Australian Journal of Rural Health最新文献

{"title":"Yarning for peer review","authors":"Clinton Schultz PhD, Victor Oguoma PhD, Justyce Pengilly MClinPsy, Pim Kuipers PhD","doi":"10.1111/ajr.13148","DOIUrl":"10.1111/ajr.13148","url":null,"abstract":"<p>The Editorial Board of the AJRH, as with the leadership of many other academic journals, is committed to decolonising, strengthening and showcasing Indigenous health research. We are committed not only to high academic standards, but also to act (and to be seen to act) with integrity and sensitivity. Recently, the AJRH has played a key role in charting ways of ensuring Indigenous authors are appropriately acknowledged.<span><sup>1</sup></span> We are currently exploring new ways of providing sustainable Indigenous oversight of the editorial process of manuscripts pertaining to First Nations people and health services. Our emerging challenge is how to ensure academic rigour and translational relevance, while ensuring culturally safe and optimal practices.</p><p>As with the majority of academic journals, one of the main strategies AJRH uses to ensure academic rigour and quality is peer review. Peer review aims to be an independent and confidential process (at the AJRH we use double anonymous reviewing), which assists in maintaining research integrity and quality. We use anonymous peer review to minimise bias and nepotism, and to build transparency and rigour.<span><sup>2</sup></span> However, the peer review process is not without limitations. It is a product of Western thought and priorities. It emerges from a particular scientific and epistemological understanding, and it may not be the best strategy in all instances.</p><p>For example, traditional peer review may not fit particularly well with Indigenous ways of knowing, being and doing. The anonymised and individual peer review process may not be consistent with more collectivist Indigenous approaches which prioritise collaboration and consensus. The challenge then, for the AJRH and other academic journals, is that this core process may not align well with Indigenous research methodologies, which prioritise relationality and reciprocity.</p><p>In response, two of our associate editors are looking into the potential of ‘Yarning’ as a way of reviewing manuscripts and research with Indigenous people and communities. Yarning is a cultural form of conversation.<span><sup>3</sup></span> It is rooted in First Nations epistemologies and ontologies. Yarning relies on the creation of a culturally safe space for sharing and learning and, in some cases, for reaching consensus. It aligns with Indigenous ways of doing, and usually comprises two-way transfer of knowledge and understanding. Importantly, the yarning process emphasises equality across participants and facilitators.<span><sup>3</sup></span></p><p>Yarning has already been recognised as a culturally appropriate process for engaging with Indigenous groups and individuals in conducting research, facilitating in-depth discussions and allowing for the collection of rich data.<span><sup>4</sup></span> We are not aware of its application to the review of research papers, but there are clear indications of its potential. For example, the authors of Ind","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 3","pages":"417-418"},"PeriodicalIF":1.8,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.13148","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297354","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":"Acceptability of a virtual prostate cancer survivorship care model in rural Australia: A multi-methods, single-centre feasibility pilot","authors":"Nicole Heneka PhD,&nbsp;Suzanne K. Chambers PhD,&nbsp;Isabelle Schaefer MScMed,&nbsp;Kelly Carmont RN,&nbsp;Melinda Parcell MMgmt,&nbsp;Shannon Wallis GCert (Clinical Redesign),&nbsp;Stephen Walker RN,&nbsp;Haitham Tuffaha PhD,&nbsp;Michael Steele PhD,&nbsp;Jeff Dunn PhD","doi":"10.1111/ajr.13149","DOIUrl":"10.1111/ajr.13149","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A multi-methods, single-centre pilot comprising a quasi-experimental pre-/post-test design and an exploratory qualitative study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>A rural Australian hospital and health service.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Men newly diagnosed with localised prostate cancer who were scheduled to undergo, or had undergone, radical or robotic prostatectomy surgery within the previous 3 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Intervention</h3>\u0000 \u0000 <p>The intervention comprised a 12-week virtual care program delivered via teleconference by a specialist nurse, using a pre-existing connected care platform. The program was tailored to the post-operative recovery journey targeting post-operative care, psychoeducation, problem-solving and goal setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Primary outcome: program acceptability.</p>\u0000 \u0000 <p>Secondary outcomes: quality of life; prostate cancer-related distress; insomnia severity; fatigue severity; measured at baseline (T1); immediately post-intervention (T2); and 12 weeks post-intervention (T3).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventeen participants completed the program. The program intervention showed very high levels (≥4/5) of acceptability, appropriateness and feasibility. At T1, 47% (<i>n</i> = 8) of men reported clinically significant psychological distress, which had significantly decreased by T3 (<i>p</i> = 0.020). There was a significant improvement in urinary irritative/obstructive symptoms (<i>p</i> = 0.030) and a corresponding decrease in urinary function burden (<i>p</i> = 0.005) from T1 to T3.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This pilot has shown that a tailored nurse-led virtual care program, incorporating post-surgical follow-up and integrated low-intensity psychosocial care, is both acceptable to rural participants and feasible in terms of implementation and impact on patient outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 4","pages":"815-826"},"PeriodicalIF":1.9,"publicationDate":"2024-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.13149","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297379","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":"Barriers and enablers to accessing perinatal health services for rural Australian women: A qualitative exploration of rural health care providers perspectives","authors":"Fiona Faulks MMSc,&nbsp;Kristina Edvardsson PhD,&nbsp;Touran Shafiei PhD","doi":"10.1111/ajr.13147","DOIUrl":"10.1111/ajr.13147","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To identify perceived barriers and enablers for rural women in accessing perinatal care within their own community from the perspective of perinatal health care providers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A qualitative descriptive study design utilising reflexive thematic analysis, using the socioecological framework to organise and articulate findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Victoria, Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Semi-structured interviews were conducted with nine perinatal health care providers who provide care to pregnant women or new mothers in rural communities. Participants were recruited across Victoria in 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Providers reported multi-level barriers and enablers that exist for rural women in accessing perinatal care within their communities. Barriers included women's personal circumstances, challenging professional relationships, inequitable service provision, ineffective collaboration between services and clinicians and government funding models and policies. Enablers included strength and resilience of rural women, social capital within rural communities, flexible care delivery and innovative practice, rural culture and continuity of care models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Rural perinatal health care providers perceived that rural women face multiple barriers that are created or sustained by complex interpersonal, organisational, community and policy factors that are intrinsic to rural health care delivery. Several addressable factors were identified that create unnecessary barriers for rural women in engaging with perinatal care. These included education regarding health systems, rights and expectations, equitable distribution of perinatal services, improved interprofessional relationships and collaborative approaches to care and equity-based funding models for perinatal services regardless of geographical location.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 4","pages":"774-788"},"PeriodicalIF":1.9,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.13147","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141238513","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":"Development of a team-specific research strategy using a modified Delphi method in a regional public hospital dietetics department","authors":"Rachel McMahon APD,&nbsp;Tilley Pain PhD,&nbsp;Felicity Dick APD,&nbsp;Susan Tench APD","doi":"10.1111/ajr.13145","DOIUrl":"10.1111/ajr.13145","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Evaluate research capacity and culture among regional hospital dietitians, develop a team specific research strategy, and build research skills of novice researchers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The Research Capacity in Context Tool was used to assess current research capacity and culture at organisational, team and individual levels. Results were analysed using descriptive statistics and content analysis of free text responses. A modified Delphi method gained consensus regarding research capacity building.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Mixed method study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Dietetics department of a regional tertiary hospital (Modified Monash Category 2).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>All clinical dietitians currently employed within the hospital (<i>n</i> = 20) regardless of employment duration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Self-rated response to research capacity and culture to produce a dietetics-specific research strategy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifteen dietitians (75%) completed the Research Capacity in Context Tool. The overall mean score was highest at an organisational level at 7.9 (IQR 2), and lowest at team and individual levels at 4.3 (IQR 2.7) and 4.9 (IQR 3.3) respectively. Common barriers to research included time, lack of skills, knowledge and support. Using the modified Delphi method 39 statements relating to research capacity building met consensus and informed the creation of a research strategy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The results of the Research Capacity in Context Tool from this regional study reflect those reported in the literature at metropolitan sites. A dietetic-specific research strategy was developed to assist with increasing research capacity at a team and individual level in a regional setting. Evaluation of long-term outcomes post implementation will be the subject of further research.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 4","pages":"789-800"},"PeriodicalIF":1.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141185787","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":"Continuing professional development training needs of allied health professionals in regional and rural Victoria","authors":"Michael Pang BPhysio,&nbsp;Alesha Sayner MPhysio,&nbsp;Kylie McKenzie PhD","doi":"10.1111/ajr.13141","DOIUrl":"10.1111/ajr.13141","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The aim of the study was to identify continuing professional development (CPD) needs of allied health professionals (AHP) in regional and rural Victoria.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>This study was an online cross-sectional design conducted between December 2022 and February 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Settings and Participants</h3>\u0000 \u0000 <p>AHPs employed at a large multi-site regional public health service providing acute, subacute, community and outpatient care in Victoria, Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measure(s)</h3>\u0000 \u0000 <p>The online questionnaire included four sections investigating satisfaction of CPD, prioritised topics for CPD, preference for CPD sourcing and perceived capabilities in delivering education. To investigate prioritised topics of CPD, a tool was adapted from the Hennessy Hicks Training Needs Analysis questionnaire to align with allied health (AH) career pathways. For organisational alignment, a second questionnaire was sent to AH managers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The response rate was 17% (53/316 AHPs) from members of 10 AH professions. The median years of clinical experience for participants was between 2 and 5 years. Participants with 6–10 years of clinical experience reported the lowest level of satisfaction. Research and education were identified as areas of highest training need. Self-perceived competence in education delivery was proportionately lower in areas of assessment, developing digital learning and constructive alignment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>CPD needs for AHPs in a regional and rural health service were shown to vary by career stage and weighted towards developing research and education delivery capabilities. Findings from this study may support public health sector and policy investment in CPD opportunities to support horizontal career progression opportunities, a balance of internal and externally sourced professional development and strategic investment in education delivery capabilities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 4","pages":"763-773"},"PeriodicalIF":1.9,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.13141","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141177101","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":"Sustaining multidisciplinary teams in rural and remote primary care","authors":"Geoff Argus BSc (Hons), MPysch (Clin), GCert Public Health, MAPS, FCCLP, GAICD","doi":"10.1111/ajr.13144","DOIUrl":"10.1111/ajr.13144","url":null,"abstract":"&lt;p&gt;The health system in rural and remote Australia has been under significant strain for decades with rural and remote Australians continuing to face barriers in accessing and utilising appropriate primary health care due to a range of factors including geographic spread, low population density, infrastructure limitations and higher costs of delivering healthcare.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; The global shortage of health care workers since the COVID-19 pandemic will likely further exacerbate the long-standing challenges for rural and remote Australian communities in attracting and retaining a suitably trained multidisciplinary primary care workforce with the appropriate mix of required skills.&lt;/p&gt;&lt;p&gt;Whilst the concept of multidisciplinary health care teams is well-established, there have been renewed calls for the implementation of sustainable multidisciplinary team-based models of primary care service delivery in rural and remote communities. There are several bodies of work in recent times that point towards the importance of needs-based multidisciplinary health workforce planning for effective and sustainable rural and remote primary care in Australia.&lt;/p&gt;&lt;p&gt;In 2023, the Office of the National Rural Health Commissioner released the &lt;i&gt;Ngayubah Gadan Consensus Statement: Rural and Remote Multidisciplinary Health Teams&lt;/i&gt;,&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; which identifies key contextual areas for successful implementation and sustainability: Policy and Funding Context, Organisational Context, Multidisciplinary Team Context and Person and Community Context. The statement provides a framework for contextual considerations in the implementation and sustainability of multidisciplinary primary health care teams in rural and remote Australia. It makes clear that place-based solutions are required where service models are co-designed with the community to meet the specific ongoing health needs of the community.&lt;/p&gt;&lt;p&gt;The Innovative Models of Care (IMOC) Program administered by the Australia Department of Health and Aged Care&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; is attempting to address these issues by funding trials of multidisciplinary primary care models in rural and remote locations. This is an important initiative to showcase successful examples of rural and remote multidisciplinary models of primary care and determine the elements of success and challenge. A diversity of models and locations have thus far been funded, and it will be valuable to see over time a robust evaluation of these projects to inform future primary care reform.&lt;/p&gt;&lt;p&gt;The findings and outcomes of the &lt;i&gt;Unleashing the Potential of our Health Workforce—Scope of Practice Review&lt;/i&gt;&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; will be important in informing the future of rural and remote primary care. Identifying the appropriate mix of skills and capabilities of multidisciplinary primary care teams and clinicians working at their full scope of practice has been identified in the review. It is heartening to see the sugges","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 3","pages":"606-607"},"PeriodicalIF":1.8,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.13144","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141158836","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":"Farm to bedside: Collaboration with local farmers to supply rural Australian hospital food","authors":"Joshua G. Kovoor,&nbsp;Brandon Stretton,&nbsp;Luke Spajic,&nbsp;Genevieve Moseley,&nbsp;Harry Brown,&nbsp;Silas D. Nann,&nbsp;Alasdair Leslie,&nbsp;Aashray K. Gupta,&nbsp;Ammar Zaka,&nbsp;Yuchen Luo,&nbsp;Samuel Gluck,&nbsp;Matthew Marshall-Webb,&nbsp;Stephen Bacchi","doi":"10.1111/ajr.13142","DOIUrl":"10.1111/ajr.13142","url":null,"abstract":"","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 4","pages":"847-849"},"PeriodicalIF":1.9,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141158834","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":"Does on-site computed tomography matter? A cross-sectional study of stroke patients’ door-to-scan-time in rural hospitals","authors":"Nicholas Arnold GradDip,&nbsp;Kathryn Gough BMSc,&nbsp;Anthony Patsalou MD,&nbsp;Brendan Carrigan MBBS,&nbsp;William MacAskill PhD","doi":"10.1111/ajr.13140","DOIUrl":"10.1111/ajr.13140","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Many rural Australian hospitals lack on-site computed tomography (CT). These hospitals often refer patients to local off-site private radiology clinics or to central hospitals, challenging the achievement of time-sensitive scans. For stroke patients, timely access to CT affects treatment options. This study questions whether on-site CT matters in rural hospitals by investigating stroke patients’ door-to-scan-time (DTST) and CT scan sequence referrals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A retrospective chart audit was completed across four rural hospitals; two with on-site CT and two without. Adult emergency stroke presentations were randomly sampled. Comparisons between on-site and off-site CT hospitals were made for DTST and CT sequence referrals using Mann–Whitney U-tests and Fisher's exact tests.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 120 charts were audited (on-site CT, <i>n</i> = 60; off-site CT, <i>n</i> = 60). DTST was longer for off-site vs. on-site CT hospitals (median = 4.30 h vs. median = 0.70 h; <i>U</i> = 338, <i>p</i> &lt; 0.001) regardless of whether presentations occurred in business hours or out of hours (<i>p</i> &lt; 0.001). Off-site CT hospitals ordered less CT angiography or perfusion scanning (32% vs. 85%, <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Off-site CT hospital patients had longer DTST and received less angiography or perfusion scanning. These findings suggest that on-site CT matters to rural stroke patients by improving equitable access to CT and appropriate scan referrals.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 4","pages":"834-839"},"PeriodicalIF":1.9,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.13140","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141066236","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 and remote pharmacists’ perspectives of grey nomads with diabetes travelling in Australia","authors":"Anita De Bellis PhD,&nbsp;Christine McCloud PhD,&nbsp;Jane Giles CDE,&nbsp;Marc Apollloni Grad Dip Comm Prac Pharm,&nbsp;Wendy Abigail PhD,&nbsp;Pauline Hill PhD","doi":"10.1111/ajr.13139","DOIUrl":"10.1111/ajr.13139","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objective of the research was to explore rural and remote pharmacists’ experiences of encountering grey nomads with diabetes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A qualitative Interpretive Description design was used to explore and capture the experiences of rural and remote pharmacists interacting with grey nomads who had diabetes. Data from the interviews were analysed thematically.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>The Pharmacy Guild of Australia was approached and through their membership rural and remote pharmacists were invited to participate in the research.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Nine rural and remote pharmacists who had encounters and provided services to grey nomads with diabetes responded to be interviewed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The analysed findings established four major themes including: the influence of rural and remote locations on services; common problems encountered by the pharmacists; preparation for travel by grey nomads with diabetes; and pharmacists’ preparedness to support grey nomads with diabetes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The findings of this study identified that pharmacists needed remuneration for services provided to grey nomads with diabetes. Also, further development of the My Health record and telehealth to include pharmacists would be advantageous for grey nomads who have diabetes. Pharmacists stated there was a need for further education and a continuing professional development module specifically designed for pharmacists on diabetes self-management that moved beyond medications. A pre-travel checklist for grey nomads with diabetes travelling in rural and remote Australia would benefit all stakeholders through better preparation of travellers with diabetes to self-manage, thereby reducing the demand for health services including pharmacies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 4","pages":"740-749"},"PeriodicalIF":1.9,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.13139","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141066344","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":"Antiarrhythmic preferences and outcomes post DC cardioversion for atrial fibrillation, an Australian rural perspective","authors":"Martin Thomas MD,&nbsp;James Elhindi BSc,&nbsp;Kanishka Kamaladasa FRACP,&nbsp;Tilak Sirisena FRACP","doi":"10.1111/ajr.13138","DOIUrl":"10.1111/ajr.13138","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Direct current cardioversion (DCCV) remains one of the recommended management strategies for symptomatic atrial fibrillation (AF). Antiarrhythmic drugs (AAD) are prescribed post procedure to maintain sinus rhythm (SR). Limited literature exists on the AAD prescribing practices and their efficacy, post-DCCV in rural Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The primary aim was to determine the preferred AAD post-DCCV and the factors affecting AAD prescribing practices. The secondary aim was to assess the efficacy of the AAD in maintaining SR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A retrospective observational audit of patients with non-valvular AF who underwent successful elective DCCV for symptomatic AF, during 2015–2020 at a regional hospital in New South Wales (NSW) (Dubbo Base Hospital). Patients were followed up for a duration of 12 months post-DCCV.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>233 patients underwent successful DCCV during the study duration. Amiodarone was the preferred AAD of choice post-DCCV followed by sotalol and flecainide, respectively (36.5% vs. 27.8% vs. 1.3%). 35.2% patients were not prescribed AAD. Amiodarone and sotalol had similar but modest efficacies and neither were superior to no AAD, in maintaining SR 12 months post-DCCV (AF recurrence rate 61.5% vs. 68.2% vs. 71.6% respectively, <i>p = 0.37</i>). Antecedent cerebrovascular accident (CVA), pulmonary disease, smoking, prior treatment with digoxin, diuretics and left ventricular (LV) dysfunction were factors that influenced AAD prescribing practices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The study demonstrates equal efficacies of amiodarone, sotalol and no AAD in maintaining SR 12 months post-DCCV. Prescribing practices post-DCCV at Dubbo Base Hospital differ from observed national trends and guidelines. AAD prescription requires a multifaceted approach with a key consideration to prioritise safety over efficacy, being mindful of challenges in delivering optimal healthcare in a rural setting.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 4","pages":"750-762"},"PeriodicalIF":1.9,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.13138","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141066233","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}