Rural Remote Health
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Rural Remote Health · Oct 2013
Assessing the effectiveness and feasibility of implementing mitigation measures for an influenza pandemic in remote and isolated First Nations communities: a qualitative community-based participatory research approach.
The next influenza pandemic is predicted to disproportionately impact marginalized populations, such as those living in geographically remote Aboriginal communities, and there remains a paucity of scientific literature regarding effective and feasible community mitigation strategies. In Canada, current pandemic plans may not have been developed with adequate First Nations consultation and recommended measures may not be effective in remote and isolated First Nations communities. ⋯ This study highlights the importance of engaging local key informants in pandemic planning in order to gain valuable community-specific insight regarding the design and implementation of more effective and feasible mitigation strategies. As it is ethically important to address the needs of marginalized populations, it is recommended that these findings be incorporated in future pandemic plans to improve the response capacity and health outcomes of remote and isolated First Nations communities during the next public health emergency.
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Rural Remote Health · Apr 2013
Accommodation in pediatric oncology: parental experiences, preferences and unmet needs.
For families of children diagnosed with cancer, proximity to the treatment center and staying close to immediate family members are essential for proper patient management. Accommodation services are therefore a key consideration in pediatric oncology. This descriptive study explored the accommodation used, and preferred, by parents of pediatric cancer patients at Sydney Children's Hospital, Randwick (SCH), Australia, and investigated their accommodation and practical needs. ⋯ With a large percentage of families travelling long distances for treatment at SCH, it is important to assess their accommodation needs and experiences. Although parents positively appraised the accommodation options they utilized, they also provided useful suggestions for enhancing the experiences of future families. There is a clear need for greater access to accommodation specifically tailored to suit the needs or preferences of families from rural and remote locations.
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Rural Remote Health · Apr 2013
Choice or chance! The influence of decentralised training on GP retention in the Bogong region of Victoria and New South Wales.
Attracting, training and retaining GPs in rural communities has long been the subject of intense interest and debate in medical and political circles. Government reviews and policy decisions, including the introduction of the ten-year moratorium (a strategy to place overseas-trained doctors in rural locations), have been implemented to address workforce shortages in rural Australia. In a landmark decision in 1998, a government assessment of GP training recommended dissolution of centralised general practice education and, in 2003, regional training providers began training GP registrars in a decentralised environment. This study examines the impact of the decentralised model of GP training on the retention of GPs who trained with Bogong Regional Training Network between 2004 and 2009. The study also explores the differences in perspectives of Australian and overseas-born GPs as these relate to remaining in rural practice. ⋯ The decentralised training model has had a positive influence on retention rates in rural practice in the Bogong region. There are cultural and regulatory differences between Australian and overseas-born doctors that profoundly influence the decision to locate and remain in rural communities with Australian-born doctors significantly more likely to remain in rural practice after the completion of training. For Australian-born doctors, informed choice draws them to rural general practice, while for overseas-born doctors, chance is a major contributing factor that influences their decisions to locate in the region. This study supports the continued development of decentralised and rural specific training pathways for Australian doctors as an effective method for attracting and retaining doctors in rural Australia during and after general practice training.
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Rural Remote Health · Apr 2013
Comparative StudyJames Cook University MBBS graduate intentions and intern destinations: a comparative study with other Queensland and Australian medical schools.
Since 1999 the number of medical school places in Australia has increased substantially in response to workforce shortages, with some of the increased capacity in regional and rural communities. The James Cook University (JCU) School of Medicine, the first of a number of new medical schools, was established with a mission to address the health needs of rural, remote and tropical Australia through aligning student selection, curriculum and assessment practices to encourage generalist postgraduate careers needed in rural and regional areas. This article reports early evidence on the career outcomes of graduates in the first six cohorts from 2005 to 2010, and compares this with available data from other Queensland and Australian medical schools. ⋯ While further follow up is needed to track career progression over a longer time, the data so far suggest that the career outcomes of JCU medical graduates are aligned with the workforce needs of the region, and different from those graduating from Australia's predominantly metropolitan medical schools, as predicted by the program's design.
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Rural Remote Health · Jan 2013
Comparing the experiences of rural and urban family caregivers of the terminally ill.
There are many challenges in delivering rural health services; this is particularly true for the delivery of palliative care. Previous work has identified consistent themes around end-of-life care, including caregiver burden in providing care, the importance of informal care networks and barriers imposed by geography. Despite these well-known barriers, few studies have explored the experience of palliative care in rural settings. The purpose of the present study was to compare the experiences of rural family caregivers actively providing end-of-life care to the experiences of their urban counterparts. ⋯ Through the use of standardized tools, this study explored the experiences of rural informal family caregivers providing palliative care in contrast to the experiences of their urban counterparts. The results of the present study suggest that while there are commonalities to the caregiving experience regardless of setting, key differences also exist. Thus, location is a factor to be considered when implementing palliative care programs and services.