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1.
Aust J Rural Health ; 25(6): 332-337, 2017 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-28677825

RESUMEN

BACKGROUND: Tasmania established its medical programme in 1965 to produce graduates to address medical workforce recruitment challenges. Many Tasmanian graduates work in Tasmania, but workforce problems continue. This paper reports the workforce outcomes of the first 42 graduating cohorts. METHODS: A database for all University of Tasmania medical graduates from the years 1970 to 2011 was developed by combining information from university, registration and local workforce survey databases. RESULTS: A total of 2012 doctors graduated from 1971 to 2011 and 1707 (85%) were registered, most commonly in general practice (45.8%), medicine (13%), anaesthetics (7.9%), surgery (7.5%), psychiatry (4.3%), emergency medicine (35, 3.5%), paediatrics (3.4%) and pathology (3.3%). While 41.9% worked in Tasmania, they comprised 35.6% of the local workforce and were clustered around the two larger cities. The proportion entering general practice has fallen since 1980s. DISCUSSION: The contribution of the Tasmanian medical programme is substantial but appears less than other regional medical schools. Relatively few work in smaller communities, particularly in specialties other than general practice. Lifestyle choices and the availability of training opportunities and career positions might be contributing factors. The medical school has established clinical schools in rural communities, promoted admission of rural applicants and increased rural clinical placement opportunities, with some early signs of success. CONCLUSION: The Tasmanian medical programme is important in this regional, island economy, but the rural and remote communities have not benefited as much as the two larger cities. Sustaining a regional workforce mission over time might require frequent adjustments to admissions and curriculum processes.


Asunto(s)
Selección de Profesión , Educación Médica/historia , Educación Médica/estadística & datos numéricos , Fuerza Laboral en Salud/historia , Fuerza Laboral en Salud/estadística & datos numéricos , Servicios de Salud Rural/historia , Estudiantes de Medicina/historia , Adulto , Estudios de Cohortes , Femenino , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Masculino , Persona de Mediana Edad , Servicios de Salud Rural/estadística & datos numéricos , Facultades de Medicina/historia , Facultades de Medicina/estadística & datos numéricos , Estudiantes de Medicina/estadística & datos numéricos , Encuestas y Cuestionarios , Tasmania
2.
Drug Alcohol Depend ; 107(1): 76-9, 2010 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-19828264

RESUMEN

Vaccines represent a new and promising avenue of treatment for drug abuse but pose new medication adherence challenges due to prolonged and widely spaced administration schedules. This study examined effects of prize-based incentives on retention and medication adherence among 26 cocaine users involved in a 6-month hepatitis B vaccination series. Participants could meet with research staff weekly for 24 weeks and receive 7 injections containing either the Hepatitis B vaccine or a placebo. All participants received $10 at each weekly visit (maximum of $240). Those randomly assigned to the incentive program received additional monetary payments on an escalating schedule for attendance at weekly monitoring and vaccination visits with maximum possible earnings of $751. Group attendance diverged after study week 8 with attendance better sustained in the incentive than control group (group by time interaction, p=.035). Overall percent of weekly sessions attended was 82% for incentive versus 64% for control (p=.139). Receiving all scheduled injections were 77% of incentive versus 46% of control participants (p=.107). A significantly larger percentage (74% versus 51%; p=.016) of injections were received by incentive versus control participants on the originally scheduled day. Results suggest that monetary incentives can successfully motivate drug users to attend sessions regularly and to receive injected medications in a more reliable and timely manner than may be seen under usual care procedures. Thus, incentives may be useful for addressing adherence and allowing participants to reap the full benefits of newly developed medications.


Asunto(s)
Trastornos Relacionados con Cocaína/psicología , Cumplimiento de la Medicación/psicología , Motivación , Vacunación/psicología , Adolescente , Adulto , Femenino , Hepatitis B/prevención & control , Vacunas contra Hepatitis B/uso terapéutico , Humanos , Masculino , Persona de Mediana Edad
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