Journal articles on the topic 'Rural clinical health'

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1

Playford, Denese E., and Edwina Cheong. "Rural Undergraduate Support and Coordination, Rural Clinical School, and Rural Australian Medical Undergraduate Scholarship: rural undergraduate initiatives and subsequent rural medical workforce." Australian Health Review 36, no. 3 (2012): 301. http://dx.doi.org/10.1071/ah11072.

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Background. This study examined postgraduate work after an undergraduate clinical year spent in the Rural Clinical School of Western Australia (RCSWA), compared with 6 weeks Rural Undergraduate Support and Coordination (RUSC)-funded rural experience in a 6-year undergraduate medical course. Rural background, sex and Rural Australian Medical Undergraduate Scholarship (RAMUS)-holding were taken into account. Methods. University of Western Australia undergraduate data were linked by hand with postgraduate placements to provide a comprehensive dataset on the rural exposure history of junior medical practitioners working in Western Australia between 2004 and 2007. Results. Participation in the RCSWA program was associated with significantly more postgraduate year one rural work than RUSC placement alone (OR = 1.5, CI 0.97–2.38). The RCSWA workforce effect increased at postgraduate year two (OR = 3.0, CI 1.6484 to 5.5935 relative to RUSC). Rural-origin practitioners who chose the RCSWA program were more likely than other rural-origin practitioners to take rural rotations in both postgraduate years. RAMUS holders’ choice in relation to the RCSWA program predicted later rural work. There were no effects of sex. Conclusions. Rural initiatives, in particular the Rural Clinical School program, are associated with postgraduate rural choices. The real impact of these data rely on the translation of early postgraduate choices into long-term work commitments. What is known about the topic? Specific training of rural graduates is strongly related to subsequent rural workforce. In addition, rural educational placements affect medical students’ intentions to practise rurally. Retrospective data from rural relative to urban general practitioners link rural background, rural undergraduate experience and rural postgraduate experience with rural work. What does this paper add? Much of the Australian prospective outcomes research has looked at workforce intentions of graduates, or the workforce outcomes of small graduate cohorts of Rural Clinical Schools. This paper followed nearly 500 graduates by name through to their PGY1 and PGY2 workforce decisions. As this cohort comprised 80% of three completely graduated MBBS years, these data validly represent the outcome of a medical school which is comparable to all Australian medical schools in its RUSC, Rural Clinical School and RAMUS recipients. The paper provides the first peer-reviewed outcomes data for the RAMUS scholarship program. What are the implications for practitioners? Rural supervision of medical students is an effective way to recruit new workforce. The longer students are supervised in rural settings, the better. But undergraduate programs need to be linked with postgraduate initiatives that take graduates of medical student initiatives into vocational programs able to deliver a trained rural workforce.
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Smock, Sara A., Lenore M. McWey, and David B. Ward. "Rural versus Urban Clinical Needs." Journal of Family Psychotherapy 17, no. 2 (May 18, 2006): 37–49. http://dx.doi.org/10.1300/j085v17n02_03.

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Hays, Richard B. "CLINICAL PRIVILEGES FOR RURAL GENERAL PRACTITIONERS." Australian Journal of Rural Health 5, no. 2 (May 1997): 94–96. http://dx.doi.org/10.1111/j.1440-1584.1997.tb00246.x.

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Kumar, Anil. "National Institute of Rural Health for India: Need of the Hour." Epidemiology International 05, no. 04 (November 20, 2020): 12–15. http://dx.doi.org/10.24321/2455.7048.202026.

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India being predominantly a rural country, striving hard to provide quality healthcare services to more than 890 million people who lives there. The importance given to rural health care by Govt. of India is visible through the implementation of dedicated submission under NHM, i.e., NRHM. However, there are still several rural health challenges, i.e., specific needs, belief/ superstition, scarcity of human resources in rural areas, lack of quality research/ coordination and collaboration between various sectors. The possible solutions to these challenges lie in strengthening research in rural health epidemiology, agricultural health, enhancing use of Information Technology & Telemedicine, designing specific clinical services, field practices, applying the biostatistics & mathematical modelling in decision making and mentoring the human resources in specific need of rural health. This article is an attempt to elucidate various rural health challenges and need for development of National Institute of Rural Health in India, to address the challenges of rural health and conduct before mentioned activities as an apex body.
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Harding, Catherine, and Louis Pilotto. "Rural student doctors top city colleagues: Representation of a rural clinical school in the rural press." Australian Journal of Rural Health 18, no. 4 (August 2, 2010): 143–47. http://dx.doi.org/10.1111/j.1440-1584.2010.01147.x.

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Alexander, Jeffrey A., Michael A. Morrisey, Lawton R. Burns, and Victoria Johnson. "Physician and Clinical Integration Among Rural Hospitals." Journal of Rural Health 14, no. 4 (September 1998): 312–26. http://dx.doi.org/10.1111/j.1748-0361.1998.tb00637.x.

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Lyle, David, and Jennene Greenhill. "Two decades of building capacity in rural health education, training and research in Australia: University Departments of Rural Health and Rural Clinical Schools." Australian Journal of Rural Health 26, no. 5 (October 2018): 314–22. http://dx.doi.org/10.1111/ajr.12470.

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8

Rosina, Robyn, Jean Starling, Kenneth Nunn, David Dossetor, and Kim Bridgland. "Telenursing: Clinical nurse consultancy for rural paediatric nurses." Journal of Telemedicine and Telecare 8, no. 3_suppl (December 2002): 48–49. http://dx.doi.org/10.1258/13576330260440844.

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summary Videoconferencing is increasingly being accepted as a medium for health-care. Telenursing is in its infancy in Australia but has enormous potential for nursing care in remote areas. The Child and Adolescent Psychological Telemedicine Outreach Service (CAPTOS) began in 1997 and in its first evaluation recommended more support for paediatric nurses. CAPTOS telenursing began as a new initiative in late 2001. The telenursing project aims to link ward nurses to CAPTOS and local community teams, and to provide both clinical consultancy on nursing and interdisciplinary issues and locally based professional development. Telenursing supports nurses via site visits, videoconferencing sessions, an interactive Website and sabbatical opportunities. Telehealth works with existing services to enhance the nursing care of young people with a complex mixture of psychological and physical health problems.
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Hale, Nathan L., Tamar Klaiman, Kate E. Beatty, and Michael B. Meit. "Local Health Departments as Clinical Safety Net in Rural Communities." American Journal of Preventive Medicine 51, no. 5 (November 2016): 706–13. http://dx.doi.org/10.1016/j.amepre.2016.05.012.

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Sokhi, Arveen, Priti Agarwal, Megha Maheshwari, and Anita Chakravarti. "Detection of Klebsiella pneumoniae Carbapenemase (KPC) Producing Enterobacteriaceae Isolates from Various Clinical Samples in a Rural Health Setup." Journal of Pure and Applied Microbiology 14, no. 1 (March 31, 2020): 397–401. http://dx.doi.org/10.22207/jpam.14.1.41.

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Pourat, Nadereh, Xiao Chen, Connie Lu, Weihao Zhou, Hank Hoang, and Alek Sripipatana. "Assessing clinical quality performance and staffing capacity differences between urban and rural Health Resources and Services Administration-funded health centers in the United States: A cross sectional study." PLOS ONE 15, no. 12 (December 8, 2020): e0242844. http://dx.doi.org/10.1371/journal.pone.0242844.

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Background In the United States, there are nearly 1,400 Health Resources and Services Administration-funded health centers (HCs) serving low-income and underserved populations and more than 600 of these HCs are located in rural areas. Disparities in quality of medical care in urban vs. rural areas exist but data on such differences between urban and rural HCs is limited in the literature. We examined whether urban and rural HCs differed in their performance on clinical quality measures before and after controlling for patient, organizational, and contextual characteristics. Methods and findings We used the 2017 Uniform Data System to examine performance on clinical quality measures between urban and rural HCs (n = 1,373). We used generalized linear regression models with the logit link function and binomial distribution, controlling for confounding factors. After adjusting for potential confounders, we found on par performance between urban and rural HCs in all but one clinical quality measure. Rural HCs had lower rates of linking patients newly diagnosed with HIV to care (74% [95% CI: 69%, 80%] vs. 83% [95% CI: 80%, 86%]). We identified control variables that systematically accounted for eliminating urban vs. rural differences in performance on clinical quality measures. We also found that both urban and rural HCs had some clinical quality performance measures that were lower than available national benchmarks. Main limitations included potential discrepancy of urban or rural designation across all HC sites within a HC organization. Conclusions Findings highlight HCs’ contributions in addressing rural disparities in quality of care and identify opportunities for improvement. Performance in both rural and urban HCs may be improved by supporting programs that increase the availability of providers, training, and provision of technical resources.
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Borgos, Jill C. "Navigating public health clinical placements for rural online RN-BSN students." Online Journal of Rural Nursing and Health Care 21, no. 1 (May 4, 2021): 118–30. http://dx.doi.org/10.14574/ojrnhc.v21i1.664.

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Purpose: In rural settings scare public health resources potentially limits the opportunities for nursing students living in these areas to participate in traditional one to one precepted experiences with public health agencies. To meet the revised Commission on Collegiate Nursing Education Standards related to direct clinical practice, creative strategies are needed for online degree seeking RN-BSN students who live in rural areas. This article explores an alternative learning experience by partnering students with a nonprofit healthcare institute to work on state health initiatives in the geographic region where the students reside. Process: In the absence of adequate opportunities for one to one precepted clinical experiences, student living in rural areas completing an online RN-BS program were partnered with a non-profit health organization. The students participate in an experiential learning experience to fulfill clinical hours in a public health setting as required by the Commission on Collegiate Nursing Education. In this case a cohort of students worked with a nonprofit healthcare institute on New York State’s T-21 campaign to further advance their knowledge on health initiatives driven by state health reform policy and actively participate community-based education. Conclusion: With a growing focus on population-based care and caring for vulnerable populations, particularly in rural areas, seeking clinical activities through partnerships with non-profit healthcare institute to improve health outcomes at the community level offers an alternative approach to engaging online degree seeking RN-BSN students in experiential clinical learning in communities with limited public health agency placements. Keywords: interprofessional learning, nursing accreditation, rural nursing students, service-learning pedagogy DOI: https://doi.org/10.14574/ojrnhc.v21i1.664
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13

Beatty, Kate, Megan Heffernan, Nathan Hale, and Michael Meit. "Funding and Service Delivery in Rural and Urban Local US Health Departments in 2010 and 2016." American Journal of Public Health 110, no. 9 (September 2020): 1293–99. http://dx.doi.org/10.2105/ajph.2020.305757.

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Objectives. To investigate differences in funding and service delivery between rural and urban local health departments (LHDs) in the United States. Methods. In this repeated cross-sectional study, we examined rural–urban differences in funding and service provision among LHDs over time using 2010 and 2016 National Association of County and City Health Officials data. Results. Local revenue among urban LHDs (41.2%) was higher than that in large rural (31.3%) and small rural LHDs (31.2%; P < .05). Small (20.9%) and large rural LHDs (19.8%) reported greater reliance on revenue from Center for Medicare and Medicaid Services than urban LHDs (11.5%; P < .05). All experienced decreases in clinical revenue between 2010 and 2016. Urban LHDs provided less primary care services in 2016; rural LHDs provided more mental health and substance abuse services (P < .05). Conclusions. Urban LHDs generated more revenues from local sources, and rural LHDs generated more from the Center for Medicare and Medicaid Services and clinical services. Rural LHDs tended to provide more clinical services. Given rural LHDs’ reliance on clinical revenue, decreases in clinical services could have disproportionate effects on them. Public Health Implications. Differences in financing and service delivery by rurality have an impact on the communities. Rural LHDs rely more heavily on state and federal dollars, which are vulnerable to changes in state and national health policy.
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Gutter, Michael S., LaToya J. O’Neal, Roberta Riportella, Laura Sugarwala, John Mathias, Melissa J. Vilaro, Samantha R. Paige, et al. "Promoting community health collaboration between CTSA programs and Cooperative Extension to advance rural health equity: Insights from a national Un-Meeting." Journal of Clinical and Translational Science 4, no. 5 (February 13, 2020): 377–83. http://dx.doi.org/10.1017/cts.2020.13.

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AbstractAddressing rural health disparities has unique challenges that require cross-sector collaborations to address social determinants of health and help those in need to get connected to care continuum. We brought the Clinical and Translational Science Award, Institutional Development Award Program Infrastructure for Clinical and Translational Research, and Cooperative Extension System Programs together for a one-day semi-structured meeting to discuss collaborative opportunities to address rural health disparities. Session notes and event materials were analyzed for themes to facilitate collaboration such as defining rural, critical issues, and organizational strengths in support of collaboration. Across 16 sessions, there were 26 broad topics of discussion. The most frequent topics included “barriers and challenges,” “strategies and opportunities,” and “defining rural.” There is a growing understanding of the opportunity that collaboration between these large programs provides in addressing rural health disparities.
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TROLLOR, JOHN. "Clinical focus: rural general practitioners and palliative care." Australian Journal of Rural Health 1, no. 4 (August 1993): 23–29. http://dx.doi.org/10.1111/j.1440-1584.1993.tb00083.x.

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16

Gautham, Meenakshi, M. Sriram Iyengar, and Craig W. Johnson. "Mobile phone–based clinical guidance for rural health providers in India." Health Informatics Journal 21, no. 4 (March 12, 2014): 253–66. http://dx.doi.org/10.1177/1460458214523153.

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Ruston, Sally A. "Extended scope practitioners and clinical specialists: A place in rural health?" Australian Journal of Rural Health 16, no. 3 (June 2008): 120–23. http://dx.doi.org/10.1111/j.1440-1584.2008.00962.x.

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Robinson, Tracy, Heidi Kurtz, Brian Kelly, Jeffrey Fuller, Lyn Fragar, Samit Roy, Kim Deans, Jenny Croft, and Brendon Hedger. "Clinical leadership in rural psychiatry: Farmers' mental health and well-being." Australian Journal of Rural Health 17, no. 5 (October 2009): 284–85. http://dx.doi.org/10.1111/j.1440-1584.2009.01093.x.

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Briggs, B., C. Jain, Miriam C Morey, E. H. Blanchard, C. C. Lee, W. Marcos Valencia, and K. K. Oursler. "PROVIDING RURAL VETERANS ACCESS TO GEROFIT THROUGH CLINICAL VIDEO TELE-HEALTH." Innovation in Aging 2, suppl_1 (November 1, 2018): 3. http://dx.doi.org/10.1093/geroni/igy023.008.

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20

Greiner, Doris S., Doris F. Glick, Pamela A. Kulbok, and Emma McKim Mitchell. "Rural Health Nursing Research Review: Global Perspectives." Annual Review of Nursing Research 26, no. 1 (January 2008): 261–94. http://dx.doi.org/10.1891/0739-6686.26.1.261.

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The CINAHL and MEDLINE databases were used to conduct a review of international rural nursing research published between 2003 and 2007. In total, 41 articles were reviewed and organized based on the United Nations Human development Index, which categorizes countries based on development status. Critical review of international rural nursing research yielded three major organizational themes: clinical issues, aspects of nursing practice, and nursing and health policy research. Despite the variety in international locale of the research, these themes and other common findings emerged. The need for increased access to specialized nursing knowledge, resources, and support is an ongoing issue facing nurses in rural and remote settings.
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Hall, Lisa. "Navigating the Rural Clinical Education Pathway in the Time of a Pandemic: Opportunities and Challenges." Australian and International Journal of Rural Education 31, no. 1 (March 24, 2021): 76–92. http://dx.doi.org/10.47381/aijre.v31i1.294.

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The outbreak of the COVID-19 pandemic has changed everything about the world we live in, in 2020. It is having obvious impacts on the way we teach and the way we learn. In Victoria, Monash Rural Health Bendigo is one of the few places that has managed to continue clinical health education and clinical placements throughout 2020 - albeit in modified forms. Monash Rural Health Bendigo provides clinical years education to a cohort of between 100 and 130 Third, Fourth- and Fifth-Year Monash Medical students in a rural setting. It is largely an 'apprentice based' model of learning where the students get access to rural clinical sites and rural health experts as well as a state-of-the-art clinical skills and simulation lab to undertake the clinical years of their medical degree. But what happens to this kind of model during a pandemic induced shut down such as was experienced in 2020? This paper explores the challenges but also opportunities for students pursuing a rural health pathway in the midst of a public health emergency. It examines the findings of the COVID-19 Educational Evaluation conducted in Bendigo throughout 2020 and reveals the advantages but also the unanticipated consequences of students choosing to study rurally in the midst of a global pandemic.
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Thomas, Tami L., Michelle Caldera, and Derrick Glymph. "Collaboration, culture and communication: Preparing the next generation to provide rural primary health care." Journal of Nursing Education and Practice 11, no. 6 (February 28, 2021): 50. http://dx.doi.org/10.5430/jnep.v11n6p50.

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Background and objective: In an ever-changing landscape of health care needs and demands, the ability to provide care for rural communities is often overwhelming. Rural health care in a new decade demands targeted programs to improve recruitment, training, and sustained employment of primary care providers. This project served to address rural primary healthcare needs by the development of a project model to recruit, train, educate and evaluate Advanced Practice Registered Nurse students (APRN) students who were rigorously selected for a rural traineeship and practiced in rural counties. The evaluation of preceptors was also done to assist in retention and increased numbers of rural preceptors and clinical sites. This program was designed collaboratively and implemented with rural community partners and rural healthcare leaders.Methods: Graduate nursing students completed both a paper application and in person interviews to be selected for a rigorous 16-week clinical traineeship in the rural communities. Qualitative data were collected during interview and feedback sessions during their traineeship. Quantitative Data were collected on Process and Outcome Measures focused on learning objectives during their rural traineeship. These data were analyzed and evaluated to measure the effectiveness of program goals, outcomes, and sustainability of the program. Results and conclusions: The results support the structured process for selecting graduate students and with an innovative program design focused on rural culture and accessing resources for patients in these same rural areas. Both students and preceptors had improved performance and satisfaction over time. The results provide a road map to recreate programs with high clinical impact and increasing numbers of rural healthcare providers. Current follow-up data with APRN post program completion demonstrated increase in employment within rural areas post-graduation.
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Asril, Nice Maylani, Keiji Tabuchi, Miwako Tsunematsu, Toshio Kobayashi, and Masayuki Kakehashi. "Predicting Healthy Lifestyle Behaviours Among Patients With Type 2 Diabetes in Rural Bali, Indonesia." Clinical Medicine Insights: Endocrinology and Diabetes 13 (January 2020): 117955142091585. http://dx.doi.org/10.1177/1179551420915856.

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Background: Type 2 diabetes is a lifelong metabolic disease closely related to unhealthy lifestyle behaviours. This study aimed to identify factors explaining the healthy lifestyle behaviours of patients with type 2 diabetes in rural Indonesia. The extended health belief model, demographic characteristics, clinical lifestyle factors and diabetes knowledge were investigated to provide a complete description of these behaviours. Method: A sample of 203 patients with type 2 diabetes representing a cross-section of the population were recruited from community health centres in the rural areas of Bali province. The data were collected through questionnaires. Descriptive statistics and a hierarchical regression test were employed. Results: This study showed demographic characteristics, clinical and lifestyle factors, diabetes knowledge and the extended health belief model accounted for 71.8% of the variance in healthy lifestyle behaviours of patients with type 2 diabetes in rural Indonesia. The significant demographic factors were age, education level, employment status and traditional beliefs. The significant clinical and lifestyle factors were alcohol use, diabetic medicine and duration of symptoms. Finally, the significant extended health belief model factors were perceived severity, susceptibility, barriers, family support, bonding social capital and chance locus of control. Conclusions: The extended health belief model forms an adequate model for predicting healthy lifestyle behaviours among patients with diabetes in rural Indonesia. The contribution of this model should be strengthened in developing the diabetes management.
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Moore, J., A. Seixas, G. Casimir, J. Nunes, F. Matadiaby, A. Khosrof, and G. Jean-Louis. "1114 Urbanicity And The Sleep-mental Health Relationship." Sleep 43, Supplement_1 (April 2020): A423—A424. http://dx.doi.org/10.1093/sleep/zsaa056.1109.

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Abstract Introduction Inadequate sleep has been found to be associated with poor mental health. This is especially true in low-income and minority populations, who are concentrated in cities. It is not understood to what degree living in a city vs. a rural environment affects sleep and resulting mental health outcomes. This study seeks to understand how living in an urban environment affects the relationship between inadequate sleep and mental health. Methods The study used data from the 2018 US Behavioral Risk Factor Surveillance System (BRFSS,) a nationwide health dataset collected by telephone. Respondents were classified as living in either an urban or rural environment based on their zip code. Respondents reported hours of sleep per night and mental health status. This study classified mental health status based on whether the respondent reported one or more incidences of poor mental health in the previous 30 days. Results After filtration, 348,540 respondents were split into urban and rural groups. Binary logistic regression was run in each group to compare how much living in an urban environment contributed to the relationship between sleep duration and mental health. Sleep in the analysis was found to significantly contribute to both models; urban X2(15, N=295,796) = 11,485.70, p &lt;0.001 rural X2(15, N=52,744) = 2,465.64, p &lt;0.001. The estimated odds ratio resulted in a decrease of 13.9% [Exp(B) = 0.861] in reported poor mental health for every unit increase of sleep in the urban population, and decrease of 14.9% [Exp(B) = 0.851] in the rural population. Conclusion In urban and rural dwellers, sleep duration predicted poor mental health. Contrary to expectations, sleep was more strongly tied to mental health in rural than urban populations. This was true even after controlling for sex, income, and education level. Further research should seek to understand how environment affects sleep and mental health. Support This study was supported by funding from the NIH: R01MD007716, R01HL142066, R01AG056531, K01HL135452, and K07AG052685.
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Elliott-Schmidt, Rachael, and Jenny Strong. "RURAL OCCUPATIONAL THERAPY PRACTICE: A SURVEY OF RURAL PRACTICE AND CLINICAL SUPERVISION IN RURAL QUEENSLAND AND NORTHERN NEW SOUTH WALES." Australian Journal of Rural Health 3, no. 3 (August 1995): 122–31. http://dx.doi.org/10.1111/j.1440-1584.1995.tb00164.x.

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., Fakharunissa, Aniqa Shahid, Qamarunissa Muhabat, and Madiha Afzal. "Effectiveness of Pregnancy Awareness and its Outcomes in Women of Rural Areas of Pakistan, A Clinical Based Study." Pakistan Journal of Medical and Health Sciences 16, no. 3 (March 31, 2022): 465–67. http://dx.doi.org/10.53350/pjmhs22163465.

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The aims and objectives of current study were to assess the level of awareness of pregnancy health and its outcomes among women of rural areas. In group-A, group-B and group-C the percentage of ultrasound sonography test and folic acid levels of pregnant women were showed a significant (P<0.05) changes. Similarly On evaluating the other parameters such as vaginal bleeding, abdominal pain, and pregnancy induced hypertension, gestational diabetes, gestational anemia, Hepatitis B & C, Acquired immunodeficiency syndrome (AIDS) regarding percentage standard mean deviation in different groups the results are significant(P<0.05) and remarkable changes were calculated. It was concluded in this study that public health facilities with proper heath awareness programs and increased in qualification of rural women is required for better healthy mother and child. Keywords: Pregnancy awareness, pregnancy induced hypertension, Gestational diabetes, Gestational anemia
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Martin, Priya, Katherine Baldock, Saravana Kumar, and Lucylynn Lizarondo. "Factors that contribute to high-quality clinical supervision of the rural allied health workforce: lessons from the coalface." Australian Health Review 43, no. 6 (2019): 682. http://dx.doi.org/10.1071/ah17258.

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Objective The aim of this study was to identify the factors contributing to high-quality clinical supervision of the allied health workforce in rural and remote settings. Methods This quantitative study was part of a broader project that used a mixed-methods sequential explanatory design. Participants were 159 allied health professionals from two Australian states. Quantitative data were collected using an online customised survey and the Manchester Clinical Supervision Scale (MCSS-26). Data were analysed using regression analyses. Results Supervisee’s work setting and choice of supervisor were found to have a positive and significant influence on clinical supervision quality. Supervisee profession and time in work role were found to have a negative and significant influence on the quality of clinical supervision. Conclusions High-quality clinical supervision is essential to achieve quality and safety of health care, as well as to support the health workforce. Information on high-quality clinical supervision identified in this study can be applied to clinical supervision practices in rural and remote settings, and to professional support policies and training to enhance the quality of supervision. What is known about the topic? There is mounting evidence on the benefits of clinical supervision to health professionals, organisations and patients. Clinical supervision enhances recruitment and retention of the health workforce. However, there are still gaps regarding the factors that contribute to high-quality clinical supervision, especially for rural and remote health professionals. What does this paper add? This study, the first of its kind, recruited rural and remote health professionals from seven allied health disciplines across two Australian states. It investigated the factors that influence high-quality clinical supervision in this under-resourced group. This paper outlines specific factors that contribute to clinical supervision quality for rural and remote allied health professionals. What are the implications for practitioners? Effective and high-quality clinical supervision of the rural and remote allied health workforce can enhance recruitment and retention in those areas. Healthcare organisations can facilitate effective clinical supervision delivery by using the evidence gathered in this study in clinical supervision policy, training and practice.
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Larnaout, Amine, Rahma Nefzi, Amina Aissa, Rouaa Trabelsi, Emira Khelifa, Hanen Ben Ammar, and Zouhaier El Hechmi. "T124. CLINICAL DIFFERENCES BETWEEN URBAN AND RURAL SCHIZOPHRENIA." Schizophrenia Bulletin 44, suppl_1 (April 1, 2018): S163—S164. http://dx.doi.org/10.1093/schbul/sby016.400.

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Eggleton, Kyle, Andy Wearn, and Felicity Goodyear-Smith. "Determining rural learning outcomes for medical student placements using a consensus process with rural clinical teachers." Education for Primary Care 31, no. 1 (December 29, 2019): 24–31. http://dx.doi.org/10.1080/14739879.2019.1705921.

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Irving, Michelle, Rosemary Stewart, Heiko Spallek, and Anthony Blinkhorn. "Using teledentistry in clinical practice as an enabler to improve access to clinical care: A qualitative systematic review." Journal of Telemedicine and Telecare 24, no. 3 (January 16, 2017): 129–46. http://dx.doi.org/10.1177/1357633x16686776.

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Background Access to dental care is important for overall health, but can remain problematic for those in rural or isolated locations. It can be difficult to encourage clinicians to choose or continue a rural health career. Teledentistry is showing some promise as a strategy to support rural, isolated and new health care workers. This study aims to explore the quantitative and qualitative framework associated with teledentistry in an effort to uncover the interaction of multiple influences on its delivery and sustainability. Methods A systematic search of the literature was undertaken and studies were included if they evaluated consultative teledentistry, reports on implementation of teledentistry in practice or attitudes to teledentistry. Studies were evaluated qualitatively. Results Thirty-nine studies were included focusing on the accuracy, effectiveness or description a teledentistry project in practice. Five main themes were identified in the qualitative analysis: (1) using information and communication technology (ICT), (2) regulatory and system improvements, (3) accuracy of teledentistry, (4) effectiveness, including increasing access to clinical services, efficiencies and acceptability, and (5) building and increasing clinical capacity of the dental workforce. Conclusion Teledentistry provides a viable option for remote screening, diagnosis, consultation, treatment planning and mentoring in the field of dentistry. Rapidly developing information and communication technologies have increasingly shown improving cost effectiveness, accuracy and efficient remote assistance for clinicians. There is high acceptability for teledentistry amongst clinicians and patients alike. Remuneration of advising clinicians is critical to sustainability.
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Ohta, Ryuichi, and Chiaki Sano. "Reflection in Rural Family Medicine Education." International Journal of Environmental Research and Public Health 19, no. 9 (April 23, 2022): 5137. http://dx.doi.org/10.3390/ijerph19095137.

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Reflection in medical education is vital for students’ development as professionals. The lack of medical educators in rural family medicine can impinge on the effective reflection of residents’ learning. Hence, based on qualitative research, we proposed a framework regarding reflection in rural family medicine education, indicating when, where, and how reflection is performed and progresses. The contents of reflection include clinical issues regarding knowledge and skills, professionalism in clinical decisions, and work-life balance. The settings of reflection include conference rooms, clinical wards, residents’ desks, and hospital hallways. The timing of educational reflection includes during and after patient examination and discussion with various professionals, before finishing work, and during “doorknob” times (right before going back home). Rural medical teachers need competence as clinicians and medical educators to promote learning in medical residents and sustain rural medical care. Furthermore, medical teachers must communicate and collaborate with medical residents and nurses for educational reflection to take place in rural family medicine education, especially regarding professionalism. In rural family medicine education, reflection can be performed in various clinical situations through collaboration with learners and various medical professionals, aiding the enrichment of residents’ learning and sustainability of rural medical care.
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Peritogiannis, Vaios, and Charalampos Lixouriotis. "Mental Health Care Delivery for Older Adults in Rural Greece: Unmet Needs." Journal of Neurosciences in Rural Practice 10, no. 04 (October 2019): 721–24. http://dx.doi.org/10.1055/s-0039-3399603.

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AbstractMental disorders may go unrecognized and undertreated in older adults. This is the rationale for the launch of specialized mental health services for the elderly in high resourced settings. Rural areas, however, do not receive adequate mental health care owing to socioeconomic and geographical reasons, and this is the case of rural Greece, where research on mental health of the elderly is scarce. This article discusses the challenges of providing mental health care for older adults in rural Greece and the available options. Care can be delivered through the existing rural mental health services that are the mobile mental health units and through the primary care physicians. Training in psychogeriatrics for the personnel of the former and in mental health for the latter is warranted.
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Paudel, Shreedhar, Nadege Gilles, Sigrid Hahn, Braden Hexom, Ramaswamy Premkumar, Shobha Arole, and Craig Katz. "Impact of Mental Health Training on Village Health Workers Regarding Clinical Depression in Rural India." Community Mental Health Journal 50, no. 4 (June 12, 2013): 480–86. http://dx.doi.org/10.1007/s10597-013-9630-6.

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34

Yunus, F., W. Teresa, M. Jahanzeb, F. Karen, S. Minhaus, R. Yunus, P. Sydow, M. Merkel, R. Kersey, and S. Gray. "Technology exchange for cancer health network." Journal of Clinical Oncology 25, no. 18_suppl (June 20, 2007): 19598. http://dx.doi.org/10.1200/jco.2007.25.18_suppl.19598.

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19598 Background: The Technology Exchange for Cancer Health Network (TECH-Net) is a collaborative, multi-state effort to implement a systematic care program to improve cancer management in the rural communities of west Tennessee, north Mississippi and east Arkansas. This Health Information Technology (HIT) project uses a two-pronged approach to total clinical decision support: (1) provide access to oncology, hematology, and other specialists through the dedicated telehealth network of the University of Tennessee's Health Science Center in conjunction with the University of Tennessee Cancer Institute; and (2) rely on a distributed electronic health record (EHR) with integrated decision support systems for online management of cancer protocols, electronic orders, and medication management. Methods: Patients with a cancer diagnosis requiring treatment for at least one year are eligible to participate. The ultimate goal for this project is to enroll 250 patients (125 rural, 125 urban) and compare quality, safety, and cost outcomes for patients receiving rural Telehealth care versus “routine” urban care. Telehealth patients see their oncologist in person at the rural sites for initial care, and see their physician via telemedicine for approximately one-half of their subsequent visits. This approach allows the clinician to make in-person clinical assessments on a regular basis while still taking advantage of the time savings associated with telemedicine. Results: 163 patients have been enrolled in the study (127 rural, 36 urban) over 18 months. Patient satisfaction has been high - 95 % of patients indicated their telemedicine visit was as good as or better than an in-person office visit. Cost analysis comparing cost savings (physician travel time) with telemedicine costs (equipment, high speed lines) indicates that the cost-benefit depends critically on distance to the rural facility and number of physician trips avoided. Initial cost data indicate that telemedicine must save at least 5 hours of physician travel time per month to break even. Conclusions: Telemedicine offers a feasible method for increasing access to oncology care in rural areas that is well-accepted by both patients and clinicians. No significant financial relationships to disclose.
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Bonnell, Levi N., Jessica Clifton, Gail L. Rose, Elizabeth N. Waddell, and Benjamin Littenberg. "Urban–Rural Differences in Mental and Physical Health among Primary Care Patients with Multiple Chronic Conditions: A Secondary Analysis from a Randomized Clinical Trial." International Journal of Environmental Research and Public Health 19, no. 23 (November 24, 2022): 15580. http://dx.doi.org/10.3390/ijerph192315580.

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Purpose: Rural health disparities are largely attributable to access to healthcare, socioeconomic status, and health behaviors. Little is known about the persistence of these disparities when differences in access to care are eliminated. We sought to investigate urban–rural differences in physical and mental health in primary care patients with demonstrated access to primary care. Methods: We obtained cross-sectional survey responses from a multicenter randomized controlled trial on 2726 adult primary care patients with multiple chronic medical or behavioral conditions from 42 primary care practices in 13 states. Study outcomes include measures of mental health including: The Patient-Reported Outcomes Measurement Information System (PROMIS-29®), General Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9), as well as physical health including: the PROMIS-29® and the Duke Activity Status Index (DASI). Urban–rural residence was indicated by census-tract Rural Urban Commuting Areas of the participant’s home address. Differences in mental and physical health outcomes attributable to rurality were assessed using multilevel models with a random intercept for census-tract. Results: After adjustment for demographic and neighborhood characteristics, urban residents had significantly worse generalized anxiety disorder (GAD-7) (ß = 0.7; 95% CI = 0.1, 1.3; p = 0.027), depression (PHQ-9) (ß = 0.7; 95% CI = 0.1, 1.4; p = 0.024), and functional capacity (DASI) (ß = −0.4; 95% CI = −0.5, −0.2; p < 0.001) compared to rural residents. Urban residents also had significantly worse anxiety and depression as measured by the PROMIS-29® compared to their rural counterparts. There were no urban–rural differences in the other PROMIS-29® subdomains. Conclusions: Among adults with demonstrated access to care and multiple diagnosed chronic conditions, rural residents had better mental health and functional capacity than their urban counterparts. This finding is not consistent with prior research documenting rural health disparities and should be confirmed.
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Peritogiannis, Vaios, Aglaia Roganaki, Eleftheria Siarava, and Maria Samakouri. "Mild Cognitive Impairment in Rural Areas: Research Advances and Implications for Clinical Practice and Healthcare Policy." Healthcare 10, no. 7 (July 19, 2022): 1340. http://dx.doi.org/10.3390/healthcare10071340.

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Mild cognitive or neurocognitive impairment (MCI) may be more prevalent in rural areas. Differences between rural and urban MCI patients in terms of risk factors, course and prognosis are rarely reported. The present review aims to summarize the latest research on MCI in rural areas. A literature search was performed in the databases of PubMed, Scopus and ScienceDirect for articles published over the last decade. Eleven articles were included in this review, reporting on the differences between rural and urban MCI patients. Several risk factors, such as older age, lack of activities and food insecurity have been associated with MCI in both rural and urban areas, whereas others, such as obesity, adverse childhood experiences and plasma chemokine C-C motif ligand 11 (considered as a potential negative regulator of neurogenesis), differed according to the place of residence. No specific protective factor for rural women has been reported. There is some evidence that MCI may present earlier in rural residents, but that progression to dementia may be more rapid in urban residents. It seems that there may be clinically relevant differences in the onset, course and prognosis of MCI with regards to the place of residence (urban vs rural). Those differences should be taken into account for the design of health policies and service delivery across different settings.
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Yue, John K., Pavan S. Upadhyayula, Lauro N. Avalos, Ryan R. L. Phelps, Catherine G. Suen, and Tene A. Cage. "Concussion and Mild-Traumatic Brain Injury in Rural Settings: Epidemiology and Specific Health Care Considerations." Journal of Neurosciences in Rural Practice 11, no. 01 (January 2020): 023–33. http://dx.doi.org/10.1055/s-0039-3402581.

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Abstract Background Mild-traumatic brain injury (mTBI) and concussions cause significant morbidity. To date, synthesis of specific health care disparities and gaps in care for rural mTBI/concussion patients remains needed. Methods A comprehensive literature search was performed using PubMed database for English articles with keywords “rural” and (“concussion” or “mild traumatic brain injury”) from 1991 to 2019. Eighteen articles focusing on rural epidemiology (n = 5), management/cost (n = 5), military (n = 2), and concussion prevention/return to play (n = 6) were included. Results mTBI/concussion incidence was higher in rural compared with urban areas. Compared with urban patients, rural patients were at increased risk for vehicular injuries, lifetime number of concussions, admissions for observation without neuroimaging, and injury-related costs. Rural patients were less likely to utilize ambulatory and mental health services following mTBI/concussion. Rural secondary schools had decreased access to certified personnel for concussion evaluation, and decreased use of standardized assessment instruments/neurocognitive testing. While school coaches were aware of return-to-play laws, mTBI/concussion education rates for athletes and parents were suboptimal in both settings. Rural veterans were at increased risk for postconcussive symptoms and posttraumatic stress. Telemedicine in rural/low-resource areas is an emerging tool for rapid evaluation, triage, and follow-up. Conclusions Rural patients are at unique risk for mTBI/concussions and health care costs. Barriers to care include lower socioeconomic status, longer distances to regional medical center, and decreased availability of neuroimaging and consultants. Due to socioeconomic and distance barriers, rural schools are less able to recruit personnel certified for concussion evaluation. Telemedicine is an emerging tool for remote triage and evaluation.
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Martin, Priya, Tarun Sen Gupta, Deanne Bond, John Douyere, and Katie Mills. "Rural competencies in emerging medical practitioners: Beyond clinical skills." Australian Journal of Rural Health 27, no. 5 (June 26, 2019): 427–32. http://dx.doi.org/10.1111/ajr.12531.

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39

Hays, Richard, Jan Veitch, and Alfred Lam. "Teaching clinical pathology by flexible delivery in rural sites." Australian Journal of Rural Health 13, no. 4 (August 2005): 232–35. http://dx.doi.org/10.1111/j.1440-1584.2005.00707.x.

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40

Webster, Sue, Violeta Lopez, Jane Allnut, Liesa Clague, Deborah Jones, and Paul Bennett. "Undergraduate nursing students' experiences in a rural clinical placement." Australian Journal of Rural Health 18, no. 5 (October 2010): 194–98. http://dx.doi.org/10.1111/j.1440-1584.2010.01153.x.

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41

Moffatt, Jennifer J., and Diann S. Eley. "The reported benefits of telehealth for rural Australians." Australian Health Review 34, no. 3 (2010): 276. http://dx.doi.org/10.1071/ah09794.

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Objective.A literature review was conducted to identify the reported benefits attributed to telehealth for people living and professionals working in rural and remote areas of Australia. Data sources.Scopus and relevant journals and websites were searched using the terms: telemedicine, telehealth, telepsychiatry, teledermatology, teleradiology, Australia, and each state and territory. Publications since 1998 were included. Study selection.The initial search resulted in 176 articles, which was reduced to 143 when research reporting on Australian rural, regional or remote populations was selected. Data synthesis.A narrative review was conducted using an existing ‘benefits’ framework. Patients are reported to have benefited from: lower costs and reduced inconvenience while accessing specialist health services; improved access to services and improved quality of clinical services. Health professionals are reported to have benefited from: access to continuing education and professional development; provision of enhanced local services; experiential learning, networking and collaboration. Discussion.Rural Australians have reportedly benefited from telehealth. The reported improved access and quality of clinical care available to rural Australians through telemedicine and telehealth may contribute to decreasing the urban–rural health disparities. The reported professional development opportunities and support from specialists through the use of telehealth may contribute to improved rural medical workforce recruitment and retention. What is known about the topic?An extensive international literature has reported on the efficacy of telehealth, and to a lesser extent the clinical outcomes and cost-effectiveness of telemedicine. Systematic reviews conclude that the quality of the studies preclude definitive conclusions being drawn about clinical and cost-effectiveness, although there is some evidence of effective clinical outcomes and the potential for cost-benefits. Little attention has been paid to the benefits reported for people who live in rural and remote Australia, despite this being a rationale for the use of telehealth in rural and remote locations. What does this paper add?Patients in rural and remote locations in Australia are reported to benefit from telehealth by increased access to health services and up-skilled health professionals. Health professionals are reported to benefit from telehealth by up-skilling from increased contact with specialists and increased access to professional development. The review findings suggest that one strategy, the increased use of telehealth, has the potential to reduce the inequitable access to health services and the poorer health status that many rural Australians experience, and contribute to addressing the on-going problem of the recruitment and retention of the rural health workforce. What are the implications for practitioners?The use of telehealth appears to be a path to up-skilling for rural and remote practitioners.
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42

Carney, Patricia A., Cirila Estela Vasquez Guzman, Cynthia Taylor, Debbie Cole, Joyce Hollander-Rodriguez, Tamara Rose, and Eric Wiser. "Health professional students’ observations about interprofessional collaborative practice during rural clinical rotations." Journal of Interprofessional Education & Practice 25 (December 2021): 100471. http://dx.doi.org/10.1016/j.xjep.2021.100471.

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43

HAYASHI, Masato. "Epidemiological and Clinical Studies of Lifestyle-induced Health Problems in Rural Areas." JOURNAL OF THE JAPANESE ASSOCIATION OF RURAL MEDICINE 50, no. 6 (2002): 792–811. http://dx.doi.org/10.2185/jjrm.50.792.

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44

Doty, Randle E. "Advancing the Role of Clinical Nurse Specialist in Rural Family Health Research." Clinical Nurse Specialist 11, no. 1 (January 1997): 2–5. http://dx.doi.org/10.1097/00002800-199701000-00002.

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45

Newell, Samuel D., Janet Englert, Anita Box-Taylor, Kenneth M. Davis, and Karen E. Koch. "Clinical Efficiency Tools Improve Stroke Management in a Rural Southern Health System." Stroke 29, no. 6 (June 1998): 1092–98. http://dx.doi.org/10.1161/01.str.29.6.1092.

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46

Soltis-Jarrett, Victoria. "A clinical specialist in psychiatric-mental health nursing in rural South Australia." Holistic Nursing Practice 9, no. 2 (January 1995): 30–36. http://dx.doi.org/10.1097/00004650-199501000-00006.

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47

Jelastopulu, Eleni, Evangelia Giourou, Konstantinos Argyropoulos, Eleftheria Kariori, Eleftherios Moratis, Angeliki Mestousi, and John Kyriopoulos. "Demographic and Clinical Characteristics of Patients with Dementia in Greece." Advances in Psychiatry 2014 (November 17, 2014): 1–7. http://dx.doi.org/10.1155/2014/636151.

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Introduction. Dementia’s prevalence increases due to population aging. The purpose of this study was to determine the demographic profile of Greek patients with dementia and the differences in management between the urban and rural population. Methods. A cross sectional study was carried out including 161 randomly selected specialists from different regions in Greece who filled in a structured questionnaire relating to patients with dementia, regarding various sociodemographic and clinical characteristics. Results. A total of 4580 patients (52% males) with dementia were recorded. Mean age was 73.6 years and 31% lived in rural areas. The Mini Mental Status Examination (MMSE) was used in 87% of cases. In the urban areas the diagnosis of dementia was made in an earlier stage of the disease in comparison to the rural areas (P=0.013). Higher comorbidity and a higher percentage of low education were evident in rural residents (P<0.001), while higher medication usage was observed in urban patients (P=0.04). Conclusions. The results implicate the need for improvement in health care delivery in Greek rural areas and health care professionals’ training to achieve a proper treatment of dementias and increase the quality of life among the elderly habitants of remote areas.
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48

Crowther, Martha R., and Cassandra D. Ford. "USING COMMUNITY-BASED MODELS TO PROVIDE INTEGRATED CARE FOR RURAL OLDER ADULTS." Innovation in Aging 3, Supplement_1 (November 2019): S553. http://dx.doi.org/10.1093/geroni/igz038.2038.

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Abstract Rural elders are one of the most at-risk populations for experiencing physical and mental health problems. In many rural communities, there are no psychosocial services available to meet the needs of the rural elderly. To provide rural older adults with integrated healthcare, we build upon our existing community-based infrastructure that has fostered community capacity for active engagement in clinical activities and has served as a catalyst to increase participation of rural older adults in clinical services. Our rural community model draws upon the role of culture in promoting health among rural older adults to provide rural service delivery. This model is built upon our network of partnerships with surrounding communities, including potential research participants, community-based organizations, community leaders, and community health-care systems and providers. By engaging the community we can create a sustainable system that will encourage rural older adults to utilize the health care system at a higher rate.
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Kaakinen, Pirjo, Uroš Železnik, Helvi Kyngäs, and Danica Železnik. "Self-evaluation of lifestyle and assessment of health condition by clinical measurements – A call to the rural population." Journal of Nursing Education and Practice 8, no. 11 (June 20, 2018): 30. http://dx.doi.org/10.5430/jnep.v8n11p30.

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Background: Although many people know that a healthy lifestyle prevents chronic diseases and improves the quality of life, the best way to invite people from rural areas to take part in health check-ups is still unclear. The aim of this study was to examine the lifestyle and health condition of people from the Carinthia regions in Slovenia.Methods: A cross-sectional study was conducted on 140 participants. Data were collected by questionnaire and clinical measurements and were analysed by descriptive statistical methods.Results: Most of the participants were ≥ 60 years old (62%) and 61% were women, 75% had a high BMI and 64% had elevated blood pressure. The older participants ate breakfast more often than younger participants (p = .010). There was a statistically significant connection between the number of daily hot meals and BMI (p = .026) and blood pressure (p = .049). Half of the participants (51%) drank a litre of water per day as recommended. Hiking was the most popular form of physical activity.Conclusions: The study findings recommended using a new way to call people in health check-ups in rural areas and provided information about the kind of lifestyle counselling rural people may need.
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Jayarathne, Y. G. Shamalee Wasana, Riitta Partanen, and Jules Bennet. "Objective Simulated Bush Engagement Experience (OSBEE): A novel approach to promote rural clinical workforce." Asia Pacific Scholar 6, no. 2 (May 4, 2021): 94–96. http://dx.doi.org/10.29060/taps.2021-6-2/cs2449.

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The mal-distributed Australian medical workforce continues to result in rural medical workforce shortages. In an attempt to increase rural medical workforce, the Australian Government has invested in the Rural Health Multidisciplinary Training (RHMT) program, involving 21 medical schools (RHMT program, 2020). This funding requires participating universities to ensure at least 25% of domestic students attend a year-long rural placement during their clinical years and 50% of domestic students experience a short-term rural clinical placement for at least four weeks.
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