Australian Journal of Rural Health最新文献

{"title":"Who carries the extra load? The added responsibility of end-of-life care for rural families","authors":"Kristina Thomas BA (Hons); DPsych (Health), Margaret Deerain BBus (Mgmt); MLitt; MLS","doi":"10.1111/ajr.13171","DOIUrl":"10.1111/ajr.13171","url":null,"abstract":"<p>There are over 7 million Australians (28%) living outside of major cities,<span><sup>1</sup></span> and these people have poorer health outcomes and poorer access to and use of primary health care services.<span><sup>2</sup></span> Just like most areas of health, there are common barriers to accessing end-of-life health care for rural Australians including geographical distance to services, lack of stable workforce and difficulty accessing culturally appropriate care.<span><sup>3-5</sup></span> While it is more difficult to access end-of-life health care for rural Australians, we know that the proportion of older Australians is higher in rural Australia so there a is significant need for end-of-life care.<span><sup>1</sup></span></p><p>When access to end-of-life health services is more challenging, who picks up the increased load? Like many areas of social and health care, family, friends and community networks end up playing an increased role in end-of-life care in rural areas.<span><sup>3</sup></span> The family ‘carer’, the person who is most involved in the person's day-to-day care, is even more vital in a rural area. Compared to carers from urban areas, rural carers are more likely to be friends or distant relatives.<span><sup>6</sup></span></p><p>Rural carers report exhaustion, lack of self-care and a need for respite.<span><sup>7</sup></span> This may be due to the fact that rural carers are likely to do more of the care tasks themselves (rather than using services).<span><sup>8</sup></span> A quarter of rural carers want more physical support with caring.<span><sup>6</sup></span> They report unmet needs such as treatment near home (37%), help with economic burden (32%) and concerns about the person being cared for (32%).<span><sup>9</sup></span></p><p>A review of studies<span><sup>3</sup></span> showed that rural end-of-life patients receive fewer home visits from doctors, less home care services, less palliative care, less respite and less allied health; however, there was increased reliance on general practitioners, pharmacy and emergency hospital. Rural carers report that local services have longer wait times, high turnover of staff, and families received late referral to palliative care.<span><sup>4</sup></span></p><p>Rural carers of cancer patients (60% of whom required end-of-life care)<span><sup>4</sup></span> report that one of the biggest stressors is travelling for health services highlighting dealing with the stress of going to the city, organising the actual travel and time away from work, family or the farm. Rural carers also find metropolitan health services difficult to navigate.<span><sup>10</sup></span> Health professionals do not always consider the effort involved in travel which may cause additional inconveniences and stress for rural carers.<span><sup>4</sup></span> Rural carers also report a strong connection to their community and miss being away from their community when travelling for health services.<span><sup","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 4","pages":"856-858"},"PeriodicalIF":1.9,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.13171","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141811486","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":"Towards a home-grown rural health workforce: Evidence from Tasmania, Australia","authors":"B. Jessup PhD,&nbsp;N. Tran PhD,&nbsp;T. Stevens,&nbsp;P. Allen PhD,&nbsp;T. Barnett PhD","doi":"10.1111/ajr.13169","DOIUrl":"10.1111/ajr.13169","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To examine the association between place of origin and principal place of practice (PPP) of domestic Tasmanian health graduates who received end-to-end training with the University of Tasmania (UTAS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The 2022 PPP for all UTAS domestic Tasmanian graduates from medicine, nursing, pharmacy, psychology, medical radiation science and paramedicine between 2011 and 2020 was identified using the online Australian Health Practitioner Regulation Agency (Ahpra) registration database. The graduate's place of origin (home address at the time of course application), together with their 2022 PPP, was described using the Modified Monash Model (MM) classification system of remoteness. Data were analysed using STATA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Over the 10-year period, 4079 domestic Tasmanians graduated from health courses at UTAS, of which 3850 (94.4%) were matched to an Australian PPP. In all, 78.3% of graduates were working in Tasmania, while the remainder (21.7%) were employed interstate. Of those with a Tasmanian PPP, 81.4% were working in a regional setting (MM2), while 77.6% of interstate employed graduates recorded a metropolitan (MM1) PPP. Rural place of origin (MM3-7) was associated with rural employment (MM3-7) in both Tasmania (OR, 37.08; 95% CI 29.01–47.39, <i>p</i> &lt; 0.001), and on the Australian mainland (OR, 21.4; 95% CI 17.4–26.3, <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Most domestic Tasmanian origin UTAS health graduates contribute to the state's health workforce after qualifying. Further research is needed to explore PPP over time and to understand why some graduates are motivated to seek employment on the Australian mainland and in particular, metropolitan cities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 5","pages":"976-986"},"PeriodicalIF":1.9,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.13169","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753451","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":"Clinical presentation and management of enterovirus and parechovirus infection in children: A single-centre study in regional Australia","authors":"Tharmarajah Sorubarajan MBBS (Sri Lanka), MD (Sri Lanka), DCH (Sri Lanka), DCH (Sydney), FRACP (Australia),&nbsp;Sivapriyan Sorubarajan","doi":"10.1111/ajr.13160","DOIUrl":"10.1111/ajr.13160","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aims to analyse the clinical presentation caused by enterovirus (EV) and/or human parechovirus (HPeV) infection in children, as well as the management of such cases admitted to a regional hospital in Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective study reviewing medical records.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Single hospital in regional Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>All children under 18 years admitted over the 5-year period beginning from 1 January 2017 with confirmed EV and/or HPeV infection. Cases with clinically insignificant EV/HPeV isolation were excluded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Data collected included demographic data, signs and symptoms present, specimens of EV/HPeV isolation, co-occurring pathogens, peak C-reactive protein (CRP), antibiotic therapy, discharge diagnosis and follow-up after discharge.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 27 patients fulfilled the inclusion criteria; 81.5% of the patients were ≤3 months of age with a median of 2 months (interquartile range 1–3); 74.1% were males. The most common clinical features were a fever ≥38°C and irritability/lethargy/high-pitched cry. 29.6% of the patients had co-occurring pathogens detected, and a CRP ≤10 mg/L was observed in 77.8% of cases. All but two children were treated with antibiotics while awaiting polymerase chain reaction results. The most common discharge diagnosis was meningitis. In all, 74.1% of the children attended follow-up appointments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>EV and HPeV should be considered as a possible aetiology of fever and irritability/lethargy/high-pitched cry in children under 3 months.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 5","pages":"938-943"},"PeriodicalIF":1.9,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141731668","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":"‘I am more than my diagnosis’: Amplifying the voice of consumers in the design and delivery of mental health services","authors":"Joy Paton PhD,&nbsp;Amie Carrington,&nbsp;Emma Gentle PhD,&nbsp;Debbie Horsefall PhD","doi":"10.1111/ajr.13150","DOIUrl":"10.1111/ajr.13150","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>In line with the Australian Government's Vision 2030, this research foregrounds consumer experiences of recovery to inform the (co)design and delivery of mental health services for people living with complex needs and/or a severe and persistent mental health condition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>The research takes a specialist focus on the regional setting, with data collected from client experiences within Western NSW, Australia, in the context of the National Disability Insurance Scheme (NDIS) implementation and inclusion of psycho-social disability within the NDIS service environment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Thirty-seven people aged 19–70 years living with complex needs and/or a diagnosis of a severe and persistent mental health condition were recruited from services where they had a care plan or where they were members of a consumer reference group for recovery-oriented services.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A tripartite framework integrating recovery oriented, trauma-informed and collective impact approaches for a qualitative, arts-based (photovoice) study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In areas of the mental health service system that had not yet applied a personalised understanding of recovery or embraced trauma-informed practice there were a range of issues and gaps in service delivery relating to authentic relationships, belonging and connection, service cultures, trauma-informed care, and workforce investment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Clinical and non-clinical services need to ensure consistent person-centred and trauma-informed practice is implemented throughout the mental health service system to meet the needs of the consumer. An eight-point checklist serves as the basis for services to reflect on how they are working with consumers and to support the review of systems and clinical governance frameworks.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 6","pages":"1140-1149"},"PeriodicalIF":1.9,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141731669","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":"Conducting mental health research with rural and regional older Australians: Reflections and recommendations","authors":"Daniel P. Wadsworth PhD,&nbsp;Belinda Cash PhD,&nbsp;Kristen Tulloch PhD,&nbsp;Rebekah Couper BSc (Hons),&nbsp;Kristy Robson PhD,&nbsp;Sally Fitzpatrick PhD","doi":"10.1111/ajr.13165","DOIUrl":"10.1111/ajr.13165","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This commentary aims to assist emerging leaders of mental health research with older rural Australians through (i) affirmation that others share the barriers, pitfalls and challenges being faced; (ii) reinforcing the rationale making this a pertinent area for research; and (iii) opening a dialogue for best practice to engage older rural Australians in mental health research.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Context</h3>\u0000 \u0000 <p>Supporting the mental health of older adults is a pertinent global challenge, none more so than in rural Australia where restricted access to services and supports are compounded by limited help-seeking behaviours and capacity to engage with support. Paradoxically, such limitations also extend to impact researchers' ability to engage rural older Australians in mental health research, particularly when combined with the stoicism and stigma that often envelopes mental health, and the contemporary challenges posed by the emergence of technology. Such challenges are however not often discussed, more-often sidelined in favour of reporting positive research outcomes, or seeing emerging researchers eschew such focus entirely.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>Through this paper, the authors utilised critical self-appraisal and iterative reflection to identify four recommendations for undertaking contemporary mental health research with rural older Australians, namely to: plan realistically through a collaborative, authentic and respectful approach; identify community champions and build/maintain trust; diversify thought, approaches and methodology; and cast the research net far, wide and often.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>By adopting recommendations, researchers can maximise accessibility to and possible participation in mental health research, providing foundations for older rural Australians' contributions to inform the development of policies and strategies to promote their health and well-being.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 5","pages":"1076-1081"},"PeriodicalIF":1.9,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.13165","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141604516","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 scoping review of early childhood support for Aboriginal and Torres Strait Islander children living with a disability in regional, rural and remote settings","authors":"Anita D’Aprano PhD,&nbsp;Kim McRae DipEd,&nbsp;Suzanne Dayton MSW,&nbsp;Catherine Lloyd-Johnsen MPH,&nbsp;John Gilroy PhD","doi":"10.1111/ajr.13164","DOIUrl":"10.1111/ajr.13164","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Many experts and communities have concerns about how National Disability Insurance Scheme services are provided to Aboriginal and Torres Strait children. This study was undertaken at the request of the NPY Women's Council in partnership with the researchers, to explore supports for Aboriginal and Torres Strait Islander children living with a disability in their remote areas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This scoping review aims to (a) explore the barriers and enablers to accessing disability support services for families of young Aboriginal and Torres Strait Islander children (0–8 years) living in regional, rural and remote settings, and (b) summarise best practice approaches for accessing support for young children in these settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>The search was run in three electronic databases, as well as grey literature sources. We assessed the quality of included publications using the Centre of Research Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange tool. A narrative synthesis was supported by thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Finding<b>s</b></h3>\u0000 \u0000 <p>From an initial search (557 citations), we identified 13 eligible documents. Most documents were peer-reviewed articles of qualitative studies. Key themes identified included the following: (1) Holistic approach, (2) Understanding disability, (3) Consistent relationships, (4), Flexibility, (5) Simplify system and (6) Enhance communication.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion/Conclusion</h3>\u0000 \u0000 <p>This scoping review has revealed gaps in the provision of quality, culturally responsive disability services for families of Aboriginal and Torres Strait Islander children living in regional, rural and remote areas of Australia. A family-centred, flexible approach will help address their needs. Future research is required to design and evaluate models of care for Aboriginal and Torres Strait Islander children.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 5","pages":"890-905"},"PeriodicalIF":1.9,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.13164","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581617","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":"Rural community-centred co-planning for sustainable rural health systems","authors":"Nerida Hyett PhD,&nbsp;Mandy Hutchinson Grad Cert,&nbsp;Donna Doyle Post Grad Healthcare Leadership,&nbsp;Trevor Adem MBA,&nbsp;Dallas Coghill Grad Dip Critical Care,&nbsp;Pamela Harvey PhD,&nbsp;Catherine Lees PhD,&nbsp;Belinda O'Sullivan PhD","doi":"10.1111/ajr.13162","DOIUrl":"10.1111/ajr.13162","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Sustaining rural healthcare services is challenging because of numerous systemic factors. Rural communities can inform the design of sustainable rural health models; however, further evidence of effective co-design is needed to guide implementation. The study aim was to co-design a series of place-based and evidence-informed rural health models, to improve local health system sustainability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>A rural region (categorised as Modified Monash Model 5) defined by three adjoining Shires in Central and Northwest Victoria, Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>A health executive co-planning network led the co-design, with input and oversight from a broader cross-sector group. Healthcare professionals (<i>n</i> = 44) and consumers and carers (<i>n</i> = 21) participated in interviews, and an online survey was completed by healthcare professionals (<i>n</i> = 11) and consumers and carers (<i>n</i> = 7) to provide feedback on the preliminary results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Community-based participatory action research was applied incorporating co-design methods and systems thinking. Data were collected through qualitative interviews followed by an online feedback survey. Mixed method data analysis (QUAL-quant) was conducted with qualitative directed content analysis of interview transcripts and quantitative descriptive analyses of survey responses to aid prioritisation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Healthcare priorities, strengths and challenges, and proposed rural health models are described. A rural health system sustainability strategy was developed with three integrated pillars: 1. Workforce strengthening, 2. Integrated health services and 3. Innovative models of care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Community-centred co-design with rural health stakeholders was effective for generating locally tailored ideas and potential health models that emulate community strengths and resources, and provide a foundation for further planning, implementation and evaluation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 5","pages":"944-958"},"PeriodicalIF":1.9,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.13162","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581618","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":"Multicultural competence in rural Australian surgical systems","authors":"Gavin J. Carmichael BSc,&nbsp;Brandon Stretton MBBS, MClinEd,&nbsp;Jonathan Henry Jacobsen BSc (Hons), PhD,&nbsp;Aashray K. Gupta MBBS, MS,&nbsp;Thiep Kuany MD,&nbsp;Yuchen Luo MBBS, MS,&nbsp;Stephen Bacchi MBBS, PhD,&nbsp;Matthew Marshall-Webb MBBS,&nbsp;Vasiliki Arachi LLB, LLM,&nbsp;David R. Tivey BSc (Hons), PhD,&nbsp;Joshua G. Kovoor MBBS, MS","doi":"10.1111/ajr.13155","DOIUrl":"10.1111/ajr.13155","url":null,"abstract":"","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 4","pages":"853-855"},"PeriodicalIF":1.9,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141565191","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":"Global prevalence of musculoskeletal pain in rural and urban populations. A systematic review with meta-analysis. Musculoskeletal pain in rural and urban populations","authors":"Carlos I. Mesa-Castrillon PhD,&nbsp;Paula R. Beckenkamp PhD,&nbsp;Manuela Ferreira PhD,&nbsp;Milena Simic PhD,&nbsp;Phillip R. Davis PT,&nbsp;Antonio Michell PT,&nbsp;Evangelos Pappas PhD,&nbsp;Georgina Luscombe PhD,&nbsp;Marcos De Noronha PhD,&nbsp;Paulo Ferreira PhD","doi":"10.1111/ajr.13161","DOIUrl":"10.1111/ajr.13161","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>To systematically compare the global prevalence of musculoskeletal pain and care-seeking in rural and urban populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review with meta-analysis of observational studies reporting a direct comparison of rural and urban populations was conducted worldwide and included back, knee, hip, shoulder, neck pain and a broad diagnosis of ‘musculoskeletal pain’. A search strategy combining terms related to ‘prevalence’, ‘musculoskeletal pain’ and ‘rural’ was used on the following databases: MEDLINE, Embase, CINAHL, Scopus, and rural and remote health from their inception to 1 June 2022. Random-effects meta-analysis was used to pool the data. Results were presented as odds ratios (OR) along with 95% confidence intervals (95% CI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 42 studies from 24 countries were included with a total population of 489 439 participants. The quality scores for the included studies, using the modified Newcastle Ottawa Scale tool, showed an average score of 0.78/1, which represents an overall good quality. The pooled analysis showed statistically greater odds of hip (OR = 1.62, 95% CI = 1.23–2.15), shoulder (OR = 1.42, 95% CI = 1.06–1.90) and overall musculoskeletal pain (OR = 1.26, 95% CI = 1.08–1.47) in rural populations compared to urban populations. Although the odds of seeking treatment were higher in rural populations this relationship was not statistically significant (OR = 0.76, 95% CI = 0.55–1.03).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Very low-certainty evidence suggests that musculoskeletal, hip and shoulder pain are more prevalent in rural than urban areas, although neck, back and knee pain, along with care-seeking, showed no significant difference between these populations. Strategies aimed to reduce the burden of musculoskeletal pain should consider the specific needs and limited access to quality evidence-based care for musculoskeletal pain of rural populations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 5","pages":"864-876"},"PeriodicalIF":1.9,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.13161","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499700","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 importance of ‘place’ and its influence on rural and remote health and well-being in Australia","authors":"Iain Butterworth PhD,&nbsp;Timmy Duggan,&nbsp;Rodney Greene,&nbsp;Matthew McConnell MD,&nbsp;James A. Smith PhD,&nbsp;Susanne Tegan,&nbsp;Carmel Williams MPH,&nbsp;Neha Lalchandani PhD,&nbsp;Amy Stearn","doi":"10.1111/ajr.13158","DOIUrl":"10.1111/ajr.13158","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This article explores the crucial role of ‘place’ as an ecological, social and cultural determinant of health and well-being, with a focus on the benefits and challenges of living rurally and remotely in Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Context</h3>\u0000 \u0000 <p>The health system, including health promotion, can contribute actively to creating supportive environments and places that foster health and well-being among individuals residing in rural and remote locations. For First Nations peoples, living on Country, and caring for Country and its people, are core to Indigenous worldviews, and the promotion of Aboriginal and Torres Strait Islander health and well-being. Their forced removal from ancestral lands has been catastrophic. For all people, living in rural and remote areas can deliver an abundance of the elements that contribute to a ‘liveable’ community, including access to fresh air, green and blue space, agricultural employment, tight-knit communities, a sense of belonging and identity, and social capital. However, living remotely also can limit access to employment opportunities, clean water, affordable food, reliable transport, social infrastructure, social networks and preventive health services. ‘Place’ is a critical enabler of maintaining a healthy life. However, current trends have led to a reduction in local services and resources, and increased exposure to the impacts of climate change.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>This commentary suggests ideas and strategies through which people in rural and remote locations can strengthen the liveability, resilience and identity of their communities, and regain access to essential health care and health promotion services and resources.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Recommended strategies include online access to education, employment and telehealth; flexible provision of social infrastructure; and meaningful and responsive university-health service partnerships.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 4","pages":"840-846"},"PeriodicalIF":1.9,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460808","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}