A Comparison of Environmental Concerns in Two Disparate Montana and Nevada Communities.

Asbestos refers to six fibrous minerals that occur naturally in the environment in the United States and throughout the world. Deposits may be found in soil, rocks, and deposits of other minerals such as vermiculite and talc. These naturally occurring asbestos (NOA) minerals belong to the serpentine and amphibole family of minerals.

Advance Care Planning in Rural Montana: Exploring the Nurse's Role.

It is recommended that advance care planning take place across the lifespan. Rural populations have a heightened risk for poor quality and high cost of end-of-life care. A doctoral project was completed to assess rural nurses' knowledge, attitudes, and experiences with advance directives using the Knowledge, Attitudinal, and Experimental Surveys on Advance Directives.

Principal components analysis to identify influences on research communication and engagement during an environmental disaster.

Objectives: To discern community attitudes towards research engagement in Libby, Montana, the only Superfund site for which a public health emergency has been declared.

Study Design: Survey study of convenience samples of residents near the Libby, Montana Superfund site.

Participants: Residents of the Libby, Montana area were recruited from a local retail establishment (N=120, survey 1) or a community event (N=127, survey 2).

Palliative Care in Critical Rural Settings.

The United States has 1332 critical access hospitals. These hospitals have fewer than 25 beds each and a mean daily census of 4.2 patients.

Critical Care in Critical Access Hospitals.

What began as a grant-funded demonstration project, as a means of bridging the gap in rural health care, has developed into a critical access hospital system comprising 1328 facilities across 45 states. A critical access hospital is not just a safety net for health care in a rural community. Such hospitals may also provide specialized services such as same-day surgery, infusion therapy, and intensive care.

Descriptive analysis of the respiratory health status of persons exposed to Libby amphibole asbestos.

Objective: Describe respiratory health and quality of life in persons exposed to Libby amphibole asbestos (LAA) contaminated vermiculite.

Design: Cross-sectional descriptive.

Setting: Asbestos-related disease clinic in Libby, Montana USA.

Teaching strategies to support evidence-based practice.

Evidence-based practice is an expected core competency of all health care clinicians regardless of discipline. Use of evidence-based practice means integrating the best research with clinical expertise and patient values to achieve optimal health outcomes. Evidence-based practice requires nurses to access and appraise evidence rapidly before integrating it into clinical practice.

Psychosocial health status of persons seeking treatment for exposure to libby amphibole asbestos.

A cross-sectional exploratory study was conducted to describe the psychosocial health status of persons seeking health care for exposure to Libby amphibole asbestos (LAA). Health indicators including depression, stress, acceptance of illness, and satisfaction with access and financial aspects of care were obtained via electronic and paper-pencil survey. The exposure pathway and demographic data were gleaned from the health record.

Determining satisfaction with access and financial aspects of care for persons exposed to Libby amphibole asbestos: rural and national environmental policy implications.

Libby, Montana is a Superfund site and epicenter of one of the worst environmental disasters in the USA history in terms of asbestos-related mortality and morbidity. Perceptions of access and financial aspects of care were explored among a national cohort of persons postasbestos exposure and prior to a 2009 Public Health Emergency Declaration. Our findings indicated the Libby cohort was significantly less satisfied with access and financial aspects of care as measured by two PSQ-III scales when compared to an adult, chronically ill patient sample.

Rural public health policy models to address an evolving environmental asbestos disaster.

The health-related dangers of asbestos exposure were recognized early in the 20th century when occupational exposure was found to be associated with excess pneumoconiosis among asbestos industry workers. Today, the epicenter for examining the public health effects and the human toll that this toxin has had on a population is located in the rural community of Libby, MT. Rurality and multideterminants of health frame both the history of asbestos-related disease and the service/policy challenges within a community dealing with chronic illness and designation as a Superfund clean-up site.

The rural context and women's self-management of chronic health conditions.

Objective: To examine the rural context and describe its influence on the self-management of chronic illness by women living in a rural setting.

Methods: The Women to Women (WTW) project is a research-based computer intervention that provides health education and peer support to rural women with chronic health conditions. Messages posted to the online support and health education chat rooms were examined to determine the characteristics of the rural context in relation to the women's illness self-management.

Chronically ill rural women: self-identified management problems and solutions.

Objective: To add to the knowledge base of illness management of chronically ill, rural women by describing the self-identified problems and solutions reported by women participants in the online health-education segment of the Women to Women (WTW) computer outreach project.

Methods: WTW is a research-based computer intervention providing health education and online peer support for rural women with chronic diseases. Messages posted to the online chat room were examined to determine the women's self-management problems and solutions.

The Center for Research on Chronic Health Conditions: a strategy for enhancing rural nursing research.

Conducting nursing research with rural populations is influenced by the multidimensional characteristics of rural dwellers, the rural environment, the paucity of nurse scientists prepared and supported to conduct rural research, and institutional constraints common to academic institutions serving rural communities. Collaboration across rural academic settings is therefore integral to the success of rural nursing science. The purpose of this article is to discuss the role of the Center for Research on Chronic Health Conditions in Rural Dwellers as a strategy for overcoming the challenges of conducting rural nursing research in the rural western mountain region of the United States.

Special feature: an approach to cardiac care in rural settings.

Rural people with cardiovascular disease-and the nurses caring for them-face unique health care challenges. Obstacles facing patients living in small rural communities include lack of critical care specialists, inadequate technological support, and inconsistent or variable levels of 24-hour patient care services requiring patients to travel to distant tertiary centers for advanced cardiac care. Rural critical care nurses face reduced access to continuing education and inservice presentations, professional isolation, and lack of anonymity.