Rural and remote health最新文献

Introduction: Violence against women is an ongoing and pervasive public health issue. In North America, the rates of intimate partner violence (IPV), sexual violence (SV), and gender-based violence (GBV) increase for those living in rural, remote and Northern (RRN) areas. These individuals face distinct challenges in accessing services; however, to date, no reviews have systematically summarized the scope of evidence on this topic. As a result, there is a need for more research that explores the lived and living experiences of IPV and SV among individuals marginalized by gender in RRN areas.

Methods: The research team conducted a scoping review following the framework outlined by Levac and colleagues to determine the existing evidence on the lived experience of SV and IPV among those marginalized by gender in RRN areas in the US and Canada. The databases Embase, PubMed (including Medline), APA PsycInfo, Web of Science, CINAHL, SocINDEX, ProQuest Dissertation and Theses Global, and LGBTQ+ Source were searched.

Results: The search was conducted by a librarian. Following removal of duplicates 2329 records were screened for title and abstract eligibility. A total of 316 records were retrieved for full-text screening, and 33 records are included in this scoping review. This included 26 records focused on IPV, five on GBV, and two on SV.

Discussion: Overall, the scoping review determined a paucity of research on SV in RRN areas of North America. Most records in RRN areas focus on IPV. There was discrepancy in the terminology used within manuscripts, and some did not include a definition of the concept being written about. It is important for all authors writing about IPV, GV, and SV to provide definitions to assist readers in analyzing the results. Additionally, the recruitment of participants from most research projects within this scoping review centered on services that provide care for those impacted by SV and IPV, which limits recruitment to those who have already sought out assistance. More research needs to be done to engage those who have not sought help, but who have experienced SV. Lastly, rates of IPV, SV, and GBV among Indigenous populations in Canada are higher than in all other populations, yet there was a gap in the literature reviewed regarding the experiences of individuals from this population in RRN areas.

Conclusion: By increasing the voice of victims/survivors in this area, there is potential to advocate for more services, as well as reduce stigma in these areas. Something must be done to decrease the rates of IPV and SV in RRN areas, and further research and knowledge development could be vital in advancing prevention efforts.

Introduction: Strengthening oral health promotion in remote riverine populations is essential for reducing persistent inequities in oral health. This study evaluated the outcomes of a community-based participatory intervention designed to enhance oral health knowledge, behaviors, and conditions among residents of a remote riverine community in the Brazilian Amazon.

Methods: A community-based participatory intervention was implemented based on the five action areas of the Ottawa Charter. Data were collected at baseline (T0) and after 8 months (T1) through face-to-face interviews using the Health Literacy in Dentistry-14 (HeLD-14) and Oral Health Impact Profile-14 instruments, for oral health literacy and oral health-related quality of life, complementary questionnaires on health behaviors and service use, and clinical oral examinations. Differences between T0 and T1 were analyzed using Wilcoxon paired, McNemar, and Cochran's Q tests.

Results: Following the intervention, participants demonstrated improvements in oral health literacy and oral health beliefs (p<0.001), oral health-related quality of life (p<0.001), and periodontal conditions, with significant reductions in gingival bleeding and dental calculus (p≤0.001). Dental service utilization increased (p=0.004), although economic barriers persisted. No change was observed in the DMFT (decayed, missing, and filled teeth) index.

Conclusion: The intervention positively influenced key oral health outcomes in this remote riverine population. These findings highlight the potential of participatory, community-driven strategies to strengthen oral health promotion in rural and remote settings.

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.