scholarly journals Parent perceptions of minimally invasive dental treatment of Australian Aboriginal pre-school children in rural and remote communities

2021 ◽  
Author(s):  
Piggott ◽  
Carter ◽  
Forrest ◽  
Atkinson ◽  
Mackean ◽  
...  
2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Mohammed Obaid ◽  
Qianwei Zhang ◽  
Scott J. Adams ◽  
Reza Fotouhi ◽  
Haron Obaid

Abstract Background Telesonography systems have been developed to overcome barriers to accessing diagnostic ultrasound for patients in rural and remote communities. However, most previous telesonography systems have been designed for performing only abdominal and obstetrical exams. In this paper, we describe the development and assessment of a musculoskeletal (MSK) telesonography system. Methods We developed a 4-degrees-of-freedom (DOF) robot to manipulate an ultrasound probe. The robot was remotely controlled by a radiologist operating a joystick at the master site. The telesonography system was used to scan participants’ forearms, and all participants were conventionally scanned for comparison. Participants and radiologists were surveyed regarding their experience. Images from both scanning methods were independently assessed by an MSK radiologist. Results All ten ultrasound exams were successfully performed using our developed MSK telesonography system, with no significant delay in movement. The duration (mean ± standard deviation) of telerobotic and conventional exams was 4.6 ± 0.9 and 1.4 ± 0.5 min, respectively (p = 0.039). An MSK radiologist rated quality of real-time ultrasound images transmitted over an internet connection as “very good” for all telesonography exams, and participants rated communication with the radiologist as “very good” or “good” for all exams. Visualisation of anatomic structures was similar between telerobotic and conventional methods, with no statistically significant differences. Conclusions The MSK telesonography system developed in this study is feasible for performing soft tissue ultrasound exams. The advancement of this system may allow MSK ultrasound exams to be performed over long distances, increasing access to ultrasound for patients in rural and remote communities.


Sexual Health ◽  
2015 ◽  
Vol 12 (1) ◽  
pp. 4 ◽  
Author(s):  
Belinda Hengel ◽  
Rebecca Guy ◽  
Linda Garton ◽  
James Ward ◽  
Alice Rumbold ◽  
...  

Background Remote Australian Aboriginal communities experience high rates of bacterial sexually transmissible infections (STI). A key strategy to reduce STIs is to increase testing in primary health care centres. The current study aimed to explore barriers to offering and conducting STI testing in this setting. Methods: A qualitative study was undertaken as part of the STI in Remote communities, Improved and Enhanced Primary Health Care (STRIVE) project; a large cluster randomised controlled trial of a sexual health quality improvement program. We conducted 36 in-depth interviews in 22 participating health centres across four regions in northern and central Australia. Results: Participants identified barriers including Aboriginal cultural norms that require the separation of genders and traditional kinship systems that prevent some staff and patients from interacting, both of which were exacerbated by a lack of male staff. Other common barriers were concerns about client confidentiality (lack of private consulting space and living in small communities), staff capacity to offer testing impacted by the competing demands for staff time, and high staff turnover resulting in poor understanding of clinic systems. Many participants also expressed concerns about managing positive test results. To address some of these barriers, participants revealed informal strategies, such as team work, testing outside the clinic and using adult health checks. Conclusions: Results identify cultural, structural and health system issues as barriers to offering STI testing in remote communities, some of which were overcome through the creativity and enthusiasm of individuals rather than formal systems. Many of these barriers can be readily addressed through strengthening existing systems of cultural and clinical orientation and educating staff to view STI in a population health framework. However others, particularly issues in relation to culture, kinship ties and living in small communities, may require testing modalities that do not rely on direct contact with health staff or the clinic environment.


2020 ◽  
Author(s):  
Ryan Buyting ◽  
Sarah Melville ◽  
Hanif Chatur ◽  
Christopher W. White ◽  
Jean-François Légaré ◽  
...  

AbstractCanada is a wealthy nation with a geographically diverse population, seeking health innovations to better serve patients in accordance with the Canada Health Act. In this country, population and geography converge with social determinants, policy, procurement regulations, and technological advances, in order to achieve equity in the management and distribution of healthcare. Rural and remote patients are a vulnerable population; when managing chronic conditions such as cardiovascular disease, there is inequity when it comes to accessing specialist physicians at the recommended frequency—increasing the likelihood of poor health outcomes. Ensuring equitable care for this population is an unrealized priority of several provincial and federal government mandates. Virtual care technology may provide practical, economical, and innovative solutions to remedy this discrepancy. Here we review the literature pertaining to the use of virtual care technologies to monitor patients with cardiovascular disease living in rural areas of Canada. A search strategy was developed to identify the literature specific to this context across three bibliographic databases. 166 unique citations were ultimately assessed for eligibility, of which 36 met the inclusion criteria. In our assessment of these articles, we provide a summary of the interventions studied, their reported effectiveness in reducing adverse events and mortality, the challenges to implementation, and the receptivity of these technologies amongst patients, providers and policy makers. Further, we glean insight into the barriers and opportunities to ensure equitable care for rural patients and conclude that there is an ongoing need for clinical trials assessing virtual care technologies in this context.SummaryPatients living in rural and remote communities’ experience diverse challenges to receiving equitable healthcare as is mandated by the Canada Health Act. Advances in virtual care technology may provide practical, economical, and innovative solutions to ensure this for patients in remote and rural living situations. Here we provide a state-of-the-art review of virtual care technologies available to patients with cardiovascular disease living in rural areas of Canada.


Author(s):  
Omer Mahmood

Distance and inaccessibility create special challenges for health practitioners in rural and remote areas. Health professionals in rural and remote areas face problems such as prescription concerns due to lack of information. This occurs due to a gap in knowledge regarding medications, as health practitioners do not have access to medical history of their patients. Frequent migration of patients in rural and remote communities results in the loss of patients’ medical records. In addition, doctors have limited access to therapeutic information, as searching the Internet from most remote communities is expensive and slow. In addition, frequent migration of patients in remote communities results in the loss of patients’ histories. This chapter proposes a refined conceptual health information management model based on the model presented by Mahmood (2006). The discussed model is based on the use of Data Grid technology and Data Recharging techniques employed in conjunction with wireless communication technologies to overcome the problems and challenges faced by health practitioners. The model categorizes the health establishments in remote areas into two categories on the basis of geographical characteristics and data access requirements. The discussed model aims to meet information and communication technology (ICT) requirements of health practitioners operating in each recognized category.


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