Volume seven, Issue 3

In an era when the health dangers of tobacco smoking are widely understood, it is alarming that the new generation continues to smoke. By considering associated socio-demographic factors, this study of rural Zambian adolescents and their smoking history offers opportunities to intervene in adolescents' smoking behaviour.

Is rural origin a factor in reduced cancer screening uptake? This Croatian study assessed the impact of a range of social disparities, including rural origin, on the opportunistic uptake of breast, colon, and prostate screening in an adult population.

Therapy assistants, often solely responsible for the delivery of therapy health services to rural clients, are an essential part of the Australia rural health workforce. This project report that documents a scheme for their appropriate training is long overdue, and may be applicable to other states - and countries - outside its West Australian origin.

It is humbling to attempt to summarize in sentences what has taken a lifetime to compile and understand. Crosato, Ward-Griffin and Leipert have devoted such an effort to understanding the Aboriginal women caregivers of the elderly. For practitioners, systems and nations to understand health care, they must understand the richness of variation and context, simplified by the concept of Circles of Caring illustrated in the article.

A rural setting can add an layer of complexity to detecting early psychosis, potentially delaying treatment, with implications for immediate and long-term outcome. This project report from rural New South Wales, Australia, describes a novel approach to harnessing existing rural community strengths to assist those on the brink of psychosis.

Where are the children? That is the question rural paediatrician Dr Peter Jones wants answered. This letter is a part of the series from people with personal or professional insight into the emergency measures imposed on remote Aboriginal communities in response to charges of child abuse. Peter reflects on his 18 years of professional experience and questions how the 'emergency response' will actually improve the situation for abused and neglected children and their families.

The problem of staphylococcal infection is an issue that is rampant among poor rural and periurban dwellers in Nigeria, related to alternative health care. This letter argues that regulation and education are required to address the problem.

The ultimate questions in health care involve access, cost, and quality. This is a challenge for health care delivered in very different environments with different levels of resources and expertise. Translations and updates are required to understand, adapt, and transform the care. This is true for individuals, for facilities, and for nations. The earliest stages of translation and transformation involve access to the best information and research. The ethnographic study Access and Use of Research by Rural Nurses captures the Montana rural nursing environment and highlights the changes needed to transform rural nursing.

Extreme makeovers are popular today. Extreme makeovers are also required when research involves the extremes of climate and geography. Readers should enjoy this walk through problem solving far beyond the usual statistical dimensions.

The shortage of GPs in rural and remote Australia is well known to readers of this Journal. Is this just the whinging of a profession that has had it pretty good in recent years? This study from a regional centre in New South Wales, Australia, suggests otherwise. Using a unique before-and-after design, the researchers find the local GPs are very sensitive to increases in the total GP workforce. The addition of a modest number of extra GPs and surgeries, among other workforce changes, improved their perception of their workload. This suggests that monitoring GP perceptions could be a value tool in workforce planning.

The researcher development program is a relatively new Australian Government initiative intended to increase research capacity in the field of prmary health care. This report from the New South Wales Northern Rivers University Department of Rural Health tells us a little of their plans and describes what has been a successful national initiative.

Seeing is believing. As many articles in Rural and Remote Health have demonstrated, giving health students an opportunity to experience rural practice is educationally rewarding and is an effective workforce recruitment strategy. This paper from the Centre for Rural and Remote Oral Health in Western Australia may be the first to document the value of rural placements for dental students.

Are rural midwives more or less competent and confident in their practice than their urban counterparts? An exploratory study from Scotland reveals that this simple question has a complex answer.

Addressing the high rates of chronic disease among Indigenous people requires significant changes in normal practice for health professionals accustomed to caring for non-Indigenous clients. This study from New South Wales, Australia, explored community pharmacists' understandings and views about information and service needs of Indigenous people in their towns. Such research is a vital step towards improving the capacity of mainstream health services to provide accessible and culturally secure care.

How does context influence practice in remote communities? This article from Victoria, Australia, sets out a theoretical model for answering this important question.

Providing effective services to women with drug dependence is challenging in any environment but particularly difficult in rural areas. This article from northern NSW describes a program of case management that resulted in measurable improvements in women's well-being. It is a great example of good program design and implementation combined with rigorous outcome evaluation.

Circumcision is commonly practised as part of initiation ceremonies in southern Africa. Complications, particularly sepsis, are common. This case report describes an unusual consequence of such sepsis and the dangers associated with it.

One of the charachteristics of working in remote locations is that your manager may live and work a long distance from you in the regional 'centre'. This article from the Northern Territory, Australia, examines how these arrangements may be affecting the retention of remote area nurses.

How to get the anti-smoking message to remote areas in the developing world where the use of tobacco products continues to rise? This letter from India offers some simple but effective strategies.

Two more letters have just been posted on the recent Australian government response to abuse in Aboriginal communities. Written by health care providers and a researcher, respectively, with considerable experience in working respectfully and effectively with Aboriginal people, both letters call for a well-resourced but thoughtful response using proven solutions and, to quote from one letter 'the collective wisdom within the community.' Rural and Remote Health urges others to share their views and experience on this issue.

Head lice infection or pediculosis is highly prevalent - at least as common among school children in small communities as in big cities. Parents, schools and health departments alike view it as a public health issue that should be managed by parents. But this paper, based on surveys in Victoria and North Queensland, Australia, reveal that parents do not have sufficient knowledge to adequately detect and treat head lice. It is a timely reminder that requiring people 'to do something' is not enough if knowledge and supportive systems are not in place.

Australian readers will be aware of recent actions by the Commonwealth Government in remote Aboriginal communities in the Northern Territory. This letter to the editor by Juli Coffin, Senior Lecturer in Aboriginal Health in Western Australia, is a response to the sudden and sweeping government policy intervention. Rural and Remote Health encourages all readers with personal or professional experience of the complex issues facing the people who live in and serve remote Aboriginal communities to submit letters. Our intention is to provide a forum to share viewpoints from those who are affected by these latest and previous interventions.

The promotion of breastfeeding is a vital area for health professionals who work with new mothers - but what is our knowledge level? For instance, what do trainee GPs know about breastfeeding? This small qualitative study of GP-trainee perceptions provides some insight.

This letter identifies a high incidence of tuberculosis among the forest dwelling Sahariya tribe of central India.

Preventing suicide deaths in rural communities, especially among men, is a universal concern. This study from Scotland examined the association of population density with suicide - and presents some compelling conclusions.

Are you interested in the workforce outcomes of rural health professional education? This new data collection instrument from Australia will provide interesting new information.

In an overview of elements with the potential to improve health services to rural areas, this Norwegian systematic appraisal of the literature transcends national or regional boundaries.

An assured, safe water supply has been taken for granted in the developed world. This study from Tasmania, Australia raises serious issues of concern regarding inequity in the provision of safe drinking water to rural communities.

Current health professional students are our future workforce. How can we encourage them to practice in rural and remote communities? This article provides a student perspective on the role of rural health clubs at universities in Australia.

A key factor in reducing the risk of an avian influenza pandemic is having an informed general population. This study of the information preparedness of a Greek population raises questions about how to deal with this serious public health threat in any country.

In developed countries effective treatment of hypertension in diabetic patients has led to a significant decline in cardiovascular disease morbidity and mortality. In this multicentre study, primary care physicians clarify whether these benefits are apparent in a rural Greek population.