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21st century rural nursing: Navajo Traditional and Western medicine.

https://arctichealth.org/en/permalink/ahliterature187143
Source
Nurs Adm Q. 2002;26(5):47-57
Publication Type
Article
Date
2002
Author
Barbara L O'Brien
Rosemary M Anslow
Wanda Begay
Sister Benvinda A Pereira
Mary Pat Sullivan
Author Affiliation
Magnetic Health Care Strategies, LLC, Middletown, New Jersey, USA.
Source
Nurs Adm Q. 2002;26(5):47-57
Date
2002
Language
English
Publication Type
Article
Keywords
Arizona
Case Management - organization & administration
Health Services, Indigenous - organization & administration
Humans
Indians, North American
Medicine, Traditional
New Mexico
Nurse practitioners
Rural health services - organization & administration
Abstract
Past experiences enhance the future. Health care providers gaining expertise in creative thinking, traditional medicine, spirituality, and cultural sensitivity is an essential requirement for 21st century health care. We must stay mindful that poverty, isolation, and rural living may create new forms of social exclusion because of lack of communication and rapidly changing technology. Conversely, sensory overload resulting from a faster paced lifestyle and rapid enhancements in technology may cause increased tension and stress. This article reviews successes that may offer the reader ideas on coping with the provision of health care services in such a volatile changing environment, while honoring tradition and cultural competency.
PubMed ID
12515233 View in PubMed
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A 50-Year Commitment to American Indian and Alaska Native Women.

https://arctichealth.org/en/permalink/ahliterature304709
Source
Obstet Gynecol. 2020 10; 136(4):739-744
Publication Type
Journal Article
Date
10-2020
Author
Alan G Waxman
William H J Haffner
Jean Howe
Kathleen Wilder
Tony Ogburn
Neil Murphy
Eve Espey
J Martin Tucker
Amanda Bruegl
Elaine Locke
Yvonne Malloy
Author Affiliation
University of New Mexico, Albuquerque, New Mexico; the Uniformed Services University of the Health Sciences, Bethesda, Maryland; the Northern Navajo Medical Center, Shiprock, New Mexico; the Mid-Columbia Medical Center, The Dalles, Oregon; the University of Texas Rio Grande Valley, Edinburg, Texas; the Alaska Native Medical Center, Anchorage, Alaska; the University of Mississippi Medical Center, Jackson, Mississippi; the Oregon Health and Science University, Portland, Oregon; and the American College of Obstetricians and Gynecologists, Washington, DC.
Source
Obstet Gynecol. 2020 10; 136(4):739-744
Date
10-2020
Language
English
Publication Type
Journal Article
Keywords
Alaskan Natives
Female
Gynecology
Health Services Accessibility - organization & administration - standards - trends
Healthcare Disparities - ethnology
Humans
Indians, North American
Intersectoral Collaboration
Obstetrics
Program Evaluation
Quality Improvement - organization & administration
Rural Health Services - standards
Surveys and Questionnaires
United States - epidemiology
Urban Health Services - standards
Vulnerable Populations - ethnology
Women's Health Services - organization & administration - standards - trends
Abstract
Since 1970, the American College of Obstetricians and Gynecologists' Committee on American Indian and Alaska Native Women's Health has partnered with the Indian Health Service and health care facilities serving Native American women to improve quality of care in both rural and urban settings. Needs assessments have included formal surveys, expert panels, consensus conferences, and onsite program reviews. Improved care has been achieved through continuing professional education, recruitment of volunteer obstetrician-gynecologists, advocacy, and close collaboration at the local and national levels. The inclusive and multifaceted approach of this program should provide an effective model for collaborations between specialty societies and health care professionals providing primary care services that can reduce health disparities in underserved populations.
PubMed ID
32925622 View in PubMed
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1997 Alaska training and employment opportunities for primary care health professionals: a resources guide for students and employers.

https://arctichealth.org/en/permalink/ahliterature288931
Source
Juneau: Alaska Dept. of Health and Social Services, Division of Public Health, Section of Community Health and Emergency Medical Services. 37 pages.
Publication Type
Book/Book Chapter
Date
1997
Source
Juneau: Alaska Dept. of Health and Social Services, Division of Public Health, Section of Community Health and Emergency Medical Services. 37 pages.
Date
1997
Language
English
Geographic Location
U.S.
Publication Type
Book/Book Chapter
Physical Holding
University of Alaska Anchorage
Keywords
Alaska
Community health aides
Rural Health Services
Primary Health Care
Notes
ALASKA RA427.A45 1997
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The 2009 H1N1 pandemic response in remote First Nation communities of Subarctic Ontario: barriers and improvements from a health care services perspective.

https://arctichealth.org/en/permalink/ahliterature130157
Source
Int J Circumpolar Health. 2011;70(5):564-75
Publication Type
Article
Date
2011
Author
Nadia A Charania
Leonard J S Tsuji
Author Affiliation
Department of Environment and Resource Studies, University of Waterloo, Waterloo, ON N2L 3G1, Canada. ncharani@uwaterloo.ca
Source
Int J Circumpolar Health. 2011;70(5):564-75
Date
2011
Language
English
Publication Type
Article
Keywords
Adult
Attitude of Health Personnel
Catchment Area (Health)
Federal Government
Female
Humans
Influenza A Virus, H1N1 Subtype
Influenza, Human - epidemiology - prevention & control
Information Dissemination
Male
Medically underserved area
Middle Aged
Ontario
Pandemics - prevention & control - statistics & numerical data
Patient Acceptance of Health Care - ethnology
Professional-Patient Relations
Retrospective Studies
Rural health services - organization & administration
Abstract
To retrospectively examine the barriers faced and opportunities for improvement during the 2009 H1N1 pandemic response experienced by participants responsible for the delivery of health care services in 3 remote and isolated Subarctic First Nation communities of northern Ontario, Canada.
A qualitative community-based participatory approach.
Semi-directed interviews were conducted with adult key informants (n=13) using purposive sampling of participants representing the 3 main sectors responsible for health care services (i.e., federal health centres, provincial hospitals and Band Councils). Data were manually transcribed and coded using deductive and inductive thematic analysis.
Primary barriers reported were issues with overcrowding in houses, insufficient human resources and inadequate community awareness. Main areas for improvement included increasing human resources (i.e., nurses and trained health care professionals), funding for supplies and general community awareness regarding disease processes and prevention.
Government bodies should consider focusing efforts to provide more support in terms of human resources, monies and education. In addition, various government organizations should collaborate to improve housing conditions and timely access to resources. These recommendations should be addressed in future pandemic plans, so that remote western James Bay First Nation communities of Subarctic Ontario and other similar communities can be better prepared for the next public health emergency.
PubMed ID
22030007 View in PubMed
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Abridged version of the Society of Rural Physicians of Canada's discussion paper on rural hospital service closures.

https://arctichealth.org/en/permalink/ahliterature149706
Source
Can J Rural Med. 2009;14(3):111-4
Publication Type
Article
Date
2009
Author
Peter Hutten-Czapski
Author Affiliation
Society of Rural Physicians of Canada, Shawville, Que. phc@srpc.ca
Source
Can J Rural Med. 2009;14(3):111-4
Date
2009
Language
English
Publication Type
Article
Keywords
Canada
Cost Savings
Health Facility Closure
Hospitals, Rural - economics - supply & distribution
Humans
Quality of Health Care
Regional Health Planning
Rural Health Services
Rural Population
Societies, Medical
PubMed ID
19594995 View in PubMed
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Accessing maternity care in rural Canada: there's more to the story than distance to a doctor.

https://arctichealth.org/en/permalink/ahliterature155499
Source
Health Care Women Int. 2008 Sep;29(8):863-83
Publication Type
Article
Date
Sep-2008
Author
Rebecca Sutherns
Ivy Lynn Bourgeault
Author Affiliation
Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.
Source
Health Care Women Int. 2008 Sep;29(8):863-83
Date
Sep-2008
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Alberta
Female
Health Care Surveys
Health Services Accessibility
Humans
Maternal Health Services - methods - trends
Medically underserved area
Needs Assessment
Ontario
Pregnancy
Prenatal Care - methods - trends
Quality of Health Care
Risk assessment
Rural Health Services - standards - trends
Rural Population
Abstract
Drawing upon a comparative, qualitative study of the experiences of rural women accessing maternity care in two Canadian provinces, we demonstrate that availability of services, having economic and informational resources to access the services offered, and the appropriateness of those services in terms of gender, continuity of care, confidentiality, quality of care, and cultural fit are key to an accurate understanding of health care access. We explore the implications of living rurally on each of these dimensions, thereby revealing both gaps in and solutions to rural maternity care access that narrower, proximity-based definitions miss.
PubMed ID
18726796 View in PubMed
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[Access to general practitioners in a county in Troms]

https://arctichealth.org/en/permalink/ahliterature70574
Source
Tidsskr Nor Laegeforen. 2005 Aug 25;125(16):2210-2
Publication Type
Article
Date
Aug-25-2005
Author
Anne Helen Hansen
Ivar J Aaraas
Jorun Støvne Pettersen
Gerd Ersdal
Author Affiliation
Tromsø kommune, Rådhuset, 9299 Tromsø. anne.helen.hansen@tromso.kommune.no
Source
Tidsskr Nor Laegeforen. 2005 Aug 25;125(16):2210-2
Date
Aug-25-2005
Language
Norwegian
Publication Type
Article
Keywords
Comparative Study
Emergency Medical Services - standards - statistics & numerical data
English Abstract
Family Practice - standards - statistics & numerical data
Female
Health Services Accessibility - standards - statistics & numerical data
Humans
Interviews
Male
Norway
Physicians, Family
Physicians, Women
Referral and Consultation - standards - statistics & numerical data
Rural Health Services - standards - statistics & numerical data
Telephone
Urban Health Services - standards - statistics & numerical data
Abstract
BACKGROUND: In 2002 the Norwegian Board of Health made a survey of the accessibility of general practitioners in Troms county in North Norway. MATERIAL AND METHODS: In a telephone interview one secretary in each surgery informed about telephone response time, planned time for telephone consultations, recorded numbers of urgent consultations, and waiting time to obtain a routine consultation. RESULTS: On average, the planned telephone time was two hours per week. Telephone time was in inverse proportion to the number of patients on the doctor's list. Rural doctors spent twice as much time as urban colleagues on the telephone with their patients. Doctors with lists between 500 and 1500 patients had a higher proportion of urgent consultations compared with doctors with shorter or longer lists. INTERPRETATION: Telephone response time below two minutes and waiting times for routine consultations below 20 days appear to be within acceptable norms. When patient lists are above 1500, doctors' capacity to offer telephone contact and emergency services to their patients seems reduced.
PubMed ID
16138139 View in PubMed
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Access to primary health care among persons with disabilities in rural areas: a summary of the literature.

https://arctichealth.org/en/permalink/ahliterature213021
Source
J Rural Health. 1996;12(1):45-53
Publication Type
Article
Date
1996
Author
D M Lishner
M. Richardson
P. Levine
D. Patrick
Author Affiliation
WAMI Rural Health Research Center, University of Washington, Seattle 98195, USA.
Source
J Rural Health. 1996;12(1):45-53
Date
1996
Language
English
Publication Type
Article
Keywords
Acquired Immunodeficiency Syndrome - complications - epidemiology
Adolescent
Adult
Child
Disabled Persons
HIV Infections - complications - epidemiology
Health Services Accessibility
Health services needs and demand
Humans
Mental Disorders - epidemiology
Rural Health Services - supply & distribution
United States - epidemiology
Abstract
Despite the prevalence of disabilities among persons living in rural areas, scarce data exist on their health care needs. While rural residents generally experience barriers to access to primary health care, these problems are further exacerbated for people with disabilities. This article summarizes findings from the published literature on access to primary health care among people with disabilities living in rural locations. A comprehensive computerized literature search turned up 86 articles meeting the study criteria, focused on the following rural populations affected by disabilities: children and adolescents, working-age adults, the elderly the mentally ill, and people with AIDS. For each of these populations, substantial problems in accessing appropriate health care have been documented. The literature consistently emphasizes the failure of local health care systems in nonmetropolitan areas to adequately address the complex medical and related needs of individuals with disabilities. In the absence of specialized expertise, facilities, and primary care providers trained specifically to care for disabled persons, local programs rely heavily on the use of indigenous paraprofessionals and alternative models of care. Further research is needed to identify and test the efficacy of innovative service delivery strategies to improve health care access for this population.
PubMed ID
10172606 View in PubMed
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Accidental out-of-hospital births in Finland: incidence and geographical distribution 1963-1995.

https://arctichealth.org/en/permalink/ahliterature202145
Source
Acta Obstet Gynecol Scand. 1999 May;78(5):372-8
Publication Type
Article
Date
May-1999
Author
K. Viisainen
M. Gissler
A L Hartikainen
E. Hemminki
Author Affiliation
STAKES (National Research and Development Centre for Welfare and Health), University of Helsinki, Department of Public Health, Finland.
Source
Acta Obstet Gynecol Scand. 1999 May;78(5):372-8
Date
May-1999
Language
English
Publication Type
Article
Keywords
Adult
Birth weight
Delivery Rooms - statistics & numerical data
Delivery, obstetric - statistics & numerical data
Female
Finland
Gestational Age
Hospitals - standards
Hospitals, Maternity - statistics & numerical data
Humans
Incidence
Infant, Newborn
Obstetrics and Gynecology Department, Hospital - statistics & numerical data
Parity
Pregnancy
Prenatal Care
Rural Health Services - statistics & numerical data
Urban Health Services - statistics & numerical data
Abstract
The study aims to describe the incidence and geographical distribution of accidental out-of-hospital births (accidental births) in Finland in relation to the changes in the hospital network, and to compare the perinatal outcomes of accidental births and all hospital births.
Data for the incidence and distribution analyses of accidental births were obtained from the official statistics between 1962 and 1973 and from the national Medical Birth Registry (MBR) in 1992-1993. The infant outcomes were analyzed for the MBR data in 1991-1995.
Between 1963 and 1975 the central hospital network expanded and by 1975 they covered 72% of births. The number of small maternity units has decreased since 1963. The incidence of accidental births decreased between 1963 and 1973, from 1.3 to 0.4 per 1000 births, and rose by the 1990s to 1/1000. In the 1990s the parity adjusted risk of an accidental birth was higher for residents of northern than of southern Finland, OR 2.51 (CI 1.75-3.60), and for residents of rural compared to urban municipalities, OR 3.26 (CI 2.48-4.27). The birthweight adjusted risk for a perinatal death was higher in accidental births than in hospital births, OR 3.11 (CI 1.42-6.84).
A temporal correlation between closing of small hospitals and an increase in accidental birth rates was detected. Due to the poor infant outcomes of accidental births, centralization policies should include measures to their prevention.
PubMed ID
10326879 View in PubMed
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Acute myocardial infarction: quality of care in rural Alberta.

https://arctichealth.org/en/permalink/ahliterature167771
Source
Can Fam Physician. 2006 Jan;52:68-9
Publication Type
Article
Date
Jan-2006
Author
Trustin Domes
Olga Szafran
Cheryl Bilous
Odell Olson
G Richard Spooner
Author Affiliation
University of Alberta, Edmonton.
Source
Can Fam Physician. 2006 Jan;52:68-9
Date
Jan-2006
Language
English
Publication Type
Article
Keywords
Acute Disease
Adult
Aged
Aged, 80 and over
Alberta
Emergency Service, Hospital - standards
Exercise Test - utilization
Female
Hospitals, Rural - standards
Humans
Inpatients
Male
Medical Audit
Middle Aged
Myocardial Infarction - therapy
Quality of Health Care
Retrospective Studies
Rural Health Services - standards
Abstract
To assess the quality of care of acute myocardial infarction (AMI) in a rural health region.
Clinical audit employing multiple explicit criteria of care elements for emergency department and in-hospital AMI management. The audit was conducted using retrospective chart review.
Twelve acute care health centres and hospitals in the East Central Health Region, a rural health region in Alberta, where medical and surgical services are provided almost entirely by family physicians.
Hospital inpatients with a confirmed discharge diagnosis of AMI (ICD-9-CM codes 410.xx) during the period April 1, 2001, to March 31, 2002, were included (177 confirmed cases).
Quality of AMI care was assessed using guidelines from the American College of Cardiology and the American Heart Association and the Canadian Cardiovascular Outcomes Research Team and Canadian Cardiovascular Society. Quality of care indicators at three stages of patient care were assessed: at initial recognition and AMI management in the emergency department, during in-hospital AMI management, and at preparation for discharge from hospital.
In the emergency department, the quality of care was high for most procedural and therapeutic audit elements, with the exception of rapid electrocardiography, urinalysis, and provision of nitroglycerin and morphine. Average door-to-needle time for thrombolysis was 102.5 minutes. The quality of in-hospital care was high for most elements, but low for nitroglycerin and angiotensin-converting enzyme (ACE) inhibitors, daily electrocardiography, and counseling regarding smoking cessation and diet. Few patients received counseling for lifestyle changes at hospital discharge. Male and younger patients were treated more aggressively than female and older patients. Sites that used care protocols achieved better results in initial AMI management than sites that did not. Stress testing was not readily available in the rural region studied.
Quality of care for patients with AMI in this rural health region was high for most guideline elements. Standing orders, protocols, and checklists could improve care. Training and resource issues will need to be addressed to improve access to stress testing for rural patients. Clinical audit should be at the core of a system for local monitoring of quality of care.
Notes
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PubMed ID
16926968 View in PubMed
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993 records – page 1 of 100.