Volume twenty-one, Issue 1

Delivering safe, reliable quality health care involves ensuring the workforce has access to the right training at the right time wherever healthcare workers are practising, a particular challenge for rural and remote health practitioners. This paper shares the development of a national Managed Educational Network for clinical skills and how its principles were used to analyse the performance of a mobile simulation delivery unit.

The use of Implantable Cardioverter Defibrillators (ICDs) is increasing in both New Zealand and Australia, but little is known about the experiences of ICD recipients living in rural contexts. This study investigates whether living rurally impacts the ICD recipient experience and that of their partners.

Indigenous Peoples around the world are disproportionately affected by mental health challenges due to intergenerational and collective trauma stemming from historical losses and ongoing colonialism. Mental wellness initiatives may be more successful and sustainable when they are developed for and with Indigenous communities using community-driven approaches that prioritize and privilege Indigenous leadership, knowledge systems, beliefs and practices. This scoping review of studies on Indigenous community-based mental wellness initiatives found that culture was a central theme of such initiatives, but identified a lack of cultural leadership in many research studies. The authors argue that initiatives must be guided by local Indigenous knowledge, improved or renewed connection to land, fostering community strengths, and the sharing of roles and responsibilities among those involved in this work.

Virtual trauma supports, coined teletrauma, is one solution to address gaps in rural trauma care. This scoping review of the literature identified benefits of teletrauma services for rural and remote areas. The authors also identified a number of factors associated with teletrauma use, such as patient age, injury type and severity. The authors reflect on gaps in current teletrauma research, including how different teletrauma technologies may support or hinder rural trauma care and how interprofessional relationships influence teletrauma encounters.

Cancer is a leading cause of death in Samoa. Cultural beliefs shape attitudes towards disease and disease prevention in Pacific countries, and are a barrier to engaging in cancer screening services. This article reports on the results of a survey of Samoan adults about their beliefs about cancer causation.

Due to global nursing shortages, recruitment and retention of nurses is a major international concern, exacerbated in rural and remote areas. This review explores the influences on nurses’ decisions to work in rural and remote healthcare settings to inform recruitment and retention strategies.

Physical activity can make significant differences in supporting the prevention or treatment of chronic diseases, ensuring that people experience active old age. This study investigates the relationship between the physical activities of adults living in rural areas of Turkey and each component of the Transtheoretical Model, an integrative theory of therapy that assesses an individual's readiness to act on a new healthier behavior.

This project report assesses current practice and future plans for physicians' delivery of maternity care services in rural areas of Kansas. Findings suggest serious shortages in rural maternity care. The authors also suggest a need for further research to investigate the need for incentives and affects on maternal and newborn health.

This rapid literature review aimed to inform the development of a new sustainable, evidence-based service delivery model for ear, nose and throat services across Cape York, Australia. The study investigates the research question ‘What are the characteristics of successful outreach services that can be applied to remote-living Indigenous children?’.

Stroke patients living long distances from a hospital are unlikely to receive time-critical reperfusion treatment. This study investigated whether inexperienced transcranial ultrasound users could acquire diagnostic images after brief training, and thus facilitate acute care in remote and rural areas.

This original research article examines dual roles – when healthcare professionals experience intersections of professional and personal relationships – in rural long-term-care (LTC) settings. Based on a multi-site study of a rural LTC, the authors suggest several considerations for policy and practice.

Smear-positive pulmonary tuberculosis (PTB) requires rapid diagnosis and treatment to prevent ongoing transmission. Collection of two sputum specimens is considered the minimum requirement for the diagnosis of PTB but current guidelines in the Torres Strait Islands, Australia, recommend three sputum specimens, which frequently delays treatment. This retrospective study investigated all PTB cases diagnosed between 2000 and 2018 in theTorres Strait Islands and found that two good quality specimens ensures adequate diagnostic yield for PTB and a third specimen should only be collected from patients with two negative specimens who have persistent symptoms.

Challenges to addressing workforce maldistribution for equitable rural healthcare access continue, including for dermatology services. This qualitative study explores the topic of working in a rural area from the perspectives of dermatologists and dermatology trainees.

The field of disability studies is a contested area of research that has transformed significantly over the past three decades. The move away from the medical model of disability in the early 1980s created opportunities for the voices of people with disabilities to be heard. However, research into the lived experiences of this population has historically relied on proxy accounts and, where first-person accounts have been included, people with disabilities have often been excluded on the basis of cognitive-communicative (dis)ability and language proficiency. This article explores the ways in which space and place influence the lived experience of disability in a rural South African context.

Paederus dermatitis (PD) is a skin reaction to paederin, a chemical produced by beetles of the genus <i>Paederus</i>. This Short Communication investigates the clinical manifestations and progression, seasonal variation and environmental factors associated with PD among patients attending the outpatient dermatology clinic of Siriraj Hospital, Thailand.

The early closure of the Voluntary Dental Graduate Year Program and the Oral Health Therapy Graduate Year Program by the Commonwealth Government adversely impacted NSW Aboriginal Community Controlled Health Services. This led to the co-design of a small-scale oral health therapy graduate year program known as the 'Dalang Project', which enabled oral health therapists to engage with local Aboriginal communities and implement culturally competent, practical and evidence-based oral health promotion activities. This paper provides an overview of the Dalang Project and its evaluation.

Women in rural and regional areas encounter challenges when accessing care for gestational diabetes mellitus (GDM). This study reports on a clinical audit of women accessing the GDM service at a large regional hospital and explores the feasibility and acceptability of a telehealth venture to enhance management of GDM from the perspectives of women with GDM and health service staff.

Access to wheelchairs for most of the South African poor population is through accessing rehabilitation services at public health facilities. This study explored access to wheelchair services from the perspective of rehabilitation therapists within the uMkhanyakude district of KwaZulu-Natal, South Africa.

Older adults are at significantly higher risk for morbidity and mortality associated with COVID-19, and are hesitant to seek health care due to fear of exposure. This project report describes an outreach effort to older adults living in rural West Virginia by their established healthcare providers. The project demonstrates the older adults' preference for, and the appropriateness of, telephone calls compared with more complex teleconference methods. The authors suggest that systematically calling older rural patients during the COVID-19 pandemic represents an effective care strategy.

This study examined rural healthcare bypass behavior in the United States &ndash; assessing patients' use of health care outside of their local community resources. Findings suggest that policymakers and healthcare workers can utilize the social vulnerability of place index (SoVI) to better understand and address bypass behavior in rural areas.

The population in Japan continues to age, and this is more pronounced in rural than urban areas. The relationship between rural elderly patients’ improvement in motor and cognitive function in relation to activities of daily life (ADL) through rehabilitation and their discharge to home has not been clarified in rural communities. This study investigated whether an improvement in ADL for elderly hospitalized patients allows them to be discharged to their home in a rural community.

Rural hospitals in New Zealand provide broad generalist clinical services, including procedural sedation and analgesia. This study explores patterns of procedural sedation use by rural hospitals including indications, equipment, medications, logistical and medical staff support available, and whether current professional guidelines support rural sedation practice.

Aboriginal people are less likely to access dental services and have twice the rate of untreated dental caries compared with other Australians. This study compares two models of service delivery designed exclusively for Aboriginal people: (1) fixed clinic in a major city with visiting services to rural areas; and (2) clinicians within rural communities and existing community facilities.