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1.
IEEE Pulse ; 11(5): 17-20, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33064639

RESUMO

Before the novel coronavirus (COVID-19) started sweeping across the United States, it began on the coasts. The first known case was reported in a county just outside of Seattle, WA, with other cases quickly cropping up in California and in the greater New York City region. As the virus lingered on the periphery of the country, doctors and physicians working in inland, rural communities worried about what might happen if the virus hit their homes.


Assuntos
Betacoronavirus , Infecções por Coronavirus/terapia , Pandemias , Pneumonia Viral/terapia , Serviços de Saúde Rural , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/epidemiologia , Criatividade , Humanos , Colaboração Intersetorial , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Saúde da População Rural , Serviços de Saúde Rural/organização & administração , População Rural , Estados Unidos/epidemiologia , Universidades , Voluntários
3.
Nurse Educ Pract ; 48: 102892, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32980557

RESUMO

The COVID-19 outbreak in Winter (2020) has caused widespread disruption for health sciences students undergoing clinical placements-vital periods of experiential learning that cannot be substituted with distance alternatives. For students placed in rural areas, already coping with isolation, precarious supply chains and shortages of essential personnel, the effects of the COVID-19 outbreak may have far-reaching implications for psychosocial wellness, self-efficacy and clinical judgment. Four nursing and eight medical students (n = 12) supplied photographs and commentary documenting the experience of withdrawing suddenly from clinical sites in rural Alberta. Collaborative, thematic analysis revealed continuities between pre- and post-outbreak life, both for the students and their rural hosts. Social determinants of health such as seclusion, environmental hazards, and health-seeking behaviors carried over and compounded the effects of the outbreak on the placement communities and clinical sites. Other continuities included the reliance on technology for clinical and social connectivity, and capitalizing on natural settings to cope with isolation and confinement. Prolonged liminality, lack of closure, and the loss of team identity were the greatest stressors brought on by the suspension of clinical activities. However, the participants felt well equipped to deal with these circumstances through the resilience, adaptability, and community ethos acquired during their placements.


Assuntos
Infecções por Coronavirus/epidemiologia , Surtos de Doenças , Pneumonia Viral/epidemiologia , Preceptoria/organização & administração , Serviços de Saúde Rural/organização & administração , Estudantes de Medicina/psicologia , Estudantes de Enfermagem/psicologia , Alberta/epidemiologia , Humanos , Pandemias , Fotografação
4.
J Prim Care Community Health ; 11: 2150132720947963, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32757817

RESUMO

The first documented case of COVID-19 in the United States occurred on January 30th, 2020. Soon after, a global pandemic was declared in March 2020 with each state issuing stay at home orders based on population, risk for community transmission and current number of positive cases. A priority for each region was to develop efficient systems for testing large patient volumes in a safe manner to reduce the risk of community transmission. A community based United States health care system in the upper mid-west implemented a drive through testing site in an attempt to divert suspected cases of COVID-19 away from larger patient areas while protecting staff and patients. This commentary outlines the planning, work flow and challenges of implementing this drive through testing site in a rural community setting.


Assuntos
Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico , Programas de Rastreamento/métodos , Pandemias , Pneumonia Viral/diagnóstico , Serviços de Saúde Rural/organização & administração , Infecções por Coronavirus/epidemiologia , Pesquisa sobre Serviços de Saúde , Humanos , Pneumonia Viral/epidemiologia , Estados Unidos/epidemiologia
5.
Artigo em Inglês | MEDLINE | ID: mdl-32796738

RESUMO

Chronic health workforce shortages significantly contribute to unmet health care needs in rural and remote communities. Of particular and growing concern are shortages of allied health professionals (AHPs). This study explored the contextual factors impacting the recruitment and retention of AHPs in rural Australia. A qualitative approach using a constructivist-interpretivist methodology was taken. Semi-structured interviews (n = 74) with executive staff, allied health (AH) managers and newly recruited AHPs working in two rural public health services in Victoria, Australia were conducted. Data was coded and categorised inductively and analysed thematically. The findings suggest that to support a stable and sustainable AH workforce, rural public sector health services need to be more efficient, strategic and visionary. This means ensuring that policies and procedures are equitable and accessible, processes are effective, and action is taken to develop local programs, opportunities and supports that allow AH staff to thrive and grow in place at all grade levels and life stages. This study reinforces the need for a whole-of-community approach to effectively support individual AH workers and their family members in adjusting to a new place and developing a sense of belonging in place. The recommendations arising from this study are likely to have utility for other high-income countries, particularly in guiding AH recruitment and retention strategies in rural public sector health services. Recommendations relating to community/place will likely benefit broader rural health workforce initiatives.


Assuntos
Pessoal Técnico de Saúde , Mão de Obra em Saúde/estatística & dados numéricos , Seleção de Pessoal , Reorganização de Recursos Humanos/estatística & dados numéricos , Serviços de Saúde Rural/organização & administração , Emprego/psicologia , Humanos , Serviços de Saúde Rural/estatística & dados numéricos , População Rural , Estados Unidos , Vitória
6.
Am J Public Health ; 110(S2): S204-S210, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32663081

RESUMO

Objectives. To examine changes in the scope of activity and organizational composition of public health delivery systems serving rural and urban US communities between 2014 and 2018.Methods. We used data from the National Longitudinal Survey of Public Health Systems to measure the implementation of recommended public health activities and the network of organizations contributing to these activities in a nationally representative cohort of US communities. We used multivariable regression models to test for rural-urban differences between 2014 and 2018.Results. The scope of recommended activities implemented in rural areas declined by 3.4 percentage points between 2014 and 2018, whereas it increased by 1.4 percentage points in urban areas. The rural-urban disparity in scope of activities grew by a total of 4.8 percentage points (P < .05) over this time. The disparity in network density grew by 2.3 percentage points (P < .05).Conclusions. Urban public health systems have enhanced their scope of activities and organizational networks since 2014, whereas rural systems have lost capacity. These trends suggest that system improvement initiatives have had uneven success, and they may contribute to growing rural-urban disparities in population health status.


Assuntos
Saúde Pública/estatística & dados numéricos , Serviços de Saúde Rural/estatística & dados numéricos , Serviços Urbanos de Saúde/estatística & dados numéricos , Humanos , Estudos Longitudinais , Administração em Saúde Pública/estatística & dados numéricos , Serviços de Saúde Rural/organização & administração , Estados Unidos , Serviços Urbanos de Saúde/organização & administração
7.
J Rural Health ; 36(4): 577-583, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32603017

RESUMO

BACKGROUND: Telehealth is likely to play a crucial role in treating COVID-19 patients. However, not all US hospitals possess telehealth capabilities. This brief report was designed to explore US hospitals' readiness with respect to telehealth availability. We hope to gain deeper insight into the factors affecting possession of these valuable capabilities, and how this varies between rural and urban areas. METHODS: Based on 2017 data from the American Hospital Association survey, Area Health Resource Files and Medicare cost reports, we used logistic regression models to identify predictors of telehealth and eICU capabilities in US hospitals. RESULTS: We found that larger hospitals (OR(telehealth) = 1.013; P < .01) and system members (OR(telehealth) = 1.55; P < .01) (OR(eICU) = 1.65; P < .01) had higher odds of possessing telehealth and eICU capabilities. We also found evidence suggesting that telehealth and eICU capabilities are concentrated in particular regions; the West North Central region was the most likely to possess capabilities, given that these hospitals had higher odds of possessing telehealth (OR = 1.49; P < .10) and eICU capabilities (OR = 2.15; P < .05). Rural hospitals had higher odds of possessing telehealth capabilities as compared to their urban counterparts, although this relationship was marginally significant (OR = 1.34, P < .10). CONCLUSIONS: US hospitals vary in their preparation to use telehealth to aid in the COVID-19 battle, among other issues. Hospitals' odds of possessing the capability to provide such services vary largely by region; overall, rural hospitals have more widespread telehealth capabilities than urban hospitals. There is still great potential to expand these capabilities further, especially in areas that have been hard hit by COVID-19.


Assuntos
Infecções por Coronavirus/terapia , Acesso aos Serviços de Saúde/organização & administração , Hospitais Rurais/organização & administração , Pneumonia Viral/terapia , População Rural/estatística & dados numéricos , Telemedicina/estatística & dados numéricos , Atitude do Pessoal de Saúde , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Registros Eletrônicos de Saúde/organização & administração , Humanos , Pandemias , Pneumonia Viral/epidemiologia , Serviços de Saúde Rural/organização & administração , Estados Unidos
8.
Int J Health Plann Manage ; 35(5): 1250-1256, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32677128

RESUMO

Since the outbreak of COVID-19, the disease has continued to spread and countries around the world have been plagued by its causal agent, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In the comprehensive fight against the SARS-CoV-2, China has taken a series of important measures, achieved major victories in safeguarding people's lives and health, and accumulated important experience. Rural epidemic prevention and control is a basic part of the entire prevention and control system, with certain particularities. This study summarizes China's experience in preventing and controlling COVID-19 and the local measures taken to effectively prevent the spread of the disease in rural areas. All countries worldwide can learn from China's experience and take measures according to their own national and local conditions to effectively achieve the rural prevention and control of COVID-19. Meanwhile, the crisis itself can be viewed as a new opportunity for rural development.


Assuntos
Infecções por Coronavirus/prevenção & controle , Controle de Infecções/organização & administração , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , População Rural/estatística & dados numéricos , Betacoronavirus , China/epidemiologia , Infecções por Coronavirus/epidemiologia , Epidemias/prevenção & controle , Humanos , Controle de Infecções/métodos , Pneumonia Viral/epidemiologia , Serviços de Saúde Rural/organização & administração
9.
Indian J Public Health ; 64(Supplement): S102-S104, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: covidwho-530400

RESUMO

At the end of April 2020, there had already been three million cases of COVID-19 in the world pandemic. Chhattisgarh might expect 90,000 diagnosed cases of COVID-19 in the end. The first step taken in March was to ensure a simple checklist of activities that needed to continue. Handbills were given with the basic information on the symptoms and what to do in the community. In urban areas, the lockdown affected the poorer section of the society, especially who are not having BPL card and no other means of availing necessary eatables. Issues that arose affecting regular activities such as tuberculosis and immunization. Residents of informal settlements are also vulnerable during any COVID-19 responses. Frontline workers such as Mitanins in the community are an important asset in the capacity building and preparedness strategies.


Assuntos
Agentes Comunitários de Saúde/organização & administração , Infecções por Coronavirus/epidemiologia , Planejamento em Desastres/organização & administração , Pandemias , Pneumonia Viral/epidemiologia , Betacoronavirus , Agentes Comunitários de Saúde/normas , Desinfecção das Mãos , Educação em Saúde , Humanos , Índia/epidemiologia , Guias de Prática Clínica como Assunto , Serviços de Saúde Rural/organização & administração , Serviços Urbanos de Saúde/organização & administração
11.
Indian J Public Health ; 64(Supplement): S102-S104, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32496236

RESUMO

At the end of April 2020, there had already been three million cases of COVID-19 in the world pandemic. Chhattisgarh might expect 90,000 diagnosed cases of COVID-19 in the end. The first step taken in March was to ensure a simple checklist of activities that needed to continue. Handbills were given with the basic information on the symptoms and what to do in the community. In urban areas, the lockdown affected the poorer section of the society, especially who are not having BPL card and no other means of availing necessary eatables. Issues that arose affecting regular activities such as tuberculosis and immunization. Residents of informal settlements are also vulnerable during any COVID-19 responses. Frontline workers such as Mitanins in the community are an important asset in the capacity building and preparedness strategies.


Assuntos
Agentes Comunitários de Saúde/organização & administração , Infecções por Coronavirus/epidemiologia , Planejamento em Desastres/organização & administração , Pandemias , Pneumonia Viral/epidemiologia , Betacoronavirus , Agentes Comunitários de Saúde/normas , Desinfecção das Mãos , Educação em Saúde , Humanos , Índia/epidemiologia , Guias de Prática Clínica como Assunto , Serviços de Saúde Rural/organização & administração , Serviços Urbanos de Saúde/organização & administração
12.
Heart Lung Circ ; 29(7): e88-e93, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32487432

RESUMO

THE CHALLENGES: Rural and remote Australians and New Zealanders have a higher rate of adverse outcomes due to acute myocardial infarction, driven by many factors. The prevalence of cardiovascular disease (CVD) is also higher in regional and remote populations, and people with known CVD have increased morbidity and mortality from coronavirus disease 2019 (COVID-19). In addition, COVID-19 is associated with serious cardiac manifestations, potentially placing additional demand on limited regional services at a time of diminished visiting metropolitan support with restricted travel. Inter-hospital transfer is currently challenging as receiving centres enact pandemic protocols, creating potential delays, and cardiovascular resources are diverted to increasing intensive care unit (ICU) and emergency department (ED) capacity. Regional and rural centres have limited staff resources, placing cardiac services at risk in the event of staff infection or quarantine during the pandemic. MAIN RECOMMENDATIONS: Health districts, cardiologists and government agencies need to minimise impacts on the already vulnerable cardiovascular health of regional and remote Australians and New Zealanders throughout the COVID-19 pandemic. Changes in management should include.


Assuntos
Cardiologia , Doenças Cardiovasculares , Controle de Doenças Transmissíveis , Infecções por Coronavirus , Pandemias , Administração dos Cuidados ao Paciente/métodos , Pneumonia Viral , Serviços de Saúde Rural , Telemedicina/métodos , Austrália/epidemiologia , Betacoronavirus , Cardiologia/métodos , Cardiologia/organização & administração , Cardiologia/tendências , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/terapia , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/organização & administração , Consenso , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Humanos , Área Carente de Assistência Médica , Nova Zelândia/epidemiologia , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Serviços de Saúde Rural/organização & administração , Serviços de Saúde Rural/tendências , Sociedades Médicas
14.
Rural Remote Health ; 20(2): 6038, 2020 05.
Artigo em Inglês | MEDLINE | ID: covidwho-431287

RESUMO

Professional and tertiary health professions education (HPE) has been markedly challenged by the current novel coronavirus (COVID-19). Mandates for training organisations to reduce social contact during the global pandemic, and make learning available online, provide an opportunity for regional, rural and remote clinicians and students to more easily access learning and professional development opportunities. Online lectures, while posing an opportunity for regional, rural and remote HPE, entail potential risks. Educators who are familiar with face-to-face pedagogies may find a transition to remote, digital interaction unfamiliar, disarming, and therefore they may not design maximally engaging lectures. The strategies used in a face-to-face lecture cannot be directly transferred into the online environment. This article proposes strategies to ensure the ongoing effectiveness, efficiency and engagement of lectures transitioning from face-to-face to online delivery. Cognitive learning theory, strategies to promote learner engagement and minimise distraction, and examples of software affordances to support active learning during the lecture are proposed. This enables lecturers to navigate the challenges of lecturing in an online environment and plan fruitful online lectures during this disruptive time. These suggestions will therefore enable HPE to better meet the existing and future needs of regional, rural and remote learners who may not be able to easily access face-to-face learning upon the relaxation of social distancing measures. Strategies to provide equitable HPE to learners who cannot access plentiful, fast internet are also discussed.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Educação a Distância/organização & administração , Educação Médica Continuada/organização & administração , Pandemias , Pneumonia Viral , Aprendizagem Baseada em Problemas/organização & administração , Competência Clínica , Currículo/tendências , Humanos , Serviços de Saúde Rural/organização & administração
16.
Rural Remote Health ; 20(2): 6038, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32466654

RESUMO

Professional and tertiary health professions education (HPE) has been markedly challenged by the current novel coronavirus (COVID-19). Mandates for training organisations to reduce social contact during the global pandemic, and make learning available online, provide an opportunity for regional, rural and remote clinicians and students to more easily access learning and professional development opportunities. Online lectures, while posing an opportunity for regional, rural and remote HPE, entail potential risks. Educators who are familiar with face-to-face pedagogies may find a transition to remote, digital interaction unfamiliar, disarming, and therefore they may not design maximally engaging lectures. The strategies used in a face-to-face lecture cannot be directly transferred into the online environment. This article proposes strategies to ensure the ongoing effectiveness, efficiency and engagement of lectures transitioning from face-to-face to online delivery. Cognitive learning theory, strategies to promote learner engagement and minimise distraction, and examples of software affordances to support active learning during the lecture are proposed. This enables lecturers to navigate the challenges of lecturing in an online environment and plan fruitful online lectures during this disruptive time. These suggestions will therefore enable HPE to better meet the existing and future needs of regional, rural and remote learners who may not be able to easily access face-to-face learning upon the relaxation of social distancing measures. Strategies to provide equitable HPE to learners who cannot access plentiful, fast internet are also discussed.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Educação a Distância/organização & administração , Educação Médica Continuada/organização & administração , Pandemias , Pneumonia Viral , Aprendizagem Baseada em Problemas/organização & administração , Competência Clínica , Currículo/tendências , Humanos , Serviços de Saúde Rural/organização & administração
19.
BMC Public Health ; 20(1): 745, 2020 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-32448243

RESUMO

BACKGROUND: Cardiovascular Disease (CVD) is a growing cause of morbidity and mortality in Ghana, where rural primary health care is provided mainly by the Community-based Health Planning and Services (CHPS) initiative. CHPS locates nurses in community-level clinics for basic curative and preventive health services and provides home and outreach services. But CHPS currently lacks capacity to screen for or treat CVD and its risk factors. METHODS: In two rural districts, we conducted in-depth interviews with 21 nurses and 10 nurse supervisors to identify factors constraining or facilitating CVD screening and treatment. Audio recordings were transcribed, coded for content, and analyzed for key themes. RESULTS: Respondents emphasized three themes: community demand for CVD care; community access to CVD care; and provider capacity to render CVD care. Nurses and supervisors noted that community members were often unaware of CVD, despite high reported prevalence of risk factors. Community members were unable to travel for care or afford treatment once diagnosed. Nurses lacked relevant training and medications for treating conditions such as hypertension. Respondents recognized the importance of CVD care, expressed interest in acquiring further training, and emphasized the need to improve ancillary support for primary care operations. CONCLUSIONS: CHPS staff expressed multiple constraints to CVD care, but also cited actions to address them: CVD-focused training, provision of essential equipment and pharmaceuticals, community education campaigns, and referral and outreach transportation equipment. Results attest to the need for trial of these interventions to assess their impact on CVD risk factors such as hypertension, depression, and alcohol abuse.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Assistência à Saúde/organização & administração , Promoção da Saúde/métodos , Papel do Profissional de Enfermagem , Educação de Pacientes como Assunto , Atenção Primária à Saúde/organização & administração , Serviços de Saúde Rural/organização & administração , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/epidemiologia , Feminino , Gana/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , População Rural
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