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					                                                                                                     winter 2011




                               U C R Hn o r t h                                           coast
PO Box 3074 Lismore NSW 2480
www.ucrh.edu.au




in this issue ....               EDUCATION                         RESEARCH                        COMMUNITY

                               Dear Reader
                                  It gives me great pleasure to introduce this issue of our UCRH news to you. This is an expanded
                               newsletter celebrating 10 years of achievement. These achievements began with people who worked
2     New Education Leaders    very hard with government to set up the Northern Rivers University Department of Rural Health
                               (NRUDRH). Some of these need to be acknowledged including Professor John Beard, who now works
2     Student News             overseas, Liz Rummery, Malcolm Marshall and Chris Crawford, to name a few.
                                  Their foresight and energy and the battles they fought were instrumental in where we are now.
                               The NRUDRH, which recently became a part of the University Centre for Rural Health (UCRH) had
3     A 10 Year History        a small beginning and has grown substantially with active involvement from local politicians,
                               local government and our clinical colleagues. Sydney University in partnership with Southern
                               Cross University and the North Coast Area Health Service (now the Northern NSW Local Health
4     UCRH Facilities          District) provided the initial foundation group and funding from the Commonwealth enabled our
                               establishment. The UCRH now includes a more recent long stay medical education program and the
                               partner universities who join us in this program at the UCRH are the Universities of Wollongong and
5     UCRH Staff               Western Sydney.
                                  This issue contains an overview of these achievements and celebrates a decade of effort and
6     Publications, Grants     success. It reflects not only the pioneers that began this endeavour but others as well. We need
                               to acknowledge staff who have worked in the Centre subsequently, such as Dr Sue Page. Sue was
      and PHD Students         instrumental in setting the foundation for medical education in the UCRH which is now a major
                               component of our education work.
6     Educational and             My best wishes to you all for the next decade.
      Professional             Lesley
      Development events
                               Stop Press
6     Innovation for           Researchers strengthen                                as well as hotel accommodation for two visits to
      Aboriginal Employment                                                          Philadelphia.
                               collaborations
      in Health                   The UCRH chronic disease research team has         Local Health Board
                               submitted an application for a $2.5m APHCRI              Director of the University Centre for Rural
                               Centre of Research Excellence grant funded by         Health, Prof Lesley Barclay and Clinical Sub-
7     PHC RED Writers          DoHA, addressing avoidable hospitalisation            Dean, Dr Austin Curtin have been appointed
      Awards                   amongst people with chronic conditions.               to the Northern NSW Local Health District
                               In developing the application the team                Governing Board.
                               collaborated closely with new and existing            International Contribution
7     Student Research         partners including: several Local Health Districts,      Prof Lesley Barclay will deliver a plenary
                               NSW Ambulance Service, NSW Health, Southern           speech at the International Conference on Allied
8     Low Intensity Mental     Cross University, The University of Newcastle and     Health Sciences held in Malaysia in July 2011.
                               other organisations affiliated with the National
      Health Workshops         Rural Health Alliance.
                                                                                     Entitled “The role of the midwife as a key to safe
                                                                                     effective maternity care and how this role can
                               Beck award win                                        be employed in rural and remote areas of low
8     UCRH Features              Assoc Prof James Bennett-Levy has accepted          income countries”.
      International            the prestigious invitation to be a 2012 Beck                                •
      Presenters at CBT
      Training
                               Institute scholar at the Beck Institute for
                               Cognitive Behavior Therapy in Philadelphia.                                   ˜
                                                                                                      ˜ been invited to speak
                                                                                       Dr Shawn Wilson has
                                 Only five Beck Institute scholarships are           at the American Indian College Fund Research
                               awarded each year.The recipients receive free         Retreat, August 18-20, Denver, Colorado on
                               tuition and weekly supervision for six months,        indigenous research methods.


                                                                                                   www.ucrh.edu.au
Education
New Education Leaders                                After visiting the midden site at The Pass        Mental Health Speciality Days
   Introducing our new leaders for the            which is thousands of years old, the students           In conjunction with the Lismore Base
education program, Dr Ellen McGirr                met up with Uncle Pete and Debra and a               Hospital Mental Health and Drug and Alcohol
(Academic) and Assoc Prof John Graham             smoking ceremony was conducted for the               Units the UCRH hosted a two-day seminar in
(Clinical) who share the role of UCRH Deputy      group. The students then split into two groups       May - a Mental Health Extravaganza.
Director Education.                               of male and female. The males going off to
                                                                                                         The program featured mental health
   Dr Ellen McGirr joined the UCRH team in        do men’s business and the women being
                                                  taught the intricate art of traditional weaving      professors from the University of Sydney,
March this year.                                                                                       University of Western Sydney and University of
   Ellen works two days per week for the UCRH     practices. One student commented “I think
                                                  the cultural walk was a wonderful way to             Wollongong who send medical students to the
and continues in her clinical practice as a
Rheumatologist the rest of the week.              introduce these concepts, which try as we            north coast for their psychiatry rotations.
   Ellen returned to Lismore in 1984 as a         might cannot ever be accurately passed on in         OSCE Exams
VMO Consultant Rheumatologist at Lismore          the class room or lecture hall”.                        On May 20th we ran OSCE (Practical) exams
Base Hospital. Ellen has strong links with        Just what the doctor ordered                         for our Wollongong students. We used the
community practitioners across the Northern          In May Dr Jane Barker, Academic                   Southern Cross University student clinic for
Rivers and is a passionate advocate for           Coordinator at the UCRH facilitated a Wellness       this purpose. It was a relaxed but professional
local services for improving chronic care         Day for the long term medical students from          setting. It is gratifying to know that all our
management.                                       all our universities who are based Lismore,
                                                                                                       students passed their final year OSCE.
   Ellen brings to the UCRH academic              Grafton and Murwillumbah. This was in part
experience in clinical curricula, having worked   a celebration of the end of the UWS and Uni          Careers Expo
part-time at Bond University over the last four   Wollongong students’ year with UCRH, but               Grafton Student Coordination team
years in development and early establishment      also to highlight the importance of self-care        participated in a very successful ‘Careers
of the Bond medical program.                      for those working in the medical profession.         Expo’ on June 16. The day was organised by
   Ellen’s priorities at the UCRH are to          “Medicine is an exciting and dynamic                 Grafton Student Coordinator Jane Nichols with
negotiate better alignment of the different       profession which will take you to all corners        funding for the event being received from the
university programs and ensure that local         of the globe in many different roles. Medicine       UCRH.
clinician teachers are appreciated and            is also tough, demanding high standards and
                                                                                                         Information was provided on all health
supported with their teaching.                    dedication. As a profession we have a higher
                                                  rate of mood disorders, drug and alcohol use         professions. Thank you to the medical, nursing
   Assoc Prof and Sub-Dean, Dr Graham
established the first independent vascular        and suicide than do other professions” said          and physiotherapy students who assisted and
surgical service in the area in 1992. He is       Dr Barker. The day involved presentations            encouraged interested students to pursue
actively involved in the medical life of the      from Hilton Koppe - a Senior Medical Educator        careers in health.
                                                  for North Coast GP Training who lectures
community serving from 2000-2002 as Chair
                                                  nationally and internationally fostering
                                                                                                       Grafton
of the Medical Staff Council of Lismore Base
Hospital and 2010 as the Executive Medical        wellness amongst medical practitioners.              Plaster workshop
Director. He remains an active supporter of the   Jem Mills - Mental Health Academic at the               There are currently six University of
medical staff activities.                         UCRH spoke on self compassion and mind               Wollongong students busily preparing for
   Dr Graham has had a long interest in the       wellness, Peter Siefkin - a Psychiatry Registrar     exams as well as completing their integrated
area of surgical (specifically rural) workforce   at Lismore Base Hospital spoke on dealing            community placements in general practice,
and was for seven years until 2008 on the         with difficult emotional situations and Marcia       Grafton and Coffs Base Hospital Emergency
Council of the Royal Australasian College         Owen - Co-partner of Activ Living, who               Departments and hospital and community
of Surgeons representing the rural interest.      delivers workshops on the importance of body
                                                                                                       settings.
He is a Foundation Instructor and Director        awareness to develop self-care.
                                                                                                          Last week Dr Anil Thakur conducted a
of the RACS’s Early Management of Severe          Career in Medicine or Allied Health                  plaster workshop in the skills laboratory where
Trauma Course and chairs that College’s Ethics       In May the UCRH hosted its annual high
                                                                                                       students could refine their practical plaster
Committee.                                        school careers day aimed at year 12 school
   Dr Graham joined the UCRH team in 2010 as                                                           skills. The Grafton skills laboratory was recently
                                                  students from the area who had a genuine
Clinical Sub Dean for the University of Western   interest in a career in medicine or allied health.   refurbished with support from the UCRH.
Sydney. In early 2011 this appointment was        Over 60 students and careers advisors attended.
complimented with the position of Deputy          The UCRH was buzzing with small group
Director Education (Clinical) to the UCRH.        activities, eg suturing workshops, packing
                                                  pharmacy Webster packs, ECG recording,
Student News                                      spirometery and recording observations.
Lismore                                           Plateau Enrichment Program
Cultural Awareness                                   The UCRH recently supported the primary
  On lucky Friday the May 13 long stay            school Plateau Enrichment Program. This
University of Sydney and University of            program is designed to provide some
Western Sydney students attended a Cultural       extension activities for Stage 3 (Year 5 and 6)
Awareness Walk led by Delta Kaye, an              students in the Alstonville High School feeder
Aboriginal Educator from the Bundjalung at        area.
Byron Bay (Arakwal People).                          Twenty-five students from Eltham,                 Murwillumbah
                                                  Tregeagle, Teven-Tintenbar, Wollongbar, Rous           Murwillumbah campus is currently
                                                  and Alstonville primary schools attended the
                                                                                                       undertaking substantial refurbishments to its
                                                  UCRH and engaged in a day of fun activities
                                                                                                       education facilities.
                                                  around careers in hospital catering, the
                                                  NSW Ambulance Service and physiotherapy.               Changes will include a lecture theatre that
                                                  These students also had the opportunity              will seat 60 people and a Clinical Unit for Skills
                                                  to participate in some fun hands-on first            & Simulation (CUSS). Education workshops and
                                                  aid activities that were led by our medical          sessions in the new facilities are expected to
                                                  students.                                            commence at the end of July 2011.


    2
                                                                                                                           www.ucrh.edu.au
History
A Brief History                                                                 with links to a number of internationally respected centres of excellence
   The Northern Rivers University Department of Rural Health                    allied with the University of Sydney. This is a very exciting time for our
(NRUDRH) opened in mid 2002. Our first office space was a cooperative           region and I invite you to be a part of it with us.
arrangement with the Northern Rivers Area Health Service (NRAHS),                                          (Professor John Beard - Head of Department)
sharing reception and offices within the Population Health and                  What have we achieved?
Planning Unit at 31 Uralba Street. Moving to new premises was a major              Evidence of our rapid growth is illustrated by the table below
event in the establishment phase of the NRUDRH.                                 indicating student numbers and clinical placement weeks from
   Staffing the NRUDRH commenced with the secondment in March                   inception to the end of 2010.
2002 of Professor John Beard – as Head of Department. John was
                                                                                   In 2009 it became evident that the running of two parallel
Director of Population Health and Planning and continued his
                                                                                government contracts independently to manage all our education and
connection with the NRAHS as the Public Health Officer. Dr Kim
                                                                                other work was confusing and inefficient. A review of our structure was
Webber was then appointed as Director of Rural Health Programs, and
Hudson Birden as Manager of Public Health Research and Education.               undertaken in order to rationalise operations, maximise efficient use of
In November 2002 the appointment of two full-time administrative                resources and to provide clear accountability and responsibilities.
staff completed the staffing for the establishment phase. It must be               Led by the Director, and in consultation with the collaborating
acknowledged that the NRAHS Population Health and Planning unit                 universities, the health service and the Department of Health and
provided research staff Dr Geoff Morgan and Dr Megan Passey, and the            Aging, a new structure under the banner of the University Centre
CREST support staff who were also seconded to the NRUDRH.                       for Rural Health (North Coast) came into existence. The benefits of
   The following shows a snapshot of how quickly we have grown                  operating under this new structure have been evident with cohesive
and how the UCRH has established itself, as an innovative and                   programming, leadership and improved administrative efficiencies.
dynamic leader in education and research linked to expanding and                Valuable support from our key stakeholders helped us achieve our goals
strengthening health workforce.                                                 in late 2010.
   The UCRH now combines another Commonwealth program, funding                  Looking Forward - Future expansions
long-stay medical students, alongside our other students on short term             This month (July 2011) has seen the UCRH in collaboration with
placements.
                                                                                the Northern New South Wales Local Health District awarded
Our beginning – 2002-2003                                                       further funding from Health Workforce Australia to provide student
(Excerpt from 2003 autumn newsletter)                                           accommodation (20 beds) and clinical education facilities at Ballina
   Welcome to the first newsletter of the Northern Rivers University            Hospital. A refurbishment of accommodation in both Grafton and
Department of Rural Health, a Department of the University of Sydney run        Murwillumbah will provide an additional 10 beds at each site for
in collaboration with Southern Cross University. We are based in northern       student accommodation; and funding to upgrade the recently acquired
New South Wales and are funded by the Commonwealth Department of
                                                                                blood bank site at 63-65 Uralba Street Lismore into a clinical education
Health and Ageing with two main aims: to improve the recruitment and
                                                                                centre has been secured. This will include a clinical simulation lab and
retention of clinicians in rural areas, and to enhance innovative service
development, particularly in public health. Our research activities are         teaching facility incorporating student coordination and education
also supported by the Northern Rivers Area Health Service. One of our           offices and a common area for students. Further to this there is
key strategies is to support student placements within the region, and to       recurrent funding to support clinical and support staff salaries which
provide a positive experience of rural health that will encourage them          will assist in the provision of clinical supervision and teaching.
to practice in rural areas once they have graduated. This program is for           We will continue to actively explore opportunities and innovative
students of all disciplines and from all universities. Another strategy is to   collaborations across the region to build and improve on the quality
help local health services and clinicians to develop and evaluate innovative    of clinical education programs, research projects and professional
models of care, and to foster world class health research in the Northern       education we offer to improve health workforce retention and the
Rivers region. We are making great progress here and have already won a         delivery of health services to the rural and remote communities that
number of prestigious grants. The NRUDRH also provides local clinicians         rely on them.

                                        Student Placement Numbers 2002-2010




3
                                                                                                                             www.ucrh.edu.au
Facilities
UCRH Facilities                                                                    The newly built 60 seat lecture theatre was named after Liz Rummery
   The Northern Rivers University Department of Rural Health (NRUDRH)           in recognition of her efforts in securing the original Commonwealth
commenced its life sharing the facilities generously provided by the            funding that established the UDRH. These teaching facilities have
Population Health Unit within the Northern Rivers Area Health Service in        added value to professional education enabling us to offer educational
2002.Having secured Commonwealth Funding, the NRUDRH was able to                activities for health professionals across the area.
acquire its current facilities at 61 Uralba Street in 2002. Major financial        With teaching facilities and office spaces now fully functional, the
support and infrastructure assistance from the Northern Rivers Area
                                                                                major limiting factor identified, which restricted growth in clinical
Health Service, and to a lesser but equally valuable degree contributions
from the University of Sydney and Southern Cross University, enabled us         placement numbers, was the ability to accommodate students.
to achieve what we have today.
   It was with great excitement the NRUDRH staff were able to occupy
their own premises in March 2003 and operate as a stand alone
organisation. These facilities consisted of a small teaching space
(pictured below) and office space. At this stage no university owned
student accommodation was available. The health service continued
to provide support by enabling our students to utilise 19 beds of
accommodation in Crawford House.
   The photos below show the original University House facilities in Lismore.
Photos on the right show the new entrance to University House and the
interior of the 60 seat lecture theatre.




                                                                                   With continued support from the Commonwealth we were able
                                                                                to acquire additional student accommodation. In 2008 we secured 9
                                                                                Dibbs Street, a large Uniting Church Manse, and converted it into a 10
                                                                                bed bedroom facility. We also acquired 67 Uralba St which increased
                                                                                our bed numbers by four to achieve a total accommodation capacity
                                                                                of 22 beds in Lismore. The NCAHS continues to support us by making
                                                                                available the 19 beds within Crawford House and we remain grateful for
                                                                                this assistance.
                                                                                   The strategic leadership of Professor John Beard was reflected in his
                                                                                negotiations to purchase the Blood Bank site and building very early on
                                                                                in 2003. During July 2011 occupancy of this facility for clinical teaching,
                                                                                student coordination and multidisciplinary use will commence.
   The NRUDRH took a big step towards becoming fully functional,                   The UCRH currently provides accommodation for 22 students in
not only for our ever increasing student body but also in relation to           Lismore (with a further 19 through Lismore Base Hospital), nine at
the professional development of other health professionals, when the            Murwillumbah and 10 at Grafton with further funding just received to
Commonwealth provided $2.4m in funding to enable the unit to fully              accommodate another 10 students at each of the distant sites.
develop its teaching facilities and office space. For the first time we were       We are supported in the provision of accommodation by our partner
able to offer 8 beds for student accommodation in Lismore. Funding              universities with both Wollongong and Western Sydney sourcing and
also supported the refurbishment of sites at Murwillumbah and Grafton.
                                                                                funding long stay accommodation for their medical students. Further
   The new Lismore facilities were opened in 2007 and provided a 60
seat tiered lecture theatre and a separate problem based learning area          to this University of Western Sydney has purpose built accommodation
along with a substantial foyer area for larger educational workshops            close to the Lismore hospital precinct which will facilitate 20 long stay
and training activities. An additional six office spaces were provided          medical students; this will help alleviate the shortage of appropriate
downstairs and a small internet café style space for student use.               accommodation to support growth in clinical placements in Lismore.

    4
                                                                                                                                  www.ucrh.edu.au
Staffing
UCRH Staff
   Over the years, as funding has increased either through successful grant applications or additional rural government program funding, the need
for additional staff at the UCRH has grown.
   The initial staffing profile of the NRUDRH consisted of five staff in academic and administrative roles.
   The UCRH currently has 66 staff and a number of casual tutors employed in conjunction with its collaborating partners. Forty four of these staff
are academic or clinical education staff and 22 are administrative staff.
   In addition we have contractual relationships with 25 General Practices and four Aboriginal Medical Services who provide excellent supervision
and clinical environments for our students, as do supervisory and clinical staff and units within the Health Services’ hospital and community sites.
We also receive continued support at the community level from a number of Allied Health and Pharmacy professionals without whom we could
not operate so successfully.
   The following tables reflect the current staffing profile by funding source, classification and function:




  Our major challenge is staffing iniatitives and continuing our grant success or Commonwealth or State funds that provide salaries for staff. For
example our Commonwealth PHCRED funding will cease at the end of this year. Our capacity to attract and retain excellent staff is extraordinary
given the liabilities of contract based funding. We are trying to ensure, where this is valuable, that our teaching and research staff undertake joint
appointments. This enables them to keep clinical and professional skills at high levels and to make a contribution to services.

5
                                                                                                                           www.ucrh.edu.au
Research
Publications; Grants and                            Excellence Committee. All are actively involved    Building an Aboriginal and Torres Strait
                                                    within the research stream teams.                  Islander Mental Health Toolkit Through
PhD students                                          In 2010 the UCRH received $522,603 from          Action Research and Formal Training in
   The NRUDRH initially attracted three grants      research grants. Further funding of $440,000       CBT
after only a year’s operation which bode well       was received to support Pharmacy, Primary             This project aims to develop a therapeutic
for the future of the rural health research,        Health Care Research Education Development         toolkit that will improve outcomes for
a priority for the Department. These were           and Australian Rural Health Research
awarded by ARC, NSW Health infrastructure                                                              Aboriginal and Torres Strait peoples
                                                    Collaboration programs.                            undergoing counselling. The process has
and the Commonwealth Department of Health
and Ageing.                                         Educational and                                    provided an evidence-based opinion about
                                                                                                       the suitability of CBT (Cognitive Behavioural
   One was an Australian Research Council           Professional Development                           Therapy) Mental Health Program for Aboriginal
funded project for almost $500,000 over a
three-year period to investigate links between      events                                             and/or Torres Strait Islander clients. The
the environment and health using advanced              Initially the NRUDRH provided a facility for    toolkit will start with CBT as CBT has a strong
techniques in spatial epidemiology. Dr Geoff        NRAHS Grand rounds to meet weekly and the          evidence base for its effectiveness with non-
Morgan and Professor John Beard worked              University of Sydney Medical School video          Aboriginal Australians. The therapeutic toolkit
with investigators from the University of           conferenced weekly lectures for students on        is being developed by five qualified and
Adelaide and industry partners including the        placements.                                        experienced Aboriginal and/or Torres Strait
                                                       One of the results that has been particularly   Islander counsellors. The counsellors have been
Commonwealth and NSW Departments of
                                                    pleasing with the expansion of the UCRH            provided with ten days of formal training in
Health and the Northern Rivers Area Health
                                                    facilities has been our ability to facilitate      CBT, delivered in three blocks from September
Service. A second grant was a Commonwealth
                                                    an expanding number of education and
funded investigation into rural general                                                                2010 to March 2011. They are incorporating
                                                    professional development events to support
practice which was led by Dr Kim Webber.            rural clinicians from all health disciplines.      aspects of their learning into their existing
As recognition of this early research success       This can be evidenced by the number of             counselling practice and gauging its
we were successful in receiving NSW Health          events and total participants who have             effectiveness and suitability with their clients.
Infrastructure support with colleagues in           made use of our facilities. During 2010 the        As part of the action research process, the
Broken Hill, Moree and Orange. This funding         Lismore, Murwillumbah and Grafton sites in         counsellors were brought together at regular
established the Australian Rural Health             collaboration with various external parties        intervals for focus group discussions around
Research Collaboration (ARHRC) and this             provided 11,220 hours of training and support      the suitability of the CBT techniques with
collaboration is still current with funding being   for students, rural health professionals and       Aboriginal and/or Torres Strait Islander clients.
reallocated again in 2010.                          communities either by leading workshops or         Indigenous Literacy program - Stepping
   Over the period 2003-2011 UCRH                   providing the facilities to enable the training    Stones to Nursing
researchers have undertaken significant roles       to be undertaken. Video conferencing and              This was a pre-nursing course run by UCRH
in 10 ARC funded grants and six NHMRC               other technologies have allowed us to support      staff during 2007. The course was designed
funded grants. Our participation in these           and reach a much expanded audience and             to prepare students with the necessary
grants has either been as the administrating        has allowed us to provide educational
                                                                                                       knowledge and skills to gain entry to a
institution or with roles of Chief Investigator     opportunities for the more rural and remote
                                                                                                       nursing course at TAFE. The course was set
(CI). Currently our staff lead or participate as    members of health workforce.
                                                       All visiting academics are given the            out in three broad areas: communication skills;
CIs in five Category 1 grants. We have current
                                                    opportunity to deliver a lecture or workshop       Aboriginal studies; and calculations in nursing
funding applications in with NHMRC, ARC and
APHCRI.                                             based on their specialty or discipline. These      practice. Students completed exercises that
   Our current research efforts now operate         lectures or workshops along with those             required comprehension of concepts, and use
under five streams of research:                     offered via the Primary Health Care – Research     of problem solving skills relevant to various
  •	 Environmental Health                           Education and Development (PHD-RED)                nursing situations. The course was constructed
  •	 Mental Health                                  program are widely promoted and open to            in user-friendly language to encourage
  •	 Child and Maternal Health                      anyone interested in participating.                frequent interaction by students. Ninety
  •	 Chronic Disease                                   In addition, on a bi-annual basis the UCRH,     percent of the students successfully completed
  •	 Aboriginal Health                              mostly through its Murwillumbah site,              the course.
                                                    has organised successful conferences that          Walking through Research
   In 2010 UCRH researchers generated:              target aspects of clinical training particularly      Walking through Research is an introductory
  •	 34 articles published, 33 of which were        pertinent for local clinicians and health          research training course aimed at Aboriginal
     peer reviewed publications                     workers.                                           and Torres Strait Islander community based
  •	 4 book chapters and reports
  •	 2 edited books                                 Innovation for Aboriginal                          research assistants. It “walks” participants
                                                                                                       through an overview of research using
  •	 5 key note addresses                           Employment in Health                               Indigenous knowledge in a culturally safe
  •	 5 staff invited to speak at both                 The following programs highlight some of         learning environment. This course has been
     international and national conferences and     the innovative activities we have successfully     run successfully for several years and was last
  •	 11 conferences presentations published in      run over past years:
     proceedings.                                                                                      conducted as a week-long residential at Sydney
                                                    Career Link Pharmacy Program                       University with 7 participants from NSW, WA,
   The output described above is evidence of           This innovative project, a collaboration of     NT and Qld in September of 2010.
the success of our research program locally,        the UCRH, NSW Department of Education
nationally and internationally. In this year        and Training, North Coast Institute of TAFE
                                                                                                       Indigenous Support Program
we are participating with Canadian scholars         and Connect, commenced 13 Aboriginal Year             During 2009 the UCRH introduced a
in rural health research. In addition the           10 and 11 secondary students in a Pharmacy         program to support indigenous trainees;
rationalisation of our program into the above       assistant traineeship employment placements        to provide a supportive environment for
streams has allowed us to coordinate and more       in early 2010. The program offers the students     developing administrative skills while at the
effectively supervise PhD students, who now         the opportunity to complete Certificate II in      same time formally completing certificate level
number 16. Thirteen of these students have          Pharmacy whilst also completing their Higher       coursework through TAFE.
their primary supervisors from within the UCRH      School Certificate. These students will then          This program has been successful with two
whilst a further three staff are supported in       have the opportunity to use their qualification    trainees completing their units of study at
their candidature. Three PhD students are on        in a community pharmacy or to continue on to       certificate level. One of the trainees has now
NHMRC scholarships with another supported           further studies in Pharmacy. Ten of the 13 have    been appointed as a staff member of the
full time by scholarship by the Clinical            completed 18 months of the program.                UCRH.

    6
                                                                                                                           www.ucrh.edu.au
Research
PHC RED writer’s awards                                                               Judy’s project,     groups of four, targeting disparity and its
   This month, five writer’s awards were                                           ‘Complementary         impact on health status. Early experience with
announced as part of the UCRH Primary Health                                       therapies in           these projects has shown that such research,
Care Research, Evaluation and Development                                          primary health         while necessarily being modest in scope
(PHC RED) program, which is funded by the                                          care: A pilot          and abbreviated in time, can still produce
Commonwealth Government Department of                                              scoping study’,        worthwhile results.
Health and Ageing. These grants are to assist                                      investigates               One project undertaken by a UoW student
people writing for peer reviewed publication                                       the uptake of          reviewed the performance of the NCAHS
on topics related to primary health care                                           complementary          flu clinics set up during the pandemic of
research and/or evaluation.                                                        therapies in           2009. Results of this project are now in press
                                                                                   mainstream             with the NSW Health Bulletin. Another UoW
   Congratulations to Dr Jo Longman, Sagun
                                                    primary health care. Despite extensive                project examined whether the Medicare
Pyakurel, Dr Judy Singer, Malinda Steenkamp
                                                    research into the prevalence of                       Item 709 “healthy kids check” was considered
and Dr Shawn Wilson.                                complementary therapies in general
   And congratulations to two awardees from                                                               useful by local GPs, finding that it was not. A
                                                    practice, there is minimal research exploring         survey of patients at GP practices that teach
last year whose papers have been published:         complementary therapies in other primary
   Liz Rix: Schutze H, Rix EF, Laws R, Passey M,                                                          medical students through parallel consulting
                                                    health care settings. This study forms stage          is identifying such patients’ comfort levels with
Fanaian M, Harris MF. How feasible are lifestyle    one of a project to create a practical guide
modification programs for disease prevention                                                              having a student present.
                                                    for organisations who have implemented, or                A group project undertaken by the first
in general practice? Australian Journal of          are intending to implement, complementary
Primary Care. In press.                                                                                   cohort of UWS students evaluated sources of
                                                    therapies programs as part of their service           information that local parents rely on in their
   Judy Singer: Singer J, Adams J. The place        delivery.
of Complementary Therapies in an integrated                                                               decision on whether or not to immunise their
model of refugee health care: counsellors’          Student Research                                      children. They found that doctors were the
and refugee clients’ perspectives. Journal of          As part of the requirement of their                most used and most useful source of such
Refugee Studies. 2011;24(2):351-75.                 placement at UCRH, medical students from              information. Another UWS project sought
                                                    the University of Western Sydney (UWS) and            to determine whether regional residents
New RDP clinician                                   University of Wollongong (UoW) Schools                aged 45-53 were aware of the Medicare Item
  Dr Judy Singer is our new Research                of medicine must design and carry out a               717 free health check-up available to them.
Development Clinician (RDP). This program           research project. UoW students are required           Students surveyed 102 locals, and found that
supports a clinician while they conduct a           to formulate a project that has a population          the vast majority (84%) were unaware of it, but
primary health research project, mentored by        health focus and work individually, while             having learned of it through the survey, 85%
senior researchers.                                 UWS students undertake their projects in              of these were now interested in getting it.

1+1= A Healthy Start to Life (NHMRC: 422503)
   The 1+1 = A Healthy Start to Life Project:        completed; interventions are in train and the          Minister’s Science, Engineering and Innovation
Targeting the year before and the year after         evaluation is underway. A cost study protocol          Council. Recently 5 papers were presented at
birth in Aboriginal children in remote areas         for the Midwifery Group Practice (MGP) has             the International Confederation of Midwives
is a three stage baseline, intervention and          been developed and data collection for this is         (ICM) 29th Triennial Congress in Durban, South
post-intervention study designed to improve          progressing.                                           Africa on 19 - 23 June.
maternal and infant health for remote dwelling          An Honours student has graduated and two                This year and next year our work is around
Aboriginal families in Maningrida and Wadeye.        PhD students are on track to complete around           evaluation and we are accelerating our
This study is funded by the National Health          the end of this year. Another PhD student has          reporting through publications. We will also
and Medical Research Council (NHMRC),                enrolled to conduct the evaluation of MGP and          revisit a sample of remote clinic data to see
the Northern Territory (NT) Research and             is expecting to finish in 2012.                        if there is a difference from 2007/8 when
Innovation Board and the Helen and Bori                 We have now published two book chapters,            the baseline data was collected. We will also
Liberman Family.                                     five peer-reviewed articles and more are under         undertake a comparison of current care
   Baseline maternal infant health data;             review and in train. We have presented our             (practice) with protocols to see if this has
ethnographic data collection and analysis            work in 20 different international and national        improved and continue reporting data through
on infant health study in Community 2 are            conferences and completed a report for Prime           our NT networks and publications.

Breastfeeding:                                      by their own breastfeeding experiences. Lesley       recently published paper (Parker et al. Environ
                                                    proposed that the professional role is subtle,       Health Perspect 2011(119):1023–1028) or
Communicating Research
                                                    watchful monitoring in the background that           contact Geoff Morgan at the UCRH.
   Professor Lesley Barclay travelled around
                                                    enhances confidence and reinforces developing        Satellites track bushfires and dust storms
Australia in March 2011 as a speaker for the
                                                    capacity.                                              Extreme air pollution events due to bushfire
Australian Breastfeeding Association (ABA).
   There were four speakers, two of whom were       International study on birth weight and air smoke and dust storms are expected to
international speakers from the US and UNICEF,      pollution                                   increase as a consequence of climate change,
Dr Alison Steube and Dr David Clark. Lesley was        The UCRH is participating in an International     yet research into the health impacts of such
joined by local colleague Dr Foteini Hassiotou      Collaboration on Air Pollution and Pregnancy         exposures is limited by the availability of
who works in Perth on the physiology of infant      Outcomes (ICAPPO) to understand how                  accurate exposure data. A recent paper in
feeding. There were hundreds of dedicated           differences in research methods contribute to        collaboration with the UCRH retrospectively
breastfeeding counsellors, lactation consultants,   variations in findings about the effects of air      identified the cause of extreme air pollution
midwives and physicians in the audiences that       pollution on birth weight. The ICAPPO study          events using a range of information sources
ranged from Hobart, Melbourne, Canberra to          includes 14 research groups (including UCRH)         and found satellite imagery to be the most
Brisbane.                                           from nine different countries. Despite using         useful tool for identifying bushfire and dust air
   Lesley spoke about the increasing                common methodology, differences in results           pollution events. The results of this study will
professionalization of breastfeeding and rigid      between cities persisted, with six research          support a multicentre analysis of the health
implementation of rules and how this appears        groups reporting statistically significant adverse   effects of vegetation fire smoke and dust
to be undermining breastfeeding mothers.            associations (including UCRH’s Sydney analysis).     pollution in Australia. For more information
   Recent research and thinking suggests            A more detailed meta-analysis is underway and        see recently published paper (Johnston et al. J
mothers should find their way gently; guided        this may uncover reasons for the differences         Air Waste Manage Assoc 2011(61):390–398) or
by the baby and supported by women skilled          across locations. For more information see           contact Geoff Morgan at the UCRH.

7
                                                                                                                              www.ucrh.edu.au
UCRH
                                                                             north coast

Lismore Campus      Phone 02 6620 7570 Fax 02 6620 7270
Murwillumbah Campus Phone 02 6672 0290 Fax 02 6672 0295
Grafton Campus      Phone 02 6640 2482 Fax 02 6640 2499

                                Wednesday afternoon seminars (4th Wednesday, 3.45 - 4.45pm)



Ur tCcR sH research seminars
n o h o a t Series – Aug-Nov 2011
        Date                             Presenter                                           Topic
24th August           Assoc Prof Geoff Morgan                            Understanding frequent hospitalisations of
4-5 pm                Director of Research UCRH, Northern NSW LHD        older people with chronic disease

28th September        Dr Jenn Johnston                                   Preliminary findings from a double blind,
4-5 pm                Trial Coordinator, Central Clinical School,        randomised control trial of lithium carbonate
                      University of Sydney                               for the management of cannabis withdrawal
23rd November         Professor Iain Graham                              Revisiting Florence Nightingale and her vision
4-5 pm                Head of School, Health and Human Sciences,         for patient-centred care
                      Southern Cross University

 WHERE: UCRH 61 Uralba Street, Lismore.
 Presentations are video-conferenced free to Ballina, Broken Hill, Casino, Coffs Harbour, Grafton,                                 A collaboration of the University
                                                                                                                                   of Sydney, University of Western
 Maclean, Moree, Murwillumbah, Port Macquarie & Tweed Heads.                                                                       Sydney, University of Wollongong
                                                                                                                                   and Southern Cross University
 This seminar series is supported by the UCRH PHCRED program, which is funded by the Australian                                    supported by the Australian
 Government Department of Health and Ageing.                                                                                       Government Department of Health
                                                                                                                                   and Ageing and the North Coast
 Contact: Aimmee or Deborah on 66 207 570 or Deborah.Donoghue@ucrh.edu.au                                                          Area Health Service




Low Intensity Mental Health                             local community, to fellow health professionals       the UK, Marjon Nadort, a top schema therapy
                                                        and to State and Federal governments,. This           researcher/trainer from Holland, and Dr Ann
Interventions workshop                                  involvement has included:
   The UCRH was recently bowled over by the                                                                   Hackmann, one of the UK’s most celebrated
massive local interest in a workshop promoting          •	 Being commissioned by beyondblue to                CBT clinician/researchers.
Low Intensity Mental Health Interventions. The          undertake the first Australian low intensity             The Lighthouse Week (August 15-19) with
workshop in March 2011 was originally set to            feasibility study, and designing and convening        Ann Hackmann and James Bennett-Levy will
be held in the UCRH lecture theatre but quickly         national beyondblue workshops
                                                                                                              introduce work from their new book, The
had to be moved to a much larger venue when             •	 Numerous presentations at conferences
                                                        for GPs, psychologists and other health               Oxford Guide to Imagery in Cognitive Therapy,
more than three times the expected numbers
                                                        professionals nationally and internationally          promising to be a highlight.
of participants registered to attend. In the end
ninety people from a wide variety of mental             •	 Lead editing the ‘ Oxford Guide to Low             New Book by James Bennett-Levy
health organisations all over our region flowed         Intensity CBT Interventions’                             James’ long awaited book, The Oxford Guide
into the Lismore Workers Club to hear experts           •	 Successful grant applications to research          to Imagery in Cognitive Therapy, has just been
Assoc Prof Nick Titov, Assoc Prof Tricia Nagel,         low intensity interventions
                                                                                                              published.
and Dr Dan Ewald present alongside our own                 The ‘Mental Health Made Easy’ workshop                Co-written with Ann Hackmann and Emily
Assoc Prof James Bennett-Levy and Mental                in March 2011 was not only well attended,
                                                                                                              Holmes of the Department of Psychiatry,
Health Academic Jem Mills. The day was                  participants also highly regarded its value. The
expertly facilitated by Kath Fisher with help           success of the workshop paves the way for             Oxford University, it is a radical book which
from UCRH’s Dr Shawn Wilson.                            the UCRH to continue efforts to work with key         establishes imagery interventions as a new
   The crowd heard how Low Intensity Mental             partners such as the Northern Rivers General          frontier for evidence-based therapies.
Health Interventions promise to radically               Practice Network to bring this valuable                  In his foreword, A T Beck, the founder of
increase access in our rural communities to             resource to our region, for the benefit of            cognitive therapy,
evidence based, effective methods for dealing           thousands of people experiencing depression           describes the text
with common mental health problems such                 and anxiety.                                          as a “timely and
as mild to moderate depression and anxiety.
The prime method of delivery is ‘guided self-           UCRH Features International                           essential guide
help’ with assistance from a psychological              Presenters at CBT Training                            to understanding
support worker using internet based programs               This year, CBT training at the UCRH                the important
or books. The interventions can be delivered            continues to prove extremely popular.                 concepts and
remotely by phone, email or SMS. Since the              The June 2011 workshop of the popular                 ideas in the field
therapeutic expertise is in the materials               introductory program Essential Skills for CBT         of imagery”.
themselves a lower level of therapeutic                 was full six weeks in advance, so an extra               The book is due
expertise is required than for traditional one to       unscheduled workshop has been added for
                                                                                                              to be launched
one therapy.                                            September 12-15, 2011.
   The University Centre for Rural Health and              Also, this year, we have brought top               after Ann and
Northern Rivers General Practice Network have           international trainers to the North Coast,            James’ workshop
been actively working for the past three years          Professor David Richards, who has led the             on Imagery in
to promote low intensity interventions to the           introduction of low intensity CBT services in         Byron Bay on August 16, 2011.

    8
                                                                                                                                www.ucrh.edu.au

				
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