Australian Journal of Rural Health最新文献

{"title":"Use of Allied Health Services in Rural Northern Victoria, Australia","authors":"Andrew J. Hamilton, Ryan McGrath, Lisa Bourke, Kristen M. Glenister, David Simmons","doi":"10.1111/ajr.70001","DOIUrl":"10.1111/ajr.70001","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Little is known about the socio-demographic factors associated with the use of allied health services in rural Australia. The objective of this study was to determine which factors were associated with the use of various modes of allied health in a region of Northern Victoria.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a secondary analysis of the Crossroads-II population health study. Generalised linear mixed models were constructed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Households were selected at random through address local government area lists. Data were collected by door-to-door surveying.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Settings</h3>\u0000 \u0000 <p>The northern part of the Goulburn Valley, Victoria, including one large rural conurbation (MM 3) and three medium rural towns (MM 4).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Over 15 years of age.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Use of allied health services.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The odds of using audiology (1.047 [1.035, 1.059]), optometry (1.034 [1.027, 1.042]) and podiatry (1.052 [1.039, 1.066]) increased with age, and psychology decreased (0.985 [0.974, 0.997]). Females had lower odds than males for audiology (0.708 [0.553, 0.907]) and greater odds for optometry (1.712 [1.421, 2.064]) and pharmacy advice (1.593 [1.317, 1.927]). Greater odds were observed forbeing Australian-born and pharmacy advice (1.581 [1.149, 2.175]), English spoken at home and physiotherapy (2.415 [1.279, 4.560]), a bachelor's degree and psychology (1.579 [1.011, 2.466]) and pharmacy advice (1.296 [1.002, 1.675]), not working and psychology (3.518 [1.999, 6.191]) and social work (4.202 [2.110, 8.367]). Those unable to work had greater odds of using six of the eight services investigated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Socio-demographic associations with allied health use vary across disciplines. For this population in rural Victoria, socio-demographic associations were observed for all of the allied health modalities studied. Such relationships need to be studied in other rural and allied health cont","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081930","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 Eye Care Access, Workforce Challenges and Opportunities: Perspectives of the Eye Health Workforce in Western Australia","authors":"Jingyi Chen,&nbsp;Sharon A. Bentley,&nbsp;Allison M. McKendrick,&nbsp;Sandra C. Thompson,&nbsp;Angus W. Turner,&nbsp;Khyber Alam","doi":"10.1111/ajr.70004","DOIUrl":"10.1111/ajr.70004","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Rural residents face numerous barriers to accessing eye care services that contribute to disparities in eye health outcomes. This study aimed to explore the perspectives of the rural workforce on opportunities to improve patient access to eye care services, as well as understand the ways the workforce can be supported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Regional, rural and remote Western Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A qualitative descriptive approach was taken. Maximum variation and snowball sampling were used, and semi-structured interviews were conducted until data saturation. Interviews were recorded, transcribed verbatim and analysed using inductive thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Seventeen semi-structured interviews were conducted with six ophthalmologists, 10 optometrists and one non-clinician involved in delivering eye care services in rural Western Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four major themes were identified. ‘Access to care’ pertained to barriers and facilitators of timely and appropriate eye care for rural residents. ‘Need for collaborative care framework’ between ophthalmology and optometry emerged as a key opportunity to decrease wait times and maximise efficiency of visiting services. ‘Motivation to work in rural settings’ and ‘challenges of working in rural settings’ suggested opportunities to support the workforce.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study finds that continued support through financial, personal, and professional means is important for workforce retention and satisfaction among eye care service providers in rural Western Australia. Although collaborative care models currently exist, the extent of collaboration between practitioners varies considerably. Further research is required on developing innovative, scalable and sustainable models of care to meet the eye care needs in rural Australia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069888","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":"Provision of Evidence-Informed Psychological Interventions Following the Queensland (Australia) 2010–11 Floods and Cyclones; the Barriers and Successes","authors":"David Crompton,&nbsp;Peter Kohleis,&nbsp;Jane Shakespeare-Finch,&nbsp;Gerard FitzGerald,&nbsp;Ross Young","doi":"10.1111/ajr.70002","DOIUrl":"10.1111/ajr.70002","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The study assessed the impact on clinicians' ‘perception of skills’ in postdisaster evidence-informed care (EIC) following participation in an online training programme implemented following the Queensland floods and cyclones of 2010–11, clinician confidence to provide EIC, the frequency clinicians used EIC and barriers to providing postdisaster specialist mental health care.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Design&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Clinician perception of pre and posttraining skills, confidence in providing therapies such as trauma-focused cognitive behaviour therapy (TF-CBT), frequency of therapies provided and clinician perception of barriers to the programme were assessed quantitatively and qualitatively.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Participants and Setting&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Clinical staff (&lt;i&gt;n&lt;/i&gt; = 60) employed by the 2010–11 postdisaster mental health programme participated in an online survey conducted over the last 12 weeks of 2012. After the programme concluded an independent audit of the clinical record of mental health clients treated by clinicians employed in the specialist mental health programme was undertaken.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Main Outcome Measure(s)&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Perception of clinical skills in various EIC modalities was completed pre and posttraining. Confidence to provide a treatment was rated on a five-point scale. The clinical record audit identified the treatments provided to clients. Barriers to programme delivery were rated on a five-point scale, with qualitative feedback highlighting programme concerns.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Posttraining clinicians perceived skills in TF-CBT (&lt;i&gt;p&lt;/i&gt; &lt; 0.0001), cognitive behaviour therapy (CBT) (&lt;i&gt;p&lt;/i&gt; &lt; 0.001) and exposure therapy (&lt;i&gt;p&lt;/i&gt; &lt; 0.001) had improved. Following training, clinicians described themselves as moderately to extremely confident in implementing TF-CBT (87%), exposure therapy (80%) and skills for psychological recovery (SPR) (88%). Clinical records analysis indicates that 25% of cases received no TF-CBT, while 43% received one to five sessions. Barriers to care included a lack of cross-service relationships. Recommendations focused on training and early commencement of intervention programmes.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The study echoes the findings of the 2020 Australian Bushfire Roya","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069886","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":"Sick Day Management Plans for Aboriginal and/or Torres Strait Islander Peoples With Chronic Kidney Disease on the Cape York Peninsula of Australia: Health Workers' Perspectives","authors":"Luke Calleja,&nbsp;Beverley Glass,&nbsp;Selina Taylor,&nbsp;Kisha Neville,&nbsp;Leanne Brown,&nbsp;Andrea Miller,&nbsp;Alice Cairns","doi":"10.1111/ajr.13223","DOIUrl":"10.1111/ajr.13223","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to explore the perspectives of healthcare professionals on the utility of sick day management plans for people with chronic kidney disease (CKD) in remote communities and collaboratively design a sick day management plan resource.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>This qualitative study utilised two phases of data collection: preliminary observational data and semi-structured interviews. The research design and analysis were guided by the normalisation process theory (NPT) framework, tailored for complex interventions in healthcare.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Three First Nations communities and one remote mining community in Cape York, Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>In-person semi-structured interviews were conducted with 23 primary healthcare workers; 40% identified as Aboriginal and/or Torres Strait Islander.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study identified three themes relating to feasibility of implementation: (1) resource coherence and readability, (2) suitability for integration into the care model and (3) safety and risk associated with sick day management plans. Iterative development of resources followed, incorporating feedback from the participants. Recommendations emerged for enhanced readability and coherence, including further co-design with individual communities and consumers, content simplification, incorporation of Aboriginal and/or Torres Strait Islander artwork and language and a flow chart structure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The study underscores the importance of culturally sensitive resource design and the active involvement of Aboriginal and/or Torres Strait Islander communities in healthcare improvement. Future research should explore cost-effective methods for personalised sick day management plans.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048861","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":"Trauma Outcomes Based on Remoteness of Injury in Australia: A Systemic Review","authors":"Sanaa Hafeez-Baig,&nbsp;Lisa Buckley,&nbsp;Mark Midwinter","doi":"10.1111/ajr.13216","DOIUrl":"10.1111/ajr.13216","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Research suggests a significant disparity between rural and urban trauma patient outcomes, causing substantial social, economic and emotional costs, impacting health-related quality of life and functionality, and straining our healthcare system. There has not been a systematic examination of contributing factors in Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aims to systematically describe the nature of research on trauma outcomes by geographical location and (where possible) describe factors found to increase or decrease the likelihood and severity of injury in rural Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Five databases (EMBASE, PubMed/MEDLINE, Web of Science, Scopus, CINAHL) and reference lists were searched. Eligible studies compared injury outcomes by geographic location in Australia, using a quantitative study design. No restrictions were placed on publication year or outcomes explored. The results were synthesised narratively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>We found 14 papers. Mortality, the most studied outcome (<i>n</i> = 11), was overall positively related to traumatic incidents in more rural locations. Other data outcomes included hospital admissions and length of stay, admission to ICU, 28-day hospital readmission, rehabilitation, and patient-reported quality of life. Study findings show different mechanisms of injury (e.g., falls) and limited accounts of pre-hospital experiences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Geographical location of trauma may impact the likelihood of injury mortality but is potentially confounded by the different mechanisms and severity of injury. There is insufficient evidence to make conclusions on other non-mortality and longer-term outcomes, and a greater understanding of prehospital outcomes is also needed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This relationship is considered weak due to the limited geographic representation across Australia and the general paucity of recent literature.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973413","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":"Mature-Aged People in the Rural Health Workforce System: A Systems Modelling Approach","authors":"Claire Quilliam,&nbsp;Jason Thompson,&nbsp;Nicole Crawford,&nbsp;Carol McKinstry,&nbsp;Aaron Chambers,&nbsp;Ravi Bhat,&nbsp;Leigh Stanbrook","doi":"10.1111/ajr.13222","DOIUrl":"10.1111/ajr.13222","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The median age of people in rural areas is older than those living in metropolitan areas. Harnessing the potential of the mature-aged population in rural communities may present a uniquely sustainable approach to strengthening the rural health workforce system. The objective of this study was to map the rural health workforce system in Australia and identify the current and potential role of mature-aged people in the workforce system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Not applicable.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Not applicable.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Systems thinking, specifically causal loop diagramming.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The causal loop diagram illustrates the interrelated variables in the rural health workforce system. It also illustrates that the potential contribution of mature-aged people living in rural communities has been overlooked in the strategies to address the rural workforce undersupply.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Health workforces in regional, rural and remote communities in Australia have experienced constant undersupply despite ongoing government and community effort. Novel approaches are required to determine potential strategies to harness the capacity of rural mature-aged people to strengthen the rural health workforce.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973411","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":"Measuring Food and Water Security in an Aboriginal Community in Regional Australia","authors":"Loretta Weatherall,&nbsp;Alinta Trindall,&nbsp;Trish Tonkin,&nbsp;Joseph Alvin Santos,&nbsp;Dori Patay,&nbsp;Ruth McCausland,&nbsp;Wendy Spencer,&nbsp;Greg Leslie,&nbsp;Eileen Baldry,&nbsp;Keziah Bennett-Brook,&nbsp;Julieann Coombes,&nbsp;Tamara Mackean,&nbsp;Janani Shanthosh,&nbsp;Ty Madden,&nbsp;Bruce Moore,&nbsp;Ann-Marie Deane,&nbsp;Niall Earle,&nbsp;Christine Corby GDip,&nbsp;Melissa Nathan,&nbsp;Sera L. Young,&nbsp;Emalie Rosewarne,&nbsp;Jacqui Webster","doi":"10.1111/ajr.13214","DOIUrl":"10.1111/ajr.13214","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To measure current levels and experiences of food and water security in Walgett to guide a community-led program and to provide a baseline measure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A community-led cross-sectional survey conducted in April 2022 by trained local researchers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Walgett, a regional town in NSW, Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>A total of 251 Aboriginal adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measured</h3>\u0000 \u0000 <p>Food and water security levels and experiences were measured using the Household Food Insecurity Access Scale (HFIAS) and Household Water InSecurity Experiences (HWISE) Scale. The relationship between food and water insecurity was determined through linear regression analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Almost half of the respondents experienced food insecurity (46%) or water insecurity (44%) in the last 12 months. Most participants attributed food insecurity to difficulties with food affordability (71%) and availability (63%). More than four in five participants reported relying on purchased or donated bottled water due to main water source interruption (83%) or quality concerns (86%). Water insecurity was associated with food insecurity; HFIAS score increased by 0.43 points for every point higher on the HWISE scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study is the first to measure levels and experiences of food and water security in an Aboriginal community in Australia using validated tools. The results highlight the interconnectedness of food and water insecurity and provide evidence of levels far higher than Australian national level estimates and comparable to low- and middle-income countries. A holistic government response alongside community-led efforts are needed to increasefood and water security to improve health and well-being in remote Aboriginal communities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973412","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":"Student-Led Falls Prevention Program for Community-Dwelling Older Adults in a Rural Community: A Pilot Study","authors":"Asmita Mudholkar,&nbsp;Stephanie Burke,&nbsp;Kehinde Obamiro","doi":"10.1111/ajr.13221","DOIUrl":"10.1111/ajr.13221","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>A third of community-dwelling adults over the age of 65 years fall each year, making falls a significant concern for the elderly. Older people living in community-dwellings account for 73% of fall-related hospitalisations in older populations. Little is known about identifying, reaching at-risk people, and delivering these interventions in rural communities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <div>Our aim was two-fold.\u0000\u0000 <ol>\u0000 \u0000 <li>To test the utility of a student-led program in identifying community-dwelling elderly people at high risk for falls in a rural and remote setting.</li>\u0000 \u0000 <li>To determine client satisfaction with the falls prevention program.</li>\u0000 </ol>\u0000 </div>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Rural and remote community settings in Queensland, Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Forty community-dwelling older adults from the MMM 4 and 6 regions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>This pilot study utilised a cross-sectional design and convenience sampling approach. A validated falls risk self-reported checklist and a screening checklist for general practitioners were used to identify older adults at risk of falling. During the home visit, participants were assessed for their cognition, balance and home safety. A client satisfaction survey was completed via telephone 3 months following the home visits.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Several risk factors for falls were identified, including unsafe use of equipment, absence of Medi alerts, insufficient supervision, lack of support, inappropriate footwear, behavioural concerns and environmental hazards. Most participants reported that the home assessment was valuable and made their homes safer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>An innovative student-led placement model has the potential to provide much-needed access to falls prevention services and minimise falls among community-dwelling older adults in rural and remote locations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11758765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959340","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":"Exploring Paramedicine Models of Care: A Novel Macro Analysis Using the RESPIGHT Framework","authors":"Anthony Weber,&nbsp;Scott Devenish,&nbsp;Louisa Lam","doi":"10.1111/ajr.13215","DOIUrl":"10.1111/ajr.13215","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the alignment of undergraduate paramedicine curricula in Australia with the RESPIGHT model, focusing on diverse aspects such as emergency response, community engagement and governance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Deductive thematic analysis was conducted to assess the alignment of curricula from 16 Australian universities with the RESPIGHT framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>The study reviewed undergraduate pre-registration paramedicine programmes across Australian universities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>The study included a comprehensive analysis of curricula from 16 universities offering undergraduate paramedicine programmes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measure</h3>\u0000 \u0000 <p>The degree of alignment of paramedicine curricula with the RESPIGHT categories: emergency response, community engagement, situated practice, primary healthcare, integration with health services, governance, leadership and treatment and transport.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The analysis revealed varying degrees of alignment across the RESPIGHT categories, with notable discrepancies in areas such as community engagement and governance. Some universities demonstrated strong alignment in emergency response and treatment, while others showed weaker integration with primary healthcare and community engagement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The study highlights significant disparities in the preparedness of paramedicine students for the broad scope of practice required in modern healthcare. The findings underscore the need for curriculum reform to better prepare students for community care models and the evolving healthcare landscape, ensuring a more comprehensive and integrated approach to paramedicine education in Australia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933714","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":"Inequitable Ethnic and Rural Variations in Mammographic Surveillance of Breast Cancer Survivors in Regional Aotearoa New Zealand","authors":"Maximilian O. Joret,&nbsp;Emily Davenport","doi":"10.1111/ajr.13219","DOIUrl":"10.1111/ajr.13219","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>New Zealand and international guidelines recommend surveillance mammography in breast cancer survivors. Ethnic breast cancer-specific diagnosis, treatment and survival inequities exist in Aotearoa New Zealand. Surveillance mammography uptake remains poorly studied internationally and has never been studied in AoNZ. We aim to study surveillance mammography uptake in our region and to probe for unrecognised ethnic and rural inequities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Retrospective cohort study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Taranaki, Aotearoa New Zealand.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Surveillance mammogram candidates who received potentially curative surgery for breast cancer between January 2008 and December 2010.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measure</h3>\u0000 \u0000 <p>Patients' surveillance mammogram opportunity fulfilment rates in the first 10 post-operative years were analysed using a multivariable logistic regression analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Only two thirds of all surveillance mammogram opportunities in our patient's first ten post-operative years were fulfilled. Fulfilment rates decrease significantly with time. Māori and those living rurally are significantly less likely to reach fulfilment rates of ≥ 70% even when accounting for covariates such as age, deprivation, healthcare system and oncology follow up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Healthcare providers have a responsibility to distribute the benefits of health care equitably. This study reports previously unrecognised inequities affecting Māori and rural patients and calls for further research and policy to improve engagement of breast cancer survivors with surveillance mammography and healthcare equity in AoNZ.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923937","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}