Australian Journal of Rural Health最新文献

{"title":"Assessing the Effect of Rural Placements Through a Pre-Post Approach With Different Temporal Targets: Are We Converting or Sustaining?","authors":"Claire Ellen Seaman, Elyce Green","doi":"10.1111/ajr.70176","DOIUrl":"10.1111/ajr.70176","url":null,"abstract":"<p><strong>Background: </strong>Rural placements are a key strategy to attract health students to rural practice. It is important that robust research methods are used to assess the effect of placements on rural career intentions to inform resource allocation and student supports.</p><p><strong>Objectives: </strong>This study explored the utility of a novel rural attitude measurement approach to evaluate the direct impact of rural placements on students' perceptions and intentions. It also examined whether anticipated differences between students from city and rural backgrounds emerged across various future temporal reference points. Finally, the research investigated the characteristics of students who demonstrated desirable rural placement outcomes, specifically those who either 'converted' to or 'sustained' an early career attraction to rural practice.</p><p><strong>Method: </strong>This research employed a pre-post cohort design, surveying health students who were commencing an Australian rural placement. Participants included those from Charles Sturt University as well as students from other universities receiving support from Three Rivers Department of Rural Health. A total of 163 matched pre- and post-placement surveys were collected. The survey measured ratings of the attractiveness of living and working outside of a Major City area across two future timepoints: (1) during the early years of practice (1-3 years after graduation) and (2) after establishing a career (10-15 years after graduation), using an 11-point scale.</p><p><strong>Results: </strong>Most respondents were from a rural background (78%), 29% had care responsibilities, and 36% were aged 30 years and older. Overall, only mid-career attraction significantly increased from pre-placement levels; however, important differences were identified among subgroups.</p><p><strong>Conclusions: </strong>Rural placement experiences serve a 'sustaining' function for those already committed to, and likely located in, rural areas. The desired 'converting' effect of rural placements may be constrained under current RHMT Program scope for health students, especially those from city areas.</p>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"34 2","pages":"e70176"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13067073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647615","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":"Correction to \"Experiences and Impact of a Rural Australian High-Risk Foot Service: A Multiple-Methods Study\".","authors":"","doi":"10.1111/ajr.70181","DOIUrl":"10.1111/ajr.70181","url":null,"abstract":"","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"34 2","pages":"e70181"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582960","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":"A Role for Public Health Training Through the Funding of University Departments of Rural Health.","authors":"Sandra C Thompson, Lisa Bourke","doi":"10.1111/ajr.70191","DOIUrl":"10.1111/ajr.70191","url":null,"abstract":"<p><strong>Aim: </strong>This commentary articulates the need for strengthened public health training and workforce development in rural and remote Australia, arguing that investment in preventive, community-centred public health is essential to addressing longstanding health inequities. Rural and remote communities experience disproportionately high burdens of chronic disease, injury and premature mortality that are inadequately addressed within a health system that prioritises clinical care over population-level approaches.</p><p><strong>Context: </strong>The authors situate this argument within the historical and contemporary context of rural disparities and rural health workforce policy. While University Departments of Rural Health (UDRHs) have long supported interprofessional rural training, the 2016 Rural Health Multidisciplinary Training (RHMT) programme narrowed eligible disciplines and excluded public health.</p><p><strong>Approach: </strong>The paper argues for strengthening rural public and preventive health within RHMT to build a locally embedded workforce capable of addressing the social, environmental and economic determinants of health. This includes supporting culturally safe, community-led public health training in First Nations communities and recognising that local leadership and knowledge systems are central to effective solutions. The authors highlight systemic underinvestment in rural public health, noting limited health workforce, inadequate preventive infrastructure and a misalignment between national strategies and on-the-ground capacity.</p><p><strong>Conclusion: </strong>Achieving rural health equity requires renewed policy commitment to public health within the rural health training pipeline. Enabling public health students to train in rural areas alongside clinical students offers a cost-neutral, immediately implementable step towards building a capable, community-connected, prevention-oriented rural health workforce.</p>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"34 2","pages":"e70191"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13066722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647560","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":"Optimising Longer-Term Training for General Practitioners in Rural Aboriginal Medical Services.","authors":"Patrick Giddings, Belinda O'Sullivan, Matthew McGrail, Marlene Drysdale, David Baker, Veeraja Uppal","doi":"10.1111/ajr.70194","DOIUrl":"10.1111/ajr.70194","url":null,"abstract":"<p><strong>Aims: </strong>This commentary explores the evidence and experience of the Remote Vocational Training Scheme (RVTS) to reflect on the long-term training of general practitioners (GPs) and rural generalists (RGs) within rural Aboriginal Medical Services (AMS).</p><p><strong>Context: </strong>Aboriginal Community Controlled Health Organisations (ACCHOs) and their AMSs provide culturally informed, holistic health services that directly and indirectly address a breadth of primary and preventative healthcare for First Nations communities. However, commonly only short-term and specialised GP/RG training posts are available in these settings, which contrasts with the continuity of care and stable workforce often required in First Nations communities. The Remote Vocational Training Scheme (RVTS) has over 10 years of evidence and experience in implementing a rural AMS training stream, providing 3-4 years of continuous training for GPs/RGs based in the same AMS.</p><p><strong>Approach: </strong>This paper reflects on the lessons learnt by the RVTS leadership team and the evidence from an independent evaluation to inform longer-term training of GP/RGs in rural AMSs across the sector. At the time of the evaluation in November 2023, the AMS stream had enrolled 71 doctors, 36 of whom had completed training in the same AMS, with 14 participants still in training. The commentary offers valuable insights into the design, delivery and outcomes of the program, providing guidance for broader implementation of longer-term training.</p><p><strong>Conclusion: </strong>Longer-term rural AMS training provides valuable learning to trainees whilst ensuring continuity of care and medical workforce stability for First Nations communities. It could be enhanced by incorporating selection and training conditions that prioritise holistic, retention-focused support for trainees.</p>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"34 2","pages":"e70194"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13094321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724683","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 Medical Education: Finding the Right Recipe.","authors":"R B Hays, T K Sen Gupta, Aaron Hollins, Lucie Walters","doi":"10.1111/ajr.70186","DOIUrl":"https://doi.org/10.1111/ajr.70186","url":null,"abstract":"","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"34 2","pages":"e70186"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647638","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":"An Evaluation of the Accuracy of Point of Care Ultrasound by Family Physicians in Rural British Columbia, Canada: Methodological Insights.","authors":"Anshu Parajulee, Oron Frenkel, Virginia Robinson, Patti Janssen, Jude Kornelsen","doi":"10.1111/ajr.70193","DOIUrl":"10.1111/ajr.70193","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated the diagnostic accuracy of point of care ultrasound (PoCUS) by rural family physicians (FPs), using consensus 'imaging expert' interpretation as the reference standard.</p><p><strong>Design: </strong>Cross-sectional.</p><p><strong>Setting: </strong>British Columbia, Canada.</p><p><strong>Participants: </strong>Five rural FPs and seven specialist physicians (imaging experts).</p><p><strong>Methods: </strong>Rural FPs saved images from their PoCUS scans over 2-10 weeks. For each scan, two expert reviewers, who were unaware of the identity of FP study participants and their interpretation of scans, independently interpreted images.</p><p><strong>Main outcome measures: </strong>Image interpretation agreement between FPs and imaging experts: percentage agreement, sensitivity, and specificity. Inter-rater reliability between expert reviewers when interpreting images, as measured by percentage agreement.</p><p><strong>Results: </strong>Seven imaging experts reviewed images from 55 scans performed by five rural FPs. Among the 20 scans with expert pair agreement (that was not 'unable to assess'), expert interpretation was the same as an FP's for all but one scan (95%). For the other 35 scans, experts in a pair (a) both could not make an assessment based on images provided ('unable to assess') (n = 4) or (b) had differing interpretations (n = 31).</p><p><strong>Conclusion: </strong>We found interpretation agreement among imaging experts for a minority of scans, resulting in inadequate power to assess the diagnostic accuracy of PoCUS by rural FPs. When using secondary image review to assess rural PoCUS quality, we recommend limiting the number of PoCUS working diagnoses being investigated, developing image sharing guidelines for FP participants, and using consensus agreement by multiple experts as the reference standard.</p>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"34 2","pages":"e70193"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13100691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790031","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":"Indigenous Culture and Health in UDRH Research: An Indigenous-Led Narrative Review.","authors":"Michael Watkins, Colleen Kelly, Charmaine Green, Samantha Bay, Ginger Minahan, Bahram Sangelaji, Sandra C Thompson","doi":"10.1111/ajr.70175","DOIUrl":"10.1111/ajr.70175","url":null,"abstract":"<p><p>Whilst University Departments of Rural Health (UDRHs) have undertaken research relevant to Indigenous health over decades, understanding of the contributions in the context of culture and health has been largely unexplored.</p><p><strong>Objective: </strong>Through use of culturally appropriate methodology, this Indigenous-led narrative review aimed to summarise how the research has responded to Indigenous perspectives and priorities to provide insights into how UDRH research has considered Indigenous cultural ways, and summarise benefits associated with UDRH studies.</p><p><strong>Design: </strong>This narrative review analysed published UDRH Indigenous health research using systematic analysis and collaborative yarning.</p><p><strong>Results: </strong>Thirty-three papers were reviewed. Key themes identified Indigenous involvement and governance, self-determined research, Indigenous research methodologies, culture as a determinant of health and Indigenous perspectives and understanding of health phenomena, which featured across the included studies.</p><p><strong>Conclusions: </strong>UDRH Indigenous culture and health research studies highlight Indigenous participation and governance in research processes which contribute to positive health and well-being outcomes and build research capacities of both Indigenous and non-Indigenous researchers.</p>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"34 2","pages":"e70175"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678750","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":"Addressing Older Adults' Sexual Health Needs in Regional Primary Care: A Qualitative Study of Barriers and Enablers.","authors":"Louise Bourchier, Lauren Ware, Meredith Temple-Smith, Jane S Hocking, Jane Tomnay, Sue Malta","doi":"10.1111/ajr.70183","DOIUrl":"10.1111/ajr.70183","url":null,"abstract":"<p><strong>Objective: </strong>To explore whether sexual health is discussed in regional settings between primary care clinicians (General Practitioners (GPs) and Practice Nurses (PNs)) and older patients (aged 60 and over), and the barriers and enablers of sexual healthcare for older adults in regional areas.</p><p><strong>Setting: </strong>Participants were based throughout regional Victoria, with all five regions of Victoria represented.</p><p><strong>Participants: </strong>Two participant groups were included: older adults aged 60 and over, and primary care clinicians (GPs and PNs). Nine older adults (5 women, 4 men, ranging in age from 60 to 87 years), and 8 clinicians (4 women, 4 men, 6 GPs and 2 PNs) were interviewed.</p><p><strong>Design: </strong>Data were collected via semi-structured interviews between July and December 2024. Data were analysed using qualitative content analysis.</p><p><strong>Results: </strong>Sexual health conversations were rare and ad-hoc between older adults and primary care clinicians. Key barriers for both groups included stigma around sexual activity and ageing, privacy concerns in small communities, high staff turnover, and structural challenges such as cost and time. Key enablers for both groups included telehealth, systematic inclusion of sexual health in routine care such as the 75+ health check, training for regional clinicians, and health promotion campaigns for older adults living regionally.</p><p><strong>Conclusion: </strong>Older adults and primary care clinicians agree that sexual health is important to older adults' quality of life, although such conversations are rarely prioritised. This study offers suggestions for clinicians to broach sexual health so that it stays on the agenda as part of older patients' overall care within regional primary care.</p>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"34 2","pages":"e70183"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13047243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147610674","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 Quasi-Experimental Retrospective Cohort Study Evaluating Demand, Utilisation and Efficiency of a Pilot 7-Day Multidisciplinary Allied Health Assistant Model of Care in a Regional Australian General Medical Ward.","authors":"Kellie Preston, Carly Harrison, Lee-Anne Polkinghorne, Kirstie Faulkner, Brendan Humphries","doi":"10.1111/ajr.70188","DOIUrl":"10.1111/ajr.70188","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate a 7 day multidisciplinary allied health assistant (mAHA) model of care in an acute general medical setting as a strategy to support service sustainability in the context of hospital bed block.</p><p><strong>Background: </strong>Regional and rural hospitals face challenges delivering timely allied health (AH) care due to workforce shortages, limited weekend coverage and increasing patient complexity. mAHAs may support service sustainability; however, evidence for acute 7-day models is limited.</p><p><strong>Methods: </strong>Analysis of 1615 delegations (pilot n = 594; BAU n = 1021) compared a 5 day business-as-usual (BAU) service (1/10/2021-28/2/2022) with a pilot 7-day model (1/10/2022-28/2/2023) servicing 56 acute beds. Outcomes assessed demand, utilisation and care efficiency.</p><p><strong>Design: </strong>A quasi-experimental evaluation of an organisational intervention.</p><p><strong>Setting: </strong>Regional hospital.</p><p><strong>Main outcome measures: </strong>Outcomes included measures of demand (delegations, occasions of service (OOS), therapy time), utilisation (by profession, day of week), and care efficiency (OOS/delegations per rostered day, time/OOS per delegation).</p><p><strong>Results: </strong>The 7-day model delivered increased delegations (81.9%, p < 0.0001), occasions of service (61.2%, p < 0.0001), and therapy time (127.4%, p < 0.0001), primarily for physiotherapy. The 7-day service model improved load-levelling, reducing early-week demand. Care efficiency improved, with more OOS and delegations per rostered day (p < 0.0001), shorter time per OOS (p < 0.0001) and greater therapy time per admission (p < 0.0001). These improvements occurred without additional AH productive FTE. Utilisation remained physiotherapy-led.</p><p><strong>Conclusions: </strong>In regional hospitals experiencing hospital bed block, a 7-day mAHA model improved access to and efficiency of AH services without the need for additional AH staffing. Limited uptake by non-physiotherapy disciplines constrained full multidisciplinary benefit and warrants further investigation.</p>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"34 2","pages":"e70188"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647576","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":"Bridging the Distance for Ischaemic Stroke Treatment in Regional Australia: A Retrospective Cohort Study.","authors":"Stephanie Caldwell, Bronwyn Griffin, Ramon Navarro, Michael Crowe, Firas Alnidawi, Elizabeth Forster","doi":"10.1111/ajr.70177","DOIUrl":"10.1111/ajr.70177","url":null,"abstract":"<p><strong>Background: </strong>One comprehensive stroke centre (CSC), in North Queensland, Australia, supports almost 700 000 people across 750 000 km². Access to urgent ischaemic stroke treatment is challenging for remote and regional residents, who are more likely to carry stroke risk factors and have a 17% higher stroke incidence than those in major cities.</p><p><strong>Aims: </strong>To review and report on patient demographics, stroke characteristics, interventions, and outcomes of ischaemic stroke in this regional population.</p><p><strong>Methods: </strong>Retrospective review of admissions to a North Queensland CSC (March 2022-September 2023) with acute ischaemic stroke (ICD-10-AM: 163).</p><p><strong>Results: </strong>Among 305 patients, the median age was 72 years, 57% were male, and 10.5% identified as First Nations. Common stroke risk factors included hypertension (83%), smoking background (58%) and hypercholesterolaemia (57%). Stroke aetiology was unknown in 42%, followed by cardioembolic (31%). Median onset-to-emergency department time was 90 min, and to the CSC was 343 min. Thrombolysis was administered to 6% at the referring facility, and 7% on arrival to the CSC (median door-to-needle time, 73 min). Endovascular clot retrieval occurred in 11.7% of the primary presenters, with an overall successful recanalisation rate of 89%. The 6-month mortality rate was 22%.</p><p><strong>Conclusions: </strong>High rates of modifiable risk factors require improved community management. Delayed presentation highlights potential gaps in stroke awareness and access to healthcare in this region. Reaching timely reperfusion targets should become a priority, which requires support from multiple stakeholders. The high proportion of unknown aetiologies may reflect incomplete stroke work-up, documentation, or loss to follow-up. Targeted stroke education for regional and remote communities and healthcare providers is recommended.</p>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"34 2","pages":"e70177"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147729897","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}