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Littérature scientifique sur le sujet « Regional and remote health »

Auteur : Grafiati

Publié le 8 février 2024

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Articles de revues sur le sujet "Regional and remote health"

Roberts, Russell. « A health commission for regional, rural and remote Australia ». Australian Journal of Rural Health 25, n^o 2 (avril 2017) : 76. http://dx.doi.org/10.1111/ajr.12356.

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Fox, Peter, et Adam Boyce. « Cancer health inequality persists in regional and remote Australia ». Medical Journal of Australia 201, n^o 8 (octobre 2014) : 445–46. http://dx.doi.org/10.5694/mja14.01217.

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Wang, Jiahu, Ming Li et Ping Lin. « Evaluation Model of Regional Comprehensive Disaster Reduction Capacity under Complex Environment ». Journal of Environmental and Public Health 2022 (5 septembre 2022) : 1–10. http://dx.doi.org/10.1155/2022/1593536.

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In order to realize the evaluation of regional comprehensive disaster reduction capacity in a complex environment, an evaluation model of regional comprehensive disaster reduction capacity in a complex environment based on remote sensing monitoring and data image feature analysis is proposed. According to the geographical location and scale of disaster spots and the parameter analysis of the model of disaster-bearing bodies around the disaster spots, the remote sensing monitoring method is adopted to extract the geographical remote sensing images of regional disaster spots in a complex environment. The collected geographical remote sensing images of regional disaster points under the complex environmental background are filtered and preprocessed, and the texture parameters of the geographical remote sensing images of regional disaster points under the complex environmental background are recognized by combining the method of image texture feature extraction. Based on the method of tone mapping, the rapid filtering and feature analysis of the geographical remote sensing images of regional disaster points under the complex environmental background are carried out, and the time, position, damage, and so on in the geographical remote sensing images of regional disaster points under the complex environmental background are analyzed. By using the method of parameter analysis and gradient operator operation, a comparison model of geographical remote sensing images of regional disaster points under the complex environmental background is established, and the reliability evaluation of regional comprehensive disaster reduction ability under the complex environmental background is realized according to the method of contrast and detail significance enhancement. The test shows that this method has high accuracy in evaluating regional comprehensive disaster reduction capability under a complex environment, high accuracy in marking the geographical location of regional disaster points under a complex environment, and good fusion performance and reliability of regional comprehensive disaster reduction capability evaluation parameters.

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Goodwin, Belinda, Arlen Rowe, Fiona Crawford-Williams, Peter Baade, Suzanne Chambers, Nicholas Ralph et Joanne Aitken. « Geographical Disparities in Screening and Cancer-Related Health Behaviour ». International Journal of Environmental Research and Public Health 17, n^o 4 (14 février 2020) : 1246. http://dx.doi.org/10.3390/ijerph17041246.

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This study aimed to identify whether cancer-related health behaviours including participation in cancer screening vary by geographic location in Australia. Data were obtained from the 2014–2015 Australian National Health Survey, a computer-assisted telephone interview that measured a range of health-related issues in a sample of randomly selected households. Chi-square tests and adjusted odds ratios from logistic regression models were computed to assess the association between residential location and cancer-related health behaviours including cancer screening participation, alcohol consumption, smoking, exercise, and fruit and vegetable intake, controlling for age, socio-economic status (SES), education, and place of birth. The findings show insufficient exercise, risky alcohol intake, meeting vegetable intake guidelines, and participation in cervical screening are more likely for those living in inner regional areas and in outer regional/remote areas compared with those living in major cities. Daily smoking and participation in prostate cancer screening were significantly higher for those living in outer regional/remote areas. While participation in cancer screening in Australia does not appear to be negatively impacted by regional or remote living, lifestyle behaviours associated with cancer incidence and mortality are poorer in regional and remote areas. Population-based interventions targeting health behaviour change may be an appropriate target for reducing geographical disparities in cancer outcomes.

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Henderson, Isabel, Karen Vanlohuizen et Ted Fenske. « Remote cardiac rehabilitation ». Journal of Telemedicine and Telecare 6, n^o 2_suppl (août 2000) : 28–30. http://dx.doi.org/10.1258/1357633001935455.

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The implementation of a remote cardiac rehabilitation service to educate people about heart disease is currently under way in northern Alberta. Twenty per cent of patients in the catchment area live in remote areas outside the regional centre and are faced with the usual difficulties of attending urban health-care programmes. The availability of the remote cardiac rehabilitation service enables patients to receive the same rehabilitation benefits as their urban counterparts.

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Butterworth, P., B. J. Kelly, T. E. Handley, K. J. Inder et T. J. Lewin. « Does living in remote Australia lessen the impact of hardship on psychological distress ? » Epidemiology and Psychiatric Sciences 27, n^o 5 (3 avril 2017) : 500–509. http://dx.doi.org/10.1017/s2045796017000117.

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Aims.Rural and remote regions tend to be characterised by poorer socioeconomic conditions than urban areas, yet findings regarding differences in mental health between rural and urban areas have been inconsistent. This suggests that other features of these areas may reduce the impact of hardship on mental health. Little research has explored the relationship of financial hardship or deprivation with mental health across geographical areas.Methods.Data were analysed from a large longitudinal Australian study of the mental health of individuals living in regional and remote communities. Financial hardship was measured using items from previous Australian national population research, along with measures of psychological distress (Kessler-10), social networks/support and community characteristics/locality, including rurality/remoteness (inner regional; outer regional; remote/very remote). Multilevel logistic regression modelling was used to examine the relationship between hardship, locality and distress. Supplementary analysis was undertaken using Australian Household, Income and Labour Dynamics in Australia (HILDA) Survey data.Results.2161 respondents from the Australian Rural Mental Health Study (1879 households) completed a baseline survey with 26% from remote or very remote regions. A significant association was detected between the number of hardship items and psychological distress in regional areas. Living in a remote location was associated with a lower number of hardships, lower risk of any hardship and lower risk of reporting three of the seven individual hardship items. Increasing hardship was associated with no change in distress for those living in remote areas. Respondents from remote areas were more likely to report seeking help from welfare organisations than regional residents. Findings were confirmed with sensitivity tests, including replication with HILDA data, the use of alternative measures of socioeconomic circumstances and the application of different analytic methods.Conclusions.Using a conventional and nationally used measure of financial hardship, people residing in the most remote regions reported fewer hardships than other rural residents. In contrast to other rural residents, and national population data, there was no association between such hardship and mental health among residents in remote areas. The findings suggest the need to reconsider the experience of financial hardship across localities and possible protective factors within remote regions that may mitigate the psychological impact of such hardship.

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O’Kane, Gabrielle. « Telehealth—Improving access for rural, regional and remote communities ». Australian Journal of Rural Health 28, n^o 4 (août 2020) : 419–20. http://dx.doi.org/10.1111/ajr.12663.

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Gunaratnam, Praveena, Gill Schierhout, Jenny Brands, Lisa Maher, Ross Bailie, James Ward, Rebecca Guy et al. « Qualitative perspectives on the sustainability of sexual health continuous quality improvement in clinics serving remote Aboriginal communities in Australia ». BMJ Open 9, n^o 5 (mai 2019) : e026679. http://dx.doi.org/10.1136/bmjopen-2018-026679.

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ObjectivesTo examine barriers and facilitators to sustaining a sexual health continuous quality improvement (CQI) programme in clinics serving remote Aboriginal communities in Australia.DesignQualitative study.SettingPrimary health care services serving remote Aboriginal communities in the Northern Territory, Australia.ParticipantsSeven of the 11 regional sexual health coordinators responsible for supporting the Northern Territory Government Remote Sexual Health Program.MethodsSemi-structured in-depth interviews conducted in person or by telephone; data were analysed using an inductive and deductive thematic approach.ResultsDespite uniform availability of CQI tools and activities, sexual health CQI implementation varied across the Northern Territory. Participant narratives identified five factors enhancing the uptake and sustainability of sexual health CQI. At clinic level, these included adaptation of existing CQI tools for use in specific clinic contexts and risk environments (eg, a syphilis outbreak), local ownership of CQI processes and management support for CQI. At a regional level, factors included the positive framing of CQI as a tool to identify and act on areas for improvement, and regional facilitation of clinic level CQI activities. Three barriers were identified, including the significant workload associated with acute and chronic care in Aboriginal primary care services, high staff turnover and lack of Aboriginal staff. Considerations affecting the future sustainability of sexual health CQI included the need to reduce the burden on clinics from multiple CQI programmes, the contribution of regional sexual health coordinators and support structures, and access to and use of high-quality information systems.ConclusionsThis study contributes to the growing evidence on how CQI approaches may improve sexual health in remote Australian Aboriginal communities. Enhancing sustainability of sexual health CQI in this context will require ongoing regional facilitation, efforts to build local ownership of CQI processes and management of competing demands on health service staff.

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Liu, Xian-Liang, Tao Wang, Daniel Bressington, Bróna Nic Giolla Easpaig, Lolita Wikander et Jing-Yu (Benjamin) Tan. « Factors Influencing Retention among Regional, Rural and Remote Undergraduate Nursing Students in Australia : A Systematic Review of Current Research Evidence ». International Journal of Environmental Research and Public Health 20, n^o 5 (23 février 2023) : 3983. http://dx.doi.org/10.3390/ijerph20053983.

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Background: This systematic review aimed to explore the factors influencing retention among regional, rural, and remote undergraduate nursing students who were enrolled in Australian universities. Methods: Mixed-methods systematic review. A+ Education, CINAHL, Education Resources Information Center (ERIC), Education Research Complete, JBI EBP database, Journals@Ovid, Medline, PsycINFO, PubMed, and Web of Science were systematically searched from September 2017 to September 2022 to identify eligible English-language studies. The methodological quality of the included studies was critically assessed using the Joanna Briggs Institute’s critical appraisal tools. Descriptive analysis with a convergent segregated approach was conducted to synthesize and integrate the results from the included studies. Results: Two quantitative and four qualitative studies were included in this systematic review. Both the quantitative and qualitative findings demonstrated that additional academic and personal support was essential for improving retention among undergraduate nursing students from regional, rural, and remote areas in Australia. The qualitative synthesis also highlighted many internal (e.g., personal qualities, stress, ability to engage with classes and institutions, time management, lack of confidence, cultural well-being, and Indigenous identity) and external factors (e.g., technical difficulties, casual tutors, different competing demands, study facilities, and financial and logistical barriers) that influenced retention among undergraduate nursing students from regional, rural, and remote areas in Australia. Conclusions: This systematic review demonstrates that identifying potentially modifiable factors could be the focus of retention support programs for undergraduate nursing students. The findings of this systematic review provide a direction for the development of retention support strategies and programs for undergraduate nursing students from regional, rural and remote areas in Australia.

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Kavanagh, Bianca E., Hannah Beks, Vincent L. Versace, Shae E. Quirk et Lana J. Williams. « Exploring the barriers and facilitators to accessing and utilising mental health services in regional, rural, and remote Australia : A scoping review protocol ». PLOS ONE 17, n^o 12 (9 décembre 2022) : e0278606. http://dx.doi.org/10.1371/journal.pone.0278606.

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Introduction Australians from regional, rural, and remote areas face diverse and complex challenges in accessing and utilising mental health services. Previous research has pointed to a range of individual, community, structural, and systemic barriers at play, however, limited literature has synthesised the knowledge on this topic. Parallel to this, information on the facilitators to accessing and utilising mental health services for this group is not well documented. This protocol describes the methodology to undertake a scoping review, which aims to explore the barriers and facilitators associated with accessing and utilising mental health services in regional, rural, and remote Australia. In addition, the scoping review aims to geographically map the identified barriers and facilitators. Methods This protocol is guided by Arksey and O’Malley’s methodological framework. A search strategy will be developed and implemented to identify relevant peer-reviewed and grey literature. Studies will be included if they report on the barriers and/or facilitators associated with accessing and/or utilising mental health services in regional, rural, and remote Australia. Two reviewers will independently screen the data at the title/abstract and full-text stage. One reviewer will extract the relevant data using a predetermined charting form and a second reviewer will validate the included data. A Geographical Information System program will be used to map the location of the studies; locations will be stratified according to the Modified Monash Model and relationships between barriers and facilitators will be analysed. Key findings will be presented in a narrative account and in text, tables, and maps. Discussion This scoping review will provide a contemporary account on the barriers and facilitators to accessing and utilising mental health services for regional, rural, and remote Australians. It is anticipated that the results of this scoping review will have national policy relevance and may be useful to healthcare providers.

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Thèses sur le sujet "Regional and remote health"

Costello, Leesa. « Communicating health promotion on the web : the building, functioning and marketing of a therapeutic online community ». Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2009. https://ro.ecu.edu.au/theses/1854.

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This research was motivated by several important communication and public health issues. In terms of communication, the issue at hand was whether an authentic online health-related service could be started from scratch that would exhibit the hallmarks of community. If so, could the community offer effective support to its members? Would such a community help reduce the disadvantage experienced by some people who live outside the metropolitan area and away from health-related face to face support groups? If the on line community were supported by a charity, would community members feel more inclined to support the charity themselves, through donations, for example? In terms of the public health agenda, heart-related diseases are a national concern in Australia and throughout many (predominantly) westernised countries. While preventing heart disease, in particular, must remain the primary focus for public health initiatives; for those already affected, the National Heart Foundation (WA) has recognised that social support is a significant protective factor along with other healthy lifestyle behaviours. Social support or access to support programs has been positioned as particularly lacking for those who reside in rural or remote areas of Australia. Therefore, finding ways to provide mechanisms and avenues for the delivery of support and rehabilitation have been identified as critical if the secondary prevention (i.e., recovery) of heart disease is to be achieved. An online community is one response to this challenge. Given that the prevalence of heart disease increases with age, Australia's baby boomer generation is moving into a vulnerable life stage. If this large cohort is not provided for, a myriad of social and economic ramifications will follow. The National Heart Foundation has also expressed concern that baby boomers are less concerned about making donations to support their work than predecessor generations; and this may ultimately reduce the types of public health programs which are made available as more of this generation encounters heart conditions. This research, funded by an ARC Linkage grant with the National Heart Foundation (WA) as the Industry Partner, set out to respond to these challenges through the provision of a best practice website to support heart patients in Western Australia. My role, as the PhD Candidate, was to oversee all aspects of the project's design, implementation and evaluation in order to achieve the research goals. Although I was supported by specialist supervisors and technicians, all aspects of the research were undertaken as part of my PhD journey. The website that was developed, HeartNET, provided the mechanism to determine if a sense of community among heart patients could be fostered online, not only to produce therapeutic outcomes but to support the healthy behaviours which reduce the recurrence of heart disease or illnesses. Given the challenges with rural and remote access to support services, the building of a 'community' was aptly positioned to deliver support and rehabilitation regardless of location. The research utilised an intervention-approach which relied upon the development of a successful website from the grassroots. That is, although research into the hallmarks of what patients consider to be community was the primary research objective, this could not be undertaken unless the website were deemed successful. Achieving the 'right' website was eventually delivered after two iterations; when it had reached a critical mass of participants, having undertaken substantial marketing and public relations activities, and after interactive tools had been fine-tuned. With the website running smoothly, utilising a netnographic methodology provided the best way to investigate the notion of community. In order to ensure rigour and trustworthiness, the research utilised two groups of participants - those who accessed the website, and those who acted as comparison, and therefore did not have access. The netnography, similar to ethnography but with unique markers for online research, utilised a number of qualitative data collection techniques - a focus group, in-depth interviews, online transcripts, and other observational techniques - along with questionnaires for quantitative data collection at the commencement of the research and after 12 months of participation. The netnography revealed that a strong sense of community developed on the HeartNET website over a 12 month duration. The community began when members started forming relationships with each other, which resulted in a sense of bonding and belonging. Members were also identified as offering mutual support as part of a 'gift economy' which led to revelations about a reduced sense of isolation or aloneness. Having identified community features, the analysis turned to issues of identity and culture which resulted in a sense of community ownership and reinforcement of community values. The analysis then revealed some positive signs of an improvement in healthy lifestyle choices for healthy diet, physical activity and smoking cessation. The questionnaire data adds some additional weight to, and provides triangulation for, what was observed online in relation to health outcomes. The final stage analysis revealed that, although methodological issues would not allow for an in-depth interrogation of philanthropic support in terms of attitudes and behaviours to do with donations, it did reveal a new philanthropic currency in that HeartNET members were willing to donate their time, stories, and experiences to support Heart Foundation events and activities. This thesis offers an innovative application of communications theory within a health context by providing a detailed roadmap for the development of other online health-related communities.

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Watson, James W. « Free Clinics and the Uninsured : The Need for Remote Area Medical in Central Appalachia After Health Reform ». Digital Commons @ East Tennessee State University, 2011. https://dc.etsu.edu/etd/1358.

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In 2008, the election of President Barack Obama brought health care to the forefront of national discussions and led to the passage of the Patient Protection and Affordable Care Act (ACA). The legislation changed the rules of health care delivery in the United States, but the ACA did not do one fundamental thing: It did not end the need for many of the nation's most needy patients to seek free medical care from groups such as Remote Area Medical (RAM). A mobile clinic, RAM brings together volunteer dentists, physicians, nurses, and other professionals as well as support staff for multi-day clinic events to provide free, on-site care to anyone presenting for treatment without qualification questions. This thesis looks at the ongoing need for RAM in central Appalachia after the passage of the ACA due to a continued lack of comprehensive health care coverage for all Americans.

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Murphy, Angela University of Ballarat. « When urban policy meets regional practice : Evidence based practice from the perspective of multi-disciplinary teams working in rural and remote health service provision ». University of Ballarat, 2004. http://archimedes.ballarat.edu.au:8080/vital/access/HandleResolver/1959.17/12747.

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"In the main, contemporary research on Evidence Based Practice (EBP) has taken place within metropolitan locations, and has offered urbocentric solutions and insights. However the transferability of these developments to rural services is untested empirically. In addition, evidence development and studies on the implementation of this evidence have tended to be discipline-stream-specific; there has been very little research into either the development of multi-disciplinary evidence guidelines or the implementation of EBP from the perspective of individual practitioners working within multi-disciplinary teams. This research shortfall has provided the rationale for this study...."
Doctor of Philosophy

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Murphy, Angela. « When urban policy meets regional practice : Evidence based practice from the perspective of multi-disciplinary teams working in rural and remote health service provision ». Thesis, University of Ballarat, 2004. http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/67365.

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Murphy, Angela. « When urban policy meets regional practice : Evidence based practice from the perspective of multi-disciplinary teams working in rural and remote health service provision ». University of Ballarat, 2004. http://archimedes.ballarat.edu.au:8080/vital/access/HandleResolver/1959.17/14586.

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Godrich, Stephanie Louise. « Food insecurity and fruit and vegetable consumption among regional and remote Western Australian children : Determinants, prevalence and predictors ». Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2017. https://ro.ecu.edu.au/theses/1975.

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Living in a community with adequate availability of nutritious food, and the capacity to access and utilise it, are key food security determinants (FSD). However, inequities relating to these determinants exist between regional and remote Western Australian (WA) communities, particularly regarding fruit and vegetables (F&V). This negatively impacts vulnerable populations, especially children. In order to understand determinants, prevalence and predictors of F&V and food security (FS), three concepts were explored in this PhD; (1) F&V consumption among regional and remote WA children (including determinants of F&V consumption, quantities, types, varieties of F&V consumed); (2) FS among regional and remote WA children (children’s FSD, prevalence of child food insecurity (FI) and socio-demographic predictors of FI); and (3) the relationship between FSD and F&V consumption among regional and remote WA children (FSD predictors of F&V consumption). Methods This mixed-methods study included semi-structured interviews with 20 key informants, to explore determinants of F&V consumption and FS among regional and remote WA children. Cross-sectional surveys were completed by caregiver-child dyads (n = 256), to understand children’s F&V consumption behaviours, determine child FI prevalence and assess whether FSD predicted adequate F&V consumption. Twenty-four hour food diaries measured F&V amounts and varieties consumed. Data analyses were conducted using IBM SPSS (version 23), Microsoft Excel and QSR NVivo (version 10). Results The determinants of children’s F&V consumption were explored using an Ecological Model of Health Behaviour. F&V quantities, types and varieties consumed were then quantified; more children achieved adequate fruit serves (65.8%) than vegetable serves (15.4%). Quantities consumed did not differ between regional and remote locations, however, F&V types and varieties consumed did. The FSD across food availability, access and utilisation dimensions were examined, illuminating inequities relating to food supply, social support and nutrition education. The calculation of prevalence and socio-demographic predictors of child FI revealed that one in five children were FI; family receipt of government income support (p = 0.022) and residency in a location of ‘Medium disadvantage’ (p = 0.023) predicted child FI. Subsequently, the association between FSD and adequate fruit intake among WA children was examined. After controlling for socio-demographic predictors, no determinants were significantly associated with fruit intake. However, FSD were associated with vegetable consumption; varieties and types of vegetables consumed (p = 0.007), health message promotion (p = 0.017), location of food outlets (p = 0.027) and price (p = 0.043) significantly predicted adequate vegetable consumption. Conclusion This study contributed a greater understanding of the complex, interwoven factors that influence FS among regional and remote WA children, namely food availability, access, utilisation, and the impact on F&V consumption. Findings provide a basis for advocacy to improve inequities across WA, relating to food supply, social support and nutrition education. It also provides focus for health promotion practitioners who work with target groups affected by FI, to customise strategies to improve F&V consumption based on FSD, and has identified valuable future research pathways.

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Coltri, Priscila Pereira. « Influência do uso e cobertura do solo no clima de Piracicaba, São Paulo : análise de séries históricas, ilhas de calor e técnicas de sensoriamento remoto ». Universidade de São Paulo, 2006. http://www.teses.usp.br/teses/disponiveis/11/11136/tde-25102006-123617/.

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As mudanças climáticas globais, regionais e locais representam, na atualidade, uma das maiores preocupações da humanidade. Essas mudanças podem ocorrer tanto a partir de causas naturais quanto a partir de causas antrópicas. As áreas das cidades se caracterizam por apresentarem temperaturas mais elevadas quando comparadas com as áreas rurais. Essa anomalia térmica causa a formação de ilhas de calor e esse fenômeno é reconhecidamente importante em estudos de clima urbano. O objetivo do presente trabalho foi, através de técnicas do sensoriamento remoto, identificar e analisar as ilhas de calor do Município de Piracicaba, SP verificando sua sazonalidade, intensidade e morfologia. Para tanto foi necessário realizar uma análise climática regional e verificar a possibilidade do uso do algoritmo de transformação termal do software IDRISI 3.2 nas imagens do satélite Landsat 7. Para validar o algoritmo foram aplicados dois métodos de transformação de temperatura aparente de superfície. Para a análise climática regional foram estudados os principais elementos climáticos do Município de Piracicaba, SP utilizando-se de dados da Estação Meteorológica da ESALQ/USP entre os anos de 1950 e 2005 e estes foram correlacionados com variáveis da urbanização. Concluiu-se, com os dados encontrados, que os elementos temperatura, precipitação, umidade relativa e evaporação tiveram tendência de aumento no período estudado e todos eles foram classificados como tendências climáticas. A temperatura apresentou tendência de aumento mais acentuada e se correlacionou positivamente com o aumento da urbanização. O algoritmo de transformação do software IDRISI 3.2 para o satélite Landsat 7 foi validado, sendo uma importante ferramenta para a utilização de imagens de melhor resolução. As ilhas de calor mais intensas do verão são representadas por locais com excesso de material de construção civil e pouca ou nenhuma área verde. A diferença entre a área urbana e a área rural da cidade ultrapassou 16°C no verão. O Parque da Rua do Porto é uma ilha de frescor e exerce um efeito oásis no centro e nos bairros vizinhos. O perfil das ilhas de calor do Município de Piracicaba não segue aquele delimitado por OKE (1974). As ilhas de calor variam sazonal e espacialmente e a intensidade destas, ao longo das estações do ano, está intimamente relacionada com a sazonalidade da cultura da cana-deaçúcar. As ilhas de calor da época da entressafra são, em média, 3.5°C mais intensas que as da época da safra. Por fim, pode-se afirmar que o uso e a cobertura do solo rural e urbano é um dos grandes agentes modificadores do clima local e regional.
Global, regional and local climate changes represent one of the greatest concerns of humanity. Climate changes can occur through natural or anthropogenic causes. Urban areas usually present higher temperatures than rural areas. This thermal effect is called heat-island phenomenon and has great importance on urban climate studies. In the present work, we identified and analyzed the heat-islands from Piracicaba, São Paulo using remote sensing techniques. The heat-islands were analyzed according to its seasonality, intensity and morphology using images from Landsat 7 satellite. We performed analysis on regional climate changes and investigated the use of the IDRISI thermal algorithm to convert Landsat 7 infrared thermal data on land surface temperature (LST). In order to transform Landsat 7 infrared thermal data we used two mathematical methods. Climate changes were analyzed by monitoring the climate elements for long periods of time, enabling the visualization of directional or periodical regional changes. The main climate elements were studied using data from ESALQ meteorological station for the last 55 years (1950-2005). Temperature, relative humidity, evaporation and precipitation variation were found to be correlated with urban growth parameters. The results indicated that temperature, precipitation, relative humidity and evaporation increased during the studied period and have been classified as climate trends. The temperature presented the more accentuated trend of increase and was positively correlated with the growing urbanization. The software IDRISI 3.2 can be used with Landsat 7 high resolution images, being a useful and rapid tool to study urban heat islands. The most intense summer heatislands were represented by regions with higher amounts of constructed areas and almost any green area. In fact, during the summer the difference between the urban and rural areas was greater than 10°C. The Rua do Porto park was identified as a fresh-island and showed the oasis effect to the Center and neighbouring regions. Heat-islands varied according to the season and space and its intensity is intimately related to the sugar-cane seasonality. During the intercrop period the heat-islands were 3.5°C more intense than during the crop period. In conclusion land cover and land use affect local and regional climates.

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Parsons, David Norman. « Autism in regional and remote communities : Examining the effect of an autism spectrum disorder diagnosis on regional and remote families and innovative therapies ». Thesis, Curtin University, 2019. http://hdl.handle.net/20.500.11937/77525.

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This PhD project aims to address therapy service access barriers for families of children with autism spectrum disorder living in regional and remote Western Australia. Therefore the feasibility, effectiveness and appropriateness of an information communication technology based intervention, the Therapy Outcomes By Your Playpad Application were examined. The findings provide partial support for the Therapy Outcomes By Your Playpad Application as a feasible, effective and appropriate intervention for families of children with autism spectrum disorder.

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Faw, Timothy Dale. « A Protected Microenvironment and White Matter Plasticity after Eccentric Rehabilitation in Spinal Cord Injury ». The Ohio State University, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=osu157442327281762.

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Rahman, Abdullah Faizur 1963. « Monitoring regional-scale surface hydrologic processes using satellite remote sensing ». Diss., The University of Arizona, 1996. http://hdl.handle.net/10150/191212.

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Satellite-based remotely sensed data were used to estimate regional-scale surface energy fluxes and a water deficit index of a semi-arid heterogeneous region in southeast Arizona. Spectral reflectance and radiometric temperature of the surface, derived from the digital counts of TM bands of LANDSAT-5 satellite, were used for this purpose. These reflectance and temperature, along with conventional meteorological information of the region, were used as inputs to numerical models which estimate surface energy fluxes. Point-based meteorological data of the region were spatially extrapolated over a grid of 120 m X 120 m so that it could be used with the spatially continuous remotely sensed data. The water deficit index (WDI) was estimated using surface temperature and a spectral vegetation index, "soil adjusted vegetation index" (SAVI). The surface fluxes were net radiation flux, sensible heat flux, soil heat flux and latent heat flux. Measured values obtained from the meteorological flux measurement (METFLUX) stations in the study area were compared with the modeled fluxes. Latent heat flux (LE) was the most important one to estimate in the scope of this study. The method of spatially extrapolating the point-based meteorological information and combining with the remotely sensed data produced good estimation of LE for the region, with a mean absolute difference (MAD) of 65 W/m² over a range of 67 to 196 W/m² . Also it was found that the numerical models that were previously used to estimate daily LE values from a region using mid-day remotely sensed data (mostly from NOAAAVHRR) can also be used with the mid-morning remotely sensed data (from LANDSAT). Out of the two models tested for this purpose (`Seguin-Itier' and 'Jackson' models), one was found to need some modification so that it could use mid-morning remotely sensed data as inputs. The other was found to be useable as it is, without any modification. Outputs from both models compared well with the measured fluxes from the METFLUX stations. In an effort of estimating the water deficit of the different biomes of the region, WDI of the biomes were estimated. The main goal of this effort was to be able to monitor the surface hydrologic conditions of the region using remotely sensed vegetation and surface information, and minimum ground data. Good estimation of the water deficit condition of the area were obtained by this method. This method was found to be sensitive to a few of the ground information such as wind speed and leaf area index (LAI). It was also found that if the required ground data were correctly estimated, this method could be used as an operational procedure for monitoring the vegetation water stress of the biomes and hence for better management of the region.

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Livres sur le sujet "Regional and remote health"

Phillips, Andrew. Rural, regional and remote health : A study on mortality. 2^e éd. Canberra : Australian Institute of Health and Welfare, 2007.

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Australia. Department of Health and Ageing. Rural, regional and remote health : Mortality trends 1992-2003. Canberra : Australian Institute of Health and Welfare, 2006.

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Bullock, Sally. A snapshot of men's health in regional and remote Australia. Canberra : Australia Institue of Health and Welfare, 2010.

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Australian Institute of Health and Welfare. Rural, regional and remote health : A guide to remoteness classifications. Canberra : Australian Institute of Health and Welfare, 2004.

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Australian Institute of Health and Welfare., dir. Rural, regional and remote health : A study on mortality : summary of findings. Canberra : Australian Institute of Health and Welfare, 2003.

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Committee, Western Australia Parliament Legislative Assembly Education and Health Standing. Adequacy and availability of dental services in regional, rural and remote Western Australia. Perth, W.A : Legislative Assembly, 2002.

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Banerjee, R. K. Remote sensing techniques for regional development. New Delhi : Concept Pub. Co., 2000.

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Chen, Lumin, Yihao Li, Lina Han, Liang Yuan, Yuxiang Sun et Xiaolu Tang. Elderly Health Services and Remote Health Monitoring. Singapore : Springer Singapore, 2020. http://dx.doi.org/10.1007/978-981-15-7154-1.

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Carey, Timothy A., et Judith Gullifer, dir. Handbook of Rural, Remote, and very Remote Mental Health. Singapore : Springer Singapore, 2020. http://dx.doi.org/10.1007/978-981-10-5012-1.

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M, Foody Giles, et Curran Paul J. 1955-, dir. Environmental remote sensing from regional to global scales. Chichester : Wiley, 1994.

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Chapitres de livres sur le sujet "Regional and remote health"

Darracott, Ros, Niki Edwards et Julie King. « Health Social Work in Regional, Rural and Remote Settings ». Dans Social Work Practice in Health, 188–201. 2^e éd. London : Routledge, 2022. http://dx.doi.org/10.4324/9781003330745-18.

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Pitblado, J. Roger, et E. Ann Gallie. « Remote Sensing and Geographic Information Systems : Technologies for Mapping and Monitoring Environmental Health ». Dans Restoration and Recovery of an Industrial Region, 299–311. New York, NY : Springer New York, 1995. http://dx.doi.org/10.1007/978-1-4612-2520-1_23.

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Torresan, Chiara, Sebastiaan Luyssaert, Gianluca Filippa, Mohammad Imangholiloo et Rachel Gaulton. « Remote Sensing Technologies for Assessing Climate-Smart Criteria in Mountain Forests ». Dans Climate-Smart Forestry in Mountain Regions, 399–433. Cham : Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-80767-2_11.

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AbstractMonitoring forest responses to climate-smart forestry (CSF) is necessary to determine whether forest management is on track to contribute to the reduction and/or removal of greenhouse gas emissions and the development of resilient mountain forests. A set of indicators to assess “the smartness” of forests has been previously identified by combining indicators for sustainable forest management with the ecosystem services. Here, we discuss the remote sensing technologies suitable to assess those indicators grouped in forest resources, health and vitality, productivity, biological diversity, and protective functions criteria. Forest cover, growing stock, abiotic, biotic, and human-induced forest damage, and tree composition indicators can be readily assessed by using established remote sensing techniques. The emerging areas of phenotyping will help track genetic resource indicators. No single existing sensor or platform is sufficient on its own to assess all the individual CSF indicators, due to the need to balance fine-scale monitoring and satisfactory coverage at broad scales. The challenge of being successful in assessing the largest number and type of indicators (e.g., soil conditions) is likely to be best tackled through multimode and multifunctional sensors, increasingly coupled with new computational and analytical approaches, such as cloud computing, machine learning, and deep learning.

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Montani, Michael, Fabio Cattaneo, Amadou Lamine Tourè, Ibrahima Sory Diallo, Lorenzo Mari et Renato Casagrandi. « Cross-Continental YouthMappers Action to Fight Schistosomiasis Transmission in Senegal ». Dans Sustainable Development Goals Series, 69–84. Cham : Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-031-05182-1_6.

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AbstractThe authors detail the design of an innovative and cooperative approach to ground truthing geospatial data through cross-continental YouthMappers coordinated action. This effort provided key geographic information to design control actions and served as a powerful, active tool to disseminate awareness about the importance of neglected tropical diseases in remote regions of the planet in support of SDG 3 Good Health and Well-being and SDG 6 Clean Water and Sanitation.

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Raj, Alok, Laxmi Kant Sharma et Rajashree Naik. « Spatial Monitoring of Soil Health Using Remote Sensing of Distinct Land Cover in the Central Himalayan Region Using GEE Platform ». Dans Soil Carbon Dynamics in Indian Himalayan Region, 303–19. Singapore : Springer Nature Singapore, 2023. http://dx.doi.org/10.1007/978-981-99-3303-7_17.

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Hirschfeld, Katherine, Kirsten de Beurs, Brad Brayfield et Ani Melkonyan-Gottschalk. « Introduction ». Dans New Wars and Old Plagues, 1–14. Cham : Springer International Publishing, 2023. http://dx.doi.org/10.1007/978-3-031-31143-7_1.

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AbstractThis chapter provides an overview of the Karabakh conflict and describes its importance for understanding population health crises that emerge from “New Wars.” The most intense phase of fighting in Karabakh coincided with the region’s first epidemic of Plasmodium vivax malaria since the 1950s. While the malaria epidemic was documented in public health scholarship, the chaotic environment of the conflict meant that very little investigation was done into the re-emergence of this ancestral vector borne disease after decades of successful control. This chapter includes a discussion of the usefulness of combining qualitative historical work with remote sensing data to reconstruct the social and environmental changes that took place in and around the conflict zone. We also discuss the significance of the work and the need for updated models to explain the growing prevalence of “New Wars” and their relationship to global health risks.

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d’Abbs, Peter, et Nicole Hewlett. « Community-Based Restrictions on Alcohol Availability ». Dans Learning from 50 Years of Aboriginal Alcohol Programs, 131–74. Singapore : Springer Nature Singapore, 2023. http://dx.doi.org/10.1007/978-981-99-0401-3_5.

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AbstractThis chapter reviews the emergence from the 1980s of community-based initiatives aimed at reducing alcohol-related harm by curtailing the availability of alcohol. We distinguish three types of local restrictions on supply: voluntary agreements negotiated between liquor outlets and neighbouring communities; restrictions negotiated between outlets and communities and then incorporated into the licence conditions of the outlets concerned, and restrictions imposed by state/territory licensing authorities. Local restrictions on supply are usually based on a public health approach to alcohol problems which focuses on reducing alcohol-related harms at a local population level rather than focusing on individual drinkers. Historically, and particularly in central Australia, campaigns to impose restrictions were often led by women, who experienced at first hand the violence associated with excessive drinking. We discuss evidencefrom local restrictions in remote communities and regions, and in regional towns with large Aboriginal populations. Evidence suggests that, where restrictions are a product of genuine community input, they are effective in reducing alcohol-related harms and enjoy strong support. Where they are imposed with little regard to community input—as in the case of some Alcohol Management Plans introduced by the Queensland Government in the early 2000s—they are often perceived by those affected as discriminatory and disempowering. Community-based restrictions are also often politically contentious, largely as a result of opposition by the liquor and hospitality industries. The chapter also discusses the relationship between alcohol restrictions and anti-discriminationlegislation and summarises factors associated with effective community-based restrictions on supply.

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Hirschfeld, Katherine, Kirsten de Beurs, Brad Brayfield et Ani Melkonyan-Gottschalk. « Conclusions ». Dans New Wars and Old Plagues, 85–95. Cham : Springer International Publishing, 2023. http://dx.doi.org/10.1007/978-3-031-31143-7_6.

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AbstractThis chapter summarizes the key lessons learned from this work. We conclude that Mary Kaldor’s concept of “New Wars” is useful for understanding the unique environmental and human impacts of contemporary armed conflicts. Combining qualitative historical research with remote sensing data provides insights into these dynamics. Specifically our research leads us to conclude that the Karabakh conflict and the Soviet collapse led to a prolonged period of violence and territorial uncertainty for the Karabakh region. Forced migration left thousands of Armenians and Azeris crowded in makeshift camps and improvised housing at a time when public health prevention measures were largely absent. The war itself generated “ecological insults” to the land creating conditions favorable for mosquito habitat. We conclude by presenting Valery Tishkov’s concept of “demodernization” and argue that New Wars have the potential to rapidly shift mortality from non-infectious to infectious and vector borne diseases in societies that have achieved a “modern” health profile.

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Ciccacci, Fausto, et Giovanni Guidotti. « DREAM Centre Remote Telemonitoring ». Dans TELe-Health, 43–47. Cham : Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-72763-9_5.

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Ali, Raza. « Wearables and Remote Monitoring ». Dans Health Informatics, 45–56. Cham : Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-031-04836-4_5.

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Actes de conférences sur le sujet "Regional and remote health"

Gilardi, Lorenza, Mattia Marconcini, Annekatrin Metz-Marconcini, Thomas Esch, Hannes Taubenboeck et Thilo Erbertseder. « Regional mobility patterns and exposure to environmental stressors : effects on the health risk assessments due to air pollution ». Dans Remote Sensing Technologies and Applications in Urban Environments VIII, sous la direction de Nektarios Chrysoulakis, Thilo Erbertseder et Ying Zhang. SPIE, 2023. http://dx.doi.org/10.1117/12.3000174.

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Barringer, Jennifer J., Michael Schlegel, Sarah Terry et Leslie Zilm. « Characterization of Regional Landforms and Landscape Analysis in Support of an Oil Field Development in the Remote Arctic Timan Pechora Region of Russia ». Dans SPE International Conference on Health, Safety, and Environment in Oil and Gas Exploration and Production. Society of Petroleum Engineers, 1998. http://dx.doi.org/10.2118/46753-ms.

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Pathinarupothi, Rahul Krishnan, et Ekanath Rangan. « Large scale remote health monitoring in sparsely connected rural regions ». Dans 2016 IEEE Global Humanitarian Technology Conference (GHTC). IEEE, 2016. http://dx.doi.org/10.1109/ghtc.2016.7857354.

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Silva, Bruno M. C., Joel J. P. C. Rodrigues, Andre Ramos, Kashif Saleem, Isabel de la Torre et Ricardo L. Rabelo. « A Mobile Health System to Empower Healthcare Services in Remote Regions ». Dans 2019 IEEE International Conference on E-health Networking, Application & Services (HealthCom). IEEE, 2019. http://dx.doi.org/10.1109/healthcom46333.2019.9009477.

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Ngo Manh Khoi, Saguna Saguna, Karan Mitra et Christer Ahlund. « IReHMo : An efficient IoT-based remote health monitoring system for smart regions ». Dans 2015 17th International Conference on E-Health Networking, Application & Services (HealthCom). IEEE, 2015. http://dx.doi.org/10.1109/healthcom.2015.7454565.

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Feng, Shuoyang, Jianing Kang, Xiaoyi Feng, Lei Tang et Zhaoqiang Xia. « Remote Heart Rate Estimation Based on Convolutional Neural Network and Regional Adaptive Weighting ». Dans ICBBT '21 : 2021 13th International Conference on Bioinformatics and Biomedical Technology. New York, NY, USA : ACM, 2021. http://dx.doi.org/10.1145/3473258.3473291.

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FATH, ALIREZA, YI LIU, SCOTT TANCH, NICK HANNA, TIAN XIA et DRYVER HUSTON. « STRUCTURAL HEALTH MONITORING WITH ROBOT AND AUGMENTED REALITY TEAMS ». Dans Structural Health Monitoring 2023. Destech Publications, Inc., 2023. http://dx.doi.org/10.12783/shm2023/36979.

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Mobile robots can access regions and collect data in structural locations not easily reached by humans. This includes confined spaces, such as inside walls, and underground pipes; and remote spaces, such as the underside of bridge decks. Robot access provides the opportunity to sense in these difficult to access spaces with robot mounted sensors, i.e. cameras and lidars, and with the robot placing and servicing standalone sensors. Teams of robots, sensors and AR-equipped humans have the potential to provide rapid and more comprehensive structural assessments. This paper presents results of studies using small robots to explore and collect structural condition data from remote and confined spaces including in walls, culverts, and bridge deck undersides. The presentation also covers system and network architecture, methods for automating data processing with localized and edge-based processors, the use of augmented reality (AR) human interfaces and discusses key technical challenges and possible solutions.

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Zhang, Mingwei, Xiaoxiang Zhu, Jinlong Fan, Guicai Li et Yeping Zhang. « Monitoring drought dynamics in Huanghuai region of China using AVHRR-based vegetation health indices in comparison with ground data ». Dans SPIE Europe Remote Sensing, sous la direction de Christopher M. U. Neale et Antonino Maltese. SPIE, 2009. http://dx.doi.org/10.1117/12.830154.

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GILMOUR, ADAM, MORTEZA TABATABAEIPOUR, ROSS MCMILLAN, KONSTANTINOS TZAFERIS, RORY HAMPSON, WILLIAM JACKSON, DAYI ZHANG et al. « ROBOTIC ULTRASONIC INSPECTION OF LARGE AND COMPLEX STRUCTURAL ASSETS ». Dans Structural Health Monitoring 2023. Destech Publications, Inc., 2023. http://dx.doi.org/10.12783/shm2023/36974.

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The implementation of robotic inspection solutions can provide massive improvements in the non-destructive testing and evaluation of large industrial structural assets. Current on-the-market remote inspection solutions are often limited in scope and lack the positional accuracy necessary for robust and repeatable structural health monitoring. This paper, therefore, describes multiple robotic navigation and inspection techniques to tackle a variety of challenges. Conventional inspection systems utilizing ultrasonic phased arrays for defect detection in large structures like storage tanks and flat steel plates typically employ a localized inspection approach. However, these systems often suffer from slow inspection speeds and an increased potential for human error, particularly in the case of large structures requiring repetitive inspections. The first challenge addressed is the inspection of large, thick steel plates used in the manufacture of industrial assets. The proposed solution focuses on achieving precise positional accuracy for spot gauge-thickness measurements and detecting laminations and inclusions. The system's novelty lies in utilizing the inspection sample itself for positional tracking. While the introduction of an automatic crawler-based approach speeds up the inspection process, it remains time-consuming and generates a substantial amount of data. To tackle this challenge, when the thickness of the inspected component allows, ultrasonic guided waves (UGW) can be employed for mid to long-range inspections. The second example outlines the integration of UGW with robotic inspection systems, which could significantly reduce inspection times by enabling rapid scanning and providing access to inaccessible regions. The final system looks at complex geometry, such as welded inserts or piping networks, and the implementation of ultrasonic phased array capabilities remotely and accurately. Standard crawlers for weld inspection are limited to simple geometry such as plates and large-bore pipes. The proposed system combines the flexibility of a sixdegree- of-freedom robotic manipulator with the remote capabilities of a magnetic base. Imbedding a sensor-driven system for live geometry assessment and tool path planning.

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Edner, H., B. Galle, A. Sunesson, S. Svanberg, L. Unéus, S. Wallin et W. Wendt. « Optical Remote Sensing of Atmospheric Pollutants ». Dans Laser Applications to Chemical Analysis. Washington, D.C. : Optica Publishing Group, 1987. http://dx.doi.org/10.1364/laca.1987.tua8.

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The problems connected with atmospheric pollutants are being more and more widely recognized. Soil and lake acidification have been long discussed while reports on widespread damage to forests are more recent. Air pollutants constitute a threat to public health both directly through inhalation and indirectly through possible long-term influences on the atmospheric environment. The need for powerful actions and international cooperation is becoming evident. Clearly, remote sensing techniques utilizing laser / optical technology provide attractive possibilities for measurements on local, regional and global scales. Source emissions, ambient air quality, atmospheric chemical transformation and long-distance transport of pollutants are all areas receiving increasing attention. Whereas point monitors can provide reasonably reliable information at a specific location, much more representative values can be obtained with remote sensing techniques, which also provide unique means to study the dynamics of the atmospheric processes. A review of the optical and laser remote sensing field is provided by e.g. Refs. 1 and 2.

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Rapports d'organisations sur le sujet "Regional and remote health"

Walker, Samantha, Tomoko McGaughey et Paul Peters. Spatial models of access to health and care services in rural and remote Canada : a scoping review protocol. Spatial Determinants of Health Lab, 2023. http://dx.doi.org/10.22215/rrep/2023.sdhl.606.

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Objective: The objective of this review is to determine the scope of spatial modelling approaches used to evaluate geographic access to health and care services in rural Canada. Introduction: Canada’s health and social policy agenda has made the requirement for equal access to primary and secondary health services for rural populations a key priority. Most rural health research in Canada has focused on measuring patterns of health outcomes or modelling geographic access to a narrow range of services, health conditions, or within specific regions. This scoping review will provide an in depth look at the spatial modelling currently being used to evaluate the barriers and facilitators for access to health and care services and will provide direction for further research. Inclusion criteria: This review will consider studies that include any person accessing health and care services in Canada, focusing on those who reside in rural or remote communities, or access health services in those areas. Methods: Published primary studies, reviews, opinion papers, reports, theses, and dissertations published in English or French across all dates will be searched in databases including CINAHL via EBSCO, PubMed, ProQuest, Scopus, Web of Science and Dissertations and Theses Global. Following the search, all titles and abstracts will then be assessed against the inclusion criteria for the review. Potentially relevant papers will be assessed in detail against the inclusion criteria. The data extracted will include geographic location, service under study, analytic methodology, data included, and specifics of the spatial models employed.

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Chen, Z., S. E. Grasby, C. Deblonde et X. Liu. AI-enabled remote sensing data interpretation for geothermal resource evaluation as applied to the Mount Meager geothermal prospective area. Natural Resources Canada/CMSS/Information Management, 2022. http://dx.doi.org/10.4095/330008.

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The objective of this study is to search for features and indicators from the identified geothermal resource sweet spot in the south Mount Meager area that are applicable to other volcanic complexes in the Garibaldi Volcanic Belt. A Landsat 8 multi-spectral band dataset, for a total of 57 images ranging from visible through infrared to thermal infrared frequency channels and covering different years and seasons, were selected. Specific features that are indicative of high geothermal heat flux, fractured permeable zones, and groundwater circulation, the three key elements in exploring for geothermal resource, were extracted. The thermal infrared images from different seasons show occurrence of high temperature anomalies and their association with volcanic and intrusive bodies, and reveal the variation in location and intensity of the anomalies with time over four seasons, allowing inference of specific heat transform mechanisms. Automatically extracted linear features using AI/ML algorithms developed for computer vision from various frequency bands show various linear segment groups that are likely surface expression associated with local volcanic activities, regional deformation and slope failure. In conjunction with regional structural models and field observations, the anomalies and features from remotely sensed images were interpreted to provide new insights for improving our understanding of the Mount Meager geothermal system and its characteristics. After validation, the methods developed and indicators identified in this study can be applied to other volcanic complexes in the Garibaldi, or other volcanic belts for geothermal resource reconnaissance.

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Yeika, Eugene, Erica L. Kocher et Carrie Ngongo. Integrating Noncommunicable Diseases into Antenatal Care in Cameroon : A Triangulated Qualitative Analysis. RTI Press, janvier 2024. http://dx.doi.org/10.3768/rtipress.2024.rr.0051.2401.

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Noncommunicable diseases (NCDs) have important implications for pregnancy outcomes and the subsequent health of women and their children. The aim of this study is to determine the status of NCD and maternal health program integration, identify barriers to integration, and explore what would be required to deepen integration of NCD care into antenatal care in Cameroon. We used two methods of data collection and synthesis: a desk review of policy documents and protocols and a series of key informant interviews with health system experts and managers working in public, private, and faith-based health facilities at central, regional, and district levels. Although screening for blood glucose and blood pressure occurs during antenatal care, post-diagnosis management is not well-integrated and often requires referral to specialists in higher-level health facilities. Key barriers to integration include lack of guidelines for the management of NCDs, financial constraints for facilities and patients, and shortages of health workers, medications, and supplies for laboratory investigations. Further integration of services for NCDs during pregnancy will require national guidelines backed up by system-wide strengthening of health information systems, insurance coverage, supply chain management, and human resource capacity, particularly in remote areas.

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Totten, Annette, Dana M. Womack, Marian S. McDonagh, Cynthia Davis-O’Reilly, Jessica C. Griffin, Ian Blazina, Sara Grusing et Nancy Elder. Improving Rural Health Through Telehealth-Guided Provider-to-Provider Communication. Agency for Healthcare Research and Quality, décembre 2022. http://dx.doi.org/10.23970/ahrqepccer254.

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Objectives. To assess the use, effectiveness, and implementation of telehealth-supported provider-to-provider communication and collaboration for the provision of healthcare services to rural populations and to inform a scientific workshop convened by the National Institutes of Health Office of Disease Prevention on October 12–14, 2021. Data sources. We conducted a comprehensive literature search of Ovid MEDLINE®, CINAHL®, Embase®, and Cochrane CENTRAL. We searched for articles published from January 1, 2015, to October 12, 2021, to identify data on use of rural provider-to-provider telehealth (Key Question 1) and the same databases for articles published January 1, 2010, to October 12, 2021, for studies of effectiveness and implementation (Key Questions 2 and 3) and to identify methodological weaknesses in the research (Key Question 4). Additional sources were identified through reference lists, stakeholder suggestions, and responses to a Federal Register notice. Review methods. Our methods followed the Agency for Healthcare Research and Quality Methods Guide (available at https://effectivehealthcare.ahrq.gov/topics/cer-methods-guide/overview) and the PRISMA reporting guidelines. We used predefined criteria and dual review of abstracts and full-text articles to identify research results on (1) regional or national use, (2) effectiveness, (3) barriers and facilitators to implementation, and (4) methodological weakness in studies of provider-to-provider telehealth for rural populations. We assessed the risk of bias of the effectiveness studies using criteria specific to the different study designs and evaluated strength of evidence (SOE) for studies of similar telehealth interventions with similar outcomes. We categorized barriers and facilitators to implementation using the Consolidated Framework for Implementation Research (CFIR) and summarized methodological weaknesses of studies. Results. We included 166 studies reported in 179 publications. Studies on the degree of uptake of provider-to-provider telehealth were limited to specific clinical uses (pharmacy, psychiatry, emergency care, and stroke management) in seven studies using national or regional surveys and claims data. They reported variability across States and regions, but increasing uptake over time. Ninety-seven studies (20 trials and 77 observational studies) evaluated the effectiveness of provider-to-provider telehealth in rural settings, finding that there may be similar rates of transfers and lengths of stay with telehealth for inpatient consultations; similar mortality rates for remote intensive care unit care; similar clinical outcomes and transfer rates for neonates; improvements in medication adherence and treatment response in outpatient care for depression; improvements in some clinical monitoring measures for diabetes with endocrinology or pharmacy outpatient consultations; similar mortality or time to treatment when used to support emergency assessment and management of stroke, heart attack, or chest pain at rural hospitals; and similar rates of appropriate versus inappropriate transfers of critical care and trauma patients with specialist telehealth consultations for rural emergency departments (SOE: low). Studies of telehealth for education and mentoring of rural healthcare providers may result in intended changes in provider behavior and increases in provider knowledge, confidence, and self-efficacy (SOE: low). Patient outcomes were not frequently reported for telehealth provider education, but two studies reported improvement (SOE: low). Evidence for telehealth interventions for other clinical uses and outcomes was insufficient. We identified 67 program evaluations and qualitative studies that identified barriers and facilitators to rural provider-to-provider telehealth. Success was linked to well-functioning technology; sufficient resources, including time, staff, leadership, and equipment; and adequate payment or reimbursement. Some considerations may be unique to implementation of provider-to-provider telehealth in rural areas. These include the need for consultants to better understand the rural context; regional initiatives that pool resources among rural organizations that may not be able to support telehealth individually; and programs that can support care for infrequent as well as frequent clinical situations in rural practices. An assessment of methodological weaknesses found that studies were limited by less rigorous study designs, small sample sizes, and lack of analyses that address risks for bias. A key weakness was that studies did not assess or attempt to adjust for the risk that temporal changes may impact the results in studies that compared outcomes before and after telehealth implementation. Conclusions. While the evidence base is limited, what is available suggests that telehealth supporting provider-to-provider communications and collaboration may be beneficial. Telehealth studies report better patient outcomes in some clinical scenarios (e.g., outpatient care for depression or diabetes, education/mentoring) where telehealth interventions increase access to expertise and high-quality care. In other applications (e.g., inpatient care, emergency care), telehealth results in patient outcomes that are similar to usual care, which may be interpreted as a benefit when the purpose of telehealth is to make equivalent services available locally to rural residents. Most barriers to implementation are common to practice change efforts. Methodological weaknesses stem from weaker study designs, such as before-after studies, and small numbers of participants. The rapid increase in the use of telehealth in response to the Coronavirus disease 2019 (COVID-19) pandemic is likely to produce more data and offer opportunities for more rigorous studies.

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Cabrol, Marcelo, et Cristina Pombo. How Digitalization can Transform Health, Education and Work as Latin America and the Caribbean Emerge from the Pandemic. Inter-American Development Bank, octobre 2021. http://dx.doi.org/10.18235/0003726.

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Like other historic disruptions, the COVID-19 pandemic has triggered chain-reactions in innovation, adaptation, and rapid behavioral change. The Latin American and Caribbean Region is no exception. The COVID-19 crisis has exposed a vast, pent-up demand for improvements in the quality, convenience, and cost of basic public services. While the ongoing human and economic toll of the pandemic has overshadowed the potential for dramatic and lasting gains in areas such as health, education, and remote work, it is not too early to ask how these gains might be retained and reinforced. This report highlights opportunities in telemedicine, tele-education, and telework the three areas we think are best positioned to achieve a profound digital transformation in the near-term. For each area, we offer a summary of the status quo, examples of early movers and innovators, and key questions regarding policy actions that can accelerate current trends.

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Turner, Katrina. Mental Health : digital health and remote care. University of Bristol, 2023. http://dx.doi.org/10.37361/sig.2023.1.1.

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Jiang, Shan, et Sofija Kaljevic. Owensboro Health Regional Hospital. Landscape Architecture Foundation, 2017. http://dx.doi.org/10.31353/cs1210.

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Randall, Linda, Thomas Jensen et Anna Vasilevskaya. Local and regional experiences of remote work and multilocality. Nordregio, septembre 2022. http://dx.doi.org/10.6027/r2022:4.1403-2503.

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This report aims to provide a deeper understanding of how the spatial trends associated with increased remote work are affecting Nordic municipalities and regions. It explores the usefulness and reliability of available statistical data for understanding the effects of increased remote work at the regional and local level. Further, it draws directly on the experiences of regional and local stakeholders to understand the effects, challenges and opportunities, and planning responses associated with increased remote work.

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Melnyk, Yuriy. Kharkiv Regional Public Organization “Culture of Health”. KRPOCH, 2005. http://dx.doi.org/10.26697/krpoch.

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Porter, Ben, Matthias Sirch, Naomi Cutler, Elissa Schuett et Jennifer Pontius. Regional Forest Health Monitoring Program : 2021 Report. Forest Ecosystem Monitoring Cooperative, mars 2023. http://dx.doi.org/10.18125/4x75j6.

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