Australian Journal of Rural Health最新文献

{"title":"Health Care and Health Information Access by Parents With Young Children in Regional Queensland","authors":"Catherine McCosker,&nbsp;Gavin Beccaria,&nbsp;Lisa Beccaria,&nbsp;Tanya Machin","doi":"10.1111/ajr.70060","DOIUrl":"https://doi.org/10.1111/ajr.70060","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The effects of childhood health, education and experiences can have long-term impacts on adult health and wellbeing. Access to health services and information can be complex especially in regional and rural areas of Australia. This research aimed to: (1) investigate how and where parents living in regional and rural Australia with young children search for health information and (2) explore how parents decide what is appropriate health information to enable them to meet the health needs of their families.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Regional and rural areas of Southern Queensland.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Parents with a child under the age of 5 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A convergent mixed methods design was utilised. Parents participated in an online survey and were invited to in-depth semi-structured telephone interviews about their health information search methods. Inductive content analysis was applied to the transcripts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The 11 interviewees searched for health information when their child was unwell, using the internet, family and friends and GPs and medical services. Websites were used for health information, whereas social media sites provided support and connection. The internet helped determine when to seek medical advice, and a preference was shown for Australian, hospital and government websites and websites recommended by GPs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The results may inform the development of targeted hospital and government websites to ensure all parents have easy access to evidence-based children's health information. GPs may also play a role in discussing internet-sourced health information with parents.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70060","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144171876","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":"When One Size Does not Fit All—Artificial Intelligence in Australian Rural Health","authors":"Lewis Hains,&nbsp;Joshua G. Kovoor,&nbsp;Brandon Stretton,&nbsp;Aashray K. Gupta,&nbsp;Ammar Zaka,&nbsp;Gavin Carmichael,&nbsp;John M. Kefalianos,&nbsp;Win Le Shwe Sin Ei,&nbsp;Alasdair Leslie,&nbsp;Andrew Booth,&nbsp;Shrirajh Satheakeerthy,&nbsp;Alexander Beath,&nbsp;Yasser Arafat,&nbsp;Mathew O. Jacob,&nbsp;Martin Bruening,&nbsp;Weng Onn Chan,&nbsp;Stephen Bacchi","doi":"10.1111/ajr.70037","DOIUrl":"https://doi.org/10.1111/ajr.70037","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Artificial intelligence (AI) is having an increasing impact on many aspects of our day-to-day lives. This change is also true in healthcare, with various tools being developed to hasten burdensome administrative tasks and increase overall healthcare efficiency, particularly in metropolitan centres.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Context</h3>\u0000 \u0000 <p>AI has remained comparatively clear of rural, regional and remote Australian hospitals, where it has the potential to provide significant benefits. Like previous health technology implementations, rural workforce requirements for AI maintenance and support may hinder AI deployment in these areas. While AI has been implemented successfully in metropolitan areas, these models may have limited translatability to rural health settings with significantly different administrative and healthcare systems.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>AI may assist with key issues in rural centres such as resource allocation and timely patient transfer for higher level care. While the potential benefits of AI in rural centres are clear, one must consider key factors in rural centres that may limit the success of AI in these hospitals. Smaller rural populations may limit the ability to train location-specific models, and connectivity issues may impede their effective use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Specific efforts are required to realise potential benefits of medical AI for rural Australia; addressing connectivity and workforce issues in rural areas is vital to allow for AI and large language models to help benefit rural centres.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70037","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172004","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":"A Cost Comparison From a Health Service Perspective of Three Allied Health Models of Care for Remote Australia: Student-Assisted Services, Fly-In Fly-Out Services and Services Provided by a Resident Clinician","authors":"Narelle Campbell,&nbsp;Jackie Roseleur,&nbsp;Jon Karnon,&nbsp;Chris Hince,&nbsp;Alice Cairns,&nbsp;Kylie Stothers,&nbsp;Chris Rissel","doi":"10.1111/ajr.70012","DOIUrl":"https://doi.org/10.1111/ajr.70012","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objectives&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The objective of this paper is to compare the costs of an allied health student-assisted model of care with Fly-In-Fly-Out (FIFO) and resident clinician models of care from a health system perspective.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A descriptive cost analysis was conducted to understand the costs of an allied health student-assisted model of care. Scenarios were developed for the two remaining service models to determine their costs from a health service perspective.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Design&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;An observed and modelled costing study.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Setting&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Northern Territory, Australia.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Participants&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Allied health professionals and students.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Main Outcome Measure(s)&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The cost of providing a student-assisted model of care from a health service perspective.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The students provided an average of 5 h of service time per client to 50 clients at a cost of $2363 per client. Three resident clinician and FIFO scenarios were modelled. The first scenario was based on time with clients across all three student cohorts. The second scenario applied the time spent with clients by the third cohort, reflecting the increase in time spent with clients as the program matured. In the third scenario, we increased the time in scenario 2 by 25% to account for the potential under-recording of client time. The resident clinician results for the three scenarios were $915, $987, and $1178, respectively. The FIFO results for the three scenarios were $1502, $1575, and $1922, respectively.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The student-assisted model was more expensive per client seen than the FIFO and resident clinician models, but significant intangible benefits were identified that positively impact both clients and students. These include training health professionals for remote communities in a culturally responsive model, greater cultural understanding, and increased care coordination provided by the students.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 ","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085401","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 Double-Edged Sword of Translational Research: Stakeholder Perspectives of the Enablers and Challenges Implementing Anorexia Nervosa Treatment in Rural Health Settings","authors":"Ashlea Hambleton,&nbsp;Verusha Kandar,&nbsp;Jane Miskovic-Wheatley,&nbsp;Sabina Vatter,&nbsp;Daniel Le Grange,&nbsp;Stephen Touyz,&nbsp;Sarah Maguire","doi":"10.1111/ajr.70043","DOIUrl":"https://doi.org/10.1111/ajr.70043","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To explore the translational research processes that emerged at the early phase of the implementation of telehealth-delivered family-based therapy (FBT) for young people with anorexia nervosa (AN) attending Australian rural health services.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Commencing mid-2019, five rural health districts across New South Wales (NSW) participated in the study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Nine stakeholders, including study coordinators, clinicians and eating disorder coordinators, participated in a semi-structured interview during the early implementation of telehealth-delivered FBT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Inductive thematic analysis methodology was used to identify key research factors that enabled and challenged the implementation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The translational research improved patient access to evidence-based care, afforded health services access to clinical expertise, workforce training and supervision and assisted with meeting government directives of improving care pathways. However, the study and intervention implementation were challenged by research-related factors, including ethical and clinical dilemmas, the burden of stakeholders holding multiple roles and general challenges associated with integrating research into non-academic health services.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>To optimise implementation and to bridge the access gaps particularly felt by rural families and health settings, translational studies ought to consider the enablers and challenges identified by the stakeholders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ACTRN12620001107910</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70043","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085400","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":"Emergence of a New Post-Professional Allied Health Workforce to Address Complex Healthcare Needs of Rural Patients: A Qualitative Exploratory Study","authors":"Anna Moran,&nbsp;Olivia King,&nbsp;Catherine Cosgrave,&nbsp;Christina Malatzky,&nbsp;Rosalie Boyce","doi":"10.1111/ajr.70056","DOIUrl":"https://doi.org/10.1111/ajr.70056","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To explore the nature and key functions of emerging allied health post-professional roles and to identify the contextual factors that continue to shape their development and operationalisation in rural public healthcare settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A qualitative exploratory study design utilising Ritchie and Spencer's team-based five-stage framework and Nancarrow's six principles to enhance workforce flexibility.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Victoria and New South Wales, Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Semi-structured individual and group interviews were undertaken with allied health professionals working in post-professional roles and their managers/directors from four teams across multiple regional and rural areas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four key themes were identified, two of which related to the nature of the allied health post-professional role: (1) Allied health post-professionals meet clients ‘where they are at’ and (2) Hidden healthcare heroes. Two further themes described the factors that shape allied health post-professional roles in rural health settings: (3) Allied health post-professionals stretch and grow their skillset and the (4) Social construction of allied health post-professional roles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The post-professional workforce exemplifies the six principles of a ‘flexible workforce’ and may play a key role in addressing many system challenges that make client-centred care in rural settings difficult to achieve. However, the ongoing evolution and advancement of this workforce is limited by macro and meso-level constraints. It is thus critical that the value of post-professional roles is structurally supported through macro-level policy levers as well as at an organisational and individual profession level.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085482","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":"Evaluation of a Hub-And-Spoke Model of Care for the Delivery of Sleep Disorder Services to a Remote Australian Community Using the RE-AIM Framework: A Controlled Before-And-After Implementation Outcome Study","authors":"Irene Szollosi,&nbsp;Sophia Worley,&nbsp;Sameera Senanayake,&nbsp;Sanjeewa Kularatna,&nbsp;Deanne Curtin","doi":"10.1111/ajr.70057","DOIUrl":"https://doi.org/10.1111/ajr.70057","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate a Hub-and-Spoke design for providing sleep disorder services in a very remote community. The health service re-design aimed to provide unattended polysomnography at the Spoke site with access to attended laboratory studies at the Hub when clinically indicated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Summative evaluation using the RE-AIM Framework including all adult patients referred for diagnosis and management of a suspected sleep disorder from Remote Health Service to Metropolitan Health Service 2 years pre-implementation and 1 year post-implementation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Controlled before-and-after implementation outcome study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Public hospital in metropolitan South-East Queensland with a comprehensive accredited sleep disorder service (Hub), networked to a Community Health Centre (Spoke), located in a very remote region defined by the Modified Monash Model in central Queensland.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcomes Measures</h3>\u0000 \u0000 <p>Referral numbers (Reach), travel avoidance and consumer satisfaction (Effectiveness), number of referrers (Adoption), unattended sleep study data quality, timeliness to testing, health service costs (Implementation), and referral numbers beyond initial 12-month pilot (Maintenance).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The Hub-and-Spoke model increased adoption five-fold by local referrers and resulted in a nine-fold increase in reach. Effectiveness was demonstrated through high levels of consumer satisfaction, and all implementation aims were met, including providing services at a lower cost. Sustainability was demonstrated through ongoing referrals and the transition of the model of care to business as usual.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Hub-and-Spoke designs for public sleep disorder services are effective at both the individual and organisational levels. Services can be delivered at a lower cost and, importantly, improve access to specialist services in remote and very remote communities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70057","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085365","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":"Decades on: Is It Time to Refine ‘Rural’ Entry Into Medical School?","authors":"Casey Stubbs,&nbsp;Jennifer Timmis,&nbsp;Bernadette Ward","doi":"10.1111/ajr.70055","DOIUrl":"https://doi.org/10.1111/ajr.70055","url":null,"abstract":"","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143925829","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":"Resilience-Focused Approaches for School-Age Australian First Nations Populations: A Systematic Review of Influential Factors","authors":"Sara Parsafar,&nbsp;Lydia Brodie,&nbsp;Robert Heirene","doi":"10.1111/ajr.70051","DOIUrl":"https://doi.org/10.1111/ajr.70051","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Building resilience has been identified as a key way to improve the wellbeing of children. However, there are currently no reviews of the evidence that explore factors influencing resilience in Australian First Nations School-age youth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We aimed to review the literature on factors influencing resilience in school-age (5–19 years) Australian First Nations populations. We also explored how resilience is defined and operationalised, how factors identified mapped onto the Social and Emotional Wellbeing (SEWB) model and whether there were differences in factors depending on age and residential localities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>We conducted a systematic review of published peer-reviewed articles that included the identification or review of factors influencing resilience in our target population. We searched key databases and performed a narrative synthesis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Of the 1093 articles identified, 13 were found to meet inclusion criteria. Fifty-one different factors influencing resilience were identified across individual, interpersonal and community socio-ecological levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The 51 factors mapped cohesively onto the SEWB domains. There was inconclusive data to determine if factors were dependent on the participants' age and location. Key limitations of the literature on this topic included the limited number of available studies and the lack of definitions and consistent operationalisation of resilience within the few existing studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our findings show the wide variety of factors that influence resilience in this population and demonstrate the importance of incorporating SEWB domains into wellbeing and resilience-focused programmes in Australian schools for First Nations populations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70051","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914229","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 Need for a Rural Surgeon Speciality Pathway in Australia and New Zealand","authors":"Gavin J. Carmichael,&nbsp;Joshua G. Kovoor,&nbsp;Brandon Stretton,&nbsp;Alexander Beath,&nbsp;John Kefalianos,&nbsp;Daksh Tyagi,&nbsp;Connor Bentley,&nbsp;Stephen Bacchi,&nbsp;Jonathan Henry W. Jacobsen,&nbsp;Weng Onn Chan,&nbsp;Aashray Gupta,&nbsp;Ammar Zaka,&nbsp;Silas D. Nann,&nbsp;Yuchen Luo,&nbsp;Matthew Marshall-Webb,&nbsp;Mathew O. Jacob","doi":"10.1111/ajr.70053","DOIUrl":"https://doi.org/10.1111/ajr.70053","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This commentary aims to address the critical shortage of surgeons in rural Australia and propose the development of a sustainable rural surgical training pathway. By examining current healthcare disparities and workforce challenges, it highlights the need for locally trained and retained rural surgeons to improve health outcomes and reduce healthcare inequities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Context</h3>\u0000 \u0000 <p>Rural Australians experience significant healthcare disparities due to geographical isolation, lower socioeconomic status and limited availability of specialist care. The current model relies heavily on patient transfers to metropolitan centres, which are costly, logistically challenging and unsustainable. Current surgical training programmes offer some rural exposure; however, they remain metropolitan-centric, resulting in fewer surgeons practising in rural areas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>A dedicated rural surgical training pathway is proposed to address this gap. It would focus on selecting candidates with a demonstrated commitment to rural practice and provide tailored training, mentorship and guaranteed rural placements. Training must align with the specific healthcare needs of rural communities. Additionally, initiatives like the rural health equity strategy and regional training hubs must be supported by structural changes in the selection process to prioritise rural trainees.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Addressing the shortage of rural surgeons is essential to improving healthcare equity. A rural surgical training pathway can aid in long-term retention of surgeons in rural areas. This model supports both healthcare and economic sustainability, aligns with national rural health strategies and fosters stronger community connections. Investing in rural surgical training is a critical step towards reducing healthcare disparities and building a more resilient rural health system.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70053","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914228","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 of Low-Value Hysterectomy Before and After Publication of the National Heavy Bleeding Clinical Care Standard in Regional Victoria","authors":"Natasha Daureen Frawley,&nbsp;Madison Phung,&nbsp;Benjamin Harrap","doi":"10.1111/ajr.70049","DOIUrl":"https://doi.org/10.1111/ajr.70049","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the prevalence of low-value care hysterectomy before and after publication of the National Heavy Menstrual Bleeding Clinical Care Standard (HMB Standard) in a regional Victorian hospital. The secondary aim was to assess whether compliance with the HMB Standard improved.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective cohort design. All patients booked for a planned benign hysterectomy were included. Manual chart review was undertaken for demographics, surgical planning, procedure, and outcomes to 28 days.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design Setting</h3>\u0000 \u0000 <p>A single regional Victorian hospital within an area identified to be high volume for benign hysterectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Patients who planned benign hysterectomy in the 10 months prior (Group 1—Control) and 10 months after (Group 2—Post-intervention) publication of the HMB Standard in October 2017.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Low-value hysterectomy was defined as the proportion of benign hysterectomies performed via the abdominal route in the absence of cancer or a previous caesarean section.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 64 patients in Group 1 and 60 in Group 2 included. Low-value hysterectomy proportion had a non-significant change from 9.4% in Group 1 to 11.7% in Group 2, 95% confidence interval = [−0.1303, 0.0857]. Compliance to the HMB Standard had mixed results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>There was no clinically significant change in low-value hysterectomy in the 10 months following publication of the HMB Standard, compared to 10 months prior, in a regional Victorian hospital. Uptake of therapeutic alternatives to hysterectomy was low.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70049","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143871643","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}