To determine the recent incidence of paediatric Acute Post Streptococcal Glomerulonephritis in Far North Queensland and associated co-occurring clinical conditions.
Setting
Paediatric inpatient unit.
Participants
Patients admitted to Hospital under 14 years of age meeting diagnostic criteria for APSGN between January 2015 and January 2020.
Design
Single centre, retrospective observational analysis. Data and clinical information was extracted from electronic medical records. Case definitions were as specified in the Northern Territory guidelines for APSGN.
Results
APSGN (n = 61) or probable APSGN (n = 4) was found in 65 of the 86 identified cases. Fifty-five APSGN cases were identified as being Aboriginal and/or Torres Strait Islander, with the remaining 10 cases identifying as other ethnic groups. Mean annual incidence (0–14 years) was 27/100 000 person years. Aboriginal and/or Torres Strait Islander population incidence was 104/100 000 person years. Recurrent skin infection was noted in the majority of cases. Nineteen cases were lost to follow up; of these, 15 were from rural regions.
Conclusions
A high incidence of childhood APSGN is present in Far North Queensland, with First nation's children overrepresented. This further adds to the national body of data on the disease, highlighting the necessity of an amplified response addressing the disease burden of group A Streptococcus and its main drivers, social disadvantage and remoteness. There is a need for enhanced surveillance and monitoring of the chronic sequelae of APSGN. Opportunities exist to amalgamate follow-up practices across the region, and there is a need to enact reporting of the disease in Queensland.
{"title":"Childhood Acute Post Streptococcal Glomerulonephritis in Far North Queensland","authors":"Mercy Nderitu, Emma McDougall, Thomas Volkman","doi":"10.1111/ajr.70069","DOIUrl":"https://doi.org/10.1111/ajr.70069","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To determine the recent incidence of paediatric Acute Post Streptococcal Glomerulonephritis in Far North Queensland and associated co-occurring clinical conditions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Paediatric inpatient unit.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Patients admitted to Hospital under 14 years of age meeting diagnostic criteria for APSGN between January 2015 and January 2020.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Single centre, retrospective observational analysis. Data and clinical information was extracted from electronic medical records. Case definitions were as specified in the Northern Territory guidelines for APSGN.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>APSGN (<i>n</i> = 61) or probable APSGN (<i>n</i> = 4) was found in 65 of the 86 identified cases. Fifty-five APSGN cases were identified as being Aboriginal and/or Torres Strait Islander, with the remaining 10 cases identifying as other ethnic groups. Mean annual incidence (0–14 years) was 27/100 000 person years. Aboriginal and/or Torres Strait Islander population incidence was 104/100 000 person years. Recurrent skin infection was noted in the majority of cases. Nineteen cases were lost to follow up; of these, 15 were from rural regions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A high incidence of childhood APSGN is present in Far North Queensland, with First nation's children overrepresented. This further adds to the national body of data on the disease, highlighting the necessity of an amplified response addressing the disease burden of group A Streptococcus and its main drivers, social disadvantage and remoteness. There is a need for enhanced surveillance and monitoring of the chronic sequelae of APSGN. Opportunities exist to amalgamate follow-up practices across the region, and there is a need to enact reporting of the disease in Queensland.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144666564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rebecca Jarrott, Judy Ranka, Melissa Nott, Robyn Williams
Objective
Explore perspectives of occupational therapists on the use of the Perceive, Recall, Plan and Perform Assessment (PRPP-A) to assess functional cognition when working with Aboriginal and Torres Strait Islander peoples.
Setting
Health services in the Northern Territory.
Participants
Thirteen occupational therapists trained in the use of the PRPP-A and experienced in working with Aboriginal and Torres Strait Islander peoples.
Design
A qualitative, exploratory research design was adopted. Data were collected via focus groups, which were audio-recorded and transcribed verbatim. Each transcript was systematically reviewed using a reflexive thematic analysis approach and inductively coded. Shared meaning was identified and analysed across the data to develop themes.
Results
Five themes were identified: (1) challenges and tensions assessing cognition (knowing); (2) effectiveness of the PRPP-A in practice (doing); (3) embedding the PRPP-A in practice (doing); (4) facilitating meaningful assessment of functional cognition (being) and (5) valuing the occupational therapy role (being). Occupational therapists described a sense of knowing more about cognition after completing PRPP-A training. They described how the process of doing cognitive assessment using the PRPP-A informed clinical reasoning processes, facilitated collaboration with clients and family members, and supported the negotiation of culturally safe practice. This culminated in their occupational therapy roles being more satisfying as participants described improved alignment between their roles and their sense of occupational therapy core values.
Conclusion
The PRPP-A was found to have clinical utility and supported clinical reasoning for occupational therapists when assessing cognition with Aboriginal and Torres Strait Islander peoples in the Northern Territory.
{"title":"Exploring Occupational Therapists Use of the Perceive, Recall, Plan and Perform Assessment When Working With Aboriginal and Torres Strait Islander Peoples in the Northern Territory","authors":"Rebecca Jarrott, Judy Ranka, Melissa Nott, Robyn Williams","doi":"10.1111/ajr.70073","DOIUrl":"https://doi.org/10.1111/ajr.70073","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Explore perspectives of occupational therapists on the use of the Perceive, Recall, Plan and Perform Assessment (PRPP-A) to assess functional cognition when working with Aboriginal and Torres Strait Islander peoples.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Health services in the Northern Territory.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Thirteen occupational therapists trained in the use of the PRPP-A and experienced in working with Aboriginal and Torres Strait Islander peoples.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A qualitative, exploratory research design was adopted. Data were collected via focus groups, which were audio-recorded and transcribed verbatim. Each transcript was systematically reviewed using a reflexive thematic analysis approach and inductively coded. Shared meaning was identified and analysed across the data to develop themes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five themes were identified: (1) challenges and tensions assessing cognition (<i>knowing</i>); (2) effectiveness of the PRPP-A in practice (<i>doing</i>); (3) embedding the PRPP-A in practice (<i>doing</i>); (4) facilitating meaningful assessment of functional cognition (<i>being</i>) and (5) valuing the occupational therapy role (<i>being</i>). Occupational therapists described a sense of <i>knowing</i> more about cognition after completing PRPP-A training. They described how the process of <i>doing</i> cognitive assessment using the PRPP-A informed clinical reasoning processes, facilitated collaboration with clients and family members, and supported the negotiation of culturally safe practice. This culminated in their occupational therapy roles <i>being</i> more satisfying as participants described improved alignment between their roles and their sense of occupational therapy core values.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The PRPP-A was found to have clinical utility and supported clinical reasoning for occupational therapists when assessing cognition with Aboriginal and Torres Strait Islander peoples in the Northern Territory.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70073","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144666495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tehan PE, Donnelly H, Martin E, Peterson B, Hawke F. Experiences and impact of a rural Australian high-risk foot service: A multiple-methods study. Aust J Rural Health. 2024; 32: 286–298. https://doi.org/10.1111/ajr.13087
The above article included an interview with an Aboriginal Health Worker, for which specific ethics approval was not sought. To rectify this omission, revisions have been made to the online article to exclude data from the Aboriginal Health Worker participant.
We apologise for this error.
Tehan PE, Donnelly H, Martin E, Peterson B, Hawke F.澳大利亚农村高风险足部服务的经验和影响：一项多方法研究。[J]农村卫生。2024；32: 286 - 298。https://doi.org/10.1111/ajr.13087The上述文章包括对一名土著卫生工作者的采访，没有为此寻求具体的伦理批准。为了纠正这一遗漏，已对在线文章进行了修订，以排除土著卫生工作者参与者的数据。我们为这个错误道歉。
{"title":"Correction to ‘Experiences and impact of a rural Australian high-risk foot service: A multiple-methods study’","authors":"","doi":"10.1111/ajr.70072","DOIUrl":"https://doi.org/10.1111/ajr.70072","url":null,"abstract":"<p>Tehan PE, Donnelly H, Martin E, Peterson B, Hawke F. Experiences and impact of a rural Australian high-risk foot service: A multiple-methods study. <i>Aust J Rural Health</i>. 2024; 32: 286–298. https://doi.org/10.1111/ajr.13087</p><p>The above article included an interview with an Aboriginal Health Worker, for which specific ethics approval was not sought. To rectify this omission, revisions have been made to the online article to exclude data from the Aboriginal Health Worker participant.</p><p>We apologise for this error.</p>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70072","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Matt Thomas, Justine Summers, Sherryn Honeywood, Alyssa Fitzgerald, Donna Ambler, Kylie Falciani, Amanda Cook, Kelly Smith, Dean Bright, Michelle Lindsay, Catherine Sanford
<p>There is a lack of evidence generated by health program evaluation in rural contexts [<span>1, 2</span>]. Evaluation of health programs is important for determining outcomes and impact [<span>3</span>], providing evidence for policy and funding decisions [<span>4</span>], and to drive continuous improvement of health programs that address inequalities in rural health outcomes [<span>5, 6</span>]. There are several challenges to healthcare evaluation in rural settings [<span>1, 2, 4-6</span>]. These can include resource limitations such as shortages of healthcare professionals, facilities, infrastructure, and funding, as well as geographical barriers such as vast distances and transportation issues, which may impede stakeholder engagement and data collection processes. Program evaluation must be tailored to the unique cultural and social contexts of rural communities. For example, qualitative data from interviews, video and audio recordings, and written feedback can provide useful evidence of outcomes and experiences of receiving care but may not be deemed appropriate in some communities. The views and support of Elders and other community leaders can guide the design and implementation of culturally safe and welcoming program evaluation activity. While a detailed explanation of these issues and management strategies is beyond the scope of this article, suggestions for approaching some of these issues are noted, and more information about managing these issues can be found.</p><p>Given these challenges, rural clinicians and health program managers are often well placed to lead the evaluation of health programs. However, they may not be familiar with evaluation methods. This article provides an overview of a simple step-by-step process for planning health program evaluation and demonstrates a method for developing data collection and reporting plans from a program logic document.</p><p>Evaluation of health programs is recognised as essential for providing evidence that can ultimately address inequality of health outcomes in rural communities [<span>4-6</span>]. However, this evidence is lacking for many rural health services [<span>1, 2</span>]. Our paper shares a simple introduction to operationalising a data collection and reporting plan from program logic. This method has been successfully implemented across several rural-based health and wellbeing programs, including a multidisciplinary paediatric outreach clinic, peer navigator, diabetes mentoring, Sense rugby (a rugby skill program for children with disability), as well as a school-based reading program. It may be useful to leaders in rural health who are considering program evaluation. Future research will evaluate and further develop this method with a focus on rural health programs.</p><p><b>Matt Thomas:</b> conceptualization, writing – original draft, methodology. <b>Justine Summers:</b> writing – review and editing. <b>Sherryn Honeywood:</b> writing – review and editing, methodology.
{"title":"Steps for Planning Health Program Evaluations: From Program Logic to Data Collection and Reporting Plans","authors":"Matt Thomas, Justine Summers, Sherryn Honeywood, Alyssa Fitzgerald, Donna Ambler, Kylie Falciani, Amanda Cook, Kelly Smith, Dean Bright, Michelle Lindsay, Catherine Sanford","doi":"10.1111/ajr.70068","DOIUrl":"https://doi.org/10.1111/ajr.70068","url":null,"abstract":"<p>There is a lack of evidence generated by health program evaluation in rural contexts [<span>1, 2</span>]. Evaluation of health programs is important for determining outcomes and impact [<span>3</span>], providing evidence for policy and funding decisions [<span>4</span>], and to drive continuous improvement of health programs that address inequalities in rural health outcomes [<span>5, 6</span>]. There are several challenges to healthcare evaluation in rural settings [<span>1, 2, 4-6</span>]. These can include resource limitations such as shortages of healthcare professionals, facilities, infrastructure, and funding, as well as geographical barriers such as vast distances and transportation issues, which may impede stakeholder engagement and data collection processes. Program evaluation must be tailored to the unique cultural and social contexts of rural communities. For example, qualitative data from interviews, video and audio recordings, and written feedback can provide useful evidence of outcomes and experiences of receiving care but may not be deemed appropriate in some communities. The views and support of Elders and other community leaders can guide the design and implementation of culturally safe and welcoming program evaluation activity. While a detailed explanation of these issues and management strategies is beyond the scope of this article, suggestions for approaching some of these issues are noted, and more information about managing these issues can be found.</p><p>Given these challenges, rural clinicians and health program managers are often well placed to lead the evaluation of health programs. However, they may not be familiar with evaluation methods. This article provides an overview of a simple step-by-step process for planning health program evaluation and demonstrates a method for developing data collection and reporting plans from a program logic document.</p><p>Evaluation of health programs is recognised as essential for providing evidence that can ultimately address inequality of health outcomes in rural communities [<span>4-6</span>]. However, this evidence is lacking for many rural health services [<span>1, 2</span>]. Our paper shares a simple introduction to operationalising a data collection and reporting plan from program logic. This method has been successfully implemented across several rural-based health and wellbeing programs, including a multidisciplinary paediatric outreach clinic, peer navigator, diabetes mentoring, Sense rugby (a rugby skill program for children with disability), as well as a school-based reading program. It may be useful to leaders in rural health who are considering program evaluation. Future research will evaluate and further develop this method with a focus on rural health programs.</p><p><b>Matt Thomas:</b> conceptualization, writing – original draft, methodology. <b>Justine Summers:</b> writing – review and editing. <b>Sherryn Honeywood:</b> writing – review and editing, methodology. ","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70068","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144537057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This commentary considers the evolving landscape of medical education in rural Australia and highlights the need to renew and innovate in rural end-to-end programs.
Context
The Commonwealth government has funded new medical school places to be based in rural locations across the country supported by accredited medical programs. This new era offers a welcome change to the medical education landscape but also shines a light on traditional curricula and selection processes in medical schools.
Approach
We highlight current trends and areas for innovation in key areas of medical curricula. We frame discussion around the key graduate outcomes outlined by the Australian Medical Council (AMC) and ask how we need to adapt to meet these outcomes for students immersed in rural regions for the duration of their studies.
Conclusion
Rural end-to-end programs have the potential to positively shape the future of medical education and rural workforce for Australia by better aligning education systems to community needs, and matching programs to students with propensity to serve rural and remote communities. Curricula and placements will need to adapt to support future graduate outcomes. The success of rural end-to-end medical schools will also depend on support for local, rural and Indigenous student entry and continued support and advocacy for rural clinicians and educators.
{"title":"The Future of Rural Medical Education in Australia","authors":"James Padley","doi":"10.1111/ajr.70071","DOIUrl":"https://doi.org/10.1111/ajr.70071","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This commentary considers the evolving landscape of medical education in rural Australia and highlights the need to renew and innovate in rural end-to-end programs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Context</h3>\u0000 \u0000 <p>The Commonwealth government has funded new medical school places to be based in rural locations across the country supported by accredited medical programs. This new era offers a welcome change to the medical education landscape but also shines a light on traditional curricula and selection processes in medical schools.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>We highlight current trends and areas for innovation in key areas of medical curricula. We frame discussion around the key graduate outcomes outlined by the Australian Medical Council (AMC) and ask how we need to adapt to meet these outcomes for students immersed in rural regions for the duration of their studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Rural end-to-end programs have the potential to positively shape the future of medical education and rural workforce for Australia by better aligning education systems to community needs, and matching programs to students with propensity to serve rural and remote communities. Curricula and placements will need to adapt to support future graduate outcomes. The success of rural end-to-end medical schools will also depend on support for local, rural and Indigenous student entry and continued support and advocacy for rural clinicians and educators.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70071","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144537056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ramsden, R., Pappas, S.-J., Rostas, J., Islam, M.I., Martiniuk, A. and Guisard, Y. (2025), Rural Health Pro—A Digital Platform Connecting Rural People, Organisations, and Communities. Aust J Rural Health, 33: e70050. https://doi.org/10.1111/ajr.70050.
In the sixth paragraph of the ‘Introduction’ section of the above article, the sentence ‘In 2020, [name of organisation] launched Rural Health Pro, a digital platform to address increasing disparities in healthcare access in rural areas to help retain health professionals in rural Australia’ should be corrected to ‘In 2020, Rural Doctors Network launched Rural Health Pro, a digital platform to address increasing disparities in healthcare access in rural areas to help retain health professionals in rural Australia’.
In the ‘2.9 Ethical Considerations’ section of the above article, the paragraph should be corrected to ‘Ethical approval for this study “Evaluating Rural Health Pro—A web platform to support rural health professionals,” was obtained from Deakin University Faculty of Health HEAG-H 195_2020’.
{"title":"Correction to ‘Ramsden, R., Pappas, S.-J., Rostas, J., Islam, M.I., Martiniuk, A. and Guisard, Y. (2025), Rural Health Pro—A Digital Platform Connecting Rural People, Organisations, and Communities’","authors":"","doi":"10.1111/ajr.70070","DOIUrl":"https://doi.org/10.1111/ajr.70070","url":null,"abstract":"<p>Ramsden, R., Pappas, S.-J., Rostas, J., Islam, M.I., Martiniuk, A. and Guisard, Y. (2025), Rural Health Pro—A Digital Platform Connecting Rural People, Organisations, and Communities. Aust J Rural Health, 33: e70050. https://doi.org/10.1111/ajr.70050.</p><p>In the sixth paragraph of the ‘Introduction’ section of the above article, the sentence ‘In 2020, [name of organisation] launched Rural Health Pro, a digital platform to address increasing disparities in healthcare access in rural areas to help retain health professionals in rural Australia’ should be corrected to ‘In 2020, Rural Doctors Network launched Rural Health Pro, a digital platform to address increasing disparities in healthcare access in rural areas to help retain health professionals in rural Australia’.</p><p>In the ‘2.9 Ethical Considerations’ section of the above article, the paragraph should be corrected to ‘Ethical approval for this study “Evaluating Rural Health Pro—A web platform to support rural health professionals,” was obtained from Deakin University Faculty of Health HEAG-H 195_2020’.</p><p>We apologise for the errors.</p>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70070","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Peter Simmons, Uchechukwu Levi Osuagwu, Hazel Dalton, Julaine Allan, John Eme, Tracy Macfarlane, Haider Mannan
Objective
To explore processes that engage rural men in a weekly, enduring, community-volunteer-organised walk for mental well-being, and compare with characteristics of Third Places (relaxing social places that are neither home nor work).
Setting
Bathurst, regional city population 44 939 (2024), New South Wales, Australia.
Participants
Bathurst Men's Walk and Talk (BMWT) walkers tend to be older and in a married/defacto relationship. More than one-third score low on mental well-being indices.
Design
In-depth semi-structured interviews (n = 20) with walkers (13) and leaders (7) of the BMWT were thematically analysed, inductively and deductively.
Main Outcome Measures
Interviewee descriptions of experiences of BMWT and its impacts reported against Oldenburg's (1989/1999) eight characteristics of Third place, and use of rituals.
Results
BMWT is more routinised but has essential characteristics of an ideal Third place. BMWT accentuates the essence of Third place including welcome, inclusion, conversation and belonging to the group. BMWT balances culture and structures that meet diverse needs for connection and enjoyment in the manner of a Third place, while communicating safety and reassurance required for men who seek or need support for mental well-being. Interviewees reported mood and well-being benefits from BMWT physical activity, social interaction and belonging.
Conclusion
Thoughtful planning can increase health-giving social interaction and feelings of belonging consistent with Third place experiences. In rural areas where men often miss out on mental well-being support, Third place provides a framework to guide individual group and community planning.
{"title":"Walk for Mental Well-Being as a Third Place: A Qualitative Study of the Bathurst Men's Walk and Talk","authors":"Peter Simmons, Uchechukwu Levi Osuagwu, Hazel Dalton, Julaine Allan, John Eme, Tracy Macfarlane, Haider Mannan","doi":"10.1111/ajr.70066","DOIUrl":"https://doi.org/10.1111/ajr.70066","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To explore processes that engage rural men in a weekly, enduring, community-volunteer-organised walk for mental well-being, and compare with characteristics of <i>Third Places</i> (relaxing social places that are neither home nor work).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Bathurst, regional city population 44 939 (2024), New South Wales, Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Bathurst Men's Walk and Talk (BMWT) walkers tend to be older and in a married/defacto relationship. More than one-third score low on mental well-being indices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>In-depth semi-structured interviews (<i>n</i> = 20) with walkers (13) and leaders (7) of the BMWT were thematically analysed, inductively and deductively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Interviewee descriptions of experiences of BMWT and its impacts reported against Oldenburg's (1989/1999) eight characteristics of <i>Third place</i>, and use of rituals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>BMWT is more routinised but has essential characteristics of an ideal <i>Third place</i>. BMWT accentuates the essence of <i>Third place</i> including welcome, inclusion, conversation and belonging to the group. BMWT balances culture and structures that meet diverse needs for connection and enjoyment in the manner of a <i>Third place</i>, while communicating safety and reassurance required for men who seek or need support for mental well-being. Interviewees reported mood and well-being benefits from BMWT physical activity, social interaction and belonging.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Thoughtful planning can increase health-giving social interaction and feelings of belonging consistent with <i>Third place</i> experiences. In rural areas where men often miss out on mental well-being support, <i>Third place</i> provides a framework to guide individual group and community planning.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70066","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144339572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The complexity of problematic alcohol, smoking, vaping and other drug use is compounded in rural, regional and remote Australia (hereafter rural), which makes up more than 30% of the population or 7.3 million people. Substance misuse in rural Australian communities intersects with historic social and economic disadvantage characterised by the tyranny of distance and the implementation of metrocentric policies and inflexible funding that do not translate into positive outcomes for rural communities. With a limited healthcare workforce and inadequate investment in supportive infrastructure, the flow-on effects to community wellbeing are prominent.
The National Rural Health Alliance has recently published a fact sheet on Alcohol, Smoking, Vaping and Other Drugs as an outcome of research collated for a Parliamentary Inquiry into the Health Impacts of Alcohol and Other Drugs in Australia. The data presented in the fact sheet and the submission support the broader implications that the social determinants of health and the historic disadvantages faced by rural Australians are intrinsically linked to outcomes of alcohol, smoking, vaping and other drug use.
Current data continues to highlight the need for rural Australia to be considered a priority area for investment for alcohol, smoking and other drug use. Rural Australians face higher rates of alcohol related harm, with residents aged over 14 living in Remote and Very Remote areas being approximately 1.4 times more likely to consume alcohol at risky levels compared to their urban counterparts [1]. People living in Very Remote areas had the highest rates of alcohol-related injury hospitalisations in the country, over 8 times the national rate and almost 11 times the rate for people living in Major Cities [1].
Tobacco smoking rates in rural Australia are also higher than those living in Major Cities. While tobacco use in rural areas remains high, the use of e-cigarettes is lower. Given the emerging public health concerns surrounding e-cigarette usage, research as to why these rates are lower must be considered to maintain lower uptake in rural communities. Rates of illicit drug use in remote areas remained the highest in recent data collection compared to other geographic areas [1].
These higher rates in rural Australia do not happen in isolation, nor out of coincidence. Rather, the direct cause of these elevated poor health outcomes is intrinsically linked to the social determinants of health, a historical lack of investment in rural health and a limited health workforce. For example, rural Australians are 24 times more likely to be hospitalised due to domestic violence than people in Major Cities [2]. Co-occurring alcohol misuse can be correlated with elevated risks of family and domestic violence, with approximately one-third of all violent incidents experienced (as victim or perpe
{"title":"The Story Behind the Data: Addressing Broader Social Determinants in Harm Reduction Policy for Rural Alcohol, Vaping, Smoking and Other Drug Use","authors":"Carmen Ellis","doi":"10.1111/ajr.70064","DOIUrl":"https://doi.org/10.1111/ajr.70064","url":null,"abstract":"<p>The complexity of problematic alcohol, smoking, vaping and other drug use is compounded in rural, regional and remote Australia (hereafter rural), which makes up more than 30% of the population or 7.3 million people. Substance misuse in rural Australian communities intersects with historic social and economic disadvantage characterised by the tyranny of distance and the implementation of metrocentric policies and inflexible funding that do not translate into positive outcomes for rural communities. With a limited healthcare workforce and inadequate investment in supportive infrastructure, the flow-on effects to community wellbeing are prominent.</p><p>The National Rural Health Alliance has recently published a fact sheet on Alcohol, Smoking, Vaping and Other Drugs as an outcome of research collated for a Parliamentary Inquiry into the Health Impacts of Alcohol and Other Drugs in Australia. The data presented in the fact sheet and the submission support the broader implications that the social determinants of health and the historic disadvantages faced by rural Australians are intrinsically linked to outcomes of alcohol, smoking, vaping and other drug use.</p><p>Current data continues to highlight the need for rural Australia to be considered a priority area for investment for alcohol, smoking and other drug use. Rural Australians face higher rates of alcohol related harm, with residents aged over 14 living in <i>Remote</i> and <i>Very Remote</i> areas being approximately 1.4 times more likely to consume alcohol at risky levels compared to their urban counterparts [<span>1</span>]. People living in <i>Very Remote</i> areas had the highest rates of alcohol-related injury hospitalisations in the country, over 8 times the national rate and almost 11 times the rate for people living in <i>Major Cities</i> [<span>1</span>].</p><p>Tobacco smoking rates in rural Australia are also higher than those living in <i>Major Cities</i>. While tobacco use in rural areas remains high, the use of e-cigarettes is lower. Given the emerging public health concerns surrounding e-cigarette usage, research as to why these rates are lower must be considered to maintain lower uptake in rural communities. Rates of illicit drug use in remote areas remained the highest in recent data collection compared to other geographic areas [<span>1</span>].</p><p>These higher rates in rural Australia do not happen in isolation, nor out of coincidence. Rather, the direct cause of these elevated poor health outcomes is intrinsically linked to the social determinants of health, a historical lack of investment in rural health and a limited health workforce. For example, rural Australians are 24 times more likely to be hospitalised due to domestic violence than people in <i>Major Cities</i> [<span>2</span>]. Co-occurring alcohol misuse can be correlated with elevated risks of family and domestic violence, with approximately one-third of all violent incidents experienced (as victim or perpe","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70064","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lauren Arthurson, Suzanne Harrison, Benjamin Clissold, Christopher Bladin, Glenn Howlett, Felix Ng, Philip M. C. Choi
Problem
People living in rural areas of Australia have an increased risk of stroke. Reperfusion decision support is increasingly available in these areas however, access to acute stroke unit care is limited.
Setting
An acute telestroke unit pilot was implemented in a regional health service in Victoria.
Key Measures for Improvement
Change in diagnosis post specialist evaluation, patient and staff satisfaction, length of stay, percentage of patients discharged with anti-platelets and care plan provision.
Strategies for Change
Partnership between metro-based stroke specialists and an onsite stroke coordinator based in a regional site. Early engagement of key decision makers (i.e., hospital executive).
Effects of Changes
This model increased diagnostic accuracy and decreased resource use including diagnostic tests, patient transfers and staff deployment. Patients, families and staff reported high levels of satisfaction. The pilot transitioned to a sustainable health service funded model, embedded into ‘usual’ care. The BUILDS pilot enabled stroke unit certification of the regional health service.
Lessons Learnt
Telestroke unit model, enabled by an adequately resourced local stroke coordinator, could be the key to ensure all regional Australians have access to stroke unit care.
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<p>The Albanese Government now has the opportunity to swiftly advance the numerous reviews and recommendations to ensure health equity for all Australians. The reviews developed in collaboration with stakeholders, including the National Rural Health Alliance (the Alliance) during their first term, recommended innovative solutions, which will go a considerable way in supporting rural, remote and regional communities, as well as urban centres. The government must now ensure that it implements grassroots recommendations, as it is there that flexible implementation and funding are needed the most. The Alliance is standing by to work hand in hand with the government to ensure that no one continues to be left behind.</p><p>The Alliance has worked closely with the first-term government on the <i>Unleashing the Potential of our Health Workforce: Scope of Practice Review</i>, the <i>Strengthening Medicare Measures</i>, the <i>National Medical Workforce Strategy</i>, and the <i>Australian Digital Health Workforce Strategy</i>. With solutions at hand, the newly elected government is now tasked with taking this a step further by putting words into practice and funding in place. Rural, regional, and remote communities rely heavily on the government's policy, funding, and flexibility to achieve health equity.</p><p>The Alliance, through its work with its members, communities and other stakeholders, considers every day how we can ensure that workable solutions are provided to the government. We need to ensure that expenditure in healthcare delivery, research, workforce training and education, as well as infrastructure and systems that underpin the health and wellbeing of rural Australians, is equitable.</p><p>The fact that rural populations are sicker than urban individuals is not new. Rather, it is getting worse with remote men dying up to 13.6 years and rural women 12.7 years earlier than in urban Australia.</p><p>It remains disappointing and unacceptable for a Western country to treat 30% of the population that provides for Australia's economic wellbeing as a burden, rather than a population that is valued, important and treated equitably. The first-term government's reforms promise to break down these barriers and inequities, and the Alliance eagerly awaits to see positive results.</p><p>The solutions are also in the context of the annual $6.55 billion health underspend in rural Australia compared to city expenditure. It is also important to factor in Australia's reliance on rural Australia for its economic contribution and vibrant and positive lifestyle status, despite the high cost of living and climate challenges such as drought, flooding and other extreme weather events.</p><p>The Alliance has been working with the Department of Health and Aged Care to provide positive solutions, rather than tweak policies around the edges. Medicare, while very much valued, is but one tool. Equitable access requires more than Medicare. The investment of $8.5 billion to
{"title":"Fair Funding for Rural Health, an Urgent Call","authors":"Susanne Tegen","doi":"10.1111/ajr.70058","DOIUrl":"https://doi.org/10.1111/ajr.70058","url":null,"abstract":"<p>The Albanese Government now has the opportunity to swiftly advance the numerous reviews and recommendations to ensure health equity for all Australians. The reviews developed in collaboration with stakeholders, including the National Rural Health Alliance (the Alliance) during their first term, recommended innovative solutions, which will go a considerable way in supporting rural, remote and regional communities, as well as urban centres. The government must now ensure that it implements grassroots recommendations, as it is there that flexible implementation and funding are needed the most. The Alliance is standing by to work hand in hand with the government to ensure that no one continues to be left behind.</p><p>The Alliance has worked closely with the first-term government on the <i>Unleashing the Potential of our Health Workforce: Scope of Practice Review</i>, the <i>Strengthening Medicare Measures</i>, the <i>National Medical Workforce Strategy</i>, and the <i>Australian Digital Health Workforce Strategy</i>. With solutions at hand, the newly elected government is now tasked with taking this a step further by putting words into practice and funding in place. Rural, regional, and remote communities rely heavily on the government's policy, funding, and flexibility to achieve health equity.</p><p>The Alliance, through its work with its members, communities and other stakeholders, considers every day how we can ensure that workable solutions are provided to the government. We need to ensure that expenditure in healthcare delivery, research, workforce training and education, as well as infrastructure and systems that underpin the health and wellbeing of rural Australians, is equitable.</p><p>The fact that rural populations are sicker than urban individuals is not new. Rather, it is getting worse with remote men dying up to 13.6 years and rural women 12.7 years earlier than in urban Australia.</p><p>It remains disappointing and unacceptable for a Western country to treat 30% of the population that provides for Australia's economic wellbeing as a burden, rather than a population that is valued, important and treated equitably. The first-term government's reforms promise to break down these barriers and inequities, and the Alliance eagerly awaits to see positive results.</p><p>The solutions are also in the context of the annual $6.55 billion health underspend in rural Australia compared to city expenditure. It is also important to factor in Australia's reliance on rural Australia for its economic contribution and vibrant and positive lifestyle status, despite the high cost of living and climate challenges such as drought, flooding and other extreme weather events.</p><p>The Alliance has been working with the Department of Health and Aged Care to provide positive solutions, rather than tweak policies around the edges. Medicare, while very much valued, is but one tool. Equitable access requires more than Medicare. The investment of $8.5 billion to ","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70058","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144256277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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