Health Sciences 3010F/G Exam Study Notes.pdf

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Western University
Health Sciences
Health Sciences 3010F/G
Christopher Brown

E Gross 1 Fall 2012HS 3010FIntro to Rural CommunitiesWeek 7Picture examplethe people had to cross the river over a walking bridge but after a proper bridge it impacted the economy because now people could travel further on their bikes to workCanadian rural physicians have been increasing and decreasing over the past 10 yearsThey have a spectrum of skillsex RNs will get additional skilling o There has been a long term shortage of HC workers o Need broad spectrum of workersPrivacy vs confidentialitypeople vs dataOnly 13 of medical students are from rural and only half say theyd go backSociety of Rural Physicians of Canada SPRC Pan Canadian Strategy For every rural community For every Rural Canadian For Canadian medical schools For Canadian health research SPRC should aim for SPRC should aim for SPRC should aim for SPRC should aim for Clean watersanitary waste Access to a welltrained rural A representative proportion Development and support of disposal family physician w primary of ruralurban students a rural health research support team network infrastructure Appropriate public healthAccess to emergency and Rural learning experiences for Development and support of social services other general hospital all students and residents to a communitybased rural services within a reasonable increase interest and health research involvingtime and distance understanding of rural rural physicians and other practice health care providers Modern and wellsupported Access to specialized Rural streams for interestedhealth care facilities diagnosis and treatment students and residents within an integrated system with outcomes comparable to patients who live in other citiesProcedural and otheradvanced training for rural physicians to enhance provision of local servicesIncludes collaboration of many different Rural Health organizationsIn the US the more rural the less coverage they get and they pay higher premiums these people are usually selfemployedChildren need coverageNeed broader coverage and sense of that is covered and what isntRural Doctor Guest LectureDifferences in the number and type of HC workersDifferences in resources o Professional expertiseif there is enough demand for an expert theres usually only one and they cant be on call 247Also there is usually a shortage of allied health workers PT OT o Technical expertise CT operatorsand usually a person is only certified to operate ONE machineAlso usually only a certain number of hours are covered to pay the technician o Diagnostic equipmentcertain tests not ordered very often might not have the lab reagents to run the test equipment is generally old and out of date E Gross 2 Fall 2012o Therapeutics drugsnewer drugs are very expensive and usually only available to bigger hospitalsSmaller stores of suppliesBlood products are perishableProfessional isolation o Limited back up and so rural doctors have to have a broader set of skills o Have harder time accessing and participating in Continuing Medical Education CME o Much of ongoing learning happens by collaborating with other doctorsless colleagues to do this withInsulationeverybody knows everybody but they dont know everything about everybodyNeed to maintain confidentialityWhat kills on the farm70 deaths are prehospital half are tractor related 40 are from head injuriesPediatric farm injuriespeak for 14 year olds and boys1 Open wounds to the head 2 FracturesMechanisms of injury vary by age groupFalls and machinery are consistently in the top 3Injuries peak in the summer timePinching wrapping cutting thrownobject crushingAnimal injuriesmother protecting young wear helmets when riding wash hands to prevent infectionGrain and silossifting grain and flowing grain in silos can trap and suffocateEmpty silos often contain deadly gases resulting from microbial fermentationHighest risk is within 3 days of fillingMultiple victims commonFalls and chemical exposurekids like to play adults workingChemicals can be inhaled ingested or absorbed through the skin or eyesSLUDGE salivation lacrimation urination defecation GI upset emesisWatermanurekids may like to play but can contain toxic gasesSometimes colourless and odourlessManure gasassume that a deadly gas is always present there has been recent agitation that may have released some gas its flammable your sense of smell is unreliable o Can lead to decreased LOC with progression to death from cardiac arrestCan occur with a single breath o Treatmentsafe removal O2 decontamination hypobaric oxygenReading Dr John has goneDocs are at the heart of networks within the communityCan loss of health infrastructure happen without significant effects on rural areasDense social networks within rural communities builds social capital communitys ability to adapt to changeService decline impacts low SES the most because it is experienced as a lossresults in deteriorating social cohesion and identityRural HC workers may feel undervalued because the extra parts of their jobs are not being acknowledgedRural doctors are more likely to be intensely involved with the health and social needs of their patients than urban doctorsRural doctors can use their knowledge about their patients and the community to proactively protect and sustain healthBoundary SpannersHC workers that can talk to bureaucrats vertical but are embedded in the community and still have horizontal linkagesCommunity defined as 1 Geographical location 2 Social systemrelationships between people in the community 3 Sense of identityshare a set of valuesSocial sustainability o Community sustainabilityprosperity adaptability cohesiveness and reaction to change o Community capacityability to change o Community wellbeingmatch between the communitys resources and the needs of the people in the community o Community resiliencyability of people and institutions to adapt to change over timeSymbolic capitalthat which is accrued through exercising professional statusReading Physician services in rural and northern OntarioGovt initiatives to recruit and retain rural doctors include training nurse practitioners and opening NOSM23 of rural based communities had no local specialist backup while onlyhad this in southern OntarioFamily health teams and family health networks are catching on in the south but the north has been doing this for awhileThe proportion of physicians in rural areas compared to the population is less in rural than urbanMore doctors in the rural base communities of the north than the southIn the large northern centres the supply of specialists is 35 lower than in the urban centres
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