Rural and remote health最新文献

Introduction: Sexually transmissible infection (STI) rates continue to rise across Australian rural and regional areas. Reported STI rates are often misleadingly low due to barriers in accessing testing, lack of service accessibility and affordability. Utilising innovative solutions such as vending machines can improve access by providing an alternative testing option that increases privacy and convenience.

Methods: Community reference groups were assembled to support an STI test vending machine pilot (STI-X) for 12 months across six planned and two temporary regional locations in northern Victoria, Australia. The vending machines were generally situated in publicly accessible areas where consumers could obtain a test kit for chlamydia, gonorrhoea and HIV, complete the specimen collection in a private setting and then post the kit to a laboratory.

Results: STI-X was deemed an acceptable solution for increasing access to specialist sexual health testing. Professionals were supportive of the additional option for individuals who may not use standard healthcare pathways. They identified that the vending machines were easy to use; however, better communication was needed to enhance uptake. Therefore, utilising community-driven promotional approaches, such as word of mouth, are necessary to ensure that information on novel health initiatives reaches the intended audiences.

Conclusion: STI testing vending machines have proved feasible and acceptable to professionals and users in rural and regional Australian communities. This technology would benefit from future research specifically in rural communities to determine whether priority populations will increase their STI testing. Policymakers should encourage innovative solutions in rural communities to combat growing workforce concerns.

A man aged 52 years was retrieved from a rural hospital in South Australia following an out-of-hospital cardiac arrest. He required a urinary catheter due to bladder distension and long retrieval time. It was not possible to insert a urinary catheter via the urethral route. Bladder decompression was achieved with a pigtail pleural drainage catheter carried in the kit of the retrieval team, with no complication. This approach is a pragmatic technique in a limited-resource setting, where access to formal suprapubic catheter kits or associated personnel may not be available.

Introduction: The present study aimed to determine whether there is an association between individual characteristics, including sociodemographic, clinical, behavioral, and functional performance variables, and the Patient Assessment of Chronic Illness Therapy (PACIC) score in the primary care setting in remote municipalities of the Brazilian Amazon.

Methods: The study was conducted between October 2020 and December 2022 in 10 rural cities in the Brazilian state of Amazonas and involved 965 participants.

Results and discussion: A generalized linear model was used to verify the association between the investigated variables. Sociodemographic, clinical, and behavioral variables were associated with PACIC scores. The evaluation of the instrument's domains demonstrated that, in addition to these variables, participants' functional performance variables were associated with their perceived level of type 2 diabetes mellitus management.

Conclusion: The study found that sociodemographic, clinical, and behavioral variables were linked to the total PACIC score.

Introduction: Vaccines, as a public good, require an inclusive approach to end vaccine-preventable diseases. Ensuring universal access to vaccination information is crucial, particularly in rural areas, where geographic and socioeconomic barriers persist. The COVID-19 pandemic highlighted these disparities, emphasizing the need for targeted advocacy strategies. This study examined information advocacy strategies used during the COVID-19 vaccination, and the implications.

Methods: The study employed a case study design with a mixed-methods approach. The qualitative phase involved community health workers, local leaders, healthcare workers, and influential figures, while the quantitative phase focused on heads of households. All resided in the Geita region in north-western Tanzania. Purposive and multistage sampling techniques were used to select individuals during the qualitative and quantitative phases, respectively. Qualitative data were analyzed thematically, while quantitative data were analyzed descriptively.

Results: Since we used a mixed-methods approach, the presentation of both qualitative and quantitative findings is on a theme-by-theme basis, or a weaving approach. The findings indicate that COVID-19 vaccination advocacy in rural settings hinges on three key elements (themes): strategic outreach points, preferred timing and the nature of the information communicated.

Conclusion: Study findings suggest that future pandemic preparedness plans must consider strategic outreach points, optimal timing, and tailored messaging to strengthen vaccination advocacy in rural settings. Further studies are needed to examine the aforementioned advocacy strategies in different settings and populations.

Introduction: To date, there has been no evaluation of the quality of agricultural safety websites. The aim of this study was to evaluate the quality of agricultural safety websites through the assessment of content, accountability and readability.

Methods: An internet search of sites was conducted using Google and the terms 'agri* safety', 'farm* safety' and 'farm* injury prevention'. Content was assessed using a standardised checklist evaluating the number of hazards addressed (completeness) and the average number of recommended control levels from the Hierarchy of Risk Controls (accuracy). Accountability was assessed through the presence of JAMA benchmarks. Readability was assessed using validated scoring systems, including Simple Measure of Gobbledygook, Flesch Reading Ease Score and Flesch-Kincaid Grade Level.

Results: Of the 13 websites included in the analysis, six were categorised as government websites, four as non-profit organisations and three as professional websites. Government website content scored higher in completeness and accuracy in comparison to other website categories. Motorcycles and water bodies were infrequently addressed. The assessment of accountability revealed that most websites (69%) did not attribute their recommendations. When using Flesch-Kincaid Grade Level scoring, only two websites (15%) met the recommendation of below grade 8 equivalent readability.

Conclusion: There is opportunity to improve the quality of agricultural safety websites. Recommendations involve addressing more hazards and improving the use of the Hierarchy of Risk Controls, in addition to increasing the attribution of recommendations and overall readability. Further research should evaluate other potential sources of information for farmers, such as online videos.

Introduction: Australians in rural and remote areas have poorer health and welfare outcomes than urban populations. Rural people are reliant on a consistent workforce to service the population. Attracting and maintaining a health professional workforce in rural Australia has been well documented as an ongoing issue. However, there is a need for research that explicitly investigates the unique factors that impact the recruitment and retention of allied health workers.

Methods: A scoping review methodology was utilised to investigate the research question: How does the current literature identify, describe and address workforce recruitment and retention issues for allied health professionals in rural and remote Australia? Utilising the PRISMA-ScR guidelines for conducting a scoping review, 14 databases (Ovid Medline, Ovid Embase, Ovid EmCare, AMED, APA PsycInfo, Ovid Medline ALL, Scopus, CINAHL Complete, Dissertations & Theses Global, Nursing & Allied Health, Rural & Remote Health database, Health Collection, ATSI-Health and Open Access Theses and Dissertations) and the grey literature were systematically searched for sources published between 2013 and 2024, with four key concepts utilised as search terms. The Crowe Critical Appraisal Tool was used to review the quality of the literature, and a narrative synthesis approach was utilised to collate and summarise the data.

Results: In total, 11,165 sources were extracted from the database search, with title and abstract screening completed on 4,441 sources. Following full-text review, 60 sources were included in the review, 45 of which were peer-reviewed. Sources included research articles (n=27), reports (n=9), review articles (n=5), conference documents (n=3), web pages and online magazine pieces (n=8) and other sources (n=8). Many studies used a qualitative study design (n=11) and 22 sources generally referred to allied health professions without specifying which discipline. Of the specified allied health profession across sources, physiotherapy was the most studied (n=16), with occupational therapy (n=11) and psychology (n=9) following. The narrative synthesis yielded five key themes: Workforce: opportunities, facilitators and challenges; Rural health career: professional and personal identity; Workplace and professional role: demands, benefits and opportunities; Community and family: support, care and connectedness; and Connection, commitment and collaboration.

Conclusion: This scoping review highlights the opportunities, facilitators and challenges that affect the allied health workforce. It informs recommendations for professionals, organisations, communities and policymakers to build on the sector's strengths, and resources and presents a range of innovative strategies being trialled and implemented by the allied health workforce.

Introduction: Scotland faces persistent challenges in addressing medical workforce shortages, particularly in remote and rural areas. The Scottish Graduate Entry Medicine (ScotGEM) program was established to address these challenges by training adaptable and resilient medical practitioners with a focus on rural and underserved healthcare settings. Evaluating the preparedness of ScotGEM graduates as they transition into clinical practice is essential for assessing the program's effectiveness.

Methods: This study utilised data from the General Medical Council Foundation Year 1 Preparedness Survey, which evaluates newly qualified doctors' self-reported perceptions of preparedness in key domains: overall preparedness, clinical practical procedures, prescribing and managing acutely unwell patients. Preparedness perceptions of the inaugural ScotGEM cohort were compared to national and Dundee University cohorts using Z-tests for proportions and Cohen's h to quantify effect sizes.

Results: ScotGEM graduates reported levels of preparedness comparable to the national average across all surveyed domains. Specifically, 57.5% of ScotGEM graduates felt adequately prepared for practice (57.9% nationally), 84.6% felt adequately skilled in clinical practical procedures (80.3% nationally), 75.0% reported adequate prescribing skills (79.3% nationally) and 75.0% felt prepared to manage acutely unwell patients (68.4% nationally). Statistical analysis revealed no significant differences between ScotGEM and other cohorts (p>0.05), with small effect sizes (h<0.2) indicating minimal practical differences.

Conclusion: ScotGEM graduates demonstrate preparedness levels comparable to their peers nationally and from traditional-entry programs, underscoring the effectiveness of Scotland's first graduate-entry and rurally delivered medical program. Future evaluations with larger sample sizes will be essential to detect subtle differences and further refine ScotGEM's contributions to Scotland's medical workforce, particularly in underserved areas.