Gavin J. Carmichael BSc, Joshua G. Kovoor MS, Win Le Shwe Sin Ei MPH, Thiep Kuany MD, James Stafford May MD (Dist.), Alexander Beath MD, Yasser Arafat FRACS, Mathew O. Jacob FRACS
{"title":"Efficiency considerations for acute surgical units in rural and regional Australia","authors":"Gavin J. Carmichael BSc, Joshua G. Kovoor MS, Win Le Shwe Sin Ei MPH, Thiep Kuany MD, James Stafford May MD (Dist.), Alexander Beath MD, Yasser Arafat FRACS, Mathew O. Jacob FRACS","doi":"10.1111/ajr.13179","DOIUrl":"10.1111/ajr.13179","url":null,"abstract":"","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 5","pages":"1084-1086"},"PeriodicalIF":1.9,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005987","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}
Sandra C. Thompson PhD, Emma V. Taylor Grad Dip, Ha Hoang PhD, Lisa Hall PhD, Bahram Sangelaji PhD, Charmaine Green PhD, Carolyn Lethborg PhD, Joanne Hutchinson MPS
{"title":"An overview of outputs of Aboriginal- and Torres Strait Islander-related publications from University Departments of Rural Health in Australia; 2010–2021","authors":"Sandra C. Thompson PhD, Emma V. Taylor Grad Dip, Ha Hoang PhD, Lisa Hall PhD, Bahram Sangelaji PhD, Charmaine Green PhD, Carolyn Lethborg PhD, Joanne Hutchinson MPS","doi":"10.1111/ajr.13177","DOIUrl":"10.1111/ajr.13177","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Disparities in the health of Indigenous people and in the health of rural populations are well described. University Departments of Rural Health (UDRHs) in Australia are federally funded under a program to address ongoing challenges with health workforce distribution for rural and remote areas. They have a significant role in research in regional, rural and remote areas, including research related to Indigenous health. However, a comprehensive analysis of their contributions to original Indigenous health related to Indigenous health is lacking.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study examines the contributions of UDRHs to Indigenous issues through analysis of publications of UDRHs focused on Indigenous health during the period 2010–2021.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>This paper examines a database of UDRH Indigenous-related publications from 2010 to 2021.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>A total of 493 publications to which UDRHs contributed were analysed, including 354 original research articles. Health services research was the most common category, followed by epidemiology and papers exploring Indigenous culture and health. While health services research substantially increased over the period, the numbers of original research papers specifically focused on Indigenous workforce issues, whether related to Indigenous people, students or existing workforce was relatively small.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>This broad overview shows the nature and trends in Indigenous health research by UDRHs and makes evident a substantial contribution to Indigenous health research, reflecting their commitment to improving the health and well-being of Indigenous communities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The analysis can help direct future efforts, and future analyses should delve deeper into the impact of this research and further engage Indigenous researchers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 5","pages":"906-917"},"PeriodicalIF":1.9,"publicationDate":"2024-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.13177","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001420","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}
Lisa Bourke PhD, Noha Merchant BSc, Supriya Mathew PhD, Michelle Fitts PhD, Zania Liddle MEd, Deb Russell PhD, Lorna Murakami-Gold MEd, Narelle Campbell PhD, Bronwyn Rossingh PhD, John Wakerman MBBS, MTH, FACRRM, FAFPHM, DSc h.c.
{"title":"Who is suited to work in remote First Nations health? Perspectives of staff in remote Aboriginal Community-Controlled Health Services in northern Australia","authors":"Lisa Bourke PhD, Noha Merchant BSc, Supriya Mathew PhD, Michelle Fitts PhD, Zania Liddle MEd, Deb Russell PhD, Lorna Murakami-Gold MEd, Narelle Campbell PhD, Bronwyn Rossingh PhD, John Wakerman MBBS, MTH, FACRRM, FAFPHM, DSc h.c.","doi":"10.1111/ajr.13175","DOIUrl":"10.1111/ajr.13175","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>There is a shortage of nurses, Aboriginal Health Practitioners, GPs and other staff in remote Australian health clinics. There is also high turnover of staff, leading to questions of ‘who’ is appropriate for remote First Nations practice? The aim of this paper was to identify the characteristics of staff who are likely to work well in remote First Nations settings, from the perspectives of remote health practitioners.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>This is a qualitative study involving content analysis of interviews.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>The study is conducted in and with 11 Aboriginal Community Controlled Health Services across northern and central Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Eighty-four staff working in these clinics who spoke about staff qualities suited to remote practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants identified a range of qualities desirable in remote practitioners, which were grouped into three topics: (1) professional qualifications and experience, including cultural skills; (2) ways of working, including holisitic approach, resilience, competence, and being a team player, approachable, flexible and hard-working; and (3) specific community needs, namely the need for local First Nations staff, male practitioners and returning short-term staff. The combination of experiences, ways of working, and fit to both the team and community were emphasised.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Identifying the characteristics of staff who are likely to work well in these settings can inform recruitment strategies. This study found that a combination of professional qualifications, skills and experience as well as ways of working, individual characteristics and needs of communities are desirable for working in remote, First Nations settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 5","pages":"1008-1017"},"PeriodicalIF":1.9,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.13175","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918195","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}
Dan Curley MBBS, Leigh Kinsman PhD, Graeme Mooney MSW, Gail Whiteford PhD, Tony Lower PhD, Megan Hobbs PhD, Beverley Morris BN, Kerry Bartlett BHSc, Alycia Jacob BL
{"title":"A cross-sectional study assessing concordance with advance care directives in a rural health district","authors":"Dan Curley MBBS, Leigh Kinsman PhD, Graeme Mooney MSW, Gail Whiteford PhD, Tony Lower PhD, Megan Hobbs PhD, Beverley Morris BN, Kerry Bartlett BHSc, Alycia Jacob BL","doi":"10.1111/ajr.13166","DOIUrl":"10.1111/ajr.13166","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To measure compliance with Advance Care Directives (ACDs) for decedents in a rural setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Observational, cross-sectional medical records audit comparing requests in ACDs with actual outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Rural Australian coastal district.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>People who had an ACD, died during the study period (30 May 2020 to 15 December 2021) and participated in a local research project.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measure(s)</h3>\u0000 \u0000 <p>Compliance was measured by comparing stated requests in the ACD with outcomes recorded in medical records. This included the place of death and a list of ‘unacceptable interventions’.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixty-eight people met the inclusion criteria (age range of 46–92 [mean 67 years; median 74 years]; 42 [62%] male). The main cause of death was cancer (<i>n</i> = 48; 71%). Preferred place of death was not stated in 16 ACDs. Compliance with documented preferred place of death was 63% (33/52): 48% (16/33) when the preferred place of death was home; 78% (7/9) when sub-acute was preferred; and 100% (10/10) when hospital was preferred. Compliance was 100% with ‘unacceptable interventions’.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These results demonstrate strong compliance with rural patients' requests in ACDs, particularly ‘unacceptable interventions’. Home was the most common preferred place of death, but the compliance measure (48%) was the lowest in this study. This requires further exploration.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 5","pages":"969-975"},"PeriodicalIF":1.9,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.13166","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914586","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}
Joanne Adams PhD, Virginia Dickson-Swift PhD, Evelien Spelten PhD, Irene Blackberry PhD, Carlene Wilson PhD, Eva Yuen PhD
{"title":"Mobile breast screening services in Australia: A qualitative exploration of perceptions and experiences among rural and remote women aged ≥75 years","authors":"Joanne Adams PhD, Virginia Dickson-Swift PhD, Evelien Spelten PhD, Irene Blackberry PhD, Carlene Wilson PhD, Eva Yuen PhD","doi":"10.1111/ajr.13174","DOIUrl":"10.1111/ajr.13174","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This qualitative descriptive study draws on data collected from a sub-sample of 15 women participating in a national study (<i>n</i> = 60) exploring the breast cancer screening motivations and behaviours of women aged ≥75 years. The study aimed to understand why women living in rural and remote areas might continue accessing mobile breast cancer screening despite being outside the targeted age range.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Settings ranged from large towns to very remote communities (according to Monash Modified Model (MMM) classification 3–7) where BreastScreen Australia mobile screening services were available.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Interview data from 15 women aged ≥75 years living in rural and remote locations who had used mobile screening services was utilised for this study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>In-depth individual interviews were conducted via telephone or online platform (Zoom). These were transcribed verbatim and imported into NVivo software to enable thematic analysis to identify key themes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Many women aged ≥75 years in rural and remote areas expressed clear intentions to continue breast cancer screening, despite no longer being invited to do so. They perceived great value in the mobile service and were highly appreciative for it yet acknowledged limited sources of information about the process of ongoing screening.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Few women in rural and remote areas had discussed ongoing breast cancer screening with their general practitioner (GP). More information is required to inform women about the risks and benefits of ongoing screening. Without an invitation to attend screening rural women reported difficulty in knowing when the service would be available. Ongoing notification of the availability of mobile services for women aged ≥75 years in rural areas is recommended.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 5","pages":"1031-1040"},"PeriodicalIF":1.9,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.13174","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141903695","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}
Rosemary Frey PhD, Janine Wiles PhD, Deborah Balmer PhD, Pare Meha PhD, John Parsons PhD, Mary Simpson PhD, Vanessa Burholt PhD
{"title":"Rural unpaid caregivers' experiences in northern Aotearoa, New Zealand during the Covid-19 pandemic: A qualitative study","authors":"Rosemary Frey PhD, Janine Wiles PhD, Deborah Balmer PhD, Pare Meha PhD, John Parsons PhD, Mary Simpson PhD, Vanessa Burholt PhD","doi":"10.1111/ajr.13173","DOIUrl":"10.1111/ajr.13173","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Rural unpaid caregivers experience different opportunities and challenges than their urban counterparts. Our aim was to understand rural unpaid caregivers' experiences of challenges and opportunities during the Covid-19 pandemic in New Zealand.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Rural northern New Zealand during the Covid-19 pandemic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>A convenience sample of 10 unpaid rural caregivers, most supporting an older person living with dementia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A qualitative descriptive design. Data included interviews and online workshops, and a thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Rural unpaid caregivers observed that some aspects of living in a rural context were helpful during the Covid-19 pandemic. However, tasks such as shopping and long-distance travel and communication (both telephonic and digital) became more complex. Abrupt changes to routine and closure of resources and support groups created challenges. Unpaid caregivers worried about what would happen if they were hospitalised themselves. There was a diversity of experience both across caregivers, of familiar routines and rural context as resources, increased challenges requiring resourcefulness to adapt, and experiences of crisis. Many experienced all three states at different times.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This research provides valuable insights into challenges and opportunities experienced by rural unpaid caregivers during the Covid-19 pandemic and may help policy-makers and healthcare professionals develop improved emergency preparedness. Multilevel, multisector responses are needed to ensure effective health and social support and access to resources including health care, access to groceries and medication, transport, and communications (telephone and digital). Enhancing rural access to effective and inexpensive online services is particularly important, as is recognition of the value of rural sites or hubs of connection and social interaction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 5","pages":"996-1007"},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.13173","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861682","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}
Margaret Thomas MMHN, Elizabeth Martin MPH, Sophie Isobel PhD
{"title":"‘Profound personal and professional impacts’: A qualitative study of clinician experiences of a mental health disaster response to Australia's black summer bushfires","authors":"Margaret Thomas MMHN, Elizabeth Martin MPH, Sophie Isobel PhD","doi":"10.1111/ajr.13163","DOIUrl":"10.1111/ajr.13163","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To explore the experiences of clinician and management stakeholders involved in a rural/metropolitan collaborative mental health disaster response to the 2019–2020 Black Summer bushfires in the Snowy Valleys region of southern New South Wales (NSW), Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>A mental health and drug health service in the Snowy Valleys region of rural NSW in collaboration with a mental health service from metropolitan Sydney, NSW.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Mental health clinicians and managers from a rural health district (<i>n</i> = 6) and a metropolitan health district (<i>n</i> = 8) involved in a collaborative disaster response to the 2019–2020 Black Summer bushfire disaster in the Snowy Valleys region of southern NSW, Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>An interpretive qualitative study design using semi-structured individual interviews, with transcripts analysed using Reflexive Thematic Analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thematic findings on participant experiences are presented under three organising constructs of before (<i>stepping up and jumping right in</i>), during (<i>finding a rhythm of working together</i>), and after (<i>profound personal and professional impacts</i>) the mental health disaster response.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Participant experiences had shared and distinct components before, during and after the mental health disaster response, culminating in profound personal and professional impacts. Findings highlight positive aspects and challenges for clinicians participating in a rural/metropolitan collaborative mental health disaster response. The findings of this study contribute new knowledge about experiences of mental health clinicians participating in a disaster response after bushfires, from dual perspectives of members of a bushfire-affected community and those responding from outside a bushfire-affected community, which may inform ongoing planning of responses to disaster in Australia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 5","pages":"959-968"},"PeriodicalIF":1.9,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753450","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":"Farmer wants a skin check: Improving skin cancer surveillance in rural Australia","authors":"Andjela Arandjelovic MD","doi":"10.1111/ajr.13172","DOIUrl":"10.1111/ajr.13172","url":null,"abstract":"","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 5","pages":"1082-1083"},"PeriodicalIF":1.9,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753449","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}
Dimitri Diacogiorgis MApplSc, Byron Matthew Perrin PhD, Michael Ian Charles Kingsley PhD
{"title":"Assessment, diagnosis and management characteristics of people with acute Charcot neuro-osteoarthropathy in a regional Australian health service: A 3-year retrospective audit","authors":"Dimitri Diacogiorgis MApplSc, Byron Matthew Perrin PhD, Michael Ian Charles Kingsley PhD","doi":"10.1111/ajr.13168","DOIUrl":"10.1111/ajr.13168","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Acute Charcot neuro-osteoarthropathy (CN) is highly destructive, causing bone and joint damage that can result in devastating structural changes to the foot. The objective of this study was to determine the characteristics of assessment, diagnosis and management of people with acute CN attending a large regional Australian health service.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Three-year retrospective medical record audit.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Large regional health service with catchment area of >250 000 people in regional Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>People with acute CN who attended emergency, orthopaedic clinics or High Risk Foot Clinic (HRFC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Participant characteristics and acute CN assessment, diagnosis and management characteristics. Trends in characteristics were investigated according to rurality as measured by the Modified Monash Model (MMM) scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventeen participants (20 presentations) of acute CN were identified. Mean age was 57.1 ± 10.8 years, with 11 female participants. Median duration to seek help was 31 (IQR 14–47) days. Total Contact Casting was undertaken for 85% of cases, with those who resided in MMM1-2 regions experienced significantly shorter time to TCC therapy compared to those residing in MMM3-7 regions (<i>U</i> = 3.0, <i>p</i> < 0.01). Resolution of acute CN with or without deformity occurred in 70% of cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Those who lived in smaller regional and rural communities were more likely to experience delayed access to gold standard treatment for acute CN. Regional models of care for acute CN should include activities to improve the knowledge of people at risk of acute CN about the condition and upskill regional health professionals for timely and local TCC therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 5","pages":"987-995"},"PeriodicalIF":1.9,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.13168","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753426","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}
Bianca E. Kavanagh PhD, Kevin P. Mc Namara PhD, Penny Bolton MPH, Carly Dennis BPH, Vincent L. Versace PhD
{"title":"Building research capacity at a rural place-based community service organisation in southwest Victoria, Australia","authors":"Bianca E. Kavanagh PhD, Kevin P. Mc Namara PhD, Penny Bolton MPH, Carly Dennis BPH, Vincent L. Versace PhD","doi":"10.1111/ajr.13170","DOIUrl":"10.1111/ajr.13170","url":null,"abstract":"<p>Due to their unique ability to appreciate the local context, rural place-based health and community services are central to the prevention and management of health and social issues.<span><sup>1</sup></span> Place-based approaches allow relevant evidence to be generated locally; however, at present, there is a lack of evidence generated from rurally based health services<span><sup>1</sup></span> and arguably less evidence produced from the community services sector.<span><sup>2</sup></span> This lack of evidence limits the ability for policy-makers to make evidence-informed decisions about how to improve outcomes for rural populations.<span><sup>3</sup></span> There is an increasing need to provide evidence of outcomes within the community services sector, and the need to have mechanisms in place to capture, analyse and report data has been identified.<span><sup>4</sup></span> However, the complexities of this sector—including that services are delivered within complex, dynamic and multifaceted social contexts, with multiple funding sources—have led to challenges for community services to conduct research. This impedes the opportunity to enhance service performance and outcomes.<span><sup>4</sup></span> The experiences of rural health services might inform a framework for generating evidence in the community services sector. Rural health services are reported to be motivated to build research capacity to attract and retain the rural workforce,<span><sup>5</sup></span> and parallels with the community services sector may exist.</p><p>Research capacity building is an effective approach to generating and applying new knowledge to improve outcomes.<span><sup>6</sup></span> Cooke et al.<span><sup>6</sup></span> suggested that if research questions are developed through consultation with users (i.e. service providers and policy-makers), then the research generated is relevant to fundamental health issues and concerns; this may be particularly relevant to regional, rural and remote (RRR) areas. The embedded research (ER) model may support evidence acumen by bridging the disparity between research and service delivery.<span><sup>7</sup></span> Embedded researchers (i.e. when a researcher is embedded into a ‘host’ organisation) may assist in building research capacity through their function of conducting collaborative and ‘on the ground’ research.<span><sup>7</sup></span> This model differs from the bench-to-bedside model and may be a sustainable approach to research capacity building in RRR contexts.<span><sup>1</sup></span> The ER model may circumvent the need for lower-resourced health and community services from consulting with external researchers to generate evidence. Despite being a relatively new approach to building research capacity in RRR contexts, the ER model has gained traction and demonstrated success in recent years.<span><sup>8</sup></span></p><p>An ER model was recently implemented at Brophy Family and Youth Services (Brophy) in south","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 5","pages":"1068-1071"},"PeriodicalIF":1.9,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.13170","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753427","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}