Palliative care training: a survey of physicians in Australia and Europe

The purpose of this paper is to present data about the level and background characteristics of physicians' training in palliative care in Australia (AU), Belgium (BE), Denmark (DK), Italy (IT), the Netherlands (NL), Sweden (SE) and Switzerland (CH) (n=16,486). The response rate to an anonymous questionnaire differed between countries (39%-68%). In most countries approximately half of all responding physicians had any formal training in palliative care (median: 3-10 days). Exceptions were NL (78%) and IT (35%). The most common type of training was a postgraduate course. Physicians in nursing home medicine (only in NL), geriatrics, oncology (not in NL), and general practice had the most training. In all seven countries, physicians with such training discussed options for palliative care and options to forgo life-sustaining treatment more often with their patients than did physicians without. Irrespective of earlier palliative care training, 87%-98% of the physicians wanted extended training.

The Migration of Doctors and Nurses from South Pacific Island Nations

Little is known of the structure of the international migration of skilled health professionals. Accelerated migration of doctors and nurses from the Pacific island states of Fiji, Samoa and Tonga to the Pacific periphery is part of the globalization of health care. The findings from a recent survey of 251 doctors and nurses from the three island countries are reported here. Key determinants of both present migration status and future migration intentions were analyzed using econometric methods. Nurses' and doctors' propensities to migrate are influenced by both income and non-income factors, including ownership of businesses and houses. Migrants also tend to have more close relatives overseas, to have trained there, and so experienced superior working conditions. Migration propensities vary between countries, and between nurses and doctors within countries. Tongan nurses have a higher propensity to migrate, mainly because of greater relative earnings differentials, but are also more likely to return home. The role of kinship ties, relative income differentials and working conditions is evident in other developing country contexts. Remittances and return migration, alongside business investment, bring some benefits to compensate for the skill drain. National development policies should focus on encouraging return migration, alongside retention and recruitment, but are unlikely to prevent out migration. (C) 2003 Elsevier Ltd. All rights reserved.

Woodleigh, Southern Carnarvon Basin, Western Australia: history of discovery, Late Devonian age, and geophysical and morphometric evidence for a 120 km-diameter impact structure

The discovery of the Woodleigh impact structure, first identified by R. P. lasky, bears a number of parallels with that of the Chlcxulub impact structure of K-T boundary age, underpinning complications inherent in the study of buried impact structures by geophysical techniques and drilling. Questions raised in connection with the diameter of the Woodleigh impact structure reflect uncertainties in criteria used to define original crater sizes in eroded and buried impact structures as well as limits on the geological controls at Woodleigh. The truncation of the regional Ajona - Wandagee gravity ridges by the outer aureole of the Woodleigh structure, a superposed arcuate magnetic anomaly along the eastern part of the structure, seismic-reflection data indicating a central > 37 km-diameter dome, correlation of fault patterns between Woodleigh and less-deeply eroded impact structures (Ries crater, Chesapeake Bay), and morphometric estimates all indicate a final diameter of 120 km. At Woodleigh, pre-hydrothermal shock-induced melting and diaplectic transformations are heavily masked by pervasive alteration of the shocked gneisses to montmorillonite-dominated clays, accounting for the high MgO and low K2O of cryptocrystalline components. The possible contamination of sub-crater levels of the Woodlelgh impact structure by meteoritic components, suggested by high Ni, Co, Cr, Ni/ Co and Ni/Cr ratios, requires further siderophile element analyses of vein materials. Although stratigraphic age constraints on the impact event are broad (post-Middle Devonian to pre-Early Jurassic) high-temperature (200-250 degrees C) pervasive hydrothermal activity dated by K-Ar isotopes of illite - smectite indicates an age of 359 +/- 4 Ma. To date neither Late Devonian crater fill, nor impact ejecta fallout units have been identified, although metallic meteoritic ablation spherules of a similar age have been found in the Conning Basin.

Holocene depositional history of the Burdekin River delta of northeastern Australia: A model for a low-accommodation, highstand delta

The Burdekin River of northeastern Australia has constructed a substantial delta during the Holocene (delta plain area 1260 km2). The vertical succession through this delta comprises (1) a basal, coarse-grained transgressive lag overlying a continental omission surface, overlain by (2) a mud interval deposited as the coastal region was inundated by the postglacially rising sea, in turn overlain by (3) a generally sharp-based sand unit deposited principally in channel and mouth-bar environments with lesser volumes of floodplain and coastal facies. The Holocene Burdekin Delta was constructed as a series of at least thirteen discrete delta lobes, formed as the river avulsed. Each lobe consists of a composite sand body typically 5-8 m thick. The oldest lobes, formed during the latter stages of the postglacial sea-level rise (10-5.5 kyr BP), are larger than those formed during the highstand (5.5-3 kyr BP), which are in turn larger than those formed during the most recent slight sea-level lowering and stillstand (3-0 kyr BP). Radiocarbon ages and other stratigraphic data indicate that inter-avulsion period has decreased through time coincident with the decrease in delta lobe area. The primary control on Holocene delta architecture appears to have been a change from a pluvial climate known to characterize the region 12-4 kyr BP to the present drier, ENSO-dominated climate. In addition to decreasing the sediment supply via lower rates of chemical weathering, this change may have contributed to the shorter avulsion period by facilitating extreme variability of discharge. More frequent avulsion may also have been facilitated by the lengthening of the delta-plain channels as the system prograded seaward. Copyright © 2006, SEPM (Society for Sedimentary Geology).