Abstract:
INTRODUCTION: AIM:To measure the quality of antenatal care in rural and remote regions of the Northern Territory, using asymptomatic bacteruria as an indicator. BACKGROUND:Indigenous Australian women and their babies have a greater frequency of adverse outcomes in pregnancy than their non-Indigenous counterparts. It is well established that asymptomatic bacteriuria may have serious outcomes in pregnancy, including an increased risk of pyelonephritis and a strong association with preterm and low birth weight delivery. Ensuring good quality antenatal care can reduce the individual risks of pregnancy for mothers and their babies. In the Northern Territory there are well established guidelines for antenatal care in rural and remote Indigenous communities. These are documented in the Women's Business Manual. Audit and feedback is one method that has been shown to have a small to moderate effect in changing clinician behaviour, in this case improving compliance with guidelines. METHODS:A retrospective chart audit of antenatal clients was conducted at 10 rural and remote primary health care clinics in the Northern Territory, Australia. The audit reviewed all the available charts (n = 268) of pregnant women, from the participating communities, who gave birth in 2002 or 2003. The diagnosis and management of asymptomatic bacteriuria was chosen as the indicator of quality antenatal care, as it is one of five areas of antenatal care where there is evidence that appropriate management improves outcomes. The quality of care was measured against the local guidelines, the Women's Business Manual. RESULTS:Women frequently had urine tests with where the dipstick showed an abnormal result, with 75% (95% CI [0.70,0.80]) of women having at least one episode of abnormal urinalysis during pregnancy. Six hundred and twenty episodes of abnormal urinalysis in pregnancy were identified. The incidence of bacteriuria at first visit was 16%, (95%-confidence interval = 95% CI [0.10, 0.21]). Compliance with the guidelines was poor. Fifty-six percent (95% CI [0.52,0.60]) of those samples testing positive on urinalysis were not sent to pathology for microscopy and culture, as recommended in the guidelines. Of those with a positive culture, 32% (95% CI 0.28,0.39) were appropriately treated with antibiotics. When antibiotics were given, good compliance of 82% (95% CI 0.76,0.87) with antibiotic guidelines was demonstrated. The positive predictive value of dipstick urinalysis in diagnosing asymptomatic bacteriuria was low in this study at 33.5%. There were 13 episodes of confirmed or probable pyelonephritis. No women with recurrent urinary tract infections were followed up according to protocol. CONCLUSION:Aboriginal women have worse pregnancy outcomes than the non-Indigenous population of Australia. Pyelonephritis is a preventable condition in pregnancy. In these rural and remote communities, pyelonephritis has not been prevented due, in part, to a failure to follow the local guidelines. Structural problems were identified and need to be addressed in order to improve compliance with guidelines and hence pregnancy outcomes for rural and remote Indigenous women.
journal_name
Rural Remote Healthjournal_title
Rural and remote healthauthors
Bookallil M,Chalmers E,Andrew Bkeywords:
subject
Has Abstractpub_date
2005-07-01 00:00:00pages
395issue
3issn
1445-6354pii
395journal_volume
5pub_type
杂志文章abstract:INTRODUCTION:This paper reports on research to ascertain the views of general practitioners (GPs) practising in rural and remote areas of South Australia, on evidence-based medicine (EBM). It follows our previous paper that identified, through a literature search, the key issues in moving towards EBM in general practic...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2002-01-01 00:00:00
abstract:INTRODUCTION:Malnutrition is a serious public health problem, particularly in developing countries, linked to a substantial increase in the risk of mortality and morbidity. Women and young children are most often affected. Rural disadvantage is a known factor, but little attention has been paid to rural-urban disparity...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2008-04-01 00:00:00
abstract:INTRODUCTION:There is growing evidence that in rural areas cancer mortality is higher and referral occurs later, indicating different patterns of care. In Scotland services to rural areas have been organized through 'managed clinical networks'. In some cases, these organizational networks have been structured so that t...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2008-10-01 00:00:00
abstract:INTRODUCTION:Retirement from paid work is a major life change for men and women. It has been suggested that, for men, self-identity is more strongly associated with paid work than is generally the case for women. If this is so, then the retirement transition for men, in which not only the behaviours of a lifetime but a...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2006-07-01 00:00:00
abstract:INTRODUCTION:There has been no research exploring the financial impact on the live renal donor in terms of testing, hospitalisation and surgery for kidney removal (known as nephrectomy). The only mention of financial issues in relation to live renal transplantation is the recipients' concerns in relation to monetary pa...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2012-01-01 00:00:00
abstract:CONTEXT:Suicide is an important public health issue among rural communities although there is no single pattern of suicide in rural areas. Despite this, there are common themes in much of the research evidence on suicide in rural areas. From the published research in the area, a conceptual model of rural suicide has be...
journal_title:Rural and remote health
pub_type: 杂志文章,评审
doi:
更新日期:2011-01-01 00:00:00
abstract:INTRODUCTION:The Australian Rural Clinical Schools, established nationally in 2000-2001, have provided an opportunity for medical students to undertake their clinical training across a network of hospitals, general practice surgeries and community medical centres in locations throughout Australia. The Rural Clinical Sc...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2006-01-01 00:00:00
abstract::In 2001, it was estimated that 4.7 million South Africans were living with HIV/AIDS. Prevalence figures have risen steadily over the past 10 years in most African countries, and in only a few, like Uganda, does the epidemic show signs of waning. In Africa, the status of the obese has risen enormously. If you're fat, y...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2004-04-01 00:00:00
abstract:INTRODUCTION:Early diagnosis and supervised treatment remains the mainstay for tuberculosis (TB) control in India. METHODS:A facility-based cross-sectional study was conducted to assess diagnostic and treatment practices of tuberculosis management as per the Revised National Tuberculosis Control Programme at a seconda...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2014-01-01 00:00:00
abstract:CONTEXT:An astounding 50% of blindness and 70% of vision impairment in Australia is caused by conditions that are said to be preventable or treatable. Aboriginal people suffer 10 times the rate of blindness and attend eyecare practitioners in far lower numbers than other members of the Australian population. ISSUE:In ...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2004-01-01 00:00:00
abstract:INTRODUCTION:In mid-July 2010 flash flooding in Pakistan destroyed the basic water, environmental sanitation and livelihood infrastructures in 82 districts. Two months later, the local press of Swat (northern Pakistan) reported that several residents of Marghazar town became ill and were hospitalized after drinking con...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2012-01-01 00:00:00
abstract:INTRODUCTION:Health promotion is a key component of comprehensive primary health care. Health promotion approaches complement healthcare management by enabling individuals to increase control over their health. Many primary healthcare staff have a role to play in health promotion practice, but their ability to integrat...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:10.22605/RRH4413
更新日期:2018-05-01 00:00:00
abstract:INTRODUCTION:Health professions students interested in future rural practice locations spend a week learning about and investigating all aspects of small town personal, professional and community life. This augments the mainly clinical experience provided by clinical rotations they complete as part of their professiona...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2012-01-01 00:00:00
abstract:INTRODUCTION:An unbalanced geographical distribution of physicians leads to important differences in healthcare outcomes and difficulties in accessing healthcare services in rural areas. As in many other countries in the world, the geographical distribution of physicians in Turkey is unbalanced. Although there has been...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2015-07-01 00:00:00
abstract:INTRODUCTION:Health care and research in rural populations are often limited due to poor infrastructure and small sample sizes. However, such populations have a need for medical care and can be of great value when studying the health effects of lifestyle and genetic factors. The Northern Sweden Population Health Study ...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2010-04-01 00:00:00
abstract:INTRODUCTION: AIM:The aim of the study was to explore and document what assists a rural district hospital to function well. The lessons learned may be applicable to similar hospitals all over the world. METHOD:A cross-sectional exploratory study was carried out using in-depth interviews with 21 managers of well-funct...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2005-10-01 00:00:00
abstract:INTRODUCTION:Skin infections including scabies and impetigo have a high burden and cause significant morbidity in remote Aboriginal communities in Australia. Nevertheless, there is limited knowledge about community, healthcare practitioner and service provider perspectives on skin infections and treatment preferences. ...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:10.22605/RRH5227
更新日期:2019-09-01 00:00:00
abstract:INTRODUCTION:Farm health and safety has historically focussed on strategies such as injury prevention, safety audits and fulfilling legislative responsibilities. However, farmer injuries mask deeper health issues including higher rates of cancer, suicides, cardiovascular disease and stress. The relationship between occ...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2009-01-01 00:00:00
abstract:CONTEXT:This article describes the development and evaluation of a tool to prioritize physiotherapy referrals in a remote, under-serviced region in Canada's eastern Arctic. The Baffin Region of Nunavut is home to approximately 16 000 people dispersed across 12 communities accessible only by air. Physiotherapists are ba...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2010-04-01 00:00:00
abstract:INTRODUCTION:There is evidence in the literature that rural background significantly encourages eventual rural practice. Given the shortage of healthcare providers in rural areas, we need to explore ways of ensuring throughput and success of rural-origin students in health sciences. It is therefore important to underst...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2012-01-01 00:00:00
abstract:INTRODUCTION:North American rural residents have higher rates of chronic disease and they report being ill more frequently compared to their urban counterparts. We recently studied health-related quality in residents living in the isolated, rural community of Bella Coola, Canada. OBJECTIVE:To assess health-related qua...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2006-04-01 00:00:00
abstract:INTRODUCTION:Time spent in remote medicine as an undergraduate is influential in career choice in Australia and Northern America. However, its influence is not known in smaller countries, where recruitment into rural medicine is also problematic. Differences across countries mean work is required to explore determinant...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2008-07-01 00:00:00
abstract:INTRODUCTION:The prevalence of obesity is greater among adults living in rural compared to urban areas of the USA. Greater obesity risk among rural adults persists after adjusting for obesity-related behaviors and sociodemographic factors. With the rural-urban obesity disparity greatest among younger adults, it is impo...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:10.22605/rrh3984
更新日期:2017-01-01 00:00:00
abstract:INTRODUCTION:Smoke-free laws and the addition of graphic warning labels to cigarette packages represent public health policies that can potentially reduce smoking and smoking-related disease. The attitudes and beliefs relating to these policies were examined among residents of Ohio Appalachia, a mostly rural region wit...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2012-01-01 00:00:00
abstract:INTRODUCTION:Atrial fibrillation (AF) is a major risk factor for ischaemic stroke and a common presentation in general practice. Scoring systems to guide antithrombotic treatment have been available since 1996, with the CHA2DS2-VASC in current use; however, little is known about adherence to guidelines in rural general...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:10.22605/RRH4342
更新日期:2019-03-01 00:00:00
abstract:INTRODUCTION:Road traffic crashes constitute a considerable public health burden and represent the eighth leading cause of death and tenth leading cause of disability adjusted life years (DALYs) globally. However, very little is known about the extent, causes and impact of crashes in low- and middle-income countries in...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2015-07-01 00:00:00
abstract::Prostate cancer mortality worldwide has recently decreased by 6% after peaking in the 1990s. Based on the recently published results of the European Randomised Study for Screening of Prostate Cancer (which showed a relative prostate cancer mortality reduction of at least 20% by PSA-based population screening) it could...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2009-04-01 00:00:00
abstract:INTRODUCTION:High prevalence rates of obesity, particularly among those residing in US rural areas, and associated physical and psychosocial health consequences, direct attention to the need for effective prevention programs. The current study describes an initial step in developing a school-based obesity prevention pr...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2009-10-01 00:00:00
abstract:INTRODUCTION:Despite reports suggesting an oversupply of pharmacists, there is currently an inadequate supply in rural and remote Australia. This can lead to a reduction in pharmaceutical services for an already vulnerable population. The objective of this study was to identify strategies for increasing the pharmacist ...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:10.22605/RRH5741
更新日期:2020-11-01 00:00:00
abstract:INTRODUCTION:A person's capability to access services and achieve good eye health is influenced by their behaviours, perceptions, beliefs and experiences. As evidence from Papua New Guinea (PNG) about people's lived experience with vision impairment is limited, the purpose of the present study was to better understand ...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2016-10-01 00:00:00