Volume fifteen, Issue 4

To produce health professionals who are oriented towards addressing community priority health needs, training in medical schools in Uganda includes a component of community based training, during which time they are supervised by faculty from their university. Although many students were satisfied with their supervision, challenges remain. Using ICT could be a solution to some of these challenges.

Ongoing workforce shortages affect the provision of mental health services to rural and remote communities. These qualitative findings provide depth to and support students' changes in interest toward working in a rural environment.

As part of the Australian Rural Clinical Training & Support program researchers are making valuable contributions to rural health research. This study reports a benchmark of research strengths and highlights areas that should be strengthened.

Water security is a basic component of life but for many communities, it is something that is not easily achieved. This article reports on an exploratory study that addressed water insecurity of a remote Indigenous community in sub-Arctic Canada.

Development assistance funding for health services has decreased in Namibia while the incidence of non-communicable diseases has increased. Innovative approaches, such as this mobile clinic, can provide cost effective wellness testing services at the workplace to help address the growing issue of non-communicable diseases.

Mental health providers and administrators are the experts regarding recruitment and retention of key mental health personnel. What do they say about the challenges of providing mental health in rural Nebraska?

Are there rural-urban differences in perceived ease of access to substances such as alcohol and tobacco? Read this article to find out.

To address physician shortages in rural areas, more than 80% of medical schools in Japan have introduced a quota program that provides educational and financial support to students placed in medically underserved areas after graduation. The aim of this study was to investigate the students' willingness to remain in these areas after the obligatory period, and to identify factors associated with willingness to stay.

To help address rural workforce shortages, this regionally based College of Medicine and Dentistry favours rural origin applicants and provides students with early and repeated exposure to rural experiences. These data suggest that this selection process does not compromise academic standards and produces many graduates who choose to work rurally.

To help attract and retain the 'right' graduates to the rural workforce and mitigate the ongoing rural doctor workforce shortage, this study compares demographic, temperament and character trait profiles of general practice Registrars across three Australian training pathways. The combination of trait levels that tend to differentiate Registrars on a rural path correlate strongly with high levels of resilience, which may be of greater benefit for the rural context.

Many rural hospitals in Australia are unable to recruit or are not large enough to sustain employment of a full-time pharmacist, leading some nurses to undertake medication-related roles outside their scope of practice. This study explores medication management gaps in rural hospitals with no on-site pharmacist, including consideration of inpatient consultation services, assistance with accreditation matters and system reviews, and input into pharmaceutical distribution activities.

A promising intervention for building the public health nutrition workforce in remote Indigenous community store settings is described. Working to improve the food supply is challenging but there is value in being supported by like-minded colleagues.

Income increases the empowerment of women and is associated with reduced fertility in this study. It is therefore one of the key issues for changing the lives of rural women in Bangladesh.

Interhospital transfers can provide insight into regional healthcare efficiency. By monitoring these transfers, evidence of real needs, priorities and interconnections can emerge to positively inform new healthcare policy.

To address Argentina's critical healthcare shortage in rural settings, this study built on international research showing that difficult working conditions and low remuneration push new medical graduates into cities instead of rural districts. One-third of students in the present study expressed altruistic motivations for choosing rural areas for their future practice, indicating that increased support from government and medical schools may tip students' choices in favor of underprivileged regions.

Appropriate healthcare-seeking practices of mothers are important to prevent child death. This study in Ethiopia recommends promotion of treatment during antenatal care, postnatal check-up and community conversation to reduce the incidence and impact of diarrhea in children.

Snakebite envenoming is a major cause of morbidity and mortality in rural areas of the tropics. Timely administration of effective antivenom remains the mainstay of management. This study explores the causes and effects of delay, distance and time taken to access care on snakebite outcomes in Nigeria.

Rural-remote communities report higher smoking rates and poorer health outcomes than metropolitan areas. Catering for the unique challenges of the rural-remote setting is necessary if anti-smoking programs are to be efficacious, cost-effective and capable of improving rural-remote health outcomes.

Obesity continues to progress in an epidemic fashion in the United States. Studies have indicated more problems for rural populations. Additional studies can help to confirm or deny the rural contribution as well as indicate other possible reasons.

Indonesia is experiencing unequal distribution of health services between rural and metropolitan areas, leading to poorer health for rural populations who have limited access to primary care physicians. To address this imbalance, this study explores intrinsic factors perceived by medical students to be important when choosing the location of their future practice, as well as a government program that places medical students in rural and remote areas.

Little is known about the academic and professional staff involved in the Australian Government's Rural Clinical Training and Support program. Addressing this knowledge gap will positively affect workforce and succession planning.

Mosquito-borne diseases are a serious global problem, particularly in tropical and subtropical countries such as Nepal. In these rural areas, topical application of citronella oil can be employed as an easily available, affordable and effective alternative mosquito repellent to prevent mosquito-borne diseases.

Emergency physicians are one of few types of physicians increasing in the rural United States. The authors ask questions about the preparation of emergency physicians and the differences between training in rural and in urban settings.

Rural background is a strong predictor of practice intentions and preferences, key factors in addressing health workforce shortages in rural and remote settings. This study provides insight into the broader range of interrelating and complex personal, contextual and experiential factors affecting the career decisions of medical graduates.

Although Australian medical school programs improve cultural safety through training at an individual level, learners tend to internalise the patterns of behaviour they are commonly exposed to. In this study, clinicians, academics and professional staff demonstrated differences in their cultural safety profile, indicating the need for a tailored approach to cultural safety learning.

Is community development the answer to improve oral health? This article provides the details to show that it can be effective.

Evaluation and monitoring of primary health care requires the establishment and maintenance of an appropriate data system. This audit provides us with an indication of how accurate routinely collected data in the electronic system is compared to the paper medical records that have traditionally been considered the gold standard.

This study found that weather is at the core of rural life - flood and drought contribute to decreased wellbeing from stress, anxiety, loss and fear, whereas social connectedness promotes resilience.

Although medical-legal partnerships in Australia are in their infancy, they could support the needs of rural people living with mental health concerns. This review article presents recommendations for developing medical-legal partnerships between mental health providers and lawyers in rural Australia.

In Australia, modifiable cardiometabolic risk factors are in excess in rural and remote communities. High quality community-level health promotion is paramount for the management of population health risk in such settings, especially in the context of reduced access to healthcare services. This study examined the extent to which formal frameworks and the adoption of socio-behavioural theories were reported in health promotion programs designed to reduce cardiometabolic disease risk in rural and remote settings.

Although the international community has condemned sorcery related killing and violence in Papua New Guinea, effective and appropriate interventions at a community level remain elusive. This case is a unique and intriguing example of biomedical and sociocultural integration in which a family sought a medical explanation of their relative's death to prevent rumours of sorcery and reduce the risk of related violence.

Although many medical schools incorporate distance learning into their curricula, assessing students at a distance occurs much less often due to the inherent challenges. This article focuses on lessons learned from implementing an objective structured clinical exam to address these challenges.

As the number of regionally based academic health faculties and clinical schools in Australia grows, it is imperative to assess the relevance of these programs for improving rural workforce outcomes. This article describes James Cook University's tracking system for medical graduates, which has resulted in a 98% complete longitudinal tracking database that enables exploration of the patterns of practice of its medical graduates.

Placements in developing countries can be professionally life changing experiences for medical students. This placement in the Solomon Islands not only provides multidisciplinary Australian students with a great experience, but also leaves a long term legacy to the community.

To put a blindness prevention program into practice in remote districts of Eastern Taiwan, a Mobile Vision Van Unit was established to work as a community eyecare station. This model was found to be highly feasible in its efficiency and cost-effectiveness in communities with deficient medical resources.

Effective role model programs designed for remote Indigenous youth can have positive outcomes for both role models and the program recipients. Cultural safety training is an important factor for preparing role models and for building their cultural competency.

Germany is facing an increasing shortage of medical doctors in rural areas as current graduation rates do not counterbalance the loss due to retirement. This study describes how even short-term courses in rural practice can help reduce barriers that prevent physicians from working in these areas.

Letter to the Editor: JCU's emphasis on rural, remote, Indigenous and tropical medicine, placements in rural or remote localities, and skills appropriate for independent practice prepare medical graduates for remote environments.