SCHOOL OF MEDICINE
UNIVERSITY OF NOTRE DAME
A/Prof Tom Brett
Director
Ph: 08 9433 0258
E: tbrett@nd.edu.au
Medical students support Notre Dame PHCRED
The Summer vacation period provided a unique opportunity for three medical students to become involved in Notre Dame PHCRED activities. Second year students, Shannon Tucker and Rose McDonnell, together with first-year student, Alison Philpott, received research bursaries for their work on the Fremantle Primary Prevention Study on cardiovascular disease.
The hands-on support provided by the students was very much appreciated by the three research practices involved. Research experience gained by the students included assistance with recruitment of patients to the study; support for the general practitioner and practice nurse with history taking and clinical assessment and support for the data manager with data entry and follow-up of test results.
Feedback from the medical students has been very positive with all expressing an increased awareness of the range and scope of the workload in general practice. Their positive experiences included increased one-on-one patient contact, a greater awareness of social and lifestyle factors in disease causation, increased opportunities to practice history taking and clinical skills, involvement in practice management discussions and interaction with practice nurses, allied health and reception staff.
Another first year student, Ari Kantzides was awarded a research bursary during 2006 for his contribution to an ongoing study into career choice aspirations of the graduate entry medical students at Notre Dame.
A key focus for Notre Dame PHCRED during 2006 was to encourage the graduate-entry medical students to become actively involved in primary care research activities. Our regular research meetings and seminars were attended by a number of interested students during the year and we hope to build on this valuable research support base in the future.
GREATER GREEN TRIANGLE UNIVERSITY DEPARTMENT OF RURAL HEALTH
FLINDERS AND DEAKIN UNIVERSITIES
Rachel Boak
PHCRED Coordinator
Ph: 03 5563 3502
E: rachel.boak@greaterhealth.org
Writing for publication –Writing Retreat in the Greater Green Triangle
Disseminating and facilitating the uptake of evidence into policy and practice
To support the dissemination and uptake of primary health care research findings and to build critical appraisal and research writing skills, the PHCRED program at Greater Green Triangle University Department of Rural Health (GGT UDRH) conducted a two week writing retreat in November 2006.
GGT UDRH research staff, visiting international academics, and bursary holders met to review current research projects and journal articles for publication.
A publication plan was produced at the start of 2006; this allowed the group to keep track of progress with writing projects and to make contributions throughout the year to colleagues' work. The writing retreat consolidated the work from fortnightly writing group sessions held during the year. It provided exposure to top international experts and their review of PHCRED bursary work, this was an important career development experience for the RDP post holder and for bursary holders.
Bringing together a critical mass of primary health care researchers at the end of the year also had the unexpected bonus of producing new concepts for additional papers from existing research work and forming new collaborations to undertake this work.
During the retreat approximately 25 papers were reviewed in readiness for submission to journals such as; the Australian and New Zealand Journal of Public Health, Medical Journal of Australia, the British Medical Journal, the Australian Journal of Rural Health, and the Healthy Lifestyles Journal. Articles represented work from senior GGT UDRH academics, the RDP post holder, and from PHCRED bursary holders.
DISCIPLINE OF GENERAL PRACTICE
UNIVERSITY OF ADELAIDE
Dr Karin Ried
Program Manager
Ph: 08 8303 6281
E: karin.ried@adelaide.edu.au
Researcher Development Program Fellows
GP Dr Susan Selby reports:
“Being a RDP Fellow in 2006 at the University of Adelaide was a privilege, enabling me to continue research for a PhD project investigating loss and grief issues in adult Australian cross-cultural workers returning to Australia and their management in the general practice setting. As a result of the fellowship, I was able to gain increased experience with conference presentations; investigate the research method ‘Modified Delphi Process'; gain valuable experience from an extensive literature search and the submission and resubmission of an article for publication. I appreciated being able to combine time for research with my clinical commitments. The interaction with my mentor Dr Ried and other researchers in the Department was very valuable and I gained much from their experience. I would like to thank PHCRED for the wonderful opportunity and encourage other GPs with an interest in research to apply for such positions.”
Jo Nolan describes her experience:
“As a physiotherapist working in falls prevention, the RDP Fellowship was a wonderful opportunity to investigate how to best present fall prevention advice so that it is likely to maximise uptake of evidence-based interventions in older people admitted to hospital with a fall-related injury. Thirteen people (aged 65-95) were interviewed. Many participants thought that falls were not preventable. Data suggest that current ‘falls prevention' messages and advice may not be acceptable to older people, despite being admitted to hospital with a serious fall-related injury. For many participants it seemed that being labelled ‘a faller' challenged their identity as a competent individual. To reduce future falls, messages need to be framed differently, which will be explored in more detailed data analysis. I have learnt an enormous amount, and developed many skills through my mentor Dr Ried and colleagues, participation in the writing group, using digital voice recorders and NVIVO for analysis of qualitative data.”
SHOWCASING PHCRED RESEARCH FROM WA
Tracy Reibel
WA PHCRED Statewide Coordinator
E: treibel@meddent.uwa.edu.au
Primary health Care NOW!
Current Research and Evaluation development in WA
Ellen McIntyre (presenter), PHC RIS & Tracy Reibel, PHCRED WA State-wide Coordinator
Professor Linda Kristjanson (Pro Vice-Chancellor, Research and Development, Curtin University) challenged the 40 plus delegates who attended the PHCRED WA annual state conference in November 2006. She stated that primary health care in Australia needs to enhance its emphasis of the social determinants of health and reach out to other sectors as is happening in Canada. The social determinants recognise the multiple social factors that contribute to health. To address this important aspect there needs to be cross-sectional planning, collaboration and coordination beyond primary health care service delivery when looking at ways to improve the health of the community.
Delegates were intrigued by over 20 presentations from GP, allied health and Divisions staff researchers around WA. These included effectiveness of laser acupuncture for chronic low-back pain, evaluation of a palliative rural respite nursing service, improving a diabetes register, evaluation of the Street Doctor & Medical Access Centre Program, assessment of trauma management in primary care, knowledge and attitudes to prostate cancer, development of a family history screening questionnaire, community residencies, attitudes and perceptions of primary care professionals to those who are intersex or androgynous and much more. All sessions promoted good discussion and feedback, key components for early career researchers to develop their skills. The judging of presentations was made difficult by the consistently great quality of both slides and oral presentation.
Workshops on using routine practice data and getting started in research were very also well attended and allowed for some useful discussions.
The day culminated in the launching of the PHCRED WA website (Web: www.phcredwa.org.au) and a forum discussion on a practice based research network in WA. A most useful day for both networking and learning more about primary health care research in WA. Conference abstracts will be available on the website from January 2007.
QLD COLLABORATION
PHCRED QUEENSLAND
Denise Schultz
PHCRED Qld Coordinator
Ph: 07 3346 4905
E: d.schultz@uq.edu.au
QLD Fellows Great Quality Research
PHCRED Fellows from Bond University, Griffith University, James Cook University, University of Queensland, and Mount Isa Centre for Rural and Remote Health met in Brisbane recently to share outcomes and findings from research activities they've been involved in over the past 12 months.
The research activities were completed as part of the PHCRED Fellowship program.
Eighteen researchers spoke on a variety of topics including managing low back pain in primary care, smoking cessation for cardiac patients, Indigenous health, and workforce issues to name a few.
The aim of the Fellowships was to develop the research skills of primary health care clinicians to conduct quality research on topics relevant to informing policy and practice, and the research undertaken by the 2006 Fellows demonstrated this.
As part of her Fellowship, Dr Melania Scrace from the Royal Flying Doctors Service (RFDS) piloted a program for skin cancer screening in remote Queensland. Melania said the program was designed to address the imbalance in medical care, expertise and technology for skin cancer care faced by rural communities.
Another study, conducted by Melissa Hilton, examined the financial benefits and implications of employing a practice nurse using nurse specific MBS item numbers. Melissa collected and analysed data from four urban GP practices. Melissa's research helps to clarify the practice nurse role and demonstrate to GPs the positive impact of employing a practice nurse.
Dr Ian Williams' research examined identifiable predictors for admission to residential aged care facilities. By determining these predictors, Ian hopes to develop strategies to identifying reversible predictors during routine health assessments to prevent admissions to residential aged care facilities.
The fellows evaluated the meeting as a great opportunity to network and to see how PHCRED funding has facilitated research at the local level. PHCRED staff chaired the sessions with some interesting "where to from here" discussions following the presentations.
QLD COLLABORATION
PHCRED QUEENSLAND
Denise Schultz
PHCRED Qld Coordinator
Ph: 07 3346 4905
E: d.schultz@uq.edu.au
Qld Collaboration first year under Phase 2 of the PHCRED Strategy
In 2006 PHCRED Queensland went from a Tripartite to a Collaboration with the Departments of General Practice at Bond and Griffith universities joining James Cook University, Mount Isa Centre for Rural and Remote Health and The University of Queensland. We also welcomed new members to our Management and Advisory Committees.
Once staffing within the new departments was finalised we were able to focus on both our individual and collaborative activities. Some of our collaborative highlights were:
On-line Research Modules. The Qld PHCRED team continue to develop a set of on-line introductory research modules. Access is available to all PHC practitioners.
Roadshows. The collaboration ran a series of rural workshops on location. Funding assistance was received from Queensland Health towards 2006 roadshow expenses. Districts visited included Longreach, Charleville and Roma at the end of August followed by Gladstone, Bundaberg and Maryborough in November. Further roadshows are planned for 2007.
Launching your research career. PHCRED Queensland offers post-graduate students mentoring, supervision and support. Each of the collaboration universities offer a sequence of postgraduate coursework and research options, starting out with Graduate Certificates and extending right through to the Doctor of Philosophy (PhD).
Annual fellows showcase. Eighteen fellows travelled to Brisbane on 14 November to share outcomes and findings from research activities they've been involved in over the past 12 months. The diversity of topics and quality of presentations was highly commended.
Policy Showcase. During 2006 one of our working groups undertook preliminary planning for a meeting to highlight to policy makers the world class primary health care research underway in Queensland. Planning is continuing with the meeting earmarked for mid 2007.
Working Groups. With an increase in Committee members, it was decided to form smaller working groups to work on planned collaborative projects. The working groups then present to regular Committee meetings. This system has proven to be very efficient.
DISCIPLINE OF GENERAL PRACTICE
The University of Queensland
Jacquii Burgess
PHCRED Fellowship
The University of Queensland
Ph: 0407 789 078
New Year, new roles
The University of Queensland has appointed two new staff to head their PHCRED Program. Dr Jenny Doust will take on the Research Facilitator position and Mrs Gillian Vey, the PHCRED Administrator role.
Dr Doust is an Associate Professor in the Discipline of General Practice at University of Queensland. She graduated in medicine in 1993 and has since worked in positions that combine her interests in general practice and clinical epidemiology.
Dr Doust is active in the Cochrane Collaboration, completing and assisting in several systematic reviews, including systematic reviews of diagnostic tests. Her PhD investigated B-type natriuretic peptide for the diagnosis and management of heart failure.
Her current research interests include:
- Diagnosis and monitoring of disease in general practice
- Management of cardiovascular disease in general practice
- Systematic reviews, particularly of diagnostic and prognostic studies.
Dr Doust is also a member of the Economic Sub-Committee of the Pharmaceutical Benefits Advisory Committee, the National Standing Committee on Research for the RACGP, Editor of the Cochrane Acute Respiratory Infections Review Group and the Cochrane Working Group for the development of Systematic Reviews of Diagnostic Accuracy.
Dr Doust holds academic qualifications including MBBS, B Econs, BA, Grad Dip Clin Epi, PhD. She is also a Fellow of the RACGP.
Joining Dr Doust, Mrs Gillian Vey will support the research capacity building activities at UQ. Mrs Vey's extensive administrative and managerial experience will ensure the smooth running of this increasingly busy primary health care research unit.
Prior to this appointment, Mrs Vey worked in the MBBS medical education program supporting medical students and registrars working in General Practice.
Both Dr Doust and Mrs Vey will contribute to the development of the PHCRED program in Queensland through their appointments at UQ.
 DEPARTMENT OF GENERAL PRACTICE
The University Of Melbourne
Hayley Shaw
Research Administration Coordinator
Ph: 03 8344 9050
Email: h.shaw@unimelb.edu.au
NHMRC Primary Health Care Postgraduate Scholar Graduates
The Department of General Practice at The University of Melbourne is delighted to announce that Dr Lucio Naccarella, one of the first PHCRED funded NHMRC Primary Health Care Postgraduate Scholarship holders successfully gained his PhD in 2006.
Lucio's PhD focused on understanding the work-related relationships between general practitioners and other health care professionals. He developed a qualitative relational schema that contextualizes GP work-related relationships by building a systematic and logical account of conditions that lead to work-related relationships, actions that occur and consequences that result. The schema has implications for the planning, implementation and evaluation of general practice integration related initiatives.
The PHCRED scholarship enabled Lucio to take time away from contract research positions to gain the qualification necessary to become a research leader in primary care. Lucio has over ten years experience in primary health care research. His research journey has ranged from coordinating the Support & Evaluation Resource Units (SERU), to researching the relative effectiveness of population health interventions in the general practice setting, to evaluating national and state-wide initiatives such as the Better Outcomes in Mental Health Program – Access to Allied Psychological Services projects and the Victorian Active Script program.
The PHCRED scholarship also provided Lucio with the opportunity to broaden his research skills, knowledge and capacity and position him to be involved in other crucial policy relevant research. For example, in 2005 he received funding from APHCRI to conduct a narrative review of evidence of innovative models for comprehensive primary health care delivery.
Lucio was recently appointed as a Senior Research Fellow in the Primary Care Research Unit within the Department and has begun working on another APHCRI review, focused on the place of generalism in the 2020 primary care team, a topic of importance to primary care policy reform.
 DEPARTMENT OF RURAL HEALTH
UNIVERSITY OF MELBOURNE
Lucia Rossi
Personal Assistant to Head Dept of Rural Health/Assistant Head, School of Rural Health
Ph: 03 5823 4550
E: luciar@unimelb.edu.au
The 2006 Shepparton Research Conference, held on 12 December was entitled, Growing together: mutually beneficial rural research and knowledge.
Keynote speakers included, Professor Frank Sullivan, a Professor of Research and Development in General Practice at the University of Dundee in Scotland, and Professor John Wakerman, the Director of the Centre for Remote Health, at Flinders University in South Australia.
The 75 conference attendees enthusiastically shared the 29 presentations on the research experiences of postgraduate students, doctors, nurses and allied health professionals. The feedback on the conference was very positive with many stating they enjoyed the venue, food, conference organisation, the wide-ranging presentations, and that they were looking forward to next year's event. Some participants asked for the conference to be extended to two days.
Prizes were awarded for Best Presentation and the Most Promising Presentation. These were won by Jacque McKenzie and Julie Poon.
A key event at the Conference was the official launch of the Rural Health Academic Network (RHAN), by Dr Sharman Stone MP, who welcomed the creation of a new Rural Centre of Excellence in Health Care Research. She hoped that it would contribute to the recruitment and retention of top quality health care professionals to the area. RHAN, established by the UDRH in partnership with local rural health services in the Goulburn Murray Valley, aims to train local health care professionals in research and education and embed them in these rural health organisations. This is the most efficient and sustainable way of building local research capacity.
Participants at the pre-conference workshop on “evaluation of networks” included people from NZ, NT, NSW and Victoria. It was very stimulating and many challenges and strategies were discussed. The facilitators, Professors Sullivan and Liaw, and members of the RHAN team are currently writing up the outcomes of the workshop for publication.
PHCRED TAS THIRD ANNUAL SYMPOSIUM
Julie Forsyth
TAS PHCRED Statewide Coordinator
Ph: (03) 6226 4803
E: julie.forsyth@utas.edu.au
Learning through Research and Evaluation
Ellen McIntyre, PHC RIS & Julie Forsyth, PHCRED Tasmanian Statewide Coordinator
The third annual Tasmanian PHCRED Symposium, held at the University of Tasmania Sandy Bay Campus, on Thursday, 23 November 2006, showed that the research being done in Tasmania was relevant to policy and practice, a focus of Phase 2 of the PHCRED Strategy. As well as a range of excellent presentations of policy and practice relevant research, the networking among the researchers, policy advisors and practitioners who attended all contributed to a very informative and useful event.
Rodney Dillon, Palawa Advocate for Aboriginal rights and Aborigine of the Year, 2005, presented the welcome to country and made the point that while we may be getting better at measuring what was happening in Aboriginal health, more than measurement is needed if health is to improve.
The following take home messages from some of the twenty presentations included:
- Smokers, who continue to smoke after an acute coronary event, may do this because they see smoking as having perceived benefits, as being part of their identity, and/or part of their daily life.
- GPs see few benefits in early diagnosing of dementia.
- The perception of alcohol-related harm among high school students is greater than actual levels.
- Yoga may help depression.
- While age is a risk factor for PND, little research has been done with young mothers and PND.
- There is consistent evidence that cannabis use increases the risk of psychosis.
Associate Professor Sue Kilpatrick, Director, UDRH, in her concluding remarks said, “the papers presented today impressed upon me the impact that changing social expectations have for health, and the implications of better evidence about the health impacts of certain behaviours has for social practices.”
The passion shown by researchers, as they presented the research they had done and outlined what they planned to do next will ensure that primary health care research is very strong in Tasmania.
DISCIPLINE OF GENERAL PRACTICE
UNIVERSITY OF SYDNEY
Dr Raechelle Rubinstein
PHCRED Coordinator
Ph: 02 9556 7200
E: raechelle@gp.med.usyd.edu.au
Our 2006 Research Capacity Building Initiative (RCBI) program finished on a positive note. Among other things, our three Researcher Development Program (RDP) Fellows completed their projects (incidents of error in General Practice; GP Registrars' Perspective on threats to Australian patient safety; evaluation of low impact exercise classes on the physical and mental wellbeing of young people with chronic health issues). The Academic Registrar attached to our Department also completed her project (the preparedness of Australian GPs for an avian flu outbreak) and has commenced writing up her findings. Between them, they delivered 12 conference presentations (seven oral presentations and five posters) over the course of the year.
Another highlight of our 2006 RCBI program was the success of the Youth Health Research Interest Group (YHRIG), a research network that we help to support. The Group has had a steady growth in membership and now has more than a dozen active members from around Australia. Members showcased their research at the recent Youth Health 2006 Conference, Young People's Health – what's it going to take? (November 2006, Sydney).
We have now embarked upon our 2007 RCBI program. Our current focus is on the recruitment of RDP (Researcher Development Program) Fellows. As a preliminary step, in late 2006 we sought expressions of interest in the RDP Program from staff and members of the Divisions of General Practice with which we work, as well as from subscribers to our email bulletins, participants in our regular monthly research seminars and recipients of the Discipline of General Practice's GP News . Some 30 people expressed interest in the Program.
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