Volume 6

Do you find rural clinicians and communities are frustrated by research being "done on them"? This project report describes the development of a series of modules designed to empower and equip Aboriginal and Torres Strait Islander health workers to take control of their own research agendas.

Could salarying rural doctors to work in mental health units improve patient care? See what rural doctors in Queensland, Australia, thought of this suggestion.

Worldwide, urolithiasis is the third most common urological disease affecting both males and females. This study from rural Thebes, Greece, makes some interesting findings about possible causative factors in a rural population.

Most rural health professionals aspire to holistic practice. What does this mean? Is it possible? This article reports on a participatory action research project which explored these questions in the context of a health district in South Africa. The authors identify a number of limitations to holistic practice in a public sector healthcare environment. Many of these are relatively easy to address. However burnout amongst health workers is one of the most significant challenges described.

Evaluation of consumer perspectives is a crucial component of quality improvement in rural health. But are you aware of how different evaluation methods may find different answers to the same question when used in rural communities? This article provides some helpful clues to navigating this important issue.

Procedural skills are an important component of rural medical practice. This article summarises what we currently know about the obstacles to maintaining such skills and how to overcome these.

High school students in a rural, tobacco-growing area of Uganda are apparently more likely to smoke cigarettes than their urban counterparts. This paper examines smoking habits of rural high school students and the possible influences on this. The authors highlight an important problem which has not received sufficient attention in East Africa.

What is the benefit of rural training? Is it confidence, competence, comfort, comparison, or a confluence of many areas? The Rockford RMED students evaluate their four month rural experience in their progression to primary care and rural practice.

As mental health becomes more prominent in rural communities, it is important that we learn from each other internationally. This paper presents some of the first preliminary data in this field from Namibia.

What changes have occurred over the last 20 years in the demographics and working hours of Australian rural doctors and nurses? This article provides all too clear documentation of very worrying trends.

Read this letter for more on irritable bowel syndrome in rural Greece.

Some journal articles instruct, others inform, while others motivate. Some community projects fail for lack of imagination. Others fail for lack of integration with the needs of people. This article instructs, informs, motivates, and integrates.

Do rural people with cancer have different attitudes from those who live in cities? Are they more fatalistic and independent? This research note points to how we may learn more about this important area.

In the last decade and a half there has been a significant increase in the burden of renal disease among Aboriginal Australians. Read how the Umoona Kidney Project stabilised renal function and improved blood pressure among Aboriginal community members identified to be at greatest risk.

Rural and Remote Health has launched a new African section. This editorial discusses the implications for rural and remote health professionals.

What does it take to keep doctors in rural practice? New evidence from South Africa provides further weight for strategic investments to solve this international problem.

Cross-sectional surveys used for identifying children with disabilities have disadvantages. Participatory rural appraisal (PRA) provides a cost-effective, efficient method that reflects the local perceptions of disability and involves local people, important for sustainability in resource-poor countries.

Interested in implementing a practice based approach to STI screening? This letter from rural Victoria documents one practice's experience.

This journal has recently published two studies that have apparently conflicting evidence about the prevelance of mental illness in rural Australian communities. This Editorial offers an explanation for these results and suggests the necessary steps forward for further research in this vitally important area.

Is living in a rural area good for your mental health? This article adds to the debate by providing Australian evidence of poorer mental health indices for patients in smaller rural towns compared to larger regional centres.

What factors influence rural women to stay locally or leave town to deliver their baby? Research by a rural practitioner in Queensland, Australia, helps us answer this important question.

How can we prepare remote health professionals to improve outcomes in chronic disease? This article describes a collaborative educational approach.

Focus on engagement, courtship, and sustaining the relationship. Live in their world, think differently, and build integrative infrastructure.... Sounds like sound advice for any developing couple, family, or group. Just happens to be sound advice for researchers regarding Building Bridges with Decision-Makers.

Coleridge noted some 200 years ago that there was "Water, water everywhere and not a drop to drink." Billions of people still lack safe water. Sand filtration offers alternatives to families in hope of better health.

Aboriginal community controlled health services provide care to a significant number of Indigenous Australians in rural and remote communities. This article provides helpful data on the consultation profile of these practices.

This article describes how an alcohol intervention program in a remote community came to focus on litter! Have similar events occurred in your rural community? This report opens an important area of enquiry, particularly in cross-cultural settings.

Rural and remote health services rely on good transition systems wihen patients need transfer to tertiary facillities. This article describes the frustrations faced by Indigenous Australians when they need city-based care, and describes some simple solutions.

How can we provide good palliative care if we don't understand our communities' perceptions of pain relief? This article outlines the views and beliefs of Aboriginal Australians living in remote communities in northern Australia.

Interprofessional education in the health sciences is perceived as enhancing collaborative practice, and as a new and challenging issue for contemporary medicine. This has special benefits for resource-poor rural health care.

What issues are you likely to confront in developing internet-based resources to support remote health professionals? This article from Australia may help you avoid some pitfalls.

Many rural health professionals deal with men who are retiring from active farming lives. What advice can we give them? This exploratory study emphasises the importance of planning for purpose and relationships.

Obesity appears to be a significant threat to the health of rural communities in developed nations. This data from rural Queensland suggests the problem may be even worse than was prevously thought.

What is the prevalence of mental illness in rural communities? This article from Australia adds new evidence for us to consider.

Are clinical simulators a way of the future for rural clinical education? Are they really only a rich person's toy? This article reviews this new field and the implications for rural health professionals.

New generations of researchers are exploring the interactions between culture, origins, locations, occupations, and peoples. These researchers probe the vast contributions of rural women caregivers in Canada, helping to understand what we know and where we should go with further studies.

These researchers explore the impact of chronic disease on health-related quality of life in a rural, remote Canadian community - the Bella Coola Valley. Using new instruments and working collaboratively, the study is a model worthy of widespread replication for those who seek answers at the interface of culture, disease, economics, and health.

This study on breastfeeding in a rural Australian community suggests an increased role for senior women within the community. Would this also apply to your community?

Many cases of quail poisoning in adults have been reported previously. What makes this case interesting is that it is a report of quail poisoning in a child.

Do Aboriginal Health Workers have a place in rural pharmacies to improve the use of prescribed medications? See what this new research suggests.

Rural Thailand communities have a high prevelence of endemic haemoglobin disorders. This letter highlights a cost-effective detection method suitable for rural health services.

Is an Aboriginal Community Liaison Worker an effective alternative to an Aboriginal Health Worker? What are the differences? This article presents the author's personal experience of working with an Aboriginal Community Liaison Worker in an Australian women's health project.

This conference report provides an interesting approach to capturing and discussing challenges and solutions to frequent and important rural health issues. It provides four clinical scenarios presented to a 2005 conference in Tromso, Norway. The scenarios have been enriched and enhanced by the diverse backgrounds and experiences of the conference's participants.

Remote-dwelling Indigenous children have frustratingly poor dental health. Why? This article provides some possible reasons for you to consider.

What do indigenous people see as the major concerns in relation to substance abuse in their rural community? This article documents the views from an Australian regional centre.

Is there a difference in the academic performance and research involvement of medical students from urban and rural backgrounds? This study from Croatia suggests there is.

What is the future demographic of rural communities? This article from Western Australia provides a clear and thought-provoking view.

Significant racial differences have demonstrated in incidence, age of onset, outcome and subsequent risk factors of stroke. This article from Xanthi region in northern Greece takes a different approach and examines the difference in stroke incidence between its Muslim and Christian populations.

Ond of the privildeges of rural practice is working and living with indigenous communities. However, there is often little data with which to guide our health efforts. This article provides as start in relation to nutrition for one Indigenous group in India.

Most now agree with the concept of the rural medical pipeline for creating a sustainable workforce. Are parts of the pipe still constricted or leaking? This article looks at the impact of cadetships in Australia on career choice- could they be one of the ways of keeping the pipe open?

Does community participation assist in supervision of health workers in rural settings? This evidence from rural Thailand would suggest it can.

This interesting paper from Greece reports on the prevalence of diabetes mellitus in three rural villages, based on OGTT measurements. The main findings of the study are in agreement with other recently reported studies from Greece, and highlight further the burden of this disease in this previously healthy European country. It also emphasizes the urgent measures that should be undertaken in ameliorating this public health problem and associated diseases, including obesity, the new threat in many European countries.

Indigenous Australians in rural communities experience high levels of musculoskeletal conditions, often assessed and managed by Aboriginal health workers. Would the screening survey described here be useful in your own community?

RRH aims to increase the evidence base for rural and remote health. This article provides a great example of how to use evidence to make a difference to health outcomes in rural hospitals.

This article addresses the subject of farming suicide and underdetermined death in males in Scotland; it offers crude and standardized data to policy makers, researchers and rural practitioners with an interest on the subject. It highlights the methods used for measuring suicide and underdetermined intent death and it opens an important dialogue on introducing networks and social support as important protective factors for farmers.

Diabetes is a chronic disease that requires multiple office visits with a multidisciplinary team to learn how to successfully manage and delay the progression of complications. Read about the successful use of "evening cluster clinics" to respond to the health-care and educational needs of Hispanic migrant farmworkers diagnosed with diabetes.

Are you interested in preceptor development for rural clinicians? This letter describes a new initiative for pharmacy preceptors, especially designed for those working in rural areas.

How often do we find that communication and collaboration are the keys to effective links between rural and urban health services? Here is more evidence in the context of aged care services in rural Australia.

Why do urban origin students choose rural practice? This study from Australia provides some useful suggestions.

What happens when rural nurses gain further qualifications and take on higher responsibility locally? This Australian study looks at the transitions involved.

Want to provide health promotion services to people living accross an area of 600,000 square kilometres? This is the challenge adressed by this project report from Australia.

A key role for this journal is helping provide data on how to translate evidence into health care that actually works in rural and remote communities. This brief communication from Thailand adds to this evidence base.

With youth suicide at alarming levels in rural communities in Australia, why is it that there is so little research on rural adolescent mental health? This paper reviews the evidence as it is currently, and suggests areas of particular need for further research. Does this ring true for rural areas in other countries? Perhaps others could inform us through sharing the research evidence in their country.

As rural adolescents enter the risk-taking stage, especially with the use of alcohol, do parents have strategies to deal with this? This article throws further light on this important rural health issue.

Positive student experiences in rural practice will result in positive rural workforce outcomes. But how do we sustain the preceptors?

Not all good ideas for rural health delivery succeed in full. If you have a great idea you would like to implement locally, read this article first to see some pitfalls that may undermine your efforts.

When people become ill they use strategies to solve their problem that include accessing existing therapeutic resources in the community. This study compares the uses of alternative and traditional treatments in a rural area and an urban area of the north of Portugal.

The growing prevalence of diabetes mellitus is well recognised as an important public health problem. It seems to seriously affect remote and rural areas with poor access and little capacity to alleviate the burden on primary care services. This article from Highland in Scotland clearly describes redesign methodology and a mapping process, where health professionals, patients and carers' views were explored and solutions were discussed in solving several key planning issues regarding diabetes mellitus management in these remote areas. This article presents an excellent paradigm on how health planners can work together with primary care services and local people in constructing a governing policy in remote and rural regions and districts.

Have you been frustrated when a promising health intervention fails to be taken up in your rural community? A letter from a group of Australian medical students provides some useful insights to this dilemma.

Youth violence can leap to the headlines and send fear to the hearts. Are rural communities at risk? Do small towns face the same issues? Rural youth speak and you have a chance to listen. This survey of rural youth might be worth a review on the way to better health for your community!

Creating regional medical schools is an emerging international strategy to increase the rural medical workforce. Do they work? This paper presents the first encouraging evidence from James Cook University in Australia.

How can we tailor our approaches to rural and remote health care without good data on what is happenning at the local level? This requires a collaboration between clinicians and researchers, and a nice example, relating to prescribing patterns, is provided in this article from Crete.

Improving rural health services is an issue that concerns us all. How these services are financed is a key component of any reform. Read this article to learn some lessons from recent experience in Mongolia.

Do positive undergraduate rural experiences necessarily translate into immediate recruitment into the rural workforce? This exploratory Queensland study suggests that this transition is multifactorial. It also highlights the urgent need for more powerful multi-cohort or multi-institution studies into the impact of rural medical education initiatives.

How do you supervise therapy assistants in remote communities? This article describes a West Australian pilot project to do just this.

What can we learn from rural women about their access to health services? This Australian research adds to our understanding.

Moving health professional education into rural regions is an internationally accepted strategy to assist in improving rural health professional recruitment. This short Personal View provides helpful insights from an important recent innovation in regional Australia.

How can we improve the quality of rural health services in regard to Indigenous mental health? This conference report provides informed views from a range of Australian experts in the field.