Rural Groups Research Articles

Dental caries lesions and impact on quality of life in adolescents living in urban and rural areas. A case study.

The concept of quality of life (QoL) developed from early studies on subjective wellbeing and satisfaction with life, interpreted as resulting from living conditions, and recognized by means of objective indicators. Indicators have been developed and validated to measure the relationship between quality of life and health Aim: To determine, during an Educational Social Practice, the association between presence of dental caries lesions and its impact on quality of life of adolescents living in rural and urban areas in Argentina. Materials and Method: This was an observational cross-sectional study in (a) a rural area (Tres Isletas; Chaco Province/Schools No. 601 and 477) and (b) an urban area (Villa Soldati; Buenos Aires City/Nuestra Sra. Fátima School). The sample included 40 students from the urban area (UG) and 30 from the rural area (RG). A calibrated researcher (Kappa 0.80) collected the survey data and performed the clinical examinations. The following were recorded: (a) sociodemographic distribution in terms of age and gender; (b) presence of dental biofilm according to Silness and Löe; caries lesions according to ICDAS II /INTCy criteria, and (d) DMFT, total and per component. Quality of life was assessed using the CPQ 11-14r. Statistical processing included calculation of frequency distribution of the variables (X± DS), and chi-square and Mann-Whitney tests to calculate association and comparisons between groups. Results: The sample included 47 girls (67.1%) and 23 boys (32.9%). Distribution according to sex and age did not differ significantly between sites (UG:12.9 years ± 0.5 and RG:11.8 years ±1.1). No significant difference was found between sites for a) plaque biofilm (p=0.759); b) DMFT, total value and per component, or c) individual and grouped ICDAS scores. Percentage analysis of the CPQr 1-14 scores showed significant differences between groups for questionnaire total scores (26.9% ± 2.2 in UG and 4.1% ± 0.8 in RG) and for the different domains. Conclusion: Perceived impact on quality of life caused by dental caries lesions was significantly higher in urban than the rural group, although neither the dental caries process nor the amount of biofilm differed significantly between groups.

Internet use, income mobility and the expansion of the rural middle-income group: Evidence from China

The expansion of the rural middle-income group has been a global focus as it contributes to narrowing income gaps and reducing social inequality. Using data from the China Family Panel Studies (CFPS), this study examines the impact of Internet use on the mobility of rural low-income groups to the middle-income group from the perspective of income mobility. Controlling for household and provincial-level variables, the results of this study indicate that Internet use significantly promotes the mobility of rural low-income groups to the middle-income group, thereby facilitating the expansion of the rural middle-income group. These conclusions hold even after conducting endogeneity and robustness tests. Mechanism analysis shows that household entrepreneurship and non-agricultural employment are crucial pathways through which Internet use facilitates the mobility of rural low-income groups to middle-income groups. Further investigation shows that mobility from rural low-income to middle-income groups is more difficult in central-western regions and among those with lower levels of education. Internet use exacerbates the “digital divide” between different areas and education groups. In particular, the effect of Internet use in promoting mobility from rural low-income to middle-income groups is more pronounced in the eastern regions and among those with higher levels of education. The results of this study provide new evidence on the role of Internet use in expanding the rural middle-income group.

Improving malaria case management with artemisinin-based combination therapies and malaria rapid diagnostic tests in private medicine retail outlets in sub-Saharan Africa: A systematic review.

Private medicine retailers (PMRs) such as pharmacies and drug stores account for a substantial share of treatment-seeking for fever and malaria, but there are widespread concerns about quality of care, including inadequate access to malaria rapid diagnostic tests (RDTs) and artemisinin-based combination therapies (ACTs). This review synthesizes evidence on the effectiveness of interventions to improve malaria case management in PMRs in sub-Saharan Africa (PROSPERO #2021:CRD42021253564). We included quantitative studies evaluating interventions supporting RDT and/or ACT sales by PMR staff, with a historical or contemporaneous control group, and outcomes related to care received. We searched Medline Ovid, Embase Ovid, Global Health Ovid, Econlit Ovid and the Cochrane Library; unpublished studies were identified by contacting key informants. We conducted a narrative synthesis by intervention category. We included 41 papers, relating to 34 studies. There was strong evidence that small and large-scale ACT subsidy programmes (without RDTs) increased the market share of quality-assured ACT in PMRs, including among rural and poorer groups, with increases of over 30 percentage points in most settings. Interventions to introduce or enhance RDT use in PMRs led to RDT uptake among febrile clients of over two-thirds and dispensing according to RDT result of over three quarters, though some studies had much poorer results. Introducing Integrated Community Case Management (iCCM) was also effective in improving malaria case management. However, there were no eligible studies on RDT or iCCM implementation at large scale. There was limited evidence that PMR accreditation (without RDTs) increased ACT uptake. Key evidence gaps include evaluations of RDTs and iCCM at large scale, evaluations of interventions including use of digital technologies, and robust studies of accreditation and other broader PMR interventions.

Sectoral impacts of climate change in Iran: A dynamic analysis with emphasis on agriculture

Iranian agriculture, the largest consumer of water, is highly vulnerable to sever climate change-induced droughts. This study aimed to analyze the impact of climate change on various sectors, with a focus on agricultural output and gross domestic product (GDP). To achieve this, a dynamic Computable General Equilibrium (CGE) model incorporating a climate damage function was utilized to project the consequences of climate change on various sectors of Iran's economy. The damage function is based on the temperature anomaly. This study simulated the impact of shocks caused by climate scenarios by 2060. The modified Social Accounting Matrix served as the primary dataset for CGE modeling. By simulating climate scenarios up to 2060, the findings indicated that certain agricultural products, such as cereals and livestock, have the potential for an annual output expansion of 2–3.5 % under the most severe climatic scenarios. This expansion is attributed to their lower reliance on capital inputs and their increased final demand for agricultural commodities. Conversely, the growth rates of output expansion and final demand for services products are lower than those for agricultural products. With climate change options, there may be a shift in output composition, favoring crops, agricultural industries, and energy products, while the growth of services output remains comparatively lower. The GDP growth path also deviates from the current path of 1.8 %, reaching rates of 1.5–1.7 %. In the most restrictive scenario, the GDP is projected to decline in the mid-2050s. Similarly, the range for consumption growth is estimated to be 1.8–2.1 %. Climate change does not significantly alter the income distribution within rural and urban income groups. However, it exacerbates rural-urban inequality by favoring urban households with higher consumption levels. The current state of the Iranian economy, especially the agricultural sector, faces increased vulnerability due to climate change. Nevertheless, certain agricultural activities may experience a relatively greater increase in output because of the growing demand for these products.

Malnutrition and intestinal parasitosis: Current prevalences and risk factors among schoolchildren in Misiones (Argentina).

To assess the current prevalences of nutritional status and intestinal parasites, and their potential association with socio-environmental conditions among schoolchildren in Aristóbulo del Valle, Misiones. We measured body weight and height in 444 schoolchildren aged 3-14 years and evaluated their nutritional status following WHO criteria. We examined fecal samples and anal swabs from 234 schoolchildren and collected socio-environmental data through questionnaires. The prevalence of undernutrition was 4.5% and excess of weight was 24.1%. The prevalence of stunting and of being overweight reached 2.3% and 12.4%, respectively. About 42% of the schoolchildren were infected with at least one of the 12 species identified. The most prevalent species were Blastocystis sp., Enterobius vermicularis, and Giardia lamblia. Entamoeba dispar was recorded for the first time in the locality. The multiple correspondence analysis identified peri-urban, urban, and rural groups. Underweight, stunting and obesity were highest in the peri-urban group, while overweight, wasting and parasitism rates were highest in the rural group. The urban group showed the lowest parasitic prevalences. Bed-sharing, mother's education, and animal husbandry were associated with parasitic infections. The study highlights a decrease in undernutrition but a rise in overweight and obesity, indicating an ongoing nutritional transition. The association between socio-environmental risk factors and parasitic infections underscore the need for comprehensive interventions addressing both nutritional and socio-environmental conditions to improve the population's life quality.

Trends of falls mortality among older adults in urban and rural China, 1987–2021

BackgroundFalls in older age pose a major public health concern, with unclear urban–rural patterns of falls mortality in China. This study examines the trends of late-life falls mortality in urban...

Auxological Status of Modern Primary School Students of Nizhny Novgorod Region

The article describes the characteristics of the resulting effector auxological morpho-functional status of primary school students, differentiated by gender and administrative-territorial characteristics. The objectives of the study included studying the auxological status of children adolescents, and primary school students in the Nizhny Novgorod region in the context of the peculiarities of the exoenvironment of residence in urban and rural areas. Materials and methods: Own data served as a source of anthropometry and physiometry indicators of the objective population of the region. The analysis of anthropological indicators was carried out by discretizing data sets that state an objective picture of auxological indicators at the regional level, taking into account the peculiarities of anthropogenic loads characteristic of the place of residence of the observed population groups. To quantify the values ​​and statistical differences in indicators by age, gender, and administrative characteristics, the median, standard deviation, and criteria were used: Fisher, Wilks, and Mahalanobis, with an error of differences at p < 0.05. Results: The stability of the age-sex evolution of auxological indicators is shown; the age-sex and territorial dimorphism of total body sizes is shown at 7-10 years of age, with residents of rural areas lagging in the observed indicators. Hemodynamic indicators in both boys and girls significantly prevail among students living in the metropolis relative to their rural counterparts, except diastolic blood pressure. Variance analytics shows differences in the distributions of anthropometry and hemodynamics, both by age and by the urbanization factor at p < 0.001. In the observed age period, at the initial stage, hemodynamic indicators act primarily as modifiers of the metropolis and rural groups. From the age of ten, according to the standardized coefficients of discriminant functions, according to the first canonical variable, the division of series also occurs according to anthropometric characteristics, among which the greatest contribution to the division of groups is made by body weight and body length, and the hemodynamic characteristic - diastolic blood pressure - has also proven to be decisive. Conclusion: Primary school students living in rural areas and in the metropolis of the Nizhny Novgorod region determine the observed indicators ambiguously; if residents of the metropolis state greater results for all observed auxological indicators, then rural peers demonstrate, while lagging in all observed indicators, greater indicators of diastolic blood pressure, which suggests a strain on adaptation mechanisms central character.

Regional Disparities in Atrial Fibrillation Management: An IMPACT-AF Substudy

BackgroundIn rural regions, atrial fibrillation (AF) management is performed predominately by local primary care professionals (PCPs). Prior work has suggested that a disparity in outcomes in AF occurs for those patients living in a rural, vs urban, location. MethodsThis post hoc analysis of the cluster randomized trial Integrated Management Program Advancing Community Treatment of Atrial Fibrillation (IMPACT-AF) compared a clinical decision support system to standard of care. Patients were classified as living in a rural (population < 10,000) or urban location. The outcomes were as follows: AF-related emergency department (ED) visits, unplanned cardiovascular (CV) hospitalizations, AF-related referrals and guideline adherence for AF treatment. ResultsA total of 1133 patients were enrolled from 2016 to 2018; 54.1% (n = 613) were classified as living in a rural location. No differences were present in age (mean, 72 ± 9.63 vs 72.5 ± 10.42 years) or Congestive Heart Failure, Hypertension, Age, Diabetes, Stroke/Transient Ischemic Attack (CHADS2) score (mean, 2.1 ± 1.36 vs 2.16 ± 1.34). Referral rates to general internists were higher in the rural population (13.4% vs 3.9%, P < 0.001), whereas the rate of cardiology referrals was higher in the urban population (10% vs 15%, P = 0.0098). At 12 months, no difference in the composite outcome of AF-related ED visits and CV hospitalizations was seen. Fewer recurrent AF-related ED visits and CV hospitalizations occurred in the urban group (incidence rate ratio [IRR], 0.65 [95% confidence interval (0.44, 0.95), P = 0.0262). The incidence of guideline adherence was similar between the rural (IRR, 3.7 ± 1.2) and urban (IRR, 3.6 ± 1.2; P = 0.11) groups. ConclusionsAF patients living in rural locations had higher rates of recurrent AF-related ED visits and unplanned CV hospitalizations. Further research to optimize AF-related outcomes is needed to ensure equitable delivery of care to all Canadians, irrespective of geography. Clinical Trial RegistrationNCT01927367.

Digital financial inclusion and household energy poverty: Evidence from China

This paper examines the impact of digital financial inclusion (DFI) on household energy poverty. We develop a simple theoretical model to explain the energy poverty alleviation effect of DFI. Using multidimensional household energy consumption survey data, we find that DFI reduces the incidence of household energy poverty by about 33.5 % and the intensity of energy poverty by 24.6 %, driven mainly by improvements in energy efficiency and an increase in household off-farm work, resulting in a stronger role in rural and low-income groups. However, the threshold model demonstrates that the Internet and digital tools are a prerequisite for this pro-poor energy effect to be realized. Notably, DFI, while exhibiting spatial spillover effects, exacerbate energy poverty in neighboring areas due to the siphoning effect.

The Impact of Off-Farm Employment Recession and Land on Farmers’ Mental Health: Empirical Evidence from Rural China

The agricultural land management under the household responsibility system (HRS) in rural China empowers farmers with land tenure rights, meeting the basic needs for their livelihoods and employment by cultivating the land. This paper investigates the pivotal role of agricultural cultivated land as a social safety net, ensuring livelihood security for farmers confronting a recession in off-farm employment. Our analysis is based on data collected from six provinces (Heilongjiang, Henan, Zhejiang, Yunnan, Shandong, and Anhui) in the rural areas of China from 2019 to 2020. We investigated the impact of the off-farm employment recession on the mental health of farmers and the moderating effect of land as a social safety net on the relationship between the off-farm employment recession and mental health. The analysis points to the following results: (1) The majority of farmers have significantly reduced off-farm working time during employment recession. (2) The off-farm employment recession has worsened farmers’ mental health. (3) Farmers’ land assets through tenure rights provide both income and employment security functions, which can mitigate the adverse effects of the off-farm employment recession on their mental health. The findings of this study highlight the crucial role of land assets to reduce the negative impact of unemployment in the context of economic recession, emphasizing the significance of the policies supporting the land rights among vulnerable rural groups.

Does digital literacy reduce intergenerational income dependency?

Smoothing upward mobility channels and reducing intergenerational income dependence are important prerequisites for realizing the sustainable development of all humankind. Starting from the impact of digital economy on micro individuals, this paper explores the mechanisms of digital literacy on families' dependence on intergenerational income. The paper revealed the following findings: First, the improvement of children's digital literacy can significantly enhance the income flow between children and their parents, as well as reduce the former's income dependence on the latter. Specifically, for every 1 unit increase in children's digital literacy, children's income dependence on their parents decreases by 0.035. Among the sub-indicators of digital literacy, social skills and digital attitudes have the highest contribution to reducing intergenerational income dependence. Second, social networks, occupational mobility, and asset allocation capabilities play a moderating role in how digital literacy affects intergenerational income dependence. The more developed the social network, the greater the occupational mobility, and the stronger the asset allocation ability, the more significant the inhibition effect of digital literacy on intergenerational income dependence. Third, the effect of digital literacy on intergenerational income dependence, which is more pronounced in rural areas, inland areas, and male groups.

Exploring Reasons and Perspectives Behind Decisions to Forego Hospital Births Among Remote Rural Populations in Bokeo Province, Lao PDR

Maternal mortality remains high among marginalized rural populations in Laos. Remote mountain villages in Bokeo Province typify persistent health access divides facing minor subgroups amidst infrastructure gaps and scattered habitation. This study explores complex drivers behind shunning hospital births using focused rural ethnography. Between October and November 2023, this qualitative study interviewed 40 participants including pregnant women, postpartum women, and their relatives across 5 villages in Bokeo Province regarding barriers to hospital births. Open-ended discussions aimed to elucidate motivations and barriers embedded in their decision to avoid formal delivery care, despite mortality awareness. Transcriptions from Lao were translated to Thai, maintaining cultural nuances. Thematic analysis identified patterns in women’s attitudes and barriers to hospital childbirth. A collaborative coding process revealed constraints on access, affordability, and autonomy, explaining why vulnerable groups often forego hospital births despite risks. The result founded that prohibitive transportation deficiencies including impassable roads, exorbitant driver fees and unreliable conveyance options were primary obstacles. Prohibitive direct and indirect costs compounded struggles for impoverished families. Restrictive traditions persisted among certain ethnicities. Discrimination fears and hospital foreignness also provoked wariness among a minority. Multidimensional geographical, financial and sociocultural barriers intersect to obstruct rural groups from accessible emergency obstetric care in Laos. Infrastructural strengthening, financial protection and public education can relieve these pronounced constraints denying the marginalized realization of maternal health rights.

Asian and Pacific Islander cancer mortality trends in the United States between 1999-2020.

e23307 Background: The Asian and Pacific Islander (API) population is the fastest growing in the United States, composing nearly 7% of the US population. Although cancer is the second leading cause of death overall in the U.S., it is the leading cause of death in the API population. Despite this, no study has assessed trends in cancer mortality in API individuals in the US. Our aim was to analyze differences and trends in API cancer mortality in the U.S. between 1999 to 2020. Methods: The CDC WONDER database was used to determine mortality statistics for patients, classified as non-Hispanic Asian or Pacific Islander, with cancer (ICD-10 codes C00-C97) as the underlying cause of death between 1999 and 2020. Age-adjusted mortality rates (AAMR) were calculated per 100,000 deaths, and were stratified by cancer type, sex, population density, U.S. census region, and age. Joinpoint regression software was used to identify temporal trends. Average annual percent change (APC) was considered statistically significant if p &lt; 0.05. Results: Between 1999 and 2020, cancer accounted for 305,386 deaths in API individuals. During this period, there was a 30% decrease in mortality due cancer and a decrease in APC of -1.5% (p &lt; 0.05). When stratified by cancer site, the largest decrease in APC was in stomach cancer at -3.7% (p &lt; 0.05), and the largest increase was in uterine cancer at 2.6% (p &lt; 0.05). In 1999, males experienced an overall cancer-related AAMR of 151, 48% higher than females at 103; however, by 2020 these differences reduced, with males having a cancer-related AAMR of 105.6 vs API females of 80.9, a 25% difference. Males experienced a larger decrease in APC (-1.8%, p &lt; 0.05), compared with females (-1%, p &lt; 0.05). Rural populations had the largest cancer-related AAMR (113.0) and largest drop in APC (-2%, p &lt; 0.05), compared with urban groups with a cancer-related AAMR of 106.7 and APC drop (-1.3%, p &lt; 0.05). The highest cancer related AAMRs was seen in lung cancer (24.3 in urban vs 25.4 in rural). Liver-cancer related AAMR was highest in urban populations at 10.4 and lowest in rural populations at 8.2. Western census regions had the highest AAMR at 113.7 with an APC decrease of –1.4% and Southern census regions had the lowest AAMR at 90.5 with an APC decrease of –1.2%. Adults aged &gt; 65 experienced the highest cancer related AAMR at 588.2, and adults aged 25-44 demonstrated the lowest AAMR at 14.7. However, adults aged 25-44 experienced the largest decrease in APC at -2% (p &lt; 0.05), compared with adults aged &gt; 65 at -1.4% (p &lt; 0.05). Conclusions: Our study identifies a significant decrease in cancer mortality in API individuals between 1999 and 2020. The largest decrease seen was in stomach cancer; however, uterine cancer mortality has increased. Notably, liver cancer mortality was higher in urban rather than rural groups. Further studies may examine differences amongst API and other racial groups, and potential sources for the disparities seen amongst API individuals.

Farming and the risk of developing osteoarthritis in Alberta, Canada.

Because farming is a physically demanding occupation, farmers may be susceptible to developing osteoarthritis (OA). The aim of this study was to determine the risk of developing OA in Canadian farm, non-farm rural and urban residents. A retrospective cohort study of five Alberta health administrative databases examined the risk of developing OA among three groups: farm (n=143 431), non-farm rural (n=143 431) and urban (n=143 431) residents over the fiscal years 2000-2001 through 2020-2021. The algorithm for OA ascertainment defined cases based on criteria including one hospital admission, two physician visits within a 2-year interval, or two ambulatory care visits within 2 years. Incidence rates, lifetime risk, and mortality rates were calculated. Cox proportional hazard models compared the incidence of OA for the three groups over the 21 years. A total of 26 957 OA cases were identified among 1 706 256 person-years (PYs) in the farm cohort. The crude incidence rate of OA over a period of 21 years ranged from 19.1 (95% confidence interval (CI) 18.6-19.6) per 1000 PYs in 2001 to 10.0 (95% CI 9.6-10.5) per 1000 PYs in 2021. The overall incidence rate was higher in the farm group (15.8 (95%CI 15.6-16.0) per 1000 PYs) as compared to the non-farm rural (14.7 (95%CI 14.5-14.9) per 1000 PYs) and the urban groups (13.3 (95%CI 13.1-13.4) per 1000 PYs). After adjusting for age and sex, the farm (6%; 95%CI 4-8%), and non-farm rural (9%; 95%CI 7-12%) groups had higher incidence rates than the urban group. The unadjusted non-injury mortality rate for the farm group with OA was lower (13.2 (95%CI 12.9-13.5) per 1000 PYs) than both the urban (14.5; 95%CI 14.1-14.8) and rural (18.0; 95%CI 17.6-18.4) groups. After adjusting for mortality, the lifetime risk of developing OA was 27.7% for farm residents, 25.6% for the non-farm rural cohort, and 24.0% for the urban cohort. When accounting for age and sex, farm and non-farm rural residents have a higher risk of developing OA as compared to the urban population. The higher mortality-adjusted lifetime risk of developing OA among farm residents highlights the necessity of specific interventions aimed at reducing the impact of this condition in rural communities. Further research is required to identify specific occupational and lifestyle risk factors associated with OA among farmers and to develop effective strategies for prevention and management.

Peru’s National Policy on Financial Inclusion and Its Alignment with Sustainable Development Goal I

This article analyzes the implementation of the National Financial Inclusion Strategy (NFIS) and its alignment with Sustainable Development Goal (SDG) I: Eradicate poverty. Despite the progress achieved, structural gaps persist and substantially limit the NFIS’s contribution to poverty reduction, especially among rural, indigenous, extreme poverty, and other vulnerable groups. The article employs a mixed methods approach combining qualitative and quantitative techniques. On the qualitative side, a hermeneutic documentary analysis of the NFIS and related regulations was carried out, with a critical textual interpretation supported by specialized software. Quantitatively, descriptive statistical techniques were applied to analyze official financial inclusion indicators—methodological integration was achieved through analytical triangulation under a concurrent mixed methods approach. The progress of initiatives under the NFIS was evaluated, identifying limitations such as the digital divide in rural areas, limited financing for Micro and Small Enterprises, gaps in financial education, and growing exposure to digital fraud. Although the NFIS promotes greater access to financial services, it does not explicitly focus on the poorest and most excluded populations. Therefore, it is recommended that the objectives and indicators of the NFIS be reformulated to focus on universal access and effective use of financial services by the population in extreme poverty and chronic exclusion. In addition, a strategic articulation with social protection policies is necessary, as well as promoting culturally relevant microfinance and inclusive finance models, strengthening consumer protection, and consolidating public–private alliances in high-poverty areas. Finally, strong monitoring and accountability are also key.

Identification of the needs and priorities of older people and stakeholders in rural and urban areas of Santo Andre, Brazil.

There are few data reporting the needs and priorities of older adults in Brazil. This hampers the development and/or implementation of policies aimed at older adults to help them age well. The aim of this study was to understand areas of importance, priorities, enablers and obstacles to healthy ageing as identified by older adults and key stakeholders in both urban and rural environments. Two locations were selected, one urban and one rural in the municipality of Santo André, in the metropolitan region of São Paulo (SP). Workshops for older adults (>60 y) and stakeholders were conducted separately in each location. The workshops incorporated an iterative process of discussion, prioritisation and ranking of responses, in roundtable groups and in plenary. Areas of commonality and differences between older adult and stakeholder responses were identified by comparing responses between groups as well as mapping obstacles and enablers to healthy ageing identified by older adults, to the priorities identified by stakeholder groups. The socio-ecologic model was used to categorise responses. There were few shared responses between stakeholders and older adults and little overlap between the top ranked responses of urban and rural groups. With respect to areas of importance, both stakeholder groups ranked policies for older people within their top five reponses. Both older adult groups ranked keeping physically and mentally active, and nurturing spirituality. There was a marked lack of congruence between older adults' obstacles and enablers to healthy ageing and stakeholder priorities, in both urban and rural settings. Most responses were located within the Society domain of the socio-ecologic model, although older adults also responded within the Individual/ Relationships domains, particularly in ranking areas of most importance for healthy ageing. Our results highlight substantial differences between older adults and stakeholders with respect to areas of importance, priorities, enablers and obstacles to healthy ageing, and point to the need for more engagement between those in advocacy and policymaking roles and the older people whose needs they serve.

The Landscape of Health Technology for Equity Deserving Groups in Rural Communities: A Systematic Review.

Equity-deserving groups face well-known health disparities that are exacerbated by rural residence. Health technologies have shown promise in reducing disparities among these groups, but there has been no comprehensive evidence synthesis of outcomes. The purpose of this systematic review was to examine the patient, healthcare, and economic outcomes of health technology applications with rural living equity-deserving groups. The databases searched included Medline and Embase. Articles were assessed for bias using the McGill mixed methods appraisal tool. Data were synthesized narratively using a convergent integrated approach for qualitative and quantitative findings. This evidence synthesis includes papers (n = 21) that reported on health technologies targeting rural equity-deserving groups. Overall, patient outcomes - knowledge, self-efficacy, weight loss, and clinical indicators - improved. Healthcare access improved with greater convenience, flexibility, time and travel savings, though travel was still occasionally necessary. All studies reported satisfaction with health technologies. Technology challenges reported related to connectivity and infrastructure issues influencing appointment quality and modality options. While some studies reported additional costs, overall, studies indicated cost savings for patients. There is a paucity of research on health technologies targeting rural equity-deserving groups, and the available research has primarily focused on women. While current evidence was primarily of high quality, research is needed inclusive of equity-deserving groups and interventions co-designed with users that integrate culturally sensitive approaches. Review registered with Prospero ID = CRD42021285994.

Mobility and the Social Differentiation of Rural Youth in Australia

Geographical mobility has become an integral element of the biographical trajectories of young people from rural areas. In this paper, we contend that theories of rural-urban inequality tend to unduly homogenise rural social groups and are insufficient to understand rural youth out-migration as a selective rather than universal practice. We draw on a statistical analysis of the social differentiation of rural youth mobility in Australia to argue that sociologists gain from further theorising the social differentiation of rural society. Empirically, we find that classed resources and stratified dispositions toward one’s future life are important properties associated with outward mobility. Theoretically, we propose the concept of rural social space to make sense of these patterns. Rural social space describes the material and symbolic hierarchies that structure the social differentiation of rural society. We conclude by suggesting how future research could refine the conceptualisation of rural social space proposed in this paper, by further considering the opportunities, practices and representations that distinguish the lives of different groups of rural young people.

Tourism in Russia’s Altai Republic: Indigenous perceptions

ABSTRACT The government of Russia’s Altai Republic encourages tourism for local socio-economic development. The year 2020 brought 2.2 million visitors to the Altai Republic, an ecologically pristine but economically depressed region, with a population of just 220,200. Ethnic Russians constitute a majority of the Altai Republic’s citizenry, but Indigenous groups make up 34 percent of the population. Using surveys and interviews, this study analyzed perceptions of tourism among four rural Indigenous groups in 2018–2019 concerning maintaining local culture, improving the standard of living, and preserving the environment. Survey participants generally did not agree that tourism helps them to maintain local culture or to improve the local standard of living, although interview respondents gave positive and negative viewpoints. Both those surveyed and those interviewed expressed overwhelming concern for the preservation of the natural environment and alarm regarding illegal and excessive hunting by outsiders.

DIGITALIZATION OF EDUCATION IN RURAL SCHOOLS: A STUDY OF ACCESS, UTILIZATION, AND IMPACT TOWARD DIGITALIZATION IN BANGLADESH

Digitalizing education in rural areas, particularly in countries like Bangladesh, presents challenges and opportunities. With the increasing availability of technology, there is a growing interest in understanding how digital education can be effectively implemented in rural schools to enhance learning outcomes. This study explores the impact of digital technologies on education in rural schools in Bangladesh, focusing on Access and utilization. Understanding the implications of digitalization for rural schools is important for informed policy-making. This study investigates the current status of digital education and its prospects in rural Bangladesh. It aims to explore the Access, utilization, and impact of digitalization in educational settings, focusing on rural schools. The study uses a mixed-methods approach to assess digitalisation in rural education, including surveys, interviews, focus groups, and observation. It examines Access to digital resources, identifies barriers to integrating technology in learning, and explores the use of digital tools and platforms in teaching and learning from both teacher and student perspectives. This study analyzes the impact of digitalization on education in rural schools in Bangladesh. It aims to uncover the benefits and challenges of digital transformation and assesses the role of government initiatives, educational policies, and community involvement. The findings of this study highlight the need for targeted interventions to address the digital divide in rural education. While digitalization shows promise in enhancing educational experiences, there is a call for comprehensive strategies that consider infrastructure development, teacher training, and curriculum integration to realize its full potential in rural schools. This study sheds light on technology in rural Bangladesh education, providing insights for policymakers and educators. It aims to enhance digital literacy and promote inclusive educational practices.