CENTRE for RURAL HEALTH Bulletin/ DECEMBER 2014

CRH

Bulletin CENTRE FOR DECEMBER 2014 RURAL HEALTH NEWS 02 In this Issue: PROJECTS 06 WRITING RETREAT ORAL HEALTH GRANTS/RESEARCH 10 04 Writing/traditional food 09 The incidence of EVENTS 12 and cultural training oral cancer in Papua workshop at larapuna New Guinea DIRECTOR’S REPORT 16 HELPING HANDS CLINICAL EDUCATION TELE-ASSISTANCE PROJECT ASSOC/PROF TONY BARNETT

The safe and correct performance of clinical procedures requires practice and repetition. Students are usually taught clinical (practical) skills in a laboratory under direct supervision. However, this supervision is resource–intensive and time-limited. In the absence of direct supervision, students can feel under prepared and lack the skills and confidence when they are asked to undertake procedures whilst on placement at a hospital and also on entering the workforce as a new graduate.

In an effort to improve and to get feedback from this situation, a team instructors and students comprising staff from the on what aspects of the School of Health Sciences technology needed to be and School of Engineering improved and what extra and ICT were awarded a functions were required to grant from the Tasmanian make it more suitable for Clinical Education Network remote teaching and learning (TCEN) to build and trial a of clinical/procedural skills. tele-assistance technology (originally developed by As shown in the images, this CSIRO) for teaching clinical technology has two units procedures. This technology that are connected through allows an instructor located Student with the headset a WiFi network. The headset at one site (e.g. a campus) unit is worn by the student to provide audio and visual who works on the patient. cues to assist the learner students. It has the potential The aim of the project was to The focus of attention, the performing a skill whilst on to benefit and augment the conduct a usability study to procedure, is captured by placement at a clinical site training that health students see whether this technology the camera mounted on the (e.g. a rural/remote hospital), receive in procedural skills could be used for remote headset unit. thus making guidance and and has application across all teaching and learning of expertise more accessible to health disciplines. clinical/procedural skills STORY CONTINUED u Page 03 n

NEWS CENTRE FOR RURAL HEALTH Bulletin/ DECEMBER 2014 /

NEWS

Latrobe student accommodation LATROBE RURAL HEALTH TEACHING SITE FILLS GAP

MS KARLA PEEK

One of the main impediments to a successful student placement program is the availability of affordable accommodation in rural Tasmania.

For many students, staying across the road from the wireless internet services the new accommodation in a hotel or motel can be Mersey Community Hospital installed. The first cohort of spreads, that greater numbers financially crippling as and with the capacity to students took up residence in of students will choose well as socially isolating. accommodate up to thirteen August and the feedback from placements at Latrobe and While students undertaking students. The Centre for students was overwhelmingly Devonport and that some of placements in many parts Rural Health manages the positive. Since then, thirty the many interstate allied of the state have been well accommodation as part of its students have been health students undertaking supported through the commitment to supporting accommodated with strong placements in the region Centre for Rural Health’s student placements. forward bookings going will avail themselves of the Rural Health Teaching Site through to January 2015. opportunity to stay there (RHTS) network, students The property consists of six as well. undertaking placements self-contained units, each What has been especially in the Latrobe/Devonport with its own bathroom and pleasing is the range of health area have missed out. Not kitchenette, and a four– disciplines represented to Further information any more. The University of bedroom house. Some minor date – paramedics, nursing, Tasmania recently purchased renovations were required, Karla Peek pharmacy and radiography. 03 6324 4012 the ‘Latrobe Motel’, located furniture was purchased and It is hoped, as news of [email protected]

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HELPING HANDS (CONTINUED)

The microphone and headphone’s on this unit enable verbal communication with the instructor.

The unit also has a near- eye display from which the student can see the “helping hands” image sent from the instructor. On the instructor side, a camera mounted on a support arm over a Instructor and screen interaction Instructor – Ms Carey Mather display screen captures the instructor’s hand gestures. This technology can be The results have confirmed that the applied both intra- and The results from this project technology works and could be a useful inter-professionally. The basic have confirmed that the parameter is that selection of technology works and could adjunct to remote teaching and learning the instructor is determined be a useful adjunct to remote of clinical/procedural skills. by their competence in a teaching and learning of particular skill and their clinical/procedural skills. leading to a significant saving for usability of the technology. capacity to provide helpful in time and resources and One instructor commented: and constructive guidance The feedback received from more effective utilisation of “I can definitely see the to the student – rather than the participants was overall expertise. This was reflected benefits, especially when their specific discipline base. very positive. It confirmed in the participants’ qualitative clinical environments are that the application of the comments about the very busy”. Future directions technology could represent a benefits and feasibility of the for further improvement Further information significant step in simulated technology but also the Likert of the technology were Assoc/Prof Tony Barnett learning with the potential of 03 6324 4011 scale ratings that they gave also identified. [email protected]

D. the interaction between H. any related matters. SENATE SELECT elements of the health system, including between Senators Deborah O’Neill, COMMITTEE ON aged care and health care; the Hon Doug Cameron, Sean Edwards, Jan McLucas HEALTH E. improvements in the and Peter Whish-Wilson provision of health comprised the panel for DR MARTIN HARRIS services, including the Launceston hearing. Dr Indigenous health and Martin Harris and Mr Stuart The Senate Select Committee on Health met in Launceston rural health; Auckland from the University on 4 November to inquire into and report on health policy, Centre for Rural Health were administration and expenditure, with particular reference to: F. the better integration invited to appear before the and coordination of committee to provide a rural A. the impact of reduced B. the impact of additional Medicare services, health perspective. The full Commonwealth funding costs on access to including access to transcript is available on this for hospital and other affordable healthcare link: www.utas.edu.au/rural- health services provided general practice, specialist and the sustainability health/news-all/news-items/ by state and territory medical practitioners, of Medicare; governments, in particular, pharmaceuticals, the-senate-select-committee- the impact on elective optometry, diagnostic, on-health C. the impact of reduced surgery and emergency dental and allied department waiting times, Commonwealth funding health services; hospital bed numbers, for health promotion, Further Information other hospital-related care prevention and G. health workforce Dr Martin Harris and cost shifting; early intervention; planning; and 03 6324 4029 [email protected]

NEWS/03/ NEWS CENTRE FOR RURAL HEALTH Bulletin/ DECEMBER 2014 /

WRITING RETREAT

The Centre for Rural Health (CRH) held a combined writing/traditional food and cultural training workshop for School of Health Sciences staff at larapuna (Eddystone Point, Bay of Fires in NE Tas) from 23 – 26 of November 2014. Larapuna is located within Mt William National Park, has the most beautiful beaches and the area contains many places of Aboriginal cultural significance. Lighthouse keeper’s houses – larapuna (Eddystone Point, Bay of Fires in NE Tas)

Accommodation was on a shared basis in the lighthouse Participants were expected to identify personal keeper’s houses that are goals to achieve during the retreat and participate managed by the Aboriginal Land Council of Tasmania. in all writing sessions. The venue is a self-catering establishment with limited on work she has been doing research paper they plan to were anticipated to produce cooking facilities, power, hot with medical students and work up during the workshop, a draft publication by the end water but no TV or internet staff at the Rural Clinical and to nominate at least the retreat. access. Participants were School (RCS). two peer-reviewed journals required to “muck in”. they plan to target for their Further Information The writing component of publication. Participants were Dr Heather Bridgman An introduction to traditional the workshop was output expected to identify personal 03 6324 4048 Tasmanian Aboriginal food focussed and participants goals to achieve during the [email protected] was facilitated by Sharon were required to submit a Ms Sharon Dennis retreat and participate in all 03 6324 4506 Dennis from the CRH, based draft title and abstract of the writing sessions. Participants [email protected]

SAFETY DRIVER ›› Indicators: When clear indicate – allow TRAINING around 3-5 seconds CRH offered a Defensive before manoeuvring. Driver training course to its entire staff on 22nd ›› Look Over: Look over your September 2014. Mark shoulder before initiating Butcher, the Managing the change to check your Director of Performance trainer observed the driver’s certificate and feedback blind spot. Driving Australia, conducted technique and behaviour; from Mark. Mark stated that the course. The course Coaching – the trainer “everyone was very receptive When slowing down – involved: Road safety provided coaching to assist and performed well during presentation, practical the driver in applying safe the drive with only a few ›› try to avoid heavy braking defensive driving skills, and driving techniques; and minor tips for a few drivers”: by looking ahead and emergency braking. Assessment – the trainer applying the brakes earlier assessed the driver’s ability When changing lanes, use than usual. This can help The highlight of the course in case further training may the acronym MILO – prevent a rear-end crash was the one-on-one driver- be required. when you have someone trainer Defensive Driver ›› Mirrors: Check your following you too closely. Training session which At the end of the training mirrors first to make sure a involved: Observation – the course, drivers received a lane change is possible.

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SUPPORTING STUDENT PLACEMENTS IN 2014

MS KARLA PEEK

What could be more popular with students than a decision to increase their allowances and to make them more readily available?

Very little, which is why the placements close to home. Centre for Rural Health’s While the Rural Placement Student Support Officer is Allowance can’t offset all possibly the most popular these additional costs, it does help. Acoustic session at Shots on Wax for R U OK? Day person in the department – at least amongst students. In 2013, the Centre for The Rural Placement Rural Health provided Allowance guidelines 144 students with a Rural were changed for 2014 in Placement Allowance. In recognition of the financial 2014, 200 students have been hardship all students face supported, and that number when they undertake is expected to increase when a placement in a rural the final round of placements area, including those finishes in December. While who are provided with most of the students are from accommodation at a Rural nursing, this figure includes Health Teaching Site. The cost an unprecedented 16 social of travel is expensive, the cost work students, and smaller of food is often higher than numbers of pharmacy and at home, and many students paramedic students. Dr Lyndsay Quarmby and Dr Heather Bridgman join forces with other agencies to promote the lose an income stream as R U OK? Day message they take leave from paid Money well spent. employment. Add to that the cost of keeping in touch with family and it’s little wonder Further information R U OK? DAY that many students would Karla Peek 03 6324 4012 prefer to undertake their [email protected] DR LYNDSAY QUARMBY

The clinical psychologists at agencies joined together to MEET LYNDSEY the Centre for Rural Health promote the R U OK? Day KINSMAN – CRH joined forces with other message. This involved café agencies in September to sit-ins, and a display and PROJECT OFFICER support R U OK? Day. R U presentation in Brisbane Lyndsey Kinsman has OK? Day is an annual event Street mall. Following this just commenced with in September dedicated the Centre for Rural Health the Centre for Rural to reminding people to and headspace with the Health as a Project Officer ask family, friends and support of local café Shots after relocating with her colleagues the question, on Wax hosted an in-store husband from Bendigo, Ms Lyndsey Kinsman – CRH Project Officer “R U OK?”, in a meaningful acoustic event that was Victoria. Lyndsey has way, because connecting attended by around 50 previously been employed by the School of Rural Health regularly and meaningfully young people. at Monash University and has spent many years at La is one thing everyone can Trobe University, Bendigo. Lyndsey is looking forward to do to make a difference working with the staff in the Centre for Rural Health and and even save lives. The developing this new position into an integral part of the Centre for Rural Health in research team. When she is not at work, Lyndsey enjoys conjunction with the UTAS Further Information walking her dogs, exploring and grazing her way around Dr Lyndsay Quarmby counselling service, external 03 6324 4006 Tasmania, and listening to bad 70s music. NGOs and government [email protected]

NEWS/05/ a

PROJECTS CENTRE FOR RURAL HEALTH Bulletin/ DECEMBER 2014 /

PROJECTS VIRTUAL ORIENTATION TOURS

DR MERYLIN CROSS

Virtual orientation tours (VTs) of 12 rural and remote health services in Tasmania have been developed and are available for students and others to view via the Tasmanian Clinical Education Network (TCEN) website: www.tcen.com.au The VT for the Flinders Island Multi-Purpose Centre (FIMPC) was initially postponed due to major capital works. We can now report that the capital works have finished and that the FIMPC VT is underway and expected to be uploaded to the TCEN website early in 2015.

The VTs are functional, involved with students on for simulated learning in Health (CRH). The goal was readily available and placement. At this stage the Simulation Centre. The to address the identified highly visible to all health student data is limited, tours have also generated need to expose more Health science students due to though feedback from those external interest: Science students to Aboriginal the prominence provided that have completed the health and prepare them by the TCEN in positioning survey suggests that they ›› Transition to practice for placement in Aboriginal them centrally on its home value having access to such coordinators use the health services. page. There were over 2,000 a resource. In the words of tours to save them time hits to the VT website one student, the tours mean developing orientation These VTs give students within six months from all … “there’s one less thing to materials to prepare new a visual overview of each Australian states, territories stress about”. graduates for a rotation in Aboriginal health service, its and overseas: primary health care. layout and facilities. Students particularly like ›› 63% from Tasmania the welcome video, knowing ›› Some directors/site VTs were developed of the where to go, the floorplan, managers are directing TACs Aboriginal health ›› 17% from Victoria being able to learn a bit about prospective employee Services in Hobart, Burnie ›› 14% from other Australian the service and to see the enquiries to the website. and Launceston with the aim of attracting students states and territories accommodation. We have to placements in Aboriginal ›› 6% international. made some minor revisions PREPARING STUDENTS health, increasing their on the basis of the feedback FOR PLACEMENT IN understanding of the nature The evaluative process is provided and made the tours ABORIGINAL HEALTH and breadth of Aboriginal continuing and includes more mobile phone-friendly. This project was undertaken health services and giving the perspectives of collaboratively by the them realistic insight into the students, placement and The VTs have stimulated Tasmanian Aboriginal Centre sorts of learning opportunities education providers. interest internally from the (TAC) and the VT team that may be available. Faculty of Health and the from the Centre for Rural The visual and informational School of Health Sciences. content of the VTs have been Accordingly, VTs have been CRH project team well received by placement developed to orientate Dr Merylin Cross, Michael Valk, Darren Grattidge, providers and placement students to the Medical Sharon Dennis and A/Professor Tony Barnett coordinators, key staff within Science Precinct in Hobart Contact: [email protected] the DHHS and by others and to prepare students

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Launceston Aboriginal Health Service - Outside

RPLO UPDATE The Rural Pharmacy Liaison Officer (RPLO) positions are funded through the Pharmacy Guild of Australia and provide an additional level of support to rural pharmacists through education and access to rural support packages. Burnie Aboriginal Health Service - Front Entrance These RPLOs are located in every UDSRH in Australia.

In September this year Mark Kirschbaum was elected as the chair of the Rural Pharmacy Support Network, which is a staff network within the peak body representing the UDSRH. As the chair, Mark’s responsibilities include coordinating activities within the group and facilitating the sharing of ideas. As most of these pharmacist educators are part-time, the position can help reduce duplication and the burden of developing new concepts which have been successfully implemented in other regions. The RPLOs Hobart Aboriginal Health Service - Outside as a collective group have been proactive in attracting students to undertake rural pharmacy placements in interdisciplinary environments with typically showcased at a public open Video introductions to the 1,000 students per year being supported across all day and all three tours were TAC and each service were the universities. embedded in the tours together presented at the TCEN Local Innovations Funded projects with information about the The RPLOs are always looking to expand the network’s (LIF) symposium. staff and services provided. opportunities to recruit students into their programs. The tours are co-located online Video introductions included One way of achieving this is by cultivating the via the TAC and TCEN websites an Aboriginal health worker, relationship with pharmacy student bodies such as to maximise access to students general practitioners, the chief the National Pharmacy Students’ Association (NAPSA). from multiple disciplines and executive officer of the TAC This is an ideal opportunity for the group to promote education providers. and a regional TAC manager. rural placements to pharmacy students. While it is To promote cultural awareness, known that there is a maldistribution of pharmacists the VTs provide students with The reach and usefulness of the in rural areas, it is believed that a quality placement access to other parts of the tours will be evaluated. opportunity could help address this imbalance. TAC website and additional Aboriginal cultural and health information. Further information Further information Mark Kirschbaum The tour for the Aboriginal Dr Merylin Cross 03 6324 4014 03 6324 4032 [email protected] health services in Burnie was [email protected]

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C. THE COMMUNITY PHCP FRIENDS AND ALUMNI PROJECT

UPDATE MARK KIRSCHBAUM AND ZOE HINGSTON A. WORKPLACE HEALTH AND SAFETY Zoe Hingston is currently working on the Community Friends Project at the L-R: Dr Ha Hoang, Winnie Nguyen and Dr Quynh Lê DR QUYNH LÊ AND WINNIE NGUYEN Centre for Rural Health. With the support of Mark Kirschbaum, Zoe is undertaking Winnie Nguyen is a registered nurse B. E-HEALTH SURVEY: an extensive review of the literature and currently working on a project surrounding rural placements and the exploring workplace health and safety MAPPING OF THE IMPACT additional levels of support that can issues which influence rural community OF THE E-HEALTH (HEALTH be provided to students to enhance nursing service provision. In this project, INFORMATICS) PROGRAM their placement experience. A common issues related to the health and safety of difficulty that some students experience community nurses are broadly examined DR SUE WHETTON when they undertake placements in in conjunction with their impacts and rural areas is that they may be under the strategies which community nurses The Centre for Rural Health is considerable strain, not only with the employ to overcome some challenges. investigating the impact of the E-Health educational demands of placements but At this stage, a target number of (Health Informatics) program on the in some cases being away from home. participants have been interviewed. career paths of graduates, on the use of electronic systems in health services A positive rural clinical placement Data from the interviews is going and on facilitating the use of health experience may increase the student’s to be extracted and analysed into informatics/e-health for health services intention to practice in a rural career themes. These themes are going to delivery, particularly to rural, remote and after graduation. This project is designed be explored further with reference to isolated individuals. The majority of the to link a key member of the community currently available statistical data about data will be collected via an anonymous with a student that is placed in the community nurses in Tasmania, the online survey with respondents being same area. The project is not like a social demographics and the health of invited to participate in a follow-up traditional mentorship program but rural communities. Expected outcomes interview. The findings of the study more of personal introduction to the at the end of the project include journal will inform course review activities rural area. The friend is a person that publications that describe useful to enhance the current program. could assist the student in fitting in insights and implications for rural The methodology for the mapping with the local community and offer an community nurses. exercise may also provide a model for insight into the benefits of living undertaking similar mapping activities in this region. for other programs.

Further Information Further information Further information Dr Quynh Lê Dr Sue Whetton Mark Kirschbaum 03 6324 4053 03 6324 4025 03 6324 4014 [email protected] [email protected] [email protected]

During Nutrition Week and approaches, and was pleased INNOVATIVE NUTRITION SCREENING Seniors Week in October the at the public recognition of PROJECT FOR OLDER PEOPLE Examiner reported on the both the issues of nutritional RECEIVING COMMUNITY SERVICES screening approach and how risk and the important roles older people in Tasmania at played by service providers The Community Nutrition As part of this project, the risk of malnutrition were at working with the Community Unit of DHHS has been work- small Rural Ageing Well team greater risk of serious hospi- Nutrition Unit. ing with a number of HACC in CRH (Dr Peter Orpin, Alex- talisation and ill health. community service providers andra King and Kim Boyer) to encourage them to under- worked with Kacey Rubie The CRH team has appre- Further information take nutritional screening in the Community Nutri- ciated working with the Dr Peter Orpin for their clients to identify tion Unit to both analyse the Community Nutrition Unit to 03 6226 7344 [email protected] potential or existing nutri- results from the screening assist in understanding the Kim Boyer tional risk. tools, and to explore the atti- efficacy and usefulness of the 0418124110 tudes of providers to the tools. screening tools and [email protected]

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ORAL HEALTH CRE EVENTS E-HEALTH (HEALTH INFORMATICS) AND PROJECT UPDATE COURSE REVIEW DENTISTRY AND ORAL HEALTH IN PAPUA NEW GUINEA DR SUE WHETTON

ASSOC/PROF LEONARD During 2014, the E-Health CROCOMBE team has been undertaking a review of the E-Health I have recently returned (Health Informatics) from a trip to Papua program. The aims of the New Guinea (PNG) with review are: colleague Prof John McIntyre, examining ›› To review the curriculum final-year students from and structure of the the School of Dentistry E-Health program to at the University of PNG ensure congruence with in Port Moresby. Children as young as three years of age are chewing betel nut the Certified Health Information Australia ORAL HEALTH AND THE (CHIA) competencies will be soon found in young and other governance INCIDENCE OF ORAL people, and Dr Andrew noted CANCER IN PNG mechanisms as that, “Precancerous lesions appropriate. The Oral health was not had been found in a 15-year- CHIA program was mentioned in the PNG old and in two 18-year-olds”. developed as a way of National Health Plan 2011- She has arranged a “No Betel Betel nut addressing the lack 2020, despite PNG having the Nut Chewing Day” with a of formal recognition highest per capita incidence of walkathon incorporating for health informatics focus on oral surgery and oral cancer in the world. The posters and tee-shirts, as well skills in the Australian trauma management. The national habit of betel nut as a Dental Public Health health workforce and BDS is a five-year program chewing (the nut acts as a Awareness Campaign. it is imperative for the and is followed by a two-year mild stimulant) is thought standing of the E-Health residency program under the to be the major contributor PNG imposed a total ban on program that it be guidance of the Chief Dental to the high incidence of oral the sale of betel nut in Port aligned with the core Officer, Dr Apaio. cancer in PNG. Despite this Moresby, Lae and Mt Hagen competencies as specified risk, and a host of other from 1 January to counter the within the CHIA program. health consequences (an negative impact of betel nut The University of PNG has increased possibility of chewing and spitting. Prof produced 80 dentists since ›› To ensure that the heart disease, gastritis, gum McIntyre was surprised by 2004. This has stimulated an program complies disease, mouth ulcers and the lack of roadside betel nut interest in private practice with the Australian discoloured teeth), chewing stalls and the red staining targeted at the segment of Qualifications Framework betel nut or “buai”, as it is caused by the blood-red the PNG community who (AQF) requirements. known locally, remains a spittle that chewing produces, can afford dental care. The The Federal Government deeply entrenched part of both of which were prominent yearly income of dentists in requires that all daily life. Unfortunately this when he visited Port Moresby PNG is in the region of 50,000 university courses must habit is occurring in younger in June last year. Despite the kina (≈$AU22,500) while the report and provide age groups than previously ban, sales of the nut are still average income is 10,000 kina evidence of compliance suggesting that the incidence being conducted openly. A (≈$AU4,300). The few senior with the Australian of oral cancer will increase cancer policy is being drafted dental officers in PNG are Qualifications Framework over time. with consultants from the reaching retirement age and (AQF) standards by World Health Organization there is no middle generation 1 January 2015. We met Dr Rose Andrew of dentists. This means the younger generation will have The review will be from the PNG Department DENTAL TRAINING to lead dentistry and oral completed by the end of Health who said “Mothers IN PNG are chewing on betel nut and health promotion forward. of 2014. then giving it to their babies” Whilst examining the final- and “children as young as year students Prof McIntyre Further information three years of age are now noted that the level of Further Information Dr Sue Whetton chewing betel nut”. This training was similar to that in Assoc/Prof Len Crocombe 03 6324 4025 0419 597 756 [email protected] suggests that oral cancer Australia, but with a greater [email protected]

PROJECTS/09/ w

GRANTS AND RESEARCH CENTRE FOR RURAL HEALTH Bulletin/ DECEMBER 2014 /

GRANTS AND GRADUATE RESEARCH ABORIGINAL AND TORRES STRAIT ISLANDER PEOPLES AND CULTURAL SAFETY: A WHOLE-OF-UNIVERSITY APPROACH

MS SHARON DENNIS

Aboriginal and Torres Strait place to voice cultural issues Riawunna Centre Islander Peoples and Cultural and barriers. There will be Safety: a Whole-of-University a reporting structure to Approach is a program that enable Aboriginal people to approach. The reporting area and resolve areas where is supported as a Project of identify areas that require to raise Aboriginal safety is Aboriginal safety can be Institutional Significance action to be responsive to currently being developed in embedded within the within the University of cultural requirements and the Work Health and Safety University practices. Tasmania. The program aims to instigate change for a University of Tasmania web to improve Aboriginal and culturally safe learning page. An Aboriginal person Torres Strait Islander student and work environment. The will reply to any forms lodged and staff participation and change can be embedded with Aboriginal safety, as well Further Information retention. The program will in the university process as an Aboriginal Advisory Ms Sharon Dennis 03 6324 4506 be developed to enable a with a whole-of-University Committee to recommend [email protected]

SOCIAL on the wellbeing of their received. The proposals form partnerships to address communities and clients. provided a valuable insight multiple deliverables within a DETERMINANTS OF into local responses on relatively short timeframe. HEALTH – THEMATIC These communities were how best to address long- ANALYSIS PROJECT invited to submit proposals to term conditions linked to Findings from the study were undertake locally place-based poverty and disadvantage. presented at a TML forum for STUART AUCKLAND projects that: (1) addressed The proposals also provided successful recipients of the and/or had the potential to a deeper understanding of funding initiative and at the In March 2014, Tasmanian impact on one or more of the how well communities are annual Tasmanian Council Medicare Local (TML), through social determinants of health; positioned to respond to large- of Social Services (TasCOSS) the Social Determinants of and (2) involved a partnership scale funding opportunities Conference in Hobart Health project, called for of three or more organisations that require the development in November. expressions of interest (EOI) based in, providing an of new initiatives based on from health and community outreach service to or wishing a Social Determinants of service provider organisations to establish a service in a COP. Health approach, to manage Further information working in 18 distinct significant projects and to Stuart Auckland Communities of Priority (COP) The CRH at the University fulfil the requirements of 03 6324 4035 to present frameworks for of Tasmania was engaged to funding bodies. In addition, [email protected] projects that would address Dr Jessica Woodroffe undertake a thematic analysis the findings also revealed how 03 6324 4020 deep-rooted issues impacting of the 59 EOI proposals communities collaborate and [email protected]

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KENTISH concerning the broader health CHNA of residents in the Tandara Lodge Community needs of their community. Kentish Local Government Care Inc, the Sheffield School, COMMUNITY Area (LGA). The project will Glenhaven Family Care and HEALTH NEEDS The Kentish Council has adopt a Social Determinant the CRH Research Team to ASSESSMENT engaged the services of the of Health approach in that it support project activities. University of Tasmania’s seeks to gather the views of STUART AUCKLAND Centre for Rural Health residents on a range of social, The study is currently (CRH) to undertake a whole- economic and environmental underway and will conclude In recent years the Kentish of-population Community factors that impact on the with the presentation of Council has spearheaded Health Needs Assessment their health and that of findings to the Kentish significant investment in (CHNA) of the Kentish their community. Council at the end of health services through Municipality. The project March 2015. the development of the builds on similar Health The CHNA is jointly funded Kentish Health Care Needs Assessment Work by the Kentish Council Further information Centre and Precinct. This undertaken by the CRH over and Tasmania Medicare Stuart Auckland development presents the past five years. Local (TML). A Project 03 6324 4035 an ideal opportunity for Advisory Committee has [email protected] the Council to engage the The aim of the project is to been convened comprising Dr Jessica Woodroffe 03 6324 4020 residents of the municipality undertake a comprehensive representatives from Council, [email protected]

research aimed to investigate OUR STUDENTS AT THE 2014 migrants’ perceptions and experiences of food security GRADUATE RESEARCH CONFERENCE in Tasmania. SHARING EXCELLENCE IN RESEARCH (SEIR) For the students, participating in this year’s SEIR conference DR QUYNH LÊ was very productive in terms of research and A SEIR conference held on 5 – 6 September 2014 in Hobart provided a good fostering a collaborative opportunity for UTAS graduate research students to share their research in spirit. The trip to Hobart progress, to learn more about research development locally and nationally, metaphorically reflects their and to network with other researchers, including their peers. research journey: inspiring, constructive, productive, and happy together, sharing Four of our graduate research students travelled and caring. Here are their to Hobart together with their feedback comments: supervisors to take part in this year’s SEIR: Thao Doan, “It was a great experience! Melissa Terry, Lorraine Walker, I enjoyed it very much, and Joanne Yeoh. educationally and socially, great thanks to SEIR organisers and Thao Doan’s research aims our Centre for Rural Health to examine the relationship From L-R: Thao Doan, Melissa Terry and Joanne Yeoh for giving me this wonderful between health literacy, opportunity.” (TD) social support and the self- management of community- (PND) from a health care on interprofessional “It was enlightening! What an dwelling rural older adults. perspective. Melissa’s study education and learning in inspiring experience for me to The preliminary results aimed to determine what role the rural context and how attend SEIR with my friends and indicate a high level of social music may play in the health interprofessional education supervisors.” (JY) support and social network and wellbeing of people opportunities could be for the participants. Education with PND. formalised, optimised and “Yes, I feel that a journey attainments and ages were supported to promote outward is a journey potential predictors for health Lorraine Walker made an students’ preparedness for inward.” (MT) literacy level. oral presentation on her interprofessional practice. thesis topic “Interprofessional Melissa Terry presented her education: An overview of Joanne Yeoh presented the Further information preliminary findings on the the rural context”. In her qualitative findings of her Dr Quynh Lê effects of music on women talk, Lorraine provided an research on the food security 03 6324 4053 with postnatal depression overview of the literature of migrants in Tasmania. Her [email protected]

GRANTS AND RESEARCH/11/ EVENTS CENTRE FOR RURAL HEALTH Bulletin/ DECEMBER 2014 /

EVENTS COMMONWEALTH DEPARTMENT OF HEALTH SEMINAR – CANBERRA

ASSOC/PROF LEONARD CROCOMBE

VARIATIONS IN ACCESS TO ORAL HEALTH CARE IN AUSTRALIA

His presentation was titled “Variations in access to oral health care in Australia and how might these be tackled?” He noted that over 40% of young children and over 60% of older children Poor oral health is experience tooth decay, three out of ten adults have untreated tooth decay, gum the third largest disease and tooth decay are common cause of hospital conditions in Australia, that poor oral health is the third largest cause admissions after of hospital admissions after kidney disease and heart disease, and that kidney disease and expenditure on dentistry in Australia heart disease was $8.3b in 2012, about three-quarters of which was funded by private consumers. The CRE is focusing its from pain and infections, and simply program of research into four themes won’t put up with it. Dental treatment designed to improve primary oral health can cause problems in people who care for disadvantaged Australians: become cognitively impaired and successful aging and oral health, rural cannot maintain an adequate level of Poor oral health oral health, Indigenous oral health, and care. This includes extractions of teeth the oral health of people with physical with crowns and bridges, of having to and intellectual disabilities. literally extract dentures that had been Assoc/Prof Leonard ‘locked in’ by calculus (dental tartar), A/Prof Leonard Crocombe stressed that and surgically removing multiple failed Crocombe represented a worsening crisis is developing in aged implants on people with multiple the Centre for Research oral health care, “The days of seeing diseases and on multiple medications. Excellence (CRE) for dentures in plastic cups on the benches The surgical operation could be fatal. beside the beds in aged care facilities Primary Oral Health Care may be ending”. As the large “baby as the guest speaker boomer generation” hit residential for a Commonwealth care facilities, they will have teeth, some of which have been saved with Department of Health some pretty heroic dental procedures. Further Information Seminar in Canberra on However, they may no longer be able Assoc/Prof Len Crocombe Tuesday 16 August. to look after their own teeth, may have 0419 597 756 poor access to dental care, will suffer [email protected]

/12/EVENTS EVENTS CENTRE FOR RURAL HEALTH Bulletin/ DECEMBER 2014 /

SARRAH CONFERENCE AND PHARMACY AUSTRALIA CONGRESS (PAC) IN CANBERRA

MARK KIRSCHBAUM

Mark Kirschbaum attended the Services for Australian Rural and Remote Allied Health (SARRAH) conference in Kingscliff and the Pharmacy Australia Congress (PAC) in Canberra this year. Mark presented two papers and a poster at these conferences. He also chaired the annual face-to-face meeting of Rural Pharmacy Liaison Officers that was held just prior to the PAC.

At the SARRAH conference, Australia. However, there are 5th Community Pharmacy the results of the Mental Mark presented the results still significant barriers to Agreement (CPA). It also Health First Aid (MHFA) – of a survey conducted students taking up this career looked at which programs Needs Analysis study for with pharmacy students path as pharmacy students rural pharmacists would pharmacists. The idea of to measure their intention were concerned about the like to have included in the receiving MHFA training to practice in a rural area standards of healthcare upcoming negotiations for the was positively received after graduation. The results and the social isolation in 6th CPA to ensure the viability by pharmacists, but some of this study showed that rural Australia. of rural practice. The results flexible was required in the pharmacy students are from this study have been training modalities to suit significantly more likely to Mark was an invited cited in the Pharmaceutical busy practices. explore a rural career if they speaker at PAC this year and Society of Australia’s key had a rural placement. The presented on the results of a document underlining their majority of students also rural pharmacists survey. This position on the needs of found that a rural placement study measured the value pharmacists going forward would be beneficial for their of rural pharmacy incentive into the next negotiating Further Information career whether or not they programs offered to rural period. In addition, a poster Mark Kirschbaum 03 6324 4014 intended to practice in rural pharmacists as part of the was presented reporting on [email protected]

ABORIGINAL STAFF ALLIANCE (ASA) ANNUAL FACE-TO FACE-MEETING

MS SHARON DENNIS

The Aboriginal Staff Alliance who is the CEO, Services for (ASA) with the University Australian Rural and Remote Department of Rural Health Allied Health (SARRAH). The held a face-to-face meeting ASA have a current proposal in Lismore, NSW, on 15 – with the Australian Rural ASA members L-R: Kate Warren, Peter Ferguson, Jillian Marsh, Sharon Dennis, Aunty Thelma James, Shaun Solomon, Shawn Wilson, Darlene Rotmah 16 September 2014. Guest Health Education Network speakers included Lindy (ARHEN) for an Aboriginal Swain who is the Chairperson, and Torres Strait Islander ARHEN Network, Rural Academic Program and the Further Information Pharmacy Support Network face-to-face meeting became Ms Sharon Dennis 03 6324 4506 (RPSN), and Rod Wellington a focus for this proposal. [email protected]

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EVENTS CENTRE FOR RURAL HEALTH Bulletin/ DECEMBER 2014 /

ENVIRONMENTAL AUTISM HEALTH CONFERENCE DR LYNDSAY QUARMBY

PRESENTATION – With the support of a UTAS career HOBART development scholarship Dr Lyndsay HEALTHY FOOD ACCESS Quarmby recently travelled to the Telethon TASMANIA – BUILDING A Children’s Research Institute in Perth, WA, RESILIENT LOCAL to meet with academics participating in the FOOD ECONOMY Autism Cooperative Research Centre (CRC).

STUART AUCKLAND AND SANDRA MURRAY The year Commonwealth meeting will be followed up funded Autism CRC will with Lyndsay’s attendance at Sandy Murray and Stuart target three objectives: 1) the Australasian Society for Auckland will provide improving precision and Autism Research in Decem- an overview of the reliability of diagnosis; 2) ber and subsequent meet- HFAT project, including empowering staff to respond ing with the Olga Tennison the results from the more effectively to the learn- Autism Research Centre in recent food pricing ing needs of students with Melbourne who also have Stuart Auckland Sandra Murray and availability survey Autism Spectrum Disor- targeted research into early conducted across Tasmania der; and 3) transition from diagnostic practices, particu- Tasmanians across all income as well as preliminary school to further education larly surveillance programs levels do not eat sufficient findings from the food and employment. Lyndsay for infants and toddlers at fruit and vegetables. The supply survey which will met with Professor Andrew risk of autism. Dr Lyndsay reasons why we do not eat map the production of Whitehouse, director of Quarmby’s ASD research enough fruit and vegetables fresh fruit and vegetables Program 1, and his colleague interest is complemented and have poor access to in a number of LGAs regarding current research through her position as state locally produced fresh fruit across Tasmania. opportunities, current diag- wide manager of Diagnostic and vegetables are complex nostic practices in Tasmania and Support Services with and vary between each local and expanding ASD research St Giles and as a recently government area (LGA). efforts In Tasmania. appointed board member of The Healthy Food Access Autism Tasmania. Tasmania (HFAT) project seeks Further information Lyndsay is currently partner- to make healthy food choices ing with the Autism CRC on Stuart Auckland easy choices by ensuring that 03 6324 4035 a national project investigat- fresh foods (preferably locally [email protected] ing the diagnostic practices Further Information grown) are readily available Sandra Murray and reliability of ASD in Dr Lyndsay Quarmby 03 6324 5493 03 6324 4006 across Tasmania. [email protected] Australia. This successful [email protected]

Through the support of a SARRAH into our therapeutic work with children, INTERNATIONAL scholarship Dr Lyndsay Quarmby had individuals and families. Dr Quarmby the opportunity to attend the first ever returned from this conference equipped CONFERENCE International Conference on Childhood with the most current evidence relating Trauma that drew together a collection to neurobiology, trauma and attachment ON of high calibre presenters to discuss and has since delivered presentations Innovation in therapeutic Approaches on such topics to relevant professional CHILDHOOD with Children, Young People and Families. groups and allied health professions.

TRAUMA The high calibre of speakers, including but not limited to Dr Dan Siegel, Dr Allan DR LYNDSAY QUARMBY Schore, Pat Ogden and Dr Ed Tronick (to name a few) delivered powerful messages highlighting the need to keep Further Information adapting important evidence about the Dr Lyndsay Quarmby 03 6324 4006 neurobiology of trauma and attachment [email protected]

/14/EVENTS EVENTS CENTRE FOR RURAL HEALTH Bulletin/ DECEMBER 2014 /

THE 20TH IEA WORLD CONGRESS OF EPIDEMIOLOGY (WCE2014), AUSTRALASIAN 17 – 21 AUGUST 2014, ANCHORAGE, COLLEGE OF ALASKA, USA HEALTH SERVICE

DR QUYNH LÊ MANAGERS ASIA PACIFIC ANNUAL The World Congress of the Congress for instance, CONGRESS Epidemiology kicked off on Emily Carter from the ASSOC/PROF Sunday 17 August and it was Department of International Dr Quynh Lê in Anchorage LEONARD CROCOMBE a wonderful opportunity Health at Johns Hopkins for me to listen to keynote School of Public Health. Assoc/Prof Leonard Crocombe terms of geographic access to addresses and presentations She currently works for the presented at the Australasian healthy food; and determine from researchers in my areas Institute for International College of Health Service the existence/non-existence of interest: food security and Programs (IIP-JHU) on the Managers Asia Pacific Annual of food deserts in a regional public health practice in a generation and use of Congress held at the Adelaide community of Tasmania. The changing environment. The evidence for health program Convention Centre 24 – 26 second one on “Challenges Congress themes included: design and implementation. September on the Medicare- Facing vulnerable young circumpolar health, climate Yes, students of today funded Chronic Disease adults in food security: change and health, nutrition are our research leaders Dental Scheme. This targeted Health disparities and and diet, health disparities, of tomorrow and it is Australians who had chronic ethics of human rights and important to cultivate their regional disadvantage” medical conditions and social justice, innovations potential ability. was about the level of food complex care needs and whose in epidemiologic methods, security among youths oral health was impacting and infectious disease. There I made two presentations who were experiencing on their general health were also many papers on the second day of employment difficulties in irrespective of their concession presented by prominent the Congress. The first rural Tasmania and about card holder status, and epidemiology researchers presentation “Spatial analysis identifying the relationship subsidised dental services up such as professors Miguel of access to healthy food between food security and to the value of $4,250 over two Hernan (Harvard), Alex in a rural area of Australia” regional disadvantage. calendar years. He reported Broadbent (Cambridge), aimed to quantify and that the scheme was costed at Neil Pearce (London) and Sir visualise geographic access Further information $100 million per year and was Richard Peto (Oxford). I was to healthy food; compare heading towards $100 million particularly pleased to see areas of different socio- Dr Quynh Lê 03 6324 4053 per month before the Senate PhD students featuring at economic disadvantages in [email protected] voted it down on its third attempt in late 2012. When the Medicare rebate claims were presentation showcased work THE 3RD ASIA-PACIFIC INTERNATIONAL split into regions, it became on music and humour being apparent that the figures are CONFERENCE ON QUALITATIVE undertaken in aged care and dominated by the major city RESEARCH IN NURSING, dementia and their outcomes areas. Assoc/Prof Crocombe MIDWIFERY AND HEALTH, for residents (wellbeing, asserted that the scheme had 1-3 OCT 2014 IN NEWCASTLE, NSW, AUSTRALIA co-operation, harmony) funding problems because and staff (e.g. alleviating it was left up to physicians DR MERYLIN CROSS absenteeism and turnover). to decide what medical conditions would be worsened The focus of the conference three outstanding keynote The conference was attended by poor oral health; there was was on sharing qualitative papers. Professor Emeritus by approximately 200 no criteria on when the more research findings related Max van Manen presented nurses, midwives, allied expensive procedures should to compassion and care. “Kairos and Inception: New health care practitioners, be undertaken; the Scheme I presented a poster to ways of understanding academics and educators was not adequately costed; the showcase some of the qualitative method”. from 13 countries and across scheme was not targeted at research we’ve done in the Prof. Catherine Acquino- Australia so it provided those most in need of dental Centre for Rural Health to Russell presented “Stories an excellent opportunity care; and the scheme was not identify the networking and from the field: Enhancing to network and to see and altered as funding concerns interprofessional activity of understanding of persons’ hear about the great things became apparent. a Tasmanian mental health lived experiences”. The third happening elsewhere. service. I participated in two keynote that stood out for pre-conference workshops me was a video presented by Further information on qualitative methods Dr Maggie, Heartsch, Director Further Information Assoc/Prof Len Crocombe (phenomenoloy and critical of the Arts Health Institute, Dr Merylin Cross 0419 597 756 03 6324 4032 [email protected] ethnography) and attended Newcastle, Australia. Her [email protected]

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DIRECTOR'S REPORT DIRECTOR’S REPORT

Associate Professor Tony Barnett

Staff from the CRH have been research that they can apply July 2014. Erica was, for some very hard work and effort. very fortunate to be involved within their local community time, the Deputy Director of We also celebrate the success in a number of projects and work environments. the CRH and led a number of Alexandra King, a PhD supported by the Tasmanian The scheme provides busy of research programs that candidate at the Rural Health Clinical Education Network practitioners some time out focussed on climate change, Discipline, who successfully (www.tcen.com.au). These from their mainstream job and health policy, oral health and completed her PhD thesis have provided an opportunity underlies the commitment we translational research. She entitled “Food security for staff to work closely with have to rural health research was an active contributor to and insecurity in older professionals from other supervision and training at debate and lively discussions adults: a phenomenological disciplines as well as industry. all levels. around community ethnographic study”. The All projects have been engagement, “small N” studies, thesis explored experiences directed to better support We have also welcomed assessment of research impact of food, meals, and eating student learning and their other new faces to the CRH and health policy. Erica was a among community-dwelling experience whilst on clinical this year. Dr Winnie Van der strong and articulate advocate rural older adults. Our placement. Projects have Ploeg (occupational therapy) for all things rural. She is congratulations are also included: Virtual (orientation) is working on our rural and greatly missed by all who extended to the supervisors Tours of Aboriginal Health remote allied health retention knew and had the pleasure who have guided and care facilities (with the project, Dr Simone Lee who is of working with her. (http:// accompanied Daniel and Tasmanian Aboriginal Centre), looking at screening in bowel onlinelibrary.wiley.com/ Alexandra at various points interprofessional learning cancer, and Lyndsey Kinsman doi/10.1111/ajr.12144/pdf). along their journey. Well done! and the “Helping Hands” has joined the CRH team as a clinical education tele- project officer. Congratulations As we head rapidly towards assistance project. to Dr Merylin Cross who the festive season, I would describes herself as a “climate like to thank each and every Our Primary Health Care refugee” and has recently member of staff at the CRH Practitioner Scheme managed been appointed as the ARHEN for their work and many by Dr Martin Harris has representative to the Climate achievements over the past 12 continued this year with a and Health Alliance (CAHA). months and also extend my number of new scholars being Daniel Terry Alexandra King thanks to our supporters and appointed: Kerry Fleming; We were partners who have all been Anthony Carnicelli; Winnie all deeply We congratulate Daniel critical to this effort. I wish Nguyen; Cherry Hazlitt; Zoe saddened Terry a research student you, your family and friends a Hingston; Alison Wild; Kate by the who has recently met the happy and safe Christmas. Cross and Fran Stewart. These sudden and requirements for the award practitioners or “mentees” untimely of Doctor of Philosophy (PhD). Further information are appointed to work on passing of Daniel’s work on international Associate Professor Tony Barnett projects on a part-time basis A/Prof Erica Bell A/Prof Erica medical graduates (IMGs) 03 6324 4011 with CRH staff to gain skills in Bell in late represents many years of [email protected]

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