Rural and Remote Health is an open-access international academic journal serving rural and remote communities and publishing articles by rural health practitioners, educators, researchers and policy makers.

Complicated appendicitis poses a diagnostic challenge in clinical practice, especially in rural centres with limited access to subspecialists and imaging facilities. This Clinical Case Report describes a case of a perforated appendix in a 9-year-old patient considered in the context of hyperbilirubinemia that facilitated prompt surgical management after appropriate imaging.

Sepsis, a life-threatening organ dysfunction caused by a response to infection, is a leading cause of death and hospitalisation worldwide. This study explores the demographic characteristics, disease specifics and outcomes of adult patients with suspected sepsis presenting to a remote Australian Emergency Department.

A motivated, well supported rural health work force is required to provide appropriate child health services to the rural population. This study explored the views of rural health workers on the impact of a programme to improve oxygen delivery systems and provide reliable power to their health facilities in Papua New Guinea.

It is common for elderly people to experience functional decline due to a general physiological and metabolic decline and the accumulation of health threats throughout their lives. East and Southeast Asia are home to a large proportion of the world’s elderly population and 46.5% of people aged 65 and over in Indonesia have some form of disability. This study examined urban–rural differences in the functional status and disability of elderly people in Indonesia.

The COVID-19 pandemic has forced a change in medical education in Israel. Clinical clerkships were suspended and lectures were delivered online, via Zoom. Tutors were able to teach from their wards and students were able to learn safely in their homes.

The Highlands and Islands Medical Service (HIMS) was introduced across the Scottish Highlands and Islands after the publication of the Dewar Report in 1913, which found that there was insufficient healthcare provision in the region. HIMS was the first state-funded medical service in the UK and one of the first in the world. This historical study addresses the ways in which support for new transport and telecommunication technologies contributed to the success of HIMS.

Physical therapists (PTs) play an important role in managing patient health needs in many rural areas, but are affected by healthcare provider shortages. This study examined values that differentiated PTs who accept and maintain employment in rural areas, as a means of advising health agencies within these designation areas. Findings may be useful for understanding effective recruitment and retention of PTs in rural and remote areas.

The management and prevention of chronic conditions is a challenge for primary care providers across Europe, and particularly in rural areas where people are less likely to be able, or willing, to have access to appropriate (well-equipped and well organised) health care. Research is needed to develop equitable chronic care models that focus on stakeholder needs, including those of individual patients, caregivers and primary care professionals. This study used a mixed-methods, online survey to determine the views of European Rural General Practitioners regarding the strengths, weaknesses, opportunities and threats of the implementation of a Chronic Care Model (CCM) in European Rural Primary Care.

Rural areas in Brazil still have worse health indicators than urban areas and there are several barriers to accessing primary health care that can encourage users to seek alternative care. In a medical anthropology framework, each health system consists of three interrelated subsystems: informal, popular and professional, widely used in an overlapping and non-exclusive way, interacting according to the individual’s needs. This study analyses how informal and popular health subsystems are featured in a remote rural municipality in the Brazilian Amazon region.

Adolescent pregnancy remains a thorny issue in developing countries, including Indonesia. Pregnancy at an early age is a risk factor for maternal and infant mortality. A recent report indicates that adolescent pregnancy is even higher in rural areas. This study identifies factors associated with adolescent pregnancy in rural Indonesia and formulates intervention actions to reduce the teenage pregnancy rate.

Previous long-term research designed to address the inequitable distribution of health workforce has primarily focused on medical students and graduates. Few longitudinal studies have targeted nursing and allied health graduate practice intentions and destinations. The Nursing and Allied Health Graduate Outcomes Tracking (NAHGOT) study is an ongoing multi-university, multi-jurisdictional investigation linking multiple data sources to better understand Australian nursing and allied health students and graduates’ choice of graduate practice location over the course of their studies and up to 10 years after graduation.

Regular antivitreal injections are an important treatment for diabetes%u2010related blindness caused by macular oedema. Barriers to antivitreal treatment for rural Australian patients include travel time to appointments, especially as patients face a high volume of other medical appointments for their diabetes and related co-morbidities. This audit addresses intravitreal injection compliance by identifying patients lost to follow up in north west Western Australia.

Rural residents with opioid use disorder often lack access to specialized services integrating opioid agonist therapy with counselling, social support and mental health care. This project report describes the evaluation of a Rural Opioid Outpatient Treatment (ROOT) pilot program in Ontario, Canada. The pilot project demonstrates that outpatient substance use treatment can be successfully integrated into a rural primary care setting. The authors share lessons learned, including the need for polysubstance support and the value of a harm-reduction approach in creating a safe space for program participants to engage with their healthcare providers.

The Cooperative Extension System (a national US education network) was used to implement the Balanced Living with Diabetes (BLD) program in rural counties in Virginia. This study evaluated the implementation and effectiveness of the BLD program in 16 rural counties over two years. The program is effective at increasing lifestyle behaviors and self-efficacy that improves glycemic control in people with type 2 diabetes. The Cooperative Extension System in the US is well positioned to fill the gap in diabetes education in rural communities as part of a chronic care model.

This study used data from the Canadian Longitudinal Study on Aging to examine life satisfaction in rural residents, and compare this with life satisfactions of residents across the urban/rural continuum. The authors found that rural residents were generally more satisfied with life than their urban counterparts, even after accounting for the effects of sociodemographic and health-related factors. Prevention or treatment of chronic conditions and reducing income inequalities might contribute to increasing life satisfaction in rural and urban populations.

In various countries, a shortage of general practitioners (GPs) and worrying health statistics on risk factors, morbidity and mortality have been observed in rural areas. However, few comparative data are available on GPs’ activities according to their location. This study analyzed French GPs’ activity according to their rural or urban practice location.

Physician shortages in rural and remote areas challenge accessibility and delivery of care to rural and remote communities, including within Scotland. Whilst there is evidence to support aspects of medical education that enhance the likelihood of practicing rurally, the mechanism by which these educational initiatives work is not clearly understood. Using a theoretical framework exploring career embeddedness, mobility and success, this study examines medical students’ perceptions of rural and remote practice. It also explores how these perceptions motivate their interest to practice rurally and what aspects of education are thought to influence these perceptions.

Palliative and end-of-life care is provided inconsistently across Australia, particularly in regional, rural and remote areas. Systematic solutions can help to address identified gaps and improve access and quality of care and support for patients, their families and carers at the end of life. This narrative report describes the ‘Far West NSW Palliative and End-of-Life Model of Care’, a consistent and contextually adaptable, patient-focused palliative approach, and identifies the essential elements to implement or maintain the Model elsewhere.

Farmers are thought to have a higher risk of skin cancers, but there is no direct evidence of this risk, and some population evidence of no greater risk to farmers of melanoma. The agricultural region of the Darling Downs in Queensland, Australia has the highest incidence of skin cancer in the State. This study defines the specific occupation risk for skin cancer among Darling Downs farmers compared with other community residents.

Despite significant progress in the last decade, Greece still deals with a large number of road traffic accidents every year. This study provides an epidemiological approach to road traffic injuries presenting to a secondary hospital in a geographical area with a very low quality road network, and indicates possible preventive measures and actions.

Public health agencies around the world are concerned about the ever-increasing burden of type 2 diabetes and related disability. This study examines patterns of primary care provider use among people with and without diagnosed diabetes in a large survey of over 230,000 people in New South Wales, Australia.

Community health workers (CHWs) connect patients in rural and remote communities to health service organizations. This diverse group of healthcare workers have aided in improving healthcare access and outcomes and enhancing the quality of life for people in hard-to-reach communities. This systematic review examines the socio-cultural challenges that CHWs experience, focusing on the unique history, geography and socio-cultural milieu of South Asia.

Immunization is one of the most cost-effective methods for reducing the mortality and morbidity rate of children. Children being fully vaccinated helps prevent the occurrence of diseases that would have great societal costs otherwise. Incomplete vaccination poses public health risks and challenges. This study examines the issue of incomplete vaccination in Indonesia.

According to the World Health Organization, there are more than 800,000 deaths by suicide every year. Of these, 20% are from pesticide poisoning and 80% occur in low- and middle-income places, especially in rural and agricultural areas. This study investigates which countries have the most publications about suicide among agricultural workers, examines the factors that lead to either suicide or intent, identifies the methods of suicide or attempted suicide and proposes preventive measures so that rural agricultural workers are not exposed to risk factors for suicide.

De acordo com a Organização Mundial da Saúde, ocorrem mais de 800.000 mortes por suicídio a cada ano. Destes, 20% são por intoxicação por agrotóxicos e 80% ocorrem em locais de baixa e média renda, principalmente em áreas rurais e agrícolas. Este estudo investiga quais países têm mais publicações sobre suicídio entre trabalhadores agrícolas, examina os fatores que levam ao suicídio ou ideação suicida, identifica os métodos de suicídio ou tentativa de suicídio e propõe medidas preventivas para que os trabalhadores agrícolas rurais não sejam expostos a fatores de risco para suicídio.

Rural and remote children with burn injuries are disadvantaged if their burns require hospitalisation and specialist rehabilitation. In Queensland, Australia, most specialist burn rehabilitation is provided in regional or metropolitan cities by a multidisciplinary team, requiring rural and remote patients to travel. This project reports on the development of an Occupational Therapy-Led Paediatric Burn Telehealth Review Clinic at Townsville University Hospital to provide ongoing rehabilitation to rural and remote children closer to home.