Rural Remote Health
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Rural Remote Health · Jul 2008
A 'RIPPER' Project: advancing rural inter-professional health education at the University of Tasmania.
Attending to the shortage and sustainability of health care professionals and resources in rural areas in Australia is a continuing challenge. In response, there is a heightened focus on new models of healthcare delivery and collaboration that optimise the quality of patient care, respond to complex health needs and increase professional job satisfaction. Interprofessional rural health education within universities has been proposed as one way of addressing these challenges. ⋯ The project evaluation indicated the importance of developing a sustainable and embedded interprofessional rural module within the undergraduate health science curriculum. The project evaluation findings also point to some of the strengths and limitations of implementing interprofessional education activities in a rural setting.
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Rural Remote Health · Jul 2008
Evidence for the acceptability and academic success of an innovative remote and rural extended placement.
Time spent in remote medicine as an undergraduate is influential in career choice in Australia and Northern America. However, its influence is not known in smaller countries, where recruitment into rural medicine is also problematic. Differences across countries mean work is required to explore determinants of success of remote and rural undergraduate training locally. The objectives of this pilot study were to identify why 4th year medical students chose an extended remote and rural option within a degree program which includes a short compulsory period of remote and rural practice. Because this was a novel option the study also looks at the academic performance of the first cohort of students to ensure quality control of teaching and learning. ⋯ The results indicate that the extended remote and rural placement was a valuable and academically successful experience for the students. Important outcomes include that: the students who chose to undertake the remote and rural option did not suffer academically; and the cohort maintained their enthusiasm for long-term remote and rural practice. This pilot study represents only the short-term results of a remote and rural extended option offered by one university medical school. We plan further follow up on these students and their successors to look at both short- and long-term outcomes in terms of post selection and choosing to live and work within rural communities.
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Rural Remote Health · Jul 2008
Life after placement: experiences of older rural caregivers after placing a family member into residential care.
The community care philosophy in Australia has led to a number of older people remaining in their own homes, dependant on others for the majority of their care needs. A small number of older people being cared for by a family member or friend will move into residential aged care facilities for full-time care. This article describes a qualitative study that explored the meanings that older rural Australian caregivers gave to their day-to-day lives after their care-receiver had entered full-time residential aged care. ⋯ This study demonstrated that there are differences found in relation to gender and tasks after in-home caring roles have ended. Worry about loss of driving ability was a major concern in the caregivers' lives. The experiences of the caregivers in this study give a better understanding of what life is like for caregivers after in-home caring has ceased. Understanding of 'life after placement' expands our knowledge about carers and the role of carer. The findings suggest a need for funding and programs for caregivers after their in-home carer role has ended to assist caregivers (particularly men) in reconnecting with people and activities outside their immediate family. The findings may direct rural community development workers to appreciate the challenges that older rural caregivers face when their in-home caring role ends and visiting and socializing is dependant on their ability to drive. This study also offers a perspective for residential aged care staff to consider as they work with families placing an older family member into full-time care. If aged care staff recognise the value of the continuing caring role of the caregiver and integrate them into the care plan, enhanced positive outcomes could transpire for both caregiver and care-recipient.
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Rural Remote Health · Apr 2008
Comparative StudyMyocardial infarction and heart failure hospitalization rates in Maine, USA - variability along the urban-rural continuum.
Cardiovascular disease, including myocardial infarction (MI) and heart failure (HF), remains the leading cause of death in wealthy countries and is of increasing concern in low- and middle-income countries as risk factors such as smoking and obesity become more common around the globe. Within each country the health burden of MI and HF generally falls more heavily on those who live in rural areas and on those who live in communities with lower average socioeconomic status (SES). Hospitalization rates are an important measure of community health because high rates may indicate a high burden of poor health, while inappropriately low rates (low hospitalization rates absent evidence of average good health) may indicate underutilization of health services. The objective of this study was to determine the predictors of MI and HF hospitalization rates at town level in the State of Maine, USA. Maine has large variations in wealth and along the urban-rural continuum at town level. Because our results shed light on variations in health and health-seeking behavior for different Maine populations (such as those living closer vs further from hospitals) they may be of interest to providers of healthcare to people who live in areas remote from healthcare, and to people who face other barriers to good cardiovascular health. ⋯ Our finding that higher MI and HF hospitalization rates were predicted for towns that had lower SES is in agreement with many previous studies and shows the importance of these variables to health, even in a setting such as Maine with large variability in rurality. The negative relationship between the distance to a hospital and hospitalization rates likely does not represent better health in those living remotely from healthcare. Rather, it may indicate that people who live in communities distant from hospitals are less likely to seek hospitalization. This suggests that patient behavior as well as socioeconomic status may impact heart-related hospitalization in Maine. It highlights the importance of patient and provider education to ensure that people who live remotely from health care are hospitalized appropriately.
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Rural Remote Health · Apr 2008
Alcohol harm and cost at a community level: data from police and health.
The Australian National Alcohol Strategy 2006-2009 recommends strengthening data collection at the local level, gathering information from emergency department (ED) attendees and, by integrating data sources, to develop a better understanding of alcohol- related harm. We piloted a method to estimate the number of alcohol-related presentations to ED and alcohol-related police incidents in a remote regional centre. We explore the practicality and benefits of integrating such alcohol related police and health data. ⋯ Future research would benefit from the use of project officers in ED and in the police force, to improve compliance and data completeness. A more comprehensive local picture would also include data from other agencies dealing with alcohol. A longer study is necessary to confirm the preliminary data on seasonal variation. Key words: alcohol, emergency department, injury prevention/ early intervention, intoxication, police incidents/crime.