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Objectives: Cardiac rehabilitation (CR) provides evidence-based secondary prevention for people with heart disease (HD) (clients). Despite HD being the leading cause of mortality and morbidity, CR is under-utilised in Australia. This research investigated healthcare systems required to improve access to CR in rural and remote areas of North Queensland (NQ). Methods: A qualitatively dominant case study series to review management systems for CR in rural and remote areas of NQ was undertaken. Data collection was via semi-structured interviews in four tertiary hospitals and four rural or remote communities. An audit of discharge planning and CR referral, plus a review of community-based health services, was completed. An iterative and co-design process including consultation with healthcare staff and community members culminated in a systems-based model for improving access to CR in rural and remote areas. Results: Poorly organised CR systems, poor client/staff understanding of discharge planning and low referral rates for secondary prevention, resulted in the majority of clients not accessing secondary prevention, despite resources being available. Revised health systems and management processes were recommended for the proposed Heart: Road to health model, and given common chronic diseases risk factors it was recommended to be broadened into Chronic disease: Road to health. Conclusion: A Chronic disease: Road to health model could provide effective and efficient secondary prevention for people with chronic diseases in rural and remote areas. It is proposed that this approach could reduce gaps and duplication in current healthcare services and provide flexible, client-centred, holistic, culturally responsive services, and improve client outcomes. What is known about the topic? Cardiac rehabilitation is known to improve health outcomes and reduce hospitalisations, but referrals and attendance are low (30%). What does this paper add? A revised systems-based model for improved access to secondary prevention for people with heart and related chronic diseases in rural and remote areas of North Queensland is proposed: Chronic disease: Road to health. What are the implications for practitioners? A functional system from hospitalisation to local healthcare services has been designed to improve access to secondary prevention. Staff require support and education to improve skills, better manage care and improve job satisfaction. [ABSTRACT FROM AUTHOR]

Introduction: Community pharmacists play an important role in pre-travel preventive care and treating the conditions and diseases travellers may acquire during or post-travel. They provide travellers with medicines (preventive, prescription and over the counter), travel health advice, health supplies and vaccination based on their travel itinerary and individual health profile. The health of international and outbound Qatari travellers is an important area of practice and there is a dearth of studies on Qatari community pharmacists' knowledge and practice of travel health and travel medicine. This study aims to investigate Qatari community pharmacists' level of knowledge, attitudes, and practice (KAP) towards travel medicine. Methods: In this study (Oct-Nov 2022), a cross-sectional study was conducted with 117 community pharmacists using a self-administered standardized questionnaire comprising of demographics and practice profile of pharmacists and questions covering knowledge, attitude and practice regarding travel medicine using Google Forms. Descriptive analysis of the collected data was performed using IBM SPSSS 38.0. Results: The survey showed that a significant portion of community pharmacists (56.4%) are aware of travel medicine but lack practical knowledge regarding the practice of travel medicine. Furthermore, most of these pharmacists (59%) recognized the significance of fundamental understanding of travel medicine and consider it their responsibility to provide travel health services. Yet only a small fraction of pharmacists provided travel-related medicines and health services to individuals visiting them. Conclusion: Although the participants displayed a positive attitude towards travel medicine, a noticeable knowledge gap existed. This knowledge gap may have contributed to their attitude and the limited practice of travel medicine observed among them. Stakeholders should offer training, resources, and a supportive regulatory environment for Qatari community pharmacists to provide travel health services. [ABSTRACT FROM AUTHOR]

Introduction: No published evidence was identified regarding the use of oxygen in the treatment of drowning in two recent systematic reviews. The aim of our study was to investigate the impact of on scene, pre-Emergency Medical Services (EMS) oxygen therapy by lifeguards in the resuscitation of drowning victims., Method: We conducted a retrospective case match analysis of drowning patients presenting to the EDs of Sunshine Coast Hospital and Health Service. Patients were matched for age, sex and severity of drowning injury. The primary outcome was in-hospital mortality. Secondary outcomes included positive pressure ventilation (PPV) by EMS and the ED, as well as admission to the Intensive Care Unit., Results: There were 108 patients in each group. Median (IQR) age was 22 (15-43) in the oxygen group and 23 (15-44) years in the non-oxygen group. There were 45 females in the oxygen group and 41 females in the non-oxygen group. Sixteen patients had suffered cardiac arrest and three patients respiratory arrest in each group. There were five deaths in each group. Initial oxygen saturation on arrival of EMS was identical in both groups 89.2% (±19.9) in the oxygen group versus 89.3% (±21.1) (P = 0.294) in the non-oxygen group. The oxygen group required PPV more frequently with EMS (19 vs 11, P < 0.01) and in the ED (19 vs 15, P < 0.01)., Conclusion: On scene treatment with oxygen by lifeguards did not improve oxygenation or outcomes in drowning patients., (© 2024 The Author(s). Emergency Medicine Australasia published by John Wiley & Sons Australia, Ltd on behalf of Australasian College for Emergency Medicine.)