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Using text analysis to assess the mental health impacts of COVID-19 on rural healthcare providers 利用文本分析评估COVID-19对农村卫生保健提供者心理健康的影响
Pub Date : 2022-01-31 DOI: 10.4148/1936-0487.1110
C. Beseler, Stacia McNeely
The pandemic increased the stress levels of frontline healthcare providers in every country across the globe, and continues to do so. Health care providers in the rural regions of the U.S. were more vulnerable to the impact of COVID-19 due to the lack of resources and the population they serve. A qualitative study of 25 rural healthcare providers in a western U.S. state was conducted during 2020. In this report, Linguistic Inquiry and Word Count (LIWC) was used to compare the use of emotion and reward words in 12 providers interviewed before the onset of COVID-19 on March 11, 2020, to 13 interviews conducted after COVID-19 onset. Results indicated that providers used fewer positive emotion words after COVID-19 onset compared to before COVID. Negative emotion words also decreased. Words related to the rewarding aspects of their work increased after COVID-19, but differed among the pre- and post-COVID groups. Positive emotion words was more strongly related to rewards in the post-COVID group. Providers reported concerns about access to care for those unable to be treated for the increased depression, anxiety and suicide ideation related to the pandemic. The rural health care system needs policies directed at improving patient access to care and greater funding.
大流行增加了全球每个国家一线医疗保健提供者的压力水平,并将继续这样做。由于缺乏资源和所服务的人口,美国农村地区的医疗保健提供者更容易受到COVID-19的影响。2020年,对美国西部一个州的25名农村医疗保健提供者进行了定性研究。在本报告中,使用语言调查和字数统计(LIWC)来比较2020年3月11日COVID-19发病前接受采访的12名提供者与COVID-19发病后接受采访的13名提供者对情绪和奖励词的使用情况。结果显示,与冠状病毒感染前相比,医护人员在冠状病毒感染后使用的积极情绪词汇较少。负面情绪词汇也减少了。在新冠肺炎之后,与他们工作中奖励方面相关的词汇有所增加,但在新冠肺炎之前和之后的人群中有所不同。在新冠肺炎后组,积极情绪词汇与奖励的相关性更强。服务提供者报告说,他们对那些因与大流行有关的抑郁、焦虑和自杀意念增加而无法得到治疗的人获得护理感到担忧。农村卫生保健系统需要旨在改善患者获得护理的机会和更多资金的政策。
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引用次数: 0
Treating a Public Health Crisis for Rural Moms – A Comparative Analysis of Four Rural States Addressing Maternal Opioid Misuse with Medicaid Innovation Models 治疗农村母亲的公共卫生危机-医疗补助创新模式解决孕产妇阿片类药物滥用的四个农村州的比较分析
Pub Date : 2021-11-16 DOI: 10.4148/1936-0487.1109
J. Semprini
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引用次数: 0
Mentee Perceptions of Public School Superintendent Mentorship in a Rural, Midwest State 中西部一个农村州公立学校校长指导的心理感知
Pub Date : 2021-10-06 DOI: 10.4148/1936-0487.1108
E. Lehmann, D. Olson, Dan Leikvold, David De Jong, Kristine Reed
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引用次数: 0
“You’re in apple land but you are a lemon:” Connection, Collaboration, and Division in Early ‘70s Indian Country “你在苹果地,但你是柠檬:”70年代初印度国家的联系、合作和分裂
Pub Date : 2020-07-01 DOI: 10.4148/1936-0487.1102
John Truden
In the first years of the 1970s, Indian Country became paradoxically more interwoven and yet also more divided. Three case studies from Oklahoma’s Indigenous communities illustrate this transformation. Beginning in the mid-1960s, a boom in Indigenous media allowed Indigenous people to communicate far more quickly over once prohibitive distances. In western Oklahoma, Southern Cheyenne parents relied upon Navajo ideas to form their own indigenous controlled school in early 1973. As a result of these exchanges between previously removed people, new indigenous communities emerged along ideological lines rather than those of tribal citizenship or ethnic identity. A few months earlier, the National Indian Youth Council’s Oklahoma chapters, one such evolving ideological community out of many in the United States, successfully brought attention to and changed a key state policy affecting indigenous students in public schools. Even as Indigenous activists collaborated with new vigor, corresponding divisions emerged in existing Indigenous communities; Native people began to debate the meaning of the messages new communities popularized. The American Indian Movement attempted to hold its 1973 national convention at Pawnee, Oklahoma, only to find that Indigenous people in the region did not support the gathering as the movement’s leaders anticipated. Together, these three case studies present a portrait of a diverse, indigenous world that facilitated collaboration through Native media yet wrought with emerging ideological schisms.
在20世纪70年代的头几年,印度国家矛盾地变得更加相互交织,但也更加分裂。来自俄克拉荷马州土著社区的三个案例研究说明了这种转变。从20世纪60年代中期开始,土著媒体的蓬勃发展使土著人民能够跨越曾经令人望而却步的距离,以更快的速度进行交流。1973年初,在俄克拉何马州西部,南夏安族的父母们依靠纳瓦霍人的思想,建立了他们自己的土著学校。由于以前被迁移的人之间的这些交流,新的土著社区沿着意识形态的路线出现,而不是那些部落公民或种族身份。几个月前,全国印第安青年理事会的俄克拉荷马州分会——美国众多意识形态团体中的一个——成功地引起了人们的注意,并改变了一项影响公立学校土著学生的关键州政策。就在土著活动家们以新的活力合作的时候,在现有的土著社区中出现了相应的分歧;当地人开始讨论新社区传播的信息的含义。美国印第安人运动(American Indian Movement)试图在俄克拉何马州的波尼市(Pawnee)召开1973年全国代表大会,结果发现当地的原住民并不像运动领袖预期的那样支持这次集会。总之,这三个案例研究呈现了一个多样化的土著世界,它促进了通过土著媒体的合作,但也造成了新兴的意识形态分裂。
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引用次数: 0
Expanding the Capacity of Rural Cancer Care With Teleoncology 利用远程肿瘤技术扩大癌症农村医疗能力
Pub Date : 2020-06-03 DOI: 10.4148/1936-0487.1101
J. Semprini
Background: In the United States, 6 of the 25 leading causes of death stem from site-specific cancers, resulting in over 1.7 million deaths annually. Yet, this burden is not evenly distributed. While the incidence of cancer is significantly higher in urban areas, rural regions face higher rates of cancer mortality. Identifying the factors contributing rural cancer disparities can facilitate more effective and feasible policy solutions.’ Problem Definition: Rural Americans are geographically isolated from high-quality cancer services and face systemic barriers to NCI designated comprehensive cancer centers. Given this disparity, rural Americans have failed to fully realize the benefits of expanded federal investment in improved cancer care. Efforts to increase the supply of rural oncologists have yielded mixed results. Rather, this policy review identifies an opportunity to expand the capacity of America’s oncologists through provider-to-provider telehealth models. Methods: Federal and state statutes were scanned for telehealth legislation. CMS guidance relating to telehealth capacity building were also reviewed. The tabulated political venues and policy activity were reported by branch and level of government. Policy recommendations were then made by the focusing on states implementing provider-to-provider teleoncology models in rural regions. Policy Report: In 2016, Congress passed the Project ECHO Act which aimed to evaluate all provider-to-provider telehealth capacity building models. However, the 2019 Project ECHO Act, which aimed to build upon the initial pilot, failed to progress through the Senate. Most provider-to-provider teleoncology activity occurred at the state-level through Medicaid Waivers. Conclusion: Neighboring states can build upon the success of these innovative healthcare delivery models by expanding the diffusion of Medicaid waiver demonstrations which authorize reimbursement for provider-to-provider teleoncology in rural areas.
背景:在美国,25种主要死因中有6种源于特定部位的癌症,每年导致170多万人死亡。然而,这一负担并不是平均分配的。虽然癌症的发病率在城市地区明显较高,但农村地区癌症死亡率较高。确定导致农村癌症差异的因素可以促进更有效和可行的政策解决方案问题定义:美国农村地区在地理上与高质量的癌症服务隔离,并面临NCI指定的综合癌症中心的系统性障碍。鉴于这种差距,美国农村地区未能充分认识到扩大联邦投资改善癌症护理的好处。增加农村肿瘤学家供应的努力取得了喜忧参半的结果。相反,这项政策审查确定了一个机会,可以通过提供者到提供者的远程医疗模式来扩大美国肿瘤学家的能力。方法:对联邦和州法规进行远程医疗立法扫描。还审查了CMS关于远程医疗能力建设的指导意见。列表中的政治场所和政策活动是按政府部门和级别报告的。然后,重点关注在农村地区实施提供者对提供者目的论模型的州,提出了政策建议。政策报告:2016年,国会通过了《ECHO项目法案》,旨在评估所有提供者到提供者的远程医疗能力建设模式。然而,旨在建立在最初试点基础上的2019年《欧洲人权法案》未能在参议院获得通过。大多数提供者对提供者的目的论活动都是通过医疗补助豁免在州一级进行的。结论:邻国可以在这些创新医疗保健模式的成功基础上,扩大医疗补助豁免示范的范围,授权对农村地区的提供者对提供者的目的论进行报销。
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引用次数: 0
Teacher Attrition and Retention in Kansas: A Case Study of Geographically Rural States with Persistent Teacher Shortages 堪萨斯州教师流失与留任:一个持续教师短缺的地理农村州的案例研究
Pub Date : 2020-03-30 DOI: 10.4148/1936-0487.1100
Tuan D. Nguyen
Teacher attrition is a key contributor to teacher shortages in many states, particularly those with large geographically rural areas. Using seven waves of the School and Staffing Survey and Kansas as a case study, this study examines the teacher labor force from 1988 to 2012. Moreover, the study describes the teacher mobility patterns for Kansas from 2000 to 2012 and compares them against the national average, the Midwest states, and the Great Plains states. Furthermore, it examines whether younger teachers, teachers with graduate degrees, and STEM and special education teachers in Kansas are more or less likely to turn over. Lastly, the study examines how certain teacher and school characteristics are associated with teacher attrition for Kansas as a whole and for rural schools in particular. Implications for research and policy are discussed.
教师流失是许多州教师短缺的主要原因,尤其是那些地理位置偏远的农村地区。本研究采用七波学校和人员配置调查和堪萨斯州的案例研究,考察了1988年至2012年的教师劳动力。此外,该研究描述了2000年至2012年堪萨斯州的教师流动模式,并将其与全国平均水平、中西部各州和大平原州进行了比较。此外,它还考察了堪萨斯州的年轻教师、拥有研究生学位的教师、STEM和特殊教育教师是否或多或少有可能离职。最后,本研究考察了堪萨斯州整体,尤其是农村学校的某些教师和学校特征与教师流失的关系。讨论了对研究和政策的影响。
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引用次数: 5
Feeding Victory: 4-H, Extension, and the World War II Food Effort 喂养的胜利:4-H,推广和第二次世界大战的粮食努力
Pub Date : 2019-09-25 DOI: 10.4148/1936-0487.1098
K. Sundgren
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引用次数: 1
Food Insecurity and Assistance on Campus: A Survey of the Student Body 校园食品安全与救助:学生群体调查
Pub Date : 2019-08-28 DOI: 10.4148/1936-0487.1097
Michael Miller, G. Middendorf, Spencer D. Wood, Sonya Lutter, Scott Jones, Brian L. Lindshield
According to recent studies, food insecurity affects from 34%-59% of college students. This will continue to be an issue as tuition increases and more low-income and first-generation students enter universities and colleges. Nearly 52% of college students live at, or near, the poverty level, compared to a national poverty rate of 14.5%. This leaves many undergraduate and graduate students with challenging decisions around meeting their basic housing, nutritional, and educational expenses. To assess food insecurity at Kansas State University (KSU), a random sample of undergraduate and graduate students was surveyed. Findings include a high rate of food insecurity (44.3%) among respondents. This measure was calculated by summing the affirmative responses to the USDA short-form food security questions in the survey. This means that during a 7-month period during the 2016 to 2017 academic year, 44.3% of respondents experienced at least two of the following: 1) didn’t have enough food to last and didn’t have money to buy more, 2) couldn’t afford to eat balanced meals, 3) cut the size of or skipped meals, 4) ate less than they felt they should because they didn’t have enough money, or, 5) were hungry and didn’t eat. This finding is consistent with other studies that report food insecurity rates between 34% and 59% at U.S. universities and community colleges. Fifty-seven percent of respondents were generally aware that food insecurity is a significant problem on college campuses. A majority of respondents (63%) reported that they knew students besides themselves who, currently or sometime during the academic year, had 1 This research was supported in part by USDA Multistate Research Project NC1196, “Food Systems, Health, and Well-Being: Understanding Complex Relationships and Dynamics of Change.” 2 problems with food insecurity or hunger. Yet food assistance (e.g., food pantries) and SNAP are seldom used and responses regarding the use of an on-campus food pantry were mixed. Despite this mixed response, over 2,000 students had used the campus food pantry within the one-year period between opening in 2017 to 2018 (Bishop 2018). Introduction Food insecurity occurs when a household reduces the quality, variety, or desirability of its diet. It can lead to disrupted eating patterns and reduced food intake (USDA ERS 2016). Before the recession in 2007, the rate of food insecurity in the U.S. was 11.1% (USDA ERS 2018). According to the latest available data, the food insecurity rate has not recovered to its prerecession level. An estimated 12.3% of households, or 15.8 million households (42 million individuals) “were food insecure at least some time during the year in 2016” (USDA ERS 2017). Many historically marginalized people in the U.S. live in so-called “food deserts” or areas with little to no available and accessible “healthy” food. Individuals residing in food deserts are more likely to be economically disadvantaged, have poorer nutrition, be exposed to
根据最近的研究,粮食不安全影响了34%-59%的大学生。随着学费的上涨,越来越多的低收入和第一代学生进入大学和学院,这将继续成为一个问题。近52%的大学生生活在或接近贫困水平,而全国贫困率为14.5%。这让许多本科生和研究生在满足基本住房、营养和教育费用方面面临着挑战。为了评估堪萨斯州立大学(KSU)的粮食不安全状况,对本科生和研究生进行了随机抽样调查。调查结果显示,受访者的粮食不安全率很高(44.3%)。这一衡量标准是通过总结调查中对美国农业部简短食品安全问题的肯定回答来计算的。这意味着,在2016至2017学年的7个月时间里,44.3%的受访者至少经历了以下两种情况:1)没有足够的食物吃,也没有钱买更多,2)吃不起均衡的膳食,3)减少用餐量或不用餐,4)因为没有足够的钱而吃得比他们觉得应该吃的少,或者,5)饿了,没有吃东西。这一发现与其他研究一致,这些研究报告称,美国大学和社区学院的粮食不安全率在34%至59%之间。57%的受访者普遍意识到,粮食不安全是大学校园里的一个重大问题。大多数受访者(63%)表示,除了他们自己之外,他们还认识一些学生,这些学生目前或在本学年的某个时候有1这项研究得到了美国农业部多州研究项目NC1196的部分支持,该项目名为“粮食系统、健康和福祉:了解复杂的关系和变化动态”。2粮食不安全或饥饿问题。然而,很少使用食品援助(如食品储藏室)和SNAP,对使用校内食品储藏室的反应也不一。尽管反应不一,但在2017年至2018年开放的一年内,已有2000多名学生使用了校园食品储藏室(Bishop 2018)。引言当一个家庭的饮食质量、种类或可取性降低时,就会出现粮食不安全。它会导致饮食模式紊乱和食物摄入减少(美国农业部ERS 2016)。在2007年经济衰退之前,美国的粮食不安全率为11.1%(美国农业部ERS 2018)。根据现有的最新数据,粮食不安全率尚未恢复到危机前的水平。据估计,12.3%的家庭,即1580万户家庭(4200万人)“至少在2016年的某个时候粮食不安全”(美国农业部ERS 2017)。美国许多历史上被边缘化的人生活在所谓的“食物沙漠”或几乎没有可用和可获得的“健康”食物的地区。居住在食物沙漠中的个人更有可能在经济上处于不利地位,营养较差,接触不健康行为,出现与饮食相关的不良健康结果,并且在其一般居住区的食品商店数量方面处于地理不利地位(Guy和David,2004年)。Morland和Filomena(2007年)以及Franco等人(2008年)报告称,在以白人为主的高收入社区,提供新鲜和冷冻农产品的全方位服务零售食品店比在黑人、混血和低收入社区更好。在大城市中,在黑人、混血和低收入社区发现的相对较少的超市和杂货店中,健康食品的数量和种类明显低于以白人为主的超市和食品店
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引用次数: 6
State Level Revenue Analysis of the Market Facilitation Program 市场促进计划的州一级收入分析
Pub Date : 2019-06-25 DOI: 10.4148/1936-0487.1099
A. Giri, Sankalp Sharma, K. Lovercamp, Iuliia Tetteh, D. Dhakal, Rudra Baral
To compensate the US producers affected by the “trade war” with China, the United States Department of Agriculture (USDA) offered direct payments to producers using 2018 production levels under the Market Facilitation Program (MFP). Results of the revenue efficiency analysis of the MFP payments show the average producers in 12 out of 14 major corn and soybean producing states were compensated such that their 2018 per acre revenue was more than their 2017 per acre revenue. Conversely, an average producer in those states that experienced drought was under-compensated, as their total per acre revenue after the MFP payment was less than their 2017 revenue. Use of the 2018 yield, instead of a three-year average, resulted in a net positive gain for most producers.
为了补偿受中美“贸易战”影响的美国生产商,美国农业部(USDA)根据“市场促进计划”(MFP),以2018年的产量水平向生产商直接支付补贴。对MFP支付的收入效率分析结果显示,在14个主要玉米和大豆生产州中,有12个州的平均生产者获得了补偿,以至于他们2018年的每英亩收入超过了2017年的每英亩收入。相反,那些经历干旱的州的普通生产者得到的补偿不足,因为在MFP支付后,他们每英亩的总收入低于2017年的收入。使用2018年的产量,而不是三年的平均产量,为大多数生产商带来了净收益。
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引用次数: 0
Defining Homelessness in the Rural United States 定义美国农村的无家可归者
Pub Date : 2018-12-22 DOI: 10.4148/1936-0487.1094
Amelia Yousey, Rhucha P Samudra
Rural homelessness in the United States is an understudied phenomenon. Among those studies which do address the issue, there exists no uniform or consistent definition for rural homelessness. In this review of the literature, we look at rural homelessness and consolidate the literature into four main groups based on the definitions currently in use. We recommend a comprehensive definition for rural homelessness that looks at this phenomenon on a spectrum of needs, populations, and periodicity. We further recommend that current homeless count methodology be improved by using a more detailed survey of homeless situations, not only in the rural United States, but in urban areas as well.
在美国,农村无家可归是一个未被充分研究的现象。在那些确实涉及这一问题的研究中,对农村无家可归没有统一或一致的定义。在这篇文献综述中,我们着眼于农村无家可归者,并根据目前使用的定义将文献整合为四个主要组。我们建议对农村无家可归者进行一个全面的定义,从需求、人口和周期性的角度来看待这一现象。我们进一步建议改进目前的无家可归者统计方法,不仅对美国农村地区,而且对城市地区的无家可归者情况进行更详细的调查。
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引用次数: 10
期刊
Online journal of rural research and policy
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