Are Australians willing to be treated by a Physician Assistant?

BackgroundPhysician assistants (PAs) are deployed to extend the role of the general practitioner and other doctors in Canada, England, Scotland, The Netherlands, the United States and elsewhere.  Because Australians have little experience with this type of provider, we undertook a study to test the willingness of patients to be treated by a PA. Method  A time trade-off preference survey was administered to women naïve about PAs in Northern Queensland in 2009.  Each survey described one of three scenarios of injury and asked the patient to make a decision between waiting four hours for a doctor or one hour for a PA.  ResultsA total of 229 candidate patients unconditionally participated (225 met criteria).  Two-thirds were between the ages of 20 & 35 years.  All but two of the participants (99%) selected to be treated by the PA regardless of the scenario.  When choices of time differences between a doctor and a PA were reduced to 2 hours and 1 hour, respectively, the preferential choice of seeing the PA persisted.  ConclusionAustralian women in Northern Queensland were willing to be treated by a PA as a theoretical construct and without actual experience or knowledge of PAs.  The familiar doctor care was traded for that of a PA when access to care was more available.  Developing PAs in Australian society may be practical and patient attitudes more accepting, than realized.  The concept of willingness to be treated has utility in socioeconomic research

The Economic, Medical & Social Costs of Road Traffic Crashes in Rural North Queensland: A 5-Year Multi-Phase Study

In Queensland in the year 2000, for example, the risk of dying (per capita) in a rural versus urban crash was 4.2 times higher, with resulting costs 2-3 times higher in rural areas compared to urban areas. In response, the Centre for Accident Research and Road Safety – Queensland (CARRS-Q) at Queensland University of Technology and James Cook University have designed a program of research to reduce the incidence and economic, medical and social costs of road crashes in Northern Queensland through the development and implementation of tailored road safety interventions

Shared antenatal care for Indigenous patients in a rural and remote community

BACKGROUND: An increase in perinatal mortality prompted a review of services to pregnant women in remote northern and western Queensland, Australia. In order to address the needs of the Indigenous population in particular, a range of service changes was implemented to improve outcomes.\ud \ud OBJECTIVE: This article aims to highlight the changes made in the delivery of local and regional antenatal services.\ud \ud DISCUSSION: Mt Isa Hospital is the supplier of obstetric services for the north and west of Queensland. Poor antenatal access rates and other service issues for Indigenous patients were identified as contributing to these poor outcomes. Consultation with Indigenous patients and health service providers prompted changes in modes of delivery of services that in the short term seem to have improved results. The models for delivery of services include primary health care clinics in remote communities, Aboriginal community controlled health services, and flying obstetrician clinics

The release of calcium from the endoplasmic reticulum induced by amyloid-beta and prion peptides activates the mitochondrial apoptotic pathway

In this study, we analyzed whether ER Ca2+ release, induced by amyloid-[beta] (A[beta]) and prion (PrP) peptides activates the mitochondrial-mediated apoptotic pathway. In cortical neurons, addition of the synthetic A[beta]1-40 or PrP106-126 peptides depletes ER Ca2+ content, leading to cytosolic Ca2+ overload. The Ca2+ released through ryanodine (RyR) and inositol 1,4,5-trisphosphate (IP3R) receptors was shown to be involved in the loss of mitochondrial membrane potential, Bax translocation to mitochondria and apoptotic death. Our data further demonstrate that Ca2+ released from the ER leads to the depletion of endogenous GSH levels and accumulation of reactive oxygen species, which were also involved in the depolarization of the mitochondrial membrane. These results illustrate that the early A[beta]- and PrP -induced perturbation of ER Ca2+ homeostasis affects mitochondrial function, activating the mitochondrial-mediated apoptotic pathway and help to clarify the mechanism implicated in neuronal death that occurs in AD and PrD.http://www.sciencedirect.com/science/article/B6WNK-4RWBSWS-2/1/e5d04335492f8e5aeee9fa1799fd301