Medicine and Health Sciences Commons^™

A Coordinated School Health Approach To Obesity Prevention Among Appalachian Youth: Middle School Student Outcomes From The Winning With Wellness Project, William T. Dalton Iii, Karen Schetzina, Elizabeth Conway-Williams

Karen E. Schetzina

The Winning With Wellness (WWW) project was a school-based obesity prevention program that was developed to promote healthy eating and physical activity in youth residing in rural Appalachia. The project was based on the Coordinated School Health model (Centers for Disease Control and Prevention (CDC), 2013a) and used a community-based participatory research approach with an emphasis on feasibility and sustainability. The purpose of this study was to examine self-reported health outcomes for middle school students across the course of the intervention. Sixth grade middle school students (N = 149; 52% girls) from four schools in Northeast Tennessee completed a …

Integration Of Rural Community Pharmacies Into A Rural Family Medicine Practice-Based Research Network: A Descriptive Analysis, Nicholas E. Hagemeier, Sarah Blevins, Kyle Hagen, Emily Sorah, Richa Shah, Kelly Ferris

Nicholas E. Hagemeier

Purpose: Practice-based research networks (PBRN) seek to shorten the gap between research and application in primary patient care settings. Inclusion of community pharmacies in primary care PBRNs is relatively unexplored. Such a PBRN model could improve care coordination and community-based research, especially in rural and underserved areas. The objectives of this study were to: 1) evaluate rural Appalachian community pharmacy key informants’ perceptions of PBRNs and practice-based research; 2) explore key informants’ perceptions of perceived applicability of practice-based research domains; and 3) explore pharmacy key informant interest in PBRN participation.

Methods: The sample consisted of community pharmacies within city limits …

Velamentous Cord: A Dangerous Case Complicated By A Rural Population, Adam Franks, Md, Carolyn Curtis, Md, Shawndra Barker, Md

Carolyn A. Curtis, MD

A velamentous cord insertion occurs when the umbilical cord’s Wharton jelly fails to reach the placenta, due to early placental atrophy around the insertion site, leaving a segment of unprotected vessels running through the thin membranes of the amniotic sac. This area of weakness exposes a threat to the well-being of the fetus through acute hemorrhage and both acute and chronic restriction of nutrition. With advances in technology, resolution capabilities of ultrasounds allow for antenatal diagnosis, when previously this was impossible. With this knowledge, considerations for screening and management of this pathology are essential when dealing with a rural population …

Malnourished Older Adults With Informal Caregivers Admitted To Rural Rehabilitation Units Remain Malnourished During And After Rehabilitation: A Prospective Cohort Study Of Current Practice, Skye Marshall, Adrienne Young, Judith Bauer, Elizabeth Isenring

Skye Marshall

Understanding the nutritional journey older adults make from rehabilitation to home may help to engage and support the patient and their informal caregiver during this process. This study aimed to determine the change in nutritional status, physical function and health-related quality of life (HRQoL) amongst malnourished older adults (≥65years) with informal caregivers admitted to rural rehabilitation and 12 weeks post-discharge to the community.

Malnutrition In Geriatric Rehabilitation: Prevalence, Patient Outcomes And Criterion Validity Of The Scored Patient-Generated Subjective Global Assessment (Pg-Sga) And The Mini Nutritional Assessment (Mna), Skye Marshall, Adrienne Young, Judith Bauer, Elizabeth Isenring

Skye Marshall

No abstract provided.

Malnourished Older Adults Admitted To Rehabilitation In Rural New South Wales Remain Malnourished Throughout Rehabilitation And Once Discharged Back To The Community: A Prospective Cohort Study, Skye Marshall, Adrienne Young, Judith Bauer, Elizabeth Isenring

Skye Marshall

No abstract provided.

Malnutrition In Geriatric Rehabilitation: Prevalence, Patient Outcomes And Criterion Validity Of The Scored Patient-Generated Subjective Global Assessment (Pg-Sga) And The Mini Nutritional Assessment (Mna), Skye Marshall, Adrienne Young, Judith Bauer, Liz Isenring

Skye Marshall

There is strong evidence showing malnutrition is under-recognized and underdiagnosed in the rehabilitation setting. Accurate identification and management of malnutrition is essential so that patient outcomes may be improved and resources used efficaciously.The Scored PG-SGA and MNA require evaluation of their validity in diagnosing malnutrition in rehabilitation. In addition, the prevalence of malnutrition and associated patient outcomes in rural Australian populations has not been reported.

Velamentous Cord: A Dangerous Case Complicated By A Rural Population, Adam Franks, Md, Carolyn Curtis, Md, Shawndra Barker, Md

Shawndra Barker MD

A velamentous cord insertion occurs when the umbilical cord’s Wharton jelly fails to reach the placenta, due to early placental atrophy around the insertion site, leaving a segment of unprotected vessels running through the thin membranes of the amniotic sac. This area of weakness exposes a threat to the well-being of the fetus through acute hemorrhage and both acute and chronic restriction of nutrition. With advances in technology, resolution capabilities of ultrasounds allow for antenatal diagnosis, when previously this was impossible. With this knowledge, considerations for screening and management of this pathology are essential when dealing with a rural population …

Velamentous Cord: A Dangerous Case Complicated By A Rural Population, Adam Franks, Md, Carolyn Curtis, Md, Shawndra Barker, Md

Adam M. Franks, MD

A velamentous cord insertion occurs when the umbilical cord’s Wharton jelly fails to reach the placenta, due to early placental atrophy around the insertion site, leaving a segment of unprotected vessels running through the thin membranes of the amniotic sac. This area of weakness exposes a threat to the well-being of the fetus through acute hemorrhage and both acute and chronic restriction of nutrition. With advances in technology, resolution capabilities of ultrasounds allow for antenatal diagnosis, when previously this was impossible. With this knowledge, considerations for screening and management of this pathology are essential when dealing with a rural population …

Gaps Revisited: Follow Up Evaluation Of An Australian Rural Palliative Care Service, Malcolm Masso, David L. Fildes, Karen Quinsey, Sheila Matete

Malcolm Masso

The Griffith Palliative Care Service (GAPS) commenced in 2001 as a project to improve palliative care in the town of Griffith. At project completion, some elements of service delivery established by the project were sustained and have remained in place, albeit with changes, since that time. Formal evaluation was undertaken in 2003. This paper reports on a follow-up evaluation in 2006. A total of 137 people were referred to GAPS between March 2003 and March 2006, with the majority of patients in the stable phase on referral. There is evidence that the service has been able to extend its reach …

Appalachian Regional Model For Organizing And Sustaining County-Level Diabetes Coalitions, Richard Crespo, Molly Shrewsberry, Darrlyn Cornelius-Averhart, Henry B. King Jr.

Richard Crespo

This article describes a model for developing diabetes coalitions in rural Appalachian counties and presents evidence of their sustainability. The rural Appalachian coalition model was developed through a partnership between two federal agencies and a regional university. Coalitions go through a competitive application process to apply for one-time $10,000 grants. The project has funded 7 to 9 coalitions annually since 2001, reaching 66 total coalitions in 2008. Sustainability of the coalitions is defined by the number of coalitions that voluntarily report on their programs and services. In 2008, 58 of 66 (87%) coalitions in the Appalachian region continue to function …

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 …

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 …

Are Patients Willing Participants In The New Wave Of Community-Based Medical Education In Regional And Rural Australia?, Judith N. Hudson, Kathryn M. Weston, Russell W. Pearson, Rowena G. Ivers, Elizabeth Farmer

Elizabeth Farmer

Community-based medical education is escalating to meet the increased demand for quality clinical education in expanded settings and patient participation is vital to the sustainability of this endeavour. This study aimed to investigate patients’ views on being used as an educational resource in medical student teaching, and whether they are being under- or over-used.

Rural Adolescents’ Help Seeking Intentions For Emotional Problems: The Influence Of Perceived Benefits And Stoicism., Coralie Wilson

Coralie J Wilson

This paper is the second from a larger multi-cite study developed and led by the third author which explores factors that influence adolescents' help-seeking intentions. Specifically, this paper investigates the extent to which perceived benefits of help seeking, stoicism, gender and symptoms of psychological distress are associated with intentions to seek professional help for emotional problems. A cross sectional self-report questionnaire was administered to adolescents recruited from seven high schools in rural towns in the Riverina region of New South Wales. A total of 778 adolescents were recruited. The sample included 373 male and 404 female participants between 13 and …

Rural Adolescents’ Help Seeking Intentions For Emotional Problems: The Influence Of Perceived Benefits And Stoicism., Coralie J. Wilson

Frank Deane

This paper is the second from a larger multi-cite study developed and led by the third author which explores factors that influence adolescents' help-seeking intentions. Specifically, this paper investigates the extent to which perceived benefits of help seeking, stoicism, gender and symptoms of psychological distress are associated with intentions to seek professional help for emotional problems. A cross sectional self-report questionnaire was administered to adolescents recruited from seven high schools in rural towns in the Riverina region of New South Wales. A total of 778 adolescents were recruited. The sample included 373 male and 404 female participants between 13 and …

Embodied Work: Insider Perspectives On The Work Of Hiv/Aids Peer Counselors, D.K. Messias, L Moneyham, M. Vyavaharkar, C. Murdaugh, Kenneth D. Phillips

Kenneth D. Phillips

Our aim in this study was to explore HIV/AIDS peer counseling from the perspective of women actively engaged in this work within the context of a community-based program in rural areas of the southeastern United States. Based on this research we suggest that the embodied work of HIV/AIDS peer counselors is constructed around their personal identities and experiences. This work involves gaining entry to other HIV-positive women’s lives, building relationships, drawing on personal experiences, facing issues of fear and stigma, tailoring peer counseling for diversity, balancing risks and benefits, and terminating relationships. Peer counselors recognize the personal and collective value …

Brief Report: Impact Of Classroom Presentations About Health And Help Seeking On Rural Australian Adolescents’ Intentions To Consult Health Care Professionals., Coralie J. Wilson

Frank Deane

Building Bridges-GP-Team (Building Bridges-Team; Wilson et al., 2004c) is a variation of the Building Bridges to General Practice: GPs in Schools program (Building Bridges-GP; Wilson et al., 2004a), which promotes consultation with health care professionals who are local and available for rural and regional adolescent’ consultation. The first major component of Building Bridges-GP-Team involves structured health professional training that provides knowledge in three basic areas: (1) adolescents’ help seeking barriers and ways to address barriers in primary health care; (2) developmental issues relevant to adolescent’ help seeking; and (3) classroom management, presentation strategies, and elementary teaching skills. Training is based …

Brief Report: Impact Of Classroom Presentations About Health And Help Seeking On Rural Australian Adolescents’ Intentions To Consult Health Care Professionals., Coralie J. Wilson

Coralie J Wilson

Building Bridges-GP-Team (Building Bridges-Team; Wilson et al., 2004c) is a variation of the Building Bridges to General Practice: GPs in Schools program (Building Bridges-GP; Wilson et al., 2004a), which promotes consultation with health care professionals who are local and available for rural and regional adolescent’ consultation. The first major component of Building Bridges-GP-Team involves structured health professional training that provides knowledge in three basic areas: (1) adolescents’ help seeking barriers and ways to address barriers in primary health care; (2) developmental issues relevant to adolescent’ help seeking; and (3) classroom management, presentation strategies, and elementary teaching skills. Training is based …

Remote Controlled Waste: Research Study Of Waste In Remote Aboriginal Communities In Central Australia For The Northern Territory Dept. Of Health And Community Services, Kurt W. Seemann, Bruce William Walker

Kurt W Seemann

One of the great challenges facing scientists, technologists, educationists and economists entering the 21st century will be to produce innovative, constructive and effective responses to unprecedented demands for comprehensive and sustainable waste management strategies. Research and development into waste management is likely to include investigations into values and ideals, population impact on land and resources, employment shifts caused by new waste processing industries, the education and economics of lifestyle changes, and the science and technologies which reduce or reprocess the range of waste a settlement produces, and the impact waste has on our health and ecology. The purposeful management of …