Tuberculosis among transhumant pastoralist and settled communities of south-eastern Mauritania.
CONCLUSIONS: TB prevalences were high among both pastoralists and villagers. None of the 14 presumptive cases sought prior diagnostic testing. TB diagnostic centres in the remote rural study zone were poorly equipped. These centres must remain in operation to reduce TB incidence in vulnerable communities in insecure remote rural zones and to reach national health goals. PMID: 27171765 [PubMed - as supplied by publisher] (Source: Rural Remote Health)
Source: Rural Remote Health - May 15, 2016 Category: Rural Health Authors: Lô A, Tall-Dia A, Bonfoh B, Schelling E Tags: Glob Health Action Source Type: research

The effect of holiday haemodialysis treatments on patient mood, adverse symptoms and subjective wellbeing using the Big Red Kidney Bus.
CONCLUSION: The Big Red Kidney Bus provided a safe and feasible holiday dialysis service. Holidaymakers' wellbeing was reflected by the decreased dialysis patient side effects. PMID: 27161902 [PubMed - as supplied by publisher] (Source: Rural Remote Health)
Source: Rural Remote Health - May 8, 2016 Category: Rural Health Authors: Sims J, Bennett PN, Ockerby C, Ludlow M, Fairbairn J, Wilson A, Kerr PG Tags: Nephrology (Carlton) Source Type: research

Management of acute traumatic intracranial haematoma in rural and remote areas of Australia.
CONCLUSION: LMOs in remote locations may consider immediate drainage of deteriorating traumatic ICH. Adequate support from a distant major trauma centre can help achieve acceptable outcomes. Effective communications are vital. The Royal Australasian College of Surgeons and Neurosurgical Society of Australasia guidelines based on the Early Management of Severe Trauma protocols can assist LMOs in making the decision to undertake emergency craniotomy. PMID: 27145070 [PubMed - as supplied by publisher] (Source: Rural Remote Health)
Source: Rural Remote Health - May 2, 2016 Category: Rural Health Authors: Gilligan J, Reilly P, Pearce A, Taylor D Tags: ANZ J Surg Source Type: research

Self-Reported Barriers to Healthcare Access for Rheumatoid Arthritis Patients in Rural and Northern Saskatchewan: A Mixed Methods Study.
Abstract OBJECTIVES: The aim of the present study was to identify potential barriers for access to medical and allied health services from the perspective of rural and Northern Saskatchewan rheumatoid arthritis (RA) patients. METHODS: A total of 100 adults with established RA, residing in rural and Northern Saskatchewan, were recruited from two rheumatology practices. Structured interviews with standardized scripts solicited patient perspectives on appointment waiting times, travel required to access medical services and satisfaction with healthcare provision. Thematic analysis was employed for qualitative da...
Source: Rural Remote Health - May 2, 2016 Category: Rural Health Authors: Nair BV, Schuler R, Stewart S, Taylor-Gjevre RM Tags: Musculoskeletal Care Source Type: research

The effectiveness of Internet-based e-learning on clinician behaviour and patient outcomes: A systematic review.
CONCLUSION: This review found insufficient evidence regarding the effectiveness of e-learning on healthcare professional behaviour or patient outcomes, consequently further research in this area is warranted. Future randomised controlled trials should adhere to the CONSORT reporting guidelines in order to improve the quality of reporting, to allow evaluation of the effectiveness of e-learning programmes on healthcare professional behaviour and patient outcomes. PMID: 27045566 [PubMed - in process] (Source: Rural Remote Health)
Source: Rural Remote Health - April 7, 2016 Category: Rural Health Authors: Sinclair PM, Kable A, Levett-Jones T, Booth D Tags: Int J Nurs Stud Source Type: research

Prevalence and incidence of frailty in Aboriginal Australians, and associations with mortality and disability.
CONCLUSIONS: Frailty in remote-living Aboriginal Australians is highly prevalent; substantially higher than in other populations. Research to understand the underlying causes of frailty in this population, and if possible, reverse frailty, is urgently needed. PMID: 27013294 [PubMed - in process] (Source: Rural Remote Health)
Source: Rural Remote Health - March 26, 2016 Category: Rural Health Authors: Hyde Z, Flicker L, Smith K, Atkinson D, Fenner S, Skeaf L, Malay R, Giudice DL Tags: Maturitas Source Type: research

Supply and Perceived Demand for Teleophthalmology in Triage and Consultations in California Emergency Departments.
Conclusions and Relevance: Availability of ophthalmology coverage for emergency eye care is limited, particularly among rural emergency departments in California. Surveyed emergency department nurse managers and physicians indicated moderately high interest and perceived value for a teleophthalmology solution for remote triage and consultation. Overall, the study suggests that teleophthalmology could play a role in mitigating coverage gaps in emergency ophthalmic care and could be further investigated through similar studies in other regions. PMID: 27010537 [PubMed - as supplied by publisher] (Source: Rural Remote Health)
Source: Rural Remote Health - March 23, 2016 Category: Rural Health Authors: Wedekind L, Sainani K, Pershing S Tags: JAMA Ophthalmol Source Type: research

Portable Ultrasound Devices in the Pre-Hospital Setting: A Review of Clinical and Cost-Effectiveness and Guidelines
Authors: Abstract Emergency physicians often rely on technology such as portable ultrasound (US) to assist in decision making when treating patients in critical condition. Portable US devices, also referred to as point-of-care US (POCUS), mobile US, bedside US, and encompassing specific procedures such as focused-assessment with sonography for trauma (FAST), comprise a range of technologies including handheld devices, conventional mobile bedside devices and other devices with mobility. Examples include PRIMEDIC HandyScan, V-scan (GE Healthcare), and SonoSite devices. Portable US devices are lauded for being light...
Source: Rural Remote Health - March 19, 2016 Category: Rural Health Tags: Book Source Type: research

Enhancing Maternal and Perinatal Health in Under-Served Remote Areas in Sub-Saharan Africa: A Tanzanian Model.
This study was established to determine the feasibility and impact of decentralizing comprehensive emergency obstetric and neonatal care (CEmONC) services in underserved rural areas using associate clinicians. METHODS: Ten health centres (HCs) were upgraded by constructing and equipping maternity blocks, operating rooms, laboratories, staff houses and installing solar panels, standby generators and water supply systems. Twenty-three assistant medical officers (advanced level associate clinicians), and forty-four nurse-midwives and clinical officers (associate clinicians) were trained in CEmONC and anaesthesia respecti...
Source: Rural Remote Health - March 19, 2016 Category: Rural Health Authors: Nyamtema AS, Mwakatundu N, Dominico S, Mohamed H, Pemba S, Rumanyika R, Kairuki C, Kassiga I, Shayo A, Issa O, Nzabuhakwa C, Lyimo C, van Roosmalen J Tags: PLoS One Source Type: research

Traditional birth attendants (TBAs) as potential agents in promoting male involvement in maternity preparedness: insights from a rural community in Uganda.
CONCLUSION: In this study area, men trust and have confidence in TBAs; closer collaboration with TBAs may provide a suitable platform through which communities can be sensitized and men actively brought on board in promoting maternal health services for women in rural communities. PMID: 26969448 [PubMed - as supplied by publisher] (Source: Rural Remote Health)
Source: Rural Remote Health - March 14, 2016 Category: Rural Health Authors: Turinawe EB, Rwemisisi JT, Musinguzi LK, de Groot M, Muhangi D, de Vries DH, Mafigiri DK, Katamba A, Parker N, Pool R Tags: Reprod Health Source Type: research

Internet Cognitive Behavioral Therapy for Women With Postnatal Depression: A Randomized Controlled Trial of MumMoodBooster.
CONCLUSIONS: Our results suggest that our Internet CBT program, MumMoodBooster, is an effective treatment option for women clinically diagnosed with PND. This is one of only two controlled evaluations of specialized online psychological treatment among women clinically diagnosed with PND. MumMoodBooster appears to be a feasible, effective treatment option, which is potentially accessible to large numbers of women in metropolitan, rural, and remote areas. Future work might be focused profitably on establishing comparability with face-to-face treatments and purely self-guided delivery. We have commenced a larger RCT comparin...
Source: Rural Remote Health - March 11, 2016 Category: Rural Health Authors: Milgrom J, Danaher BG, Gemmill AW, Holt C, Holt CJ, Seeley JR, Tyler MS, Ross J, Ericksen J Tags: J Med Internet Res Source Type: research

Optometric use of a teleophthalmology service in rural Western Australia: comparison of two prospective audits.
Abstract BACKGROUND: Lions Outback Vision provides a telehealth service ('the telehealth service') to rural and remote communities in Western Australia aiming to deliver timely ophthalmic care to this underserved population. A number of barriers to its use were identified by an initial prospective audit. A multifaceted intervention was designed to increase the use of the telehealth service by optometrists. METHODS: Optometrists referred patients from rural and remote Western Australia to the telehealth service. Two five-month prospective audits of the telehealth service were compared. The first, in 2012, was ...
Source: Rural Remote Health - March 9, 2016 Category: Rural Health Authors: O'Day R, Smith C, Muir J, Turner A Tags: Clin Exp Optom Source Type: research

Mindfulness-based interventions for coping with cancer.
Abstract Work in the development and evaluation of mindfulness-based interventions (MBIs) for cancer care has been underway for the last 20 years, and a growing body of literature now supports their efficacy. MBIs are particularly helpful in dealing with common experiences related to cancer diagnosis, treatment, and survivorship, including loss of control, uncertainty about the future, and fears of recurrence, as well as a range of physical and psychological symptoms, including depression, anxiety, insomnia, and fatigue. Our adaptation, mindfulness-based cancer recovery (MBCR), has resulted in improvements across ...
Source: Rural Remote Health - March 9, 2016 Category: Rural Health Authors: Carlson LE Tags: Ann N Y Acad Sci Source Type: research

Backcountry Travel Emergencies in Arctic Canada: A Pilot Study in Public Health Surveillance.
Abstract Residents in the Canadian Arctic regularly travel in remote, backcountry areas. This can pose risks for injuries and death, and create challenges for emergency responders and health systems. We aimed to describe the extent and characteristics of media-reported backcountry travel emergencies in two Northern Canadian territories (Nunavut and Northwest Territories). A case-series of all known incidents between 2004 and 2013 was established by identifying events in an online search of two media outlets, Nunatsiaq News and Northern News Services. We identified 121 incidents; these most commonly involved young ...
Source: Rural Remote Health - March 8, 2016 Category: Rural Health Authors: Young SK, Tabish TB, Pollock NJ, Young TK Tags: Int J Environ Res Public Health Source Type: research

Point of care testing for group A streptococci in patients presenting with pharyngitis will improve appropriate antibiotic prescription.
CONCLUSION: Clinician judgement and Centor score are inadequate tools for clinical decision-making for children presenting with sore throat. Adjunctive POC testing provides sufficient accuracy to guide antibiotic prescription on first presentation. PMID: 26934845 [PubMed - as supplied by publisher] (Source: Rural Remote Health)
Source: Rural Remote Health - March 3, 2016 Category: Rural Health Authors: Orda U, Mitra B, Orda S, Fitzgerald M, Gunnarsson R, Rofe G, Dargan A Tags: Emerg Med Australas Source Type: research

Teleophthalmology: improving patient outcomes?
Abstract Teleophthalmology is gaining importance as an effective eye care delivery modality worldwide. In many developing countries, teleophthalmology is being utilized to provide quality eye care to the underserved urban population and the unserved remote rural population. Over the years, technological innovations have led to improvement in evidence and teleophthalmology has evolved from a research tool to a clinical tool. The majority of the current teleophthalmology services concentrate on patient screening and appropriate referral to experts. Specialty care using teleophthalmology services for the pediatric gr...
Source: Rural Remote Health - March 2, 2016 Category: Rural Health Authors: Sreelatha OK, Ramesh SV Tags: Clin Ophthalmol Source Type: research

Using Technology-Based Therapeutic Tools in Behavioral Health Services
Abstract This Treatment Improvement Protocol (TIP) provides an overview of current technology-based assessments and interventions (including treatment, recovery support, relapse prevention, and prevention-focused interventions) targeting behavioral health, and it summarizes the evidence base supporting the effectiveness of such interventions. It also examines opportunities for technology-assisted care (TAC) in the behavioral health arena—particularly in improving early access to care, client engagement in and commitment to treatment and recovery, client education, specific treatment interventions, relapse pr...
Source: Rural Remote Health - February 20, 2016 Category: Rural Health Authors: Center for Substance Abuse Treatment (US) Tags: Book Source Type: research

Expanding the primary health care workforce through contracting with nongovernmental entities: the cases of Bahia and Rio de Janeiro.
CONCLUSIONS: Both cases highlight that improvements in cost and performance data will be critical for meaningful comparative evaluation of delivery arrangements in primary care. Despite the different institutional and implementation arrangements of each model, which make comparison difficult, the analysis provides important lessons for contracting out health professionals for PHC within Brazil and elsewhere. PMID: 26887693 [PubMed - in process] (Source: Rural Remote Health)
Source: Rural Remote Health - February 20, 2016 Category: Rural Health Authors: Ireland M, Cavalini L, Girardi S, Araujo EC, Lindelow M Tags: Hum Resour Health Source Type: research

Impact and feasibility of the Allied Health Professional Enhancement Program placements - experiences from rural and remote Queensland.
CONCLUSION: Allied Health Professional Enhancement Program placements can result in important benefits to the participant, their health service, and positively influence health care service delivery. PMID: 26893585 [PubMed] (Source: Rural Remote Health)
Source: Rural Remote Health - February 20, 2016 Category: Rural Health Authors: Martin P, Kumar S, Stone M, Abernathy L, Burge V, Lizarondo L Tags: Adv Med Educ Pract Source Type: research

Creating a Community of Practice to Prevent Suicide Through Multiple Channels: Describing the Theoretical Foundations and Structured Learning of PC CARES.
This article describes such an approach: Promoting Community Conversations About Research to End Suicide (PC CARES). PC CARES uses popular education strategies to build a "community of practice" among local and regional service providers, friends, and families that fosters personal and collective learning about suicide prevention in order to spur practical action on multiple levels to prevent suicide and promote health. This article will discuss the theoretical underpinnings of the community intervention and describe the form that PC CARES takes to structure ongoing dialogue, learning, solidarity, and multilevel ...
Source: Rural Remote Health - February 15, 2016 Category: Rural Health Authors: Wexler L, McEachern D, DiFulvio G, Smith C, F Graham L, Dombrowski K Tags: Int Q Community Health Educ Source Type: research

Message on a bottle: are alcohol warning labels about cancer appropriate?
CONCLUSIONS: The findings suggest that providing detailed warnings about cancer risk on alcohol products is a viable means of increasing public awareness of the health risks associated with alcohol consumption. Further research is needed to explore the ability of such warnings to influence behavioural intentions and actual drinking behaviour. PMID: 26864239 [PubMed - in process] (Source: Rural Remote Health)
Source: Rural Remote Health - February 14, 2016 Category: Rural Health Authors: Miller ER, Ramsey IJ, Baratiny GY, Olver IN Tags: BMC Public Health Source Type: research

The importance of age, sex and place in understanding socioeconomic inequalities in allostatic load: Evidence from the Scottish Health Survey (2008-2011).
This study aimed to determine the contextual and demographic factors (age, sex and place) that may be important in better understanding the links between lower SEP and higher allostatic load. METHODS: Data were from a nationally representative sample of adults (18+): the Scottish Health Survey (2008-2011). Higher SEP ('1') was defined as having 'Higher'-level, secondary school qualifications versus having lower level or no qualifications ('0'). For allostatic load, a range of 10 biomarkers across the cardiovascular, metabolic and immune systems were used. Respondents were scored "1" for each biomarker that f...
Source: Rural Remote Health - February 11, 2016 Category: Rural Health Authors: Robertson T, Watts E Tags: BMC Public Health Source Type: research

The Case for Telemental Health for Improving the Accessibility and Quality of Children's Mental Health Services.
Conclusions: TMH is a rapidly developing service delivery model that is already beginning to innovate systems of care to meet the expanding mental healthcare needs of the nation's children. PMID: 26859537 [PubMed - as supplied by publisher] (Source: Rural Remote Health)
Source: Rural Remote Health - February 9, 2016 Category: Rural Health Authors: Myers K, Comer JS Tags: J Child Adolesc Psychopharmacol Source Type: research

Expansion of Safe Abortion Services in Nepal Through Auxiliary Nurse-Midwife Provision of Medical Abortion, 2011-2013.
This article describes a training and support strategy to train auxiliary nurse-midwives (ANMs), already certified as skilled birth attendants, as medical abortion providers and expand geographic access to safe abortion care to the community level in Nepal. METHODS: This was a descriptive program evaluation. Sites and trainees were selected using standardized assessment tools to determine minimum facility requirements and willingness to provide medical abortion after training. Training was evaluated via posttests and observational checklists. Service statistics were collected through the government's facility logbook ...
Source: Rural Remote Health - February 9, 2016 Category: Rural Health Authors: Andersen KL, Basnett I, Shrestha DR, Shrestha MK, Shah M, Aryal S Tags: J Midwifery Womens Health Source Type: research

Prevalence of heart failure in Australia: a systematic review.
CONCLUSION: This systematic review highlights the limited available data on the epidemiology of heart failure in Australia. Population level studies, using standardized approaches, are needed in order to precisely describe the burden of HF in the population. PMID: 26852410 [PubMed - as supplied by publisher] (Source: Rural Remote Health)
Source: Rural Remote Health - February 8, 2016 Category: Rural Health Authors: Sahle BW, Owen AJ, Mutowo MP, Krum H, Reid CM Tags: BMC Cardiovasc Disord Source Type: research

Effect of telehealth on hospital utilisation and mortality in routine clinical practice: a matched control cohort study in an early adopter site.
Abstract OBJECTIVES: To assess the effects of a home-based telehealth intervention on the use of secondary healthcare and mortality. DESIGN: Observational study of a mainstream telehealth service, using person-level administrative data. Time to event analysis (Cox regression) was performed comparing telehealth patients with controls who were matched using a machine-learning algorithm. SETTING: A predominantly rural region of England (North Yorkshire). PARTICIPANTS: 716 telehealth patients were recruited from community, general practice and specialist acute care, between June 2010 and March 2013. Pat...
Source: Rural Remote Health - February 5, 2016 Category: Rural Health Authors: Steventon A, Ariti C, Fisher E, Bardsley M Tags: BMJ Open Source Type: research

Multiple causes of an unexpected malaria outbreak in a high-transmission area in Madagascar.
CONCLUSIONS: Increased rainfall, decreasing use and reduced insecticide activity of long-lasting insecticide-treated nets, and drug shortages may have been responsible for, or contributed to, the outbreak observed in South-Eastern Madagascar in 2011-2012. Control interventions for malaria elimination must be sustained at the risk of triggering harmful epidemics, even in zones of high transmission. PMID: 26838369 [PubMed - in process] (Source: Rural Remote Health)
Source: Rural Remote Health - February 4, 2016 Category: Rural Health Authors: Kesteman T, Rafalimanantsoa SA, Razafimandimby H, Rasamimanana HH, Raharimanga V, Ramarosandratana B, Ratsimbasoa A, Ratovonjato J, Elissa N, Randrianasolo L, Finlay A, Rogier C, Randrianarivelojosia M Tags: Malar J Source Type: research

National Characteristics of Emergency Medical Services in Frontier and Remote Areas.
Abstract Although much is known about EMS care in urban, suburban, and rural settings, only limited national data describe EMS care in isolated and sparsely populated frontier regions. We sought to describe the national characteristics and outcomes of EMS care provided in frontier and remote (FAR) areas in the continental United States (US). We performed a cross-sectional analysis of the 2012 National Emergency Medical Services Information System (NEMSIS) data set, encompassing EMS response data from 40 States. We linked the NEMSIS dataset with Economic Research Service-identified FAR areas, defined as a ZIP Code&...
Source: Rural Remote Health - January 25, 2016 Category: Rural Health Authors: Mueller LR, Donnelly JP, Jacobson KE, Carlson JN, Mann NC, Wang HE Tags: Prehosp Emerg Care Source Type: research

An Innovative Australian Outreach Model of Diabetic Retinopathy Screening in Remote Communities.
Conclusion. This innovative model has greatly improved accessibility to DR screening in remote communities, thereby reducing preventable blindness. It provides a holistic, locally appropriate diabetes service and utilises existing infrastructure and health workforce more efficiently. PMID: 26798648 [PubMed - in process] (Source: Rural Remote Health)
Source: Rural Remote Health - January 23, 2016 Category: Rural Health Authors: Glasson NM, Crossland LJ, Larkins SL Tags: J Diabetes Res Source Type: research

Growth data of underprivileged children living in rural areas of Chin State, Burma/Myanmar, compared to the WHO reference growth standards: an observational study.
CONCLUSIONS: Many more than expected-according to the WHO reference values-in CCP and CCS suffered from stunting, wasting and thinness. PMID: 26787249 [PubMed - in process] (Source: Rural Remote Health)
Source: Rural Remote Health - January 22, 2016 Category: Rural Health Authors: Prenkert M, Ehnfors M Tags: BMJ Open Source Type: research

Social and Economic Burden of Human Leishmaniasis.
Abstract Leishmaniasis continues to pose a major public health problem worldwide. With new epidemics occurring in endemic areas and the spread of the disease to previously free areas because of migration, tourism, and military activities, there is a great need for the development of an effective vaccine. Leishmaniasis is a disease of the poor, occurring mostly in remote rural villages with poor housing and little or no access to modern health-care facilities. In endemic areas, diagnosis of any form of leishmaniasis puts a huge financial strain on an already meagre financial resource at both the individual and comm...
Source: Rural Remote Health - January 19, 2016 Category: Rural Health Authors: Okwor I, Uzonna J Tags: Am J Trop Med Hyg Source Type: research

Acceptability and feasibility of an e-mental health intervention for parents of childhood cancer survivors: "Cascade".
CONCLUSIONS: Cascade is highly acceptable and feasible. Its online delivery mechanism may address inequities in post-treatment support for parents, a particularly acute concern for rural/remote families. Future research needs to establish the efficacy of the intervention. TRIAL REGISTRATION: ACTRN12613000270718, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12613000270718. PMID: 26781620 [PubMed - as supplied by publisher] (Source: Rural Remote Health)
Source: Rural Remote Health - January 19, 2016 Category: Rural Health Authors: Wakefield CE, Sansom-Daly UM, McGill BC, Ellis SJ, Doolan EL, Robertson EG, Mathur S, Cohn RJ Tags: Support Care Cancer Source Type: research

Initiating Childhood Cancer Treatment in Rural Rwanda: A Partnership-Based Approach.
CONCLUSIONS: These data suggest that chemotherapy can be administered with curative intent to a subset of cancer patients in this setting. This approach provides a platform for pediatric cancer care models, relying on local physicians collaborating with remote specialist consultants to deliver subspecialty care in resource-poor settings. PMID: 26785111 [PubMed - as supplied by publisher] (Source: Rural Remote Health)
Source: Rural Remote Health - January 19, 2016 Category: Rural Health Authors: Stulac S, Mark Munyaneza RB, Chai J, Bigirimana JB, Nyishime M, Tapela N, Chaffee S, Lehmann L, Shulman LN Tags: Pediatr Blood Cancer Source Type: research

Removal of Fecal Indicators, Pathogenic Bacteria, Adenovirus, Cryptosporidium and Giardia (oo)cysts in Waste Stabilization Ponds in Northern and Eastern Australia.
Abstract Maturation ponds are used in rural and regional areas in Australia to remove the microbial loads of sewage wastewater, however, they have not been studied intensively until present. Using a combination of culture-based methods and quantitative real-time PCR, we assessed microbial removal rates in maturation ponds at four waste stabilization ponds (WSP) with (n = 1) and without (n = 3) baffles in rural and remote communities in Australia. Concentrations of total coliforms, E. coli, enterococci, Campylobacter spp., Salmonella spp., F+ RNA coliphage, adenovirus, Cryptosporidium spp. and Giardia (oo) cysts in...
Source: Rural Remote Health - January 16, 2016 Category: Rural Health Authors: Sheludchenko M, Padovan A, Katouli M, Stratton H Tags: Int J Environ Res Public Health Source Type: research

Clinical and Environmental Surveillance for Vibrio cholerae in Resource Constrained Areas: Application During a 1-Year Surveillance in the Far North Region of Cameroon.
Abstract Biological confirmation of the presence of Vibrio cholerae in clinical and environmental samples is often constrained due to resource- and labor-intensive gold standard methods. To develop low-cost, simple, and sustainable surveillance techniques, we modified previously published specimen sampling and culture techniques and applied the use of enriched dipstick testing in conjunction with the use of filter paper for DNA specimen preservation during clinical and environmental surveillance in the Far North of Cameroon from August 2013 to October 2014. The enriched dipstick methodology during routine use in a...
Source: Rural Remote Health - January 11, 2016 Category: Rural Health Authors: Debes AK, Ateudjieu J, Guenou E, Ebile W, Sonkoua IT, Njimbia AC, Steinwald P, Ram M, Sack DA Tags: Am J Trop Med Hyg Source Type: research

Fatal injuries in rural and urban areas in northern Finland: a 5-year retrospective study.
CONCLUSION: The crude mortality rate for fatal injuries was high overall as compared to other studies, and elevated in rural areas, where pre-hospital deaths were more common. Almost half of pre-hospital deaths occurred under the influence of alcohol. PMID: 26749577 [PubMed - as supplied by publisher] (Source: Rural Remote Health)
Source: Rural Remote Health - January 8, 2016 Category: Rural Health Authors: Raatiniemi L, Steinvik T, Liisanantti J, Ohtonen P, Martikainen M, Alahuhta S, Dehli T, Wisborg T, Bakke HK Tags: Acta Anaesthesiol Scand Source Type: research

Telenephrology application in rural and remote areas of Jordan: benefits and impact on quality of life.
This study aimed to assess the impact of live interactive telenephrology on diagnosis and disease management, patients' quality of life, and time- and cost savings. METHODS: A pre-test-post-test one-group design was used to evaluate the process and outcomes of the teleconsultations among all consecutive patients who attended or were referred to the teleclinics for suspected kidney diseases. Patients were interviewed for relevant information and their quality of life was assessed during the first visit. The quality-of-life questionnaires (short form (SF) 8) were filled 8 weeks after the last visit to assess the changes...
Source: Rural Remote Health - January 1, 2016 Category: Rural Health Authors: AlAzab R, Khader Y Tags: Rural Remote Health Source Type: research

Geographic scope and accessibility of a centralized, electronic consult program for patients with recent fracture.
Abstract INTRODUCTON: Low-trauma, osteoporotic fractures among older men are associated with a significant increase in morbidity and mortality. Despite effective therapies for osteoporosis, several studies have demonstrated that management and treatment after a low trauma fracture remains inadequate, especially among men. Fracture liaison services have been shown to significantly improve osteoporosis evaluation and treatment. However, such programs may be less feasible and accessible in rural areas, with limited availability of specialty services. The study objective was to evaluate a centralized, electronic consu...
Source: Rural Remote Health - January 1, 2016 Category: Rural Health Authors: Lee RH, Pearson M, Lyles KW, Jenkins PW, Colon-Emeric C Tags: Rural Remote Health Source Type: research

Scotland's GP Rural Fellowship: an initiative that has impacted on rural recruitment and retention.
This article describes this program and reports on a survey of the output of the Fellowship from 2002 to 2013. THE RURAL FELLOWSHIP PROGRAM: The Fellowship is aimed at newly qualified GPs, who are offered a further year of training in and exposure to rural medicine. The Fellowship has grown and undergone several modifications since its inception. The current model involves co-funding arrangements between NES and participating boards, supporting a maximum of 12 fellows per year. The Health Boards' investment in the Fellowship is returned through the service commitment that the Fellows provide, and the funding share fro...
Source: Rural Remote Health - January 1, 2016 Category: Rural Health Authors: MacVicar R, Clarke G, Hogg DR Tags: Rural Remote Health Source Type: research

Public health implications of molecular point-of-care testing for chlamydia and gonorrhoea in remote primary care services in Australia: a qualitative study.
CONCLUSIONS: Results indicate a high level of support from clinicians and public health practitioners for wider access to CT/NG POC tests citing potential benefits, including earlier, more accurate treatment decisions and reductions in ongoing transmission. However, the data also highlight the need for new systems to avoid adverse impact on disease surveillance. TRIAL REGISTRATION NUMBER: Australian and New Zealand Clinical Trials Registry: ACTRN12613000808741. PMID: 25922100 [PubMed - indexed for MEDLINE] (Source: Rural Remote Health)
Source: Rural Remote Health - December 26, 2015 Category: Rural Health Authors: Natoli L, Guy RJ, Shephard M, Whiley D, Tabrizi SN, Ward J, Regan DG, Badman SG, Anderson DA, Kaldor J, Maher L, TTANGO investigator group Tags: BMJ Open Source Type: research

Cross-sectional comparison of point-of-care with laboratory HbA₁c in detecting diabetes in real-world remote Aboriginal settings.
Abstract OBJECTIVES: To determine if point-of-care (POC) glycated haemoglobin (HbA₁c) is sufficiently accurate in real-world remote settings to predict or exclude the diagnosis of diabetes based on laboratory HbA1c measurements. DESIGN: Cross-sectional study comparing POC capillary HbA₁c results with corresponding venous HbA₁c levels measured in a reference laboratory. PARTICIPANTS: Aboriginal patients ≥15 years old who were due for diabetes screening at the participating clinics were invited to participate. Two hundred and fifty-five Aboriginal participants were enrolled and 241 were included...
Source: Rural Remote Health - December 22, 2015 Category: Rural Health Authors: Marley JV, Oh MS, Hadgraft N, Singleton S, Isaacs K, Atkinson D Tags: BMJ Open Source Type: research

Remote supervision of medical training via videoconference in northern Australia: a qualitative study of the perspectives of supervisors and trainees.
CONCLUSIONS: Remote supervision via videoconference provides readily available guidance to trainees supporting their delivery of appropriate care to patients. However, resources required for upskilling, training in the use of supervision via videoconference, administration issues and nursing support, as well as physical barriers to examinations, must be addressed to enable more efficient implementation. PMID: 25795687 [PubMed - indexed for MEDLINE] (Source: Rural Remote Health)
Source: Rural Remote Health - December 22, 2015 Category: Rural Health Authors: Cameron M, Ray R, Sabesan S Tags: BMJ Open Source Type: research

Association between self-efficacy, career interest and rural career intent in Australian medical students with rural clinical school experience.
Abstract OBJECTIVES: To investigate medical student's self-efficacy at the time of finishing their rural clinical school (RCS) placement and factors associated with self-efficacy. Secondary aims are to explore whether interest levels or self-efficacy are associated with rural or remote career intentions. DESIGN, SETTING AND PARTICIPANTS: A cross-sectional study of medical students who had completed their RCS term in 17 Australian universities. Data were derived from the 2013 Federation of Rural Australian Medical Educators (FRAME) evaluation survey. Questionnaire responses were analysed from 653 medical stude...
Source: Rural Remote Health - December 19, 2015 Category: Rural Health Authors: Isaac V, Walters L, McLachlan CS Tags: BMJ Open Source Type: research

Bereaved Families and the Coronial Response to Traumatic Workplace Fatalities: Organisational Perspectives.
PMID: 26681297 [PubMed - as supplied by publisher] (Source: Rural Remote Health)
Source: Rural Remote Health - December 17, 2015 Category: Rural Health Authors: Matthews LR, Fitzpatrick SJ, Quinlan MG, Ngo M, Bohle P Tags: Death Stud Source Type: research

A randomised controlled trial of a physical activity and nutrition program targeting middle-aged adults at risk of metabolic syndrome in a disadvantaged rural community.
This study aims to determine if a low-cost, accessible lifestyle program targeting insufficiently active adults aged 50-69 y can be successfully implemented in a rural location, and whether its implementation will contribute to the reduction/prevention of metabolic syndrome, or other risk factors for type 2 diabetes, and cardiovascular disease. METHODS/DESIGN: This 6-month randomised controlled trial will consist of a nutrition, physical activity, and healthy weight intervention for 50-69 year-olds from a disadvantaged rural community. Five hundred participants with central obesity and at risk of metabolic syndrome wi...
Source: Rural Remote Health - December 16, 2015 Category: Rural Health Authors: Blackford K, Jancey J, Lee AH, James AP, Howat P, Hills AP, Anderson A Tags: BMC Public Health Source Type: research

Clinical and biochemical characterization of high risk and not high risk for cardiovascular disease adults in a population from peripheral region of Bangladesh.
Abstract BACKGROUND: A group of 63708 Bangladeshi adults from a rural area were screened in 2011-12 for cardiovascular diseases (CVD) risk using a questionnaire based tool developed as part of the 'WHO CVD-RISK Management Package for low-and medium resource setting'. In the current study participants who were found to be high risk and a sample of the not high risk participants from the screening were further characterized clinically and biochemically to explore the burden and determinants of CVD risk factors in a remote rural Bangladeshi population. METHODS: The high risk participants comprised all 1170 subje...
Source: Rural Remote Health - December 16, 2015 Category: Rural Health Authors: Fatema K, Zwar NA, Zeba Z, Milton AH, Rahman B, Ali L Tags: BMC Public Health Source Type: research

Albuminuria and its associated biomedical factors among indigenous adults in Far North Queensland: a 7-year follow up study.
Abstract BACKGROUND: To document albuminuria prevalence and its associated factors in Aboriginal and Torres Strait Islander (TSI) adults with high renal and metabolic risks from 19 rural and remote north Queensland communities. METHODS: One thousand nine hundred seventy-one indigenous adults were enrolled in 1998 and 566 completed follow up in 2007 in this population-based study. Measurements included weight, waist circumference (WC), blood pressure (BP), fasting glucose, lipids, gamma-glutamyltransferase (GGT), urinary albumin creatinine ratio (UACR), smoking, alcohol intake and physical activity (PA). Album...
Source: Rural Remote Health - December 16, 2015 Category: Rural Health Authors: Li M, McDermott R Tags: BMC Nephrol Source Type: research

A Defence of Conscientious Objection in Medicine: A Reply to Schuklenk and Savulescu.
Abstract In a recent (2015) Bioethics editorial, Udo Schuklenk argues against allowing Canadian doctors to conscientiously object to any new euthanasia procedures approved by Parliament. In this he follows Julian Savulescu's 2006 BMJ paper which argued for the removal of the conscientious objection clause in the 1967 UK Abortion Act. Both authors advance powerful arguments based on the need for uniformity of service and on analogies with reprehensible kinds of personal exemption. In this article I want to defend the practice of conscientious objection in publicly-funded healthcare systems (such as those of Canada ...
Source: Rural Remote Health - December 10, 2015 Category: Rural Health Authors: Cowley C Tags: Bioethics Source Type: research

Evaluating impact of clinical guidelines using a realist evaluation framework.
CONCLUSION: Implementing a realist evaluation framework to generate robust findings in this context has required innovation in the evaluation design and adaptation by researchers. This article captures the RPHCM team's experience in designing this evaluation. PMID: 26640246 [PubMed - as supplied by publisher] (Source: Rural Remote Health)
Source: Rural Remote Health - December 7, 2015 Category: Rural Health Authors: Reddy S, Wakerman J, Westhorp G, Herring S Tags: J Eval Clin Pract Source Type: research

Spatial access disparities to primary health care in rural and remote Australia.
Abstract Poor spatial access to health care remains a key issue for rural populations worldwide. Whilst geographic information systems (GIS) have enabled the development of more sophisticated access measures, they are yet to be adopted into health policy and workforce planning. This paper provides and tests a new national-level approach to measuring primary health care (PHC) access for rural Australia, suitable for use in macro-level health policy. The new index was constructed using a modified two-step floating catchment area method framework and the smallest available geographic unit. Primary health care spatial...
Source: Rural Remote Health - December 4, 2015 Category: Rural Health Authors: McGrail MR, Humphreys JS Tags: Geospat Health Source Type: research