Outcome of treatment seeking rural gamblers attending a nurse-led cognitive-behaviour therapy service:A pilot study

Objectives:Little is known about the differences between urban and rural gamblers in Australia,in terms of comorbidity and treatment outcome.Health disparities exist between urban and rural areas in terms of accessibility,availability,and acceptability of treatment programs for problem gamblers.However,evidence supporting cognitivebehaviour therapy as the main treatment for problem gamblers is strong.This pilot study aimed to assess the outcome of a Cognitive-Behavioural Therapy(CBT)treatment program offered to urban and rural treatment-seeking gamblers.Methods:People who presented for treatment at a nurse-led Cognitive-Behavioural Therapy(CBT)gambling treatment service were invited to take part in this study.A standardised clinical assessment and treatment service was provided to all participants.A series of validated questionnaires were given to all participants at(a)assessment,(b)discharge,(c)at a one-month,and(d)at a 3-month follow-up visit.Results:Differences emerged between urban and rural treatment-seeking gamblers.While overall treatment outcomes were much the same at three months after treatment,rural gamblers appeared to respond more rapidly and to have sustained improvements over time.Conclusion:This study suggests that rural problem gamblers experience different levels of co-morbid anxiety and depression from their urban counterparts,but once in treatment appear to respond quicker.ACBT approach was found to be effective in treating rural gamblers and outcomes were maintained.Ensuring better availability and access to such treatment in rural areas is important.Nurses are in a position as the majority health professional in rural areas to provide such help.

Improving Health Services for Rural Pregnant and Lying-in Women——Achievements in the Reproductive Health Program of Chinese Women

FROM 1992 to 1997, the All-China Women’s Federation organized and implemented a reproductive health program for Chinese women, which was sponsored by the American Ford Foundation. The program was divided into two phases. The first phase, lasting from 1992 to 1994, focused on locating problems and studying them. Women’s federations from 16 provinces, municipalities and autonomous regions throughout China formed a research group and conducted extensive studies in a variety of fields while cooperating with experts from sociology,

Impact of colorectal cancer screening participation in remote northern Canada:A retrospective cohort study

BACKGROUND Screening provides earlier colorectal cancer(CRC)detection and improves outcomes.It remains poorly understood if these benefits are realized with screening guidelines in remote northern populations of Canada where CRC rates are nearly twice the national average and access to colonoscopy is limited.AIM To evaluate the participation and impact of CRC screening guidelines in a remote northern population.METHODS This retrospective cohort study included residents of the Northwest Territories,a northern region of Canada,age 50-74 who underwent CRC screening by a fecal immunohistochemical test(FIT)between January 1,2014 to March 30,2019.To assess impact,individuals with a screen-detected CRC were compared to clinically-detected CRC cases for stage and location of CRC between 2014-2016.To assess participation,we conducted subgroup analyses of FIT positive individuals exploring the relationships between signs and symptoms of CRC at the time of screening,wait-times for colonoscopy,and screening outcomes.Two sample Welch t-test was used for normally distributed continuous variables,Mann-Whitney-Wilcoxon Tests for data without normal distribution,and Chi-square goodness of fit test for categorical variables.A P value of<0.05 was considered to be statistically significant.RESULTS 6817 fecal tests were completed,meaning an annual average screening rate of 25.04%,843(12.37%)were positive,629 individuals underwent a follow-up colonoscopy,of which,24.48%had advanced neoplasia(AN),5.41%had CRC.There were no significant differences in stage,pathology,or location between screen-detected cancers and clinically-detected cancers.In assessing participation and screening outcomes,we observed 49.51%of individuals referred for colonoscopy after FIT were ineligible for CRC screening,most often due to signs and symptoms of CRC.Individuals were more likely to have AN if they had signs and symptoms of cancer at the time of screening,waited over 180 d for colonoscopy,or were indigenous[respectively,estimated RR 1.1895%CI of RR(0.89-1.59)];RR 1.523(CI:1.035,2.240);RR 1.722(CI:1.165,2.547)].CONCLUSION Screening did not facilitate early cancer detection but facilitated higher than anticipated AN detection.Signs and symptoms of CRC at screening,and long colonoscopy wait-times appear contributory.

Intervention Effect Based on Self-Regulation to Promote the Continuation of Self-Care Behavior of Patients with Type-2 Diabetes Mellitus

[Purpose] The purpose of this study was to identify the effect of a support program based on self-regulation. [Methods] Participants: Patients with type-2 diabetes mellitus in rural areas;Research design: Quasi-experimental research. A t-test and Mann-Whitney U test were performed to compare the intervention and control groups before the intervention. For the comparison within the groups before and after the interventions, a t-test and the Wilcoxon signed-rank test were performed. For statistical analysis, the significance level was set to 5%. [Results] The intervention group included 19 participants (age 59.8 ± 6.14) and 10 participants in the control group (age 64.3 ± 3.95). After the program, the scores in knowledge about diabetes (p = 0.001) and sub-items of the diabetes self-management (foot care) (p = 0.048) of the intervention group statistically significantly increased, and the calorie intake decreased (p = 0.080). The intervention group had higher scores in all three sub items of the self-efficacy (positiveness, control, and total score). There were no statistically significant differences in the changes in BMI, HbA1c, and the subscales of self-efficacy between the two groups. However, the scores of these items of the intervention and control groups were 3.3 and 2.9, 2.2 and −0.3, and 5.5 and 2.6, respectively. [Conclusions] The support program based on self-regulation in this study helped the participants to acquire general knowledge of diabetes to assess own medical condition and problems in self-care behavior and practical knowledge to manage diabetes in daily life, and this shows the effectiveness of the program.