Poll Finds Rural Residents More Hesitant to Get Vaccinated.
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ABSTRACT:
SUBMITTER: Marema T
PROVIDER: S-EPMC9138735 | biostudies-literature |
REPOSITORIES: biostudies-literature
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| S-EPMC9258752 | biostudies-literature
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| S-EPMC8174028 | biostudies-literature
Project description:BACKGROUND: Although increasing staff numbers during shifts when emergency department (ED) crowding is severe can help meet patient demand, it remains unclear how different types of added staff, particularly junior residents, may affect crowding. METHODS: To identify associations between types of staff and ED crowding, we conducted a cross-sectional, single-center study in the ED of a large, teaching hospital in Japan between January and December 2012. Patients who visited the ED during the study period were enrolled. We excluded (1) patients previously scheduled to visit the ED, and (2) neonates transferred from other hospitals. During the study period, 27,970 patients were enrolled. Types of staff analyzed were junior (first and second year) residents, senior (third to fifth year) residents, attending (board-certified) physicians, and nurses. A generalized linear model was applied to length of ED stay for all patients as well as admitted and discharged patients to quantify an association with the additional staff. RESULTS: In the model, addition of one attending physician or senior resident was associated with decreased length of ED stay for total patients by 3.88 or 1.64 minutes, respectively (95% CI, 2.20-5.56 and 0.81-2.48 minutes); while additional nursing staff had no association. Surprisingly, however, one additional junior resident was associated with prolonged length of ED stay for total patients by 0.97 minutes (95% CI 0.37-1.57 minutes) and for discharged patients by 1.01 minutes (95% CI 0.45-1.59 minutes). CONCLUSION: Staffing adjustments aimed at alleviating ED crowding should focus on adding more senior staff during peak-volume shifts.
| S-EPMC4219696 | biostudies-literature
Project description:During July-August 2021, a COVID-19 outbreak involving 21 residents (all fully vaccinated) and 10 staff (9 fully vaccinated) occurred in a Connecticut nursing home. The outbreak was likely initiated by a fully vaccinated staff member and propagated by fully vaccinated persons. Prior COVID-19 was protective among vaccinated residents.
| S-EPMC8689795 | biostudies-literature
Project description:Discrepancies between needed and received hospice care exist, especially in rural areas. Hospice care quality ratings for 743 rural and urban patients and their families were compared. Rural participants reported higher overall satisfaction and with pain/symptom management. Regardless of geographic location, satisfaction was higher when patients were informed and emotionally supported. Patients and family ratings did not differ. Findings support prior reports using retrospective rather than our study's point-of-care surveys.
| S-EPMC4582410 | biostudies-literature
Project description:Patterns of poultry exposure in rural and urban areas in China have not been systematically evaluated and compared. The objective of our study is to investigate patterns in human exposure to poultry in rural and urban China. We conducted a two-stage household-based clustered survey on population exposure to live/sick/dead poultry in Xiuning and Shenzhen. Half of the rural households (51%) in Xiuning raised poultry, mostly (78%) free-range. Around half of those households (40%) allowed poultry to stay in their living areas. One quarter of villagers reported having contact with sick or dead poultry. In Shenzhen, 37% urban residents visited live poultry markets. Among these, 40% purchased live poultry and 16% touched the poultry or cages during purchase. Our findings indicated that human exposure to poultry was different in rural and urban areas in China. This discrepancy could contribute to the observed differences in epidemiologic characteristics between urban and rural cases of influenza A(H7N9) and A(H5N1) virus infection.
| S-EPMC4000224 | biostudies-literature
Project description:BackgroundEfficacy of telemedicine for stroke was first established by the Stroke Team Remote Evaluation Using a Digital Observation Camera (STRokE DOC) trials in California and Arizona. Following these randomized controlled trials, the Stroke Telemedicine for Arizona Rural Residents (STARR) network was the first telestroke network to be established in Arizona. It consisted of a 7 spoke 1 hub telestroke system, and it was designed to serve rural, remote, or neurologically underserved communities.ObjectiveThe objective of STARR was to establish a multicenter state-wide telestroke research network to determine the feasibility of prospective collection, recording, and regularly analysis of telestroke patient consultations and care data for the purposes of establishing quality measures, improvement, and benchmarking against other national and international telestroke programs.MethodsThe STARR trial was open to enrollment for 29 months from 2008 to 2011. Mayo Clinic Hospital, Phoenix, Arizona served as the hub primary stroke center and its vascular neurologists provided emergency telestroke consultations to seven participating rural, remote, or underserved spoke community hospitals in Arizona. Eligibility criteria for activation of a telestroke alert and study enrollment were established. Consecutive patients exhibiting symptoms and signs of acute stroke within a 12 h window were enrolled, assessed, and treated by telemedicine. The state government sponsor, Arizona Department of Health Services' research grant covered the cost of acquisition, maintenance, and service of the selected telemedicine equipment as well as the professional telestroke services provided. The study deployed multiple telemedicine video cart systems, picture archive and communications systems software, and call management solutions. The STARR protocol was reviewed and approved by Mayo Clinic IRB, which served as the central IRB of record for all the participating hospitals, and the trial was registered at ClinicalTrials.gov.ResultsThe telestroke hotline was activated 537 times, and ultimately 443 subjects met criteria and consented to participate. The STARR successfully established a multicenter state-wide telestroke research network. The STARR developed a feasible and pragmatic approach to the prospective collection, storage, and analysis of telestroke patient consultations and care data for the purposes of establishing quality measures and tracking improvement. STARR benchmarked well against other national and international telestroke programs. STARR helped set the foundation for multiple regional and state telestroke networks and ultimately evolved into a national telestroke network.ConclusionsMultiple small and rurally located community hospitals and health systems can successfully collaborate with a more centrally located larger hospital center through telemedicine technologies to develop a coordinated approach to the assessment, diagnosis, and emergency treatment of patients manifesting symptoms and signs of an acute stroke syndrome. This model may serve well the needs of patients presenting with other time-sensitive medical emergencies.Clinical Trial Registration number: NCT00829361.
| S-EPMC9052207 | biostudies-literature
Project description: Not available
| S-EPMC8438595 | biostudies-literature
Project description:China has seen an accelerated process of urbanization in the past 30 years. The influence of urbanization on health is complex and primarily influenced by changes in social capital. The purpose of this research was to compare the social capital between urban residents and urbanized rural residents of southwest China and its relationship with self-rated health. It is of great significance to study the difference of social capital between urban and urbanized rural residents to help urbanized rural residents improve their social adaptability and health. Data was collected from 1,646 residents between November and December of 2017 in Chengdu. Three logistic regressions were used to investigate the association between social capital and self-rated health by controlling for demographic variables, lifestyles factors, and health status factors. We observed that urban residents' self-rated health had a higher proportion of "good" than that of urbanized rural residents (P = 0.017). After controlling for factors such as health status and demographic characteristics, participants with higher social capital had better self-rated health. Urbanized rural residents with higher community trust and belonging had better self-rated health (OR = 0.701, 95% CI = 0.503~0.978), however urban residents with higher personal social networks and family relationships had better self-rated health (OR = 0.676, 95% CI = 0.490~0.933 and OR = 0.666, 95% CI = 0.450~0.987, respectively). Different types of communities should focus on the types of social capital from different sources, so as to take more targeted measures to improve the social support of residents and improve their health. Improving residents' social trust and sense of belonging may help urbanized rural residents better adapt to the new living environment and help them complete the identity transformation.
| S-EPMC8425509 | biostudies-literature
Project description:BACKGROUND/OBJECTIVES:This study aims to identify resident characteristics associated with being offered and subsequently shown an advance care planning (ACP) video in the Pragmatic Trial of Video Education in Nursing Homes (PROVEN) and if differences are driven by within- and/or between-facility differences. DESIGN:Cross-sectional study, from March 1, 2016, to May 31, 2018. SETTING:A total of 119 PROVEN intervention nursing homes (NHs). PARTICIPANTS:A total of 43 303 new NH admissions. MEASUREMENTS:Data came from the Minimum Data Set and an electronic record documenting whether a video was offered and shown to residents. We conduct both naïve logistic regression models and hierarchical logistic models, controlling for NH fixed effects, to examine the overall differences in offer and show rate by resident characteristics. RESULTS:In naïve regression models, compared to white residents, black residents are 7.8 percentage point (pp) (95% confidence interval [CI] = -9.1 to -6.5 pp) less likely to be offered the video. These differences decrease to 1.3 pp (95% CI = -2.61 to -0.02 pp) when accounting for NH fixed effects. In fully adjusted models, black residents compared to white residents were 2.1 pp more likely to watch the video contingent on being offered (95% CI = 0.4-3.7 pp). Residents with cognitive impairment were less likely to be offered and shown the video. CONCLUSIONS:After controlling for NH fixed effects, there were smaller racial differences in being offered the video, but once offered, black residents were more likely to watch the video. This suggests that black residents are receptive to this type of ACP intervention but need to be given an opportunity to be exposed. J Am Geriatr Soc 68:603-608, 2020.
| S-EPMC7056595 | biostudies-literature