Discussion of federal policies affecting broadband expansion and telehealth in Appalachia.

BACKGROUND: There have been 188 rural hospital closures in the United States since 2010 with approximately 20% of these in Appalachia. Telehealth has become a way that nurses can reach rural patients who might not otherwise receive health care. OBJECTIVES: The purpose of this paper is to (1) outline the federal policies enacted during COVID-19 for broadband expansion; and (2) suggest how advanced practice nursing care might be affected by broadband expansion and telehealth in the region. METHODS: A search of PubMed was conducted in January 2023, using the search words, "policy", "telehealth", "broadband", and "Appalachia". FINDINGS: New laws appropriated funds to expand broadband infrastructure that made it possible for telehealth to be used by nurses to deliver health care to rural patients. CONCLUSION: This discussion paper found that broadband legislation was instrumental in expanding telecommunications and telehealth by NPs. There is a great need for broadband to continue to expand and for trained nurses to provide care via telehealth.

A profile of skin cancer prevention media coverage in 2009.

BACKGROUND: Little is known about the coverage of skin cancer prevention messages in news print media. OBJECTIVE: To perform a content analysis of mass-media articles from newspaper and magazines pertaining to skin cancer prevention in 4 specific months (January, May, July, and October) in 2009 and assess the extent of coverage of skin cancer prevention messages. METHODS: We conducted a content analysis of 144 articles related to skin cancer prevention extracted from strategic media scans of selected months in 2009. We sought to provide the frequency of mass-media content categorized by theme and focus related to ultraviolet radiation (UVR) protection and risk-reducing behaviors. RESULTS: The audience for the vast majority (78%) of the articles was the general public. Among the assessed articles, more were published in May (49%) and July (35%) than in the remaining other months. The two most frequent themes focused on 'protection of the skin' (32%) and on 'skin cancer prevention' (23%) via risk reduction behavioral practices. Analysis of message content regarding UVR reduction practices showed that many mentioned 'use of sunscreen' (65% of messages) with the least-often mentioned behaviors being 'seek shade' (6.3%) and 'do not burn' (1.4%). In addition, a quarter of the articles lacked any content mentioning recommended UVR reduction behaviors. LIMITATIONS: This study was limited to the narrow scope of articles published in 2009 and for selected months. CONCLUSIONS: This profile of mass-media content regarding skin cancer prevention revealed gaps in coverage of UVR reduction behaviors with possible room for improvement. Strategies for improving and comprehensiveness of coverage of recommended skin cancer prevention behaviors in the media are discussed.

Experiences of United States Graduates at the Latin American Medical School in Cuba: A Road Less Traveled.

OBJECTIVES: Determine if United States graduates of the Latin American Medical School in Cuba: 1) provide primary health care to disadvantaged populations; 2) complete licensing exams and obtain residencies; and 3) accrue additional debt during their medical education. METHODS: A Qualtrics secure web-based survey was provided to 158 graduates via email, completed anonymously. Responses were compiled and descriptive statistics generated. RESULTS: Fifty-six valid surveys were returned, for a response rate of 35.4%. Chi-square analysis showed no statistically significant differences between survey respondents and the sampling frame. Most graduates are people of color; 68% work in clinical medicine; of these, 90% are in primary care, with 100% serving disadvantaged populations. Most accrued no further educational loan debt. CONCLUSIONS: United States graduates of the Latin American Medical School work in primary care with disadvantaged populations. Graduates accrue little additional student loan debt.

A US Patient in Havana: Health Care the Cuban Way.

As a nurse and doctoral candidate, I learned from my research in and about Cuba that the country has an international reputation for having an excellent health system, providing universal care for its citizens, with major indicators-such as life expectancy-rivaling those of industrialized countries, including the USA. Little did I know that I would be accessing this health care system myself.