Articles de revues : « Regional and remote health »

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Roberts, Russell. « A health commission for regional, rural and remote Australia ». Australian Journal of Rural Health 25, n^o 2 (avril 2017) : 76. http://dx.doi.org/10.1111/ajr.12356.

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Fox, Peter, et Adam Boyce. « Cancer health inequality persists in regional and remote Australia ». Medical Journal of Australia 201, n^o 8 (octobre 2014) : 445–46. http://dx.doi.org/10.5694/mja14.01217.

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Wang, Jiahu, Ming Li et Ping Lin. « Evaluation Model of Regional Comprehensive Disaster Reduction Capacity under Complex Environment ». Journal of Environmental and Public Health 2022 (5 septembre 2022) : 1–10. http://dx.doi.org/10.1155/2022/1593536.

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In order to realize the evaluation of regional comprehensive disaster reduction capacity in a complex environment, an evaluation model of regional comprehensive disaster reduction capacity in a complex environment based on remote sensing monitoring and data image feature analysis is proposed. According to the geographical location and scale of disaster spots and the parameter analysis of the model of disaster-bearing bodies around the disaster spots, the remote sensing monitoring method is adopted to extract the geographical remote sensing images of regional disaster spots in a complex environment. The collected geographical remote sensing images of regional disaster points under the complex environmental background are filtered and preprocessed, and the texture parameters of the geographical remote sensing images of regional disaster points under the complex environmental background are recognized by combining the method of image texture feature extraction. Based on the method of tone mapping, the rapid filtering and feature analysis of the geographical remote sensing images of regional disaster points under the complex environmental background are carried out, and the time, position, damage, and so on in the geographical remote sensing images of regional disaster points under the complex environmental background are analyzed. By using the method of parameter analysis and gradient operator operation, a comparison model of geographical remote sensing images of regional disaster points under the complex environmental background is established, and the reliability evaluation of regional comprehensive disaster reduction ability under the complex environmental background is realized according to the method of contrast and detail significance enhancement. The test shows that this method has high accuracy in evaluating regional comprehensive disaster reduction capability under a complex environment, high accuracy in marking the geographical location of regional disaster points under a complex environment, and good fusion performance and reliability of regional comprehensive disaster reduction capability evaluation parameters.

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Goodwin, Belinda, Arlen Rowe, Fiona Crawford-Williams, Peter Baade, Suzanne Chambers, Nicholas Ralph et Joanne Aitken. « Geographical Disparities in Screening and Cancer-Related Health Behaviour ». International Journal of Environmental Research and Public Health 17, n^o 4 (14 février 2020) : 1246. http://dx.doi.org/10.3390/ijerph17041246.

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This study aimed to identify whether cancer-related health behaviours including participation in cancer screening vary by geographic location in Australia. Data were obtained from the 2014–2015 Australian National Health Survey, a computer-assisted telephone interview that measured a range of health-related issues in a sample of randomly selected households. Chi-square tests and adjusted odds ratios from logistic regression models were computed to assess the association between residential location and cancer-related health behaviours including cancer screening participation, alcohol consumption, smoking, exercise, and fruit and vegetable intake, controlling for age, socio-economic status (SES), education, and place of birth. The findings show insufficient exercise, risky alcohol intake, meeting vegetable intake guidelines, and participation in cervical screening are more likely for those living in inner regional areas and in outer regional/remote areas compared with those living in major cities. Daily smoking and participation in prostate cancer screening were significantly higher for those living in outer regional/remote areas. While participation in cancer screening in Australia does not appear to be negatively impacted by regional or remote living, lifestyle behaviours associated with cancer incidence and mortality are poorer in regional and remote areas. Population-based interventions targeting health behaviour change may be an appropriate target for reducing geographical disparities in cancer outcomes.

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Henderson, Isabel, Karen Vanlohuizen et Ted Fenske. « Remote cardiac rehabilitation ». Journal of Telemedicine and Telecare 6, n^o 2_suppl (août 2000) : 28–30. http://dx.doi.org/10.1258/1357633001935455.

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The implementation of a remote cardiac rehabilitation service to educate people about heart disease is currently under way in northern Alberta. Twenty per cent of patients in the catchment area live in remote areas outside the regional centre and are faced with the usual difficulties of attending urban health-care programmes. The availability of the remote cardiac rehabilitation service enables patients to receive the same rehabilitation benefits as their urban counterparts.

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Butterworth, P., B. J. Kelly, T. E. Handley, K. J. Inder et T. J. Lewin. « Does living in remote Australia lessen the impact of hardship on psychological distress ? » Epidemiology and Psychiatric Sciences 27, n^o 5 (3 avril 2017) : 500–509. http://dx.doi.org/10.1017/s2045796017000117.

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Aims.Rural and remote regions tend to be characterised by poorer socioeconomic conditions than urban areas, yet findings regarding differences in mental health between rural and urban areas have been inconsistent. This suggests that other features of these areas may reduce the impact of hardship on mental health. Little research has explored the relationship of financial hardship or deprivation with mental health across geographical areas.Methods.Data were analysed from a large longitudinal Australian study of the mental health of individuals living in regional and remote communities. Financial hardship was measured using items from previous Australian national population research, along with measures of psychological distress (Kessler-10), social networks/support and community characteristics/locality, including rurality/remoteness (inner regional; outer regional; remote/very remote). Multilevel logistic regression modelling was used to examine the relationship between hardship, locality and distress. Supplementary analysis was undertaken using Australian Household, Income and Labour Dynamics in Australia (HILDA) Survey data.Results.2161 respondents from the Australian Rural Mental Health Study (1879 households) completed a baseline survey with 26% from remote or very remote regions. A significant association was detected between the number of hardship items and psychological distress in regional areas. Living in a remote location was associated with a lower number of hardships, lower risk of any hardship and lower risk of reporting three of the seven individual hardship items. Increasing hardship was associated with no change in distress for those living in remote areas. Respondents from remote areas were more likely to report seeking help from welfare organisations than regional residents. Findings were confirmed with sensitivity tests, including replication with HILDA data, the use of alternative measures of socioeconomic circumstances and the application of different analytic methods.Conclusions.Using a conventional and nationally used measure of financial hardship, people residing in the most remote regions reported fewer hardships than other rural residents. In contrast to other rural residents, and national population data, there was no association between such hardship and mental health among residents in remote areas. The findings suggest the need to reconsider the experience of financial hardship across localities and possible protective factors within remote regions that may mitigate the psychological impact of such hardship.

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O’Kane, Gabrielle. « Telehealth—Improving access for rural, regional and remote communities ». Australian Journal of Rural Health 28, n^o 4 (août 2020) : 419–20. http://dx.doi.org/10.1111/ajr.12663.

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Gunaratnam, Praveena, Gill Schierhout, Jenny Brands, Lisa Maher, Ross Bailie, James Ward, Rebecca Guy et al. « Qualitative perspectives on the sustainability of sexual health continuous quality improvement in clinics serving remote Aboriginal communities in Australia ». BMJ Open 9, n^o 5 (mai 2019) : e026679. http://dx.doi.org/10.1136/bmjopen-2018-026679.

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ObjectivesTo examine barriers and facilitators to sustaining a sexual health continuous quality improvement (CQI) programme in clinics serving remote Aboriginal communities in Australia.DesignQualitative study.SettingPrimary health care services serving remote Aboriginal communities in the Northern Territory, Australia.ParticipantsSeven of the 11 regional sexual health coordinators responsible for supporting the Northern Territory Government Remote Sexual Health Program.MethodsSemi-structured in-depth interviews conducted in person or by telephone; data were analysed using an inductive and deductive thematic approach.ResultsDespite uniform availability of CQI tools and activities, sexual health CQI implementation varied across the Northern Territory. Participant narratives identified five factors enhancing the uptake and sustainability of sexual health CQI. At clinic level, these included adaptation of existing CQI tools for use in specific clinic contexts and risk environments (eg, a syphilis outbreak), local ownership of CQI processes and management support for CQI. At a regional level, factors included the positive framing of CQI as a tool to identify and act on areas for improvement, and regional facilitation of clinic level CQI activities. Three barriers were identified, including the significant workload associated with acute and chronic care in Aboriginal primary care services, high staff turnover and lack of Aboriginal staff. Considerations affecting the future sustainability of sexual health CQI included the need to reduce the burden on clinics from multiple CQI programmes, the contribution of regional sexual health coordinators and support structures, and access to and use of high-quality information systems.ConclusionsThis study contributes to the growing evidence on how CQI approaches may improve sexual health in remote Australian Aboriginal communities. Enhancing sustainability of sexual health CQI in this context will require ongoing regional facilitation, efforts to build local ownership of CQI processes and management of competing demands on health service staff.

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Liu, Xian-Liang, Tao Wang, Daniel Bressington, Bróna Nic Giolla Easpaig, Lolita Wikander et Jing-Yu (Benjamin) Tan. « Factors Influencing Retention among Regional, Rural and Remote Undergraduate Nursing Students in Australia : A Systematic Review of Current Research Evidence ». International Journal of Environmental Research and Public Health 20, n^o 5 (23 février 2023) : 3983. http://dx.doi.org/10.3390/ijerph20053983.

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Background: This systematic review aimed to explore the factors influencing retention among regional, rural, and remote undergraduate nursing students who were enrolled in Australian universities. Methods: Mixed-methods systematic review. A+ Education, CINAHL, Education Resources Information Center (ERIC), Education Research Complete, JBI EBP database, Journals@Ovid, Medline, PsycINFO, PubMed, and Web of Science were systematically searched from September 2017 to September 2022 to identify eligible English-language studies. The methodological quality of the included studies was critically assessed using the Joanna Briggs Institute’s critical appraisal tools. Descriptive analysis with a convergent segregated approach was conducted to synthesize and integrate the results from the included studies. Results: Two quantitative and four qualitative studies were included in this systematic review. Both the quantitative and qualitative findings demonstrated that additional academic and personal support was essential for improving retention among undergraduate nursing students from regional, rural, and remote areas in Australia. The qualitative synthesis also highlighted many internal (e.g., personal qualities, stress, ability to engage with classes and institutions, time management, lack of confidence, cultural well-being, and Indigenous identity) and external factors (e.g., technical difficulties, casual tutors, different competing demands, study facilities, and financial and logistical barriers) that influenced retention among undergraduate nursing students from regional, rural, and remote areas in Australia. Conclusions: This systematic review demonstrates that identifying potentially modifiable factors could be the focus of retention support programs for undergraduate nursing students. The findings of this systematic review provide a direction for the development of retention support strategies and programs for undergraduate nursing students from regional, rural and remote areas in Australia.

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Kavanagh, Bianca E., Hannah Beks, Vincent L. Versace, Shae E. Quirk et Lana J. Williams. « Exploring the barriers and facilitators to accessing and utilising mental health services in regional, rural, and remote Australia : A scoping review protocol ». PLOS ONE 17, n^o 12 (9 décembre 2022) : e0278606. http://dx.doi.org/10.1371/journal.pone.0278606.

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Introduction Australians from regional, rural, and remote areas face diverse and complex challenges in accessing and utilising mental health services. Previous research has pointed to a range of individual, community, structural, and systemic barriers at play, however, limited literature has synthesised the knowledge on this topic. Parallel to this, information on the facilitators to accessing and utilising mental health services for this group is not well documented. This protocol describes the methodology to undertake a scoping review, which aims to explore the barriers and facilitators associated with accessing and utilising mental health services in regional, rural, and remote Australia. In addition, the scoping review aims to geographically map the identified barriers and facilitators. Methods This protocol is guided by Arksey and O’Malley’s methodological framework. A search strategy will be developed and implemented to identify relevant peer-reviewed and grey literature. Studies will be included if they report on the barriers and/or facilitators associated with accessing and/or utilising mental health services in regional, rural, and remote Australia. Two reviewers will independently screen the data at the title/abstract and full-text stage. One reviewer will extract the relevant data using a predetermined charting form and a second reviewer will validate the included data. A Geographical Information System program will be used to map the location of the studies; locations will be stratified according to the Modified Monash Model and relationships between barriers and facilitators will be analysed. Key findings will be presented in a narrative account and in text, tables, and maps. Discussion This scoping review will provide a contemporary account on the barriers and facilitators to accessing and utilising mental health services for regional, rural, and remote Australians. It is anticipated that the results of this scoping review will have national policy relevance and may be useful to healthcare providers.

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Kelly, Wade B., Sean MacDermott et Evelien Spelten. « A seat at the table : Regional, rural and remote health research and impact ». Australian Journal of Rural Health 29, n^o 6 (17 octobre 2021) : 1002–7. http://dx.doi.org/10.1111/ajr.12802.

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Stiller, Anna, Belinda C. Goodwin, Fiona Crawford-Williams, Sonja March, Michael Ireland, Joanne F. Aitken, Jeff Dunn et Suzanne K. Chambers. « The Supportive Care Needs of Regional and Remote Cancer Caregivers ». Current Oncology 28, n^o 4 (9 août 2021) : 3041–57. http://dx.doi.org/10.3390/curroncol28040266.

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Objective: As cancer survival rates continue to increase, so will the demand for care from family and friends, particularly in more isolated settings. This study aims to examine the needs of cancer caregivers in regional and remote Australia. Methods: A total of 239 informal (i.e., non-professional) cancer caregivers (e.g., family/friends) from regional and remote Queensland, Australia, completed the Comprehensive Needs Assessment Tool for Cancer Caregivers (CNAT-C). The frequencies of individuals reporting specific needs were calculated. Logistic regression analyses assessed the association between unmet needs and demographic characteristics and cancer type. Results: The most frequently endorsed needs were lodging near hospital (77%), information about the disease (74%), and tests and treatment (74%). The most frequent unmet needs were treatment near home (37%), help with economic burden (32%), and concerns about the person being cared for (32%). Younger and female caregivers were significantly more likely to report unmet needs overall (OR = 2.12; OR = 0.58), and unmet healthcare staff needs (OR = 0.35; OR = 1.99, respectively). Unmet family and social support needs were also significantly more likely among younger caregivers (OR = 0.35). Caregivers of breast cancer patients (OR = 0.43) and older caregivers (OR = 0.53) were significantly less likely to report unmet health and psychology needs. Proportions of participants reporting needs were largely similar across demographic groups and cancer type with some exceptions. Conclusions: Caregiver health, practical issues associated with travel, and emotional strain are all areas where regional and remote caregivers require more support. Caregivers’ age and gender, time since diagnosis and patient cancer type should be considered when determining the most appropriate supportive care.

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Taylor, Monica, Naomi Kikkawa, Elisabeth Hoehn, Helen Haydon, Maike Neuhaus, Anthony C. Smith et Liam J. Caffery. « The importance of external clinical facilitation for a perinatal and infant telemental health service ». Journal of Telemedicine and Telecare 25, n^o 9 (octobre 2019) : 566–71. http://dx.doi.org/10.1177/1357633x19870916.

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Introduction Clinical facilitation is an established strategy for introducing innovation into clinical practice. The Queensland Centre for Perinatal and Infant Mental Health has used clinical facilitation to establish a telehealth service to support perinatal and infant mental health in regional, rural and remote areas of the Australian state of Queensland. The aim of this study is to explore the role of clinical facilitation in implementing and sustaining the telehealth service. Methods Semi-structured interviews were conducted with 14 remote-site users of the telehealth service. Interviews were analysed using thematic analysis. Results Two dominant themes emerged: unmet need and service visibility. The study confirms the usefulness of telehealth as a way to address unmet need for specialist mental health services in regional, rural and remote areas. The study also provides evidence that a telehealth service with intermittent demand requires a consistent clinical facilitator, to keep the service visible to remote-site clinicians and maintain awareness of the service as a referral option. Conclusion Previous research has identified the importance of clinical facilitation in initial service implementation. This study demonstrates the necessity of clinical facilitation for ongoing service provision. Facilitation is likely to be more important where the telehealth service responds to intermittent or infrequent clinical need, compared with high-volume services where clinics are conducted routinely.

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Purnamasari, Try, Diah Ayu Puspandari, Mubasysyir Hasanbasri, Firdaus Hafidz et Muttaqien Muttaqien. « Regional government concerns in health services in remote areas : Case study on special capitation policies in North Bengkulu Regency ». BIO Web of Conferences 28 (2020) : 05003. http://dx.doi.org/10.1051/bioconf/20202805003.

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The Minister of Health Regulation No. 52 of 2016 states that the tariff for first-level health services in remote areas and islands is determined based on special capitation tariffs, which is greater than the usual capitation tariffs. In North Bengkulu there is a primary health care that does not include a special capitation even though the criteria are the same as the primary health care that received it. The perception of stakeholders involved is needed to see whether the determination of criteria for disadvantaged areas for recipients of special capitation funds is in accordance with existing regulations or not. The study was based on in-depth interviews with 6 respondents from 6 institutions (Local Government, Regional Secretary, Health Office, the BPJS health branch office, and two Primary health care). The local government does not help question that matter to BPJS or help in other ways so that health care that do not receive special capitation funds can still provide optimal services like other remote health care. This study found the lack of socialization about health services in remote areas to non-health officials in local governments is the causes of weak support by local governments. This research shows that the application of central policies without joint review and verification with local stakeholders can lead to unproductive situations. Local governments should also look for solutions so that health care in remote areas that do not receive special capitation funds continue to run optimally.

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Ridgewell, Emily, Michael Dillon, Jackie O'Connor, Sarah Anderson et Leigh Clarke. « Demographics of the Australian orthotic and prosthetic workforce 2007–12 ». Australian Health Review 40, n^o 5 (2016) : 555. http://dx.doi.org/10.1071/ah15147.

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Objective Health workforce data are vital to inform initiatives to meet the future healthcare needs of our society, but there are currently no data describing the Australian orthotic and prosthetic workforce. The aim of the present study was to describe demographic changes in the Australian orthotic and prosthetic workforce from 2007 to 2012. Methods In the present retrospective time series study, data from the Australian Orthotic Prosthetic Association member database were analysed for trends from 2007 to 2012. Data describing the absolute number of practitioners, the number of practitioners per 100 000 population, age, gender, state or territory of residence and service location (i.e. metropolitan, regional and remote) were analysed for significant changes over time using linear regression models. Results Although the number of orthotist/prosthetists in Australia increased (P = 0.013), the number of orthotist/prosthetists per 100 000 population remained unchanged (P = 0.054). The workforce became younger (P = 0.004) and more female (P = 0.005). Only Victoria saw an increase in the proportion of orthotist/prosthetists in regional and remote areas. There was considerable state-to-state variation. Only Victoria (P = 0.01) and Tasmania (P = 0.003) saw an increase in the number of orthotist/prosthetists per 100 000 population. Conclusions The orthotic and prosthetic workforce has increased proportionately to Australia’s population growth, become younger and more female. The proportion of practitioners in regional and remote areas has remained unchanged. These data can help inform workforce initiatives to increase the number of orthotist/prosthetists relative to the Australian population and make the services of orthotist/prosthetists more accessible to Australians in regional and remote areas. What is known about the topic? Currently, there are no demographic data describing changes in the Australian orthotic and prosthetic workforce over time. These data are vital to inform initiatives to increase the size of the workforce, locate practitioners where health services are most needed and thereby plan to meet the future health care needs of our society. What does this paper add? This paper describes changes in the Australian orthotic and prosthetic workforce, where previously these data have not been available as part of federal initiatives to plan for future workforce needs. What are the implications for practitioners? Demographic data describing changes in the orthotic and prosthetic workforce are needed to inform workforce initiatives that improve access in regional and remote Australia, and retain a younger and more female workforce.

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Li, Songsheng, et Christopher Chiu. « Improved Smart Pillow for Remote Health Care System ». Journal of Sensor and Actuator Networks 10, n^o 1 (28 janvier 2021) : 9. http://dx.doi.org/10.3390/jsan10010009.

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The outbreak of novel coronavirus (COVID-19) resulted in the clinical decision that reduced direct contact is optimal, especially for senior citizens residing in nursing homes. A smart pillow adapted for the Remote Healthcare System is presented in this paper, whose core is a Bluetooth (BT) host equipped with temperature and pressure sensors. The measurement of Core Body Temperature (CBT) from the perspective of heat transfer is first analyzed, with two proven effective methods introduced—classical Zero-Heat-Flux (ZHF) and Dual-Heat-Flux (DHF)—then finally the similarities between the Smart Pillow and ZHF are demonstrated. A pressure pad is inserted inside the pillow to detect occupancy and the specific position of the head on the pillow that meets clinical diagnostic needs. Furthermore, a real-time proactive monitoring mode is enabled for urgent warnings, which forces the pillow to keep detecting and reporting data in a defined time duration but results in rapid battery drain of the pillow. In this way, the system can detect the CBT and in-bed situation of the inhabitant without being physically present to determine critical measurements. Utility of this system can be extended to elderly people living alone in regional or remote areas, such that medical help can be dispatched as soon as possible in case of medical emergency.

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ZUB, Mariya. « INFRASTRUCTURE OF DISTANCE WORK IN CONDITIONS OF CORONACRISIS ». HERALD OF KHMELNYTSKYI NATIONAL UNIVERSITY 300, n^o 6 Part 2 (décembre 2021) : 245–50. http://dx.doi.org/10.31891/2307-5740-2021-300-6/2-40.

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The concept of remote work is considered in the article, its characteristic features are investigated. Situational, planned, fixed types and two types (type of employment and type of self-employment) of remote work are determined. The author’s definition of the terms “remote work” and “remote worker” is given. Emphasis is placed on the main problems of infrastructural support of remote work in the regions of Ukraine. The author emphasizes that the need for flexibility of remote work infrastructure, its foresight, innovation, adaptability to challenges, ability to mobilize the region’s resource potential in overcoming crises should motivate domestic officials to reconsider regional development priorities. The expediency of building a viable infrastructure for remote work in Ukraine, which could operate on different fronts simultaneously and synchronously, is substantiated. The author’s interpretation of the concept of “remote work infrastructure” as a system of regulatory, organizational, technical and informational components that help transform remote workers into active agents who are able to independently or with the help of the employer to create autonomous remote jobs anywhere and perform functional tasks , minimize costs, increase motivation and productivity. A conceptual model of the system of remote work infrastructure at the regional level is proposed. It is proved that the determinant of the functioning of effective remote work infrastructure is increasing the attractiveness of remote work in the regions of Ukraine, ensuring the continuity of enterprises, firms, institutions and organizations, increasing new decent remote jobs, expanding remote employment, dynamic living standards and improving health. creating equal employment opportunities for all citizens; reduction of costs of labor market participants, increase of labor productivity; reduction of regional asymmetries, strengthening of interregional cooperation, increase of digitalization and transformation of economic changes in the regions of Ukraine.

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Sanders, Paul, et Marissa Lindquist. « Charles Fulton : the regional reach of modernism in Australia ». Cure and Care, n^o 62 (2020) : 86–93. http://dx.doi.org/10.52200/62.a.agpqon3z.

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Charles Fulton (1905-1987) was an Australian architect who applied influences of European Modernism, particularly the civic architecture of Willem Dudok, into the design for several hospital projects in regional towns across Queensland, at the same time adapting a climatic responsive rationale to the projects. As with many remote contexts that have been overlooked by a European and American centric focus upon Modern architecture, the account of Australian Modernism has not been widely acknowledged outside its borders, despite a local momentum to effectively document and publish its achievements. Compounding this predicament, Queensland has suffered from its own exclusion relative to the southern states of New South Wales (Sydney) and Victoria (Melbourne), which have always been the dominant centers of the national profession, its conferences and publications. This paper seeks to address these schisms through the presentation of the work of Fulton, demonstrating how even in remote areas of Queensland, thousands of kilometers from major cities, the reach of Modern architecture found a place. Mobilized by the national federal body, the Office of Health and Home Affairs, drive to improve health services across the country post WWI, Fulton became a leading architect to modernize health facilities and brought about a cultural shift in the reception of Modern architecture across the regions.

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Trinidad, Sue, Elaine Sharplin, Graeme Lock, Sue Ledger, Don Boyd et Emmy Terry. « Developing Strategies at the Pre-service Level to Address Critical Teacher Attraction and Retention Issues in Australian Rural, Regional and Remote Schools ». Australian and International Journal of Rural Education 21, n^o 1 (1 mars 2011) : 111–20. http://dx.doi.org/10.47381/aijre.v21i1.595.

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This ALTC project is a collaborative endeavour between the four public universities involved in teacher education in Western Australia (Curtin University, Edith Cowan University, Murdoch University and The University of Western Australia), focussed on improving the quality of preparation of pre-service teachers for rural, regional and remote appointments. The project, building on the work of other recent Australian rural education research projects (conducted through the ARC funded Renewing Rural Teacher Education: Sustaining Schooling for Sustainable Futures [TERRAnova] and the Renewing Rural and Regional Teacher Education ALTC Curriculum projects), will create a nexus between the theory and practice of teaching and learning by developing models of pre-service teacher rural, regional and remote practicums. Existing rural health collaborative models will be drawn upon to inform the developing project. The project brings together rural community and professional partnerships (including the Society for the Provision of Education for Rural Australia [SPERA] and The National Centre of science, Information and Communication Technology, and Mathematics Education for Rural and Regional Australia [SiMERR]) that will help to sustain rural communities through the provision of quality, prepared rural, regional and remote teachers.

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Nolan-Isles, Davida, Rona Macniven, Kate Hunter, Josephine Gwynn, Michelle Lincoln, Rachael Moir, Yvonne Dimitropoulos et al. « Enablers and Barriers to Accessing Healthcare Services for Aboriginal People in New South Wales, Australia ». International Journal of Environmental Research and Public Health 18, n^o 6 (15 mars 2021) : 3014. http://dx.doi.org/10.3390/ijerph18063014.

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Background: Australia’s healthcare system is complex and fragmented which can create challenges in healthcare, particularly in rural and remote areas. Aboriginal people experience inequalities in healthcare treatment and outcomes. This study aimed to investigate barriers and enablers to accessing healthcare services for Aboriginal people living in regional and remote Australia. Methods: Semi-structured interviews were conducted with healthcare delivery staff and stakeholders recruited through snowball sampling. Three communities were selected for their high proportion of Aboriginal people and diverse regional and remote locations. Thematic analysis identified barriers and enablers. Results: Thirty-one interviews were conducted in the three communities (n = 5 coastal, n = 13 remote, and n = 13 border) and six themes identified: (1) Improved coordination of healthcare services; (2) Better communication between services and patients; (3) Trust in services and cultural safety; (4) Importance of prioritizing health services by Aboriginal people; (5) Importance of reliable, affordable and sustainable services; (6) Distance and transport availability. These themes were often present as both barriers and enablers to healthcare access for Aboriginal people. They were also present across the healthcare system and within all three communities. Conclusions: This study describes a pathway to better healthcare outcomes for Aboriginal Australians by providing insights into ways to improve access.

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Moran, Anna, Helen Haines, Nicole Raschke, David Schmidt, Alison Koschel, Alexandre Stephens, Cynthia Opie et Susan Nancarrow. « Mind the gap : is it time to invest in embedded researchers in regional, rural and remote health services to address health outcome discrepancies for those living in rural, remote and regional areas ? » Australian Journal of Primary Health 25, n^o 2 (2019) : 104. http://dx.doi.org/10.1071/py18201.

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Research capacity building in healthcare works to generate and apply new knowledge to improve health outcomes; it creates new career pathways, improves staff satisfaction, retention and organisational performance. While there are examples of investment and research activity in rural Australia, overall, rural research remains under-reported, undervalued and under-represented in the evidence base. This is particularly so in primary care settings. This lack of contextual knowledge generation and translation perpetuates rural–metropolitan health outcome disparities. Through greater attention to and investment in building research capacity and capability in our regional, rural and remote health services, these issues may be partially addressed. It is proposed that it is time for Australia to systematically invest in rurally focussed, sustainable, embedded research capacity building.

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Cui, Fangfang, Xianying He, Yunkai Zhai, Minzhao Lyu, Jinming Shi, Dongxu Sun, Shuai Jiang, Chenchen Li et Jie Zhao. « Application of Telemedicine Services Based on a Regional Telemedicine Platform in China From 2014 to 2020 : Longitudinal Trend Analysis ». Journal of Medical Internet Research 23, n^o 7 (12 juillet 2021) : e28009. http://dx.doi.org/10.2196/28009.

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Background Telemedicine that combines information technology and health care augments the operational model of traditional medical services and brings new opportunities to the medical field. China promotes telemedicine with great efforts, and its practices in the deployment of telemedicine platforms and delivery of services have become important references for the research and development in this field. Objective Our work described in this paper focuses on a regional telemedicine platform that was built in 2014. We analyzed the system design scheme and remote consultations that were conducted via the system to understand the deployment and service delivery processes of a representative telemedicine platform in China. Methods We collected information on remote consultations conducted from 2015 to 2020 via the regional telemedicine platform that employs a centralized architectural system model. We used graphs and statistical methods to describe the changing trends of service volume of remote consultation, geographical and demographic distribution of patients, and waiting time and duration of consultations. The factors that affect consultation duration and patient referral were analyzed by multivariable linear regression models and binary logistic regression models, respectively. The attitudes toward telemedicine of 225 medical practitioners and 225 patients were collected using the snowball sampling method. Results The regional telemedicine platform covers all levels of medical institutions and hospitals in all 18 cities of Henan Province as well as some interprovince hospitals. From 2015 to 2020, 103,957 remote medical consultations were conducted via the platform with an annual increasing rate of 0.64%. A total of 86.64% (90,069/103,957) of medical institutions (as clients) that applied for remote consultations were tier 1 or 2 and from less-developed regions; 65.65% (68,243/103,945) of patients who applied for remote consultations were aged over 50 years. The numbers of consultations were high for departments focusing in the treatment of chronic diseases such as neurology, respiratory medicine, and oncology. The invited experts were mainly experienced doctors with senior professional titles. Year of consultation, tier of hospital, consultation department, and necessity of patient referral were the main factors affecting the duration of consultations. In surveys, we found that 60.4% (136/225) of medical practitioners and 53.8% (121/225) of patients had high satisfaction and believed that telemedicine is of vital importance for the treatment of illness. Conclusions The development of telemedicine in China shows a growing trend and provides great benefits especially to medical institutions located in less developed regions and senior citizens who have less mobility. Cases of remote consultations are mainly for chronic diseases. At present, the importance and necessity of telemedicine are well recognized by both patients and medical practitioners. However, the waiting time needs to be further reduced to improve the efficiency of remote medical services.

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Curtis, Katy. « Including Infants : An Inter-Agency Model for Parent–Infant Mental Health and Well-Being in Rural Regions ». Children Australia 37, n^o 3 (9 août 2012) : 90–93. http://dx.doi.org/10.1017/cha.2012.26.

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There are well-recognised and articulated difficulties in the provision of health services to communities in rural and remote areas. These difficulties encompass practicalities and geography, economics and politics, as well as the personal and professional. This article describes a multi-level model developed by a group of regional services to address the mental health and well-being needs of infants and small children of rural and remote families, utilising existing resources creatively and collaboratively. The model draws on understandings from attachment theory about the nature and needs of humans as relational beings.

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Bourke, Sharon L., Claire Harper, Elianna Johnson, Janet Green, Ligi Anish, Miriam Muduwa et Linda Jones. « Health Care Experiences in Rural, Remote, and Metropolitan Areas of Australia ». Online Journal of Rural Nursing and Health Care 21, n^o 1 (4 mai 2021) : 67–84. http://dx.doi.org/10.14574/ojrnhc.v21i1.652.

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Background: Australia is a vast land with extremes in weather and terrain. Disparities exist between the health of those who reside in the metropolitan areas versus those who reside in the rural and remote areas of the country. Australia has a public health system called Medicare; a basic level of health cover for all Australians that is funded by taxpayers. Most of the hospital and health services are located in metropolitan areas, however for those who live in rural or remote areas the level of health service provision can be lower; with patients required to travel long distances for health care. Purpose: This paper will explore the disparities experienced by Australians who reside in regional and remote areas of Australia. Method: A search of the literature was performed from healthcare databases using the search terms: healthcare, rural and remote Australia, and social determinants of health in Australia. Findings: Life in the rural and remote areas of Australia is identified as challenging compared to the metropolitan areas. Those with chronic illnesses such as diabetes are particularly vulnerable to morbidities associated with poor access to health resources and the lack of service provision. Conclusion: Australia has a world class health system. It has been estimated that 70% of the Australian population resides in large metropolitan areas and remaining 30% distributed across rural and remote communities. This means that 30% of the population are not experiencing their health care as ‘world-class’, but rather are experiencing huge disparities in their health outcomes. Keywords: rural and remote, health access, mental health issues, social determinants DOI: https://doi.org/10.14574/ojrnhc.v21i1.652

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Casey, F., D. Brown, B. G. Craig, J. Rogers et H. C. Mulholland. « Diagnosis of neonatal congenital heart defects by remote consultation using a low-cost telemedicine link ». Journal of Telemedicine and Telecare 2, n^o 3 (1 septembre 1996) : 165–69. http://dx.doi.org/10.1258/1357633961930004.

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To determine whether telemedicine could assist in the earlier diagnosis of neonates with congenital heart disease (CHD) in an area hospital remote from a paediatric cardiologist, we established a low-cost telemedicine link between the neonatal unit of a district general hospital and the regional paediatric cardiology unit. Realtime ultrasound images of babies suspected of having CHD were obtained by a paediatrician and transmitted for realtime interpretation by a paediatric cardiologist. In a four-month pilot study, 10 neonates were studied in this way. In eight of the ten cases, the diagnosis made over the telemedicine link was confirmed subsequently in a direct examination at the regional unit. In one case the patient died before the direct examination was possible. In one case two small muscular ventricular septal defects were missed on the remote examination. Our early experience suggests that, with realtime guidance by a paediatric cardiologist, transmitted images of sufficient quality to allow confirmation or exclusion of major cardiac defects can be obtained. This form of remote consultation should improve morbidity and mortality rates by reducing the waiting time for specialist diagnosis and treatment.

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Harrod, Mary Ellen, Sophia Couzos, James Ward, Mark Saunders, Basil Donovan, Belinda Hammond, Dea Delaney-Thiele et al. « Gonorrhoea testing and positivity in non-remote Aboriginal Community Controlled Health Services ». Sexual Health 14, n^o 4 (2017) : 320. http://dx.doi.org/10.1071/sh16046.

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Background Gonorrhoea occurs at high levels in young Aboriginal and Torres Strait Islander people living in remote communities, but there are limited data on urban and regional settings. An analysis was undertaken of gonorrhoea testing and positivity at four non-remote Aboriginal Community Controlled Health Services participating in a collaborative research network. Methods: This was a retrospective analysis of clinical encounter data derived from electronic medical records at participating services. Data were extracted using the GRHANITE program for all patients aged 15–54 years from 2009 to 2013. Demographic characteristics and testing and positivity for gonorrhoea were calculated for each year. Results: A total of 2971 patients (2571 Aboriginal and/or Torres Strait Islander) were tested for gonorrhoea during the study period. Among Aboriginal and/or Torres Strait Islander patients, 40 (1.6%) tested positive. Gonorrhoea positivity was associated with clinic location (higher in the regional clinic) and having had a positive chlamydia test. By year, the proportion of patients aged 15–29 years tested for gonorrhoea increased in both men (7.4% in 2009 to 15.9% in 2013) and women (14.8% in 2009 to 25.3% in 2013). Concurrent testing for chlamydia was performed on 86.3% of testing occasions, increasing from 75% in 2009 to 92% in 2013. Factors related to concurrent testing were sex and year of test. Conclusions: The prevalence of gonorrhoea among young Aboriginal and/or Torres Strait Islander people in non-remote settings suggests that the current approach of duplex testing for chlamydia and gonorrhoea simultaneously is justified, particularly for women.

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McGrath, Pam. « Post-treatment support for patients with haematological malignancies:findings from regional, rural and remote Queensland ». Australian Health Review 23, n^o 4 (2000) : 142. http://dx.doi.org/10.1071/ah000142.

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Social support is a significant factor in the cancer patient's psychosocial wellbeing. This paper presents the findings ofrecent Queensland-based research that explored the experience of families returning home to the regional, rural andremote sector after a family member completed specialist treatment for a haematological malignancy and related blooddisorder in a major metropolitan centre.Family and friends are the key resource persons providing support. To a large degree, this is because of the absence ofalternative sources. Even support from health professionals can be problematic and for many the only source of supportis the specialist centre many hundreds of kilometres away. The primary response to developing supportive services needsto be through person to person contact either via telephone or newsletter. If targeted appropriately, there is alsoevidence that educational programs, support groups and volunteers would be an effective medium for providingsupport. Educating the local health professionals (GPs and nurses) about haematological conditions is a logicalextension of providing support to families.

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Johnston, Michael, Heidi Smith-Vaughan, Sophie Bowman-Derrick, Jayde Hopkins, Kelly McCrory, Raelene Collins, Robyn Marsh, Kalinda Griffiths et Mark Mayo. « <i>Corrigendum to</i> ; : Building health workforce capacity in Northern Australia ». Microbiology Australia 43, n^o 4 (9 janvier 2023) : 198. http://dx.doi.org/10.1071/ma22031_co.

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The Menzies Ramaciotti Regional and Remote Health Sciences Training Centre (Menzies-Ramaciotti Centre) is located within the Menzies School of Health Research (Menzies) in Darwin, Northern Territory (NT). The Menzies-Ramaciotti Centre is contributing to the development of a local health workforce in the NT, including a strong biomedical workforce. The Centre facilitates health workforce career progression for regional and remote youth, with a focus on career development for Aboriginal and Torres Strait Islander (First Nations) youth. The Centre works in collaboration with a range of industry and education partners, who also have strong workforce development goals and a commitment to serving a vital community need to build pathways into work and study with First Nations peoples. Part of the Centre’s focus entails delivery of high-quality training in biomedical sciences, including theoretical and practical skill development in microbiology, laboratory techniques, immunology, public health, data science, allied health, and health research. The Centre uses a non-linear, strengths-based approach to training with a multiplicity of entry and exit points including high school work experience placements, traineeships, vocational placements, as well as undergraduate and postgraduate placements.

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Li, Yingying, Zhengyong Zhao, Sunwei Wei, Dongxiao Sun, Qi Yang et Xiaogang Ding. « Prediction of Regional Forest Soil Nutrients Based on Gaofen-1 Remote Sensing Data ». Forests 12, n^o 11 (20 octobre 2021) : 1430. http://dx.doi.org/10.3390/f12111430.

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The study on the spatial distribution of forest soil nutrients is important not only as a reference for understanding the factors affecting soil variability, but also for the rational use of soil resources and the establishment of a virtuous cycle of forest ecosystems. The rapid development of remote sensing satellites provides an excellent opportunity to improve the accuracy of forest soil prediction models. This study aimed to explore the utility of the Gaofen-1 (GF-1) satellite in the forest soil mapping model in Luoding City, Yunfu City, Guangdong Province, Southeast China. We used 1000 m resolution coarse-resolution soil map to represent the overall regional soil nutrient status, 12.5 m resolution terrain-hydrology variables to reflect the detailed spatial distribution of soil nutrients, and 8 m resolution remote sensing variables to reflect the surface vegetation status to build terrain-hydrology artificial neural network (ANN) models and full variable ANNs, respectively. The prediction objects were alkali-hydro-nitrogen (AN), available phosphorus (AP), available potassium (AK), and organic matter (OM) at five soil depths (0–20, 20–40, 40–60, 60–80, and 80–100 cm). The results showed that the full-variable ANN accuracy at five soil depths was better than the terrain-hydrology ANNs, indicating that remote sensing variables reflecting vegetation status can improve the prediction of forest soil nutrients. The remote sensing variables had different effectiveness for different soil nutrients and different depths. In upper soil layers (0–20 and 20–40 cm), remote sensing variables were more useful for AN, AP, and OM, and were between 10%–14% (R2), and less effective for AK at only 8% and 6% (R2). In deep soil layers (40–60, 60–80, and 80–100 cm), the improvement of all soil nutrient models was not significant, between 3 and 6% (R2). RMSE and ROA ± 5% also decreased with the depth of soil. Remote sensing ANNs (coarse resolution soil maps + remote sensing variables) further demonstrated that the predictive power of remote sensing data decreases with soil depth. Compared to terrain-hydrological variables, remote sensing variables perform better at 0–20 cm, but the predictive power decreased rapidly with depth. In conclusion, the results of the study showed that the integration of remote sensing with coarse-resolution soil maps and terrain-hydrology variables could strongly improve upper forest soil (0–40 cm) nutrients prediction and NDVI, green band, and forest types were the best remote sensing predictors. In addition, the study area is rich in AN and OM, while AP and AK are scarce. Therefore, to improve forest health, attention should be paid to monitoring and managing AN, AP, AK, and OM levels.

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Li, Tongwen, Yuan Wang et Qiangqiang Yuan. « Remote Sensing Estimation of Regional NO2 via Space-Time Neural Networks ». Remote Sensing 12, n^o 16 (5 août 2020) : 2514. http://dx.doi.org/10.3390/rs12162514.

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Nitrogen dioxide (NO2) is an essential air pollutant related to adverse health effects. A space-time neural network model is developed for the estimation of ground-level NO2 in this study by integrating ground NO2 station measurements, satellite NO2 products, simulation data, and other auxiliary data. Specifically, a geographically and temporally weighted generalized regression neural network (GTW-GRNN) model is used with the advantage to consider the spatiotemporal variations of the relationship between NO2 and influencing factors in a nonlinear neural network framework. The case study across the Wuhan urban agglomeration (WUA), China, indicates that the GTW-GRNN model outperforms the widely used geographically and temporally weighted regression (GTWR), with the site-based cross-validation R2 value increasing by 0.08 (from 0.61 to 0.69). Besides, the comparison between the GTW-GRNN and original global GRNN models shows that considering the spatiotemporal variations in GRNN modeling can boost estimation accuracy. All these results demonstrate that the GTW-GRNN based NO2 estimation framework will be of great use for remote sensing of ground-level NO2 concentrations.

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Marschollek, M., K. H. Wolf, R. Haux et O. J. Bott. « Towards New Scopes : Sensor-enhanced Regional Health Information Systems ». Methods of Information in Medicine 46, n^o 04 (2007) : 476–83. http://dx.doi.org/10.1160/me9057.

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Summary Objectives: To analyze utilization of sensor technology in telemonitoring and home care and to discuss concepts and challenges of sensor-enhanced regional health information systems (rHIS). Methods: The study is based upon experience in sensor-based telemedicine and rHIS projects, and on an analysis of HIS-related journal publications from 2003 to 2005 conducted in the context of publishing the IMIA Yearbook of Medical Informatics. Results: Health-related parameters that are subject to sensor-based measurement in home care and tele-monitoring are identified. Publications related to tele-monitoring, home care and smart houses are analyzed concerning scope and utilization of sensor technology. Current approaches for integrating sensor technology in rHIS based on a corresponding eHealth infrastructure are identified. Based on a coarse architecture of home care and telemonitoring systems ten challenges for sensor-enhanced rHIS are identified and discussed: integration of home and health telematic platforms towards a sensor-enhanced telematic platform, transmission rate guarantees, ad hoc connectivity, cascading data analysis, remote configuration, message and alert logistic, sophisticated user interfaces, unobtrusiveness, data safety and security, and electronic health record integration. Conclusions: Utilization of sensor technology in health care is an active field of research. Currently few research projects and standardization initiatives focus on general architectural considerations towards suitable telematic platforms for establishing sensor-enhanced rHIS. Further research finalized by corresponding standardization is needed. Part 2 of this paperwill present experiences with a research prototype for a sensor-enhanced rHIS telematic platform.

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Speers, David. « Role of testing for the COVID-19 response in Aboriginal, Torres Strait Islander and regional populations ». Microbiology Australia 42, n^o 1 (2021) : 23. http://dx.doi.org/10.1071/ma21007.

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Aboriginal and Torres Strait Islander people may be disproportionately affected by COVID-19 and despite isolation remote communities have an increased risk of COVID-19 transmission due to overcrowding and frequent travel over long distances for family, cultural or community events. The response to an outbreak in remote settings will be logistically challenging requiring a coordinated multiagency response. The provision of timely COVID-19 diagnostic testing is central to this response.

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Matthews, Rebecca. « Additional barriers to clinical supervision for allied health professionals working in regional and remote settings ». Australian Health Review 38, n^o 1 (2014) : 118. http://dx.doi.org/10.1071/ah13172.

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Suriyanti, Suriyanti, et Shakira Noor Azlan. « Tangible and Intangible Factors Affecting the Organizational Performance of Remote Health Workers ». Jurnal Minds : Manajemen Ide dan Inspirasi 10, n^o 1 (28 mars 2023) : 85–100. http://dx.doi.org/10.24252/minds.v10i1.33690.

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The poor performance of local health workers in Indonesia has often been voiced in the regional health facility. This study investigates whether the bureaucratic behaviour, facilities and infrastructure, and organizational culture will increase local health workers' motivation and job performance. This study collects data from 22 local health facilities across Maros Regency, Indonesia, for a quantitative investigation. A response rate of 294 samples is obtained following the normal distribution sampling. The data is then analyzed using the covariance-based Structural Equation Model (CB-SEM) with AMOS software. The results indicate that only facilities, infrastructures, and cultures are crucial for increasing health-worker motivation and job performance. The direct and mediating effects are also reported, with the results discussed with the following implication.

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Pisarski, Konrad. « A Narrative Review of the Recent ‘Ice’ Epidemic : An Australian Perspective ». Substance Abuse : Research and Treatment 15 (janvier 2021) : 117822182110105. http://dx.doi.org/10.1177/11782218211010502.

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Background: The use of methamphetamine or amphetamine stimulant drugs has been identified by authoritative public health bodies as a global health issue, with a worrying trend towards production and consumption of a higher purity crystalline form methamphetamine (ice) over the past decade. This trend has been well documented within Australia, resulting in a public perception of there being an ‘ice’ epidemic in regional/rural areas. Considering the illicit nature of ice, monitoring it is challenging and as such little information is available regarding the actual extent of methamphetamine use, harms and patterns in regional/remote Australia. Aim: To collate the available literature regarding methamphetamine use in regional/rural Australia and identify gaps in the literature. Methods: A literature search was conducted by searching 6 databases (PUBMED, Medline, CINAHL, EMBASE, PsycINFO and SCOPUS) following which exclusion/inclusion criteria were applied. Included papers were appraised with the Joanna Briggs Institute Critical appraisal tools and synthesised in light of the sociocultural, ethnic and geographic differences in methamphetamine use in Australia. Results: Regarding rural/regional Australia there is a significant lack of research into methamphetamine use, patterns and epidemiology since the rise of crystalline methamphetamine in 2013. The existing literature available suggests great variability in methamphetamine harms in rural communities. This can be a double-edged sword however, as the introduction of ice into a remote/rural community may result in greater harms if it becomes ingrained in local customs. Similarly, there is a lack of research into the specific factors within Indigenous communities leading to an increased rate of methamphetamine use amongst members. Recommendation: Future research should address the causes of variance in methamphetamine harms in rural/remote regions. Although the scope of this paper was the Australian context, a wider international approach may yield useful information.

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Große, Christine, Pär M. Olausson et Bo Svensson. « Resilience Endangered : The Role of Regional Airports in Remote Areas in Sweden ». Infrastructures 6, n^o 12 (26 novembre 2021) : 167. http://dx.doi.org/10.3390/infrastructures6120167.

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This paper examines the role of regional airports in regional and municipal crisis preparedness based on evidence from a case study in Sweden. During the summer of 2018, Sweden experienced some of the most extensive wildfires in modern time. Aerial suppression, for which airports provided the essential preconditions, played an important role in extinguishing these fires. This study includes analyses of public policies that shape the Swedish airport system as well as evidence from interviews and a workshop with stakeholders. The results show that an efficiently operated network of regional airports is critical not only for crisis management but also to ensure important societal services such as health care in sparsely inhabited regions. Moreover, access to quick transportation by air is necessary for the Swedish Prison and Probation Service, tourism industry, public institutions and private businesses. Additionally intensified by effects of both the public debate on flight shame and the COVID-19 pandemic on air-based transportation, the insights arising from this study emphasise that the currently one-sided focus on the number of passengers is an insufficient foundation for the Swedish airport system to construct a resilient base for regional development, crisis management and civil defense.

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Fernandes, Brian, Edward R. Scheffer Cliff et Amelia Chowdhury. « Achieving self-sufficiency : training Australia’s future medical workforce ». Australian Health Review 42, n^o 6 (2018) : 640. http://dx.doi.org/10.1071/ah17019.

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There is an oversupply of Australian junior doctors, but significant training bottlenecks are developing, and geographical maldistribution in rural and remote areas remains. Last year, the Federal Minister for Immigration rejected a Department of Health recommendation for the removal of 41 health roles from the Skilled Occupation List after concerns that rural and regional communities would be left without access to medical services in areas currently serviced by international medical graduates. In an effort to achieve workforce self-sufficiency, Australia must ensure access to high-quality vocational training places in rural and regional settings while managing immigration of overseas-trained health professionals.

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Westervelt, Daniel M., Andrew J. Conley, Arlene M. Fiore, Jean-François Lamarque, Drew T. Shindell, Michael Previdi, Nora R. Mascioli, Greg Faluvegi, Gustavo Correa et Larry W. Horowitz. « Connecting regional aerosol emissions reductions to local and remote precipitation responses ». Atmospheric Chemistry and Physics 18, n^o 16 (28 août 2018) : 12461–75. http://dx.doi.org/10.5194/acp-18-12461-2018.

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Abstract. The unintended climatic implications of aerosol and precursor emission reductions implemented to protect public health are poorly understood. We investigate the precipitation response to regional changes in aerosol emissions using three coupled chemistry–climate models: NOAA Geophysical Fluid Dynamics Laboratory Coupled Model 3 (GFDL-CM3), NCAR Community Earth System Model (CESM1), and NASA Goddard Institute for Space Studies ModelE2 (GISS-E2). Our approach contrasts a long present-day control simulation from each model (up to 400 years with perpetual year 2000 or 2005 emissions) with 14 individual aerosol emissions perturbation simulations (160–240 years each). We perturb emissions of sulfur dioxide and/or carbonaceous aerosol within six world regions and assess the significance of precipitation responses relative to internal variability determined by the control simulation and across the models. Global and regional precipitation mostly increases when we reduce regional aerosol emissions in the models, with the strongest responses occurring for sulfur dioxide emissions reductions from Europe and the United States. Precipitation responses to aerosol emissions reductions are largest in the tropics and project onto the El Niño–Southern Oscillation (ENSO). Regressing precipitation onto an Indo-Pacific zonal sea level pressure gradient index (a proxy for ENSO) indicates that the ENSO component of the precipitation response to regional aerosol removal can be as large as 20 % of the total simulated response. Precipitation increases in the Sahel in response to aerosol reductions in remote regions because an anomalous interhemispheric temperature gradient alters the position of the Intertropical Convergence Zone (ITCZ). This mechanism holds across multiple aerosol reduction simulations and models.

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Galvan, Pedro, Miguel Velazquez, Ronald Rivas, Gualberto Benitez, Antonio Barrios et Enrique Hilario. « VP21 Telemedicine As A Tool For Public Health Planning ». International Journal of Technology Assessment in Health Care 33, S1 (2017) : 155. http://dx.doi.org/10.1017/s0266462317003129.

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INTRODUCTION:The telediagnostic systems can achieve relevant epidemiological information from local community needs to global countrywide opportunities. In this context the telemedicine applications should be directed to gain the prevalence of pathologies towards developing better equity in the provision of services (1), and greater concern for the effectiveness and usefulness of health technologies in remote locations without access to specialists (2). This study, has evaluated the results of a telemedicine system in remote public regional and district hospitals in Paraguay (3), in order to show the epidemiological trends in communities of a low income country.METHODS:This prospective study used the results of telemedicine for diagnosis in remote regional and district hospitals to evaluate a as tool to determine the prevalence of pathologies countrywide over three years (2014-16). For these purposes, type and frequency of pathology diagnosed was determined. Sampling was non-probabilistic of convenience.RESULTS:A total of 182,406 telediagnoses were performed in 54 hospitals. The electrocardiography (ECG) diagnosis performed in the 52 hospitals were normal (62.1 percent), unspecified arrhythmias (12.5 percent), sinus bradycardia (10.4 percent), left ventricular hypertrophy (4.1 percent), sinus tachycardia (4.4 percent), right bundle branch block (3.5 percent), ischemia (1.4 percent), atrial fibrillation (1.0 percent) and left bundle branch block (0.6 percent). Teletomography was performed in twelve hospitals, where 54.4 percent corresponded to skull as a consequence of accidents (motorcycles) and cerebrovascular diseases, 13.8 percent chest, 6.2 percent dorsal spine, 5.4 percent abdominal and the rest the other anatomical regions. Regarding electroencephalography (EEG), antecedents of seizure (54.3 percent), evolutionary control (14.0 percent), headache (11.5 percent), cognitive impairment (2.0 percent), attention deficit in children (learning) (2.0 percent), brain death (1.0 percent), abnormal movements (0.8 percent), and sleep disturbances (0.3 percent) were diagnosed. The nineteen ultrasound studies corresponded to prenatal controls.CONCLUSIONS:Despite the results of the telediagnosis implemented in the public health system to determine the prevalence of pathologies countrywide, a widespread use-assessment should be analyzed before deciding a large diffusion as a tool for public health planning.

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Fleming, Mary-Louise, Helen Higgins, Neville Owen, Alexandra Clavarino, Wendy Brown, Jacqui Lloyd et Trish Gould. « Community Capacity Building for Health Promotion : Lessons from a Regional Australian Initiative ». Australian Journal of Primary Health 13, n^o 3 (2007) : 22. http://dx.doi.org/10.1071/py07034.

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This paper discusses a health promotion intervention that sets out to develop local capacity to address chronic disease risk factors in a remote Australian community. Community focus groups, and researcher and community discussions, aimed to determine the community's health concerns and build a partnership for community action. The journey from conception to reality was difficult for a number of reasons that are described here. Despite these difficulties, a range of outcomes included the establishment of an organisational structure that involved a local health promotion committee as the principal decision-maker, the establishment of a grants scheme to support locally determined initiatives and the formal incorporation of a community Health Promotion Committee (HPC) that ensured the sustainability of activities beyond the funded project period. The HPC is still coordinating health promotion activities. The promotion of community ownership of health promotion activities is a complicated process, given that time, resources, expertise and community involvement require a much longer-term commitment than that currently imposed by many funding bodies.

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Krom, Irina L., Marina V. Erugina, Maria G. Yeremina, Maria D. Sapogova, Maria M. Orlova, Tatiana P. Lipchanskaya et Marina V. Vlasova. « Optimization of medical care in regional health care : perspectives and barriers ». Sociology of Medicine 22, n^o 1 (18 janvier 2024) : 19–27. http://dx.doi.org/10.17816/socm252064.

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The perspectives of Russian health care in the transition to personalized medicine are realized in the formation of an innovative digital health care system. Forming with the use of digital technologies the accessibility of health care provides enormous social advantages in regional conditions and assumes a qualitatively new level of regional health care system. The problems of the COVID-19 pandemic, requiring isolation, quarantine and social distancing and characterized by the formation of trends of social “atomization”, accelerated the dependence on digital health care, and served as a “catalyst for the development and implementation of a wide range of remote monitoring technologies in health care delivery”. However, the digitalization process is “objectively slow” in Russia. The research establishes a high differentiation of digitalization of regional health care systems in the Russian Federation. The implementation in regional health care of digital technologies, which have a high potential for improving the efficiency of the health care system, is limited by institutional barriers. The article presents a typology of institutional barriers to the digitalization of the regional health care system: on federal level [legal barriers, organizational and managerial (logistical) and technological barriers], regional level (financial barriers), level of medical organizations and users (medical staff and patients) [behavioral barriers, organizational and managerial (logistic) and technological barriers]. Modern health care is experiencing large-scale digital technology inclusion, which can radically change the health care system by determining the accessibility and quality of medical care. However, the provision of cost-effective and quality health care initiated by the regional health care digitalization process is limited by institutional barriers at the federal, regional, medical organization and user levels.

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McGrail, Matthew R., Bushra F. Nasir, Alan Bruce Chater, Bahram Sangelaji et Srinivas Kondalsamy-Chennakesavan. « The value of extended short-term medical training placements in smaller rural and remote locations on future work location : a cohort study ». BMJ Open 13, n^o 1 (janvier 2023) : e068704. http://dx.doi.org/10.1136/bmjopen-2022-068704.

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ObjectivesTo investigate the effects of extended short-term medical training placements in small rural and remote communities on postgraduate work location.Design and settingCohort study of medical graduates of The University of Queensland, Australia.ParticipantsGraduating medical students from 2012 to 2021 who undertook a minimum of 6 weeks training in a small rural or remote location. Some participants additionally undertook either or both an extended short-term (12-week) placement in a small rural or remote location and a long-term (1 or 2 years) placement in a large regional centre.Primary outcome measureWork location was collected from the Australian Health Practitioner Regulation Agency in 2022, classified as either rural, regional or metropolitan and measured in association with rural placement type(s).ResultsFrom 2806 eligible graduates, those participating in extended small rural placements (n=106, 3.8%) were associated with practising rurally or regionally postgraduation (42.5% vs 19.9%; OR: 2.2, 95% CI: 1.1 to 4.6), for both those of rural origin (50% vs 30%; OR: 4.9, 95% CI: 2.6 to 9.2) or metropolitan origin (36% vs 17%; OR: 2.8, 95% CI: 1.7 to 4.8). Those undertaking both an extended small rural placement and 2 years regional training were most likely to be practising in a rural or regional location (61% vs 16%; OR: 8.6, 95% CI: 4.5 to 16.3). Extended small rural placements were associated with practising in smaller rural or remote locations in later years (15% vs 6%, OR: 2.7, 95% CI: 1.3 to 5.3).ConclusionThis work location outcome evidence supports investment in rural medical training that is both located in smaller rural and remote settings and enables extended exposure with rural generalists. The evaluated 12-week programme positively related to rural workforce outcomes when applied alone. Outcomes greatly strengthened when the 12-week programme was combined with a 2-year regional centre training programme, compared with either alone. These effects were independent of rural origin.

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Kassam, Shehzad, Jesus Serrano-Lomelin, Anne Hicks, Susan Crawford, Jeffrey A. Bakal et Maria B. Ospina. « Geography as a Determinant of Health : Health Services Utilization of Pediatric Respiratory Illness in a Canadian Province ». International Journal of Environmental Research and Public Health 18, n^o 16 (6 août 2021) : 8347. http://dx.doi.org/10.3390/ijerph18168347.

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Respiratory diseases contribute to high healthcare utilization rates among children. Although social inequalities play a major role in these conditions, little is known about the impact of geography as a determinant of health, particularly with regard to the difference between rural and urban centers. A regional geographic analysis was conducted using health repository data on singleton births between 2005 and 2010 in Alberta, Canada. Data were aggregated according to regional health sub-zones in the province and standardized prevalence ratios (SPRs) were determined for eight respiratory diseases (asthma, influenza, bronchitis, bronchiolitis, croup, pneumonia, and other upper and other lower respiratory tract infections). The results indicate that there are higher rates of healthcare utilization in northern compared to southern regions and in rural and remote regions compared to urban ones, after accounting for both material and social deprivation. Geography plays a role in discrepancies of healthcare utilization for pediatric respiratory diseases, and this can be used to inform the provision of health services and resource allocation across various regions.

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McGrath, Pam. « Overcoming the distance barrier in relation to treatment for haematology patients : Queensland findings ». Australian Health Review 39, n^o 3 (2015) : 344. http://dx.doi.org/10.1071/ah14147.

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Objective The aim of the present study was to document the financial and psychosocial impact of relocation for specialist haematology treatment in Queensland. Methods This study was a qualitative exploratory study comprising 45 in-depth interviews with haematology patients supported by the Leukaemia Foundation of Queensland. Results The findings indicate that decentralisation of treatment is assisting haematology patients to overcome the profound difficulties associated with travelling to the metropolitan area for treatment. Conclusion Fostering specialist outreach and building capacity in regional cancer centres are service delivery strategies that are greatly appreciated by regional, rural and remote haematology patients who are stressed by the many challenges associated with leaving home to travel distances for specialist treatment. It is the hope and expectation that these findings will make a contribution to informing future health policy and service delivery planning. What is known about the topic? Internationally, there is evidence of the benefits of visiting specialists and the development of local specialist services for cancer patients in regional and rural areas, but there is limited research on the topic in Australia. What does this paper add? The findings herein make a contribution to this area of research through an up-to-date, in-depth consumer perspective on non-metropolitan oncology hospital services for haematology patients in Queensland. The evidence indicates that the opportunity to avoid travel to the metropolitan treating hospitals for regional, rural and remote haematology patients is increasingly an option in Queensland and greatly appreciated by many of those who have this option. What are the implications for practitioners? The findings applaud the work of the health professionals providing the opportunity for regional specialist care for haematology patients. With regard to service delivery and health policy decision making, it is important to note that for patients positive about access to local treatment, psychosocial concerns (e.g. remaining at home, connection with family, avoidance of financial hardship) predominate in their reasoning about benefit. Thus, it is important that regional, rural and remote patients are offered greater choice in treatment options and have more involvement in decision making about specialist care.

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Sung, Jong Ho, et Jung Ha Kim. « Problems and Reconsideration of the Concept of Public Health Care (Public Health and Medical Services) in South Korea ». Korean Medical Education Review 24, n^o 1 (28 février 2022) : 3–9. http://dx.doi.org/10.17496/kmer.2022.24.1.3.

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The concept of “public health care (public health and medical services)” as discussed in South Korea is used in an unclear sense, with a meaning unlike the terminology used worldwide. The terms “public health care (public health and medical services)” and “health care (health and medical services)” have the same legal definition in Korea. Globally, “public health care (public health and medical services)” refers to medical services provided to the public that are operated as publicly funded resources, but in Korea, this term is confined to limited medical services prescribed by the government. The following considerations regarding “public health care (public health and medical services)” in Korea are proposed: All medical services performed by the state, regional governments, health care institutions, or health care workers to protect and promote the health of the people should be clearly established as “public health care (public health and medical services)” by definition. The financial burden borne by the state through national health insurance should be increased to an appropriate level to clarify the states responsibility. Improving public health is an urgent priority in Korea, and this goal can be achieved by improving regional public health through systematic relationships between the state and regional governments, establishing a Ministry of Health, and efficiently allocating public health doctors who are important for providing regional medical care in rural and remote areas. It will be possible to actively deal with infectious diseases at the national level through establishment of a Ministry of Disease Control and Prevention.

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Versace, Vincent L., Tony Smith et Keith Sutton. « Beyond the black stump : rapid reviews of health research issues affecting regional, rural and remote Australia ». Medical Journal of Australia 215, n^o 3 (10 juillet 2021) : 141. http://dx.doi.org/10.5694/mja2.51165.

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Gillam, Marianne H., Martin Jones et Esther May. « Beyond the black stump : rapid reviews of health research issues affecting regional, rural and remote Australia ». Medical Journal of Australia 215, n^o 3 (10 juillet 2021) : 141. http://dx.doi.org/10.5694/mja2.51167.

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Zhou, Chengli, Juan Hu et Ni Chen. « Remote Care Assistance in Emergency Department Based on Smart Medical ». Journal of Healthcare Engineering 2021 (19 juin 2021) : 1–10. http://dx.doi.org/10.1155/2021/9971960.

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Smart medical care is user-centric, medical information is the main line, and big data, Internet of Things, cloud computing, artificial intelligence, and other technologies are used to establish scientific and accurate information, as well as an efficient and reasonable medical service system. Smart medical plays an important role in alleviating doctor-patient conflicts caused by information asymmetry, regional health differences caused by irrational allocation of medical resources, and improving medical service levels. This article mainly introduces the remote care assistance system of emergency department based on smart medical and intends to provide some ideas and directions for the technical research of patients in emergency department receiving remote care. This paper proposes a research method for remote care assistance in emergency departments based on smart medical, including an overview of remote care based on smart medical, remote care sensor real-time monitoring algorithms based on smart medical, signal detection algorithms, and signal clustering algorithms for smart medical. Remote care in the emergency department assisted in research experiments. The experimental results show that 86.0% of patients like the remote care system based on smart medical studied in this paper.

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Peterson, Sandra, Evelyn Shapiro et Noralou P. Roos. « Regional Variation in Home Care Use in Manitoba ». Canadian Journal on Aging / La Revue canadienne du vieillissement 24, S1 (2005) : 69–80. http://dx.doi.org/10.1353/cja.2005.0054.

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ABSTRACTPrevious studies report geographic variation in the use of home care services. In the province of Manitoba, home care is a core service that Manitoba' twelve regional health authorities (RHAs) are obligated to deliver. Manitoba' RHAs range from remote northern and rural southern regions to a major city, resulting in different challenges for delivering home care. Given this potential for inconsistent delivery and the previous findings of regional variation in other settings, the objective of this study was to measure and assess variation in the use of home care across Manitoba' RHAs. We used data from the Provincial Home Care Program' client registry, other health care administrative databases, and Vital Statistics. Home care use was measured using multiple indicators, including rates of population use, use after hospitalization, before entry to a long-term care facility, and before death. While some important differences emerged, overall we found comparable use of home care across Manitoba.

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D'Abbs, Peter, et Samantha Togni. « Liquor licensing and community action in regional and remote Australia : a review of recent initiatives ». Australian and New Zealand Journal of Public Health 24, n^o 1 (février 2000) : 45–53. http://dx.doi.org/10.1111/j.1467-842x.2000.tb00722.x.

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