Optimizing locations of waste transfer stations in rural areas.
Ontology highlight
ABSTRACT:
SUBMITTER: Chen Y
PROVIDER: S-EPMC8139517 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:The purpose of this paper is to describe current practices of medical waste management, including its generation, investments, collection, storage, segregation, and disposal, and to explore the level of support from upper tiers of the government and health care system for medical waste management in rural China.The authors draw on a dataset comprised of 209 randomly selected rural township health centers (THCs) in 21 counties in three provinces of China: Anhui, Shaanxi and Sichuan. Surveys were administered to health center administrators in sample THCs in June 2015.The results show that the generation rate of medical waste was about 0.18 kg/bed, 0.15 kg/patient, or 0.13 kg/person per day on average. Such per capita levels are significant given China's large rural population. Although investments of medical waste facilities and personnel in THCs have improved, results show that compliance with national regulations is low. For example, less than half of hazardous medical waste was packed in sealed containers or containers labeled with bio-hazard markings. None of the THCs segregated correctly according to the categories required by formal Chinese regulations. Many THCs reported improper disposal methods of medical waste. Our results also indicate low levels of staff training and low rates of centralized disposal in rural THCs.Medical waste is a serious environmental issue that is rising on the agenda of policymakers. While a large share of THCs has invested in medical waste facilities and personnel, it appears that actual compliance remains low. Using evidence of low rates of training and centralized disposal, we surmise that a lack of support from upper tiers of management is one contributing factor. Given these findings, we recommend that China's policymakers should enhance support from upper tiers and improve monitoring as well as incentives in order to improve medical waste management.
| S-EPMC6054418 | biostudies-other
Project description:PURPOSE:Compared to urban populations, rural populations rank poorly on numerous health indicators, including cancer outcomes. We examined the relationship of rural residence with stage and treatment among patients with prostate cancer, the second most common malignancy in men. MATERIALS AND METHODS:Using the Pennsylvania Cancer Registry we identified all men diagnosed with prostate cancer between 2009 and 2015. Patients were classified as residing in a rural area, a large town or an urban area using the Rural-Urban Commuting Area classification. Our primary outcomes included indicators of prostate cancer treatment and treatment types but we also examined disease stage and mortality. We used the chi-square tests to assess differences between groups and estimated multivariable logistic regression models to assess the association between rural residence and treatment. RESULTS:We identified 51,024 men diagnosed with localized or metastatic prostate cancer between 2009 and 2015. The overall incidence of prostate cancer decreased during the study period from 416 to 304/100,000 men while the incidence of metastatic disease increased from 336 to 538/100,000. Rural residents were less likely to undergo treatment than urban residents even when stratified by low, intermediate and high risk disease (aOR 0.77, 95% CI 0.64-0.91; aOR 0.71, 95% CI 0.58-0.89; and aOR 0.68, 95% CI 0.53-0.89, respectively). Rural status did not affect the receipt of radiation therapy compared to other treatment types. CONCLUSIONS:Prostate cancer treatment differs between urban and rural residents. Rural residents are less likely to receive treatment even when stratified by disease risk.
| S-EPMC7098431 | biostudies-literature
Project description:Food waste has gained prominence in the European political debate thanks to the recent Circular Economy package. Currently the waste hierarchy, introduced by the Waste Framework Directive, has been the rule followed to prioritize food waste prevention and management measures according to the environmental criteria. But when considering other criteria along with the environmental one, such as the economic, other tools are needed for the prioritization and optimization. This paper addresses the situation in which a decision-maker has to design a food waste prevention programme considering the limited economic resources in order to achieve the highest environmental impact prevention along the whole food life cycle. A methodology using Life Cycle Assessment and mathematical programing is proposed and its capabilities are shown through a case study. Results show that the order established in the waste hierarchy is generally followed. The proposed methodology revealed to be especially helpful in identifying "quick wins" - measures that should be always prioritized since they avoid a high environmental impact at a low cost. Besides, in order to aggregate the environmental scores related to a variety of impact categories, different weighting sets were proposed. In general, results show that the relevance of the weighting set in the prioritization of the measures appears to be limited. Finally, the correlation between reducing food waste generation and reducing environmental impact along the Food Supply Chain has been studied. Results highlight that when planning food waste prevention strategies, it is important to set the targets at the level of environmental impact instead of setting the targets at the level of avoided food waste generation (in mass).
| S-EPMC5773089 | biostudies-other
Project description:BackgroundThis study aimed to calculate life expectancy in the areas around 614 subway stations on 23 subway lines in the Seoul metropolitan area of Korea from 2008 to 2017.MethodsWe used the National Health Information Database provided by the National Health Insurance Service, which covers the whole population of Korea. The analysis was conducted on the level of the smallest administrative units within a 200-m radius of each subway station. Life expectancy was calculated by constructing an abridged life table using the number of population and deaths in each area and 5-year age groups (0, 1-4, …, 85+) during the whole study period.ResultsThe median life expectancy in the areas around 614 subway stations was 82.9 years (interquartile range, 2.2 years; minimum, 77.6 years; maximum, 87.4 years). The life expectancy of areas around subway stations located in Seoul was higher than those in Incheon and Gyeonggi-do, but variation within the region was observed. Significant differences were observed between some adjacent subway stations. In Incheon and Gyeonggi-do, substantially higher life expectancy was found around subway stations in newly developed urban areas, and lower life expectancy was found in central Incheon and suburbs in Gyeonggi-do.ConclusionWhen using areas around subway stations as the unit of analysis, variation in life expectancy in the Seoul metropolitan area was observed. This approach may reduce the stigma associated with presenting health inequalities at the level of the smallest administrative units and foster public awareness of health inequalities.
| S-EPMC7669455 | biostudies-literature
Project description:BackgroundSignificant investment has been undertaken by many countries into 'Rural Clinical Training Placement Schemes' for medical students in order to deal with shortages of trained health care professionals in rural and remote locations. This systematic review examines the evidence base of rural educational programs within medical education and focusses on workforce intentions and employment outcomes. The study provides a detailed description of the methodological characteristics of the literature, thematic workforce outcomes and key related factors are identified, study quality is assessed, and the findings are compared within an international context.MethodsA systematic review looking at international literature of rural placement programs within medical education between January 2005 to January 2017 from databases including; Medline, Embase, NursingOVID, PubMed and Cochrane. The study adopted the PRISMA protocol. A quality assessment of the literature was conducted based on the Health Gains Notation Framework.ResultsSixty two papers met the inclusion criteria. The review identified three program classifications; Rural Clinical Placement Programs, Rural Clinical Placement Programs combined with a rural health educational curriculum component and Rural Clinical School Programs. The studies included were from Australia, United States, Canada, New Zealand, Thailand and Africa. Questionnaires and tracking or medical registry databases were the most commonly reported research tools and the majority were volunteer programs. Most studies identified potential rural predictors/confounders, however a number did not apply control groups and most programs were based on a single site. There was a clear discrepancy in the ideal rural clinical placement length. Outcomes themes were identified related to rural workforce outcomes. Most studies reported that an organised, well-funded, rural placement or rural clinical school program produced positive associations with increased rural intentions and actual graduate rural employment.ConclusionsFuture research should focus on large scale methodologically rigorous multi-site rural program studies, with longitudinal follow up of graduates working locations. Studies should apply pre-and post-intervention surveys to measure change in attitudes and control for predictive confounders, control groups should be applied; and in-depth qualitative research should be considered to explore the specific factors of programs that are associated with encouraging rural employment.
| S-EPMC6092777 | biostudies-literature
Project description:Telehealth offers strategies to improve access to subspecialty care for children in rural communities. Rural pediatrician experiences and preferences regarding the use of these telehealth strategies for children's subspecialty care needs are not known. We elicited rural pediatrician experiences and preferences regarding different pediatric subspecialty telehealth strategies.Seventeen semistructured telephone interviews were conducted with rural pediatricians from 17 states within the United States. Interviewees were recruited by e-mails to a pediatric rural health listserv and to rural pediatricians identified through snowball sampling. Themes were identified through thematic analysis of interview transcripts. Institutional Review Board approval was obtained.Rural pediatricians identified several telehealth strategies to improve access to subspecialty care, including physician access hotlines, remote electronic medical record access, electronic messaging systems, live video telemedicine, and telehealth triage systems. Rural pediatricians provided recommendations for optimizing the utility of each of these strategies based on their experiences with different systems. Rural pediatricians preferred specific telehealth strategies for specific clinical contexts, resulting in a proposed framework describing the complementary role of different telehealth strategies for pediatric subspecialty care. Finally, rural pediatricians identified additional benefits associated with the use of telehealth strategies and described a desire for telehealth systems that enhanced (rather than replaced) personal relationships between rural pediatricians and subspecialists.Rural pediatricians described complementary roles for different subspecialty care telehealth strategies. Additionally, rural pediatricians provided recommendations for optimizing individual telehealth strategies. Input from rural pediatricians will be crucial for optimizing specific telehealth strategies and designing effective telehealth systems.
| S-EPMC4855729 | biostudies-literature
Project description:BackgroundNumerous urban villages (UVs) and frequent infectious disease outbreaks are major environmental and public health concerns in highly urbanized regions, especially in developing countries. However, the spatial and quantitative associations between UVs and infections remain little understood on a fine scale.Methodology and principal findingsIn this study, the relationships between reported dengue fever (DF) epidemics during 2012-2017, gross domestic product (GDP), the traffic system (road density, bus and/or subway stations), and UVs derived from high-resolution remotely sensed imagery in the central area of Guangzhou, were explored using geographically weighted regression (GWR) models based on a 1 km × 1 km grid scale. Accounting for 16.53%-18.07% of residential area and 16.84%-18.02% of population, UVs possessed 28.55%-38.24% of total reported DF cases in the core area of Guangzhou. The density of DF cases and the DF incidence rates in UVs were 1.81-3.13 and 1.82-3.06 times of that of normal construction land. Approximately 90% of the total cases were concentrated in the UVs and their buffering zones of radius ranged from 0 to 500 m. Significantly positive associations were observed between gridded DF incidence rates and UV area (r = 0.33, P = 0.000), the number of bus stops (r = 0.49, P = 0.000) and subway stations (r = 0.27, P = 0.000), and road density (r = 0.39, P = 0.000). About 60% of spatial variations in the gridded DF incidence rates were interpreted by the different variables of GDP, UVs, and bus stops integrated in GWR models.ConclusionsUVs likely acted as special transfer stations, receiving and/or exporting DF cases during epidemics. This work increases our understanding of the influences of UVs on vector-borne diseases in highly urbanized areas, supplying valuable clues to local authorities making targeted interventions for the prevention and control of DF epidemics.
| S-EPMC6504109 | biostudies-literature
Project description:The 4th Industrial Revolution (4IR) is the term given to encompass a range of technological developments that many argue will fundamentally change society, much in the same way that electricity and digital technology did during previous industrial revolutions. This paper argues that current debates around 4IR are centred on the urban core, with rural areas being relegated to the peripherality and the remainder. The paper therefore examines these technologies from a rural perspective and considers what impact they could have in rural areas, both positive and negative. The analysis shows that the impacts of 4IR technologies could be just as important in rural as in urban places. Drawing on extant theories of rural development, the paper examines the physical and cultural barriers facing rural areas when attempting to engage with 4IR. The paper concludes by proposing that rural theorists engage with smart urban theoretical debates. New research should seek to understand the multi-faceted aspects of 4IR in rural regions, and to support the transition to smart rural futures.
| S-EPMC7443211 | biostudies-literature
Project description:The data described in this article were collected daily over the period June 10, 2010, to November 25, 2012, from the website of the Spanish Ministry of Industry, Energy and Tourism. The database includes information about fuel stations regarding to their prices (both gross and net of taxes), brand, location (latitude and longitude), and postal code in the Spanish provinces of Madrid and Barcelona. Moreover, obtaining the postal codes has allowed us to select those stations that are operating within the metropolitan areas of Madrid and Barcelona. By considering those fuel stations that uninterruptedly provided prices during the entire period, the data can be especially useful to explore the dynamics of prices in fuel markets. This is the case of Balaguer and Ripollés (2016), "Asymmetric fuel price responses under heterogeneity" [1], who, taking into account the presence of the potential heterogeneity of the behaviour of fuel stations, used this statistical information to perform an analysis on asymmetric fuel price responses.
| S-EPMC4764895 | biostudies-other
Project description:ObjectiveTo assess rural-urban differences in electronic medical record (EMR) adoption among office-based physician practices in the United States.MethodsSurvey data on over 270 000 office-based physician sites (representing over 1 280 000 physicians) in the United States from 2012 was used to assess differences in EMR adoption rates among practices in rural and urban areas. Logistic regression tests for differences in the determinants of EMR adoption by geography, and a nonlinear decomposition is used to quantify how much of the rural-urban gap is due to differences in measureable characteristics (such as type of practice or affiliation with a health system).ResultsOverall EMR adoption rates were significantly higher for practices in rural areas (56%) vs those in urban areas (49%) in 2012 (P < 0.001). Twenty-nine states had statistically significantly different adoption rates between rural and urban areas, with only two states demonstrating higher rates in urban areas. EMR adoption continues to be higher for primary care practices when compared to specialists (51% vs 49%, P < 0.001), and state-level rural-urban differences in adoption are more pronounced for specialists. The decomposition technique finds that only 14% of the rural-urban gap can be explained by differences in measurable characteristics between practices.ConclusionsAt the national level, rates of EMR adoption are higher for rural practices than for their urban counterparts, reversing earlier trends. This suggests that outreach efforts, namely the Regional Extension Centers created by the Office of the National Coordinator, have been particularly effective in increasing EMR adoption in rural areas.
| S-EPMC8485927 | biostudies-literature