Australian Journal of Rural Health最新文献

{"title":"Management of Type I Diabetes Mellitus at a Rural Paediatric Diabetes Clinic","authors":"Kuangjun Li,&nbsp;Ann M. Maguire,&nbsp;Jacqueline Askwith","doi":"10.1111/ajr.70013","DOIUrl":"https://doi.org/10.1111/ajr.70013","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Australia currently lacks a standardised paediatric diabetes care model. This study explores the model of care and outcomes of paediatric Type 1 diabetes mellitus (T1D) at a rural multidisciplinary paediatric diabetes clinic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cross-sectional study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A single centre quantitative study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>A rural multidisciplinary paediatric diabetes clinic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Patients under 19 years old with a T1D diagnosis who attended the paediatric diabetes clinic for at least 12 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Baseline demographics, glycosylated haemoglobin (HbA1c) levels, time in range, clinic appointment adherence, and diabetes-related hospitalisations over a 12-month period from October 2021 to September 2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifty-two patients, with a median age of 13.5 (IQR 7) years and 58% females, were included. Of the patients, 40% lived more than 50 km away from the diabetes clinic, 73% were on continuous subcutaneous insulin infusion, and 92% used continuous glucose monitoring. The median HbA1c was 8.3% (67 mmol/mol), with four patients (8%) achieving the international target HbA1c level of less than 7.0% (53 mmol/mol). The CGM users' average time in range was 54%. A total of 29 patients (56%) attended all annual clinic reviews. Six patients (12%) were hospitalised for diabetes-related complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Paediatric T1D managed in a rural multidisciplinary paediatric diabetes clinic, with experienced local clinicians and support from a tertiary centre, can attain outcomes in glycaemic control, clinic attendance, and diabetes-related hospitalisation comparable to those of large Australian metropolitan clinics. However, glycaemic outcomes remain suboptimal when compared to international standards.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143475755","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":"Decennial Ward-Level Influence of Demographic, Farming, and Economic Predictors on All-Cause Mortality","authors":"Kelly Trearty,&nbsp;Brendan Bunting,&nbsp;John Mallett","doi":"10.1111/ajr.70016","DOIUrl":"https://doi.org/10.1111/ajr.70016","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study has arisen in response to a lack of studies examining how farming affects mortality patterns across areas of Northern Ireland (NI) over a 10-year period. This paper aims to investigate whether agriculturally intensive electoral Wards have higher mortality rates compared to non-agriculturally based Wards, controlling for relevant factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The population census and farm census information was downloaded from the Northern Ireland Neighbourhood Service (NINIS) website to construct two original mortality-based datasets. Linear regression was used for the analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Decennial Ward-Level Influence of Demographic, Farming, and Economic Predictors on All-Cause Mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Five hundred and eighty-two Ward areas of Northern Ireland.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measure</h3>\u0000 \u0000 <p>Mortality risk within Ward areas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Findings showed larger amounts of natural log of the population, 65 to 100+ year-olds, limiting long-term illnesses, Farming Intensity Scores, residents living alone and full-time workers within Wards were predictive of mortality risk within those Wards.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study is the first of its kind in NI to provide evidence for Farming Intensity Scores explaining the variation of mortality rates between areas, in addition to many of the usual predictors.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143475756","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 Role of Medical Student Quality Improvement Projects in Health Care: A Scoping Review","authors":"Casey Stubbs,&nbsp;Bernadette Ward","doi":"10.1111/ajr.70009","DOIUrl":"https://doi.org/10.1111/ajr.70009","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Across Australia, there is considerable variation in the quality of health care and the risk of associated complications. Hence, many patients are receiving poor-quality care. This may be exacerbated in rural and remote areas where the availability of health care is relatively limited. Addressing this requires a multipronged approach that supports the workforce. Involving medical practitioners in medical students' quality improvement (QI) scholarly projects may be one strategy to assist with bridging this gap. The aim of this review was to synthesise the evidence relating to medical students' compulsory curriculum-based quality improvement projects and associated practice outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Scoping review of peer-reviewed literature (January 2000–June 2024).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 239 articles, six empirical studies from Australia, New Zealand, the UK and the USA were included. Half of these were based in community settings and the rest in hospitals. Only one was in a rural setting. The time allocated to projects was between 5 and 12 weeks. Five of the six studies reported that student project recommendations had been implemented. One study reported that the process enhanced doctors' adherence to best practice guidelines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Much of the research about the outcomes of medical student curriculum-based projects focuses on research outputs. These relatively short student QI projects are one strategy to improve evidence-based practice while upskilling clinicians. Further work is needed to examine their impact, particularly in rural areas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Integrating medical students into ‘real-world’ QI health service projects can enhance the quality of health care whilst building the skills of the medical workforce.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466303","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":"Dementia and Cognitive Impairment in the Australian Farming Community. A Preliminary Qualitative Investigation of Healthcare Provider's Perceptions of Risks/Barriers to Care","authors":"James Gunning,&nbsp;Kerri-Lynn Peachey,&nbsp;Tony Lower,&nbsp;Carlos Mesa-Castrillon","doi":"10.1111/ajr.70006","DOIUrl":"https://doi.org/10.1111/ajr.70006","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Farmers are at higher risk of developing dementia due to occupational exposures throughout their lives. People living in regional and remote areas also have increased barriers to care compared with urban populations, while farmers face additional barriers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To explore the barriers to care and risks faced by farmers with dementia, from the perspectives of healthcare workers. This preliminary study also aims to explore the differences in barriers faced by farmers and non-farming rural populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Seven participants from a range of health professions were interviewed in a semi-structured style to explore their experiences. The data were coded and analysed using a constructivist grounded theory approach to search for recurring themes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Six key themes emerged from the data: (1) barriers arising from typical farmer personality traits; (2) geographic isolation; (3) late diagnoses of dementia; (4) barriers to the provision of care on the farm; (5) on-farm risks; and (6) transition to residential aged care home.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Farmers living with dementia on-farm may face significant barriers to care and risks to themselves and others compared to non-farm rural and urban populations. These additional barriers predominantly stem from increased geographic isolation and personality traits common to farming populations. However, there is potential for change to improve care provision through earlier diagnosis, more efficient service funding to enhance treatment availability and the use of residential aged care homes more suited to farmers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466304","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":"Examining the Effectiveness and Acceptability of Internet-Delivered Psychological Pain Management for Regional and Rural Australians With Chronic Pain","authors":"Blake F. Dear,&nbsp;Lauren Staples,&nbsp;Olav Nielssen,&nbsp;Nickolai Titov","doi":"10.1111/ajr.70008","DOIUrl":"https://doi.org/10.1111/ajr.70008","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To examine the characteristics, satisfaction levels and clinical outcomes of rural and remote Australians with chronic pain completing an internet-delivered psychological pain management program (PMP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Longitudinal routine care cohort study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>An Australian national digital psychology service.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Patients in inner regional locations (<i>n</i> = 401), outer regional and remote locations (<i>n</i> = 198), and major cities (<i>n</i> = 968), who used the service over a 6-year period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Demographic and clinical data, patient-reported satisfaction and improvements, and meaningful clinical improvements (≥ 30% improvement).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Clinical improvements were observed from pre-treatment to post-treatment in pain-related disability (32% [95% CI: 29, 34]), depression symptoms (44% [95% CI: 39, 49]), anxiety symptoms (43% [95% CI: 39, 47]), and average pain intensity (23% [95% CI: 21, 26]), which were maintained to 3-month follow-up. High levels of satisfaction and treatment completion were also observed. Minor demographic and clinical differences were observed. However, there were similar rates of clinical improvement, treatment satisfaction and treatment completion in all groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The current findings further highlight the value of internet-delivered psychological PMPs for Australians with chronic pain living in regional and remote parts of the country. Further work is needed to raise awareness about the availability of these effective programmes and to integrate their use with traditional pain management services.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424283","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":"Establishment of a New Retinal Service in Remote Western Australia: Kimberley Hub—A Comparative Audit 2019–2022","authors":"James Wiffen,&nbsp;Jocelyn Drinkwater,&nbsp;Vaibhav Shah,&nbsp;Angus Turner","doi":"10.1111/ajr.13217","DOIUrl":"https://doi.org/10.1111/ajr.13217","url":null,"abstract":"<div>\u0000 <section>\u0000 <h3> Background</h3>\u0000 <p>Lions Outback Vision provides access to specialist eye care in rural and remote Western Australia. In 2020, the Kimberley Hub was established as a new regional base in Broome for outreach services in the northwest of the state. Vitreoretinal services commenced for the first time in Broome in 2021.</p>\u0000 <p>This is a retrospective audit of retinal services provided by Lions Outback Vision in the year prior to, and following, establishment of the Kimberley Hub.</p>\u0000 </section>\u0000 <section>\u0000 <h3> Methods</h3>\u0000 <p>All ophthalmology occasions of service in the Kimberley in 2019 (1/1/19–31/12/19) were compared with those from April 2021 to March 2022.</p>\u0000 <p>Data are presented as number (percentage) and mean ± SD as continuous data was normally distributed. Two-way comparisons were by chi-square test.</p>\u0000 </section>\u0000 <section>\u0000 <h3> Results</h3>\u0000 <p>Occasions of service increased by 75% from 3307 to 5793 between the 2019 and 2021/22 periods respectively. Nonattendance significantly reduced from 28.5% to 18.7% (<i>p</i> &lt; 0.001). In the 12 months following the introduction of vitreoretinal capabilities, 42 surgeries were performed on 35 people (mean ± SD age of 56.1 ± 13.1 years at first surgery), 17 (48.6%) were male, 29 (82.9%) identified as Aboriginal or Torres Strait Islander and 19 (54.3%) had diabetes. Nine (21.4%) of these cases were emergency procedures. The number of intravitreal injections given significantly increased by 87% between 2019 and 2021/22. There were 3.5 times more laser photocoagulative procedures.</p>\u0000 </section>\u0000 <section>\u0000 <h3> Conclusion</h3>\u0000 <p>Establishment of the Kimberley Hub saw increased appointments, reduced nonattendance and establishment of the first vitreoretinal service in remote Western Australia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424284","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":"How Is Chronic Pain Managed in Rural Australia? A Qualitative Study Exploring Rural Healthcare Professional and Consumer Experiences","authors":"Ashley R. Grant,&nbsp;Gill Westhorp,&nbsp;Amelia Mardon,&nbsp;Monique White,&nbsp;Peter D. Hibbert,&nbsp;Emma L. Karran,&nbsp;Christopher Roeger,&nbsp;G. Lorimer Moseley","doi":"10.1111/ajr.70000","DOIUrl":"https://doi.org/10.1111/ajr.70000","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Guideline-based care for chronic pain is variably provided. Existing data on chronic pain management in Australia come primarily from metropolitan samples. As the initial investigations for a wider needs assessment, we sought to understand how chronic pain is managed in rural Australia, focused on investigating the gap between guideline-recommended care and provided care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted semistructured interviews with rural healthcare professionals who treat patients with chronic pain and rural consumers affected by chronic pain. We asked healthcare professionals what treatments they deliver to patients with chronic pain. We asked consumers to describe the healthcare service providers they had accessed for pain care and the treatments they received from these providers. We utilised content analysis to gain an understanding of what care for chronic pain is being provided and compared these findings to guideline recommendations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We interviewed 15 healthcare professionals and 27 consumers. Both healthcare professionas and consumers reported minimal use of most first-line management strategies. We also found differences between healthcare professional and consumer reports of pain care. Healthcare professionals frequently described delivering guideline-aligned pain care and consumers frequently described receiving care that contradicted guidelines. We identified challenges with rural access to pain care services, including minimal usage of telehealth services.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Given the identified gaps in care, future research may consider ways of improving rural access to pain care services, including investigating ways to increase uptake of telehealth services, and how to shift consumer expectations of pain care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70000","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143380047","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":"Establishment of a Research Unit in Colac, a Medium Rural Town: An Update on Progress and Guidance for Rural Health Service Research Strategy Development","authors":"Laura Alston,&nbsp;Michael Field,&nbsp;Alison Buccheri,&nbsp;Fiona Brew,&nbsp;Anna George,&nbsp;Nikita Wheaton,&nbsp;Stella Harrington,&nbsp;Warren Payne,&nbsp;Drew Aras,&nbsp;Alice Bennett,&nbsp;Hannah Beks,&nbsp;Kevin Mc Namara,&nbsp;Vincent L. Versace","doi":"10.1111/ajr.70005","DOIUrl":"https://doi.org/10.1111/ajr.70005","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Rural health services have not had the same opporunities for research as metropolitan health services. Despite increasing awareness of the importance of placed-based research led by rural health services, there are few examples in the literature on how this can be done.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>In this AJRH Practice Insight we aim to provide an update on the establishment and progress of the Colac Area Health (CAH) research unit. This is a health service led research unit that services rural areas classified as MM4-5 by the Modified Monash Model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Practice insight.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>This experience may assist other small or medium-sized rural health services to undertake the same strategic goal of building locally relevant and place-based research, along with providing hope for those setting out to integrate research into rural health service organisational structures, while minimising the burden on existing resources.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This Practice Insight demonstrates that rural health services can integrate research units into their organisational structures, with minimal burden on resources alongside support from partners who understand the value of rural health research. Lessons learned serve as a valuable example for other rural health services who are seeking to drive their own research programs and support their staff to access research career opportunities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362833","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 Causes, Characteristics and Outcomes of Paediatric Farm Burns in Australia and New Zealand","authors":"Marcel Chua,&nbsp;Warwick J. Teague,&nbsp;Lincoln M. Tracy","doi":"10.1111/ajr.70003","DOIUrl":"10.1111/ajr.70003","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Burn injuries on farms are under-recognised in Australia and New Zealand. Previous studies suggested children are at risk of burn injury, focusing on risk factors including unmodified farm work, risk-taking behaviours, lack of supervision, and limited safety regulations. This study investigated the causes, characteristics, and outcomes of paediatric farm burns.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Registry-based retrospective cohort study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Observational.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Burns Registry of Australia and New Zealand (BRANZ).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Paediatrics aged &lt; 16 years and registered to the BRANZ between 2009 and 2021.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>The demographics, causes of burn injuries, pre- and in-hospital management, severity, and outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Out of 10 936 paediatric burns, 186 were farm-related (1.7%). Children sustaining farm-related burns were older than those in non-farm environments, with 78.8% aged ≥ 5 years. Most farm burns occurred during leisure (72.5%). Predominant causes were found to be contact (62.4%), followed by flame (19.9%) and friction (10.8%). Only 56.9% received gold-standard first aid compared to 74.0% in non-farm environments. Farm-related burns were smaller but a greater proportion were full-thickness injuries, requiring surgical management with skin grafts. The majority of farm-related burns were discharged home (97.3%) with zero deaths.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Farm-related burns in children are distinct from burns in non-farm environments. Despite children being well-recognised participants in farm work, work-related burns were relatively uncommon, and the occurrence of burns during leisure may explain low rates of recommended first aid. These insights can inform burn prevention and first aid strategies targeted at farm communities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191227","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":"Childhood obesity in the first 2000 days: A focus on primary health care in regional and rural Australia","authors":"Juliana M. Betts MPH,&nbsp;Michelle Gooey MPH,&nbsp;Alex Chung PhD,&nbsp;Heather Craig PhD,&nbsp;Heidi Bergmeier PhD,&nbsp;Caroline Amirtharajah MHumNut,&nbsp;Bernie Peacock MBA,&nbsp;Sophie Ping PhD,&nbsp;Kylie Rix MBBS,&nbsp;Stephanie Veal MHA,&nbsp;Helen Skouteris PhD","doi":"10.1111/ajr.13208","DOIUrl":"10.1111/ajr.13208","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Rates of childhood obesity have increased in regional and rural areas in Australia over the past two decades.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To review the current literature to gain an understanding of (i) ways to improve access to primary health care in the first 2000 days, (ii) models of care for delivering healthy lifestyle advice in the first 2000 days and (iii) the development of partnerships between health and social care services in the first 2000 days in rural and regional settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Three literature reviews were undertaken. Results were limited to published, peer-reviewed literature from the past 5 years (2017–2022).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Access to care could be improved through the expansion of telemedicine, nurse roles and community health worker models. A range of organisational and leadership factors facilitated the integration of health and social care services in the first 2000 days in rural areas with evidence of resultant positive health impacts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Telemedicine, the expansion of nursing roles and the implementation of a formalised community health worker model, may serve to improve access to primary health care for families in the first 2000 days; however, further research on particular models of care for delivering healthy lifestyle advice to rural and regional families is required.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Policy-makers should consider the interdependent nature of increasing access to care, establishing best practice models of care and strengthening local partnerships to prevent and manage childhood obesity in the first 2000 days in rural and regional areas.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.13208","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191271","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}