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Objectives: Arterial catheters (ACs) are critical for haemodynamic monitoring and blood sampling but are prone to complications. We investigated the incidence and risk factors of AC failure. Methods: Secondary analysis of a multi-centre randomised controlled trial (ACTRN 12610000505000). Analysis included a subset of adult intensive care unit patients with an AC. The primary outcome was all-cause device failure. Secondary outcomes were catheter associated bloodstream infection (CABSI), suspected CABSI, occlusion, thrombosis, accidental removal, pain, and line fracture. Risk factors associated with AC failure were investigated using Cox proportional hazards and competing-risk models. Results: Of 664 patients, 173 (26%) experienced AC failure (incidence rate [IR] 37/1000 catheter days). Suspected CABSI was the most common failure type (11%; IR 15.3/1000 catheter days), followed by occlusion (8%; IR 11.9/1,000 catheter days), and accidental removal (4%; IR 5.5/1000 catheter days). CABSI occurred in 16 (2%) patients. All-cause failure and occlusion were reduced with ultrasound-assisted insertion (failure: adjusted hazard ratio [HR] 0.43, 95% CI 0.25, 0.76; occlusion: sub-HR 0.11, 95% CI 0.03, 0.43). Increased age was associated with less AC failure (60–74 years HR 0.63, 95% CI 0.44 to 0.89; 75 + years HR 0.36, 95% CI 0.20, 0.64; referent 15–59 years). Females experienced more occlusion (adjusted sub-HR 2.53, 95% CI 1.49, 4.29), while patients with diabetes had less (SHR 0.15, 95% CI 0.04, 0.63). Suspected CABSI was associated with an abnormal insertion site appearance (SHR 2.71, 95% CI 1.48, 4.99). Conclusions: AC failure is common with ultrasound-guided insertion associated with lower failure rates. Trial registration Australian New Zealand Clinical Trial Registry (ACTRN 12610000505000); date registered: 18 June 2010. [ABSTRACT FROM AUTHOR]

Workers in the oil and gas industry are exposed to numerous health risks, ranging from poor health behaviours to the possibility of life-threatening injuries. Determining the most appropriate models of healthcare for the oil and gas industry is difficult, as strategies must be acceptable to multiple stakeholders, including employees, employers, and local communities. The purpose of this review was to broadly explore the health status and needs of workers in the oil and gas industry and healthcare delivery models relating to primary care and emergency responses. Database searches of PubMed, EMBASE, CINAHL, PsycINFO, and Scopus were conducted, as well as grey literature searches of Google, Google Scholar, and the International Association of Oil and Gas Producers website. Resource-sector workers, particularly those in 'fly-in fly-out' roles, are susceptible to poor health behaviours and a higher prevalence of mental health concerns than the general population. Evidence is generally supportive of organisation-led behaviour change and mental health-related interventions. Deficiencies in primary care received while on-site may lead workers to inappropriately use local health services. For the provision of emergency medical care, telehealth and telemedicine lead to favourable outcomes by improving patient health status and satisfaction and reducing the frequency of medical evacuations. [ABSTRACT FROM AUTHOR]

Studies of doctors' life satisfaction (subjective well-being) have largely overlooked the specific experiences of international or overseas trained doctors. This study explores any difference in life satisfaction and its determinants between international and domestic medical graduates (i.e. IMGs vs. DMGs), in Australia (a major destination country). We pooled eight waves of data from the Medicine in Australia: Balancing Employment and Life (MABEL) longitudinal survey of Australian doctors (2009–2016). Life satisfaction was measured on a standard 10-point scale. We applied Oaxaca and Ransom's linear decomposition method to evaluate factors associated with any observed difference in satisfaction between the two groups of doctors. IMGs were more likely to report lower life satisfaction than DMGs (mean 7.37 vs 7.48, p-value < 0.001). The well-being gap (of 0.11) was largely attributable to the groups' differences in observable characteristics such as psychosocial and demographic factors. Most notably, the IMG group was worse off with respect to self-reported financial security, exposure to work-related psychosocial risk factors, and community integration. Our study highlights the importance of the workplace and community context in understanding the life satisfaction difference between IMGs and DMGs. The study results may have important implications for policies and programs that seek to promote the integration and retention of IMGs. [ABSTRACT FROM AUTHOR]

Objective: To investigate the impact of the COVID‐19 pandemic on clinical supervision practices of health care workers in health care settings in one Australian state. Method: A bespoke survey was developed and administered online using Qualtrics™. The survey consisted of Likert scale and closed questions, with options for free text comments. Numerical data were analysed descriptively and using Chi‐Square tests. Textual data were analysed through content analysis. Results: Of the 178 survey respondents, 42% were from allied health disciplines, 39% from nursing and midwifery, and 19% from medicine. The type and mode (i.e., face‐to‐face, telesupervision) of clinical supervision prior to the pandemic and at the time of survey completion (i.e., July–August 2021) were similar. Eighteen percent of respondents had a change in supervision arrangements but only 5% had a change in supervisor. For the 37% who changed roles due to COVID‐19, 81% felt their current supervisor was still able to support them, 69% were still having their supervisory needs met. Analyses of textual data resulted in the development of two categories: Supervision deteriorating, and some clinical supervision functions (i.e., formative and restorative) being more impacted than others (i.e., normative). Conclusion: There were substantial disruptions to several parameters of clinical supervision due to COVID‐19, that may pose a threat to high quality supervision. Health care workers reported pandemic‐induced stress and mental health challenges that were not always addressed by effective restorative supervision practices. [ABSTRACT FROM AUTHOR]

Background: To better target rural background and rurally interested applicants during medical school admission, it is increasingly common for rural medical programs to include multiple mini-interview (MMI) scenarios designed to screen for rural interest. It remains unclear whether the inclusion of regionally/rurally focused MMI scenarios positively impacts the selection of rural background applicants and evidence is limited regarding why rural background applicants may perform worse on the MMI. Therefore, this study explored how rural and metropolitan applicants prepare for and perceive the MMI for admission to a regional medical pathway. Methods: A mixed-methods survey was sent to provisional entry regional pathway medical school applicants who had completed an MMI. The survey was distributed before any offers of admission had been released. Results: Rural applicants spent less time and money preparing for the MMI and felt less prepared (P < 0.05). However, time and money spent, and resources used to prepare were not associated with feeling more prepared (all P > 0.05). Respondents mostly felt that the MMI process aligned with their expectations (83%), is fair (64%), and helps a rural program select the most suitable applicants (61%). Rural applicants generally felt that they had an advantage over other applicants (61%) while most metropolitan applicants did not (23%; P = 0.002). Discussion: Applicants to a regional medical pathway are generally supportive of the MMI process. It appears valuable for applicants to prepare for the MMI by understanding the format and requirements; however, investing substantial time and money does not underpin feeling better prepared. MMI scenarios which include a regional focus are perceived to advantage rural applicants. [ABSTRACT FROM AUTHOR]

An expansion of Commonwealth-supported medical student places is required in rurally located end-to-end medical school programs, rather than a reliance solely on redistribution, to ensure that each state has at least one rural medical school program that provides remote or rural training from the start to the completion of the medical degree. Highlight rural medicine in medical school curricula Showcase diverse rural contexts Medical curricula and assessments shape students' views of rural career options.[30] Traditional medical school teaching is predominantly metropolitan focused and specialist led. Invest in rural training pathways Immerse students in a rural place Immersive rural training remains a cornerstone for producing more rural doctors. Keywords: Rural health services; Healthcare disparities; Education, medical; Resource allocation EN Rural health services Healthcare disparities Education, medical Resource allocation S8 S13 6 08/08/23 20230803 NES 230803 Rural communities across Australia face an ongoing shortage of doctors, which reduces access to care and leads to poorer health outcomes for people living in rural areas. [Extracted from the article]

Objective: To investigate student supervisor experiences of supervising students on clinical placements since the onset of the COVID‐19 pandemic. Background: Studies on the impact of COVID‐19 on student clinical placements have focused largely on student reports and have been specific to individual professions or topic areas. There is a need to investigate student supervisor experiences. This study was conducted in Queensland (Australia) in four regional and rural public health services and four corresponding primary health networks. Methods: The anonymous, mixed methods online survey, consisting of 35 questions, was administered to student supervisors from allied health, medicine, nursing and midwifery between May and August 2021. Numerical data were analysed descriptively using chi‐square tests. Free‐text comments were analysed using content analysis. Results: Complete datasets were available for 167 respondents. Overall trends indicated perceived significant disruptions to student learning and support, plus mental health and well‐being concerns for both students and supervisors. Extensive mask wearing was noted to be a barrier to building rapport, learning and teaching. Some positive impacts of the pandemic on student learning were also noted. Conclusions: This study has highlighted the perceived impact of the pandemic on supervisors' mental health, and on the mental health, learning and work readiness of students. This study provides evidence of the pandemic impacts on student clinical placements from a supervisor point of view. Findings can assist in future‐proofing clinical education and ensuring that students continue to receive learning experiences of benefit to them, meeting curriculum requirements, in the event of another pandemic. [ABSTRACT FROM AUTHOR]

Academics are expected to publish. In Australia universities receive extra funding based on their academic publication rates and academic promotion is difficult without a good publication record. However, the reality is that only a small percentage of academics are actively publishing. To fix this problem, a number of international universities and other higher education institutions have implemented interventions with the main aim being to increase the number of publications. A comprehensive literature search identified 17 studies published between 1984 and 2004, which examined the effects of these interventions. Three key types of interventions were identified: writing courses, writing support groups and writing coaches. The resulting publication output varied, but all interventions led to an increase in average publication rates for the participants.

The World Health Organization has endorsed the use of outreach to promote: efficient redeployment of the health-care workforce; continuity of care at the local level; and professional support for local, rural, health-care workers. Australia is the only country that has had, since 2000, a sustained national policy on outreach for subsidizing medical specialist outreach to rural areas. This paper describes the adoption, implementation and prioritization of a national specialist outreach policy in Australia. Adoption of the national policy followed a long history of successful outreach, largely driven by the professional interest and personal commitment of the workforce. Initially the policy supported only new outreach services but concerns about the sustainability of existing services resulted in eligibility for funding being extended to all specialist services. The costs of travel, travel time, accommodation, professional support, staff relief at specialists' primary practices and equipment hire were subsidized. Over time, a national political commitment to the equitable treatment of indigenous people resulted in more targeted support for outreach in remote areas. Current priorities are: (i) establishing team-based outreach services; (ii) improving local staff's skills; (iii) achieving local coordination; and (iv) conducting a nationally consistent needs assessment. The absence of subsidies for specialists' clinical work can discourage private specialists from providing services In remote areas where clinical throughput is low. To be successful, outreach policy must harmonize with the interests of the workforce and support professional autonomy. Internationally, the development of outreach policy must take account of the local pay and practice conditions of health workers. L'Organisation mondiale de la Sante a approuve l'utilisation de services de proximite pour promouvoir: le redeploiement efficace du personnel des soins de sante; la continuite des soins au niveau local; et le support professionnel au personnel de sante local et rural. L'Australie est le seul pays qui possede, depuis l'an 2000, une politique nationale soutenue de services de proximite afin de subventionner la presence de medecins specialistes dans les zones rurales. Cet article decrit l'adoption, la mise en oeuvre et la priorisation d'une politique nationale de proximite specialisee en Australie. L'adoption de cette politique nationale a fait suite a une longue histoire de services de proximite dont la reussite est largement attribuable a l'interet professionnel et a l'engagement personnel des professionnels de sante. A l'origine, cette politique soutenait seulement les nouveaux services de proximite, mais les preoccupations concernant la durabilite des services existants ont abouti a l'extension de l'admissibilite au financement a tous les services specialises. Les couts des deplacements, des temps de deplacement, d'hebergement, du soutien professionnel, de personnel de remplacement dans les cabinets primaires des medecins specialistes et de la location d'equipement ont ete subventionnes. Au fil du temps, l'engagement politique national pour le traitement equitable des populations autochtones a entraine un soutien plus cible pour acheminer les services de medecine mobile dans les zones reculees. Les priorites actuelles sont: (i) l'etablissement de services de proximite en equipe; (ii) l'amelioration des competences des professionnels locaux; (iii) la realisation de la coordination locale; et (iv) la conduite d'une evaluation coherente des besoins a lechelle nationale. L'absence de subventions pour le travail clinique des medecins specialistes peut decourager les medecins specialistes prives de venir soigner dans les zones eloignees ou le rendement clinique est faible. Pour quelle reussisse, la politique de proximite doit s'harmoniser avec les interets des professionnels de sante et soutenir l'autonomie professionnelle. A l'echelle internationale, le developpement de politiques de proximite doit tenir compte du salaire local et des conditions d'exercice des professionnels de la sante. La Organizacion Mundial de la Salud ha aprobado el uso de la difusion con el objetivo de promover la reasignacion eficiente del personal sanitario, la continuidad de la atencion a nivel local y el apoyo profesional para el personal sanitario a nivel local y rural. Australia es el unico pais que ha mantenido, desde el ano 2000, una politica nacional continuada en materia de subvencion de la difusion de especialistas medicos en las zonas rurales. Este articulo describe la adopcion, implementacion y prioridad de la politica de difusion de especialistas en dicho pais. La adopcion de la politica nacional obedecio a un largo historial de difusion con buenos resultados, impulsado en gran parte por el interes profesional y el compromiso personal de los trabajadores. En un principio, la politica apoyaba unicamente los servicios de difusion nuevos, pero la preocupacion acerca de la sostenibilidad de los servicios existentes auspicio una ampliacion de la financiacion a la totalidad de los servicios especializados. Se subvencionaron los costes y el tiempo de viaje, el alojamiento, el apoyo profesional, la asistencia al personal en los consultorios principales de los especialistas y el alquiler de equipos. Con el tiempo, el compromiso politico nacional respecto al trato equitativo de los pueblos indigenas se tradujo en un apoyo mas especifico para la difusion en las areas mas alejadas. Las prioridades actuales son: (i) establecer servicios perifericos por equipos, (ii) mejorar las capacidades del personal local, (iii) lograr la coordinacion local y (iv) llevar a cabo una evaluacion cohesiva de las necesidades a nivel nacional. La ausencia de subsidios para el trabajo clinico de los especialistas puede disuadir a los especialistas privados de prestar servicios en zonas remotas, en las que el rendimiento clinico es bajo. Para resultar satisfactoria, la politica de difusion debe armonizar los intereses del personal y apoyar la autonomia profesional. A nivel internacional, el desarrollo de una politica de divulgacion debe tener en cuenta los salarios y las condiciones locales de los miembros del personal sanitario., Introduction The World Health Organization (WHO) recognizes the need for policies designed to overcome the chronic undersupply of health workers in rural areas in both developed and developing countries. (1) [...]