 GREATER GREEN TRIANGLE UNIVERSITY DEPARTMENT OF RURAL HEALTH
FLINDERS AND DEAKIN UNIVERSITIES
Andrea Hernan
Research Assistant,
Researcher Development Program
P: +61 3 5563 3505
E: andrea.hernan@greaterhealth.org
Diabetes will become the leading contributor to the overall burden of disease in Australia, particularly as the population ages and becomes more obese. Various programmes, such as the Greater Green Triangle University Department of Rural Health’s (GGT UDRH) Life! Taking Action on Diabetes programme funded by Diabetes Australia Victoria and the Department of Human Services, seek to reduce the risk of progression to type 2 diabetes among those at high risk through lifestyle modification.
For certain culturally and linguistically diverse (CALD) groups, the risk of developing diabetes is two to three times higher than the Australian average. This is of particular concern in Victoria as it is one of the most multicultural states in Australia, with 44% of the population being born overseas or having at least one parent who was born overseas. The GGT UDRH reviewed the current demographic data of CALD populations and of diabetes prevalence in Melbourne. Demographic data from the Australian Bureau of Statistics 2006 Census identified the Local Government Areas that contained high numbers of CALD populations (as categorised by country of birth). However, the review found that specific data on prevalence rates for type 2 diabetes by country of birth has not been recorded to date so that actual prevalence rates for CALD groups are lacking or not readily available. The findings of this study emphasise the need for improved and efficient data collection that couple location and diabetes prevalence of CALD groups. Future work at GGT UDRH will examine methods to match areas of enhanced prevalence of diabetes with CALD groups so that future high-risk areas can be identified in order to better target diabetes prevention and management resources, as well as assist in reducing health disparities for these high risk communities.
The results from this study were recently presented at the International Diabetes Federation World Diabetes Congress in Montreal.
 FACULTY OF HEALTH SCIENCES AND MEDICINE
BOND UNIVERSITY
Belinda Fitzpatrick
Novice Research Fellow
E: bfitzpat@bond.edu.au
I am a registered nurse having graduated from The University of Sydney in 1991. My career path took me overseas to both Great Britain and Italy. In London, I worked in the field of Paediatrics with acutely ill and terminally ill children. I am passionate about the care of patients in the terminal phase. I have had a long association with The Gold Coast Hospital and the Palliative Care Unit.
 As a result of my special interest in Palliative Care, I became interested in my research topic The Care Of The Dying Pathway. In Great Britain, the Liverpool Care Pathway was instigated as a means to offer the highest quality of care in the end of life phase.
My research focuses on the delivery of optimum care in the final hours or days of a patients’ life based on a Care of the Dying Pathway already implemented in the Palliative Care Unit at the Gold Coast Hospital. Quality of care is fully achieved when a specific plan/pathway is recognised. The pathway is multi-faceted with the integration of all health workers.
In my research I am doing a literature review on pre-existing End of Life Care Plans and their comparative elements with the aim to evaluate their differences and similarities.
Based on these results, The Care of The Dying Pathway will be implemented in other wards in The Gold Coast Hospital, thus enabling high quality end of life care.
Beverly Dennis
Novice Research Fellow
P: 0433 832 016
E: bdennis@bond.edu.au
 I commenced my nursing career in 1975 as a hospital trained enrolled nurse. In 2005 I completed my Bachelor of Nursing at Charles Darwin University. I am currently studying for my Masters of Palliative Care at Flinders University.
The majority of my nursing career has been in Palliative Care units, commencing in 1978 when we opened up a few beds in a general medical unit in South Australia to nurse patients in their dying stage of cancer. This led to not only caring for cancer patients in their final days prior to dying, but to also manage their symptoms at an earlier stage of their disease, therefore designating more beds for this speciality nursing.
Many patients in palliative care show signs of depression at the end of life and this is often put down to end of life sadness and not treated. My research focuses on the prevalence of depression in these patients and risk factors such as age, gender and uncontrolled symptoms such as pain and debility in basic activities.
I intend to write a systematic literature review especially concentrating on the incidence of depression with different illnesses and the tools currently used to recognise depression therefore giving a more accurate diagnosis. I look forward to publishing a paper on my findings in the near future.
 RURAL HEALTH RESEARCH UNIT (RHRU)
JAMES COOK UNIVERSITY
Dr. Tracy Cheffins
Research Network Coordinator
P: +61 7 4781 3184
E: tracy.cheffins@jcu.edu.au
The North Queensland Practice Based Research Network (NQPBRN) was established by the Primary Health Care Research, Evaluation and Development (PHCRED) program within RHRU. It has completed research projects on chronic road crash trauma, management of otitis externa, evaluation of health assessments and wound management. Currently they are researching opportunistic parental immunisation in General Practice. Practice nurses, with training and assistance from JCU, have been instrumental in completing all projects. The research network includes practices in Mackay, Cairns and Townsville.
Links between RHRU and the Townsville GP Network (TGPN) have been forged through support of nurse research fellows employed by TGPN. They receive funding and academic assistance from PHCRED to undertake research within their program areas. These relate to web-based referral tools for team care and the role of self-management in chronic conditions treated in General Practice. This link between a university department and a Division is facilitated by the employment of the same academic GP by both institutions. This role allows shared research opportunities to be identified and followed up.
Activities to build research capacity are aimed mainly at GPs and practice nurses. The research network coordinator visits practices to meet with GPs and gain their support for practice based research projects. Practice nurses are then trained either on-site or at a workshop in the methods and administration of research. This training covers consent, confidentiality, data collection and research design issues.
Both GPs and nurses are encouraged to put forward research questions which are then developed by the academic network coordinator into feasible projects. Ethics applications, data analysis and paper preparation is undertaken within RHRU. Results of completed papers are disseminated to the participating GPs and nurses through practice visits, dinner meetings and the distribution of published papers.
 DEPARTMENT OF GENERAL PRACTICE
UNIVERSITY OF MELBOURNE
Assoc Prof Meredith Temple-Smith
PHCRED Coordinator and
Research Training Coordinator
P: +61 3 8344 3371
E: m.temple-smith@unimelb.edu.au
An integral part of the research process is obtaining ethics approval, to ensure the work is methodologically and ethically sound. The relief accompanying the final receipt of ethics approval is not just confined to novice researchers; sometimes even experienced researchers can find it a challenge to satisfy ethics committees, especially when the topic covers a sensitive issue in a vulnerable population.
 PHCRED Fellow Shelley Walker is both nurse and youth worker who, through her role in a local community health centre, was alerted to the issue of ‘sexting’. Sexting involves the sending or receiving of sexually explicit photos or video clips via mobile phone. The word now appears in the on-line Macquarie Dictionary, suggesting it is a phenomenon which is well-established. Shelley’s literature review showed very little research has been conducted on this topic, particularly from the perspective of young people. Such research is necessary to inform the development of effective responses in dealing with this issue. There have been reports in the US of young people exchanging nude photos of themselves being charged with producing and distributing child pornography and of course such images can be easily uploaded to the net where it is impossible to remove them or control who sees them.
Shelley’s research will include in-depth interviews with adult health professionals and with young people. There has been a myriad of ethical issues to consider: What are the ethical problems associated with recruiting young people aged 14-18? Will the seeking of parental consent be a barrier to participation in this research? What are Shelley’s legal responsibilities if she inadvertently uncovers illegal activity?
Shelley’s ethics application has been successfully reviewed at the department level, and is now under consideration at the University level, which is standard for research dealing with young people. Presenting her study to the Ethics Committee highlighted how differently such research is seen through the eyes of the non-research community but also provided excellent advice to progress her application. Watch this space for further news on Shelley’s fascinating study!
 PHCRED RDP PROGRAM
NORTHERN RIVERS UNIVERSITY DEPARTMENT OF RURAL HEALTH
Larisa Barnes
RDP Clinician
P: +61 2 6620 7570
E: larisa.barnes@ncahs.health.nsw.gov.au
 New mothers’ groups are important, research finds
Support groups for new mothers are valuable resources, providing social, emotional, spiritual and breastfeeding support, mental stimulation, education, time-out and information about other services, according to new research findings.
PHCRED research clinician Larisa Barnes undertook the study as part of her position at the Northern Rivers University Department of Rural Health during 2008 and 2009.
Larisa, a practising naturopath who also cares for her two children, including a daughter born in September, sought to discover the perceived benefits of belonging to pre/postnatal support groups.
“Current research on the role of pre and postnatal support groups mainly describes how groups are established and run”, according to Larisa. “There is little information on women’s perceptions of the benefits of belonging to groups. This study aimed to increase our understanding of the roles mothers’ groups play in meeting women’s needs, and our knowledge of women’s pre and postnatal wellbeing”.
Eighteen pregnant or postnatal women from four different Northern Rivers support groups participated in semi-structured interviews. Recruitment at group meetings used maximum variation sampling. Transcribed interviews were analysed thematically using phenomenology and symbolic interactionalism as the theoretical framework.
“The research found that first-time mothers felt their groups helped normalise and support the transition to motherhood”, Larisa said.
“Mothers having subsequent children valued giving back to groups that had helped normalise their initial transition, and receiving support in mothering multiple children. Groups provided women with social contact that extended into support for women’s holistic health. The shared experience of motherhood was of paramount importance, regardless of the mother’s background or situation. Significantly, both the informal and formal group processes were important.”
Larisa presented her results at the 2009 General Practice and Primary Health Care Research Conference: Driving Change in Melbourne in July, and is preparing an article for publication. She hopes the results will be used by support groups in funding applications ensuring continued advocacy and services to pregnant and postnatal women. Specific feedback will be provided to each group that participated in the research, to enable tailoring of these local programs to better meet women’s needs.
 PHCRED QUEENSLAND
UNIVERSITY OF QUEENSLAND
Denise Schultz
PHCRED Statewide Coordinator
p: +61 7 3346 4905
E: d.schultz@uq.edu.au
Rural research roadshows reap rewards
PHCRED Queensland packed up and headed out to the country delivering Project Planning and Evaluation Workshops across regional Queensland visiting Townsville, Bowen, Charters Towers, Emerald, Barcaldine, Longreach and Roma.
Dr Stephanie De La Rue, Robyn Preston and Lily Cheung presented the one day workshops for primary and allied health care workers which covered the basic elements on evaluating community projects.
What is evident about work in regional centres is the level of commitment and passion that people in community areas have for their work. Many of the participants travelled up to 300 kilometres to take part in the workshops. Good connections between people working in regional areas also meant that a number of people attending this year had done so on the recommendation of peers in other centres that PHCRED Queensland had visited previously.
In Longreach, the community child health team were working in collaboration with the hospital to improve ante-natal care. A multidisciplinary team used the day to plan their implementation and evaluation strategy of the project which received some funding earlier this year. Their work will now be improved by a suite of clear key performance indicators and their associated means of verification which can be reported back to their funders and wider community.
In Roma, the entire oral health team ‘closed shop’ to attend the workshop to plan a prevention project designed to increase community awareness of the importance of dental hygiene across their lifespan. The team of seven staff, led by the principal dentist, worked solidly on planning their project and also used the day to network with other important regional stakeholders.
PHCRED Queensland is committed to developing the close links with regional primary health care providers and to supporting the ongoing education in research and evaluation in rural areas. The strategy has provided many opportunities for developing research and evaluation resources for nascent researchers working in rural communities.
 DISCIPLINE OF GENERAL PRACTICE
UNIVERSITY OF NEWCASTLE
Georgina Cotter
NRGP Project Officer
P: +61 2 4968 6735
E: georgina.cotter@newcastle.edu.au
A group of enthusiastic early-career researchers met on 25 June 2009 in the tranquil Hunter Valley for the 7th Annual Writing Retreat. The event is co-hosted by the University of Newcastle PHCRED Programs from the Discipline of General Practice and the University Department of Rural Health in Tamworth. The purpose of the retreat was to provide protected time for writing, access to mentors for writing and tips on writing in order to better resource would-be writers with skills and confidence.
 We were very lucky to once again have engaging presenters. Dr Ann Gregory, Deputy Editor of the Medical Journal of Australia (MJA), led an interesting workshop and discussion that gave useful insights into manuscript editing from a medical editor’s perspective. A few participants had kindly provided earlier versions of their draft research manuscripts for the group to edit in the workshop.
Ann also contributed to the success of the retreat by generously making herself available to provide individual mentoring for writing to attendees throughout the day. Attendees were able to work in a peaceful covered garden room at individual desks with on-line facilities for all laptops – and receive personal specialist advice from the deputy editor of the MJA.
Jackie Treadaway, MJA Librarian, gave a presentation on copyright from a Librarian’s perspective and an eye opening discussion followed. Internet copyright issues were a hot topic of interest. The acknowledgement of pictures, charts and other information downloaded from the internet for use in research reports, manuscripts and presentations was highlighted.
Our Annual Writing Retreat continues to be an important mechanism for building the research capacity within the Hunter-New England regional PHC community and a useful forum for exchanging resources and ideas.
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