Children from Rural Appalachia And Urban Communities are Diagnosed With Cerebral Palsy Significantly Later Than Children From Suburban Communities

ABSTRACTObjective:To describe rapid implementation of telehealth during the COVID-19 pandemic and assess for disparities in video visit implementation in the Appalachian region of the United States.Methods:A retrospective cohort of consecutive patients seen in the first four weeks of telehealth implementation was identified from the Neurology Ambulatory Practice at a large academic medical center. Telehealth visits defaulted to video and when unable phone-only visits were scheduled. Patients were divided into two groups based on the telehealth visit type: video or phone-only. Clinical variables were collected from the electronic medical record including age, sex, race, insurance status, indication for visit, and rural-urban status. Barriers to scheduling video visits were collected at the time of scheduling. Patient satisfaction was obtained by structured post-visit telephone call.Results:Of 1011 telehealth patient-visits, 44% were video and 56% phone-only. Patients who completed a video visit were younger (39.7 vs 48.4 years, p<0.001), more likely to be female (63% vs 55%, p<0.007), be White or Caucasian (p=0.024), and not have Medicare or Medicaid insurance (p<0.001). The most common barrier to scheduling video visits was technology limitations (46%). While patients from rural and urban communities were equally likely to be scheduled for video visits, patients from rural communities were more likely to consider future telehealth visits (55% vs 42%, p=0.05).Conclusion:Rapid implementation of ambulatory telemedicine defaulting to video visits successfully expanded video telehealth. Emerging disparities were revealed, as older, male, black patients with Medicare or Medicaid insurance were less likely to adopt video visits.

Download Full-text

Residential mobility and the geography of low-income households

Urban Studies ◽

10.1177/0042098020922127 ◽

2020 ◽

pp. 004209802092212 ◽

Cited By ~ 1

Author(s):

Andrew Schouten

Keyword(s):

Urban Communities ◽

Low Income ◽

Urban Areas ◽

Central City ◽

Panel Study ◽

Suburban Communities ◽

Household Resources ◽

Suburban Poverty ◽

Using Data ◽

Low Income Households

In contrast to the traditional image of suburban communities as stable and secure enclaves surrounding a more volatile urban core, scholars have noted considerable increases in suburban poverty over the past several decades. Using data from the Panel Study of Income Dynamics (PSID) from 1999 to 2015 and a seven-category neighbourhood typology, this analysis seeks to better understand the growing economic distress of suburban areas in two stages: first by examining the degree to which low-income residents have left urban communities for suburban neighbourhoods; and second by identifying the types of low-income households that have made urban-to-suburban moves. Results show that although low-income households rapidly suburbanised during the study period, higher-income households left urban areas for suburban neighbourhoods at nearly the same rate. This finding suggests that while the overall number of economically disadvantaged residents in the suburbs has grown, population flows have had only a modest impact on the income composition of suburban neighbourhoods. Results also highlight important differences between low-income households that suburbanised during the study period and those that remained in urban communities. In particular, urban-to-suburban movers were more likely to be white, had more household resources and lived in origin neighbourhoods with fewer urban characteristics than the origin neighbourhoods of those who relocated within central-city areas.

Download Full-text

OSU Extension in Urban Communities: A Case Study

Journal of Extension ◽

10.34068/joe.59.03.17 ◽

2021 ◽

Vol 59 (Summer 2021) ◽

Author(s):

DaVonti' Haynes ◽

Amelia Michaels ◽

Julie Fox

Keyword(s):

Urban Communities ◽

Ohio State University ◽

State University ◽

Urban Context ◽

Ohio State University Extension ◽

Suburban Communities ◽

Urban Rural ◽

Insight Into

With a presence in all 88 Ohio counties, Ohio State University Extension strives to engage citizens within urban, rural, and suburban communities. As populations have shifted, so has the need of Ohio’s urban counties. Thus, to help ensure Extension remains vibrant, relevant, and accessible in all communities, a team of faculty, staff, and students conducted a case study, focusing on the National Urban Extension Leaders four themes of position- ing, programs, personnel, and partnerships. The data provided insight into what Extension can do to address the urban context of scale, diversity, complexity, and urban-rural interface.

Download Full-text

Prevalence of Speech Problems and the Use of Augmentative and Alternative Communication in Children With Cerebral Palsy: A Registry-Based Study in Norway

Perspectives on Augmentative and Alternative Communication ◽

10.1044/aac19.1.12 ◽

2010 ◽

Vol 19 (1) ◽

pp. 12-20 ◽

Cited By ~ 29

Author(s):

Guro Andersen ◽

Tone R. Mjøen ◽

Torstein Vik

Keyword(s):

Cerebral Palsy ◽

Motor Function ◽

Gestational Age ◽

Augmentative And Alternative Communication ◽

Alternative Communication ◽

Gross Motor ◽

Gross Motor Function ◽

Children With Cerebral Palsy ◽

Communicative Abilities ◽

Normal Speech

Abstract This study describes the prevalence of speech problems and the use of augmentative and alternative communication (AAC) in children with cerebral palsy (CP) in Norway. Information on the communicative abilities of 564 children with CP born 1996–2003, recorded in the Norwegian CP Registry, was collected. A total of 270 children (48%) had normal speech, 90 (16%) had slightly indistinct speech, 52 (9%) had indistinct speech, 35 (6%) had very indistinct speech, 110 children (19%) had no speech, and 7 (1%) were unknown. Speech problems were most common in children with dyskinetic CP (92 %), in children with the most severe gross motor function impairments and among children being totally dependent on assistance in feeding or tube-fed children. A higher proportion of children born at term had speech problems when compared with children born before 32 weeks of gestational age 32 (p > 0.001). Among the 197 children with speech problems only, 106 (54%) used AAC in some form. Approximately 20% of children had no verbal speech, whereas ~15% had significant speech problems. Among children with either significant speech problems or no speech, only 54% used AAC in any form.

Download Full-text