Understanding childhood injuries in rural areas : using rural acute hospital data register to address previous data deficiencies
- Peck, Blake, Terry, Daniel, Kloot, Kate
- Authors: Peck, Blake , Terry, Daniel , Kloot, Kate
- Date: 2020
- Type: Text , Journal article
- Relation: EMA - Emergency Medicine Australasia Vol. 32, no. 4 (2020), p. 646-649
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- Description: Objective: The state of childhood injury in rural areas of Victoria is poorly understood. Currently only data on those children transferred from smaller hospital settings to larger settings appear in existing government datasets, significantly underestimating the characteristics of injury. Methods: Detailed emergency presentation data (Victorian Emergency Minimum Dataset [VEMD] and non-VEMD) that makes up the Rural Acute Hospital Data Register database was collected and compared among children (aged 0–14 years) who have a principal diagnosis of injury. Results: Of the 8647 episodes of care identified for injured children aged 0–14 years, 3257 children were managed initially at smaller hospitals that do not report episode data to existing datasets. Conclusions: The Rural Acute Hospital Data Register database captures the presentations at low-resource sites and highlights as much as a 35% deficit in the data that is currently available to inform injury prevention and safety initiatives in Victoria. © 2020 Australasian College for Emergency Medicine
- Authors: Peck, Blake , Terry, Daniel , Kloot, Kate
- Date: 2020
- Type: Text , Journal article
- Relation: EMA - Emergency Medicine Australasia Vol. 32, no. 4 (2020), p. 646-649
- Full Text:
- Reviewed:
- Description: Objective: The state of childhood injury in rural areas of Victoria is poorly understood. Currently only data on those children transferred from smaller hospital settings to larger settings appear in existing government datasets, significantly underestimating the characteristics of injury. Methods: Detailed emergency presentation data (Victorian Emergency Minimum Dataset [VEMD] and non-VEMD) that makes up the Rural Acute Hospital Data Register database was collected and compared among children (aged 0–14 years) who have a principal diagnosis of injury. Results: Of the 8647 episodes of care identified for injured children aged 0–14 years, 3257 children were managed initially at smaller hospitals that do not report episode data to existing datasets. Conclusions: The Rural Acute Hospital Data Register database captures the presentations at low-resource sites and highlights as much as a 35% deficit in the data that is currently available to inform injury prevention and safety initiatives in Victoria. © 2020 Australasian College for Emergency Medicine
The urban-rural divide : hypertensive disease hospitalisations in Victoria 2010–2015
- Robins, Shalley, Gardiner, Samantha, Terry, Daniel
- Authors: Robins, Shalley , Gardiner, Samantha , Terry, Daniel
- Date: 2017
- Type: Text , Journal article
- Relation: Australasian Medical Journal Vol. 10, no. 11 (2017), p. 953-963
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- Description: Background Hypertension is present in 23–32 per cent of Australians, making it one of the most prevalent diseases in the country. It is the greatest risk factor for cardiovascular disease, the leading cause of death in Australia and it affects rural populations at a higher rate than urban residents. Aims The aims of this study were to investigate the differences in hypertensive disease hospitalisations across rural and urban Victoria, and to determine predicting variables. Methods Hospital admission data from 1 July 2010 to 30 June 2015 were obtained through the Victorian Admitted Episodes Dataset and other organisations. Data included various patient demographics for each hospital admission entry. The rates of hospitalisation for each Local Government Area were analysed. Further regression analysis was undertaken to examine the association between hypertensive disease hospitalisation and various predictor variables. Results From 2010–2015 11,205 hypertensive disease hospital admissions were recorded of which 64.8 per cent were female, 74.7 per cent admissions were at urban hospitals, and 65.0 per cent were public patients. Hospitalisation rates were consistently higher in rural areas than in urban areas, and rural residents on average stayed in hospital for longer. Significant predictor variables for hypertensive disease hospitalisation included various indicators of socioeconomic disadvantage, GPs per 1,000 population and GP attendance per 1,000 population. Conclusion Hypertensive disease hospitalisation in Victoria continues to rise and rates of hospitalisation of rural Victorians continue to be higher than their urban counterparts. Females were hospitalised almost twice as often as males. Further research is required to identify the specific factors that impede access to health services, particularly in the identified high-risk populations. © 2017, Australasian Medical Journal Pty Ltd. All rights reserved.
- Authors: Robins, Shalley , Gardiner, Samantha , Terry, Daniel
- Date: 2017
- Type: Text , Journal article
- Relation: Australasian Medical Journal Vol. 10, no. 11 (2017), p. 953-963
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- Description: Background Hypertension is present in 23–32 per cent of Australians, making it one of the most prevalent diseases in the country. It is the greatest risk factor for cardiovascular disease, the leading cause of death in Australia and it affects rural populations at a higher rate than urban residents. Aims The aims of this study were to investigate the differences in hypertensive disease hospitalisations across rural and urban Victoria, and to determine predicting variables. Methods Hospital admission data from 1 July 2010 to 30 June 2015 were obtained through the Victorian Admitted Episodes Dataset and other organisations. Data included various patient demographics for each hospital admission entry. The rates of hospitalisation for each Local Government Area were analysed. Further regression analysis was undertaken to examine the association between hypertensive disease hospitalisation and various predictor variables. Results From 2010–2015 11,205 hypertensive disease hospital admissions were recorded of which 64.8 per cent were female, 74.7 per cent admissions were at urban hospitals, and 65.0 per cent were public patients. Hospitalisation rates were consistently higher in rural areas than in urban areas, and rural residents on average stayed in hospital for longer. Significant predictor variables for hypertensive disease hospitalisation included various indicators of socioeconomic disadvantage, GPs per 1,000 population and GP attendance per 1,000 population. Conclusion Hypertensive disease hospitalisation in Victoria continues to rise and rates of hospitalisation of rural Victorians continue to be higher than their urban counterparts. Females were hospitalised almost twice as often as males. Further research is required to identify the specific factors that impede access to health services, particularly in the identified high-risk populations. © 2017, Australasian Medical Journal Pty Ltd. All rights reserved.
Glycaemic control among rural health consumers : a retrospective study of a diabetes center
- Terry, Daniel, Glenister, Kristen, Kilmartin, John, Kilmartin, Gloria, Sands, Rob, Fowler, Jeremy, Wright, Julian
- Authors: Terry, Daniel , Glenister, Kristen , Kilmartin, John , Kilmartin, Gloria , Sands, Rob , Fowler, Jeremy , Wright, Julian
- Date: 2015
- Type: Text , Journal article
- Relation: Advances in Diabetes and Metabolism Vol. 3, no. 2 (2015), p. 11-15
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- Description: Aim: The aim of this paper is to highlight the successes of and challenges faced by a publically funded diabetes center in a regional area. Methods: Demographic and laboratory cross sectional data were collected from electronic patient records. Data from a patient’s very first test undertaken when attending the hospital and the latest test undertaken at the dabetes center were noted and included age, sex, residential postcode and glycated haemoglobin (HbA1c) levels. Results: A third of patients reached the therapeutic guideline of ‘very good control’ for HbA1c levels. Females had lower Hb1Ac levels, while males and those that lived further away from the diabetes center had higher levels of HbA1c. However, a significant improvement in glycaemic control among men and those who lived ‘out of town’ was noted, while the corresponding pattern for women was not evident. Conclusion: The study demonstrated that there was an overall improvement in diabetes control among health consumers who attend the regional diabetes center, however, female patients residing in town showed a negligible change over time. At risk’ patient groups may need further targeting for intensive intervention to achieve optimal diabetes control, even within the diabetes center.
- Authors: Terry, Daniel , Glenister, Kristen , Kilmartin, John , Kilmartin, Gloria , Sands, Rob , Fowler, Jeremy , Wright, Julian
- Date: 2015
- Type: Text , Journal article
- Relation: Advances in Diabetes and Metabolism Vol. 3, no. 2 (2015), p. 11-15
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- Description: Aim: The aim of this paper is to highlight the successes of and challenges faced by a publically funded diabetes center in a regional area. Methods: Demographic and laboratory cross sectional data were collected from electronic patient records. Data from a patient’s very first test undertaken when attending the hospital and the latest test undertaken at the dabetes center were noted and included age, sex, residential postcode and glycated haemoglobin (HbA1c) levels. Results: A third of patients reached the therapeutic guideline of ‘very good control’ for HbA1c levels. Females had lower Hb1Ac levels, while males and those that lived further away from the diabetes center had higher levels of HbA1c. However, a significant improvement in glycaemic control among men and those who lived ‘out of town’ was noted, while the corresponding pattern for women was not evident. Conclusion: The study demonstrated that there was an overall improvement in diabetes control among health consumers who attend the regional diabetes center, however, female patients residing in town showed a negligible change over time. At risk’ patient groups may need further targeting for intensive intervention to achieve optimal diabetes control, even within the diabetes center.
Workplace health and safety issues among community nurses : a study regarding the impact on providing care to rural consumers
- Terry, Daniel, Lê, Quynh, Nguyen, Uyen, Hoang, Hoang
- Authors: Terry, Daniel , Lê, Quynh , Nguyen, Uyen , Hoang, Hoang
- Date: 2015
- Type: Text , Journal article
- Relation: BMJ Open Vol. 5, no. 8 (2015), p.
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- Description: Objectives: The objective of the study was to investigate the types of workplace health and safety issues rural community nurses encounter and the impact these issues have on providing care to rural consumers. Methods: The study undertook a narrative inquiry underpinned by a phenomenological approach. Community nursing staff who worked exclusively in rural areas and employed in a permanent capacity were contacted among 13 of the 16 consenting healthcare services. All community nurses who expressed a desire to participate were interviewed. Data were collected using semistructured interviews with 15 community nurses in rural and remote communities. Thematic analysis was used to analyse interview data. Results: The role, function and structures of community nursing services varied greatly from site to site and were developed and centred on meeting the needs of individual communities. In addition, a number of workplace health and safety challenges were identified and were centred on the geographical, physical and organisational environment that community nurses work across. The workplace health and safety challenges within these environments included driving large distances between client's homes and their office which lead to working in isolation for long periods and without adequate communication. In addition, other issues included encountering, managing and developing strategies to deal with poor client and carer behaviour; working within and negotiating working environments such as the poor condition of patient homes and clients smoking; navigating animals in the workplace; vertical and horizontal violence; and issues around workload, burnout and work-related stress. Conclusions: Many nurses achieved good outcomes to meet the needs of rural community health consumers. Managers were vital to ensure that service objectives were met. Despite the positive outcomes, many processes were considered unsafe by community nurses. It was identified that greater training and capacity building are required to meet the needs among all staff.
- Authors: Terry, Daniel , Lê, Quynh , Nguyen, Uyen , Hoang, Hoang
- Date: 2015
- Type: Text , Journal article
- Relation: BMJ Open Vol. 5, no. 8 (2015), p.
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- Description: Objectives: The objective of the study was to investigate the types of workplace health and safety issues rural community nurses encounter and the impact these issues have on providing care to rural consumers. Methods: The study undertook a narrative inquiry underpinned by a phenomenological approach. Community nursing staff who worked exclusively in rural areas and employed in a permanent capacity were contacted among 13 of the 16 consenting healthcare services. All community nurses who expressed a desire to participate were interviewed. Data were collected using semistructured interviews with 15 community nurses in rural and remote communities. Thematic analysis was used to analyse interview data. Results: The role, function and structures of community nursing services varied greatly from site to site and were developed and centred on meeting the needs of individual communities. In addition, a number of workplace health and safety challenges were identified and were centred on the geographical, physical and organisational environment that community nurses work across. The workplace health and safety challenges within these environments included driving large distances between client's homes and their office which lead to working in isolation for long periods and without adequate communication. In addition, other issues included encountering, managing and developing strategies to deal with poor client and carer behaviour; working within and negotiating working environments such as the poor condition of patient homes and clients smoking; navigating animals in the workplace; vertical and horizontal violence; and issues around workload, burnout and work-related stress. Conclusions: Many nurses achieved good outcomes to meet the needs of rural community health consumers. Managers were vital to ensure that service objectives were met. Despite the positive outcomes, many processes were considered unsafe by community nurses. It was identified that greater training and capacity building are required to meet the needs among all staff.
Satisfaction amid professional challenges : international medical graduates in rural Tasmania
- Terry, Daniel, Lê, Quynh, Hoang, Hoang
- Authors: Terry, Daniel , Lê, Quynh , Hoang, Hoang
- Date: 2014
- Type: Text , Journal article
- Relation: Australasian Medical Journal Vol. 7, no. 12 (2014), p. 500-517
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- Description: Background At the time of recruitment, migration, and placement, international medical graduates (IMGs) encounter professional challenges. These challenges may include a loss of status and professional identity, professional isolation in rural practice, restrictions on medical practice, and social isolation. Understanding the nature of these challenges may facilitate the recruitment, placement, and success of international medical graduates within rural Tasmania. Aims The aim of this study was to investigate the experiences, challenges, and barriers that IMGs encounter as they work and live in rural Tasmania. Methods The study used a mixed-methods design where data were collected using a questionnaire and semi-structured interviews across the south, north, and northwest of Tasmania. IMGs were recruited through purposive snowball and convenience sampling. Results A total of 105 questionnaires were returned (response rate 30.0 per cent) and 23 semi-structured interviews were conducted with IMGs across Tasmania. Questionnaire participants indicated that the majority of IMGs are satisfied in their current employment; however, interview participants indicated there were a number of barriers to practising medicine in Tasmania as well as factors that would influence ongoing employment in the state. Despite these challenges, professional support was recognised as a key contributor to professional satisfaction, particularly among IMGs who had just arrived. Conclusion The study contributes to the current knowledge and understanding of IMGs who live and work in rural areas. The study shows that there are high levels of satisfaction among IMGs with their current position; however, the research also provides insight into the complexities and factors that impact IMGs as they work and live within rural areas such as Tasmania. This study offers an understanding for policy to improve greater retention of IMGs across rural areas. © 2014 Australasion Medical Jaurnal. All rights received.
- Authors: Terry, Daniel , Lê, Quynh , Hoang, Hoang
- Date: 2014
- Type: Text , Journal article
- Relation: Australasian Medical Journal Vol. 7, no. 12 (2014), p. 500-517
- Full Text:
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- Description: Background At the time of recruitment, migration, and placement, international medical graduates (IMGs) encounter professional challenges. These challenges may include a loss of status and professional identity, professional isolation in rural practice, restrictions on medical practice, and social isolation. Understanding the nature of these challenges may facilitate the recruitment, placement, and success of international medical graduates within rural Tasmania. Aims The aim of this study was to investigate the experiences, challenges, and barriers that IMGs encounter as they work and live in rural Tasmania. Methods The study used a mixed-methods design where data were collected using a questionnaire and semi-structured interviews across the south, north, and northwest of Tasmania. IMGs were recruited through purposive snowball and convenience sampling. Results A total of 105 questionnaires were returned (response rate 30.0 per cent) and 23 semi-structured interviews were conducted with IMGs across Tasmania. Questionnaire participants indicated that the majority of IMGs are satisfied in their current employment; however, interview participants indicated there were a number of barriers to practising medicine in Tasmania as well as factors that would influence ongoing employment in the state. Despite these challenges, professional support was recognised as a key contributor to professional satisfaction, particularly among IMGs who had just arrived. Conclusion The study contributes to the current knowledge and understanding of IMGs who live and work in rural areas. The study shows that there are high levels of satisfaction among IMGs with their current position; however, the research also provides insight into the complexities and factors that impact IMGs as they work and live within rural areas such as Tasmania. This study offers an understanding for policy to improve greater retention of IMGs across rural areas. © 2014 Australasion Medical Jaurnal. All rights received.
Type 2 diabetes mellitus management : a retrospective study in rural general practice
- Wyett, Ruby, Peck, Blake, Terry, Daniel
- Authors: Wyett, Ruby , Peck, Blake , Terry, Daniel
- Type: Text , Journal article
- Relation: Advances in Diabetes and Metabolism Vol. 7, no. 1 (), p. 1-7
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- Description: Type 2 Diabetes Mellitus (T2DM) is a chronic, progressive metabolic disease that is an international epidemic. General Practitioners (GPs) are the cornerstones of T2DM management. The aim of this study was to determine the scope of care and management of patients with T2DM within General Practice, while highlighting domains of success and areas where improvement can be made. Demographic and laboratory cross sectional data were collected by examining electronic patient records at one rural General Practice to address the aims of the study. Data included key management parameters of Hemoglobin A1c (HbA1c), estimated Glomerular Filtration Rate (eGFR), microalbuminuria, blood pressure and cholesterol levels, in addition to age, sex, and residential postcode. Further, data regarding the use of insulin, antihypertensive medications and lipid-lowering medications were collected and analyzed. Descriptive and inferential statistics were used and significance was determined at p
- Authors: Wyett, Ruby , Peck, Blake , Terry, Daniel
- Type: Text , Journal article
- Relation: Advances in Diabetes and Metabolism Vol. 7, no. 1 (), p. 1-7
- Full Text:
- Reviewed:
- Description: Type 2 Diabetes Mellitus (T2DM) is a chronic, progressive metabolic disease that is an international epidemic. General Practitioners (GPs) are the cornerstones of T2DM management. The aim of this study was to determine the scope of care and management of patients with T2DM within General Practice, while highlighting domains of success and areas where improvement can be made. Demographic and laboratory cross sectional data were collected by examining electronic patient records at one rural General Practice to address the aims of the study. Data included key management parameters of Hemoglobin A1c (HbA1c), estimated Glomerular Filtration Rate (eGFR), microalbuminuria, blood pressure and cholesterol levels, in addition to age, sex, and residential postcode. Further, data regarding the use of insulin, antihypertensive medications and lipid-lowering medications were collected and analyzed. Descriptive and inferential statistics were used and significance was determined at p
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