Ambient Particulate Matter and Paramedic Assessments of Acute Diabetic, Cardiovascular, and Respiratory Conditions.

Background: Ambulance data provide a useful source of population-based and spatiotemporally resolved information for assessing health impacts of air pollution in nonhospital settings. We used the clinical records of paramedics to quantify associations between particulate matter (PM2.5) and diabetic, cardiovascular, and respiratory conditions commonly managed by those responding to calls for emergency ambulance services.

Barriers to increasing hospital birth rates in rural Shanxi Province, China.

This study investigated the reasons for continued high rates of home births in rural Shanxi Province, northern China, despite a national programme designed to encourage hospital deliveries. We conducted semi-structured interviews with 30 home-birthing women in five rural counties and drew on hospital audit data, observations and interviews with local health workers from a larger study. Multiple barriers were identified, including economic and geographic factors and poor quality of maternity care.

Availability and quality of emergency obstetric care in Shanxi Province, China.

Objective: To investigate the availability and quality of emergency obstetric care (EmOC) received by women in a rural Chinese province.

Methods: The study was conducted in 7 rural counties and townships in Shanxi Province, China. Data sources included interviews with 7 hospital leaders, 5 maternal and child health workers, and 7 obstetricians; 118 records of complicated delivery were audited, 21 Maternal and Child Health Annual Reports analyzed, and observations conducted of facilities and advanced labor care.

Small area estimation of sparse disease counts using shared component models-application to birth defect registry data in New South Wales, Australia.

In the field of disease mapping, little has been done to address the issue of analysing sparse health datasets. We hypothesised that by modelling two outcomes simultaneously, one would be able to better estimate the outcome with a sparse count. We tested this hypothesis utilising Bayesian models, studying both birth defects and caesarean sections using data from two large, linked birth registries in New South Wales from 1990 to 2004.

Outcome evaluation of community health promotion intervention within a donor funded project climate in Papua New Guinea.

Introduction: The Australian Agency for International Development (AusAID) funded Women and Children's Health Project sought to improve the health of women and children throughout Papua New Guinea between 1998 and 2004. The project utilised education, community development and health promotion interventions aimed to increase community support for the health of women and children.

Methods: An outcome evaluation in 2006 investigated the long-term impact of the project using a multi-methods approach and covering 10 selectively sampled provinces, 19 districts and 93 communities.

Secondary prevention of osteoporosis post minimal trauma fracture in an Australian regional and rural population.

Objective: Minimal trauma fracture (MTF) is an indication of osteoporosis and risk of future fracture. Our objective was to describe osteoporosis risk identification and secondary prevention in a regional and rural population hospitalised for an MTF.

Design: A retrospective inpatient file audit and follow-up telephone interview.

Ageing medical workforce in Australia--where will the medical educators come from?

Background: As the general practitioner and specialist medical workforce ages there is likely to be a large number of retirees in the near future. However, few Australian studies have specifically examined medical practitioner retirement and projected retirement patterns, and the subsequent impact this may have on training future health care professionals.

Methods: Extracts from the Australian Medicare database and Medical Labour Force Surveys are used to examine trends in attrition of general medical practitioners and specialists over the age of 45 years from the workforce and to predict their rate of retirement to 2025.

Health problems and retirement due to ill-health among Australian retirees aged 45-64 years.

Objective: To examine which health problems are associated with retirement due to ill-health among Australians aged 45-64 years.

Methods: Cross-sectional analysis of self-reported data of 1933 retired men and 3160 retired women aged 45 and over, living in NSW in 2008, who took part in the 45 and Up Study.

Main Outcome Measure: retirement due to ill-health versus retirement for other reasons.

Older Australians' medication use: self-report by phone showed good agreement and accuracy compared with home visit.

Objective: To ascertain the accuracy of telephone-interview method for measuring older people's medication use ("self-report by phone") by determining agreement between results from this method and from a home visit ("home inventory").

Study Design And Setting: An agreement study involving community-dwelling patients aged more than 65 years, selected from four general practices in the Hunter Region of Australia. Commonly used classes of drugs were selected for comparison.

The establishment of the Australian and New Zealand Neonatal Network.

The Australian and New Zealand Neonatal Network was established in 1994 to monitor high-risk newborns admitted for care. Uniquely, all units in both countries have participated since inception, making it integral to the care of babies. The network's objectives include auditing care, publishing aggregated results annually, providing feedback to units, monitoring technologies and developing clinical indicators.

Where do students in the health professions want to work?

Background: Rural and remote areas of Australia are facing serious health workforce shortages. While a number of schemes have been developed to improve recruitment to and retention of the rural health workforce, they will be effective only if appropriately targeted. This study examines the factors that most encourage students attending rural clinical placements to work in rural Australia, and the regions they prefer.

The promise of online cognitive behavioural therapy training for rural and remote mental health professionals.

Objective: The aim of this paper is to indicate how online cognitive behavioural therapy (CBT) training for rural and remote health professionals can enhance access to evidence-based treatments in rural communities and address psychotherapy training shortfalls for rural practitioners treating Australians with high prevalence psychological disorders.

Conclusions: Issues of cost, distance and disruption to services have meant that, until now, it has been very difficult to provide really effective training in evidence-based therapies (in the main, CBT) for Australian rural and remote health professionals. The recent development of online CBT training provides new opportunities.

Loss of income and levels of scholarship support for students on rural clinical placements: a survey of medical, nursing and allied health students.

Objective: To quantify the financial impact of rural clinical placements on medical, nursing and allied health students in rural Australia.

Design: The Careers in Health Tracking Survey provided data on whether students were employed, usual weekly hours of employment and a range of covariates, such as age, sex, course of study, marital status, dependents and rural or urban origin.

Participants: A total of 121 students from a range of health professions completed the Careers in Health Tracking Survey while on rural placement at the Northern Rivers University Department of Rural Health.

The rural allied health workforce study (RAHWS): background, rationale and questionnaire development.

The allied health professions form approximately 18% of the health workforce in Australia and are well placed to contribute to future multidisciplinary models of health care. There are many reports describing the health workforce in Australia for the medical and nursing professions but there is very little information available about the nature of the allied health workforce. Recent studies have highlighted the need for more current and detailed information about the rural allied health workforce to inform future workforce planning.

Multidisciplinary management of complex care.

Rural and remote areas of Australia are facing serious health workforce shortages. Multidisciplinary teams are one way of making the most of the rural workforce. In this paper, the advantages of multidisciplinary care in terms of patient outcomes, clinician satisfaction and system efficiency are considered with reference to an innovative rural multidisciplinary model that highlights how these positive outcomes can be achieved.

Chronic disease and labour force participation among older Australians.

Objective: To examine the association between long-term health conditions and being out of the labour force among older Australians.

Design, Setting And Participants: Retrospective analysis of cross-sectional data from the Australian Bureau of Statistics 2003 Survey of Disability, Ageing and Carers for people aged 45-64 years.

Main Outcome Measures: Rates of premature retirement associated with ill health; odds ratios of being out of the labour force associated with each long-term health condition and number of conditions; weighted population estimates; estimates of gross domestic product lost as a result.

Where are older workers with chronic conditions employed?

Objective: To determine which industries and occupational groups are associated with employment of older workers with chronic work-limiting health conditions in Australia.

Design And Participants: Analysis of data from the 2005 National Health Survey for 4228 workers aged 45-64 years.

Main Outcome Measures: Rate of employment by industry and occupation of older workers with specific chronic conditions.

The impact of generational change and retirement on psychiatry to 2025.

Background: Australia is currently experiencing widespread shortages of psychiatrists. The changing nature of the workforce and increasing demand mean that these shortages are unlikely to ease. This study aims to identify demographic change and retirement patterns of the Australian psychiatry workforce from 1995 to 2003, and the implications of those changes for future workforce planning.

Are we getting healthier as we grow older? Implications for babyboomer labor force participation.

The Intergenerational Report (IGR) released by the Department of the Treasury of the Commonwealth of Australia in 2002 highlighted pressures that in the future would threaten the sustainability of the Australian government's budget balance. These pressures result from the growing needs of an aging population and labor shortages that will limit economic growth and taxation revenue. The IGR has become a driving force in planning government policy.

The researcher development program: how to extend the involvement of Australian general practitioners in research?

Context: This article reviews the Researcher Development Program (RDP) component of the Australian Government's Primary Health Care Research, Evaluation, and Development (PHC RED) strategy, examining critical aspects of program performance and suggesting strategies that might increase the involvement of rural GPs in research.

Issue: Primary health care research capacity can only be built by providing sustainable, dedicated funding and a dedicated redistribution of workload from practice to research. The PHC RED funds and program supports only provide incentives to redirect existing capacity within primary health care from patient care to research for the time during which incentives are in place, generally as a part-time funded position for less than one-year's duration.

Baby boomer retirement and the future of dentistry.

Background: The dental workforce, like the Australian population, is ageing. As the large baby boomer cohort retires dental shortages will likely increase.

Methods: Australian Bureau of Statistics census data from 1986 to 2001 were used to examine ageing of the dental workforce and attrition of dentists aged 50 years and over.

Impact of case management on rural women's quality of life and substance use.

Introduction: It is widely accepted that women experience drug dependency in different ways from men, including a greater sense of social stigma, higher levels of shame and self-blame, and higher rates of psychological co-morbidity. There is also evidence that women's experience of substance dependency may be negatively affected by living in a rural area. Recognising the complex needs of rural drug dependent women, a community-based case management model (known as WRAP--women's referral and access program) was developed, which adopted a holistic approach and aimed to address the physical, social and psychological dimensions of women's lives.

Decision criteria in health professionals choosing a rural practice setting: development of the Careers in Rural Health Tracking Survey (CIRHTS).

Introduction: Rural background and training have previously been found to increase the likelihood of rural practice. However, practitioners of many health professions remain in shortage in rural and remote Australia. This study builds on previous work in that it includes medical, nursing and allied health professions, considers the role of the health professional's family in employment decisions, and includes a broader array of factors influencing employment preference and the preferred location of practice.

Replacing the projected retiring baby boomer nursing cohort 2001-2026.

Background: The nursing population in Australia is ageing. However, there is little information on the rate and timing of nursing retirement.

Methods: Specifically designed health workforce extracts from the Australian Bureau of Statistics (ABS) censuses from 1986 to 2001 are used to estimate the rate of nursing retirement.