Virtual care with digital technologies for rural and remote Canadians living with cardiovascular disease

AbstractCanada is a wealthy nation with a geographically diverse population, seeking health innovations to better serve patients in accordance with the Canada Health Act. In this country, population and geography converge with social determinants, policy, procurement regulations, and technological advances, in order to achieve equity in the management and distribution of healthcare. Rural and remote patients are a vulnerable population; when managing chronic conditions such as cardiovascular disease, there is inequity when it comes to accessing specialist physicians at the recommended frequency—increasing the likelihood of poor health outcomes. Ensuring equitable care for this population is an unrealized priority of several provincial and federal government mandates. Virtual care technology may provide practical, economical, and innovative solutions to remedy this discrepancy. Here we review the literature pertaining to the use of virtual care technologies to monitor patients with cardiovascular disease living in rural areas of Canada. A search strategy was developed to identify the literature specific to this context across three bibliographic databases. 166 unique citations were ultimately assessed for eligibility, of which 36 met the inclusion criteria. In our assessment of these articles, we provide a summary of the interventions studied, their reported effectiveness in reducing adverse events and mortality, the challenges to implementation, and the receptivity of these technologies amongst patients, providers and policy makers. Further, we glean insight into the barriers and opportunities to ensure equitable care for rural patients and conclude that there is an ongoing need for clinical trials assessing virtual care technologies in this context.SummaryPatients living in rural and remote communities’ experience diverse challenges to receiving equitable healthcare as is mandated by the Canada Health Act. Advances in virtual care technology may provide practical, economical, and innovative solutions to ensure this for patients in remote and rural living situations. Here we provide a state-of-the-art review of virtual care technologies available to patients with cardiovascular disease living in rural areas of Canada.

Download Full-text

A CONCEPTUAL FRAMEWORK FOR UNDERSTANDING "RURAL" POSITIONING

Journal of Enterprising Culture ◽

10.1142/s0218495813500039 ◽

2013 ◽

Vol 21 (01) ◽

pp. 45-74 ◽

Cited By ~ 2

Author(s):

LYNNE SIEMENS

Keyword(s):

Economic Development ◽

Small Business ◽

Marketing Strategy ◽

Rural Areas ◽

Rural And Remote ◽

Remote Communities ◽

Rural Region ◽

Rural Economic Development ◽

Rural Businesses ◽

Declining Populations

In many rural and remote communities, residents have traditionally relied on jobs in natural resource-based industries. Over the years, employment has been steadily reduced due to changes in these industries. Both the communities, faced with declining populations as a result, and the residents are examining the potential of small business to create economic development. However, these locations create challenges for small business operators. Some communities experience accessibility and transportation issues and often lack standard business infrastructure. At the same time, the very nature of these rural areas can become components of a marketing strategy. This paper will examine three conceptualizations of rural and the commodification process and propose a framework for positioning the concept of rural as part of a marketing strategy. Three case studies from a rural region in Canada will be presented and analyzed within this framework. The paper concludes with recommendations for rural businesses, communities and governments and other interested parties within the context of rural economic development.

Download Full-text

Quantifying the impacts of biomass driven combined heat and power grids in northern rural and remote communities

Renewable and Sustainable Energy Reviews ◽

10.1016/j.rser.2021.111296 ◽

2021 ◽

Vol 148 ◽

pp. 111296

Author(s):

Joe Coady ◽

Jean Duquette

Keyword(s):

Combined Heat And Power ◽

Power Grids ◽

Rural And Remote ◽

Remote Communities

Download Full-text

Development and assessment of a telesonography system for musculoskeletal imaging

European Radiology Experimental ◽

10.1186/s41747-021-00227-z ◽

2021 ◽

Vol 5 (1) ◽

Author(s):

Mohammed Obaid ◽

Qianwei Zhang ◽

Scott J. Adams ◽

Reza Fotouhi ◽

Haron Obaid

Keyword(s):

Degrees Of Freedom ◽

Ultrasound Images ◽

Ultrasound Probe ◽

Rural And Remote ◽

Significant Delay ◽

Remote Communities ◽

Internet Connection ◽

Good For ◽

4 Degrees Of Freedom

Abstract Background Telesonography systems have been developed to overcome barriers to accessing diagnostic ultrasound for patients in rural and remote communities. However, most previous telesonography systems have been designed for performing only abdominal and obstetrical exams. In this paper, we describe the development and assessment of a musculoskeletal (MSK) telesonography system. Methods We developed a 4-degrees-of-freedom (DOF) robot to manipulate an ultrasound probe. The robot was remotely controlled by a radiologist operating a joystick at the master site. The telesonography system was used to scan participants’ forearms, and all participants were conventionally scanned for comparison. Participants and radiologists were surveyed regarding their experience. Images from both scanning methods were independently assessed by an MSK radiologist. Results All ten ultrasound exams were successfully performed using our developed MSK telesonography system, with no significant delay in movement. The duration (mean ± standard deviation) of telerobotic and conventional exams was 4.6 ± 0.9 and 1.4 ± 0.5 min, respectively (p = 0.039). An MSK radiologist rated quality of real-time ultrasound images transmitted over an internet connection as “very good” for all telesonography exams, and participants rated communication with the radiologist as “very good” or “good” for all exams. Visualisation of anatomic structures was similar between telerobotic and conventional methods, with no statistically significant differences. Conclusions The MSK telesonography system developed in this study is feasible for performing soft tissue ultrasound exams. The advancement of this system may allow MSK ultrasound exams to be performed over long distances, increasing access to ultrasound for patients in rural and remote communities.

Download Full-text

1010. Effective Management of HIV in Rural Georgia Using Telemedicine

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1196 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S533-S533

Author(s):

Folake J Lawal ◽

Arni S R Srinivasa Rao ◽

Jose A Vazquez

Keyword(s):

Rural Areas ◽

Viral Suppression ◽

Retrospective Chart Review ◽

Cd4 Count ◽

Hiv Care ◽

Resistance Mutations ◽

Remote Communities ◽

Hiv Viral Load ◽

Viral Control ◽

Significant Difference

Abstract Background The increasing incidence of HIV and lack of care in rural areas contributes to the ongoing epidemic. The dearth of specialized health services within remote communities and access of this population to available services poses a challenge to HIV care. Telemedicine (TM) is a potential tool to improve HIV care in these remote communities, but little is known about its effectiveness when compared to traditional (face-to-face) (F2F) care. The objective of this study is to examine the effectiveness of HIV care delivered through TM, and compare to F2F care. Methods This is a retrospective chart review of all HIV positive patients who attended either the F2F clinic (Augusta, GA) or the TM clinic (Dublin, GA) between May 2017 to April 2018. Data extracted included demographics, CD4 count, HIV PCR, co-morbidities, dates of clinic attendance, HIV resistance mutations and ART changes. Viral suppression and gain in CD4 counts were compared. T-test was conducted to test differences in characteristics and outcomes between the two groups. Results 385 cases were included in the study (52.5% black, 82% females, F2F=200, TM=185). Mean CD4 count in the TM group was statistically higher (643.9 cells/mm3) than the F2F group (596.3 cells/mm3) (p< 0.001). There was no statistically significant difference in mean HIV viral load (F2F= 416.8 cp/ml, TM=713.4 cp/ml, p=0.3) and rates of year-round viral control (F2F= 73% vs TM = 77% p= 0.54). 38 patients achieved viral suppression during the study period (F2F= 24, TM =14) with a mean change of -3.34 x 104 vs -1.24 x 104, respectively. The difference in mean change was not statistically significant by Snedacor’s W Statistics. This indicates there was no significant difference between the two populations in terms of mean viral suppression among patients who were otherwise not suppressed before the study period. Conclusion To achieve an HIV cure, HIV care is required to extend to rural areas of the country and the world. Through delivery of care using TM, trained specialists can target communities with little or no health care. Moreover, use of TM achieves target outcome measures comparable to F2F clinics. Increase in the use of TM will improve the access to specialty HIV care and help achieve control of HIV in rural communities. Disclosures All Authors: No reported disclosures

Download Full-text

Appreciating the Contribution of Broadband ICT With Rural and Remote Communities: Stepping Stones Toward an Alternative Paradigm

The Information Society ◽

10.1080/01972240701224044 ◽

2007 ◽

Vol 23 (2) ◽

pp. 85-94 ◽

Cited By ~ 22

Author(s):

Ricardo Ramírez

Keyword(s):

Rural And Remote ◽

Remote Communities ◽

Stepping Stones

Download Full-text

On the State of Genre/Form Vocabulary: A Quantitative Analysis of LCGFT Data in WorldCat

Library Resources and Technical Services ◽

10.5860/lrts.65n2.52-64 ◽

2021 ◽

Vol 65 (2) ◽

pp. 52

Author(s):

Colin Bitter ◽

Yuji Tosaka

Keyword(s):

Quantitative Analysis ◽

Detailed Analysis ◽

The State ◽

Bibliographic Databases ◽

Moderate Increase ◽

Large Set ◽

Library Of Congress ◽

Bibliographic Data ◽

Innovative Solutions ◽

Over Time

The purpose of this paper is to report on a quantitative analysis of the LCGFT vocabulary within a large set of MARC bibliographic data retrieved from the OCLC WorldCat database. The study aimed to provide a detailed analysis of the outcomes of the LCGFT project, which was launched by the Library of Congress (LC) in 2007. Findings point to a moderate increase in LCGFT use over time; however, the vocabulary has not been applied to the fullest extent possible in WorldCat. Further, adoption has been inconsistent between the various LCGFT disciplines. These and other findings discussed here suggest that retrospective application of the vocabulary using automated means should be investigated by catalogers and other technical services librarians. Indeed, as the data used for the analysis show somewhat uneven application of LCGFT, and with nearly half a billion records in WorldCat, it remains a certainty that much of LCGFT’s full potentials for genre/form access and retrieval will remain untapped until innovative solutions are introduced to further increase overall vocabulary usage in bibliographic databases.

Download Full-text

IMPACT OF DIGITAL MARKETING: THE PRESENT SCENARIO IN TELANGANA STATE – AN EMPERICAL STUDY

Scholarly Research Journal for Interdisciplinary Studies ◽

10.21922/srjis.v8i65.1575 ◽

2021 ◽

Vol 8 (65) ◽

pp. 15164-15172

Author(s):

S. Pratap ◽

Aziz Fatima

Keyword(s):

Rural Areas ◽

Urban Areas ◽

Digital Marketing ◽

Rural And Remote ◽

Remote Areas ◽

Wide Range ◽

Rural And Remote Areas ◽

Telangana State ◽

The Impact ◽

Made In

In present scenario of COVID-19, the effect of pandemic on Digital Marketing is visible not only in urban areas but also in rural areas. Customers are searching for various products and services through Google by which they can purchase wide range of products and services to fill their needs and desires at relatively low price. The freedom to select numerous products is available by browsing various websites. Hence this study focuses on Impact of digital marketing particularly in the selected rural areas of Telangana state. This state been formed recently but in the IT sector it is receiving much attention throughout the globe, as many MNC’s are establishing their operations in this state. Therefore, an attempt has been made in this study to find out how the Impact of digital marketing is trickling down in the rural and remote areas of newly formed Telangana state. Hence this study focuses the impact of digital marketing in the selected areas of Telangana state.

Download Full-text