Australian Journal of Rural Health最新文献

{"title":"Examining Differences Among Opioid Agonist Treatment Clients in Regional and Metropolitan Settings of New South Wales, Australia","authors":"Daniel T. Winter, Lauren A. Monds, Nicholas Lintzeris, Paul S. Haber, Carolyn A. Day","doi":"10.1111/ajr.70029","DOIUrl":"https://doi.org/10.1111/ajr.70029","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Whilst prior studies have examined characteristics and barriers for opioid agonist treatment (OAT) clients in regional settings, there are limited studies examining these differences in relation to metropolitan OAT clients. This study aimed to examine key characteristics, including sedating medication and substance use, transport and driving behaviours and differences between OAT clients within regional and metropolitan areas of New South Wales, Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Cross-sectional survey of OAT clients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Fifteen public OAT clinics across New South Wales, Australia, between January 2020 and June 2021.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Survey was completed by 482 people currently receiving OAT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Self-reported sample characteristics, self-reported sedating medication use and substance use, transportation and driving histories.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Significant differences in OAT pharmacotherapies prescribed between regional and metropolitan participants were noted (aOR = 2.42, 95% CI = 1.42–4.11). Methadone was the most commonly prescribed OAT in both settings (74.1% and 54.4%, respectively). Nearly half (45.6%) of regional participants received OAT from a private dispensary compared to 4.7% in metropolitan areas. While few differences in past-month substance use were noted, reported heroin use was lower (aOR = 0.27; 95% CI = 0.09–0.78) in regional areas. Regional participants were more likely than metropolitan participants to drive a vehicle to dosing (aOR = 2.89, 95% CI = 1.12–7.46) and less likely to take public transport (aOR = 0.41, 95% CI = 0.18–0.93) or active transport (aOR = 3.75, 95% CI = 1.50–9.40). Few differences regarding driving offences, based on geography, were noted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Key differences with treatment, substance use, transport and driving were noted within this study. It is evident that regional OAT clients more often rely on motor vehicles to complete daily activities. Such challenges related to OAT should be addressed by informed policy and regulatory changes that ensure","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70029","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143645850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recognising and Managing Distress Among Farming Clients: An Evaluation of Brief Training for Rural Financial Counsellors and Other Non-Clinical Rural Support Workers","authors":"Gemma Skaczkowski,&nbsp;Donna Hughes-Barton,&nbsp;Sophie Loxton,&nbsp;Kate Gunn","doi":"10.1111/ajr.70027","DOIUrl":"https://doi.org/10.1111/ajr.70027","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the impact of a tailored, brief, 3-h training program to help Rural Financial Counsellors and other non-clinical rural support workers recognise and manage distress experienced by their farming clients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Rural, regional and remote Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Rural support workers (<i>N</i> = 75; primarily Rural Financial Counsellors and Family and Business mentors) undertaking a 2-part, online training programme for recognising and managing distress in farmers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Individual questionnaires were collected before the first workshop, after the second workshop, and 3 months post completion of both workshops.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p><b>S</b>eventy-five participants provided pre-training data. A series of mixed models for repeated measures identified significant improvements in participants' confidence in recognising and managing farmers' distress pre- to post-training. Specifically, increases in confidence in differentiating mild distress from distress requiring professional help (<i>F</i> = 11.30, <i>p &lt;</i> 0.001), skills to use time well (<i>F</i> = 14.17, <i>p</i> &lt; 0.001), recognising distress (<i>F</i> = 9.16, <i>p</i> &lt; 0.001), dealing with the needs of distressed farmers (<i>F</i> = 22.93, <i>p</i> &lt; 0.001), talking to farmers about their wellbeing (<i>F</i> = 16.47, <i>p</i> &lt; 0.001), knowing <i>when</i> to refer farmers for additional support (<i>F</i> = 19.10, <i>p &lt;</i> 0.001), knowing <i>where</i> to refer farmers for additional support (<i>F</i> = 14.00, <i>p</i> &lt; 0.001), were maintained at the 3-month follow-up. Pre- post-training, participants' behavioural intentions to refer their clients to a farmer-specific mental health intervention (www.ifarmwell.com.au) increased (<i>F</i> = 48.26, <i>p</i> &lt; 0.001), which was maintained at 3-month follow-up. The training did not significantly change participants' quality of life or work stress.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Findings suggest that a brief, tailored training programme significantly increases rural support workers' confidence in recognising and managing distress in their farming clients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70027","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143632907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosing and Preventing Q Fever in Regional New South Wales, Australia—A Qualitative Exploration of Perspectives of General Practitioners","authors":"Sachith Maduranga,&nbsp;Lok Bahadur Shrestha,&nbsp;Braulio Mark Valencia,&nbsp;Graeme Horton,&nbsp;Michelle Guppy,&nbsp;Heather F. Gidding,&nbsp;Stephen Graves,&nbsp;John Stenos,&nbsp;William Rawlinson,&nbsp;Andrew R. Lloyd,&nbsp;Chaturaka Rodrigo","doi":"10.1111/ajr.70030","DOIUrl":"https://doi.org/10.1111/ajr.70030","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To qualitatively explore the perceptions of general practitioners in regional New South Wales, Australia, on diagnosing, managing and preventing Q fever.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Q fever is a prevalent zoonosis in regional New South Wales, but diagnosis may be missed as patients have symptoms similar to influenza or COVID. Perspectives of general practitioners who are the primary health care providers in rural areas are important to understand the logistical difficulties in providing optimum care to Q fever patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>General practitioners practicing outside of metropolitan Sydney in regional postcodes of New South Wales, Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Eligible general practitioners were interviewed online using a semi-structured interview guide on their approach to diagnosis, management and prevention of Q fever. The data were transcribed, coded using NVivo software, and analysed to identify emerging overarching themes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thematic saturation was achieved after 11 interviews. Diagnostic delays due to prioritising more common differential diagnoses for an influenza-like illness, difficulties in navigating the complex serological test interpretations for diagnosis, logistical difficulties in arranging immunisation, and the need for continuing medical education were the broad themes emerging from the data analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Investment in continuing medical education and expansion of the reference resources made available to general practitioners regarding the diagnosis and management of Q fever will improve health care for people suffering from and at risk of Q fever in regional New South Wales.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70030","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143622538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Employment Models to Attract and Sustain Rural Generalist Doctors: Barriers and Enablers","authors":"Belinda O'Sullivan,&nbsp;Shane Boyer,&nbsp;Angela Stratton,&nbsp;Jacque Philips","doi":"10.1111/ajr.70019","DOIUrl":"https://doi.org/10.1111/ajr.70019","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Explore the barriers and enablers related to employment models to attract and sustain rural generalist (RG) doctors emerging from a state-wide RG program.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Stakeholders across five rural regions in Victoria, associated with the Victorian Rural Generalist Program (VRGP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>36 stakeholders who responded from a list of 122 potential identified by a state-wide advisory group for the VRGP. Respondents included 13 program staff, nine people from related collaborative agencies, four state policy decision-makers and 10 RG employees/supervisors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>In-depth interviews were thematically coded through ongoing reflection and sense-making and verified by an independent qualitatively trained researcher.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were four barriers to employment models to attract and retain RGs and three enablers. Barriers included health service competition, variability in health service leadership and executive capabilities/competencies regarding the RG workforce, specialist competition and supply-based planning. Enablers were a state-wide vision, improving regional-level planning and RG recognition and reward.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The research offers insights about the need for state-wide, coordinated regional and local levels of strategy, planning and implementation to achieve employment models that attract and sustain RGs. Further, attracting and sustaining RGs depends on establishing and implementing clinical service models for the range of RGs needed in the community, using outpatient clinics and other networked service options across the region. It also relies on appropriate pay that recognises the additional skills that RGs have. The results might inform Australia's National Rural Generalist Pathway and the state and territory RG programs and their coordination units with progressing attractive and sustainable RG employment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143622539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective Cohort Study to Determine the Effect of Socioeconomic Status and Distance to Hospital on Negative Appendicectomy Rates in a Rural Setting","authors":"Roy Huynh,&nbsp;Kevin Tree,&nbsp;Matthew Smith,&nbsp;Lily Builth-Snoad,&nbsp;Faisal Syed,&nbsp;Dean Fisher","doi":"10.1111/ajr.70026","DOIUrl":"https://doi.org/10.1111/ajr.70026","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The impact of socioeconomic status and distance to hospital on negative appendicectomy rates is unknown. These factors have been shown to be important predictors of health in a rural setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To determine whether socioeconomic status and road distance to hospital were risk factors for negative appendicectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis of all appendicectomies at a large rural hospital in Australia between January 2018 and December 2022 was performed. Patients' data were extracted from electronic medical records. Regression modelling was performed to determine whether socioeconomic status and road distance to hospital were risk factors for negative appendicectomy. The surgical outcomes for negative and positive appendicectomies were compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 830 patients were included in our analysis, of which 106 (12.8%) had negative appendicectomy. The rate of negative appendicectomy was not significantly impacted by socioeconomic status (OR = 1.004, 95% CI 0.989–1.20, <i>p</i> = 0.583) or road distance to hospital (OR = 1, 95% CI 0.998–1.001, <i>p</i> = 0.635). There was no significant difference in complications and 30-day readmission rates between patients in the negative and positive appendicectomy groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In a rural setting, the risk of negative appendicectomy does not increase with lower socioeconomic status and longer road distance to hospital. This challenges the prevailing notion that rural surgeons have a lower threshold to operate on patients with lower socioeconomic status or who live further away from hospitals due to the perception that these patients have less access to healthcare.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70026","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143595265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Community's Role in Rural Youth Suicide Prevention: Perspectives From the Field","authors":"Laura Grattidge,&nbsp;Ha Hoang,&nbsp;Jonathan Mond,&nbsp;Denis Visentin,&nbsp;David Lees,&nbsp;Stuart Auckland","doi":"10.1111/ajr.70024","DOIUrl":"https://doi.org/10.1111/ajr.70024","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study explored how rural communities can be involved in suicide prevention efforts for young people aged 12–25. It provides a focus on who is best placed to drive these efforts and what support these people need to implement initiatives in their communities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>The research was conducted across Australia, with a focus on rural areas, where suicide rates are higher due to unique challenges, including geographic isolation, stigma and limited access to health services. These areas require community-driven solutions tailored to local contexts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Thirty-seven participants aged 29–72 contributed insights, with diverse professional roles and lived experiences in rural youth suicide prevention, including service providers, programme leaders, researchers and policymakers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A qualitative approach was used, with semi-structured interviews and focus groups conducted between January and September 2021. Data were thematically analysed using a reflective approach to identify key factors supporting rural youth suicide prevention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two key themes emerged: (1) Program planning and implementation: highlighting the need for adaptable, stigma-sensitive and culturally responsive approaches, and (2) Breaking down silos: emphasising collaboration between schools, families, health services and community leaders. Trusted local figures such as teachers, sports coaches and peers were identified as crucial for fostering engagement and early intervention. Lived experience voices were recognised as integral to co-designing and sustaining community-led efforts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Rural communities are central to youth suicide prevention. By leveraging local relationships, addressing stigma and fostering collaboration, communities can create supportive environments that save lives. Policy and practice must prioritise funding and resources for community-led, culturally sensitive approaches.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70024","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143581599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Connections Reduce Rheumatic Heart Disease-Related Mortality in Western Australia: A Mixed Methods Study","authors":"Virginia DeCourcy,&nbsp;Daniel Hunt,&nbsp;Ingrid Stacey,&nbsp;Emma Haynes,&nbsp;Beverley Paterson,&nbsp;Clare Huppatz,&nbsp;Marisa Gilles,&nbsp;Judith Katzenellenbogen","doi":"10.1111/ajr.70022","DOIUrl":"https://doi.org/10.1111/ajr.70022","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Preventable rheumatic heart disease (RHD) deaths continue to occur in Australia, with Aboriginal people disproportionately affected. Despite research into structural drivers and the lived experience of people with RHD, and national guidelines focusing on RHD prevention and treatment, recent coronial inquests have highlighted that systemic failures are ongoing. Few studies describe RHD service delivery and/or mortality within the Western Australian (WA) context.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to integrate quantitative information regarding RHD-related deaths in WA between 2012 and 2021 with qualitative interview data to identify system-level opportunities for the prevention of RHD-related mortality in the WA health care setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Using quantitative data from the WA RHD register, a descriptive analysis of the clinical and demographic characteristics of RHD patients aged &lt; 65 years was conducted, stratified by vital status. Thematic qualitative analysis of RHD stakeholder interviews was conducted in parallel, capturing systemic factors perceived to prevent or contribute to RHD-related mortality in WA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Limited health service contacts were documented for the 60 registered-recorded deaths among people with RHD. Interviewees emphasised that access to appropriate care was vital to prevent mortality. Passionate healthcare providers connect patients with care by fostering trusting relationships, but logistical, socio-cultural and care quality barriers continue to hamper connections.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Systemic change is needed in WA to support motivated providers and ensure that efforts to reduce RHD mortality do not rely on individual initiatives. This study contributes evidence for the need to improve RHD program design by prioritising patient-provider connections, empowering, and resourcing providers to effectively engage with RHD patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70022","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143581679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What Makes for Healthy Ageing in the Torres Strait?","authors":"Chenoa Wapau,&nbsp;Malcolm McDonald,&nbsp;Fintan Thompson,&nbsp;Rachel Quigley,&nbsp;Sarah G. Russell,&nbsp;Betty Sagigi,&nbsp;Gavin Miller,&nbsp;Tania Korinihona,&nbsp;Edward Strivens","doi":"10.1111/ajr.70020","DOIUrl":"https://doi.org/10.1111/ajr.70020","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Many studies focus on impediments to healthy ageing, but few examine factors leading to healthy ageing. Whilst many older First Nations people are ageing well, few studies have examined this issue in First Nations people. This study examined indicators associated with healthy ageing in the Torres Strait region of Queensland, Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from a Torres Strait Dementia Prevalence Study (2015–2018) were used to explore indicators of healthy ageing in 249 participants. A specific Torres Strait Healthy Ageing Index was created, based on 10 indicators from the dataset. One point was assigned for each indicator, with higher scores representing healthier ageing. This Index was then used to assess healthy ageing in a subset of participants aged 70 years and older.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Healthy ageing scores were higher in younger people. However, among 80 people aged ≥ 70 years, many were ageing well according to the healthy ageing index, with 44% scoring 7–8 and 28% scoring 9–10. Age-adjusted analyses identified that more education, lack of vascular risk factors, good medication prescribing patterns, absence of stroke and geographic location were all associated with a higher healthy ageing index.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our study suggested that many older First Nations residents of the Torres Strait region were ageing in a healthy way, based on the indicators available. The results showed both predictable and unexpected associations with healthy ageing. Stroke prevention stood out as a key priority. These results highlight the need for prospective population studies to better understand, promote and celebrate healthy ageing in this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Learnings From the Front Line: Early Implementation Experiences of the Central Queensland Foot Hub Virtual Multidisciplinary Team Model-of-Care","authors":"Shanal Kumar,&nbsp;Amy Walker,&nbsp;Caitlin Leech,&nbsp;Emma Powell,&nbsp;Ruth Varrall,&nbsp;Siobhan Ramsay,&nbsp;Rebecca Searle,&nbsp;Sarah Jensen","doi":"10.1111/ajr.70014","DOIUrl":"https://doi.org/10.1111/ajr.70014","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The ‘Central Foot Hub’ was operationalised in mid-February 2024 to provide multidisciplinary team (MDT) support from the Royal Brisbane and Women's Hospital (RBWH) to three hospital and health services (HHS) across Central Queensland. This model aimed to enhance diabetes-related foot disease (DFD) care by integrating virtual and local MDTs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study presents early implementation learnings from frontline clinicians involved in the co-design, implementation and refinement of this innovative model-of-care (MOC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A preparatory phase involved stakeholder engagement, service mapping and funding allocation to RBWH for recruitment. Site preparedness varied, influencing referral rates. A mixed-methods approach was used to evaluate challenges and successes, with input from local end-users.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Key enablers included local champions, collective leadership and integration with existing providers. At Rockhampton Base Hospital, the MDT expanded subsequently improving care coordination. However, challenges such as funding constraints, hybrid health information systems, and technological barriers affected implementation. Discipline-specific insights highlighted the need for structured communication, local workforce expansion and ongoing refinement of MOC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The Central Foot Hub enhanced access to specialist care and optimised local service delivery for people living with DFD in Central Queensland. Sustainable scale-up will require additional funding, streamlined health information systems and continued collaboration between healthcare providers across HHS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143554312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Experience of a Student-Led Rural Indigenous Outplacement Dental Clinic","authors":"Sandra March,&nbsp;Clare Mangoyana,&nbsp;Ratilal Lalloo,&nbsp;Laurence J. Walsh","doi":"10.1111/ajr.70007","DOIUrl":"https://doi.org/10.1111/ajr.70007","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The study aimed to explore the patient view of care provided by a student-led rural Indigenous dental clinic and of service access.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Clinic patients voluntarily undertook a short exit survey on completion of their care. Participants were asked how they initially knew about the service and the location from which they had travelled to attend. A 5-point Likert scale ranging from Very Satisfied to Very Dissatisfied measured patient satisfaction with the dental clinic services.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants (<i>n</i> = 159) age ranged from 18 years, with 49% (78/159) aged over 55, while 60% (96/159) were female. Indigenous status was identified by 48% (77/159) of survey participants. Referral by the local Indigenous Health Service was the primary means of introduction to the dental clinic for patients, with word of mouth second. Patients travelling from outside the local area accounted for 41% (66/159) of dental clinic clientele. An overwhelming 97.5% (155/159) ‘Very Satisfied’ response by participants indicated their unqualified acceptance and approval of the quality of student-led provision of oral healthcare services.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Patients highly rated the students' oral healthcare provision. The clinic's presence greatly facilitated access to dental care for local area residents and Indigenous clients living geographically much farther afield.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}