scholarly journals PrEP Care Continuum Engagement Among Persons Who Inject Drugs: Rural and Urban Differences in Stigma and Social Infrastructure

2021 ◽  
Author(s):  
Suzan M. Walters ◽  
David Frank ◽  
Brent Van Ham ◽  
Jessica Jaiswal ◽  
Brandon Muncan ◽  
...  
Keyword(s):  
Qualitative Interviews ◽  
Urban Setting ◽  
Rural Setting ◽  
Social Infrastructure ◽  
Persons Who Inject Drugs ◽  
Urban Settings ◽  
Service Programs ◽  
Rural And Urban ◽  
Hiv Acquisition ◽  
Willingness To Use

AbstractPre-exposure prophylaxis (PrEP) is a medication that prevents HIV acquisition, yet PrEP uptake has been low among people who inject drugs. Stigma has been identified as a fundamental driver of population health and may be a significant barrier to PrEP care engagement among PWID. However, there has been limited research on how stigma operates in rural and urban settings in relation to PrEP. Using in-depth semi-structured qualitative interviews (n = 57) we explore PrEP continuum engagement among people actively injecting drugs in rural and urban settings. Urban participants had more awareness and knowledge. Willingness to use PrEP was similar in both settings. However, no participant was currently using PrEP. Stigmas against drug use, HIV, and sexualities were identified as barriers to PrEP uptake, particularly in the rural setting. Syringe service programs in the urban setting were highlighted as a welcoming space where PWID could socialize and therefore mitigate stigma and foster information sharing.

On-Scene Intravenous Line Insertion Adversely Impacts Prehospital Time in Rural Vehicular Trauma

2008 ◽  
Vol 74 (11) ◽  
pp. 1083-1087 ◽  
Author(s):  
Richard P. Gonzalez ◽  
Glenn R. Cummings ◽  
Herbert A. Phelan ◽  
Madhuri S. Mulekar ◽  
Charles B. Rodning
Keyword(s):  
Linked Data ◽  
Motor Vehicle ◽  
Motor Vehicle Crash ◽  
Urban Setting ◽  
Rural Setting ◽  
Urban Settings ◽  
Intravenous Line ◽  
Rural And Urban ◽  
Rural Settings ◽  
Prehospital Time

Fatality rates from rural vehicular trauma are almost double those found in urban settings. Increased emergency medical services (EMS) prehospital time has been implicated as one of the causative factors for higher rural fatality rates. Advanced Trauma Life Support guidelines suggest scene time should not be extended to insert an intravenous catheter (IV). The purpose of this study was to assess the association between intravenous line placement and motor vehicle crash (MVC) scene time in rural and urban settings. An imputational methodology using the National Highway Traffic Safety Administration Crash Outcome Data Evaluation System permitted linkage of data from police motor vehicle crash and EMS records. Intergraph GeoMedia software permitted this linked data to be plotted on digital maps for segregation into rural and urban groups. MVCs were defined as rural or urban by location of the accident using the U.S. Bureau of Census Criteria. Linked data were analyzed to assess for EMS time on-scene, on-scene IV insertion, on-scene IV insertion attempts, and patient mortality. Over a 2-year period from January 2001 through December 2002, data were collected from Alabama EMS patient care reports (PCRs) and police crash reports. A total of 45,763 police crash reports were linked to EMS PCRs. Of these linked crash records, 34,341 (75%) and 11,422 (25%) were injured in rural and urban settings, respectively. Six hundred eleven (1.78%) mortalities occurred in rural settings and 103 (0.90%) in urban settings (P < 0.005). There were 6,273 (18.3%) on-scene IV insertions in the rural setting and 1,290 (11.3%) in the urban setting (P < 0.005). Mean EMS time on-scene when single IV insertion attempts occurred was 16.9 minutes in the rural setting and 14.5 minutes in the urban setting (P < 0.0001). When two attempts of on-scene IV insertion were made, mean EMS time on-scene in the rural setting (n = 891 [2.6%]) was 18.4 minutes and 15.7 minutes in the urban setting (n = 142 [1.2%; P < 0.005). Excluding dead on-scene patients, mean EMS time on-scene when mortalities occurred in rural and urban settings was 18.9 minutes and 10.8 minutes, respectively (P < 0.005). On-scene IV insertion occurred with significantly greater frequency in rural than urban settings. This incurs greater EMS time on-scene and prehospital time that may be associated with increased vehicular fatality rates in rural settings.

scholarly journals Administrative incidence of psychosis assessed in an early intervention service in England: first epidemiological evidence from a diverse, rural and urban setting

2010 ◽  
Vol 41 (5) ◽  
pp. 949-958 ◽  
Author(s):  
F. Cheng ◽  
J. B. Kirkbride ◽  
B. R. Lennox ◽  
J. Perez ◽  
K. Masson ◽  
...  
Keyword(s):  
Early Intervention ◽  
Urban Areas ◽  
Clinical Epidemiology ◽  
Population Based ◽  
Service Planning ◽  
Urban Setting ◽  
First Episode ◽  
Urban Settings ◽  
Rural And Urban ◽  
Early Intervention In Psychosis

BackgroundEarly Intervention in Psychosis Services (EIS) for young people in England experiencing first-episode psychosis (FEP) were commissioned in 2002, based on an expected incidence of 15 cases per 100 000 person-years, as reported by schizophrenia epidemiology in highly urban settings. Unconfirmed reports from EIS thereafter have suggested higher than anticipated rates. The aim of this study was to compare the observed with the expected incidence and delineate the clinical epidemiology of FEP using epidemiologically complete data from the CAMEO EIS, over a 6-year period in Cambridgeshire, for a mixed rural–urban population.MethodA population-based study of FEP (ICD-10, F10–39) in people aged 17–35 years referred between 2002 and 2007; the denominator was estimated from mid-year census statistics. Sociodemographic variation was explored by Poisson regression. Crude and directly standardized rates (for age, sex and ethnicity) were compared with pre-EIS rates from two major epidemiological FEP studies conducted in urban English settings.ResultsA total of 285 cases met FEP diagnoses in CAMEO, yielding a crude incidence of 50 per 100 000 person-years [95% confidence interval (CI) 44.5–56.2]. Age- and sex-adjusted rates were raised for people from black ethnic groups compared with the white British [incidence rate ratio (IRR) 2.1, 95% CI 1.1–3.8]. Rates in our EIS were comparable with pre-EIS rates observed in more urban areas after age, sex and ethnicity standardization.ConclusionsOur findings suggest that the incidence observed in EIS is far higher than originally anticipated and is comparable to rates observed in more urban settings prior to the advent of EIS. Sociodemographic variation due to ethnicity and other factors extend beyond urban populations. Our results have implications for psychosis aetiology and service planning.

scholarly journals Women differentials in fertility: The case of rural and urban educational development in Benue State, Nigeria

2021 ◽  
Vol 2 (1/2) ◽  
pp. 80-86
Author(s):  
Bridget Demekaa ◽  
Umbur Demekaa
Keyword(s):  
Educational Development ◽  
General Purpose ◽  
Urban Setting ◽  
Girl Child ◽  
Urban Settings ◽  
Fertility Differential ◽  
Rural And Urban ◽  
Child Education ◽  
Lower Fertility ◽  
The Government

This study relates women education to fertility in the Ihugh (rural) and Makurdi (urban) setting in Benue State. The general purpose of the study is to test whether women with substantial schooling do have lower fertility than those without schooling. The study reveals that there is fertility differential for rural and urban settings, and that schooling is an index of the differentials. The study presents its findings and puts forward some recommendations that can help the government to address the issue of women education, especially the girl-child education.

scholarly journals Spatial modelling of sand fly vector’s response to a synthetic sex-aggregation pheromone: impact on the incidence of visceral leishmaniasis in rural and urban settings

2020 ◽  
Author(s):  
Renata Retkute ◽  
Erin Dilger ◽  
James GC Hamilton ◽  
Matt J Keeling ◽  
Orin Courtenay
Keyword(s):  
Visceral Leishmaniasis ◽  
Aggregation Pheromone ◽  
Human Infection ◽  
Urban Setting ◽  
Sand Fly ◽  
Mathematical Framework ◽  
Urban Settings ◽  
Infection Incidence ◽  
Host Seeking ◽  
Rural And Urban

AbstractBackgroundVisceral leishmaniasis (VL) is a potentially fatal protozoan parasitic disease of humans and dogs. In the Americas, dogs are the reservoir and Lutzomyia longipalpis is the sand fly vector. A synthetic version of the vector’s sex-aggregation pheromone attracts conspecifics to co-located lethal insecticide, reducing reservoir infection and vector abundance. Mathematical models of spatially deployed interventions are lacking, thus best practise using this novel lure-and-kill vector control approach to reduce infection incidence has not been fully explored.MethodsWe developed a predictive mathematical model of vector host-seeking behaviour combined with spatially explicit transmission models to evaluate changes in human and canine spatial infection incidence under variable pheromone implementation scenarios and demographic conditions.ResultsThe risk of human infection increased exponentially with canine incidence, but at different rates between rural and urban settings with spatial clustering of high forces of human infection related to their proximity to canine infected households. A predicted 70% household coverage using a cost-effective amount (50mg) of pheromone, plus insecticide, reduced rural and urban setting infection incidence by approximately 44% and 50% in dogs, and by 64% and 68% in humans, within 1-2 years. Near or complete transmission elimination in dogs and humans was achieved after 10 years intervention using 50mg of pheromone under 70% household coverage in urban settings when newly acquired (immigrant) dogs had no pre-existing infections, but in rural settings required 90% coverage using 500mg. The willingness to pay (WTP) price per 10mg unit of pheromone is likely to be <$3 USD, making it a cost-beneficial intervention compared to current alternative strategies.ConclusionsIntegrated stochastic and spatial models capturing vector host-seeking behaviour, is a useful mathematical framework to evaluate spatially dependent intervention methods, fine-scale transmission dynamics, and to identify best practise.

scholarly journals Survival of eight LLIN brands 6, 12, 24 and 36 months after a mass distribution campaign in rural and urban settings in Senegal

2021 ◽  
Author(s):  
Mbaye DIOUF ◽  
Babacar Thiendella FAYE ◽  
El hadji DIOUF ◽  
Abdoulaye Kane DIA ◽  
Abdoulaye KONATE ◽  
...  
Keyword(s):  
Survival Time ◽  
Median Survival ◽  
Median Survival Time ◽  
Universal Coverage ◽  
Malaria Prevention ◽  
Urban Setting ◽  
Good Survival ◽  
Urban Settings ◽  
Good Communication ◽  
Rural And Urban

Abstract Background Long lasting insecticidal nets (LLIN) are one of the core components of global malaria prevention and control. The lifespan of LLIN varies widely depending on the population or environment, and randomized studies are required to compare LLIN in households under different field conditions. This study investigated survival of different LLIN brands in Senegal. Methods 10,608 LLINs were distributed in five regions, each stratified by rural and urban setting. As part of the longitudinal follow-up, 2,222 nets were randomly sampled and monitored from 6 to 36 months. Using random effects for households, Bayesian models were used to estimate independent survival by net type (Interceptor®, Life Net®, MAGNet™, Netprotect®, Olyset® Net, PermaNet® 2.0 R, PermaNet® 2.0 C, Yorkool® LN) and by area (rural/urban). In addition to survival, median survival time and attrition of each LLIN brand was determined. Attrition was defined as nets that were missing because they were reported given away, destroyed and thrown away, or repurposed. Results Three net types had a proportion of survival above 80% after 24 months: Interceptor ® 87.8% (95% CI 80-93.4); conical PermaNet ® 2.0 86.9% (95% CI 79.3-92.4) and Life Net ® 85.6% (95% CI 75-93). At 36 months, conical PermaNet ® 2.0 maintained a good survival rate, 79.5% (95% CI 65.9-88.8). The attrition due to redistributed nets showed that the two conical net types (PermaNet ® 2.0 and Interceptor ® ) were more often retained by households and their median retention time was well above three years (median survival time =3.5 years for PermaNet ® 2.0 and median survival time =4 years for Interceptor ® ). Despite this good retention, Interceptor ® had weak physical integrity and its median survival due to wear and tear was below three years (median survival time = 2.4 years). The odds ratio of survival was 2.5 times higher in rural settings than in urban settings (OR 2.5; 95% CI 1.7-3.7). Conclusions Differences in survival among LLIN may be driven by brand, shape or environmental setting. In this study in Senegal, conical PermaNet ® 2.0 were retained in households while rectangular PermaNet ® 2.0 had lower retention, suggesting that net shape may play a role in retention and should be further investigated. Distribution of preferred LLIN shape, accompanied by good communication on care and repair, could lead to increased effective lifespan, and allow for longer intervals between universal coverage campaigns.

scholarly journals La fiction urbaine contemporaine swahilie : quelques pistes

2013 ◽  
pp. 57-68
Author(s):  
Sheila Ali Ryanga ◽  
Rachel Wangari Maina
Keyword(s):  
Bertolt Brecht ◽  
Urban Life ◽  
Urban Setting ◽  
Rural Setting ◽  
Literary Texts ◽  
Urban Migration ◽  
Urban Centers ◽  
Rural And Urban ◽  
Constant Feature ◽  
Rural Urban Migration

Kenyan literary writers in Swahili soon after independence dwelt mostly with rural setting. Most of the works dwelt on African social values and philosophy within work ethics and relationships. However, with the growth of industries in urban centers, the issue of rural urban migration arose. Many educated Kenyans moved to urban centers in search of jobs. To mirror this change in society, literary writers enriched their works by using both the rural and urban settings. This became a constant feature in the works of literary writers in Swahili. Some of these features include street life, life in the slums and pollution. This paper attempts to study how the urban setting is depicted in modern Kenyan Swahili literary texts. Realism theory as propagated by both Georg Lukács and Bertolt Brecht will be invoked during the analysis of the texts, specifically, how the urban genre developed, images used to depict urban life and centers, and establish the influence of this genre on Swahili literary writing as a whole.

scholarly journals Maternal Knowledge, Attitudes and Practices towards Prevention and Management of Child Diarrhoea in Urban and Rural Maseru, Lesotho

2019 ◽  
pp. 1-20
Author(s):  
A. I. Adeleke ◽  
T. Mhlaba
Keyword(s):  
Tertiary Education ◽  
Urban Setting ◽  
Maternal Knowledge ◽  
Monthly Income ◽  
Cross Sectional ◽  
Urban Settings ◽  
Maternal Characteristics ◽  
Attitudes And Practices ◽  
Rural And Urban ◽  
Knowledge Attitudes And Practices

Aim: To compare the knowledge, attitudes and practices of mothers in the prevention and management of child diarrhoea, in rural and urban settings of Maseru. Methodology: This cross-sectional study was carried out in the Domiciliary (Urban) and Tlali (Rural) Health centres in Maseru, within the period of February to May, 2017. Data was collected from 458 mothers/caregivers, with 299 (65%) and 159 (35%) from urban and rural settings respectively. Scores were assigned for the level of knowledge, attitudes, and practices. STATA 14.1 was applied to determine the strengths of associations between categories of the maternal characteristics and the outcome variables. Results: Aggregation of participants’ knowledge, attitudes, and practices response reveal a statistical significant association with residence. The maternal age range of 30-39 years, P = .03, and mothers with three (3) children, P = .02 were significantly associated with the knowledge of prevention and management of diarrhoea in the rural area. In the urban area, mothers with tertiary education, P = .04, employed, P = .001, unemployed, P = .004, and all categories of monthly income were significantly associated with the knowledge of prevention and management of diarrhoea. For the urban setting, an association between mothers’ attitudes and monthly income between M500 – M1399, P = .05 was observed. The practices of mothers/caregivers in the prevention and management of diarrhoea showed no significant differences in the light of the socio-demographic variables in both settings. Conclusion: The study revealed low level of maternal knowledge, attitudes and practices in prevention and management of child diarrhea in the rural and urban settings, hence the need to strengthen the existing health education messages on both settings.

scholarly journals Traditional toys in turkey: comparison in a rural and urban setting

2006 ◽  
Vol 16 (33) ◽  
pp. 37-42
Author(s):  
Müge Artar
Keyword(s):  
Content Analysis ◽  
Present Situation ◽  
Urban Setting ◽  
City Center ◽  
Urban Settings ◽  
Mountain Village ◽  
Rural And Urban ◽  
Positive Feelings

The interaction between children and adults through playful activities creates possibilities for reciprocal spontaneous and demanded influences and for the development of reciprocal positive feelings. The main aim of this study was to find out the present situation of traditional toys by comparing the rural and urban settings - a mountain village and city center of Bursa (Northwest Anatolia), Turkey. It was questioned, if industrial toys were sold in villages, how village children effected this change. Data was collected by interviews in the houses of the participants, with the answers record permited by the parents. Interviews passed by content analysis. Results show that traditional hand made toys are going to disappear even in villages. This may happen because of the imitations of original toys and their cheap prices but at the same time because of the attractive nature of modern toys have the big impact as well.

scholarly journals Profiles of inflammatory markers and their association with cardiometabolic parameters in rural and urban Uganda

2021 ◽  
Vol 6 ◽  
pp. 291
Author(s):  
Richard E. Sanya ◽  
Angela Nalwoga ◽  
Richard K. Grencis ◽  
Alison M. Elliott ◽  
Emily L. Webb ◽  
...  
Keyword(s):  
Inflammatory Mediators ◽  
Inflammatory Markers ◽  
Cardiometabolic Risk ◽  
Fasting Blood Glucose ◽  
Principal Component ◽  
Urban Setting ◽  
Rural Setting ◽  
Model Assessment ◽  
Urban Residence ◽  
Rural And Urban

Background: Inflammation may be one of the pathways explaining differences in cardiometabolic risk between urban and rural residents. We investigated associations of inflammatory markers with rural versus urban residence, and with selected cardiometabolic parameters previously observed to differ between rural and urban residents: homeostatic model assessment of insulin resistance (HOMA-IR), fasting blood glucose (FBG), blood pressure (BP) and body mass index (BMI). Methods: From two community surveys conducted in Uganda, 313 healthy individuals aged ≥ 10 years were selected by age- and sex-stratified random sampling (rural Lake Victoria island communities, 212; urban Entebbe municipality, 101). Fluorescence intensities of plasma cytokines and chemokines were measured using a bead-based multiplex immunoassay. We used linear regression to examine associations between the analytes and rural-urban residence and principal component analysis (PCA) to further investigate patterns in the relationships. Correlations between analytes and metabolic parameters were assessed using Pearson’s correlation coefficient. Results: The urban setting had higher mean levels of IL-5 (3.27 vs 3.14, adjusted mean difference [95% confidence interval] 0.12[0.01,0.23] p=0.04), IFN-⍺ (26.80 vs 20.52, 6.30[2.18,10.41] p=0.003), EGF (5.67 vs 5.07, 0.60[0.32,0.98] p<0.00001), VEGF (3.68 vs 3.28, 0.40[0.25,0.56] p<0.00001), CD40 Ligand (4.82 vs 4.51, 0.31[0.12, 0.50] p=0.001) and Serpin-E1 (9.57 vs 9.46, 0.11[0.05,0.17] p<0.00001), but lower levels of GMCSF (2.94 vs 3.05, -0.10[-0.19,-0.02] p=0.02), CCL2 (2.82 vs 3.10, -0.45[-0.70,-0.21] p<0.00001) and CXCL10 (5.48 vs 5.96, -0.49[-0.71,-0.27] p<0.00001), compared to the rural setting. In PCA, the urban setting had lower representation of some classical inflammatory mediators but higher representation of various chemoattractants and vasoactive peptides. HOMA-IR, FBG, BP and BMI were positively correlated with several principal components characterised by pro-inflammatory analytes. Conclusions: In developing countries, immunological profiles differ between rural and urban environments. Differential expression of certain pro-inflammatory mediators may have important health consequences including contributing to increased cardiometabolic risk observed in the urban environment.

scholarly journals Rates of voluntary and compulsory psychiatric in-patient treatment in England: An ecological study investigating associations with deprivation and demographics

2016 ◽  
Vol 209 (2) ◽  
pp. 157-161 ◽  
Author(s):  
Patrick Keown ◽  
Orla McBride ◽  
Liz Twigg ◽  
David Crepaz-Keay ◽  
Eva Cyhlarova ◽  
...  
Keyword(s):  
Urban Areas ◽  
Adult Population ◽  
Secondary Analysis ◽  
Rural Setting ◽  
Patient Treatment ◽  
Compulsory Treatment ◽  
Ethnic Density ◽  
Urban Settings ◽  
Rural And Urban ◽  
Individual Variables

BackgroundIndividual variables and area-level variables have been identified as explaining much of the variance in rates of compulsory in-patient treatment.AimsTo describe rates of voluntary and compulsory psychiatric in-patient treatment in rural and urban settings in England, and to explore the associations with age, ethnicity and deprivation.MethodSecondary analysis of 2010/11 data from the Mental Health Minimum Dataset.ResultsAreas with higher levels of deprivation had increased rates of in-patient treatment. Areas with high proportions of adults aged 20–39 years had the highest rates of compulsory in-patient treatment as well as the lowest rates of voluntary in-patient treatment. Urban settings had higher rates of compulsory in-patient treatment and ethnic density was associated with compulsory treatment in these areas. After adjusting for age, deprivation and urban/rural setting, the association between ethnicity and compulsory treatment was not statistically significant.ConclusionsAge structure of the adult population and ethnic density along with higher levels of deprivation can account for the markedly higher rates of compulsory in-patient treatment in urban areas.

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