Volume twenty, Issue 4

In response to the COVID-19 pandemic, 17 state governors in the USA passed waivers or suspended physician oversight requirements for Advanced Practice Nurses, a key component of the rural health workforce. This short commentary examines this response, including how the waivers or suspensions varied by political affiliation of the governors. This current "natural experiment" could contribute to our understanding of the impact of full autonomy for Advanced Practice Nurses on health care and patient outcomes.

As the effects of climate change escalate, the mental health of rural and remote communities will be placed at increasing risk. This Commentary suggests ways in which current and future research on climate change and rural mental health can be enhanced by social geographic perspectives.

Despite reports suggesting an oversupply of pharmacists, there is currently an inadequate supply in rural and remote Australia. This can lead to a reduction in pharmaceutical services for an already vulnerable population. This study identifies strategies for increasing the pharmacist workforce, and factors associated with retention in rural and remote Australia.

Delivering health services and improving health outcomes of the 1.3 million people residing in northern Australia, a region spanning three million square kilometres across the three jurisdictions of Western Australia, Northern Territory and Queensland, presents specific challenges. This review addresses a need for systems-level analysis of the issues influencing the coverage, quality and responsiveness of health services across this region by examining the available published literature and identifying key policy-relevant gaps.

New Zealand faces an ongoing shortage of rural medical professionals. In an effort to increase interest in rural practice, medical schools in NZ offer rural immersion programmes. This study compares the effects of long (>33 weeks) or short (5-week inter-professional) rural immersion with no rural immersion on the career location intentions of medical students.

Domestic migrant workers were left stranded far from home when India declared nation-wide lockdown to combat the novel coronavirus pandemic. A large number of these workers were left with no economic support, no food and, in many cases, nowhere to live. This Commentary describes the socio-economic and health issues experienced by migrant workers during the COVID-19 crisis, and outlines some of the ways out.

Social factors might bring about health inequities. Vulnerable population groups, including those suffering from non-communicable diseases such as type 2 diabetes and depression, might be more prone to suffering the effects of such inequities. This study describes the social and health inequities for type 2 diabetic patients attending primary healthcare centres in Malta.

Over the past few decades, Australia’s population and multicultural landscape have changed significantly. The growing population of culturally and linguistically diverse (CALD) groups requires changes in the provision of health services to meet their special health needs. This qualitative study explored the perspectives of health providers and community members about factors affecting access to, and utilisation of, health services among CALD populations in the south and east regions of the South Australia.

This qualitative study explores the treatment decision-making practices among Indigenous peoples with cancer in rural Canada, using a storytelling research methodology. Findings suggest that a healthcare system that provides access to both traditional and Western medicine may be essential to culturally safe, high quality cancer care for Indigenous peoples. Given the role of spirituality, ceremony and Elder guidance, the implementation of Indigenous world view into cancer care practice could be beneficial.

The safe and effective application of psychomotor skills in the clinical environment is a central pillar of the health professions. The current global coronavirus pandemic has significantly impacted routine face-to-face skill education for health professionals and clinical students worldwide, a problem familiar to regional, rural and remote health professionals and students. This Commentary considers how the problem of physical distance might be overcome, so that quality skill education might continue.

Although critically important for maintaining a healthy population, primary health care is not always easily accessible, particularly in rural regions. This is partly due to an insufficient number of medical graduates entering and being retained in the rural workforce. This Commentary discusses key elements of international and national programmes designed to address this shortfall.

Indigenous children and adolescents in Australia and globally bear the burden of acute rheumatic fever (ARF), although it has been virtually eliminated in well-resourced, developed settings. Adherence to the schedule of intramuscular penicillin injections used to manage ARF has been reported as difficult due to the painful nature of the injections, the long timeframes of the prescription, young age of patients, access problems and costs in some locations. This Clinical Case Report reports on the use of clonidine for reducing pain-related distress and facilitating adherence to the penicillin regimen.

The findings of this multi-centered, mixed-method study suggest that physicians should be aware of the possible disconnection between their patients' perceived and actual blood pressure control. Knowledge gaps, intolerance of adverse events, negligence, unmet individual preferences, financial barriers and overtreatment of hypertension are among the identified barriers.

The adoption of adequate oral hygiene practices is important for the maintenance of good oral health in children. This study examined rural–urban differences and associated sociodemographic factors in oral hygiene practices in Peruvian children under twelve years of age.

Recurrent injurious falls are common among the elderly in tribal areas of eastern India. Along with the incidence of unintentional injurious falls, this study also reports on the factors responsible. The findings suggest that proper nutrition and regular check-ups and rehabilitative measures are needed to reduce the frequency of recurrent falls.

Retaining the health workforce in rural areas is a global problem. Job dissatisfaction or work-related distress are among the factors that drive doctors to leave rural places. Resilience has been recognised as a key component of well-being and is associated with better satisfaction with life. This study examined the association between rural doctors’ personal resilience and the duration of rural practice.

Diarrheal diseases are a significant cause of morbidity among school-aged children due to inadequate sanitation, lack of access to potable water and poor hygiene practices. This study compares the prevalence and associated factors of diarrheal diseases in school-aged children between schools in Habru District, northeast Ethiopia that have adopted water, sanitation and hygiene interventions and those that have not.

Access to essential medicines is a human right and an objective of the National Medicines Policy in Australia. In remote Australia, registered nurses may find themselves responsible for a broader range of activities in the medication management cycle than they would be elsewhere in the nation. This study examines national legislation and regulations concerning the use of medications from a nursing perspective, focusing on the context of health service delivery in remote areas.

This cross-sectional descriptive study examined differences between rural and urban areas in unpaid caregiver burden. It leveraged nationally representative survey data in the United States to examine differences in financial, emotional and physical burden and caregiver health status.

This study explored factors that contributed to sustainability of a program that facilitates access to resources and provides social support to older persons living in community with serious illness. Using the i-PARIHS (integrated Promoting Action on Research Implementation in Health Services) framework, this study identified key factors for facilitating sustainability of this rural community intervention for older adults.

Green Beacons are used by many doctors across the United Kingdom to alert other road users to the doctor’s urgent need to reach a destination when responding to emergencies, particularly in rural areas. While such warning lights have been used for many years, there is a paucity of research into the safety and efficacy of their use. This pilot study explores whether the use of Green Beacons does lead to reduced response times in rural areas.

Despite the aging population in Brazil, little is known about the occurrence of functional dependency in rural older adults. This cross-sectional study estimated a high prevalence of functional dependency among community-dwelling older adults in a rural area in Rio Grande do Sul state, Brazil.