MAFLD but not MASLD increases risk of all-cause mortality in regional Australia, with components of metabolic syndrome exacerbating factors: 20 year longitudinal, cohort study.

Background And Aims: Controversy remains whether the mortality risk in people with fatty liver disease (FLD) including metabolic-(dysfunction) associated steatotic liver disease (MASLD) and metabolic-(dysfunction) associated fatty liver disease (MAFLD) is higher than observed in those without FLD. We aimed to determine the mortality rate and mortality rate ratio (MRR) for these FLDs.

Methods: The study population was a randomly selected cohort of community-dwelling adults in regional Victoria, Australia between 2001 and 2003 with sufficient data evaluable for Fatty Liver Index and determination on alcohol consumption.

Validation of serum non-invasive tests of liver fibrosis as prognostic markers of clinical outcomes in people with fatty liver disease in Australia.

Background And Aim: The validity of non-invasive tests (NITs) of liver fibrosis for the prediction of liver and mortality outcomes in an Australian cohort is unknown. We aimed to verify the utility of available NITs to predict overall and cause-specific mortality and major adverse liver outcome (MALO).

Methods: This was an analysis from the Crossroads 1 clinic sub-study of a randomly sampled adult cohort from regional Australia between 2001 and 2003.

NAFLD and MAFLD independently increase the risk of major adverse cardiovascular events (MACE): a 20-year longitudinal follow-up study from regional Australia.

Background And Aims: The association between fatty liver disease (FLD) and cardiovascular disease (CVD) in an Australian context has yet to be defined. The primary aim of this study was to investigate the association between FLD and 3-point major adverse cardiovascular events (MACE).

Methods: This was a longitudinal follow-up study of a randomly sampled adult cohort from regional Australia between 2001 and 2003.

Positive change in intent to practice rurally is strongly associated with nursing and allied health students of metropolitan origin after rural clinical placement.

Objective: To: (1) assess whether rural clinical placements influence change in intention to practice rurally for nursing and allied health students, (2) to assess whether residential origin (metropolitan or rural) or university location (metropolitan or non-metropolitan) influence this change, and (3) assess residential origin of health professionals practicing rurally after graduation.

Design: Cross-sectional survey (2014-2022) conducted in Northern/Northeastern Victoria and Grampians region by nursing and allied health students completing rural clinical placements. Survey explored student placement satisfaction, intention to practice rurally and demographic information, with a follow-up two years' post-placement.

Palliative Approach Remains Lacking in Terminal Hospital Admissions for Chronic Disease Across Rural Settings: Multisite Retrospective Medical Record Audit.

Introduction/aim: Despite clear benefit from palliative care in end-stage chronic diseases, access is often limited, and rural access largely undescribed. This study sought to determine if a palliative approach is provided to people with chronic disease in their terminal hospital admission.

Methods: Multisite, retrospective medical record audit, of decedents with a primary diagnosis of chronic lung, heart, or renal failure, or multimorbidity of these conditions over 2019.

Management of chronic pain in a rural Australian setting: Findings from the Crossroads-II mixed-methods study.

Method: A cross-sectional survey (2016-18) involving quantitative and text-based data was completed by adults from randomly selected households in the Goulburn Valley, Victoria.

Results: Among the 2680 respondents, 594 (22%) reported chronic pain. Few (6%) respondents with chronic pain were accessing specialist pain clinics.

Non-alcoholic fatty liver disease prevalence in Australia has risen over 15 years in conjunction with increased prevalence of obesity and reduction in healthy lifestyle.

Background And Aim: Non-alcoholic fatty liver disease (NAFLD) is the most prevalent liver condition globally. The aim of this study was to evaluate the change in age- and sex-standardized prevalence of NAFLD in regional Victoria over a 15-year period and explore the underlying factors associated with differences over time.

Methods: Repeated comparative cross-sectional studies in four towns in regional Victoria, Australia.

Understanding potentially avoidable hospitalisations in a rural Australian setting from the perspectives of patients and health professionals: a qualitative study and logic model.

Background: Potentially avoidable hospitalisations (PAHs) are proxy measures of effective primary care at a population level. PAHs are higher in rural and disadvantaged areas. This qualitative study sought a deeper understanding of PAHs for chronic health conditions in a rural context from the perspectives of patients and health professionals, and aimed to develop a logic model for rural health services to identify intervention targets.

Self-Rated Oral Health as a Valid Measure of Oral Health Status in Adults Living in Rural Australia.

It is unclear how well self-rated oral health (SROH) reflects actual oral health status in the rural Australian population. Therefore, this study aimed to compare the clinically assessed oral health status and SROH of adults living in rural Australia. The data were from 574 participants who took part in the Crossroads II cross-sectional study.

Service Level Characteristics of Rural Palliative Care for People with Chronic Disease.

Context: Despite clear benefit from palliative care in end-stage chronic, non-malignant disease, access for rural patients is often limited due to workforce gaps and geographical barriers.

Objectives: This study aimed to understand existing rural service structures regarding the availability and provision of palliative care for people with chronic conditions.

Methods: A cross-sectional online survey was distributed by email to rural health service leaders.

Prevalence and factors associated with mental health problems of psychological distress and depression among rural Victorians - analysis of cross-sectional data (Crossroads II).

Background: Research suggests that rates of mental illness are similar in rural and urban Australia, although there are significant workforce shortages in rural regions along with higher rates of chronic disease and obesity and lower levels of socioeconomic status. However, there are variations across rural Australia and limited local data on mental health prevalence, risk, service use and protective factors. This study describes the prevalence of self-reported mental health problems of psychological distress and depression, in a rural region in Australia and aims to identify the factors associated with these problems.

Identifying Frailty in Older Adults in Rural Victoria, Australia: A Secondary Analysis of Population Health Data.

To determine the prevalence of frailty among community-dwelling older adults in regional Victoria, Australia. Frailty status of 376 participants from the Crossroads II cross-sectional study was assessed by selected markers of frailty. The selected variables were psychometrically tested.

Design and implementation characteristics of research training for rural health professionals: a qualitative descriptive study.

Background: Research capacity and capability of rural health professionals is essential to the delivery of evidence-based care and for informing strategies to address rural health inequities. Effective implementation of research education and training is fundamental to building rural health professional research capacity and capability. A lack of overarching guidance to inform the delivery of research education and training in rural health services can contribute to gaps in capacity-building approaches.

Twelve Tips for Inclusive Practice in Healthcare Settings.

This paper outlines practical tips for inclusive healthcare practice and service delivery, covering diversity aspects and intersectionality. A team with wide-ranging lived experiences from a national public health association's diversity, equity, and inclusion group compiled the tips, which were reiteratively discussed and refined. The final twelve tips were selected for practical and broad applicability.

Trends and Factors Associated with Obesity Prevalence in Rural Australian Adults-Comparative Analysis of the Crossroads Studies in Victoria over 15 Years.

This study examined the changes in the prevalence of obesity and associated lifestyle factors using data from repeated cross-sectional, self-reported surveys (Crossroads I: 2001-2003 and Crossroads II: 2016-2018, studies) and clinic anthropometric measurements collected from regional and rural towns in the Goulburn Valley, Victoria. Given that past community studies have only focused categorically on dietary intake, or assessed caloric energy intake, we examined the difference in broad dietary practices at two different times. Clinical assessments from randomly selected household participants aged ≥18 years were analyzed.

A qualitative descriptive study of a novel nurse-led skin cancer screening model in rural Australia.

Background: People residing in rural areas have higher rates of skin cancer and face barriers to accessing care. Models of skin cancer care addressing the specific needs of rural communities and overcoming specific challenges are required, but literature is scarce. This study aimed to describe the elements of a nurse-led skin cancer model in rural Victoria using qualitative methodology and programme logic to inform implementation and ongoing sustainability.

Prevalence of atrial fibrillation in a regional Victoria setting, findings from the crossroads studies (2001-2003 and 2016-2018).

Objective: To estimate the prevalence of atrial fibrillation (AF) in regional Victoria at two time points (2001-2003 and 2016-2018), and to assess the use of electrocardiogram rhythm strips in a rural, community-based study for AF investigation.

Design: Repeated cross-sectional design involving survey of residents of randomly selected households and a clinic. Predictors of AF were assessed using Firth penalised logistic regression, as appropriate for rare events.

Research education and training for nurses and allied health professionals: a systematic scoping review.

Background: Research capacity building (RCB) initiatives have gained steady momentum in health settings across the globe to reduce the gap between research evidence and health practice and policy. RCB strategies are typically multidimensional, comprising several initiatives targeted at different levels within health organisations. Research education and training is a mainstay strategy targeted at the individual level and yet, the evidence for research education in health settings is unclear.

Community Health Programs Delivered Through Information and Communications Technology in High-Income Countries: Scoping Review.

Background: The COVID-19 pandemic has required widespread and rapid adoption of information and communications technology (ICT) platforms by health professionals. Transitioning health programs from face-to-face to remote delivery using ICT platforms has introduced new challenges.

Objective: The objective of this review is to scope for ICT-delivered health programs implemented within the community health setting in high-income countries and rapidly disseminate findings to health professionals.

Impact of renaming NAFLD to MAFLD in an Australian regional cohort: Results from a prospective population-based study.

Background And Aims: Clinical and public health implications of the recent redefining of non-alcoholic fatty liver disease (NAFLD) to metabolic-associated fatty liver disease (MAFLD) remain unclear. We sought to determine the prevalence and compare MAFLD with NAFLD in a well-defined cohort.

Methods: A cross-sectional study was conducted in regional Victoria with participants from randomly selected households.

Building a rural workforce through identifying supports for rural, mature-aged nursing and allied health students: A systematic scoping review.

Introduction: There is a long-standing undersupply of nursing and allied health professionals in rural Australia. Rural, mature-aged people form an untapped section of rural communities that could help to address these workforce needs. There is little understanding of the supports required to assist rural, mature-aged nursing and allied health students to complete their studies and enter the rural health workforce.