Volume seventeen, Issue 1

Many rural and remote communities are characterised by significant inequities in primary healthcare service availability, quality, performance and sustainability. This article investigates how best to ascertain the costs of delivering high quality primary healthcare services in rural locations of different population sizes, and to describe the methodological issues associated with such an exercise.

This article describes the use of in-depth qualitative interviews with healthcare professionals to examine opportunities and challenges in promoting CRC screening in rural areas. Findings suggest opportunities to increase rates through alternative healthcare delivery models such as accountable care organizations.

This project report describes how simulated medical scenarios were used to improve collaboration among wilderness medicine professionals. The authors present sharing as a core concept of a grounded theory with application for interprofessional education, particularly relevant to rural and remote contexts.

This article examines the history of rural training track residency programs in the United States over the past 30 years. This account reveals the significance of a community of practice for ongoing support and development of these programs.

In this short communication, the authors describe an innovative approach to IPE for medical students and physician assistants in the clinical setting. Reflections from a pair of students highlight the potential value of a concurrent clinical placement.

This article examines the potential for a text-message-based smoking cessation intervention to reach American Indian college students. Results offer insight into cell phone access, internet use, and preferences regarding the use of digital media for health information among American Indian college students.

This article examines cardiovascular disease risk factors in children and adolescents in West Virginia. Contrary to previous literature suggesting a straightforward link between rurality and cardiovascular risk factors, the authors found mid-sized metropolitan areas presented with the highest risk, and recommend future longitudinal studies to explore mechanisms between cardiovascular risk factors and rurality.

This qualitative case study explores how a rural women's shelter adapted to a changing role with increased integration of health and social services. The authors report relationship building, community mobilization (both education and empowerment), and redesigning delivery were implemented as adaptation strategies.

Agricultural communities have unique healthcare requirements owing to the high rate of workplace deaths, preventable injuries and illness. They typically also have limited access to services. To address these needs, the University of Iowa, USA, established a course in agricultural medicine, which has since been adapted for Australian students. This article reviews the educational and practice outcomes of students who have completed the agricultural medicine course in Australia and the USA.

This study examines obesity in college students living in rural and urban areas of Kentucky. Findings suggest that living in economically distressed rural Appalachia is associated with excess body weight in college students independent of individual-level socioeconomic factors, depressive symptoms, and health behaviors.

In New Zealand, a unique set of postgraduate pathways has evolved to train rural medical practitioners in extended scopes of generalist practice. This article describes these pathways and the history of their devolopment.

A public health surveillance model was developed following earthquakes on Kefalonia, Greece, in 2014. It involved daily reporting of clinical symptoms by local healthcare clinics and close observation by mayors for any unusual health events. The model provided assurance of quick identification of any possible outbreaks.

This study examines how well prepared high schools are to deal with a life threatening emergency during school athletic programs. The authors identify financial and other challenges for rural schools, and recommend training and certification of coaches in the absence of trained healthcare personnel at sporting events.

This study describes two instances in which the mental health care of Australian Aboriginal and Torres Strait Islander clients was culturally inappropriate and/or inadequate. The author reflects that culturally safe therapeutic interventions, supported by reflective thinking and practice, can promote understanding and improve care.

This article reports on the results of a survey of rural lesbians in the United States which assessed access to and experiences with women's healthcare as well as preventative behaviour. Results suggest that rural lesbians experience more health risks than their urban counterparts.

There are very few prospectively recruited studies examining the outcomes of an ICU admission for a life-threatening illness, especially in regional areas. This study, from Alice Springs Hospital, Central Australia, followed a heterogeneous cohort of survivors of critical illness to 5 years and found disproportionately high ongoing morbidity (and correspondingly high rates of healthcare utilisation) and mortality (and at a young median age) than comparable international studies.

A case study from rural Greenland is used to highlight the potential for radiographic detection of osteoporotic fractures in the absence of other testing capacity in remote areas. Use of available technology, specifically lateral chest radiograph, enabled the diagnosis of fragility fractures and the timely initiation of treatment for osteoporosis.

Maintaining an adequate medical workforce in rural and remote northern Australian towns has been a challenge for many years. Based on medical graduates from James Cook University, Queensland, Australia, this study provides the first Australian evidence that likelihood of remote medical practice is enhanced by investment in a 'remote pipeline' - medical education via clinical schools and internships in rural/remote locations, with a later option of a rural generalist pathway. The proportion of medical graduates working in remote practice may also be increased by preferentially selecting Indigenous Australian applicants and applicants who score highly for communication, teamwork, self-reliance and motivation for rural and remote practice.

This article explores issues in rural emergency department care for older adults with dementia from the perspective of healthcare professionals. Findings suggest strategies to minimize harm in emergency department transitional care among this population.

Food insecurity is a complex issue which affects many Aboriginal people living in Victoria. The Victorian Population Health Survey results suggest that community food programs are a central component of many rural and regional Victorian Aboriginal Community Controlled Health Organisations.

This article examines the effects of a Canadian program aimed at improving recruitment and retention of dieticians to rural and remote practice locations. Findings suggest that distributed and community-engaged learning models can be successful in augmenting the rural and northern dietetics workforce.

This article reports on the introduction of an asynchronous telemedicine partnership (TECS) that allowed rural veterans to receive eye screening in their primary care office, rather than travelling to a specialist center. The program increased access and reduced healthcare costs for both the healthcare provider and the veteran.

Up to 33% of Australians have untreated dental decay and up to 34% of Australian adults have inadequate dentition. The majority of dental care in Australia is provided by private practice, with patients bearing the cost of consultation and treatment. Low-income earners can access subsidised care through public dental clinics, but demand has outstripped the capabilities of the public system, resulting in long waiting lists. This study found that utilisation of the existing network of private dental practices across Australia for delivery of subsidised dental care could dramatically increase geographic reach (improving service availability in rural and remote areas), reduce waiting lists, and make good oral health a more realistic goal to achieve for the economically disadvantaged members of our community.

This short communication reports on the results of a monitoring program aimed at detecting Avian Influenza virus prevalence among hunter-harvested birds from a remote First Nation community. This research points to the benefits of community-level surveillance of Avian Influenza virus in remote subsistence hunting communities.

This study examined hospitalisation and public dental service records and found that residents of rural communities in Queensland, Australia, experience poorer oral health and are a greater risk of hospitalisation for dental conditions compared with the whole of Queensland. Although public dental services account for a small proportion of all dental care across the state, service utilisation data provide a unique insight into the population groups that may not be accessing public dental services. In the rural context, more effective use of the local workforce and a flexible approach to funding models could have a positive impact on access to dental care.