Web 2.0 is a term describing new collaborative Internet applications. The primary difference from the original World Wide Web is greater user participation in developing and managing content, which changes the nature and value of the information. Key elements of Web 2.0 include: Really Simple Syndication (RSS) to rapidly disseminate awareness of new information; blogs to describe new trends; wikis to share knowledge; and podcasts to make information available “on the move”. The medical community needs to be aware of these technologies and their increasing role in providing health information “any time, any place”.

BackgroundYoung Adult Males (YAMs) in rural Australia are poorly studied with respect to overweight and obesity. Firstly, we explored the feasibility of recruiting 17–25 year old YAMs to obtain baseline data on overweight and obesity rates, socio-demographics, nutrition, exercise and mobile phone usage. Secondly, we explored the views of YAMs with a waist measurement over 94 cm about using mobile phone text messages to promote weight loss and incentives to promote healthy lifestyles.MethodsA two-staged, mixed-methods approach was used to study obesity and overweight issues in Dubbo, a regional city in New South Wales, Australia. In Phase I, socio-demographic, health behaviour and mobile phone usage data were collected using a questionnaire and anthropometric data collected by direct measurement. In Phase II, YAMs’ views were explored by focus group discussion using a semi-structured questionnaire.ResultsPhase I (145 participants): mean Body Mass Index (BMI) 25.06 ± 5.01; mean waist circumference 87.4 ± 15.4 cm. In total, 39.3% were obese (12.4%) or overweight (26.9%) and 24.1% had an increased risk of metabolic complications associated with obesity. 135 (93.1%) owned a mobile phone and sent on average 17 ± 25 text messages per day and received 18 ± 24.Phase II (30 participants): YAMs acknowledged that overweight and obesity was a growing societal concern with many health related implications, but didn’t feel this was something that affected them personally at this stage of their lives. Motivation was therefore an issue. YAMs admitted that they would only be concerned about losing weight if something drastic occurred in their lives. Text messages would encourage and motivate them to adopt a healthy lifestyle if they were individually tailored. Gym memberships, not cash payments, seem to be the most favoured incentive.ConclusionThere is a clear need for an effective health promotion strategy for the almost 40% overweight or obese Dubbo YAMs. The high rate of text message usage makes it feasible to recruit YAMs for a prospective study in which personalized text messages are used to promote healthy behaviours. It may be important to target motivation specifically in any weight-related intervention in this group with incentives such as gym membership vouchers.

An AHW-led STI/BBV screening program identified a large number of asymptomatic and previously undiagnosed infections in this group of young male detainees. Such an education and screening program using skilled Aboriginal staff not affiliated with the correctional system could have a substantial impact on the prevalence of STI/BBV among juvenile detainees.

Objective: To examine the trend in unplanned readmissions (URs) to Dubbo Base Hospital (DBH) over the period 1996-2005 and assess possible correlations with basic demographic data. Results: URs increased over the study period, both as a total number and as a proportion of total admissions (from 4.7 to 5.4%), while average length of stay decreased from 5.3 to 4.4 days and available hospital beds decreased from 156 to 116. The proportion of URs for people aged 75 years has more than doubled over the same period. There were clear temporal variations in URs (greatest number occurring on Fridays and in late winter/early spring) and variations with age and gender (greatest number in young males; peaks for males in 0-10 and 71-80-year deciles and for females in 0-10, 21-30 and 71-80 year deciles). Fifty percent of URs occurred within 7 days of discharge. There was a statistically significant but small correlation between length of prior admission and time to readmission (Spearman correlation coefficient, 0.068; P < 0.01) although the time to readmission did not change over the study period. Chronic obstructive pulmonary disease (3.8%), complications of procedures (3.6%), heart failure and pneumonia (each 2.2%), angina (2.1%) and acute bronchiolitis (1.8%) were the top causes of URs. Conclusion: URs are becoming more frequent in DBH; analysis of associations and trends over time are the first step in determining targeted HOSPITAL READMISSION RATES have been increasing during the last 5 years in developed 1-3 as well as developing countries. 4 Major concerns of readmission are the cost to the health services, financial implications and emotional distress to patients and their families and perpetuating dependency behaviour among patients. Furthermore, a recent statement by the then Australian Government Minister for Health and Ageing suggests that a range of indicators including unplanned readmission rates are likely to be used to compare hospital performance into the future. 5 It has been reported that a lower quality of inpatient care increases the risk for unplanned early readmission in patients with heart failure, diabetes, or obstructive lung disease, 6 and a recent study concluded that adjusted rates of What is known about the topic? Hospital readmission rates have been reported to be rising but there is little published Australian data, and no comprehensive hospital studies. It has been suggested that unplanned readmission might relate to premature discharge and quality of care, and unplanned readmission rates have been proposed as a potential key performance indicator for comparisons between hospitals in Australia, as is already occurring overseas. What does this paper add?This paper confirms that the unplanned readmission rate to a major regional public hospital has risen over the last 10 years and that there is a small but significant negative correlation with prior length of stay. It highlights some key demographic factors that are associated with high rates of unplanned readmissions, and diseases which...

There is geographic maldistribution of physicians across Australia and their professional isolation, particularly in relation to continuing professional development, is a definite problem. It tends to be worse in smaller centres where there is no critical mass that allows for peer support. Although some academic research has been carried out concerning the needs of rural GP, none has targetted rural specialists. Several activities, including the Commonwealth-funded Support Scheme for Rural Specialists, have been well received and other initiatives, including the rural clinical schools and university departments of rural health, are beginning to provide an infrastructure that will help overcome the professional isolation through the use of innovative technologies such as interactive videoconferencing. This is being used to deliver RACP initiatives such as the basic physician trainee lecture series and the potential for vertical integration of training in rural settings which offer some promise to address the rural workforce shortage in the years to come.

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Objective: To determine temporal trends in PubMed publications for Australian authors compared with changes in funding for health and medical research (HMR). Design: Retrospective observational study. Setting: Internet‐based bibliometric study that collated Australian HMR expenditure from the Australian Institute of Health and Welfare and Australian (and other) research publications from PubMed. Main outcome measures: Australian expenditure on HMR and numbers of PubMed‐cited publications from 1980 to 2004, with subgroup analyses for universities, clinical trials, and genetic and biotechnology research, and comparison with similar results from the United Kingdom and New Zealand. Results: From 1980–81 to 2003–04, Australian HMR expenditure increased from $66 million to $1503 million and total Australian PubMed publications increased from 844 to 13 836. From 1995–96 to 2003–04, Australian publications for university‐derived research and for clinical trials increased at a fairly constant rate. Genetic and biotechnology publications increased about fivefold (49 to 277) between 1990–91 and 2003–04. Between 1990 and 2004, total publications increased from 1754 to 3288 for New Zealand and from 12 401 to 19 600 for the UK. Conclusions: There is an association between increased funding for HMR and increased publications, as determined using PubMed, in the past 10 years. Using PubMed may be a simple way to track output from HMR expenditure.

The need for consistency in assessing international medical graduates for work in Australia led the Council of Australian Governments, in 2006, to direct health ministers to implement a nationally consistent approach. An Implementation Committee was established in late 2006 to oversee the development of the new assessment process; the first steps were completed by July 2007 and further development will occur over the next 12 months. The pre‐existing Australian Medical Council (AMC) examination pathway will continue to be available, and there will be two additional pathways for non‐specialists. The pre‐existing pathway for specialists is being revised. Elements that are being introduced include: standardised pre‐employment assessment, including an off‐shore screening examination; assessment of competence against a standardised position description and, if necessary, a structured clinical interview by an AMC‐accredited provider before obtaining limited registration; orientation to the job, the Australian health care system and to communication and cultural issues; standardised supervision and supervisory reporting; a requirement for compulsory continuing professional development for reregistration; workplace‐based assessment; assessment by an AMC‐accredited provider before gaining full registration; and consistency of assessment for specialists by specialist colleges. Some elements have been operating in some jurisdictions from July 2007, and there is a commitment to full implementation in participating jurisdictions by July 2008.