Volume seven, Issue 4

At the heart of the rural construct is the concept of inside and outside. Who is included and who is left out? What is the appropriate therapy for the disease of 'perimeteritis', lacking awareness of anything outside of major metro areas? Rural health care leaders were interviewed regarding their own definitions of rural, community, health, well-being, and a healthy rural community. Rural communities and their health leaders may want to review their own definitions and how perceptions from inside and outside may impact their futures.

This article provides a great example of how junior rural health professionals can contribute to important public health research in rural communities under difficult circumstances - and you will learn some helpful facts about snake bites in rural Sri Lanka!

The determination of racially appropriate waist circumference (WC) has emerged as an important factor in the prevention, management and prognostication of a variety of disease conditions. This study of a rural population from Iraq makes an important contribution to the literature.

What do we really 'need' to ensure the community feels happy with the healthcare services available in their town? This study elegantly demonstrates that what might be perceived as satisfactory by one community is inadequate to another. The words of the community members is this Australian qualitative article should be read especially by capital-city-based health service planners.

Inaccuracy in recording the cause of death on death certificates has implications for health planning. This study from rural western Greece shows that while certifying accuracy is improving, many physicians still overlook this important epidemiological issue.

Public health campaigns enjoy variable success. This study of obesity among rural Malaysians suggests a vital precursor to initiating public health strategies.

A supportive workplace is a pre-requisite for happy and productive staff, wherever they work. Trying to better understand the nature of our working relationships is an ongoing challenge. This interesting qualitative study describes how rural nurses support one another in the workplace. It brings to life additional understanding of what it takes for people to learn how to work well together.

We all know about the problems small rural communities face in gaining access to required health professionals. In this study we learn how paramedics are offering a solution by training a volunteer community-based workforce to help manage emergencies in towns too small to support a full time paramedic.

Does a rural emergency medicine training rotation discourage the best trainees from applying to the program? This US study asks the people involved.

Children are commonly thought of as the victims of farm injuries but they are also active agents for identifying and preventing hazard risks and accidents. The authors of this article conducted focus groups with Australian rural children to determine the comprehension and attractiveness of three promotion tools addressing child farm safe. The results will surprise you - and make you rethink how to design communication programs.

Neonatal mortality is a serious concern in India, especially in rural areas. The authors of this letter highlight important but often overlooked contributing factors.

How can we help a vulnerable rural population avoid diabetes mellitus? This pilot study from Victoria Australia uses the transtheoretical model of behaviour change to evaluate the possibility of diabetes prevention.

Few physician workforce studies take a chance on attempting to understand national or regional changes in physician location. In this long-term US study, physicians were matched up in the Masterfile across a 22 year span to determine regional migration patterns. The researchers were rewarded with some interesting results.

This review from a team of medical academics in rural New South Wales, Australia, used the power of electronic data sets to track the trends in rural health publications since 1990 in Australia, Canada and the United States. It's not a race but, hey folks, the number of rural health publications are increasing every year and Australian authors are nosing to the front!

Despite acknowledged curative and preventive measures, child malaria remains a concern in many countries. Does parental empowerment and participation in control efforts offer a way forward? This review of recent literature suggests a unique approach.

From the chaos of civil war in Ethiopia in the 1990s comes a useful model of care. The authors of this letter to the editor describe a unique "grass roots" system for providing health care to large displaced and dispersed populations.

The Australian Rural Health Education Network (ARHEN) is the peak body representing the 11 University Departments of Rural Health (UDRHs) in Australia. One of ARHEN's strategic purposes is to promote national networks. This editorial provides a position statement from the network regarding Australian rural interprofessional education. Everyone knows we should try and enourage health professions to learn together. Yet, as this editorial highlights, we are still a long way from having clinical undergraduate interprofessional education implemented in any systematic way in Australia.

What is it really like to be new graduate nurse in rural New South Wales, Australia? This article uses qualitative methodology to allow the reader an insight into the real stresses that confront our junior nurses, making it a "must read" for rural health service managers who want to retrain new and much needed new recruits.

What does resilience mean for a rural community? A group from Queensland, Australia, provide us with some interesting clues.

Can rural doctors who smoke play a part in stopping their patients from smoking? This question is raised in relation to rural India.

This well written paper is a "must read" for any medical educator. The Australian College of Rural and Remote Medicine's (ACCRM) struggle to gain recognition was achieved this year, and its fellowship program is a world first in rural and remote medical education. Not only are the fellowship's underpinning principles clearly documented, but the article also provides new evidence about the effectiveness of a comprehensive and contemporary assessment system in the postgraduate medical setting.

Research over the past two decades is building evidence of a clinical correlation between diabetes and low magnesium intake. In this paper Queensland researcher draw on a range of ecological data and convenience samples to argue that low magnesium in water, and through poor dietary intake and sweat loss may be responsible for the high rates of diabetes in Indigenous Australian populations. With greater international attention on the importance of magnesium, readers will find this article's implications for rural health thought provoking.

Qualitative studies provide rich insights into the lives of informants and increasingly rural health research can offer many such studies. This article pulls together the findings of six qualitative studies on Australian rural women's strategies to maintain health to create a new and deeper understanding of the issues then is possible in single case studies. The article is not only about an important topic but it is also provides a clear explanation of a technique known as metasynthesis which is increasingly being used to create robust and generalisable results from multiple qualitative studies.

Rural and remote medicine is a "broad church" and although we may believe that it is a recent academic speciality, this essay tells the story of how a Clergyman, Reverend John Flynn, developed a lasting rural clinical service in Australia nearly 100 years ago. It also reveals that the father of modern cardiology, James Mackenzie, was really a generalist at heart. The essay offers a way to use the infrastructure established by the Rural Clinical School program in Australia to guide the vocational training pathways for the rural generalists and specialists of tomorrow.

In rural areas, working with children who have special needs can be frustrating. The resources that parents can access in the city to help maximise their child's development often do not exist. This personal view reflects on the recent case of "Amillia" , an extremely preterm infant born in the USA, where such access for children with disabilties is enshrined in law. While Amillia would not have been so fortunate if she had been born in Australia, this commentary encourages those who advocate for rural children with special needs to keep the issue in the spotlight.

For decades the Rural Physician Associate Program has been preparing physicians for the American heartland with a nine month longitudinal rural experience. Fewer medical students have had rural experiences, and even fewer have a clue regarding the challenge of transitioning from the passive basic science and clinical roles of medical centers to the wide open interactions and opportunities provided in rural practice environments. University of Minnesota rural medical educators have developed some tools to ease this transition.