The place of research in the rural health workplace structure: a content analysis of a rural health organisation's strategic and operational documents.

INTRODUCTION: Research training is conducted within rural health organisations without a clear understanding of the role of research within the structure of the organisation itself, potentially limiting the effectiveness of that training. This study sought to identify the role of research within the organisational structure of a large rural health organisation in Australia. Specifically, the study sought the answer to the following questions: Is research identified within the strategic documents of the organisation? If so at what level of the organisation is responsibility for research attributed? Is research identified within the position descriptions of staff? If so, at what level of the organisation are staff expected to conduct research? Is there evidence of research activity elsewhere within the organisational structure? METHODS: This qualitative study used a critical realist approach and content analysis to identify and contextualise the terms 'research' and 'evaluation' within publicly available and internal documents from a large rural health organisation in New South Wales, Australia. Secondary thematic analysis identified organisational factors influencing research activity. Data were sourced from strategic, operational and other documents from the 2015 calendar year, with key documents extracted from 1654 external and internal websites, 159 position descriptions and approvals for research projects active in 2015 (n=53). RESULTS: Only a third of research conducted in the organisation was locally instigated or involved local staff as researchers. Matching between positional responsibility for research and research activity was limited. Research was a strategic goal for the organisation; however, this was not well represented in operational documents. A lack of research in operational documents devolves responsibility for research to individuals. Individuals with greater levels of individual agency were more likely to be engaged in research. A low critical mass of local researchers means that collaboration, both internal and external, is essential to strengthen research capacity. CONCLUSION: Health services can create conditions for local health research in a rural environment by addressing structural barriers such as a lack of operational planning for research. Identifying research-active individuals as champions to build internal research collaboration is an important strategy, as is partnering with external organisations for necessary expertise.

Impact of a remotely delivered, writing for publication program on publication outcomes of novice researchers.

INTRODUCTION: Increased publication of clinician-led health research is important for improving patient care and health outcomes. The aim of this retrospective cohort study conducted in rural Australia was to determine the impact of a writing for publication (WFP) program delivered by teleconference on the publication rates and skill acquisition of novice researchers who have graduated from the New South Wales (NSW) Health Education and Training Institute Rural Research Capacity Building Program (RRCBP). METHODS: Between 2012 and 2015, eight WFP 'bootcamp' programs were offered by the New South Wales Health Education and Training Institute to 112 RRCBP graduates, resulting in 50 participants completing at least one bootcamp. Participants completed a once-weekly WFP group teleconference for six consecutive weeks, and were expected to complete homework activities between sessions and participate in two follow-up teleconferences within 3 months of program conclusion. The primary outcome measure was manuscript publication resulting from participation in bootcamp, with secondary measures being changes in skills, knowledge and confidence in WFP, publication rate and cost per publication. RESULTS: Twenty-one participants (42%) published their bootcamp paper or a related paper that directly resulted from bootcamp WFP skills. Five other participants submitted their bootcamp manuscript for publication, but had not yet had it accepted for publication. The overall publication rate of RRCBP graduates who completed bootcamp was 0.80 compared to 0.23 who did not complete bootcamp. On a 1 to 5 scale, mean scores increased for writing (knowledge, experience, confidence) from 2.0 to 3.5 (p<0.01) and for publishing from 1.1 to 3.4 (p<0.01). The estimated cost incurred by the RRCBP to deliver the program was $230 per publication. CONCLUSION: WFP workshops delivered by teleconference support rural clinician researchers to improve their skills in writing and publishing. A remotely conducted WFP program was effective in increasing publication rates among novice researchers who had conducted a clinically based research project. This shows that novice researchers respond to similar intervention features as experienced researchers do when engaging with WFP, and that WFP outcomes can be increased substantially with modest investment of funding and resources by the host organisation.

Comparative functional anatomy of the epaxial musculature of dogs (Canis familiaris) bred for sprinting vs. fighting.

The axial musculoskeletal system of quadrupedal mammals is not currently well understood despite its functional importance in terms of facilitating postural stability and locomotion. Here we examined the detailed architecture of the muscles of the vertebral column of two breeds of dog, the Staffordshire bull terrier (SBT) and the racing greyhound, which have been selectively bred for physical combat and high speed sprint performance, respectively. Dissections of the epaxial musculature of nine racing greyhounds and six SBTs were carried out; muscle mass, length, and fascicle lengths were measured and used to calculate muscle physiological cross-sectional area (PCSA), and to estimate maximum muscle potential for force, work and power production. The longissimus dorsi muscle was found to have a high propensity for force production in both breeds of dog; however, when considered in combination with the iliocostalis lumborum muscle it showed enhanced potential for production of power and facilitating spinal extension during galloping gaits. This was particularly the case in the greyhound, where the m. longissimus dorsi and the m. iliocostalis lumborum were estimated to have the potential to augment hindlimb muscle power by ca. 12%. Breed differences were found within various other muscles of the axial musculoskeletal system, particularly in the cranial cervical muscles and also the deep muscles of the thorax which insert on the ribs. These may also highlight key functional adaptations between the two breeds of dog, which have been selectively bred for particular purposes. Additionally, in both breeds of dog, we illustrate specialisation of muscle function by spinal region, with differences in both mass and PCSA found between muscles at varying levels of the axial musculoskeletal system, and between muscle functional groups.

Influencing population health performance: feedback from managers, population health staff and clinicians on the NSW Population Health Standards for Area Health Services.

The NSW Population Health Standards for Area Health Services have recently been introduced in NSW to assist area health services assess and improve performance in population health. Greater Western Area Health Service was the pilot site for trialling the Standards as a self-assessment tool. Following self-assessment, managers, population health staff and clinicians were asked for feedback. Staff were either interviewed or participated in a group discussion. Consulting with staff who would be required to use the Standards in the long term was seen as important for facilitating implementation across the area health service. The Standards were seen as credible and potentially beneficial, especially in raising the profile of population health work and encouraging population-based and integrated approaches.