scholarly journals Procedural Telementoring in Rural, Underdeveloped, and Austere Settings: Origins, Present Challenges, and Future Perspectives

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Juan P. Wachs ◽  
Andrew W. Kirkpatrick ◽  
Samuel A. Tisherman
Keyword(s):  
Rural Communities ◽  
Rural Areas ◽  
The United States ◽  
Rural Practice ◽  
Annual Review ◽  
Publication Date ◽  
Future Perspectives ◽  
Medical Assistance ◽  
Residency Programs ◽  
Rural Settings

Telemedicine is perhaps the most rapidly growing area in health care. Approximately 15 million Americans receive medical assistance remotely every year. Yet rural communities face significant challenges in securing subspecialist care. In the United States, 25% of the population resides in rural areas, where less than 15% of physicians work. Current surgery residency programs do not adequately prepare surgeons for rural practice. Telementoring, wherein a remote expert guides a less experienced caregiver, has been proposed to address this challenge. Nonetheless, existing mentoring technologies are not widely available to rural communities, due to a lack of infrastructure and mentor availability. For this reason, some clinicians prefer simpler and more reliable technologies. This article presents past and current telementoring systems, with a focus on rural settings, and proposes a set of requirements for such systems. We conclude with a perspective on the future telementoring systems and the integration of artificial intelligence within those systems. Expected final online publication date for the Annual Review of Biomedical Engineering, Volume 23 is June 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Reimagining Rural: Shifting Paradigms About Health and Well-Being in the Rural United States

2021 ◽  
Vol 43 (1) ◽  
Author(s):  
R.A. Afifi ◽  
E.A. Parker ◽  
G. Dino ◽  
D.M. Hall ◽  
B. Ulin
Keyword(s):  
Rural Communities ◽  
Rural Health ◽  
Health Equity ◽  
Rural Areas ◽  
Paradigm Shift ◽  
Well Being ◽  
Annual Review ◽  
Publication Date ◽  
Rural Places ◽  
Health And Well Being

Rural health disparities have attracted increased national attention, compelling an expanded focus on rural health research. In this manuscript, we deconstruct the definitions and narratives of “rural” communities and suggest that a paradigm shift is needed that centers the complexity and strength of rural places. We discuss the relevance of health equity frameworks, implementation science, and community-engaged approaches to promote rural well-being. Focusing on rural in its own right will lead to intervention innovations and reinvention with implications beyond rural areas. We conclude with suggestions for research and practice to inspire renewed interest in partnering with rural communities to promote health equity. Expected final online publication date for the Annual Review of Public Health, Volume 43 is April 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Building a Practice in Rural Settings: Special Considerations

2013 ◽  
Vol 35 (3) ◽  
pp. 228-244 ◽  
Author(s):  
Tracy Cohn ◽  
Sarah Hastings
Keyword(s):  
Mental Health ◽  
Rural Communities ◽  
Rural Areas ◽  
Mental Health Problems ◽  
Metropolitan Areas ◽  
Economic Resources ◽  
Rural Practice ◽  
Collaborative Networks ◽  
Mental Health Counselors ◽  
Rural Settings

Private practice in rural areas presents special challenges. Rural communities often hold more stigmatizing views about psychotherapy and have fewer economic resources, yet rates of mental health problems are comparable to those in metropolitan areas. Rural practice can be particularly rewarding for clinicians who can build collaborative networks, adjust to visibility, negotiate boundaries, and successfully integrate into the community. This article offers recommendations for mental health counselors on building a practice for branding, marketing, collaborating, and exercising self-care. It also discusses challenges associated with counseling in rural areas and gives suggestions for building a thriving practice.

scholarly journals Preparing Students in Professional Programs for Rural Practice: A Case Study

2015 ◽  
Vol 45 (2) ◽  
pp. 23-40 ◽  
Author(s):  
Julia Brook ◽  
Neil Hobbs ◽  
Denise Neumann-Fuhr ◽  
Anne O'Riordan ◽  
Meagan Troop ◽  
...  
Keyword(s):  
Rural Communities ◽  
Professional Practice ◽  
Rural Areas ◽  
Interprofessional Collaboration ◽  
Rural Practice ◽  
Working Relationships ◽  
Remote Communities ◽  
Professional Programs ◽  
Rural Settings

Understanding the supports and constraints available in rural communities is integral to the education of professionals who choose to practise in rural settings. Previous research has indicated that many professionals do not have an accurate understanding of rural contexts and how rural settings impact personal life and professional practice. To address this gap, an interprofessional course centring on professional practice in rural and remote communities was developed. This course was designed to be reflective of rural practice, not only in content but also in the way the course was delivered. Findings from this case study indicated that students’ understanding of the complexity of rural settings was enhanced on multiple levels. The interactive and experiential nature of the course allowed students to develop working relationships that increased both their understanding of the value of interprofessional collaboration as well as the professional opportunities that are available in rural areas.  

Implementing Play Streets in Low-Income Rural Communities in the United States

2020 ◽  
pp. 152483992095722
Author(s):  
Keshia M. Pollack Porter ◽  
Christina N. Bridges Hamilton ◽  
M. Renée Umstattd Meyer
Keyword(s):  
Rural Communities ◽  
Low Income ◽  
Rural Areas ◽  
Urban Areas ◽  
Grey Literature ◽  
The United States ◽  
Active Play ◽  
Safe Place ◽  
Rural Settings ◽  
Temporary Closure

Play streets involve the temporary closure of streets that for a specified time create a safe place for active play. Play streets have been implemented primarily in cities; it is unknown if they could be adapted and implemented in rural areas. To learn about implementation, core components of play streets and inform adaptation, we conducted systematic peer-reviewed and grey literature searches and interviews with a purposive sample of key informants. Data were analyzed by theme and used to inform implementation of play streets by four community organizations in low-income rural areas of Maryland, North Carolina, Oklahoma, and Texas from June to September 2017. Core elements of play streets in urban areas were present in rural settings—the content (e.g., activities offered), delivery of the intervention in partnership with community members and local organizations, and reoccurrence of play streets at a single location. There were three key adaptations relating to delivery and context to consider uniquely when implementing play streets in rural areas (1) using locations other than streets, (2) varying locations to account for geographic dispersion, and (3) maximizing participation and resources by coupling play streets with community events. Play streets can be successfully implemented in rural settings with these modifications, which support feasibility, reach, and access. Play streets in rural areas should include activities for active play that are age-appropriate and fun, without necessarily tailoring content for rural areas.

scholarly journals Tackling Rural Health, Energy, … and Technological Issues All at Once: A Call for a Global Interdisciplinary Platform for Strengthening Rural Setting Amid the COVID-19 Pandemic

Challenges ◽  
2021 ◽  
Vol 12 (2) ◽  
pp. 16
Author(s):  
Farshad Amiraslani
Keyword(s):  
Rural Communities ◽  
Rural Health ◽  
Rural Areas ◽  
Rural Setting ◽  
Global Challenges ◽  
Rural Settings ◽  
Research Studies

The recent COVID-19 pandemic has revealed flaws in rural settings where most people live without the necessary tools, income, and knowledge to tackle such unprecedented global challenges. Here, I argue that despite the research studies conducted on rural areas, these have not solved rising rural issues, notably poverty and illiteracy. I propound a global institute to be formed by governments that provides a platform for empowering rural communities through better training, skills, and competencies. Such global endeavour will ensure the remaining rural communities withstand future pandemics if they occur.

Inflation Inequality: Measurement, Causes, and Policy Implications

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Xavier Jaravel
Keyword(s):  
United States ◽  
Income Distribution ◽  
Interest Rates ◽  
Optimal Taxation ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
The United States ◽  
Policy Implications ◽  
Annual Review ◽  
Publication Date

Does inflation vary across the income distribution? This article reviews the growing literature on inflation inequality, describing recent advances and opportunities for further research in four areas. First, new price index theory facilitates the study of inflation inequality. Second, new data show that inflation rates decline with household income in the United States. Accurate measurement requires granular price and expenditure data because of aggregation bias. Third, new evidence quantifies the impacts of innovation and trade on inflation inequality. Contrary to common wisdom, empirical estimates show that the direction of innovation is a significant driver of inflation inequality in the United States, whereas trade has similar price effects across the income distribution. Fourth, inflation inequality and non-homotheticities have important policy implications. They transform cost-benefit analysis, optimal taxation, the effectiveness of stabilization policies, and our understanding of secular macroeconomic trends—including structural change, the decline in the labor share and interest rates, and labor market polarization. Expected final online publication date for the Annual Review of Economics, Volume 13 is August 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

The Recent Rise of Suicide Mortality in the United States

2021 ◽  
Vol 43 (1) ◽  
Author(s):  
Gonzalo Martínez-Alés ◽  
Tammy Jiang ◽  
Katherine M. Keyes ◽  
Jaimie L. Gradus
Keyword(s):  
Public Health ◽  
United States ◽  
Suicide Risk ◽  
The United States ◽  
Health Concern ◽  
Suicide Mortality ◽  
Annual Review ◽  
Publication Date ◽  
Suicide Rates ◽  
Subsequent Decrease

Suicide is a major public health concern in the United States. Between 2000 and 2018, US suicide rates increased by 35%, contributing to the stagnation and subsequent decrease in US life expectancy. During 2019, suicide declined modestly, mostly owing to slight reductions in suicides among Whites. Suicide rates, however, continued to increase or remained stable among all other racial/ethnic groups, and little is known about recent suicide trends among other vulnerable groups. This article ( a) summarizes US suicide mortality trends over the twentieth and early twenty-first centuries, ( b) reviews potential group-level causes of increased suicide risk among subpopulations characterized by markers of vulnerability to suicide, and ( c) advocates for combining recent advances in population-based suicide prevention with a socially conscious perspective that captures the social, economic, and political contexts in which suicide risk unfolds over the life course of vulnerable individuals. Expected final online publication date for the Annual Review of Public Health, Volume 43 is April 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

scholarly journals Student perception about working in rural United States/Canada after graduation: a study in an offshore Caribbean medical school

F1000Research ◽  
2014 ◽  
Vol 3 ◽  
pp. 301
Author(s):  
P Ravi Shankar ◽  
Arun K Dubey ◽  
Atanu Nandy ◽  
Burton L Herz ◽  
Brian W Little
Keyword(s):  
United States ◽  
Rural Areas ◽  
Professional Growth ◽  
Student Perception ◽  
Medical Schools ◽  
The United States ◽  
Rural Practice ◽  
Growth Potential ◽  
Cultural Issues ◽  
The Government

Introduction: Rural residents of the United States (US) and Canada face problems in accessing healthcare. International medical graduates (IMGs) play an important role in delivering rural healthcare. IMGs from Caribbean medical schools have the highest proportion of physicians in primary care.  Xavier University School of Medicines admits students from the US, Canada and other countries to the undergraduate medical (MD) course and also offers a premedical program. The present study was conducted to obtain student perception about working in rural US/Canada after graduation.  Methods: The study was conducted among premedical and preclinical undergraduate medical (MD) students during October 2014. The questionnaire used was modified from a previous study. Semester of study, gender, nationality, place of residence and occupation of parents were noted. Information about whether students plan to work in rural US/Canada after graduation, possible reasons why doctors are reluctant to work in rural areas, how the government can encourage rural practice, possible problems respondents anticipate while working in rural areas were among the topics studied.Results: Ninety nine of the 108 students (91.7%) participated. Forty respondents were in favor of working in rural US/Canada after graduation. Respondents mentioned good housing, regular electricity, water supply, telecommunication facilities, and schools for education of children as important conditions to be fulfilled. The government should provide higher salaries to rural doctors, help with loan repayment, and provide opportunities for professional growth.  Potential problems mentioned were difficulty in being accepted by the rural community, problems in convincing patients to follow medical advice, lack of exposure to rural life among the respondents, and cultural issues.Conclusions: About 40% of respondents would consider working in rural US/Canada. Conditions required to be fulfilled have been mentioned above. Graduates from Caribbean medical schools have a role in addressing rural physician shortage. Similar studies in other offshore Caribbean medical schools are required as Caribbean IMGs make an important contribution to the rural US and Canadian health workforce.

scholarly journals Social Inequality and the Future of US Life Expectancy

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Iliya Gutin ◽  
Robert A. Hummer
Keyword(s):  
United States ◽  
Life Expectancy ◽  
Social Inequality ◽  
Population Health ◽  
The United States ◽  
Annual Review ◽  
Publication Date ◽  
The Social ◽  
The Future ◽  
Extreme Longevity

Despite decades of progress, the future of life expectancy in the United States is uncertain due to widening socioeconomic disparities in mortality, continued disparities in mortality across racial/ethnic groups, and an increase in extrinsic causes of death. These trends prompt us to scrutinize life expectancy in a high-income but enormously unequal society like the United States, where social factors determine who is most able to maximize their biological lifespan. After reviewing evidence for biodemographic perspectives on life expectancy, the uneven diffusion of health-enhancing innovations throughout the population, and the changing nature of threats to population health, we argue that sociology is optimally positioned to lead discourse on the future of life expectancy. Given recent trends, sociologists should emphasize the importance of the social determinants of life expectancy, redirecting research focus away from extending extreme longevity and toward research on social inequality with the goal of improving population health for all. Expected final online publication date for the Annual Review of Sociology, Volume 47 is July 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Rural midwifery practice in Aotearoa/New Zealand: Strengths, vulnerabilities, opportunities and challenges

2020 ◽  
Vol 56 ◽  
pp. 17-25
Author(s):  
Rea Daellenbach ◽  
Lorna Davies ◽  
Mary Kensington ◽  
Susan Crowther ◽  
Andrea Gilkison ◽  
...  
Keyword(s):  
New Zealand ◽  
Rural Communities ◽  
Social Services ◽  
Health Professionals ◽  
Rural Women ◽  
Rural Areas ◽  
Service Providers ◽  
Rural Practice ◽  
Midwifery Practice ◽  
Adverse Weather

Background: The sustainability of rural maternity services is threatened by underfunding, insufficient resourcing and challenges with recruitment and retention of midwives. Aims: The broader aim of this study was to gain knowledge to inform the optimisation of equitable and sustainable maternity care for rural communities within New Zealand and Scotland, through eliciting the views of rural midwives about their working conditions and practice. This article focuses on the New Zealand midwives’ responses. Method: Invitations to participate in an online questionnaire were sent out to midwives working in rural areas. Subsequently, themes from the survey results were followed up for more in-depth discussion in confidential, online group forums. 145 New Zealand midwives responded to the survey and 12 took part in the forums. Findings: The New Zealand rural midwives who participated in this study outlined that they are attracted to, and sustained in, rural practice by their sense of connectedness to the countryside and rural communities, and that they need to be uniquely skilled for rural practice. Rural midwives, and the women they provide care to, frequently experience long travel times and distances which are economically costly. Adverse weather conditions, occasional lack of cell phone coverage and variable access to emergency transport are other factors that need to be taken into account in rural midwifery practice. Additionally, many participants noted challenges at the rural/urban interface in relation to referral or transfer of care of a woman and/or a baby. Strategies identified that support rural midwives in New Zealand include: locum and mentoring services, networking with other health professionals, support from social services and community service providers, developing supportive relationships with other rural midwives and providing rural placements for student midwives. Conclusion: Midwives face economic, topographic, meteorological and workforce challenges in providing a service for rural women. However, midwives draw strength through their respect of the women, and the support of their midwifery colleagues and other health professionals in their community.

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