Journal: Rural and remote health
There is little knowledge about the use of point-of-care (POC) tests among general practitioners (GPs). The aim of this study was to determine which POC tests are known and used by GPs and how they estimate the usefulness of those tests. The use of POC tests among GPs and university-associated general practitioners who teach undergraduates (GPTUs) was elucidated. Differences between GPs working in urban and rural areas were also investigated.
Evidence shows that the government of Papua New Guinea is failing to provide basic services in health to the majority of its people. Local non-government organisations (NGOs), partnered with international NGOs, are attempting to fill this gap. With limited resources, these small Indigenous organisations must focus much of their effort on training that supports self-reliance as the main strategy for communities to improve their quality of life. This project explored the training content and methodology of Touching The Untouchables (TTU), a small Indigenous NGO based in Goroka, Eastern Highlands Province, that has trained a network of village volunteers in health promotion and safe motherhood.
Village life imposes multiple demands, from self-sufficiency in food to maintaining law and order. There are established attitudes about power and dependence, referred to as ‘cargo thinking’. Cargo thinking stands as a barrier to the necessity of self-reliance, and requires training strategies that seek to empower participants to create change from their own initiative. Empowerment is understood as oriented towards individual people taking collective action to improve their circumstances by rectifying disparities in social power and control. To achieve self-reliance, empowerment is necessarily operational on the levels of person, community and society.
In addition to being operational on all three levels of empowerment, the training content and methodology adopted and developed by TTU demonstrate that empowering practice in training employs approaches to knowledge that are evidence-based, reflexive, contextual and skill-based. Creating knowledge that is reflexive and exploring knowledge about the broader context uses special kinds of communicative tools that facilitate discussion on history, society and political economy. Furthermore, training methodologies that are oriented to empowerment create settings that require the use of all three types of communication required for cooperative action: dramaturgical, normative and teleological communication.
The success of TTU’s training content and methodology demonstrates that creating the conditions for achieving collective self-reliance through empowerment is a necessary part of primary health promotion in Papua New Guinea, and that underlying the success of empowerment oriented training are definable types of knowledge and communication.
Rural healthcare resource limitations can affect the choices people make and their quality of life during its end stages. In rural regions of Australia, district nurses (DNs) working in generalist community roles provide access to care by visiting people in their homes. They may be well positioned to improve the quality of the end-of-life experience by advocating for choice and person-centred end-of-life goals; however, knowledge about care in this context is limited. Initial findings from an exploratory qualitative study describing how rural DNs are able to successfully advocate for the end-of-life choices and goals of people living at home need to be confirmed and further developed to inform clinical practice. This survey aimed to test and complement the findings from a narrative exploration of how DNs advocate successfully for the end-of-life goals of rural Australians.
For the past 50 years paramedic services and paramedic roles in high-income nations have evolved in response to changes in community needs and expectations. The aim of this article is to review paramedic models of service delivery, with an emphasis on models that have the potential to improve the health and wellbeing of frontier and remote populations.
In most Western countries occupational therapy is well established as a crucial aspect of overall health care; however, in low-middle-income countries it is still an emerging profession. This article investigates the role of occupational therapy in the Solomon Islands by examining the experiences and perceptions of occupational therapists (OTs) and other rehabilitation health workers who have worked there.
Geographic measures of accessibility can quantify inequitable distributions of health care. Although closest distance measures are often used in Aotearoa New Zealand these may not reflect patient use of health care. This research examines patterns of patient enrolment in general practitioner (GP) services from a geospatial perspective.
Introduction Foetal alcohol spectrum disorder (FASD) is a neurodevelopmental impairment that may result in individuals experiencing poor development, cognitive issues and disruptive behaviours. In Australia, the prevalence of FASD is unknown; however, two studies have revealed the prevalence of FASD in high risk populations in Western Australia. Individuals with FASD may experience higher rates of negative outcomes including poor school performance, involvement with the justice system and incarceration, substance use and are at risk of being placed in out-of-home care. Caregivers of children with FASD can experience challenges and high levels of stress due to the disruptive behaviours displayed by many children diagnosed with FASD. Whilst experiences of caregivers raising children with FASD have been documented globally, little is known about the experiences of caregivers in a remote Australian context, particularly from an Australian Aboriginal perspective. This study aimed to investigate the experiences of caregivers in a remote Australian context. The findings will be valuable to inform programs at the family, community and broader policy levels that can help enhance children’s development and wellbeing.
Recent evidence indicates that the oral health for children in Timor-Leste is deteriorating, with 40% of school children experiencing toothache during 2014. Timorese have easy access to sugar, poor food security and lack of water fluoridation, all of which exacerbate the risk of dental caries. A lack of quality epidemiological data is available to confirm anecdotal information of high caries rates in rural and remote Timor-Leste. Such data are required to inform oral health issues and health policy at both the local and national levels. This study investigated the caries status and potential risk factors among primary school children in the rural Aileu municipality of Timor-Leste. The objectives of this study were to determine caries prevalence and experience, the status (active/arrested) of existing caries lesions and associations between dental caries and potential risk factors, among primary school children in the Aileu municipality, Timor-Leste.
Australia’s National Disability Insurance Scheme (NDIS) is the catalyst for a significant shift in the delivery of disability services to people with a disability and their families, including those residing in rural and remote parts of Australia. Allied health services in rural areas of Australia are often limited, existing services are characterised as being of a generalist nature and demand for services often exceeds service capacity. This shift in the delivery of disability services with the rollout of NDIS could have a poignant impact on the rurally based allied health providers delivering these services. The aim of this study was to explore in depth the experiences of providing clinical services under the NDIS in a rural area.
Demographic changes and shifting populations mean growing numbers of older people are living alone in rural areas. General practitioner (GP) out-of-hours (GPOOH) services have an essential role in supporting older people to remain living in their own homes and communities for as long as possible, but little is known about use of GPOOH services by this cohort. This research examines how rurality impacts accessibility and utilisation of GPOOH services by people aged 65 years or more in rural Ireland.