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3.  Concordance between Sources of Morbidity Reports: Self-Reports and Medical Records 
As part of a 10-year follow-up study of morbidity following spouse bereavement, concordance between subject reports of their illness experience and that given by their doctors’ and other medical records has been assessed. Enumeration from medical records involved extensive and careful perusal of general practitioner, specialist, and hospital records while subject reports were aided by a structured questionnaire which helped to prompt subjects’ memories. The findings showed generally poor concordance between these two sources of morbidity data. Overall only 22% of disease events were found in both sources: of the diseases that did not match 65% were from the record source and 35% were from the self-report source. Despite finding that concordance rates varied with some subject and disease factors, concordance was always less than might be expected to occur by random chance (the throw of a coin). These findings have serious implications for epidemiological and pharmacoeconomic research involving morbidity history as they suggest that neither the subject nor their medical record can generally be assumed to provide a complete enumeration of morbidity burden. Indeed, irrespective of the significant factors under consideration, the maximum concordance reached in this study was 45.7%.
PMCID: PMC3108553  PMID: 21687511
bereavement; concordance; morbidity; medical records; self-reports
4.  Representations and coverage of non-English-speaking immigrants and multicultural issues in three major Australian health care publications 
No recent Australian studies or literature, provide evidence of the extent of coverage of multicultural health issues in Australian healthcare research. A series of systematic literature reviews in three major Australian healthcare journals were undertaken to discover the level, content, coverage and overall quality of research on multicultural health. Australian healthcare journals selected for the study were The Medical Journal of Australia (MJA), The Australian Health Review (AHR), and The Australian and New Zealand Journal of Public Health (ANZPH). Reviews were undertaken of the last twelve (12) years (1996-August 2008) of journal articles using six standard search terms: 'non-English-speaking', 'ethnic', 'migrant', 'immigrant', 'refugee' and 'multicultural'.
In total there were 4,146 articles published in these journals over the 12-year period. A total of 90 or 2.2% of the total articles were articles primarily based on multicultural issues. A further 62 articles contained a major or a moderate level of consideration of multicultural issues, and 107 had a minor mention.
The quantum and range of multicultural health research and evidence required for equity in policy, services, interventions and implementation is limited and uneven. Most of the original multicultural health research articles focused on newly arrived refugees, asylum seekers, Vietnamese or South East Asian communities. While there is some seminal research in respect of these represented groups, there are other communities and health issues that are essentially invisible or unrepresented in research. The limited coverage and representation of multicultural populations in research studies has implications for evidence-based health and human services policy.
PMCID: PMC2817687  PMID: 20044938
5.  Analysis of draft Australian rehabilitation service standards: comparison with international standards 
Following her review of health systems and structures Dwyer [1] suggested that there is a need to evaluate models of care for individuals with chronic diseases. Rehabilitation services aim to optimise the activity and participation of individuals with restrictions due to both acute and chronic conditions. Assessing and optimising the standard of these services is one method of assuring the quality of service delivered to these individuals. Knowledge of baseline standards allows evaluation of the impact of health care reforms in this area of need. The aim of this article is to compare the currently available rehabilitation service standards in Australia with those used in the USA and the UK.
The mixed method qualitative analysis performed on the three sets of standards demonstrated repeatability and convergence via the use of triangulation. Australian Faculty of Rehabilitation Medicine (AFRM) standards were found to be consistent and concise, to provide definitions, and to cover the majority of clinically relevant issues to an extent similar to the other rehabilitation service standards. Inclusion of standards for business practices, the rehabilitation process for the person served, and outpatient and community-based rehabilitation services should be considered by the AFRM.
The AFRM standards are an appropriate way of assessing rehabilitation services in Australia. As suggested by other workers [2,3] there should be ongoing review and field testing of the standards to maximise the relevance and utilisation of the standards.
PMCID: PMC2474639  PMID: 18590530

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