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.

It is critical that those working with Aboriginal and Torres Strait Islander communities engage in culturally safe practice by acknowledging and understanding the impacts of trauma. In this Commentary, the authors examine the origins of cultural safety as a recommended practice for working with Indigenous peoples, demonstrating its flaws and shortcomings in practice and argue that without an understanding of the impacts of trauma, ‘ticking the box’ of cultural safety training simply is not enough to achieve equity in Indigenous health outcomes.

Water is crucial for food security and health, but fewer than 40% of rural households in Brazil are connected to the water distribution network. Boardwalk Cisterns is a rainwater harvesting program that provides clean water for populations with precarious access to water in Brazil. This study reports on the perceptions of farmers about the impact of the Boardwalk Cisterns program in the northeast, semi-arid region of the country.

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.

This study evaluated pilot community paramedicine (CP) programs from the perspectives of paramedics to gain program recommendations related to both rural and urban settings. Researchers distributed an online questionnaire to paramedics with and without CP experience employed at eight emergency medical services providers in northern Ontario. Results demonstrate the value of CP and indicate areas for CP program inprovement.

This study examined whether social support, problem solving and family function predicted depressive symptoms, caregiving-related life changes, self-care and caregiver burden in rural heart failure caregivers. It also compared differences in these variables between rural and urban caregivers. Findings suggest important considerations for reducing burden and improving outcomes for rural heart failure caregivers.

Remote area nurses often work in isolated and extreme geographical locations, alongside and with Aboriginal and Torres Strait Islander people. This study investigated what remote area nurses perceived were enablers and barriers to being involved in the delivery of care to an Aboriginal person with a terminal diagnosis passing away on their traditional lands.

Type 2 diabetes mellitus (T2DM) and social disadvantage are related. In Australia, this association is most pronounced amongst Indigenous people. Indigenous Australians are among the most socially disadvantaged in the country, with the worst social determinants of health (SDoH). This study combines the perspectives of Indigenous Australians with T2DM and Indigenous health workers to explore the SDoH-related barriers and facilitators to self-managing T2DM, and how SDoH could be incorporated into usual clinical care for Indigenous Australians with T2DM.

A 5-year-old girl presented to the coronavirus assessment centre on a remote Scottish island with symptoms consistent with COVID-19, including an irregular pulse. To minimise potential spread of coronavirus in the healthcare setting, a portable ECG device was immediately delivered to the patient with the ECG tracing being sent electronically to the cardiologist, who was then able to communicate a diagnosis to the parents within 2 hours of the initial contact.

Distance learning methods have long been an integral part of medical education in rural and remote settings, but the global coronavirus crisis has stimulated a rapid shift in medical education everywhere from predominantly face to face to being delivered online. As thinking and practice in distance learning have developed, the idea of distance learning (in which the central institution delivers teaching and learning resources to remote learners) is changing to distributed learning (where the institution itself distributes its functions to be near those students). This Commentary examines the design and management of distributed learning.

Chronic medical workforce shortage and maldistribution continues to be a significant challenge in rural Australia. The Rural Clinical Schools (RCSs) program helps to alleviate this problem with evidence of increased rural location in graduates of rural training programs. However, rural work intent may change during the years after completing a rural placement. This qualitative study investigated the factors involved in the change of career intention from rural to urban work location among the Australian National University Medical School Rural Stream alumni.

International electives and exchange programs for medical students have sometimes been criticized as providing little benefit for host institutions. This personal view is offered as an example of how international electives may contribute a helpful comparative perspective on a local healthcare systems, in this case, primary care.

This mixed methods study sought to explore the use of dating apps amoung men who have sex with men (MSM) in rural areas of the southern United States, and the potential to use dating apps to deliver HIV prevention information. Dating app use was found to be high amongst rural MSM, with individuals using dating apps more likely to be interested in pre-exposure HIV prophylaxis (PrEP).

This qualitative study explores barriers to accessing contraceptives in a rural, culturally conservative area in the USA. The authors reflect on how a Federally Qualified Health Center adapted to their cultural setting, by integrating contraceptive services into their primary care model. This ensured that every woman seeking primary care was screened for contraceptive need, offered contraceptive counselling and comprehensive contraceptive methods. Recommendations to further strengthen the responsiveness of services are provided.

While cancer deaths have decreased nationally, declines have been much slower in rural areas compared with urban areas. This cross-sectional study explored the association between breast cancer service capacity, and breast cancer incidence and mortality, in Arizona’s low populous counties. Compared to urban counties, rural county status was associated with lower breast cancer incidence rates, although there were no statistically significant differences in breast cancer mortality. These findings may reflect the challenges of using county level data, particularly per capita data, in a state where counties average over 7500 square miles.

Rural physicians face many challenges with providing rural health care, which often leads to innovative solutions. Despite this, there is a lack of support for rural health research – an area of health care where research makes great impacts on small communities. This article describes the rural research capacity building (RRCB) ecosystem and explains how the 6for6 and Rural360 programs at Memorial University of Newfoundland address the need for RRCB.

Access to health care in developing countries is scarce. One solution to this problem has been for doctors from the USA to provide single-visit care through short-term medical service trips. There is interest in using ultrasound imaging as a portable diagnostic tool; however, data describing its usefulness are scarce. This study determined the usefulness of portable ultrasound imaging during a medical service trip to rural Guatemala.

Slaughterhouse workers are at high risk of accidents and pathogen contamination. Although cattle production is a big industry in Brazil, there are illegal operators in the countryside outside several Brazilian cities. This illegal activity represents severe risks to the health of consumers and slaughterhouse workers. This article reports on the first study to analyze the health of illegal slaughterhouse workers in rural Brazil.

Having a stoma after bowel surgery is associated with inferior quality of life (QoL). Care of patients with stoma-related problems is usually reliant on hospital-based stoma nurses and surgeons. This study reports on the impact of distance to nearest hospital on the QoL of rectal cancer patients who receive a stoma at index surgery.

The number of maternal deaths remains high in sub-Saharan Africa. Although improved antenatal care (ANC) service provision has been prioritized across the region, research is limited on the ANC experiences of Indigenous women. This study describes ANC attendance patterns at a hospital, and characterizes factors influencing attendance among Bakiga and Indigenous Batwa women in Kanungu District, Uganda.

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.