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Skin cancer remains a major public health issue in Australia, which is known as ?the skin cancer capital of the world?.[sup.1] Australia has some of the highest incidence[sup.2] and mortality [...], : Objective: To assess whether self?reported use of sun?protective measures and skin examination have changed between 2001 and 2018 in a rural setting. Methods: Repeat cross?sectional survey of randomly selected households in four rural Victorian towns. People aged 16 years and older were eligible to participate. Logistic regression was used to identify demographic factors associated with sun?protective measures and skin examination. Results: Overall, 5,328 participated in 2001?2003 and 2,680 in 2016?2018. Among participants who go out in the sun, the mean number of reported sun?protective measures (2.6±1.3 vs. 2.6±1.6, p=0.867) and the proportion of participants reporting usually/always using sun protection (65.1% vs. 63.9%, p=0.307) were unchanged between the two surveys. However, an increased proportion of participants reported avoiding the sun when outdoors in the more recent survey (from 18.8% to 34.3%, p Conclusions: Given the small changes in sun protection over time, updated skin cancer campaigns are needed to encourage increased sun?protective behaviours and skin examinations among rural residents. Implications for public health: Results suggest that updated health promotion campaigns targeted to rural areas are warranted.

Featured Application: Oral health-related general health diseases and conditions refers to medical conditions or diseases that have a connection or impact on both oral health and overall health. (1) Background: A study was undertaken to provide a comprehensive profile of the prevalence and distribution, by selected socio-demographic characteristics, of chronic diseases and health conditions including those that impact the oral health and oral health self-care of independently living older adults in rural areas of the state of Victoria; (2) Methods: The study analyzed data from the Crossroads-II project, with a total of 1407 participants aged 55 years and older. Participants responded to questionnaires about their medical health history, health service use, and socio-demographics. In total, 572 attended a 2-h health screening that included an assessment of prescribed medications; (3) Results: Most participants were female (55.3%), with a mean age of 69.1 (SD = 9.2) years. Participants had a high prevalence of medical conditions; the most common were high blood pressure, arthritis, high lipids, hearing loss, and chronic pain. Almost all participants reported taking medications, with an average of 4.3 medications per person. Among those who attended the health screening, 78.1% were taking medications that could cause xerostomia (dry mouth); (4) Conclusions: This study provides initial information on the prevalence of medical conditions, medication usage, and the potential impact on the oral health of older adults living in rural Victoria. This information would be valuable for healthcare and dental workforce planning, policy development, and improving the overall well-being of this population. [ABSTRACT FROM AUTHOR]

Objective: The relationship between chronic pain and complementary and alternative medicine (CAM) use is poorly understood, and the situation in rural Australia is particularly unclear. The objective here was to determine the socio‐demographic factors associated with the use of CAM for the treatment of chronic pain in a region of rural Australia. Methods: This secondary analysis used data from a population health survey, Crossroads‐II, to assess the relationships of various socio‐demographic factors with the use of CAM by those suffering from chronic pain. Design: Face‐to‐face surveys at households randomly selected from residential address lists. Setting: A large regional centre and three nearby rural towns in northern Victoria, Australia. Participants: Sixteen years of age and older. Main Outcome Measures: Use of a CAM service to treat chronic pain. Results: Being female (2.40 [1.47, 3.93], p < 0.001) and having a bachelorʼs degree (OR 2.24 [1.20, 4.20], p < 0.001) had a significant positive relationship with the use of CAM overall to redress chronic pain and those 50 years and older had greater odds of using manipulation therapies relative to those below 50 years (50–64: OR 0.52 [0.32, 0.86], p = 0.010; 65+: 0.37 [0.18, 0.75], p = 0.005). Conclusion: In the studied region, females and those with university education have the greatest odds of using CAM to treat chronic pain. This study needs to be complemented with more mechanistic investigations into the reasons people make the decisions they make about using CAM for the management of chronic pain. [ABSTRACT FROM AUTHOR]

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. Findings: Experience of a rural placement increased students' intention of practicing rurally. Importantly, 57% of metropolitan origin students studying at metropolitan campuses exhibited positive change. Logistic regression analysis suggested that after controlling for age, gender and satisfaction with placement and supervision, students of metropolitan origin at metropolitan campuses were 6.4 times more likely to report positive change in intent to practice rurally after placement than students of rural origin studying at non‐metropolitan campuses.Follow‐up data suggested that a substantial proportion of health professionals providing services in rural areas were of metropolitan origin. Results: These findings concur that rural origin and rural training are important predictors of working rurally. Additionally, metropolitan students can change their intention to practice rurally after a rural placement. Conclusions: This study supports strategies to enhance intention to practice rurally that are not restricted to rural origin students to build rural workforce. [ABSTRACT FROM AUTHOR]

Objectives: To determine the prevalence of frailty among community-dwelling older adults in regional Victoria, Australia. Methods: 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. Associations between frailty and socio-demographic, environmental and health factors were analysed using chi-square, ANOVA and binary logistic regression (BLR). Results: Estimated prevalence of frailty was 39.4%. BLR indicated that frailty decreased with higher educational attainment, (OR =.23; 95% CI:.10–.51) increased for divorced/separated participants (OR = 2.68; 95% CI: 1.29–5.56) and when having three (OR = 3.27; 95% CI: 1.07–9.98), four (OR = 7.20; 95% CI: 2.22–23.31) or five or more chronic conditions (OR = 9.18; 95% CI: 2.83–29.72). Discussion: Frailty in this Australian regional community-dwelling sample was higher than other studies conducted in urban areas of Australia. Present results highlight the importance of exploring the multidimensionality of the frailty construct to have a better understanding which factors are associated with the development of this syndrome. [ABSTRACT FROM AUTHOR]

This article examines the prevalence of non-alcoholic fatty liver disease (NAFLD) in rural and regional Victoria, Australia. NAFLD is closely linked to obesity and affects approximately 25-30% of adults globally. The article also discusses the proposed renaming of NAFLD to better reflect its pathophysiology and reduce stigma. The study analyzed data from two longitudinal studies in rural Victoria and found that the prevalence of NAFLD, as well as the proposed renamed versions MAFLD and MASLD, was higher in the second study compared to the first. However, after adjusting for age and gender, there were no statistically significant differences. The study also highlighted the need for further testing and referral to tertiary care for participants with steatotic liver disease who had high fibrosis index values. The rising prevalence of these liver diseases, along with obesity, could have significant implications for healthcare in regional and rural Victoria. [Extracted from the article]

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. Three trained and calibrated dentists evaluated the oral health status of participants based on WHO criteria. SROH was assessed with the question 'Overall, how would you rate the health of your teeth and gums?', with a score ranging from excellent = 5 to poor = 1. A logistic regression analysis (LRA) was performed, allowing us to assess factors associated with SROH. The mean age of participants was 59.2 years (SD 16.3), and 55.3% were female. The key results from the LRA show poorer SROH in those with more missing teeth (OR = 1.05; 95% CI; 1.01–1.08), more decayed teeth (OR = 1.28; 95% CI: 1.11–1.46), and more significant clinical attachment loss of periodontal tissue (6mm or more) (OR = 2.63; 95% CI: 1.29–5.38). This study found an association between negative SROH and clinical indicators used to measure poor oral health status, suggesting that self-rated oral health is an indicator of oral health status. When planning dental healthcare programs, self-reported oral health should be considered a proxy measure for oral health status. [ABSTRACT FROM AUTHOR]

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. Setting: Goulburn Valley, Victoria. Participants: Household residents aged ≥16 years. Non‐pregnant participants aged 18+ were eligible for the clinic. Main outcome measures: Atrial fibrillation by 12 lead electrocardiogram (earlier study) or electrocardiogram rhythm strip (AliveCor® device) (recent study). Results: The age standardised prevalence of AF was similar between the two studies (1.6% in the 2001–2003 study and 1.8% in the 2016–2018 study, 95% confidence interval of difference −0.010, 0.014, p = 0.375). The prevalence in participants aged ≥65 years was 3.4% (1.0% new cases) in the recent study. Predictors of AF in the earlier study were male sex, older age and previous stroke, while in the recent study they were previous stroke and self‐reported diabetes. AliveCor® traces were successfully classified by the in‐built algorithm (91%) vs physician (100%). Conclusion: The prevalence of AF among community‐based participants in regional Victoria was similar to predominantly metropolitan‐based studies, and was unchanged over time despite increased rates of risk factors. Electrocardiogram rhythm strip investigation was successfully utilised, and particularly benefited from physician overview. [ABSTRACT FROM AUTHOR]