Decentralised clinical trials in rural Australia: Opportunities and challenges.

AIMS: To present opportunities and a model to redress the under-representation of rural communities and people in Australian clinical trials. CONTEXT: Clinical trials are essential for building and understanding the health evidence base. The lack of representation of rural people in clinical trials is evident in other countries. Examining the Australian New Zealand Clinical Trial Registry (ANZCTR) suggests this is also the case in Australia. APPROACH: We propose an approach that empowers rurally based academics and clinicians to co-design clinical trials and increase rural Australians' participation in clinical trials to address this inequality of access. A case study of a decentralised, co-designed clinical trial is presented to support this approach. CONCLUSION: Decentralising clinical trials could improve access to clinical trials, strengthen the social capital of rural communities and help address the health inequalities that exist between rural and metropolitan communities.

Do undertaking rural placements and place of origin inform where allied health graduates work in South Australia?

OBJECTIVE: To examine the principal place of practice after graduation of students who participated in the Rural Health Multidisciplinary Training (RHMT) program and allied health students' place of origin. DESIGN: Cross-sectional study. PARTICIPANTS: Graduates who completed their degree in podiatry, occupational therapy and physiotherapy in 2019. MAIN OUTCOME MEASURES: Principal place of practice at first and third years after graduation. RESULTS: In 2020, 40 allied health professionals (AHPs) who graduated from the University of South Australia in 2019 were practising in rural areas but only 26 of them remained in the rural practice in 2022. The retention rate for rural practice was 65% within 2 years. However, in 2022, 25 allied health professionals left their metropolitan employment location and transitioned to rural practice. Of the 25 allied health graduates who joined the rural practice in 2022, most of them (80%, 20/25) had either rural exposure through the RMHT program or were from rural origin. CONCLUSIONS: Rural exposure via the RHMT program and allied health students' rural place of origin have an important role for rural principal place of practice at first and third years after graduation.

The distribution of registered occupational therapists, physiotherapists, and podiatrists in Australia.

BACKGROUND: In Australia, the distribution of occupational therapists, physiotherapists, and podiatrists density (per 10,000 population) by measure of location/rurality, usual resident population, and area-level socioeconomic status has not been described. OBJECTIVE: To describe the national as well as states-and territories-wide distribution of registered allied health workforce-occupational therapists, physiotherapists, and podiatrists-by measures of rurality and area-level socioeconomic position in Australia. METHODS: A linked data study that brings together (1) the location of health practitioners' principal place of practice from the Australian Health Practitioner Regulation Agency, (2) a measure of location/rurality-Modified Monash Model (MMM), and (3) an area-level measure of socioeconomic status-Index of Relative Socio-Economic Advantage and Disadvantage (IRSAD). The provider-to-population ratio (i.e., density) of three Australia's allied health workforce (occupational therapists, physiotherapists, and podiatrists) was calculated according to the MMM classifications (i.e., Modified Monash 1-7) and IRSAD quintiles at state and national level. RESULTS: Nationwide, the density of occupational therapists and physiotherapists was highest in metropolitan areas (Modified Monash 1) and decreased with the increasing levels of the MMM categories. The national density of podiatrists was highest in Modified Monash 3 areas. The density of occupational therapists, physiotherapists, and podiatrists was highest in areas with IRSAD quintile 5 (i.e., the highest socioeconomic position) and decreased with the declining levels of the IRSAD quintiles nationwide. Moreover, there were notable disparities in the density of occupational therapists, physiotherapists, and podiatrists across each state and territory in Australia when stratified by the MMM classifications and IRSAD quintiles. CONCLUSIONS: There was uneven distribution of registered occupational therapists, physiotherapists, and podiatrists when stratified by measures of location/rurality and area-level socioeconomic status across Australian jurisdictions. The density of these three groups of allied health workforce tended to be more concentrated in metropolitan and most advantaged areas while remote and most disadvantaged areas exhibited less allied health workforce distribution across each state and territory.

Influence of surface charge on wetting kinetics.

The wettability of a titania surface, partially covered with octadecyltrihydrosilane, has been investigated as a function of solution pH. The results show that surface charge affects both static wettability and wetting kinetics. The static contact angle decreases above and below the point of zero charge of the titania surface in a Lippman-like manner as the pH is altered. The dependence of dynamic contact angle on velocity is also affected by pH. The molecular-kinetic theory (MKT) is used to interpret the dynamic contact angle data. The frequency of molecular displacement κ(0) strongly varies with surface charge, whereas the mean molecular displacement length λ is essentially unaffected. There is an exponential dependence of contact-line friction upon work of adhesion, which is varied simply by altering the pH.

The effects of perceived organizational support, perceived supervisor support and perceived co-worker support on safety and health compliance.

Although knowledge is cumulating, very little is known about the effects of various sources of support on safety and health compliance. This study goes beyond previous research by investigating the relationships among perceived support from organizations, supervisors and co-workers, and employees' safety and health compliance behaviour at chemical and petroleum process plants. The results of this study show that the support from organizations, supervisors and co-workers was significantly related to employees' safety and health compliance. Also, the findings reveal that perceived supervisor support has the strongest influence in ensuring employees' safety and health compliance behaviour.