Volume seventeen, Issue 4

Japan’s over-65 population is expected to surpass 30% in 2030, making it the first super-aged society in history. With this rapid demographic and epidemiological transition, medical education in Japan needs comprehensive reform. Community-based medical education, particularly in small rural medical institutions, with a focus on primary care, should be central to the reform. 

In rural areas with few doctors, Penrose drains are sometimes avoided in minor surgeries for soft tissue trauma or small subcutaneous tumors, even though the drain would prevent hematoma, because of the limited availability of professional postsurgical care. This study reports on the development of a simple fixation method for Penrose drains that is safe and particularly suitable for minor surgeries in rural areas where there are no resident doctors.

Exposure to undifferentiated patient presentations is increasingly common in medical education, particularly in longitudinal integrated placements. This research, from an international research workshop attended by clinician teachers and medical educators who work in rural primary care, explored clinicians' perspectives of how students develop their clinical reasoning: by learning from patients; from their supervisors; and by understanding the context of their clinical interactions.   

The Australian Aboriginal and Torres Strait Islander population has a higher cancer mortality rate and a lower 5-year survival rate for all cancers than the non-Aboriginal population and barriers to accessing medical treatment and health services, particularly for people living in regional and remote locations, have been identified. This article reports on the usage, acceptability and usefulness of the Cancer Healing Messages flipchart and patient flyer, which were developed by Cancer Council South Australia to assist health professionals in discussing cancer and the cancer journey with Indigenous cancer patients and their families and improve access to health care. 

Although the association between child mortality and socioeconomic status is well established, the role of household assets as predictors of child mortality, over and above other measures of socioeconomic status, is not well studied in developing nations. This study investigated the contribution of several household resources to child mortality, beyond the influence of maternal education as a measure of socioeconomic status.

Marginalization is a significant issue in Mexico, involving a lack of access to health services with different impacts on Indigenous, rural and urban populations. Although health coverage is highly concentrated in urban areas in Mexico, shortages are mostly concentrated in rural areas where Indigenous groups represent the extreme end of marginalization and access to medical coverage. Inadequate access to health services in the Indigenous and rural populations throws the gravity of the public health problem into relief.

Not enough medical graduates choose to work in rural and regional areas, especially in general practice. The Pūkawakawa Programme, a year-long regional and rural experience for selected Year 5 students from the University of Auckland‘s Medical Programme in New Zealand in partnership with the Northland District Health Board and two Primary Health Organisations, is found to be an important contributor to the regional and rural workforce of the Northland District, New Zealand. The academic–clinical partnership has been shown to support a regional and rural clinical learning environment.

This article reports on the findings of a qualitative investigation into the experiences of new registered nurses (RNs) transitioning into the rural acute care environment. Findings related to transition supports and challenges suggest implications for developing strategies for support and retention.

This article offers a theoretical model to portray the complexity of factors influencing the experiences of rural emergency medicine physicians. Identification of a range of factors, both previously and not previously identified in the literature, can contribute to systems improvement.

Mobile emergency simulation offers innovative continuing medical educational support to regions that may lack access to such opportunities. This study evaluated Canadian rural health care providers' satisfaction from high fidelity emergency simulation training using a modified motorhome as a Mobile Education Unit.

This research presents cross-sectional analysis of the "Caregiving in the U.S. 2015" survey conducted by the National Alliance for Caregiving (NAC) and AARP Research. Findings suggest a need to understand culture and other characteristics of rural care providers when interpreting self-reported health status.

This paper reviews the factors contributing to suicide in older rural males in Australia. Living with experiences of drought, dramatic weather change, lower employment opportunities, out-migration, changing family dynamics, ageism in the community, economic change and competitive labour markets all add to the diverse experience for an older person who is ageing in a rural setting.

People living with chronic obstructive pulmonary disease (COPD) outside of urban areas have higher rates of hospitalisations, but hospital admissions and lengths of stay are reduced for people with COPD who participate in an integrated disease management program. This review explores the type and cost-effectiveness of COPD management interventions located in rural or remote settings of Australia and New Zealand in order to inform planning and ongoing service development.

This article presents a unique pathway for care aimed specifically at spinal patients. As a result of the shift of the spoke direction from the existing hub and spoke model, patient care is being redirected successfully with great benefit to a rural department.

Papua New Guinea has a special history in regards to the training of Community Health Workers (CHWs) and is currently preparing its frontline health workforce to serve the people who live in rural and remote settings (85% of the total population of 7.3 million). This article identifies and explains the five major developmental stages in the current CHW training program, as well as the changes that have occurred over the past century.

This article reports that Mid-Upper Arm Circumference (MUAC) is a viable cost- and time-effective measurement tool for screening women at risk of under nutrition in a rural setting.