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Rural and remote health

Nash Ak Witten, Joseph Humphry
The Lana'i Community Health Center (LCHC) like other health care organizations, is striving to implement technology-enabled care (TEC) in the clinical setting. TEC includes such technological innovations as patient portals, mobile phone applications, wearable health sensors, and telehealth. This study examines the utilization of communication technology by members of the Lana'i community and LCHC staff and board members in the home and in their daily lives and evaluates the community's electronic health literacy...
March 2018: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
Shannon M Melody, Veronica Martin-Gall, Ben Harding, Mark Gk Veitch
OBJECTIVES: To describe the retail availability of tobacco and to examine the association between tobacco outlet density and area-level remoteness and socio-economic status classification in Tasmania. DESIGN: Ecological cross-sectional study; analysis of tobacco retail outlet data collected by the Department of Health and Human Services (Tasmania) according to area-level (Statistical Areas Level 2) remoteness (defined by the Remoteness Structure of the Australian Statistical Geographical Standard) and socio-economic status (defined by the 2011 Australian Bureau of Statistics Index of Relative Socioeconomic Advantage and Disadvantage)...
March 19, 2018: Medical Journal of Australia
Caitriona Monahan, Mathew Coleman
OBJECTIVES: Despite research showing higher use of amphetamine-type stimulants (ATS) in rural areas, limited research has examined the epidemiology of ATS-related presentations and admissions to remote regional centres. To determine the epidemiology of ATS-related (a) Emergency Department (ED) presentations and (b) inpatient admissions over a five-year period at the Hedland Health Campus (HHC) in remote Western Australia. METHODS: A retrospective review of medical records was conducted...
March 1, 2018: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
Meseret Molla, Henok Negussie, Moses Ngari, Esther Kivaya, Patricia Njuguna, Fikre Enqueselassie, James A Berkley, Gail Davey
BACKGROUND: We use the example of the Gojjam Lymphoedema Best Practice Trial (GoLBeT), a pragmatic trial in a remote rural setting in northern Ethiopia, to extract lessons relevant to other investigators balancing the demands of practicality and community acceptability with internal and external validity in clinical trials. METHODS: We explain in detail the preparation for the trial, its setting in northern Ethiopia, the identification and selection of patients (inclusion and exclusion criterion, identifying and screening of patients at home, enrollment of patients at the health centres and health posts), and randomisation...
March 7, 2018: BMC Medical Research Methodology
Kristine Williams, Diane Blyler, Eric D Vidoni, Clarissa Shaw, JoEllen Wurth, Denise Seabold, Yelena Perkhounkova, Angela Van Sciver
The number of persons with dementia (PWD) in the United States is expected to reach 16 million by 2050. Due to the behavioral and psychological symptoms of dementia, caregivers face challenging in-home care situations that lead to a range of negative health outcomes such as anxiety and depression for the caregivers and nursing home placement for PWD. Supporting Family Caregivers with Technology for Dementia Home Care (FamTechCare) is a multisite randomized controlled trial evaluating the effects of a telehealth intervention on caregiver well-being and PWD behavioral symptoms...
March 5, 2018: Research in Nursing & Health
Ian Hall
The Isles Network of Care (INOC) community nurses work at the extreme of the remote and rural continuum, working mostly as lone practitioners. Following the development of sustainable clinical supervision model for Isles nurses in Orkney, clinical supervision was found to improve both peer support and governance for this group of isolated staff. A literature overview identified the transition of clinical supervision in general nursing over 24 years from 'carrot' to 'stick'. The study included a questionnaire survey that was sent to the 2017 Queen's Nursing Institute Scotland cohort to elicit information about the nurses' experience of clinical supervision...
March 2, 2018: British Journal of Community Nursing
Anderson da Silva Souza, Jacqueline de Almeida Gonçalves Sachett, João Arthur Alcântara, Monique Freire, Maria das Graças Costa Alecrim, Marcus Lacerda, Luiz Carlos de Lima Ferreira, Hui Wen Fan, Vanderson de Souza Sampaio, Wuelton Marcelo Monteiro
Snake envenoming represents a major burden for public health worldwide. In the Amazon, the official number of cases and deaths detected is probably underestimated because of the difficulty riverine and indigenous populations have reaching health centers in order to receive medical assistance. Thus, integrated analysis of health information systems must be used in order to improve adequate health policies. The aim of this work is to describe a series of deaths and identify risk factors for lethality from snakebites in the state of Amazonas, Brazil...
February 25, 2018: Toxicon: Official Journal of the International Society on Toxinology
Temmy Sunyoto, Gamal K Adam, Atia M Atia, Yassin Hamid, Rabie Ali Babiker, Nugdalla Abdelrahman, Catiane Vander Kelen, Koert Ritmeijer, Gabriel Alcoba, Margriet den Boer, Albert Picado, Marleen Boelaert
Early diagnosis and treatment is the principal strategy to control visceral leishmaniasis (VL), or kala-azar in East Africa. As VL strikes remote rural, sparsely populated areas, kala-azar care might not be accessed optimally or timely. We conducted a qualitative study to explore access barriers in a longstanding kala-azar endemic area in southern Gadarif, Sudan. Former kala-azar patients or caretakers, community leaders, and health-care providers were purposively sampled and thematic data analysis was used...
February 26, 2018: American Journal of Tropical Medicine and Hygiene
Susan Thomas, Kristy Crooks, Fakhrul Islam, Peter D Massey
Objective: Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) can cause bacterial skin infections that are common problems for Aboriginal children in New South Wales (NSW). MRSA is not notifiable in NSW and surveillance data describing incidence and prevalence are not routinely collected. The study aims to describe the epidemiology of CA-MRSA in Aboriginal children in the Hunter New England Local Health District (HNELHD). Methods: We linked data from Pathology North Laboratory Management System (AUSLAB) and the HNELHD patient administration system from 33 hospital emergency departments...
October 2017: Western Pacific Surveillance and Response Journal: WPSAR
Rebecca Kehm, Cynthia S Davey, Martha Y Kubik, Marilyn S Nanney
The purpose of this study was to further explore the rural school food environment. This study assessed trends in prevalence of vending machines and vending items within and between Minnesota schools located in 3 rural subtypes: town/rural fringe, town/rural distant, and remote rural. Generalized estimating equation models were employed to analyze data from the 2006 through 2012 School Health Profiles Principal's Surveys (Profiles). All 3 rural subtypes had a statistically significant decrease in the prevalence of low nutrient energy dense (LNED) vending items between 2006 and 2012, with the exception of sports drinks...
2018: Journal of Hunger & Environmental Nutrition
Tarsh Pandit, Robin Ray, Sabe Sabesan
The aim of the study was to determine the training needs of doctors managing emergencies in rural and remote Australia. A systematic review of Australian articles was performed using MEDLINE (OVID) and INFORMIT online databases from 1990 to 2016. The search terms included 'Rural Health', 'Emergency Medicine', 'Emergency Medical Services', 'Education, Medical, Continuing' and 'Family Practice'. Only peer-reviewed articles, available in full-text that focussed on the training needs of rural doctors were reviewed...
February 22, 2018: Emergency Medicine Australasia: EMA
Emma Jane Croager, Victoria Gray, Iain Stephen Pratt, Terry Slevin, Simone Pettigrew, C D'arcy Holman, Max Bulsara, Jon Emery
Introduction: Cancer outcomes for people living in rural and remote areas are worse than for those living in urban areas. Although access to and quality of cancer treatment are important determinants of outcomes, delayed presentation has been observed in rural patients. Methods: Formative research with people from rural Western Australia (WA) led to the Find Cancer Early campaign. Find Cancer Early was delivered in three regions of WA, with two other regions acting as controls...
2018: Frontiers in Public Health
Elizabeth M Wallack, Chelsea Harris, Michelle Ploughman, Roger Butler
BACKGROUND: Telegerontology is an approach using videoconferencing to connect an interdisciplinary team in a regional specialty center to patients in rural communities, which is becoming increasingly practical for addressing current limitations in rural community-based dementia care. OBJECTIVE: Using the remotely-delivered expertise of the Telegerontology dementia care team, we aim to enhance the caregiver/patient/physician triad and thereby provide the necessary support for the person with dementia to "age in place...
February 22, 2018: JMIR Research Protocols
Sidsel Nag, Poul-Erik Kofoed, Johan Ursing, Camilla Koldbæk Lemvigh, Rosa Lundbye Allesøe, Amabelia Rodrigues, Christina Aaby Svendsen, Jacob Dyring Jensen, Michael Alifrangis, Ole Lund, Frank M Aarestrup
BACKGROUND: Plasmodium falciparum malaria remains a major health burden and genomic research represents one of the necessary approaches for continued progress towards malaria control and elimination. Sample acquisition for this purpose is troublesome, with the majority of malaria-infected individuals living in rural areas, away from main infrastructure and the electrical grid. The aim of this study was to describe a low-tech procedure to sample P. falciparum specimens for direct whole genome sequencing (WGS), without use of electricity and cold-chain...
February 23, 2018: Malaria Journal
Tarun Sen Gupta, Peter Johnson, Roy Rasalam, Richard Hays
BACKGROUND: James Cook University (JCU) enrolled its first cohort of 64 in 2000 into a 6-year undergraduate medical program aimed at producing graduates capable of meeting the needs of North Queensland, Australia, with a focus on rural, remote, Indigenous and tropical health. The school's 1465 graduates over 13 cohorts who have a pattern of practice likely to meet the region's health needs. The JCU course was the first new Australian medical program for 25 years. The number of Australian medical schools has since doubled, while enrollments have almost tripled...
February 19, 2018: Medical Teacher
Philip Emerson, Naomi Dodds, David R Green, Jan O Jansen
Background: Critical illness requires specialist and timely management. The aim of this study was to create a geographic accessibility profile of the Scottish population to emergency departments and intensive care units. Methods: This was a descriptive, geographical analysis of population access to 'intermediate' and 'definitive' critical care services in Scotland. Access was defined by the number of people able to reach services within 45 to 60 min, by road and by helicopter...
February 2018: Journal of the Intensive Care Society
Anna M Gorczyca, Richard A Washburn, Lauren Ptomey, Matthew S Mayo, Debra K Sullivan, Cheryl A Gibson, Robert Lee, Sarah Stolte, Joseph E Donnelly
Obesity prevalence is higher in rural compared to urban residents. Rural health clinics offer a potential venue for delivery of weight management. However, traditional programs require travel to attend on-site meetings which is impractical or inconvenient for rural residents. Clinic staff in most rural settings are unlikely to be trained to provide effective weight management. Remote delivery using group phone conferences (GP) or individual phone calls (IP), by staff associated with rural clinics eliminates the need for travel to attend on-site meetings...
February 14, 2018: Contemporary Clinical Trials
Boniface A Ushie, Chimaraoke O Izugbara, Michael M Mutua, Caroline W Kabiru
BACKGROUND: Complications of unsafe abortion are a leading cause of maternal mortality in sub-Saharan Africa. Adolescents and young women are disproportionately represented among those at risk of these complications. Currently, we know little about the factors associated with young women's timing of abortion. This study examined the timing of abortion as well as factors influencing it among adolescents and young women aged 12-24 years who sought post-abortion care (PAC) in health facilities in Kenya...
February 17, 2018: BMC Women's Health
Kate Fennell, Melissa Hull, Martin Jones, James Dollman
INTRODUCTION: The prevalence of chronic disease, mortality and suicide rates is higher in rural Australia than in urban centres. Understanding rural Australians' barriers to accessing health services requires urgent attention. The purpose of this study was to compare barriers to help-seeking for physical and mental health issues among rural South Australian adults. METHODS: A total of 409 people from three rural and remote regions in South Australia completed a computer-assisted telephone interview...
February 2018: Rural and Remote Health
Karen M Lawford, Audrey R Giles, Ivy L Bourgeault
BACKGROUND: Aboriginal peoples in Canada are comprised of First Nations, Métis, and Inuit. Health care services for First Nations who live on rural and remote reserves are mostly provided by the Government of Canada through the federal department, Health Canada. One Health Canada policy, the evacuation policy, requires all First Nations women living on rural and remote reserves to leave their communities between 36 and 38 weeks gestational age and travel to urban centres to await labour and birth...
February 10, 2018: Women and Birth: Journal of the Australian College of Midwives
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