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Objective: To evaluate the contribution of the Adelaide Rural Clinical School (ARCS) longitudinal integrated clerkship to the rural medical workforce. Methods: Design: Retrospective cohort study. Setting: Practice location data were sourced from the Australian Health Practitioner Regulation Agency (AHPRA, January 2021) and matched using university records. Participants: University of Adelaide medical school alumni graduating between 2004 and 2019 (ARCS alumni who completed a full year of rural training [n = 423], metropolitan‐trained peers [n = 1655]). Main outcome measures: The proportions of medical graduates working in a rural location (Modified Monash Model [MMM3‐7] or Australian Statistical Geography Standard [ASGS‐RA2‐5] classifications). Logistic regression was used to examine the association between ARCS training and working rurally, and the influence of rural background and sociodemographic factors. Results: Working in a rural location was almost three times more frequent among ARCS alumni than their metropolitan‐trained peers, using the MMM3‐7 (14.7% vs. 5.3%) classification; for ASGS‐RA2‐5 classification (21.3% vs. 8.9%). In adjusted analysis, working rurally (MMM3‐7) was associated with having a rural/remote residence on enrolment (OR 8.29, 95% CI 4.22–16.26) and was 3.1 times more likely for ARCS alumni (OR 3.06, 95% CI 2.06–4.53) than their peers. The magnitude of the effects of ARCS training on whether they are working rurally was similar among those with metropolitan or rural background (p‐value for interaction 0.873). Similar associations were observed using ASGS‐RA2‐5 classifications. Conclusions: Extended rural placements through the Adelaide Rural Clinical School increased the rural medical workforce, with a similar impact among those with a rural or metropolitan background. [ABSTRACT FROM AUTHOR]

Objective: To determine the work location (metropolitan, regional, rural and remote) of graduates in nursing, allied health and oral health disciplines who complete their professional training, end‐to‐end training, in a regional or rural area noting the potential inclusion of a metropolitan‐based placement for speciality practice not available in rural or regional Victoria. Methods: We tracked the place of employment from the Australian Health Practitioners Regulation Agency (AHPRA) of all graduates from a regional/rural tertiary education provider. The student home address at enrolment, locations where they undertook all placements and their current place of work were described using an objective geographical model of access, the Modified Monash Model. Results: Seventy‐five per cent of 5506 graduates were located in the AHPRA database. About one third of graduates were working in metropolitan areas, 1/3 in regional cities and 1/3 in rural areas. Students' origin accounted for 1/3 of variance in current workplace location. The more placement days students completed in regional/ rural areas was also a significant predictor of working in a regional or rural area. Conclusion: End‐to‐end training in regional/rural areas is an effective approach to retaining a regional/rural workforce. Student origin is a strong predictor of working rural or regionally, as is undertaking placements in rural areas. This suggests that priority for rural/ regional student placements should be given to students in end‐to‐end regional/ rural programs and students from a regional/ rural background. [ABSTRACT FROM AUTHOR]

Objective: To investigate coronavirus disease 2019 community transmission concerns and adherence to social distancing and hygiene practices across metropolitan, regional, rural and remote areas in Australia. Design: Cross‐sectional online survey of Australian adults conducted between April and May 2020 through convenience snowball sampling. Setting: A range of locations across all states and territories of Australia. Participants: Six hundred and seventy‐seven Australian adults, of which 78.8% lived outside of a metropolitan area. Main outcome measures: Perceived threat of coronavirus disease 2019; social distancing guidelines and adherence; infection concerns; hygiene practices; frequency of leaving the house; impact of coronavirus disease 2019 on day‐to‐day life. Results: Almost all respondents perceived the threat of the coronavirus disease 2019 pandemic was serious. There were high levels of support for the Australian Government's social distancing guidelines, although the perception that social distancing guidelines in participants' communities were 'too strict' increased with remoteness area classification. Most respondents reported adherence with Australian Government social distancing guidelines. There was an association between remoteness and risk perception, with non‐metropolitan respondents more likely to feel safe when leaving the house. However, there was no association between geographical remoteness and self‐reported adherence with Australian Government social distancing guidelines. Conclusions: This study provides an important initial insight into Australian perceptions and behaviours relating to the coronavirus disease 2019 pandemic, and how perceptions and behaviours varied by geographical remoteness. The geographical remoteness of communities should be considered by policy makers to ensure effective communication with the Australian public regarding coronavirus disease 2019 and ongoing adherence with preventative health behaviours. [ABSTRACT FROM AUTHOR]

Objective: To determine the prevalence and clinical management characteristics of chiropractors practising in urban and rural or remote Australia. Design: A cross‐sectional analysis of the Australian Chiropractic Research Network project data. Setting: Nationally representative sample of registered chiropractors practising in Australia. Participants: Chiropractors who participated in the Australian Chiropractic Research Network project and answered a question about practising in urban or rural or remote areas in the practitioner questionnaire. Main outcome measure: The demographics, practice characteristics and clinical management of chiropractors. Results: The majority of chiropractors indicated that they practise in urban areas only, while 22.8% (n = 435) practice in rural or remote areas only and 4.0% (n = 77) practice in both urban and rural or remote areas. Statistically significant predictors of chiropractors who practice in rural or remote areas, as compared to urban areas, included more patient visits per week, practising in more than one location, no imaging facilities on site, often treating degenerative spinal conditions or migraine, often treating people aged over 65 years, frequently treating Aboriginal and Torres Strait Islander people and frequently using biomechanical pelvic blocking or the sacro‐occipital technique. Conclusion: A substantial number of chiropractors practice in rural or remote Australia and these rural or remote‐based chiropractors are more likely to treat a wide range of musculoskeletal cases and include an Indigenously diverse group of patients than their urban‐located colleagues. Unique practice challenges for rural or remote chiropractors include a higher workload and a lack of diagnostic tools. Chiropractors should be acknowledged and considered within rural or remote health care policy and service provision. [ABSTRACT FROM AUTHOR]

Objective This paper aims to describe cancer survival and examine association between survival and socio-demographic characteristics across Barwon South- Western region ( BSWR) in Victoria, Australia. Design This study is based on the retrospective cohort database of patients accessing oncology services across BSWR. Setting Six rural and three urban hospital settings across the BSWR. Participants The participants were patients who were diagnosed with cancer in 2009. Main outcome measures Overall survival (OS) of participants was the main outcome measure. Results Total of 1778 eligible patients had four-year OS for all cancers combined of 59.7% (95% CI, 57.4-62.0). Improved OS was observed for patients in the upper socio-economic tertile (64.2%; 95% CI, 60.9-67.5) compared to the middle (59.3%; 95% CI, 55.5-63.1) and lowest tertiles (49.6%; 95% CI, 44.2-54.9) ( P < 0.01). On multivariate analyses, higher socio-economic status remained a significant predictor of OS adjusting for gender, remoteness and age ( HR [hazard ratio] 0.81; 95% CI 0.74-0.89; P < 0.01). Remoteness was significantly associated with improved OS after adjusting for age, gender and socio-economic status ( HR 0.86; 95% CI, 0.77-0.97; P = 0.01). Older age ≥70 years compared to <70 years conferred inferior OS ( HR 3.08; 95% CI, 2.64-3.59; P < 0.01). Conclusions Our study confirmed improved survival outcomes for patients of higher socio-economic status and younger age. Future research to explain the unexpected survival benefit in patients who lived in more remote areas should examine factors including the correlation between geographical residence and eventual treatment facility as well as compare the BSWR care model to other regions' approaches. [ABSTRACT FROM AUTHOR]