Volume eleven, Issue 4

Despite the challenges of location and culture, hereditary cancer syndromes can be managed for individuals and families who live in remote areas. This Lynch syndrome case report from Western Australia provides valuable advice to ensure appropriate care and follow up is available for identified at-risk individuals and their families who are difficult to reach.

Recently in Australia, human infection with swine brucellosis has been disproportionately high among feral pig hunters in some rural areas. To explore an apparent failure of established risk-reduction strategies, a grounded theory approach gave voice to this hard-to-reach group. The researchers were rewarded with some rich data, including public health strategies specific to this group - and advice on how to disseminate them.

It may surprise you that in 2011 RRH is publishing one of the first and largest oral health studies of rural and remote Australian pre-schoolers. When Indigenous and non-Indigenous groups were compared, the prevalence and severity of decay for some (with associated suffering and morbidity) is sobering. In 2011, we might well ask: how can this be?

Fear, trust and suspicion - common human emotions that can de-rail or contribute to the success of integrating separate rural health services to improve health outcomes in the local community. This small study, one of the first to investigate local perspectives on Australia's Multi-purpose Service Program, suggests that negotiation can sometimes save the day.

Health human resource shortages are a common topic of discussion in clinical and policy arenas. This article offers new insights about the ethical dimensions of recruitment and retention of health care professionals for rural communities.

Throughout the rural world, humans in close contact with cattle, sheep and goats are at risk of the infection 'Q fever'. Because the most common chronic manifestation for those at cardiac risk is a high mortality endocarditis, careful cardiac assessment is essential for confirmed and suspected cases. Is this being done in Australian rural/district hospitals?

It is no news to rural and remote hospital administrators that the cost and difficulty of obtaining locum consultants is burdensome. For the rest of us, this intriguing Scottish study of one rural general hospital over 8 years raises questions about the sustainability of this medical staffing model in an era of shrinking resources globally.

Depressed or not depressed? Do rural men and women identify depression and what do they do about it? What is the relationship of education and gender regarding depression literacy? How do mental health care professionals and churches fit into the picture? Many questions are raised when exploring depression literacy in rural Arkansas.

This project report from the UK describes the challenges overcome by Keele University Medical School and its partners to establish a rural campus, bringing undergraduates into the teaching environment of previously inaccessible rural general practices and community hospitals.

This Letter to the Editor from Slovakia reports on a successful recent workshop on commencing research in general practice.

It is difficult to anticipate likely changes when establishing regional/rural sites for medical education. The authors' description of the Prince George site in Canada within the framework of social capital assists our understanding of what can result from collaborative health professional education efforts and what participants, partners, and stakeholders can expect.

This Letter to the Editor questions the effect of increasing Australian medical school cohorts on the quality of rural clinical placements.

With an ageing rural population, access to primary care for rural Australians with chronic disease is a public health concern. This article begins to fill a research gap by comparing patterns of primary care usage according Victorian location, among those with defined chronic illnesses. Of particular rural relevance is the range of non-medical health professionals included in the study.

In the Ukraine, scarce rural pharmacists are vital primary healthcare providers in an ailing health system. This unique study applied theories of motivation to the practice intentions of pharmacy undergraduates, adding the Ukraine view to the international rural workforce literature.

Does rural living limit access to mental health services? This thought-provoking article analyzed the Canadian Community Health Survey, Mental Health & Well-being data cycle to find out.

The traditional Mediterranean diet has been protective against obesity. Why, then, has epidemic childhood obesity appeared on a remote Greek island? These authors tested a range of familial and environmental factors in a small local study with a high participation rate.

Rural living is a significant risk factor for the neurodegenerative disorder Parkinson's disease. However, rural patients are often disadvantaged by reduced access to disease-specific care. This small, unique study from one rural Australian area gives voice to the person with Parkinson's and their personal and professional carers as a microcosm of a widespread but largely silent group.

This tribute to Dr John Irwin who died on 31 May 2011 celebrates his life as a committed Canadian rural surgeon and physician.

There are few studies that examine the health of rural children. In an attempt to address this gap, the authors of this cross-sectional study used a health questionaire with rural children in Saskatchewan, Canada. Their data reveals much about participating childrens' food intake, activity levels and weight status.

This new book review of the 2011 publication "Struggle for social service in Nepal" by Mrigendra Raj Pandey also provides background information on the Mrigendra-Samjhana Medical Trust, Kathmandu, Nepal.

In the 'information age' we should all be able to obtain more and better health information. How does the new technology of the internet compare with traditional methods of obtaining health education, such as the personal provision of information directly from a nurse educator?

Better health outcomes require a balance between research-tested interventions and population-specific application, along with adaptation, implementation and evaluation playing key roles. Appalachia is an appropriate testing ground for assessing adaptation to evidence based interventions.