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Background: Australia's National Disability Insurance Scheme (NDIS) was launched in 2013 to provide financial support packages for people with disability to purchase supports and services to enhance independence. People with disability are required to develop a plan with the National Disability Insurance Agency (NDIA), the government department responsible for managing the NDIS. This scoping review aims to ascertain the level of research into people's experience of the NDIS planning process in these geographic areas. Methodology: Research publication databases were searched using a specific search string to identify research about people with disability and their families/carer's experiences of the NDIS planning process in regional, rural and remote regions of Australia. The Mixed Methods Appraisal Tool (MMAT) was adopted to appraise the quality of the research publications. Research publications focused on Aboriginal and Torres Strait Islander people were additionally appraised using the Aboriginal and Torres Strait Islander Quality Appraisal Tool developed by the Centre for Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange. A thematic synthesis of the publications' contents was undertaken to ascertain people with disabilities and carers experience of the NDIS planning process. Results: Ten (N = 10) research papers were found that met the inclusion criteria. Two papers were policy reviews and reported on the improvements of the NDIS planning process since its conception. The analysis found the research archive focused on five themes: (1) healthcare workforce and NDIA staff; (2) NDIS package holders and carers lack of awareness of the NDIS; (3) cultural/socio‐economic barriers; (4) travel funding; and (5) emotional burden of the NDIS planning process. Conclusion: There are limited papers available that explore people's experiences of the NDIS planning process in regional, rural and remote regions of Australia. This systematic review illuminates the difficulties, barriers and concerns of people with disability and their carers about the planning process. [ABSTRACT FROM AUTHOR]

Introduction: Allied health has a valuable role in providing services to people living in residential aged care. The recent Royal Commission into Aged Care Quality and Safety included several important recommendations relating to the nursing, personal care, and allied health workforce and the care that they provide. The purpose of this paper is to review these recommendations and the Australian Government's policy responses and explore the emerging changes in allied health service provision in residential aged care. Methods: Data from the four available Quarterly Financial Reports from the 2022–2023 financial year were extracted and analysed in relation to staff costs and time per person per day across personal care, nursing, and allied health workers. Supplementary data sources including the 2020 Aged Care Workforce Census were accessed to provide contextual data relating to individual allied health professions, including occupational therapy. Results: The analysis shows a modest increase in median registered nurse minutes per person per day, and cost per person per day, from the first to second quarter, and again in the third and fourth. By contrast, median time and cost for allied health declined. From 5.6 minutes per person per day in the first quarter, reported allied health minutes fell to 4.6 minutes per person per day in the second quarter, an 18% decrease, and by the fourth quarter was 4.3 minutes per person per day. This is just over half the Australian average of 8 minutes reported to the RCACQS in 2019. Conclusion: Under recent residential aged care reforms, aged care providers have regulatory incentives to concentrate their financial resources on meeting the mandated care hours for registered nurses, enrolled nurses, personal care workers, and assistants in nursing. These same reforms do not mandate minutes of allied health services. Although providers of residential aged care in Australia continue to employ and value allied health, we argue that mandating care minutes for personal and nursing care without mandating the provision of allied health creates a perverse incentive whereby access to allied health services is unintentionally reduced. PLAIN LANGUAGE SUMMARY: Allied health has a valuable role in providing services to people living in residential aged care. The recent Royal Commission into Aged Care Quality and Safety included several important recommendations relating to the nursing, personal care, and allied health workforce and the care that they provide. In this paper, we argue that despite the positive intentions of some of the reforms following the Royal Commission, there have been unintended consequences that have reduced the spending on allied health in residential aged care and reduced the minutes residents receive of allied health. Consideration to mandating allied health care minutes in residential aged care should be considered. [ABSTRACT FROM AUTHOR]

Introduction: Telepractice service delivery of allied health interventions to people with disability can potentially reduce access barriers and improve service equity. However, questions remain regarding telepractice functionality for people with disability. This study addressed questions related to how allied health clinicians and managers perceive telepractice as functioning in the provision of therapy services to people with disability. Methods: Thirteen interviews of allied health clinicians and managers from across Australia were conducted between 21 November and 22 February via MS teams. Qualitative methodology and critical realist theoretical paradigm underpin the study. Data analysis was completed using a reflective thematic analysis method and five themes were generated and described utilising an analytic metaphor. Results: The study themes were described in relation to a shopping for shoes analytic metaphor and the five themes included (1) a shoe for every foot, (2) planned purchases, (3) shoe on the other foot, (4) you need both shoes and (5) help choosing their shoes. In summary, the function of telepractice fits differently for each individual, similar to pairs of shoes. Conclusions: Telepractice has its own strengths and weaknesses and isn't a direct substitute for in‐person sessions, much like left and right shoes are similar but not the same. The results support participant perceptions that telepractice functions best as an adjunct to in‐person sessions through a flexible hybrid delivery model in the provision of therapy services to people with a disability. A strategy for improving perceived usefulness may involve positioning telepractice as unique with strengths and weaknesses, not replacing in‐person care. Patient or Public Contribution: The paper forms part of a larger codesign process which included customer and carer participants throughout the design and planning of the project, inclusion of a peer researcher, and the selection of the analytic metaphor including in the findings of this article production. [ABSTRACT FROM AUTHOR]

Introduction: Student‐led clinics can provide health services to marginalised groups where service offerings are sparse or difficult to access, such as rural areas. Offering these services to children and young people can promote health and well‐being by addressing the individual challenges and the social determinants of health. There is uncertainty, however, as to whether student‐led clinics can meet Australian accreditation standards for health professionals completing degree programs. Objective: This study aims to determine the capacity for health student placements in school‐based student‐led clinics to meet accreditation standards. Design: A systematic scoping review was conducted based on Arksey and O'Malley's framework and the PRISMA‐ScR statement. Setting: Several databases were examined, including Ebsco (Academic Source and CINAHL), ProQuest (PsycINFO, ERIC) and grey literature sources along with a desktop review of accreditation standards across seven health disciplines. Two independent reviewers screened eligible studies. Findings: The search retrieved 1037 records with 65 full‐text papers assessed for eligibility. Eleven papers met the inclusion criteria. Based on the evidence, both nursing and exercise and sports science accreditation standards were best suited to student‐led clinics. Discussion: Although broad categories of work‐integrated learning activities were applied, it appears feasible to expect accreditation standards for health disciplines at an Australian university to be a good fit for health student‐led school‐based clinics. Conclusion: Increasing health student placement opportunities within student‐led clinics can improve the health and well‐being of children and young people in regional, rural and remote (RRR) areas of Australia who may otherwise have limited access to allied health services. [ABSTRACT FROM AUTHOR]

Background: The Australian geographically rural and remote disability workforce has historically demonstrated difficulties to keep up with the demand for quality services and supports for people with disability. In 2013, the National Disability Insurance Scheme (NDIS) was launched to provide individualised disability support packages to meet people's needs. To receive funding, people with disability are required to develop a NDIS plan. That plan is then funded by the National Disability Insurance Agency (NDIA), the government agency responsible for managing the NDIS. Although the NDIS has been operating for almost 10 years, there is limited research into the planning experiences of the workforce in regional, rural and remote regions of Australia. This review aims to ascertain the level of scholarly investigation into workers' experiences of NDIS planning. Methodology: Research publication databases were searched using a specific search string to identify publications that included reference to the workforce's experiences of the NDIS planning process in regional, rural and remote regions of Australia. The Mixed Methods Appraisal Tool (MMAT) was adopted to appraise the quality of the research publications. Research publications that focused on those working with Aboriginal and Torres Strait Islander people were also appraised using the Aboriginal and Torres Strait Islander Quality Appraisal Tool developed by the Centre for Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange. A thematic synthesis of the publications was undertaken to ascertain disability and health workforce experiences of the NDIS planning process. Results: Seven papers met the selection criteria. Two papers were policy reviews and reported the improvements of the NDIS planning process since its inception. These studies reported four reoccurring themes: (1) cultural/socioeconomic and geographical factors; (2) administrative burden and bureaucracy; (3) values, culture and geography; and (4) burden on allied health workers. Conclusion: The NDIS planning process has developed and progressed since its rollout in 2013. There are limited research papers available that describe the workforce's experience of the planning process in regional, rural and remote regions. More research in this area is needed to identify the experiences of the disability workforce in relation to the NDIS planning process. [ABSTRACT FROM AUTHOR]

Background: Simulated learning activities are an effective tool for reducing speech–language therapy (SLT) students' anxiety and improving their confidence for clinical placements. Such activities include interacting with patients who are actors, clinical educators or peers and are known to decrease anxiety and increase confidence in SLT students. Screen‐simulated patients using video are another alternative, which has not yet been fully evaluated in the education of SLT students. Aims: To compare the effectiveness of (1) modified simulated patient and (2) video simulated learning for increasing self‐reported (a) confidence and (b) preparedness and (c) decreasing self‐reported anxiety. Methods & Procedures: This study used a randomized crossover design with 127 first‐year graduate‐entry master's SLT student participants. Students participated in two activities related to a clinical interaction with a paediatric client's carer: (1) a 1‐hr modified simulated patient experience with clinical staff as the simulated patient; and (2) a video‐learning task, with two videos of a clinician–carer interaction and an accompanying worksheet. Students were randomly allocated to a group of four students and the groups randomly allocated to receive modified simulated patient or video‐learning first. Students were not blinded to the activities. The students completed a 19‐item questionnaire at three time points: before either activity, after the first activity and after the second activity, to evaluate their self‐reported confidence, clinical preparedness and anxiety. Outcomes & Results: A total of 62 students completed modified simulated patient first and 63 completed video‐learning first. After either single activity the students had significantly increased confidence and preparedness scores, while only the modified simulated patient significantly reduced student anxiety scores. As a second activity, modified simulated patient resulted in further significant improvements in confidence, preparedness and anxiety; however, adding video learning as a second activity resulted in no significant benefit. Conclusions & Implications: This study demonstrates the effectiveness of two low‐resource clinical‐learning activities for novice SLT students that can be applied in a range of settings. Of the two activities, modified simulated patient had greater effectiveness, as it was the only activity to decrease anxiety. An investigation of the pedagogical principles within the activities revealed that modified simulated patient activity had more opportunities for peer learning, supervisor feedback and verbal reflection in comparison with video learning that may explain the increased benefits. What This Paper Adds: What is already known on the subject: Simulated learning activities are an effective teaching tool for SLT students, increasing confidence and decreasing anxiety in preparation for placement. Simulated patients require more resources than video simulation. Both simulated patients and video simulation provide a safe learning environment, where students can learn without risk to clients. What this paper adds to existing knowledge: This study is among the first to investigate a modified version of simulated patients; our modification involves a clinical educator performing the role of both the simulated patient and simulation facilitator. It is the first to evaluate simulation via video learning for SLT students. The paper demonstrates the effectiveness of these two activities, and the slight advantage of modified simulated patient, for increasing novice students' confidence and preparedness and decreasing their anxiety about clinic. It also unpacks the pedagogical principles used in each activity to explain the reasons that modified simulated patient had greater effectiveness. What are the potential or actual clinical implications of this work?: The two educational activities required no specialist equipment and can be applied in a range of pre‐clinical and clinical settings by university staff and/or community clinical educators. Increasing confidence and preparedness, and decreasing anxiety will help ensure that student learning on scarce clinical placements is maximized. [ABSTRACT FROM AUTHOR]

Aims and Context: As a University Department of Rural Health, we have identified recurrent areas of service need among vulnerable rural populations, specifically the need for allied health. Concurrently, we have also identified missed opportunities for deliberate collaborative practice in rural clinical placements. This paper provides a commentary on our work in progress as we work to leverage available opportunities to provide both service from and education for health profession students on rural clinical placements. Approach: We developed a transdisciplinary placement model, informed by practice theory, which encompasses pre‐placement preparation, student support, host sites and clinicians, and a structured evaluation strategy. This model aims to facilitate service provision alongside of student learning about community and collaborative practice. In particular, the co‐design of the model is expected to facilitate student's sense of social accountability and reduce stigma in working with vulnerable population groups. Conclusion: This paper highlights the need for greater alignment between rural health education and practice, describes a placement model that is working towards this and showcases how this has been enacted in a remote community in New South Wales. More cross‐sector discussion and evaluation is needed to determine the implications of adopting this model more widely if service and learning opportunities are to be equally achieved, and to determine the ways in which training and service provision can be aligned with community need, as recommended in the recent Rural Health Commissioner Report. [ABSTRACT FROM AUTHOR]

Objective: To examine the principal place of practice after graduation of students who participated in the Rural Health Multidisciplinary Training (RHMT) program and allied health students' place of origin. Design: Cross‐sectional study. Participants: Graduates who completed their degree in podiatry, occupational therapy and physiotherapy in 2019. Main Outcome Measures: Principal place of practice at first and third years after graduation. Results: In 2020, 40 allied health professionals (AHPs) who graduated from the University of South Australia in 2019 were practising in rural areas but only 26 of them remained in the rural practice in 2022. The retention rate for rural practice was 65% within 2 years. However, in 2022, 25 allied health professionals left their metropolitan employment location and transitioned to rural practice. Of the 25 allied health graduates who joined the rural practice in 2022, most of them (80%, 20/25) had either rural exposure through the RMHT program or were from rural origin. Conclusions: Rural exposure via the RHMT program and allied health students' rural place of origin have an important role for rural principal place of practice at first and third years after graduation. [ABSTRACT FROM AUTHOR]

Objective: To explore and describe strategies to enhance the implementation of an organisational clinical supervision framework and subsequently inform the development of a model of implementation of clinical supervision for allied health professionals in a regional health care setting. Setting: A large regional health service in Victoria, providing hospital, rehabilitation, community, mental health and aged care services. Participants: Allied health managers employed at the health service were members of an action research group. Design This longitudinal study used an action research approach. The action research group informed the repeated cycles of planning, action and reflection. Data from recorded action research meetings were analysed using content analysis. Results: The action research group met 11 times over a 5‐year period informing four action research cycles. Six main themes relating to factors that enhanced the quality of clinical supervision emerged from the analysis of the action research group data: purpose and value of clinical supervision; clinical supervision characteristics; differences between disciplines; framework development; training and support and implementation of clinical supervision. Conclusion: The findings from this comprehensive longitudinal study provide evidence‐based approaches to the implementation of allied health clinical supervision. The action research approach used ensures that the strategies described are realistic and sustainable. A model has been developed to inform the implementation of clinical supervision for allied health. [ABSTRACT FROM AUTHOR]

The purpose of this review was to identify the different augmented reality (AR) modalities used to teach anatomy to students, health professional trainees, and surgeons, and to examine the assessment tools used to evaluate the performance of various AR modalities. A scoping review of four databases was performed using variations of: (1) AR, (2) medical or anatomical teaching/education/training, and (3) anatomy or radiology or cadaver. Scientific articles were identified and screened for the inclusion and exclusion criteria as per Preferred Reporting Items for Systematic Reviews and Meta‐Analyses with extension for scoping reviews guidelines. Virtual reality was an exclusion criterion. From this scoping review, data were extracted from a total of 54 articles and the following four AR modalities were identified: head‐mounted display, projection, instrument and screen, and mobile device. The usability, feasibility, and acceptability of these AR modalities were evaluated using a variety of quantitative and qualitative assessment tools. Within more recent years of AR integration into anatomy education, the assessment of visuospatial ability, cognitive load, time on task, and increasing academic achievement outcomes are variables of interest, which continue to warrant more exploration. Sufficiently powered studies using validated assessment tools must be conducted to better understand the role of AR in anatomical education. [ABSTRACT FROM AUTHOR]

Objective: To investigate students' perceptions of the impact of coronavirus SARS‐CoV‐2 on rural and remote placements facilitated by 16 University Departments of Rural Health in Australia in 2020. Design: A mixed‐method design comprising an online survey and semi‐structured interviews. Setting: Australia. Participants: Allied health, nursing and medical students with a planned University Departments of Rural Health‐facilitated rural or remote placement between February and October 2020. Intervention: A planned rural or remote placement in 2020 facilitated by a University Departments of Rural Health, regardless of placement outcome. Main outcome measures: Questionnaire included placement outcome (completed or not), discipline of study (nursing, allied health, medicine), and Likert measures of impact to placement (including supervision, placement tasks, location, accommodation, client contact and student learning) and placement experience (overall, support, supervision, university support). Semi‐structured interviews asked about placement planning, outcome, decisions, experience and student perceptions. Results: While coronavirus SARS‐CoV‐2 reportedly impacted on the majority of planned placements, most students (80%) were able to complete their University Departments of Rural Health‐facilitated placement in some form and were satisfied with their placement experience. Common placement changes included changes to tasks, setting, supervisors and location. Allied health students were significantly more likely to indicate that their placement had been impacted and also felt more supported by supervisors and universities than nursing students. Interview participants expressed concerns regarding the potential impact of cancelled and adapted placements on graduation and future employment. Conclusions: The coronavirus SARS‐CoV‐2 pandemic was reported to impact the majority of University Departments of Rural Health‐facilitated rural and remote placements in 2020. Fortunately, most students were able to continue to undertake a rural or remote placement in some form and were largely satisfied with their placement experience. Students were concerned about their lack of clinical learning and graduating on time with adequate clinical competence. [ABSTRACT FROM AUTHOR]

Background: Pharmacy‐led medicine information (MI) services are available in many countries to support clinicians and patients make decisions on use of medicines. Objectives: To establish what impact, if any, pharmacy‐led MI services have on clinician and patient outcomes. Methods: All published works indexed in Embase or PubMed, meeting this review's inclusion and exclusion criteria, that wholly or partially attempted to measure the effects of MI advice were retrieved and assessed. Results: Twenty studies were reviewed. Five broad themes were identified describing study findings, three were specific to clinicians: their views on the effect MI answers had; actions they took; and influence on their decision making. A fourth theme centred on patient utilisation of advice, and the fifth on 'process measures' attempting to determine MI worth. Discussion: Studies report on positive patient outcomes as a direct result of MI advice. Clinicians and patients acted upon the advice provided. Clinicians also reported using MI advice as a 'safety net', to check, reassure or confirm what to do. MI advice also demonstrated economic worth, although these studies are old. Conclusion: MI Service advice appears to affect clinician and patient outcomes. However, study design limitations require findings be viewed cautiously. [ABSTRACT FROM AUTHOR]

Introduction: To assist with the increasing orthopaedic workload, an allied health led hand therapy clinic was established to manage people having routine hand surgeries. The aim of this study was to evaluate patient and doctor satisfaction and safety of this alternative service delivery model. Methods: Prospective multimethod design evaluation was undertaken by occupational therapists and physiotherapists working in the field of hand therapy. Satisfaction surveys were completed by orthopaedic doctors and patients. Patient outcomes were assessed at 6 weeks post operatively using the Quick Disability of Arm, Shoulder and Hand questionnaire, total active range of motion, Crawford Classification, sensation using light touch and pain with activity utilising Wong Baker FACES® Pain Rating Scale. Quantitative satisfaction survey data were analysed and presented as frequencies and percentages with open question responses analysed using a qualitative description approach. All complications and readmissions within a 3‐month period were identified and recorded to assess safety of this model of care. Results: For the 6‐week post‐operative review, 81 patients were seen by an allied health professional rather than a doctor. Patient satisfaction was high with 90% of patients satisfied with post‐operative care provided by allied health; 2% of patients preferred to be seen by a doctor. Doctor satisfaction was also high with 95% of doctors being satisfied and confident with the quality of care provided. A high proportion of patients reported pain 2/10 or less with activity (82.72%), had full sensation (69.14%), excellent range of motion (82.72%), and Quick Disability Arm, Shoulder and Hand scores on average were below 25% indicating minimal functional deficits. Only five patients required doctor involvement post‐operatively. Conclusion: The allied heath led service delivery model was demonstrated to be safe and have high patient and doctor satisfaction, indicating an acceptable alternate pathway for management of people following routine hand surgery. [ABSTRACT FROM AUTHOR]

Issues addressed: This study aimed to identify risk factors associated with weight gain post a diagnosis of breast cancer in a cohort of Australian women. Methods: In this retrospective clinical audit, objectively measured weight, age and menopause status, treatment type/s, grade, stage, oestrogen receptor and progesterone receptor (PR) status were extracted for 73 breast cancer patients from an ongoing breast cancer treatment quality assurance project. Weight gain or loss was classified as a body mass increase or decrease of ≥5% of weight at diagnosis. Results: When compared to weight at diagnosis, 57% of patients maintained, 22% gained, and 21% lost weight at 24 months post‐diagnosis. Factors associated with weight gain were a diagnosis of grade II (P <.001) or grade III (P <.001) compared to grade I breast cancer, and refusal of radiotherapy (P <.001). Factors associated with weight loss were being postmenopausal compared to premenopausal (P =.033), PR positive compared to PR negative (P <.001), refusal of chemotherapy (P <.001) and radiotherapy recommended (P <.001). Conclusions: The maintenance of weight in a majority of women in this cohort is a novel finding. Early identification of women at risk of weight gain post a breast cancer diagnosis can assist health professionals identify, and therefore assisting patients in the prevention and management of weight gain and associated sequela. Investigating the weight‐related communications between a patient and specialist, their access to allied health professionals and social support may assist in understanding the overall positive changes in this cohort. [ABSTRACT FROM AUTHOR]

Background: Evidence‐based practice requires health professionals to recognise situations of uncertainty in their practice, translate that uncertainty into answerable questions, and find and appraise information relevant to those questions. No research to date has explored the research‐based information needs of allied health professionals (AHPs) in regional and rural Australia. Objective: To examine the information‐seeking experiences and needs of AHPs in regional and rural Australia. Methods: A total of 80 AHPs, predominantly occupational therapists and physiotherapists, practising in regional and rural areas of Australia completed an online survey. Results: Almost all respondents reported having questions requiring research evidence, but most of their questions were worded non‐specifically. Respondents practising in rural areas had greater perceived difficulty in obtaining relevant evidence than their regional counterparts. Many respondents reported wanting additional support to find relevant research evidence. Discussion: The findings offer insights regarding information‐seeking challenges AHPs face and potential solutions, including improved training and increased health librarian support. However, due to sampling limitations, the results cannot be generalised to all allied health professions. Conclusion: Allied health professionals may require more training and support to engage in efficient and effective information‐seeking behaviours. Health librarians have a valuable role to play in providing this training and support. [ABSTRACT FROM AUTHOR]

Introduction: The maldistribution of health care workers between metropolitan, rural or remote areas is globally recognised. Allied health professional's workplace location choice is a complex interplay between professional and non‐professional elements. Policy‐makers should understand factors that influence workplace location choices when designing structures to attract allied health professionals to rural practice. Objective: To determine factors influencing recruitment and retention of allied health professionals in metropolitan, rural and remote locations. Design: Systematic review. Findings: Twenty‐two studies met inclusion criteria. Extracted data were synthesised into subthemes: (a) opportunities for career development, (b) clinical load, (c) organisational and workplace structure, (d) previous location exposure and (e) personal factors. Of these 22 studies, 12 reported organisational/workplace structure and personal factors positively impacting recruitment and 11 studies discussed organisational and workplace structure also negatively impacting on retention. Career opportunities positively impacted on recruitment, while lack of opportunity negatively affected retention. Previous location exposure positively impacted recruitment however had limited impact on retention. Similarly, a diverse clinical load was reported as being attractive during recruitment, but unmanageable caseloads affected retention. Discussion: This review identifies the need for effective and sustainable solutions for the issues with recruitment and retention of allied health professionals. While the different allied health professions share similar recruitment and retention challenges, further research is needed to isolate factors impacting each discipline. Conclusions: Retention and recruitment of different allied health professions is multifactorial. Organisational and workplace structure and opportunities for career development emerged as having impact on the recruitment of allied health professionals. [ABSTRACT FROM AUTHOR]

Background: Children living in out‐of‐home care (OOHC) have significant unmet health care needs and use more tertiary and specialist health care services compared with children from similar social and economic backgrounds. Allied health professionals and nurses have a central role in health care; however, very little is known about the engagement of children in OOHC with nursing and allied health professionals. This scoping review addresses this knowledge gap. Methods: A scoping review methodology framework was used to search for relevant articles published between January 1970 and November 2019, identified using three databases: MEDLINE, CINAHL and ProQuest. Selection of studies was based on empirical research about the health of children in OOHC and their engagement with nursing or allied health services. A total of 37 relevant articles met the eligibility criteria for inclusion in this review. Results: Findings could be summarized under five broad themes: (1) nursing and allied health professionals engaging with children in OOHC to support their health and development, (2) opportunities and challenges for nursing and allied health professionals to engage children in OOHC in healthcare, (3) identification and complexity of healthcare needs, (4) access to healthcare services and (5) coordination of healthcare. Conclusions: Children in OOHC have multiple healthcare needs that require monitoring and treatment by allied health professionals and the health and development of these children is best supported through comprehensive health screening on entry into OOHC, and community‐based, multidisciplinary healthcare while children are living in OOHC. While nurses in hospitals and community settings were found to play a role in health assessment and care coordination targeted at children in OOHC, the literature was silent on the role of allied health professionals in this healthcare approach. [ABSTRACT FROM AUTHOR]

ASD is a neurodevelopmental disorder that affects people across the entire lifespan, yet most of the research identifying the health and medical needs for autistic individuals have been among minors. As individuals with ASD transition to emerging adulthood, the services, already limited, become less available. This study aimed to identify the use of services for Latin American adults on the spectrum. We surveyed 295 caregivers of adults with ASD from six Latin American countries. Comparing the results for all the possible services observed in this study, the adults in our sample were primarily underserved: 84.4%–95.9% were receiving zero hours per week, 3.7%–12.9% 1%–10 h, 0%–1.7% 11–20, and only 0%–1% above 20 h of services. Almost half of the sample used medication, and neurologists were the most consulted health providers. Next to inexistent health care usage in Latin American adults with ASD highlights socioeconomic and health disparities in service provision for ASD in the region. The lack of services places adults with ASD in Latin America at a higher risk of worse symptom severity than autistic adults from regions with broader access to services. Lay Summary: This study aimed to identify the quantity of services received by adults with autism in Latin America. Most of our sample was not receiving health services yet almost half had access to medication. This could mean that adults with autism in Latin America are at higher risk for poorer health. [ABSTRACT FROM AUTHOR]

Objective: The Allied Health Rural Generalist Pathway pilot aimed to improve consistent access to physiotherapy services in rural communities using the "grow own" workforce strategy and existing resources. Design: A summative evaluation of the quality improvement project used to implement the Allied Health Rural Generalist Pathway was completed. A mixed method design was used and included focus groups and a framework analysis. Participants: The temporary redesign of specific workforce resources created "development" positions. A shared same‐discipline supervisor resource supported five early‐career physiotherapists, the participants. Setting: The project was undertaken in rural New South Wales in the public health system. Main outcome measures: The main outcome measures included a number of chronically vacant physiotherapy positions and stakeholder satisfaction. Results: Targeted vacancies were filled, services sustained with minimal service gaps and mean retention rate of 2.9 years. A statistically significant increase in service activity to patients in rural locations occurred as a result of the intervention (R‐squared 29%, P <.05). Four out of five early career physiotherapists fulfilled terms of their contract and secured senior positions within the region. Whilst participants developed professionally, they did not complete the tertiary education component. Conclusions: The Allied Health Rural Generalist multi‐factorial approach supported recruitment, retention and capacity building within the targeted discipline of the allied health workforce. Patient need was met. The rural pipeline capacity was developed. The pathway was complementary of existing NSW Health systems. Systemic change is needed to overcome inefficiencies experienced during implementation and to ensure sustainability. Further research to develop discipline‐specific clinical training guidance through the stages of a rural allied health professionals' career may be helpful. [ABSTRACT FROM AUTHOR]

Objective This paper describes the sociodemographic and health-related characteristics of people with chronic disease attending an interprofessional student-assisted clinic in regional Queensland. Design A retrospective review of data collected during the first 10 months of operation of the clinic was conducted. Setting, participants and outcome measures Data was collected on up to 378 patients during an intake appointment at the Capricornia Allied Health Partnership ( CAHP) community-based clinic and compared with normative reference groups where available. Sociodemographic characteristics included age, gender and education level; health-related characteristics included body mass index and hospitalisations in the previous 12 months; and risk factors included prescribed medications, smoking status and general practitioner-diagnosed medical conditions. Results Patients attending the CAHP clinic had a mean number of chronic conditions of 4.9 ± 2.1 per patient, and 97% of patients had multimorbidities. A high level of socioeconomic disadvantage was found in comparison with normative comparison groups based on employment, highest level of schooling completed and the index of social disadvantage. Patients predominantly lived in inner regional areas (76.7%). The most common diagnoses of patients attending the clinic for the first time were hypertension, osteoarthritis, high cholesterol, diabetes and chronic back pain. Conclusions The CAHP clinic offers a unique student-assisted service model for interprofessional management of patients who are socioeconomically disadvantaged, have multimorbid chronic disease and live in regional areas. The description of baseline data in this paper is important to refine clinic services, to guide other chronic disease clinics and to inform future research study designs. [ABSTRACT FROM AUTHOR]

Introduction: There is growing interest in developing research culture and opportunities for allied health professionals working in medical imaging. However, little attention has been given to identifying the research interest and needs of this group relative to the other allied health professions. We aimed to measure self‐reported research participation, interest, experience and confidence of allied health professionals working in medical imaging and compare the findings to clinicians working in allied health therapies. Methods: A cross‐sectional survey of allied health professionals from medical imaging (radiographers, sonographers and nuclear medicine technologists) was conducted. The primary outcome, the Research Spider survey, measures 10 domains of research interest/experience/confidence on a 5‐point Likert scale. Results were compared to allied health therapy data. Results: Responses were received by 82 medical imaging allied health professionals (65% response rate). Overall, medical imaging professionals rated themselves as having 'some interest' and 'little experience or confidence' in research. There was no difference in interest, experience and confidence among different imaging professions (interest P = 0.099, experience P = 0.380, confidence P = 0.212) or allied health therapists (interest P = 0.137, experience P = 0.363, confidence P = 0.791). Participants reported greatest interest in finding and reviewing literature and lowest interest in applying for funding. Conclusion: There are strong similarities between medical imaging allied health professionals and allied health therapy professionals. Therefore, strategies used to promote research culture in allied health therapy professions could be leveraged to provide opportunities for medical imaging allied health professionals. [ABSTRACT FROM AUTHOR]

Objective: Assess nursing and allied health student satisfaction with their remote Northern Territory integrated learning placement and consideration of future rural/remote workDescribe the characteristics of these studentsExamine changes in student characteristics over time. Design: A cross‐sectional survey of students and a review of student placement data. Setting: Northern Territory, Australia. Participants: Former students having a work integrated learning placement of more than 1 week in the Northern Territory from 2017 to 2019. Main outcome measure(s): Agreement with the statements 'This placement has encouraged me to consider living and working in a rural or remote location after I graduate' and 'Overall, I was satisfied with my placement.' The administrative record review examined student numbers, and placement length over time. Results: A total of 341 students responded to the online survey. Overall satisfaction with the placement was very high (93%), and 84% agreed/strongly agreed that the placement had encouraged them to consider working in a rural or remote setting. High‐quality clinical supervision and educational resources were associated with overall placement satisfaction. Overall placement satisfaction, prior interest in working remotely and satisfaction with educational resources were associated with consideration of working remotely. The number of students having a placement increased by 29% in 2017 to 2019. The number of placement weeks also increased (35%). Conclusions: The number/placement time of nursing and allied health students has increased in the NT. Satisfaction with remote work integrated learning placements is an the important pathway to growing a local health professional workforce in remote and rural settings. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to investigate parent perspectives on how heritable disorders of connective tissue (HDCT) affect a child's everyday life. In addition, this study aimed to determine if parents seeking health professional services perceive their children with HDCT to have difficulties with activities reliant on hand function.Methods: This cross-sectional study used a questionnaire for parents to explore the impact of an HDCT on a child's ability to carry out everyday activities. Parents of children (8-18 years) attending a tertiary connective tissue dysplasia clinic, over a 12-month period, were invited to participate.Results: We analysed 100 surveys completed by parents. Children with Ehlers-Danlos syndrome-hypermobile type, joint hypermobility syndrome (48%) and osteogenesis imperfecta (42%) were the largest diagnostic groups represented. Pain (73%) and fatigue (68%) were the most common symptoms parents perceived to affect day-to-day activities. More parents were satisfied with their child's self-care (61%) than school participation (33%). Keeping up with handwriting (71%) and gross motor activities (70%) were the most frequently reported difficulties at school. Most parents (65%) reported leisure activity difficulties, with pain (64%) and fatigue (60%) as the main contributing factors.Conclusions: This study has provided new knowledge about the concerns of parents with their child's engagement in everyday life including the impact of HDCT on hand function. Further research is needed on effective management strategies to reduce symptoms and improve hand function for these children. [ABSTRACT FROM AUTHOR]

Physiotherapists report using a range of psychosocial strategies in their practice, yet, barriers to implementation include lack of time, limited knowledge, and minimal training. This research aimed to establish what training physiotherapists have had with regards to psychosocial strategies, why they think they would benefit from more training, what training they want, and delivery preferences. Content analysis of answers to four open‐ended, online survey questions collected from Australian physiotherapists (N = 208) was conducted. Physiotherapists reported having minimal training specific to psychosocial strategies. Physiotherapists reported wanting training in assessment and management of psychosocial issues, and practical application of specific psychosocial strategies. Didactic and interactive training delivered by experts who understand the psychosocial needs of their patients, and the constraints of physiotherapy practice was preferred. These findings suggest that training in psychosocial strategies at the undergraduate level and continued professional development are necessary. Specifically, training in the assessment and management of psychosocial factors, and in referral processes is warranted, and should be applicable and appropriate for rehabilitation settings. Training should be both didactic and interactive as outlined in the proposed framework. [ABSTRACT FROM AUTHOR]

Issue Addressed: We developed and evaluated a health literacy training program for allied health professionals, and explored the feasibility of a train-the-trainer model to support dissemination.Methods: The program combined didactic and experiential teaching methods and behaviour change techniques, with a focus on teach-back and developing easy-to-understand written materials. Outcomes included participant reactions, confidence (range: 6-30), behavioural intentions (range: 6-42), and dissemination of training content. Implementation outcomes were evaluated using the Normalization MeAsure Development (NoMAD) tool, assessing the constructs of coherence (range: 4-20), cognitive participation (range: 4-20), collective action (range: 7-35) and reflexive monitoring (range: 5-25).Results: Of the 29 allied health professionals who participated, 90% rated the program as 'excellent'/'very good', and 97% said the information was 'extremely'/'very' helpful for their everyday practice. We observed increases in confidence (mean difference [MD] = 6.3, standard deviation [SD] = 2.7, t25  = 11.87, P < .001) and intentions (MD = 3.6, SD = 8.1, t23  = 2.2, P = .04) related to health literacy practices after 6 weeks. Improved confidence was retained over 6 months (MD = 7.1, SD = 5.2, t18  = 5.96, P < .001). After 6 months, 95% of participants (n = 19) reported using teach-back and 50% (n = 10) reported having used a readability formula. Eight-five per cent of participants (17/20) had trained others in health literacy, reaching n = 201 allied health professionals and students. NoMAD scores were highest in relation to cognitive participation (/20) (M = 18.2, SD = 2.1) and lowest in relation to collective action (/35) (M = 25.4, SD = 3.0).Conclusions: A train-the-trainer model appears to be a feasible method to disseminate health literacy training, but additional work may be needed to improve the collective work done to enable health literacy practices in real-world clinical contexts.So What: Staff training is particularly important in highly diverse areas where patients are disproportionately affected by low health literacy. [ABSTRACT FROM AUTHOR]

Aim: This study investigated the impact of a transdisciplinary advanced allied health practitioner (AAHP) in a public hospital general paediatric outpatient department for children referred for concerns with neurodevelopment, learning and/or behaviour. It was hypothesised that time from referral to initial consultation and diagnosis was reduced for children initially assessed by AAHP. It was also hypothesised that children seen by AAHP were less likely to require a medical specialist appointment. Methods: De‐identifiable data were gathered from hospital records both retrospectively and prospectively for each group. Data were collected from: 75 children who attended a medical consultation only clinic in 2014; 75 children who attended an AAHP clinic and a medical officer in 2014 and 75 children who attended an AAHP clinic and a medical officer 2 years after establishment in 2016/2017. Results: On average, 52% children were managed independently by the AAHP. Wait time from referral to consultation significantly decreased from 169 days to 48 days. Similarly, time from referral to diagnosis significantly reduced by almost a half, from 57.2 to 30.59 weeks. Conclusion: This study provides preliminary evidence that utilisation of transdisciplinary AAHPs in general paediatric outpatient departments may reduce waitlists, reduce amount of medical specialist appointments required and provide earlier diagnosis for children with neurodevelopmental, behavioural and/or learning difficulties. [ABSTRACT FROM AUTHOR]

Introduction: At present, sonography in Australia is experiencing a workforce shortage and increasing demand for services. This shortage has been linked to a lack of clinical placements for sonography students, creating a need to develop solutions to the paucity of training opportunities. Methods: A three‐round ranking‐type Delphi analysis in conjunction with thematic analysis was used to develop and rank a list of potential solutions to the shortage of clinical placements. Participants were recruited purposively based on their roles in the field of sonography that involved management of students in clinical placements. Results: In total, 32 potential solutions were developed based on thematic analysis of open‐ended questionnaires completed by participants. Of which, 13 were deemed essential and ranked from most to least important. Discussion: The potential solutions developed in the present study has implications for how sonography services, governing bodies and universities could overcome barriers to providing clinical placements. The highest ranked solution among participants was support from management to employ student sonographers, with the remaining solutions primarily pertaining to assistance in structuring and financing placements, and further support from higher education institutions. It was recommended that future research focus on structuring and financing placements. [ABSTRACT FROM AUTHOR]

Objective: Clinical placements in rural locations are perceived by students to provide positive learning experiences to support their transition to practice. This study explores how clinical placements in a rural health setting might influence students and new graduates to think, feel and act as a health professional. Design: A qualitative study comprising focus group discussions was conducted. Setting: The study was conducted in a rural health service in Queensland, Australia. Participants: Allied health students (n = 12) on placement and new graduates (n = 11) working in a regional health service. Main outcome measures: This study identified allied health student and new graduate perspectives on clinical placement factors which support them to think, feel and act as a health professional. Results: Thematic analysis was used to understand student and new graduate perceptions of how rural placements support thinking, feeling and acting as a health professional. Suggestions for supporting learning included the following: Development of learning partnerships between students and clinical educators with inbuilt expectations and opportunities for reflection and supervision.Creating a culture where students are welcomed, valued and encouraged to take meal breaks with the team supported connectedness.The importance of balancing student autonomy with educating and grading support to increase independence. Conclusions: Findings show clinical placement experiences identified by allied health students and new graduates which support them to begin to think, feel and act as a health professional. Suggestions provided by students and new graduates can be used to inform implementation of clinical placement experiences. [ABSTRACT FROM AUTHOR]

Objective: Students from regional and remote backgrounds are more likely to stay and work in regional and remote locations. Health students transition and retention at university impacts the retainment of a competent rural health workforce. This study aimed to examine the perceptions of allied health students as they reflected upon their first six weeks at university and identified strategies which enhanced these experiences. Design: A cross‐sectional study. Surveys were administered to students who then completed a reflection exercise. Data were analysed using Pearson correlation coefficient and chi‐squares. Setting: An Australian regional university. Participants: First year occupational therapy, physiotherapy and speech pathology students. Main outcome measures: Factors influencing the first 6 weeks at university. Results: One hundred and forty‐three students participated. Homesickness was the major challenge in transitioning to university life. Subthemes identified were adjusting to being away from home, adjusting to university culture and the mature‐aged student. Specific issues included a lack of familiarity with university campuses and services, being unprepared for the workload and confusion while learning new skills. Conclusion: Orientation week activities assist students transition into university and age‐appropriate and family‐friendly activities should be considered for mature‐age students. All students were found to benefit from support to address economic pressures and skill development focusing on coping with university workload. The development of regional university policy including these strategies is likely to enhance student success. [ABSTRACT FROM AUTHOR]

Objective: To examine allied health client, provider and community referrer perceptions of telehealth for the delivery of rural paediatric allied health services to facilitate adoption. Design: A qualitative design employed semistructured interviews with the three key stakeholder groups. Setting: Stakeholders were associated with BUSHkids (The Royal Queensland Bush Children's Health Scheme), a not‐for‐profit organisation serving children and families in Queensland, Australia. Participants: Thirty‐nine stakeholders (12 clients, 16 providers and 11 community referrers). Main outcome measures: Participants were asked about familiarity with telehealth, willingness to use telehealth and perceived barriers and facilitators to telehealth acceptability. Result: Fifty‐nine percent of participants had experienced telehealth and 77 percent were willing to use it. Participants perceived that technology problems were a barrier to telehealth, that children would not be able to concentrate on or enjoy telehealth sessions, that relationships and communication would be inferior to in‐person sessions, and that telehealth was inappropriate for disciplines employing physical touch. Participants identified access to health services as a key benefit of telehealth, said that technology problems could be worked around, and said that telehealth services could be supported with internal partners (eg, assistants) and external partners (eg, local medical centres). They also identified a variety of telehealth benefits to families (eg, convenience, privacy). Conclusion: Overall, telehealth was acceptable to stakeholders. Providers need training to facilitate child participation online and identify alternatives to physical touch. Co‐learning opportunities should be used to address low provider and referrer self‐efficacy. [ABSTRACT FROM AUTHOR]

The prevalence of health risk behaviours and associated poor physical health is high in people with severe mental illness. Mental health service guidelines and policies stipulate that mental health services should address physical health of people who access services. This study reports results from a large, interdisciplinary, cross‐sectional study exploring mental health clinicians' (n = 385) views of role legitimacy in physical health service provision. All disciplines reported that mental health clinicians have a role to play in addressing the physical health of consumers. Among mental health clinicians, psychiatrists and mental health nurses received higher endorsement than allied health clinicians in relation to the provision of physical health care, with primary care providers including general practitioners also ranking highly. As community mental health services routinely appoint allied health staff to case management roles, a challenge for services and a challenge for clinicians are to ensure that physical health and the effects of medication are monitored appropriately and systematically. Online and telephone support services received relatively lower endorsement. As the availability of nonface to face services increases, there is a need to explore their utility in this population and where appropriate promote their uptake. [ABSTRACT FROM AUTHOR]

Objectives: Allied health and complementary and alternative medicines (CAM) are therapeutic therapies commonly accessed by consumers to manage low back pain (LBP). We aimed to identify the literature regarding patients' perceived needs for physiotherapy, chiropractic therapy and CAM for the management of LBP. Methods: A systematic scoping review of MEDLINE, EMBASE, CINAHL and PsycINFO (1990‐2016) was conducted to identify studies examining patients' perceived needs for allied health and CAM for LBP. Data regarding study design and methodology were extracted. Areas of patients' perceived need for allied health and CAM were aggregated. Results: Forty‐four studies from 2202 were included: 25 qualitative, 18 quantitative and 1 mixed‐methods study. Three areas of need emerged: (i) physiotherapy was viewed as important, particularly when individually tailored. However, patients had concerns about adherence, adverse outcomes and correct exercise technique. (ii) Chiropractic therapy was perceived to be effective and needed by some patients, but others were concerned about adverse outcomes. (iii) An inconsistent need for CAM was identified with some patients perceiving a need, while others questioning the legitimacy and short‐term duration of these therapies. Conclusions: Our findings regarding patients' perceived needs for allied health and CAM for LBP may assist in informing development of more patient‐centred guidelines and service models for LBP. Understanding patients' concerns regarding active‐based physiotherapy, which is recommended in most guidelines, and issues surrounding chiropractic and CAM, which are generally not, may help inform management that better aligns patient's perceived needs with effective treatments, to improve outcomes for both patients and the health‐care system. [ABSTRACT FROM AUTHOR]

Prenatal genetic counselors work with clients who are at risk of having a child with a fetal anomaly, or who have been diagnosed with a fetal anomaly. This can raise challenging ethical, moral and legal issues for both clients and counselors. Few studies have explored whether this type of work impacts on genetic counselors themselves. Interviews were conducted with 15 prenatal genetic counselors, five from Toronto, Canada and ten from Melbourne, Australia. A qualitative approach was used to allow for an in-depth exploration of the experiences of genetic counselors working in the prenatal setting. While participants reported that working in a prenatal setting affected them in several ways, this paper focuses on one particular unanticipated finding-that of the impact experienced by counselors from both countries while working when pregnant. [ABSTRACT FROM AUTHOR]

Background/aim: Allied health professionals frequently use surveys to collect data for clinical practice and service improvement projects. Careful development and piloting of purpose‐designed surveys is important to ensure intended measuring (that respondents correctly interpret survey items when responding). Cognitive interviewing is a specific technique that can improve the design of self‐administered surveys. The aim of this study was to describe the use of the cognitive interviewing process to improve survey design, which involved a purpose‐designed, online survey evaluating staff use of functional electrical stimulation. Methods: A qualitative study involving one round of cognitive interviewing with three occupational therapists and three physiotherapists. Results: The cognitive interviewing process identified 11 issues with the draft survey, which could potentially influence the validity and quality of responses. The raised issues included difficulties with: processing the question to be able to respond, determining a response to the question, retrieving relevant information from memory and comprehending the written question. Twelve survey amendments were made following the cognitive interviewing process, comprising four additions, seven revisions and one correction. Conclusions: The cognitive interviewing process applied during the development of a purpose‐designed survey enabled the identification of potential problems and informed revisions to the survey prior to its use. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To describe features that promote transformational and sustainable community engaged health partnerships and services in rural and remote Australian locations. Design: A pragmatic qualitative study using focus groups and individual semi‐structured interviews. Data were analysed using four stages of data comparison. Setting: Far west New South Wales, Australia. The health partnership, initiated by primary school principals in 2008, aimed to address allied health service inequities experienced by regional children. A service‐learning program was developed, aligning allied health student placements to student‐led services. The program has been operational since 2009. Participants: Community participants included school principals (n = 7) and senior managers (n = 2) from local facilitating agencies. Campus participants included allied health students (n = 10) and academics (n = 2), one rurally located with student supervision responsibility and one metropolitan located with a strategic partnership role. Measures: All data were collected by an independent researcher. Four stages of data comparison were undertaken. A thematic analysis was conducted and six key features identified through Stage Four comparison, a comparison across the findings from discrete community and campus groups, reflecting transformational community engagement were identified. Results: These six features are: (i) identifying and responding to community need, (ii) providing services of value, (iii) community leadership and innovation, (iv) reputation and trust, (v) consistency, and (vi) knowledge sharing and program adaptation. Conclusion: We propose that these features contributed to the transformational engagement of community and university participants. These features can inform health sector approaches to community engagement, enhancing rural and remote service accessibility, acceptability, and sustainability outcomes. [ABSTRACT FROM AUTHOR]

Abstract: Background: As allied health professions change over time to keep up with and reflect a rapidly changing society, it is quite possible that the people attracted to the profession may also change. If this is the case, then knowing this could be critical for future workforce marketing, training and planning. Aims: The aim was to investigate whether the personality of students entering a speech‐language pathology (SLP) program had changed over time and whether there were generational differences in personality. Methods & Procedures: The study used the Big Five personality inventory to consider whether there were differences in the personality in speech–language pathology (SLP) students enrolled in the same regional university in Australia in 2005 and 2016. Outcomes & Results: The results showed there were significant differences between the two groups on the Agreeableness and Extroversion scales. The students who were more Conscientious were also more Confident in their ability to perform as an SLP. Generational differences across the two cohorts were also considered. Conclusions & Implications: SLP is a dynamic profession that is reflected through an evolving scope of practice, increasing utilization of technology and specialization. As careers evolve it is logical that the people attracted to those careers may also shift; as demonstrated here via changes in the personality of SLP students. Understanding the personality of current SLP students and future Generation Z students may assist universities to identify specific skills and experiences students need to be successful in the workforce. [ABSTRACT FROM AUTHOR]

This review identifies two models of allied health advanced practitioner practice that are currently in place in the National Health Service in the United Kingdom (UK). A review of the background to advanced practitioner status is given for UK allied health professionals and comments made on the outcomes of the UK roles. Description of the work of Clinical Specialist and Extended Scope Practitioner is given. Alignment with senior physiotherapy staff roles in Australia is commented upon. Some barriers or impediments to implementation of such a system in Australia are discussed with respect to registration, funding and support. The feasibility of such advanced practice roles for physiotherapy is discussed while benefits and cautions are identified. The potential for such a model of health service to be used in Australia, particularly in rural and remote areas, is identified for debate. [ABSTRACT FROM AUTHOR]

There is an emerging recognition of the need for health research that is conducted by and for rural people. Rural research promotes excellence in clinical practice and can improve staff recruitment and retention. A group of clinicians from a regional brain injury service collaborated with academics at their local university to form the Rural Rehabilitation Research on Brain Injury initiative. This initiative has funded four peer-reviewed research projects, secured an Australian Research Council grant and established the beginnings of a state-wide rural research collective involving all Brain Injury Rehabilitation Programs in New South Wales. Sustainable research enterprises such as this have significant potential as a ‘prototype’ for building research capacity in other rural health sectors. Governments and funding bodies should support these initiatives. [ABSTRACT FROM AUTHOR]

Objectives: The authors conducted a systematic review to determine: a) What dental schools and dental hygiene programs are doing to promote knowledge and skills related to addressing childhood obesity and to reduce consumption of sugar-sweetened beverages (SSBs) and b) What else these schools and programs could do to better equip future oral health professionals to address childhood obesity and reduce consumption of SSBs.Methods: The authors searched PubMed, Scopus, Education Full Text (EBSCOHost), and ERIC (EBSCOHost) to identify peer-reviewed publications reporting on obesity or dietetic-related curricula in dental and dental hygiene education within the last 20 years. Three studies met inclusion and exclusion criteria. Outcomes of the identified studies were abstracted and summarized independently by two investigators.Results: The first study describes a 2009 survey of pediatric dentistry residents. Approximately, half had received formal training yet they lacked essential knowledge or skills for managing children who were obese. The second study describes nutrition-related coursework offered in the second year of a predoctoral dental school curriculum in Saudi Arabia, and the third study reports on the development of an "oral health rotation" dietetic internship in a pediatric dentistry clinic, in the context of interprofessional education (IPE).Conclusions: Evidence of dental schools' and dental hygiene programs' efforts to address obesity and SSB consumption in children in their curricula is scant, while Commission on Dental Accreditation standards make sporadic mentions of diet and nutrition. Opportunities exist to leverage existing resources and innovative, experiential approaches, including IPE, to formally, and effectively address this important issue in predoctoral oral health education. [ABSTRACT FROM AUTHOR]

Objective To describe the geographical distribution of physiotherapy clinical placements and investigate the relationship between geographical setting and clinical placement marks in physiotherapy students. Design A retrospective cohort design was used for this study. Setting The University of Newcastle, New South Wales. Participants Data from entry-level Bachelor of Physiotherapy student clinical placements. Main outcome measure(s) Data from all clinical placements in the Physiotherapy program between 2003 and 2014 were included. For all clinical placements, student assessment mark, year of study, type of placement and placement location were collected. Placement location was then classified using the Modified Monash Model ( MMM) categories: one (most metropolitan) to seven (most remote). Results Over the 12 year period of the study 3964 placements were completed. Between 2003 and 2005 the average proportion of clinical placements occurring in metropolitan areas ( MMM1) was 78% and in rural areas ( MMM categories 3-6) was 22%. In 2014 these proportions had changed to 59% ( MMM1) and 40% ( MMM3-6). There were significant differences in clinical placement grades between MMM1 and all other categories except MMM2, with lower assessment marks in MMM1 than other categories. Conclusions The changing distribution of physiotherapy clinical placements may be reflective of increasing student numbers and greater efforts to support students completing rural and remote placements. This change may lead to a positive effect on the rural and remote physiotherapy workforce. Further research is required to determine the specific training and support needs of students and clinical educators in rural and remote settings. [ABSTRACT FROM AUTHOR]

Aim: To better understand the income of dietitians delivering Medicare Chronic Disease Management services by comparing the amount of time dietitians spend on activities with remuneration received. Methods: Data were collected on time invested and remuneration received for 179 consultations provided by 20 dietitians through the Medicare Chronic Disease Management initiative. Descriptive statistics and t ‐ tests were used to compare time spent and remuneration received. A mixed effects model was performed to assess the significant factors in predicting the mean hourly rate received for consultations. Results: Consultations accrued an average of $67.32 ± $24.38 (range $0 – $150) in remuneration, and required an average of 44 ± 20 minutes (range 14 – 136 minutes) including over 10 minutes of administration time. The average calculated gross rate of pay was $102.62/hour. Set ‐ fee consultations were longer than bulk ‐ billed consultations (51 minutes vs 39 minutes, P = 0.002), but resulted in greater remuneration ($83.20 vs $52.95, P < 0.001). Initial consultations resulted in greater remuneration than review consultations ($76.52 vs $60.75, P < 0.001). Dietitians without administration assistance spent more total time on consultations compared with dietitians with administration support (54 minutes vs 42 minutes, P = 0.001), but there was no difference in fees charged (P > 0.005). Conclusions: The hourly income received by dietitians providing services under Medicare appears high; however, practice expenditures have not been considered in the present study. Dietitians should consider the logistical and financial outcomes of their practices in order to enhance financial sustainability. [ABSTRACT FROM AUTHOR]

Objective To compare the outcomes of two cycles of continuous quality improvement ( CQI) at a paediatric physiotherapy service with findings from interviews with clients and their carers using the service. Design Case study based at one paediatric physiotherapy service Setting Community-based paediatric allied health service in Northern Australia. Participants Forty-nine clinical records and four staff at physiotherapy service, five Indigenous children with physical disability aged 8-21 years, and nine carers of Indigenous children aged 0-21 years (current or previous clients). Interventions The CQI process based on the Audit and Best Practice for Chronic Disease involved a clinical audit; a workshop where clinicians assessed their health care systems, identified weaknesses and strengths, and developed goals and strategies for improvement; and reassessment through a second audit and workshop. Twelve open-ended, in-depth interviews were conducted with previous or current clients selected through purposive and theoretical sampling. CQI and interview results were then compared. Main outcome measure Comparison of findings from the two studies Results Both CQI and interview results highlighted service delivery flexibility and therapists' knowledge, support and advocacy as service strengths, and lack of resources and a child-friendly office environment as weaknesses. However, the CQI results reported better communication and client input into the service than the interview results. Conclusion The CQI process, while demonstrating improvements in clinical and organisational aspects of the service, did not always reflect or address the primary concerns of Indigenous clients and underlined the importance of including clients in the CQI process. [ABSTRACT FROM AUTHOR]

Objective Improving the quality and safety of health care in Australia is imperative to ensure the right treatment is delivered to the right person at the right time. Achieving this requires appropriate clinical governance and support for health professionals, including professional supervision. This study investigates the usefulness and effectiveness of and barriers to supervision in rural and remote Queensland. Design As part of the evaluation of the Allied Health Rural and Remote Training and Support program, a qualitative descriptive study was conducted involving semi-structured interviews with 42 rural or remote allied health professionals, nine operational managers and four supervisors. The interviews explored perspectives on their supervision arrangements, including the perceived usefulness, effect on practice and barriers. Results Themes of reduced isolation; enhanced professional enthusiasm, growth and commitment to the organisation; enhanced clinical skills, knowledge and confidence; and enhanced patient safety were identified as perceived outcomes of professional supervision. Time, technology and organisational factors were identified as potential facilitators as well as potential barriers to effective supervision. Conclusions This research provides current evidence on the impact of professional supervision in rural and remote Queensland. A multidimensional model of organisational factors associated with effective supervision in rural and remote settings is proposed identifying positive supervision culture and a good supervisor-supervisee fit as key factors associated with effective arrangements. [ABSTRACT FROM AUTHOR]

Introduction Recent times have witnessed dramatic changes in health care with overt recognition for quality and safety to underpin health care service delivery. In addition to systems-wide focus, the importance of supporting and mentoring people delivering the care has also been recognised. This can be achieved through quality clinical supervision. In 2010, Country Health South Australia Local Health Network developed a holistic allied health clinical governance structure, which was implemented in 2011. Objective This research reports on emergent findings from the evaluation of the clinical governance structure, which included mandating clinical supervision for all allied health staff. Methods A mixed method approach was chosen with evaluation of the impact of clinical supervision undertaken by a psychometrically sound instrument (Manchester Clinical Supervision Scale 26-item version), collected through an anonymous online survey and qualitative data collected through semistructured interviews and focus groups. Results Overall, 189 allied health professionals responded to the survey. Survey responses indicated allied health professionals recognised the importance of and valued receiving clinical supervision ( normative domain), had levels of trust and rapport with, and were supported by supervisors ( restorative domain) and positively affected their delivery of care and improvement in skills ( formative domain). Qualitative data identified enablers such as profession specific gains, improved opportunities and consistency for clinical supervision and barriers such as persistent organisational issues, lack of clarity (delineation of roles) and communication issues. Conclusion The findings from this research highlight that while clinical supervision has an important role to play, it is not a panacea for all the ills of the health care system. [ABSTRACT FROM AUTHOR]

Objective We compared the research experience or support needs of allied health professionals in rural versus regional cities to identify if they were the same or different. Design Descriptive study using a cross sectional survey. Setting This study was carried within Queensland Health's northern six health services. Participants Queensland health staff classified as Health Practitioners. Interventions This survey was conducted as part of a research capacity building initiative within Queensland Health to increase AHPs' participation in research in regional cities and rural areas of Queensland. Main outcome measures Questions in the survey identified demographics, research experience, need for research support, research knowledge and beliefs about research. Data were compared using Chi-square and t-tests. Results The total response rate was 54.5% with 18% of the HPs located in rural communities of less than 5000 people and the rest from the three major cities in northern Queensland. Rural HPs have less research experience in most research activities than regional city HPs and need more research support. Rural HPs have more qualitative research experience than regional city HPs and research is perceived positively by both. Barriers to conducting research were similar across both groups and included insufficient time, lack of staff and no statistical support. Conclusion Rural HPs are younger and have less research experience than their counterparts working in regional cities. Therefore, building rural HP research capacity initiatives may require more access to facilitators such as the Research Fellows. [ABSTRACT FROM AUTHOR]

Aim: To review changes in utilisation of dietetics services through the Medicare Chronic Disease Management program over the last decade and describe patient uptake in 2013. Methods: Dietetics service data were extracted from published Medicare statistics for the periods (i) January 2004 to December 2013 and (ii) January to December 2013. Data comprised individual dietetics services by state and patient demography, and group services data for provider professions regarding type 2 diabetes: dietitians, diabetes educators and exercise physiologists. t ‐ test was used to investigate the association of dietetics' individual service utilisation and workforce statistics. Results: Individual dietetics Chronic Disease Management consultations in private practice have increased annually since 2004. Dietetics has remained the third largest provider. In 2013, a total of 302 910 individual consultations were conducted; 7% of allied health consultations. Likewise, individual services for Indigenous Australians increased since 2008. Utilisation of group services for type 2 diabetes comprised <2% of dietetics services. Dietitians provided more group services than diabetes educators but considerably fewer than exercise physiologists. Middle ‐ aged and older patients were common, with highest uptake by those aged 55 – 74 years. Overall, total and per capita utilisation rates were considerably higher in NSW, Victoria and Queensland compared to less populous states, although this disparity has reduced since 2010. Conclusions: As 10 years has elapsed since the program's inception, further evaluation of the policy is needed to examine large variations in dietetics' Chronic Disease Management uptake by state and territory in both individual and group services. [ABSTRACT FROM AUTHOR]

Objective To examine the association between children's clinical oral health status and their residential location using the latest available data (2009) and to ascertain whether poor oral health among rural children is related to being Indigenous, having less access to fluoridated water or being of lower socioeconomic status ( SES), than children from urban areas. Design Cross-sectional survey. Setting and participant Data were collected on 74 467 children aged 5-12 years attending school dental services in Australia (data were not available for Victoria or New South Wales). Main outcome measures Clinical oral health was determined by the mean number of permanent teeth with untreated caries, missing and filled permanent teeth, and the mean decayed, missing and filled permanent teeth index ( DMFT) of 8 to 12-year-old-children and the mean number deciduous teeth with untreated caries, missing and filled deciduous teeth, and the mean decayed, missing and filled deciduous teeth index (dmft) of 5-10-year-olds. Results The multivariable models that included coefficients on whether the child was Indigenous, from an area with fluoridated water and SES, were controlled for age and sex. The mean DMFT of 8-12-year-old children and the mean dmft of 5-10-year-old-children were significantly higher in rural areas compared with urban centres after accounting for Indigenous status, fluoridated water and SES. Conclusion Children's oral health was poorer in rural areas than in major city areas. [ABSTRACT FROM AUTHOR]

Aim To describe the demographic, operational and financial working profile of private practice dietitians in Australia. Methods A cross-sectional online survey examined the demographics, business structure, key services and fees, marketing strategies, financial welfare, professional support and motivation for dietitians working in the private practice sector in Australia. A link to the survey was posted on the Dietitians Association of Australia, Dietitians In the Private Sector Interest Group national list serve, from September to October 2011 (potential reach of 1222 members). Reminder emails were posted every seven days; data collection ceased after 28 days. Results A total of 156 dietitians completed the online survey, representing a response rate of 13%. The majority were female, aged 20-30 years. Seventy-four per cent of the dietitians identified themselves as the proprietor of the business in which they worked. Eighty-four per cent of the respondents had prior dietetic experience before entering private practice, mainly in the hospital/clinical setting. Most dietitians conducted <20 consultations per week, with the main source of referrals being general practitioners. Initial consultations were on average 52 ± 13 minutes in length (range 30-120 minutes) and incurred a fee of $99 ± 22 (range $60-$195). For dietitians renumerated on a 'per-hour' basis (41%), the gross hourly rate was $71 ± $35 (range $20-$135). For those renumerated on a 'percentage of income generated' basis (44%), the rate was 52 ± 23% (range 15-89%). Conclusions The present study provides valuable data on the working profile of private practice dietitians in Australia, which will inform support and advocacy for this working group. [ABSTRACT FROM AUTHOR]