Exploring Rural Medicine: Current Issues and Concepts/
- New York: SAGE, 2013.
Chapter 1: Rural Medical Practice: Present and Future Introduction Characteristics of Rural Areas Have Rural Medical Needs been Defined? How is Rural Practice Different? What is the Future of Rural Medicine? Health Care Reform Terminology What would the New System Look Like? Practice Organization Concerns Reimbursement Concerns Recruitment and Retention Concerns Summary Chapter 2: Labor and Delivery Crises: Rural Solutions Introduction Dysfunctional Labor Case Report Diagnosis and Treatment Discussion Augmentation of Labor Procedure for Augmentation of Labor Fetal Distress Case Report Diagnosis and Treatment Discussion Shoulder Dystocia Case Report Diagnosis and Treatment Discussion Unique Rural Situations Chapter 3: Stabilization and Transport of the Ill Newborn Infant Introduction Resuscitation Consideration of Transfer of the Infant to an NICU Stabilization Hypothermia Hypotension Hypoglycemia Hypoxemia Hypercapnia Acidosis Ventilation General Measures Summary Chapter 4: Bronchopulmonary Dysplasia: After the Infant goes Home Introduction Key Management Requirements Nutrition Gastroesophageal Reflux Prevention of Cor Pulmonale Airways Disease Other Complications Home Equipment Needs Consultation Needs Summary Chapter 5: Attention Deficit-Hyperactivity Disorder Introduction Diagnosis History Physical Examination Performance and Academic Evaluation Treatment Drug Therapy Summary Chapter 6: Recognition and Evaluation of Child Abuse Introduction Evaluation of Possible Child Abuse History Physical Examination Laboratory Evidence What to do when Suspicious Special Rural Concerns Summary Chapter 7: Adolescent Pregnancies in Rural America: A Review of the Literature and Strategies for Prevention Introduction The Scope of Teen Sexual Activity Conceptualization Biology and Maturation Social Influences Race, Cultural, and Economic Factors Media Exposure Parental Influence Peers and Dating Personality and Self-Esteem Risks, Benefits, and Societal Trends Prevention of Teen Pregnancy Abstinence Programs School Programs Community-Based Programs Male-Only Programs Recommendations and Conclusions Chapter 8: Common Mental Health Problems Introduction The Mood Disorders Definitions Evaluation Treatment Referral Prevention Anxiety Disorders Definitions Evaluation Treatment Referral Prevention Psychotic Disorders Definitions Evaluation Treatment Referral Prevention Chemical Dependency Definitions Evaluation Treatment Referral Prevention Psychiatric Emergencies Definitions Evaluation of Suicide Risk Summary Chapter 9: Environmental Hazards Introduction Nitrates and Nitrites Case Report Source of the Toxin Who is at Risk? Effects of the Toxin Diagnosis Treatment Lead Toxicity Case Report Definition of the Problem Source of the Toxin Who is at Risk? Effects of the Toxin Diagnosis Treatment Chronic Arsenic Toxicity Case Report Source of the Toxin Who is at Risk? Effects of the Toxin Diagnosis Treatment Asbestos Case Report Exposure Who is at Risk? Effects of the Toxin Diagnosis Treatment Summary Chapter 10: Managing Trauma in the Rural Emergency Department: Basic Organization Introduction Epidemiology of Rural Trauma Unique Problems of Rural Trauma Understanding the Rural Trauma System Communications and Dispatch: Access to Emergency Care Preparations before the Accident Preparing the Resuscitation Area Preparing the Staff The Trauma Protocol The Rural Hospital Trauma Team Approach to the Injured Patient Summary Chapter 11: Managing Trauma in the Rural Emergency Department: Specific Problems Introduction Airway Management Blind Nasotracheal Intubation Orotracheal Intubation with Rapid Sequence Intubation Technique for RSI Cricothyrotomy Procedure for Cricothyrotomy Shock Recognition of Shock Head Injuries Trivial Head Injury Minor Head Injury Moderate Head Injury Severe Head Injury Amputations Care of the Amputated Part: Complete Amputations Care of the Amputated Part: Incomplete Amputations Care of the Stump Transferring the Patient Summary Chapter 12: Treatment of Acute Myocardial Infarction with Thrombolytic Drugs in the Rural Hospital Introduction Selection of Patients Informed Consent Evaluation before Administering Thrombolytic Agents Choice of Thrombolytic Agent Method of Administration Adjunctive Therapy Complications Follow-up Care Summary Chapter 13: Women's Health Issues Introduction Prevention Pap Tests The Abnormal Pap Test Screening for Breast Cancer The Breast Lump Contraception Barrier Methods Natural Family Planning (NFP) Intrauterine Device (IUD) Oral Contraceptives Progestin Implants Depo-Provera Vaginitis Sexually Transmitted Diseases Chlamydia Human Papilloma Virus Hepatitis B Virus (HBV) Genital Herpes Simplex Virus (HSV) Pelvic Inflammatory Disease (PID) Violence against Women The Female Menopause Osteoporosis Cardiovascular Disease Techniques of Hormone Replacement Therapy (HRT) Summary Chapter 14: Caring for the AIDS Patient in a Rural Practice Introduction Background Pathophysiology and Natural History Transmission Testing Counseling and Diagnosis The Patient with a Positive HIV Test HIV Infection and Moderate Immunosuppression (CD4 = 200–500) HIV Infection and Severe Immunosuppression (CD4 < 200) Clinical AIDS End-of-Life Issues Doctor (Docere—to Teach) How to Keep up to Date Chapter 15: Treatment of Patients with Terminal Cancer Introduction What Care is Futile? Therapeutic Benefit Marginal Plan of Care for TBM Patients Therapeutic Benefit Unlikely Plan of Care of TBU Patients Therapeutic Benefit Futile Plan of Care of TBF Patients Assessing Futility of Treatment Non-Small Cell Lung Cancer (NSCLC) Breast Cancer Colon Cancer Prostate Cancer Renal Cell Cancer Leukemia Pancreatic Cancer Ovarian Cancer Summary Chapter 16: Caring for Dying Patients and their Families Setting the Stage: Telling the Truth, with Hope Walking the Path: Let the Patient set the Pace Emotionally Self-Determination: Establish a Road Map for the Future Guidelines for Self-Determination Opening the System: Involving Family and Consultants Negotiate Conflict: See the Big Picture Total Pain Management Physical Pain Management Emotional Pain: Anticipatory Grief Management Actively Dying: Letting go of Life Summary Chapter 17: Health Maintenance in Clinical Practice: Strategies and Barriers Introduction Barriers to Clinical Prevention Health System Barriers Patient Barriers Physician Barriers Strategies for Implementing Prevention Health Maintenance Flow Sheet Example of a System Computerized Systems Time Management Behavior Reinforcement Summary Chapter 18: Patient Education in the Rural Practice Introduction Rationale for Patient Education Philosophy of Practice Patient Education Committee Assessing Needs Applying Adult Education Research Appropriate use of Patient Education Materials Practical Implementation Considerations Locating and Selecting Materials Reading Level Evaluative Service Creating your Own Materials Organizing Materials Premade Packets for Special Types of Visits Computer Software in Patient Education Beyond the Office Visit Role Modeling Chapter 19: Making your Practice Palatable for your Patients: Cultural Competency Introduction Awareness of the Role of Culture When Cultural Sensitivity is Mandatory for Success Resources for Gathering Cultural Information Starting a New Practice When you Need the Information Yesterday Southeast Asians American Indians or Native American People African Americans Summary Chapter 20: Ethics Dilemmas in Rural Practice Introduction Ethics Conflicts in Rural Settings The Ethics Decision-Making Process Ethics Decision Making: A Case Analysis Case Presentation Discussion Autonomy Beneficence Utility Justice Outcome Recommendations Summary Chapter 21: Quality Assessment in Rural Practice Introduction Hospital Quality Assessment Outpatient Quality Assessment The CQI Process Developing Criteria and Setting Goals Measuring Care Results Improving Care Example: Pediatric Eye Care Topic Selection Criteria and Goal Selection Data Collection and Data Summary Results Improving Care Remeasuring Chapter 22: Living through Malpractice Litigation Introduction Rationale Caplan's Theory of Crisis Phase I: Impact Phase II: Disorganization Phase III: Recovery Phase IV: Reorganization Caplan's Theory Applied to the Family and Community Human Responses to Medical Litigation The Impact of Receiving the Subpoena The Legal Process Exacerbates Disorganization Coping with the Litigation Process Recovery Community Impact and Disorganization Impact of Litigation on Medical Practice Peer Responses to Litigation: Physicians and Nurses Helping Families Cope Summary