The Impact of Climate Change on Aeromedical Retrieval Services in Remote Northern Australia: Planning for a Hotter Future.

It is known that environmental heat is associated with increased morbidity manifesting as increasing demand on acute care health services including pre-hospital transport and emergency departments. These services play a vital role in emergency care, and in rural and remote locations, where resource capacity is limited, aeromedical and other retrieval services are a vital part of healthcare delivery. There is no research examining how heat impacts remote retrieval service delivery.

The relative value of sociocultural and infrastructural adaptations to heat in a very hot climate in northern Australia: a case time series of heat-associated mortality.

Background: Climate change is increasing heat-associated mortality particularly in hotter parts of the world. The Northern Territory is a large and sparsely populated peri-equatorial state in Australia. The Northern Territory has the highest proportion of Aboriginal and Torres Strait Islander people in Australia (31%), most of whom live in remote communities of over 65 Aboriginal Nations defined by ancient social, cultural, and linguistic heritage.

A method for rapid machine learning development for data mining with doctor-in-the-loop.

Classifying free-text from historical databases into research-compatible formats is a barrier for clinicians undertaking audit and research projects. The aim of this study was to (a) develop interactive active machine-learning model training methodology using readily available software that was (b) easily adaptable to a wide range of natural language databases and allowed customised researcher-defined categories, and then (c) evaluate the accuracy and speed of this model for classifying free text from two unique and unrelated clinical notes into coded data. A user interface for medical experts to train and evaluate the algorithm was created.

'COVID on Country': an innovative model safely supporting high-risk patients in Central Australia.

In January 2022, as the COVID pandemic reached remote communities in Central Australia, The Northern Territory Health Central Australian Regional Health Service and the Royal Flying Doctor Service (RFDS) executed 'COVID on Country', a program designed to triage cases and to implement treatment and clinical review of individuals in their community without the need to be relocated to larger centres for safe provision of care. The program assessed patient factors and community/capacity factors to triage and enact pathways. Remote living people who qualified for the program or who declined aeromedical retrieval, were provided with comprehensive clinical support, including administration of intravenous sotrovimab by daily scheduled visits to all affected communities by a doctor transported on an RFDS plane.

Surveying the changing climate of Northern Territory medical workforce retention.

Introduction: Low retention is a significant contributor to medical workforce shortages in rural and remote regions of Australia, including in the Northern Territory (NT). Many of these areas are susceptible to climate change, which could exacerbate workforce retention problems.

Objective: To examine factors influencing medical workforce retention in the NT, including the potential impact of climate change.

The Effect of Heat Events on Prehospital and Retrieval Service Utilization in Rural and Remote Areas: A Scoping Review.

Introduction: It is well-established that heatwaves increase demand for emergency transport in metropolitan areas; however, little is known about the impact of heat events on demand for prehospital retrieval services in rural and remote areas, or how heatwaves are defined in this context.

Inclusion Criteria: Papers were eligible for inclusion if they reported on the impact of a heat event on the activity of a prehospital and retrieval service in a rural or remote area.

Methods: A search of PubMed, Cochrane, Science Direct, CINAHL, and Google Scholar databases was undertaken on August 18, 2020 using search terms related to emergency medical transport, extreme heat, and rural or remote.

Addressing Profound Disadvantages to Improve Indigenous Health and Reduce Hospitalisation: A Collaborative Community Program in Remote Northern Territory.

Background: Aboriginal people in rural and remote areas of the Northern Territory of Australia have suffered longstanding issues of homelessness and profound health and social inequities. The town and region of Katherine are particularly impacted by such inequities and have the highest rates of homelessness in Australia, composed almost entirely of Aboriginal people who represent 51% of the total population of 24,000 people. The region is serviced by a 60-bed hospital, and a small cohort of frequent attenders (FAs) represent 11% of the Emergency Department (ED) case load.

Providing palliative care closer to home: a retrospective analysis from a remote Australian hospital.

Background: Rural and remote patients have reduced access to palliative care, often resulting in inter-hospital transfers and death a long way from home and family. Katherine Hospital (KH), a 50-bed hospital services a population with high Aboriginality who experience this issue.

Aims: To characterise trends in mortality and transfers at a remote hospital in reference to increasing capacity to provide palliative care.

Factors contributing to frequent attendance to the emergency department of a remote Northern Territory hospital.

Objectives: To determine the clinical and environmental variables associated with frequent presentations by adult patients to a remote Australian hospital emergency department (ED) for reasons other than chronic health conditions.

Design: Unmatched case-control study of all adult patients attending Katherine Hospital ED between 1 January and 31 December 2012.

Participants: Cases were defined as frequent attenders (FAs) without a chronic health condition who presented to the ED six or more times during the 12-month period.

Rural general physicians: improving access and reducing costs of health care in the bush.

Objective: To assess the effectiveness of the introduction of a trainee specialist physician into the workforce mix of a rural hospital in the Northern Territory.

Methods: A retrospective review comparing clinical and non-clinical outcomes during two corresponding 6-month periods in 2011 and 2012, before and after a FRACP Trainee in General and Acute Care Medicine commenced employment in the hospital.

Results: There was a significant reduction of 18% in total length of stay of admitted adult patients, with a 23% reduction of inter-hospital transfers and a 43% reduction of total aeromedical evacuations after the introduction of the trainee specialist.

A tale of two cancers: collision presentation of ovarian carcinoma and lymphoma.

Synchronous malignancies are rare diagnostic and treatment challenges. Here we present three cases of synchronous ovarian cancer and lymphoma. Both malignancies were recognised in the same histopathology sections.