European shrinking rural areas: Key messages for a refreshed long-term vision

El artículo comienza con un debate sobre el concepto de "contracción” y sus orígenes, fuera del ámbito del desarrollo rural. A partir de ahí, se muestra la distribución de las zonas rurales en contracción en toda Europa. A continuación, se describen los procesos socioeconómicos que impulsan el declive demográfico en las zonas rurales, utilizando tanto la revisión bibliográfica del proyecto ESCAPE como los resultados de sus ocho estudios de caso. Seguidamente, se describe de forma breve la evolución de las intervenciones de la UE para paliar los efectos del declive demográfico, y se hacen algunas observaciones sobre el panorama político/de gobernanza actual. Concluimos considerando cómo una mejor comprensión del problema y del proceso de reducción puede conducir a intervenciones más eficaces, en el contexto de una visión renovada a largo plazo para el medio rural europeo. Este último debe reconocer plenamente el creciente abanico de oportunidades a las que se enfrentan las zonas rurales, a medida que la COVID-19 cambia estas y se aceleran las transformaciones en el comportamiento laboral y en la geografía de la actividad económica, y se cumplen los anteriores cambios graduales en la tecnología y los mercados.Alternate :The paper begins with a discussion of the concept of "shrinking”, and its origins, outside the realm of rural development. Building on this, the paper shows the distribution of shrinking rural areas across Europe. Using both the project's literature review and findings from its eight case studies the socio-economic processes which drive demographic decline in rural areas are then described. A brief account of the evolution of EU interventions to alleviate the effects of shrinking, and some remarks about the current policy/governance landscape follow. We conclude by considering how a better understanding of the problem and process of shrinking may lead to more effective interventions, within the context of a refreshed long-term vision for Rural Europe. The latter needs to fully acknowledge the expanding repertoire of opportunities confronting rural areas as COVID-19 changes in working behaviour, and the geography of economic activity, accelerate, and fulfil, previously incremental shifts in technology and markets.

595 The COVID Effect: Exploring the Impact of Coronavirus on an Academic Burn Center

Introduction Globally, medical centers have faced unprecedented times with the onset of the Novel Coronavirus pandemic. Emergency departments (ED) and burn units have had to adapt to uncertainty and new challenges. At our institution, we had to alter our daily burn practice, physically moving our burn unit to our surgical intensive care unit to accommodate staff cohorting. While some hospitals have seen patient surges, most have endured dramatic decreases in productivity. A UK burn unit documented lower ED presentations and reduced referrals from other centers, with 50% fewer patients admitted to their burns ward (Farroha). In Israel, a 66% decrease in adult burn patients was noted (Kruchevska et al.). We sought to identify the impact of COVID-19 on burn injury epidemiology in our burn unit based in a large, urban, academic medical center. Methods We conducted a retrospective review of our burn database for ED visits and admissions related to burn injuries between March 1st and June 30th in the years 2017, 2018, 2019, and 2020. We looked at the age and sex of patient, type of visit, length of stay (LOS), the mechanism of injury, the setting in which injury occurred, and the details of the injury. We compare annual trends, with emphasis on comparison of 2020 to previous years. Results From admissions and ED data records, 215 patient encounters were reviewed. We saw a yearly rise in total burn patients seen in the ED or admitted to our burn unit 2017–2020 (39, 43, 63, and 70 respectively) with the highest volume of patients in 2020. Mean patient age ranged from 45 (2020) to 51 (2017). More males were burned in all years (male:female ratio 3.9 in 2017, 2.1 in 2018, 2.5 in 2019, 1.9 in 2020). Median LOS in 2020 was 2.5 days, consistent with 2017–2019 values (2, 3, 3, respectively). Between 2017 and 2019, 10%, 2%, and 8% respectively of patients evaluated were treated on an outpatient basis, while in 2020, 20% were outpatient. Rates of flash, scald, flame, chemical, electrical, and contact burns were stable over the period. Of those patients who were admitted, 1.8% sustained work-related burns in 2020 versus 8.9% over 2017–2019. In 2020, 23% of burns were cooking related versus 18% over the prior 3 years. Conclusions Despite documented decreased burn admissions in some units, our unit saw an increase in burn injuries presenting for evaluation in the first 3 months of the COVID-19 pandemic as compared to the analogous period in the three years prior. Burns were less often tied to work-related incidents and more frequently related to cooking injuries. Even with more patients treated and released from the ED, inpatient admission numbers were maintained. These findings support the importance of protecting our staffing and burn unit resources in a pandemic setting in order to appropriately treat regional patients and an increase in home-based injuries.

Essential and Vulnerable: Implications of Covid-19 for Farmers in Ireland.

Objectives: This paper seeks to: provide an overview of the impacts of and responses to the spread of COVID-19 in Ireland; assess the vulnerability of the population living in rural areas to COVID-19; compare the health status of male farmers to underlying medical conditions frequently associated with those experiencing the worst impacts of the illness; and assess the implications of COVID-19 for farmers living alone and farm households with children. Methods: We present an overview of the impact and response to COVID-19 through the use of public health statistics and reference to policy documents. We subsequently draw on the results of ongoing geographic and health research to present an overview of the impacts and potential implications of COVID-19. Results: The population of many rural areas and farmers in particular are highly vulnerable to adverse outcomes to COVID-19 infection. Single person farm households are at particular risk of isolation, whilst those families with children are at increased risk of stress. Conclusions: There is an urgent need to address both COVID-19 challenges and the health and wellbeing issues confronting farmers and farm families arising out of the current pandemic by supporting these populations adopt and sustain health behaviour changes, improve their wellbeing and develop the resources that support resilience.