Rural Remote Health
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Rural Remote Health · Jan 2012
Small rural maternity units without caesarean delivery capabilities: is it safe and sustainable in the eyes of health professionals in Tasmania?
In Australia, over 50% of small rural maternity units have been closed in the past two decades. Workforce shortages, safety and quality concerns and cost considerations are the three interrelated reasons that have led to these closures. Women and families face many challenges when these critical services are absent from their local communities. In an effort to continue to provide maternity services in rural areas, small maternity units without caesarean delivery capabilities have been established in a few rural communities in Tasmania. However, they have divided the opinions of Tasmanian health professionals. This article is part of a larger study which focused on maternity services for rural women and reports the views of the health professionals on this model of care. ⋯ The findings of this study offer insights for policy-makers and state government with regard to the future planning of this model of care. It is recommended that safety and sustainability issues should be considered when this model of care is to be implemented in other rural communities.
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Rural Remote Health · Jan 2012
Comparative StudyAccess to difficult airway equipment and training for rural GP-anaesthetists in Australia: results of a 2012 survey.
In rural Australia, general practitioners (GPs) form the frontline for provision of medical services. Besides responsibilities for primary care via private practice, rural doctors often provide emergency and inpatient services for rural hospitals. The aim of this study was to determine access to difficult airway equipment and training among the GP-anaesthetist cadre in rural Australia. ⋯ Despite the existence of well-publicised algorithms for difficult airway management and the need for specific equipment to manage the difficult airway, Australian GP-anaesthetists report difficulty accessing essential equipment for these infrequent but life-threatening events. This is surprising in the light of recommendations from the Australian and New Zealand College of Anaesthetists. The consequences of difficulty in airway management can be catastrophic. Equipment needs must be balanced against important considerations including ease of use, initial and ongoing training, and cost. Suggestions for affordable equipment and ongoing training for rural GP-anaesthetists are made. The involvement of GP-anaesthetists in prehospital responses occurs in the absence of formal arrangements and with a dearth of training. There is scope to improve rural prehospital responses in Australia, utilising the advanced skills of GP-anaesthetists in resuscitation and airway management.
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Rural Remote Health · Jan 2012
Remote participants' experiences with a group-based stroke self-management program using videoconference technology.
Telehealth is an all-inclusive term for the provision of health services using information and communication technology. Videoconference delivery is one form of telehealth whereby a synchronous, two-way audio and visual connection is made between two or more sites. Videoconference is used in remote areas to improve access to healthcare, perform individual clinical assessments and deliver group education. Moving On after Stroke (MOST®) is a group-based, self-management program for stroke survivors and their caregivers, which consists of information sharing, facilitated discussion, goal-setting, and exercise. This program was delivered simultaneously to local participants onsite in Thunder Bay, Canada, and distant participants in smaller, remote communities in Northwestern Ontario using videoconferencing (MOST-Telehealth Remote). The objective of this study was to explore the experiences of remote participants, their perceptions regarding factors that enable or limit videoconference participation, and to obtain suggestions for enhanced delivery of videoconferenced group programs. ⋯ For MOST-TR participants, videoconference participation was valuable. Addressing the limitations of videoconference connection and enhanced local support may improve the experience for remote participants in small-group, videoconferenced, self-management programs. Using videoconference technology to participate in existing programs greatly increases accessibility for people living in remote areas.
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Farmers as a group have unique attitudes, sources of stress and a heightened risk of suicide. In the context of a prolonged drought and associated stress and increased risk of mental-health problems, this study provides an insight into the levels of psychological distress experienced by different demographic groups within the Australian farming community. The study also addresses a significant gap in the literature by exploring ways in which this unique cohort copes and may better cope, with the inevitable challenges of life 'on the land'. ⋯ This study offers a rare examination of farmers' psychological distress and coping in a time of drought. The results demonstrate that in this unique context it is erroneous to assume the universality of models of coping that have been validated in other samples. The results provide for the development of tailored interventions to help farmers cope more effectively during future times of drought.
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Rural Remote Health · Jan 2012
Service contacts prior to death in people dying by suicide in the Scottish Highlands.
Many people who die by suicide have been in contact with health services prior to their death. This study examined service contacts in people in urban and rural areas of the Scottish Highlands. ⋯ Overall service contact rates prior to death by suicide were very similar to the results of a previous meta-analysis. Rates of contact with specialist mental health services were significantly lower in rural than urban areas, and this finding increased with greater rurality.