Susan Heaney

Objective: To provide the first national analysis of the distribution and professional composition of PhD‐qualified health professionals across metropolitan, regional, rural and remote Australia. Design: Cross‐sectional analysis of 2021 Australian Census data. Setting: Australia, classified by Modified Monash Model (MM) remoteness categories. Participants: Health professionals reporting a doctoral‐level qualification (PhD). Main Outcome Measures: Counts and proportions of PhD‐qualified health professionals by MM category and occupation group; association between remoteness and PhD representation. Methods: Occupations were grouped into medicine, allied health, and nursing. Residential locations were mapped to MM categories. Descriptive statistics and linear regression examined distribution patterns. Results: Of 21 510 PhD‐qualified health professionals, 85% lived in metropolitan areas (MM1), with 3027 (14%) in regional, rural and remote communities and only 12 (< 1%) in very remote areas (MM7). Medical practitioners comprised 61%, allied health 36% (predominantly psychology) and nursing 3%. Increasing remoteness was associated with reduced PhD representation ( β = −0.0041, p = 0.011). Conclusions: Research capacity is concentrated in metropolitan areas, yet a substantial base of PhD‐qualified professionals exists in RRR communities. Targeted investment in funding, infrastructure and support could leverage this workforce to build sustainable rural health research capacity.

To explore allied health students' perspectives on rural immersion placements facilitated by the University of Newcastle Department of Rural Health (UONDRH), and how these experiences influence learning quality and rural career intent. Four rural UONDRH sites across New South Wales, Australia, where students undertook extended placements ranging from 12 weeks to a full academic year. Sixty final-year allied health students from nutrition and dietetics, occupational therapy, medical radiation sciences, physiotherapy, and speech pathology programs. A qualitative study using semi-structured interviews was conducted post-placement. Data were analysed using qualitative content analysis, supported by field notes and student co-analysis to enhance rigour and authenticity. Four themes emerged: (1) Focusing inwards-students initially prioritised their own needs; (2) Focusing nearby-support networks and interprofessional learning enriched the experience; (3) Focusing outward-community engagement fostered critical reflection and cultural awareness; (4) Focusing forward-considered their career intent, but now with a knowledge of rural health care context. The extended duration of placements enabled deeper immersion, reflective practice, and a broadened understanding of rural health contexts. Rural immersion placements offer transformative learning experiences that foster clinical competence, interprofessional collaboration, and rural career interest. Addressing structural barriers and enhancing rural job opportunities are essential to harnessing this intent and strengthening the rural allied health workforce.

Background: Management of diabetes in pregnancy requires input from multiple health professionals throughout the course of an individual's pregnancy. Implementing healthcare delivery that suits the local context of a metropolitan or rural region may contribute to improvements in care delivery and pregnancy and birthing outcomes. Aims: To compare healthcare delivery for people with diabetes in pregnancy in metropolitan and rural areas of Australia. Materials and Methods: A cross‐sectional survey was conducted, with questions focused on healthcare delivery for women with diabetes in pregnancy, including the multidisciplinary care provided. Data were collected via a nationwide survey of health professionals currently involved in the healthcare management of people with diabetes in pregnancy in Australia. Survey data were analysed using descriptive and inferential statistics. Results: The main aspects of healthcare delivery were similar between metropolitan and rural respondents. The proportion of health professionals offering face‐to‐face services was greater in rural areas ( n = 38, 100%) compared to metropolitan ( n = 34, 71%). Rural respondents (21%) reported they were collocated with an endocrinologist and 48% with an obstetrician. This was compared to 71% of metropolitan respondents reporting being collocated with an endocrinologist, and 63% with an obstetrician. Conclusions: This research offers direction as to potential considerations when planning and implementing models of care in rural areas. Additional research confirming the priorities within the rural context is needed to support the development of optimal care delivery for pregnant people with diabetes living in rural regions.

Objective: To explore allied health students' perspectives on rural immersion placements facilitated by the University of Newcastle Department of Rural Health (UONDRH), and how these experiences influence learning quality and rural career intent. Setting: Four rural UONDRH sites across New South Wales, Australia, where students undertook extended placements ranging from 12 weeks to a full academic year. Participants: Sixty final‐year allied health students from nutrition and dietetics, occupational therapy, medical radiation sciences, physiotherapy, and speech pathology programs. Design: A qualitative study using semi‐structured interviews was conducted post‐placement. Data were analysed using qualitative content analysis, supported by field notes and student co‐analysis to enhance rigour and authenticity. Results: Four themes emerged: (1) Focusing inwards—students initially prioritised their own needs; (2) Focusing nearby—support networks and interprofessional learning enriched the experience; (3) Focusing outward—community engagement fostered critical reflection and cultural awareness; (4) Focusing forward—considered their career intent, but now with a knowledge of rural health care context. The extended duration of placements enabled deeper immersion, reflective practice, and a broadened understanding of rural health contexts. Conclusion: Rural immersion placements offer transformative learning experiences that foster clinical competence, interprofessional collaboration, and rural career interest. Addressing structural barriers and enhancing rural job opportunities are essential to harnessing this intent and strengthening the rural allied health workforce.

Aim: To explore the qualitative literature regarding the experiences of survivors of critical illness re‐engaging in activities of daily living. Design: Qualitative systematic review. Methods: Databases were searched with three broad categories of search terms: (1) critical illness, (2) activities of daily living, and (3) participant experiences. Articles were included if they reported qualitative data on the experiences of adults who were re‐engaging with activities of daily living after admission to an intensive care unit. The findings from these studies were thematically analysed. Data Sources: A search of Medline, Embase, CINAHL, PsycINFO and AMED was conducted on the 9th September 2024. Results: After removing duplicates, the literature search identified 6267 articles. The full texts of 120 articles were reviewed, and 44 were included for data extraction. Thematic analysis identified three themes: (1) loss of autonomy, (2) striving to reclaim independence, and (3) shifting familial dynamics and imposing a burden. Conclusion: Survivors of critical illness face significant challenges when re‐engaging with daily activities. The effort to regain autonomy often leads to feelings of helplessness and a reluctance to engage in both daily tasks and social activities. The emotional burden of dependence and the perception of being a burden further complicate their recovery. Implications for the Profession: Health services should focus on integrating physical rehabilitation, mealtime support, and cognitive and psychological therapy to effectively cater to the diverse needs of critical illness survivors and their families. Impact: This review highlights the complex challenges of re‐engaging in activities of daily living after critical illness and emphasises the need for multidisciplinary rehabilitation to improve physical, cognitive, and emotional recovery. Reporting Method: Reporting of this review followed the ENTREQ checklist, in accordance with EQUATOR guidelines. Patient or Public Contribution: No Patient or Public Contribution.

Background: Rural Australians experience poorer health outcomes due to complex intersecting factors. Addressing these challenges requires skilled researchers embedded in rural communities. However, the distribution, work patterns, and demographics of PhD-qualified professionals in rural Australia remains largely unknown. Objective: To examine the distribution of Australian PhD-qualified workforce across levels of remoteness to identify the current state of rural/urban research workforce distribution and characteristics. Methods: Using 2021 Australian Census data, we analysed individuals whose highest qualification was a doctoral degree (PhD), excluding professional doctorates. Data were examined by Modified Monash Model (MM) levels of remoteness and included variable such as location, sex, age, industry, sector (private/public), income, and weekly hours worked. Results: 85% of PhD-qualified persons were based in cities (MM1) with decreasing representation across more remote MM levels. While the public sector (including universities) was the overall dominant employer, its presence decreased with remoteness, with the private sector becoming predominant medium rural towns onwards (MM4-7). The workforce was male dominated in more urbanised areas (MM1-3), reached gender parity at small rural towns (MM5), and became female dominated remote areas (MM6-7). Rural PhD holders (MM3-5) tended to be older than urban (MM1) and remote (MM6-7) counterparts. Income tended to decrease with remoteness, and hours skewed toward part-time or excessive workloads. Conclusions: Improving rural health outcomes may require greater investment in the PhD-qualified workforce in rural and remote places. This includes addressing precarious employment conditions, lower income, and underrepresentation in the public sector.

Objective: The aim of this study was to describe the antenatal healthcare service delivery experienced by Australians with previous diabetes in pregnancy and to compare across regional, rural and metropolitan areas. Methods: An email invitation with an online survey was sent to potentially eligible individuals on the National Diabetes Services Scheme email list. Individuals over the age of 18 who had experienced diabetes in pregnancy in the previous 2 years, who received their care in Australia and were not currently pregnant were eligible. Design: Cross‐sectional survey. Setting: Australia‐wide. Participants: People with experience of diabetes in pregnancy in Australia within 2 years at the time of survey completion. Main Outcome Measures: Demographic, pregnancy and diabetes‐related data, frequency and location of contact with key health professionals, distance travelled for care and satisfaction with care delivery. Results: A total of 668 respondents completed the survey ( n = 489 metropolitan, n = 74 regional, n = 101 rural). Those in rural Australia were less likely to see an endocrinologist during their pregnancy compared to metropolitan (34.8% rural, 53.2% metropolitan). There was a statistically significant difference in overall care satisfaction between metropolitan and rural respondents, with rural respondents less likely to be ‘very satisfied’ with their care compared to metropolitan ( p = 0.011). Conclusion: Understanding the differences in antenatal care delivery from the perspectives of those with diabetes in pregnancy can assist in the planning and delivery of optimal antenatal healthcare in rural areas. Further research is required to explore the specific elements of care that rural women would like changed to improve their overall experience.

Nutritionists and dietitians are the leading nutrition experts, increasingly leveraging social media to share nutrition and health information. While nutritionists and dietitians share role similarities, differences in qualifications, regulatory frameworks, and scope of practice remain. This study aimed to assess and analyse the professional and ethical use of Instagram by Australian nutritionists and dietitians. Using a cross-sectional approach, 500 Instagram posts by nutritionists and dietitians were assessed using a modified Social Media Evaluation Checklist. The criteria included categories of financial disclosure, cultural awareness, evidence-based information, transparency, privacy/confidentiality, professionalism, and justifiability. Descriptive data analysis was conducted, and scores were reported in both frequencies (n) and percentages (%). Both nutritionists and dietitians primarily shared content related to diet information and service promotion on Instagram. Scores suggest good professional and ethical demonstration in areas such as cultural awareness, balanced and accurate information, adherence to scope of practice, and transparent imagery. However, inconsistencies were noted with financial disclosure, transparent advertising, referencing sources, accessible language, and safeguarding patient identity. While nutritionists and dietitians demonstrated adherence to professional and ethical practices in certain areas, not all standards were fully met. With the growing usage of social media by nutritionists and dietitians for service promotion, there is a need for clear regulations and updated guidelines tailored to these professionals, with an emphasis on transparent financial disclosure and ensuring accessibility of content. Such guidance would ensure nutritionists and dietitians uphold high ethical and professional standards, fostering public trust and enhancing credibility of information shared by these nutrition experts.

Background: Delivery of dietary interventions using e‐health for severe mental illness populations show promise. Yet the details of what has been trialled and the effectiveness of such interventions in this population group has not been systematically reviewed. Objective: To systematically review and synthesise published research to determine the evidence of e‐health delivered nutritional interventions on diet, physical and mental health outcomes in adults living with severe mental illness. Design: Five electronic databases were searched to March 2025 to identify studies in adults living with severe mental illness, interventions including a dietary focus and delivered via e‐health, and reporting diet, mental health, or anthropometric outcome/s. The completeness of intervention reporting was evaluated using the TIDieR (Template for Intervention Description and Replication) framework. Results: Eleven studies ( n = 1827 individuals, 56% female) were included, including randomised controlled trials ( n = 6) and pre/post studies ( n = 5). Most interventions were delivered by health professionals ( n = 8 studies) and the duration was highly varied (6 weeks − 12 months). Anthropometrics were the most common outcome ( n = 8 studies; with five reporting significant improvements) followed by physical activity ( n = 6 studies; with two reporting significant improvements), mental health and cardiovascular outcomes ( n = 5 studies each; with five and four of these studies, respectively, reporting significant improvements in outcomes). Diet was assessed in only three studies, one reporting significant changes. Ten studies incorporated smartphone technology including using phone calls ( n = 5 studies), text messages ( n = 3 studies), smartphone applications or multimodal delivery. Conclusion: This review identified opportunities to inform clinical service including more opportunity to harness other aspects of technology for the entire scope of the nutrition care process (e.g. better dietary assessment and use of features such as text message and assessing outcome measures).

Background: People receiving dialysis treatment are at higher risk of sarcopenia. This review aimed to determine the global prevalence of sarcopenia in people on peritoneal dialysis and hemodialysis. We investigated whether the prevalence of sarcopenia differs based on assessment criteria, timing of assessment, and measurement tools used and explored the risk factors for sarcopenia in people on dialysis.Methods: This review followed JBI and PRISMA guidelines and included studies assessing sarcopenia in adults aged 18 and older with chronic kidney disease undergoing dialysis. Five databases were searched from inception to November 2022. The JBI SUMARI software was used to perform the meta‐analysis. Publication bias and risk factor analysis were performed using STATA (Version 18).Results: A meta‐analysis of 62 studies (15,382 participants) found the global prevalence of sarcopenia to be 30.1% (95% CI: 25.6%–39.9%) for hemodialysis and 20.5% (95% CI: 15.1%–26.4%) for peritoneal dialysis. Sarcopenia prevalence ranged between 23.1% and 30.3% in HD and between 6.1% and 26.9% in PD, based on the assessment criteria. Post‐dialysis sarcopenia prevalence was higher (33%) than pre‐dialysis (24.2%) in hemodialysis patients. Measuring muscle mass after dialysis using dual‐energy X‐ray assessment yielded a lower prevalence of sarcopenia (22.5%) than bioimpedance analysis or spectroscopy (33%). Risk factors in the HD population included age, sex, diabetes, inflammation markers, nutritional indices, and dialysis vintage, although heterogeneity between studies was high.Conclusion: This study showed a high prevalence of sarcopenia among the dialysis population and identified many risk factors, emphasizing the need for early identification and intervention and standardized assessments.