Volume twelve, Issue 2

Fly in/fly out services are increasingly being proposed for remote health services. Are they the answer? What does the evidence say?

This 3 phase Australian participatory research study provides insight into the working world of acute care rural clinicians. The participants from New South Wales identify challenges to rural practice but also make a positive contribution with practical solutions and strategies unique to the rural sphere of practice.

Rural physicians who become rural medical educators soon realize that it is difficult or impossible to do rural medical education without the rural community. One solution has been rural preceptorship experiences, but not always do students find out as much about rural communities. Five days of immersion can help students to explore rural communities and rural life.

In order to understand the complexity of rural and remote allied health professions' recruitment and retention, this international review assessed positive and negative motivating factors intrinsic to the work. The result is accessible, evidence-based advice for rural health organisations wanting to recruit and keep its allied health staff.

Does the effect of medical students' short-term rural placements endure and influence eventual practice location? This study from New Zealand revisited graduates' student intentions to find out.

The development of teeth begins in intrauterine life. However, the health of women in Russia and particularly in the remote Northwest region has worsened during the time of transition from Socialism to market economy. The hypothesis of this thought-provoking study is that poorer maternal health, combined with low access to dental health preventive programs, has increased the prevalence of caries the rural among children of this region.

Are workforce factors also access barriers to rural disability therapist services in NSW, Australia? After wide consultation, these authors present the evidence.

As urgent cardiac reperfusion is lifesaving in ST elevation myocardial infarction, how does the frequency and outcome of rural GPs' initiation of thrombolysis in small EDs compare with that of larger regional centres? While this small study from south-eastern Australia is encouraging for the prognosis of rural patients, it also raises questions about delays in presentation.

For decades the Indonesian Government has implemented and refined strategies to improve the distribution of health workers to remote areas. This author analyses the evolution of Indonesian policy and legislative initiatives in a unique health delivery environment.

In a rural nursing practice course, the students used photovoice to document the challenges and facilitators of rural nursing practice. This interesting article reveals the benefits of this specific research method - in this case, helping students to discover the uniqueness of rural nursing practice.

Specialized health services are not always available in remote locations. This article focuses on the integration of psychogeriatric care in northern British Columbia, Canada and presents the findings from an examination of this process.

In the context of Nigeria's severe coastal environmental degradation from oil spillages, an impoverished rural population favours the use of crude oil from those same spillages as a traditional medicine, resulting in toxic complications, particularly among rural children. In this first study of its kind, the authors surveyed the use of crude oil among rural mothers in an attempt to understand this toxic practice.

Do access barriers to diagnosis and treatment of prostate cancer disadvantage the survival of rural men? This systematic review considered worldwide incidence, ethnicity, mortality and - above all - location.

In the Dominican Republic, multidisciplinary teams of healthcare professionals organize 'health fairs' for rural residents. This article describes the process and what they discovered about the health of participants from three rural villages in 2009 - along with wider implications for improving the Dominican health system.

How do small towns concentrate upon the candidates most likely to migrate to a rural practice? Studies of physicians and physician characteristics indicate different probability of migration when considering origin, gender, age, training, and proximity measures. The right candidate could be closer than you think.

The 'voices from the bush' of expert Australian remote area nurses report alarmingly high levels of workplace violence. The variety of hazards and contributing factors indentified say loudly that expert, urgent action is required to manage the workplace risk of this highly skilled but highly vulnerable group.

'Individual members of the family contribute to the health of the family, but the child is often the catalyst for health promotion within the family, not only the siblings to the unborn child, but also the unborn child'. So state the authors of this unique literature review that examines and interprets the intricate and complex construction of family in the indigenous Inuit culture, and in so doing illuminate the central role of the child.

Rural, minority populations with language and healthcare coverage issues can face great barriers, especially in areas such as the prevention of disease. This is captured in Hispanic rural populations in Georgia via a study of HPV vaccine utilization. The article is an outstanding example of "how to do" such studies and "why" qualitative approaches are important contributors to the development of better healthcare delivery.

A rapid increase in physicians does not necessarily correct a urban-rural maldistribution; however, would an insufficient supply of physicians worsen an existing rural inequity? This study answers the question by applying spacial competition models to the situation of Japan. Regardless of location, if you have an interest in rural physician workforce strategies do not miss this article.

Is location or socioeconomic status more important in food security? This study of rural and metropolitan South Australia considered both, building on the authors' earlier work. While a plentiful and healthy diet is required for individual and community health, this article questions the affordability of healthy food in rural areas of South Australia.

As in the rest of the world, Australia's Northern Territory is feeling the impact of rural nurse shortages as the baby boomers retire and significant nursing knowledge is lost. However the unique challenges of the NT's often remote nursing posts and its small local and mobile, imported workforce call for specific solutions. This undeniably small study yields a wealth of novel strategies and recommendations to entice older rural nurses to remain involved in the workforce - on their own conditions.

It is accepted now that rural undergraduate educational experience has a positive impact on rural workforce recruitment. For Australian medical students this means long-term rural GP clerkships - but are these students a financial liability or significant contributors to the practice? This Australian study analysed qualitative data from their GP supervisors, and financial and patient activity data from participating New South Wales medical practices to find out.

Due to chronic rural health worker shortages, in small-town Australia paramedics may now provide first-line primary care. As a result of broad consultation in south-eastern Australia and supported by multiple case-study methodology, this article puts the case for a 'rural expanded scope of practice' model for paramedics.

Why are Australian rural and remote communities underserved by dietitians - and what can be done about it? The data from dietitians and their managers from 6 rural New South Wales sites contributes to a solution.

Authors highlight the problems facing rural low-income families as more families with more chronic conditions and more challenging situations try to access fewer providers. The characteristics of rural families may worsen health situations - just as changes in health designs may or may not help address the problems facing rural families.

High Sub-Saharan African maternal mortality rates are unmatched in the world. These researchers focused on an extreme example, Msambweni District in Kenya, to determine the attitudes and beliefs that influence rural women to deliver their babies without skilled supervision. Admittedly this is a small local study, but the evidence from hospital staff and the parturant women themselves suggests a wealth of strategies likely to be relevant and useful in similar contexts with similar concerns