Rethinking policies for the retention of allied health professionals in rural areas : a social relations approach

Objective: Retaining allied health professionals in rural areas is a recognised problem. Generally the literature has concentrated on three elements: practitioner needs, community needs and organisational needs. There has been little attempt to focus other types of social relations in which health practitioner retention and recruitment takes place. The aim of this paper is to question the present dominant hierarchical approach taken in relation to the retention of allied health professionals in rural localities.

Methods: The data derives from a survey in Southwest Victoria, Australia. The sample was purposive rather than representative as it was intended to be exploratory in nature rather than definitive.

Results: The data indicates that there is a greater tendency for allied health professionals in private practice to be retained in rural areas than those in the public sector.

Conclusion: The paper concludes by raising some questions about the pertinence of present models for regional health initiatives since they are locked into a bureuacratic model where relationships are hierarchical and asymmetrically controlled.

Interrogating 'imagined' communities : exploring the impact of international students in local schools

This paper suggests new directions understanding the impact of international students in schools. It is concerned with the ways that community representatives discuss these students and their impact on the community of the school. Recent literatures describe communities such as those of schools as ones of perception and materiality whereby some are included differently than others. Discourses such as multiculturalism and monoculturalism, which have traditionally shaped these discussions about community relations, have always been ambivalent. They take on new forms as local/global interaction, and the individualistic and market-driven changes that lead to the arrival of international students have consequences for the everyday lives of school community members. These need to be investigated if the location of international students in local school communities is to be properly described and interrogated.

Dyslipidaemia in rural Australia : the evidence treatment gaps

Aims & rationale/Objectives : Hypercholesterolaemia accounts for 11.6% of total deaths and 6.2% of the disability burden for the Australian population.1 This paper reports population lipid profiles for three rural Australian populations, and assesses evidence-treatment gaps against the most recent (2005-2007) Australian guidelines.

Methods : Three population surveys were undertaken in the Greater Green Triangle. 3,320 adults aged 25-74 yrs were randomly selected using age/gender stratified electoral roll samples and of these 1563 subjects participated in the survey. Anthropometric, clinical and self-administered questionnaire data relating to chronic disease risk were collected in accordance with the WHO MONICA protocol.2 A detailed investigation of dyslipidaemia was included.

Principal findings : All required data was available for 1255 participants. Age-standardised mean total cholesterol (TC), triglycerides, LDL cholesterol and HDL cholesterol concentrations were 5.36 mmol/l, 1.42 mmol/l, 3.23 mmol/l and 1.48 mmol/l, respectively. Amongst those taking lipid-lowering medication, just 11% categorised as secondary prevention/diabetes, and 39% as primary prevention, achieved all lipid targets. In the 20% of untreated participants at high risk of a primary cardiovascular event, 26% were aware of their hypercholesterolaemia and just 2% achieved all lipid targets (2.8% achieved TC?5.5 mmol, 8.5% achieved LDL<3.5 mmol/l). 11.2% of the overall population used lipid-lowering medication (95% was statin monotherapy).

Implications : Most adults do not achieve their target lipid profile. This paper identifies the subpopulations and lipid components which need to be targeted for future interventions. It also identifies substantial evidence-treatment gaps which should be addressed to help improve lipid profiles at a population level.

Adolescents' use of purpose built shade in secondary schools : cluster randomised controlled trial

Objective To examine whether students use or avoid newly shaded areas created by shade sails installed at schools.

Design Cluster randomised controlled trial with secondary schools as the unit of randomisation.

Setting 51 secondary schools with limited available shade, in Australia, assessed over two spring and summer terms.

Participants Students outside at lunch times.

Intervention Purpose built shade sails were installed in winter 2005 at full sun study sites to increase available shade for students in the school grounds.

Main outcome measure Mean number of students using the primary study sites during weekly observations at lunch time.

Results Over the study period the mean change in students using the primary study site from pre-test to post-test was 2.63 (95% confidence interval 0.87 to 4.39) students in intervention schools and –0.03 (–1.16 to 1.09) students in control schools. The difference in mean change between groups was 2.67 (0.65 to 4.68) students (P=0.011).

Conclusions Students used rather than avoided newly shaded areas provided by purpose built shade sails at secondary schools in this trial, suggesting a practical means of reducing adolescents’ exposure to ultraviolet radiation.

Trial registration Exempt.

School innovation in science: improving science teaching and learning in Australian schools

School Innovation in Science is a major Victorian Government initiative that developed and validated a model whereby schools can improve their  science teaching and learning. The initiative was developed and rolled out to more than 400 schools over the period 2000-2004. A research team worked with 200+ primary and secondary schools over three years, supporting them in developing new initiatives in science, and monitoring the impact on school and classroom practice, and student outcomes. The research effort underpinning the development phase included the development and validation of a set of components describing effective teaching, the refinement of a school and teacher change strategy, the development of instruments to monitor teacher classroom practice and a variety of student outcomes, and the development of insights into the change process using questionnaires, observations, and interviews across four years. This paper describes the project and its major outcomes, and raises a number of issues concerning the nature of school and teacher change, pedagogy, school and community, and student learning, and the way these interact. A number of research issues are raised by the size and developmental nature of the project, the range of research methods, and the different audiences served by the research. The issue of sustainability of such system-wide change initiatives is discussed.