Australian health review : a publication of the Australian Hospital Association
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Only a small proportion of the treatment of mental illness occurs in an institution or hospital. By far the most significant treatment happens in the community and in the patient's own social and family environment. However, de-institutionalisation of mental health services has brought increasing numbers of patients to the emergency department in need of psychiatric assistance. ⋯ The literature review identified numerous psychiatric service models in place but dramatically highlighted the lack of a specific service model addressing psychiatric patients who present on multiple occasions [multi-presenters] in emergency departments. At present, accurate data on the effects of multi-presentation of psychiatric disorders are not available. Recent international and local research into models of service delivery management and best practice is examined.
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This paper, which is based on the preliminary findings of the Australian Midwifery Action Project (AMAP), outlines the issues around the midwifery labour force and education in Australia. One of the most alarming features is the lack of comprehensive data on midwives. ⋯ It is difficult to form a national picture with published sources of data because there are differences in definition and a lack of relevant information. Strategies for educational reform are discussed in relation to improving the supply and preparation of midwives.
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The Australian Medical Workforce Advisory Committee (AMWAC) was established by the Australian Health Ministers' Advisory Council (AHMAC) in 1995 to provide information and analysis to AHMAC and the profession about the medical workforce to inform the policy process. This article provides a brief history of the events leading to the formation of AMWAC and of the work of this committee, particularly its approach to medical workforce planning and the outcomes of some of its research. The paper concludes that the forces leading to and maintaining workforce geographic and structural maldistribution are better understood as a result of AMWAC studies and the work of other stakeholders. Further research is required to improve understanding of the hospital medical workforce and the factors influencing the career decisions of young doctors and to monitor the impact of strategies to improve workforce distribution.
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Laparoscopic surgery continues to evolve and to offer major potential for achieving benefits to patients and to health care providers because of decreased morbidity. Laparoscopic cholecystectomy has diffused rapidly and widely. However, the spread of other minimal access surgery methods has been more gradual, reflecting uncertainties as to the degree of benefit and rate of change of technology. Firm evidence of efficacy and costs of the new methods is still limited, and a number of organisational issues continue to demand attention.
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Research on stress experienced by staff in critical care units has predominantly focused on the nurses; however, a small number of investigations have centred on intensivist neonatologists and paediatricians. Australian studies which have highlighted the major stressors encountered by critical care staff are reviewed. Research is reported which suggests that job satisfaction is diminished for staff working within highly stressful critical care units. Implications are discussed in order to focus attention upon the effects of high dependency stressful work environments.