Volume twenty-one, Issue 4

Specialized care barriers are widespread and multifactorial, with consequences for timely access, health outcomes, and equity, especially in rural contexts. This article identifies and analyzes arrangements for providing specialized care in the Brazilian remote rural municipalities.

Obesity, a complex and multifactorial disease causing severe health problems, is still the second most important cause of preventable deaths after smoking. Childhood obesity is also associated with overweight and obesity in adulthood. This study investigates the prevalence of overweight and obesity in primary school students and their parents and how these relate to location (rural vs urban) and gender.

In the Kimberley region of Western Australia, Aboriginal children experience six times the rate of untreated dental decay than non-Aboriginal children. Access to dental care is challenged by the availability and appropriate delivery of services in remote locations. This study reports on the experiences and perceptions of parents and carers who participated in a project that tested the minimally invasive Atraumatic Restorative Treatment and the Hall Technique approaches to manage early childhood dental caries among Australian Aboriginal pre-school children.

Early-career James Cook University (JCU) medical graduates are more likely to practise in regional, rural and remote areas than other Australian medical practitioners. This study investigates whether these non-metropolitan practice location outcomes continue into mid-career, and identifies the key underlying demographic, selection process, curriculum and postgraduate training factors associated with JCU graduates choosing to practise in regional, rural and remote areas of Australia.

Cardiovascular disease is a leading cause of global mortality. Indigenous women in Mexico are particularly vulnerable, experiencing a lag in medical services and gender inequalities that cause disadvantages in access to health services. This study evaluates the predictive capacity of three anthropometric indexes for cardiovascular risk in Matlatzinca women.

Las enfermedades cardiovasculares son la principal causa de mortalidad global. Las mujeres de pueblos originarios en México son particularmente vulnerables, debido a la falta de servicios médicos y desigualdades de género que causan menor acceso a los servicios de salud. Este estudio evalúa la capacidad predictiva de tres índices antropométricos para riesgo cardiovascular en las mujeres del pueblo Matlatzinca.

A doença cardiovascular é uma das principais causas de mortalidade global. As mulheres indígenas no México são particularmente vulneráveis, experimentando um atraso nos serviços médicos e desigualdades de gênero que causam desvantagens no acesso aos serviços de saúde. Este estudo avalia a capacidade preditiva de três índices antropométricos de risco cardiovascular em mulheres Matlatzinca.

The remoteness of the Bahamas, an archipelago in the Atlantic Ocean, makes the import of food costly and labor intensive, limiting the amount of diverse and nutritious food available to the population of 388,000 people. This study reports on the validity of the Food Insecurity Experience Scale and measures food security in the Bahamas.

COVID-19 highlighted longstanding challenges in the treatment of opioid use disorder in rural areas of the USA and brought needed changes that accommodated people seeking methadone treatment during the pandemic. This Commentary describes how previous policies created barriers to care, and how they can be adapted long-term, in line with more flexible models used in other countries, to improve access to care for rural communities.

There is a growing interest in fear of childbirth. The prevalence, reasons and treatment have been investigated, but the development of fear of birth during and after pregnancy in a sample of women from a rural area is less studied. This study explores the trajectories of fear of birth and associated factors in a sample of women living in a rural area of Sweden.

Scotland's National Health Service (NHS) provides health care that is free at the point of use and almost all Scottish citizens are registered with an NHS general practice. Patients attending rural and remote practices are likely to be served by a smaller clinical team that provides a greater range of clinical services than urban practices, which are more likely to be located close to hospitals. This study examines the differences between satisfaction levels expressed by NHS patients attending a general practice in urban and rural areas in Scotland.

Palliative and end-of-life care is provided inconsistently across Australia, particularly in regional, rural and remote areas. Systematic solutions can help to address identified gaps and improve access and quality of care and support for patients, their families and carers at the end of life. This narrative report describes the ‘Far West NSW Palliative and End-of-Life Model of Care’, a consistent and contextually adaptable, patient-focused palliative approach, and identifies the essential elements to implement or maintain the Model elsewhere.

The COVID-19 pandemic has had serious health and socioeconomic impacts on people all over the world. Nigeria and other African nations worked with non-government organizations to institute a framework for controlling the spread of the disease and the resultant economic woes. However, the measures largely focused on urban centres. This study explores the experiences of traditional rulers, who are closest to the rural people in the fight against COVID-19.

The incidence of type 2 diabetes is increasing in the Azores (an archipelago in the mid-Atlantic), Portugal. The Azorean population has unique health-related characteristics (remote and rural with double insularity phenomena and consanguinity marriages) that necessitate the development of a predictive model. This paper presents a model, the AzoresDiab Model, that assesses the risk of type 2 diabetes mellitus for residents of the Azores.

While all James Cook University (JCU) medical students undertake rural placements throughout their course, approximately 10 per year undertake extended rural placements in rural and remote towns – 5-month Integrated Rural Placement or 10-month Longitudinal Integrated Clerkship programs. This study uses a return-on-investment approach to quantify student and rural medical workforce benefits arising from these ‘extended placements’ between 2012 and 2018.

The gram-negative organism Aeromonas is found in freshwater and marine environments and can cause a variety of diseases in humans, ranging from diarrhoea to cellulitis. When approaching water-immersed soft-tissue injuries and infections, prompt recognition of this pathogen is needed because treatment involves specific antibiotics and possible surgical intervention.

Rural and remote physiotherapy in Australia has evolved to be regarded by some as a discipline in its own right, requiring additional competencies and skills to bridge the gap from metropolitan practice. This study outlines an introductory set of competencies that contribute to effective physiotherapy practice in rural Australia.

The Longitudinal Integrated Clerkship (LIC) is a model of medical training that involves community-based education in which the student participates in the care of patients over an extended time, building relationships with clinicians and the community and working on clinical competencies across multiple disciplines. Although many schools in the USA, Canada and Australia have implemented LICs in undergraduate programs in many different ways, few published reports in Asia exist. This first report of modified LICs in Thailand assesses different rural educational environments using the DREEM questionnaire.

To build a ‘home grown’ local Northern Territory (NT) medical workforce, Flinders University established the NT Medical Program (NTMP) in 2011. Ten years on, we provide an update on NTMP performance: graduation rates are increasing; one in three Indigenous students graduate from the program; and a large proportion of graduates go on to work in the NT.

Social capital is considered an important determinant of health and overall well-being, but there is a paucity of literature relating social capital to malnutrition in low-income countries. This paper examines the relationships between social capital and chronic malnutrition and anemia in a population of rural coastal children in Ecuador.

El capital social se considera un determinante importante de la salud y el bienestar general, pero hay escasez de literatura que relacione el capital social con la desnutrición en los países de bajos ingresos. Este artículo examina las relaciones entre capital social y desnutrición crónica y anemia infantil, en una población rural de la zona costera de Ecuador.

O capital social é considerado um importante determinante da saúde e do bem-estar geral, mas há uma escassez de literatura relacionando capital social à desnutrição em países de baixa renda. Este artigo examina as relações entre capital social, desnutrição crônica e anemia em uma população de crianças de áreas costeiras rurais do Equador.

Within Australia, there has been particular concern about the impact of COVID-19 on Aboriginal and Torres Strait Islander communities, given the disproportionate impacts previous pandemics have had on Indigenous peoples. This Commentary reports on the effectiveness of an Aboriginal Community Controlled Health Organisation, The Bendigo & District Aboriginal Co-operative, in managing this deadly pandemic amongst a vulnerable population group by administering specialised health care, health promotion and health interventions to its members.

Greater levels of social fragmentation have been found to be associated with impaired mental health but studies have predominantly focused on urban populations. This study investigated whether social fragmentation and psychological distress were associated in a rural area of south-eastern Australia, and examined whether there were spatial hotspots of psychological distress and social fragmentation in the region.

Longitudinal studies are important tools for public health and epidemiological research, but are resource-intensive and difficult to perform in rural and remote populations. This Letter to the Editor describes how pseudo-longitudinal designs can be utilized as a valuable alternative to traditional longitudinal studies.

Colombia's rural areas, already geographically isolated, have also suffered from government neglect and armed conflict, further exacerbating their isolation in terms of basic needs and health access. This study constructs new categories of rurality in Colombia, taking into consideration the armed conflict and typology of isolation, to help inform policymakers and planners.

Las áreas rurales de Colombia, que ya se encuentran geográficamente aisladas, han sufrido además la negligencia del gobierno y los conflictos armados, lo que agrava aún más su aislamiento en términos de necesidades básicas y acceso a la salud. Este estudio construye nuevas categorías de ruralidad en Colombia, tomando en consideración el conflicto armado y la tipología de aislamiento, para contribuir al trabajo de legisladores y planificadores.

As áreas rurais da Colômbia, já geograficamente isoladas, também têm sofrido com a negligência do governo e conflitos armados, agravando ainda mais seu isolamento em termos de necessidades básicas e acesso à saúde. Este estudo constrói novas categorias de ruralidade na Colômbia, levando em consideração o conflito armado e a tipologia do isolamento, para auxiliar os formuladores de políticas e planejadores.