DISCIPLINE OF GENERAL PRACTICE
 UNIVERSITY OF SYDNEY
Dr Raechelle Rubinstein
PHCRED Coordinator
P: 02 9556 7200
E: raechelle@gp.med.usyd.edu.au
Our 2008 RDP Fellows have completed their placements.
Penny Abbott completed the evaluation of a cooking program for Aboriginal people with diabetes. She is writing up her findings in two papers which she hopes to publish. The draft of the first of these is now complete: Barriers and enhancers to dietary behaviour change for Aboriginal people – lessons for nutrition education programs.
Promising trends emerged from Sam Stott's SMS appointment reminder trial for marginalised youth attending Youthblock Health & Resource Service, while Melinda Prince's literature review of General Practice Registrar work-life balance identified moderate stress and lack of wellbeing and/or work-life balance for one quarter to one third of participants in the various studies examined.
For her RCBI Bursary, Aline Smith completed a literature review focusing on early diagnosis of patients with eating disorders. Penny Abbott also held a bursary and evaluated the effectiveness of a DVD about heart disease in promoting heart health at the Aboriginal Medical Service Western Sydney.
Applications for our 2009 RDP Program closed on 16 January, and we hope to get our new Fellows off to an early start on their research.
As in 2007 and 2008, we will also be offering bursaries and writing grants.
This year the Youth Health Research Interest Group (YHRIG) is planning to hold a Breakfast Session at the 2009 GP & PHC Research Conference, so keep an eye out for further announcements.
Finally, building on the enormous success of our 2008 program of research training short courses and workshops, we are planning a range of research training workshops and short courses throughout the year.
Workshops for February/March include:
- Critical Reading of Scientific Literature
- Writing for Publication, and possibly
- Health Program Evaluation.
UNIVERSITY DEPARTMENT OF RURAL HEALTH NORTHERN NSW
UNIVERSITY OF NEWCASTLE
Luke Wakely
Tamworth Community Health, Hunter New England Area Health Service
Paediatric Physiotherapist (RDP Fellow 2008)
P: 02 6762 1975
E: luke.wakely@hnehealth.nsw.gov.au
Research Update: Rural Parents' Experience of Parenting a Premature Infant
Regional health services aim to support families of premature infants to ensure that infants are able to fulfil their developmental potential. Parental experiences post-discharge from Neonatal Intensive Care Units, particularly those of rural parents have not been well explored with the literature citing difficulty accessing health services in rural areas as a major impact.
This qualitative study aimed to understand the experiences of rural parents caring for premature infants. Seven parents (5 mothers, 2 fathers) participated in face-to-face, semi-structured, in-depth interviews examining their lived experience of the first 12 months of caring for a premature infant while living in a rural area. Data analysis was grounded in a phenomenological methodology and approached through thematic analysis.
Three themes emerged: Coping through optimism , Striving for normal , and Stoic survival . Participants expressed optimistic thoughts on their experience even in the most negative times and may have fixated on positive aspects in order to cope more effectively. Striving for normal emerged from participant descriptions of focusing on whatever small milestones their infant achieved (ie. transitioning from tube fed to breastfed) in order to feel that their experience was closer to a term infant experience. Stoic survival described participants expressing that they had little time to reflect on their experience during or afterwards due to the demands of caring for a premature infant while juggling family, work and distance realities. Improved knowledge of the experience of rural parents caring for premature infants can inform health service delivery. Parents may benefit from clinicians assisting them to see the positive aspects of their experience, in particular the progress their child has made. By encouraging families to take time to reflect on their experience, parents may be assisted in adjusting to being a parent of a premature infant.
UNIVERSITY DEPARTMENT OF RURAL HEALTH NORTHERN NSW
UNIVERSITY OF NEWCASTLE
Joanne Blake
Midwife (RDP Fellow 2008)
P: 02 6767 8197
E: joanne.blake@hnehealth.nsw.gov.au
Aboriginal families should be afforded flexible, individualised, family centred care, using evidence based and culturally sensitive practices. It has been established that working in partnership with Aboriginal families facilitates health care. The Aboriginal Mothers and Babies Service provide women and their families with support to make informed decisions in relation to their own and their baby's care and wellbeing.
A research project was undertaken to explore barriers that Aboriginal families have in accessing maternal, infant and child health care services in Tamworth. This information will guide the development of health services to better meet the needs of Aboriginal families. The HNEAHS Human Ethics Committee approved this research project.
An action research methodology was used to develop a survey - with the assistance of Aboriginal Health staff - to ensure appropriate language use, length and cultural sensitivity. Women in Aboriginal families of child-bearing age were asked to participate. Results indicate that continuity or carer in a community based setting with access to an Aboriginal Health Education Officer is of high importance. Participants know to access antenatal care early, but choose to delay. The main barriers that were identified were transport, financial concerns and knowledge of available services. This information will be used to either influence or reinforce future pathways for the Aboriginal Mothers and Babies Service.
This research project has enabled partnerships to be brokered with a variety of people within a number of different services, including the Tamworth Aboriginal Medical service, Coledale Community centre, mainstream maternity providers, and especially the multidisciplinary staff of the Tamworth University Department of Rural Health. This has enabled the research experience to be as advantageous as it has been.
SCHOOL OF MEDICINE
GEIFFITH UNIVERSITY
Xanthe Golenko
Research Administrator PHCRED
P: 02 3382 1337
E: x.golenko@griffith.edu.au
Griffith PHCRED Fellow wins ASICS Award
Podiatrist and Griffith Primary Health Care Research Evaluation and Development (PHCRED) Fellow Kent Sweeting was presented with the ASICS Award for Best New Investigator - Lower Limb at the recent ASICS Conference of Science and Medicine in Sport.
Kent won the award for his paper, co-authored by Associate Professor Michael Yelland, which investigates how prolotherapy injections compare to an exercise program for the treatment of Achilles tendinosis.
The project involved a randomised clinical trial which saw patients randomised into three groups for a 12 week course of either prolotherapy, eccentric loading exercises or a combination of both treatments.
Outcomes for the groups were measured over 12 months using the Victorian Institute of Sport Assessment – Achilles (VISA-A) questionnaire. The research found that while there was little difference in the effectiveness between prolotherapy and eccentric loading exercises, there was a trend towards a more rapid and greater improvement using a combination of the two treatments.
In winning this award, Kent has been invited to present his paper at the American College of Sports Medicine Annual Meeting in Seattle in May 2009. He has also been awarded a second PHCRED Fellowship to work on the final stage of his research which evaluates treatment preferences for chronic Achilles tendon pain using discrete choice modelling.
Prolotherapy involves injecting hypertonic glucose and local anaesthetic around the tendon which stimulates new collagen production and tendon healing.
Eccentric loading exercises are done by dropping the heel off the back of a step so that the calf muscles contract whilst they lengthen at the same time. Like prolotherapy, this can also stimulate new collagen production.
CENTRE FOR REMOTE HEALTH, ALICE SPRINGS
FLINDERS UNIVERSITY
Rikkisha Collins
PHCRED RCBI Research Associate (Indigenous Research Trainee)
P: 08 89 51 4722
E: rikkisha.collins@flinders.edu.au
Rikkisha Collins joined the Centre for Remote Health (CRH) in May 2007 as a PHCRED Research Associate (Indigenous Research Trainee).
Rikkisha completed a Traineeship placement at the Central Australian Aboriginal Congress where she worked as an Administrative Receptionist for three years. She completed a certificate III in Business Skills at Charles Darwin University in 2007 and this year commences study for a Bachelor of Primary Health Care (Health Promotion) at Batchelor Institute of Indigenous Tertiary Education.
Rikkisha's role includes assisting with research projects (such as a current project investigating occupational stress in the remote area nursing workforce), and assisting to organise the PHCRED research seminar series. She has also been involved in two internal evaluations (CRH staff orientation, and Aboriginal and Torres Strait Islander Student Support and Recruitment Strategy).
Rikkisha's personal motivation for undertaking the PHCRED RCBI position comes from a strong desire for knowledge, capacity, confidence and career development in the area of PHC and PHC research. The main motivation is her vision for the future that is the abolition of disparities between Aboriginal and non Aboriginal peoples lives.
CENTRE FOR REMOTE HEALTH, KATHERINE OFFICE
FLINDERS UNIVERSITY
Kylie Stothers
PHCRED RCBI Research Associate (Indigenous Research Trainee)
P: 08 8971 2758
E: kylie.stothers@flinders.edu.au
Kylie Stothers joined the Centre for Remote Health at the Katherine Campus in August 2008, as a PHCRED Research Associate (Indigenous Research Trainee). Kylie is a young mother of two children. She is a Jawoyn woman who was born and raised in Katherine and comes from a large extended family with strong ties to Katherine and surrounding communities.
Kylie studied a Bachelor of Social Work at NTU (now Charles Darwin University) and after graduating from there she has spent the last 10 years working throughout the Northern Territory – both Top End and Central. Kylie has worked in the areas of Child Protection, Hospital and with Aboriginal Community Controlled Health services.
Kylie's passion and interest in Indigenous health relates to her own local NT Indigenous community experience (personal and professional) but she also has strong ties to her husband's New Zealand Maori community and as a family they spend time in and with both communities when possible, ensuring her children have access to both cultures and family experiences.
Kylie is just beginning her career in the field of research and is keen to have exposure to a vast range of research topics which work towards creating changing and having sustainable and positive impacts on the local communities. Since commencing with CRH Kylie has been involved in an internal CRH evaluation report looking at the CRH Mental Health seminar series which was run in 2008.
ACADEMIC UNIT OF GENERAL PRACTICE & COMMUNITY HEALTH
AUSTRALIAN NATIONAL UNIVERSITY
Carl Brusse
Research Assistant
P: 02 6244 4953
E: carl.brusse@anu.edu.au
PracNet is a research network of 10 General Practices from Canberra and the ACT region, which operates in association with the PHCRED program of the Academic Unit of General Practice and Community Health at the ANU Medical School. We meet regularly to manage and develop a broad suite of research projects and activities in Primary Care, with an emphasis on capacity building, securing external funding for research and engagement with the wider Primary Care and research community.
One recent PracNet project is an antibiotic resistance study of patients treated for Propionibacterium acnes to test the concern that the use of antibiotics in acne treatments would lead to increased and sustained levels of antibiotic resistance. Main results have been presented at the 2008 WONCA conference and are being prepared for publication. When compared to data from a similar study from ten years ago (which involved a current PracNet member, Dr Cameron Webber), the results also shed light on changes in prescription behaviour. Further analysis is in progress.
Other projects have attracted funding from sources such as the NHMRC and ACT Health, including a study into the effectiveness of the ACT's unique Benzodiazepine Voluntary Undertaking (BVU) program, a policy designed to encourage better doctor-patient relationships and improve treatment outcomes for methadone users. Another funded study titled ‘No Symptoms, No Disease' is taking place investigating the attitudes of patients toward chronic illness, and how these attitudes correlate with their use of health care services and health outcomes.
During 2009 we intend to develop further projects and linkages, including a formal relationship with the ACT Division of General Practice, and projects integrated with research education at the ANU School of Medicine. We look forward to a sustained presence in the ACT region as an active nexus between Primary Care providers, researchers, educators and the wider community.
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