bluuebunny/crossref_metadata_2025_split huggingface dataset:
STAFF PERCEPTIONS OF CARE FOR DELIBERATE SELF‐HARM PATIENTS IN RURAL WESTERN AUSTRALIA: A QUALITATIVE STUDY
Authors: Slaven Janine , Kisely Stephen 
Published: August 2010

ABSTRACT: Suicide has been a major community concern in Esperance, a geographically isolated port on the south coast of Western Australia. This study to explores the views of regional health staff on barriers to the effective management of deliberate self‐harm (DSH) and ways in which those barriers could be addressed. Semi‐structured interviews were tape‐recorded, transcribed and subjected to qualitative content analysis. Interviewees included 77% of general practitioners (n = 7), 18% of nurses (n = 13) and 55% of mental health professionals (n = 5). The most important barrier was a lack of structure to treating DSH, resulting in deficiencies and inconsistencies in its management. Suggestions to improve the management of DSH included better communication between services, support for nurses in raising the issue of suicide, use of a simple risk assessment tool, the development of a nurse liaison position, and a multidisciplinary planning group.The higher rates of DSH and completed suicide in rural and remote regions compared with metropolitan areas make secondary prevention particularly important.
BALANCING HOSPITAL AND COMMUNITY TREATMENT: EFFECTIVENESS OF AN EXTENDED‐HOURS COMMUNITY MENTAL HEALTH TEAM IN A SEMI‐RURAL REGION OF AUSTRALIA
Authors: Habibis Daphne , Hazelton Mike , Schneider Rosemary , Davidson John , Bowling Alison 
Published: August 2010

ABSTRACTObjective: To examine the effectiveness of the introduction of a community mental health team on consumer psychosocial outcomes.Design: Longitudinal panel design.Setting: District general hospital in a semi‐rural region of Australia.Numbers: Two matched groups (n = 37 in each group)Main outcome measure: These included: Brief Psychiatric Rating Scale (BPRS), Global Assessment Scale (GAS), Rosenberg Self‐Esteem, Life Skills Profile as well as self‐report.Results: The study found that the introduction of the new service resulted in few significant differences in consumer outcomes.Conclusions: The paper argues that because the state was the only specialist mental health service provider and it was unable to offer assertive community treatment, hospital care remained central. Evidence that a substantial proportion of consumers and carers preferred hospital to community care is placed against this background. The paper argues that in regions like these, where community‐based services are likely to remain underdeveloped, it may be best to maintain quality hospital services and to target community services more precisely on what is achievable rather than developing community services at the expense of hospital care.
IDENTIFYING MUSCULOSKELETAL CONDITIONS AMONG RURAL INDIGENOUS PEOPLES
Authors: Vindigni Dein , Perkins Janice 
Published: August 2010

ABSTRACTObjective: To critically review the methodological properties of previous musculoskeletal studies among Indigenous populations. In particular, non‐rheumatic, musculoskeletal conditions of mechanical origin are examined as these appear to be commonly related to syndromes of pain and disability.Design: Systematic review.Setting: Rural, Indigenous communities throughout the world.Subjects: Indigenous peoples aged 16 and over living in rural communities.Main outcome measure: Minimum requirements for methodologically sound musculoskeletal health research according to previously published criteria.Results: Due to methodological limitations in the 14 studies reviewed, only five methodologically acceptable studies were found.Conclusion: Given the paucity of methodologically sound musculoskeletal studies among Indigenous populations, the true prevalence of musculoskeletal conditions in these communities remains largely unknown.
GETTING THE BALANCE RIGHT? GPS WHO CHOSE TO STAY IN RURAL PRACTICE
Authors: Hays Richard , Wynd Shona , Veitch Craig , Crossland Lisa 
Published: August 2010

ABSTRACTBackground: Despite major challenges to the retention of rural GPs in Australia, little is known about why some rural GPs stay long‐term within their communities.Method: A group of rural GPs interviewed as part of another study about 10 years ago were re‐interviewed to explore their attitudes to their reasons for staying.Results: Eighteen of the original group of 23 could be contacted and 13 were interviewed. Factors that appeared to promote staying in rural practice were: strong attachment to the community; and practice arrangements that allow for adequate time off‐call and for holidays. However, several GPs were stressed and some had considered leaving. The stressors were similar to those identified in earlier research, including overwork and having to send children to boarding school.Conclusion: Personal and professional support arrangements within the community appear to be associated with decisions by rural GPs to remain in practice for substantial periods of time. Retention strategies should focus on facilitation of local integration.
WORK OF FEMALE RURAL DOCTORS
Authors: Wainer Jo 
Published: August 2010

Objectives: To identify the impact of family life on the ways women practice rural medicine and the changes needed to attract women to rural practice. Design: Census of women rural doctors in Victoria in 2000, using a self‐completed postal survey. Setting: General and specialist practice. Subjects: Two hundred and seventy‐one female general practitioners and 31 female specialists practising in Rural, Remote and Metropolitan Area Classifications 3–7. General practitioners are those doctors with a primary medical degree and without additional specialist qualifications. Main outcome measure: Interaction of hours and type of work with family responsibilities. Results: Generalist and specialist women rural doctors carry the main responsibility for family care. This is reflected in the number of hours they work in clinical and non‐clinical professional practice, availability for oncall and hospital work, and preference for the responsibilities of practice partnership or the flexibility of salaried positions. Most of the doctors had established a satisfactory balance between work and family responsibilities, although a substantial number were overworked in order to provide an income for their families or meet the needs of their communities. Thirty‐six percent of female rural general practitioners and 56% of female rural specialists preferred to work fewer hours. Female general practitioners with responsibility for children were more than twice as likely as female general practitioners without children to be in a salaried position and less likely to be a practice partner. The changes needed to attract and retain women in rural practice include a place for everyone in the doctor's family, flexible practice structures, mentoring by women doctors and financial and personal recognition.
EDUCATIONAL NEEDS OF RURAL AND REMOTE AUSTRALIAN NON‐SPECIALIST MEDICAL PRACTITIONERS FOR OBSTETRIC ULTRASOUND
Authors: Glazebrook Roz , Manahan Dan , Chater Bruce , Barker Peter , Row David , Steele Brendan , Morris Graham , Cornelius Sally , McLellan Tony 
Published: August 2010

Objective: To determine the educational needs of rural and remote non‐specialist Australian doctors for obstetric ultrasound. Design: Survey design. Setting: The study surveyed rural and remote doctors practising in a variety of settings including general practice, rural hospitals, Aboriginal communities and flying doctor organisations throughout Australia. Subjects: Subjects included 314 solo and group practice rural general practitioners, rural hospital medical superintendents, senior medical officers, Aboriginal community controlled health service doctors, flying doctors, rural locums, registrars and two rural obstetricians. A total of 55% of the subjects were general practitioners in group practice. Respondents included 68 (22%) women and 246 (78%) men. Results: The response rate was 32%. The highest priority areas of need for education included detecting foetal abnormalities and anomalies (19.1%), basic routine ultrasonography (17.17%), placental position (17.17%), dating (17.17%), foetal viability (12.88%) and morphology scan (12.26%). The main areas where doctors stated they lacked confidence included detecting foetal abnormalities (29.09%), basic routine ultrasonography (including machine use), such as, carrying out and interpreting obstetric ultrasound scans (27.27%), morphology scans (16.36%) and placental position (14.54%). Conclusion: The study showed there was a large unmet need for education in obstetric ultrasound among rural and remote non‐specialist doctors. Information from the needs assessment was used to develop the Australian College of Rural and Remote Medicine national obstetric ultrasound professional development program.
ARE RURAL PEOPLE GETTING HEARTSMART?
Authors: Aoun Samar , Rosenberg Michael 
Published: August 2010

Objective: This study evaluates the impact of a cardiac rehabilitation program (HeartSmart) in a rural area on the quality of life, dietary behaviour, weight loss and physical activity participation of patients with cardiovascular disease (CVD) or at high risk of CVD. Design: The evaluation of the program consisted of a single group pre and post‐test design with follow‐up at 3, 6 and 12 months after program completion, complemented with a cross‐sectional survey of non‐participants as a pseudo comparison group. Setting: The HeartSmart program is a hospital‐based cardiac rehabilitation program in Bunbury, a regional centre of Western Australia. Subjects: A total of 203 participants and 159 non‐participants. Interventions: The program consisted of 7 weeks of education and exercise sessions. Results: The program had a high rate of completion (92%). Evaluation results suggested that HeartSmart participants demonstrated significant improvements in quality of life, compliance with medication, dietary behaviour, weight loss and physical activity participation. The largest changes were mostly observed between pre and post‐program stages, with sustained behaviour change at 6 months after the completion of the program. Further evidence of the HeartSmart benefits was provided through significantly better health‐related behaviour, confidence to diet and exercise, dietary fat intake, cardiac knowledge and quality of life scores among HeartSmart participants compared with non‐participants. Conclusions: While this program has achieved its objectives, there are a few issues that need to be considered by similar programs: the post‐program stage of patient follow‐up by general practitioners; the geographical disadvantage of those living outside regional centres to access the service; enhancing the primary prevention aspect of the program; adapting the program to the needs of Aboriginal clients; facilitating evaluations by resourcing and training program staff in computer skills.
Trichomonas vaginalis in Vanuatu
Authors: Fotinatos Nina , Warmington Adrian , Walker Todd , Pilbeam Mark 
Published: August 2010

AbstractObjective:  To assess the prevalence of Trichomonas vaginalis in two island populations of Vanuatu using the Pap smear as the screening technique.Study design:  Women were randomly selected from specific sites on the islands of Efate (urban setting) and Ambae (rural setting). Pap smears were collected, screened and reported. Setting:  The first collection site was the Women's Health/Antenatal Care Clinic at Vila Central Hospital in Port Vila, the capital city located on the island of Efate, and the second collection site was a rural village on a sparsely populated inhabited northern island, Ambae. Participants:  A total of 905 Ni‐Vanuatu women participants: Efate (n = 562) 62%, and Ambae (n = 343) 38%. The mean age was 35.8 years: Efate 32.6 years, and Ambae 40.8 years.Main outcome measure:  The presence or absence of T. vaginalis in these Pap smears was documented during the study's cervical screening process.Results:  The overall prevalence of T. vaginalis within the study participants was 25.3%. Almost half of the infected sample group were in the age group of 30–39 years (43.8%). The prevalence of T. vaginalis in Efate was 14.7%, compared with 43.4% in Ambae.Conclusion:  The prevalence of T. vaginalis in Vanuatu women is significantly higher compared with developed countries. Women in rural settings are less likely to have access to sexually transmitted disease prevention and treatment programs, thus contributing to high infection rates compared with women in urban settings. Cultural and educational differences in the rural setting might also contribute to higher sexually transmitted disease rates among these women.
How do registered nurses define rurality?
Authors: Kulig Judith C. , Andrews Mary Ellen , Stewart Norma L. , Pitblado Roger , MacLeod Martha L. P. , Bentham Donna , D'Arcy Carl , Morgan Debra , Forbes Dorothy , Remus Gail , Smith Barbara 
Published: August 2010

AbstractObjective:  The objective of this analysis was to identify the meaning of rurality for registered nurses (RNs) practising in rural and remote Canada. Setting and design:  An existing Statistics Canada definition was used to stratify Canada's 10 provinces into urban and rural areas. As part of a national multi‐method study, a random sample of RNs in these rural strata, plus all RNs working in outpost settings and northern territories, were surveyed concerning the nature of nursing practice. Content analysis was used to identify themes from an open‐ended question: ‘How do you define rural/remote?’ Refinement of the themes was conducted by the survey team and credibility was supported through investigator triangulation. Participants:  Of the 3933 RNs who responded to the survey (68% response rate), 3412 provided a definition of rural/remote. A subsample of 1285 RNs was used for detailed thematic analysis because these respondents provided definitions with a clear referent to rural and/or to remote; the remaining sample was used for verification of themes. Results:  Four defining themes were identified by RNs for both rural and remote: community characteristics, geographical location, health human and technical resources, and nursing practice characteristics. Conclusions:  The themes can be used as content domains or dimensions of rurality to improve our understanding of how to describe rural communities, including geographical location and nursing practice, from the perspective of RNs.
Prevalence and predictors of depressive symptoms among rural older Australians and Americans
Authors: Buys Laurie , Roberto Karen A. , Miller Evonne , Blieszner Rosemary 
Published: August 2010

AbstractObjective:  To examine the predictors of depressive symptoms among older married rural Australian and American men and women, using comparable measures from two separate studies. Design:  Postal survey for Australians; telephone interviews for Americans. Setting:  Rural Australia (six states and two territories) and America (Virginia). Participants:  Older married rural men and women, aged 65 years and over, in Australia (n = 216) and America (n = 156).Main outcome measures:  Whether predictors of depressive symptoms, specifically demographic factors, health, pain, functional limitations and social networks, differed according to nationality or sex. Results:  Approximately one‐third of older rural Australian (37%) and Americans (28%) reported recently experiencing depressive symptoms. For Australian men and women, pain was the strongest predictor of depressive symptoms. For American women, dissatisfaction with social support predicted depressive symptoms, whereas no variable predicted depressive symptoms in American men. Conclusions:  In the context of a globally ageing population, the fact that nearly one in three older rural people on two continents described themselves as recently feeling depressed is a troubling finding of considerable importance to both practitioners and policy‐makers. The findings raise questions about the cultural acceptance, definition and manifestations of symptoms of depression in rural communities, as well as the role of different public health and support systems in the two countries.
Multidetector spiral CT venography in the diagnosis of upper extremity deep venous thrombosis
Authors: Sabharwal R , Boshell D , Vladica P 
Published: August 2010

SUMMARYUpper extremity deep vein thrombosis is a rare thrombotic disorder (1–4% of all DVT) which has the potential for considerable morbidity. We present a case which demonstrates the limitations in diagnostic accuracy of ultrasonography in the diagnosis of upper extremity deep venous thrombosis. Multidetector spiral computed tomography (CT) continues to evolve as a state of the art imaging modality and our case demonstrates the role and value of multidetector spiral CT venography (CTV) in the diagnosis of upper extremity deep venous thrombosis.
NITRIC OXIDE, ERECTILE DYSFUNCTION AND BETA‐BLOCKER TREATMENT (MR NOED STUDY): BENEFIT OF NEBIVOLOL VERSUS METOPROLOL IN HYPERTENSIVE MEN
Authors: Brixius K , Middeke M , Lichtenthal A , Jahn E , Schwinger R H G 
Published: August 2010

SUMMARY

Hypertensive men treated with beta‐blockers frequently complain of erectile dysfunction. The present study investigated the effects of two β1‐adrenoceptor‐selective antagonists, namely nebivolol and metoprolol, on erectile function in hypertensive men.
Male out‐patients (age range 40–55 years) with newly diagnosed or existing stage 1 essential hypertension (mean seated systolic blood pressure 140–159 mmHg; diastolic blood pressure 90–99 mmHg) were enrolled in the study. All patients lived in a stable, heterosexual partnership and had no history of sexual dysfunction. After a 2 eek placebo run‐in period, patients were randomized double‐blind to either Treatment group A (comprising nebivolol 5 mg once daily for 12 weeks, followed by placebo for 2 weeks and then metoprolol succinate 95 mg once daily for 12 weeks) or Treatment group B (comprising metoprolol succinate 95 mg for 12 weeks, placebo for 2 weeks and then nebivolol 5 mg for 12 weeks). An international index of erectile function (IIEF) questionnaire and a diary documented patients’ sexual function and activity.
Nebivolol and metoprolol lowered blood pressure to a similar extent. Metoprolol, but not nebivolol, significantly decreased the IIEF erectile function subscore by 0.92 in the first 8 weeks after onset of beta‐blocker treatment. In contrast with metoprolol, nebivolol improved secondary sexual activity scores and other IIEF subscores.
Despite similar antihypertensive efficacy of the cardioselective β1‐adrenoceptor antagonists nebivolol and metoprolol, nebivolol may offer additional benefits by avoiding erectile dysfunction in male hypertensive patients on long‐term β‐adrenoceptor antagonist therapy.
INHIBITION OF INDUCIBLE NITRIC OXIDE SYNTHASE ATTENUATES ACUTE ENDOTOXIN‐INDUCED LUNG INJURY IN RATS
Authors: Su Chain Fa , Yang Fwu Lin , Chen Hsing I 
Published: August 2010

SUMMARY

In the present study, we investigated the effects of the inducible nitric oxide (iNOS) inhibitors S‐methylisothiourea (SMT) and l‐N6‐(1‐iminoethyl)‐lysine (l‐Nil) on endotoxin‐induced acute lung injury (ALI), as well as the associated physiological, biomedical and pathological changes, in anaesthetized Sprague‐Dawley rats and in rat isolated perfused lungs.
Endotoxaemia was induced by an intravenous (i.v.) infusion of lipopolysaccharide (LPS; Escherichia coli 10 mg/kg). Lipopolysaccharide produced systemic hypotension and tachycardia. It also increased the lung weight/bodyweight ratio, lung weight gain, exhaled nitric oxide (NO), the protein concentration in bronchoalveolar lavage and microvascular permeability.
Following infusion of LPS, plasma nitrate/nitrite, methyl guanidine, pro‐inflammatory cytokines (tumour necrosis factor‐α and interleukin‐1β) were markedly elevated. Pathological examination revealed severe pulmonary oedema and inflammatory cell infiltration. Pretreatment with SMT (3 mg/kg, i.v.) or l‐Nil (3 mg/kg, i.v.) significantly attenuated the LPS‐induced changes and ALI.
The results suggest that the inflammatory responses and ALI following infusion of LPS are due to the production of NO, free radicals and pro‐inflammatory cytokines through the iNOS system. Inhibition of iNOS is effective in mitigating the endotoxaemic changes and lung pathology. Inhibitors of iNOS may be potential therapeutic agents for clinical application in patients with acute respiratory distress syndrome.
INHIBITION OF NAD(P)H OXIDASE REDUCES FIBRONECTIN EXPRESSION IN STROKE‐PRONE RENOVASCULAR HYPERTENSIVE RAT BRAIN
Authors: Cui Chunmei , Chen Alex F , Jiang Zongpei , Wu Qingqing , Lin Jianwen , Wen Hongmei , Zeng Jinsheng 
Published: August 2010

SUMMARY

The aim of the present study was to test the hypothesis that in vivo chronic inhibition of NAD(P)H oxidase reduces cerebrovascular fibronectin expression in stroke‐prone renovascular hypertensive rats (RHRSP).
The RHRSP model was induced by two clips and NAD(P)H oxidase was inhibited with apocynin. The mRNA and protein expression of NAD(P)H oxidase subunit p22phox in brains of RHRSP and Sprague‐Dawley (control) rats was determined using real‐time reverse transcription–polymerase chain reaction, western blot and immunohistochemistry. The expression of fibronectin protein was localized immunohistochemically in cerebral vessels and then quantified by western blot.
Cerebrovascular fibronectin levels in RHRSP (n = 6) were significantly higher than control (n = 5) levels 8 weeks after operation (1.29 ± 0.04 vs 1.15 ± 0.02, respectively; P = 0.007). The p22phox immunopositive reactivity was localized in the cerebral vasculature of control rats and RHRSP. Furthermore, chronic treatment of RHRSP with apocynin, a selective NAD(P)H oxidase inhibitor, in the drinking water for 4 weeks (1.5 mmol/L, 5 weeks after operation) resulted in a significant decrease in the expression of p22phox protein (0.85 ± 0.01 vs 0.93 ± 0.01 in non‐treated RHRSP; n = 5; P = 0.002), with a concomitant reduction of fibronectin levels in the cerebral vasculature (1.31 ± 0.03 vs 1.56 ± 0.05 in non‐treated RHRSP; n = 5; P = 0.002). No significant differences were detected in the expression of p22phox mRNA and protein between RHRSP (4 and 8 weeks after renal artery constriction) and the control group.
These findings suggest that the chronic inhibition of NAD(P)H oxidase in vivo by apocynin reduces cerebrovascular fibronectin levels, which may lessen hypertensive cerebrovascular fibrosis.