Postoperative deterioration remains a challenge, particularly in rural and remote hospitals. Early recognition of complications is critical, yet intermittent ward monitoring may fail to detect subtle physiological changes. Wearable biosensors offer a promising strategy to extend high-dependency surveillance beyond intensive care. These devices can provide continuous, real-time monitoring, enabling earlier intervention, supporting clinical decision-making, and reducing reliance on limited rural health care staff. Evidence suggests these devices are feasible and well tolerated. This viewpoint examines their potential to enhance postoperative surveillance in resource-limited settings and highlights the need for targeted evaluation in rural Australian hospitals to assess effectiveness, cost-benefit, and integration into perioperative practice.

Objective: This study aims to analyze the spatial distribution and service coverage of Primary Health Centres (PHCs) in South West Garo Hills district, Meghalaya, North East India, using geospatial techniques to assess accessibility and planning efficiency. Methodology: The study was conducted from March to September 2025, using secondary data from geographic, demographic, and administrative sources. Eleven PHCs were analyzed using Nearest Neighbor Analysis to determine whether their spatial arrangement was clustered, random, or dispersed, with the Nearest Neighbor Index quantifying the degree of dispersion. Thiessen Polygon analysis was employed to delineate service areas for each PHC and assess spatial coverage and locational efficiency. Geographic boundary shapefiles facilitated accurate spatial mapping. Results: The Nearest Neighbor Index was 1.24, indicating a generally dispersed distribution, with the mean observed distance between centers (5.35 km) exceeding the expected distance (4.32 km). Thiessen Polygon analysis revealed significant variability in service areas, with some PHCs covering extensive regions, suggesting reduced accessibility, while others served smaller, more localized zones. These disparities highlight uneven health service availability, particularly in remote and geographically challenging areas. Conclusion: The study emphasizes the need for strategic reallocation of existing PHCs and establishment of additional facilities, considering population distribution and terrain, to enhance equitable healthcare access. Geospatial analysis proves valuable for evidence-based planning, supporting targeted interventions to improve the efficiency and accessibility of rural health infrastructure.

Teletherapy may increase mental healthcare access in rural and remote communities that have limited access to mental health care. Clinicians practicing rural and remote teletherapy must be responsive to the ways that rurality and remote service provision impact their patients and practice. However, the unique challenges of remote clinical practice, when clinicians and patients are located in different settings, are not well understood. It is often not feasible for independent clinicians to provide rural teletherapy using models developed by large healthcare institutions, and current teletherapy practice guidelines underemphasize the ways rural, situational, and environmental pressures impact teletherapy with rural and remote patients, especially in culturally and geographically diverse settings like Alaska in the US. Therefore, to better understand these challenges, this study explored the critical events that informed Alaskan clinicians' approaches to teletherapy with rural patients, and how those 'turning point' events subsequently influenced their practice. This qualitative study used the critical incident technique and thematic analysis to explore critical events that most informed Alaskan clinicians' approaches to rural and remote teletherapy. Participants (n=26) were licensed mental health clinicians who had provided teletherapy to rural patients in Alaska and did not live in the patients' community themselves. Each participant provided written responses to an anonymous online survey that asked them to describe a critical event relating to rural teletherapy practice, their perceived outcome of the event, and an optional narrative describing what would have better prepared them for the critical event. The study's authors followed an iterative process of coding, reflexive discussion, consensus, and recoding throughout the thematic analysis of critical events. Participants' narratives revealed situations where clinical, cultural, ethical, technological, and/or administrative concerns interacted with rural environmental pressures to create novel situations that required thoughtful and complex responses. Many narratives illustrated advanced integration of teletherapy and rural mental health competencies. Specific themes included attending to rural cultural and contextual (situational and environmental) factors; responding to crises, traumas, and complex clinical concerns; navigating technological barriers and ethical challenges; and practicing clinical and administrative flexibility in light of unique circumstances with their rural and remote patients. In response to what would have better prepared them for these events, participants identified greater awareness and experience, more training and education, and better resources and infrastructure. The results suggest a need to integrate and expand existing teletherapy and rural mental health competencies to include contextual assessment, responsivity, and reflexivity, as well as to integrate specific teletherapy skills into a cross-contextual framework. This study introduces the concept of contextual humility, an expansion of the previously established concept of cultural humility in rural teletherapy, which emphasizes responsiveness to situational and environmental factors as they overlap with, but are distinct from, cultural dimensions of rural teletherapy. Insights from Alaskan clinicians who have adapted to the unique challenges of rural and remote teletherapy highlight the need for clinical training tailored to rural and remote settings and updated approaches to teletherapy that integrate contextual humility across competency domains.

Rural communities experience disproportionately higher rates of chronic diseases, less access to healthcare services, and poorer health outcomes compared to their urban counterparts in the United States. However, inconsistencies in how rurality is defined across biomedical research, including limitations in geographic detail within large-scale datasets, present significant challenges for reliably studying rural health outcomes. This study aimed to develop and apply an operational rurality scale using 3-digit ZIP codes to characterize rural participation in the All of Us Research Program and to examine associations between rurality, delayed care, and healthcare affordability. Publicly available information from the Federal Office of Rural Health Policy and the Environmental Systems Research Institute was integrated to generate a continuous rurality scale at the 3-digit ZIP code level. A Kolmogorov-Smirnov test identified statistically significant differences in the geographic distribution of those who had delayed access to care (P < 0.001) and those with difficulties affording care (P < 0.001). The proposed continuous rurality scale is reproducible and extensible in several ways within the All of Us Workbench, as it provides a framework for categorizing participants by geolocation and facilitates standardized analyses of rurality-related research questions.

Rural communities experience disproportionately higher rates of chronic diseases, less access to healthcare services, and poorer health outcomes compared to their urban counterparts in the United States. However, inconsistencies in how rurality is defined across biomedical research, including limitations in geographic detail within large-scale datasets, present significant challenges for reliably studying rural health outcomes. This study aimed to develop and apply an operational rurality scale using 3-digit ZIP codes to characterize rural participation in the All of Us Research Program and to examine associations between rurality, delayed care, and healthcare affordability. Publicly available information from the Federal Office of Rural Health Policy and the Environmental Systems Research Institute was integrated to generate a continuous rurality scale at the 3-digit ZIP code level. A Kolmogorov-Smirnov test identified statistically significant differences in the geographic distribution of those who had delayed access to care (P < 0.001) and those with difficulties affording care (P < 0.001). The proposed continuous rurality scale is reproducible and extensible in several ways within the All of Us Workbench, as it provides a framework for categorizing participants by geolocation and facilitates standardized analyses of rurality-related research questions.

Clinical audit aims to improve maternal and newborn care by systematically reviewing clinical practices, identifying gaps, implementing corrective actions, and monitoring progress. Audit can improve outcomes but effective implementation requires strong teamwork, communication and trust. To explore how health professionals experience audit, individual semi-structured interviews were conducted with maternity managers in 11 rural health facilities in KwaZulu-Natal, South Africa, between November 2022 and February 2023. Participants included medical managers (5) and nursing managers (11). Analysis used inductive thematic analysis supported by Nvivo v15. Managers described the maternity team working together to systematically assess care across a range of clinical areas, suggesting that reflective practice was embedded in their work. Audit activities included auditing of clinical case records, caesarean sections, and perinatal and maternal deaths. However, managers reported that clinical audit was time consuming and required high level technical and facilitation skills. Feedback was often described as didactic, emphasising teaching rather than reflection and learning, and frequently involved elements of identifying and blaming individuals. It is important that maternity managers have skills to provide feedback in a safe, blame-free environment. Inappropriate or judgemental feedback could lead to a blame culture and negatively affect communication, teamwork and collaboration across the maternity team.

NAFLD is an important cause of liver disease in India. During the past century, dramatic modifications in lifestyle have radically changed the health priorities in most areas of the world, owing to a growing incidence of non-communicable disease. Fatty liver has earlier often been related with excessive alcohol consumption. During the past 20 years, the interest in fatty liver occurring in non-drinkers i.e. non-alcoholic fatty liver disease (NAFLD) has raised quickly. Methods A prospective experimental study design without control group.Patients will be collected from the In-patient and Out-patient Departments, Peripheral Centres, Rural Health Camps and Medical Camps conducted by Vinayaka Mission’s Homoeopathic Medical College and Hospital Result This study provides evidence to say that, there is significant reduction in the Non-alcoholic fatty liver disease after giving homoeopathic constitutional medicine

BackgroundThe Chinese government initiated a compulsory services programme (CSP) to provide skilled general practitioners (GPs) to rural regions. This study examined the early career trajectories of medical graduates with compulsory services and the factors influencing their retention in primary healthcare facilities.MethodsA cohort of CSP graduates from four universities in central and western China was established in 2015 to examine the career development within rural healthcare settings. Annual online surveys followed up their career development. This study used baseline and follow-up data from 2015 to 2022, which involved 2041 CSP graduates. Descriptive analysis was used to report transition and job retention. Logistic regression models were used to assess factors that affect retention. Multiple chain equation imputation was employed to explore the impact of sample attrition on retention.ResultsAfter the CSP contract ended, 38.54% of the CSP graduates retained in primary healthcare facilities. Of those leaving primary healthcare, 34.65% chose hospitals above county-level, 25.41% chose county-level hospitals, 7.92% pursued higher degrees and 27.72% were unemployed. Multivariable analysis showed that signing contracts with hometown had a positive association with improved retention (OR=2.64, p=0.001). There is no significant effect of sample attrition on the retention of GPs in primary healthcare settings (p=0.247).ConclusionCSP significantly contributes to staffing rural health workforce in China. Ensuring signing contracts with hometown and lifting financial burden during school could increase retention in the long run. Increased attention should also be directed to GPs with a senior professional title to increase retention.

In rural Australia, recent trends reveal an exponential increase in the rates of physical inactivity, central obesity, metabolic syndrome, and cancer in the population. The limited rural health workforce, which is struggling to meet this growing burden, is boosted by digital technologies such as My Health Record, Cardihab, Healthdirect, and MindSpot, all of which offer opportunities for improved diagnostics, monitoring, and management of chronic diseases. However, implementing proven digital health technologies in rural communities has been challenging on numerous fronts. This perspective aims to (1) highlight the rural health gap and propose a way forward in implementing evidence-based digital health technologies in the rural, regional, and remote communities of Australia and (2) guide future rural health policy.

This opinion piece is based on a study that investigated the contribution of Rehabilitation `Care Workers in strengthening rehabilitation in community-based services at the primary level of care level and a collaborative inquiry with the rehabilitation teams responsible fofr outreach community services in a rural district. We are of the opinion that rural contexts require a different set of community-based rehabilitation (CPR) competencies than those applicable in better-resourced urban and per-urban settings. We investigated the health system strengthening benefits of CBR as a facet of community orientated primary care (COPC), which focuses on the inter-sectoral services that rehabilitation care workers who are supervised by rehabilitation therapists can offer to persons with disabilities. We endorse extant public health literature on the urgent need to build rural inclusive health workforce capacity, suggesting that human resource shortages for rehabilitation n rural areas can be addressed through training mid-level, multi-skilled workers who are part of the ward-based teams with rehabilitation therapists. Community health workers (CHWs0 in rural areas who upgrade their skills set to include competencies in community-based disability inclusive development practice and address the rehabilitation service gaps faced by persons with disabilities and their families. Implications for practice: Embedding community-based disability inclusive development practices in COPC will promote access to rehabilitation services in rural communities. In addition to nurse-led, ward-based teams of CHWs, ward-based teams of RCWs led by rehabilitation therapists will strengthen the primary level rural health system. Health outcomes of rural populations withn disability will be improved by access to RCWs with competencies in inter-sectoral collaboration.

Remote Telerobotics in Interventional Radiology: Development, Procedures, and Challenges.

Although leprosy was declared eliminated in Malaysia in the 1990s, it continues to affect the indigenous Penan community in rural Baram, Sarawak, with prevalence rates of 2.08-35.5 per 10,000-far above the WHO threshold. Previous studies noted delayed diagnoses and geographical clusters among the Penan, but the drivers of ongoing transmission remain unclear. This study examined factors contributing to the persistent high incidence of leprosy within the Penan community in Upper Baram, Sarawak. Semi-structured qualitative interviews were conducted from January-May 2022 with Penan individuals and healthcare professionals (HCPs), using guides based on the Socioecological Model. Villages with high leprosy incidence and relevant rural health facilities were purposively sampled. Interviews were recorded, transcribed, and thematically analysed. Thirty-seven participants were interviewed: 22 Penan (aged 19-82) and 15 HCPs (aged 28-62). Three themes emerged: (i) transmission was linked to family-level spread, inter-village movement, and disease characteristics; (ii) community factors included low awareness, nomadic lifestyle, overcrowding, and poor nutrition; (iii) health system barriers included limited access, inadequate diagnostic capacity, fear of slit skin smear procedures, and infrequent active case detection. Leprosy transmission among the Penan is sustained by cultural, environmental, and healthcare system challenges. Addressing this requires a multifaceted response, including stronger rural health infrastructure, improved diagnostics, regular active case detection, and culturally tailored health education to halt transmission in this underserved community.

The growing shortage of general surgeons in the United States poses significant challenges, particularly in rural areas of Washington State, where limited health care access can exacerbate disparities. Washington State University College of Medicine (WSU COM) has implemented strategic educational initiatives to address rural workforce shortages, including a longitudinal integrated clerkship (LIC) and required rotations in rural health, many of which are hosted by rural general surgeons. Our IRB-approved study conducted at WSU COM examined the impact of these rural surgeons on medical students' career trajectories through qualitative interviews with WSU alumni. Participant responses highlighted themes such as responsibility, adaptability, and community engagement. Additionally, WSU COM is working towards developing a post-residency rural surgery training program to equip trainees with broad surgical expertise while also encouraging surgeon retention in Washington state. These efforts aim to cultivate a well-prepared surgical workforce and ultimately improve health care access for rural Washington communities.

Low- and middle- income countries face a surgical workforce shortage amidst a high burden of diseases amenable to surgery. Rural Nigeria, which is mainly supported by primary health care, lacks access to timely, affordable and safe surgical care, leading to high morbidity and mortality. This review aims to assess the burden of lack of personnel, evaluate current innovative strategies, and provide future directions for rural surgical workforce development in Nigeria. A total of 79 articles were included in this review. A comprehensive literature search was conducted in PubMed/MEDLINE and Google Scholar for articles published up to December 2024. Search terms included "rural surgical practice," "rural surgery challenges," "rural surgical care," and "Nigeria." Eligible studies included observational studies, systematic reviews, meta-analyses, and narrative reviews. Only full-text articles published in English were considered. Two reviewers independently screened articles for relevance and determined inclusion based on predefined criteria. The review revealed models such as government-led initiatives, task-shifting, mobile surgical units, private and mission hospitals, and surgical outreach programs which are aimed at improving surgical care delivery in rural Nigeria. We also identified global strategies such as rural surgery residency programs, incentivization, and telemedicine, which have been adopted in other countries to address workforce challenges in rural areas. Existing models in Nigeria demonstrate both capabilities and constraints. Strategies such as government-led initiatives and task-shifting which involve the deployment of locally-trained staff in rural centers are limited by lack of required infrastructure and technology, as well as ethical concerns on the quality of care. Although the problem of accessibility is partly addressed in some settings with Mobile Surgical Units and private hospitals, there are significant challenges bordering on patient selection and affordability respectively. Furthermore, mission hospitals and surgical outreach programs occasionally provide surgical services among underserved populations at subsidized or no cost. However, financial sustainability is a major challenge for these programs which rely heavily on donor funding. This study aims to explore current global strategies being implemented to address rural surgical workforce shortage, identifying strengths and weaknesses in a bid to assess reproducibility in the Nigerian context. Unequal distribution of workforce has greatly affected the delivery of surgical care in rural areas in Nigeria. Current models are faced with limitations and innovative solutions are needed to address existing challenges in rural healthcare. Further investment is also required to provide timely and efficient surgical healthcare in rural Nigeria.

Beyond traditional models: A qualitative study of barriers and facilitators to rural teen mental health

Bacteriophage as a promising approach for the biocontrol of typical pathogenic bacteria Escherichia coli in fecal environment.

Rural public health has been hit with a triple set of challenges: overstretched health care, poor health status, and limited public health capacities. MaineHealth, a nonprofit integrated 10-hospital health system, serves a mostly rural area with no local public health departments in its rural communities. By integrating primary care with public health and partnering with communities, MaineHealth has developed an infrastructure to successfully address these challenges. We believe this approach is worthy of consideration in other rural areas. (Am J Public Health. 2025;115(12): 2002-2005. https://doi.org/10.2105/AJPH.2025.308233).

Australian rural nurses' experiences of the implementation and impact of HIRAID® emergency nursing framework on nursing practice. A qualitative study.

Rural Women's Healthcare:: Rethinking Provision of Care Through Diversification.

The issue of maternal morbidity and mortality is a highly urgent American health problem, with more than 50,000 women experiencing pregnancy complications each year. However, Black women are three times more likely to die because of pregnancy-related problems than White women in the United States (U.S.). Black women also experience disproportionately higher rates of maternal mortality than women of every other ethnic and racial group. Compared to other affluent countries, the United States has a strikingly high maternal mortality rate. Between 1990 and 2019, the rate in the U.S. nearly tripled, rising from 8.0 to 20.1 deaths per 100,000 live births. In the last twenty years, maternal mortality rates have declined in countries around the globe, but in the U.S., there has been a 50% increase in maternal mortality. Maternal mortality rates are highest in Mississippi, which had 82.5 deaths per 100,000 births in 2021, and lowest in California, which had 9.7 deaths per 100,000 births in 2021. Expanding Medicaid eligibility, extending postpartum coverage, standardizing care delivery, combating racial bias in medical care through provider training, subsidizing Black physician tuition, and increasing rural health care access will help not only reduce maternal deaths nationwide but also diminish racial disparities in maternal health outcomes.