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1.
Rural Remote Health ; 24(1): 8687, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38494593

RESUMO

INTRODUCTION: Pharmacists serve an important role in rural communities, and in some cases they may be the only health professional available. Their recruitment and retention is a major concern for rural communities and health services; however, a deeper understanding regarding the advantages and challenges of sustaining a rural pharmacy workforce is somewhat limited. The aim of this study was to develop a deeper understanding of pharmacists' perspectives about factors influencing pharmacist recruitment and retention to rural and remote communities. METHODS: The exploratory study, carried out in rural Tasmania and rural Western Victoria, used a qualitative descriptive design. Structured interviews, lasting between 30-60 minutes, were conducted by a single researcher using the Pharmacist Community Apgar Questionnaire via face-to-face, telephone or videoconferencing technology. Data were analysed thematically using verbatim transcription, extraction of significant statements and identification of similarities in formulated meanings, grouping the similar meanings and significant statements that pertained to the phenomena of interest. Specifically, qualitative data were used to provide a deeper understanding of factors identified as key assets, capabilities, or those most challenging for pharmacist recruitment and retention. RESULTS: The advantages and disadvantages rural communities face in recruiting and retaining pharmacists are presented. These insights are linked to the advantages of financial income, incentives and moving allowance. Further advantages include the degree of practice autonomy, breadth of tasks, the perception of the community, loyalty to the pharmacy and its pharmacists, along with community recognition. Challenges associated with the recruitment and retention of pharmacists centred on the need for spousal or partner employment opportunities, having greater proximity to schools, access to social or cultural opportunities, along with good transport connections. Further challenges included housing, the cost of schooling for children, having adequate locum or peer coverage and opportunities to host interns. DISCUSSION: The study provides a deeper exploration of the meaning and experiences of factors that previous research has shown are considered advantageous or challenging to the recruitment and retention of pharmacists in rural areas. Through the voices of pharmacists living and working in a rural area, the findings further enlighten our understanding regarding how the multifaceted and complex nature of health workforce planning may be addressed. As such, greater pharmacist recruitment and retention is enabled through adequate financial compensation and incentives, along with additional tax incentives for business and health services. Further, innovation is required to enhance economic sustainability. Locum coverage and intern opportunities also require innovative approaches to address concerns among potential candidates. Lastly, efforts to enable and support social connections such as schooling and spousal employment, while building community connection and a sense of rural community belonging, remain essential to recruit and retain pharmacists. CONCLUSION: Rural pharmacist recruitment and retention is complex, requiring a multi-pronged approach to implement practical solutions. Given this complexity and the unique features of each rural community, solutions require whole-of-community ownership to create innovative solutions. Recognition of specific advantages and challenges can address key driving factors for pharmacist recruitment and retention in rural communities.


Assuntos
Serviços Comunitários de Farmácia , Assistência Farmacêutica , Serviços de Saúde Rural , Criança , Humanos , Farmacêuticos , População Rural , Pesquisa Qualitativa , Emprego
2.
BMC Nurs ; 23(1): 50, 2024 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-38233912

RESUMO

BACKGROUND: Global nursing workforce shortage represents an impediment to the delivery of safe, evidence-based healthcare. Despite collective efforts, a consistent stream of nurses leaving the profession remains, particularly within the first five years of practice, which is exacerbated in rural communities. The aim of the study was to compare self-efficacy, grit, and rural career aspirations among nursing graduates between their second and fourth year of their nursing profession. METHODS: As part of a longitudinal investigation, a repeated cross-sectional design was utilised. Participants included, 117 (response rate 52.2%) who completed an online questionnaire 18-24 months after graduating, and 32 participants (response rate of 21.0%) who agree to repeat the questionnaire 36-48 months after graduating. The questionnaire included demographic, employment, and measures examining general and occupational self-efficacy, grit, and rural career aspirations. RESULTS: No differences between general and occupational self-efficacy or grit were identified between second- and fourth-year nurses. In addition, the importance placed on undertaking rural career also remains unchanged. However, a higher proportion of fourth year nurses were more likely to be in management or were considering leaving the profession. CONCLUSIONS: This examination of early career nurses, now in their second and fourth-year post-graduation highlights self-efficacy, grit, and rural career aspirations remains stable between two- and four-years following graduation, while nursing in their fourth year were more likely to consider leaving the profession. Nursing retention is a 'Wicked Problem' that is unavoidably a complex amalgam of macro, meso and micro factors that we are yet to fully appreciate.

3.
Cancer Prev Res (Phila) ; 16(7): 393-404, 2023 07 05.
Artigo em Inglês | MEDLINE | ID: mdl-37210751

RESUMO

The first biomarker-based cervical cancer screening test, p16/Ki-67 dual-stained cytology (DS), has been clinically validated and approved in the United States for triage of women being screened for cervical cancer who test positive for high-risk human papillomavirus (hrHPV). The primary aim of this work is to evaluate the cost-effectiveness of DS triage after co-testing findings of positive non-16/18 HPV types and atypical squamous cells of undetermined significance or low-grade squamous intraepithelial lesions cytology. A payer-perspective Markov microsimulation model was developed to assess the impact of DS reflex testing. Each comparison simulated 12,250 screening-eligible women through health states defined by hrHPV status and genotype, cervical intraepithelial neoplasia grades 1-3, invasive cervical cancer (ICC) by stage, and cancer-related or non-cancer death. Screening test performance data were from the IMPACT clinical validation trial. Transition probabilities were from population and natural history studies. Costs of baseline medical care, screening visits, tests, procedures, and ICC were included. DS reflex after co-testing was cost-effective with incremental cost-effectiveness ratios per quality-adjusted life-year gained of $15,231 [95% confidence interval (CI), $10,717-$25,400] compared with co-testing with hrHPV pooled primary and genotyped reflex testing, and $23,487 (95% CI, $15,745-$46,175) compared with co-testing with hrHPV genotyping with no reflex test. Screening and medical costs and life-years increased, while ICC costs and risk of ICC death decreased. Incorporating DS reflex into co-testing cervical cancer screening algorithms is projected to be cost-effective. PREVENTION RELEVANCE: The p16/Ki-67 dual-stained cytology (DS) test was recently approved in the United States as a reflex test for cervical cancer screening following positive high-risk human papillomavirus (hrHPV) test results. Adding DS reflex to hrHPV and cervical cytology co-testing strategies in the United States is expected to be cost-effective per life-year or quality-adjusted life-year gained.


Assuntos
Infecções por Papillomavirus , Neoplasias do Colo do Útero , Feminino , Humanos , Estados Unidos , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/prevenção & controle , Neoplasias do Colo do Útero/patologia , Análise Custo-Benefício , Antígeno Ki-67 , Genótipo , Detecção Precoce de Câncer/métodos , Papillomaviridae/genética , Programas de Rastreamento/métodos
4.
Aust J Rural Health ; 31(2): 218-229, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36317745

RESUMO

OBJECTIVE: To pilot the Pharmacist Community Apgar Questionnaire (PharmCAQ) and evaluate its usability and capacity to develop a greater understanding of the unique factors that impact the rural recruitment and retention of pharmacists. DESIGN: Cross-sectional design involving face-to-face, telephone or video conferencing interviews. SETTING: Twelve rural communities across Tasmania and Western Victoria, Australia. PARTICIPANTS: Participants (n = 24) included pharmacists, a Director of Clinical Services, pharmacy practice managers and senior pharmacy assistants. MAIN OUTCOME MEASURES: Interviews enabled the completion of the PharmCAQ, which assigns quantitative values to 50 key factors to ascertain a community's strengths and challenges associated with recruitment and retention and their relative importance to the pharmacist workforce. RESULTS: The cumulative PharmCAQ scores indicated the tool was sensitive enough to differentiate high- and low-performing communities. Overall, the highest-rated factors considered most vital to pharmacist recruitment and retention were the reputation of the pharmacy, the ability of the pharmacist to be independent and autonomous, the loyalty of the community to the pharmacy, the level and stability of monetary compensation and the breadth of tasks available to a pharmacist. CONCLUSIONS: This study identified the strengths and challenges of participating communities and provided an insight into the shared factors to consider in recruiting and retaining pharmacists. Further, each community has unique strengths that can further be promoted in recruitment, flagging where limited resources are best used to address site specific challenges. This is more likely to ensure the matching of the right candidate with the right community.


Assuntos
Serviços Comunitários de Farmácia , Farmácia , Serviços de Saúde Rural , Humanos , População Rural , Estudos Transversais , Recursos Humanos , Vitória
5.
Rural Remote Health ; 22(4): 7347, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36446135

RESUMO

INTRODUCTION: An adequate healthcare workforce remains essential for the health of rural communities. Strategies to address rural health workforce challenges have often centred on the medical and nursing workforce; however, addressing the rural pharmacist workforce also remains critical as they are often the first point of contact for health advice. Initiatives have increased pharmacist supply; however, key issues such as poor attraction, recruitment, and retention to rural areas remain. The aim of this study was to support the recruitment and retention of pharmacists in rural areas of Australia through the development of the Pharmacy Community Apgar Questionnaire (PharmCAQ). METHODS: A modified Delphi technique was employed to develop the PharmCAQ. A panel of experts were purposively selected. Eight representatives were from organisations with rural experience relevant to the study including the Society of Hospital Pharmacists of Australia, the Pharmaceutical Society of Australia, the Pharmacy Guild of Australia, the Pharmacy Board of Australia, and a representative of a government health agency, who also leads a hospital pharmacy. Three additional participants included local and international academics with health policy and rural health workforce expertise. All participants participated in three separate focus groups of 45-60 minutes duration, where the review and refinement of factors that drive recruitment and retention of pharmacist were discussed. Face and content validity was achieved through the representatives, while internal consistency was achieved when the tool was piloted among 10 rural pharmacists in rural Victoria. RESULTS: Fifty key factors that impact the recruitment and retention of pharmacists were identified, developed and succinctly described. All factors were grouped into five classifications: (1) geographic, (2) economic and resources, (3) practice and scope of practice, (4) practice environment and (5) community practice support. After final consensus, the factors and their definitions formed the final questionnaire. Lastly, the reliability of PharmCAQ was determined, with a Cronbach's alpha coefficient of 0.852. CONCLUSION: While the development and use of the Apgar questionnaire for the recruitment and retention of health professionals is not a novel idea, seeking to specifically focus on pharmacists is unique. However, 10 factors were similar to factors associated with rural recruitment and retention of both physicians and nurses; they encompassed geographic, community support, and economic and resource factors. Regardless of similarities or differences between health professions in terms of recruitment and retention, as a mechanism for addressing the worsening health professional shortage currently experienced in rural areas, the PharmCAQ was developed to support the recruitment and retention of the pharmacist workforce in rural areas.


Assuntos
Farmacêuticos , Farmácia , Humanos , População Rural , Técnica Delfos , Reprodutibilidade dos Testes , Inquéritos e Questionários , Vitória
6.
PLoS One ; 17(8): e0270498, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35947546

RESUMO

Determining the acoustic ecology of extinct or rare species is challenging due to the inability to record their acoustic signals or hearing thresholds. Katydids and their relatives (Orthoptera: Ensifera) offer a model for inferring acoustic ecology of extinct and rare species, due to allometric parameters of their sound production organs. Here, the bioacoustics of the orthopteran Prophalangopsis obscura are investigated. This species is one of only eight remaining members of an ancient family with over 90 extinct species that dominated the acoustic landscape of the Jurassic. The species is known from only a single confirmed specimen-the 150-year-old holotype material housed at the London Natural History Museum. Using Laser-Doppler Vibrometry, 3D surface scanning microscopy, and known scaling relationships, it is shown that P. obscura produces a pure-tone song at a frequency of ~4.7 kHz. This frequency range is distinct but comparable to the calls of Jurassic relatives, suggesting a limitation of early acoustic signals in insects to sonic frequencies (<20 kHz). The acoustic ecology and importance of this species in understanding ensiferan evolution, is discussed.


Assuntos
Ortópteros , Acústica , Animais , Aves , Insetos , Som
8.
BMC Health Serv Res ; 21(1): 1052, 2021 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-34610827

RESUMO

BACKGROUND: Recruiting and retaining medical, nursing, and allied health professionals in rural and remote areas is a worldwide challenge, compromising continuity of care and population health outcomes in these locations. Specifically, pharmacists play an essential and accessible frontline healthcare role, and are often the first point of contact for health concerns. Despite several incentives, there remains a maldistribution and undersupply of pharmacists in rural and remote areas across many parts of the world. Although current systematic reviews have focussed on factors affecting pharmacists' retention generally, literature specifically focused on rural pharmacist workforce in a global context remains limited. The aim of this systematic review is to identify factors associated with recruitment and retention of the pharmacist workforce in rural and remote settings. Better understanding of these contributors will inform more effective interventional strategies to resolve pharmacist workforce shortages. METHODS: A systematic search of primary studies was conducted in online databases, including Medline, Embase, CINAHL, Scopus, Web of Science and PsycINFO, and by hand-searching of reference lists. Eligible studies were identified based on predefined inclusion/exclusion criteria and methodological quality criteria, utilising the Critical Appraisal Skills Programme (CASP) and Good Reporting of A Mixed Methods Study (GRAMMS) checklists. RESULTS: The final review included 13 studies, with quantitative, qualitative, or mixed methods research design. Study-specific factors associated with recruitment and retention of pharmacists in rural practice were identified and grouped into five main themes: geographic and family-related, economic and resources, scope of practice or skills development, the practice environment, and community and practice support factors. CONCLUSIONS: The results provide critical insights into the complexities of rural recruitment and retention of pharmacists and confirms the need for flexible yet multifaceted responses to overcoming rural pharmacist workforce challenges. Overall, the results provide an opportunity for rural communities and health services to better identify key strengths and challenges unique to the rural and remote pharmacist workforce that may be augmented to guide more focussed recruitment and retention endeavours.


Assuntos
Farmacêuticos , Serviços de Saúde Rural , Humanos , Motivação , População Rural , Recursos Humanos
9.
Healthcare (Basel) ; 9(9)2021 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-34575006

RESUMO

Addressing nursing shortages in rural areas remains essential, and attracting nursing graduates is one solution. However, understanding what factors are most important or prioritized among nursing students contemplating rural employment remains essential. The study sought to understand nursing student decision-making and what aspects of a rural career need to be satisfied before other factors are then considered. A cross-sectional study over three years at an Australian university was conducted. All nursing students were invited to complete a Nursing Community Apgar Questionnaire to examine their rural practice intentions. Data were analyzed using principal component analysis, and mean scores for each component were calculated and ranked. Overall, six components encompassed a total of 35 items that students felt were important to undertake rural practice after graduating. Clinical related factors were ranked the highest, followed by managerial, practical, fiscal, familial, and geographical factors. Maslow's Hierarchy of Needs provided a lens to examine nursing student decision-making and guided the development of the Rural Nursing Workforce Hierarchy of Needs model. Each element of the model grouped key factors that students considered to be important in order to undertake rural employment. In culmination, these factors provide a conceptual model of the hierarchy of needs that must be met in order to contemplate a rural career.

10.
Rural Remote Health ; 20(1): 5341, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31961700

RESUMO

INTRODUCTION: The need for family physicians in rural areas across the USA and Canada is a longstanding issue that has been well documented. Since family physicians constitute the largest population of rural practitioners, the problem has been exacerbated by a sharp decline in medical students' interest in the field of family medicine and the aging of the current rural workforce. Previous research has shown that female physicians in rural areas need strong support networks to maintain a healthy work-life balance. The purpose of this study was to better understand the types of support they need and how they find it, as well as how their needs change over time. METHODS: Twenty physicians from the same rurally focused family medicine residency were interviewed over a 3-month period using a semi-structured format. Physicians ranged in experience from 1 year out of residency to 25 years out of residency. Using a phenomenological approach, interviews were transcribed and then coded and analyzed by three members of the research team, one of them an experienced qualitative researcher, who met periodically to reflect on the process of coding. Emergent subthemes and themes were discussed by the multidisciplinary team. RESULTS: The participants discussed in detail the types of support they relied on and the continuing challenges of maintaining a healthy work-life interface. Main themes included the need to select carefully one's life partner and practice partners and the difficulties in setting up practice in an area without family, friends or professional mentors nearby. Although forming boundaries was important, so was developing close relationships with patients and their families. The one thing that sustained all of the physicians was a meaningful relationship with their patients. The doctor-patient connection is what brings joy and helps every one of them cope with the harder aspects of life in rural areas. CONCLUSION: The general consensus of respondents was that the career-life interface varies across individuals, changes over time and is always a work in progress. Rural female physicians think of their work in relational terms, and it involves a great deal of emotional labor. Support systems mitigate the psychological effects of this labor and help physicians develop resilience in managing both career and life. Educators can better prepare female physicians by discussing the costs and benefits of emotional labor and the necessity of support networks, as well as how to negotiate a contract that is consistent with one's values, practice style and family life.


Assuntos
Medicina de Família e Comunidade , Médicas/psicologia , Serviços de Saúde Rural , Equilíbrio Trabalho-Vida , Adaptação Psicológica , Adulto , Feminino , Humanos , Satisfação no Emprego , Pessoa de Meia-Idade , Relações Médico-Paciente , Pesquisa Qualitativa , Estados Unidos
11.
Int J Cancer ; 146(9): 2599-2607, 2020 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-31490545

RESUMO

The objective of our study was to assess the performance of different triage strategies for high-risk human papillomavirus (hrHPV)-positive results utilizing either extended genotyping or a p16/Ki-67 dual-stained cytology (DS) approach, with or without partial genotyping. A subset of women with hrHPV infections participating in the Addressing the Need for Advanced HPV Diagnostics (ATHENA) study were analyzed to determine the number of cervical intraepithelial neoplasia grade 3 or worse (≥CIN3) cases detected, and the absolute risk for ≥CIN3 of each genotype. A clinical utility table was constructed to compare the impact of different triage strategies. In all, 2,339 women with single-genotype hrHPV infections were identified. Among these were 171 ≥CIN3 cases. The U.S. Food and Drug Administration (FDA)-approved algorithm (HPV16/18 positive, or 12-other hrHPV positive and Pap positive, i.e., ≥ atypical squamous cells of undetermined significance) for primary HPV screening detected 132/171 (77.2%) ≥CIN3 cases and required 964 colposcopies (colposcopies per ≥CIN3 ratio: 7.3). An approach that uses DS instead of cytology in the FDA-approved algorithm detected 147/171 (86.0%) ≥CIN3 cases, requiring 1,012 colposcopies (ratio: 6.9). Utilizing DS for triage of all hrHPV-positive women identified 126/171 (73.7%) ≥CIN3 cases, requiring 640 colposcopies (ratio: 5.1). A strategy that detected HPV16/18/31/33/35+ captured 130/171 (76.0%) ≥CIN3 cases, requiring 1,025 colposcopies (ratio: 7.9). Inclusion of additional genotypes resulted in greater disease detection at the expense of higher colposcopy ratios. Substituting cytology with a DS triage approach improved disease detection and the colposcopy detection rate. Further reduction of colposcopy rates can be achieved by using DS without partial genotyping. Extended genotyping strategies can identify a comparable number of cases but requires an increased number of colposcopies.


Assuntos
Inibidor p16 de Quinase Dependente de Ciclina/metabolismo , Antígeno Ki-67/metabolismo , Programas de Rastreamento/normas , Papillomaviridae/genética , Infecções por Papillomavirus/diagnóstico , Triagem/normas , Neoplasias do Colo do Útero/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Citodiagnóstico , DNA Viral/análise , Feminino , Seguimentos , Genótipo , Humanos , Pessoa de Meia-Idade , Papillomaviridae/classificação , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/virologia , Prognóstico , Estudos Retrospectivos , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/virologia , Adulto Jovem , Displasia do Colo do Útero/diagnóstico , Displasia do Colo do Útero/epidemiologia , Displasia do Colo do Útero/virologia
12.
Biodivers Data J ; 7: e36783, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31723333

RESUMO

A study of 100 papers from five journals that make use of bioacoustic recordings shows that only a minority (21%) deposit any of the recordings in a repository, supplementary materials section or a personal website. This lack of deposition hinders re-use of the raw data by other researchers, prevents the reproduction of a project's analyses and confirmation of its findings and impedes progress within the broader bioacoustics community. We make some recommendations for researchers interested in depositing their data.

13.
J Health Organ Manag ; 33(5): 617-634, 2019 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-31483205

RESUMO

PURPOSE: Identifying and measuring personality traits assists to understanding professional career choices, however, what impact personality traits have on nursing student rural career choice remains absent. The purpose of this paper is to identify personality traits among nursing students that may be predictive of pursuing a rural career. DESIGN/METHODOLOGY/APPROACH: A cross-sectional design was used to examine the importance Bachelor of Nursing students place on undertaking rural careers. All nursing students (n=1,982) studying a three-year bachelor's degree were invited to complete a questionnaire examining personality traits and rural practice intentions. FINDINGS: Students who saw themselves working rurally after graduation had higher levels of conscientiousness than those who wanted metropolitan careers. Students with higher levels of agreeableness or open-mindedness were more likely to consider rural practice when individual community factors were carefully considered. Finally, students with higher levels of neuroticism were less likely to consider rural practice as a future career pathway. RESEARCH LIMITATIONS/IMPLICATIONS: The cohort had high numbers of student from rural and regional settings, which may limit the ability to generalise the findings. In addition, student respondents of the survey may not be representative of the whole student cohort given the low response rate. ORIGINALITY/VALUE: Key personality traits are identifying factors that contribute to nursing student decision making regarding rural practice. Students who displayed higher levels of agreeableness and conscientiousness and open-mindedness have traits that are most likely to impact the consideration of rural practice across their nursing career, which gives additional insight into targeted recruitment strategies.


Assuntos
Escolha da Profissão , Serviços de Saúde Rural , Estudantes de Enfermagem/psicologia , Adulto , Estudos Transversais , Feminino , Necessidades e Demandas de Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Personalidade , Inquéritos e Questionários , Adulto Jovem
14.
Database (Oxford) ; 20192019 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-30985890

RESUMO

The Natural History Museum, London (NHM), generates and holds some of the largest global data sets relating to the biological and geological diversity of the natural world. A majority of these data were, until 2015, not widely accessible, and, even when published, were typically hard to find, poorly documented and in formats that impede discovery and integration. To better serve the bespoke needs of user communities outside and within the NHM, a dedicated data portal was developed to surface these data sets and provide a sustainable platform to encourage their citation and reuse. This paper describes the technical development of the data portal, from its inception to beta launch in December 2015, its first 2 years of operation, and future plans for the project. It outlines the development principles adopted for this prototypical project, which subsequently informed new digital project management methodologies at the NHM. The process of developing the data portal acted as a driver to implement policies necessary to encourage a culture of data sharing at the NHM.


Assuntos
Bases de Dados Factuais , Museus , História Natural , Londres
15.
Rural Remote Health ; 18(3): 4561, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-30089214

RESUMO

INTRODUCTION: Despite existing studies in this field, community factors behind recruiting and retaining rural general practitioners (GPs) are not fully understood. To address this issue, the Community Apgar Questionnaire (CAQ) was developed to extend the understanding of communities' assets and capabilities that impact GP recruitment and retention. However, more in-depth insights are vital to develop a comprehensive approach. METHODS: This mixed methods study was administered using face-to-face structured interviews with a total of 40 health service representatives. All interviews lasted 35-40 minutes and were audio-taped. Qualitative data were generated from the extended responses to the structured questions of the CAQ and later transcribed. Thematic analysis was conducted in relation to explanations, elaborations, and relevant strategic approaches to improving workforce retention. RESULTS: The qualitative findings illuminated the most important advantages of recruiting and retaining GPs were linked to medical support, hospital and community support, and economic factors, while the challenges were related to geographic factors. The underlying reasons for and nature of those advantages and challenges reinforce that health professionals' decisions to stay or leave are complex and multifactorial. CONCLUSION: The originality of the study rests on the administration of the CAQ accompanied by the opportunity for participants to provide extended responses, which gives critical insights into the complexities of rural recruitment and retention. As such, the results confirm the need for a flexible multifaceted response to improving rural GP workforce and informs decision-making in terms of addressing workforce issues within the scope of available resources and capacity.


Assuntos
Clínicos Gerais/provisão & distribuição , Seleção de Pessoal , Serviços de Saúde Rural , Clínicos Gerais/psicologia , Humanos , Entrevistas como Assunto , Satisfação no Emprego , Satisfação Pessoal , Seleção de Pessoal/métodos , Reorganização de Recursos Humanos , Inquéritos e Questionários , Vitória
17.
Rural Remote Health ; 16(4): 3990, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27884056

RESUMO

INTRODUCTION: Rural communities continue to experience significant challenges recruiting and retaining physicians. The Community Apgar Questionnaire (CAQ) was developed in Idaho in the USA to comprehensively assess the characteristics associated with successful recruitment and retention of rural physicians. The CAQ has been utilised and validated across the USA; however, its value in rural Australia has not been examined. The objective of this study was to use the CAQ in rural Australia to examine its utility and develop a greater understanding of the community factors that impact general practitioner (GP) recruitment and retention. METHOD: The project conducted structured face-to-face interviews with hospital chief executive officers (CEOs) and directors of clinical services (DCSs) from 14 of the 21 (76%) health services that agreed to participate in rural north-eastern Victoria, Australia. The interviews were undertaken to complete the CAQ, which contains 50 questions centred on factors that influence physician recruitment and retention. Once completed, CAQs were scored by assigning quantitative values to a community's strengths and challenges including the level of importance placed on each factor. As such, the most important factors in physician recruitment, whether they are advantages or challenges for that community, were then weighed for their relative importance. Scores were then combined to create a CAQ score. To ensure reliability and validity of the results, three additional CAQs were purposefully administered to key general practices within the region. RESULTS: The 14 rural communities exhibited cumulative CAQ scores ranging from a high of 387 to a low score of 61. This suggests the tool was sensitive enough to differentiate between communities that were high and low performers in terms of physician recruitment. The groups of factors that had the greatest impact on recruitment and retention were ranked highest to lowest and included medical support, hospital/community support, economic, scope of practice and geographic factors. Overall, the highest individual factors to impact recruitment and retention were perception of quality, hospital leadership, nursing workforce and transfer arrangements. Conversely, the lowest factors and challenges to recruitment and retention were family related, specifically spousal satisfaction and access to schools. CONCLUSIONS: Hume, in rural Victoria, was the first international site to implement the CAQ to differentially diagnose a community's relative strengths and challenges in recruiting and retaining GPs, while supporting health facilities to prioritise achievable goals to improve long-term retention strategies. It provided each community with a tailored gap analysis, while confidentially sharing best practices of other health facilities. Within Hume, open communication and trust between GPs and health facility leadership and nursing staff ensures that GPs can feel valued and supported. Possible solutions for GP recruitment and retention must consider the social, employment and educational opportunities that are available for spouses and children. Participation in the program was useful as it helped health facilities ascertain how they were performing while highlighting areas for improvement.


Assuntos
Atitude do Pessoal de Saúde , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Médicos de Atenção Primária/provisão & distribuição , Atenção Primária à Saúde , Serviços de Saúde Rural , Feminino , Humanos , Masculino , Lealdade ao Trabalho , Seleção de Pessoal , Fatores Socioeconômicos , Inquéritos e Questionários , Vitória , Recursos Humanos
19.
Biodivers Data J ; (4): e7441, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26929715

RESUMO

BACKGROUND: The wasp subfamilies Amiseginae and Loboscelidiinae (Hymenoptera: Chrysididae) were last catalogued in Kimsey and Bohart (1991). The subfamilies are considered to be obligate egg parasitoids of the Phasmida (stick insects), which are known to be pests in many areas of the world (Baker 2015). Our lack of knowledge of these wasps, in particular their host associations and host specificity, prevents studies into using them as potential control agents for pest phasmids. Phasmids are popular throughout the world with people from a wide range of backgrounds, from pet keepers to professional entomologists. NEW INFORMATION: A taxonomic database of the subfamilies Amiseginae and Loboscelidiinae has been created as the Chrysididae SpeciesFile, summarising the current state of scientific knowledge about these groups. In addition, a bibliography of works on these subfamilies has been created. In total information is provided for 187 valid species.

20.
Biodivers Data J ; (3): e5792, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26379465

RESUMO

BACKGROUND: Sound collections for singing insects provide important repositories that underpin existing research (e.g. Price et al. 2007 at http://bio.acousti.ca/node/11801; Price et al. 2010) and make bioacoustic collections available for future work, including insect communication (Ordish 1992), systematics (e.g. David et al. 2003), and automated identification (Bennett et al. 2015). The BioAcoustica platform (Baker et al. 2015) is both a repository and analysis platform for bioacoustic collections: allowing collections to be available in perpetuity, and also facilitating complex analyses using the BioVeL cloud infrastructure (Vicario et al. 2011). The Global Cicada Sound Collection is a project to make recordings of the world's cicadas (Hemiptera: Cicadidae) available using open licences to maximise their potential for study and reuse. This first component of the Global Cicada Sound Collection comprises recordings made between 2006 and 2008 of Cicadidae in South Africa and Malawi. NEW INFORMATION: This collection of sounds includes 219 recordings of 133 voucher specimens, comprising 42 taxa (25 identified to species, all identified to genus) from South Africa and Malawi. The recordings have been used to underpin work on the species limits of cicadas in southern Africa, including Price et al. (2007) and Price et al. (2010). The specimens are deposited in the Albany Museum, Grahamstown, South Africa (AMGS). The harvesting of acoustic data as occurrence records by GBIF has been implemented by the Scratchpads Team at the Natural History Museum, London. This link increases the value of individual recordings and the BioAcoustica platform within the global infrastructure of biodiversity informatics by making specimen/occurence records from BioAcoustica available to a wider audience, and allowing their integration with other occurence datasets that also contribute to GBIF.

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