Australian Journal of Rural Health最新文献_第5页

Integrating Lived and Clinical Perspectives to Advance Transgender Healthcare in Rural Aotearoa New Zealand 整合生活和临床观点，推进新西兰奥特罗阿农村的变性人医疗保健。

IF 2.1 4区医学 Q2 NURSING

Australian Journal of Rural Health

Pub Date : 2025-10-07 DOI: 10.1111/ajr.70100

Katie E. McMenamin, Angie Enoka

Objective

This study aimed to explore healthcare experiences of transgender and gender diverse (TGD) individuals, their whānau (family), and primary care clinicians in rural Aotearoa New Zealand. It explored the enablers of gender-affirming care (GAC) and the challenges that remain, using these insights to build a culturally responsive, strengths-based model of care.

Design

Qualitative study using semi-structured interviews, analyzed via reflexive thematic analysis.

Setting

Whanganui, a regional district in Aotearoa New Zealand.

Participants

Participants included 12 TGD individuals, two whānau members, and five clinicians providing GAC within primary care.

Main Outcome Measures

Experiences of accessing and delivering healthcare, with a focus on GAC pathways, mental health support, and culturally appropriate service models.

Results

TGD participants described fragmented systems requiring self-navigation, with delays, gatekeeping, and limited access to affirming mental health services. Clinicians reported gaps in training, a lack of clear pathways, and few referral options. Both groups emphasized the value of peer support, whānau-centered models, and culturally safe approaches. There was shared support for a local, centralized GAC service in Whanganui, building on existing resources and grounded in cross-sector collaboration, clinician education, and local leadership.

Conclusion

This study demonstrates both the challenges and potential of rural TGD healthcare. Findings support a regionally tailored model of GAC involving services and community, sustained through partnership and grounded in cultural safety. In Whanganui, strong foundations already exist to support such a model. With local adaptation, it could guide equitable service development in other rural regions of Aotearoa.

目的：本研究旨在探讨新西兰奥特罗阿农村跨性别和性别多样化（TGD）个体、他们的whānau（家庭）和初级保健临床医生的医疗保健经历。它探讨了性别肯定护理（GAC）的推动因素和仍然存在的挑战，并利用这些见解建立了一个对文化敏感的、基于优势的护理模式。设计：采用半结构化访谈的定性研究，通过反身性主题分析进行分析。环境：旺加努伊，新西兰奥特罗阿的一个地区。参与者：参与者包括12名TGD个体，2名whānau成员和5名在初级保健中提供GAC的临床医生。主要结果测量：获得和提供医疗保健的经验，重点是GAC途径、心理健康支持和文化上适当的服务模式。结果：TGD参与者描述了支离破碎的系统，需要自我导航，有延误，把关，以及获得肯定的精神卫生服务的机会有限。临床医生报告培训存在差距，缺乏明确的途径，转诊选择很少。两组都强调同伴支持、whānau-centered模式和文化安全方法的价值。在现有资源的基础上，以跨部门合作、临床医生教育和地方领导为基础，共同支持旺格努伊的地方集中GAC服务。结论：本研究显示了农村TGD医疗的挑战和潜力。研究结果支持一种区域性的GAC模式，该模式涉及服务和社区，通过伙伴关系维持，并以文化安全为基础。在旺格努伊，支持这种模式的坚实基础已经存在。通过当地的适应，它可以指导奥特罗阿其他农村地区的公平服务发展。

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引用次数: 0

‘I Couldn't Imagine Doing It Any Other Way’—The Use of Flipped Classroom Design for Occupational Therapy and Speech Pathology Students in a Regional Australian University “我无法想象做任何其他方式”——在澳大利亚一所地区大学使用翻转课堂设计的职业治疗和语言病理学学生。

IF 2.1 4区医学 Q2 NURSING

Australian Journal of Rural Health

Pub Date : 2025-09-30 DOI: 10.1111/ajr.70099

Desley Simpson, Clancy Conlon

Objective

To explore the use of flipped classroom (FC) design for occupational therapy and speech pathology students studying in regional Australia.

Setting

Occupational therapy and speech pathology students in a regional Australian university in Central Queensland.

Participants

33 occupational therapy and speech pathology students provided survey data; 5 students supplied in-depth data from focus groups; three educators completed teaching reflections.

Design

A multiple case study methodology was implemented based on Yin's definition¹. Case study one involved occupational therapy students and case study two involved speech pathology students. A sequential exploratory mixed methods design was embedded within each case study. After participation in a unit using FC design, students completed a quantitative survey followed by a focus group for each case. Document analysis of teacher reflections and unit evaluations was also completed.

Results

Quantitative results show that student confidence, knowledge, and satisfaction are strongly supported by the FC approach. Rich qualitative data from the cases yielded four themes: individual attributes of the educator; purposeful and flexible design features; the role of the student as an active learner; facilities and resources for flipped classrooms.

Conclusion

This case study data supports the benefits of FC design for health professions students, has enabled the development of a conceptual framework which could be applied to health professions and beyond to other disciplines, and has also provided the foundations for guidelines to support educators to implement FC methodology.

目的：探讨翻转课堂（FC）设计在澳大利亚地区职业治疗和语言病理学学生学习中的应用。背景：昆士兰中部一所澳大利亚地区大学的职业治疗和语言病理学专业学生。研究对象：33名职业治疗与言语病理学专业学生提供调查资料；5名学生提供了来自焦点小组的深入数据；三位教育工作者完成了教学反思。设计：基于尹的定义实施了多案例研究方法1。案例研究一涉及职业治疗专业的学生案例研究二涉及语言病理学专业的学生。在每个案例研究中嵌入了顺序探索性混合方法设计。在参与了使用FC设计的单元后，学生们完成了一个定量调查，然后是针对每个案例的焦点小组。完成了教师反思和单元评价的文献分析。结果：定量结果显示，学生的信心、知识和满意度受到FC方法的强烈支持。从案例中获得的丰富定性数据产生了四个主题：教育者的个人属性；目的明确、灵活的设计特点；学生作为主动学习者的角色；翻转课堂的设施和资源。结论：本案例研究数据支持了FC设计对卫生专业学生的好处，使概念框架得以发展，可以应用于卫生专业和其他学科，并且还为支持教育工作者实施FC方法提供了指导基础。

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引用次数: 0

Type 2 Diabetes Management in Aotearoa New Zealand: A Comparison of Urban and Rural Primary Care Clinics 新西兰奥特罗阿的2型糖尿病管理：城市和农村初级保健诊所的比较

IF 2.1 4区医学 Q2 NURSING

Australian Journal of Rural Health

Pub Date : 2025-09-30 DOI: 10.1111/ajr.70098

Sara Mustafa, Mark Rodrigues, Ross Lawrenson, Jo Scott-Jones, Valentina Papa, Jinru Zhao, Rebekah Crosswell, Tim Kenealy, Rinki Murphy, Rawiri Keenan, Allan Moffitt, Ryan Paul, Lynne Chepulis

Objective

To examine the demographic differences between individuals with Type 2 Diabetes (T2D) enrolled in rural and urban clinics and evaluate the quality of care they receive.

Design

Cross-sectional observational study.

Setting

Primary care data from four large Primary Healthcare Organisations across the Auckland and Waikato regions of New Zealand.

Participants

Patients aged 18–75 years with T2D from February 2021 to August 2022.

Main Outcomes Measures

Associations between rurality and sociodemographic variables, clinical measures, and prescribing rates.

Results

A total of 56 937 patients with T2D were included, with 85.3% enrolled in urban practices and 14.7% in rural. Rural clinics had a significantly higher proportion of Māori individuals than urban clinics (31.4% vs. 17.4%). Patients in rural clinics had lower but not clinically significant reductions in mean HbA1c, LDL-c, blood pressure, and eGFR than those in urban clinics; however, the number of laboratory tests completed during the study period was lower in rural clinics. Māori were less likely to receive HbA1c and uACR tests than non-Māori. Clinically indicated prescribing for metformin (79.1% vs. 72.5%), ACE inhibitors (80.5% vs. 75.2%), and statins (61.2% vs. 54.4%) was higher in patients enrolled in urban than rural clinics (all p < 0.05), and regression showed lower odds of insulin (OR: 0.65, 95% CI: 0.61–0.69) and SGLT2i/GLP1RA (OR: 0.87, 95% CI: 0.82–0.93) prescribing in rural clinics (both p < 0.001).

Conclusion

Targeted strategies are needed to address the disparities in T2D care for patients in rural clinics, as well as Māori, particularly optimizing medication prescribing and laboratory tests to improve overall care.

目的：研究在农村和城市诊所登记的2型糖尿病（T2D）患者的人口统计学差异，并评估他们接受的护理质量。设计：横断面观察性研究。背景：来自新西兰奥克兰和怀卡托地区四个大型初级保健组织的初级保健数据。参与者：2021年2月至2022年8月，年龄在18-75岁的T2D患者。主要结局指标：农村与社会人口变量、临床指标和处方率之间的关系。结果：共纳入56 937例T2D患者，其中85.3%在城市就诊，14.7%在农村就诊。农村诊所Māori个体比例明显高于城市诊所（31.4%比17.4%）。农村诊所的患者平均HbA1c、LDL-c、血压和eGFR的降低低于城市诊所的患者，但没有临床意义；然而，在研究期间，农村诊所完成的实验室检查数量较低。Māori接受HbA1c和uACR测试的可能性低于non-Māori。临床指征二甲双胍处方（79.1% vs. 72.5%）、ACE抑制剂（80.5% vs. 75.2%）和他汀类药物（61.2% vs. 54.4%）在城市诊所的患者中高于农村诊所(均p结论：需要有针对性的策略来解决农村诊所患者T2D护理的差异，以及Māori，特别是优化药物处方和实验室检查以改善整体护理。

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引用次数: 0

Aboriginal and/or Torres Strait Islander Allied Health Co-Workers: A Possible Role in Advancing Aboriginal and Torres Strait Islander Health and Well-Being 原住民和/或托雷斯海峡岛民联合健康同事：在促进原住民和托雷斯海峡岛民健康和福祉中的可能作用

IF 2.1 4区医学 Q2 NURSING

Australian Journal of Rural Health

Pub Date : 2025-09-26 DOI: 10.1111/ajr.70096

Alice Cairns, Kylie Stothers (Jawoyn), Paul Gibson, James Debenham, Stephanie Topp, Narelle Campbell, Lauren Toll, Heather Malcolm, Jena Stephen

Aim

To propose the novel role of Aboriginal and/or Torres Strait Islander Allied Health Co-Worker to address an urgent unmet need in rural and remote Australia that focuses on disability, rehabilitation and preventative health needs in a unique cultural context.

Context

Allied health and therapy assistants represent a rapidly expanding workforce with considerable potential to relieve workforce shortages and address urgent and unmet healthcare needs in rural and remote Australia. However, the current recognised roles of “Allied Health Assistant” or “Therapy Assistant” are incompatible with the needs of the Aboriginal and Torres Strait Islander communities.

Approach

This commentary prosecutes the case that for Aboriginal and Torres Strait Islander families and communities, the allied health assistant role should be adapted to an Aboriginal and/or Torres Strait Islander Allied Health Co-Worker (AHCW). The AHCW would provide allied health clinical care within the scope of an allied health assistant, as well as cultural brokerage and leadership to support the cultural needs of the people and communities with which the services are interacting. Recommendations are proposed for sustainable implementation of this role.

Conclusion

It is proposed that Aboriginal and/or Torres Strait Islander Allied Health Co-Workers' roles and appropriate recognition of their cultural leadership roles be introduced and embedded in health and disability employment policies.

目的提出土著和/或托雷斯海峡岛民联合健康同事的新作用，以解决澳大利亚农村和偏远地区迫切未满足的需求，重点关注独特文化背景下的残疾、康复和预防性健康需求。专职保健和治疗助理代表着迅速扩大的劳动力队伍，在缓解劳动力短缺和解决澳大利亚农村和偏远地区紧急和未满足的保健需求方面具有相当大的潜力。然而，目前公认的“联合保健助理”或“治疗助理”的角色与土著和托雷斯海峡岛民社区的需求不相容。本评论提出，对于土著和托雷斯海峡岛民家庭和社区，联合卫生助理的角色应该适应土著和/或托雷斯海峡岛民联合卫生同事（AHCW）。AHCW将在联合健康助理的范围内提供联合健康临床护理，以及文化中介和领导，以支持与服务互动的人民和社区的文化需求。为可持续地发挥这一作用提出了建议。结论建议将原住民和/或托雷斯海峡岛民联合医疗同事的角色和对其文化领导角色的适当认可纳入健康和残疾就业政策。

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引用次数: 0

Surgeons Outside of Cities: Longitudinal Trends in the Surgical Workforce of Rural Australia From 2013 to 2022 城市以外的外科医生：2013年至2022年澳大利亚农村外科劳动力的纵向趋势

IF 2.1 4区医学 Q2 NURSING

Australian Journal of Rural Health

Pub Date : 2025-09-26 DOI: 10.1111/ajr.70097

Tracey Edwards, David Garne, Lyndal Parker-Newlyn, Rowena G. Ivers, Judy Mullan, Kylie J. Mansfield, Andrew Bonney, Colin H. Cortie

Objective

To examine differences and changes in workplace and demographic factors between metropolitan and rural surgeons in Australia over 10 years.

Methods

A retrospective study which analysed data from the Health Workforce Dataset Online Data Tool, based on annual registration data from the Australian Health Practitioner Regulation Agency (AHPRA) spanning 2013–2022. The dataset includes information on all surgeons who have completed their training and are registered as fellows with the Royal Australasian College of Surgeons, and who were working in Australia during the study period. The factors analysed included mean hours worked per week, gender, age, and origin of qualification. Regions of work were defined using the Modified Monash Model (MM) model.

Results

During the study period, the number of surgical fellows in Australia increased from 4568 to 5724, with a notable increase in the proportion working in metropolitan regions. On average, these surgeons worked 45 h per week across most regions. The percentage of female surgeons rose from 9.6% to 15.4% in metropolitan regions and from 6.9% to 12.4% in rural regions. Surgeons working in rural regions tended to be older. However, there has been an increase in the number of surgeons aged 35–44 working in these areas. Additionally, sub-specialties other than general surgery were rarely found in rural areas.

Conclusion

While the number of surgeons in Australia has increased, there is a disproportionate shortfall of surgeons practising in rural areas.

目的探讨近10年来澳大利亚城市外科医生与农村外科医生在工作场所和人口因素方面的差异和变化。方法回顾性研究分析了来自卫生人力数据集在线数据工具的数据，基于2013-2022年澳大利亚卫生从业人员监管机构（AHPRA）的年度注册数据。该数据集包括所有完成培训并在澳大利亚皇家外科学院注册为研究员的外科医生的信息，并且在研究期间在澳大利亚工作。分析的因素包括每周平均工作时间、性别、年龄和学历来源。使用修正莫纳什模型（MM）模型定义工作区域。结果在研究期间，澳大利亚的外科研究员人数从4568人增加到5724人，在大都市地区工作的比例显著增加。在大多数地区，这些外科医生平均每周工作45小时。女性外科医生的比例在大都市地区从9.6%上升到15.4%，在农村地区从6.9%上升到12.4%。在农村地区工作的外科医生往往年龄较大。然而，在这些领域工作的35-44岁的外科医生数量有所增加。此外，农村地区很少发现普通外科以外的亚专科。结论虽然澳大利亚的外科医生数量有所增加，但在农村地区执业的外科医生数量却不成比例地不足。

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引用次数: 0

Counts, Characteristics and Outcomes of Patients Transported by the Royal Flying Doctor Service to Metropolitan Perth With Suspected Acute Coronary Syndrome: Western Australian Linked Data Study 由皇家飞行医生服务运送到珀斯大都会疑似急性冠状动脉综合征患者的数量、特征和结果：西澳大利亚关联数据研究

IF 2.1 4区医学 Q2 NURSING

Australian Journal of Rural Health

Pub Date : 2025-09-23 DOI: 10.1111/ajr.70093

Julian Ming, Helen Bartholomew, David Preen, John Fisher, Tom Briffa, Andrew Hooper, James M. Rankin, Abdul Rahman Ihdayhid, Derrick Lopez

Objectives

Determine counts, characteristics and outcomes following transport by the Royal Flying Doctor Service Western Operations (RFDSWO) to Perth.

Study Design

Retrospective cohort study of the RFDSWO aeromedical patient dataset linked to administrative datasets.

Participants

Suspected acute coronary syndrome (ACS) patients aged ≥ 25 years transported from rural Western Australia to Perth between 2001 and 2017.

Main Outcome Measures

Basic counts and proportions. Poisson regression was used to determine absolute change in number of transports and relative risk (RR) of receiving diagnostic coronary angiography; logistic regression to model odds ratio (OR) of death between transport and end of hospital care.

Results

RFDSWO carried out 11 390 transports for suspected ACS between 2001 and 2017, with the absolute number of annual transports increasing by 6.0%. After excluding 164 transports without linked records, the remaining 11 226 consisted of patients with a mean age of 60.3 years and 70.8% male. Most (99.1%) were hospitalised and 1.8% died. Among those hospitalised, 84.5% received diagnostic coronary angiography and 74.5% were discharged with a diagnosis of ACS. Females (RR = 0.97; CI = 0.95–0.99), higher comorbidity scores, and those from the Pilbara/Midwest/Wheatbelt regions (compared to South West) were less likely to receive diagnostic coronary angiography. Older patients (OR = 1.07; CI = 1.06–1.11), earlier transport years, higher comorbidity scores, those with priority 1 transport or requiring medical escort, and those from the Kimberley (compared to South West) were more likely to die.

Conclusions

Findings suggest a high suspicion of coronary artery pathology among transported patients. Patient-level and regional differences in outcomes warrant further investigation with more granular data.

目的：确定由皇家飞行医生服务西部业务（RFDSWO）运送到珀斯后的数量、特征和结果。研究设计：对RFDSWO航空医疗患者数据集与行政数据集相关联的回顾性队列研究。参与者：2001年至2017年间从西澳大利亚农村转移到珀斯的年龄≥25岁的疑似急性冠脉综合征（ACS）患者。主要结果测量：基本计数和比例。使用泊松回归确定接受诊断性冠状动脉造影的转运数和相对危险度（RR）的绝对变化；logistic回归分析运输与医院护理结束之间的死亡率比值比（OR）。结果：2001 - 2017年，RFDSWO对疑似ACS进行了11 390次转运，年转运绝对数量增加了6.0%。在排除164例无相关记录的转运后，剩余的11226例患者平均年龄为60.3岁，70.8%为男性。大多数（99.1%）住院，1.8%死亡。在住院患者中，84.5%接受了诊断性冠状动脉造影，74.5%诊断为ACS出院。女性（RR = 0.97; CI = 0.95-0.99）、较高的共病评分以及来自皮尔巴拉/中西部/小麦带地区（与西南地区相比）的患者接受诊断性冠状动脉造影的可能性较小。年龄较大的患者（OR = 1.07; CI = 1.06-1.11）、较早的转运年份、较高的共病评分、优先转运或需要医疗护送的患者以及来自金伯利的患者（与西南地区相比）更容易死亡。结论：研究结果提示转运患者对冠状动脉病变有很高的怀疑。患者水平和地区差异的结果值得进一步研究更细粒度的数据。

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引用次数: 0

Comparing Parkinson's Disease Medications Categorised by Location in New South Wales, Australia: Linking the 45 and Up Study and the Pharmaceutical Benefits Scheme (PBS) Data 比较澳大利亚新南威尔士州按地点分类的帕金森病药物：将45及以上研究与药物福利计划（PBS）数据联系起来。

IF 2.1 4区医学 Q2 NURSING

Australian Journal of Rural Health

Pub Date : 2025-09-23 DOI: 10.1111/ajr.70094

Patricia A. Logan, Peter S. Micalos, Shanna Fealy, Marguerite Bramble, Alfred Wong

Objective

Explore Parkinson's Disease (PD) related prescription patterns for people with PD living in metropolitan and non-metropolitan areas of New South Wales, Australia.

Methods

Exploratory, cross-sectional data linkage study. Participants were grouped according to geographic location and by age group: metropolitan or non-metropolitan; rural, regional, and remote. Prescription patterns were analysed using descriptive and inferential statistics.

Design

The Sax Institute's 45 and Up Study data was linked to the Pharmaceutical Benefits Scheme (PBS) records (2004–2017) for all participants with PD.

Setting

Retrospective data exploration and analysis.

Participants

1648 participants who self-identified as having PD and voluntarily contributed to the 45 and Up longitudinal study.

Main Outcome Measures

Statistical comparisons based on location were undertaken for the different groupings for PD-specific medications.

Results

Significant differences in the proportions of PD-related medications are observed between locations. Significant differences in the proportions of PD-related medications are observed between locations. A higher proportion of levodopa and levodopa combinations is reported for major cities (75.5%) compared with the inner region (70.3%) and outer and remote regions (74.1%). Additionally, other PD-related medications in the non-metropolitan areas are proportionally higher than those reported for major cities. Analysis by age groups suggests large effect sizes for the 75–79 and 45–49 age groups, while medium and small effect sizes are reported for the 55–59 and 70–74 age groups, respectively.

Conclusion

Inequities with best practice medication treatment for PD exist between metropolitan and non-metropolitan areas of NSW. Efforts are required to successfully bridge gaps. Upskilling GPs may provide one way to optimise therapy and quality of life.

目的：探讨澳大利亚新南威尔士州大都市和非大都市地区帕金森病患者的相关处方模式。方法：探索性、横断面数据关联研究。参与者根据地理位置和年龄分组：大都市或非大都市；农村、地区和偏远。使用描述性和推理统计分析处方模式。设计：Sax研究所的45和Up研究数据与所有PD参与者的药物福利计划（PBS）记录（2004-2017）相关联。设置：回顾性数据探索和分析。参与者：1648名自认为患有PD并自愿参与45岁及以上纵向研究的参与者。主要结果测量：对pd特异性药物的不同分组进行了基于地点的统计比较。结果：不同地区pd相关药物的使用比例有显著差异。不同地区pd相关药物的比例有显著差异。主要城市左旋多巴和左旋多巴联合使用的比例（75.5%）高于内陆地区（70.3%）和偏远地区（74.1%）。此外，其他pd相关药物在非大都市地区的比例高于主要城市。按年龄组分析表明，75-79岁和45-49岁年龄组的效应量较大，而55-59岁和70-74岁年龄组的效应量分别为中等和较小。结论：新南威尔士州大都市与非大都市之间存在PD最佳实践药物治疗的不平等。需要努力成功地弥合差距。提高全科医生的技能可能会提供一种优化治疗和生活质量的方法。

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引用次数: 0

Implementing an Online Sexually Transmitted Infection Testing Service for Young People in Regional and Rural Victoria, Australia: Insights From Local Public Health Authorities 在澳大利亚维多利亚州地区和农村为年轻人实施在线性传播感染检测服务：来自当地公共卫生当局的见解

IF 2.1 4区医学 Q2 NURSING

Australian Journal of Rural Health

Pub Date : 2025-09-22 DOI: 10.1111/ajr.70092

Lauren Ware, Mitchell McGrath, Oliva Walsh, Ethan T. Cardwell, Jane Tomnay, Dave Evans, Anne-Marie Kelly, Jason J. Ong, Jane S. Hocking, Fabian Y. S. Kong, Teralynn Ludwick

Objective

This study investigated local public health authorities' perspectives on implementing a new online STI testing service for young people in regional/rural Victoria, Australia.

Setting

Study was conducted to support the design of Test it, a free, online STI testing service being developed for Victoria. After completing an online registration and sexual health questionnaire, users receive an electronic test request form to take directly to a pathology centre without seeing a general practitioner (GP).

Participants

Ten individuals responsible for the coordination of community sexual health services within 7 Victorian Local Public Health Units (LPHUs) and the Department of Health, and a state-wide health promotion organisation.

Design

Semi-structured interview topics covered: attitudes towards online STI testing, advantages and challenges of online STI testing for regional and rural communities, and strategies to support effective implementation.

Results

Participants were enthusiastic about the potential of an online STI testing service, perceiving it to offer options in settings with limited sexual health providers, provide users with greater anonymity (bypassing GPs), improve efficiency, and support LPHUs to deliver their priorities. However, needing to attend a pathology service in-person may reduce appeal and create barriers given limited transport/opening hours and stigmatisation concerns by young people. Navigating treatment, if needed, may also be challenging.

Conclusion

Despite offering advantages, regional/rural young people are likely to encounter barriers to online STI testing that are different from and more significant than those faced by young people in urban areas. Strategies are needed to support implementation in regional/rural areas to realise the full potential of online testing to improve equitable access for underserved communities.

目的本研究调查了当地公共卫生当局对澳大利亚维多利亚州地区/农村年轻人实施新的在线性传播感染检测服务的看法。设置研究是为了支持Test it的设计，这是一项为维多利亚州开发的免费在线STI测试服务。在完成在线注册和性健康调查问卷后，用户会收到一份电子测试申请表，直接带到病理中心，而无需见全科医生（GP）。参加者10人，负责协调维多利亚州7个地方公共卫生单位（LPHUs）和卫生部以及一个全州范围的健康促进组织的社区性健康服务。设计半结构化访谈的主题包括：对在线STI测试的态度，在线STI测试对区域和农村社区的优势和挑战，以及支持有效实施的战略。结果参与者对在线性传播感染检测服务的潜力充满热情，认为它可以在性健康提供者有限的情况下提供选择，为用户提供更大的匿名性（绕过全科医生），提高效率，并支持lphu提供优先事项。然而，由于交通/开放时间有限以及年轻人对耻辱的担忧，需要亲自参加病理服务可能会降低吸引力并造成障碍。导航治疗，如果需要的话，也可能具有挑战性。尽管具有优势，但区域/农村年轻人在进行在线性传播感染检测时可能遇到的障碍与城市地区年轻人面临的障碍不同，而且比城市地区年轻人面临的障碍更严重。需要制定战略，支持在区域/农村地区实施，以充分发挥在线检测的潜力，改善服务不足社区的公平获取机会。

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引用次数: 0

Rural Food Forward: An Appetite for Change 农村食品发展：渴望改变

IF 2.1 4区医学 Q2 NURSING

Australian Journal of Rural Health

Pub Date : 2025-09-22 DOI: 10.1111/ajr.70091

Keith McNaught, Gina Sjepcevich

Aims

This paper explores the pervasive influence of Commercial Determinants of Health (CDoH), particularly the proliferation of ultra-processed foods (UPFs), on rural diets, and introduces the concept of Commercial Determinants of Rural Health (CDoRH) to highlight the unique challenges faced by rural Australian communities. In response, we propose a framework for simple, low-cost, and adaptable initiatives aimed at improving rural food environments and dietary behaviours.

Context

Rural populations experience a disproportionately high burden of non-communicable diseases (NCDs), with poor diet and the widespread availability of UPFs as major contributing factors. The impacts of CDoH, amplified by centralised supply chains and limited market competition, are particularly acute in rural settings. As poor diet remains the most significant modifiable risk factor for NCDs, the need for targeted rural interventions is urgent.

Approach

The proposed model leverages the potential of small-scale, low-cost initiatives that harness social capital and local resources. These initiatives aim to transform local rural food environments and dietary habits through place-based, collaborative, educative, and practical activities such as community gardens, food events, and local partnerships.

Conclusion

This model intervenes in the space between large-scale systemic reform and the everyday food choices of individuals and communities. By fostering quick, accessible, and contextually grounded initiatives, it offers a practical framework for improving local food environments and behaviours, enhancing food literacy, and mitigating the harms of CDoRH in ways that resonate with rural lived experience.

本文探讨了商业健康决定因素（CDoH）对农村饮食的普遍影响，特别是超加工食品（upf）的扩散，并介绍了农村健康商业决定因素（CDoRH）的概念，以突出澳大利亚农村社区面临的独特挑战。为此，我们提出了一个简单、低成本、适应性强的倡议框架，旨在改善农村粮食环境和饮食行为。农村人口承受着不成比例的高非传染性疾病负担，饮食不良和普遍提供普遍健康补贴是主要因素。集中的供应链和有限的市场竞争放大了CDoH的影响，在农村地区尤为严重。由于不良饮食仍然是非传染性疾病最重要的可改变风险因素，因此迫切需要有针对性的农村干预措施。提出的模式利用了利用社会资本和地方资源的小规模、低成本倡议的潜力。这些倡议旨在通过社区花园、食品活动和地方伙伴关系等基于地点的协作、教育和实践活动，改变当地农村的食品环境和饮食习惯。该模型介入了大规模系统性改革与个人和社区日常食物选择之间的空间。通过促进快速、可获取和基于实际情况的举措，它为改善当地食品环境和行为、提高食品素养以及以与农村生活经验产生共鸣的方式减轻CDoRH的危害提供了一个实用框架。

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引用次数: 0

Parkinson's Disease in Australia: Evaluation of Regional Differences and Health-Related Quality of Life 帕金森病在澳大利亚：区域差异和健康相关生活质量的评估。

IF 2.1 4区医学 Q2 NURSING

Australian Journal of Rural Health

Pub Date : 2025-09-19 DOI: 10.1111/ajr.70089

Alycia Messing, Megan J. Hobbs, Frances Quirk, Deborah Apthorp

Background

Parkinson's disease (PD) is a common neurodegenerative condition with no known cure. The prevalence of PD and barriers to accessing clinical care increase with distance from major cities. Understanding factors associated with health-related quality of life (HRQoL) in PD has important clinical and public health implications.

Method

In a national survey of Australian adults diagnosed with PD, we examined the influence of location on HRQoL and demographics, symptom course and diagnosis, treatment utilisation and preferences, and satisfaction with current services. Final data included 87 respondents from six states in Australia, with 55 identified as living in regional areas and 32 in major cities. Measures also included the Parkinson's Disease Questionnaire (PDQ-39) and self-reported Hoehn and Yahr scale for disease severity.

Results

Time to obtain a diagnosis was significantly longer for regional respondents than major city counterparts. There were also significant differences in prioritising 10 statements relating to PD. In an overall analysis examining the impact of all the above variables on HRQoL as determined by the PDQ-39, only the Hoehn and Yahr scores explained significant variance; there was no significant difference between regional and metropolitan respondents after accounting for the other variables.

Conclusion

Individuals living in regional areas experienced longer delays in obtaining a diagnosis of PD. Both groups highly rated better access to neurologists and the need for better diagnosis as priorities. Location, disease duration and satisfaction with services were not significantly associated with HRQoL.

背景：帕金森病（PD）是一种常见的神经退行性疾病，目前尚无治愈方法。PD患病率和获得临床护理的障碍随着距离主要城市的距离而增加。了解PD患者与健康相关的生活质量（HRQoL）相关因素具有重要的临床和公共卫生意义。方法：通过对澳大利亚成年PD患者的全国性调查，我们研究了地理位置对患者HRQoL和人口统计学、症状病程和诊断、治疗利用和偏好以及对当前服务的满意度的影响。最终数据包括来自澳大利亚六个州的87名受访者，其中55人居住在偏远地区，32人居住在大城市。测量还包括帕金森病问卷（PDQ-39）和疾病严重程度的自我报告Hoehn和Yahr量表。结果：获得诊断的时间对地区受访者明显长于主要城市同行。与PD相关的10个陈述的优先级也有显著差异。在检验上述所有变量对由PDQ-39确定的HRQoL的影响的整体分析中，只有Hoehn和Yahr分数解释了显著差异；在考虑了其他变量后，地区和大都市受访者之间没有显著差异。结论：生活在地区的个体在获得PD诊断方面有较长的延迟。两组患者都高度评价了更好地接触神经科医生和更好地诊断的必要性。地点、病程和服务满意度与HRQoL无显著相关。

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引用次数: 0

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