Recent advances in artificial intelligence (AI) and telemedicine are transforming healthcare delivery, particularly in rural and underserved communities. Background/Objectives: The purpose of this systematic review is to explore the use of AI-driven diagnostic tools and telemedicine platforms to identify underlying themes (constructs) in the literature across multiple research studies. Method: The research team conducted an extensive review of studies and articles using multiple research databases that aimed to identify consistent themes and patterns across the literature. Results: Five underlying constructs were identified with regard to the utilization of AI and telemedicine on patient diagnosis in rural communities: (1) Challenges/benefits of AI and telemedicine in rural communities, (2) Integration of telemedicine and AI in diagnosis and patient monitoring, (3) Future considerations of AI and telemedicine in rural communities, (4) Application of AI for accurate and early diagnosis of diseases through various digital tools, and (5) Insights into the future directions and potential innovations in AI and telemedicine specifically geared towards enhancing healthcare delivery in rural communities. Conclusions: While AI technologies offer enhanced diagnostic capabilities by processing vast datasets of medical records, imaging, and patient histories, leading to earlier and more accurate diagnoses, telemedicine acts as a bridge between patients in remote areas and specialized healthcare providers, offering timely access to consultations, follow-up care, and chronic disease management. Therefore, the integration of AI with telemedicine allows for real-time decision support, improving clinical outcomes by providing data-driven insights during virtual consultations. However, challenges remain, including ensuring equitable access to these technologies, addressing digital literacy gaps, and managing the ethical implications of AI-driven decisions. Despite these hurdles, AI and telemedicine hold significant promise in reducing healthcare disparities and advancing the quality of care in rural settings, potentially leading to improved long-term health outcomes for underserved populations.

Background: More than 18 million Americans are currently suffering from alcohol use disorder (AUD): a compulsive behavior of alcohol use as a result of a chronic, relapsing brain disease. With alcohol-related injuries being one of the leading causes of preventable deaths, there is a dire need to find ways to assist those suffering from alcohol dependence. There still exists a gap in knowledge as to the potential of telemedicine in improving health outcomes for those patients suffering from AUD. Objective: The purpose of this systematic review was to evaluate the measures of effectiveness, efficiency, and quality that result from the utilization of telemedicine in the management of alcohol abuse, addiction, and rehabilitation. Methods: This review was conducted utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The articles used in this analysis were gathered using keywords inclusive of both telemedicine and alcohol abuse, which were then searched in the Cumulative Index to Nursing and Allied Health Literature, Cochrane, and MEDLINE (PubMed) databases. A total of 22 articles were chosen for analysis. Results: The results indicated that telemedicine reduced alcohol consumption. Other common outcomes included reduced depression (4/35, 11%), increased patient satisfaction (3/35, 9%), increase in accessibility (3/35, 9%), increased quality of life (2/35, 6%), and decreased cost (1/35, 3%). Interventions included mobile health (11/22, 50%), electronic health (6/22, 27%), telephone (3/33, 14%), and 2-way video (2/22, 9%). Studies were conducted in 3 regions: the United States (13/22, 59%), the European Union (8/22, 36%), and Australia (1/22, 5%). Conclusions: Telemedicine was found to be an effective tool in reducing alcohol consumption and increasing patients’ accessibility to health care services or health providers. The group of articles for analysis suggested that telemedicine may be effective in reducing health care costs and improving the patient’s quality of life. Although telemedicine shows promise as an effective way to manage alcohol-related disorders, it should be further investigated before implementation.

Purpose: The main objective of this study was to investigate abuse of residents with either dementia or Alzheimer’s disease in long-term care settings, to identify facilitators and barriers surrounding implementation of systems to prevent such occurrences, and to draw conclusions on combating the issue of abuse. Patients and methods: A systematic review was conducted using the Medline, CINAHL, and Academic Search Ultimate databases. With the use of key terms via Boolean search, 30 articles were obtained which were determined to be germane to research objectives. The review was conducted and structured based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Residents with dementia or Alzheimer’s disease are at greater risk of abuse. The growing population could increase this problem exponentially. The most common facilitators were the introduction of policies/programs in the facility, education, and working conditions. The most cited barriers were poor training, lack of research, and working conditions in the long-term care setting. Conclusion: The examples given would be useful in minimizing the potential for abuse in the long-term care setting. Leadership can take an active role in the prevention of abuse of the elderly through their actions, education of employees, and changes in the work environment.

Previous literature has shown how associate engagement has positively impacted on productivity, job satisfaction, safety, retention, consumer sentiment, and financial performance in hospitals and healthcare systems. However, a lack of research showing the relationship between associate engagement and job satisfaction within the long-term care environment has existed. Our objective was to investigate characteristics within the long-term care environment that promote and detract from associate job satisfaction and extrapolate the best practices in maintaining job satisfaction and engagement. This systematic review queried CINAHL, PubMed (MEDLINE), and Academic Search Ultimate databases for peer-reviewed publications for facilitators and barriers commensurate with employee job satisfaction in long-term care facilities using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) and the Kruse Protocols. The authors identified 11 facilitators for job satisfaction and 18 barriers to job satisfaction in the 60 selected articles. The top four facilitators were Supportive Leadership, Capable and Motivated Employees, Positive Organizational Values, and Social Support Mechanisms. The top four barriers were condescending management style, high job demands, lack of self-care, and lack of training with medically complex patients. The systematic review revealed the importance of maintaining satisfied employees in the long-term care workplace through am emphasis leadership and on the facilitators identified to best serve their associates and improve care for residents.

Intelligent use of rural residential land and sustainable construction is inexorably linked to cost; however, options exist that are eco-friendly and have a positive return on investment. In 2011, a research residence was built to evaluate various land-use and sustainable components. This Texas house has subsequently been used for both residential and research purposes. The purpose of this case study was to evaluate break-even construction considerations, to assess environmental impacts, and to evaluate qualitatively efficacy of sustainable options incorporated in the research residence. Some of the specific components discussed are home site placement (directional positioning); materiel acquisition (transportation); wood product minimization; rainwater harvesting; wastewater management; grid-tied solar array power; electric car charging via a solar array; geothermal heating and cooling; insulation selection; windows, fixtures, and appliance selection; and on-demand electric water heaters for guest areas. This study seeks to identify the impact of proper land use and sustainable techniques on the environment and return-on-investment in rural areas. Break-even and 15-year Net Present Value (NPV) analysis at 3% and 5% cost of capital were used to evaluate traditional construction, partially sustainable construction, and fully sustainable construction options for the case study house, which was built sustainably. The additional cost of sustainable construction is estimated at $54,329. At 3%, the analysis suggests a 15-year NPV of $334,355 (traditional) versus $250,339 million (sustainable) for a difference of $84K. At 5% cost of capital, that difference falls to $63K. The total estimated annual difference in carbon emissions is 4.326 million g/CO₂e for this research residence. The results indicate that good choices for quick return-on-investment in rural construction would be the use of engineered lumber, Icynene foam, and Energy Star windows and doors. Medium-term options include photovoltaic systems (PVS) capable of powering the home and an electric car. Sustainable construction options should positively affect the environment and the pocketbook. Regulations and code should require adoption of short-range, break-even sustainable solutions in residential construction.

Background/Purpose: The purpose of this research is to determine if the tradeoffs that Kissick proposed among cost containment, quality, and access remain as rigidly interconnected as originally conceived in the contemporary health care context. Although many have relied on the Kissick model to advocate for health policy decisions, to our knowledge the model has never been empirically tested. Some have called for policy makers to come to terms with the premise of the Kissick model tradeoffs, while others have questioned the model, given the proliferation of quality-enhancing initiatives, automation, and information technology in the health care industry. One wonders whether these evolutionary changes alter or disrupt the originality of the Kissick paradigms themselves. Methods: Structural equation modeling (SEM) was used to evaluate the Kissick hypothetical relationships among the unobserved constructs of cost, quality, and access in hospitals for the year 2018. Hospital data were obtained from Definitive Healthcare, a subscription site that contains Medicare data as well as non-Medicare data for networks, hospitals, and clinics (final n = 2766). Results: Reporting significant net effects as defined by our chosen study variables, we find that as quality increases, costs increase, as access increases, quality increases, and as access increases, costs increase. Policy and Practice Implications: Our findings lend continued relevance to a balanced approach to health care policy reform efforts. Simultaneously bending the health care cost curve, increasing access to care, and advancing quality of care is as challenging now as it was when the Kissick model was originally conceived.