Volume twenty-four, Issue 4

Low back pain is an international public health issue affecting over half a billion people worldwide, and the burden of low-back-pain-related disability is increasing, particularly in low- and middle-income countries. A recent quantitative study in Suriname provided the first insights into the burden of musculoskeletal diseases in the country and found that low back pain is highly prevalent. Indigenous Peoples face numerous and unique barriers in seeking care for their low back pain. This Original Research article presents the results of a qualitative study that aimed to better understand the experiences of low back pain and care-seeking among Indigenous Peoples in Suriname by using a culturally relevant approach supported by the local traditional authority. The research was carried out in Galibi, a remote Kalinya Indigenous village in the north-east of Suriname.

A dor lombar é uma questão de saúde pública internacional que afeta cerca de 500 milhões de pessoas ao redor do mundo, e cuja carga de incapacidade está aumentando, particularmente em países de renda média e baixa. Um recente estudo quantitativo no Suriname forneceu as primeiras informações sobre a carga das doenças musculoesqueléticas no país e encontrou que a dor lombar é altamente prevalente. Indígenas se deparam com barreiras numerosas e únicas na procura por cuidado para a dor lombar. Este artigo original apresenta os resultados de um estudo qualitativo que objetivou uma melhor compreensão sobre as experiências de dor lombar e procura por cuidados entre indígenas do Suriname, utilizando uma abordagem qualitativa relevante apoiada pela autoridade tradicional local. A pesquisa foi realizada em Galibe, uma remota aldeia Kalinya no nordeste do Suriname.

El dolor lumbar es un problema de salud pública internacional que afecta a más de 500 millones de personas en todo el mundo, y la carga de discapacidad relacionada con el dolor lumbar está aumentando, en particular en los países de ingresos bajos y medios. Un estudio cuantitativo reciente en Surinam proporcionó los primeros conocimientos sobre la carga de enfermedad musculoesquelética en el país y descubrió que el dolor lumbar es muy prevalente. Los pueblos indígenas enfrentan numerosas y singulares barreras a la hora de buscar atención médica para su dolor lumbar. Este artículo de investigación original presenta los resultados de un estudio cualitativo que tuvo como objetivo comprender mejor las experiencias del dolor lumbar y la búsqueda de atención médica entre los pueblos indígenas de Surinam mediante el uso de un enfoque culturalmente relevante respaldado por la autoridad ancestral local. La investigación se llevó a cabo en Galibi, en una aldea indígena remota Kalinya en el noreste de Surinam.

General practice (GP) plays a vital role in delivering improved community health outcomes, particularly in rural communities, where geographical barriers, lack of transport and increased distances to healthcare services lead to poorer health outcomes for rural dwellers compared with people living in urban areas. In Ireland, approximately 1 in 3 people live in rural areas and only 7% of rural people live within walking distance of the nearest GP clinic. It has been forecasted that by 2031, there will be a 46% increase in demand for primary care services across Ireland but the number of rural Irish GPs has been decreasing over the past two decades. This Original Research study explores the distribution of GP clinics among rural and urban populations in the Mid-West of Ireland and the impact on new travel distances if GP clinics were individually closed across the region.

Enduring inequities in rural healthcare provision, underpinned by an inadequately sized and fit-for-purpose workforce, are well known to those invested in or tasked with supporting the sustainability of rural communities. In this Commentary, the authors discuss what the rural GP shortage discourse has meant for bottom-up, community development approaches to strengthening the rural health workforce and top-down supports for improving rural healthcare quality. They explore how well the frame of the rural GP shortage marries with rural residents’ current health and social care needs, and the circumstances of rural GPs. They propose implementing several multi-level actions to further stimulate and promote a much-needed shift in discourse and power to alter investment and lead a future re-imagining of the rural health workforce.

Human papillomavirus (HPV), which can cause cancer, is the most prevalent sexually transmitted infection in the USA. Before the global COVID-19 pandemic disrupted cancer prevention and control systems, HPV-associated cancer incidence was rising in rural USA. However, understanding the burden of HPV-associated cancer in rural areas has been complicated by two factors: (1) ignoring heterogeneity within non-metropolitan populations, which might mask the excessive burden in small, rural communities; and (2) not accounting for mortality where HPV-associated cancer was not the underlying cause of death but a contributing factor. This Research Letter provides a clearer picture by analyzing the latest Surveillance, Epidemiological, End Results (SEER) incidence and incidence-based mortality data.

The use of community paramedics in rural communities has been expanded within recent years; however, little is known of whether community paramedics are a valid option in reducing hospitalization for specific procedures. This study assesses reduction of hospitalization for patients who underwent a coronary artery bypass grafting procedure.

Limited access to psychological treatment is a pressing problem in the United States, especially in more rural areas. One potentially underutilized resource is informal care from friends and family members. These authors report on a pilot test of the Friends and Family for Mental Health Program, a mental health skills program developed to enhance informal care and reduce psychological symptoms among informal caregivers.

Australia’s Great Barrier Reef (GBR), stretching 2300 km along the Queensland coast, has millions of visitors per year. Medical emergencies are not uncommon among visitors to the GBR, and patients often require aeromedical retrieval due to their remote location. Little is known about the clinical characteristics of these patients. This Short Communication describes the characteristics and outcomes of patients experiencing cardiac conditions who were retrieved to Cairns Hospital from locations along the northern GBR.

Despite educational and policy efforts, the projected healthcare professional shortage in the USA is expected to increase in the coming years, with rural and underserved communities among those that will be most affected. For newly graduated clinicians, the juncture between the conclusion of formal training and initial practice in a rural community is a critical time that influences retention. Particular challenges for new healthcare professionals in rural areas include isolation, inexperience, purpose, and community integration. To that end, Mountain Area Health Education Center developed a Rural Fellowship program with the intention of facilitating both the placement and continued development of recent graduates from family medicine and one clinical pharmacy residency program in rural western North Carolina. This Original Research article outlines promising results from the Rural Fellowship program.