Volume fifteen, Issue 3

Knowledge about type 2 diabetes and attitudes toward the condition are known to affect compliance and play an important role in diabetes management. In this study of a rural region, more than 65% of the population thought that there is no cure for diabetes, and more than 90% did not know the essential combination of drugs, diet and physical activity in type 2 diabetes treatment, suggesting significant implications for their diabetes management.

Central American countries face a shortage of rural health physicians, exacerbated by a lack of rural exposure during training, fewer role models in rural areas, a lack of funding for programs, and low collaboration between clinical and educational systems. This review article discusses ways to overcome these challenges with creative solutions and new partnerships.

An unrecognised consequence of health professional shortages in rural and remote regions is the shortage of role models to inspire school students to become health professionals. These findings help explain why few students from rural and remote Australia go on to become health professionals and subsequently provide information and attract students for future rural health workforce recruitment and retention.

The shortage of physicians in rural and remote communities is an ongoing problem. Read this article to find out which factors predispose urban students to choose a career in rural medicine.

Farmers have a heightened suicide risk compared to the general population. This study contributes a better understanding of suicide among farmers in different job positions, and highlights the need for tailored suicide prevention initiatives that consider age- and job-specific suicide risk and protective factors among farmers.

Despite efforts to address malnutrition and premature death among rural Indian children, optimal exclusive breastfeeding rates have not been achieved. With a high level of infant mortality and under-nutrition and a low exclusive breastfeeding rate in rural Odisha, the findings of this study could be used to design appropriate intervention strategies.

Among Aboriginal and Torres Strait Islander peoples there is a higher incidence of heart failure, leading to more hospitalisations and deaths than for non-Aboriginal people. By working in collaboration with heart failure experts, Aboriginal researchers and patients, a culturally safe heart failure resource has been developed for Aboriginal and Torres Strait Islander patients.

Climate change is a major foreseeable public health threat. Complex community-level assessments about climate change can offer actionable information about priorities for health sector adaptation.

Innovative integrated clerkships for medical students offer rural healthcare services an opportunity to really integrate education with service. Perspectives from a multi-disciplinary group of stakeholders confirm the significant clinical exposure, skill and teaching capacity in these previously unrecognised placements but caution that realising the potential of health services needs careful management.

Rural and remote communities experience a disproportionate burden of communicable diseases compared to their urban counterparts. This systematic review identified communicable diseases that cause considerable morbidity in remote Aboriginal communities, with growing recognition of other social and environmental factors that can influence the burden of disease.

Perinatal mortality rate is regarded as an indicator of the quality of prenatal, obstetric and neonatal care in an area, which also reflects the maternal health and socioeconomic environment. Our findings that prematurity, poor accessibility and high parity were significantly associated with perinatal deaths in this tribal population are therefore of concern.

To plan effective interventions for recruitment of doctors to rural areas, it is crucial to understand 'what works' and 'why' in each specific country and region. Central to this study was understanding the views of graduates regarding practicing as a doctor in Wales, and how their perceptions and future career options were affected by contact with practitioners in rural environments.

The establishment of Rural Clinical Schools through government funding has been a significant policy initiative in Australian rural health. Since the policy was implemented, graduates have chosen rural practice because they have positive learning experiences, good infrastructure and support within rural areas.

This study confirms high rates of teenage pregnancy, prematurity, low birth weight and perinatal mortality in a rural township in the Solomon Islands. Three low cost interventions to reduce the rate of prematurity and low birth weight infants are discussed.

The shortage of GPs in rural and remote Australia has led to a lack of continuity in the medical supervision of patients with diabetes, resulting in poor outcomes. This article describes a nurse-led cycle of diabetes care and the factors that patients consider important in diabetes self-management.

Aging in rural communities poses unique challenges that affect older adults' quality of life. In this population in rural Brazil, factors associated with the quality of life of older adults in rural areas were similar to those found in urban areas, but the rural context may influence these variables in unique ways.

To overcome serious challenges concerning recruiting and retaining GPs, three small and remote municipalities developed an inter-municipal service. The increased continuity of patient care and creation of a robust professional environment for young doctors are discussed.

Attracting health professionals to work in rural locations in Australia and elsewhere is a well documented challenge. By addressing the diversity within and between professions and reflecting the different stages at which allied health professionals enter rural practice, recruitment and retention strategies can be established to better meet their needs.

Readmission rates are being used to measure "quality" but the measurements can vary due to other factors such as patient factors rather than care factors. Women's health care offers the opportunity to look at low risk and higher risk conditions. Do rural hospitals have higher or lower readmission rates?

Rural clinicians require expertise across a broad range of specialties, presenting difficulty in maintaining currency of knowledge and application of best practice. FOAMed provides content to augment traditional education, reducing delays from knowledge translation and increasing knowledge about cutting edge techniques.

The United States is a leader in grandparents raising children. What challenges are African American grandparents facing in rural America?

Persons with disabilities are vulnerable to stigma and discrimination, social isolation and physical barriers to accessing support services. For those living in rural areas, this study found previously undocumented context-specific experiences that could be used to improve policy implementation and service provision.

Cancer mortality disparities have been observed between rural and urban regions in north-eastern Greece. Health promotion and education, including improved access to medical facilities and early cancer screening, can help mitigate the burden of cancer and extend long-term survival rates.

This study adds to the growing evidence that training medical students in rural areas delivers graduates that work rurally. The additional year spent in a rural area, even when their medical school was in a regional city, significantly affected graduates' work place choices after graduation.

An innovative pilot program could be the key to successful cultural awareness programs for medical students.

Vulnerable or neglected populations are often more disadvantaged during epidemics as health systems are designed to produce the best outcomes for the majority of the population. The research framework described here allowed the voices of a vulnerable group to be heard, listened to and appropriate action taken to mitigate their risk of disease pandemics.

Malnutrition during adolescence has serious consequences for growth and development, a situation experienced by many adolescent girls in developing countries. This study reports the presence and effects of malnutrition in both rural and urban adolescent girls in Ethiopia.

Are place and race important considerations with regard to breast cancer outcomes?

Because most physicians prefer to work in urban areas, rural populations suffer difficulties in accessing healthcare services, resulting in poorer health outcomes. By finding out what motivates physicians to practice in rural areas of Turkey, this study provides valuable insights to redress this imbalance.

Mobile technology can play a vital role in extending healthcare support and services to rural populations. This research shows how a smartphone app could be a useful tool for young adults wanting to quit smokeless tobacco.

Sleep deprivation can be debilitating among CPAP users in remote areas with lack of electricity or in areas of frequent power outages. Knowledgeable primary care physicians can help sleep apnea patients improve treatment compliance to mitigate morbidity and long term complications.

Rural health care faces serious, yet similar challenges around the world. This paper describes the international advocacy and leadership shown by the WONCA Working Party for Rural Practice to advance the health of the world's rural people. Much has been achieved in the past two decades, but there is still much more to do.

Rural patients face disadvantage in accessing medical services that patients in urban settings may take for granted. This report describes a patient who presented early to medical services following the onset of symptoms, but who was delayed in accessing treatment through the particularities of living in a remote area.

Young men are the most frequent victims of road traffic crashes, with alcohol and physical vulnerability playing large roles. The impacts on families who rely on these young men for economic survival are also discussed in this retrospective record review.

In remote populations suffering from a disproportionately high burden of disease, we help build the case for better resourced and more collaborative care.

Do rural variations matter with regard to infant mortality? Researchers in Maine examine 11 years of data in the state of Maine by rurality tier.

What are the drivers of change and what will help them find a voice?

Although it is known that tailoring primary health care delivery to rural regions can significantly address the poorer health outcomes of these areas, enacting that change remains a challenge. This research describes how a rural community driven by strong self-determination, participation and partnerships established a successful and culturally relevant primary health care service.

This study cautions against the use of Fly-in Fly-out and Drive-in Drive-out services without concurrent development of well-resourced primary healthcare services.

Around 80% of households in rural Vietnam are at risk of avian influenza outbreaks through poultry farming. It is vital that programs are available to support access to vaccines, medical equipment and information about preventing and controlling this pathogen.

Addressing mental health issues among rural and remote populations remains a challenge. This article reports on the intersection between PHC and mental health disorders among a remote population in Quebec.