Artículos de revistas:

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Anderson, Emily, Sarah Larkins, Sarah Beaney y Robin Ray. "Should I Stay or Go: Rural Ageing, a Time for Reflection". Geriatrics 3, n.º 3 (3 de agosto de 2018): 49. http://dx.doi.org/10.3390/geriatrics3030049.

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(1) Background: Studies have shown that older people prefer to continue living in their own home and community as they age; however this is dependent upon available services and social support. In Australia about two thirds of people will age at home. The Australian Government provides home care packages to support ageing in place yet in rural areas not all services are available. The lack of employment opportunities in rural areas often results in family residing at a distance reducing available social support. This study aims to evaluate informal social support and its influence on ageing in place amongst older people in three Australian rural communities in Australia. (2) Methods: A multiple embedded case study was undertaken in three diverse rural communities. Eleven older rural residents ageing in place aged 65+ were interviewed about their ageing experience and plans for their future in the light of available social support along with 15 members of their social networks. Social networks were then visually depicted with the use of ecomaps and network members were interviewed. (3) Results show that kin and non-kin social networks support ageing in place however ageing is a time of change and reflection. (4) Conclusions: There is a need for more discussion within these networks when it comes to future planning.

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Hanna, Liz. "Support Funding for Australian Rural and Remote Health Workforce: A Medical - Nursing Mismatch". Australian Journal of Primary Health 7, n.º 1 (2001): 9. http://dx.doi.org/10.1071/py01002.

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Successive Australian federal governments have introduced numerous strategies aimed at reducing the differentials in health status between rural and remote populations and their metropolitan counterparts. Foremost among these strategies have been those focused on increasing the numbers of medical practitioners in rural and remote areas (Australian Institute of Health and Welfare, 1998a). The paper challenges the prioritisation of this strategy, identified as a "planning priority" by the Commonwealth government. The 1999-2000 Federal Budget allocated $171 million to "significantly improve access to services in rural and remote areas of Australia and to strengthen the rural workforce". Nurses provide 90% of the health services to these populations yet receive only 0.9% of funding in direct role specific support. This systematic neglect of nursing services results in high turnover as nurses desert their posts, frustrated by lack of organisational support, and subsequent inability to provide adequate care in the difficult circumstances in which they must function. Interruptions to clinical health care provision and health promotion activities diminish health enhancement opportunities for the communities with demonstrated high levels of need (Australian Institute of Health and Welfare [AIHW], 1999; Commonwealth Department of Health & Aged Care, 2000; Kreger, 1991; NSW Health Department, 1998).

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Peiris, Sujanie, Janneke Berecki-Gisolf, Bernard Chen y Brian Fildes. "Road Trauma in Regional and Remote Australia and New Zealand in Preparedness for ADAS Technologies and Autonomous Vehicles". Sustainability 12, n.º 11 (26 de mayo de 2020): 4347. http://dx.doi.org/10.3390/su12114347.

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Achieving remote and rural road safety is a global challenge, exacerbated in Australia and New Zealand by expansive geographical variations and inconsistent population density. Consequently, there exists a rural-urban differential in road crash involvement in Australasia. New vehicle technologies are expected to minimise road trauma globally by performing optimally on high quality roads with predictable infrastructure. Anecdotally, however, Australasia’s regional and remote areas do not fit this profile. The aim of this study was to determine if new vehicle technologies are likely to reduce road trauma, particularly in regional and remote Australia and New Zealand. An extensive review was performed using publicly available data. Road trauma in regional and remote Australasia was found to be double that of urban regions, despite the population being approximately one third of that in urban areas. Fatalities in 100 km/h + speed zones were overrepresented, suggestive of poor speed limit settings. Despite new vehicle ownership in regional and remote Australasia being comparable to major cities, road infrastructure supportive of new vehicle technologies appear lacking, with only 1.3–42% of all Australian roads, and 67% of all New Zealand roads being fully sealed. With road quality in regional and remote areas being poorly mapped, the benefits of Advanced Driver-Assistance Systems (ADAS) technologies cannot be realised despite the fact new vehicles with these technologies are penetrating the fleet. Investments should be made into sealing and separating roads but more importantly, for mapping the road network to create a unified tracking system which quantifies readiness at a national level.

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Rao, Hamna. "Reforms Needed in Aged Patient’s Care". International Journal of Frontier Sciences 2, n.º 1 (1 de enero de 2018): 56–64. http://dx.doi.org/10.37978/tijfs.v2i1.34.

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Today’s health workforce is constantly engaged to enhance the standards of healthcare services and ensuring comprehensive healthcare standards to the community. Queensland’s health workforce is Australia’s second largest health workforce (1) and serving proportionately in all areas of QLD, making efforts to make health better by making research, surveys and developmental planning in rural and regional areas. Aged Care is currently the most concerned health issue among OECD countries (2) as aged population continues to grow and it’s challenging for Australian health sector to meet the standards of quality care in provision of aged care health services. As per Australian Institute of Health and Welfare statistics it is projected that Australia will constitute 22% of aged population in next 30 years (AIHW).

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Eikelboom, Robert H., Marcus D. Atlas, Mathew N. Mbao y Mark Gallop. "Tele-otology: Planning, design, development and implementation". Journal of Telemedicine and Telecare 8, n.º 3_suppl (diciembre de 2002): 14–17. http://dx.doi.org/10.1258/13576330260440718.

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summary The view of the tympanic membrane of the ear provides the specialist with important information for the assessment of ear disease and for treatment planning. In rural and remote areas, the incidence of ear disease is high but access to ear specialists is limited. As part of a project to deliver tele-otoscopy services to remote Western Australia, we have investigated various aspects of a tele-otoscopy system. We found that the MedRX video-otoscope is relatively safe to use and produces images of very good quality. A confident diagnosis could be made from still images compressed to 20 kByte. Video sequences could be compressed to a ratio of 1:300. Furthermore, a software package has been developed, and we are developing a training course for health-care workers in remote areas.

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Mitchell, Geoffrey, Caroline Nicholson, Keith McDonald y Anne Bucetti. "Enhancing palliative care in rural Australia: the residential aged care setting". Australian Journal of Primary Health 17, n.º 1 (2011): 95. http://dx.doi.org/10.1071/py10054.

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The delivery of palliative care in residential aged care communities is challenging, even more so in rural areas due to workforce ageing and shortages. The objectives of the present study were to: (i) assess the needs of, and quality of palliative care delivered to residents of 16 residential aged care facilities in rural southern Australia; and (ii) identify the needs of care staff to facilitate the delivery of quality palliative care. A cross-sectional survey of all residents, assessing the degree of functional limitation, stage of palliative care, and the presence of several quality indicators was conducted. Separate focus groups of care staff and relatives of residents sought information on the quality of care delivered, perceived strengths and weaknesses of the care delivered, and education and training needs. Quality palliative care in residential aged care facilities (RACFs) is hampered by workforce shortages, with low ratios of registered nurses, limited access to general practitioners after hours, and some communication difficulties. Some staff reported low confidence in technical and psychosocial aspects of care, especially for relatives. Relatives described mostly appropriate care, while acknowledging workload constraints. Most residents whose condition was unstable, deteriorating or terminal received advance care planning, though family expectations and unwillingness to discuss end-of-life care did tend to delay planning. Unstable residents with a reasonable prognosis were more likely to be transferred to hospital than terminally ill residents. Palliative care in participating RACFs appears to be adequate. Provision of targeted education for health care providers and implementation of protocols for advance care planning and end-of life care pathways will enhance this care.

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Soldatic, Karen, Kelly Somers, Kim Spurway y Georgia van Toorn. "Emplacing Indigeneity and rurality in neoliberal disability welfare reform: The lived experience of Aboriginal people with disabilities in the West Kimberley, Australia". Environment and Planning A: Economy and Space 49, n.º 10 (7 de julio de 2017): 2342–61. http://dx.doi.org/10.1177/0308518x17718374.

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This article maps the impact of neoliberal restructuring of disability services and income support measures on Aboriginal people with disabilities living in rural areas of the West Kimberley in Australia. The international literature has extensively documented disability and Indigenous neoliberal welfare retraction measures, though as discrete areas of research. We aim to emplace the intersectional experience of such reforms by exposing their unique and qualitatively different dynamics and processes of disablement and Indigenous dispossession in the lived experiences of Aboriginal Australians with disabilities in rural Australia. Interviews conducted with Aboriginal people with disabilities living in the West Kimberley revealed the impact of neoliberal policies of retracting disability supports and rationalising services. The effects were felt in terms of people’s mobility, autonomy and economic security, with chronic, and at times crisis, levels of socio-economic insecurity experienced. Neoliberal spatial structures have led to further peripheralisation of rural and remote populations and a resulting increase in levels of inequality, deprivation and marginalisation for Aboriginal Australians with disabilities, who endure and survive by navigating these disabling spaces.

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van Spijker, Bregje A., Jose A. Salinas-Perez, John Mendoza, Tanya Bell, Nasser Bagheri, Mary Anne Furst, Julia Reynolds et al. "Service availability and capacity in rural mental health in Australia: Analysing gaps using an Integrated Mental Health Atlas". Australian & New Zealand Journal of Psychiatry 53, n.º 10 (28 de junio de 2019): 1000–1012. http://dx.doi.org/10.1177/0004867419857809.

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Objective: Access to services and workforce shortages are major challenges in rural areas worldwide. In order to improve access to mental health care, it is imperative to understand what services are available, what their capacity is and where existing funds might be spent to increase availability and accessibility. The aim of this study is to investigate mental health service provision in a selection of rural and remote areas across Australia by analysing service availability, placement capacity and diversity. Method: This research studies the health regions of Western New South Wales and Country Western Australia and their nine health areas. Service provision was analysed using the DESDE-LTC system for long-term care service description and classification that allows international comparison. Rates per 100,000 inhabitants were calculated to compare the care availability and placement capacity for children and adolescents, adults and older adults. Results: The lowest diversity was found in northern Western Australia. Overall, Western New South Wales had a higher availability of non-acute outpatient services for adults, but hardly any acute outpatient services. In Country Western Australia, substantially fewer non-acute outpatient services were found, while acute services were much more common. Acute inpatient care services were more common in Western New South Wales, while sub-acute inpatient services and non-acute day care services were only found in Western New South Wales. Conclusion: The number and span of services in the two regions showed discrepancies both within and between regions, raising issues on the equity of access to mental health care in Australia. The standard description of the local pattern of rural mental health care and its comparison across jurisdictions is critical for evidence-informed policy planning and resource allocation.

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Fraser, Jennifer Anne, Marie Hutchinson y Jessica Appleton. "Nurses’ experiences of home visiting new parents in rural and regional communities in Australia: a descriptive qualitative study". Journal of Children's Services 11, n.º 3 (19 de septiembre de 2016): 204–16. http://dx.doi.org/10.1108/jcs-07-2015-0023.

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Purpose Child and family health (CAFH) services in Australia initially provide at least one nurse-home-visit following the birth of a child. Planning and referral then commences for the on-going provision of appropriate services to families. Unfortunately, services in rural and regional communities in Australia can be fragmented and poorly resourced. Little is known about CAFH nurses’ experiences of working with families in these communities. The purpose of this paper is to examine the way CAFH nurses work within a universal health service model that may be compromised by isolation, discontinuity and fragmentation. Design/methodology/approach Focus groups with 26 CAFH nurses from five rural, two regional and one urban community in New South Wales (NSW), Australia were conducted. A secondary, thematic analysis of the qualitative data were undertaken to reflect on change and continuity in the field of universal CAFH services. Analysis was driven by two key research questions: How do CAFH nurses experience their role in universal home-based CAFH services within rural and regional areas of Australia and, what unique factors are present in rural and regional areas that impact on their CAFH nursing role? Findings The experience of the CAFH nurses as presented by these data revealed a role that was family centred and concerned for the welfare of the family, yet compromised by the need to meet the disproportionately complex needs of families in the absence of a strong network of services. The opportunity to present the findings provides insight into the way in which families engage with available services in isolated communities. CAFH nurses in the study attempted to maintain service integrity by adapting to the unique context of their work. Originality/value It is important to understand the mechanisms through which CAFH nurses operate to work effectively with families referred to their service. This paper describes the way in which CAFH nurses work with families not meeting the threshold for more intensive and targeted home-visiting service delivery in rural and regional communities of NSW, Australia.

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Tiller, KG, LH Smith, RH Merry y PM Clayton. "The dispersal of automotive lead from metropolitan Adelaide into adjacent rural areas". Soil Research 25, n.º 2 (1987): 155. http://dx.doi.org/10.1071/sr9870155.

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About 600 surface samples and key horizons of 240 soil profiles from a 90 x 20 km study area extending from the metropolitan area of Adelaide, South Australia, to its rural hinterland, were analysed for lead. Atmospheric fallout was collected monthly at 19 locations for 2 years, and up to 3 years at fewer sites in the same area. Lead in atmospheric fallout showed little year-to-year variation and tended to be seasonally controlled with highest values in winter. Collection of lead in fallout was unaffected by the filtering action of vegetation. The lead content of surface soils and atmospheric fallout showed that part of petrol-lead emitted within Adelaide from automotive exhausts has measurably contaminated the rural landscape to about 50 km downwind of the city. The variation in lead content of surface soils in the agricultural region near Adelaide can be largely explained in terms of accessions of aerosol-lead of automotive origin. This research complements previous investigations which showed that the lead isotopic compositions of selected soils were close to the composition of the lead tetraethyl used in South Australia. An environmental budget showed that only 3% of the lead in petrol burned in Adelaide has been dispersed via the atmosphere beyond the immediate highway zone, and deposited on the land surface within 50 km of the city centre. On the assumption that no more than 35% of the lead is retained within the vehicle, and that about half of the total burned lead is deposited near the roadway, the 30% of the total lead which cannot be accounted for (about 200 t at the time of this study) has probably dispersed beyond the study region and should be viewed as a contribution to continental and global pollution. Lead levels measured in rainfall, air and soils were low in relation to the accepted standards and experience. Although the lead levels were low, this investigation indicates the likely dispersal pattern of other pollutants with similar atmospheric residence times, and thus provides guidance to planning decisions concerning placement of polluting industries, and in relation to possible industrial accidents which cause pollution.

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PAYNTER, S., R. S. WARE y G. D. SHANKS. "Host and environmental factors reducing mortality during the 1918–1919 influenza pandemic". Epidemiology and Infection 139, n.º 9 (22 de marzo de 2011): 1425–30. http://dx.doi.org/10.1017/s0950268811000367.

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SUMMARYMortality from influenza and pneumonia during the 1918–1919 pandemic was compared between subgroups of civilian and military populations from states in Australia and the USA. Exposures to crowded environments before and during the pandemic were used as proxies for exposure to respiratory infections. In three separate datasets, civilian mortality from influenza and pneumonia was higher in urban than rural populations. In contrast soldiers from these same urban backgrounds had significantly lower mortality than their rural counterparts. This suggests the lower mortality in rural civilians was due to the rural environment, probably due to the relative social isolation in rural areas. This is encouraging for pandemic planning, as it suggests social distancing interventions have the potential to reduce mortality in future pandemics. Soldiers recruited before 1918 had significantly lower mortality than those recruited in 1918, and this effect was separate from the protection given by urban origin to soldiers. Both these effects substantially reduced mortality in soldiers. Further research to identify the mechanisms of these separate protective effects may yield important evidence to inform pandemic planning strategies.

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O'Sullivan, Belinda G., Matthew R. McGrail, Catherine M. Joyce y Johannes Stoelwinder. "Service distribution and models of rural outreach by specialist doctors in Australia: a national cross-sectional study". Australian Health Review 40, n.º 3 (2016): 330. http://dx.doi.org/10.1071/ah15100.

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Objective This paper describes the service distribution and models of rural outreach by specialist doctors living in metropolitan or rural locations. Methods The present study was a national cross-sectional study of 902 specialist doctors providing 1401 rural outreach services in the Medicine in Australia: Balancing Employment and Life study, 2008. Five mutually exclusive models of rural outreach were studied. Results Nearly half of the outreach services (585/1401; 42%) were provided to outer regional or remote locations, most (58%) by metropolitan specialists. The most common model of outreach was drive-in, drive-out (379/902; 42%). In comparison, metropolitan-based specialists were less likely to provide hub-and-spoke models of service (odd ratio (OR) 0.31; 95% confidence interval (CI) 0.21–0.46) and more likely to provide fly-in, fly-out models of service (OR 4.15; 95% CI 2.32–7.42). The distance travelled by metropolitan specialists was not affected by working in the public or private sector. However, rural-based specialists were more likely to provide services to nearby towns if they worked privately. Conclusions Service distribution and models of outreach vary according to where specialists live as well as the practice sector of rural specialists. Multilevel policy and planning is needed to manage the risks and benefits of different service patterns by metropolitan and rural specialists so as to promote integrated and accessible services. What is known about this topic? There are numerous case studies describing outreach by specialist doctors. However, there is no systematic evidence describing the distribution of rural outreach services and models of outreach by specialists living in different locations and the broad-level factors that affect this. What does this paper add? The present study provides the first description of outreach service distribution and models of rural outreach by specialist doctors living in rural versus metropolitan areas. It shows that metropolitan and rural-based specialists have different levels of service reach and provide outreach through different models. Further, the paper highlights that practice sector has no effect on metropolitan specialists, but private rural specialists limit their travel distance. What are the implications for practitioners? The complexity of these patterns highlights the need for multilevel policy and planning approaches to promote integrated and accessible outreach in rural and remote Australia.

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Boylan, Colin y David McSwan. "Long-Staying Rural Teachers: Who are They?" Australian Journal of Education 42, n.º 1 (abril de 1998): 49–65. http://dx.doi.org/10.1177/000494419804200104.

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ISSUES of teacher recruitment and retention in rural and isolated areas have received considerable attention in Australia and North America. Research findings have influenced policy and many training incentive programs and packages are in place. Litle attention, however, has been given to long-staying rural teachers and why they are satisfied to stay in locations which others in the profession find disagreeable. This report analyses available studies and, among other things, reveals much variation in the definition of ‘long-staying’. A survey was administered to 427 long-staying rural teachers, teachers who had been in their current school for at least six years and were not planning to move within twelve months. It sought information on professional pre- and inservice education, satisfaction, commitment and community. There emerged a profile of a professionally satisfied, community integrated, family oriented teacher who enjoyed the rural lifestyle and environment. The results carry strong messages for teacher education and teacher selection processes.

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Huxedurp, Leonie M., Guðný Þ. Pálsdóttir y Nanda Altavilla. "Risk-based planning for water recycling in an Australian context". Water Supply 14, n.º 6 (3 de junio de 2014): 971–83. http://dx.doi.org/10.2166/ws.2014.058.

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Australia has seen an unprecedented proliferation in large scale water recycling schemes since the late 1990s. This has been driven by a recent decade of drought, policies to encourage water efficiency in new homes and buildings in urban areas, and to reduce pressure on rain-fed water supplies by replacement with alternate water sources in rural areas. Underpinning these drivers are principles of economic and environmental sustainability and protection of public health. National guidelines for recycling of treated sewage, released in 2006, replaced an approach using prescriptive end point water quality targets, with a 12-step risk-based framework for the planning and operation of Australian water recycling schemes. Essential to this risk-based approach is an understanding of the sewage treatment system and assessing the risks in the catchment, the treatment process, distribution system and end use environment. Inherent also in this process is the identification of critical control points with tangible operational targets for pre-empting, preventing and correcting off-spec conditions before they derail a scheme. Validation of systems through microbial log reduction targets for indicator viruses, bacteria, protozoa and helminths, differentiated according to end use and expected exposures, may be obtained through treatment, site controls or a combination of both. Drawing on case studies from the Australian states of New South Wales (NSW) and Queensland (Qld), this paper gives insight to preventative risk management of water recycling schemes with typical risk profiles. Some advantages and disadvantages of the guideline approach are considered. The information paints a picture of the industry's risk management obligations in the planning phase and may be of use to practitioners in other regions where planning for safe and sustainable water recycling is developing.

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Armstrong, Elizabeth, Juli Coffin, Meaghan McAllister, Deborah Hersh, Judith M. Katzenellenbogen, Sandra C. Thompson, Natalie Ciccone et al. "‘I’ve got to row the boat on my own, more or less’: aboriginal australian experiences of traumatic brain injury". Brain Impairment 20, n.º 2 (2 de julio de 2019): 120–36. http://dx.doi.org/10.1017/brimp.2019.19.

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ABSTRACTBackground:The overarching cultural context of the brain injury survivor, particularly that related to minority peoples with a history of colonisation and discrimination, has rarely been referred to in the research literature, despite profoundly influencing a person’s recovery journey in significant ways, including access to services. This study highlights issues faced by Australian Aboriginal traumatic brain injury (TBI) survivors in terms of real-life consequences of the high incidence of TBI in this population, current treatment and long-term challenges.Method:A case study approach utilised qualitative interview and file review data related to five male Aboriginal TBI survivors diagnosed with acquired communication disorders. The five TBI survivors were from diverse areas of rural and remote Western Australia, aged between 19 and 48 years at the time of injury, with a range of severity.Case Reports:Common themes included: significant long-term life changes; short-term and long-term dislocation from family and country as medical intervention and rehabilitation were undertaken away from the person’s rural/remote home; family adjustments to the TBI including permanent re-location to a metropolitan area to be with their family member in residential care; challenges related to lack of formal rehabilitation services in rural areas; poor communication channels; poor cultural security of services; and lack of consistent follow-up.Discussion and Conclusion:These case reports represent some of the first documented stories of Aboriginal Australian TBI survivors. They supplement available epidemiological data and highlight different contexts for Aboriginal people after TBI, contributing to an overall profile that is relevant for rehabilitation service planning.

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Balasubramanian, Madhan, David S. Brennan, A. John Spencer, Keith Watkins y Stephanie D. Short. "Overseas-qualified dentists’ experiences and perceptions of the Australian Dental Council assessment and examination process: the importance of support structures". Australian Health Review 38, n.º 4 (2014): 412. http://dx.doi.org/10.1071/ah14022.

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Objective The Australian Dental Council is responsible for the assessment of overseas-qualified dentists seeking to practice dentistry in Australia. The aim of this paper is to reflect on the Council’s assessment and examination process through the experiences and perceptions of overseas-qualified dentists in Australia. Methods Qualitative methods were used. Life stories of 49 overseas-qualified dentists from 22 nationalities were analysed to discern significant themes and patterns. We focused on their overall as well as specific experiences of various stages of the examination. The analysis was consistent with a hermeneutic phenomenological approach to social scientific research. Results Most participants referred to ‘cost’ of the examination process in terms of lost income, expenses and time. The examination itself was perceived as a tough assessment process. Some participants seemed to recognise the need for a strenuous assessment due to differences in patient management systems in Australia compared with their own country. Significantly, most of the participants stressed the importance of support structures for overseas-qualified dentists involved in or planning to undertake the examination. These considerations about the examination experience were brought together in two themes: (1) ‘a tough stressful examination’; and (2) ‘need for support.’ Conclusion This paper highlights the importance of support structures for overseas-qualified dentists. Appropriate support (improved information on the examination process, direction for preparation and training, further counselling advice) by recognised bodies may prevent potential exploitation of overseas-qualified dentists. Avenues that have been successful in providing necessary support, such as public sector schemes, offer policy options for limited recruitment of overseas-qualified dentists in Areas of Need locations. Such policies should also be in line with the local concerns and do not reduce opportunities for Australian-qualified dentists. What is known about the topic? During the past decade there has been a substantial increase in the number of overseas-qualified dentists migrating to Australia. Currently, one in every four dentists in Australia qualified overseas. It is likely that approximately three-quarter of migrating dentists in a given year enter through the Australian Dental Council’s examination process. To date, there is no published scholarly evidence on the experiences of overseas-qualified dentists involved in the Council’s assessment and examination process. Because more overseas-qualified dentists are being examined by the Council, it is important to reflect on the examination process so as to identify areas for future improvement. What does this paper add? This paper highlights the importance of support structures for overseas-qualified dentists involved in or planning to undertake the Australian Dental Council’s examination process. Appropriate support (improved information on the examination process, direction for preparation and training, further counselling advice) by recognised bodies may prevent potential exploitation of overseas-qualified dentists. What are the implications for practitioners? A possible implication of the findings of this study for dentists migrating to Australia and intending to take the Australian Dental Council’s examination process would be to consider the advantages of the public sector dental schemes that have been brought to light in this study. Policy makers should also be certain that although recruitment of overseas-qualified dentists reduces the gap in service provision in rural areas, it does not constrain opportunities for Australian-qualified graduates.

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Ansari, M. Z., D. Simmon s, W. G. Hart, F. Cicuttin i, N. J. Carson, N. I. A. G. Brand, M. J. Ackland y D. J. Lang. "Preventable Hospitalisations for Diabetic Complications in Rural and Urban Victoria". Australian Journal of Primary Health 6, n.º 4 (2000): 261. http://dx.doi.org/10.1071/py00060.

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The objective of the study was to describe and explain variations in rates of hospital admissions for long-term complications of diabetes mellitus in rural and urban Victoria as an indicator of the adequacy of ambulatory care services. The Victorian Inpatient Minimum Database (VIMD), Health Insurance Commission data for 1998, Medical Labour Force Annual Survey 1998, Socioeconomic Indexes for Areas 1996 (SEIFA) and Accessibility/Remoteness Index of Australia (ARIA) were merged to determine the extent to which hospitalisation for complications of diabetes can be predicted from accessibility and utilisation of general practitioner services. The rural and urban differentials for long-term diabetic complications and their strong relationship with GP services, the degree of remoteness, lack of insurance, and Aboriginality reflect issues related to equity and access, patient and GP education, and inclination to seek care, all of which have implications for planning of primary health services in rural areas. This study describes a model for the analysis of ambulatory care sensitive conditions, and illustrates the important use of routine databases combined with other sources of information in quantifying the impact of factors related to primary care services.

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Phillips, Jane L., Patricia M. Davidson, Debra Jackson, Linda Kristjanson, Margaret L. Bennett y John Daly. "Enhancing palliative care delivery in a regional community in Australia". Australian Health Review 30, n.º 3 (2006): 370. http://dx.doi.org/10.1071/ah060370.

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Although access to palliative care is a fundamental right for people in Australia and is endorsed by government policy, there is often limited access to specialist palliative care services in regional, rural and remote areas. This article appraises the evidence pertaining to palliative care service delivery to inform a sustainable model of palliative care that meets the needs of a regional population on the mid-north coast of New South Wales. Expert consultation and an eclectic literature review were undertaken to develop a model of palliative care service delivery appropriate to the needs of the target population and resources of the local community. On the basis of this review, a local palliative care system that is based on a population-based approach to service planning and delivery, with formalised integrated network agreements and role delineation between specialist and generalist providers, has the greatest potential to meet the palliative care needs of this regional coastal community.

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Mallitt, Kylie-Ann, James Jansson, Levinia Crooks, David McGuigan, Handan Wand y David P. Wilson. "Demand for HIV clinical services is increasing in Australia but supply is decreasing". Sexual Health 10, n.º 1 (2013): 43. http://dx.doi.org/10.1071/sh12051.

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Background HIV clinical service planning requires accurate estimates of the number of people living with HIV (PLHIV) and the capacity of existing clinical services, each by geographical location. The aim of this study was to quantify current HIV clinical service capacity in Australia. Methods: This study was a retrospective analysis of records of HIV clinical service capacity in Australia. Participants were general practitioners who completed an annual survey in 2007–2009. Information on the number of hospital departments, sexual health services, antiretroviral-prescribing general practitioners (ARV-GPs) and shared-care services providing expertise in HIV management from 2007 to 2010 were also available. Results: From 2007 to 2009, the proportion of ARV-GP survey respondents treating 2–9 patients with HIV per week increased from 36.5% to 49.1%, with a corresponding decrease in the average proportion who saw less than one patient with HIV per week. The estimated number of PLHIV has increased by 12.5% in metropolitan areas, and 16.5% in rural and remote areas over the period 2007–2010; however, the total number of services with at least one HIV ARV-GP has decreased over the same period. Conclusions: Current methods to estimate clinical service capacity reveal decreasing supply in the workforce in Australia despite increasing numbers of PLHIV. Further training of HIV clinicians and their placement in regions of greatest supply–demand deficits are required. Further studies are required to precisely quantify and locate the capacity of the HIV clinical workforce with expertise in HIV case-management to enable efficient service planning.

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Kent, Lillian, Michelle McPherson y Nasra Higgins. "A positive association between cryptosporidiosis notifications and ambient temperature, Victoria, Australia, 2001–2009". Journal of Water and Health 13, n.º 4 (10 de abril de 2015): 1039–47. http://dx.doi.org/10.2166/wh.2015.130.

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Increased temperatures provide optimal conditions for pathogen survival, virulence and replication as well as increased opportunities for human–pathogen interaction. This paper examined the relationship between notifications of cryptosporidiosis and temperature in metropolitan and rural areas of Victoria, Australia between 2001 and 2009. A negative binomial regression model was used to analyse monthly average maximum and minimum temperatures, rainfall and the monthly count of cryptosporidiosis notifications. In the metropolitan area, a 1 °C increase in monthly average minimum temperature of the current month was associated with a 22% increase in cryptosporidiosis notifications (incident rate ratio (IRR) 1.22; 95% confidence interval (CI) 1.13–1.31). In the rural area, a 1 °C increase in monthly average minimum temperature, lagged by 3 months, was associated with a 9% decrease in cryptosporidiosis notifications (IRR 0.91; 95% CI 0.86–0.97). Rainfall was not associated with notifications in either area. These relationships should be considered when planning public health response to ecological risks as well as when developing policies involving climate change. Rising ambient temperature may be an early warning signal for intensifying prevention efforts, including appropriate education for pool users about cryptosporidiosis infection and management, which might become more important as temperatures are projected to increase as a result of climate change.

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Jennings, Natasha, Grainne Lowe y Kathleen Tori. "Nurse practitioner locums: a plausible solution for augmenting health care access for rural communities". Australian Journal of Primary Health 27, n.º 1 (2021): 1. http://dx.doi.org/10.1071/py20103.

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With 2020 being designated the Year of the Nurse and Midwife, it is opportune to acknowledge and recognise the role that nurses undertake in primary care environments. Nurses and midwives play a pivotal role in the delivery of high-quality health care, particularly in geographically challenged areas of Australia, where they may be the only provider of care within their communities. Rural and remote health services require strategic planning to develop and implement solutions responsive to the challenges of rural and remote communities. Maintenance of health services in rural and remote areas is a challenge, crucial to the equity of health outcomes for these communities. Many small communities rely on visiting medical officers to provide the on-call care to facility services, including emergency departments, urgent care centres, acute wards and aged care facilities. It is increasingly difficult to maintain the current rural workforce models, particularly the provision of after-hours ‘on-call’ care necessary in these communities. An alternative model of health care service delivery staffed by nurse practitioners (NP) is one proposed solution. NPs are educated, skilled and proven in their ability to provide an after-hours or on-call service to meet the expectations of rural and remote communities. Achievement of high-quality health care that is cost-efficient, safe and demonstrates improved patient outcomes has been reported in NP-led health care delivery impact evaluations. The value of an NP locum service model is the provision of a transparent, reliable service delivering consistent, equitable and efficient health care to rural and remote communities.

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22

Halliday, Glen. "International Perspectives on Best Practice in the Development of Urban Environmental Education, and Education for Sustainability Programs". Australian Journal of Environmental Education 22, n.º 1 (2006): 141–45. http://dx.doi.org/10.1017/s0814062600001804.

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This paper reports on the international practices I observed as part of a study tour I undertook as a 2005 NSW Premier's Visy Industries Environmental Education Scholarship holder. Interest in urban environmental education (EE) and education for sustainability (EFS) is increasing as rapid urbanisation emerges as one of the greatest challenges facing the world today. The urbanisation processes, fueled by globalisation, environmental degradation, rural unemployment and technological change, are forcing a global exodus from rural areas to urban ones. For developed countries like Australia, urbanisation has resulted in localised environmental and social problems in our cities. These issues include urban design; land clearing and urban sprawl; transport and infrastructure planning; disposal of solid waste; water, noise and air pollution; preservation of biodiversity and heritage; water scarcity; social isolation; loss of social capital and socio economic inequality. The impact of the developed world's largely urban population on the all eco-systems, has focused critical world attention on urban places as the sources of widespread environmental degradation.

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23

Jolly, Lesley. "Waving a Tattered Banner? Aboriginal Language Revitalisation". Aboriginal Child at School 23, n.º 3 (septiembre de 1995): 1–19. http://dx.doi.org/10.1017/s0310582200004880.

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This paper examines the philosophy and practice of programs that aim to maintain, renew, or revive Aboriginal languages in Australia. I focus here on languages, mainly those of urban and rural rather than remote areas, for which there are few if any fluent speakers left. I will refer to them as dead or dying languages although I am aware that in the Aboriginal tradition people consider themselves to own languages that neither they themselves nor their dose kin speak, and that this ownership is very much a part of a living culture. I begin by reviewing some basic issues that arise in planning language programs for such languages. The final section considers some of the factors affecting the success of such programs.

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Spinks, Jean, Stephen Birch, Amanda J. Wheeler, Lisa Nissen, Christopher Freeman, Thao Thai y Joshua Byrnes. "Provision of home medicines reviews in Australia: linking population need with service provision and available pharmacist workforce". Australian Health Review 44, n.º 6 (2020): 973. http://dx.doi.org/10.1071/ah19207.

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ObjectiveIdentifying and quantifying the health needs of a population are the basis of evidence-based health policy and workforce planning. The motivation for undertaking the present study was to evaluate whether the current level of medication review services corresponds to population need, as proxied by the rate of polypharmacy, and to undertake a preliminary analysis of the sufficiency of the current workforce. This paper: (1) estimates the age- and sex-standardised rates of polypharmacy as a proxy for population need for home medicines review; (2) compares the rate of polypharmacy with current service provision of home medicines reviews; and (3) links the estimated need for services with the current number and location of pharmacist providers. MethodsAge- and sex-adjusted polypharmacy rates, by state, were estimated from the National Health Survey of Australia (2017–18), service levels were estimated from national-level administrative claims data (2017–18) and the current workforce was estimated from the Australian Association of Consultant Pharmacists (2018). The current level of service provision was compared to the estimated population need for services, alongside the size of the pharmacy workforce required if need was met. ResultsThe adjusted rate of polypharmacy in Australia, using the strictest definition of ≥10 medications and ≥3 current chronic illnesses, was 1389 per 100000 population. The illustrative needs-based analysis suggests that there may be a disconnect between the current level of service provision and population health needs. ConclusionGiven that polypharmacy is a risk factor for medication-related problems, and that medication review is one of the few targeted strategies currently available to address medication-related problems in the population, service provision may be inadequate. Policy options to improve service provision could include interventions to increase workforce productivity and relaxing the current eligibility criteria for review, especially in rural and remote areas. What is known about the topic?Polypharmacy is a risk factor for medication-related problems, which can cause increased morbidity and mortality in the population. What does this paper add?This paper provides representative, population-based rates of polypharmacy in Australia and uses these rates in a needs-based analysis of service provision and workforce adequacy to provide home medicines review services. What are the implications for practitioners?Several policy options are available for consideration, including interventions to increase workforce productivity and relaxation of the current eligibility criteria for medicines review, especially in rural and remote areas.

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Hepburn, Valerie A. y Judith Healy. "Stakeholders' perspectives on health workforce policy reform". Australian Health Review 31, n.º 3 (2007): 385. http://dx.doi.org/10.1071/ah070385.

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We administered an electronic survey in October? November 2006 to gauge stakeholder perspectives on Australia?s recently adopted health workforce policies. Nearly all of the 41 survey respondents (65% response rate) ranked workforce as very important to overall health policy. Respondents identified decreasing health disparities and rates of disease and mortality as top goals, and identified improved quality and safety and more professionals in rural areas as priority measures for success. Lack of coordination between the governments and insufficient long-range planning were seen as threats to the success of the new workforce initiatives. The survey results suggest the need for clear goals and measurable outcomes. Although they represented different organisations and perspectives, the health workforce policy opinion leaders that participated in this survey reflected remarkable commonality in goals, measures, alternatives, and potential threats.

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Jessup, Belinda, Tony Barnett, Kehinde Obamiro, Merylin Cross y Edwin Mseke. "Review of the Health, Welfare and Care Workforce in Tasmania, Australia: 2011–2016". International Journal of Environmental Research and Public Health 18, n.º 13 (30 de junio de 2021): 7014. http://dx.doi.org/10.3390/ijerph18137014.

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Background: On a per capita basis, rural communities are underserviced by health professionals when compared to metropolitan areas of Australia. However, most studies evaluating health workforce focus on discrete professional groups rather than the collective contribution of the range of health, care and welfare workers within communities. The objective of this study was therefore to illustrate a novel approach for evaluating the broader composition of the health, welfare and care (HWC) workforce in Tasmania, Australia, and its potential to inform the delivery of healthcare services within rural communities. Methods: Census data (2011 and 2016) were obtained for all workers involved in health, welfare and care service provision in Tasmania and in each statistical level 4 area (SA4) of the state. Workers were grouped into seven categories: medicine, nursing, allied health, dentistry and oral health, health-other, welfare and carers. Data were aggregated for each category to obtain total headcount, total full time equivalent (FTE) positions and total annual hours of service per capita, with changes observed over the five-year period. Results: All categories of the Tasmanian HWC workforce except welfare grew between 2011 and 2016. While this growth occurred in all SA4 regions across the state, the HWC workforce remained maldistributed, with more annual hours of service per capita provided in the Hobart area. Although the HWC workforce remained highly feminised, a move toward gender balance was observed in some categories, including medicine, dentistry and oral health, and carers. The HWC workforce also saw an increase in part-time workers across all categories. Conclusions: Adopting a broad approach to health workforce planning can better reflect the reality of healthcare service delivery. For underserviced rural communities, recognising the diverse range of workers who can contribute to the provision of health, welfare and care services offers the opportunity to realise existing workforce capacity and explore how ‘total care’ may be delivered by different combinations of health, welfare and care workers.

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27

Vázquez Vicente, Guillermo, Victor Martín Barroso y Francisco José Blanco Jiménez. "Sustainable Tourism, Economic Growth and Employment—The Case of the Wine Routes of Spain". Sustainability 13, n.º 13 (25 de junio de 2021): 7164. http://dx.doi.org/10.3390/su13137164.

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Tourism has become a priority in national and regional development policies and is considered a source of economic growth, particularly in rural areas. Nowadays, wine tourism is an important form of tourism and has become a local development tool for rural areas. Regional tourism development studies based on wine tourism have a long history in several countries such as the US and Australia, but are more recent in Europe. Although Spain is a leading country in the tourism industry, with an enormous wine-growing tradition, the literature examining the economic impact of wine tourism in Spanish economy is scarce. In an attempt to fill this gap, the main objective of this paper is to analyze the impact of wine tourism on economic growth and employment in Spain. More specifically, by applying panel data techniques, we study the economic impact of tourism in nine Spanish wine routes in the period from 2008 to 2018. Our results suggest that tourism in these wine routes had a positive effect on economic growth. However, we do not find clear evidence of a positive effect on employment generation.

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Knapton, Anthony, Declan Page, Joanne Vanderzalm, Dennis Gonzalez, Karen Barry, Andrew Taylor, Nerida Horner, Chris Chilcott y Cuan Petheram. "Managed Aquifer Recharge as a Strategic Storage and Urban Water Management Tool in Darwin, Northern Territory, Australia". Water 11, n.º 9 (9 de septiembre de 2019): 1869. http://dx.doi.org/10.3390/w11091869.

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Population growth and increased irrigation demand have caused a decline in groundwater levels that limit water supply in the Darwin rural area. Managed Aquifer Recharge (MAR) is a practical solution that can be adopted to augment stressed groundwater systems and subsequently increase the security of water supply. Aquifer storage capacity is considered to be the primary constraint to MAR where unconfined dolostone aquifers rapidly recharge during the tropical, wet season and drain again in the dry season. As a result, there is a general understanding that aquifers of this nature recharge to full capacity each wet season. However, the aquifer storage capacity and the potential for niche opportunities for MAR to alleviate declining groundwater levels has not previously been examined. This paper uses the Darwin rural area’s Proterozoic Koolpinyah Dolostone aquifer and the existing Koolpinyah Groundwater System to evaluate the prospects of MAR using both infiltration and injection techniques. Direct injection wells in an aquifer storage transfer and recovery (ASTR) scheme were favoured in this area, as injection wells occupy a smaller surface footprint than infiltration basins. This assessment suggested MAR during the early to mid-dry season could alleviate the impact of the dry season decline in groundwater levels in the Darwin rural area. The use of a larger aquifer storage and recovery (ASR) system (5,000,000 m3/year) was also assessed as a potentially viable technical solution in the northern part of the aquifer where it is understood to be confined. The ASR scheme could potentially be scaleable to augment the urban water system and provide strategic long-term storage. Consideration must also be given not only to the strategic positioning of the ASR water bank, but also to the hydrogeology of the aquifers in which the systems would be developed. Not all locations or aquifer systems can successfully support a strategic storage ASR system. Scheme-scale feasibility assessment of an ASR water bank is required. The study reported here is an early phase of a series of investigations that would typically be required to demonstrate the viability of any proposal to apply MAR to increase the reliability of conjunctive groundwater and surface water supplies in stressed water resources systems. It focusses on assessing suitable storage areas in a lateritic aquifer.

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Higgins, Niall S., Kersi Taraporewalla, Michael Steyn, Rajesh Brijball y Marcus Watson. "Workforce education issues for international medical graduate specialists in anaesthesia". Australian Health Review 34, n.º 2 (2010): 246. http://dx.doi.org/10.1071/ah09793.

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International medical graduate (IMG) specialists in anaesthesia need education to be part of the assessment process for pre-registration college fellowship. Fellowship of the anaesthetic college is required in Australia for registration as a specialist in this field. Marked differences exist between local trainees and IMG specialists in terms of training, stakes of the exam and isolation of practice. We have examined the reasons for the low pass rate for IMG specialists compared to the local trainees in the Australian and New Zealand College of Anaesthetists (ANZCA) final fellowship examinations. We also offer an IMG specialists’ view of this perceived problem. It highlights their difficulties in obtaining adequate supervision and education. What is known about the topic?There has been a worldwide shortage of doctors over the last decade. In Australia this shortage has been attributed to government policy in the 1990s limiting the number of medical school places. Other factors that may have contributed to this shortage are changes in the practice of medicine, increasing specialisation, growth in population and patterns of population settlement at the coastal fringes of Australia. The use of international medical graduates and reliance on them is associated with several problems and challenges. A key factor relates to their performance at a standard acceptable to the country. What does the paper add?This paper offers an examination of the issues that present to IMG specialists located at rural and remote areas of Australia. The global aim of this study is to understand the workforce education issues that present to IMG specialists as a basis for supporting this group, having migrated to Australia, to better prepare for assessment of their practice in this country. Results of a survey of IMG specialists in Anaesthesia are included to contribute to an overall view. It highlights their understanding of the issues that present when preparing for specialist assessments. What are the implications for practitioners?This information will be useful for policy practitioners who determine critical elements that influence workforce planning and education support. Decision makers will be able to make more informed decisions on the need to integrate education into planning for workforce efficiencies. There are currently no published data explaining why the pass rate for IMG specialist in anaesthesia is so different from local trainees and this paper also offers a viewpoint of present issues from those who are attempting these examinations.

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See, Lydia, Rohan L. Rasiah, Rachael Laing y Sandra C. Thompson. "Considerations in Planning Physical Activity for Older Adults in Hot Climates: A Narrative Review". International Journal of Environmental Research and Public Health 18, n.º 3 (2 de febrero de 2021): 1331. http://dx.doi.org/10.3390/ijerph18031331.

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Regular physical activity has multiple health benefits for both the prevention and management of disease, including for older adults. However, additional precautions are needed with ageing given physiological changes and the increasing prevalence of comorbidities. Hot ambient temperatures increase the risks of exercise at any age, but are particularly important given thermoregulatory changes in older people. This narrative review informs planning of physical activity programs for older people living in rural areas with very hot climates for a period of the year. A multi-database search of peer-reviewed literature was undertaken with attention to its relevance to Australia, starting with definitions and standard advice in relation to physical activity programming and the incremental limitations imposed by age, rurality, and extreme heat. The enablers of and barriers to increasing physical activities in older adults and how they can be modified for those living in extreme hot climates is described. We describe multiple considerations in program design to improve safety, adherence and sustaining physical activity, including supervision, simple instructions, provision of reminders, social support, encouraging self-efficacy. Group-based activities may be preferred by some and can accommodate special populations, cultural considerations. Risk management is an important consideration and recommendations are provided to assist program planning.

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Arzal, Mohammad. "K. Mahadevan (ed). Fertility Policies in Asian Countries. New Delhi: Sage Publications. 1989.320 pp.Hardbound. Indian Rs 225.00." Pakistan Development Review 32, n.º 2 (1 de junio de 1993): 223–25. http://dx.doi.org/10.30541/v32i2pp.223-225.

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The book consists of twelve papers and presents the contributors' observations regarding fertility control policies in Australia, Bangladesh, China, India, Iran, Kuwait, Malaysia, Pakistan, Sri Lanka, Taiwan, and Thailand. In the first paper, which provides a perspective (mostly in the Indian context) to the concerns about policy formulation for fertility control, the authors discuss various issues and place an emphasis on the multi sectoral approach. The need to implement the policies for eligible couples, for female education and enhancement of female status, for strengthening the strategies for programme development and management, and for making policies relating to the elderly people, is stressed in this paper. The paper on planned birth policies of China provides a view of the actions and the successes achieved through organised programmes in the recent years. Conceding that the programme in China was not entirely voluntary, the paper also highlights the problems and failures of the fertility control efforts through the emphasis on a single-child family, especially in the rural areas.

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Homer, Caroline S. E., Janice Biggs, Geraldine Vaughan y Elizabeth A. Sullivan. "Mapping maternity services in Australia: location, classification and services". Australian Health Review 35, n.º 2 (2011): 222. http://dx.doi.org/10.1071/ah10908.

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Objective. To describe maternity services available to Australian women and, in particular, the location, classification of services and support services available. Design. A descriptive study was conducted using an online survey that was emailed to eligible hospitals. Inclusion criteria for the study included public and private maternity units with greater than 50 births per year. In total, 278 maternity units were identified. Units were asked to classify their level of acuity (Levels 2–6). Results. A total of 150 (53%) maternity units responded. Those who responded were reasonably similar to those who did not respond, and were representative of Australian maternity units. Almost three-quarters of respondents were from public maternity units and almost 70% defined themselves as being in a rural or remote location. Maternity units with higher birth rates were more likely to classify themselves as providing higher acuity services, that is, Levels 5 and 6. Private maternity units were more likely to have higher acuity classifications. Interventions such as induction of labour, either using an artificial rupture of membranes (ARM) and oxytocin infusion or with prostaglandins, were common across most units. Although electronic fetal monitoring (EFM) was also widely available, access to fetal scalp pH monitoring was low. Conclusion. Maternity service provision varies across the country and is defined predominately by location and annual birth rate. What is known about the topic? In 2007, over 99% of the 289 496 women who gave birth in Australia did so in a hospital. It is estimated that there are more than 300 maternity units in the country, ranging from large tertiary referral centres in major cities to smaller maternity units in rural towns, some of which only provide postnatal care with the woman giving birth at a larger facility. Geographical location, population and ability to attract a maternity workforce determine the number of maternity units within a region, although the means of determining the number of maternity units within a region is often unclear. In recent years, a large number of small maternity units have closed, particularly in rural areas, often due to difficulties securing an adequate workforce, particularly midwives and general practitioner obstetricians. There is a lack of understanding about the nature of maternity service provision in Australia and considerable differences across states and territories. What does this paper add? This paper provides a description of the geographic distribution and level of maternity services, the demand on services, the available obstetric interventions, the level of staffing (paediatric and anaesthetic) and support services available and the private and public mix of maternity units. The paper also provides an exploration of the different interventions and discusses whether these are appropriate, given the level of acuity and access to emergency Caesarean section services. What are the implications for practitioners? This study provides useful information particularly for policy-makers, managers and practitioners. This is at a time when considerable maternity reform is underway and changes at a broader level to the health system are planned. Understanding the nature of maternity services is critical to this debate and ongoing planning decisions.

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Ward, Bernadette, John Humphreys, Matthew McGrail, John Wakerman y Marita Chisholm. "Which dimensions of access are most important when rural residents decide to visit a general practitioner for non-emergency care?" Australian Health Review 39, n.º 2 (2015): 121. http://dx.doi.org/10.1071/ah14030.

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Objective Access to primary healthcare (PHC) services is key to improving health outcomes in rural areas. Unfortunately, little is known about which aspect of access is most important. The objective of this study was to determine the relative importance of different dimensions of access in the decisions of rural Australians to utilise PHC provided by general practitioners (GP). Methods Data were collected from residents of five communities located in ‘closely’ settled and ‘sparsely’ settled rural regions. A paired-comparison methodology was used to quantify the relative importance of availability, distance, affordability (cost) and acceptability (preference) in relation to respondents’ decisions to utilise a GP service for non-emergency care. Results Consumers reported that preference for a GP and GP availability are far more important than distance to and cost of the service when deciding to visit a GP for non-emergency care. Important differences in rankings emerged by geographic context, gender and age. Conclusions Understanding how different dimensions of access influence the utilisation of PHC services is critical in planning the provision of PHC services. This study reports how consumers ‘trade-off’ the different dimensions of access when accessing GP care in rural Australia. The results show that ensuring ‘good’ access requires that policymakers and planners should consider other dimensions of access to services besides geography. What is known about the topic? Research indicates that poorer ‘access’ to GPs, an impediment to seeking primary care at times of need, is the most important factor distinguishing rural from urban health service utilisation behaviour, which undoubtedly contributes to the poorer health outcomes characterising rural and remote populations. Much of the policy on access to date has focussed on increasing the number of GP located in rural and remote areas that are characterised by acute medical workforce shortages. What does this paper add? This study provides empirical data to show how different dimensions of access influence rural Australians’ decisions to utilise a GP service. Overall, rural Australians rank preference for a GP as the most important factor in their decision to visit a doctor for a non-emergency consultation. Important differences in rankings emerged by geographic context, gender and age. Distance to a GP service ranks consistently as the third most important access factor and cost is rated the least important aspect of access. What are the implications for practitioners? Although current rural health policies and incentives should continue to target the need to increase the availability of GP in non-metropolitan areas, this alone may not be sufficient to improve GP service utilisation. Other dimensions of access, particularly consumer preference, which are amenable to interventions both nationally and locally, are equally important.

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Dimla, Bernadette, Denise Wood y Lynne Parkinson. "A Qualitative Study on How Social Workers From Regional and Metropolitan Queensland, Australia Perceive the Impact of the National Prioritisation System on Hospital Discharge Planning: A Study Protocol". International Journal of Qualitative Methods 19 (1 de enero de 2020): 160940692097354. http://dx.doi.org/10.1177/1609406920973543.

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In 2012, the Australian Commonwealth Government introduced a series of reforms for the aged care sector including the implementation of the National Prioritisation System for a flexible, accessible and demand-driven approach to home care services for older people. Nevertheless, an increasing number of older people continue to wait for months to be assigned home care packages on the national prioritisation queue, a component of the National Prioritisation System. There is limited evidence on the impact of the national prioritisation queue on discharge planning practices of social workers in supporting older people returning home from hospital admission. The aim of the research described in this paper is to explore the perceptions of social workers from rural and urban health services areas on how the introduction of the national prioritisation queue has influenced discharge planning of older people who are still waiting assignment of home care packages. This study protocol establishes the need for this qualitative study and provides an overview of the theoretical framework underpinning the research; discusses and describes the methods for sampling/recruitment and data collection, the approach to be utilised for qualitative analysis and the planned dissemination strategy. Understanding how social workers respond to the perceived challenges to discharge planning posed by the national prioritisation queue and the implications arising from the research have the potential to inform the development of best practice approaches and further enhance social work response to identified issues.

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Griffin, Cassandra, Ricardo Vilain, Simon King, Sandy Nixon, Alisha Gooley, Samara Bray, James Lynam, Marjorie M. Walker, Rodney J. Scott y Christine Paul. "Mind Over Matter: Confronting Challenges in Post-Mortem Brain Biobanking for Glioblastoma Multiforme". Biomarker Insights 16 (enero de 2021): 117727192110133. http://dx.doi.org/10.1177/11772719211013359.

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Over the past 10 years, there has been limited progress for the treatment of brain cancer and outcomes for patients are not much improved. For brain cancer researchers, a major obstacle to biomarker driven research is limited access to brain cancer tissue for research purposes. The Mark Hughes Foundation Brain Biobank is one of the first post-mortem adult brain banks in Australia to operate with protocols specifically developed for brain cancer. Located within the Hunter New England Local Health District and operated by Hunter Cancer Biobank, the boundaries of service provided by the Brain Bank extend well into the surrounding regional and rural areas of the Local Health District and beyond. Brain cancer biobanking is challenging. There are conflicting international guidelines for best practice and unanswered questions relating to scientific, psychosocial and operational practices. To address this challenge, a best practice model was developed, informed by a consensus of existing data but with consideration of the difficulties associated with operating in regional or resource poor settings. The regional application of this model was challenged following the presentation of a donor located in a remote area, 380km away from the biobank. This required biobank staff to overcome numerous obstacles including long distance patient transport, lack of palliative care staff, death in the home and limited rural outreach services. Through the establishment of shared goals, contingency planning and the development of an informal infrastructure, the donation was facilitated within the required timeframe. This experience demonstrates the importance of collaboration and networking to overcome resource insufficiency and geographical challenges in rural cancer research programmes.

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Edwards, Amanda y Nicholas Gill. "Living with landscape fire: Landholder understandings of agency, scale and control within fiery entanglements". Environment and Planning D: Society and Space 34, n.º 6 (26 de julio de 2016): 1080–97. http://dx.doi.org/10.1177/0263775816645588.

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Around the world, debates over how to manage and adapt to bushfires (or wildfires) are increasingly prominent as more and different people, many of whom have little or no experience with landscape fire or land management, inhabit fire-prone environments. But bushfire events represent only the most visible aspect of complex entanglements which operate across huge temporal and spatial scales and over which humans have very limited control. In this article, we focus on how Australian landholders of settler or migrant heritage understand scalar complexities and agency and control within human/landscape fire entanglements. In view of the fact that the learning styles of landholders new to rural areas have been developed in different environments with very different challenges, we also ask whether immersion within rural, fire-prone environments influences ways of ‘knowing’ land and fire.

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37

Harris, Mark F., Patrick G. Powell Davies, Mahnaz Fanaian, Nicholas A. Zwar y Siaw-Teng Liaw. "Access to same day, next day and after-hours appointments: the views of Australian general practitioners". Australian Health Review 36, n.º 3 (2012): 325. http://dx.doi.org/10.1071/ah11080.

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Objective. To evaluate factors associated with the availability of same or next day appointments and after-hours access reported by Australian general practitioners (GPs). Methods. Secondary analysis of a survey of primary care practitioners conducted by the Commonwealth Fund in 2009 in 11 countries. Analysis of factors likely to be associated with reported availability of same or next day appointments and after-hours access. Findings. Of 1016 Australian GPs, 78.8% reported that most patients in their practice had access to an appointment on the same or next day and 50% that their practice had arrangements for after-hours access. Access to same or next day care was better in practices where practitioners reported larger numbers of patients seen per GP per week and reviewed their performance against annual targets, but worse in rural areas and practices routinely reviewing outcomes data. Arrangements for after-hours care were more common among GPs who were planning to retire in the next 5 years; worked in practices with high electronic functioning information systems; and received and reviewed clinical outcome data and incentives for performance. Conclusions. Improving after-hours access requires a comprehensive approach which includes incentives, improvements to information management and organised systems of care with review of data on clinical outcomes. What is known about the topic? Access to general practice is an important priority for the health system and the subject of several reforms and initiatives over the past decade in Australia. Access to same or next day appointments and after-hours has been an increasing concern related to workforce availability, and limited access to general practice is one factor influencing the demand on hospitals, especially their emergency departments. What does this paper add? This paper reports on secondary analysis of a survey of over 1000 general practitioners in Australia. Responses to questions about access to same or next day appointments or after-hours arrangements were analysed for associations with practitioner and practice characteristics and their processes and systems of care. Access to same day appointments is particularly challenging in rural general practice but is more likely to be reported by GPs working in larger practices. Incentives, quality improvement and better information management may be important strategies to improve after-hours access. What are the implications for practitioners? Strategies to improve access to appointments and to after-hours care need to be considered as part of a comprehensive approach which includes financial incentives, strengthening information systems and quality improvement activities.

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Daneshmand, Hossein, Sina Alaghmand, Matteo Camporese, Amin Talei, Pat J. F. Yeh y Edoardo Daly. "Long-Term Impacts of Partial Afforestation on Water and Salt Dynamics of an Intermittent Catchment under Climate Change". Water 12, n.º 4 (9 de abril de 2020): 1067. http://dx.doi.org/10.3390/w12041067.

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Soil salinization is a major environmental issue in arid and semi-arid regions, and has been accelerated in some areas by removal of native vegetation cover. Partial afforestation can be a practical mitigation strategy if efficiently integrated with farms and pastures. Using an integrated surface-subsurface hydrological model, this study evaluates the water and salt dynamics and soil salinization conditions of a rural intermittent catchment in the semi-arid climate of southeast Australia subjected to four different partial afforestation configurations under different climate change scenarios, as predicted by several general circulation models. The results show that the locations of afforested areas can induce a retarding effect in the outflow of groundwater salt, with tree planting at lower elevations showing the steadier salt depletion rates. Moreover, except for the configuration with trees planted near the outlet of the catchment, the streamflow is maintained under all other configurations. It appears that under both Representative Concentration Pathways considered (RCP 4.5 and RCP 8.5), the Hadley Centre Global Environmental Model represents the fastest salt export scheme, whereas the Canadian Earth System Model and the Model for Interdisciplinary Research on Climate represent the slowest salt export scheme. Overall, it is found that the location of partial afforestation generally plays a more significant role than the climate change scenarios.

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Perkins, Rachel y Catheryn Khoo-Lattimore. "Friend or foe: Challenges to collaboration success at different lifecycle stages for regional small tourism firms in Australia". Tourism and Hospitality Research 20, n.º 2 (26 de marzo de 2019): 184–97. http://dx.doi.org/10.1177/1467358419836719.

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Small tourism businesses are essential to Australia’s economy and development, particularly in regional and rural areas, where a majority of these firms are located. It is important to understand the operation of regional small tourism business, to create strategies for their sustained success into the future. This research paper explores collaboration as an operation of small tourism businesses, by understanding the extent to which small tourism firms face challenges in collaborating at different stages of their business life cycle, and how these challenges to collaboration can be overcome. Collaboration is the selected concept examined within this study as it exposes businesses to shared knowledge, resources, marketing, and capabilities, which these businesses alone would not typically possess. To understand this further, reponses about collaborative behavior were gathered from 24 small tourism operators/managers from The Granite Belt region in South-East Queensland, Australia. Tourism operators recognized several hindrances to successful collaboration: (1) a limited understanding of what collaboration is and how it can be enacted, (2) the informal nature of current collaborations, (3) unbalanced efforts from stakeholders within the collaborations, (4) competition between stakeholders, (5) differing opinions of collaborating businesses, and (6) perceived failure or misdirected leadership from local governing bodies. Using these challenges, a framework was developed that makes recommendations to tourism scholars, organizations, operators, and local councils on how to overcome these hindrances by improving communication, formalizing selected collaborative efforts, and reporting on collaborations.

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McGrath, Pam. "Overcoming the distance barrier in relation to treatment for haematology patients: Queensland findings". Australian Health Review 39, n.º 3 (2015): 344. http://dx.doi.org/10.1071/ah14147.

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Objective The aim of the present study was to document the financial and psychosocial impact of relocation for specialist haematology treatment in Queensland. Methods This study was a qualitative exploratory study comprising 45 in-depth interviews with haematology patients supported by the Leukaemia Foundation of Queensland. Results The findings indicate that decentralisation of treatment is assisting haematology patients to overcome the profound difficulties associated with travelling to the metropolitan area for treatment. Conclusion Fostering specialist outreach and building capacity in regional cancer centres are service delivery strategies that are greatly appreciated by regional, rural and remote haematology patients who are stressed by the many challenges associated with leaving home to travel distances for specialist treatment. It is the hope and expectation that these findings will make a contribution to informing future health policy and service delivery planning. What is known about the topic? Internationally, there is evidence of the benefits of visiting specialists and the development of local specialist services for cancer patients in regional and rural areas, but there is limited research on the topic in Australia. What does this paper add? The findings herein make a contribution to this area of research through an up-to-date, in-depth consumer perspective on non-metropolitan oncology hospital services for haematology patients in Queensland. The evidence indicates that the opportunity to avoid travel to the metropolitan treating hospitals for regional, rural and remote haematology patients is increasingly an option in Queensland and greatly appreciated by many of those who have this option. What are the implications for practitioners? The findings applaud the work of the health professionals providing the opportunity for regional specialist care for haematology patients. With regard to service delivery and health policy decision making, it is important to note that for patients positive about access to local treatment, psychosocial concerns (e.g. remaining at home, connection with family, avoidance of financial hardship) predominate in their reasoning about benefit. Thus, it is important that regional, rural and remote patients are offered greater choice in treatment options and have more involvement in decision making about specialist care.

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Dillon, P., S. Toze, D. Page, J. Vanderzalm, E. Bekele, J. Sidhu y S. Rinck-Pfeiffer. "Managed aquifer recharge: rediscovering nature as a leading edge technology". Water Science and Technology 62, n.º 10 (1 de noviembre de 2010): 2338–45. http://dx.doi.org/10.2166/wst.2010.444.

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Use of Managed Aquifer Recharge (MAR) has rapidly increased in Australia, USA, and Europe in recent years as an efficient means of recycling stormwater or treated sewage effluent for non-potable and indirect potable reuse in urban and rural areas. Yet aquifers have been relied on knowingly for water storage and unwittingly for water treatment for millennia. Hence if ‘leading edge’ is defined as ‘the foremost part of a trend; a vanguard’, it would be misleading to claim managed aquifer recharge as a leading edge technology. However it has taken a significant investment in scientific research in recent years to demonstrate the effectiveness of aquifers as sustainable treatment systems to enable managed aquifer recharge to be recognised along side engineered treatment systems in water recycling. It is a ‘cross-over’ technology that is applicable to water and wastewater treatment and makes use of passive low energy processes to spectacularly reduce the energy requirements for water supply. It is robust within limits, has low cost, is suitable from village to city scale supplies, and offers as yet almost untapped opportunities for producing safe drinking water supplies where they do not yet exist. It will have an increasingly valued role in securing water supplies to sustain cities affected by climate change and population growth. However it is not a universal panacea and relies on the presence of suitable aquifers and sources of water together with effective governance to ensure human health and environment protection and water resources planning and management. This paper describes managed aquifer recharge, illustrates its use in Australia, outlining economics, guidelines and policies, and presents some of the knowledge about aquifer treatment processes that are revealing the latent value of aquifers as urban water infrastructure and provide a driver to improving our understanding of urban hydrogeology.

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Singh, Achyut Man. "An Environmentally Friendly Integrated Development Approach for Nepal (Experiences from Irrigation Sector Projects)". Hydro Nepal: Journal of Water, Energy and Environment 20 (27 de enero de 2017): 31–40. http://dx.doi.org/10.3126/hn.v20i0.16486.

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Nepal has distinctly three ecological regions: (i) high mountain, (ii) mid-hills, and (iii) terai with their varying climatic and physiographic features. The experiences gathered from Irrigation Sector Projects implemented under various donor agencies such as the World Bank (WB), Asian Development Bank (ADB), and UN/ILO have shown that successful irrigation projects must be defined and planned according to specific ecological regions and pertinent to the local environment. An integrated development approach considers the land use, roads, market, and other economic activities as they relate to prospects for poverty alleviation. Land evaluation and subsequent land use planning according to the soil, climate, land profile, and suitability of agriculture practices should be considered in the development works to ensure true benefit to the rural populations. The integrated approach as such will provide long term sustainability through environmentally sound practices. This approach has been widely applied in the European countries, Korea, Japan, and Sri Lanka.This paper primarily focuses on the irrigation and development approaches most suitable to Nepal’s three ecological regions. High mountain regions should be developed with pasture land, horticulture, organic vegetable farming, and tourism. Irrigation technology in these areas should be simple pipe conveyance, and tank irrigation. In the mid-hills horticulture on the sloping terrain and cereal crops in the river valleys with other diversified cropping systems should be applied. The Terai region is the ‘Bread Basket’ of Nepal, and has high potential for diversified agriculture and industrial development.For development in these regions to succeed, road networks and transportation facilities are essential to economic growth. Road transportation maximizes opportunity for tourism and other economic activities. Development work must be planned in an integrated approach, which should be based on appropriate land use patterns for environmentally sustainable practices. An ideal solution would be to envision the watershed as the unit for eco-friendly sustainable development planning involving all the stakeholders under the watershed purview. As an example, the principles of Integrated Water Resources Management Planning (IWRMP), and Integrated Watershed Management Plan (IWMP) have been successfully applied in the USA and Australia (Box 1). It has illustrated that vegetative covered catchment stores large amount of rain water, increases groundwater table, reduces erosion of soil, and lastly decreases the intensity of flood hazard. Whereas, the naked catchment areas are highly erodible, does not store rain water, susceptible to high erosion and landslides, and increases the flood intensity by three fold than a vegetative covered one. The vegetative cover increases the water resources availability for over all development for agriculture. HYDRO Nepal JournalJournal of Water Energy and EnvironmentIssue: 20Page: 31-40

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Willsher, Kerre A. "Disability in Rural Areas of Australia". International Journal of Community Diversity 13, n.º 4 (2015): 1–12. http://dx.doi.org/10.18848/2327-0004/cgp/v14i04/39972.

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Zhou, Wenyu, Anthony Lin Zhang, Brian H. May, Vivian K. Lin, Anne-Louise Carlton y Charlie Changli Xue. "The Victorian experience of transitional registration for Chinese Medicine practitioners and its implications for national registration". Australian Health Review 36, n.º 1 (2012): 61. http://dx.doi.org/10.1071/ah09861.

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Background. Statutory registration of Chinese Medicine (CM) practitioners was introduced in Victoria in 2000. The application assessment process for those who were granted registration during the transitional period (2002–04) was resource intensive, as little was known about their age, education, practice and language proficiency. This study offers insights that may be useful for the planning of national registration to commence in 2012. Methods. Data were extracted from registration application forms submitted to the Chinese Medicine Registration Board of Victoria (CMRB) between 2002 and 2004, using pre-defined data collection forms. Results. In 2006, 639 ‘grandparented’ Victorian CM practitioners had been registered, with a median age of 44 years old (range 23–86). There was a higher proportion of younger female, English-speaking, acupuncturists v. a higher proportion of older male, non-English-speaking, Chinese herbalists. There were few CM practitioners in rural areas, particularly herbalists. More than one-third of practitioners had obtained qualifications overseas and almost half of these practitioners provided no evidence of past study in professional issues and medical ethics. Conclusions. Ageing, diversity in qualifications and training, English proficiency, and level of study in professional issues and medical ethics represent major challenges for the implementation of CM national registration in 2012. What is known about the topic? Statutory registration of Chinese Medicine (CM) practitioners was introduced in the state of Victoria in 2000. The process of registering practitioners during the transitional period was resource intensive, because of the diverse background of the workforce. In May 2009, Health Ministers of all States and Territories and the Commonwealth agreed to include the CM profession, from 1 July 2012, in the National Registration and Accreditation Scheme for the health professions. What does this paper add? This paper, based on data from the registration application forms submitted to the Chinese Medicine Registration Board of Victoria (CMRB) between 2002 and 2004, provides a demographic and geographic profile of the 639 Victorian CM practitioners grandparented under the transitional arrangements of the Chinese Medicine Registration Act 2000. This study offers insights that may be useful for the planning of national registration for the Chinese Medicine profession. What are the implications for practitioners? With the introduction of national registration for the CM profession, this study provides critical data for developing effective strategies to implement the grandparenting process in all states and territories in Australia. Particularly, data collected in this study will help to deal with assessing knowledge in ethics and the healthcare system, biomedical sciences and language proficiency as part of the assessment process for a substantial number of applicants during the national registration of CM practitioners.

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Sorensen, Tony. "Impacts on Rural Australia". Urban Policy and Research 9, n.º 3 (septiembre de 1991): 178–79. http://dx.doi.org/10.1080/08111149108551505.

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ATTESLANDER, Peter. "Problems of Planning in Rural Areas". JOURNAL OF RURAL PLANNING ASSOCIATION 3, n.º 4 (1985): 50–53. http://dx.doi.org/10.2750/arp.3.4_50.

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Syssner, Josefina y Marlies Meijer. "Informal Planning in Depopulating Rural Areas". European Countryside 9, n.º 3 (1 de septiembre de 2017): 458–72. http://dx.doi.org/10.1515/euco-2017-0027.

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AbstractPlanning research has increasingly recognised that planning in depopulating areas differs from planning in growth areas. Several studies have sought to identify planning theories and strategies that are capable of meeting the challenges presented by depopulating areas. However, most of these studies and strategies are based on dense urban environments. This paper seeks to add to planning theory and practice by focusing on informal planning practices in rural depopulating areas. Starting from a resource-based view, the paper introduces an analytical framework that allows a systematic examination of the resources that are generated through informal planning practices in such areas.

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Proudfoot, Bruce. "Planning and development in rural areas". Journal of Rural Studies 2, n.º 1 (enero de 1986): 78. http://dx.doi.org/10.1016/0743-0167(86)90087-2.

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Bavithra, Guna, Joana Azevedo, Flávio Oliveira, João Morais, Edgar Pinto, Isabel M. P. L. V. O. Ferreira, Vitor Vasconcelos, Alexandre Campos y C. Marisa R. Almeida. "Assessment of Constructed Wetlands’ Potential for the Removal of Cyanobacteria and Microcystins (MC-LR)". Water 12, n.º 1 (18 de diciembre de 2019): 10. http://dx.doi.org/10.3390/w12010010.

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Microcystis blooms and the subsequent release of hepatotoxic microcystins (MCs) pose a serious threat to the safety of water for human and livestock consumption, agriculture irrigation, and aquaculture worldwide. Microcystin-LR (MC-LR), the most toxic variant of MCs, has been widely detected in a variety of environments such as water, sediments, plants, and many aquatic organisms. Conventional solutions of water treatment are costly, requiring specific infrastructure, as well as specialized personnel and equipment. Therefore, these solutions are not feasible in many rural areas or in the treatment of large reservoirs. In this regard, low-cost and low-technology solutions, such as constructed wetlands (CWs), are attractive solutions to treat surface waters contaminated with toxic cyanobacteria blooms from lakes, ponds, reservoirs, and irrigation systems. In line with this, the main aim of this work was to evaluate the potential of CWs for the treatment of water contaminated with MC-LR produced by Microcystis aeruginosa—LEGE 91094. For that, microcosms (0.4 × 0.3 × 0.3 m) simulating CWs were assembled with Phragmites australis to treat lake water contaminated with Microcystis aeruginosa cells and MCs. Results showed removal percentages of M. aeruginosa cells above 94% and about 99% removal of MC-LR during 1 week treatment cycles. CWs maintained their functions, regardless the presence of MC-LR in the system, and also showed significant removal of nutrients (ammonium ion removal up to 86%) and organic matter (removal reaching 98%). The present work indicates that CWs have the potential for removal of cyanobacterial cells and cyanotoxins, which can be useful for the treatment of eutrophic waters and provide water of sufficient quality to be used, for instance, in agriculture.

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Krivokapic-Skoko, Branka, Carol Reid y Jock Collins. "Rural cosmopolitism in Australia". Journal of Rural Studies 64 (noviembre de 2018): 153–63. http://dx.doi.org/10.1016/j.jrurstud.2018.01.014.

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