Use of telehealth in the provision of after-hours palliative care services in rural and remote Australia: A scoping review protocol

Introduction After-hours services are essential in ensuring patients with life limiting illness and their caregivers are supported to enable continuity of care. Telehealth is a valuable approach to meeting after-hours support needs of people living with life-limiting illness, their families, and caregivers in rural and remote communities. It is important to explore the provision of after-hours palliative care services using telehealth to understand the reach of these services in rural and remote Australia. A preliminary search of databases failed to reveal any scoping or systematic reviews of telehealth in after-hours palliative care services in rural or remote Australia. Aim To review and map the available evidence about the use of telehealth in providing after-hours palliative care services in Australian rural and remote communities. Methods The proposed scoping review will be conducted using the Arksey and O’Malley methodological framework and in accordance with the Joanna Briggs Institute methodology for scoping reviews. The reporting of the scoping review will be guided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). This review will consider research and evaluation of after-hours services using telehealth for palliative care stakeholders in rural and remote Australia. Peer reviewed studies and grey literature published in English from 2000 to May 2021 will be included. Scopus, Web of Science, CINAHL Complete, Embase via Ovid, PsycINFO via Ovid, Emcare via Ovid, Medline via Ovid, and grey literature will be searched for relevant articles. Titles and abstracts will be screened by two independent reviewers for assessment against the inclusion criteria. Data will be extracted and analysed by two reviewers using an adapted data extraction tool and thematic analysis techniques. Diagrams, tables, and summary narratives will be used to map, summarise and thematically group the characteristics of palliative care telehealth services in rural and remote Australia, including stakeholders’ perceptions and benefits and challenges of the services.

A review of teleradiology in Africa – Towards mobile teleradiology in Nigeria

eHealth is promoted as a means to strengthen health systems and facilitate universal health coverage. Sub-components (e.g. telehealth, telemedicine, mhealth) are seen as mitigators of healthcare provider shortages and poor rural and remote access. Teleradiology (including mobile teleradiology), widespread in developed nations, is uncommon in developing nations. Decision- and policy-makers require evidence to inform their decisions regarding implementation of mobile teleradiology in Nigeria and other sub-Saharan countries. To gather evidence, Scopus and PubMed were searched using defined search strings (September 2020). Duplicates were removed, and titles and abstracts reviewed using specified selection criteria. Full-text papers of selected resources were retrieved and reviewed against the criteria. Insight from included studies was charted for eight a priori categories of information: needs assessment, implementation, connectivity, evaluation, costing, image display, image capture and concordance. Fifty-seven articles were identified, duplicates removed and titles and abstracts of remaining articles reviewed against study criteria. Twenty-six papers remained. After review of full-texts, ten met the study criteria. These were summarised, and key insights for the eight categories were charted. Few papers have been published on teleradiology in sub-Saharan Africa. Teleradiology, including mobile teleradiology, is feasible in sub-Saharan Africa for routine X-ray support of patients and healthcare providers in rural and remote locations. Former technical issues (image quality, transmission speed, image compression) have been largely obviated through the high-speed, high-resolution digital imaging and network transmission capabilities of contemporary smartphones and mobile networks, where accessible. Comprehensive studies within the region are needed to guide the widespread introduction of mobile teleradiology.

Educator Perceptions of Early Learning Environments as Places for Privileging Social Justice in Rural and Remote Communities

Early childhood education and care (ECEC) in Australia has long been associated with the concept of social justice, however, a clear understanding of what it looks like across diverse services and communities is not available. This article reports the process of inquiry, as well as the outcomes, of a small-scale study designed to uncover the perceptions of ECEC educators working in rural and remote communities in the state of Queensland. Data were collected through individual semi-structured interviews with five educators from rural and remote settings identified as areas experiencing significant growth in population diversity. An initial thematic analysis of the data revealed three key themes. A secondary analysis using a place and space conceptual framework uncovered deeper, more sophisticated meanings of the educator experience of social justice. The research is important in bringing pedagogical conversations to the forefront regarding ECEC educator perceptions of their role in creating a socially just learning environment. In addition to identifying future research possibilities, implications from the findings indicate opportunities for re-examining and rethinking initial teacher education and ongoing professional learning.

Source attribution of salmonellosis by time and geography in New South Wales, Australia

Background Salmonella is a major cause of zoonotic illness around the world, arising from direct or indirect contact with a range of animal reservoirs. In the Australian state of New South Wales (NSW), salmonellosis is believed to be primarily foodborne, but the relative contribution of animal reservoirs is unknown. Methods The analysis included 4543 serotyped isolates from animal reservoirs and 30,073 serotyped isolates from domestically acquired human cases in NSW between January 2008 and August 2019. We used a Bayesian source attribution methodology to estimate the proportion of foodborne Salmonella infections attributable to broiler chickens, layer chickens, ruminants, pigs, and an unknown or unsampled source. Additional analyses included covariates for four time periods and five levels of rurality. Results A single serotype, S. Typhimurium, accounted for 65–75% of included cases during 2008–2014 but < 50% during 2017–2019. Attribution to layer chickens was highest during 2008–2010 (48.7%, 95% CrI 24.2–70.3%) but halved by 2017–2019 (23.1%, 95% CrI 5.7–38.9%) and was lower in the rural and remote populations than in the majority urban population. The proportion of cases attributed to the unsampled source was 11.3% (95% CrI 1.2%–22.1%) overall, but higher in rural and remote populations. The proportion of cases attributed to pork increased from approximately 20% in 2009–2016 to approximately 40% in 2017–2019, coinciding with a rise in cases due to Salmonella ser. 4,5,12:i:-. Conclusion Layer chickens were likely the primary reservoir of domestically acquired Salmonella infections in NSW circa 2010, but attribution to the source declined contemporaneously with increased vaccination of layer flocks and tighter food safety regulations for the handling of eggs.

Transformations of Women in Tourism Work: A Case Study of Emancipation in Rural Nepal

A key challenge still exists for emancipation of women in the tourism industry in Nepal. The research addresses how females in Nepal transform themselves through engagement with trekking in remote areas. The authors investigated a female only tourism enterprise to determine how women can encounter avenues to reliable income support. Interviewees were members of Empowering Women Nepal (EWN), a Nepali Non-Government Organisation (NGO), and their interviews were used as a case study regarding women’s training. Open ended questions focused on the background of women who are likely to engage with tourism, barriers preventing engagement in tourism, the positive and negative side to tourism, avenues of support, and specific outcomes to date. The research found that rural and remote Nepali women are being emancipated via engagement with tourism.

Undergraduate Nursing Students' Experience of Northern Rural and Remote Indigenous Communities

Undergraduate nursing programs are moving towards a service learning model in teaching nursing student cultural awareness. In this article, we discuss the nursing student experience in a university elective which immerses students in rural and remote Indigenous communities resulting in cultural consciousness. This service learning experience that students encountered promoted growth in nursing praxis, and fostered positive curriculum growth and community partnerships between the College and the Indigenous communities in which they visited. Students gained cultural consciousness and increased awareness, which is beneficial in their future nursing careers as they grow into better culturally competent care providers. Also discussed is the history and background of these Indigenous communities, The Truth and Reconciliation Commission (TRC) and the First Nations Principles of OCAP (ownership, control, access and possession). These topics are discussed in detail throughout the student experience as they respond to nurses’ professional standards, development of cultural competency and integrating calls to action in truth and reconciliation.