Medicine and Health Sciences Commons^™

Why Do Rural Gps Engage In Longitudinal Integrated Community-Based Clerkships At A Time Of Workforce Shortage?, Elizabeth Farmer, Judith Hudson, Kathryn Weston

Elizabeth Farmer

Background: In keeping with its mission to produce doctors for rural and regional Australia, the University of Wollongong Graduate School of Medicine has established an innovative model of clinical education. This involves a 12-month integrated community-based clerkship where students live, learn and work in a regional or rural community. Summary of work: Before the first student cohort started their clerkship, we interviewed 28 general practitioners to determine why they engaged as clerkship supervisors at a time of workforce shortage. Independent researchers conducted semi-structured interviews. Responses were transcribed for thematic analysis. Summary of results: The new model motivated supervisors to engage …

Poor Food And Nutrient Intake Among Indigenous And Non-Indigenous Rural Australian Children, Josephine D. Gwynn, Victoria M. Flood, Catherine A. D'Este, John R. Attia, Nicole Turner, Janine Cochrane, Jimmy Chun Yu Louie, John H. Wiggers

Jimmy Chun Yu Louie

BACKGROUND: The purpose of this study was to describe the food and nutrient intake of a population of rural Australian children particularly Indigenous children. Participants were aged 10 to 12 years, and living in areas of relative socio-economic disadvantage on the north coast of New South Wales. METHODS: In this descriptive cross-sectional study 215 children with a mean age of 11.30 (SD 0.04) years (including 82 Indigenous children and 93 boys) completed three 24-hour food recalls (including 1 weekend day), over an average of two weeks in the Australian summer of late 2005. RESULTS: A high proportion of children consumed …

Demam Berdarah Dengue Di Perdesaan, Erna Kusumawardani, Umar Fahmi Achmadi

Kesmas

Berbeda dengan beberapa negara, laporan kejadian kasus demam berdarah dengue (DBD) di perdesaan Indonesia belum banyak dilaporkan. Penelitian ini bertujuan untuk memberikan gambaran kejadian DBD di perdesaan di wilayah perbatasan Kabupaten Bogor dan Kabupaten Lebak, Jawa Barat. Penelitian ini menggunakan desain studi kasus seri dengan sampel seluruh penderita DBD yang tercatat di puskesmas pada periode bulan Januari 2011 sampai April 2012. Hasil penelitian menemukan 18 kasus DBD dan 4 kasus kematian (case fatality rate, CFR = 22%). Sebagian besar kasus berjenis kelamin laki-laki (58,3%), berusia > 15 tahun (58,3%), tidak bekerja/ibu rumah tangga (50%), melakukan mobilitas (66,7%), mempunyai pengetahuan yang baik …

Cautiousness In Young Rural And Semi-Rural Drivers: Are There Influencing Factors?, Patricia J. Knight, Donald C. Iverson, Mark F. Harris

Don C. Iverson

All drivers have to be prepared for driving with changed conditions, either intrinsic or external to the vehicle. This study explores factors influencing the cautiousness while driving of high school students in a rural and small semirural town community in New South Wales. Perceptions of caution in response to a range of different conditions including driving with passengers, bad weather, driving an unfamiliar car, poor road conditions, driving in heavy traffic and darkness - all conditions which have the potential to affect driving style or speed - were reported. Many of the young rural students reported having started to drive …

Annual Incidence Of Snake Bite In Rural Bangladesh, Ridwanur Rahman, M. Abdul Faiz, Shahjada Selim, Bayzidur Rahman, Ariful Basher, Alison Jones, Catherine D'Este, Moazzem Hossain, Ziaul Islam, Habib Ahmed, Abdul Hasnat Milton

Alison L Jones

Background Snake bite is a neglected public health problem in the world and one of the major causes of mortality and morbidity in many areas, particularly in the rural tropics. It also poses substantial economic burdens on the snake bite victims due to treatment related expenditure and loss of productivity. An accurate estimate of the risk of snake bite is largely unknown for most countries in the developing world, especially South-East Asia. Methodology/Principal Findings We undertook a national epidemiological survey to determine the annual incidence density of snake bite among the rural Bangladeshi population. Information on frequency of snake bite …

Gaining Ground, Losing Ground: The Paradoxes Of Rural Homelessness, Cheryl Forchuk, Phyllis Montgomery, Helene Berman, Catherine Ward-Griffin, Rick Csiernik, Carolyn Gorlick, Elsabeth Jensen, Patrick Riesterer

Rick Csiernik

The study examined rural housing and homelessness issues and looked at similarities and differences between rural and urban areas. It involved a secondary analysis of focus group data collected in a 2001-06 Community University Research Alliance study of mental health and housing. The findings highlight concerns regarding the lack of services, which can precipitate a move from a rural to an urban community. Inadequate transportation services often posed a challenge to rural residents attempting to access services. Many participants preferred rural living but felt they had to choose between residing where they wanted to and having access to essential services. …

Optimizing Cdes And Chws For Kentucky’S Rural Diabetes Belt Counties, Frances J. Feltner

Center of Excellence in Rural Health Presentations

CDC scientists have identified a diabetes belt located mostly in the southern portion of the United States. This diabetes belt consists of 644 counties in 15 states. Sixty-eight (68) of Kentucky’s 120 counties are in this diabetes belt, which requires that ≥ 11% of adults aged ≥ 20 have been diagnosed as having type 2 diabetes.

Certified Diabetes Educators (CDEs) are a major resource for health campaigns to prevent type diabetes, delay its onset, and to lessen its serious negative health outcomes. Unfortunately Kentucky has only 257 publicly listed CDEs and becoming a CDE is a long and arduous process. …

The Influence Of Cognitive-Perceptual Variables On Patterns Of Change Over Time In Rural Midlife And Older Women's Healthy Eating., Bernice C, Yates, Carol H. Pullen, Jonathan Bruce Santo, Linda Boeckner, Patricia A. Hageman, Paul J. Dizona, Susan Noble Walker

Journal Articles: College of Nursing

Although studies demonstrate that dietary interventions for healthy adults can result in beneficial dietary changes, few studies examine when and how people change in response to these interventions, particularly in rural populations. The purpose of this study was to examine patterns of change over time in healthy eating behaviors in midlife and older women in response to a one-year health-promoting intervention, and to examine what predictors (perceived benefits, barriers, self-efficacy, and family support for healthy eating) influence the changes during the intervention and follow-up. Data for this secondary analysis were from the Wellness for Women community-based trial. Women (N = …

Community Health News, Georgia Southern University

Community Health Department News (2011-2018)

• Farmer’s Markets in Rural Communities

The Last Frontier: Rural Emergency Nurses’ Perceptions Of End-Of-Life Care Obstacles, Renea L. Beckstrand, Virginia C. Giles, Karlen E. (Beth) Luthy, Lynn C. Callister, Sondra Heaston

Faculty Publications

Introduction: Caring for dying patients is part of working in a rural emergency department. Rural emergency nurses are prepared to provide life-saving treatments but find there are barriers or obstacles to providing end-of-life (EOL) care. This study was completed to discover the size, frequency, and magnitude of obstacles in providing EOL care in rural emergency departments as perceived by rural emergency nurses.

Methods: A 57-item questionnaire was sent to 52 rural hospitals in Idaho, Wyoming, Utah, Nevada, and Alaska. Respondents were asked to rate items on size and frequency of perceived obstacles to providing EOL care in rural emergency departments. …

Exploring Barriers To Inclusion Of Widowed And Abandoned Women Through Microcredit Self-Help Groups: The Case Of Rural South India, Margaret Lombe, Chrisann Newransky, Karen Kayser, Paul Mike Raj

The Journal of Sociology & Social Welfare

Microcredit programs have been applauded as the magic bullet for the poor, especially women with limited financial resources. Building on previous research, this study examines effects of a microcredit self-help group (SHG) program on perceptions of social exclusion among widowed and abandoned women who participated in groups established after the 2004 Indian Ocean Tsunami in Tamil Nadu, India (N=109). Data were collected on key aspects of the program such as loan amount and investment patterns, group experience, demographics, and perceived barriers to inclusion. Results indicate that investment patterns and group experience impacted the women's perception of barriers to social inclusion. …

Patient Safety Competencies In Rural Asn Students: An Evidence-Based Curricular Innovation, Janeen Berndt

Evidence-Based Practice Project Reports

Hospital clinical experiences are important events in prelicensure nursing education. Benefits include the opportunity for students to experience actual nursing responsibilities, immersion into environment, and professional socialization. However, challenges in finding appropriate clinical experiences include competition over clinical sites, decreasing patient acuity, and high student-faculty ratios. Rural schools of nursing have these challenges and those inherent in rural environments such as limited health care access, restricted critical access hospitals, and limited resources. The purpose of this evidence-based practice project was to plan, implement, and evaluate the use of a series of patient care simulations as an educational intervention to improve …

Utilizing Community Resources To Reduce The Presence Of Type 2 Diabetes In Rural Youth, Antonia S. Mead, M. C. Nagy, Stephen Nagy

Journal of Health Disparities Research and Practice

The purpose of this study was to implement a program designed to promote diabetes prevention activities among preadolescents in a rural southern setting using a day camp intervention. Participants in the study were eleven youth from a rural Alabama county who participated in a week-long half-day camp administered by local and community volunteers. Change scores were used to compare pre- to post- to follow-up measures for camp participant responses. Program results consistently demonstrated that the day camp was theoretically sound and that program activities positively impacted behavioral antecedents. This study demonstrated the feasibility of conducting a diabetes prevention day camp …

A Review Of Smoking Among Rural African Americans: Recommendations For Research And Cessation Interventions, Susan Hedgecock, Anita Fernander

Journal of Health Disparities Research and Practice

Objective: The purpose of this review is to synthesize the available literature on smoking among rural African Americans.

Methods: Using search terms “rural” “African American” “Black” and “smoking” 19 relevant articles were identified in the Medline data base. Findings gleaned from the 19 articles are presented in four categories: a) smoking prevalence, b) smoking behavior and patterns, c) smoking cessation interventions and quitting, and d) smoking-related outcomes.

Results: There may be gender differences, a pattern of late onset of smoking, and a preference for mentholated brands among rural African American smokers. There is no evidence that rural African Americans are …

A Measurement Of Readiness For Tennessee Hospitals To Implement “Meaningful Use” Criteria Resulting From The American Recovery And Reinvestment Act, 2009, Kathryn Wallin Wilhoit

Electronic Theses and Dissertations

In 2009, the American Recovery and Reinvestment Act was signed into law. This legislation provided for monetary rewards for those acute-care hospitals that meet "meaningful use" computerization and reporting criteria.

The study used a descriptive, nonexperimental design to answer three research questions (1) What is the level of readiness to meet "meaningful use" criteria in the Tennessee Hospital Association (THA) member hospitals; (2) What is the level of readiness to meet "meaningful use" criteria in the rural THA member hospitals; and (3) Is there a difference in the readiness to meet "meaningful use" criteria between rural and urban THA member …

Rural Implications Of Geographic Rating Of Health Insurance Premiums, Andrew F. Coburn Phd, Erika C. Ziller Phd, Zachariah T. Croll Ba, Elizabeth Kilbreth Phd

Access / Insurance

This brief examines how and to what extent states allow health plans to vary premiums by geographic rating area and, using insurance data from selected states, assesses the direction and magnitude of variations in rural and urban geographic rating factors. The authors conclude with a discussion of strategies that federal and state policymakers might use to help ensure that premium variations based on geography are justified. KEY POINTS: There is no clear pattern of geographic rating factors favoring rural or urban areas. This lack of a clear pattern suggests that health plans may use geographic rating for business purposes other …

Physical Activity And Screen Time Behaviour In Metropolitan, Regional And Rural Adolescents: A Cross-Sectional Study Of Australians Aged 9–16 Years, James Dollman, Carol Maher, Tim S. Olds, Kate Ridley

Aboriginal Policy Research Consortium International (APRCi)

Objectives: While there is consistent evidence that rural adults in Australia are less active than their urban counterparts, studies relating geographical remoteness to activity patterns in Australian adolescents have yielded inconsistent results. The aim of this study was to describe objectively and subjectively measured patterns of physical activity and sedentary behaviours across remoteness categories in a representative sample of 9–16 year old Australians. Design: Cross-sectional observational study. Methods: 2071 Australian adolescents provided self-report use of time data on four days and wore a pedometer for at least 6 days within the 2007 Australian National Children’s Nutrition and Physical Activity Survey. …

Effectiveness Of The Coping Power Program In A Mexican-American Sample: Distinctive Cultural Considerations, Susan L. O'Donnell, Diomaris E. Jurecska, Robert Dyer

Aboriginal Policy Research Consortium International (APRCi)

This study responds to the challenges associated with delivering culturally sensitive and evidence-based treatment (EBT) to at-risk children. Current research supports group interventions based on the Coping Power Program (CPP) curriculum as EBT for improving the frequency of positive behaviors in children and adolescents. However, the effectiveness of the CPP in a Mexican-American sample has not been explored to date. This study investigated the effectiveness of the CPP delivered as a preventative intervention to Mexican-American adoles- cents in a rural school setting. A major emphasis is put on cultural sensitivity when working with this population. Cultural sensitivity is expressed by …

Comparison Of Assessment Performance Of Rural And Regional Students In A Unique Australian Graduate-Entry Medical Program, David L. Garne, J Bushnell, A Lethbridge, J Douglas

Faculty of Science, Medicine and Health - Papers: part A

The Graduate School of Medicine at the University of Wollongong is one of Australia's newest medical schools, with a regional/rural focus and a distributed campus, and students are all expected to spend a significant proportion of their training in a rural setting. Due to the diverse learning environments that students are exposed to, we sought to determine by phase if there was any difference in examination results between groups who were located in rural settings and those in regional settings.

Climate Change And Rural Child Health: Results And New Directions From An International Collaboration, Bastian Seidel

Faculty of Science, Medicine and Health - Papers: part A

No abstract provided.

Risk Factors For Stroke In Rural African Americans And Factors That Influence Exercise Behaviors To Reduce Stroke Risk, Dawn M. Aycock

All ETDs from UAB

Stroke has increased among young adults, which is concerning for African Americans (AA) who tend to have stroke at an earlier age and an increased risk for mortality and severe disability. Rural dwellers lack resources which may increase their susceptibility to stroke. Regular exercise can reduce stroke; however, physical activity among AA is low. The purpose of this research was to use an Expanded Health Belief Model to examine perceived and actual stroke risk among rural AA 19 to 54 years of age and factors that influence exercise behaviors to reduce stroke risk. A cross-sectional correlational design was used. Participants …

Relationships Of Access And Affordability To Household Food Security Status Among Rural, Low Income Caregivers, Jodi Elaine Marani

Theses and Dissertations--Kinesiology and Health Promotion

Household food security status in rural areas is a significant issue facing caregivers as positive health outcomes depend on appropriate access to healthy foods necessary to lead an active life. Access and affordability of healthy foods are two mediating factors of household food security that may be improved to ultimately increase rates of food security and overall health status among rural, low income populations.

The purpose of the study was to examine the factors of access and affordability of nutritionally adequate food sources in one rural community in relation to food security status through the perspective of its caregivers. In …

Access And Barriers To Diabetic Self Care Education And Support Groups In A Rural Southern Minnesota Community, Elizabeth Waters

All Graduate Theses, Dissertations, and Other Capstone Projects

Diabetic education and support groups promote self care, improve health outcomes, and decrease health care costs. Self care, an important aspect of diabetes care, can be promoted through diabetes education and support groups. Few studies have been done to explore rural population's access to and attendance of diabetes self care education and support groups. The purpose of this qualitative study was to determine if residents of a rural southern Minnesota community have access to diabetes education and support groups and what barriers they face to attending the groups. The understanding gained through this study will help to develop nursing interventions …

Re-Creating The Rural, Reconstructing Nature: An International Literature Review Of The Environmental Implications Of Amenity Migration, Jesse B. Abrams, Hannah Gosnell, Nicholas J. Gill, Peter J. Klepeis

Faculty of Science, Medicine and Health - Papers: part A

The term 'amenity migration' describes a broad diversity of patterns of human movement to rural places in search of particular lifestyle attributes. This review of international literature, drawn from the authors' own prior research and searches on relevant databases, synthesises findings on the implications of amenity migration for the creation and distribution of environmental harms and benefits. Further, we critique common framings of amenity migration-related environmental transformations and offer suggestions for future research. Analysis is positioned within a review of five common themes reflected in the cases we consider: land subdivision and residential development; changes in private land use; cross-boundary …

Rural Placements Are Effective For Teaching Medicine In Australia: Evaluation Of A Cohort Of Students Studying In Rural Placements, H H. Birden, I Wilson

Faculty of Science, Medicine and Health - Papers: part A

Introduction: Medical education in Australia is increasingly delivered through longitudinal placements in general practice and other community settings. Early meaningful exposure to patients has been shown to improve the transition from medical student to junior doctor. This study examines the experience of the first year cohort of the University of Western Sydney (UWS) Medical School long-term rural placement students. Results have been placed in the context of other published results for rural training schemes, comparing and contrasting the present results to those of others. Methods: Students undertaking a rural placement in their final year of the UWS medical program (n=21) …

Cautiousness In Young Rural And Semi-Rural Drivers: Are There Influencing Factors?, Patricia J. Knight, Donald C. Iverson, Mark F. Harris

Graduate School of Medicine - Papers (Archive)

All drivers have to be prepared for driving with changed conditions, either intrinsic or external to the vehicle. This study explores factors influencing the cautiousness while driving of high school students in a rural and small semirural town community in New South Wales. Perceptions of caution in response to a range of different conditions including driving with passengers, bad weather, driving an unfamiliar car, poor road conditions, driving in heavy traffic and darkness - all conditions which have the potential to affect driving style or speed - were reported. Many of the young rural students reported having started to drive …

Early Driving Experience And Influence On Risk Perception In Young Rural People, Patricia J. Knight, Donald Iverson, Mark F. Harris

Graduate School of Medicine - Papers (Archive)

Young people, particularly males and those from a rural area, are over represented in road crashes; this occurs in vehicle dependent countries around the world, including Australia. The attitudes, experiences and behaviours of young drivers are some of the key factors which affect their potential to have an earlyon road driving experience that is crash free.

This paper considers the views of young people, some of whom were brought up on rural properties, and had significant, responsible roles in agricultural work, including task related driving from a very early age. This early responsibility and associated awareness of risk of injury …

Patient Perceptions Of Innovative Longitudinal Integrated Clerkships Based In Regional, Rural And Remote Primary Care: A Qualitative Study, Judith N. Hudson, Patricia J. Knight, Kathryn M. Weston

Graduate School of Medicine - Papers (Archive)

No abstract provided.

The Study Design And Methodology For The Archer Study - Adolescent Rural Cohort Study Of Hormones, Health, Education, Environments And Relationships, Katharine Steinbeck, P Hazell, Robert Cumming, S Skinner, Rebecca Ivers, Robert Booy, G Fulcher, D Handelsman, Andrew Martin, Geoff Morgan, J M. Starling, Adrian E. Bauman, M Rawsthorne, D Bennett, C Chow, Mary K. Lam, P Kelly, Ngiare J. Brown, K Paxton, C Hawke

Graduate School of Medicine - Papers (Archive)

Background: Adolescence is characterized by marked psychosocial, behavioural and biological changes and represents a critical life transition through which adult health and well-being are established. Substantial research confirms the role of psycho-social and environmental influences on this transition, but objective research examining the role of puberty hormones, testosterone in males and oestradiol in females (as biomarkers of puberty) on adolescent events is lacking. Neither has the tempo of puberty, the time from onset to completion of puberty within an individual been studied, nor the interaction between age of onset and tempo. This study has been designed to provide evidence on …

Poor Food And Nutrient Intake Among Indigenous And Non-Indigenous Rural Australian Children, Josephine D. Gwynn, Victoria M. Flood, Catherine A. D'Este, John R. Attia, Nicole Turner, Janine Cochrane, Jimmy Chun Yu Louie, John H. Wiggers

Faculty of Health and Behavioural Sciences - Papers (Archive)

BACKGROUND: The purpose of this study was to describe the food and nutrient intake of a population of rural Australian children particularly Indigenous children. Participants were aged 10 to 12 years, and living in areas of relative socio-economic disadvantage on the north coast of New South Wales. METHODS: In this descriptive cross-sectional study 215 children with a mean age of 11.30 (SD 0.04) years (including 82 Indigenous children and 93 boys) completed three 24-hour food recalls (including 1 weekend day), over an average of two weeks in the Australian summer of late 2005. RESULTS: A high proportion of children consumed …