Rural and remote health最新文献

{"title":"A community-based intervention to challenge attitudes towards intimate partner violence: results from a randomised community trial in rural South-West Nigeria.","authors":"Olusegun Awolaran, Funmilola M OlaOlorun","doi":"10.22605/RRH9269","DOIUrl":"10.22605/RRH9269","url":null,"abstract":"<p><strong>Introduction: </strong>Intimate partner violence (IPV) is a major public health concern worldwide, with significant repercussions for women's health. In some parts of the world, IPV is considered an acceptable practice, especially in rural areas. Attitudes supportive of IPV have been reported as one of the foremost predictors of IPV, and a shift in the attitudes that permit, promote, and perpetuate IPV is required to substantially reduce its occurrence. Community-based interventions are a feasible strategy to engage community members in efforts to prevent IPV. This study tested a community mobilisation intervention to challenge attitudes towards IPV and prevent violence within intimate relationships.</p><p><strong>Methods: </strong>This randomised community trial was conducted in selected rural communities in Oyo State, Nigeria, between January 2019 and April 2021. The study employed a convergent parallel mixed-methods design and a three-stage sampling technique in selecting two local government areas, eight communities and the study participants. The 6-month community mobilisation intervention, focused on creating awareness and challenging attitudes supportive of IPV, was evaluated using two cross-sectional surveys (pre-and post-intervention), 12 in-depth interviews, and nine focus group discussions. The outcomes for this study, assessed using the WHO Women's Health Questionnaire, included attitudes supportive of IPV, women's experiences of IPV and men's perpetration of IPV. Difference-in-differences (DID) regression models were estimated to compare changes in IPV levels in the intervention and control arms, while qualitative data were analysed using a thematic approach.</p><p><strong>Results: </strong>At baseline, 628 men and 667 women responded to the survey, and 640 men and 658 women responded to the survey at endline. The median age of the respondents was 35 years at baseline and 40 years at endline. In the intervention group, the proportion of women with attitudes supportive of IPV reduced between baseline and endline from 65.2% to 35.1% versus 45.2% to 32.7% in the control group (DID= -0.116, p=0.039). Women's past year experience of IPV also reduced from 30.3% to 1.2% versus 48.4% to 33.2% in the control group (DID= -0.131, p=0.006). Changes in the proportion of men who had attitudes supportive of IPV or perpetrated IPV did not follow this trend. In the intervention group, the proportion of men with attitudes supportive of IPV increased between baseline and endline from 40.1% to 44.6%, as they did in the control group - from 43.7% to 45.8% (DID=0.015, p=0.805). Men's past-year perpetration of IPV reduced from 29.9% to 19.9% versus 43.2% to 10.2% in the control group (DID= -0.050, p=0.155). Respondents to the qualitative interviews in both the intervention and control groups at baseline were aware of the various forms of IPV in their communities, and had attitudes supportive of physical violence; however, those in the interventi","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"25 2","pages":"9269"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An integrative review of new nurse practitioners' experiences in rural healthcare practice.","authors":"Candace Stidolph, Jennifer Kawi, Catherine E Dingley, Ann Marie Hart, Jarod Giger, Rebecca Benfield, Andrew Thomas Reyes","doi":"10.22605/RRH9626","DOIUrl":"10.22605/RRH9626","url":null,"abstract":"<p><strong>Introduction: </strong>A maldistributed primary care workforce and disparities in health outcomes are ongoing concerns for rural populations across the globe. Nurse practitioners (NPs) are a promising solution for mitigating rural healthcare inequities by reducing provider shortages and improving access to essential primary care services. The NP workforce is the fastest growing sector of primary care providers in the US. NPs are more likely than their physician colleagues to spend careers in rural and underserved settings practicing in isolation from other providers, with higher rates of turnover. An indistinct understanding of rural NPs' early career experiences highlights the need for a critical synthesis of the literature and key future recommendations. This integrative review aimed to analyze and synthesize various types of empirical reports and theoretical articles about new NPs' experiences in rural primary healthcare practice; identify current literature gaps; and discuss implications for education, policy, and further research.</p><p><strong>Methods: </strong>Whittemore and Knafl's integrative method was used to inform the selection, review, and analysis of the literature. Search keywords were based on the Population, Effect of Interest, Measure, Study Design, Setting framework: (1) population (primary care NPs), (2) effect of interest (early career phase in a rural context), (3) measure (NP perspectives about their experiences), (4) study design (empirical, theoretical), and (5) setting (rural US and countries with a similar healthcare system and NP workforce, such as Australia, Canada, Ireland, Netherlands, and New Zealand). Four key databases (PubMed, Embase, Web of Science and CINAHL) were searched, followed by manual searching of reference lists to identify relevant empirical and theoretical literature; no time delimitation was applied in the search. A total of 174 sources were scanned. Data were iteratively compared, and significant patterns were extracted and organized into thematic clusters.</p><p><strong>Results: </strong>The literature search yielded five studies that met the eligibility criteria: three phenomenological studies, one descriptive qualitative study, and one descriptive quantitative study. Three themes emerged: the trajectory of early career practice for rural NPs, commitment and persistence of new rural NPs, and adaptive and maladaptive early career factors for rural NPs.</p><p><strong>Conclusion: </strong>This review included articles published in the US, although emergent themes may contribute to global knowledge about early career experiences in rural settings where advanced practice nurses are used. This review reinforced that NPs as a distinct professional population are underrepresented in rural workforce research, particularly during their early career phases. Scholarly literature about new rural NPs emphasized clinical preparedness and competence, workplace recruitment incentives, transition-to-p","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"24 2","pages":"9626"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Features of lipid metabolism in Arctic residents depending on ethnicity and lifestyle.","authors":"Olga Vlasova, Fatima Bichkaeva, Boris Shengof, Ekaterina Nesterova, Alexandra Strelkova, Nina Baranova","doi":"10.22605/RRH9140","DOIUrl":"https://doi.org/10.22605/RRH9140","url":null,"abstract":"<p><strong>Introduction: </strong>Metabolic adaptations can differ significantly among Arctic residents with different ethnicities, lifestyles and adherences to traditional diets. The objective of this study was to examine the status of saturated fatty acids (SFAs) and triglycerides and the variability of BMI among Russian Arctic residents according to ethnicity and lifestyle.</p><p><strong>Methods: </strong>The study involved adult females and males living in the territories of the Russian Arctic. The participants were divided into three groups: Indigenous reindeer herders leading a nomadic lifestyle (NIP), Indigenous people leading a sedentary lifestyle (SIP) and the Caucasian population (CP). The content of SFAs (C6-C24) and metabolic characteristics was determined using gas chromatographic and spectrophotometric methods. The study also included a quantitative comparison of the consumption of certain categories of food products. To analyze data, we used the descriptive analyses by non-parametric methods, as well as multiple linear regression analysis.</p><p><strong>Results: </strong>The study found that the Caucasian females had higher triglyceride levels (p<0.001), higher total content of long-chain SFAs (LCSFAs) (C13-C18) (p=0.002) and that the SIP females had reduced content of very-long-chain fatty acids (C20-C24) (p=0.039). These changes were not statistically significant for the males, partly due to the almost identical levels of triglycerides C16:0 and C18:0 in the NIP and the CP. The content of medium-chain SFAs (MCSFAs) (C6-C12) was higher in the SIP (p<0.001 for females; p=0.002 for males). The Indigenous males tended to have a lower BMI compared to the Caucasian males, resulting in a lower prevalence of overweight or obesity: 49.3% in the NIP (p=0.006) and 57.4% in the SIP versus 69.3% in the CP. In female participants, these frequencies did not differ, being 64%, 65.4% and 66% respectively. The NIP and SIP groups had higher consumption of traditional foods, carbohydrate-rich foods, meat products and vegetable oils, the latter of which was positively associated with SFA content.</p><p><strong>Conclusion: </strong>The study revealed the dependence of the studied parameters of lipid metabolism on ethnicity (Indigenous v Caucasian) and lifestyle (nomadic v sedentary). The population metabolic variability was expressed as the increase in the levels of LCSFAs and triglycerides in the CP, reflecting, most likely, an imbalance in the processes of their accumulation and consumption with a predominantly western type of nutrition. Indigenous populations, despite changes in diet towards an increased consumption of carbohydrate-rich products, have preserved an adaptive metabolism with the predominant use of lipids as energy resources. Higher levels of MCSFAs in the SIP, who are less adherent to a traditional diet compared to the NIP, may be compensatory, with a growing role of such fatty acids in energy consumption and thermogenesis.</p>","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"25 2","pages":"9140"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prescribing for acute migraine in a rural Australian hospital.","authors":"John J van Bockxmeer, Sarah Briody, Marshall Makate, Jack Kalotas","doi":"10.22605/RRH8686","DOIUrl":"10.22605/RRH8686","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Migraine is an episodic, debilitating form of headache. Guidelines exist for the management of acute migraine, concluding that opioids should be avoided, unless as a last resort. Australian research shows a poor consistency in ED prescribing patterns with no published rural hospital data. Treatment of acute migraine often involves multiple medications used in succession. The overprescription of opioids is reported and often accompanied by an underuse of triptans. Previous studies do not differentiate prescriber intervention over time. It is unclear if opioid medications are routinely selected as first-line therapy in rural Australian EDs. The aim of this research is to complete an evaluation of migraine management in a rural Australian ED and compare trends to pre-existing data.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study is a retrospective cohort analysis of clinician-diagnosed migraine patients presenting to a single Australian ED between 1 January 2017 and 31 December 2021. Cases with migraine were defined by a primary G439 diagnosis (International Classification of Diseases 10th Revision). Patients with alternative diagnoses and those who did not wait were excluded. Cases underwent a non-blinded chart review extracting demographic and clinical data. Diagnoses were not evaluated against the international headache society criteria. ED interventions were recorded as first-, second-, third- or fourth-line based on the ordering time by the prescribing doctor. Medications were classified as being compliant or non-complaint with current standards of care. Trends were compared to previous studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 341 patients were diagnosed with migraine, 72.4% female, median 35 years. A total of 6.5% arrived by ambulance, 76.8% had a prior history of migraine, 6.5% were admitted, 36.4% underwent blood investigations and 12.0% neuroimaging. A total of 7.6% of patients received opioids as first-line therapy, 44.3% failed self-medication and 21.7% of patients with migraine history trialled opioids prior to presentation. Regarding prescriptions, 795 were written, 18.1% were non-compliant with guidelines. Seventy percent of patients received dopamine and 5-HT3 antagonists, 43.1% non-steroidal anti-inflammatory drugs (NSAIDs), 27.0% serotonin receptor agonists and 27.0% opioids. There was a statistically significant prescribing difference for aspirin, used in 16.4% of those with a migraine history and 5.1% without (p=0.01). A total of 13.8% reported allergies/contraindications to guideline therapies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Prescribing for acute migraine in Australia is highly variable by context. This single-site study has similarities and differences with prior research. Rates of opioid prescribing were lower, possibly due to the known sparing effect of serotonin receptor agonist usage. Similar rates of NSAID and intravenous hydration prescription occurred. Patterns of intervention o","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"25 2","pages":"8686"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of recent methamphetamine use on treatment outcomes among individuals initiating medications for opioid use disorders in rural treatment settings: a 1-year retrospective cohort study.","authors":"Leslie A Kenefick, Lisa Khairy, Luke Hall, Kibeom Kwon, Nicole Limberg, Kirsi Kirk-Lewis, Megan Lewis, Matt Owen, Sterling McPherson, André Q Miguel","doi":"10.22605/RRH9536","DOIUrl":"10.22605/RRH9536","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Rates of N-methylamphetamine (methamphetamine) use in rural areas of the US have been steadily increasing, particularly among individuals who are already struggling with opioid use disorder. Despite this alarming trend, there remains a significant gap in our understanding of how methamphetamine use affects treatment response for those undergoing treatment with medications for opioid use disorder (MOUD). This study aimed to explore the predictive role of methamphetamine urinalysis (UA) results at intake in treatment retention and in opioid and methamphetamine use over time among individuals seeking MOUD treatment in four clinics located in rural areas. The study was conducted across four clinics situated in rural areas, where access to addiction treatment services is known to be limited.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Clinical data for this study were collected between January and December 2019. A substantial number of participants were enrolled from those patients initiating treatment in 2019 in four clinics in rural Oregon. Data included intake demographics, attendance, and monthly opioid and methamphetamine UA results over a 1-year period. Our primary outcomes were opioid and methamphetamine use, and treatment retention over a 1-year period. Objective verification of opioid and methamphetamine use was determined using UA results collected once per month. Treatment retention was determined considering the number of days elapsed from treatment intake to treatment dropout. Generalized estimating equations were used to compare methamphetamine and opioid use over time, and Kaplan-Maier survival analysis was used to compare treatment retention by methamphetamine UA result at intake.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 554 patients enrolled at one of the four rural MOUD clinics, of whom 277 (50%) had a negative methamphetamine and 277 (50%) had a positive methamphetamine UA result at intake. Participants were mostly White individuals (89.5%), half of participants were male (54.5%), and the mean age was 36.8 years (standard deviation 10.8 years). About a third were unemployed (32.3%), more than a quarter reported legal problems (26.2%), and 5.4% were currently homeless. Compared to those testing negative for methamphetamine, patients initiating MOUD treatment with a positive methamphetamine UA were more likely to be unemployed (36.5% v 28.2%; p=0.048) and to have a positive opioid UA result at intake (88.4% v 45.8%; p&lt;0.001). A negative methamphetamine UA result at intake was associated with fewer positive methamphetamine UA results over time (p=0.022) but was not associated with either better treatment response for opioid use over time (p=0.849) or treatment retention (p=0.51).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;While patients who had negative methamphetamine UA results when initiating MOUD treatment had higher rates of methamphetamine abstinence over time, methamphetamine UA results at intake did not predict ","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"25 2","pages":"9536"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental wellbeing of Norwegian farmers: what are the main facilitators and barriers? An exploratory study.","authors":"Anette Dølen, Friedolin Steinhardt, Linda Røset","doi":"10.22605/RRH9103","DOIUrl":"10.22605/RRH9103","url":null,"abstract":"<p><strong>Introduction: </strong>Farmers are among the occupational groups with the highest risk of mental illness. This exploratory study aimed to investigate how Norwegian farmers perceive different facilitators of and barriers to mental wellbeing in their everyday lives, and the possible relationships between these factors and overall mental wellbeing.</p><p><strong>Methods: </strong>This study included 265 Norwegian farmers (142 males and 123 females) who responded to an online survey. The five-item WHO Well-Being Index was employed to evaluate farmers' mental wellbeing.</p><p><strong>Results: </strong>The results showed that 34.7% of the respondents reported wellbeing scores that indicated they should be further screened for major depression. Female farmers reported significantly lower mental wellbeing scores than male farmers. Furthermore, full-time farmers had lower wellbeing scores than part-time farmers. The factors that most respondents perceived to be barriers to wellbeing in everyday life were unstable economics and a lack of appreciation for their work. The primary facilitators were stable and secure economics and a good social network within and outside of agriculture.</p><p><strong>Conclusion: </strong>Analysis suggests that perceived barriers seem to have a higher importance for farmers' wellbeing than the perception of facilitators. Future studies should further investigate the effects of individual barriers on mental wellbeing.</p>","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"25 2","pages":"9103"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health outcomes and healthcare access experiences of incarcerated and recently released women in rural areas: a scoping review.","authors":"Clare Heggie, Chloë Fuller, Alex Goudreau, Martha Paynter","doi":"10.22605/RRH9618","DOIUrl":"10.22605/RRH9618","url":null,"abstract":"<p><strong>Introduction: </strong>The goal of this scoping review was to identify and synthesize what is known about the health outcomes and healthcare access experiences of women who are currently incarcerated or recently released from prison/jail in rural areas.</p><p><strong>Methods: </strong>We followed the Joanna Briggs Institute methodology for scoping reviews. The population of interest was adult women or gender-diverse people who are either currently incarcerated or had been released in the prior year. The concepts of interest were health outcomes and health access experiences. The context was rural institutions of incarceration and rural communities in the post-incarceration period.</p><p><strong>Results: </strong>We identified 48 relevant studies conducted in the US, Australia and England, published between 2001 and 2024. Ten studies took place in a rural community up to 1 year post-incarceration, and the remaining 38 took place in a rural prison or jail. The most common outcomes of interest were those related to substance use.</p><p><strong>Conclusion: </strong>Women in rural institutions of incarceration experience a general lack of healthcare options and availability, and may have elevated needs related to substance use. Women released into rural communities face barriers to accessing care, often relying on relationships to facilitate access to health care and social services, in lieu of the clinical and transitional services available in urban areas. Gaps in research include evidence on health outcomes not related to substance use, and experiences accessing primary care both while incarcerated and after release.</p>","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"25 2","pages":"9618"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introducing ultrasonography in family medicine training: a pilot evaluation.","authors":"Paul Aujoulat, Jérôme Fonseca, Gabriel Perraud, Jeanlin Viala, Jean-Yves Le Reste, Benoît Chiron","doi":"10.22605/RRH9549","DOIUrl":"10.22605/RRH9549","url":null,"abstract":"","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"25 2","pages":"9549"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Public healthcare personnel's experiences and opinions on access and readiness to provide mental health care in a remote rural area in South Africa.","authors":"Divan Rall, Leslie Swartz","doi":"10.22605/RRH8961","DOIUrl":"10.22605/RRH8961","url":null,"abstract":"<p><strong>Introduction: </strong>WHO encourages decentralising mental health care away from the tertiary locus of care into lower levels of care so as to reform mental healthcare worldwide. Recently, attempts have been made to facilitate the integration of public mental health care into general healthcare systems in South Africa. It is well established that the country's public healthcare system faces numerous multifaceted challenges - including very limited human, structural and material resources needed to accommodate and treat patients. We studied the experiences and opinions of public healthcare workers at primary healthcare clinics and the associated referral hospitals, focusing mainly on exploring their views on the ability and readiness for access to and provision of mental health to state health patients.</p><p><strong>Methods: </strong>The Mental Health Knowledge Schedule (MAKS), the Mental Illness: Clinicians' Attitudes Scale (MICA-4) and a purpose-made questionnaire were used for data collection. The data from the MAKS and MICA-4 were imported into IBM SPSS Statistics Software to yield descriptive information, and Spearman's rank correlations were performed between the measures. The purpose-made questionnaire produced descriptive quantitative data and qualitative data that were analysed through conventional content analysis.</p><p><strong>Results: </strong>Results from the MAKS suggest that participants experienced gaps in mental health knowledge and had fair levels of familiarity and ability to recognise different mental health conditions. Results from the MICA-4 suggest that participants in our study generally displayed a positive attitude towards people with mental illness and aspects involving psychiatry. Quantitative results from the purpose-made questionnaire describe aspects around mental health services, training, resources and care. Qualitative findings suggest healthcare workers wished for more mental-health-specific resources and contact with the healthcare system to facilitate interventions and care.</p><p><strong>Conclusion: </strong>This research presents possible solutions to the challenges faced in public mental health care. Some of these solutions are within workers' control, while many of the solutions to the successful integration of more comprehensive basic care are out of their ambit of control, remaining locked up in policy and implementation rather than in field-level practice.</p>","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"25 1","pages":"8961"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supplement use among a diverse sample of perimenopausal and menopausal women in rural Hawai&#x02BB;i.","authors":"Paris N Stowers, Emilie Stickley, Russell Woo, Andras Bratincsak","doi":"10.22605/RRH9490","DOIUrl":"10.22605/RRH9490","url":null,"abstract":"<p><strong>Introduction: </strong>Supplement use is common among women experiencing menopause and perimenopause. Previous studies have identified regional, cultural, and ethnic differences in supplement use patterns and have identified a high prevalence of supplement use among rural populations. The objective of this study was to characterize supplement use among an ethnically diverse population of perimenopausal and menopausal women living in a rural region of Hawai&#x02BB;i in the US.</p><p><strong>Methods: </strong>From May to August 2023, women aged over 40 years presenting for care at an academic women's health clinic were recruited to participate in this cross-sectional study. A 10-minute survey including questions concerning demographic characteristics and supplement use was administered. Descriptive statistics were used to describe data obtained from the survey.</p><p><strong>Results: </strong>One hundred participants completed the survey. Of these, most participants identified as Asian, White, or Native Hawaiian. Ninety-four percent of respondents reported using at least one supplement in the previous 6 months. Most participants (60%) used four or more supplements, and the mean monthly cost was US$55 (A$83). The most commonly reported supplements included vitamin D, calcium, a multivitamin, and magnesium. Health professionals were the most commonly identified source of information regarding supplement use (69%). The most common motivations for supplement use were promotion of general health (51%) and replacement of dietary deficiencies (11%).</p><p><strong>Conclusion: </strong>The prevalence of supplement use among perimenopausal and menopausal women in rural Hawai&#x02BB;i is higher than previously published measures of supplement use among similarly aged women in the continental US, the UK, and Canada. In the setting of such widespread use, clinicians caring for this population may consider initiating thoughtful discussions with patients on the risks and benefits of using these products.</p>","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"25 1","pages":"9490"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}