Journal articles: 'NSW Rural Doctors Network'

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Lopez-Abuin, Jose, and Jane Randall-Smith. "EURIPA – THE PAST, PRESENT AND FUTURE." Medical Science Pulse 8, no. 3 (September 1, 2014): 22–25. http://dx.doi.org/10.5604/01.3001.0003.3170.

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EURIPA (European Rural and Isolated Practitioners Association) is a regional rural health network, which was founded by family doctors to address the health and well-being needs of rural communities, on one hand, and the practitioners’ needs across Europe, on the other. EURIPA began its activity in 1995 with a small group of family doctors from across Europe, and in 1997 the structure was formalised into that of EURIPA today. EURIPA was initially recognized by WONCA Europe as a special interest group and subsequently as a representative network for rural family doctors across Europe. Now, it actively participates in WONCA Europe meetings and their annual conferences. The constitution was revised in 1997 when the International Advisory Board was created to support the work of EURIPA and its Executive Committee. EURIPA has worked hard to raise the profile of rural general practice, from its first research project in 1997, to the series of Annual Rural Health Forums, which started in 2010. These forums have focussed on quality, education and research with the 5th Forum taking place in September 2014 focussing on policy engagement. EURIPA uses social media to engage its membership and publishes regular newsletters - “Grapevine”, as well as encourages rural GPs to publish in the European Section of the Journal of Rural and Remote Health.

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Islam, Md Irteja, Sharif Bagnulo, Yiwen Wang, Robyn Ramsden, Trent Wrightson, Amanda Masset, Richard Colbran, Mike Edwards, and Alexandra Martiniuk. "Job Satisfaction of Health Practitioners Providing Outreach Health Services during COVID-19 in Rural New South Wales (NSW) and the Australian Capital Territory (ACT), Australia." Healthcare 11, no. 1 (December 20, 2022): 3. http://dx.doi.org/10.3390/healthcare11010003.

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Outreach health practitioners play a key role in enhancing access to healthcare for remote, rural, regional, and Aboriginal and Torres Strait Islander communities in Australia. Outreach health practitioners are those providing ongoing and integrated health services in communities that would otherwise have limited access. In the context of the COVID-19 pandemic, it is important to understand the job satisfaction of health workers as it correlates with long-term retention of the workforce, as well as effectiveness in the role and clinical outcomes for patients. Method: The study analysed data from 258 outreach health practitioners who responded to two cross-sectional surveys conducted by the NSW Rural Doctors Network during the COVID-19 pandemic in 2020/21 and 2021/22 in NSW and the ACT, Australia. Both bivariate and multivariate analyses were employed to assess the associations between the outcome variable (outreach health practitioners’ job satisfaction) and independent variables (sociodemographic factors, motivation, self-confidence, communication, capability). Results: Overall, the study showed that 92.2% of health practitioners were satisfied in their role providing outreach health services during the COVID-19 pandemic. In the multivariable model, factors significantly associated with higher satisfaction included good communication with other local health practitioners, using telehealth along with in-person care, and having high self-rated capability compared to those health practitioners who said they had lower job satisfaction. Conclusions: Outreach health practitioners’ job satisfaction is important because poor satisfaction may lead to suboptimal healthcare delivery, poor clinical outcomes, and poor retention of staff in rural settings. These findings should be taken into consideration when developing future strategies to improve job satisfaction among rural outreach health practitioners and to enhance attraction, recruitment and retention and may be applicable to the broader health workforce.

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Heifetz, Laurence J., Ahrin B. Koppel, Elaine Melissa Kaime, Daphne Palmer, Thomas John Semrad, Cathey Bervid, Christina Potter, Janet Goodall, Ann Truscott, and Scott Christensen. "A virtual tumor board-driven synaptic knowledge network." Journal of Clinical Oncology 35, no. 8_suppl (March 10, 2017): 89. http://dx.doi.org/10.1200/jco.2017.35.8_suppl.89.

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89 Background: In 2006, Tahoe Forest Hospital District—a 25-bed hospital in Truckee, CA, a mountain resort community one hour from regional and two hours from academic cancer services—designed and implemented an oncology program utilizing effective telecommunications with a committed academic partner, the UC Davis Comprehensive Cancer Center in Sacramento. Methods: The UC Davis Cancer Care Network was established with four remote cancer programs, enabling participation in daily virtual tumor boards, clinical trial enrollment, and quality assurance assistance. (Richard J. Bold, et. al., Virtual tumor boards: community-university collaboration to improve quality of care. Community Oncol 10(11):310-315, November 2013.; Laurence J. Heifetz, MD, et. al., A Model for Rural Oncology. J Oncol Pract, 7:168-171, May 2011.). An increasing number of patients were observed to in-migrate to Truckee from even more remote rural areas in the mountains. In 2013, the now Gene Upshaw Memorial Tahoe Forest Cancer Center developed four remote telemedicine clinics to allow even more physically distant patients the capacity to be followed locally. Results: Since we opened the remote telemedicine clinics, our Sullivan-Luallin patient satisfaction scores have averaged 4.82/5.00 for “overall satisfaction with the practice” and 4.90/5.00 for “recommending your provider to others”; our in-migration rate of patients from outside our primary catchment area increased from 43% to 52%: and clinical trial accrual rate averaged 10%. Conclusions: Reducing cancer health disparities is an ASCO mission. (cover, ASCO Connection, July 2014; Laurence J. Heifetz, MD. Country Docs with City Technology Can Address Rural Cancer Care Disparities. Oncol, 29(9):641-644, September 2015.). We believe this synaptic knowledge network effectively addresses that mission for rural communities. This model can be scaled in many configurations to address the inherent degradation of quality care as a function of physical distance to an academic center that rural doctors and patients deal with on a daily basis. The key is to insist on a cultural shift – Do something smart at lunch every day. Attend a virtual tumor board.

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Hu, Rong, Jianguo Jiang, Lijun Chen, and Xiuman Li. "Under the Background of "Internet +", Mixed Teaching Mode of Science in the Reform of Rural Medical Majors." Learning & Education 10, no. 2 (September 16, 2021): 254. http://dx.doi.org/10.18282/l-e.v10i2.2348.

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With the construction of the network online course platform under the background of “Internet +”, the mixed teaching [1] based on the background of “Internet +” came into being, and has been widely used in the daily teaching of full-time students, and proved its existence advantages. Rural medical majors have limited education degree, age gap, fixed time and other factors, so that students’ teaching methods and full-time undergraduate students cannot be rigid. As one of the most important clinical medical courses for rural doctors, science not only requires students to master theoretical knowledge, but also requires proficiency in basic clinical operation skills. Therefore, for this kind of students, we by building “Internet +” science online open course platform, to provide high quality science teaching resources, at the same time using online learning + offline flip classroom mixed teaching model, the “tailored” for rural medical students, build in line with their learning ability level and receive knowledge ability of new teaching mode[2].

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Chatterjee, Sumanta, Pabitra Kumar Bhunia, Poulami Mondal, and Monalisa De. "Wireless sensor network enabled real-time remote intelligent health monitoring and management system using Internet of Things (IoT) sensing with cloud-based processing during covid-19 situation." Journal of Physics: Conference Series 2286, no. 1 (July 1, 2022): 012005. http://dx.doi.org/10.1088/1742-6596/2286/1/012005.

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Abstract Mankind was living quite an ordinary life when Covid 19 pandemic struck. The whole world was in turmoil and was busy trying to make the situation normal again. But it was impossible to regain the old scenario and people had to accept the new normal. The new normal demands people to follow different guidelines out of which maintaining a social distance of 6 feet was a prominent one. Even in this situation occurrence of any disease does not stop and there are always some patients visiting a doctor. Also, a doctor doesn't always have the luxury to visit every place to see patients, especially in rural areas where there is a transportation problem. So we have come up with a cloud-based system that will use the internet of things to diagnose a patient. This device will contain different sensors like temperature sensor, body oxygen level sensor, blood pressure sensor, heart rate sensor, and height and weight measuring gadgets to measure the body parameters of the patient and then store this information in the secured cloud which can then be accessed by the doctor to diagnose the patient. The sensors will be embedded in an Arduino and it will be connected to the cloud wirelessly with the help of a GSM module and node MCU. Also, a laptop will be present to connect the patient and the doctor in video mode for conversations. This system will also generate a prescription provided by the doctor which can be used anywhere. Thus, this device will not only promote social distancing but also it will prohibit the spread of diseases that are communicable. The doctors can work from the comfort of their home without touching a patient and also without traveling long distances to remote locations.

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Bhattarai, Madhur Dev. "Facilitation of free residential training inside the country – The fundamental health service responsibility of the Government and its regulatory body." Journal of Nepal Medical Association 53, no. 197 (March 31, 2015): 40–69. http://dx.doi.org/10.31729/jnma.2704.

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For optimum Peripheral Health Service and implementation of various Vertical Public Health Programme Services, network of public Rural and Urban Health Centers with trained Specialists in General Practice (GP) is essential. Later such Specialist GPs will thus fulfill both comprehensive training and experience required for Health Management and Planning Service in the centre. About 40%-50% of all Residential Trainings and Specialists are required in GP. There are further up to 100 to 150 possible specialties in which remaining doctors can be trained for Specialty Health Services. Though free Residential Training has numerous advantages, its shortage inside country is the bottleneck to provide above mentioned Health Services. Planning for health service delivery by at least trainee residents under supervision or appropriately trained specialists guides Residential Training’s regulations. Fulfillment of objective training criteria as its core focus is the concept now with the major role of Faculty as supervising residents to provide required service in the specialty and simultaneously updating themselves and their team for Evidence-Based Medicine practice. Similarly the need of Ambulatory Health Service and joint management of in-patients by specialists in hospitals has changed unit and bed divisions and requirements for Residential Training. Residents, already the licensed doctors, are thus providing required hospital service as indispensable part of its functional hierarchy for which they need to be paid. With such changing concepts and trends, there are some essential points in existing situation to facilitate free Residential Training inside country. For Government doctors, relevant amendment in their regulation is accordingly required. Keywords: ambulatory care; general practice; health service; hospitalist; medical council; medical education; public health; regulatory body; research; residential training.

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Anwer, Anusha, Maham Fatima, and Aabia Zakai. "Towards the future – Telerehabilitation in stroke care in Pakistan." Journal of the Pakistan Medical Association 73, no. 9 (August 15, 2023): 1938. http://dx.doi.org/10.47391/jpma.8245.

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Stroke is the third leading cause of death globally. Pakistan, a low-middle income country (LMIC), reports approximately 350 000 new stroke cases annually, including 20 000 cases each year from Karachi, Pakistan’s largest city populated by 12 million people1. Telerehabilitation is a fairly new branch of telemedicine, defined as the provision of rehabilitation amenities by experts to the patient using telecommunication technology. It reduces hospital stay and expense, thus proving beneficial for both the patient and healthcare provider. Its use is more common in high-income countries (HICs) than LMICs. Popular systems like the Rehab@Home2 framework are examples of telerehabilitation models for patients suffering from stroke3. There is a shortage of literature to comprehensively comment on the impact of telerehabilitation on stroke patients in LMICs. However, telehealth in neurology, termed teleneurology, has the potential for advancement in the treatment of patients with neurological diseases in LMICs, as they have the highest incidence of neurological disorders. A paper proposed that establishing a teleneurology network for Sub-Saharan Africa consisting of transcontinental, inter-regional, intraregional, and national networks will allow neurologists and neurology residents from LMICs to consult with their counterparts in HICs, thus improving the overall quality of the healthcare system4. Pakistan only has 3.2% of the current GDP devoted to the health sector, leading to limited medical facilities nationwide. The outbreak of Covid led to an uplift in the growth of telehealth which encourages evolution in the future. However, this advancement in the use of telehealth has been hindered by several factors since its inception in 2003, including a lack of legal framework and laws for the establishment of new programs, lack of sustainable support from the government, deficiency of funds and resources for the organization of infrastructure, distant rural areas with poverty, low literacy rate, limited cell phone ownership, and internet access. The scarcity of qualified doctors and trained paramedics or nurses and lack of awareness is another significant impediment as depicted by a survey, which informed that 98.2% of doctors employed in the public health sector in Karachi recorded a paucity of training workshops or conferences for telemedicine5. Hence, measures to overcome these barriers like investments from HICs, training workshops from pioneers of the field, and healthcare professionals who can offer services in multiple languages are some of the factors that can aid in effectively introducing telerehabilitation for the masses.

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Rusnak, Oleksandr. "Main tendencies of healthcare system development of Northern Bukovyna and Hhotyn region during the interwar period." History Journal of Yuriy Fedkovych Chernivtsi National University, no. 53 (June 21, 2022): 77–89. http://dx.doi.org/10.31861/hj2021.53.77-89.

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In the article the author characterizes main tendencies of healthcare system development of Northern Bukovyna and Khotyn region in 1918-1940. Investigates the state of sanitary and hospital services, covers the problem of combating epidemic diseases. Lack of qualified and well-timed care for patients with smallpox, typhus, tuberculosis, dysentery and other diseases that became widespread after World War I, led to an increase in mortality among the population. However, over time, the normal work of medical institutions has been restored and the threat of epidemics has been eliminated, and the number of diseases and deaths has decreased significantly.By 1921, the health care system of Northern Bukovyna and Khotyn region was almost completely in line with that in the Old Kingdom. However, the payment for treatment remained. For the most part, in 1918-1940, after receiving new equipment, continued to operate medical institutions established during the period when Bukovyna was a part of Austria-Hungary. According to the needs of time, their structure, number and qualification of medical staff was changing. New branches, laboratories and institutes were being opened on their basis. The pharmacy network was developing, societies of doctors and pharmacists were working, and county councils of hygiene were functioning.While noting some of the undoubted successes in the health care system of the region during this period, it should be noted that a large number of the rural population (especially the inhabitants of mountainous areas) did not have access to medicine.

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Limanto, Susana, and Andre Andre. "Information system to enhance medical services quality in Indonesia." International Journal of Electrical and Computer Engineering (IJECE) 9, no. 3 (June 1, 2019): 2049. http://dx.doi.org/10.11591/ijece.v9i3.pp2049-2056.

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The consequence of disproportionate distribution and placement of Doctor in Indonesia is affecting people who live in rural area. Patient have to travel to city to receive medical treatment and must encounter another different problem such as: patients often have to wait a long time in the doctor's office even sometimes do not get the service because of holiday or rejected because the queue is full. Medical record in some cases may lost due in Indonesia mostly medical record recorded manually (paper based). Therefore doctor treatment is not optimal because doctor can no longer inspect patient illness history and any treatment that have been conducted before. This research proposes a new concept to help people who live in rural area to get better medical treatment. People could register and monitor doctor service queue via smart phone. System expanded with medical record management facilities to improve service quality of patient. Research object was doctor service in Sulawesi, Indonesia. This research indicates system could increase time efficiency, energy, and cost efficiency for patient and also the doctor. Additionally current system will be optimal if supported with stable internet network.

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Tran, Carolyn-Thi Thanh Dung, and Brian Dollery. "Municipal Performance in a Network Structure of Financial Operations and Service Provision in the New South Wales Local Government." Public Finance and Management 22, no. 1 (March 2023): 65–89. http://dx.doi.org/10.37808/pfm.22.1.3.

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Whereas the bulk of empirical research has employed nonparametric approaches to estimate efficiency in local government, especially Data Envelopment Analysis (DEA), in this paper we employ a Network DEA (NDEA) model to investigate the impact of the separate divisions of financial management and service provision on overall municipal efficiency. We apply this approach to the New South Wales (NSW) state local government system in Australia using a NDEA model for the four-year period of 2014/15 to 2017/18. We find that the overall efficiency of NSW local councils is statistically significantly associated with financial efficiency more strongly than with service efficiency, indicating that financial activities are relatively more important in terms of municipal performance. Using a fractional regression model in a second-stage NDEA model, we also establish that urban local councils are more efficient than their rural counterparts in terms of both financial efficiency and overall network efficiency.

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Lower, Tony, Lyn Fragar, Julie Depcynzksi, Jeffrey Fuller, Kathy Challinor, and Warwick Williams. "Social network analysis for farmers' hearing services in a rural community." Australian Journal of Primary Health 16, no. 1 (2010): 47. http://dx.doi.org/10.1071/py09043.

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This study aimed to define current hearing health service networks for farming families in a major regional centre in New South Wales, in order to identify approaches that can strengthen local service provision. A pilot survey of individuals and agencies that potentially work with farmers was undertaken and a social network analysis completed to assess the self-reported links of agencies with each other. Thirteen agencies with a role in hearing health service provision participated with results indicating that nurse audiometrists, WorkCover NSW and agricultural retailers have the lead role in disseminating relevant information within the network. For client referrals the nurse audiometrist, private audiometry services, general practitioners, ear, nose and throat specialists and industry groups played the major roles. Social network analysis can assist in defining hearing health networks and can be used to highlight potential actions that can strengthen networks to enhance services for farmers and their families.

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Squires, Don. "Providing Vocational Education and Training (VET) for NSW Rural Schools and Students: the 'Stage of Play'." Australian and International Journal of Rural Education 10, no. 2 (July 1, 2000): 37–46. http://dx.doi.org/10.47381/aijre.v10i2.456.

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A strategic framework for VET in Schools (1998-2000) was developed by the Department of Education and Training to coordinate the development and implementation of Vocational Education andTraining (VET) in government schools across NSW. One clear advantage of the vocational education curriculum in schools is that it offers a broader range of choices to students and has the potential to satisfy the needs and aspirations of a broader range of students than can be accommodated within the traditional curriculum. Vocational learning and VET are also emerging as major mechanisms for helping young people negotiate the complex transition from CHILD to ADULT. The major distance education provider for NSW school and TAFE students is the Open Training and Education Network - Distance Education Directorate (OTEN-DE). OTEN-DE meets the needs of students across the state who must access vocational education and training by means of distance education, either as isolated learners or as students in smaller rural schools. This paper explores some conceptual and practical issues associated with the provision of vocational learning and VET for students in isolated and rural areas.

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Shiikha, Yulia, Estie Kruger, and Mathew Coleman. "Using social network analysis approach in developing rural psychiatrist workforce." Australasian Psychiatry 31, no. 1 (February 2023): 34–37. http://dx.doi.org/10.1177/10398562231155053.

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Objective This study examines how rural and remote junior doctors career decisions are influenced by highly connected principles within a discipline. Methods Social network analysis was completed with data collected, by structured interview, with five psychiatry trainees and three early career psychiatrists in a rural location rated MM3 using the Modified Monash Model. UNICET software was used to determine the interactions between individual networks to look for overlap and common influencers. Results A single central, highly connected, psychiatrist was found at the core of the entire social network. This connector was instrumental in recruitment and retention in rural psychiatry workforce. Conclusion Improving the understanding of human capital can encourage innovative solutions in developing sustainable strategies for recruiting and retaining rural psychiatry workforces.

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McLean, Fiona M., Roselyn M. Dixon, and Irina Verenikina. "Bringing it to the Teachers." Australian and International Journal of Rural Education 24, no. 2 (July 1, 2014): 15–22. http://dx.doi.org/10.47381/aijre.v24i2.683.

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Teachers in isolated schools are often under-resourced and overwhelmed with additional pressures. Teaching in an isolated community can sometimes challenge teachers’ skills and knowledge, particularly when additional pressures such as behavioural issues associated with students with Oppositional Defiant Disorder (ODD) like behaviours are present. Teachers in isolated schools catering for students exhibiting elements of ODD need additional support and resources, but distance and isolation are barriers to the provision and receipt of these services. Professional support networks are often relied on by these teachers, but these support communities can be hard to build because of the physical distances occurring in rural NSW. Thus, teachers in isolated schools are often faced with dealing with stress and student behaviours on their own, with very little support, which might leave them feeling disconnected. One method of connecting isolated teachers is through an online Community of Practice (CoP). Websites which can enable the development of a CoP have been proposed as a way of solving this problem. This study was developed to examine the building of an online support structure named 'Bringing It To The Teachers' to provide for an emergent online professional network for teachers in isolated rural NSW schools. The study involved ten teachers from five isolated schools catering for students who had been identified as displaying oppositional and defiant behaviours. This paper presents the preliminary findings of the study, investigating the elements required for successful development of an online CoP for teachers in isolated rural communities.

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Das, Tapan K., Chiranji Lal Chowdhary, and X. Z. Gao. "Chest X-Ray Investigation: A Convolutional Neural Network Approach." Journal of Biomimetics, Biomaterials and Biomedical Engineering 45 (May 2020): 57–70. http://dx.doi.org/10.4028/www.scientific.net/jbbbe.45.57.

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Though India being home of one out of every six people in the globe, is facing an arduous task of providing healthcare service, especially to the large number of patients in remote areas due to lack of diagnosis support systems and doctors. It is reported that hospitals in rural areas have an insufficient radiologist due to which thousands of cases are usually handled by single doctor. In this context, we aim to develop an AI based computer-aided diagnosis tool, which can classify abnormalities by reading chest X-ray so that it could assist the doctors in arriving at quick diagnosis. We have employed a Convolutional Neural Network (CNN) designed by Google known as XceptionNet to detect those pathologies in ChestX-ray14 data. Further, same data is being used for executing other CNN- ResNet. Finally, both the results obtained are compared to assess the superior CNN model for X-ray level diagnosis.

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Fraser, Jennifer Anne, Marie Hutchinson, and Jessica Appleton. "Nurses’ experiences of home visiting new parents in rural and regional communities in Australia: a descriptive qualitative study." Journal of Children's Services 11, no. 3 (September 19, 2016): 204–16. http://dx.doi.org/10.1108/jcs-07-2015-0023.

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Purpose Child and family health (CAFH) services in Australia initially provide at least one nurse-home-visit following the birth of a child. Planning and referral then commences for the on-going provision of appropriate services to families. Unfortunately, services in rural and regional communities in Australia can be fragmented and poorly resourced. Little is known about CAFH nurses’ experiences of working with families in these communities. The purpose of this paper is to examine the way CAFH nurses work within a universal health service model that may be compromised by isolation, discontinuity and fragmentation. Design/methodology/approach Focus groups with 26 CAFH nurses from five rural, two regional and one urban community in New South Wales (NSW), Australia were conducted. A secondary, thematic analysis of the qualitative data were undertaken to reflect on change and continuity in the field of universal CAFH services. Analysis was driven by two key research questions: How do CAFH nurses experience their role in universal home-based CAFH services within rural and regional areas of Australia and, what unique factors are present in rural and regional areas that impact on their CAFH nursing role? Findings The experience of the CAFH nurses as presented by these data revealed a role that was family centred and concerned for the welfare of the family, yet compromised by the need to meet the disproportionately complex needs of families in the absence of a strong network of services. The opportunity to present the findings provides insight into the way in which families engage with available services in isolated communities. CAFH nurses in the study attempted to maintain service integrity by adapting to the unique context of their work. Originality/value It is important to understand the mechanisms through which CAFH nurses operate to work effectively with families referred to their service. This paper describes the way in which CAFH nurses work with families not meeting the threshold for more intensive and targeted home-visiting service delivery in rural and regional communities of NSW, Australia.

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Khristenko, Dmitrii Nikolaevich, and Yuliya Vladimirovna Krasovskaya. "Collectivization and public health system formation in rural Russia." Samara Journal of Science 8, no. 4 (November 29, 2019): 200–204. http://dx.doi.org/10.17816/snv201984215.

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Collectivization in the USSR, without any doubt, became one of the most difficult and tragic pages in the history of our country. Not denying the devastating results of the socialization of agriculture in the 1930s, some positive consequences, nevertheless, should be noted, especially in the public health service. In this paper the authors analyze changes in the public health service for rural residents from the late 19th century to the end of the 1930s. They use various types of historical sources, such as statistical data, studies of Zemstvo leaders, government officials and memoirs of contemporaries. The state policy in the public health, the availability of medical care and the provision of medical personnel, the attitude of the population towards doctors and official medicine and the sanitary and hygienic living conditions of the rural residents are examined in detail. It is concluded that the depressing situation in the public health service for the rural population in pre-revolutionary Russia, aggravated by ignorance, numerous superstitions and distrust of doctors, changed dramatically only after the establishment of the Soviet government. In the process of collectivization in rural areas, an extensive network of hospitals, medical sites, maternity hospitals and pharmacies appeared. As a result, in spite of numerous problems in rural public health, it can be argued that it was in the 1930s that general medical care became an integral part of rural life.

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Yan, Yan, Li Liu, Jing Zeng, and Liang Zhang. "Evaluation and Exploration on the Effect of the Management of Chronic Obstructive Pulmonary Disease in Rural Areas through an Internet-Based Network Consulting Room." Medical Principles and Practice 27, no. 3 (2018): 222–26. http://dx.doi.org/10.1159/000488591.

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Objective: This study aims to improve the management quality of chronic obstructive pulmonary disease (COPD) in rural areas. Methods: Two hundred forty discharged COPD patients were divided into an intervention group and a control group. In the intervention group, 120 patients established contact with doctors through the network consulting room, i.e., the doctor’s mobile platform, and were managed through video, voice, and text by the doctors, kept close contact with the doctors after discharge (education, consultation), and received electronic prescriptions, and drugs were sent to the patients’ door by online retailers. The patients in the control group were managed in the traditional manner. One year later, the predicted forced expiratory volume in 1 s (FEV1)%, FEV1/forced vital capacity (FVC), and CAT scores and the number of rehospitalized patients were compared between these 2 groups. Results: After 1 year of follow-up, the predicted FEV1% and the FEV1/FVC ratio were significantly higher in the intervention group than in the control group (p < 0.05). CAT scores were lower for patients in the intervention group than for those in the control group after 1 year of follow-up (p < 0.05). After 1 year of follow-up, 22 (18.33%) patients were rehospitalized in the intervention group and 58 (48.33%) patients were rehospitalized in the control group (p < 0.05). Conclusion: Doctors can improve the quality of life of patients with COPD and reduce the number of rehospitalizations through use of the network consulting room.

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Perez-Balboa, Irene-Crisely, Santiago-Omar Caballero-Morales, Diana Sanchez-Partida, and Patricia Cano-Olivos. "Design of logistic criteria to establish healthcare facilities in vulnerable regions in Mexico." Acta logistica 10, no. 2 (June 30, 2023): 251–65. http://dx.doi.org/10.22306/al.v10i2.391.

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According to the World Health Organization (WHO), health inequities refer to those dimensional, measurable, and avoidable differences between socially, economically, demographically, or geographically defined population groups. In Mexico, despite several advances in health services and infrastructure, there are health inequities in rural communities, particularly those with indigenous population. These communities have limited or non-existent healthcare facilities, medical equipment, transport infrastructure, medicines, and human resources such as doctors and nurses. In this work, a conceptual design of a healthcare network is proposed to serve a region with several rural communities with limited healthcare resources. The designed network allocates rural communities to the most appropriate facilities based on (a) a vulnerability community index, and (b) a facility service index. The application of the conceptual network led to a hierarchical referral scheme between communities and different types of healthcare facilities to improve medical services and infrastructure planning. These results can support the decisions aimed to expand already existent facilities, replace multiple basic facilities with an appropriate number of larger and more advanced facilities, and determine the transportation infrastructure required to reach these facilities.

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Yanagawa, H., M. Irahara, S. Kawashima, and S. Kagawa. "The Views of Doctors on Registration Trials in a Japanese Rural Area: A Survey of Medical Institutions Registered to the Tokushima Network for Clinical Trials." Journal of International Medical Research 36, no. 5 (October 2008): 1117–22. http://dx.doi.org/10.1177/147323000803600532.

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Tokushima University Hospital has established the Tokushima Network for Clinical Trials (TNCT) to promote clinical trials in the area in collaboration with the Tokushima Medical Association. The present study investigated the views of doctors towards registration trials in the TNCT. A questionnaire was provided to 49 clinics/hospitals registered to the TNCT in 2006 and 38 (78%) responded. It revealed that 48% of doctors were aware of registration trials and 87% were favourable towards participating as investigators in them. They considered close contact with developmental drugs, advancement of therapy and the opportunity to learn about state-of-the-art treatment as benefits of participation. The main areas of difficulty included management of adverse reactions and patients' refusal to take part. Many doctors wanted more opportunity to learn about trial-related issues such as regulations. The survey indicates that the TNCT needs to develop the infrastructure and enlighten participants to promote registration trials in this rural regional area.

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Wang, Qingtong, Yuzhu Gong, and Kezhen Niu. "The Yantai Model of Community Care for Rural Psychiatric Patients." British Journal of Psychiatry 165, S24 (August 1994): 107–13. http://dx.doi.org/10.1192/s0007125000293069.

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The main characteristics of the Yantai model are (a) a three-tier (county, township, village) management structure; (b) the vertical integration of community mental health workers, including a professional advisory group of psychiatrists from the central psychiatric hospital, groups of community psychiatrists at small county psychiatric hospitals, non-psychiatric physicians who run psychiatric out-patient clinics at township general hospitals, and village paramedics (‘village doctors’) who supervise patients in the community; (c) ongoing training of all community mental health workers; (d) registration and yearly follow-up of all patients with mental illnesses in the community; (e) provision of home-care services to a proportion of acutely ill patients; and (f) most of the cost of the service is borne by the state. The network of services provided by this model makes it convenient for patients to obtain treatment and, if necessary, go into hospital; it reduces the economic burden on the family and the community; it combines treatment, prevention, rehabilitation, and supervision under one administrative network; and it decreases the overall level of psychopathology and psychosocial dysfunction in the community.

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Armstrong, David N., Iwona Sudoł-Szopińska, Vincent de Parades, Francesco Litta, Manuel Limbert, and Khaw C. W. James. "Pankaj Garg: A Community Doctor to a Master Innovator to a Global Icon." Global Journal of Medical, Pharmaceutical, and Biomedical Update 18 (August 24, 2023): 16. http://dx.doi.org/10.25259/gjmpbu_59_2023.

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Pankaj Garg’s story is an interesting one and is a source of inspiration for all physicians and budding innovators. He started his career as a community doctor about two decades back in the year 2001, then changed gears in between to become an avid researcher and innovator. He progressed to become a leading international figure in his field. Garg has exemplified three important points. First, with proper temperament, it is possible to achieve academic excellence and conduct research even in a primary care setting. Second, every specialist should fulfill the role of a family physician as well. While pursuing any specialty, the role of a “general physician” should never be ignored. Third, innovation is a state of mind, and big institutions and well-equipped laboratories with costly gadgets are not a prerequisite to it. This is clearly exemplified by Pankaj Garg’s story that it is possible to excel in research, academics, and clinical work at the global level without any research budget, big institute tag, or the help of government or non-government organizations. Garg has more than 175 publications in high-impact journals. He has 30 innovations to his name, in and outside his field of expertise, all of which have been published in international journals. The innovations include new operative procedures, successful non-operative management, the discovery of new anatomical spaces, new concepts in disease understanding and management, and finding non-operative treatment for diseases for which surgery is routinely performed. It is impressive that seven of his innovations are popularly known by his name - Garg classification, Garg space, Garg protocol, Garg cardinal principles, Garg scoring system, Garg phenomenon, and Garg incontinence scores. Due to 30 innovations done single-handedly, Garg has been certified as a “doctor with maximum innovations” by several record books. Due to his ability to think “out-of-the-box” and his immense contribution to advancements in the field of proctology, he is recognized as a global icon in his field. Garg is a master teacher. He has taught surgical skills and the art of scientific paper writing to hundreds of surgeons and doctors. In spite of limited resources at his disposal, Garg goes out of his way to help poor people. He performs about 30–40% of operations free of cost. He has successfully treated patients from 41 countries and several patients from royal families of the Gulf who offered him lucrative money to move to the Middle East. However, Garg flatly refused all offers because his priority was to serve his country and countrymen first. Hence, a simple doctor working in a small city was never discouraged by the lack of resources, and the fear of working alone in a small set-up and without any help from the government has carved out a tale that can motivate professionals in any corner of the world. Dr. Garg’s story provides immense inspiration to every practicing physician in the country to innovate whether he/she is practicing in a primary healthcare center or a rural area.

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Brennan-Horley, Chris. "Maps and Mobilities: On the Possibilities and Limits of Spatial Technologies for Humanities Research." International Journal of Humanities and Arts Computing 9, no. 2 (October 2015): 242–61. http://dx.doi.org/10.3366/ijhac.2015.0151.

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This paper explores the limits of spatial representation for understanding historic mobilities in a rural Australian setting. For this research, an historical GIS was populated from paper map archives denoting where and when bitumen roads were sealed in the Bega Valley, NSW. Using existing geospatial methods, a temporally sensitive network analysis was conducted, revealing a picture of regional mobility reshaped by modernist infrastructure improvements. Yet a straightforward binary pitting sealed roads as ‘good’ vs unsealed roads as ‘bad’ was challenged in subsequent qualitative interviews with long-time residents. Instead, a range of opinions emerged about the role that differing road surfaces played in everyday and historic mobilities. A fuller picture of the motivations and cultural associations of bitumen vs dirt road driving resulted from deploying humanities research methods of interviewing and discourse analysis. Such an approach revealed preferences and motivations that sometimes challenged inferences gained from mapping results alone. There are limits then in relying solely on historical cartographic data to produce maps and spatial representations and existing humanities techniques may hold, in some instances, greater explanatory power.

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Schumaker, Alice M. "Interorganizational Networks: Using a Theoretical Model to Predict Effectiveness of Rural Health Care Delivery Networks." Journal of Health and Human Services Administration 25, no. 3 (September 2002): 371–406. http://dx.doi.org/10.1177/107937390202500305.

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Interorganizational health care delivery networks have potential for sustaining health services delivery in rural areas faced with economic and demographic challenges. Four Nebraska rural health care delivery networks (Albion-Ord, Blue River Valley. Rural Partners. Inc., and Western Nebraska) were compared to an interorganizational model based on theories of interorganizational relations, exchange, population ecology, and synthesized collaboration. It assumes that outcomes, including effectiveness, are influenced by external and internal factors that are operationalized through external control, technology, structure, and operational process variables. Data were collected by a non-random, two-level cluster mail survey of network, members (45/59 = 76.3% response rate). All networks received technical assistance from the Nebraska Office of Rural Health. Networks have formal organization, strategic plans, and official coordinators. Hospital administrators hold most leadership positions; few doctors or citizens are involved. Correlation and multiple regression analysis show partial fit between the research model and study networks. Effectiveness, measure by the gap between best possible and actual practice, increased with network connectivity (r=.36, p<.05), group methods of administrative decisionmaking (r=.52, p<.001) and sequential pattern of service delivery (r=.39, p<.05). Greater dependence on vertical funding corresponds to greater external control (r=.43, p<.01). The prediction that, as scope narrows, task intensity (r=.56, p<.001). duration (r=.41, p<.01), and task volume (r=.50, p<01) increase is upheld. Centrality and network size decrease together (r=.43, p<01) where there is little reliance on vertical sources of funds (r=.36, p<.05). The integrated interorganizational model demonstrates some efficacy for testing potential effectiveness of networks.

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Perera, Kithsiri, Ryutaro Tateishi, Kondho Akihiko, and Srikantha Herath. "A Combined Approach of Remote Sensing, GIS, and Social Media to Create and Disseminate Bushfire Warning Contents to Rural Australia." Earth 2, no. 4 (October 6, 2021): 715–30. http://dx.doi.org/10.3390/earth2040042.

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Bushfires are an integral part of the forest regeneration cycle in Australia. However, from the perspective of a natural disaster, the impact of bushfires on human settlements and the environment is massive. In Australia, bushfires are the most disastrous natural hazards. According to the records of the Parliament of Australia, the recent catastrophic bushfires in NSW and Victoria burnt out over 10 million hectares of land, a figure more significant than any previous bushfire damage on record. After the deadly 2009 Black Saturday bushfires, which killed 173 people in Victoria, public attention to bushfires reached a new peak. Due to the disastrous consequences of bushfires, scientists have explored various methods to mitigate or even avoid bushfire damage, including the use of bushfire alerts. The present study adds satellite imagery and GIS-based semi-real-time bushfire contents to various bushfire warnings issued by government authorities. The new product will disseminate graphical bushfire contents to rural Australians through social media, using Google Maps. This low-cost Media GIS content can be delivered through highly popular smartphone networks in Australia through social media (Facebook and Twitter). We expect its success to encourage people to participate in disaster mitigation efforts as contributors in a participatory GIS network. This paper presents a case study to demonstrate the production process and the quality of media GIS content and further discusses the potential of using social media through the mobile network of Australia while paying attention to mobile blackspots. Media GIS content has the potential to link with the public information systems of local fire management services, disseminate contents through a mobile app, and develop into a fully automated media GIS content system to expand the service beyond bushfires.

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Mansfield, Jennifer, Donna Vandergraff, Krystal Lynch, Douglas Miller, and Dennis Savaiano. "2335 A mixed-methods evaluation to improve sustainability of community health coalition partnerships, activities, and impact on county-level health." Journal of Clinical and Translational Science 2, S1 (June 2018): 78. http://dx.doi.org/10.1017/cts.2018.273.

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OBJECTIVES/SPECIFIC AIMS: Community health coalitions (CHC) aim to improve local cultures of health, health behaviors, and health outcomes. However, challenges sustaining partnerships and activities limit CHC impact. Traditional CHC evaluations survey members about perceived effectiveness, failing to capture underlying network structures and community health outcomes. Thus, we applied a mixed-methods evaluation in eight rural Indiana CHC, triangulating social network analysis [(SNA), conducted in 2017], functioning effectiveness [Coalition Self-Assessment Survey (CSAS), also 2017], and latest county health statistics (2015–2016) to assess existing CHC building efforts, inform best practices, and facilitate the adoption of evidence-based programming. METHODS/STUDY POPULATION: Across the eight rural Indiana CHC, relationships between the three evaluation components were analyzed using Pearson’s correlations. We are now collaborating with Purdue’s Nutrition Education Program Community Wellness Coordinators to scale up evaluation efforts throughout Indiana. RESULTS/ANTICIPATED RESULTS: CHC effectiveness was positively correlated with the average number of connections CHC members held in the network (mean indegree) and negatively correlated with the presence of a network broker (eigenvector centrality). However, effective leadership was positively correlated with opioid deaths and treatment, food insecurity, smoking during pregnancy, lack of healthcare coverage, and fair/ poor health status, and negatively correlated with prenatal care. Effective operating norms was positively correlated with smoking during pregnancy and preterm births, and negatively correlated with prenatal care. Effective action outcomes was positively correlated with opioid deaths and treatments, smoking during pregnancy, preterm births, and fair/ poor health status, and negatively correlated with respondents reporting they had no personal doctor. DISCUSSION/SIGNIFICANCE OF IMPACT: Interestingly, CHC effectiveness was positively correlated with poor county health outcomes related to infant well-being. Thus, CHC may develop in counties with a high unmet need for effective pregnancy and infant services. Alternatively, the prevalent CHC focus on obesity prevention may eclipse programmatic efforts to improve infant well-being. Longitudinal evaluations and scaling up evaluation efforts across Indiana are being pursued to clarify trajectories and inform best practices, which in turn should provide recommendations for network structures to improve CHC effectiveness and county health.

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Darkwa, Osei. "An exploratory survey of the applications of telemedicine in Ghana." Journal of Telemedicine and Telecare 6, no. 3 (June 1, 2000): 177–83. http://dx.doi.org/10.1258/1357633001935185.

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We examined the use of telemedicine at two major medical institutions in Ghana. Doctors and administrators were surveyed to assess their knowledge of computers and familiarity with telemedicine. The use of modern telecommunications and information technology products within the health service was also examined. Thirty questionnaires were distributed to staff at the two hospitals, one urban and one rural. Twenty were returned (a response rate of 67%). Although most of the respondents were computer literate, they were less familiar with telemedicine applications. Only a minority of the respondents were participating in an information-sharing network, transmitting information by fax or telephone, or had Internet access. Financial constraint appeared to be the major barrier to establishing information-sharing networks. Other constraints were technological and organizational. The respondents expressed an interest in using telemedicine, having access to health-care databases and specific telemedicine applications such as tele-education and videoconferencing. Staff in the urban hospital were more likely to be familiar with telemedicine and more likely to have access to information technology than those in the rural hospital.

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SHIN, Changhoon. "The ‘Korean’ Resolution of the Doctorless Village Crisis and the Entanglement with the Conscription System in South Korea in the 1950s-70s." Korean Journal of Medical History 32, no. 3 (December 31, 2023): 1043–73. http://dx.doi.org/10.13081/kjmh.2023.32.1043.

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This article reviews how the crisis of doctorless villages in South Korea in the 1950s-70s was closely linked to the conscription system. In the second half of the twentieth century, South Korea’s public health system faced a dual challenge: the colonial legacy of medical shortage and urban concentration, and the massive conscription of military doctors after the Korean War. The term ‘doctorless village’ was a signifier that reflected these historical contexts, symbolizing the chronic medical crisis in rural areas. Behind the crisis, there as a growing idea of reversing the constraints from conscription and using it as a solution for the doctorless village problem. Initially, the Ministry of Health and Social Affairs planned two alternatives to fill the gaps in the public health network. One was to station military doctors in doctorless villages, and the other was to dispatch civilian doctors in doctorless villages and exempt them from military service. After a series of doctor mobilizations since the May 16 coup, the medical community generally agreed with this plan and publicized it. They developed arguments for alternative services through public health work and strengthened its logic. By the 1970s, the plan culminated in the establishment of the current Public Health Doctor system. In terms of condition and momentum, the introduction of alternative service in other sectors, as well as the extension of the consensus among the government and medical community, accelerated this trend. As a result, the doctorless village crisis in South Korea, which had been a critical issue for a quarter of a century, entered a phase of resolution by utilizing the conscription system as its institutional foundation. It represented an aspect of the ‘Korean’ public health system characterized by the entanglement with conscription. However, another aspect to consider is that it has imposed additional limitation on medical care in rural areas by institutionalizing the public health system relying on mobilization and minimum budget.

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Ferreira, Adilson Cunha, Edward O’Mahony, Antonio Hélio Oliani, Edward Araujo Júnior, and Fabricio da Silva Costa. "Teleultrasound: Historical Perspective and Clinical Application." International Journal of Telemedicine and Applications 2015 (2015): 1–11. http://dx.doi.org/10.1155/2015/306259.

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The health care of patients in rural or isolated areas is challenged by the scarcity of local resources, limited patient access to doctors and hospitals, and the lack of specialized professionals. This has led to a new concept in telemedicine: teleultrasonography (or teleultrasound), which permits ultrasonographic diagnoses to be performed remotely. Telemedicine and teleultrasonography are effective in providing diagnostic imaging services to these populations and reduce health care costs by decreasing the number and duration of hospitalizations and reducing unnecessary surgical procedures. This is a narrative review to present the potential clinical applications of teleultrasonography in clinical practice. The results indicate that although barriers persist for implementing teleultrasonography in a more universal and routine way, advances in telecommunications, Internet bandwidth, and the high resolution currently available for portable ultrasonography suggest teleultrasonography applications will continue to expand. Teleultrasound appears to be a valuable addition to remote medical care for isolated populations with limited access to tertiary healthcare facilities and also a useful tool for education and training.

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Sommer, Jessica, William Macdonald, Caroline Bulsara, and David Lim. "Grunt language versus accent: the perceived communication barriers between international medical graduates and patients in Central Wheatbelt catchments." Australian Journal of Primary Health 18, no. 3 (2012): 197. http://dx.doi.org/10.1071/py11030.

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Due to the chronic shortages of GPs in Australian rural and remote regions, considerable numbers of international medical graduates (IMG) have been recruited. IMG experience many difficulties when relocating to Australia with one of the most significant being effective GP−patient communication. Given that this is essential for effective consultation it can have a substantial impact on health care. A purposive sample of seven practising GPs (five IMG, two Australian-trained doctors (ATD)) was interviewed using a semistructured face-to-face interviewing technique. GPs from Nigeria, Egypt, United Kingdom, India, Singapore and Australia participated. Interviews were transcribed and then coded. The authors used qualitative thematic analysis of interview transcripts to identify common themes. IMG−patient communication barriers were considered significant in the Wheatbelt region as identified by both IMG and ATD. ATD indicated they were aware of IMG−patient communication issues resulting in subsequent consults with patients to explain results and diagnoses. Significantly, a lack of communication between ATD and IMG also emerged, creating a further barrier to effective communication. Analysis of the data generated several important findings that rural GP networks should consider when integrating new IMG into the community. Addressing the challenges related to cross-cultural differences should be a priority, in order to enable effective communication. More open communication between ATD and IMG about GP−patient communication barriers and education programs around GP−patient communication would help both GP and patient satisfaction.

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Talatam, Subash, and Rooha K. "Harnessing New Technologies in Prevention, Diagnosis and Treatment of Cancer Patients in India." International Journal of Science and Healthcare Research 8, no. 3 (July 20, 2023): 62–75. http://dx.doi.org/10.52403/ijshr.20230312.

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Cancer care in India is highly concentrated in urban areas, with limited access to quality care in rural areas. The health and wellbeing of those who have cancer have been severely compromised by the huge gaps in cancer care resulting from the lack of access to early detection and treatment for cancer, the absence of facilities with qualified cancer specialists in rural regions, and the high expense of cancer treatment. India needs to harness emerging technologies to transform the cancer care landscape. The goal of India's cancer screening program is to include screening for breast, cervical, and oral cancers. This can be accomplished through extending the scope of cancer screening programs, constructing additional cancer treatment facilities, and offering financial aid to people who cannot afford medical treatment. Cancer screening aids in early detection and reduces mortality and morbidity. Once diagnosed, the doctor will discuss the treatment options with the patient. A form of cancer treatment called curative care tries to eradicate the disease from the body. The availability and cost of cancer therapy in India are both undergoing a paradigm change as a result of technology. Remote cancer screening and prevention services are accessible through telehealth. In order to increase access to cancer care in India, new hybrid cancer care delivery models have evolved over time. A network of smaller community-based clinics connected to a larger cancer center is offered via the hub-and-spoke approach. This model facilitates in increasing care coordination and cut down on patients' travel expenses and time. India may make major strides in the fight against cancer by following these suggestions. Keywords: Cancer screening, National Cancer Registry, Artificial Intelligence, Curative Care, Immunisation, Hub and spoke model.

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Iurcov, Raluca, Lavinia Maria Pop, Gabriela Ciavoi, and Magdalena Iorga. "Evaluating the Practice of Preventive Behaviors and the Fear of COVID-19 among Dentists in Oradea Metropolitan Area after the First Wave of Pandemic; a Cross-Sectional Study." Healthcare 9, no. 4 (April 9, 2021): 443. http://dx.doi.org/10.3390/healthcare9040443.

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Dental clinics were suspected to be a hotspot for nosocomial transmission of COVID-19 due to the easy spread of the virus. The study investigated the preventive behaviors applied in dentistry settings and the level of fear of COVID-19 infection among dentists. A total of 83 respondents (34.94% male and 63.86% female) were included in the research. Sociodemographic data were collected, together with new institutional and personal rules regarding preventive behaviors. Fear of COVID-19 Scale was used to measure the fear of infection. Data was analyzed using SPSS (v.25, SPSS Inc., Chicago, IL, USA). During the first seven months of confinement, 3.9% of dentists were confirmed with COVID-19 and one fourth treated confirmed positive patients. A quarter of the doctors declared that they had periods when they lived away from home being afraid of transmitting the disease to their family members, and significant data were found in doctors being parents. The closure of dental offices had a negative impact on the financial situation of dentists, especially on those working in rural area offices. Many doctors encountered difficulties in purchasing protective suits and medical supplies, and more than half of the respondents (65.1%, N = 54) focused on the quality of protective suits when purchasing them. More than half of the dentists were trained how to use them. The score for fear of COVID 19 was similar to dentists from other countries. Respondents with chronic diseases were more prone to show higher level of anxiety when following the news and stories related to COVID-19 on TV, media, or social networks. One third of dentists mentioned that they had treated exclusively specific urgent dental problems since the onset of the pandemic and more than 13.3% declared that they refused to provide medical assistance to some specific pathologies because of the fear of infection. The results reflect new challenges and rules adopted by dentists in order to diminish the risk of infection and the impact of pandemic considering their psychological, familial, and financial context. Policymakers and professional associations around may benefit from these findings while formulating guidelines to support dentists during COVID-19 or any future pandemics.

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Barkauskaitė, Marijona, and Daiva Karužaitė. "Problems of (Self-) education Substantiated by Scientific Research." Pedagogika 118, no. 2 (June 10, 2015): 254–67. http://dx.doi.org/10.15823/p.2015.018.

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The scientific community members tend to acknowledge that scientific achievements in educational sciences are much slower compared to other areas. However, it is encouraging that in 2014 responding to the challenges relevant to the system of education, the young researchers of Lithuanian University of Educational Sciences searched for and substantiated solutions to a number of problems employing their original scientific research. In the Committee of Joint Doctoral Studies (Lithuanian University of Educational Sciences, Kaunas University of Technology, Šiauliai University and Lithuanian Sports University) Kęstutis Trakšelys defended his doctoral thesis on the theme: “Education accessibility within the context of the transformation of Lithuanian society (1990–2010)”. The Committee of the Defence Council consisted of the representatives-researchers from the Joint Doctoral Committee and Prof. Dr. Habil. Alicja Šerlong, Director of the Institute of Pedagogy of Wroclaw University (Poland). All the members of the Doctoral Defence Council unanimously emphasized that the emerging processes of transformations in the global world impose specific tasks on the system of education and oblige the school to organize the process of (self-) education in such a way, which satisfies needs of learners, modern society and the epoch. Therefore, the author of the thesis analyzed an urgent research problem identifying links between social transformations and changes in the system of education from the perspective of accessibility, while solving the problem of accessibility of education in the context of social transformations during the period, which was particularly challenging to the system of education in Lithuania (1990–2010). All the members of the Dissertation Defence Council and opponents considered the doctoral thesis “The development of creative writing skills of primary school pupils using interactive whiteboard” by Agnė Saylik as one of the first works in Lithuania, which focuses on development of primary learners’ creative writing skills employing information and communication technologies. The members of the Committee highly evaluated the creativity of the author, i.e., her ability to create original ideas, make insights, manage the collected information, to employ a variety of methods, to cope with a big sample of respondents, to process the data in a reliable way, etc. The members of the Dissertation Defence Council and opponents of the doctoral thesis “Expression and development of the learning to learn competence of the adults improving their qualification” written by Vilija Lukošūnienė unanimously recognized the relevance and particular innovative character of the thesis, which is said to be timely and answering the urgent challenges of today: ability to approach the competence of learning to learn through the prism of multidimensionality, autonomous learning is analyzed, internal and external factors are singled out, which result in the competence of learning to learn, the hypothetic model for development of the adults’ competence of learning to learn was designed. Analyzing the theme “Developing entrepreneurial capacities of pupils in 9th–12th forms applying coaching in technology lessons” and being a professional teacher-practitioner, Oksana Kietavičienė perceived technological education as a continuous process and understood the necessity to integrate teacher’s and learner’s creation as well as their creative ideas and to apply them in practical pedagogical activities. The thesis was evaluated as a timely, relevant and significant scientific study, which enriches educational powers of all the social sciences and educational science in particular, targeting at nurturance of an initiator and a responsible personality, who is capable of creation, rather than on development of an executor. Kristina Viršulienė used the time of her doctoral studies for scientifi research on pedagogical communication and her efforts were finalized by the written doctoral thesis “Student-teachers’ instructional communication skills and their development”. The Chairperson of the Dissertation Defence Council pointed out that the relevance of the theme is obvious as education is a focused development of individual’s powers on the basis of the created interaction. Pedagogical communication is a basic component of the latter and an essential area of teacher’s professional activity. Empirical testing of efficiency of the programme of educational project is one of the main advantages of this doctoral thesis and this is a new contribution to the treasure trove of the educational science. In his defended doctoral thesis “Pedagogical substantiation of social educator’s educational environment enriched with information and communication technologies”, Rokas Gulbinas theoretically and empirically substantiated the educational environment of a special needs teacher enriched with information and communication technologies (ICT) as a prerequisite for fulfilment of special needs teacher’s functions at new quality level. This is a particularly significant empiric study, which contributed to designing of the hypothetic model of special needs teacher’s activity in the educational environment enriched with ICT, which is relevant not only as the construct of development of methodology of quantitative research but also as a model for improvement of special needs teacher’s activity under changing technological conditions. Giedrė Misiūnienė wrote the doctoral thesis “Modelling of socio-educational activities of multifunctional center in rural (territorial) community”, which aimed to substantiate the hypothetic model of socio-educational activity of multifunctional center in rural territorial community. The Dissertation Defence Council highly evaluated the capability and commitment of the young researcher to addressing severe problems of our time, whereof scientific research, substantiation, forecasting as well as strengthening of positive socio-educational activities in rural communities and their dissemination may not only help an individual and the society but also eliminate illiteracy, exclusion and decline in value-based principles. The initiative of the author of the thesis and her academic supervisor to implement one of the fundamental goals of Dr. M. Lukšienė, i.e, to expand the network of rural and basic schools (10 forms), their activity and, thus, to enhance the national identity, culture and the image of the state, is of particular value. This objective is also outlined in the National Education Strategy for 2013–2022; therefore, the scientific interest of the young researcher to model the emerging multifunctional centers is particularly timely and significant. This is the first unique research of such kind in the country. All the doctoral theses discussed above were defended in Lithuanian University of Educational Sciences in 2014 and their authors were conferred the degree of doctor of Social Sciences (Educational Science (07S)).

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et al., Nawaz. "Impact of telecommunication network on future of telemedicine in healthcare: A systematic literature review." International Journal of ADVANCED AND APPLIED SCIENCES 9, no. 7 (July 2022): 122–38. http://dx.doi.org/10.21833/ijaas.2022.07.013.

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Telemedicine is a combination of networking technologies and clinical data. The implementation of telemedicine has enhanced the regional distribution of resources, decreased the workforce of personnel, and shortened the space between healthcare staff and patients. Typically, the specialist doctors are settled and offer their services only in large urban areas. It is pertinent to reduce the imbalance of medical resources between urban and rural areas. The advent of telemedicine has the potential to address this issue. However, current telemedicine has its limitations in terms of data transfer and thus struggles to offer low latency in real-time applications. The recent developments in communication systems offer 5G and above connectivity. This study aims to analyze and synthesize the role of telecommunication networks for potential developments in the field of telemedicine. To this end, a systematic literature review has been conducted to address well-defined research questions. These questions aim to understand the working, flow, scope, and framework of the research area. This review provides an overview of telemedicine, the 5G-based telemedicine framework, and its comparison with the current system. It also discusses how the fast communication network (i.e., 5G and beyond 5G) with devices operating at low latency can revolutionize the healthcare system. Furthermore, a framework for future telemedicine has been provided along with potential application domains. Lastly, challenges and future directions beyond 5G have also been presented.

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Hildebrandt, Helmut. "Rural healthcare kiosks with telemedicine connectivity: Germany starts to offer 1.000 health kiosks within the next years." International Journal of Integrated Care 23, S1 (December 28, 2023): 041. http://dx.doi.org/10.5334/ijic.icic23019.

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A rural healthcare kiosk is an innovative healthcare and social infrastructure for those areas where no physician practices exist and has the goal of not only providing access to healthcare services, but also of preventing social isolation and making possible care, aid to the aged and general welfare. Additionally, the conveyance and development of a digital health competence for the popu-lation is an essential task. A network of healthcare kiosks can provide local inhabitants a first point of contact directly in the rural area of districts in Thuringia, Germany which have limited access to medical care. They serve as points of information, advice and navigation, as a social infrastructure and as preventative healthcare for rural localities and villages, as well as mediators and problem solvers for outpatient care, medical services and nursing. In combination with community care outreach, healthcare kiosks fill the holes in provision of care in extensive rural areas. The first rural healthcare kiosk was built and opened in 2022 in the Unstrut-Hainich district. The organization “Gesundes Landleben GmbH” owned by a local foundation and OptiMedis guides and administers the care for residents through this healthcare kiosk. Through a telemedi-cine link with cooperating doctor’s offices and clinics, residents can have their vital medical data taken at healthcare kiosks and then, using an easily serviced device, securely conveyed to partici-pating medical providers. Implementation has taken place so the first results can be reported to ICIC 2023. Local stakehold-ers are already involved in this on-going project. Additionally, this provision of care should be linked with further new forms of care and consultation in order to provide the best-possible enhancement to local healthcare competence and quality of care, while simultaneously avoiding unnecessary waste of time for patients and healthcare providers. Note: OptiMedis founded as well the first health kiosk in Germany in a deprived urban area in Hamburg and reported on it at the ICIC conference in Dublin in 2017. Today the ministry of health in Germany announced that up to 1.000 health kiosks will be opened in Germany during the next years.

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Casey, Mavourneen G., Michael David, and Diann Eley. "Diversity and consistency: a case study of regionalised clinical placements for medical students." Australian Health Review 39, no. 1 (2015): 95. http://dx.doi.org/10.1071/ah14033.

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Objective A major challenge for medical schools is the provision of clinical skills training for increasing student numbers. This case study describes the expansion of the clinical school network at The University of Queensland (UQ). The purpose of the study was to investigate consistency in medical education standards across a regional clinical teaching network, as measured by academic performance. Methods A retrospective analysis of academic records for UQ medical students (n = 1514) completing clinical rotations (2009–2012) was performed using analysis of covariance (ANCOVA) for comparisons between clinical school cohorts and linear mixed-effects modelling (LEM) to assess predictors of academic performance. Results In all, 13 036 individual clinical rotations were completed between 2009 and 2012. ANCOVA found no significant differences in rotation grades between the clinical schools except that Rural Clinical School (RCS) cohorts achieved marginally higher results than non-RCSs in the general practice rotation (5.22 vs 5.10–5.18; P = 0.03) and on the final clinical examination (objective structured clinical examination; 5.27 vs 5.01–5.09; P < 0.01). LEM indicated that the strongest predictor of academic performance on clinical rotations was academic performance in the preclinical years of medical school (β = 0.38; 95% confidence interval 0.35–0.41; P < 0.001). Conclusions The decentralised UQ clinical schools deliver a consistent standard of clinical training for medical students in all core clinical rotations across a range of urban, regional and rural clinical settings. Further research is required to monitor the costs versus benefits of regionalised clinical schools for students, local communities and regional healthcare services. What is known about the topic? To help meet the demand of increasing numbers of students, Australian medical schools locate clinical training outside the traditional tertiary hospitals. However the viability of maintaining teaching standards across regional and rural locations is uncertain. What does this paper add? Maintaining teaching standards outside established urban teaching hospitals and across a diverse range of urban, regional and rural clinical settings is viable. What are the implications for practitioners? Decentralised clinical teaching networks provide consistent quality of clinical placements while diversifying exposure to different patient populations and clinical environments. These important outcomes may not only alleviate the strain on clinical teaching resources, but also help address the maldistribution of doctors in Australia.

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Liao, Li, Jiahao Feng, Xi Fu, Lifang Cao, Min Fan, Cheng Huang, Jun Zhang, Lin Zhang, Peng Chen, and Fengming You. "Comparison between Traditional Chinese Medicine Constitution and Blood Biochemical Markers Associated with Left and Right Mammary Hyperplasia in Rural Areas of Southwest China." Journal of Healthcare Engineering 2022 (March 23, 2022): 1–12. http://dx.doi.org/10.1155/2022/9274060.

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Background. Hyperplasia of mammary glands (HMG) is the breast disease with the highest clinical incidence. Many traditional Chinese medicine (TCM) doctors suggest that the treatment of HMG should be based on the left and right breast pain difference. However, these views are based on case reports, and an objective basis has not been established for treatment according to left-side and right-side differences. Methods. We enrolled 150 patients who met the clinical diagnostic criteria of HMG. The incidence bias was determined according to the score difference between bilateral breast pain and mass in patients with HMG. A left group, right group, and bilateral group were included, and TCM constitution was investigated in each group. Blood biochemical indicators were measured for 120 fasting patients. We conducted a network pharmacology study of the key herb qingpi and chenpi, which are used by TCM doctors to treat different lateral HMG. Results. In patients with biased onset of HMG, the results showed that the frequency and constitution score of stagnant blood in the L group were higher than those of the R group, and the frequency and constitution score of phlegm-dampness in the R group were higher than those of the L group. Both the L and R groups had high proportion of stagnant Qi. The results indicated that the concentration of coagulation factor VIII (FVIII) was higher in the L group than that in the R group, and the concentration of lipoprotein a (Lp-α) was higher in the R group than that in the L group. The results showed that sinensetin and neohesperidin contained in qingpi might interfere with platelet activation, thrombogenesis, prolactin signaling pathway, and atherosclerosis process, in removing “blood stasis” and eventually treating the left-leaning group of HMG patients. Sitosterol and citromitin contained in chenpi could regulate lipid metabolism by interfering with regulation of lipolysis in adipocytes, salivary secretion, estrogen signaling pathway, and thyroid hormone signaling pathway. Chenpi could eliminate “phlegm turbidity” and treat HMG patients in the right-leaning group. Conclusions. We preliminarily confirmed that the clinical pathogenesis of HMG is not a left-right equilibrium and TCM constitution, coagulation function, and lipid metabolism may be used as the objective basis for the difference between the left and right in HMG pathogenesis. For left-sided HMG patients, the doctor can consider qingpi, herb of activating blood and removing stasis, to treat HMG. However, for right-sided HMG, we think doctors should apply herb of activating Qi and eliminating phlegm, such as chenpi.

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Choi, WooSung, YongSu Lim, Tag Heo, SungMin Lee, Won Kim, Sang-Chul Kim, YeonWoo Kim, et al. "Characteristics and Effectiveness of Mobile- and Web-Based Tele-Emergency Consultation System between Rural and Urban Hospitals in South Korea: A National-Wide Observation Study." Journal of Clinical Medicine 12, no. 19 (September 28, 2023): 6252. http://dx.doi.org/10.3390/jcm12196252.

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(1) Background: The government of South Korea has established a nationwide web- and mobile-based emergency teleconsultation network by designating urban and rural hospitals. The purpose of this study is to analyze the characteristics and effectiveness of the tele-emergency system in South Korea. (2) Methods: Tele-emergency consultation cases from May 2015 to December 2018 were analyzed in the present study. The definition of a tele-emergency in the present study is an emergency consultation between doctors in rural and urban hospitals via a web- and mobile-based remote emergency consultation system (RECS). Consultations through an RECS are grouped into three categories: medical procedure or treatment guidance, image interpretation, and transportation requests. The present study analyzed the characteristics of the tele-emergency system and the reduction in unnecessary transportation (RUT). (3) Results: A total of 2604 cases were analyzed in the present study from 2985 tele-emergency consultation cases. A total of 381 cases were excluded for missing data. Consultations for image interpretation were the most common in trauma cases (71.3%), while transfer requests were the most common in non-trauma cases (50.3%). Trauma patients were more frequently admitted to rural hospitals or discharged and followed up with at rural hospitals (20.3% vs. 40.5%) after consultations. In terms of disease severity, non-severe cases were statistically higher in trauma cases (80.6% vs. 59.4%; p < 0.001). The RUT was statistically highly associated with trauma cases (60.8% vs. 42.8%; p < 0.001). In an analysis that categorized cases by region, a statistically higher proportion of transportation was used in island regions (69.9% vs. 49.5%; p < 0.003). More RUT was associated with non-island regions (30.1% vs. 50.5%; p = 0.001). (4) Conclusions: The tele-emergency system had a great role in reducing unnecessary patient transportation in non-severe trauma cases and non-island rural area emergency cases. Further research is needed for a cost/benefit analysis and clinical outcomes.

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Tsys, V. V. "Formation of System of Medical Institutions in Tobolsk North in XIX — Early XX Centuries." Nauchnyi dialog 11, no. 2 (March 19, 2022): 497–512. http://dx.doi.org/10.24224/2227-1295-2022-11-2-497-512.

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The history of the creation and development of the system of medical institutions on the territory of the Tobolsk North (within the modern borders — the Khanty-Mansiysk and Yamalo-Nenets Autonomous Okrugs) in the pre-revolutionary period is studied. It is noted that since the mid-1830s, a network of medical centers has been organized in the region: three hospitals, up to a dozen paramedical stations, medical barracks in fishing fields and steamship piers. The state played the main role in this. It financed medical institutions, provided personnel, necessary equipment and medicines, regulated activities through legislation and by-laws, and controlled the organization of medical care by entrepreneurs. Particularly rapid growth in the network of hospitals and feldsher stations was observed at the end of the 19th and beginning of the 20th centuries, which was facilitated by the involvement of the region in market relations, the intensification of the resettlement process, and the implementation of the legislative act of May 10, 1888 “On the arrangement of a rural medical unit in the provinces of Tobolsk and Tomsk”. It is indicated that in matters of providing medical care, the indigenous population was in a privileged position in comparison with the Russians, since they received it free of charge. Difficulties in creating a system of modern medical institutions in the Tobolsk North were noted: a shortage of personnel not only for doctors, but also for paramedical personnel, especially in rural areas; the extreme dispersion and rarity of villages, which made it difficult to regularly monitor the health of local residents, the slow pace of modernization. It is concluded that the opinion about the extremely low level of development of medicine in the region is not fully fair.

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Otgon, Saranchuluun, Khorolsuren Lkhagvasuren, Yerkebulan Mukhtar, Anujin Baatar, Casati Fabio, Agnieszka Czajka, and Sugarmaa Myagmarjav. "THE DETERMINANTS OF LIFE SATISFACTION AMONG MONGOLIAN OLDER ADULTS." Innovation in Aging 6, Supplement_1 (November 1, 2022): 748. http://dx.doi.org/10.1093/geroni/igac059.2719.

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Abstract Background As the average life expectancy and the proportion of the elderly population increases, approaches that limit their policies, programs, and activities to health issues are changing worldwide. International organizations, such as the WHO, United Nations, have pledged their member countries to update their policies on the elderly population and increase their psychological and social participation over the next 20 years. We determined social demographic factors of life satisfaction among Mongolian older adults. Methods A cross-sectional study recruited three hundred four older adults recruited by geriatric doctors and seniors’ association units in urban and rural areas of Mongolia. The questionnaire included life satisfaction, social network, loneliness, social participation, self-rated health, and demographics. We used multiple linear regression analyses. Result: Life Satisfaction of the older adults living in urban is higher than those living in rural area (β = 0.954, p = 0.001). Good self-rate of health (β = 1.013 p = 0.001), voluntary work (β = 0.847 p = 0.001), and employment increase life satisfaction levels. Life satisfaction scores increased by 0.3 points for male older adults with a 1-point increase in education, 0.9 points for women living in cities (β = 0.929 p = 0.002), and 0.8 points for volunteering (β=0.790 p=0.006) respectively. However, when the loneliness score increases by one, the satisfaction score decreases by 0.3 points (β = -0.353 p = 0.013). Conclusions: The level of satisfaction of the Mongolian older adults is associated with self-rate of health, education level, loneliness, social activities, and living areas.

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Costa, Me Tiago Pereira da, Dra Lúcia Marisy Souza Ribeiro de Oliveira, and Aurivan Santana da Silva. "Agroka’atinga System in the Brazilian Semiarid Region." International Journal of Advanced Engineering Research and Science 9, no. 10 (2022): 473–82. http://dx.doi.org/10.22161/ijaers.910.52.

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This article is part of the doctoral thesis entitled “The IRPAA and the Snap of Coexistence with the Semiarid Region as a Paradigm and Political Project in the Optics of Good Living”. bring the results obtained in experiments carried out at Escolas Famílias Agrícolas (EFAs), with emphasis on to the school located in the municipality of Sobradinho, state of Bahia/Brazil, serving the young family farmers in the region. In addition to the Alternation methodology used in this modality of teaching community and contextualized education, it was approached here the experience of the Network of Integrated Agricultural Family Schools in the Semi-Arid Region (REFAISA) in the formation of rural youth, especially from traditional communities of pasture, extractivists, agrarian reform settlers, riverside communities, quilombolas and peasant communities, introducing the Technical and Educational Program called Agroka’atinga for Sustainable Agriculture and Market Access, in five Schools Agricultural Families and on fifteen family properties in the states of Bahia and Sergipe. In this context, the EFAs inserted in their teaching-learning process, an approach on climate change, which causes lower thermal amplitude and changes in the pattern precipitation, favoring the appearance of extreme events, such as droughts, prolonged periods and increase in temperature, which will affect the production of some crops agricultural activities, demanding different attitudes and behaviors from populations, based on new paradigms (focus of the doctoral thesis), both in production systems and in the conscious consumption and marketing, ensuring socio-environmental sustainability and of technological innovations that promote the resilience of the Caatinga biome to changes climate change, resulting in the creation of the Agroka’atinga concept in the Brazilian semiarid region.

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Piryani, R. M., and R. S. Poudel. "Necessity of strengthening neurology services in Nepal." Journal of Chitwan Medical College 5, no. 2 (August 14, 2015): 50. http://dx.doi.org/10.3126/jcmc.v5i2.13158.

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Dear Editor,Stroke, head injuries and epilepsy are common neurological problems reported worldwide including Nepal. Nepal also bears the burden of nervous system infection such as meningitis, cerebral malaria, Japanese B encephalitis. The average life expectancy of Nepalese population has increased noticeably in the last twelve years; hence it may lead to increase in age related neurological conditions such as dementia, Parkinson disease. Because of poor road condition, rapidly increasing number of two- wheelers, disorganized traffic pattern, and lack of driving discipline in Nepal, motor vehicles accidents are on rise, so the head injuries too. The accompanied person along for the ride on two- wheel vehicles are not required to wear helmet and passengers in four wheelers avoid using safety belts are at risk. Moreover, the implementation of legislation to prevent driving in drunken state is limited.Presently some of the government hospitals, private medical college teaching hospitals and corporate sector hospitals located in urban areas provide neurological services. However, a large number of patients of sub-urban and rural areas having common neurological aliments have limited access. Ignorance, illiteracy, limited resources, negative attitude, discrimination, faith on traditional healers and weak economical status may be the limiting factor to access. Establishing neurological services network with public private partnership and use of latest technology may improve care and delivery of neurological services in country. At the same time government need to 1) motivate, encourage and facilitate young doctors to get training in neurosurgery and neuromedicine, 2) invest in infrastructure development, 3) create awareness among public especially of suburban and rural areas and 4) promote research.These approaches may improve quality of care and service delivery.SincerelyDr. Rano Mal Piryani- Prof of Medicine and Medical Education, Chitwan Medical CollegeMr. Ramesh Sharma Poudel- Pharmacist, Pharmacy, Chitwan Medical College Teaching Hospital

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Banovcinova, Andrea. "The importance of social capital in the community to meet the needs of a family with a disabled child." SHS Web of Conferences 85 (2020): 03001. http://dx.doi.org/10.1051/shsconf/20208503001.

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The birth, education and care of a disabled child can negatively affect not only the life and functioning of individual members but also the family as a whole. An important role in assisting and supporting families with disabled children can be played by the community and its social capital, including both formal and informal social networks and the sources of support, the relationships that families have built up. The aim of the research was to find out how the parents of a child with disabilities reflect the importance of the community for their family, with an emphasis on meeting the child's needs. A qualitative research strategy has been used to achieve the goal. The method of data collection was a semi-structured interview. The research file was made up of parents of children with disabilities. The results highlight the importance of an informal social network for the family, which includes a wider family, organizations operating in the third sector to help children with disabilities and their families. One of the most significant obstacles perceived by parents is the poor spatial availability of the organization, which is particularly evident in the rural environment, and also poor awareness of the possibilities of helping and supporting the family. From formal resources, parents particularly perceived the importance of doctors and medical staff.

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Vautrin, Hanna, Nicolas Senn, and Christine Cohidon. "Primary prevention of sexually transmitted infections in Switzerland: practices of family physicians and their determinants—a national cross-sectional survey." BMJ Open 10, no. 9 (September 2020): e032950. http://dx.doi.org/10.1136/bmjopen-2019-032950.

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ObjectivesTo describe the activities of general practitioners (GPs) pertaining to primary prevention in the field of affective and sexual life, studying the advice they provide as well as their vaccination practices.DesignCross-sectional national survey.Setting/participantsThe study was carried out using the Swiss Primary Care Active Monitoring GPs’ network, a national GP network created in 2012. One hundred and seventy Swiss GPs, from a random sample from professional lists stratified by canton, participated in the present study.Primary and secondary outcome measuresPrevention practices against sexually transmitted infections (STIs) performed by GPs through advice provided as well as their vaccination practices. Predictive factor of these practices through their links with the doctors’ relevant characteristics and their opinions about STI prevention.ResultsApproximately 80% consider prevention in the area of affective and sexual life to be part of their duty and discuss it easily with patients. Most of them spontaneously give advice regarding STIs during a routine consultation. Regarding human papillomavirus (HPV) immunisation in adults, almost half of GPs report never doing it, while almost 75% often or always immunise their adult patients against hepatitis B. Higher numbers of consultations per day are associated with vaccinating more adults against HPV (OR 1.13 (1.05 to 1.23)) and against hepatitis A (OR 1.17 (1.05 to 1.31)). Vaccinating children against hepatitis B is associated with practising in rural areas (OR 4.64 (1.20 to 17.98)). GPs practising in the French-speaking region of Switzerland immunise children less against HPV (OR 0.40 (0.20 to 0.80)). Longer consultations are associated with providing advice on affective and sexual life during a first consultation (OR 1.08 (1.01 to 1.14)).ConclusionSwiss GPs are involved in primary prevention against STIs and consider it as their responsibility. Prevention practices are associated with GPs’ favourable opinions on prevention.

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Iftikhar, Shagufta, Iqra Naz, Anmol Zahra, and Syeda zainab Yousuf Zaidi. "Report Generation of Lungs Diseases From Chest X-ray using NLP." Vol 3 Issue 5 3, no. 5 (February 26, 2022): 223–33. http://dx.doi.org/10.33411/ijist/2021030518.

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Pulmonary diseases are very severe health complications in the world that impose a massive worldwide health burden. These diseases comprise of pneumonia, asthma, tuberculosis, Covid-19, cancer, etc. The evidences show that around 65 million people undergo the chronic obstructive pulmonary disease and nearly 3 million people pass away from it each year that make it the third prominent reason of death worldwide. To decrease the burden of lungs diseases timely diagnosis is very essential. Computer-aided diagnostic, are systems that support doctors in the analysis of medical images. This study showcases that Report Generation System has automated the Chest X-Ray interpretation procedure and lessen human effort, consequently helped the people for timely diagnoses of chronic lungs diseases to decrease the death rate. This system provides great relief for people in rural areas where the doctor-to-patient ratio is only 1 doctor per 1300 people. As a result, after utilizing this application, the affected individual can seek further therapy for the ailment they have been diagnosed with. The proposed system is supposed to be used in the distinct architecture of deep learning (Deep Convolution Neural Network), this is fine tuned to CNN-RNN trainable end-to-end architecture. By using the patient-wise official split of the OpenI dataset we have trained a CNN-RNN model with attention. Our model achieved an accuracy of 94%, which is the highest performance.

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Aggarwal, Ritu, and Suneet Kumar. "Classification Model for Meticulous Presaging of Heart Disease Detection through SDA and NCA using Machine learning :CMSDANCA." International Journal on Recent and Innovation Trends in Computing and Communication 10, no. 1s (December 10, 2022): 217–24. http://dx.doi.org/10.17762/ijritcc.v10i1s.5827.

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For the design and implementation of CDSS, computation time and prognostic accuracy are very important. To analyze the large collection of a dataset for detecting and diagnosis disease ML techniques are used. According to the reports of World Health Organizations, HD is a major cause of death and killer in urban and rural areas or worldwide. The main reason for this is a shortage of doctors and delay in the diagnosis. In this research work, heart disease is a diagnosis by the data mining techniques and used the clinical parameters of patients for early stages diagnosis. The intend of this learning to develop a representation that relies on the prediction method for coronary heart disease. This proposed work used the approach of self-diagnosis Algorithm, Fuzzy Artificial neural network, and NCA & PCA and imputation methods. By the use of this technique computation time for prediction of Coronary HD can be reduced. For the implementation of this the two datasets are using such as Cleveland and Statlog datasets that is collected from the UCI kaggle the ML repository. The datasets for the disease prediction measure are used to accurately calculate the difference between variables and to determine whether they are correlated or not. For this classification model, the performance measure is calculated in requisites of their accuracy, precision, recall, and specificity. This approach is evaluated on the heart disease datasets for improving the accuracy performance results obtained. The outcome for KNN+SDA+NCA+FuzzyANN for Cleveland dataset accuracy achieved 98.56 %.and for Statlog dataset 98.66 %..

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Metelmann, Camilla, Bibiana Metelmann, Dorothea Kohnen, Clara Prasser, Rebekka Süss, Julia Kuntosch, Dirk Scheer, et al. "Evaluation of a Rural Emergency Medical Service Project in Germany: Protocol for a Multimethod and Multiperspective Longitudinal Analysis." JMIR Research Protocols 9, no. 2 (February 14, 2020): e14358. http://dx.doi.org/10.2196/14358.

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Background German emergency medical services are a 2-tiered system with paramedic-staffed ambulances as the primary response, supported by prehospital emergency doctors for life-threatening conditions. As in all European health care systems, German medical practitioners are in short supply, whereas the demand for timely emergency medical care is constantly growing. In rural areas, this has led to critical delays in the provision of emergency medical care. In particular, in cases of cardiac arrest, time is of the essence because, with each passing minute, the chance of survival with good neurological outcome decreases. Objective The project has 4 main objectives: (1) reduce the therapy-free interval through widespread reinforcement of resuscitation skills and motivating the public to provide help (ie, bystander cardiopulmonary resuscitation), (2) provide faster professional first aid in addition to rescue services through alerting trained first aiders by mobile phone, (3) make more emergency physicians available more quickly through introducing the tele-emergency physician system, and (4) enhance emergency care through improving the cooperation between statutory health insurance on-call medical services (German: Kassenärztlicher Bereitschaftsdienst) and emergency medical services. Methods We will evaluate project implementation in a tripartite prospective and intervention study. First, in medical evaluation, we will assess the influences of various project measures on quality of care using multiple methods. Second, the economic evaluation will mainly focus on the valuation of inputs and outcomes of the different measures while considering various relevant indicators. Third, as part of the work and organizational analysis, we will assess important work- and occupational-related parameters, as well as network and regional indexes. Results We started the project in 2017 and will complete enrollment in 2020. We finished the preanalysis phase in September 2018. Conclusions Overall, implementation of the project will entail realigning emergency medicine in rural areas and enhancing the quality of medical emergency care in the long term. We expect the project to lead to a measurable increase in medical laypersons’ individual motivation to provide resuscitation, to strengthen resuscitation skills, and to result in medical laypersons providing first aid much more frequently. Furthermore, we intend the project to decrease the therapy-free interval in cases of cardiac arrest by dispatching first aiders via mobile phones. Previous projects in urban regions have shown that the tele-emergency physician system can provide a higher availability and quality of emergency call-outs in regular health care. We expect a closer interrelation of emergency practices of statutory health insurance physicians with the rescue service to lead to better coordination of rescue and on-call services. International Registered Report Identifier (IRRID) DERR1-10.2196/14358

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Hills, Danny J. "Differences in risk and protective factors for workplace aggression between male and female clinical medical practitioners in Australia." Australian Health Review 41, no. 3 (2017): 313. http://dx.doi.org/10.1071/ah16003.

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Objectives The aim of the present study was to investigate differences in prevalence, as well as risk and protective factors, for exposure to workplace aggression between male and female clinicians in Australian medical practice settings. Methods In a cross-sectional, self-report study in the third wave of the Medicine in Australia: Balancing Employment and Life survey (2010–11), 16 327 medical practitioners were sampled, with 9449 (57.9%) respondents working in clinical practice. Using backward stepwise elimination, parsimonious logistic regression models were developed for exposure to aggression from external (patients, patients’ relatives or carers and others) and internal (co-workers) sources in the previous 12 months. Results Overall, greater proportions of female than male clinicians experienced aggression from external (P < 0.001) and internal (P < 0.01) sources in the previous 12 months. However, when stratified by doctor type, greater proportions of male than female general practitioners (GPs) and GP registrars experienced external aggression (P < 0.05), whereas greater proportions of female than male specialists experienced external (P < 0.01) and internal (P < 0.01) aggression. In logistic regression models, differences were identified in relation to age for males and experience working in medicine for females with external and internal aggression; working in New South Wales (vs Victoria) and internal aggression for females; a poor medical support network and external aggression, and perceived unrealistic patient expectations with internal aggression for males; warning signs in reception and waiting areas with external aggression for males; and optimised patient waiting conditions with external and internal aggression for females. Conclusions Differences in risk and protective factors for exposure to workplace aggression between male and female clinicians, including in relation to state and rural location, need to be considered in the development and implementation of efforts to prevent and minimise workplace aggression in medical practice settings. What is known about the topic? Workplace aggression is prevalent in clinical medical settings, but there are conflicting reports about sex-based differences in the extent of exposure, and little evidence on differences in risk and protective factors for exposure to workplace aggression. What does this paper add? Differences in workplace aggression exposure rates between male and female clinicians are highlighted, including when stratified by doctor type. New evidence is reported on differences and similarities in key personal, professional and work-related factors associated with exposure to external and internal aggression. What are the implications for practitioners? In developing strategies for the prevention and minimisation of workplace aggression, consideration must be given to differences between male and female clinicians, including with regard to personality, age and professional experience, as well as work locations, conditions and settings, as risk or protective factors for exposure to aggression in medical work.

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Makhmudova, Mukhabbat Madirimovna. "STUDYING THE HISTORY OF THE DEVELOPMENT OF THE HEALTHCARE SYSTEM IN UZBEKISTAN DURING THE YEARS OF INDEPENDENCE." CURRENT RESEARCH JOURNAL OF HISTORY 02, no. 05 (May 30, 2021): 31–36. http://dx.doi.org/10.37547/history-crjh-02-05-10.

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The article briefly highlights the history of the study of the health problem by Uzbek scientists in a certain period of time. The works of the authors are divided into groups based on their quality, nature and focus. Monographic and dissertation research is especially highlighted. Used methods of chronological and comparative analysis, particular attention is paid to the study of orientalists of Uzbekistan and publications of foreign authors. It is recognized that as a result of the implementation of the results of dissertation research by individual authors, there is an optimization of the structure of health care authorities and a decrease in the level of disease in the population. Over the years of independence, a health care reform program has been implemented. Much has been done to improve its quality and culture of timeliness and efficiency. A network of urgent emergency care, rural medical outpatient clinics and city polyclinics, multidisciplinary specialized clinics, scientific centers has been created. Medical care for women and children of the country is provided at the level of world standards, personnel training is carried out in 14 medical universities and one pharmaceutical institute, in 85 medical colleges. Advanced training and retraining of medical personnel is carried out in universities and an advanced training institute. At present, it is one of the most important branches of the country’s national economy. As a result of socio-economic and medical measures in Uzbekistan, medical care has become universal and publicly available, such dangerous diseases as cholera, plague, smallpox, parasitic typhus, trachoma have been eliminated, and the incidence of many others has been reduced. Over the past 10 years, the incidence of the population with such socially dangerous ailments as congenital defects by 32.4%, infectious diseases by 40%, the incidence of the upper respiratory tract has decreased by 4.2 times. The incidence of diphtheria, paratyphoid fever, poliomyelitis, malaria has been completely eradicated [1]. The health care system employs about 650 thousand people (this is almost 10 percent of the able-bodied population of the republic), including more than 84 thousand doctors and 500 thousand paramedical workers. An extensive network of medical institutions in Uzbekistan is capable of providing the necessary medical and preventive care to the entire population.

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Trivedy, Chet, Vijaykumar Tate, Sheetal Kolhe, Vishal Gadre, and Anish Andheria. "109 Access to emergency health care in tiger reserves in the central Indian landscape. lessons for global emergency care." Emergency Medicine Journal 37, no. 12 (November 23, 2020): 848.1–848. http://dx.doi.org/10.1136/emj-2020-rcemabstracts.46.

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Aims/Objectives/BackgroundForest staff working in remote locations are at high risk of life-threatening emergencies; including major trauma and snakebites. Timely access to appropriate emergency care is pivotal to life-saving treatment. This is the first study to systematically map public health facilities (PHFs) around tiger reserves (TRs) in central Indian state of Maharashtra.Methods/DesignUsing publically available data; GPS coordinates, medical staff, and services were identified for PHFs in increasing order of specialism; including Primary Healthcare Centre (PHC), Community Health Centre (CHC), Sub-district Hospital (SDH) and District Hospital (DH). GIS Network Analysis was used to identify the nearest PHFs in relation to the access points of eight TRs; and the shortest distance by road and corresponding travel time by vehicle were calculated.Results/ConclusionsOf all PHFs, 87.5% offered basic emergency care, while only 54% offered radiology services. Of all trauma beds 99.9% were placed at DH level; along with 89% of all MBBS trained doctors. Only 28.6% of TR exit points had access to emergency ambulance service based within 30 minutes.Abstract 109 Table 1Average distance and time to access the nearest PHFType of Health Facility (n=96)Average distance from a TR access point to the nearest PHF in KilometersAverage time to reach the nearest PHF in minutes by a carPHC (38.5%)12.3 ± 8.6 (0.7–39.4) 24 ±17 (1–79) CHC (26%)24.9 ±12.4 (2.5–61.6) 47 ± 25 (5–123) SDH (13.5%)42 ±15.8 (4.7–80.9) 82 ± 32 (8–162) DH (22%)65.4 ± 28.9 (11.7–137.2) 126 ± 57 (23–235) ConclusionThis study highlight the challenges of providing emergency healthcare in low- and middle-income countries and the urgent need for greater resources and infrastructure to support the delivery of emergency care for frontline forest staff in rural areas. Further work in progress to look at the provision of emergency care in remote settings.

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Journal articles on the topic 'NSW Rural Doctors Network'

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