmic Physiol Opt 2024; 44:52-70. [PMID: 38009804 DOI: 10.1111/opo.13246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 10/18/2023] [Accepted: 10/25/2023] [Indexed: 11/29/2023]
Abstract
PURPOSE The Queensland Children's Hospital Paediatric Optometry Alignment Program commenced with a pilot phase to assess its feasibility, effectiveness and acceptability. This study identified the barriers that hinder effective interprofessional collaboration and the facilitators that contribute to its success, and assessed changes in optometrists' satisfaction since the pilot phase of the collaborative care programme. METHODS Qualitative deductive and inductive content analysis was applied to open-ended free-text survey responses collected in 2018 from the optometrists involved in the Program's pilot phase. The responses were coded using the Theoretical Domains Framework (TDF) to categorise barriers and facilitators into key themes. Key behavioural determinants were mapped to the COM-B (Capability, Opportunity, Motivation-Behaviour) elements of the Behaviour Change Wheel model to identify intervention strategies. Intervention recommendations were derived from behaviour change mapping and compared with programme quality improvement initiatives. A cross-sectional explanatory survey informed by the TDF was conducted within the current 2023 cohort, and a longitudinal comparative analysis was carried out using data from the 2018 survey. RESULTS Among the 97 surveys distributed in 2018, 44 respondents participated; from this group, 38 individuals contributed a total of 200 free-text responses. Facilitators (240 comments) outnumbered barriers (65 comments). Key facilitators were accessible and timely care, professional development, confidence and positive outcome beliefs. Barriers included communication, information handover, credibility, relationships and skill gaps. Optometrists actively engaged in the programme in 2023 reported heightened satisfaction with their involvement, increased confidence and greater engagement in paediatric eyecare delivery. However, challenges in clinical information transfer persist. CONCLUSION The interprofessional collaborative model of paediatric eyecare has contributed efficiencies within the health system by building paediatric care capacity in the community, fostering professional credibility and promoting interdisciplinary trust. Insights gained should prove valuable for other paediatric eyecare services exploring hospital-to-community care models.
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Affiliation(s)
- Ann L Webber
- School of Optometry and Vision Science, Queensland University of Queensland, Brisbane, Queensland, Australia
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Melinda Toomey
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Lisa Keay
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Shuan Dai
- Children's Health Queensland, Brisbane, Queensland, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Glen A Gole
- Children's Health Queensland, Brisbane, Queensland, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Dana Newcomb
- General Practice Clinical Unit, Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Lynne McKinlay
- Children's Health Queensland, Brisbane, Queensland, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
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West S, Franklin D, Harvey N, Cairns A. Nasal high flow therapy in remote hospitals: guideline development using a modified Delphi technique. Rural Remote Health 2024; 24:8516. [PMID: 38282353 DOI: 10.22605/rrh8516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2024] Open
Abstract
INTRODUCTION In remote Australian hospitals there are no onsite paediatric intensive care units (PICUs), increasing the reliance on aeromedical retrieval to access tertiary care. Nasal high flow (NHF) therapy is an oxygen therapy used in tertiary hospitals to treat paediatric patients with respiratory conditions. In rural and remote Queensland, Australia, the use of NHF therapy is inconsistent and there are no guidelines on how this therapy should be implemented in practice. Therefore, three remote hospitals within the Torres Strait and Cape York commenced a project to improve consistent and equitable access to NHF therapy. Implementing NHF therapy in remote hospitals may improve health and social outcomes for children with acute respiratory distress. A clinical guideline for the use of NHF therapy in the three participating remote hospitals was published on 28 October 2021. This study aimed to develop a clinical guideline for the use of NHF therapy in three remote hospitals. METHODS A modified Delphi technique was used to develop the guideline. Remote medicine and nursing clinicians at the three study sites, retrieval experts, a receiving tertiary-based paediatrician, PICU specialists and NHF therapy experts made up the expert panel of participants. These experts participated in an iterative round table discussion to develop remote-specific guidelines for the use of NHF therapy. Prior to the meeting, panellists were provided with an executive summary of the current literature on NHF therapy implementation with key questions for consideration. Participants were able to add relevant issues ad hoc. A final guideline representing the panellists' recommendations was submitted to the Torres and Cape Health Service for ratification. RESULTS Remote-specific decisions on the following topics were produced: environment of care, nasogastric tube usage, timings of chest X-ray, automatic approvals to arrange courier services for pathology, medication use, staff training; staff ratios, observations regimes, both tertiary and local medical consultation frequency and the experience level of the medical officer required to attend to these consultations, location of the on-call medical officer, documentation, escalation of care considerations and disposition of the patient in relation to retrievals. DISCUSSION Decisions were made to mitigate two highly representative remote factors: delays in the workplace practices, such as time to arrange treatment locally and delays in retrievals; and burden of the lack of access to services, such as lack of access to trained staff, staffing levels on-shift, adequate oxygen and equipment/consumable supplies. CONCLUSION The aim was to develop a clinical guideline that was contextualised to the remote hospital. This outcome was achieved by using a modified Delphi technique, with a panel of experts providing the decision-making for the guideline. Consistency and safety were addressed by reducing delays in workplace practices; examples were time to arrange treatment locally and mitigate delays in an unknown time to retrievals, access to trained staff, staffing levels, and communication between remote and tertiary teams.
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Affiliation(s)
- Sally West
- Murtupuni Centre for Rural and Remote Health, James Cook University, Mount Isa, Qld 4825, Australia
| | - Donna Franklin
- Children's Emergency and Critical Care Research, Gold Coast University Hospital, Southport, Qld, Australia
| | - Nichole Harvey
- College of Medicine and Dentistry, James Cook University, Townsville, Qld 4814, Australia
| | - Alice Cairns
- Murtupuni Centre for Rural and Remote Health, James Cook University, Mount Isa, Qld 4825, Australia
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Sarovich E, Lowrie D, Geia L, Kris S, Cairns A. Different meanings… what we want in our lives… a qualitative exploration of the experience of Aboriginal and/or Torres Strait Islander peoples in a co-designed community rehabilitation service. Disabil Rehabil 2024; 46:354-361. [PMID: 36576264 DOI: 10.1080/09638288.2022.2161645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 12/17/2022] [Indexed: 12/29/2022]
Abstract
PURPOSE Promoting positive psychological, social and functional health outcomes for Aboriginal and Torres Strait Islander people requires health services to be culturally safe, respecting culture as central to the individuals and their communities. This study explored the experience of Aboriginal and Torres Strait Islander people, participating in a co-designed student-assisted community rehabilitation service in a remote Aboriginal community in Far North Queensland. MATERIALS AND METHODS Observation, informal yarning and semi-structured interviews with older Aboriginal and Torres Strait Islander people (n = 6) engaged in the service was conducted over a 7 week period. Interpretive phenomenological analysis was applied through inductive thematic analysis. RESULTS Four themes illustrated that experiences within the program promoted: A connection to people, both within the program and those significant in people's lives; a connection to past experiences, roles and events; a connection to the future of cultural knowledge; and a sense of achievement and fun. Participants shared their unique stories on their positive experience of the culturally responsive approach in the activities. CONCLUSIONS These results suggest that knowledge translation and reciprocity provide a strong foundation for rehabilitation programs that support healthy ageing for Aboriginal and Torres Strait Islander people and encourage active and ongoing individual and community involvement.
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Affiliation(s)
- Emma Sarovich
- College of Healthcare Sciences, James Cook University, Townsville, Australia
| | - Daniel Lowrie
- College of Healthcare Sciences, James Cook University, Townsville, Australia
| | - Lynore Geia
- College of Healthcare Sciences, James Cook University, Townsville, Australia
| | - Sylvia Kris
- College of Healthcare Sciences, James Cook University, Weipa, Australia
| | - Alice Cairns
- College of Healthcare Sciences, James Cook University, Townsville, Australia
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Australia
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