A Qualitative Inquiry into Rural Primary Schooler's Hygiene during the Covid-19 Pandemic in Kupang regency, East Nusa Tenggara Province, Indonesia

Introduction: The importance of personal hygiene in preventing the spread of infection cannot be underestimated. Handwashing is an essential aspect of personal hygiene, especially among children. This study aimed to explore primary school students' hygiene in rural and remote areas in the Kupang regency. Methods: This study was conducted as a part of the end line evaluation of the MEMBACA II project. Teachers from four primary schools in three villages were purposively selected to participate in this study. The teachers were recruited from the participant schools of the MEMBACA II Project. Data was collected using phone interviews. Data were analyzed using inductive thematic analysis. Results: In total, there were 31 participants across four primary schools interviewed. The participants consisted of teachers, village leaders, village reading camp facilitators, and school supervisors. Participants were recruited as a proxy for providing information about students' hygiene. There were three themes identified as a result of the data analysis. The first theme is an improvement in children’s hygiene behavior. The second theme is the benefit of the little doctor program in children’s hygiene practices. The third theme challenges in children’s hygiene promotion and education. Overall, children were used to handwashing practices. They understood the importance of handwashing, especially during the Covid-19 pandemic. They were also aware of four essential times of handwashing. However, the adults perceived the need for handwashing equipment and access to clean water were the main challenges to maintaining students' hygiene. Conclusion: The study demonstrated the significance of regularly teaching children about handwashing in making handwashing habits among these youngsters. A continuing provision of health literacy and access to clean water is required to maintain hygiene behavior

Infrastructure sharing model to connect the unconnected in rural areas

One of the major problems the telecommunication industry faces in providing connectivity to the unconnected, particularly in rural and remote areas, is the lack of infrastructure in these areas. Indeed, deploying a network in an isolated area can be more expensive for an operator than in an urban area, while the return on investment is not possible. This is the primary cause of the coverage divide. To remedy this, in this work, we propose a techno-economic analysis of infrastructure sharing. First, we develop a mathematical model of the overall cost of extending a mobile network in rural areas. Different scenarios involving infrastructure sharing at varying levels of deployment are then presented. Then, using the models proposed in each scenario, we make a case study to deduce the most economically advantageous scenario for operators to extend their networks to remote areas. This case involves the sharing of passive infrastructure and also the sharing of active resources in a cloud-RAN. Based on the proposed model, our simulation results show that while passive sharing is beneficial, active sharing using cloud-RAN as technology increases this benefit. This work also indicates and highlights the technical constraints to be respected in the sharing for this scenario.

Quality of Telehealth Services in Delivery of Paediatric Surgical Care in Australia: A Systematic Literature Review

Telehealth services are commonly used in many aspects of medicine to improve access to medical care for populations in rural and remote regions, and can and do play an important role in ensuring equitable access to paediatric surgery in Australia’s more rural and remote areas.

Improving access to cardiac rehabilitation in rural and remote areas: a protocol for a community-based qualitative case study

Background/Aims Heart disease is the largest single cause of death and contributes to poor quality of life and high healthcare costs in Australia. There are higher rates of heart disease in rural and remote areas, with the highest rates in Aboriginal and Torres Strait Islander people. Cardiac rehabilitation is known to improve health outcomes for people with heart disease but referral rates remain low (30.2% overall and 46% following acute coronary syndrome) in Australia. Further, access to cardiac rehabilitation in rural and remote areas is affected by there being few centre-based services, and poor use of home-based services. The aim of this protocol is to investigate: (i) understanding of cardiac rehabilitation by health staff, community leaders and community participants discharged from hospital following treatment for heart disease; (ii) access and support for cardiac rehabilitation in rural and remote areas via health service availability in each community. Methods A qualitative case study methodology, using an interpretive descriptive framework, will be used together with content analysis that will encompass identification of themes through a deductive/inductive process. Conclusions To improve access to services and health outcomes in rural and remote areas, a strong evidence base is essential. To achieve this, as well as having appropriate methodology, it is necessary to build relationships and trust with local communities and healthcare providers. This research protocol describes a qualitative community-based case study, together with processes to build sound relationships required for effective data collection through semi-structured interviews or focus groups. Each step of the pre-research planning data collection and analysis is described in detail for the guidance of future researchers.

Rural Resilience Through COVID-19

The effects of the COVID-19 pandemic have been felt globally affecting everyone, but have disproportionately harmed some of the most vulnerable and marginalized including individuals residing in rural and remote areas. The geographic isolation initially thought to protect rural and remote communities from the pandemic soon became a disadvantage, requiring individuals to navigate long-standing systemic barriers (e.g., lack of transportation issues, limited access to healthcare resources, and fragmented accessibility to vaccines), alongside the new challenges posed by COVID-19 restrictions to mitigate the spread of disease. The purpose of this symposium is to showcase examples of rural resiliency in the face of significant struggle. Taking a strength-based approach, the papers discuss efforts to identify healthy coping and positive aspects of physical distancing (Paper 1; Weaver), explore social support and psychological mindset (Paper 2; Fuller), inform successful strategies to pivot programming to remote coalition engagement for obesity prevention (Paper 3; Buys), implement a peer mentoring program to spur development of new strategies to build community resilience (Paper 4; Oh), and review elements of rurality that empower or exclude older people and the implications for a post-COVID world (Paper 5; Curreri). As we continue to uncover and learn about the short and long-term implications of living through the pandemic, these papers describe ways in which rural communities demonstrate resilience in the face of adversity. Our presenters will showcase a range of US and international perspectives and offer policy and program recommendations for building resilience in the longer term.

Wireless Terrestrial Backhaul for 6G Remote Access: Challenges and Low Power Solutions

Despite developments in communication systems over the last few decades, a digital divide exists in the unconnected part of the world. The latter is characterized by large distances to internet access points, underdeveloped infrastructure, sparse populations, and low incomes. This concern of digital divide is raised in the sixth generation’s (6G) initial vision as an extremely important topic. However, it is important to understand affiliated challenges and potential solutions to achieve this vision. Motivated by the recent backhaul link forecasts that expect a dominance of the microwave technology within the backhauling market, this paper studies the potential of a low-power terrestrial microwave backhaul from the sufficient-data-rate and solar powering perspective. Competing technologies (e.g., fiber) may not be energy efficient and commercially viable for global connectivity. Since rural and remote areas may not have grid power, we look at the viability of alternative sustainable sources, in particular solar power, to power the wireless backhaul in 6G. In addition, we also explore services for the operators and users to use the system efficiently. Since the access points are connected to backhaul, we also compare the two prominent solutions based on low-power small-radius cells and a mega-cell that covers a large area and show insights on the power autonomy of the systems. In the end, we propose directions for research and deployment for an inclusive connectivity as a part of future 6G networks.

Distribution and Location Stability of the Australian Ophthalmology Workforce: 2014–2019

Objective: To investigate the ophthalmology workforce distribution and location stability using Modified Monash Model category of remoteness. Methods: Whole of ophthalmologist workforce analysis using Australian Health Practitioner Registration Agency (AHPRA) data. Modified Monash Model (MMM) category was mapped to postcode of primary work location over a six-year period (2014 to 2019). MMM stability was investigated using survival analysis and competing risks regression. Design: Retrospective cohort study. Setting: Australia. Participants: Ophthalmologists registered with AHPRA. Main outcome measures: Retention within MMM category of primary work location. Results: A total of 948 ophthalmologists were identified (767 males, 181 females). Survival estimates indicate 84% of ophthalmologists remained working in MMM1, while 79% of ophthalmologists working in MMM2–MMM7remained in these regions during the six-year period. Conclusion: The Australian ophthalmology workforce shows a high level of location stability and is concentrated in metropolitan areas of Australia. Investment in policy initiatives designed to train, recruit and retain ophthalmologists in regional, rural and remote areas is needed to improve workforce distribution outside of metropolitan areas.